NCG021015_Application_20230307

RECEIVED
FOR AG NCY USE ONLY
NCG02 _ 01 5
Assigned to:
ARO FRO MRO RRO
u 0 2023
DEW-Stormwater Program
WARO WIRO WSRO
Division of Energy, Mineral, and Land Resources Land Quality Section
National Pollutant Discharge Elimination System
NCG020000 Notice of Intent
This General Permit covers STORMWATER AND/OR WASTEWATER DISCHARGES associated with activities under
SIC (Standard Industrial Classification) Code 14 [Mineral Mining Industry] except for: peat mining, coal mining,
metal mining, oil and gas extraction, tourist gem mines, NCDOT borrow pits, in -stream sand mining, and
discharges from mining operations which are intermixed on site with Stormwater from concrete operations. You
can find information on the DEMLR Stormwater Program at deq.rc.gov/SW.
Directions: Print or type all entries on this application. Send the original, signed application with all required
items listed in Item (9) below to: NCDEMLR Stormwater Program, 1612 MSC, Raleigh, NC 27699-1612. The
submission of this application does not guarantee coverage under the General Permit. Prior to coverage under
this General Permit a site inspection will be conducted.
1. Owner/Operator (to whom all permit correspondence will be mailed):
Name of legal organizational entity:
Legally responsible person as signed in Item (10) below:
h roKee Qvb� M' nc t LC,
Er.C_ Nuv,4+-f c,t7tr Pol de( -
Street address:
City:
State:
Zip Code:
yl Cherokee m,ne
Fra✓1<j,y1
►VC.
- X73 Ll
Telephone number:
Email address:
$28 3�4 9 a 9 q l
OlecoKe e r-,jbj vvtlne = w,-Al COvyl
Type of Ownership:
Government
❑ County ❑ Federal ❑ Municipal ❑ State
Non -government
,Business (If ownership is business, a copy of NCSOS report
must be included with this. application)
❑ Individual
2. Industrial Facility (facility being permitted):
Facility name:
hey-oleee Q�b YYl',n�
Facility environmental tact:
co
d
"C hd�e Zachert t,l r
Street address:
qI Chrn&ee Mine d
City:
nave 1.n
St te: Zip Code:
(� ' 8 1q
Parcel Identification Number (PIN)
SO T I;1 0-701
County:
Ma COY1
Telephone num
199Lq
er:
Email address: ,
eroktt I -Ay t'vl,vle 1►1A 1 (. LAN')
Latitude of entrance:
Longitude of entrance:
4-digit SIC code:
Facility is:
Date operation is to begin or began:
�1 6evr-,4
l `t99 M,
El New ❑ Proposed
// IS
rN I n
Existing
V
Types of minerals mine'd at this facility:
❑ Clay ❑ Feldspar Ore ❑ Lithium Ore ❑ Phosphate ❑Soil Construction Sand ❑ Industrial Sand
other: Q�yvt
J
Page 1 of 11

