NCG210435_Renewal COC Request_20180907 9:58:00 AM

JI
Environmental
Quality
Permit COC
NCG210435
Number *
Enter the Certificate of Coverage (COC) number, not the General Pernit number (e.g., NOG030222 is the OOC, not
COC No.
NCG030000) MUST BEGIN WTTH CARTAL "NO3'
Name of Person
Greg Jarrett
Obtaining COC*
First and Last Name
Phone Number* 336-956-2118
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.
NCG210435
Permittee
Valendrawers Inc
Facility Name
Valendrawers, Inc.
Address
555 Dixon St
City
Lexington
County
Davidson
Waterbody
North Potts Creek (Second Potts 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 *
��'w I"e
Date * 09/07/2018