NCG060378_Renewal COC Request_20181130 10:29:59 AM

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NORTH CAFOLINA
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Permit COC
NCG060378
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
David Hamilton
Obtaining COC*
First and LastNarra
Phone Number* 9196032216
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. NCG060378
Permittee Revlon
Facility Name Revlon
Address 1501 Williamsboro St
City Oxford
County Granville
Waterbody Coon Creek
Classification QNSW
River Basin Tar -Pamlico
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 /30/2018