NCG210180_Renewal COC Request_20180919 2:20:47 PM

JI
Environmental
Quality
Permit COC
NCG210180
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 WITH CARTAL "NO3'
Name of Person
Logan Josey
Obtaining COC*
First and Last Name
Phone Number* 2528265614
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.
NCG210180
Permittee
Josey Lumber Company Inc
Facility Name
Josey Lumber Company Incorporated
Address
664 Lee's Meadow Rd
City
Scotland Neck
County
Halifax
Waterbody
Kehukee Swamp (White Millpond)
Classification
C
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 *
-6}r! [d
Date * 09/19/2018