SW6190701_Supplemental Info Review_9/23/2019

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 9/23/2019 1:27:35 PM (Supplemental Submittal)
Submit by Strickland, Shane 9/24/2019 9:44:10 AM (Supplemental Info Submittal)
• The task was assigned to Strickland, Shane 9/23/2019 1:27 PM

Submittal Dated: 9/23/2019
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
SW6190701
Exarrples: SWxxxxxxx, NOC;axxxx, or NCSxxxxxx
Facility Name:* The Farms Subdivision
County: Cumberland
Name: Scott Brown, PE
Who is submitting the information?
Email Address:* [e-mail]
Please upload all files that need to be submited.
Qick the upload button or drag and drop files here to attach document
signed Deed restriction.pdf
81.92KB
signed Low density supplement.pdf
228.43KB
signed SWU 101 application.pdf
402.29KB
1360-REVISED SHEETS.pdf
1.95MB
Only pdf files are accepted.
Please alert us to any confidential information contained in the uploaded documents.
Uploads contain r NO
Confidential r YES
Information * NOTE The following information cannot be clairred as confidential: the narre and address of any permit applicant or
perrrittee, perrrit applications, permits, effluent data, information required by WDES application forms provided by
the Director inclusive of all forrrs and attachments [Ref. 40 CFR 122.7(b) and (c)].
Describe the attachments:
Changes made as a result of review comments.
* 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:* Scott Brown
Signature:
Date Submitted: 9/23/2019

Initial Review
Updated ID#: IWORfANT: FEVIBAERSHOLLDVERIFY and revise here if necessary.
SW6190701
Who needs a V Central Office
copy?* r- Regional Office
Central Office Reviewer:*
Jim Farkas - eads\jjfarkas
Select Reviewing Office*
Fayetteville Regional Office — 910-433-3300
Select RO Reviewer:*
[e-mail]