NCG060216_Renewal COC Request_20181210 5:08:28 PM

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NORTH CAFOLINA
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Permit COC
NCG060216
Number *
Enter the Certificate of Coverage (GOC) number, not the General Fbrmt nurrber (e.g., NCGO30222 is the COC, not
NCG030000) M-ST BEGIN WTTH CAPITAL "NCG'
Name of Person
Kevin Weston
Obtaining COC*
First and LastNarra
Phone Number* 910-293-5363
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.
NCG060216
Permittee
Murphy -Brown LLC
Facility Name
Laurinburg Feed Mill (Murphy -Brown LLC)
Address
19600 Andrew Jackson Hwy
City
Laurinburg
County
Scotland
Waterbody
Leith Creek (Johns Pond)
Classification
C;Sw
River Basin
Lumber
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 * 12/10/2018