NC0021865_Signature Authority_20141002

Town of Chadbourn
"The Strawberry Capital"
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602 NORTH BROWN STREET * CHADBOURN, NORTH CAROLINA 28431
TELEPHONE: [phone]
September 24, 2014
Dean Hunkele, Senior Environment Specialist — Surface Water Protection
North Carolina Department of Environment and Natural Resources
Wastewater Branch
Water Quality Permitting Section
Division of Water Resources
127 North Cardinal Drive
Wilmington, North Carolina 28405
Subject: Delegation of Signature Authority
Dear Mr. Hunkele:
On October 7, 2014, Stevie Cox will be stepping down as the Chadbourn Town Manager. At this
time, he has the power of delegation of signature authority for the Town of Chadbourn. Upon his
departure, Patricia Garrell will serve as the interim Town Manager until a new manager can be named.
I authorize that Patricia Garrell be given all administrative responsibility and authority effective
October 3, 2014 for the Town of Chadbourn. By notice of this letter, I hereby delegate signatory
authority to Patricia Garrell for all permit applications, discharge monitoring reports, and other
information relating to the Town of Chadbourn as required by all applicable federal, state, and local
environmental agencies specifically with the requirements for signatory authority as specified in 15A
NCAC 2B.0506. Attached are copies of the following documents that have been completed and
signed:
1. Submitter Change Request Form.
Name Title
Patricia Garrell Finance Officer and Town Clerk
If you have any questions regarding this letter, please feel free to contact me at: (910) 654 -4148.
Sincerely,
Donald Ray Bass
Mayor Pro Tern
cc: NCDWR Wilmington Regional Office, Water Quality Permitting Section

DWR
1XV14on of Water Resources
Submitter Change Request Form — (Add /update users)
North Carolina Electronic Discharge Monitoring Report System
EDMR registered Owners may use this form to add or update eDMR users to the NCDWR's Electronic
Discharge Monitoring Report system. If the Organization is not currently registered for eDMR, then the
Owner or designated Responsible Official will need to complete the required eDMR Registration Form
(available from the eDMR website) and submit it to the NCDWR eDMR Administrator at the address
below.
Type of Request (please select):
_Add Submitter Permissions: (See Section B)
Update Submitter Permissions: (See Section B)
To add or update eDMR user permissions, please provide the following information:
Section A: Owner Information
NPDES Permit Number:
NC 001-1 &-6 5
Owner / Organization Name:
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Responsible Official
as identified in accordance with 40 CF-R 122.22
Street Address:
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Telephone number:
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E -mail address:
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Section B: Activate New Submitter or Update Existing User
Please complete the Submitter User Details on page 2 for the individuals who will need Submitter
permissions or to update Submitter details, such as adding additional permits, to an existing user.
Submitter permissions can only be assigned by the NCDWR eDMR Administrator. Note: The Owner
and Facility Administrator can deactivate or delete eDMR user permissions for any individual within
its organization, including Submitter permissions.
The Submitter is equivalent to the individual who signs the certification statement on the back of the
Discharge Monitoring Report. The Submitter must be an individual with delegated signatory authority
for the Owner /Organization. If individuals other than the Responsible Official for the Owner have been
delegated signatory authority, the Division of Water Resources must be notified in writing of such
delegations. A delegation of authority form is available from the eDMR website.
In addition to the User Details, please specify the NPDES permit(s) that each user will be associated with
for eDMR submittal. Should additional space be needed for users and/or permits, please make additional
copies of the Submitter User Details page and complete as needed.
NCDWR eDMR Submitter Change Request Form - ver.1.0 Page 1

Submitter User Details
Permit No. (s):
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First Name:
First Name:
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Middle Name:
Last Name:
Last Name:
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Phone Number:
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User 1D:
(Assigned by NCDWR eDMR Administrator
Select Request
Type:
ErAdd User Permission
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Add/Update User Permission as of (Date): 1—? 3 1
11 Update User Permission
Submitter User Details
Permit No. (s):
First Name:
First Name:
Middle Name:
Middle Name:
Last Name:
Last Name:
Phone Number:
Phone Number:
( )
Email:
User ID:
User ID:
Assigned 6y NCDWR eDMR Administrator
Select Request
Type:
❑Add User Permission
Add/Update User Permission as of (Date):
❑ Update User Permission
Submitter User Details
Permit No. (s):
First Name:
Middle Name:
Last Name:
Phone Number:
( )
Email:
User ID:
(Assigned 6 NCDWR eDMR Administrator)
Select Request
Type:
❑ Add User Permission
Add/U date User Permission as of (Date):
❑ Update User Permission
NCDWR eDMR Submitter Change Request Form — ver.1.0 Page