NCG060151_Renewal COC Request_20181217 10:44:34 AM

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NORTH CAFOLINA
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Permit COC
NCG060151
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 CAPRAL "NOG'
Name of Person
Christina Fleming
Obtaining COC*
First and Last Nbrra
Phone Number* 9197783130
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.
NCG060151
Permittee
Goldsboro Milling Company
Facility Name
Goldsboro Milling Company
Address
938 Miller's Chapel Rd
City
Goldsboro
County
Wayne
Waterbody
Walnut Creek (Lake Wackena, Spring Lake)
Classification
QNSW
River Basin
Neuse
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 *
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Date * 12/17/2018