NCG140451_Contact Info Update_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 permit as of 2/2312022.
Permit Number:
NCG14,Q451 Permit Status: Active
Permit Type;
Ready Mix Concrete Stormwater/Wastewater Discharge COC
Facility Name:
Eagle Rock Concrete Franklinton
Facility Addressl:
2095 US Hwy 1
Facility Address2:
City, State & Zip:
Fr nklinton NC 27525
Owner Information
Details:
MAST submit a Change of Name/Ownership form to DEMLR to make any changes to this ©owner information.
(Click Here for "Chan�e Of,Name/OWnershIV"Farm)
/
Owner Name:
Eagle Rock Concrete
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:
$311_Bandfgrd Way Ste 003
/
Address2:
City, State & Zip:
Raleigh, NC 27615
Work Phone:
919-81 -1100 Fax:
Email Address:
[e-mail]
*** Permit Annual Fee Billing ***
Billing Month: February
Invoice Number
Invoice Date invoice Due Date Invoice Amount Invoice Status
Owner Contact Person(s)
Contact Name Tag Address phone Fax I°mail
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Facility Contact Persons)
Contact Name Title Address Phone Fax Email
s -6ym4aR Ae4m 8310 Bandford Way, Raleigh, NC 27615 919-781-3744
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Permit Contact Person(s)
Contact Name Iftk Addrej§ phone EMN 9DR
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Permit Billing Contact(s)
Contact Name T_ i lP Address Phon Fax Amffff
�.r�A fii} 8311 Bandford Way Ste 003, Raleigh, NC
7G1'r' `iTJI�, 27615
2/23/2022

NC Division of Energy, Mineral and Land Resources
NPDES Stormwater Permit Summary
NC DEMLR has the following information in our Permit Database for your permit as of 2/23/2022.
Person(s) with Delegated Signatory Authority
jM Contact Name JLUg Addrqss Phone Fax KORH
Dex eA_ TAV 4.$673 A46k �/l B�1D nib W.dY, s o03 dc�Cay'rerr�C�e�ner '
wE5c6r MssFY Ass6T5lG�F,�t/C� 276r5'_
Person(s) with Electronic Signature Authority
e ligg Address Phone Fax m i
Stet(- /kl��
Outfalls
Outfall #: 001 Outfall Description: ..Stermyrdter outfall OID 1
Outfall Lattitude: 3 .6£ 56940 Outfall Longitude:-78.4869© Represented by Outfall:
Stormwater: 100
Basin
Tar -Pamlico
Industrial:
Waterbody Name
Cedar Creek
Stream
Index Number
28-29-(2)
Waterbody
Classification
C;NSW
2/23/2022