Kontane Site Improvements - 5/9/2018 1:53:09 PM

Water Resources
ENVIRONMENTAL QUALITY
Staff Review:
Updated ID#: sw3180304
Updated Version: 1
Who needs a copy?* 17 Central
Office
r Regional
Office
Select Reviewing Office*
Mooresville Regional Office — 704-663-1699
Central Office Reviewer:
Annette Lucas - eads\amlucas1
Select RO Reviewer:*
[e-mail]
SUBMITTED PROJECT INFORMATION
Existing Project Information:
ID# sw3180304
Version: 1
Facility Name: Kontane Site Improvements
County: Iredell
Name: Dan Shabeldeen
Vft is submitting the inforrraticn?
Email Address: [e-mail]
Describe the attachments:
Cover letter with calculations
Revised site plan
Please upload all files that need to be submitted.
Ltr Anen Sand Filter.pdf 3.22MB
17-320-8c Sand Filter.pdf 3.88MB
Only pdt files are accepted.

fJ By
checking
the
box
and
signing
box
below,
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 form.
Full Name: Daniel Shabeldeen
Signature:
Oalllr,-W-9aA1a�,-W!
Date Submitted: