NCG110094_Renewal COC Request_20180621 11:44:05 AM

JI
Environmental
Quality
Permit COC
NCG110094
Number *
Enter the Certificate of Coverage (COC) number, not the General Pernit number (e.g., NOG030222 is the OOC, not
NOW30000) MUST BEGIN WITH CARTAL "NO3'
Name of Person
Morgan Huffman
Obtaining COC*
First and Last Name
Phone Number*
336-475-4220
Email *
[e-mail]
The OOCw ill be e-mailed to this contact.
Additional Email
[e-mail]
(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].
Master General
NCG110000
Permit No.
COC No.
NCG110094
Permittee
City of Thomasville
Facility Name
Hamby Creek WWTP
Address
110 Optimist Park Rd
City
Thomasville
County
Davidson
Waterbody
North Hamby Creek
Classification
C
River Basin
Yadkin
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 *
Datta'j'k ylj�(4 ah
Date * 06/21/2018