NCG050405_Renewal COC Request_20180705 7:42:21 AM

Environmental
Quality
Permit COC
NCG050405
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
ROBERT WOOD
Obtaining COC*
First and Last Name
Phone Number*
7703268140
Email *
[e-mail]
The COCwill be e-mailed 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.
NCG050405
Permittee
West Rock -Southern Container LLC
Facility Name
West Rock
Address
279 Mooresville Blvd
City
Mooresville
County
Iredell
Waterbody
Back Creek
Classification
WS-II;HQW
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 *
Date * 07/05/2018