WQ0003765_Monitoring - 11-2022_20221216

Monitoring Report Submittal
.....................................................
Permit Number#* WQ0003765
Name of Facility:* New Bern Seven Water Reclamation Facility
Month: * November Year: * 2022
Report Information
Type *
NDMR, NDAR-1, NDAR-2, NDMLR
Confirmation Email Address: *
Name of Submitter: *
Signature:
Date of submittal:
Initial Review
Upload Document*
11-November 2022 New Bern Seven Water 1.11 MB
Reclamation Facility.pdf
PDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
[e-mail]
Cheryl King
Reviewer: Wanda.Gerald
12/16/2022
This will be filled in automatically

Is the project number correct?* W00003765
Is the monitoring report accepted?* Yes NO
Regional Office* Washington
Reviewer: _anonymous
Review Date: 3/13/2023

FORM: NEAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page 1 of4
Permit No.:
WQ0003765
Facility Name:
New Bern Seven Water Reclamation Facility
County:
Craven
Month:
November
Year:
2022
Did irrigation occur
Field Name
1
Field Name:
2
Field Name
3
Field Name:
4
-
Area (acres)
14:4
Area (acres}:
13
Area
(acres)
13
Area {acres}:
13.8
at t�IIS aClllty!
Cover Crop:
Bermuda/Hardwood'
Cover Crop:
BermudalHardwood
Cover Crop
BermudalHardwood
Cover Crop:
Bermuda/Hardwood
0
YES
❑ NO
Hourly. Rate (in).
NIA
Hourly Rate (in):
NIA
Hourly Rate (in),
NIA
Hourly Rate (in):
NIA
Annual Rate (in}:
52.1
Annual Rate (in):
65.2
Annual Rate (in):
65.2=
Annual Rate (in):
65.2
Weather
Freeboard
Field Irrigated?
A YES
No
Field Irrigated?
0 YES
❑ No
Field Irrigatad?
❑� ;YES
❑ No
Field Irrigated?
❑YES
❑ No
a�
o
�o
m
E
TE
a:a r
E
a
�
E
�
EEE
E m
ar ;?
E e3
Q.
a
1
E
]o
O
E
sE
o
iMO
0
o
>
�
=o
osi
>a
oE
orcsn
a
F
a
_
_m
°
in
ft
ft
gal
min
!n
in
gal
min
in
in
gal.
min
in
in
gal
min
in
in
1
PC
63
4.9
2.5
2
PC
55
0.04
5
2.5
3
C
58
5
2.6
4
C
58
5
2.7
<.
5
5
2.7
6
5
2.6
7
C
57
4.9
2.6
8
C
58
4.9
2.8
9
C
53
4.9
2.9
101
1
0.65
1 5
3
11
4.7
3
12
4.6
3
13
4.5
3
14
C
38
4.5
3
64,059
120
0.15
0.08
56,688
120
0.16
0.08
61,284
120
Q17
0,09
61,284
120
0.16
0.08
15
PC
49
4.6
3
16
PC
49
0.13
4.6
3
60,059
120
015
0.08
56,688
120
0.16
0.08
61,294
120
0 17
D 09
61,284
120
0.16
0.08
17
C
37
4.7
3
60 059
f20
015
0 D8
56.688
120
0.16
0.08
61,284
120
0,17
0.09
61,284
120
0.16
0.08
18
C
32
4.7
3.1
6Q,059
12D.
0.15.
i 0,08
56,688
120
0.16
0.08
611284
120
017
0.09
61,284
120
0,16
0.08
19
4.7
3.1
20
4.7
3.2
21
C
34
0.01
4.7
3.2
60,059
120
015
= 0.08
56,688
120
0.16
0.08
61,284
120
017
0. 0 V
61,284
120
0.16
0.08
221
C
48
4.7
3.4
60,059
120
0.15
❑.08
56,688
120
0.16
0,08
61,284
120
017
O.09..3'
61,284
120
0.16
0.08
23
C
50
4.7
3.5
60,059
120
015
0,08
56,688
120
0.16
0.08
61,284
120
0.17
0.09
61,284
120
0,16
0.08
24
4.8
3.6
25
4.7
3.7
26
4.6
3.6
27
4.6
3.6
.:
28
C
53
0.38
4.5
3.6
60,059
120
0.15
0.68 ''
56,688
120
0.16
0.08
61,284
120
017
0.09
61,284
120
0.16
0.08
29
CL
4.6
3.7
60,059
120
0.15
0,08
56,688
120
0.16
0.08
61:284
120
017.
