NCC233744_Contact Update Record_20231228

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by Tev.Holloman 12/28/2023 3:26:44 PM (Contact Changes Submitted)

Contact • - for • • • ONLY)
updatesThis form • . .
Certificate of NCC233744
Coverage(COC) No.* Enter the Certificate of Coverage Number(Use capital letters)
NC Reference No. NCG01-2023-3744
Original NOI No.* 174159
Project information associated with this permit(cannot change):
Permittee Listed Organizaiton cannot be changed(new COC required)
J.H. Reaben Oil and Supply Company, Inc.
Project Name Triangle Stop Mills River-Proposed Expansion
Address 4197 Haywood Road, Mills River, NC
County Henderson
Latitude 35.3884
Longitude -82.5660
Date COC Issued* 12/21/2023
Prior Rescission Date This field will populate only if COC has already been rescinded.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? Q No
n Yes
Billing Email [e-mail]
NEW Billing Email [e-mail]
Billing Telephone No. 828-692-0246
NEW Billing 828-692-0246 ext 309
Telephone No. (Optional)
Change Requested Hall Waddell,via email on 12/28/2023
by:* Include any additional correspondence records in the Repository COC folder.
Additional Information for this update to contact information:
Addional Explanation
(Optional)
Date* 12/28/2023