NCG080927_Renewal COC Request_20181120 7:52:16 AM

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NORTH CAFOLINA
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Permit COC
NCG080927
Number *
Enter the Certificate of Coverage (GOC) number, not the General Fbrmt nurrber (e.g., NCGO30222 is the COC, not
NCG030000) M-ST BEGIN WTTH CAFTTAL "NCG'
Name of Person
Chelsea Seagle
Obtaining COC*
First and LastNarra
Phone Number* 734-757-1657
Email * Chelsea.Seagle@>po.com
The COC will be e-rrailed to this contact.
Additional Email (Optional) Enter an additional email address to whom to send the CDC
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 NCG080000
Permit No.
COC No.
NCG080927
Permittee
Con -Way Freight
Facility Name
Con -Way Freight - NLB
Address
4715 W Fifth St
City
Lumberton
County
Robeson
Waterbody
Jacob Swamp (Jacob Branch)
Classification
C;Sw
River Basin
Lumber
RENEWAL STATUS
Active
Issuance Date*
11/16/2018
Effective Date
11/16/2018
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 * 11 /20/2018