NCG130083_Renewal COC Request_20190515 11:03:07 AM

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Permit COC
NCG130083
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
Dell Golanski
Obtaining COC*
First and LastNarra
Phone Number* 281-923-2494
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].
Master General NCG130000
Permit No.
COC No.
NCG130083
Permittee
Strategic Materials
Facility Name
Strategic Materials (Wilson)
Address
2606 Wilco Blvd
City
Wilson
County
Wilson
Waterbody
Hominy Swamp
Classification
C;Sw,NSW
River Basin
Neuse
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 * 05/15/2019