WQ0019665_Monitoring - 06-2023_20230731

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR)
PermitNo.: WQ0019665 FacilityName: Swan Quarter Sanitary District WWTF County: Hyde Month:
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NUN -DISCHARGE APPLICATION REPORT (NDAR-1) Page _� of I
Did the application rates exceed the limits in Attachment B of your permit?
❑ Compliant ❑ Non -Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites? ❑ Compliant ❑ Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit? ❑ Compliant ❑ Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site? ❑ 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 Permittee Certification
ORC: 7psEpN F•
Permittee: SOAVV GPI AR-1-EIZ SAPITRI2y O(S(IeICT
Certification No.: 1610 a Signing Official: SCF F E R 1 S TO TES 3 E e P. y
Grade: I[ Phone Number: IJ' -1 Z 4P Z 2 Z L4 Signing Official's Title: SG-0-REA
Has the ORC changed since the previous NDAR-1? ❑ Yes �o Phone Number: Permit Exp.: Qg ,3 j..Z 02.
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, North Carolina 27699-1617

FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page —f _- of __f__
"imp
Field Na�e: Field Name:
Area (acres):
Cover Crop:
HourtMate
Annual Rate (in):
Annual Rate (in)-
Annual Rate (in
Field Irrigated?',
Field Irrigated?
Field Irrigated?

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page I of_-2_
Sampling Person(s)
Name: TOSEPH F-,S► bL.ER
Name: TEFFEQy STOTESB Iff"9
Certified Laboratories
Name: CFIJV LROtj m E V T IZ— (NC
Name:
.Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? Ocompliant []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: "T05EPti F, 5AD -ER,
Permittee: SWAN gVA127'E1? SAO1- ARp pts-Rlcr
Certification No.: W W 2 i S� l 51 15650
Signing Official: 'f E F F E R "I 3 rOT ES 13 1� R R V
Grade: Phone Number: a S 2) q L43 -- 5 43 5
Signing Official's Title: SEC THE A -S
Has the ORC changed since the previous NDMR? Dyes ❑No
Phone Number: (j2) Jr��— 9 1 Permit Expiration: ZO%b
? 2 G 2023
ZCo 23
Signature Date
(S),nature 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