NCG070206_Renewal COC Request_20181010 4:07:38 PM

Envirnnmun tat
Quality
Permit COC
NCG070206
Number *
Enter the Certificate of Coverage (COC) number, not the General Rsnit number (e.g., NOG030222 is the OCC, not
N0W30000) MJST BEGIN WTTH CAPRAL "NO3'
Name of Person
Jamie Smith
Obtaining COC*
First and Last Nbrre
Phone Number*
704-660-0900
Email*
[e-mail]
The COCwill be e-mailed to this contact.
Additional Email
(Optional) Enter an additional email address to whom to send the OOC
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
NCG070000
Permit No.
COC No.
NCG070206
Permittee
Cardinal Fg
Facility Name
Cardinal FG
Address
342 Mooresville Blvd
City
Mooresville
County
Iredell
Waterbody
Back Creek
Classification
WS-II;HQW
River Basin
Yadkin
RENEWAL STATUS
Active
Issuance Date*
05/31/2018
Effective Date
06/01/2018
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 * 10/10/2018