NCS000554_MONITORING INFO_20190528

M)
STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/�/ C, S U �C) 55�
DOC TYPE
❑ HISTORICAL FILE
MONITORING REPORTS
DOC DATE
❑ ,-/ D
YYYYM M D D

(' DUKE
ENERGY®
May 22, 2019
DEMLR - Stormwater Program
Department of Environmental Quality
1612 Mail Service Center
Raleigh, NC 27699-1612
Subject: Delegation of Signature Authority
Buck Combined Cycle
NPDES Permit No. NCS000554
Rowan County
To Whom It May Concern:
Paul Draovitch
Senior Vice President
Environmental, Health & Safety
526 S. Church Street
Mail Code: EC3XP
Charlotte, NC 28202
[phone]
SCANNED
MAY 2019
vPlft,t.e 40 L-F
REOFITF7
MAY 2 8 2019
DENR-LAND QUALITY
STORMWATER PERMITTING
Duke Energy Carolinas, LLC, submits this correspondence as a revision to documentation for your
records of designation of duly authorized representatives ("Delegated Authorities") for the NPDES
Stormwater Permit for Buck Combined Cycle. We are requesting the removal of Henry Botkins Jr. as the
delegated Authority, effective .tune I, 2019.
Should you have any questions regarding this letter or require additional information, please contact Ms.
Elizabeth Glenn at [e-mail] or 980-373-0530.
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that qualified personnel properly gather and
evaluate the information submitted. Based on my inquiry of the person or persons who manage the system,
or those persons directly responsible for gathering the information, the information submitted is, to the best
of my knowledge and belief, true, accurate, and complete. 1 am aware that there are significant penalties for
submitting false information, including the possibility of fines and imprisonment for knowing violations."
Sincere[ ,
Paul Draovitch
SVP - Environmental, Health & Safety
Enclosure
cc: Mooresville Regional Office - Stormwater Section

Division of Energy, Mineral, and Land Resources
Land Quality Section / Stormwater Program
National Pollutant Discharge Elimination System (NPDES)
EnergLand
, sourc s PERMIT OWNER AFFILIATION DESIGNATION FORM
Land Resources
ENVIRONMENTAL QUALITY (Individual Legally Responsible for Permit)
Use this form if there has been:
FOR AGENCY used ONLY
Mw Rer i,,
Year
Nfo111I1
I Day
NO CHANGE in facility ownership or facility name, but the individual
who is legally responsible for the permit has changed.
If the name of the facility has changed, or if the ownership of the facility has changed,
do NOT use this form. Instead, you must fill out a Name -Ownership Change Form
and submit the completed form with all required documentation.
What does `legally responsible individual' mean?
The person is either:
• the responsible corporate officer (for a corporation); pp
• the principle executive officer or ranking elected official (for a municipality, state, fedMAY pbth20df lblic
agency); DENR-LAND OUALI
TY
• the general partner or proprietor (for a partnership or sole proprietorship); "ORMWATER PERMI NG
• or, the duly authorized representative of one of the above.
1) Enter the permit number for which this change in Legally Responsible Individual ("Owner Affiliation")
applies:
Individual Permit
N C S lo lo I0 5 5 4
2) Facility Information:
Facility name:
Company/Owner Organization:
Facility address:
(or) Certificate of Coverage
N I C I G
Buck Combined Cycle Station (CTCC)
Duke Energy Carolinas, LLC
1385 Dukeville Road
Address
Salisbury NC 28146
City State Zip
To find the current legally responsible person associated With your permit, go to this website:
http://deg. nc. gov/about/d ivis i ons/energy-m i neral-land-resources/energy-mineral-I and -perm its/stormwater-program
and run the Permit Contact Summary Report.
3) OLD OWNER AFFILIATION that should be removed:
Previous legally responsible individual: Henry A Botklns Jr.
First MI Last
d) NEW OWNER AFFILIATION (legally responsible for the permit):
Person legally responsible for this permit:
Kristopher C Eisenrieth
First MI Last
Page I of
S W U-OWN17 RAFT 11,23 Ma rch2017

NPDES Stormwater Permit OWNER AFFILATION DESIGNATION Form
(if no Facility Name/Ownership Change)
5) Reason for this change:
A result of:
1j'o1her please explain:
General
Title
1385 Dukeville Road
Mailing Address
Salisbury NC 28146
City State Zip
( 704 ) 630-3015 [e-mail]
Telephone E-mail Address
Fax Number
❑� Employee or management change
❑ Inappropriate or incorrect designation before
❑ Other
The certification below must be completed and signed by the permit holder.
PERMITTEE CERTIFICATION:
1, Paul Draovitch , attest that this application for this change in Owner Affiliation
(person legally responsible for the permit) has been reviewed and is accurate and complete to the best of my
know ge. I understa» hat if all required parts of this form are not completed, this change may not be
processe .
Signature Date
PLEASE SEND THE COMPLETED FORM TO:
DEMLR - Stormwater Program
Dept. of Environmental Quality
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
For more information or staff contacts, please call [phone] or visit the website
at: littp:Hdeg.nc.gov/about/divisions/energv-mineral-land-resources/stortmvntei-
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