HomeMy WebLinkAboutWQ0004967_Monitoring - 11-2016_20170103� fORM: NDMR 0312 NON-DISCHARGE MONITORING REPORT (NDMR Pege�of�
FORM: NDMR 03-12 NON-DISCHARCE MONITORING REF'ORT (NDMR Page,�ofv�
Sampling Person(s) Cartified Laboratories
Name: Juanita James ' Name: James & James Env. Mgt., Inc.
Name: Name: Research & Anal iCal
Does all monitoring data and sampling frequencies m��et the ret�uirements in Attachment A of your permit? ❑ compiiant ❑ Non-compiiant
N the faWlily is non-compliant, please explain In the spece baloW the reason(s) the fadlily was not in compllance. Provida in you explanation the dete(s) of the non-compliance end describe the coirective
eCpon(s) taken. Apach addltlonal sBeets fF necessary.
O erator in Responsible Char e ORC) Certification Permittee Certiflcation
OFtC: Juanita James Permittee: Alljuice Food & Beverage
Certification No.: 25034 Signing O�cial: James & James Env, Mgt., Inc. �
Grade • Phone Number: 828-697-0063 Signing pfficiaPs Title: Contract Operations
Has the O.RC changed since the previous NDMR? Yes No phone Number: 828-697-0063 Permit Expiration: 4-30-17
12128/2076 � ��i 92128/2016
Signature Date gnature Date
By the signature, I certify that this report is accurate and complete to the best of my knowledge, e�ify, und�r penalry of iew,lhat this documeni and all atte�hment were prepared under my directlon oP supervision in accordan
ith a systetn designed to asaure that ell qualified personneFproperly gathered and evelueted the information submitted. Based o
y inquiry ot the person or persons who manage the system, or those persons directly responsible for gaihering the informatlon, l
formation 'submitled is, to the best of my knowledge and belief, true, eccurate, and complet2. I am aw8rethe there are signiflc
panelties for submittlng false infomt�tlon, including the possibtlity ot fi�1es and lmprisonment tor knowing violetfons.
Mail Original and Two Copieg to:
Diviaion of Weter Quality
Information Proces�afng Unit
1617 Mail Servlce Center
Raleigh, North Garolfna 27688•1617
, FORM: NDAR-1 os-11 _ NON-DISCHARGE APPLICATION REPORT (NDAR-1) Page � of�
FORM: NDAR-1 08-17
NON-DISCHARGE APPLICATION REPORT (NDAR-1)
Did the application rates exceed the limits in Attachment B of your permit?
Page � of a
� Compliant ❑ Non-Compilant
Were adequate measures taken to prevent effluent ponding in or runoff from the_sites? � Compliant I] Non-Compliant
War a suitable vegetative cover maintained on all sites as specified in your permit? p c�mp��a�t ❑ Non-Compllant
Were �II setbacks list�d in your permit maintained for every application ta each permitted site? � Compliant ❑ Non-Compllant
We�e all freeboards maintain�d in accordance with the specified freeboard heights in your permit? p camP��a�c ❑ Non-CompAant
If the faciliry is non-compliant, pleese explain in the spaaa below the reason(s) the facility was not in campliance. Provide in your explanation the date(s) of the non-compliance end describe the corrective
ection(s) taken. Aitach additional sheets if necessary.
0
Operator in Responslbl� Cha�ge (QRC) Certiflcation Permittee Certificatlon
oRC: JUANITA JAMES � Permittee: -
Alljuice Food & Beverag�
Certffication No.: �5034 , Signing Offlcial: James & James Enu. Mgt., Inc.
Grade: Phone Number: $28-697�0063 Signtng Oiflcial's Tltle: Contract Operations
Has the QRC changed since the previous NDAR-17 ❑ Yes � No Phone Number; 828-697-0063 Permit Exp.; 4/30/17
12/28/16 � .{CttlJ' �, 12/2$/16
Signa re Date gnature Date
By ihis signature, i`certify that thls report is accurrate end wmplete to the best of my knowledge. I certify, under penalty of lew, that thia dowment and all ettachmeols were prepered under my direclion or superviaion In aecordance
wlth e system deslgned to assure thet all qualiiled personnel properiy gathered end evalueted the infortnaUon submitted. Based on my
inquiry of the perspn or persons who managa 1he system, or those persnna direcqy responsible for galhedng the Information, the
Iniormetion submitted is, to the bast of mY knowledge and belief, Vue, accurate, and complete. I am eware thet there ere slgniiicent
peneltias far submitUng false infortnatlon, Including the possibility of nnes and imprisonmant far knowinp vlotedons.
Mall O�iginal and Two Copies to:
Division of Wate� �uality
Information Processing Unit
1617 Mall Service Center
Raleigh, North Carolina 27699-1617