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HomeMy WebLinkAboutNCG020437_Renewal COC Request_20210820 7:56:29 AMPermit COC NCG020437 Number * Enter the Certificate of Coverage (COC) number. MIST BEGIN WITH CARTAL "NOG' Please review the information below for accuracy before submitting. If there are inconsistencies, please contact suzanne.mccoy@ncdenr.gov, or check the box below that says "permit information is incorrect". Permittee * Meridian Brick LLC Facility Name Meridian Brick, LLC - Sampson Mine II Address Old Brick Mill Rd Sr 1403 City Roseboro County Sampson Name of Person Patsy Royal Requesting COC* First and LastNarre Phone Number* 704.630.4224 Email * patsy. royal@meridianbrick.com The COC w ill be e-nailed to this contact. Additional Email (Optional) Enter an additional email address to whom to send the OOC Master General Permit NCG020000 Issuance Date 06/30/2021 Master General F2rnit Issuance Effective Date 07/01/2021 Master General Fbrrrit Effective NOTE: You can verify the COC facility information and renewal status by running this Permit Summary Report (check the Permit Status at the top of the report). If the permit is expired, a renewal COC will not be available. This may be because fees are owed. You can check for outstanding invoices at https://deq.nc.gov/sw-epayments. V I am requesting a copy of the renewal COC. « Do not check this box below unless you verified the COC is e)pired with the report above. » r the COC is still expired, but owed fees have been paid. r- permit information is incorrect or old. 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. If a COC is not available, I request a follow-up from Stormwater Program staff. 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 * 08/20/2021 Time 07:56:29 AM If you do not receive an email with a copy of your renewal COC within a day, please contact bethany.georgoulias@ncdenr.gov or suzanne.mccoy@ncdenr.gov