WQ0034380_Monitoring - 01-2022_20220223

Monitoring Report Submittal
Permit Number #* WQ0034380
Name of Facility:* Sanderson Farms Kinston Processing Facility
Month: * January Year: * 2022
Report Information
Type* Upload Document*
NDMR, NDAR-1, NDAR-2, NDMLR Jan. 2022 NDAR NDMLR 1.17MB
NDMR.pdf
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: * Joseph H. Franklin
Signature:
C-11&11 a+f Vt aWol
Date of submittal: 2/23/2022
This will be filled in automatically
Initial Review
Reviewer: EADS\wgerald 1

Is the project number correct?* WQ0034380
Is the monitoring report accepted?* YeS No
Regional Office* Washington
Accepted Date: 4/4/2022

FORM: NDAR-1 07-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page / of
Permit No.: WQ0034380
Facility Name: Sanderson Farms-Kinston.unty:
Lenoir
Month:Area
-®
Field Name:
�Illllil�l��
Did irrigation occur
at this facility.
FZIYES ■ •
t
Hourly Rate (in):�„
®IWIi�i1llii1iliftl��
��
t
Annual Rate
Field Irrigated?
NEW-��
t t

FORM: NDAR-1 07-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of
Permit No.: WQ0034380
Facility Name: Sanderson Farms -Kinston Facility
County: Lenoir
Month: January
Field Name:
leld Name:
Rum
Did irrigation occur
Area (acres):
Area (acresy
Area (acres):
at this facility?
��Hourly
-
®■®
Cover Crop:
Rate (in):
Hourly Rate (in):
Hourly Rate (in):
Annual Rate (in):
-
Annual Rate (in):
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Loading:!,
12 Month Floating Total (in)::

FORM: NDAR-1 07-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page 3 of -5
-- lll0:1
•- • •
. Lenoir.
1
:ield
.
Field
Field Name:
Did irrigation occur
Area (acresy
Area (acres):
Area (ac
at this facility?
Cover Crop:
Cover Crop:
Cover Crop:
Hourly Rate (in):
Hourly Rate (in):',
Hourly Rate
ff=Mgff7 ggj mom
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•Annual
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IIIIIIIIIIIII21711341I • w :•
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FORM: NDAR-1 07-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page 4of —°
Permit No.: Q11 :1
Facility Name: Sanderson Farms-Kinston•unty:
Lenoir
Month:Field
Field Name:
Name:;
Did irrigation occur
Area (acres):
at this facility?
Cover Crop-
Cover Crop:;
F-,;IYES F1N0
Hourly Rate (in)
Annual Rate (in):'
Field Irrigated?
Field lrrigated?�
In=
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0011.4 IT, E►1971 V 5KiMa
NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Page of
Did the application rates exceed the limits in Attachment B of your permit?
❑✓ Compliant ❑Non -Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites? ❑� Compliant ❑Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit? ❑✓ Compliant ❑Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site? ❑✓ Compliant ❑Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? ❑✓ 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
Permittee Certification
ORC: Randy Clark
Permittee:
Sanderson Farms, Inc
Certification No.: WW22332/SI996273
Signing Official: William Keise)
Grade: 4 Phone Number: 910-674-9546
Signing Officials Title: Plant Manager
Has the ORC changed since the previous NDAR-1? ❑� yes ❑No
Phone Number: 252-522-9145 Permit Exp.: 12/31/26
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 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 knowing violations.
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

