SW3240203_Supplemental Info Review_20240522

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by Anonymous User 5/22/2024 5:51:44 PM (Supplemental Submittal)
Accept by bethany.georgoulias 5/27/2024 11:16:24 AM (Supplemental Info Submittal)
• The task was assigned to DEMLR Post-Construction Team 5/22/2024 5:51:45 PM
• The task was assigned to bethany.georgoulias by round robin distribution 5/22/2024 5:51:45 PM

=DEQ •
Submittal from 5/22/2024
Permit Information:
Please provide specific permit details below.
................................................................................................................................................................................................................................................................................................................................................................................................
What Type of Permit? Choose one:
* NPDES Industrial or MS4 Permit
State Stormwater(Post-Construction)Permit
Other
Permit Number* SW3240203
Begins with"SW","NCG",or"NCS"
What DEQ Office is Reviewer:Please correct if misidentified,close this review form,and reassign task to the appropriate contact.
the Primary Contact? Central Office
*
Washington Regional Office(Attn: Carl Dunn)
Wilmington Regional Office(Attn:Christine Hall)
................................................................................................................................................................................................................................................................................................................................................................................................
Project Name* Union County Shrine Club
Owner/Operator* William Cox
County: Union
Submitter Name:* Jesse W.Wilson
Who is submitting this information?
E-mail Address:* [e-mail]
Phone Number* 3367369267
Additional E-mail for [e-mail]
Submittal (Optional)
Confirmation:
State Stormwater (Post-Construction) Information Uploads
Choose file type and upload attachment(Reviewer may remove unnecessary submittals)
File Type* Plansheet-Grading/Drainage Plan
File Upload Click the upload button,or drag and drop files to attach
5-21-24-Shrine Club Drainage Area Map.pdf 979.35KB
Only PDF files are accepted.
File Type* Design Calculations

File Upload Click the upload button,or drag and drop files to attach
5-21-24-DITCH-CALCS.pdf 72.79KB
ECMDSDITCH 1.pdf 73.26KB
ECMDSDITCH 2.pdf 73.36KB
ECMDSDITCH 3.pdf 73.29KB
ECMDSDITCH 4.pdf 73.37KB
Precipitation Frequency Data Server.pdf 1.23MB
Only PDF files are accepted.
File Type* Supplement-EZ Form
File Upload Click the upload button,or drag and drop files to attach
5-21-24-Supp-EZ Form-signed.pdf 657.05KB
Only PDF files are accepted.
File Type* O&M Agreement/Plan
File Upload Click the upload button,or drag and drop files to attach
5-22-24 O-M-EZ-20201215-to be signed.pdf 29.68KB
Only PDF files are accepted.
File Type* Response To Comments
File Upload Click the upload button,or drag and drop files to attach
Add Info 5-20-24-WEG Responses(WEG).pdf 572.7KB
Only PDF files are accepted.
Is this project funded No
with ARPA grant Yes
funds?*
Uploads contain NO
Confidential YES
Information* NOTE:The following information cannot be claimed as confidential:the name and address of any permit applicant
or permittee,permit applications,permits,effluent data,information required by NPDES application forms provided
by the Director inclusive of all forms and attachments[Ref.40 CFR 122.7(b)and(c)].
Notes about the attachments:
The O-M-EZ Form is being signed and a hard copy will be mailed to your office.
* By checking the box and signing box below, I certify that:
o I have given true,accurate,and complete information on this form;
o I agree that submission of this Supplemental Information form is a"transaction"subject to Chapter 66,Article 40 of the
NC General Statutes(the"Uniform Electronic Transactions Act)
o 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 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 the Supplemental Information Upload form.
Full Name:* William Cox
Signature:

Date Submitted: 05/22/2024

Initial Review
Verify Permit No.* IMPORTANT:REVIEWER SHOULD VERIFY and revise here if necessary.
SW3240203
Who needs a Copy?* Reviewer selections will only be required for offices checked here.
Central Office Staff
Regional Office Stormwater Contact
State Stormwater RO Staff
No Copy Needed
Central Office Reviewer:*
Notifies CO Staff with Email
Jim Farkas
Any Comments or
Added Info for CO
Staff Reviewer?
Review Date* 05/27/2024