NCG020924_Supplemental Info Review_1/29/2018

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upplemental Information Upload Fon
Staff Review:
Updated ID#: NCG020924
Updated Version: 1
Who needs a copy?* r Central Office
rJ Regional Office
Select Reviewing Office*
Mooresville Regional Office — 704-663-1699
Central Office Reviewer:
Robert Patterson - eads\rdpatterson
Select RO Reviewer:*
[e-mail]
SUBMITTED PROJECT INFORMATION
Existing Project Information:
ID# NCG020924
Version: 1
Facility Name: Smith Mine
County: Catawba
Name: Samar Bou-Ghazale
Vft is subrritting the information?
Email Address: [e-mail]
Describe the attachments:
Mining Permit application for Smith Mine. NCG020924
Please upload all files that need to be submitted.
Smith Mine Stormwater NCG020924.pdf
Only pdf files are accepted.
W By checking the box and signing box below, I certify that:
5.84MB
Water Resources
ENVIRONMENTAL QUALITY
• 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
o I intend to electronically sign and submit the Supplemental Information form.
Full Name: Samar Bou-Ghazale
Signature:
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