WQ0005150_Monitoring - 11-2016_20161219 (2)

FORM: NDMR 08-11
NON -DISCHARGE MONITORING REPORT (NDMR)
Page --/—, of Z
Permit No.: WQ0005150
Facility Name: North End Elementary �
County: Person
Month: November
1TIM
Flow Measuring •. ■ p E]No flow generated Parameter Monitoring •. E:Iinfluent DEffluent ■ E]Surface water
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Daily,

FORM: NDMR 08-11
NON -DISCHARGE MONITORING REPORT (NDMR)
Sampling Person(s) Certified Laboratories
Name: Paul J. Phillips Name: Pace Analytical
Name: Chris B. Clayton Name:
Page G 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 Official's Title: Superientendent
Has the ORC changed since the previous NDMR? ❑Yes EjNo
Phone Number: 336- 599-0223 Permit Expiration:
5/31/2020
/2 /Z-
Superintendent oiS
�3
Signatu 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 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