NCG210179_Renewal COC Request_20180830 2:46:21 PM

Envirnnmun tat
Quality
Permit COC
NCG210179
Number *
Enter the Certificate of Coverage (COC) number, not the General Rsrrit number (e.g., NOG030222 is the OCC, not
N00030000) MBT BEGIN WTTH CAPRAL "NO3'
Name of Person
Clay Culberson
Obtaining COC*
First and Last Nbrre
Phone Number*
9196632323
Email*
[e-mail]
The COCw ill be e-mailed to this contact.
Additional Email
(Optional) Enter an additional errail address to whom to send the OOC
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.
NCG210179
Permittee
Carolina Wood Enterprises Inc
Facility Name
Carolina Wood Enterprises Inc
Address
902 S Chatham Ave
City
Siler City
County
Chatham
Waterbody
Loves Creek
Classification
C
River Basin
Cape Fear
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 *
&11031 gid" &&
Date * 08/30/2018