NCG210355_Renewal COC Request_20180920 9:31:08 AM

Environmental
Quality
Permit COC
NCG210355
Number *
Enter the Certificate of Coverage (COC) number, not the General Pernit number (e.g., NOG030222 is the OOC, not
NCG030000) MUST BEGIN WITH CARTAL "NO3'
Name of Person
Phil Ferguson
Obtaining COC*
First and Last Name
Phone Number*
615-517-6828
Email *
[e-mail]
The OOCw ill 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.
NCG210355
Permittee
Louisiana-Pacific Corporation
Facility Name
Louisiana Pacific Corp
Address
PO Box 98 Hwy 268
City
Roaring River
County
Wilkes
Waterbody
YADKIN RIVER
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
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Date * 09/20/2018