WQ0001664_Monitoring - 11-2022_20221220

Monitoring Report Submittal
Permit Number #*
Name of Facility:*
Month: * November
Report Information
WQ0001664
Belvedere Plantations WWTF
Type *
NDMR, NDAR-1, NDAR-2, NDMLR
GW-59
Confirmation Email Address:*
Name of Submitter: *
Signature:
Date of submittal:
Year:* 2022
Upload Document*
belvedere wwtp November 9.35MB
2022.pdf
PDF Only
BELVEDERE NOVEMBER 29.03MB
MW 2022.pdf
PDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
[e-mail]
Gregory Spillman
12/20/2022
This will be filled in automatically

Initial Review
Reviewer: Gerald, Wanda
Is the project number correct?* WQ0001664
Is the monitoring report accepted?* Yes No
Regional Office* Wilmington
Reviewer: _anonymous
Review Date: 1/10/2023

FORM NOMR0 -16 Page of
1 0-5 NOWNWHARGE MONITORING REPORT NOW

FORliA NDMR 0 5_1 NON -DISCHARGE MON °° NG REPORT N Page f
Sampling er ni(s
Name; r Spillman
Certified Laboratories
Name: nvir r nChemists, Inc DW
Nerve: Name: ("arolina err Services Inc, - Eastern Region Cep llCa
Does all monitoring data and sampling frequencies meet the requirements n Attachment your its
If the W-ni( non -compliant, .-'3e X' t „5 in t.s® space below £ e reason(s) tre facer.+ was not in cornpliance Prov e in your x a na >.t the dinets) ofthepi - nc_, and Odescribe "he correetive
Operator harge tORC) Certification
Permittee Certification
Greg S f,lman
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Certification No,, 101041824
l Signing Official:Tony Konsul
Grade: 4 Phan: r: 25 - 1 -0561
Signing Official's Title. l ,r * r off0perattions
Has the n- in t r i m 1?
1 t r; Permit Expiration: J3 l;I �
Tony Konsu h a{
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Mail Originaland Two Copies to:
Division of Water Resources
Infortnation Processing Unit
1617 Mali Service Center
Raleigh, North Carolina 276991617

FORM_ NDINIR 05-16 NON -DISCHARGE MONITORING REPORTPage

FORM, NDIVAR 0-5-16NON-DISCHARGE MONITORING REPORT N M Page — Of
SamplingPerson(s)
Name: Greg Spillman
Certified Laboratories
Name: Enviromentai Charmers. _ c. DW # 94
Name. Name-, Carolina Water Services inc. - Eastem Regimen Cerfificatte # 5162
Does all monitoring data and sampling frequencies meet the requirements in Attachmentf your ifs
€h facility is non-- ;p ant. please `lp n in the space i s =1 -- feonal
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Operator in Responsible Certification Frewal-ittee Certification
Greg
Spillman
Permitt: CWSNC
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certification -:
100,4824 24
l Signing Official: ony Konsul
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Phone Number:
' - Signing Official's Title: it ct r f r�l�z
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Mail Original and Two Cop to -
Division f Water Resources
Inforination ProcessingUnit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

DAAR 05- 19, NON -DISCHARGE MONITORING REPORT N p6 e of

FORM, 0- 1NON-DISCHARGE MONITORING REPORT N #age
Sampling Persons)
Certified Laboratories
Name- viromment € Chernists,, .Inc, DW # 94
Nauss: Carolina Wate
r r Services inc - Pastern Region Cedfficate
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit?
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Operator in Responsible Charge fORCI Certification
Permittee C-ftcation
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Certification ?i i„ 1004824__
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igt`3ft Official, i-ion Kam_; sw
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Has the ORC changed since the previous 1 _._ c,
Phone Number: 4 -5 _ 6 5 i t Expiration: 3. ; =202
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Mail Original and Two Copy to:
Division of Water Resources
Information ig Unit
1617 Mail Service Center
Raleigh, Now Carolina 2-1 1

SON -DISCHARGE APPLICATION REPORT N - page o

FORAW . - '0_? "? NON -DISCHARGE APPLICATION REPORT (NDAR-2) Page — � o`
Did the application rates exceed the limits in Attachment B of your permit?
If not a basin, were the sites kept free of vegetation and raked?
If not a basin, were there any instances of effluent pending in or runoff from the sites
If a basin, were there any instances of breakout from theberms?
Was the onsite automatically activated standby power source tested and operational?
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if "Pe aim 33t is non- o'1`=,i ni, Please e'p,ialn in the Space -ue-Ear'he ,eu'.., o ;a; ffie . sr iv as `.max ...svmphatxe. -0-n b it your expili # _l:on Me da'.e s, ofrie rioco .Hance a n<< s?E.:aanbe i e _oare€?:ve
s vti.s} taken Aflach addffional sneets 4 necessary.
O r f - in Responsible Charge
r
is C) Certification
ss �rtifi�at �
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[ORC: Greg Spillman
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Permattee:
Carolina Water Service, Inc N-C
cenification .: 824'
Signing Officiar T o , y Korttsu!
Grade; 4 Phone Number!
252-241 C
i=
Signing Leff€c € j' Title: Direclor of u-er n-,
Has the ORC changed since the previous ND-
.` 'Phone
ar. Permit x.: €
Tony Konsu {
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Date
mo a._bE e_ _ 1.. _ �- cr!n_ w1ow _ ge a-', _ _c
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Mail Original and Two Copies to;
Division of Water Resources
Info ton Proce"ing fief
1617 Mail Service Center
Raleigh, Noft Carolina 27699-1617