NCG080762_Renewal COC Request_20181213 1:23:47 PM

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NORTH CAFOLINA
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Permit COC
NCG080762
Number *
Enter the Certificate of Coverage (OOC) 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 Last Narre
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 OOC
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.
NCG080762
Permittee
North Carolina and Virginia Railroad
Facility Name
North Carolina and Virginia Railroad
Address
214 N Railroad St
City
Ahoskie
County
Hertford
Waterbody
Whiteoak Swamp
Classification
QNSW
River Basin
Chowan
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