HomeMy WebLinkAboutNC0059552_Fact Sheet_20230313FACT SHEET FOR EXPEDITED PERMIT RENEWALS
This form must be completed by Permit Writers for all expedited permits which do not require
full Fact Sheets. Expedited permits are generally simple 100% domestics (e.g., schools, mobile
home parks, etc.) that can be administratively renewed with minor changes but can include
facilities with more complex issues (Special Conditions, 303(d) listed water, toxicity testing,
instream monitoring, compliance concerns).
Basic Information for Expedited Permit Renewals
Permit Writer/Date
Charles Weaver 3/13/2023
Permit Number
NCO059552
Facility Name
Highlands Falls WWTP
Basin Name/Sub-basin number
Little Tennessee 04-04-01
Receiving Stream
UT to Cullasa'a River Ravenel Lake
Stream Classification in Permit
WS-III Trout
Does permit need Daily Max NH3 limits?
Already present. Limits are compliant with
2016 NH3 guidance document.
Does permit need TRC limits/language?
Already resent
Does permit have toxicity testing?
No
Does permit have Special Conditions?
No
Does permit have instream monitoring?
Temperature & DO
Is the stream impaired on 303 d list)?
Yes. Impaired for benthos since 1998
Any obvious compliance concerns?
No
Any permit mods since lastpermit?
No
New expiration date
January 31, 2028
Changes in Draft Permit?
➢ Added turbidity monitoring (Trout
waters)
➢ Updated eDMR text
Changes to finalpermit?
➢ None
Invoice / Affidavit
The Highlander
Post Office Box 249
Highlands, NC 28741
STATE OF NORTH CAROLINA
COUNTY OF MACON
AFFIDAVIT OF PUBLICATION
Personally appeared before the undersigned, Rachel Hoskins, who having been
duly sworn on oath that she is Regional Publisher of The Highlander, and the
following legal advertisement was published in The Highlander newspaper, and
entered as second class mail in the Town of Highlands in said county and state;
and that she is authorized to make this affidavit and sworn statement; that the
notice or other legal advertisement, a true copy of which is attached hereto, Public Notice
North Carolina Environmental
was published in The Highlander newspaper on the following dates: Management
PDES U t
PUBLIC NOTICE NORTH CAROL
NC0059552
O1/26/2023
Commission/N ni
1617 Mail Service Center
Raleigh, NC 27699-1617
Notice of Intent to Issue a
NPDES Wastewater Permit
NC0059552 Highlands Falls
Community Association Sand
Filter The North Carolina
And that the said newspaper in which such notice, paper, document or legal Environmental Management
issue a
advertisement was published, was at the time of each and every such NPDESslon wasptewaters tdischarge
publication, a newspaper meeting all the requirements and qualifications of permit to the person(s) listed
Section I-597 of the General Statues of North Carolina and was a qualified below. Written comments
regarding the proposed permit
newspaper within the meaning of the Section I-597 of the General Statues of will be accepted until 30 days
North Carolina. after the publish date of this
notice The Director of the NC
�.
Signatu e of person making affidavit/
Division of Water Resources
(DWR) may hold a public hearing
should there be a significant
degree of public interest. Please
mail comments and/or
information requests to DWR at
the above address. Interested
persons may visit the DWR at
512 N. Salisbury Street, Raleigh,
NC 27604 to review the
Sworn to and subscribed before me this 26th dayof January, 2023. information on file. Additional
y� information on NPDES permits
and this notice may be found on
Notary Public �1
My Commission Expires: J
Total Cost of Advertisement: $62.11
Filed With: NCDENR-DIVISION OF WATER RESOURCES
Address: 1617 MAIL SERVICE CENTER RALEIGH NC 27699-1617
our website:
https://deq.nc.gov/public-notices-
hearings,or by calling (919) 707-
3601. The Highlands Falls
Community Association (91 Falls
Drive West, Highlands, NC
28741) requested renewal of
NPDES permit NC0059552 for
the Highlands Falls Country Club
septic tank/sandfilter system
WWTP in Macon County. This
permitted facility discharges
treated domestic wastewater to
N&�'Lake)
unnamed to the
o���M• i
Ctributary
(Rnin
•
••.•••••• . •s�''��
• •.
helLittlea TeRiver
River Bas in.
