WQ0028693_Monitoring - 08-2013_20130925

NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Page I of 1 `-
-�Y 1
-1 08-11
.: ' WQ0028693
Facility, Name: Mountaintop Golf &Lake Club WWTF
county: Jackson
Month: August
Year: 2013
rDidigationn 6ccZr
1�1. `
at this facility?-,.'-'
Field Name:
01
Field Nafrta+
• 02
Field Name:
03
Field Name:
04
Area's(acres):
3.09
_ �.-
Aa MA):'
4.35
Area (acres):
4.32
Area (acres):
4.26
Cover Crop:
-,
Bluegrass/Bent ras
Cover.
Bluegrass/Bentgras
Cover Crop:
Bluegrass/Bentgras
Cover Crop:
Bluegrass/Bentgrass
Q vEs'. Q No ; !i�
'�.� Hourly Rate (in):
0.15
��Hourfy Rate (in):
.� Un;t 0.15
Hourly Rate (in):
0.15
Hourly Rate (in):
0.15
Annual Rate (in):
18.2
A yI-Kale
18.2
Annual Rate (in):
18.2
Annual Rate (in):
18.2
Weather
Freeboard
Field Irrigated?
0 YES ❑ NIP"
FiWi gated?
Q YES ❑ No
Field Irrigated?
❑ YES ❑ No
Field Irrigated?
❑ YES I] NO
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1
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58
0
4.5
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4.800
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7,200
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4,800
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7,200
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0.06
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4,800
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7,200
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0.00
5
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64
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6
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61
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6
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0.06
7.200
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0.06
0
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0
0
0.00
0.00
7
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72
1.5
8.5
8.5
0
0
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0.00
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0
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0.00
0
0
0.00
0.00
8
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65
0.2
10
8.5
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
9
CL
64
0.651
11.5
8
4,800
20
0.06
0.06
7,200
20
0.06
0.06
0
0
0.00
0.00
0
0
0.00
0.00
10
1
4.800
20
0.06
0.06
7,200
20
0.06
0.06
0
0
0.00
0.00
0
0
0.00
0.00
11
1
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
12
C
70
0.35
10.5
8
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
13
CL
68
0
9.5
8.5
4,800
20
0.06
0.06
7,200
20
0.06
0.06
0
0
0.00
0.00
0
0
0.00
0.00
14
CL
71
0.3
8.5
11
4,800
20
0.06
0.06
7,200
20
0.06
0.06
0
0
0.00
0.00
0
0
0.00
0.00
15
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62
0
7.5
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0
0
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0
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0
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161
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69
0
7
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4,800
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0.06
7.200
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0.06
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0
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0.00
17
0
0
0.00
0.00
0
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0.00
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0
0
0.00
0.00
0
0
0.00
0.00
18
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
19
R
66
1.6
5.5
12
4,800
20
0.06
0.06
7.200
20
0.06
0.06
0
0
0.00
0.00
0
0
0.00
0.00
20
CL
64
0.35
5
12
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
21
CL
64
0
6.5
12
4,800
20
0.06
0.06
7.200
20
0.06
0.06
0
0
0.00
0.00
0
0
0.00
0.00
221
PC
66
0.1
1 9
12
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
23
C
56
0
9
12
4,800
20
0.06
0.06
7,200
20
0.06
0.06
0
0
0.00
0.00
0
0
0.00
0.00
24
4.800
20
0.06
0.06
7.200
20
0.06
0.06
0
0
0.00
0.00
0
0
0.00
0.00
25
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
26
C
46
0.2
10
12
4,800
20
0.06
0.06
7.200
20
0.06
0.06
0
0
0.00
0.00
0
0
0.00
0.00
27
C
47
0
10
12
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
28
PC
80
0
9
11.5
4.800
20
0.06
0.06
7,200
20
0.06
0.06
0
0
0.00
0.00
0
0
0.00
0.00
29
C
76
0
9
11.5
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
30
PC
66
0
8.5
11
4,800
20
0.06
0.06
7,200
0
20
0.06
0.06
0
0
0.00
0.00
0
0
0.00
0.00
31
0
0
0.00
0.00
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
Monthly Loading:
76,800
0.92
115.200
0.98
0
0.00
0
0.00
12 Month Floating Total (in):
5.33
5.67
0.00
0.00

