WQ0006254_Monitoring - 04-2021_20210601

Monitoring Report Submittal
............................................................................................................................................
Permit Number #* WQ0006254
Name of Facility:*
Month:* April
Report Information
Corolla Light WWTP #1
Type *
NDMR, NDAR-1, NDAR-2, NDMLR
Confirmation Email Address:*
Name of Submitter:*
Signature:
Date of submittal:
Initial Review
Year:* 2021
Upload Document*
CL NDMR and NDAR-2 6.84MB
Reports APR21 Signed.pdf
IPDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
[e-mail]
Travis Tucker
p�" 11 �'Y, 9ut
Reviewer: Williams, Kendall N
6/1 /2021
This will be filled in automatically

Is the project number correct?* WQ0006254
Is the monitoring report t: Yes r No
accepted?*
Regional Office* Washington
Accepted Date: 6/3/2021

FORM: NDlVIR 05-16
NON -DISCHARGE MONITORING REPORT (NDMR)
of
Permit No.: W� �� � Valli 11 r e: �r � f �. � � �1�" � � f Currituck Month. April Year: 2021
P P I` 001 Flowea urig Point: influent Effluent w generated Parameter Monitoring Po*n;influent
Groundwater
yyy +y Lowering
Surface Water
Parameter Code - 5.6' 00310
V bloom
a C
b�
*"�' .. a
LL 4V 41141W MW =6 S Z 2 0 0 CL
co :E 4 IUL 14 Z 4W 1..., 0
.. �.�
0 CL
Fool
24-hr hrs GpD m g/L mg/L. m g/L Mg/L, #/100 m L' MgIL mg/L
g L /L L
WIN
6
10
13
14 lm
1
18
No
19
17
1
2
6AW.A.-
231
25
24
2
28
29
3
31
Average: 4DIV101..
Daily Maximum, .0
DailyMinimum: .0
-mom om
Sampling Typen Recorder Composite Composite Corte site Grab Grab Composite Composite Composite ComposN e Gra b C 'i l Composite Composite
Monthly Limit: 160000 10 14 4
Daily Limit: 3 6-9
Sample Frequency: Clonti-nuous See Permit X Year 3 X Year 5 X Week See Permit '

FORM: NDMR05-16 NON -DISCHARGE MONITORING REPORT (NDMR) Page _of _
Sampling Person(s) 11 Certified Laboratories
Name: Travis Tucker 11 Name: Environmental Chemists Inc. - Lab Certification #37729; DWQ #94
Name: 11 Name: Carolina Water Service of NC Inc. Eastern Region #5162
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit?
2 Compliant ❑Nan-Campiiant
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.
On September 21, 2420 at 12:25, all flow started being redirected to Monteray Shores WVIiTP (W00009772). In October 2020, wastewater in tanks transferred to Manfieray Shires VI1V1tTP and contractors
cleaned tanks. Main power disconnected on October 27, 2020 and the last dad operations staff was onsite was October 28, 2024.
Operator in Responsible Chart C Certification Perm ittee Certification
ORC: Travis Tucker Permittee: Carolina Water Service of North Carolina Inc.
Certification No.* 1002180 Signing official: Dana Hill
Grade: 4 Phone Number: 252-256-1190 signing Official's Title: Regional Manager
Has the ORC changed since the previous NDMR? Yes No Phone Number: 252-269-2540 Permit Expiration: 10/31/2021
Digitally signed by Dana Hill
DN: C=US, O=CWSNC, CN=Dana Hill, E=[e-mail]
Reason: I am the author of this document
ana Location: your signing location here
Date:2021.06.01 07:45:10-04'00'
Foxit PhantomPDF Version: 10.1.3
Signature Date signature Date
D H 11
By this signature, l certify that this report is accurrate and complete to the best of my knowledge. l cer#ffy, under penalty of law, that this document and all attachments ents were prepared under my direction or supervision in
accordance With a system designed to assure that all quafffied 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. l am
aware that there are significant penalties for submKting false information, including the possi ifity of fines and impdsonrnent for
mowing violations
Mai! Original and Two Copies to:
Division of Water Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

FORM: A-2 5- 1 6
NON -DISCHARGE APPLICATION REPORT (NDARw2)
ME
f
Permit No.,: WQ0006254 Facility Name.. Corolla Light WW # Count ; Currituck April Year. 2021
Did infiltration occur at Site Name.,-'
� Sie rune. ietr 2 .-Sim SP�Y SiteLP
this facility?
:. Area (acres):, 0.18 Area (acres): 0.18 Area (acres):..Area(acres):.0.18
E] YES NO
Rate(GPD�5.09. Rate Rats G 5.
(GPD.
Weather Freeboard Site Infiltrated? YES NO Site Infiltrated?
Ism, 0
• „ . ".`"
30
ID T 7E
E w E 0 02 C 0
dipIM 1010
ftmm$ 40M VMMVP
ww" E 0 440w VEW 0 E 0 0
16. E CL E U) MMMMM` r: -0
,- 0..
in fitGPD/fe - ft gal min GPD ft Min GPD1f1? ft gal min
2
3
4P.-..* R, P v P1 . . ....
5
Rr....
8
7
10
12
131
16
.
A PF
9P pp... Ip
bm P
23
241
22
261
27
28_Aft IM'
29
____M W.
Monthly Ling (GP #! #D1 V/O!
0.00
Year to Date Loath GPD/ft t 8 008 7.63

FORM: NDAR-2 05-16 NON -DISCHARGE APPLICATION REPO (NDAR.,2) Page ` of
Did the application rates exceed the limits in Attachment B of your permit?
If not a basin, were the sites kept free of vegetation and raked?
If not a basin, were there any instances of effluent ponding in or runoff from the sites?
If a basin, were there any instances of breakout from the berms?
Was the onsite automatically activated standby power source tested and operational ?
E Compliant ❑Non -Compliant
[A Compliant ❑Nan -Compliant
El Compliant ❑ Non-CompEiant
M Compliant D Non -Compliant
Compliant [I Non -Compliant
-If the facility is non -compliant, please explain in the apace below the reason(s) the facility was not in compliance. Provide 'in your explanation the date(s) of the non-compliance F
actions taken. Attach additional sheets if necessary.
Operator in Responsible Charge RC certification Perm iftee Certification
ORC: Travis Tucker Permittee: Carolina Water Service of North Carol'ina, Inc.
Certification No.: 1002180 IS g nip fiia: a Hill
Grade: 4 Phone Number: 252-256-1190 Signing Offiial' Titles Regional Manager
Has the ORC changed since the previous NDAR-2? 0 Yes No PhoneNumber: 252-269-2540 Permit Exp,,. 10/31/21
, Digitally signed by Dana Hill
DN: C=US, O=CWSNC, CN=Dana Hill, E=[e-mail]
} ' Reason: I am the author of this document
"} Al Dana Hill Location: your signing location here
Date: 2021.06.01 07:45:34-04 00
. Foxit PhantomPDF Version: 10.1.3
SignatureDate 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
Wth 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 gathe&g the information, the
information submitted is, to the best of my knowledge and belief, true, accurate, and complete. i am acre that there are significant
penalties for submitting false information, including the passibility of fines and implIsonme t for knowing violations.
Mail Original and Two Copies to.:
Division of Water Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 276994617