NCG210391_Renewal COC Request_20180831 11:38:15 AM

JI
Environmental
Quality
Permit COC
NCG210391
Number *
Enter the Certificate of Coverage (COC) number, not the General Pernit number (e.g., NOG030222 is the OOC, not
COC No.
NCG030000) MUST BEGIN WTTH CARTAL "NO3'
Name of Person
John Bryan
Obtaining COC*
First and Last Name
Phone Number* 9196902640
Email * [e-mail]
The COCwill 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
NCG210000
Permit No.
COC No.
NCG210391
Permittee
John Bryan Yard Waste Recycling
Facility Name
John Bryan Yard Waste Recycling
Address
3092 Sam Usry Rd
City
Oxford
County
Granville
Waterbody
TAR RIVER
Classification
WS-V;NSW
River Basin
Tar -Pamlico
RENEWAL STATUS
Active
Issuance Date*
07/31/2018
Effective Date
08/01/2018
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 *
C' aifs� rt�rt!
Date * 08/31/2018