WQ0033325_Monitoring - 02-2024_20240304

Monitoring Report Submittal
.....................................................
Permit Number#* WQ0033325
Name of Facility:* Bladen County Water District - Tobermory
Month: * February 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*
NDMR TOB FEB 24.pdf 720.24KB
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
3/4/2024
This will be filled in automatically

Is the project number correct?* W00033325
Is the monitoring report accepted?* Yes NO
Regional Office* Fayetteville
Reviewer: _anonymous
Review Date: 4/16/2024

FORM: NDMR 03-12
Sampling Person(s)
Name: /T14^'I Z;;
Flame: Leelov ! CS C2
MON-DISCHARGE MONITCR�MG REPORT ([NDMR)
Certifled Laboratories
Page --I— of
dame: 6A171
Name:
Ocss aII ira-ooni<tar° ng date and sampling frequencies meet the requa Tements in Attachment A of 49B. ur permit? mpliant to 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 (OIRC) Cartification
ORC:
Certification No,:
6?-WC-/j
Grade: ,Q - 0 y7`Q, `j 44, o,4 Phone Number: Q( d
8&Z — 6P��
CROSS- CoA0eee.4-1*0A)
Has the ORC changetf since the previous NDMR? Yes
—1—z
signature Data
By this signature, I certify that this report is accurrats and complete to the best of my knowledge.
Permittee Certification
Permittee: i3l4 de-ft Cv. W e,+eir /a.Sa Li
Signing Official;
Signing Official's Tittle: r;,/ c-�A
Phone Number: �('®'�EZ' �� � PermitErpiration:
—i_z
algnaiure 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, 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 offines and imprlsormentfor knowing violations.
Mai[ Original and Two Copies to:
Division of Wafter Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

.:.7RM: 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
Lf"Compliant ❑ Non -Compliant
(/Compliant ❑ Non -Compliant
2 Compliant ❑ Non -Compliant
U 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: lTC��/ ` �
Permittee: 81,jkl C@ 4 40 4_1
Certification No.: g7641?,?
Signing Official: A
r w
Grade: 04 - ,d.;dZ4&�--�� Phone Number:
Signing Official's Title:
�
Has the ORC changed since the previous NDAR-1? ❑ Yes Ly'No/
QEi Z. r�
Phone Number: �!O - p - 64Z,6 Permit Exp.:
d4--�r�
- j z
Signature ®ate
Signature Date
By this signature, I certify that this report is accurate and complete to the best of my knowledge.
(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 sign ficant
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-'I) Page A, of .7—
Permit No.:VJ6Z 0033 32
Facility Name: �L C}
County:
Month:14j
Year:►
Did irrigation occur
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