The URL can be used to link to this page

Home My WebLink AboutWQ0033325_Monitoring - 12-2016_20170131FORM: NDMR 10-13 NON -DISCHARGE MONITORING REPORT (NDMR) Page Permit No.: WQ0033325 Facility Name: Tobermory Well County: Bladen Month: December Year: 2016 PPI: 001 Tlow Measuring Point: ❑ Influent O Effluent ❑ No flow generated Parameter Monitoring Point: ❑ Influent E Effluent ❑ Groundwater Lowering ❑ Surface water Parameter Code —► 50050 00940 01045 D C O E m a E_ w U F' U� 0 of O O 3 o LL ° .0 L U c 0 24 -hr hrs Gallons mg/L mg/L 1 08:39 6,900 2 3 4 5 6 7 8 08:23 6,800 9 10 11 12 a 1 13 ` 14 a 15 10:20 7,000 16dNGL�- 17 S �lFQR4dIK i , 18 19 20 21 22 12:56 6,800 23 24 25 26 27 28 29 09:46 6,800 30 31 Average: 6,860 Daily Maximum: 7,000 Daily Minimum: 6,800 Sampling Type: Recorder Grab Grab Monthly Avg. Limit: Weekly Limit: 8,000 FORM: NDMR 10-13 NON -DISCHARGE MONITORING REPORT (NDMR) Page of Sampling Person(s) Certified Laboratories Name: Name: Name: Name: Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? ❑ 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 necessary. Operator in Responsible Charge (ORC) Certification Permittee Certification ORC: Permittee: L Certification No.: Signing Official: Grade: • Phone Number: Signing Official's Title: IOV %� lily / '/ee ci-0,< Has the ORC changed since the previous NDMR? ❑ yes ❑ No Phone Number: 9��` ��_� . `jIJ _3l_ l Permit Expiration: D .2 Signature 1x ~ 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 law, that this document and all attachments were prepared under my direction orsupervision 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 Resources Information Processing Unit 1617 Mail Service Center FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of Permit No.: WQ0033325 Facility Name: Tobermory Road Well County: Bladen Month: December Field Name: Field Name: Field Name: • irrigation occur 1Area (acres�. Area (acres): at this facility? 0 YES 0 NO Cover Crop:. .. Cover-Crop Crop: .-Hourly -. 1 . -. . -. . -. Annual Rate (in)� Annual Rate (in): ! L Annual Rate (in): ... . . . ■ ■ sField . ■ Nwk • Field Irrigated?■ v • MMM___ ��-- -_-- -��- ---- ®___ __ ��-� ---- ®®-� -_-- a - FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of Did the application rates exceed the limns in Attachment B of your permit? ❑ Compliant ❑ Non -Compliant 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 as specified in your permit? ❑ Compliant ❑ Non -Compliant Were all setbacks listed in. your permit maintained for every application to each permitted site? ❑ Compliant ❑ Non -Compliant Were all freeboards maintained in accordance with the specified freeboard heights in your permit? ❑ 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 necessary. Operator in Responsible Charge (ORC) Certification Permittee Certification ORC: 9 Permittee: Certification No.: 4 Signing Official: � / /� � r^�� /k e_ dA, Grade: Phone Number: Signing Official's Title: Has the ORC changed since the previous NDAR.1? 9 P ❑ Yes ❑ No Phone Number: Permit Fit / �0 "� lc -V ,Y p•: rl Signature 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 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 an 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 awar6 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 �- FORM: NDMR 10-13 fVON-DISCHARGE MONITORING REPORT (NDMR) Page_of �� ..- , _'_ , _ '_ � ��I� • " • 1 � ■ o ■ - ■ o • ■ . � . . . . . . . . . . . � . . . � . � �� i � � � i•. i � i. -�--_--_-_--- � � ' � � ',,�� '�' �' �' -�-�---�---�-',,. � -- �- �---�---�-�-�-1�' ��-,. • •11 -�-�-�-�-------�, o �� a��i o �� e��! o�� o �� o��1 n �� 1 o��—��—�� m�� ,,, �� m.�� ;��:uv�� m �� ■ww�� m��—��zsu�� m��—�■�� '�m �� a��5��s�,p��,,��p��: m.--��-�---�---��Y�IIIW�IYWIIY� L i�\.I�i��'Y�-: �'�m�-�. �1 -�---�---�--��-.. I�-- �---�_�------��- I m -- -------- �-------� m -- �-�---�-----�-�-�i m -- �---�-----�-�---��I. m -- �-�---�-�---�-�-��I m�,�,-- �---------�---�-�'�.. m.�-,, .:11 -------------�-..�'�� ..-- �---------�-�-�-.. m -- --------�-----�-�,. m.----�-�-�---�---�-��. � -- �-----------�-�-� m��i��-�s�-��i m�� m �� e-��' ■��a�� I, � " �� ■� .:,, ��s��_��, �� :,o, ��. FORM: NDMR 10-13 Sampling Person(s) IVarvee: Name: NOfV-DISCHARGE MONITORING REPORT (fdDflflR) Name: Certified Laboratories Pa9e—of_ , Idame: �o�s �19 vmoeostoPereg s�aga �n�g 5��0�� feequencies meet the requirements in Attachment A off your pereevit? ❑ Compliant ❑ Non-Compliant If the faciliry 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 antl describe the corrective action(s) taken. Attach additional sheets if necessary. ORC: Certdfecation Mo.: Grad�: Operetor in Responsible Charge (ORC) Certification Phone Wumber: Has fhe ORC changed since the previous WDMR7 Signature ❑ Yes ❑ No Permittee Certification Permittee: � C � � Signing Official: SigningOfficial'sTiOe: �� j1�� y� ��2�L�yr� Phane Number. 