WQ0031506_Monitoring - 04-2023_20230530

Monitoring Report Submittal
Permit Number#*
Name of Facility:*
Month: * April
WQ0031506
Mason Farm WWTP
Report Information
Type *
NDMR, NDAR-1, NDAR-2, NDMLR
Confirmation Email Address:
Name of Submitter: *
Signature:
Date of submittal:
Initial Review
Year:* 2023
Upload Document*
April Ndmr.pdf
PDF Only
92.22KB
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
[e-mail]
Travis Rich
Pf;"/.5a0
Reviewer: Wanda.Gerald
5/30/2023
This will be filled in automatically

Is the project number correct?* W00031506
Is the monitoring report accepted?* Yes NO
Regional Office* Raleigh
Reviewer: _anonymous
Review Date: 6/21/2023

FORM: NDMR03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page 1 of
Permit No.: WQ0031506
•
Orange
•2023
Flow Measuring Point: Influent Effluent No flow generated
Parameter Monitoring Point: Influent Effluent Groundwater Lowering [71 Surface Water
Parameter Code
INN
©
11
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1 1
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11
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•
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m
11
1
1 1
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' - . • -
• • 111
1 11
11
1 •
1 11
1 11
---------�
• .
11
11
1 1----------
• .
11
11
1 1
1
Monthly1----------
.
1©----------
Daily
®�©�----------

Permit No.: WQ0031506
• Bulk Fill StationOrange
A•2023
11Flow
Measuring •.
Point:
Parameter Code
•
©
• 1
®
---------------
11LU---------------
'
•.
---------------
•.
---------------
Sampling Type:
Monthly Avg. Limit:
•.
---------------

FORM: NDMR03-12
NON -DISCHARGE MONITORING REPORT (NDMR)
Page 3 of 3
Sampling Person(s)
Name: Ronnie Weed
Name: Travis Rich
Name: OWASA
Name: PACE Analytical, LLC
Certified Laboratories
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? E] 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: Travis Wayne Rich
Permittee: Orange Water and Sewer Authority
Certification No.: 999730
Signing Official: Wilmer Anthony Lawson
Grade: IV Phone Number: 919-537-4354
Signing Official's Title: Wastewater Treatment & Biosolids Recycling Manager
Has the ORC changed since the previous NDMR? ❑ Yes 0 No
Phone Number: 919-537-4351 Permit Expiration: 11/30/2027
. 5/30/2023
,(Q, /1i 05/30/2023
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 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