WQ0034380_Monitoring - 03-2024_20240430

Monitoring Report Submittal
...................................................
Permit Number#* WQ0034380
Name of Facility:* Sanderson Farms LLC, Kinston Processing Facility
Month: * March Year: * 2024
Report Information
Type *
NDMR, NDAR-1, NDAR-2, NDMLR
Upload Document*
NDAR NDMLR NDMR March 2024.pdf
PDF Only
1.27MB
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 Franklin
Signature:
�/itl�pF W. 11"AA11 r
Date of submittal: 4/30/2024
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: 6/7/2024

FORM: NDAR-1 07-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page
4—of
Permit No.: WQ0034380
Facility Name: Sanderson Farms -Kinston Facility
County: Lenoir
Month- March
Did irrigation
1•�
����
occur
at this facility?
Hourly Rate (in):!
Annual Rate (in):
....
..
o ■.
..
o ■.
..
a' ■.
Field Irrigated?:o
■.
MO=O
mmmo
Monthly Loading:,
gyms ml��Imm
fffflwimwm�
12 Month Floating Total (in):

FORM: NDAR-1 07-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page Z of 5
Permit No.: 1111 :I
Facility Name: Sanderson Farms-Kinston.unty:
Lenoir
Month:1
irrigation
. - .Field
• occur
Area (acres):
Area (acres):
c.
at this facility?
Cover Crop:
Cover Crop:
PIYES ■ •
-.
•
-.
. -.
-.
-
••■
..
...
..
p •Field
Irrigated?p
■ •
..
p■�
..
p ■ •
'
:
:
RIM MI,
12 Month Floating -Total (-in)-:

FORM: NDAR-1 07-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page 3 of 5
Permit No.: WQ0034380
Facility Name: Sanderson Farms -Kinston Facility
County: Lenoir
Month: March
irrigation
• occur
Area (acres):
at this facility.
I'm
Cover Crop:
��■�IZFIQM.
Rate
:-
-
-
-
-
®omM��
Monthly Loading:
- M,��Nmjsw
Me

FORM: NDAR-1 07-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page L'I of
Permit No.: WQ0034380
Facility Name: Sanderson Farms -Kinston Facility
County: Lenoir
Month: March
1
Did irrigation
Field Name:
�amrwguma
occur
Area ®at
�
11;WNEVE"
.�.�
Area (acres):
this facility?
Cover Crop:
Cover Crop:'
Mj YES F-INO
Ho urly Rate (in).
Hourly Rate (in):
� 1Annual
Rate (in):
...
FieldIrrigated?0
■ •
..
■■ •
•. •
■��Field
.. •.
■i ■ �•
®m®m®-
all
��
Monthly• . • •
12 Month Floating TM-1

