WQ0005790_Monitoring - 08-2016_20161004 (2)

FORM: NDAR-1 07-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of
Permit No.:
W00005790
Facility Name:
Oak Island WWTF
County: Brunswick
Month:
August
Year:
2016
Did irrigation- occur
at=syfacl�lt '
Field Name:
6
Field Name:
7
Field Name:
8
Field Name:
9
Area (acres): 1.25
Area (acres): 1.7
Area (acres): 1.55
Area (acres): 1.99
Cover Crop: Grass/Trees
Cover Crop: Grass
Cover Crop: Grass
Cover Crop: GrassfTrees
❑
��ST O � g1�
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Hourly Rate (in):.
0.2
Hourly Rate (in):
0.2
Hourly Rate (iri):
0.2
Hourly Rate (in):
0.2
Annual Rate (in):127
Annual Rate (in): 127
_Annual Rate (in): 127
Annual Rate (in):
127
W�ather?1� MW661d
field Irrigated?
(] Yes
❑ No
Field Irrigated?
YES
❑ No
Field Irrigated?
❑ YES
❑ NO
Field Irrigated?
❑ YES
❑ No
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in
ft
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gal
min .
in
in
gal
I min
in
in
gal min
in- ,
in
gal
min
in
in
1
CL
81
0
3.1
3.8
5,716
40
0.17
0:11
26,234
207
0.57
0.16
0 0
- 0.00
0.00
6,209
30
0.11
0.11
2
PC
71
0
3.1
3.8
5,703
40
1.17
0.17-
26,234
207
0.57
0.16
0 0
0.00,
0,00
6,152
30
0.11
0.11
3
PC
73
4.5
3.1
3.8
5,825
40
0.17
OAT-
22,916
171
0.50
0.17
0 0
0.00=,;
-0.00--,
6,31830
0.12
0.12
4
PC
73
0.6
3.1
3.8
5,825
40
70.17
017
6,379
37
0.14
0.14
0 0
0:00
.0.00
6,466
30
0.12
0.12
5
PC
74
0
3.2
3.8
5,794
40
1-117-
0.17 16,409
37
0.14
0.14
0 0
0:00
0.00
6,483
30
0.12
0.12
61
PC
80
0
3.2
3.9
5,943
40
1 0;18 -
018
6,409
137
0.14
0.14
0 0
0,00 `
0:00f
6,649
30
0.12
0.12
7
C
82
0
3.2
3.9
5,943
40
1 0.16
0:18.
6,379
37
0.14
0.14
0 0
0.00 "
0:00_
6,649
30
0.12
0.12
8
C
80
0
3.2
4
5,485
40
0.16
0:16
6,379
37
0.14
0.14
0 0
0.00._
0.00
6,723
34
0.12
0.12
9
PC
79
0.5
3.2
4
5,263
40
0.16.
0.16
5,912
35
0.13
0.13
0 0
0.00'
0.00
6,723
34
0.12
0.12
10
PC
79
0 1
3.2
4
15,188
40
0.15
0.15
6,396
38
0.14
0.14
0 0
0.00.
- 0.00
6,026
30
0.11
0.11
11
PC
79
0
3.2
4
5,315
40
0.16
0.16'
6,396
38
0.14
0.14
0 0
-0.00,.:.
0.00.
5,991
30
0.11
0.11
121
CL
79
0
3.2
4
5,524
40
0.16
0.16 ,
6,348
138
0.14
0.14
0 0
:0.00 '
0.00
6,209
30
0.11
0.11
13
C
82
0
3.2
4
5,524
40
0.16
0.16
6,261
35
0.14
0.14
0 0
0.00,
0.00
6,370
30
0.12
0.12
14
C
82
0
3.3
4
5,699
40
0.17
0,17 _
6,261
135
0.14
0.14
0 0
0.00 `.
