WQ0022697_Monitoring - 11-2016_20161228 (2)

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDAR-1)
Page 1 of 2
1111
-: Town of • • Neck Reclaim Water Generation•
•
•nth:
November1
1 • irrigation
occur
at this facility?
YES MR NO
•
•
Field Irrigated?
1
•
•
1
1
•NEW
•
M-0 r. FE
1
IMME]
Monthly
Loadirq
12 Month FloatinIg—Total (in):

FORM: NDAR-01 08 11 NON -DISCHARGE MONITORING REPORT (NDAR-1)
Page 2 of 2
Did the application rates exceed the limits in Attachment B of your permit'
Ox
Compliant
F-1Non-Complian
Certification No.: 997714
Were adequate measures taken to prevent effluent ponding in or runoff from the sites?
❑x
Compliant
F-1Non-Complian
Phone Number: 52-826- 52 Permit Expiration: 03/31/2013
Was a suitable vegetative cover maintained on all sites as specified in your permit?
❑X
Compliant
By this signature, I certify that this report is accurrate and complete to the best of my knowledge,
Non-Complian
Were all setbacks listed in your permit maintained for every application to each permitted site'
1x
Compliant
D
Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
FX
Compliant
Non-Complian
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 sheet if necessary
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Ricky Artis
Permittee: Town of Scotland Neck
Certification No.: 997714
Signing Official: Gary Stainback
Grade: 2 Phone Number: 252-826-5540
Signing Official's Title Consultant
Has the ORC changed since the previous NDAR-1? El Yes
Phone Number: 52-826- 52 Permit Expiration: 03/31/2013
Signatu Date
gnature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge,
I certify, under pe 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 property 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