NCG030281_Email from Consultant_20210104

McCoy, Suzanne
From: Lindsay Fletcher <[e-mail]>
Sent: Monday, January 4, 2021 1:50 PM
To: McCoy, Suzanne
Cc: Downes, Robert
Subject: [External] Changes to Permit Contacts for Tipper Tie Inc. (NCG030281)
Attachments: Tipper Tie Responsible Party Designation Form.pdf, Tipper Tie Delegation of Authority
Letter.pdf, SW E-Permitting Registration_1_4_2020.pdf
Follow Up Flag: Follow up
Flag Status: Flagged
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
Report Spam.
Suzanne,
I am working with Tipper Tie Inc. on updating their permit contacts for SW Permit NCG030281.
There is currently no legally responsible person listed for the permit. I am mailing the "Permit Owner Affiliation
Designation Form" to list Robert T. Downes as the Responsible Official. I am also attaching a copy of the form here. He is
also the Facility Administrator and Billing Contact
His contact information should be updated and listed for the Owner Contact Person, Facility Contact Person, Permit
Contact Person, and Permit Billing Contact.
Contact Name: Robert T. Downes
Title: Facilities Manager
Address: 2000 Lufkin Road Apex, NC 27539
Phone: [phone]
Fax: [phone]
Email: Robert. [e-mail]
I am also attaching copies of the Signature Delegation Form and the E-Reporting Registration Forms. I will mail the
original copies to the addresses provided.
For Person with Delegated Signatory Authority, my contact information is listed below
Contact Name: Lindsay Fletcher
Title: Kleinfelder, Professional Engineer
Address: 3200 Gateway Centre Blvd. Suite 100 Morrisville, NC 27560
Phone: [phone]
Fax: [phone]
Email: [e-mail]
I submitted the site's 2020 DMRs today as discussed over the phone.
Thank you for your assistance,
1

Lindsay L. Fletcher, PE
Project Professional
3200 Gateway Centre Blvd, Suite 100
Morrisville, NC 27560
d 919.653.7023
o 919.755.5011
m 1713.299.0304
r DER
Bright Noph!. fight SOUTions.
This email may contain confidential information. If you have received this email —including any attachments —in error, please notify
the sender promptly and delete the email and any attachments from all of your systems.

NORTH CAROLINA
Environmental Quality
NC Department of Environmental Quality
Division of Energy, Mineral and Land Resources
Stormwater eReporting Registration Form
� Completion of the Stormwater Electronic Reporting (eReporting) Registration Forrn is a
required step for the Owner and, if applicable, Facility Administrator(s) to obtain the
privilege of submitting electronic reports to DEQ and in lieu of submitting paper reports.
� In addition, this form allows for Owners to designate Responsible Officials and Facility
Administrators who can act on their behalf. Responsible Officials and Facility
Administrators must agree to the Electronic Signature Agreement (ESA) Conditions
contained in this form.
A. Owner Information
The Owner is the legal entity to which/whom a permit has been issued. The Owner
may be an individual or organization. Every Owner is required to have a Responsible
Official who meets the legal signature authority requirements in 40 CFR 122.22.
• For a corporation, this individual shall 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, this individual shall be a general partner or
the proprietor, respectively; or
• For a municipality, State, Federal, or other public agency, this individual shall be
either a principal executive officer or ranking elected official.
Owner Name:
Tipper Tie Inc.
Responsible Official Name:
Robert T. Downes
Title:
Facilities Manager
Does the Responsible Official
already have an eDMR account?
❑Yes El NO
If Yes,
User ID:
Email Address:
Robert. [e-mail]
Phone:
919-802-2466
Mailing Address:
2000 Lufkin Road
City:
Apex
IState:
INC
I Zip:
27539
Stormwater Electronic Reporting Registration Form
Page 1

B. Permit Information
=> Include all stormwater permit currently held by the Owner (both Individual and General
permits). Designate any applicable Facility Administrators for each permit. Attach
additional pages if you need more space.
Permit No.
Facility Name
Facility Address
Facility Administrators)
if applicable)
NCG030281
Tipper Tie Inc.
2000 Lufkin Road Apex, NC 27539
Robert T. Downes
stormwater Electronic Reporting Registration Form
Page 2

