WQ0002015_Monitoring - 05-2021_20230131

Monitoring Report Submittal
Permit Number#* WQ0002015
Name of Facility:* OAK HILL FELLOWSHIP CENTER
Month: * May Year: * 2021
Report Information
Type* Upload Document*
Revised - NDMR, NDAR-1, NDAR-2, NDMLR COH-MAY2021.pdf 1.77MB
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:
4/We- K1fjr71.11A Z
Date of submittal: 1/31/2023
This will be filled in automatically
Initial Review
Reviewer: Wanda.Gerald

Is the project number correct?* WQ0002015
Is the monitoring report accepted?* Yes No
Regional Office* Raleigh
Reviewer: _anonymous
Review Date: 4/3/2023

FORM: 11 NDivir- 03-12 NON -DISCHARGE MON JNG REPORT (NDMR)

FORM: NDiv,H 03-12
NON -DISCHARGE MOh LING REPORT (NDMR)
Page _
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?
Compliant FlNon-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
Permittee Certification
ORC: Dale Lee Mathews
Permittee: Oak Hill Fellowship Center
Certification No.: 22794
Signing Official: Alan Glover
Grade: Spray Irrigation Phone Number: [phone]
Signing Official's Title: Facility Manager
Has C changed since the previous NDMR? yes ED No Phone Number: 919
( ) 691-3883 Permit Expiration: 7/31 /24
Signature Date
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
I certify, urx#,v 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 tfhere are significant penalties for submitting false information, including the
sib>ility 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

FORM: NDHrt-1 10-13 NON -DISCHARGE APPLU ON REPORT (NDAR-1) Pa np

FORM: NDArt-1 10-13
t
NON -DISCHARGE APPLt. ION REPORT (NDAR-1)
Page _
Did the application rates exceed the limits in Attachment B of your permit?
El Compliant � Non -Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites?
�i Compliant � Nan -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit?
Compliant � Noncompliant
Were all setbacks listed in your permit maintained for every application to each permitted site?
ED Compliant ❑Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
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 action(s)
taken. Attach additional sheets if necessary.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Dale Lee Mathews
Permittee:
Certification No.: 22794 Oak Hill Fellowship Center
Signing Official: Alan Glover
Grade: Spray Irrigation Phone Number: [phone]
Signing Officials Title: Facility Manager
Has the ORC changed since the previous NDAR-1?
❑Yes Q, No Phone Number: [phone] Permit Exp.: 7/31/24
Signature Date Signature
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 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, tta 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