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HomeMy WebLinkAboutWQ0000731_Monitoring - 04-2022_20220601_4kFOR*A: NDMR 10-13 NON -DISCHARGE MONITORING REPORT (NDMR) Page Permit No.: W00000731 Facility Name: Lake Toxaway Company County: Transylvania Month: Year: 9 PPI; Flow Measuring Point: ❑ Influent Effluent ❑ No Flow generated Parameter Monitoring Point: ❑ tnfluent D Effluent ❑ Gr undwater Lowering G Surface Water Parameter Code —► 50050 00400 50060 00310 00610 00530 31616 00076 D0600 00665 D0625 00620 o m aD �F c m E ern O _ 0 '� �° �t tC U LO p m c0 0 E Q D ;g c 'o 6 CD_p �0.0 E M LL c U 'a F iv 0<o F°-w z ,� r a v iU 0) YY Z o 0 CD M z 24-hr hrs GPD su mg/L mg/L mg/L mg/L #/100 mL NTU mg/L mg/L mg/L mg/L /S-7 /. G 2 7' a 3 /`7<Z 4 7y �- 5 6 7- 7 'If ' f' i G%31 71/ L 9 10 2, 7ze 11 c',-foZ. j r 12 [ j `ev 13 41.o O, `{S < ,I. S G ;7 02.33 < O,.S /0. F 142,1 7, 15 16 17 18 Jc�J 19 Lul`- J C/`% 20 p�._ 7:, 21 '4, 22 s 22 L1 1 23 7' 24 25 26 27 ci '3 t zG j .— 3 1 Jy. a 28 517c iss l ' j 29 6S"Ir 1 14 30 31 Average: Daily Maximum: 3 , S! 2,1 O < ,j,s 7 5 < O,-Y O Daily Minimum: 243 `7 L 1,3 L D 0-11S L _ 5 L! to 8 .7 < Sampling Type: Recorder Grab Grab Grab Grab Grab Grab Recorder Grab Grab Grab Grab Grab Monthly Avg. Limit: 6-9 10 4 5 14 Daily Limit: 20,000 15 6 10 25 10 vrcror. tvulvlr� lu- o NUN-DI5CHARGE MONITORING REPORT (NDWAR) Sampling Person(s) I, Certified Laboratories Name: GaryNorton Name: Enviromental Testing Solutions, Inc Name: Richard McCrary Name: Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? tSiCompilant ONo,-compliant If the facility is non -compliant, please explain in the space below the reason(s) the facility was not in compliance. Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s) taken. Attach additional sheets if necessarv. Operator in Responsible Charge (ORC) Certification Permittee Certification ORC: Gary Norton Permittee: Lake Toxaway Company Certification No.: 21853 Signing Official: Scott McCall, by signatory authority Grade: 11 Phone Number: 828-553-2990 Signing Official's Title: Broker, Lake Toxaway Company Has the ORC changed since the previous NDMR? ❑ yes Ci No Phone Number: 828-966-4260 Permit Expiration: 10/31/2021 ignature Date Signature DWI By this signature, I certify that this report is accurrate and complete to the best of my knowledge, 1 certify, under penally of law, that this document and all attachments were prepared under my direction or supeMsion 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 betfef, true, aoaxate, and complete. I am aware that there are significant penalties for submitting false Information, including the possibility of runes and imprisonment for knowing violations. Mail Original and Two Copies to: Division- of Water Resources Information Processing Unit 1617 Mail Service Center Raleigh, North Carolina 27699-1617 FORM: NDAR-1 07-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page I of 40 Permit No.: WQ0000731 Facility Name: Lake Toxaway Company County: Transylvania Month: April D irrigation -fi■ii�Nam • occur ■� •. -�, Area (acres): • at this facility? Cover Crop °II II Cover Crop: YES NO Hourly Rate (in): Hourly Rate (in): Hourly Rate (in): c •c c c ,. Field Irrigated? �E�m Field Irrigated? Field Irrigated? logo MN MI.M INN M NNN ®' m_M Monthly ... •• V////� • •' Z////�/.��////Z • • �/////�/.