NC0040061_Delegated Authority_20161220

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December 20,2016
Wastewater Branch RECEIVEDINCDEQIDWR
Water Quality Permitting Section JAN 11 2017
Division of Water Resources
1617 Mail Service Center
Water Quality
Permltteng
Raleigh,NC 27699-1617
Subject: Delegation of Signature Authority
BEAVER DAM CREEK WWTP
NPDES Permit Number NC0040061
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.
Individual #1 Individual#2 (f applicable)
Name: John Nichols
Title: Public Utilites Director
P.O. Box 249
Mailing Address: Bolivia,N.C. 28422
Physical Address: 250 Grey Water Road
Of different) Supply,Nc 28462
Email Address: [e-mail]
Office Phone: 910 - 253 - 2653 - -
Mobile Phone: ' 910 - 512 - 2334 - -
If you have any questions regarding this letter, please feel free to contact me at Enter Email or Phone
Number.
Sincerely,
Authorized Signing Official's Name: Ann B. Hardy
Authorized Signing Official's Title: County Manager
Mailing Address: P. O. Box 249, Bolivia,NC 28422
Email Address: [e-mail]
Office Phone [phone]
Mobile Phone
cc: Select a region Regional Office, Water Quality Permitting Section