NCG060117_Renewal COC Request_20181126 1:59:39 PM

'rl n
NORTH CAFOLINA
Emlre -.1 Qd Wy
Permit COC
NCG060117
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
SHEILA I HIGGINBOTHAM
Obtaining COC*
First and LastNarra
Phone Number* 2523484364
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].
M aste r Ge ne ral NCG060000
Permit No.
COC No.
NCG060117
Permittee
Venture Milling Inc
Facility Name
Venture Milling, Inc.- Ansonville
Address
N NCSR 1627 And US 52
City
Ansonville
County
Anson
Waterbody
Rocky River
Classification
C
River Basin
Yadkin
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 /26/2018