HomeMy WebLinkAboutNC0020842_WPCSOSOCC Operator Designation Form_20210407WATER POLLUTION CONTROL SYSTEM OPERATOR DESIGNATION FORM (LhrPCSOCC)
NCAC LER BG .0201
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Psrmi etee0huner/Olfi ter Name: Town of Snow Hi.
Ema l Address:
Pernittee9g,natu se:
manageres cde:iilne.wm
Fariity Nine: Snow Hil 1Ar'rhTP
WWI TA SEPARATE FDRIVI FOR EACH SYSTEM CLASSIFICATION: WW-II
Date: 9/7/Yot
Permit If HCO020842
t ° COERMOR INZISP4 si11i i ` .: °, :f
Print F ul Name: Drake Want Robart
Worts Phone: {252)9N-5213
Ce-tirica'tType: VON a Certficate6rade II LJ Cer#ificsate4: 1DDEIS23
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aertijy rot r egree to .rny desip rztias es the Operator r.7 P-ipanrrire Cso.ye for Ehe f =iffy heed 1 usdersmnd oar w,i'J Gibed? by th
riqC.i and uy[sGtixrr M the respoymO5Pries aj the aPC as set forth. is 15.4 //CAC 1280 .0204 ordlaf.Y.riff to de s7 cen rexuh 11
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Priit Ful.dame: Darya Douglas Hill
Via* Mons :
(252) 28 B2540
Certifica'eTyrpe: VON Certificate C-arde: Rr Certificate4: 93B.819
Erna tiAchress: Dana.Hill r0l'nawealerserviGeri :.00m
S7gtiatxlre �- CIFer3Srve Date: rif-7 :.
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ORIGIF AL§:
VJPCSOC t:, 16i8rd ai' Service Center, Flaleish.. MC 27693-16 1
Mal or Farr CQFYta: AAeviIle
2033 US I -My 70
Swannanoe,- NC 28778
Fax sza-293-7043
Mon 826-2964574
Waahitbtor,
943Wa r'n;rsnSq.10all
Washington, NC27689
• S17.3R10.
Phone: 252.346d4B1
Fax:in-71 -272.fi
FaLretteuirla
225 Green 5 . 5...if:e 714
Fa�elte;�ll a, NC 2630t-SQ43
Fare 920-886fi7D7
Phone: 910430.3360
WYllmlrlglon
1Z7 Cs rd nal Dr.
l fiv lItta:4 NC 2043$-2345
Faoc91U-3i 0-1o]S
Phone 91C-736-7215
Mooresville
6IL!t. CL i1cr Ave„ 5UIte 3.01
Mea-esx,Pe, (SC 23115
Fax 704-663-648J
Phone 7,74S53-1659
YJFist orr5alen
SSW -Hanes Mil Rd
wir :1-Salerrr,r4C27103
Fat: 33 5-776-9747Phone:
33,5-7T6-9300
Raleial
3330 Barrett Di.
Ra1egh, NC 2T6Cr3
Fano 919-5i1LT18
Pnoae: g14-731-4200
Rsrascs 1 ra¢