WQ0015491_Monitoring - 11-2016_20170126

FORM: NDAR-1 08-11
NON -DISCHARGE APPLICATION REPORT (NDAR-1)
PageJ_of

FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) rage a— or 2
`Did the application rates exceed the limits in Attachment B of your permit? Lf Compliant ❑ Nan -Compliant
W.ore.adequate measures taken to prevent effluent ponding in or runoff from the sites?541-pliant ❑ Non -Compliant
Volas 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 per oglitted site? compliant El Non-compliant
Dere all -freeboards maintained in accordance with the specified freeboard heights in your permit? 911ompliant ❑ 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
�rfinnlcl takan Attarh aririitinnal sheets if necessarv.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: : Darren A. Hackett
Permittee: Russell H. Hackett
Certification No.: 25029
Signing Official:
Grade: SI Phone Number: (336) 629.- 58803
Signing Official's Title:
Has the ORC changed since the previous NDARA? ❑ Yes
Phone Number: [phone] Permit Exp.: 4/30/17
Signature ate
. Signature to
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: NDMR 03-12
NON -DISCHARGE MONITORING REPORT (NDMR)
page of
P.MEonffhly Avg. Limit
Daily L�mft t9F 99 9P ' _
.4xyr �_Xvr. . 3Xyr _ 3Xvr °
a
___I— r_—�........... ....1C-1414. .�...:,w''�.. "�—.._..:e.......;� .rv»+.,.a......�... �w��
Facility Name: Caraway Speedway
County:
Randolph Month:
X
Yes Z,,
Permit
No.: W00015491
Flow Measuring Point: Influent El Effluent El No Flow generated Parameter Monitoring Point:
El influent ❑✓ Effluent
ED Groundwat-e Lowering
(] Surface water
PPI: 001
5Q050
00400 50066 00310
:0061 Q,y.'I 00530
3616
00620
Parameter
Code
E d
Qto C
I
- fA%
LGL
Fa
�
Ot1o1
v
N2
p
z
0
t
0
Lsu
mg/L
k
mg/L
L
24 -hr hrs
mg/
56910
`
sr
12
z
13
14
A
5
s�m
16
F
x
17
1817,
19
20
21
f
,.i
22
23
24
25
;
26
271t1
`
is'
rs .1
4
3
g'_ t'
28
[f
- X•
29
30Ell
311
d
Average#DIUIOt
Daily Maximum
Daily Minimum 0
w
�.�ti�;,1 1 rah
r�a6 Grab
Grab .
Grab
Gran
i7777
_--
P.MEonffhly Avg. Limit
Daily L�mft t9F 99 9P ' _
.4xyr �_Xvr. . 3Xyr _ 3Xvr °
a
___I— r_—�........... ....1C-1414. .�...:,w''�.. "�—.._..:e.......;� .rv»+.,.a......�... �w��

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Paged of 2
/ Sampling Person(s) 1' KAI_
Certified Laboratories
j yL1�vC��� Name: 1 ! 4 KA I_ 7.�Lir -e
Name U-e�-�,
Name: Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permire int u Non-tompuanr
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
�nNnnlcl fakan Aftnnh arirlitinnal sheets if necessarv.
Operator in Responsible Charge (ORC) Certification Permittee Certification l
ORC: Darren A. Hackett Permittee: Russell H. Hackett
Certification No.: 25029 Signing Official:
Grade: SI_ Phone Number: (336) 629 - 5803 Signing Official's Title:
Has the ORC changed since the previous NDMR? ❑ Yes ffNo Phone Number: ($36) 629 - 5803 Permit Expiration: 4/30/2017
It, 13(
Signature
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
v Signature Date
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. 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