NCC202335_Contact Update Record_20230721 (2)

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by Tev.Holloman 7/21/2023 9:17:50 AM (Contact Changes Submitted)

Contact • - for • • • ONLY)
updatesThis form • . .
Certificate of NCC202335
Coverage(COC) No.* Enter the Certificate of Coverage Number(Use capital letters)
NC Reference No. NCG01-2020-2335
Original NOI No.* 26508
Project information associated with this permit(cannot change):
Permittee Listed Organizaiton cannot be changed(new COC required)
Johnston County
Project Name Johnston County MSW Landfill-Phase 6
Address 680 County Home Road,Smithfield, NC
County Johnston
Latitude 35.5133
Longitude -78.4422
Date COC Issued* 06/05/2020
Prior Rescission Date This field will populate only if COC has already been rescinded.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. 9199384752
Site Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Site Contact Rick Proctor
(Previous)
Site Contact Title Solid Waste Director
(Previous)
Organization Johnston County
(Previous)
First Name(New)* Brian

Last Name(New)* Beasley
NEW Site Contact* Reflects any revisions above
Brian Beasley
NEW Site Contact Solid Waste Director
Title
NEW Organization Johnston County
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 919-938-4750
Telephone No.
(Previous)
NEW Site Contact 919-938-4752
Telephone No.*
Site Contact Mailing P.O. Box 2263,0,Smithfield, N.C. 27577
Address(Previous)
NEW Site Contact Street Address
Mailing Address* P.O. Box 2263
Address Line 2
City State/Province/Region
Smithfield N.C.
Postal/Zip Code Country
27577 USA
Change Requested Brian Beasley(Director of Solid Waste)via email on 7/21/23.
by:* Include any additional correspondence records in the Repository COC folder.
Additional Information for this update to contact information:
Addional Explanation
(Optional)
Date* 07/21/2023