NCG050083_Renewal COC Request_20191126 12:24:15 PM

NORTH C W Q-rA
EnHmnmertm! dafny
Permit COC
NCG050083
Number *
Enter the Certificate of Coverage (COC) nun ber, not the General Pen-rit nurrber (e.g., N00030222 is the ODC, not
NCG030000) M-ST BEGIN WTTH CARTAL "NCG'
Name of Person
Kenneth Laws
Obtaining COC*
First and Last Name
Phone Number*
704-813-0780
Email *
[e-mail]
The COC w ill be e-nailed to this contact.
Additional Email
(Optional) Enter an additional email address towhom tosend 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
NCG050000
Permit No.
COC No.
NCG050083
Permittee
Buckeye Fire Equipment
Facility Name
Buckeye Fire Equipment
Address
102 Industrial Dr
City
Kings Mountain
County
Gaston
Waterbody
Abernethy Creek
Classification
C
River Basin
Catawba
RENEWAL STATUS
Active
Issuance Date*
05/31/2018
Effective Date
06/01/2018
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 /26/2019