WQ0003765_Monitoring - 03-2021_20210506

FORM: NDAR-1 08-11 NON-DISCHARGE APPLICATION REPORT(NDAR-1) Page 1 of 7
Permit No.: WQ0003765 I Facility Name: New Bern Seven Water Reclamation Facility I county: Craven Month: March Year: 2021
Field Name: 1 Field Name: 2 Field Name: 3 Field Name: 4
Did irrigation ,
�f� �� ` Area(acres): 14.4 Area(acres): 13 Area(acres): 13 Area(acres): 13.8
at th i��l l l 7 q Cover Crop: Bermuda/Hardwood Cover Crop: Bermuda/Hardwood Cover Crop: Bermuda/Hardwood Cover Crop: Bermuda/Hardwood
P P P
\ �, 20 Hourl Rate in : N/A HourlyRate in : N/A HourlyRate in : N/A HourlyRate in : N/A
�YES ❑�Wf3' ( ) ( ) l ) ( )
Z Rate(in): 52.1 Annual Rate(in): 65.2 Annual Rate(in): 65.2 Annual Rate(in): 65.2
Weathey. � � :, Field Irrigated? ❑YES ❑NO Field Irrigated? 0 YES ❑NO Field Irrigated? RI YES ❑NO Field Irrigated? 0 YES ❑NO
as y IV; t m
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cl . °• •- w ,,,' * ° I' 0 o m = o ° ~ cT) o o m o o o a i" o O o o a °s o = o
.L E ` L7 ] ] Q - J J Q JI J Q _ J J Q _ J J
yD
I- d Ln w
°F in' ft ft gal min in in gal min in in gal min in in gal min in in
1 PC 66 0.02 2.7 2 60,059 120 0.15 0.08 56,688 120 0.16 0.08 61,284 120 0.17 0.09 61,284 120 0.16 0.08
2 C 44 0.04 2.8 2 60,059 120 0.15 0.08 56,688 120 0.16 0.08 61,284 120 0.17 0.09 61,284 120 0.16 0.08
3 PC 45 2.9 2 60,059 120 0.15 0.08 56,688 120 0.16 0.08 61,284 120 0.17 0.09 61,284 120 0.16 0.08
4 C 37 2.9 2 60,059 120 0.15 0.08 56,688 120 0.16 0.08 61,284 120 0.17 0.09 61,284 120 0.16 0.08
5 C 38 3 2 60,059 120 0.15 0.08 56,688 120 0.16 0.08 61,284 120 0.17 0.09 61,284 120 0.16 0.08
6 C 45 3.2 2
7 C 50 3.1 2
8 C 33 3.1 2 60,059 120 0.15 0.08 56,688 120 0.16 0.08 61,284 120 0.17 0.09 61,284 120 0.16 0.08
9 C 35 3.2 2 60,059 120 0.15 0.08 56,688 120 0.16 0.08 61,284 120 0.17 0.09 61,284 120 0.16 0.08
10 C 39 3.7 2 60,059 120 0.15 0.08 56,688 120 0.16 0.08 61,284 120 0.17 0.09 61,284 120 0.16 0.08
11 C 41 3.5 2 60,059 120 0.15 0.08 56,688 120 0.16 0.08 61,284 120 0.17 0.09 61,284 120 0.16 0.08
12 C 46 3.6 2.1 60,059 120 0.15 0.08 56,688 120 0.16 0.08 61,284 120 0.17 0.09 61,284 120 0.16 0.08
13 PC 60 3.7 2.1 60,059 120 0.15 0.08 56,688 120 0.16 0.08 61,284 120 0.17 0.09 61,284 120 0.16 0.08
14 C 47 3.7 2.2 60,059 120 0.15 0.08 56,688 120 0.16 0.08 61,284 120 0.17 0.09 61,284 120 0.16 0.08
15 C 48 3.8 2.2 60,059 120 0.15 0.08 56,688 120 0.16 0.08 61,284 120 0.17 0.09 61,284 120 0.16 0.08
16, CL 43 3.9 2.3
17 PC 47 1.70 3.8 2.2
18 PC 55 0.01 3.5 2.2 60,059 120 0.15 0.08 56,688 120 0.16 0.08 61,284 120 0.17 0.09 61,284 120 0.16 0.08
19 CL 55 0.04 3.6 2.2 60,059 120 0.15 0.08 56,688 120 0.16 0.08 61,284 120 0.17 0.09 61,284 120 0.16 0.08
20 PC 40 0.28 3.5 2 60,059 120 0.15 0.08 56,688 120 0.16 0.08 61,284 120 0.17 0.09 61,284 120 0.16 0.08
21 PC 45 3.6 2 60,059 120 0.15 0.08 56,688 120 0.16 0.08 61,284 120 0.17 0.09 61,284 120 0.16 0.08
22 C 52 3.7 2 60,059 120 0.15 0.08 56,688 120 0.16 0.08 61,284 120 0.17 0.09 61,284 120 0.16 0.08
