NCG160231_Supplemental Info Review_3/25/2019

Submittal Dated: 3/25/2019
Please note: fields marked with a red asterisk below are required. You will not be able to submit the form until all
mandatory questions are answered.
Existing Project Information:
Rease supply the perrrit nunber for this project.
D# * FL-rrrit Narrber
NCG160231
Ecarrples: SWxxxxxxx, NOC;axxxx, or NCSxxxxxx
Facility Name:* FSC Kenly Asphalt Plant
County: Johnston
Name: Amy McDonald
Who is submitting the information?
Email Address:* [e-mail]
Please upload all files that need to be submited.
Oick the upload button or drag and drop files here to attach document
Revised Site Plan Sht 3.pdf 6.24MB
Only pdf files are accepted.
Describe the attachments:
Plan revised w/ outfall shown as requested.
* V 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 form."
Full Name:* Amy McDonald
Signature:
Date Submitted: 3/25/2019

Initial Review
Updated ID#: IWORfANT: FEVEAERSHOLLDVERIFY and revise here if necessary.
NCG160231
Who needs a d Central Office
copy?* F Regional Office
Central Office Reviewer:*
Bethany Georgoulias - eads\bagorgoulias
Select Reviewing Office*
Raleigh Regional Office — 919-791-4200
Select RO Reviewer:*
[e-mail]