WQ0034715_Monitoring - 05-2023_20240402

Monitoring Report Submittal
Permit Number#*
Name of Facility:*
Month: * May
Report Information
W00034715
Concert 12 Oaks,LLC
Type *
NDMR. NDAR-1. NDAR-2. NDMLR
Year:* 2023
Upload Document*
May 2023 Revised.pdf
PDF Only
814.03KB
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: * John Parrish
Signature:
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Date of submittal: 4/2/2024
This will be filled in automatically
Initial Review
Reviewer: Wanda.Gerald

Is the project number correct?* WQ0034715
Is the monitoring report accepted?* Yes No
Regional Office* Raleigh
Reviewer: _anonymous
Review Date: 4/2/2024

rONM Nr1MN 03.12 NON -DISCHARGE MONITORING REPORT (NDINR)
PAQq or
Sampling Person(s) Certined Laborstorlss
Nams John Parrish Nalfla:
Name
Narns:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? i i `r""pl"M ` i ►Nm r"mplbnf
It the facility Is non -compliant, please explain In the space below the resson(s) the facilly was not in compl�snce Provide In your explanation the dale(s) of the non-compliance and describe the corrective
adion(s) taken Attach additional sheets if necessary
Operator in Responsible Charge (ORC) Certification
Pormittoo Certification
ORC:
John Parrish
Permitted: Concert 12 Oaks, LLC
Certification
No.:
Signing Official: John Parrish
Grade:
Phone Number: 919A22-8665
Signing Official's Title: Superintendent
Has the ORC changed since the previous NDMR? U yes [1 No
Phone Number: 919A22-8665 Permit Expiration:
j�jq
A*W
Signature Date
Signature Date
By this signature. I certify that fihis report Is accurrale and complole to live benl of my kmrvdedge
I cefllfy, under penally of low. that this document and all attachments were prepared under my direction or supervision in
accordance with a nyntom dasigned to assure that all quairhed personnel properly gathered and evaluated the information
eutim fad. Based on my Inquiry of the parson or persons who manage the system, or those persons directly responsible for
gafhodng the Information, file inlrxmation submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am
aware that [hero are significant ponallion for submitting false information, including the possibility of fines and impnsonmenl for
knowing violations.
Mall 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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