NCG030009_Renewal COC Request_20181127 5:51:55 PM

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NORTH CAFOLINA
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Permit COC
NCG030009
Number *
Enter the Certificate of Coverage (OOC) number, not the General Fbrmt nurrber (e.g., NCGO30222 is the COC, not
NCG030000) M-ST BEGIN WTTH CAPITAL "NCG'
Name of Person
Jacqueline Abou-Rink
Obtaining COC*
First and LastNarre
Phone Number* 336-881-6025
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 OOC
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.
NCG030009
Permittee
Thomas Built Buses Inc
Facility Name
Thomas Built Buses Inc - High Point
Address
715 W Fairfield Rd
City
High Point
County
Guilford
Waterbody
Muddy Creek
Classification
WS-IV:*
River Basin
Cape Fear
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