0,00
6,370
30
0.12
0.12
15
C
78
0
3.3
4
5,699
40
0.17
0.17
14,009
121
0.30
0.15
10 10
0.00
0.00
6,318
30
0.12
0.12
16
PC
80
1 0.65 1
3.3
4
15,132
40
0:1b
0.15
14,009
121
0.30
0.15
0 0
0.00.
0.00',
5,716
30
0.11
0.11
17
C
76
0
3.2
4
4,822
40
0.1.4
0.'14.
11,231
90
0.24
0.16
0 0
0.00
6.06
12,958
71
0.24
0.20
181
CL
81
0 1
3.2
4
4,683
40
0.14
0.14
11,231
90
0.24
0.16
0 0
0,00
0.00
12,958
71
0.24
0.20
19C
72
0.1
3.2
4
4,844
40
.. 0.14
0.14
5,236
35
0.11
0.11
0 0
0:00
0;00
5,716
30
0.11
0.11
20
CL
76
0.251
3.2
4
5,119
40
0.15
0.75 -
5,921
138
0.13
0.13
0 0
0.00
0.00
5,956
30
0.11
0.11
21
C
80
0.15 1
3.3
4
5,302
40
0.16
0.16
6,113
38
0.13
0.13
0 10
0.00
0.00-
5,956
30
0.11
0.11
22
C
77
0
3.3
4
15,441
40
0.16
0.16
6,113
37
0.13
0.13
0 0
0.00'
0.'00
6,457
30
0.12
0.12
23
C
73
0
3.3
4
5,511
40
0.16
0.16
7,246
43
0.16
0.16
0 0
0.00-.
`0.00
6,457
30
0.12
0.12
241
C
69
0
3.3
4
5,511
40
0.16
0.16
7,246
43
0.16
0.16
0 0
0.00
0.00
6,431
30
0.12
0.12
25
C
70
0
3.3
4
5,507
40
0.16
0.16
6,758
40
0.15
0.15
0 0
0:00
0.00
6,431
30
0.12
0.12
26
C
71
0
3.2
4
5,276
40
0.16
0.16
6,143
37
0.13
0.13
0 0
0.00
0.00
6,135
30
0.11
0.11
27
C
73
1 0 1
3.2
4
4,992
40
0.15'
0.15
5,393
33
0.12
0.12
0 0
0.00
0.00
5,991
30
0.11
0.11
28
CL
75
0.13 1
3.2
4
4,142
40
0.12
0.12
5,393
33
0.12
0.12
0 0
0.00
0.00
5,899
30
0.11
0.11
29
CL
72
0
3.2
4
4,072
40
0.12
0:12.
6,571
44
0.14
0.14
0 0
0.00
0.00
5,729
30
0.11
0.11
30
CL
71
0.1
3.2
4
4,761
40
0.14
0.14,
6,571
44
0.14
0.14
0 0
0.00
0.00
5,877
30
0.11
0.11
31
CL
74
0
3.2
4
4,761
40
0.14
1 0.14
5,572
38 1
0.12
0.12
0 0
0.00
0.00
5,877
30
0.11
0.11
Monthly Loading:
12 Month Floating Total (in):
164,320 -
4.84'
32.42
275,670
5.97
27.01
0
0.00
.17:88
206,197
3.82
43.80

FORM: NDAR-1 07-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of _
Certification
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?
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
❑� Compliant
❑ Non -Compliant
Compliant
❑ Non -Compliant
0 Compliant
❑ Non -Compliant
21 Compliant
❑ Non -Compliant
Q 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: David Kelly
Permittee:
Town of Oak Island
Certification No.: 21215
Signing Official:
Grade: 3 Phone Number: [phone]
Signing Official's Title:;
Has the ORC changed since the previous NDAR-1? ❑ yes 2] No
Phone Number: [phone] Permit Exp.: 7/31/21
I V�-
/J44X46. . *; ;/Z 0/ 4
Signa ur Date
J Signature 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 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 Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

FORM: NDAR-1 07-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page Aof -I
Permit No.:
W00005790
Facility Name:
Oak Island WWTF
County:
Brunswick
Month:
August
Year:
2016
Did It'occur
8t this facility?
