WQ0029346_Monitoring - 12-2020_20210127

Monitoring Report Submittal
............................................................................................................................................
Permit Number #* WQ0029346
Name of Facility:*
Month:* December
Report Information
Blue Ridge Mountain Club
Type *
NDMR, NDAR-1, NDAR-2, NDMLR
Confirmation Email Address:*
Name of Submitter:*
Signature:
Date of submittal:
Initial Review
Year:* 2020
Upload Document*
WQ0029346.pdf 5.2MB
FDF only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-t, NDAR-2, NDMLR, GW-59).
[e-mail]
Kimber Reese
Reviewer: Williams, Kendall
1 /27/2021
This will be filled in automatically

Is the project number correct? * WQ0029346
Is the monitoring report r Yes r No
accepted?*
Regional Office * Winston-Salem
Accepted Date: 1/27/2021

FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Page0f
�
�WQ0029346
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Club
County. nth:
December
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FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR®1) Page of
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FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page 3 of
Did the application rate exceed the limits in Attachment B of your permit? A Compliant ❑ Non -Compliant
Were adequate measures talon to prevent effluent ponding in or runoff from the sites? ompliant ❑ Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit? mpliant ❑ 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 necessarv.
Operator in Responsible Charge (ORC) Certification Perrnittee Certification
ORC: Dale Holman Permittee: glue Ridge Mountain Club
Certification No.: SI 1003141 Signing Official: Robert Barr
Grade: Sl Phone Number: 828-251-1900 Signing Official's Title: Signatory
Has the ORC changed since the previous NDAR-1? ❑ Yes 0 No Phone Number: 828-251-1900 Permit Exp.: 4/30117
1 1 2
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 2769-1617

FORM: NDMR 03-12
NON -DISCHARGE MONITORING REPORT (NR) Page-ilf of
Permit No.: WQOO29346 Facility Name: Blue Ridge Mountain Club WWTP County: Wilkes December Year: 2020
PPI: 001 Flow Measuring Point: ID Influent Q Effluent n No flow generated Parameter Monitoring Point: ❑ influent Ell Effluent ❑ Groundwater Lowering ❑ Surface Water
Parameter Code
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L ---

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR)
Page 5 of
Name: Dale Holman Name: Water Tech Labs, Inc.
Name: Robert Barr Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? ompliant ❑ 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
Boo
Operator in Responsible Charge (ORC) Certification Permittee Certification
ORC: Dale Holman Permittee: Blue Ridge Mountain Club
Certification No.: SI 1003141 Signing Official: Robert Barr
Grade: Sl Phone Number: 828-251-1900 Signing Official's Title: Signatory
Has the ORC changed since the previous NDMR? [I Yes NJICO Phone Number: 828-251-1900 Permit Expiration: 4/30/2017
Agw-�l 1jZL0U_ VV4----- 1dzwj
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