WQ0015068_Monitoring - 08-2022_20220912

r,',*,'FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) n Page I_ of
Permit No.: WQ001 5068
Facility Name: Rex WTP
County: Robeson
Month: August
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gam FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page .1 off
Sampling Person(s) Certified Laboratories
Name: Gary Davenport Name: Environment 1
Name: Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? [DCompliant ❑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: Gary Davenport
Permittee: Robeson County
Certification No.: 273.47
Signing Official: Gary Davenport
Grade: PC/1 Phone Number: [phone]
Signing Official's Title: Water Treatment Superintendent
Has the ORC changed since the previous NDMR? Elves FZ]No
Phone Number: [phone] Permit Expiration: Jan. 31, 2028
9/12/2022
9/12/2022
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