NCG100036_Renewal COC Request_20181128 10:58:03 AM

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Permit COC
NCGl00036
Number *
Enter the Certificate of Coverage (GOC) number, not the General Fbrmt nurrber (e.g., NCGO30222 is the COC, not
NCG030000) M-ST BEGIN WTTH CAPITAL "NCG'
Name of Person
Keith L. Schronce
Obtaining COC*
First and LastNarre
Phone Number* 828-256-2631
Email * [e-mail]
The COC will be e-rrailed to this contact.
Additional Email (Optional) Enter an additional email address to whom to send the CDC
Please review the information below for accuracy before submitting. If there are inconsistencies, please
contact Bethany Georgoulias at [phone] or [e-mail].
Master General NCGl00000
Permit No.
COC No.
NCG100036
Permittee
Schronce Used Parts and Cars Inc
Facility Name
Schronce Used Parts and Cars Inc.
Address
2256 Recycling Rd
City
Conover
County
Catawba
Waterbody
Elk Shoal Creek (West Side)
Classification
WS-IV
River Basin
Catawba
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 *
Date * 11 /28/2018