WQ0002005_Monitoring - 02-2023_20230327

Monitoring Report Submittal
Permit Number#*
Name of Facility:*
Month: * February
WQ0002005
House of Raeford Rosehill
Report Information
Type *
NDMR, NDAR-1, NDAR-2, NDMLR
Confirmation Email Address:
Name of Submitter: *
Signature:
Date of submittal:
Initial Review
Reviewer:
Year:* 2023
Upload Document*
NDMR, NDAR-1, NDMLR February 2023.pdf 1.16MB
PDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
Mason. [e-mail]
Mason Drew
44,460AI D)Lsw
Wanda.Gerald
3/27/2023
This will be filled in automatically

Is the project number correct?* W00002005
Is the monitoring report accepted?* Yes NO
Regional Office* Wilmington
Reviewer: _anonymous
Review Date: 5/15/2023

FORM: NDMR 05-16 NON -DISCHARGE MONITORING REPORT (NDMR) Page of
Permit No.: W00002005
Facility Name: House of Raeford - Rose Hill WWTF
County, Duplin
Month: February
Year: 2023
PPI: 001
Flow Measuring Point: ❑ Influent ❑� Effluent ❑ No flow generated
Parameter Monitoring Point: ❑ Influent ❑ EMLent ❑ Groundwater Lowering ❑ surface water
Parameter Code --►
50050
00310
00681
00680
00940
50060
31616
00610
00025
00620
00600
00400
00565
WQ09C
703W
00530
is
0
E
U
0
O
O01
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F
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To �3
N
24-hr
hrs
OPO
mglL
m
m L
m
m /L
W100 mL
m
mg1L
mgIL
su
m L
M91L
mg/L
1
07:00
8.5
650,000
0.12
8.09
2
07:00
9
640.000
0.08
8.15
3
07:00
9
310,000
1
0.08
7.64
4
08:00
2
0
6
08:00
2
340,000
5
07:00
9
620.000
0.08
7.8
71
07:00
9
630,000
0.29
8.5
8
07:00
8
8W,000
0.29
8.48
9
07:00
8
630,000
0.29
8.51
10
07:00
8
320.000
34
0.28
328
54.3
62.5
0.07
82.8
8.37
7.66
29.9
649
124
11
07:00
2
0
12
08:00
2
320,000
13
07:00
9
570,000
0.3
8.22
14
07:00
8
6W,000
0.38
8.31
15
07:00
8.25
&*,000
0.27
8.25
16
07:00
9
590,000
0.29
8.24
17
07:00
7:00
320,000
0.27
8.25
181
08:00
2
0
19
08:00
2
340,000
20
07:00
9
600,000
0.35
8-25
21
07:00
8.5
590,000
0.26
8.12
22
07:00
8
5W,000
71
104
0.28
301
49.3
62.6
<0.02
62.B7
7:00
4.44
28.8
663
123
23
07:00
8.75
570,000
0.3
8-04
24
07:00
8.5
320,000
0.32
7.95
25
08:00
2
0
26
08:00
2
350,000
27
07:00
9
670,000
0.36
7.86
28
07:00
9
580,000
0.28
7.93
29
30
31
Average:
438,929
52.50
104.00
0.26
313.25
51.80
62.55
0.04
62.84
6.05
29.35
656.00
123.50
Daily Maximum:
650,000
71.00
104.00
0.38
326.00
54.30
82.80
0.07
62.87
8.51
7.66
29.90
663.00
124.00
Daily Minimum:
0
34.00
104.00
0.08
301.00
49.30
62.50
1 0.02
62.80
0.29
4.44
28.80
649.00
123.00
Sampling Type:
Reorder
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Monthly Limit:
8W,000
Daily Limit:
Sample Frequency:
CoritlnuouE
2 X Month
ArtnuaUy
Annually
3 X Year
5 X Week
2 X Month
2 X Month
2 X Month
2 X Month
2 X Month
5 X Week
2 X Morttlt
2 X Month
3 X Year
2 X Month

