NCG210281_Renewal COC Request_20180830 12:52:34 PM

Environmental
Quality
Permit COC
NCG210281
Number *
Enter the Certificate of Coverage (COC) number, not the General Pernit number (e.g., NOG030222 is the OOC, not
COC No.
NOW30000) MUST BEGIN WTTH CARTAL "NO3'
Name of Person
Eben Snow
Obtaining COC*
First and Last Name
Phone Number* [phone]
Email * [e-mail]
The COCwill be e-mailed to this contact.
Additional Email (Optional) Enter an additional enail address to whom to send the COC
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
NCG210000
Permit No.
COC No.
NCG210281
Permittee
Cmh Manufacturing Inc DBA Schult Homes -
Rockwell Frame Shop
Facility Name
Schult Homes - Rockwell Frame Shop
Address
1 Viscount Ave
City
Rockwell
County
Rowan
Waterbody
Second Creek
Classification
C
River Basin
Yadkin
RENEWAL STATUS
Active
Issuance Date*
07/31/2018
Effective Date
08/01/2018
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
to,�f
Date * 08/30/2018