WQ0006941_Monitoring - 05-2022_20220630

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DWR - NonDischarge Monitoring Report Submittal
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NORTH CAROLINA
E Mranmenlcl Quaffly
Monitoring Report Submittal
..............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................
Permit Number#* WQ0006941
Name of Facility:* Stoney Creek Elementary SChool
Month:* May Year:* 2022
Report Information
Type* Upload Document*
NDMR, NDAR-1, NDAR-2, NDMLR Stoney Creek_May.pdf 959.64KB
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:
jrddLuz,4
Date of submittal: 6/30/2022
This will be filled in automatically
Initial Review
.............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................
Reviewer: Gerald,Wanda

Is the project number correct?* WQ0006941
Is the monitoring report accepted?* Yes No
Regional Office* Winston-Salem
Reviewer: _anonymous
Review Date: 7/25/2022

FORM:NDMR 05-16 NON-DISCHARGE MONITORING REPORT(NDMR) Page_1_of_2_
Permit No.: WQ0006941 I Facility Name: Stoney Creek Elementary School I County: Caswell I Month: May I Year: 2022
PPI: 001 I Flow Measuring Point: I Parameter Monitoring Point:
Parameter Code --► ;50050 ; 00310 50060, 31616 00610.:.; 00625 •;00620 00600 00400-, 00665 00530
> E ar" E m _ t g c m
› :cE vc u. o o - O d _ E W
Q .. • z t vi .
24-hr hrs GPO. mglL mg1L::=: #1100 mL mglL : mglL mg/L mg/L .--su mglL mg1L'
1 , 1,210
2 10:07 0.25 1,210 0.14 6.5 ,
3 . .990.; ':
4 -990
5 99i) _ ,
6 990..
7 990?,.
8 990°
9. 990
10 990.:-
11 09:53 0.25 :?99Q,-. is �0.89_ ,', ,..:..6,4 -
12 -. ,137 .,.
'1 _ _ .
13 1;137': .,
14 1137...; r
15 ^r1,1 37.` is .- _ ..
16 1.137.;
17 .1,137
._ 6.4: - ,
18 13:09 0.25 • ,1,137_°;'= • 066, .,, .�_s :� �� > .r- � :>
19 1,084: i'=...,..: : s=
20 <1,084`. .
21 1,084
22 ;1,084::
23 =1,084 ._i :
24 1,084--,
25 1,084
26 09:44 0.25 .1,084;4: <2.0 , - 0 23„ 816 -..,.0.16,: II, 4.5 w :8.5 ..: 14.3 5,,,.6.5.;. 0.71 ;.61.4 `'
27 ''1,010 4 i ,
28 ,.1,010 _ - • .
29 1,010r.: :_:!
30 1,010,ti .11 _.4,, ,,a i„
31 .. 1,0101*'- . ` - ` ``,,.f{ ,:: '.v ..
Average: 1,Q65 _. 0.00 .•...Q;48.i,,: 816.00 - 016'=;'--. 4.50 8.50 14.30 0.71 61,40 ' -
Daily Maximum ;'l1 210 2.00 t0 69f,.. 816.00 .0.16 = 4.50 : 8.50" 14.30 '.`:6.50 .. 0.71 - 61:40.
Daily Minimum 1i-990l ;-"- 2.00 1014s;.. 816.00 :0.16s-: 4.50 -8.50. 14.30 s;6:90m -. 0.71 61.40u.•
Sampling Type: •,;,Estimate:''. Grab ..PG{abk? Grab .Grab.:;.;` Grab r....:Grab„: Grab w,,;Grab:. Grab '.,:,.:;,Grab,..;
Monthly Limit: 3,5Qp
:_:„
Daily Umit:
Sample Frequency: MOpthty-th: 3 X Year Weekly,- 3 X Year ;,3 X Years:, 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:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? IJ npliant ❑r ompliiant
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: Glenn Price Permittee: Baron Neal McDuffie(Authorized Agent)
Certification No.: 987931/20771 Signing Official: Baron Neal McDuffie
Grade: ll Phone Number. 336-996-2841 Signing Official's Title: Field Services Director(Pace Analytical)
Has the ORC changed since the previous NDMR? ❑Yes O No Phone Number: 336-996-2841 Permit Expiration: 8/31/2021
C 6
7.70-a
Signature Date Signal 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

