WQ0010034_Monitoring - 09-2016_20161004 (2)

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page __L of
Permit No.: 1111 11
- • -
- •September1
Flow Measuring '•
■ ■ No flow generated
Parameter Monitoring•.
ElInfluent D Effluent ■ E]Surface Water
•
s
u
NOW
Nam
©
e• /
-®-
1.
1. 1
nos
mwz��
[more
.
[more
1•
M
0 or -WIN
®iMonthly
Daily Maximum -
Sampling Type:
-®-
-®-�-
Avg. 1-imit:
Daily Limit.®-
-�-®-
-®-

FORM: NDMR 03-12
a�
NON -DISCHARGE MONITORING REPORT (NDMR) Page of
Sampling Person(s) Certified Laboratories
Name: Ronnie Huettmann Name: Environment 1 Inc
Name: Name:
.s all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? OCompliant El Non -Compliant
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 correctiu
acuonks) taKen. Anacn aoaitionai sneers Ir necessary.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Ronnie Huettmann
Permittee: Acre Station Meat Farm Inc
Certification No.: SI 15619 WW1 14983
Signing Official: Ronnie Huettmann
Grade: 1 Phone Number: 252-927-3489
Signing Official's Title: ORC'
Has the ORC changed since the previous NDMR? ❑Yes ONo S
Phone Number: 252-927-3489 Permit Expiration: 4/30/2019
/( 3 W
D /�
Signature Date
Sig ture 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