NCG070167_Renewal COC Request_20190116 10:33:29 AM

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NORTH CAFOLINA
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Permit COC
NCG070167
Number *
Enter the Certificate of Coverage (COC) number, not the General Fbrmt number (e.g., NCGO30222 is the COC, not
NCG030000) M-ST BEGIN WTTH CAPITAL "NCG'
Name of Person
David McKeown
Obtaining COC*
First and LastNarra
Phone Number* 803-691-3121
Email * [e-mail]
The COC will be e-rrailed to this contact.
Additional Email patsy. [e-mail]
(Optional) Enter an additional email address to whom to send the COC
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 NCG070000
Permit No.
COC No.
NCG070167
Permittee
Meridian Brick LLC
Facility Name
Meridian Brick, LLC
Address
700 S Long St
City
East Spencer
County
Rowan
Waterbody
Town Creek
Classification
C
River Basin
Yadkin
RENEWAL STATUS
Active
Issuance Date*
05/31/2018
Effective Date
06/01/2018
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 * 01/16/2019