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Home My WebLink AboutWQ0029653_Monitoring - 11-2016_20170103��.� �� a�� !r7f � \�� I� 1R,�1 � � \ � � t �' 1. I�� ii��t�' 1 .� `� 'fdFtM: NDMR 03-12 Sampling Person�s) Name: Name: NON-0ISCHAR(iE MONITORING REPORT (NDMR) Name: Name: Certifletl Laboratories Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? Page ❑ComvlWrrt of ❑ NonLompllairt If the faciliry is non-compliant, please explain in the space below the reason(s) the facility was not in compliance. Provide in your ezplanation the date(s) of the rwn-compliance and describe the conective action(s) laken. -- � - -.. _ . . ._ Operator in Responsible Charge (ORC) CeAification Pertnittee Certifiwtion oRc: RICK HARRELL Permmee: SCOTCH HALL PRESERVE WWTP Certification No.: SI 986118 Signing �cial: DANIEL SUMEREL Grade: Phone Number: 252-724-1663 Signing Otficial's Titk: GENERAL MANAGER Has the ORC changed since the previous NDMR4 ❑ rs ❑ Na Phone Number: 919-300-9316 Permit Expiration: /' ' ` � ,-c� ��r�� ,�-� lG � �� i�-a5-� Signature Date Signature Date By this signature, I certify that this report ia accmrate antl complMe to t�e best of my knrnNedpe. I certify, untler penatty W law, ihat thia documeM and all attachments were preparetl under my Airection or supeMsion in accordance wdh a system OesiBnetl to assure that all Qual�etl peisonnel pmpedy gathered a�q evaluated the infortnation su�mitletl. Based on my inquiry of the person or persons who manape [he system, or [hose persons directly responsible for pathennB «�nformatioq the info�mation submdted is, to the hest of my knaMetlge antl belief, true, accurate, and complete. I am aware that there are significaM penatties for submitting False informatioq includinp the possibility of fines and imprisonment for knowing vioWtions. Mail Original and Two Copies to: Division of Water Resources Intormation Prxessing Unit 1617 Mail Service Center �oRM: NDAR-1 10-13 NON-DISCHARGE APPLICATION REPORT (NDAR-1) Page _ ot_ •�� • - - - � � � � . . . �' �' iiWi��-��-�- �� - �- �- �� - �- �- ■ a . �- �- �- �- �- �- �- �- �� ■ o . � ■ ■ . � ■ ■ ,� ■ ■ . 0�0� �� 0 �� '0�� I�� IO�� /�� A �� '�o�� r— �� n � �� 'n�� , � � .�� ■�� i � � �� n�� ►� ■ ■ �� :f�ar:r� rr.T,,�� 'r 'ra�� m�� 1\tl.:l'_1 <.1�11\�� l`-�7�� m�� L.�� r��ia `�� m�� Y�� r�� m�� m�� m�� I�m�� /!�� Im�� m�� /�'!�\T7� �� 'm�� /'//� 1 1 ■ t � �� Im�� Z=Z�J ir�a�� Im�� !m�� !m�� ',m�� m�� m�� m�� m�� m�� m �� m�� 0%///%%% • , � %O%�%i;0;%%///%%//,/ � � � � ��%/ v 0/O%%/,/�i � � � /%/%///i/G,�OG/'O%%//;;� �; O,ii ;%i� i %%/�%''��%%�' %%/,'i%%'%O%%'�O//://///%�i, %��i�o /r��i;,,� ; r„�/��,''%////%%i%��%%%' � i%//�/ FORM: NDAR-1 10-13 IVON-DISCHARGE APPLICATIOIV REPORT (NDRR-1) Did the application rates exceed the limits in Attachment B of your permit? Were aslequa'te 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? Ullere all setbacks listed in your permit maintained for every application to each permitted site? V1lere all freeboards rnaintained in accordance with the specified freeboard heights in your permit? Page of ❑ Compliant [] Non-Compliant ❑ CompUant ❑ Non-Compliant ❑ Compllant ❑ Non-Compliant ❑Compliant ❑Non-Compliant Q 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 necessaN. Operator in Responsible Charge (ORC) Certification Permittee Certi£cation ORC: RICK HARRELL Permittee: . SCOTCH HALL PRESERVE WWTP Certification No.: SI 986118 Signing official: DANIEL SUMEREL Grade: Phone Number: 252-724-1663 Signing Official's Title: GENERAL fVIANAGER Has the ORC changed since the previous NDAR-1? ❑ Yes ❑ No Phone Number: 919-300-9316 Permit Exp.: 2/29/20 ,- �% /�- ? � / �l�L /lt�r�'zl� �j o7��f � ,=`� �1- ,, - ,�,_� _ � Signatu e'� 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 taw, that this document and alI 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, accurete, 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 Resources Information Processing Unit 1617 Mail Service Center Raleigh, North Carolina 27699-1617