WQ0002648_Monitoring - 05-2024_20240723

Monitoring Report Submittal
Permit Number#* WQ0002648
Name of Facility:* Seagrove Ulah Metropolitan
Month: * May
Report Information
Type *
Revised - NDMR, NDAR-1, NDAR-2, NDMLR
Year:* 2024
Upload Document*
5-May 2024 Amended.pdf 2.8MB
PDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
Confirmation Email Address: * [e-mail]
Name of Submitter: * Larry T. Chilton
Signature:
v6t t tJ ry 641l-ew
Date of submittal: 7/23/2024
This will be filled in automatically
Initial Review
Reviewer: Wanda.Gerald

Is the project number correct?* WQ0002648
Is the monitoring report accepted?* Yes No
Regional Office* Winston-Salem
Reviewer: _anonymous
Review Date: 7/29/2024

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page I of
Permit No.: WQ0002648
Facility Name: Seagrove -Utah Metropolitan
County: Randolph
Month: May
Year: 2024
PPI: 001
Flow Measuring Point: 0 influent ❑ Effluent ❑ No flow generated
Parameter Monitoring Point: ❑ influent p Effluent ❑ Groundwater Lowering ❑ Surface Water
Parameter Code -►
50050
00310
00940
50060
31616
00610
00626
00620
00600
00400
00666
70300
00530
E W
a E
~
0
i= '
v c
p
0
3
o
LLco
to
0
O
v
'_
o
U
;
o N o
~ rY U
o
t
U. U
a
o
E
E
a
r d
M to
° y
F- 0 Z
::
Z
o
N Z
a
c
o a
f" p
a
d N
o o'o
F- �i rf1
y
0 00
F- ; v7
rn
24-hr
hrs
GPD
mglL
mglL
mglL
#1100 mL
mglL
mglL
mglL
mg1L
su
mglL
mg1L
mglL
1
06:30
8
35,600
1.47
7.12
2
06:15
8
37,700
1.78
7.14
3
06:15
8
47,800
1.19
7.01
4
47,800
5
47,800
6
06:30
8
42,000
0.99
7.09
7
06:30
8
39.300
1.41
7
8
06:30
8
42,700
1.69
7.12
9
06:30
8
47,200
1.07
6.99
10
06:30
8
31,100
1.48
7.03
11
31,100
12
03:45
8
20.400
2.03
7.24
13
06:30
8
40,400
1.67
7.19
14
06:30
8
90,300
1.83
7.2
15
06:30
8
43,500
0.99
7.01
16
06:30
8
34,900
1.44
1
7.08
17
06:30
8
51,000
1 1.71
7.18
18
11:00
8
19,600
0.51
7.23
19
19,600
20
06:30
8
34,300
1.77
7.2
21
06:30
8
32,000
1.52
7.17
22
06:30
8
31,900
1.38
7.11
23
06:30
8
37,300
9.48
1 1.96
<2
59.7
1 93.5
<1
94.4
7.22
7.98
10.7
24
06:30
8
32,150
1.79
7.19
251
32,150
26
03:15
8
33,300
1.9
7.11
27
06:30
4
20,200
1.75
7.04
28
06:30
8
33,900
1.81
7.22
29
06:30
8
34,800
1 1.33
7.19
30
06:30
8
38,700
1.64
7.13
31
06:30
8
31,700
1.52
7.1
Average:
37,490
9.48
1.52
1.00
59.70
93.50
0.00
94.40
7.98
10.70
Daily Maximum:
90,300
9.48
2.03
2.00
59.70
93.50
1.00
94.40
7.24
7.98
10,70
Daily Minimum:
19,600
9.48
0.51
2,00
59.70
93.50
1.00
94.40
6.99
7.98
10.70
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
Monllily
Monthly
1 Monthly
Monthly
5 X Week
Monthly
3 X Year
Monthly