9/D, ��.� , � � ry � � Permit Expiration: �e1 `��- / . � �, p . Date � -� -anr^oam�.%�F-A�a By Ihis signature, I certity ihat ihis report is accurtate antl wmplete !o �he hest of my knawietlge. 5�9�ailJte . Date I cerlify, under penalty of law, that this tlocument antl all atlachments were preparetl under my tlireclion or supervision in accortlance wifh a system tlesigned ta assure Ihat ali qualifietl personnel properly gatheretl antl evaluatea Ihe infomialion suhmitted. Basetl on mylnquiry ofthe person or persons who manage Ne syslem, or Ihose persons d'vectly responsihle for galhenng Ne Informafion, Ne information su6mittetl is, lo the best of my knoW�etlge antl belieF, hue, accurate, antl complete. I am aware Ihat there ere slgnificant penalties for submilling fatse informaqon, Includin8 Ne possi6iliy of Mes and imprisonmenl Por knowing violafions. Mail Original and Two Copies to: ' Division of Water Resources Information Processing Unit 1677 Mail Service Center � FORM: NDAR-1 10-13 NON-DISCHARGE APPLICATION REPORT (NDAR-1) Page_ of •11 •�' . '�.. ..- • ' '' � � �. � � . � • �—�—��— �� — �� — �— �— �— �— • • • � �— � � �—. �� — � � — �— �� ■ • • � ■ � � � ■ ■ � � � o • �� '�' �� '�' �� '�' �� '�' �� 0 _____ ��-- ---- �—�� ---- � _____ ---� —_-- �� —_-- ��m___ .:�� _ � � --_----_�---- � ___ __ —�—� ---- ��—� —_-- � _—_ __ ---- —_-- --�� ---- � ___ __ �� ---- �—_� ---- � _____ ---- —_-- ---- ---- � ___ __ —___ ---- —_�� ---- � ___—_ ---- ---- �--- —_-- mmm___ �� —�--_--�------- m ___ __ ��—� ---- �_�� ---- m ___ __ —_-- —_-- ---- —_-- m ___ __ ��— ---- �—�� ---- m _____ —��_ ---_ —�—� —�-- m ___ _— —��— —_-- �� ---- m ___ __ —�� ---- �_�— ---- m0m___ �� _��-----��---- � ___ __ �_-- —_-- �--- —_-- m ___ __ �_-- ---- —_�� ---- m ___ __ ��-- ---- —�� ---- m __�__ ��_— ---- —�—� ---- m 0__ __ —��— ---- �� ---- m ___ __ �� ---- —_—� —_-- mOm___ .:�� — � � -----�_�--_-- m ___ __ �--- —_-- —�-- ---- � ___ __ —�� —_-- �--- ---- m ___ __ —�-- —_-- �--- ---- m ___ __ ��-- ---- ��—� —_-- m _____ —�� ---- �—�� ---- m.___ _— —�—� —_-- —�� ---- m ___ __ ---� ---- ��—� ---�-� . . � � %%/�l///.��%%///i.0�� /�/�� '�i.%lI%/. � � � %I/%%� 0 ��/// � � � / FORM: NDAR-1 10-13 -a NON-DISCHARGE APPLICATION REPORT (NDAR-1) Did the application �ates exceed the Iimits in Attachment B of yaur 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? INere 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 _ of _ ❑ Compliant ❑ Non-Complian[ ❑ Compliant ❑ Non-Compiiant ❑ Camplian[ ❑ Non-Camplian[ ❑ Compliant ❑ Non-Cumpliant ❑ Compliant ❑ Non{ompliant �� If the facility is non-compliant, please explain in the space below the reason(s) the facility was not in compliance. Provide in yaur explanation the date(s) of the non-campliance and descrihe the corrective � action(sl taken. Attach additional sheets if necessarv_ Operator in Responsihle Charge (ORC) Certifieation ' Permittee Certification ORC: Permittee: � �, j�� CertificaGon No.: Signing O�cial: Grade: Phone Numher. Signing O�cial's Titie: �J�. � � f� G C.% D�, Has the ORC changed since the previous NDAR.77 ❑ ves ❑ tuo Phone Numher: 9��:�� ^ ��G 4 Permit Exp.: �a. �cJ /�. � 4. / Gr/ ` �. c� —r�3 ^ / Signature Date Signature Date ;. _ . �� By Ihis signalure, I certily Ihat Ihls reporl is accurtate and complete to Ne best of my knovAeAge. I certlF/, under penaity of law, Nat Ihls document and all attaehmenls were prepared under my direelion or supervision in aeeortlance . wilh a system tlesignetl lo assure Ihal all quaiiiletl persannel pmpetly ga�hered and evaluated Ihe inlarmation suhmiltetl. 9ased on my Inqulryatlhepersonarpersonswhamanagelhesystem,arlhosepersansdirecllyrespansiblefargalheringlhalnfarmatian,lhe . information suhmitted is, to I�e hesl of my knowledge and belieP, We, accurale, and complete. I am awarA Ihal lhere are significant penallies fo� submilOng false Information, includng Ihe possihiliry at Mes and imprisonmenf far knowing vialations. Mail Original and Two Copies to: Division of Water Resaurces Information Processing Unit 1617 Mail Service Center