HomeMy WebLinkAboutWQ0028666_Monitoring - 11-2022_20221230 (3)Monitoring Report Submittal
Permit Number #*
Name of Facility:*
Month: * November
Report Information
WQ0028666
Cannons Gate at Bogue Sound
Type *
NDMR, NDAR-1, NDAR-2, NDMLR
Confirmation Email Address:*
Name of Submitter: *
Signature:
Date of submittal:
Initial Review
Year:* 2022
Upload Document*
2022 11 Cannonsgate 3.45MB
DMR.pdf
PDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
ermartin@aquaamerica.com
Erikah Martin
SAX WIZI& PG
Reviewer: Gerald, Wanda
12/30/2022
This will be filled in automatically
Is the project number correct?* WQ0028666
Is the monitoring report accepted?* - Yes NO
Regional Office* Wilmington
Reviewer: _anonymous
Review Date: 1/23/2023
FORM NA-2 NON-D.'SCHARGF A. PUCATION EPA £
Facilit-v Name:
�_annons Gate at Bope Sound
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FORM NDAR-2 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-2) Page ?_ of 7
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Did the ap lication rates exceed the limits in Attachment B of your permit? Ecompliant ❑Non -Compliant
If not a basIin, were the sites kept free of vegetation and raked? Ipcompliant ❑Non -Compliant
If not a basin, were there any instances of effluent ponding in or runoff from the sites? Ocomphant ❑Non -compliant
If a basin, Were there any instances of breakout from the berms? MCompliant ❑Non -Compliant
Was the orxIsite automatically activated standby power source tested and operational? ❑� Comp!iant []Non -compliant
!
if the facility is on -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: Raymond
Lacy Braxton
Permlttee: Aqua, North Carolina INC
Certification N
.: 999895
signing Official: Christopher A. Collirs
Grade: IV
Phone Number: 910 431-9248
Signing Official's Title: Coastal Regional Supervisor
Has the ORC c
anged since the previous NDAR-2? ❑yes [ZNo
Phone Number: 910 779-0794 Permit Exp.: 8131/24
I
I
g
Signature Date
Signature Bate
By th
s signature, I certify that this report is accuaraie and complete to the hest of my knmAedga
I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervisssn In accordance
with a system dastgned to assure that all qualified personnel pmpmy gathered and evaluated the information submitted Baud on
my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the
mforenatinn submitted is. to the best of my knowledge =1 tieftf, true, acwrale. and Complete I am aware that there are s9n1ficant
ponsttios for submitting fads® information, including the pors!biiily of fines and imprisonment for knowing vlalalron9.
Mail Original and Two Copies to:
Division of Water Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
-`r:., NDUR _43
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FORK NPMR 10-13 NON -DISCHARGE MONITORING REPORT (NOMR) Page 2 of 1d
Sampling Person(s) Certified Laboratories
Name: Ra mond Lacy Braxton Name: Environmental Chemists, INC
Name: € game: I�complant (�Ivon•Complant
t
Does all mo itoring data and sampling frequencies meet the requirements in Attachment A of your permit?
If the facility is noncompliant, 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: Ra
mond Lacy Braxton Ores ONO
Permittee: Aqua, NC, INC
Certification No.:
999895
Signing official: Christopher A. Collins
Grade: IV
Phone Number: 910-431-9248
Signing Official's Title: Coastal Regional Supervisor
Has the ORC changed
since the previous NDMR7
Phone Number: 910 779-0794 Permit: Expiration: 8/31/2024
Signature Date
Signature hate
By tits
s,gnalure, I certify that this report is accurrate and complete to the hest of my knoModge
I certify, under penalty of taw, that this document and all attachments wore prepared under my direction or tupervl5ion in
accordancewiRh a system designed to assure that all qualified personnel property gathered and evatuated tie information
cubmAled. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for
gathering Ilia lntormation, the Information submitted is, to the best of my knowledge and belief, true, acwrato, and complete. I am
aware that (hare are stgnificant penalties for submitting false information, including the pnssimity of fines and cnpnsonment for
knowing violations.
Mail Original and Two Copies to:
Division of Water Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, Notch Carolina 27699.1617
FORM: ryDMR 10-13 NON -DISCHARGE MONITORING REPORT" (NDMR) Page � of
Sampling Person(s) Certified Laboratories
Name: Ra mond Lacy Braxton Name: Environmental Chemists, INC
Name: Name:
ElComptiant ❑Non•CompEiant
Does all mopitoring data and sampling frequencies meet the requirements in Attachment A of your permit?
