WQ0002571_Monitoring - 09-2016_20161101 (2)

FORM: NDAR-1 10-13
NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Did the application rates exceed the limits in Attachment B of your permit?
Page of
DCompliant ❑Non -Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites?
DCompliant
❑Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit?
❑✓ Compliant
❑Non -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?
[Acompliant
❑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.
Signature Date
ig ature Date
III
� N1
NOV 01 2016
Operator in Responsible Charge (ORC) Certification
ISR I J
Permittee Cert ton
ORC: Regina Myers
Permittee:
Bobby Williams
Certification No.: WW2 -1000620 SI -1001732
Signing Official:
Grade: WW2, SI Phone Number: 910-340-1390
Signing Official's Title: Permittee & Owner
Has the ORC changed since the previous NDARA? ❑Yes [2]No
Phone Number: 910-346-9912 Permit Exp.: 7/31/19
Signature Date
ig ature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
1 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

SPRAY IRRIGATION srm(s)
TkIE� FARE NVQ APPLIP. T19N F,140 PER PAGE USE ADQITIONAL: PAGES AS NEEDED..
PERMIT NUltyBER: �Q. 00b YEAR. ( --
MONTH: R
FACILITY NAME:y%11Ase 074kS i%)OR!E //oma PAIP,e COUNTY:__ DA) SCO 4J
Formulas:
Dally Loading (Inches)' ={Valsnt�lppfb (C► ) x 0.1338 (aLk feotyeson) x 12 (bd�saToot))![Ares Sproysd (erns) x 43,3Q0 (squsrs feelJeene)) OR
=VadsroAPP+b(Oefone)/(Nae Sprayed(sass)x27.152(PI ee/eas•trxh))
MaxintmnHourlYLoad)ay(Inch")-DLosarg( )/(TkmMOfd( )r@o( 1
12 Month Flowng TOW (Inch") - of fts Monthly Loading (Inches) - 51sn of Deny loedr>oa {trx�es)
Av Loath Inch" _ L D (Inches) ed txaNan 11 MOWS MontNy Loednp (ftntm)
Ilnd�"A11onri)/ Pharaer o1 in;tfie mordh ) x 7
ofTh Facift.
Yes: No. Yes: iO�! This : No:
' C3 Did irrtgatlon Occur on This Field:
Yes: O No: ❑
FIELDNU
M
BER:
CR
OP
FIELD
NU
M
B
RAREASPRAYEDaecer3AREA SPRYeres
COVERROP
•
PERM
ITTED HOURLY RATE Inches
HA
:: , WEATHER CONDITIONS PERMITTED YEARL ( PERMITTED HOURLY RATE (Inches):
Y BATH taches PERMITTED YEARLY RATE I es
27PP11-1km
8tocl'reeipka. L.Q, volume Time tion Fw�aoe C --
Plied
1 "tad Q�• �° •FOP ���
Inch" Lf ge m n
3-4C�tr��®��I�lvi� . �a
MOM
IWO
NMI
Spray Ird9alon Operator In Raponsl6N Charge. (ORO): - - -
CRC CerWlcaiion Numt�r: Check Box Nn OHas Changed:O
Mail ORIGINAL and. TWO COPIES to:
ATTN: Non-®iacharye Compliance Unit
DENR -
®Ivleton of wow Quality (Susie %—#VREOFOPI!RATOR`IN RESAONSIBiECAARGE)-fir
1617 Mail Starvice Center By THIS SIGNATURE, I CERTIFY THAT`THIS' REPORT IS ACCURATE AND COMRLETE
RALEIGH, NC 276991617 TO THE BEST OF MY KNOWLEDGE
� Y Q.t.f. ` ISI DENR FOW NDAR-1(5!2003)

FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of
Permit No.: W00002571
Facility Name:
Village Oaks MHP
County: Onslow
Month:
September
Year:
2016
Field Name:
1
Field Name:
Field Name:
Field Name:
Did irrigation occur
Area (acres):
3.6
Area (acres):
Area (acres):
Area (acres):
at this facility?
Cover Crop:
Hardwood trees
Cover Crop:
Cover Crop:
Cover Crop:
AYES ❑NO
Hourly Rate (in):
0.25
Hourly Rate (in):
Hourly Rate (in):
Hourly Rate (in):
Annual Rate (in):
52
Annual Rate (in):
Annual Rate (in):
Annual Rate (in):
Weather Freeboard
Field Irrigated?
21YES
❑NO
Field Irrigated?
DYES
❑NO
Field Irrigated?
DYES
❑NO
Field Irrigated?
❑YES
❑NO
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