WQ0017530_Monitoring - 05-2024_20240625

Monitoring Report Submittal
..................................................
Permit Number#* WQ0017530
Name of Facility:* Highlands Cove WWTP
Month: * May Year: * 2024
Report Information
Type* Upload Document*
NDMR, NDAR-1, NDAR-2, NDMLR Highlands Cove WWTP 05-2024.pdf 1016.92KB
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: * Mark Teague
Signature:
i
Date of submittal: 6/25/2024
This will be filled in automatically
Initial Review
Reviewer: Wanda.Gerald

Is the project number correct?* W00017530
Is the monitoring report accepted?* Yes NO
Regional Office* Asheville
Reviewer: _anonymous
Review Date: 6/26/2024

FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page
Permit No.: W00017530
Facility Name: Highlands Cove WWTP
County: Jackson
Month: May
Year: 2024
Did irrigation
Field Name:
A
Field Name:
B
Field Name:
C
Field Name:
D
occur
at this facility?
Arse (acres):
2.81
Area (acres):
2.71
Area (acres):
1
Area (acres):
213
Cover Crop:
P�
Cover P�
Cover P:
CoverCro P:
❑YES ONO
Hourly Rate (In):
0.11
Hourly Rate (in):
0.1
Hourly Rate (in):
0.1
Hourly Rate (in):
0.1
Annual Rate (in):
23.92
Annual Rate (in):
23.92
Annual Rate (in):
23.92
Annual Rate (in):
23.92
Weather
Freeboard
Field Irrigated?
❑YES ONO
Field Irrigated?
❑YES pNo
Field Irrigated?
❑YES GINo
Field Irrigated?
❑YES pNO
om
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1
C
54
0
0
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0.00
0
0
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0
0
0.00
0.00
0
0
0.00
0.00
2
C
52
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0
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0
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0
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3
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55
12.8
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0
0
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0.00
0
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0
0
0.00
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4
0
0
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0
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0
0
0.00
0.00
0
0
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0.00
5
0
0
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0.00
0
0
0.00
0.00
0
0
0.00
1 0.0o
0
0
000
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6
R
57
0
0
0:00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
7
C
52
0
0
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0
0
0.00
0.00
0
0
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0
0
0.00
0.00
8
PC
56
0
0
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0.00
0
0
0.00
0.00
0
0
0.00
0.00
9
R
53
0
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0
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0
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10
PC
54
12.5
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0
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0
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11
0
0
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0
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0
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0
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121
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! 0.00
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0
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0
0
0.00
0.00
13
PC
56
1 0
0
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1 0.00
0
0
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0.00
0
0
1 0.00
0.00
0
0
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0.00
14
PC
56
0
0
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0
0
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0
0
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0.00
0
0
0.00
0.00
15
PC
55
0
0
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0
0
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0
0
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0
0
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16
PC
68
0
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0
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0
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17
CL
57
12.1
4.2
_ 0
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181
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0
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19
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0
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0
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0.00
20
C
60
0
0
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0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
21
C
61
0
0
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0.00
0
0
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0.00
0
0
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0
0
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22
C
59
0
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0
0
000
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0
0
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0
0
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0.00
23
CL
58
0
0
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0
0
000
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0
0
0.00
0.00
0
0
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241
C
64
11.9
4
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0
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251
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6
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26
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27
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28
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61
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0
0
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0.00
29
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55
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0
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30
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50
1
0
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0
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0.00
0
0
0.00
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0
0
0.00
0.00
31
CL
59
11.7
42
0
0
0.00
0.00
0
0
000
0.00
0
0
0.00
0.00
0
0
0.00
0.00
Monthly Loading:
0
0.00
0
0.00
0,00
0
0.00
0
0.00
12 Month Floating Total (in):

FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of
Permit No.: W00017530
Facility Name: Highlands Cove WWTP
County: Jackson
Month: May
Year: 2024
Did irrigation
Field Name:
E
Field Name:
G
Field Name:
H
Field Name:
I
occur
Area (acres):
I 0.84
Area (acres):
1.1
Area (acres);
0.85
Area (acres):
0-44
at this facility?
Cover Crop:
P�
Cover P�
Cover P�
CoverCro P:
❑YES EINO
Hourly Rate (1n):
0.1
Hourly Rate (in):
0.1
Hourly Rate On):
0.1
Hourly Rate (in):
0-1
Annual Rate (in):I
23.92
Annual Rate (in):
23.92
Annual Rate (in):
23.92
Annual Rate (in):
23.92
Weather
Freeboard
Field Irrigated?
OYES ONO
Field Irrigated?
OYES ONO
Field IRlgated?
OYES ONO
Field Irrigated?
OYES EINo
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min
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gal
min
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1
0
0
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( 0.00
0
0
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0
0
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0.00
0
0
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2
0
0
i 0.00
0.00
0
0
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0.00
0
0
0.00
0.00 f
0
0
0.00
0.00
3
0
0
0.00
0.00
0
0
0.00
0.00
0
0-
0.00
0.00
0
0
0.00
0.00
4
0
0
MOO
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
5
0
0
0.00
0.00 _
0
0
0-00
0.00
0
0
0.00
0.00
0
0
0.00
0-00
6
0
0
o:o0
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
7
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0-00
8
0
0
0:00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
9
0
0
0.00
0.00
0
0
0,00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
10
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
11
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
12
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
13
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
14
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0-00
15
0
( 0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
16
0
0
0.00
0.00
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0
0.00
0.00
0
0
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0
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17
0
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0
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0
0
0.00
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0
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18
0
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0.00
1 0
0
0.00
0.00
0
0
0.00
0.00
19
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
20
0
0
0.00
0.00
0
0
0.00
0-00
0
0
0.00
0.00
0
0
0-00
0-00
21
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0-00
0.00
22
0
0
0.00
( 0.00
0
0
0 00
0.00
0
0
0.00
0.00
0
0
0-00
000
23
0
0
0.00
0.00
0
0
0.00
0-00
0
0
0.00
0.00
0
0
0.00
0.00
24
0
0
0.00
0.00
0
0
0.00
o.00
0
o
0.00
0.00
0
0
0.00
0.00
25
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
000
0.00
26
0
0
0.00
0.00
0
0
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0.00
0
0
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0
0
0.00
0.00
27
0
0
0.00.
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
28
0
0
0.00
0.00
0
0
0-00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
29
0
0
I 0.00
0.00
0
0
0.00
0-00
0
0
0.00
0.00
j 0
0
0.00
0.00
30
0
0
0.00
0.00
0
0
0,00
0.00
0
0
0.00
0.00
0
0
0-00
0.00
31
0
0
0.00
0.00
0
0
0.00
0.00A"ieo.00
0-00
0.00
0
0
0-00
Monthly Loading:
12 Month Floating Total (in):
0
0.00
0.00
0

FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page
Permit No.: WQ0017530
Facility Name: Highlands Cove WWTP
County: Jackson
Month: May
Year: 2024
Did irrigation
Field Name:
J
Field Name:
K
Field Name:
L
Field Name:
M
occur
this facility?
Area (acres):
10.06
Area (acres):
2.2
Area (acres):
5.35
Area (acres):
13.5
at
Cover Crop:Cover
Crop:
P=
Cover Crop:
P�
Cover Crop:
P:
❑YEs OrvO
Hourly Rate (in):
0A
Hourly Rate (in):
0.1
Hourly Rate (in):
0.1
Hourly Rate (in):
0.1
Annual Rate (in):
23.92
Annual Rate (in):
23.92
Annual Rate (in):
23.92
Annual Rate (in):
23.92
Weather
Freeboard
Field Irrigated?
❑YFS ONO
Field Irrigated?
DYES ONO
Field Irrigated?
❑YES QN0
Field Irrigated?
❑YES ONO
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in
gal
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1
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0:00
0.00
0
0
0.00
0.00
2
0
0
I 0.00
0.00
0
0
0.00
0.00
0
0
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0
0
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3
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
4
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
5
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
6
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
7
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
8
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
9
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
10
0
0
0.00
0,00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
11
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
12
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
13
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
14
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
15
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0-00
16
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
17
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
000
181
1
0
1 0
0.00
0.00
0
1 0
0.00
1 0.00
0
0
0.00
0.00
0
0
0.00
0.00
19
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
20
0
0
0.00
0.00
0
0
0.00
a00
0
0
0.00
O.00
0
0
0.00
0.00
21
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
22
f 0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
23
0
0
1 0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
24
0
0
j 0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
25
0
0
0.00
0.00
0
0
0.00
0.00
0
0
1 0.00
0.00
0
0
0.00
0.00
26
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
27
0
0
0.00
0.00
0
0
000
0.00
0
0
0.00
0.00
0
0 I
0.00
000
28
0
0
0.00
0.00
0
0
0,00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
29
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
30
0
0
0.00
0.00
0
0
0,00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
311
1
1
0
0
0.00
0.00
0
0
0,00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0.00
0.00
Monthly Loading:
12 Month Floating Total (in):
0
0.00
0.00
0
0.00
0.00
0
0.00
0.00
0

FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of
Permit No.: WQ0017530
Facility Name: Highlands Cove WWTP
County: Jackson
Month: May
Year: 2024
Did irrigation occur
Field Name:
N
Field Name:
O
Field Name:
P
Field Name:
at this facility?
Area (acres):
2.4
Area (acres):
1.02
Area (acres):
1.11
Area (acres):
Cover Crop:
P�
Cover p:
Cover p:
CoverCro p:
❑YES ONO
Hourly Rate (In):
0.1
Hourly Rate (in):
0.1
Hourly Rate (In):
0.1
Hourly Rate (in):
Annual Rate (in):
23.92
Annual Rate (in):
23.92
Annual Rate (in):
23.92
Annual Rate (in):
Weather
Freeboard
Field Irrigated?
OYES 2NO
Field Irrigated?
❑YES pNO
Field Irrigated?
❑YES pNO
Field Irrigated?
OYES ONo
>`
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min
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in
in
1
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
#DIV/O!
#DIV/01
2
0
0
0.00
0.00
0
0
0.00
0.00
0
0
9.00
0.00
0
0
#DIV/O!
#DIV/O!
3
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
#DIV/O!
#DIV/O!
4
0
0
0,00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
#DIV/01
#DIV/O!
5
D
0
0.00
0.00:
0
0
0.00
0.00
0
0
0.00
0.00
1 0
0
#DIV/O!
#DIV/0!
6
0
0
0.00
0.00
0
1 0
0.00
0.00
0
0
0.00
0.00
0
0
#DIV/0!
#DIVlO!
7
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
#DIV/O!
#DIV/O!
8
0
0
0.00
0.00
0
0
0.00
1 0.00
0
0
0.00
0:00
0
0
#DIV/01
#DIV/01
9
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
I #DIV/01
#DIV/01
101
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
#DIV/O!
#DIV/O!
ill
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
#DIV/O!
#DIV/01
12
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
#DIV/O!
#DIV/O!
13
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
#DIV/O!
#DIV/O!
14
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
1 0
0
#DIV/O!
#DIV/01
15
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
#DIV/O!
#DIV/O!
16
0
0
0.00
0.00
0
0
0.00
1 0.00
0
0
0.00
0.00
1 0
0
#DIV/O!
#DIV/O!
171
0
0
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
#DIV/O!
#DIV/O!
18
0
0
E0.00
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
#DIV/01
#DIV/O!
19
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
#DIV/0!
#DIV/0!
201
11
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
#DIWO!
#DIV/O!
211
11
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
#DIV/O!
#DIV/O!
221
1
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
#DIV/01
#DIV/O!
231
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
#DIV/01
#DIV/O!
241
0
0
0.00
0.00
0
0
0,00
0.00
0
0
0.00
0.00
0
0
#DIWO!
#DIV/01
25
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
#DIV/O!
#DIV/O!
26
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
#DIWO!
#DIV/O!
27
0
0 i
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
#DIV/O!
#DIV/01
28
0
0
0.00
0.00
0
0
000
0.00
0
0
0.00
0.00
0
0
#DIV/O!
#DIV/O!
29
0
0
O.UO
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
#DIV/01
#DIV/O!
30
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
#DIWO!
#DIV/01
31
0
0
0.00
6.00
0
0
0.00
0.00
0
0
O.OD
0.00
0
0
0
#DIV/O!
#DIV/O!
#DIV/O!
Monthly Loading:
0
0.00
0
0.00
0
0.00
12 Month Floating Total (in):

FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of
Did the application rates exceed the limits in Attachment B of your permit? OCompbnt ❑Non-cornpra„t
Were adequate measures taken to prevent effluent ponding in or runoff from the sites? OCormpliant ❑Non{ompliant
Was a suitable vegetative cover maintained on all sites as specified in your permit? pconviant ❑Nort-comprrant
Were all setbacks listed in your permit maintained for every application to each permitted site? Elcomprant ❑Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? pcompliant ❑Non-comphant
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: Dale Wike
Permittee:
Jerry West
Certification No.: 996012
Signing Official: Jerry West
Grade: WW-4, SI Phone Number: 828-586-5588
Signing Official's Title:
Has the ORC changed since the previous NDAR-1? ❑ves Ono
Phone Number. Permit Exp.:
"25-e-2 L/
�' Signature Date
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
l cPttdy, under penally of raw, that this document and all attachments were prepared under my direction or supervision in accordance
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

