NCC211990_Contact Update Record_20210408

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Georgoulias, Bethany 4/8/2021 11:06:59 AM (Contact Changes Submitted)

Certificate of NCC211990
Coverage (COC) Enter the Certificate of Coverage Ninber (Use capital letters)
No.*
NC Reference No. NCG01-2021-1990
Original NOI No.* 49220
Project information associated with this permit (cannot change):
Permittee Listed Organizaiton cannot be changed (new OOC required)
Quinn Sales, Inc
Project Name
Plastic Materials
Address
SR#1118 Canterbury Road, Kings Mountain, NC
County
Gaston
Latitude
35.2369
Longitude
-81.3152
Date COC Issued*
04/05/2021
Prior Rescission
This field will populate only if COChas already been rescinded.
Date
Which Contacts
f Billing Only
Have Changed?*
r Legally Responsible Individual Only
r 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
[e-mail]
Billing Telephone
704-865-2479
No.
Site Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Site Contact Chris Wilson
(Previous)
Site Contact Title Project Manger
(Previous)
Organization Custom Building Systems
(Previous)

First Name (New)* Chris
Last Name (New) * Wilson
NEW Site Contact* Peflects any revisions above
Chris Wilson
NEW Site Contact Project Manger
Title
NEW Organization Custom Building Systems
This field is not required on the NOI form and nay not pre -populate.
Site Contact Email [e-mail]
(Previous)
NEW Site Contact [e-mail]
Email*
Site Contact 704-865-2479
Telephone No.
(Previous)
NEW Site Contact 704-865-2479
Telephone No.*
Site Contact Mailing 4538 S. York Highway, 0, Gastonia, NC
Address (Previous) 28052
NEW Site Contact
Mailing Address*
Street Address
4538 S. York Highway
Address Line 2
Cty
Gastonia
Fbstal / Zip Code
28052
State / Rovince / Fbgion
NC
Country
us
Change Requested Chris Wilson via e-mail on 4/5/2021
by: * Include any additional correspondence records in the Pepository 00Cfolder.
Additional Information for this update to contact information:
Addional Correction to e-mail address for site contact / project manager.
Explanation
(Optional)
Date * 04/08/2021