WQ0014306_Monitoring - 11-2016_20161228 (2)

FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page _L_ of I
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Facility Name:
Sandler Utitlities, LLC., Inc.- Eagle Creek
Did
irrigation occu
at this facility?
EDYES LINO
Hourly Rate (ln�
Annual Rate (in):
Field Irrigated?
Field Irrigated?
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FORM: NDAR-1 08.11
NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Did the application rates exceed the limits in Attachment B of your permit?
Were adequate measures taken to prevent effluent ponding in or runoff from the sites?
Was a suitable vegetative cover maintained on all sites as specified in your permit?
Were all setbacks listed in your permit maintained for every application to each permitted site?
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
Page _ of _
❑+Compilant ❑Non -Compliant
❑O Compliant ❑NWcompkant
❑O CartWiert ❑NprrConpltant
(]Compliant ❑Non Compliart
i]Comphant (3Non-Comptwt
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 dates) of the noncompliance and describe the corrective
auuusntey mRtn. nrrarn a ididonan sneer if necessary.
Operator In Responsible Charge (ORC) Certification
Permittee Certification
ORC: Randall Mans
Permittee:
Sandler Utilities
Certification No.: 993714
Signing Official: William G. Freed
Grade: WW2 Phone Number: 252-340-4586
Signing Officials Tile: President, Envirotech
Has the OR nW1,4Wsince the previous NDAR-1? ❑yes ❑, No
Phone Number: 252-207-5853 Permit Exp.: 9/30/20
Signature Date
Signature Date
By NS aignatoe. I certify Mat ties repot is acarrde and complete to de beat of my knoM9dge.
I certify. under perelry of lex, Mat Cts document anti at adachnents were prep" under my direction or supervision In accordance
with a system dealgred to assra that Y queued persorsel property gatimed and evalWad Ma efermation ebmaed. Based on my
Inquiry of the person o Panora vdm manage the system. Or Coe persons deeoty resporebe for getterlre the Information. the
Hameaon submitted is. to the best of my Imoalecipe ant belief. has, acc rW, and complale. I am sense that Mere are s4rdicant
penalties for wbmmee false i formalJoR Wudsg Me possibility, of sues and Ynprleosensens for knowtp violations.
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mall Service Center
Raleigh, North Carolina 27699.1617