WQ0002015_Monitoring - 05-2023_20230705

Monitoring Report Submittal
Permit Number#* WQ0002015
Name of Facility:* OAK HILL FELLOWSHIP CENTER
Month: * May Year: * 2023
Report Information
Type* Upload Document*
NDMR, NDAR-1, NDAR-2, NDMLR OAKHILL-MAY23.pdf 1.94MB
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- K1fjrrC/AtZ
Date of submittal: 7/5/2023
This will be filled in automatically
Initial Review
Reviewer: Wanda.Gerald

Is the project number correct?* W00002015
Is the monitoring report accepted?* Yes NO
Regional Office* Raleigh
Reviewer: _anonymous
Review Date: 7/21/2023

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page of
Permit No.: W00002015
Facility Name: Oak Hill Fellowship Center
County: Granville
Month: May
Year: 2023
PPI:
Flow Measuring Point: Influent ❑Effluent No flow generated Parameter Monitoring Point: influent �, Effluent Groundwater Layering El Sufiace water
Parameter Code
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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:
noes all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? nCompliant ❑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.
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 ORC ged since the previous NDMR? Yes [7,1 No
Phone IN 919-782-2888 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 car*, 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

FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page
Permit No.: WQ0002015
Facility Name: Oak Hill Fellowship Center
County: Granville
Month: May
Year: 2023
Did irrigation
this facility?
YES
occur at
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Annual Rate m
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YES NO
Annual Rate (in):
Field Irrigated?
OYES NO
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12 Month

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?
�r Compliant
Non -Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites?
❑i Compliant
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?❑i
Compliant
Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
ID 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
noncompliance and describe
the corrective action(s)
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 Officials Title: Facility Manager
Has the ORC changed since the previous NDAR-1? yes No
Phone Num 919-782-2888 Permit Exp.: 7/31 /24
-30-23-3o
-Z3
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 Erection or supervision in accordance with a system
designed to assure that all qualified personncd properly gathered and evaluated the information submitted. Based on my inquiry of the person or persons
who manage the system, or those persons Erectly 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