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WQ0000731_Monitoring - 02-2021_20210331
FORM: NDMR 10-13 NON -DISCHARGE MONITORING REPORT (NDMR) Page of_Z_ Permit No.: Q1111731 Facility Name: Lake Toxaway Company. . , 11111111,Iwill IN ••• 11 1 11.11 INN 1 �110 • 11 - FORM' NDMR 10-13 NON -DISCHARGE MONITORING REPORT (NDMR) Page 2 of Sampling Person(s) Certified Laboratories Name: Gary Norton Name: Enviromental Testing Solutions, Inc Name: Richard McCrary 11 Name: Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? KComptiant ❑ Non -compliant If the facility is non -compliant, please explain in the space below the reason(s) the facility was not in compliance. Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s) taken. Attach additional sheets if necessary. Operator in Responsible Charge (ORC) Certification Permittee Certification ORC: Gary Norton Permittee: Lake Toxaway Company Certification No.: 21853 Signing Official: Scott McCall, by signatory authority Grade: II Phone Number: 828-553-2990 Signing Official's Title: Broker, Lake Toxaway Company Has the ORC changed since the previous NDMR? ❑ yes ❑ No Phone Number: 828-966-4260 Permit Expiration: 10/31/2021 ignature Date Signature mate By this signature, I certify that this report is accurrate and complete to the best of my knowledge. 1 certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that all qualified personnel property gathered and evaluated the information submitled. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted Is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, inducting the possibility of fines and imprisonment for knowing violations. Mail Original and Two Copies to: Division- of Water Resources Information Processing Unit 1617 Mail Service Center Raleigh, North Carolina 27699-1617 FORM: NDAR-1 07-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page I of (a emit No.: Q1111 • • •_ . • -• 1 Did irrigation • ® �i�i�i'a3 . occur Area (acres): at this facility? Cover Crop: Cover Crop: YES NO Hourly Rate (in):� Hourly Rate (in): Annual Rate (in):�. - , . .... ... ,s .... . . .... mom■■■ • . m , , .. �m , , , , • , m , ,. . ,. �� LIM M1 mom■■■ • . m , , , , �m , , , , • , m , ,. , ,. � Me Wro OR ..... . ......r.....,.® .�... r.....�0;��...� .• P.....,:.........,: .....,,.��.000,VOW,,®��,1...., ..v..-....vv..�.w� r. . �.vr.. rvr• r�...r vr�. tnur�r �-�� ..y„ I ... �_ Did the application rates exceed the limits in Attachment B of your permit? 21Compliant ❑Non -Compliant Were adequate measures taken to prevent effluent ponding in or runoff from the sites? El Compliant ❑ Non -Compliant Was a suitable vegetative cover maintained on all sites as specified in your permit? ❑r Compliant ❑ Non -Compliant Were all setbacks listed in your permit maintained for every application to each permitted site? 21Compliant 0 Non-Comaiant Were all freeboards maintained in accordance with the specified freeboard heights in your permit? 21Compliiant ❑Non -Compliant If the facility is non -compliant, please explain in the space below the reason(s) the facility was not in compliance. Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s) taken. Attach additional sheets if necessary. Operator in Responsible Charge (ORC) Certification ORC: Gary Norton Certification No.: 29126 Grade: SI Phone Number: 828-553-2990 Has the ORC changed since the previous NDAR-1? ❑ yes El No Signature Date By this signature, I certify that this report is accurrate and complete to the best of my knowledge. Permittee Certification Permittee: Lake Toxaway Company Signing Official: Scott McCall, by signatory authority Signing Official's Title: Broker, Lake Toxaway Company Phone Number: 828-966-4260 Permit Exp.: Oct. 31, 2021 4� a Signature Date I certify, under penalty of taw, that this document and all attachments were prepared under my direction or supervision in accordance vith a system designed to assure that all qualified personnel property gathered and evaluated the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are sign icant penalties for submitting false information, including the possibility of fines and imprisonment for krKrMng violations. Mail Original and Two Copies to: Division of Water Quality Information Processing Unit 1617 Mail Service Center Raleigh, North Carolina 27699-1617 FORM: NDAR-1 07-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page __Z_ of -4_ Permit No.: WQ0000731 Facility Name: Lake Toxaway Company County: Transylvania Month: February Year: 2021 Did irrigation Field Name: ------------- FW-4 Field Name: T-5 Field Name: T-6 Field Name: FW-6 occur Area (acres): 1.06 Area (acres): 2.11 - Area (acres): ------ 0.68 Area (acres): 1.33 at this facility? Cover Crop:Turf 9 rass Cover Crop: P� Turf rass 9 Cover Crop: p� Turfgrass 9 Cover Crop: P� Turf rass 9 ❑✓ YES ❑ No Hourly Rate (in): 0.19 Hourly Rate (in): 0.24 Hourly Rate (in): 0.15 Hourly Rate (in): 0.23 Annual Rate (in): 26.25 Annual Rate (in): 16.55 Annual Rate (in): 32 Annual Rate (in): 24.99 Weather Freeboard Field Irrigated? _ YES ❑ NO Field Irrigated? ❑� YES ❑ No Field Irrigated? ❑ YES ❑ No Field Irrigated? 0 YES ❑ No N p v :Oi = 4)i m °G' N ~ o •a � a ` m a E °°' > a ° J E rn x ° J m y � ° > Q E rn >, S ° J E rn 0_ p J m E 2 O 7 Q a _ ° E � E 0_° O J y o E d O CL > o N rn �. OC J E0. rn OE J 3: °F in ft ft gal min in in gal min in in gal min in in gal min in in 1 PC 2.2 2.5 5.5 2 C 3 C 46 2.5 930 10 0.03 0.03 2,320 10 0.04 0.04 460 10 0.02 0.02 1,390 10 0.04 0.04 4 CL 5.5 5 R 0.2 6 SN 2 7 SN 0.1 8 PC 45 930 10 0.03 0.03 2,320 10 0.04 0.04 460 10 0.02 0.02 1,390 10 0.04 0.04 9 C 56 2 930 10 0.03 0.03 2,320 10 0.04 0.04 460 10 0.02 0.02 1,390 10 0.04 0.04 101 PC 1 57 1 1 930 10 0.03 0.03 2,320 10 0.04 0.04 460 10 0.02 0.02 1,390 10 0.04 0.04 11 R 0.6 5 5 12 R 0.4 13 R 0.7 14 R 0.1 15 R 1.1 161 CL 42 2 930 10 0.03 0,03 2,320 10 0.04 0.04 460 10 0,02 0.02 1,390 10 0.04 0.04 171 PC 38 930 10 0.03 0.03 2,320 10 0.04 0.04 460 10 0.02 0.02 1,390 10 0.04 0.04 181 R 1.1 5 5 19 CL 45 930 10 0.03 0.03 2,320 10 0.04 0.04 460 10 0.02 0.02 1,390 10 0.04 0.04 20 C 44 930 10 0.03 0.03 2,320 10 0.04 0.04 460 10 0.02 0.02 1,390 10 0.04 0.04 21 CL 2.5 22 CL 23 C 57 930 10 0.03 0.03 2,320 10 0.04 0.04 460 10 0.02 0.02 1,390 10 0.04 0.04 24 CL 25 CL 0.5 5 5 26 R 0.9 3 27 R 0.1 28 R 0.1 5.5 29 30 31 Monthly Loading: 8,370 0.29 20,880 0.36 4,140 0.22 12,510 0.35 12 Month Floating Total (in): 1.51 1.88 1.14 1.78 - v Did the application rates exceed the limits in Attachment B of your permit? Were adequate measures taken to prevent effluent ponding in or runoff from the sites? Was a suitable vegetative cover maintained on all sites as specified in your permit? 