WQ0034380_Monitoring - 02-2022_20220323

Monitoring Report Submittal
Permit Number #*
Name of Facility:*
Month: * February
Report Information
WQ0034380
Sanderson Farms Kinston Processing Facility
Year:* 2022
Type* Upload Document*
NDMR, NDAR-1, NDAR-2, NDMLR Feb. 2022 NDAR, NDMR, 1.15MB
NDMLR.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: 3/23/2022
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 / off
Permit No.: WQ0034380
Facility Name: Sanderson Farms -Kinston-
•
.nth: February1
Did irrigation
Field Name:
Field
.�
occur
-�
Area (acres):
Area (acres):
at this facility?
Cover Cr p:
o
PIYES FINO
Hourly Rate (in):
Hourly Rate (in):
„Annual
Rate (in)::
'=
Annual Rate (in):'
... .Field
.. :.
■ ■ I•
Field Irrigated?
Field Irrigated?■
■ •
Loading:
AM
12 MonthMonthly
is",
O%/OMEM
ne
=11 /�%%%%%%%%
////%%%

FORM: NDAR-1 07-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page2-of_
Permit No.: 1111 :1
Facility Name: Sanderson Farms-Kinston.unty:
Lenoir
Month:-•
irrigation
Fiel
• occur
Area (acres):
Area (acres):
at this facility'?
Cover Crop:
PYES ONO
Hourly Rate (in):
Annual Rate (in)::
IRON
Im
MMMI
MMMI'MMMI,
®=m-
W.4��
• • . • •
/ • / •
• •. • •
MEMO=
on=

FORM: NDAR-1 07-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of
Permit No.: Q10:0
Facility Name: Sanderson Farms -Kinston-
•February
Did irrigation
occur
at this facility'?
w .. zmw
���
1 1:
• •.. .
®���11501F",jj����jjjjjjj��j%jj/�/®jjjjj%�jjjjjj/®
Month12 •. • Total

FORM: NDAR-1 07-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of
Permit No.: WQ0034380
Facility Name: Sanderson Farms -Kinston-
•
.nth: FebruaryDid
irrigation
®�Field
Name:
occur1
at this facility.
Hourly Rate (in):
••Annual
Rate (in):'
Field lrriaated?����
Will��
-_-_
M0®_�_
®=m_®_
___-
____
®®
®-__-