Year: 2b23
1
2
3
4
5
6

FORM NDMR 05-16 NON -DISCHARGE MONITORING REPORT (NDMR) Page of
Sampling Person(s) Certified Laboratories
Name: Jay Baker Name: Enviromental Chemist
Name: Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? [d 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 necessary.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Joseph Teachey
Permittee: House of Raeford
Certification No.: 14930
Signing official: Nicole Reynolds
Grade: SI Phone Number: [phone]
Signing Officials Title: Plant Manager
Has the ORC changed since the previous NDMR? I Yes (, J No
Phone Number: [phone] Permit Expiration: 10/31/2023
z3
w 14
- Signature Date
Signature Date
lify,
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
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: NDMLR 10-13 NON -DISCHARGE MASS LOADING REPORT (NDMLR) Page / of r
Permit No.: W00002005
Facility Name: House of Raeford Farms, Inc.
County: Duplin
Month: February
Year. 2023
Field Name:
L1
FWd Name:
L2
Field Name:
L3
Field Name:
L4
Field Name:
L5
Area (acres):
12.04
Area (acres):
12.04
Area (acres):
12.04
Area (acres):
12.04
Area (acres):
10.52
Cover Crop:
Cover Crop:
Cover Crop:
Cover Crop:
Cover Crop:
Load Type:
PAN
Load Type:
PAN
Load Type:
PAN
Load Type:
PAN
Load Type:
PAN
Field Loaded?
O YES ❑ NO
Field Loaded?
[ YES ❑ No
Field Loaded?
Q YES ❑ No
Field Loaded?
YES ❑ No
Field Loaded?
❑ YES C No
a
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M
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Va
3
<
ra
o
aU
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<
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Month
gal
m L
Ibslac
lbslac
gal
mgfL
Ibs/ac
Ibalac
gal
m L
Ibslac
Ibslac
gal
MgPL
tbelac
Ibwac
gal
mq1L
Ibslac
Ibs/ac
January
487,800
39.6
13.4
13.4
044,100
39.6
25.9
25.9
479,700
39.6
13.2
13.2
719,100
39.6
19.7
19.7
477,000
39.6
15.0
15.0
February
648,000
29.35
13.2
26.6
350,100
29.35
7.1
33.0
352,800
29,35
7.2
20.3
171,000
29.35
3.5
23.2
688,700
29.35
16.0
31.0
March
369,900
36.9
9.5
36.0
576,000
36.9
14.7
47.7
756,000
36.9
19.3
39.7
680,406
36.9
17.4
40.6
1 641,700
36.9
18.8
49.8
Aprii
468,000
33.5
10.9
46.9
484,200
33.5
11.2
59.0
565,200
33.5
13.1
52.8
583,200
33.5
13.5
54.1
117,000
33.5
3.1
52.9
May
266,400
31.4
5.8
52.7
865,8W
31.4
18.8
77.8
706,500
31.4
15.4
68.1
182,700
31.4
4.0
58.1
0
31.4
0.0
52.9
June
889,200
23.95
14.8
67.4
790,2W
23.95
13.1
90.9
1,106,100
23.95
18.4
86.5
736,300
23.95
12.2
70.3
363,600
23.95
6.9
59.8
July
554,400
16.25
6.2
73.7
706.500
16.25
8.0
98.9
11 675,900
16.25
7.6
94.1
849,600
16.25
9.6
79.9
939,600
16.25
12.1
71.9
August
630,000
36.65
16.0
89.7
577,800
36.65
14.7
113.5
432,000
36.65
11.0
105.1
517,500
36.65
13.1
93.0
270,000
36.65
7.8
79.7
September
546,300
1 18.45
7.0
96.6
5221900
18.45
6.7
120.2
539,100
18.45
6.9
112.0
539,100
18.45
6.9
99.9
492,300
18.45
7.2
86.9
October
594,900
23.5
9.7
106.3
630,900
23.5
10.3
130.5
513,000
23.5
8.4
120.3
518,400
23.5
8.4
108.3
489,600
23,5
9,1
96.1
November
674,100
26.5
12.4
118.7
707,400
26,5
13.0
143.5
626,400
26.5
11.5
131.8
441,000
26.5
8.1
116.4
154,800
26.5
3.3
99.3
December 571,500 33.15
13.1
131.8
2286W
33,15
5.2
148.7
266,400
33.15
6.1
137.9
453,600
33.15
1D.4
126.8 411,300
33.15
10.8
110.1
12 Month Floating PAN Load
131.8
148.7
137,9
128,8
110.1
(ibsla r):
Annual PAN Load Limit
300
300.00
300.00
300.Q0
300.00
(lbsla r):

