WQ0036210_Monitoring - 10-2022_20221129 (2)

Monitoring Report Submittal
Permit Number #* WQ0036210
Name of Facility:* Moore's Keep Christian Camp/ Benchmark Ministries
Month: * October Year: * 2022
Report Information
Type* Upload Document*
NDMR, NDAR-1, NDAR-2, NDMLR NDMR and NDAR-1 Nov
2022.pdf
PDF Only
2.77MB
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: * Thomas Lewis
Signature:
Date of submittal: 11/29/2022
This will be filled in automatically
Initial Review
Reviewer: Gerald, Wanda

Is the project number correct?* WQ0036210
Is the monitoring report accepted?* - Yes NO
Regional Office* Fayetteville
Reviewer: _anonymous
Review Date: 12/6/2022

FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (N®AR-1) Page of
Did the application rates exceed the limits in Attachment B of your permit? ©Compliant ❑Non-Compliar
Were adequate measures taken to prevent effluent ponding in or runoff from the sites? EgCompliant ❑Non-Compliar
Was a suitable vegetative cover maintained on all sites as specified in yourpermit? ffcompliant ❑Non-Compliar
Were all setbacks listed in your permit maintained for every application to each permitted site? uCompliant ❑Non-Compliar
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? compliant ❑Non-Compliar
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 coi
action(s) taken. Attach additional sheets if necessary.
Operator in Responsible Charge (ORC) Certification
ORC: Thomas Lewis
Certification No.: 1002746
Grade: SI Phone Number: 919-815-7603
Has the ORC changed since the previous NDAR-1? ❑yes ONo
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
Permittee Certification
Permlttee: Benchmark Ministries Inc.
Signing official: Thomas Lewis
Signing Officials Title: President
Phone Number: 919-815-7603 Permit Exp.: 1131/23
Signature De
I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in
with a system designed to assure that all qualified personnel properly gathered and evaluated the information submitted. E
inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the inform
Information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are
penalties for submitting false Information, including the possibility of fines and imprisonment for knowing violation
Division of • e
InformationProcessing

FORM: NDMR 03-12 NON -DISCHARGE ONITORING REPORT (NDMR) Page of
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FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page _ of
Sampling Person(s)
Certified Laboratories
Name: Name:
Name: Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? 7Compliant ❑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: Thomas Lewis Parmittee: Benchmark Ministries Inc.
Certification No.: 1002746 Signing Official: Thomas Lewis
Grade: SI Phone Number: 919-815-7603 Signing Official's Title; President
Has the ORC changed since the previous NDIVIR? []Yes [ZNO Phone Number: 919-815-7603 Permit Expiration: 1/31/2023
�&natre — Date 7Signature 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 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 Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617