NCG080697_SW Permit DOSA_20210318

McCoy, Suzanne
From: Huffman, Mike <[e-mail]>
Sent: Thursday, March 18, 2021 1:26 PM
To: McCoy, Suzanne
Subject: RE: [External] Facility Contact Information NCG080697
Attachments: SW-DOSA-Form-020821 City_Signed.pdf
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
Report Spam.
Attached is the DOSA for our MS4 permit - NCS000489. Where can I find the eDMR registration form?
Please let me know if you need any additional information.
Thanks Suzanne!
Mike
From: McCoy, Suzanne <[e-mail]>
Sent: Thursday, March 18, 2021 12:45 PM
To: Huffman, Mike <[e-mail]>
Subject: RE: [External] Facility Contact Information NCG080697
Be Advised: This email originated from outside of the Hendersonville network. Do not click links or open attachments unless you
recognize the sender and know the content is safe.
I don't see why not.
What is the NCS# so I may link a copy to the NCG#.
You will still need to complete the eDMR registration form, if you have Quantitative reporting.
Suzanne McCoy
Stormwater Program Administrative Specialist
Division of Energy, Mineral and Land Resources
Department of Environmental Quality
512 N. Salisbury Street, Office 640K, Raleigh, NC 27604
1612 Mail Service Center, Raleigh, NC 27699-1612
919-707-3640
Based on the current guidance to minimize the spread of COVID-19, the Department of Environmental Quality has adjusted operations to protect the health and
safety of the staff and public. Many employees are working remotely or are on staggered shifts. To accommodate these staffing changes, all DEQ office locations are
limiting public access to appointments only. Please check with the appropriate staff before visiting our offices, as we may be able to handle your requests by phone or
email. We appreciate your patience as we continue to serve the public during this challenging time.
Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties.

From: Huffman, Mike <[e-mail]>
Sent: Thursday, March 18, 2021 12:09 PM
To: McCoy, Suzanne <[e-mail]>
Subject: RE: [External] Facility Contact Information NCG080697
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
Report Spam.
Thank you Suzanne,
I have one other questions. I've submitted a DOSA form for the City's MS4 Permit, can that form also serve as the DOSA
for this facility's General Permit?
Thanks!
Mike H
From: McCoy, Suzanne <[e-mail]>
Sent: Thursday, March 18, 2021 12:06 PM
To: Huffman, Mike <[e-mail]>
Subject: RE: [External] Facility Contact Information NCG080697
Be Advised: This email originated from outside of the Hendersonville network. Do not click links or open attachments unless you
recognize the sender and know the content is safe.
Good afternoon Mike.
I have updated the facility contact and it will appear on reports the next day.
Suzanne McCoy
Stormwater Program Administrative Specialist
Division of Energy, Mineral and Land Resources
Department of Environmental Quality
512 N. Salisbury Street, Office 640K, Raleigh, NC 27604
1612 Mail Service Center, Raleigh, NC 27699-1612
919-707-3640
Based on the current guidance to minimize the spread of COVID-19, the Department of Environmental Quality has adjusted operations to protect the health and
safety of the staff and public. Many employees are working remotely or are on staggered shifts. To accommodate these staffing changes, all DEQ office locations are
limiting public access to appointments only. Please check with the appropriate staff before visiting our offices, as we may be able to handle your requests by phone or
email. We appreciate your patience as we continue to serve the public during this challenging time.
N{7kfT�
p@pNpno-M of FnrironmruUl q—ih�y
Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties.
From: Huffman, Mike <[e-mail]>
Sent: Thursday, March 18, 2021 11:56 AM
To: McCoy, Suzanne <[e-mail]>
Subject: [External] Facility Contact Information NCG080697

CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
Report Spam.
Good afternoon Suzanne,
I would like to update the facility contact information for the City of Hendersonville Garage, Permit NCG080697
The facility contact should be:
Michael Huffman, Stormwater Administrator
Email: [e-mail]
Phone: [phone]
Address: 305 Williams St. Hendersonville, NC 28792
Please let me know if you need any additional information,
Thanks!
Michael Huffman, CPMSM
Stormwater Administrator
City of Hendersonville, NC
Office: 828-697-3013
Cell: 828-458-5693
[e-mail]

