WQ0003626_More Information (Received)_20230216

Initial Review
Reviewer
Nathaniel.Thornburg
Is this submittal an application? (Excluding additional information.) *
Yes No
If not an application what is the submittal type?* Annual Report
Residual Annual Report
Additional Information
Other
Permit Number (IR) * WQ0003626
Applicant/Permittee Campbell Soup Supply Company L.L.C.
Email Notifications
............ .... .... ... ... .......... ...... ... .. .. .. .. ... ... .. .. ..
Does this need review by the hydrogeologist? * Yes No
Regional Office
CO Reviewer
Admin Reviewer

Submittal Form
Project Contact Information
Please provide information on the person to be contacted by NDB Staff regarding electronic submittal, confirmation of receipt, and other correspondence.
............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................
Name* Keith Osterman
Email Address*
keith—[e-mail]
Project Information
Application/Document Type*
New (Fee Required)
Modification - Major (Fee Required)
Renewal with Major Modification (Fee
Required)
Annual Report
Additional Information
Other
Phone Number*
9108441202
Modification - Minor
Renewal
GW-59, NDMR, NDMLR, NDAR-1,
N DAR-2
Residual Annual Report
Change of Ownership
We no longer accept these monitoring reports through this portal. Please click on the link below and it will take you to the correct form.
hftps://edocs.deq.nc.gov/Forms/NonDischarge_Monitoring_Report
Perm it Type:*
Wastewater Irrigation
High -Rate Infiltration
Other Wastewater
Reclaimed Water
Closed -Loop Recycle
Residuals
Single -Family Residence Wastewater
Other
Irrigation
Permit Number: *
WQ0003626
Has Current Existing permit number
Applicant/Permittee Address*
2120 HWY 71 N, Maxton, NC 28364
Facility Name*
Maxton Plant and Silgan Can Company WWTF
Please provide comments/notes on your current submittal below.
I am submitting the additional information requested by Mr. Zachary J. Mega in a letter dated
January 19, 2023. 1 have also sent the original to WPCSOCC in Raleigh and the Fayetteville
Regional Office via FedEx. Please let me know if any more actions are needed, and I will
gladly get you what you need. Thank all for your continued help.
Keith Osterman
At this time, paper copies are no longer required. If you have any questions about what is required, please contact Nathaniel Thornburg
at [e-mail].
Please attach all information required or requested for this submittal to be reviewed here.
(Application Form, Engineering Plans, Specifications, Calculations, Etc.)
2023 W00003626 Permit Information Request.pdf 249.15KB
Upload only 1 PDF document (less than 250 Me). Multiple documents must be combined into one PDF file unless file is larger
than upload limit.
* By checking this box, I acknowledge that I understand the application will not be
accepted for pre -review until the fee (if required) has been received by the Non -
Discharge Branch. Application fees must be submitted by check or money order and
made payable to the North Carolina Department of Environmental Quality (NCDEQ).
I also confirm that the uploaded document is a single PDF with all parts of the
application in correct order (as specified by the application).
Mail payment to:
NCDEQ — Division of Water Resources
Attn: Non -Discharge Branch
1617 Mail Service Center
Raleigh, NC 27699-1617

Signature
C O
Submission Date 2/16/2023

2120 NC 71 Highway North
Maxton, NC 28364
February 16, 2023
Attn: Mr. Zachary J. Mega
NC DEQ — Div. of Water Resources
512 North Salisbury Street
1617 Mail Service Center
Raleigh, NC 27699-1617
RE: Application No. WQ0003626
Mr. Mega,
Campbell Soup Supply Company is responding to your request for additional information as
stated in your letter dated January 19, 2023.
A. Section V-ORC Information:
1. An updated Operator Designation Form is attached. A copy will also be sent to
the WPCSOCC and Fayetteville Regional Offices.
B. Section V111- Monitoring Wells:
1. Monitoring Well 7 is no longer in-service and should be listed as inactive.
C. Attachment B- Signature Authority Delegation:
1. A signed Signature Authority Delegation Letter was emailed January 6, 2023.
delegating signing authority from Brett Dunson to Mark Rogers, Senior Director
of Operations and myself. I have attached another copy as reference.
D. Attachment H- Affiliations:
1. Completed
E. Attachment 1- Compliance Schedules:
1. Fulfilled. No response required.
If you have any questions concerning this information, please contact me at [phone].
Sincerely,
Keith Osterman
Environmental Engineer- Maxton

