WQ0002648_Monitoring - 10-2022_20221124

Monitoring Report Submittal
Permit Number #*
Name of Facility:*
Month: * October
Report Information
WQ0002648
Seagrove -Utah Metropolitan WWTF
Year:* 2022
Type* Upload Document*
NDMR, NDAR-1, NDAR-2, NDMLR Oct 2022 NDMR,NDAR 2.03MB
Signed.pdf
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: * Larry Chilton
Signature:
a. *wP ,> ir�vw
Date of submittal: 11/24/2022
This will be filled in automatically
Initial Review
Reviewer: Gerald, Wanda

Is the project number correct?* WQ0002648
Is the monitoring report accepted?* - Yes NO
Regional Office* Winston-Salem
Reviewer: _anonymous
Review Date: 11/29/2022

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR)
Page J of
Permit No.: WQ0002648
Facility
Name:
Seagrove-Ulah
Metropolitan
Parameter
00620
County:
Monitoring
00600
Randolph Month: October Year: �uc�
Point: ❑ Influent © Effluent ❑ Groundwater Lowering ❑ Surface Water
00400 00665 70300 00530
PPI: 001
Flow Measuring
Point:
❑ Influent
❑ Effluent
❑ No flow
generated
00626
Parameter Code --►
50060
00310
00940
50060
31616
00610
Tr.0
LL O
0
c
a
`w°�o
~ Y Z
Z
~ Z"
a
~ t ~ p N ~ N N
a
su m IL , mall m IL
6.7
6.8
6.7
7
7.1
7
7
6.8
6.8
6.8
7.2
71 6.94 18
6.9
6.9
6.9
6.7
7.2
7.1
7
6.9
6.8
6.8
6.6
7.2
7.2
7
6.9
6.5
6.5
6.5
6.94 18.00 .
18.00
7.20 6.94 98.00
6.50 6.94
Grab Grab Grab Grab
Week Monthly 3 X Year Monthly
try
V
O
y
O
o
LL
o
m
c
L
V
w�''�
f�- ayi 0 C
24-hr
hrs
GPD
mg/L
m /L-
mg/L
#/100 mL
mg/L
mg/L
m /L
m /L
1
04:00
10
39,900
0.8
2
04:00
6
15,700
1.4
3
06:30
8
27,500
1.5
4
5
6
06:30
06:30
06:30
8
8
8
22,300
26,500
11,800
1.6
1.5
1.9
7
06:00
04:00
8
9
36,100
19,300
1.9
1.4
8
9
05:00
6
13,100
1.6
10
06:00
8
29,900
1.6
11
12
06:30
06:30
8
8
18,200
1 25,600
<3
1.4
1.6
25
9.48
9.48
12.2
23.9
13
06:00
8
27,000
1.7
14
06:00
8
26,400
1.5
15
04:30
12:00
8
6
23,100
9,800
1.9
1.4
16
17
06:30
8
28,400
1.7
18
0670
8
24,100
1.9
19
06:00
8
26,100
1.5
20
06:30
8
25,900
1.6
21
06:00
8
25,100
1.4
22
04:30
8
16,000
2.1
23
24
04:00
06:30
06:30
06:30
06:30
06:00
6
8
8
8
8
8
17,100
23,400
25,900
24,900
1 26,200
25,100
2.2
2
1.8
1.9
1.8
1.7
25
26
27
28
29
04.00
8
14,900
1
30
03:30
6
15,400 "
2.1
31 06:30 Average:
Daily Maximum:
Daily Minimum:
Sampling Type:
22,9811,
39,900
9,800
Recorder
0.00
3.00
3.00
Grab
Grab
11.65
2.20
0.80
Grab
25.00 -
25.00
25.00
Grab
9.48
9.48
9.48
Grab
9.48
9.48
9.48
Grab
12.20
12.20
12.20
Grab
23.90 ..
23.90
23.90
Grab
Monthly Avg. Limit:
30,000
Daily Limit:
Sample Frequency:
Continuous
Monthly
3 X Year
5 X Week
Monthly
Monthly
Monthly
Monthly
�MnlhllX

