HomeMy WebLinkAboutWQ0005426_Monitoring - 10-2020_20201202FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page / of=
Permit No.: WQ0005426
Facility Name: Holly Point State Recreation AreaOctober
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FORM: NDMR 07-13 NON -DISCHARGE MONITORING REPORT (NDMR) Page of
Permit No.: WQ0005426
Facility Name: Holly Point State Recreation • -
October
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FORM: NDMR 07-13
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NON -DISCHARGE MONITORING REPORT (NDMR)
Page J of J
Sampling Person(s) Certified Laboratories
Name: Jay Nicely Name: Statesville Analytical
Name: Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? 21 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)
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Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Curtis Tyree
Permittee: Falls Lake SRA
Certification No.: SI 1004690
Signing Official: David Mumford
Grade: Phone Number: 919-841-4043
Signing Officials Title: Park Superintendent
Has the ORC hanged since the previous NDMR? ❑ yes 21 No
Phone Number: 919-841-4043 Permit Expiration: 11/30/2026
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Signature Date
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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