NCG060339_Renewal COC Request_20181127 4:08:08 PM

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NORTH CAFOLINA
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Permit COC
NCG060339
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 CAFTTAL "NOG'
Name of Person
Robert Elks
Obtaining COC*
First and LastNarra
Phone Number* 252-482-2193 e)d 7427
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.
NCG060339
Permittee
Jimbo's Jumbos Peanuts
Facility Name
Jimbo's Jumbo's Peanuts
Address
185 Peanut Dr
City
Edenton
County
Chowan
Waterbody
Potts Creek and Queen Anne Creek
Classification
C and QNSW
River Basin
Little Tennessee and Chowan
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 /27/2018