WQ0029289_Monitoring - 09-2016_20161024 (2)

FORM: NDMR 08-11 NON -DISCHARGE MONITORING REPORT (NDMR) Page I of 7
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FORM: NDMR 08-11
NON -DISCHARGE MONITORING REPORT (NDMR)
Sampling Persons) Certified Laboratories
Name: Emily Elmore Stephanie Gardella Name: Kinston Regional WRF Lab
Name: Raymond Tyndall Ben Overton Name: Environment 1, Inc
Page Z of� I
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
action(s) taken. Attach additional sheets if necessary.
Operator in Responsible Charge (ORC) Certification
ORC: Swindell Flowers, Jr
Certification No.: 990523
Grade: SI Phone Number: 252-939-3248
Has the ORC changed since the previous NDMR? ❑ yes ❑+ No
Permittee Certification
Permittee: City of Kinston, NC
Signing Official: Brian Lucas
Signing Official'sriitle: Kinston Water Resources Manager
Phone Number: 252-939-3316 Permit Expiration: 3/31/2020
t.Srgnature Date 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 signigcam 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