NCG080699_Renewal COC Request_20190103 5:22:14 PM

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NORTH CAFOLINA
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Permit COC
NCG080699
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
Jeff Batton
Obtaining COC*
First and LastNarra
Phone Number* 910-295-1900
Email * [e-mail]
The COC will be e-rrailed to this contact.
Additional Email (Optional) Enter an additional errail 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.
NCG080699
Permittee
Pinehurst Village
Facility Name
Pinehurst Public Works & Central
Maintenance Facility
Address
600 McCaskill Rd
City
Pinehurst
County
Moore
Waterbody
Joes Fork
Classification
WS-III
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 *
CZ
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Date * 01 /03/2019