WQ0024508_Monitoring - 12-2021_20220210

ti
DWR - NonDischarge Monitoring Report Submittal
'
•4 ..
NORTH CAROLINA
Erwlranmenlcl QHaflly
Monitoring Report Submittal
..............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................
Permit Number#* WQ0024508
Name of Facility:* Carolina Research Center WWTF
Month:* December Year:* 2021
Report Information
Type* Upload Document*
NDMR, NDAR-1, NDAR-2, NDMLR Smithers_Dec.pdf 1.23MB
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:* Jessica Mize
Signature:
jGdd(14
Date of submittal: 2/10/2022
This will be filled in automatically
Initial Review
.............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................
Reviewer: Gerald,Wanda

Is the project number correct?* WQ0024508
Is the monitoring report accepted?* Yes No
Regional Office* Winston-Salem
Accepted Date: 3/14/2022

FORM:NDMR 05-16 NON-DISCHARGE MONITORING REPORT(NDMR) Page of
Permit No.: WQ0024508 I Facility Name: Carolina Research Center WWTF I County: Alamance I Month: December , Year: 2021
PPI: 001 I Flow Measuring Point: 0 Influent 0 Effluent 0 No flow generated I Parameter Monitoring Point: 0 Influent p Effluent 0 Groundwater Lowering 0 Surface Water
Parameter Code —+ .50050 00310 00940 50060 31616. 00610 00625 ; 00620 00600_,. 00400 00665 70300 00530
m
Qi N -O CA
r. of E 0/ rn ` P. G 2 m C _ 2 , 0
ep 4. U e j <- d .-'6 G y O m.. .." E `; d 0 .,2�''• ..,o a C t. O — 2O ."C 's
8 ( p ., 0 5 f- m r u...o, E I- •-.� I- .. !-,'.d F- : 0S F- w c
O U U U Q Y Z 0
24-hr hrs GPD•: mglL mg/L. mglL #/100 mL mg/L _:,mglL- mg/L . mg/L, su mg/L mg/L mg/L
1 10:55 0.25 228 >2.20
2 228
228 --.
4 291
5_ 291 .
6 - 291" •
7 12:13 0.25 . 291 "':i >2.20 6.91
9 291
10 .-! 291
11 -291
12 - .291 • •.
13 .£..291
14 11:53 0.25 291 >2.20
15 ..291.-
16 ,3. 291. ",-" _-.- • .....: ..,, 7.06
17 291
18 0 .:
19 0
20 0
21 0
22 11:06 0.25 .,--11,- 0 1.44
23 0. .
24 ,i, 0
25 214
26 214
27 214....= • ,
28 11:50 0.25 - 214 1.72 7.01
29 ? 21447
30 ' 214�.:-
31 214 . `
Average: il 202 t . 0.63
Daily Maximum: .291. _ : `;. -=? 1.72 .. ._ 7.06
Daily Minimum: 0 -V ..;< 1.44 6.91
Sampting Type: Estimate's Grab ``;Grab -,, Grab Grab .;' Grab ';:,Grab Grab ..:;Grab , Grab Grab Grab Grab
Monthly Limit: 2,000 "
Daily Limit :rr.,"
Sample Frequency: Monthly ` 3 X Year 3 X Year Per Event 3 X.Year 3 X Year '3 X.Year'. 3 X Year '3 X Year' Per Event 3 XYear_ 3 X Year 3 XYear

FORM:NDMR 05-16. NON-DISCHARGE MONITORING REPORT(NDMR) Page
• of
Sampling Person(s) Certified laboratories
Name: Glenn Price Name: Pace Analytical Services
Name: Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? l= tant 0 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 • Pennittee Certification
ORC: Glenn Price Permittee: Gus Zieske
Certification No.: 987931/20771 Signing Official: Ron Alcom
Grade: . II Phone Number: ..336-996-2841 c. Signing Official's Title: Manager,Avian and Wildlife Toxicology
Has the ORC changed since the previous NDMR? D Yes._ C No • Phone Number. 336-376-0141 Permit Expiration: 8/31/2021
•
Z/f/e-t
Lz�.
