NCS000400_Owner Affiliation Change Request_20201019

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 10/19/2020 3:04:14 PM (Owner Affiliation Change Submission)
Approve by McCoy, Suzanne 10/30/2020 8:35:27 AM (Notification to Admin)
• The task was assigned to McCoy, Suzanne 10/19/2020 3:04 PM

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Default Page
NPDES Permit
Enter your NPIDES storrrwater pernit nunber or Certificate of Coverage (COC) nunber.
Number*
NCS000400
NCS)00000(or NCC)00000(
Submittor's Name*
Reaseenter your FIRST and LAST narre
Matthew Johnson
Phone Number*
Reaseenter your phone number
3364547386
Any format is fine.
Email Address *
Rease enter a valid e-rmil 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 "FbrmitCwnerAffiliation DesignationForn'
Upload* NPDES Owner Affiliation Designation Form.pdf 1.87MB
pdf only

Initial Review
Project ID * Reviewer may revise permt nunber below if incorrect.
NCS000400