WQ0028666_Monitoring - 11-2023_20240129

Monitoring Report Submittal
...................................................
Permit Number#* WQ0028666
Name of Facility:*
Month: * November
Cannonsgate at Bogue Sound
Report Information
Type *
Revised - NDMR, NDAR-1, NDAR-2, NDMLR
Year:* 2023
Upload Document*
2023 11 Cannonsgate DMR RREVISED.pdf 5.14MB
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: * Erikah Martin
Signature:
cgimz# r�<Lt&*
Date of submittal: 1/29/2024
This will be filled in automatically
Initial Review
Reviewer: Wanda.Gerald

Is the project number correct?* W00028666
Is the monitoring report accepted?* Yes NO
Regional Office* Wilmington
Reviewer: _anonymous
Review Date: 2/28/2024

FORM. NDMR 10-13 `,` NON -DISCHARGE MONITORING REPORT (NDMR) Page ofj 0
1
Permit No.: W00028666
Facility Name: Cannonsgate at Bogue Sound
County: Carteret
Month: November
Year: 2023
PPI: 001
Flow Measuring o n : e uent L. No ow ger Grateo
Parameter r6l:S ViR in : ndwater Lowe x7 ._, Su Water
Parameter Code - ►
50050
00310
00W
31616
00Bt0
00625
00620
00600
00400
00665
70300
00630
00076
mC4>
E
O
C
E
UO
Ix
O
O
m
G
U
°°
!?
°
fZ Ur
.d.
ro tU
Z
3oLL
1,-
O
a
v LLc�
UL'o»)
;o13
N
i
r-
t'
24-hr
hrs
GPD
mg/L
mg/L
1000 mL
mg1L
I mg1L
mgiL
mg/L
su
mg/L
m91L
mg/L
NTU
1
07'00
2
43,000
7.28
0.09
2
0700
2
51,000
--
728
O.D9
3
0700
2
38.887
7.3
4 077
4
38,667
<10
5
38.667
<10
A
6
07.00
i
35,000
726
0 t t 2
7
08 00
1
37.000
7,21
0 088
8
0700
1
42.000
7.27
0 091
9
0700
1
36.000
719
0.086
10
05,00
1
41333
7.2
0.079
11
41.333
<10
12
41,333
<10
13
0700
3
57,000
7,27
0082
14
07:00
2
41.000
8
64
<1
0.3
58.2
582
7.29
102
641
<2 5
0 091
15
07:00
4
40 000
7.32
0.099
16
07,00
5
37 000
;
7 35
_
0.085
17
12,00
1
39.000
7.39
0 077
18
39,000
<10
19
39,000
<10
20
07:00
2
41,000
73
0 072
21
07.00
2
29.000
12
<1
102
<0 5
25.4
254
7.28
�, ?
<2 5
0_082
22
07:00
3
45.5W
7.25
0 095
23
H
45 500
<10
24
0600
1
45 333
7.21
0066
25
45 333
_
<10
26
45,333
<10
-""--
27
0- 00
1
43 000
7.24
0 096
28
0700
1
46,000
7.28
0.087
29
0700
2
41 000
734
0 086
30
0700
2
37,000
7,29
0,065
31
Average:
41,333
4.00
64.00
1 0O
0.15
000
41,80
4180
7.66
641.00
O.00
006
Daily Maximum:
57.000
800
64.00
1.00
0.30
050
b8.20
58.20
739
1020
941.00
2.50
1000
Daily Minimum:
29.000
200
6400
1 00
020
050
40,
25,40
7.19
5.12
641.00
2.50
0.07
Sampling Type:
Recorder
Composite
Composla-
Grab
Composhe
Composite
Compos,t,+
Grab
Composite
Gompoeile
cornpos!te
Re-offtr
Monthly Avg. Limit:
200 000
10
14
4
Daily Limit:
15
25
8 1
6 to 9
1
10
10
Sample Frequency:
Cori ,ri-mus
2 x Month
3 x Year
2 x Month
2 x Morth 1
2 x Month jff&NWOh
I
2x Month
5 x Week
2 x Month
3 x Year 1
2 x Month
Coot rxxxw

FORM: NDMR 10-13
NON -DISCHARGE MONITORING REPORT (NDMR)
Sampling Person(s) Certified Laboratories
Name: Raymond Lacy Braxton Name: Environmental Chemists, INC
Name: Name:
Compliant _; Non -Compliant
Page Z. of 10�
�VGZ5, 01 titV111FLU:itty udtd dims sarnpling frequencies meet the requirements in Attachment A of your permit?
