WQ0019782_Monitoring - 11-2020_20210122

FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page 1 of 2
Permit No.: WQ001 9782
Facility Name: YMCA -CAMP WEAVER
County: Guilford
Month: November
Year: 2020
Did irrigation occur
at this facility?
ED YES 0 NO
Field Name:
2
Area (acres):
0.3719
Area (acres):
0.4477
Cover Crop:
Natural Forest
C over Crop:
Natural Forest
...... . . . . . . . V
"YQ
Hourly Rate
te (in):
0. 4
Hourly Rate (in):
0.4
Annual Rate (in):
38.3
Weather
Freeboard
jw;
Field irrigated?
❑0 YES 2 NO
MINE
�.Q
115,11%
Field Irrigated?
9 YES 0 NO
Q
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lea IL
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12 Month Floating Total (in):
23.7934
17.95

FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page 2 of 2
Did the application rates exceed the limits in Attachment B of your permit?
o Compliant ❑ Non -Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites? 0 Compliant ❑ Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit? o Compliant ❑ Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site? o Compliant ❑ Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? o 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: Chip White
Permittee:
YMCA of Greensboro
Certification No.:
Signing Official: Rhonda Anderson
Grade: Phone Number: 252-235-4900
Signing Official's Title: President/CE0
Has the ORC changed since the previous NDAR-1? O Yes o No
Phone Number: Permit Exp.: 12/31/26
I
p
Signature I 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 property 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: NDMR 10-13 NON -DISCHARGE MONITORING REPORT (NDMR) Page 1 of
Permit No.: WQ0019782
Facility Name: YMCA -CAMP WEAVER
County: Guilford
Month: November
Year: 2020
PPI: 001
Flow Measuring Point: G Influent 0 Effluent ❑ No flow generated
Parameter Monitoring Point: O Influent m Effluent ❑ Groundwater Lowering 0 Surface water
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FORM: NDMR 10-13 NON -DISCHARGE MONITORING REPORT (NDMR) Page of
Sampling Person(s) Certified Laboratories
Name: Chip White Name: Statesville Analytical
Name: Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? G 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.
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
ed 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
Jle with the State about the missed visit on the 27th and 29th. The ORC went Saturday 10/31 to make up 1 day. ORC was in conversation with Mike Meilenger about the SSO occurring 10/28. ORC had to
out of town on that date in Norwood to handle the spill.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Chip White
Permittee: YMCA of Greensboro
Certification No.:
Signing Official: Rhonda Anderson
Grade: Phone Number: 252-235-4900
Signing Official's Title: President/CEO
Has the ORC changed since the previous NDMR? 0 Yes o No
Phone Number: Permit Expiration: 12/31 /2026
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