NC0027103_Significant Non-Compliance Report (SNCR) Form-2001_20210413

Pretreatment Annual Report (PAR)
WWTP = Wastewater Treatment Plant, use separate form for each WWTP.
SIU = Significant Industrial User
SNC = Significant Non -Compliance
PAR covers this calendar year =>
Control Authority=Program=Town Name =>
WWTP Name =>
NPDES # =>
A SNCR Form must be submitted with every PAR, please write "None " if you had No SIUs in SNC during calendar year
IUP
#
Pipe
#
Industry Name
Parameter
or "Reporting"
SNC ? ( Yes / No )
for each 6-month period.
Jan. - June
July - Dec.
002
1
Steven Roberts
BOD Monthly Average
Yes
No
Attach a copy of the Division's "SIUs in SNC Historical Report" for your POTW's SIUs behind this page .
Is the database correct ? Notify the Division of any errors ! Database indicates SNC history for previous years.
EVERY SNC MUST be explained in the Narrative, How was, is, or will it be resolved?
REPEAT SNCs are serious matters that MUST be explained in the Narrative.
Form name: PAR,SNCR,2001
Date Revised: 1/4/2001

2020
Pembroke
Pembroke WWTP
NC0027103
Form name: PAR,SNCR,2001
Date Revised: 1/4/2001