WQ0002829_Monitoring - 02-2022_20220322

Monitoring Report Submittal
........ ......... ......... ......... .........
Permit Number #* WQ0002829
Name of Facility:* KDHWWTP LLC
Month: * February Year: * 2022
Report Information
Type* Upload Document*
NDMR, NDAR-1, NDAR-2, NDMLR WQ0002829 FEB 22.pdf 1.08MB
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: * TINA GEE
Signature:
Date of submittal: 3/22/2022
This will be filled in automatically
Initial Review
Reviewer: EADS\wgerald 1

Is the project number correct?* WQ0002829
Is the monitoring report accepted?* Yes No
Regional Office* Washington
Accepted Date:
3/28/2022

FORM: NDMR 05-16 NON -DISCHARGE MONITORING REPORT (NDMR) Page of
Permit No.: Qlll •
• Dare
•nth: February1
11Flow
Measuring •• ■ Influent ■ Effluent ■ No flow generated
Parameter Monitoring •• ■ Influent ■ Effluent ■ Groundwater Lowering ■ Surface Water
Parameter Code 1,
•
Daily Maximum:
Daily Minimum:

FORM: NDMR 05-16 NON -DISCHARGE MONITORING REPORT (NDMR) Page of
Permit No.: WQ0002829
Facility Name: KDHWWTP
County: Dare
Month: February
Year: 2022
PPI: 002
Flow Measuring Point: ❑ influent ❑ Effluent ❑ No flow generated
Parameter Monitoring Point: ❑ Influent ❑ Effluent ❑ Groundwater Lowering ❑ Surface Water
Parameter Code No
60060
00310
00940
31616
00610
00626
00620
00600
00400
00666
70300
00630
>
U(YL ~
O
O
E
H
U0
O
O
LL3
a
m
d
LU
_ E
O
ri O
U
2
O
a
L
C
Y
OZ
Z
C
Z
N
i
CL
O
d
yy O
O
y fN
R d
'O
CCC.
H faN
W
24-hr
hrs
GPD
mg/L
mg/L
#/100 mL
mg/L
mg/L
mg/L
mg/L
su
mg/L
mg/L
mg/L
1
00:00
0
0
7.76
2
08:30
2
0
7.71
3
08:15
2
0
7.98
4
08:15
3
0
7.69
5
00:00
0
0
6
00:00
0
0
7
08:30
2
0
7.82
8
08:30
3
0
7.68
9
08:15
3
0
7.84
10
08:15
2
122,000
13
<1
<0.2
1.3
3.82
5.1
7.92
<0.26
<2.5
11
08:35
2
144,000
7.93
12
00:00
0
167,000
13
00:00
0
143,000
14
08:30
3
116,000
7.79
15
08:30
3
0
7.85
16
08:30
2
0
7.56
171
08:05
2
0
<2
<1
<0.2
0.8
3.65
4.5
7.78
<0.09
<2.5
18
08:15
2
0
7.83
19
00:00
0
0
20
00:00
0
0
21
08:30
2
0
7.87
22
07:45
3
190,000
7.74
231
14:30
2
136,000
7.79
24
08:00
3
120,000
7.38
25
08:00
3
154,000
7.82
26
00:00
0
152,000
27
00:00
0
122,000
28
00:00
0
98,000
7.82
29
30
31
Average:
59,429
6.50
1.00
0.00
1.05
3.74
4.80
0.00
0.00
Daily Maximum:
190,000
13.00
1.00
0.20
1.30
3.82
5.10
7.98
0.26
2.50
Daily Minimum:
0
2.00
1.00
0.20
0.80
3.65
4.50
7.38
0.09
2.50
Sampling Type:
Recorder
Composite
Composite
Grab
Composite
Composite
Composite
Composite
Grab
Composite
Composite
Composite
Monthly Limit:
327,735
10
14
4
7
3
20
Daily Limit:
43
6-9
Sample Frequency:
Continuous
See Permit
3 X Year
See Permit
See Permit
See Permit
See Permit
See Permit
5 X Week
See Permit
3 X Year
See Permit

FORM: NDMR 05-16 NON -DISCHARGE MONITORING REPORT (NDMR) Page of
Permit No.: Qlll •
• Dare
•nth: February1
11Flow
Measuring •• ■ Influent ■ Effluent ■ No flow generated
Parameter Monitoring •• ■ Influent ■ Effluent ■ Groundwater Lowering ■ Surface Water
Parameter Code 1,
•
•
Daily Maximum:
Daily Minimum:

FORM: NDMR 05-16 NON -DISCHARGE MONITORING REPORT (NDMR) Page of
Permit No.: Qlll •
• Dare
•nth: February1
11Flow
Measuring •• ■ Influent ■ Effluent ■ No flow generated
Parameter Monitoring •• ■ Influent ■ Effluent ■ Groundwater Lowering ■ Surface Water
Parameter Code 1,
•
Daily Maximum:
Daily Minimum:

FORM: NDMR 05-16 NON -DISCHARGE MONITORING REPORT (NDMR) Page of
Permit No.: WQ0002829
Facility Name: KDHWWTP
County: Dare
Month: February
Year: 2022
PPI: 005
Flow Measuring Point: ❑ influent ❑ Effluent ❑ No flow generated
Parameter Monitoring Point: ❑ Influent ❑ Effluent ❑ Groundwater Lowering ❑ Surface Water
Parameter Code No
60060
0
Z
L
V~
0
O
c
O
d
U y
O
LL
24-hr
hrs
GPD
1
00:00
0
0
2
08:30
2
0
3
08:15
2
0
4
08:15
3
0
5
00:00
0
0
6
00:00
0
0
7
08:30
2
0
8
08:30
3
0
9
08:15
3
0
10
08:15
2
0
11
08:35
2
0
12
00:00
0
0
13
00:00
0
0
14
08:30
3
0
15
08:30
3
0
16
08:30
2
0
171
08:05
2
0
18
08:15
2
0
19
00:00
0
0
20
00:00
0
0
21
08:30
2
0
22
07:45
3
0
231
14:30
2
0
24
08:00
3
0
25
08:00
3
0
26
00:00
0
0
27
00:00
0
0
28
00:00
0
0
29
30
31
Average:
0
Daily Maximum:
0
Daily Minimum:
0
Sampling Type:
Recorder
Monthly Limit:
215,456
Daily Limit:
Sample Frequency:
Continuous

FORM: NDMR 05-16 NON -DISCHARGE MONITORING REPORT (NDMR) Page of
Sampling Person(s) Certified Laboratories
Name: Jimmy Bliven Name: Envirochem
Name: Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of 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) taken. Attach additional sheets if necessary.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Jimmy Bliven
Permittee: George E Goodrich
Certification No.: 991879
Signing Official: Tina Gee by Authority
Grade: 4 Phone Number: 252-489-9583
Signing Official's Title: Manager of Atlantic OBX
Has the ORC changed since the previous NDMR? ❑ Yes 0 No
Phone Number: 252.491.8771 Permit Expiration: 6/30/2022
P
3/22/2022
3/22/2022
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 Water Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

FORM: NDAR-1 05-16 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of
Permit No.: WQ0002829
Facility Name: KDHWWTP
County: Dare
Month: February
Year: 2022
Did irrigation
Field Name:
IRR-1
Field Name:
IRR-2
Field Name:
IRR-3
Field Name:
IRR-4
occur
Area (acres):
4.6
Area (acres):
6.47
Area (acres):
3.27
Area (acres):
5.62
at this facility?
Cover Crop:Cover
Crop:
p�
Cover Crop:
p�
Cover Crop:
p:
❑ YES ❑ No
Hourly Rate (in):
1
Hourly Rate (in):
1
Hourly Rate (in):
1
Hourly Rate (in):
1
Annual Rate (in):
118
Annual Rate (in):
118
Annual Rate (in):
118
Annual Rate (in):
118
Weather
Freeboard
Field Irrigated?
❑ YES ❑ No
Field Irrigated?
❑ YES ❑ No
Field Irrigated?
❑ YES ❑ No
Field Irrigated?
❑ YES ❑ No
N
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in
ft
ft
gal
min
in
in
gal
min
in
in
gal
min
in
in
gal
min
in
in
1
C
40
0
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
2
C
42
0
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
3
C
55
0
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
4
PC
62
0
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
5
CL
38
0
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
6
R
1 38
0.2
1
0
0
0.00
1 0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
7
CL
40
0.3
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
8
CL
40
0
3.75
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
9
C
36
0
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
10
C
44
0
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
11
C
48
0
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
12
C
54
0
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
13
R
42
0.2
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
14
C
32
0
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
15
C
34
0
3.5
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
16
C
44
0
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
17
PC
56
0
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
18
CL
65
0
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
19
C
37
0
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
20
C
35
0
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
21
PC
48
0
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
22
CL
58
0
3.25
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
23
CL
60
0
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
24
CL
46
0
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
25
CL
48
0
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
26
CL
40
0
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
27
CL
40
0.1
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
28
C
44
0
4
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
29
30
31
Monthly Loading:
0
0.00
MINE01119MINIUMMIN
0
0.00
MENEMIN11111HEM
0
0.00
0
0.00
M
12 Month Floating Total (in):

