WQ0036210_Monitoring - 09-2022_20221031

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR)• Page — of
Sampling Person(s) Certified Laboratories
Name: -Name:
Name: Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? O 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 0 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 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
submllled. 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-11) Page.. of
PermltNo.: WQ0036210 Facility Name: Wore's Keep Christian Camp County: Moore Month: e Year: 7o2
Field Name: Zone 2 Fielda. held Name:
Field N -A.13
Did irrigation occur amp:
Area %{acres). 1.34 Area (acres): 1`,69777Xre Area:(acres):
at this facility? Cover . Crop: Forest. Cover Crop: Forest/Grass Cove'r.C! 0", Cover Crop:
n YES LSO Hourly Rate (in): Hourly Rate (in): Hourly. Rate (In')Hourly Rate (in):
,,,Annual; Rate.,,(!n Annual Rate:(in):,
Annual Rate Annual Rate (in):
(in),
Weather Freeboard Field Irrigated? El YES Field Irrigated? [I YES 2'NO Field, Irrigated? El YES [:1 No. Field Irrigated? ❑ YES ❑ NO
E
0 E tM E tM. 0 V tM
tM tM
CD 'D
E 1, r.
'I , M M = .5 M "S " E T 0 1 1- 1 >1 :�-% -E E E 2 z,
E 2 . 0 1 -0
a is = -a .9 0 -0 5. E. m 'g tn cm
x 0
I! D tM 0 M.
X1. 0 0 0 0
CL CL 0 'E
0 CL 0
(0, M.0 E _j >
E V > .3 "�g
CL _j
a.
of: in ft ft gal min In In gal min In in min in in. gal min In in
.3
3
4
6
7
8'
9

FORMADAR-1 10-13, NON -DISCHARGE APPLICATION REPORT (NDAR-1) rage
Did" the application rates .exceed the limits in Attachment B of your permit? p'comPuant ❑ Non -compliant
Were adequate measures taken to prevent effluent pon'ding in or runoff -from. the sites? p compliant- :: C7 Non -compliant.
Was a suitable vegetative cover maintained,on all sites as specified in your permit? © compliant ❑ Non -compliant
Were all setbacks listed in your permit maintained for every application to each permitted site? 2�6ompliant ❑ Non -Compliant
Were all freeboards maintained in accordance with the -specified -freeboard-- heights in your permit? pcompit tit ❑ Non -Compliant
If the facility is non-compllant, 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: 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 0 No Phone Number: 919-815-7603 Permit Exp.: 1131 /23
Signature Date gnature - Date
By this signature, I certify that this report is accurrate and complete to the best of my;knowiedge. I certify, under penalty of law, that this document and all attachments were prepared under my, direction or supeNIslon In accordance
witfi 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 responslbla 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
Inforniation Pro dessing Unit
1,6.17 Mail'Service Center
Raleigh, North Carolina 27699-1617