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Home My WebLink AboutWQ0036210_Monitoring - 05-2020_20200623FCIRAC, NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page ? of Moore wll • 1 •• - • •County: Pe Point: DInfluent [:]Effluent [:]Groundwater Lowering F]Surface Water Parameter Monitoring m ■ram ��■��■�■�� rwr�-vww gr%Aw� MWIM. 1 rya,-. - . Sampling Person(s) Certified Laboratories 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. Huacn aaamunw sneew n Operator In Responsible Charge (ORC) Certification Permittee Certification ORC: Thomas Lewis Permlttee: Benchmark Ministries Inc. Certification No.: 1002746 Signing Official: Thomas Lewis Grade: SI Phone Number: 919-815-7603 Signing Officials Title: President Has the ORC changed since the previous NDMR? ❑Yes ❑✓ No Phone Number: 919-815-7603 Permit Expiration: 1/31/2023 r e2 O i ature 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 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 FORMFNDAR NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page I_ of C1.1111111111=9 11119i.,YAM' Facility Name: ..Keep Christian • Moore Did irrigation occur at this facility? EJYES ■ . Field Na C Area (acres,): Area (acresy. . Cover Cr . .. . ��__ � Crop.Cover - MUM Annual Rate (in): ©rrr ol�r[�r! mrrr mill rrrr rrrrr�� rrrrrr■r �r��■ r�� E$�� rrrrrrrr rrrrrrrr �r��r� rr��r� rrr rrrrrrrr rrrrrrrr rrr�� r�r■ mrr� ., :�� rrrrrrrr rrrrrr�r rrrrr� r�� mrNArrr� rr �rrrr■rrrr rrrrrrrr rr�� ri�� mrr�rrr�rrrrrrrrr rrrrrrrr �rrr� �r��r� mrrrmr�� rrrrrrrr rrrrrrrr ■r�� r�� IMM m an m�.�i�E�7k�rr rrrrrrrr rrrrrrr� r�� rr�� ®r �r rr_�_�_� rrrrrrrrr rrr■�rr �r��r mIMMI V �r rrrrrrrr r■rrrrrrr rr�r■r� rr��rr mrrrrrr�rrrrrrr■rr rrrr�rr �� r■�� m rrr rr rrrrrrrrr rrrrrrrr �� rr�rr FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page Z of 3 Did the application rates exceed the limits in Attachment B of your permit? Compliant []Non-Compliar Were adequate measures taken to prevent effluent ponding in or runoff from the sites? []Compliant ❑Non-Compliar Was a suitable vegetative cover maintained on all sites as specified in your permit? ❑Compliant []Non-Compliar Were all setbacks listed in your permit maintained for every application to each permitted site? ❑Compliant []Non-Compliar Were all freeboards maintained in accordance with the specified freeboard heights in your permit? ❑Compliant ❑Non-Compliar 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 col action(s) taken. Attach additional sheets if necessary. Operator in Responsible Charge (ORC) Certification ORC: Thomas Lewis Certification No.: 1002746 Grade: SI Phone Number: 919-815-7603 Has the ORC changed since the previous NDAR-1? ❑Yes QNo By this signature, I certify that this report is accurrate and complete to the best of my knowledge. Permittee Certification Permittee: Benchmark Ministries Inc. Signing Official: Thomas Lewis Signing Official's Title: President Phone Number: 919-815-7603 Permit Exp.: 1/31/23 f 70 70 Signature De I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in with a system designed to assure that all qualified personnel properly gathered and evaluated the information submitted. E inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the inform information submitted Is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are penalties for submitting false information, including the possibility of fines and Imprisonment for knowing violation Mail Original and Two Copies to: Division of Water Resources Information Processing Unit 1617 Mail Service Center