HomeMy WebLinkAboutWQ0036210_Monitoring - 05-2021_20210606; FARM- NDMR 03-12 " N()N-nl-qr-HARr.r- MnhliTf)Rlhlr. RFPORT (NDMRI Page . - - . of
t No.: WQ003621 0
Facility Name: Moore's Keep Christian Camp
County: Moore
Month:
MEN
Flow Measuring Point: Ej Influent 0 Effluent 0 No flow generated
FRI
Parameter Monitoring Point: El Influent Ej Effluent Groundwater Lowering Ej Surface Water
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FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR)-..Page . of
A,
Sampling Person(s)11
Certified Laboratories'
Name: Name:
Name: Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? 2]Compliant. ❑Non-Compilant
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 srieets 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 ❑� No
Phone Number: 919-815-7603 Permit Expiration: 1/31/2023
gnature Date
Ignatdre 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 thosepersons directly responsible for
- - -
-gathering the Information,-thelnformatlon.submitted.ls, to-the.best of my knowledge and.bellef,itrue, 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
FARM: NDAR-1 10.1'3 NON -DISCHARGE APPLICATION REPORT (NDAR-1)'
Page' : - - of
Permit No.: WQ0036210-
Facility Name: Moore's Keep Christian Camp
county: Moore
Month:.
Year: �L
Did irrigation occur
at this facility?
❑ YES NO
e Name:
Z.17
Field Name:
Zone 2-A,B
kll am
Field N a m e:
Area(acte
Area (acres):
1.69
reacrds
Aria'(acres):
,Covbr.Cio P:
Cover. Crop:
Forest/Grass
C C P.—,
over� r
Cover Crop:
ouilyRi
Hourly Rate (in):
'H 1
ouq Rate; n i
'� � -t � li'�
Hourly Rate (in):
Annual ,� n
Annual'Rate (I
Annual:Rate.( In):
Weather
Freeboard
5i" 11g 1
at
t'20"Y6
Field Irrigated?
r
❑YES 1;9NO
Irrigated?
Field Irrigated?
Ej YES El NO*
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Monthly Loading:
12 Month Floating Total (in):
'[11
L-
FORM: NDAR-1 10-13
NON -DISCHARGE APPLICATION REPORT (NDAR-1)
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?
Was a suitable vegetative cover maintained on all sites as specified in your permit?
Were all setbacks listed in your permit maintained for every application to.each permitted site?
Page of
[Compliant ❑ Non -Compliant
lCompliant ❑ Non -Compliant
[(Compliant ❑ Non -Compliant
ilCompliant ❑ Non-Compllant
Were all freeboards maintained in accordance with the specified freeboard'heights in your permit? 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
actionlsl taken. Attach additional sheets if necessary:
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: _ Thomas Lewis
Permittee:
Benchmark Ministries Inc.
Certification Nw. 1002746
Signing Official: Thomas Lewis.
Grade: SI Phone Number: 919-815-7603
Signing Official's Title: President
Has the ORC changed since the previous NDARA? ❑ Yes [] No
Phone Number: 919-815-7603 Permit Exp.: 1/31/23
L
at• re Date
Sighature 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 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 gathering the information, the
Information submitted is, to the best of my knowledge and belief, true, accurate, end complete. I am aware that there are slgniflcant
_
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
1611 Mail Service Center
Raleigh, North Carolina 27699-1617