HomeMy WebLinkAboutNCG170418_Renewal COC Request_20191025 3:26:33 PM'rl n
NORTH CAFOLINA
Emlre -.1 Qd Wy
Permit COC
NCG170418
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
Sarah Welch
Obtaining COC*
First and LastNarra
Phone Number* 317-333-6224
Email * swelch@corner-enviro.com
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 (919) 707-3641 or bethany.georgoulias@ncdenr.gov.
Master General NCG170000
Permit No.
COC No.
NCG170418
Permittee
Polymer Group Inc
Facility Name
Polymer Group
Address
111 Excellence Ln
City
Mooresville
County
Iredell
Waterbody
Back Creek
Classification
WS-II;HQW
River Basin
Yadkin
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 * 10/25/2019