WQ0002005_Monitoring - 02-2024_20240326

Monitoring Report Submittal
Permit Number#*
Name of Facility:*
Month: * February
WQ0002005
House of Raeford Rosehill
Report Information
Type *
NDMR, NDAR-1, NDAR-2, NDMLR
Confirmation Email Address:
Name of Submitter: *
Signature:
Date of submittal:
Initial Review
Reviewer:
Year:* 2024
Upload Document*
NDMR, NDAR-1, NDMLR February 2024.pdf 871.92KB
PDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
[e-mail]
Mason Drew
44,460dP)kNW
Wanda.Gerald
3/26/2024
This will be filled in automatically

Is the project number correct?* W00002005
Is the monitoring report accepted?* Yes NO
Regional Office* Wilmington
Reviewer: _anonymous
Review Date: 7/31/2024

FORM; NQMR 05-16 NON -DISCHARGE MONITORING REPORT (NOMR) Page of 6'
Permit No.: W00002005
Facility Name: House of Raeford - Rose Hill WWTF
County: Duplin
Month: February
Year. 2024
PPI: 001
Plow Measuring Point: ❑ lnnuent E Effluent ❑ No now generated
Parameter Monitoring Point: ❑ tr kmIt 0 went ❑ Growdwater torvft ❑ Surface water
Parameter Code
60090
00310
WM
MM
00940
50060
3"16
00610
WIM
D0820
00600
00400
onu
WQ09C
71300
00530
w
O
Oc
V�
Q
.Y
c
O�
V
9
E
24-hr
hrs
OPD
m
m
#MOO mL
m
mgIL
su
mq&
rnqIL
nIIII&
mqIL
1
07:00
8
6KOW
O.D4
7.67
2
07:00
8
280,000
131
0.12
821
71.7
7U
<0.02
76.64
7.8
12.7
37.4
103
3
08:00
2
0
4
08:00
2
310,000
5
07:30
7
600,000
0.14
8
6
07:30
8
610,000
0.07
7.79
7
07:00
8
590,000
0.12
7.91
8
07:30
8
600,000
0.07
7.79
9
07:30
2:00:58
310,000
112
142
0.11
1120
70.3
77
0.21
7723
8.07
5.83
37.4
723
127
10
08:00
2
1 0
11
08:00
2
320,000
121
07:30
7
590,000
0.05
T9
13
07:30
8
610,000
0.02
7.77
14
07:00
8
810,000
0.1
7.93
15
07:00
8
620,000
0.18
8.05
16
07:30
8
320,000
0.08
8
17
08:00
2
0
181
08:00
2
290,000
19
07:00
8
43O,000
0.06
7.94
20
07:30
7
020.000
0.02
8.01
21
07:30
8
6110,000
0.11
7.93
22
07:00
8
600,000
0.09
7.98
23
07:30
8
340,000
0.06
7.9
24
08:00
2
0
25
08:00
2
360,000
26
07:30
8
600,000
0.06
7.91
27
07:30
8
590,000
0.09
7.93
28
07:00
8
6201000
0.08
7.85
291
07:30
8
6001000
0.12
7.79
30
311
Average:
442,414
121.50
142.60
0.09
958.92
71.00
76.75
0.11
76.94
9,27
37.40
723.00
115.00
Daily Maximum:
63Q000
131.00
142.00
0.18
1,120.00
71.70
77.00
0.21
77.23
8.07
12.70
37.40
723.00
127.00
Daily Minimum:
0
112.00
142.00
0.02
821.00
70.30
76.50
0.02
78.84
7.67
5.83
37.40
723.00
103.00
SampAnp Type:
Recorder
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Monthly Umlt:
800000
Daily Limit:
Sample Frequency:j
Condrujotu
1 2 X Month
Mrually
Annually
3 X YSW
5 X Week
2 X Month
2 X Monte
2 X Mordh
2 X Month
2 X Month
5 X Week
2 X Month
2 X Month
3 X Yaar
2 X Month