0.09 ;{
61,284
120
0.16
0.08
30
PC
4.6
3.8
540529':
138
510,192
1.45
551,556,
1.56
.,
551,556
1.47
12 Month Floating Total (in):
36.13
38.16
44.38
's
39.D0

FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page 2 of 4
Permit No.:
WQ0003765
Facility Name:
New Bern Seven Water Reclamation Facility
County:
Craven
Month:
November
Year:
2022
Did irrigation occur
m
Field Nae
5
Field Name:
6-A
Field Name
6 C
Field Nam e:
7-A
Area {acres):
`
11
Area (acres):
1,18
Area (acres):
9.64
Area
(acres):
2,82
at this faClilt]I?
Cover Crop;
BermudalHardwood
Cover Crop:
Berm�rdalHardwood
;. co.VeC Crap.
8ermudalHardwood i
Cover
Crop:
Bermuda/Hardwood
Q YES
❑ No
Hourly Rate (rn}
NIX...Hourly
Rate (in):
NIA
Hourly:Rate'(M)
:.N/A.:
Hourly Rate (in):
NIA
Annual Rate (In}:
52.1
Annual Rate (in):
31.7
Annual.Rate (In)
52A
Annual Rate (in):
31.7
Weather
Freeboard
Field Iri.igated?
'; [] Yes
' ❑ NO
Field Irrigated?
❑ YES 0 No
Field Irrigated?
�YtS
❑ No '
Field Irrigated?
0 YES
❑ No
v
m
y a
m a
a
rn
1= A
c>
c
m
y
c
�, c
c
v
m
E m
m;'
M
a c
v
a c
E��.
E,�'
m
E R
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a
L
E� CS
E m
d �'
>=
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;'
a�i
E
7 o
T
E a
❑
r
fl•
=
O
�, C.
R
O1
16
�.
x O !R :
� Q
al
~'
ro R
❑
'X p tp
T
a
�'
Q
M
❑
pr tC
ro
Q'
Q
Cl
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Id
❑°
•K p M
M x 0
E
d
ni° m
Q
°.:..:
m 2 J.;
Q
-
to
-
J
Z: J'
-
v
a
w
°E
in
ft
ft
gal
min
in
in . ,
gal I
min
in
in
gal
min '
in
In .I
gal
I min
in
I in
1
PC
63
4.9
2.5
32,436..
;i. 120
0.11
. ? D 05`:',
4102
120..;
0.16
0:D8
5,881
120
0,08
0,04
2
PC
55
0.04
5
2.5
32,436
120
6.11
0 05.::': '
411062 ',
120 ':
0,16;
Ua.....
5,881
120
0.08
0.04
3
C
58
5
2.6
32,436..
'..': 120
0 11
s:` 0105;
41,062.'
120.
DA
0.08
5,881
120
0.08
0.04
4
C
58
5
2,7
32,436
120
0.11
:; 0.05 t '
41,062 :`
120 :
0.1,6`
008 I`
5,881
120
0.08
0.04
5
5
2.7
6
5
2.6
7
C
57
1
4.9 1
2.6
32,436
120
0.11
0.05 ':
41,062
'120::
0'1. 6;
0.08.:
5,881
120
0.08
0.04
8
C
58
4.9
2.8
32,436
120
0 11
0,05..I
41,062
120 :
016;
0;08
5,881
120
0.08
0.04
9
C
53
4.9
2.9
32,436:120..0.11
0.05;
41,062..
:...120..:.
0.16
0 .,
5,881
120
0.08
0.04
10
0,65
5
3
11
4.7
3
12
4.6
3
13
4.5
3
14
C
38
4.5
3
24,327
90
0 D8
0 054 ;
30,796
90 '
0,12.
0,08
4,411
90
0.06
0.04
151
PC
49
4.6
3
32A
i 120
0.11
U5`i
41,062:
120:
0.16
U8..
5,881
120
0,08
0,04
16
PC
49
0.13
4.6
3
32,436 ,.
120
D,11..
;, 0.05 `
41,062.
120 '
0:1,6
5,881
120
0.08
0.04
171
C
37
4.7
3
32,436
.
,
.16.
0 013 i
5,881
120
0,08
0.04
181
C
32
4.7
3.1
19
4.7
3.1
20
4.7
3.2
21
C
34
0.01
4.7
3.2
22
C
48
4.7
3.4
32,436
120
0.11
.:` 0.05;'' ;
41,062 '
120.;
D.16.
0'08 ':
5,881
120
0.08
0.04
23
C
50
4.7
3.5
;32,436
120
0.11..'
..0.05:.