❑� YES ❑ No
Field
Field Name:
10
Field Name:
11
Field. Name:
12
Field Name:
13
(acres): 1.75
Area (acres): 2.47
Area (acres): 1.62
Area (acres): 1.19
Cover Crop- Grass
Cover Crop: Grass
Cover Crop; -Grass
Cover Crop; Grass
Hourly Rate (in): 0.2
Hourly Rate (in): 0.2
Hourly Rate (in): 0.2
Hourly Rate (in): 0.2
Annual Rate (in): 127.
Annual Rate (in): 127
Annual Rate (in): 127
Annual Rate (in): 127
Weather
Freeboard
Field Irrigated?
i] YES
❑ NO
Field Irrigated?
❑� YES
❑ No
Field Irrigated?
Q YES
❑ No
Field Irrigated?
[Z YES
❑ No
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in
ft
ft
gal
min
in.
in
gal
min
in
in
gal
min -
in
in
gal
min
in
in
1
CL
81
0
3.1
3.8
14,231
68
0.30
.0.26
5,764
30
0.09
0.09
7,586
47
0.17
0.17
10,634
49
0.33
0.33
2
PC
71
0
3.1
3.8
14,231
68
0.30
0.26
17,523
96
0.26
0.16
10,159
55
0.23
0.23
18,857
85
0.58
0.41
3
PC
73
4.5
3.1
3.8
4,626
24
0.10
0.10.
17,523
96
0.26
0.16
10,159
55
0.23 ,
0.23
18,857
85
0.58
0.41
41
PC
73
0.6 1
3.1
3.8
4,002
19
0.08
0.08
5,860
130
0.09
0.09
3,667
20
0.08
0.68
10,194
45
0.32
0.32
5
PC
74
0
3.2
3.8
4,002
19
0.08
0.08
8,262
41
0.12
0.12
4,081
23
0,09
009
10,704
48
0.33
0.33
6
PC
80
0
3.2
3.9
3,863
19
0.08
. , 0;08.
8,262
41
0.12
0.12
5,982
134
0,14
- 0.14
10,704
48
0.33
0.33
7
C
82
0
3.2
3.9
4,805
24
0.10
0.10
6,039
30
0.09
0.09
5,982
34
0.14
0.14
10,547
47
0.33
0.33
8
C
80
0
3.2
4
4,805
24
0.10
0.10
5,590
30
0.08
0.08
4,774
28
0.17
0.11
10,215
47
0.32
0.32
9
PC
79
0.5
3.2
4 14,430
22
0.09
0.09
5,393
30
0.08
0.08
3,261
19
0.07.
0.07
9,557
44
0.30
0.30
101
PC
79
0 1
3.2
4 13,593
18
0.08
0.08
5,511
30
0.08
0.08
7,081
41
0.16
0.16
9,300
144
0.29
0.29
11
PC
79
0
3.2
4
5,437
28
0.11
0.11
5,751
30
0.09
1 0.09
9,858
60
0.22
0.22
9,636
149
0.30
0.30
12
CL
79
0
3.2
4
12,788
74
0.27
0.22
5,751
30
0.09
0.09
13,036
85
0.30
0.21
9,636
51
0.30
0.30
13
C
82
0
3.2
4
12,788
74
0.27
0.22
5,572
30
0.08
0.08
13,036
85
0.30
0.21-
9,618
51
0.30
0.30
14
C
82
0
3.3
4
3,723
18
0.08
0.08
5,646
30
0.08
0.08
5,424
33
0.12,
0.12
9,758
45
0.30
0.30
15
C
78
0 1
3.3
4 115,652
111
0.33
0.18
5,646
130
0.08
0.08
10,760
179
0.24
0.19
9,758
53
0.30
0.30
161
PC
80
1 0.651
3.3
4
15,652
111
0.33
0.18
4,997
30
0.07
0.07
10,760
79
0.24
0.19
8,890
53
0.28
0.28
17
C
76
0
3.2
4
23,762
150
0.50
0.20
5,149
30
0.08
0.08
7,207
51
0.16
0.1.6
14,480
79
0.45
0.34
18
CL
81
0
3.2
4
23,762
150
0.50
0.20
5,149
31
0.08
0.08
10,368
79
0.24
0.18
14,480
79
0.45
0.34
19
C
72
0.1
3.2
4
14,449
96
0.30
0.19
5,154
30
0.08
0.08
18,369
128
0.42.
