WQ0010878_Monitoring - 01-2021_20210215

FORM: NDMR 05-16
NON -DISCHARGE MONITORING REPORT (NDMR)
Page ::_ of
Sampling Person(s)
,came: Scott Vesgaard
i i Name: Water Tech
Name:
Name: Best Water Services
Certified Laboratories
Does ail monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? it ~�
Non-Compifartt
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 no mpliance and describe the corrective
action(s) taken. Attach additional sheets if necessarv.
Operator in Responsible Charge (ORC) Certification
Permittee CertMcation
rGrade:4
VGsgaard i Permittee: Blue Ridge Preservation
II
15219 +Signing Official: Scott Vasgaard
Phone Number: 82812976234 j Signing Official's Tit►e: ORC
ed since tjprevios NDMR? ❑ fes ❑ No Phone Number: 8282976234 Permit Expiration: 4/30/2026
i
d
i
6 � 1
i Signature /
� �
r By this signature, 1 certify that this report is accurrate and complete to the best of my kno+rdedge. i certify, Date Signature Date
i under penalty of law, that this document and all attachments we,-e prepared under my direction or supervision in
accordance with a system designed 4o assure that all qualified personnel properly gathered and evaluated the information
submitted. Based on my Inquiry of the person or persona who manage the system, or those persons directly responsible for
I gathering the information, the information submitted is, to the best of my knovAedge and belief, true, accurate, and complete. I am
aware that there are significant penalties for subndtft false information, including the possibility of fires 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: NDAR-1 05-16 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page __ of
Permit No.: WQ0010878
Facility Name: Blue Ridge Preservation WWTP County: Watauga
Month: 4,j
Year: 262 1
Did irrigation occur
at this facility?
Field Flame:
1
Field Name:
2 Field Name:
c`
Field Name:
4
Area (acres):
1.5
Area (acres):
1.5 Area (acres):
1.5
Area (acres):
1.5
El YES NO
Cover Crop:
Cover- Crop:
Cover Crop:
Cover Crop:
Hourly Rat (in):
0.2
Hourly Rate (in):
0.2 Hourly Rate (in).
0.2
Hourly Rate (in):
0.2
Annual Rate (in):
117
Annual Rate (in):
117 Annual Rate (in):
117
Annual Rate (in):
117
Weather
Freeboard
Field Irrigated?
Q YES
Field Irrigated?
❑ YES o Field Irrigated?
❑ YES
Field Irrigated?
❑ YES
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Month) Loading:
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12 Month Floating Total (m):r:
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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?
mpliant ❑ Non -Compliant
Were adequate m
q to measures taken t0 prevent effluent ponding in or runoff from the sites?
/Y
pliant ❑ Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit?
�Cgmpliant ❑ Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site?
pliant ❑ Non -Compliant
Were all freeboards maintained in accordance
a ce with the specified freeboard heights in your permit?
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)
aCtinnfr) taken Attach 2rlriitinn.1 chnnfe if no..-_
/pliant ❑ Non -Compliant
of the noh compliance and describe the corrective
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: S Gd // V GC -S j z � 4a. f Q
,/�
Permittee: /J 1ze� �� sC M S< <' Va l 11Yf
`1Va
Certification No.: /S�.l /
Signing Official: 5C67/ Sa w'N iW
Grade: S� _ Z2, phone Number:
1 �`l 8 � 7 23
^ �% .�!
Signing Official's Title: (J /�
Has the ORC changed since the previous NDAR-1? ❑ yes
Phone Number: k.ZB 2�j'� Cj y Permit Exp.: �d �� 6
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 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 sibxnitted 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: NDAR-1 05-16 NON -DISCHARGE ;APPLICATION REPORT (NDAR-1 ) Page of
Permit No.: W00010878
Facility Narre: Blue Ridge Preservation WWTP
County: Watauga
Month: J a%,
Year: Z. 02-
Did irrigation occur
Field Name:
—
5
Field Name:
7
Fieid Name:
£�
Field Name:
at this facility?
Area (acres):
1.5
Area (,acres):
1.5
Areei (acres):
1.5
Area (acres):
Cover Crop:
Cover- Crop:
Cover Crop:
Cover Crop:
❑ YES
Hourly Rate (in):
0.2
Hourly Rate (in):
0.2
Hourly Rate (in):
0.2
Hourly Rate (in):
Annual Rate (in):
117
Annual Rate (in):
117
Annual Rate (in):
117
Annual Rate (in):
Weather
Freeboard
Field Irrigated?
❑ Yes r0
Field Irrigated?
❑ Yes No
Field Irrigated?
❑ YES o
Field Irrigated?
❑ YES ❑ No
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Monthly Loading:
12 Month Floating Total (in):;'z
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FORM: NDAR-1 05-16 NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Pageof-
Did the application raters exceed the limits in Attachment B of your permit?
pliant
❑ Non -Compliant
Were adequate measures taken to prevent effluent ponding in or, runoff from the sites?
11 Cimpliant
❑ Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit?
11-11pmpliant
El Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site?
`NC-ompliant
❑ Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
e/I �tCompliant
❑ 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
ORC: S GO Vet sS Gt ea r
Certification No.: / 572_ l 9 / (/
Grade: 51:r — 2 Phone Number: 2'2 8 2, 7t�j 23
Has the ORC changed since the previous NDAR-1? ❑ yes ]�
K4
By this signature, I certify that this report is accurrate and complete to the best of my knowledge
Permittee Certification
Permittee: /2lLl- /1 / co/
S{
Signing Official: 5,,-6 7�' !/lc Sg al -A r t/
D Signing Official's Title: *
413d(z�,,/
Phone Number: k2g 25'7 0 2 37
Permit Exp.:
Date en / 1 Signature I t 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 Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617