NCG030255_Renewal COC Request_20181126 10:58:50 AM

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NORTH CAFOLINA
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Permit COC
NCG030255
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
Curtis Daniels
Obtaining COC*
First and LastNarra
Phone Number* 7047683230
Email * [e-mail]
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 NCG030000
Permit No.
COC No.
NCG030255
Permittee
J C Steele & Sons Inc
Facility Name
J C Steele And Sons Incorporated
Address
710 S Mulberry St
City
Statesville
County
Iredell
Waterbody
Fourth Creek
Classification
C
River Basin
Yadkin
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 *
&&mod 06W,W,4
Date * 11 /26/2018