NCG050137_Renewal COC Request_20180823 10:27:52 AM

JI
Environmental
Quality
Permit COC
NCG050137
Number *
Enter the Certificate of Coverage (COC) number, not the General Pernit number (e.g., NOG030222 is the OOC, not
Facility Name
NOW30000) MUST BEGIN WTTH CARTAL "NO3'
Name of Person
Michael Henderson
Obtaining COC*
First and Last Name
Phone Number* 919-575-6515
Email * [e-mail]
The COCwill be e-mailed to this contact.
Additional Email (Optional) Enter an additional eneil 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].
M aste r Ge ne ral NCG050000
Permit No.
COC No.
NCG050137
Permittee
J -M Manufacturing Co Inc
Facility Name
JM Eagle
Address
2602 W Lyon Station Rd
City
Creedmoor
County
Granville
Waterbody
Ledge Creek (Lake Rogers)
Classification
WS-II;HQW,NSW,CA
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 *
Date * 08/23/2018