WQ0002648_Monitoring - 12-2023_20240124

Monitoring Report Submittal
Permit Number#*
Name of Facility:*
Month: * December
WQ0002648
Seagrove Ulah Metropolitan
Report Information
Type *
NDMR, NDAR-1, NDAR-2, NDMLR
Confirmation Email Address:
Name of Submitter: *
Signature:
Date of submittal:
Initial Review
Year:* 2023
Upload Document*
12-Dec 2023 NDMR,NDAR Signed.pdf 2.95MB
PDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
[e-mail]
Larry T. Chilton
v6;t tJ P. 641l-ew
Reviewer: Wanda.Gerald
1 /24/2024
This will be filled in automatically

Is the project number correct?* WQ0002648
Is the monitoring report accepted?* Yes No
Regional Office* Winston-Salem
Reviewer: _anonymous
Review Date: 2/20/2024

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page I of S
Permit No.: WQ0002648
Facility Name: Seagrove -Utah Metropolitan
County: Randolph
Month: December
Year: 2023
PPI: 001
Flow Measuring Point: [A cnfluent ❑ Effluent ElNo flow generated
Parameter Monitoring Point: ElInfluent 0 Effluent ❑ Groundwater Lowering ElSurface water
Parameter Code -►
50050
00310
00940
50060
31616
00610
00625
00620
00600
00400
00665
70300
00530
>Q
m
E
�
o
p
LL
O
'
12
U
E
c
oO
2
YZ
c
0-
2
o
o a
0
(L
'a
o 0
n0
Q
m
a10
0O
'O
U)
24-hr
I hrs
GPD
mg/L
mg/L
mg/L
#/100 mL
mg/L
I mg/L
mg/L
mg/L
I su
mg/L
mg/L
mg/L
1
08:00
10
43,200
0.81
6.9
2
10:00
8
20,350
0.92
6.92
3
20,350
4
06:00
8
37,000
1.04
6.89
5
06:00
8
39,000
1.62
6.81
6
06:00
8
36,000
0.96
1
6.84
7
06:00
8
38,300
1.7
6.98
8
06:00
8
34,900
1.58
6.96
9
10:00
8
65,450
1.44
7.04
10
65,450
11
06:00
8
57,100
1.47
6.82
121
06:00
8
35,900
26.6
0.81
<10
1 17.9
22.2
6.59
28.8
1 6.89
4.57
42.3
13
06:00
8
33,100
1.12
6.92
14
06:00
8
31,900
1.46
6.99
15
05:00
8
33,600
1.19
6.47
16
04:00
8
24,300
1.27
7.21
17
04:00
8
154,300
1.68
7.18
181
06:00
8
52,700
0.91
7.14
19
06:00
8
34,800
1.62
7.28
20
06:00
8
22,400
1.82
7.21
21
05:00
8
22,400
1.99
7.1
22
05:00
8
29,600
1.94
7.1
23
04:00
8
24,000
1.52
7.04
241
04:00
8
20,400
1.39
7.07
25
06:00
5
19,300
1.44
7.09
26
06:00
8
118,900
1.37
7.12
27
06:00
8
74,800
1.16
6.98
28
06:00
8
41,000
1.38
7.23
29
16:00
2
11,300
301
04:00
8
24,800
1
1.9
7.06
311
05:00
6
17,900
1.4
7.16
Average:
41,435
26.60
1.39
1.00
17.90
22.20
6.59
28.80
4.57
42.30
Daily Maximum:
154,300
26.60
1.99
10.00
17.90
22.20
6.59
28.80
7.28
4.57
42.30
Daily Minimum:
11,300
26.60
0.81
10.00
17.90
22.20
6.59
28.80
6.47
4.57
42.30
Sampling Type:
Recorder
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Monthly Avg. Limit:
30,000
Daily Limit:
Sample Frequency:
Continuous
Monthly
3 X Year
5 X Week
Monthly
Monthly
Monthly
Monthly
Monthly
5 X Week
Monthly
3 X Year
Monthly

FORM: NDAR-1 05-16 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page oZ of_5-
Permit No.: WQ0002648
Facility Name: Seagrove -Utah Metropolitan Water District WWTP
County: Randolph
Month: December
Year: 2023
Did irrigation occur
Field Name:
1
Field Name:
2
Field Name:
3
Field Name:
4
facility?
