WQ0005247_Monitoring - 11-2022_20221219

Monitoring Report Submittal
Permit Number #*
Name of Facility:*
Month: * November
Report Information
WQ0005247
Falls Lake - Rolling View WWTF
Type *
NDMR, NDAR-1, NDAR-2, NDMLR
Confirmation Email Address: *
Name of Submitter: *
Signature:
Date of submittal:
Initial Review
Year:* 2022
Upload Document*
Rolling View Signed 1.75MB
November 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]
Stephen Donaldson
C51--'e 01--1
Reviewer: Gerald, Wanda
12/19/2022
This will be filled in automatically

Is the project number correct?* WQ0005247
Is the monitoring report accepted?* Yes No
Regional Office* Raleigh
Reviewer: _anonymous
Review Date: 12/20/2022

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FORM: DAR-'. 10-13 NON -DISCHARGE APPL TI N REPORT (N -) Page of
Permit No.: WQ0005247
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Facility Name: Falls Lake - Rolling View VVWTF
i�County: m ember
Field
Area (acres):
55
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Annual Rate (in)-
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Page ` or
,_ Alonaing in ti
Was a suitable vegetative cover maintained on all sites as specified in your permit'?
� . Compliant ` Nor -Compliant
Cornptiant _ Non. -Compliant
Compliant
Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site? F:�] Compliant NonCornptant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit' compliant ` Nor.-Cor ;ntiant
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
actionM taken. Attach additional sheets if necessary,
Operator in Responsible Charge ( RC) Certification
Permittee Certification
R: Joel Valentine
Rernittee:
NC D E R i DPR I Falls Lake - Rolling View MAITF
Certification No., SI1012362
Signing Official: David Murnferd
Grade: SI Phone Number: 8 - 7-80 Q
Signing Official's Title: Park Superintendent
Has the ORC changed since the Previous I R-1 r s he
Phone (umber =8 7=BtIC� Permit Exp.: €2' ;`2
`.
s
Date
Signaturenature
Date
By this signature, t certify it2t this report is ac.cu€rate and cairipiete to the best of my knowledge.
I en�t3i. under penatty of '_N, that this docu.€nsrit andat'. attachments were prepared under my direction €1 supervision in accordance
with a syster n designed to assure that ail qualified personnel properly gathered and evaluated the information submitted. Based on my
inquiry of the person o_ persons who manage the system, or those persons directly respensicle for gathering the information, the
information submitted is tc the best of my knowledge and belief, true accurate and cormptete I air aware that there are significant
penalties for s. bmAbng false information including the possibility €s fines and imprisonment for knowing violations,
Mail 3..l a Two Copies to:
Division of Water Resources
Information Proce

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FORM: NDMR 03- 2 NON -DISCHARGE MONITORIN REPORT NDMR Page of f

FORM: NDMR 03-12
Page of
Sampling Persorttst Certified Laboratories
Name: Anthony Branch blame: Statesville Analytical / Envirolink
I
Name:Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit'? ,- Compon-, El Non-coplant
if the facility is non -compliant, please explain in the space below the reasons the facility was nct 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 ( RC) Certification Permutes Certification
OR : Joel valentine Permittee: NC D I R / DPR / Falls Lake - Rolling View WWT
Certification o.- S11012362 Signing Official: David Mumford
Grade- sl Phone Number- - 6f= 666 Signing Official's Title: Park Superintendent
Yes E No
Has the ORC changedsince the pr vioufs NDMR? i Phone Number: 4- 67- 6 6 PermitExpiration: 121 1/2021
By this stynatiur= certify that this rlep t 3s accurrate and rumps€t to the best of my knowledge.
Date Sfgrrature Date
t certify, under penalty of law that this document and ail attachments ells were prepared under my direction or supervision in
accordance vrtP a system designed to assure. that of! qualified personnel properly -gathered and evaluated the information
spbmitied. used on try inquiry of the person ar persons who manage the system, or these peons directly responsible for
t gatheong the information, the inrorrnatien sutirrutted s, to the best of try knorvledeae and belief tree, accurate., and complete, l am
i aware that there am s pr._ scant penalties for submitting false inf •matio,n, including the possibility of fines aid imprisonment for
knCwng violations,
OriginalMail • TwoCopies s
! ♦. ! Resources
Inforrination Processing Unit
1617 Mail Service
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