FORM: NDAR-1 05-16 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page V of .-
Permit No.: WQ0002648
Facility Name: Seagrove -Utah Metropolitan Water District WWTP
County: Randolph
Month: May
Year: 2024
Did irrigation
Field Name:
1
Field Name:
2
Field Name:
3
Field Name:
4
occur
Area (acres):
2.1
Area (acres):
2
Area (acres):
2.1
Area (acres):
3.4
at this facility?
Cover Crop:Grass
Cover Crop:
P'
Grass
Cover Crop:
p�
Grass
Cover Crop:
P'
Grass
O 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?
O YES ONO
Field Irrigated?
121 YES ❑ No
Field Irrigated?
OO YES ❑ No
o
m
v
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v
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j=' E
rn
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E rn
Eov
mx B
J
°F
in
I ft
ft
gal
I min
In
In
gal
I min
in
I in
gal
I min
In
I In
gal
I min
in
I in
1
PC
58
0
57'
21
C
57
0
4'10"
8,750
17.5
0.15
0.15
8,750
17.5
0.16
0.16
7,952
15.9
0.14
0.14
13,524
26.9
0.15
0.15
3
PC
60
0.4
6'5"
4
5
6
R
68
1 0.3
4'8"
1 7,500
1 15
0.13
1 0.13
7,500
1 15
0.14
1 0.14
6,816
13.6
0.12
0.12
11,592
23
0.13
0.13
7
PC
64
0
5'9"
8
R
67
0.2
5'4"
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
9
R
65
0.3
6'1"
10
PC
58
0
5'8"
2,600
5
0.04
0.04
2,500
5
0.05
0.05
2,272
7.5
0.04
0.04
3,864
7.7
0.04
0.04
11
12
C
59
0
5'9"
13
CL
50
0
515"
5,000
10
0.09
1 0.09
5,000
10
0.09
0.09
4,545
9
0.08
0.08
7,727
15.4
0.08
0.08
Uj
R
1 60
1.6
1 65"
15
CL
60
0
5'3"
16
PC
58
0
4'10"
8,750
17.5
0.15
0.16
8,760
17.5
0.16
0.16
7,952
15.9
0.14
1 0.14
13,524
26.9
0.15
0.15
17
R
60
0.2
6'5"
18
R
78
5111"
19
20
PC
1 56
1 0
5'4"
21
C
57
0
410"
7,500
15
0.13
0.13
7,500
15
0.14
0.14
6,816
13.6
0.12
0.12
11,592
23
0.13
0.13
22
PC
60
0
6'5"
23
R
65
0.2
6'1"
24
CL
68
0
5'8"
1 5,000
1 10
0.09
0.09
5,000
1 10
0.09
0.09
4,545
9
0.08
0.08
7,727
1 15.4
0.08
1 0.08
25
26
R
1 69
0.5
5'9"
27
R
68
0.3
5'4"
28
C
66
0
5'0"
5,000
10
0.09
0.09
5,000
10
0.09
0.09
4,545
9
0.08
0.08 1
7,727
15.4
0.08
0.08
29
PC
59
0
6'0"
30
C
56
0
68"
311
PC
54
0
5'4"
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
Monthly Loading:
j62s0W0.11
1.10
62,500
1.15
66,803
1.00
96,597
1.05
12 Month Floating Total (in):
9.83
10.38
9.12
9.46

