WQ0002829_Monitoring - 11-2016_20161228

FORM: NDAR-2 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-2) Page S of
Permit No.:
WQ0002829
Facility Name:
KDHWWTP
County:
Dare
Month:
November
Year:
2016
Did infiltration occur at
this facility?
❑ YES ❑ NO
Site Name:
1-A
Site Name:
1-13
Site Naive:
3
Site Name:
4
Area (acres): 0.28
Area (acres): 0.28
Area (acres: 0.06
Area (acres): 0.12
Rate (GPD/ft Z)c 10
Rate (GPD 10 10
Rate (GPD/ftp)`: 1.0
. I 1,
Rate (GPD/ft): 10
Weather Freeboard
Site Infiltrated?
❑ YES ❑ NO
Site Infiltrated?
❑ YES
❑ NO
Site Infiltrated?
❑ YES
❑ NO
Site Infiltrated?
❑ YES
❑ NO
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gal
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GPD/ftZ
ft
1
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;',
#VALUE!
?
#VALUE!
2
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0
0
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?
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3
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0
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!'
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?
#VALUE!
4
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0.00
0
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#VALUE!
?
#VALUE!
5
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#VALUE! ,
?
#VALUE!
6
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?
#VALUE!
7
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0
01
0.00
0
0.00
?
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#VALUE!,
?
#VALUE!
S
C 56
0
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0
0.00
?
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#VALUE?
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#VALUE!
9
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0
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' ii
#VALUE!
?
#VALUE!
10
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1 0
0
0:00
0
0.00
?
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#V.ALUE!
?
#VALUE!
111
C 56
0
0
0.00
0
0.00
?#
VALUE!
?
#VALUE!
12
CL 54
0
0
0.00
0
0.00
?
r i
#VAL-UE!
?
#VALUE!
13
C 60
0
0
0.00
0
0.00
?
#VALUE!
?
#VALUE!
14
R 60
0.3
0
0.00
0
0.00
?
#VALUE!.
?
#VALUE!
15
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0
0
0.00
0
0.00
?
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#VALUE!
?
#VALUE!
16
C 64
1 0 1
0
0.00 1
0
0.00
?
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#VALUE!
?
#VALUE!
17
C 60
0
0
0.00
0
0.00
5,376
0i,
2.06
66
10164
0.01
18
C 64
0
0
0.00
0
0.00
6,272
541i
2.40
84
12936
0.02
19
C 60
0
0
0.00
0
0.00
6,720
60.1
2.57
84
12936
0.02
20
C 45
0
0
0.00
0
0.00
6,720
60!
2.57
84
12936
0.02
21
C 40
0
1 0
0.00
0
0.00
6;272
54 !
2.40
90
13860
0.02
22
C 40
0
0
0.00
0
0.00
8,06.4
72',
3.09
96
14748
0.02
23
C 42
0
0
0.00
0
0.00
8,064
-72-„
3.09
96
14748
0.02
24
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0
0
0.00
0
0.00
7,392
E6,';
2.83
_
102
15708
0.02
25
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0
0
0.00
0
0.00
8,064
721!,
3.09
108
16632
0.02
26
R 53
0.6
0
0.00
0
0.00
1 6,720
60
2.57
96
14748
0.02
27
C 47
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0.00
6,272
54;'
2.40
90
13680
0.02
28
C 48
0
0
0.00
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0.00
7,392
66 i
2.83
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1 13680
0.02
29
CL 60
0
0
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7 392
E•6: i
2:83
90
13680
0.02
30
CL 62
0
0,
0.00
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5,376
481;
2.06
66
10164
0.01
31
Monthly Loading (GPD/ftZ):
Year to Date Loadin GPD/ftZ
0.00
0.00
#VALUE!
#VALUE!
10

FORM: NDAR-2 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-2) Page of
Did the application rates exceed the limits in Attachment B of your permit?
If not a basin, were the sites kept free of vegetation and raked?
If not a basin, were there any instances of effluent ponding in or runoff from the sites?
If a basin, were there any instances of breakout from the berms?
