WQ0004240_Monitoring - 09-2016_20161021 (2)

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FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR) Page 2 of 2
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? p Compliant ❑ Non -Compliant
Was a suitable. vegetative'cover maintained on all sites as specified in your permit?p Compliant E]' Non -Compliant
Were all setbacks listed in your permit maintained for every application to eachpermitted.site? p Compliant :❑ Non -Compliant
Were all freeboards.maintained. in accordance with the specified freeboard.heights in your permit? p 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
Operator in Responsible Charge (ORC) Certification:
Permittee Certification
ORC- Jeffrey Clayton .
Permittee: U.S. Marine Corps Air Station, Cherry, Point
Certification No.:., 998515
Signing official: George W. Radford
Grade: Si Phone Number: 252466-5874
Signing Official's Title: By direction of the. Commanding .Officer
Has the ORC changed'since the:previous NDAR=1?res .No
Phone Number;' ; ; 252-466=4599 Permit Exp.::. : , 7/31/1.9 .:
10/14/16
Si natur Date
Signature Date :
By this signature, I certify that this report is accurrate and complete t6 the best of my. knowledge.
1 certify, under penalty of law, that.this document an chmenTs 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 27699-1,617