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Home My WebLink AboutWQ0000267_Monitoring - 10-2020_20201130FORM: NDAR-1 05A6 12 Month Total NON -DISCHARGE APPLICATION REPORT (NDAR4) G7 Page I of FORM: NDARA 05A6 NON -DISCHARGE APPLICATION REPORT (NDARA) 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 e 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 i]Compliant ❑Non -Compliant Compliant Non -Compliant QCompliant ❑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 Permittee Certification Permittee: County of Gates signing Official: Ray Freeman Signing Official's Title: Chairman, Board of Commisioners Has the ORC changed since the previous NDAR-1? ❑Yes ❑✓ No II Phone Number: 252-357-1240 Permit Exp.: 6/30/21 Signature Date By this signature, I certify that this reportis accurrate and complete to the best of my knowledge. 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 ol 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 05-16 4 X Year Per Event NON -DISCHARGE MONITORING REPORT (NDMR) 4 X Year 4 X Year Per Event 3 X Year Page of I/ FORM: NDMR 05-16 NON -DISCHARGE MONITORING REPORT (NDMR) Page off Sampling Person(s) Name: Bobby Fox Name: Tom Beasley Name: Environment 1, Inc. Name: Certified Laboratories Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? =Compuant ❑Non -Compliant If the facty 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. are communicating with khrone to fix the meter at the lift station. Influent, at this 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 [ZNo Signature is still being estimated. By this signature, I certify that this report is accurrate and complete to the best of my knowledge. Permittee Certification Permittee: County of Gates signing OfFcial: Ray Freeman signing Official's 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 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. 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 Resources Information Processing Unit 1617 Mail Service Center Raleigh, North Carolina 27699-1617