NC0003417_Other_20190730

�DUKE
"' ENERGY
July 30, 2019
WPCSOCC
1618 Mail Service Center
Raleigh, NC 27699-1618
H.F. Lee Energy ComplejP .i
Duke Energy PN.ress (,
1199 Black Jack Chum d 6'
Goldsboro, N.C.°1V e
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Subject: Water Pollution Control System Operator Designation Form
Duke Energy Progress, LLC
H. F. Lee Energy Complex
Goldsboro, Wayne County, NC
NPDES Permit no.: NC0003417
Dear Sir/Madame:
Enclosed please find a completed Water Pollution Control System Operator Designation Form
for Duke Energy Progress' H. F. Lee Energy Complex. This form will serve to designate James
P. Herring as the Operator in Responsible Charge and Thomas A. Hare, William M. Graham, and
Eric H. Stroupe as Backup Operators in Responsible Charge.
If there are any questions, or additional information required, please contact Mike Graham at
[phone].
Respectfully submitted,
Mike Graham
EHS Field Services
H. F. Lee Energy Complex
Attachment: Water Pollution Control System Operator Designation Form
Cc: North Carolina Division of Water Quality
Washington Regional Office
943 Washington Square Mall
Washington, North Carolina 27889
Lori Tollie
Steve Cahoon
Sharat Gollamudi
Plant Environmental Files

t► WATER POLLUTION CONTROL SYSTEM OPERATOR DESIGNATION FORM (WP
NCAC 15A 8G .0201
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Press TAB to enter information
Permittee Owner/Officer Name: Jeffery Hines, General Manager
Email r
ress: [e-mail]
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Permittee Signature:
Facility Name: Duke Energy Progress, LLC, H. F. Lee Energy Complex
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Date: '
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Permit # NC0003417
SUBMIT A SEPARATE FORM FOR EACH CLASSIFICATION OF SYSTEM: Facility Type: PC
Facility Grade: I
I ORC - OPERATOR IN RESPONSIBLE CHARGE I
Print Full Name: James Patrick Herring Work Phone: [phone]
Certificate Type: PC
Certificate Grade: I
Email Address: [e-mail]
Certificate #: 1007920
Signature: ��C 10,
Effective Date: ;7..;?4 — /
"I certify that I agree to my designation as the Operator in Responsible Charge for the facility noted. I understand and will abide by the
rules and regulations pertaining to the responsibilities of the ORC as set forth in 15A NCAC 08G .0204 and failing to do so can result in
Disciplinary Actions by the Water Pollution Control System Operators Certification Commission."
BACKUP ORC
Print Full Name: Thomas Authur Hare Work Phone: [phone]
Certificate Type: PC
Certificate Grade
Email Address: [e-mail]
Certificate #: 26766
Signature: f f2% z2 Effective Date: %"2 S/—I
"I certify that/ agree to my designation as a Back-up Operator in Responsible Charge for the facility noted. I understand and will abide by
the rules and regulations pertaining to the responsibilities of the ORC as set forth in 15A NCAC 08G .0204 and failing to do so can result in
Disciplinary Actions by the Water Pollution Control System Operators Certification Commission."
Mail, fax or email
ORIGINAL to:
Mail or Fax a COPY to
WPCSOCC, 1618 Mail Service Center, Raleigh, NC 27699-1618
Email: [e-mail] Fax: [phone]
Asheville
2090 US Hwy 70
Swannanoa, NC 28778
Fax: [phone]
Phone: [phone]
Washington
943 Washington Sq. Mall
Washington, NC 27889
Fax: [phone]
Phone: [phone]
Fayetteville
225 Green St., Suite 714
Fayetteville, NC 28301-5043
Fax: [phone]
Phone: [phone]
Wilmington
127 Cardinal Dr.
Wilmington, NC 28405-2845
Fax: [phone]
Phone:[phone]
Mooresville Raleigh
610 E. Center Ave., Suite 301 3800 Barrett Dr.
Mooresville, NC 28115 Raleigh, NC 27609
Fax:[phone] Fax:[phone]
Phone:[phone] Phone:[phone]
Winston-Salem
45 W. Hanes Mill Rd.
Winston-Salem, NC 27105
Fax: [phone] Phone:
336-776-9800 Revised 5/2019

Facility Name: Duke Energy Progress, LLC, H. F_Lee Energy Complex Permit #
Print Full Name: William Michael Graham
Certificate Type: PC
BACKUP ORC
Certificate Grade:
Email Address: [e-mail]
NC0003417
Work Phone: 919-722
Certificate #: 1003536
Signature: y,/�✓���... % tn•-�-� Effective Date: 02L2f/9
"/ certify that/ agree to my designation as a Back-up Operator in Responsible Charge for the facility noted. I understand and will abide by
the rules and regulations pertaining to the responsibilities of the ORC as set forth in 15A NCAC 08G .0204 and failing to do so can result in
Disciplinary Actions by the Water Pollution Control System Operators Certification Commission."
BACKUP ORC
Print Full Name: Eric Hand Stroupe Work Phone: [phone]
Certificate Type: PC
Certificate Grade: II
Email Address: [e-mail]
Signature
Certificate #: 990465
Effective Date: '7-_�Y-(
"/ certify that I agree to my designation as a Back-up Operator in Responsible Charge for the facility noted. I understand and will abide by
the rules and regulations pertaining to the responsibilities of the ORC as set forth in 15A NCAC 08G .0204 and failing to do so can result in
Disciplinary Actions by the Water Pollution Control System Operators Certification Commission."
BACKUP ORC
Print Full Name: Work Phone:
Certificate Type: Select Certificate Grade: Select Certificate #:
Email Address:
Signature: Effective Date:
"I certify that / agree to my designation as a Back-up Operator in Responsible Charge for the facility noted. I understand and will abide by
the rules and regulations pertaining to the responsibilities of the ORC as set forth in 15A NCAC 08G .0204 and failing to do so can result in
Disciplinary Actions by the Water Pollution Control System Operators Certification Commission."
BACKUP ORC
Print Full Name: Work Phone:
Certificate Type: Select Certificate Grade: Select Certificate #:
Email Address:
Signature: Effective Date:
"/ certify that I agree to my designation as a Back-up Operator in Responsible Charge for the facility noted. I understand and will abide by
the rules and regulations pertaining to the responsibilities of the ORC as set forth in 15A NCAC 08G .0204 and failing to do so can result in
Disciplinary Actions by the Water Pollution Control System Operators Certification Commission."
Revised 5/2019