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Home My WebLink AboutWQ0038171_Monitoring - 06-2020_20200706FORM NOMR 05-16 NON -DISCHARGE MONITORING REPORT (NDMR) Page of Permit No.: III3 8171 Facility Name: Town of Boone Jimmy Smith VVWTP County:._ - 1 1 -- .. - � • • r • u . VAFAV � 1WALA�JFAUU m �� r•-�■ �r��r��rs-. ire �►. �� Permit No.: WQ0038171 Facility Name: Town of Boone Jimmy Smith WWTP County. Watauga Month: June Year: 2020 t 0 . •11151 11 ii 11 ill 1111111111111111- m ® A �Iwi LIB` m�� .. D- FORM, NDMR 05-16 NON -DISCHARGE MONITORING REPORT (NDMR) Page of Sampling Person(5) 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 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: 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 ND ? Eyes ❑� No Phone Number: 828-268-6271 Permit Expiration: 7/31/2021 � Signature Date Signature hate By this signature. I certify that this report is accurrate and complete to the best of my knowledge I certify, under penaity of law, that this document and ah attachments were prepared under my direction or supervision in accordance with a system designed 10 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 fcr 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 penailies for submitting false information, including the possibility of fines and imprisonment for knowing vtolahons. Mail Original and Two Copies to: Division of Water Resources Information Processing Unit 1617 Mail Service Center Raleigh, North Carolina 27699-1617