WQ0015010_Monitoring - 03-2022_20220404

FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR4) Page I of

-it `''' ' FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION. REPORT (NDAR-1) Page 2— of
Did the application rates exceed the limits in Attachment B of your permit?
E] Compliant
❑ Non -Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites?
p Compliant
❑ Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit?
❑Q Compliant
❑ Non-Complant
Were all setbacks listed in your permit maintained for every application to each permitted site?
❑✓ 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 date(s)
of the non-compliance and
describe the corrective
taKen. mnacu auuluunan unccrs a ncLcaaaly.
Operator in Responsible Charge (ORC) Certification
Permittee Certililication
ORC: Doug Niemond
Petmittee. TDM Farms
Certification No.: 22600
Signing official: Doug Niemond
.Grade• SI Phone Number.,
Signing Official's Title: Enviromental Mgr.
Has the ORC changed since the previous NDAR-1? ❑ Yes E) No
Phone Number: 910-590-6137 Permit Exp.: 12/31/25
414/22
4/4122
Signature Date
Signature Date
By this signature, 1 certify that this report Is ac currate and complete to the hest of my knowledge.
I certify. under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance
designed to assure that all qualified personnel properly gathered and evaluated the information submitted. Based on my
with a system
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. 1 am aware that there are significant
penalties for submitting false Information, including the possibility of firm" 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: NDMLR 10-13 NON -DISCHARGE MASS LOADING REPORT (NDMLR)
Page f of

, FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page —L— of
WQ001 5010 .Facility
-Name:
TDM Fanns, Incorporated
County.-
Sampson
Month,
March
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•b : FORM: NDMLR 10-13 NON -DISCHARGE MASS LOADING REPORT (NDMLR) Page of
Did the mass loading rates exceed the limits in Attachment B of your permit? p 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
—di fev fnlrnn Affaph arlefifinnal sheets if necessarv.
Operator in Responsible.Charge (ORC) Certification Permittee Certification
ORC: Doug Niemond Pennittee' TDM Farms
Certification Number: 22800 Signing Official* Doug Niemond
Grade: SI Phone Number: Signing Official's Title: Environmental Mgr.
Has the ORC changed since the previous NDMLR? . ❑ Yes Q No Phone No.: 910-590-6137 Permit Exp.: 12/31/20
4/4122 414122
Signature Date Signature Date
By this signature, I certify Mat,this report Is accuirate and complete to the best of my knowledge. I certify, under penalty of law, thatthis 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 Qre 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. t am aware that there are significant penatfies 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
16v Mail Service Center
Raleigh, North Carolina 27699-1617

• FORM: NDMR 03-12
NON -DISCHARGE MONITORING REPORT (NDMR)
Page a of
Sampling Person(s)
Name: Doug Niemond
Name:
I] compio Non- Name: NCDA & CS
Name:
Certified Laboratories
Does all monitoring data and sampling frequencies meet the requirements in Attachment A oT your:ptermitr
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
taken. rittacn aaanwnar auccra It
1-J1 Yd I No
operator in Responsible Charge (ORC) Certification
Pennittee Certification
ORQ Doug Niemond
Permittee: TDM Farms
Certification No.: 22800
Signing Official: Doug Niemond
Grade: SI Phone Number: 910-590-6137
Signing Official's Title:
III
Phone Number: Permit Expiration: 12/31/2025
4/4/2022
4/4/2022
Signature Date
Signature Date
By this signature, I certify that this report is acdmate and complete to the best of my knowtedge.
I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in
with a system designed to assure that all qualified personnel property gathered and evaluated the information
accordance
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 276994617