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Permit No.: VVQ0015491
Facility name: Caraway Speedway
County: Randolph
Month: ,,
Year:
�, �,^J
Field Name:
1
Field Name:
2
Field Name: ,
3
Field Name:
4
Area (acres):
0.49=
Area (acres):
0.49
Area (acres):)
0.49
Area (acres):
0.49
at fts fact ty?
Cover Crop:
Forest
Cover Crop:
Forest
Cover Crap:
Forest
Cover Crop:
Forest
�.�Hourly
❑
Rate (in): in
0.15
Hourly Rate In :
0.15
Hourly Rate(In
) i
G.15
T
Hourly Rate (in):
0.15
YES
Annual Rate (in):
26
Annual Rate (in):
26
I Annual Rate (%)L
`-.
Annual Rate (in):
26
Weather
Freeboard
Field irrigated?
[,YES
l�'NO
Field Irrigated?
❑ YES
2-NO
( Field`lrrigated?l
J r_,
; r,e
Field Irrigated?
❑ YES
❑ NO
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Monthly Loatling
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�12 Month Floating Total (in):1
FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page 1
11)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? compliant ❑ Non -compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit? 3Compliant El Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site? comp ant" ❑ Non -compliant
Were all freeboards maintained in accordance with the specified freeboard heights in 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 dates) of the non-compliance and describe the corrective
action(s) taken. Attach additional sheets if necessary.
Operator in Responsible Charge (ORC) Certification
P1ermittee Certification
ORC: / -c._, C r✓(LC ` '
/
Permittee:u��
Certification No.: /
Signing Official Li✓/
Grade: �''( Phone Number: �3(� �v _����
I
Signing Official's Title: )nl
'
Has the ORC changed since the pre iV ous NDAR-1? [I Yes '
Phone number: 3' _��,.� Y Permit Exp.: �l I
i I
'•1
J
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
Raleigh, North Carolina 27699-1617
FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Pages_ of
Permit No.: WQ0015491 Facility Name: Caraway Speedway County: Randolph Month: rz_, �� Yes es c+
PPI: 001 Flow Measuring Point: ❑ Influent ❑ Effluent ❑ No flow generated Parameter Monitoring Point: ❑ Influent ❑✓ Effluent ❑ Groundwater Lowering ❑ Surface Water
Parameter Code —� 50050 00400 50060' 00310 777
00610 00530 31616 00620 00625 '
0
P
o
(n
6-1
E -- o
.y
�
° Q C O ~ a
E Nn z c7VOhrs OPD su nag(L mg/L and{L mg/L i3OO �_ mg/L nyiL
>
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I _ —
4 —
5 . u
6 --
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9
10
11
12 -
13 _
14-
15 —
16 -I —
17
19-
20 -- — --
21
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22
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24 ,
25 --1 - -
26
27 -` - -. ---- — ---
28
29 i i
30 —
31 i I
i
Average: #DlVJ01
Daily Maximum: 0 _ ----
Daily Minimum: C.-
Sampling Type: Fst��,nate' Grab Grab Grab Grab Grab �; Grab Grab
Monthly Avg. Limit. ,-- -- - - - ----I
Daily Limit: 9;999 gp:' ' ---
Sample Freauencv: Monthly ,--,3 X yr 3 X yr 3 X yr 3 X yr
3Xyr
FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page,'-? of
Sampling Person(s)
Name:
Name:
Name:
Name:
Certified Laboratories
Does aH monitoring data and sampling frequencies sheet 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 incompliance. Provide in your explanation the date(s) of the non-compliance and describe the corrective
nntinnftl taken_ Attach additional sheets if necessary.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
�Permittee:o.:
0 -Or-
r,ade
Signing Official: e /1 �.
i�5
Phone Plumber: �j - � � 4
Signing Ofr`icial's Title: 'rnhanged
since the previous PIDMR? ❑ Yes
Phone Number: � '� ���1 rl Permit Expiration: `1 (22
1 r✓ 2���
_ _ 3Y�� 2=��
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 directtbn 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 imprisonmentfor
knowing violations.
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Dail Service Center
Raleigh, North Carolina 27699-1617