WQ0033804_Monitoring - 01-2020_20200126

""^^_ I NON -DISCHARGE APPLICATION REPORT (NDAR-1) l Page _J_ of
Permit No.: W00033804
Facility Name: Laurel Mountain Retreat
County: Buncom a
Month: January
Year: 2020
Did irrigation occur
at this facility?
O YES ❑ No
[� a
Field Name:
1 B
K
Field Name:
3
« . res
0
Area (acres):
0.19
piro
t i
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(acres)
0.45
;
o .e t3 o
as
+
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`�.0 p
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0.2E
ein)
_ : 02'«�
Hourly Rate (in):
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n
$ _ m
:
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_
a
'
Annual Rate (in):
2&53
�53 a k�
in Annual Rate :
( )
23.53
A
O
Weather
Freeboard
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❑ YES p No
tei" gated?� �N
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❑ YES O NO
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FORM: NDAR-1.05-16
NON -DISCHARGE APPLICATION, REPORT (NE)AR-1)
Page -L gf I:::- ,
Did the application rates exceed the limits in Attachment B of your permit?
914pliant ❑ Non -Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites?
Xmpllant ❑ Non -Compliant
Was a suitable vegetative cover maintained',,on.all sites as specified in your permit?
ompllant ❑ Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site?
l/Compliant ❑Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
ZC mpliant ❑ 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: Robert Barr- .
Permittee: Laurel Mountain Retreat
Certification, No.: 24262
Signing Official: Robert Barr
Grade: SI Phone Number: 828-251-1900
Signing Official's Title: Signatory
Has the ORC changed since the previous NDAR-1? ❑ Yes ❑ No
Phone Number: 828-251-1900 Permit Exp.: 1/31/22
IUh0fi4
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
Raleigh, North Carolina 27699-1617

FORM: NDAR-1 05-16 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page JL off ---
Permit No.: W00033804
Facility Name: Laurel Mountain Retreat
County: Buncombe
Month: January
Year: 2020
Did irrigation occur
at this facility?
0 YES ❑ NO
�)1@109ex+4'
Field Name:
5
I i d a 6: n
Field Name:
7
e (acres)e 0, 1
Area (acres):
0.33
'fix A acres): 0:
p11
Area (acres):
0.38
Cow rCro LN
Cover Crop:
Go Cr
Cover Crop:
o rly �)";; x 0INE
Hourly Rate (in):
0.2
Ho ri )
"
Hourly Rate (in):
0.2
Annual Rate (in):
23.53+;e
Annual Rate (in):
23.53
Weather
Freeboard
F d}1 igat
Field Irrigated?
❑ YES Rl No
� 1` ! • igale ES�"' ° v" a�
Field Irrigated?
❑ YES 2 NO
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FORM: NDAR-1 05-16 NON -DISCHARGE APPLICATION, REPORT (NDAR-1) Page.
Did the application rates exceed the limits in Attachment B of your permit?mpliant ❑Non -Compliant -. r
Were adequate measures taken to prevent effluent ponding in or runoff from the sites? Pbmpliant ❑ 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?0 compliant ❑Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in 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 necessani
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Robert Barr
Permittee:
Laurel Mountain Retreat
Certification No.: 24262 "
Signing Official: Robert Barr
Grade: SI Phone Number: 828-251-1900
Signing Official's Title: Signatory
Has the ORC changed since the previous NDAR-1? ❑ Yes ❑ No
Phone Number: 828-25171900 Permit Exp.: 1/31/22
Al
�
''II
z !,
Z
4
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
Raleigh, -North Carolinaa27699=1617

I-UKM: NUAK-1 05-16 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page : "
Permit No.: WQ0033804
Facility Name: Laurel Mountain Retreat
County: Buncombe Month:
January
Year: 2020
Did irrigation occur
eel e; 8 K Field Name:
s.,�
ei arue"�
Field Name:
icrss 0
Areaacres
(acres):
Area (acres):
at this facility?
c )
aG
r a rpm} t
Cover Crop:
Cover Crop:
❑ YES ❑ No
�Fit�e'i(i"'i uI Elf�- T `
"a kf.'urly { d Lf1
rt
Hourly Rate (in):.
Hourly Rate (in)
n
e d Jff� a I
Annual Rate (in):
n 1�
t=x r ?. ° . �pd
Annual Rate (in):
Weather
Freeboard
Field Irrigated?
❑ YES
❑ No
Field Irrigated?
❑ YES ❑ NO
'F'
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Monthly Loading:
12 Month Floating Total (in):U'"00,
.:'

FORM: NDAR-1 06-16 NON-DISCHARGEAPPLICATION:REPORT, ,(NDAR4) Page 3,of '
Did the application rates exceed the limits in Attachment B of your permit?
Rtompliant
❑ Non -Compliant
Were adequate measures taken to prevent.effluent po,nding in or runoff from the sites?
Potompilant
❑ Non -Compliant
Was a suitable vegetative cover maintained; on all sites as specified in your permit?
ompllant
❑Non -compliant
Were all setbacks listed -in your permit maintained for every application to each petmitted site?
E;e-ompliant
❑ No
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
po mpiiant
❑ 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 additinnal sheets if necessary
Operator in Responsible. Charge (ORC) Certification
Permittee Certification
ORC: Robert, Barr
Permittee:
Laurel Mountain Retreat
Certification No.: 24262
Signing Official: Robert Barr .
Grade: SI Phone Number: 828-251-1900
Signing Official's Title: Signatory
Has the ORC changed since the previous NDARA? ❑ Yes ❑ No
Phone Number: 828-251-1900 Permit Exp.: 1/31/22
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 property 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
Raleigh; North Carolina 27699-161.7

FORM: NDMR 05-16 NON -DISCHARGE MONITORING REPORT (NDMR) Page ct—of

FORM: NDMR 05-16 NON-DISCHARGE:MONITORING REPORT-(NDMR) Page ,�.of
Sampling Person(s)
Certified Laboratories
Name: Robert Barr Name: Pace Analytical, Inc.
Name: Kevin Bryan Name:
Does all monitoring data and sampling frequencies meet he 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 additinnal chpptc if npepccary
Operator in Responsible Charge (ORC) Certification Permittee Certification
ORC: Robert Barr Permittee: Laurel Mountain Retreat
Certification No.: 24262 Signing Official: Robert Barr
Grade: SI Phone Number: 828-.251-1900 Signing Official's Title: Signatory
Has the ORC changed since the previous NDMR? ❑ Yes ❑ No Phone Number: 828-251-1900 Permit Expiration: 1/31/2022
L�M/Zo LG �..�
Signature Date Signature Date
By this signature, I certify that this report Is accurate 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
Raleigh, North Carolina 27699-1617