WQ0000088_Monitoring - 12-2022_20230124 (2)

Monitoring Report Submittal
Permit Number #*
Name of Facility:*
Month: * December
Report Information
WQ0000088
Governors Club WWTP
Type *
NDMR, NDAR-1, NDAR-2, NDMLR
NDMR, NDAR-1, NDAR-2, NDMLR
Confirmation Email Address:*
Name of Submitter: *
Signature:
Date of submittal:
Year:* 2022
Upload Document*
December 2022 Governors 3.77MB
Club NDAR.pdf
PDF Only
December 2022 Governors 595.79KB
Club NDMR.pdf
PDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
[e-mail]
Roy Lyons
10y4eW6
1 /24/2023
This will be filled in automatically

Initial Review
Reviewer: Wanda.Gerald
Is the project number correct?* WQ0000088
Is the monitoring report accepted?* Yes No
Regional Office* Raleigh
Reviewer: _anonymous
Review Date: 2/14/2023

FORM: NDMR 03-12 Page of
I NON -DISCHARGE MONITORING REPORT (NDMR)

FORM: NDMR 03-12 NOK-DISCHARGE MONITORING REPORT (NDMR) Page of
Sampling Person(s) Certified Laboratories
Name: Roy Lyons Name: Enco 591f Eurofins 269
Name: Name: Aqua 5051
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? 0 Compliant ❑ 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
antinnW taken_ Attach additional sheets if necessary.
1216/22 Nitrate and Nitrate/Nitrite flagged D - The sample was analyzed at dilution. 12120/22 Ammonia flagged -F1 - IVIS and/or IVISD recovery exceeds control limits: F2- MS/MSD RPD exveeds control limits.
12/20/22 Nitrate and Nitrate/Nitrite flagged D - The sample was analyzed at dilation.
Operator in Responsible Charge (ORC) Certicication Permittee Certification
ORC: Roy Lyons Permittee: Aqua North Carolina
Certification No.: 1005944 Signing Official: Katie Dickens
Grade: IV Phone Number: 919-323-1213 Signing Official's Title: Field Supervisor I
Has the ORC changed since the previous NDMR? El Yes - 2 No Phone Number: 910-695-5846 Permit Expiration: 7/31/2023
P 121
Signature Date Signature Date
By this signature, I certify that this report is accurrate and complete to the hest of my knowledge. I certify, under penalty of law, that this document and all attachments wer, crapared under my direction or supervision in
accordance with a system designed to assure that all qualified personnel pror ariv 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 a, d 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