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HomeMy WebLinkAboutNCG160081_Renewal COC Request_20191028 3:34:50 PM'rl n NORTH CAFOLINA Emlre -.1 Qd Wy Permit COC NCG160081 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 "NCG' Name of Person Greg Davis Obtaining COC* First and LastNarra Phone Number* 7043953264 Email * Greg.Davis@blytheconstruction.com The COC will be e-rrailed to this contact. Additional Email Greg.Davis@blytheconstruction.com (Optional) Enter an additional email 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 NCG160000 Permit No. COC No. NCG160081 Permittee Blythe Construction Inc Facility Name Arrowood Plant Address 12609 Nations Ford Rd City Charlotte County Mecklenburg Waterbody McCullough Branch Classification C River Basin Catawba RENEWAL STATUS Active Issuance Date* 08/01/2019 Effective Date 08/01/2019 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 * 10/28/2019