WQ0028785_Monitoring - 03-2021_20210416

Monitoring Report Submittal
............................................................................................................................................
Permit Number #* WQ0029785
Name of Facility:*
Month:* March
Report Information
Queens Grant WWTF
Type *
NDMR, NDAR-1, NDAR-2, NDMLR
Confirmation Email Address:*
Name of Submitter:*
Signature:
Date of submittal:
Initial Review
Year:* 2021
Upload Document*
Queens Grant WWTP - 924.88KB
NDMR & NDAR - 202103.pdf
FOF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
[e-mail]
Jeremy Lemaire
Reviewer: Williams, Kendall
4/16/2021
This will be filled in automatically

Is the project number correct?* WQ0028785
Is the monitoring report t: Yes r No
accepted?*
Regional Office* Wilmington
Accepted Date: 4/16/2021

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10028785 Facility Name: QUEENS GRANT WWTP Comw. Porldw
3ccurat she Na".. I Site Name: 2
Y? Area (serm): 0.15 Area (acres): 0.15
Rafe (GPGVft�}: 1.49 Rate (GPDMe): 1.49
Freeboard Site Mfift*W?l 0 Y6 El No Site Infiltrated? l p YB Elm
F �000
r----- -
I mmol #13

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FORM: NDAR-2 05-16 NOW
DISCHARGE APPLICATION REPORT (NDAR-2)
Page
of
Did the application rates exceed the limits in Attach n
ient B of your permit?
P1 compliant
❑ Non -compliant
If not a basin, were the sites kept free of vegetation z
nd raked?
2 Compliant
❑ Non -Compliant
If not a basin, were there any instances of effluent pending
in or runoff from the sites?
[Z Compliant
EINon-Compliant
If a basin, were there any instances of breakout fro
the berms?
[Z Compliant
❑ Non -Compliant
Was the onsite automatically activated standby pow
source tested and operational?
[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
E
ction(s) taken. Attach additional sheetslif necessary.
Operator in Responsible Charge (ORC) Certificatior
Permittee Certification
ORC: Darrell James Covington
Permittee:
Queens Grant Rec Association
Certification No.: 1009643
Signing Official: Jim Hepner
Grade: Sl Phone Number: 9104675034
Signing Official's Title: PRESIDENT
Has the ORC changed since the previous NDAR-2? ❑ Yes 2
o
Phone Number: Permit Exp.: 2/28/25
21
Date
S MA
Signature
U J Signature Date
By this signature, I certify that this report is accurrate and complete to the best of m
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

FORM: NDMR 05-16 NON -DISCHARGE MONITORING REPORT (NI1MR) Page $ Of a
Sampling Person(s) Certified Laboratories
Name: Darrell J. Covington Name: Environme ital Chemists, Inc. 37729
Name: Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachmeil it A of your permit? E 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 you, explanation the date(s) of the non-compliance and describe the corrective
action(s) taken. Attach additional sheets if necessary
lProblems with Ammonia and BOD this mnth were caused by a failed butterfly valve in the Nxclear basin. Additional sampling was dine while making adjustments. Valves have been replaced I
Operator in Responsible Charge (ORC) Certification
Perm ittee Certification
ORC: Darrell J. Covington
Permittee: C
iueens Grant Rec Association
Certification No.: WW 4:1002814/ SS: 1005107
Signing Official: J
m Hepner
Grade: 4/SS Phone Number: 910 467-5034
Signing Official's Title
President
Has the ORC changed since the previous NDMR? ❑ Yes No
Phone Number:
Permit Expiration: 2/28/2025
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
w, that this document and all attachments were prepared under my direction or supervision in
accordance with a system
Jesigned to assure that all qualified personnel property gathered and evaluated the information
submitted. Based on my in
uiry of the person or persons who manage the system, or those persons directly responsible for
gathering the information, the I
rformation submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am
aware that there are signifia
it 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