NCG110136_Renewal COC Request_20180622 1:36:20 PM

JI
Environmental
Quality
Permit COC
NCG110136
Number *
Enter the Certificate of Coverage (COC) number, not the General Pernit number (e.g., NOG030222 is the OOC, not
COC No.
NCG030000) MUST BEGIN WTTH CARTAL "NO3'
Name of Person
Dean Gaster
Obtaining COC*
First and Last Name
Phone Number* 9108903803
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].
Master General
NCG110000
Permit No.
COC No.
NCG110136
Permittee
City of Dunn
Facility Name
Black River Wastewater Treatment Plant
Address
580 Jw Edwards Ln
City
Dunn
County
Harnett
Waterbody
Black River (Little Black River) (Popes Lake,
Rhodes Pond)
Classification
C;Sw
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 Storni Permit records.
Signature *
Date * 06/22/2018