WQ0019782_Monitoring - 10-2020_20201130

FORM: NDMR 10-13 NON -DISCHARGE MONITORING REPORT (NDMR) Page 1 of 2
ermit No.: WQ0019782
Facility Name: YMCA -CAMP WEAVER
County: Guilford
Month: October
Year: 2020
PPI: 001
Flow Measuring Poin 9 Influent ❑Effluent O No flow generated
Parameter Monitoring Point: 0 Influent (B Effluent ❑ Groundwater Lowering ❑ Surface water
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FORM: NDMR 10-13 NON -DISCHARGE MONITORING REPORT (NDMR) Page 2 of 2
Sampling Person(s)
Name: Chip White
Name:
Name: Statesville Analytical
Name:
Certified Laboratories
Des all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? Q 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.
iw is "0" for 10/21. This is due to the deduct values being higher than the well values. This occurred due to people using more water at the areas where the deducts are located than the wells. One day was
>sed for the 5th week period due to David Burton of YMCA Camp Weaver contracting coronavirus. ORC Chip White was involved with a SSO at the Town of Norwood, NC. Chip White contacted Caitlin
udle with the State about the missed visit on the 27th and 29th. The ORC went Saturday 10131 to make up 1 day. ORC was in conversation with Mike Meilenger about the SSO occurring 10/28. ORC had to
y out of town on that date in Norwood to handle the spill_
Operator in Responsible Charge (ORC) Certification
Permittee Certification
RC: Chip White
Permittee: YMCA of Greensboro
artification No.:
Signing Official: Rhonda Anderson
rade: Phone Number: 252-235-4900
Signing Official's Title: President/CEO
as the ORC changed since the previou NDMR? ° Yes o No
Phone Number: Permit Expiration: 12/31/2026
Signature Date
v
Signature Date
By this signature, 1 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 Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page 1 of 2
PermitNo.: W00019782
Facility Name: YMCA -CAMP WEAVER
County: Guilford
Month: October
Year: 2020
Did irrigation occur
at this facility?
B YES ONO
Field Name:
2
®R
Field Name:
4
. . . . . .
67"MV
Area (acres):
0.3719
A.
Area (acres):
0A477
Cover Crop:
Natural Forest
22 010"'
09
Cover Crop:
Natural Forest
"k09 Fay?
Hourly Rate (in):
0.4
nnua ate n
Weather
Freeboard
WIN,'
Field Irrigated?
0 YES 91 NO
I
Field Irrigated?
13 YES 0 NO
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Monthly Loading:
0
0.00
47.729
3.93
12 Month Floating Total (in):
25.05E
8.81

FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page 2 of 2
I the application rates exceed the limits in Attachment B of your permit?
1@ Compliant ❑ Non -Compliant
.re adequate measures taken to prevent effluent ponding in or runoff from the sites? 0 Compliant 0 Non -Compliant
s a suitable vegetative cover maintained on all sites as specified in your permit? 2 Compliant ❑ Non -Compliant
+re all setbacks listed in your permit maintained for every application to each permitted site? G Compliant ❑ Non -Compliant
!re all freeboards maintained in accordance with the specified freeboard heights in your permit? 0 Compliant 0 Non -Compliant
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 I` Permittee Certification 1
Chip White Ispigning
ermittee: YMCA of Greensboro
tiftcation No.: Official: Rhonda Anderson
:de: Phone Number. 252-235-4900 11 Signing Officials Title: President/CEO
i the OR changed since the previous NDAR-1? ❑ Yes o No Phone Number: Permit Exp.: 12/31/26
1
Signature Date Signature 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 Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
4