NCG060343_Renewal COC Request_20190211 11:33:04 AM

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NORTH CAFOLINA
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Permit COC
NCG060343
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
Pat Rowe
Obtaining COC*
First and LastNarra
Phone Number* 2525850838
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.
NCG060343
Permittee
Severn Peanut Company Inc
Facility Name
Severn Peanut Company, Inc
Address
202 Peanut St
City
Severn
County
Northampton
Waterbody
Kirbys Creek
Classification
QNSW
River Basin
Chowan
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
lt�r/LO/P'k�

Date * 02/11 /2019