Area (acres):
2.1
Area (acres):
2
Area (acres):
2.1
Area (acres):
3.4
at this
Cover Crop:Grass
Cover Crop:
p:
Grass
Cover Crop:
p:
Grass
Cover Crop:
p:
Grass
(] YES ❑ No
Hourly Rate (in):
Hourly Rate (in):
Hourly Rate (in):
Hourly Rate (in):
Annual Rate (in):
38.4
Annual Rate (in):
38.4
Annual Rate (in):
38.4
Annual Rate (in):
38.4
Weather
Freeboard
Field Irrigated?
L7 YES ❑ NO
Field Irrigated?
❑ YES ❑ No
Field Irrigated?
❑ YES ❑ No
Field Irrigated?
O YES ❑ No
p
a)
o
=
d
2
+'
CL
E
F
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a
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m
in
y m
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LO
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E .�
a
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d
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rn
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a
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a
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F '°�
_
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c
,� o
a o
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E rn
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m 2 0
J
°F
in
ft
ft
gal
I min
in
in
gal
min
in
in
gal
min
in
in
gal
I min
in
in
1
CL
46
0
66"
2
R
54
0.05
62'
3
4
PC
45
0
57'
5
R
37
0.05
5'3"
6,250
12.5
0.11
0.11 1
6,250
12.5
0.12
0.12
5,680
1 11.4
0.10
0.10 1
9,660
19.3
0.10
0.10
6
PC
35
0
6'2"
7
C
28
0
5'9"
8
PC
37
0
55"
5,000
10
0.09
0.09
5,000
10
0.09
0.09
4,545
9
0.08
0.08
7,727
15.4
0.08
0.08
9
R
60
0.2
6'4"
10
R
1.9
11
PC
35
0
50"
12
C
28
0
4'8"
7,500
15
0.13
0.13
7,500
156
0.14
0.05
6,816
13.6
0.12
0112
11,592
23
0.13
0.13
13
PC
32
0
6'0"
14
C
30
0
5'6"
6,250
12.5
0.11
0.11
6,250
12.5
0.12
0.12
5,680
11.4
0.10
0.10
9,660
19.3
0.10
0.10
15
C
28
0
6'5"
16
C
30
0
6'1"
17
R
48
2.3
1 610
18
C
46
0
4'4"
19
C
28
0
3'11"
7,500
15
0.13
0.13
7,500
156
0.14
0.05
6,816
13.6
0.12
0.12
11,592
23
0.13
0.13
201
C
24
0
5'5"
5,000
10
0.09
0.09
5,000
10
0.09
1 0.09
4,545
9
0.08
0.08
7,727
15.4
0.08
0.08
21
PC
28
0
69"
5,000
10
0.09
0.09
5,000
1 10
0.09
0.09
4,545
9
0.08
0.08
7,727
15.4
0.08
0.08
22
C
34
0
67'
23
CL
31
0
6'3"
24
CL
34
0
511"
25
R
41
0.1
57'
3,750
7.5
0.07
0.07
3,750
7.5
0.07
0.07
3,408
6.8
0.06
0.06
5,796
11.6
0.06
0.06
26
R
53
2
6'4"
271
R
54
0.1
5'0"
28
PC
48
0
4'4"
10,000
20
0.18
0.18
10,000
20
0.18
0.18
9,088
18.18
0.16
0.16
15,456
30.76
0.17
0.17
29
CL
42
0
6'3"
30
CL
30
0
6'1"
31
C
28
0
1 5'9"
Monthly Loading:
56,250
0.99
56,250
1.04
51,123
0.90
86,937
0.94
12 Month Floating Total (in):
8.97
9.49
8.34
8.63

FORM: NDAR-1 05-16 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page 3 of 6-
Permit No.: W00002648
Facility Name: Seagrove -Utah Metropolitan Water District WWTP
County: Randolph
Month: December
Year: 2023
Did irrigation
Field Name:
5
Field Name:
6
Field Name:
7
Field Name:
8
occur
Area (acres):
2.2
Area (acres):
2.6
Area (acres):
2.7
Area (acres):
2.4
at this facility?
Cover Crop:Grass
Cover Crop:
P�
Grass
Cover Crop:
p�
Grass
Cover Crop:
p�
Grass
L7 YES ❑ No
Hourly Rate (in):
Hourly Rate (in):
Hourly Rate (in):
Hourly Rate (in):
Annual Rate (in):
38.4
Annual Rate (in):
38.4
Annual Rate (in):
38.4
Annual Rate (in):
38.4
Weather
Freeboard
Field Irrigated?
21 YES ❑ No
Field Irrigated?
M YES ❑ NO
Field Irrigated?
O YES ❑ No
Field Irrigated?