FORM: NDMLR 10-13 NON -DISCHARGE MASS LOADING REPORT (NDMLR) Page Z of_�
Permit No.: WQ0002005
Facility Name: House of Raeford Farms, Inc.
County: Duplin
Month: February
Year. 2023
Field Name:
L6
Field Name..
L7
Field Name:
LB
Field name;
L9
Field Name:
L10
Area (acres):
8.66
Area {,acres):
12.04
Area (acres):
12.04
Area (acrosi
12.04
Area (acres):
10.52
Cover Crop:
Cover Crop:
Cover Crop:
Cowr Crop:
Cover Crop:
Load Type:
PAN
Load Typo:
PAN
Load Type:
PAN
Load Type;
PAN
Load Type:
PAN
Field Loaded?
❑ YEs ❑ No
Reid Loaded?
❑ YEs ONO
Field Loaded?
0 YES ❑ NO
FWd Loaded?
[] YEs ❑ No
Field Loaded?
❑ YEs 0 NO
m
z e
o
z
m
z
zm
Ez
.�
E�
:
°�
��
Ez
cis
c.
e
va
V
V
a V
>
>
>
>
Month
gal
L
lbs/ac
Ibslac
gal
29&
Welec
UWac
I
m L
Ibalac
Ibs/ac
RX04C
ibshc
gal
m
lbstac
ftWac
January
287,100
39.6
10.9
10.9
866,700
39.6
23.8
23.8
984,600
39.6
27.0
27.0
778,500
39-6
21.4
21.4
479,700
39.6
15.1
15.1
February
671,400
29.36
19.0
29.9
565,100
29.35
11.5
35.3
509,400
29.35
10.4
37.4
667,W0
29.35
13.6
34.9
356,400
29.35
8.3
23.4
March
549,900
36.9
19.5
49.5
709,200
38.9
18.1
53.4
576,900
36.9
14.7
52.1
588,6W
36.9
15.0
50.0
485,100
36.9
14.2
37.5
Aprii
324,900
33.5
10.5
59.9
441,000
33.5
10.2
63.6
631,800
33.5
14.7
66.8
367,200
33.5
8.5
58.5
366.300
33.5
9.7
47.3
May
314,100
31.4
9.5
69.4
790,200
31.4
17.2
80.8
768,600
31.4
16.7
83.5
W8,5W
31.4
13.0
71.5
319,500
31.4
8.0
55.2
June
567,000
23.95
13.1
82.5
753,3W
23,95
12.5
93.3
869,400
23.95
14A
97.9
53Y,800
23.95
8.8
80.4
443,700
23.95
8.4
63.6
July
780,300
16.25
12.2
94.7
953,100
16.25
10.7
104.0
664,200
16.25
7.5
105.4
524,700
16.25
5.9
86.3
0
16.25
0.0
63.6
August
479,B00
36.65
16.9
111.7
554,400
36.65
14.1
118.1
501,300
36.65
12.7
118.1
091,200
36.65
17.5
103.8
459,900
36,65
13.4
77.0
September
525,600
18.45
9.3
121.0
5W,400
18.45
6.4
124.5
348,300
18.45
4.5
122.6
351,000
1 18.45
4.5
108.3
254,700
18.45
3.7
80.7
October
309,600
23.5
7.0
128.0
553,5W
23.5
9.0
133.5
229,500
23.5
3.7
126.3
639,900
1 23.5
10.4
1181
622,661
November
653,400
26.5
16.7
144.7
W8,800
28.5
12.1
145.6
534,600
26.5
9.8
136.1
eb5,200
28.5
12.0
130.7
423,2December
0 33.15
0.0
144.7
0
33.15
0.0
145.6
287,100
33.15
6.fi
142.7
415800
33.15
9.5
140.3
242,612
Month Floating PAN Load
(lbslactyr):
144 7
1456
1427
140.3
Annual PAN Load Limit
(lbe! r):
300.00
300.00
300.00

