WQ0006941_Monitoring - 01-2023_20230228

Monitoring Report Submittal
....................................................
Permit Number#* WQ0006941
Name of Facility:* Stoney Creek Elementary School
Month: * January Year: * 2023
Report Information
Type* Upload Document*
NDMR, NDAR-1, NDAR-2, NDMLR Stoney Creek Elem_Jan.pdf 1.16MB
PDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
Confirmation Email Address: * Jessica. [e-mail]
Name of Submitter: * Jessica Mize
Signature:
je"&A lot
Date of submittal: 2/28/2023
This will be filled in automatically
Initial Review
Reviewer: Wanda.Gerald

Is the project number correct?* W00006941
Is the monitoring report accepted?* Yes NO
Regional Office* Winston-Salem
Reviewer: _anonymous
Review Date: 4/21/2023

FORM: NDMR 05-16 NON -DISCHARGE MONITORING REPORT (NDMR) Page _1_ of -2-
Permit No.: WQ0006941
Facility Name:
Stoney Creek Elementary School
County:
Caswell
Month: January
Year: 2023
PPI: 001
Flow Measuring Point:
Parameter Monitoring
Point:
Parameter Code
'60050",
00310
56060,..
31616
610-,:
00625
'00620
00600
00400.-,,.
00665
00630
E
o
0.2
C
0
B
0
CL
47!
C
LL 0
E_
E
-b
11 ,
0
I— &!
0
VY
it 0
0
2
z
z
0
0
IL
24-hr
hrs
:,,-GPD:
mg/L
mgj.,�
#1100 mL
mq(L
mg/L
mg&�.-
mg/L
SW
mg/L
mq&.�.
1
_1�625 t.
2
625
3
4
626
t::
5
11:46
0.25
0.01
61
7
8
959 i�
9
10
11.
09:33
0.25
1959`,�
'Q� 4
6.4
12
13
-1;3W
14
t--1136:
15
16
wt.
171
09:06
0.25
18
19
20
21
08-
tt:t,
22
231
241
25
11108.
26
08:20
0.25
023,
pt.
6.4,
t
V
27
'A=
28
.'t
29.
301
09:44
0.5
98.2
'�U"'10:'
168
2a;9,
89.6
0�4
Q
89.6
6A 4;:
7.9
178
�`
311
:tL
Average:
0
98.20
0,1&i'_a1
168.00
2190
89.60
"t 0.0Q­,,
89.60
7.90
00t 178.
Daily Maximum:
1j,301
98.20
'6137,;
168.00
23.90.
89.60
-.0.04
89.6 0
6.50"'
7.90
1-78.00
Daily Minimum:
98.20
�A0
'
168.00
23�00,, r:I
89.60
0.04
89.60
4UG.
7.90
:;10 78;­
Sampling Type:
EsUmale'
Grab
06V.T'
Grab
Grab':::
Grab
Grab
-.'Grab;'
Grab
Giab,
Monthly Limit
r :%600`
4
Daily Limit
I
Sample Frequency:
th'y;r%,*
„Monthly
3 X Year
ew6,9W.:7-
M�
�-�tj
3 X Year
-!3 X r',
Y,*,
3 X Year
Ye#r-
3 X Year
:t r I
�W,
3 X Year [�'tb,X
Y6

