WQ0023580_Monitoring - 09-2020_20201021

A pZ)RM: NDMR 05-16 NON -DISCHARGE MONITORING REPORT (NDMR) Page __ of

FORM: NDMR 05-16 NON -DISCHARGE MONITORING REPORT (NDMR)
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Sampling Person(s) II Certified Laboratories
Name: Brandon Long Name: Pace Analytical - Huntersville
Name:
Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? E]Compliant ❑ Non -Compliant
If the facility is non -compliant, please explain in the space below the reason(s)
th taken Attach additional sheets if facilitymplinecessary. your explanation the date(s) of the non-compliance and describe the corrective
Operator in Responsible Charge (ORC) Certification Permittee Certification
ORC: Brandon Long Permittee: Cove Key Association, Inc.
Certification No.: WW 1000788 Signing Official: Tim Bannister
Grade: WW2 Phone Number: 704-776-4443 Signing Officials Title: Owner, TCW Wastewater Mgmt., Inc.
No Phone Number: 704-776-4443 Permit Expiration: 11/30/2023
Has the ORC changed since the previous NDMR? ❑ yes ❑
/4/
Signature
D to Signature Cate
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
Raleigh, North Carolina 27699-1617

FORM: NDAR-1 05-16 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Pace of

FORM: NDAR-1 05-16
NON -DISCHARGE APPLICATION REPORT (NDAR-1)
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?
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Compliant ❑ Non -Compliant
❑Q Compliant E] Non -Compliant
❑r Compliant ❑ Non -compliant
❑✓ compliant ❑ Non -Compliant
2] 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: Braondon Long
Permittee:
Cove Key Association, Inc.
Certification No.: SI 991385
Signing Official: Tim Bannister
Grade: SI Phone Number: 704-776-4443
Signing Official's Title: Owner, TCW Wastewater Mgmt., Inc.
Has the ORC changed since the previous NDAR-1? ❑ yes 7 No
Phone Number: 704-776-4443 Permit Exp.: 11/30/23
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d 0
/a z C)
Jr
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 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