NCG030125_Renewal COC Request_20181220 4:55:46 PM

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NORTH CAFOLINA
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Permit COC
NCG030125
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
CONNIE PETTIS
Obtaining COC*
First and LastNarre
Phone Number* 2518677752
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.
NCG030125
Permittee
Frit Car, Inc.
Facility Name
Frit Car Incorporated
Address
Hwy 17 N
City
Bridgeton
County
Craven
Waterbody
Mills Branch
Classification
SC;Sw,NSW
River Basin
Neuse
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 * 12/20/2018