NCG210206_Renewal COC Request_20180830 1:07:35 PM

Environmental
Quality
Permit COC
NCG210206
Number *
Enter the Certificate of Coverage (COC) number, not the General Pernit number (e.g., NOG030222 is the OOC, not
NCG030000) MUST BEGIN WTTH CARTAL "NO3'
Name of Person
Tim Ligowski
Obtaining COC*
First and Last Name
Phone Number*
2524597026
Email *
[e-mail]
The COCwill be e-rreiled 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
NCG210000
Permit No.
COC No.
NCG210206
Permittee
Cavalier Homes Inc DBA Clayton Nashville
Facility Name
Clayton Nashville
Address
1001 Eastern Ave
City
Nashville
County
Nash
Waterbody
Sapony Creek
Classification
WS-IV;NSW
River Basin
Tar -Pamlico
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 *
RAW,• 470Mw
Date * 08/30/2018