NCG060089_Renewal COC Request_20181215 12:49:41 PM

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Permit COC
NCG060089
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
Michael Mulier
Obtaining COC*
First and LastNarre
Phone Number* 910-892-3175
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
NCG060000
Permit No.
COC No.
NCG060089
Permittee
Dunbar Foods Corporation
Facility Name
Moody Dunbar Incorporated
Address
1000 S Fayetteville A
City
Dunn
County
Harnett
Waterbody
Black River (Little Black River) (Popes Lake,
Rhodes Pond)
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 * 12/15/2018