23 PC 54 0.05 3.8 2 60,059 120 0.15 0.08 56,688 120 0.16 0.08 61,284 120 0.17 0.09 61,284 120 0.16 0.08
24 CL 64 0.16 3.9 2 60,059 120 0.15 0.08 56,688 120 0.16 0.08 61,284 120 0.17 0.09 61,284 120 0.16 0.08
25 PC 53 3.9 2 60,059 120 0.15 0.08 56,688 120 0.16 0.08 61,284 120 0.17 0.09 61,284 120 0.16 0.08
26 PC 70 4 2.1 60,059 120 0.15 0.08 56,688 120 0.16 0.08 61,284 120 0.17 0.09 61,284 120 0.16 0.08
27 4.1 2.1
28 4 2.1
29 PC 50 0.63 3.9 2.2
30 PC 41 3.8 2.2
31 PC 58 3.8 2.3
1,321,294� . 3.38.2 ����AV247,1361�%/////. 3..3 �//���/1,348'248 0.44.82 , 1,348,248 ////// 3.60.21
12 Month Floating Total(in):������1�//�/ 40.24 yJ/J/ 42.30 50.44 43.21

FORM: NDAR-1 08-11 NON-DISCHARGE APPLICATION REPORT(NDAR-1)
Did the application rates exceed the limits in Attachment B of your permit? E Compliant ❑Non-Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites? E Compliant ❑Non-Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit? E Compliant ❑Non-Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site? E Compliant ❑Non-Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? 7 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: John Timothy Scott Permittee:
Mark Stevens (City Manager) City of New Bern
Certification No.: 993732 Signing Official: Jordan Hughes
Grade: IV Phone Number: [phone] Signing Official's Title:
Has the ORC changed since the previous NDAR-1? ❑Yes 0 No Phone Number: [phone] Permit Exp.: 7/31/22
9Crivi.„_4 ICO.../1 4/26/21 / 4/27/21
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:NDAR-1 08-11 NON-DISCHARGE APPLICATION REPORT(NDAR-1) Page 2 of 7
Permit No.: WQ0003765 I Facility Name: New Bern Seven Water Reclamation Facility I county: Craven Month: March Year: 2021
Field Name: 5 Field Name: 6-A Field Name: 6-C Field Name: 7-A
Did irrigation occur
Area(acres): 11 Area(acres): 1.18 Area(acres): 9.64 Area(acres): 2.82
at this facility? Cover Crop: Bermuda/Hardwood Cover Crop: Bermuda/Hardwood Cover Crop: Bermuda/Hardwood Cover Crop: Bermuda/Hardwood
E YES ❑NO Hourly Rate(in): N/A Hourly Rate(in): N/A Hourly Rate(in): N/A Hourly Rate(in): N/A
Annual Rate(in): 52.1 Annual Rate(in): 31.7 Annual Rate(in): 52.1 Annual Rate(in): 31.7
Weather Freeboard Field Irrigated? ❑YES ❑NO Field Irrigated? ❑YES 0 NO Field Irrigated? ❑YES ❑NO Field Irrigated? 0 YES ❑NO
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`m o_ o 0 0. i- '� D o o O a R .122 o o O o o. i= •c a o 0 0 0. � 'c a o 0
t ` co 16 1 Q _ J = J Q _ J g = J > < _ J g = J > < _L.
J = J
j I- a
°F in ft ft gal min in in gal min in in gal min in in gal min in in
1 PC 66 0.02 2.7 2.0 32,436 120 0.11 0.05 41,062 120 0.16 0.08 5,881 120 0.08 0.04
2 C 44 0.04 2.8 2.0 32,436 120 0.11 0.05 41,062 120 0.16 0.08 5,881 120 0.08 0.04
3 PC 45 2.9 2.0 32,436 120 0.11 0.05 41,062 120 0.16 0.08 5,881 120 0.08 0.04
4 C 37 2.9 2.0 32,436 120 0.11 0.05 41,062 120 0.16 0.08 5,881 120 0.08 0.04
5 C 38 3 2.0 32,436 120 0.11 0.05 41,062 120 0.16 0.08 5,881 120 0.08 0.04
