NCG080823_Renewal COC Request_20181213 12:40:23 PM

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Permit COC
NCG080823
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
Debbie L Falls
Obtaining COC*
First and LastNarre
Phone Number* 7049277370
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 NCG080000
Permit No.
COC No.
NCG080823
Permittee
Rolling Frito-Lay Sales LP
Facility Name
Kings Mountain Bin
Address
564 Waco Rd
City
Kings Mountain
County
Cleveland
Waterbody
Potts Creek (Pilot Branch)
Classification
C
River Basin
Broad
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 * 12/13/2018