FORM: NDAR-1 05-16 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page _'�_ of s'
Permit No.: WQ0002648
Facility Name: Seagrove -Utah Metropolitan Water District WWTP
County: Randolph
Month: October Year: 2022
Did irrigation occur
at this facility?
© YES ❑ No
Field Nemec
1
Field Name:
2
Field Name:
3
Field Name: 4
Area (acres):
2.1
Area (acres):
2
Area (acres):
21
Area (acres): 3.4
Cover Crop:
Grass
Cover Crop:
Grass
Cover Crop:
Grass
Cover Crop:
Grass
Hourly Rate (in):
Hourly Rate (in):
Hourly Rate (in):
Hourly Rate (in):
Annual Rate (in):
38.4
Annual Rate (in):
38.4
Annual Rate (in):
38.4
Annual Rate (in):
38.4
Weather
Freeboard
Field Irrigated?
© YES, ❑ No
Field Irrigated?
0 YES ❑ No
Field Irrigated?
21 YES ❑ No
Field Irrigated?
RI YES ❑ NO
°a
v
d
CL
o
,
o o
Eco
0
°
o
IQ
"
Rm
5
°O
_
EE
-E
E
°_
_r
Bx3
�
a
1
R
°F
54
in
0.1
ft
66"
ft
gal
min
in
in
gal
min
in
in
gal
min
in
in
gal
min
in
in
2
C
50
0
5'2"
3
4
PC
C
52
42
0
0
5'0"
6'4"
6,250
12.5
0.11
0.11
6,250
12.5
0.12
0.12
5,680
11.4
0.10
0.10
9,660
19.3
0.10
0.10
5
C
43
0
61"
6
C
48
1 0
57'
7
8
C
PC
50
55
0
0
5151,
65"
3,750
7.5
0.07
0.07
3,750
7.5
0.07
0.07
3,408
6.8
0.06
0.06
5,796
11.6
0.06
0.06
9
C
45
0
610"
10
PC
49
0
5'10"
11
PC
44
0
1 57'
12
13
R
CL
49
60
0.1
0
5'5"
67"
5,000
10
0.09
6.09
5,000
10
0.09
0.09
4,545
9
0.08
0.08
7,727
15.4
0.08
1 0.08
14
15
C
C
49
45
0
0
5'11'
6'4'
2,500
5
0.04
0.04
2,500
5
0.05
0.05
2,272
4.5
0.04
0.04
3,864
7.7
0.04
0.04
16
C
74
0
61"
17
PC
59
0
5'11"
18
C
42
0
5'8"
19
20
C
C
29
32
0
0
65"
614,
3,750
7.5
0.07
0.07
3,750
7.5
0.07
0.07
3,408
6.8
0.06
0.06
5,796
11.6
0.06
0.06
21
22
C
C
32
35
0
0
60"
6'3"
2,500
5
0.04
0.04
2,500
5
0,05
0.05
2,272
4.5
0.04
0.04
3,864
7.7
0.04
0.04
23
C
43
0
610.1
24
C
44 1
0
5'8"
25
PC
41
0
65"
26
CL
56
0
57°
27
28
PC
PC
50
46
0
0
50"
6'5"
1
6,250
12.5
0.11
0.11
6,250
12.5
0.12
0.12
5,680
11.4
0.10
0.10
9,660
19.3
0.10
0.10
291
CL
51
0
6101,
301
CL
53
0
5'10"
311
R
54
0.5
57"
Monthly
Loading:
30,000
0.53
7.92 W.8.28
30,000
0.55
27,265 0.48
7.39
L367i
---6/01
0.50
7.42
12 Month Floating Total (in):

