NCG080586_eReporting Registration Letter and Emails_20220610

Georgoulias, Bethany
From: Georgoulias, Bethany
Sent: Friday, June 10, 2022 10:02 AM
To: Joseph Santangelo
Cc: Tran, Kieu M; Smith, Danny
Subject: Important Stormwater eReporting Registration Information
Attachments: GFL Env eReporting Registration Letter.pdf, Email Correspondence RE Signature
Requirements.pdf
Good morning, Mr. Santangelo,
Please see the attached correspondence that has been mailed out to you this week. Please let our supervisor, Danny
Smith, know if you have any questions.
Best regards,
Bethany Georgoulias (she/her)
Environmental Engineer
Stormwater Program, Division of Energy, Mineral, and Land Resources
N.C. Department of Environmental Quality
919 707 3641 office
[e-mail]
512 N. Salisbury Street, Raleigh, NC 27604 (location)
1612 Mail Service Center, Raleigh, NC 27699-1612 (mailing)
Website: http://deq.nc.gov/about/divisions/energy-mineral-land-resources/stormwatgr
Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties
Based on the current guidance to minimize the spread of COVID-19, the Department of Environmental Quality has
adjusted operations to protect the health and safety of the staff and public. Many employees are working remotely or
are on staggered shifts. To accommodate these staffing changes, all DEQ office locations are limiting public access to
appointments only. Please check with the appropriate staff before visiting our offices, as we may be able to handle your
requests by phone or email. We appreciate your patience as we continue to serve the public during this challenging
time.

ROY COOPER
Governor
ELIZABETH S. BISER
Secretory
BRIAN WRENN
Director
NORTH CAROLINA
Environmental Quality
June 9, 2022
Mr. Joseph Santangelo
Regional Environmental Compliance Manager
GFL Environmental Inc./Waste Industries LLC
3301 Benson Drive
Suite 601
Raleigh, NC 2760S
Subject: Stormwater Permit eReporting Registration
GFL Environmental Inc./Waste Industries LLC
Dear Mr. Santangelo:
We received your Stormwater eReporting Registration Form on January 6, 2022. We also received
Stormwater Permit Signature Authority (DOSA) Forms for several permits (electronic uploads on May
20, 2022, and hard copies that arrived on June 6, 2022). These included NPDES Stormwater General
Permits NCG080586, NCG080587, NCG080845, NCG080803, NCG080878, NCG080955, and
NCG080965. Attached are copies of these forms for your reference.
All of the forms were signed with a digital signature rather than an original wet -ink signature, which is
not acceptable. On May 24, 2022, our Stormwater Program Administrative Assistant reached out to your
consultant, Mr. Jim Frei, to explain that these forms would be rejected based on signatory requirements in
40 CFR § 122.22. In follow-up communication with him, we explained that 40 CFR § I22.22(e) allows for
electronic signatures only when submitted through a system that is compliant with Cross -Media
Electronic Reporting Rule (CROMERR) in 40 CFR §3 and NPDES Electronic Reporting Requirements in
40 CFR § 127. Please see the email correspondence with Mr. Frei enclosed.
To date, North Carolina has only one such system: the N.C. eDMR system. Both the eReporting
Registration Form (which includes an Electronic Signature Agreement) and the Stormwater Permit DOSA
forms must have original wet -ink signatures to comply with federal requirements and successfully
complete this registration step, which then enables electronic certification and signature for submitting
data monitoring reports (DMRs) through eDMR. Please note that until permittees report monitoring data
through eDMR, all paper copy DMRs mailed to N.C. DEQ must have original signatures as well (not
digital) as required by federal NPDES signature requirements.
We understand that digital signature on these forms would be very convenient and even acceptable in
other contexts; however, our Program is limited for specified components in federal NPDES permitting
regulations and by CROMERR constraints, including for monitoring data reports and written
authorization of responsibility.
D�O%Z North Carolina Department of Environmental Quality I Division of Energy, Mineral and Land Resources
512 North Salisbury Street 1 1612 Mall Service Center I Raleigh, North Carolina 27699-1612
�� /'� 919.707.9200

Please resubmit the eReporting Registration and DOSA forms with original signatures to comply with all
NPDES requirements in 40 CFR § 122(b)(3) and § 122(e) and to complete registration in eDMR.
This office intends to address permit condition and reporting violations through appropriate compliance
actions going forward. We have included the subject email correspondence to our permit file for future
reference and support in this matter. If you have any questions, please do not hesitate to contact me at
[phone].
Danny Smitl
Stormwater
Division of Energy
cc: Jim Frei, Stormwater Services Group LLC (Consultant)
DEMLR Stormwater Permit File
Mineral and Land Resources
D E Q�y North Carolina Department of Environmental Quality I Division of Energy. Mineral and Land Resources
512 North Salisbury Street 1 1612 Mail Service Center I Raleigh, North Carolina 27699-1612
919.707.9200