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 nerpscary
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Raymond Lacy Braxton 0 yes u No
Permittee: Aqua, NC. INC
Certification No.: 999895
Signing Official: Katie Dickens
Grade: IV Phone Number: 910-431-9248
Signing Officials Title: Coastal Regional Supervisor
Has the ORC changed since the previous NDMR?
I
Phone Number: 910 779-0794 Permit Expiration: 8/31 /2024
C `(UL (DSk
I / �2_5_1 2 Y
Signature Date
Signature Date
By this signature. I cen(ty that this report ks acckinate arks complete to the best of my knowledge
1 oenAy, under penalty of law. that this document and ail attachments were prepared under my (ilrection or supervision n accordance
with a system designed to assure that all qualified personnel properly gathered and evaluated the unformal,on submitted Based on
my Inquiry of the person or persons who manage the system, or those persons directly responsttle for gathering the trYormation the
Information Submitted Is, to the test of my knowledge and bel;ef, true, accurate and complete I ant aware that there are slgrlTlcant
penattles for submitting false information. including the possbility of fines and imprisonment for knowing violators.
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 3 of �d
Permit No.: W00028666
Facility Name: Cannonsgate at Bogue Sound county: Carteret
Month: November Year: 2023
PPi: 002
Flow Measuring o t cent No genera
Para "r a A gtP air ti9 - - ace via! `
Parameter Code
i
a Q E
p U F=
tY
O
—►
O
a0
!
1
24-hr
07-00
hm
2
GPD
26,000
i
—
2
07 00
2
26,000—_-
3
07:00
2
25,333
4
25.333
— —
5
25.333
6
07:00
1
27,000
;
----
_
7
06.30
1
26,000
,
8
07:00
1
25,000
9
07:00
1
22.000
—
10
06:00
1
28.000
11
28,000
v
- -
-- --
-
12
28,000
13
07:00
3
27,000
14
07:00
2
32,000
15
07:00
4
21.000
-----�-
16
07:00
5
38.000
17
12:00
1
23.333
i
18
23,333
-
19
23,333
- -
-
-
20
07:00
2
29,000
-
---
�
-
-
21
07:00
2
33.000
22
07:00
3
28,500
_
-
23
H
28.500
24
06.00
1
-
25
32,333
---
— -
26
32,333
--
-
27
07:00
1 1
30,000
28
07:00
1
30,000
29
07:00
2
24,000--
301
07:00
2
30,000
31
�
-
Average:
27.667
Daily Maximum:
38.000
t,
--
--
-
Daily Minimum:
Sampling Type:
21,000
Recorde, 1
- -
Monthty Avg. Limit:
80.000
Daily Limit:
Sample Frequency:1
Cmt:nuous--{—

FORM: NDMR 10-13 NON -DISCHARGE MONITORING REPORT (NDMR) Page -f of to
Sampling Person(s) Certified Laboratories
Name: Raymond Lacy Braxton Name: Environmental Chemists, INC
Name: Name:
Compliant D Non -Compliant
LJVW� do rnurtrtUrimi aata ana sampling rrequencies meet the requirements in Attachment A of your permit?
