NCG140283_COMPLETE FILE - HISTORICAL_20170510

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/v No a b 2j
DOC TYPE
C! HISTORICAL FILE
❑ MONITORING REPORTS
DOC DATE
❑ �al 7 O
YYYYMMDD

NC Division of Energy, Mineral and Land Resources
NPDES Stormwater Permit Contacts Summary
NC DEMLR has the following contact information in our Permit Database for vour Dermit as of 312712017.
Permit Number: NCG140283
Permit Type: Readv Mix Conaete Stormwater/Wastewater Discharge COC
Facility Name: Thomas Concrete ofjCaro1in-al I —rcI Goncocd Plant rV D
Facility Addressl: 6364 Poplar Tent Rd. MAY 0 2017
Facility Address2:
City, State & Zip: Concord, NC 28027i r ,
Owner Information Details:
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_ MU57;sutbtnrt a Change aflYame/Ownersh2nforni,tn D�MLRto make any cfianges W,th�s Owner;information. � -
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'� Y i See,�Miscellaneaus:Forms�,�at h ortal.ncdenr.a weh Ir n des-starmwater�_ � „�.
Owner Name: Thomas Concrete Of Carolina inc
Owner Type: Non -Government Owner Type Group: QmarilzaWO
Owner Affiliation: J7eff ders
Addressl: PO Box 790105
Address2:
City, State & Zip: Charlotte. NC 28206
Work Phone:
Email Address:
Title: VPIGM''
Fax: [phone]
Orvner,ContactiPe�son(s) dxsr' 3 IN
Contact Name rift Address Phone EM Emai1
ContactJName Ella Address Phone fix 9111"
Darrell Myers VP Production PO Box 790105, Charlotte, NC 28206 704-333-0390 704-335-8784
Contact Name Title del dress one Fax MCI •
Farrell Myers . - PO Box 790105 C_harl_oite, NE�28206 704�33330390
Perm�itSilling:Contact-
Contact Name Addim Phone F LIZ" V/
250'0 Cumberland - Su'te 200 Atlanta, GA 30339 770-431-3300
3/27/2017 Page 186

C.
Division of Energy, Mineral, and Land Resources
i Land Quality Section / Stormwater Program
r National Pollutant Discharge Elimination System (NPDES)
Energy, lVltnercts .. PE'
LandResourcesRMIT OWNER AFFILIATION DESIGNATION FORM
iattd
c'NVjftQNMENTALOUAUTY (individual Legally Responsible for Permit)
Use this form if there has been:
FOR AGENCY USE ONLY
Date Received
Year
I Month
Da
NO CHANGE in facility ownership or facility name, but the individual
who is legally responsible for the permit has changed.
If the name of the facility has changed, -or if the owne`rshin of the facility has changed,
do NOT use this form. Instead, you must Fill out a Name -Ownership Change Form
and submit the completed form with all required documentation.
What does "legally responsible individual" mean?
The person is either:
• the responsible corporate officer (for a corporation);
• the principle executive officer or ranking elected official (for a municipality, state, federal or other public
agency);
• the general partner or proprietor (for a partnership or sole proprietorship);
• or, the duly authorized representative of one of the above.
1) Enter the permit number for which this change in Legally Responsible Individual ("Owner Affiliation')
applies:
Individual Permit (or) Certificate of Coverage
Nj C I S N C -G til I IJ Z$ 3
2) Facility Information:
Facility name: % of NO -It
Company/Owner Organization: & j ,.
Facility address: �60 — 4, �0o/Q,. /t
Address
AY, ABo-A 7
City State Zip
To find the current legally responsible person associated with your permit, go to this website:
http://deq.nc.gov/about/divisions/energy-mineral-land-resources/energy-mineral-land-permits/storinwater-prp ogram
and run the Permit Contact Summary Report.
3) OLD OWNER AFFILIATION that should be removed:
Previous legally responsible individual:
First MI Last
4) NEW OWNER AFFILIATION (legally responsible for the permit):
Person legally responsible for this permit:
First MI Last
Page 1 of 2
r
S WU-O WNERAFFLIr23March2017

