WQ0004270_Monitoring - 02-2020_20200326

FORM: NDMR 10-13 NON -DISCHARGE MONITORING REPORT (NDMR) Pagr- of
Permit No.: WQ0004270 Facility Name: A.D. Carter, Inc. WWTF
County: Gaston Month: r Year: a o�ZS PPI: 002 Flow Measuring Point: ❑ Influent Effluent ❑ ❑ No flow generated Parameter Monitoring Point: ❑ Influent fSL Effluent ❑ Groundwater Lowe g ❑ Surface Water '
Parameter Code — ► 50050 00310 00916 50060 31613 00927 00610 00400 00931 00929 00530
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Average:
Daily Maximum:
s
Daily Mininunn:
Sampling Type:
Monthly Avg. I_Inllt:
Dally Limit:
Estimate
5 000
Grab
Grah
Grab '
Grab
Grab
Grab
Grab
-----.
Grab
Grab
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SatnPle Frequency:
Monthly
2 x year
2 x year
2 x year
Seo Permit
2 x yrar
2 x year Y
2 x year
2 x year
2 x year
2 x year

FORM: NDMR 03-12
NON -DISCHARGE MONITORING REPORT (NDMR)
Page of
Sampling Person(s)
l Certified LaboratoriesName: K �✓ i n �31 Sot p (� ` 4 A n �+ I 1 r Ca
_ I Name: W 0.i ID o i n y
Name: I�uSS�e. �� � V Q i� 2'�'�
Name: POIr Lqkl, 0r0j0 11-1 fs
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit
NCompllant ❑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
action(s) taken, Attach additional sheets If necessary. -compliance and describe the corrective
Operator In Responsible Charge (ORC) Certification
ORC: Lee Pennington
Certification No.: 987583, 98706
Grade: 2 Phone Number: 704-874-2754
Has the ORC changed since the previous NDMR?
❑Yes I]No
Si lure
Date
By this signature, I certify that this report Is accurrate and complete to the best of my knowledge.
Permittee Certification
rermtttee: 1).r QVr, K2 r, -i- /'OvV
Signing Official: S+ e. V e- r `-� h PrC °V
Signing Official's Title: J 'QG,�'O f' (j ! I la ri L� �G-� ll r ► /1�
Phone Number: 704-865-1201 Permit Expiration: March 31,2020
L92:11hL-,I.ng
20
Sign re Date
under penalty of law, that this document and all attachments were prepared under my direction or supervision In
nce with a system designed to assure that all qualified personnel properly gathered and evaluated the Information
. Based on my Inquiry of the person or persons who manage the system, or those persons directly responsible for
Information, the Information submitted Is, to the best of my knowledge end ballet, true, accurate, end complete. I amthere 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

I•
No.: 000 1 ,
irric* ® -County: Gaston
Field me:
Cover Crop
. .
at this facinty? Area, (acres):
'Area (acres). Area (acres):
rCover CroPl.
..
►=YESCove Crop:'
• _ Hourlyurly Rate (in)-
®�®
Annual Rate (in):
Annual Rate (in):
. cri�%i ® ■�ii�®■■i ._ - .. ��� raw®e®�
M1 r.®®®.■.�...... �®®®....r...■.

FORM: NDAR-3 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-3) Page of
Did the application rates exceed the limits in Attachment Q 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?
Compliant
[]Non -Compliant
Ncompllant
❑Non -Compliant
Wompllant
❑Non -Compliant
[}Compliant
❑Non -Compliant
IYICompllant ❑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 nrldifinnal chpptc if non—coni
Operator in Responsible Charge (ORC) Certification Permittee Certification
ORC: Lee Pennington Permittee: J�C V k ` z n M 'W
Certification No.: 987583, 987903 Signing Official: j'f E' U e ` A . o T r b v✓
Grade: 2 Phone Number: 704-874-2754 Signing Official's Title: 0 ; r e C� U f' of Al I rot <J (It r
Has the ORC changed since the previous NDAR-3? DYes EDNo Phone Number: 704-865-1201 Permit Exp.: 3/31/20
dA� ao-l"
1-/6-rao 3 -t
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 penally of law, that this document and all attachments were prepared under my directlon 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