FORM: NDAR-1 05-16 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page 3 of-s'_
Permit No.,: WQ0002648
Facility Name: Seagrove-Ulah Metropolitan Water District WWTP
County: Randolph
Month: October
MEOW
Did irrigation occur
at this facility?
R YES ■ NO
Field Name::
Field Name:
Area (acres):
-.
.=
M=
..
n ■ •
a ■ •
a ■ •
..
■ o
...�.c
®
• .•
..•
®���----

FORM: NDAR-1 05-16 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page_ Of-6,
Permit No.: WQ0002648
Facility Name: Seagrove -Utah Metropolitan Water District WWTP
County: Randolph
Month: October
Year: 2022
Did irrigation occur
at this facility?
® YES ❑ NO
Field Name:
9
Field Name:
10
Field Name:
11
Field Name:
12
Area (acres):
2.3
Area (acres):
2
� Area (acres):
-- 2.7
Area (acres):
2
Cover Crop:
Grass
Cover Crop:
Grass
Cover Crop:,
Grass
Cover Crop:
Grass
Hourly Rate (in):
Hourly Rate (in):
Hourly Rate (in):
Hourly Rate (in):
Annual Rate (in):
38.4
Annual Rate (in):
38.4
Annual Rate (in):,.,,,
38.4
Annual Rate (in):
38.4
Weather
Freeboard
Field Irrigated?
© YES ❑ NO
Field Irrigated?
0 YES ❑ No
Field Irrigated?
10 YES ❑ No
Field Irrigated?
❑ YES p No
o
ci
3
H
0
a
a
N
a,o.
=a
N.a
=S
�a
.`� Q
E o�
�,`
r
R o
p�
J
E _ °
�_�
J
= a
oa
>Q
E `°
i=°'
o
oc
J=J
�Te
.E a
xcc
'oc
�Q
col
E
o>
?'`�
oeg
a....:�=j
E o>
E tea'
xotp
a,tm
ca
�Q
Eol
~
a
G
J
Ez.S
ceap
�= O
J
OF
in
it
It
gal
min
in
in
gal
min
in
in
gal
min
in
in
gal
min
in
in
1
R
54
0.1
5'6"
2
C
50
0
57'
3
PC
52
0
5'0"
1 5,110
10.2
0.08
0.08
4,540
9.1
0.08
0.08
8,520
17
0.12
0.12
4
C
42
0
64'
6
C
43
0
61"
6
C
48
0
5'7"
71
C
50
0
65"
3,066 '
6.1
0.05
0.05
2,724
5.5
0.05
0.05
5,112
10.2
0.07
0.07
8
PC
55
0
615"
9
C
45
0
6'0
10
PC
49
0
5'10"
11
PC
44
0
57"
12
R
49
0.1
5'5"
1 4,091
8
0.07
0.07'
3,636
7.2
0.07
1 0.07
6,818
13.6
0.09
0.09
131
CL
60
0
6'3"
141
C
49
0
511'
2,044
4.1
0,03
0.03
1,816
3.6
0.03
1 0.03
3,408
6.8
0.05
0.05
16
C
45
0
64"
16
C
74
0
6'1"
17
PC
59 1
0
611"
18
C
42
0
5'8"
19
C
29
0
65"
3,066
6.1
0.05
0.05
2,724
5.5
0.05
0.05
5,112
10.2
0.07
0.07
20
C
32
0
6W
21
C
32
0
6'0"
1
2,044
4.1
0.03
0.03.
1,816
3.6
0.03
0.03
3,408
6.8
0.05
0.05
22
C
35
0
63"
23
C
43
0
67
24
C
44
0
5'8"
26
PC
41
26
CL
56
27
PC
50
5,110
10.2
0.08
0.08
4,540
9.1
0.08
0.08
8,520
17
0.12
0.12
28
PC
46
C
51
J]L]
53
54
0.52
=tom..- iai////, IEu .1._m.//%//%/%//s'b.'a%/%%//%/%%/!t'��:�'r:�%%��%/��%/////=i0 ��%%�/ ' ' •

