NCG020863_Name Ownership Change Request Form 2_20190604

New Submission
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ea' %TAT[..
NPDES Permit Name/Ownership Change
n
N 0 FtT H CAROU N A Request
Env MFiMdrnfol QUdkilly
I. Permit Information II. Permit Status
III. Requested Change Information IV. Permit Contact Information
V. Permit Facility Activities I VI. Signature
III. Please provide the following for the requested change (revised
permit).
a. Request for changes is a QQ Change in ownership of facility
result of: * O Name Change of the facility or owner
b. Permit to be issued to: * Vulcan Construction Materials, LLC
Company Name
c. Person to be legally responsible for permit:
First name: * Middle name: Last name:
Richard Roper
Title: Vice -President, Finance, Mideast Division
Permit holder's mailing Street Address
address: * 4401 North Patterson Avenue
Address Line 2
City State / Province / Region
Winston-Salem NC
Postal / Zip Code Country
27105-1638 US
https://edocs.deq.nc.gov/Forms/SW-Name-Change 6/4/2019

New Submission
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Phone #: * Email
336-744-2445 address:
[e-mail]
d. Faciltiy name:*
North 321 Quarry
e. Facility address:* Street Address
3578 Blowing Rock Boulevard
Address Line 2
City State / Province / Region
Lenoir NC
Postal / Zip Code Country
28645 US
Is the FACILITY contact different than the person legally responsible above?*
QQ Yes
Q No
f. Facility contact person:
First name: * Middle name: Last name: *
ravis I (Barnes
Phone #: * 828-754-5348
Email address: * [e-mail]
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https://edocs.deq.nc.gov/Forms/SW-Name-Change 6/4/2019