FORM:NDAR-1 05-16 NON-DISCHARGE APPLICATION REPORT(NDAR-1) Page_2_of_2
Permit No.: WQ0006941 I Facility Name: Stoney Creek Elementary School J County: Caswell I Month: May Year: 2022
Field Name: : , 1> Field Name: Field Name: Field Name:
Did irrigation occur , Area(acres): 3.12 Area(acres): Area(acres): Area(acres):
at this facility? Cover Crop: ' Woods Cover Crop: Cover Crop: Cover Crop:
❑YES 9 NO -` Hourly Rate(in): .. :0.3 •.: Hourly Rate(in): Hourly Rate(in): Hourly Rate(in):
Annual Rate(in): • :18.72 • . : Annual Rate(in): Annual Rate(In): , . • Annual Rate(in):
Weather Freeboard Field Irrigated? 'D YES . :' .0 NO Field Irrigated? 0 YES 0 NO Field irrigated? ❑YES 0 NO Field Irrigated? ❑YES 0 NO
c 15). m •
mm C _� co 0 • d � c § =
m ti ga E an y, E . E . mm ', 2 Fc ,pa m1 ? ' E E d ' E ` c� E 0 0 E o 0 ' E " ' 0 E c Eo. am E ° E a- ap iti a iic ›.a a '° ° 0w0 , o o, m0 00
o A {r . ofs I- . of _ _ 'Q1- _ ~ = _ -It E N co > Q . 2. > d 2 > .e 2 , > Q _1 2
W W of
°F in ft ft gal min in .in gal min in in gal min in In gal min in in
1
2 PC 75 0 2.5
3
4
5 .
6
7
8
9
10
11 C 62 0 2.4
12
13 ,•. ..
14
15
16 ,._
17
18 C 80 0 2.4 i,
19
20 ,r
21
22 . ..
23 ..._
24 -
25 . . . .
26 CI 65 0 2.3
27
28
29
30
31
Monthly Loading: ; .: 0 / / •':0.00 /��/��/% 0 / / 0.00 / V 0 './ / 0.00 /�%���i, 0 / / 0.00 V
12 Month Floating Total(in):'/////////A :- 3.33 - // //7 .�J�//%' z.7. i.�///"/////r .�// /7/ /7

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? li ;iprtant 0 Non-Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites? liiitompliant ❑Non-Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit? 110ernpliant 0 Non-Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site? aiaSinpliant ❑Non-Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? �nmpriant ❑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 Codification
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 Official's Title: Field Services Director(Pace Analytical Services)
Has the ORC changed since the previous NDAR-1? ❑Yes t No Phone Number: 336-996-2841 Permit Exp.: 8/31/21
Signature Date Signal 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 directon or supervision in accordance
with a system designed to assure that ail 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 betlef,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.
Mall Original and Two Copies to:
Division of Water Resources
Information Processing Unit
1617 Mail Service Center
Raleigh,North Carolina 27699-1617

