NCG120047_Renewal COC Request_20181127 3:35:56 PM

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NORTH CAFOLINA
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Permit COC
NCG120047
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
Robert Hudson
Obtaining COC*
First and LastNarre
Phone Number* 423-303-7101
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.
NCG120047
Permittee
Santek Environmental of North Carolina LLC
Facility Name
Haywood Co -White Oak Sanitary
Address
3898 Fines Creek Rd
City
Waynesville
County
Haywood
Waterbody
PIGEON RIVER (Waterville Lake below
elevation 2258)
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