WQ0018087_Signature Authority Delegation_20240725

Initial Review
Reviewer
nathaniel.thornburg
Is this submittal an application? (Excluding additional information.) *
Yes No
If not an application what is the submittal type?* Annual Report
Residual Annual Report
Additional Information
Other Signature Authority Delegation
Permit Number (IR) * W00018087
Applicant/Permittee Alpek Polyester USA, LLC
Email Notifications
Does this need review by the hydrogeologist? * Yes No
Regional Office
CO Reviewer
Admin Reviewer

Submittal Form
Project Contact Information
Please provide information on the person to be contacted by NDB Staff regarding electronic submittal, confirmation of receipt, and other correspondence.
...................................................................................................................................................................................................................................................................................... ... ... ... ... ... .. ... ... ... ... ..
Name* Phyllis H Simmons
Email Address*
[e-mail]
Project Information
.........................
Application/Document Type*
New (Fee Required)
Modification - Major (Fee Required)
Renewal with Major Modification (Fee
Required)
Annual Report
Additional Information
Other
Signature Authority Delegation
Phone Number*
[phone]
Modification - Minor
Renewal
GW-59, NDMR, NDMLR, NDAR-1,
N DAR-2
Residual Annual Report
Change of Ownership
We no longer accept these monitoring reports through this portal. Please click on the link below and it will take you to the correct form.
https:Hedocs.deq.nc.gov/Forms/NonDischarge Monitori ng_Report
Permit Type:*
Wastewater Irrigation
High -Rate Infiltration
Other Wastewater
Reclaimed Water
Closed -Loop Recycle
Residuals
Single -Family Residence Wastewater
Other
Irrigation
Permit Number:*
WQ0018087
Has Current Existing permit number
Applicant/Permittee Address*
3216 Cedar Creek Road„ Fayetteville, NC 28312
Facility Name *
Alpek Polyester - Cape Fear Manufacturing Facility SDU
Please provide comments/notes on your current submittal below.
Penny Mahoney retired from Alpek Polyester USA, LLC this year. She was delegated to sign permit reports related to the Cape Fear Manufacturing
Site. She has been replaced with Jeffrey Ross - Global Safety, Health & Environmental Director. We are submitting a change "Delegation of
Signature Authority."
At this time, paper copies are no longer required. If you have any questions about what is required, please contact Nathaniel Thornburg
at [e-mail].
Please attach all information required or requested for this submittal to be reviewed here.
(Application Form, Engineering Plans, Specifications, Calculations, Etc.)
Delegation of Authority Letter CF.pdf 78.48KB
Upload only 1 PDF document (less than 250 MB). Multiple documents must be combined into one PDF file unless file is larger
than upload limit.
* By checking this box, I acknowledge that I understand the application will not be accepted for pre -review until the fee (if required) has
been received by the Non -Discharge Branch. Application fees must be submitted by check or money order and made payable to the
North Carolina Department of Environmental Quality (NCDEQ). I also confirm that the uploaded document is a single PDF with all parts
of the application in correct order (as specified by the application).
Mail payment to:
NCDEQ — Division of Water Resources
Attn: Non -Discharge Branch
1617 Mail Service Center
Raleigh, NC 27699-1617
Signature
Submission Date 7/25/2024

July 25, 2024
Division of Water Resources
Non -Discharge Branch
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
To Whom It May Concern:
Subject: Permit No. WQ0018087
Signature Authority Designation
Alpek Polyester USA, LLC
Manufacturing Facility SDU
Surface Disposal of Residuals
Brunswick County
As an appropriate signing official for Alpek Polyester USA, LLC (city/tou177 or business name) as
designated by 15A NCAC 02T .0106(c). I hereby delegate authority to sign and certify all permit
applications, reports or other permit related documents to the following staff for the following permit
types (sewer, spray, land application) and/or permit numbers:
Person Permit Tvpe
Position Currently in or Permit
Position Number
Global Safety, Health, & Jeffrey Ross WQ0018087
Environmental (SHE) Director
If you have any questions, please contact me at the following:
Permittee/Applicant name (please print): Matthew P. Hendrickson
Title: Site Director Cedar Creek Resins & Clear Path Recvclinsz and Cape Fear Site
Complete mailing address: 3216 Cedar Creek Road
City: Favetteville State: North Carolina Zip: 28312
Telephone number: [phone]. Facsimile number: [phone]
Sincerely,
Matthew P Hendrickson
Confidential - External and Internal Use