NCG180224_Renewal COC Request_20191022 11:45:37 AM

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Permit COC
NCG180224
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
George Lemerise
Obtaining COC*
First and LastNarre
Phone Number* 252-523-4131
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 NCG180000
Permit No.
COC No.
NCG180224
Permittee
Masterbrand Cabinets
Facility Name
Masterbrand Cabinets-Plt 9
Address
651 Collier -Loftin Rd
City
Kinston
County
Lenoir
Waterbody
Southwest Creek (Kellys Pond)
Classification
C;Sw,NSW
River Basin
Neuse
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