WQ0000485_ORC Designation Form_20240823

Water Pollution Control System OPERATOR IN RESPONSIBLE CHARGE (ORC) Designation Form
NCAC 15A 8G .0201
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Facility Name: DARLING INGREDIENTS ROSE HILL
Permit # WQ0000485
Facility Type/Classification: WW Facility Grade: II SUBMIT A SEPARATE FORM FOR EACH CLASSIFICATION
Permittee Owner/Officer Name: Thomas Tyner
Email Address: [e-mail]
Permittee Signature: Date: Z�ZC
ORC
Full Name: Corey Myles Lanier
Work Phone: [phone]
Email Address: [e-mail]
Certificate Type: WW Certificate Grade: 11
Certificate #: 1010055
Signature:
Effective date:
"1 certify that I agree to my designation as the 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 as set forth in 15A NCAC 08G .0204 and failing to do so can result in Disciplinary Actions by the WPCSOCC"
Backup ORC
Full Name: Luis Alejandro Fernandez Vasquez
Work Phone: [phone]
Certificate Type: WW Certificate Grade: II
Certificate #: 1011970
Signature:
Effective Date:
"I certify that 1 agree to my desig tion as the Aerator in Responsible Charge for the facility noted.
I 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 WPCSOCC"
Backup ORC
Full Name: Ana Karina Cruz
Work Phone: [phone]
Certificate Type: WW Certificate Grade: I
Certificate #: 1015389
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Signature: �� �'� '
Effective Date:—',-s
"I certify that I agree to my designation as the Ope toga esponsible harge for the facility noted.
I understand and will abide by the rules and regulations
pertaining to the responsibilities of the ORC as set forth in 15A CAC .0204 and failing to do so can result in Disciplinary Actions by the WPCSOCC"
Email this form to: [e-mail]
AND
Send to your DEQ Regional Office (send to your contact or find emails here: www.deq.nc.gov/about/contact/regional-offices
or fax using this drop down list: Choose DWR Regional Office that has coverage of this facility.
Use the 2nd page only if you need to list additional Backups.
Revised 0212024