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 additinnai shpptc if nnrvicenry
Operator in Responsible Charge (ORC) Certification
I Permittee Certification
ORC: Raymond Lacy Braxton yes Li No
Permittee: Aqua, NC. INC
Certification No.: 999895
Signing Official: Katie Dickens
Grade: IV Phone Number: 910-431-9248
Signing Official's Title: Coastal Reginal Supervisor
Has the ORC changed since the previous NDMR?
Phone Number: 910 779-0794 Permit Expiration: 8/31/2024
-,a _`t
/Q�L t/;zs/2z_
Signature Date
Signature Date
81 this signature. I oert*y that this repurt,s accurrete and complete to the best of my knowle-)ge
I candy, under penalty of iaw. that this document and au attachments were prepared under my direC.ron or supervision n accadance
wdh a system designed to assure that all quaitf ed personnel properly gathered and evaluated the information submitted eased on
My inquiry of the person Or persons who manage the system, or those persons directty responsible for gathering the iiYormatton, the
information submitted ,s, to the best of my knowledge and belief, true, accurate, and complete I am aware that there are s!gnificant
penalties for submitting false Infomtaton ncluding the possiNdy of fines and imprisonment for knowing vo%tons
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 S of !a
Permit No.: WQ0028666
Facility Name: Cannonsgate at Bogue Sound county: Carteret
Month: November
Year: 2023
PPi: 003
Flow Measuring or' t Parame er o r ngtP � m{°u water L0.111g ; wa e
Parameter Code --►
60060
31616
00400
G
1
2
Q
0.
€
N
O
O
LL U. E
U
C
Q
Z
1L
n
f
su
-- -
i
24-hr
07:00
07:00
hm
2
2
GPD ' 8/100 mL
0
0
-
3
07:00
2
0
4
0
5
0
5
0:00
1
0
—
�
7
066:00
1
0
8
07:00
1
0
9
07:00
1
0
10
06:00
1
0
-
11
0
— I
12
0
13
07:00
3
418,000
-
---
14
07:00
2
252,000
<1
2
588
—
15
07:00
4
133.000
_
16
07:00
5
146.700
17
12:00
1
1 362,333
18
362.333
i
-
19
362,333
- -
20
07:00
2
0
--
21
07:00
2
0
---
22
07:00
3
0
23
H
0
24
06:00
1
0
25
0
26
0
27
07:00
1
0
28
07:00
1
0
_
29
07:00
2
0
--
30
07:00
2
0
31
Average:
67,889,97
1.00
2.00
Daily Maximum:
418,000.00
1.00 1
2.00
6.88
Daily Minimum:
0.00
1.00 j
2.00
6.88
Sampling Type:
Reorder
Grab
Grab
Grab
Monthly Avg. Limit:
- -
Daily Limit.
Sample Frequency:.
Monthly Mcrtnry
^ontnry
;

FORM: NDMR 10-13 NON -DISCHARGE MONITORING REPORT (NDMR) Page 6 of 10
Sampling Person(s) Certified Laboratories
Name: Raymond Lacy Braxton Name: Environmental Chemists, INC
Name: Name:
la Complant : ! Non -Compliant
Ljuva cxfr frfurrfturtrty vats anu sampling rrequencies meet the requirements in Attachment A of your permit?
If the facility is noncompliant, 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 char tc if naracc
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Raymond Lacy Braxton `' & NO
Permittee: Aqua, NC. INC
Certification No.: 999895
Signing Official: Katie Dickens
Grade: IV Phone Number: 910-431-9248
Signing Officials Title: Coastal Regional Supervisor
Has the ORC changed since the previous NDMR?
