NCG050297_Renewal COC Request_20180627 2:10:53 PM

Envirnnmun tat
Quality
Permit COC
NCG050297
Number *
Enter the Certificate of Coverage (COC) number, not the General Rsnit number (e.g., NOG030222 is the ODC, not
N00030000) MBT BEGIN WTTH CAPRAL "NO3'
Name of Person
TJ Jakobs
Obtaining COC*
First and Last Narre
Phone Number*
8283260269
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.
NCG050297
Permittee
Klingspor Abrasives Inc
Facility Name
Klingspor Abrasives Incorporated
Address
2555 Tate Blvd SE
City
Hickory
County
Catawba
Waterbody
Miller Branch (Bolicks Dry Branch)
Classification
C
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 *
9 C��vLfd
Date * 06/27/2018