NC0022756_ORC Designation Form_20230116

01-16-' 23 15:56 FROM- Linville Land Harbor 828-733-1918
T-614 P0001 /0002 F-617
TO: WPCSOCC
ASHEVILLE BRANCH
2090 US HWY 70
SWANNANO A NC 28778
VIA FAX: [phone]
FROM: SCOTTCARPNETER SC
LINVILLE LAND HARBOR WWTP PERMIT# NCO022756
SUBJECT: ORC UPDATE
DATE; JANUARY 16, 2023
Water Quality Regional 0
Asheville Regional C
Included in this fax you will find the required paperwork to update our backup orc for Linville Land
Harbor POA WWTP This paperwork has also been emailed to certadrnin [e-mail].
Please confirm receipt of this email.
Thank you.
I_, I 1 V Y L L E Property Owners Post: Office Box 160 Linville, North Carolina 28646
L. A ICJ F-) i-t A t� 1� () p, Association 828.733.8300 www,LinvilleLanc.11iarl)nr.com

01-16-' 23 15: 56 FROM- Linville Land Harbor 828-733-1918 T-614 P0002/0002 F-617
WATER POLLUTION CONTROL. SYSTEM OPERATOR DESIGNATION FORM (wPCSOCC)
NCAC 15A 8G A201
Press TAB to enter information
Permittee Owner/Officer Name: Linville Land Harbor Propertv Owners Association/Scott
Mailing Address: P 0 Box 160 Phone: [phone]
City: Linville State: NC Zip: 28646
Email Address:
Signature:
Facility Name; Linville Land Harbor WWTP
County: Avery
Date:
Permit # N C0022756
YOU MUST SUBMIT A SEPARATE FORM FOR EACH TYPE AND CLASSIFICATION OF SYSTEM:
Facility Type: WW
Facility Grade: II
::::..:..:..::�':,'�„'.„•,,,,,,,�„,:..:,;,..:,,,.::;::....-...�.:::���,,,.:_,,.,.,<,:,;;-.-.;,..::............,
..:...: , �.. .. ... .........:•i_"f��.. i�.l .........r..,.m, ..1. ...{...., :. h,:. ,�R�r�)1<i ,il�:,�•., .��fn .�:,. •.
........... ....
.. .. .... ................... ..... ........... ..i ..:.-.....-r -i
........ � � �� �, .., .... ... �.... .. :..i is r.r�.i„i.,1 �.,�... .............�r.�,i� �. �. .. .
.... is i... �. i. ........................ ....
Print Full Name: Cecil L Lewis - Work Phone: [phone]
Certificate Type: WW
Email Address: Gil
Certificate Grade: II
is(_IinviIIeland harbor, com
Certificate #: 10911
Signature: —� ( T w_ Effective Date: " 149
"1 certify that 1 agree to my designation as the Operator in Responsible Charge for the facility noted. 1 understand and will abide by the
rules and regulations pertaining to the responsibilities of the ORC as set forth in 15A NCAC 08G ,0204 and failing to do so can result in
Disciplinary Actions by the Water Pollution Control System Operators Certification Commission."
tji ::,',1„'m,:, ,!'a;:;,,'•,..,., _.._.__�....,�.�,:,,�:no,., ,r. _,.�..�.,,,�,,,. ,u'n l,., I,. .., r: �..�::;.... �. n::d:�';:d„.•:,,,,. a:.:.::;..: „ono-,.,,,,,,,<;,.. ,.
Print Full Name: Joshua Cole 011is work Phone [phone]
Certificate Type: WW Certificate Grade: I Certificate #:1012821
Email Address: iolIis(cDlinvill Ian Iharbor.com
Signature: Effective pate: 1-16 — -� 3 _
"I certify that 1 agree to lertaining
ion as a Back-up Operator in Responsible Charge for the facility noted. i understand and will abide by
the rules and regulationto the responsibilities of the. ORC asset forth in 15A NCAC 08G ,0204 and failing to do so can result in
Disciplinary Actions by the Water Pollution Control System Operators Certification Commission."
Mail, fax or email WPC5OCC,1618 Mail Service Center, Fax: 919-71S-272611!IRI;Ggrri;`mlFi'�;e%ilG;,Y
ORIGINAL to: Raleigh, NC 27699-1618
Mail or Fax Asheville Fayetteville Mooresville Raleigh
a COPY to: 2090 US Hwy 10 225 Green St., Suite 714 610 E. Center Ave., Suite 301 3800 Barrett Dr.
Swannanoa, NC 28778 Fayetteville, NC 28301-5043 Mooresville, NC 28115 Raleigh, NC 27609
Fax: [phone] Fax: [phone] Fax: [phone] Fax; 919-571-4718
Phone: [phone] Phone: [phone] Phone; 704-663-1699 Phone: [phone]
Washington
Wilmington
Winston-Salem
943 Washington Sq. Mall
127 Cardinal Dr,
45 W. Hanes Mall Rd.
Washington, NC 27889
Wilmington, NC 28405-2845
Winston-Salem, NC 27105
Fax: [phone]
Fax: [phone]
Fax; 336-776-9797
Phone:[phone]
Phone:[phone]
Phone:[phone] POVJ8Ed412016