WQ0036210_Monitoring - 05-2022_20220622

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Sampling Person(s) Certified Laboratories t
Name: Name:
Name: Name:
Does all monitoring data and .sampling frequencies meet the requirements in Attachment A of your permit? i] 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: Thomas Lewis Permittee: Benchmark Ministries Inc.
Certification No.:. .1002746 Signing Official: Thomas Lewis
Grade: SI Phone Number: 919-815-7603 Signing Official's Title: President
Has the ORC changed since the previous NDMR? ❑ Yes Q No Phone Number.: 919-815-7603 Permit Expiration: 1/31/2023
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 _ of
Permit No.: WQ003621 0 Facility Name: Moore's Keep Christian Camp County: Moore Month: N, A, 0, Year:
0 0
nej,, Field Name: Zone 2-A
Name ,.'�o' ., : - 4,�_ Fiqld"Na 13 Field Name:
Did irrigation occur
Area (acres): 1.60 Area, (acres) Area (acres):
at this facility? Cover Crop:
-,C,oyer Crop: Forest, Cover Crop: Forest/Grass Plover. crop:
Hourly Rate (in):
Rate (lh),
Hourly Rate (in): Hourly Rate_(in) HourlyF-1 YES [9'NO
Annual Rate (in)- Annual Rate (in): Annual Rate ( in):
Field Irrigated? Field Irrigated? F YES NO :TIe1Id:`1rrI'a*
'YES-' YES ❑ NO
Weather Freeboard 161 Irrig
ated? f
0
:E a) .0 -0 cc tm (D V
E M CD
0 W J3 r=
0,
CL M E E
E 2v (D
E E j= CL 0
E 0 0 � -1 _ . L. ". , 0� a
C , -, 0 > _j
CL 0 M
(D CL tM 0, CL cc x
U) 0 0 0
� ;6j �
CL 0:; P r 0 0
ge
E
om
_'inin _V .I aal min in in
Monthly Loading:
12 Month Floating

FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) rage or
Did the application rates exceed the limits in Attachment B of your permit? E�Compllant . ❑ Non-Compllant
Were adequate measures taken to -prevent effluent ponding in or -runoff from the sites? gcompriait p Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified �in your permit? 9compliant p Non-Compllant
Were all setbacks1•listed in your permit maintained for every application to each permitted site? E4.Compliant El Non -Compliant
Were all freeboards maintained in accordancewith the specified. freeboard.heights in your permit. Ej-corripliartt : -.❑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 addition al'sheets if necessary.
n
Operator in Responsible Charge (ORC) Certification
. Permittee Certification _
ORC: Thomas Lewis
Permittee:
Benchmark Ministries Inc.
Certification No.: 1002746
Signing Official: Thomas Lewis
Grade: SI Phone Number: 919-815-7603
Signing Official's Title: President
Has the ORC changed since the previous NDAR-1? ❑ Yes No
Phone Number: 919-815-7603 Permit Exp.: i-1/31/23
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 at 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