FORM: NDMR 10-13 NON -DISCHARGE MONITORING REPORT (NDMR) Page
Permit No.: WQ0017530
Facility Name: Highlands Cove WWTP
County: Jackson
Month: May
Year: 2024
PPI: 001
Flow Measuring Point: ❑influent BEffluent [:]No flow generated
Parameter Monitoring Point: ❑tnfluent Effluent ❑Groundwater Lowering ❑Surface Water
Parameter Code - 1P
50050
00310
00940
50060
I 31616
00610
00625
00620
00600
00400
00665
70300
00530
00076
Zm
c
OE
a
r
Ix
O
o
a
Cv�
aor
s
rU
op€
c
°
E
Q
t
�
o�
z
0
�<E
2
-,0
�
a
°
oo
~
o�0U
ach�vom
om
~�U
B°
24-hr
hrs
GPD
mg1L
mg1L
mg1L
#1100 mL
mq/L
I mg_/L
mg1L
mg1L
su
mg/L
mg1L
mglL
NTU
1
07:40
0.5
13,296
0.6
7
2.163
2
07:50
0.5
12,895
(
0.7
6.9
3.129
3
07:30
0.5
9,707
0.6
7
2.876
4
8,928
<5
5
1
8,928
1
<5
6
08:00
0.5
8.928
0.7
7
3.001
7
07:30
0.5
8,775
I 0.6
7
2_998
8
08:00
0.5
6,467
0.7
7
3.142
9
08:00
0.5
6,814
I 0.6
7
3.077
101
07:50
0.5
7,211
I 0.5
7
3.019
11
8.314
<5
12
8,314
<5
13
08:00
0.5
8,314
0.6
I
7
2.875
14
12:00
0.5
8,467
07
I
I 7
2.943
15
08:00
0.5
5,538
43
0.6
<4
06
1.7
266
28.3
1 6.8
4.4
! <2.5
2.801
16
11:00
0.5
6,312
07
6.9
2.765
17
08:00
0.5
7,214
0.6
7
3.012
18
7,963
<5
19
7,963
<5
20
07:50
0.5
7,963
07
7
3.123
211
07:30
0.5
10,306
06
I
6.9
I 2.873
22
07:30
0.5
10,175
0.7
7
I 2.777
23
07:30
10,342
f
f
07
6.9
3.079
24
07:3014,897
0.6
i
7
3.125
25
dH
18,568
<5
26
18,568
<5
27
holiday18.568
H
H
H
H-1
H
H
H
H
H
H
H
H
<5
H
H
28
09:00
0.5
18,568
0.7
7
2.876
29
07:30
0.5
17,694
0.6
7
2.998
30
07:45
0.5
15,694
0.7 I
7
2.869
31
11:00
0.5
14,732
0.6
7
2.797
Average:
10,854
215
0.00
0.61
1.00
0.30
0.85
13.30
14.15
2.20
0.00
0.00
2.07
0.00
0.00
Daily Maximum:
18,568
4.30
0.00
0.70
4.00
0.60
1.70
26.60
28.30
7.00
4.40
0.00
2.50
5.00
0.00
0.00
Daily Minimum:
5.538
4.30
0.00
0.50
4.00
0.60
1.70
26.60
28.30
6.80
4.40
0.00
2.50
2.16
0.00
0.00
Sampling Type:
Recorder
Composite
Composite
Grab
Grab
Composite
Composite
Composite
Composite
Grab
Composite
Composite
Composite
Recorder
Monthly Avg. Limit:
60.000
10
14
4
I
5
Daily Limit:
15
25
6
6-9
�
10
10
�
Sample Frequency:
Continuous
Monthly
3 x Year
5 x Week
Monthly
Monthly
Monthly
Monthly
Monthly
5 x Week
Monthly
3 x Year
Monthly lContinuous

FORM: NDMR 10-13
NON -DISCHARGE MONITORING REPORT (NDMR)
Page
Of
Sampling Person(s)
Name: Dale Wilke
Name:
Name: Environmental, Inc.
Name: Pace Analytical
Certified Laboratories
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? lia"t
❑piwit
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: Dale Wike Permittee: Jerry West
Certification No.: 996012 Signing Official: Jerry West
Grade: WW-4, SI Phone Number. [phone] Signing Official's Title:
Has the ORC changed since the previous NDMR? ❑yes BNo Phone Number: Permit Expiration:
Signature Date 1 y Signature Date
a
By this signature, I certify ghat this report is accurate and complete to the best of my knowledge. ceC*, under penally of law, that this document and all attachments were prepared under my direction or supervision In
Based on
with a system designed to assure that all qualified personnel property gathered and evaluated the information submitted -
my the
my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering
the information submitted is, to the best of my knowledge and befie . true, accurate, and complete. i alt aware ghat there are slgntficent
penalties for submitting false efonnation, including the possibility of fines and imprisonment for knrnnnng vrolarK—'
Mail Original and Two Copies to:
Division of Water Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617