FORM: NDAR-1 08-11
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?
Were all freeboards maintained in accordance With the specified freeboard heights in your permit?
Page
(] Compliant ❑ Non -Compliant
0 Compliant . ❑ ,Non -Compliant
2 Compliant ❑ Non -Compliant
Q Compliant ❑ Non -Compliant
121 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: Michael Beck
Permittee:
Mountaintop Golf & Lake Club
Certification No.: SI-991669 WWIV-7930
Signing Official: Robert Barr
Grade: SI WWIV Phone Number: [phone]
Signing Official's Title: Signatory
Has the ORC changed since the previous NDAR-1? ❑ yes 0 No
Phone Number: [phone] Permit Exp.: 7/31/14
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 27699-1617

NEFF71 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page 2_ of i0
P,FIFNo.: W00028693
Facility Name: Mountaintop Golf & Lake Club WWTF
County: Jackson
Month: August
Year: 2013
Did irrigation occur
at this facility?
F YES ❑ No
Field Name:
05
Field Name:
06
Field Name:
07
Field Name:
08
Area (acres):
3.37
Area (acres):
3.95
Area (acres):
4.02
Area (acres):
2.31
Cover Crop:Blue
rass/Bent ras
9 9
Cover Crop:
P�
Blue rass/Bent ras
9 9
Cover Crop:
P�
Blue rass/Bent ras
9 9
Cover Crop:
P�
Blue rass/Bent rass
9 9
Hourly Rate (in):
0.15
Hourly Rate (in):
0.15
Hourly Rate (in):
0.15
Hourly Rate (in):
0.15
Annual Rate (in):
18.2
Annual Rate (in):
18.2
Annual Rate (in):
18.2
Annual Rate (in):
18.2
Weather
Freeboard
Field Irrigated?
❑ YES ❑ NO
Field Irrigated?
❑ YES ❑ NO
Field Irrigated?
❑ YES ❑ NO
Field Irrigated?
❑ YES ❑r NO
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°F
in
ft
ft
gal
min
in
in
gal
min
in
in
gal
min
in
in
gal
min
in
in
1
C
58
0
4.5
8
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
2
C
54
0
6
8
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
3
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
4
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
5
PC
64
0
5
8
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
6
CL
61
0
6
8
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
7
CL
72
1.5
8.5
8.5
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
8
CL
65
0.2
10
8.5
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
9
CL
64
0.65
11.5
8
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
10
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
11
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
12
C
70
0.35
10.5
8
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
13
CL
68
0
9.5
8.5
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
14
CL
71
0.3
8.5
11
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
151
CL
1 62
0
1 7.5
13
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
16
PC
69
0
7
13
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
17
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
18
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
19
R
66
1.6
5.5
12
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
20
CL
64
0.35
5
12
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
21
CL
64
0
6.5
12
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
22
PC
66
0.1
9
12
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
23
C
56
0
9
12
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
24
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
25
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
26
C
46
0.2
10
12
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
27
C
47
0
10
12
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
28
PC
80
0
9
11.5
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
29
C
76
0
9
11.5
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
30
PC
66
0
8.5
11
0
0
0.00
0.00
0
0
1 0.00
0.00
0
0
0.00
1 0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
Monthly Loading:
r��
0
0.00
0
0.00
0
0.00
0ME
0.00
12 Month Floating Total (in):
0.00
0.00
0.00
0.00

