NCG210393_Renewal COC Request_20180910 10:09:00 AM

JI
Environmental
Quality
Permit COC
NCG210393
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
Jacob Ainsworth
Obtaining COC*
First and Last Name
Phone Number*
828-349-7003
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.
NCG210393
Permittee
Zickgraf Hardwood Flooring LLC
Facility Name
Zickgraf Hardwood Flooring, LLC -Plant Z1
Address
41 Hardwood Dr
City
Franklin
County
Macon
Waterbody
LITTLE TENNESSEE RIVER (Including the
backwaters of Lake Emory)
Classification
C
River Basin
Little Tennessee
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 * 09/10/2018