NCG110085_Renewal COC Request_20190412 2:32:54 PM

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NORTH CAFOLINA
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Permit COC
NCG110085
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 "NCG'
Name of Person
Chris McCorquodale
Obtaining COC*
First and LastNarre
Phone Number* 919-742-4581
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 NCG110000
Permit No.
COC No.
NCG110085
Permittee
Town of Siler City
Facility Name
Siler City WWTP
Address
370 Waste Treatment Plant Rd
City
Siler City
County
Chatham
Waterbody
Loves Creek
Classification
C
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 * 04/12/2019