WQ0004823_Signature Authority_20220404

Division of Water Resources
Non -Discharge Branch
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Subject: Permit No. WQ0004823
Signature Authority Designation
Reclaimed Water Generation,
Non-Conjuctive Reclaimed
Water Utilization and High -Rate
Infiltration System
Currituck County
To Whom It May Concern:
As an appropriate signing official for PINE ISLAND CURRITUCK CLUB WWTP (city/town or
business name) as designated by 15A NCAC 2T .0106, I hereby delegate authority to sign and certify all
permit applications, reports or other permit related documents to the following staff for the following
permit types (sewer, spray, land application) and/or permit numbers:
Position
Person
Currently in
Position
Permit Type
or Permit
Number
O&M Mgr
TINA GEE
W 0004823
If you have any questions, please contact me at the following:
Permittee/Applicant name (please print): ROLF BLIZZARD
Title: MEMBER
Complete mailing address:
Citv:
4400 SILAS CREEK PKWY, STE 302
State: NC
Telephone number: ( 336 ) 722.2236 Facsimile number:
Sincerely,
signature
Zip: 27104