NCG060254_Renewal COC Request_20181231 9:33:42 AM

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NORTH CAFOLINA
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Permit COC
NCG060254
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 CAFTTAL "NCG'
Name of Person
Derrick Sims
Obtaining COC*
First and LastNarra
Phone Number* 336-364-6045
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.
NCG060254
Permittee
U.S. Flue -Cured Tobacco Growers, Inc.
Facility Name
U.S. Flue -Cured Tobacco Growers, Inc.
Address
250 Crown Blvd
City
Timberlake
County
Person
Waterbody
North Flat River
Classification
WS-III;NSW
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
eic. ;,ff a

Date * 12/31 /2018