WQ0020881_Monitoring - 01-2024_20240223

Monitoring Report Submittal
Permit Number#*
Name of Facility:*
Month: * January
WQ0020881
LAKE NORMAN STATE PARK
Report Information
Type *
NDMR, NDAR-1, NDAR-2, NDMLR
Confirmation Email Address:
Name of Submitter: *
Signature:
Date of submittal:
Initial Review
Year:* 2024
Upload Document*
01-2024 LNSP NDMR-AR.pdf 1.46MB
PDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
[e-mail]
Envirolink, Inc.
Reviewer: Wanda.Gerald
2/23/2024
This will be filled in automatically

Is the project number correct?* W00020881
Is the monitoring report accepted?* Yes NO
Regional Office* Mooresville
Reviewer: _anonymous
Review Date: 3/19/2024

FORM NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page 1 of
Permit No.: WQ0020881
Facility Name: Div. Of Parks & Rec (Lake Norman SP)
County: Ired
Month: January
1 • irrigation occur
at this facility?
Area (acres):
I
Area (acres):
.... .
.
.... .
YES NO
Hourly Rate (in):
Hourly Rate (in):
Hourly Rate (in):
Annual Rate (in):
•Field
Irrigatel
•Field
Irrigate d ?

FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page 2 of 2
Did the application rates exceed the limits in Attachment B of your permit?
O Compliant ❑ Non -Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites?
m Compliant ❑ Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit?
la Compliant ❑ Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site?
o Compliant ❑ Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
(a 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 II Permittee Certification 1
ORC: Todd Robinson
Certification No.: 1006252
Grade: S1 Phone Number: 252-235-8809
Has the ORC changed since the previous NDAR-1? o Yes ❑ No
Digitally signed by. Todd Robinson
Todd DN' CN = Todd Robinson email =
tmt)[e-mail] C = US
O - ENVIROLINK. INC. OU = ORC
Robinson Date 2024 02.20 15:2129-05'00'
2/20/2024
Signature Date
By this signature. I certfy that this report is accurrate and complete to the best of my knowledge.
Permittee:
Div. Of Parks & Rec (Lake Norman SP)
Signing Official: Nathan Greene
Signing Officials Title: State Ranger
Phone Number: [phone] Permit Exp.: 6130/26
)/z2/
Signature Date
I certify. under penally of lawthat this document and all attachments were prepared under my direction or supervision in accordance
with a system designed to assure that all quallied personnel properly gathered and evaluated the information submitted, Based on my
inquiry of the person or persons who manage the systemor 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 informationincluding 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 NDMR 10-13 NON -DISCHARGE MONITORING REPORT (NDMR) Page 1 of 2
Permit No.: VV00020881
Rec (Lake Norman SP)
•■
Facility•.•
COUnty: Iredell
Month: January
•.
��
• r, ■ • .Parameter
Monitoring •• ■ Influent D Effluent 0 Groundwater Lowering ■ Surface Water
•.•
11 1
11.1
11.11
• /
®
11. 1
11. 1
11. 1
11.
11 1
11..
11.11
---_
•
Monthly Avg. Limit:
Sample Frequency:

FORM' NDMR 10-13 NON -DISCHARGE MONITORING REPORT (NDMR) Page 2 of 2
Sampling Person(s) Certified Laboratories
Name: Operators Name: Statesville Analytical, Inc.
Name: Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? Ia 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: Todd Robinson
Permittee: Div. Of Parks & Rec (Lake Norman SP)
Certification No.: 1006252
Signing Official: Nathan Greene
Grade: S1 Phone Number: 252-235-8809
Signing Officials Title: State Ranger
Has the ORC changed since the previous NDMR? 11 yes m No
Phone Number: [phone] Permit Expiration: 6/30/2026
Todd Digitally signed by: Todd Robinson
DN: CN = Todd Robinson email =
[e-mail] C = US
RabonscinO = ENVIROLINK. INC. OU = ORC 2/2012024
or
9190,
r ZZ j
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