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Home My WebLink AboutWQ0020881_Monitoring - 04-2022_20220531FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page 1 of 2 Permit No.: WQ0020881 Facility Name: Div. Of Parks & Rec (Lake Norman SP) County: Iredell Month: April • irrigation occur ,- Field Name:i this facility? at Cover Crop:' • YES • NO • - , Annual Rate • • • II • • • ■ ■ • �•Field • • FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page 2 of 2 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? 17 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 Cl Non -Compliant Were all freeboards maintained in accordance with the specified freeboard heights in your permit? ID 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. IOperator In Responsible Charge (ORC) Certification II Permittee Certification I ORC: Todd Robinson Certification No.: 1006252 Grade: S1 Phone Number: 252-235-8809 Has the ORC changed since the previous NDAR-1? ❑ Yes o No 1Wa,7 saY-;12 Signature Date By this signature, I certify that this report is accurrate and complete to the best of my knowledge. Pernittee: Div. Of Parks & Rec (Lake Norman SP) Signing Official: Malcolm Scott Avis Signing Official's Title: Park Superintendent Phone Number: 704-528-6350 Permit Exp.: 6/30/26 Ar`4 -- is of - zz 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 as 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 27699-1617 FORM: NDMR 10-13 NON -DISCHARGE MONITORING REPORT (NDMR) Page 1 of 2 -Permit No.: — •11 1:: of Parks : • Iy-, Iredell• �� Flow Measuring Point: 2) Influent 0 Effluent 0 No flow generated • MWO FORM: NDMR 10-13 NON -DISCHARGE MONITORING REPORT (NDMR) Page 2 of 2 Sampling Person(s) Certified Laboratories Name: Operators Name: Statesville Analytical, Inc. Name: Name: Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? o Compliant 0 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: Todd Robinson Permittee: Div. Of Parks & Rec (Lake Norman SP) Certification No.: 1006252 Signing Official: Malcolm Scott Avis Grade: S1 Phone Number: 252-235-8809 Signing Official's Title: Park Superintendent Has the ORC changed since the previous NDMR? ° Yes 0 No Phone Number: 704-528-6350 Permit Expiration: 6/30/2026 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, Notch Carolina 27699-1617