6 C 45 3.2 2.0
7 C 50 3.1 2.0
8 C 33 3.1 2.0 32,436 120 0.11 0.05 41,062 120 0.16 0.08 5,881 120 0.08 0.04
9 C 35 3.2 2.0 32,436 120 0.11 0.05 41,062 120 0.16 0.08 5,881 120 0.08 0.04
10 C 39 3.7 2.0 32,436 120 0.11 0.05 41,062 120 0.16 0.08 5,881 120 0.08 0.04
11 C 41 3.5 2.0 32,436 120 0.11 0.05 41,062 120 0.16 0.08 5,881 120 0.08 0.04
12 C 46 3.6 2.1 32,436 120 0.11 0.05 41,062 120 0.16 0.08 5,881 120 0.08 0.04
13 PC 60 3.7 2.1
14 C 47 3.7 2.2
15 C 48 3.8 2.2 32,436 120 0.11 0.05 41,062 120 0.16 0.08 5,881 120 0.08 0.04
16 CL 43 3.9 2.3 24,327 90 0.08 0.05 30,796 90 0.12 0.08 5,881 120 0.08 0.04
17 PC 47 1.7 3.8 2.2
18 PC 55 0.01 3.5 2.2 32,436 120 0.11 0.05 41,062 120 0.16 0.08 5,881 120 0.08 0.04
19 CL 55 0.04 3.6 2.2
20 PC 40 0.28 3.5 2.0 32,436 120 0.11 0.05 41,062 120 0.16 0.08 5,881 120 0.08 0.04
21 PC 45 3.6 2.0 32,436 120 0.11 0.05 41,062 120 0.16 0.08 5,881 120 0.08 0.04
22 C 52 3.7 2.0 32,436 120 0.11 0.05 41,062 120 0.16 0.08 5,881 120 0.08 0.04
23 PC 54 0.05 3.8 2.0 32,436 120 0.11 0.05 41,062 120 0.16 0.08 5,881 120 0.08 0.04
24 CL 64 0.16 3.9 2.0 32,436 120 0.11 0.05 41,062 120 0.16 0.08 5,881 120 0.08 0.04
25 PC 53 3.9 2.0 32,436 120 0.11 0.05 41,062 120 0.16 0.08 5,881 120 0.08 0.04
26 PC 70 4.0 2.1 32,436 120 0.11 0.05 41,062 120 0.16 0.08 5,881 120 0.08 0.04
27 4.1 2.1
28 4.0 2.1
29 PC 50 0.63 3.9 2.2
30 PC 41 3.8 2.2 32,436 120 0.11 0.05 41,062 120 0.16 0.08 5,881 120 0.08 0.04
31 PC 58 3.8 2.3 32,436 120 0.11 0.05 41,062 120 0.16 0.08 5,881 120 0.08 0.04
Monthly Loading: 705,483 % 2.36 0 %���� 0.00 7 893,090r///�j 3.41 r 129,381 % 1.69 r12 Month Floating Total(in): ��%�� A 27.85 /, 0.00 /////�/j���//�� /!//. 40.51 i/���f�������� 20.34

FORM: NDAR-1 08-11
NON -DISCHARGE APPLICATION REPORT (NDAR-1)
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: John Timothy Scott
Permittee:
Mark Stevens (City Manager) City of New Bern
Certification No.: 993732
Signing Official: Jordan Hughes
Grade: IV Phone Number: [phone]
Signing Official's Title:
Has the ORC changed since the previous NDARA? ❑ Yes 0 No
Phone Number: [phone] Permit Exp.: 7/31/22
4/26/21
4/27/21
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: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page 3 of 7
Permit No.: WQ0003765
Facility Name: New Bern Seven Water Reclamation Facility
County: Craven
Month: March
Year: 2021
Did irrigation
Field Name:
7-13
Field Name:
7-C
Field Name:
8-8
Field Name:
8-C
occur
--
Area (acres):
0.61
Area (acres):
9.34
Area (acres):
1.91
Area (acres):
10.9
at this facility?
Cover Crop:Bermuda/Hardwood
Cover Crop:
p�
Bermuda/Hardwood
Cover Crop:
P�
Bermuda/Hardwood
Cover Crop:
P�
Bermuda/Hardwood
❑ YES ❑ No
Hourly Rate (in):
N/A
Hourly Rate (in):
N/A
Hourly Rate (in):
N/A
Hourly Rate (in):
N/A
Annual Rate (in):
65.2
Annual Rate (in):
52.1
Annual Rate (in):
65.2
Annual Rate (in):
52.1
Weather
Freeboard
Field Irrigated?
❑ YES ❑ NO
Field Irrigated?
0 YES ❑ NO
Field Irrigated?
❑ YES ❑ NO
Field Irrigated?
