NCG140293_Updated Contact Info_20220301

NC Division of Energy, Mineral and Land Resources
NPDES Stormwater Permit Summary
NC DEMLR has the following information in our Permit Database for your hermit as of 2/23/2022.
Permit Number: NCG140293 Permit Status: Active
Permit Type: Ready Mix Concrete Stormwater/Wastewater Discharge COC
Facility Name: Eagle hock Concrete -Wilson Plant
Facility Addressi: 3214 Turnage Rd
Facility Address2:
City, State & Zip: Wilson, NC 27893-7580
Owner -Information Details:
MUST submit a Change of Name/Owme►shipform to DEMLR to make any changes to this Owner information.
(Click Here for "Change of Name/Ownership"Form j
Owner Name: Eagle Rock Concrete
y/ Owner Type: Non -Government Owner Type Group: Organization
*** Legally Responsible for Permit ***
(Responsible corporate officer/ principle executive officer or ranking elected official/general partner or proprietor;
or any other person with delegated signatory authority from the legally responsible person.)
Owner Affiliation: Adam Loftin Title:
Addressl: 8311 Bandford Way Ste 003
Address2:
JCity, State & Zip: Raleigh. NC 27515
Work Phone: [phone] Fax:
Email Address: adamCa eaglerockconcretexom
*** Permit Annual Fee Billing ***
Billing Month: June
Invoice Number Invoice Date invoice Due Date invoice Amount Invoice Status
Owner Contact Person(s)
Contact Name Tis Address Phone Fax Email
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Facility Contact Person(s)
Contact Name Tie Address Phone Fax Email
]ay-�c ieveatr 293=f15-0& -�r@eaglerockconeret
Permit Contact Person(s)
Contact Name Ijag Address Phone Fax Email
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2/23/2022

NC Division of Energy, Mineral and Land Resources
NPDES Stormwater Permit Summary
NC DE- -MLR has the following information_ in our Permit Database, f , or, your permit as of 2/2312022.
Permit Billing Contact(s)
Contact Namg T._ i 2 Address Phone Fax Emil
Spreelrn� F53-293'0='00' 252 299-6638
Air
Person(s) with Delegated Signatory Authority V� 37Y
IM Contact N r e IjLIg AAd ,gjj Phone
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W661ky M45S6y &ST ,�IS �iQ�L�lGx� �G f w�s�
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Persons) with Electronic Signature Authority
1�am Contact Names Ift Addreg Phone FM Kniau
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Outfalis
Outfall #: Q Outfall Description: 61077rM4 pa/
Outfall Lattitude: 35,682220
Stormwater: 100
Basin
Neuse
Outfall Longitude:-77,952220
a/a Industrial:
Waterbody Name
Contentnea Creek (Wiggins Mill Reservoir)
Represented by Outfall:
Stream
Index Number
27-86-(5.8)
Waterbody
Classification
WS-IV;NSW,CA
2/23/2022