WQ0024003_Monitoring - 09-2022_20221021

Monitoring Report Submittal
Permit Number #*
Name of Facility:*
Month: * September
Report Information
WQ0024003
Harvey Point Defense Testing Activity WWTP
Year:* 2022
Type* Upload Document*
NDMR, NDAR-1, NDAR-2, NDMLR Scan NDMR Sept. 2022.pdf 1.96MB
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: * Dustin B. Combs
Signature:
Date of submittal: 10/21/2022
This will be filled in automatically
Initial Review
Reviewer: Gerald, Wanda

Is the project number correct?* WQ0024003
Is the monitoring report accepted?* Yes No
Regional Office* Washington
Reviewer: _anonymous
Review Date: 11/2/2022

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page - of —a—
Permit No.: WQ0024003
Facility Name: Harvey Paint Defense Facility
County: P'erquimans
' Month: September
Year:. 2022
PPL 001
Flow Measuring Point: Qinfluent DEffluent EjNo now generated
Parameter Monitoring Point: [ Influent Eunuent EiGroundwater Lowering []Surface water
Parameter Code
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FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page R of --a
Sampling Person(s) Certified Laboratories
Name: Dustin Combs 1� Name: Environmental Chemists Inc.
Name'. 11 Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? DCompliant LINon-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: Dustin B.Combs
Permittee: Harvey Point Defense Testing Activity
Certification No.: 1003645
Signing Official: Stephan Oltjen
Grade: ill Phone Number: 252-562-2684
Signing Official's Title: Enviromental Safety Officer
Has the ORC changed since the previous NDMR? Dyes PINO
Phone Number: 252-426-4360 Permit Expiration: 3131/2023
V
Signature Date
Signature Date
By this signature, I certify that this report is accurrate and complete to the best at 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 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 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
Permit No.: W00024003
Facility Name: Harvey Print Defense Testing Activity WWTP
County: Perquimans Month. September
Year: 2022
Field Name:
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NON -DISCHARGE APPLICATION REPORT (NDAR®1)
Page 3 of
Did the application rates exceed the limits in Attachment B of your permit?
MCompl€ant ❑Non -Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites? Elcompfant []Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit? (CCompliant []Non -compliant
Were all setbacks listed in your permit maintained for every application to each permitted site? QCompliant ❑Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? ❑compliant ]Non-Cornpllant
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 (CRC) Certification
I ORC: Dustin B. Combs
Certification No.: 1007989
I Grade: SI Phone Number: 252-562-2684
Has the ORC changed since the previous NDAR-1? Qves ®No
Signature
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
Permittee Certification
Perm tiles:
Harvey Point Defense Testing Activity
Signing official: Stephan Oltjen
Signing Official's Title: Enviromental Safety Officer
Phone Number: 252-426-4250 Permit Exp.: 3/31t23
Date Signature Date
I certify, under penalty of taw, 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 knotting violations..
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617