WQ0005134_Monitoring - 09-2020_20201027

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page! of L4
Permit No.: w111
- County Wildlife Club
.
.nth: September1
1
Flow Measuring Point: [A influent [] Effluent E] No flow generated
Parameter Monitoring Point: Influent Effluent Groundwater Lowering Surface Water
!Parameter Code 0
•
•
•
�Maximum:-------------

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page of
Sampling Person(s) 11 Certified Laboratories
Name: Guido J Carrara 11 Name: Pace Analytical Services, Inc.
Name: 11 Name: G.C. Environmental, Inc.
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? ❑O 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: Guido J Carrara
Permittee: Wake County Wildlife Club
Certification No.: 25013
Signing Official: Mr. Jim Daughtridge
Grade: Si Phone Number: [phone]
Signing Officials Title: Past President
Has the ORC changed since the previous NDMR? ❑ Yes (] No
Phone Number: [phone] Permit Expiration: 8/31/2026
Signature Date
Sig ture 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 for
knowing violations.
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of
Permit No.: Q1115134
Facility Name: Wake County Wildlife•
.nth: Septemberat
1 1
Did irrigation occur
Field Name.,
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facility?
1
Area (acres):
Area (acres):
this
Cover • •
Hardwood
Cover Crop—
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Annual Rate (in):
Annual Rate (iny.
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...Field
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Monthly Loacling:���i
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FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page 9 of y
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?
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
❑✓ Compliant ❑ Non -Compliant
0 Compliant ❑ Non -Compliant
❑� Compliant ❑ Non -Compliant
Compliant ❑ Non -Compliant
2 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: Guido Carrara
Permittee:
Wake County Wildlife Club
Certification No.: 25013
Signing Official: Mr. Jim Daughtridge
Grade: SI Phone Number: 919-427-1786
Signing Official's Title: Past President
Has the ORC changed since the previous NDAR-1? ❑ Yes [Z No
Phone Number: 919 832-3927 Permit Exp.: 8/31/26
ignature Date
Signature Date
By this signature, I certify that this report is accurrale 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 Two Copies to:
Division of Water Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617