NCG160251_Application_20240510

FOR AGENCY USE ONLY
NCG16 Q z51
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Division of Energy, Mineral, and Land Resources Land Quality Section I07p7�
National Pollutant Discharge Elimination System
NCG160000 Notice of Intent
This General Permit covers STORMWATER DISCHARGES associated with activities under the following Standard
Industrial Classifications: SIC 2951[Asphalt Paving Mixtures and Blocks]and like activities deemed by DEMLR to
be similar in the process or the exposure of raw materials, intermediate products,final products, by-products, or
waste materials. You can find information on the DEMLR Stormwater Program at deq.nc.gov/SW.
Directions: Print or type all entries on this application. Send the original,signed application with all required
items listed in Item (6) 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 assigned in Item(7) below:
Maymead Materials, Inc Nathan K Turner(Vice President)
Street address: City: State: Zip Code:
1995 Roan Creek Rd Mountain City TN 37683
Telephone number: Email address:
828-320-3336 [e-mail]
Type of Ownership:
Government
❑County ❑ Federal ❑ Municipal ❑State
Non-government
to 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: Facility environmental contact:
Maymead Asphalt Plant
Street address: City: State: Zip Code:
5273 US Hwy 421 S Boone NC 28607
Parcel Identification Number(PIN): County:
2931733203000 Watauga
Telephone number: Email address:
4-digit SIC code: Facility is: Date operation is to begin or began:
2951 2 New ❑ Proposed ❑Existing TBD
Latitude of entrance: Longitude of entrance:
36.23060 81.5877°
Brief description of the types of industrial activities and products manufactured at this facility:
Production of asphalt pavement
If the stormwater discharges to a municipal separate storm sewer system(MS4),name the operator of the MS4:
Cd N/A
Page 1 of 5

Check all activities conducted at this facility:
♦a Outdoor Stockpiling of Materials 2 Transport of Materials by a Conveyor or Front-end Loader
2 Storage of Raw Materials ❑Vehicle and Equipment Maintenance
0 Storage of Materials in Above-ground Storage Tanks ❑Vehicle or Equipment Washing
0 Material Loading and Unloading 8 Vehicle and Equipment Fueling
3. Consultant(if applicable):
Name of consultant: Consulting firm:
MAX PRESTWOOD III P.E. BREC, PA
Street address: City: State: Zip Code:
1520 Meadowview Drive Wilkesboro NC 28697
Telephone number: Email address:
[phone] [e-mail]
4. Outfall(s)At least one outfall is required to be eligible for coverage.
3-4 digit identifier: Name of receiving water: Classification: ❑This water is impaired.
001 Thaxon Creek C+ ❑This watershed has a TMDL.
Latitude of outfall: Longitude of outfall:
36.23090 -81.58770
Brief description of the industrial activities that drain to this outfall:
Material Stockpiles and storage, Loading and unloading.
Do Vehicle Maintenance Activities occur in the drainage area of this outfall? ❑ Yes 6a 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.
002 [Na
Creek C+ ElThis watershed has a TMDL.
Latitude of outfall: Longitude of outfall:
36.23060 -81.5851°
Brief description of the industrial activities that drain to this outfall:
Material Stockpiles,Transport of materials Conveyour and Front-End Loader, Loading and unloading
Do Vehicle Maintenance Activities occur in the drainage area of this outfall? ❑ Yes 42 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.
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 outfalis may be added in the section
"Additional Outfalls"found on the last page of this NOI.
Page 2 of 5

