NCG050317_Owner Affiliation Change Request_10/14/2019

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NORTH CAROLINA
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Default Page
NPDES Permit
Enter your WDES storawater perrrit nurrber or Certificate of Coverage (CCC) number.
Number*
NCG050317
NCSX)0000(or NCGx)0000(
Submittor's Name*
Rease enter your FIRST and LAST narre
Timothy Stricker
Phone Number*
Reaseenter your phone nurrber
336-870-1617
Any format is fine.
Email Address *
Rease enter a valid a-rrail address
[e-mail]
A confirmation of subrrission w ill be e-nailed to this address.
Need a copy of the Permit Owner Affiliation Designation Form? You must upload a signed copy of that form below.
Questions? Call Bethany Georgoulias at [phone] or e-mail her at [e-mail].
Completed Form Rease upload the signed "Fkrmit Cwner Affiliation Designation Forts'
Upload * NPDES Owner Affiliation Change - Henniges
1.25MB
Automotive 2019.pdf
pdf only

Initial Review
Project ID * Fbviewer may revise perrrit number below if incorrect.
NCG050317