WQ0002829_Monitoring - 07-2021_20210826

DWR - NonDischarge Monitoring Report Submittal
NORTH CAROLINA
Ertrlranmrrttat Quaffty
Monitoring Report Submittal
Permit Number #*
Name of Facility:*
Month:* July
Report Information
Type*
WQ0002829
KDHWWTP LLC
NDMR, NDAR-1, NDAR-2, NDMLR
Confirmation Email Address:*
Name of Submitter:*
Signature:
Year:* 2021
Upload Document*
WQ0002829 JULY 21.pdf 1.02MB
ME Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
TGEE@ATLANTICSEWAGE. COM
TINA GEE
Date of submittal: 8/26/2021
This will be filled in autonatically
Initial Review
Reviewer: Giri, Poonam a

Is the project number correct?* WQ0002829
Is the monitoring report
accepted? *
Regional Office*
Yes r No
Washington
Accepted Date: 8/30/2021

FORM: NDMR 05-16 NON-DISCHARGE MONITORING REPORT (NDMR)Page _____ of _____
County: Month: Year:2021
001
50050
ORC Arrival TimeORC Time On SiteFlow 24-hr hrs GPD
1 07:20 3 362,000
2 00:00 0 376,000
3 00:00 0 389,000
4 00:00 0 375,000
5 00:00 0 348,000
6 07:30 2 347,000
7 08:00 3 331,000
8 07:00 3 360,000
9 07:00 3 431,000
10 00:00 0 249,000
11 00:00 0 376,000
12 07:15 3 344,000
13 07:30 2 353,000
14 07:00 3 342,000
15 07:20 3 382,000
16 07:10 3 372,000
17 00:00 0 361,000
18 00:00 0 354,000
19 07:20 3 404,000
20 07:10 3 382,000
21 07:10 3 379,000
22 07:30 3 376,000
23 07:45 3 364,000
24 00:00 0 320,000
25 00:00 0 387,000
26 07:45 3 384,000
27 07:30 2 381,000
28 07:40 2 363,000
29 07:30 3 378,000
30 07:45 3 422,000
31 00:00 0 339,000
365,516
431,000
249,000
Recorder
660,000
Continuous
July
PPI:
Average:DayMonthly Limit:
Sampling Type:
Daily Maximum:
Daily Minimum:
Permit No.:WQ0002829 Facility Name:KDHWWTP Dare
Sample Frequency:
Daily Limit:
Flow Measuring Point: Parameter Monitoring Point:
Parameter Code
Influent No flow generatedEffluent Influent Effluent Surface WaterGroundwater Lowering
FORM: NDMR 05-16 NON-DISCHARGE MONITORING REPORT (NDMR)Page _____ of _____
County: Month: Year:2021
002
50050 00310 00940 31616 00610 00625 00620 00600 00400 00665 70300 00530
ORC Arrival TimeORC Time On SiteFlowBOD5ChlorideFecal ColiformAmmoniaTotal Kjeldahl NitrogenNitrateTotal NitrogenpHTotal PhosphorusTotal Dissolved SolidsTotal Suspended Solids 24-hr hrs GPD mg/L mg/L #/100 mL mg/L mg/L mg/L mg/L su mg/L mg/L mg/L
1 07:20 3 217,210 6.79
2 00:00 0 238,650 6.8
3 00:00 0 249,250
4 00:00 0 237,000
5 00:00 0 224,130 H
6 07:30 2 56,950 <2 <1 <0.2 1.5 10.9 12.4 6.92 0.57 2.7
7 08:00 3 147,190 7.09
8 07:00 3 176,880 7.02
9 07:00 3 208,400 6.97
10 00:00 0 110,160
11 00:00 0 200,730
12 07:15 3 173,350 6.87
13 07:30 2 91,020 <2 <1 0.2 1.2 8.83 10 7.07 0.52 3.2
14 07:00 3 78,390 7.11
15 07:20 3 261,780 6.96
16 07:10 3 263,590 7.02
17 00:00 0 254,330
18 00:00 0 251,340
