WQ0005150_Monitoring - 10-2022_20221104 (3)

Monitoring Report Submittal
Permit Number #*
Name of Facility:*
Month: * October
Report Information
WQ0005150
North End Elementary
Type *
NDMR, NDAR-1, NDAR-2, NDMLR
Confirmation Email Address:*
Name of Submitter: *
Signature:
Date of submittal:
Initial Review
Year:* 2022
Upload Document*
NE NDAR-1 Oct. 22.pdf 222.03KB
PDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
[e-mail]
Paul Phillips
Reviewer: Gerald, Wanda
11 /4/2022
This will be filled in automatically

Is the project number correct?* WQ0005150
Is the monitoring report accepted?* Yes No
Regional Office* Raleigh
Reviewer: _anonymous
Review Date: 11/9/2022

FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page 1 i f -c-

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?
Were adequate measures taken to prevent effluent ponding in or runoff from the sites?
Was a suitable vegetative cover maintained on all sites as speced 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?
[21 compliant E] Non -compliant
ED compliant F1 Non -Compliant
121 compliant E Non -compliant
[Z Compliant ❑ Non -compliant
21 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 clate(s) of the non-compliance and describe the corrective
action(s) taken. Attach additional sheets if n
Operator In Responsible Charge (ORC) Certification Permittee Certification
ORC: Paul J. Phillips Permittee: Dr. Rodney Peterson
Certification No.: 986029 Signing Official: Dr. Rodney Peterson
Grade: Sl Phone Number: 336-599-0223 Signing Official's Title: Superientenclent
Has the ORC changed since the previous NDAR-1? El Yes E/1 No Phone Number: 336-599-0223 Permit Exp.: 7/31/26
AKF V-t 0 �2_z
Signature Date ignature 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
vith a system designed to assure that all qualified personnel properly gathered and evaluated the information submitted,
Mail Original and Twc Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center