WQ0028693_Monitoring (Report)_20200129

NUN -DISCHARGE APPLICATION REPORT (NDAR-1) Page � of ( Z/
o.: WQ0028693
top Golf & Lake Club WWTF
County: Jackson
PDpiCg
Month: December
Year: 2019
IiisgatlOtl OCCUI'
Field Name:
02X2
"A
!03 a
Field Name:
04
e�raltacras;
'4� 3
Area (acres):
4.35
Aro� (cresj
4 3
Area
at fills faClllt�/!
�' _
(acres):
4.26
. Dover C#roja
Bi�tegrassiBentgras;
Cover Crop:
Bluegrass/Bentgras_
t. hover Crop
F#lueg�ass/8entgras�
Cover Crop:
Bluegrass/Bentgrass
(] YES ❑ No
Nnur)y I�te (on}
015'
Hourly Rate (in):
0.15
Q I�Gprty 62aFe (in)
0 15`
Hourly Rate (in):
0.15
"�� Rite {fin)
gt�tlts�
F ti182
filar 3 {
k
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Field Irrigated?
18.2
O YES ❑ No
- .f ftF i, 4
°IdlrrlgaEaiY
18 2�
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21,600
0.18
0 p 00
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0.00
12 Month
Floating Total (in):
6.87
,<
U0,0,-
0.00
Facility Name: Mountain

FORM: NDAR-1 08-11
NOWDISCHARGE. 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 ?EINon-Compli..t
o21 Compliant
0 Compliant ❑ Non -Compliant
I] Compliant ❑ Non -Compliant
O 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
actions) 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? 0 Yes 0 No
Phone Number: [phone] Permit Exp.: 8/31/19
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 qualifiedpersonnel 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 7� of Facility Name: Mountaintop Golf & Lake Club WWTF County:. Jackson Month: December Year: 2019
rN,028693
Did irri irrigation occurx
at this facility?
O YES ❑ NO�,wY{t�,_
Id aaiil s
Field Name:
06'
l iel Name 4 , ,a
Field Name:
08
Area ac$ 3�
Area (acres):
3.95
re {acres)4402�kEk'° n
xa�
Area (acres):
2.31
�Cbve op Btuegrr�ass/ ent'q*'%
Cover Crop:
Bluegrass/Bentgras
rY t a'Cw pC p B`ueg ss/Be tgras
Cover Crop:
Bluegrass/Bentgrass
0+�
Hourly Rate (in):
0.15
i,y„ �'I ``t
�Hour�R(i�n}� ,01�j �.
Hourly Rate (in):
0.15
"T ssu
Annual Rate (in):
18.2
Annual Rate (in):
18.2
G
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0.00

FORM: NDAR-1 08-11
NON -DISCHARGE APPLICATION REPORT (NDAR=1)
Page
Did the application rates exceed the limits in Attachment B of your permit?
o Compliant ❑Non -Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites?
i
O Compliant ❑ Non -Compliant
Was a suitable vegetative cover maintained on all sites ass specified in our permit? p y p
❑Compliant ❑Non -Compliant
i
Were all setbacks listed in your permit maintained for every application to each permitted site?
O Compliant ❑Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in 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
action(s) taken..Affach additional sheets if ner.Pssary .
the non-compliance and describe the corrective
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.: 8/31/19
VVq
- 01-0
Signature Date
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
1 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

AR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page�of �U
No.: W00028693 Facility Name: Mountaintop Golf & Lake Club WWTF County: Jackson Month: December Year: 2019
Dlef I�I'19atlOn OCCUR
at this facility?
O YES O No
Field Name
09
Field Name:
10
Field Name:
11
Field Name:
12
Area (acres)
2.77
Area (acres):
2.22
Area (acres):
- 2,16
Area (acres):
3.88
cover Crop:Blue
rassiBent ras
9 9
Cover Crop:
P�
slue rass/Bent ras
9 9
Cover Crop:
P=
Blu rass/Bent ra
e9 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
in
Annual Rate 061
:. 18.2
Annual Rate (in):
18.2
Annu'al,Rate (in),
18.2
Annual Rate (in):
18.2
Weather
Freeboard
Field Irrigated?
O•YEs 9) No
Field Irrigated?
O YES O NO
Field Irrigated?
0 YES (a No
Field Irrigated?
O YES O NO
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FORM: NDAR-1 08-11
Page c7 of
0 Compliant 13 Non -Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites? 0 Compliant ❑ Non -Compliant
Was a suitable vegetative cover maintained .on all sites as specified in your permit? o Compliant ❑.Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site? o Compliant ❑Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in 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 corrective
action(s) taken. Attach additional sheets if necessary.
NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Did the application rates exceed the limits in Attachment B of your permit?
Operator in Responsible Charge (ORC) Certification Permittee Certification
ORC: Michael Beck Permittee:
Mountaintop Golf& Lake Club
Certification No.: 8I-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.: 8/31/19
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.lhe 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 27609-1617