*FORM:NDMR 05-16 NON-DISCHARGE MONITORING REPORT(NDMR) Page_1_of_2_
Permit No.: WQ0006941 I Facility Name: Stoney Creek Elementary School I County: Caswell Month: I Year: 20 2-2_
PPI: 001 I Flow Measuring Point: J Parameter Monitoring Point:
Parameter Code —► 50050 00310 50060 31616 00610 00625 00620 00600 00400 00665 00530
C L N
OO E in
(3 3O '- h O O N Or in « Ol = teS .G
CO C •0
a E - r o O o ,4 o m E . oQ O. Q o a'
G � y co ~ u' = z F I- O � p7 co
r re oi CZ z c 0
0 re
O
a to
-
24-hr hrs GPD • mg/L mg/L #1100 mL mg/L mg!L mg!L mglL su mg1L mglL
2JO07 ,0.f,f 1Zto 0.ss4 to•5' .
3
5
7 rr J
8
9
10
11 04/5-3 0•2 - qqo o-r /0e4 .
12
13
14
15
16
17
18t301 .1-Z5- tt37 6.(p(0 (p,y
19
20
21
22
23
24 '
25
6 vq Y °'.1f" to5sy e2.0 04-3 ' I 6 , c,Ito 4. 5 $,S 19.3 to•$' 0-11 t,h
27
`(
26
29
30
31 /0/0
Average:
Daily Maximum:
Daily Minimum:
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:NDAR-1 05-16 NON-DISCHARGE APPLICATION REPORT(NDAR-1) Page_2 of_2
Permit No.: WQ0006941 , Facility Name: Stoney Creek Elementary School l County: Caswell Month: Aoii Year: 2.0 2Z.
Field Name: 1 Field Name:, Field Name: field Name:
Did irrigation occur
Area(acres): 3.12 Area(acres): Area(acres): Area(acres):
at this facility? Cover Crop: Woods Cover Crop: Cover Crop: Cover Crop:
0 YES 0 NO Hourly Rate(in): 0.3 Hourly Rate(in): Hourly Rate(in): Hourly Rate(in):
Annual Rate(in): 18.72 Annual Rate(in): Annual Rate(in): Annual Rate(in):
Weather Freeboard Field Irrigated?-0 YES IB No Field Irrigated? 0 YES 0 NO Field Irrigated? 0 YES 0 NO Field Irrigated? 0 YES ❑ NO
Ss
o• 0 o a, H o o 'c c0 E T co o) .0 d c, E Tot 0 a v 1� E'a cs m •c 'c c1 E a 0)
R V « l0 a t0 E Ci cl .0 7.. E F. C E w 0 .. ?+ E 3 ` E E 41 ct .. >. c g i c 0 e .2i T E 7 .- C
L o ° 5u 3a Ea eat Eo1 3a Ea . .E81 = a E & a1 y�. a.� � fl Ea E2, �
t V A a 0 0• 1- in 0 g = 0 0 a i- E 0 0 g = p a s 1- = 0 o i0 Z O 'o a 1- •E 0 o R = 0
m 0 no. > Q ,,.1 22 J .Td J 2 J > Q J 2 J .74 `'
0 .- J J
9 to
In 4
°F in ft ft gal min In In gal min in in gal min in in gal min in in
1
2 Pc 7r fi z.f
3
4
5
7 �� ��
s , rtsvt‘
9
10 ,
11 L tot 2df_
12 (
13
14
15
16
17
18C. ,0 pr Z.Li
19
20
21 .
22
23
24
25
26 G1 6< 50 2.
27
28 .
29
30
31
Monthly Loading: '*% v \l V/ r/ . V f��� fl %/
12 Month Floating Total(in): •5 4

Pace Analytical Services,LLC
1377 South Park Drive
'aceAnalytical Kemersville,NC 27284
ww.pacelabs.com [phone]
Page 1 of 1
Laboratory Report
Caswell County Schools/Jerry Report Date: 06/07/2022
Caswell County Schools Date Received: 05/26/2022
P.O. Box 160
Yanceyville, NC 27379
Project: Stoney Creek Elementary
Pace Project No.:92606523
Sample: Effluent Lab ID: 92606523001 Collected: 05/26/22 10:32 Matrix: Water
Method Parameters Results Units Report Limit Analyzed Qualifiers
SM 2540D-2015 Total Suspended Solids 61.4 mg/L 17.2 05/31/22 21:45
EPA 353,2 Rev 2.0 1993 Nitrogen,NO2 plus NO3 9.8 mg/L 0.20 05/26/22 17:35
EPA 353.2 Rev 2.0 1993 Nitrogen,Nitrate 8.5 mg/L 0.20 05/26/22 17:35
SM 5210B-2016 BOD,5 day ND mg/L 2.0 06/01/22 16:46 B2
Colilert-18 Fecal Coliforms 816 MPN/100mL 1.0 05/27/22 11:17
TKN+NO3+NO2 Total Nitrogen 14.3 mg/L 0.040 06/07/22 09:10
Calculation
EPA 350.1 Rev 2.0 1993 Nitrogen,Ammonia 0.16 mg/L 0.10 05/28/22 17:35
EPA 351.2 Rev 2.0 1993 Nitrogen,Kjeldahl,Total 4.5 mg/L 0.50 06/03/22 04:24
EPA 365.1 Rev 2.0 1993 Phosphorus 0.71 mg/L 0.050 06/01/22 15:56
ANALYTE QUALIFIERS
B2 Oxygen usage is less than 2.0 for all dilutions set. The reported value is an estimated less than value and is calculated
for the dilution using the most amount of sample.
Reviewed by: �9/acgl&
Stephanie Knott
704-977-0981
Stephan [e-mail]
Pace Analytical Services Asheville
2225 Riverside Drive,Asheville,NC 28804 South Carolina Laboratory ID:99030
Florida/NELAP Certification#:E87648 South Carolina Certification#:99030001
North Carolina Drinking Water Certification#:37712 VirginiaNELAP Certification#:460222
North Carolina Wastewater Certification#:40
Pace Analytical Services Eden
205 East Meadow Road Suite A,Eden,NC 27288 North Carolina Wastewater Certification#:633
North Carolina Drinking Water Certification#:37738 VirginiaNELAP Certification#:460025
Page 1 of 3