FORM: NDAR-1 05-16 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page. -:5- of S-
Permit No.: WQ0002648
Facility Name: Seagrove -Utah Metropolitan Water District WWTP
County: Randolph .
Month: October
Year: 2022
Did irrigation occur
at this facility?
© YES ❑ No
Field Name:
13
Field Name:
14
Field Name:
15
Field Name:
16
Area (acres):
2.2
Area (acres):
2.1
Area (acres):
3.4
Area (acres):
3.8
Cover Crop:
Grass
Cover Crop:
Grass
Cover Crop:
Grass
Cover Crop:
Grass
Hourly Rate (in):
Hourly Rate (in):
Hourly Rate (in):
Hourly Rate (in):
Annual Rate (in):
38.4
Annual Rate (in):
38.4
Annual Rate (in):
38.4
Annual Rate (in):
-38.4
Weather
Freeboard
Field Irrigated?
© YES ❑ No
Field Irrigated?
0 YES ❑ No
Field irrigated?
©YEs ❑ No
Field Irrigated?
©YES ❑ NO
1
c
..
R
ro
E
OF
54
0
A
in
0.1
rn
v�
It
5'6"
a
'c.
Ra
4„
It
� °-
oa
>a
gat
6 rn
h�
..
min
ar
��
Cc.,
in
E T
EIS
�co_
_.�
in
o
3 a
oa
>a
gal
E�
f=Mm
min
a�
m o
pR
o
in
E C"
E 5 o
KOR
Rxo
I in
'_
-a
oa
gal
9
-aM
f--
min
tM
_ o
R
c_B
in
E� o
_
�_$
I in
C -'
_a
oa
gal
E
E
Po,
min
g, 5
�a
ova
in
o` e
Eo°a
ko
in
2
C
50
0
5'2"
3
4
PC
C
52
42
0
0
5'0"
6'4"
4,540
9.1
0.08
0.08
4,540
9.1
0.08
0.08
10,790
21.6
0.12
0.12
11,930
23.9
0.12
0.12
6
C
43
0
61"
6
C
48
0
57'
7
8
C
PC
50
55
0
0
5'5"
6'5"
2,724
5.5
0.05
0.05
2,724
5.5
0.05
0.05
6,474
13
0.07
0.07
7,158
14.3
0.07
0.07
9
C
45
0
6-0,
10
PC
49
0
5110"
11
PC
44
0
57"
12
13
R
CL
49
60
0.1
0
5'5"
63"
3,636"
7.2
0.06` '
0.06
3,636
7.2
0.06
1 0.06
8,636
17.2
0.09
0.09
9,545
19.1
0.09
0.09
14
16
C
C
49
45
0
0
611'
6'4'
1,816
3.6
0.03
0.03
1,816
3.6
0.03
0.03
4,316
8.6
0.05
0.05
4,772
9.5
0.05
0.05
16
C
74
0 1
6111.
17
PC
59
0
611"
18
C
42
0 1
5'8"
19
20
C
C
29
32
0
0
515"
64"
2,724
5.5
0.05
0.05
2,724
5.5
0.05 1
0.05
6,474
13
0.07
0.07
7,158
14.3
0.07
0.07
21
22
C
C
32
35
0
0
60"
6'3"
1,816
3.6 1
0.03 :'
0.03 ,
1,816
3.6
0.03
0.03
4,316
8.6
0.05
0.05 _
4,772
9.5
0.05
0.05
23
C
43
0
60"
24
C
44
0 1
5'8" .
26
PC
41
0
55"
26
CL
56
0
57
27
28
PC
PC
50
46
0
rO
5'0"
6,5,
4,540
9.1
_..
0.08
0.018
4,540
9.1
0.08 1
0.08
10,790
21.6
0.12
0.12
11,930
23.9
0.12 1
0.12
29
CL
51
0
6101,
301
CL
53
0
5'10"
311
54
0.5
67"
Monthly
Loading:
21,796 0.36
6.18
ro 21,796 0.38
5.74
51,796 0.56
8.37
57,265 0.56
8.35
12 Month Floating Total 0n):

