WQ0038171_Monitoring - 02-2020_20200528

FORM: NDMR 05-16 NON -DISCHARGE MONITORING REPORT (NDMR) Page of
Permit No.: W00038171 Facility Name: Town of Boone Jimmy Smith WWTP County: Watauga month: February Year: 2C20
PPI: n01 I Flow Mea5urinq Point: ❑influent PlEffluent ❑No Flow generated I Parameter Monitoring Point: ❑influent [2Effluent ❑Groundwater Lowering [_]Surface Water
Parameter Code 01
•
a �
•
- - . - • S
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FORM NDMR 05-16 NON -DISCHARGE MONITORING REPORT (NDMR) Page of
Permit No.: W00038171 I Facility Name: Town of Boone Jimmy Smith WWTP County: Watauga Month: February Year: 2020
PPI: 002 Flow Measuring Point: ❑Influent MEffluent ❑No Flow generated
Parameter Monitoring Point: ❑influent FlEffluent ❑Groundwater
t_owenng ❑Surface water
Parameter Code
WQ01
s
� O
2
'V
CD
E •—'
m Mr
U
0 O
24-hr hrs
Gallons
1
2
3
4
5
6
7
8
9
AA
10
11
77
12
13
.
14
15
1fi
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Average:
#DIV101
Daily Maximum:
0
Daily Minimum:
0
Sampling Type:
Fstimate
Monthly Limit:
Daily Limit:
___Ka­mnle Freauencv:1
Monthly I_

FORM NDMR 05-16 NON -DISCHARGE MONITORING REPORT (NDMR) Page of
Sampling Person(s) Certified Laboratories
Name: Name:
Name: 11 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 reason(s) the facility was not in compliance Provide in your explanation the date(s) of the non-compliance and describe the corrective
nrhnnfcl takan Attach additional sheets if necessary.
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 ONO Phone Number: 828-268-6271 Permit Expiration: 7/31/2021
Signature ate Signature Gate
By this signature. I certify that this report is accurrate and complete to the best of my knowledge I certify, under penally 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 compli t am
aware Fhat 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