NCG060161_Renewal COC Request_20181203 2:03:59 PM

'rl n
NORTH CAFOLINA
Emlre -.1 Qd Wy
Permit COC
NCG060161
Number *
Enter the Certificate of Coverage (GOC) number, not the General Fbrmt nurrber (e.g., NCGO30222 is the COC, not
NCG030000) M-ST BEGIN WITH CAPRAL "NCG'
Name of Person
Tracy Wolfe
Obtaining COC*
First and LastNarra
Phone Number* 8283296647
Email * [e-mail]
The GOCwill be e-rrailed to this contact.
Additional Email (Optional) Enter an additional email address to whom to send the GOC
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.
NCG060161
Permittee
Clement Pappas NC LLC
Facility Name
Clement Pappas Plant
Address
125 Industrial Park Rd
City
Hendersonvlle
County
Henderson
Waterbody
Mud Creek
Classification
C
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