FORM: NDMLR 07-11 NON -DISCHARGE MASS LOADING REPORT (NDMLR) Page / of�
Permit No.: WQ0034380
Facility Name: Sanderson Farms -Kinston Facility
County: Lenoir
Month: January
Year: 2022
Field Name:
1A
Field Name:
113
Field Name:
2A
Field Name:
2B
Field Name:
3A
Area (acres):
22.4
Area (acres):
8.81
Area (acres):
22.4
Area (acres):
10.4
Area (acres):
24
Cover Crop:
Rye Grass
Cover Crop:
Rye Grass
Cover Crop:
Rye Grass
Cover Crop:
Rye
Cover Crop:
PINES
Load Type:
PAN
Load Type:
PAN
Load Type:
PAN
Load Type:
PAN
Load Type:
PAN
Field Loaded?
E]YES [:]NO
Field Loaded?
E]YES [:]NO
Field Loaded?
E]YES ONO
Field Loaded?
[ZYES ONO
Field Loaded?
E]YES [:]NO
o
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Month
gal
3,803,051
mg/L
Ibs/ac
Ibs/ac
gal
mg/L
Ibs/ac
Ibs/ac
gal
mg/L
Ibs/ac
Ibs/ac
gal
mg/L
Ibs/ac
lbs/ac
gal
mg/L
Ibs/ac
Ibs/ac
February
8.4
11.9
11.9
0
8.4
0.0
0.0
3139961
8.4
9.8
9.8
1457840
8.4
9.8
9.8
2,852,900
8.4
8.3
8.3
March
3,104,084
6.82
7.9
19.8
671,748
6.82
4.3
4.3
3126091
6.82
7.9
17.8
1451400
6.82
7.9
17.8
3,349,381
6.82
7.9
16.3
April
3,771,053
7.47
10.5
30.3
601,303
7.47
4.3
8.6
2279983
7.47
6.3
24.1
591940
7.47
3.5
21.3
3,026,358
7.47
7.9
24.1
May
2,816,754
8.01
8.4
38.7
1,107,840
8.01
8.4
17.0
3526002
8.01
10.5
34.6
0
8.01
0.0
21.3
4,145,605
8.01
11.5
35.7
June 2,410,608
21.02
18.9
57.5
948,101
21.02
18.9
35.9
2158754
21.02
16.9
51.5
0
21.02
0.0
21.3
3,825,450
21.02
27.9
63.6
July 4,778,075
19.24
34.2
91.8
1,879,234
19.24
34.2
70.1
3820734
19.24
27.4
78.9
0
19.24
0.0
21.3
4,093,641
19.24
27.4
91.0
August 1,979,743
14.39
10.6
102.4
778,640
14.39
10.6
80.7
3754833
14.39
20.1
99.0
0
14.39
0.0
21.3
5,247,693
14.39
26.2
117.2
September 2,881,690
11.54
12.4
114.7
1,133,380
11.54
12.4
93.1
3492355
11.54
15.0
114.0
539956
11.54
5.0
26.3
4,322,826
11.54
17.3
134.5
October 4,263,841
9.84
15.6
130.4
1,676,983
9.84
15.6
108.7
3079977
9.84
11.3
125.3
1429990
9.84
11.3
37.6
4,201,005
9.84
14.4
148.9
November 2,186,284
15.17
12.3
142.7
209,024
15.17
3.0
111.7
3039630
15.17
17.2
142.5
1411258
15.17
17.2
54.8
3,054,703
15.17
16.1
165.0
December 2,895,504
20.31
21.9
164.6
0
20.31
0.0
111.7
3548096
20.31
26.8
169.3
1647332
20.31
26.8
81.6
3,382,008
20.31
23.9
188.9
January 3,376,494
15.26
19.2
183.8
0
15.26
0.0
111.7-
2761293
15.26
15.7
185.0
1282030
15.26
15.7
97.3
2,958,531
15.26
15.7
F204.E
12 Month Floating PAN Load
183.8
111.7
185.0
97.3
204.E
(Ibs/ac/yr):
Annual PAN Load Limit
(Ibs/ac/yr):
8318

