NCG080876_Renewal COC Request_20181213 1:44:34 PM

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NORTH CAFOLINA
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Permit COC
NCG080876
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.
NCG080876
Permittee
Rolling Frito-Lay Sales LP
Facility Name
Roanoke Rapids Bin
Address
1405 Hwy 48
City
Roanoke Rapids
County
Halifax
Waterbody
Little Quankey Creek
Classification
C
River Basin
Roanoke
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