NCG060385_Renewal COC Request_20181203 8:26:48 AM

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NORTH CAFOLINA
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Permit COC
NCG060385
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
Chip Thomas
Obtaining COC*
First and LastNarra
Phone Number* 8288835996
Email * [e-mail]
The COC will 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
NCG060000
Permit No.
COC No.
NCG060385
Permittee
Gaia Herbs Inc
Facility Name
Gaia Herbs
Address
101 Gaia Herbs Dr
City
Brevard
County
Transylvania
Waterbody
Spanish Oak Branch
Classification
C;Tr,HQW
River Basin
French Broad
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 * 12/03/2018