NCG080761_Renewal COC Request_20181217 8:37:03 AM

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NORTH CAFOLINA
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Permit COC
NCG080761
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 CAFTTAL "NCG'
Name of Person
Brenden Rose
Obtaining COC*
First and LastNarre
Phone Number* 870-365-4087
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.
NCG080761
Permittee
Fedex Freight Inc
Facility Name
Fed Ex Freight, Inc - WMN
Address
10214 Blackwell Rd
City
Leland
County
Brunswick
Waterbody
Brunswick River
Classification
SC
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 * 12/17/2018