WQ0029169_Monitoring - 12-2016_20170131

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FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page of r }
Sampling Person(s) Certified Laboratories
Name: Steve Oates Name: Mount Olive WWTP Lab
Name: Glenn Holland Name: Microbac
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? 2compliant ❑Non-compllant
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: Glenn Holland
Permittee: Town of Mount Olive
Certification No.: 27255
Signing Official: Charles S. Brown
Grade: SI Phone Number: 919-658-6538
Signing Official's Title: Town Manager
Has the ORC changed since the previous NDMR? ❑Yes [2]No
Phone Number: 919-658-9539, ext. 107 Permit Expiration: 3/31/2020
2
- /Z.)
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 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 Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

FbRM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page _ (_ of 3
Permit No.: WQ 0029169
Facility Name:
Town of Mount Olive
County: Wayne
Month:
December
Fie[ d Name:
Field
Did irrigation occur
Area (acres):
e
at this facility'?
M YES NO
®�
..
..
mrm�g
i
Monthly Loading:������
e ee����0����
e ee�����0�����/%/%
e ee�����%0�����%
a •e

FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of 4 �
Did the application rates exceed the limits 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.
with a system designed to assure that all qualified personnel properly gathered and evaluated the information submitted. Based on my
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Glenn Holland
Permittee: Town of Mount Olive
Certification No.: 27255
Signing Official: Charles S. Brown
Grade: SI Phone Number: 919-658-6538
Signing Official's Title: Town Manager
Has the ORC changed since the previous NDAR-1? ❑Yes ❑� No
Phone Number: 919-658-9539, ext. 107 Permit Exp.: 3/31/20
U
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 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 Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

• FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page `- of _-L
Permit No.: WQ 0029169
Facility Name:
Town of • -
-
December1
D • irrigation occur.
at this facility'?
F-1 YES P-1 NO
Cover Crop:
Cover Crop:
Hourly Rate (Iny
1Czz=
ME==
Field Irrigated?
��a
v
Monthly Loading:
1��N=�Mmj�ff
12 Month Floating Total

FORM: NDAR-1 08-11
NON -DISCHARGE APPLICATION 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?
Page of
❑� Compliant ❑Non -Compliant
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: Glenn Holland
Permittee:
Town of Mount Olive
Certification No.: 27255
Signing Official: Charles S. Brown
Grade: SI Phone Number: 91.9-658-6538
Signing Officials Title: Town Manager
Has the ORC changed since the previous NDAR-1? ❑Yes ONo
Phone [phone], ext. 107 Permit Exp.: 3/31/20
Number:
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 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 Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page 3 Of�
Permit No.: w II • .•I
• • •-
-
December
irrigation
- . -. --
• occur
at this facility?
Area (acresy�
/ •.
1•
Cover Crop:
Hourly Rate (in):
ow M -PATI -Mm
Hourly Rate (in):
W1r1UTrM1;FUln, 31
fn
IFITM. UTIVIT11
Annual Rate (in):
...
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1 11

FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of
Did the application rates exceed the limits in Attachment B of your permit?
❑� Compliant ❑Non -Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites? 21compliant []Non-compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit? 21Compllant ❑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
2ction(s) taken. Attach additional sheets if necessary.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Glenn Holland
Permittee:
Town of Mount Olive
Certification No.: 27255
Signing Official: Charles S. Brown
Grade: SI Phone Number: 919-658-6538
Signing Official's Title: Town Manager
Has the ORC changed since the previous NDAR-1? ❑Yes E]No
Phone Number: 919-658-9539, ext. 107 Permit Exp.: 3/31/20
L�ZSignature 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 personnelproperly 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 Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617