WQ0002052_WPCSODF_20201204

December 411 , 2020
Ashville Regional Office
2090 US Highway 70
Swannanoa, NC 28778
Re: WQ0002052
To whom it may concern:
Enclosed, please find ORC Designation Form. Mike Fortenberry will
the Operator in Responsible Charge. Barbara Warlick and Kyle Towery will be
backup ORCs.
Si
ncerely ,
f_
Greg Marana
Engineering Services Leader
Milliken & Company
Golden Valley Plant
( 828 ) 247-4313
W�� + I
DEC 0 I
Water Quality Regional 0 Asheville Regional pW ticrj .

WATER POLLUTION CONTROL SYSTEM OPERATOR DESIG IO��EQRM(�AffS CC)
NCAC 15A 8G .0201 D 11 UU �� LZuUIuu
Press TAB to enter information Water Quality Regional U. ration'
Permittee Owner/Officer Name: Mike Tutterow Asheyllle Regional 01 ice
Email Address: [e-mail]
�:. ✓ I� -- Date: /ZAWZ70 Z.
Permittee Signature: A
Facility Name: Milliken & Company, Golden Valley Plant Permit # WQ0002052
SUBMIT SEPARATE FORM FOR EACH CLASSIFICATION OF SYSTEM: Facility Type: SI
Facility Grade: N/C
ORC- OPERATOR IN RESPONSIBLE CHARGE
Print Full Name: Mike Fortenberry Work Phone: [phone]
Certificate Type: SI Certificate Grade: Select Certificate #: 27004
Email Address: m
Signature: //� ✓ Effective Date:
"I certify that agree to my designatio�i as the Opera(or ' Responsible Charge for the facility noted. I understand and will abide by the
rules and regulations pertaining to the responsibilities of the ORC as set forth in 15A NCAC OBG .0204 and failing to do so can result in
Disciplinary Actions by the Water Pollution Control System Operators Certification Commission."
BACKUP ORC
Print Full Name: Barbara Warlick Work Phone: [phone]
Certificate Type: SI Certificate Grade: Select
Email Address: [e-mail]
Certificate #: 1003683
Signature: �jdAb6(A.— �J G Effective Date:
"I certify that / 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 ORC as set forth in 15A NCAC 08G .0204 and failing to do so can result in
Disciplinary Actions by the Water Pollution Control System Operators Certification Commission."
Mail, fax or email WPCSOCC, 1618 Mail Service Center, Raleigh, NC 27699-1618
ORIGINAL to: Email:[e-mail] Fax:[phone]
Mail or Fax a COPY to: Asheville
Fayetteville
Mooresville
Raleigh
2090 US Hwy 70
225 Green St., Suite 714
610 E. Center Ave., Suite 301
3800 Barrett Dr.
Swannanoa, NC 28778
Fayetteville, NC 28301-5043
Mooresville, NC 28115
Raleigh, NC 27609
Fax: [phone]
Fax:[phone]
Fax:[phone]
Fax:[phone]
Phone: [phone]
Phone:[phone]
Phone:[phone]
Phone:[phone]
Washington
Wilmington
Winston-Salem
943 Washington Sq. Mall
127 Cardinal Dr.
45 W. Hanes Mill Rd.
Washington, NC 27889
Wilmington, NC 28405-2845
Winston-Salem, NC 27105
Fax:[phone]
Fax:[phone]
Fax:[phone] Phone:
Phone:[phone]
Phone:[phone]
336-776-9800

Page 2
Facility Name: Milliken & Company, Golden Valley Plant Permit #: WQ0002052
BACKUP ORC
Print Full Name: Kyle Towery
Work Phone: [phone]
Certificate Type: SI
Certificate Grade: Select
Email Address: [e-mail]
Signature:
Certificate #:1003684
Effective Date: —a ,q • go
"I certify that/ agree [o my designati6las 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 ORC as set forth in 15A NCAC 08G.0204 and failing to do so can result in
Disciplinary Actions by the Water Pollution Control System Operators Certification Commission."
BACKUP ORC
Print Full Name:
Certificate Type: Select
Email Address:
Certificate Grade: Select
Work Phone:
Certificate #:
Signature: EffectiveT1j. '
"I certify that I agree to my designation as a Back-up Operator in Responsible Charge far the facility r rs ari an w 4k.�p�d� by
the rules and regulations pertaining to the responsibilities of the ORC as set forth in 15A NCAC 08G. and failing to do so can resultini
Disciplinary Actions by the Water Pollution Control System Operators Certification Commission." DEC 0 7 2020
BACKUP ORC
Print Full Name:
Certificate Type: Select Certificate Grade: Select
Email Address:
Signature:
Work Phone:
Certificate #:
Effective Date:
"1 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 ORC as set forth in 15A NCAC 08G.0204 and failing to do so can result in
Disciplinary Actions by the Water Pollution Control System Operators Certification Commission."
BACKUP ORC
Print Full Name: Work Phone:
Certificate Type: Select Certificate Grade: Select Certificate #:
Email Address:
Signature:
Effective Date:
"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 ORC as set forth in 15A NCAC OSG.0204 and failing to do so can result in
Disciplinary Actions by the Water Pollution Control System Operators Certification Commission."