WQ0031030_Monitoring - 11-2020_20201231

Monitoring Report Submittal
............................................................................................................................................
Permit Number #* WQ0031030
Name of Facility:*
Month:* November
Report Information
Shawboro Elementary (North)
Type *
NDMR, NDAR-1, NDAR-2, NDMLR
Confirmation Email Address:*
Name of Submitter:*
Signature:
Date of submittal:
Initial Review
Year:* 2020
Upload Document*
North Elementary Binder- 11- 278.34KB
2020. pdf
FDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
[e-mail]
Rebecca Manning
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Reviewer: Williams, Kendall
12/31 /2020
This will be filled in automatically

Is the project number correct?* WQ0031030
Is the monitoring report t: Yes r No
accepted?*
Regional Office* Washington
Accepted Date: 1/5/2021

FORM: NDMR 05-16 NON -DISCHARGE MONITORING REPORT (NDMR) Page of
Permit No.: WQ0031030
Facility Name: Shawboro Elementary School (North)
County: Currituck
Month: November
Flow Measuring Point: Influent Effluent No flow generated
Parameter Monitoring Point: El Influent Effluent Groundwater Lowering Surface Water

FORM: NDMR 05-16 NON -DISCHARGE MONITORING REPORT (NDMR) Page _ of
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? ❑ 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: Tracy Miller
Permittee: Envirolink, Inc.
Certification No.: 1005193
Signing Official:
Grade: WW3 Phone Number: 828-785-3323
Signing Official's Title: Compliance Coordinator
Has the ORC changed since the previous NDMR? ❑ Yes ❑ No
Phone Number: 984-365-9155 Permit Expiration: 7/31/2021
12-30-2020
12-30-2020
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

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FORM: NDAR-2 05-16 NON -DISCHARGE APPLICATION REPORT (NDAR-2) Page of
Did the application rates exceed the limits in Attachment B of your permit? ❑ Compliant ❑ Non -Compliant
If not a basin, were the sites kept free of vegetation and raked? ❑ Compliant ❑ Non -Compliant
If not a basin, were there any instances of effluent ponding in or runoff from the sites? ❑ Compliant ❑ Non -Compliant
If a basin, were there any instances of breakout from the berms? ❑ Compliant ❑ Non -Compliant
Was the onsite automatically activated standby power source tested and operational? ❑ 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: Tracy Miller
Permittee:
Envirolink, Inc.
Certification No.: 1009365
Signing Official:
Grade: SI Phone Number: 828-785-3323
Signing Official's Title: Compliance Coordinator
Has the ORC changed since the previous NDAR-2? ❑ Yes ❑ No
Phone Number: 984-365-9155 Permit Exp.: 7/31/21
12-30-2020
12-30-2020
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