NCG210432_Renewal COC Request_20180831 10:50:42 AM

Environmental
Quality
Permit COC
NCG210432
Number *
Enter the Certificate of Coverage (COC) number, not the General Pernit number (e.g., NOG030222 is the OOC, not
NOW30000) MUST BEGIN WTTH CARTAL "NO3'
Name of Person
Sulley Quinones Pellot
Obtaining COC*
First and Last Narre
Phone Number*
4074624854
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.
NCG210432
Permittee
Chep Services LLC
Facility Name
CHEP Charlotte
Address
5808 Long Creek Park Dr
City
Charlotte
County
Mecklenburg
Waterbody
Long Creek
Classification
C
River Basin
Catawba
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