NCG030605_Owner Affiliation Change Request_20210806

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 8/6/2021 11:13:29 AM (Owner Affiliation Change Submission)
Approve by McCoy, Suzanne 8/13/2021 12:27:42 PM (Notification to Admin)
• The task was assigned to McCoy, Suzanne 8/6/2021 11:13 AM

1 S
�i.
mnvV��
NORTH CARCLINA
Emlmnm MI Quat<ty
Default Page
NPDES Permit
Enter your MPDES storrrwater pernit nunber or Certificate of Coverage (COC) nunber.
Number*
NCG030605
NCS)00000(or NCG00000(
Submittor's Name*
Reaseenter your FIRST and LAST narre
Danielle Loyd
Phone Number*
Reaseenter your phone nunber
18288375115
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 "FbrnitC,vnerAffiliation Designation Fornl'
Upload* Permit Owner change 080621.PDF 54.47KB
pdr only

Initial Review
Project ID * Peviewer rmy revise perrrit nunber below if incorrect.
NCG030605