FORM: P1DAi2-1 05-16
NON -DISCHARGE APPLICATION REPORT (NDAR4) Page_„ -of �
Did the application- rates exceed the ffmits in Attachment B of
pp your. permit? -
© Compliant Cl Non-CompfWnt
Were adequate measures taken to prevent effluent ponding in or runoff from the sites?
© compliant ❑ Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified In your permit?
© Compliant ❑ Non-CompHant
Were all setbacks listed in your permit maintained -€or every application to each permitted site-
12 Compliant ❑ Non -compliant , ..
Were all freeboards maintained in accordance with the specified freeboard heights In your permit? G, Compliant o Non -compliant
If the faciitty is non -compliant, please explain in the space below the reason(s)'thefaciiity 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.
No irrigation occurred dudM rain. Rain was evening and overrt ht after irri atiomevent:
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC:, Larry T. Chilton Pemtittee:
- Seagrove/Utah Metropolitan Water District
Certification No.: 2WW-10681 _ S1-28234 Signing Official: Michael T. Walker
Grade; 2 Phone Number: 336-30273782 _ . Signing Official's Title: Secretary
Has the ORC chang
ed since the previous NDAR-1?
❑ Yes p No Phone Number: 336-873-9055 Permit EW: 4/30127
f
Ci _ Z2 4
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 evaivated theinfomwation
submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsibie 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 Process.ing.Unit
1617 Mail Service Center
Raleigh; North Carolina 276994617

FORM: NDAR-1 05-16 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of S'
Did the application rates exceed the limits in.Attachment B of your permit?
fY� compliant 13 Non-cogopilant_
Were adequate measures taken to prevent effluent ponding in or runoff from the sites?
© compliant ❑ Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit?
compliant ❑ Non -compliant
Were all setbacks listed in your permit maintained for every application to each permitted site?
rR ❑ Non -compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit
Complfa
!f the facility is non-cornpiiant, piease:expiain in the space t�elow the reasons} the facility was not in compliance: Provide in Your ® compliant ❑ Non-Compiiant
Yo explanation the date(s) of the non-compliance and describe the corrective action(s)
taken. Attach additional sheets if necessary.
N* Lrogation occurred during rain: Rain was ng and ovemi ht after inigation event.
Operator in Responsible Charge (ORC) Certification
Penhittee Certification '
oRC: Larry T. Chilton _J
Permittee:
Certification No.: 2WW-10687 Si-28234 Seagrove/Ulah M10tropoiitan Water District
Signing official: Michael T. Walker
Grade: 2 Phone Number: 336-302-3782 f
Signing Official's Title: Secretary
Has the ORC chan
ged since the previous NDAR-11 p Yes a No. Phone Number: 336-873-9055 Permit Exp.: 4/30/27
r 7- tat .
Signature
Date Signature
Date
By this signature, i certify that this report is accurcate and complete to the best of my im.medge. I cartunder certify, 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 infomaation, the infdrmafion submitted is, to the best of my imowiscige and belief, true, accurate, and complete. I am
aware that there are Significant penalties for submitting false information, including the possibifdy of fines and imprisonment for
imowing'4iolations.
Mail Original and Two Copies. -to:
Division of Water Resources
Information Processing unit
1617 Mail Service Center "
Raleigh, NorthCarolina 27699-1617 -

