NCG090031_Renewal COC Request_20181203 11:04:08 AM

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Permit COC
NCG090031
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
Michael Brown
Obtaining COC*
First and LastNarra
Phone Number* 9783524510
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 NCG090000
Permit No.
COC No.
NCG090031
Permittee
Rockingham Group LLC
Facility Name
2135 Manufacturing, LLC
Address
106 Enterprise Dr
City
Rockingham
County
Richmond
Waterbody
Cartledge Creek
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 * 12/03/2018