NCG180003_Renewal COC Request_20191024 6:40:22 AM

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NORTH CAFOLINA
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Permit COC
NCG180003
Number *
Enter the Certificate of Coverage (COC) number, not the General Fbrmt number (e.g., NCGO30222 is the COC, not
NCG030000) M-ST BEGIN WTTH CAPITAL "NCG'
Name of Person
Bonita Ann Mathis
Obtaining COC*
First and LastNarra
Phone Number* 7046924001
Email * [e-mail]
The COC will be e-rrailed to this contact.
Additional Email [e-mail]
(Optional) Enter an additional email 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].
Master General NCG180000
Permit No.
COC No.
NCG180003
Permittee
Westrock Converting Company
Facility Name
WestRock Converting Company
Address
376 Pine St Ext
City
Forest City
County
Rutherford
Waterbody
Morrow Creek
Classification
WS-V
River Basin
Broad
RENEWAL STATUS
Active
Issuance Date*
08/01/2019
Effective Date
08/01/2019
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
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Date * 10/24/2019