NCG050282_Renewal COC Request_20180622 1:54:23 PM

Envirnnmun tat
Quality
Permit COC
NCG050282
Number *
Enter the Certificate of Coverage (COC) number, not the General Permit number (e.g., N0G030222 is the OCC, not
NOG030000) MJST BEGIN WTTH CAPRAL "NOG'
Name of Person
William Hoover
Obtaining COC*
First and Last WTe
Phone Number*
919-440-2152
Email*
[e-mail]
The COCwill be e -Trailed to this contact.
Additional Email
(Optional) Enter an additional email address towhom tosend the OOC
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.
NCG050282
Permittee
Cooper -Standard Automotive Inc
Facility Name
Cooper -Standard Automotive, Inc.
Address
280 Woodland Church Rd
City
Goldsboro
County
Wayne
Waterbody
NEUSE RIVER
Classification
QNSW
River Basin
Neuse
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 *
wkzCZ17G Gff
Date * 06/22/2018