FORM: NDMR 05-16
NON -DISCHARGE MONITORING REPORT (NDMR)
Page
of
Sampling Person(s)
Name: Glenn Price
Name:
Certified Laboratories
Name: Pace Analytical Services
Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit?
❑ 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
66L0.11tD) Ldr V11. Y1Udtil dUWUU1141 Drnairl rl
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Glenn Price
Permittee: Baron Neal McDuffie ( Authorized Agent)
Certiflcation 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? ❑ Yes p No
Phone Number: 336-996-2841 Permit Expiration: 8/31/2021
Signature Date
Sig lure Date
By this signature, I certify that this report is accurate 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.: VVQ0006941
Facility Name: Stoney Creek Elementary School
County: Caswell
Month: January
Year: 2023
Did irrigation
Field Name:
1
Field Name:
Field Name:
Field Name:
occur
Area (acres):
3.12
Area (acres):
Area (acres):
Area (acres):
at this facility?
Cover Crop:
P�
Woods
Cover P�
Cover p�
CoverCro P:
YES r;o
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 L! No
Field Irrigated?
❑ YES ❑ NO
Field Irrigated?
YES _ NO
Field Irrigated?
YCS = N3
❑>
°
0
W
m
°
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o
.
, o
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w
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°F
in
ft
ftv
gal
min
in
in
gal
min
in
in
gal
min
in
in
gal
min
in
in
1
2
3
4
5
PC
49
0
2.6
6
7
8
9
10
11
C
38
0
2.6
12
13
14
15
16
17
R
40
1.1
2.3
18
19
20
21
22
23
24
25
26
C
44
0
2.1
27
28
29
30
CI
48
0
2.1
48,000
320
0,57
0.11
31
Monthly Loading:
1 48,000
0.57
0
0.00
0
0.00
0
0.00
12 Month Floating Total (in):
F
4.24

FORM: NDAR-1 05-16 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page _2_ of _2_
Did the application rates exceed the limits in Attachment B of your permit?
Were adequate measures taken to prevent effluent ponding in or runoff from the sites?
Ip6mpliant ❑ Non -Compliant
Compliant ❑ Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit? ISCompliant ❑ Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site? empliant ❑ Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? R 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.
IOperator in Responsible Charge (ORC) Certification 11 Permittee Certification I
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 0RC changed since the previous NDAR-17 ❑ Yes O No Phone Number: 336-996-2841 Permit Exp.: 8/31/21
z� -2 2S-- z
Signature Date gnature 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 possibitity 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

lacieAnalytical"
www.pacelabs=
Laboratory Report
Caswell County Schools /Jerry
Caswell County Schools
P.O. Box 160
Yanceyville, NC 27379
Project: Stoney Creek Elementary
Pace Project No.: 92649286
Pace Analytical Services, LLC
1377 South Park Drive
Kemersville, NC 27284
[phone]
Page 1 of 1
Report Date: 02/10/2023
Date Received: 01/30/2023
Sample: Effluent
Method
Parameters
Lab ID: 92649286001 Collected: 01/30/23 10:19 Matrix: Water
Results Units Report Limit Analyzed Qualifiers
SM 254OD-2015
Total Suspended Solids
178
mg/L
62.5
01/31/23 11:56
EPA 353.2 Rev 2.0 1993
Nitrogen, NO2 plus NO3
ND
mg/L
0.040
01131/23 15:39
EPA 353.2 Rev 2.0 1993
Nitrogen, Nitrate
ND
mg/L
0.040
01/31/23 15:39
SM 521OB-2016
BOD, 5 day
98.2
mg/L
2.0
02/05/23 12:04 R6
SM 9222D-2015
Fecal Coliforms
168
CFU/100 mL
1.0
01/31/23 14:37
TKN+NO3+NO2
Total Nitrogen
89.6
mg/L
0.040
02/10/23 17:54
Calculation
EPA 350.1 Rev 2.0 1993
Nitrogen, Ammonia
23.9
mg/L
0.50
02/07123 12:50
EPA 351.2 Rev 2.0 1993
Nitrogen, Kjeldahl, Total
89.6
mg/L
5.0
02/03/23 05:36
EPA365.1 Rev 2.01993
Phosphorus
7.9
mg/L
0.10
02/0712312:57 M1
ANALYTE QUALIFIERS
M1 Matrix spike recovery exceeded QC limits. Batch accepted based on laboratory control sample (LCS) recovery.
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
Florida/NELAP Certification #: E87648
North Carolina Drinking Water Certification #: 37712
North Carolina Wastewater Certification #: 40
Pace Analytical Services Eden
205 East Meadow Road Suite A, Eden, NC 27288
North Carolina Drinking Water Certification IP 37738
South Carolina Laboratory ID: 99030
South Carolina Certification #: 99030001
Virginia/VELAP Certification #: 460222
North Carolina Wastewater Certification #: 633
Virginia/VELAP Certification M 460025
Page 1 of 3

