NCG090006_Renewal COC Request_20200424 11:13:46 AM

NORTH C W Q-rA
EnHmnmertm! dafny
Permit COC
NCG090006
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
Jens Schoenfuss
Obtaining COC*
First and Last Name
Phone Number*
7048879450
Email *
[e-mail]
The COC w ill be e-nailed to this contact.
Additional Email
(Optional) Enter an additional enailaddress towhom tosend the COC
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
NCG090000
Permit No.
COC No.
NCG090006
Permittee
Mallard Creek Polymers Inc
Facility Name
Mallard Creek Polymers Incorporated
Address
2800 Morehead Rd
City
Charlotte
County
Mecklenburg
Waterbody
Mallard Creek
Classification
C
River Basin
Yadkin
RENEWAL STATUS
Active
Issuance Date*
10/29/2018
Effective Date
11/01/2018
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 *
coffllfl o�-1vld
Date * 04/24/2020