SW3200701_Supplemental Info Review_20200707

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 7/7/2020 1:03:47 PM (Supplemental Submittal)
Submit by Strickland, Shane 7/13/2020 10:08:46 AM (Supplemental Info Submittal)
• The task was assigned to Strickland, Shane 7/7/2020 1:04 PM

Submittal Dated: 7/7/2020
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# * Fbrnit Nurrber
SW3200701
Earrples: SWxxxxxxx, NC Gxxxxxx, or NCSxxxxxx
Facility Name:* Prescot Village Phase I
County: Union
Name: Brian LaFranchi
Vft is subrritting the inforrration?
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
01-Application. pdf
264.78KB
02-Deed Restriction.pdf
70.41KB
03-O&M. pdf
161.39KB
03-Supplement EZ.pdf
283.03KB
04-Check.pdf
35.28KB
06-USGS Map.pdf
27.97MB
07-Calculations.pdf
29.43MB
08-Plans.pdf
7.26MB
10-DEED.pdf
152.95KB
13-PNB Holding Co. 2, inc. - Certificate of
23.74KB
Authority.pdf
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 inforrretion cannot be claimed as confidential: the narre and address of any perrrit applicant or
pernittee, pernit applications, perrrits, effluent data, information required by WCM application forms provided by
the Director inclusive of all forrrs and attachments [Ref. 40 CFR 122.7(b) and (c)].
Describe the attachments:

* 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:* Brian LaFranchi
Signature:
Date Submitted: 07/07/2020

Initial Review
Updated ID#: WFORfANT. REV1RAERSH0LLDVMFY and revise here if necessary.
SW3200701
Who needs a W Central Office
copy?* r Regional Office
Central Office Reviewer:*
Corey Anen - eads\scanen
Review Date * 07/13/2020