NCG100082_Renewal COC Request_20181205 9:06:44 AM

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Permit COC
NCG100082
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
BRIAN KISER
Obtaining COC*
First and LastNarra
Phone Number* 704-309-2446
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].
Master General NCG100000
Permit No.
COC No.
NCG100082
Permittee
City Salvage Inc
Facility Name
City Salvage Incorporated
Address
3628 Northley Rd
City
Charlotte
County
Mecklenburg
Waterbody
Irwin Creek
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 *
J)'s. '

Date * 12/05/2018