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HomeMy WebLinkAboutWQ0021289_Monitoring - 08-2016_20161004FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Paged of 8 • l�11 :• • • - • • - • • • 1 irrigation ROM Field Name: Field Name: • occur Area (acres): Area jacres)� • 1 at this facility? Crop:Cover .. ..Crop: Hourly Rate (in): Hourly Rate (in): Hourly Rate (in): Annual Rate (Iny Annual .•. •WO • . 0 • . .. . 0 • .--Irrigated?0 •Field .. 0 • ©!!l olull ilk Ai mill!! ��■!�� ���� ���� ���� m 111 ll ���!■!! ���� �!l�i� ���� m lil it ��!■!� ���� ��!!■� ���� Monthly .. .%%/ • l%//%%///////�%%/%/%%//%l///// 1 • 1 %//////%i;� %�/ 1 11 PENNERMs 11 %////�/�%%��G %/%%//%%//%%�,�%%///%i 1 11T►�%!//./ FORM: NDAR-1 0841 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page A of S ' Did the application rates exceed the limits in Attachment B of your permit? R�ompliant 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? ❑Compliant ❑Non -Compliant Were all setbacks listed in your permit maintained for every application to each permitted site? Qcompliant Don -Compliant Were all freeboards maintained in accordance with the specified freeboard heights in your permit? Q✓compliant QNon-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: Charles A. Jones, Jr Permittee: Toirtfrr of Hertofrd Certification No.: 985305 / 993143 Signing Official: Brandon Shoaf Grade: IV/,Sl Phone Number: 252.333.6948 Signing Official's Title: Town Manager Has the ORC changed since the previous NDAR-1? []yes ®No Phone Number: 252.426.1969 Permit Exp.: 12/19/14 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 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 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page S of 0 Permit No.: wll :• Facility Name: Town of - • • WWTF county:- •uimans Month: August1 irrigation • occur Area �acres). at this facility? ..Cover Crop:•. .. []YES Fv� NO Hourly Rate Hourly Rate (in): Hourly Rate (i _ Annual ate (in): Annual Rate (in). Annual Rate (I •... M.N. .. •. ■ D • • .. ■ D • . Irrir. •. W mfilkne . .. •• ■ D • N1 mill iii ii -_-- ---- -_-- ---- ©iii ii ---- -_-- -_-- ---- -_-- E3 miiiii i���i��r� ���r��m���w ■©��� ���� miiiii ili�i�a� ■i���vr i ���� ���� m iii ii ��i■i■ ���� �i��i� ���� m iii ii ��i■� ���� �i��i� ii��� m iii ii ��iii■i ���� �i��� �■�� ..Monthly Loading:j 1/1,011,11ME%/// �iiii� i�iii�i� iii■ ii�,��i�,�%,.�i,, FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of 8 Did the application rates exceed the limits in Attachment B of your permit? QCompliant ❑Non -Compliant Were adequate measures taken to prevent effluent ponding in or runoff from the sites? Rcompliant Non -Compliant Was a suitable vegetative cover maintained on all sites as specified in your permit? QCompliant Don -Compliant Were all setbacks listed in your permit maintained for every application to each permitted site? Q✓Compliant Don -Compliant Were all freeboards maintained in accordance with the specified freeboard heights in your permit? Ecompliant []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: Charles A. Jones, Jr - - Permittee: Town of Hertofrd Certification No.: 985305 / 993143 Signing Official: Brandon Shoaf Grade: IV/ SI Phone Number: 252.333.6948 Signing Official's Title: Town Manager Has the ORC changed since the previous NDAR-1? Des RINo Phone Number: 252.426.1969 Permit Exp.: 12/19/14 - I 2 � • � So � SCJ G% _ 2� , 20! L 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. 1 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 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page -7 of _B_ Permit No.: 1111 '• Facility Name: Town of - • • '- •uimans Month: August1 Did irrigation occur Field Name:� Field Name:� Field Name: Area (acres Area facresy Area (acres)f at this facility? • -MM ... .. 0 • ■ ■ •Field lrriqated?�■ • ■ ■ • MMM== RWA=MKAWWq1W� ■MMWAWffffA Monthly.. FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page -0 of $ 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 Don -Compliant Was a suitable vegetative cover maintained on all sites as specified in your permit? -gcompiiant Don -Compliant Were all setbacks listed in your permit maintained for every application to each permitted site? Q mpiiant QNon-Compliant Were all freeboards maintained in -accordance with the specified freeboard heights in your permit? gCompliant ❑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 . Operator in Responsible Charge (ORC) Certification Permittee Certification ORC: Charles A. Jones, Jr Permittee: Town of Hertofrd Certification No.: 985305 / 993143. Signing Official: Brandon Shoaf Grade: IV/ SI Phone Number: 252.333.6948 Signing Official's Title: Town Manager Has the ORC changed since the previous NDAR-1? Ely- ONO Phone Number: 252.426.1969 Permit Exp.: 12/19/14 . 4' ? •14 Z q-'t-7--Zo1 b 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 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 _.