WQ0014046_Monitoring - 10-2016_20161128

FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page—Lof Jj
Permit No.• )060 O
Facility Name_5 f6. /� + I -r.
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County: o
Month:
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Year:
Did irrigation occur
Fie'd Name: ,-�
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Field Name:
Field Name:
✓? -
Field Name:
this facility?
Area (acre):
Area (acres):
Are
Area (acres):
CcverC_roe GS _:
Cover Crop:
.
covercruPji
—
cover Crop:
/y� El No
Hourly Raw n_n). •_ ;I
Hourly Rate (In):
•�(in)5
Hourly Rate (In):
Ann,i.,[ Rate lin) ',
Annual Rate (in):
y tnnual Rate (in):_�
Annual Rate (In):
Weather Freeboard
Fiel ! Inigai 8 1« i NO,ynm
Field Irrigated?
VYES
❑ No
Field L4igoted�
I G'I ;
r� rv0
Field Irrigated?
GES
❑ NO
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Monthly Loading
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12 Month Floating Total (in):EMi%i:S.

Or)-�' NUIV-UIJl.r7AKlaG APPLII,A I WN Ktt'UK l (NUAK-1) Page _�ofA—
M dJDAR rid A)0j). D1!gcha9,Q 9pp4;carcjv ,eryy,Qr c✓DAa-I
Did the application rates exceed the limits in Attachment B of your permit? 212pham ❑ Non -Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites? Pjampliant ❑ Non-compliant
Was a'suitable vegetative cover maintained on all sites ars specified in your permit? pliant ❑ Non-compliant
Were all setbacks listed in your permit maintained for every application to each permitted site? 9 compliant ❑ NoMompliait
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? IQG6,19liant ❑ 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
canon. w,aacn ationlonal sneets
Operator in Charge (ORC) Certification
Permittee Certification
N!Responsible
ORC: A4�Crkorg
N
Gia./tR S4.P�cP�2
Permittee: TCRi�(.� �SJ C�
Certification No.: 991 S©�
n .y'f
Signing Official: 43 „(uT `' AW/Ca/I
Grade: -5T Phone Number:9/ 9-693- 4646 -Wj Q..e-
•1 919-1D 91- 5364 ' ea.ae
Signing Official's Title: MAJOR
Has the ORC changed since the previous NDAR-1? El Yes El 140
j 2
Phone Number:�1/ q- (q 93- All, Permit Exp.: /Q .219 1;$'
Signature Date
lure Date
By this signature, I certily that this report is a=nrale and complete to the best of my knoMedge.
I certify, under penalty of law, than this dowment and all stla :hments were prepared under my direclion or supervision in accordance
Mtn a system designed to assure that all qualified personnel property gathered and metaled the Information submitted. Based on my
Inquiry of the person or persons who manage to system, or those persons dkeCW nispomsible for gathering the Information, the
information submitted Is, to the best of My knowledge and belle/, true, aaourate, and wmplele. I am aware that mare are signlncant
penalties for submitting false IMormalion, Including the possibility, of Ines and Imprisonmem for knowing violations.
1
16
Mall Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699.1617

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rage 3 of
Per No Q D
Facility Names
County;VPg4rr JaLg Month: OC+T Year:
Did irrigation occur
e� rtlea 5 *i -
Field Name:
Nam r = Field Name:
� � rte'`%
alt this facility
w . _
Area (acres):
Area acres
(acres): 3�
Cover Crop-.'
Cover Crop:
NO
�] R( ) /�
ur6 Rate�'lm'gy ''
"
Hour ly Rate (In) •
H ourly Rate In: S
Fk!t'n al,(i ,�j,r,.i..,,
Annual Rate (in):
nude (In) .,; 2_
Annual Rate (in):
Weather
Freeboard!?a*
ed'"71g ed`�'°'ty�1S''
Field Irrigated? YES' ❑ NO
1 I`��sr ae �4-5
e CI
v
Field Irrigated. ❑ YES • O
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Monthly Loading
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12 Month Floating Total fin)-
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FORM. NDAR-1 0E-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?
Was a'suitable vegetative cover maintained on all sites a's specified in your permit?
Were all setbacks listed in your permit maintained for every application to each permitted site?
�/�t Page ~of_\
Z Canpiant ❑ Non -Compliant
U�C Plant ❑ Non-Cempllxnt
WSrtplisnt ❑ non -Compliant
ETbdrnpiant ❑ Nor -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? Plf—pliant ❑ Na.cempliam
If the facility is non-compliant, please explain in the space below the reasons) 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.
C�oertor {n Responsible Charge (ORC) Certification,
9i9 -k13: -J" Cif
Grad, .s Phone Number: iij. Ca /r j, 536:) C-"1
Has the ORC changed since the previous NDAR-1? ❑ yg 4Ka
e
Signature Date
By Inis sgnalum. I cenify Ihel Iris repot Is accurrale and complete to the best of my knoededge.
Permittee Certification
' [ r -JA: 07 ,.i 7c-MzLL L 41,L S/? `Air'. . y -,k: ir.: ., •`C>t`,_j',!-_
sinning Official: �i.l„rJZ7 L ICIzAee
Signing Official's Title: h4l %V&o
Phone Number: 91 Q . `13-44 44 Permit Exp.: /a2- S 1— •2 0 15._
U side Date
I cenity, under penally of law, that this dowmnt and all attachments were prepareel under my director, w supervision In accordance
with a system designed to assure that all quapBed personnel property gathered and evaoeled the Informaaan subnlged. Based w my
Inqury of the parson w persons who manage the system, or those persons directly responsnia for galherktg Use nfdrmeton, (to
information wbmitted is, to die bast of my krwvaedge and belef, true. acouate, and complete. I am 8er90e mal there ars sigNOunt
penalties for wbMaing false Information, hcluding the possinaty of fines and Imprtsaanerm for krawing HNegons,
Mail Original and Two Copies to:
Division of water Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699.1617