AR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page _-of�
No.: WQ0028693 Facility Name: Mountaintop Golf & Lake Club WWTF county: Jackson Month: December Year: 2019
�"`�"'� I ON tr
Ia .S3g,
Field Name:
Area (acres):
14l"ie
2.81
gam
i5 '" Field Name:
u Area (acres):
16
1.76
Did irrigation occur
at this facility?
p Yes ❑ No
1000.�r ra'p� I g s� /B g' `s�;
Cover Crop:
Bluegrass/Bentgras
" Cove Gtnps
Bois rani Bt ra Cover Crop:
Bluegrass/Bentgrass
�oUrlycRte`("w0 5
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0.15
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a 5' Hourly Rate (in):
0.15
,
•..{ eJ•ifYWi:C"..t s
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t1i.V i2L Skr'
18.2a�UO
Weather
Freeboard
�� E c Irrtsd ��
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12 Month Floating Total (in):
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0.00.."Q00

FORM: NDAR-1 08-11
NON -DISCHARGE APPLICATION REPORT`(NDAR-1)
Page -4of
Did the application rates exceed the limits in Attachment B of your permit?
o compliant ❑ Non -Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites?
o Compliant ❑Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit?
o Compliant ❑ Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site?
o compliant ❑Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in 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. 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.: 8/31/19
�n 1 2
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,properiy 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, NorthCarolina276994617

ARA 08-11 NON -DISCHARGE APPLICATION REPORT. (NDAR-1) Page 5_ Of
No.: W00028693 Facility Name: Mountaintop Golf & Lake Club WWTF County: Jackson Month: December Year: 2019
Did irrigation occur
Field Name:
18
i (a
r .. a
Field Name:
20
rea acres)
"x� �1
s� 3s93
�"
Area (acres):
3.26
r, cres M
Area (acres):
3.96
at this facility?
Coy C
�`' ,
BI a rs�tgras
g,,.,r,
Cover Crop:
Bluegrass/Bentgras
yr • , �pv R uegrass�etga� f
Cover Crop:
Bluegrass/Bentgrass
R1 YES. ❑ NO
Flo ri ��` ;„ "
.;0,-
w J 'J
S 0
Hourly Rate (in):
0.15
,
oU"r a �0 15 _, '.:
Hourly Rate (in):
0.15
l `r
1X
l a
x a:
Rate (in :
18.2
Annual RateAnnual in):
18.2
Weather
Freeboard
Field irrigated?
g
❑ YES ONO
Fad OI��
Field Irrigated?
g
❑ YES p No
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FORM: NDAR-1 08-11 NON-DISCHARGEAPPLICATION REPORT (NDAR-1) Page of
-Did the application .rates exceed the. limits in Attachment B of your permit? o Compliant ❑Non-Compllant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites?
o compliant ❑ Non -Compliant
Was a suitable vegetative cover, maintained on,all sites as specified in your permit?
a Compliant ❑ Non-Compllant
Were all setbacks listed in your permit maintained for every application to each permitted site?
o Compliant ❑Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
O Compliant ❑ Non -Compliant
If the facility is non -compliant, please explain in the space below the reason(s) thefacility was not in compliance. Provide in your explanation the date(s) of
action(s) taken. Attach additional sheets if necessary.
the non-compliance and describe the corrective
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 O No . Phone Number: [phone] Permit Exp.: 8/31/19
121 Za
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

I uu-�i ! NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page -� of _LV028693 Facility Name: Mountaintop Golf & Lake Club WWTF County: Jackson Month: December Year: 2019
V
Did irrigation occur
at this facility?
YEs ❑ rvo
ram, „ietd Natne
21 ,.
Field Name:
22
F)eld NaRte,
23
Field Name:
24
s Area (��re`s}
Area (acres):
5.49
Area {acres)
2,99'
Area (acres):
3.81
over.,Crop
Bluegrass/Bentgras
Cover Crop:
Bluegrass/Bentgras
Cover Grop�
-
Bluegrass/Bentgra_
Cover Crop:
Bluegrass/Bentgrass
Hourly Ra#e. {in}
0.15
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0.15
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0.1.5
Hourly Rate (in):
0.15
Annlual Rate 00)
18 2 y
Annual Rate (in):
18.2
l�ntlual Rate (i0)
(8.2.
Annual Rate (in):
18.2
Weather
Freeboard
3eld Irrigated?yt
Field Irrigated?
❑ YEs O NO
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O'YE5 ' 'I D ;; �
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❑Yes O No
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FORM: NDAR-1 08-11 NON-DISCHARGE:APPLICATION, REPORT. (NDAR-1) Page of
Did the application rates exceed the limits in Attachment B of your permit? o compliant El Non,
Were adequate measures taken to prevent effluent ponding in or runoff from the sites? o Compliant ❑ Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit? o Compliant ❑ Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site? o Compliant ❑ Non -Compliant
Were all freeboards maintained in accordance with, the specified freeboard heights in 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 corrective
action(s) taken- Affarh additinnal shppts if nprtpcenni
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.: 8/31/19
Zd
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