Was the onsite automatically activated standby power source tested and operational?
r❑ Compliant
❑ Non -Compliant
❑� Compliant
❑ Non -Compliant
❑ Compliant
❑ Non -Compliant
0 Compliant
❑ Non -Compliant
0 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
ORC: Jimmy Bliven
Permittee:
George E Goodrich
Certification No.: 991879
Signing Official: William G Freed by Authority
Grade: 4 Phone Number: 2522022435
Signing Official's Title: Pres of Envirotech
Has the ORC changed since the previous NDAR-2? ❑ Yes ❑ No
Phone Number: 2524915277 Permit Exp.: 8/31/18
/2 -,;Z.2 -
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 forgathering 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-2 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-2) Page & of y
Permit No.:
WQ0002829
Facility Name:
KDHWWTP
County:
Dare
Month:
November
Year:
2016
Did infiltration occur at
this facility?
❑ YES ❑ No
Site Name:
5
Site Name:
6
i'r`
Site -Name:
r." .
7=A
Site Name:
7-B
Area (acres): 0.06
Area (acres): 0.21
Area (acres)': .0.1`7
HT1
Area (acres): 0.17
Rate (GPD/ft2): 10
Rate (GPD/ft): 10
Rate (GPD/el): 10
. Ifi,r
Rate (GPD/ft): 10
Weather Freeboard
Site Infiltrated?
❑YES
❑ No
Site Infiltrated?
El YES
❑ No
Site Infiltra6,0
❑YES
❑ NO
Site Infiltrated?
❑ YES
❑ NO
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GPD/ftz
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GPD/ft"
ft
gal
min
GPD1ft2
ft
1
C
60
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#VALUE!
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121
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10,080
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3.86
37,800
150
4.13
21,420
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2.89
26,460
126
3.57
18
C
64
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12,768
114
4.89
48,384
192
5.29
27,720
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3.74
30,240
144
4.08
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12,768
114
4.89
46,872
186
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61`32''i,
31,74
37,800
180
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20
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12,768
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4.89
48,384
192
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27,720
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34,020
162
4.59
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12,768
114
4.89
48,384
192
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34,020
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4:59
35,280
168
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10,752
96
4.11
46,872
186
5.12
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4:59
41,580
198
1 5.61
231
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11,424
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59,052
222
6.46
45,360
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0.13
40,320
192
5.44
24
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54
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16,128
144
6.17
54,432
216
5.95
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4.59
41,580
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5.61
25
C
64
0
14,784
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52,668
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1 5.76
1 32,760
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40,320
192
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26
R
53
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15,456
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5:91
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41,580
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27
C
47
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14,112
126
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52,668
198
5.76
32,760
f (16'1_
4.42
39,060
186
5.27
28
C
48
1 0 1
12,768
114
4.89
63,504
252
6.94
27,720
1, 1132,
3.74
34,020
162
4.59
291
CL
60
1 0
10,080
90
3:86
39,312
156
4.30
22,680
"1(x,8`',
3.06
27,720
132
3.74
30
CL
62
0
11,424
1.02
4.37
43,848
174
4.79
21,420
1021
2.89,
25,200
120
3.40
31
Monthly Loading (GPD/ ):
Year to Date LoadingGPD/ft2ZA
#VALUE!
#VALUE!
#VAL`UE!
#VALUE!

FORM: NDAR-2 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-2) Page of
Did the application rates exceed the limits in Attachment B of your permit?
If not a basin, were the sites kept free of vegetation and raked?
If not a basin, were there any instances of effluent ponding in or runoff from the sites?
If a basin, were there any instances of breakout from the berms?
Was the onsite automatically activated standby power source tested and operational?
Compliant
❑ Non -Compliant
Compliant
❑ Non -Compliant
Compliant
❑ Non -Compliant
❑� Compliant
❑ Non -Compliant
❑✓ 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
ORC: Jimmy Bliven
Permittee:
George E Goodrich
Certification No.: 991879
Signing Official: William G Freed by Authority
Grade: 4 Phone Number: 2522022435
Signing Officials Title: Pres of Envirotech
Has the ORC changed since the previous NDAR-2? ❑ yes 0 No
Phone Number: 2524915277 Permit Exp.: 8/31/18
/2 2 —/
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-2 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-2) Page of
Permit No.: WQ0002829
Facility Name:
KDHWWTP
County: Dare
Month:
November
Year:
2016
Did infiltration occur at
this fatality?
❑ YES ❑ NO
Site Name:
POND 1
Site Name:
POND 2
Site Name:
. 1r .
Site Name:
Area (acres): 0.67
Area (acres): 2.1
Area (acres)
Area (acres):
Rate (GPD/ft): 1.49
Rate (GPD/ft): 1.49
Rate (GPD16?j:
Rate (GPD/ft):
Weather Freeboard
Site Infiltrated?