19 07:20 3 306,110 6.91
20 07:10 3 163,290 <2 <1 <0.2 0.9 6.36 7.3 6.96 2.69 2.5
21 07:10 3 154,640 6.89
22 07:30 3 155,260 6.93
23 07:45 3 135,160 6.97
24 00:00 0 122,690
25 00:00 0 162,670
26 07:45 3 175,550 <2 <1 <0.2 0.9 0.89 1.8 6.88 0.29 2.7
27 07:30 2 168,080 6.93
28 07:40 2 218,510 7.04
29 07:30 3 241,640 6.87
30 07:45 3 250,330 6.97
31 00:00 0 213,370
190,569 0.00 1.00 0.05 1.13 6.75 7.88 1.02 2.78
306,110 2.00 1.00 0.20 1.50 10.90 12.40 7.11 2.69 3.20
56,950 2.00 1.00 0.20 0.90 0.89 1.80 6.79 0.29 2.50
Recorder Composite Composite Grab Composite Composite Composite Composite Grab Composite Composite Composite
327,735 10 14 4 7 3 20
43 6-9
Continuous See Permit 3 X Year See Permit See Permit See Permit See Permit See Permit 5 X Week See Permit 3 X Year See Permit
July Permit No.:WQ0002829 Facility Name:KDHWWTP Dare
Sample Frequency:
PPI: Flow Measuring Point: Parameter Monitoring Point:
Parameter Code DayAverage:
Daily Maximum:
Daily Minimum:
Sampling Type:
Monthly Limit:
Daily Limit:
Influent No flow generatedEffluent Influent Effluent Surface WaterGroundwater Lowering
FORM: NDMR 05-16 NON-DISCHARGE MONITORING REPORT (NDMR)Page _____ of _____
County: Month: Year:2021
003
00310 31616 00610 00400 00530 00076
ORC Arrival TimeORC Time On SiteBOD5Fecal ColiformAmmoniapHTotal Suspended SolidsTurbidity 24-hr hrs mg/L #/100 mL mg/L su mg/L NTU
1 07:20 3 6.79 0.78
2 00:00 0 6.8 0.84
3 00:00 0 0.75
4 00:00 0 0.77
5 00:00 0 H 0.78
6 07:30 2 <2 <1 <0.2 6.92 2.7 0.83
7 08:00 3 7.09 0.72
8 07:00 3 7.02 0.75
9 07:00 3 6.97 0.83
10 00:00 0 0.81
11 00:00 0 0.92
12 07:15 3 6.87 0.77
13 07:30 2 <2 <1 0.2 7.07 3.2 0.76
14 07:00 3 7.11 0.88
15 07:20 3 6.96 0.86
16 07:10 3 7.02 0.94
17 00:00 0 0.81
18 00:00 0 0.9
19 07:20 3 6.91 0.87
20 07:10 3 <2 <1 <0.2 6.96 2.5 0.93
21 07:10 3 6.89 0.82
22 07:30 3 6.93 0.87
23 07:45 3 6.97 0.84
24 00:00 0 1.02
25 00:00 0 0.94
26 07:45 3 <2 <1 <0.2 6.88 2.7 0.78
27 07:30 2 6.93 0.81
28 07:40 2 7.04 0.8
29 07:30 3 6.87 0.87
30 07:45 3 6.97 0.89
31 00:00 0 0.9
#DIV/0! 1.00 0.05 2.78 0.84
0 1.00 0.20 7.11 3.20 1.02
0 1.00 0.20 6.79 2.50 0.72
Composite Grab Composite Grab Composite Recorder
10 14 4 5
15 25 6 6-9 10 10
See Permit See Permit See Permit 5 X Week See Permit Continuous
July Permit No.:WQ0002829 Facility Name:KDHWWTP Dare
Sample Frequency:
PPI: Flow Measuring Point: Parameter Monitoring Point:
Parameter Code DayAverage:
Daily Maximum:
Daily Minimum:
Sampling Type:
Monthly Limit:
Daily Limit:
Influent No flow generatedEffluent Influent Effluent Surface WaterGroundwater Lowering
FORM: NDMR 05-16 NON-DISCHARGE MONITORING REPORT (NDMR)Page _____ of _____
County: Month: Year:2021
004
50050
ORC Arrival TimeORC Time On SiteFlow 24-hr hrs GPD
1 07:20 3 64,790