Facility Name: House of Raeford - Rose Hill WWTF

FORM: NDMR 05-16
NON -DISCHARGE MONITORING REPORT (NDMR)
Page 'g, of g
Sampling Person(s)
Name: Jay Baker
Name:
Name: Enviromental Chemist
Name:
Certified Laboratories
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? O comptont ❑ pliant
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
tirtiur)ts) odnon. madur duuniundr srntcra rr
Operator In Responsible Charge (ORC) Certification
Permittee Certification
ORC: Joseph Teachey
Permtttee: House of Raeford
Certification No.: 14930
Signing Official: Nicole Reynolds
Grade: SI Phone Number: [phone]
Signing Official's Title: Plant Manager
Has the ORC changed since the previous NDMR? ❑ Yes R1 No
Phone Number. [phone] Permit Expiration: 10/31/2031
f
Zy
Signature D to
Signatur Date
By this signature, I certtfy that this report is accurate and complete to the best of my knowledge.
i cerili�, under penalty of law, that this document and 0 attadxnerts were prepared under my direction of supervision in
accordance YMh a system designed to assure that all qualified personnet 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
gadwring the Information, the information submitted is, to the best of my krwvAedge and belief, true, accurate, and complete. I am
aware that there are significant penalties for submitting false Information, inducting the posslb ilty of fines and imprisonment for
krtowtng violations.
Mall Original and Two Copies to:
Division of Water Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

WIN -
FORM: NDMLR 10-13 NON -DISCHARGE MASS LOADING REPORT (NDMLR) Page
l of 5
Permit No.: W00002005
Facility Name: House of Raeford Farms, Inc.
Cowry: Duplin
Month: February
Year: 2024
Field Name:
L1
Field Name:
L2
Field Name:
L3
Field Name:
L4
Field Name:
L5
Area (acres):
12.04
Ana (acres):
12.04
Area (acres):
12.04
Ana (acres):
12.04
Area (acres):
10.52
Cover Crop:
Cover Crop:
Cover Crop:
Cover Crop:
Cover Crop. -
Load Type:
PAN
Load Type:
PAN
Load Type:
PAN
Load Type:
PAN
Load Type:
PAN
Field Loaded?
-, �: YES ❑ No
FiNd Lo~l
0 yes ❑ w
Field Loaded?
2 YES ❑ No
FNid Loaded?
❑ YES M No
Field Loaded?
E ves ❑ No
o
>
a
�<
a
a
''a
•
�Z
<
<
�
ri
�
•
a
>
as
a.
a
a
•�
�Z
>
�
<
i
�
E•
0
<
a
a
a
`
o
• �
vEy
a
Month
gal
m
Ibslac
Ibs/ac
nigAL
ibslac
Ibalac
gal
m
flWac
Ibs/ac
mWt
UW&c
UWac
gal
m L
Ibalac
lbslac
January
468,000
36.3
11.8
11.8
567,000
36.3
14.3
14-3
229,500
36.3
5.8
5.8
536,500
36.3
13.5
13.5
279,000
36.3
8.0
&0
Fe"ry
468,000
37.4
12.1
23.9
409,6W
37.4
10.6
24.9
882,000
37.4
22.8
28.5
477.000
37.4
12.4
25.8
418,500
37.4
12.4
20.4
March
436,500
30.35
9.2
33.1
673,200
30.35
14.2
39.0
630,000
30.35
13.2
41.9
548,300
30,35
11.5
37.3
472,500
30.35
11.4
31.8
April
544,500
34.45
13.0
46.1
929,700
34.45
22.2
61.2
369,000
34.45
8.8
50.7
531,000
34,45
12 7
50.0
578,700
34.45
15.8
47.6
May
747,000
29.6
16.3
61.4
5W,100
29.6
14.0
75.2
469,800
29.6
9.6
60.3
488,000
29.6
10.0
59.9
477,000
29.6
11.2
58.8
June
521,100
26.8
9.7
71.1
486,100
26.8
9.0
84.2
639,000
26.8
11.9
72.2
414,900
26.8
7.1
67.8
512,100
26.8
10.9
69.7
July
423,000
22.1
6.5
77.5
805,5W
22.1
12.3
96.6
864,900
22.1
13.2
85.4
747,900
22.1
11.4
79.1
431,100
22.1
7.6
77.2
August
270,000
22,95
4.3
81.8
522,9W
22.95
8.3
104.9
715,500
22.95
11.4
96.8
554,400
22.95
8.6
87.9
868,500
22.95
15.8
93.0
September
1,035,000
15.75
11.3
93.1
873,000
15.75
9.5
114.4
562,600
15.75
6.1
102.9
0
1 15.75
0.0
87.9
540,000
15.75
8.7
99.8
October
769,500
31.2
16.6
109.7
522,000
31.2
11.3
125.7
805,500
31.2
17.4
120.3
405,000
31.2
8.8
96.7
810,000
31.2
20.0
119.8
November
750,500
34.05
17.9
127.7
733,500
34.05
17.3
143.0
738,000
34.05
17.4
137.7
882fl00
34.05
20.8
117.5
652,500
34.05
17.6
137.4
December 774,000 35.8
12 Month Floating PAN Load
(lbe/aclyr):
19.2
i46.9
146.9
661
35.8
16.4
159.4
300.00
159A 585,000
35.8
14.5
152.2
300.00
152.2
387
36.8
9.6
127.1
300.00
127.1
531,000
35.8
15.1
152.5
300.00
152.5
Annual PAN Load Limit
Ibsl r):
300

