WQ0033325_Monitoring - 08-2022_20220907

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page of
Sampling Person(s) Certified Laboratories
Name:
J � Name: ���bp®1. ®d��✓8 ��� � ���. ®��®�✓4'��
I
iSarne- Name:
Ooeo aHl monitoring data and sampping frequencies meet the requirements in Qttaa hment A of your permit? ompllant ❑ 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.
I ORC:
Certific
Grade:
Has fhc
REECEIVED
S r P 0 7 2022
w4ownwaon Prowiawtv UnM
p19 US0t3
Operator in Responsible Charge (ORC) Certification
Permittee Certification
Permittee: /314d(eA Co. we,+eir 0
G�
D2ionNo.: Q/f�Z,� �
Signing Official:
Phone Number: e?j _
Signing Official's Title:
Yes
ORC changed since the previous NDNIR? "'"
Phone Number: 9f1®—c764— 6gcF6
Permit Expiration:
JI
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 27699-1617

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page of
Permit No.: '
—
Facility Name
L
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-
MIA
-------------

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 permR?
Were adequate measures taken tm 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'
W(,compliant El Non -Compliant
Ll'1/Compliant ❑ Non -Compliant
Ll Compliant ❑ Non -Compliant
IE/C.Mpliant ❑ Non -Compliant
LI Compliant ❑ Non -Compliant
Iffthe 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: "Vi'l"Ov �f
Certification No.: q?64,?-?
13-w&J,/
Grade: y¢ - ,d-� >~ Phone Number: PeZ — aQ��
Has the ORC changed since the previous NDAR-1?
❑ Yes No
,Z,O
Signature Late
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
Permittee Certification
Permittee: 134� o Gj 4j, rii.et�{
Signing Official:
Signing Official's Title: 46 g
Phone Number: 47,1946z— 616K6 PermitExp.:
re 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

FORM: n!DAR-1 10-13 NON -DISCHARGE APPLICAMN REPORT (NDAR-a) Page
Permit No.: 33 S
Facility Name: �' 1*
County: d P
Month:
Year: _Dz2
Did irrigation occur
Field Name:
�!
Field Name:
Field Name:
Field Name:
this faco���S9`�
Area.(acres):
C, 7 Z
Area (acres):
Area (acres):
Area (acres):
at
Cover Crop:
Cover Crop:
Cover Crop:
Cover Crop:
�/
L`SYES ❑ No
Hourly'Rate'(in)E
PD
Hourly Rate (in):
Hourly Rate (in):
Hourly Rate (in):
Annual Rate (i'n):.
Annual Rate (in):
Annual Rate (in):
Annual Rate (in):
Weather
Freeboard
Field Irrigated?
ES ❑ NO
Field Irrigated?
❑ YES ❑ NO
Field irrigated?
❑ YES ❑ NO
Field Irrigated?
❑ YES ❑ NO
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Monthly Loading:
12 Month Floating Total (in):
31 S'DO
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