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HomeMy WebLinkAboutNCG160168_Renewal COC Request_20191021 12:18:22 PM'rl n NORTH CAFOLINA Emlre -.1 Qd Wy Permit COC NCG160168 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 Sean Mackey Obtaining COC* First and LastNarre Phone Number* 4235717159 Email * smackey@maymead.com The COC will be e-rrailed to this contact. Additional Email smackey@maymead.com (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 (919) 707-3641 or bethany.georgoulias@ncdenr.gov. Master General NCG160000 Permit No. COC No. NCG160168 Permittee Maymead Materials Inc Facility Name Maymead Materials (Denver) Address 4949 Hwy 16 N City Denver County Lincoln Waterbody Killian 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