2 00:00 0 57,350
3 00:00 0 59,750
4 00:00 0 58,000
5 00:00 0 43,870
6 07:30 2 190,050
7 08:00 3 83,810
8 07:00 3 83,120
9 07:00 3 122,600
10 00:00 0 38,840
11 00:00 0 75,270
12 07:15 3 70,650
13 07:30 2 161,980
14 07:00 3 163,610
15 07:20 3 20,220
16 07:10 3 8,410
17 00:00 0 6,670
18 00:00 0 2,660
19 07:20 3 0
20 07:10 3 118,710
21 07:10 3 124,360
22 07:30 3 120,740
23 07:45 3 128,840
24 00:00 0 97,310
25 00:00 0 124,330
26 07:45 3 108,450
27 07:30 2 112,920
28 07:40 2 44,490
29 07:30 3 36,360
30 07:45 3 71,670
31 00:00 0 25,630
78,241
190,050
0
Recorder
136,283
Continuous
July Permit No.:WQ0002829 Facility Name:KDHWWTP Dare
Sample Frequency:
PPI: Flow Measuring Point: Parameter Monitoring Point:
Parameter Code DayAverage:
Daily Maximum:
Daily Minimum:
Sampling Type:
Monthly Limit:
Daily Limit:
Influent No flow generatedEffluent Influent Effluent Surface WaterGroundwater Lowering
FORM: NDMR 05-16 NON-DISCHARGE MONITORING REPORT (NDMR)Page _____ of _____
County: Month: Year:2021
005
50050
ORC Arrival TimeORC Time On SiteFlow 24-hr hrs GPD
1 07:20 3 80,000
2 00:00 0 80,000
3 00:00 0 80,000
4 00:00 0 80,000
5 00:00 0 80,000
6 07:30 2 100,000
7 08:00 3 100,000
8 07:00 3 100,000
9 07:00 3 100,000
10 00:00 0 100,000
11 00:00 0 100,000
12 07:15 3 100,000
13 07:30 2 100,000
14 07:00 3 100,000
15 07:20 3 100,000
16 07:10 3 100,000
17 00:00 0 100,000
18 00:00 0 100,000
19 07:20 3 100,000
20 07:10 3 100,000
21 07:10 3 100,000
22 07:30 3 100,000
23 07:45 3 100,000
24 00:00 0 100,000
25 00:00 0 100,000
26 07:45 3 100,000
27 07:30 2 100,000
28 07:40 2 100,000
29 07:30 3 100,000
30 07:45 3 100,000
31 00:00 0 100,000
96,774
100,000
80,000
Recorder
215,456
Continuous
July Permit No.:WQ0002829 Facility Name:KDHWWTP Dare
Sample Frequency:
PPI: Flow Measuring Point: Parameter Monitoring Point:
Parameter Code DayAverage:
Daily Maximum:
Daily Minimum:
Sampling Type:
Monthly Limit:
Daily Limit:
Influent No flow generatedEffluent Influent Effluent Surface WaterGroundwater Lowering
FORM: NDMR 05-16 NON-DISCHARGE MONITORING REPORT (NDMR)Page _____ of _____
Name:
Name:
Raleigh, North Carolina 27699-1617
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
4 Phone Number:252-489-9583 Signing Official's Title:
Has the ORC changed since the previous NDMR? Phone Number:252-491-8771
Manager of Atlantic OBX Grade:
Permit Expiration:6/30/2022
ORC:Jimmy Bliven Permittee:George E Goodrich
Certification No.:991879 Signing Official:Tina Gee by Authority
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit?
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.
TN was over limit 7/6, 7/13, and 7/20. We are working on getting the plant upgrades dialed in but all work to upgrades has not been completed.
