WQ0033325_Monitoring - 06-2023_20230706

Monitoring Report Submittal
Permit Number#* WQ0033325
Name of Facility:* Bladen County - Tobermory well
Month: * June Year: * 2023
Report Information
Type* Upload Document*
NDMR, NDAR-1, NDAR-2, NDMLR NDMR TOBER JUNE 2023.pdf 726.67KB
PDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
Confirmation Email Address: * [e-mail]
Name of Submitter: * Alan Edge
Signature:
0/�
Date of submittal: 7/6/2023
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: 7/11/2023

FORM: NDMR 03-'2 MON-DISCS-iARGE MONITORING REPORT 4NDMRb Page-1 Of
Marne: A14A."
Name: 1/{t=•ir/'ly
Sampling Person(s)
�f Es F/L
Certified Laboratories
Name: C�✓►��.Q4•vrtr �rii/7` � ��G v r,�� p.e,�q.7�"�
Name:
Does -an monitoring ftlra and sampHng frequencies meet the requram eats M Attachment A of your P-orrm t?
El Non-Cbmplient
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
II r
I; ORC: 01,A,.J Permit'cee: ,h
Cady Co. I. e,+err !AtS`ti2' ci
1� Certification No.: Signing Official: 41, A)
-,,Jcz c
Grade:-40o.5-tA, Phone Number: e?j p Signing Official's Title:
• io,�e
oss 11 /Nos thC changed since the previous NDIVIR? C Yes0 C�� p.. �6�� ��}��
Phone Number: Permit Expiration:
I�
N �J I!.Ziv
II Signature Date
Date
Signature
By this signature, I cert fy that thla 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
I Information submitted Is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant
pena[tes for submitting false information, including the possibility of fines and imprisonment for knowing vlclatEons.
I
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 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page i of 2—
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?
L��ompffant ElNon-Compliant
Lompliant ❑ Non -Compliant
,,�,//Compliant. ❑ Non -Compliant
f.�Complfant ❑ Non -Compliant
dCompliant ❑ 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-comp(iance and describe the corrective
action(s) taken. Attach additional sheets if necessarv.
Operator in Responsible Charge tORC) Certification
Permittee Certification
ORC: 1q141V &� 5-
Permittee: g&c.- a.
Certification No.: q 76-2, 1
Signing Official: Ao,1
Grade: d4 - ,dam Phone Number: ��� - �6z — �Q�a
Signing Official's Title:
Has the OORC changed since previous NDAR-1? ❑ Yes N�
Phone Number: �`O - �fi 2. �- d�g6 Permit E,p.;
3
Signature ate
Signature F 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.[ 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-1) Page .7. of
Permit No.: ViR ft3332C_
Did irrigation occur
,att this facility?
V YES ❑ NO
Weather Freeboard
a tz
LM 2
c E a�i N Q
°F in I ft eft
Facility Name:
r."I'Ve-
Field Name:
a�
Area (acres):
ofi
Cover Crop:
Hourly Rate (in):
nua,Fta a �n,:�
Annual Rate (in):
l � l ri�ga er7 a
Cj�
Field Irrigated?
❑ yzs ❑ NO
is _ ,per
a
E
ro ro
E a
> a
_j
gal
min
I in
in
County: ,PQ�`Q�,. Month: .., I Year:
Field Name:
Area (acres):
Cover Crop:
Hourly Rate (in):
Annual Rate (in):
Field Irrigated?
❑ YES
❑ NO
m
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� a
a m
E ar
~
-•a
c
8 `ov
qal
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Monthly Loadi
onth Floating Total (