WQ0023310_Renewal Application_20240531

Initial Review
Reviewer nathaniel.thornburg
Is this submittal an application? (Excluding additional information.) *
Yes No
Permit Number (IR) * WO0023310
Applicant/Permittee Murphy -Brown LLC
Applicant/Permittee Address P.O. Box 856 Warsaw, NC 28398
Is the owner in BIMS? Yes No Is the facility in BIMS?
Owner Type
Facility Name
County
Fee Category Major
Is this a complete application?*
Yes No
Signature Authority
Signature Authority Title
Signature Authority Email
Document Type (if non -application)
Email Notifications
Organization
Warsaw Sanitation Trailer Wash
Duplin
Does this need review by the hydrogeologist? * Yes No
Regional Office
CO Reviewer
Admin Reviewer
Fee Amount
Complete App Date
05/31 /2024
$0
Below list any additional email address that need notification about a new project.
Email Address
Comments to be added to email notfication
Comments for Admin
Comments for RO
Yes No

Comments for Reviewer
Comments for Applicant

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* Kevin Weston
Email Address*
[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*
910-293-5363
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.
https://edoes.deq.nc.gov/Forms/NonDischarge_Monitoring_Report
Permit Type:*
Wastewater Irrigation
High -Rate Infiltration
Other Wastewater
Reclaimed Water
Closed -Loop Recycle
Residuals
Single -Family Residence Wastewater
Other
Irrigation
Permit Number:*
WQ0023310
Has Current Existing permit number
Applicant/Permittee*
Murphy -Brown LLC
Applicant/Permittee Address*
P.O. Box 856 Warsaw, NC 28398
Facility Name *
Warsaw Sanitation Trailer Wash
Please provide comments/notes on your current submittal below.
This is submittal of Wastewater Irrigation System Renewal application, Form WWIS-R 02-21, for the Warsaw Sanitation Trailer Wash, Permit No.:
W00023310.
Also attached is a copy of the recorded setback waiver that is currently listed in the existing permit. This waiver is no longer needed as this property
is now owned by Murphy -Brown, LLC.
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.)
WWIS-R-02-21 Warsaw TW WQ0023310 053124.pdf 750.49KB
Upload only 1 PDF document (less than 250 MB). 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
clllili t r I-1/7-arr

Submission Date 5/31/2024

State of North Carolina
DWR
Department of Environmental Quality
Division of Water Resources
Division of Water Resources 15A NCAC 02T .0500 — WASTEWATER IRRIGATION SYSTEM — RENEWAL
FORM: WWIS-R 02-21
Pursuant to 15A NCAC 02T .0107i b I. if the application does not include all required information and the necessary supporting
documentation, the application shall be returned. The application and attachments shall be prepared in accordance with 15A
NCAC 02T .0100, 15A NCAC 02T .0500, and Division Policies. For more information, visit the Water Quality Permitting
Section's Non -Discharge Branch website. The Applicant shall submit an electronic copy of the application and attachments
uploaded as a single Portable Document Format (PDF) file to htti)s://edoes.dec[.ne.eov/Forms/NonDischaree-Branch-Submittal-
Form-Ver2, or emailed to Non-Discharge.Renorts�7ncdenr. ov if less than 20 megabytes (MB).
SECTION I —APPLICANT INFORMATION
1. Applicant: Murphy -Brown, LLC
12. Permit No.: WQ0023310
3. Signature authority: Kraig Westerbeek
Phone number: [phone] Office
4. Mailing address: P.O. Box 856
City: Warsaw
5. Contact person: Kevin Weston
Primary phone number: [phone] Office
Title: President, Smithield Hog Production
Email: [e-mail]
State: NC Zip: 28398-
Email: [e-mail]
Secondary phone number: [phone] Cell
SECTION II — FACILITY INFORMATION
1. Physical address: 2822 NC Hwy 24 W County: Duplin and Parcel No.: 245500442354
Sampson
City: Warsaw State: NC Zip: 28398-
2. Treatment facility coordinates to the sixth decimal degree:
Latitude: 34.995247' Longitude:-78.148828' Method: Select
SECTION III — FLOW INFORMATION
1. Permitted flow: 20000 GPD (The maximum allowable flow based on what has been permitted)
2. As -built flow: 20000 GPD (The maximum allowable flow based on what has been constructed)
3. Average flow: 4351 GPD (The average of all reported flows on the previous calendar year's NDMRs)
14. Hydraulic capacity: 22 % (Divide the average flow in Item 3 by the As -built flow in Item 2)
5. Wastewater composition: Domestic : % Industrial: % Stormwater: %
1. Billing address: P.O. Box 856
City: Warsaw
SECTION IV — BILLING INFORMATION
State: NC Zip: 28398-
2. Verify the Applicant does not have any overdue annual fees:
httos:,'/deu.nc. p-ov/about/divisions/water-resources/water-resources-vermits/wo-enavments
Pursuant to 15A NCAC 02T .0120(c), permits for renewing facilities shall not be granted if the Applicant or any affiliation has
an unpaid annual fee.
FORM: WWIS-R 02-21 Page 1 of 6

