NCG050216_Renewal COC Request_20180626 11:24:09 AM

Environmental
Quality
Permit COC
NCG050216
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
Jeremy Shelton
Obtaining COC*
First and Last Name
Phone Number* 3363022036
Email * [e-mail]
The COCwill be e-mailed to this contact.
Additional Email (Optional) Enter an additional enail 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].
M aste r Ge ne ral
NCG050000
Permit No.
COC No.
NCG050216
Permittee
Prestige Fabricators Inc
Facility Name
Prestige Fabricators Incorporated -Dumont
Street
Address
2206 Dumont St
City
Asheboro
County
Randolph
Waterbody
DEEP RIVER
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 Storni Permit records.
Signature
Date * 06/26/2018