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HomeMy WebLinkAboutWQ0004268_Renewal (Application)_20221028Initial Review Reviewer Thornburg, Nathaniel D Is this submittal an application? (Excluding additional information.)* Yes No Permit Number (IR) * WQ0004268 Applicant/Permittee Murphy -Brown LLC Applicant/Permittee Address P.O. Box 856 Warsaw, Nc 28398 Is the owner in BIMS? Yes No Is the facility in BIMS? Owner Type Organization Facility Name Murphy -Brown WWIS County Fee Category Minor Is this a complete application?* Yes No Signature Authority Signature Authority Title Signature Authority Email Document Type (if non -application) Email Notifications Does this need review by the hydrogeologist? * Yes No Regional Office CO Reviewer Admin Reviewer llr�ore Fee Amount $0 Complete App Date 10/28/2022 Below list any additional email address that need notification about a new project. ... ... .. Email Address Comments to be added to email notfication Comments for Admin Comments for RO Comments for Reviewer Comments for Applicant Submittal Form Project Contact Information Please provide information on the person to be contacted by NDB Staff regarding electronic submittal, confirmation of receipt, and other correspondence. ............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................ Name* Kevin Weston Email Address* kweston@smithfield.com Project Information Application/Document Type* New (Fee Required) Modification - Major (Fee Required) Renewal with Major Modification (Fee Required) Annual Report Additional Information Other Phone Number* 910-293-5363 Modification - Minor Renewal GW-59, NDMR, NDMLR, NDAR-1, N DAR-2 Residual Annual Report Change of Ownership We no longer accept these monitoring reports through this portal. Please click on the link below and it will take you to the correct form. hftps://edocs.deq.nc.gov/Forms/NonDischarge_Monitoring_Report Permit Type: * Wastewater Irrigation Other Wastewater Closed -Loop Recycle Single -Family Residence Wastewater Irrigation Permit Number: * WQ0004268 Has Current Existing permit number Applicant/Permittee* Murphy -Brown LLC Applicant/Permittee Address* P.O. Box 856 Warsaw, Nc 28398 Facility Name* Murphy -Brown WWIS Please provide comments/notes on your current submittal below. Attached is the renewal application for the Murphy -Brown WWIS, WQ0004268 along with supporting documentation and a copy of a letter of request for permit extension. High -Rate Infiltration Reclaimed Water Residuals Other At this time, paper copies are no longer required. If you have any questions about what is required, please contact Nathaniel Thornburg at nathaniel.thornburg@ncdenr.gov. Please attach all information required or requested for this submittal to be reviewed here. (Application Form, Engineering Plans, Specifications, Calculations, Etc.) W00004268 MB WWIS RenewalApp WWIS-R-02-21 1.08MB 102822. pdf Upload only 1 PDF document (less than 250 MB). Multiple documents must be combined into one PDF file unless file is larger than upload limit. * By checking this box, I acknowledge that I understand the application will not be accepted for pre -review until the fee (if required) has been received by the Non - Discharge Branch. Application fees must be submitted by check or money order and made payable to the North Carolina Department of Environmental Quality (NCDEQ). I also confirm that the uploaded document is a single PDF with all parts of the application in correct order (as specified by the application). Mail payment to: NCDEQ — Division of Water Resources Attn: Non -Discharge Branch 1617 Mail Service Center Raleigh, NC 27699-1617 Signature Submission Date 10/28/2022 FORM: WWIS-R 02-21 Pursuant to l A i t; fit: 02"1" wt111Du 1 , if the application does not include all required information and the