WQ0006317_Monitoring - 01-2022_20220318

Monitoring Report Submittal
Permit Number #*
Name of Facility:*
Month: * January
Report Information
WQ0006317
Colonial Pipeline - Greensboro Junction WWTF
Year:* 2022
Type* Upload Document*
Revised - NDMR, NDAR-1, NDAR-2, NDAR - January 2022.pdf 532.5KB
NDMLR
PDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
Confirmation Email Address:* [e-mail]
Name of Submitter: * Maribeth Hughes
Signature:
lqt4�e;741V
Date of submittal: 3/18/2022
This will be filled in automatically
Initial Review
Reviewer: Gerald, Wanda

Is the project number correct?* WQ0006317
Is the monitoring report accepted?* Yes No
Regional Office* Winston-Salem
Accepted Date:
3/22/2022

FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page _1—of_2_,_

FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page _2_ of_2_
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?
Was a suitable vegetative cover maintained on all sites as specified in your permit?
Were 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?
QCompliant
❑Non -Compliant
121Compliant
❑Non -Compliant
OCompliant
❑Nan -Compliant
ElCompliant
❑Nan -Compliant
❑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
Laken. Attacn aaamonai sheets IT
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Robert P. Willcox, Jr.
Permittee:
Colonial Pipeline -Greensboro Junction WWTF
Certification No.: 18600
Signing Official: Brian L. Smith
Grade: SI Phone Number: [phone]
Signing Official's Title: Operations Manager
Has the ORC changed since the previous NDAR-1? Eyes ❑No
Phone Number: [phone] Permit Exp.: 1/31/25
- �l Z
1/31/22
Signature Date
Signature Date
By this signature, I certify that this report is accurrale 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 Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617