❑YES ❑ NO
Site Infiltrated?
❑ YES
❑ NO
Site InflltratetJ7
❑ YES
❑ NO
Site Infiltrated?
❑ YES
❑ NO
ro
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LL m
OF in ft ft
gal min
GPDIft2 ft
gal min
GPD/ft2
ft
gal m't'n'
GPD/ft2
ft
gal min
GPD/ft2
ft
1
C 60 0
0
0.00
0 0
0.00
2
C 60 0
0
0.00
0 0
0.00
j
3
C 64 0
0
0.00
0 0
0.00
4
PC 58 0
0
0.00
0 0
0.00
-
5
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0
0.00
0 0
0.00
rf
6
C 56 0
0
0.00
0 0
0.00
_
it Ai
71
C 58 0
0
0:00
0 0
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r l 1
8
C 56 0
0
0.00
0 0
0.00
9
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0
0.00
0 0
0.00
10
CL 52 0
0
0.00
0 0
0.00
l•
11
C 56 0
0
0.00
0 0
0.00 '
12
CL 54 0
0
0.00
0 0
0.00'
131
C 60 0
0
0.00
173,000 288
1.89,
j •', ', J
14
R 60 0.3
0
0.00
133,000 306
1.45
r ,
15
C 54 0
0
0.00
131,000 420
1.43
16
C 64 0
0
0.00
0 0
0.00
17
C 60 0
0
0.00
0 0
0.00
t'
18
C 64 0
0
0.00
0 0
0.00
191
C 60 0
0
0.00
0 0
0.00
20
C 45 0
0
0.00
0 0
0.00
j
21
C 40 0
0
0.00
0 0
0.00
22
C 40 0
0
0.00
0 0
0.00
23
C 42 0
0
0.00
0 0
0.00
l j-' •'
24
R 54 0
0
'0.00
0 0
0.00
25
C 64 0
0
0.00
0 0
0.00
; l
26
R 53 0.6
0
0.00
0 0
0.00
27
C 47 0
0
0.00
0 0
0.00
28
C 48 0
0
0.00
0 0
0.00
29
CL 60 0
0
0.00
0 0
0.00
301
CL 62 1 0
0
0.00
11 L j ; ' `
311
1 1 1
Monthly Loading (GPD/ft):
Year to Date Loading GPD/f2
MAIMEW0.00
0.16
#DIV/01
#DIV/0!

FORM: NDAR-2 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-2) Page of
Did the application rates exceed the limits in Attachment B of your permit?
If not a basin, were the sites kept free of vegetation and raked?
If not a basin, were there any instances of effluent ponding in or runoff from the sites?
If a basin, were there any instances of breakout from the berms?
Was the onsite automatically activated standby power source tested and operational?
Q Compliant
❑ Non-compliant
Compliant
❑ Non -Compliant
❑✓ Compliant
❑ Non -Compliant
❑� compliant
❑ Non -Compliant
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
ORC: Jimmy Bliven
Permittee:
George E Goodrich
Certification No.: 991879
Signing Official: William G Freed by Authority
Grade: 4 Phone Number: 2522022435
Signing Official's Title: Pres of Envirotech
Has the ORC changed since the previous NDAR-2? ❑ Yes, 0 No
Phone Number: 2524915277 Permit Exp.: 8/31/18
/2-`2--7"4�
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-2 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-2) Page I- of `_I
Permit No.:
WQ0002829
Facility Name:
KDHWWTP
County:
Dare
Month:
November
Year:
2016
Did infiltration occur at
this facility?
❑ YES ❑ NO
Site Name:
IRRA
Site Name:
IRR -2
Site{�ya7ie:
IRR -3
Site Name:
IRR -4
Area (acres): 4.6
Area (acres): 6.47
Area (acres): 3.27
IM,
Area (acres): 5.62
Rate (GPD/ftp): 1
Rate (GPD/ft2): 1
Rate (GPDI): 1
Rate (GPD/ft): 1
Weather Freeboard
Site Infiltrated?
❑ YES
❑ NO
Site Infiltrated?
❑ YES
❑ NO
Site In, ltraA ?
[I YES
❑ NO
Site Infiltrated?
