HomeMy WebLinkAboutWQ0036210_Monitoring - 07-2020_20200813` FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1)
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,ft. FORM: NDAR-1 10-13
NON -DISCHARGE APPLICATION REPORT (NDAR-1)
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?
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IlCompllant ❑Non-Compliar
!�Compliant ❑Non-Compliar
zcompliant ❑Non-Compliar
LyCompliant ❑Non-Compliar
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? Qt ompliant ❑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-11
❑Yes E]No
Signature Date
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
Vz
v '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 inforrr
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 violatior
Mail Original and Two Copies to:
Division of Water Resources
Information Processing Unit
1617 Mail Service Center