Currently, fecal coliform, total
NpTARY
residual chlorine, and ammonia
CIO:'
nitrogen are water quality limited.
' �•� =
•; Q =
This discharge may affect future
Ic
PUBLIC'
allocations in this portion of the
:•.
��%. .•••��• ••,.' �Qv`•`
watershed.
#745153 01/26/23
IWC Calculations
Highlands Falls Community Association Sand Filter
NC0059552
Prepared By: Charles Weaver
Enter Design Flow (MGD): 0.003
Enter s7Q10(cfs): 0.15
Enter w7Q10 (cfs): 0.15 (no Winter 7Q10 data in file; used Summer data)
Residual Chlorine
Ammonia (NH3 as N)
(summer)
7Q10 (cfs)
0.15
7Q10 (CFS)
0.15
DESIGN FLOW (MGD)
0.003
DESIGN FLOW (MGD)
0.003
DESIGN FLOW (cfs)
0.00465
DESIGN FLOW (cfs)
0.00465
STREAM STD (ug/L)
17.0
STREAM STD (mg/L)
1.0
UPS BACKGROUND LEVEL (l
0
UPS BACKGROUND LEVEL (mg/L)
0.22
IWC (%)
3.01
IWC (%)
3.01
Allowable Conc. (ug/1)
565
Allowable Conc. (mg/1)
26.2
Ammonia (NH3 as N)
(winter)
7Q10 (CFS)
0.15
Fecal Limit
200/100ml
DESIGN FLOW (MGD)
0.003
(If DF >331; Monitor)
DESIGN FLOW (cfs)
0.00465
(If DF <331; Limit)
STREAM STD (mg/L)
1.8
Dilution Factor (DF)
33.26
UPS BACKGROUND LEVEL (mg/L)
0.22
IWC (%)
3.01
Allowable Conc. (mg/1)
52.8
NPDES Servor/Current Versions/IWC
3/13/2023
North Carolina
Department of Environmental Quality Modified Application Form 2A
Division of Water Resources Revised March 2021
Modified Application
Form 2A
Minor Sewage Facilities < 0.1 MGD
and No Pretreatment Program
NPDES Permitting Program
Note: Complete this form if your facility is a MINOR new or existing publicly owned treatment works.
NPDES Permit Number
Facility Name
Modified Application Form 2A
NCO059552
Highlands Fall Community
n�:..a. C-.... [..—
Modified March 2021
Form
NC Department of Environmental Quality - Application for NPDES Permit to Discharge Wastewater
MINOR SEWAGE FACILITIES (Before completing this form, please read the instructions. Failure to follow
NPDES
the instructions mgy result in denial of the a ication.
SECTION
1. BASIC
APPLICATION INFORMATION FOR ALL APPLICANTS (40 CFR 122.210)(1) and (9))
1.1
Facility name
Highlands Falls Community Association Sand Filter
Mailing address (street or P.O. box)
91 Falls Drive West
F, -"
City or town
State
ZIP code
Highlands
North Carolina
28741
Contact name (first and last)
Title
Phone number
Email address
c'
Jennifer Royce
Community Manager
(828) 526-2203
jennifer@highlandsfallsca.con
ki
Location address (street, route number, or other specific identifier) ❑ Same as mailing address
Off US Highway 64 East
City or town
State
ZIP code
Highlands
North Carolina
28741
1.2
Is this application for a facility that has yet to commence discharge?
„,
❑ Yes 4 See instructions on data submission ❑✓ No
''
requirements for new dischargers.
1.3
Is applicant different from entity listed under Item 1.1 above?
E
❑ Yes ❑ No 4 SKIP to Item 1.4.
Applicant name
Applicant address (street or P.O. box)
p
F,
City or town
State
ZIP code
Contact name (first and last)
Title
Phone number
Email address
s�
r,
1.4
Is the applicant the facility's owner, operator, or both? (Check only one response.)
❑✓ Owner ❑ Operator ❑ Both
V�
1.5
To which entity should the NPDES permitting authority send correspondence? (Check only one response.)
� t� „.
❑ Facility ❑ Applicant 0 Facility and applicant
(they are one and the same)
1.6
Indicate below any existing environmental permits. (Check all that apply and print or type the corresponding permit
number for each.
