WQ0012696_Monitoring - 05-2022_20220610

' FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page of
Permit No.: J012696
Pamlico River Ferry
Flow Measuring Point: 0 Influent F] Effluent No flow generated
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FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page of
Sampling Person(s) Certified Laboratories
Name: 11 Name:
Name: I) Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? P''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
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: ( St fi QX M A-SOA j
Permittee: ()(?D o % P14m1 r GQ R ivc'r i-t'YY�/
Certification No.:
Signing Official: _5*rry HQ 1/ 111Wp �(
Grade: Phone Number: 2 .Z " E 4liS'Z i
Signing Official's Title: A%4
Has the ORC changed since the previous NDMR? ❑ Yes No
Phone Number: a 5-2- 96Y-451-1 Permit Expiration:01
2-2Z-
l
Signature Date
Signature Date
By this signature, I certify that this report is accurrale 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 of
Permit No.: ..'00012696
• River Ferry TerminalMonth:
ear: CZZ
irrigation
• occur
Area (acres):1Area
(acres):

FORM: NDAR-1 05-16
NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Did the appnuation rates exceed the limits in Attachment B of your permit?
Were adequate measures taken to prevent effluent ponding in or runoff from the sites?
Page
['Compliant
Compliant
of
❑ Non -Compliant
❑ Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit? pliant ❑ Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site? ompliant ❑ Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in 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 necessary.
Operator in Responsible Charge (ORC) Certification
ORC: i&4Ry MA50A_1
Certification No.:
Grade: ! Phone Number:
Has the ORC changed since the previous NDAR-1? ❑ Yes U o
Permittee Certification
Permittee: A'ULDoT Pgrn le co F-rry
Signing Official: Sherry Rollow ell
Signing Official's Title: M/9 N,f 9 ,er
Phone Numbef: 2 SZ - 9bLl -Jf5-2 r Permit Exp.: //- ,j C) -2,02-6
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