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?
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?
❑� Compliant ❑Non -Compliant
QCompliant ❑Non -Compliant
Compliant ❑Non -Compliant
❑✓ Compliant ❑Non -Compliant
❑✓ Compliant ❑Nan -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: Complex Manager
Has the ORC changed since the previous NDAR-1? ❑Yes PlNo
Phone Number: 252-522-9145 ext 4105 Permit Exp.: 12/31/26
� � 4
()�2
Signature Date
Signature , ate
7oflaw,
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
I certify, under pena 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: NDMLR 07-11 NON -DISCHARGE MASS LOADING REPORT (NDMLR) Page / of y
Permit No.: WQ0034380
Facility Name:
Sanderson Farms
-Kinston Facility
County:
Lenoir
Month:
March
Year: 2024
Field Name:
1A
Field Name:
1B
Field Name:
2A
Field Name:
2B
Field Name:
3A
Area (acres):
22.4
Area (acres):
8.81
Area (acres):
22.4
Area (acres):
10.4
Rye
PAN
Area (acres):
Cover Crop:
Load Type:
24
PINES
PAN
Cover Crop:
Rye
Cover Crop:
Rye
Cover Crop:
Rye
Cover Crop:
Load Type:
Loaded?
PAN
DYES ❑No
Load Type:
Field Loaded?
PAN
DYES ❑No
Load Type:
Field Loaded?
PAN
❑✓ YES ❑NO
Load Type:
Field Loaded?
❑YES [-]NO
Field Loaded
❑YES ❑NO
LE
m .``�a
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April 1,600,510
May 4,174,963
June 3,299,166
July 3,265,267
August 3,715,481
September 3,827,707
October 3,331,193
November 3,654,260
December 3,081,567
January 4,423,258
February 3,283,021
March 4oatin 68
12 Month Floating PAN
14.05
17.69
12.29
19.84
14.02
10.83
12.38
11.13
13.71
21.02
12.49
20.2
Load
Ibs/ac
8.4
27.5
15.1
24.1
19.4
15.4
15.4
15.1
15.7
34.6
15.3
35.0
Ibs/ac
8.4
35.9
51.0
75.1
94.5
109.9
125.3
140.4
156.1
190.8
206.0
241.1
gal mg/L
1 629,486 14.05
1,642,028 17.69
1,297,573 12.29
1,284,240 19.84
1,461,312 14.02
0 10.83
0 12.38
0 11.13
0 13.71
0 21.02
0 12.49
684,839 20.2
Ibs/ac
8A
27.5
15.1 "
24.1
19.4
0.0
0.0
0.0
0.0
0.0
0.0
13.1
Ibs/ac
8.4
35.9
51.0
75.1
94.5
94.5
94.5
94.5
94.5
94.5
94.5
107.6
gal mg/L Ibs/ac
1997173 14.05 10.4
3683784 17.69 24.3
3842546 12.29 17.6
3295956 19.84 24.3
3362660 14.02 17.6
2588480 10.83 10.4
39 24216 12.38 18.1
3201399 11.13 13.3
3244514 13.71 16.6
3904396 21.02 30.6
2485819 12.49 11.6
3247301 20.2 24.4
Ibs/ac
10.4
34.7
gal
0
0
mg/L
14.05
17.69
ibs/ac
0.0
0.0
Ibs/ac
0.0
0.0
gal
3,824,770
4,525,776
mg/L
14.05
17.69
Ibs/ac
18.7
27.8
Ibs/ac
18.7
46.5
52.3
76.6
94.2
104.6
122.7
136.0
152.5
183.1
194.7
219.1
0
737528
1561235
1201794
1821959
1486364
1506382
1812755
1154131
12.29
19.84
14.02
10.83
12.38
11.13
13.71
21.02
12.49
0.0
11,7
17.6
10.4
18A
13.3
16.6
30.6
11.6
0.0
11.7
29.3
39.7 -
57.8
71.1
87.6
118.2
129.8
4,117,013
4,765,695
3,602,849
12.29
19.84
14.02
17.6
32.9
17.6
64.1
96.9
114.5
3,927,872
10.83
14.8
129.3
4,204,518
3,988,612
12.38
11.13
18.1
15.4
147.4
162.8
3,476,266
4,183,281
2,663,379
13.71
21.02
12.49
16.6
30.6
11.6
179.3
209.9
221.5
1507675 20.2
24.4
154.2
3,479,251 20.2
24.4
245.9
(Ibs/ac/yr):
241.1
8318
107.6
219.1
154.2
245.9
Annual PAN Load Limit
(Ibs/ac/yr):

