WQ0015491_Monitoring - 12-2016_20170206

FORM: NDAR-1 08-11
NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Page of �2
0
to fE
permit No.: W00015491
Facility Name: Caraway Speedway
county: Randolph
Month:>eU
Year::��{
-Field Name:
- 1
Field Name:
2
Field Name:
3
Field Name:
4
Did
irrigation occur
Area (acres)
0.49
Area (acres):
0.49
Area (acres):
0.49
Area (acres);
0.49
at this facility?
Cover Crop:
Forest
Cover Crop:
Forest
Cover Crop:
Forest
Cover Crop:
Forest
Hourly Rate (in):
0:'15
Hourly Rate (in):
0.15
Hourly: Rate (in):
0.15
Hourly Rate (in):
0.15
YES amd
Annual Rate (in):
26
Annual Rate (in):
26
Annual Rate (in):
26
Annual Rate (in):
26
Weather Freeboard
Field Irrigated?
❑ Yes No
Field Irrigated?
❑ YEs 0
Field. irrigated?
❑ YES
'I_:NO. -
Field Irrigated?
❑ YES
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in in
gal min
in
in
gal min
in
in
1
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5
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9
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.: ;..
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-
---
30
31
-
Monthly Loading
12 Month Floating Totat

FORM: NDAR-1 08-11
NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Did the application rates exceed the limits in Attachment B of your permit?
Were adequate measures taken to prevent effluent ponding in or runoff from the sites?
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?
rag or 2
Compliant El Non -Compliant
Compliant ❑ Non -Compliant
COmplbnt
❑ Non -Compliant
Compllam
❑ Nan-CAmpliant
E,104fiant
❑ Non -Compliant
If the facilitv 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
mneu. nuau i auwuuum aucaw „ ,�c..�»o, �.
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 - 5803
Signing Official's Title:
HastheORC changed since the previ NDAR-1? ❑ yg 940
Phone Number: [phone] Permit Exp.: 4/30/17
Signature Date
Signature - Date
By this signature, I certify that this report is accurate 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 aocordwm
and evaluated the Information submitted. Based on my
with a system designed to assure that all qualified personnel properly gathered
Inquiry of the person or persons who menage the system. or those persons directly responsible for gathering the information, the
Information submitted Is, to the best of my knowledge and belief, true, acomaua. 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 z -
Permit No • WQ0015491 Facility Name: Caraway Speedway County: Randolph
PPI: 001 Flow Measuring Point: ED Influent El Effluent El No Flow generated Parameter Monitoring Point: El Influent
Month:
❑✓ Effluent ❑Groundwater) wenn
Yea 2p 1
❑Sufiace water .
Parameter Code --►
50050
00400
50060 "
00310 00610 '
00530
31696,
00620
0062575
3
0
�. E E
¢
O
a
o y °`
O E
to E
° v.o
~ W ur
N
o
U
~
O O
24 -hr hrs
GPD
su
mglL.
mglL mglL
mglL
#(900 mG
mglL
-mglL
1
2
3
4
5
6
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
31
Average:
Daily Maximum:
Daily Minimum:
Sampling Type:
:.#DIV/Of'.
0
0
Estimate.
Grab
Grab
Grab Grab
Grab
Grab.
Grab
Grab
-
Monthly Avg. Limit:
Daily Limit
.. __
9,999 g
.._.. i..
' aY­ 1Yvr.
4Xvr
'.�'"3Xvr
3Xvr
'3XVf-.
--

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page ;2- of 2'
Sampling Person(s) �7 / /� Certified Laboratories
Name:U-�--. `y61..\ Name: 'K f-C'�.12.`N��C�I
Name: / J Name: 1�-
Does all monitoring data and sampling frequencies meet the requirements In Attacnment A or your permitr I_Iwmpienc �, ••gyp•••
If fhc fnniiity is nnn-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
raKen. Aaacn apaRlonal bimcu n
Operator in Responsible Charge (ORC) Certification
ORC: Darren A. Hackett
Certification No.: 25029
Grade: SI Phone Number: (336) 629 58033
Has the ORC changed since the p*lous NDMR? ❑ Yes E
Signature /
By this signature, l certify that this report is accurate and complete to Me best of my knowledge.
Permittee Certification
Permittee: Russell H. Hackett
Signing Official:
Signing Official's Title:
Phone Number: (336) 629 - 5803 Permit Expiration: 4/30/2017
3 I 1 z�
Da a Signature Date
I termly, under penally of law. thrd this doorman and as ellxhmenb ware prepared under my c ireclim or wpervieiwr In
ecmrdenre with a system designed to assum Met all qualMed personnel pmp" gathered and evaluated the infamatim
submlaed. Based on my Inquiry of the person or persons who menage the system, or prose persons directly responsible for
gastedng the infomaaon, the h6cm dlon wbm ided is, to the best of my knowledge and belief, true, acamte, and cgnplete. I am
awam that them em significant penalses for submltblg Use Infomuaicn, including the possibllhy of fines and impdsonmenl 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