NCG030562_Renewal COC Request_20181207 2:25:04 PM

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NORTH CAFOLINA
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Permit COC
NCG030562
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 CAFTTAL "NCG'
Name of Person
Andrew Tye
Obtaining COC*
First and LastNarra
Phone Number* 8287656144
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.
NCG030562
Permittee
New Buck Corporation
Facility Name
New Buck Corporation
Address
200 Ethan Allen Dr
City
Spruce Pine
County
Mitchell
Waterbody
Grassy Creek
Classification
C;Tr
River Basin
French Broad
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 * 12/07/2018