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Home My WebLink AboutWQ0007283_Monitoring - 11-2016_20161222 (2)' FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Permit No.: •1117283 Facility Name: TOWN of POLLOCKSVILLE County: Jones Month: November1 • irrigation occur Area (acresy Area (acres): Area (acres): Area (acres): at this facility? Cover Crop: Cover Crop: Bermuda/Rye Cover Crop: Bermuda/Rye EYES LINO Hourly-.te (in): Hourly -.te (in): Hourly �.te (in): Hourly -. • Annual Rate (in): Annual Rate (iny Annual Rate (in): ...Field D ■ •Field Irrigated?D ■•Irrigated?■ •Irrigated?■ • ®�®� �_ ---_ -_-- �l�iC�lTIL'lll�lilitl�(ii➢� -_-- m 000_ ---- ---- ---- -_-- FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Did the application rates exceed the limits in Attachment B of your permit? ❑OCompllant ❑Non -Compliant 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? (]Compliant []Non -Compliant Were all setbacks listed in your permit maintained for every application to each permitted site? OCompliant []Non -Compliant Were all freeboards maintained in accordance with the specified freeboard heights in your permit? ElCompliant ❑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 aaaltlonal sneets It Operator in Responsible Charge (ORC) Certification Permittee Certification ORC: Tony Randell Hawkins Permittee: Town of Pollocksville Certification No.: 990822 / 990494 Signing Official: James Bender Jr. Grade: IV Phone Number: (252)639-7558 Signing Official's Title: Mayor Has the ORC changed since the previous NDAR-1? ❑yes pNo Phone Number: 4-9831 Permit Exp.: 4/30/16 L/ /4 e��d* 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) Permit No.: WQ0007283 Facility Name: TOWN of POLLOVCKSVILLE County: Jones -1 Month: November t • irrigation occur ��VVFMMM�� Field Name: Field Name: Area (aceAj�� Area (acres): Area (acres): t this facl Bermuda/Rye Cover Crop: Bermuda/Rye I �41-1114 AM EYES ■. Hourly Rate (in):!I�� Hourly Rate (iny. Hourly Rate (in): Annual Rate (in):- A nnual Rate i -n): ...... ■ v • ■ v :. ■ vField Irrigate■ v . 11111MMININ MMM Nil M Bill mem FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Did the application rates exceed the limits in Attachment B of your permit? ❑.r Compliant ❑Non -Compliant Were adequate measures taken to prevent effluent ponding in or runoff from the sites? ECompliant ❑Non -Compliant Was a suitable vegetative cover maintained on all sites as specified in your permit? RCompllant ❑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? ❑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 taKen. Httacn aaaltlonal sneets It Operator in Responsible Charge (ORC) Certification Permittee Certification ORC: Tony Randell Hawkins Permittee: Town of Pollocksville Certification No.: 990822 / 990494 Signing Official: James Bender Jr. Grade: IV Phone Number: (252)639-7558 Signing Official's Title: Mayor Has the ORC changed since the previous NDAR-1? ❑yes ONo Phone Number: 4-9831 Permit Exp.: 4/30/16 i" ,4m, 11 Signature Date Signature Date By this signature, I certify that this report is accurrate and complete to the best of my knowledge. 1 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