NCG210354_Renewal COC Request_20180831 10:49:44 AM

Environmental
Quality
Permit COC
NCG210354
Number *
Enter the Certificate of Coverage (COC) number, not the General Pernit number (e.g., NOG030222 is the OOC, not
NOW30000) MUST BEGIN WITH CARTAL "NO3'
Name of Person
Christopher Robillard
Obtaining COC*
First and Last Narre
Phone Number*
910 439 6959
Email *
[e-mail]
The OOCw ill be e-mailed 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.
NCG210354
Permittee
Unilin Flooring N V
Facility Name
Unilin
Address
149 Homanit Usa Rd
City
Mount Gilead
County
Montgomery
Waterbody
Big Town Creek
Classification
C
River Basin
Yadkin
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 * 08/31/2018