necessary supporting documentation, the application shall be returned. The application and attachments shall be prepared in accordance with ) t"M021,.,6100, 15A IM'A.0 021�.0150 'W, and ) iv iisi�,�ig Policies. For more information, visit the Water Quality Permitting Section's Non -Discharge Branch �w�kiMte". The Applicant shall submit an electronic copy of the application and attachments uploaded as a single Portable Document Format (PDF) file to�t3/��,ii�:ctsx���m�ltncic7i��i:c:�Iu�c�i�:➢I- p or r w V:vi°2, or emailed to c31��, iu� g� qy if less than 20 megabytes (MB). 1. Physical address: 5900 Turkey Hwy City: Turkey 2. Treatment facility coordinates to the sixth decimal degree: Latitude: 34.9824880 Longitude:-78.227995' 1. Billing address: P.O. Box 856 County: Sampson State: NC Method: Select SECTION III — FLOW INFORMATION Parcel No.: 18053760004 Zip:28393-9030 City: Warsaw State: NC Zip: 28398- 2. Verify the Applicant does not have any overdue annual fees: .......... e :a ����r� �� �� �u;�m' Pursuant to 15 " 1 t A,, " 0 i .0 2(kej, permits for renewing facilities shall not be granted if the Applicant or any affiliation has an unpaid annual fee. FORM: WWIS-R 02-21 Page 1 of 6 SECTION V — OPERATOR IN RESPONSIBLE CHARGE (ORC) INFORMATION 1. ORC: James Derek Brown Grade: SI Certification No.: 27678 Mailing address: P.O. Box 856 City: Warsaw State: NC Zip: 28398- Phone number: (910) 271-0917 Cell Email: debrown@smithfield.com , ....------- .... ..m _.......m..........................m......................... .,... .- 12. Back -Up ORC: Michael Leon Norris ........... �... � ....... Grade: Sl Certification No.. 23931 Mailing address: P.O. Box 856 City: Warsaw State: NC Zip: 28398- Phone number: (910) 284-0435 Cell Email: mnorris@smithfield.com SECTION VI — OPEN -ATMOSPHERE STRUCTURES 1. List all open -atmosphere treatment and storage structures associated with the renewing permit. Attach additional sheets if necessary. �.. Type Parcel No. .„ Volume (gal) .... ................ Liner Type Freeboard (ft) Latitude Longitude Treatment 18053760004 ........................ ... Unknown 2 ------ ------------ ,m 34.9825080 .,..._ ., . ,....,. -78.2279640 Storage 18053760004 Unknown 2 34,9796060 -78.2287860 Select Select 0- ° S11 e11 lect Select - ° SECTION VII — RELATED PERMITS 1. List all wastewater permits (i.e., sewer, collection system, NPDES, residuals) that have interactions with the renewing permit. Attach additional sheets if necessary. Permit Type Permit No. Relationship Type Select — ........................ ... Select ...... .... .....------.. ,,. ------ ............ .____ .......... _............. —.......--------- ---.. Select ... Select Select .. Select . my Select Select SECTION VIII — MONITORING WELLS i 1. List all groundwater monitoring wells associated with the renewing permit. Attach additional sheets if necessary. Well Name Parcel No Status Gradient Location _ -- Latitude - Longitude ................. -- MW-1 -------- ........w. ._ .... 18053760004 . ............. Active .......................... Select ...................................... ............ .._ Inside Review Boundary 34.9814050 -78.226537° MW-2 18053760004 Active Select Between CB and RB 34.979636 ° - 4885° 78.22 _ .... MW 3 18038504504 Active Select - -- On Review Boundary 34.9759870 78 220606° R-1 15029369001 Active Select Inside Review Boundary 34.9720270 -78.2359200 R-2A 15029369001 Active Select On Review Boundary 34.9707890 -78.2338270 ... ._...... ._ __..____...__ .._.�� ..__._. R-3 15029369001 Active Select Inside Review Boundary 34.9694580 78.2321220 R 4 15029369001 Active Select Review Boundary 34.9666500 -78.2339710 R---5A 15029369001 Active Select mInside ^ Between CB and RB 34.967678° .... . ___ -78.239556° � 29369001 Active Select On Review Boundary... 