NCG030478_Renewal COC Request_20181128 8:24:54 AM

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Permit COC
NCG030478
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 CAPITAL "NCG'
Name of Person
Phil Stilwell
Obtaining COC*
First and LastNarre
Phone Number* 704-994-6377
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].
M aste r Ge ne ral NCG030000
Permit No.
COC No.
NCG030478
Permittee
Columbus McKinnon-Wadesboro Oprs
Facility Name
Columbus McKinnon-Wadesboro Oprs.
Address
2020 Country Club Rd
City
Wadesboro
County
Anson
Waterbody
Lampley Branch
Classification
C
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 /28/2018