SECTION V —OPERATOR IN RESPONSIBLE CHARGE (ORC) INFORMATION
1. ORC: Bradley Devone Herring
Grade: SI Certification No.: 988691
Mailing address: P.O. Box 856
City: Warsaw
State: NC Zip: 28398-
Phone number: [phone] Cell
Email: [e-mail]
2. Back -Up ORC: Michael Leon Norris
Grade: SI Certification No.: 23931
Mailing address: P.O. Box 856
City: Warsaw
State: NC Zip: 28398-
Phone number: (910) 284-435 Cell
Email: [e-mail]
TSECTION VI — OPEN -ATMOSPHERE STRUCTURES
1. List all open -atmosphere treatment and storage structures associated with the renewing permit. Attach additional sheets if
necessary.
Type Parcel No. Volume (gal) Liner Type Freeboard (ft) Latitude I Longitude
Treatment/Storage 245500442354 2,573,134 Full, clay 2 34.9966840-78.152145"
Select Select 0- °
Select
Select
Select - °
Select - °
SECTION VII — RELATED PERMITS
1. List all wastewater permits (i.e., sewer, collection system, NPDES, residuals) that have interactions with the renewing permit.
Attach additional sheets if necessary.
Permit Type Permit No. Relationship Type
ISelect Select
Select I Select
Select Select
Select I
Select
SECTION VIII — MONITORING WELLS
J
1. List all groundwater monitoring wells associated
with the renewing
permit. Attach additional sheets if necessary.
Well Name
Parcel No.
Status
Gradient
Location
Latitude Longitude
MW-1R
245500442354
Active
Select
Inside Review Boundary
34.996858° I-78.153017°
f MW-2R
1245500442354
Active
Select
Inside Review Boundary
34.994947° I-78.150992°
MW-3R 245500442354
Active
+ Select
Inside Review Boundary
34.99545°
I-78.15937°
Select
I Select
Select
Select
I Select I
Select
Select
I Select I
Select
Select
I Select
Select
Select
Select
Select
Select
Select I
Select
°
- °
Select
Select I
Select
- ° 1
Select
Select
Select
FORM: WWIS-R 02-21
Page 2 of 6

SECTION IX — IRRIGATION FIELDS
1. List all irrigation fields associated with the renewing permit. Attach additional sheets if necessary.
Field County Parcel No. Deeded Owner Area Cover Crop Latitude Longitude
A Sampson/Duplin 245500442354 Murphy -Brown LLC 3.53 Row Crops 34.994976'-78.153862°
B Sampson 2455-24-23 Murphy -Brown LLC 3.38 Row Crops 34.995248'-78.154661'
C Sampson 2455-24-23 Murphy -Brown LLC 3.31 Row Crops 34.995253'-78.155133'
D Sampson 2455-24-23 Murphy -Brown LLC 3.48 Row Crops 34.995125'-78.155777
E I Sampson 2455-24-23 Murphy -Brown LLC 3.18 _ Row Crops 34.995187'-78.156372°
F I Sampson 2455-24-23 Murphy -Brown LLC 2.92 Row Crops 34.995297'-78.157128°
G I Sampson 2455-24-23 Murphy -Brown LLC 2.93Row Crops 34.995262'-78.158083°
H Sampson 2455-24-23 Murphy -Brown LLC 2.35 Row Crops 34.995442'-78.158706°
Zone 1 I Duplin 245500442354 �Carroll's Realty Partnership 0.52 Fescue 34.9967780-78.1508250
I Zone 2 I Duplin 245500442354 Carroll's Realty Partnership 2.03 Fescue 34.9963050-78.1508360
Zone 3 I Duplin 245500442354 Car -roll's Realty Partnership 1.60 Fescue 34.9958810 -78.1509000
Zone 4 I Duplin 245500442354 Carroll's Realty Partnership 2.39 Fescue 34_995662'-79.1509270
Zone 5 Duplin 245500442354 Carroll's Realty Partnership 0.84 Fescue 134.995462"-78.1509430
°I
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Total Acreage:
FORM: WWIS-R 02-21 Page 3 of 6