FORM: NDMLR 07-11 NON -DISCHARGE MASS LOADING REPORT (NDMLR) Page L._ of Li(
Permit No.:
W00034380
Facility Name:
Sanderson Farms
-Kinston Facility
County:
Lenoir
Month:
March
Year: 2024
Field Name:
3B
Field Name:
4A
Field Name:
4B
Field Name:
5A
Field Name:
56
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:
Rye
Cover Crop:
PINES
Cover Crop:
Rye
Cover Crop:
Rye
Load Type:
PAN
Load Type:
PAN
Load Type:
PAN
Load Type:
PAN
Load Type:
PAN
Loaded?
EYES EINo
Field Loaded?
YES ❑No
Field Loaded?
OYES �No
Field Loaded?
DYES ❑No
Field Loaded?
EYES �NO
JrField
Month
gal
150,483
565,539
z C
o
a.
m�
m
U
a U
mg/L
14.05
17.69
z
¢
a o
co
w O
-j
=
Ibs/ac
5.0
23.8
17.6
32.9
17.6
14.8
18.1
15.4
16.6
0.0
9.2
24.4
195.2
>
� o
J
�z
E
a
U a
Ibs/ac
5.0
28.8
46.4
79.2
96.8
111.6
129.7
145.1
161.E
161.6
170.8
195.2
d C
_ zz
QQ ¢ ;.
a ° w
¢ m
a) me
df
E V
O ¢ V
gal mg/L
3,714,908 17.69
3,379,383 12.29
3,911,841 19.84
2,957,340 14.02
2,820,396 10.83
2,816,139 12.38
3,273,986 11.13
2,853,434 13.71
2,853,434 13.71
3,433,778 21.02
2,186,1891 12.49
2,855,886 20.2
a
a v
o
..�
= .J
Ibs/t
27.
17.
32.
17.
12.9
14.8
15.4
16.6
16.6
30.6
11.6
24.4
238.E
m 0
to `0o
:3
z
E
V a
108.7
123.5
138.9
155.5
172.1
202.E
214.2
238.6
CD
Q
a
a
d
6
gal
1,534,992
988,944
0
0
0
0
0
0
0
321,791
903,328
1,180,046
z
O
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April
mg/L
17.69
12.29
19.84
14.02
10.83
12.38
11.13
13.71
13.71
21.02
12.49
20.2
Ibs/ac
27.8
12.5
0.0
0.0
0.0
0.0
0.0
0.0
0.0
6.9
11.6
24.4
g3 .2
Ibs/ac
27.8
40.3
40.3
40.3
40.3
40.3
40.3
40.3
40.3
47.2
58.8
83.2
gal mg/L
4,951,777 14.05
2,086,851 17.69
4,128,300 12.29
4,067,004 19.84
4,370,263 1A W)
4,767,545 10.83
4,237,145 12.38
4,168,109 11.13
3,838,202 13.71
5,509,325 21.02
3,359,095 12.49
5,801,541 20.2
Ibs/ac
20.4'
10.8 `
14.8
23.6
17.9
15.1
15.4
13.6
15.4
33.9
12.3
Ibs/ac
20.4
31.2
46.0
69.6
87.6
102.7
118.0
131.6
147.0
'180.9
193.2
F::gal
0
0
0
0
176,535
239,231
212,617
009,153
192,599
276,453
168,557
mg/L
14.05
17.69
12.29
19.84
14.02
10.83
12.38
11.13
13.71
21.02
12.49
Ibs/ac
0.0
0.0
0.0
0.0
14.7
15.4
15.7
13.9
15.7
34.6
12.5
Ibs/ac
0.0
0.0
0.0
0.0
14.7
30.2
45.9
59.7
75.5
110.1
.E
12222.6
May
June
602114
12.29
July
696,983
19.84
August
526,917
14.02
September
574,451
10.83
October
614,910
12.38
November
December
January
February
March
12 Month
583,334 11.13
508,403 13.71
0 21.02
309,151 12.49
508,840 20.2
Floating PAN Load
(Ibs/ac/yr):
34.3
227.4
227.4
291,118
20.2
35.0
157.6
1
Annual
PAN Load Limit
(Ibs/ac/yr):

