NCG120070_Owner Affiliation Change Request_20210622

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 6/22/2021 11:39:53 AM (Owner Affiliation Change Submission)
Approve by McCoy, Suzanne 7/1/2021 8:28:27 AM (Notification to Admin)
• The task was assigned to McCoy, Suzanne 6/22/2021 11:40 AM

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Default Page
NPDES Permit
Enter your NPIDES storrrwater pernit nunber or Certificate of Coverage (COC) nunber.
Number*
NCG120070
NCS)00000(or NCC)00000(
Submittor's Name*
Please enter your FIRST and LAST narre
Kenn Webb
Phone Number*
Rease enter your phone nurrber
18288841842
Any format is fine.
Email Address *
Rease enter a valid a -mail 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 Reaseupload the signed "FbrrritOwner Affiliation DesignationForn'
Upload* Permit Owner Affiliation Designation Form,
751.84KB
062221. pdf
pdf only

Initial Review
Project ID * Peviewer rmy revise perrrit nunber below if incorrect.
NCG120070