NCG170423_Renewal COC Request_20191118 10:01:58 AM

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Permit COC
NCG170423
Number *
Enter the Certificate of Coverage (COC) nun ber, not the General Parnit nurrber (e.g., N00030222 is the ODC, not
NCG030000) M-ST BEGIN WTTH CARTAL "NCG'
Name of Person
Tim Young
Obtaining COC*
First and Last Name
Phone Number* 662-284-3578
Email * [e-mail]
The COC w ill be e-nailed to this contact.
Additional Email [e-mail]
(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 [phone] or [e-mail].
Master General
NCG170000
Permit No.
COC No.
NCG170423
Permittee
Kimberly-Clark Corporation
Facility Name
Kimberly Clark -Berkeley Mill-Nonwovens
Address
Smythe Mills
City
Hendersonville
County
Henderson
Waterbody
Mud Creek
Classification
C
River Basin
French 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 *

Date * 11 /18/2019