�Z////Z� Z////� 0�////Zr.w-.Mmw rumnn. rtunrc- t ur-i i NUN-U1-.'1U 1AKlot Al t-LIUA I IUN KtVUK I INUAK-1) rdyc _�__ ur _(R__ Did the application rates exceed the limits in Attachment B of your permit? R Compliant ❑ Non -Compliant Were adequate measures taken to prevent effluent ponding in or runoff from the sites? p compliant ❑ Non-Comprrant Was a suitable vegetative cover maintained on all sites as specified in your permit? QCompliant ❑Non -Compliant Were all setbacks listed in your permit maintained for every application to each permitted site? OCompliant ❑Non -Compliant Were all freeboards maintained in accordance with the specified freeboard heights in your permit? 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: Gary Norton Permittee: Lake Toxaway Company Certification No.: 29126 Signing Official: Scott McCall, by signatory authority Grade: SI Phone Number: 828-553-2990 Signing Official's Title: Broker, Lake Toxaway Company Has the ORC changed since the previous NDAR-1? ❑ Yes [A No Phone Number: 828-966-4260 Permit Exp.: Oct. 31, 2021 Signature Date Signature Date/ By this signature, 1 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 07-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page a- of (P s Permit No.: VVQ0000731 Facility Name: Lake Toxaway Company County: Transylvania Month: April Year: 2022 Did irrigation Field Name: FW-4 Field Name: T-5 Field Name: T-6- Field Name: FW-6 occur - Area (acres): 1,06 Area (acres): 2.11 --- Area (acres): 0.68 Area (acres): 1.33 at this facility? - - --- Cover Crap: Turfgrass Cover Crop: Turfgrass Cover Crop: Tudgrass Cover Crop: Turfgrass ❑ YES ❑ NO Hourly Rate (m): 0.19 Hourly Rate (in): 0.24 Hourly Rate (in): 0.15 Hourly Rate (in): 0.23 Annual Rate (in): 26.25 Annual Rate (in): 16.55 Annual Rate (in): 32 Annual Rate (in): 24.99 Weather Freeboard Field lrrigated? YES 7i, NO Field Irrigated? ❑YES ❑ NO Field irrigated? 1 Yrs ao Field Irrigated? ❑ YES ❑ NO cc O> °m,md E VO L 0) � uo Q CL co v ¢ CL >< E >a J E� O Ca O J EE d O > Q E 0 t f O J X O O c O a > Q E . L O E' f M O E OCLCL > Q LM - @Q M O J aa_� E E _ O'O- LO J °F in ft ft gal min in in gal min in in gal min in in gal min in in 1 C 5.5 2 PC 55 2.5 930 10 0.03 Q03 2,320 10 0.04 0.04 460 _ 10 0.02 0.02 1,390 10 0.04 0.04 3 C 4 PC 5 R 1 6 R 0.2 5.5 _ -- 7 R 0.25 8 R 0.1 2 9 CL 10 C 62 930 10 0.03 003 2,320 10 0.04 0.04 460 10 0.02 _ 0.02- 1,390 10 0.04 0.04 11 PC 5.5 121 CL 13 CL 14 CL 2.5 _ 15 C 16 R 0.25 17 R 0.1 5.5 18 R 1.1 19 C - 201 C 1 56 2 930 10 0.03 0.03 2,320 10 0.04 0.04 460 10 0.02 ' 0.02 1,390 10 0.04 0.04 21 C 22 C 23 C 24 PC 25 C 5.5 261 R 1 0.2 27 C 2.5 28 PC 5.5 29 PC 30 CL 31 n/a n/a n/a I n/a Monthly Loading: 2,790 - 0.10 6,960 0.12 1,380'', 0-07 4,170 0 12 12 Month Floating Total (in): 1,51 1.88 1.14 1.78 rvrtm, rvvnrc- r w-r i IVUIV-UlbUHAKUl= Al t'LIUA I JUN Kt_t'UK I JNUAK-1) rayC �_ vt Did the application rates exceed the limits in Attachment B of your permit? ElCompliant ❑non -Compliant Were adequate measures taken to prevent effluent ponding in or runoff from the sites? El Compliant ❑Non -Compliant Was a suitable vegetative cover maintained on all sites as specified in your permit? 0Compliant El Non -Compliant Were all setbacks listed in your permit maintained for every application to each permitted site? QCompliant " ❑Non -Compliant Were all freeboards maintained in accordance with the specified freeboard heights in your permit? EDCompliant El Non -Compliant If the facility is non=compliant, please explain in the space below the reason(s) the facility was not in compliance. Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s) taken, Attach additional sheets if necessary. f IOperator in Responsible Charge (ORC) Certification II Permittee Certification I ORC: Gary Norton Certification No.: 29126 Grade: Sl Phone Number: 828-553-2990 Has the ORC changed since the previous NDAR-1? El yes 0 No = C;Y Date By this signature, 1 certify that this report is accurrate and complete to the best of my knowledge. Pennittee: Lake Toxaway Company Signing Official: Scott McCall, by signatory authority Signing Official's Title: Broker, Lake Toxaway Company Phone Number: 828-966-4260 Permit Exp.: Oct. 31, 2021 Signature D e I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance th a system designed to assure that all qualified personnel property gathered and evaluated the information submitted. Based Rmt y inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the informalioninformation submitted is, to the best of my knowledge and belief, true, accrate, and complete. I am aware that there are signifn 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 3l& 4rmAo.: WQ0000731 Facility Name: Lake Toxaway Company County: Transylvania irrigation Field Nam • occur Area (acres): Area (acres): at this facility? ■ ■ . - WAST-JUM MUM Annual Rate (i Annual Rate (in): .... ��S .. . .. ■ ■Field Irrigated? YES NO Irrigated? ■ p . MMMMM MMMMM MMMMM ammmmMMMM m���i���� Monthly• • • �WoM/.�%IIII% 0%/////% %////102 M4r ///.. f////% rvrtm. rvvnrt-f ur-r i NIUN-LAW-MAKIst AVI'11_Il.AI1VN KtYVKI (NUAK-1) reyC ur Did the application rates exceed the limits in Attachment B of your permit? E)Compliant ❑rion-Compliant Were adequate measures taken to prevent effluent ponding in or runoff from the sites? 0Compliant ❑Non -Compliant Was a suitable vegetative cover maintained on all sites as specified in your permit? 0Compliant ❑Non -Compliant Were all setbacks listed in your permit maintained for every application to each permitted site? 0Compliant ❑Non -Compliant Were all freeboards maintained in accordance with the specified freeboard heights in your permit? 2compliant El Non -Compliant If the facility is non=compliant, please explain in the space below the reason(s) the facility was not in compliance. Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s) taken. Attach additional sheets if necessary. f IOperator in Responsible Charge (ORC) Certification II Permittee Certification I ORC: Gary Norton Certification No.: 29126 Grade: SI Phone Number: Has the ORC changed since the previous NDAR-1? 828-553-2990 Permittee: Lake Toxaway Company Signing Official: Scott McCall, by signatory authority Signing Official's Title: Broker, Lake Toxaway Company ❑ Yes El No Phone Number: 828-966-4260 Permit Exp.: Oct. 31. 2021 "Signature Date I Signature i Da(e By this signature, I certify that this report is accufrate and complete to the best of my knowledge. 1 certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that all qualfied 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. 