NCG100059_Renewal COC Request_20191107 10:36:17 AM

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Permit COC
NCG100059
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
Stewart L. Cooke
Obtaining COC*
First and LastNarra
Phone Number* 9104832217
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
NCG100000
Permit No.
COC No.
NCG100059
Permittee
Devore & Cooke Auto Parts Co Inc
Facility Name
Devore & Cooke Auto Parts Co Inc
Address
1529 Clinton Rd
City
Fayetteville
County
Cumberland
Waterbody
Locks Creek
Classification
C
River Basin
Cape Fear
RENEWAL STATUS
Active
issuance Date *
10/29/2018
Effective Date
11/01/2018
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 /07/2019