FORM: NDAR-1 05-16 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of
Permit No.: WQ0002829
Facility Name: KDHWWTP
County: Dare
Month: February
Year: 2022
Did irrigation
Field Name:
IRR-5
Field Name:
IRR-6
Field Name:
IRR-7
Field Name:
occur
Area (acres):
0.94
Area (acres):
1.65
Area (acres):
2
Area (acres):
at this facility?
Cover Crop:Cover
Crop:
p�
Cover Crop:
p�
Cover Crop:
p:
❑ YES ❑ No
Hourly Rate (in):
1
Hourly Rate (in):
1
Hourly Rate (in):
1
Hourly Rate (in):
Annual Rate (in):
118
Annual Rate (in):
118
Annual Rate (in):
118
Annual Rate (in):
Weather
Freeboard
Field Irrigated?
❑ YES ❑ No
Field Irrigated?
❑ YES ❑ No
Field Irrigated?
❑ YES ❑ No
Field Irrigated?
❑ YES ❑ No
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in
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gal
min
in
in
gal
min
in
in
gal
min
in
in
gal
min
in
in
1
C
40
0
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
2
C
42
0
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
3
C
55
0
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
4
PC
62
0
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
5
CL
38
0
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
6
R
1 38
0.2
1
0
0
0.00
1 0.00
0
0
0.00
0.00
0
0
0.00
0.00
7
CL
40
0.3
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
8
CL
40
0
3.75
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
9
C
36
0
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
10
C
44
0
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
11
C
48
0
1 0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
12
C
54
0
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
13
R
42
0.2
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
14
C
32
0
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
15
C
34
0
3.5
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
16
C
44
0
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
17
PC
56
0
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
18
CL
65
0
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
19
C
37
0
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
20
C
35
0
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
21
PC
48
0
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
22
CL
58
0
3.25
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
23
CL
60
0
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
24
CL
46
0
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
25
CL
48
0
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
26
CL
40
0
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
27
CL
40
0.1
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
28
C
44
0
4
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
29
30
31
Monthly Loading:
0
0.00
0
0.00
0
0.00
0
0.00
12 Month Floating Total (in):

