NCC202331_Contact Update Record (Leg Resp and Site Contact)_20221024

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Georgoulias, Bethany A 10/24/2022 12:26:31 PM (Contact Changes Submitted)

Certificate of NCC202331
Coverage (COC) No.* Enter the Certificate of Coverage Number (Use capital letters)
NC Reference No. NCG01-2020-2331
Original NOI No.* 26483
Project information associated with this permit (cannot change):
Permittee Listed Organizaiton cannot be changed (new COC required)
ThermoFisher Scientific
Project Name ThermoFisher Temporary Parking Lot
Address 5900 Martin Luther King Jr. Hwy, Greenville, NC
County Pitt
Latitude 35.6601
Longitude-77.3601
Date COC Issued * 06/12/2020
Prior Rescission Date This field will populate only if COC has already been rescinded.
Which Contacts Have Billing Only
Changed?* Legally Responsible Individual Only
Site Contact Only
• BOTH Legally Responsible Individual and Site Contact
Has Billing Contact Choose'Yes'to revise Billing Contact details.
Changed? U No
Yes
Billing Email
NEW Billing Email adam.campbell@thermof!sher.com
Billing Telephone No.
NEW Billing [phone]
Telephone No. (Optional)
Legally Responsible Individual Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Legally Responsible Brandon Williamson
Individual (Previous)
First Name (New)* Adam
Last Name (New)* Campbell

NEW Legally Reflects any revisions above
Responsible Adam Campbell
Individual*
Permittee Email [e-mail]
(Previous)
NEW Permittee [e-mail]
Email*
Permittee Telephone [phone]
No. (Previous)
NEW Permittee [phone]
Telephone No.*
Permittee Mailing 5900 Martin Luther King Jr. Hwy, 0,
Address (Previous) Greenville, NC 27834
NEW Permittee Street Address
Mailing Address* 5900 Martin Luther King Jr. Hwy
Address Line 2
City
State / Province / Region
Greenville
NC
Postal / Zip Code
Country
27834
USA
Permittee Street 5900 Martin Luther King Jr. Hwy, 0,
Address (Previous) Greenville, NC 27834
NEW Permittee Street Street Address
Address* 5900 Martin Luther King Jr. Hwy
Address Line 2
City State / Province / Region
Greenville NC
Postal / Zip Code Country
27834 USA
Site Contact Information
REVISE ONLY WHERE NECESSARY. KEEP INFORMATION THESAME IF NO CHANGES!
Site Contact Brandon Williamson
(Previous)
Site Contact Title Project Engineer
(Previous)
Organization ThermoFisher Scientific
(Previous)
First Name (New)* Adam
Last Name (New)* Campbell
NEW Site Contact* Reflects any revisions above
Adam Campbell

NEW Site Contact Sr. Manager Project Engineering
Title
NEW Organization ThermoFisher Scientific
This field is not required on the NOI form and may not pre -populate.
Site Contact Email [e-mail]
(Previous)
NEW Site Contact [e-mail]
Email*
Site Contact 252-413-8827
Telephone No.
(Previous)
NEW Site Contact [phone]
Telephone No.*
Site Contact Mailing 5900 Martin Luther King Junior Highway, 0,
Address (Previous) Greenville, NC 27834
NEW Site Contact Street Address
Mailing Address* 5900 Martin Luther King Junior Highway
Address Line 2
City
State / Province / Region
Greenville
NC
Postal / Zip Code
Country
27834
us
Change Requested Adam Campbell via e-mail on 10/21/2022.
by: * Include any additional correspondence records in the Repository COC folder.
Additional Information for this update to contact information:
Addional Explanation
(Optional)
Date * 10/24/2022