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Home My WebLink AboutWQ0033325_Monitoring - 03-2023_20230605Monitoring Report Submittal ..................................................... Permit Number#* WQ0033325 Name of Facility:* Bladen County Water District - Tobermory Road Month: * March Year: * 2023 Report Information Type * NDMR, NDAR-1, NDAR-2, NDMLR Confirmation Email Address: * Name of Submitter: * Signature: Date of submittal: Initial Review Upload Document* DMR TOB MAR 2023-corrected.pdf 737.3KB PDF Only Please upload one PDF containing all applicable monitoring reports (i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59). bcwater@bladenco.org Alan Edge �lar 6 S�' * Reviewer: Wanda.Gerald 6/5/2023 This will be filled in automatically Is the project number correct?* WQ0033325 Is the monitoring report accepted?* Yes No Regional Office* Fayetteville Reviewer: _anonymous Review Date: 6/6/2023 FORM: NOMR 03-12 MON-DISCHARGE MOMITORING REPORT (NDMR) Page —I—of-2,,, Sampling Person(s) Name: /¢l.4'0 % t Name: Certified Laboratories Name: C/�OI�/LO/rI/�16A ( l Name: Ones all Monitoring data and sa>T>tpHng frequencies meet the requirements in Attachment A of your permit? --pliant ❑ Non-complltna - 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 (OR(;) Certification ORC: A14ri � C Certification No.: 17,16 �! . 6-we/1 Grade:R-,d��tQi h�f-oo� Phone Number: 4?1b - ,?4Z_ 6Mf COWS- CoA•tet-�spAj Has thORC changed since the previous NDMR? vs �w Permittee Certification Permittee: 13144d��f Signing Official: 441,.E Signing Official's Title: O ii GecT A Phone Number: (�� ^�6 ,L"6� E� Permit Expiration: -71 C _ ,,V 3 ��Zs Signature Date Signature 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 with a system designed to assure that all qua[ified 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 knowledge and belief, true, accurate, and complete. 1 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 Maii Service Center RaWgh, North Carolina 27699-1617 FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page ` of_4,, 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? ,,__,,//Compliant ElNon-Compliant LfCompliant ❑ Non -Compliant 5��CCompliant ❑ Non -Compliant L�°1Compliant ❑ Non -Compliant 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 action(s) taken. Attach additional sheets if necessary. Operator in Responsible Charge (ORC) Certification Permittee Certification ORC: AMA/ 6j� 15- Permittee: ,8�� Certification No.: 1762,V Signing Official: Ltx0� - w Q,t,1! Grade: 4 _ ��`tiz;w��Phone Number: gfb �- tQ6L � �oQp� Signing Official's Title: A,t Cam- — av--� Has the ORC changed since the previous NDAR-1? ❑ yes No 6 p Phone Number: ve 0 Z Permit Exp.: 41 Signature Date Signature iQate By this signature, I certify that this report is aocurrate 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 wth 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 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 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-9) Page of