NCG050141_Renewal COC Request_20180629 12:32:27 PM

JI
Environmental
Quality
Permit COC
NCG050141
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 WTTH CARTAL "NO3'
Name of Person
Johnny Welch
Obtaining COC*
First and Last Narre
Phone Number* 3364744406
Email * [e-mail]
The OOC will be e-mailed to this contact.
Additional Email (Optional) Enter an additional enail 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].
M aste r Ge ne ral
NCG050000
Permit No.
COC No.
NCG050141
Permittee
Coveris Flexibles US LLC
Facility Name
Coveris Flexibles US LLC
Address
1308 Blair St
City
Thomasville
County
Davidson
Waterbody
Hunts Fork
Classification
C
River Basin
Yadkin
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 *
I
Date * 06/29/2018