WQ0005150_Monitoring - 09-2016_20161028 (2)

FORM: NDMR 08-11 NON -DISCHARGE MONITORING REPORT (NDMR) Page of
Permit No.: WQ0005150
Facility Name: North End Elementary
County: Person-•
- •-
1
11Flow
Measuring '. ElInfluent OlEffluent E]No flow generated. . •. ■ 0 ■ . ■
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FORM: NDMR 08-11
Sampling Person(s)
Name: Paul J. Phillips
Name: Chris B. Clayton
NON -DISCHARGE MONITORING REPORT (NDMR)
Name: Pace Analytical
Name:
Certified Laboratories
Page of
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? Elcompliant ❑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 n
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Paul J. Phillips
Permittee: Danny Holloman
Certification No.: 986029
Signing official: Danny Holloman
Grade: SI Phone Number: 336-599-0223
Signing Officials Title: Superientendent
Has the ORC changed since the previous NDMR? ❑yes [2]No
Phone Number: 336- 599-0223 Permit Expiration: 5/31/2020
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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 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 property gathered and evaluated the information
submitted.
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

FORM: NDMR 08-11 NON -DISCHARGE MONITORING REPORT (NDMR) Page of
Permit No.: WQ0005150
Facility Name:
North End Elementary
County: Person-•
- •-
1
Flow Measuring Point:
[]Influent E]Effluent E]No flow generated
Parameter Monitoring Point: FlInfluent [21Effluent DGroundwater Lowering ElSurface Water
•
•

FORM: NDMR 08-11 NON -DISCHARGE MONITORING REPORT (NDMR) Page of
Sampling Person(s)
Name: Paul J. Phillips
Name: Chris B. Clayton
Name: Pace Analytical
Name:
Certified Laboratories
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? E]Compliant ❑Nan -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 n
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Paul J. Phillips
Permittee: Danny Holloman
Certification No.: 986029
Signing Official: Danny Holloman
Grade: , SI Phone Number: 336-599-0223
Signing Official's Title: Superientendent
Has the ORC changed since the previous NDMR? ❑Yes ❑� No
Phone Number: 336- 599-0223 Permit Expiration: 5/31/2020
ignature Date
�ign ture Date
By this signature, I certify that 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 designed to assure that all qualified personnel properly gathered and evaluated the information
submitted.
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617