NCG200498_Renewal COC Request_20200514 8:38:05 AM

NORTH C W Q-rA
EnHmnmertm! dafny
Permit COC
NCG200498
Number *
Enter the Certificate of Coverage (COC) nun ber, not the General Pen-rit nurrber (e.g., N00030222 is the OOC, not
N00030000) M-ST BEGIN WTTH CARTAL "NCG'
Name of Person
Patsy Ballance
Obtaining COC*
First and Last Name
Phone Number* 919-550-8008
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].
M aste r Ge ne ral NCG200000
Permit No.
COC No.
NCG200498
Permittee
Source Recycling of Raleigh LLC
Facility Name
Source Recycling of Raleigh LLC
Address
440 Source Tech Park Ln
City
Clayton
County
Johnston
Waterbody
Cooper Branch
Classification
C;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 *

05/14/2020