Operator in Responsible Charge (ORC) Certification Permittee Certification
Name:
Sampling Person(s)Certified Laboratories
Name:Jimmy Bliven Envirochem
Yes No
Compliant Non-Compliant
08/26/21 08/26/21
FORM: NDAR-1 05-16 NON-DISCHARGE APPLICATION REPORT (NDAR-1)Page _____ of _____
County: Month: Year:2021
TemperaturePrecipitationStorage5-Day Upset (if applicable)Volume AppliedTime IrrigatedDaily LoadingMaximum Hourly LoadingVolume AppliedTime IrrigatedDaily LoadingMaximum Hourly LoadingVolume AppliedTime IrrigatedDaily LoadingMaximum Hourly LoadingVolume AppliedTime IrrigatedDaily LoadingMaximum Hourly LoadingºF in ft ft gal min in in gal min in in gal min in in gal min in in
1 C 78 0 14,000 180 0.11 0.04 8,000 120 0.05 0.02 14,000 180 0.16 0.05 20,000 300 0.13 0.03
2 PC 80 0 14,000 180 0.11 0.04 8,000 120 0.05 0.02 14,000 180 0.16 0.05 20,000 300 0.13 0.03
3 CL 74 0 14,000 180 0.11 0.04 8,000 120 0.05 0.02 14,000 180 0.16 0.05 20,000 300 0.13 0.03
4 C 73 0 14,000 180 0.11 0.04 8,000 120 0.05 0.02 14,000 180 0.16 0.05 20,000 300 0.13 0.03
5 C 81 0 14,000 180 0.11 0.04 8,000 120 0.05 0.02 14,000 180 0.16 0.05 20,000 300 0.13 0.03
6 C 80 0 3.5 14,000 180 0.11 0.04 18,000 180 0.10 0.03 14,000 180 0.16 0.05 30,000 360 0.20 0.03
7 C 78 0 14,000 180 0.11 0.04 18,000 180 0.10 0.03 14,000 180 0.16 0.05 30,000 360 0.20 0.03
8 PC 82 0.5 14,000 180 0.11 0.04 18,000 180 0.10 0.03 14,000 180 0.16 0.05 30,000 360 0.20 0.03
9 C 78 0 14,000 180 0.11 0.04 18,000 180 0.10 0.03 14,000 180 0.16 0.05 30,000 360 0.20 0.03
10 C 84 0 14,000 180 0.11 0.04 18,000 180 0.10 0.03 14,000 180 0.16 0.05 30,000 360 0.20 0.03
11 C 81 0 14,000 180 0.11 0.04 18,000 180 0.10 0.03 14,000 180 0.16 0.05 30,000 360 0.20 0.03
12 C 80 0 14,000 180 0.11 0.04 18,000 180 0.10 0.03 14,000 180 0.16 0.05 30,000 360 0.20 0.03
13 C 80 0 3.5 14,000 180 0.11 0.04 18,000 180 0.10 0.03 14,000 180 0.16 0.05 30,000 360 0.20 0.03
14 C 80 0 14,000 180 0.11 0.04 18,000 180 0.10 0.03 14,000 180 0.16 0.05 30,000 360 0.20 0.03
15 C 80 0 14,000 180 0.11 0.04 18,000 180 0.10 0.03 14,000 180 0.16 0.05 30,000 360 0.20 0.03
16 C 80 0 14,000 180 0.11 0.04 18,000 180 0.10 0.03 14,000 180 0.16 0.05 30,000 360 0.20 0.03
17 C 80 0 14,000 180 0.11 0.04 18,000 180 0.10 0.03 14,000 180 0.16 0.05 30,000 360 0.20 0.03
18 PC 80 0.6 14,000 180 0.11 0.04 18,000 180 0.10 0.03 14,000 180 0.16 0.05 30,000 360 0.20 0.03
19 CL 75 2 14,000 180 0.11 0.04 18,000 180 0.10 0.03 14,000 180 0.16 0.05 30,000 360 0.20 0.03
20 CL 74 0 14,000 180 0.11 0.04 18,000 180 0.10 0.03 14,000 180 0.16 0.05 30,000 360 0.20 0.03
21 CL 76 0 3.25 14,000 180 0.11 0.04 18,000 180 0.10 0.03 14,000 180 0.16 0.05 30,000 360 0.20 0.03
22 PC 78 0 14,000 180 0.11 0.04 18,000 180 0.10 0.03 14,000 180 0.16 0.05 30,000 360 0.20 0.03
