WQ0036210_Monitoring - 12-2022_20230103

Monitoring Report Submittal
Permit Number #*
Name of Facility:*
Month: * December
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*
December 2022.pdf 2.6MB
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

[26mpllant ❑Non-Compllar
Were adequate measures taken to prevent effluent ponding in or runoff from the sites? [3Compliant ❑Non-Compiiar
Was a suitable vegetative cover maintained on all sites as specifiedin your permit? [Compliant ❑Non-Cornp(iar
Were all setbacks listed in your permit maintained for every application to each permitted €t Z'Smpilant EINon-Compliar
Were all freeboards maintained in accordance with the specifiedfreeboard heights in your permit? C Compliant []Non-Comp(iar
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 col
action(s) taken. Attach additional sheets if necessary.
Operator in Responsible Charge ( RC) Certification Permittee Certification
OR : Thomas Leis Permittee.
Benchmark Ministries Inc.
Certification o.: 1002746 Signing Official: Thomas Lewis
Grace. S1 Phone Number: 919-61 -7603 £ Signing Official's Title: President
Has the ORC changed since the previous NDAR-1 a [:ves ['✓ Nil Phone Number. 919-815-7603 PermitExp.: 1131/23
nature Date Signature DE
i
By this signature, I certify that this report is accurrate and complete to the best of my knowledge. l (oertlfy, under penalty of law, that this document and all attachments were prspred under my direction or supervision in
it with a system designed to assure that all qualified personnel property gathered And evaluated the Information submitted. E
j inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the inform
i 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 violatior
Mail Original and Two Copies to.
Division of Water Resources
Information Processing Unit
1617 Mail Service Centdr

FORM: hlDMR 03-12 MON-DISCHARGE MONITORINGREPORT ( . R) !image of
9-miff "1311111��
i
Does all monitoring data and sampling frequencies en meet the requirements in Attachment A of yourpermit? []Compliant Eplon•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 dates) of the non-compliance and describe he corrective
action(s) taken. Attach additional sheets if necessary.
Operator in Responsible Charge (01RC) certification F Permittee certification -
OR : Thomas Lewis rPermitteir, Benchmark Ministries Inc.
Certification o.: 1002746 � Signing Official: Thomas Lewis
Grade: SI Phone Number: 919-815-7603 Sighing Official's Title, President
Has the ORC changed since the previous R r ❑Yes [ZNO Phone € umber: 919- 15-7 03 Permit Expiration: 1 /31 /2 23
—3
i Signature Date ignature 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 directlon 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 systemi 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 o:
Division of Water Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617