WQ0005790_Monitoring - 09-2016_20161031 (3)

FORM: NDAR-1 07-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page _�:[_ of _a_
Permit No.:
W00005790
Facility Name,
Oak Island WWTF
County: Brunswick
Month:
September
Year:
2016
Did irrigation occur
at this facility?
❑� YES ❑ NO
Field Name:
10
Field Name:
11
Field Name:
12
Field Name:
13
Area (acres):1.75
Area (acres): 2.47
Area (acres): 1.62
Area (acres): 1.19
Cover Crop:Grass
Cover Crop: Grass
P'
Cover Crop: Grass
P�
Cover Crop: Grass
P�
Hourly Rate.(m): 0.2
Hourly Rate (in): 0.2
:.Hourly Rate (in): 0.2
Hourly Rate (in): 0.2
Annual Rate (in): 127
Annual Rate (in): 127
-Annual Rate (in): 127
Annual Rate (in): 127
Weather
Freeboard
Field Irrigated?
YES
❑ No
Field Irrigated?
YES
❑ No
Field Irrigated?
❑ YES
NO
Field Irrigated?
FZI YES
❑ NO
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in
ft
ft
gal min
in
In
gal
min
in
in
gal minrin
in
gal
min
in
in
1
CL
72
0
3.2
4
43,923 251
0.92
0.22
5,188
30
0.08
0.08
0 0
0.00
9,187
47
0.28
0.28
2
CL
73
4
3.2
3.8
43,923 251
0.92
0.22
5,594
30
0.08
0.08
0 0
-0.00
9,187
47
0.28
0.28
3
CL
70
5.5
3.2
3.5
0 0
0.00
0:00
5,651
30
0.08
0.08
0 0
•0.0Q
9,187
46
0.28
0.28
4
CL
68
0
3.1
3.5
0 0
0.00'
0.00-
5,685
30
0.08
0.08
0 0
0.00
9,391
44
0.29
0.29
5
C
62
0
3.3
3.5
0 0
0.00
0,00
5,685
30
0.08
0.08
0 0
0.00
0,00
9,631
45
0.30
0.30
6
CL
65
1 0 1
3.3
3.5
0 0
0.00
0.00
5,616
30
0.08
0.08
0 0 1
0.00
0.00
10,477
150
0.32
0.32
7
PC
73
0
3.5
3.4
0 0
-0.00
0.00
5,616
30
0.08
0.08
0 0
0.00
0.00
10,477
50
0.32
0.32
8
PC
76
0
3.5
3.4
0 0
0.00
0,00
5,559
30
0.08
0.08
0 0
0.00
0.00
9,958
48
0.31
0.31
9
PC
72
0
3.5
3.4
0 0
0.00
0.00
5,223
30
0.08
0.08
0 0
0.00
0.00
10,852
51
0.34
0.34
101
C
74
0
3.5
3.4
0 0
0.00
0.00
5,873
31
0.09
0.09
10 0
0.00
0.00 -
11,214
54
0.35
0.35
11
C
77
0
3.5 1
3.4
0 0
0.00
0.00
5,873
31
0.09
0.09
0 0
0.00
0.00
11,214
54
0.35
0.35
12
CL
75
0
3.6
3.4
0 0
0.00
0.00
5,855
30
0.09
0.09
0 0
0.00
0.00
10,294
48
0.32
0.32
13
CL
73
0
3.6
3.4
0 0
0.00
0.00
5,694
30
0.08
0.08
0 0
0.00
0.00
10,294
48
0.32
0.32
14
CL
73
1.25
3.6
3.4
0 0
0.00
0.00-
5,786
30
0.09
0.09
0 0
0:00
0.00'
9,897
45
0.31
0.31
15
CL
73
0.5
3.6
3.4
0 0
0.00
0.00
5,821
30
0.09
0.09
0 0
0.00
0.00
10,172
47
0.31
0.31
16
PC
71
0
3.6
3.6
0 0
0.00
0.00
5,821
30
0.09
0.09
0 0
0.00
0.00
10,172
47
0.31
0.31
17
PC
73
0
3.6
3.6
0 0
0.00
0.00
5,646
30
0.08
0.08
0 0
0.00
0.00
9,862
46
0.31
0.31
18
CL
