WQ0031030_Monitoring - 09-2016_20161031

FORM: NDAR-2 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-2) Page I of
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Permit No.: WQ61331030
Facility Name:
North Elementary SchoolMonth:September
Year:
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FORM: NDAR-2 10.-13 NON -DISCHARGE APPLICATION REPORT (NDAR-2) Page of
Did the appliaation,-rates exceed the limits .in Attachment B of your permit? (]Compliant ❑Non Compliant
If not a basin, were the sites -kept'free- of vegetation and raked? (]compliant []Non-compliant
If not a basin, were -there any.,instances of -,effluent ponding -in -or runoff -from the sites? (]compliant ❑Non-compliant
Iff-a basin, were there any instances of=breakout from -the berms? DCompriant ❑Non -Compliant
Was the onsite automatically activated standby power source tested and -operational? ❑� 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 neressarv_
Operator in Responsible Charge:(ORC) Certification
Permittee Certification
ORC: Randall -Marrs
Permittee:
Michael Warren
-Certification No.: 993714
Signing Official: William G. Freed
Grade: WW2 Phone Number: 252-340-4586
Signing Official's Title: President; Envirotech
Has the.OR a e since the previous NDAR-2? ❑Yes 2No
Phone Number: 252-207-5853 Permit -Exp.: 12/1/15
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 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 Resources
Information -Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617