FORM: NOMLR 10-13 NON -DISCHARGE MASS LOADING REPORT (NDMLR) Page -3 of
Permit No.: WQ0002005
Faculty Name: House of Raeford Farms, Inc.
County: Duplin
Month; February
Year. 2023
Field Name:
CP4
Field Name:
5A
Field Name:
5AA
Field Name:
58
field Name:
6A
Area (aces):
23
Arwa jwjm :
6.9
Area (acres):
5.5
Area (acres):
6.9
Area (acres):
16.02
Cover Crop:
Cowr Crop:
Cover Crop:
Cover Crop:
Cover Crop:
Load Type:
PAN
Load Type:
PAN
Load Type:
PAN
Load Type:
PAN
load Type:
PAN
Field Loaded?
❑ ve5 ❑ NO
Field Loaded?
❑ YC-5 No
Field Loaded?
❑ YES ❑ No
Field Loaded?
Q YES ❑ NO
Field Loaded?
❑ YEs ❑ NO
43
0.
<
0. V
a
5
1
a
o
a
a 7
e
0.
rL
r
v
�
3
z
Q.
z
IL
v
Month
gal
m L
Ibalac
Ibslac
gal
mg&
kbalac
lbafac
221
Malec
Ibslac
gal
rnq1L
Ibelac
ibelac
gal
I m
Ibalac
kbelac
January
1,117,800
39.6
16.1
16.1
628,714
39.6
30.1
30.1
0
_Tj1L
39.6
0.0
0.0
W9,053
39.6
42.6
42.6
582,483
39.6
12.0
12.0
February
2,103,300
29.35
22.4
38.4
697,783
29.35
24.8
54.8
0
29.35
0.0
0.0
548,911
29.35
19.4
62.0
358,321
29.35
5.5
17.5
March
2,637,900
36.9
35.3
73.7
410,774
36.9
18.3
73.2
0
36.9
0.0
0.0
321,958
36.9
14.4
76.3
210,938
36.9
4.1
21.5
April
2,615,400
33.5
31.8
105.5
1 617,012
33.5
25.0
98.2
0
33.5
0.0
0.0
483,604
33.5
19.6
95.9
318,844
33.5
5.5
27.1
May
2,629,800
31.4
29.9
135.4
708.772
31.4
26.9
125.1
0
31A
0.0
0.0
586,524
31.4
21.1
117.0
363,964
31A
5.9
33.0
June
2,322,900
23.95
20.2
155.6
700,891
23.95
20.3
146.3
0
23.96
0.0
0.0
549,347
23.95
15.0
132.9
359,917
23.95
4.5
37.5
July
2,340,900
16.25
13.8
169.4
874,754
16.25
17.2
102.5
0
16.25
0.0
0.0
685,618
16.25
13.5
148.3
449,198
18.25
3.8
41.3
August
2,136.600
36.65
28.4
197.8
481,222
36.65
21.3
183.8
0
36.65
0.0
0.0
377,174
36.65
16.7
163.1
247,114
36.65
4.7
46.0
September
12,130,300
18.45
14.3
212.1
882,707
18.45
14.8
198.8
0
18.45
0.0
0.0
519,419
18.45
11A
174.6
340,309
18.45
3.3
49.3
October
2,907,900
23.5
24.8
236.8
7%474
23.5
20.2
218.8
0
23.5
0.0
0.0
5W08
23.5
15.8
190.5
364,838
23.5
4.5
53.7
November
2,097,000
26.5
20.2
257.0
0
26.5
0.0
218.8
0
26.5
0.0
0.0
727,407
28.5
23.3
213.8
476,577
26.5
6.6
60.3
December 2,226,600 33.15
12 Month Floating PAN Load
(lbel r):
Annual PAN Load Lkmit
Ibala r):
26.8
283.8
283.8
0
33.15
0.0
218.8
300.00
218.8
0
33.15
0.0
0.0
300.nr
0.0
727,407
33.15
29.1
Z42.9
300.00
242.9
476,577
33.15
8.2
68.5
300.00
68.5
300

