NCG030676_Renewal COC Request_20181219 12:26:32 PM

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NORTH CAFOLINA
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Permit COC
NCG030676
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
Alex Roberts
Obtaining COC*
First and LastNarre
Phone Number* 7043007801
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 NCG030000
Permit No.
COC No.
NCG030676
Permittee
Greenheck Fan Corporation
Facility Name
Greenheck - Kings Mountain
Address
110 Enterprise Dr
City
Kings Mtn
County
Cleveland
Waterbody
Beason Creek
Classification
C
River Basin
Broad
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 * 12/19/2018