Georgoulias, Bethany
From: Georgoulias, Bethany
Sent: Thursday, May 26, 2022 8:46 AM
To: [e-mail]
Cc: Tran, Kieu M; Smith, Danny
Subject: RE: [External] RE: DOSA Signature Issue
Hi, Jim,
Kieu may have already responded. However, I wanted to follow up with some information on your reference to 40 CFR
122.22 below. I think there's a misunderstanding about what section (e) allows.
(e) Electronic reporting, If documents described in paragraph d or b of this
section are submitted electronically by or on behalf of the NPDES-regulated facility,
any person providing the electronic signature for such documents shall meet all relevant
requirements of this section, and shall ensure that all of the relevant requirements of 40
CFR part 3 (including, in all cases, subpart D to part 3) (Cross -Media Electronic
Reporting) and 40 CFR part 127 (NPDES Electronic Reporting Requirements) are met for
that submission.
This means that electronic signatures are allowed if they are provided through a system that meets CROMERR
requirements. The only system that North Carolina has for electronic submission of NPDES documents with electronic
signature at the moment is the eDMR system. To use it and certify and sign submissions through it, the registrants must
complete and sign, in original wet ink signature, the Electronic Signature. This process is one that EPA accepted as part
of its approval of NC's system to meet CROMERR requirements.
In other words, original signature on the ESA is one of the steps required for that registration in order to be able to
submit anything through NC's eDMR system with an electronic signature ... and thus being able to engage in the allowed
electronic reporting and signature described above in 122.22(e).
I hope this helps clarify that component of the federal NPDES regs. that you said allows electronic signature.
Best regards,
Bethany Georgoulias (she/her)
Environmental Engineer
Stormwater Program, Division of Energy, Mineral, and Land Resources
N.C. Department of Environmental Quality
919 707 3641 office
[e-mail]
512 N. Salisbury Street, Raleigh, NC 27604 (location)
1612 Mail Service Center, Raleigh, NC 27699-1612 (mailing)
Website: ht112: //deq.nc.govlab out /divisions/energy-mineral-land-resources/stormwater

Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties
Based on the current guidance to minimize the spread of COVID-19, the Department of Environmental Quality has
adjusted operations to protect the health and safety of the staff and public. Many employees are working remotely or
are on staggered shifts. To accommodate these staffing changes, all DEQ office locations are limiting public access to
appointments only. Please check with the appropriate staff before visiting our offices, as we may be able to handle your
requests by phone or email. We appreciate your patience as we continue to serve the public during this challenging
time.
From: Jim Frei <[e-mail]>
Sent: Tuesday, May 24, 2022 10:44 AM
To: Tran, Kieu M <[e-mail]>
Cc: Smith, Danny <[e-mail]>; 'Joseph Santangelo' <[e-mail]>
Subject: [External] RE: DOSA Signature Issue
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
Report Spam.
Ms. Tran —
This eDMR registration process has proven to be way too complicated.
40 CFR 122.22(e) allows for electronic signatures. In our opinion, our DOSA forms as submitted are legally binding. No
where in the NCDEQ instructions is a "wet signature" required. In fact, the formal name of the form is Stormwater
Electronic Reporting Registration Form.
BTW - DMRs have been uploaded with digital signatures since last year with no rejection.
Our original eDMR registration form gives Facility Administrators report submittal authority as indicated in the first
paragraph on the first page of the form. Its seems to me the DOSA forms are redundant. However, we will mail the
"original signed copies" as requested.
Jim Frei
[phone]
From: Tran, Kieu M [maiIto: [e-mail]]
Sent: Tuesday, May 24, 2022 10:04 AM
To: Jim Frei
Subject: DOSA Signature Issue
Good morning Jim,
All the DOSA forms submitted for review will be rejected due to the lack of original wet signature on the form.
Permittees and applicants must fulfill signatory requirements in the NPDES federal regulations in 40 CFR §122.22. Until
NCDEQ's electronic submission process meets Cross -Media Electronic Reporting (CROMERR) requirements.
Essentially: an original wet signature (not a digital signature) is required, and the form must be mailed in. Please see
images below for reference:

Persons) with Delegation of Signature Authority (D )
Complete and sign this Stormwater Permit Delegation of Signature Authority Form. Then upload it below_ We c
begin making updates wit#i this submittal: but please note that you must mail in the original signed copy to our
in accordance Waft requkirements in 40CFR 122.22.
I have given true, accurate, and complete information on this faun,
I agree that submission of this farm is a "transaction" subject to Chapter 66, Article 40 of the NC: General Slatutes (t
'Uniform Electronic Transactions Act'}:
I agree to conduct this transaction by electronic means pursuant to Chapter 66, Article 40 of the NC General Statute
'Uniform E=ectronic TransactlonsAct`}:
I understand that an electronic signature has tfke same legal effect and can be enforced in the same war as a wrote
signature (except for any uploaded Owner Afftliatiort Change or Delegation of Signature of Authority forms, Wh
also must be mailed in with Drtginal signature): AND
I intend to elect ran ically sign and submd this Permit Contact Update Request form.
Once I receive the updated forms with the original signatures, I'll be able to process all the DOSA forms.
Thank you,
Mrs. Kieu Tran
Stormwater Program Administrative Assistant
Office: (919) 707- 3640
Kieu. Tran @ncdenr. qov
North Carolina Department of Environmental Quality
Division of Energy, Mineral, and Land Resources Stormwater Program
512 N. Salisbury Street, Raleigh, NC 27604 (location)
1612 Mail Service Center, Raleigh, NC 27699-1612 (mailing)
Website: http://deq.nc.gov/about/divisions/energy-mineral-land-resources/stormwater
QE
-N,
N.r
Email correspondence to and from this address is subject to the North Carolina Public Records Law and may be disclosed
to third parties

NC Department of Environmental Quality
Division of Energy, Mineral and Land Resources
NORTH CAROLINA
ERWro nmenfai QriDiffy
Stormwater Permit Delegation of Signature Authority Form
Directions are in red.
=> This form shall be used to delegate signature authority from the permit Owner (Permittee) to
another party. Only the Responsible Official defined below may submit permit applications and
reports required by the permit (such as Data Monitoring Reports and Annual Reports) until this
form is completed and submitted to the DEMLR Stormwater Program. Please note that delegating
signature authority does not relieve the Permit Owner from the responsibility for permit
compliance.
=> The permit Owner is the legal entity to which/whom a permit has been issued, and may be an individual
or an organization such as a company or government agency. Every Owner is required to have a
Responsible Official who meets the legal signature authority requirements in 40 CFR 122.22, summarized
below:
• For a corporation, the Responsible Official shall be 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, the Responsible Official shall be a general partner or the
proprietor, respectively; or
• For a municipality, State, Federal, or other public agency, the Responsible Official shall be either a
principal executive officer [City/County Manager] or ranking elected official [Mayor].
=> Even if delegated signatory authority has been delegated to another individual, the Responsible Official
retains responsibility for compliance with permit conditions.
Organization Name:
Waste Industries LLC
Joseph Santangelo
Responsible Official Name:
Responsible Official Title:
Regional Environmental Compliance Manager
Email Address:
[e-mail]
Phone:
[phone]
Mailing Address:
3301 Benson Drive Suite 601
City:
Raleigh
State:
NC
ZiP:
27609
Stormwater Delegation of Signature Authority Form
Page 1

A. Persons to Receive Signatory Authority
=> The signatures of the persons listed below indicates their acceptance of signatory authority.
Delegated Party Name:
James D. Frei
Delegated Party Title:
Consultant
Permit Number:
NCG080586
Email Address:
[e-mail]
I Phone:
919-661-9954
Mailing Address:
8916 Oregon Inlet Ct
City:
Raleigh
I State:
NC
I Zip:
27603
Signature of Delegated Party indicating
acceptance of Signatory Authority:
�' ��
Date:
I Ma 0, 2022
Delegated Party Name:
Patrick Moseley
Delegated Party Title:
Operations Supervisor
Permit Number:
NCG080586
Email Address:
[e-mail]
I Phone:
252-536-2011
Mailing Address:
2211 US Hwy 301
City:
Halifax
State'
NC
Zip:
27839
Signature of Delegated Party indicating
acceptance of Signatory Authority:
%���� ���
l
Date:
I May 20, 2022
Delegated Party Name:
Delegated Party Title:
Permit Number:
Email Address:
Mailing Address:
City:
Signature of Delegated Party indicating
acceptance of Signatory Authority:
Date:
Phone:
State: I I Zip:
Delegated Party Name:
Delegated Party Title:
Permit Number:
Email Address:
Phone:
Mailing Address:
City:
State:
Zip:
Signature of Delegated Party indicating
acceptance of Signatory Authority:
Date:
Stormwater Permit Delegation of Signatory Authority Form
Page 2

B. 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.
As the Responsible Official, I, Joseph Santangelo
have the authority to enter into this Agreement for
Waste Industries LLC
(Owner/Organization Name).
(printed name),
I request that the DEMLR Stormwater Program include the persons listed in Part A of this form
signatory authority for the above -named permit.
I acknowledge that I, and the persons listed in Part A of this form work at/for my organization
and have authority to act as a signatory for purposes of the NCDEQ's electronic document
systems.
By submitting this application, I, Joseph Santangelo (printed name),
have read, understand, and accept the terms and conditions of the stormwater permit(s) for
which I am the Responsible Official.
`c
ns6le Official Signature
Regional Environmental Compliance Manager
Title
05/20/2022
Date
Stormwater Permit Delegation of Signatory Authority Form
Page 3