FORM: NDAR-1 08-11
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?
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
Page 7'qq
Compliant ❑ Non -Compliant
0 Compliant ❑ Non -Compliant
E Compliant ❑ Non -Compliant
0 Compliant ❑ Non -Compliant
ll 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: Michael Beck
Permittee: Mountaintop Golf & Lake Club
Certification No.: SI-991669 WWIV-7930
Signing Official: Robert Barr
Grade: SI WWIV Phone Number: [phone]
Signing Official's Title: Signatory
Has the ORC changed since the previous NDAR-1? ❑ yes Ej No
Phone Number: [phone] Permit Exp.: 7/31/14
ofik;jw
17 _
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 27699-1617

R-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page S of 10
No.: WQ0028693
Facility Name: Mountaintop Golf & Lake Club WWTF
County: Jackson
Month: August
Year: 2013
Did irrigation occur
Field Name:
09
Field Name:
10
Field Name:
11
Field Name:
12
this facility?
Area (acres):
2.77
Area (acres):
2.22
Area (acres):
2.16
Area (acres):
3.88
at
Cover Crop:Blue
rass�Bent ras
9 9
Cover Crop:
P�
Blue rass�Bent ras
9 9
Cover Crop:
P�
Blue rass�Bent ras
9 9
Cover Crop:
P�
Blue rass�Bent rass
9 9
P1 YES ❑ NO
Hourly Rate (in):
0.15
Hourly Rate (in):
0.15
Hourly Rate (in):
0.15
Hourly Rate (in):
0.15
Annual Rate (in):
18.2
Annual Rate (in):
18.2
Annual Rate (in):
18.2
Annual Rate (in):
18.2
Weather
Freeboard
Field Irrigated?
❑ YES NO
Field Irrigated?
❑ YES NO
Field Irrigated?
❑ YES No
Field Irrigated?
❑ YES 21 NO
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21
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FORM: NDAR-1 08-11
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?
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
Page
i] Compliant ❑ Non -Compliant_
1] Compliant ElNon-Compliant
I] Compliant ❑ Non -Compliant
❑� Compliant ❑ Non -Compliant
I] 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: Michael Beck
Permittee:
Mountaintop Golf & Lake Club
Certification No.: SI-991669 WWIV-7930
Signing Official: Robert Barr
Grade: SI WWIV Phone Number: [phone]
Signing Official's Title: Signatory
Has the ORC changed since the previous NDARA? ❑ Yes E] No
Phone Number: [phone] Permit Exp.: 7/31/14
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 27699-1617

-1 08-1 I NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page '7-7f 10
No.: WQ0028693
Facility Name: Mountaintop Golf & Lake Club WWTF
County: Jackson
Month: August
Year: 2013
Did irrigation occur
Field Name:
13
Field Name:
14
Field Name:
15
Field Name:
16
Area (acres):
3.38
Area (acres):
2.81
Area (acres):
4.16
Area (acres):
1.76
at this facility?
Cover Crop:Blue
rass�Bent ras
9 9
Cover Crop:
P�
Blue rass�Bent ras
9 9
Cover Crop:
p�
Blue rass/Bent ras
9 9
Cover Crop:
P:
Blue rass�Bent rass
9 9
F YES ❑ NO
Hourly Rate (in):
0.15
Hourly Rate (in):
0.15
Hourly Rate (in):
0.15
Hourly Rate (in):
0.15
Annual Rate (in):
18.2
Annual Rate (in):
18.2
Annual Rate (in):
18.2
Annual Rate (in):
18.2
Weather
Freeboard
Field Irrigated?
❑ YES No
Field Irrigated?
❑ YES NO
Field Irrigated?
❑ YES 21 No
Field Irrigated?
❑ YES ❑� NO
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13
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68
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14
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15
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16
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17
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181
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19
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66
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20
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64
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0
0
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0
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0
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21
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64
0
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22
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66
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23
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56
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241
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25
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0.00
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0.00
26
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0.00
0
0
0.00
0.00
0
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0.00
0.00
0
0
0.00
0.00
47
0
10
12
0
0
0.00
0.00
0
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0.00
0
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0.00
0.00
80
0
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0
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0
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0.00
0.00
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0.00
fl9C
76
0
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0
0
0.00
0.00
0
0
0.00
0.00
0
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0.00
0.00
0
0
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0.00
66
0
8.5
11
0
0
0.00
0.00
0
0
0.00
0.00
0
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0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
Monthly Loading:
0
0.00
0
0.00
0
0.00
0
0.00
12 Month Floating Total (in):
0.00
0.00
0.00
0.00

