NC0044199_Delegated Authority_20180215

State of North Carolina | Environmental Quality | Water Resources
2090 U.S. 70 Highway, Swannanoa, NC 28778
828-296-4500

February 15, 2018

Robert Rose-Sam’s Mart Inc.
7935 Council Pl, Suite 200
Matthews, NC 28105

SUBJECT: Delegation of Signature Authority
Facility: Sam’s Mart #45 WWTP
Permit No: NC0044199
County: Haywood

Dear Permittee:
A review of our records indicates your facility’s Delegation of Signature Authority Form on file
or those forms submitted by your operator are either invalid or outdated. 15A NCAC 2B.0506
requires a valid form granting third parties signatory authority to submit permit applications,
monitoring reports and other information relating to the operations at the subject facility on your
behalf. To maintain continued compliance, the Division of Water Resources requests you submit
an updated form to the Water Quality Permitting Section. A copy of the form is attached and may
also be found at the following link:

https://deq.nc.gov/about/divisions/water-resources/edmr/forms-and-reports

If you no longer wish to delegate your signatory authority, please notify the appropriate Regional
Office and the Water Quality Permitting Section in Raleigh.

Additionally, please review all registered EDMR users, ORC designations and Responsible
Official listings to insure the Division has the most accurate and up-to-date information for your
facility. If you have any questions, please feel free to contact Janet Cantwell or me at the ARO at
828-296-4500.
Sincerely,

Mikal Willmer, Environmental Specialist
Water Quality Regional Operations Section
Asheville Regional Office
Division of Water Resources
Attachment: Delegation of Signature Authority
EC: WQS-ARO Server
LF

20180215_NC0044199_LTR_RobertRose_DelSigAuth