NCG090028_Renewal COC Request_20190102 6:56:48 AM

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Permit COC
NCG090028
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
Libby Robinson
Obtaining COC*
First and LastNarra
Phone Number* 9194611517
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 NCG090000
Permit No.
COC No.
NCG090028
Permittee
Coatings and Adhesives Corporation
Facility Name
Coatings and Adhesives Corp - Leland
Address
1901 Popular St NE
City
Leland
County
Brunswick
Waterbody
Sturgeon Creek
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 *
Date * 01 /02/2019