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 ail 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,tare,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.: WQ0024508 I Facility Name: Carolina Research Center WWTF I County: Alamance I Month: December Year: 2021
Field Name: . 2 Field Name: 3 Field Name: 4 Field Name: 5
Did irrigation occur -
,i., Area(acres): :-. 0.3 ' Area(acres): 0.3 -, Area(acres): -- ' 0.5 '. Area(acres): 0.3
at this facility? Cover Crop: "-- Cover Crop: Cover Crop: Cover Crop:
YES NO
Hourly Rate(in): 0.3 --- Hourly Rate(in): 0.3 Hourly Rate(in): 0.3 Hourly Rate(in): 0.3 0
---,Annual Rate(in): :,'''' 42.9 i-,c,--- Annual Rate(in): 42.9 '''Annual Rate(in): ,-. 42-8 Annual Rate(in): 42.9
Weather Freeboard Field Irrigated? OYES op° Field Irrigated? 0 YES 0 NO Field Irrigated? El YES 0 NO Field Irrigated? 0 YES El NO
43 ' 0
z a - . 0 . 6 , Ts . 0) a'.,L c„ . .t, 73 a) E ,,, a) a 1, , v cc E ,., 4> co a a co E , cr)
co c 0 0 2 - y. 0 0 .'C' C E 0 CS >, C 04-- C -'E m - - 41) ,,„..,., 2% C 2 = C E 0 0 43 )... C .
.2 g = E co 77:1 iii E t ,5' = t' E a) ,;:i i:i E t it . b =a E 03 rit; ,a E = ,6 . = E CC 1,1 13 E t :I3
.7) o. i::: .2 C3 ‘ca, HI ,--6. 0. i= •,_12) og *Rog -aft 1= -E-Ji.
> < 2-- -1 a - ...1 ,-' > < - ..L.: ...1 a x ...1 > < _
°F in ft ft gal min in in gal min in in gal min in in gal min in in
1
2 ' .-"i, -:- .,
3
4
•,„1.;, . ,,_ ;-- , - ,<„
6
7 PC 46 , 0 2.6 , ..:- - ' 1,600 20 0.12 0.12
8
9
1 0
11 , -,, ,'.,.. • ,:- :::
12 _ .
13 _ " _ •,--
14
15 - '-` - "
16 C 61 0 2.6 . 1,600 _ 20 0.12 0.12
17 . -
18 _.
19
20
21 • • --."'-`-' -"-- , '- n - ; ,' .. - ' -
n
23 ,
24 i;',, ' . , -4,- ; ' , ,
25
26
27 i ,.,:i , ,i',
28 C 57 0 2.6 1,600 20 0.12 0.12
29 _
30
31 - , ` _
Monthly Loading: 0 'V 0.00 ' 0 V 0.00 '7 4,800 V 0.35 P' 0 V 0.00 V
12 Month Floating Total(in): ... ,1.43 , 2.12 / / 3.10 , 2.67 VVA1

•
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? tJTomplWrt o Non-compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites? IfKemptiant. o Non-Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit? D c tpliant o Non-Compliant
Were all setbacks listed in your permit f maintained for every application to each permitted site? I�Cartnpuattt o Non-Compliant
Were all freeboards maintained in accordance with the specified freeboard,heights'in your permit? ::: O' npliant o Non-Compliant'`''
if the facility is non-compliant;please explain in the space below the reason(s)the facilitywas 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 Permlttee Certification •
ORC: Glenn Price Permittee: Gus Zieske •
Certification No.: 987931/20771 Signing Official: Ron Alcorn
Grade: II Phone Number: ,::'336-996-2741' Signing Official's Title: Manager,Avian and Wildlife Toxicology
Has the ORC changed since the previous NDAR-1?:r•••: ' D yes •o Na' • Phone Number.: 336-376-0141 Permit Exp.: 8/31/21
/ '/ZZ ?../2/,2 Z.
