WQ0013398_Monitoring - 09-2020_20201110

FORM: NDAR-1 CI8-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of_�
Permit NO.: WQ00'l3398
Facility Nan1e: Sandpiper Bay WVVTF
County: Brunswick
Month: September
Year: 2020
Did irrigationDCCUr
at this facility?
0 YES i j
Field Name:
E3-FW
23
I
51�
Field Name:
t3_GR
Field Name:
E3-PER
5.5
Field Name:
13-RGH
Area (acres):
Area (adres):
2.5
Area (ac;res):
Cover h rop:
Area (ar-res):
21
Cover (; rop:
Crop:
Cover (% P�
61GW
Crop:
Cover P:
(in):
Annual Rate (in):
Hourly Ratd (III)
Annual Rath (in):
Field Irrigated?
1
51
YES ❑ NO
rn E r�
�, c c
E»
oo m2a
J rt J
in in
�JQ( iff)! RRIb (in):
Annual I2atO (in):
Hourly Raba (in):
Annual Rat? (in):
1
51
❑ YE° 71 NO
M E Trn
?E 5
�� Ems'°
oo M=o
J J
in in
m
Weather
Freeboard
Field Irrigated?
YES ❑ NO
Field Irrigated?
❑ YES
rn
�+ c
,�'o
oo
J
in
0 No
Field Irrigated?
v
o
0
m
�°
w
a
N.d.
C
E
°
a.
m
rn
L°
°
N
an d
Wz
0 m
��
�o
A
Lh
wa
E °'
oa
� Q
v
d
N«
E10
i=°'
E
rn
�, c
��
oo
J
E rn
�,
= c
E»
xoo
= J
m y
E m
�c
oa
Q
o
N
eo
i- °r
my
E m
CL
� Q
;:
° �
Vic'
t
E rn
' c
Env
xoo
= J
m�
E 2
�c
oa
> Q
M
i-E
°F
in
ft
ft
gal
min
in
in
gal
rhin
gal
ruin
in
gal
thin
1
0.10
12,000
12
0.18
0.18
0.18
0.18
0.18
2
PC
91
3.7
2.6
12,000
12
12
3
0.18
4
12,000
5
PC
88
3.8
2.7
0.18
6
65,000
65
0.10
12,000
12
24
7
0.18
8
9
CL
84
0.6
3.9
2.7
24,000
0.35
0.18
0.35
10
11
12
12,000
12
13
0.18
14
PC
77
2.5
3.6
2.2
15
CL
76
0.4
3.5
2.7
65,000
65
0.10
0.10
12,000
12
0.18
0.18
16
12
17
12,000
0.18
0.18
0.53
0.18
18
CL
78
4.4
2.8
2.2
v
19
12,000
12
0.18
20
,,.
21
36,000
36
0.53
22
C
81
3.3
2.3
23
PC
86
3.3
2.3
24
65
0.10
_
25
65,000
0.10
26
CL
75
0.5
3.3
2.3
12
12
27
12,000
0.18
0.18
28
29
PC
94
0.2
3.4
2.2
12,000
0.18
0.18
30
1
31
Monthly
Loading:
195,000
0.31
i 94
180,000
2.65
25,Og
0
0.00
0.82
0
0.00
0.19
12 Month Floating Total (in):

FOf M: NDAR-1 U8-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of__
Did the opplication rates eXceed the limits in Attachmerit B of your permit?
Were adequate measures taken to prevent effluent pontling in or runoff frgm the sites?
Was a spitable 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 freeboarq heights in your permit?
Compliant ❑ Non-Carripliant
I,
(] Compliant ❑ Non -Compliant
2] Compliant ❑ Non -Compliant
El Compliant ❑ Non -Compliant
❑� 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 necessarv.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Wilbur Allen Williams
Permittee:
timothy P. Yilma
Certification No.: 15664
Signing Official:
Grade: 81 Phone Number: [phone]
Signing Official's Title: General Manager
Has the ORC changed since the previous NDAR-1? ❑ Yes Fl� No
Phone Number: [phone] Permit Exp.: 5/31/14
Signature Date
Signature Date
By this signature, I certify that this teport is accurrate and complete to the best of my knowledge.
I certify, under penalty of lyw, that this document and all attachments were prepared under my direr -'lion or supervision in accordance
with a sy,tem designed to assure that all personnel property gathered and evaluated the information submitted. Based on my
qualified
inquiry of the person or persons who manage the system, or those persons directly responsible fpr gathering the information, the
information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I ain aware that there are significant
penalties for subrnitting 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 (Nail Service Center
Raleigh, North Carolina 27699-1617

