NCG160227_Renewal COC Request_20191104 2:05:50 PM

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NORTH CAFOLINA
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Permit COC
NCG160227
Number *
Enter the Certificate of Coverage (COC) number, not the General Fbrmt number (e.g., NCGO30222 is the COC, not
NCG030000) M-ST BEGIN WTTH CAFTTAL "NCG'
Name of Person
Gregg Bowler
Obtaining COC*
First and LastNarre
Phone Number* 919-747-6400
Email * [e-mail]
The COC will be e-rrailed to this contact.
Additional Email [e-mail]
(Optional) Enter an additional email address to whom to send the COC
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.
NCG160227
Permittee
Carolina Sunrock LLC
Facility Name
Carolina Sunrock - Prospect Hill Facility
Address
4266 Wrenn Rd
City
Prospect Hill
County
Caswell
Waterbody
Sugartree Creek
Classification
WS-II;HQW
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 * 11 /04/2019