S. Other Facility Conditions(check all that apply and explain accordingly):
2 This facility has other NPDES permits.
If checked, list the permit numbers for all current NPDES permits:
NCG020744
❑This facility has Non-Discharge permits(e.g.recycle permit).
If checked, list the permit numbers for all current Non-Discharge permits:
♦a This facility uses best management practices or structural stormwater control measures.
If checked, briefly describe the practices/measures and show on site diagram:
Stormwater basin used to treat runoff prior to leaving site. See Site Plan
♦a This facility has a Stormwater Pollution Prevention Plan(SWPPP).
If checked, please list the date the SWPPP was implemented:
See Attached SWPPP
❑This facility stores 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
6. Required Items(Application will be returned unless all of the following items have been included):
a Check for$120 made payable to NCDEQ
la Copy of most recent Annual Report to the NC Secretary of State See Attached 2022 Report
B This completed application and any supporting documentation
2 A site diagram showing,at a minimum, existing and proposed: See Attached SWPPP Dated 4-29-2024
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 industrial process materials are stored
g) impervious areas
h) site property lines
2 Copy of county map or USGS quad sheet with the location of the facility clearly marked See Attached
Page 3 of 5

7. Applicant Certification:
North Carolina General Statute 143-215.68(1)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).
Under penalty of law, I certify that:
69 1 am the person responsible for the permitted industrial activity,for satisfying the requirements of this permit,and for any
civil or criminal penalties incurred due to violations of this permit.
UrThe information submitted in this NOI is,to the best of my knowledge and belief,true,accurate,and complete based on
my Inquiry of the person or persons who manage the system,or those persons directly responsible for gathering the
information.
99 1 will abide by all conditions of the NCG160000 permit.I understand that coverage under this permit will constitute the
permit requirements for the discharge(s)and is enforceable in the same manner as an individual permit.
�I hereby request coverage under the NCG160000 General Permit.
Printed Name of Applicant: Nathan Kipp Turner
Title: Vice President-Construction
na ZX7al c oo `�uHINZ&
(Signature of Applicant) (Date Signed)
Mail the entire package to: DEMUR—Stormwater Program
Department of Environmental Quality
1612 Mail Service Center
Raleigh,NC 27699-1612
Page 4 of 5

BUSINESS CORPORATION ANNUAL REPORT RFQ*lkeo
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NAME OF BUSINESS CORPORATION: Maymead Materials, Inc.
0344075 Filing Office use any
SECRETARY OF STATE ID NUMBER: STATE OF FORMATION: TN E-Filed Annual Report
0344075
REPORT FOR THE FISCAL YEAR END: 12/31/2022 CA202310803241
4/18/2023 11:00
SECTION A: REGISTERED AGENT'S INFORMATION ❑X Changes
1. NAME OF REGISTERED AGENT: The Prentice-Hall Corporation System, Inc.
2.SIGNATURE OF THE NEW REGISTERED AGENT:
SIGNATURE CONSTITUTES CONSENT TO THE APPOINTMENT
3. REGISTERED AGENT OFFICE STREET ADDRESS&COUNTY 4.REGISTERED AGENT OFFICE MAILING ADDRESS
2626 Glenwood Avenue 2626 Glenwood Avenue, Suite 550
Raleigh, NC 27608 Wake County Raleigh, NC 27608
SECTION B: PRINCIPAL OFFICE INFORMATION
1. DESCRIPTION OF NATURE OF BUSINESS: 2009110196308
2. PRINCIPAL OFFICE PHONE NUMBER: [phone] 3.PRINCIPAL OFFICE EMAIL: Privacy Redaction
4. PRINCIPAL OFFICE STREET ADDRESS 5.PRINCIPAL OFFICE MAILING ADDRESS
1995 Roan Creek Rd 1995 Roan Creek Rd
Mountain City,TN 37683 Mountain City,TN 37683
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:OFFICERS(Enter additional officers in Section E.)
NAME: Wiley B Roark NAME: Mary Katherine Harbin NAME: Wiley B Roark , Jr
TITLE: President TITLE: Vice President TITLE: Vice President
ADDRESS: ADDRESS: ADDRESS:
P.O.Box 911 PO Box 911 PO Box 911
Mountain City,TN 37683-0911 Mountain City,TN 37683 Mountain City,TN 37683
SECTION D: CERTIFICATION OF ANNUAL REPORT. Section D must be completed in its entirety by a person/business
entit irmeth J Beam 4/18/2023
K SIGNATURE DATE
Form must be signed by an officer listed under Section C of this form.
Kenneth J Beam Treasurer
Print or Type Name of Officer Print or Type Title of Officer
MAIL TO:Secretary of State, Business Registration Division,Post Office Box 29525,Raleigh,NC 27626-0525

