NCG070010_Renewal COC Request_20180618 3:57:36 PM

Environmental
Quality
Permit COC
NCG070010
Number *
Enter the Certificate of Coverage (COC) number, not the General Pernit number (e.g., NOG030222 is the OOC, not
COC No.
NOW30000) MUST BEGIN WTTH CARTAL "NO3'
Name of Person
Jeff Lamm
Obtaining COC*
First and Last Name
Phone Number* 828-253-6421
Email * [e-mail]
The COCwill be e-mailed to this contact.
Additional Email (Optional) Enter an additional email 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.
NCG070010
Permittee
Southern Concrete Materials Inc
Facility Name
Southern Concrete Materials, Inc. -Charlotte
Block
Address
5125 Roaells Ferry Rd
City
Charlotte
County
Mecklenburg
Waterbody
Stewart Creek
Classification
C
River Basin
Catawba
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 Storni Permit records.
Signature
C1`�fir.
Date * 06/18/2018