NCG070176_Renewal COC Request_20180618 12:01:17 PM

JI
Environmental
Quality
Permit COC
NCG070176
Number *
Enter the Certificate of Coverage (COC) number, not the General Pernit number (e.g., NOG030222 is the OOC, not
Facility Name
NOW30000) MUST BEGIN WITH CARTAL "NO3'
Name of Person
Edward Garner
Obtaining COC*
First and Last Narre
Phone Number* 919-718-5181
Email * [e-mail]
The OOCw ill be e -n -ailed to this contact.
Additional Email (Optional) Enter an additional eneil address to whom to send the COC
Please review the information below for accuracy before submitting. If there are inconsistencies, please
contact Bethany Georgoulias at [phone] or [e-mail].
M aste r Ge ne ral NCG070000
Permit No.
COC No.
NCG070176
Permittee
Garners Septic Tanks Inc
Facility Name
Garners Septic Tank, Inc.
Address
121 Stanton Hill Rd
City
Carthage
County
Moore
Waterbody
Pocket Creek
Classification
C
River Basin
Cape Fear
RENEWAL STATUS
Active
Issuance Date*
05/31/2018
Effective Date
06/01/2018
1 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.
Signature *
Date * 06/18/2018