WQ0018857_Monitoring - 09-2020_20201102

FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Page
Permit
Facility Nam,:
•
'
•Field
a
•
• -
ccur
•irrigation
Area (acres):
rea acres
rea acre
-■
■®
at this facility?
Cover Crop:
I
Hourly Rate (in)::
Hourly Rate (in):
Annudr�'Rate (in):'
AnnugMate (in):
Annual Rate in
�••.
•Field
Irrigated?
Field Irrigated?��
•
•. ••
•
Ilium
• •
•
•
•
a
in
__
-___
-_--_
S____--
NON!
_�_
ONE
-___
©NEENNEMONE
NOR,
M/N�INEEMENIONEUNNOMENRIONNOW112=1
NON
®MENNON
®
®ONEEMON
MENNE��
NOWEEN«ONE
ENO
ME1MYIMEN
1���
IE.:/Ilia���
�[\VO�■�
ONIN
����
IME®
01001
���
IMEN��
mMMOOMM
INNOINNIN
ONIN
11001
OW
m
OOME
ME
EMIN��
m
OOME
NN
INNOONNIME
NON111001
INNE
®OOMENE
r/��
INONSION
ANEMONE!
MINEI
ONE!
®MOMEN
NOM
MINE1
11001�
ME
MOOM
MINNI
1100
01001
NNININEN��
®��NE
O�
0���
I���
��
m
ONNOME
N
NOIN
ONIN
11001
INNO��
®OOMMON
MONIONSIONE
ONNIONNIONO
I���
m
EENNEE
NNEE
NNININNO
INENIONO
MINE!�
mOMMENIONNE
INONIONE
MINNI���
m
OMENNO
MME
ONIN
®NNNNNONEEEEM�
OWN
MINE
Monthly• . •

FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of
Did the application rates exceed the limits in Attachment B of your permit? ❑ Compliant ❑ Non -Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites? ❑ Compliant ❑ Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit? ❑ Compliant ❑ Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site? ❑ Compliant ❑ Non -Compliant
Were all freeboards maintained in accordance With the specified freeboard heights in your permit? ❑ 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 shaptc if nprpccn—
Operator in Responsible Charge (ORC) Certification
ORC: Qeh;� Lcss;+cr-
Certification No.: 100 1$ 3 Z
I Grade: 3 Phone Number: 252 —$ t'3-27Y0
Has the ORC changed since the previous NDAR-1? [9`�es ❑ No
2 2
Signature QL Date
By this signature, I certify that this report Is accurrate and complete to the best of my knowledge.
Permittee:
Signing Official:
Signing Official's Title:
Phone Number:
Permittee Certification
Permit Exp.:
Signature Date
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 signifcant
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