FORM: NDAR-1 05-1.6 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page 3 of
ag
,Did the application rates exceed `the limits in Attachment B of your permit?
© Compliant ❑ Non -Compliant'
Were adequate measures taken to prevent effluent ponding in or runoff from the sites?
G Compliant' 0 Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit?
[a Compliant ❑Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site?
0 ComPAant ❑Non-ComPilant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
If the facility is non -compliant, please explain in the spade below the reason ® Compliant l] Non-Compilant'
s) the facility was not in aampliance. Provide in your elanatiort the date(s) of the non-compliance and descrit�e the corrective action(s)
taken. Attach additional sheets if necessary.
No irrigation. occurred dudng rain. Rain was evenIN and overnight after irrigation event.
Operator in Responsible, Char9 (ORC) certification Permittee, Certifcaton
ORC: Larry T. Chilton
Permittee:
Seagrove/Ulah Metropolitan Water District
certificatfort No.: 2WW-10681 St-28234
_ Signing official, Michael T. Walker
Grades 2 Phone Number: 336-302-3782
Signing Official's Title: Secretary
Has the ORC changed since the previous NDAR-17 ❑yes p No Phone Number:
336-873-9055 Permit Exp.: 4/30/27
?—.202R
Signature
Date Signature
By this signature, 1 certify that this report is accunate and corn Date
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 supeMsion in
accordance with a system designed to assure that all'qualified personnel properly gathered and evaluated the information
submitted. Based on m m ui of the Y q rY 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. ! am
aware that there are significant penatties.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 276994617

FORM: NDAR-1 06-16 NON -DISCHARGE APPLICATION REPORT MARA) Pa a. S
$e 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?
® Compliant ❑ Non-ComPltant
Was a suitable vegetative covermaintained on all sites as specified in your permit?
© Compliant ❑ Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site?
© Compliant ❑ Non -Compliant
Were ail freeboards maintalned in accordance 'with the specified -freeboard permit?
heights in our Y permit? © 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
yc explanation the date(s) of the non-eomplianceand describe the corrective action(s)
taken. Attach additional sheets if necessary.
No irrigation -occurred during rain. Rain was evening and ovemi ht after inigation event.
Operator in Responsible Charge (ORC) Certification
Pemtittee Certification
ORC: Larry T. Chilton Permittee:
Seagrove/Ulah Metropolitan Water District
Certification No.: 2WW-10681 61-28234 �! signing Official: Michael T. V61a1icet
Grade: 2 Phone Number: 336-3fl2-3782 i Signing Official's Title: Secretary
Has the ORC changed since the previous NDAR-1?
❑ yes ID No Phone Number: 336-873-9055Pemiit Exp.: 4/30127
Signature
Date Signature
Date-
By
this signature, I certify, that this report is accurrate and complete to the best of my Imowiedge. I certify, under penalty of law, that this document and all attachments were prepared undermy 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 hest of my knowledge and belief,true, accurate, and complete. I am
aware that there are significant penalties for submitting false information, includingthe 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 27699-161

FORM: NDMR 03-12
NON -DISCHARGE MONITORING REPORT (NDMR)
Page _J_ of 5'
Sampling Person(s) Certified Laboratories
Name: Chris Cameron w/Cameron Testing Services Name: Cameron Testing Services
Name:
Name:
Does all monitoring data and sampling frequencies sheet the requirements in Attachment A Of your permit? m rompllan, p 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 aetion(s) takes
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Larry T. Chilton
Permittee: Seagrove/Utah Metropolitan Water District
Certification No.: 2WW-10681 SI-28234
Signing Official: Michael T. Walker
Grade: 2 Phone Number: 336-302-3782
Signing Official's Title: Secretary
Has the ORC changed since the previous NDMR? O Yes © Na
P
Phone Number:. 336-873-9055 Permit Expiration: _ . 4/30/2027
Signature Date
Signature Date
By this signature, I certify that this report is accurrate and complete to the best or my knowledge.
I certify, under penalty of law, that this document and all attachments ware prepared under my direction or supervision in
accordance with a system designed toassure 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 knoMedge and belief, true, accurate, and complete. I
am aware that there are signifcant penalties for submitting false information, including the possibility of fines and imprisonment
forlmowing violations
Mail Original and Taro. Copies to:
Division of Water Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 276994617