WQ0014785_Monitoring - 08-2024_20240912

Monitoring Report Submittal
Permit Number#* WQ0014785
Name of Facility:* Midway Middle School
Month: * August Year: * 2024
Report Information
Type* Upload Document*
NDMR, NDAR-1, NDAR-2, NDMLR Aug 2024.pdf 4.24MB
PDF Only
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: * Robert Carroll
Signature:
Roped cC3,4roll
Date of submittal: 9/12/2024
This will be filled in automatically
Initial Review
Reviewer: Wanda.Gerald

Is the project number correct?* WQ0014785
Is the monitoring report accepted?* Yes No
Regional Office* Fayetteville
Reviewer: _anonymous
Review Date: 10/10/2024

FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page
Permit No.: VVQ0014785
Facility Name: Midway Middle School
County: Sampson
Month: August
Year: 2024
Did irrigation occur
Field Name:
1
Field Name:
2
Field Name:
3
Field Name:
4
at this facility?
Area (acres):
0.435
Area (acres):
0.435
Area (acres):
0.435
Area (acres):
0.435
Cover Crop:
Cover Crop:
Cover Crop:
Cover Crop:
Li YES 7 NO
Hourly Rate (in):
0.16
Hourly Rate (in):
0.16
Hourly Rate (in):
0.16
Hourly Rate (in):
0,16
Annual Rate (in):
39
Annual Rate (in):
39
Annual Rate (in):
39
Annual Rate (in):
39
Weather
Freeboard
Field Irrigated?
❑YES ONO
Field Irrigated?
DYES ❑NO
Field Irrigated?
OYES ONO
Field Irrigated?
DYES ❑No
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in
ft
ft
gal
min
in
in
gal
min
in
in
gal
min
in
in
gal
min
in
in
1
C
94
5
5
5
5
5
5
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
2
PC
88
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1.250
20
0,11
0.11
3
C
84
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
4
PC
84
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
5
C
78
1.250
20
0.11
0.11
1,250
20
0.11
0.11
1.250
20
0.11
0.11
1,250
20
0.11
0.11
6
CL
74
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
7
R
5
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
8
R
5
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
9
R
5
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
101
R
5
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
11
C
5
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0,00
12
CL
5
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0,00
0.00
13
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5
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
14
C
5
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
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0
0
0.00
0.00
15
C
5
0
0
0.00
0.00
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0.00
0.00
0
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0.00
0.00
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0
0.00
0.00
16
CL
5
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
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0.00
0.00
17
C
79
5
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
18
C
84
5.5
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0,11
19
C
87
5.5
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
20
C
83
5.5
1,250
20
0.11
0.11
1,250
20
0.11 1
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
21
C
82
5.5
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
22
PC
81
5.5
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
23
PC 1
83
1
5.5
1,250
20
0.11
0.11
1,250
20
0,11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
24
C
84
5.5 1
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
25
C
85
5.5
1,250
20
0.11
0.11
1.250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
26
C
88
5.5
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
27
C
91
5.5
1,250 1
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0,11
0.11
1,250
20
0.11
0.11
28
C
94
5.5
1.250 1
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
29
PC
94
5.5
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
30
CL 1
92 1
1
5.5 1
1,250
20
0.11 1
0.11 11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
31
CL
91
5.5
1,250
20
0.11
0.11
1,250
0.11
1,250
20
0.11
#REF!
1,250
20
0.11
0.11
Monthly Loading:
26,250
2.22
26,250jj;2
k101
26,250
2.22
26,250
2.22
12 Month Floating Total (in):
7.41
1
7.41
7.41

FORM: NDAR-1 08-11 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?
91 Compliant ❑ Non -Compliant
O Compliant ❑ Non -Compliant
O Compliant ❑ Non -Compliant
121 Compliant ❑ Non -Compliant
O 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: Robert Carroll
Permittee:
SAMPSON COUNTY SCHOOLS
Certification No.: 26341
Signing official: Robert Carroll
Grade: SI Phone Number: 910-385-6116
Signing Official's Title: ORC
Has the ORC changed since the previous NDAR-1? ❑yes oNo
Phone Number: 910-385-6116 Permit Exp.: 10/31/28
,ai22a / 9/12/24
4M,,12v 9/12/24
Signature Date
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
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

FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page
Permit No.: WQ0014785
Facility Name: Midway Middle School
County: Sampson
Month: August
Year: 2024
Did irrigation occur
Field Name:
5
Field Name:
6
Field Name:
7
Field Name:
8
at this facility?
Area (acres):
0.435
Area (acres):
0.435
Area (acres):
0.436
Area (acres):
0.435
Cover Crop:
Cover Crop:
Cover Crop:
Cover Crop:
n YES L.NO
Hourly Rate (in):
0.16
Hourly Rate (in):
0.16
Hourly Rate (in):
0.16
Hourly Rate (in):
0.16
Annual Rate (in):
39
Annual Rate (in):
39
Annual Rate (in):
39
Annual Rate (in):
39
Weather
Freeboard
Field Irrigated?
7YES ❑No
Field Irrigated?
AYES El NO
Field Irrigated?
BYES ❑NO
Field Irrigated?
❑YES ONO
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in
in
gal
min
in
in
1
C
94
5
1,250
20
0.11
0.11
1,250
20
0.11
0.11
17250
20
0.11
0.11
1,250
20
0.11
0.11
2
PC
88
5
1,250
20
0.11
0.11
1,250
20
0.11
0,11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
3
C
84
5
1,250
20
0.11
0.11
1,250
20
0.11
0,11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
4
PC
84
5
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
5
C
78
5
1,250
20
0.11
0,11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
6
CL
74
5
1,250
20
0.11
0,11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0,11
7
R
5
0
0
0.00
0.00
0
0
0.00
1 0.00
0
0
0.00
0,00
0
0
0.00
0.00
8
R
5
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
000
9
R
5
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0,00
101
R
5
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
11
C
5
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
12
CL
5
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
13
C
5
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
14
C
5
0
0
0.00
0.00
0
0
0,00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
15
C
5
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
16
CL
5
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
17
C
79
5
1,250
20 1
0,11
0.11
1,250
20
0.11
0.11
1,250
0
0.11
0.11
1,250
0
0.11
0.11
18
C
84
5.5
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
0
0.11
0.11
1,250
0
0.11
0.11
19
C
87
5.5
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
0
0.11
0.11
1,250
0
0.11
0.11
20
C
83
5.5
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
0
0.11
0.11
1,250
0
0.11
0.11
21
C
82
5.5
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
0
0.11
0.11
1,250
0
0.11
0.11
22
PC
81
5.5
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
0
0.11
0.11
1,250
0
0.11
0.11
23
PC
83
5.5
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
0
0.11
0.11
1,250
0
0.11
0.11
24
C
84
5,5
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1.250
0
0.11
0.11
1,250
0
0.11
0.11
25
C
85
5.5
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
0
0.11
0.11
1,250
0
0,11
0.11
26
C
88
5.5
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
0
0.11
0.11
1,250
0
0.11
0,11
27
C
91
5.5
1,250
20
0.11
0.11
1,250
20
0.11
0,11
1,250
0
0.11
0.11
1,250
0
0.11
0.11
28
C
94
5.5
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
0
0.11
0.11
1,250
0
0.11
0.11
29
PC
94
5.5
1,250
20
0.11
0.11
1,250
20
0.11
0.11
11250
0
0.11
0,11
1,250
0
0.11
0.11
30
1311CL
CL
92
5.5
1.250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
0
0.11
0.11
1,250
F-0-1
0.11
0.11
91
5.5
1,250
20
0,11
0.11
1,250
20
0.11
0.11
1,250
0
0.11
0.11
1,250
0
0.11
Monthly Loading:
26,250
2.22
26,250
2.22
26,250
2.22
26,250
f22
12 Month Floating Total (in):
7.41
7.41
7.41

FORM: NDAR-1 08-11 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?
O Compliant ❑ Non -Compliant
O Compliant ❑ Non -Compliant
O Compliant ❑ Non -Compliant
O Compliant ❑ Non -Compliant
O 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: Robert Carroll
Permittee:
SAMPSON COUNTY SCHOOLS
Certification No.: 26341
Signing Official: Robert Carroll
Grade: SI Phone Number: 910-385-6116
Signing Official's Title: ORC
Has the ORC changed since the previous NDAR-1? ❑ves oNo
Phone Number: 910-385-6116 Permit Exp.: 10/31/28
r-2b 1) 9/12/24
V
9/12/24
Signature Date
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
I certify, under penally 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 property 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

FORM: NDMLR 08-11 NON -DISCHARGE MASS LOADING REPORT (NDMLR) Page
Permit No.: WQ0014785
Facility Name: Midway Middle School
County: Sampson
Month: August
Year: 2024
Field Name:
1
Field Name:
2
Field Name:
3
Field Name:
4
Field Name:
5
Area (acres):
0.435
Area (acres):
0.435
Area (acres):
0,435
Area (acres):
0.435
Area (acres):
0.435
Cover Crop:
Cover Crop:
Cover Crop:
Cover Crop:
Cover Crop:
Load Type:
PAN
Load Type:
PAN
Load Type:
PAN
Load Type:
PAN
Load Type:
PAN
Field Loaded?
O YES ❑ No
Field Loaded?
El YES ❑ No
Field Loaded?
❑ YES ❑ No
Field Loaded?
❑ YES ❑ No
Field Loaded?
❑ YES ❑ No
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Month
gal
mg/L
Ibs/ac
Ibslac
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
September
October
November
December
January
February
March
April
May
June
July
August
26,250
9.29
4.7
4.7
26,250
9.29
4.7
4.7
26.250
9.29
4.7
4.7
26.250
9.29
4.7
4.7
26,250
9.29
4.7
4.7
12 Month Floating PAN Load
(Ibs/ac/yr):
4.7
4.7
4.7
4.7
4.7ME
Annual PAN Load Limit
(Ibslac/yr):
15.7
15.70
15.70
15.7 1
15.70

