WQ0019665_Monitoring - 06-2022_20220805

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) ray.
�;�rmit No.: WQ001 M�! Facility Name: Swan Quarter Sanitary District WWTF
County: Hyde Month: f) jz-
MEW
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Sample Frequency-i

NUN -DISCHARGE APPLICATION REPORT (NDAR-1)
Page � of L
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?
❑ Compliant ❑ Non -Compliant
❑ Compliant ❑ Non -Compliant
❑ 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
IORC: TQSeNi F. SAZLEIZ
Certification No.: W Lu -2-. I $ s t ri `s� T_ 166570
Grade: � Phone Number: �251) q L-3 - $ 4 3 6-
Has the ORC changed since the previous NDAR-1? ❑ yes F`No
U
Signature
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
Permittee Certification
Permittee: SWgN cgQ01,RTCf- 5p>vlT)kR4 blsrelcr
Signing Official: J i2 FFE R�{ STOIC y
ES 9EI??
Signing Official's Title: SEC RE- TPrR y // -a es
Phone Number: d 5� 1 '542 Oq O t ((( Permit Exp.:
- zo2z- i.
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.: WQ0019665
Facility Name: Swan Quarter Sanitary District WWTF
County: Hyde
Month: ((ne,
Year:�)2
Did lCPlgatl®!� ®CC111
Field —Na,,.
Field Name:
Field Flame:
T
Field Name:
�$ this i�da@ii�°�
L( YES ❑ No
Area (acres):
58.1
Area acres :
( )
Area acres :
( )
Area (acres):
Cover Crop:
Cover Crop:
Cover Crop: p
Cover Crop:
Hourly Rate (in):
0.25
Hourly Rate (in):
Hourly Rate (in):
Hourly Rate (in):
Annual Rate (in):
Field Irrigated?
32:5
' ❑ YES C�'r,o
Annual Rate (in):
Field Irrigated?
❑ YES [�-No
Annual Rate (in):
Annual Rate (in):
Weather
Freeboard
Field Irrigated?
YES ❑ No
Field Irrigated?
❑ YES [Z'NO
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rvvly-vlJ�,nHK�t HrrLS-A 11UN KLFUK I (NUAK-1)
Hage _V of 6
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?
❑ Compliant ❑ Non -Compliant
❑ Compliant ❑ Non -Compliant
❑ 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 explangtion 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:--OSEPH
Permittee: SLA) 6tJ 45 I'AA ER 5 AN IT14 R`i D lST1ZtCT
Certification No.: tt1W 2, 1 5r; f'7 iS (D 5-0
Signing Official: 7��� �� rz; / 07 ES g eicRV
Grade: If: Phone Number: �2j a) q �s l 3s-
Signing Official's Title: SEG,�TiF�ff�S
Has the ORC changed since the previous NDAR-1? �:,' Yes [✓]'No
Phone Number: Ca 5�> 5 L-4 Permit Exp.: �� _ 3 [ _ Z 02 6
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 forgathering 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