NCG030504_Renewal COC Request_20181130 8:43:40 AM

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NORTH CAFOLINA
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Permit COC
NCG030504
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 CAFTTAL "NCG'
Name of Person
Sharon Owens
Obtaining COC*
First and LastNarre
Phone Number* 919-831-3227
Email * [e-mail]
The GOCwill 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].
M aste r Ge ne ral NCG030000
Permit No.
COC No.
NCG030504
Permittee
Flowserve US Inc
Facility Name
Flowserve US Inc -Raleigh
Address
1900 S Saunders St
City
Raleigh
County
Wake
Waterbody
Walnut Creek
Classification
QNSW
River Basin
Neuse
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 /30/2018