FORM: NDAR-1 05-16 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page _3-- of 5-
Permit No.: W00002648
Facility Name: Seagrove -Utah Metropolitan Water District WWTP
County: Randolph
Month: May
Year: 2024
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:
P�
Grass
Cover P'
Grass
Cover P�
Grass
Cover P'
Grass
121 YES O 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
Froeboard
Field Irrigated?
❑O YES ❑ NO
Field Irrigated?
❑O YES ❑ NO
Field Irrigated?
121 YES O No
Field Irrigated?
❑ YES p No
T
w
o
3
Iv
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rn
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a
oa
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J
°� m
=-
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w 2
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rn
i=-
t
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OF
in
ft
I ft
I gal I
min
in
I In
gal
I min
in
I in
gal
I min
In
I In
gal
I min
In
I in
1
PC
58
0
57'
2
C
57
0
410"
6,356
12.8
0.11
0.11
11.130
22.2
0.16
0.16
13,524
26.9
0.18
0.18
3
PC
60
0.4
6'5"
4
5
6
R
68
0.3
4'8"
5,448
11
0.09
0.09
9,540
1 19
0.14
1 0.14
9,540
1 19
0.13
1 0.13
7
1 PC
64
0
519"
B
R
67
0.2
5'4"
4,540
9.1
0.08
0.08
7,950
15.9
0.11
0.11
9,660
19.3
0.13
0.13
9
R
65
0.3
6'1"
10
PC
58
0
5'8"
1,816
3.6
0.03
0,03
3,180
6.4
0.05
0.05
3,864
7.7
0.05
0.05
11
12
C
59
0
5'9"
131
CL
50
0
5'5"
1 9,540
1 19
0.16
1 0.16
6.363
12.7
0.09
0.09
6,363
12.7
1 0.09
0.09
14
R
60
1.6
6'5"
15
CL
60
0
5'3"
16
PC
58
0
4'10"
6,356
12.8
0.11
0.11
11,130
22.2
0.16
0.16
13,524
26.9
0.18
0.18
17
R
60
0.2
6'5"
18
R
78
1
5111.1
19
20
PC
56
0
5'4"
21
C
57
0
4'10"
6.448
11
0.09
0.09
9,540
19
0.14
0.14
9,540
19
0.13
0.13
22
PC
60
0
6'5"
23
R
65
0.2
6'1"
24
CL
68
0
5'8"
9,540
19
0.16
0.16
6,363
12.7
0.09
0.09
6,363
1 12.7
0.09
0.09
26
26
R
69
0.5
5'9"
27
R
68
0.3
5'4"
28
C
66
0
5'0"
9.640
19
0.16
0.16
6,363
12.7
0.09
0.09
6,363
12.7
0.09
0.09
29
PC
59
0
6'0"
30
C
1 56
1 0
1 5'8"
1311
PC
1 54
1 0
1 5'4"
1
4,540
1 9.1
1 0.08
0.08
7,950
15.9
0.11
0.11
9,660
19.3
0.13
0.13
Monthly Loading:
63,124
1.06
79,509
1.13
88,401
1.21
0
0.00
12 Month Floating Total (in):
7.34
10.12
11.74

FORM: NDAR-1 05-16 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page __V_ of j_
Permit No.: WQ0002648
Facility Name: Seagrove -Utah Metropolitan Water District WWTP
county: Randolph
Month: May
Year: 2024
Did irrigation
Field Name:
9
Field Name:
10
Field Name:
11
Field Name:
12
occur
Area (acres):
2.3
Area (acres):
2
Area (acres):
2.7
Area (acres):
2
at this facility?
Cover Crop:Grass
Cover Crop:
p'
Grass
Cover Crop:
p�
Grass
Cover Crop:
p�
Grass
❑O 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?
O YES ❑ No
Field Irrigated?
2 YES ❑ No
Field Irrigated?
❑ YES El No
n
v
'ad
m
o
a
y ar
a s
i
N
Nv
E
v
E
E
rn
E
E-
2
E
t
E
c
y
Ew
�
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M
❑y J
c�'R
J
4) V
CL
v
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',
❑
J=E
EE` vJrn
ocry
OF
in
it
ft
gal
min
in
In
gal
min
in
In
gal
min
In
in
gal
min
in
in
1
PC
58
0
1 5'2"
2
C
57
0
4'10"
7.164
14.04
0.11
0.11
6,356
12.8
0.12
0.12
11,928
23.4
0.16
0.16
3
PC
60
0.4
6'5"
4
5
61
R
68
0.3
4'8"
6,132
12
0.10
0.10
5,448
11
0.10
0.10
10,224
1 20
0.14
0.14
7
PC
64
0
1 5.9"
8
R
67
0.2
5'4"
5,110
10.2
0.08
0.08
4,540
9.1
0.08
0.08
8,520
17
0.12
0.12
9
R
65
0.3
61"
10
PC
58
0
5'8"
2.044
4.1
0.03
0.03
1,816
3.6
0.03
0.03
3,408
6.8
0.05
0.05
11
121
C
1 59
0
5.9"
13
CL
50
0
5'5"
4,091
1 8
0.07
1 0.07
3,636
7.2
0.07
0.07
1 6,818
13.6
0.09
0.09
14
R
60
1.6
6'5"
15
CL
60
0
5'3"
16
PC
58
0
4'10"
7,154
14.04
0.11
0.11
6.356
1 12.8
0.12
0.12
11,928
23.4
0.16
0.16
17
R
60
0.2
6'5"
181
R
1 78
5-11"
19
20
PC
56
0
5'4"
21
C
57
0
4'10"
6,132
12
0.10
0.10
5,448
11
0.10
0.10
10,224
20
0.14
0.14
22
PC
60
0
6'5"
23
R
65
0.2
6'1"
24
CL
68
0
5'8"1
1 4,091
8
0.07
1 0.07
3,636
7.2
0.07
0.07
6,818
13.6
0.09
0.09
25
26
R
69
0.5
5'9"
27
R
68
0.3
5'4"
28
C
66
0
510"
4,091
8
0.07
0.07
3,636
1 7.2
0.07
1 0.07
6.818
13.6
0.09
0.09
291
PC
59
0
6'0"
301
C
56
0
5'8"
311
PC
1 54
1 0
5'4"
5,110
10.2
0.08
0.08
4,540
9.1
0.08
0.08
8,520
17
0.12
0.12
Monthly Loading:
51,109
0.82
45,412
0.84
85,206
1.16
0
0.00
12 Month Floating Total (in):
11.01
7.40
10.48

