WQ0002571_Monitoring - 09-2023_20231107

Monitoring Report Submittal
Permit Number#*
Name of Facility:*
Month: * September
WQ0002571
Village Oaks Mobile Home 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*
Sept23 Monitoring Reports.pdf 2.92MB
PDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
[e-mail]
Brandon Williams
Reviewer: Wanda.Gerald
11 /7/2023
This will be filled in automatically

Is the project number correct?* W00002571
Is the monitoring report accepted?* Yes NO
Regional Office* Wilmington
Reviewer: _anonymous
Review Date: 11/8/2023

h-UKM: NUAK-1 Ub-lb NON -DISCHARGE APPLICATION REPORT (NDAR-1) Nage o1
Did the application rates exceed the limits in Attachment B of your permit?
Q Compliant ❑ Non -Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites?
(D Compliant ❑ Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit?
Q Compliant ❑ Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site?
Q Compliant ❑ Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights In your permit?
i) 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
actions) taken. Attach additional sheets if necessary.
Operator In Responsible Charge (ORC) Certification II Permittee Certification
ORC: Stanley Buck
Certification No.: WW 4: 993396/ SI: 987939
Grade: 3/SI Phone Number: 252-503-5307
503 ❑ Yes 0 No
Signature
By this signature, I certify that this report Is acourrate and complete to the best of my knowledge.
Date
Permittee: Bobby Williams
Signing Official: Bobby Williams
Signing Officials Title: Owner/ Permitee
Phone Number: 90 389-1280 Permit Exp.:
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Signature
9/30/24
11 1 10 Z Lr
Date
I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision In accordance
dth 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. 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 Mail Service Center
Raleigh, North Carolina 27699-1617

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f-UKM: NUMK Ub-lb NON -DISCHARGE MONITORING REPORT (NDMR) Page of
Sampling Person(s) 11 Certified Laboratories
Name: Stanley Buck 11 Name: Environmental Chemists
Name: II Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? Q 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 II Permlttee Certification
ORC: Stanley Buck
Certification No.: W W 3: 993396
Grade: 3
Phone Number: 252-503-5307
Has the ORC changed since the previous NDMR? ❑ yes Q No
Signature Date
By this signature. I certify that this report Is accurrate and complete to the hest of my knowledge.
Permittee: Bobby Williams
Signing Official: Bobby Williams
Signing Official's Title: Owner/ Permitee
Phone Number: 910 389-1280
Signature
Permit Expiration: 9/30/2024
1 IZc, 2 Z3
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 lines 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

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