2 Compliant ❑ Non -Compliant ❑' Compliant ❑ Non -Compliant F1 Compliant ❑ Non -Compliant Were all setbacks listed in your permit maintained for every application to each permitted site? 0Compliant [I Non -Compliant Were all freeboards maintained in accordance with the specified freeboard heights in your permit? Q compliant ❑ Non -Compliant If the facility is non -compliant, please explain in the space below the reason(s) the facility was not in compliance. Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s) taken. Attach additional sheets if necessary. Operator in Responsible Charge (ORC) Certification ORC: Gary Norton Certification No.: 29126 Grade: SI Phone Number. 828-553-2990 Has the ORC changed since the previous NDAR-1? ❑ yes El No el Signature Date By this signature. I certify that this report is accurrate and complete to the best of my knowledge. Permittee Certification Permittee: Lake Toxaway Company Signing Official: Scott McCall, by signatory authority Signing Official's Title: Broker, Lake Toxaway Company Phone Number: 828-966-4260 Permit Exp.: Oct. 31, 2021 zo �-_, 5 4� oZ Signature Date I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance vith a system designed to assure that all qualified personnel properly gathered and evaluated the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the informaton, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations. Mail Original and Two Copies to: Division of Water Quality Information Processing Unit 1617 Mail Service Center Raleigh, North Carolina 27699-1617 316 rmit No.: WQ0000731 j Facility Name: Lake Toxaway Company County: Transylvania Month: February Did irrigation occur at this facility? YES NO Hourly Rate (in --.... .. -. .. ■ o . ..Field.. ■ o . logo MMMI mmmm MMME Monthly Loading: Floating12 Month . . %/////All ..v.a-✓.vv..�.ava_�. . �wra..v.•.�a_r vr�tnv�r�-� ..y..��... �_ Dick the application rates exceed the limits in Attachment B of your permit? 2 Compliant ❑ Non -Compliant Were adequate measures taken to prevent effluent ponding in or runoff from the sites? pcompliant El Non -Compliant Was a suitable vegetative cover maintained on all sites as specified in your permit? OCompliant ❑Non -Compliant Were all setbacks listed in your permit maintained for every application to each permitted site? ElCompliant ❑Non -compliant Were all freeboards maintained in accordance with the specified freeboard heights in your permit? ElCompliant ❑Non -compliant If the facility is non -compliant, please explain in the space below the reason(s) the facility was not in compliance. Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s) taken. Attach additional sheets if necessary. Operator in Responsible Charge (ORC) Certification I ORC: Gary Norton Certification No.: 29126 Grade: SI Phone Number. 828-553-2990 Has the ORC changed since the previous NDAR-1? ❑ Yes O No Signature Date By this signature, I certify that this report is accurrate and complete to the best of my knowledge. Permittee Certification Permittee: Lake Toxaway Company Signing Official: Scott McCall, by signatory authority Signing official's Title: Broker, Lake Toxaway Company Phone Number: 828-966-4260 Permit Exp.: Oct. 31, 2021 /,:;z Signature Date I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that all qualified personnel property gathered and evaluated the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for krxrMng violations. Mail Original and Two Copies to: Division of Water Quality Information