WQ0000061_11-2014 Monitoring Report_20141219

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FORM: NDMR 03-12
Sampling Person(s)
Name: Glenn Ross (CSX Transportation, Inc.)
Name: Mike Gregory (CSX Transportation, Inc.)
NON -DISCHARGE MONITORING REPORT (NDMR)
Certified Laboratories
Name: TestAmerica Laboratories
Name:
Page 2 of 2
Does all monitoring data.and sampling frequencies meet the requirements in Attachment A of your permit? ® Compliant ❑ Non -Compliant
If the facility is non -compliant, please explain in the space below 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 necessary.
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D ®R pRQG�S 1NC UNIT
INFORMR+11
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Michael Gregory
Permittee: CSX Transportation, Inc.
Certification No.: 985463
Signing Official: Carl A. Gerhardstein
Grade: 2 Phone Number: 910-205-6379
Signing Officials Title: AVP Health, Environment and Sustainability
Has the RC _hang d i e the previous NDMR? ❑ Yes 0 No
Phone b 904-366-4303 Permit Expiration: 7/31/2017
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Signature
Signature Date
By this signature, I certify that this report is accurate 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 supervisim 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 imprisonnent for
knowing violations. Y TY�1mg �m°-am-
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Caroline 27699-1617
DEC 19 2�;4
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FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page 1 of 2
,Permit No.: W0000061
'Facility Name: CSX Transportation Hamlet WWTF
County: Richmond
Month: November:
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