WQ0000948_Monitoring - 11-2016_20161222

,- _ -' "u"'• �" NON -DISCI- APZGE APPLICATION REPORT (NDAR- l Maar_ / n4
Permit No,. WO?OOOOcJ4i}
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Facility . -�
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70W(\I OF JACKSON
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County: N01'Chm
li:On Month:
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year: l
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C.�0�0 Dfr `7�:d©V�i ®a;�0
G°lo � 6"
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Field
2
Field Name:
3
Field Name.
�4
at Gi10 �;210V 09$� ,
Arez (sores):;
11.'22 '
Area (acres):
12.40
Area (acrzs):
: 15.55
Area (acres):
12.26
t.ovcr'CsoFescue
h:
cover crop:
Fescue
Cave'r CVol)::
Fescue.;
cover crop:
Fescue
YES ❑ No
i lourly 157to (ln):
Hourly Rate (In):
I3ourlj f"Zafe (in);
Hourly Rate (in):
Weather Freeboard
Alirival Rate (in):
Annual Rate (in):
llniival Rate (m):
Annual Rate (in):
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p .w. w
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5
FieldIrripatecl?
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ata.
91 YI:S j_J NU
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N� Asa
Field Irrigated?
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YES I] NO
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Mold ln'igated7
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MUN-IJIZ5G:l1At UL; APPLICATION REPORT (NDAR-1) Page -� of .2—
Permit
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Permit• No.: WQ0000948
1131d !6'(ogaiSDO-0
c
at this �'�1dflty?
®YEs ❑ No
occur
Freeboard
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t
Q
Facility Name:
Field hiame:
TOWN OF JACKSON
5
Field Name:
m�.
County: NO11-`'-`
11 ampton
FIoId:Na
Month:
C ,e N�
Field Name;
Year. as Q
al'rea (acmes)::.
T1:: $9
Area (acres):
Area (acres):
Area (acres):
Cover Crop:
Elourly 1:7ta (in):
:: 'lliirival lite (in):
Pieid Irclgated?
'Fescue
Yrs ❑ k)
Cover Crop:
Hourly Rate (in):
Annual Rate (in):
Field Irrigated?
❑YES ❑ No
Cover Cs`op:
HourIj Rate (ill):
Annual rate (in):
Field laic ated r
J
:
❑ YES ❑ rlo
Cover Crop:
Hourly Rate (in):
Annual Rate (in):
Field Irrigated?
❑YES ❑ iso
weather
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42
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ft
gai
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in
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gal
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min
in
in
„mi;l
gai
min
In
3
6
7
B
10
,13
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18
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•is
20
300.
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26
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30
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12Mont11 Floating Tot al (in):
LL -20
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.W- -"FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page _L of
Did the application rates exceed the limits in Attachment B of your permit?mpliant ❑ Non -Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites? //__COmpliant El Non -Com pliant
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? XCompliant ❑ Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? CV�Fompliant El 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 nPcessary
Operator In Responsible Charge (ORC) Certification
Permittee Certification
ORC: Johnny G. Young
Permittee: Town of Jackson
Certification No.: 2 312 9
Signing Official: Jason S. Morris
Grade:l collection Phone Number: 252-534-3811
Signing Official's Title: Mayor
Has the ORC changed since the previous NDAR-1? ❑ Yes
Phone Number: 252-534-3811 Permit Exp.: 12-31-16
Z- 't - d (z
dmm / Zo/
Signatu e . Date
Signature Date
Ihls signal.. I ertify that this report Is accurrate and complete to the best of my knowledge,
I certify, under penally 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