NCG210111_Renewal COC Request_20180907 11:05:00 AM

Environmental
Quality
Permit COC
NCG210111
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
Mike Veihl
Obtaining COC*
First and Last Name
Phone Number*
4347971321
Email *
[e-mail]
The OOC will 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.
NCG210111
Permittee
Blue Ridge Fiberboard Inc
Facility Name
Blue Ridge Fiberboard, Inc.
Address
250 Celotex Way
City
Danville
County
Caswell
Waterbody
DAN RIVER (North Carolina portion)
Classification
WS -IV
River Basin
Roanoke
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 *
6WI-I& c l
Date * 09/07/2018