NCG030085_Owner Affiliation Change Request_20200923

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 9/23/2020 2:21:10 PM (Owner Affiliation Change Submission)
Approve by McCoy, Suzanne 9/24/2020 3:14:23 PM (Notification to Admin)
• The task was assigned to McCoy, Suzanne 9/23/2020 2:21 PM

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Default Page
NPDES Permit
Enter your MPDES storrrwater pernit nunber or Certificate of Coverage (COC) nunber.
Number*
NCG030085
NCS)00000(or NCGX)0000C
Submittor's Name*
Reaseenter your FIRST and LAST narre
Sean Quarry
Phone Number*
Rease enter your phone nurrber
7048227034
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 Rease upload the signed "Fbrmit Owner Affiliation Designation Forn1'
Upload* image2018-06-15-123123.pdf 422.01KB
pdr only

Initial Review
Project ID * Peviewer rmy revise perrrit nunber below if incorrect.
NCG030085