FORM: NDMLR 07-11 NON -DISCHARGE MASS LOADING REPORT (NDMLR) Page Z of q
Permit No.: W00034380
Facility Name: Sanderson Farms -Kinston Facility
County: Lenoir
Month: January
Year: 2022
Field Name:
3B
Field Name:
4A
Field Name:
4B
Field Name:
5A
Field Name:
5B
Area (acres):
3.51
Area (acres):
19.7
Area (acres):
8.14
Area (acres):
28.5
Area (acres):
1.4
Cover Crop:
PINES
Cover Crop:
Rye Grass
Cover Crop:
PINES
Cover Crop:
Rye Grass
Cover Crop:
Rye Grass
Load Type:
PAN
Load Type:
PAN
Load Type:
PAN
Load Type:
PAN
Load Type:
PAN
Field Loaded?
EYES ❑NO
Field Loaded?
OYES QNO
Field Loaded?
EYES ❑No
Field Loaded?
EYES []NO
Field Loaded?
EYES ❑NO
m
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Month
gal
417,236
mg/L
Ibs/ac
Ibs/ac
gal
mg/L
Ibs/ac
Ibs/ac
gal
mg/L
Ibs/ac
Ibs/ac
gal
mg/L
Ibs/ac
Ibs/ac
gal
mg/L
Ibs/ac
Ibs/ac
February
8.4
8.3
8.3
2,488,020
8.4
8.8
8.8
1,028,046
8.4
8.8
8.8
4,736,835
8.4
11.6
11.6
237,692
8.4
11.9
11.9
March
489,846
6.82
7.9
16.3
2,749,284
6.82
7.9
16.8
1,135,999
6.82
7.9
16.8
3,866,247
6.82
7.7
19.4
194,005
6.82
7.9
19.8
April
442,605
7.47
7.9
24.1
2,964,276
7.47
9.4
26.2
1,224,833
7.47
9.4
26.2
4,696,981
7.47
10.3
29.6
143,088
7.47
6.4
26.1
May
606,296
8.01
11.5
35.7
2,065,115
8.01
7.0
33.2
954,240
8.01
7.8
34.0
3,244,244
8.01
7.6
37.2
0
8.01
0.0
26.1
June
0
21.02
0.0
35.7
3,603,528
21.02
32A
65.2
1,488,971
21.02
32.1
66.1
3,146,8821
21.02
19.4
56.6
0
21.02
0.0
26.1
July
0
19.24
0.0
35.7
3,360,199
19.24
27.4
92.6
1,388,4261
19.24
27.4
93.4
3,854,4971
19.24
21.7
78.3
34,621
19.24
4.0
30.1
August
0
14.39
0.0
35.7
4,307,482
14.39
26.2
118.8
1,545,371
14.39
22.8
116.2
5,071,106
14.39
21.4
99.6
0
14.39
0.0
30.1
September
146,779
11.54
4.0
39.7
2,205,431
11.54
10.8
129.6
911,279
11.54
10.8
127.0
4,968,2961
11.54
16.8
116.4
37,998
11.54
2.6
32.7
October
614,397
9.84
14.4
54.1
2,895,086
9.84
12A
141.7
1,196,243
9.84
12.1
139.0
2,048,037
9.84
5.9
122.3
102,769
9.84
6.0
38.7
November
446,751
15.17
16.1
70.2
2,846,238
15.17
18.3
160.0
1,176,059
15.17
18.3
157.3
4,487,802
15.17
19.9
142.2
225,194
15.17
20.4
59.1
December
494,620
20.31
23.9
94.0
3,120,425
20.31
26.8
186.8
801,524
20.31
16.7
174.0
3,606,454
20.31
21.4
163.7
180,969
20.31
21.9
81.0
January
432,684
15.26
15.7
109.7
2,428,461
15.26
15.7
202.5
0
15.26
0.0
174.0
4,205,545
15.26
18.8
182.5
211,032
15.26
19.2
100.2
12 Month Floating PAN Load
109.7
202.5 `
174.0
182.5 '
111"I
100.2
(Ibs/ac/yr):
Annual PAN Load Limit
(Ibs/ac/yr):

