NCG110145_Renewal COC Request_20190924 7:10:54 AM

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Permit COC
NCG110145
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
Evan Rubins
Obtaining COC*
First and LastNarra
Phone Number* 82844652279
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.
NCG110145
Permittee
City of Conover
Facility Name
Northeast WWTP
Address
3680 Hillview Dr
City
Conover
County
Catawba
Waterbody
Lyle Creek
Classification
C
River Basin
Catawba
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 * 09/24/2019