FORM: NDAR-1 Q8-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of _
Permit Noy WQOO'13398
Facility NarVie: Sandpiper Bay WVVTF
County: Brunswick
Month: September
Year: 2020
Did irrigation occur
at this facility?
YES ❑ N0
Field Name:
E(-TEE
28
51
Field Name:
P-1
Field Dame:
P-2
7.82
_
51
Field game:
Area (aFres):
P-3
1.16
1
51
❑ YE5 NO
n
?�C i.
e-v° oego
to x 0 0
0 0 ro i
J J
in in
Area (ac res):
Area (ad res):
4•59
1
51
❑ YES 0 NO
Area (ac,res):
Cover (;;rop:
()(;liP!( �1 (Fi (in):
Annual hater (in):
Cover (%rop:
Hourly Ratd (NNN)
Cover
_- A rop:
I (r,N,IN'(tf flRfb (in):
Annual Mate' (in):
Crea
Cover p:
Hourly Rath
Annual Ratg (in):
Annual Rate (in):
0
yyaather
Freeboard
Field Irrig<Ited?
❑✓ YES NO
Field Irrigdted?
Field Irrigi3ted?
❑ YES NO
Field Irrigated?
0
U
0)
{tea
�a
°
1�
2-
'C1
Q
p)
0
-
co
N.0
11v
D
�. p,
M C
LO
ft
d
E'
C
0 C.
� Q
tU
E m
to
P. •C
_
7.0
m°
M
0
J
in
E cn
7 ` C
E v
0 to
g= J
in
m
©
O Q.
i' Q
gal
'�
CD
i-. .`
min
ae
�.0
0
O
J
in
E rn
C
E m
K o
tax 0
-!
m -o
9!
a
O G•
7 Q
v
+d.
rn
i-' '`
ruin
rn
?+r_
Mm
O
J
E rn
� TC
E°
x 0 M
= 0
J
m®
E_d
a
O a
' Q
gal
o
d
1°
j Cn
r
Min
°F
in
ft
gal
rain
in
gal
in
in
1
2.6
2.7
2
PC
91
3.7
3
24,000
24
0.03
0,03
4
5
6
PC
88
3.8
24
7
0.03
0.03
8
2.7
24,000
9
CL
84
0.6
3.9
10
11
2.7
12
13
24,000
24
0.03
0.03
14
PC
77
2.5
3.6
15
CL
76
0.4
3.5
2.7
16
17
18
CL
78
4.4
2.8
2.2
19
24,000
24
0.03
0.03
0.03
20
2.3
21
22
CL
81
3.3
23
PC
86
3.3
2.3
24
�4
25
24,000
0.03
26
CL
75
0.5
3.3
2.3
27
2.2
-
_
28
29
PC
94
0.2
3.4
0.03
30
24,000
24
0.03
31
Monthly Loading:
12 Month Floatin Total (in):
144,000
'
0.19
0
MIMEx.
0.00
0
0.00
0
0.00
°
;`.
3.07

FORM: NDAR-1 Cl8-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) __
Page of
Did the Application rates e9ceed the limits in Attachment B of your permiY� ❑ Compliant ❑ Non-Corripliant
Were adequate measures tpken to prevent effluent pontling in or runoff from the sites? Q Compliant ❑ Non-Corripliant
Was a suitable vegetative cover maintained or1 all sites as specified in your permit? El Compliant � NQn'CO'ipliant
Were all setbacks listed in your permit maintained for r every application to each perrnitted Site? ❑ Compliant L] Non -Compliant
Were all freeboargs maintained in accordance with the (specified freeboard heights in your permit? ❑ Compliant ❑ Non -Compliant
If the facility is non-corripliant, 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 any describe the corrective
action(s) taken. Attach additional sheets if necessary.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Wilbur Allen Williams
Permittee:
Timothy P. 1 ilma
Certification No.: 15664
Signing Official:
Grade: 41 Phone Number: [phone]
Signing Official's Title: General Manager
Has the OItC changed since the previous NDAR-1I ❑ yes 0 No
Phone Number: [phone] Permit Exp.: 5/,11/14
V "' `YAW `J I - _ n'� V (/ �
_-2—Imb LAY & � 1 t 4
Signature Date
Signature Date
By this signature, I certify that this teport is accurrate and complete to the best of my knowledge.
I certify, under penally of Iqw, that this document and all attachments were prepared under my direnion or supervision in accordance
with a system designed to assure that all qualified personnel property 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 subrnitting false information, including the possibility of fines and imprisonment for knowing violations.
Mail Origihal and Two Copies to:
Division of Water Quality
Information Procesoing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