FORM: NDMLR 07-11 NON -DISCHARGE MASS LOADING REPORT (NDMLR) Page 3 of /-t
Permit No.: W00034380
Facility Name: Sanderson Farms -Kinston Facility
County: Lenoir
Month: January
Year: 2022
Field Name:
6
Field Name:
7
Field Name:
8A
Field Name:
8B
Field Name:
9
Area (acres):
30
Area (acres):
29.6
Area (acres):
22.8
Area (acres):
1.84
Area (acres):
16.2
Cover Crop:
Rye Grass
Cover Crop:
PINES
Cover Crop:
PINES
Cover Crop:
PINES '
Cover Crop:
Rye Grass
Load Type:
PAN
Load Type:
PAN
Load Type:
PAN
Load Type:
PAN
Load Type:
PAN
Field Loaded?
❑✓ YES [:]NO
Field Loaded?
[ZYES ❑NO
Field Loaded?
❑� YES ❑NO
Field Loaded?
❑' YES []NO
Field Loaded?
❑� YES [:]NO
m
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Month
gal
mg/L
Ibs/ac
Ibs/ac
gal
mg/L
Ibs/ac
Ibs/ac
gal
mg/L
Ibs/ac
Ibs/ac
gal
mg/L
Ibs/ac
Ibs/ac
gal
mg/L
Ibs/ac
Ibs/ac
February
4559454
8.4
10.6
10.6 1
4,404,8251
8.4
10A
10A
3,392,905
8.4
10.4
10.4
0
1 8.4
0.0 `
0.0
2,750,4221
8.4
11.9
11.9
March
5676518
6.82
10.8
21.4
4,953,331
1 6.82
9.5
19.9
4,314,152
6.82
10.8
21.2
0
6.82
0.0
0.0
2,244,918
6.82
7.9
19.8
April
4527150
7.47
9.4
30.8
4,463,737
7.47
9.4
29.3
2,918,669
7.47
8.0
29.2
152,899
7.47
5.2
5.2
2,167,127
7.47
8.3
28.1
May
3287778
8.01
7.3
38.1
4,423,750
8.01
10.0
39.3
4,177,071
8.01
12.2
41.4
0
8.01
0.0
5,2 '
1,874,302
8.01
7.7
35.8
June
5151592
21.02
30.1
68.2
5,082,904
21.02
30.1
69A
3,419,5601
21.02
26.3
1 67.7
0
21.02
0.0
5.2
3,055,655
21.02
33.1
68.9
July
2682888
19.24
14A
82.6
5,256,321
19.24
28.5
97.9
4,048,789
19.24
28.5
96.2
0
19.24
0.0
5.2
3,455,574
19.24
34.2
103.1
August
2810680
14.39
11.2
93.8
5,629,051
14.39
22.8
120.7
4,335,890
14.39
22.8
119.0
0 '
14.39
0.0
5.2
2,944,511
14.39
21.8
124.9
September
5320516
11.54
17.1
110.9
5,249,574
11.54
17.1
137.8
4,043,592
11.54
17.1
136.1
76,318
11.54
4.0''
9.2'
2,555,011
11.54
15.2
140.1
October
3157407
9.84
8.6
119.5
5,539,409
9.84
15.4
153.2
4,266,843
9.84
15.4
151.4
344,341
9.84
15.4
``'24.5 '
2,555,011
9.84
12.9
153.1
November
4428776
15.17
18.7
138.2
5,014,225
15.17
21.4
174.6
3,862,306
15.17
21.4
172.9
311,694
15.17
21.4 <
46.0
1,476,058
15.17
11.5
164.6
December
4229860
20.31
23.9
162.1
4,173,464
20.31
23.9
198.5
2,717,3791
20.31
20.2
193.1
219,297
20.31
20.2 >
'' 66.1
2,094,072
20.31
21.9
186.5
January
3722578
15.26
15.8
177.9
3,672,943
15.26
15.8
214.3
2,829,1601
15.26
1 15.8
1 208.9
1 228,318'1
15.26
1 15.8
1 81.9'
2,441,929
15.26
19.2IN
12 Month Floating PAN Load
177.9
214.3
208.9
81.9
205.
(Ibs/ac/yr):
Annual PAN Load Limit
(Ibs/ac/yr):

Ll
FORM: NDMLR 07-11 NON -DISCHARGE MASS LOADING REPORT (NDMLR) Page _ of
Did the mass loading rates exceed the limits in Attachment B of 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
ORC: Randy Clark
Certification Number: WW22332/S1996273
Grade: 4 Phone Number: 910-674-9546
Has the ORC changed since the previous NDMLR? ❑Yes E]No
Permittee Certification
Permittee:
Sanderson Farms, Inc
Signing Official:
William Keisel
Signing Officials Title: Plant Manager
Phone No.: 252-522-9145 Permit Exp.: 12/31/26
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
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

