NCS000290_Owner Affiliation Change Request_20201008

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 10/8/2020 1:53:10 PM (Owner Affiliation Change Submission)
Approve by McCoy, Suzanne 10/9/2020 12:46:52 PM (Notification to Admin)
* only updated phone number and zip code.
• The task was assigned to McCoy, Suzanne 10/8/2020 1:53 PM

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Default Page
NPDES Permit
Enter your NPDES storrrwater pernit nunber or Certificate of Coverage (COC) nunber.
Number*
NCS000290
NCS)00000(orNQG)00000(
Submittor's Name*
Reaseenter your FIRST and LAST narre
Michael Taylor
Phone Number*
Reaseenter your phone number
9104519657
Any format is fine.
Email Address *
Rease enter a valid a -mail address
[e-mail]
A confirmation of submssion will be e-mailed to this address.
Need a copy of the Permit Owner Affiliation Designation Form? You must upload a signed copy of that form below.
Questions? Call Bethany Georgoulias at [phone] or e-mail her at.bethany.georgouliasencdenr.gov.
Completed Form Reaseupload the signed "FbrmitC,vnerAffiliation Designation Forn1'
Upload* NCS000290 PERMIT OWNER AFFILIATION
61.59KB
DESIGNATION FORM LOWDER.ROBERT.pdf
pdt only

Initial Review
Project ID * Reviewer may revise permt nunber below if incorrect.
NCS000290