NCC212797_Contact Update Record_20230322

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by bethany.georgoulias 3/22/2023 3:10:42 PM (Contact Changes Submitted)

Certificate of
NCC212797
Coverage (COC) No.*
Enter the Certificate of Coverage Number (Use capital letters)
NC Reference No.
NCG01-2021-2797
Original NOI No.*
52191
Project information associated with this permit (cannot change):
Permittee Listed
Organizaiton cannot be changed (new COC required)
MCB Camp Lejeune
Project Name
2nd Regimental HQ (P1509) - EXPRESS
Address
Endurance Drive, Camp Lejeune, NC
County
Onslow
Latitude
34.6834
Longitude
-77.3460
Date COC Issued*
05/10/2021
Prior Rescission Date
This field will populate only if COC has already been rescinded.
Which Contacts Have
Billing Only
Changed?*
Legally Responsible Individual Only
Site Contact Only
BOTH Legally Responsible Individual and Site Contact
Has Billing Contact
Choose'Yes'to revise Billing Contact details.
Changed?
Q No
Yes
Billing Email
[e-mail]
Billing Telephone No.
510-828-1131
Site Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Site Contact
Darren McGill
(Previous)
Site Contact Title
Superintendent
(Previous)
Organization
RQ Construction
(Previous)
First Name (New)*
Ryan

Last Name (New)* Smith
NEW Site Contact* Reflects any revisions above
Ryan Smith
NEW Site Contact Sr Project Engineer
Title
NEW Organization RQ Construction
This field is not required on the NOI form and may not pre -populate.
Site Contact Email [e-mail]
(Previous)
NEW Site Contact [e-mail]
Email*
Site Contact 910-530-2767
Telephone No.
(Previous)
NEW Site Contact [phone]
Telephone No.*
Site Contact Mailing 200 Cape Fear Circle, Suite 7, Sneads Ferry,
Address (Previous) NC 28460-9192
NEW Site Contact Street Address
Mailing Address* CTR 133 Julian C. Smith St.
Address Line 2
City
State / Province / Region
Camp Lejeune
NC
Postal / Zip Code
Country
28547
us
Change Requested Talia Prendergast via Modification request submitted 3/20/2023 and additional email
by: * details from Ryan Smith on 3/21/2023.
Include any additional correspondence records in the Repository COC folder.
Additional Information for this update to contact information:
Addional Explanation
(Optional)
Date * 03/22/2023