NCG050424_Renewal COC Request_20180620 3:20:01 PM

Environmental
Quality
Permit COC
NCG050424
Number *
Enter the Certificate of Coverage (COC) number, not the General Pernit number (e.g., NOG030222 is the OOC, not
NOW30000) MUST BEGIN WITH CARTAL "NO3'
Name of Person
Teddy Chrisman
Obtaining COC*
First and Last Narre
Phone Number*
919-273-4917
Email *
[e-mail]
The OOCw ill be e-rreiled to this contact.
Additional Email
[e-mail]
(Optional) Enter an additional email 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].
Master General
NCG050000
Permit No.
COC No.
NCG050424
Permittee
Uchiyama Mfg America LLC
Facility Name
Uchiyama MFG America, LLC
Address
494 Arrington Bridge Rd
City
Goldsboro
County
Wayne
Waterbody
NEUSE RIVER
Classification
QNSW
River Basin
Neuse
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 *
Date * 06/20/2018