FORM: NDMLR 10-13 NON -DISCHARGE MASS LOADING REPORT (NDMLR) Page 2 of
Permit No.: W00002005
Facility Name: House of Raeford Farms, Inc.
County: Duplin
Month: February
Year: 2024
Field Name:
L6
field Name:
L7
Field Name:
L8
Field Name:
L9
Fuld Name:
L10
Area (acres):
8.66
Area (acres):
12.04
Area (acres):
12.04
Am (acres):
12.04
Area (acres):
10.52
Cover Crop:
Cover Crop:
Cover Crop:
Cover Crop:
Cover Crop:
Load Type:
PAN
Load Type:
PAN
Load Type:
PAN
Load Type:
PAN
Load Type:
PAN
Field Loaded?
C YES ❑ No
Field Loaded?l
YES ❑ No
Field Loaded?
:1] YES ❑ No
Reid Loaded?
D YES No
Field Loaded?
❑ YES [ NO
3.
C.
°
>
e
a
�oc
o
U
a
a
v
s
t�
c�
�
a
>
a
n
r$
>
z
>
r
<
>
e
U
0.
c
o
E a
Month
gal
mg1L
lbslac
Ibslac
gal
rnq1L
Ibslac
lbstac
gal
mg1L
Ibalac
Ibs/ac
9W
mg&
ibslac
lbslsC
al
m91L
Ibalac
Ibelac
January
378,000
36.3
13.2
13.2
234,000
36.3
5.9
5.9
526,500
36.3
13.2
13.2
472,500
36.3
11.9
11.9
382,500
36.3
11.0
11.0
February
342,000
37.4
12.3
25.5
571,500
37.4
14.8
20.7
634,500
37.4
16.4
29.7
787,500
37.4
20.4
32.3
382,500
37.4
11.3
22.3
March
305,100
30.35
8.9
34.5
504,000
30.35
10.6
31.3
741,600
30.35
15.6
45.3
634,500
30.35
13.3
45.6
604,800
30.35
14.6
36.9
April
398,700
34.45
13.2
47.7
822,600
34.45
19.6
$0.9
565,200
34.45
13.5
58.8
355,500
34.45
8.5
54.1
742,500
34.45
20.3
57.2
May
314,100
31.4
9.5
57.2
790,200
31.4
17.2
68.1
768,600
31.4
16.7
75.5
598,600
31.4
13.0
1 67.1
319,500
31.4
8.0
65.1
June
345,600
26.8
8.9
66.1
591,300
1 26.8
11.0
79.1
493,200
26.8
9.2
84.6
266,400
26.8
4.9
72.1
880,200
26.8
18.7
83.8
July
333,000
22.1
71
73.2
774,000
22.1
11.8
90.9
731,700
22.1
11.2
95.8
612,000
22.1
9.4
81.4
639,000
22.1
11.2
95.0
August
678,600
22.95
15.0
88.2
W7,600
22.95
8.1
99.0
423,000
22.95
6.7
102.6
487,800
22.95
7.8
89.2
337,500
22.95
6.1
101.2
September 1
643,500
15.75
9.8
97.9
886,500
15,75
9.7
108.7
355,500
15.75
1 3.9
106.4
472,500
1 15.75
5.2
94.3
0
15.75
0.0
101.2
October
283,500
31.2
8.5
106.5
198,000
31.2
4.3
112.9
598,500
31.2
12.9
119.4
630,000
31.2
13.6
108.0
252,000
31.2
6.2
107.4
November
400,500
34.05
13.1
119.6
643,500
34.05
15.2
128.1
643,500
34.05
15.2
134.5
14.4
122.4
1,228,500
34.0533.2
140.6
December 527,400 35.8
12 Month Floating PAN Load137.8
(lbelaclyr):Annual PAN Load Limit
(lbslactyr):
18.2
137.8
773.100 35.8
19.2
147.3
300A0
147.3
733,500
35.8
18.2
152.7
300.Q0
152.7
iii
13.2
35.E
00.00
136.E
270,004
35.8
7.7
148.2
300.00
148.2

