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WQ0036210_Monitoring - 01-2021_20210222
FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page Permit No.: loll . 1 Facility Name: Moore's Keep Christian Camp .unty: Moore 1111111111111111116 . • •. ■ ■ ■ • • . •. ■ ■ ■ ■ Parameter Code 11 • Da ly Maximum: Monthly Avg. Limif. Daily Limit: Sample Frequency: FORM: NDMR 03-12 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? R 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: Thomas Lewis Permittee: Benchmark Ministries Inc. Certification No.: 1002746 Signing Official: Thomas Lewis Grade: SI Phone Number: 919-815-7603 Signing Official's Title: President Has the ORC changed since the previous NDMR? ❑ Yes No Phone Number: 919-815-7603 Permit Expiration: 1 /31 /2023 ignature 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 ,FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of f", e, WQ0036210 •• - --• Christian Camp . Moore Field Name: • irrigation occur (acres): .®Area (acres):Area .•Area (acres):! Area (acres): at this facility? Forest/Grass Cover Crop, Cover Crop: F� YES PTNO Hourly Rate (in): Hourly Rate (in):! Hourly Rate (iny Annual Rate (in): EM.W.Rilligraln, ::...Field Irrigated?• .. :. (� �• . .. :. • : .M .. :. MMM ©MW=ram ©___ _ _ ---_ -_-- --_- -_-- o MMM or=W MW MN��� m®mjr�®� Monthly Loading: �, 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? s4ompliant ❑ 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 MAW[lkb) rd MV 1. MUdUrl dUUILIUI ldl SI Wu Lb II Operator in Responsible Charge (ORC) Certification Permittee Certification ORC: Thomas Lewis Permittee: Benchmark Ministries Inc. Certification No.: 1002746 Signing Official: Thomas Lewis Grade: SI Phone Number: 919-815-7603 Signing Official's Title: President Has the ORC changed since the previous NDAR-1? ❑ Yes P] No Phone Number: 919-815-7603 Permit Exp.: 1 /31 /23 15- �4, dAd—_- 42 -Z�z — z gnature 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