73
1 0.8 1
3.6
3.8
0 0
0.00
0.00
5,716
30
0.09
0.09
0 0
0.00
0.00
10,067
47
0.31
0.31
19
PC
78
1.1
3.7
3.8
0 0
0.00
0.00
5,716
30
0.09
0.09
0 0
0.00
0.00
10,098
47
0.31
0.31
20
CL
69
0.2
3.7
3.8
0 0
0.00 0.00
5,707
130
0.09
0.09
0 0
0.00
0.00
10,215
48
0.32
0.32
21
CL
71
0
3.7
4
0 0
0.00
0.00
5,707
30
0.09
0.09
10 0
0.00
0.00
10,551
49
0.33
0.33
221
CL
72
1.2
3.7
4
0 0
0.00
0.00
5,646
30
0.08
0.08
0 0
0.00
0,00
10,551
49
0.33
0.33
23
CL
72
0.8
3.7
4
0 0
0.00
0.00
5,603
30
0.08
0.08
0 0
0.00
0.00
10,098
46
0.31
0.31
24
CL
71
0
3.7
4
0 0
0,00
0.00
5,821
30
0.09
0.09
0 0
0.00
0.00
9,897
45
0.31
0.31
25
CL
70
0 1
3.8
3.8
0 0
0.00
0.00
5,821
30
0.09
0.09
0 0
0,00
0.00
9,915
145
0.31
0.31
26
C
68
0
3.8
3.8
0 0
0.00
0.00
5,720
30
0.09
0.09
0 0
0.00
0.00
10,486
48
0.32
0.32
27
C
78
0
3.8
3.8
0 0
0.00
0.00
5,668
30
0.08
0.08
0 0
0.00
0.00
10,486
48
0.32
0.32
281
C
69
0
3.8
3.5
0 0
0.00
0.00
5,633
30
0.08
0.08
0 0
0.00
0.00
9,819
45
0.30
0.30
29
CL
77
0.1
3.8
3.5
0 0
0.00
0.00
5,855
30
0.09
0.09
0 0
0.00
0.00
9,810
45
0.30
0.30
30
CL
75
1.8
3.8
3.5
0 0
0.00
0.00
5,855
30
0.09
0.09
0 0
0.00
0.00
9,736
44
0.30
0.30
31
Monthly Loading:
12 Month Floating Total (in),
87,8451.85
46.29
170,655
2.54
15.43
0
0.00
30.46
303,194
9.38
55.17

FORM: NDAR-1 07-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of
Certification ❑, Compliant ❑ Non -Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites? 0 Compliant ❑ Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit? El Compliant ❑ Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site? 0 Compliant ❑ Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? Q 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
iaKen. HIIacn aaamonal sneeis IT necessary.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: David Kelly II Backup ORC, Sunny Wright ORC out on medical leave
Permittee: Town of Oak Island
Certification No.: 21215
Signing Official: Lisa Stites
Grade: 3 Phone Number: [phone]
Signing Officials Title: Interm Manager / Town Clerk
Has the ORC changed since the previous NDAR-1? Yes ❑ No
Phone Number: [phone] Permit Exp.: 7/31/21
o �-z'7-16
Signatur 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 07-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page _S__ of I
Permit No.:
W00005790
Facility Name:
Oak Island WWTF
County:
Brunswick
Month:
September
Year:
2016
DIC: Iiil9atIO11 occur
at this facility?