CHAIN-OF-CUSTODY Analytical Request Document • lABU5EONLY•afflxworkaraMT„La W(1 : g2606523 '
ace Analytical
/ Chain-of-Custody Is a LEGAL DOCUMENT•Complete all relevent fields
Company: Stoney Creek Elementary Billing Information: ALL SHADED AREI 111111 111111 1111111 Ill
Address: Container Preservative Type•• 92606523
u12Ie 1 11 1 [ 1
Report To: Email To: ••Preservative Types:(1)nitric acid,(2)sulturic acid,(3)hydrochloric acid,(4)sodium hydroxide,(5)zinc acetate,
(Si methanol,(7)sodium bisulfate,(8)sodium thiosulfate,(9)hexane,(A)ascorbic acid,(B)ammonium sulfate,
Copy To: Site Collection Info/Address: (C)ammonium hydroxide,(D)TSP,(U)Unpreserved,(0)Other
Anayses Lab Profile/Line:
Customer Project Name/Number: State: County/City: Time Zone Collected: - Lab Sample Receipt Checklist:
/ ( (PT[ IMT( (CT ( (ET
Custody Seale Present/Intact YONA
Phone: Site/Facility ID#: Compliance Monitoring? custody Signatures Present Y NA
Email: ['Yes I )No Z collector Signature Present N NA
yyyy Y Bottles Intact N WA
Collettedy(print): Purchase Order# N: DW PWS ID#: Correct Rottles !IA
,,/���n — • Quote#: OW Location Code: Z sufficient volume N NA
CL61'[ , Q c.j samples Received on Ice N NA
Collected By Lsignatur ' Turnaround Date Required: Immediately Packed on Ice: 0 VOA - Neadepace Acceptable Y zr g
(l Z USDA Regulated Soils Y N
..-r/f ( )Yes [ )No - Samples in Holding Time xlryta NA
Sample Disposal: Rush: Field Filtered(if applicable): Z Residual chlorine Present Y N b
( I Dispose as appropriate [ I Return [ I Same Day [ I Next Day I I Yes I I No Cl Stripe:
I I Archive: ( 12 Day I )3 Day ( 14 Day ( 15 Day Sample pH Acceptable Y N
I (Hold: jEspedite charges Apply) Analysts: pH Strips:
CI: Sulfide Present Y N tom,
•Matrix Codes(Insert in Matrix box below):Drinking Water(DW),Ground Water(GW),Wastewater(WW), m Lead Acetate Strips:
Product(P),Soil/Solid(Si),Oil COL),Wipe(WP),Air(AR),Tissue ITS),Bioassay(B),Vapor(V),Other(0T) CO FCO LA8 USE ONLY:
Comp/ Collected(or Res If of I— Z
Lab Sample ti / Conmento:
Composite End
Customer Sample ID Matrix• Grab Composite CI [ins = UO
D to lime Date Time CO Z
Effluent \NW G 1- G/ZL '032 .4 X X x
•
Customer Remarks/Special Conditions/Possible Hazards: Type of Ice Used: (We Blue Dry None r `SHORT HOLDS PRESENT(<72 hours) N N/A Lab Sample Temperature Info:
Packing Material Used: Lab Tracking#: Temp Blank Received: N yA
—Caswell County Schools'• Therm ID#: ♦ -r L
Cooler 1 Temp Upon Receipt:b'•1-oC
Samples received via: Cooler 1 Therm Corr.Factor: 0 oC
Radchem sample(s)screened(<500 cpm): Y N NA FEDEX UPS Client Courier Pace Courier Cooler 1 Corrected Temp: S. 2oC
Relinquished b /Compan :(Signature) ç /l, : r R ' d by/Compan':(Signature) Date/Time: MTlL LAB USE ONLY Comments:
�--C o SA,17/bL I OS D Table#:
Acctnum:
R squished by Company:(Signature Date/Time: Received by/Co ny:( nature) Date/Time:
� Template: Trip Blank Received: Y N NA
m
hi Prelogln: HCL McOH T P Other
Rt6nquished by/Company:(Signature) Daterime: Received by/Company:(Signature) Date/Time: PM:to Non Conformance(s): I Page:
! IPB: YES / NO l of: __`�

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