NCG120023_Owner Affiliation Change Request_20200630

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 6/30/2020 3:37:36 PM (Owner Affiliation Change Submission)
Approve by McCoy, Suzanne 7/16/2020 8:58:50 AM (Notification to Admin)
• The task was assigned to McCoy, Suzanne 6/30/2020 3:37 PM

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Default Page
NPDES Permit
Enter your NPIDES storrrwater pernit nunber or Certificate of Coverage (COC) nunber.
Number*
NCG120023
NCS)00000(or NCC)00000(
Submittor's Name*
Reaseenter your FIRST and LAST narre
Melissa Moore
Phone Number*
Reaseenter your phone nurrber
910-989-2107
Any format is fine.
Email Address *
Rease enter a valid a -mail address
[e-mail]
A confirmation of submssion will be e-mailed to this address.
Need a copy of the Permit Owner Affiliation Designation Form? You must upload a signed copy of that form below.
Questions? Call Bethany Georgoulias at [phone] or e-mail her at.bethany.georgouliasencdenr.gov.
Completed Form Reaseupload the signed "FbrrritOwner Affiliation DesignationForn'
Upload* Permit Owner Affliiation Designation Form.pdf 113.95KB
pdr only

Initial Review
Project ID * Peviewer rmy revise perrrit nunber below if incorrect.
NCG120023