WQ0001284_Monitoring - 03-2024_20240430

FORM: NDMR 03-12
NON -DISCHARGE MONITORING REPORT (NDMR)
Page _I of t
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? 0Compliant El Non -Comp
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 correctiv
taken. Attach additional sheets if necessary.
Operator in Responsible Charge (ORC) Certification
ORC: Jeffrey Long
Certification No.: 992044
Grade: Wastewater 1 Phone Number: 252-308-2984
Has the ORC changed since the previous NDMR? ❑ Yes ❑x No
04-24-2024
Date
By this signature, I certify that this report is accurate and complete to the best of my knowledge.
Perm ittee Certification
Permittee: Town of Conway
Signing Official: Jeffrey Long
Signing Official's Title: ORC
Phone Number: 252-585-0488
Permit Expiration: 08-31-2029
04-24-2024
Signature D�
I certify, under penalty of law, that this document and at attachments were prepared under my direction or supe
accordance with a system designed to assure that all qualified personnel property gathered and evaluated the it
submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly rest
athering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and c
aware that there are significant penalties for submitting false information, including the possibility of fines and impr
knowing violations.
Mail Original and Two Copies to:
Division of Water Resources
Information Processing Unit
1617 Mail Service Center

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page _g of I
>z q

FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page y_ of I_

FORM. NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Page _ t_ _ of P_
Did the application rates exceed the limits in Attachment B of your permit?
©Compliant
El Non -Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites?
©Compliant
El Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit?
ZCompliant
❑Non-Compllant
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?
© 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
taken. Attach additional sheets if necessary.
and describe the corrective action(s)
Operator in Responsible Charge (ORC) Certification
Perm ittee Certification
ORC: Jeffrey Long
Permittee:
Town of Conway
Certification No.: 993135
signing Official: Jeffrey Long
Grade: Sprayfield Phone Number: 252-308-2984
Signing Official's Title: ORC
Has the ORC changed since the previous NDAR-1?
Phone Number: 252-585-0488 Permit Exp.: 08-31-2028
04-24-2024
04-24-2024
ignature 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 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

Monitoring Report Submittal
Permit Number#*
Name of Facility:*
Month: * March
WQ0001284
TOWN OF CONWAY
Report Information
Type *
NDMR, NDAR-1, NDAR-2, NDMLR
Confirmation Email Address:
Name of Submitter: *
Signature:
Date of submittal:
Initial Review
Year:* 2024
Upload Document*
JEFF0424.pdf 737.62KB
PDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
JEFFREYLONG267@GMAT L.COM
JEFFREY LONG
1-1&1-'jij . -t"�
Reviewer: Wanda.Gerald
4/30/2024
This will be filled in automatically

Is the project number correct?* W00001284
Is the monitoring report accepted?* Yes NO
Regional Office* Raleigh
Reviewer: _anonymous
Review Date: 6/28/2024