WQ0035784_Monitoring - 07-2020_20200826

Monitoring Report Submittal
............................................................................................................................................
Permit Number #* WQ0035784
Name of Facility:* Cottages of Boone
Month:* July
Report Information
Type *
NDMR, NDAR-1, NDAR-2, NDMLR
Year:* 2020
Upload Document*
WQ0035784.pdf
FDF Only
Please upload only one combined pdf document. Upload GW-59 individually.
Confirmation Email Address:* [e-mail]
Name of Submitter:* Kimber Reese
Signature:*
Date of submittal: 8/26/2020
This will be filled in &Aorratically
Initial Review
Reviewer: Williams, Kendall
Is the project number correct?* WQ0035784
2.8MB

Is the monitoring report Yes r No
accepted?*
Regional Office* Winston-Salem
Accepted Date: 8/26/2020

FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of
Watauga Month:
July
Mixed
Ems=
0=0=
Em
111m
1 JIM
�m

FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page 2- of 5

FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page -3 of 6
[2"Compliant E] Non -Compliant
Were adequate measures taken to prevent effluent pore in in or runoff from the sites? 1;lzompliant F-1 Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit? 13Compliant 0 Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site? mpliant F-1 Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? E-Compliant 71 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 Permlittee Certification
ORC: Dale Holman Permittee:
Boone Cottages
Certification No.: SI 1003141 Signing Official: Robert Barr
Grade: Sl Phone Number: 828-251-1900 Signing Official's Title: Signatory
Has the ORC changed since the previous NDAR-1? El Yes 5R<o Phone Number: 828-251-1900 Permit Exp.: 4/30/17
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 Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

FORM: N®MR 03-12 NON -DISCHARGE MONITORING REPORT ( D R) Page 4 of
Permit No.: WQ0035784 Facility Name: Cottages of Boone
County: Watauga Month: July
Year: 2020
PPI: Q01 Fiow Measuring Point: ❑ Influent [Z Effluent ❑ No flow generated Parameter
Monitoring Paint: ❑ Influent 2 Effluent ❑ Groundwater Lowering
❑ Surface water
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FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR)
Page 5 of 5
Sampling Person(s) 11 Certified Laboratories
1
Name: Dale Holman Name: Water Tech Labs, Inc.
Name: Robert Barr Name: Pace Analytical
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? S/Ompliant [:] 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 necessarv.
Operator in Responsible Charge (ORC) Certification
ORC: Dale Holman
Certification No.: SI 1003141
Grade: Sl Phone Number: 828-251-1900
Has the ORC changed since the previous NDIVIR? XYes No
Q 040-1
�a�A ALV�C)
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
Permittee Certification
Permittee: Boone Cottages
Signing Official: Robert Barr
Signing Official's Title: Signatory
Phone Number: 828-251-1900 Permit Expiration: 4/30/2017
vtl*� F kizo
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 Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617