34.968103° 3 78 243190°� m. 01 m .R-7 150293690. Active -----------.......---- Select Inside Review Boundary - ... f 8.244747° R-8 15029369001 Active Select Inside Review Bound Boundary 34.973427° 1__.__— -78.2-78.234.9700760_ 43981° a FORM: WWIS-R 02-21 Page 2 of 6 SECTION V - OPERATOR IN RESPONSIBLECHARGE (ORC) INFORMATION 1. ORC: Grade: Certification No.: Mailing address: City: State: Zip: - Phone number ( ) - Select Email: — — ......... ...... ... 2. Back -Up ORC: ..................................................................�..� Grade: Certification No.: Mailing address: City: State: Zip: - Phone number: ( ) - Select Email: SECTION VI - OPEN -ATMOSPHERE STRUCTURES 1. List all open -atmosphere treatment and storage structures associated with the renewing permit. Attach additional sheets if necessary. Type Parcel No. Volume (gal) - Liner Type -- Freeboard (ft) .......... .... Latitude ... Longitude ... _ Select Select 0° _..... Select ......... ....... Select ....... ......,,,.. 0- Select Select 0- ° Select Select - ° SECTION� �� TION VII —RELATED PERMITS 1. List all wastewater permits (i.e., sewer, collection system, NPDES, residuals) that have interactions with the renewing permit. Attach additional sheets if necessary. Permit Type Permit No. Relationship Type Select Select Select -- ..... .............. . Select ... ............................._....................................... _ Select .................. Select Select Select SECTION VIII - MONITORING WELLS I. List all groundwater monitoring wells associated with the renewing permit. Attach additional sheets if necessary. Well Name Parcel No. Status Gradient Location Latitude Longitude R-9 15029369001 Active Select Inside Review Boundary 34.9725880 -78.2386120 ................................ ...... _ _ . Select_... Select Select ° Select Select Select ° - ° mm...m Select Select ------- _..... -- -------- Select ° - ° ............... .... a ...................... ........ . Select .. _... _ Select Select ......... ° - ° Select Select Select 0- ° Select Select Select ° - 1 ° Select Select Select ° - ° Select Select Select ° - ° Select Select ......... ° - ° Select Select Select 0° FORM: WWIS-R 02-21 Page 2 of 6 SECTION IX — IRRIGATION FIELDS FORM: WWIS-R 02-21 Page 3 of 6 Was the facility originally permitted or had a major modification issued after September 1, 2006? Yes —Pursuant to 1 1,;C,,%C 02T 0105(iIj, submit a site map pursuant to the requirements in 1 `dA N ,� CI 02 � 0"��„04(i ); These requirements are: ❑ A scaled map of the site with topographic contour intervals not exceeding 10 feet or 25 percent of total site relief and showing all facility -related structures and fences within the wastewater treatment, storage, and irrigation areas. ❑ Soil mapping units shown on all irrigation sites. ❑ The location of all wells (including usage and construction details if available), streams (ephemeral, intermittent, and perennial), springs, lakes, ponds, and other surface drainage features within 500 feet of all wastewater treatment, storage, and irrigation sites. P P 0 .0 ., and 1 ; 1a A.°;._02 O�N.�1ts�c ❑ Delineation o the compliance and review boundaries per 1 a _1'^1 p 1p1 4V:1,V 1 an u 11D if applicable. ❑ Setbacks as required by 15 A J1IQ, AQ 1521'0506,. ❑ Site property boundaries within 500 feet of all wastewater treatment, storage, and irrigation sites. ❑ All habitable residences or places of public assembly within 500 feet of all treatment, storage, and irrigation sites. ® No — Skip Attachment A. Does the signature authority in Section I, Item 3 meet the requirements pursuant to 15A N ' Q1 Q;9,,06(� ,u')? ® Yes — Skip Attachment B. No — Submit a r � qa J,oap,j,1^ft r pursuant to 15 � . � 1V„� 1 .1.1 � 1u�pi:� authorizing the signature authority to sign. Does the existing permit include an