HomeMy WebLinkAboutWQ0005233_Monitoring - 10-2016_20161121FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) , Page 1 of 2
Permit No.: 1111
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'FORM: NDMR 03-12
NOWDISCHARGE. MONITORING REPORT (NDMR),. Page' 2 of 2
Sampling Person(s) Certified• Laboratories
Name:. J. Clayton Name: • MCAS Cherry Point, NC 28533_
Name: Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit?„ n Compliant 0 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: Jeffrey Clayton
Permittee: U.S. Marine Corps Air Station; Cherry Point
Certification No.: 998515
Signing official: ' George W. Radford,
Grade: SI Phone Number, 252-466-5874
Signing Official's Title: By direction of the Commanding Officer
Has the ORC changed. since the previous NDMR? 0 _Yes -0 No
Phone Number: 252-466-4599 :' Permit Expiration: 7/31/2019,'
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11/14/2016
Signature .. Date ..
Sig ature 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 entand 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 otthe 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. 1 am
aware that.there are significant,penalties for submitting false information, including the possibility.of fines and imprisonment for
_
knowing violations.