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HomeMy WebLinkAboutWQ0019908_Monitoring - 04-2023_20231212Monitoring Report Submittal Permit Number#* WQ0019908 Name of Facility:* COUNTRY CLUB OF JOHNSTON COUNTY Month: * April Year: * 2023 Report Information Type* Upload Document* NDMR, NDAR-1, NDAR-2, NDMLR APRIL23NDMR.pdf 284.82KB PDF Only Please upload one PDF containing all applicable monitoring reports (i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59). Confirmation Email Address: * astephens3241 @gmail.com Name of Submitter: * andrew stephens Signature: 044&W,�k rd Date of submittal: 12/12/2023 This will be filled in automatically Initial Review Reviewer: Wanda.Gerald Is the project number correct?* W00019908 Is the monitoring report accepted?* Yes NO Regional Office* Raleigh Reviewer: _anonymous Review Date: 12/19/2023 Sampling Person(s) Certified Laboratories Name: NA Name: Name: NA Name: Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? j'Compliant HNon-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:,, c�✓�""J Permittee: Holt Lake Golf & Rec. LLC DBA Johnston Co. Country Club Signing Official:. j (-51, 0, Certification No.: NA • Grade: NA Phone Number: `® Signing Official's Title: t% d / f 31, ! ` Permit Expiration: Has the ORC changed since the revious NDMR? ❑Yes ❑No Phone Number: Signature Date Signa 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 pefson 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