NCC223824_NOI 112647 Payment Verification_20221122

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 11/13/2022 3:15:36 PM (NCG01 NOI Submission)
Approve by Broussard, Brooklyn C 11/14/2022 9:40:32 AM (Review - NOI 112647 Mt. Holly Medical Park)
• The task was assigned to Broussard, Brooklyn C by round robin distribution 11/13/2022 3:16 PM
• The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: November 17, 2022 5:00
PM 11/13/2022 3:16 PM
by Workflow 11/14/2022 9:40:42 AM (Workflow Start Event)
Submit by Holloman, Tevye L 11/22/2022 12:17:06 PM (Payment Verification for NCC223824)
F Davis Moore Acquisition
Holloman, Tevye L assigned the task to Holloman, Tevye L 11/22/2022 12:15 PM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: December 26, 2022 5:00
PM 11/14/2022 9:40 AM

Payment •
NORTH CAROLINA
Environmental Quallty
Project Name
Mt. Holly Medical Park
Lot Numbers
(If listed on the eNOl)
NC Reference No.*
NCG01-2022-3824
Certificate of
NCC223824
Coverage (COC) No.*
Invoice Date
11/14/2022
Initial Invoice No.
NCC223824-2022
Initial Fee
$ 100.00
Invoice Due Date
12/14/2022
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
11/22/2022
Received *
(Or, if not received, date rejected for no payment)
Method of Payment*
electronic
check
Other
Check Number*
1476
NOI Tracking No.
112647
Tracking ID referenced upon submittal
This is an Express
No
Review Project
Yes
Project Tracking ID
NCC-GASTO-2023-Mt. Holly Medical Park