NCG080669_Renewal COC Request_20190214 9:05:44 AM

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Permit COC
NCG080669
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
Dusty Wentz
Obtaining COC*
First and LastNarra
Phone Number* 828/695/4210
Email * [e-mail]
The GOCwill be e-rrailed to this contact.
Additional Email (Optional) Enter an additional errail 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.
NCG080669
Permittee
City of Newton
Facility Name
Newton City - Public Works Complex
Address
201 W 4th St
City
Newton
County
Catawba
Waterbody
Hildebran Creek (Anthony 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 *
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Date * 02/14/2019