NCG080368_Renewal COC Request_20181213 11:26:45 AM

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NORTH CAFOLINA
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Permit COC
NCG080368
Number *
Enter the Certificate of Coverage (COC) number, not the General Fbrmt number (e.g., NCGO30222 is the COC, not
NOG030000) M-ST BEGIN WTTH CAPITAL "NCG'
Name of Person
JAMES W. WILLARD II
Obtaining COC*
First and LastNarre
Phone Number* 704-662-8192
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 NCG080000
Permit No.
COC No.
NCG080368
Permittee
United Parcel Service Inc
Facility Name
United Parcel Service -Chapel Hill
Address
7411 Rex Road
City
Chapel Hill
County
Orange
Waterbody
Old Field Creek
Classification
WS-V;NSW
River Basin
Cape Fear
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 * 12/13/2018