NCG110124_Renewal COC Request_20180625 8:57:19 AM

JI
Environmental
Quality
Permit COC
NCG110124
Number *
Enter the Certificate of Coverage (COC) number, not the General Pernit number (e.g., NOG030222 is the OOC, not
NOW30000) MUST BEGIN WTTH CARTAL "NO3'
Name of Person
City of Mount Holly
Obtaining COC*
First and Last Narre
Phone Number*
704-458-1309
Email *
[e-mail]
The OOC will be e-mailed 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
NCG110000
Permit No.
COC No.
NCG110124
Permittee
City of Mount Holly
Facility Name
Mount Holly WWTP
Address
165 Broome St
City
Mount Holly
County
Gaston
Waterbody
CATAWBA RIVER (Lake Wylie below
elevation 570)
Classification
WS-IV;CA
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
�y

Date * 06/25/2018