NC Department of Environmental Quality
Division of Energy, Mineral and Land Resources
NORTH CAROLINA
shvlronmenralQuality
Stormwater Permit Delegation of Signature Authority Form
Directions are in red.
This form shall be used to delegate signature authority from the permit Owner (Permittee) to
another party. Only the Responsible Official defined below may submit permit applications and
reports required by the permit (such as Data Monitoring Reports and Annual Reports) until this
form is completed and submitted to the DEMLR Stormwater Program. Please note that delegating
signature authority does not relieve the Permit Owner from the responsibility for permit
compliance.
The permit Owner is the legal entity to which whom a permit has been issued, and may be an individual
or an organization such as a company or government agency. Every Owner is required to have a
Responsible Official who meets the legal signature authority requirements in 40 CFR 122.22 summarized
below.•
• For a corporation, the Responsible Official shall be a president, secretary, treasurer, or vice-
president in charge of a principal business function, or another individual who performs similar
functions for the corporation, or the manager of one or more manufacturing, production, or operating
facilities who is authorized to make management decisions about the facility operation.
• For a partnership or sole proprietorship, the Responsible Official shall be a general partner or the
proprietor, respectively; or
• For a municipality, State, Federal, or other public agency, the Responsible Official shall be either a
principal executive officer [City/County Manager] or ranking elected official (Mayor].
Even if delegated signatory authority has been delegated to another individual, the Responsible Official
retains responsibility for compliance with permit conditions.
Permittee:
Permit Number:
Responsible Official Title:
Email Address:
Mailing Address:
City:
City of Hendersonville, NC
NCS000489
City Manager
[e-mail]
160 6th Ave. East
Hendersonville
Phone: [phone]
State: INC I Zip: 128792
Stormwater Delegation of Signature Authority Form
Page 1

A. Persons to Receive Signatory Authority
=:> The signatures of the persons listed below indicates their acceptance of signatory authority.
Delegated Party Name:
Michael S. Huffman
Delegated Party Title:
Stormwater Administrator
Delegated Party Organization:
city of Hendersonville, NC
Email Address:
[e-mail]
Phone:
828-697-3013
Mailing Address:
305 Williams St
City:
Hendersonville
I State:
NC
Zip:
28792
Signature of Delegated Party indicating
acceptance of Signatory Authority:
Date:
2/8/21
Delegated Party Name:
Delegated Party Title:
Delegated Party Organization:
Email Address:
Phone:
Mailing Address:
City:
State:
Zip:
Signature of Delegated Party indicating
acceptance of Signatory Authority:
Date:
Delegated Party Name:
Delegated Party Title:
Delegated Party Organization:
Email Address:
Phone:
Mailing Address:
City:
State:
Zip:
Signature of Delegated Party indicating
acceptance of Signatory Authority:
Date:
Delegated Party Name:
Delegated Party Title:
Delegated Party Organization:
Email Address:
Phone:
Mailing Address:
City:
State:
Zip:
Signature of Delegated Party indicating
acceptance of Signatory Authority:
Date:
Stormwater Permit Delegation of Signatory Authority Form
Page 2

B. Responsible Official Signature
The Responsible Official, as identified in accordance with 40 CFR 122.22, is the appropriate
individual with the authority to sign and submit reports for the organization.
As the Responsible Official, I, %Lv1_P Cbnn4�_ (printed name),
havetheauthority to enter into this Agreement for
lam. o� e"► d��"so►'��i'i%-C- (Owner/Organization Name).
I request that the DEMLR Stormwater Program include the persons listed in Part A of this form
signatory authority for the above -named permit.
I acknowledge that I, and the persons fisted in Part A of this form work at/for my organization
and have authority to act as a signatory for purposes of the NCDEQ's electronic document
systems.
By submitting this application, I, S� �r1 CQvXy>44— (printed name),
have read, understand, and accept the terms and conditions of the stormwater permit(s) for
which I am the Responsible Official.
Z-g -2(
Date
Stormwater Permit Delegation of Signatory Authority Form
Page 3