NCG210406_Renewal COC Request_20180905 9:39:22 AM

JI
Environmental
Quality
Permit COC
NCG210406
Number *
Enter the Certificate of Coverage (COC) number, not the General Pernit number (e.g., NOG030222 is the OOC, not
Facility Name
NCG030000) MUST BEGIN WITH CARTAL "NO3'
Name of Person
Paul Comings
Obtaining COC*
First and Last Narre
Phone Number* 704-872-6366
Email * [e-mail]
The COCwill be e -n -ailed to this contact.
Additional Email (Optional) Enter an additional enail 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.
NCG210406
Permittee
Godfrey Lumber Co Inc
Facility Name
Godfrey Lumber Company
Address
1715 Amity Hill Rd
City
Statesville
County
Iredell
Waterbody
Third Creek (Third Creek WS No. 37)
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 *
wdl (34Ml Vr$
Date * 09/05/2018