FORM: NDMR 07-11 NON -DISCHARGE MONITORING REPORT (NDMR) Page / of 3
Permit No.: W00034380
Facility Name: Sanderson Farms -Kinston Facility
County: Lenoir
Month: January
Year: 2022
PPI: 001
Flow Measuring Point: ❑influent ❑✓ Effluent ❑No flow generated
Parameter Monitoring Point: ❑Influent ❑✓ Effluent ❑Groundwater Lowering ❑surface water
Parameter Code IN
50050
00310
00916
00940
31616
00927
00610
00625
00620 '
00600
00400
00665
W009C
00931
00929 '
70300
t6
U~
p
c
U
3
LL
UlG
LU
E
L=.N
U. O
U
E
R
E
Q',
acp
N
d
O:t
Z
F~o-
«
Z
H
O
M
a
°E
C Li
Q.Z.
g
7d
!q •O
Q
E
O
N
N
a+ a LO
O
in
Q N
24-hr
hrs
GPD
mglL
mg/L
mg/L
#1100 mL
mg/L
mg/L
mg/L
mg/L
mg/L
su
mg/L
mg/L
Ratio
mg/L '
mg/L
1
957,000
2
914,000
3
10:00
1.5
613,000
6.89
4
662,000
4
12.7
1
6.39
8.31
12.4
3.24
15.7
6.97
16.4
8.7
10.2
180
5
10:00
1.5
605,000
6.92
6
516,000
3
1
6.09
8.1
4.48
12.6
6.99
14.1
8.2
7
10:00
1.5
497,000
6.84
8
557,000
9
812,000
10
10:00
1.5
588,000
6.86
11
520,000
2
1
3.88
4.9
7.62
12.5
6.60
15.5
9.9
121
10:00
1.5
519,000
7.27
13
642,000
3
1
5.54
7.6
12.2
19.8
7.62
13
15.6
14
10:00
1.5
687,000
6.93
15
627,000
16
702,000
17
731,000
181
10:00
1.5
513,000
3
1
9.41
12.4
10.5 '
22.9
6.92
18.8
16.1
19
10:00
1.5
620,000
6.90
20
518,000
2
1
8.86
14
14.8
28.8
7.03
17.1
20.8
21
10:00
1.5
320,000
6.71
22
423,000
23
472,000
241
10:00
1.5
515,000
6.74
25
592,000
2
1
9.52
11.8
16.3
28.1
7.05
13.5
213
26
10:00
1.5
488,000
7.33
27
503,000
3
1
15.7
16.2
13.1
29.3
7.27
12.3
21.1
28
10:00
1.5
734,000
7.85
29
620,000
301
839,000
311
10:00
1.5
631,000
7.75
Average:
610,871
2.75
12.70
1.00
6.39
8.41
10.93
10.28
21.21
15.09
15.26 '
10.20
180.00
Daily Maximum:
957,000
4.00
12.70
1.00
6.39
15.70
16.20
16.30
29.30
7.85
18.80
21.70
10.20
180.00
Daily Minimum:
320,000
2.00
12.70
1,00
6.39
3.88
4.90
3.24
12.50
6.60
12.30
8.20
10.20
180.00
Sampling Type:
Recorder
Composite
Composite
Composite
Grab
Composite
Composite
Composite
Composite
Composite
Grab '>
Composite
Calculated
Calculated
Composite
Composite
Monthly Limit:
- 1,400,000
Daily Limit:
Sample Frequency:
Continuous
2 X Week
Monthly
3 X Year
2 X Week
Monthly
2 X Week
2 X Week
2 X Week
2 X Week
5 X Week
2 X Week
2 X Week
Monthly
Monthly '
3 X Year

FORM: NDMR 07-11 NON -DISCHARGE MONITORING REPORT (NDMR) Page Z of 3
Permit No.: WQ0034380
Facility Name: Sanderson Farms -Kinston Facility
County: Lenoir
Month: January
Year: 2022
PPI: 001
Flow Measuring Point: ❑Influent DEffluent ❑No flow generated
Parameter Monitoring Point: ❑Influent QEffluent ❑Groundwater Lowering ❑Surface Water
Parameter Code --►
00530
i
M
d
Q E
U I-
O
c
CD
E_ r
~
U
0
y
Y d
[— C fA
tn
24-hr
hrs
mg/L
1
2
3
10:00
1.5
4
2.5
5
10:00
1.5
6
2.5
7
10:00
1.5
8
9
10
10:00
1.5
11
2.5
12
10:00
1.5
13
2.7
14
10:00
1.5
15
16
17
18
10:00
1.5
10.2
19
10:00
1.5
20
3.3
21
10:00
1.5
22
23
24
10:00
1.5
251
6
26
10:00
1.5
27
2.9
28
10:00
1.5
29
30
31
10:00
1.5
Average:
4
Daily Maximum:
10
Daily Minimum:
3
Sampling Type:
Composite
Monthly Limit:
Daily Limit:
Sample Frequency:
2 X Week

FORM: NDMR 07-11
NON -DISCHARGE MONITORING REPORT (NDMR)
Page 3 of 3
Sampling Person(s) Certified Laboratories
Name: Joseph Franklin Name: Environmental Chemists, Inc
Name: Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of 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 Permittee Certification
ORC: Randy Clark Permittee: Sanderson Farms, Inc
Certification No.: WW22332/S1996273 Signing Official: William Keisel
Grade: 4 Phone Number: 910-674-9546 Signing Official's Title: Plant Manager
Has the ORC changed since the previous NDMR? ❑Yes QNo Phone Number: 252-522-9145 Permit Expiration: 12/31/2026
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
Sig ture 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 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