FORM: NDAR-1 07-11 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/S1996273
Signing Official: Jared Lowe
Grade: 4 Phone Number: 910-674-9546
Signing Officials Title: Divison Manager
Has the ORC changed since the previous NDAR-1? EYes ❑No
Phone Number: 252-522-9145 Permit Exp.:
j � �, - � Q �, 31,312,_
�f -3 le a,
Signature Date
Signature Date
�undernalty
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
I ce 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
Permit No.: W00034380
Facility Name: Sanderson Farms -Kinston Facility
County: Lenoir
Month: February
Year: 2022
PPI: 001
Flow Measuring Point: ❑influent Effluent ❑No flow generated
Parameter Monitoring Point: ❑Influent ❑✓ Effluent ❑Groundwater Lowering ❑Surface Water
Parameter Code -►
50050
00310
00916
00940
31616
00927
00610
00625
00620
00600
00400
00665
WQ09C
00931
00929
70300
am
c
O
m
E
o
W
co
E
m
U.
E
E
cc
•~ d
0M
Z
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c
0
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-Z
;a t0
a
a
m e
a.>
Z
o
C
wO
C
E
Zp
C
a
w faan
�on oco
.o~
13O
24-hr
hrs
GPD
mg/L
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
783,000
5
11.2
1
6.01
15.1
17.4
16.5
34
7.79
14.9
24.8
10.1
169'
2
11:00
1.5
785,000
7.06
3
856,000
4
2420
12.3
15.1
21.8
37
6.66
18.1
28.9
4
11:00
1.5
965,000
6.63
5
942,000
6
861,000
7
11:00
1.5
763,000
6.90
8
724,000
6
1
16.8
19.6
13.7
33.4
6.80
18.4
23
9
11:00
1.5
763,000
6.80
10
808,000
3
1
9.52 1
13.4
28.3
41.8
6.72
18.4
34.3
11
11:00
1.5
506,000
6.88
121
706.000
13
635,000
14
11:00
1.5
631,000
6..96
15
666,000
4
1
16.8
19
1 13.2
32.3
6.64
1 18.5
22.4
16
11:00
1.5
685,000
6.87
17
734,000
3
1
17.4
20.7
20.2
41
6.80
19.7
30
181
11:00
1.5
771,000
6.86
19
846,000
20
734,000
21
11:00
1.5
740,000
6.92
22
960,000
7
1
10.6
14.6
23.1
37.8
6.75
19.8
29.7
23
11:00
1.5
888,000
6.79
241
852,000
5
1
18.5
21.8
16.6
38.5
6.67
19.5
26.9
25
11:00
1.5
843,000
6.91
26
818,000
27
743,000
28
11:00
1.5
686,000
6.94
29
30
31
Average:
774,786
4.63
11.20
2.65
6.01
14.63
17.70
19.18
36.98
18.41
27.50
10.10
169.00
Daily Maximum:
965,000
7.00
11.20
2,420.00
6.01
18.50
21.80
28.30
41.80
1 7.79
19.80
34.30-
10.10
169.00
Daily Minimum:
506,000
3.00
11.20
1,00 '
6.01
9.52
1 13.40
13,20
32.30
6.63
14.90
22.40 "1
10.10
169.00
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:1
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 of
Permit No.: WQ0034380
Facility Name: Sanderson Farms -Kinston Facility
County: Lenoir
Month: February
Year: 2022
PPI: 001
Flow Measuring Point: ❑Influent []Effluent ❑No Flow generated
Parameter Monitoring Point: ❑Influent ❑� Effluent ❑Groundwater Lowering ❑Surface Water
Parameter Code —►
00530
m
aE
O
c
E m
i-v�
U
Oir
v
m c a
°co
co
24-hr
hrs
mg/L
1
4.8
2
11:00
1.5
3
3.6
4
11:00
1.5
5
6
7
11:00
1.5
8
8.3
9
11:00
1.5
10
3.1
11
11:00
1.5
12
13
14
11:00
1.5
15
4.7
16
11:00
1.5
17
4.4
18
11:00
1.5
19
20
21
11:00
1.5
22
7
23
11:00
1.5
24
3.7
25
11:00
1.5
26
27
28
11:00
1.5
29
30
31
Average:
5
Daily Maximum:
8
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 .J of 3
Sampling Person(s) Certified Laboratories
Name: Joseph Franklin Name: Environmental Chemists, Inc
Name: II Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of 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 11 Permittee Certification I
ORC: Randy Clark
Certification No.: WW22332/S1996273
Grade: 4 Phone Number: 910-674-9546
Has the ORC changed since the previous NDMR? ❑Yes I]No
)
`/- L
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
Permittee: Sanderson Farms, Inc
Signing Official: Jared Lowe
Signing Officials Title: Divison Manager
Phone Number: 252-522-9145 Permit Expiration: 12/31/2026
/ 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 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: NDMLR 07-11 NON -DISCHARGE MASS LOADING REPORT (NDMLR) Page of
Permit No.: W00034380
Facility Name: Sanderson Farms -Kinston Facility
County: Lenoir
Month: February
Year: 2022
Field Name:
1A
Field Name:
1B
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 ENO
Field Loaded?
EYES []NO
Field Loaded?
❑' YES ENO
Field Loaded?
AYES [:]NO
Field Loaded?
❑� YES [:]NO
am¢c,
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3
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2
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U
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Month
gal
3,104,084
mg/L
Ibs/ac
Ibs/ac
I gal
mg/L
Ibs/ac
Ibs/ac
gal
I mg/L
Ibs/ac
Ibs1acF
gal
mg/L
Ibs/ac
Ibs/ac
gal
mg/L
Ibs/ac
Ibs/ac
March
6.82
7.9
7.9
671,748
6.82
4.3
4.3
3126091
6.82
7.9
7.9
1451400
6.82
7.9
7.9 ''
3,349,381
6.82
7.9
7.9
April
3,771,053
7.47
10.5
18.4
601,303
7.47
4.3
8.6
2279983
7.47
6.3
14.3
591940
7.47
3.5
11.5
3,026,358
7.47
7.9
15.8
May
2,816,754
8.01
8.4
26.8
1,107,840
8.01
8.4
17.0
3526002
8.01
10.5
24.8
0
8.01
0.0
11.5
4,145,605
8.01
11.5
27.3
June 2,410,608
21.02
18.9
45.6
948,101
21.02
18.9
35.9
2158754
21.02
16.9
41.7
0
21.02
0.0
11.5-
3,825,450
21.02
27.9
55.3
July 4,778,075
19.24
34.2
79.9
1,879,234
19.24
34.2
70.1
3820734
19.24
27.4
69.1
0
19.24
0.0
11.5
4,093,641
19.24
27.4
82.6
August 1,979,743
14.39
10.6
90.5
778,640
14.39
10.6
80.7
3754833
14.39
20.1
89.2
0
14.39
0.0
11.5
5,247,693
14.39
26.2
108.9
September 2,881,690
11.54
12.4
102.9
1,133,380
11.54
12.4
93.1
3492355
11.54
15.0
104.2
539956
11.54
5.0
16.5
4,322,826
11.54
17.3
126.2
October 4,263,841
9.84
15.6
118.5
1,676,983
9.84
15.6
108.7
3079977
9.84
11.3
115.5
1429990
9.84
11.3 '`
`27.8
4,201,005
9.84
14.4
140.6
November 2,186,284
15.17
12.3
130.8
209,024
15.17
3.0
111.7
3039630
15.17
17.2
132.6
1411258
15.17
17.2
44.9
3,054,703
15.17
16.1
156.7
December 2,895,504
20.31
21.9
152.7
0
20.31
0.0
111.7
3548096
20.31
26.8
159.5
1647332
20.31
26.8
71.8 '
3,382,008
20.31
23.9
180.6
January 3,376,494
15.26
19.2
171.9
0
15.26
0.0
111.7
2761293
15.26
15.7
175.2
1282030
15.26
15.7 '
`87.5''
2,958,531
1 15.26
15.7
196.2
February 3,027,795
27.5
31.0
202.9
0
27.5
0.0
111.7
1 2852284
27.5
29.2
204.4
1324274
27.5
29.2
t16.7;
3,056,0201
27.5
1 29.2
225.5
12 Month Floating PAN Load
202.9
111.7
204.4
116.7
225.5
(Ibs/ac/yr):
Annual PAN Load Limit
8318
(Ibs/ac/yr):