NC Department of Environmental Quality
Division of Energy, Mineral and Land Resources
NORTH CAROLINA
ERWro nmenfai QriDiffy
Stormwater Permit Delegation of Signature Authority Form
Directions are in red.
=> This form shall be used to delegate signature authority from the permit Owner (Permittee) to
another party. Only the Responsible Official defined below may submit permit applications and
reports required by the permit (such as Data Monitoring Reports and Annual Reports) until this
form is completed and submitted to the DEMLR Stormwater Program. Please note that delegating
signature authority does not relieve the Permit Owner from the responsibility for permit
compliance.
=> The permit Owner is the legal entity to which/whom a permit has been issued, and may be an individual
or an organization such as a company or government agency. Every Owner is required to have a
Responsible Official who meets the legal signature authority requirements in 40 CFR 122.22, summarized
below:
• For a corporation, the Responsible Official shall be 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, the Responsible Official shall be a general partner or the
proprietor, respectively; or
• For a municipality, State, Federal, or other public agency, the Responsible Official shall be either a
principal executive officer [City/County Manager] or ranking elected official [Mayor].
=> Even if delegated signatory authority has been delegated to another individual, the Responsible Official
retains responsibility for compliance with permit conditions.
Organization Name:
Waste Industries LLC
Joseph Santangelo
Responsible Official Name:
Responsible Official Title:
Regional Environmental Compliance Manager
Email Address:
[e-mail]
Phone:
[phone]
Mailing Address:
3301 Benson Drive Suite 601
City:
Raleigh
State:
NC
ZiP:
27609
Stormwater Delegation of Signature Authority Form
Page 1

A. Persons to Receive Signatory Authority
=> The signatures of the persons listed below indicates their acceptance of signatory authority.
Delegated Party Name:
James D. Frei
Delegated Party Title:
Consultant
Permit Number:
NCG080587
Email Address:
[e-mail]
Phone:
919-661-9954
Mailing Address:
8916 Oregon Inlet Ct
City:
Raleigh
State:
NC
I Zip:
27603
Signature of Delegated Party indicating
acceptance of Signatory Authority:
D
Date:
May , 2022
Delegated Party Name:
Willie Brown
Delegated Party Title:
Operations Supervisor
Permit Number:
NCG080587
Email Address:
[e-mail]
I Phone:
252-792-0576
Mailing Address:
1805 W. Main St
City:
Williamston
State:
NC
Zip 27892-1447
Signature of Delegated Party indicating
acceptance of Signatory Authority:
664wel�, 54.eUlel
Date:
May 20, 2022
Delegated Party Name:
Crystal Slone
Delegated Party Title:
General Manager
Permit Number:
NCGO80587
Email Address:
[e-mail]
I Phone:
252-294-6635
Mailing Address:
2810 Contentnea Rd
City:
Wilson
I State:
NC
I Zip
27893-8501
Signature of Delegated Party indicating
acceptance of Signatory Authority:
Date:
May 20, 20 2
Delegated Party Name:
Delegated Party Title:
Permit Number:
Email Address:
Phone:
Mailing Address:
City:
State:
Zip:
Signature of Delegated Party indicating
acceptance of Signatory Authority:
Date:
Stormwater Permit Delegation of Signatory Authority Form
Page 2

B. 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.
As the Responsible Official, I, Joseph Santangelo
have the authority to enter into this Agreement for
Waste Industries LLC
(Owner/Organization Name).
(printed name),
I request that the DEMLR Stormwater Program include the persons listed in Part A of this form
signatory authority for the above -named permit.
I acknowledge that I, and the persons listed in Part A of this form work at/for my organization
and have authority to act as a signatory for purposes of the NCDEQ's electronic document
systems.
By submitting this application, I, Joseph Santangelo (printed name),
have read, understand, and accept the terms and conditions of the stormwater permit(s) for
which I am the Responsible Official.
Responsible Official Signature
Regional Environmental Compliance Manager
Title
05/20/2022
Date
Stormwater Permit Delegation of Signatory Authority Form
Page 3

