WQ0004270_Monitoring - 09-2020_20201019

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page) o1`4
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Month: September
Year: 2020
Effluent ❑ Groundwater Lowering ❑ Surface Water
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Sample Frequency: MOntllly 2 X Year 2 X Year 1 2 X Year 1 Per Event i 2 X Year 2 X Year I 2 X Year I 2 X Year i 2 X Year i 2 X Year' Per Event 2 X Year.- 2 X Year '2 XYear:. 2 X Year

FORM: NDMR 03-12
NON -DISCHARGE MONITORING REPORT (NDMR)
Page a of q
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? 0 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 1 987583, 987903
Signing Official: Steve Renfrow
Grade: 2 Phone Number: 704-874-2754
Signing Officials Title: Vice President of Manufacturing
Has the ORC changed since the previous NDMR? ❑ Yes No
Phone Number: 704-865-1201 Permit Expiration: 6/30/2025
9410/19/2020
10/19/2020
Signature Date
Si ature 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 far
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: NDAR-1 05-16 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page _3 of I/

FORM: NDAR-t 05-16 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page N of tf
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?
❑� Compliant ❑ Non -Compliant
❑ Compliant ❑ Nan -Compliant
0 Compliant ❑ Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site? 0 Compliant ❑ Nan -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? [d Compliant ❑ Non -Compliant
If the facility is non -compliant, please explain in the space below the reasons) 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
ORC: Lee Pennington
Certification No.: 987583, 987903
Grade: 2 Phone Number: 704-874-2754
Has the ORC changed since the previous NDAR-1? ❑ Yes 0 No
SignaVe
By this signature, I certify that this report is accurrale and complete to the best of my knowledge.
Permittee Certification
Permittee:
A B Carter Inc.
Signing Official: Steve Renfrow
Signing Official's Title: Vice President of Manufactuing
Phone Number: 704-865-1201 Permit Exp.: 6/30/25
10/19/20 IF _ 10/19/20
Date SvIgnature Date
1 certify, under penally 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