NCC205539_Modification Review_20210422

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 4/20/2021 4:07:25 PM (ADD TO FILE Submittal)
Approve by Georgoulias, Bethany 4/22/2021 10:14:33 AM (Construction COC ADD TO FILE Review- NCC205539)
• The task was assigned to Georgoulias, Bethany. The due date is: April 23, 2021 5:00 PM
4/20/2021 4:07 PM

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NORTH CAPOLINA
EnYlrenmemf& Qualay
Certificate of NCC205539
Coverage (COC) Enter the Certificate of Coverage Ninber (Use capital letters)
No.*
Information associated with this permit
Project Name
Fluor -United Concrete Batch Plant
Address
5200 Hendersonville Road, Fletcher, NC
County
Henderson
Latitude
35.4115
Longitude
-82.5108
Permittee Listed
Fluor -United Asheville LLC
Legally Responsible
Andrew Owen
Individual
NC Reference No.
NCG01-2020-5539
E&SC Plan ID
HENDE-2021-006
Original NOI
37786
Tracking No.*
Date COC Issued*
12/02/2020
Prior Rescission
This field will populate only if CCChas already been rescinded.
Date
Modification Information:
Reason for r Closed -Out Lots/Outparcels in E&SC Plan
Modification * r Additional Lots/Outparcels Approved - E&SC Revised
F Other Revision(s) to E&SC Plan
r Legally Responsible Individual and/or Site Contact Has Changed
r Multiple Reasons (List)
Addional Ivbre information (e.g., new Site Contact details). If lots are being added, please include specific lot nunbers.
Explanation Site revised and acres approved changed from 3.00 acres to 4.00 acres.
You must upload supporting documentation below. Do not upload E&SC Plans unless specific plan
sheets are the only documentation with approval for revised acres of disturbance, etc. (only upload applicable
sheets).
For changes to the legally responsible individual, you must upload this form.

Supporting Upload Supporting Documentation (%vised E&SCApproval, (lose -Cut Doc, etc.)
Documentation Fluor -United Asheville - Batch Plant - Letter of
Approval with Modifications (LoAwM) & CoPA 04-13- 728.79KB
2021.pdf
Mast be FDFformat
North Carolina General Statute 143-215.66 (1) provides that:
Anyperson who knowinglymakes anyfalse statement, representation, or certification in anyapplication, record, report, plan, or other
documentfiled or required to be maintained under this Article or a rule implementing this Article; or who knowinglymakes a false statement
of a material fact in a rulemaking proceeding or contested case underthis Article; orwho falsifies, tampers with, or knowingly renders
inaccurate any recording or monitoring device or method required to be operated or maintained under this Article or rules of the
Commission implementing this Article shall be guiltyofa Class 2 misdemeanor which mayinclude a fine notto e)ceed ten thousand
dollars ($10,000).
rJ I hereby request modification to coverage under the NPDES Stormwater Permit
for the subject project site. I am familiar with the information contained in this
request and to the best of my knowledge and belief such information is true,
complete and accurate.
Specify if you are:* r The Legally Responsible Individual
f Authorized Responsible Person*
*This form must be signed by a responsible corporate officer that owns or operates the construction activity, such as a
president, secretary, treasurer, or vice president, or a manager that is authorized in accordance with Part IV, Section B,
Item (6) of the NCG010000 General Permit. For more information on signatory requirements, see Part IV, Section B,
Item (6) of that permit.
Signature
vio-
Type Name* Andrew Owen
Title * Project Engineer
Organization* Fluor -United Asheville, LLC
Date * 04/20/2021
Email Address* [e-mail]
Errail for confirmation
Telephone Number* 8645615785
Contact nun ber if we need to reach you
Note: Original permittee and site contact are copied on modification correspondence.
Additional Email [e-mail]
(Optional) Additional errail for confirmation
Original Permittee [e-mail]
Email
Original Site Contact [e-mail]
Email
Review Date 04/22/2021
Rescinded Since
Submitted?

Request Date 20210420
Formatted
Review Date 20210422
Formatted