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Home My WebLink AboutWQ0020881_Monitoring - 10-2020_20201130FORM: NEW 10-13 NON -DISCHARGE MONITORING REPORT (NDMR) Page 1 of 2 T1011 Facility Name: Div. of Parks & Rec (Lake Norman SP) Flow Measuring Point: 0 1"flOe"t 0 Effluent 0 No flow generated Parameter Monitoring Point: 13 Influent 0 Efflo"t 0 Gromdwater Lowe"ng 0 Surface Water NEGINMEM I MGM loss :Sr FORM: NDMR 10-13 NON -DISCHARGE MONITORING REPORT (NDMR) Sampling Person(s) d Certified Laboratories Name: Chip White Name: Statesville Analytical. Inc. Name: Name: Page 2 of 2 Des all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? ° compliant o 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 4c: Chip White Permittes: Div. Of Parks & Rec (Lake Norman SP) rrtification No.: Signing Official: Malcolm Scott Avis ,ade: S2 Phone Number: 336-549-8990 Signing Officlars Title: Park Superintendent as the ORC changed since the previous NDMR? a Yes ® No Phone Number: 704-528-6350 Permit Expiration: Q SigNature Date Signature Date ey Iha sgnatt". i centty tool This report is accurrate am complete to the best of my knowledge I csndy, under penally of law. Mal this document and ale attachments were prepared under my desertion or supervision in accordance with a system designed to assure that all quakried parson al properly gathered and avaksow the intormal,ion submitted. Based on my ngtary of the parson or persons who martape the system. or 0=0 perear tlUectly responsible for gatne,ft the iNormshion, the Wotmahion U& Mled is, to the best of my knowtadge and bellet. true. ecwrab. and txtrrtplete. I arrt aware tMl there are sgmhcaM Penakles br s013mir*19 fake infarm~t rCku"g the possibility of fins and Imprisonment M knowing violatbns- 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) Page 1 of 2 PermitNo.: W00020881 Facility Name: Div. Of Parks & Rec (Lake Norman SP) Did irrigation occur at � Cover Crop:, Crop: 2 YES A NO Hourly Rate (in):' Hourly Rate (in):' ' �Cover OEM= milli Mill m�0®M_-_-- 12 Month Floating Tot FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) I the application rates exceed the limits in Attachment B of your permit? Page 2 of 2 ra Compliant ❑ Non Compliant !re adequate measures taken to prevent effluent ponding in or runoff from the sites? m compliant o Non -compliant is a suitable vegetative cover maintained on all sites as specified in your permit? 0 Compliant o Non-complant :re all setbacks listed in your permit maintained for every application to each permitted site? o Compliant 0 Non -Compliant ire all freeboards maintained in accordance with the specified freeboard heights in your permit? 7 Compliant o Non -Compliant f 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 I —11 C Chip White rtification No.: 1004687 ide: S2 Phone Number: 336-549-8990 s the 6RC changed since the previous NDAR-1? ❑ Yes c No Signature Date By this signature, I certify that this report is accwrate and compels to the best of my knowledge Permittee: Div. Of Parks & Rec (Lake Norman SP) Signing Official: Malcolm Scott Avis Signing Officials Title: Park Superintendent Phone Number: 704-528-6350 Permit Exp.: 9130/20 I "40Z M Signature Date I certify, under penalty of law, that this document and all attachments were prepared under my diiecton or supervision ri accordance with a system designed to assure that as qualified personnel properly gathered and evalusted Ili iMpfmalion submitted Based on my ugu, o1 the person or persons who manage the system, or Inose persons directly responsible for gatherng the ft-91ion, the m.1—ion submitted is, to the best of my knowledge and belief, True, accurate, aril complete. am aware Thal here are signA�anl penalties for submdtmg taus mfnrmalioninckrddg the possibility of lines and irnprlsonmenl for knowing vnlet.ns Mail Original and Two Copies to: Division of Water Resources Information Processing Unit 1617 Mail Service Center Raleigh, North Carolina 27699-1617