NCG210266_Renewal COC Request_20180831 10:33:32 AM

Envirnnmun tat
Quality
Permit COC
NCG210266
Number *
Enter the Certificate of Coverage (COC) number, not the General Rsnit number (e.g., NOG030222 is the COC, not
NOW30000) MJST BEGIN WTTH CAPRAL "NOG'
Name of Person
Lesley Anderson
Obtaining COC*
First and Last Nbrre
Phone Number*
7045394751
Email*
[e-mail]
The COCwill be e-mailed to this contact.
Additional Email
(Optional) Enter an additional erreiladdress towhom tosend the OOC
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
NCG210000
Permit No.
COC No.
NCG210266
Permittee
Somers Lumber & Mfg
Facility Name
Somers Lumber & Mfg
Address
1872 W Memorial Hwy
City
Union Grove
County
Iredell
Waterbody
Hunting Creek
Classification
WS -III
River Basin
Yadkin
RENEWAL STATUS
Active
Issuance Date *
07/31/2018
Effective Date
08/01/2018
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 * 08/31/2018