NCG030653_Renewal COC Request_20190108 1:16:24 PM

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NORTH CAFOLINA
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Permit COC
NCG030653
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
Tiffanee Grumbly
Obtaining COC*
First and LastNarre
Phone Number* 904-861-2819
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
NCG030000
Permit No.
COC No.
NCG030653
Permittee
Csx Transportation Inc
Facility Name
Hamlet Turnout Facility
Address
113 Sheppard St
City
Hamlet
County
Richmond
Waterbody
Marks Creek (Boyds Lake, City Lake,
Everetts Lake)
Classification
C
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 * 01 /08/2019