NCG100158_Owner Affiliation Change Request_2/25/2020

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 2/25/2020 1:18:04 PM (Owner Affiliation Change Submission)
Approve by McCoy, Suzanne 2/27/2020 11:29:52 AM (Notification to Admin)
• The task was assigned to McCoy, Suzanne 2/25/2020 1:18 PM

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Default Page
NPDES Permit
Enter your NPIDES storrrwater pernit nunber or Certificate of Coverage (COC) nunber.
Number*
NCG100158
NCS)00000(orNCG)00000(
Submittor's Name*
Reaseenter your FIRST and LAST narre
Renita Sasser
Phone Number*
Rease enter your phone nurrber
910-249-2587
Any format is fine.
Email Address *
Rease enter a valid e-rrail address
[e-mail]
A confirmation of submssion will be e-mailed to this address.
Need a copy of the Permit Owner Affiliation Designation Form? You must upload a signed copy of that form below.
Questions? Call Bethany Georgoulias at [phone] or e-mail her at.bethany.georgouliasencdenr.gov.
Completed Form Reaseupload the signed "FbrrritOwner Affiliation Designation Forn'
Upload* Permit Owner Affiliation Designation Form.pdf 835.11 KB
pdf only

Initial Review
Project ID * Peviewer rmy revise perrrit nunber below if incorrect.
NCG100158