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HomeMy WebLinkAboutWQ0022384_Monitoring - 10-2016_20161207 (4)- FORiv.: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page _[__ of 3 Permit o,o ,, .. irrigation occur Area.,(acres): Area (acres): Area (acres): at this facility. Co er Crop: v Cover Crop: Cover Crop. El YES .. -. -. -. te Ciny Annual Rate (in): Annual'Rate .... ... .... . .. ... ..Field Irrigated?. .. JOIN 11 i MMMMMM MMMM MMMMMM�®� m MMM MM —��� ���� ���� ���■� m MMM MM Monthly .... �■iiiii,� iiiiii iia�■iiiiii, ®iiiii.®iaii� �iiiii/ice: FOKUl: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page 3 of 3 Did the application rates exceed the limits in Attachment B of your permit? Compliant ❑ Non -Compliant Were adequate -measures taken to prevent effluent ponding in or runoff from the sites? Compliant EJ 'Non -Compliant Was a suitaNe vegetative cover maintained on epi sites as specified in your permit? Compliant ❑ Non -Compliant Dere 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? 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. Operator in Responsible Charge (ORC) Certification Permittee Certification 0RC:-_Pep& Ery j Permittee: c0 Mer 1'e(_' -'JD ^r' Certific.attiio��n1N�•Nllo.: (,f�� Signing Official: G�(I e6(ail. 611(-U)L )1.-� jr. Grade: Phone Number: Z C�71 f._CJS�(� Signing Official's Title: rn((()01J e( Has the ORC changed since the previous NDARA? �1 ❑ Yes 1 )(No Phone Number: 6z-6zq-,-D,%q Permit Exp.: aa–Z61 �S 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