WQ0002503_Monitoring - 01-2021_20210315

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page __L_of
Permit No.: 11111 1
Parameter Monitoring Point: El Influent 21 Effluent El Groundwater Lowering E Surface Water
Parameter Code
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FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page 2 of;
Sampling Person(s) Certified Laboratories
Name: Christopher Barnes Name: Pace Analytical
Name: Name:
uoes.an monitoring aata ana sampling trequencies meet the requirements in Attachment A of your permit? o 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 cnrrPr:t;vP
Men, Attach acantonal sheets it necessary.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Danny Hombeck Permittee: Frit Car Inc.
Certification No.: 26718 Signing Official: Michael Newby
Grade: Phone Number: 252-638-2675 Signing Official's Title: Senior Vice President
Has the ORC changed since the Previous NDMR? O Yes 2 No Phone Number- 251-867-7752 Permit Expiration: 6/30/2022
' .33101
Signature Date I Si Date
By this signature, 1 certify that this report is accwrate and complete to the best of my knowledge. I certify. water 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 qualitbd personnel property gathered and evaluated it* 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 irdormatbn submitted, is, to fhe best of myknowWge and belief; true, accurate, and complete. 1 am
aware that there are significant penalties for submitlig false information, including the possibility of fines and impi sonment for
knowmig 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 17
Permit No.: W00002503.
-
.
1
Did irrigation occur
facility?at this
Cover Crop:
El YES ® NO
Hourly '.te (in):
Hourly '.te (in):
Hourly -.
-
-Hourly
Rate (in):
WITITITMWEIrWRI!
Annual Rate (in):
Annual Rate (in):"
Annual Rate (in):
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FORM: NDAR-1 10-13
NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Did the application rates exceed the limits in Attachment B of your permit?
Were adequate measures taken to prevent effluent ponding in or runoff from the sites?
Was a suitable 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?
Page (A of
O Compliant
❑ Non -Compliant
CI Compliant
❑ Non -Compliant
21 Compliant
❑.NorrCompliant
3 Compliant
❑ Non -Compliant
Were all freeboards maintained in accordance with the specified freeboardheightsin your permit? o Compliant n 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: Danny Hornbeck Permittee:
Frit Car Inc.
Certification No.: 26718 Signing Official: Michael Newby
Grade: Phone Number: 255-638-2675 signing Official's Title: Senior Vice President
Has the ORC changed since the previous NDAR-1? U yes p No Phone Number: 251 67-7752 Permit Exp.: 6/30/22
3 3z-z
1
Signature Date Signature Date
Bythis signature. I certifytta this report is accurrate and complete to the best of my knowledge. I certify, under penalty of law, that this document and aA attachments were prepared under m direction or supervision
with a s tern Ysubite in accordance
system designed to assure that all qualified persomel properly gathered and evaluated the information submitted. Based on my
kquky of the person or persons who manage the system, or those persons directly responsgle for gathering the information, the
information submitted is. to the best of my knowledge arrd belief,: true, accurate, and complete. I. am aware that there are significant
penalties for submitting false information, including the possibility of fines and knposonment for knowing v4oliora
Mail Original and Two Copies to:
Division of Water Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617