FORME. NDMLR 10-13 NON -DISCHARGE MASS LOADING REPORT (NDMLR) Page /- of S
Permit No.: W00002005
Facility Name: House of Raeford Farms, Inc.
County: Duplin
Month: February
Year: 2023
Field Name:
6B
Field Nance:
Field Name:
Field Name:
Field Name:
Area (acres):
6.7
Area (acres):
Area (acres):
Am& (acrssy
Area (acres):
Cover Crop:
Cover Crop:
Cover Crop:
Cover Crop:
Cover Crop:
Load Type:
PAN
Load Type:
Load Type:
Load Type:
Load Type:
Field Loaded?
[] YE5 ❑ No
Field Loaded?
❑ YES ❑ No
Field Loaded?
❑ YES ❑ NO
Field Loaded?
❑ YES ❑ No
Field Loaded?
❑ YES ❑ No
.
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L
J
U
Month
gal
m L
Ibs/ac
Ibalac
Raise
Ibs/ac
al
mgfL
Ibs/ac
lbslac
Onlac
Ibalac
gal
m
Ibalac
Ibs/ac
January
613,140
39.6
30.2
30.2
February
377,180
29.35
13.8
44.0
March
222,040
36.9
10.2
54.2
April
333,500
33.5
13.9
68.1
May
383,120
31.4
15.0
83.1
June
378,860
23.95
11.3
94.4
July
472,840
16.25
9.6
103.9
August
260,120
36.65
11.9
115.8
September
358,220
18.45
8.2
124.0
October
384,040
23.5
11.2
135.3
November
501,660
26.5
16.5
151.8
December 501,660 33.15
12 Month Floating PAN Load
Ibs/ac/yr):
Annual PAN Load Limit
Ibs/a r):
20.7
1725
300
172.5
0 0

