NCG140362_Contact Info Update_20220301

NC Division of Energy, Mineral and Land Resources
NPDES Stormwater Permit Summary
NC DEMLR has the followinu information in our Permit Database for your Dermit as of 2/23/2022.
Permit Number: NCG140362 Permit Status: Active
Permit Type: Ready Mix Concrete Stormwater/Wastewater Discharge COC
Facility Name: Eagle Rock Concrete - Selma Plant,
Facility Addressi: 3073 W Oak St
Facility Address2:
City, State & Zip: Selma NC 27576
wrier Information Details:
MUST submit a Change of Name/Ownership form to DEMLR to make any changes to this Owner information.
(Click Here for "Change of Name/Ownership"Form)
Owner Name: Eagle Rock Concrete
Owner Type: Non -Government
Owner Type Group: Qrganization
*** 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 00
Address2:
City, State & Zip: Raleigh, NC 27615
Work Phone: [phone] Fax:
Email Address: adamCdeaglerockconcrete.com
*** Permit Annual Fee Billing ***
Billing Month: January
Invoice Number Invoice Date InygilgM DUe Date invoice Amount Invoice Status
Owner Contact Person(s)
Contact Name Title Address Phon Fax Email
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Facility Contact Person(s) Cd/I
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Permit Contact Person(s)
Contact Name LftLe Addregs Phone EM Email
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2/23/2022

NC Division of Energy, Mineral and Land Resources
NPDES Stormwater Permit Summary
NC DEMLR has the followins information in our Permit Database for your permit as of 2/23/2022,
Permit Billing Contact(s)
Contact Name J:idg Address Phone Fax Kin -Aft
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Person(s) with Delegated Signatory Authority
Tyne Contact Name Title Address Phone ,ux Emaif
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Person(s) with Electronic Signature Authority
Tv`ge Ctontact Name Tag Address Phone NIX Emaii
Outfalls
Outfall #: 001
utfall Lattitude:
vl-/,Stormwater:
Basin
Neuse
Outfall Description: NON -DISCHARGE FACILITY
12,5-5417Q Outfall Longitude:-78.313610
100 % Industrial:
Waterbody Name
Mill Creels (at Selma)
Represented by Outfall:
Stream
Index Number
Waterbody
Classification
27-40 WS-IV; NSW
2/23/2022