NCG180016_Renewal COC Request_20191111 7:46:16 AM

NORTH C W Q-rA
EnHmnmertm! dafny
Permit COC
NCG180016
Number *
Enter the Certificate of Coverage (COC) nun ber, not the General Pen-rit nurrber (e.g., N00030222 is the OOC, not
N00030000) M-ST BEGIN WTTH CARTAL "NCG'
Name of Person
Patrick Beard
Obtaining COC*
First and Last Name
Phone Number* 8284648318
Email* [e-mail]
The COC w ill be e-nailed to this contact.
Additional Email [e-mail]
(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].
Master General NCG180000
Permit No.
COC No.
NCG180016
Permittee
Lee Industries Inc
Facility Name
Lee Industries Incorporated -Catawba
Address
402 W 25th St
City
Newton
County
Catawba
Waterbody
Hildebran Creek (Anthony Creek)
Classification
C
River Basin
Catawba
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 *

11/11/2019