NCG170260_Renewal COC Request_20191009 8:18:11 AM

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Permit COC
NCG170260
Number *
Enter the Certificate of Coverage (GOC) number, not the General Fbrmt nurrber (e.g., NCGO30222 is the COC, not
NCG030000) M-ST BEGIN WITH CAPRAL "NCG'
Name of Person
Tyler Saunders
Obtaining COC*
First and LastNarre
Phone Number* 706-272-4935
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 GOC
Please review the information below for accuracy before submitting. If there are inconsistencies, please
contact Bethany Georgoulias at [phone] or [e-mail].
Master General NCG170000
Permit No.
COC No.
NCG170260
Permittee
Mohawk Industries
Facility Name
Mohawk Industries-Karastan
Address
712 Henry St
City
Eden
County
Rockingham
Waterbody
DAN RIVER
Classification
WS-IV
River Basin
Roanoke
RENEWAL STATUS
Active
Issuance Date*
08/01/2019
Effective Date
08/01/2019
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 * 10/09/2019