NCG160171_Renewal COC Request_20200122 8:59:09 AM

NORTH C W Q-rA
EnHmnmertm! dafny
Permit COC
NCG160171
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
Kim Vernal
Obtaining COC*
First and Last Name
Phone Number* 9197826515
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
NCG160000
Permit No.
COC No.
NCG160171
Pe rmitte e
Facility Name
T R Vernal Paving Inc
Address
8705 Fleet Service Dr
City
Raleigh
County
Wake
Waterbody
Sycamore Creek (Big Lake)
Classification
B;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 *

Date * 01 /22/2020