WQ0033325_Monitoring - 07-2024_20240731

Monitoring Report Submittal
.....................................................
Permit Number#* WQ0033325
Name of Facility:* Bladen County Water District - Tobermory
Month: * July Year: * 2024
Report Information
Type *
NDMR, NDAR-1, NDAR-2, NDMLR
Confirmation Email Address: *
Name of Submitter: *
Signature:
Date of submittal:
Initial Review
Upload Document*
TobermoryNMDRJuly2024.pdf 581.52KB
PDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
[e-mail]
Alan Edge
�lar 6 S�' *
Reviewer: Wanda.Gerald
7/31 /2024
This will be filled in automatically

Is the project number correct?* W00033325
Is the monitoring report accepted?* Yes NO
Regional Office* Fayetteville
Reviewer: _anonymous
Review Date: 8/14/2024

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page —1— e4
--171
Sampling Person(s)
'Jame: '414AJ � r.
s
Name:
Certified Laboratories
Name:
Name:
Doss aH monitoring daira and sampling fregaencc es meet the requirements in Attachment A of your permit? V5 pliant © Non-Cbmpuant .
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 Change (ORC) Certification
ORC: R1fpi
Certification No.: 7174 4 2-1173
(7-w&/I
Grade: e4Phone Number: 410 - 60f
Cle"T— M❑ res /sr
Has the ORC changed since the previous ND R? tie
MLIE
V
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
Permittee Certification
Permittee: 1314d,,,, CO. 1)et+L'ar' dV/sta1 L'I
Signing Official: 041AV t-Q e-
Signing Official's Titie: lolloepsc��O/%
PhoneUumber: q/0-4?4z-14-76 Permit Expiration-
- 3-2V
o V' j.L ui C Date
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 property 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 Bail Service Center
Raleigh, North Carolina 27699-1617

rORM: NOAR-1 08-11 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?
►Lrcmpliant El Non -Compliant
e/c.mpliant ❑ Non -Compliant
M/ .mpliant ❑ Non -Compliant
Y&rnpliant ❑ Non -Compliant
IJ 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 dates) 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: 414AI 6 1�5
Permittee:
Certification No.: 97(2 11?�?
Signing Official:
6-w&LI QQ®
Grade: j4- Phone Number: f{D - P6Z ` 4f 9i
Signing Official's Title:
Has the ORC changed since the previous NDAR-1? ❑ yes No
Phone Number: we ' Permit Exp.:
- :! 7
-z
Signature Bate
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 ail 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 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 of .,I.