� p
0 NPDES (discharges to surface
❑ RCRA (hazardous waste)
❑ UIC (underground injection
water)
control)
❑ PSD (air emissions)
❑ Nonattainment program (CAA)
❑ NESHAPs (CAA)
yA
❑ Dredge or fill (CWA Section
❑ Other (specify)
❑ Ocean dumping (MPRSA)
404)
x
Page 1
NPDES Permit Number
Facility Name
Modified Application Form 2A
NCO059552
Highlands Fall Community
Modified March 2021
1.7
Provide the collections
stem information
requested below for the treatment works.
Municipality
Population
Collection System Type
Served
Served
indicatepercentage)ownership
Status
Highlands Falls
Private facility
100 % separate sanitary sewer
0 Own ❑ Maintain
a
Community
not POTW
% combined storm and sanitary sewer
❑ Own ❑ Maintain
❑ Unknown
❑ Own ❑ Maintain
c
% separate sanitary sewer
ElOwn ElMaintain
% combined storm and sanitary sewer
❑ Own ❑ Maintain
Q
❑ Unknown
❑ Own ❑ Maintain
0
% separate sanitary sewer
❑ Own ❑ Maintain
% combined storm and sanitary sewer
❑ Own ❑ Maintain
❑ Unknown
❑ Own ❑ Maintain
;;
% separate sanitary sewer
❑ Own ❑ Maintain
% combined storm and sanitary sewer
❑ Own ❑ Maintain
❑ Unknown
❑ Own ❑ Maintain
o
Total Private Facility
Population
0
Served
Separate Sanitary Sewer System
Combined Storm and
Sanitary Sewer
Total percentage of each type of
sewer line in miles
100 %
0 °iC
1.8
Is the treatment works located in Indian Country?
c
'
0
L)
ElYes ❑r No
1.9
Does the facility discharge to a receiving water that flows through Indian Country?
❑ Yes No
1.10
Provide design and actual flow rates in the designated spaces.
Design Flow Rate
0.003 mgd
Annual Average Flow Rates Actual
Two Years Ago
Last Year
This Year
c o
o mgd
0 mcd
D mgd
rn LL
Maximum Daily Flow Rates Actual
Two Years Ago
Last Year
This Year
0 mgd
0 mgd
D mgd
y
1.11
Provide the total number of effluent dischar e points to waters of the State of North Carolina by type.
.r-
Total Number of Effluent Discharge Points by Type
a
Combined Sewer
Constructed
a' +—
Treated Effluent Untreated Effluent
Overflows
Bypasses
Emergency
_
Overflows
Page 2
NPDES Permit Number Facility Name
Modified Application Form 2A
NC0059552 Highlands Fall Community
Modified March 2021
Outfalls Other Than to Waters of the State of North Carolina
1.12
Does the POTW discharge wastewater to basins, ponds, or other surface impoundments that do not have outlets
for discharge to waters of the State of North Carolina?
❑ Yes ❑r No 4 SKIP to Item 1.14.
1.13
Provide the location of each surface impoundment and associated discharge information in the table below.
Surface im oundment Location and Discharge Data
Average Daily Volume
Continuous or Intermittent
Location
Discharged to Surface
(check one)
Impoundment
❑ Continuous
gpd
❑ Intermittent
❑ Continuous
gpd
❑ Intermittent
❑ Continuous
gpd
❑ Intermittent
w
1.14
Is wastewater applied to land?
❑ Yes ❑ No 4 SKIP to Item 1.16.
1.15
Provide the land application site and discharge data requested below.
C-
Land Application Site and Discharge Data
Average Daily Volume
Continuous or
o
a,
Location
Size
Applied
Intermittent
check one
acres
gpd
❑ Continuous
0
❑ Intermittent
acres
d
gpd
[I Continuous
❑ Intermittent
acres
9P d
❑ Continuous
❑ Intermittent
1.16
Is effluent transported to another facility for treatment prior to discharge?
o
El Yes ❑✓ No 4 SKIP to Item 1.21.
1.17
Describe the means by which the effluent is transported (e.g., tank truck, pipe).
1.18
Is the effluent transported by a party other than the applicant?
❑ Yes ❑ No 4 SKIP to Item 1.20.
1.19
Provide information on the transporter below.
