WQ0001664_Monitoring - 08-2022_20220912

Monitoring Report Submittal
Permit Number #*
Name of Facility:*
Month: * August
Report Information
WQ0001664
Belvedere Plantations WWTF
Type *
NDMR, NDAR-1, NDAR-2, NDMLR
Confirmation Email Address:*
Name of Submitter: *
Signature:
Date of submittal:
Initial Review
Year:* 2022
Upload Document*
Belvedere August2022.pdf 7.65MB
PDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
[e-mail]
Greg Spillman
Reviewer: Gerald, Wanda
9/12/2022
This will be filled in automatically

Is the project number correct?* WQ0001664
Is the monitoring report accepted?* Yes No
Regional Office* Wilmington
Reviewer: _anonymous
Review Date: 9/13/2022

FORM: NDMR 05-16 NON -DISCHARGE MONITORING REPORT (NDMR) Page _ of _

FORM. NDIVIR 05-16 NON -DISCHARGE MONITORING REPORT (NDMR) Page of
Sampling Person(s) II Certified Laboratories
game: Greg Spillman 11 Name: Enviromental Chemists, Inc. DW ## 94
Name: 11 Name: Carolina Water Services Inc. - Eastern Region Certificate ## 5162
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? M r mpliant Non-COmplian,
If the facility is non -compliant. Tease 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
actions} taken. Attach additional sheets if necessary.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Greg Spillman
Permittee: CWSNC
Certification No.: 1994824
Signing Official: Dana Hill
Grade: 4 Phone Number: 252-241-0661
Signing Official's Title: Director of Operations
Has the ORC changed since the previous NDMR? yes No
Phone Number: 252-269-2540 Permit Expiration: 3f31 /2926
Digitally signed by Dana Hill
DIN: O=US, O=OWSNO, CN=Dana Hill,
this document
Reason: I the document
E-danaDana H
I l Reason hill@the
am author of
author of
Location: your signing location here
i
22
Date: 2022.Og.12 10:13:33-04'00' 9/12/22
Foxit PDF Editor Version: 11.2.2
Signature Date
Signature Date
By this signature. I certify that [his ruff^ is accurrate and complete to the best of my kt owiedge
1 certify, aunder p =rtalt-v of law, -hat this document and all attachments were prepared under my direct:W �� or supervision in
accordance with a system designed tO assure that all qualified personnel property gathered and evaluated the information
submitted. Based on .y 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 know ledge and oeiief, true, accurate, and cumpiets, I am
aware that .".ere are sign€fican' penalties for submitting false information, including the possibility of fines and imprisonment for
knowing violations,
OriginalMail # Two Copies to:
Division ofWater Resources
Information Processing Unit
1617 Mail Service Center
# #

FORD NDMR 05-16 NON -DISCHARGE MONITORING REPORT (NDMR) Page of
Permit No.: WQ0001664
Facility Name: Belvedere Plantation WWTF
PPI: 662
Flow Measuring Point: - TTinfluen, Effluent No flow generated
Parameter Code ►
v
, �.
as
0
�
08:36 1
0836 1
08:43 1
11:25 1
06:35 1
09:23 i 1
08:57 1
11:59 1
06:23 1
0701 1
County: Fender Month: August Year: 2022
Parameter Monitoring Point: Influe t � Effluent J Groundwater Lowering Surface hater

