WQ0017791_Monitoring - 11-2020_20210105

-FORM: NDMR 05-16
NON -DISCHARGE MONITORING REPORT (NDMR)
Page of
Permit No.: WQ001 7791
Facility Name: Goldsboro WRF Reclaimed Water Project
County: Wayne
Month: November_____
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' FORM: NDMR 05-16 NON -DISCHARGE MONITORING REPORT (NDMR) Page of
Permit No.: WQ0017791
Facility Name: Goldsboro WRF Reclaimed Water Project
county: Wayne
Month: November
Year: 2020
PPI: 002
Flow Measuring Point: ❑Influent [2]Effluent ❑No flow generated
Parameter Monitoring Point: ❑Influent ❑Effluent ❑Groundwater Lowering ❑Surface water
Parameter Code 10
WQ01
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10
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21
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22
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23
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24
25
26
d
27
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28
LLI
29
30
31
Monthly Total:
0.00
Sampling Type:
Estimate
Monthly Limit:
Daily Limit:
Sample Frequency:
Monthly

FORM: NDMR 10-13
NON -DISCHARGE MONITORING REPORT (NDMR)
Page 3 of 3
Sampling Person(s) Certified Laboratories
Name: Operators Name: City of Goldsboro WRF Laboratory
Name: Name:
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 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 necessary.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Robert P. Sherman
Permittee: Goldsboro Water Reclamation Facility
Certification No.: 26362
Signing Official: Michael Wagner
Grade: SI Phone Number: [phone]
Signing Official's Title: Public Utilities Director
Has the ORC changed since the previous NDMR? ❑Yes ❑✓ No
Phone Number: [phone] Permit Expiration: 1/31/2026
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 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 imprisonment for
knowing violations.
Mail Original and Two Copies to:
Division of Water Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617