❑ YES
❑ NO
A
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m
U. Co
°F
in ft ft
gal
min
GPDlftz
ft
gal
min
GPD/ft2
ft
gal
mini,
GPD/ft? .
ft
gal
min
GPD/ftZ
ft
1
C
60
0
19,200
144
0.10
38,400
288
0.14
28,800
.11321
0:20
67,200
480
0.27
2
C
60
0
19,200
144
0.10•
38,400
288
0.14
28,800
192�R
0:20_
67,200
480
0.27
3
C
64
0
19,200
144
0.10
38,400
288
0.14
28,800
1.92+{
0.20
67,200
480
0.27
4
PC
58
0
19,200 _
144
0.10
38,400
288
0.14
28,800
102JI ;
020
67,200
480
0.27
5
C
60
0
19,200
144
0.1.0 ,
38,400
288
0.14
28;800
192j(,
0.20
67,200
480
0.27
6
C
56
0
19,200
144
0.10
38,400
288
0.14
28,800
1�Vj S
0.20
67,200
480
0.27
7
C
58
0
19,200
144
0.10
38,400
288
0.14
28,800
192! {
0.20
67,200
480
0.27
8
C
56
0
19,200
144
0.10
38,400
288
0.14
28;800' ,
{'1;92'; 1
0,20',
67,200
480
0.27
9
C
58
0
19,200
144
0.10
38,400
288
0.14
28,8001;(192
0.20
67,200
480
0.27
10
CL
52
0
19,200
144
0.10
38,400
288
0.14
28;800,
1922;
0.20
67,200
480
0.27
III
C
56
0
19,200
144
0.10
38,400
288
0.14
28,800
192;1 ..
0:20
67,200
480
0.27
12
CL
54
0
19,200
144
0.10
38,400
288
0.14
�`
28,800
1;2{
020
67,200
480
0.27
13
C
60
0
19,200
144
0,.10
38,400
288
0.14
28,800,
1;02;
0.20
67,200
480
0.27
14
R
60
0.3
0
0.00
0
0.00
0
(�
0.00
0
0.00
15
C
54
0
0
0.00
0
0.00
0!�,
}'�
0.00
0
0.00
16
C
64
0
0
0.00
0
0.00
0
�;�1 {
0.00.
0
0.00
171
C
60
0
0
0.00
0
0.00
0
: ' (�
0.00
0
0.00
18
C
64
0
0
0.00
0
0.00
0
{ 4 Il ;j
0.00
0
0.00
19
C
60
0
6
0.00
0
0.00
0
��,�
0.00
0
0.00
20
C
45
0
1 0
0.00
0
0.00
0
{ j i
0.00
0
0.00
21
C
40
0
0
0:00
0
0.00
0
(!,
0.00
' _
0
0.00
22
C
40
0
0
0.00
0
0.00
6
(�;! I
0.00
0
0.00
231
C
42
0
0
0.00
0
0.00
0
()1
0.00
0
0.00
24
R
54
0
0
0.00
0
0.00
0
f y`
0:00
0
0.00
25
C
64
0
0
•0.00
0
0.00
0'(
0.00
0
0.00
26
R
53
0.6
0
0.00
0
0.00
0
iti ({
0:00
0
0.00
27
C
47
0
0
0.00
0
0.00
0
l 'S� (';
_ 0.00
0
0.00
28
C
48
0
0
0.00
0
0.00
0
(i r11
0.00
0
0.00
291
CL
60
0
0
0.00
0
0.00
SR.
1 0.00'
0
1
0.00
30
CL
62
1 0
0
0.00
0
0.00
0
{ { J
0:00
0
0.00
311
1
1 1
rill
Monthly Loading (GPD/ft
Year to Date Loadin GPD/ftZ
:
0.04
0.06
0:09
0.12

FORM: NDAR-2 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-2) Page of
Did the application rates exceed the limits in Attachment B of your permit?
F±] Compliant
❑ Non -Compliant
If not a basin, were the sites kept free of vegetation and raked?
O Compliant
❑ 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?
121 Compliant
❑ Non -Compliant
Was the onsite automatically activated standby power source tested and operational?
I] 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
ORC: Jimmy Bliven
Permittee:
George E Goodrich
Certification No.: 28243
Signing Official: William G Freed by Authority
Grade: SI Phone Number: 2522022435
Signing Official's Title: Pres of Envirotech
Has the ORC changed since the previous NDAR-2? ❑ Yes E] No
Phone Number: 2524915277 Permit Exp.: 8/31/18
Z —2 2- l,�
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-2 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-2) Page -2- of
Permit No.: W00002829
Facility Name:
KDHWWTP
County: Dare
Month:
November
Year:
2016
Did infiltration occur at
this facility?
