WQ0034380_Monitoring - 12-2023_20240126

Monitoring Report Submittal
...................................................
Permit Number#* WQ0034380
Name of Facility:* Sanderson Farms LLC, Kinston Processing Facility
Month: * December Year: * 2023
Report Information
Type *
NDMR, NDAR-1, NDAR-2, NDMLR
Upload Document*
NDAR, NDMLR, NDMR Dec. 2023.pdf
PDF Only
7.55MB
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
Confirmation Email Address: * [e-mail]
Name of Submitter: * Joseph H. Franklin
Signature:
�/itl�pF W. 11"AA11 r
Date of submittal: 1/26/2024
This will be filled in automatically
Initial Review
Reviewer: Wanda.Gerald

Is the project number correct?* WQ0034380
Is the monitoring report accepted?* Yes No
Regional Office* Washington
Reviewer: _anonymous
Review Date: 2/27/2024

FORM: NDAR-1 07-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page / of 41
Permit No.: VVQ0034380
Facility Name: Sanderson Farms -Kinston Facility
County: Lenoir
Month: December
irrigation
• occur
Area (acres):
Area (acres):
,•
at this facility?
[71YES [JNO
Hourly Rate (in):
Hourly Rate (in):,
•.Annual
Rate (in).
rm=���
Field Irrigated?
Field Irrigated?
KIM�
1 1 •�
• •
®�®
1 11
----

FORM: NDAR-1 07-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of
Permit No.: Q11 :1
Facility Name: Sanderson Farms -Kinston-
•
December1
irrigation
• occur
at this facility?
..
....
NO ..
■ ■Field
Irrigated?■
■.
..
■.
..
■ o.
logo
MMME
mmm=��

FORM: NDAR-1 07-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page ! of 6
Permit No.: WQ0034380
Facility Name: Sanderson Farms -Kinston Facility
County: Lenoir
Month: December
­1
irrigation
• occur
Area (acres):
at this facility?
E]YES EINO
Hourly Rate (in):
Annual Rate (in):
Field Irrigated?
Field lrrigatecl?�
Monthly Loading:

FORM: NDAR-1 07-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page _�_ of
Permit No.: WQ0034380
Facility Name: Sanderson Farms-Kinston.unty:
Lenoir
Month:DecemberArea
Did irrigation
occur
(acres):
Area (acres):
Area (acres):
Area (acres
at this facility?
Cover Crop:
[��IYES EINO
Hourly Rate (in):
Hourly Rate (in):
Hourly Rate (in).
Hourly Rate (in)
Annual Rate (in):
Annual Rate (iny.
Annual Rate (in):
...Field
Irrigated?IiY�
■iField
lrrigate_d?�■
p•
Field Irrigated?
Field Irrigated?■
■•