FORM: NDAR-1 08-11
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?
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
Page
I] Compliant ❑ Non -Compliant .
0 Compliant ❑ Non -Compliant
E Compliant ❑ Non -Compliant
El Compliant ❑ Non -Compliant
I] 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: Michael Beck
Permittee:
Mountaintop Golf &Lake Club
Certification No.: SI-991669 WWIV-7930
Signing Official: Robert Barr
Grade: SI WWIV Phone Number: [phone]
Signing Official's Title: Signatory
Has the ORC changed since the previous NDARA? ❑ Yes 0 No
Phone Number: [phone] Permit Exp.: 7/31/14
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 myi
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 27699-1617

-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of (0
No.: WO0028693
Facility Name: Mountaintop Golf & Lake Club WWTF
County: Jackson
Month: August
Year: 2013
Did irrigation occur
Field Name:
17
Field Name:
18
Field Name:
19
Field Name:
20
facility?
Area (acres):
3.93
Area (acres):
3.26
Area (acres):
3.64
Area (acres):
3.96
at this
Cover Crop:Blue
rass/Bent ras
9 9
Cover Crop:
P�
Blue rass/Bent ras
9 9
Cover Crop:
P�
Blue rass/Bent ras
9 9
cover Crop:
P�
Blue rass/Bent rass
9 9
YES ❑ No
Hourly Rate (in):
0.15
Hourly Rate (in):
0.15
Hourly Rate (in):
0.15
Hourly Rate (in):
0.15
Annual Rate (in):
18.2
Annual Rate (in):
18.2
Annual Rate (in):
18.2
Annual Rate (in):
18.2
Weather
Freeboard
Field Irrigated?
❑ YES 0 NO
Field Irrigated?
❑ YES El No
Field Irrigated?
❑ YES No
Field Irrigated?
❑ YES ❑✓ NO
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58
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0
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2
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54
0
6
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0
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0
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0
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3
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0.00
0
0
0.00
0.00
0
0
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0.00
0
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4
0
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0.00
0
0
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0
0
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0
0.00
0.00
5
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64
0
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8
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0.00
0.00
0
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0
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0.00
0
0
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6
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61
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0.00
0
0
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0.00
0
0
0.00
0.00
0
0
0.00
0.00
7
CL
72
1.5
8.5
8.5
0
0
0.00
0.00
0
0
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0
0
0.00
0.00
0
0
0.00
0.00
8
CL
65
0.2
10
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0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
9
CL
64
0.65
11.5
8
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
10
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
11
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
12
C
70
0.35
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8
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
13
CL
68
0
9.5
8.5
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
14
CL
71
0.3
8.5
11
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
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15
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62
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0
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0
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16
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17
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18
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19
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66
1.6
5.5
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0
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0
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0
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0
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0.00
20
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64
0.35
5
12
0
0
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0
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0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
21
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64
0
6.5
12
0
0
0.00
0.00
0
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22
PC
66
0.1
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12
0
0
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0
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0
0
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0.00
0.00
23
C
56
0
9
12
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
24
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
25
0
0
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0
0
0.00
0.00
0
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0.00
0.00
0
0
0.00
0.00
26
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46
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12
0
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0
0
0.00
0.00
27
C
47
0
10
12
0
0
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0.00
0
0
0.00
0.00
0
0
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0
0
0.00
0.00
28
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80
0
9
11.5
0
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0.00
0
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29
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76
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30
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31
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Monthly Loading:
r-12
0
0.00
0
0.00
0
0.00
0
0.00
Month Floating Total (in):
0.00
0.00
0.00
0.00