Is this a processing -only facility for materials mined elsewhere?
Is this an inactive mine site?
❑ Yes
❑ Yes
No
No
Does total area of this mine site include ready -mixed concrete plant and/or asphalt plant areas?
❑ Yes, and has separate NPDES stormwater permits (provide permit numbers):
❑ Yes, and does not have separate NPDES stormwater permits
No
Does this facility already have a valid Mining Permit from DEMLR's Land Quality Section?
��Yes (please provide the Mining Permit Number) SA-, AA &/- Og
❑ No (please indicate the status of the Mining Permit application)
Are you applying for a discharge permit in the same location as a previously permitted mine?
DKYes (please provide permit number and mine name) glue e ,(;)Ce4. ��a.e��-A� men}
❑ No CG SaDD
If the stormwater discharges to a municipal separate storm sewer system (MS4), name the operator of the MS4:
XN/A
3. Consultant (if applicable): (V 14.
Name of consultant:
Consulting firm:
Street address:
City:
State
Zip Code
Telephone number: ..^'
Email address: ,
4. Development Activities and Buffers
5.
Mining operation will precede development activities at this site:
❑ Yes
No_-.._ - ...
Mine is located within one of the 20 Coastal Counties, and will it add more than 10,000 ftzof impervious surface:
❑Yes(toboth)i
❑ No, this mine is within one of the 20 Coastal Counties, butwill not at more than10,000 ftz of impervious surface
No, this mine is not within one of the 20 Coastal Counties
Mine is in the Neuse, Tar -Pamlico, or Catawba River Basins, OR in the Randleman or Jordan Water supply Watersheds?
❑ Yes (specify size of stream buffers)
jA No
Mine site will include wastewater discharges from a ready -mix concrete batch plant?
❑ Yes (please seek additional coverage under General Permit NCG140000: Ready -Mix Concrete)
No
tvune uewatermg
Mine dewatering will occur at this site:
❑ Yes k No (mark N/A for the rest of this section)
Mine dewatering from this facility will be discharged to:
❑Surface Waters and/or Wetlands
❑Other (specify)
❑Mine will not discharge dewatering to Surface Waters and/or Wetlands; specify how dewatering will occur and where
water will be directed:
Page 2 of 11

Wetlands and/or Surface Waters are within 400' of the mine pit perimeter:
404/401 Certification permits required:
❑ Yes (specify distance)
❑ Yes (briefly describe)
&XNo
❑ No
❑ N/A
N N/A
Have you been required to obtain a wetland delineation certified by the US Army Corps of Engineers?
❑ Yes (please attach to this application) O(No
6. Wastewater Treatment
Will this facility wash mined materials?
XYes ❑ No
Will discharges of process wastewater treatment systems occur (including possible recycle system overflows)
11 Yes (please describe)
p;seytr.-r9e "C a,�Afr 60"n9 4nrough seWfinen, - POVI S,
❑ No
Will this facility employ chemical additives to flocculate suspended solids?
❑ Yes (specify name/manufacturer/quantity of daily use)
D No
No e: please visit: https://flles.nc.gov/ncden/Water+Quality/Environmental+Sciences/AlU/PAMS 30 18.pdf for list of
approved PAMS
Will any of the wastewater treatment facilities at this mine overflow only during rainfall events that exceed the 10-yr, 24-hr
rainfall event?
❑ Yes (specify which systems)
5
v i
No
Are wastewater treatment facilities (including recycle systems) planned. in the 100-year flood plan?
❑ Yes No _
`.Wastewate"r'Treatment Alternative Review as required by15A NCAC 214.0105(c)(2)
'
Types of wastewater this mine site will discharge: =- -❑ Mine Dewatering Process Wastewater
Types of wastewater considered for this alternative review: ❑ Mine Dewatering Process Wastewater
Are there existing sewer lines within alone -mile radius?'--
❑ Yes
❑ Wastewater treatment plant will accept wastewater
❑ Is feasible to connect (explain)
❑ Is not feasible to connect (explain)
El treatment plant will not accept wastewater (please attach letter documenting this)
No
Page 3 of 11

