NCG090021_Renewal COC Request_20181206 1:07:34 PM

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NORTH CAFOLINA
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Permit COC
NCG090021
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
Bhupendrasing Girase
Obtaining COC*
First and LastNarre
Phone Number* 336-801-0873
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.
NCG090021
Permittee
Akzo Nobel Coatings Inc
Facility Name
Akzo Nobel Coatings Incorporated
Address
1431 Progress Ave
City
High Point
County
Guilford
Waterbody
Uwharrie River
Classification
WS-III
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 *
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Date * 12/06/2018