HomeMy WebLinkAboutNCC233018_Annual Fee Payment Record (2024 Fee)_20241015 Action History (UTC-05:00)Eastern Time(US&Canada)
by Workflow 9/28/2024 12:14:34 PM (Workflow Start Event)
Submit by Tev.Holloman 10/15/2024 2:56:03 PM (2024 Annual Fee Payment Verification for NCC233018-2024)
0 Wake Forest University Baptist Medical Center
• The task was assigned to DEMLR NCG01 Annual Fee Team.The due date is: November 11,2024 5:00
PM 9/28/2024 12:14:35 PM
• Tev.Holloman assigned the task to Tev.Holloman 10/15/2024 2:34:25 PM
2024 Annual Fee Payment Verification
NORTH CAROLINA
Environmental Quality
Certificate of NCC233018
Coverage(COC)No.* This is passed from the workflow when the invoice is filed.
NC Reference COC NCG01-2023-3018
No.*
Permit Status: Active
Expiration Date 3/31/2029
Year COC Issued 2023
This field will be hidden.
Check previous years for outstanding fees(years that do not apply will be blank):
2020 Fee Status 2021 Fee Status 2022 Fee Status
2023 Fee Status
Project Name* AHWFB Cloverdale ASC
Project Address* 342 Medical Center Blvd,Winston-Salem, NC
Permittee* Atrium Health Wake Forest Baptist
County Forsyth
Invoice No.* NCC233018-2024
This is passed from the workflow when the invoice is filed.
Annual Fee* $ 120.00
Invoice Date* 10/1/2024
This is passed from the workflow when the invoice is filed.
Invoice Due Date* 11/1/2024
This is passed from the workflow when the invoice is filed.
An automated email reminder is sent to the permittee when the invoice is due.Wait until invoice is 15 days overdue
before proceeding to a Notice of Deficiency.
Important: If you change the choice below to Payment NOT RECEIVED,the fee status becomes PAST DUE,and the
permittee will receive a Notice of Deficiency.
Annual Fee Payment Fee Payment Received or Not Applicable.
Received* Fee Payment NOT RECEIVED.
Date Payment 10/15/2024
Received* Or,if WAIVED or NOT RECEIVED,this is the date that status is recorded.
Method of Payment* electronic
check
other
Check Number* 60049350
Fee Status* PAID
Legally Responsible Kevin High
Person(Orig.)
Permittee E-mail* khigh@wakehealth.edu
CONFIRM Permittee khigh@wakehealth.edu
E-mail* Opportunity to modify problem e-mail address or permittee contact info
Site Contact E-mail* ggangita@wakehealth.edu
CONFIRM Site ggangita@wakehealth.edu
Contact E-mail* Opportunity to correct problem e-mail address or site contact info
Billing E-mail ggangita@wakehealth.edu
(If available)
CONFIRM Billing E- ggangita@wakehealth.edu
mail Opportunity to correct problem e-mail address or billing contact info
Billing Telephone No. 743-649-0990
Permittee Email for khigh@wakehealth.edu
30-day Reminder This is the email for the 30-day reminder if needed(passed from workflow).
Site Contact Email for ggangita@wakehealth.edu
30-day Reminder This is the email for the 30-day reminder if needed(passed from workflow)
Billing Contact Email ggangita@wakehealth.edu
for 30-day Reminder This is the email for the 30-day reminder if needed(passed from workflow).
Project Name for 30- AHWFB Cloverdale ASC
day Reminder The project name is passed from workflow for the 30-day reminder
Permittee Name for Atrium Health Wake Forest Baptist
30-day Reminder The permittee is passed from workflow for the 30-day reminder
County for 30-day Forsyth
Reminder The county is passed from workflow for the 30-day reminder
Additional Billing Contact E-mails
Additional E-mail for
CC:
Review Date* 10/15/2024