approved flow reduction? ❑ Yes — Submit a copy of the flow reduction approval letter, as well as the measured monthly average amount of wastewater flow contributed per unit for the 12 months prior to permit renewal. If any of these monthly averages are within 20% of the approved flow reduction value, the Permittee shall provide a reevaluation of the reduced flow value pursuant to the requirements in � 5A ]ha1CAC—Q 1 _11 .:1, • ® No — Skip Attachment C. Is the Applicant a Privately -Owned Public Utility? ❑ Yes —Pursuant to 1 1', 1,4CAC 11 a 1 M Q ➢ Lf 1p, submit the Certificate of Public Convenience and Necessity from the 1r.uu �l,i Car aa11a a demonstrating the Applicant is authorized to hold the utility franchise. ® No — Skip Attachment D. Is the Applicant a Home/Property Owners' Association or Developer of Lots to be Sold? ❑ Yes (Home/Property Owners' Association) — Pursuant to 15A 1'1 02T.0 p �1 � , submit an executed ,bla�sail ioimu Agri mti iiig tFOR k' 1K)Aj. Pursuant to 15A 1 CAC 02T 011 "rtc; , if the applicant is a legally formed Homeowners' or Property Owner's Association, submit a copy of the Articles of Incorporation, Declarations, and By-laws. ❑ Yes (Developer of Lots to be Sold) — Pursuant to ..1.1� 14CAC 0211` ,111 �5[,aj�?_), submit an executed 01,jpraluaraaal, 111µa°cenicral 11 Pursuant to 15A, 1,4CAC 021 0,11,15111)i, if the applicant is a developer of lots to be sold, submit a copy of the Articles of Incorporation, Declarations, and By-laws. ® No — Skip Attachment E. FORM: WWIS-R 02-21 Page 4 of 6 ATTACHMENT F — DEMONSTRATION OF FUTURE WASTEWATER TREATMENT CAPACITIES Is the applicant a municipality, county, sanitary district, or public utility? ❑ Yes — Proceed to the next question. ® No — Skip Attachment F. Does the hydraulic capacity in Section III, Item 4 exceed 70%? ❑ Yes (the hydraulic capacity is greater than 70%, but less than 80%) — Pursuant to ;u;';mr _N :;, �D_ T tD q 1 (9,i, prior to exceeding 80 percent of the system's permitted hydraulic capacity (based on the average flow during the last calendar year), the permittee shall submit an engineering evaluation of their future wastewater treatment, utilization, and disposal needs. This evaluation shall outline plans for meeting future wastewater treatment, utilization, or disposal needs by either expansion of the existing system, elimination or reduction of extraneous flows, or water conservation and shall include the source of funding for the improvements. If expansion is not proposed or is proposed for a later date, a justification shall be made that wastewater treatment needs will be met based on past growth records and future growth projections, and as appropriate, shall include conservation plans or other measures to achieve waste flow reductions. ❑ Yes (the hydraulic capacity greater than 80%) — Proceed to the next question. ❑ No — Skip Attachment F. If answered Yes above, does the hydraulic capacity in Section III, Item 4 exceed 80%? ❑ Yes (the hydraulic capacity is greater than 80%) — Pursuant to 15 �\111I' a' IAIC,,, uU 1OI_ q rid 2), prior to exceeding 90 percent of the system's permitted hydraulic capacity (based on the average flow during the last calendar year), the permittee shall obtain all permits needed for the expansion of the wastewater treatment, utilization, or disposal system and, if construction is needed, submit final plans and specifications for expansion, including a construction schedule. If expansion is not proposed or is proposed for a later date, a justification shall be made that wastewater treatment needs will be met based on past growth records and future growth projections, and as appropriate, shall include conservation plans or other specific measures to achieve waste flow reductions. ❑ No — Skip Attachment F. Does the Permittee own all of the land associated with the wastewater collection, treatment, conveyance, and irrigation system? ® Yes — Skip Attachment G. ❑ No — Pursuant to 15A,..14t,AC...02' 0116(c), provide a copy of all easements, lease agreements, and encroachment agreements allowing the Permittee to operate and maintain the wastewater collection, treatment, conveyance, and irrigation system on property not owned by the Permittee. Are the Permittee's affiliations of record correct? 