WQ0034102_Monitoring - 02-2022_20220304

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DWR - NonDischarge Monitoring Report Submittal
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NORTH CAROLINA
Enrlranmenlel QHaflly
Monitoring Report Submittal
..............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................
Permit Number#* WQ0034102
Name of Facility:* Town of Fremont
Month:* February Year:* 2022
Report Information
Type* Upload Document*
NDMR, NDAR-1, NDAR-2, NDMLR NDMR-February 2022.pdf 6.55MB
PDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2,NDMLR,GW-59).
Confirmation Email Address:* [e-mail]
Name of Submitter:* Kenneth Stanley
Signature:
Date of submittal: 3/4/2022
This will be filled in automatically
Initial Review
.............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................
Reviewer: Gerald,Wanda

Is the project number correct?* WQ0034102
Is the monitoring report accepted?* Yes No
Regional Office* Washington
Accepted Date: 3/21/2022

FORM NDMR 07-13 NON-DISCHARGE MONITORING REPORT (NDMR) Page of
Permit No.: WQ0034102 Facility Name: Fremont WWTP Sprayfield County: Wayne Month: February Year: 2022
PPI: 001 Flow Measuring Point: L.LInf'uent Effluent END flow generated , Parameter Monitoring Point: Influent EiEtr.r_..t r_Gro..ndwater Lowering Lsr:rf ce Water
Parameter Code — 50050 50060 00400 00310 00940 31616 00610 00620 ou530 70300 006 5; 00600 00665
- - z
i
'� — ._ V) 1 — 2 _ - Ga tea?+ '20 Az
i= ir5 o ,- o it o - 0 ty, E e o! 2 ° Les � o c�si
O 0 U < b Z ,o
0
24-hr MO •SPD m !L
7.
g Sit mg}L mIL1100 rnL migtL mglL rfitE mg/L 3ti11 mg/L mg
0 07:3Q ME 84,457 0.17 18'
B 08'45 Mil -88,914 0.09
f 07:30 2 MEM 0.09 _IIMIIIMIEMMINIME _.
09:30 1.5 4 ..
6 0
7 10:15 tt
8 10:00 NM' 0
Q 08:30 2.5 85,648 0.08 7.2
.10 07:30 2.5 0 08 7.5
11 07.30 1.5 49,795 0.09 7.62 ;
Inme
Ea9:45 0 MIIIII=1111
B08:45 787 0.08 7:81 MIN
07'30 8811 i . 0.Q9 7,55 MIN IIIIIIIIIIIIIIIIIIIIMMEMINIIIIMMINIIIIIIIMIIII
u; 07:30 2 INIIIIIIINII18
MIIIIIMMI INN
ig 10:C}0 .
20 0
07.30 2,5 73,938 0 08 9-.�7 -
07:30 3 7 3,145 0,07 8.2
MR 11111
07:30 3 8]8 0.07 9 85 —_ MEM 111.1111 . INI111111111111111
24 10:00 2.5 0
Ei 11:00 ® MI =
26.11111011.1 0 IIIMIIIIIIIIIIIIIIIIIIIIMIIIIIIII ill Sill,
El10:30 5.5 0 '-
30 ----,
31
Average: 30,176 0.09 El= =
Daily Maximum ,514 0.17 9:$5
Daily Minimum: 0 0.07 7,18
Sampling Type: FiecO'er-. Grab Grab Composite .Cornpasite Grab Composite- Composite -Composite Coupes€te . Grab Grab Grab
Monthly Avg. Limit: 91,629 - 30 200 15
Daily Limit:
Sample Frequency: dairy irrigation daily, 4xyear 3xyear 1 4xyear 4xyear 4xyear 4xyear 3xyear 4xyeac 4xyear 4xyeat

