WQ0029233_Monitoring - 09-2016_20161101 (2)

'FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Page ( of
Permit No.:
W00029233
Facility Name:
Bear Lake Reserve
County:
Jackson
Month:
September
Year:
2016
Did irrigation occur
at this facility?
DYES [21NO
��
Field Name:
A
Field Name:
B
Field Name:
C
Field Name:
D
Area (acres): 0.67
Area (acres): 0.84
Area (acres): 0.82
Area (acres): 1.26
Cover Crop: Mature Forest
P�
Cover Mature Forest
P�
Cover Mature Forest
P'•
Cover Mature Forest
P�
Hourly Rate (in): 0.05
Hourly Rate (in): 0.05
Hourly Rate (in):: 0.05
Hourly Rate (in): 0.05
1`
V
Annual Rate (in):
70.5/7.0
Annual Rate (in):
85.7/8.6
Annual Rate (in):
72.5 ( 7.2
Annual Rate (in):
69.6/7.0
Wea her
itbU
Field Irrigated?
DYES
EINo
Field Irrigated?
[:]YES
EINO
Field Irrigated?
DYES
[jNO
Field Irrigated?
DYES
ONO
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in
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min
in
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in
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1
C
72
0
9 19
0
0
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0
0
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0.00
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2
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67
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9 19
0
0
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0.00
0
0
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0
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0
0
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0.00
3
0
0
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0.00
0
0
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0.00
0
0
0.00
0.00
0
0
0.00
0.00
4
0
0
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0.00
0
0
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0.00
0
0
0.00
0.00
0
0
0.00
0.00
5
a
0
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4.00
0
0
0.00
0.00
0
0
0.00 0:00
0
0
0.00
0.00
61
C
69
0
9 19
0
0
0.00
0.00
0
0
0.00
0.00
0
0
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0.00
0
1 0
0.00
0.00
7
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71
0
9 18.5
0
0
0,00
0.00
0
0
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0.00
0
0
0.00
0.00
0
0
0.00
0.00
8
C
68
0
9 18.5
0
0
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0:00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
9
C
72
0
9 18.5
0
0
0.00
0.00
0
0
0.00
0.00
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0
0.00
0.00
0
0
0.00
0.00
10
0
0
0,00
0.00
0
0
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0.00
0
0
0,.00
0,00
0
0
0.00
0.00
11
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0
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0
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0.00
12
C
67
0
9 18
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0
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0.00
0
0
0.00
0.00
0
0
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0,00
0
0
0.00
0.00
13
C
70
0
9 18
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
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0
0.00
0.00
14
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68
0
9 18
0
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0
0
0.00
0.00
15
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60
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0,00
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16
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71
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17
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18
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19
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68
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20
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66
0
9 17.5
0
0
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0.00
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0
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0
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21
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60
0
9 17.5
0
0
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0.00
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0
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0
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0.00
0
0
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221
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68
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9 17
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0
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23
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66
0
9 16
0
0
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0
0
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0.00
0
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0.00
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0
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0.00
24
0
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0
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0
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25
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0
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26
C
68
0
9 15
0
0
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0,00
0
0
0.00
1 0.00
0
0
0.00
0.00
0
0
0.00
0.00
27
R
65
0.9
9 14.5
0
0
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0.00
0
0
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0.00
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0,00
0
0
0.00
0.00
281
CL60
0
9 14
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0
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0
0
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0
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0
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0
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129
30
C
0
9 12
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0
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311
0
0
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0
0
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0
0
0.00
0.00
Monthly Loading:
0
0.00
2.57
0
0.00
2.54
0
0.00
2.49
0
0.00
2.39 '.
12 Month Floating Total (in)-

FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page I of—A,
Did the application rates exceed the limits in Attachment B of your permit?
Were adequate measures taken to prevent effluent ponding in or runoff from the sites?
Was a suitable vegetative cover maintained on all sites as specified in your permit?
Were all setbacks listed in your permit maintained for every application to each permitted site?
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
❑� Compliant ❑Non -Compliant
❑� Compliant ❑Non -Compliant
EZCompliant ❑Non -Compliant
❑✓ Compliant ❑Non -Compliant
❑� 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: Michael Beck
Permittee:
Bear Lake Reserve
Certification No.: SI -991669 WWIV-7930
Signing Official: Robert Barr
Grade: SI WWIV Phone Number: [phone]
Signing Official's Title: Signatory
Has the ORC changed since the previous NDAR-1? ❑Yes FYINo
Phone Number: [phone] Permit Exp.: 9/30/14
LVV2
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

FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page Z of
Permit No.:
WQ0029233
Facility Name:
Bear Lake Reserve
County:
Jackson
Month:
September
Year:
2016
Did irrigation occur
at this facility?
Field Name:
E
Field Name:
F
Field Name:
G
Field Name:
H
Area (acres): 0.74
Area (acres): 0.95
Area (acres): 0:71
Area (acres): 0.53
Cover Crop: Mature Forest
Cover Crop: Mature Forest
Cover Crop: Mature Forest
Cover Crop: Mature Forest
❑YES
PINO
Hourly Rate (in):
0.05
Hourly Rate (in):
0.05
Hourly Rate (in):
0.05
Hourly Rate (in):
_
0.05
Annual Rate (in):
70.217-0
Annual Rate (in):
73.9/7.4
Annual Rate (in):
63.5.:/ 6.3
Annual Rate (in):
77.3/7.7
Weather
Freeboard
Field Irrigated?
DYES
❑✓ NO
Field Irrigated?
DYES
ONO
Field Irrigated?
DYES
pN0
Field Irrigated?
DYES
❑✓ NO
V
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1
C
72
0
9
19
0
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7
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71
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18.51
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0
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0
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0
0
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0
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0.00
8
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68
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9
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0
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0
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0:00
0
0
0.00
0.00
9
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72
0
9
18.5
0
0
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0.00
0
0
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0.00
0
0
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0
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0.00
101
0
0
0.00
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0
0
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0
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0
0.00
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11
0
0
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0.00
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0
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0
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12
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67
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9
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13
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70
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9
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0
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14
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68
0
9
18
0
0
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0
0
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0
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0
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15
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60
0
9
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0
0
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0
0
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0
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16
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71
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0
0
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0
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17
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0
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0
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0
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0
0
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0.00
18
0
0
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0.00
0
0
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0
0
0.00
0:00
0
0
0.00
0.00
19
C
68
0.3
9
17.51
0
0
0.00
0.00
0
0
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0.00
0
0
0.00
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0
1 0
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0.00
20
C
66
0
9
17.5
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0,.00
0.00
0
0
0.00
0.00
21
C
60
0
9
17.5
0
0
0.00
0.00
0
0
0.00
0.00
0,
0
0.00
1 0.00
0
0
0.00
0.00
22
C
68
0
9
17
0
0
0.00
0.00
0
0
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0.00
0
0
0.00
0:00
0
0
0.00
0.00
231
C 1
66
0
9
16
0
0
0.00
0.00
0
0
0.00
0.00
0
0
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0.00
0
0
0.00
0.00
24
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
25
0
0
0:00
0.00
0
0
0.00
0.00
0
0
0.00
.0.00
0
0
0.00
0.00
26
C
68
0
9
15
0
0
0.00
0,00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
27
R
65
0.9
9
14.5
0
0
0.00
0.00
0
0
0.00
0.00
0
0
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0.00
0
0
0.00
0.00
28
C
67
0
9
140
0
0.00
0.00
0
1 0
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0.00
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0
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29
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60
0
9
13
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0.00
0
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0
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0
0
0.00
0.00
30
C
60
0
9
12
0
0
0.00
0.00
0
0
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0
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0.00
31
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0
0.00
0.00
2.51
0.00
0
0
0.00
Monthly Loading:
12 Month Floating Total (in):
0 0.00
2.52
0 0.00
1.53
0 0.00
2.44 iw

FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page 2- of
Did the application rates exceed the limits in Attachment B of your permit?
Were adequate measures taken to prevent effluent ponding in or runoff from the sites?
Was a suitable vegetative cover maintained on all sites as specified in your permit?
Were all setbacks listed in your permit maintained for every application to each permitted site?
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
❑� Compliant ❑Non -Compliant .
(]Compliant ❑Non -Compliant
❑� Compliant ❑Non -Compliant
❑� Compliant ❑Non -Compliant
❑✓ 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: Michael Beck
Permittee:
Bear Lake Reserve
Certification No.: SI -991669 WWIV-7930
Signing Official: Robert Barr
Grade: SI WWIV Phone Number: [phone]
Signing Official's Title: Signatory
Has the ORC changed since the previous NDAR-1? ❑Yes ONo
Phone Number: [phone] Permit Exp.: 9/30/14
%k4 I e, (0 -,R7-16
P ) o ft i//
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

FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Page __� of
Permit No.:
W00029233
Facility Name:
Bear Lake Reserve
County:
Jackson
Month:
September
Year:
2016
Did irrigation occur
at this facility?
Field Name:
I
Field Name:
K
Field Name:
M
Field Name:
N
Area (acres): 0.85
Area (acres): 0.99
Area (acres): 0.52
Area (acres): 0.58
Cover Crop:Mature Forest
Cover Crop: Mature Forest
P�
Cover Crop: Mature Forest
P�
Cover Cro Mature Forest
P'
❑YES
ONO
Hourly Rate (in):
0.05
Hourly Rate (in):
0.05
Hourly Rate (in):
0.05
Hourly Rate (in):
0.05
Annual Rate (in):
80.0/8.0
Annual Rate (in):
71.0/7.1
Annual Rate (in):
66.8/6.7
Annual Rate (in):
60.2/6.0
Weather
Freeboard
Field Irrigated?
DYES
[ENO
Field Irrigated?
DYES
ENO
Field Irrigated?
DYES
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Field Irrigated?
DYES
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in
ft
ft
gal
min
in
in
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min
in
in
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min
in
in
gal
min
in
in
1
C
72
0
9
19
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
2
CL
67
0.1
9
19
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
3
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
4
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
5
0
0
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0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
6
C
69
0
9
19
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
7
C
71
0
9
18.5
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
8
C
68
0
9
18.5
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
9
C
72
0
9
18.5
0
0
0.00
0.00
0
0
0.00
0.00
1 0
0
0.00
0.00
0
0
0.00
0.00
10
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
11
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0,00
0.00
0
0
0.00
0.00
12
C
67
0
9
18
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
13
C
70
0
9
18
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0,00
0.00
0
0
0.00
0.00
14
C
68
0
9
18
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
15
C
60
0
9
18
0
0
0.00
0.00
0
0
0.00
0.00
0
0 1
0.00
0:00
0
0
0.00
0.00
16
C
71
0
9
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0
0
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0.00
0
0
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0
0
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0
0
0.00
0.00
17
0
0
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0.00
0
0
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0.00
0
0
0.00
0:00
0
0
0.00
0.00
18
0
0
0.00
0.00
0
0
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0.00
0
0
0.00
0,00
0
0
0.00
0.00
19
C
68
0.3
9
17.5
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
20
C
66
0
9
17.5
0
0
0.00
0,00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
21
C
60
0
9
17.5
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
22
C
68
0
9
17
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
23
C
66
0
9
16
0
0
0,00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
24
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
251
j
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
1 0
0
0.00
0.00
261
C 1
68
0
9
15
0
0
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0.00
0
0
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0.00
0
0
0.00
0;00
0
0
0.00
0.00
27
R
65
0.9
9
14.5
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
28
C
67
0
9
14
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
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0.00
29
C
60
0
9
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0
0
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0
0
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0
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0
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30
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60
0
9
12
0
0
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0
0
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31
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=
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2.37 ''.
Monthly Loading:
12 Month Floating Total (in):
0 0.00
2.53
0.; � �- � 0.00
2.60 :: '
0 0.00
2.47

FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page 3 of
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?
ECompliant
❑Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit?
❑� 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.
I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Michael Beck
Permittee:
Bear Lake Reserve
Certification No.: SI -991669 WWIV-7930
Signing Official: Robert Barr
Grade: SI WWIV Phone Number: [phone]
Signing Official's Title: Signatory
Has the ORC changed since the previous NDAR-1? Elves ENo
Phone Number: [phone] Permit Exp.: 9/30/14
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

•FORM: NDAR-1 08-11
NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Page -1--- of
Permit No.:
W00029233
Facility Name:
Bear Lake Reserve
County:
Jackson
Month:
September
Year:
2016
Field Name:
O
Field Name:
P
Field Name:
Q
Field Name:
R
Did irrigation
at this facility?
occur
Area (acres):
0.5
Area (acres):
1.1
Area (acres):
0.43
Area (acres):
0.7
Cover Crop: Mature Forest
P�
Cover Cro Mature Forest
P�
Cover Cro Mature Forest
P�
Cover Cro Mature Forest
P'
❑YES
ONO
Hourly Rate (in):
0.05
Hourly Rate (in):
0.05
Hourly Rate (in):
0.05
Hourly Rate (in):
0.05
Annual Rate (in):
78.6/7.9
Annual Rate (in):
80.7/8.1
Annual Rate (in):
87.318.7
Annual Rate (in):
77.6/7.8
Weather
Freeboard
Field Irrigated?
DYES
❑✓ NO
Field Irrigated?
DYES
❑✓ NO
Field Irrigated?
DYES
❑a NO
Field Irrigated?
DYES
❑� NO
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min
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in
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min
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min
in
in
1C
72
0
9
19
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
2
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67
0.1
9
19
0
0
0.00
0.00
0
0
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0.00
0
0
0.00
0.00
0
0
0.00
0.00
3
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
4
0
0
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0.00
0
0
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0.00
0
0
0.00
0.00
0
0
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0.00
5
0
0
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0.00
0
0
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0.00
0
0
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0.00
0
0
0.00
0.00
6
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69
0
9
19
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0;00
0
0
0.00
0.00
7
C
71
0
9
18.5
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
8
C
68
0
9
18.5
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
9
C
72
0
9
18.5
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
10
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
11
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
12
C
67
0
9
18
0
0
0.00
0,00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
13
C
70
0
9
18
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
14
C
68
0
9
18
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0,00
0
0
0.00
0.00
15
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60
0
9
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0
0
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0.00
0
0
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0.00
0
0
0,00
0.00
0
0
0.00
0.00
16
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71
0
9
18
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
17
0
0
0.00
0.00
0 1
0
0.00
0.00
0
0
0:00
0.00
0
0
0.00
0.00
18
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
191
C
68
0.3
9
17.5
0
0
0.00
0:00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
, 0.00
20
C
66
0
9
17.5
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0 'c .
;0.00
,• , . Q-.00
21
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60
0
9
17.5
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
22
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68
0
9
17
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0,00
0
0
0.00
0.00
23
C
66
0
9
16
0
0
0.00
0,00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
24
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
25
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
26
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68
0
9
15
0
0
0,00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
27
R
65
0.9
9
14.5
0
0
0.00
0,00
0
0
0.00
0.00
0
0
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0.00
0
0
0.00
0.00
28
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67
0
9
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0
0
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0.00
0
0
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0
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0.00
0
0
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0.00
29
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60
0
9
13
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
30
C
60
0
9
12
0
0
0.00
0.00
0
0
0.00
0.00
1 0
0
0.00
0.00
0
0
0.00
0.00
311
1
1 1
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
10
0
0.00
0.00
Monthly Loading:
0
0.00
2.57
0
-�*
Y
-_- - -
0.00-
2.35k�
0
0.00
0
0.00 _ qL;-:,
12 Month Floating Total (in):

FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page 4— of& -
Did the application rates exceed the limits in Attachment B of your permit?
Were adequate measures taken to prevent effluent ponding in or runoff from the sites?
Was a suitable vegetative cover maintained on all sites as specified in your permit?
Were all setbacks listed in your permit maintained for every application to each permitted site?
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
(]Compliant ❑Non -Compliant
(]Compliant ❑Non -Compliant
ElCompliant []Non -Compliant
❑✓ Compliant ❑Non -Compliant
OCompliant ❑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: Michael Beck
Permittee:
Bear Lake Reserve
Certification No.: SI -991669 WWIV-1930
Signing Official: Robert Barr
Grade: SI WWIV Phone Number: [phone]
Signing Official's Title: Signatory
Has the ORC changed since the previous NDAR-1? ❑Yes ONO
Phone Number: [phone] Permit Exp.: 9/30/14
.
- 10-27-16.
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

FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of
Permit No.:
W00029233
Facility Name:
Bear Lake Reserve
County:
Jackson
Month:
September
Year: 2016
Did irrigation occur
at this facility?
DYES ONO
Field Name:
S
Field Name:
T
Field Name:
U
Field Name:
Area (acres): 0.92
Area (acres): 0.61
Area (acres): 0.58 Area
(acres):
Cover Crop:Mature Forest
Cover Crop: Mature Forest
P'
Cover Crop: Mature Forest
p'
Cover Crop:
P'
Hourly Rate (in): 0.05
Hourly Rate (in): 0.05
Hourly Rate (in): 0,05
Hourly Rate (in):
Annual Rate (in):
67.416.7
Annual Rate (in):
73.517.3
Annual Rate (in):
S5.449.5
Annual Rate (in):
Weather
Freeboard
Field Irrigated?
DYES
QNO
Field Irrigated?
DYES
ONO
Field Irrigated?
DYES
ONO
Field Irrigated?
DYES ❑NO
C3
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in
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in in
1
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72
0
9
19
0 0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
2
CL
67
0.1
9
19
0 0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
3
0 0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
4
0 0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
5
0 0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
6
C
69
0
9
19
0 0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
7
C
71
0
9
18.5
0 0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
8
C
68
0
9
18.5
0 0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0,00
9
C
72
0
9
18.5
0 0
0.00
0,00
0
1 0
0.00
0.00
1 0
0
0.00
0.00
10
0 0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
11
0 0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
12
C
67
0
9
18
0 0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
13
C
70
0
9
18
0 0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
14
C
68
0
9
18
0 0
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0.00
0
0
0.00
0.00
0:
0
0.00
0:00
15
C
60
0
9
18
0 0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0100
16
C
71
0
9
18
0 0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0:00
171
0 0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
18
0 0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0:00
19
C
68
0.3
9
17.5
0 1 0
0.00
0,00
0
0
0.00
0.00
0
0
0.00
0.00
20
C
66
0
9
17.5
0 0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0;00
21IC60
0
9
17.5
0 0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
2268
0
9
17
0 0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
2366
0
9
16
0 0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
24
0 0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
25
0 0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
2668
0 1
9
15
0 0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0::00
27
R
65
0.9
9
14.5
0 0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
28
C
67
0
9
14
0 0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
29
C
60
0
9
13
0 0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
DAO
30
C
60
0
9
12
0 0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
31
0 1 0
1 0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
Monthly Loading:
12 Month Floating Total (in):
0
0.00
2.53
0
0.00
2.51
0
0.00
2.37
0
0.00

FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page S of
Did the application rates exceed the limits in Attachment B of your permit?
Were adequate measures taken to prevent effluent ponding in or runoff from the sites?
Was a suitable vegetative cover maintained on all sites as specified in your permit?
Were all setbacks listed in your permit maintained for every application to each permitted site?
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
❑✓ Compliant ❑Non -Compliant
❑✓ Compliant ❑Non -Compliant
❑✓ Compliant ❑Non -Compliant
❑� Compliant ❑Non -Compliant
[]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 necessarv.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Michael Beck
Permittee:
Bear Lake Reserve
Certification No.: SI -991669 WWIV-7930
Signing Official: Robert Barr
Grade: SI WWIV Phone Number: [phone]
Signing Official's Title: Signatory
Has the ORC changed since the previous NDAR-1? ❑Yes [2]No
Phone Number: [phone] Permit Exp.: 9/30/14
%�L_ Q -
V�/� / .012-qlt �
10_9�7_1&
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