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Home My WebLink AboutWQ0021289_Monitoring - 12-2020_20210201FORM: NDMR 08-11 NON -DISCHARGE MONITORING REPORT (NDMR) Page I of Permit No.: WQ0021289 Facility Name: Town of • • WWTP County: Perquimans Month:December1 1 • • • . Monthly FORM: NDMR 08-11 NON -DISCHARGE MONITORING REPORT (NDMR) Page of Sampling Person(s) Certified Laboratories Name: Operators Name: Environment 1, Inc. Name: Name: Town of Hertford WWTP Laboratory Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? o 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: Charles A. Jones, Jr. Permittee: Town of Hertford Certification No.: 985305 / 993143 Signing Official: Pamela Hurdle Grade: IV / SI Phone Number: 252.333.6948 Signing Officials Title: Town Manager Has the O changed since the previous NDMR? ❑ Yes 0 No Phone Number: 252.426.1969 Permit Expiration: 12/31/2019 SdInature 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 Quality Information Processing Unit 1617 Mail Service Center Raleigh, North Carolina 27699-1617 FORM: NDMR 08-11 NON -DISCHARGE MONITORING REPORT (NDMR) Page 3 of`� Permit No.: WQ0021289 Facility Name: Town of • • - • - - •- December 1 1 11 •. ■ ■ ■ . . ■ ■ ■ . . ■ Parameter Code __P • • .. .. FORM: NDMR 08-11 NON -DISCHARGE MONITORING REPORT (NDMR) Page _�,_ of Sampling Person(s) Certified Laboratories Name: Operators Name: Environment 1, Inc. Name: Name: Town of Hertford WWTP Laboratory Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? O 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: Charles A. Jones, Jr. Permittee: Town of Hertford Certification No.: 985305 / 993143 Signing official: Pamela Hurdle Grade: IV / SI Phone Number: 252.333.6948 Signing Officials Title: Town Manager Has the 0 7changed since the previous NDMR? E-1 yes ElNo cj Phone Number: 252.426.1969 Permit Expiration: 12/31/2019 " "A __ ,,, . Z - ze I uJ�d& lZ ao it Sig ture 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 Quality Information Processing Unit 1617 Mail Service Center Raleigh, North Carolina 27699-1617