FOIRM: NDAR-1 Q8-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of__
PermitNO.: WQOOq 3398
Facility Narr1e; Sandpiper Bay WWTF
County: Brunswick
Month: September
Year; 2020
Did irrigation occur
at this facility?
❑ Yet i-o
Field Name:
P-4
7.23
3 _
51
Field Name:
P-5
Field Name:
Area (acres):
P-6
Field Name:
P-7
6.21
Area (acres):
Area (adres):
5,39
.:._
51
❑ YES 0 No
w E rn
c
ro�O ro
o x
in in
2.6
Area (aFres):
Craver (:, rop:
11011)R'p F?Ultt� (in):
.,
Annual kate (in):
ro
Cover (= P:
Hourly Ratd (dfil�s
Annual Rater (in):
Cover
_ rop:
�rt� 864� � � m
Annual katO (in):
Cro
Cover P:
1
HourlyRat�(Ppf�
5l
Annual Rata (ln):
51
❑ YE4 ❑ NO
E ovy
£ c
, -0
ro % O ro=
o0
o
J
in in
Weather
Freeboard
Field Irrigated?
❑ YES El NO
Field Irrigated?
Field Irrigated?
❑ YES 0 NO
Field Irrigated?
Q
gal
,
I:JC
htin
�
r
j
sa
n
E
c
C
y
L°
C
c
4a °
•o
E °
O
o
9
a'
`
'
p
J
E rn
E
mo
J
a+ v
o
C
v
Em
c
M o
c
E z 'a
o
°F
In
ft
ft
gal
ruin
in
in
gal
rhin
gal
rnin
in
in
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
_
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Monthly Loading:
p
0.00
0
0.00
0
0.00
0
^"
Ila
0.00
s;�,
12 Month Floatin Total (in):

FORM: NDAR-1 ()8-11
NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Page of __
Did the Application rates eXceed the limits in Attachmerlt B of your permit
Were adequate measures tpken to pi,event effluent pontling in or runoff from the sits?
[D Compliant ❑ Non -Compliant
R Compliant ❑ Non -Compliant
Was a spitable vegetative cover mairtained orl 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
actioh(s) taken. Attach additional sheets if necessary.
Operator in Responsible Charge (ORC) Certification11 Permittee Certification
ORC: Wilbur Allen Williams
Certification No.: 15664
Grade: $1 Phone Number: [phone]
Has the ORC changed since the previous NDAR-1 ? Yes El No
Signature Date
By this signature. I certify that this teport is accurrate and complete to the best of my knowledge.
Permittee: Timothy P. T'ilma
Signing Official:
Signing Official's Title: Graneral Manager
Phone Number: [phone] Permit Exp.: 5/,31/14
P 6 0 4Zi-___40 ty3%z3
Signature Date
I certify, under penalty of I,01w, that this document and all attachments were prepared under my direption or supervision in accordance
with a system designed to assure that all qualified personnel property gathered and evaluated the information submitt§d. Based on my
inquiry of the person or persons who manage the system, or those persons directly responsible fi)r gathering the inrormation, the
Information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I ain aware that ther§ are significant
penalties for subrnitting false information, including the possibility of fines and imprisonment for knowing violations.
Mail Origihal and Two Copies to:
Division of Water Quality
Information Proceseing Unit
1617 Mail Service Center
Raleigh, Nprth Carolina 27699-1617

