NCG080759_Renewal COC Request_20181213 1:13:58 PM

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Permit COC
NCG080759
Number *
Enter the Certificate of Coverage (GOC) number, not the General Fbrmt nurrber (e.g., NCGO30222 is the COC, not
NCG030000) M-ST BEGIN WTTH CAPITAL "NCG'
Name of Person
Su Son
Obtaining COC*
First and LastNarre
Phone Number* 252-301-0508
Email * [e-mail]
The COC will be e-rrailed to this contact.
Additional Email (Optional) Enter an additional email address to whom to send the GOC
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.
NCG080759
Permittee
Chesapeake & Albermarle Railroad
Facility Name
Chesapeake & Albermarle Railroad
Address
1500 Lexington Dr
City
Elizabeth City
County
Pasquotank
Waterbody
Knobbs Creek
Classification
C;Sw
River Basin
Pasquotank
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 * 12/13/2018