AMEND_05_Attach_(4)_54112_NVW_Hemenway_Harbor_Boat_Launch_DMR_Form_0005.docx
DOCX document 29 KB Posted
- Solicitation number
- 140P2024R0147
About this file
This document is a Discharge Monitoring Report (DMR) related to a temporary groundwater discharge permit for the Hemenway Harbor Boat Launch facility located in the Lake Mead National Recreation Area in Nevada. The permit is held by the National Park Service under permit number NVW-54112. The DMR provides details on the monitoring of various water quality parameters such as quantity, quality, and frequency of analysis at outfall 001 for the reporting period. It requires certification by the principal executive officer attesting to the accuracy and completeness of the information submitted. The related federal contract opportunity is for extending the public launch ramp at Hemenway Harbor, Lake Mead National Recreation Area, in Boulder City, Nevada. The solicitation number is 140P2024R0147 and the agency is the Department of the Interior National Park Service National Office.
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Text version
| PERMITTEE ADDRESS | STATE OF NEVADA TEMPORARY GROUNDWATER DISCHARGE | Form Approved |
| (Include Facility Name/Location if different) | DISCHARGE MONITORING REPORT (DMR) | OMB No. 2000-0015 |
| NAME: |
| National Park Service |
NVW-54112
| NA |
| Pg. 1 of __ |
| ADDRESS: |
| 601 Nevada Way |
PERMIT NUMBER
| REUSE SUPPLIER PERMIT NUMBER |
| NOTE: Read instructions before completing |
this form.
Boulder City, NV 89005
OUTFALL: 001
| MONITORING PERIOD |
| REPORTING QUARTER |
| FACILITY: |
| Hemenway Harbor Boat Launch |
| YEAR |
| MONTH |
| DAY |
| YEAR |
| MONTH |
| DAY |
| _________________, _____________ |
QUARTER YEAR
| LOCATION: |
| Lake Mead National Recreation Area, NV |
| From |
TO
PARAMETER
| QUANTITY OR LOADING |
| QUALITY OR CONCENTRATION |
| No. of Exceptions |
| Frequency of Analysis |
| Sample Type |
| 30-DAY AVERAGE |
| MAXIMUM |
| Units |
| MINIMUM |
| AVERAGE |
| MAXIMUM |
| Units |
Sample Measurement
Permit Requirement
Sample
Permit
Sample
Permit
Sample
Permit
Sample
Permit
Sample
Permit
Sample
Permit
Name/Title Principal Executive Officer (Typed or Printed)
| I certify under penalty of law that I have personally examined and am familiar with the information submitted herein; and based on my inquiry of those individuals immediately responsible for obtaining the information. I believe the submitted information is true, accurate and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment. See 18 U.S.C. §1001 and 33 U.S.C. §1319. (Penalties under these statutes may include fines up to $10,000 and/or maximum imprisonment of between 6 months and 5 years.) |
| Signature of Principal Executive |
Officer or Authorized Agent
| DATE: | |||
| , | |||
| Month | Day | Year |
Telephone No.:
COMMENT AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here)
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