NCG180155_Renewal COC Request_20191021 9:41:57 AM

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Permit COC
NCG180155
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 CAFTTAL "NCG'
Name of Person
Edward Pitts
Obtaining COC*
First and LastNarra
Phone Number* 8287596348
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].
Master General
NCG180000
Permit No.
COC No.
NCG180155
Permittee
Bernhardt Furniture Co
Facility Name
Bernhardt Furniture Co-Plt 3
Address
1502 Morganton Blvd
City
Lenoir
County
Caldwell
Waterbody
Lower Creek
Classification
C
River Basin
Catawba
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 * 10/21 /2019