❑ YES O No
T
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M= 0
J
°F
in
ft
ft
gal
min
in
in
gal I
min
in
in
gal
min
in
in
gal
min
in
in
1
CL
46
0
66"
2
R
54
0.05
6'2"
3
4
PC
45
0
57'
5
R
37
0.05
5'3"
4,540
9.1
0.08
0.08
7,950
15.9
0.11
0.11
9,660
19.3
0.13
0.13
6
PC 1
35
0
6'2"
7
C
28
0
5'9"
8
PC
37
0
5'5"
3,636
7.2
0.06
0.06
6,363
12.7
0.09
0.09
7,727
15.4
0.11
0.11
9
R
60
0.2
6'4"
10
R
1.9
11
PC
35
0
5'0"
121
C
1 28
0
4'8"
5,448
11
0.09
0.09
9,540
19
0.14
0.14
11,592
23
0.16
0.16
13
PC
32
0
6'0"
14
C
30
0
56"
4,540
9.1
0.08
0.08
7,950
15.9
0.11
0.11
9,660
19.3
0.13
0.13
15
C
28
0
1 6'5"
16
C
30
0
611"
17
R
48
2.3
5'10
181
C
46
0
4'4"
19
C
28
0
3' 11 "
5,448
11
0.09
0.09
9,540
19
0.14
0.14
9,540
19
0.13
0.13
20
C
24
0
5'5"
3,636
7.2
0.06
0.06
6,363
12.7
0.09
0.09
7,727
15.4
0.11
0.11
21
PC
28
0
5'9"
3,636
7.2
0.06
0.06
6,363
12.7
0.09
0.09
7,727
15.4
0.11
0.11
22
C
34
0
67'
23
CL
31
0
6'3"
241
CL
34
0
5'11"
25
R
41
0.1
57'
2,724
5.5
0.05
0.05
4,770
9.6
0.07
0.07
5,796
11.6
0.08
0.08
26
R
53
2
6A"
27
R
54
0.1
5'0"
28
PC
48
0
4'4"
7,264
14.62
0.12
0.12
12,720
25.4
0.18
0,18
15,456
30.76
0.21
0.21
29
CL
42
0
6'3"
30
CL
30
0
6'1"
31
Monthly Loading:IL
40,872
0.68
71,559
1.01
84,885
1.16
0
0.00
12 Month Floating Total (in):
6.46
9.30
10.83

FORM: NDAR-1 05-16 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page 'I of
Permit No.: W00002648
Facility Name: Seagrove -Utah Metropolitan Water District WWTP
County: Randolph
Month: December
Year: 2023
Field Name:
9
Field Name:
10
Field Name:
11
Field Name:
12
Did irrigation occur
Area (acres):
2.3
Area (acres):
2
Area (acres):
2.7
Area (acres):
2
at this facility?
Cover Crop:
Grass
Cover Crop:
Grass
Cover Crop:
Grass
Cover Crop:
Grass
[A YES ❑ NO
Hourly Rate (in):
Hourly Rate (in):
Hourly Rate (in):
Hourly Rate (in):
Annual Rate (in):
38.4
Annual Rate (in):
38.4
Annual Rate (in):
38.4
Annual Rate (in):
38.4
Weather
Freeboard
Field Irrigated?
O YES ❑ NO
Field Irrigated?
Id YES ❑ NO
Field Irrigated?
O YES ❑ NO
Field Irrigated?
