WQ0000731_Monitoring - 10-2016_20161128

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page_(_ of 2_
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FbRM: NDMR 10-13 NON -DISCHARGE MONITORING REPORT (NDMR) Page _-Z of 2
Sampling Person(s) Certified Laboratories
Name: Gary Norton I Name: Enviromental Testing Solutions, Inc
Name: Richard McCrary II Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? I Gomphant ❑ 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
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Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Gary Norton
Permittee: Lake Toxaway Company
Certification No.: 21853
Signing Official: Scott McCall, by signatory authority
Grade: II Phone Number: 828-553-2990
Signing Official's Title: Broker, Lake Toxaway Company
Has the ORC changed since the previous NDMR? ❑ yes ❑ No
Phone Number: 828-966-426600 Permit Expiration: 10/31/2021
gnature Date
Signature Dale
By this signature, I certify that this report is accumate and complete to the best of my knowledge.
I certxy, 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 kno.4adge and belief, hue, acwrale, and complete. I am
aware Mal there are significant penalties for submitting false information, indudirg the possibliy, of fines and imprisonment for
knowing violations.
Mail Original and Two Copies to:
Division of Water Resources
Information Processing Unit
1617 Mall Service Center
Raleigh, North Carolina 27699-1617