NCG100066_Renewal COC Request_20181127 4:44:35 PM

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NORTH CAFOLINA
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Permit COC
NCGl00066
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
LOUTA MOTOR COMPANY
Obtaining COC*
First and LastNarre
Phone Number* 3362491557
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 CDC
Please review the information below for accuracy before submitting. If there are inconsistencies, please
contact Bethany Georgoulias at [phone] or [e-mail].
Master General
NCGl00000
Permit No.
COC No.
NCG100066
Permittee
Louia Motor Co Inc
Facility Name
Louia Motor Co Incorporated
Address
2647 E US Hwy 64
City
Lexington
County
Davidson
Waterbody
Pounder Fork
Classification
WS-V,B
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