NCG080892_Renewal COC Request_20181213 1:30:56 PM

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NORTH CAFOLINA
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Permit COC
NCG080892
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.
NCG080892
Permittee
Rolling Frito-Lay Sales LP
Facility Name
Wallace Bin
Address
3824 NC Hwy 11
City
Wallace
County
Duplin
Waterbody
Paget Branch
Classification
C;Sw
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 * 12/13/2018