WQ0004115_Monitoring - 10-2020_20201201

Monitoring Report Submittal
............................................................................................................................................
Permit Number #* WQ0004115
Name of Facility:* Champion Hills
Month:* October
Report Information
Type *
NDMR, NDAR-1, NDAR-2, NDMLR
Confirmation Email Address:*
Name of Submitter:*
Signature:
Date of submittal:
Initial Review
Year:* 2020
Upload Document*
WQ0004115.pdf 3.45MB
FDF only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-t, NDAR-2, NDMLR, GW-59).
[e-mail]
Kimber Reese
Reviewer: Williams, Kendall
11 /25/2020
This will be filled in automatically

Is the project number correct? * WQ0004115
Is the monitoring report r Yes r No
accepted?*
Regional Office * Asheville
Accepted Date: 12/1/2020

FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page I of
Permit No.: WQ0004115
Facility Name: CHAMPION HILLS, POA
county: Henderson Month October
Year: 2020
t
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Field Name:
2
Field Name:
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Area (acre):
11.27��,
Area (acres):
20.35
t this facility?
Cover Crap:
TURFGRASS
Cover Crap:
TURFGRASS
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91
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FORM: NDAR-1 10-13
Page (� of I�L_
Did the application rates exceed the limits in Attachment B of your permit?
Dcompliant
EINon-Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites?
[ZCornpliant
ONon-compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit?
IzCompliant
EINon-Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site?
®Compliant
E]Non-compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
(Compliant
EINon-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: Karl Griffiths Permittee: Champion Hills, POA
Certification No.: 15613 Signing Official: Karl Griffiths
Grade: Phone Number: 828 696 1962 Signing Official's Title: ASSISTANT SUPERINTENDANT
Has the ORC changed since the previ, sNDAR-1? EjYeS 2NO Phone Number: 8286961962 Permit Exp.: 1/31/24
Al
11/17/20 11/17/20
Signature
e .0 .n.
I c
9 s document and all attachments were prepared under my direction or supervision in accordance
Si ature Date Signature Date
By this signature, I c fy that this report is accurrate and complete to the best of my knowledge. I certify, under penalty of law, t .1 this rnd all ft.,hrrienl, mm nmp.
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
Yalei

NON -DISCHARGE MONITORING REPORT (NDMR)
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FORM: NDMR 10-13 NON -DISCHARGE MONITORING REPORT (NDMR)
Page of
Sampling Person(s) Certified Laboratories
Name: Danielle Hunter dame: Face Analytical
Name: Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? comprant ❑ 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 Perrnittee Certification
ORC: Danielle Hunter Permlttee: Champion Hills POA
Certification No.: 1007992 Signing Official: Robert Barr
Grade: Sl Phone Number: 828-251-1900 Signing Official's `title: Signatory
Has the ORC changed since the previous NDMR7 ❑ Yes No Phone Number: 828-696-1962 Permit Expiration: 1/31/2024
co�" a119___ o,�� 1 -�
Signature Date Signature Cate
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 Twi Copies
Divisionof i
Information Processing Unit
1617