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Home My WebLink AboutWQ0012696_Monitoring - 12-2020_20210122FORM: i 2 03-12 NON -DISCHARGE MON1 LING REPORT (NDMR) Page _ Sampling Person(s) Certified Laboratories Name: Name: Name: Name: i Does all monitoring data and sampling frequencies meet the requirements in Attachment A or your permit s &y.campuanc L_J ryun-k-V,,,N„a,,. 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 __a.X 4..6. err,..k . AA;fi o l chaofc if norassarv. Operator in Responsible Charge (ORC) Certification ORC: G j9)z_y M aSOt) Certification No.: Grade: / Phone Number: ZsZ- ! o4' 4r21 Has the ORC changed since the previous NDMR? ❑ Yes 0 //- Z Signature Date By this signature, I certify that this report is accurrate and complete to the best of my knowledge. Permittee Certification Permittee: ✓ V nPo % Pe, rn l r'G ✓ p /T r 'e q)-e I/ Signing Official: -5 eft y //C)/ u�c'�� Signing Official's Title: Z✓1- Phone Number: Z 57,-- qi T )l Permit Expiration: Zl—_30- ?Give 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 Ahering 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 FORM: NDAR-1 08-11 NON -DISCHARGE APPI Ir'ATION REPORT (NDAR-1) Page. -of Permit WQ0012696�• Did irrigation occur _ • County: Beaufort Field Name:: this facility? Area (acres) 1 / -at Area (acres): ®�� Area (acres): ■- cover 6 rop: Cover Crop: Co or rop;, Cover Crop:, V<ES ■ NO Hourly Rate (in):_E. Hourly Rate (I Annual Rate (in)::Th i • * *0 w WIN om........ ..�.�.."�C ...�...��.. mom........ .. ...■.�.. .. ®...�...�..� ®®ram®..nc� �� ■�� ®.............®� �.......� ..�r... C....... m�...�..........® ......�.�.�" ....�.........�... m �...�.�.� ®.....®.......�.�. ®..®... �...�.�... m ��..... ®®®........�.....�....®...r.......�.� m ��.....�.....�®.....��..�.�. .....�.. �....■...�. ®��C ::..................�...:�.....e...�....�... ®..��..........®......�..............�........�... m...��.......®...........�.�...........®... �.....�.� ®....� ��. ®®®....�.�...■. .........®...�....�. m=.......� ........�.�..��.......�.......�.�....� m�� ■■�_�s� ■�■i��i s�s�� FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) rdye _ Did the application rates exceed the limits in Attachment B of your permit? afllo pliant ❑ Non -Compliant Were adequate measures taken to prevent effluent ponding in or runoff from the sites? Compllant ❑ Non -Compliant Was a suitable vegetative cover maintained on all sites as specified in your permit? �rnpliant ❑ Non -Compliant Were all setbacks listed in your permit maintained for every application to each permitted site? ae pllant [I Non -Compliant Were all freeboards maintained in accordance with the specified freeboard heights in your permit? 0<0-mpliant ❑ 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 o tinn/cl fni—n Attarh ArirlitinnAl ChpptS if nprp.Ssarv. Operator in Responsible Charge (ORC) Certification ORC: V 4ky M 50N Certification No.: Grade: i Phone Number: 2 !�-2 ' I b 7Y/s2, Has the ORC changed since the previous NDAR-1? ❑ Yes [B No r% Signature Date By this signature, I certify that this report is accurrale and complete to the best of my knowledge. Permittee Certification / Signing Official: SA (,rr1 /) o %1V Well Signing Official's Title: III-M qef— Phone Number: Z 5-2 11 S-2 ( Permit Exp.: — 'J(,� CJ �f✓ Signature !I! 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 dire city responsible for gathering the information, lire 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 CTrolina 27699-1617