NC0034967_Regional Office Historical File Pre 2018 (57)

NO.: NCO034967
PERMIT VERSION: 4.0
PERMIT STATUS: Active
Carolina Glove Company
CLASS: WW-2
�� �'��VnUNTY: Alexander
OWNER NAME: Carolina Glove Company
ORC: Steve Brian Eades
ORC CERT NUMBER: 16860
GRADE: WW-4.
ORC HAS CHANGED: No
MAY 2 4 2017g
RECEIVED/NCDENR/DWR
eDMR PERIOD: 04-2017 (April 2017)
VERSION: 1.0
CENTRAL FILEJTATUS: Processed
-
DWR SECTION
MAY 3 2017
S PERMIT
AGILITY NAME
SAMPLING LOCATION: EFFLUENT DISCHARGE NO.: 001 NO DISCHARGE*: NJQROS
MOORESVILLE REGIONAL OFFICE
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0 rAC11NAUME:
T NO.: NCO034967
Carolina Glove Company
OWNER NAME: Carolina Glove Company
GRADE: W W-4.
eDMR PERIOD: 04-2017 (April 2017)
COMPLIANCE STATUS: Compliant
PERMIT VERSION: 4.0
CLASS: W W-2
ORC: Steve Brian Eades
ORC HAS CHANGED: No
VERSION: 1.0
CONTACT PHONE #: [phone]
PERMIT STATUS: Active
COUNTY: Alexander
ORC CERT NUMBER: 16860
STATUS: Processed
SUBMISSION DATE: 05/18/2017
05/18/2017
ORC/Certifier Signature: Steve Brian Eades E-Mail:[e-mail] Phone #:[phone] Date
By this signature, I certify that this report is accurate and complete to the best of my knowledge.
The permittee shall report to the Director or the appropriate Regional Office any noncompliance that potentially threatens public health or the environment.
Any information shall be provided orally within 24 hours from the time the permittee became aware of the circumstances. A written submission shall also be
provided within 5 days of the time the permittee becomes aware of the circumstances.
If the facility is noncompliant, please attach a list of corrective actions being taken and a time -table for improvements to be made as required by part II.E.6 of
the NPDES permit.
I [[ rr
i Caa l- 05/18/2017
Permittee/Submitter Signature:*** Rachel Bentley Mecimore E-Mail:[e-mail] Phone #:[phone] Date
Pemuttee Address: 140 Glove Mill Rd Taylorsville NC 28681 Permit Expiration Date: 03/31/2020
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 qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who managed 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.
CERTIFIED LABORATORIES
LAB NAME: Water Tech Labs Inc, R & A Laboratories, Taylorsville W WTP #5062
CERTIFIED LAB #: Water Tech Labs, R & A Labs, Taylorsville W WTP #5062
PERSON(s) COLLECTING SAMPLES: Brian Eades, Darrin Weaver, Warren Miller
PARAMETER CODES
Parameter Code assistance may be obtained by calling the NPDES Unit [phone] or by visiting http://portal.ncdenr.org/web/wq/swp/ps/npdes/forms.
FOOTNOTES
Use only units of measurement designated in the reporting facility's NPDES permit for reporting data.
* No Flow/Discharge From Site: Check this box if no discharge occurs and, as a result, there are no data to be entered for all of the parameters on the DMR
for entire monitoring period.
** ORC on Site?: ORC must visit facility and document visitation of facility as required per 15A NCAC 8G .0204.
*** Signature of Permittee: If signed by other than the permittee, then delegation of the signatory authority must be on file with the state per 15A NCAC 2B
.0506(b)(2)(D).