NC0089052_Delegated Authority_20200103

Date: a-
Wastewater Branch RECEIVED
Water Quality Permitting Section JAN 0 3 2020
Division of Water Resources
1617 Mail Service Center NCDEQ/DWRINPDES
Raleigh,NC 27699-1617
Subject: Delegation of Signature Authority
Facility Name:
NPDES Permit Number: NICI 0 I 0 I -8 19 10 15 12 I
To Whom It May Concern:
By notice of this letter, I hereby delegate signatory authority to each of the following individuals for all
permit applications, discharge monitoring reports, and other information relating to the operations at
the subject facility as required by all applicable federal, state, and local environmental agencies
specifically with the requirements for signatory authority as specified in I5A NCAC 2B.0506.
Individual #1 Individual #2 (if applicable)
Name: Alan Reitzel Gaddis William Keith McDonald
Title: Wastewater Consultant Operator in Responsible Charge
6119 Asheton Drive 3427 Katrina Drive
Mailing Address: Trinity,N.C. 27370 Thomasville,N.C. 27360
Physical Address:
(f different)
Email Address: [e-mail] [e-mail]
Office Phone:
Mobile Phone: [phone] 336-905-1717
If you have any questions regarding this letter, please feel free to contact me at either the phone
number or email address below.
Si •el ,
/76-4/
Authorized SI' ning Official's Signature
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Mailing Address
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Email Address
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Office Phone Mobile Phone
cc: Winston Salem Regional Office. Water Quality Permitting Section
(Enter region ncnne)