NCG050361_Renewal COC Request_20180621 1:28:26 PM

JI
Environmental
Quality
Permit COC
NCG050361
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
Terry Devine
Obtaining COC*
First and Last Narre
Phone Number* 704-498-1202
Email * [e-mail]
The OOC will be e-mailed 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
NCG050000
Permit No.
COC No.
NCG050361
Permittee
Pratt Industries
Facility Name
Pratt Industries
Address
185 Deer Ridge Ln
City
Statesville
County
Iredell
Waterbody
Morrison 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
Date * 06/21/2018