FORM: NDAR-1 07-11
NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Page of
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?
ECompliant
❑Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit?
❑p Compliant
❑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?
Elcompliant
❑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: Joseph H. Franklin
Permittee:
Sanderson Farms, Inc
Certification No.: WW1012108T/S11012364
Signing Official: Jared Lowe
Grade: 3 Phone Number: 252 522 9145 ext.4127
Signing Officials Title: Divison Manager
Has the ORC changed since the previous NDAR-1? ❑yes ONO
Phone Number: 252-522-9145 ext 4105 Permit Exp.: 12/31/26
aa;j a( �, 1 IL7 y
2zyi/ 12,G /Z V
Signature Date
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
I certify der penalty law, that this document and all attachments were prepared under my direction or supervision in accordance
with a s tem 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: NDMLR 07-11 NON -DISCHARGE MASS LOADING REPORT (NDMLR) Page of
Permit No.: W00034380
Facility Name: Sanderson Farms -Kinston Facility
County: Lenoir
Month: December
Year: 2023
Field Name:
1A
Field Name:
16
Field Name:
2A
Field Name:
2B
Field Name:
3A
Area (acres):
22A
Area (acres):
8.81
Area (acres):
22.4
Area (acres):
10.4
Area (acres):
24
Cover Crop:
Bermuda
Cover Crop:
Bermuda
Cover Crop:
Bermuda
Cover Crop:
Bermuda
Cover Crop:
PINES
Load Type:
PAN
Load Type:
PAN
Load Type:
PAN
Load Type:
PAN
Load Type:
PAN
Field Loaded?
AYES LINO
Field Loaded?
OYES []NO
Field Loaded?
❑YES ENO
Field Loaded?
AYES ENO
Field Loaded?
[EYES ENO
Z C
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Month
gal
mg/L
Ibs/ac
Ibs/ac
gal
mg/L
Ibs/ac
Ibs/ac
gal
mg/L
Ibs/ac
Ibs/ac
gal
mg/L
Ibs/ac
Ibs/ac
gal
mg/L
Ibs/ac
Ibs/ac
January 3,110,401
17.23
20.0
20.0
0
17.23
0.0
0.0 3377527
17.23
21.7
21.7
1568109
17.23
21.7
21.7
3,618,714
17.23
21.7
21.7
February 3,216,573
15.44
18.5
38.4
0
15.44
0.0
0.0
2569910
15.44
14.8
36.4
984585
15A4
12.2
33.9
2,753,475
15.44
14.8
36.4
March 3,985,014
14.78
21.9
60.4
742,492
14.78
10A
10.4
3663593
14,78
20.2
56.6
0
14.78
0.0
33.9
3,925,282
14.78
20.2
56.6
April 1.600,510
14.05
8.4
68.7
629,486
1 14.05
8.4
18.8
1997173
14.05
10.4
67.0
0
14.05
0.0
33.9
1 3,824,770
14.05
18.7
75.3
May 4,174,963
17.69
27.5
96.2
1,642,0281
17.69
27.5
46.3
3683784
17.69
24.3
91.3
0
17.69
0.0
33.9
4,525,776
17.69
27.8
103.1
June 3,299,166
12.29
15.1
111.3
1,297,573
12.29
15.1
61.4
3842546
12.29
17.6
108.9
0
12.29
0.0
33.9
4,117,013
12.29
17.6
120.7
July 3,265,267
19.84
24.1
135.5
1,284,240
19.84
24.1
85.5
3295956
19.84
24.3
133.2
737528
19.84
11.7
45.6
4,765,695
19.84
32.9
153.5
August 3,715,481
14.02
19.4
154.9
1,461,312
14.02
19.4
104.9
3362660
14.02
17.6
150.8
1561235
14.02
17.6
63.1
3,602,849
14.02
17.6
171.1
September 3,827,707
10.83
15.4
170.3
0
10.83
0.0
104.9
2588480
10.83
10.4
161.2
1201794
10.83
10.4
73.6
3,927,872
10.83
14.8
185.9
October 3,331,193
12.38
15.4
185.6
0
12.38
0.0
104.9
3924216
12.38
18.1
179.3
1821959
12.38
18.1
91.7
4,204,518
12.38
18.1
204.0
November 3,654,260
11.13
15.1
200.8
0
11.13
0.0
104.9
3201399
11.13
13.3
192.6
1486364
11.13
13.3
104.9
3,988,612
11.13
15.4
219.4
December 3,081,567
13.71
15.7
216.5
0
13.71
0.0
104.9
3244514
.6
209.1
1506382
13.71
16.6
121.5
3,476,266
13.71
16.612
Month Floating PAN Load
216.5.1
121.5
235.9
(Ibs/ac/yr):
1!!!
Annual PAN Load Limit
8318
(Ibs/ac/yr):

