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HomeMy WebLinkAboutNCG100034_Renewal COC Request_20190322 5:13:12 PM'rl n NORTH CAFOLINA Emlre -.1 Qd Wy Permit COC NCGl00034 Number * Enter the Certificate of Coverage (GOC) number, not the General Fbrmt nurrber (e.g., NCGO30222 is the COC, not NCG030000) M-ST BEGIN WTTH CAFTTAL "NCG' Name of Person Brandon Walsh Obtaining COC* First and LastNarra Phone Number* 6159883371 Email * bswalsh@lkgcorp.com The COC will be e-rrailed to this contact. Additional Email (Optional) Enter an additional email address to whom to send the CDC Please review the information below for accuracy before submitting. If there are inconsistencies, please contact Bethany Georgoulias at (919) 707-3641 or bethany.georgoulias@ncdenr.gov. Master General NCGl00000 Permit No. COC No. NCG100034 Permittee Lkq Corporation Facility Name LKQ City Auto Parts Address 1301 S Miami Blvd City Durham County Durham Waterbody Little Lick Creek (including portion of Little Lick Creek Arm of Falls Lake) Classification WS-IV;NSW,CA River Basin Neuse RENEWAL STATUS Active Issuance Date * 10/29/2018 Effective Date 11/01/2018 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 * ffll&lrcr'vx L5. � l?"z Date * 03/22/2019