NCG110149_Renewal COC Request_20190528 3:48:15 PM

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NORTH CAFOLINA
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Permit COC
NCG110149
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
David M. Mohr, PE
Obtaining COC*
First and LastNarre
Phone Number* 910-937-7550
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.
NCG110149
Permittee
Onslow Water and Sewer Authority
Facility Name
Northwest Regional WRF
Address
189 Mills Field Rd
City
Richlands
County
Onslow
Waterbody
Cowhorn Swamp
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 *
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Date * 05/28/2019