NCG120066_Renewal COC Request_20181127 8:22:29 AM

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NORTH CAFOLINA
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Permit COC
NCG120066
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 CAFTTAL "NCG'
Name of Person
Anderia Byrd
Obtaining COC*
First and LastNarre
Phone Number* 336-696-5806
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 NCG120000
Permit No.
COC No.
NCG120066
Permittee
Wilkes Co
Facility Name
Roaring River Landfill
Address
9219 Elkin Hwy
City
Roaring River
County
Wilkes
Waterbody
YADKIN RIVER
Classification
WS-V
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

Date * 11 /27/2018