NCG200342_Renewal COC Request_20191021 2:05:10 PM

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NORTH CAFOLINA
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Permit COC
NCG200342
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
Shan Conner
Obtaining COC*
First and LastNarre
Phone Number* 7047398053
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].
M aste r Ge ne ral NCG200000
Permit No.
COC No.
NCG200342
Permittee
C & C Scrap Iron & Metal Inc
Facility Name
C & C Scrap Iron & Metal Inc
Address
1538 Bethlehem Rd
City
Kings Mountain
County
Cleveland
Waterbody
Long Branch
Classification
C
River Basin
Broad
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