NC Department of Environmental Quality
Division of Energy, Mineral and Land Resources
NORTH CAROLINA
ERWro nmenfai QriDiffy
Stormwater Permit Delegation of Signature Authority Form
Directions are in red.
=> This form shall be used to delegate signature authority from the permit Owner (Permittee) to
another party. Only the Responsible Official defined below may submit permit applications and
reports required by the permit (such as Data Monitoring Reports and Annual Reports) until this
form is completed and submitted to the DEMLR Stormwater Program. Please note that delegating
signature authority does not relieve the Permit Owner from the responsibility for permit
compliance.
=> The permit Owner is the legal entity to which/whom a permit has been issued, and may be an individual
or an organization such as a company or government agency. Every Owner is required to have a
Responsible Official who meets the legal signature authority requirements in 40 CFR 122.22, summarized
below:
• For a corporation, the Responsible Official shall be 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, the Responsible Official shall be a general partner or the
proprietor, respectively; or
• For a municipality, State, Federal, or other public agency, the Responsible Official shall be either a
principal executive officer [City/County Manager] or ranking elected official [Mayor].
=> Even if delegated signatory authority has been delegated to another individual, the Responsible Official
retains responsibility for compliance with permit conditions.
Organization Name:
Waste Industries LLC
Joseph Santangelo
Responsible Official Name:
Responsible Official Title:
Regional Environmental Compliance Manager
Email Address:
[e-mail]
Phone:
[phone]
Mailing Address:
3301 Benson Drive Suite 601
City:
Raleigh
State:
NC
ZiP:
27609
Stormwater Delegation of Signature Authority Form
Page 1

A. Persons to Receive Signatory Authority
=> The signatures of the persons listed below indicates their acceptance of signatory authority.
Delegated Party Name:
James D. Frei
Delegated Party Title:
Consultant
Permit Number:
NCG080803
Email Address:
[e-mail]
Phone:
919-661-9954
Mailing Address:
8916 Oregon Inlet Ct
City:
Raleigh
State:
NC
I Zip:
27603
Signature of Delegated Party indicating
acceptance of Signatory Authority:
Z .
Date:
May 0, 2022
Delegated Party Name:
Jeremy Freeman
Delegated Party Title:
Manager
Permit Number:
NCG080803
Email Address:
[e-mail]
I Phone:
910-423-4122
Mailing Address:
4621 Marracco Dr
City:
Hope Mills
State:
NC
Zip:
28348
Signature of Delegated Party indicating
acceptance of Signatory Authority:
Date:
May 2 , 2022
Delegated Party Name:
Delegated Party Title:
Permit Number:
Email Address:
Mailing Address:
City:
Signature of Delegated Party indicating
acceptance of Signatory Authority:
Date:
Phone:
State: I I Zip:
Delegated Party Name:
Delegated Party Title:
Permit Number:
Email Address:
Phone:
Mailing Address:
City:
State:
Zip:
Signature of Delegated Party indicating
acceptance of Signatory Authority:
Date:
Stormwater Permit Delegation of Signatory Authority Form
Page 2

B. 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.
As the Responsible Official, I, Joseph Santangelo
have the authority to enter into this Agreement for
Waste Industries LLC
(Owner/Organization Name).
(printed name),
I request that the DEMLR Stormwater Program include the persons listed in Part A of this form
signatory authority for the above -named permit.
I acknowledge that I, and the persons listed in Part A of this form work at/for my organization
and have authority to act as a signatory for purposes of the NCDEQ's electronic document
systems.
By submitting this application, I, Joseph Santangelo (printed name),
have read, understand, and accept the terms and conditions of the stormwater permit(s) for
which I am the Responsible Official.
5L
Resporfsible Official Signature
Regional Environmental Compliance Manager
Title
05/20/2022
Date
Stormwater Permit Delegation of Signatory Authority Form
Page 3

NC Department of Environmental Quality
Division of Energy, Mineral and Land Resources
NORTH CAROLINA
ERWro nmenfai QriDiffy
Stormwater Permit Delegation of Signature Authority Form
Directions are in red.
=> This form shall be used to delegate signature authority from the permit Owner (Permittee) to
another party. Only the Responsible Official defined below may submit permit applications and
reports required by the permit (such as Data Monitoring Reports and Annual Reports) until this
form is completed and submitted to the DEMLR Stormwater Program. Please note that delegating
signature authority does not relieve the Permit Owner from the responsibility for permit
compliance.
=> The permit Owner is the legal entity to which/whom a permit has been issued, and may be an individual
or an organization such as a company or government agency. Every Owner is required to have a
Responsible Official who meets the legal signature authority requirements in 40 CFR 122.22, summarized
below:
• For a corporation, the Responsible Official shall be 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, the Responsible Official shall be a general partner or the
proprietor, respectively; or
• For a municipality, State, Federal, or other public agency, the Responsible Official shall be either a
principal executive officer [City/County Manager] or ranking elected official [Mayor].
=> Even if delegated signatory authority has been delegated to another individual, the Responsible Official
retains responsibility for compliance with permit conditions.
Organization Name:
Waste Industries LLC
Joseph Santangelo
Responsible Official Name:
Responsible Official Title:
Regional Environmental Compliance Manager
Email Address:
[e-mail]
Phone:
[phone]
Mailing Address:
3301 Benson Drive Suite 601
City:
Raleigh
State:
NC
ZiP:
27609
Stormwater Delegation of Signature Authority Form
Page 1

