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Home My WebLink AboutWQ0033325_Monitoring - 05-2023_20230602Monitoring Report Submittal Permit Number#* WQ0033325 Name of Facility:* Bladen County - Tobermory well Month: * May Year: * 2023 Report Information Type* Upload Document* NDMR, NDAR-1, NDAR-2, NDMLR NDMR TOBER MAY 2023.pdf 729.72KB PDF Only Please upload one PDF containing all applicable monitoring reports (i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59). Confirmation Email Address: * bcwater@bladenco.org Name of Submitter: * Alan Edge Signature: Date of submittal: 6/2/2023 This will be filled in automatically Initial Review Reviewer: Wanda.Gerald Is the project number correct?* WQ0033325 Is the monitoring report accepted?* Yes No Regional Office* Fayetteville Reviewer: _anonymous Review Date: 6/5/2023 FORM: NDMR 03-12 Sampling Person(s) Name: �1•�.�J� t Name: LION -DISCHARGE MONITORING REPORT (NDMR) Certified Laboratories Page -__ — of-,,, Name: C-A111 0,,C/,44&" L/ l _Z;Ue 0,pZp0 T Name: Does aH monitoring data and sampling frequencies Fleet the requirements in Attachment A of your permit? ompliant C ivcn-Compliant If the facility is non -compliant, please explain in the space below the reasons) the facility was not in compliance, Provide in your explanation the date(s) of the non-compliance and describe the corrective it action(s) taken. Attach additional sheets if necessary. __ Operator in Responsible Charge (ORC) Certification ORC: ,414,1 � C Certification No.: q76 2-173 01-WC-/f Grade: d9`,0j*5?-A,h&i+ocot phone Number: 4?f(p —8/Z� 6e0f G.evss �- �.t S e_-)L vaJ P Y Has the ORC changed since the previous NDMR? Yes "" Signature V pate By this signature, I certify that this report is accurrate and complete to the best of my knowledge. Permittee Certification Permittee: /314d,,,, (:v. (�}4k�� /q�•�t L'� Signing Official:li4�J Signing Official's Title: lologCGC.�OA Phone Number: —6q,?6 Permit Expiration: a„a 1 � " Date certify, under penalty of law, that this document and alf attachments were prepared under my direction or supervision in accordance with a system designed to assure that all quaffed personnel properly gathered and evaluated the information submitted. Based on ny 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 and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility offines and imprisonment for knowing violations. Mail Originai and Two Copies to: Division of Water Resources Information Processing Unit 1617 Mail Service Center Raleigh, Borth Carolina 27699-1617 FORM: NDAR-1 98-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page l of_21. Did the application rates exceed the limits in Attachment B of your permit? Were adequate measures taken to prevent effluent ponding in or runoff from the sites? Was a suitable vegetative cover maintained on all sites as specified in your permit? Were all setbacks listed in your permit maintained for every application to each permitted site? Were all freeboards maintained in accordance with the specified freeboard heights in your permit? V,Compliant ElNon-Compliant l�Compliarrt ❑ Non -Compliant Lr�1/Campliant ElNon-Compliant I Compliant ❑ Non -Compliant TleCompliant ❑ 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 action(s) taken. Attach additional sheets if necessary Operator in Responsible Charge (ORC) Certification Permittee Certification ORC: 441A/ 6d e r Permittee: A ." Certification No.: 1t7641?y Signing Official• 13~W� b Number: g{b — �6Z — �O Q(� Grade: .4 _ ,d�.-�" Signing Official's Title: ��(itOC "Phone 4U,CAQ — &o—A �wL Has the ORC changed since the previous NDAR-17? ❑ Yes PN< Phone Number: p e �10—O62-r �4Q,ea PermitExp.: 64—C.- 41r2p,Z3 Signature te Signature g 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 direction or supervision in accordance w th a system designed to assure that all 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 knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possiblity of fines and imprisonment for knowing violations. Mail Original and Two Copies to: Division of Water Quality Information Processing Unit 1617 Mail Service Center Raleigh, North Carolina 27699-1617 FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page .2. of