NCS000061_Owner Affiliation Change Request_20201112

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 11/12/2020 4:45:01 PM (Owner Affiliation Change Submission)
Approve by McCoy, Suzanne 11/20/2020 11:26:02 AM (Notification to Admin)
• The task was assigned to McCoy, Suzanne 11/12/2020 4:45 PM

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Default Page
NPDES Permit
Enter your NPIDES storrrwater pernit nunber or Certificate of Coverage (COC) nunber.
Number*
NCS000061
NCS)00000(orNCG)00000(
Submittor's Name*
Reaseenter your FIRST and LAST narre
Darrell G Wilson
Phone Number*
Reaseenter your phone nunber
8287283271
Any format is fine.
Email Address *
Rease enter a valid a-rrail address
[e-mail]
A confirmation of submission will be e-mailed to this address.
Need a copy of the Permit Owner Affiliation Designation Form? You must upload a signed copy of that form below.
Questions? Call Bethany Georgoulias at [phone] or e-mail her at.bethany.georgouliasencdenr.gov.
Completed Form Reaseupload the signed "FbrnitCwnerAffiliation Designation Forn'
Upload* NPDES Stormwater Permit OWNER AFFILIATION
990.76KB
DESIGNATION.pdf
pdt only

Initial Review
Project ID * Reviewer may revise permt nunber below if incorrect.
NCS000061