NCG030139_Owner Affiliation Change Request_20210521

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 5/21/2021 8:42:30 AM (Owner Affiliation Change Submission)
Approve by McCoy, Suzanne 5/21/2021 9:38:44 AM (Notification to Admin)
• The task was assigned to McCoy, Suzanne 5/21/2021 8:42 AM

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Default Page
NPDES Permit
Enter your NPIDES storrrwater pernit nunber or Certificate of Coverage (COC) nunber.
Number*
NCG030139
NCS)00000(or NCC)00000(
Submittor's Name*
Reaseenter your FIRST and LAST narre
John Small
Phone Number*
Rease enter your phone nurrber
7042785334
Any format is fine.
Email Address *
Rease enter a valid e-rrail address
[e-mail]
A confirmation of submssion will be e-mailed 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 Rease upload the signed "Permit Owner Affiliation Designation Forn'
Upload* Permit Owner Affiliation Designation Form 05-
51.42KB
2021.pdf
pdt only

Initial Review
Project ID * Peviewer nay revise perrrit nunber below if incorrect.
NCG030139