WQ0004115_Monitoring - 08-2016_20160926 (2)

FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) nv- Page __L_ of
Permit No.: W00004115
Facility Name:
CHAMPION HILLS, POA
County: Henderson
Month:
August
Year:
2016
Did irrigation occur
at this facility?
❑� YES ONO
Field Name:
1
Field Name:
2
Field Name:
3
Field Name:
4
Area (acres): 9.14
Area (acres): 11.27
Area (acres): 9.21
Area (acres): 20.35
Cover Crop: TURFGRASS
Cover Crop: TURFGRASS
Cover Crop: TURFGRASS
Cover Crop: TURFGRASS
Hourly Rate (in):
Hourly Rate (in):
Hourly Rate (in):
Hourly Rate (in):
Annual Rate (in): 91
Annual Rate (in): 91
Annual Rate (in): 91
Annual Rate (in): 91
Weather Freeboard
Field Irrigated?
AYES
[]NO
Field Irrigated?
DYES
ONO
Field Irrigated?
AYES
ONO
Field Irrigated?
❑� YES
ONO
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FORM: NDAR-1 10-13
NON -DISCHARGE APPLICATION REPORT (NDAR-1) I Page I— of 4
Did the application rates exceed the limits in Attachment B of your permit? ❑✓ Compliant ❑Non -Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites? ❑� Compliant ❑Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit? OCompliant ❑Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site? 2Compliant ❑Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? [ZCompliant ❑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.
DISCHARGED TO STREAM FROM 8/3 > 8/30
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: KARL GRIFFITHS
Permittee:
CHAMPION HILLS, POA
Certification No.: 15613
Signing Official: KARL GRIFFITHS
Grade: . Phone Number: 828 696 1962
Signing Official's Title: ASSISTANT SUPERINTENDANT
Has the ORC changed since the previo s NDAR-1? ❑Yes RNo
Phone Number: 828 96 1962 Permit Exp.: 1/31/19
i 9/19/16
9/19/16
ature Date
/document
nature Date
By this signature, I rtity that this report is accurrate and complete to the best of my knowledge.
I certify, under penalty of law, that thi 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 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