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Home My WebLink AboutWQ0038171_Monitoring - 04-2020_20200514FORM: NDMR 05-16 NON -DISCHARGE MONITORING REPORT (NDMR) Page Permit No.: WQ0038171 Facility Name: Town of Boone Jimmy Smi th WWTP County: Watauga • • • o�� Sri ��v�w►�►�s�r�..r■�� .. FORM: NDMR 05-16 NON -DISCHARGE MONITORING REPORT (NDMR) Page Per -it No.: W00038171 Facility Name: Town of Boone Jimmy Smith WWTP County: Watauga • • • m m��w■��ww�■ w■� �w■�ww�� ■www� ■• I�ww�w= •, r l www �.'wr �r Irr. ��ww■w�� w■■w�� .. FORM: NDMR 05-16 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? ❑compliant ❑Non -compliant If the facility is non -compliant, please explain in the space below the reasons) the facility was not in compliance. Provide in your explanation the date(s) of the non-compliance and describe the corrective antinnrcl 4alran Gffvr-h o 4e4zfi., I -r,.,.-.r,- :f ....,...----.. Operator in Responsible Charge (ORC) Certification Permittee Certification ORC: Rudy Broschinski Permittee: Town of Boone Certification No.: 24084 Signing Official: Rudy Broschinski Grade: 4 Phone Number: 828-268-6271 Signing Official's Title: ORC Has the ORC changed since the previous NDMR? ❑Yes ENO Phone Number: 828-268-6271 Permit Expiration: 7/31/2021 Vf tv /Z L Signature / ate J signature ' Date l By this signature. I certify that this report is accurrate and complete to the best of my knowledge I cel 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 intormafion submitted Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathenng the information, the information submitted is, In 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