Trans orter Data
Entity name
Mailing address (street or P.O. box)
City or town
State
ZIP code
Contact name (first and last)
Title
Phone number
Email address
Page 3
NPDES Permit Number
Facility Name
Modified Application Form 2A
NCO059552
Highlands Fall Community
Modified March 2021
1.20
In the table below, indicate the name, address, contact information, NPDES number, and average daily flow rate of the
receivinq facilit .
" Receivina F cilitv Data
Facility name
Mailing address (street or P.O. box)
3
City or town
State
ZIP code
0
U
Contact name (first and last)
Title
0
d
Phone number
Email address
0
NPDES number of receiving facility (if any) ❑ None
Average daily flow rate mgd
o.
2
0
1.21
Is the wastewater disposed of in a manner other than those already mentioned in Items 1.14 through 1.21 that do
0
not have outlets to waters of the State of North Carolina (e.g., underground percolation, underground injection)?
m
❑ Yes ❑ No -* SKIP to Item 1.23.
0
1.22
Provide information in the table below on these other disposal methods.
Information on Other
Dis osal Methods
Disposal
Location of
Size of
Annual Average
Continuous or Intermittent
Method
Disposal Site
Disposal Site
Daily Discharge
(check one)
M
Description
Volume
acres
gpd
ElContinuous
❑ Intermittent
o
❑ Continuous
acres
gpd
❑ Intermittent
acres
gpd
❑ Continuous
❑ Intermittent
1.23
Do you intend to request or renew one or more of the variances authorized at 40 CFR 122.21(n)? (Check all that apply.
Consult with your NPDES permitting authority to determine what information needs to be submitted and when.)
❑ Discharges into marine waters (CWA ❑ Water quality related effluent limitation (CWA Section
Cr
Section 301(h)) 302(b)(2))
❑✓ Not applicable
1.24
Are any operational or maintenance aspects (related to wastewater treatment and effluent quality) of the treatment works
the responsibility of a contractor?
✓❑ Yes ❑ No +SKIP to Section 2.
1.25
Provide location and contact information for each contractor in addition to a description of the contractor's operational
and maintenance responsibilities.
Contractor Information
Contractor 1
Contractor 2
Contractor 3
Contractor name
Environmental, Inc
com an name
oMailing
address
c
street or P.O. box
p0 BOX 954
City, state, and ZIP16
Cullowhee, NC 28723
o
R
code
Contact name (first and
u
last)g
Mark Tea ue
Phone number
(828) 586-5588
Email address
Environmentalinc@aol.com
Operational and
All operations & maintenance
maintenance
responsibilities of
contractor
Page 4
NPDES Permit Number Facility Name Modified Application Form 2A
NCO059552 Highlands Fall Community Modified March 2021
A--;--- C,-,
ADDITIONALSECTION 2. INFORMATION ' t CFR 122.2111 and
c Outfalls to Waters of the State of North Carolina
2.1
Does the treatment works have a design flow greater than or equal to 0.1 mgd?
0s
c
❑ Yes ❑✓ No 4 SKIP to Section 3.
0
2.2
Provide the treatment works' current average daily volume of inflow
Average Daily Volume of inflow and infiltration
and infiltration.
gpd
=
Indicate the steps the facility is taking to minimize inflow and infiltration.
0
a
c
2.3
Have you attached a topographic map to this application that contains all the required information? (See instructions for
CL
*`;
specific requirements.)
o"'';
0
❑ Yes ❑ No
2.4
Have you attached a process flow diagram or schematic to this application that contains all the required information?
o
(See instructions for specific requirements.)
c
❑ Yes ❑ No
2.5
Are improvements to the facility scheduled?
❑ Yes ❑ No 4 SKIP to Section 3.
Briefly list and describe the scheduled improvements.
=
0
M
1.
C
d
E
ax
a
2.
E
3.
0 0
5
4.
m
2.6
Provide scheduled or actual dates of completion for improvements.
Scheduled
or Actual Dates of Completion for Improvements
E
Scheduled
Affected
Outfalls
Begin
End
Begin
Attainment of
Operational
>
Improvement"
(list outfall
Construction
Construction
Discharge
Level
Q
E
(from above)
number)
(MM/DDIYYYY)
(MMIDDiYYYY)
(MM/DDIYYYY)
MM/DD/YYYY
v
3
1.
d
n
2.
