Jo Ellen Ammons Fieldhouse - 6/5/2018 4:28:44 PM

WW "Arpplemental Information Upload Fon
Staff Review:
Updated ID#:
Updated Version:
Who needs a copy?*
SW1180402
1
V Central
Office
r Regional
Office
Select Reviewing Office*
Asheville Regional Office — 828-296-4500
Central Office Reviewer:
Corey Anen - eads\scanen
Select RO Reviewer:*
[e-mail]
SUBMITTED PROJECT INFORMATION
Existing Project Information:
ID# SW1180402
Version: 1
Facility Name: Jo Ellen Ammons Fieldhouse
County: Madison
Name: Zachary Roman
Who is subnitting the inforrration?
Email Address: [e-mail]
Water Resources
ENVIRONMENTAL QUALITY
Describe the attachments:
The attachment contains calculations relating to the sizing of the rip rap outlets at the site. Please let us know if you
need any additional information.
Please upload all files that need to be submitted.
NCDEQ Stormwater June 2018.pdf 492.95KB
Only pdf files are accepted.

fJ By
checking
the
box
and
signing
box
below,
certify
that:
• 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');
• I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written
signature; AND
• I intend to electronically sign and submit the Supplemental Information form.
Full Name: Zachary Roman
Signature: f-,�
Date Submitted: