NCG050098_Renewal COC Request_20180710 1:55:13 PM

Envirnnmun tat
Quality
Permit COC
NCG050098
Number *
Enter the Certificate of Coverage (COC) number, not the General Rsnit number (e.g., NOG030222 is the OCC, not
N0W30000) NMT BEGIN WTTH CAPRAL "NO3'
Name of Person
Beverly Welch
Obtaining COC*
First and LastNarre
Phone Number*
704-902-4522
Email*
[e-mail]
The COCwill be e -nailed to this contact.
Additional Email
(Optional) Enter an additional enailaddress 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.
NCG050098
Permittee
International Paper Company
Facility Name
International Paper Co -Container
Address
930 Meacham Rd
City
Statesville
County
Iredell
Waterbody
Gregory 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 *
OK� W"'
Date * 07/10/2018