WQ0029169_Monitoring - 06-2022_20220727

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page of
Permit No.: •11 • ••
Facility Name: Town of • Olive Reclamation
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FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page of
Sampling Person(s) 11 Certified Laboratories
N«nie: Plant Staff 11 rd _rno: Town of Mount Olive Lab
Name: 11 Name: Environmental Chemists Inc
,r°r �I' r �� ry�c t►r lsr4 r+"•tt ^^" T►�iP"t fif'n-��nrrr Cc me-r-!f Mr, 7rn,-VfF(--rnent n fn Attachment A of your Permit? [3compllant ONon-Compliant
If fhe 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
action(s) taken. Attach additional sheets if necessary.
JINO FLOW TO SYSTEN
Operator in Responsible Charge (ORC) Certification Permittee Certification
ORC: Glenn Holland Permittee: Town of Mount Olive
Certification No.: 27255 Signing Official: Jammie Royall
Grade: SI Phone Number: 919 658 6538 Signing Official's Title: Town Manager
Has the ORC changed since the previous NDMR? E]Yes FZ No Phone Number: 919 658 9539 Permit Expiration: 3/31/2020
7
Signature Date Signature _ Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge. I certify, under penalty of raw, 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 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 Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, north Carolina 27699-1617