WQ0006941_Monitoring - 09-2021_20211101

Monitoring Report Submittal
Permit Number #*
Name of Facility:*
Month: * September
Report Information
WQ0006941
Stoney Creek Elementary School
Year:* 2021
Type* Upload Document*
NDMR, NDAR-1, NDAR-2, NDMLR Stoney Creek_September.pdf 1.81MB
PDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
Confirmation Email Address:* [e-mail]
Name of Submitter: * Jessica Mize
Signature:
jwd rA lip
Date of submittal: 11/1/2021
This will be filled in automatically
Initial Review
Reviewer: Saunders, Erickson G

Is the project number correct?* WQ0006941
Is the monitoring report accepted?* Yes No
Regional Office* Winston-Salem
Accepted Date:
11 /10/2021

FORM: NDMR05-16 NON -DISCHARGE MONITORING REPORT (NDMR) Page_l_of_2_
Permit No.: WQ0006941
Facility Name: Stoney Creek Elementary School
County: Caswell
Month: September Year: 2021
PPk 001
Flow Measuring Point:
Parameter Monitoring Point:
Parameter Code 11.
50050
00310
50060
31616
00610
00625
00620
00600
00400
00665
00530
om
m
}
UQ H
m
E m
U C
O
°
LL
m
C
°
m
Q!U
E
V °
u- oQ
U
CIS_
C
°
E
Q
L N
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Y
ZO
o 2
z
=
Q
En
° Q
t
a
_13
'aIVC
QN t`NLP
o
qo
N
24-hr
hrs
GPD
mglL
mg1L
#1100 mL
mg1L
mg1L
mglL
mglL
su
mg1L
mglL
1
11739
0.25
1,103
0.61
6.5
2
762
3
762
4
762
5
752
61
1
762
7 1
762
8
762
9
762
10
09:52
0.25
762
0.&4
6.6
11
849
121
1
849
13
849
14
849
15
849
16
09:09
0.25
849
0.97
6.8
17
896
181
1 896
19
896
20
896
21
896
22
896
23
09:16
0.25
896
<0.01
6.6
241
1
908
25
908
26
908
27
908
28
0852
0-25
908
4.7
<0.0i
<1-0
53.7
54.4
<0.040
54.4
6.4
2.2
26.6
29
1,001
30
1
1,001
31
Average:
862
4.70
0.48
1.00
53.70
54.40
0.00
54,40
2.20
26.60
Daily Maximum:
1,103
4.70
0.97
1.00
53.70
54.40
0.04
54.40
6.80
2.20
26.60
Daily Minimum:
762
4.70
0.01
1.00
53.70
54.40
0.04
54.40
6.40
2.20
26.60
Sampling Type:
Estimate
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Monthly Limit:
3,500
Daily Limit:
Sample Frequency:
Monthly
3 X Year
Weekly
3 X Year
3 X Year
3 X Year
3 X Year
3 X Year
Weekly
3 X Year
3 X Year

FORM: NDMR 05-16 NON -DISCHARGE MONITORING REPORT (NDMR) Page of
Sampling Person(s)
Certified Laboratories
Name: Glenn Price Name: Pace Analytical Services
Name: Name:
Dees all mnnitnrinn data and samnlinn freeupncies mppt the reeuirempnts in Attachment A of veur nermit? 1510doMpliant O Non{omptlant
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
faKen. Anson actattional sneers a
Operator in Responsible Charge (ORC) Certification Permittee Certification
ORC: Glenn Price Permittee: Baron Neal McDuffie ( Authorized Agent)
Certification No.: 987931/20771 Signing Official: Baron Neal McDuffie
Grade: II Phone Number. 336-996-2841 Signing Official's Title: Field Services Director ( Pace Analytical )
Has the ORC changed since the previous NDMR? 0 Yes O No Phone Number. 336-996-2841 Permit Expiration: 8/31/2021
Signature Date
By this signature, I certify that this report is aecurrate and complete to the best of my knowledge.
Signature Date
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 05-16 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page _2_of_2_
Q111.941
Facility Name: Stoney Creek Elementary••l
County: Caswell
Month: SeptemberNUFTiRM
! irrigation
•
at this facility?
El YES DNO
Hourly Rate (in):
Hourly Rate (iny
Hourly Rate (in):
Annual Rate (in):
Annual Rate (in):
Annual Rate (in�'
Field Irrigated?
d •
3 ■
Field Irrigated?
• . •
m=MM
®
___
__
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----
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----
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-__Ems
_-
----
----
----
----
Loading:Monthly
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...
o
o , •.

