NCG160055_Renewal COC Request_20200317 4:01:23 PM

NORTH C W Q-rA
EnHmnmertm! dafny
Permit COC
Number*
Name of Person
Obtaining COC*
Phone Number*
NCG 160055
Enter the Certificate of Coverage (COC) nun ber, not the General Rarnit nurrber (e.g., NOG030222 is the OOC, not
N00030000) M-ST BEGIN WTTH CARTAL "NCG'
James Washburn
First and Last Nacre
2522905912
Email * [e-mail]
The COC w ill be e-nailed to this contact.
Additional Email [e-mail]
(Optional) Enter an additional email address to whom to send the CDC
Please review the information below for accuracy before submitting. If there are inconsistencies, please
contact Bethany Georgoulias at [phone] or [e-mail].
Master General NCG160000
Permit No.
COC No.
NCG160055
Permittee
S T Wooten Corporation
Facility Name
S T Wooten Corporation- Sanford
Address
966 Rocky Fork Church Rd
City
Sanford
County
Lee
Waterbody
Little Juniper Creek
Classification
C
River Basin
Cape Fear
RENEWAL STATUS
Active
Issuance Date*
08/01/2019
Effective Date
08/01/2019
1 hereby request a copy of the Certificate of Coverage (COC) entered above. I understand that the COC e-mailed as a
result of this request will serve as the Permittee's record of renewed coverage under the General Permit, and that this
record must be maintained with the Permittee's NPDES Stormwater Permit records.
Signature *

Date * 03/17/2020