NCG160114_Renewal COC Request_20191021 12:20:06 PM

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Permit COC
NCG160114
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 * [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 NCG160000
Permit No.
COC No.
NCG160114
Permittee
Maymead Materials Inc
Facility Name
Maymead Materials Inc - Pineola
Address
US 221 And NC 181
City
Pineola
County
Avery
Waterbody
Anthony Creek
Classification
C;Tr
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