SW4191201_Supplemental Info Review_1/31/2020

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 1/31/2020 12:45:43 PM (Supplemental Submittal)
Submit by Strickland, Shane 2/3/2020 10:22:31 AM (Supplemental Info Submittal)
• The task was assigned to Strickland, Shane 1/31/2020 12:45 PM

Submittal Dated: 1 /31 /2020
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 suDDly the Derrrit nunber for this Drolect.
D# * Fbrrrit Nurrber
SW4191301
Examples: SWxxxxxxx, NC Gxxxxxx, or NCSxxxxxx
Facility Name:* Lewisville Middle School
County: Forsyth
Name: Hannah Banks
Vft is subrritting the information?
Email Address:* [e-mail]
Please upload all files that need to be submited.
Click the upload button or drag and drop files here to attach docurrent
CO3.03. pdf
1.66MB
CO3.04. pdf
1.41 MB
CO3.07. pdf
806.92 KB
CO3.08. pdf
769.27KB
C07.05. pdf
990.9KB
C07.06. pdf
1.97MB
17-116 - Stormwater Permit Application_2nd
486.51 KB
Submittal.pdf
17-116 - SuppEZ-2018_2nd Submittal.pdf
166.9KB
2020-01-30 Colon Moore authorized memo.pdf
182.03KB
2020-01-31 Stormvvater Comment Response.pdf
118.84KB
17-116-Stormwater Narrative_2nd submittal.pdf
1.02MB
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 perrrit applicant or
perrrittee, perrrit applications, permits, effluent data, inforrretion required by NR7ES application forms provided by
the Director inclusive of all forms and attachments [Ref. 40 CFR 122.7(b) and (c)].

Describe the attachments:
The attached contain the 2nd submittal for the Lewisville Middle School permit review and contains revisions only.
Please let me know if you have any further comments. ([e-mail])
* 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
o I intend to electronically sign and submit the Supplemental Information form."
Full Name:* Hannah Banks
Signature:
#� PS
Date Submitted: 1/31/2020

Initial Review
Updated ID#: WFORfANT. REV1RAERSH0LLDVMFY and revise here if necessary.
SW4191201
Who needs a W Central Office
copy?* r Regional Office
Central Office Reviewer:*
Jim Farkas - eads\jjfarkas
Select Reviewing Office*
Winston-Salem Regional Office — 336-776-
9800
Select RO Reviewer:*
[e-mail]