41,062
120 ;
016.
O Q8 .'
5,881
120
0,08
0.04
241
4.8
3.6
25
4.7
3.7
26
4.6
3.6
27
4.6
3.6
28
C
53
0.38
4.5
3.6
29
C
39
4.6
3.7
32,436
120
0.11
0.05.
41,Q62.
120
0,16
0.08 '
5,881
120
0.08
0.04
301
PC
59
4.6
3.8
32,436
120.1
04
1..0.05
41,062
120
0.16
0.. "
5,881
120
0.08
0.04
0
0
Monthly Loading:
478,431..::;
1.60
0
0.00
605,659;';
2'31(
:`
86,744
1.13
12 Month Floating Total (in):
25.41
0.00
37'.02
f
18.61

FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page 3 of 4
Permit No.: WQ0003765
Did irrigation occur
at this facility?
Q YES ❑ NO
Weather
Freeboard
0
yam.,
tll
U)
❑ t4
xh
in
tt
tt
1
PC
63
4.9
2.5
2
PC
55
0.04
5
2.5
3
C
58
5
2.6
4
C
58
5
2.7
6
5
2.7
6
5
2.6
7
C
57
4.9
2.6
8
C
58
4.9
2.8
9
C
53
4.9
2.9
10
0.65
5
3
11
4.7
3
12
4.6
3
13
4.5
3
14
C
38
4.5
3
15
PC
49
4.6
3
16
PC
49
0.13
4.6
3
17
C
37
4.7
3
18
C
1 32
1 4.7
3.1
19
4.7
3.1
20
4.7
3.2
21
C
34
0.01
4.7
3.2
22
C
48
4 77
3.4
23
C
50
4.7
3.5
24
4.8
3.6
25
4.7
3.7
26
4.6
3.6
27
4.6
3.6
28
C
53
0.38
4.5
3.6
29
C
39
4.6
3.7
30
PC
59
4.6
3.8
12 Month Floating Total
Facility Name: New Bern Seven Water Reclamation Facility
Field:=Name 7w8 Field Name: 7 C
Area(acres). 0;61 Area (acres): 1 9.34
County: Craven Month: November Year: 2022
Field Name 8 B Field Name: 8-C
Area (acres) 1.91 Area (acres): 10.9
Covet Grop
- BermudalHardwood
Cover Crop:
Bermuda/Hardwood
p: Cover Cro
BermudalHardwood
Cover Crop:
Bermuda/Hardwood
Hourly Rate 6.
i`€!A
Hourly Rate (in):
NIA
Hourly Rate (in):
NIA
Hourly Rate (in):
NIA
6512
Annual Rate (in):
52.1
YES
❑ No .;!
Field Irrigated?
Yes
❑ NO
t�s
E rn.
m v
-o
CD
E aM
A o
t2
a
°
Q c
ca
mi o
� Q
J
J
in
In
gal
min
in
in
0.07
0.04 ..
37,982
120
0.15
0.07
0 07
0.04 `
37.982
120
0.15
0.07
0,07
` 0.04 i';
37,982
120
0,15
0,07
0.07
0.04 i-
37,982
120
0.15
0.07
37,982 1 120 1 0.15 0.07
37,982 120 0.15 0.07
37,982 120 0,15 0.07
28,487
90 1
0,11 1
0.07
37,982
120
0.15
0.07
37,982
120
0.15
0.07
37,982
120
0.15 1
0.07
37,982 120 0.15 0.07
37,982 120 0,15 0.07
65,2
Annual Rate (in):
52.1
YES
❑ NO
Field Irrigated?
0 YES
❑ NO
rn
E rn
4)o
a
rn
E rn
m
K'o a°
rn
o R
ccX
in
in
gal
min
in
in
0>13
38,453
120
0.13
0.06
038,453
120
0.13
0.06
0.13.38,453
z:::.::U7::.:
120
0.13
0.06
38,453
120
0.13
0,06
38,453 120 1 0.13 1 0.06
38,453 120 1 0.13 1 0.06
38,453 120 1 0.13 1 0,06
28,840
90 1
0,10
0.06
38,453
120
OA 3
0.06
38,453
120
0.13
0.06
38.453
120
0.13
0.06
120 0.13 0.06
120 0.13 0.06
K11�11`1/.

FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page 4 of 4
Permit No.:
WQ0003765
Facility Name:
New Bern Seven Water Reclamation Facility
Field Name:
9_g
Field Name:
9-C
Did
irrigation occur
Area
(acres).
1:48
Area
(acres):
8.43
at this aCENlt71!
