WQ0002015_Monitoring - 10-2022_20221215

Monitoring Report Submittal
Permit Number #*
Name of Facility:*
Month: * October
Report Information
WQ0002015
OAK HILL FELLOWSHIP CENTER
Year:* 2022
Type* Upload Document*
NDMR, NDAR-1, NDAR-2, NDMLR CAMP OAK HILL-OCT22.pdf 1.95MB
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: * Dale Mathews
Signature:
Date of submittal: 12/15/2022
This will be filled in automatically
Initial Review
Reviewer: Gerald, Wanda

Is the project number correct?* WQ0002015
Is the monitoring report accepted?* Yes No
Regional Office* Raleigh
Reviewer: _anonymous
Review Date: 1/6/2023

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page of

FORM: NDMR 03-12
NON -DISCHARGE MONITORING REPORT (NDMR)
Page of
Sampling Person(s)
Certified Laboratories
Name: Dale Lee Mathews Name: Meritech
Name: Andy L. Mathews Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit?
❑i Compliant 0 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 necessary
Operator in Responsible Charge (ORC) Certification
ORC: Dale Lee Mathews
Certification No.: 22794
Grade: Spray Irrigation Phone Number: [phone]
Has the since the previous NDMR?
Yes ElNo
O t
IiL30 211-
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
Permittee:
Signing Official:
Signing Official's Title:
Phone Num 919-782-2888
Permittee Certification
Oak Hill Fellowship Center
Liza Farrar
Facility Manager
Permit Expiration: 7/31 /24
Signature Date
I certify, under penalty of taw, 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 vidations.
Mail Original and Two Copies to:
Division of Water Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of
9 __

FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of
Did the application rates exceed the limits in Attachment B of your permit?
Candiarn � Non -Can pliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites?
Candiarn � Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit?
❑i Compliant � Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site?
El Candiarn � Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
�i 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 dates) 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: Dale Lee Mathews Permittee:
Oak Hill Fellowship Center
Certification No.: 22794 Signing Official: Liza Farrar
Grade: Spray Irrigation Phone Number: [phone] Signing Official's Title: Facility Manager
Has the OR chan eel since the previous NDAR-t? ❑Yes n, No Phone Number: 919-782-2888 Permit Exp.: 7131/24
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Signature Date
Signature Date
By this signature, I certify that this reportis accurrate and complete to the test of my knowledge. I certify, under penaltyof 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