NCC240534_NOI 183869 Payment Verification_20240223

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by Anonymous User 2/22/2024 2:48:47 PM (NCG01 NOI Submission)
Approve by Brooklyn.Broussard 2/23/2024 6:23:04 AM (Review-NOI 183869 Dental Surgery Center for Valleygate
Dental)
• The task was assigned to DEMLR NCG01 NOI Review Team.The due date is: February 27,2024 5:00
PM 2/22/2024 2:48:56 PM
• The task was assigned to Brooklyn.Broussard by round robin distribution 2/22/2024 2:48:56 PM
Submit by Tev.Holloman 2/23/2024 1:50:27 PM (Payment Verification for NCC240534)
0 Ethan Hart
• The task was assigned to DEMLR NCG01 Payment Team.The due date is:April 5,2024 5:00 PM
2/23/2024 6:23:18 AM
• Tev.Holloman assigned the task to Tev.Holloman 2/23/2024 1:49:57 PM

Payment Verification
NORTH CAROLINA
Environmental Quality
Project Name Dental Surgery Center for Valleygate Dental
Is this project funded with ARPA(American Rescue Plan Act)grant funds?
No
Yes
CONFIRMED ARPA Project Number(if applicable)
Lot Numbers (If listed on the eNOl)
NC Reference No.* NCG01-2024-0534
Certificate of NCC240534
Coverage(COC)No.*
Invoice Date 2/23/2024
Initial Invoice No. NCC240534-2024
Initial Fee $ 120.00
Invoice Due Date 3/24/2024
Important: If you change the choice below to Payment NOT RECEIVED,the application will be rejected,and a COC will
not be issued. This is the ONLY way to reject an eNOI at this step.
Payment Received* Payment Received.
Payment NOT RECEIVED.
Payment Status PAID
Date Payment 2/23/2024
Received* (Or,if not received,date rejected for no payment)
Method of Payment* electronic
check
Other
ePayment 734909112
Transaction Number*
NOI Tracking No. 183869
Tracking ID referenced upon submittal
This is an Express No
Review Project Yes
Project Tracking ID NCC-WAKE-2024-Dental Surgery Center for Valleygate Dental