NCG030156_Renewal COC Request_20190312 2:40:31 PM

'rl n
NORTH CAFOLINA
Emlre -.1 Qd Wy
Permit COC
NCG030156
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
Matthew Jones
Obtaining COC*
First and LastNarre
Phone Number* 9103617014
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
NCG030000
Permit No.
COC No.
NCG030156
Permittee
Scotland Manufacturing Co Inc
Facility Name
Scotland Manufacturing Co Inc
Address
22261 Skyway Church Rd
City
Laurinburg
County
Scotland
Waterbody
Shoe Heel Creek (Big Shoe Heel Creek)
(Ma)don Pond)
Classification
C;Sw
River Basin
Lumber
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 * 03/12/2019