WQ0034350_Monitoring - 09-2016_20161017

FORM: NDAR-3 0&11 NON -DISCHARGE APPLICATION REPORT (NDAR-3) Page —�— of2
Permit No.: WQ0034350
Facility.Name: Hendersonville WWTP
County: Henderson Month: September Year: 2016
Did conjunctive utilization
occur at this facility?
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71
FORM: NDAR-3 08-11
NON -DISCHARGE APPLICATION REPORT (NDAR-3)
Did the application rates exceed the limits. in Attachmentl3 of your permit?
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 t-2!
(]Compliant ONon-Compliant
.Compliant [INon-Compliant
[2]Compliant ONon-Compliant
[ZCompilant E]Non-Compilanf
❑✓ Compliant oNon•Compliant
If the facility is non-compliant, please explain in thespace below the reason(s) the facility was not incompliance. Provide in yourexplanation the date(s) of the non-compliance and describe the corrective
action(s) taken. Attach additional sheets ifnecessarv.
Operator InResponsible Charge (ORC) Certification
Permittee Certification
ORC: Garrett DeMoss
Permittee:
CITY OF HENDERSONVILLE
Certification No.: WW -1000305, LA 1001681
Signing Official: Garrett DeMoss
Grade: IV Phone Number: 828-697-3077
Signing Official's Title: Pla-0 Superintendent
Has the ORC changed since the previous NDAR-3? Dues Q✓ No
Phone;Number: 828-697-3077 Permit E,xp.; 12/31/1.5
re(�
"ar—Aw
Signature Date
Signature Date
By this signature, I certify that this report'is.accurrate and complete to the best of my knowledge.
I certify, underpenalty of law,,that this documentand.all attachments were prepared under my direction or supervision in accordance
hat
With a system designed to assure'tall qualified personnel properiygathered 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
Informationsubmltted Is; to the best of myknowledge and belief; true, accurate, and complete. Tam 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
1.617 Mail Service Center
Raleigh, North Carolina '27699=1617