0.20
10,433
60
0.32
0.32
20
CL
76
0.25
3.2
4
14,449
96
0.30
0:19
5,293
30
0.08
0.08
18,369
128
0.42
0.20
10,433 -
60
0.32
0.32
21
C'
80
0.15
3.3
4
25,920
169
0.55
0,19
5,293
130
0.08
0.08
26,936
186
0.61
0.20
10,734
66
0.33
0.30
221
C
77
0
3.3
4
25,920
169
0.55
0.19
5,520
130
0.08
0.08
26,936
186
0.61
0.20
10,734
66
0.33
0.30
23
C
73
0
3.3
4
17,893
109 1
0.38
0:21
5,520
130
0.08
0.08
15,417
103
0.35
0.20
9,893
51
0.31
0.31
24
C
69
0
3.3
4
17,893
109
0.38
0.21
5,794
30
0.09
0.09
15,949
103
0.36
0.21
12,465
62
0.39
0.37
25
C
70
0
3.3
4
19,380
130
0.41
0.19
5,794
30
0.09
0.09
15,949
115
0.36
0.19
12,465
66
0.39
0.35
26
C
71
0
3.2
4
19,380
130
0.41
0.19
5,424
30
0.08
0.08
15,530
115
0.35
0.18
11,441
66
0.35
0.32
271
C
73
0
3.2
4
6,858
41
0;14
0.14
5,354
30
0.08
0.08
23,814
178
0.54
0.18
9,923
56
0.31
0.31
28
CL
75
0.13
3.2
4
57,513
415
1.21
0.17
5,058
30
0.08
0.08
55,015
449
1.25
0.17
20,815
150
0.64
0.26
29
CL
72
0
3.2
4
57,513
415
1.21
1 0.17
-a-18-1
5,127
130
0.08
0.08
55,015
449
1.25
0.17
20,815
150
0.64
0.26
30
CL
71
0.1
3.2
4
39,541
285
0.83
F
5,162
130
0.08
0.08
32,138
1259
0.73
0.17
115,299
106
0.47
0.27
31
CL
74
0
3.2
4
12,731
81
0.27
0.20
5,162
30
0.08
0.08
0
0
0.00
0.00
8,384
47
0.26
0.26
Monthly Loading:
12 Month Floating Total (in):
505,594
10.64
47.27
199,043
2.97
15.70
462,618
10.52
30.46
369,658M
11.44
15.50

FORM: NDAR-1 07-11
Certification
NON -DISCHARGE APPLICATION REPORT (NDAR-1)
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?
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
Page of
❑� Compliant
❑ Non -Compliant
❑Q Compliant
❑ Non -Compliant
Q Compliant
❑ Non -Compliant
❑Q Compliant
❑ Non -Compliant
E 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: David Kelly
Permittee:
Town of Oak Island
Certification No.: 21215
Signing Official:� oi`. L(
, f�ie
11�,,
Grade: 3 Phone Number: [phone]
Signing Official's Title: �• NCS o eve Aar -
Has the ORC changed since the previous NDAR-7? ❑ Yes Q No
Phone Number: [phone] Permit Exp.: 7/31/21
y' CL 3a --(C,
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 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 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 submitling false information, including the possibility of fines and imprisonment for knowing violations.
