NCG050173_Renewal COC Request_20181001 2:45:53 PM

JI
Environmental
Quality
Permit COC
NCG050173
Number *
Enter the Certificate of Coverage (COC) number, not the General Pernit number (e.g., NOG030222 is the OOC, not
NOW30000) MUST BEGIN WITH CARTAL "NO3'
Name of Person
Christopher France
Obtaining COC*
First and Last Narre
Phone Number* 252-456-6602
Email * [e-mail]
The OOCw ill be e-mailed to this contact.
Additional Email (Optional) Enter an additional eneil 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].
M aste r Ge ne ral NCG050000
Permit No.
COC No. NCG050173
Permittee International Paper Company
Facility Name International Paper Company
Address 967 US Hwy 1
City Manson
County Warren
Waterbody Rocky Creek
Classification QNSW
River Basin Tar -Pamlico
RENEWAL STATUS Active
Issuance Date* 05/31/2018
Effective Date 06/01/2018
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 * 10/01/2018