Q YES E] No
Field Name:
14
Field Name:
ZONES 1,2, &3
> >• Field Name
ZONES 4 &:4r4-
Field Name:
ZONES 5 & 5A
Area(acresy 0.98
Area (acres): 6.3
Area,(acres): ` 2.2 ,"
Area (acres): 2.5
Cover Crop, Grass-"
Cover Crop: Trees
Cover Crop; Grass
Cover Crop: Grass
Hourly Rate (in): 0.2
Hourly Rate (in): 0.4
Hourly Rate (in): 0A
Hourly Rate (in): 0.4
'Annual Rate (m):.,
127 =" ' : -
Annual Rate (in):
156
Annual Rate (in),, 52
Annual Rate (in):
156
Weather
Freeboard
" - Field Irrigated?
2 YES -
❑ NO:'.-
Field Irrigated?
I] YES
❑ No
--Field Irrigated? -❑=YES' • -Q NO
Field Irrigated?
0 YES
❑ No
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ft
ft
,-; gal
min _
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in ".
gal
min
in
In
gal-
min'"
, ° In -
in
gal
min
in
in
1
CL
72
0
3.2
4
12,334
76
0:46
`0.37
68,919
470
0.40
0.05
0 - _
0
0.00
. 0.'00
48,000
240
0.71
0.18
2
CL
73
4
3.2
3.8
12,334
76
0.46
,0,37
68,452
470
0.40
0.05
0 .-'
00Q
= 0::00
0
0
0.00
0.00
3
CL
70
5.5
3.2
3.5
0
0
0:00
0:00;:
45,584
297
0.27
0.05
0.
0.>
;' _0.00,"
-0.00
0
0
0.00
0.00
4
CL
68
0
3.1
3.5
0
0
0:00
0:00
57,726
378
0.34
0.05
0
0';`.
:0,00' ,' 0.00`'
48,000
240
0.71
0.18
5
C
62
0
3.3
3.5
0
0
:.,' 0.00
0(00
57,818
378
0.34
0.05
', 0
0 = ` ` 0.00:
0.00 -
498,000
240
7.34
1.83
6
CL
65
0
3.3
3.5
0
0
-0.00
0.00
74,416
500
0.44
0.05
° `' 0. '.
0
0:00
-'0.00 -
48,000
240
0.71
0.18
7
PC
73
0
3.5
3.4
11,637
69
0.44
0.38.
74,416
500
0.44
0.05
=:>_ 0...
'0 ,:
`0.00 -
'" :0.00
48,000
240
0.71
0.18
8
PC
76
0
3.5
3.4
11,637
69
.--0.44
0:38.:
74,765
533
0.44
0.05
'0
0,
0.00 '.
. '0.00
48,000
240
0.71
0.18
9
PC
72
0
3.5
3.4
4,983
57
0:19
:,0.19: �.
76,605
533
0.45
0.05
:., '0 .
0:00.
0.00.
48,000
240
0.71
0.18
10
C
74
0
3.5
3.4
4,983
57
• - 0:19'
0:19`
74,347
498
0.43
0.05
0",
0
0.00
0.00 _
48,000
240
0.71
0.18
11
C
77
0
3.5
3.4
0
0
0,00,
0.00
43,304
316
0.25
0.05
-0
0--.
. 0:00
0.00
0
0
0.00
0.00
12
CL
75
0
3.6
3.4
0
0
0.00
0,00
43,330
316
0.25
0.05
= 0 -
0 '.
0.00-
.:.0:00,
0
0
0.00
0.00
13
CL
73
0
3.6
3.4
0
0.
0:00
0.09
41,738
290
0.24
0.05
0 • ..
0
0.00'
0,00
0
0
0.00
0.00
14
CL
73
1.25
3.6
3.4
0
0
0.00
° 0,00:''
41,677
290
0.24
0.05
' ,0
0
0.00-
0.00 ; .
48,000
240
0.71
0.18
15
CL
73
0.5
3.6
3.4
0
0
0.00 `-
0:00
41,568
290
0.24
0.05
0 ..
