WQ0028693_Monitoring - 01-2021_20210225

Monitoring Report Submittal
............................................................................................................................................
Permit Number #* WQ0028693
Name of Facility:*
Month:* January
Report Information
Mountaintop Golf & Lake Club
Type *
NDMR, NDAR-1, NDAR-2, NDMLR
Confirmation Email Address:*
Name of Submitter:*
Signature:
Date of submittal:
Initial Review
Year:* 2021
Upload Document*
WQ0028693. pdf 16.17 MB
FDF Cnly
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-t, NDAR-2, NDMLR, GW-59).
[e-mail]
Kimber Reese
Reviewer: Williams, Kendall
2/25/2021
This will be filled in automatically

Is the project number correct? * WQ0028693
Is the monitoring report r Yes r No
accepted?*
Regional Office * Asheville
Accepted Date: 2/25/2021

Page I of
Did the application rates exceed the limits in Attachment B of your permit? QQ Compliant ❑ Non -Compliant
Were adequate measures taken to prevent effluent pending in or runoff from the sites? I] Compliant ❑ Non -Compliant
s a suitable vegetative cover maintained on all sites as specified in your permit? El Compliant ❑ Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site? E Compliant ❑ Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard ei is in your permit? Q 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 (CRC) Certification Permittee Certification
ORC: Michael Beck Permittee:
Mountaintop Golf & Lake flub
Certification No.: SI-991 69 IV-7930 Signing Official: Robert Barr
Grade: Sl WWIV Phone Number: [phone] Signing Official's Title: Signatory
Has the CRC changed since the previous NDAR-1? ❑ Yes n No Phone Number: [phone] Permit Exp.: 8/31/19
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 Quality
Information
1617 Mail Service Center
'..110 1 4.T

FARM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR)
Page � : of
Permit No.: WQ0028693 Facility Name: Mountaintop Golf & Lake Club WWTF County: Jackson Month: January Year: 2021
PPI:
001 Flew Measuring Point: ❑ Influent [ Effluent ❑ No flow generated
Parameter Monitoring Point:
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Effluent
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❑ Surface Water
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FORM: NDMR 03-12 ON -DISCHARGE -MONITORING REPORT (N ) Page of
Permit No.: WQ0028693 Facility Name: Mountaintop Golf six Lake Club 1(UW TF
Jackson
Month:
Janua
Year: 2021
PPI: 002 Flow Measuring Point: ❑ influent ❑ Effluent ❑ No flow generated
Parameter MoiItoring;Point: ❑ influent
❑ Effluent
❑ Groundwater Lowering
Surface Water
Parameter Code
00600
1__0
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24-hr
hra mg/L
1 Holiday
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3
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FORM: NDMR 08-11 NON -DISCHARGE MONITORING REPORT (NDMR)
Page LA, of
Sampling Person(s) Certified Laboratories
Name: Michael Beck Name: Environmental Testing Solutions, Inc
Name: Dame: Prisim Laboratories, Inc
Does II monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? 0 compliant ❑ Noncompliant
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: Michael Beck Permittee: Mountaintop Golf & Lake Club
Certification No.: SI-991669 IV-7930 Signing Official: Robert Barr
Grade: SI WWIV Phone Number: (628) 2 1-1900 Signing Official's Title: Signatory
Has the ORC changed since the previous NDMR? ❑ Yes [21 No Phone Number: (82$} 251®1900 Permit Expiration: 8/31/2019
in -
0. ` 9
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
Division of Water Quality