NCG210395_Renewal COC Request_20181001 8:36:54 AM

JI
Environmental
Quality
Permit COC
NCG210395
Number *
Enter the Certificate of Coverage (COC) number, not the General Pernit number (e.g., NOG030222 is the OOC, not
NCG030000) MUST BEGIN WITH CARTAL "NO3'
Name of Person
William Pleasant
Obtaining COC*
First and Last Name
Phone Number*
3368442620
Email *
[e-mail]
The COCwill 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
NCG210000
Permit No.
COC No.
NCG210395
Permittee
Cobble Creek Lumber LLC
Facility Name
Cobble Creek Lumber Hice Avenue
Address
225 Hice Ave
City
West Jefferson
County
Ashe
Waterbody
Little Buffalo Creek
Classification
C;Tr:+
River Basin
New
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 *
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Date * 10/01/2018