NCG070122_Renewal COC Request_20180627 3:35:53 PM

JI
Environmental
Quality
Permit COC
NCG070122
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
DAVID E MCKINNEY
Obtaining COC*
First and Last Narre
Phone Number*
3365585447
Email *
[e-mail]
The OOCw ill be e-rreiled 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
NCG070000
Permit No.
COC No.
NCG070122
Permittee
Hydro Conduit Corp
Facility Name
Hydro Conduit Corp -Davidson 208
Address
208 Randoph Rd
City
Thomasville
County
Davidson
Waterbody
Hamby 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 *
4*1�
Date * 06/27/2018