NCG170016_Renewal COC Request_20191112 3:23:35 PM

NORTH C W Q-rA
EnHmnmertm! dafny
Permit COC
NCG170016
Number *
Enter the Certificate of Coverage (COC) nun ber, not the General P n-rit nurrber (e.g., N00030222 is the OOC, not
NCG030000) M-ST BEGIN WTTH CARTAL "NCG'
Name of Person
Jim Fitz
Obtaining COC*
First and Last Name
Phone Number* 9194797463
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
NCG170000
Permit No.
COC No.
NCG170016
Permittee
Freudenberg Performance Materials LP
Facility Name
Freudenberg Performance Materials, L.P.
Address
3500 Industrial Dr
City
Durham
County
Durham
Waterbody
Eno River (including the Eno River Arm of
Falls Lake)
Classification
WS-IV;NSW
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 *
0

Date * 11 /12/2019