NCG060182_Renewal COC Request_20200121 11:01:39 AM

NORTH C W Q-rA
EnHmnmertm! dafny
Permit COC
NCG060182
Number *
Enter the Certificate of Coverage (COC) nun ber, not the General P n-rit nurrber (e.g., N00030222 is the OOC, not
NCG030000) M-ST BEGIN WTTH CARTAL "NCG'
Name of Person
Yin-Pong George CHANG, P. E.
Obtaining COC*
First and Last Narre
Phone Number*
7046244317
Email*
[e-mail]
The COC w ill be e-nailed to this contact.
Additional Email
(Optional) Enter an additional enailaddress towhom tosend 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.
NCG060182
Permittee
Pilgrim's Pride Corporation
Facility Name
Pilgrim's Pride - Marshville Complex
Address
5901 Hwy 74 E
City
Marshville
County
Union
Waterbody
Salem Creek
Classification
C
River Basin
Yadkin
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 * 01 /21 /2020