NC0034703_Delegated Authority_20141020

•
October 114,2014
Wastewater Branch p�pENRJpWR
WaterQuality Permitting Section RECENE
Division of Water Resources
1617 Mail Service.Center
I OCT $ Q '/1��'+
Raleigh,:NC' 276.991617
Waw uuam
permitting ecibn
Subject: Delegation of Signature Authority
Knollwood Elementary School
N 'DES Number NC0034703
To Whom It May Concern:
By.notice of this.letter, I hereby delegate signatory authority to each of the following
individuals for all permit applications, discharge monitoring reports, and other
information relating to the:operations at Knollwood Elementary School as required by
all applicable federal, state, and local environmental agencies specifically with the
requirements for signatory authority as specified in 15A NCAC 213.0506.
Name Title
Jody Blythe Wells Pesticide
lib you have any questionsregarding this Ietter,please feel free to contact me at.
Sincerely,.
rr.Lynn Moody
SUpeetntendent
cc: Mooresville Regional Office,Water Quality Permitting Section

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1
Submitter Change Request Form —(Add/update users)
North Carolina Electronic Discharge Monitoring Report System
tllMathoi Wow ertinitmes
EDMR registered Owners may use this form to add or update eDMR users to the NCDWR's Electronic
Discharge Monitoring Report system. If the Organization is not currently registered for eDMR,then the
Owner or designated Responsible Official will need to complete the required eDMR Registration Form
(available from the eDMR website)and submit it to the NCDWR eDMR Administrator at the address
below.
Type of Request(please select):
X •Add Submitter Permissions: (See Section B)
Update Submitter Permissions: (See Section B)
To add or update eDMR user permissions,please provide the following information:
Section A: Owner Information
NPDES Permit Number: NC0034959
Owner/Organization Name: Rowan-Safisbur r_Schools
Responsible Official
(as identified in accordance with 41 ; ; 122.22 B•H. Bivens
Street Address: 8050 Nc Hwy 801
City: Salisbury
State/Zip Code: NC 28125
Telephone number: (704 ) 8573400
E-mail address: [e-mail]
Section B: Activate New Submitter or Update Existing User
Please complete the Submitter User Details on page 2 for the individuals who will need Submitter
permissions or to update Submitter details,such as adding additional permits,to an existing user.
Submitter permissions can only be assigned by the NCDWR eDMR Administrator. Note: The Owner
and Facility Administrator can deactivate or delete eDMR user permissions for any individual within
its organization,including Submitter permissions.
The Submitter is equivalent to the individual who sjgns the certification statement on the back of the
Discharge Monitoring Report. The Submitter must be an individual with delegated signatory authority
for the Owner/Organization. If individuals other than the Responsible Official for the Owner have been
delegated signatory authority,the Division of Water Resources must be notified in writing of such
delegations. A delegation of authority form is available from the eDMR website.
In addition to the User Details,please specify the NPDES permit(s)that each user will be associated with
for eDMR submittal. Should additional space be needed for users and/or permits,please make additional
copies of the Submitter User Details page and complete as needed.
NCDWR eDMR Submitter Change Request Form-ver.1.0 Page 1