C. Facility Administrator Information
=> Include the following information for all Facility Administrators listed in Part D. Attach
additional pages if you need more space.
Facility Administrator for Permit Number:
Name:
Robert T. Downes
Title:
Facilities Manager
Do you already have an eDMR
account?
❑Yes 0 No
If Yes,
User ID:
Organization:
Tipper Tie Inc.
Email Address:
[e-mail] I
Phone:
919-802-2466
Mailing Address:
2000 Lufkin Road
City: lApex
State:
NC
Zip:
27539
Facility Administrator for
Permit Number:
Name:
Title:
Do you already have an eDMR
account?
❑Yes ❑ No
If Yes,
User ID:
Organization:
Email Address:
Phone:
Mailing Address:
City:
IState:
Zip:
Facility Administrator for
Permit Number:
Name:
Title:
Do you already have an eDMR
account?
❑Yes ❑ No
If Yes,
User ID:
Organization:
Email Address:
Phone:
Mailing Address:
City:
State:
Zip:
Facility Administrator for
Permit Number:
Name:
Title:
Do you already have an eDMR
account?
❑Yes ❑ No
If Yes,
User ID:
Organization:
Email Address:
Phone:
Mailing Address:
City:
State:MENNEN
Zip:
Facility Administrator for Permit Number:
Name:
Title:
Do you already have an eDMR
account?
❑Yes ❑ No
If Yes,
User ID:
Organization:
Email Address:
Phone:
Mailing Address:
City:
State:
Zip:
Stormwater Electronic Reporting Registration Form
Page 3

D. Delegation of Signature Authority Letter
=> Attach a Stormwater Delegation of Signature Authority Letter on official company
letterhead that lists every Facility Administrator included in Part B. This letter must be
signed by the Responsible Official to request that the User(s) be allowed to submit
electronic reports.
E. Electronic Signature Agreement Conditions
To receive and accept the required electronic signature credential, consisting of a User ID and
password, issued by the North Carolina Department of Environmental Quality (NCDEQ) in order
to sign electronic documents submitted to NCDEQ's Electronic Document Systems and to
receive electronic documents from NCDEQ's systems;
The Responsible Official and Submitter(s) (if applicable) named in this form do herby:
1. Understand that this Electronic Signature Agreement requires me to submit electronic
documents to NCDEQ's approved eDMR system under the authorized program in lieu of paper
submissions.
2. Understand that this Electronic Signature Agreement requires me to accept electronic
transmissions, in lieu of paper transmissions of all permits, permit modifications, authorizations
to construct, and any other correspondence related to reviewing and processing permits from
NCDEQ. This authorization will not become effective until NCDEQ establishes a system for
processing electronic documents; I am notified in writing from NCDEQ that use of the electronic
systems has officially been initiated; and North Carolina rules and statutes are changed to allow
the implementation of electronic submittal and acceptance of documents.
3. Understand that this Electronic Signature Agreement requires me to submit electronic all
necessary information for processing of NPDES application including information for renewal of
existing permits, modification to existing permits, and applications for new discharge permits.
The submittals may include all necessary applications and supporting documentation to
NCDEQ's approved system for electronic submittals in lieu of paper submissions. This
authorization will not become effective until NCDEQ establishes a system for processing
electronic documents; I am notified in writing from NCDEQ that use of the electronic systems
has officially been initiated; and North Carolina rules and statutes are changed to allow the
implementation of electronic submittal and acceptance of documents.
4. Understand that this Electronic Signature Agreement requires me to accept electronic
submissions, in lieu of paper submissions, of all Notices of Deficiency, Notices of Violation, Civil
Penalty Assessments, and any other correspondence related to compliance with federal and
state water quality laws and regulations that might be sent by NCDEQ. This authorization will
not become effective until NCDEQ establishes a system for processing electronic documents;
am notified in writing from NCDEQ that use of the electronic systems has officially been
initiated; and North Carolina rules and statutes are changed to allow the implementation of
electronic submittal and acceptance of documents.
5. Agree to protect both the electronic signature credential, consisting of my User ID and
password, and security questions and answers, from compromise and from use by anyone
except me. Specifically, I agree to maintain the secrecy of my electronic signature credential
and security questions and answers; I will not divulge or delegate my credential or security
questions and answers to any other individual; I will not store my credential or security
questions and answers in an unprotected location; and I will not allow my electronic signature
Stormwater Electronic Reporting Registration Form
Page 4

