NC0089656_ORC Name change document_20220912

RECEIVED/NCDEQ/DWR
Water Pollution Control System Operator Designation DYED/NCDEQ/DWR
NOV 9 2022 wPCsoCC 4{ ,
NCAC 15A 8G .0201i;
WQROS
MC1fiYY4APAYtilc@lFNgEle:
Dimensional Plaza LLC/ Bernard Grzelak
Mailing Address: 6300 Bee Cave Road
City: Austin
State: TX Zip: 78746
Email address: [e-mail]
Signature:
WQROS
MOORESVILLE REGIONAL OFFICE
Phone #: ( 512) 306-7400
Facility Name: Dimensional Place - Subterranean Parking Dewatering permit #: NC 0089656
SUBMIT A SEPARATE FORM FOR EACH TYPE SYSTEM!
Facility Tyne/Grade:
Biological WWTP
Physical/Chemical
Collection System
Surface Irrigation
Land Application
Operator in Responsible Charge (ORC)
Print Full Name: Glenn Price
Certificate Type / Grade / Number: PC / 1 / 985800
Signature: g/4.C4-
Work Phone #: ( 336) 408 - 7924
Date: 11 / 01 / 2022
"1 certify that I agree to my designation as the Operator in Responsible Charge for the facility noted. I understand and will abide by the Hiles
and regulations pertaining to the responsibilities of the ORC as set forth in I5A NCAC 08G .0204 and failing to do so can result in Disciplinary
Actions by the Water Pollution Control System Operators Certification Commission."
Back -Up Operator in Responsible Charge (BU ORC)
Print Full Name: Baron Neal McDuffie
Certificate Type / Grade / Number: PC / 1 / 987105
Signature: 9a44 44aiNc-Payr.e,.g.
Work Phone #: ( 336 )402 - 9924
Date: 11 / 01 / 2022
"I certify that I agree to my designation as a Back-up Operator in Responsible Charge for the facility noted. I understand and will abide by the
rules and regulations pertaining to the responsibilities of the BU ORC as set forth in I5A NCAC 08G .0205 and failing to do so call result in
Disciplinary Actions by the Water Pollution Control System Operators Certification Conunission."
Mail, fax or email the
original to:
Mail or fax a copy to the
appropriate Regional Office:
WPCSOCC, 1618 Mail Service Center, Raleigh, NC 27699-1618
Etttatt tadinin(&ticdenr.gov
r:go
Asheville
2090 US Hwy 70
Swannanoa 28778
Fax: [phone]
Phone: [phone]
Washington
943 Washington Sq Mall
Washington 27889
Fax: [phone]
Phone: [phone]
Fayetteville
225 Green St
Suite 714
Fayetteville 28301-5043
Fax: [phone]
Phone: [phone]
Wilmington
127 Cardinal Dr
Wilmington 28405-2845
Fax: [phone]
Phone: [phone]
Fax: [phone]
Mooresville
610 E Center Ave
Suite 301
Mooresville 28115
Fax: [phone]
Phone: [phone]
Winston-Salem
585 Waughtown St
Winston-Salem 27107
Fax: [phone]
Phone: [phone]
Raleigh
3800 Barrett Dr
Raleigh 27609
Fax: [phone]
Phone:[phone]
Revised 02-2013