WQ0004270_Monitoring - 05-2020_20200619

FORM: NDAR-1 05.16 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page _1_ of _4_

FORM: NDAR-1 05-16 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page _2_ of _4_
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?
❑r Compliant
❑ Non -Compliant
❑� Compliant
❑ Nan -Compliant
❑� Compliant
❑ Non -Compliant
Compliant
❑ Non -Compliant
❑r 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 necessary.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Lee Pennington
Permittee:
A B Carter Inc.
Certification No.: 987583, 987903
Signing Official: Steve Renfrow
Grade: 2 Phone Number: 704-874-2754
Signing Official's Title: Vice President of Manufactuing
Has the ORC changed since the previous NDAR-1? ❑ Yes 71 No
Phone Number: 704-865-1201 Permit Exp.: 6/30/25
C�w6116120
�• 6116120
Signature Date
SU ature Date
By this signature, I certtty 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 Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) page 3 of 4
Permit No.: WQ0004270
Facility Name: A. B. Carter - Gastonia WWTP
PPI: 001
Flow Measuring Point: []Influent ❑ Effluent ❑ No flow generated
Parameter Code --►
50050 -.
00310
00916.`-
00940
50060 -
31616
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County: Gaston
Month: May
Year: 2020
Parameter Monitoring Point: ❑ Influent ❑✓ Effluent ❑ Groundwater Lowering ❑ Surface Water
00610
00625
00620
00600
00400
00665
00931
-'00929 '
70300
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mg/L
mg/L
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Ratio
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mg1L
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1: 11
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l: 11
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rye
Il le
I Sampling Type:l Estirdate ';:I Grab I Grab --;.I Grab I. Grab _ I Grab I Grab I:'.I Grab I Grab ,I Grab I Grab-:`. I Grab I Grab ;:.I Grab I Grab -1 Grab
Daily Limit:
Sample Frequency: Monthly 2 X Year 2 X Year -. 2 X Year Per EyenU 2 X Year 2 X Year' 2 X Year 2 X Year -- 2 X Year 2 X Year' Per Event 2 X Year 2 X Year 2 X Ysar 2 X Year

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page `i of `i
Sampling Person(s) Certified Laboratories
Name: Name:
Name: Name:
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 necessary.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Lee Pennington
Permittee: A B Carter Inc.
Certification No.: 987583, 987903
Signing Official: Steve Renf row
Grade: 2 Phone Number: 704-874-2754
Signing Official's Title: Vice President of Manufacturing
Has the ORC changed since the previous NDMR? ❑ yes 0 No
Phone Number: 704-865-1201 Permit Expiration: 6/30/2025
6/16/2020
6/16/2020
Si tore Date
Signature Date
By this signature, I certify that this report is accuFrate and complete to the best of my knowledge.
certify, under penalty of law, that this document and ail 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 or 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 signircant penalties for submitting false information, including the possibility of fines and imprisonment for
knowing violations.
Mail Original and Two Copies to:
Division of Water Resources
information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617