WQ0014046_Monitoring - 04-2023_20230614

FORM: NDMR 05-16 NON -DISCHARGE MONITORING REPORT (NDMR) pa o F

FORM: NDMR 05-16 NON -DISCHARGE MONITORING REPORT (NDMR) Page of
Sampling Person(s)
Name: Dale Mathews
Name: Andy Mathews
Name: Meritech
Name:
Certified Laboratories
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? ❑i compliant 1:1Norcompliant
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: Andy Mathews Permittee: Town Of Stovall
Certification No.: 993132 Signing Official: Janet Parrott
Grade: Sl Phone Number: 919-939-0232 Signing Official's Title: Mayor
Has the OR ged since the previous NDMR? Yes No Phone Number: 919-693-4646
Permit Expiration: 10/31 /26
Signature Date Signature
Date
By this signature, I certify that this report Is awurrate and complete to the hest of my knowledge. I certify, under penalty of law, that this document and all attachments were prepared under m direction or su
pervision upervision 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 hest 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 Original and Two Copies to:
Division of Water Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

FORM: NDAR-1 05-16 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Paae of

FORM: NDAR-1 05-16 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Paae of

FORM: NDAR-1 05-16 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of
Did the application rates exceed the limits in Attachment B of your permit?
❑i Can pliant 1:1 Nan -Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites?
0 Compliant EI NorrCompliant
Was a suitable vegetative cover maintained on all sites as specified in your permit?
Compliant n Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site?
ElCompliantNon-Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? r'
iant
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 eaand describe thCompliant hee corre tine action(s)
taken. Attach additional sheets if necessary.
Operator in Responsible Charge (ORC) Certification 11
ORC: Andy Mathews
Certification No.: 993132
Grade: SI Phone Number: 919-939-0232
Has the ORC changed since the previous NDAR-1?
❑i Yes RNo
Signature
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
Permittee:
Town Of Stovall
Signing Official: Janet Parrott
Signing Official's Title: Mayor
Phone Numbers 919-693-4646
Permittee Certification
Permit Exp.: 10/31 /26
-= e
Date Signature Date
I certify, under penaty 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 tx� ief, 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: * April
WQ0014046
TOWN OF STOVALL WWTF
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*
STOVALL-APRIL2023.pdf 2.82MB
PDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
[e-mail]
Dale Mathews
ti✓�i�/ �%fjltC/!At'�IZ
Reviewer: Wanda.Gerald
6/14/2023
This will be filled in automatically

Is the project number correct?* WQ0014046
Is the monitoring report accepted?* Yes No
Regional Office* Raleigh
Reviewer: _anonymous
Review Date: 7/6/2023