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

FORM: NDAR-1 07-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page 3- of
Permit No.:
W00005790
Facility Name:
Oak Island WWTF
County:
Brunswick
Month:
August
Year:
2016
Did
irrigation
occur
Field Name:
14'
Field Name:
ZONES 1,2, &3
Field Name:
ZONES 4 & 4A
Field Name:
ZONES 5 & 5A
at this facility?
❑� YES ❑ NO
Area (acres):
0.98
Area (acres):
6.3
Area (acres),
2.2
Area (acres):
2.5
Cover Crop: Grass
Cover Crop: Trees
Cover Crop' Grass
Cover Crop' Grass
Hourly Rate (in)": 0.2
Hourly Rate (in): 0.4
Hourly Rate (in): 0.4
Hourly Rate (in): 0.4
Annual Rate (in):
127
Annual Rate (in):
156
Annual Rate (in):
52
Annual Rate (in):
156
Weather
Freeboard
Field Irrigated?
El YES
❑ NO
Field Irrigated?
(] YES
❑ NO
Field Irrigated?
❑ YES'
21 NO
Field Irrigated?
Q YES
❑ NO
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in
It
ft
= gal min,
In
in
gal
min
in
in
gal
min
in_'".
in
gal
min
in
in
1
CL
81
0
3.1
3.8
0 0
0.00
:0.00
62,130
435
0.36
0.05
-0
0
0.00,
0.00
48,000
240
0.71
0.18
2
PC
71
0
3.1
3.8
0 0
0-00
0.00 "
63,163
440
0.37
0.05
0
0
0.00_
0.00
0
0
0.00
0.00
3
PC
73
4.5
3.1
3.8
0 0
0.00,
0:00
78,999
537
0.46
0.05
:; -. -0 - ' : ;
0; . ,
',0.00'
0,00
48,000
240
0.71
0.18
4
PC
73
0.6
3.1
3.8
0 0
0.00
0.00 `
79,012
538
0.46
0.05
.° 0
0
0.00
0.00
0
0
0.00
0.00
5
PC
74
0
3.2
3.8
10 0
0.00
0.00
78,367 1
533
0.46
0.05
„0
0-
0.00
0.00
0
0
0.00
0.00
6
PC
80
0
3.2
3.0
0 0
0.00_
0.00-
41,132
291
0.24
0.05
= 0,
6
0.00-_
0.00
48,000
240
0.71
0.18
7
C
82
0
3.2
3.9
0 0
0.00
0.00
59,610
410
0.35
0.05
0
0
0.00
`0:00
48,000
240
0.71
0.18
8
C
80
0
3.2
4
0 0
0.00 0.00
63,547
441
0.37
0.05
0
0
0.00 '
0.00
48,000
240
0.71
0.18
9
PC
79
0.5
3.2
4
0 0
0.00
0.00
80,856
546
0.47
0.05
0
0
0.00
0'.00
0
0
0.00
0.00
10
PC
79
0
3.2
4
0 0
0.00
0.00-
82,312
555
0.48
0.05
0
0
0.00
0.00
0
0
0.00
0.00
111
PC
79
0
3.2
4
4,425 27
0.17,:.
'0.17
82,169
555
0.48
0.05
0
0
0.00
0.00
0 1
0
0.00
0.00
12
CL
79
0
3.2
4
6,993 43
0126-
0,26.
61,733
425
0.36
0.05
0
0
0.00
0.00
0
0
0.00
0.00
13
C
82
0
3.2
4
6,993 43
0;26
" -0.26.
