WQ0018857_Monitoring - 09-2016_20161025

- FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page J— of 12—
Permit No.:"
Facility Name: Al
County:
Month: Year-A&
F161d
Name:
Field Na
Field Name:
Did irrigation
occur
Are`zij*'
Area (acres):
Area (acres):
at thiS facility?
Cover Crop:
Cover Cropf
CoverCrop:
Hourly Rate (in):
Hourly Rate In):
E3 YES
: M
Annual Rate (tn)
Annual Rate (in).,Annual
Rate in
Weather Freeboard
Field Irrigated? ❑ YES
I
❑ NO
LD
z 0 43
(D
, 4:
0 V
�j
0 E
0
Q
E
CL
to, 0 0 0
0 0
0 CL x o 0
-E
mx
-j
> -J
-j
I IL
,4
-F In ft
In in
min In
ft
gal min
gal in
2
s.
3
4
4 7,
..... . ....
6
7'
w T
7
011
8
iY.
wl
9
Ak.. 1.
10
Z.,
"e, 5s
12
7777
13
n
14
42
15
U
16
M;
17
18
jyi
19
20
- 7g.77'
21
22
V V�
23tF
24
25
. .. . ... ..... . ....
26
27
4E
77,7
,
29
7777
30
31
Monthly Loading:
ME
1 12 Month Floating Total(in):

FORM: NDAR-1 10-13
NON -DISCHARGE APPLICATION REPORT (NDAR=1)
Did the application rates exceed the limits in Attachment B 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
❑ pliant
❑ Non -Compliant
❑ pliant
❑ Nan -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: i``/i�O G��i►/(.�l^/� %'V Permittee:
� �iIliam Lee, Le
Certification No.: JT 2 9l i/J,9 y Signing Official: ,,A
Grade: J� Phone Number: �,��' / v4�y z3 Signing Official's Title: 0,"t yor
Has the ORC changed since the previous NDAR-1? ❑ yg L No Phone Number: ,r /l - y �� y ? Permit Exp.:
Signature Date
Signature Date
By this signature, I certify that this report is accurrale and complete to the best of my knowledge. I certify, under penalty of taw, that ttris document and all attachments were prepared under my direction or supervision in accordance
with a system designed to assure that all qualified personnel property 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
penakies for submfdting false kformation, induding the possft ity of fees and imprisonment for krwwkug violations.
Mail Original and Two Copies to:
Division of Water Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617