NCG180249_Renewal COC Request_20191203 11:16:58 AM

NORTH C W Q-rA
EnHmnmertm! dafny
Permit COC
NCG180249
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
Spencer Thompson
Obtaining COC*
First and Last Narre
Phone Number*
828-471-1136
Email *
[e-mail]
The COC w ill be e-nailed to this contact.
Additional Email
(Optional) Enter an additional enailaddress towhom tosend 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
NCG180000
Permit No.
COC No.
NCG180249
Permittee
Taylor King Funiture Inc
Facility Name
Taylor King Furniture Inc
Address
286 County Home Rd
City
Taylorsville
County
Alexander
Waterbody
Glade Creek
Classification
WS-IV
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 *
Date * 12/03/2019