WQ0002838_Monitoring - 10-2021_20211214

Monitoring Report Submittal
Permit Number #*
Name of Facility:*
Month: * October
Report Information
WQ0002838
Deerhurst Mobile Home Park
Type *
NDMR, NDAR-1, NDAR-2, NDMLR
Confirmation Email Address:*
Name of Submitter: *
Signature:
Date of submittal:
Initial Review
Year:* 2021
Upload Document*
SMMWATERSER21121407... 1.92MB
PDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
[e-mail]
Dale Mathews
Reviewer: Zhong, Vivien
12/14/2021
This will be filled in automatically

Is the project number correct?* WQ0002838
Is the monitoring report accepted?* Yes NO
Regional Office* Raleigh
Accepted Date:
12/21 /2021

FORM: NDMR 08-11 NON -DISCHARGE MONITORING REPORT (NDMR) Page of

FORM: NDMR 08-11 NON -DISCHARGE MONITORING REPORT (NDMR) Page of
Sampling Person(s) Certified Laboratories
Name: Dale Mathews Name: Meritech
Name: Andy Mathews Name:
vvGs do rnonkoring aata ana sampling trequencies meet the requirements in Attachment A of your permit? ElCompliant 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 a iHiti-I chn fc if ---
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Dale Mathews, M&M Water and Wastewater Services
Permittee: Yes! Companies, EXP., LLC (Attn: Ed Redmond, Regional Manager)
Certification No.: 22794
Signing Official:
Grade: SI Phone Number: [phone]
Signing Official's Title:
Has the hanged since the previous NDMR? RYes Q No
Phone Nu r: Permit Expiration: 11 /30/25
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 m direction or fX Pa y supervision in accordance with asyst<xxn
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 t for knowing vidations.
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of
Did the application rates exceed the limits in Attachment B of your permit?Compliant
0 Non -Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites?
OCompliant
RNonrCompliant
Was a suitable vegetative cover maintained on all sites as specified in your permit?
❑i Compliant
0Not-Conpliant
Were all setbacks listed in your permit maintained for every application to each permitted site?
�i Compliant
Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in 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)
... 111-101 WIGGW It
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Dale Mathews, M&M Water and Wastewater Services
Permittee:
Yes! Companies, EXP., LLC (Attn: Ed Redmond, Regional Manager)
Certification No.: 22794
Signing Official:
Grade: SI Phone Number: 919-691-1056
Signing Official's Title:
Has the ORC changed since the previous NDAR-1? Yes 0 No
Phone N Permit Exp.: 11 /30/25
9 1�13�iz
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 direcfionor 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