310189_File Review Form_20180830

STATE OF NORTH CAROLINA
Department of Environmental Quality
127 Cardinal Drive Extension
Wilmington, North Carolina 28405
[phone]
FILE ACCESS RECORD
DEQ Mary
CA-E-y REVIEW TIME / DATE. � '0 D ` 3: 2S
ME: V gI3011, -
NAary JUrena 04-1ran)-S nn II'' EMAIL:
REPRESENTING: tl)a 11 aGe 4- G'ra Aam 4W q rile ySPHONE.
Guidelines for Access- The staff of Wilmington Regional Office is dedicated to malting public records in our custody
readily available to the public for review and copying. We, also have the responsibility to the public to safeguard these
records and to carry out our day-to-day program obligations Please read carefully the following guidelines signing the
form•
1. Due to the large public demand for file access, we request that you call at least a day in advance to schedule
an appointment to review the files: Appointments will be scheduled between 9:00am and 3:00pm
Viewing time ends at 4:45pm. Anyone arriving without an appointment may view the files to the extent
that time and staff supervision is available.
2 You must specify files you want to review by facility name. The number of files that you may review at one
time will be limited to five.
3. You may make copies of a file when the copier is not in use by the staff and if time permits. Cost per copy is
$ 05 cents. Payment may be made by check, money order, or cash at the reception desk
4. FILES MUST BE KEPT IN ORDER YOU FOUND THEM. Files may not be taken from the office To
remove, alter, deface, mutilate, or destroy material in one of these files is a misdemeanor for which you can
be fined up to $500.00. No briefcases. large totes etc. are permitted in the file review area.
& ', i Necessary large plan copies can be,scheduled with Cameron Weaver@ncdenr goy 919-796-7475 for a later
date/time at an offsite location at your expense. Large plan copies needed should be, attached on top of the
file. Allways Graphics can be contacted to set up payment options. Written Questions may be left with
this completed form and a.staff memhci *iQ bei in contact with you IF you provide your contact
inform thin where indicated above: ,
6. In accordance with General Statue 25-3-512, a $25.00 processing fee will be charged and collected for checks
on which payment has been refused
FACILITY NAME COUNTY
1. OS 31031 C
2 a_A)S 3 / a / LT
3. IA)S 166,5t�
4.
5.
Si�r'uturetand Name ofFirm/Business Date Time In Time Out
COPIES MADE 3( PAID INVOICE
G / ADWShared/Fde Review Access Form rev 2018