WQ0009267_Monitoring - 01-2022_20220429

Monitoring Report Submittal
Permit Number #*
Name of Facility:*
Month: * January
Report Information
WQ0009267
City of Jacksonville WWTF
Type *
Revised - NDMR, NDAR-1, NDAR-2,
NDMLR
Confirmation Email Address:*
Name of Submitter: *
Signature:
Date of submittal:
Initial Review
Year:* 2022
Upload Document*
WQ0009267 REVISED 7.89MB
January 2022.pdf
PDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
[e-mail]
Amy Palaschak
LW ff
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Reviewer: Gerald, Wanda
4/29/2022
This will be filled in automatically

Is the project number correct?* WQ0009267
Is the monitoring report accepted?* Yes No
Regional Office* Wilmington
Accepted Date: 5/24/2022

FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDARA) Page of
Did the application rates exceed the limits in Attachment B of your permit?
Were adequate measures taken to prevent effluent ponding in or runoff from the sites?
Was a suitable vegetative cover maintained on all sites as specified in your permit?
Were all setbacks listed in your permit maintained for every application to each permitted site?
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
❑� Compliant ❑Non -Compliant
QCompliant ❑Non -Compliant
QCompliant ❑Non -Compliant
QCompliant ❑Non -Compliant
QCompliant ❑Non Compliant
If the facility is non -compliant, please explain in the space below the reasons) the facility was not in compliance. Provide in your explanation the dates) 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: Brandon D. Davis Permittee:
City of Jacksonville /Richard L. Woodruff
Certification No.: SI 10020723 WWI 999355 Signing Official: Wally Hansen
Grade: Sl, WWI Phone Number: 910-938-5322 Signing Officials Title: Public Services Director
Has the ORC changed since the previous NDAR-1? Yes ❑No I� Phone Number: 910-938-5260 Permit Exp.: 4/30/22
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Signature
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
Signature
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 Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

FORM: NDMR 08A 1 NON -DISCHARGE MONITORING REPORT (NDMR) Page of
Sampling Person(s) 11 Certified Laboratories
Name: Plant Operators 11 Name: City of Jacksonville, #128
Name: Plant Operators 11 Name: Environmental Chemists, #94
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 reasons) the facility was not in compliance. Provide in your explanation the dates) of the non-compliance and describe the corrective
action(s) taken. Attach additional sheets if necessary.
was no irrigation on 1/1, 1/2, 1/3, 1/8, 1/9, 1/15, 1/16, 1/17, 1/18, 1/21, 1/22, 1/23, 1/29 or 1/30. So no pH or Cl2 were collected on those
Operator in Responsible Charge (ORC) Certification
Permittee Certification
oRc: Brandon D. Davis Permittee: City of Jacksonville /Richard L. Woodruff
Certification No.: SI 10020721 WWI 999355 Signing Official: Wally Hansen
Grade: SI, WWI Phone Number: 910-938-5322 Signing Official's Title: Public Services Director
Has the ORC changed since the previous NDMR? ❑✓ Yes ❑No Phone Number: 910-938-5360 Permit Expiration: 4/30/2022
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Signature Date Q 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 inquiryof 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

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page of
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Daily Maximum:
Daily Minimum:
Sampling Type:
Monthly Limit:
Daily Limit:
Sample Frequency:

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page of

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page of

FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDARA) Page of

FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDARA) Page of

FORM: NDAR-1 0&11 NON=DISCHARGE APPLICATION REPORT (NDARA) Page of

FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDARA) Page of

FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of

FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDARA) Page Of

FORM: NDAR-1 08-11 NON=DISCHARGE APPLICATION REPORT (NDARA) Page of