NCG160194_Renewal COC Request_20191022 10:32:32 AM

'rl n
NORTH CAFOLINA
Emlre -.1 Qd Wy
Permit COC
NCG160194
Number *
Enter the Certificate of Coverage (GOC) number, not the General Fbrmt nurrber (e.g., NCGO30222 is the COC, not
NCG030000) M-ST BEGIN WTTH CAFTTAL "NCG'
Name of Person
Eduardo Valdivieso
Obtaining COC*
First and LastNarra
Phone Number* 2522613336
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 CDC
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.
NCG160194
Permittee
R P C Contracting Inc
Facility Name
RPC Contracting
Address
170 Knobbs Creek Rd
City
Elizabeth City
County
Pasquotank
Waterbody
Pasquotank River
Classification
SC
River Basin
Pasquotank
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 * 10/22/2019