NCG080958_Renewal COC Request_20201208 11:00:51 AM

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 12/8/2020 11:00:51 AM (COC Request Submission)

NORTH C W Q-rA
EnHmnmertm! dafny
Permit COC
NCG080958
Number *
Enter the Certificate of Coverage (COC) nun ber, not the General Pen-rit nurrber (e.g., N00030222 is the OOC, not
NCG030000) M-ST BEGIN WTTH CARTAL "NCG'
Name of Person
Jennifer Welch
Obtaining COC*
First and Last Narre
Phone Number*
8323495863
Email * [e-mail]
The COC w ill be e-nailed to this contact.
Additional Email (Optional) Enter an additional enailaddress towhom tosend the OOC
Did you check the permit COC file in our repository to ensure this COC was not already available from a previous
request? If it is, please obtain it from there instead of this form.
rJ Yes, this COC was not already there.
Please review the information below for accuracy before submitting. If there are inconsistencies, please
contact Bethany Georgoulias at [phone] or [e-mail].
M aste r Ge ne ral NCGO80000
Permit No.
COC No.
NCG080958
Permittee
Blue Ridge Southern Railroad
Facility Name
Canton Yard Facility
Address
2 Depot St
City
Canton
County
Haywood
Waterbody
PIGEON RIVER (Waterville Lake below
elevation 2258)
Classification
C
River Basin
French Broad
RENEWAL STATUS
Active
Issuance Date*
10/29/2018
Effective Date
11/01/2018
Effective Date
20181101
Reformatted
I 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.
In addition, I agree that submission of this form is a "transaction" subject to Chapter 66, Article 40 of the NC General
Statutes (the "Uniform Electronic Transactions Act"); and 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");
Signature *
c, wkw
Date * 12/08/2020