NCG210168_Renewal COC Request_20180830 12:56:56 PM

JI
Environmental
Quality
Permit COC
NCG210168
Number *
Enter the Certificate of Coverage (COC) number, not the General Pernit number (e.g., NOG030222 is the OOC, not
COC No.
NCG030000) MUST BEGIN WITH CARTAL "NO3'
Name of Person
Brandy Turley
Obtaining COC*
First and Last Narre
Phone Number* 9197050526
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.
NCG210168
Permittee
Georgia Pacific Wood Products LLC
Facility Name
Dudley Plywood Plant
Address
139 Brewington Rd
City
Dudley
County
Wayne
Waterbody
Brooks Swamp (Buck Sw)
Classification
WS-IV;NSW
River Basin
Neuse
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