NC0036935_Signatory Authority_20160811

Date: �� I
Wastewater Branch
Water Quality Permitting Section
Division of Water Resources
1617 Mail Service Center
Raleigh, NC 27699-161.7
RECEIVED
AUG. I IS, 7016
Information Processing Unit
DWR Ssction
Subject: Delegation of Signature Authorityter' 7–X /' lr,S
Facility Name: piny i • QLA-Cl i'n Cr !
NPDES Permit Number: N I C 1010131 1913.15 -1 -
To
91315-1
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
the subject facility as required by all applicable federal, state, and local environmental agencies
specifically with the requirements for signatory authority as specified in 15A NCAC 2B.0506.
TnrUv;rinal #1 Individual #2 (fapplicable)
If you have any questions regarding this letter, please feel free to contact me at either the phone
number -or email address below.
Sincerely,
uthorized igzzing Official's Signature
Authorized igninggl1 Official's Name; (type orprint) 1Title
Mailing Address
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If you have any questions regarding this letter, please feel free to contact me at either the phone
number -or email address below.
Sincerely,
uthorized igzzing Official's Signature
Authorized igninggl1 Official's Name; (type orprint) 1Title
Mailing Address
H
& �, ),S –/
ile hone
cc: b—k(w i 11 e— Regional Office, Water Quality Permitting Section
(Enter region name)

Permit No.: NCO036935
Owner/Permittee :
Responsible :Official:
Resp. Official Title:
Facility Name
Facility Address:
.eDMR Owner Verification Report
Version: 4.00
Pine Mountain Property Owners Assoc
Jimmy C.Fredell
Pine Mountain Lakes WWTP
2885 Pine Mtn Dr
Connellys Springs: NC 28612
Permt Status: Active
'RECEIVED
AUG � 5 2016
Information Processing Unit
DWR Section
Registered for eDMR? : No
Facility Classification: WW -2
ORC Name
Certification #
Cert Status
ORC Designation
Rowe, Robert G.
VWV-2 / 999739
Active
ORC
Hunter, Danielle A.
WW -2 / 23477
Active
Backup
James, Davis A.
WW -2 / 997463
Active
Backup
James, Harry D.
WW -2 / 10430
Invalid
Backup
James, Juanita R.
WW -3.124074
Active
Backup
Rummel, Kenneth J.
WW 2 / 994182
Active
Backup
Page #: 1
Date: 813/2016