SW6240402_Supplemental Info Review_20240405

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by Anonymous User 4/5/2024 1:47:01 PM(Supplemental Submittal)
Accept by Kaitlin Peck 4/5/2024 3:13:05 PM (Supplemental Info Submittal)
• The task was assigned to Kaitlin Peck 4/5/2024 1:47:02 PM

=DEQ •
Submittal from 4/5/2024
Permit Information:
Please provide specific permit details below.
................................................................................................................................................................................................................................................................................................................................................................................................
What Type of Permit? Choose one:
* NPDES Industrial or MS4 Permit
State Stormwater(Post-Construction)Permit
Other
Permit Number* SW6240402
Begins with"SW","NCG",or"NCS"
What DEQ Office is Reviewer:Please correct if misidentified,close this review form,and reassign task to the appropriate contact.
the Primary Contact? Central Office
*
Washington Regional Office(Attn: Carl Dunn)
Wilmington Regional Office(Attn:Christine Hall)
................................................................................................................................................................................................................................................................................................................................................................................................
Project Name* Blackburn Farm Phase 2
Owner/Operator* Blackburn Farm HOA, LLC
County: Hoke
Submitter Name:* Lee Humphrey
Who is submitting this information?
E-mail Address:* [e-mail]
Phone Number* 9106848646
Additional E-mail for (Optional)
Submittal
Confirmation:
State Stormwater (Post-Construction) Information Uploads
Choose file type and upload attachment(Reviewer may remove unnecessary submittals)
File Type* Supplement-EZ Form
File Upload Click the upload button,or drag and drop files to attach
03 EZ Supplement-SIGNED.pdf 490.51 KB
Only PDF files are accepted.
File Type* Design Calculations
File Upload Click the upload button,or drag and drop files to attach
05 Stormwater Report-Blackburn Farm_Ph 2.pdf 15.05MB
Only PDF files are accepted.
File Type* Plansheet-SCM Detail

File Upload Click the upload button,or drag and drop files to attach
06 SWD Plan-Blackburn Farm—Ph 2.pdf 3.28MB
Only PDF files are accepted.
File Type* Property Deed
File Upload Click the upload button,or drag and drop files to attach
07 Property Deed.pdf 161.97KB
Only PDF files are accepted.
File Type* Signing Official Title&Position Information
File Upload Click the upload button,or drag and drop files to attach
08 LLC(Raeford Development Company).pdf 1.13MB
Only PDF files are accepted.
File Type* Signing Official Title&Position Information
File Upload Click the upload button,or drag and drop files to attach
Agent Authorization Letter.pdf 30.39KB
Only PDF files are accepted.
File Type* Plansheet-Cover Sheet
File Upload Click the upload button,or drag and drop files to attach
Blackburn Cover Sheet.pdf 5.44MB
Only PDF files are accepted.
File Type* Plansheet-Existing Conditions/Survey
File Upload Click the upload button,or drag and drop files to attach
Blackburn Existing Conditions.pdf 11.9MB
Only PDF files are accepted.
File Type* Signing Official Title&Position Information
File Upload Click the upload button,or drag and drop files to attach
Blackburn Farm HOA, LLC.pdf 74.93KB
Only PDF files are accepted.
File Type* Plansheet-Grading/Drainage Plan
File Upload Click the upload button,or drag and drop files to attach
Blackburn Grading Plan.pdf 9.83MB
Only PDF files are accepted.
File Type* Plansheet-Proposed Conditions/Site Plan
File Upload Click the upload button,or drag and drop files to attach
Blackburn Site Plan.pdf 6.37MB
Only PDF files are accepted.
File Type* Plansheet-Proposed Drainage Area
File Upload Click the upload button,or drag and drop files to attach
Blackburn Storm Drainage Area Plan.pdf 8.17MB
Only PDF files are accepted.

File Type* Soils/Geotechnical Report
File Upload Click the upload button,or drag and drop files to attach
D&L Blackburn SHWT Report.pdf 958.06KB
Only PDF files are accepted.
File Type* Application Form
File Upload Click the upload button,or drag and drop files to attach
Revised Stormwater Permit Application.pdf 363.74KB
Only PDF files are accepted.
File Type* Deed Restriction/Protective Covenant Form
File Upload Click the upload button,or drag and drop files to attach
Signed Blackburn Deed Restrictions.pdf 68.86KB
Only PDF files are accepted.
File Type* O&M Agreement/Plan
File Upload Click the upload button,or drag and drop files to attach
Signed O&M Blackburn Phase 2dist.pdf 1022.84KB
Only PDF files are accepted.
File Type* USGS Topographic Site Map
File Upload Click the upload button,or drag and drop files to attach
USGS.pdf 243.09KB
Only PDF files are accepted.
Is this project funded No
with ARPA grant Yes
funds?*
Uploads contain NO
Confidential YES
Information* NOTE:The following information cannot be claimed as confidential:the name and address of any permit applicant
or permittee,permit applications,permits,effluent data,information required by NPDES application forms provided
by the Director inclusive of all forms and attachments[Ref.40 CFR 122.7(b)and(c)].
Notes about the attachments:
* By checking the box and signing box below, I certify that:
d I have given true,accurate,and complete information on this form;
o 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)
cl 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');
d I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written
signature;AND
o I intend to electronically sign and submit the Supplemental Information Upload form.
Full Name:* Lee Humphrey

Signature:
J4,
Date Submitted: 04/05/2024

Initial Review
Verify Permit No.* IMPORTANT:REVIEWER SHOULD VERIFY and revise here if necessary.
SW6240402
Who needs a Copy?* Reviewer selections will only be required for offices checked here.
Central Office Staff
Regional Office Stormwater Contact
State Stormwater RO Staff
No Copy Needed
Central Office Reviewer:*
Notifies CO Staff with Email
Jim Farkas
Any Comments or
Added Info for CO
Staff Reviewer?
Review Date* 04/05/2024