WQ0000267_Monitoring - 06-2023_20230706 (3)

Monitoring Report Submittal
Permit Number#*
Name of Facility:*
Month:* June
WQ0000267
Gates County WWTFs
Report Information
Type *
NDMR, NDAR-1, NDAR-2, NDMLR
Confirmation Email Address:
Name of Submitter: *
Signature:
Date of submittal:
Initial Review
Year:* 2023
Upload Document*
June 2023 NDAR-1.pdf 595.57KB
PDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
[e-mail]
Jonathan Arnold
Reviewer: Wanda.Gerald
7/6/2023
This will be filled in automatically

Is the project number correct?* WQ0000267
Is the monitoring report accepted?* Yes No
Regional Office* Washington
Reviewer: _anonymous
Review Date: 7/6/2023

FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page C of Z-

FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page Z of Z
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 specified 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?
Compliant
❑ Non -Compliant
EZ Compliant
❑ Non -Compliant
R Compliant
❑ Non -Compliant
0 Compliant
❑ Non -Compliant
0 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: Jonathan Arnold
Permittee:
County of Gates
Certification No.: SI-995921/CS-1008519
Signing Official: Dr. Althea Riddick
Grade: 4 Phone Number: 252-287-5957
Signing Official's Title: Chairwoman' Board of Commisioners
Has the ORC changed since the previous NDAR-1? ❑ Yes El No
Phone Number: 252-357-1240 Permit Exp.: 9130/29
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, 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