3.
4.
2.7
Have appropriate permits/clearances concerning other federal/state requirements been obtained? Briefly explain your
response.
❑ Yes ❑ No ❑ None required or applicable
Explanation:
Page 5
NPDES Permit Number
Facility Name Modified Application Form 2A
NC0059552
Highlands Fall Community Modified March 2021
SECTION 3. INFORMATION
ON EFFLUENT DISCHARGES (40 CFR 122.210)(3) to (5))
3.1
Provide the following information for each outfall. (Attach additional sheets if you have more than three outfalls)
Outfall Number 001
Outfall Number
Outfall Number
State
North Carolina
County
Macon
w
0
City or town
Highlands
o
c
Distance from shore
ft.
ft.
ft.
c
•c
a"
Depth below surface
ft.
ft.
ft.
Q
Average daily flow rate
mgd
mgd
mgd
Latitude
35° 04' 48" N
°
Longitude
83° 11 20" W
3.2
Do any of the outfalls described under Item 3.1 have seasonal or periodic discharges?
R
❑ Yes ❑✓ No 4 SKIP to Item 3.4.
m
3.3
If so, provide the following information for each applicable outfall.
Outfall Number
Outfall Number
Outfall Number
0
Number of times per year
0
discharge occurs
a
Average duration of each
`o
discharge (specify units
Average flow of each
mgd
mgd
mgd
n
discharge
R
Cn
Months in which discharge
occurs
3.4
Are any of the outfalls listed under Item 3.1 equipped with a diffuser?
❑ Yes ✓❑ No 4 SKIP to Item 3.6.
3.5
Briefly describe the diffuser t e at each applicable outfall.
Outfall Number 001 Outfall Number Outfall Number
Q
k
E �
ME
t /
R
r a
c
Does the treatment works discharge or plan to discharge wastewater to waters of the State of North Carolina from
d j
3.6
one or more discharge points?
Yes ❑ No 4SKIP to Section 6.
Page 6
NPDES Permit Number
Facility Name
Modified Application Form 2A
NCO059552
Highlands Fall Community
Modified March 2021
3.7
Provide the receivinq water and
related information if known
for each outfall.
Outfall Number 001
Outfall Number
Outfall Number
Receiving water name
Cullasaja River
Name of watershed, river,
0
or stream system
Little Tennessee River Basin
.L3-
U.S. Soil Conservation
Service 14-digit watershed
o
code
Name of state
cn
management/river basin
Little Tennessee River Basin
U.S. Geological Survey
8-digit hydrologic
0601020202
x
cataloging unit code
Critical low flow (acute)
cfs
cfs
cfs
Critical low flow (chronic)
cfs
cfs
cfs
Total hardness at critical
mg/L of
mg/L of
mg/L of
low flow
CaCO3
CaCO3
CaCO3
3.8
Provide the following information
describing the treatment pr vided for discharges from each outfall
°5 - -• •
Outfall Number 001
Outfall Number
Outfall Number
Highest Level of
0 Primary
❑ Primary
❑ Primary
Treatment (check all that
❑ Equivalent to
❑ Equivalent to
❑ Equivalent to
apply per outfall)
secondary
secondary
secondary
❑ Secondary
❑ Secondary
❑ Secondary
❑ Advanced
❑ Advanced
❑ Advanced
❑ Other (specify)
❑ Other (specify)
❑ Other (specify)
0
Design Removal Rates by
Outfall
BOD5 or CBOD5
%
%
%
N
N
m
E
m
TSS
%
%
%
❑ Not applicable
❑ Not applicable
❑ Not applicable
Phosphorus
%
%
ova
❑ Not applicable
❑ Not applicable
❑ Not applicable
Nitrogen
%
%
%
Other (specify)
❑ Not applicable
❑ Not applicable
❑ Not applicable
%
%
%
Page 7
NPDES Permit Number
Facility Name
Modified Application Form 2A
NCO059552
Highlands Fall Community
n ..,.,...:-....., c.,.,.. tea-
Modified March 2021
3.9
Describe the type of disinfection used for the effluent from each outfall in the table below. If disinfection varies by
season, describe below.