Was the facility originally permitted or had a major modification issued after September 1, 2006?
❑ Yes — Pursuant to 15A NCAC 02T .0105(d), submit a site map pursuant to the requirements in 15A NCAC 02T .0504(d]. These
requirements are:
❑ A scaled map of the site with topographic contour intervals not exceeding 10 feet or 25 percent of total site relief and showing
all facility -related structures and fences within the wastewater treatment, storage, and irrigation areas.
❑ Soil mapping units shown on all irrigation sites.
❑ The location of all wells (including usage and construction details if available), streams (ephemeral, intermittent, and
perennial), springs, lakes, ponds, and other surface drainage features within 500 feet of all wastewater treatment, storage,
and irrigation sites.
❑ Delineation of the compliance and review boundaries per 15A NCAC 02L .0107 and .0108, and 15A NCAC 02T .0506(c)
if applicable.
❑ Setbacks as required by 15A NCAC 02T .0506.
❑ Site property boundaries within 500 feet of all wastewater treatment, storage, and irrigation sites.
❑ All habitable residences or places of public assembly within 500 feet of all treatment, storage, and irrigation sites.
® No — Skip Attachment A.
ATTACHMENT B — SIGNATURE AUTHORITY DELEGATION PE
Does the signature authority in Section I, Item 3 meet the requirements pursuant to 15A NCAC 02T_0106t ha?
® Yes — Skip Attachment B.
❑ No — Submit a delectation letter pursuant to 15A NCAC 02T .0106ic E authorizing the signature authority to sign.
ATTACHMENT C —FLOW REDUCTION
Does the existing permit include an approved flow reduction?
❑ Yes — Submit a copy of the flow reduction approval letter, as well as the measured monthly average amount of wastewater flow
contributed per unit for the 12 months prior to permit renewal. If any of these monthly averages are within 20% of the approved
flow reduction value, the Permittee shall provide a reevaluation of the reduced flow value pursuant to the requirements in 15A
NCAC 02T .0114(t).
® No — Skip Attachment C.
ATTACHMENT D — CERTIFICATE OF PUBLIC CONVENIENCE AND NECESSITY
Is the Applicant a Privately -Owned Public Utility?
❑ Yes — Pursuant to 15A NCAC 02T .0115(a)(11, submit the Certificate of Public Convenience and Necessity from the North
Carolina Utilities Commission demonstrating the Applicant is authorized to hold the utility franchise.
® No — Skip Attachment D.
ATTACHMENT E — OPERATIONAL AGREEMENT
Is the Applicant a Home/Property Owners' Association or Developer of Lots to be Sold?
❑ Yes (Home/Property Owners' Association) —Pursuant to 15A NCAC 02T .0115(a)(2), submit an executed Operational AeTeement
LORM: HOAI. Pursuant to 15A NCAC 02T .0115(c), if the applicant is a legally formed Homeowners' or Property Owner's
Association, submit a copy of the Articles of Incorporation, Declarations, and By-laws.
❑ Yes (Developer of Lots to be Sold) — Pursuant to 15A NCAC 02T .0115(a)(2), submit an executed Operational Agreement
(FORM: DEV). Pursuant to 15A NCAC 02T .0115(bl, if the applicant is a developer of lots to be sold, submit a copy of the
Articles of Incorporation, Declarations, and By-laws.
® No — Skip Attachment E.
FORM: WWIS-R 02-21 Page 4 of 6

