WQ0029169_Monitoring - 10-2023_20231128

Monitoring Report Submittal
...................................................
Permit Number#* WQ0029169
Name of Facility:* Town of Mount Olive
Month: * October Year: * 2023
Report Information
Type* Upload Document*
NDMR, NDAR-1, NDAR-2, NDMLR Reclaim Report Oct 2023.pdf 136.07KB
PDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
Confirmation Email Address: * [e-mail]
Name of Submitter: * Glenn Holland
Signature:
Date of submittal: 11/28/2023
This will be filled in automatically
Initial Review
Reviewer: Wanda.Gerald

Is the project number correct?* WQ0029169
Is the monitoring report accepted?* Yes No
Regional Office* Washington
Reviewer: _anonymous
Review Date: 11/29/2023

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page of
Sampling Person(s)
Name: Plant Staff
Name:
Certified Laboratories
Name: Town of Mount Olive
Name: Environmental Chemists Inc
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
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FLOW TO SYSTEM
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Glenn Holland
Permittee: Town of Mount Olive
Certification No.: 27255
Signing Official: Jammie Royall
Grade: Sl Phone Number: 919 658 6538
Signing Official's Title: Town Manager
Has the ORC changed since the previous NDMR? ❑Yes QNo
Phone Number: 919 658 9539 Permit Expiration: 11/30/2026
s
Sig ure 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

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