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Home My WebLink AboutWQ0022384_Monitoring - 08-2016_20161007FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page i of Did irrigation occur at this facilitir? Cover .. . .. .Crop: YES NO Hourly,,Rate (in):,l Hourly Rate (Iny Hburly,!R�te;(iny:�,�� Hourly Rke (in): WRITIM I -.,mrjtni Annual lRate: (in): Annual Rate (in): 1 .... ■ ■ .. ■ ■ ■ ■Field Irrigated?■ ■ . :. DIM== MM ®®M® ENWrAP MME ®=1®11M WMI1MI1MI1M M=MM MM ®®®® l V' EAFAlM ®®®® WMINMMIMM FARM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page_�3__of�_ Did the application rates exceed the limits in Attachment B of your permit? Were adequate xmeasures 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 _l Compliant ❑ Non -Compliant (} Compliant ❑ Non -Compliant Compliant ❑ Non -Compliant 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: an-Ef_ 6m l�4h Permittee: CDniell Dto— m6_ Certification No.: Ca In I Signing Official: Crxa(i-en ro .6wj�(.I-)L JI CL 3 Grade: Phone Number: 5zy—�j�j��' Signing Official's Title: j (C+ mQoa�er Has the ORC changed since the previous NDAR-1? ❑ Yes `XNo Phone Number: Permit Exp.: 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 in 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