NCG210249_Renewal COC Request_12/13/2022 12:52:12 PM

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 12/13/2022 12:52:11 PM (COC Request Submission)

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NORTH CAROLINA
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Permit COC Number*
NCG210249
Enter the Certificate of Coverage (COC) number, not the General Permit number (e.g., NCG030222 is the COC,
not NCG030000) MUST BEGIN WITH CAPITAL "NCG"
Name of Person
Gary Middleton
Obtaining COC*
First and Last Name
Phone Number*
4349497707
Email*
[e-mail]
The COC will be e-mailed to this contact.
Additional Email
[e-mail]
(Optional) Enter an additional email address to whom to send the COC
Did you check the permit COC file in our repository to ensure this COC was not already available from a previous
request? If it is, please
obtain it from there instead of this form.
* Yes, this COC was not already there.
Please review the information below for accuracy before submitting. If there are inconsistencies, please
contact Bethany Georgoulias at [phone] or [e-mail].
Master General
NCG210000
Permit No.
COC No.
NCG210249
Permittee
Meherrin River Forest Products
Facility Name
Meherrin River Forest Products Weldon
Address
1772 Trueblood Rd
City
Weldon
County
Halifax
Waterbody
Chockoyotte Creek
Classification
C
River Basin
Roanoke
RENEWAL STATUS
Active
Issuance Date*
07/31/2018
Effective Date
08/01/2018
Effective Date
20180801
Reformatted

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.
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 * 12/13/2022