NCS000022_DOSA Form_20221011

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NC Department of Environmental Quality
Division of Energy, Mineral and Land Resources
NORTH CAROLINA
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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.
mt� 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 122.2Z 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].
=zp Even if delegated signatory authority has been delegated to another individual, the Responsible Official
retains responsibility for compliance with permit conditions.
Organization Name: Global Nuclear Fuel - Americas LLC
Responsible Official Name: Ryan Huth
Responsible Official Title: Executive Plant Management
Email Address: [e-mail] I Phone: [phone]
Mailing Address: PO Box 780
City: Wiiminaton state: INC I Zip: 128402
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:
Ryan Huth
Delegated Paqy Title:
Permit Number.
NCS000022
Email Address:
[e-mail]
I Phone:
513-203-5817
Mailing Address:
City: — -
P.O Box 780
Wilmin ton
State:
INC
I ZiP:
128402
Signature of Delegated Party indicating
acceptance of Signatofy Autho
Date:
/ Z
Delegated Party Name:
Karen Williams
Delegated Party Title_:_ _
Permit Number:
EHS Programs Manager
NCS000022
Email Address:
Mailing Address:
City:
Signature of Delegated Party indicating
acceptance of Signatory_ Authori .
Date:
[e-mail] I
Phone:
910-547-2758
P.O Box 780
Wilmiggton INC I ZiP: 28402
10 11 Z
Delegated Pady Name:
Andrew Reeside
Delegated Pa Title: _
Permit Number:
Sr. Facilities Environmental Lead
NCS000022
Email Address: _ _
Mailing Address:
City: _
of b Signature a_legated Party indicating
acceptance of Signatory Authority.
Date:
andrew.reeside e.com
I Phone:
910-523-0215
P.O Box 780
Wilmington
I State:
INC
I ZiP:
128402
VOM&L
(oh l -Z z-
Delegated Party Name:
Delegated Party Title:
Permit Number.
Christopher Cronin
NCS000022
Email Address:
Mailing_ Address:
[e-mail] I
Phone:
910- 274-6452
P.O Box 780
Wilmington State: NC Zip: 28402
_
City: __ _
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, Ryan Huth (printed name),
have the authority to enter into this Agreement for
Global Nuclear Fuel - Americas LLC
(Owner/Organization Name).
I request that the DEMLR Stormwater Program include the persons listed in Part A of this for}
signatory authority for the above -named permit.
I acknowledge that I, and the persons listed in Part A of this form work attfor my organization
and have authority to act as a signatory for purposes of the NCDEQ's electronic document
systems.
By submitting this application, I, Ryan Huth (printed name),
have read, understand, and accept the terms and conditions of the stormwater permit(s) for
which I am the Responsible Official.
Executive Plant Management 10 1 !
Title Date
Stormwater Permit Delegation of Signatory Authority Form
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