23 C 76 0 14,000 180 0.11 0.04 18,000 180 0.10 0.03 14,000 180 0.16 0.05 30,000 360 0.20 0.03
24 C 70 0 14,000 180 0.11 0.04 18,000 180 0.10 0.03 14,000 180 0.16 0.05 30,000 360 0.20 0.03
25 C 77 0 14,000 180 0.11 0.04 18,000 180 0.10 0.03 14,000 180 0.16 0.05 30,000 360 0.20 0.03
26 C 78 1.5 14,000 180 0.11 0.04 18,000 180 0.10 0.03 14,000 180 0.16 0.05 30,000 360 0.20 0.03
27 CL 75 0 14,000 180 0.11 0.04 18,000 180 0.10 0.03 14,000 180 0.16 0.05 30,000 360 0.20 0.03
28 CL 80 0 3.25 14,000 180 0.11 0.04 18,000 180 0.10 0.03 14,000 180 0.16 0.05 30,000 360 0.20 0.03
29 C 77 0 14,000 180 0.11 0.04 18,000 180 0.10 0.03 14,000 180 0.16 0.05 30,000 360 0.20 0.03
30 C 80 0 14,000 180 0.11 0.04 18,000 180 0.10 0.03 14,000 180 0.16 0.05 30,000 360 0.20 0.03
31 C 85 0 14,000 180 0.11 0.04 18,000 180 0.10 0.03 14,000 180 0.16 0.05 30,000 360 0.20 0.03
434,000 3.47 508,000 2.89 434,000 4.89 880,000 5.77
Annual Rate (in):Annual Rate (in):118
Area (acres):6.47
Cover Crop:
1
Dare JulyFacility Name:KDHWWTP
IRR-2 Field Name:
Permit No.:WQ0002829
DayField Name:IRR-1
Area (acres):4.6
1
Cover Crop:
Hourly Rate (in):
Field Irrigated?Freeboard
118
Did irrigation occur
at this facility?
Monthly Loading:
Annual Rate (in):
Hourly Rate (in):
Field Irrigated?
Field Name:IRR-3
Area (acres):3.27
Cover Crop:Weather Code118
12 Month Floating Total (in):
Weather
Annual Rate (in):
Field Name:IRR-4
Area (acres):5.62
Cover Crop:
Hourly Rate (in):1
Field Irrigated?
Hourly Rate (in):1
Field Irrigated?
118
YES NO
YES NO YES NOYESNO YES NO
FORM: NDAR-1 05-16 NON-DISCHARGE APPLICATION REPORT (NDAR-1)Page _____ of _____
County: Month: Year:2021
TemperaturePrecipitationStorage5-Day Upset (if applicable)Volume AppliedTime IrrigatedDaily LoadingMaximum Hourly LoadingVolume AppliedTime IrrigatedDaily LoadingMaximum Hourly LoadingVolume AppliedTime IrrigatedDaily LoadingMaximum Hourly LoadingVolume AppliedTime IrrigatedDaily LoadingMaximum Hourly LoadingºF in ft ft gal min in in gal min in in gal min in in gal min in in
1 C 78 0 10,000 120 0.39 0.20 14,000 180 0.31 0.10 0 0 0.00 0.00
2 PC 80 0 10,000 120 0.39 0.20 14,000 180 0.31 0.10 0 0 0.00 0.00
3 CL 74 0 10,000 120 0.39 0.20 14,000 180 0.31 0.10 0 0 0.00 0.00
4 C 73 0 10,000 120 0.39 0.20 14,000 180 0.31 0.10 0 0 0.00 0.00
5 C 81 0 10,000 120 0.39 0.20 14,000 180 0.31 0.10 0 0 0.00 0.00
6 C 80 0 3.5 10,000 120 0.39 0.20 14,000 180 0.31 0.10 0 0 0.00 0.00
7 C 78 0 10,000 120 0.39 0.20 14,000 180 0.31 0.10 0 0 0.00 0.00
8 PC 82 0.5 10,000 120 0.39 0.20 14,000 180 0.31 0.10 0 0 0.00 0.00
9 C 78 0 10,000 120 0.39 0.20 14,000 180 0.31 0.10 0 0 0.00 0.00
10 C 84 0 10,000 120 0.39 0.20 14,000 180 0.31 0.10 0 0 0.00 0.00
11 C 81 0 10,000 120 0.39 0.20 14,000 180 0.31 0.10 0 0 0.00 0.00
