NCG170202_Renewal COC Request_20191122 9:14:56 AM

NORTH C W Q-rA
EnHmnmertm! dafny
Permit COC
NCG170202
Number *
Enter the Certificate of Coverage (COC) nun ber, not the General P n-rit nurrber (e.g., N00030222 is the OOC, not
NCG030000) M-ST BEGIN WTTH CARTAL "NCG'
Name of Person
Eric Page
Obtaining COC*
First and Last Name
Phone Number* 336-516-4176
Email* [e-mail]
The COC w ill be e-nailed to this contact.
Additional Email [e-mail]
(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 [phone] or [e-mail].
Master General
NCG170000
Permit No.
COC No.
NCG170202
Permittee
Burlington Industries LLC
Facility Name
Burlington Industries- BHP Plant
Address
906 Anthony St
City
Burlington
County
Alamance
Waterbody
Bowden Branch
Classification
WS-V;NSW
River Basin
Cape Fear
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 *
(iu Nle

Date * 11 /22/2019