WQ0012696_Monitoring - 11-2016_20161230

FOPV,( 3 NON -DISCHARGE; mn,,' ^it?tmn oC®nnr tatr..—

ur
FORM: NDfviR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) rage
Sampling Person(s)
Name:
Name:
Certified Laboratories
Name: .
Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A. of your permit?
Com¢llant ❑ f4t7n.Complfant°
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 non-compliance and describe the corrective
action(s) taken. Attach additional sheets if necessary.
6Operator in Responsible Charge (ORC) Certification
ORC:
Certification No.: cT
Grade: r Phone Number: -2,-7Z
Has the ORC changed since the previous NDIViR? Yes I
Signature Date
By this slgnaitire, I cetFify that this report is accurrate and complete to the best of my knowledge.
Permittee Certification
Permittee: y 606) Pem l.'c-o k/rt/ e .-
Signing Official. .Sh eyrl / l�Ikw e jl
Signing official's Title: /��///U/'�Cj � ✓
Permit Expiration: q-3
Phone Number: �S �r b Lf li`" 0�
Date
Signature
I certify, under penalty of law, that this document and all attachments were prepared under my direction of supery€sion in
accordance with a system designed to assure that all qualified personnel properly gathered and evaluated Vire information
submitted: Based on my Inquiry of the person or persons who manage the system, or those persons directly responsible for
is, to the best of my knowledge and belie(, true, accurate, and complete. I am
gathering the information, the Information submitted
aware that there are significant penalties for subr6tting false information, Including iha possibility of fines and pnFrisonmeni for
knovrfng violations,
Mail original and Two Copies ta:
Division of Mater Resources
Information Processing Unit
1617 mail Service Center
Raleigh, forth Carolina 276gg-1617
i

FORM: NDAR-1 08-11
NON -DISCHARGE APPLICATION REPORT (NDAR-1)
I.. Page of
mIt No.: W00012696
Facility Name: Pamlico River Ferry Terminal
County: Beaufort Month: Year:,
Did irrigation occur
at this facility?
❑ NO
I ------Name 1
Field Name:
Field Name 4
Field Name:
£Area (acfes) 0 5
Area (acres):
1 Area (acres) x
Area (acres):
"a cover Crap s
CoverCrop:
fi CaverCrop '
Cover Crop:
Hoarly Rate In 017
Hourly Rate (In):
*Woody Rate (Irl) a Y
Hourly Rate (in):
annual Rate (in 3118 ; „
Annual Rate (in):
Annuall Rite (In) 7
Annual Rate (in).
Weather Freeboards
Field Irdgated7 LJ YES r mC! No -'
Field Irrigated? ❑YES' ❑ NOFieid=lr�igated?
AYES;` ❑No
Field Irrigated? DYES ❑ No
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gal min In In
_"gale_ mTn .- Flo ;,-_ i}t-
gal min in in
4 L
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4
6
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13
14
16
17
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18
19
x
20
2125
22
r:
25
2028
27
28
301
311
Monthly Loading
12 Month Floating Total (In):

FORM: NDAR-1'08-11 NON -DISCHARGE 'APPLIi4A1(ION REPORT (NDAR-1) Page of
Did the appimationrates exceed the .limits in Attachment B of your permit? E?&mpnanr C] r,oncomP,lant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites?:compliant.., ,;;❑ Non-compliant
Was a suitable vegetative cover maintained on all sites asspecified in your permit? , I/J compuapt ❑Non Compliant
Were all setbacks listed. in your permit maintained for every application to each -permitted site?`
Compllant _­ ❑ Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? 6m mpliant' ❑ Non-Compllant
If the facility is non-compliant, please explain in the space below the reasons) the facility was not in compliance. Provide in your explanation the date(s):of the nori-compliance and describe the .'corrective
Operator in Responsible Charge, (ORC) Certification
Permittee Certification
ORC: i9PU`/ /" 1 450/`! ...
Permittee: �G Pr7 "( vtwt)ico rr )
Certification No.:. '' -
Signing Official:d(PY'i�8l
Grade: ( Phone Number: ��Z — °(� — Z�
Signing Official's Title: M #,&),'- lei- ,
Has the ORC changed since the previous NDAR-1? . e
❑ yes, t!d'No
Pho ir: z SZ -164 —Z(' sl Permit'Ex -2 ,p 7—b
� p.: �..:3 (7
Jv
Signature Date -
Signature:Date
By this signature, I certify that this report is accurrate and complete to the best of.my. knowiedge.
('certify, under penalty of law, that this document and all attachments were prepared undekmy direction or supervision in accordance
!..
'e'Information
with a system designed to assure that all qualified personnel properly gelhered and evaluated th ., 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 rriy knowledge and belief, true; accurate,.and comp tete. I'am aware that there. are significant
penalties for submitting false information; Including the possibility of floes and,ltriprisonment for knowing violallons.
Mall Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617