NCG030308_Renewal COC Request Review (Revised Address)_20210818

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 8/18/2021 8:13:15 AM (COC Request Submission)
Submit by McCoy, Suzanne 8/18/2021 8:24:19 AM (Review COC Request for NCG030308)
• The task was assigned to McCoy, Suzanne. The due date is: August 23, 2021 5:00 PM
8/18/2021 8:13 AM

Permit COC NCG030308
Number * Enter the Certificate of Coverage (000) nun ber. MIST BEGIN WITH CARTAL "NOG'
NOTE: You can verify the COC facility information and renewal status by running this Permit Summary Report (check the
Permit Status at the top of the report). If the permit is expired, a renewal COC will not be available. This may be
because fees are owed. You can check for outstanding invoices at https://deq.nc.gov/sw-epayments.
r- the COC is still expired, but owed fees have been paid.
17 permit information is incorrect or old.
What is incorrect? please change the street address from 17666 to 17665
M aste r Ge ne ral Pe rmit NCG030000
Issuance Date* 06/30/2021
Mester General Fbrnit Issuance
Effective Date 07/01/2021
Master General Perrrit Effective
Name of Person RYAN TAYLOR
Requesting COC* First and LastNarre
Phone Number* 910-591-5202
Email* [e-mail]
The CDC will be e-rrailed to this contact.
Additional Email [e-mail]
(Optional) Enter an additional enail address to whom to send the COC
I hereby request a copy of the Certificate of Coverage (COC) entered above. I understand that the COC e-mailed as a
result of this request will serve as the Permittee's record of renewed coverage under the General Permit, and that this
record must be maintained with the Permittee's NPDES Stormwater Permit records. If a COC is not available, I request a
follow-up from Stormwater Program staff.
In addition, I agree that submission of this form is a "transaction" subject to Chapter 66, Article 40 of the NC General
Statutes (the "Uniform Electronic Transactions Act"); and I agree to conduct this transaction by electronic means
pursuant to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act");
Signature
Date * 08/18/2021
Time
08:13:15 AM
Permittee *
Verify owner/operator is correct.
Godwin Mfg Co
Facility Name *
Godwin Mfg Co
Verify facility name is correct.
Address
17665 US Hwy 421 S

City Dunn
County Harnett
Is the COC eligible Check to see if it has already been renewed/created before choosing "Yes"
for renewal or r Yes (will generate anew COC).
revision?* r No, fees are still outstanding.
f No, it was already renewed and is available.
r No, for another reason.
If the COC needs to be renewed or corrected, enter waterbody information and appropriate dates below.
Receiving Water(s)
* Enter all unique receiving waters identified in BINS.
Mingo Swamp
Wate rbody
(e.g., WSIV) List rrultiple classifications as they should read on the CCC
Classification(s) *
C; SW
River Basin(s) *
Enter the river basin(s) the receiving waters drain in.
Cape Fear
COC Issuance Date*
8/17/2021
COC Effective Date*
8/17/2021
COC status in BIMS ChooseActiveifyou havejustrenewed the CCCsuccessfully.
Now r Active
f Expired
f Inactive
Comments Additional inforrration to convey to requester in a-rrail comrunication.
Corrected Facility address per request. Please replace previous COC with this
one.
Thank you for your patience and understanding.
Document(s) to add Documents that may be helpful to send requester (e.g., fees owed letter or BINS screen shot).
to records FDForJFGallowed
Request Instance ID 62391
For request tracking purposes only.
Review Date * 8/18/2021