FORM: NDAR-1 05-16 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of
Did the application rates exceed the limits in Attachment B of your permit? p Compliant ❑ Non -Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites? p Compliant ❑ Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit? p Compliant ❑ Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site? ❑ 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) taken. Attach additional sheets if necessary.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Jimmy Bliven
Permittee:
George E Goodrich
Certification No.: 28243
Signing Official: Tina Gee by Authority
Grade: SI Phone Number: 252-489-9583
Signing Officials Title: Manager of Atlantic OBX
Has the ORC changed since the previous NDAR-1? ❑ Yes ❑ No
Phone Number: 252.491.8771 Permit Exp.: 6/30/22
'
— 3/22/22
3/22/22
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 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 of
Permit No.: WQ0002829
Facility Name: KDHWWTP
County. Dare
Month: February
Year: 2022
Did infiltration occur at
Site Name:
5
Site Name:
6
Site Name:
7-A
Site Name:
7-B
this facility?
Area (acres):
0.06
Area (acres):
0.21
Area (acres):
0.17
Area (acres):
0.17
❑ YES ❑ No
Rate (GPDIft2):
10
Rate (GPDIft):
10
Rate (GPDIft2):
10
Rate (GPDIft):
10
Weather
Freeboard
Site Infiltrated?
❑ YES ❑ No
Site Infiltrated?
❑ YES ❑ No
Site Infiltrated?
❑ YES ❑ No
Site Infiltrated?
❑ YES ❑ No
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m
°F
in
ft
ft
gal
min
GPDlft2
ft
gal
min
GPDlft2
ft
gal
min
GPDlft2
ft
gal
min
GPDlft2
ft
1
C
40
0
0
0
0.00
0
0
0.00
0
0
0.00
0
0
0.00
2
C
42
0
0
0
0.00
0
0
0.00
0
0
0.00
0
0
0.00
3
C
55
0
0
0
0.00
0
0
0.00
0
0
0.00
0
0
0.00
4
PC
62
0
0
0
0.00
0
0
0.00
0
0
0.00
0
0
0.00
5
CL
38
0
0
0
0.00
0
0
0.00
0
0
0.00
0
0
0.00
6
R
38
0.2
0
0
0.00
0
0
0.00
0
0
0.00
0
0
0.00
7
CL
40
0.3
0
0
0.00
0
0
0.00
0
0
0.00
0
0
0.00
8
CL
40
0
0
0
0.00
0
0
0.00
0
0
0.00
0
0
0.00
9
C
36
0
0
0
0.00
0
0
0.00
0
0
0.00
0
0
0.00
10
C
44
0
10,080
90
3.86
37,800
150
4.13
22,680
108
3.06
26,460
126
3.57
11
C
48
0
11,424
102
4.37
43,848
174
4.79
25,200
120
3.40
31,500
150
4.25
12
C
54
0
13,440
120
5.14
54,264
204
5.93
28,980
138
3.91
36,540
174
4.93
13
R
42
0.2
11,424
102
4.37
42,336
168
4.63
25,200
120
3.40
31,500
150
4.25
14
C
32
0
8,736
78
3.34
33,264
132
3.64
18,900
90
2.55
22,680
108
3.06
15
C
34
0
0
0
0.00
0
0
0.00
0
0
0.00
0
0
0.00
16
C
44
0
0
0
0.00
0
0
0.00
0
0
0.00
0
0
0.00
17
PC
56
0
0
0
0.00
0
0
0.00
0
0
0.00
0
0
0.00
18
CL
65
0
0
0
0.00
0
0
0.00
0
0
0.00
0
0
0.00
19
C
37
0
0
0
0.00
0
0
0.00
0
0
0.00
0
0
0.00
20
C
35
0
0
0
0.00
0
0
0.00
0
0
0.00
0
0
0.00
211
PC
1 48
0
1
0
0
0.00
0
0
0.00
0
0
0.00
0
0
0.00
22
CL
58
0
14,112
126
5.40
54,264
204
5.93
30,240
144
4.08
36,540
174
4.93
23
CL
60
0
8,736
78
3.34
33,264
132
3.64
18,900
90
2.55
23,940
114
3.23
24
CL
46
0
9,408
84
3.60
33,264
132
3.64
20,160
96
2.72
23,940
114
3.23
25
CL
48
0
10,752
96
4.11
40,824
162
4.46
22,680
108
3.06
28,980
138
3.91
26
CL
40
0
9,408
84
3.60
34,776
138
3.80
21,420
102
2.89
25,200
120
3.40
27
CL
40
0.1
6,720
60
2.57
25,704
102
2.81
15,120
72
2.04
18,900
90
2.55
28
C
44
0
6,720
60
2.57
24,192
96
2.64
13,680
66
1.85
16,380
78
2.21
29
30
31
1.65
1.799
1.27
1.56
FYearMoto nthly Loading (GPDIft2):
Date Loading (GPDIft2):

FORM: NDAR-2 05-16
NON -DISCHARGE APPLICATION REPORT (NDAR-2)
Page of
Did the application rates exceed the limits in Attachment B of your permit? 0 Compliant ❑ Non -Compliant
If not a basin, were the sites kept free of vegetation and raked? 0 Compliant ❑ Non -Compliant
If not a basin, were there any instances of effluent ponding in or runoff from the sites? 0 Compliant ❑ Non -Compliant
If a basin, were there any instances of breakout from the berms? 0 Compliant ❑ Non -Compliant
Was the onsite automatically activated standby power source tested and operational? ❑ 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 (ORC) Certification
Permittee Certification
ORC: Jimmy Bllven
Permittee:
George E Goodrich
Certification No.: 28243
Signing Official: Tina Gee by Authority
Grade: SI Phone Number: 252-489-9583
Signing Official's Title: Manager of Atlantic OBX
Has the ORC changed since the previous NDAR-2? ❑ Yes ❑ No
Phone Number: 252.491 .8771 Permit Exp.: 6/30/22
-- - 3/22/22
3/22/22
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 m
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
Raleigh, North Carolina 27699-1617