WQ0003271_Monitoring - 10-2020_20201201

FORM: NOAR-2 05-16 NON -DISCHARGE APPLICATION REPORT (NDAR-2) peas _ I of 1

FORM: NDAR-205-16 NON -DISCHARGE APPLICATION REPORT(NDAR-2) Page i of�l_
Did the application rates exceed the limits in Attachment B of your permit?
If not a basin, were the sites kept free of vegetation and raked?
If not a basin, were there any instances of effluent ponding in or runoff from the sites?
If a basin, were there any instances of breakout from the berms?
Was the onsite automatically activated standby power source tested and operational?
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If the facility is non -compliant, please explain in the space below the mason(s) the facility was not in compliance. Provide in your explanation the data(s) of the non-comp8ence and describe the corrective
Operator In Responsible Charge (ORC) Certification
Permmee Certification
ORC: Stacy A. Goff
Permittoe:
Certification Na: 999982
Signing Official: Dana Hill
Grade: 4 Phone Number. 252-606-5955
Signing Official's Title: Director of Operations
Has the ORC changed since the previous NOAR4? ❑yea Elm
Phom Number: 252-269-2540 Permit Exp.: 12/31/23
Sgnalure Date
S(gnature Date
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Mail Original and Toro Copies to:
Division of Water Resources
Information Processing Unit
1617 Mall Service Center
Raleigh, North Carolina 276994617

FORM: NDMR 05-16 NON -DISCHARGE MONITORING REPORT (NDMR)
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Month:
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FORM: NDMRD&16 NON -DISCHARGE MONITORING REPORT(NDMR) Page of
Sampling Pannonia) Cer88ed Laboratories
Name: Stacy A. Goff N Name: Environment 1, Inc#10
Name: I Name: Carolina Water Services Inc.- Eastern Region #5162
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? O onvent ❑ moo,mpuara
If the facility is non -compliant, please explain in the space below the reason(s) the facility was not in compliance. Provide in yourexylanation the delete) of the non-compliance and describe the corrective
acfion(s) taken. Attach additional sheets A nprassam
Operator in Responsible Charge (ORC) certificationTDat�e
Permillee Cenigcatlon
ORC: Stacy A. Goff es:
Certification No.: 998882 g Official: Dana Hill
Grade: 4 Phone Number: 252-8085955g Official's Title: Director of Operations
Has C changed since the previous NOMRT ❑ vas Elm Number: 252-259-2540 Permit Expiration: 12131IM23
nature signalure Date
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Mail Original and Two Copies to:
Division of Water Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, Norm Carolina 27699.1817