FORM: NDMLR 07-11 NON -DISCHARGE MASS LOADING REPORT (NDMLR) Page of
Permit No.: WQ0034380
Facility Name: Sanderson Farms -Kinston Facility
County: Lenoir
Month: March
Year: 2024
Field Name:
6
Field Name:
7
Field Name:
8A
Field Name:
8B
Field Name:
9
Area (acres):
30
Area (acres):
29.6
Area (acres):
22.8
Area (acres):
1.84
Area (acres):
16.2
Cover Crop:
Rye
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?
❑� YES [:]NO
Field Loaded?
DYES EINO
Field Loaded?
DYES ❑No
Field Loaded?
121YES ❑NO
Field Loaded?
❑' YES AND
m
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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
mglL
lbs/ac
Ibs/ac
April
4358974
14.05
17.0
17.0
5,006,474
14.05
19.8
19.8
3,856,339
14.05
19.8
19.8
311,214
14.05
19.8
19.8
2,875,227
14.05
20.8
20.8
May
3044955
17.69
15.0
32.0
5,528,899
17.69
27.6
47.4
4,258,745
17.69
27.6
47.4
343,689
17.69
27.6
47.4
2,061,868
17.69
18.8
39.6
June
4922721
12.29
16.8
48.8
4,857,084
12.29
16.8
64.2
3,741,267
12.29
16.8
64.2
301,927
12.29
16.8
64.2
2,759,961
12.29
17.5
57.0
July
3171652
19.84
17.5
66.3
4,366,518
19.84
24.4
88.6
3,363,397
19.84
24.4
88.6
271,433
19.84
24.4
88.6
2,361,487
19.84
24.1
81.2
August
4610155
14.02
18.0
84.3
4,824,375
14.02
19.1
107.7
3,716,074
14.02
19.1
107.7
299,894
14.02
19.1
107.7
2,891,9151
14.02
20.9
1 102.0
September
4511752
10.83
13.6
97.9
5,141,321
10.83
15.7
123.4
3,960,206
10.83
15.7
123.4
276,721
10.83
13.6
121.2
2,735,5211
10.83
15.3
1 117.3
October
3511145
12.38
12.1
109.9
4,130,368
12.38
14.4
137.8
3,181,501
12.38
14.4
137.8
0
12,38
0.0
1 121.2
2,829,2921
12.38
18.0
1 135.3
November
4707028
11.13
14.6
124.5
4,644,269
11.13
14.6
152.3
3,082,704
11.13
12.6
150.3
0
11.13
0.0
121.2
2,756,782
11.13
15.8
151.1
December
4198907
13.71
16.0
140.5
4,142,922
13.71
16.0
168.3
3,191,169
13.71
16.0
166.3
0
13.71
0.0
121.2
2,228,633
13.71
15.7
166.8
January
4521846
21.02
26.4
166.9
4,461,552
21.02
26.4
194.7
3,436,603
21.02
26.4
192.7
0
21.02
0.0
121.2
3,198,963
21.02
34.6
201.5
February
4245873
12.49
14.7
181.7
4,189,262
12.49
14.7
209.5
3,226,863
12.49
14.7
207.5
0
12.49
0.0
121.2
2,374,328
12.49
15.3
216.7
March
3599635
20.2
20.2
201.9
3,551,640
20.2
20.2
229.7
2,735,723
20.2
20.2
1 227.7
IFO
20.2
0.0
121.2
3,368,636
20.2
35.0
251.8
12 Month Floating PAN Load
201 9
229.7
227.7
121.2
251.8
(Ibsyr):
Annual PAN Load Limit
(Ibs/ac/yr):

