NCG110141_Renewal COC Request_20180622 3:00:48 PM

Envirnnmun tat
Quality
Permit COC
NCG110141
Number *
Enter the Certificate of Coverage (COC) number, not the General Pernit nunber (e.g., N0G030222 is the OCC, not
N00030000) MJST BEGIN WTTH CAPRAL "NO3'
Name of Person
Michael Dean Rhoney
Obtaining COC*
First and Last Nbrre
Phone Number*
3366261201
Email*
[e-mail]
The COCwill be e-mailed 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].
Master General
NCG110000
Permit No.
COC No.
NCG110141
Permittee
City of Asheboro
Facility Name
Asheboro WWTP
Address
1032 Bonkemeyer Dr
City
Asheboro
County
Randolph
Waterbody
Haskett Creek
Classification
C
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 Stormwater Permit records.
Signature *
Date * 06/22/2018