Are you already proposing a closed -loop recycle system (CLRS) that meets design requirements of 15A NCAC 2T .10000?
❑ Yes, for dewatering
❑ Yes, for process wastewater
❑ Yes, for both
❑ No, this option is technologically feasible (explain)
❑ No, this option is not technologically feasible (explain)
❑ No, this option is otherwise feasible (explain)
XNo, this option is otherwise not feasible (explain)
Nat- lea ,ale =a redes,c�v 41il (9xts4�ny SyS4fYY)
What is the feasibility of building a CLRS compared to di ct surface water discharge?
Surface or Subsurface Disposal System
❑ A surface or subsurface disposal system is technologically feasible (explain)
❑ A surface or subsurface disposal system is not technologically feasible (explain)
❑ A surface or subsurface disposal system is otherwise feasible to implement (explain)
IXA surface of subsurface disposal system is.not otherwise feasible to implement..(explai )_.__....__ _
Svs-F-wn iS a)read ,-lv, IpIC hC,n) Ie �S vSrl
WhAt is the feasibility ofemploying /a subsurfacL of surface discharge.. as compared toa direct discharge to" -surface waters?
Direct Discharge to surface"waters is the most environmentally soundalternative to all reasonably cost-effective options
for the wastewaters being considered?
XYes
❑ No
If this review included all wastewater discharge types, would excluding some types make any of the above -non -discharge
options feasible for some the wastewaters? - _ -
❑ Yes
No
7. Outfalls(s) At least one outfall is required to be eligible for coverage.
3-4 digit identifier:
0
Name of receiving water:
`feQ k
Classification:
C,
❑ This water is impaired.
❑ This watershed has a TMDL.
Discharge from this outfall is from:
❑ Stormwater ❑ Mine Dewatering K Process Wastewater
7Q10 Flow of receiving waterbody (if discharging Mine Dewatering or Process Wastewater to waters classified as HOW,
ORW, Tr, WS-1, WS-II, WS-III, SA, or PNA ):
Discharge occurs from this outfall:
❑ Only during a rainfall event
❑ Intermittently (indicate how often)
Continuously (indicate Flow in CFS)
Latitude 1:
lo' 23 N
Longitude of outfall:
3a al o
Brief description of the industrial activities that drain to this outfall:
UUgSh- rl m VLt-1- 'NJ- Alzoa -'% ev) n
Do Vehicle Ma ntenance Activities occur in the drainage area of this outfall? ❑ Yes K No
If yes, how many gallons of new motor oil are used each month when averaged over the calendar year?
3-4 digit identifier:
Name of receiving water:
Classification:
❑ This water is impaired.
❑ This watershed has a TMDL.
Page 4 of 11

Discharge from this outfall is from:
❑ Stormwater ❑ Mine Dewatering ❑ Process Wastewater
7Q10 Flow of receiving waterbody (if discharging Mine Dewatering or Process Wastewater to waters classified as HOW,
ORW, Tr, WS-I, WS-II, WS-III, SA, or PNA ):
Discharge occurs from this outfall:
❑ Only during a rainfall event
❑ Intermittently (indicate how often)
❑ Continuously (indicate flow in CFS)
Latitude of outfall:
Longitude of outfall:
Brief description of the industrial activities that drain to this outfall:
Do Vehicle Maintenance Activities occur in the drainage area of this outfall? ❑ Yes ❑ No
If yes, how many gallons of new motor oil are used each month when averaged over the calendar year?
3-4 digit identifier:
Name of receiving water:
Classification:
❑ This water is impaired.
❑ This watershed has a TMDL.
Discharge from this outfall is from:
❑ Stormwater ❑ Mine Dewatering ❑ Process Wastewater
7Q10 Flow of receiving waterbody (if discharging Mine Dewatering or Process Wastewater to waters classified as HQW,
ORW, Tr, WS-1, WS-11, WS-III, SA, or PNA ):
Discharge occurs from this outfall:
❑ Only during a rainfall event
❑ Intermittently (indicate how often)
❑ Continuously (indicate flow in CFS)
Latitude of outfall:
Longitude of outfall:
Brief description of the industrial'activities that drain to this outfall: ;. - - U
Do Vehicle Maintenance Activities occur in the drainage area of this outfall? !' �"" ❑ Yes` ,r❑ No
If yes, how many gallons ofhew motoroil are used each month when averaged over tfie.calendaryear?
3-4 digit identifier:
Name of receiving water:
r <t.
Classification:
ElThis water is impaired.
❑_This°watershed has a TMDL.
Discharge from this outfall is from:
❑ Stormwater ❑ Mine Dewatering ❑ Process Wastewater -
7Q10 Flow of receiving waterbody (if discharging Mine Dewatering or Process Wastewater to waters classified as HOW,
ORW, Tr, WS-I, WS-11, WS-III, SA, or PNA ):
Discharge occurs from this outfall:
❑ Only during a rainfall event
❑ Intermittently (indicate how often)
❑ Continuously (indicate flow in CFS)
Latitude of outfall:
Longitude of outfall:
Brief description of the. industrial activities that drain to this outfall:
Do Vehicle Maintenance Activities occur in the drainage area of this outfall? ❑ Yes ❑ No
If yes, how many gallons of new motor oil are used each month when averaged over the calendar year?
3-4 digit identifier:
Name of receiving water:
Classification:
❑ This water is impaired.
❑ This watershed has a TMDL.
Discharge from this outfall is from:
❑ Stormwater ❑ Mine Dewatering ❑ Process Wastewater
7Q10 Flow of receiving waterbody (if discharging Mine Dewatering or Process Wastewater to waters classified as HOW,
ORW, Tr, WS-I, WS-11, WS-III, SA, or PNA ):
Discharge occurs from this outfall:
Page 5 of 11

