NCG120042_Renewal COC Request_20181205 1:41:23 PM

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Permit COC
NCG120042
Number *
Enter the Certificate of Coverage (OOC) number, not the General Fbrmt nurrber (e.g., NCGO30222 is the COC, not
NCG030000) M-ST BEGIN WTTH CAPITAL "NCG'
Name of Person
David Lambert
Obtaining COC*
First and LastNarre
Phone Number* 704-878-5432
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].
Master General NCG120000
Permit No.
COC No.
NCG120042
Permittee
Iredell County
Facility Name
Iredell County Solid Waste
Address
354 Twins Oaks Rd
City
Statesville
County
Iredell
Waterbody
Fourth 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 * 12/05/2018