SW5231201_Supplemental Info Review_20240410

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by Anonymous User 4/10/2024 10:26:21 AM (Supplemental Submittal)
Accept by Kaitlin Peck 4/10/2024 10:45:36 AM (Supplemental Info Submittal)
• The task was assigned to Kaitlin Peck 4/10/2024 10:26:23 AM

=DEQ •
Submittal from 4/10/2024
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* SW5231201
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* Mavis Tire
Owner/Operator* Mavis Southeast, LLC
County: Franklin
Submitter Name:* Andrew Mueller
Who is submitting this information?
E-mail Address:* [e-mail]
Phone Number* 704-851-7102
Additional E-mail for [e-mail]
Submittal (Optional)
Confirmation:
State Stormwater (Post-Construction) Information Uploads
Choose file type and upload attachment(Reviewer may remove unnecessary submittals)
File Type* Application Form
File Upload Click the upload button,or drag and drop files to attach
Executed SWM Applcation.pdf 605.03KB
Only PDF files are accepted.
File Type* Design Calculations
File Upload Click the upload button,or drag and drop files to attach
C-RPT-2202013-LOUISBURG MAVIS-
STORMWATER REPORT NARRATIVE 2024-04- 8.75MB
02.pdf
Only PDF files are accepted.

File Type* Plansheet-Cover Sheet
File Upload Click the upload button,or drag and drop files to attach
Mavis Tires#2096 1.pdf 1.31 MB
Only PDF files are accepted.
File Type* Plansheet-Notes
File Upload Click the upload button,or drag and drop files to attach
Mavis Tires#2096 2.pdf 1.31 MB
Only PDF files are accepted.
File Type* Plansheet-Existing Conditions/Survey
File Upload Click the upload button,or drag and drop files to attach
Mavis Tires#2096 3.pdf 885.99KB
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
Mavis Tires#2096 4.pdf 864.29KB
Only PDF files are accepted.
File Type* Plansheet-Grading/Drainage Plan
File Upload Click the upload button,or drag and drop files to attach
Mavis Tires#2096 5.pdf 1.04MB
Only PDF files are accepted.
File Type* Plansheet-SCM Detail
File Upload Click the upload button,or drag and drop files to attach
Mavis Tires#2096 10.pdf 1.52MB
Only PDF files are accepted.
File Type* Plansheet-Existing Drainage Area
File Upload Click the upload button,or drag and drop files to attach
Mavis Tires#2096 8.pdf 879.94KB
Only PDF files are accepted.
File Type* Plansheet-Proposed Drainage Area
File Upload Click the upload button,or drag and drop files to attach
Mavis Tires#2096 9.pdf 1.06MB
Only PDF files are accepted.
File Type* Plansheet-Landscape/Planting Plan
File Upload Click the upload button,or drag and drop files to attach
Mavis Tires#2096 25.pdf 1.43MB
Only PDF files are accepted.
File Type* Response To Comments

File Upload Click the upload button,or drag and drop files to attach
C-RTC-Holland.B-2202013-NCD EQ-
164.22KB
Stormwater_2024-04-01.pdf
Only PDF files are accepted.
File Type* Stormwater Report
File Upload Click the upload button,or drag and drop files to attach
C-RPT-2202013-LOUISBURG MAVIS-
STORMWATER REPORT NARRATIVE 2024-04- 8.75MB
02.pdf
Only PDF files are accepted.
File Type* Supplement-EZ Form
File Upload Click the upload button,or drag and drop files to attach
S u p p E Z-2020-Version-2.1.3-20201203-D E M L R-
140.69K6
SW.pdf
Only PDF files are accepted.
File Type* O&M Agreement/Plan
File Upload Click the upload button,or drag and drop files to attach
0-M-EZ-20201215-2.1--3-(5).pdf 51.33KB
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:
Signed O&M Agreement and Signing OfficiAl Document to follow.
* By checking the box and signing box below, I certify that:
cl 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');
cl I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written
signature;AND
d I intend to electronically sign and submit the Supplemental Information Upload form.
Full Name:* Andrew Mueller
Signature:
I�WVwlet
Date Submitted: 04/10/2024

Initial Review
Verify Permit No.* IMPORTANT:REVIEWER SHOULD VERIFY and revise here if necessary.
SW5231201
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
Brianna Holland
Any Comments or
Added Info for CO
Staff Reviewer?
Review Date* 04/10/2024