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Home My WebLink AboutWQ0006254_Monitoring - 11-2016_20161219 (3)FORM:_ NDAR-2 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-2) Page .3 of L ni��111#1111W.j Facility Name: Corolla Light WWTP #1 Did infiltration t6is facility? Area (acres): DYES EINO MMM ®®®0__-___-__--_-- .... m®- FORM: NDAR-2 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-2) Page LI of y - acuonts) taxen. nnacn aaaaiunai mreete n Carolina Water Service Inc. of INC P.O. Box 240908 Charlotte, NC 28228-908 704-525-7990 Operator in Responsible Charge (ORC) Certification ORC: Matthew L. Palmiter Certification No.: 1000301 Grade: 4 Phone Number: 910-376-4185 Has the ORC changed sincethe previous NDAR-2? ❑Ya ❑+ No Signature By this signature, I codify Uat this report is a=srate and complete to the bast of my Wrowtedge. Permittee Certification Permittee' Danny Lassiter C. Signing Official: Regional Manager dwiassiter@uiwater.com Signing Officifere T 800-525-7990 Phone Number: 252-240-1398 Permit Exp.: 9/30/16 Date 11 T— Signature Date I certify, under penalty of law, that Ula downient and all attachments were prepared under my direction or supervision In=, - with a system designed to assure that all gwNred personnel property gathered and evaluated the information submitted. n my hAulry or the person or parsons who manage the system, or those persons directly responsible fur gatheraig the infortnatbn, the ' information submitted Is, to the beat of my Im.Wedge and belief, true, accurate, and complete. I am aware Ciet Uere are sgMticam . penakbs for submitting false information, Including the posslbility of fines and Imprisonment for Imoymg violations. I V Mail Original and Two Copies to: -- - -Division of water Quality Information Processing Unit 1617 Mail Service Center Raleigh, North Carolina 27699-1617 Did the application rates exceed the limits in Attachment B of your permit? ❑J CompNant ❑Hort-Compliant If not a basin, were the sites kept free of vegetation and raked? Ocompliant []Non -Compliant If not a basin, were there any instances of effluent ponding in or runoff from the sites? ❑' Compliant ❑NonCampllant If a basin, were there any instances of breakout from the berms? (DCompliant ❑Non-Compllant Was the onsite automatically activated standby power source tested and operational? V OCompllant ❑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 noncompliance and describe the corrective acuonts) taxen. nnacn aaaaiunai mreete n Carolina Water Service Inc. of INC P.O. Box 240908 Charlotte, NC 28228-908 704-525-7990 Operator in Responsible Charge (ORC) Certification ORC: Matthew L. Palmiter Certification No.: 1000301 Grade: 4 Phone Number: 910-376-4185 Has the ORC changed sincethe previous NDAR-2? ❑Ya ❑+ No Signature By this signature, I codify Uat this report is a=srate and complete to the bast of my Wrowtedge. Permittee Certification Permittee' Danny Lassiter C. Signing Official: Regional Manager dwiassiter@uiwater.com Signing Officifere T 800-525-7990 Phone Number: 252-240-1398 Permit Exp.: 9/30/16 Date 11 T— Signature Date I certify, under penalty of law, that Ula downient and all attachments were prepared under my direction or supervision In=, - with a system designed to assure that all gwNred personnel property gathered and evaluated the information submitted. n my hAulry or the person or parsons who manage the system, or those persons directly responsible fur gatheraig the infortnatbn, the ' information submitted Is, to the beat of my Im.Wedge and belief, true, accurate, and complete. I am aware Ciet Uere are sgMticam . penakbs for submitting false information, Including the posslbility of fines and Imprisonment for Imoymg violations. I V Mail Original and Two Copies to: -- - -Division of water Quality Information Processing Unit 1617 Mail Service Center Raleigh, North Carolina 27699-1617