WQ0029169_Monitoring - 02-2023_20230306

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page of
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Facility Name: Town of • Olive Reclamation
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FORM: NDMR 03-12 NON -DISCHARGE MONITORIIIO REPORT (NDMR) Page of
Sampling Person(s) Certified Laboratories
Name: Plant Staff 11 Mcnio: Town of Mount Olive Lab
Name: p Name: Environmental Chemists Inc
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If the facility is non -compliant, pierlsra eyplaln in the space below the reasons) the fncilihr was not in compliance. Provide in your explanation the date(s) of the non-compliance and describe the corrective
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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
!alas the ORC changed since the previous NI7MR? OYes ❑� No Phone Number: 919 658 9539 Permit Expiration: 3/31/2020
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Signature Date Signature _ Date
Bythls 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 bellef, 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 27699-1817