NC0090182_ORC Designation Form_20231031

WATER POLLUTION CONTROL SYSTEM OPERATOR DESIGNATION FORM (WPCSOCQ
NCAC 15A 8G ,0201
Press i-AB to enter information
Permittee Owner/Officer Name: Daniel Corporation, LLC I Cameron Conner
Mailing Address: 505 20th Street N, Suite 1000 Phone; [phone]
City: Birmingham State: AL zip; 35203
Email Address: [e-mail]
Signature:
Facility Name: Graham & 6th Street Dewatering 1 GW-REM permit q N00090182
County: Mecklenburg
YOU MUST SUBMIT A SEPARATE FORM FOR EACH TYPE AND CLASSIFICATION OF SYSTEM:
Facility Type: PC Ell
Facility Grade: !
OPERATOR IN RESPONSIBLE CHARGE (ORC)
Print Full Name: Caleb Seth Greene work Phone: [phone]
Certificate Type: PC 0 Certificate Grade: I 0 Certificate q: 1011860
Email Address: [e-mail]
Signature: S.-gbd,�&t Effective Date: 1 a/3f / z bz 3
certify that I agree to my designation as the Operator In Responsible Charge for the facility noted. t understand and will abide by the
rules and regulations pertaining to the responsibilities of the ORC as set forth in ISA NCAC 08G .0204 and failing to do so con result in
Disciplinary Actions by the Water Pollution Control System Operators Certification Commission.'
BACKUP ORC
Print Full Name: John Franklin McMahan Ili Work Phone-,980-288-0375
Certificate Type: PC 0 Certificate Grade: I Certificate p:1009605
Email Address: [e-mail]
Signature: � F:.- N N4,�, , Effective Date. 10/30/23
'1 certify that l agree to ky designation as a Back-up Operator in Responsible Charge for the facility noted. i understand and will abide by
the rules and regulations pertaining to the responsibilities of the ORC asset forth in 1SA NCAC 08G .0204 and foiling to do so con result in
Disciplinary Actions by the Water Pollution Control System Operators Certification Commission."
Mail, fax or email WPCSOCC, 1618 Mail Service Center, Fax: [phone] Email: certadmin@ocaler,r,eov
ORIGINAL to: Raleigh, NC 27699-1618
Mail or Fax Asheville Fayetteville Mooresville Raleigh
a COPY to: 2090 US Hwy 70 225 Green 5t., 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; 910.433-3300 Phone: [phone] 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:[phone]
Phone: 252.946,6481
Phone. [phone]
Phone: [phone] R4r:SM4-;ar¢