NCG070187_Renewal COC Request_20190322 11:23:49 AM

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NORTH CAFOLINA
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Permit COC
NCG070187
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 CAFTTAL "NCG'
Name of Person
Jerome Coker
Obtaining COC*
First and LastNarre
Phone Number* 9106162994
Email * [e-mail]
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 [phone] or [e-mail].
M aste r Ge ne ral
NCG070000
Permit No.
COC No.
NCG070187
Permittee
Cape Fear Precast LLC
Facility Name
Cape Fear Precast Mildred Thomas Crt
Facility
Address
620 Mildred Ct
City
Jacksonville
County
Onslow
Waterbody
NEW RIVER
Classification
QNSW
River Basin
White Oak
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 * 03/22/2019