FORM: NDAR-1 08-11
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?
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
Page
(] Compliant NanComplian❑ t
Q Compliant Non -Compliant
[21 Compliant ❑ Non -Compliant
0 Compliant ❑ Non -Compliant
E] 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: Michael Beck
Permittee:
Mountaintop Golf &Lake Club
Certification No.: SI-991669 WWIV-7930
Signing Official: Robert Barr
Grade: SI WWIV Phone Number: [phone]
Signing Official's Title: Signatory
Has the ORC changed since the previous NDAR-1? ❑ Yes E] No
Phone Number: [phone] Permit Exp.: 7/31/14
9-�4-B
VV0V
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 27699-1617

pr-
-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page Of_6
o.: WQ0028693
Facility Name: Mountaintop Golf & Lake Club WWTF
County: Jackson
Month: August
Year: 2013
Did irrigation occur
Field Name:
21
Field Name:
22
Field Name:
23
Field Name:
24
facility?
Area (acres):
5.33
Area (acres):
5.49
Area (acres):
2.99
Area (acres):
3.81
at this
Cover Crop:Blue
rass�Bent ras
9 9
Cover Crop:
P�
Blue rass�Bent ras
9 9
Cover Crop:
P�
Blue rass�Bent ras
9 9
Cover Crop:
P�
Blue rass/Bent rass
9 9
❑� YES ❑ NO
Hourly Rate (in):
0.15
Hourly Rate (in):
0.15
Hourly Rate (in):
0.15
Hourly Rate (in):
0.15
Annual Rate (in):
18.2
Annual Rate (in):
18.2
Annual Rate (in):
18.2
Annual Rate (in):
18.2
Weather
Freeboard
Field Irrigated?
❑ YES 2] No
Field Irrigated?
❑ YES 0 No
Field Irrigated?
❑ YES [21 NO
Field Irrigated?
❑ YES ❑� NO
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1
C
58
0
4.5
8
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
2
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54
0
6
8
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
3
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
4
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
5
PC
64
0
5
8
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
6
CL
61
0
6
8
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
7
CL
72
1.5
8.5
8.5
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
8
CL
65
0.2
10
8.5
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
9
CL
64
0.65
11.5
8
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
10
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
11
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
12
C
70
0.35
10.5
8
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
13
CL
68
0
9.5
8.5
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
14
CL
71
0.3
8.5
11
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
15
CL
62
0
7.5
13
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
16
PC
69
0
7
13
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
17
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
18
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
19
R
66
1.6
5.5
12
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
20
CL
64
0.35
5
12
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
21
CL
64
0
6.5
12
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
221
PC
66
0.1
9
12
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
23
C
56
0
9
12
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
24
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
25
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
26
C
46
0.2
10
12
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
27
C
47
0
10
12
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
28
PC
80
0
9
11.5
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
29
C
76
0
9
11.5
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
30
PC
66
0
8.5
11
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
31
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
Monthly Loading:
0
0.00
0
0.00
0
0.00
0
0.00
12 Month Floating Total (in):
0.00
0.00
0.00
0.00

FORM: NDAR-1 08-11
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?
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
Page 71N
21 Compliant ❑ Non -Compliant
0 Compliant ❑ Non -Compliant
I] Compliant ❑ Non -Compliant
21 Compliant ❑ Non -Compliant
0 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: Michael Beck
Permittee:
Mountaintop Golf &Lake Club
Certification No.: SI-991669 WWIV-7930
Signing Official: Robert Barr
Grade: SI WWIV Phone Number: [phone]
Signing Official's Title: Signatory
Has the ORC changed since the previous NDAR-1? ❑ Yes E] No
Phone Number: [phone] Permit Exp.: 7/31/14
9- ' ""rT 13
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 27699-1617

