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FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Pon. .
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FORM: '-'IR 03-12 NON -DISCHARGE MONF""RING REPORT (NDMR) Page
Sampling Person(s)
Name: IRVIN W. EDWARDS, JR.
Name:
Certified Laboratories
Name: ENVIRONMENTAL CHEMISTS, INC.
Name:
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
Permittee Certification
ORC: IRVIN W. EDWARDS, JR.
Permittee: JENNETT'S PIER
Certification No.: 9337
Signing Official: MICHAEL P: REMIGE
Grade: 4 Phone Number: 252-305-6956
Signing Official's Title: GENERAL MANAGER
Has the ORC changed since the previous NDMR? 1771Yes E]No
Phone Number: 252-255-1501 Permit Expiration: 2/28/2019
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10/22/2018
C 10/22/2018
Signature, Date
Sign re 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 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 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, North Carolina 27699-1617
3 FORM: NDAR-2 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-2) Pana „f
FORM:. ' R-2 08-11 NON -DISCHARGE APPL�
I . m' TION REPORT (NDAR-2) Page , �f
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Did the application rates exceed the limits in Attachment B of your permit? ❑r Compliant ❑Non -Compliant
If not a basin, were the sites kept free of vegetation and raked? []Compliant ❑Non-Compllant
If not a basin, were there any instances of effluent ponding in or runoff from the sites? ❑Compliant ❑Non -Compliant
If a basin, were there any instances of breakout from the berms? [2]Compliant ❑Nan -Compliant
Was the onsite automatically activated standby power source tested and operational? [OCompfiant ❑Non-Compiiant
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
taken. Attach additional sheets If necessary.
a
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: IRVIN W. EDWARDS, JR.
Permittee:
JENNETT'S PIER
Certification No.: 9337
Signing Official:' MICHAEL P. REMIGE
Grade: 4 Phone Number: 252-305-6956
Signing Official's Title: GENERAL MANGER
Has the ORC changed since the previous NDAR-2? ❑Yes QNo
Phone Number: 252-255-1501 Permit Exp.: FEBRUARY 28,2019
W 10/22/18
r fil�,AWL A-1h..0 �7 10/22/18
Signature Date
Signrd re 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 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
Infor ation 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, North Carolina 27699-1617