WQ0022523_Monitoring - 09-2016_20161101

FORM: NDMLR 05-16 NOWDISCHARGE MASS LOADING REPORT (NDMLR) Page of
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FORM; NDMLR,05-16 NON -DISCHARGE MASS LOADING REPORT (NDMLR) Page of"
Did the mass loading :rates exceed the limits In Attachment B of your permit? © compliant . ❑ Non-compliant
If 1hedaclBty Is non-compliant, please explain In the spaceUlow 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) taxen. Anson additional sheets It necessary.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Timothy Alan sugg
Permittee:
Jeff Turnage
Certification Number: SI -24668 WWA 24001
Signing Official:
Jeff Turnage
Grade:: 1 Phone Number,: 252=714-2398
Signing Official's Title: Owner
Has the iORC changed!since the previous NDMLR? ❑ Yes © No
Phone. No.: 252-717-0370 Permit Exp.: 3/30/16
Signature Date
Signature Date
By this slgnatur% I certify that this report Is eccurrate and complete to the hest of my knowledge.
der penalty of law, that this document and all attachtntts were prepared under rhy direction a supervision in
I certif7noevvIth
accord a system designed to assure that all qualified personnel properly gathered and evaluated the information
submitted. Based on my Inqulrycf the person or persons who manag the system, a those persons directly responsible fa
gathering the information, the Information submitted is, to the best ofr�y ImrnMedge and belief, true, accurate and complete.
I am awarethat there aresignificant penalties for submitting falsd information. Including the possibility of fines end
imprisonment for kno Mng violations.
Mail Original and Two Copies to:
Division of Water Resources
Information Processing Unit
1617Bail Service:Center
Raleigh, North Carolina 27699-1617