FORM: NDAR-1 05-16 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page - ofS-
Permit No.: WQ0002648
Facility Name: Seagrove -Utah Metropolitan Water District WWTP
County: Randolph
Month: May
Year: 2024
Did irrigation occur
Field Name:
13
Field Name:
14
Field Name:
15
Field Name:
16
Area (acres):
2.2
Area (acres):
2.1
Area (acres):
3.4
Area (acres):
3.8
at this facility?
Cover Crop -,Grass
Cover Crop:
P�
Grass
Cover Crop:
p'
Grass
Cover Crop:
p�
Grass
0 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?
P YES ❑ NO
Field Irrigated?
R1 YES ❑ NO
Field Irrigated?
O YES ❑ NO
Field Irrigated?
0 YES ❑ NO
d
d
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v
E
~
>. vc
w m
J`Z°E
EE _Toa.rno
o m
c.i
OF
In
ft
ft
I gal
I min
In
I In
gal
I min
in
In
gal
I min
in
I In
gal
I min
In
I in
1
PC
58
0
57'
2
C
57
0
4'10"
6,356
12.8
0.11
0.11
6,356
12.8
0.11
0.11
20,564
30.3
0.22
0.22
16,702
33.4
0.16
0.16
3
PC
60
0.4
6'5"
4
5
6
R
68
0.3
4'8"
1 5,448
1 11
0.09
1 0.09
5,448
1 11
0.10
0.10
12,948
1 26
0.14
1 0.14
14,316
1 28.6
0.14
1 0.14
7
PC
64
0
519"
8
R
67
0.2
5'4"
4,540
9.1
0.08
0.08
4,640
9.1
0.08
0.08
10,790
21.6
0.12
0.12
11,930
23.9
0.12
0.12
9
R
65
0.3
6'1"
10
PC
58
0
68"
1,816
3.6
0.03
0.03
1,816
3.6
0.03
0.03
4,316
8.6
0.05
0.05 1
4,772
9.5
0.05
0.05
11
12
C
59
0
69"
13
CL
50
0
5'5"
3,636
7.2
0.06
0.06
3,636
1 7.2
0.06
1 0.06
8,636
17.2
0.09
0.09
9,545
19.1
0.09
0.09
14
R
60
1.6
6'5"
15
CL
60
0
5'3"
16
PC
58
0
4'10"
6,356
12.8
0.11
0.11
6,356
12.8
0.11
0.11
20,554
30.3
0.22
0.22 1
16,702
33.4
0.16
0.16
17
R
60
0.2
6'5"
18
R
78
5'11"
19
20
PC
56
0
64"
21
C
57
0
4'10"
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
22
PC
60
0
6'5"
231
R
65
0.2
6'1"
241
CL
68
0
68"
3,636
7.2
0.06
1 0.06
3,636
1 7.2
0.06
0.06
8,636
17.2
0.09
0.09
9,545
19.1
0.09
0.09
25
26
R
69
0.5
69"
27
R
68
0.3
5'4"
28
C
66
0
510"
3,636
7.2
0.06
0.06
3.636
7.2
0.06
0.06
8,636
17.2
0.09
0.09
9,645
19.1
0.09
0.09
29
PC
59
0
6'0"
30
C
56
0
5'8"
31
PC
54
0
T4"
4,540
9.1
0.08
0.08
4,540
9.1
1 0.08
0.08
10,790
21.6
0.12
0.12
11,930
23.9
0.12
0.12
Monthly Loading:
45,412
0.76
45,412
0.80
118,808
1.29
119,303
1.16
12 Month Floating Total (in):
7.55
7.43
11.88
10.43

