WQ0002015_Monitoring - 02-2021_20210412

FORM: rn )3-12 NON -DISCHARGE MOt ZING REPORT (NDMR) Page
Permit No.: 1111 1
Oak Hill Fellowship Center
County: Granville
Month: FebruaryFlow
Measuring Point: El influent [:] Eff I uent No flow gererated
Parameter Monitoring Point: Influent ElEffluent [:] Groundwater Lowering Surface Water
•
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E---------------
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FORM: IN )3-12
NON -DISCHARGE MOI ZING REPORT (NDMR)
Page _
Sampling Person(s) Certified Laboratories
Name: Dale Lee Mathews Name: Meritech
Name: Andy L. Mathews Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? ElCompliant❑"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.
SPRAY PUMPS WERE PLACED BACK INTO OPERATION FOR THE MONTH OF FEBRURARY, DE -WINTERIZED
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Dale Lee Mathews
Permittee: Oak Hill Fellowship Center
Certification No.: 22794
Signing Official: Alan Glover
Grade: Spray Irrigation Phone Number: [phone]
Signing Official's Title: Facility Manager
Has C changed since the previous NDMR? Yes ❑� No
Phone r: [phone] Permit Expiration: 7/31/19
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31
313 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 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

FORM: P 1 10-13 NON -DISCHARGE APPL 'ION REPORT (NDAR-1) Page
Permit No.: Q111 1
Oak Hill Fellowship Center
County: Granville
Month: February1
• irrigation occur atfn
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this facility?
NO
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Hourly Rate (in):
YES
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Annual Rate (in):
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Irrigated?•
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I - FORMI 1 10-13 NON -DISCHARGE APPL 'ION REPORT (NDAR-1) Page
Did the application rates exceed the limits in Attachment B of your permit?
❑i Compliant
Non -Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites?
ElCompliant
Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit?
ElCompliant
0Non-Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site?
M Compliant
F�Non-Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
❑i Compliant
Non -Compliant
If the facility is noncompliant, please explain in the space below the reason(s) the facility was not in compliance. Provide in your explanation the date(s) of the
noncompliance and describe
the corrective action(s)
is non. r+uaw auu niunai JIICGW u n
IOperator in Responsible Charge (ORC) Certification Permittee Certification
IORC: Dale Lee Mathews
Certification No.: 22794
Grade: Spray Irrigation Phone Number: [phone]
Has t C changed since the previous NDAR-1? �yg ❑� No
33tZ.�
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
Permittee: Oak Hill Fellowship Center
Signing Official: Alan Glover
Signing Official's Title: Facility Manager
Phone er: [phone] Permit Exp.: 7/31/19
4 -0,
0W". S�3\)Zl
Signature Date
I cerfify, 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