SECTION E:ADDITIONAL OFFICERS
NAME: Nathan K Turner NAME: Kenneth J Beam NAME: Timothy S Mackey
TITLE: Vice President TITLE: Treasurer TITLE: Secretary
ADDRESS: ADDRESS: ADDRESS:
PO Box 911 P.O. Box 911 PO Box 911
Mountain City,TN 37683 Mountain City,TN 37683-0911 Mountain City,TN 37683
NAME: NAME: NAME:
TITLE: TITLE: TITLE:
ADDRESS: ADDRESS: ADDRESS:
NAME: NAME: NAME:
TITLE: TITLE: TITLE:
ADDRESS: ADDRESS: ADDRESS:
NAME: NAME: NAME:
TITLE: TITLE: TITLE:
ADDRESS: ADDRESS: ADDRESS:
NAME: NAME: Name:
TITLE: TITLE: TITLE:
ADDRESS: ADDRESS: ADDRESS:
NAME: NAME: NAME:
TITLE: TITLE: TITLE:
ADDRESS: ADDRESS: ADDRESS:

North Carolina Department of Environment and Natural Resources
Pat McCrory Donald R.van der Vaart
Governor Secretary
May 28, 2015
Mr. Wiley Roark
Maymead Materials, Inc.
P.O. Box 911
Mountain City,TN 37683
Subject: NPDES General Permit NCG020744
Maymead Materials,Inc.
Formerly J.W. Hampton Co.
Certificate of Coverage NCG020744
Watauga County
Dear Mr. Roark:
Division personnel received your request to revise your stormwater permit Certificate of Coverage
to accurately reflect your new company and/or facility name.
Please find enclosed the revised Certificate of Coverage. The terms and conditions contained in
the General Permit remain unchanged and in full effect. This revised Certificate of Coverage is
issued under the requirements of North Carolina General Statutes 143-215.1 and the
Memorandum of Agreement between North Carolina and the U.S.Environmental Protection
Agency.
If you have any questions or need further information, please contact the Stormwater Permitting
Program at(919)707-9220.
Sincerely,
ORIGINAL SIGNED M
for Tracy E. Da� IK PM,Director
Division of Energy,Mineral and Land Resources
cc: Winston-Salem Regional Office
Stormwater Permitting Program Files
Central Files
Division of Energy,Mineral,and Land Resources
Energy Section •Geological Survey Section•Land Quality Section
1612 Mall Service Center,Raleigh,North Carolina 27699.1612.919-707-9200/FAX:910,715.8801
512 North Salisbury Street.Raleigh.North Carolina 27604•Internet:hfo://oortal.nodenr.omlwebArl
An Equal opportunity 1 Affirmative Action Employer—50%Recycled 110%Post Consumer Paper

STATE OP NORTI-I CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF ENERGY, MINERAL, AND LAND RESOURCES
GENERAL PERMIT NO. NCG020000
CERTIFICATE OF COVERAGE No. NCGO20744
STORMWATElt AND WASTEWATER DISCHARGES
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision ol'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,
Maymead Materials, Inc.
is hereby authorized to operate approved wastewater treatment system(s) and discharge
stormwater and/or wastewater,as approved in the original permit/application or subsequent
permit modification, from a facility located at:
May mead Materials, Inc.
5251 US HNy 4214 S
Boone
Watauga County
to receiving waters designated as Thaxon Creek, a class C water in the New River Basin, in
accordance with the effluent limitations, monitoring requirements, and other conditions set forth
in accordance in Parts 1, 11, 111,and IV of General Permit No. NC6020000 as attached.
This certificate of coverage shall become effective May 28, 2015.
This Certificate of Coverage shall remain in effect 1'or the duration of the General Permit.
Signed this day May 28, 2015.
ORIGINAL SIGNED B1
KEN PICKLE
fin- Tracy 1 . Davis, P.E, Director
Division of Energy, Mineral, and Land Resources
By the Authority of the Environmental Management Commission