Processing Unit 1617 Mail Service Center Raleigh, North Carolina 27699-1617 Hl, Permit No.: W00000731 Facility Name: Lake Toxaway Company County: Transylvania Month: February Year: 2021 Did irrigation Field Name: 02-FW-15 Field Name: 02-FW-16 Field Name: 02-T-10 Field Name: 02-T-11 occur Area (acres): 2.02 Area (acres): 1.34 Area (acres): ----------- 1.11 Area (acres): 1.62 at this facility? Cover Crop:Turf 9 rass Cover Crop: P� Turf rass 9 Cover Crop: p� Turf rass 9 Cover Crop: P� Turfgrass 9 ❑� YES ❑ No Hourly Rate (in): 0.3 Hourly Rate (in): 0.23 Hourly Rate (in): 0.28 Hourly Rate (in): 0.25 Annual Rate (in): 10.77 Annual Rate (in): 12.16 Annual Rate (in): 17.75 Annual Rate (in): 11.08 Weather Freeboard Field Irrigated? ;_ YES _1 No Field Irrigated? YES ❑ No Field Irrigated? ❑ YES NO Field Irrigated? 0 YES ❑ No a U a�i Y a F o « cal a m °� ° m m y o c`°i - a u, �.. E -T O °� a m a E F- L m > c a o -I E T rn - c E 3 0 2 J m y E m ° a iQ v m a; E ~ '� - rn c v J E T rn ` c E 'a m 2 0 J m a E T ° iQ n a° E ~ ' - 7 c a J E - c E a S J m y E m ° a iQ a m„ E ~ - rn > c v ° J E> _ c E 'a _ J 3 °F in ft ft gal min in in gal min in in gal min in in gal min in in 1 PC 2.2 2.5 5.5 2 C 3 C 46 2.5 2,780 10 0.05 0.05 1,390 10 0.04 0.04 1,860 10 0.04 0.04 4 CL 5.5 5 R 0.2 6 SN 2 7 SN 0.1 8 PC 45 2,780 10 0.05 0.05 1,390 10 0.04 0.04 1,860 10 0.04 0.04 9 C 56 2 2,780 10 0.05 0.05 1,390 10 0.04 0.04 1,860 10 0.04 0.04 10 PC 57 2,780 10 0.05 0.05 1,390 10 0.04 0.04 1,860 10 0.04 0.04 11 R 0.6 5.5 12 R 0.4 13 R 0.7 14 R 0.1 15 R 1.1 16 CL 42 2 2,780 10 0.05 0.05 1,390 10 0.04 0.04 1,860 10 0.04 0.04 17 PC 38 2,780 10 0.05 0.05 1,390 10 0.04 0.04 1,860 10 0.04 0.04 18 R 1.1 5.5 19 CL 45 2,780 10 0.05 0.05 1,390 10 0.04 0.04 1,860 10 0.04 0.04 20 C 44 2,780 10 0.05 0.05 1,390 10 0.04 0.04 1,860 10 0.04 0.04 211 CL 1 2.5 221 CL 231 C 1 57 2,780 10 0.05 0.05 1,390 10 0.04 0.04 1,860 10 0.04 0.04 24 CL _ 25 CL 0.5 5.5 26 R 0.9 3 27 R 0.1 28 0.1 5.5 29 30 J 31 EJ I Monthly Loading: 25,020 0.46 12,510 0.34 0 0.00 16,740 0.38 12 Month Floating Total (in): 2.35 1.78 2.16 1.98 ..v..-u.vv..�.w� �. . �.vr...vn i�t-. v... t.•vru l-rr ..y.. � ... �� Did the application rates exceed the limits in Attachment B of your permit? ❑O Compliant ❑ Non -Compliant Were adequate measures taken to prevent effluent ponding in or runoff from the sites? ❑Compliant ❑Noncompliant Was a suitable vegetative cover maintained on all sites as specified in your permit? OCompliant El Non -Compliant Were all setbacks listed in your permit maintained for every application to each permitted site? 0Compliant [I Non -Compliant Were all freeboards maintained in accordance with the specified freeboard heights in your permit? 0Compliant ❑Non -compliant If the facility is non -compliant, please explain in the space below the reason(s) the facility was not in compliance. Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s) taken. Attach additional sheets if necessary. Operator in Responsible Charge (ORC) Certification ORC: Gary Norton Certification No.: 29126 Grade: SI Phone Number: 828-553-2990 Has the ORC changed since the previous NDAR-1? ❑ Yes , ❑ No Signature Date By this signature, I certify that this report is accurrate and complete to the best of my knowledge. Permittee Certification Permittee: Lake Toxaway Company Signing Official: Scott McCall, by signatory authority Signing