NCC201416_Contact Update Record_20210505

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Georgoulias, Bethany A 5/5/2021 4:22:24 PM (Contact Changes Submitted)

Certificate of NCC201416
Coverage (COC) Enter the Certificate of Coverage N.mber (use capital letters)
No.*
NC Reference No. NCG01-2020-1416
Original NOI No.* 24145
Project information associated with this permit (cannot change):
Permittee Listed Organizaiton cannot be changed (new OOC required)
City of Raleigh
Project Name
DE Benton WTP Dewatering Facilities
Address
2301 Benson Road, Garner, NC
County
Wake
Latitude
36.0000
Longitude
-79.0000
Date COC Issued*
04/08/2020
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This field will populate only if COChas already been rescinded.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 919-996-3477
Telephone No. (Optional)
Change Requested Dennis Lassiter via e-mail on 5/5/2021.
by: * Include any additional correspondence records in the Fbpository COCfolder.
Additional Information for this update to contact information:

Addional
Explanation
(Optional)
Date * 05/05/2021