NCG030246_Owner Affiliation Change Request_20201021

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 10/21/2020 11:50:18 AM (Owner Affiliation Change Submission)
Approve by McCoy, Suzanne 10/30/2020 8:37:44 AM (Notification to Admin)
• The task was assigned to McCoy, Suzanne 10/21/2020 11:50 AM

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Default Page
NPDES Permit
Enter your MPDES storrrwater pernit nunber or Certificate of Coverage (COC) nunber.
Number*
NCG030246
NCS)00000(orNQG)00000(
Submittor's Name*
Reaseenter your FIRST and LAST narre
Steve Street
Phone Number*
Rease enter your phone nurrber
8289016695
Any format is fine.
Email Address *
Rease enter a valid a-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 Reaseupload the signed "FbrrritCwnerAffiliation Designation Forn1'
Upload* 10212020 Trivium Permit Owner Affiliation Form.pdf 904.81 KB
pdf only

Initial Review
Project ID * Peviewer nay revise perrrit nunber below if incorrect.
NCG030246