NCG210263_Renewal COC Request_20180912 10:17:00 AM

Environmental
Quality
Permit COC
NCG210263
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
Margaret Rhoades
Obtaining COC*
First and Last Narre
Phone Number*
3369733380
Email *
[e-mail]
The OOCw ill 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.
NCG210263
Permittee
Bryant Church Hardwoods Inc
Facility Name
Bryant Church Hardwoods Inc
Address
683 Buck Rd
City
Wilkesboro
County
Wilkes
Waterbody
Millers Creek
Classification
WS -IV
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 *
�rP�tr�rr t.�orr��t
Date * 09/12/2018