YES ❑ NO
m
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°F
in
ft
ft
gal
I min
I in
in
gal
I min
in
I in
gal
I min
in
in
gal
I min
in
I in
1
PC
66
0.02
2.7
2.0
1,176
120
0.07
0.04
37,982
120
0.15
0.07
6,785
1 120
0.13
0.07
38,453
120
0.13
0.06
2
C
44
2.8
2.0
1,176
120
0.07
0.04
37,982
120
0.15
0.07
6,785
120
0.13
0.07
38,453
120
0.13
0.06
3
PC
45
2.9
2.0
1,176
120
0.07
0.04
37,982
120
0.15
0.07
6,785
120
0.13
0.07
38,453
120
0.13
0.06
4
C
37
2.9
2.0
1,176
120
0.07
0.04
37,982
120
0.15
0.07
6,785
120
0.13
0.07
38,453
120
0.13
0.06
5
C
38 1
3
2.0
1,176
120
0.07
0.04
37,982
120
0.15
0.07
6,785
120
1 0.13
0.07
38,453
120
0.13
0.06
6
C
45
3.2
2.0
7
C
50
3.1
2.0
8
C
33
1 3.1
2.0
1,176
120
0.07
0.04
37,982
120
0.15
0.07
6,785
120
0.13
0.07
38,453
120
0.13
0.06
9
C
35
3.2
2.0
1,176
120
0.07
0.04
37,982
120
0.15
0.07
1 6,785
120
0.13
0.07
38,453
120
0.13
0.06
10
C
39
3.7
2.0
1,176
120
0.07
0.04
37,982
120
0.15
0.07
6,785
120
0.13
1 0.07
38,453
120
0.13
0.06
11
C
41
3.5
2.0
1,176
120
0.07
0.04
37,982
120
0.15
0.07
6,785
120
0.13
0.07
38,453
120
0.13
0.06
12
C
46
3.6
2.1
1,176
120
0.07
0.04
37,982
1 120
0.15
0.07
6,785
120
0.13
0.07
38,453
120
0.13
0.06
13
PC
60
3.7
2.1
14
C
47
3.7
2.2
15
C
48
3.8
2.2
1,176
120
0.07
0.04
37,982
120
0.15
1 0.07
6,785
120
0.13
0.07
38,453
120
0.13
0.06
16
CL
43
3.9
2.3
882
90
0.05
0.04
28,487
90
0.11
0.07
5,089
90
0.10
0.07
28,840
90
0.10
0.06
17
PC
47
1.7
3.8
2.2
18
PC
55
0.01
3.5
2.2
1 1,176
120
0.07
0.04
37,982
120
0.15
0.07
6,785
120
0.13
0.07
38,453
120
0.13
0.06
19
CL
55
0.04
3.6
2.2
20
PC
40
0.28
3.5
2.0
1,176
120
0.07
0.04
37,982
120
0.15
0.07
6,785
120
0.13
0.07
38,453
120
0.13
0.06
21
PC
45
3.6
2.0
1,176
120
0.07
0.04
37,982
120
0.15
0.07
6,785
120
0.13
0.07
38,453
120
0.13
0.06
22
C
52
3.7
2.0
1,176
120
0.07
0.04
37,982
120
0.15
0.07
6,785
120
0.13
0.07
38,453
120
0.13
0.06
23
PC
54
0.05
3.8
2.0
1,176
120
0.07
0.04
37,982
120
0.15
0.07
6,785
120
0.13
0.07
38,453
120
0.13
0.06
24
CL
64
0.16[31203
1,176
120
0.07
0.04
37,982
120
0.15
0.07
6,785
120
0.13
0.07
38,453
120
0.13
0.06
25
PC
53
0
1,176
120
0.07
0.04
37,982
120
0.15
0.07
6,785
120
0.13
0.07
38,453
120
0.13
0.06
26
PC
70
0
1,176
120
0.07
0.04
37,982
120
0.15
0.07
6,785
120
0.13
0.07
38,453
120
0.13
0.06
27
28
29
PC
50
0.63
30
PC
41
1,176
120
0.07
0.04
37,982
120
0.15
0.07
6,785
120
0.13
0.07
38,453
120
0.13
0.06
31
PC
58
1,176
120
0.07
0.04
37,982
120
0.15
0.07
6,785
120
0.13
0.07
38,453
120
0.13
0.06
25,578
1.54
826,117
3.26
1 147,569
2.85
836,348
2.83
12 Month Floating Total (in):
19.00
40.19
35.24
34.32

FORM:NDAR-1 08-11 NON-DISCHARGE APPLICATION REPORT(NDAR-1)
Did 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? ❑Compliant ❑Non-Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit? E Compliant ❑Non-Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site? E Compliant ❑Non-Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? 2 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: John Timothy Scott Permittee:
Mark Stevens (City Manager) City of New Bern
Certification No.: 993732 Signing Official: Jordan Hughes
Grade: IV Phone Number: [phone] Signing Official's Title:
Has the ORC changed since the previous NDAR-1? ❑Yes E No Phone Number: [phone] Permit Exp.: 7/31/22
jann— 4/26/21 4/27/21
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:NDAR-1 08-11 NON-DISCHARGE APPLICATION REPORT(NDAR-1) Page 4 of 7
Permit No.: WQ0003765 I Facility Name: New Bern Seven Water Reclamation Facility I County: Craven Month: March Year: 2021
Field Name: 9-B Field Name: 9-C Field Name: SBF-1 Field Name: SBF-2
Did irrigation occur
Area(acres): 1.48 Area(acres): 8.43 Area(acres): 0.72 Area(acres): 0.72
at this facility?
