NCG110049_Renewal COC Request_20180702 8:53:11 AM

JI
Environmental
Quality
Permit COC
NCG110049
Number *
Enter the Certificate of Coverage (COC) number, not the General Pernit number (e.g., NOG030222 is the OOC, not
NOW30000) MUST BEGIN WITH CARTAL "NO3'
Name of Person
Marla Dalton
Obtaining COC*
First and Last Name
Phone Number*
9199963700
Email *
[e-mail]
The COCwill 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
NCG110000
Permit No.
COC No.
NCG110049
Permittee
City of Raleigh
Facility Name
Little Creek WW -FP
Address
1419 INC Hwy 39
City
Zebulon
County
Wake
Waterbody
Little Creek (West Side)
Classification
QNSW
River Basin
Neuse
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 *
hra' patx
Date * 07/02/2018