61,982
424
0.36
0.05
0
0
0.00
.0.00 _
0
0
0.00
0.00
14
C
82
0
3.3
4
0 0
0.00
0.00
41,280
289
0.24
0.05
0
0
0.00
0:00
48,000
240
0.71
0.18
16
C
78
0
3.3
4
0 0
0.00
.0:00
41,241
290
0.24
0.05
0
0
0.00
0.00
48,000
240
0.71
0.18
16
PC
80
0.65
3.3
4
0 0
0.00
0.00
41,280
290
0.24
0.05
0
0
0.00
0.00
48,000
240
0.71
0.18
171
C
76
0
3.2
4
8,912 57
0.33
0.33
51,095
330
0.30
0.05
0
0
0.00.
0:00
48,000
240
0.71
0.18
18
CL
81
0 1
3.2
4
8,912 57
0.33
0.33
51,095
330
0.30
0.05
0
0 '
0.00
0.00
0
0
0.00
0.00
19
C
72
0.1
3.2
4
0 0
0.00
0.00
66,542
431
0.39
0.05
0
0
0.00
0:00
0
0
0.00
0.00
20
CL
76
0.25
3.2
4
0 0
0.00
0.00
66,542
431
0.39
0.05
0
0
0,00
0.00
0
0
0.00
0.00
21
C
80
0.15
3.3
4
0 0
0.00
0.00
37,282
240
0.22
0.05
0
0
0.00
0.00"
0
0
0.00
0.00
22
C
77
0
3.3
4
0 0
0.00
0.00
73,431
494
0.43
0.05
0
0
0.00
0:00
0
0
0.00
0.00
23
C
73
0
3.3
4
0 0
0:00
0:00
73,710
496
0.43
0.05
0
0
0.00
0.00
0
1 0
0.00
0.00
24
C
69
0
3.3
4
0 0
0.00
•0.00
41,180
290
0.24
0.05
0
0
0.00
0.00
0
0
0.00
0.00
25
C
70
0
3.3
4
0 0
0.00
0.00
40,871
290
0.24
0.05
0
0
0.00
0.00
0
0
0.00
0.00
26
C
71
0
3.2
4
0 0
0.00
0.00
43,500
325
0.25
1 0.05
0
0
0.00
0.00
0
0
0.00
0.00
27
C
73
0
3.2
4
10 0
0.00
0.00
43,565
325
0.25
0.05
0
0
0.00• .
0.00
0
0
0.00
0.00
281
CL
75
0.13
3.2
4
0 0
0.00
0.00
41,215
290
0.24
0.05
0
0
0.00
0.00
0
0
0.00
0.00
29
CL
72
0
3.2
4
0 0
0.00
0.00-
40,810
290
0.24
0.05
0
0
0.00
0.00
0
0
0.00
0.00
30
CL
1 71
1 0.1 1
3.2
4
0 10
.0.00
1 0.00 1
40,923
290
0.24
0.05
0
0
0.00
0.00
0
0
0.00
r 0.00
31
CL
1 74
1 0 1
3.2
4
2,817 17
0.11
0.11
50,293
369
0.29
0.05
0
0
0.00
0.00
0
0
0.00
1 0.00
Monthly Loading:
12 Month Floating Total (in):
39,053
1.47
38.18
VZ1,780,867
10.417MI
54.160.00
0
M
0.00 -
432,000
6.36
100.69

FORM: NDAR-1 07-11
Certification
NON -DISCHARGE APPLICATION REPORT (NDAR-1)
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?
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
Page of
Compliant ❑ Non -Compliant
Q Compliant ❑ Non -Compliant
El Compliant ❑ Non -Compliant
Q 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
action(s) taken. Attach additional sheets if necessary.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: David Kelly
Permittee:
Town of Oak Island
Certification No.: 21215
Signing Official: �QV j 1•t�Z�
Grade: 3 Phone Number: [phone]
Signing Official's Title: .; -Df®-A-6,e.- '.
Has the ORC changed since the previous NDAR-1? ❑ Yes I] No
Phone Number: [phone] Permit Exp.: 7/31/21
C ,3 a
30/W�,�
L) .
Signatur Date
Signature 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 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 Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617