WQ0041136_Monitoring - 02-2021_20210331

Monitoring Report Submittal
............................................................................................................................................
Permit Number #* WQ0041136
Name of Facility:* Cervini Farms
Month:* February
Report Information
Type *
NDMR, NDAR-1, NDAR-2, NDMLR
Confirmation Email Address:*
Name of Submitter:*
Signature:
Date of submittal:
Initial Review
Year:* 2021
Upload Document*
WQ0041136.pdf 7.26MB
FDF only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-t, NDAR-2, NDMLR, GW-59).
[e-mail]
Kimber Reese
Reviewer: Williams, Kendall
3/31 /2021
This will be filled in automatically

Is the project number correct? * WQ0041136
Is the monitoring report r Yes r No
accepted?*
Regional Office * Asheville
Accepted Date: 3/31/2021

FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATIONNON-DISC(-1) Page of 4
Did the applicationrates exceed the limits in Attachment B of your permit? F1 Compliant ❑ Non -Compliant
Were adequate measuresto prevent effluent ponding in or runoff fromsites? O Compliant ❑ Non -Compliant
Was a suitable vegetative coV r maintained on all sites as specified in your permit? 0 Compliant ❑ Non -Compliant
Were allsetbacks listed in your permit maintained for every applicationto each permittedsite? 0 Compliant ❑ Non -Compliant
Were all freeboards maintainedin accordanceit the specifiedfreeboard i t in your permit? D Compliant ❑ Non -Compliant
If the facility is non -compliant, please explain in the space below the reasons) 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: Danielle Hunter Permittee:
Cervini Farms North Carolina Inc.
Certification No.: 1007992 Signing official: Robert Barr
Grade: Sl Phone Number: [phone] Signing Official's Title: Signatory
Has the oRC changed since the previous N AR-1? ❑ Yes O No Phone Number: (828)-251-1900 Permit Exp.: 12/31125
oi­ 41 ?1311
Signature Cate signature Gate
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 27 -1617

FORM: NDMR 03-12 NON - DISCHARGE I 1 P (NDMR) rage ±L
of
Sampling Person(s) Certified Laboratories
Name: Danielle taunter Name: Race Analytical
Name: Robert Barr Name:
Does all monitoring datai r cies meet the requirements in Attachment A of your permit? D compliant 21 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.
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Operator in Responsible Charge (ORC) Certification Permittee Certification
CRC: Danielle Hunter Permittee, Cervini Farms North Carolina, Inc.
Certification No.: 100792 Signing Official: Robert Barr
Grade: Sl Phone Number: (32 ) 251-1 00 Signing Official's "title: Signatory
Has the ORC changed since the previous NDMR? ❑ Yes CO No Phone Number: [phone] Permit Expiration: 12/31/2025
3- ( 31
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 Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 276 9-1617