NCG060348_DMR Upload Review_20240506

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by Anonymous User 4/30/2024 12:50:44 PM (DMR Submittal)
Submit by Brittany.Cook 5/6/2024 3:11:29 PM (DMR Submittal Review)
0 COC should read NCG060348
• The task was assigned to DEMLR SW Admin for DMRs 4/30/2024 12:50:44 PM
• Brittany.Cook assigned the task to Brittany.Cook 5/6/2024 2:40:23 PM

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DMR Submittal from 4/30/2024
Permit and Facility Information:
..............................................................................................................................................
Permit Number* Enter COC or Individual Permit Number
NCG060348
Must begin with NCS or NCG
Facility Name:* American Skin Food Group LLC
Owner/Operator American Skin Co
Name:*
County:* Pender
Note: Facility name and county are used to help the reviewer verify the permit number entered,and to display the
Regional Office address on the submitter's form(not here).These metadata details will be pulled from current BIMS
information after the DMR(s)are filed. If the submittal is accepted,simply note any errors in the reviewer's comments.
Reason for not yet If applicable:
reporting data There was a change of management within the company and the new compliance
through eDMR for director was not given online access before the report for Q1 was due.
this permit:
Monitoring Period Information:
..............................................................................................................................................................................................................................................................................................................................................................................................
Monitoring Period What is the YEAR of the sample date(s)?
Year:* 2024
DMR Upload* Click the upload button or drag and drop files here to attach document.
Facility Name American Skin Food Group_Q1.pdf 503.69KB
Only PDFs are accepted.
Comments:
* By checking the box and signing box below, I certify that:
o I have given true,accurate,and complete information on this form;
d I agree that submission of this Discharge Monitoring Report(DMR)Upload form is a"transaction"subject to Chapter 66,
Article 40 of the NC General Statutes(the"Uniform Electronic Transactions Act");
d I agree to conduct this transaction by electronic means pursuant to Chapter 66,Article 40 of the NC General Statutes
(the"Uniform Electronic Transactions Act");
o I understand that an electronic signature on this upload form has the same legal effect and can be enforced in the same
way as a written signature;AND
o I intend to electronically sign and submit this DMR Upload form.
Full Name:* Ray Chavis
Name of person submitting this form
Email Address:* [e-mail]

Phone Number:* 9102592232
Signature:
L ay pa4w
Date:* 04/30/2024

Review
Review Date: 05/06/2024
Confirm Permit No.* Correct the permit ID number if needed.
NCG060348
Confirm DMR Year* 2024
Multiple DMRs will be automatically filed in a subfolder denoting the sampling year entered above.
Can submittal be Yes
accepted?* No(Explain why below)
Do Central Office No
staff need to be Yes
alerted?*
Do Regional Office No
staff need to be Yes
alerted?
Type of Permit* General
Ensures DMR(s)filed correctly.