NCG120001_Renewal COC Request_20181217 10:37:19 AM

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Permit COC
NCG120001
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 CAPITAL "NCG'
Name of Person
Nathalia Queen
Obtaining COC*
First and LastNarre
Phone Number* 8284658261
Email * [e-mail]
The COC will be e-rrailed to this contact.
Additional Email [e-mail]
(Optional) Enter an additional errail 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].
Master General
NCG120000
Permit No.
COC No.
NCG120001
Permittee
Catawba Co
Facility Name
Catawba County Landfill
Address
4017 Rocky Ford Rd
City
Newton
County
Catawba
Waterbody
South Fork Catawba River
Classification
WS-V
River Basin
Catawba
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 * 12/17/2018