A. Persons to Receive Signatory Authority
=> The signatures of the persons listed below indicates their acceptance of signatory authority.
Delegated Party Name:
James D. Frei
Delegated Party Title:
Consultant
Permit Number:
NCG080845
Email Address:
[e-mail]
I Phone:
919-661-9954
Mailing Address:
8916 Oregon Inlet Ct
City:
Raleigh
I State:
NC
I Zip:
27603
Signature of Delegated Party indicating
acceptance of Signatory Authority:
Date:
Ma 0, 2022
Delegated Party Name:
William Davidson
Delegated Party Title:
operations Supervisor
Permit Number:
NCG080845
Email Address:
[e-mail]
I Phone:
919-596-1363
Mailing Address:
148 Stone Park Ct
City:
Durham
State'
NC
Zip 27703
Signature of Delegated Party indicating
acceptance of Signatory Authority:
lit/
Date:
I May 20, 2022
Delegated Party Name:
Delegated Party Title:
Permit Number:
Email Address:
Mailing Address:
City:
Signature of Delegated Party indicating
acceptance of Signatory Authority:
Date:
Phone:
State: I I Zip:
Delegated Party Name:
Delegated Party Title:
Permit Number:
Email Address:
Phone:
Mailing Address:
City:
State:
Zip:
Signature of Delegated Party indicating
acceptance of Signatory Authority:
Date:
Stormwater Permit Delegation of Signatory Authority Form
Page 2

B. 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.
As the Responsible Official, I, Joseph Santangelo
have the authority to enter into this Agreement for
Waste Industries LLC
(Owner/Organization Name).
(printed name),
I request that the DEMLR Stormwater Program include the persons listed in Part A of this form
signatory authority for the above -named permit.
I acknowledge that I, and the persons listed in Part A of this form work at/for my organization
and have authority to act as a signatory for purposes of the NCDEQ's electronic document
systems.
By submitting this application, I, Joseph Santangelo (printed name),
have read, understand, and accept the terms and conditions of the stormwater permit(s) for
which I am the Responsible Official.
III
risible Official Signature
Regional Environmental Compliance Manager
Title
05/20/2022
Date
Stormwater Permit Delegation of Signatory Authority Form
Page 3

NC Department of Environmental Quality
Division of Energy, Mineral and Land Resources
NORTH CAROLINA
ERWro nmenfai QriDiffy
Stormwater Permit Delegation of Signature Authority Form
Directions are in red.
=> This form shall be used to delegate signature authority from the permit Owner (Permittee) to
another party. Only the Responsible Official defined below may submit permit applications and
reports required by the permit (such as Data Monitoring Reports and Annual Reports) until this
form is completed and submitted to the DEMLR Stormwater Program. Please note that delegating
signature authority does not relieve the Permit Owner from the responsibility for permit
compliance.
=> The permit Owner is the legal entity to which/whom a permit has been issued, and may be an individual
or an organization such as a company or government agency. Every Owner is required to have a
Responsible Official who meets the legal signature authority requirements in 40 CFR 122.22, summarized
below. -
For a corporation, the Responsible Official shall be 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, the Responsible Official shall be a general partner or the
proprietor, respectively; or
• For a municipality, State, Federal, or other public agency, the Responsible Official shall be either a
principal executive officer [City/County Manager] or ranking elected official [Mayor].
=> Even if delegated signatory authority has been delegated to another individual, the Responsible Official
retains responsibility for compliance with permit conditions.
Organization Name:
Waste Industries LLC
Responsible Official Name:
Joseph Santangelo
Responsible Official Title:
Regional Environmental Compliance Manager
Email Address:
[e-mail]
Phone:
[phone]
Mailing Address:
3301 Benson Dr., Suite 601
City:
Raleigh
State:
NC
ZiP:
27609
Stormwater Delegation of Signature Authority Form
Page 1