0 - °'
"0.00
m -
0
0
1 0.00
0.00
16
PC
71
0
3.6
3.6
0
0
0.00
0.00
41,464
290
0.24
0.05
0
•0`,,
0.00
0.00 •.
48,000
240
0.71
0.18
17
PC
73
0
3.6
3.6
0
0
0.00•
0.00
41,394
289
0.24
0.05
0
0 -:
_ 0.00
=0.00
48,000
240
0.71
0.18
18
CL
73
0.8
3.6
3.8
0
0
0.00.
0;00
41,485
289
0.24
0.05
0
0-.
0.00
-0.00
0
0
0.00
0.00
19
PC
78
1.1
3.7
3.8
0
0
0100
' . 0.00. "
49,900
334
0.29
0.05
0
0'
.' 0:00'
0;00
48,000
240
0.71
0.18
20
CL
69
0.2
3.7
3.8
0
0
0.00
0,00 '
40,535
260
0.24
0.05
•'_ " 0 '
. 0 -;"
0.00
=.; 0.00
0
0
0.00
0.00
211
CL
71
0
3.7
4
0
0
0.00
0.00
56,113
370
0.33
0.05
0'
0
0.00
- 0.00 -
' 48,000
240
0.71
0.18
221
CL
72
1.2
3.7
4
0
0
0.00
0.00.
56,309
370
0.33
0.05
; - 0
0-
0.00
;0.00
0
0
0.00
0.00
231
CL
72
0.8
3.7
4
0
0
0.00:
. ' 0.00
43,365
260
0.25
0.06
= 0
0 "_
- 0.00
0.00 •
48,000
240
0.71
0.18
24
CL
71
0
3.7
4
0
0
0.00
0:00
52,006
336
0.30
0.05
0
0.:
0.00.
'0.00
0
0
0.00
0.00
25
CL
70
0
3.8
3.8
0
0
: 0,00
0.00 '-
47,598
321
0.28
0.05
0
0
0.00 '
= 0:00
0
0
0.00
0.00
261
C
68
0
3.8
3.8
0
0
0.00
0.00
69,738 1
469
0.41
0.05
0
0 °
0.00 •
:0.00
48,000
240
0.71
0.18
271
C
78
0
3.8
3.8
0
0
0.00
"0:00 '
69,773
469
0.41
0.05
0
_0.
0.00
0.00
48,000
240
0.71
0.18
281
C
69
0
3.8
3.5
0
0
0.00
0:00
41,594
291
0.24
0.05
0
0-
• 0.00
0.00.
0
0
0.00
0.00
29
CL
77
0.1
3.8
3.5
0
0
0.00.
..0.00.
68,626
467
0.40
0.05
0
0-
0.00
-.0.00
48,000
240
0.71
0.18
30
CL
75
1.8
3.8
3.5
0
0
-0.00 .
" 0:60
68,666
468
0.40
0.05
0
0."
10.00
0.00
48,000
240
0.71
0.18
31
Monthly Loading:
12 Month Floating Total (in):
57,910
2.18
33.79
1,673,231
9.78
55.63
0
- -.0.00
_-..0.00 "'
1,314,000
M,
19.36
116.51

FORM: NDAR-1 07-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of
Certification
Q Compliant ❑ Non -Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites? E Compliant ❑ Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit? 0 Compliant ❑ Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site? 0 Compliant ❑ Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? ❑r 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
LaKen. muacn aaaluonal sneets IT necessary.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: David Kelly II Backup ORC, Sunny Wright ORC out on medical leave
Permittee:
Town of Oak Island
Certification No.: 21215
Signing Official: Lisa Stites
Grade: 3 Phone Number: [phone]
Signing Official's Title: Interm Manager / Town Clerk
Has the ORC changed since the previous NDAR-1? ❑✓ Yes ❑ No
Phone Number: [phone] Permit Exp.: 7/31/21
G(��Z7-/
)0-2-7-)b
_A4
Signre Date
Signature Date
By this signature, I certify tha 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 07-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page �, of
Permit No.:
WQ0005790
Facility Name:
Oak Island WWTF
County:
Brunswick
Month:
September
Year:
2016
Did irrigation occur
at this facility?
