SW6240707_Supplemental Info Review_20241001

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by Anonymous User 10/1/2024 10:06:13 AM (Supplemental Submittal)
Accept by bethany.georgoulias 10/8/2024 8:12:51 AM (Supplemental Info Submittal)
• The task was assigned to DEMLR Post-Construction Team 10/1/2024 10:06:15 AM
• bethany.georgoulias assigned the task to bethany.georgoulias 10/8/2024 8:12:06 AM

=DEQ •
Submittal from 10/1/2024
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* SW6240707
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* Circle K-HSD Addition 2723051
Owner/Operator* Circle K Stores, Inc
County: Cumberland
Submitter Name:* John Best
Who is submitting this information?
E-mail Address:* [e-mail]
Phone Number* 2522368187
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* Application Form
File Upload Click the upload button,or drag and drop files to attach
01 NCDEQ Stormwater Application signed.pdf 1.3MB
Only PDF files are accepted.
File Type* O&M Agreement/Plan
File Upload Click the upload button,or drag and drop files to attach
02 O&M from 37630.130 Storm Report 2024-03-
208.79K6
27.pdf
Only PDF files are accepted.

File Type* Supplement-EZ Form
File Upload Click the upload button,or drag and drop files to attach
02 Supplemental form from 37630.130 Storm Report
1.72M6
2024-03-27.pdf
Only PDF files are accepted.
File Type* Stormwater Report
File Upload Click the upload button,or drag and drop files to attach
04 37630.130 Storm Report 2024-03-27.pdf 16.03MB
Only PDF files are accepted.
File Type* Soils/Geotechnical Report
File Upload Click the upload button,or drag and drop files to attach
06 37630.130-Geotechnical Exploration Report.pdf 1.02MB
Only PDF files are accepted.
File Type* Property Deed
File Upload Click the upload button,or drag and drop files to attach
07 DB5032 PG0683.pdf 78.69KB
07 DB11835 PG0433.pdf 136.48KB
Only PDF files are accepted.
File Type* Wetland Determination/Report
File Upload Click the upload button,or drag and drop files to attach
08 404 Report and Wetland Deli neation_SAW-2023-
00559 Circle K stores Inc. PJD tear 1.95MB
sheet_signed_final.pdf
Only PDF files are accepted.
File Type* Plansheet-Cover Sheet
File Upload Click the upload button,or drag and drop files to attach
COVER 05 37630.130-Circle K-HSD Addition
746.37K6
2723051 Plans 2024-04-12.pdf
Only PDF files are accepted.
File Type* Plansheet-Notes
File Upload Click the upload button,or drag and drop files to attach
NOTES 05 37630.130-Circle K-HSD Addition
8.04M6
2723051 Plans 2024-04-12.pdf
Only PDF files are accepted.
File Type* Plansheet-Existing Conditions/Survey
File Upload Click the upload button,or drag and drop files to attach
EXCOND 05 37630.130-Circle K-HSD Addition
970.08KB
2723051 Plans 2024-04-12.pdf
Only PDF files are accepted.
File Type* Plansheet-Proposed Conditions/Site Plan

File Upload Click the upload button,or drag and drop files to attach
PROPCOND 05 37630.130-Circle K-HSD
717.87KB
Addition 2723051 Plans 2024-04-12.pdf
Only PDF files are accepted.
File Type* Plansheet-Grading/Drainage Plan
File Upload Click the upload button,or drag and drop files to attach
GND 05 37630.130-Circle K-HSD Addition
941.83K6
2723051 Plans 2024-04-12.pdf
Only PDF files are accepted.
File Type* Plansheet-SCM Detail
File Upload Click the upload button,or drag and drop files to attach
DETAILS 05 37630.130-Circle K-HSD Addition
15.25M B
2723051 Plans 2024-04-12.pdf
Only PDF files are accepted.
File Type* Plansheet-Landscape/Planting Plan
File Upload Click the upload button,or drag and drop files to attach
LSCAPE 05 37630.130-Circle K-HSD Addition
666.29K6
2723051 Plans 2024-04-12.pdf
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:
* By checking the box and signing box below, I certify that:
cl I have given true,accurate,and complete information on this form;
• 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)
• 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');
cl I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written
signature;AND
d I intend to electronically sign and submit the Supplemental Information Upload form.
Full Name:* John Best
Signature: 7
r,&W rL'IlJt
Date Submitted: 10/01/2024

Initial Review
Verify Permit No.* IMPORTANT:REVIEWER SHOULD VERIFY and revise here if necessary.
SW6240707
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
Brianna Holland
Any Comments or
Added Info for CO
Staff Reviewer?
Review Date* 10/08/2024