FORM: NDMLR 07-11 NON -DISCHARGE MASS LOADING REPORT (NDMLR) Page Z of__�t
Permit No.: W00034380
Facility Name: Sanderson Farms -Kinston Facility
County: Lenoir
Month: December
Year: 2023
Field Name:
3B
Field Name:
4A
Field Name:
4B
Field Name:
5A
Field Name:
5B
Area (acres):
3.51
Area (acres):
19.7
Area (acres):
8.14
Area (acres):
28.5
Area (acres):
1.4
Cover Crop:
PINES
Cover Crop:
Bermuda
Cover Crop:
PINES
Cover Crop:
Bermuda
Cover Crop:
Bermuda
Load Type:
PAN
Load Type:
PAN
Load Type:
PAN
Load Type:
PAN
Load Type:
PAN
Field Loaded?
21YES ❑N0
Field Loaded?
EYES ❑NO
Field Loaded?
QYES [-]NO
Field Loaded?
[DYES []NO
Field Loaded?
❑YES [-]NO
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Month
gal
0
mg/L
Ibs/ac
Ibs/ac
gal
mg/L
Ibs/ac
Ibs/ac
gal
mg/L
Ibs/ac
Ibs/ac
gal
mg/L
Ibs/ac
Ibs/ac
gal
mg/L
Ibs/ac
Ibs/ac
January
17.23
0.0
0.0
2,970,362
17.23
21.7
21.7
1,227,347
17.23
21.7
21.7
3,874,114
17.23
19.5
19.5
0
17.23
0.0
0.0
February
0
15.44
0.0
0.0
2,260,143
15.44
14.8
36A
933,887
15A4
14.8
36.4
4,006,271
15.44
18.1
37.6
0
15.44
0.0
0.0
March
0
14.78
0.0
0.0
2,758,371
14.78
17.3
53.7
1,139,754
14.78
17.3
53.7
4,963,476
14.78
21.5
59.1
0
14.78
0.0
0.0
April
150,483
14.05
5.0
5.0
844,591
14.05
5.0
58.7
348,983
14.05
5.0
58.7
4,951,777
14.05
20.4
79.5
0
14.05
0.0
0.0
May
565,539
17.69
23.8
28.8
3,714,908
17.69
27.8
86.5
1,534,992
17.69
27.8
86.5
2,086,851
17.69
10.8
90.3
0
17.69
0.0
0.0
June
602.114
12.29
17.6
1 46A
3,379,3831
12.29
17.6 1
104.1
988,944
12.29
12.5
99.0
4,128,300
12.29
14.8
105.1
0
12.29
0.0
0.0
July
696,983
19.84
32.9V723,911,841
19.84
32.9
137.0
0
19.84
0.0
99.0
4,067,004
19.84
23.6
128.7
0
19.84
0.0
0.0
August
526,917
14.02
17.6
2,957,340
14.02
17.6
154.5
0
14.02
0.0
99.0
4,370,263
14.02
17.9
146.7
176,535
14.02
14.7
14.7
September
574,451
10.83
14.8
2,820,396
10.83
12.9
167.5
0
10.83
0.0
99.0
4,767,545
10.83
15.1
161.8
239,231
10.83
15.4
30.2
October
614,910
12.38
18.1
2,816,139
12.38
14.8
182.2
0
12.38
0.0
99.0
4,237,145
12.38
15.4
177.1
212,617
12.38
15.7
45.9
November
583,334
11.13
15.4
3,273,986
11.13
15.4
197.7
0
11.13
0.0
99.0
4,168,109
11.13
13.6
190.7
209,153
11.13
13.9i
December
508,403
13.71
16.6
161.6
2,853,434
13.71
16.6
214.2
0
13.71
0.0
99.0
3838,202
13.71
15.4
206.1
192,599
13.71
15.7
12 Month Floating PAN Load
161.6
214.2
99.0
206.1
75.5
(Ibs/ac/yr):
Annual PAN Load Limit
(lb s/ac/yr):

