NCG050041_Renewal COC Request_20180607 2:24:36 PM

JI
Environmental
Quality
Permit COC
NCG050041
Number *
Enter the Certificate of Coverage (COC) number, not the General Pernit number (e.g., NOG030222 is the OOC, not
Facility Name
NCG030000) MUST BEGIN WITH CARTAL "NO3'
Name of Person
B Georgoulias
Obtaining COC*
First and Last Name
Phone Number* 919-807-6372
Email * [e-mail]
The OOCw ill be e-mailed to this contact.
Additional Email (Optional) Enter an additional eneil address to whom to send the COC
Please review the information below for accuracy before submitting. If there are inconsistencies, please
contact Bethany Georgoulias at [phone] or [e-mail].
M aste r Ge ne ral NCG050000
Permit No.
COC No.
NCG050041
Permittee
Plastics Color Corp Of INC
Facility Name
Plastics Color Corporation Of NC
Address
1134 HM 49 S
City
Asheboro
County
Randolph
Waterbody
Taylors Creek
Classification
C
River Basin
Yadkin
RENEWAL STATUS
Active
Issuance Date
05/31/2018
Effective Date
06/01/2018
1 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.
Signature *
rfr wfo-'W
Date * 06/07/2018