ATTACHMENT F — DEMONSTRATION OF FUTURE WASTEWATER TREATMENT CAPACITIES
N.
Is the applicant a municipality, county, sanitary district, or public utility?
❑ Yes — Proceed to the next question.
® No — Skip Attachment F.
Does the hydraulic capacity in Section III, Item 4 exceed 70%?
❑ Yes (the hydraulic capacity is greater than 70%, but less than 80%) — Pursuant to 15A NCAC 02T .011801, prior to exceeding
80 percent of the system's permitted hydraulic capacity (based on the average flow during the last calendar year), the permittee
shall submit an engineering evaluation of their future wastewater treatment, utilization, and disposal needs. This evaluation shall
outline plans for meeting future wastewater treatment, utilization, or disposal needs by either expansion of the existing system,
elimination or reduction of extraneous flows, or water conservation and shall include the source of funding for the improvements.
If expansion is not proposed or is proposed for a later date, a justification shall be made that wastewater treatment needs will be
met based on past growth records and future growth projections, and as appropriate, shall include conservation plans or other
measures to achieve waste flow reductions.
❑ Yes (the hydraulic capacity greater than 80%) — Proceed to the next question.
❑ No — Skip Attachment F.
If answered Yes above, does the hydraulic capacity in Section III, Item 4 exceed 80%?
❑ Yes (the hydraulic capacity is greater than 80%) — Pursuant to 15A NCAC 02T .0118(2 ), prior to exceeding 90 percent of the
system's permitted hydraulic capacity (based on the average flow during the last calendar year), the permittee shall obtain all
permits needed for the expansion of the wastewater treatment, utilization, or disposal system and, if construction is needed,
submit final plans and specifications for expansion, including a construction schedule. If expansion is not proposed or is proposed
for a later date, a justification shall be made that wastewater treatment needs will be met based on past growth records and future
growth projections, and as appropriate, shall include conservation plans or other specific measures to achieve waste flow
reductions.
❑ No — Skip Attachment F.
t _ ATTACHMENT G — EASEMENT, ENCROACHMENT, AND LEASE AGREEMENTS
Does the Permittee own all of the land associated with the wastewater collection, treatment, conveyance, and irrigation system?
® Yes — Skip Attachment G.
❑ No — Pursuant to 15A NCAC 02T .0116(c), provide a copy of all easements, lease agreements, and encroachment agreements
allowing the Permittee to operate and maintain the wastewater collection, treatment, conveyance, and irrigation system on
property not owned by the Permittee.
ATTACHMENT H — AFFILIATIONS
Are the Permittee's affiliations of record correct? Check affiliations.
® Yes — Skip Attachment H.
❑ No — Provide the corrected affiliations and their contact information.
ATTACHMENT I — COMPLIANCE SCHEDULES
Does the existing permit include any Compliance Schedules? (See Section I of the most recently issued permit)
❑ Yes — Submit documentation that the compliance schedules have been met.
® No — Skip Attachment I.
ATTACHMENT J — CIVIL PENALTIES AND OUTSTANDING VIOLATIONS
Does the Permittee have any existing civil penalties or outstanding violations?
❑ Yes (civil penalties) — Submit payment for the civil penalty, or proof of remission request.
❑ Yes (violations) — Submit a copy of your response to the Notice of Violation.
® No — Skip Attachment J.
FORM: WWIS-R 02-21 Page 5 of 6

ATTACHMENT K — INDUSTRIAL WASTEWATER
Does the wastewater composition in Section III, Item 5 include any industrial wastewater?
❑ Yes — Proceed to the next question.
ED No — Skip Attachment K.
Has the nature of the industrial wastewater changed since the last permit issuance (i.e., changes in industrial process, introduction of
new materials or chemicals, etc.)?
❑ Yes — Provide a chemical analysis of the wastewater pursuant to the requirements in 15A NCAC 02T .0504(h). Provide an
overview of the manufacturing process; an inventory of all chemical and biological materials used in the manufacturing process;
and an overview of the cleaning and treatment methodology.
❑ No — Provide an overview of the manufacturing process; an inventory of all chemical and biological materials used in the
manufacturing process; and an overview of the cleaning and treatment methodology.
fti ATTACHMENT L — SETBACK WAIVERS �� 1
Does the existing permit include setback waivers?
® Yes — Pursuant to 15A NCAC 02T .0506 d , provide setbacks waivers that have been written, notarized, signed by all parties
involved, and recorded with the county Register of Deeds. Waivers involving the compliance boundary shall be in accordance
with 15A NCAC 02L .0107.
❑ No — Skip Attachment L.
APPLICANT'S CERTIFICATION
I. Kraig Westerbeek attest that this application
(Signature authority's name as noted in Section 1, Item 3)
has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that if all required parts of this
application package are not completed, and that if all required supporting information and attachments are not included, this
application package will be returned as incomplete. I further certify pursuant to 15A NCAC 02T .0120(b). that the applicant, or any
parent, subsidiary, or other affiliate of the applicant has: not been convicted of environmental crimes under; not previously abandoned
a wastewater treatment facility without properly closing the facility; not paid a civil penalty; not been compliant with any compliance
schedule in a permit, settlement agreement, or order; not paid an annual fee.
Note: The Applicant's Certification shall be signed pursuant to 15A NCAC 02T .0106(b). An alternate person maybe delegated as
the signing official if a letter is provided pursuant to 15A NCAC 02T .0106(c). Pursuant to § 143-215.6A. and § 143-215.613, any
person who knowingly makes any false statement, representation, or certification in any application package shall be guilty of a Class
2 misdemeanor, may include a e not to exceed $10,000 as well as civil penalties up to $25,000 per violation.
Signature: Date:
THE COMP ETED rPLICATION AND ATTACHMENTS SHALL BE SUBMITTED AS A SINGLE PDF FILE VIA:
Email: Laserfiche Upload:
Non-DischarQe.Reoortsfa ncdenr.Eov httos://edoes.deu.ne.gov/Forms/NonDischaree-Branch-
Submittal-Form-Ver2
FORM: WViTIS-R 02-21 Page 6 of 6