If the facility is noi-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 actions)
taken. Attach additional sheets if necessary
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Raymond
Lacy Braxton ❑Yes [jNo
Permittee: Aqua, NC. INC
Certification No.!
999895
Signing Official: Christopher A. Collins
Grade: IV
Phone Number: 910-431-9248
Signing Official's Title: Coastal Regina[ Supervisor
Has the ORC chznged
since the previous NDMR?
Phone Number: 910 779-0794 Permit Expiration: 8/31/2024
/111
Signature Date
Signature Date
By t
is s>gnature. I certify that this report is accurrate and complete to the best of my knowledge
I certify, under penally of taw• that this document and all attachments were prepared under my direciion or supervision in
accordance wrath 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 6rectiy rospansVe 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 slgniflcam pena€tics for submitting false information. including the possibi#dy of fines and imprisonment for
knOmrig violA"ne
Mail Original and Two Copies to:
Division of Water Resources
information Processing knit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
FORM: NIUMR 10-13 NON -DISCHARGE MONITORING REPORT (NDMR) Page (; of !
Sampling Person(s) Certified Laboratories
Name: Fla I mond Lacy Braxton Name: Environmental Chemists, INC
Name: Name: EconplianE Non•conpiont
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit?
If the facility is nor -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: Ra�mond
Lacy Braxton []Yes E]N°
Permittee: Aqua, NC. INC
Certification No.
999895
Signing Official: Chrisopher A. Collins
Grade: IV
Phone Number: 910-431-9248
Signing Official's Title: Coastal Regional Supervisor
Has the ORC changed
since the previous NDMR?
Phone Number: 910 779-0794 Permit Expiration: 8-81-24
i / G
J
Signature Date
Q
Signature Date
By this
I
signature, t certify that this report is accurrale and complete to the best of my knawSedgo.
E certi4y, under penalty of law, tRat this document and ail attachments were prepared under my daredian or supervisaan in
accordance with a system designed to assure that ail 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 best of my krxnvtedgo and be64ef, true, accurate. and complete t am
aware that there are significant penalties for submitiing false information, inctu6ng the possitaitity of fines and imprisonment for
knowing vmtabons.
Gail Original and Two Copies to:
Division of Water Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
FORM NOMR 10-13 NON -DISCHARGE MONITORING REPORT (NDMR) Page of jd
Sampling Person(s) Certified Laboratories
Name: Raymond Lacy Braxton Name: Environmental Chemists, INC
Name, Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? Ocompliant []felon -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: Ra
mond Lacy Braxton
Permittee: Aqua, NC. INC
Certification No.
999895
Signing Official: Christopher A. Collins
Grade: IV
Phone Number: 910-431-9248
Signing Official's Title: Coastal Reginai Supervisor
Has the ORC changed
since the previous NDMR7 ❑yes 2n0
Phone Number; 910 779-0794 Permit Expiration: 8/31/2024
Signature Date
91L-- 6-,-,
Signature Date
By ibis
signature, I certify that this report is accurrate and complete to Iho Kest of my knowledge.
I certify, under pens€ty, of law. that this document and all attachments were prepared under my direction or supervision in
accordance m1h a system designed to assure that al 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 knovAedge and belief, true, accurate, and comptale. I am
aware that there are sigmrioant penalties for submitting false inlormation, including the possibility of fines and imprisonment for
i
knowing violations.
Mail Original and Two Copies to:
Division of Water Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
FORM: NIDMR 10-13 NON -DISCHARGE MONITORING REPORT (NDMR) Page )0 Of
Sampling Person(s) Certified Laboratories
Name: Raymond Lacy Braxton Name: Environmental Chemists, INC
Name: Name:
pCnmpiiant ❑Non-Ccxnpliant
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit?
If the facility is no 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: Raymond
Lacy Braxton ❑yes 2]"°
Permittee: Aqua, NC. INC
Certification No :
999895
Signing Official: Christopher A. Collins
Grade: IV
Phone Number: 910-431-9248
Signing Official's Title: Coastal Regina[ Supervisor
Has the ORC ch
nged since the previous NDMR?
Phone Number: 910 779-0794 Permit Expiration: 8/31/2024
Signature Date
Signature Date
By ti)is
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
so milled. Based on my inquiry of the person or persons who manage the system, or arose persons directly responsible for
gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, aid complete i am
aware that there are significant penalties for submitting false information. including the possihi:ity of fines and mpnsonment for
kncwnng wrilalions.
Rail Origina[ and Two Copies to:
Division of Water Resources
Information Processing unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617