NCG090025_Renewal COC Request_20181206 12:39:43 PM

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NORTH CAFOLINA
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Permit COC
NCG090025
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
Ed Cueva
Obtaining COC*
First and LastNarra
Phone Number* 704-794-7066
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.
NCG090025
Permittee
Bonakemi USA Inc
Facility Name
BonaKemi USA, Inc.
Address
4275 Corporate Ctr Dr
City
Monroe
County
Union
Waterbody
East Fork Twelvemile 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

Date * 12/06/2018