NCG030450_Renewal COC Request_20181204 1:09:36 PM

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NORTH CAFOLINA
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Permit COC
NCG030450
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 "NCG'
Name of Person
Mike Brown
Obtaining COC*
First and LastNarra
Phone Number* 2529339547
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
NCG030000
Permit No.
COC No.
NCG030450
Permittee
Electrolux Home Products
Facility Name
Electrolux Home Products
Address
4580 W Vernon Ave
City
Kinston
County
Lenoir
Waterbody
Falling Creek
Classification
C;Sw,NSW
River Basin
Neuse
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 *
N6Pan

Date * 12/04/2018