WQ0015053_Monitoring - 12-2021_20220131

DWR - NonDischarge Monitoring Report Submittal y. •4 ..
NORTH CAROLINA
Enrlranmenlel QHaflly
Monitoring Report Submittal
..............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................
Permit Number#* WQ0015053
Name of Facility:* Moyock Commons WWTP
Month:* December Year:* 2021
Report Information
Type* Upload Document*
NDMR, NDAR-1, NDAR-2, NDMLR Moyock Commons 883.42KB
D M R_01312022173631.pd f
PDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2,NDMLR,GW-59).
Confirmation Email Address:* [e-mail]
Name of Submitter:* Rod Holley
Signature:
Date of submittal: 1/31/2022
This will be filled in automatically
Initial Review
..............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................
Reviewer: Gerald,Wanda

Is the project number correct?* WQ0015053
Is the monitoring report accepted?* Yes No
Regional Office* Washington
Accepted Date: 3/21/2022

FORM:NDMR 03-12 NON-DISCHARGE MONITORING REPORT(NDMR) Page_L of (
Permit No.: WQ0015053 Facility Name: Moyock Commons WWTP I County: Currituck Month: December Year: 2021
PPI: 001 Flow Measuring Point: 0 Influent 0 Effluent 0 No flow generated i Parameter Monitoring Point: ©Influent I]Effluent 0 Groundwater Lowering 0 Surface Water
Parameter Code 800 4;:': 003.10 ':,,0094© >: 80060 :: 00610 ::!.00828 00620 ;: .:.O.OB00;:::;: 00400 :::;`00888�:�' 70300 -::;;00630;:;.:39®18:`:
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--
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Sample Frequency! Continuous Monthly :' 3 XYear'. 6 X Week MonthlyMonthly3 X Yonr
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FORM:NDMR 03-12 NON-DISCHARGE MONITORING REPORT(NDMR) Page Z of Y
Permit No.: WQ0015053 1 Facility Name: Moyock Commons WWTP I county: Currituck Month: December Year: 2021
PPI: 002 Flow Measuring Point: 0 Influent ❑Effluent 0 No flow generated Parameter Monitoring Point: 0 Influent 0 Effluent 0 Groundwater Lowering El Surface water
P ctc mm . .r Code -►a00090... 00000 .00300:.:: 00886 :00e26 ':
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FORM:NDMR 03-12 NON-DISCHARGE MONITORING REPORT(NDMR) Page 3 of rf
Permit No.: WQ0015053 I Facility Name: Moyock Commons WWTP County: Currituck Month: December Year; 2021
PPE: 004 (Flow Measuring Point: 0 Influent ❑Effluent ❑No flow generated Parameter Monitoring Point: 0 Influent 0 Effluent ©Groundwater Lowering 0 Surface Water
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FORM: NDMR 03-12 NON-DISCHARGE MONITORING REPORT(NDMR) Page -1 of 'I
Sampling Person(s) Certified Laboratories
Name: Rod Holley Name: Enviro Chem
Name: Name.
1 .
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? Ld Compliant L 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
1 Permittee Certification
ORC: Rod Holley Permittee: County of Currituck
Certification No.: 1009155 Signing Official: Rod Holley
Grade: WW3 Phone Number: 252-232-6065 Signing Official's Title: Wastewater Superintendent Trainee
0
Has the ORC changed since the previous NDMR? 0 YesNo Phone Number: 252-232-6065 Permit Expiration: 11/22/2022
v.
"73 ')
1 1 ././ ,--) - A /I
,
1_4) Ci 1/28/2022 LL--i-ii—C•ii /7141447- 1/28/2022
Siature Date Anature 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 tines and imprisonment for
knowing violations.
Mail Original and Iwo Copies to:
Division of Water Resources
Information Processing Unit
1617 Mail Service Center
Raleigh,North Carolina 27699-1617

FORM: NDAR-2 05-16 NON-DISCHARGE APPLICATION REPORT(NDAR-2) Page_L of__
Permit No.: WQ0015053 Facility Name: Moyock Commons WWTP I
County' CLlrrituck Month: December Year: 2021
Did infiltration occur at ` :::<Sits Name :!";: :::!. :...t.:;=`:::=:i Site Name: 2 :-[P'r--::-Site Name: :::':::.:."::.:. :::::;::`:::i:r Site Name:
this facility? :. .. ....:... .. :. .. :_
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2,,.:::..,..,,.,.„..„.,,..
YE
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FORM: NDAR-2 05-16 NON-DISCHARGE APPLICATION REPORT (NDAR-2) Page 7_of Z
Did the application rates exceed the limits in Attachment B of your permit? D Compliant D Non-Compliant
If not a basin, were the sites kept free of vegetation and raked? 0 Compliant D Non-Compliant
If not a basin, were there any instances of effluent ponding in or runoff from the sites? E I Compliant D Nan-Compliant
It a basin, were there any instances of breakout from the berms? M Compliant D Non-Compliant
Was the onsite automatically activated standby power source tested and operational? M Compliant 0 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.
I
Operator in Responsible Charge(ORC)Certification Permittee Certification
ORC: Rod Holley Permittee:
County of Currituck
Certification No.: 1009155 Signing Official: Rod Holley
Grade: WW3 Phone Number: 252-232-6065 Signing Official's Title: Wastewater Superintendent Trainee
Has the ORC changed since the previous NDAR-2? D Yes DI No Phone Number: 252-232-6065 Permit Exp.: 11/30/22
t c 1/28/22
- _ ,---; ' 1/28/22
/signature
/
Dale 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 ot Water Resources
IntonnutIon Processing Unit
1617 Mail Service Center
Raleigh,North Carolina 27699-1617