WQ0002905_Monitoring - 04-2022_20220502

FORM: NDMR 03-12 NON-DISCHARGE MONITORING REPORT (NDMR) Page of
Permit No.: W0000$905 I Facility Name: Addis Cates Company, Inc. County: Robeson Month: qp(L Year: 'j.'y
PPI: Flow Measuring Point: ❑influent ❑Effluent E No flow generated Parameter Monitoring Point: ❑influent ❑Effluent ❑Groundwater Lowering ❑Surface Water
Parameter Code --► 50050
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24-hr hrs GPD
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5 Facility not in use
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20 ?0�9
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31
Average: 0.00 0.00
Daily Maximum: 0.00 0.00
Daily Minimum: 0.00 0.00
Sampling Type:
Monthly Avg.Limit:
Daily Limit:
Sample Frequency:

FORM: NDMR 03-12 NON-DISCHARGE MONITORING REPORT(NDMR) Page of
Sampling Person(s) Certified Laboratories
Name: Duncan Malloy Name: Microbac Laboratory
Name: Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? ElCompliant El 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: Duncan Malloy Permittee: Addis Cates Company, Inc.
Certification No.: SI 28917 Signing Official: John Cates
Grade: Phone Number: 910-858-3800 Signing Official's Title: President
Has the ORC c n ed since the previous NDMR? Yes 0 No Phone Number: 910-:I.8-3439 Permit Expiration: 2/28/2022
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!law,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: NDAR-1 10-13 NON-DISCHARGE APPLICATION REPORT (NDAR-1) Page of
Permit No.: W00002905 Facility Name: Addis Cates Company, Inc. ! County: Robeson Month: Ai& Year: 209V1,
Field Name: #1 Field Name: Field Name: Field Name:
Did irrigation occur
Area(acres): 7 Area(acres): Area(acres): Area(acres):
at this facility? Cover Crop: Coastal Bermuda Cover Crop: Cover Crop: Cover Crop:
❑YES ❑NO Hourly Rate(in): Hourly Rate(in): Hourly Rate(in): Hourly Rate(in):
Annual Rate(in): Annual Rate(in): Annual Rate(in): Annual Rate(in):
Weather Freeboard Field Irrigated? ❑YES 0 NO Field Irrigated? ❑YES ❑NO Field Irrigated? ❑YES ❑NO Field Irrigated? ❑YES ❑NO
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f) I- a
°F in ft ft gal min in in gal min in in gal min in in gal min in in
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18 -
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31 Monthly Loading: 7 % yv//l/ %� %//�������� vy
�� //////// �/////12 Month Floating Total (inyr l rf����f� /

FORM: NDAR-1 10-13 NON-DISCHARGE APPLICATION REPORT (NDAR-1) Page of—
Did the application rates exceed the limits in Attachment B of your permit? 0 Compliant ❑Non-Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites? i Compliant ❑Non-Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit? ❑✓ Compliant El Non-Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site? CIcompliant ❑Non-Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? ElCompliant ❑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: Duncan Malloy Permittee:
Addis Cates Company, Inc.
Certification No.: SI 28917 Signing Official: John Cates
Grade: Phone Number: 910-858-3800 Signing Official's Title: President
Has the 0•' =nged since the previous NDAR-1? ❑Yes 0 No Phone Number: 910-858-3439 Permit Exp.: 2/28/22
5)411\41 4 'VI' IN
4 k
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