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HomeMy WebLinkAboutNCG080008_Renewal COC Request_20191025 12:22:44 PM'rl n NORTH CAFOLINA Emlre -.1 Qd Wy Permit COC NCG080008 Number * Enter the Certificate of Coverage (GOC) number, not the General Fbrmt nurrber (e.g., NCGO30222 is the COC, not NCG030000) M-ST BEGIN WTTH CAFTTAL "NCG' Name of Person Derek Bouchard Obtaining COC* First and LastNarra Phone Number* 314-302-3634 Email * DBouchard@RepublicServices.com The COC will be e-rrailed to this contact. Additional Email (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 (919) 707-3641 or bethany.georgoulias@ncdenr.gov. M aste r Ge ne ral NCG080000 Permit No. COC No. NCG080008 Permittee Republic Services of North Carolina LLC Facility Name Republic Services of NC, LLC-GDS/Forest City Address 141 Fairground Rd City Spindale County Rutherford Waterbody Bracketts Creek Classification C River Basin Broad 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 * 10/25/2019