NCG030277_Renewal COC Request_20181211 1:46:04 PM

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NORTH CAFOLINA
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Permit COC
NCG030277
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
David A Stamps
Obtaining COC*
First and LastNarre
Phone Number* 7048225182
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.
NCG030277
Permittee
Gaston Co Dyeing Machine Co
Facility Name
Gaston County Dyeing Machine C
Address
1310 Charles Jonas Raper Hwy
City
Mount Holly
County
Gaston
Waterbody
Taylors Creek
Classification
WS-IV
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 * 12/11 /2018