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HomeMy WebLinkAboutWQ0001284_Monitoring - 04-2024_20240521FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page i of # �z4f FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page j_ of 1 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? 0 Compliant ❑ Non -{Amp 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 correctiv taken. Attach additional sheets if necessary. Operator in Responsible Charge (ORC) Certification ORC: Jeffrey Long Certification No.: 992044 Grade: Wastewater 1 Phone Number: 252-308-2984 Has the ORC changed since the previous NDMR? ❑ yes © No 05-15-2024 Signature Date By this signature, I certify that this report is accurrate and complete to the best of my knowledge. Permittee Certification Permittee: Town of Conway Signing Official: Jeffrey Long Signing Official's Title: ORC Phone Number: 252-585-0488 Permit Expiration: 08-31-2021 05-15-2024 / r / Signature D� I certify, under penalty of law, that this document and all attachments were prepared under my direction or sup( accordance with a system designed to assure that all qualified personnel properly gathered and evaluated the it submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly resp athering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and c aware that there are significant penalties for submitting false information, including the possibility of fines and impr knowing violations. Mail Original and Two Copies to: Division of Water Resources Information Processing Unit 1617 Mail Service Center FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page __ I of f_ FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page 1 of 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? ❑X Compliant ❑ Non -Compliant 0 Compliant ❑ Non -Compliant Lx�. Compliant ❑ Non-Comptlant © Compliant ❑ Non-Compllant © 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: Jeffrey Long Permittee: Town of Conway Certification No.: 993135 Signing Official: Jeffrey Long Grade: Sprayfield Phone Number: 252-308-2984 Signing Official's Title: ORC Has the ORC changed since the previous NDAR-1? Phone Number: 252-585-0488 Permit Exp.: 08-31-2028 05-15-2024 05-15-2024 Sig nature 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 property 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 Monitoring Report Submittal Permit Number#* WQ0001284 Name of Facility:* TOWN OF CONWAY Month: * April Year: * 2024 Report Information Type* Upload Document* NDMR, NDAR-1, NDAR-2, NDMLR JEFF-APRIL.pdf 746.06KB PDF Only Please upload one PDF containing all applicable monitoring reports (i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59). Confirmation Email Address: * jeffreylong267@gmail.com Name of Submitter: * JEFFREY LONG Signature: L1&1--e'� .t . -t" tip Date of submittal: 5/21/2024 This will be filled in automatically Initial Review Reviewer: Wanda.Gerald Is the project number correct?* W00001284 Is the monitoring report accepted?* Yes NO Regional Office* Raleigh Reviewer: _anonymous Review Date: 6/28/2024