0eck af-'Nations. ❑ Yes — Skip Attachment H. ® No — Provide the corrected affiliations and their contact information. Does the existing permit include any Compliance Schedules? (See Section I of the most recently issued permit) ® Yes — Submit documentation that the compliance schedules have been met. ❑ No — Skip Attachment I. Does the Permittee have any existing civil penalties or outstanding violations? ❑ Yes (civil penalties) — Submit payment for the civil penalty, or proof of remission request. ❑ Yes (violations) — Submit a copy of your response to the Notice of Violation. ® No — Skip Attachment J. FORM: WWIS-R 02-21 Page 5 of 6 Does the wastewater composition in Section III, Item 5 include any industrial wastewater? ❑ Yes — Proceed to the next question. ® No — Skip Attachment K. Has the nature of the industrial wastewater changed since the last permit issuance (i.e., changes in industrial process, introduction of new materials or chemicals, etc.)? ❑ Yes — Provide a chemical analysis of the wastewater pursuant to the requirements in V, -A N ,k ¢� ° IJ,_,0 04� _iii,;,�. Provide an overview of the manufacturing process; an inventory of all chemical and biological materials used in the manufacturing process; and an overview of the cleaning and treatment methodology. ❑ No — Provide an overview of the manufacturing process; an inventory of all chemical and biological materials used in the manufacturing process; and an overview of the cleaning and treatment methodology. Does the existing permit include setback waivers? ❑ Yes — Pursuant to ll 5 A N CAC 0 r 0ri0u: d, provide setbacks waivers that have been written, notarized, signed by all parties involved, and recorded with the county Register of Deeds. Waivers involving the compliance boundary shall be in accordance with II.;5A NCA Q 021..., ...d) Ili 0 7. ® No — Skip Attachment L. 1, _Jafl fLGeNT ......... ......._ attest that this application (Signature authority's name as noted in Section I, Item 3) has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that if all required parts of this application package are not completed, and that if all required supporting information and attachments are not included, this application package will be returned as incomplete. I further certify pursuant to '1 A i CA( 2, QM)11[,,w), that the applicant, or any parent, subsidiary, or other affiliate of the applicant has: not been convicted of environmental crimes under; not previously abandoned a wastewater treatment facility without properly closing the facility; not paid a civil penalty; not been compliant with any compliance schedule in a permit, settlement agreement, or order; not paid an annual fee. Note: The Applicant's Certification shall be signed pursuant to I,5A NCA q1 e111 An alternate person may be delegated as the signing :ial if a letter is provided pursuant to i 5 A 1 C AC' 021' .0 I'O f $'(g) Pursuant to § Il �� t , � �� and § 'l A� � � fit , any person who I io � y m ' es any false statement, representation, or certification in any application package shall be guilty of a Class 2 misdemeano w c mad �clude a fine not to exceed $10,000 as well as civil penalties up to 1$25,00Q0 per violation. Signature: _..... 0 ..................a,..�.W, �.,,,.