FORM: NDMR 07-13 NON-DISCHARGE MONITORING REPORT(NDMR) Page of
— ------ -
Sampling Person(s) Certified Laboratories
,
Name: Kenneth Stanley •Name: Microbac, Fayetteville Divison. Cert#11
Name: Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? L./icon-vont ENon-Compiiant
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: Kenneth Stanley , Permittee: Town of Fremont
1
Certification No.: 997045 1 Signing Official: Tony Howell
Grade: SI Phone Number: 919-738-2982 Signing Official's Title: Town Administrator
Has the ORC changed since the previous NDMR? i=11Yes LL,liiNo Phone mber: 919-242-5 5 Permit Expiration: 2/28/2022
, - .,a 14...6 -
44-----A
. \
Signature Date Signature Date
I
By this signature.I certify that this report is acourrate and complete to the best of my know edge I cerhry,under penalty of law,that this document and at attachments were prepared under my direction or superiosion in
accordance with a system designed to assure that all guatified personnel properly gathered and evaluated the information
sahmtled Based on my iiiiguiry 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 at my knowledge and belief,true,accurate,and complete,I am
aware that there are significant penalties fcr submitting false information,including 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 08-11 NON-DISCHARGE APPLICATION REPORT (NDAR.1) Page of
Permit No.: WQ0034102 Facility Name: Fremont WWTP Sprayfield County: Wayne L Month: February Year: 2022
�, 1! \ �, 0� * \v\�� � Field Name:
��, Field Narr e: 14 � ��o ` -
Did irrigation occur '� =
�� Area acres
? a' Area(acres): 0.44 � (acres):
at this facility' Ka _ -° Cover Crop: Bermuda '"� - *` - Crop:a a t o a.W t o ,-- -. p' �\ ° _ s a Wit; Cover
EYES E{'P, HourlyRate m L.` : -` Hourly Rate(in):
I � \ Annual Rate(in): 26.67 1 i�t� r h - Annual Rate(in):
Freeboard - s -D a v , Field Irrigated? AYES " 1 I Field irrigated? DYES : o
,� 4rK � �
Q' '5 d '..n o_ �. -�.. �'' - O H1I34'jdig S�'+ 4 J a� �tJ
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B®= 0 3.5 IMF um. \-\}�\ 0 � -I 0 0 Q.4fl 0.00 E -�
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• 9 c 58 0 . 3.42 � - 0 0 O.00 0 00 �&� -� v `f� �t
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74 0 3.2 I \ 0 0 D DO 0.00 \ �\ \„`- IMO
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®� 56 0 3.26 � € 0 0 O.(10 0.00 e��-- `y�� y � �
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6 0.02 3.26 \\\_tea\ `\\- - a 0 0 0.00 0.00 F ti \ -�-\\ � \
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MonthlyLoading: = y 0 soniza 0.00 Ky y 34Mil,MatatD 0,00
D.00 = \
12 Month Floating Total(in) - - _ yv., tL _ � -�, .

FORM: NDAR-1 08-11 NON-DISCHARGE APPLICATION REPORT (NDAR-1) Page of
Did the application rates exceed the limits in Attachment B of your permit? ECOmpharit Mon=Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites? EiCembliant Then Comp
Was a suitable vegetative cover maintained on all sites as specified in your permit? EComirdiant LiNon-Compiiant
Were all setbacks listed in your permit maintained for every application to each permitted site? Comp ant ,Thlan-Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? ia.Ornpliant '—iNlen=Chmplant
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: Kenneth Stanley Permittee:
Town of Fremont
Certification No.: 997045 1 Signing Official: Tony howell
Grade: SI Phone Number: 919-738-2982 Signing Official's Title: Town Administrator
Has the ORC changed since the previous NDAR-1? ryesNo Phone mber: 19-242-51 Permit Exp.: 2/28/27
/1 1
3 9' 20Ze'
t91
Signature Date Signature Date
By this signature.I certify that this report is accurrate and complete in the best of my knowledge I certify,under penalty cf law that this document and all attachments were prepared under ow direction or supervision in accordance
with 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
pens ties for submill:ng false information,including the possibility of fires 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 08-11 NON-DISCHARGE APPLICATION REPORT (NDAR-1) Page cf
Permit No.: WQ0034102 Facility Name: Fremont WWTP Sprayfield County: Wayne Month: February Year: 2022
a .. -_. ~ Field Name: 10 - - . ,_ 3 `� �� - \-
Field Name: 12
Did irrigation occur - � __ _ -_
- Area(acres): 2,93 • Area(acres): 2.6
at this facility? �_� Cover Cro Trees , ._. ' ` Cover Cro Bermuda
F yES No - --� , ::: ::::
5478 = _ - ): 43.83
• Weather Freeboard 0 .-.. .f Irrigated? Ewes P4 s � �4 Field Irrigated? 7?i 5 NC,
I1 : itIT! Ji1'
fl
3C
®� ft e.� y, ��a >�t ._ in ��s c``= �� ��. �� S,f'c'� in
�OM 0.00 0.00 5� *,� f s \ s , 0 IIMmin
0.00
t 01`.[.�
4 ��� � st 0 0 0 00 O.00 itt S 0 C 0 00
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8 , - � . 19 c 58 • 3.42 6 !'t 0 � /10 •- 1 4 ! 0.0011 c . ! s s ! ! I1 ti ! s
12 ! La,--,--- --_ s � r 0 0 0.00 0.00 K 0.i, �l t A 0 0 0.00 0.00
13�� I mil`` � `� ▪ '�c 0 0 0.00 0.00 - ,V1#7 �1' i .-G� - 0 0 , 0.00 0.00
14 c 48 0 3.56 .Z 4 i � s e�� 0 0 0.00 0.00 e`1 `
15 c 52 0 • 3.56 � � �- `z -* 0 0 a.a0 0.00 �` '1 w `. *. I. 0 0 a.00IEEE
a o�
16 ! � `?, ti _ c -„ `� ®� 0.00 \�£ ,. 0 0 0,00 0.00
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20 ! �� �' 0 0 0.00 0,00 M` i ���` i 4 1 0. 0 0.00 0.00
21 ma's t 'o=1- 0 0 0.00 0.00 ' ,, a�w- ,i''� . 0 0 0.00 0,00
22 .' 'sf ▪ s -',, k 0 0 0.00 0.00 '" c q ` ~ 0 0 0.00 0.00
23 pc 75 ! 3.26 � a ! � s f -�1 0 . . 0 0.00 0.00
0 0 O. 0.00
24 0 3.26 ! s lI k 1 I 0.00 0.00 @ i 0 0.00 ! s1
25 r6 0.02 7 3.26 !`. ! �!�!I' I & 1 1 1 ! 0.00 � p �� 1 0.00 0.00
8� �` f 0 0.00 .
2728®� I • L_- s s s 1 ! s s 1 s a s I 0 0 0.00 0,00
.1 1 �s € 1 f=sue' 0 0 0.00 0 0'O e r \ 1 1 0 0.00 0.00 •
29 III� -
30 y -- --
31 �l _ .. .1,` j -
M�_ ..�
Monthly Loading: �s '144� 0 114,711,1 0.00 - s,. g `, f 0_00
12 Month Floating Total(in) . E * � .r, �M 0.00 -. `3 18.07