WATER POLLUTION CONTROL SYSTEM OPERATOR DESIGNATION FORM (WPCSOCC)
NCAC 15A 8G .0201
Press TAB to enter information
Permittee Owner/Officer Name: Mark Rogers
Mailing Address: 2120 HWY 71 N
city: Maxton
Phone: [phone]
State: NC zip: 28364
Email Address: [e-mail]
Signature: Date: a
Facility Name: Campbell Soup Supply Company, LLC
County: Robeson
Permit # WQ0003626
YOU MUST SUBMIT A SEPARATE FORM FOR EACH TYPE AND CLASSIFICATION OF SYSTEM:
Facility Type: ISI J_j
Facility Grade: N/C R
OPERATOR IN RESPONSIBLE CHARGE (O
Print Full Name: Keith J. Osterman Work Phone: [phone]
Certificate Type: SI C] Certificate Grade: I Q Certificate #: 1005252
Email Address: keith—[e-mail]
Signature: 0 Effective Date: o211�10_z0'z3
"1 certify that 1 agree to my de ' otion as the Operator in Responsible Charge for the facility noted. I understand and will abide by the
rules and regulations pertaining to the responsibilities of the ORC as set forth in 15A NCAC 086' .0204 and failing to do so can result in
Disciplinary Actions by the Water Pollution Control System Operators Certification Commission."
BACKUP ORC
Print Full Name: Allan Baldwin Work Phone:[phone]
Certificate Type: SI 0_ Certificate Grade: I [] Certificate #:28640
Email Address: [e-mail]
Signature: Effective Date: -s-'s
"7 certify that/ agree to y designation as a Back-up Operator in Responsible Charge for the facility noted. 1 understand and will abide by
the rules and regulations pertaining to the responsibilities of the ORC as set forth in 15A NCAC 08G .0204 and failing to do so can result in
Disciplinary Actions by the Water Pollution Control System Operators Certification Commission."
Mail, fax or email WPCSOCC, 1618 Mail Service Center, Fax: [phone] Email: [e-mail]
ORIGINAL to: Raleigh, NC 27699-1618
Mail or Fax Asheville
a COPY to: 2090 US Hwy 70
Swannanoa, NC 28778
Fax: [phone]
Phone: [phone]
Washington
943 Washington Sq. Mall
Washington, NC 27889
Fax: [phone]
Phone: [phone]
Fayetteville
225 Green St., Suite 714
Fayetteville, NC 28301-5043
Fax: [phone]
Phone: [phone]
Wilmington
127 Cardinal Dr.
Wilmington, NC 28405-2845
Fax:[phone]
Phone: [phone]
Mooresville
610 E. Center Ave., Suite 301
Mooresville, NC 28115
Fax:[phone]
Phone:[phone]
Winston-Salem
45 W. Hanes Mall Rd.
Winston-Salem, NC 27105
Fax:[phone]
Phone: [phone]
Raleigh
3800 Barrett Dr.
Raleigh, NC 27609
Fax: [phone]
Phone: [phone]
Revised 412016

WPCSOCC Operator Designation Form (continued) Page 2
Facility Name: Campbell Soup Supply Company, LLC Permit #: WQ0003626
I^ BACKUP ORC
Print Full Name: Jeffrey L. Scott Work Phone:[phone]
Certificate Type: WiA4 S Certificate Grade: I ]] Certificate #:101485
Email Address: [e-mail]
z
Signature: Effective Date: Z
"I certify that/ agr401114designotion as a Back-up Operator in Responsible Charge for the facility noted. I understand and will abide by
the rules and regulations pertaining to the responsibilities of the ORC as set forth in 15A NCAC 08G .0204 and failing to do so can result in
Disciplinary Actions by the Water Pollution Control System Operators Certification Commission."
BACKUP ORC
Print Full Name: Jimmie Lewis Britt Jr. Work Phone:[phone]
Certificate Type: $j El Certificate Grade: Certificate #:1006722
Email Address: [e-mail]
Signature: Effective Date:—/4p�d�►
"I certify that I agree o my designation as a Back-up Operator in Responsible Charge for the facility noted. I understand and will abide by
the rules and regulations pertaining to the responsibilities of the ORC as set forth in 15A NCAC 08G .0204 and failing to do so can result in
Disciplinary Actions by the Water Pollution Control System Operators Certification Commission."
Print Full Name:
Certificate Type: Select
Email Address:
Signature:
BACKUP ORC
Certificate Grade: Select
Work Phone:
Certificate #:
Effective Date:
"I certify that/ agree to my designation as a Back-up Operator in Responsible Charge for the facility noted. 1 understand and will abide by
the rules and regulations pertaining to the responsibilities of the ORC as set forth in 15A NCAC 08G .0204 and failing to do so can result in
Disciplinary Actions by the Water Pollution Control System Operators Certification Commission."
Print Full Name:
Certificate Type: Select
Email Address:
Signature:
BACKUP ORC
Certificate Grade: Select
Work Phone:
Certificate M
Effective Date:
"I certify that/ agree to my designation as a Back-up Operator in Responsible Charge for the facility noted. I understand and will abide by
the rules and regulations pertaining to the responsibilities of the ORC as set forth in 15A NCAC 08G .0204 and failing to do so can result in
Disciplinary Actions by the Water Pollution Control System Operators Certification Commission."
Revised 412016

January 6, 2023
Division of Water Resources
Non -Discharge Permitting Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Subject: Signature Authority Designation
To Whom It May Concern:
As an appropriate signing official for Campbell Soup Supply Go„ _MMtop NC. as designated by 15A
NCAC 2T .0106, I hereby delegate authority to sign and certify all permit applications, reports or other
permit related documents to the following staff for the following permit types (sewer, spray, land
application) and/or permit numbers:
Position
Person
Currently in
Position
Permit Type
or Permit
dumber
Senior Director
of Operations
Mark Rogers
WQ0003626
Plant Services
Lead/ ORC
Keith Osterman
WQ0003626
If you have any questions, please contact me at the following:
Permittee/Applicant name (please print): Brest Dunson
Title: Senior Director of Operations
Complete mailing address: Campbell Sou S0121y Co. 2120 HWY 71 N
City:
State: NC Zip: 283
Telephone number: (910) 844- 1574 Email: [e-mail]
Sincerely,
.signature