NCG060069_Renewal COC Request_20181128 4:44:06 PM

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NORTH CAFOLINA
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Permit COC
NCG060069
Number *
Enter the Certificate of Coverage (OOC) number, not the General Fbrmt nurrber (e.g., NCGO30222 is the COC, not
NCG030000) M-ST BEGIN WTTH CAPITAL "NCG'
Name of Person
APRIL HALEY
Obtaining COC*
First and LastNarre
Phone Number* 336-207-5348
Email * [e-mail]
The COC will be e-rrailed to this contact.
Additional Email (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].
M aste r Ge ne ral NCG060000
Permit No.
COC No.
NCG060069
Permittee
Procter & Gamble Manufacturing
Facility Name
Procter & Gamble Mfg -Brown Sum
Address
6200 Bryan Park Rd
City
Browns Summit
County
Guilford
Waterbody
Reedy Fork (Hardys Mill Pond)
Classification
WS-V;NSW
River Basin
Cape Fear
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 /28/2018