Phone Number: 910 779-0794 Permit Expiration: 8-81-24
Signature Date
Signature Date
By tn:s signature, I cenity that m:s report is aeturrate and complete to the best of my knowledge
I centy, under penalty of law, that this document and ail attachments were prepared under my direction cr supervision in accordance
with a system designed to assure that all qual Pied 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 responsib:e for gathering the iryormatcri. the
ctformat!ori submitted is, to the best of my knowledge and belief, true accurate, and complete. I am aware mat there are significant
penalties for submitting false information. ncludirg the possibility of fines and imprisonment for knowing violatons
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 ? of
Permit No.: W0002$666
Facility Name: Cannonsgate at Bogue Sound
county: Carteret
Month: November
Year: 2023
PPI: 004
Flow Measuring o n : t t o genera
pararriiafer o r ormgtporn
: ater LoweIN aw
Parameter Code
❑ o~
24-hr
—►
c
p
O
31616
o°
u L)
00600
o Q
¢— Z
00400
a
00480
c
{
j
hrs
0/100 mL
mglL
su
mg/L
1
2
07:00
07:00
2
2
-
---
—?�
—
3
07:00
2
--
4
5
-
6
07:00
1
-
- - -
7
06:00
1
8
07:00
1
9
07:00
1
10
06:00
1
12
i
—
13
07:00
3
f
--"-
14
07:00
2
"
15
07:00
4
16
07:00
5
17
12:00
1
—
18
19
20
07:00
2
-
-
21
07:00
2
1
i
22
07:00
3
23
H
24
06:00
1
25
26
27
28
07:00
07:00
1
1
—
—
29
07:00
2
i
_-
i
30
07:00
2
—
31
i
--
Avemge:
Daily Maximum:
Daily Minimum:
Sampling Type:
Grab
c i
Grab
Grab j
t
Monthly Avg. Limit:
-
Daily Limit:
Sample Frequency::
Annual !
,-^uai
Annual
i
Annual
-

FORM: NDMR 10-13 NON -DISCHARGE MONITORING REPORT (NDMR) Page I? of 10
Sampling Person(s) Certified Laboratories
Name: Raymond Lacy Braxton Name: Environmental Chemists, INC
Name: Name:
Lives do monitoring data ana sampling frequencies meet the requirements in Attachment A of your permit? r compliant e 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 descnbe the corrective action(s)
taken, Attach additional sheets if npcaccary
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Raymond Lacy Braxton
Permittee: Aqua, NC. INC
Certification No.: 999895
Signing Official: Katie Dickens
Grade: IV Phone Number: 910-431-9248
Signing Officials Title: Coastal Reginal Supervisor
Has the ORC changed since the previous NDMR? 3 Lies C No
Phone Number: 910 779-0794 Permit Expiration: 8/31 /2024
V2:51;2 y
Signature Date
Signature Date
By this <_!gnarure. I certify that this report is aoc urrate and complete to the best of my knowledge
I certifyunder penalty of law, that this document and an attachmems were prepared under my direction or supervision n accordance
with a system designed to assure that ail quaAed personnel properly gathered and evaluated the informatrcn submitted. Based on
my ,nqury of the person or persons who manage the system, rx those persons directly responsibe for gathelvig the olormatron, the
information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are s�gn4icant
penatt:es for submitting false unformation, including the possbdity of fines and impriscrxnerd for knowing violatcrts
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 / of
Permit No.: WQ0028666
Facility Name: Cannonsgate at B0gUe Sound County: Caderet
Month: Nove
Flow Me Suring 94"n Effluent U No flow generated
L ?_55avvaf�i Lower-ingla 34race a loom=
su
EL
MU
Sampling
Type:
r�

FORM: NDMR 10-13 NON -DISCHARGE MONITORING REPORT (NDMR) Page /d of /d
Sampling Person(s) Certified Laboratories
Name: Raymond Lacy Braxton Name: Environmental Chemists, INC
Name: Name:
compliant ❑ Non -Compliant
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit?
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 Chargo (ORC) Certification
Permittee Certification
ORC: Raymond Lacy Braxton C1 Yes u No
Permittee: Aqua, NC. INC
Certification No.: 999895
Signing Official: Katie Dickens
Grade: IV Phone Number: 910-431-9248
Signing Officials Title: Coastal Reginal Supervisor
Has the ORC changed since the previous NDMR?
