WQ0004230_Monitoring - 10-2016_20161202

FORM: NDAR-2 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-2) Page
Permit NoQ0004230
- BeachCarteret
October
Year:
2016
• infiltration
this facility?
• -. -s):
Area -s):
Area(acresy
p
YES ■ NO
Rate (GPD/ft):
Rate (GPD/ft
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FORM: NDAR-210-13 NON -DISCHARGE APPLICATION REPORT (NDAR-2) Page of
X❑✓ Compliant ❑ Non -Compliant
Did the application rates exceed the limits in Attachment B of your permit?
❑r Compliant ❑ Non -Compliant
If not a basin, were the sites kept free of vegetation and raked?
[D Compliant ❑ Non -Compliant
If not a basin, were there any instances of effluent ponding in or runoff from the sites? a Compliant ❑ Non -Compliant
If a basin, were there any instances of breakout from the berms?
Compliant E]Non-Compliant
Was the onsite automatically activated standby power source tested and operational? ,
planation the date(s) of the non-compliance and describe the corrective
If the facility is non-compliant, please explain in the space below the reasontion facilitythe takenwas not
ach in compliance.
sheets if Proviiecessa your ex
ermitte Certification
Operator in Responsible Charge (ORC) Certification
Permittee:
ORC: Donald Omara
Signing Official:
Certification No.: 22801
Grade: SI - Phone Number: [phone]
Signing Official's Title:
No Phone Number: Permit Exp.:
Has the ORC changed since the previous NDAR-2? ❑Yes [D
,s _ 7�,An i. ,. n_ / Date
Signature Date v� under my
I certify, under penalty f law, that this document and all attachments ere gathered and evaluated the information submittednBased on my
on or supe
By this signature. I certify that this report is accurrate and complete to the best of my knowledge, with a system designed to'assure that all qualified personnel property g
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