❑Q YES ❑ NO
Field Name:
.6
Field Name:
7
Field Name:
8
Field Name:
9
_ Area (acres): 1.25
Area (acres): 1.7
Area (acres): 1.55
Area (acres): 1.99
Cover Crop: Grass/Trees
Cover Crop: Grass
Cover Crop: Grass
Cover Crop: Grassrrrees
Hourly Rate (in): 0.2 -
Hourly Rate (in): 0.2
" .Hourly Rate (in): 0.2
Hourly Rate (in): 0.2
Annual Rate (in): 127.
Annual Rate (in): 127
Annual Rate (in): 127 -
Annual Rate (in): 127
Weather
Freeboard
Field Irrigated?
Q YES
❑ No
Field Irrigated?
❑ YES
❑ No
Field Irrigated?
R1 YES
❑ No
Field Irrigated?
❑✓ YES
❑ NO
M
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a CL
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OF
in
ft
ft
gal
min
1n
in -
gal
min
in
in
gal
min
in:
_in
gal
min
in
in
1
CL
72
0
3.2
4
5,193
40
0.15
0.15
5,816
35
0.13
0.13
0
0
-70.00
0.00
5,960
30
0.11
0.11
2
CL
73
4
3.2
3.8
5,402
40
0.16
0:16
5,816
35
0.13
0.13
0
0
0.00
0.00
6,217
30
0.12
0.12
3
CL
70
5.5
3.2
3.5
5,603
40
0.17
0.1-7
5,742
31
0.12
0.12
0
0
0.00
0,00"
6,252
30
0.12
0.12
4
CL
68
0
3.1
3.5
5,603
40
0.17
0.17
5,742
31
0.12
0.12
0
0
6.00 ,
0.00
6,387
30
0.12
0.12
5
C
62
0
3.3
3.5
5,668
140
0.17
0.1.7 "
5,812
132
0.13
0.13
0
0
0.00 .
0:00-
6,387
30
0.12
0.12
61
CL
65
0
3.3
3.5
5,668
40
0.17
0,17
5,812
32
0.13
0.13
0
0
0.00
0.00
6,387
30
0.12
0.12
7
PC
73
0
3.5
3.4
5,511
40
0.16
0.16
5,642
32
0.12
0.12
4,011
22
0.1.0
0.10
6,161
30
0.11
0.11
8
PC
76
0
3.5
3.4
5,380
40
0.16
0.16
4,927
30
0.11
0.11
4,011
22
0.10
0.10
6,161
30
0.11
0.11
9
PC
72
0
3.5
3.4
5,581
40
0.16
0,16
0
0
0.00
0.00
6,932
36
0.16
0.16
6,326
30
0.12
0.12
10
C
74
1 0 1
3.5
3.4
15,581
40
0.16
1 0.16
0
0
0.00
1 0.00
6,932
36
0.16
0.16
6,418
30
0.12
0.12
11
C
77
0
3.5
3.4
5,498
40
0.16
1 0.16
6,017
135
0.13
0.13
6,017
33
0.14
0.14
6,453
30
0.12
0.12
121
CL
75
0
3.6
3.4
5,481
40
0.16
1 0.16
6,017
35
0.13
0.13
6,871
36
0.16
0.16
6,453
30
0.12
0.12
13
CL
73
0
3.6
3.4
5,624
40
0.17
0.17
6,902
41
0.15
0.15
6,871
36
0.16
0.16
6,348
30
0.12
0.12
14
CL
73
1.25
3.6
3.4
5,633
40
0.17
0.17
6,902
41
0.15
0.15
6,688
33
.0.16
0.16
6,536
30
0.12
0.12
15
CL
73
0.5
3.6
3.4
15,633
40
0:17
0.17
6,017
32
0.13
0.13
6,688
33
0.16
0.16
6,536
30
0.12
0.12
16
PC
71
1 0 1
3.6
3.6
15,563
40
0.16
0.16
1,160
8
0.03