❑ Only during a rainfall event
❑ Intermittently (indicate how often)
❑ Continuously (indicate flow in CFS)
Latitude of outfall:
Longitude of outfall:
Brief description of the industrial activities that drain to this outfall:
Do Vehicle Maintenance Activities occur in the drainage area of this outfall? ❑ Yes ❑ No
If yes, how many gallons of new motor oil are used each month when averaged over the calendar year?
All outfalls must be listed and at least one outfall is required. Additional outfalls may be added in the section
"Additional Outfalls" found on the last page of this NO].
8. Other Facility Conditions (check all that apply and explain accordingly):
This facility has other NPDES permits. If checked, list the permit numbers for all current NPDES permits:
IJ Do n
❑ This facility has Non -Discharge permits (e.g. recycle permit). If checked, list the permit numbers for all current Non -
Discharge permits:
This facility uses best management practices or structural stormwater control measures.
If checked, briefly describe the practices/measures.and.show on site.diagram: ------
El This facility has a Stormwater Pollution Preventlo Plan (SWPPP).
If checked, please list the datetlieSWPPPwasimplemented: `- -' 2' �
❑ This facility`stcres hazardous waste in the 100-year floodplain. ,
If checked, describe how the area is protected from flooding: ,
❑ This facility is a (mark all that apply) - -
❑ Hazardous Waste'Generation':Facility;;, - -
❑ Hazardous Waste Treatment Facility
❑ Hazardous Waste Storage Facility -'
❑ Hazardous Waste Disposal Facility
If checked, indicate:
Kilograms of waste generated each month:
Type(s) of waste:
How material is stored:
Where material is stored:
Number of waste shipments per year:
Name of transport/disposal vendor:
Transport/disposal vendor EPA ID:
Vendor address:
❑ This facility is located on a Brownfield or Superfund site
If checked, briefly describe the site conditions:
❑ Facility provides appropriate secondary containment for bulk storage of liquid materials
If checked, briefly describe these measures:
❑ Site has an active landfill within the mining permit boundary
If checked, please indicate type:
a) ❑ LCID (Land clearing and Inert Debris)
b) ❑ other (specify)
Page 6 of 11

