WQ0033325_Monitoring - 05-2024_20240603 (2)

Monitoring Report Submittal
Permit Number#* WQ0033325
Name of Facility:* Bladen County Water District - Tobermory
Month: * May Year: * 2024
Report Information
Type* Upload Document*
NDMR, NDAR-1, NDAR-2, NDMLR NDMR TOB MAY 24.pdf 603.47KB
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: * Alan Edge
Signature:
Date of submittal: 6/3/2024
This will be filled in automatically
Initial Review
Reviewer: Wanda.Gerald

Is the project number correct?* WQ0033325
Is the monitoring report accepted?* Yes No
Regional Office* Fayetteville
Reviewer: _anonymous
Review Date: 6/10/2024

FORM: NDMR C3-12 NON -DISCHARGE MOYi9 TORM REPORT (NDMR) Page of .21
Sampling Person(s) Certified Laboratories
iFlame: Name:
Name: `e,60ov �� $ 4Name:
Does &ii monitrorring data and sampling frrsquelveiee meet the requirements in AirtachMe it A oil your paei m' tr? cmpliant ❑ 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 correctve
action(s) taken. Attach additional sheets if necessary.
Operator in Responsible Charge (ORC) Certification
Perm ittee Certification
ORC:
Permittee:
Cv. we'- ed— c.-f
Certification No,: Q'll 2-,?3
,AQr.sm
Signing Official: 041-4)
Grade: —,0o StA, jhe4 `a o,a Phone number- ?IV �J
Signing Official's Title: Oi igecicA
a AOSS- 4e7slmte-C-)-c0AJ
Has the ORC changed since the previous NOMR? El Yes
Phone Number: Permit Expiration:
kSignature Date
Signature Date
By this signature, I certify that this reportis accurrate and complete to the best of my knowledge.
l 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 qualifled personnel properly gathered and evaluated the information submitted. Based on
I
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 MaB Service Center
Raleigh, north Carolina 27699-1617

PORK NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page l of.2,
Did the application rates exceed the limits in Attachment B of your permit? 52rCornpliant ❑ Non -Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites? FiXc mpliant ❑ Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit? M1,1c mpliant ElNon-Compiiant
L`7
Were all setbacks listed in your permit maintained for every application to each permitted site? Compliant ❑ Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? Yrcmpliant ❑ 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
actiontsl taken. Attach additional sheets if necessary.
Operator in Responsible Charge (ORC) Certification Permiitteee Certification
ORC: 1q1*V 6G Permittee:
Certification No.: C�`Zd,�G�� Signing Official: AQO .
r 9q7 Grade: � - � Phone Number: ��b _ ���. — �Q�� Signing Official's Title: AAp
Has the O hanged since the previous NDAR-1? El yes No Phone Number: t?1,1 O6 Z 491A Permit Exp.:
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, 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 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 A of -7—