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Home My WebLink AboutWQ0020809_Monitoring - 11-2016_20161228FORM: NDMR-1 08-11 NON -DISCHARGE MONITORING REPORT (NDAR-1) Page 1 of 2 '- ltll 1:1' Facility Name:- Golf : Country Club Reclaimed Water County:•nth: November• 1 • irrigation occur FORM: NDAR-01 08 11 NON -DISCHARGE MONITORING 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 2 of 2 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: James Shoulders Permittee: Town Of Farmville Certification No.: 986266 Signing Official: Gary Stainback Grade: 4 Phone Number: 252-753-3913 Signing Official's Title Consultant Has the ORC changed since the previous NDAR-1? El Yes 0 X Phone.Number: 800-722-0 Permit Expiration: 07/31/2014 Signature Date gna re Dale By this signature, I certify that this report is accurrate and complete to the best of my knowledge, I certify, under penall aw, that Ihls 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 athering the information, the Information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I a 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 Compliant Non-Complian ACompliant ❑ Non-Complian Compliant Non•Compllan IKICompliant Non -Compliant ❑X 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: James Shoulders Permittee: Town Of Farmville Certification No.: 986266 Signing Official: Gary Stainback Grade: 4 Phone Number: 252-753-3913 Signing Official's Title Consultant Has the ORC changed since the previous NDAR-1? El Yes 0 X Phone.Number: 800-722-0 Permit Expiration: 07/31/2014 Signature Date gna re Dale By this signature, I certify that this report is accurrate and complete to the best of my knowledge, I certify, under penall aw, that Ihls 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 athering the information, the Information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I a 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 Page 2 of 2 FORM: NDMR-1 08-11 NON -DISCHARGE MONITORING REPORT (NDAR-1) Permit No.: WQ0020809 Facility Name: Farmville Golf & Country Club Reclaimed Water Month: November • irrigation occur at this facility? YES No .. PRO] lllllll�j*MCn.1 . .. .. - IMMEZ, Monthly Loadg'-- 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? �X Compllanl ❑ Non-Compllan Were adequate measures taken to prevent effluent ponding in or runoff from the sites?X� Compliant Non-Complian Was a suitable vegetative cover maintained on all sites as specified in your permit? ❑X Compliant Non-Compllan Were all setbacks listed in your permit maintained for every application to each permitted site X❑ Compliant 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 dale (s) of the non-compliance and describe the corrective action (s) taken. Attach additional sheet If necessary Operator in Responsible Charge (ORC) Certification RC: James Shoulders ertification No.: 966266 Grade: 4 Phone Number: 252-753-3913 the ORC changed since the previous NDAR-1? Yes El X By this signature, I certify that this report is accurrate and complete to the best of my knowledge, Permittee Certification Permittee: Town Of Farmville Signing Official: Gary Stainback Signing Official's Title Consultant Phone.Number: 600-72 469 Permit Expiration: 07/31/2014 I certify, under entV6 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 alhering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I ar 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