WQ0018857_Monitoring - 05-2020_20200714

FORM: NDAR-1 10-13
NON -DISCHARGE APPLICATION REPORT (NDAR-i)
Page I / of/
Permit No.
WQ op
Facility Name:
_/1'A 6 0 A)
County:
C-CrEvecoml,_1
Month.
M 4�
Did irrigation occur
F'idid4an e'
Field Name:
Field ifi6m6--.
Fitld Name:
at this facility?
Area (acre
Area (acres):
Area(acres):I
Area (acres):
Cover'Crop
Cover Crop:
C.,over Crop
Cover Crop:
El YES NO
Hou
rly urly fi�
Hourly Rate (in):
Hourly Rate (in):
nn
Annual Rate (in):
Annual Rate (iri)
Weather Freeboard
Meld, z IrrigatedNO
.�j
Field Irrigated?
❑ YES
Fi' J t
S NO
a)
4)
0
0C
0. M
CD
E
-0 M Z
E 2
-0
z .5
-0
E
V
�'Co*
A i
a)
CL
U
>, CL
M a
0 CL
CM
0 M
0
x
0
E
P
cc
0-
L0
OF
in
ft
ft
9-
in
gal
min
in
2
3
4
A:
5
6
7
8
y,
9
10
11
A A
12
13,
MMMMMMNWA�
M=====w1M
M=====wAw
M
W/Me/1
V11110
4
Annual Rate (in):
Field Irrigated?
F] YES E] NO
0 M
E 2
M
m m
0)
T C
E rn
7 C
75 CL
F
-5
p ca
0
E
0 M
0
>
_j
gal 1
min
in
in

NUN -DISCHARGE APPLICATION REPORT (NDAR-1)
�_-Id the application rates exceed the limits in Attachment B of your permit?
Page �_ of C
Compliant ❑ Non -Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites?
❑Compliant ❑ Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit?
❑ Compliant ❑ NonCompliant
Were all setbacks listed in your permit maintained for every application to each permitted site?
❑ Compliant ❑ NonrCompliaM
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
❑ Compliant ❑ NorrCvmpfiant
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: a
Permittee:
Certification No.: Signing Official:
Grade: J ` Phone Number. Signing Official's Title:
Has the ORC changed since the previous NDAR-1? ❑ Yes f5d''No Phone Number: Permit Ex
r � i
Signature Date
Signature Date
By this signature. I certify that this report is accurrate and complete to the best of knowledge- ed9e- I certdy, 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 Uwe 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