NC0035708_Operator Designation Form_20090415

Department of Public Works
Wastewater Treatment Plant
1094 Addor Road
Aberdeen, NC 28315
Ceo-an0
April 17, 2009
N.C. Division of Water Quality
1618 Mail Service Center
Raleigh, NC 27699-1618
Re: Moore County WPCP, permit #NC0037508
Town of Vass WWTP, permit # NC0074373
Dear Sirs:
Telephone: [phone]
Facsimile: [phone]
DENR FR
O
APR 2 1 2009
DWQ
Attached with this letter are revised ORC Designation Forms for the Moore County
Water Pollution Control Plant (Permit # NC0037508) and the Town of Vass Wastewater
Treatmeff Plants (Permit # NC0074373).
If you have any questions or comments, please feel free to call me at 910-281-3146.
Sincerely,
J. Brant Sikes, System Superintendent
Moore County Water Pollution Control Plant
Enc: ORC Designation Form, Moore County WPCP, permit #NC0037508
ORC Designation Form, Vass WWTP, permit # NC0074373
C.EMaFk-Brantley,-NCDWQ Fayetteville Regional Office

Water Pollution Control System ORC Designation. Form
WPcsocc
NCAC 15A:08G .0201
General Information:
Permittee Owner/Officer Name: Dennis Brobst — Public Works Director
Mailing Address: PO Box 1927
City: Carthage State: NC Zip: 28327
Telephone Number: ( 910 ) 947-6315
Signature:- .-C�-s Date: `✓X.f/ s
Facility Information:
Facility: Moore County Water Pollution Control Plant
Permit Number: NC0037508 County: Moore County
! SUBMIT A SEPARATE FORM FOR EACH TYPE OF SYSTEM !
Mark (X) Type of Facility Class (1 — 4) Class
Wastewater Plant X 4 Spray Irrigation N/A
Physical/Chemical Land Application N/A
Collection System Subsurface N/A
Operator in Responsible Charge:
Print Name: Jimmy Brant Sikes- Superintendent _ Social Security # : — 245-11-8091
Certificate Type and Grade: Wastewater IV Certificate #: 4095
Work Telephone: (910 ) 281-3146 Signature:
Email: bsikes(a),moorecountvnc.gov
•
Back -Up Operator in Responsible Charge:
Print Name: Jeffery W. Corder
Social Security # : 237-27-3533
Certificate Type and Grade: Wastewater IV Certificate #: 16856
Work Telephone: ( 910 ) _281-3146 Signature:
Email: icorder a;moorecountvnc.2ov

Back -Up Operator in Responsible Charge:
Print Name: Bruce A. Turner Social Security #: 353-58-5074
Certificate Type and Grade: Wastewater IV
Work Telephone: [phone] Signature:
Certificate #:
19193
Back -Up Operator in Responsible Charge:
Print Name: _ Kenneth D. Chavis Social Security # : 244-54-8582
Certificate Type and Grade: Wastewater III
Work Telephone: j910) 281-3146 Signature:
Mail or Fax to:
WPCSOCC
1618 Mail Service Center
Raleigh, N.C. 27699-1618
Fax: [phone]
Certificate #: 14081
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Revised 10/2000