WQ0009098_Monitoring - 03-2021_20210504

'FORM: NDAR-1 10-13 NON-DISCHARGE APPLICATION REPORT(NDAR-1) Page of
Permit No.: Lt` �; Facility Name: \0 iN k k 1 s.Yv#k jr `��tj e l County: �,��a.re Month: �a( pti awl
fill ���1 Field Name:J ) Field Name: Field Name: Field Name: pier
Did irrigation occur
Area(acres): Area(acres): Area(acres): Area(acres):
at this facility? Cover Crop: Cover Crop: Cover Crop: Cover Crop:
❑ YES o Hourly Rate(in): Hourly Rate(in): Hourly Rate(in): Hourly Rate(in):
N/NfAnnual Rate(in): Annual Rate(in): Annual Rate(in): Annual Rate(in):
Weather Freeboard Field Irrigated? ❑ YES ❑ NO Field Irrigated? ❑ YES Cl] NO Field Irrigated? ❑ YES ❑ NO Field Irrigated? ❑ YES
m C
a) w
° a) m aa) v •o a) E a ° -a Y a) E a) a) v a a) E a) ° -a -a rn
>. ° lya ...7,
al � � E N a) a; TC 7 ` C E °' 02 TC 7iC E 61 0 ii: >+ C 7 � C E °' N „, TC
m U 12 •= m °- � m E R r :a E to : E 5 '5 3 E a
N D. ❑ a o• E m 'o a v a Q E a `i3 a m E 0- in
❑ m °- •5 $ >,a o a H •a' ❑ o R = o o a H c' ❑ o m = o . < � •,_ ❑ o _1 < F a' ❑ o
Y E N Cl) 10 Q > Q .- J 2 J > Q - J a J > Q J ct, J > Q — J
°F in ft ft gal min in in gal min in in gal min in in gal min in
1
2
3 _
4 1� (�
5 am t€ C
6
7 ,
T rir 1 lct-71 (-) 1,-) IA____
9
10
11
12
13 _ 1.,...--a..' Ci [ t+1 _.
14 L.,)
151�
16
17 - 14`.c\` � �\�GSS\
18
19 \1re��
20 ' 2'M
21
22
23
24
25
26
27
28
29
30
31
Monthly Loading:
G. .
12 Month Floating Total(in): tip °

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? dompliant [] Non-Compli
Were adequate measures taken to prevent effluent ponding in or runoff from the sites? VCompliant ❑ Non-Compli
Was a suitable vegetative cover maintained on all sites as specified in your permit? Compliant ❑ Non-Compli
Were all setbacks listed in your permit maintained for every application to each permitted site? 'ompliant ❑ Non-Compli
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? 'Compliant ❑ Non-Compli
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 cor
action(s)taken.Attach additional sheets if necessary.
Operator in Responsible�� Charge(ORC)Certification Permittee Certification
ORC , \ 1 �t 1� cL l lActvk Permittee: Qime5 t 1p ,� L(mr tae .5h
Certification No.: Li C/ Signing Official: c J(�y es_�e �"t6 l'tail
J „ e
Grade: Phone Number:Gj tQ rr�ir.,�a5q(( Signing Official's Title: COW\b f7 t 5' ra_ r
Has the ORC changed since the previous NDAR--1? l❑ Yes Et/Not Phone Number: ollij_3-6a_aapo
Permit Exp.:
S[S I aa
Tctit• Aj 1.0 MC-ikkaQt4A 1118)Clat
I 40, / :12_ 1204..(b IMeAkto
Signature to , Signature Da
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
with a system designed to assure that all qualified personnel properly gathered and evaluated the information submitted.E
inquiry of the person or persons who manage the system,or those persons directly responsible for gathering the inform
information submitted is,to the best of my knowledge and belief,true,accurate,and complete.I am aware that there are
penalties for submitting false information,including the possibility of fines and imprisonment for knowing violation
Mail Original and Two Copies to:
Division of Water Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

--FORM: NDMR 03-12 NON-DISCHARGE MONITORING REPORT(NDMR) Page of
Permit No.:(Dig g Facility Name 50 4l• thvie 1� U 1 County: L��cj V'e Month:&t�ek /
144VV '"� Influent Effluent Groundwaterl' 1 Lowering ❑"Surf
PPI: Flow Measuring Point: ❑ Influent ❑ Effluent '�j No flow generated Parameter. Monitoring Point: ❑ ❑ ❑
Parameter Code —1. 50050
O
t m 3
>, . 16
U ~ V LL
0 O cc
•
24-hr hrs GPD
2
3
5
7
9 ‘11)- 4-rPlAry7ri_ C
10
12 11 1eleVY)
13 Lk)
14 C ,
15
16
17
18
19
20
21
22
23
24
25
26
•
27
28
29
30
31
Average:
Daily Maximum:
Daily Minimum:
Sampling Type:
Monthly Avg.Limit:
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? Compliant ❑ Non-Cc
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 coi
action(s)taken.Attach additional sheets if necessary.
Flo LOc 5+eL er
Y-i LADLO-1f* Sis-f-e tin
Operator� in Responsible► bli Charge(ORC)Certification Permittee Certification
ORC e1 V t'`Cl^►�l( [,'CAI\ Permittee: .1a es 'F`it i l 14' R,.-.J-1� I► (�
Certification No.: 11.-1 CtO3 Signing Official: Eck6.the_ e_me.vyk,lvkr
Grade: s' Phone Number: Q l I ot /t, �j� Signing Official's Title:Q 4
t R( �^
Has the ORC changed since the previous NDMR? ri Yes No yl Phone Number: `C��y
Permit Ex iration:
t L1-?3a—a is st311
?, Ate PaabOAC ( ,L&I)
Signature to Signature Da
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
with a system designed to assure that all qualified personnel properly gathered and evaluated the information submitt
my inquiry of the person or persons who manage the system,or those persons directly responsible for gathering the in
information submitted is,to the best of my knowledge and belief,true,accurate,and complete.I am aware that there
penalties for submitting false information,including the possibility of fines and imprisonment for knowing violat
Mail Original and Two Copies to:
Division of Water Resources
Information Processing Unit
1617 Mail Service Center