FORM: NDMLR 10-13 NON -DISCHARGE MASS LOADING REPORT (NDMLR) Page 3 of
Permft No.: WON02005 Facility Name: House of Raeford Farms, Inc. County: Duplin Month: February Year: 2024
Field Name: CP4 F M Name: 5A Field Name: 5AA Ffetd Name: 5B Field Name: 6A
Area (acres): 23 Area (acres): 6.9 Area (acres): 5.5 Arw (acres): 6.9 Area (acres): 16.02
Cover Crop: Cover Crop: Cover Crop: Cover Crop: Cover Crop:
Load Type: PAN Load Type: PAN Load Type: PAN Load Type: PAN Load Type: PAN
Field Loaded? ❑YES ❑ No field Loaded?l 0 YES ❑ No Field loaded? ❑ YES ❑ Na Field Loaded? 0 YES ❑ No Field Loaded? ❑ Yes ❑ No
z z
z
3 > t;a. a < Bz
< ' - > ci a E�mi > d > o ° a
U < o < 3 U
> > U < � Q
Month pal m Ibs/ac Jbs/ac Gal me& lbelac tbslac oaf m fbs/ac Ibs/ac 9M mgA. lbs/ac Ibslac gal mgfL Melee Ibslac
January 2,736,000 36.3 36.0 36.0 721,833 36.3 31.7 31.7 0 36.3 0.0 0.0 565,761 36.3 24.8 24.8 370,671 36.3 7.0 7.0
February 733,500 37.4 9.9 46.0 618,714 37.4 28.0 59.6 0 37.4 0.0 0.0 484,938 37.4 21.9 46.7 317,718 37.4 6.2 13.2
March 1,511,100 30.35 16.6 62.6 618,714 30.35 22.7 82.3 0 30.35 0.0 0.0 484.08 30.35 17.8 $4.5 317,718 30.35 5.0 18.2
Apri! 2,682,900 34.45 33.5 96.1 761,913 34.45 31.7 114.1 0 34.45 0.0 0.0 404,515 34.45 16.8 81.4 370,671 34.45 6.6 24.9
May 1,748,700 29.5 18.8 114.9 1 711,510 29.6 25.5 139.5 0 29.6 0.0 0.0 557,870 29.6 20.0 101.31 360,370 29.6 5.6 30.4
June 3,208,500 26.8 31.2 146.1 596,366 26.8 19.3 158A 0 26.8 0.0 0.0 499,757 26.8 16.2 117.5 306.242 26.8 4.3 34.7
July 2,979,000 22.1 23.9 169,9 855,847 22.1 22.9 181.7 0 22.1 0.0 0.0 670,799 22.1 17.9 135.4 439,489 22.1 5.1 39.7
Au usf 2,218,500 22.95 18.5 188.4 601,509 22.95 16.7 198.4 0 22.95 0.0 0.0 471,453 2.2.95 13.1 148.5 308,883 22.95 3.7 43.4
September 1,953,000 l5.75 11.2 199.5 608,391 15.75 11.6 210.0 0 15.75 0.0 0.0 476,847 15.75 9.1 157.6 312,417 15.75 2.6 46.0
October 1,750,500 31.2 19.8 219.3 402,153 31.2 15.2 225.1 D 31.2 0.0 0,0 316,201 31.2 11.9 169.5 206,511 31.2 3.4 49.3
November 2,893,500 34.05 35.7 255.1 393,569 34.05 16.2 241.3 0 34.05 0.0 0.0 306,473 34.05 12.7 182.2 202,103 34.05 3.6 52.9
December 2,439,000 35.8 31.7 288.7 603.248 35.8 26.1 267.4 0 35.8 0.0 0.0 472 16 35.8 20.5 1 202.6 309,776 35.8 5.8 58.7
12 Month Floating PAN Load
(lbs/aclyr): 2�'7 �7 4 0-0 202.8
587
Annual PAN Load Limft 300
( r): 300.00 3�.00 300.00

