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Home My WebLink AboutWQ0036210_Monitoring - 08-2022_20220925FORM; NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR). Page of Sampling Person(s) Certified Laboratories i �t Name: - Name: - Name: Name: s all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? (Z Compliant ❑ Non -Compliant he 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 ORC: Thomas Lewis Certification No.: 1002746 Grade: Sl Phone Number: 919-815-7603 Has the ORC changed since the previous NDMR? ❑ Yes 0 No Signature i Date By this signature, I certify that this report is accurrate and complete to the best of my knowledge, Permittee Certification Permittee: Benchmark Ministries Inc. Signing Official: Thomas Lewis' Signing Official's Title: President Phone Number:* 919-815-7603 Permit Expiration: 1/31/2023 .,, Signature Date I certify, under penalty of law, that this document and all attachments were Iprepared 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'syslem, 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 Unite 4 1617 Mail Service Center ' Raleigh, North Carolina 27699-1617, FORM: NDAR-1-10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page : of i , w01 1 •• - --• Christian Camp e Moor0- J Did • • at this facility? RAN • -r Crop,• a • . • • ■ • e . - Annual Rate (in)..,= A Iiiiiii ®®®i■ ii®�i�i ®®®®®®iii� ®rlomm m®[mii miiiii IM M! miiiii ®®®® "iLtJ..' -�k.'.:.::v.l -3- y. 8MW51§1025. :.-u�® ,fy,•. `,e z.. 4�r:+.'..."®4 { '? . kf abwY."�..' FORM: NDAR-1 10-12 NON -DISCHARGE APPLICATION REPORT (NDAR-1) r-dy` "' --�-- Did the application rates'exceed the limits in Attachment B of your permit? [�cmpliant ❑ Non Comp*t' •'°� Were adequate measures taken to prevent effluent ponding in or runoff from the sites? acompliant ❑ Non-compiiant Was a suitable vegetative cover maintained on all sites as specified in your permit? [kcompliant ❑ Non -Compliant Were all setbacks listed in your permit maintained for every application to each permitted site? [a'Compliant ❑ Non -compliant Were all freeboards maintained in accordance with the specified freeboard heights in your permit? ij 4mpliant ❑ 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. artinnfs) 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 NDAR-1? ❑ Yes 21 No Phone Number: 919-815-7603 Permit Exp.: 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 a system designed to assure that all qualified personnel prope`,dy 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