Cover Crop;
,!BermudalHaMwood:
Cover
Crop:
BermudalHardwood
❑�
YES
❑ No
.Hourly Rate (In):
;
NIA
Hourly Rate (in):
NIA
Annual Rate {inj:
65 2
Annual Rate (in):
52.1
Weather
Freeboard
Field lrrigatod?
€❑ YE
❑ No
Field Irrigated?
0 YES
❑ NO
M
An
�+
U
ro
a
Ew ra
E2
Q
y, vc
l= a vc
nm
wQ
o
o 0
U
o cc
N
F
a
L6
°E
in
ft
ft
gal
min.
in
m :i
gal
min
in
I in
1
PC
63
4.9
2.5
?,691
120
0.19
0,10 `
37,548
120
0.16
0.08
2
PC
55
0.04
5
2.5
7;691
120
0.19
010.'(
37,548
120
0.16
0.08
3
C
58
5
2.6
7:,691
120
A.19
t 0.10 ....
37,548
120
0.16
0.08
4
C
58
5
2.7
7,691.
120
019
-; 010 ::;:
37.548
120
0.16
0.08
5
5
2.7
6
5
2.6
7
C
57
4.9
2.6
7 691
120
0,19
0.10 .::
37,548
120
0.16
0.08
8
C
58
4.9
2.8
7.691',
120
019
;; 0,10 '.
37,548
120
0.16
0.08
9
C
53
4.9
2.9
7,691
1-20
0191
010.':
37.548
120
0.16
0.08
10
0.65
5
3
11
4.7
3
12
4.6
3
13
4.5
3
14
C
38
4.5
3
5,768
90
014
:'' 0,10 ',
28,161
90
0.12
0.08
15
PC
49
4.6
3
7,691
120
0.,19
it 010 >
37,548
120
0.16
0.08
16
PC
49
0.13
4.6
3
71691
'' 120
0.19
0.10 :'
37,548
120
0.16
0.08
17
C
37
4.7
3
7,691
120
0.19
`` 0.101
37,548
120
0.16
0.08
18
C
32
4.7
3.1
19
4.7
3.1
20
4.7
3.2
21
C
34
0.01
4.7
3.2
22
C
48
4.7
3.4
7;691
120
0.19
s 0 10 ;
37,548
120
0.16
0.08
23
C
50
4.7
3.5
,7,691
120
0.19
0110
37,548
120
0.16
0.08
24
4.8
3.6
25
4.7
3.7
26
4.6
3.6
27
4.6
3.6
28
C
53
0.38
4.5 1
3.6
291
C
39
4.6
3.7
7,691
120
0:19
?` 0.10
37,548
120
0.16
0.08
301
PC
59
4.6
3.8
7 691
:.:.120:.:,::
0.19
0.10 `:
37,548
120
0.16
0.08
Monthly Loading.
113;441 ';;
2.82
:I
553,833
2,42
12 Month Floating Total (in):
49 61
42.10
County: Craven
Month:
November
Year:
2022
Field Name:
Field Name:
Area (acres):
Area (acres):
Cover Crop
Cover Crop:
Hourly Rate (inj
Hourly Rate (in):
Annual Rate {in).
Annual Rate (in):
Field Irrigated
❑ Yl s
El I
Field Irrigated?
❑ YES
❑ NO
GI
i7
N,rd,
Q)
i.0
C)
�!'C
Ol 'O
E d
C1
N,h61,,
M
, a
E v)
7 Z C
E m
v
E :`a a
E ro
- •o
E a
g
qal _
min
it1
In
teal
min
in
in

FORM: NDARA 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) November 2022
Permit No.: WQ0003765
Did the application rates exceed the limits in Attachment B of your permit?
Were adequate measures taken to prevent effluent ponding in or runoff from the sites?
Was a suitable vegetative cover maintained on all sites as specified in your permit?
Were all setbacks listed in your permit maintained for every application to each permitted site?
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
M Compiiant
❑ Non -Compliant
L] Compliant
❑ Non -Compliant
Compliant
❑ Non -Compliant
0 compliant
❑ Non-Compllant
❑� Compliant
❑ Non-Compllant
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
OPC: John Timothy Scott
Permitfee:
Foster Hughes (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 [D No
Phone Number: [phone] Permit Exp.: 03/31/2029
C 12/13/2022
12/15/2022
Signature Date
Signature Date
(7'—By'this signature, I certify that [his report is accurrate and complete to the best of my knowledge.
I certify, under penalty of law, that this document and all attachments ware 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 [here are significant penalties for submitting false information, inctuding the possibliTty 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
PPI:
001
Flow Measuring Point:
❑ Innuent 0 Effluent ❑ No flow generated
Parameter Code
0.
