NCG030033_Renewal COC Request_20181127 4:12:34 PM

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Permit COC
NCG030033
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
Lee Hancock
Obtaining COC*
First and LastNarre
Phone Number* 336-349-2329 x111
Email * [e-mail]
The GOCwill 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.
NCG030033
Permittee
Isometrics Inc
Facility Name
Isometrics Incorporated -Plant 1
Address
1266 N Scales St
City
Reidsville
County
Rockingham
Waterbody
Wolf Island Creek
Classification
C
River Basin
Roanoke
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