Official's Title: Broker, Lake Toxaway Company Phone Number: 828-966-4260 Permit Exp.: Oct. 31, 2021 o� Signature Date I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance vith a system designed to assure that all qualified personnel properly gathered and evaluated the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons dkeaty responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations. Mail Original and Two Copies to: Division of Water Quality Information Processing Unit 1617 Mail Service Center Raleigh, North Carolina 27699-1617 S/6 Permit No.: W00000731 Facility Name: Lake Toxaway Company County: Transylvania Month: February Year: 2021 Did irrigation Field Name: 02-FW-17 Field Name: 02-FW-18 Field Name: 02-T-17 Field Name: 02-T-18 occur Area (acres): - 1.87 Area (acres): 2.64 Area (acres): 1.58 Area (acres): 1.25 at this facility? Cover Crop:Turf 9 rass Cover Crop: p� Turfgrass 9 Cover Crop: p� Turf rass 9 Cover Crop: p� Turf rass 9 El YES ❑ NO Hourly Rate (in): 0.27 Hourly Rate (in): 0.35 Hourly Rate (in): 0.26 Hourly Rate (in): 0.25 Annual Rate (in): 10.42 Annual Rate (in): 9.41 Annual Rate (in): 11.67 Annual Rate (in): 14.04 Weather Freeboard Field Irrigated? YES '� N0 Field Irrigated? ❑ YES ❑ NO Field Irrigated? ❑ YES Ell NO Field Irrigated? ❑ YES ❑ No �. m m U t Q 2 t6 ° E N F r CL U y - 0- m m to p (n 4 N a 0 U •- a Q a Q Cp d 'D E d Q' 0° Q N � E ti m 'z _ � ?. C o M 0 0 J � T m - __ E a o c0 = O J d '0 E 2 3 0 CL � a � d .�, E m m i _ m �+ c o to C o J E T m 7 C E` v p m M 2 O J (D "6 E °' °- 6 fl_ 7 Q 'D N ..2 E m a) F- '� _ � y, C a t0 ca 0 0 J E T m 7_ C_ E 0 m M= 0 J N V E? 7 a o a i Q � d 4; E m rn ~ = m �, C o f9 0 0 J E �, m 3_ C_ E a m= 0 J 3. °F in ft ft gal min in in gal min in in gal min in in gal min in in 1 PC 2.2 2.5 5.5 2 C 3 C 46 2.5 2,320 10 0.05 0.05 4,180 10 0.06 0.06 1,390 10 0.04 0.04 4 CL 5.5 5 R 0.2 6 SN 2 7 SN 0.1 8 PC 45 2,320 10 0.05 0,05 4,180 10 0.06 0.06 1,390 10 0.04 0.04 9 C 56 2 1 2,320 10 0.05 005 4,180 10 0.06 0.06 1 1 1,390 1 10 0.04 0.04 10 PC 57 2,320 10 0.05 0.05 4,180 10 0.06 0.06 1,390 10 0.04 0.04 11 R 0.6 5 5 12 R 0.4 13 R 0.7 14 R 0.1 15 R 1.1 16 CL 42 2 2,320 10 0,05 0,05 4,180 10 0.06 0.06 1,390 10 0.04 0.04 17 PC 38 2,320 10 0,05 0.05 4,180 10 0.06 0.06 1,390 10 0.04 0.04 18 R 1.1 5.5 19 CL 45 2,320 10 0.05 0,05 4,180 10 0.06 0.06 1,390 10 0.04 0.04 20 C 44 2,320 10 0.05 0.05 4,180 10 0.06 0.06 1,390 10 0.04 0.04 21 CL 2.5 22 CL 23 C 57 2,320 10 0.05 0.05 4,180 10 0.06 0.06 1,390 10 0.04 0.04 24 CL 25 CL 0.5 5.5 26 R 0.9 3 27 R 0.1 28 R 0.1 5 5 29 30 31 Monthly Loading: 20,880 OA1 37,620W40 0.52 0 0.00 12,510 0.37 12 Month Floating Total (in): 2 15 2.66 2.05 1.89 ..v..-v.vv..�.w� r. . �.v�..v.• .�a..r v.�. tnv�r�'rr ..y.. S ... �_ -"Did & application rates exceed the limits in Attachment B of your permit? i] compliant ❑ Non -compliant Were adequate measures taken to prevent effluent ponding in or runoff from the sites? 2Compliant ❑Non -compliant Was a suitable vegetative cover maintained on all sites as specified in your permit? MCompliant El Non -Compliant Were all setbacks listed in your permit maintained for every application to each permitted site? OCompliant ❑Non -compliant Were all freeboards maintained in accordance with the specified freeboard heights in your permit? 0 Compliant ❑ Non -Compliant If the facility is non -compliant, please explain in the space below the reason(s) the facility was not in compliance. Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s) taken. Attach additional sheets if necessarv. Operator in Responsible Charge (ORC) Certification ORC: Gary Norton Certification No.: 29126 Grade: SI Phone Number. 828-553-2990 I Has the ORC changed since the previous NDAR-1? ❑ Yes 0 No Signature Date By this signature, I certify that this report is accur ate and complete to the best of my knowledge. Permittee Certification Permittee: Lake Toxaway Company Signing Official: Scott McCall, by signatory authority Signing Officials Title: Broker, Lake Toxaway Company Phone Number: 828-966-4260 Permit Exp.: Oct. 31, 2021 a Signature Date I certify, under penalty of law, that INS document and all attachments were prepared under my direction or supervision in accordance vith a system designed to assure that all qualified personnel properly gathered and evaluated the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of roes and imprisonment for knowing violations. Mail Original and Two Copies to: Division of Water Quality Information Processing Unit 1617 Mail Service Center Raleigh, North Carolina 27699-1617 6 // WQ0000731 Facility Name: Lake Toxaway Company County: Transylvania Month: February Did irrigation occur Area (acres): Area (acres)� Area (acres): at this facility? I! Cover Cr.p:� YES NO Hourly Rate (irly- A� Field Irrigated? E 17 ---- o ©omm m � ��m■■� �■��� ��®� ���� omm©� �■��� ��� ���� ���� m omm mm mom®m®���� ���� ��■�� ���� mom m • . m .. . , .., m , , . , . , � .. , . ���� m omm © ���■®���� ���� ���� mommm ■���� ���� ���� ���� Monthly Loading: 12 Month Floating Total fin) WN/100/1 Per�nit No ~'Did the application rates exceed the limits in Attachment B of your permit? OCompliant ❑ Non -Compliant Were adequate measures taken to prevent effluent ponding in or runoff from the sites? OCompliant ❑Non -Compliant Was a suitable vegetative cover maintained on all sites as specified in your permit? OCompliant ❑Non -Compliant Were all setbacks listed in your permit maintained for every application to each permitted site? (]compliant ❑Non-Compiiant Were all freeboards maintained in accordance with the specified freeboard heights in your permit? 21Complant El Non -Compliant If the facility is non -compliant, please explain in the space below the reason(s) the facility was not in compliance. Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s) taken. Attach additional sheets if necessary. Operator in Responsible Charge (ORC) Certification ORC: Gary Norton Certification No.: 29126 Grade: SI Phone Number. 828-553-2990 I Has the ORC changed since the previous NDAR-1? ❑ yes 0 No Signature Date By this signature, I certify that this report is accurrate and complete to the best of my knowledge. Permittee Certification Permittee: Lake Toxaway Company Signing Official: Scott McCall, by signatory authority Signing Official's Title: Broker, Lake Toxaway Company Phone Number: 828-966-4260 Permit Exp.: Oct. 31, 2021 a Signature Date I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance vith a system designed to assure that all qualified personnel properly gathered and evaluated the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations. Mail Original and Two Copies to: Division of Water Quality Information Processing Unit 1617 Mail Service Center Raleigh, North Carolina 27699-1617