WQ0020881_Monitoring - 10-2023_20240426

Monitoring Report Submittal
Permit Number#*
Name of Facility:*
Month: * October
WQ0020881
LAKE NORMAN STATE PARK
Report Information
Type *
Revised - NDMR, NDAR-1, NDAR-2, NDMLR
Year:* 2023
Upload Document*
1ano_ndmr_rpt_Oct2023.pdf 1.48MB
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: * Envirolink, Inc.
Signature:
Date of submittal: 4/26/2024
This will be filled in automatically
Initial Review
Reviewer: Wanda.Gerald

Is the project number correct?* W00020881
Is the monitoring report accepted?* Yes NO
Regional Office* Mooresville
Reviewer: _anonymous
Review Date: 5/3/2024

FORM NDMR 10-13 NON -DISCHARGE MONITORING REPORT (NDMR) Page 1 of
Permit • • 0 1::
of Parks & Rec•
. -•-
. October
Flow Measuring Point: 2 Influent 11 Effluent 0 No flow generated
Parameter Monitoring Point: 0 Influent ia Effluent 13 Groundwater Lowering 0 Surface Water
•.•
11 1
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11. 1
11. 1
11.
11 1
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-___
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1/
---------------

FORM: NDMR 10-13 NON -DISCHARGE MONITORING REPORT (NDMR) Page 2 of 2
Sampling Person(s) Certified Laboratories
Name: Operators Name: Statesville Analytical, Inc.
Name: Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? la Compliant o 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.
reports were finalized throughout the period when the facility was under the operation of Hayseed Environmental from May to October 2023.
ORC on -site during October 2023.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Todd Robinson
Permittee: Div. Of Parks & Rec (Lake Norman SP)
Certification No.: 1006252
Signing Official: Nathan Greene
Grade: S1 Phone Number: 252-235-8809
Signing Official's Title: State Ranger
Has the ORC changed since the previous NDMR? la Yes o No
Phone Number: [phone] Permit Expiration: 6/30/2026
Todd Digitally signed by Todd Robinson
=Todd Robinson email =
[e-mail] C = US
rob
�j
0 = ENVIROLINK. INC. OU = ORC 4/25/2024
Robinson
t' 9
J (i
Date 2024.04.250913.47-04'00'
Signature Date
Signature Date
By this signature, I certify that this report is accurrate 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 my knowledge and belieftrue, 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
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

Permit • •11 1::
• •rman SP)
County: Iredell•
••-
1
Did irrigation
Area (acres):
Area (acres):
at this facility?
...:.
..
.....Cover
D NO
Hourly Rate (in):
Hourly -.
1
Annual Rate1
1 .
-■
. . .. . •Field
Irrigated?■
•
• •
' G
1
6 •Field
Irrigated?
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12 Month Floating Ti,tal (in):
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III
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III

Did the application rates exceed the limits in Attachment B of your permit?
o Compliant ❑ Non -Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites? o Compliant ❑ Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit? o Compliant ❑ Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site? m Compliant ❑ Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? o 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.
No reports were finalized throughout the period when the facility was under the operation of Hayseed Environmental from May to October 2023.
No ORC on -site during October 2023.
IOperator in Responsible Charge (ORC) Certification 1I Permittee Certification
ORC: Todd Robinson
Certification No.: 1006252
Grade: SI Phone Number: [phone]
Has the ORC changed since the previous NDAR-1? o Yes a No
Todd Digitally signed by Todd Robinson
DN. CN = Todd Robinson email =
[e-mail] C = US
Rnhi n snn O = ENVIROLINK INC. OU = ORC 4/25/2024
Signature Date
By this signature. I certify that this report is accurate and complete to the best of my knovledge.
Permittee:
Div. Of Parks & Rec (Lake Norman SP)
Signing Official: Nathan Greene
Signing Official's Title: State Ranger
Phone Number: [phone] Permit Exp.: 6/30/26
� zs L
Signature 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 informationthe
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
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617