NCG050368_Renewal COC Request_20180625 10:19:57 AM

JI
Environmental
Quality
Permit COC
NCG050368
Number *
Enter the Certificate of Coverage (COC) number, not the General Pernit number (e.g., NOG030222 is the OOC, not
NCG030000) MUST BEGIN WITH CARTAL "NO3'
Name of Person
Theresa Elliott
Obtaining COC*
First and Last Narre
Phone Number*
813-783-7212 ext.3314
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.
NCG050368
Permittee
Latham Pool Products Inc
Facility Name
Viking Pools, LLC -Rockingham Facility
Address
162 Enterprise Rd
City
Rockingham
County
Richmond
Waterbody
Cartledge Creek
Classification
C
River Basin
Yadkin
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 *
eef C-6
Date * 06/25/2018