FORM: NDMLR 07-11 NON -DISCHARGE MASS LOADING REPORT (NDMLR) Page 2- of
Permit No.: WQ0034380
Facility Name: Sanderson Farms -Kinston Facility
County: Lenoir
Month: February
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?
DYES ENO
Field Loaded?
OYES []NO
Field Loaded?
[ZYES E]No
_'field Loaded?
E]YES ❑No
Field Loaded?
DYEs ONO
z
,
<.p
ZN
zm
a
zd
z>.
z
z
¢
m
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d
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Yo
J
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¢
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m
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y
M
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¢
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m a�i
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¢
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d
m
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¢
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0
¢ U
°
>
¢
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U
>
U
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Month
gal
489,846
mg/L
Ibs/ac
Ibs/ac
gal
mg/L
Ibs/ac
lbs/ac
gal
mg/L
Ibs/ac
Ibs/ac
gal
mg/L
Ibs/ac
Ibs/ac
gal
mg/L
Ibs/ac
Ibs/ac
March
6.82
7.9
7.9
2,749,284
6.82
7.9
7.9
1,135,999
6.82
7.9
7.9
3,866,2471
6.82
7.7
7.7
194,005
1 6.82
7.9
7.9
April
442,605
7.47
7.9
15.8
2,964,276
7.47
9.4
17.3
1,224,833
7.47
9.4
17.3
4,696,9811
7.47
10.3
18.0
143,088
7.47
6.4
14.2
May
606,296
8.01
11.5
27.3
2,065,115
8.01
7.0
24.3
954,240
8.01
7.8
25.1
3,244,2441
8.01
7.6
25.6
0
8.01
0.0
14.2
June
0
21.02
0.0
27.3
3,603,528
21.02
32.1
56.4
1,488,971
21.02
32.1
57.2
3,146,882
21.02
19.4
44.9
0
21.02
0.0
14.2
July
0
19.24
0.0
27.3
3,360,199
19.24
27.4
83.8
1,388,426
19.24
27.4
84.6
3,854,497
19.24
21.7
66.6
34,621
19.24
4.0
18.2
August
0
14.39
0.0
27.3
4,307,482
14.39
26.2
110.0
1,545,371
14.39
22.8
107.4
5,071,106
14.39
21.4
88.0
0
14.39
0.0
18.2
September
146,779
11.54
4.0
31.4
2,205,431
11.54
10.8
120.8
911,279
11.54
10.8
118.1
4,968,296
11.54
16.8
104.8
37,998
11.54
2.6
20.8
October
614,397
9.84
14.4
45.7
2,895,086
9.84
12.1
132.8
1,196,243
9.84
12.1
130.2
2,048,037
9.84
5.9
110.7
102,769
9.84
6.0
26.9
November
446,751
15.17
16.1
61.8
2,846,238
15.17
18.3
151.1
1,176,059
15.17
18.3
148.5
4,487,802
15.17
19.9
130.6
225,194
15.17
20.4
47.2
December
494,620
20.31
23.9
85.7
3,120,425
20.31
26.8
177.9
801,524
20.31
16.7
165.2
3,606,454
20.31
21.4
152.0
180,969
20.31
21.9
69.1
January
432,684
15.26
15.7
101.4
2,428,461
15.26
15.7
193.6
0
15.26
0.0
165.2
4,205,545
15.26
18.8
170.8
211,032
15.26
19.2
88.3
February I
446,943
27.5
29.2
130.6
2,508,482
27.5
29.2
222.8
0
27.5
0.0
165.2
3,771225
27.5
30.3
201.2
189,238
31.0A
l2 Month Floating PAN Load
130.6
222.8
165.2
201.2 `
119.3
(Ibs/ac/yr):
a
Annual PAN Load Limit
(Ibs/ac/yr):

