NCG200495_Renewal COC Request_20191113 2:59:26 PM

NORTH C W Q-rA
EnHmnmertm! dafny
Permit COC
NCG200495
Number *
Enter the Certificate of Coverage (COC) nun ber, not the General Pen-rit nurrber (e.g., N00030222 is the OOC, not
NCG030000) M-ST BEGIN WTTH CARTAL "NCG'
Name of Person
Scott Powell
Obtaining COC*
First and Last Name
Phone Number* 704-873-9004
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].
M aste r Ge ne ral NCG200000
Permit No.
COC No.
NCG200495
Permittee
L Gordon Iron & Metal Company
Facility Name
L Gordon Iron & Metal Company
Address
735 Monroe St
City
Statesville
County
Iredell
Waterbody
Third Creek (Third Creek WS No. 37)
Classification
C
River Basin
Yadkin
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 /13/2019