WQ0000601_Monitoring - 05-2021_20210622

CSX] 500 Water StreetJ-275
Jacksonville, FL 32202-4422
Mow tomorrow moves
:-904-359-3691
Fax [phone]
Samuel Ross Samuel,_ross t@esx,eom
Director Environmental Field Services
June 22, 2021
NC Dept.-ofNatural Resources
Attn: Infonnation'Processing Unit
Division of Water Quality,
1611 Mail Service Center
.Raleigh; NC 27699-1617
Re: Non -Discharge itlonitoring Repart Submittal
CSX Transportation, Inc. Hamlet
Permit Number N%1Q000060 t
Dear Sir/Madam,
Attached is the completed self -monitoring report for the period ending in May 2021 for the facility at the above
referenced permitted location.
if you have any questions or comments, please do not hesitate to'contact me at-[phone].
Sincerely,
Samuel Ross
Attachments

500 V4later.Streot
Jacksonville. FL 32202
Plwne: [phone].
1 Mail: Nathan Goldmanrc cst.com
C ORFORAT ON
�NkrIIAN D. G01 NI N
Executive vice President &
Chief' Legal Officer
February 4, 2021
Mr. Samuel Ross
Director Environmental Field Services
CSX 'Transportation, Inc,
500 Water- Street, J-275
Jacksonville, FL 32202
Dear Mr. Ross,
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-certifickions. and such.other documents and papers as necessary to
assure compliance with environmental laws"and regulations
Accordingly, i hereby audiorize-you to sign the necessary environmental documents on.
"behalf of the Company to. carry out your work.
This -authorization is in addition to electronic agency permitting submissions currently in
effect.
Sincerely;
Nathan D. Goldman -
i

FORM: NDMR 65-16 NON -DISCHARGE MONITORING REPORT (NDMR) Page 7 of 2
C$X Transportation Hamlet WW"rF
M.,
EffluentName:
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FORM: NDMR 05-16
NON -DISCHARGE MONITORING REPORT (NDMR)
Page,2 of 2"
h
,Sampling Person(s) Certified Laboratories
Name: ' Name: 'Not applicable
Name: Name:
Does all monitoring. data and sampling frequencies meet the requirements in Attachment A of,your,permit? o Compliant o Non -Compliant.
If the -facility is non -compliant, please explain in'the space below reason(s) the facility was nof"in compliance. Provide in your explanation the date(s) of the non-compliance
and describe the corrective actions) 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?
Phone Number: 904-359-3691. Permit Expiration: 7/31/2023
17 Yes [a No.
6/22/2021
06/22/2021
Signa re Date
Signature Date
ay 1fils sl jnature, I eertlly lhdl this rbpon IsnpcurAi4 and camPlmo to tna best of my kno vledgo
I cartify, under penalty of taw,, that this docutneni and all,aliacdments were propnrad under my direction or suporvisfori In
accarifanco wilha system designed to ossuro lhat all qualified personnel proporly flalhered, andevaluated the lnlormation
_
submflied. eased an my inquiry, of the parson or persons vAfo manage the system, or those persons directly responsible for
gathering the information, the information submitted is, 10the best of my kriuMedge and belief„we;,accurale, and complete. I
-
am nvrara that marearesigniricMi pennides rorsubroindfntse inrommarion, including lhapossibitity of tines and imprisonment
for knotsing 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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Did the application rates exceed the limits in Attachment B .of your,permit?
m Compliant
13 Non -Compliant
If not a basin, were the sites kept free of vegetation and raked?
❑ Compliant
❑ Non -Compliant
If nova basin, were there any, instances of effluent ponds in or runoff from the sites?
❑Compliant
o Non:Compliant
If a basin, were there any instances of breakout from the berms?
to Compliant
o Non -Compliant
Was this onsite automatically activated standby power source tested and operational?
m 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
Signirig 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 m No
Phone Number: 904-359-3691 Permit Expiration: 7/31/2023
r'. ' 6/22/2021
06/22/2021
Date
Sig turNepon
Signature Date
By this signature. I certify trial this ecurat complete to the best of my knavledge
I cerfify, under penally of low, that this document and all attachments were prepared under my direction or supervision In
accordance with a systom designed to assure that all qualified personnel properly gathered and evaluated the Information
submittpd, Based an my inquiry of Ilia person or persons who manage the system, or lbose,persons directly responsible for
gathering the Information,,tho,information submitted is, to the best of my knowledge and belief, true, occumte„and compieto. I
am aware that there are significant penalties for submitting false information, Including the possibility of fines.and imprisonment
for knowing violations.
1