9. Reg4ired Items (Application will be returned unless all of the following items have been included):
eck for $100 made payable to NCDEQ
py of most recent Annual Report to the NC Secretary of State (if applicable)
his completed application and any supporting documentation
Cl Copy of the approved mining permit or indication of mining permit application status ns ( Av,) pro
❑ py of US Army Corps — approved wetland delineation (if applicable)
inawing of thee drawing water flowthrough the facility or block flow diagram
Pictorial description of the nature of any sources of water and any collection and treatment measures
A site diagram showing, at a minimum, existing and proposed:
a) outline of drainage areas
b) surface waters
c) stormwater management structures
d) location of stormwater outfalls corresponding to the drainage areas
e) runoff conveyance features
f) areas where process materials are stored
g) impervious areas
site property lines
copies of large scale (24"x36" minimum) site plan showing:
a) topographical lines _
b) all outfall locations
c) applicable buffers and delineated wetlands
d) receiving waters --.
e) 100-year flood plain (Ifapplicable) 3. „::''
Copy of county map or USGS quad sheet with the location of the facility.clearly marked It,
If mines site is in one of the 20'Coastal Counties (if applicable)
❑ Applicant has check with the appropriate regional office to verify the need for a Coastal State Stormwater.'permit.
a) Indicate the Regional Office Contact: '
❑ Detailed list,of: _
a) impervious surface areas and percentages
b) sub-drainageareas
c) total drainage area
If mine is dewatering and near wetlands, or may otherwise impact surface waters or groundwater
❑ 2 copies of large scale (24"x36" minimum) plans delineating areas on the listing acreage including:
a) wetlands
b) ditches
c) well -placements
d) pits
e) borrow areas
f) overburden storage
g) stormwater controls/BMPs
h) vehicle maintenance areas
i) settling basins
j) product process (such as screening, stockpiles, and waste piles)
k) total drainage area
1) impervious surface percentages (if state stormwater programs apply)
m) applicable buffers
n) access and/or haul roads
❑ Pump dewatering size and information on its specifications
Page 7 of 11
S

❑ Well information (design, depths, maintenance)
❑ Physical monitoring for the wetland areas
❑ Settling pond size information, if applicable
❑ Level spreader design, if applicable
❑ Details about dewatering method
❑ Cone of influence calculations
❑ Description of measures to prevent erosion and flooding
❑ Description and information about 4011404 permits that have been obtained
❑ Copy of US Army Corps of Engineers wetlands delineations or approved wetland delineation (if applicable)
❑ 1 have contacted my local regional office about a Pumping Operation and Monitoring (POM) plan
a) Regional Office Contact:
b) Date Contacted:
10. Applicant Certification:
North Carolina General Statute 143-215.6B (i) provides that: Any person who knowingly makes any false statement,
representation, or certification in any application, record, report, plan, or other document filed or required to be maintained
under this Article or a rule implementing this Article ... shall be guilty of a Class 2 misdemeanor which may include a fine not
to exceed ten thousand dollars ($10,000).
U er penalty of law, I certify that:
I am the person responsible for the permitted industrial activity, for satisfying the requirements of this permit; and for any
evil or criminal penalties incurred due to violations of this permit
The information submitted In this NOI is, to,the: best of my knowledge and belief; true, accurate, andPcompletebased on
my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the
nformation:;' -
will abide by all conditions of the NCG020000.permit. I understand that coverage under this permit will constitute the
ermit requirement$ for the discharge(s) and isenforceablein the same'manner as an individual permit,}_-
I hereby request coverage under the NCG020000 General Permit:-.
j'
Printed Name of Applicant:
Title:
aJ'9Yl a3
(Sigur_nsf'�eof Applicant) (Date Signed)
Mail the entire package to: DEMLR— Stormwater Program
Department of Environmental Quality
1612 Mail Service Center
Raleigh, NC 27699-1612
Page 8 of 11