��... ...... .... — -- ...... Date:..... THE COMPLETED .AP ;.,JCATION AND ATTACHMENTS SHALL BE SUBMITTED AS A SINGLE PDF FILE VIA: Email: Laserfiche Upload: :r�mr �t:�llNmr�� R�� m:��ts�tr twd�nu �imf ��m�a.0@��:ms�iunitmmwl�: l tt�as: a:I�:�s d „�........ _�����_ . __�_ I _ � ��.� _���_.� � � �Su Ib infltt a � AMA oiu-mVe r° FORM: WWIS-R 02-21 Page 6 of 6 North Carolina Department of Environmental Quality Division of Water Resources Permit Number: WQ0004268 Permit Type: Wastewater Irrigation Facility Name: MurPhy Brown WWI$ Facility Addressl: 5900 Turkey HIM Facility Address2: City, State & Zip: Turkey, NC 28393 Owner information Details: Owner Name: Murphy -Brown LLC Owner Type: No,n Goye,rnment (1114wPonsiblecorprH*te off Owner Affiliation: John Sargent Addressl: PO Box 856 Address2: City, State & Zip: Warsaw. NC 28398-0856 Work Phone: 910-293-3434 Email Address: jsargent@smithfield.com Owner Type Group: Organization Title: Exe„,gti,VeV,icePresident Fax: 910-293-3138 *** Permit Annual Fee i3illin *** Billing Month: August Invoice Number Invoice Date Invoice our. Date Invoice Amount Invoice Status Owner Contact Person(s) Contact Name Title Address Phone Fax Email Kevin Weston Environmental PO Drawer 856, Warsaw, NC 28398 910-293-5363 910-293-3138 kweston@smithfield.com Resource S cialist IFac i Contact Person(s) Contact Name Title Address Phone Fax ma'I TUAM -om 1 22 T g. t.° m See V'Iare 2 fa'quo,°rected Affffiaflorii corn Nwnm t_Contact Person(s) Contact Name Title Address Phone Fax Email Permit Billing Contact Person(s) Contact Name Me Address Phone Fax Email Murphy -Brown PO Box 856, Warsaw, NC 28398-0856 910-293-3434 910-293-3138 Persons with Signa#ory Authority Type Contgq N@me Title Address Phone Fax Email Owner John Sargent PO Box 856, Warsaw, NC 910-293-3434 jsargent@smithfiled.com 28398-0856 10/28/2022 Page 1 Permit Number: WQ0004268 Permit Type: Wastewater Irrigation Facility Name: Murphy -Brown VVWIS Facility Addressl: 5900 Turkey Hwy Facility Address2: City, State & Zip: Turkey. NC 28393 Facilitv Classification: SI Operator Name Role Cert Type Cart Statu Cert # Effective Date James Derek Brown ORC SI Active 27678 5/1812018 Michael Leon Norris Backup SI Active 23931 5/14/2018 ntai3 IICF eii°°son Coirda(!I Nairie Tillie DaAid VIlor&i �3r, Dhectoof Eiriv, Afl:alm Address Phone 1�3��iix 856 Wau saw,, NC 910-293,3434 28�398 10/28/2022 Page 2 idiir, ; iii I Cri'ipII'liiarice Sche( III'C III' �w)CU'ne;vtalIJiiiaii VF, L ABANDON NT RECORD North Carojba llapatl,tient of EAVirt1I1 wn1 and Nulurat tesonroes- MWon of Water Quality WELL C4ONTRACTOR CERTIFICATION # } 1. WELL COMACrOR: Wctl Conh=W (Individmat)Name Well � p r Co'yNttme STREETADDRP,Ss ! Z1 Fi, A �V�! ,l 1 A if 2 CkyorTown State ZpCc& ("�Ld�• .zY2y 3171C Area codb- Phone btimber 2. W:�LL�If'D.��s4T10Y SiTETTEL•t(Dif(itap[ihcable) %/hW_ n ... STATEWPLL1'E21M V(11'a¢plicvBle,) —____ COUNTYWELL PERMIT# (ifapplicable) WELLfft (Check applicable use);-[A6uitoring ❑ YR"Itlintial 0 AlualcipAVI'atiHe 0 TeduslrluMummoviai 0 Agritultund Q Recovery, ❑ ,14jceHon ❑ Irrigation [] Other (ust use) 3.lVELLLOCA71 N: C0UNTYy:9U&At AQUADRANGL) NAME ____-,�--- NEAREST f0►N14: ( ,e 10ORrnE2 p LLC- (sunattewda �, t.� ,cauamatty, Stitatvt�on tatrte., k,uml. v eo a TOI,0dE APAtc /LAND 5Rl•rING: InfOnTaiOO OSlope ❑Valley RV09 []Ridge00thw __ Cc4' (ctteelt apgl 1 9 3 � 0 G May be m d. m=, LATITUDE / (`J(�..f7 tuiuuteo� lefvnda, or im a LONGITUDL'!F°Az Y- 7. Lt dacitasi lorarat . xcs8� Latitade7uug13da qurce S pTopographic ntap (Local- ofwd( mtut be ahawn on a, USOS'lopo map and ar -&d ro Mmf—1 091141119 GPS j 4a. FACILITY-11w.natm ctdw b,witum where dun well is beard L.amotte4a mMb. (Ifa«sidentislvrcil. skip 4o:somitleleAQvucii^,arn�:) FACII.fTXID#(ifapplirable) 4 NAME or PactI T—" STREET' ADDRESS 4% Co. w City ar Towa I Stmo zip Cndn- 4b. CONTACT PERSONA WJ L OWNER- STRL•ETADDRESs .2 .4 6. WELL DETAIL a: Total Depth: 3l✓,„,_ & Dr,.M er: b. Water Levc1(Balow MrasuTinS Point): _ rL iNeesaring poirttis _ Z R. above land surface, 6. CASMG: Length Diameter a. Casing Depth (f inowa): _.. � it. is baCasing Removed: ft 7. VMMEChCOY: ,_ I OX a (Amount of 65%75% calcium h)pochigrltp used) & SEALING MTERIA.1: NeAt coneup Smell, ilomem CemL'nt '16. (;.