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HomeMy WebLinkAboutNCC204399_NOI Application_20201006Action History (UTC-05:00) Eastern Time (US & Canada) Subrrit by Anonymous User 9/30/2020 1:18:27 PM (NCG01 NOI Submission) Approve by Garcia, Lauren V 10/1/2020 3:10:57 PM (Review- Construction NOI 32314) • The task was assigned to Garcia, Lauren V by round robin distribution 9/30/2020 1:18 PM The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: October 2, 2020 5:00 PM 9/30/2020 1:18 PM Submit by Selkane, Aziza 10/6/2020 9:18:11 AM (Payment Verification for NCC204399) * Holly Ntemann • Selkane, Aziza assigned the task to Selkane, Aziza 10/6/2020 9:17 AM The task was assigned to DEMLR NCG01 Payment Team. The due date is: November 12, 2020 5:00 PM 10/1/2020 3:11 PM .• SThF� '; 1 NORTH CAROLINA EnrlronmertW quallly A. Project Information Part A. Project Location and Waterbody Information Are you submitting IT No an NOI that was r Yes rejected before? 1a. Project Name * H.F. Lee Energy Complex Inactive Basin Closure (Inactive Basin 3) 1 b. Specific Lot This field rray be used to list specifc lot numbers. Numbers 2. County* Wayne 3. Highway or Street 1199 Black Jack Church Road Address* Street narre only is acceptable if no address number assigned yet 4.CityorTownship* Goldsboro 5. State * NC 6. Zip Code * 27530 7. Latitude* Enter the latitude in decimal degrees 35.3832 8. Longitude* Enter the longitude in decimal degrees (MUST be negative) -78.1087 If you do not know the latitude and longitude coordinates for this project, you can search the location on this map of North Carolina. Look for the coordinates in the bottom left corner. 9. Date to Begin* 10/12/2020 Estinated Construction Project Start Date 10. Date to End * 09/16/2024 Estimated Construction Project End Date 11. SIC (Primary) * Other (9999) Standard Industrial Classification for Leveloprrent 12. Acres to be 92.87 disturbed* (including off -site borrow and waste areas) 13. Total site area 92.87 (acres) * 14. Post- 0.10 construction (Estirrated) impervious area (acres) * NCC Project NCC-WAYNE-2020-H.F. Lee Energy Complex Inactive Basin Tracking ID Closure (Inactive Basin 3) Assigned autorratically Below you must enter waterbody information for surface waters affected by this project. Please consult DWR's Surface Water Classifications Map Viewer to find waterbody name and corresponding index number. Please enter only immediate receiving waterbodies - not waters downstream of those unless the project extends there. You may enter up to 3 waterbodies if needed. 15a. Receiving Neuse River Waterbody* Ibrre of w aterbody into w hich storrrw ater runoff w ill discharge 15b. Waterbody 20-(50.375) Index No.* NCWaterbody Index Nunber Stormwater rJ No discharges will flow r- Yes to additional wate rs * 16a. Is this project r Yes subject to the NC r No, not subject to NC SPCA Sediment Pollution Control Act?* B. Permittee Information Part B. ^ F2rnittee Inforrration - Legally Fbsponsible Entity and Individual Important: The person who signs the NOI Certification Form and signs the Certification in Section E of this application form should be the same person as listed in THIS SECTION, or an authorized responsible individual within the same organization. That person must be a responsible corporate officer who owns or operates the construction activity, such as a president, secretary, treasurer, or vice president, or a manager that is authorized in accordance with Part IV, Section B, Item (6) of the NCG010000 General Permit. For more information on signatory requirements, see Part IV, Section B, Item (6) of that permit. 1. Organization Legally Pesponsible Entity Name * Duke Energy Progress, LLC It pernittee is an individual (i.e., organization does not apply), enter first and last narre in this field. Note: The organization name must match the business entity name registered with the NC Secretary of State. You can verify the registration here. 2. First Name * Issa IF Corporation, enter Faegistered Agent First %rre 3. Last Name* Zarzar It Corporation, enter F;bgistered Agent Last %rre 3b. Title General Manager - CCP Project Management 4. Permitee E-mail Issa.Zarzar@duke-energy.com Address* 5. Permittee 919-546-7574 Telephone No.* 6. Permittee Mailing Street Address Address* 410 South Wilmington Street Address Line 2 10th floor City State / Frovince / Fbgion Raleigh NC Fbstal / Zip Code Country 27601-1849 us Check box if the V Yes street address the same as mailing address 7. Permittee Street Street Address Address* 410 South Wilmington Street Address Line 2 10th floor City State / Ftovince / Region Raleigh NC Fbstal / Zip Code Country 27601-1849 us 8. Type of Non -Government Ownership* C. Site Contact Information Part C. ^ Roject Site Contact Inforrration ....................................................................................................................................................................................................................................................................................................................................................................................... 