HomeMy WebLinkAboutWQ0000488_Monitoring - 07-2022_20220805FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page _L of
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.FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page— of --o
Sampling Person(s) Certified Laboratories
Name: Kegan Butler Name: Cameron Testing Services Inc.
Name: William Baker Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? P] compliant 1-1 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: William Baker III
Permittee: Jordan Lake SRA
Certification No.: 1003671
Signing Official: Shederick Mole
Grade: SI Phone Number: 919-362-0586
Signing Official's Title: Park Superintendent IV
Has the ORC changed since the previous NDMR? - Yes No
Phone Number: 919-362-0586 Permit Expiration: 1/31/2027
8/1/2022
(/ i' / 8/1/2022
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 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 an,
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 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page _L of i)—
Permit No.: WQ0000488 _'
Facility Name: Jordan Lake SRA - Vista Point
County: Chatham
M
• irrigation occur
facility?
Area (acres):
Area (acres):
at this
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Crop:
YES NO
Hourly Rate (in):
Hourly Rate (in):
Hourly Rate (in):
Annual Rate (in):1:
Field irrigaw_d?_���
Field Irrigated?
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FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page tz— of —:1
Did the application rates exceed the limits in Attachment B of your permit?
❑ Compliant ❑ Non -Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites? ❑✓ Compliant ❑ Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit? Q Compliant ❑ Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site? ❑✓ Compliant ❑ Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? ❑ Compliant ❑ 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: William Baker III
Permittee:
Jordan Lake SRA
Certification No.: 1003671
Signing Official: Shederick Mole
Grade: SI Phone Number: 919-362-0586
Signing Official's Title: Park Superintendent IV
❑ yes C No
Phone Number: 919-362-0586 Permit Exp.: 1/31/27
8/1/22
8/1/22
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 Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617