NCC200253_Contact Update Record_20210105

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Georgoulias, Bethany 1/5/2021 8:07:43 AM (Contact Changes Submitted)

Certificate of NCC200253
Coverage (COC) Enter the Certificate of Coverage Ninber (Use capital letters)
No.*
NC Reference No. NCG01-2020-0253
Original NOI No.* 20896
Project information associated with this permit (cannot change):
Permittee Listed Organizaiton cannot be changed (new OOC required)
WAL Wilmington CW, LLC
Project Name
Caliber Car Wash - Wilmington
Address
7032 Market St, Wilmington, NC
County
New Hanover
Latitude
34.2681
Longitude
-77.8225
Date COC Issued*
01/31/2020
Prior Rescission
This field will populate only if COChas already been rescinded.
Date
Which Contacts
f Billing Only
Have Changed?*
F Legally Responsible Individual Only
f Site Contact Only
r BOTH Legally Responsible Individual and Site Contact
Has Billing Contact
Choose'Yes'torevise Billing Contact details.
Changed?
r No
r Yes
Billing Email
NEW Billing Email [e-mail]
Billing Telephone
No.
NEW Billing [phone]
Telephone No. (Cptional)
Legally Responsible Individual Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Legally Responsible Michael Alterman
Individual
(Previous)

First Name (New)* Michael
Last Name (New) * Alterman
NEW Legally Peflects any revisions above
Responsible Michael Alterman
Individual*
Permittee Email [e-mail]
(Previous)
NEW Permittee [e-mail]
Email*
Permittee 6783587650
Telephone No.
(Previous)
NEW Permittee [phone]
Telephone No.*
Permittee Mailing 2970 Peachtree Rd NW, Suite 805, Atlanta,
Address (Previous) GA 30305
NEW Permittee
Mailing Address*
Street Address
3715 Northside Parkway
Address Line 2
Suite 515
Cty
Atlanta
Fbstal / Zip Code
30327
Permittee Street 2970 Peachtree Rd NW, Suite 805, Atlanta,
Address (Previous) GA 30305
State / Rovince / f;bgion
GA
Country
USA
NEW Permittee Street Address
Street Address* 3715 Northside Parkway
Address Line 2
Suite 515
City
State / Rovince / Region
Atlanta
GA
Fbstal / Zip Code
Country
30327
USA
Change Requested Michael Alterman via e-mail on 1/4/2021.
by: * Include any additional correspondence records in the Repository CDC folder.
Additional Information for this update to contact information:
Addional New address. Permittee designated as billing contact.
Explanation
(Optional)
Date * 01 /05/2021