0.03
16,627
33
0.16
0.16
6,536
30
0.12
1 0.12
17
PC
73
0
3.6
3.6
15,437
40
0.16
0.16
0
10
0.00
0.00
6,200
31
0.15
0.15-
6,244
30
0.12
0.12
181
CL
73
0.8
3.6
3.8
5,437
40
0.16
0.16
0
10
0.00
0.00
6,200
31
0.15
0.15
6,348
30
0.12
0.12
19
PC
78
1.1
3.7
3.8
5,568
40
0.16,
0,16
0
0
0.00
0.00
6,531
33
0.16
0.16
6,444
30
0.12
0.12
20
CL
69
0.2
3.7
3.8
5,581
40
0.16'
0.16
1,304
9
0.03
0.03
6,531
33
0A6
0.16
6,444
30
0.12
0.12
21
CL
71
0
3.7
4
5,581
40
0.16
0.16
2,437
16
0.05
0.05
0
0
0.00
0.00 "
6,427
130
0.12
0.12
22
CL
72
1.2
3.7
4
5,511
40
0.16
0.16
2,437
16
0.05
0.05
6,387
32
0.15
6.15
6,427
30
0.12
0.12
23
CL
72
0.8
3.7
4
5,511
40
0.16
0.16
2,581
17
0.06
0.06
6,387
32
0.15
0.15
6,344
30
0.12
0.12
241
CL
71
0
3.7
4
5,659
40
0.17
0.17.
2,581
17
0.06
0.06
0
0
0.00
0.00
6,488
30
0.12
0.12
25
CL
70
0
3.8
3.8
5,685
40
0.17
'0.17
0
0
0.00
0.00
0
0
0.00
0.00
6,540
30
0.12
0.12
26
C
68
0
3.8
3.8
5,685
40
0.17
0.17
0
0
0.00
0.00
6,196
32
0.15
0.15
6,540
30
0.12
0.12
27
C
78
0
3.8
3.8
5,633
40
0.17
0.17
0
0
0.00
0.00
6,196
32
0.15
0.15.
6,536
31
0.12
0.12
28
C
69
0 1
3.8
3.5 15,454
40 1
0.16
0.16
0
0
0.00
0.00
6,553
32
0.16
0.16.
6,509
31
0.12
0.12
29
CL
77
0.1
3.8
3.5 15,507
140-1
0.16
1 0.16
0
10
0.00
0.00
6,553
32
0.16
0.16
6,453
30
0.12
0.12
301
CL
75
1.8
3.8
3.5
5,620
140
0.17
0.17
0
0
0.00
0.00
6,780
131
0.16
0.16
6,514
30
0.12
0.12
31
-
Monthly Loading:
12 Month Floating Total (in):
166,491
4.91
25,34
89,663
1.94
25.63
132,165
3.14
17.49
191,775
3.55
42.82

FORM: NDAR-1 07-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of
Certification
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?
❑✓ Compliant
❑ Non -Compliant
lj Compliant
❑ Non -Compliant
Q Compliant
❑ Non -Compliant
[2] Compliant
❑ Non -Compliant
D 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: David Kelly II Backup ORC, Sunny Wright ORC out on medical leave
Permittee:
Town of Oak Island
Certification No.: 21215
Signing Official: Lisa Stites
Grade: 3 Phone Number: [phone]
Signing Official's Title: Interm Manager / Town Clerk
Has the ORC changed since the previous NDAR-1? Q Yes ❑ No
Phone Number: [phone] Permit Exp.: 7/31/21
.. Z -744,D
ature 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