FORK NDAAR 05-16 NON -DISCHARGE MONITORING REPORT (NDMR) Page of
Sampling Person(s) 11
i Certified Laboratories
Name: Greg Spillman 11 game: Enviromental Chemists, Inc. DW # 94
Name: 11 Name: Carolina Meter Services Inc. - Eastern Region Certificate # 5162
Does all monitoring data f sampling frequencies meet the requirementsof •-
If the facility is non -compliant, please explain in the space below the reasons) 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: Greg Spillman
Permittee: CSNC
Certification No.: 1994824
Signing Official: Lana Hill
Grade: 4 Phone Number: 252-241-0661
Signing Official's Title: Director of Operations
Has the ORC changed since the previous NDMR? Yes I No
Phone Number: 252-269-2549 Permit Expiration: 3/31 /2026
Digitally signed by Oana Mill
DNC=US,O=CWSNC,CN=DanMill,ana E=dana hill@ca. rth derservicenc..tt
Reason'. amtheauthordrthisd rdmad
ill
L—tion. your, signing location here
1..r 11 2 2 9/1 Zf22
Ode'. 2DF Edit.,
Foxit POF Editor Version'. � �.2.2
Signature Date
Signature Date
By this signature1 certtfy that this report is accurrate andcomplete to the best of my knovAedae
; cert#fy, under penalty of lak,..hat this document and all attachments were prepared Under my directio t, or supervision in
accordance ;with a syste€n designed to assure that all qualified personnel properly gathered and evaluated the information
submEfled, Based an my inquiry of the person or persons vato manage the System, or those per ons directly responsible for
gathering the information, the information submitted :s, to the best O9 n,y. kno .'3edae and belief, true, accurate, and complete, lam
aW=are that there are significant penalties for submitting false mformat on, including the possibility of fines and imprisonment for
knovona violations,
OriginalMail f Copies to
Divisionof f
Information f f Unit
1617 Mail Service Center
f t f

FOR : I`JDMR 05-16 NON -DISCHARGE MONITORING REPORT (NDMR) Page of
Permit No.: 'JVOOOO1664
Facility Name: Belvedere Plantation WWTF
PPI. 003
Flow Measuring Point: Influent E Effluent No flow germs aced
Parameter Code
0
00940
00610
0ti40fl
0
E2'�
h
x
etc
V#
.c
<
\ \
O
v v
24-hr
hrs
`y mmg/L
mgfL
SU
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1
0 3
\ \ 7.62
,.
\`
2 08:54
1`
v
.�
A
z
v
3 10:30
1
\..
4 12:52
1
5
06:54
1
\
\
6
7...
8
08:36
1
\
0,2
7.71
9
08:36
1
\ \
\
10
08:43
1
11
1125
1
12
06:35
1
15
09:23
1
<0 2
� 7.76
16
0&57
1
44 '
17
11:59
1
440;
18
06:23
1
..
19
07:01
1:..�
20
21
22
09:35
1
` :: .... ..,
` : 03
7.59
23
09:22
1
24
08:49
1
25
08:07
1
26
0658
1
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27
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29 09:19 1
\. <0 2
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30 08:49 1
v \
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v
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v
31 08.51
Average
" o
012
Daily Maximum
A v v _,'
0.30
7.76
Daily Minimum
�... 0.20
7.24
:'
a.
Sampling Type
Grate
Grab
Grab
Monthly Litittt
�� 250
5
Daily Lima
6.5-8.5
Sample Frequency:c€
3 X Year
Weekly
1
County: Pender
Month: August
Year: 2022
Parameter Monitoring Point: In urn[ -j Eff`luent � r nol.vater �_uve '..a S�acd water
70300.�v
5Q0b0
>`
rs
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0
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1