Signature Date Signature Date
By this signature,I certify that this report is accurate 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 queried personnel properly gathered and evaluated the Information submitted.Based on my
• ' . Inquiry of the person or persons who manage the system,or those persona 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:NDAR-1 05-16 NON-DISCHARGE APPLICATION REPORT(NDAR-1) Page of
Permit No.: WQ0024508 I Facility Name: Carolina Research Center WWTF I County: Alamance I Month: December Year: 2021
Field Name: 6 Field Name: 7 Field Name: Field Name:
Did irrigation occur '
Area(acres): 0.9 Area(acres): 0.3 Area(acres): Area(acres):
at this facility? Cover,Crop: Cover Crop: Cover Crop: Cover Crop:
O Yes ❑NO ,- Hourly Rate(in): 0.3 Hourly Rate(in): 0.3 Hourly Rate(in): Hourly Rate(in):
,.Annual Rate(in): 42.9 - Annual Rate(in): 42.9 Annual Rate(in): Annual Rate(in):
Weather Freeboard ; Field Irrigated? ❑YES "', .El NO ,r Field Irrigated? ❑YES DI No Field Irrigated? ❑YES, ❑NO ;, Field Irrigated? 0 YES ❑NO
m 11. m i
t rn
0 I
i4 0, 0- 8 E m "0 2 AG g AG m 61 >' E 7 �" G E o ° m > - ? AC E 2 o 2 ?� C > >" C
o o n, . ` � a E � •W •a E � zs � fl, a E m CO G t°0 >'.< �. ", G p X .J > Q E' 0J co = J ›_..c .. � J '� =.oi > < ~ , � J mJ
°F in ft ft gal min in in gal min in in gal min in in gal min in in
1
2 .a,L,
3
4
5
6
. .. 7 PC 46 0 2.6 ,
8 .' _,
9 _; -
10
11
!Y: 12
13
14
15
16_ C 61 0 2.6
17
18
19 _.
20
21
22 :'
23
24 ,
25 't'r x#r .'-
26 ::
27
28 C 57 0 2.6
29 .
30 '
31
Monthly Loading ;..0 ✓ ' 0.00 0 0.00 0 0.00. 0 % 0.00
12 Month Floating Total(in):'''0/L/l�l.����.� 2.03,, �/% i.! ��.��//°/ , 1.97 y /r >E,, 1 G 5f.

•
• • .FORM:NDAR-1 05=16 NON-DISCHARGE APPLICATION REPORT(NDAR-1) Page of
pp your permit? [1�.ontptiard ❑Non Cornprran t
bid the application rates exceed the limits in Attachment B of our. -
Were adequate measures taken to prevent effluent ponding in or runoff from the sites? i .amptiant •o Non:comphant
Was a suitable vegetative cover maintained on all sites as specified in your permit? • arampilard 0 Nowcomptiant
Were all setbacks listed in your permit maintained for every application to each permitted site? ( omprent o Non-compliant
Were all freeboards maintained in:accordance with the specified freeboard heights in your permit? -. p. mpt►ant • in Non-car am
lithe 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 : • . Permitter)Certification
ORC: Glenn Price Pennittee: Gus Zieske
Certification No.: 987931/20771 Signing Official: Ron Alcorn
Grade: II Phone Number: is -- 336-996-2741 Signing Official's Title: Manager,Avian and Wildlife Toxicology ,
Has the ORC changed since the previous NDAR-1?•: •o yes o Ne% Phone Number: - 336-376-0141 Permit Exp.: 8/31/21
z./2/2.z.
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 quaaried personnel property gathered and evaluated the information submitted.Based on my
• . •- Inquiry of the person or persons who manage the system,orthose 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 possihitty of rules 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:NDMLR 05-16 NON-DISCHARGE MASS LOADING REPORT(NDMLR) Page of
Permit No.: WQ0024508 Facility Name: Carolina Research Center WWTF County: Alamance Month: December Year: 2021
Field Name: 2 Field Name: 3 Field Name: 4 Field Name: 5 Field Name: 6
Area(acres): 0.3 Area(acres) 0,3 ` Area(acres): 0.5 Area(acres): " 0.3 Area(acres): 0.9
Cover Crop: ,. Cover Crop Cover Crop: Cover'Cro
�' p: ...�-... _ ,, Cover Crop:
Load Type: PAN Load Ty
pe: x PAN" Load Type: PAN Load Type: ; PAN Load Type: PAN
-:'"
Field Loaded? 0 YES O NO Field Loaded? 0 YES 0 No Field Loaded? O YES 0 NO Field Loaded? O YES p NO Field Loaded? O YES El No