FORM NDMLR 10-13 NON -DISCHARGE MASS LOADING REPORT (NDMLR) Page _L of
Did the mass loading rates exceed the limits in Attachment B 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 additional sheets if necessary
Operator in Responsible Charge (ORC) Certification Permittee Certification
ORC: Joseph Teachey Permittee:
House of Raeford
Certification Number: 14930 Signing Official:
Nicole Reynolds
Grade: SI Phone Number: [phone] Signing Officials Title: Plant Manager
Has the ORC changed since the previous NDMLR? ❑ yes 2 No Phone No.: [phone] Permit Exp.: 10/31/23
Signature
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
Date 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 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 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page / of
Permit No.: W00002005 Facility Name: House of Raeford Farms, Inc
County: Duplin Month: February Year: 2023
Did irrigation occur Flow No" 5-A Field Name: 5-AA field Harris: 5•B Flew Name: 6-A
at this facility? �a ( ): 8'9 Area (acres): 5.5 Arm (screaj: 8.9 Area (acres): 16.2
cowcrop.. Cover Crop: Cover Crop: Cover Crop:
i] YES ❑ NO HOL* Rab (krr Hourly Rate (in): Hourly Rafe (M): Hourly Rate (In):
Annual Rate (Iny Bt? Annual Rate (in): 6o Annual Rate (in): 80 Annual Rate (In): 50
Weather Freeboard field lrripaWo ❑ YES ❑ NO Field Irrigatsd? ❑ rEs ❑ No FIW Krigalyd? ❑ v1"S ❑ No Field Irrigated? ❑ Yes ❑ NO
E
CL LE. � i
>Q x 3 a o
_ > �a
3 26
a wLy � >Q E
'F In ft l min M in al min In In min In In al min in In
1 R 59 0 3.75
2 R 38 0.4 3.71
3 R 43 0.9E 3.71
4 C 40 0 3.5
5 CL 50 0.1 3.41 103,119 300 0.55 6.11 80,823 300 0.43 0.09 52,953 3 - 0.12 0.02
7 C 35 0 3.79
6 C 44 0 3.103,119 300 0.55 0.11 80,823 300 0.43 0.09 52,953 300 0.12 0.02
79
8 C 49 0 3. 11
9 CL 43 0 4.04
10 CL 61 0 3.75 103,119 300 0.55 0.11
11 CL 50 0 3.83 80,823 300 0.43 0.09 52,953 300 0.12 0.02
12 R 45 1.6 3.58
13 CL 43 0.25 3.58 103,119 300 0.65 0.11 80,823 300 0.43 0.09 52,953 300 0.12 OA2
[117
C 35 0 3.96 103,1#9 300 0.55 0.11 80,823 300 0.43 0.09 52,953 300 0.12 0.02
C d5 0 3.96
C 56 0 3.83
C 67 0 3.83
C 48 0.1 3.75
19 C 62 0 3.5
20 CL 53 0 3.41
21 CL 71 0 3.41 79,089 230 0.42 0.11 61,973 230 0.33 0.09 40,603 230 0.09 0.02
2T PC 74 0 3.58
23 C 67 0 3,87
24 C 66 0 4.25
25 R 46 0.3 4.58
26 C 61 0 3.79 103,119 300 0.55 0.11 80,823 300 0.43 52,953 00 0.12 0.02
27 CL 52 0 3.96
0.09 3
28 C 66 0 4.83
29
30
31
Monthly Loading: 897-783 3.72 0 0.00 546,911 2.92 358,321 0.81
12 Month Floating Total (in): 27.44 7.06
27 25.32

FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-4) Page 2, of__�
w111 11
House of • •
: •
a•
it;at
1
Did Irrigation occur
this facility?
No
i
-
I
MGM
12 • •
�■
�■

FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page ? of
Permit No.: W00002005
Facility Name: House of Raeford Farms, Inc
Month: February
Did Irrigation occur
at this facility?
0 YES No
j
•. .
I
i
18008MMMMIMI
;M
M
MM':M
WTI
12 Month Floating Total (in);
r

FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page _4 of
•Ili li5
Facift Name: House of • • Forms, Inc
County: •
+ •
1
Did irrigation occur
at this facilil
I
i
1
•
-.-7-701�1ffMMMMMMMM
f
®i
-
I
i
MMMMMMMM
�
t
MMIMM
.
': 1 •,r: '
i :.: !1
MMM
1�11
f 1
:. :1•
ME=
1•

FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page —� of `2
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?
0 Compliant ❑ Non -Compliant
[� Compliant ❑ Non -Compliant
Q Compliant ❑ Non -Compliant
Q Compliant ❑ Non -Compliant
L 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 dates) 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: Joseph Teachey
Permittee:
House of Raeford
Certification No.: 14930
Signing Official: Nicole Reynolds
Grade: SI Phone Number: [phone]
Signing Officials Title: Plant Manager
Has the ORC changed since the previous NDAR-1? yeS El No
Phone Number: [phone] Permit Exp.: 10/31/23
3 z7 3
( 4 t 3 z, 161
Signature Date
j &4nature 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 qualdled 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