Additional Outfalls
3-4 digit identifier:
Name of receiving water:
Classification:
❑ This water is impaired.
❑ This watershed has a TMDL.
Discharge from this outfall is from:
❑ Stormwater ❑ Mine Dewatering ❑ Process Wastewater
7Q10 Flow of receiving waterbody (if discharging Mine Dewatering or Process Wastewater to waters classified as HOW,
ORW, Tr, WS-I, WS-Il, WS-III, SA, or PNA ):
Discharge occurs from this outfall:
❑ Only during a rainfall event
❑ Intermittently (indicate how often)
❑Continuously (indicate flow in CFS)
Latitude of outfall:
Longitude.of outfall:.,
Brief description of the industrial activities that drain to this outfall:
Do Vehicle Maintenance Activities occur in th'e;drainage area of this outfall? 10 Yes" ❑ No
If yes, how many gallons of new motor oil are used each month when averaged over the calendar year?_-.-..
3-4 digit iden_tif_ier: -
:Name of receiving water:-
Classification: ,�
-
❑ This water is impaired.
❑ This watershed has a TMDL.
Dischargefrom,thisoutfall;isfrom: - ,r
❑ Stormwater ` ❑ {Mine Dewatering ' ❑ Process Wastewater
7Q10 Flow of receiving waterbody (if discharging Mine Dewatering or Process. Wastewater to waters classified as HOW,
ORW, Tr, WS-I, WS-II, WS-III, SA, or PNA ): - =—
Discharge occurs from this outfall:
❑ Only during a rainfall event
❑ Intermittently (Indicate how often)
❑Continuously (indicate flow in CFS)
Latitude of outfall:
Longitude of outfall:
Brief description of the industrial activities that drain to this outfall:
Do Vehicle Maintenance Activities occur in the drainage area of this outfall? ❑ Yes ❑ No
If yes, how many gallons of new motor oil are used each month when averaged over the calendar year?
3-4 digit identifier:
Name of receiving water:
Classification:
❑ This water is impaired.
❑ This watershed has a TMDL.
Discharge from this outfall is from:
❑ Stormwater ❑ Mine Dewatering ❑ Process Wastewater
7Q10 Flow of receiving waterbody (if discharging Mine Dewatering or Process Wastewater to waters classified as HQW,
ORW, Tr, WS-1, WS-II, WS-III, SA, or PNA ):
Discharge occurs from this outfall:
❑ Only during a rainfall event
❑ Intermittently (indicate how often)
❑ Continuously (indicate flow in CFS)
Page 9 of 11

Latitude
of the industrial activities that drain to
Longitude
Do Vehicle Maintenance Activities occur in the drainage area of this outfall? ❑ Yes ❑ No
If yes, how many gallons of new motor oil are used each month when averaged over the calendar year?
3-4 digit identifier:
Name of receiving water:
Classification:
❑ This water is impaired.
❑ This watershed has a TMDL.
Discharge from this outfall is from:
❑ Stormwater ❑ Mine Dewatering ❑ Process Wastewater
7Q10 Flow of receiving waterhody (if discharging Mine Dewatering or Process Wastewater to waters classified as HOW,
ORW, Tr, WS-I, WS-II, WS-III, SA, or PNA ):
Discharge occurs from this outfall:
❑ Only during a rainfall event
❑ Intermittently (indicate how often)
❑ Continuously (indicate flow in CFS)
Latitude of outfall:
Longitude of outfall:
Brief description of the industrial activities that dralnao this outfall;_,'___'
'3: k
Do Vehicle Maintenance Activities occur in the. drainage area of this outfall?' - ❑ Ye's ❑ No
If yes, how many gallons ofnew-motor oil are used each month when averaged over the calendar year? 1 .., "
3-4 digit identifier:
I Name of,receivingwater:
Classification: -,
.'
❑ This water is impaired:,.'
El This watershed has`a TMDL.
Discharge from this outfall is from: _ - - - '•
❑ Stormwater ❑ Mine Dewatering ❑ Process Wastewater-
7Q10 Flow of'receivingvvaterhody (if 'discharging Mine Dewatering or Process Wastewater to waters classified as HQW,
ORW, Tr, WS-I, WS-11, WS-111, SA, or PNA ):
Discharge occurs from this outfall:i. -
❑ Only during a rainfall event
❑ Intermittently (indicate how often)
❑ Continuously (indicate flow in CFS)
Latitude of outfall:
Longitude of outfall:
Brief description of the industrial activities that drain to this outfall:
Do Vehicle Maintenance Activities occur In the drainage area of this outfall? ❑ Yes ❑ No
If yes, how many gallons of new motor oil are used each month when averaged over the calendar year?
3-4 digit identifier:
Name of receiving water:
Classification:
❑ This water is impaired.
❑ This watershed has a TMDL.
Discharge from this outfall is from:
❑ Stormwater ❑ Mine Dewatering ❑ Process Wastewater
7Q10 Flow of receiving waterhody (if discharging Mine Dewatering or Process Wastewater to waters classified as HOW,
ORW, Tr, WS-I, WS-II, WS-III, SA, or PNA):
Discharge occurs from this outfall:
❑ Only during a rainfall event
❑ Intermittently (indicate how often)
❑ Continuously (indicate flow in CFS)
Latitude of outfall: I Longitude of outfall:
Page 10 of 11