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 y/6 Permit No.: WQ0000731 Facility Name: Lake Toxaway Company County: Transylvania Month: April Year: 2022 Did irrigation occur Field Name: -- 02-FW-15 Field Name: 02-FW-16 Field Name: 02-T-10 Field Name: 02-T-11 Area (acres): 2,02 Area (acres): 1.34 Area (acres): -- 1.11 Area (acres): 1.62 at this facility? Cover Crop:Turf 9 rass Cover Crop: p� Turf rass 9 Cover Crop: P� Turfgrass 9 Cover Crop: p� Turf rass 9 0 YES ❑ N0 Hourly Rate (in): 0.3 Hourly Rate (in): 0.23 Hourly Rate (in): 0.28 Hourly Rate (in): 0.25 Annual Rate (m): 10?7 Annual Rate (in): 12.16 Annual Rate (in): 17.75 Annual Rate (in): 11.08 Weather Freeboard Field ,rrirgaled?_ Yr �r_, Field Irrigated? ❑ YES ❑ N0 Field Irrigated? YES No Field Irrigated? 0 YES ❑ No >` '� y 0 Uy :5 a16i d tC a E F O .t6+ •a a` CDN m `.o° t _1 .Q Q' U a s_� 6 Q 0 M _ c1t 'J Q � '0CT1 E - hC O -1 �' >' _ E O .J G7 E N a i E _rn rn M O X O m 2=-1 C. > Q E P � E o MO £E N i Q d >. C m O J 7 �03 ` Ca E =O J °F in ft ft g al min in in g al min in in gal min in in gal min in in 1 C 5.5 2 PC 55 2.5 2,780 10 0,05 0.05 1,390 10 0.04 0.04 1,860 10 0.04 0.04 3 C 4 PC 5 R 1 6 R 0.2 5.5 7 R 0.25 8 R 0.1 2 9 CL 10 C 62 2,780 , 10 0,05 0 05 1,390 10 0.04 0.04 1,860 10 0.04 0.04 11 PC 5.5 12 CL 13 CL 14 CL 2.5 15 C _ 161 R 0.25 17 R 0.1 5.5 18 R 1.1 19 C 20 C 56 2 2,780 10 0.05 005 1,390 10 0.04 0.04 i 1,860 10 0.04 0.04 21 C 22 C _ _ 23 C - 24 PC 251 C 1 5.5 26 R 0.2 27 C 2.5 28 PC 5.5 29 PC 30 CL 31 n/a n/a n/a n/a Monthly Loading: 8,340 0.15 4 170 0.11 0 0.00 5,580 0.13 12 Month Floating Total (in): 2.35 '' 1.78 2.16 1.98 rurrtrvt. rvunrc-r yr-11 NUN-UIJI.HAKUt At'VLII.AIlUN Kt1-UKI JrWAK-l) rays 'Y ur Did the application rates exceed the limits in Attachment B of your permit? Q Compliant ❑ Non -Compliant Were adequate measures taken to prevent effluent ponding in or runoff from the sites? 0Compliant El 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? 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. s Operator in Responsible Charge (ORC) Certification Permittee Certification ORC: Gary Norton Permittee: Lake Toxaway Company Certification No.: 29126 signing Official: Scott McCall, by signatory authority Grade: SI Phone Number: 828-553-2990 Signing Official's Title: Broker, Lake Toxaway Company Has the ORC changed since the previous NDAR-1? ❑ Yes ONO Phone Number: 828-966-4260 Permit Exp.: Oct. 31, 2021 17-7 It S Signature Date Signature D e 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 slt. Permit No.: 111111 - Toxaway Company. . 1 Did irrigation Field Nze��l o ccur Area (acres):! Area (acres):..Area (acres Area (acres): at this facility? Cover Crop: Cover Crop elr. ..... .: .: .. ._ El YES El. .Hourly / oil IN lim�jj MM NMI ©omomm�� 0 omm m ®■���� ���� ���� ���� mommmm�m 1 1 1 . �m 1 /. / /. 1 1• 1 1• ������ m mmm m m ���IMMM��IMMM mommm®���m■i ���� o��� ���� mom®mm�■������ -������� momm©mmm ! ! • • �m / 1. 1 1. �®_ '1 � / 1• 1 1• • %//////%i%/////®'//ONEi%//////%i'///////N 1111W////MPM//////%//////.. ' rvrtm. rvvr�rt-r ur-r t NUN-UlJIatAKldt AVVL1t AIJUN Ktt'UKI tNUAK-1) rdyc�ur E A 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? 21Compliant El Non -Compliant Was a suitable vegetative cover maintained on all sites as specified in your permit? 0Compliant ❑Non -Compliant Were all setbacks listed in your permit maintained for every application to each permitted site? QCompliant ❑Non -Compliant Were all freeboards maintained in accordance with the specified freeboard heights in your permit? 