WQ0036557_Monitoring - 08-2016_20161004 (2)

PERMITJ,-TUMBER:
FACILITY NAME:
NON DISCHARGE WASTEWATER MONITORING REPORT Page
WQ0036557
Mark Miller
of
MONTH: August YEAR: 2016
COUNTY: Wake
•.
OR -MrVITTIRM. •.
••
Daily Rate
•ol
System
(Flow) intoMonthly
Total:•.
Phosphorus
Limit(s)
Operator in Responsible Charge (ORC): Cory Brantley Grade:
Check Box if ORC Has Changed: ORC Certification Number:
Certified Laboratories (1):
Person(s) Collecting Samples:
Mail ORIGINAL and TWO COPIES to:
DENR
Division of Water Quality
ATTN: Information Processing Unit
1617 Mail Service Center
RALEIGH, NC 27699-1617
(2):
SI Phone: [phone]
994484
(SIGNAL UR F OPERATOR IN RESPONSIBLE CHARGE)
BY THIS SI ATURE, I CERTIFY THAT THIS REPORT IS ACCURATE
AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
DENR FORM NDMR-1 (11/2005)

NON DISCHARGE WASTEWATER MONITORING REPORT
Facility Status:
Page of
Please answer the following question:
Compliant (V
1. Does all monitoring data and sampling frequencies meet permit requirements? OY
If the facility is non-compliant, please explain in the space below the reason(s) the facility was not in compliance
with its permit. Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s)
taken. Attach additional sheets if necessary.
"I certify, under penalty 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 complete. I am aware that there are significant penalties for submitting
false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee)* Date
Mark Miller
rmittee-Please print or type)
2025 Cadenza Lane
Raleigh, NC 27614
(Permittee Address)
Parameter Codes:
Cory Brantley
(Name of Signing Official -Please print or type)
Operator
(Position or Title)
252-478-3721
(Phone Number)
01002 Arsenic
31504 Coliform, Total
00600 Nitrogen, Total _
00929 Sodium
01022 Boron
00094 Conductivity
00630 NO2&NO3
00931 SAR
00310 BOD5
01042 Copper
00620 NO3
00745 Sulfide
01027 Cadmium
00300 Dissolved Oxygen
00556 Oil -Grease
70295 TDS
00916 Calcium
31616 Fecal Coliform
WQ09 PAN (Plant Available)
00010 Temperature
00940 Chloride
01051 Lead
00400 pH
00625 TKN
50060 Chlorine, Total
Residual
00927 Magnesium
71900 Mercury
32730 Phenols
00665 Phosphorus, Total
00680 TOC
00530 TSS/TSR
01034 Chromium
00610 NH3asN
00937 Potassium
00076 Turbidity
00340 COD
01067 Nickel
00545 Settleable Matter
01092 Zinc
Parameter Code assistance may be obtained by calling the Water Quality Land Application Unit at [phone].
10/31/2018
(Permit Exp. De
The monthly average for Fecal Coliform is to be reported as a GEOMETRIC mean. Use only the units designated in the reporting
facility's permit for reporting data.
* If signed by other than the permittee, delegation of signatory authority must be on file with the state per 15A NCAC 28.0506 (b)(2)(D).
DENR FORM NDMR-1 (11/2005)