FORM: NDf~ R 05-16
m f f ;
Certified Laboratories
Name: Enviromental Chemists, Inc. DW # 94
Nate: Name: Carolina rater Services Inc. - Eastern Region Certificate # 5162
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? 1-3 Non ompliart
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
Per ittee Certification
ORC: Greg Spillman
Permittee: CWSNC
Certification fil 1004824
Signing Official: Cana Hill
Grade: 4 Phone Number: 252-241-0661
Signing Official's Title: Director of Operations
Has the ORC changed since the previous NDMR? Yes No
Phone Number: 252-269-2540 Permit Expiration: 3/31/2026
DigiMl ly signed by Dana Hill
■ DN,C IS,0 CWSNC, Cl Hill,
Reason: the this document
Dana H I l E=danahill®�rnlinawatarsaricanccnm
am author bf
Location: your signing location here
i
_
.�
Date: 2g22.g8.12 1g:ifi:1 9-04'00'
l PDE Editor Version: 11.2.2 9/12/22
Signature mate
Signature Date
By this signature. 1 certify that this report is accurrate and complete to the best of my knowledge-
, certify. under penalty of law, that this nooument and di attachments were prepared under my direction or supervision to
accordance wits a system desaned to assure that all qualified personnel property gathered and evaluated the information
uomi ted. used on my mqui r 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 knolbirledge and belief '.,.1eaccurate, and complete. 3 am
aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for
knowing violations -
Mail Original # Two Copies to:
Division of #
Information Processing
1617 Mail Service Center
t i •

FORN : NDAP-2 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-2) Page
Permit No,: W00001664
Facility Name: Belvedere Plantation WWTF
County: Pender Month: August
Year: 2022
Chid infiltration occur at
��
� Site Name:
B
Site Name
t}lI5 facility?
tva
v `
Area {acres}:
0.27
v
\
Area {acres}
{ES PAC
Rate (GP DIft):
8.55
�y
`
Rate {GPDIft):
Weather Freeboard
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A Site Infiltrated?
YES 0
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Site Infiltrated?
-YES - NO
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�'t",

FORM: NDAR-2 M-13 NON -DISCHARGE APPLICATION REPORT NDAR-2) Page of
Did the application rates exceed the limits in Attachment B of your permit?
-rvlEiirrt
N Comp ant
If not a basin, were the saes kept free of vegetation and raked?
__ cow .la t
,o �o <a r
If not a basin, were there any Instances of effluent ponding in or runoff from the sites?
_Conbrihairt
^ Nora -compliant
If a basin, were there any instances of breakout from the berms?
Coneliant
P No -i ohipAant
Was the onsite automatically activated standby power source tested and operational?
77� cornpiiant
nipliant
if the facility is non -compliant.. please explain in the space below the reasons) 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: Greg Spillman
Permittee:
Carolina Patel` SciViCe, Inc N.C.
Certification No.: 1004824
Signing Official:
Grade: 4 Phone dumber: 252-241-0661
Signing Official's Title:
Has the ORC changed since the previous NDAR-2? 7`es ` No
Phone Number: 800-348-2383 Permit Exp.: 3/31/26
Digitally slgnetl by Dana Hul
DI: C-US, O-CW SNC, CN-Dana HIII,
E-tlanabill@earelinawat.,b,heneeem
ft a
Reason:lamibeautbb ottblstlb—,'t
Looatl on: your12 ning looatlon here
Dana Hill,
O—t 2g22.g9.12 1g:15:5 11.2.2' 9112122
Foxit PDF Etlitor Version: 11.2.2
Signature gate
Signature Cate
Bv,ncssianarue.. I canify,ba, t.:._ mqpari .s a._v-J. rate and ccrnerroe ?v : e mes, o k. a .'e
,erv.t V.-indie penalocif ra#. _^a.....s do.,..... ... a a a'! anacninems were prepared under di -at -tor 7ision in
accordance ., f a s_vete _ j6Siy'.n.ea e= aSSure « v a_. Vucf reri pers3nnei proper s gathered and eta_=ia eea e
sub ::ed. Based on m : qs'. y of toe peerenr ,.r vet so .S oha .._. age yster- or ftose eersoos d r? .it rrispo ;_ ble for
gathering the --.forma„cin zhe inform>eat " "" -..tted is to ;he best of rnir K _ t-ed e end belief fig,, rue acc a abe and coincz iae .; am
awa. _ that tHere are iagr' t._, t pence flee L'= Su- miff na fa se inf,.....abon ` ciuding the Ct... sie t} of fines and �...,J, _Sp-ent'or
knowing `trolisficins.
Mail Original i Two Copies to:
Division of i
Information Processing