FORM: NDAR-1 08-11 NON-DISCHARGE APPLICATION REPORT(NDAR-1) Page of
Did the application rates exceed the limits in Attachment B of your permit? 1cornpi.ait ENOn-Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites? ECompliant Don-Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit? LE'Compliant ENon-Compliant
Were all setbacks listed in your permit maintained'for every application to each permitted site? rlinCompHant LNon-Compiiant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? ECompliant ENon-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: Kenneth Stanley Permittee:
Town of Fremont
Certification No.: 997045 Signing Official: Tony howell
Grade: SI Phone Number: 919-738-2982 Signing Official's Title: Town Administrator
Has the ORC changed since the previous NDAR-1? i Phone Number: 919-242-5151 Permit Exp.: 2/28/27
7-Yes ENo
1\ /1
ke/vvkaA 471-2A
Signature Date Signature Date
By this signature,I certify that this report is accurrate and complete to the best of my knowledge. 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 properly gathered and evaluated the Informabon submitted Based on my
inquiry of the person or persons who manage the system,or those persons directly responsible for gathenng 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 possibtity of tines 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 08-11 NON-DISCHARGE APPLICATION REPORT(NDAR-1) Page of
Permit No.: W00034102 Facility Name: Fremont WWTP Sprayfield County: Wayne Month: February Year: 2022
g as a-= Field Name: 6 1 g Field Name: 8
Did irrigation n occur
i` - Area(acres): 1. �-� Area(acres): 2.39
at fi1s facility? Ber� � � CoverCrop: much �. - � � Cover Crop: Bermuda
vFS ° - Hourly Rate(in): l ( - `� Hour) Rate in .
i� ` ii �V Annual Rate(in): 54.78 g 4 �' Annual Rate(in): 43.83
Weather Freeboard Field Irrigated? EYES ENO "F = .tg,. ` Field irrigated? ;YES .j1
Ci r,. �� �\ ._ '� �`'- vim , ` .k��
'p i
Ii
Qf0WK !
N ? ?� c = ` C l � ,� - `�. '� E .orC 1 -�� F\\" �,\`- •c ❑ q @ 2 q ^\ .� '� i-�' r ` \ O 2 j•'� •s ❑ S'�j •X q
s. J ,.! �` zip .� �. a \r' t( s. T
°F in ft \ \`� tea` _i. gal minMin in \ti�a, y \- 8 � \ �O �~ gal min in in •
1 c I 0 • 3.46 �� A 1�v 7,822 45 0.13 0.13 9 �, 6,17 3 30 0.10 0.10
2 c 59 0 3.5 �,14 �_,W ' t 3 8.375 45 0.14 0.14 `�o v 1' 6,542 30 0.10 0.10
3 pc 70 0 3.54 " t ` i 5,115 30 0,08 0.08 ��l V*�y� t_�� a� a 1 4.048 20 0.05 0.06
4 r 0.18 3.58 v tiit� �� AA.---,---- t -� � 0 0 O OO 0 00 t \ � ��� I�� + \ y# 0 0 0.0 0.0+0
• S 4ti 6 M --t U 0 0 0.00 0.00 \\; `��! \`-gin € \ 3 0
5 0 � v v\ .s� ` ` =� ; `' 0 0 0.00 J_0
6 i 0 titi�> v�� � , 4s -•. 0 0 0.00 0.00 ggf �` -' ... 0 0� 0.00 -0.�,....-..I
7 r ' 39 1.35 3.58 --_,---„-'-4,� �� 0 0 0.00 0.00 Via` \4t� z M 0 0 0.00 0 00
8 el Es 0 3.42 ��\MW e '-� -t 0 0 0.00 0.00 ` \?`- ��• - t= *-a W- j 0.00 0.00 i
9 c 58 0 • 3.42 vv 14 ii t Ct ')i - - ' Z:, v 0 0�
-z. 8.24. 45 D.13 0.13 �z L � � 6,456 30 D.10 0.10
• ° c ti
1l? c 6 0 3.48 - \ yt t 7.243 45 0.12 0.12 1�� v�w 4* 5,787 30 0.09 l 0_tom
11 c ! 69 - 0 3_52 _V. tr �at 4,586 30 0.07 0,07 : 4s ` \4,,q• t,.. NOM 3.696 20 0.06 0.06
12 0 y� \~ _ `\ 0 0 0.00 0 00 t�.�� \�, A \ .ate k, 0 0 0.00 0.00
.. vim v
13 0 .,_.\� \ \$ ' ivy` - I 0 I 0 �.C'�
\ \"1Q , R \ 0.00
14 c 48 0 - 3.5& '' �� � v �- 0 0 0,00 O.GO 0.00
` k `� ^1 yew e `€ -� ---- --_
15 c 52 0 3.56 4.859 30 0.08 0.08 4 � � �� �� , 3.877 20 0.(76 0.0fi
16 c Eii0 3.4 � s , -W _7,726 45 0.13 0.13 y , t -9 ��� � t 6,109 30 0.09 0.09
17 pc 0 3-2 b- 4 �0i ` 8.060 45 0.13 0.13 vv y
__ -_ �,��� �� � �� ��� 6.332 30 0-10 0.10
18 r 68 ® y� �` . t Vs s€ s 0aktili 1 =.O ` 0 0 0.00 0.00
0 0 0.00 0.00 � v y� `- 7 v��
19 11111111E11.111 Z' �' ` # B� ils 0 0 0.00 0.00 �* M�\}yv� w 0 0 0-00 0.00
20 \ $ Z i -i - ,'*--,,,,:-,;-4,, ,:- >A\ \ \41Q�. *1-� ` � ,
�� v � �- �� 0 0 0.00 (},00 vyv�. � �\ ti � � \- 0 0 0,GO 0.00
21 pc 70 0 • 3.16 � � � � �� 7,466 45 0.12 0.12 �` _ � f 1 5.935 30 0.09 0.09
22 ci ® 0 3.2 = 4a't .. sue -t s' t ti, 7487 = 45 0.12 0.12 W -- tom, 1 Ad 5,949 30 0.09 0 09
23 pc MS 0 3.26 -may y t g t `' 4,862 30 0.08 0.08 t 1 0- A' y -I `� 3,880 20 0.06 0_06
24 ci 56 0 • 3.26 `-- s melt i' 0 0 0.00 0.00 - 1 'I 1 0 0 0.00 0 00
25 r 76 0.02 3.26 * s s sue.- 0 0 0.00 0.00 j- k .ti1 # l - - 0 0 0.00 0.00
26 0 '\ =\ � \ \ \
0 0 0.00 O.Ot7 s t y �y e 0 0 0.0° 0.00
27 r 0.16 . \s ! Ls so •te c 0 0.00 0.00 \ 11 ' , \ \ - \, 0 0 0.00 0.00
28 c 60 0 • 3-28 �1 � „me- � yv v�
�� 0 0 0�00 O.00 ,y s y �� �. 0.
ti �....�a'�.� _._ _ - - ..^'-�-vA� t^
0 0 0.0(} 0fl
•
Monthly Loading: \6� 81,848 1.33 ` e ��� 64,784 00
1 1
12 Month Floating Total(m): - 2�.77 22.76

