NCG200482_Renewal COC Request_20200121 2:39:30 PM

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Permit COC
NCG200482
Number *
Enter the Certificate of Coverage (COC) nun ber, not the General Pernit nurrber (e.g., N00030222 is the OOC, not
NCG030000) M-ST BEGIN WTTH CARTAL "NCG'
Name of Person
Sabrina Edwards
Obtaining COC*
First and Last Name
Phone Number*
252-946-6176
Email*
[e-mail]
The COC w ill be e-nailed to this contact.
Additional Email
(Optional) Enter an additional email address towhom tosend the OOC
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.
NCG200482
Permittee
Obi Limited
Facility Name
OBI Limited
Address
2904 Frederick Rd
City
Chocowinity
County
Beaufort
Waterbody
Maple Branch
Classification
C;Sw,NSW
River Basin
Tar -Pamlico
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 * 01 /21 /2020