NCG210412_Renewal COC Request_20180905 1:37:54 PM

Environmental
Quality
Permit COC
NCG210412
Number *
Enter the Certificate of Coverage (COC) number, not the General Pernit number (e.g., NOG030222 is the OOC, not
COC No.
NOW30000) MUST BEGIN WTTH CARTAL "NO3'
Name of Person
Bristol Industries
Obtaining COC*
First and Last Name
Phone Number* 828-584-3335
Email * [e-mail]
The COCwill be e-mailed to this contact.
Additional Email (Optional) Enter an additional eneil 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.
NCG210412
Permittee
Bristol Industries Inc
Facility Name
Bristol Industries Incorporated
Address
3991 Bridgewater Rd
City
Morganton
County
Burke
Waterbody
CATAWBA RIVER (including backwaters of
Rhodhiss Lake belowelevation 995)
Classification
WS -IV
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 Storni Permit records.
Signature *
ew 6"�"e'e
Date * 09/05/2018