NCG050266_Renewal COC Request_20210108 12:06:37 PM

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 1/8/2021 12:06:37 PM (COC Request Submission)

NORTH C W Q-rA
EnHmnmertm! dafny
Permit COC
Number*
Name of Person
Obtaining COC*
Phone Number*
NCG050266
Enter the Certificate of Coverage (COC) nun ber, not the General Penrit nurrber (e.g., NOG030222 is the OOC, not
N00030000) M-ST BEGIN WTTH CARTAL "NCG'
John Steber
First and Last Nacre
9198039624
Email* [e-mail]
The COC w ill be e-nailed to this contact.
Additional Email [e-mail]
(Optional) Enter an additional errail address to whom to send the CDC
Did you check the permit COC file in our repository to ensure this COC was not already available from a previous
request? If it is, please obtain it from there instead of this form.
V Yes, this COC was not already there.
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
NCG050000
Permit No.
COC No.
NCG050266
Permittee
Armacell LLC
Facility Name
Armacell LLC
Address
7600 Oak Wood St Exention
City
Mebane
County
Orange
Waterbody
HAW RIVER
Classification
WS-V;NSW
River Basin
Cape Fear
RENEWAL STATUS
Active
Issuance Date*
05/31/2018
Effective Date
06/01/2018
Effective Date
20180601
Reformatted
I 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.
In addition, I agree that submission of this form is a "transaction" subject to Chapter 66, Article 40 of the NC General
Statutes (the "Uniform Electronic Transactions Act"); and I agree to conduct this transaction by electronic means
pursuant to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act");
Signature *
G 0 g. zwe, t
Date * 01 /08/2021