NCG070201_Renewal COC Request_20180717 12:33:56 PM

Environmental
Quality
Permit COC
NCG070201
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
Patrick Cavanagh
Obtaining COC*
First and Last Narre
Phone Number*
3363226314
Email *
[e-mail]
The COCwill be e -n -ailed 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.
NCG070201
Permittee
Certain Teed Gypsum Inc
Facility Name
Certain Teed Gypsum Inc
Address
921 Shore Dr
City
Semora
County
Person
Waterbody
Hyco River, including Hyco Lake below
elevation 410
Classification
WS-V,B
River Basin
Roanoke
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 *

Date * 07/17/2018