FORMNDMLR07-11 NON -DISCHARGE MASS LOADING REPORT (NDMLR) Page J of
Permit No.: W00034380
Facility Name: Sanderson Farms -Kinston Facility
County: Lenoir
Month: December
Year: 2023
Field Name:
6
Field Name:
7
Field Name:
8A
Field Name:
813
Field Name:
9
Area (acres):
30
Area (acres):
29.6
Area (acres):
22.8
Area (acres):
1.84
Area (acres):
16.2
Cover Crop:
Bermuda
Cover Crop:
PINES
Cover Crop:
PINES
Cover Crop:
PINES
Cover Crop:
Rye
Load Type:
PAN
Load Type:
PAN
Load Type:
PAN
Load Type:
PAN
Load Type:
PAN
Field Loaded?
EYES ENO
Field Loaded?
EYES ONO
Field Loaded?
EYES ENO
Field Loaded?
DYES [:]NO
Field Loaded?
EYES [:]NO
Q
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Month
I gal
mg/L
Ibs/ac
Ibs/ac
gal
mg/L
Ibs/ac
Ibs/ac
gal
mg/L
Ibs/ac
Ibs/ac
gal
mg/L
Ibs/ac
Ibs/ac
gal
mg/L
Ibs/ac
Ibs/ac
January
3986467
17.23
19.1
19.1
3,933,316
17.23
19.1
19.1
31029,715
17.23
19.1
19.1
244,503
17.23
19.1
19.1
2,249,486
17.23
20.0
20.0
February
4551282
15.44
19.5
38.6
4,490,598
15A4
19.5
38.6
3,458,974
15.44
19.5
38.6
279,144
15.44
19.5
38.6
2,326,223
15.44
18.5
38.4
March
3792381
14.78
15.6
54.2
3,741,813
14,78
15.6
54.2
2,882,209
14.78
15.6
54.2
232.599
14.78
15.6
54.2
2,882,019
14.78
21.9
60.4
April
4358974
14.05
17.0
71.2
5,006,474
14.05
19.8
74.0
3,856,339
14.05
19.8
74.0
311,214
14.05
19.8
74.0
2,875,227
14.05
20.8
81.2
May
3044955
17.69
15.0
86.2
5,528,899
17.69
27.6
101.6
4,258,745
17.69
27.6
101.6
343,689
17.69
27.6
101.E
2,061,868
17.69
18.8
99.9
June
4922721
12.29
16.8
103.0
4,857,084
12.29
16.8
118.4
3,741,267
12.29
16.8
118.4
301,927
12.29
16.8
118.4
2,759,961
12.29
17.5
117.4
July
3171652
19.84
17.5
120.5
4,366.518
19.84
24.4
142.8
3,363,397
19.84
24.4
142.8
271,433
19.84
24.4
142.8
2,361,487
19.84
24.1
141.5
August
4610155
14.02
18.0
138.5
4,824,375
14.02
19.1
161.9
3,716,074
14.02
19.1
161.9
299,894
14.02
19.1
161.9
2,891,915
14.02
20.9
162.4
September
4511752
10.83
13.6
152.1
5,141,321
10.83
15.7
177.6
3,960,206
10.83
15.7
177.6
276,721
10.83
13.6
175.5
2,735,521
10.83
15.3
177.7
October
3511145
12.38
12.1
164.2
4,130,368
12.38
14.4
192.0
3,181,501
12.38
14.4
192.0
0
12.38
0.0
175.5
2,829,292
12.38
18.0
195.7
November
4707028
11.13
14.6
178.7
4,644,269
11.13
14.6
206.5
3,082,704
11.13
12.6
204.5
0
11.13
0.0
175.5
2,756,782
11.13
15.8
211.5
December
4198907
13.71
16.0
194.7
4,142,922
13.71
16.0
222.5
3,191,169
13.71
16.0
220.5
0
13.71
0.0
175.5
2,228,633
13.71
15.7
227.2
12 Month Floating PAN Load
194.7
222.5
220.5
175.5
227.2
(Ibs/ac/yr):
Annual PAN Load Limit
(Ibs/ac/yr):

FORM: NDMLR 07-11 NON -DISCHARGE MASS LOADING REPORT (NDMLR) Page L, of
Did the mass loading rates exceed the limits in Attachment B of your permit? OCompliant ❑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 11 Permittee Certification I
ORC: Joseph H. Franklin
Certification Number: WW1012108T/S11012364
Grade: 3 Phone Number: 252 902 8906
Has the ORC changed since the previous NDMLR? ❑Yes ONo
// Z 1(1/2
Signature
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
Permittee:
Sanderson Farms, LLC
Signing Official:
Jared Lowe
Signing Official's Title: Complex Manager
Phone No.: 252-522-9145 ext 4105 Permit Exp.: 12/31 /26
Signature ' I Date
I ce under penr1tyofw, 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 07-11 NON -DISCHARGE MONITORING REPORT (NDMR) Page _L of 3
Permit No.: WQ0034380
Facility Name: Sanderson Farms -Kinston Facility
County: Lenoir
Month: December
Year: 2023
PPI: 001
Flow Measuring Point: ❑Influent ❑Effluent ❑No flow generated
Parameter Monitoring Point: ❑Influent DEffluent [-]Groundwater Lowering ❑surface water
Parameter Code
50050
00310
00916
00940
31616
00927
00610
00625
00620
00600
00400
00665
WQ09C
00931
00929
1 70300
@
_
0
QL m
F
O
c
0
E
v
W
O
o
E
m o
o
L)
E
c
p
E
E
M
:2 C
m
Yp
0a
C
z
U)
P
L
O
d C
ca
- o
>
a z
.o
-0 o
°
rQO
p
tE
°
�
-8m 0LL a'n
>o
24-hr
hrs
GPD
mg/L
mg/L
mg/L
#/100 mL
mg/L
mg/L
mg/L
mg/L
mg/L
su
mg/L
mg/L
Ratio
mg/L
mg/L
1
07:00
10
627,000
6.92
2
852,000
3
757,000
4
07:00
10
642,000
6.98
5
07:00
10
632,000
4
14
1
7.3
8.36
10.6
7.71
18.4
6.94
17.8
12.6
11.3 1
210
6
07:00
10
606,000
6.92
7
07:00
10
680,000
2
1
4.46
5
18A
23.5
6.86
20
20.9
8
07:00
8
656,000
6.89
9
710,000
101
793,000
11
07:00
10
581,000
6.91
12
07:00
10
664,000
3
1
1
3.9
5
7.06
12.1
6.90
18
9.4
13
07:00
10
642,000
6.89
14
07:00
10
666,000
2
1
2.23
4.5
12.7
17.2
6.88
18
14.5
15
07:00
10
645,000
6.88
161
799,000
171
1941,000
18
07:00
10
586,000
6.92
19
07:00
10
644.000
3
1
1.11
5
7.75
12.8
6.92
17.9
9.5
20
07:00
10
726,000
6.85
21
07:00
10
1 696,000
3
1
0.1
5
7.05
12.1
6.84 1
17.1
8.6
22
07:00
10
819,000
6.83
231
511.000
24
410,000
25
316,000
26
07:00
10
1,302,000
6
1
0.56
1.1
4.28
5.43
6.89
14.5
4.8
27
07:00
10
998,000
1
6•77
28
07:00
10
943,000
4
1
1.11
5.6
27.5
33.1
6.73
19.5
29.4
291
07:00
10
1,049,000
6.77
30
07:00
10
1,025,000
6.81
311
1,004,000
Average:
739,419
3.38
14.00
1.00
7.30
2.73
5.23
11.56
16.83
17.85
13.71
11.30
210.00
Daily Maximum:
1,302,000
6.00
14.00
1.00
7.30
8.36
10.60
27.50
33.10 1
6.98
20.00
29.40
11.30
210.00
Daily Minimum:
316,000
2.00
14.00
1.00
7.30
0.10
1.10
4.28
5.43
6.73
14.50
4.80
11.30
210.00
Sampling Type:
Recorder
Composite
Composite
Composite
Grab
Composite
Composite
Composite
Composite
Composite
Grab
Composite
Calculated
Calculated
Composite
Composite
Monthly Limit:
1,400,000
Daily Limit:
Sample Frequency:
Continuous
2 X Week
Monthly
3 X Year
2 X Week
Monthly
2 X Week
2 X Week
2 X Week
2 X Week
5 X Week
2 X Week
2 X Week
Monthly
Monthly
3 X Year