A. Persons to Receive Signatory Authority
=> The signatures of the persons listed below indicates their acceptance of signatory authority.
Delegated Party Name:
William Smith
Delegated Party Title:
Operations Supervisor
Permit Number:
NCG080878
Email Address:
[e-mail]
Phone:
910-253-4177
Mailing Address:
2809 Galloway Rd NE
City:
Bolivia
State:
NC
I Zip:
28422
Signature of Delegated Party indicating acceptance of Signatory Authority:
Date:
May 20, 2022
Delegated Party Name:
James D. Frei
Delegated Party Title:
Consultant
Permit Number:
NCG080878
Email Address:
[e-mail]
Phone:
919-661-9954
Mailing Address:
8916 Oregon Inlet Ct
City:
Raleigh
State:
NC
I Zip:
27603
Signature of Delegated Party indicating
acceptance of Signatory Authority:
Date:
May ZO, 2022
Delegated Party Name:
Delegated Party Title:
Permit Number:
Email Address:
Mailing Address:
City:
Signature of Delegated Party indicating
acceptance of Signatory Authority:
Date:
Phone:
State: I I Zip:
Delegated Party Name:
Delegated Party Title:
Permit Number:
Email Address:
Phone:
Mailing Address:
City:
State:
Zip:
Signature of Delegated Party indicating
acceptance of Signatory Authority:
Date:
Stormwater Permit Delegation of Signatory Authority Form
Page 2

B. 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.
As the Responsible Official, I, Joseph Santangelo (printed name),
have the authority to enter into this Agreement for
Waste Industries LLC (Owner/Organization Name).
I request that the DEMLR Stormwater Program include the persons listed in Part A of this form
signatory authority for the above -named permit.
I acknowledge that I, and the persons listed in Part A of this form work at/for my organization
and have authority to act as a signatory for purposes of the NCDEQ's electronic document
systems.
By submitting this application, I, Joseph Santangelo (printed name),
have read, understand, and accept the terms and conditions of the stormwater permit(s) for
which I am the Responsible Official.
nsible Official Signature
Regional Environmental Compliance Manager
Title
05/20/2022
Date
Stormwater Permit Delegation of Signatory Authority Form
Page 3

NC Department of Environmental Quality
Division of Energy, Mineral and Land Resources
NORTH CAROLINA
ERWro nmenfai QriDiffy
Stormwater Permit Delegation of Signature Authority Form
Directions are in red.
=> This form shall be used to delegate signature authority from the permit Owner (Permittee) to
another party. Only the Responsible Official defined below may submit permit applications and
reports required by the permit (such as Data Monitoring Reports and Annual Reports) until this
form is completed and submitted to the DEMLR Stormwater Program. Please note that delegating
signature authority does not relieve the Permit Owner from the responsibility for permit
compliance.
=> The permit Owner is the legal entity to which/whom a permit has been issued, and may be an individual
or an organization such as a company or government agency. Every Owner is required to have a
Responsible Official who meets the legal signature authority requirements in 40 CFR 122.22, summarized
below:
• For a corporation, the Responsible Official shall be 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, the Responsible Official shall be a general partner or the
proprietor, respectively; or
• For a municipality, State, Federal, or other public agency, the Responsible Official shall be either a
principal executive officer [City/County Manager] or ranking elected official [Mayor].
=> Even if delegated signatory authority has been delegated to another individual, the Responsible Official
retains responsibility for compliance with permit conditions.
Organization Name:
Waste Industries LLC
Joseph Santangelo
Responsible Official Name:
Responsible Official Title:
Regional Environmental Compliance Manager
Email Address:
[e-mail]
Phone:
[phone]
Mailing Address:
3301 Benson Drive Suite 601
City:
Raleigh
State:
NC
ZiP:
27609
Stormwater Delegation of Signature Authority Form
Page 1

A. Persons to Receive Signatory Authority
=> The signatures of the persons listed below indicates their acceptance of signatory authority.
Delegated Party Name:
James D. Frei
Delegated Party Title:
Consultant
Permit Number:
NCG080955
Email Address:
[e-mail]
Phone:
919-661-9954
Mailing Address:
8916 Oregon Inlet Ct
City:
Raleigh
State:
NC
I Zip:
1 27603
Signature of Delegated Party indicating
acceptance of Signatory Authority:
D
Date:
Ma 20, 2022
Delegated Party Name:
Mike Lee
Delegated Party Title:
Operations Manager
Permit Number:
NCG080955
Email Address:
[e-mail]
I Phone:
252-291-6635
Mailing Address:
2810 Contentnea Rd
City:
Wilson
State:
NC
Zip
27893-8501
Signature of Delegated Party indicating
acceptance of Signatory Authority:
Z--ez
Date:
May 20, 2022
Delegated Party Name:
Crystal Slone
Delegated Party Title:
General Manager
Permit Number:
NCGO80955
Email Address:
[e-mail]
I Phone:
252-291-6635
Mailing Address:
2810 Contentnea Rd
Wilson I State: NC I Zip 27893-1805
City:
Signature of Delegated Party indicating
acceptance of Signatory Authority:
�a
Date:
I May 20, V022
Delegated Party Name:
Delegated Party Title:
Permit Number:
Email Address:
Mailing Address:
City:
Signature of Delegated Party indicating
acceptance of Signatory Authority:
Date:
Phone:
State: I I Zip:
Stormwater Permit Delegation of Signatory Authority Form
Page 2

