NCG210402_Renewal COC Request_20180830 12:47:17 PM

JI
Environmental
Quality
Permit COC
NCG210402
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 WITH CARTAL "NO3'
Name of Person
Mark Delosreyes
Obtaining COC*
First and Last Name
Phone Number* 2527712497
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 NCG210000
Permit No.
COC No.
NCG210402
Permittee
JW Jones Lumber Company Inc
Facility Name
J.W. Jones Lumber Company
Address
1105 Poindexter St
City
Elizabeth City
County
Pasquotank
Waterbody
Knobbs Creek
Classification
C;Sw
River Basin
Pasquotank
RENEWAL STATUS
Active
Issuance Date*
07/31/2018
Effective Date
08/01/2018
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 * 08/30/2018