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Home My WebLink AboutWQ0021289_Monitoring - 09-2016_20161101FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page 3 of 8 Permit No.: WQ0021289 i� Facility Name: Town of Hertford WWTF County: PerquimanS Month: September • irrigation occur Field Name: I at this facility?1 .. ..Civer Crop:.. F-IYES F-�' NO Hourly Rate (in):,�� Hourly Rate (in): Hourly Rate (m) - Annual Rate (iny Annual Rate (in):-; Annual Rate (in): • ... • r r . - • 0 • . .. • . 0 •r .. • Q • .Irrigated? 0 • FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page A of S ' Did the application rates exceed the limits in Attachment B of your permit? Rcompliant QNon-Compliant Were adequate measures taken to prevent effluent ponding in or runoff from the sites? Rcompliant ❑Non -Compliant Was a suitable vegetative cover maintained on all sites as specified in your permit? .r❑compliant Don -Compliant Were all setbacks listed in your permit maintained for every application to each permitted site? ®Compliant ❑Non -Compliant Were all freeboards maintained in accordance with the specified freeboard heights in your permit? ❑.compliant EINon-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 raKen. /aaacn aaamonal sneers n Operator in Responsible Charge (ORC) Certification Permittee Certification ORC: Charles A. Jones, Jr Permittee: Town of Hertofrd Certification No.: 985305 / 993143 Signing Official: Brandon Shoaf Grade: IV/ SI Phone Number: 252.333.6948 Signing Officials Title: Town Manager Has the OR hanged since the previous NDAR-1? []yes ZNo Phone Number: 252.426.1969 Permit Exp.: 12/19/14 Signature Date SP nature 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 FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page _f__ of e Permit No.: 111 :• own of - • • '- • •nth: September1 • irrigation occur Field Name::�� Field Name: Field Name:'�� Area (acres):: !� Area Jac Area (acres)� at this facility? Cover Crop: Cover Crop: Caver C op: F-IYES FV -1 NO Hourly Rate (In):� I Hourly Rate (in):;' Ho- (i n)-' Annual Rate (in): Annual Rate (in)-.��MIIUITITM. ffzfil=��WMITNIR. IMUM .. —F... .. . 0 • F . .. •. 0 • . .. •. {� • . .. •. Q • ®!!!!! WMINM !f!IWlPIWUN z'�IIMIIM 0=11=11MM m!!!!! WWWW„7W� rRMWAM /OOMW/! FORM: NDAR-1 08-11 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? Page 6 of E5 QCompliant Non -Compliant QCompliant E]Non-Compliant Was a suitable vegetative cover maintained on all sites as specified in your permit? QCompliant QNon-Compliant Were all setbacks listed in your permit maintained for every application to each permitted site? Rompliant Don -Compliant Were all freeboards maintained in accordance With. the specified freeboard heights in your permit? QCompliant ❑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 taKen. Httacn aaalttonal sneets It Mail Original and Two Copies to: Division of Water Quality Information Processing Unit 1617 Mail Service Center Raleigh, North Carolina 27699-1617 Operator in Responsible Charge (ORC) Certification Permittee Certification ORC: Charles A. Jones, Jr Permittee: Town of Hertofrd Certification No.: 985305 / 993143 Signing Official: Brandon Shoaf Grade: IV/ SI Phone Number: 252.333.6948 Signing Official's Title: Town Manager Has the O changed since the previous NDAR-1? Des QNo Phone Number: 252.426.1969 Permit Exp.: 12/19/14 .,Aj � 6-1 &J. A0- - Signa re Date Sig ature 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 FdRM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page 1 of 8 Permit No.: 1111 :• Facility Name: Town of - • • '- •uirnans Month: SeptemberField / Name: Field -. me:' Field Name: Field Name:1 • irrigation occur Area (acres): Area�"S)--� Area (acres):' Area facres),.-I at this facility? Cover Crop� Cover Crop: Giver Crop. ■ YES D NO F -M ERRIMI Hourly -. -. •Eff I Annual Rate ... .. ■ D • .. ■ ■ • ■ ■ • . ■ ■ • riWMWAN�� c��WEa=MWA0� mmmm�� AMMMM ri � KAMM-MWXAr Wrri m M==y ■�� Monthl Loading: 12 M . FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Pages of 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? ❑Compliant ❑Non -Compliant ®Compliant ❑Non -Compliant v'❑CCompliant Don -Compliant ❑Compliant ❑Non -Compliant 2compliant ❑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 taKen. Httacn aaaltlonal sneets It Operator in Responsible Charge (ORC) Certification Permittee Certification ORC: Charles A. Jones, Jr Permittee: Town of Hertofrd Certification No.: 985305 / 993143 Signing Official: Brandon Shoaf Grade: IV/Sl Phone Number: 252.333.6948 Signing Official's Title: Town Manager Has the ORC changed since the previous NDAR-1? []Yes FV No Phone Number: 252.426.1969 Permit Exp.: 12/19/14 14 �QIA_ l6~l9-G S ZX!D- r? -2016 ignature Date Signatur J, 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