❑ YES ❑ NO
Site Name:
IRR -5
Site Name:
IRR -6
Site Narie:
IRR -7'
Site Name:
Area (acres): 0.94
Area (acres): 1.65
Area (acres): 2
Area (acres):
Rate (GPD/ft 1
Rate (GPD/ft): 1
Rate (GPDlft,) 1
Rate (GPD/ft2):
Weather Freeboard
Site Infiltrated?
❑ YES
❑ NO I
Site Infiltrated?
❑ YES
❑ NO
Site InfiltFafnd?
❑ YES
❑ NO
Site Infiltrated?
❑ YES
❑ NO
d
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0
na
ACycIy0
� O
L�m
OF in ft ft
gal min
GPDlft2
ft
gal
min
GPD/ft'
ft
gal min ';
GPD/ft'
ft
gal min
GPD/ftZ
ft
1
C
60 0
0
0.00
38,400
288
0.53
0 r
0.00
2
C
60 0
0
0.00
38,400
288
0.53
0 ",';
0.00
3
C
64 0
0
0.00
38,400
288
0.53
0 1 I;
0.00
4
PC
58 0
0
0.00
38,400
288
0.53
0 ! ,':
0.00
5
C
60 0
0
0.00
38,400
288
0.53
0 ti,;;
0.00
6
C
56 0
0
0.00
38,400
288
0.53
0 % , ;
0.00
7
C
58 0
0
0.00
38,400
288
0.53
0 ° •
0.00
8
C
56 0
0
0.00
38,400
288
0.53
0 ', ; :
0.00
9
C
58 0
0
0.00
38,400
288
0.53
0
0.00
10
CL
52 0
0
0.00
38,400
288
0.53
0 i
0,00
11
C
56 0
0
0.00
38,400
288
0.53
0
0.00
12
CL
54 0
0
0.00
38,400
288
0.53
0
0.00
13
C
60 0
0
0.00
38,400
288
0.53
0 "
0.00
14
R
60 0.3
0
0.00
0
0.00
0 1
0.00
15
C
54 0
0
0.00
0
0.00
0
0.00
16
C
64 0
0
0.00
0
0.00
0
0.00
17
C
60 0
0
0.00
0
0.00
0 ! i i
0.00
18
C
64 0
0
0.00
0
0.00
0 `! (
0.00
19
C
60 0
0
0.00
0
0.00
0
0.00
20
C
45 0
0
0.00
0
0.00
0 j,
0.00
21
C
40 0
0
0.00
0
0.00
0
0.00
221
C
40 0
0
0.00
0
0.00
0
0.00
23
C
42 0
0
0.00
0
0.00
0 j
0.00
24
R
54 0
0
0.00
0
0.00
0 ; ,
0.00
25
C
64 0
0
0.00
0
0.00
0 j i ',
0.00
26
R
53 0.6
0
0.00
0
0.00
0 S ;
0.00
27
C
47 0
0
0.00
0
0.00
0 v �,
0.00
281
C
48 0 1
0
0.00
0
0.00
0 %',''
0.00
29
CL
60 0
0
0.00
0
0.00
0 ;.;
0-00
30
CL
62 0
0
0.00
0
0.00
0 !'
0.00
31
Monthly Loading (GPD/ft ):
Year to Date Loading (GPD/ft):
0.00
0.23
0.00
#Div/Oi

FORM: NDAR-2 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-2) Page of
Did the application rates exceed the limits in Attachment B of your permit?
If not a basin, were the sites kept free of vegetation and raked?
If not a basin, were there any instances of effluent ponding in or runoff from the sites?
If a basin, were there any instances of breakout from the berms?
Was the onsite automatically activated standby power source tested and operational?
Compliant
❑ Non -Compliant
21 Compliant
❑ Non -Compliant
El Compliant
❑ Non -Compliant
❑✓ Compliant
❑ Non -Compliant
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
ORC: Jimmy Bliven
Permittee:
George E Goodrich
Certification No.: 28243
Signing Official: William G Freed by Authority
Grade: SI Phone Number: 2522022435
Signing Official's Title: Pres of Envirotech
Has the ORC changed since the previous NDAR-2? ❑ yes ❑ No
Phone Number: 2524915277 Permit Ftp.: 8/31/18
/.Z -.2-.2. -
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. 1 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