1. Primary Site Joyce Contact - First Name * 2. Primary Site Dishmon Contact - Last Name * 3. Title Permtting and Compliance - Carolinas East 4. Site Contact E- Joyce.Dishmon@duke-energy.com mail Address* 5. Site Contact 336-394-5524 Telephone No.* 6.Organization EHS Name 7. Site Contact Street Address Mailing Address* 864 South Edgewood Road Address Line 2 City State / Rovince / Region Eden NC Postal / Zip Code Country 27288 us 8. Consultant Name (Optional) First and Last narre 9. Consultant E-mail This person will be copied on all correspondence. 10. Consultant Telephone No. D. E&SC Plan Part D. ^ Erosion & Sediment Control (E&SC) Ran Approval Information ...................................................................................................................................................................................................................................................................................................................................... 1. Date E&SC Plan 09/28/2020 Approved * 2. E&SC Plan Project WAYNE-2016-011 Number/ID * Assigned by agency or local program 3. E&SC Plan r State DEQ Office Approved by* r Local Program 4. State DEQ Office * Washington (WaRO) Documentation of E&SC Plan approval and the signed Notice of Intent (NOI) Certification Form is required for a complete application. For linear projects, please also upload a site map showing the overall extent of the project or include the beginning point and end point coordinates in the "Notes" box below. 5. E&SC Plan Wayne-2016-011 HF Lee Energy Complex Inactive Approval letter or 874.85KB Basin Closure (Inactive Ba.._ (002).pdf Grading Permit Mast be FDFfon-rat 6. Site Location Map Helpful for linear project review (Optional) Mast be FDFfornat. Rease do not upload entire set of E&SCplans. 7. Notes (Optional) Frovide any additional information that night help the reviewer better understand how uploaded docurrents support the application. Include additional waterbodies for linear projects if necessary. 8. NOI Certification H.F. Lee Energy Complex Inactive Basin Closure - Form 41.35KB Inactive Basin 3.pdf Mast be FDFformat This is an Express r No Review Project* r Yes E. Certification North Carolina General Statute 143-215.6E (i) provides that: Any person who knowingly makes anyfalse statement, representation, or certification in any application, record, report, plan, or other document filed or required to be maintained under this Article or a rule implementing this Article; or who knowingly makes a false statement of a material fact in a rulemaking proceeding or contested case under this Artcle; or who falsifies, tampers with, or knowingly renders inaccurate any recording or monitoring device or method required to be operated or maintained under this Article or rules of the Commission implementing this Artcle shall be guilty ofa Class 2 misdemeanor which may include a fine not to exceed ten thousand dollars ($10,000). Under penalty of law, I certify that: 17 I am the person responsible for the construction activities of this project, for satisfying the requirements of this permit, and for any civil or criminal penalties incurred due to violations of this permit. rJ The information submitted in this NOI is, to the best of my knowledge and belief, true, accurate, and complete based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information. * 17 I will abide by all conditions of the NCG010000 General Permit and the approved Erosion and Sediment Control Plan. * rJ I hereby request coverage under the NCG010000 General Permit and understand that coverage under this permit will constitute the permit requirements for the discharge(s) and is enforceable in the same manner as an individual permit. Specify if you are:* r The Responsible Person named on this Notice of Intent f Authorized Responsible Person* Important: The person who electronically signs this Certification above must be the same person who signs the NOI Certification Form. If that person is signing on behalf of the Permittee, that individual must be an authorized responsible person within the same organization as the Permittee. *An authorized individual is a responsible corporate officer who owns or operates the construction activity, such as a president, secretary, treasurer, or vice president, or a manager that is authorized in accordance with Part IV, Section B, Item (6) of the NCG010000 General Permit. For more information on signatory requirements, see Part IV, Section B, Item (6) of that permit. Signature Type Name * Issa J. Zarzar Title General Manager - CCP Project Management Organization Legally Plesponsible Entity Duke Energy Progress, LLC Date * 09/30/2020 F. Tracking and COC Info NOI Tracking No. 32314 NC Reference No. NCG01-2020-4399 Uses 'count_nurrber' variable (increrrented by SP) Certificate of NCC204399 Coverage (COC) Uses 'count number' variable (increrrented by SP) No.* Count Number 4399 Sequential nurrber for subrrittal that is incremented by Stored Frocedure COC Year 2020 Year of date reviewed (used to assign YY digits after "NOC' in COCno.) Initial Invoice No. NCC204399-2020 Invoice Due Date 10/31/2020 Initial Fee $ 100.00 Invoice Status OPEN