NCG030376_Renewal COC Request_20181214 4:54:04 PM

'rl n
NORTH CAFOLINA
Emlre -.1 Qd Wy
Permit COC
NCG030376
Number *
Enter the Certificate of Coverage (GOC) number, not the General Fbrmt nurrber (e.g., NCGO30222 is the COC, not
NCG030000) M-ST BEGIN WITH CAPITAL "NCG'
Name of Person
Anthony Woodard
Obtaining COC*
First and LastNarre
Phone Number* 252-972-6032
Email * [e-mail]
The GOCwill be e-rrailed to this contact.
Additional Email (Optional) Enter an additional email address to whom to send the CDC
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.
NCG030376
Permittee
Draka Elevator Products
Facility Name
Draka Elevator Products Incorporated
Address
2151 N Church St
City
Rocky Mount
County
Nash
Waterbody
TAR RIVER
Classification
QNSW
River Basin
Tar -Pamlico
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 *
�j�lil�Jldra']r ��/Odd�rPtl.�
Date * 12/14/2018