Cover Crop: Bermuda/Hardwood Cover Crop: Bermuda/Hardwood Cover Crop: Bermuda Cover Crop: Bermuda
E YES ❑NO Hourly Rate(in): N/A Hourly Rate(in): N/A Hourly Rate(in): 0.57 Hourly Rate(in): 0.57
Annual Rate(in): 65.2 Annual Rate(in): 52.1 Annual Rate(in): N/A Annual Rate(in): N/A
Weather Freeboard Field Irrigated? ❑YES ❑NO Field Irrigated? 0 YES ❑NO Field Irrigated? ❑YES El NO Field Irrigated? ❑YES 0 NO
a 2 o an d
a a w a d a a m E a) a s a a) E m a s a a) E a> a s a a) E a>
T f° l6 « A ° V E d Gf Y >, E 7 T a E N a 2,, >, E 7 T 5 E E . N .�.. > C 7 A C E y e w T E 3 >` C
ca ' E a . a E '5 a a E a n E 5 'a 3 E a a E 5 E A :n E '5 :a
p m 2 a. o T a a rn a m •R o R °- a� R a •R o m a. rn R n K o R a of R a •R o R
=rv; E N (n 0 iE > Q ~ J = J Q ~ J = J Q ct ~ J R = J Q 0. ~ J R = J
~ a
°F in ft ft gal min in in gal min in in gal min in in gal min in in
1 PC 66 0.02 2.7 2.0 7,691 120 0.19 0.10 37,548 120 0.16 0.08
2 C 44 0.04 2.8 2.0 7,691 120 0.19 0.10 37,548 120 0.16 0.08
3 PC 45 2.9 2.0 7,691 120 0.19 0.10 37,548 120 0.16 0.08
4 C 37 2.9 2.0 7,691 120 0.19 0.10 37,548 120 0.16 0.08
5 C 38 3 2.0 7,691 120 0.19 0.10 37,548 120 0.16 0.08
6 C 45 3.2 2.0 _
7 C 50 3.1 2.0
8 C 33 3.1 2.0 7,691 120 0.19 0.10 37,548 120 0.16 0.08
9 C 35 3.2 2.0 7,691 120 0.19 0.10 37,548 120 0.16 _ 0.08
10 C 39 3.7 2.0 7,691 120 0.19 0.10 37,548 120 0.16 0.08
11 C 41 3.5 2.0 7,691 120 0.19 0.10 37,548 120 0.16 0.08
12 C 46 3.6 2.1 7,691 120 0.19 0.10 37,548 120 0.16 0.08
13 PC 60 3.7 2.1
14 C 47 3.7 2.2
15 C 48 3.8 2.2 7,691 120 0.19 0.10 37,548 120 0.16 0.08
16 CL 43 3.9 2.3 5,768 90 0.14 0.10 28,161 90 0.12 0.08
17 PC 47 1.7 3.8 2.2
18 PC 55 0.01 3.5 2.2 7,691 120 0.19 0.10 37,548 120 0.16 0.08
19 CL 55 0.04 3.6 2.2
20 PC 40 0.28 3.5 2.0 7,691 120 0.19 0.10 37,548 120 0.16 0.08
21 PC 45 3.6 2.0 7,691 120 0.19 0.10 37,548 120 0.16 0.08
22 C 52 3.7 2.0 7,691 120 0.19 0.10 37,548 120 0.16 0.08
23 PC 54 0.05 3.8 2.0 7,691 120 0.19 0.10 37,548 120 0.16 0.08
24 CL 64 0.16 3.9 2.0 7,691 120 0.19 0.10 37,548 120 0.16 0.08
25 PC 53 3.9 2.0 7,691 120 0.19 0.10 37,548 120 0.16 0.08
26 PC 70 4 2.1 7,691 120 0.19 0.10 37,548 120 0.16 0.08
27 4.1 2.1
28 4 2.1
29 PC 50 0.63 3.9 2.2
30 PC 41 3.8 2.2 7,691 120 0.19 0.10 37,548 120 0.16 0.08
31 PC 58 3.8 2.3 7,691 120 0.19 0.10 37,548 120 0.16 0.08
Monthly Loading: 167,278 V 4.16 �r�/��j 816,669 %��� 3.57 �������� 0 0 dW 0 V 0 ir
12 Month Floating Total(in): � 53.92 / 45.79 �������������1������i�R j�//7�������� 7������1

FORM:NDAR-1 08-11 NON-DISCHARGE APPLICATION REPORT(NDAR-1)
Did the application rates exceed the limits in Attachment B of your permit? E 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? E Compliant ❑Non-Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site? E Compliant ❑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 necessary.
Operator in Responsible Charge(ORC)Certification Permittee Certification
ORC: John Timothy Scott Permittee:
Mark Stevens (City Manager) City of New Bern
Certification No.: 993732 Signing Official: Jordan Hughes
Grade: IV Phone Number: [phone] Signing Official's Title:
Has the ORC changed since the previous NDAR-1? ❑Yes E No Phone Number: [phone] Permit Exp.: 7/31/22
4/26/21 4/27/21
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:NDAR-1 08-11 NON-DISCHARGE APPLICATION REPORT(NDAR-1) Page 5 of 7
Permit No.: WQ0003765 Facility Name: New Bern Seven Water Reclamation Facility I County: Craven Month: March Year: 2021
` Field Name: SBF-3 Field Name: SBF-4 Field Name: SBF-5 Field Name: SBF-6
Did irrigation occur - -
Area(acres): 0.72 Area(acres): 0.72 Area(acres): 1.62 Area(acres): 1.62
at this facility? Cover Crop: Bermuda Cover Crop: Bermuda Cover Crop: Bermuda Cover Crop: Bermuda
❑YES ❑NO Hourly Rate(in): 0.57 Hourly Rate(in): 0.57 Hourly Rate(in): 0.57 Hourly Rate(in): 0.57
Annual Rate(in): N/A Annual Rate(in): N/A Annual Rate(in): N/A Annual Rate(in): N/A
Weather Freeboard Field Irrigated? ❑YES ❑NO Field Irrigated? ❑YES RI NO Field Irrigated? ❑YES 2 NO Field Irrigated? ❑YES 0 NO
a El? c .)
