WQ0007217_Monitoring - 10-2016_20161121

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page 1 of 2
Permit No.: WQ0007217
Facility Name:
S. NAVAL FAC. ATLANTIC DIV., BT -11 '�
Couinty:
Carteret
Month:U. October
1
=-0
Parameter Monitoring Point:
Influent[:] Effluent E] Groundwater Lowering No Flow Generated
Daily Maximum:

FORM: NDMR 03-12 NON -DISCHARGE 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?:. E] Compliant I] 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.: 998.515
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? []:Yes No
Phone Number: 252-466-4599 Permit Expiration: 4/30/2016
°�I � a"a"�
/ ✓oC�-tel
11/14/2016
.0 C')4
Signature Date
S' nature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
I certify, under penalty of aw; the his docu nt and all attachments were prepared under my direction or supervision in
accordance with a system esigned 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 person's 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,
enter Raleigh, North Carolina 27699=1617