NCG210290_Renewal COC Request_20181022 10:33:52 AM

Environmental
Quality
Permit COC
NCG210290
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
Kevin Williams
Obtaining COC*
First and Last Narre
Phone Number*
9199344115
Email *
[e-mail]
The OOC will 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.
NCG210290
Permittee
Jerry G Williams & Sons Inc
Facility Name
Wet Log Deck Storage site
Address
524 Brogden Rd
City
Smithfield
County
Johnston
Waterbody
Polecat Branch
Classification
QNSW
River Basin
Neuse
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 *
Date * 10/22/2018