m H . a -a a a, E rn a s a a) E rn a s a rn E rn m a a rn E rn
U Vs :9 a j E °' m g >, c a E E m m 2' >,c a a c E m a >, c a a c E m m ;; > c 3 - c
�a a E 3 a E a -a E � =o
ra a > a o a i- R K ° f0 o a F °� 0 1O R o co o a F- 0 /6 K ° f6 o a ' p m x ° R
a
N fn is > < _ J = J > Q J m = J > Q J = J > Q J = J
- 0-
(1)
L
°F in ft ft gal min in in gal min in in gal min in in gal min in in
1 PC 66 0.02 2.7 2
2 C 44 0.04 2.8 2
3 PC 45 0 2.9 2
4 C 37 0 2.9 2
5 C 38 0 3 2
6 C 45 0 3.2 2
7 C 50 0 3.1 2
8 C 33 0 3.1 2
9 C 35 0 3.2 2
10 C 39 0 3.7 2
11 C 41 0 3.5 2
12 C 46 0 3.6 2.1
13 PC 60 0 3.7 2.1
14 C 47 0 3.7 2.2
15 C 48 0 3.8 2.2
16 CL 43 0 3.9 2.3
17 PC 47 1.7 3.8 2.2
18 PC 55 0.01 3.5 2.2
19 CL 55 0.04 3.6 2.2
20 PC 40 0.28 3.5 2
21 PC 45 0 3.6 2
22, C 52 0 3.7 2
23 PC 54 0.05 3.8 2
24 CL 64 0.16 3.9 2
25 PC 53 0 3.9 2
26 PC 70 0 4 2.1
27 00:00 0 0 4.1 2.1
28 00:00 0 0 4 2.1
29 PC 50 0.63 3.9 2.2
30 PC 41 0 3.8 2.2
31 PC 58 0 3.8 2.3
Monthly Loading: 0 % A 0 / 0 A 0 % 0 % , 0 0 % 0 V. A
12 Month Floating Total(in): ������������������������;����//�������������������������A V // // XV�����

FORM:NDAR-1 08-11 NON-DISCHARGE APPLICATION REPORT(NDAR-1)
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? 2 Compliant ❑Non-Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit? E Compliant ❑Non-Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site? E Compliant ❑Non-Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? E 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: John Timothy Scott Permittee:
Mark Stevens (City Manager) City of New Bern
Certification No.: 993732 Signing Official: Jordan Hughes
Grade: IV Phone Number: [phone] Signing Official's Title:
Has the ORC changed since the previous NDAR-1? ❑Yes 0 No Phone Number: [phone] Permit Exp.: 7/31/22
)devy.- 4/26/21�. '�'...., 4/27/21
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:NDAR-1 08-11 NON-DISCHARGE APPLICATION REPORT(NDAR-1) Page 6 of 7
Permit No.: WQ0003765 1 Facility Name: New Bern Seven Water Reclamation Facility I County: Craven Month: March Year: 2021
Field Name: SBF-7 Field Name: SBF-8 Field Name: SF-1 Field Name: SF-2
Did irrigation occur
Area(acres): 1.62 Area(acres): 1.62 Area(acres): 2.12 Area(acres): 2.16
at this facility?
Cover Crop: Bermuda Cover Crop: Bermuda Cover Crop: Bermuda Cover Crop: Bermuda
E YES ❑NO Hourly Rate(in): 0.57 Hourly Rate(in): 0.57 Hourly Rate(in): 0.57 Hourly Rate(in): 0.57
Annual Rate(in): N/A Annual Rate(in): N/A Annual Rate(in): N/A Annual Rate(in): NA
Weather Freeboard Field Irrigated? ❑YES ❑NO Field Irrigated? ❑YES 0 NO Field Irrigated? ❑YES E NO Field Irrigated? ❑YES E NO
ta`m ma C mo N> m
o aa�
cdo -0 -om aa) EE T a e 'a --a a) E rn a aQ E aoo E ac 3 Tt a E ° d E Em 173.) c aTc E : 3 E E
~ o' a ° a 'X ~ rnR R 'K rn a R
E fn > J > < R > J > < JN a co
~ a
°F in ft ft gal min in in gal min in in gal min in in gal min in in
1 PC 66 0.02 2.7 2
2 C 44 0.04 2.8 2
3 PC 45 0 2.9 2
4 C 37 0 2.9 2
5 C 38 0 3.0 2
6 C 45 0 3.2 2
7 C 50 0 3.1 2
8 C 33 0 3.1 2
9 C 35 0 3.2 2
10 C 39 0 3.7 2
11 C 41 0 3.5 2
12 C 46 0 3.6 2.1
13 PC 60 0 3.7 2.1
14 C 47 0 3.7 2.2
15 C 48 0 3.8 2.2
16 CL 43 0 3.9 2.3
17 PC 47 1.7 3.8 2.2
18 PC 55 0.01 3.5 2.2
19 CL 55 0.04 3.6 2.2
20 PC 40 0.28 3.5 2
21 PC 45 0 3.6 2
22 C 52 0 3.7 2
23 PC 54 0.05 3.8 2
24 CL 64 0.16 3.9 2
