WQ0038171_Monitoring - 03-2021_20210409

Monitoring Report Submittal
...........................................................................................................................................
Permit Number #* WQ0038171
Name of Facility:* Town of Boone WWTP
Month:* March Year:* 2021
Report Information
Type* Upload Document*
NDMR, NDAR-1, NDAR-2, NDMLR marchNDMR.pdf 1.23MB
PDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-t, NDAR-2, NDMLR, GW-59).
Confirmation Email Address:* [e-mail]
Name of Submitter:* Rudy Broschinski
Signature:
Date of submittal: 4/9/2021
This will be filled in autorratically
Initial Review
Reviewer: Williams, Kendall

Is the project number correct? * WQ0038171
Is the monitoring report r Yes r No
accepted?*
Regional Office * Winston-Salem
Accepted Date: 4/9/2021

FORM, NDMR 05-16 NON -DISCHARGE MONITORING REPORT (NDMR) Page of
Permit • «1138 171
Facility Name: Town of Boone •.Month:
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FORM NDMR 05-16 NON -DISCHARGE MONITORING REPORT (NDMR) Page
Permit No.: WQ0038171 Facility Name: Town of Boone Jimmy Smith VVWTP
County: Watauga
Mcnth: March
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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 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 it 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? Elves i]No
Phone Number: 828-268-6271 Permit Expiration: 7/31 /2D21
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Signature Date
By this signature, I certify Ihal 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 desigri to assure *al all qualified personnel properly gathered and evaluated the Information
submitted Based on my Enquiry of the person or persons who manage the system, or those persons directly responsible for
gathenng 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 mformalion, including the possibility of fines and impnsonmentfor
knowing violations
Mail Original and Two Copies to:
Division of Water Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617