Brief description of the industrial activities that drain to this outfall:
Do Vehicle Maintenance Activities occur in the drainage area of this outfall? ❑ Yes ❑ No
If yes, how many gallons of new motor oil are used each month when averaged over the calendar year?
Page 11 of 11

:9 LIMITED LIABILITY COMPANY ANNUAL REPORT
II6mm
NAME OF LIMITED LIABILITY COMPANY: Cherokee Ruby Mine LLC.
FOing Office Use Only
SECRETARY OF STATE ID NUMBER: 2306944 STATE OF FORMATION: NC E- Filed Annual Report
2306944
REPORT FOR THE CALENDAR YEAR: 2022 3/2712022 0309
SECTION A: REGISTERED AGENT'S INFORMATION Changes
1. NAME OF REGISTERED AGENT: Handte, Eric N
2. SIGNATURE OF THE NEW REGISTERED AGENT:
SIGNATURE CONSTITUTES CONSENT TO THE APPOINTMENT
3. REGISTERED AGENT OFFICE STREET ADDRESS 8 COUNTY 4. REGISTERED AGENT OFFICE MAILING ADDRESS
41 Cherokee Mine Rd 41 Cherokee Mine Rd
Franklin, NC 28734 Macon County Franklin, NC 28734
SECTION B: PRINCIPAL OFFICE INFORMATION
1. DESCRIPTION OF NATURE OF BUSINESS: Tourism based gem mine.
2. PRINCIPAL OFFICE PHONE NUMBER: [phone] 3. PRINCIPAL OFFICE EMAIL: Privacy Redaction
4. PRINCIPAL OFFICE STREET ADDRESS
41 Cherokee Mine Rd
5. PRINCIPAL OFFICE MAILING ADDRESS
41 Cherokee Mine Rd
Franklin, NC 28734-4127 Franklin, NC 28734-4127
6. Select one of the following if applicable. (Optional see instructions)
❑ The company is a veteran -owned small business
❑ The company is a service -disabled veteran -owned small business
SECTION C: COMPANY OFFICIALS (Enter additional company officials in Section E.)
NAME: Eric N Handte
TITLE: Member
ADDRESS:
NAME: Zachery W Holder NAME:
TITLE: Member TITLE:
ADDRESS:
41 Cherokee Mine Rd 41 Cherokee Mine Rd
Franklin, NC 28734-4127 Franklin, NC 28734-4127
ADDRESS:
SECTION D: CERTIFICATION OF ANNUAL REPORT. Section D must be completed in its entirety by a person/business entity.
Eric N Handte
SIGNATURE
Form must be signed by Company Official listed under Section C of This form.
3/27/2022
DATE
Eric N Handte Member
Print or Type Name of Company Official Print or Type Title of Company Official
This Annual Report has been filed electronically.
MAIL TO: Secretary of State, Business Registration Division, Post Office Box 29525, Raleigh, NC 27626-0525

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Macon County Boundary ❑ Tax Parcels (Orthos Off)
Street Centerline
Tax Parcels
0 0.0325
1:3,902
0.065
0.13 mi
0 0.05
DA
0.2 km