WQ0033325_Monitoring - 11-2020_20201222

FORM: NDMR 10-13 NON -DISCHARGE MONITORING REPORT (NDMR) Page of
Permit No.: W00033325
Facility Name: Tobermory Road
County: Bladen
Month: November
Year: 2020
PPI: 001
Flow Measuring Point: ❑ Influent El Effluent ❑ No Flow generated
Parameter Monitoring Point: ❑ Influent Effluent ❑ Groundwater Lowering ❑ Surface Water
Parameter Code 0-
50 550
00940
01045
A
ro
QE
O
F
O
O
p`
U
O
24-hr
hrs
Gallons
mg/L
mg/L
1
2
3
4
5
15:40
6,800
6
7
8
9
10
11
12
08:58
6,700
13
14
15
16
17
18
19
16:09
6,700
20
21
22
23
24
251
10:31
6,900
26
27
28
29
30
31
Average:
6,775
Daily Maximum:
6,900
Daily Minimum:
6,700
Sampling Type:
Recorder
Grab
Grab
Monthly Avg. Limit:
Weekly Limit:
8,000
Sample Frequency:
Continuous
Annually
Annually

FORM: NDMR 10-13 NON -DISCHARGE MONITORING REPORT (NDMR) Page of=
Sampling Person(s) Certified Laboratories
Name: Name:
Name: Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? LI Compliant U 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
actlonts) to Ken. Auacn auumuriai 51iuu Lb II IK utzbb iIy.
Operator in Responsible Charge (ORC) Certification
ORC:
Certification No.:
Grade: Phone Number:
Has the ORC changed since the previous NDMR? ❑ Yes ❑ No
0
Signature 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 Expiration:
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. 1 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

FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page
Permit No.: loll33325
Facility Name: Tobermory '•.• Well
County: Bladen•
- •-
1 1
Did irrigation occur
•
_�
.
.�__
1
Area (acres):
Area (acres):
Area (acresy
at this facility?
Cover Crop:
Cover Crop:
Cover Crop:
■ YES ■ NO
Hourly'.e (iny
Hourly '.
• '.
Annual Rate (in):'
EXINTMOVII M11
Annual Rate (in):
.. •
■ ■ �i
..
■ ■ •
.. •
■ ■ •Field
Irrigated?■
■ •
Monthly• - • •
11
%l/'/®1f////./f/.%/////
1 11
/////r/S

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
dl.tlullkz) WAUJl. r\ttdU1 dUURlulldl anCCta II IICGC55
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Alan Edge
Permittee:
Bladen County Water District
Certification No.: 976293
Signing Official: Alan Edge
Grade: Phone Number: 910 862-6996
Signing Official's Title: Director
Has the ORC changed since the previous NDAR-1? ❑ Yes O No
Phone Number: 910 862-6996 Permit Exp.: 3/31/22
0-4� '�_j CL — 2. t i
call-,O D - � - d
u
Signature Date
Signature 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 Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617