NCG080063_Renewal COC Request_20190206 8:30:41 PM

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Permit COC
NCG080063
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 CAFTTAL "NOG'
Name of Person
Kristen O'Reilly
Obtaining COC*
First and LastNarra
Phone Number* 7045170814
Email * [e-mail]
The COC will be e-rrailed to this contact.
Additional Email [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 NCG080000
Permit No.
COC No.
NCG080063
Permittee
Mecklenburg County Fleet
Facility Name
Mecklenburg Co - Fleet Management Facility
Address
900 W 12th St
City
Charlotte
County
Mecklenburg
Waterbody
Little Sugar Creek
Classification
C
River Basin
Catawba
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 * 02/06/2019