NCG140308_COMPLETE FILE - HISTORICAL_20170510

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
No 3v "
DOC TYPE
HISTORICAL FILE
❑ MONITORING REPORTS
DOC DATE
YYYYMMDD

1 NC Division of Energy, Mineral and Land Resources `
. 9Y.
- NPDES Stormwater Permit Contacts Summary
NC DEMLR has the following contact information in our Permit Database for Vour permit ns of 312712017.
Permit Number: NGG140308
Permit Type: Ready Mix Concrete Stormwater/Wastewater Disc hatge COC
Facility Name: Thomas Concrete of Carolina Inc Charlotte Plant
FacilityAddressi: 3701 N Graham St.�r1 J�
Facility Address2: MAY 1/' `20 1
City, State &Zip; Charlotte, NC 28206
��ff/`{ n��
Owner Name: Thomas Concrete Of Carolina Inc
Owner Type: Non-Goyefthrpent Owner Type Group: Oraanir4ti4n
has w3wi : �v trr, , r aF? w.•..ac��r -� s:srr:h9-r,..�{. _, to• �, �,,yea
I egally Responsible for Permit s:*' ' �V4H �1 , ,e t r;`1
.'..fcri. ��c t 7
;{ ��� �..-� a �'� .,. „�(itespon�b�feNcCrporate �oerlPnnupl�execup�e,;a�ff+cer qr rankg elected afTa�/9 �� I partner�or p �yne. i - .� ,�..i �.i���,y
.�-� �+i�'.�'�.�.,,,_��;�}f�..�.xar any oti+erpersan•unth delegated signatory aut�ion�r_f++om the t,�a11y-responQble person) r,:.;.,�,,a_4«�:c�`..�x,.r„x�...�" .'s'��.»?�a�
Owner Affiliation: lieff Sanders Title: VPIGM
Addressi: PO Box 790105
Address2;
City, State & Zip: Charlotte. NC 28206
Work Phone: [phone] Fax: [phone]
Email Address:
OWnerCOrita 'Person s ni T "{ �i ] �. :ra' r t_". 3El.cFr r
- �.x���_ u> .r. .t-b:t ���ra.:.,i��.�2ai :+ �•'.'y.:
Contact Name Title dA -dress Phone Email
Contact Name r= Ad¢m--;;s Phone €DA Email
Darrell Myers VP Production PO Box 790105, Charlotte, NC 28206 704-333-0390 704-335-8784
Permlt'Contact Parson{s} ���Y F�fv {�.. x f ..:i �'�f l•nr k �t 7MT7s.,
Contact Name Title Address Phone Fax Email
i7arrell Myers pO Box 790105 Charlotte, NC 28206 704-333 0390
PermiR'-t i � ii• .0 � ��-��a�}'�.�� ��'""� 1• « .��;•�-���� �� .. R_`�� .� r, ,.. �.
Contact Name LU@ Addn= Phone flu ZMAjj
V 2500 Cumberland Pkwy Suite 200 Atlanta, GA 30339 770-431-3300
3/27/2017 Page 186

1 Division of Energy, Nhneral, and Land Resources
Land Quality Section / Stormwater Program
j•3•
National Pollutant Discharge Elimination System (NPDES)
Energy, Mineral & PERMIT OWNER AFFILIATION DESIGNATION FORM
Land Resources
ENVIRONMENTAL OUALITY (Individual Legally Responsible for Permit)
Use this form if there has been:
FOR AGENCY USE ONLY
Date Received
Year
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 ownership 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
N I C I S I I I I I I N I C G I f q Q I Sle>101
2) Facility Information:
Facility name: a., 4 t c�Lw �� Psi
Company/Owner Organization: LJ "Lf ;yG
Facility address: _s'701 N , a S4-
Address
C 1� tr kc— OR za
City State Zip
To find the current legally responsible person associated with your permit, go to this website:
htt-p:Hdeq.nc.gov/about/divisions/energy- ineral-land-resources/energy-mineral-land-I)ermits/ston-nwater-program
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: 0J . je oC �T^S
First MI Last
Page 1 of 2
5 WU-OWNERAFFIL,23March2017

NPDES Stormwater Permit OWNER AFFILATION DESIGNATION Form r
(if no Facility Name/Ownership Change)
Title
1> %x -790105
Mailing Address
.vc
City State Zip
(7a�) 333 o39a
Te1e hone E-mail Address
( 70 335 X 7S t�
Fax Number
5) Reason for this change:
A result of: 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:
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.
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:
http://deg. nc. gov/about/divisi ons/energy-mineral-1 and-resources/stormwater
Page 2 of 2
SWU-0WNERAFFDr23Mar2017

State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
Michael F. Easley, Governor
Sherri Evans -Stanton, Acting Secretary
Kerr T. Stevens, Director
Mr. Hugh Gladden
Thomas Concrete of S.C., Inc.
448 Lakeshore Pkwy., Ste, 205
Rock Hill, SC 29730
Dear Mr, Gladden:
January 12, 2001
1 • �
NCDENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RF-SOURCES
Subject: General Permit No. NCG140000
Thomas Concrete of S.C. — Charlotte Plant
COC NCG 140308
Mecklenburg County
In accordance with your application for discharge permit received on December 28, 2000, 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 A and the
Memorandum of Agreement between North Carolina and the US Environmental Protection agency dated December
6, 1983.
The stormwater permit you are receiving, NCG140000, does not permit wasting concrete, dumping excess
concrete, directly into storm sewer outfalls or into waters of the state. Any facility which either dumps excess
concrete or washes excess concrete into storm sewers or waters of the state will be operating in direct violation to
both the terms of this permit and the North Carolina General Statutes. Such a discharge shall be considered an illegal
discharge and may subject the owner to enforcement actions in accordance with North Carolina General Statutes
t 43-215.6A
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 Ms. Delonda Alexander at telephone
number 919/733-5083 ext. 584.
Sincerely,
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. NCG140308
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
Federal Water Pollution Control Act, as amended,
THOMAS CONCRETE OF SOUTH CAROLINA, INC.
is hereby authorized to construct and operate a process wastewater treatment system, and is hereby authorized to
discharge process wastewater and stormwater from a facility located at
3701 N. Graham St.
Charlotte
Mecklenburg County
to receiving waters designated as a tributary to Irwin Creek, Class C waters, in the Catawba River Basin
in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts I, II, III,
IV, V, and VI of General Permit No. NCG140000 as attached.
This certificate of coverage shall become effective January 12, 2001.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day January 12, 2001.
WIL � r0 C. M'-? S
Kerr T. Stevens, Director
Division of Water Quality
By Authority of the Environmental Management Commission

Latitude:
Longitude:
350 16' 04"
80' 48' 58'
USGS Quad #:
F15SE (Derita)
Receiving Stream:
UT to Irwin Creek
Basin:
03-08-34 (Catawba)
Stream Class:
C
Thomas Concrete of S.C., Inc.
Charlotte Plant
Mecklenburg County
NCG 140308