WQ0033325_Monitoring - 03-2024_20240416

Monitoring Report Submittal
..................................................
Permit Number#* Wg0033325
Name of Facility:* Bladen County Water District - Tobermory
Month: * March Year: * 2024
Report Information
Type *
NDMR, NDAR-1, NDAR-2, NDMLR
Confirmation Email Address: *
Name of Submitter: *
Signature:
Date of submittal:
Initial Review
Upload Document*
tobermory ndmr april 2024.pdf 716.96KB
PDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
[e-mail]
Alan Edge
�lar
Reviewer: Wanda.Gerald
4/16/2024
This will be filled in automatically

Is the project number correct?* Wg0033325
Is the monitoring report accepted?* Yes NO
Regional Office* Fayetteville
Reviewer: _anonymous
Review Date: 4/16/2024

FORM: NDMR 03-12 NON-MSCHARGC
-- ®`T�RiN� ' PC e (!C lR) Page of
Nams:.41-q,,
Nance: t/1 -!!WC!
Sampling Person(s)
t
�Esfc2
Certified Laboratories
Name:
Name:
Dcas all monitoring Matra ,are sampling frequenc!es Meet the requirements in Attachment A of your pgrm t?
ompliartt II Non -Compliant
If the facility is non -compliant, please explain in the space below the reasons) the facility was not in compliance. Provide in your explanation the date(s) of the non-compliance and describe the corrective
I — --- acticn(s) taken. Attach additional sheets if necessary.
Operator in Responsible Charge (ORC) Certification
ORC: /414/1 J C
Certification No.: 2-173
6- w C-
Grade: R—QiS�f2� h roe Phone Number: 4jn — a 6eOf
(-.tivss— COw•tec+,o,kJ Has the ORC changed since the previous NDMR-) n i Yes °
_7-zq
Signature Date
Permittee Certification
Permittee: 4
f d gym, AD SM
Signing Offiicial:
Signing Official's Title:
Phone Number: �PO��BZ�6Qg� Permit Expiration:
- 7 -ZLI
_.0...
...
. Date
By this signature, i certify that this report is accurrate and complete to the best of my knowledge. I ce Airy, 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, orthose 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 fines and imprisonment for knowing violations.
Mail Original and Two Copies to:
Division of Water Resources
➢nforrnation Processing Unit
1617 Mail Service Center
Raleigh, North Caroiina 27699-1617

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR)
Permit No.: 0,3 3 3-ZA Facil[ity Name.
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Daily Maximum:
Daily Minimum:
Sampling Type:
Monthly Avg. Limit: r
Daily Limit:
Sample Frequency:&Z�
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Page

m -JRM. NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page l of
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?
(,.,,//Compliant ❑ Non -Compliant
LdSCompliant ❑ Non -Compliant
/Compliant ❑ Non -Compliant
& Compliant ❑ Non -Compliant
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
ORC: 14`44ti C: �
Certification No.: 776214�.?
Grade: f� _ ,� � Phone Number: 1710 —
Has the ORC changed since the previous NDAR-1? ❑ Yes 160
f1-:- 7 - Z-q
101
Signature oate
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
Permittee Certification
Permittee: gjgt
Signing Official: mo�
Signing Official's Title:
Phone Number: j1,0 46 Z_- 691,E Permit Exp.:
re
3 -7-ZV
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 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 of
Permit No.: VJ6Z 40033 3 ;L S-
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Month: X&te_ -
Year: Z�
Did irrigation occur
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Area (acres):
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Cover Crop:
Coverrop
1 Cover Crop:
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Yes ❑ IVO
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