WQ0036210_Monitoring - 11-2022_20230103

Monitoring Report Submittal
Permit Number #*
Name of Facility:*
Month: * November
Report Information
WQ0036210
Moore's Keep Christian Camp
Type *
NDMR, NDAR-1, NDAR-2, NDMLR
Confirmation Email Address:*
Name of Submitter: *
Signature:
Date of submittal:
Initial Review
Year:* 2022
Upload Document*
November 2022.pdf 2.64MB
PDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
[e-mail]
Thomas Lewis
/rPW zd ce.,
Reviewer: Gerald, Wanda
1 /3/2023
This will be filled in automatically

Is the project number correct?* WQ0036210
Is the monitoring report accepted?* Yes No
Regional Office* Fayetteville
Reviewer: _anonymous
Review Date: 1/3/2023

FORM: NDAR_t 10-13 -DISCHARGE APPLICATION REPORT (-1) Wage of
Cl: Thomas Lewis
Certification No.. 1902746
Grade: S1 Phone umber: 919-815-7 93
Has the changed since the previous -1? []Yes [/]No
gnatura Data
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
errnittee Certification
errnitt :
Benchmark Ministries Inc.
Signing official: Tticimas Levis
Signing Official's Title: President
Phone Number: 919- 15-7693 Permit Exp.: 1/31/23
4 0 -
Signature 0
t 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 menage 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 vlolatior
InformationDivision of Water Resources
Processing

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT ( Page of
Name: Name:
Name: aurae:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? EY]Compilant ❑Non•Compilant
If the facility is non -compliant, phase 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 ( C) Certification Permittee Certification _
ORC: Thornas Lewis I Fern€ttee: Benchmark Ministries Inc.
Certification o.: 1002746 i SigningOfficial: Thomas Lewis
Grade: SI Phone umber: 919-615-7603 1 Signing Official's Title: President
Has the ORC changed since the previous Pit ? Des Eajbto Phone umber: 919-815-7603 Permit Expiration: 1 /31 /2023
1
' Signature Date I Si nature mate
By this signature, I co, llfy that this report is accurrate and complete to the best of my knowledge, l 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 i
submitted, used on my inquiry of the person or persons who manage the system;. or those persons directly responsible for j
gathering the information, the Information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am
al aware that there are significant penalties for submitting false information, Including the possibility of lines and imprisonment for
tl knowing violations.
s ,
Mail Original and Two Copies to:
Division of Water Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 276 9-1617