WQ0028693_Revised Monitoring - 02-2020_20200505

raRM: NDAR-1 08-11
NOWDISCHARGE APPLICATION REPORT (NDAR-1)
, �" p A3 l 64- 10 Page 1- of L
Perlii, No.: WQ0028693
Facility Name: Mountaintop Golf & Lake Club WWTF
County:
Jackson Month: February
Year:
2020
D d irrigation
occur
Field Name:
02
-
Field Name:
04
at this facility?
Area (acres):
Area
4.35
Area (acres):
4.26
Crop:
Bluegrass/Bentgras
Cover Crop:.
Bluegrass/Bentgras
❑ YES
LINO
Hourly Rate (in):
0.15
Hourly Rate (in):
0.15
-
Annual Rate (in):
18.2
Annual Rate (in):
18.2
Weather
Freeboard
Field Irrigated?
❑ YES
ONO
Field Irrigated?
❑ YES
ONO
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'.K � :!.' M&aAM ��

FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page I of[ o
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?
21 Compliant ❑ Non -Compliant
2 Compliant ❑ Non -Compliant
21 Compliant ❑ Non -Compliant
21 Compliant ❑ Non -Compliant
O 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
tdnen. Auacn aoalnonal sneers IT
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Michael Beck
Permittee:
Mountaintop Golf & Lake Club
Certification No.: SI-991669 WWIV-7930
Signing Official: Robert Barr
Grade: SI WWIV Phone Number: [phone]
Signing Official's Title: Signatory
Has the ORC changed since the previous NDAR-1? ❑ yes O No
Phone Number: [phone] Permit Exp.: 8/31/19
f
,a�Z Zo
Signature Date
Signature Date
By this signature, I certify that this report is accumate and complete to the best of my knowledge
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

FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page Z of % t>
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?
O Compliant ❑ Non -Compliant
O Compliant ❑ Non -Compliant
O Compliant ❑ Non -Compliant
2) Compliant ❑ Non -Compliant
O 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
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Michael Beck
Permittee:
Mountaintop Golf & Lake Club
Certification No.: SI-991669 WWIV-7930
Signing Official: Robert Barr
Grade: SI WWIV Phone Number: [phone]
Signing Official's Title: Signatory
Has the ORC changed since the previous NDAR-1? ❑ yes 0 No
Phone Number: [phone] Exp.: 8/31/19
&''-
, -,Permit
3 -2 .
Signature Date
Signature Date
By this signature, I certify that this report is accurtale 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: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page'S of I
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?
0 Compliant ❑ Non -Compliant
0 Compliant ❑ Non -Compliant
O Compliant ❑ Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site? o Compliant ❑ Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? O 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
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Michael Beck
Permittee:
Mountaintop Golf & Lake Club
Certification No.: SI-991669 WWIV-7930
Signing Official: Robert Barr
Grade: SI WWIV Phone Number: [phone]
Signing Official's Title: Signatory
Has the ORC changed since the previous NDAR-1? El YES 0 No
Phone Number: [phone] Permit Exp.: 8/31/19
�12Z
Signature Date
Signature Date
By this signature, 1 certify that this report is accurtate 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

s'a � �
� ��

FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page `'r of % a
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?
O Compliant ❑ Non -Compliant
171 Compliant ❑ Non -Compliant
O Compliant ❑ Non -Compliant
17 Compliant ❑ Non -Compliant
O 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
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Michael Beck
Pennittee:
Mountaintop Golf & Lake Club
Certification No.: SI-991669 WWIV-7930
Signing Official: Robert Barr
Grade: SI WWIV Phone Number: [phone]
Signing Official's Title: Signatory
Has the ORC changed since the previous NDAR-1? ❑ Yes O No
Phone Number: (828) 251-1 00 Permit Exp.: 8/31/19
3-a4-aa
Signature Date
Signature Date
By this signature, I certify that this report is accurrale 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. 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: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page `5 of J
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?
171 Compliant ❑ Non -Compliant
21 Compliant ❑ Non -Compliant
ED Compliant ❑ Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site? O Compliant ❑ Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? p 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
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Michael Beck
Permittee:
Mountaintop Golf & Lake Club
Certification No.: SI-991669 WWIV-7930
Signing Official: Robert Barr
Grade: SI WWIV Phone Number: [phone]
Signing Official's Title: Signatory
Has the ORC changed since the previous NDAR-t? ❑ yes O No
Phone Number: [phone] Permit Exp.: 8/31/19
A.;�r.R &-�_ 3 -14 - ;�b
31,gJ2�-
Signature Date
Signature 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 qualUied personnel properly gathered and evaluated the information submitted. Based on my
inquiry of the person or persons who manage the system, or Nose 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

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