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HomeMy WebLinkAboutNCG110062_Renewal COC Request_20180628 11:39:04 AMJI Environmental Quality Permit COC NCG110062 Number * Enter the Certificate of Coverage (COC) number, not the General Pernit number (e.g., NOG030222 is the OOC, not COC No. NCG030000) MUST BEGIN WITH CARTAL "NO3' Name of Person Timothy Robbins Obtaining COC* First and Last Narre Phone Number* (919)894-3553 Email * trobbins@townofbenson.com The OOCw ill be e-mailed to this contact. Additional Email (Optional) Enter an additional eneil 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 (919) 807-6372 or bethany.georgoulias@ncdenr.gov. Master General NCG110000 Permit No. COC No. NCG110062 Permittee Town of Benson Facility Name Benson WWTP Address 770 Hannah Creek Rd City Benson County Johnston Waterbody Hannah Creek Classification QNSW 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 * %w#� w4v Date * 06/28/2018