NCG110022_Renewal COC Request_20180817 10:57:30 AM

JI
Environmental
Quality
Permit COC
NCG110022
Number *
Enter the Certificate of Coverage (COC) number, not the General Pernit number (e.g., NOG030222 is the OOC, not
COC No.
NOW30000) MUST BEGIN WITH CARTAL "NO3'
Name of Person
Kyle Ketchum
Obtaining COC*
First and Last Name
Phone Number* 704-282-4612
Email * [e-mail]
The COCwill be e -nailed to this contact.
Additional Email (Optional) Enter an additional enail 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.
NCG110022
Permittee
City of Monroe
Facility Name
Monroe WWTP
Address
775 Treeway Dr
City
Monroe
County
Union
Waterbody
Joes Branch and Richardson 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 *
C�r✓�
Date * 08/17/2018