WQ0012694_Monitoring - 08-2016_20160908

FORM: Nan,R-9 06.11 NON -DI- igRGE APPLIGA-fm l PcPRT(wv! AR -q
��ah�l�a •.
W90012684 Faoll ampul
IilAan® ��� C i ®ue�f s We
1 bald ��e
Did 9rrIgatic
�-�s_ - �.�,��_•-:�
I � 9 FBeld Nlan7e. 2 , PIeBd rB3
AA ffi qpp aY� AP
A 1.5
cover crop.,
0. YES
vis N®
_ ... Hourly Mato (In):
pn�y i ��annual Rata (16): 28 I� { �g�
.. P,AIR
YOdi°N'�
Cher Preaboard Plald 16.1 �fed`P G� v[s a Nn Field 1psl mead's I , -r".,�..._...» ,..
Z
•r .... t� ,.:. !i f,� ., .� - .., __. ..... ?. .....�.,.1y.,r,, ...'�'
•
Page . of a
monfiva rj( War.- .20
Id Name 4
9
Area (acres). 1.6
'Oovar.Crmp:
,
Hourly Refe.(In}.
-.
••r
�Ir,r..�
j t
in 7
� tF ..f
N
Page . of a
monfiva rj( War.- .20
Id Name 4
9
Area (acres). 1.6
'Oovar.Crmp:
Hourly Refe.(In}.
Annual #�ke'00.
28 . .
N
PI irrigated?.
; E I_vas
l� No
, t

FORM: NDAR-1 08-11 NON-DIW-MARGE APPLICATION REPORT (NDAR-1) Page of
Did the application rates exceed the limits in Attachmaint B of your permit? ' fan mpitaq't ❑ Non-Compilant
Were adequate measures taken to prevent effluent ponding In or runc;ff trim the sites? Compliant ❑ Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit? compliant ❑ Non -Compliant
here all setbacks listed in your permit maintained for every application to each permitted site? onnpaant ❑ Non-compilaot
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 nZon -compliance and describe the co
actions) taken. Attach additional sheets if necessary.
Op6rator In Responsible Charge (ORC) Certification
ORC:°
Certification No.:
Grade: Phone Number: t `� .
Has the ORC changed since the previous NDAR-1? ❑ Yes ❑ No
By this signature, I certify that this report Is accurrate and complete to the best of my knowledge.
PernmlWe Certification
Permittee::�
Signing Official:
Signing Officlaft Title: ,
Phone Number: r jcPermit Exp.:e°
s
Date Signe a DE
I certify, under penalty or law, that this document and all attachments wore prepared under my direction or supervision In
with a system designed to assure that all qualified personnel property gathered and evaluated the information submitted. E
Inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the Inforrr
Information submitted Is, to the best of my knowledge and belief, true; accurate, and complete; I am aware that there are
penalties for submitting false information, including the posslbftlty of fines and Imprisonment for knowing violatlot
Mall Original and Two Copies to:
Division of water Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

Peeeval NO : VaI OQ 9 69
M �� � �� ��� �� ��
this facifl y
F9 YES
Facility �Ia ae:East
Field Name:
Area (acras):
-- cover Crop:
i��aarly Rate (Bay):
Annual Rate (in):
Campus
5
1.5
6
J Y—ESD NO
cm"",dw
in In
Hold Maas®:
Area (aeras):
Corer Crop:
Hourly Rate (in):.
Anrmal pate (in):
Field irrigated?
gal train
6
— 1.5
`
0 YES p NO .
In In
County: eataUg8 Month:
Fle0d Name:
Area(acwas):1
covar Crop..
Hourly Rate (Ira):
Annual Maga (in). -Annual
Field Irrigated? 0 YES • ONO
a9 asp"`e8
goal malts in in
� F
ideas: Z bl
_ of d. Name:
Arca (acres).i
Cover Crop.
Hourly mate (in):
Rate (1,q).Vlfeather
Field Irrigatedl
1
gal orales
FJ YES p NO
g
las in
q�
2
3
E�
OF
r
In
Froeboard
�a
ft
Field
gal
iprlg a e€l?
Min
4
5
6
Y
9
1�
1�
14
79
2Q
22
24
2S
2i
28
d29
_
--
Mon tlaly Loading:P
ISS 1�1140n`�m�at. v� Tota6 p6t aa�
,—„`e.7,9M

FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REMRT (MID -1) Fade of
Did the appOic itB n rages exceed the flpnQfe hn ft-achnient B of your Pan'Ii ilt? om ;ant Ll Non -Compliant
Were adequate measures re b-2ke E to preverat affluent ponding hn or i'iui' a from tali dgtt3z Cornplkant ❑ Non-Compllant
Was a suitable a3ogetafive cover minta➢n ed on 0 shies as specified in g%ouv piE'ruu �k? �mpilant LJ Non -Compliant
Were all setbacks Hste 9 in your permit maintained for every application to each permitted sate? mpliant U Non -Compliant
Were ali fraeboavds rnailitiWned in a ccau"dcancs, with the specified oA ebt av--d heights in your ermuit?�ompliant L 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 no -compliance and describe the corrective
action(s) taken. Attach additional sheets if necessary.
Operator in Responsible Charge (ORC) Ceri ication
Certification NO.: I !����
Grade: �l Phone Number:���
Has the OIC chvn¢ged since the previou NDAR-1? Yes i---3 No
Signature Date
By this signature, i certify that this report is accurrate and complete to the best of my knowledge.
Permittee Certification
Permittee: MAS
Signing Official:
Sinning Official's Title:
Phone Number; � �`��7 Permit Egp.:
61
Signature b 6 Date
I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance
vith 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.
Mall Original and g vvo Copies to:
Division of Vilater Quality
information Procersing Unit
1617 Mail Service Center,
Raleigh, Notal Carolina 27695-1617