ll YES O NO
T
p
m
v
o
U
d
Y
tN
m
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c
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OF
in
ft
ft
gal I
min
in
in
gal I
min
in
in
gal
min
in
in
gal
min
in
in
1
CL
46
0
6'6"
2
R
54
0.05
6'2"
3
4
PC
45
0
57'
5
R
37
0.05
5'3"
5,110
10.2
0.08
0.08
4,540
9.1
0.08
0.08
8,520
17
0.12
0.12
6 1
PC 1
35
0
62"
7
C
28
0
519"
8
PC
37
0
5'5"
4,091
8
0.07
0.07
3,636
7.2
0.07
0.07
6,818
13.6
0.09
0.09
9
R
60
0.2
6'4"
10
R
1.9
11
PC
35
0
50"
121
C
1 28
0
4'8"
6,132
12
0.10
0.10
5,448
11
0.10
0.10
10,224
20
0.14
0.14
131
PC
1 32
0
6'0"
14
C
30
0
5'6"
5,110
10.2
0.08
0.08
4,540
1 9.1
0.08
0.08
8,520
17
1 0.12
0.12
15
C
28
0
6'5"
16
C
30
0
6'1"
17
R
48
2.3
610
18
C
46
0
4'4"
191
C
28
0
3'11"
6,132
12
0.10
0.10
5,448
11
0.10
0.10
10,224
20
0.14
0.14
20
C
24
0
5'5"
4,091
8
0.07
0.07
3,636
7.2
0.07
0.07
6,818
13.6
0.09
0.09
21
PC
28
0
5'9"
4,091
8
0.07
0.07
3,636
7.2
0.07
0.07
6,818
13.6
0.09
0.09
22
C
34
0
1 67'
23
CL
31
0
63"
24
CL
34
0
51111,
251
R
41
0.1
57'
3,066
6.1
0.05
0.05
2,724
5.5
0.05
0.05
5,112
10.2
0.07
0.07
26
R
53
2
6'4"
27
R
54
0.1
5'0"
28
PC
48
0
4'4"
8,176
16.08
0.13
0.13
7,264
14.62
0.13
0.13
13,632
26.8
0.19
0.19
29
CL
42
0
63"
30
CL
30
0
6'1"
31
Monthly Loading:
45,999
0.74
40,872
0.75
76,686
1.05
0
0.00
12 Month Floating Total (in):
10 in
6.89
9.57

FORM: NDAR-1 05-16 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page _ r of
Permit No.: WQ0002648
Facility Name: Seagrove -Utah Metropolitan Water District WWTP
County: Randolph
Month: December
Year: 2023
Did irrigation occur
Field Name:
13
Field Name:
14
Field Name:
15
Field Name:
16
this facility?
Area (acres):
2.2
Area (acres):
2.1
Area (acres):
3.4
Area (acres):
3.8
at
Cover Crop:
p�
Grass
Cover p�
Grass
Cover p:
Grass
Cover p:
Grass
I] YES ❑ No
Hourly Rate (in):
Hourly Rate (in):
Hourly Rate (in):
Hourly Rate (in):
Annual Rate (in):
38.4
Annual Rate (in):
38.4
Annual Rate (in):
38.4
Annual Rate (in):
38.4
Weather
Freeboard
Field Irrigated?
U YES ❑ NO
Field Irrigated?
2 YES ❑ NO
Field Irrigated?
F1 YES ❑ No
Field Irrigated?
❑ YES ❑ NO
p
❑T
cm
aroi
m
a)
a
i-
o
d
N
°'
a n
0. ro
ro
-
o
E
v
i
E
.E
o
E
Q
romo
>. C
ro
E
Xo ro
J
E.N
O O
�
(D�
rn
O
J
E
7 �`
E
ro
E .2
a
Oo
� a
E
>
ro2U
ON
E0 T rnc
=
m vO
°F
in
ft
ft
gal
min
in
in
gal
min
in
in
gal
min
in
in
gal
min
in
in
1
CL
46
0
6'6"
2
R
54
0.05
67'
3
4
PC
45
0
57'
5
R
37
0.05
5'3"
4,540
9.1
0.08
0.08
4,540
9.1
0.08
0.08
10,790
21.6
0.12
0.12
11,930
23.9
0.12
0.12
6
PC
35
0
67'
7
C
28
0
519"
8
PC
37
0
515"
3,636
7.2
0.06
0.06
3,636
7.2
0.06
0.06
8,636
17.2
0.09
0.09
9,545
19.1
0.09
0.09
9
R
60
0.2
6'4"
10
R
1.9
11
PC
35
0
5'0"
12
C
28
0
4'8"
5,448
11
0.09
0.09
5,448
11
0.10
0.10
12,948
26
0.14
0.14
14,316
28.6
0.14
0.14
13
PC
32
0
60"
14
C
30
0
5'6"
1 4,540
9.1
0.08
0.08
4,540
9.1
0.08
0.08
10,790
21.6
0.12
0.12
11,930
23.9
0.12
0.12
151
C
28
0
6'5"
161
C
30
0
6'1"
17
R
48
2.3
5-10
18
C
46
0
4'4"
19
C
28
0
3'11"
5,448
11
0.09
0.09
5,448
11
0.10
0.10
12,948
26
0.14
0.14
14,316
28.6
0.14
0.14
20
C
24
0
65"
3,636
7.2
0.06
0.06
3,636
7.2
0.06
0.06
8,636
17.2
0.09
0.09
9,545
19.1
0.09
0.09
21
PC
28
0
59"
3,636
7.2
0.06
0.06
3,636
7.2
0.06
0.06
8,636
17.2
0.09
0.09
9,545
19.1
0.09
0.09
221
C
1 34
0
67"
23
CL
31
0
6'3"
24
CL
34
0
5'11"
25
R
41
0.1
57'
2,724
5.5
0.05
0.05
2,724
5.5
0.05
0.05
6,474
13
0.07
0.07
7,158
14.34
0.07
0.07
26
R
53
2
64"
27
R
54
0.1
60"
281
PC
1 48
0
44"
7,264
14.62
0.12
0.12
7,264
14.62
0.13
1 0.13
22,712
34.62
0.25
0.25
19,088
38.18
0.19
0.19
29
CL
42
0
6'3"
30
CL
30
0
61"
31
Monthly Loading:
40,872
0.68
40,872
0.72
102,570
M
.11
107,373
1.04
12 Month Floating Total (in):
6.97
6.81
E9.70
9.53

FORM: NDAR-1 05-16 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page !F of S
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?
