NCG200498_Renewal COC Request_20191025 4:17:38 PM

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NORTH CAFOLINA
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Permit COC
NCG200498
Number *
Enter the Certificate of Coverage (OOC) number, not the General Fbrmt nurrber (e.g., NCGO30222 is the COC, not
NCG030000) M-ST BEGIN WTTH CAFTTAL "NCG'
Name of Person
source recycling
Obtaining COC*
First and Last Nlarre
Phone Number* 919-550-8008
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].
M aste r Ge ne ral
NCG200000
Permit No.
COC No.
NCG200498
Permittee
Source Recycling of Raleigh LLC
Facility Name
Source Recycling of Raleigh LLC
Address
440 Source Tech Park Ln
City
Clayton
County
Johnston
Waterbody
Cooper Branch
Classification
QNSW
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 * 10/25/2019