NCG160120_Renewal COC Request_20191022 10:32:53 AM

'rl n
NORTH CAFOLINA
Emlre -.1 Qd Wy
Permit COC
NCG160120
Number *
Enter the Certificate of Coverage (GOC) number, not the General Fbrmt nurrber (e.g., NCGO30222 is the COC, not
NCG030000) M-ST BEGIN WITH CAPITAL "NCG'
Name of Person
Julian Stinson
Obtaining COC*
First and LastNarra
Phone Number* 4344413719
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.
NCG160120
Permittee
Piedmont Asphalt LLC
Facility Name
Piedmont Asphalt LLC - Reidsville Plant
Address
7641 NC 87
City
Reidsville
County
Rockingham
Waterbody
Wolf Island Creek
Classification
C
River Basin
Roanoke
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