NCG100146_Renewal COC Request Review_20220408

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 4/7/2022 12:24:58 PM (COC Request Submission)
Submit by Georgoulias, Bethany A 4/8/2022 8:49:02 AM (Review COC Request for NCG100146)
* Renewed coverage upon fees resolution.
The task was assigned to Georgoulias, Bethany A. The due date is: April 12, 2022 5:00 PM
4/7/2022 12:25 PM

Permit COC Number* NCG100146
Enter the Certificate of Coverage (COC) number. MUST BEGIN WITH CAPITAL "NCG"
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.
the COC is still expired, but owed fees have been paid.
permit information is incorrect or old.
Master General Permit NCG100000
Issuance Date*
06/30/2021
Master General Permit Issuance
Effective Date
07/01/2021
Master General Permit Effective
Name of Person
Jeff Gerlock
Requesting COC*
First and Last Name
Phone Number* 336-382-6849
Email* [e-mail]
The COC will be e-mailed to this contact.
Additional Email (Optional) Enter an additional email 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 * 04/07/2022
Time 12:24:58 PM
Permittee * Verify owner/operator is correct.
All Star Auto Parts Inc
Facility Name* All Star Auto Parts, Inc
Verify facility name is correct.
Address 7224 Old Lexington Rd
City Winston Salem
County Davidson

Is the COC eligible Check to see if it has already been renewed/created before choosing "Yes"
for renewal or • Yes (will generate a new COC).
revision?* No, fees are still outstanding.
No, it was already renewed and is available.
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 BIMS.
Unnamed tributary to Soakas Creek
Waterbody
(e.g., WS-IV) List multiple classifications as they should read on the COC.
Classification(s) *
C
River Basin(s) *
Enter the river basin(s) the receiving waters drain in.
Yadkin
COC Issuance Date*
4/7/2022
COC Effective Date*
4/7/2022
COC status in BIMS
Choose Active if you have just renewed the COC successfully.
Now*
• Active
Expired
Inactive
Comments
Additional information to convey to requester in e-mail communication.
Payment processed on 3/30/2022. Permit coverage has been renewed.
Document(s) to add
Documents that may be helpful to send requester (e.g., fees owed letter or BIMS screen shot).
to records
NCG100146 BIMS Active Status and Paid
110.72KB
Fees_20220408.JPG
PDF or JPG allowed
Request Instance ID
86688
For request tracking purposes only.
Review Date*
4/8/2022