NCC230010_NOI Signed Certification_20230104

NCG01. Notice of Intent I rt l+ &'L On Form
Directions:
Print this form, complete, scan and upload to the electronic NOL
Then, mail the original form to the NC DEMLR Stormwater Program (with $100 check if paying by check) ai:
Division of Energy, Mineral & Land Resources Stormwater Program
512 N. Salisbury Street, 61h Floor (Office 640K)
1612 Mail Service Center
Raleigh, NC 27699-1612
DO NOT MAIL T HIS FORM PAYMENT UNTIL YOUR APP? ICAT 1ON Hp"xS REEN ACCEPTED AS CO _'ET
T� IE FORM YOU MAIL MUST BE �..OPOPLE.`I WITH T AN ORIGINAL SIGNATURE URE I 0:. =1Ci IAL) E4 CFR `.2. 1 ..
Per NC General Statute 143-215.6B (i), any person who knowingly makes any false statement, representaticn, 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 ... shall be guilty of a Class 2 misdemeanor which may include a fine not to
exceed ten thousand dollars ($10,000).
Under penalty of law, I certify that (check all boxes to indicate your agreement):
I am the person responsible for the construction activities of this project, for satisfying the requirements of th::::
permit, and for any civil or criminal penalties incurred due to violations of this permit.
The information submitted in this NOi is, to the best of my knowledge and belief, true, accurate, and couplet-
based on my inquiry of the person or persons who manage the system, or those persons directly responsible f r
gathering the information.
171 1 will abide by all conditions of the NCG010000 General Permit and the approved Erosion and Sediment Cos trr;
Plan.
If the approved Erosion and Sediment Control Plan is not compliant with Part II (Storm�,%later Pollution
Prevention Plan) of the NCC_7'10000 Ger3eral Permit, I will nonetheless ensure that all conditions of Part i of d
permit are met on the project at all times.
I hereby request coverage under the NCGO10000 General Permit and understand that coverage under tl?is
permit will constitute the permit requirements for the discharge(s) and is enforceable in the same rnanner a. ,
individual permit.
Project Name (must match Ala): Wolfspeed Temporary Substation - - — -- --
Specific Lot Numbers (must match Alb):
Permittee (must match B2): Duke Energy Progress, LLC
Legally Responsible Person (must match B2 & B3): Nuwan Wijesuriya
Title of Legally Responsible Person (must match B3b): Lead Transrnissicri Permitting Mainager
Name & Title of Signed if Authorized Individual
Differs from Legally Responsible Person:
Phone Number: 919-546-2090
Signature of Legal
ponsi' Q
n or Authorized Individual
13/,,Lo2.3
-- Date --—
ia+iPORTANT NOTE: This form must be signed by a responsible corporate officer that owns or operates the construction a--tivity,
such as a president, secretary, treasurer, or vice president or a manager that is authorized in accordance with Part I'l, Section B,
Item (6) of the NCGO10000 permit.