NCG030674_Owner Affiliation Change Request_20210510

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 5/10/2021 9:24:05 AM (Owner Affiliation Change Submission)
Approve by McCoy, Suzanne 5/10/2021 3:53:26 PM (Notification to Admin)
• The task was assigned to McCoy, Suzanne 5/10/2021 9:24 AM

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Default Page
NPDES Permit
Enter your MPDES storrrwater pernit nunber or Certificate of Coverage (COC) nunber.
Number*
NCG030674
NCS)00000(orNQG)00000(
Submittor's Name*
Reaseenter your FIRST and LAST narre
Jeremy ElRite
Phone Number*
Reaseenter your phone nunber
9197753628
Any format is fine.
Email Address *
Rease enter a valid a-rrail address
[e-mail]
A confirmation of submission will be e-rrailed 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 "FbrnitCWnerAffiliation Designation Fornl'
Upload* Change of Owner.pdf 311.14KB
pdf only

Initial Review
Project ID * Peviewer rmy revise perrrit nunber below if incorrect.
NCG030674