FORM; NOMLR 10-13 NON -DISCHARGE MASS LOADING REPORT (NDMLR) Page of
Permit No.: W00002005
Facility Name: House of Raeford Farms, Inc.
County: Duplin
Month: February
Year. 2024
Field Name:
6M
ield Namo:
Field Name:
Fh W Flame:
Field Name:
Area (acres):
6"
(acres);
Area (acres):
AM* (acres):
Area (acres):
Cover Crop:oves
Crop:
Cover Crop:
Covsr C Cop:
Cover Crop:
Load Type:
PALoad
Type:
Load Type:
Load Type:
Load Type:
Field
Loaded?
0 Yes
Loaded?
❑ ves
❑ No
Field
Loaded?
❑ Yes
❑ No
Field Loaded?
❑ YE5 ❑ No
Field
Loaded?
❑ Yes [] NO
P
a p
*3-
CL
Ft
a
�
J
E
m
�'
E j
>
>
>
G
> U
>
(�
Month
gal
n
lbslac
Ibslac
am
MgIL
Hwac
4XW%C
gal
motL
Ibslac
Ibalac
oni. MO&
lbsiac lbslac
gal
mgtL
Ibslac Ibslac
Janua
390,180
36.3
17.6
17.6
February
334,"0
37.4
15.6
33.2
March
334,440
30.35
12.6
45.8
April
390,180
34.45
16.7
62.6
May
384,600
29.6
14.2
76.7
June
322,360
26.8
10.8
87.5
July
462,620
22.1
12.7
100.2
A st
325,140
22.95
9.3
109.5
September
328,860
15.75
6.4
116.0
October
217,380
31.2
8.4 1
124.4
November 212,740 34.05
9.0 1
133.4
December 326,080 35.8
14,51
147.9
12 Month Floating PAN Load
{ibslaclyr):
147.9
0 0
0.0
0.0
0.0
Annual PAN Load Unit
Iba!
300

FORM: NDMLR 10-13 NOWDISCHARGE MASS LOADING REPORT (NDMLR) Page .3 of
Did the mass loading rates exceed the limits in Attachment B of your permit? '�-71 corrount ❑ lim-catrtpilant
If the fad-lity 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 Change (ORC) Cert1fication
ORC: Joseph Teachey
Cwdflcatlon Number: 14930
Grade: SI Phone Number:
Has the ORC changed since the previous NOMLR?
Perrntttee Certtflcatlon
Pefmlttse. House of Raeford
Signing Official:
Nicole Reynolds
[phone] Signing Offlciars TitMe: Plant Manager
❑ Yes ENO Phone No.: [phone] Permit Exp.: 10/31/31
r
2 " l/ /'4
S nature
I9 Date `, Signature Date
BY tW& slgn8t—. I certify mat this report is acwrcate and compete to th nest of my knowledge. I cdMy, under penalty of law, tbat fie doaNrwr old all attachmeMs were prepared under my direcom or supervision in
accordance wph a system designed to assure rw al quww personnel propody geow ad and evaluated the
knformstion submitted. Based on my ipuiry d the person or persona who manage me system, or those persons air
resporrs"e Tar yslherrig the irOwnetim, the Wormatlon aubnnlAW !s, to the best of my knowledge and belef, true,
accurate, and complete. I am aware that there are sigrdncant penalties for submitting false hformalion, i ncludkrg the
possibility of times and ImpriaonmeM for krwAV 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 APPUCATION REPORT (NDAR-1) Page of 5
Permit No.: WQ0002005
Facility Name: House of Raeford Farms, inc
County: Duplin
Month: February
Year. 2024
Did irrigation occur
at this facility?
❑ YES C) No
FMid No :
field Name:
5-AA
FiMd Naras:
5-B
Field Name:
6-A
Ar" (= M1.
6.9
Area (acres):
5.5
Amu (acnar
6.9
Area (acres):
16.2
C~ Crop:
Cover Crop:
C~Crop:
Cover Crop:
Houft Rate (Inj:
Hourly Rats (In):
Hourly Rile (inj:
Hourly Rate (in):
Annuel Rate (in):
80
Annual Rate (in):
60
Annual Rate fin):
80
Annual Rate (In):
50
Weather
Freeboard
Field Grigated?
❑ YES ❑ NO
Field Irrigated?
❑ YES ❑ NO
FMW krfigated?
❑ YES ❑ NO
Field Irrigated?
❑ YES ❑ No
(n
>
L
,E
as
J
�
=J
><
#
°F
In
R
R
V4
min
In
M
al
min
In
In
gal
min
In
In
gal
min
In
In
1
C
30
0.2
4.54
2
CL
41
0
4.41
103,119
300
0.55
0.11
80,823
3000.43
0.09
52,953
300
0.12
0.02
3
C
63
0
4.33
103,119
300
0.55
0.11
80,823
300
0.43
0.09
52,953
300
0.12
0.02
4
C
54
0
4.54
103,119
300
0.55
0.11
80,823
300
0.43
0.09
52,953
300
0.12
0.02
S
PC
31
0
4.83
61
C
35
0
4.91
7
C
31
0
4.75
8
C
26
0
4.5
9
CL
41
0
4.58
103,119
300
0.55
0.11
80,823
300
0.43
0.09
52,953
300
0.12
0.02
10
C
68
0
4.79
103,119
3M
0.55
0.11
80823
300
0.43
0.09
52,953
300
0.12 1
0.02
III
PC
70
0
5
121
R
60
0
4.96
131
CL
45
1.5
4.58
14
C
34
0
4.5
15
C
40
0
4.41
16
CL
48
1 0
1 4.37
17
C
65
1 0
1 4.66
18
C
48
1 0
1 4.83
103,119
300
0.55
0.11
90,823
300
0.43
0.09
52,953
300
0.12
0.02
19
C
31
0
1 5
20
C
27
0
1 5
21
C
28
0
1 5
22
C
35
0
4.71
23
CL
56
0
1 4.66
241
C
68
0.3
1 4.37
25
C
54
0
1 4.5
26
CL
42
fl
14.58
27
C
50
0
1 4.75
28
CL
59
0
14.83
29
CL
44
0.4
4.66
30
31
Monthly Loading:1
12 Month Floating Total (In):
618,714
3.30
32,79
0
0.00
7.06
484,938
2.59
21.32
317,718
0.72
23.68