FORM: NDAR-1 C18-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of__
Permit No•: W000'13398
Facility Nan•1e:
Sandpiper Bay WVVTF
P-8
1.21
1
Field Name:
P-9
County: Brunswick
Field Name:
Month:
P-DR
4.45
j
51
September
Field Name:
Area (aFres):
Cover Crop:
r Hourly RatO, (P�f
Annual Rata (in):
Field Irrigated?d
Year: 2020
S.1
6.82
1
51
❑ YE_ ❑ No
ci E rn
N iK G 1O
❑ o mx
J r2 J
in in
Did irrigation Occur
at this facility?
❑ YES (� No
Field Name:
Area (a(;res):
Area (adres):
4.97
Area (atCes):
Cover r; rop:
l Id+ (in):
Annual C2ate (in):
Crop:
Cover C p
Hourly Ratd �111)
1
Cover t, rop:
Afl�i+bdii'� ( efRa- (in):
�
Annual Rato (lh):
51
❑ YES NO
cr E or
c c` c
D E c
ro X O
❑ o pax
J J
in in
Annual katd (in):
❑
Waather
Freeboard
Field Irrig�lted?
a °i
E m
i..'. •�
—
❑ YES
El No
E rn
c c
E o
X M
o
Field Irrigyted?
Field IrrigAted?
❑ YES E NO
e
w
f�0
w
a
Q
'U
a
c'
L°
«
w n
2
�, —
a
❑ A
LO
w v
w
p G
!Q
a c
o
❑ pro
J=J
in
w -o
E 2
c Q
O Q.
�Q
•o
a� �
8 �a
i c
w 2
O Q
iQ
a� °'
'°
F. .�
rein
rn
> c
m y
❑ 0
J=J
E m
c T c
E c
K 0 is
o
w •o
E m
G G
�Q
v
w
1-_ LM
c
°F
in
ft
ft
gal
rein
in
gal
min
gal
in
in
gal
ruin
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
_
19
20
21
22
23
24
25
26
27
28
29
30
31
Monthly
Loading:
Total
(in):
p
a
0.00
0
�' ;
0.00
0
0.00
0
"��`
12
Month
Floatin
,x+a

FORM: NDAR-1 Ci8-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of __
Did the Application rates eXceed the limits in Attachmerit B of your permit# ❑ Compliant ❑ Non -Compliant
Were adequate measures taken to prevent effluent pont ling in or runoff frgm the sits? Q Compliant ❑ Non -Compliant
Was a spitable vegetative cover maintained on all sites as specified in your permit? 0 Compliant Non -Compliant
Were all setbacks listed in +fur erne t maintained for eve application to each errnitted site?
�' �'} every pp p Q Compliant C] Non-CorttPliant
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 sheets if necessary.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Wilbur Alien Williams
Permittee
Timothy P. 1'ilma
Certification No.: 15664
Signing Official:
Grade: ;41 Phone Number: [phone]
Signing Official's Title: Graneral Manager
Has the ORC changed since the previous NDAR-1 I ❑ yes 0 No
Phone 'Number: [phone] Permit Exp.: 5/31 /14
Signature Date
Signature Date
By this signature. I certify that this teport is accurrate and complete to the best of my knowledge
I certify, under penalty of ]EK that this document and all attachments were prepared under my dirertlon or supervision in accordance
with a sy;;tem 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 f-ar gathering the information, the
information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I atn aware that there are significant
penalties for subrnitting false information, including the possibility of fines and imprisonment for knowing violations.
Mail Origihal and Two Copies to:
Divisit)n of Water Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, Ngrth Carolina 27699-1617

FORM: NDAR-1 C18_11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of __
PermitNO.: WQ00'13398
Facility Nan1Q: Sandpiper Bay WVVTF
County: Brunswick
Month: September
Year. 2020
Did irrigation'OCCur
at this facility?
y
❑ YES 1 i;�ri
Field Name:
S 2
1.82
) � aGx
51
Field Name:
8_3
Field Name:
S-4
4.16
1
51
Field Name:
S-5
G.G
Area (acres):
)
Area ages):
(
Cover (%rop:
4.1
Area (a<, res):
res :
Area (aF )
Cover CrOP:
Hourly Rat#'
Cover Qrop:
Cover Nrop:
~)�($RIN�(f � (in):
Annual Rate (in):
1
"01-Iffy RAID (in):
. Annual Rate (in):
Hourly Rated (in):
Annual Rah (in):
1
51
❑ YES NO
Annual Rat i�•(n)
a 51
❑ YE5 ❑ NO
> CM
T co
xo>,
E
'-a.2
m C�a
O 0
W6ather
Freeboard
Field Irrigated?
❑ YES FZI NO
Field Irrigated?
Field lrrig;3ted?
❑ YES 0 NO
Field Irrigated?
T
❑
c
L
d
m
E
c
a
y
m
rn
o.
❑m a
M
>.o,
m a
Ln
m
E m
2 a
oa
>
E
��c
❑O
E 0
X
Ji
E A?
0CL
� •c
��Jc
°
O
0E
xo
1
i
m
cE>,c
E
o
x o
J
E d
>Q
a
�'NV
in
OF
in
ft
ft
gal
niin
in
in
gal
rein
in
in
gal
rnin
in
in
gal
in
in
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Monthly
Loading:11
0.00
0
0.00
0
0.00
0
0.00
12 Month Floatin Total (in):

