NCG070072_Renewal COC Request_20180709 10:02:53 AM

JI
Environmental
Quality
Permit COC
NCG070072
Number *
Enter the Certificate of Coverage (COC) number, not the General Pernit number (e.g., NOG030222 is the OOC, not
NOW30000) MUST BEGIN WTTH CARTAL "NO3'
Name of Person
Larry Ball
Obtaining COC*
First and Last Name
Phone Number*
7043614155
Email *
[e-mail]
The COCwill be e-mailed to this contact.
Additional Email
Larry. [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.
NCG070072
Permittee
Old Castle Precast Inc
Facility Name
NC Products - Raleigh
Address
920 Withers Rd
City
Raleigh
County
Wake
Waterbody
Unnamed Tributary to Swift Creek (Yates Mill
Pond)
Classification
WS-III;NSW
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
t�Y w

Date * 07/09/2018