B. 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.
As the Responsible Official, I, Joseph Santangelo
have the authority to enter into this Agreement for
Waste Industries LLC
(Owner/Organization Name).
(printed name),
I request that the DEMLR Stormwater Program include the persons listed in Part A of this form
signatory authority for the above -named permit.
I acknowledge that I, and the persons listed in Part A of this form work at/for my organization
and have authority to act as a signatory for purposes of the NCDEQ's electronic document
systems.
By submitting this application, I, Joseph Santangelo (printed name),
have read, understand, and accept the terms and conditions of the stormwater permit(s) for
which I am the Responsible Official.
Responsible Official Signature
Regional Environmental Compliance Manager
Title
05/20/2022
Date
Stormwater Permit Delegation of Signatory Authority Form
Page 3

NC Department of Environmental Quality
Division of Energy, Mineral and Land Resources
NORTH CAROLINA
ERWro nmenfai QriDiffy
Stormwater Permit Delegation of Signature Authority Form
Directions are in red.
=> This form shall be used to delegate signature authority from the permit Owner (Permittee) to
another party. Only the Responsible Official defined below may submit permit applications and
reports required by the permit (such as Data Monitoring Reports and Annual Reports) until this
form is completed and submitted to the DEMLR Stormwater Program. Please note that delegating
signature authority does not relieve the Permit Owner from the responsibility for permit
compliance.
=> The permit Owner is the legal entity to which/whom a permit has been issued, and may be an individual
or an organization such as a company or government agency. Every Owner is required to have a
Responsible Official who meets the legal signature authority requirements in 40 CFR 122.22, summarized
below:
• For a corporation, the Responsible Official shall be 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, the Responsible Official shall be a general partner or the
proprietor, respectively; or
• For a municipality, State, Federal, or other public agency, the Responsible Official shall be either a
principal executive officer [City/County Manager] or ranking elected official [Mayor].
=> Even if delegated signatory authority has been delegated to another individual, the Responsible Official
retains responsibility for compliance with permit conditions.
Organization Name:
Waste Industries LLC
Joseph Santangelo
Responsible Official Name:
Responsible Official Title:
Regional Environmental Compliance Manager
Email Address:
[e-mail]
Phone:
[phone]
Mailing Address:
3301 Benson Drive Suite 601
City:
Raleigh
State:
NC
ZiP:
27609
Stormwater Delegation of Signature Authority Form
Page 1

A. Persons to Receive Signatory Authority
=> The signatures of the persons listed below indicates their acceptance of signatory authority.
Delegated Party Name:
James D. Frei
Delegated Party Title:
Consultant
Permit Number:
NCG080965
Email Address:
[e-mail]
Phone:
919-661-9954
Mailing Address:
8916 Oregon Inlet Ct
City:
Raleigh
State:
NC
I Zip:
27603
Signature of Delegated Party indicating
acceptance of Signatory Authority:
%�.
Date:
May 0, 2022
Delegated Party Name:
Spencer Pernell
Delegated Party Title:
Operations Supervisor
Permit Number:
NCG080965
Email Address:
[e-mail]
I Phone:
252-438-5333
Mailing Address:
241 Vanco Mill Rd
City:
Henderson
State:
NC
Zip 27537
Signature of Delegated Party indicating
acceptance of Signatory Authority:
n
Date:
May 20, 2022
Delegated Party Name:
Randy Deming
Delegated Party Title:
Manager
Permit Number:
NCGO80965
Email Address:
[e-mail]
I Phone:
260-579-1861
Mailing Address:
241 Vanco Mill Rd
City:
Henderson
I State:
NC
I Zip 27537
Signature of Delegated Party indicating
acceptance of Signatory Authority:
7--1�
Date:
May 20, 202
Delegated Party Name:
Delegated Party Title:
Permit Number:
Email Address:
Mailing Address:
City:
Signature of Delegated Party indicating
acceptance of Signatory Authority:
Date:
Phone:
State: I I Zip:
Stormwater Permit Delegation of Signatory Authority Form
Page 2

B. 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.
As the Responsible Official, I, Joseph Santangelo
have the authority to enter into this Agreement for
Waste Industries LLC
(Owner/Organization Name).
(printed name),
I request that the DEMLR Stormwater Program include the persons listed in Part A of this form
signatory authority for the above -named permit.
I acknowledge that I, and the persons listed in Part A of this form work at/for my organization
and have authority to act as a signatory for purposes of the NCDEQ's electronic document
systems.
By submitting this application, I, Joseph Santangelo (printed name),
have read, understand, and accept the terms and conditions of the stormwater permit(s) for
which I am the Responsible Official.
nsible Official Signature
Regional Environmental Compliance Manager
Title
05/20/2022
Date
Stormwater Permit Delegation of Signatory Authority Form
Page 3