NCG190023_Renewal COC Request_20201218 9:35:24 AM

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 12/18/2020 9:35:18 AM (COC Request Submission)

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Permit COC
Number*
Name of Person
Obtaining COC*
Phone Number*
NCG 190023
Enter the Certificate of Coverage (COC) nun ber, not the General Rarrrit nurrber (e.g., NOG030222 is the OOC, not
N00030000) M-ST BEGIN WTTH CARTAL "NOG'
David Cullipher
First and Last Nacre
2524823837
Email* [e-mail]
The COC w ill be e-nailed to this contact.
Additional Email [e-mail]
(Optional) Enter an additional errail address to whom to send the CDC
Did you check the permit COC file in our repository to ensure this COC was not already available from a previous
request? If it is, please obtain it from there instead of this form.
V Yes, this COC was not already there.
Please review the information below for accuracy before submitting. If there are inconsistencies, please
contact Bethany Georgoulias at [phone] or [e-mail].
Master General
NCG190000
Permit No.
COC No.
NCG190023
Permittee
Regulator Marine Inc
Facility Name
Regulator Marine Inc -Edenton
Address
187 Peanut Dr
City
Edenton
County
Chowan
Waterbody
Turnbull Creek
Classification
C
River Basin
Cape Fear
RENEWAL STATUS
Active
Issuance Date*
10/01/2020
Effective Date
10/01/2020
Effective Date
20201001
Reformatted
I 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.
In addition, I agree that submission of this form is a "transaction" subject to Chapter 66, Article 40 of the NC General
Statutes (the "Uniform Electronic Transactions Act"); and I agree to conduct this transaction by electronic means
pursuant to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act");
Signature *
Date * 12/18/2020