:60050
00310
00940f'.';
50060
31616
00610
�F
_
_
.Cp
`o
o
>
m
0
0
0
o
O.
O E
U
m
F-
V
u U
a
a
F
O
24-hr
hrs
YlN1B
GPD
mglL
mglL '
mglL
#1100 ML'
mglL
1
07:00
5:30
Y
2831000
0.9
2
06:35
6:40
Y
163,000
3.3
0.81
<0.5
3
06:35
6:25
Y
209,000
1.1
4
06:15
7:15
S
278,000
0.7
5
06:30
7:30
N
290,000:
6
06:30
7:00
N
2701000
7 1
0625
6:35
Y
292,000...
0.7
8
06:25
6:50
Y
29.9,000;:
0.8
9
06:20
6:40
Y
' 295,000
1.3
10
06:30
6:30
Y
267010 i
2.3
11
05:30
10:00
N
284,000
H
12
06:00
7:30
N
318,000
13
06:20
7:40
N
256,000'
14
06:20
6:40
Y
m2,000'
1.5
15
06:50
6:25
Y
161.,000'`
1.0
16
06:30
6:30
Y
25.1,000
4.1
1.2
<1.0
<0.5
17
06:20
6:10
Y
274,000
0.8
181
06:30
6:00
Y
284000;
0.7
19
06:20
5:40
N
258,000 r
20
06:20
7:10
N
296,000..
21
06:40
6:40
Y
41.0,000.
1.1
22
06:25
6:35
Y
264,000 =
1.4
23
06:35
5:10
Y
3.31,000 is
1.6
241
05:50
6:10
N
2721000:
H
25
06:00
8:00
N
.309,000'
H
26
06:20
7:40
N
250,000
27
06:45
7:45
N
265,000.
28
06:20
7:10
Y
291,000.
1.0
29
07:00
7:00
Y
304,000
0.9
301
06:45
6:15
Y
229,000:
0.7
County:
Craven I
Month:
November
Year: 2022
Parameter Monitoring Point:
❑ Influent
[j effluent
❑ Groundwater Lowering
❑ surface water
00625`':i
OG620
00600
00400
00865,:-'
00076
70300
00530
s
o
m
a a�
v °
.0O
af
rn
o'
a
o a ''
c
a
p°
n
y .0
win
f-
Q
a
V7
MWL :"'
mg/L
mgfL
su
mg/L. ;
NTU
mglL .:>
mg1L
7.04
2.57
1.39 ' `
40.1
41.49
6.87
2.64 !`';
2.11
3.5
6.72
3.19
7.13
4.63
2.33
2.95
7.05
3.63
6.93
2.fi6
6.88
4,06
6.67
5.26
H
3.58
3.17
2.54
6.82
2.30
6.95
1.84
0.59 ''
39.7
40.29 `
6.76
6.95
<1
3.7
6.57
2.92
7.22
2.17
2.72
4.32
6.83
5.14
6.76
4.55
6.90
4.59
H
3.92
H
3.18
2.91
2.97
6.93
3.2fi
7,01
2.94
6,88
3.22
Average:
272 a33.1
3.7
0.93
1.00.0
1.00 '
39.9
40.9
4.30 ";`
3.10
3.6
Daily Maximum:
410,000,
4.1
2.30
0
0
1.39 :' :
40.1
41..49
7.2
5.95
5.26
3.7
Daily Minimum:
161,000':
3.3
0.70
0
0
0.59.. `
39.7
40.29
6.6
2.64 ;;
0
3.5
Sampling Type:
Recorder's
Composite
Composite.
Grab
Grab
Composite
':Composite;
Composite
Cvniposite
Grab:.Composite.
Recorder
Coiriposife:
Composite
Monthly Avg. Limit:
499,362:
10
74
4
5
Daily Limit:
1,152,000.
15
25
6
10
10
Sample Frequency:1
Continuodsl
2 X Month
3.XYear.l
5 X Week
I 2 X`Month
2 X Month
:2 X Month':
2 X Month
2 XfMorltlj'.
5 X Week
2 X Month'
Continuous
75 X?Yoar `::
2 X Month
r

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) November 2022
Permit No.: W40003765
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? ❑r 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: Foster Hughes 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 R] No
Phone Number: 252-639-7526 Permit Expiration: 03/31/2029
12/13/2022
12/15/2022
Signature Date
Signature Date
By this signature, I certify that this report is accurrate and complete 10 the best of my knowedge.
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