25 PC 53 0 3.9 2
26 PC 70 0 4.0 2.1
27 00:00 0 0 4.1 2.1
28 00:00 0 0 4.0 2.1
29 PC 50 0.63 3.9 2.2
30 PC 41 0 3.8 2.2
31 PC 58 0 3.8 2.3
Monthly Loading:
12 Month Floating Total(in): 0 /////I 0 ����1� 0 :7 0 ������ 0 �/����A_ 0 0 v A 0 v�����j

FORM:NDAR-1 08-11 NON-DISCHARGE APPLICATION REPORT(NDAR-1)
Did the application rates exceed the limits in Attachment B of your permit? E 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? 2 Compliant ❑Non-Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? 2 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: John Timothy Scott Permittee:
Mark Stevens (City Manager) City of New Bern
Certification No.: 993732 Signing Official: Jordan Hughes
Grade: IV Phone Number: [phone] Signing Official's Title:
Has the ORC changed since the previous NDAR-1? ❑Yes E No Phone Number: [phone] Permit Exp.: 7/31/22
ddv,..,J. ,g e t 4/26/21 `✓V 4/27/21
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:NDAR-1 08-11 NON-DISCHARGE APPLICATION REPORT(NDAR-1) Page 7 of 7
Permit No.: WQ0003765 I Facility Name: New Bern Seven Water Reclamation Facility I County: Craven Month: March Year: 2021
Field Name: SF-2 EXT Field Name: SF-3 Field Name: SF-3 EXT Field Name: SF-4
Did irrigation occur
Area(acres): 0.91 Area(acres): 2.11 Area(acres): 0.76 Area(acres): 2.15
at this facility? Cover Crop: Bermuda Cover Crop: Bermuda Cover Crop: Bermuda Cover Crop: Bermuda
❑YES El NO Hourly Rate(in): 0.57 Hourly Rate(in): 0.57 Hourly Rate(in): 0.57 Hourly Rate(in): 0.57
Annual Rate(in): N/A Annual Rate(in): N/A Annual Rate(in): N/A Annual Rate(in): N/A
Weather Freeboard Field Irrigated? ❑YES E NO Field Irrigated? ❑YES 0 No Field Irrigated? ❑YES ❑NO Field Irrigated? ❑YES 0 NO
o m o i 13
o ' °' am a' D rn E Trn y � a rn E Trn , . v rn E Trn a) -0 a rn Earn
>. R R rn g E E . d >, c 3 - c E °' ° . >,C ' - c E E . d :: >, c = _ c E am a) :i >, c = _ c
aEis a E ' 'o E R a E ma E R 'v E L.
E m v E = 7o
❑ U W a ` >,•C, �' a) to 2 2 cL a7 m N a a a. n g 2 a c R N N
m ° ° m a o a F ❑ o m = o o a H ❑ o = o o a i- ❑ o = o o a i= ❑ o = o
y E d CO Q R Q J J Q _ J J > Q _ J 2 J > Q J 2, J
0
~ a
°F in ft ft gal min in in gal min in in gal min in in gal min in in
1 PC 66 0.02 2.7 2.0
2 C 44 0.04 2.8 2.0
3 PC 45 2.9 2.0
4 C 37 2.9 2.0
5 C 38 3 2.0
6 C 45 3.2 2.0
7 C 50 3.1 2.0
8 C 33 3.1 2.0
9 C 35 3.2 2.0
10 C 39 3.7 2.0
11 C 41 3.5 2.0
12 C 46 3.6 2.1
13 PC 60 3.7 2.1
14 C 47 3.7 2.2
15 C 48 3.8 2.2
16 CL 43 3.9 2.3
17 PC 47 1.7 3.8 2.2
18 PC 55 0.01 3.5 2.2
19 CL 55 0.04 3.6 2.2
20 PC 40 0.28 3.5 2.0
21 PC 45 3.6 2.0
22 C 52 3.7 2.0
23 PC 54 0.05 3.8 2.0
24 CL 64 0.16 3.9 2.0
25 PC 53 3.9 2.0
26 PC 70 4 2.1
27 4.1 2.1
28 4 2.1
29 PC 50 0.63 3.9 2.2
30 PC 41 3.8 2.2
31 PC 58 3.8 2.3
Monthly Loading: 0 0 0 :�/ 0 7 0 % 0 7 0 0 7
12 Month Floating Total(in): A

FORM: NDAR-1 08-11
NON -DISCHARGE APPLICATION REPORT (NDAR-1)
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? F] Compliant ❑ Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? 21 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: John Timothy Scott
Permittee:
Mark Stevens (City Manager) City of New Bern
Certification No.: 993732
Signing Official: Jordan Hughes
Grade: IV Phone Number: [phone]
Signing Official's Title:
Has the ORC changed since the previous NDARA? ❑ Yes 0 No
Phone Number: [phone] Permit Exp.: 7/31/22
