NCG050180_Renewal COC Request_20180622 10:49:42 AM

JI
Environmental
Quality
Permit COC
NCG050180
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
Jason Schwartz
Obtaining COC*
First and Last Narre
Phone Number*
7047329922
Email *
[e-mail]
The COCwill be e -n -ailed 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
NCG050000
Permit No.
COC No.
NCG050180
Permittee
UCS, Inc
Facility Name
UCS Main Plant
Address
511 Hoffman Rd
City
Lincolnton
County
Gaston
Waterbody
South Fork Catawba River
Classification
WS -V
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 Stormwater Permit records.
Signature
Date * 06/22/2018