NCG240012_Owner Affiliation Change Request_20210713

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 7/13/2021 9:54:22 AM (Owner Affiliation Change Submission)
Approve by McCoy, Suzanne 7/15/2021 7:05:56 PM (Notification to Admin)
• The task was assigned to McCoy, Suzanne 7/13/2021 9:54 AM

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Default Page
NPDES Permit
Enter your MPDES storrrwater pernit nunber or Certificate of Coverage (COC) nunber.
Number*
NCG240012
NCS)00000(or NCC)00000(
Submittor's Name*
Reaseenter your FIRST and LAST narre
Meagan Lewis
Phone Number*
Reaseenter your phone nunber
9199069737
Any format is fine.
Email Address *
Rease enter a valid a-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 Reaseupload the signed "FbrnitC,vnerAffiliation Designation Fornl'
Upload* YWC Stormwater designation SWS.pdf 704.97KB
pdr only

Initial Review
Project ID * Reviewer may revise permt nunber below if incorrect.
NCG240012