00'0
00"0
00'0
00'0
:(ul) Ie;ol 6ul;sold y;uow ZL
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FORM: NDAR-1 08-11
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?
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
Page
F21 Compliant ❑ Non-Complia
0 Compliant ❑ Non -Compliant
121 Compliant ❑ Non -Compliant
R1 Compliant ❑ Non -Compliant
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:
Michael Beck
Permittee:
Mountaintop Golf &Lake Club
Certification No.: SI-991669 WWIV-7930
Signing Official: Robert Barr
Grade:
SI WWIV Phone Number: [phone]
Signing Official's Title: Signatory
Has the ORC changed since the previous NDAR-1? ❑ yes p No
Phone Number: [phone] Permit Exp.: 7/31/14
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 27699-1617

NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Page Id of
No.: W00028693
Facility Name: Mountaintop Golf & Lake Club WWTF
County: Jackson
Month: August
Year: 2013
Did irrigation OCCUf
facility?
Field Name:
29
Field Name:
30
Field Name:
31
Field Name:
32
Area (acres):
4.24
Area (acres):
5.34
Area (acres):
4.74
Area (acres):
4.8
at this
Cover Crop:Blue
rass/Bent ras
9 9
Cover Crop:
P
Blue rass/Bent ras
9 9
Cover Crop:
P
Blue rass/Bent ras
9 9
Cover Crop:
P
Blue rass/Bent rass
9 9
❑� YES ❑ No
Hourly Rate (in):
0.15
Hourly Rate (in):
0.15
Hourly Rate'(in):
0.15
Hourly Rate (in):
0.15
Annual Rate (in):
18.2 _
Annual Rate (in):
18.2
Annual Rate (in):
18.2
Annual Rate (in):
18.2
Weather
Freeboard
Field Irrigated?
0 YES ❑ NO
Field Irrigated?
0 YES ❑ NO
i Field Irrigated?
0 YES ❑ NO
Field Irrigated?
❑� YES ❑ No
T
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min
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min
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in
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min
in
in
gal
min
in
in
1
C
58
0
4.5
8
7,200
20
0.06
0.06
4,800
20
0.03
0.03
15,573
20
0.12
0.12
16,608
20
0.13
0.13
2
C
54
0
6
8
.0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
3
7,200
20
0.06
0.06
4,800
20
0.03
0.03
15,624
20
0.12
0.12
16,593
20
0.13
0.13
4
7,200
20
0.06
0.06
4,800
20
0.03
0.03
15,607
20
0.12
0.12
16,584
20
0.13
0.13
5
PC
64
0 1
5
8 1
7,200 1
0
0.06
0.06
0 1
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
6
CL
61
0
6
8
7,200 1
20
0.06
0.06
4,800 1
20
0.03
0.03
15,591
20
0.12
0.12
16,641
20,
0.13
0.13
7
CL
72
1.5
8.5
8.5
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
8
CL
65
0.2
10
8.5
0
0
0.00
0.00
0
0_
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
9
CL
64
0.65
11.5
8
7,200
20
0.06
0.06
4,800
20
0.03
0.03
15,588
20
0.12
0.12
16,572
20
0.13
0.13
10
7,200
20
0.06
0.06
4,800
20
0.03
0.03
15,526
20
0.12
0.12
16,686
20
0.13
0.13
11
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
12
C
70
0.35
10.5
8
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
13
CL
68
0
9.5
8.5
1,200
20
0.06
0.06
4,800
20,
0.03
0.03
15,622
20
0.12
0.12
16,599
20
0.13
0.13
14
CL
71
0.3
8.5
11
7,200
20
0.'06
0.06
4,800
20
0.03
0.03
15,536
20
0.12
0.12
16,601
20
0.13
0.13
15
CL
62
0
7.5
13
0
0
-0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
16
PC
69
0
7
13
7,200
20
0.06
0.06
4,800
20
0.03
0.03
15,562
20
0.12
0.12'
16,583
20
0.13
0.13
17
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
18
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
19
R
66
1.6
5.5
12
7,200
20
0.06
0.06
4,800
.20
0.03
0.03
15,617
20
0.12
0.12
16,523
20
0.13
0.13
20
CL
64
0.35
5
12
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
21
CL
64
0
6.5
12
7,200
20
0.06
0.06
4,800
20
0.03
0.03
15,542
20
0.12
0.12
16,579
20
0.13
0.13
22
PC
66
0.1
9
12
0
0
0.00,
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
23
C
56
0
9
12
7,200
20
0.06
0.06
4,800
20
0.03
0.03
15,591
20
0.12
0.12
16,619
20
0.13
0.13
24
7,200
20
0.66
0.06
4,800
20
0.03
0.03
15,533
20
0.12
0.12
16,622
20
0.13
0.13
25
0.
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
261
C
46
0.2
10
12
7,200
20
0.06
0.06
4,800
20
0.03
0.03
15,627
20
0.12
0.12
16,543
20
0.13
0.13
27
C
47
0
10
12
01
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
28
PC
80
0
9
11.5
7,200
-20
0.06- '
0.06
4,800
20
0.03
0.03
15,612
20
0.12
0.12
16,519
20
0.13
0.13
29
C
76
1 0
9
11.5
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
30
PC
66
0
8.5
11
7,200
20
0.06
0.06
4,800
1 0
20
0.03
0.03
15,587
20
0.12
0.12
16,588
20
0.13
0.13
31
1
1
0
0
0.00
0.00
0
0.00
0.00
0
0
0.00
0.00
0
0
0.90
0.00
Monthly
Loading:
122;400
1.06 IV76,800
0.53
249,338
1.94
265,460
.04
12 Month Floating Total (in):
5.98
3.08
11.14
11.72

