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Home My WebLink AboutWQ0029169_Monitoring - 10-2016_20161129FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page t of Permit No.: • 0029169 • ••1 Olive - • ••- . Field Name: Field Name: Field Name:' • irrigation occur at this facility.? N�M� -� Area (acres): 1 Cover Cro P. Cover Crv;t: F-1 YES Fl� NO mm VA ZM rn4 Hourly -. -. Annual Rate (in): ... ■ • ■ • .. ■ s ■ • igloo • •-. • �jjjjjj 1 11 jjj�/��j�jj/ 1 1/ jj�jjj/jjj�j� WRIII Month12 • . • Total FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of . 1 , Did the application rates exceed the limits in Attachment B of your permit? ❑Compliant ❑Non -Compliant Permittee: Town of Mount Olive Were adequate measures taken to prevent effluent ponding in or runoff from the sites? []Compliant ❑Non -Compliant Was a suitable vegetative cover maintained on all sites as specified in your permit? FZ]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? pcompliant ❑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. Inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the Operator in Responsible Charge (ORC) Certification Permittee Certification ORC: Glenn Holland Permittee: Town of Mount Olive Certification No.: 27255 Signing Official: Charles S. Brown Grade: SI Phone Number: 919-658-6538 Signing Officials Title: Town Manager Has the ORC changed since the previous NDAR-1? ❑Yes ONO Phone Number: 919-658-9539, ext. 107 Permit Exp.: 3/31/20 eel I I t 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. 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 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page lf" of --3— } • 0029169 Facility Name: Town of • Olive - October 1 . Field Name: Field Name: • irrigation occur at this facility'? Cover Cra;t: Cover Cri;i: F-1 YES NO Hourly Rate (in): Hourly Rate (in): Annual Rate (in): Annual Rate (in: Annual Rate (in): ... ■ p •Field Irrigated?■ p • ■ p • ■ p • MM m Mm= -_-- ---- ---- ---- FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of Did the application rates exceed the limits in Attachment B of your permit? ❑� Compliant []Non-compliant Permittee: Town of Mount Olive Were adequate measures taken to prevent effluent ponding in or runoff from the sites? ❑s Compliant ❑Non -Compliant Was a suitable vegetative cover maintained on all sites as specified in your permit? ElCompliant ❑Non -Compliant Were all setbacks listed in your permit maintained for every application to each permitted site? EZCompliant ❑Non -Compliant Were all freeboards maintained in accordance with the specified freeboard heights in your permit? [2]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. inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the Operator in Responsible Charge (ORC) Certification Permittee Certification ORC: Glenn Holland Permittee: Town of Mount Olive Certification No.: 27255 Signing Official: Charles S. Brown Grade: SI Phone Number: 919-658-6538 Signing Officials Title: Town Manager Has the ORC changed since the previous NDAR-1? ❑Yes ❑� No Phone Number: 919-658-9539, ext. 107 Permit Exp.: 3/31/20 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. 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 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page —L of Permit No.: • 0029169 Facility Name: Town of • Olive • • October I • • irrigation F I Field Name: occur at this facility Area (acres): Ar ea (acres): Cover Crop: - Annual Rate (in): Annual Rate (in): ... Field .. I=n. -. ■ D • • . ■ D • MMM MonthlyM •.• • Month12 •. •Totaljjjjj%jjj/jjjj%ij/jjjjjjj/j��j��jjjjj��jj/j/�j�j�j/�jjjjjjjj/jjjj�j�j��/�jj FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of Did the application rates exceed the limits in Attachment B of your permit? (]Compliant ❑Non -Compliant Permittee: Town of Mount Olive Certification No.: 27255 Signing Official: Charles S. Brown Were adequate measures taken to prevent effluent ponding in or runoff from the sites? [2]Compliant ❑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? IZCompliant ❑Non -Compliant Were all freeboards maintained in accordance with the specified freeboard heights in your permit? (]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. information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant Operator in Responsible Charge (ORC) Certification Permittee Certification ORC: Glenn Holland Permittee: Town of Mount Olive Certification No.: 27255 Signing Official: Charles S. Brown Grade: SI Phone Number: 919-658-6538 Signing Officials Title: Town Manager Has the ORC changed since the previous NDAR-1? ❑Yes ❑� No Phone Number: 919-658-9539, ext. 107 Permit Exp.: 3/31/20 it t // —Q_Lc- _C 1 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. 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