NCG030388_Renewal COC Request_20181120 12:16:17 PM

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NORTH CAFOLINA
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Permit COC
NCG030388
Number *
Enter the Certificate of Coverage (COC) number, not the General Fbrmt number (e.g., NCGO30222 is the COC, not
NCG030000) M-ST BEGIN WTTH CAPITAL "NCG'
Name of Person
Bob Levy
Obtaining COC*
First and LastNarra
Phone Number* 9197805484
Email * [e-mail]
The COC will be e-rrailed 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].
M aste r Ge ne ral NCG030000
Permit No.
COC No.
NCG030388
Permittee
SMT Inc
Facility Name
SMT Incorporated - Raleigh Plant
Address
7300 Acc Blvd
City
Raleigh
County
Wake
Waterbody
Sycamore Creek
Classification
QNSW
River Basin
Tar -Pamlico
RENEWAL STATUS
Active
Issuance Date *
10/29/2018
Effective Date
11/01/2018
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
aid �J

Date * 11 /20/2018