Phone Number: 910 779-0794 Permit Expiration: 8/31/2024
-2,Y
� � I V),512
Signature Date
Signature Date
By ibis signature, I cenfy that ;hi s report ,s accurraie and complete to fhe best of my knowledge
I certify. under penalty of taw. that this document and all attachments were prepared under my ddrecticn or supervision in accordance
with a system designed to assure that all qualified personnel property gathered and evacuated the information submitted Based on
my inquiry of the person or persons who marage me system, or those persons directly responsible for gathering the rtormst`on, the
information submitted is to the best of my knowledge and belief.. true, accurate, and complete, I am aware that there are s,gnfrant
penalties for submitting false mformat!on, Including the possibility of fries and i mpnsonment 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-2 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-2) Page _I of a[
Permit No.: VV00028666
Facility Name: Cannons Gate at Bogue Sound
County: Carteret
Month: November
Year: 2023
Did infiltration occur at
this facility?
Site Name:
1
Site Name:
2
Site Name:
3
Site Name:
4
Area (acres):
1.66
Area (acres):
0.67
Area (acres):
1 32
Area (acres):
0.36
JYEs
2
Rate (GPD/ft ):
1.145
z
Rate (GPD/ft ):
1 14�
2
Rate (GPDlft ):
1.145
2
Rate (GPDIft ):
1.145
Weather
Freeboard
Site Infiltrated?
�eIYE$ `iNo
Site infiltrated?
EYES LINO
Site Infiltrated?
(.-]YES `NO
Site Infiltrated?
❑YES 0N0
y
a
p
ma
y
61
Q. mN
U>
E
cL
>
E
-=
c
72 1
C
o O
•
Mm
u in
E.d
a
>
'a
c
o
C
O
L
cococ-
E m
>
�
p
O
o
�
i A
E m
c
0.
>a
CD =
=0c
CM
>1
Ma
-�
^
°
°O
ap
Z
@E
LL m
OF
in
ft
ft
gal
min
GPD/ft2
ft
gal
min
GPD/ft2
ft
gal I
min
GPD/ft2
ft
gal
min
GPD/ft2
ft
1
C
53
0.01
3.5
14,333
0.20
3.30
14,333
049
3.50
14,333
0.25
3.50
0
0,00
3.40
2
C
56
3.5
17,000
0.24
330
17,000
0.58
3.50
17,000
0.30
3.50
0
0.00
3.40
3
C
66
3.5
12,889
0.18
3.30
12,889
0.44
3.50
12.889
0.22
3.50
0
0.00
3.40 `
4
C
70
3 5
12.889
0.18
3,30
12,889
0,44
3.50
12,889
0,22
3.50
0
0.00
340
5
R
72
3.5
12,889
0.18
3.30
12,889
0.44
3.50
12,889
0.22
3.50
0
0.00
3.40
6
R
73
3.5
11,667
0.16
3.30
11,667
0.40
3.50
11,667
0,20
350
0
0.00
340
7
R
72
3.5
12,333
0.17
3.30
12,333
0.42
3.50
12,333
0.21
3.50
0
0.00
3.40
8
C
74
3.5
14.000
0.19
340
14,000
0A8
3.50
14,000
0.24
3.50
0
0.00
3.40
9
C
72
1
3.5
12,000
0.17
3 40
12,000
0.41
360
12,000 i
0.21
3,60
0
0.00
3.40
10
CL
73
3.5
13,777
0.19
3.40
13,777
0.47
3.60
13,777
0.24
3.60
0
0.00
3.40
11
C
55
016
3.5
13.777 1
0.19
3.40
13,777
0.47
3.60
13,777
0.24
3.60
0
000
3.40
12
R
55
0.25
3.5 j1
13,777
0.19
3.40
i 13,777
0.47
360
13,777
0.24
3.60
0
000
3 40
13
C
62
0.14
3A
19,000
0.26
3.40
19,000
0.65
3.60
19,000