FORM: NDAR-1 08-11 NON-DISCHARGE APPLICATION REPORT(NDAR-1) Page of
Did the application rates exceed the limits in Attachment B of your permit? ElCorrptiant Ei.Non-COmpliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites? .2Compliant EiNon-compiont
Was a suitable vegetative cover maintained on all sites as specified in your permit? ...ZICornpiant ENon-Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site? EiCompkant ElNon-Ccmpliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? Ecompliant EINon-compiiant
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.
-- - - - —
- ,
I
Operator in Responsible Charge(ORC)Certification
I .
Permittee Certification
.,
I
ORC: Kenneth Stanley II Permittee:
i Town of Fremont
1
Certification No.: 997046 il Signing Official: Tony howell
II
Grade: SI Phone Number: 919-738-2982
Ili Signing Official's Title: Town Administrator
Has the ORC changed since the previous NDAR-1? DYes ENO 1 Phone Number: 91 -242-5151 Permit Exp.: 2/28/27
if ov-Ah,
Signature )/ Date Signature Date
By this signature.I pelt fy that this report is accurrate and complete to the best of my knowledge I certify,under penalty of law bathst document and all attachments were prepared under my direction Cr supervision ir accordance
with 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
informat[on submitted is,to the best of my knowledge and belief,true accurate,and complete,I am aware that there are signIficant
penalties for submithrig false information,including the possibllily of fines and enpnsonment for krowrng v!clations
Mail Original and Two Copies to:
Division of Water Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