FORM: NDMLR 07-11 NON -DISCHARGE MASS LOADING REPORT (NDMLR) Page of
Permit No.: WQ0034380
Facility Name: Sanderson Farms -Kinston Facility
County: Lenoir
Month: February
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?
E]YES [-]NO
Field Loaded?
EYES ❑No
Field Loaded?
Q✓ YES ❑No
Field Loaded?
DYES [:]NO
Field Loaded?
❑� YES [-]NO
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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
March
5676518
6.82
10.8
10.8
4,953,331
6.82
9.5
9.5
4,314,152
6.82
10.8
10.8
0
1 6.82
0.0
0.0 '
2,244,918
6.82
7.9
7.9
April
4527150
7.47
9.4
20.2
4,463,737
7.47
9A
18.9
2,918,669
7.47
8.0
18.7
152,899
7.47
5.2
5.2
2,167,127
7.47
8.3
16.2
May
3287778
8.01
7.3
27.5
4,423,750
8.01
10.0
28.9
4,177,071
8.01
12.2
31.0
0
8.01
0.0
5.2
1,874,302
8.01
7.7
23.9
June
5151592
21.02
30.1
57.6
5,082,904
21.02
30.1
59.0
3,419,560
21.02
26.3
57.3
0
21.02
0.0
5.2
3,055,655
21.02
33.1
57.0
July
2682888
19.24
14.4
71.9
5,256,321
19.24
28.5
87.5
4,048,789
19.24
28.5
85.8
0
19.24
0.0
5.2
3,455,574
19.24
34.2
91.2
August
2810680
14.39
11.2
83.2
5,629,051
14.39
22.8
110.3
4,335,890
14.39
22.8
108.6
0
14.39
0.0
5.2
2,944,511
14.39
21.8
113.1
September
5320516
11.54
17.1
100.3
5,249,574
11.54
17.1
127.4
4,043,592
11.54
17.1
125.7
76,318
11.54
4.0
9.2 `
2,555,011
11.54
15.2
128.2
October
3157407
9.84
8.6
108.9
5,539,409
9.84
15A
142.7
4,266,843
9.84
15.4
141.0
344,341
9.84
15.4
24.5
2,555,011
9.84
12.9
141.2
November
4428776
15.17
18.7
127.6
5,014,225
15.17
21.4
164.2
3,862,306
15.17
21.4
162.4
311,694
15.17
21.4
46.0
1,476,058
15.17
11.5
152.7
December
4229860
20.31
23.9
151.4
4,173,464
20.31
23.9
188.1
2,717,379
20.31
20.2
182.6
219,297
20.31
20.2
66.1 `
2,094,072
20.31
21.9
174.6
January
3722578
15.26
15.8
167.2
3,672,943
15.26
15.8
203.9
112,829,1601
15.26
15.8
198.4
228,318
15.26
15.8
81.9
12,441,929
1 15.26
19.2
193.8
February
4372506
27.5
33.4
200.7 114,314,2071
27.5
33.4
237.3
113,323,1061
27.5
1 33.4
1 231.9
268,181
27.5
1 33A
1 115.4
12,189,7431
27.5
31.0
224.8
12 Month Floating PAN Load
200.7
237.3
231.9
115.4
E PAU
M
224.8
(Ibs/ac/yr):
Annual PAN Load Limit
(Ibs/aclyr):

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? ❑✓ 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 11 Permittee Certification
ORC: Randy Clark
Certification Number: WW22332/S1996273
Grade: 4 Phone Number: 910-674-9546
Has the ORC changed since the previous NDMLR? ❑Yes (]No
CLL7�. L_- w J
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
Permittee:
Sanderson Farms, Inc
Signing Official:
Jared Lowe
Signing Official's Title: Division Manager
Phone No.: 252-522-9145 Permit Exp.
C
12/31 /26
(/�/ Signature uate
Iz/nIffy,nder penalty of iaw, 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. 1 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