NCG080909_Renewal COC Request_20190114 12:48:00 PM

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NORTH CAFOLINA
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Permit COC
NCG080909
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
Toni Scott
Obtaining COC*
First and LastNarra
Phone Number* 9373821494
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.
NCG080909
Permittee
Greenwood Motor Lines Inc
Facility Name
R+L Carriers - CHR
Address
175 N Pine Rdg Rd
City
China Grove
County
Rowan
Waterbody
Cold Water Creek
Classification
WS-IV
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 /14/2019