NCG130048_Renewal COC Request_20190328 10:44:33 AM

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Permit COC
NCG130048
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
Thomas Frye
Obtaining COC*
First and LastNarre
Phone Number* 9194992301
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].
Master General NCG130000
Permit No.
COC No.
NCG130048
Permittee
Central Carolina Holdings LLC
Facility Name
Central Carolina Holdings, LLC
Address
1616 McKoy Town Rd
City
Cameron
County
Harnett
Waterbody
Buffalo Creek and Cypress Creek
Classification
WS-III
River Basin
Cape Fear
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 * 03/28/2019