FORM: NDMR 07-11 NON -DISCHARGE MONITORING REPORT (NDMR) Page L- of
Permit No.: WQ0034380
ac
Fility Name: Sanderson Farms -Kinston Facility
county: Lenoir
Month: December
Year: 2023
PPI: 001
Flow Measuring Point: ❑Influent ❑Effluent ❑No Flow generated
Parameter Monitoring Point: ❑Influent ❑Effuent ❑Groundwater Lowering 7—Surface water
Parameter Code — ►
00530
p
i
c
Q E
U ~
O
c
O
m
E N
~
U
m
a
« O
N in
24-hr
hrs
mg1L
1
07:00
10
2
3
4
07:00
10
5
07:00
10
2.8
6
07:00
10
7
07:00
10
2.6
8
07:00
8
9
10
11
07:00
10
121
07:00
10
2.5
13
07:00
10
14
07:00
10
3-9
15
07:00
10
16
17
181
07:00
10
19
07:00
10
4.7
20
07:00
10
21
07:00
10
4.6
22
07:00
10
23
24
25
261
07:00
10
7.9
27
07:00
10
28
07:00
10
9.1
29
07:00
10
30
07:00
10
31
Average:
5
Daily Maximum:
9
Daily Minimum:
3
Sampling Type:
Composite
Monthly Limit:
Daily Limit:
Sample Frequency:
2 X Week

FORM: NDMR 07-11 NON -DISCHARGE MONITORING REPORT (NDMR) Page 3 of 3
Sampling Person(s) Certified Laboratories
Name: Joseph Franklin Name: Environmental Chemists, Inc
Name: Dontay Holmes Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? Elcompliant ❑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: Joseph H. Franklin
Permittee: Sanderson Farms, Inc
Certification No.: WW1012108T/S11012364
Signing Official: Jared Lowe
Grade: 3 Phone Number: 252 902 8906
Signing Officials Title: Divison Manager
Has the ORC changed since the previous NDMR? ❑Yes ❑✓ No
Phone Number: 252-522-9145 ext 4105 Permit Expiration: 12/31/2026
Z�a % Z b Z
ZC
Signature Date
Signature to
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
I rtify, under pe I of law, that this document and all attachments were prepared under my direction or supervision in
accordance with a tem 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