n- I "O-1 ' NUN-D15CHARGE APPLICATION REPORT (NDAR-1) Page --L- of r "
Q0028693 Facility Name: Mountaintop Golf & Lake Club WWTF county: Jackson Month: December Year: 2019
pirrigawbor
Did occur
at this facility?
Name
25
Field Name:
26Field
Name:
28
Area (acres):
4.05
: Area,{acres)
3 47
Area (acres):
2.28
cover Cro
Blue rays%Bent ras,'
g 9
Cover Crop:
P
Blue rassBent ras
9 9
• Cover:Cro p„
Blue rasa%Ben ras
9 ,tg
Cover Crop:
P
Blue rass�Bent rass
9 9
O YES ❑ No
Hor,`rly Rai$' (in)'
0.15
Hourly Rate (in):
0.15
Hourly Rate. ((n)
0;15
Hourly Rate (in):
0.15
Annual Rate(rn)
1$2
Annual Rate (in):
18.2
Annual Rete_(1r1)
182
Annual Rate (in):
18.2
Weather
Freeboard
Field Irrigated?'
Q YE5 C7 NQ :''
L
Field Irrigated?
❑ YES O NO
f%Id irrigated?
CI .YES l�tO
Field Irrigated?
El YES O No
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FORM: NDAR-1 08-11
NOWDISCHARGE APPLICATIOMREPORT(NDAR=1)
Did the application rates exceed•the limits in Attachment B of your permit?
Page 7 of
O Compliant ..❑ Non -Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites?
p Compliant ❑ Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit?
o Compliant ❑ Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site?
o Compliant ❑ Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in 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 corrective
activnts) 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.: 8/31/19
/ ILC7 z b
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 ail 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

HK- I UC-1 I NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page a of o v
rNiWQ0028693 Facility Name: Mountaintop Golf & Lake Club WWTF County: Jackson Month: December Year: 2019
Diation occur
at this facility?
Fiald Name
29;
Field Name:
30
Meld Name
31,
Field Name:
32
,Area (acres)
4.24
Area (acres):
5.34
Area (acres)
$.74 ,,
Area (acres):
4.8
'Cover Cro P
Blue rass/Bent rase
..". 9 9
Cover Cro P
Blue rass/Bent ras
9 9
Gover.Cro
_ P
Blue rass/Ben ras
9 t9 ,.:
Cover Crop:
P
Blue rass/Bent rass
9 9
❑ YES ❑ No
Hourly Rate (m)
0.15
Hourly Rate (in):
0.15
Hourly Rate'(m)
:, 0,15
Hourly Rate (in):
0,15
Ar}ual Rats (in')
�..,;..
18,2
Annual Rate (in):
18.2
A[>gUdl }iate;(itl)
1$'2
Annual Rate (in):
18.2
Weather
Freeboard
Field Irrlgaed�,
CjhY�S . _p NO '
Field Irrigated?
❑O YES ❑ No
Field (trig'afed?
OYES ONO, ':
Field Irrigated?
❑� YES ❑ NO
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ME
Monthly Loading:
12 Month Floating Total (in):
2160D.-
.-0,19 ;':,
7,07
14,400
0.10
3.75
46,623
f3,(i6
49,861

FORM: NDAR-1 08-11
NON -DISCHARGE -APPLICATION -REPORT (NDARA)
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 of
O Compliant ❑ Non -Compliant
O Compliant ❑ Non -Compliant
0 Compliant ❑ Non -Compliant
El 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 21 No
Phone Number: [phone] Permit Exp.: 8/31/19
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

FORM: NDMR 08-11 NON -DISCHARGE MONIT..ORING REPORT;;(NDMR) ' Page o
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? ❑ Compliant o Non -Compliant
If the facility is non -compliant, please explain in the space below the reason(s) the facility was not incompliance. Provide in your explanation the date(s) of the non-compliance and describe the corrective
ammonia,.limits were exceeded.
acvon(5) taKen. mttacn aaaalonai sneets IT necessary.
was changed and effluent improved.
Operator in. Responsible Chairge,(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: (828).251-1900
Signing Official's Title: Signatory
Has the ORC changed since the previous NDMR? ❑ Yes 2 No
Phone Number: [phone] Permit Expiration: 8/31/2019
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.bestof 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

FORM: NDMR 08-11 NON -DISCHARGE. MONITORING. REPORT (NDMR) Page
Sampling Person(s) 11 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? ❑ Compliant O 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.
Daily ammonia limits were exceeded. Aeration operation was changed and effluent improved.
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 NDMR? ❑ Yes O No
Phone Number: [phone] Permit Expiration: 8/31/2019
PIP
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 Ouality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617