NCG070034_Renewal COC Request_20180622 9:31:25 AM

JI
Environmental
Quality
Permit COC
NCG070034
Number *
Enter the Certificate of Coverage (COC) number, not the General Pernit number (e.g., NOG030222 is the COC, not
COC No.
NCG030000) MUST BEGIN WITH CARTAL "NO3'
Name of Person
Keith Blackburn
Obtaining COC*
First and Last Narre
Phone Number* 336-838-4201
Email * [e-mail]
The OOCw ill be e-mailed to this contact.
Additional Email (Optional) Enter an additional enail 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
NCG070000
Permit No.
COC No.
NCG070034
Permittee
B & C Concrete Products Inc
Facility Name
B & C Concrete Products
Address
228 New Brickyard Rd
City
North Wilkesboro
County
Wilkes
Waterbody
YADKIN RIVER
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 *
Ccs
Date * 06/22/2018