12 C 80 0 10,000 120 0.39 0.20 14,000 180 0.31 0.10 0 0 0.00 0.00
13 C 80 0 3.5 10,000 120 0.39 0.20 14,000 180 0.31 0.10 0 0 0.00 0.00
14 C 80 0 10,000 120 0.39 0.20 14,000 180 0.31 0.10 0 0 0.00 0.00
15 C 80 0 10,000 120 0.39 0.20 14,000 180 0.31 0.10 0 0 0.00 0.00
16 C 80 0 10,000 120 0.39 0.20 14,000 180 0.31 0.10 0 0 0.00 0.00
17 C 80 0 10,000 120 0.39 0.20 14,000 180 0.31 0.10 0 0 0.00 0.00
18 PC 80 0.6 10,000 120 0.39 0.20 14,000 180 0.31 0.10 0 0 0.00 0.00
19 CL 75 2 10,000 120 0.39 0.20 14,000 180 0.31 0.10 0 0 0.00 0.00
20 CL 74 0 10,000 120 0.39 0.20 14,000 180 0.31 0.10 0 0 0.00 0.00
21 CL 76 0 3.25 10,000 120 0.39 0.20 14,000 180 0.31 0.10 0 0 0.00 0.00
22 PC 78 0 10,000 120 0.39 0.20 14,000 180 0.31 0.10 0 0 0.00 0.00
23 C 76 0 10,000 120 0.39 0.20 14,000 180 0.31 0.10 0 0 0.00 0.00
24 C 70 0 10,000 120 0.39 0.20 14,000 180 0.31 0.10 0 0 0.00 0.00
25 C 77 0 10,000 120 0.39 0.20 14,000 180 0.31 0.10 0 0 0.00 0.00
26 C 78 1.5 10,000 120 0.39 0.20 14,000 180 0.31 0.10 0 0 0.00 0.00
27 CL 75 0 10,000 120 0.39 0.20 14,000 180 0.31 0.10 0 0 0.00 0.00
28 CL 80 0 3.25 10,000 120 0.39 0.20 14,000 180 0.31 0.10 0 0 0.00 0.00
29 C 77 0 10,000 120 0.39 0.20 14,000 180 0.31 0.10 0 0 0.00 0.00
30 C 80 0 10,000 120 0.39 0.20 14,000 180 0.31 0.10 0 0 0.00 0.00
31 C 85 0 10,000 120 0.39 0.20 14,000 180 0.31 0.10 0 0 0.00 0.00
310,000 12.15 434,000 9.69 0 0.00 0 0.00
Monthly Loading:
12 Month Floating Total (in):
Annual Rate (in):DayWeather Freeboard Field Irrigated? Field Irrigated? Field Irrigated? Field Irrigated?Weather Code118
Hourly Rate (in):1 Hourly Rate (in):1
Annual Rate (in):118 Annual Rate (in):118 Annual Rate (in):
Cover Crop: Cover Crop:
Hourly Rate (in):1 Hourly Rate (in):
IRR-7 Field Name:
Area (acres):0.94 Area (acres):1.65 Area (acres):2 Area (acres):
Field Name:Did irrigation occur
at this facility?
Field Name:IRR-5 Field Name:IRR-6
Cover Crop: Cover Crop:
July Permit No.:WQ0002829 Facility Name:KDHWWTP Dare
YES NO
YES NO YES NOYESNO YES NO
FORM: NDAR-1 05-16 NON-DISCHARGE APPLICATION REPORT (NDAR-1)Page _____ of _____
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
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
Has the ORC changed since the previous NDAR-1? Phone Number:252-491-8771 Permit Exp.:6/30/22
Manager of Atlantic OBX
ORC:Jimmy Bliven Permittee:George E Goodrich
Certification No.:28243 Signing Official:Tina Gee by Authority
Grade:SI Phone Number:252-489-9583 Signing Official's Title:
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
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?
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
Yes No
Compliant Non-Compliant
Compliant Non-Compliant
Compliant Non-Compliant
Compliant Non-Compliant
Compliant Non-Compliant
08/26/21 08/26/21