NCG160155_Renewal COC Request_20200317 4:08:54 PM

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Permit COC
Number*
Name of Person
Obtaining COC*
Phone Number*
NCG160155
Enter the Certificate of Coverage (COC) nun ber, not the General Parnit nurrber (e.g., NOG030222 is the OOC, not
N00030000) M-ST BEGIN WTTH CARTAL "NOG'
James Washburn
First and Last Nacre
252-290-5912
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.
NCG160155
Permittee
S T Wooten Corporation
Facility Name
S T Wooten Corporation - Youngsville
Asphalt
Address
255 Material Dr
City
Franklinton
County
Franklin
Waterbody
Cedar Creek
Classification
QNSW
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 *
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Date * 03/17/2020