WQ0005150_Monitoring - 10-2016_20161122

`FORM: NDAR-.1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page I—of a—
•.: WQ0005150
Facility Name:
North End Elementary
County: Person
Month:
October
1
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FORM: NDAR-1 08-11NON-DISCHARGE APPLICATION REPORT (NDAR-1) Page' 08-11F—
NON-DISCHARGE
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?
[2]Compliant
❑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?
DCompliant
❑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 n
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: Paul J. Phillips
Permittee:
Danny Holloman
Certification No.: 986029
Signing Official: Danny Holloman
Grade: SI Phone Number: 336-599-0223
Signing Official's Title: Superientendent
Has the ORC changed since the previous NDAR-1? ❑yes [ANo
Phone Number: 336-599-0223 Permit Exp.: 5/31/20
f
U4LA7 11 -7 -IG
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 property gathered and evaluated the information submitted.
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617