WQ0001284_Monitoring - 09-2023_20240801

Monitoring Report Submittal
Permit Number#*
Name of Facility:*
Month: * September
WQ0001284
TOWN OF COWNAY
Report Information
Type *
NDMR, NDAR-1, NDAR-2, NDMLR
Confirmation Email Address:
Name of Submitter: *
Signature:
Date of submittal:
Initial Review
Year:* 2023
Upload Document*
SEPT 20232. pdf 594.71 KB
PDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
[e-mail]
JEFFREY LONG
1-1&1-'jij . -t"�
Reviewer: Wanda.Gerald
8/1 /2024
This will be filled in automatically

Is the project number correct?* WQ0001284
Is the monitoring report accepted?* Yes No
Regional Office* Raleigh
Reviewer: _anonymous
Review Date: 8/1/2024

FORM: NL)MR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page _ i of `L

FORM: NDMR 03-12
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? Z Compliant ❑ 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 Permittee Certification
ORC: Jeffrey Long Permittee: Town of Conway
Certification No.: 992044 Signing Official: Jeffrey Long
Grade: Wastewater 1 Phone Number: 252-308-2984 Signing Official's Title: ORC
Has the ORC changed since the previous NDIVIR? ❑ Yes © No Phone Number: 252-585-0488 Permit Expiration: 08-31-20Lp
10-16-2023
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
10-16-2023
Signature De
I certify, under penalty of law, that this document and all attachments were prepared under my direction or sup(
accordance with a system designed to assure that all qualified personnel properly gathered and evaluated the it
submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly resp
athedng 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

FJRivi.,vDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page. l of I

FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page I_ of I
Did the application rates exceed the limits in Attachment B of your permit?
❑X Compliant ❑ Non -Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites? ❑X Compliant ❑ Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit? ❑X Compliant ❑ Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site? ❑X Compliant ❑ Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? ❑X 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: 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
10-16-2023
10-16-2023
Signatke Date
Signatur 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 signtficant
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