Division of Energy,Mineral &Land Resources FOR AG Dale R aciv eivad Y
Land Quality Section/Stormwater Permitting veer Mann oa
�ICDE�IR National Pollutant Discharge Elimination System
. T Na .. a PERMIT NAMEIOWNERSHIP CHANGE FORM
rM HQVY.1}]y'IIR�
1. Please enter the permit number for which the change is requested.
DES Permit (or) Certificate of Coverage
2 0 7 4 4 Gin WO I
B. Permi staWs Prior to requested change. .
a" Permit issued to(company name): J.W.Hampton Cc
b. Person legally responsible for permit: Johnny Hampton
First MI Last
Title
3632 Old HWY 421 S
Permit Holder Mailing Address
Boone NC 28607
City State Zip,
[phone] { )
Phone Fax
c. Facility name(discharge): J.W.Hampton Recycling Cc
d. Facility address: 5251 US HWY 421 S
Address
Boone NC 28607
City State Zip
e. Facility contact person: Johnny Hampton [phone]
First /MI/last Phone
W. Please provide the following for the requested change(revised permit).
a. Request for change is a result of: ® Change in ownership of the facility"
® Name change of the facility or owner
If other please explain:
b. Permit issued to(company name): Maymead Materials.Inc.
c. Person legally responsible for permit: Wiley Roark
First Mi Last
a :ECEIVED President
Title
IDR 13 2015• POBox911
Permit Holder Mailing Address
tvto c':• '"vUTY Mountain C TN 37683
gTQftMttiAfertraicntTih` City State Zip
[phone] [e-mail]
Phone E-mail Address
d. Facility name(discharge): Maymead Materials 421 Recycle Yard
e. Facility address: 5251 US HWY 4214 S
Address
Boone NC 28607
City State Zip
f. Facility contact person: Wiley Roark
First MI Last
r [phone] [e-mail]
(� •' Phone E-mail Address
IV. Permit contact information(if different from the_person legally.responsible for the permit)
f Revised Jan.27.2014

• NPDES PERMIT NAMEIOWNERSHIP CHANGE FORM
Page 2 of 2
Permit contact: Sean Mackey
First Mt Last
Project Manager
Title
PO Box 911
Mailing Address
Mountain City TN 37683
City State Zip
[phone] [e-mail]
Phone E-mail Address
V. Will the permitted facility continue to conduct the same industrial activities conducted prior
to this ownership or name change?
® Yes
❑ No (please explain)
VI. Required Items: THIS APPLICATION WILL BE RETURNED UNPROCESSED IF ITEMS
ARE INCOMPLETE OR MISSING:
❑ This completed application is required for both name change and/or ownership change
requests.
❑ Legal documentation of the transfer of ownership(such as relevant pages of a contract deed,
or a bill of sale)is required for an ownership change request. Articles of incorporation are
not sufficient for an ownership change,
The certifications below must be completed and signed by both the permit holder prior to the change,and
the new applicant in the case of an ownership change request. For a name change request,the signed
Applicant's Certification is sufficient.
PERMITTEE CERTIFICATION(Permit holder prior to ownership change):
1, Johnny Hampton,Jw Hamoton,attest that this application for a name/ownership change has been
reviewed and is accurate and complete to the best of my knowledge. I understand that if all required parts
of this application are not completed and that if all required supporting information is not included this
application package will be returned as incomplete.
Signature Date
APPLICANT CERTIFICATION
I,W.B.Roark,Maymcad Materials.Inc., attest that this application for a name/ownership change has been
reviewed and is accurate and complete to the best of my knowledge. I understand that if all required parts
of this application are not cplopted and that if all required supporting information is not included, this
applica ' n package wit a ret ed as incomplete.
Signature Date
....................................
PLEASE SEND THE COMPLETE APPLICATION PACKAGE TO:
Division of Energy,Mineral and Land Resources
Stormwater Permitting Program
1612 Mail Service Center
Raleigh,North Carolina 27699-1612
-- Heymea in.27,2014 - - ----- --- ---- --- - -------

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