CHAIN -OF -CUSTODY Analytical Request Document
LAB USE ONLY Affix Workofdee/Login Label Here or List Pace Workorder.Number. or
... __
aceAnalytical
? '' Chain -of -Custody is a LEGAL DOCUMENT Complete all relevent fields
r v,,a, 1 WO . 92649286 sn
Company.Billing
Stoney Creek Elementary"
Information
_ -
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Address:
...
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2 92649286
•• PrescrvatiirETyper (1) nitric add, (2) sub...- _. ... .
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Email To: _ _ - -'.
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(6) methanot, (7) sodium bisulfate, (8 sodium thiosui te; 9 exam A ascorbic aci , B) ammonium swrase,
(C) ammonium hydroxide, (D) TSP, (U) Unpreserved, (0) Other
Copy To:
Site Collection Info/Address:
Anal
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Customer Project Name/Number:
State: County/City: Time Zone Collected:
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Compliance Monitoring?
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[ Yes [ ] No
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Collector Bgnatura Peaeat NA
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Correct BottTea !d NA
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Purchase Order #:
DW PWS 10 #:
Quote M.
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Z
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Sufficieoc Yaiurna N NA
Samples Received onIce N 11A
VOA eNpadm ce Aaao table -! Y N
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Turnaround Date Required:
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USDA &egulatei Soilep' N -x
I I Yes I I Na
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Baiaplas' la �Boldiag Tiiae 1rA
Residual Chloitae prevent sr
Sample Disposal:
Rush:
Field Filtered (if applicable):
( ) Dispose as appropriate (] Return
(] Same Day [ [ Next Day
[ I Yes ( ]No
Cl Stripo: ii
[ ) Archive:
[ )Hold
[ ] 2 Day [ ] 3 Day [ ) 4 Day [ ] S Day
(Expedite Charges Apply)
Analysis:
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pH Strips Z % S J i t% A
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LAB, [7B8 OtVLYi .
Lab 8a la
mp # 1 Coaaaeate:
`
-
` Matra Codes (Insert in Matrix box below). Drinking Water (DW), Ground Water (GW), Wastewater (WW),
Product (P), Soil/Solid (SL), Oil (OL), Wipe (WP), Air (AR), Tissue (TS), Bioassay (B), Vapor (V), Other (OT)
Customer Sample ID
Matrix'
Comp /
Grab
Collected (or
Composite Start)
Composite End
Res
CI
# of
Ctns
ate
Time
Date
Time
Effluent
WW
Customer Remarks / Special Conditions /Possible Hazards:
Type'of lie Used: Wet ' Buie Dry' None
SHORT
HOLDS
PRESENT
(<72'haurs).
: Y.` N N/A;
Lab Samp[$ Ter►lperature info.
emp'BlinkReive Y NA
Cooler 1 TempUpan Receipt_oC
Coojer 1 6le in Corr: Factor: " > ! 'oC
Coo[e ;l Co(pecled Temp: oC
Comments
PackingMaterlalUsed .:
LabTrdckingil ,
Radchem sample(e) screened (c50D"rpm) Y : N NA'
Sa mples received via .- -;'
ADE)(.: ' UPS :': CHent.-- Courier ' •Pace Courier .
Relinqu�d by/Co�pany: (Sign re
/
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IZ7,
Re " ed by/Company: (Signature)
Drn
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N
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num:
Template: Trip:BlankRecehred: Y. N NA .
Prelogln: HCL`' ° McOH TSP Other
PM: Non Conformance(s): Page:
Pe: YES / NO of:

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Page 3 of 3