Page of
FORM_ NDAR-1 08-11 NON-DISCHARGE APPLICATION REPORT (NDAR-1)
Permit No.: W00034102 Facility Name: Fremont WWTP Sprayfield County: Wayne Month: February Year: 2022
i a,` ip \' `'- � Field Na e: 2 2`.`� '4i7-:*, ,\, 1-74 .\ \\�\3. --_ - _-- m s___-
'-f- _ . \\ \ Field Name:* 4
Did irrigation occur ,- \ ` t
Area(acres): 3.19 i o� Area(acres, 2.29
� � 14
at this facility? --a �--- ----..---- _-,4‘..--,-, e* \� Cover Crop: Bermuda \ �� $ .:_-,,,,,, ,,--._,_,--.4- Cover Crop: Bermuda
vas n 1- al- a ---3- Hourly Rate(in): , k r1 i - � Houriy Rate(in):
�,k -• `_ Annual Rate(in): 54.78 _ 7 Annual Rate in 54.78
--- _ --- - � .� ? i ,�• _ a` x� - ,� \�-`� --Field Irrigated). DYES
Weather Freeboard Field Irrigated? YES r \ � ��
u
•
a 7 ° _N \\\ \ter \ -� \\�-"= 4\ ,i \ , `& c\?
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31 monthly
onth( Loading:
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12 Month Floating Total(in) - '1 27.56 \ a , _ �:

FORM: NDAR-1 08-11 NON-DISCHARGE APPLICATION REPORT (NDAR-1) Page of
Did the application rates exceed the limits in Attachment B of your permit? Ecomphar,t ENori-Cornpliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites? r7CompN3nt 7Non-Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit? ECompLant Ellon-Compi:ant
Were all setbacks listed in your permit maintained for every application to each permitted site? ICom alt ENOri-Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? compliant ENon-Com.pliant
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: Kenneth Stanley
Permittee:
Town of Fremont
Certification No.: 997045 I Signing Official: Tony howell
Grade: SI Phone Number: 919-738-2982 Signing Officials Title: Town Administrator
Has the ORC changed since the previous NDAR-1? riYes Phone Number: 919-242- 151 Permit Exp.: 2/28/27
riffrO(/
Signature 1/4) Date Signature Date
By it signature,I certify that this repel a accurrate and complete to the best of my knowledge 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 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.tarn aware that there are significant
penalties for submit ng false information,including the possibility of fines and iinprisonrnent for kriowng violations
Mail Original and Two Copies to:
Division of Water Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617