FORM: NDAR-1 05-16 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of
Did the application rates exceed the limits in Attachment B of your permit?
9Compliant
❑ Non -Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites?
UoCi mpllant
❑ Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit?
Ja6mpliant
❑ Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site?
215mpfiant
❑ Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
eC npliant
❑ 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
Callen. ^uacn aaanionai sneets IT
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Glenn Price
Permittee:
Baron Neal McDuffie (Authorized Agent)
Certification No.: 987931 /20771
Signing Official: Baron Neal McDuffie
Grade: II Phone Number: 336-996-2741
Signing Officials Title: Field Services Director (Pace Analytical Services)
Has the ORC changed since the previous NDAR-1? ❑ Yes O No
Phone Number: 336-996-2841 Permit Exp.: 8/31 /21
Signature Date
Signatur 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, tore, 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

(�Ia'neAuditbcal
>r�paalatgeon
Laboratory Report
Caswell County Schools /Jerry
Caswell County Schools
P.O. Box 160
Yanceyville, NC 27379
Project: Stoney Creek Elem.
Pace Project No.: 92563694
Pace Analytical Services, LLC
1377 South Park Drive
Kemersville, NC 27284
[phone]
Page 1 of 1
Report Date: 10/11/2021
Date Received: 09/28/2021
Sample: Effluent Lab ID: 92563694001 Collected: 09/28/21 08:55 Matrix: Water
Method
Parameters
Results
Units
Report Limit
Analyzed
SM 254OD-2011
Total Suspended Solids
26.6
mg/L
8.6
09/29/21 17:12
EPA 353.2 Rev 2.0 1993
Nitrogen, Nitrate
ND
mg/L
0.040
09/28/21 18:08
SM 521OB-2011
BOD, 5 day
4.7
mg/L
2.0
10/04/21 09,47 R6
Colilert-18
Fecal Coliforms
NO
MPN/100mL
1.0
09/29/21 08:37
TKN+NO3+NO2
Total Nitrogen
54A
mg/L
0.52
10/11/21 17:42
Calculation
EPA 350.1 Rev 2.0 1993
Nitrogen, Ammonia
53.7
mg/L
2.5
10/08/21 13:34
EPA 351.2 Rev 2.0 1993
Nitrogen, Kjeldahl, Total
54A
mg1L
2.5
10/09/21 07:37
EPA 353.2 Rev 2.0 1993
Nitrogen, NO2 plus NO3
ND
mg/L
0.040
10/11/21 11:29
EPA 365.1 Rev 2.0 1993
Phosphorus
2.2
mg/L
0.050
10/08/21 20:26
ANALYTE QUALIFIERS
R6 The RPD between valid sample dilutions exceeded 30%.
Reviewed by:
Stephanie Knott
704-977-0981
[e-mail]
Pace Analytical Services Asheville
2225 Riverside Drive, Asheville, NC 28804
Flodda/NELAP Certification #: E87648
North Carolina Drinking Water Certification #: 37712
Pace Analytical Services Eden
205 East Meadow Road Suite A, Eden, NC 27288
North Carolina Drinking Water Certification #: 37738
North Carolina Wastewater Certification #: 40
South Carolina Certification #: 99030001
Virginia/VELAP Certification #: 460222
North Carolina Wastewater Certification #: 633
VirginiaNELAP Certification #: 460025
Qualifiers
Page 1 of 2

CHMN-OF C!]STODYAnalytical Requestbacd-rhik-`
d Chain -of y is a LEGAL DOCIJMU4T - Complete all relevent fields
Company: Billing Information
Stoney Creek Elementary
Address:
Re pc rt To: Email To.
Copy To: Site Collection InfolMdress:
I
GustomerProiectName/Number.
stave. County
Time Zone Collected.
/
fr [ ]PT[ IMT[ 1cr [ lEr
Phane:
Site/Facility ID M:
Compliance Monitoring?
Email:
[ 4'Yes [ ]NO
Collected B rint):
Purchase Order#: I
DW PWS IA A:
Quote t.
DW Location Code:
Colected By (si tore)
Turnaround Gate Required:
Immediately Packed an Ece:
[ ] Yes [ ] No
Sample Disposal:
Rush:
Field Filtered (if applicable):
f ) use as apP@Prine I 1 Return
[ 1 same Day [ ) Next Day
[ I Yes I ]NO
I 1 ArdtivC
1 ] 2 Day [ 13 Day [ ] 4 Day [ ] S Day
f I Md.
(Bpedit* x]—gmAppW
Anaiysig
• MaWX Codes (Insert in Matrix box below): DriltlRng Water (DW), Ground Water (GM, Wastewater (WW],
Product (P), Soil/Solid (SL), CHI (Ola, Wipe (WP), Air (AR), Tissue (i5), Bioassay (B), Vapor M, Other (OT)
CustomerSamplelo
ltllatrbt'
Camp J
Grab
Collected (or
Compositestart)
Composite End
Res
Cl
it of
Ctns
gate,
I Time
Date
I Time
5:
6
0. WO# ' 92563694
.:�:w moo.
COntainerPre,errative7 e"
92563694
" Preservative Types; (11 fthrk acid, m surfinic add, (3) hvur mnwnC goo, cal sndhzm hydroxide, (5) zinc aorta
(G) med,m,ol, (7) sodium Wsuftte,18J sodium thiewpate, l9) hexane, (A) mwrbic add, (Bl arra lum surfate, ...�
(C) ammonium hydroxde, (D)isp, (u) UriwesffwcL (D) Other
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