HomeMy WebLinkAboutWQ0015515_Monitoring - 01-2021_20210215FQRN': NDMR 05-16 NOWDISC:HARGE MONITORING REPORT (NDMR) Pace
Permit No.: WQ0015515 Facility Name: Bear Pen Village WWTP County: Watauga Month: Year: 7 A Z %
PPI: 001! Flow Measuring Point: J Parameter Monitoring Point:
-
Parameter Code -i
50050
00310
50060
31616
00620
00625
00620 00600
00400
00665
~00530
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Sampling Type:
Recorder
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Gr<,b
Monthly Limit:
10,000
Daily Limit -
Continuous
4 X Year
Sample Frequency:
Weekly
4 X fear
4 X YBar
4 X Year
# X Year
4 X Year
Weekly
4 X Year
# X Year
FORM: NDMR 05-16 NON -DISCHARGE MONITORING REPORT (NDMR) Page of
/ Sampling Person(s) Certified Laboratories
Name: �Gd 7�/ Name:
Name: c� J - , J e rU/G S
Name: CS Z � Y
Goes all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? ❑Non-com
oant
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 dater(s) of the non -co ince7ddescribe the corrective action(s)
taken. Attach artrtitinnni Qhaaf-- if nanaec
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: J G6 vCC s �� l"r
Permittee:
Certification No.: Z' / S21 l
Signing Official:
?
Grade: Phone Number: �Z J
Signing Official's Title:
Has the ORC changed since the previous NDMR? ❑ Yes ❑ to
Phone Number: 92? 2 q 7 Permit Expiration:
�-�
71-9-1
Signature Date
Signature Date
By this signature, I certify that tMs report is accurrate and complete to the best of my knowledge.
! rtlfy, order penalty of law, that tMs document and e1 attachments were prepared uxbr my dked+on or supervision in axoniarw;e
with a System designed to assure that a1 cgalilled personnel property gadwed and evak*W the information submitted. Based
on my
inquiry of the person or persons who menage the syatam, or those persona direly responsitge for gathering the irtorrnation, the
information submitted is, to dw treat of my knowledge and belief. true, accurate, and complete. I am aware that there are signdkant
Penalties for g false Information, Wmkx p the poasbiity of fines and Imprisonment for knower violations.
a
Mail Original and Two Copies to:
Division of Water Resources
information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 2TOW1617
FORM: NDAR-1 05-15
NON -DISCHARGE APPLICATION REPORT INDAR-1D
pAnA of
PenrnitNo.:
_ ....
Bear Pen Vf1lage P
_
Did irrigation occur
at this facility?
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FORM: NDAR-1 U6-16 MON-09SCHARGE APPUCA£d REpORT p1 R-j) P ,
age of
®pardior in R—ponsffAe Qu-" (ORC)
O'ertniflea CartlpcatBon
-tea_
ORC: Scott Vasgaard 1 :
Heavenly Wt. Residential Assoc.
Certfto ion Alo.: 18393 9 egns eg O ficw- Scott Vasgaard
Gard!: 5f Plane Number 828-2976234 sknirg Official`s TNb: ORC
Has so ORC dwiped since flee prwions NAA 47 O y- ❑ No Plane Number: 828-2976234 pwnp
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