NCG100079_Renewal COC Request_20181123 4:55:28 PM

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NORTH CAFOLINA
Emlre -.1 Qd Wy
Permit COC
NCGl00079
Number *
Enter the Certificate of Coverage (COC) number, not the General Fbrmt number (e.g., NCGO30222 is the COC, not
NCG030000) M-ST BEGIN WTTH CAPITAL "NOG'
Name of Person
Debbie Lassiter
Obtaining COC*
First and LastNarre
Phone Number* 9192426154
Email * [e-mail]
The COC will be e-rrailed 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 NCGl00000
Permit No.
COC No.
NCG100079
Permittee
Green's Auto Salvage Inc
Facility Name
Green's Auto Salvage Incorporated
Address
2646 NC Hwy 222 E
City
Fremont
County
Wayne
Waterbody
Watery Branch
Classification
C;Sw,NSW
River Basin
Neuse
RENEWAL STATUS
Active
Issuance Date *
10/29/2018
Effective Date
11/01/2018
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 * 11 /23/2018