SW3241004_Supplemental Info Review_20241118

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by Anonymous User 11/18/2024 9:07:57 AM(Supplemental Submittal)
Accept by bethany.georgoulias 11/18/2024 9:11:52 AM(Supplemental Info Submittal)
• The task was assigned to DEMLR Post-Construction Team 11/18/2024 9:07:58 AM
• bethany.georgoulias assigned the task to bethany.georgoulias 11/18/2024 9:11:30 AM

=DEQ •
Submittal from 11/18/2024
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* SW3241004
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* Central Cowboy Church
Owner/Operator* Central Station Cowboy Church Inc.
County: Cabarrus
Submitter Name:* Jake Lee
Who is submitting this information?
E-mail Address:* [e-mail]
Phone Number* 704-880-2826
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
240539.000 NCDEQ SWU App-executed.pdf 1.75MB
Only PDF files are accepted.
File Type* Design Calculations
File Upload Click the upload button,or drag and drop files to attach
240539.000 Site Report-sealed.pdf 28.01 MB
Only PDF files are accepted.
File Type* Plansheet-Cover Sheet

File Upload Click the upload button,or drag and drop files to attach
[1]CVR.pdf 666.51KB
Only PDF files are accepted.
File Type* Plansheet-Notes
File Upload Click the upload button,or drag and drop files to attach
[2]C001.pdf 1.17MB
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
[3]C200.pdf 670.9KB
Only PDF files are accepted.
File Type* Plansheet-Grading/Drainage Plan
File Upload Click the upload button,or drag and drop files to attach
[4]C300.pdf 845.38KB
Only PDF files are accepted.
File Type* Plansheet-Proposed Drainage Area
File Upload Click the upload button,or drag and drop files to attach
DA Sheets.pdf 3.06MB
Only PDF files are accepted.
File Type* Property Deed
File Upload Click the upload button,or drag and drop files to attach
DB-PG 16968-0109.pdf 526.07KB
Only PDF files are accepted.
File Type* Response To Comments
File Upload Click the upload button,or drag and drop files to attach
240539.000 CESI Response Letter SWU.pdf 165.6KB
Only PDF files are accepted.
File Type* Supplement-EZ Form
File Upload Click the upload button,or drag and drop files to attach
240539.000 NCDEQ EZ Form-sealed .pdf 353.52KB
Only PDF files are accepted.
File Type* USGS Topographic Site Map
File Upload Click the upload button,or drag and drop files to attach
240539.000 USGS.pdf 14.69MB
Only PDF files are accepted.
File Type* Stormwater Narrative
File Upload Click the upload button,or drag and drop files to attach
240539.000 Cover Letter and Narrative.pdf 120.28KB
Only PDF files are accepted.

File Type* O&M Agreement/Plan
File Upload Click the upload button,or drag and drop files to attach
240539.000 O&M-executed.pdf 648.65KB
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:
• 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');
• I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written
signature;AND
• I intend to electronically sign and submit the Supplemental Information Upload form.
Full Name:* Jake Lee
Signature:
0,14 -169�
Date Submitted: 11/18/2024

Initial Review
Verify Permit No.* IMPORTANT:REVIEWER SHOULD VERIFY and revise here if necessary.
SW3241004
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
Jacob Beeker
Any Comments or
Added Info for CO
Staff Reviewer?
Review Date* 11/18/2024