NCG140259 - Name Change Form

March 5, 2018
NCDENR
Division of Energey, Minerals and Land Resources
Bethany Georgoulias
515 N. Salisbury Street, 51 Floor
Raliegh, NC 27604
RE: NPDES Permit Name change and Ownership Change
NCG140117 Avery County
NCG140259 Watauga County
Dear Bethany,
AGGREGATES • AGRICULTURE • ASPHALT
W. B. Roark May M. Roark
President Secretary/Treasurer
Thomas G. Purpur
Vice -President
P.O. Box 911 Mountain City, TN 37683
[phone] Fax [phone]
RECEIVE®
MAR 07 2018
DENSTORMWq ER pEERMj NG
Please find two requests for Name/Ownership change for the above mentioned permits. Maymead has purchased
these two facilities and formed a new company.
If your office will require any further action from me, please advise.
Sincerely,
Sean Mackey
Project Manager
423-571-7159
Cc: Permit File
Tennesse • Virginia • North Carolina
www.maymead.com

�'� Date Received
Division of Energy, Mineral &Land Resources FOR AGENCY USE ONLY
�/ Land Quality Section/Stormwater Permitting Year I Month I Day
National Pollutant Discharge Elimination System
NC®E1lR
Naim Cumuru D-- or
ENVIRON mDNR Resoua PERMIT NAME/OWNERSHIP CHANGE FORM
I. Please enter the permit number for which the change is requested.
NPDES Permit
(or) Certificate of Coverage
1 1 4 1 0 2 5 9
II. Permit status prior to requested change.
a. Permit issued to (company name):
R H Loven Co Inc
b. Person legally responsible for permit:
Robert Loven
First MI Last
President
Title
PO Box 155
RECEIVED
Permit Holder Mailing Address
®� 2�1�
Pineola NC 28662'
LIAR
City State Zip
[phone] [phone]
Phone Fax
c. Facility name (discharge):
R H Loven Co Inc
d. Facility address:
1996 HWY 421 N
Address
Boone NC
City State Zip
e. Facility contact person:
Robert Loven [phone]
First / MI /Last Phone
III. 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):
c. Person legally responsible for permit:
Loven Readv Mix LLC
Wiley B Roark
First MI Last
Manager
Title
PO Box 911
Permit Holder Mailing Address
Mountain City TN 37683
City State Zip
[phone] wbr@,maymead.com
Phone E-mail Address
d. Facility name (discharge): Loven Ready Mix LLC
e. Facility address: 1996 HW 421 N
Address 919
Boone NC
City State Zip
f. Facility contact person: Robert Loven
First MI Last
[phone] [e-mail]
Phone E-mail Address
IV. Permit contact information (if different from the person legally responsible for the permit) (.1
Revised Jan. 27, 2014 W

NPDES PERMIT NAME/OWNERSHIP CHANGE FORM
Page 2 of 2
Permit contact:
First MI Last
Title
Mailing Address
City State Zip
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):
I, Robert H Loven, 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, Wiley B Roark, 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 complStpdand that if all required supporting information is not included, this application
package will be return �as i omplete.
Revised Jan 27, 2014
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

BILL OF SALE
'P-eb
THIS BILL OF SALE is made and entered into this V9 day of.Me5ela-, 2018, by
RH LOVEN ("Seller"), a North Carolina Corporation, in consideration of the sum the
amounts described below, the receipt of which is hereby acknowledged, for the benefit of
LOVEN READY MIX, LLC, a North Carolina Limited Liability Company, ("Buyer") its
successors and assigns, the following property:
1. Furniture, equipment and fixtures, supplies and inventory located on the premises of
Seller's Boone, NC and Pineola, NC plants and offices. The rights to the use of the name
"Loven Ready Mix" and "Loven Ready Mix Concrete." Goodwill, intellectual property,
and land use and other permits and approvals, to the extent the foregoing is related to the
ready mix business operated by Seller.
2. All of those assets shown on Exhibit A.
3. All rights to the domain name and website for www.lovenreadymix.com.
Excluding all furniture and equipment located on the second floor of Seller's office
located in in Pineola, NC, the peace lily plant in the office lobby, and those items shown
on Exhibit A-1. Also excluding post office box numbers 155 and 145, and the phone
number 838-733-0525.
Seller does hereby sell, convey, assign, grant, bargain, sell, transfer, and deliver
all of Seller's right, title and interest in and to the described personal property.
Seller covenants with Buyer that it is the lawful owner of the personal property
described above, that the personal property is free from liens, claims, pledges, security
interests and all other encumbrances.
IN WITNESS THEREOF, the Seller has caused this Bill of Sale to be executed in its
corporate name by its duly authorized corporate officer, this Ze. day of Marelr, 2018,
Pta
RH Loven Company,
A North Carolina Corporation
Robert H. Loven, President
Notary Public
Sworn to and subscribed before me this the `Z day of
My Commission Expires: /-Z -7 l Zv Z p
NIICHAELLE POORE
Notary Public
Burke County, NC
My Commission Expires September 27, 2020