F] Compliant ❑ Non -Compliant
ED Compliant ❑ Non -Compliant
D Compliant ❑ Non -Compliant
El Compliant ❑ Non -Compliant
(�] 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 necessarv.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Larry T. Chilton
Permittee:
Seagrove Ulah Metropolitan
Certification No.: WW,SI
Signing Official: Michael T. Walker
Grade: 2 Phone Number: 336-302-3782
Signing Officials Title: Secretary
Has the ORC changed since the previous NDAR-1? ❑ Yes IJ No
Phone Number: 336-873-7738 Permit Exp.: 4/30/27
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 05-16 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page Y of 5-
Did the application rates exceed the limits in Attachment B of your permit?
P] Compliant ❑ Non -Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites?
I] Compliant ❑ Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit?
F] Compliant ❑ Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site?
O Compliant ❑ Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
0 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: Larry T. Chilton Permittee:
Seagrove Ulah Metropolitan
Certification No.: WW,SI Signing Official: Michael T. Walker
Grade: 2 Phone Number: 336-302-3782 Signing Official's Title: Secretary
Has the ORC changed since the previous NDAR-1? ❑ Yes O No Phone Number: 336-873-7738 Permit Exp.: 4/30/27
Signature Date J
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 05-16 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page 3 of S
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?
1A Compliant ❑ Non -Compliant
E Compliant ❑ Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit? 2 Compliant ❑ Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site? M Compliant ❑ Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? FYI 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 necessarv.
Operator in Responsible Charge (ORC) Certification Permittee Certification
ORC: Larry T. Chilton Permittee:
Seagrove Ulah Metropolitan
Certification No.: WW,SI Signing Official: Michael T. Walker
Grade: 2 Phone Number: 336-302-3782 Signing Official's Title: Secretary
Has the ORC changed since the previous NDAR-1? ❑ Yes M No Phone Number: 336-873-7738 Permit Exp.: 4/30/27
1 , 1
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 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 05-16 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page ,� of $
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?
121 Compliant ❑ Non -Compliant
171 Compliant ❑ Non -Compliant
121 Compliant ❑ Non -Compliant
M Compliant ❑ Non -Compliant
F11 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: Larry T. Chilton
Permittee:
Seagrove Ulah Metropolitan
Certification No.: WW,SI
Signing Official: Michael T. Walker
Grade: 2 Phone Number: 336-302-3782
Signing Official's Title: Secretary
Has the ORC changed since the previous NDAR-1? ❑ Yes Cl No
Phone Number: 336-873-7738 Permit Exp.: 4/30/27
di
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: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page i of f
Sampling Person(s) Certified Laboratories
Name: Russell Welch Name: Cameron Testing
Name: Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? ❑ Compliant 1-1 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.
Ve are out of compliance on our influent. We are permitted for 30,000gpd. We have seen an increase of flow into the plant due to a local truck stop closing, (Quick-Check/Hardees). This business had an On-
ite waste treatment system therefore we never saw their flow. Now that they have closed, travelers and truckers are using the Interstae Rest Stops more than ever. The flow from the two reststops are part of ou
ystem. The hope is that another owner will resume operations at this truck stop which should reduce our flow under our permitted allowance.
Operator in Responsible Charge (ORC) Certification Permittee Certification
ORC: Larry T. Chilton Permittee: Seagrove Ulah Metropolitan
Certification No.: WW, SI Signing Official: Michael T. Walker
Grade: 2 Phone Number: 336-302-3782 Signing Official's Title: Secretary
Has the ORC changed since the previous NDMR? ❑ Yes f11 No Phone Number: 336-873-7738 Permit Expiration: 4/30/2027
1'/ AVA Y C k. i �' We are out of complia
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