FORM: NDAR-1 08-11
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?
Were all freeboards maintained in accordance with the -specified freeboard heights in your permit?
Page
❑ Compliant ❑ Non-Complian
❑' Compliant ❑ Non:Compliant
E] Compliant ❑ Non -Compliant
❑� Compliant [I Non -Compliant
E] 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
­flnn/cl takon attach nrirlitinnnl sheets if necessarv.
r
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Michael Beck
Permittee: Mountaintop Golf & Lake Club
Certification No.: SI-991669 WWIV-7930
Signing Official: Robert Barr
Grade: SI WWIV Phone Number: [phone]
Signing Official's Title: Signatory
Has the ORC changed since the previous NDAR-1? ❑ Yes p No
Phone Number: [phone] Permit Exp.: 7/31/14
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 27699-1617

2 NON -DISCHARGE MONITORING REPORT f NDMR) Page � Of
md - LV - 0701
PF%o.: W00028693 IFacility Name: Mountaintop Golf & Lake Club WWTF ICounty: Jackson Month: August Year:
PPI: 001 Flow Measuring Point: ❑ influent ❑. Effluent ❑ No Flow generated Parameter Monitoring Point: ❑ Influent Q Effluent ❑ Groundwater Lowering ❑ SurfE
Parameter Code -►
50050
00310
00680
00940
50060
31616
00610
00620
00400
70300
00530
00076
o>.
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>/
24-hr
hrs
GPD
mg/L
mg/L
mg/L
mg/L
#/100 mL
mg/L
mg/L
su
mg/L
mg/L
NTU
1
06:00
1
13,100
2
6.9
2.15
2
07:30
1
17,900
2.2
6.9
1.67
3
17,600
1.65
4
17,600
1.6
5
10:30
1
17,500
2
6.9
1.53
6
06:30
1
13,500
< 2.0
2.1
< 1.0
0.18
29
6.9
<2.5
1.57
7
10:00
1
17,700
2
6.9
1.58
8
08:30
1
11,100
2
6.9
1.62
9
07:30
1
17,600
2
6.9
1.69
10
18,300
1.6
11
18,300
1.5
121
08:30
1 1
18,200
2.1
6.9
1.76
13
09:00
1
53,400
2
6.9
1.39
14
13:30
1
50,000
2
6.9
1.43
15
10:30
1
36,000
2
6.9
1.5
16
17:30
1
21,600
2
6.9
1.48
17
15,600
1.45
18
15,600
1.4
19
11:00
1
15,600
2
6.9
1.36
20
09:30
1
10,200
< 2.0
2
< 1.0
< 0.10
29.7
6.9
12
1.41
o
21
08:30
1
9,600
2
6.9
1.51
22
13:00
1
14,200
2
6.9
1.44
231
06:00
1
7,100
2.1
6.9
1.57
14,500
1.5
14,500
1.45
:00
1
14,400
2
6.9
7.6
1.4
:30
t
1
10,600
2
6.9
1
1.47:00
1
13,700
2
6.9
1.42
:00
1
10,000
2
6.9
1
1.45:00
1.5
9,700
2.1
6.9
1.55
23,400
1.5
Average:
lb,UU3
U.uU
Z.U3
I 1.UU
U.U9
29.3b
9.3
1.54
Daily Maximum:
53,400
2.00
2.20
1.00
0.18
29.70
6.90
14.00
2.15
Daily Minimum:
7,100
2.00
2.00
1.00
0.10
29.00
6.90
2.50
1.36
Sampling Type:
