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HomeMy WebLinkAboutWQ0000267_Monitoring - 04-2020_20200529FORM: NDAR-1 05-16 Monthly Loading 12 Month Floating Total (in) NON -DISCHARGE APPLICATION REPORT (NDAR-1) 143,033 2.29 0 Page of l� o.00 FORM: NDAR-1 05-16 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 (]Compliant ❑Non -Compliant Compliant ❑Non -Compliant ❑� Compliant ❑Non -Compliant ❑� Compliant ❑Non -Compliant If the facility is non -compliant, please explain in the space below the reasons) the facility was not in compliance. Provide in your explanation the dates) of the non-compliance and describe the corrective actions) taken. Attach additional sheets if necessary. Operator in Responsible Charge (ORC) Certification oRc: Timothy Hedgepeth Certification No.: SI-995918/CS-995758 Grade: 1 Phone Number: Has the ORC changed since the previous NDAR-1? 252-287-5957 ❑Yes (]No Permittee: County of Gates Permittee Certification Signing official: Ray Freeman Signing Official's Title: Chairman, Board of Commisioners Phone Number: 252-357-1240 Permit Exp.: 6/30/21 .. �, � �� wa ,_ � r�,, Signature Date Signature D to 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 qual'fied 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 Resources Information Processing Unit 1617 Mail Service Center Raleigh, North Carolina 27699-1617 FORM: NDMR 05A6 NON -DISCHARGE MONITORING REPORT (NDMR) Page of FORM: NDMR 05-16 NON -DISCHARGE MONITORING REPORT (NDMR) Page of Sampling Person(s) Name: Bobby Fox 11 Name: Environment 1, Inc. Name: Tom Beasley 11 Name: Certified Laboratories 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 reasons) the facility was not in compliance. Provide in your explanation the dates) of the non-compliance and describe the corrective action(s) taken. Attach additional sheets if necessary. Operator in Responsible Charge (ORC) Certification oRc: Timothy Hedgepeth Certification No.: SI-995918 / CS-995758 Grade: 1 Phone Number: 252-287-5957 Has the ORC changed since the previous NDMR? ❑Yes 7No Signature By this signature, I certify that this report is accurrate and complete to the best of my knowledge. C�Ff� Permittee Certification Permittee: County of Gates signing Official: Ray Freeman Signing Officials Title: Chairman, Board of Commisioners Phone Number: 252-357-1240 Signature Permit Expiration: 6/30/2021 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 qual""fled 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 Resources Information Processing Unit 1617 Mail Service Center Raleigh, North Carolina 27699=1617