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HomeMy WebLinkAboutNCG070163_Renewal COC Request_20180913 11:18:38 AMJI Environmental Quality Permit COC NCG070163 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 Doug Fouts Obtaining COC* First and Last Name Phone Number* 336 275-9114 Email * doug.fouts@oldcastle.com The COCwill 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. M aste r Ge ne ral NCG070000 Permit No. COC No. NCG070163 Permittee Bonsal American Inc Facility Name Bonsal American - Lilesville Address 351 Hailey's Ferry Rd City Lilesville County Anson Waterbody Island Creek 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 Date * 09/13/2018