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Home My WebLink AboutWQ0020881_Monitoring - 03-2023_20230428FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page 1 of 2 • -• • irrigation occur Field Name: at this facility? Area (acres): Area (acres): ••. 7 YES NO ' . •. 1 1 . . •. Field Irrigated? Field Irrigated?, Field Irrigati loll o ®_®- MUSTIN FORM. NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page 2 of 2 Did the application rates exceed the limits in Attachment B of your permit? a Compliant ❑ Non -Compliant Were adequate measures taken to prevent effluent ponding in or runoff from the sites? o Compliant ❑ Non -Compliant Was a suitable vegetative cover maintained on all sites as specified in your permit? o Compliant ❑ Non -Compliant Were all setbacks listed in your permit maintained for every application to each permitted site? o Compliant ❑ Non -Compliant Were all freeboards maintained in accordance with the specified freeboard heights in your permit? o 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 I Permittee Certification ORC: Todd Robinson Certification No.: 1006252 Grade: S1 Phone Number: 252-235-8809 Has the ORC changed since the previous NDAR-1? ❑ Yes 2 No 4/25/2023 Signature Date By this signature, I certify that this report is accurrate and complete to the best of my knowledge. Permittee: Div. Of Parks & Rec (Lake Norman SP) Signing Official: Malcolm Scott Avis Signing Official's Title: Park Superintendent Phone Number: 704-528-6350 Permit Exp.: 6/30/26 G�j• �ro i� ��-, �2 3 Signature Date 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 Resources Information Processing Unit 1617 Mail Service Center Raleigh, North Carolina 27699-1617 FORM. NDMR 10-13 NON -DISCHARGE MONITORING REPORT (NDMR) Page 1 of 2 Permit No.: VVQ0020881 ul Month: March ■ • Monthly Avg. Limit: Sample Frequency- I rft,"Wffl� FORM. NDMR 10-13 NON -DISCHARGE MONITORING REPORT (NDMR) Page 2 of 2 Sampling Person(s) Certified Laboratories Name: Operators Name: Statesville Analytical, Inc. Name: Name: Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? :3 Compliant -1 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: Todd Robinson Permittee: Div. Of Parks & Rec (Lake Norman SP) Certification No.: 1006252 Signing Official: Malcolm Scott Avis Grade: S1 Phone Number: 252-235-8809 signing Officials Title: Park Superintendent Has the ORC changed since the previous NDMR? -1 yes m No Phone Number: 704-528-6350 Permit Expiration: 6/30/2026 Z6�� )Q 4/25/2023 /;%.,irg=Z% � 3 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 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 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 Raleigh, North Carolina 27699-1617 Monitoring Report Submittal Permit Number#* Name of Facility:* Month: * March WQ0020881 LAKE NORMAN STATE PARK 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* 03-2023 LNSP NDMR-AR.pdf 1.65MB PDF Only Please upload one PDF containing all applicable monitoring reports (i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59). mmills@envirolinkinc.com Envirolink, Inc. Reviewer: Wanda.Gerald 4/28/2023 This will be filled in automatically Is the project number correct?* W00020881 Is the monitoring report accepted?* Yes NO Regional Office* Mooresville Reviewer: _anonymous Review Date: 6/22/2023