WQ0001664_Monitoring - 10-2016_20161202

'FORM: NDAR-2 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-2) Page of
Permit No.:
WQ0001664
Facility Name:
Belvedere Plantation WWTF
County:
Pender
Month:
October Year: 2016
Did
infiltration occur at
Site Name:
A
Site Name:
B
Site Name:
C
Site Name:
this facility?
Area (acres):
0.27
Area (acres):
0.27
Area (acres):
0.27
Area (acres):
DYES
ONO
Rate (GPD/ft):
8.55
Rate (GPD/ft):
8.55
Rate (GPD/ft):
8.55
Rate (GPD/ft):
Weather Freeboard
Site Infiltrated?
DYES
ONO
Site Infiltrated?
DYES
ONO
Site In iltrated?l
DYES
ONO
Site Infiltrated? DYES ONO
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FORM: NDAR-2 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-2) Page of ti
Did the application rates exceed the limits in Attachment B of your permit? 0> (]Compliant ❑Non -Compliant
If not a basin, were the sites kept free of vegetation and raked? Elcompliant ❑Non -Compliant
If not a basin, were there any instances of effluent ponding in or runoff from the sites? []Compliant ❑Non -Compliant
If a basin, were there any instances of breakout from the berms? (]Compliant ❑Non -Compliant
Was the onsite automatically activated standby power source tested and operational? OCompliant []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.
Carolina Water Service Inc. of NC
P.O. Box 240908
Charlotte, NC 28224-908
704-525-7990
Operator in Responsible Charge (ORC) Certification
ORC: EDDIE BALDWIN
Certification No.: 18533
Grade: SI Phone Number: 910-367-8999
Has the ORC changed since the previous NDAR-2? W., ❑No
er,ec,�
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
Permittee Certification
Danny Lassiter
Permittee: i Regional Manager
Signing Official: j [e-mail]
800-525-7990
Signing Official's Til
Phone Number: 800-348-2383 Permit Exp.: 1/31/20
Signature Date
I certify, under pen f 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