WQ0005150_Monitoring - 12-2016_20170126

FORM: NDMR 08-11
NON -DISCHARGE MONITORING REPORT (NDMR)
Page of Z
Permit No.: WQ0005150
Facility Name: North End Elementary
County: Person
Month: December
��Flow
Measuring •• ■ G E:]No flow generated
Parameter Monitoring -. ■ R]Effluent FIGroundwater Lowering 0surface Water

FORM: NDMR 08-11 NON -DISCHARGE MONITORING REPORT (NDMR) Page. Z!of Z
Sampling Person(s)
Name: Paul J. Phillips
Name: Chris B. Clayton
Name: Pace Analytical
Name:
Certified Laboratories
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of 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 n
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Paul J. Phillips
Permittee: Danny Holloman
Certification No.: 986029
Signing Official: Bfflff7 He� 1-14-11
(o/
Grade: SI Phone Number: 336-599-0223
Signing Official's Title!13,J- ;- Superientendent
Has the ORC changed since the previous NDMR? ❑Yes ONo
Phone Number: 336- 599-0223 Permit Expiration: 5/31/2020
'ey� -2� -
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Signat a Date
8 - ature 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.
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 --L of
Permit No.: WQ0005150
Facility Name:
North End Elementary
County: Person
Month:
December
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Area (acres):
Area (acresY
Area (acres):
at this facility?
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FIYES DNO
HourlyRate(i n):
Hourly Rate (in):'
03
Annual Rate (in):,
Armu"ate (in):
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FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page C/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? EZCompliant ❑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 n
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Paul J. Phillips
Permittee:
Danny Holloman
Certification No.: 986029
Signing Official: DaRey-4#6}f61tTi� -7--l-
7-- r -Grade:
Grade:SI Phone Number: 336-599-0223
Signing Official's Title:Y­�ww Superientendent
Has the ORC changed since the previous NDAR-1? ❑yes ONO
Phone Number: 336-599-0223 Permit Exp.: 5/31/20
Signature Date
Ig ature 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