•ement. lb. Watts gar. - water gal. __t1VI�L Batttmita lb. T21M[3Sltary ills wSEP 10 Uii� aXar .. PL lLh� Type tn:tterisl F-,�y �Q�io� Amount tEREGJORJAJ FFICE ,fWltloD of EWLACENIENTIOF RATER Lt t 10.\YTsI'd.QfAGR4RiDrawgdetailcdalchQflliewellonUbb3cko£this form *Aft toml dt:pth, depth mid diamoter bf screens (if any) minaining lathe wall, gmvel.mwval, intcnnals or asiogperforations, and depths and types oftill materhIsrsed. 11. DATI? 1VbLL ABAhTD[ 'q1) �. 1 DO HMMY CWTIFY'-MT THMt WELL WM.AQANDQIdm mt A('_CORDAMC;i WFIH UA NCAC 7C, WfiL1 Ct1ttS]'ttliLlYoN $xAPl1)ARi?S, AND THAT A COPY OF T$iS RECORD HAS MIX.MOi7DEDTO TM WELL OkTAML 5! . 'MA1 O .CER7'iPtED MULU , - M A `CrOR — DATE SIGNATUltK OF P tYATE YVELL OWNERA DOIIrt�(Q 11rE V1B16 1�1TE f,'he private well ownX tra,tba an ladivldool crho PCsuna MI c6nrtdeee hEsrytar,�i iadihl,sell in aocordaace with ISA NCAC ZC .0I13.) PROMD NAME OFPERSON A$L107!)ONING Tilt; WELL Sublrtit a copy to theownermid the origivai to the Dhisloti of Water Quality within 30 days. Form OW 3o Attu: iaformatloa ManageMent,1617 Mall Service Center-Rulelgh, NC2769N1617, Phone Na. (919) T33.7015 ntt 568. Rev. 50 C4-4 en C) r. C, a, cn o I.- CD c) cc: Z r.- 14 I, z ol; Lu w LAJ wj IZ �z A a 00 Ln L4 Ln 11 Ln 1i - Ln 7 z Na CD C: r, F- C6 'i I In C4 m z r, -- It 1-i co LO kD•m m =) A N O. cti E Ln w w — w at i Lu 11r Ir ce !� ,z 'Lnu 'n o C3 00 u u, --� ,3. Mir u Z, Ln 0 CS, 0 la 0 u (D 1- m tz ED CA to elf u m f Lu 1, u 0 t; Ln Z co Iffi 3 w < c 3 000 o a- " i- V) 0 W WLn P < > > > < Ln Ln vi U :s z ED 0 < 14 w J !� a IN w Un ce ce w I. w 0 0 n cwr w H rw- ID z ui w L. w cl: -j u w Ln z z z z LLJ < U U, Z m u g ITU M 9 0. z z u L, 0 0* w CE CL Ln n LL < a P. o o 0 0 < :3 ......... . . a FAME MINE, I ro I'll 52111 W fit ll rFq LU co 7— .0 0 M Im LU tn mU, c s! IV Lu z LU �: z j m > �0� 0 0 u 0 & v 9 . I 2L L) Ln --j 0: --j 0 -j 1.735 Heckle Blvd, d, Suite 1.03-291., Rock Hill, SC 29732 1ION111F, (336) 51& 0340 I,1?aLL (336) 31.Z, 9007 October 27, 2022 N.C. Department of Environmental Quality Division of Water Resources 512 North Salisbury Street 1617 Mail Service Center Raleigh, North Carolina 27699-1617 ATTENTION: Mr. Nathaniel Thornburg REFERENCE: REQUEST FOR PERMIT EXTENSION WQ0004268 Murphy -Brown WWIS (Former Allen Canning) Turkey, North Carolina BR&S Job No. 2022-135 Dear Mr. Thornburg: Murphy -Brown has retained Branch Residuals & Soils to assist in the closure of the lagoons at the former Allen Canning facility now Murphy -Brown WWIS in Turkey, North Carolina. Murphy -Brown has been engaged in the closure of the lagoons at the facility and the removal of solids. Due to several years of uncooperative weather, efforts have been hampered. However, this year the weather has cooperated and significant progress is being made. Unfortunately the permit is at an end and is slated to expire on April 30, 2023. Under ideal circumstances we would like to have the closure completed by the end of permit expiration but we rather secure some extra time just in case ideal conditions are not available. Murphy- Brown would request that Permit WQ0004268 be extended an additional year and allowed to expire on April 30, 2025. Please review with NCDWQ Fayetteville Regional Office and consider our request. Please give me a call if you have any questions or comments, (336) 312-9007, Sincerely, ram,., Robert T. Branch Branch Residuals & Soils ,LLC Cc: Mr. David Nordin — Smithfield Mr. Dave Elkins — Smithfield Mr. Trent Allen — NCDWQ FRO