WQ0006941_Monitoring - 08-2016_20160929 (2)

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NON -DISCHARGE WASTE WATER MONITORING REPORT
PERMIT NUMBER: W00006941 MONTH: August YEAR: 2016
FACILTTY NAME: Caswell County Schools/ Stoney Creek Elem. School COUNTY: Caswell
Operator in Responsible Charge (ORC): Steven Yarbrough Grade: H Phone: [phone]
Check Box if ORC Has Changed: 0
ORC Certification Number: 986612
Certified Laboratories (1): R & A Laboratories. Inc. (2):
Person(s) Collecting Samples: Steven Yarbrough
Mail ORIGINAL and Two COPIES to:
ATTN: Non -Discharge Compliance Unit X
DENR (SIGNATURE O k6PERATOR IN RESPONSIBLE CHARGE)
Division of Water Quality By this signature, I certify that this report is accurate and
1617 Mail Service Center complete to the best of my knowledge.
RALEIGH, NC 27699-1617
DENR Form NDAR-1 (5/2003)

NON DISCHARGE WASTEWATER MONITORING REPORT
FACILITY STATUS:
Please answer the following question: Com lian Y,N)
1. Does all monitoring data and sampling frequencies meet permit requirements?
If the facility is non-compliant, please explain in the space below the reason(s) the facility was not in compliance with its
permit. Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s) taken. Attach
additional sheets if necessary.
"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 a qualified personnel properly gather and evaluate 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 aur aware that there are significant
penal ' or bmitting fa e inf ation, including the possibility of fines and imprisonment for knowing violations."
t":e
James M. Cheshire
( gnae it eof Perm)* (Name of Signing Official -Please print or type)
ames M. Cheshire (Authorized Agent) President R & A Laboratories
(Permittee -Please print or type) (Position or Title)
P.O. Box 160 336-694-4116 06/30/2012
Yanceyville, NC 27329 (Phone Number) (Permit Exp. Date)
(Permittee Address)-
01002
ddress)
01002 Arsenic
01022 Boron
00310 BOD5
01027 Cadmium
00916 Calcium
00940 Chloride
50060 Chlorine, Total
Residual
01034 Chromium
00340 COD
31504
Coliform, Total
00094
Conductivity
01042
Copper
00300
Dissolved Oxygen
31616
Fecal Coliform
01051
Lead
00927
Magnesium
71900
Mercury
00610
NH3 as N
01067
Nickel
00600 Nitrogen, Total
00630 NO2 & NO3
00620 NO3
00556 Oil & Grease
W 09 PAN (Plant Available)
00400 pH
32730 Phenols
00665 Phosphorus, Total
00937 Potassium
00545 Settleable Matter
00929 Sodium
00931 SAR
00745 Sulfide
00515 TDS
00010 Temperature
00625 TKN
00680 TOC
00530 TSS/TSR
00076 Turbidi
01092 Zinc
Parameter Code assistance may be obtained by calling the Water Quality Compliance/Enforcement Unit at [phone], extension 529.
The monthly average for Fecal Coliform is to be reported as a GEOMETRIC mean. Use only units designated in the reporting
facility'spermit for reporting data.
* If signed by other than the Permittee, delegation of signatory authority must be on file with the state per 15A NCAC 2B.0506 (b) (2) (D).