a ra a w m -o a 0 a . m m a a W a ? 03 a, 'a<.,. a_g 4: >;W ro 4g a w n. - co
;; E m m >,I w � E`a+ m ).o as,o. E a 4! >,m � � E a m ai v m``o E w a >,so 4 o
40 2 a. 0) c t o 0 f 3 o. ,0) c . ""t o "`S ' a m e L o ."EL c c - o 5..J = o. m e g -J
o o a E u .. -1 EQ 'o o. E" 8 .. -r Ea o o. E u c Ea o"a E E4 o a E 0 c _, E4> a > 0 �° Va > 4 > 0 Va > a > 0 g tia > Q ao Ua > ¢ Qo ° Ua
Month gal mg1L lbs/ac lbs/ac gal mg/L lbs/ac Ibslac gal mg/L lbs/ac lbs/ac gal: _ : mg/L Ibslac lbs/ac gal mg/L lbs/ac lbs/ac
January 0 20.6 0.0 0.0 0 !20.6 0.0 0.0 0 20.6 0.0 0.0 .6,000" 20.6 " .3.4 3.4; 6,400 20.6 1.2 1.2
February 0 20.6 0.0 0.0 6,000 20.6 - -3.4 3.4 10,400 20.6 3.6 3.6 0 20.6 0.0 3.4 0 20.6 0.0 1.2
March 0 64.1 0.0 0.0 0 64.1 -'0.0 3.4 0 64.1 0.0 3.6 0, 64.1 0.0 3.4 ! 7,600 64.1 4.5 5.7
April 0 64.1 0.0 0.0 = 0 64.1 0.0 3.4 0 64.1 0.0 3.6 2,000 64.1 3.6 7.0>' 6,800 64.1 4.0 9.8
May 5,600 64.1 10.0 10.0 ...0_< 64.1 .0.0 -3.4 7,200 64.1 7.7 11.3 2,000 64,1 .. 3.6 10.6; 0 64.1 0.0 9.8
June 0 64.1 0.0 10.0 6,000 64;1= 10.7. , 14 1 : 3,600 64.1 3.8 15.1 0_. . 64.1 0.0 10.6`` 4,000 64.1 2.4 12.2
t July 0 66.8 0.0 10.0 • 0: 66 8 :> 0,0 14.1 0 66.8 0.0 15.1 2,000 66.8' ':3.7 14.3 ` 10,400 66.8 6.4 18.6
' August 4,000 66.8 7.4 17.4 0 _> 66.8 0.0 14:1-` 10,000 66.8 11.1 26.3 4,000 66.8 7.4 21.7 0 66.8 0.0 18.6
September 2,000 66.8 3.7 21.1 5,200., 66.8. 9.7 23.8_ 0 66.8 0.0 26.3 0 66.8 '. 0.0 ' 21.7 3,600 66.8 2.2 20.8
October 0 66.8 0.0 21.1 O i:.:: 66.8, 0.0 23.8_ 0 66.8 0.0 26.3 3,600` 66.8 6.7• 28.4 10.800 66.8 6.7 27.5
November 0 65.1 0.0 21.1 0 n 651,141,0.0, 23,8 6,000 65.1 6.5 32.8 ;2,000.;., ,'651 = 3.6 _ ;32,0 0 65.1 OA 27.5
• December 0 65.1 0.0 21.1 .,.,.. 0 .651 -0.0 238 4,800 65.1 5.2 38.0 _z•0 , 65.1 >>DA n 32.0;' 0 65.1 0.0 27.5
12 Month Floating PAN Load
{Ibslaclyr):
21.1 j 23.8 38.0 32.0 27.5
Annual PAN Load Limit 159 '159 159 159 159
(Ibslaclyr): A4

FORM:NDMLR 05-16 • NON-DISCHARGE MASS LOADING REPORT(NDMLR) Page of
Did the mass loading rates exceed the limits in Attachment B of your permit? Er<iant ❑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 • 'Permtttee.Certification' •
ORC: Glenn Price Permittee:
Gus Zieske
Certification Number: 987931/20771 Signing Official: '
Ron Alcorn
Grade: II Phone Number:. ti:; 336-996-2741 Signing Official's Title: . Manager,Avian and Wildlife Toxicology
Has the ORC changed since the previous NDM ? :c ❑Yes 0 No Phone No.: ; 336-376-0141 Permit Exp.: 8/31/21
•
A/4,, 22Z
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 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 tines 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:NDMLR 05-16 NON-DISCHARGE MASS LOADING REPORT(NDMLR) Page of
**
Permit No.: WQ0024508 Facility Name: Carolina Research Center WWTF County: Alamance Month: December Year: 2021
Field Name: 7 ...J ,Field Name: • ., - ,- Field Name: • Field Name: ..-. Field Name:
Area(acres): 0.3 '''.;1.i"-'''Aleilaeiee): . !:4;-!':-'46-: ':' Area(acres):
• '-'-Arealaciet): -,...:: -'' Area(acres):
Cover Crop: ,'..":" Cover Crop: .'",-.7-,4-, --,:-..f.,., r Cover Crop: '-...-;: Cover Crop: ' ' • 77' Cover Crop:
.. ,
Load Type: PAN .:-.4 . .l''. .aci Tyiti• ' ', ..4=-• ''.4_ ,,/: Load Type: .'' Load Type: i Load Type:
._. ..._
Field Loaded? 0 YES El No ',,Fleid.Leaded? [DYES 0 NO Field Loaded? 0 YES 0 No •-1-,-,...Field Loaded? DYES. a NO Field Loaded? 0 YES 0 NO
_
, ' ' '''' : ''.:''.--C' •0".: . c V . c V `, c 1:3
Z c z
a 2 < ? .13 ' -.2, . -...3 ,.g., , 0 .3 0
0 7. 0 > 0 40 0
_ .0 0 ,r. 0 ›
V. iz -© 13 - ,rw*i Ilti,-.4. *=/.1i":• '2' "Es cs) co -I 1g ..0 11 „.&1 4 . 1 13 g 0 --1 1 ,,
40 E .2 0 I- > 13 0 0 , .' E .2 ...--,c --,',.7, ,•,,, ' E .- to ,u
to'a - 2, 3 - ', = 15,,-..' miz 04. 7.-'>` ' 5 ca 'a 6- = >, s CI = T3.' ' ..c E B = :E. ` t >'
,6 E -1 43 0. Z. E ..a -6* 0.
