NCG030130_Renewal COC Request_20181203 2:53:20 PM

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NORTH CAFOLINA
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Permit COC
NCG030130
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
Ryan Pennington
Obtaining COC*
First and LastNarra
Phone Number* 704-868-5612
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.
NCG030130
Permittee
Daimler Trucks Na
Facility Name
Daimler Trucks NA
Address
1400 Tulip Dr
City
Gastonia
County
Gaston
Waterbody
Kaglor Branch and Rankin Lake
Classification
C
River Basin
Catawba
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