NPDES Stormwater Permit OWNER AFFILATION DESIGNATION Form
(if no Facility Name/Ownership Change)
v. 6 Q
Title
Ax -74a 1 oS
Mailing Address
City State Zip
-
Telephone E-mail Address
8-784
Fax Number
5) Reason for this change:
A result of: Lr Employee or management change
❑ Inappropriate or incorrect designation before
❑ Other
If other please explain:
The certification below must be completed and signed by the permit holder.
PERMITTEE CERTIFICATION:
I, si C-FPO l , attest that this application for this change in Owner Affiliation
(person legally responsible for the permit) has been reviewed and is accurate and complete to the best of my
knowledge. I understand that if all required parts of this form are not completed, this change may not be
processed.
�'J
OM --
Signature Date
PLEASE SEND THE COMPLETED FORM TO:
Division of Energy, Mineral, and Land Resources
Stormwater Program
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
For more information or staff contacts, please call [phone] or visit the website at:
htt ://de .ne. ov/about/divisions/ener -mineral-land-resources/stormwater
Page 2 of 2
S W U-OWNERAFFJ1,23 Mar2017

I G", �
Thomd!�
CONCRETE
May 9, 2017
Division of Energy, Mineral, and Land Resources
Stormwater Program
1612 Mail Service Center
Raleigh, N.C. 27699-1612
RE: Thomas Concrete of Carolina Permit Contact Information
REFCE/k/et)
OAY�
I am enclosing the reports, for the following Thomas Concrete Plants:
Charlotte
Gastonia
Concord
Monroe
Huntersville
Airport
Harrisburg
Mooresville
Denver
If you have any questions, please contact at 803.242.0691.
Thank you,
DARRELL MYERS
Production Manager
Tharmas Concrete,; 3701 N. Graham. St., P.O, Sox 790105 Charlotte„NC 28206
a
Tel [phone] Fax [phone] WWWA iomasconcrete.cam�..
";,

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State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
Jaynes B. Hunt, Jr., Governor
Bill Holman, Secretary
Kerr T. Stevens, Director
March 31, 2000
Dan O'Shaughnessey
448 Lakeshore Parkway, Suite 205
Rock Hill, SC
29730
A • e
NCDENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
Subject: General Permit No. NCG 140000
Concord Plant -Thomas Concrete, SC
COC NCG140283
Cabarrus County
Dear Mr. O'Shaughnessey:
In accordance with your application for discharge permit received on October 20,1999 we are
forwarding herewith the subject certificate of coverage to discharge under the subject state - NPDES
general permit. This permit is issued pursuant to the requirements of North Carolina General Statute
143-215 .1 and the Memorandum of Agreement between North Carolina and the US Environmental
Protection agency dated December 6, 1983-
If any parts, measurement frequencies or sampling requirements contained in this permit are
unacceptable to you, you have the right to request an individual permit by submitting an individual
permit application. Unless such demand is made, this certificate of coverage shall be final and binding.
Please take notice that this certificate of coverage is not transferable except after notice to the
Division of Water Quality. The Division of Water Quality may require modification or revocation and
reissuance of the certificate of coverage.
This permit does not affect the legal requirements to obtain other permits which may be required
by the Division of Water Quality or permits required by the Division of Land Resources, Coastal Area
Management Act or any other Federal or Local governmental permit that may be required.
If you have any questions concerning this permit, please contact Antonio Evans at telephone
number 919/733-5083 ext. 584.
Sincerely,
ORIGINAL SIGNED BY
WILLIAM C. MILLS
Kerr T. Stevens
cc: Mooresville Regional Office
Central Files
Stormwater and General Permits Unit Files
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE No. NCG140283
STORMWATER AND PROCESS WASTEWATER DISCHARGES
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards and
regulations promulgated and adopted by the North Carolina Environmental Management Commission, and the
C•ederal Water Pollution Control Act, as amended,
Thomas Concrete of South Carolina, Inc.
is hereby authorized to operate a process wastewater treatment system, and is hereby authorized to discharge process
wastewater and stormwater from a facility located at
Concord Plant
6360 Poplar Tent Road
Concord, NC
Cabarrus County
to receiving waters designated as Coddle Creek, class C waters, in the Yadkin River Basin
in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts 1, I1, III,
IV, V, and VI of General Permit No. NCG140000 as attached.
This certificate of coverage shall become effective March 31. 2000.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day March 31, 2000.
ORIGINAL SIGNED BY
WILLIAM C. MILLS
for Kerr T. Stevens, Director
Division of Water Quality
By Authority of the Environmental Management Commission

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Markers
Name: NCG140283 Concord Plant
Short Name: NCG140
Coordinates: 0350 24' 22.3" N, 080" 40' 32.5" W
Comment: County: Cabarrus, Map #:F16NW, Subbasin #: 03-07-11, Recv. Stream: Coddle Creek, Stream Class: C