NCG090019_Renewal COC Request_20181127 6:08:27 AM

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NORTH CAFOLINA
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Permit COC
NCG090019
Number *
Enter the Certificate of Coverage (OOC) number, not the General Fbrmt nurrber (e.g., NCGO30222 is the COC, not
NCG030000) M-ST BEGIN WTTH CAPITAL "NCG'
Name of Person
David Phillips
Obtaining COC*
First and LastNarra
Phone Number* 8287288266
Email* [e-mail]
The COC will be e-rrailed to this contact.
Additional Email (Optional) Enter an additional errail 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 NCG090000
Permit No.
COC No.
NCG090019
Permittee
Rpm Wood Finishes Group Inc
Facility Name
RPM Wood finishes Group, Inc.
Address
3194 Hickory Blvd
City
Hudson
County
Caldwell
Waterbody
Gunpowder Creek (Old Mill Pond)
Classification
WS-IV
River Basin
Catawba
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 /27/2018