HomeMy WebLinkAboutWQ0022224_Monitoring - 11-2016_20170103NON DISCHARGE WASTEWATER MONITORING REPORT
PERMRNUMBER: WQ0022224 MONTH:November YEAR: 2016
FACIIRY NpME: LII�IE CfCEk W8�8f RBG31112G011, Cley[Otl CouNiv: Johnston
Op�nmr In R�sponslbla Gharp� (00.C�: J3f11¢S WBffBf1 IV Phons: 97&5531538
G��ek Boz HORC Mu C�anpetl: ORC CMlflqtion NumWr: 7149
c.mi.a�eaman..ue EnvironmentOne (z):
Pmanp�Colbctinp �I4nwn CbtlnM�rtNl C�M1Nbn NY i. m
M�il ORIGINAL �nd TWO COPIES W� �/ �i
DENR �y %� ( NA E OF OPERATOR IN RESPONSIBLE CHARGE)
DIvltlonofWahr�ualily y4 ,_�`�/ ��SIGNATURE,ICERTIFYTHATTHISREPoRTISAGGURATE
ATTN: IMormetion Proe�uinp UnR ��� Q v (� AND COMPLETE TO TNE BEST OF MY KNOWLEDGE.
1877 Mail Sarvlca CeMar O
RALEIGH, NC 27899-7617 ��� �0
��
Z�
�
�
.,
NON DISCHARGE WASTEWATER MONITORING REPORT
FaciIIN Status:
Please anawer the following quastlon:
Com Ilant Y,N)
1. Does all monitoring dafa and sampling frequeneies meet permit requlrements? �V
Ii ihe facility is noncomoliant, please explain in the space below the reason(s) the faciliry was not in compliance
with its pertnit. Provide in your explanation Ne date(s) oi ihe non-compliance and describe the corrective action(s)
taken. Attach additional sheets if necessary.
"I certiTy, under penalty of law, that this document and all attachments were preparetl under my tlirec6on or
supervision in accordance with a system designed to assure that all qualifed personnel properly gathered and
evaluated the infortnation submittetl. Basetl on my inquiry of the person or persons who manage lhe system, or
those persons directly responsible tor gathering the information, the information submiked is, to ihe best ot my
knovAedpe and belief, true, accurale, anC complete. I am aware that there are significant penalties for submitting
false information, inGuding the possibility of fines and imprisonment for knowing violations"
L[{w�-(/ �o� � �2��°'�G ACam Lintlsay
(Slgnatu o ermktee Date (Name of Slgning Offietal-Pleasa print or type)
Adam Lindsay
(PermHNe-Please print or type)
PO Boz 8�9, Claylon NC 27528
(Permlttae Adtlress)
Town Manager
(Position or Title)
919-553-5002 9/30Y1020
(Phone Number) (Pertnit Exp. Date)
Pammalx CoEe msi6terwe may Do oE�abrotl by celAnp Me Watx OueGry LenO Appliwtlon Wrvt et (919) 7156189.
The manMy averepe for Fecal Coliform is to De reported as e GEOMETRIC mean. se anl i si na e i h rtin fauli s rmit for
reDonina tlete.
• If sipn�C ey ot�ar tnen tha parmitW, tlalpation o/ sipnatory sut�oriry must bs on flls with tha stnM v�r 15A NCAC 2B.o5o8 (Ej(]xD).