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Home My WebLink AboutWQ0021289_Monitoring - 10-2016_20161130-FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page 3 of $ Permit No.: •11 '• Facility Name: Town of - • • '- • October 1 Field Name:� Field Name: Field Name: /irrigationoccur Area (acres):' Area (acresy Area (acres):�� • / at this facility? I Cover Crop: Cover Crop: Giver Crop-'� E]YES NO Hourly Rate (in): •.•. . . .. -. 0 • . .. • 0 • . .. •. 0 •MORE .. . � Q • NEF ®!!!!! !^!l ri !l �A E�M�i'■ m!!!!! !�I ■l�i�ll� !►J�II��III�! l0�� ! Monthly Loading: FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page "i of _0 - Did the application rates exceed the limits in Attachment B of your permit? ❑Compliant Don -Compliant Were adequate measures taken to prevent effluent ponding in or runoff from the sites? ✓❑Compliant Don -Compliant Was a suitable vegetative cover maintained on all sites as specified in your permit? QCompliant ❑Non -Compliant Were all setbacks listed in your permit maintained for every application to each permitted site? ✓❑Compliant Don -Compliant Were all freeboards maintained in accordance With the specified freeboard heights in your permit? R�ompliant ❑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 iaKen. Auacn aaanional sneeis 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/ SI Phone Number: 252.333.6948 Signing Official's Title: Town Manager Has the ORC changed since the previous NDAR-1? ❑y- Zo Phone Number: 252.426.1969 Permit Exp.: 12/19/14 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 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 .5 of 8 •11 :• Facility Name: Town of Hertford '- • October Field Name: Field Name: Field Name:::�� -Field-Name:l • irrigation occur Area (acres): Area (acres), Area �acmsy. Area at this facility? Cover Crop: Giv rop: E] YES FV1 NO .•. . . .. •. 0 • . .. . {7 • . .. •. 0 • . .. •. 0 • FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page 6, 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? ✓gcompliant Don -Compliant 2Compliant ❑Non -Compliant gCompliant E]Non-Compliant 2compliant Non -Compliant �ompliant 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 aaaiuonal sneets n Operator in Responsible Charge (ORC) Certification Permittee Certification ORC: Charles A. Jones, Jr Permittee: Town ofHertofrd Certification No.: 985305 / 993143 Signing Official: Brandon Shoaf Grade: IV / SI Phone Number: 252.333.6948 Signing Official's Title: Town Manager Has the ORC changed since the previous NDAR-1? Des QNo Phone Number: 252.426.1969 Permit Exp.: 12/19/14 16 Signature Date -7 Si nature If 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 -7 of 0 Permit No.: WQ0021289 Facility Name: Town of - • • WWTF County:- • • October 1 Name: Field Name: CoverField ..-Cover•. Civer Crop:,. •• 0 • Hourly'.te lin', Hourly '.te (in): Hourly '.te (in), Hourly '. Annual _ •Annual Rate (in): Annual Rate (in): .•. •Field . L%jjjjjLC1J= Field Irrigated? R • Field Ir i& -teV • FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NIDAR-1) Page—of15� ' , Did the application rates exceed the limits in Attachment B of your permit? 2Compliant ❑Non -Compliant Were adequate measures taken to prevent effluent ponding in or runoff from the sites? v°�compliant ❑Non -Compliant Was a suitable vegetative cover maintained on all sites as specified in your permit? ®Compliant E]Non-Compliant Were all setbacks listed in your permit maintained for every application to each permitted site? QCompiiant ❑Non -Compliant Were all freeboards maintained in accordance with the specified freeboard heights in your permit? gcompliant ❑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. Attach additional sheets It Operator in Responsible Charge (ORC) Certification Permittee Certification ORC: Charles A. Jones, Jr Permittee: Town ofHertofrd Certification No.: 985305 / 993143 Signing Official: Brandon Shoaf Grade: IV/ SI Phone Number: 252.333.6948 Signing Official's Title: Town Manager Has the ORC changed since the previous NDAR-1? Des FNo Phone Number: 252.426.1969 Permit Exp.: 12/19/14 `` 1 1 ,� b 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 Quality Information Processing Unit, 1617 Mail Service Center Raleigh, North Carolina 27699-1617