FORM: NDAR-1 Cl8-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) page of __
Did the application rates egceed the limits in Attachmerit B of your permits 0 Compliant ❑ Non -Compliant
Were adequate measures t.9ken to prevent effluent ponying in or runoff frgm the sites? ❑ Compliant ❑ Non -Compliant
Was a spitable vegetative cover maintained ort all sites as specified in Your permit? ❑ Compliant ❑ Non -Compliant
Were all setbacks listed in yfi�i�p p sr1rit 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? El Compliant ❑ Non-Conipliant
If the facility is non -compliant, please explain in the space below the reason(s) the facility was not in compliance. Provide in your explanption the date(s) of the non-compliance and describe the corrective
actioh(s) taken. Attach additional sheets if necessary.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Wilbur Allen Williams
Permittee:
Timothy P. 7ilma
Certification No.: 15664
Signing Official:
Grade: 81 Phone Number: [phone]
Signing Officials Title: General Manager
Has the ORC changed since the previous NDAR-11 ❑ Yes [] No
Phone Number: [phone] Permit Exp.: 5/51/14
Signature Date
Signature Date
By this signature. I certify that this teport is accurrate and complete to the best of my knowledge.
I certify, under penalty of 1s w, that this document and all attachments were prepared under my direvtion or supervisioh in accordance
with a sy..tem designed to fissure that all qualified personnel property gathered and evaluated the information submitted. Based on my
inquiry of the person or Persons who manage the system, or those persons directly responsible fpr gathering the information, the
information submitted is, to the best of my knowledge and belief, true, accurate, and complete. 1 ain aware that thers are significant
penalties for subrnitting false information, including the possibility of fines and imprisonment for knowing violations.
Mail Origihal and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

FOW: NDAR-1 (I8.11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of _
Permit y0.6' WQ00'1 3398
'
Facility Nan1e: Sandpiper Bay WVVTF
County: Brunswick
Month: September
Year. 2020
Did irrigation occur
at this facility?
❑ YES 11r
Field Name:
S-6
2.23
1
51
Field Name:
S-7
Field Name:
S-8
1.71
Field Name.
S-9
Area (acres):
Area (acres):
4.34
Area (a(-res):
c°per rop:
m.
B(fR(II� �( (� (')
Annual kato (in):
Area (acres):
4.83
1
` 51
❑ YE5 NO
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,�v E0'v
❑o �x°o
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in in
cover c .rop:
r°
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51
❑ YES ❑ NO
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m� xo�
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in in
Cover Crop:
Hourly Rat(
y ji")
Annual Ratgl(in):
Field Irrigated?
PI0lJP(RRt#(in
(f )
Annual Mate (in):
Field Irrigated?
Y {
Hourly Ratd If7-.
Annual Rath (iti):
51
❑ YES a NO
W4ather
Freeboard
❑ YES ❑ NO
Field Irrigated?
Field Irrigated?
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rain
1
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5
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7
8
9
10
11
12
13
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15
16
17
18
19
20
21
22
23
24
25
26
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27
28
29
30
31
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Total
(in):
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0
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0
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0
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12

FORM: NDAR-1 Cl8_11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of__
Did the Application rates exceed the limits in .Attachmerit B of your permit's ❑r Compliant ❑ Non -Compliant
Were adequate measures token to pl•event effluent ponging in or runoff frgm the sits? ❑ Compliant ❑ Non -Compliant
Was a saitable vegetative cover maintained on all sites as specified in your permit? ❑ Compliant El Non-ONTipliant
Were all setbacks listed in your permit maintained for every application to each permitted Site? ❑ Compliant 0 Non -Compliant
Were all freeboards maintained in accordance with the specified freeboarlq heights in your permit? 21 Compliant ❑ Non -Compliant
If the facility is non-cornpliant, 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.
IOperator in Responsible Charge (ORC) Certification 11 Permittee Certification
ORC: Wilbur Allen Williams
Certification No.: 15664
Grade: 51 Phone Number: [phone]
Has the OaC changed since the previous NDAR-11 ❑ Yes 7 No
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
Permittee: _
timothy P. -f ilma
Signing Official:
Signing Officials Title: General Manager
Phone Number: [phone] Permit Exp.: 5/31/14
Signature Date
I certify, under penalty of 19w, that this document and all attachments were prepared under my direeyion or supervisioP in accordance
with a system designed to fissure 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 fhr 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 subrnitting 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 Dail Service Center
Raleigh, North Carolina 27699-1617