FORM: NDMLR 07-11 NON -DISCHARGE MASS LOADING REPORT (NDMLR) Page �I of_�t_
Did the mass loading rates exceed the limits in Attachment B of your permit? QCompliant ❑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, LLC
Certification Number: WW1012108T/SI1012364 Signing Official:
Jared Lowe
Grade: 3 Phone Number: 252 902 8906 Signing Officials Title: Complex Manager
Has the ORC changed since the previous NDMLR? ❑Yes E]No Phone No.: 252-522-9145 ext 4105 Permit Exp.: 12/31 /26
Signature Date Signature ate
By this signature, I certify that this report is accurrate and complete to the best of my knowledge. I cee,und/eralty
law, that this document and all attachments were prepared under my direction or supervision in
system designed to assure that all qualified personnel properly gathered and evaluated the
information ildbmitted. 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. 1 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 _I of�
Permit No.: W00034380
Facility Name: Sanderson Farms -Kinston Facility
County: Lenoir
Month: March
Year: 2024
PPI' 001
Flow Measuring Point: ❑Influent QEffluent ❑No flow generated
Parameter Monitoring Point ❑Influent ❑� Effluent ❑Groundwater Lowering ❑surface water
Parameter Code -►
50050
00310
00916
00940
31616
00927
00610
00625
00620
00600
00400
00665
WQ09C
00931
00929
70300
d
F-
O
c
O
E w
_
~
3U
m
O
d
U
0U£wm
w
L Ca
to
4)
C)
2
is
s
Qp
c
M0
Ym
0
t
�
E
c
O)
r
I— =
Z
O
aO
m e
m
cc
a.
Z
c
? Qo
=
a
N
Yta
> oU
QNt6
NZ
24-hr
hrs
GPD
mg/L
mg/L
mg/L
#/100 mL
mg/L
mg1L
mg/L
mg/L
mg/L
su
mg/L
mg/L `'
Ratio
mg/L
mg/L
1
07:00
10
1,022,000
3
1
1.66
5
21.6 <
26.7
6.8
11.9
" 23.5
2
07:00
10
1,059,000
3
07:00
8
951,000
4
07:00
10
725,000
7.0
5
07:00
10
755,000
3
9.99
87
2
5.46
1.66
6.6
19.7
26.4
6.9
17.7
22.1
11.4
181
711
6
07:00
10
760,000
6.8
7
07:00
10
762,000
2
1 :
0.1
3.3
13.2
16.7
6.9
19.3
14.4
8
07:00
10
1,101,000
6.9
9
1,313,000
101
07:00
8
1,220,000
111
07:00
10
1 734,000
6.8
12
07:00
10
733,000
2
1
1.11
3.3
13.6
17
6.8
19.4
14.9'
13
07:00
10
769,000
6.8
14
07:00
10
869,000
2
1
1.66
1.7
2.45
4.2
6.8
18.4
3.4
15
07:00
10
990,000
6.8
16
960,000
171
1,000,000
181
07:00
10
796,000
6.9
191
07:00
10
732,000
2
4
18.8
22.7
0.02
22.7
6.9
0.04
10.6
20
07:00
10
716,000
6.9
21
07:00
10
"'728,000
2
1
1.11
5.5
29A ''`
35
6.7
18.6
31.4r
22
07:00
10
731,000
6.8
23
829,000
24
870,000
251
07:00
10
682,000 "
6.7
26
07:00
10
815,000
2
2
0.55
6.6
24.7' `
31.4
6.8
23.9
26.9'
27
07:00
10
855,000
6.8
28
07:00
10
788,000
2
2 `
0.1
6.1
32.6
38.8
6.8
21
34.6
29
07:00
10
772,000 ,
6.8
30
850,000
311
1,080,000
Average:
869,903
2.22
9.99
87.00
1.47 '
5.46
2.97
6.76
17.47`'
24.32
16.69
20.20
11.40
181.00
711.00
Daily Maximum:
1,313,000
3.00
1 9.99
87.00
4.00
5.46
18.80 1
22.70
32.60
38.80
1 7.00
23.90
34.60'1
11.40
181.00
711.00
Daily Minimum:
682,000
2.00
9.99
87.00
1.00
5.46
0.10
1.70
0.02
4.20
1 6.70
0.04
3.40
11.40
181.00 ''
711.00
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:1
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 -2— of_�L
Permit No.: Q11 :1Facility
Name: Sanderson Farms-Kinston.unty:
Lenoir
Month:1
INN

FORM: NDMR 07-11 NON -DISCHARGE MONITORING REPORT (NDMR) Page 3 Of_�L
Permit No.: WQ0034380
Facility Name: Sanderson Farms -Kinston Facility
County: Lenoir
Month: March
Dail
Daily Minimum:

FORM: NDMR 07-11 NON -DISCHARGE MONITORING REPORT (NDMR) Page � of
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? ❑� 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.
3/5/24 BOD sample estimated. Did not meet quality control requirements. Blank result 0.36 mg/L, above acceptable limit of 0.2
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: Complex Manager
Has the ORC changed since the previous NDMR? ❑Yes E]No Phone Number: 252-522-9145 ext 4105 Permit Expiration: 12/31/2026
11 // lq(�
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
Signature pate
I rt fy, u er penalty of law, that this document and all attachments were prepared under my direction or supervision in
ccorda e with a system designed to assure that all qualified personnel property gathered and evaluated the information
submitted. Based on my,
y 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