NCG130040_Renewal COC Request_20200207 8:41:34 AM

NORTH C W Q-rA
EnHmnmertm! dafny
Permit COC
NCG130040
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
Stephen Nichting
Obtaining COC*
First and Last Name
Phone Number* 9196028118
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
NCG130000
Permit No.
COC No.
NCG130040
Permittee
US Tire Recycling Partnership, L.P.
Facility Name
U S Tire Recycling LP
Address
6322 Poplar Tent Rd
City
Concord
County
Cabarrus
Waterbody
Coddle Creek
Classification
C
River Basin
Yadkin
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
51&1P14 Ac joy

Date * 02/07/2020