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page/_of_-
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? D Compliant 0 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.
We are out of compliance on our influent. We are permitted for 30,000gpd. The local truck stop that had been closed has reopened which helped us stay below our
can think of is that due to increased travel on the Interstate more people are using the Sate owned reststops. Also. I&I issues, there have been some heavy rains.
Operator in Responsible Charge (ORC) Certification I Permittee Certification I
ORC: Larry T. Chilton
Certification No.: WW, SI /069/ / 21l*.2 q
Grade: 2 Phone Number: 336-302-3782
Has the ORC changed since the previous NDMR? ❑ Yes U No
✓% Z�_ 6 4-etc
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
Permittee: Seagrove Ulan Metropolitan
Signing Official: Michael T. Walker
Signing Official's Title: Secretary
Phone Number: 336-873-7738 Permit Expiration: 4/30/2027
,!�)-2-4�
We are out of corn lie
Signature Date
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.
Mall Original and Two Copies to:
Division of Water Resources
Information Processing Unit
1617 Mall Service Center
Raleigh, North Carolina 27699-1617

FORM: NDAR-1 05-16 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page a 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?
O Compliant ❑ Non -Compliant
121 Compliant ❑ Non -Compliant
O Compliant ❑ Non -Compliant
❑O Compliant ❑ Nan -Compliant
171 Compliant ❑ Nan -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
Operator in Responsible Charge (ORC) Certification
Perrmittee 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 P] No
Phone Number: 336-873-7738 Permit Exp.: 4/30/27
Ctr�
Signature Date
Signature Date
By this signature, I certify [hat this report Is accurrale and complete to the best of my knowledge.
I certify, under penally of law, that [his document and all attachments were prepared under my direclion 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, [rue, 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
Infortmation 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,1
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?
I] Compliant
❑ Non -Compliant
FA Compliant
❑ Non-Compllant
F] Compliant
❑ Non -Compliant
21 Compliant
❑ Non -Compliant
Fal 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
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Larry T. Chilton
Permittee:
Seagrove Ulah Metropolitan
Certification No.: WW,SI /,ajWW 104-at" ;n,734/
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 ONO
Phone Number: 336-873-7738 Permit Exp.: 4/30/27
b- o
(f:)f�-
Signature Date
Signature Date
By this signature, I certify that this report Is accurrale 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 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 submilling 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 _,5
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?
Compliant O Non -Compliant
I] Compliant ❑ Non -Compliant
M Compliant ❑ Non -Compliant
Compliant ❑ Non -Compliant
2 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
actions) taken. Attach additional sheets If necessary.
Operator In Responsible Charge (ORC) Certificatlon
Pernnittee Certification
ORC: Larry T. Chilton
Permittee:
Seagrove Ulah Metropolitan
Certification No.: WW,SI /Q(,$ / ;?102314
Signing Official: Michael T. Walker
,
Grade: 2 Phone Number: 336-302-3782
Signing Official's Title: Secretary
Has the ORC changed since the previous NDARA? ❑ Yes O No
Phone Number: 336-873-7738 Permit Exp.: 4/30/27
3':2IV
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 dlroction 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, [rue, 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
Infortnation Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

FORM: NDAR-1 05-16 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page a of f
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?
RI Compliant ❑ Non -Compliant
Compliant ❑ Non -Compliant
IJ Compliant ❑ Non -Compliant
O Compliant ❑ Non -Compliant
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
dUtlurlt5f WACrr. /1UCILAI 6UUmU1141 011VCtA 11
Operator In Responsible Charge (ORC) Certification
Permittee Certification
ORC: Larry T. Chilton
Permittee:
Seagrove Ulah Metropolitan
Certification No.: WW,SI / 0 6 is / P.T;Z"
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
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 qua!ifled personnel properly gathered and evaluated Ilia information submitted. Based on my
Inquiry of the person or persons who manage the system, or those persons directly responsible for gathering Ilia information, the
Information submitted Is, to ilia 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