WQ0029653_Monitoring - 12-2023_20240130

Monitoring Report Submittal
...................................................
Permit Number#* WQ0029653
Name of Facility:* SCOTCH HALL PRESERVE WWTP
Month: * December Year: * 2023
Report Information
Type *
NDMR, NDAR-1, NDAR-2, NDMLR
Confirmation Email Address: *
Name of Submitter: *
Signature:
Date of submittal:
Initial Review
Upload Document*
doc01032320240130132723.pdf
PDF Only
2.16MB
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
[e-mail]
Brian Jernigan
cL'J t-44W C,01hy-9RN
Reviewer: Wanda.Gerald
1 /30/2024
This will be filled in automatically

Is the project number correct?* WQ0029653
Is the monitoring report accepted?* Yes No
Regional Office* Washington
Reviewer: _anonymous
Review Date: 5/7/2024

FORM: NDMR 05-16 NON -DISCHARGE MONITORING REPORT (NDMR) Page
Permit No.: WQ0029653
Facility Name: Scotch Hall Preserve WWTP
County: Bertie
Month: December
Sampling Type:
Monthly Limit:
Daily Limit:
—Sample Frequency:

FORM: NDMR 05-16 NON -DISCHARGE MONITORING REPORT (NDMR) Page of
Sampling Person(s) Certified Laboratories
Name: Name:
Name: Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit-! u compliant ivon-k Uf1I pildI IL
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
..,.�;,...��� r,Len A+t—h ­l Ai+innnl chAPtR if npnp. ,Rarv.
IWe were over on our monthly limit because of I&I I found some caps broken and a cleanout damaged has been repaired.
Operator in Responsible Charge (ORC) Certification Permittee Certification
ORC: BRIAN JERNIGAN Permittee: SCOTCH HALL PRESERVE WWTP
Certification No.: SI 1006435 Signing Official: MIKE PARAH
Grade: Phone Number: 252-325-0771 Signing Official's Title: GENERAL MANAGER
Has the ORC changed since the previous NDMR? ❑ Yes 0 No Phone Number: 336-410-4761 Permit Expiration: 2/28/2026
Si ture Date Signature Date
this signature _.certiry 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 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

nicruA0r'-G APPI (CATION REPORT (NDAR-1)
Page

FORM: NDAR-1 05-16 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of

FORM: NDAR-1 05-16 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page _ of

FORM: NDAR-1 05-16 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page 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?
❑A Compliant
❑ Non -Compliant
❑� Compliant
❑ 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 Permittee Certification
ORC: BRIAN JERNIGAN Permittee: SCOTCH HALL PRESERVE WWTP
Certification No.: SI 1006435 Signing Official: MIKE PARAH
Grade: Phone Number: 252-325-0771 Signing Official's Title: GENERAL MANAGER
Has the ORC cha ged since the previous NDAR-1? ❑ Yes 7 No Phone Number: 336-410-4761 Permit Exp.: 2/28/26
10
Signature
Date Signature Date
By this signature, I certify that Phisf report is accurrate and complete to the best of my knowledge. I certify, under penally 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 Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617