WQ0010878_Monitoring - 12-2016_20170105

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FORM: NDAR-108-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page _ of
Did the application rates exceed the limits In Attachment B of your pemtlt?
Were adequate measures taken to prevent effluent ponding In or runoff from the aitas?
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?
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❑ NonCmyNent
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❑ NanconpWA
❑ NarConyilent
CerN6eaton No.: 18595
❑ Nan-ComplYrk
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If the facility Is noncompliant, please explain in the apace below the reason(s) the facility was not In compliance. Provide in your explanation the date(s) of the noncompience and describe the conactve
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Operator In Responsible Charge (ORC) Cerfiflcaton
Permittee Codi icaton
ORC: Scott Vasgaard
Permittee:
Blue Ridge Preservation
CerN6eaton No.: 18595
Signing Oficial: Sett Vasgaard
orade: SI Phone Number. 828.297-6234
Signing Officlars Title: ORC
Has the ORC changed since the previous NDAR-1? ❑ yw CI No
Phone Number. 828-297.8234 Perna Exp.: V3W"
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Signature Date
Signl4mi Date
BY tlee SOW&", I oer* ad er. MW M aoar,ab ad OWOp m dw lose of ray Ianrledge.
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Mall Original and Two Copies to:
Division of Water Quality
Informadon Processing Unit
1617 Mall Service Center
Raleigh, North Carolina 276 6 9-1 61 7

FORK NDAR•1 o&11 NON.Dier.H RQE AP., (NDAR-1) Pe6e—�—
d the application rates exceed the limits In Attachment B of your panni!? a NOVOKOW
Or* adequate measures taken to prevent effluent ponding In pq ruRoff11'otn the Asset e a r ria
as a sultable vegetative cover maintained on all alba as specNled lia•your pwwW / a Noo-mnboo
Mi sit setbacke Noted In your permit maintained for every appellation to each pwmNbd sib? o NarObipMnt .
are all **aboard* maintained in accordance with the apecWbd Awboard heighf* In your permit? /��/ ��� ❑
If" te0aty N 110" ttprent, Pleas OPINIn In tin epe0e bal" fib mmm(e) 0b wit ww not In 0osr *mbe. Protide In your expinnaron Iib dAWS) of Mb nofi-O "duorft ft owreAl
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Win 81 Phone Numbers 828.207-0284
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IntbMadon Proo"Swo th*
1017 MON *ervl confer
Relelgh, Moth Camila* 27 1017
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