0.33
3.70
0
0.00
34.00
14
R
64
3A
13,667
0.19
3.50
13.667
0.47
3.50
13.667
0.24
3.70
0
0.00
340
15
C
64
34
13,333
0.18
3.50
13,333
0.46
3.50
13,333
0,23
3.70
0
0.00
3.50
16
CL
71
3.4
12,333
0.17
3.50
12,333
0.42
3.50
12,333
0.21
3.70
0
0.00
3.50
17
CL
73
3.4
13,000
0.18
3.50
13,000
0.45
3.50
13,000
0.23
3.70
0
0.00
3.50
18
CL
73
3.4
13.000
0.18
3.50
13,000
0A5
3.50
13.000
0.23
3.73
0
0.00
3.50
19
R
61
3.4
13.000
0.18
3,50
13 000
0.45
3.50
13,000
0.23
3.70
0
000
3.50
20
R
65
3.4
13.667
0.19
3.50
13,667
0.47
3.50
13,667
0.24
3.70
0
000
356
21
R
71
3.5
9,667
0.13
3.50
9,667
0.33
350
9,667
0.17
3.70
0
0.00
3.50
22
C
70
1.36
3.5
15,166
0.21
3.50
15,166
0 52
3.50
15.166
0.26
3.60
0
0 00
3.50
23
C
58
3.5
j 15,166
0.21
3.50
15,166
052
3.50
15,166
0.26
3.60
0
0.00
3.50
24
C
59
0.06
3.5
15,111
0.21
3.50
15,111
052
3.50
15,111
0.26
3.60
0
0.00
3.50
25
C
53
35
15,111
0.21
3.50
15,111
0.52
3.50
15,111
0.26
3.60
0
0.00
3.50
26
C
53
0.34
35
15,111
0.21
3.50
15,111
0,52
3.50
15,111
0.26
3.60
0
0 00
3.50
27
C
58
0.31
3.3
14,333
0.20
3.50
14,333
0.49
3.60
14,333
0.25
3.60
0
0.00
3.60
28
C
51
3.3
15.333
0.21
3.40
15,333
0.53
3.60
15,333
0.27
3.60
0
0.00
3.60
29
C
46
3.3
13,667
0.19
3.40
13,667
0.47
3.60
13,667
0.24
3.60
0
0.00
3.60
30
1311
C
58
3.3
12.333
0.17
1 3.40 ji
12,333
0,42
1 3.60
12 333
0.21
3.60
0
0.00
3.60
Month) Loadin (GPD/ft ):
Et,
0.47
4.g2
0.24
2.49
0.00
4.52
Year to Date Loadin GPD/ft2):

FORM NDAR-2 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-2) Page �, of 1_�
Did the application rates exceed the limits in Attachment B of your permit?
If not a basin, were the sites kept free of vegetation and raked?
If not a basin, were there any instances of effluent ponding in or runoff from the sites?
If a basin, were there any instances of breakout from the berms?
Was the onsite automatically activated standby power source tested and operational?
2compiiant ( Non -Compliant
ElComphant ❑Non -Compliant
l 4 Compliant ❑Non -Compliant
QCompliant ❑Non-Complant
[]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: Raymond Lacy Braxton
Permittee:
Aqua, North Carolina INC
Certification No.: 999895
Signing Official: Katie Dickens
Grade: IV Phone Number: 910 431-9248
Signing Official's Title: Coastal Regional Supervisor
Has the ORC changed since the previous NDAR-2? eyes 2No
Phone Number: 910 779-0794 Permit Exp.: 8/31/24
1�/)� & f
3
)2/ 2 1 123
Signature Date
Signature Date
By this signature, I certify that this report is accurrale 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 mw knowledge and belief. true. accurate. and complete I am aware that there are significant
penalties fa 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