FORM: NDAR-1 14-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page Z of S
Permit No.: 0I00••5
Facility Name: House of a • •
Ouplina•
® ,•
• Irrigation occur
at this facility?
El Yes El No
WX
I
i
IMMMM
mmmm
mmmm
I
12 Month Floating Total (in):

FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1 ) Page --� - Of 3
is l l / / 1
FacilltyName.- House of Raeford Farms, Inc
■month:
February
1
Did Irrigation occur
at this facilit
YES. ■ NO
�■�i
I
i
11UHIM
�
i
it
Sam
1=11111
11

FORMS NDAR-1 10-13 NON4NSCHARGE APPLICATION REPORT (NDAR-1) Page -5 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?
o� oNM-Q�
C7 Compliant ❑ Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified In your permit? O CMMW ❑ NorCbmptlant
Were all setbacks listed in your permit maintained for every application to each permitted site? E,] ant ❑ NorrCoepltarY
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? ❑ c mpaant ❑ Narcompiiant
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
aNNlikol Wn0". /'1R0 1 CUMKIV110 ONOCra 11
I Operator In Responsible Charge (ORC) Cerdficatbn R Pormtttee CertllFcation l
ORC: Joseph Teachey Permtlise:
House of Raeford
CortiflcaUon No.: 14930 Signing OfBclal: Nicole Reynolds
I Grade: SI Phone Number. [phone] Y slgning Ofticlars Title: Plant Manager
Has the ORC changed since the previous NDAR-1? ❑ Yes Q No Phone Nttmt»r: [phone] Permit Exp.: 10/31/31
Signature t3ate Signature Date
By this a"Ln'e. I certlN that Its report is a0currate and Complete to Vle best of my knowledge. I .116W. under penaky of low, that ttua document And at ameovnents were prepared undw my duettist or supervision in s000rderrs
a system designed to assure that al quallied personnel property gathered and evaluated the information submitted. Based on my
inquiry of the person or persons vMo manage ft system, or those persons directly reoponoble for gathering the information, the
Wormation suDrtMtted * to the best of my knoMedge and belef, true, accurate, and complete. I am aware that there are ovok;ant
penalties for submittIng false Mrmatim, incWng the possibility of tares and Wplaonment for knaMng vbiadons,
Mail Original and Two Copies to:
Divislon of Water Resources
Information Processing Unit
1617 Mail Service Cenb w
Raleigh, North Carolina 27699-1617