SW5210305_Supplemental Info Review_20210514

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 5/14/2021 3:32:06 PM (Supplemental Submittal)
Submit by McCoy, Suzanne 5/18/2021 3:07:43 PM (Supplemental Info Submittal)
• The task was assigned to McCoy, Suzanne 5/14/2021 3:32 PM

Submittal Dated: 5/14/2021
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# * Perrrit Nurrber
SW5210305
Examples: SWxxxxxxx, NC Gxxxxxx, or NCSaxxxx
Facility Name:* Siler City Water Treatment Plant
County: Chatham
Name: David Honeycutt
Vft is subrritting the information?
Email Address:* [e-mail]
Please upload all files that need to be submited.
dick the upload button or drag and drop files here to attach docurrent
SSW-SWU-1 01 -Application- DEMLR-SPU Oct
2.79M6
2013.pdf
AL.SWU.20210322 Signed.pdf
555.61KB
17.04006 USGS Figure.pdf
1.27MB
Stormwater Narrative.pdf
40.8KB
Filter Plant Plat.pdf
448.85KB
Main Plant Lot DB433PG448.pdf
56.63KB
Alred and Brewer Deeds.pdf
244.97KB
17.04006 Permit Set.pdf
17.51 MB
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, perrrit 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:

Cover Letter
Application Form
USGS Site Figure
Stormwater Narrative
Deed Information
Project Plans
* 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:* David Honeycutt
Signature:
Date Submitted: 05/14/2021

Initial Review
Updated ID#: IWORfANT. RE\/1RAE 2SH0LLDVMFY and revise here if necessary.
SW5210305
Who needs a W Central Office
copy?* r Regional Office
Central Office Reviewer:*
Corey Anen - eads\scanen
Review Date * 05/18/2021