21Compliant ❑ Non-comphant 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. s Operator in Responsible Charge (ORC) Certification Permittee Certification ORC: Gary Norton Permittee: Lake Toxaway Company Certification No.: 29126 Signing Official: Scott McCall, by signatory authority Grade: SI Phone Number: 828-553-2990 signing Official's Title: Broker, Lake Toxaway Company Has the ORC changed since the previous NDAR-1? ❑ Yes 0 No Phone Number: 828-966-4260 Permit Exp.: Oct. 31, 2021 a1 - a s z-7 Signature Date Signature D e 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 direly 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 Permit No.: WQ0000731 Facility Name: Lake Toxaway Company County: Transylvania Month: April Year: 2022 Field Name: 02-DR-01 Field Name: 02-FW-11 Field Name: 02-FW-12 Field Name: 02-FW-14 Did irrigation occur Area (acres): - 1,63 Area (acres): 1.79 Area (acres) -- 2.35; Area (acres): 1.64 at this facility? Cover Crop: Turfgrass Cover Crop: Turfgrass Cover Crop. Turfgrass Cover Crop: Turfgrass YES ENO Hourly Rate (in): 0.31 Hourly Rate (in): 0.34 Hots€ iy Rate (in): 0.31 Hourly Rate (in): 031 Annual Rate (in): 13.79 Annual Rate (in): 13.75 Annual Rate (in): 9.28 Annual Rate (in): 13.6 Weather Freeboard Field Irrigated? , YES rdG Field Irrigated? ❑ YES ❑ NO Field Irrigated? �1 yFs NO Field Irrigated? ❑ YES ❑ NO >. 0 m a U t fi a E °' E- = ° 10 w Q u a L57 m o N m m-0 a U D •- �, a c6 LO - y N a CL > Q N ti E a .� rn T �_ ` Zs m m 12x J. E r m a E .2 > Q N E s� ~_ os _T a f6 M O J E o� i= E 3 R o o 2 J c Zs E QS a 5 Q rs v ,� E sa }... • tr 7+ �_ rs Ll... J= 1 rs 4 E cz X O M J a E d 7 > Q 0 CL~C: N y E o' >. C_ m a 0_ J= E rn C_ E � X o J °F in ft ft gal min in in gal min in in gal min in in gal min in in 1 C 5.5 2 PC 55 2 5 930 10 0.02 0,02 460 10 0.01 0.01 930 - 10 0.01 0.01 3 C 4 PC 5 R 1 6 R 0.2 5.5 7 R 0.25 8 R 0.1 2 -- 9 CL 10 C 62 930 10 0,02 - 0,02 460 10 0.01 0.01 930 10 0.01 0.01 11 PC 5.5 12 CL 13 CL 14 CL 2.5 151 C 161 R 0.25 171 R 0.1 5.5 18 R 1.1 -- 19 C 20 C 56 2 930 10 0,02 _ 0,02 460 10 0.01 0.01 930 10 0,01 0.01 21 C 22 C - 23 C 24 PC 25 C 5.5 26 R 0.2 27 C 2.5 28 PC 5.5 _ 29 PC 30 CL #VALUE'. 31 n/a n/a n/a n/a Monthly Loading: 2,790 0.06 1.380 0.03 2,790 0.04 1 0 #VALUE! 12 Month Floating Total (in): 2:45 2.69 2.29 2,46 ' rvrcnn. rvunrc-r ur-i t NL)N-UI,t.;HAKUt AYYLIL.AIIUN KtNVKI t19UAK-1) rays 6 ur Did the application rates exceed the limits in Attachment B of your permit? ElCompliant ❑Non -Compliant Were adequate measures taken to prevent effluent ponding in or runoff from the sites? p Compliant ❑ Non -Compliant Was a suitable vegetative cover maintained on all sites as specified in your permit? 0Compliant ❑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? El 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 dates) of the non-compliance and describe the corrective action(s) taken. Attach additional sheets if necessary. J Operator in Responsible Charge (ORC) Certification Permittee Certification ORC: Gary Norton Petmittee: Lake Toxaway Company Certification No.: 29126 Signing Official: Scott McCall, by signatory authority Grade: SI Phone Number: 828-553-2990 Signing Official's Title: Broker, Lake Toxaway Company Has the ORC changed since the previous NDAR-1? El Yes 0 No Phone Number: 828-966-4260 Permit Exp.: Oct. 31, 2021 Signature Date Signature D e 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