WQ0000948_Monitoring - 09-2020_20201102

FORM: NDMR 05-16 NON -DISCHARGE MONITORING REPORT (NDMR) Page 1 of
�err;lt No.: WQ0000948
Facility Name: Town of Jackson WWTF
County: Northampton
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NOM-l)PSO(IARGE MONITOi IMO R.EPOM' (NDNiR)
Page 1 of _ I
Sampling Persorl(s) Certified Laboratories
Mamo: Johnny Young Name: inviroonent 1, Inc. Greenville, N C
Flame: Name:
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if th6 facility Is non -compliant, please explain in the space below the reason(s) the facility was not in compliance. Provide in your e:fplanalion the daie(s) of fhe non-complance and describe the corrective
artinnkli taimn- Allarh additional sheets if lleceSSSM
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Operator in Responsible Charge (011C) Certification Permiites Certification
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Johnny Young Permittee: Town of Jackson
Certification No., 2-3129 Signing Official: Jason S. Morris
Glad©: q ()ollectjM Phone Number: 252—�-3811 Signing official's Title: Mayor
Sias tile ORC changed since the previous NDNIP%? ❑ Yes kAfto Phone Number: 252 534-3811 Porrotif Erpira4:ion; �Z" ��' ��
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ii3y1hIrnignalkire,icorl that tidy report Is accurrole and complete to the bast of my tomwiedgo, I certify, under penally of law, that this document and ail atincionanis wore prepared under my dircellon or suporvislon In
accordance vAlh a system designed to nosuro Mat all quail lod personnel properly gathered and ovalunlod the Information
sobailllod. aasad an my inquiry of tho person or persons wba, manoga ilia system, or those persons dlroclly responsible for
gotherkrg llto Information, lira Information submitted In, to the best of my immulodgo and ballot, true, occurnta, and complete. 10111
aware Ilral there are aignfficant penalties for submitting false Information, Including lho possibifily of thus and Imprisonment for
knowing violations.
Mail Original and Two Copies to:
Division ofr Water Quality
information Processing unit
•i6'l7 Mail Service Center
Raleigh, North Carofina 27699-1617

FORM: NDAR-1 05-16 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page / of /7-
Permit No.: WQ0000948
Facility Name: Town of Jackson WWTF
County: Northampton
Did irrigation occur
at this facility.
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.FORM: NDAR-1 05-16 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page _,,I— of �.
Permit No.: WQ0000948
Facility Name: Town ofJackson VVWTF
County: Norlhampton
Field Name:'
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Field Name
Field Name:
• irrigation occur
Area (ac res):
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Area (acres):
Area (ac
Area (acres):'
at this facility?
Cover Crop:
Cover Cr*;F:
Hourly Rate (in):]
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Annual Rate (in):
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FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page 1 of 1
Did the application rates exceed the limits in Attachment B of your permit? Cf compliant ❑ Non -compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites? ffCompliant ❑ Non -compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit? C7 Compliant ❑ Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site? ffCompliant 0 Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? VC/Impliant ❑ 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: Johnny G. Young
Permittee: Town of Jackson
Certification No.: 2 312 9
Signing Official: Jason S. Morris
Grade:1 collect ion Phone Number: 2 5 2 - 5 3 4 - 3 811
Signing Official's Title: Mayor
Has the ORC changed since the previous NDAR-1? I] Yes LN No
Phone Number. 2 5 2 - 5 3 4 - 3 811 Permit Exp.: 12-31-at!
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natur Date
Signature Date
By this signature, I certify [hat [his report Is accurrale and complete to line best of my knowledge.
I 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 submilling false information, Including the possibility of fines and Imprisonment for knowing vidations.
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617