'J l� 4/26/21L
4/27/21
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 03-12 NON-DISCHARGE MONITORING REPORT(NDMR) Page 1 of 1
Permit No.: WQ0003765 Facility Name: New Bern Seven Water Reclamation County: Craven Month: March Year: 2021
PPI: 001 Flow Measuring Point: ❑Influent ❑Effluent ❑No flow generated Parameter Monitoring Point: ❑Influent ❑Effluent ❑Groundwater Lowering ❑Surface Water
Parameter Code . 50050 00310 00940 50060 31616 00610 00625 00620 00600 00400 00665 00076 70300 00530
G1 o .2 a
o `o V) m m �' E f6 c c a.+ d m
'° ~ c c 3 p z is .a c a o o .`9 Ro a> R .`° a' x .a s :o A i m c v
m m o d 0 O c O o o w o m E o - 2 o 2 a o N a o oy -6 o Q.o
0 o.` G d C.) LL m t F y c Li_ O E I- ._ 2 1-- += F O 7 F N U) F N „,
OQ OF O U ceU 0 Q Yz Z ..o a. F O Cl)
24-hr hrs YIN/B GPD mg/L mg/L mg/L #/100 mL mg/L mg/L mg/L mg/L su mg/L NTU mg/L mg/L
1 06:38 5:57 Y 396,000 1.0 6.92 4.03
2 06:32 6:58 Y 260,000 7.9 4.0 <1.0 <0.5 1.82 31.2 33.02 7.27 1.14 3.31 5.5
3 06:29 7:01 Y 366,000 2.5 7.50 4.08
4 06:26 6:54 Y 391,000 2.7 7.57 4.06
5 06:25 7:05 Y 354,000 2.8 7.08 3.85
6 06:45 7:45 N 369,000 3.39
7 06:55 6:05 N 377,000 5.65
8 06:32 6:58 Y 406,000 2.9 7.13 5.66
9 06:29 7:01 Y 336,000 1.6 7.11 4.47
10 06:27 6:48 Y 320,000 1.6 7.67 2.95
11 06:27 6:58 Y 313,000 1.1 7.07 3.93
12 06:15 6:15 Y 185,000 1.6 7.08 3.71
13 06:45 5:45 N 187,000 2.86
14 07:00 6:45 N 221,000 2.87
15 06:25 7:05 Y 223,000 1.2 6.76 3.79
16 06:10 16:05 Y 205,000 2.6 7.14 4.87
17 06:36 6:49 Y 562,000 1.9 6.77 5.56
18 06:25 6:50 Y 485,000 2.2 6.94 4.67
19 06:40 6:20 Y 260,000 0.5 7.07 9.77
20 06:30 7:00 N 389,000 5.04
21 06:40 6:50 N 260,000 4.74
22 06:35 6:55 Y 285,000 3.7 7.02 3.19
23 06:24 7:11 Y 273,000 9.1 1.8 <1.0 <0.5 1.55 32.6 34,15 7.04 4.06 1.80 3.7
24 06:37 6:23 Y 289,000 1.0 6.99 1.71
25 06:42 6:33 Y 297,000 1.4 6.93 2.45
26 06:38 6:22 Y 285,000 3.1 6.78 1.53
27 05:15 5:15 N 279,000 2.12
28 06:00 7:00 N 291,000 2.02
29 06:29 6:41 Y 289,000 0.5 6.63 2.42
30 06:28 6:57 Y 302,000 1.1 7.20 2.69
31 06:37 6:58 Y 242,000 1.5 6.98 1.67
Average: 312,806 8.5 1.93 1.00 0 1.70 31.9 33.6 2.60 3.70 4.6
Daily Maximum: 562,000 9.1 4.00 0 0 1.82 32.6 34.2 7.7 4.06 9.77 5.5
Daily Minimum: 185,000 7.9 0.50 0 0 1.55 31.2 33.0 6.6 1.14 1.53 3.7
Sampling Type: Recorder Composite Composite Grab Grab Composite Composite Composite Composite Grab Composite Recorder Composite Composite
Monthly Avg.Limit: 499,362 10 14 4 5
Daily Limit: 1,152,000 15 25 6 10 10
Sample Frequency: Continuous 2 X Month 3 X Year 5 X Week 2 X Month 2 X Month 2 X Month 2 X Month 2 X Month 5 X Week 2 X Month Continuous 3 X Year 2 X Month

FORM: NDMR 03-12 NON-DISCHARGE MONITORING REPORT(NDMR)
Sampling Person(s) Certified Laboratories
Name: Tony Hawkins/John Tim Scott/Operator on Duty Name: New Bern WWTP
Name: Lab Personnel Name: Environment 1
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 Permittee Certification
ORC: John Timothy Scott Permittee: Mark Stephen City Manager
Certification No.: 993732 Signing Official: Jordan Hughes
Grade: IV Phone Number: 252-639-7556 Signing Official's Title: City Engineer
Has the ORC changed since the previous NDMR? ❑Yes 0 No Phone Number: 252-639-7526 Permit Expiration: 7/31/2022
4 ,� �� 4/26/2021 4/27/2021
(79Ctr,.._
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