NCC220547_NOI 79361 Payment Verification_20220201

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 1/26/2022 9:34:49 AM (NCG01 NOI Submission)
Approve by Broussard, Brooklyn C 1/26/2022 9:37:07 AM (Review - Construction NOI 79361)
• The task was assigned to Broussard, Brooklyn C by round robin distribution 1/26/2022 9:35 AM
• The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: January 28, 2022 5:00
PM. The priority is: High 1/26/2022 9:35 AM
Submit by Selkane, Aziza 2/1/2022 11:02:16 AM (Payment Verification for NCC220547)
F Pruitthealth, Inc
• Selkane, Aziza assigned the task to Selkane, Aziza 2/1/2022 11:01 AM
• The task was assigned to DEMLR NCG01 Payment Team. The due date is: March 9, 2022 5:00 PM. The
priority is: High 1/26/2022 9:37 AM

STA—
NORTH CAROLINA
Environmental Quallty
Project Name PruittHealth Crystal Coast
Lot Numbers (If listed on the eNOI)
NC Reference No.* NCG01-2022-0547
Certificate of NCC220547
Coverage (COC) No.*
Invoice Date 1/26/2022
Initial Invoice No. NCC220547-2022
Initial Fee $ 100.00
Invoice Due Date 2/25/2022
Important: If you change the choice below to Payment NOT RECEIVED, the application will be rejected, and a COC will
not be issued. This is the ONLY way to reject an eNOI at this step.
Payment Received* Payment Received.
Payment NOT RECEIVED.
Payment Status PAID
Date Payment 2/1/2022
Received * (Or, if not received, date rejected for no payment)
Method of Payment* electronic
check
Other
Check Number* 2037150
NOI Tracking No. 79361
Tracking ID referenced upon submittal
This is an Express No
Review Project Yes
Project Tracking ID NCC-CARTE-2022-PruittHealth Crystal Coast