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FORM: NDMR 08-11
NON -DISCHARGE MONITORING REPORT (NDMR)
Page ;91 of Ol
Sampling Persons) Certified Laboratories
Name: James Edwards - Name: Water Tech Labs Inc
Name: Cindy McGinnis Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? 0 carols. ❑ wan-CnmplN.
If the facility is non -compliant, please explain in the space below the reasons) the facility was not in compliance. Provide in your explanation the bagels) of the non-compliance and describe the corrective
action(s) taken. Attach additional sheets if necessary.
Operator in Responsible Charge (ORC) Certification
Permitla a Certification
ORC: Cindy McGinnis
Permitting: Case Farms Hatchery
Certification No.: 992943
Signing Official: Cindy McGinnis
Grade: SI Phone Number: 808-438-6900
Signing Official's Title: Hatchery Supervisor
Has the ORC changed since thenpremiiious NDMR? ❑ was 0 N.
Phone Number: 828-438-6900 Permit Expiration: 12/31/2021
3—
Signature Date
Signature Data
By this signature, I onVy that this start is accunale and confirm to Ne War of my kamNedge.
I certiry, under penalty of law, that lhia..mend and all attachments were prepared under my dire.ion or supervision in
accordance with a system designed to assure that all qualified perso del property gathered and evaluated the inform.. n
submitted. Based on W inquiry. the person or parsons who manage the ryatem, or those persons didual, responsible for
,.then,, the information, Ne information submitted o. to the best of my knowledge and order rate, accurate, and complete. I am
ware that ther, am signlficand penalties for subs ring talso "information lnd ing the possibility offines and imprisonment for
knowing vmla4ons.
Mail Original and Two Copies to:
Division of Walter Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) P., / of A
FORM: NDAR-i 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page __�?af a
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?
1Z camprmnt
❑Non-Complim,
E Compliant
❑ Non -Compliant
Q' Complaint
❑ Non Compliant
Q Compliant
❑Non{ompl'am
0' Compliant
❑ NoonComphant
If the facility is non -compliant, please explain in the space below the reasons) the facility was not in compliance. Provide in your explanation the dates) of the non-compliance and describe the corrective
actions) taken. Attach additional sheets if necessary.
Operator in Responsible Charge (ORC) Certification
Permiftee Certification
ORC: Cindy McGinnis
Permiftee:
Case Fanns Hatchery
Certification No.: 992943
Signing Official: Cindy McGinnis
Grade: SI Phone Number: 828-438-6900
Signing Official's Title: Hatchey Supervisor
Has the ORC changed since the previous NDAR-17 ❑ yes 0 No
Phone Number: 828-438-6900 Permit Exp.: 12/31/21
C' e-cirwar 3 �3 3
� t t
Signature Date
Signature Date
By this signature, I carry Nat this report is amurrete and complete to the best of my knowleEge.
I ceNfy, under penally of law, that this d-umenl and all attachments asom preparad under my tllre4ion or supervision in acmMance
win a system dwil to assure that all qualified personnel pmpeM gathered and evaluated the information submitted. Based on my
inquiryatepmonorpersonswhomanage Nery em, or those persons directly responsible for gathering the Inblmaddq the
iurc matron submitted is, to the beer of my knowledge and belie[ true, amrver and complete. I am axare that there are sign¢ant
pelaNas for submitting raise infonnar ran, including the possibi4ry of Mes and Impns nment 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