0
15
0
Outfall Number 001
Outfall Number
Outfall Number
U
o
:
a
Disinfection type
Tablet Chlorination
a
0
G
Seasons used
Continious Year Round
v
E
Dechlorination used?
❑ Not applicable
❑ Not applicable
❑ Not applicable
❑✓ Yes
❑ Yes
❑ Yes
❑ No
❑ No
❑ No
3.10
Have you completed monitoring for all Table A parameters and attached the results to the application package?
❑ Yes ❑r No
3.11
Have you conducted any WET tests during the 4.5 years prior to the date of the application on any of the facility's
discharges or on any receiving water near the discharge points?
❑ Yes ✓❑ No 4 SKIP to Item 3.13.
3.12
Indicate the number of acute and chronic WET tests conducted since the last permit reissuance of the facility's
dischar es by outfall number or of the receiving water near the discharge points.
Outfall Number
Outfall Number
Outfall Number
Acute
Chronic
Acute
Chronic
Acute
Chronic
R
c
Number of tests of discharge
a�
water
U
Number of tests of receiving
water
d
w
3.14
Does the POTW use chlorine for disinfection, use chlorine elsewhere in the treatment process, or otherwise have
reasonable potential to discharge chlorine in its effluent?
❑ Yes 4 Complete Table B, including chlorine. ✓❑ No + Complete Table B, omitting chlorine.
3.15
Have you completed monitoring for all applicable Table B pollutants and attached the results to this application
package?
❑ Yes ✓❑ No
Have you completed monitoring for all applicable Table D pollutants required by your NPDES permitting authority and
3.18
attached the results to this application package?
additional sampling required by NPDES
El Yes El
permitting authority.
Page 8
NPDES Permit Number
Facility Name
Modified Application Form 2A
NCO059552
Highlands Fall Community
Modified March 2021
3.19
Has the POTW conducted either (1) minimum of four quarterly WET tests for one year preceding this permit application
or (2) at least four annual WET tests in the past 4.5 years?
❑ Yes ❑ No 4 Complete tests and Table E and SKIP to
Item 3.26.
3.20
Have you previously submitted the results of the above tests to your NPDES permitting authority?
❑ Yes ❑ No + Provide results in Table E and SKIP to
Item 3.26.
3.21
Indicate the dates the data were submitted to your NPDES permitting authority and provide a summary of the results.
Date(s) Sunbymitted
Summary of Results
c
:µ
c
0
3.22
Regardless of how you provided your WET testing data to the NPDES permitting authority, did any of the tests result in
c
toxicity?
❑ Yes ❑ No SKIP to Item 3.26.
d
3.23
Describe the cause(s) of the toxicity:
c,
d
w
L
W
3.24
Has the treatment works conducted a toxicity reduction evaluation?
❑ Yes ❑ No + SKIP to Item 3.26.
3.25
Provide details of any toxicity reduction evaluations conducted.
3.26
Have you completed Table E for all applicable outfalls and attached the results to the application package?
Not applicable because previously submitted
❑
❑ Yes information to the NPDES permitting authority.
Page 9
ModifW Application Pogo 2A
MDVrf March 2021
6.1
Column 1 below, mark the sections of Form 2A that you have completed and are submitting with your application. For
1In
each section, specify in Column 2 any attachments that you are enclosing to alert the permitting authority. Note that not
2 a icants are re aulred to Provide attachments.
Column 11 � Column 22
I
❑ Section 1: Basic Application
I nformation for All Applicants
❑ wi variance request(s) ❑ wl additional attachments
❑ Section 2: Additional
r
Information
❑ wl topographic map ❑ wl process flow diagram
❑ wl additional attachments
❑ w/ Table A ❑ wl Table D
❑ Section 3: Information on
Effluent Discharges
❑ w/ Table B ❑ w/ additional attachments
❑ wi Table C
Section 4: Not Applicable
Section 5: Not Applicable
a Section 6: Checklist and
Certification Statement
❑ w/ attachments
B.2
Certification Statement
I certify under penalty of taw that this document and al( attachments were prepared under my direction or supervision in
accordance with a system designed to assure that qualified personnel properly gather and evaluate 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 fine
and im risonment for knowfm violations.
Name (print or type first and last name)
Jennifer Royce +!
Official title
Community Manager
�.�.
Signature . _�.
Date signed
•— _�
12/07/2022
Page 10