WQ0020881_Monitoring - 05-2024_20240627

Monitoring Report Submittal
..................................................
Permit Number#* WQ0020881
Name of Facility:* Lake Norman State Park
Month: * May Year: * 2024
Report Information
Type* Upload Document*
NDMR, NDAR-1, NDAR-2, NDMLR 05-2024 LNSP NDMR-AR.pdf 1.43MB
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: * Heather Parker
Signature:
��thFet ��at.F�t
Date of submittal: 6/27/2024
This will be filled in automatically
Initial Review
Reviewer: Wanda.Gerald

Is the project number correct?* W00020881
Is the monitoring report accepted?* Yes NO
Regional Office* Mooresville
Reviewer: _anonymous
Review Date: 7/3/2024

FORMNDMR 10-13 NON -DISCHARGE MONITORING REPORT (NDMR) Page 1 of 2
Permit No.: VVQ0020881of
•
.Iredell
��
•.Parameter
Monitoring Point: Influent J Effluent u Groundwater Lowerinq J Surface Water
•

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? ° Compliant Ll 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 Official's Title: State Ranger
Has the ORC changed since the previous NDMR? D Yes a No
Phone Number: [phone] Permit Expiration: 6/30/2026
t.NTodd Robinson ON.CN signdtl by Toso email-n
DN. CN • Todd Robinson email
[e-mail] C = US O =
e Inc.
06/19/2024
202024.06.19 11 28.22
/
Date
Date -04'00'
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) Pagel of 2
Permit No.: 1111 1::
- •rman SP)
County: Iredell1
irrigation
• occur
Area (acres).
Area (acresj_Area
(acres):
at this facility?
Hourly Rate
Hourly -.l"):�
Hourly Rate
Hourly-.
Annual Rate (I rz
1
1Annual
Rate (in):
Annual Rate (in):
..... .
•
•Field
Irrigated?
Monthly Loading-11111IM1111
12 Month Floating Total (in):.
®
111
11/

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?
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?
o Compliant ❑ Non -Compliant
o Compliant ❑ Non -Compliant
o Compliant ❑ Non -Compliant
u Compliant u Non -Compliant
o Compliant El 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
Perri
Div. Of Parks & Rec (Lake Norman SP)
Certification No.: 1006252
signing Official: Nathan Greene
Grade: S1 Phone Number: 252-235-8809
Signing Official's Title: State Ranger
Has the ORC changed since the previous NDAR-1? D Yes No
Phone Number: [phone] Permit Exp.: 6/30/26
Digiblly sgned Dy Todd Robinson
Todd RobinsonDN CN=Totltl RoMnsonemal=
Dobinzon®envnolinkinc.com C = VS O = Envaohnk.
Date 2024.05. 191127 59-041D006/19/2024
�y
Signature Date
Signature Date
By this signature. 1 certify that this report is accurrate and complete to the best of my knowledge.
I certifyunder 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
Raleigh, North Carolina 27699-1617