WQ0000601_Monitoring - 10-2022_20221121 (2)

Monitoring Report Submittal
Permit Number #*
Name of Facility:*
Month: * October
Report Information
WQ0000601
Hamlet Yard
Type *
NDMR, NDAR-1, NDAR-2, NDMLR
Confirmation Email Address:*
Name of Submitter: *
Signature:
Date of submittal:
Initial Review
Year:* 2022
Upload Document*
2022_10_WQ0000601 _Ha... 470.48KB
PDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
[e-mail]
Tiffanee Grumbly
P� WA �/
Reviewer: Gerald, Wanda
11 /21 /2022
This will be filled in automatically

Is the project number correct?* WQ0000601
Is the monitoring report accepted?* Yes No
Regional Office* Fayetteville
Reviewer: _anonymous
Review Date: 11/23/2022

Samuel Ross
Director Environmental Field
Services
NC Dept. of Natural Resources
Attn: Information Processing Unit
Division of Water Quality
1617 Mail Service Center
Raleigh, NC 27699-1617
Re: Non -Discharge Monitoring Report Submittal
CSX Transportation, Inc. Hamlet
Permit Number WO0000601
Dear Sir/Madam,
500 Water Street J-275
Jacksonville, FL 32202
[phone]
Fax [phone]
[e-mail]
November 21, 2022
Attached is the completed self -monitoring report for October 2022 for the above referenced location.
If you have any questions or comments, please do not hesitate to contact me at [phone].
Sincerely,
Samuel Ross
Attachments

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page 2 of 6
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Transportation -
. Richmond
. October
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11
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■ Influent 0 Effluent ■ Groundwater Lowering ■ Surface Water
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FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page 3 of 6
Sampling Person(s) Certified Laboratories
Name: Name:
Name: Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? 0 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.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Michael Gregory
Permittee: CSX Transportation, Inc.
Certification No.: 985463
Signing Official: Samuel Ross
Grade: 2 Phone Number: 910-205-6379
Signing Officials Title: Director Environmental Field Services
Has the ORC changed since the previous NDMR? ❑ Yes 0 No
Phone Number: 904-359-3691 Permit Expiration: 7/31/2023
{ 11/10/2022
s 11/21/202
Signa re Date
a 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 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
,j
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: NDAR-2 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-2) Page 4 of 6
Permit No.: •••••60
•
• infiltration occur atYES NO
this facility?
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FORM: NDAR-2 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-2) Page 5 of 6

FORM: NDAR-2 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-2) Page 6 of 6
Did the application rates exceed the limits in Attachment B of your permit? 0 Compliant ❑ Non -Compliant
If not a basin, were the sites kept free of vegetation and raked? N/A El Compliant ❑ Non -Compliant
If not a basin, were there any instances of effluent ponds in or runoff from the sites? N/A El Compliant ❑ Non -Compliant
If a basin, were there any instances of breakout from the berms? EZ Compliant ❑ Non -Compliant
Was this onsite automatically activated standby power source tested and operational? ❑� Compliant ❑ Non -Compliant
If the facility is non -compliant, please explain in the space below the reason(s) 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: Michael Gregory
Permittee: CSX Transportation, Inc.
Certification No.: 985463
Signing Official: Samuel Ross
Grade: 2 Phone Number: 910-205-6379
Signing Officials Title: Director Environmental Field Services
Has the O C changed since the previous NDAR-2? ❑ Yes 0 No
Phone Number: 904-359-3691 Permit Expiration: 7/31/2023
t 11 /10/2022
_-K ,
' _ p - c 11 /21 /2022
SigNtureX X Date
Signature Date
By this signature, I certify that this report i ccurat .- 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.

February 4, 2021
Mr. Samuel Ross
Director Environmental Field Services
CSX Transportation, Inc.
500 Water Street, J-275
Jacksonville, FL 32202
Dear Mr. Ross,
500 Water Street
Jacksonville, FL 32202
Phone: [phone]
C-Mail: Nathan Goldman c csx.com
NATHAN D. GOLDMAN
Executive Vice President &
Chief Legal Officer
You handle matters pertaining to compliance with Federal, State, and local environmental
laws and regulations. One of your responsibilities is preparing permit applications, variance
requests, report forms and certifications, and such other documents and papers as necessary to
assure compliance with environmental laws and regulations.
Accordingly, I hereby authorize you to sign the necessary environmental documents on
behalf of the Company to carry out your work.
effect.
This authorization is in addition to electronic agency permitting submissions currently in
Sincerely,
Nathan D. Goldman