NCG080188_Renewal COC Request_20181226 11:48:51 AM

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Permit COC
NCG080188
Number *
Enter the Certificate of Coverage (GOC) number, not the General Fbrmt nurrber (e.g., NCGO30222 is the COC, not
NCG030000) M-ST BEGIN WTH CAPRAL "NCG'
Name of Person
Terry Kolacki
Obtaining COC*
First and LastNarra
Phone Number* 6305908614
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.
NCG080188
Permittee
Superior Carriers Inc
Facility Name
Superior Carriers Inc.
Address
2831 Uwharrie Rd
City
Archdale
County
Randolph
Waterbody
Uwharrie River
Classification
WS-III
River Basin
Yadkin
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 * 12/26/2018