NCG030600_Renewal COC Request_20181127 10:54:21 AM

'rl n
NORTH CAFOLINA
Emlre -.1 Qd Wy
Permit COC
NCG030600
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 CAPITAL "NCG'
Name of Person
David Trout
Obtaining COC*
First and LastNarre
Phone Number* 828-350-5584
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 GOC
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.
NCG030600
Permittee
Kearfott Corporation - Motion Systems
Division
Facility Name
Kearfott Corporation - Motion Systems
Division
Address
Hwy 70 W
City
Black Mtn
County
Buncombe
Waterbody
North Fork Swannanoa River and
Swannanoa River
Classification
C
River Basin
French Broad
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