NCG170068_Renewal COC Request_20200207 8:57:34 AM

NORTH C W Q-rA
EnHmnmertm! dafny
Permit COC
NCG170068
Number *
Enter the Certificate of Coverage (COC) nun ber, not the General Pen-rit nurrber (e.g., N00030222 is the OOC, not
N00030000) M-ST BEGIN WTTH CARTAL "NCG'
Name of Person
Adam Davis
Obtaining COC*
First and Last Name
Phone Number* 8288947249
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.
NCG170068
Permittee
Milliken & Company
Facility Name
Milliken and Co -Hatch Plant
Address
960 E NC Hwy 108
City
Columbus
County
Polk
Waterbody
Whiteoak Creek
Classification
C
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 *
0,14�11r 6?ly

Date * 02/07/2020