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HomeMy WebLinkAboutNCG100165_Renewal COC Request_20181129 3:30:45 PM'rl n NORTH CAFOLINA Emlre -.1 Qd Wy Permit COC NCG100165 Number * Enter the Certificate of Coverage (COC) number, not the General Fbrmt number (e.g., NCGO30222 is the COC, not NCG030000) M-ST BEGIN WTTH CAFTTAL "NOG' Name of Person Kristyn Jacher Obtaining COC* First and LastNarre Phone Number* 512-244-3631 Email * Kjacher@jamesenvironmental.com The COC will be e-rrailed to this contact. Additional Email reid@rstroud.com (Optional) Enter an additional erreil 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 (919) 707-3641 or bethany.georgoulias@ncdenr.gov. Master General NCG100000 Permit No. COC No. NCG100165 Permittee Reid Stroud Facility Name R. Stroud's Inc. Address 6118 Hwy 96 W City Youngsville County Franklin Waterbody Horse Creek Classification WS-V;NSW River Basin Neuse RENEWAL STATUS Active Issuance Date * 10/29/2018 Effective Date 11/01/2018 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 * Date * 11 /29/2018