Atlantic Coast Pipeline Project - Raleigh Region - 11/9/2017 11:14:00 AM

Water Resources
' ENVIRONMENTAL QUALITY
Staff Review:
Updated ID#: SWG040095
Updated Version: 1
Who needs a copy?* I7 Central Office
r Regional Office
Select Reviewing Office
Raleigh Regional Office — 919-791-4200
Central Office Reviewer:
Robert Patterson - eads\rdpatterson
Select RO Reviewer:*
[e-mail]
SUBMITTED PROJECT INFORMATION
Existing Project Information:
ID# SWG040095
Version: 1
Facility Name: Atlantic Coast Pipeline Project - Raleigh
Region
County:
Name: Robert Hare
Mo is subnitting the information?
Email Address: [e-mail]
Describe the attachments:
SWG04 General Stormwater Management Permit package for the built -upon areas of the Atlantic Coast Pipeline
project within the Raleigh Region.
Please upload all files that need to be submitted.
^ACP SWG040095 General Permit Application -Raleigh 10-20-17—v1.pdf 20.9MB
Only pdf files are accepted.
V By checking the box and signing box below, I certify that:
Q I have given true, accurate, and complete information on this form;
Q 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 form.
Full Name: Tiffini Smith
Signature: AtUL �rA