Recorder
Composite
Grab
Grab
Grab
Grab
Composite
Composite
Grab
Grab
Composite
Recorder
Monthly Limit:
120,000
10
14
4
5
Daily Limit:1
1 15
1
25
6
6-9
10
10
Sample Frequency:
1 Continuous
I See Permit
1 3 x Year
3 x Year
5 x Week
See Permit
I See Permit
See Permit
5 x Week
1 3 x Year
I See Permit
I Continuous

FORM: NDMR 08-11
NON -DISCHARGE MONITORING REPORT (NDMR)
Sampling Person(s)
Name: Michael Beck
Name:
Certified Laboratories
Name: Environmental Testing Solutions, Inc
Name: Prisim Laboratories, Inc
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? ❑ 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.
7-55 oj� �: l� � Za"r t �74-) j � 2 5 c-J t` '► /2� l q / 0 14-espRd-,Ve-
Operator in Responsible Charge (ORC) Certification
ORC: Michael Beck
Certification No.: SI-991669 WWIV-7930
Grade: SI WWIV Phone Number:
Has the ORC changed since the previous NDMR?
..,. ; M
[phone]
❑ Yes 21 No
01-ar�+-t
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
Permittee Certification
Permittee: Mountaintop Golf & Lake Club
Signing Official: Robert Barr
Signing Official's Title: Signatory
Phone Number: [phone]
Permit Expiration: 7/31/2014
5-zS_l/3
Signature Date
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 27699-1617

MMOPOF12 NON -DISCHARGE MONITORING REPORT (NDMR) Page L of r�
Off.**
Mountaintop Golf & Lake Club
.
August
Influent Effluent No now generated
RFTF =Ii-
Ml
0
----------------
Or= '
0
----------------
m
or,0--------------
0-----------�-
m
®�---��---------

FORM: NDMR 08-11
NON -DISCHARGE MONITORING REPORT (NDMR)
Sampling Person(s) Certified Laboratories
Name: Michael Beck Name: Environmental Testing Solutions, Inc
Name: Name: Prisim Laboratories, Inc
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? ompliant ❑ 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 necessarv.
Operator in Responsible Charge (ORC) Certification
ORC: Michael Beck
Certification No.: SI-991669 WWIV-7930
Grade: SI WWIV Phone Number: [phone]
Has the ORC changed since the previous NDMR? ❑ Yes 2 No
-a�-- t 3
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
Permittee Certification
Permittee: Mountaintop Golf & Lake Club
Signing Official: Robert Barr
Signing Official's Title: Signatory
Phone Number: [phone] Permit Expiration: 7/31/2014
7-2 F-13
Signature Date
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 27699-1617