WQ0036210_Monitoring - 10-2021_20211106

Month: C�iEiC�BC2
9
10
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13

FORM: NDMR-03-12
NON -DISCHARGE MONITORING REPORT (NDMR)
Page of
Sampling Persons) Certified.Laboratorlea
Name: Name:
Name: Name:
all monitoring data and sampling frequencies meet the requirements in Attachment A of your' permit? ❑i Compliant - UNon-Complia
facility is non -compliant, please explaln In the space below the resson(s) the facility was not In compliance. Provide In your explanation the date(s) of the non-compliance and describe the corre
Operator In Responsible Charge (ORC) Certification
Permittee Certification
oRcc Thomas Lewis
Permittee: Benchmark Ministries Inc.
Certification No.: 1002746
signing Official: Thomas Lewis
Grade: Si Phone Number: 019-815-7603
Signing Ofticiars'Title: President
Has the ORC changed since the prevlous'NOMR? []yes OW
Phone Number: 919-815-7603 Permit Expiration: 1/31/2023
`r J Ignature Date
Signature ` Date
By this signature, I certify that this report Is accurrate and complete to the beat of my knowledge,
I certify, under penalty of law, that this document and all attachments were prepared:under my direction or supervlslon 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 persona directly responsible for
gathering the Information, the information submitted, Is, to the best of my knowledge and belief, hue, 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 Mall Service Center
Raleigh, North Carolina 27699.1617

lhbRM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of
Permit No.: WQDD36210 Facility Name: MOORE'S KEEP CHRISTIAN CAMP ,County: Moore Month: (D L Oja 2 Year: O2 )
• :.: ,
Fieltl Name ;ZONE 1 a' -' Field Name :ZONE 2 A,B P� FieldrName`' Field Name; „ ..
Did irrigation Oct. rArea (acres): �5 ,134 Area (acres): 1:69 Area (acres) Area (acres):
at this facility?.:;..' Sw , Cover Crop:; . ',FOREST °;^' Cover Crop'' - 1,.69 Cover:Crop Cover Crop:
sir r
Heu`rly Rate (m) y Hourly Rate (in): FORESVORASS a' Hourly Rate (in) I a • Hourly Rate (In)
[] YES :
Annual Rate (m) Annual Rate (in):' Annual Rate (in) i' Annual Rate'(in).
Weather- '' - Freeboard ;' Field 'rrigated? .pivEs No Field Irrigated?; El:vEs ;0 eo Field Irrigated? Q',YEs 0 No, ;' Fieldarrigated? OYES ❑ No
o �.,- ;° w,.°' t�a� E �, oi; d v o�.. E s d a' io', e > >+ e' �, �:� �;'e E a
o R as o� >,e o e d "d�i �,c o_ d �— C
o'.o t.+ ...4� , � m `s,. O C;
. J'EE
y f/G JJ = J
o.021
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min In, I nE i m . '11 pal min in in
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Monthly Loading:

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FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of 5,
Did the application rates exceed the limits in Attachment B of your permit? p<ampliant Q Non -Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from -the sites? [ o6mpllant ❑ Non -Compliant
Was a suitable vegetative cover maintained On all sites as specified in your permit? R16ompliant ❑ Non -Compliant
Were all setbacks listed'in your permit maintained for every application to, each permitted site? p'compliant El Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? Ecompriant ❑ Non -Compliant
'the reason(s) the facility was not in compliance. Provide in your explanation the date(s) of the non-compliance and describe the corrective
If the facility is'non-compliant; please explain in the space below
Operator in Responsible Charge (ORC) Certification • _ _. _
Permlttee Certification
ORC: THOMAS LEWIS i
Permittee: BENCHMARK MINISTRIES
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,:. 1/31/23
6 !U
Signature Date
./ Ignature Date
By this signature, l certify that this raper t Is accurrate •and complete to tho best of my knowledge.
fcertify,'under penalty or 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 pf 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