NCG060231_Renewal COC Request_20181127 11:47:36 AM

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NORTH CAFOLINA
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Permit COC
NCG060231
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 CAPITAL "NCG'
Name of Person
Kelly E. Fie
Obtaining COC*
First and LastNarra
Phone Number* 9196923118
Email * [e-mail]
The COC will be e-rrailed to this contact.
Additional Email (Optional) Enter an additional errail address to whom to send the GOC
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
NCG060000
Permit No.
COC No.
NCG060231
Permittee
Santa Fe Natural Tobacco Company
Facility Name
Santa Fe Natural Tobacco Co
Address
3220 Knotts Grove Rd
City
Oxford
County
Granville
Waterbody
Fishing Creek
Classification
QNSW
River Basin
Tar -Pamlico
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 *
Date * 11 /27/2018