NCG210444_Renewal COC Request_20180921 10:32:57 AM

Environmental
Quality
Permit COC
NCG210444
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
Charles E. Powell, Jr.
Obtaining COC*
First and Last Narre
Phone Number*
919-566-4018
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.
NCG210444
Permittee
Wyeth LLC
Facility Name
Wyeth, LLC
Address
4300 Oak Park Rd
City
Sanford
County
Lee
Waterbody
Little Buffalo Creek
Classification
C
River Basin
Cape Fear
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 *
C -A? 'S C9 Wil,
Date * 09/21/2018