NCG080828_Renewal COC Request_20181221 9:50:29 AM

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NORTH CAFOLINA
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Permit COC
NCG080828
Number *
Enter the Certificate of Coverage (GOC) number, not the General Fbrmt nurrber (e.g., NCGO30222 is the COC, not
NCG030000) M-ST BEGIN WTTH CAPITAL "NCG'
Name of Person
Matt Einsmann
Obtaining COC*
First and LastNarre
Phone Number* 9196722837
Email * [e-mail]
The COC will 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 NCG080000
Permit No.
COC No.
NCG080828
Permittee
Republic Services of North Carolina LLC
Facility Name
Republic Waste Services -Dunn
Address
2435 2477 US 301 N
City
Dunn
County
Harnett
Waterbody
Stony Run (Hannas Pond)
Classification
C;Sw
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 *
&W,Me4rJ.S.d# WAI
Date * 12/21 /2018