credential or security questions and answers to be written into computer scripts to achieve
automated log -in.
6. Understand and agree that I will be held as legally bound, obligated, and responsible for the use
of my electronic signature as I would be using my hand-written signature.
7. Understand that I will be informed through my registered email address whenever my User ID
or password has been modified.
8. Understand that eDMR reports the last date my User ID and password were used immediately
after successfully logging into eDMR.
9. Agree to contact the NCDEQ SW-eDMR Administrator via email at SW-eDMR(a�ncdenr.gov as
soon as possible, but no later than 24 hours, after suspecting or determining that my User ID
and/or password have become lost, stolen or otherwise compromised.
10. Agree that I will review the contents of all electronic submissions prior to submission.
11. Understand that I will automatically receive an email receipt at my registered email address
from the NCDEQ's SW-eDMR system for any submission that contains a valid electronic
signature, identifying the document received, the signatory, and the date and time of receipt.
12. Agree to contact the NCDEQ SW-eDMR Administrator via email at SW-eDMR(a),ncdenr.gov if
do not receive an email receipt as specified above within five (5) business days for any
electronically signed submission using my credentials.
13. Agree that if I received an email notification for an activity that I do not believe that I performed,
will notify the NCDDEQ SW-eDMR Administrator via email at SW-eDMR(cbncdenr.gov as soon
as possible, but no later than 24 hours, after receipt.
14. Agree to report, within 24 hours of discovery, any evidence of discrepancy between any
electronic document I have signed and submitted and what the NCDEQ eDMR has received
from me by contacting the NCDEQ SW-eDMR Administrator via email at SW-
eDMR(a)ncdenr.gov.
15. Understand that the NCDEQ eDMR's system will automatically reject any electronic document
submitted without a valid electronic signature if such signature is required.
16. Agree to contact the NCDEQ SW-eDMR Administrator via email at SW-eDMR a().ncdenr.gov
within ten working days if my duties change and I no longer need to interact with eDMR on
behalf of my organization.
17. Agree to notify the NCDEQ SW-eDMR Administrator via email at SW-eDMR(@ncdenr.gov if
cease to represent the regulated entity specified above as signatory of that organization's
electronic submissions as soon as this change in relationship occurs.
18. Understand that the NCDEQ may contact the Organization's Responsible Official, who signs
below to authorize me as a signatory for the Owner/Organization, in order to verify my identity.
19. Agree to retain a copy of this signed agreement as long as I continue to represent the regulated
entity specified above as signatory of the Organization's electronic submissions.
20. Certify that I have the authority to enter into this Agreement on behalf of the Organization
identified above, and I am a signatory authorized to represent that Organization, and I am able
to sign and submit reports and other information on behalf of that Organization in the capacity
required by statute and/or regulation.
Stormwater Electronic Reporting Registration Form
Page 5

F. 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.
Robert I Downes
this Agreement for Tipper Tie Inc.
name), UV y
(printed he the authoritto enter into
(Owner/Organization Name).
I request the NCDEQ grant me and, if included in Part B of this form, the named Facility
Administrator(s), an electronic signature credential to submit and accept documents
electronically on behalf of my organization.
I acknowledge that I, and if included in Part B of this form, the named Facility Administrator(s),
work at/for my organization and have authority to submit and accept electronic documents and
act as a signatory for purposes of the NCDEQ's electronic document systems.
By submitting this application, I, Tipper Tie Inc. (printed name),
have read, understand, and accept the terms and conditions of this Electronic Signature
Agreement. I certify under penalty of law that I have personally examined and am familiar with
the information submitted in this application and all attachments and that, based on my inquiry
of those persons immediately responsible for obtaining the information contained in the
application, I believe that the information is true, accurate and complete. I am aware that there
are significant penalties for submitting false information, including the possibility of fine and
imprisonment.
Responsible Official Signature
Robert, [e-mail]
Email Address
Facilities Manager
Title
919-802-2466
Phone Number
1 /4/2021
Date
NA
eD AR User ID
Subscribed and sworn to before me this � day of 20��
(SEAL)
Printed Name of Notary Public
My Commission Expires:�(AVL2 ZU,`I
Stormwater Electronic Reporting Registration Form
Page 6

G. Facility Administrator Signature
_-> Provide a separate page of Part F for every Facility Administrator listed in Part 8.
Facty Administrators are users other than the Responsible Official who can submit this
agreement to request to sign reports electronically and other information and to accept
electronic documents.
Robert I Downes
(printed name), am authorized by the Responsible
Official named in this document, who has the authority under the applicable standards, to enter
into this agreement for Tepper Tle InC.
(Owner/Organization Name).
By submng this application, I, Robert T. Downes (printed name),
have read, understand, and accept the terms and conditions of this Electronic Signature
Agreement. I certify under penalty of law that I have personally examined and am familiar with
the information submitted in this application and all attachments and that, based on my inquiry
of those persons immediately responsible for obtaining the information contained in the
application, I believe that the information is true, accurate and complete. I am aware that there
are significant penalties for submitting false information, including the possibility of fine and
imprisonment.
z Facilities Manager 1 /4/2021
Submitter Signature Title Date
[e-mail] 91MO2-2466 NA
Email Address Phone Number eDMR User ID
Subscribed and sworn to before me this day of % 20
�v Notary Public
Q Wake N
(s g County
My Comm. E%P•
��/llllllllll\\
Printed Name of Notary Public
My Commission Expires: 'I 7WZ�+'
Stormwater Electronic Reporting Registration Form
Page 7