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Home My WebLink AboutWQ0019665_Monitoring - 07-2023_20230911FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) `"aye —15 — --A— Permit No.: �11 •.. Quarter - •- Year: • • mom m r • •rrr�®�® -®�-® ®-® ® •iI ®��F ®__ -_ •Y r —®_�—®—®� —®—® m MDaily _— • a —®— _®—®— —®—® Maximum:, D. Sampling Type: .III• -®-®-®_®-®_®-- Monthly Avg. Limit: Sample Fr quency: ��NBC M_ -_ NUN -DISCHARGE APPLICATION REPORT (NDAR-1) Page _ � of 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? El -Compliant ❑ Non -Compliant []-'Compliant ❑ Non -Compliant [4 Compliant ❑ Non -Compliant E -Compliant ❑ Non -Compliant Were all freeboards maintained in accordance with the specified freeboard heights in 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 ORC: oSGPH F, S A13LI.: le Certification No.: u) U) II ( 5S1-1 SI l S to 5 b Grade: � Phone Number. a S:�) 9 y3 5 4.3 S Has the ORC changed since the previous NDAR-1? ❑ Yes [P-too re By this signature, I certify that this report is accurrate and complete to the best of my knowledge. Permittee Certification Permittee: S L,)pttj j�j Qj► RtER SAID (' lq Signing Official: ZICFFF-0 5Tokr=5 $E R ll Signing Official's Title: SEL//-FRI— S. sz) ,54z - oa° I Phone Number:C� Permit Exp vISTkl(--r (3%/311z02_1� Date \J U Signature Date I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accirdance 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 FC:RM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page .2 of 2 -- — w 1 1 • . • Did irrigation occur ------ ---- - ---- - --- tt _ - - - Field Narne�- 7- __ - - -- — -- -- -- - - - _ ----- Field Name:, -- • • -'� - - Cover Crop:: ■ • •• Cover Cro YES Hourly Rate (in):; Hourly Rate (in): nnu Field Irrigated? _Wnnual Rate (in): Field Irrigated?'ii m�� ®�_®��■ ems®®� �� FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page I Of I Sampling Person(s) Certified Laboratories Name: BOgi,6� Go2s Name: � N V (A0 T ►�'L Name: JOSEPI-i F, SNI)LE R Name: Does all monitoring data and sampling frequencies meet the requirements in Attachment A 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: 765EPH F, SApt_E(2 Permittee: !SWAN Q UARTE9 S/}IV -MRV DIS T RIFT Certification No.: W tI) Z 15511 S� (S 50 Signing Official: TF FF!^ Rl 6TOc s 6 ERO Grade: IT Phone Number: �rj�.^ �l L43 S 43S Signing Official's Title: SE{_ /-rR E f\S Has the ORC changed since the previous NDMR? 1]yes 5#m Phone Number: � S 41 Permit Expiration:U. 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 penally 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 direclfy 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