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HomeMy WebLinkAboutNCG090006_Renewal COC Request_20190115 3:21:36 PM'rl n NORTH CAFOLINA Emlre -.1 Qd Wy Permit COC NCG090006 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 Dave Haley Obtaining COC* First and LastNarra Phone Number* 7048879450 Email * dhaley@mcpolymers.com 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 (919) 707-3641 or bethany.georgoulias@ncdenr.gov. M aste r Ge ne ral NCG090000 Permit No. COC No. NCG090006 Permittee Mallard Creek Polymers Inc Facility Name Mallard Creek Polymers Incorporated Address 2800 Morehead Rd City Charlotte County Mecklenburg Waterbody Mallard Creek 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 * z"nao. � Date * 01 /15/2019