NCG060114_Renewal COC Request_20190122 6:58:49 AM

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NORTH CAFOLINA
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Permit COC
NCG060114
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
Katherine Lane
Obtaining COC*
First and LastNarre
Phone Number* 910-691-8882
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.
NCG060114
Permittee
Unilever Manufacturing US Inc
Facility Name
Unilever Raeford facility
Address
100 Faberge Blvd
City
Raeford
County
Hoke
Waterbody
Pedler Branch
Classification
C
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
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Date * 01 /22/2019