WQ0036557_Monitoring - 10-2023_20231103

Monitoring Report Submittal
Permit Number#*
Name of Facility:*
Month: * October
WQ0036557
Mark Miller
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*
Mark Miller NDMR & NDAR October 2023.pdf 906.63KB
PDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
[e-mail]
Robbin Maynard
Reviewer: Wanda.Gerald
11 /3/2023
This will be filled in automatically

Is the project number correct?* W00036557
Is the monitoring report accepted?* Yes NO
Regional Office* Raleigh
Reviewer: _anonymous
Review Date: 11/7/2023

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page of
Permit No.: W00036557
Facility Name: Mark Miller
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Flow Measuring Point: ❑ Influent ❑ Effluent ❑ No flow generated
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County: Wake
Month: October
Year: 2023
Parameter Monitoring Point: ❑ Influent ❑ Effluent ❑ Groundwater Lowering ❑ Surface water
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FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page of
Sampling Person(s) Certified Laboratories
Name: Name:
Name: Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? Lid Compliant L 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: Cory Brantley
Permittee: Mark Miller
Certification No.: 11553
Signing Official: Mark Miller
Grade: SI Phone Number: 252-478-3721
Signing Official's Title: Mark Miller
Has the ORC changed since the previous NDMR? ❑ Yes No
Phone Number: Permit Expiration:
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

FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page
Permit No.: W00036557
Facility Name: Mark Miller
County: Wake
Month: October
Year: 2023
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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?
2 Compliant ❑ Non -Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites? [Z Compliant ❑ Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit? 2 Compliant ❑ Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site? 2 Compliant ❑ Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? O 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
ORC: Cory Brantley
Certification No.: 11553
Grade: SI Phone Number: 252-478-3721
Has the ORC changed since the previous NDAR-1? ❑ Yes p No
Signature V
By lissignature, I certify that this report is accurrate and complete to the best of my knowledge.
Permittee Certification
Permittee:
Mark Miller
Signing Official: Mark Miller
Signing Official's Title: Mark Miller
Phone Number: Permit Exp.:
11 /1 /23 11 /1 /23
Date Signature Date
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