111111111111111111111 N
Doc No: 10009095
Recorded: 10262016 03:05:18 PM
Fee Amt S26.00 Page t of 3
Duplin County North Carolina
Davis H. Brinson, Register of Deeds
BK 1836 PG 676 - 678 (3)
State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
NON -DISCHARGE WASTEWATER SYSTEM WAIVER
(7'HISFORMM,4YBE PHOTIOCOPIED FOR USEAS"ORIGINAL)
The Division of Water Resources will not consider this form complete unless all instructions are followed- Failure
to follow lastruetiona or to submit all required items will lead to additional processing and review time.
For more in0bromfon or for an elaclronie version of iNs fans, visit our web site at.
hit p_//part�rgiieehfwq/curs/!au/anvlications
INSTRUCTIONS TO THE APPLICANT:
✓ Do not submit this form for review without a corresponding Non -Discharge Permitting Unit application form.
✓ Any changes to this form will result in the application package being returned.
✓ Any other setbacks required by 15A NCAC Subchapter 02T other than those referenced below, cannot be waived
through execution of this form.
✓ A copy of the completed and appropriately executed form must be provided to the property owner.
AGREEMENT TO WAIVE SETBACKS AS REQUIRED BY
15A NCAC 02T .0506(s} .0506(b), .0606(a), .0706(a) and .1006(a)
The undersigned property awner(e) hereby permits:
Applicant's name: Mtwpkgftw, LLC
Complete mailing address of applicant:
City: . Warsaw
Telephone number: S�_) 291-34U
P.O. Box $58 2622 Hwy 24 v4lest
State: North Carolina Zip: 28M
Hereinafter referred to as the Permtttee, to (check all that apply):
® Noe -Discharge disposal of wastewater effluent within 0
Facsimile number: 910 293.3138
feet of the property line,
❑ Non -Discharge disposal of wastewater effluent witbin feet of the identified residence,
❑ Construct treatment and storage twits witbin feet of the property line,
❑ Construct treatment and storage units within feet of the ideadfied residence.
FORM: NDWSW 11-13 Page 1 of 2
IV

® I certify that I am a deeded property owner of above -referenced property and am authorized to make decisions
regarding this property on behalf of other deeded property owners. Furthermore, I certify that I have read and
understand this Agreement and do hereby grant permission to the Permittee to dispose of wastewater effluent or
construct wastewater treatment units as specified herein. I further a%MLdpt_oon the Division of Water Resources's
issuance of a hermit for the sUbb'ect non-discharge-"vm,. I will record this waiver form with the appropriate Register
of ids and provide the Permittee and Division of Water Resources with documentation of such.
Property owners ): Mettthem Family pmtkn. tic
Signature: L , 17�,4,V4 4'F...: Date: i - &0 - � h
Signature: Date:
NORTH CAROLiNA, COUNTY
1, , a Notary Public for
do hereby certify that
V l/1* 4 aAWl . County, North Carolina,
personally appeared before me this day and
acknowledged the due execution of the foregoing instrument,
Witness my hand and official seal this the 3001 day of �
A. Tti "'r
-
��R� 2�'t.:, S re of Notary Public
Comm. g
'
v.
y r 1-12-yn
" My commission expires
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COUN
FORM: NDWSW 11-13 Page 2 of

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