-:-,c .,c , > a a c •-c- c > a d. S , c 0 > < . c c c
> .. o t.,) 114 ••,.; , :. ,.' .,,c4-...- 1"-0 ' . ;IQ'' 0 o c..) -,.. • . 0, o tj.,,,
8 L' °
.. .
Month gal mg/L lbs/ac lbs/ac - gal ,..>.; mg/L lbs/ac lbs/ac gal mglL lbs/ac lbs/ac gal .- mg/L lbs/ac lbs/ac gal , mg/L lbs/ac lbs/ac
January 0 20.6 0.0 0.0 . ".2... ' .'"r4iv .-1,`'''',,,',',
February 0 20.6 0.0 0.0 ' ..'...7 :..-• .-.-- ._• -------
March 6,000 64.1 10.7 10.7 '''.- 4-,-..4Lz4.•."'•t-'-'1".il" ''.•--.",..'4'',..:,."•-,-",ii....-1 , .: ,;-- ... •-:-, !, J-,..-• '.
April 0 64.1 0.0 10.7
May 0 64.1 0.0 10.7 ..,• • -a, ; ,-t ,tfir •
ri. June 6,000 64.1 10.7 21.4 '''..: .
. , .
July 0 68.8 0.0 21.4 -...,,..1'.1-''... ,7,-i- •.--144,, --'444-r1-- V•s•;:-''':r'r , ,
August 0 66.8 0.0 21.4
September 4,000 66.8 7.4 28.8 -,-'•:;',7:' . ,:-:-•:. ,'-'1:7 ,: ,- .'7,.. ..-,:-,,- ',„ ' , , ., ,,,.
October 0 66.8 0,0 28.8
November 0 65.1 0.0 28.8 -,-,-,. ...-.4.1. ', 11417. -:::;:?. . 'rr, . ,-, . .",:::..:
December 0 65.1 0.0 28.8 NJ-.A.'4.1i.•.1.-V.-.,---1.11 .4:'.'illaiii. d;',,,' :eifil,b:4 ,illiiiill. • ' ..' ;4'4i' ',';',i'";',,."'.,',- ,, 4,,,t.;
12 Month Floating PAN Load
28.8 ,-,-..10:O 0.0 .0.0' 0.0
lbslac/ : •_4....#4.1 .:„. ...-
Annual PAN Load Limit - ",_•,tv. .
159

FORM:NDMLR 05-16 NON-DISCHARGE MASS LOADING REPORT(NDMLR) Page of
Did the mass loading rates exceed the limits in Attachment B of your permit? _ 13. pliant 0 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: Glenn Price Permittee:
Gus Zieske
Certification Number: 987931/20771 Signing Official: Ron Alcorn
Grade: II Phone Number:, 336-996-2741 ,.• Signing Official's Title: Manager,Avian and Wildlife Toxicology
Has the ORC changed since the previous NDMLR? ..<:, D Yes O No Phone No.: . 336-376-0141 Permit Exp.: 8/31/21
Signature Date Signature Date
By this signature,I certify that this report is accun'ate 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 Resources
Information Processing Unit
1617 Mail Service Center
Raleigh,North Carolina 27699-1617