FORM: NDMLR 08-11 NON -DISCHARGE MASS LOADING REPORT (NDMLR) Page of
Did the mass loading rates exceed the limits in Attachment B of your permit? 10Compliant ❑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: Robert Carroll Permittee: SAMPSON COUNTY SCHOOLS
Certification Number: 26341 Signing Official: Robert Carroll
Grade: SI Phone Number: 910-385-6116 Signing Official's Title: ORC
Has the ORC changed since the previous NDMLR? []Yes 121 No Phone No.: 910-385-6116 Permit Exp.: 10/31/28
a
Signature
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
9/12/24 9/12/24
Date Signature Date
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 property 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 08-11 NON -DISCHARGE MASS LOADING REPORT (NDMLR) Page
Permit No.: WQ0014785
Facility Name: Midway Middle School
County: Sampson
Month: August
Year: 2024
Field Name:
6
Field Name:
7
Field Name:
8
Field Name:
Field Name:
Area (acres):
0.435
Area (acres):
0.435
Area (acres):
0.435
Area (acres):
Area (acres):
Cover Crop:
Cover Crop:
Cover Crop:
Cover Crop:
Cover Crop:
Load Type:
PAN
Load Type:
PAN
Load Type:
PAN
Load Type:
Load Type:
Field Loaded?
O YES ❑ NO
Field Loaded?
❑ YES ❑ No
Field Loaded?
o YES ❑ NO
Field Loaded?
❑ YES 0 NO
Field Loaded?
❑ YES Ll NO
o
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Month
gal
mg/L
Ibslac
Ibslac
gal
mglL
Ibs/ac
Ibslac
gal
mg/L
Ibs/ac
Ibslac
gal
mg/L
Ibslac
Ibslac
gal
mg/L
Ibslac
Ibslac
September
October
November
December
January
February
March
April
May
June
July
�26,250
August
9.29
4.7
4.7
26,2itl
7
4.7
26,250
9,29
4.7
4.7
12 Month Floating PAN Load
(Ibslac/yr):
47
7
4.7
0.0
0.0
W///,�
Annual PAN Load Limit
(Ibs/aclyr):
15.7
70
15.70

FORM: NDMLR 08-11 NON -DISCHARGE MASS LOADING REPORT (NDMLR) Page 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 Permittee Certification
ORC: Robert Carroll Permittee: SAMPSON COUNTY SCHOOLS
Certification Number: 26341 Signing Official:
Robert Carroll
Grade: SI Phone Number: 910-385-6116 Signing Official's Title: ORC
Has the ORC changed since the previous NDMLR? ❑Yes 2 No Phone No.: 910-385-6116 Permit Exp.: 10/31/28
Signature
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
9/12/24 / 9/12/24
Date Signature Date
I certify, under penally 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

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page
Permit No.: W00014785
Facility Name: Midway Middle School
County: Sampson
Month: August
Year: 2024
PPI: 001
Flow Measuring Point: L] Influent L. Effluent ❑ No flow generated
Parameter Monitoring Point: ❑ Influent I] Effluent El Groundwater Lowering [-J surface water
Parameter Code 0
50050
00400
00625
00310
00610
00530
31616
00665
00620
WQ09
00940
00600
70300
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24-hr
hrs
GPD
su
mg/L
mg/L
mg/L
mg/L
#/100 mL
mg/L
mg/L
mg/L
mg/L
mg/L
mg/L
1
71
2
71
3
71
4
71
5
414
6
414
7
414
8
414
9
414
10
414
11
414
12
343
13
343
14
343
15
343
16
343
17
343
18
343
19
514
20
514
21
514
22
514
23
514
24
514
25
514
26
17,300
27
17,300
28
17,300
29
17,300
30
17,300
31
17,300
Average:
3,645
Daily Maximum:
17,300
Daily Minimum:
71
Sampling Type:
Monthly Limit:
310,000
Daily Limit:
Sample Frequency:

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page of
Sampling Person(s) Certified Laboratories
Name: Name:
Name: Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A 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 Permittee Certification
ORC: Robert Carroll Permittee: Sampson County Schools
Certification No.: 26341 Signing Official: Robert Carroll
Grade: S Phone Number: 910-385-6116 Signing Official's Title: ORC
Has the ORC changed since the previous NDMR? ❑ yes 10 No Phone Number: 910-385-6116 Permit Expiration: 10/31/2028
Signature
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
9/12/2024 &Zf /Ld 9/12/2024
Date Signature Date
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