WQ0002015_Monitoring - 09-2016_20161028 (2)

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PERMIT NUMBER:
FACILITY NAME:
NON DISCHARGE WASTEWATER MONITORING REPORT Page I of2-
WQ0002015
Oak Hill Fellowship Center
MONTH: September YEAR: 2016
_COUNTY: Granville
Fiow Monitoring Point: Effluent: Influent:
Parameter Monitoring Point: Effluent: Influent: Surface_ ;Nater (SW):
SW CodelNarne:
SI
Was There Effluent Flow For This Month Generated At This Facility:
Yes.
No:
D Operator
-[Dally
A Arrival Operator ORC
T Time 2400 Time on on
Clock Site Site?System
50050
Rate (Flow)
Treatment
'00400
pH
50060 0031:117(70610
Residual BOD•5
Chlorine 20°C
I
NH3-N
00530
TSS
31616
Fecal
coliform cee
tE
metric Mean*)
630
Nitrite
6_30
Nitrate
:665
Total
Phos.
625
TKN
00010
TEMP.
HRS YIN
GALLONS
UNITS
UG/L MG/L
MG/L
MG/L
/100ML
MG/L
MG/L
NIG/L
MG/L
F
1 10:30 1 Y
420
7.27
1360
81
2
200
3
273
4
273
5
273
6 10:45 1 Y
200
7
200-
s 9:45 1 Y
200
7.16
1340 70
0
0
0
0
0.52
4.68
11.7 "
76
-210
10
640
ill
640
12
640
13 9:30 1 Y
210
7.2
1250
78
14
410
-
15 9:00 1 Y
200
7.15
750
1
78
16
210
_
17
1460
1s
1460
19 .10:45 .1„ Y_
.1460.,
20
1300
211300
113:00.
22 1..: e, : Y
'1',;40.-'-
40:.23
23
1770
24 -
2670
25
2670
26 10:00 1 Y
2670
27
,410
_
28
840
29 11:15 1 Y
3110
30
1970
31
Average
994.3:
1175 70
0
0
'#NUM!
0
0.52
4.68
11.7
- 78.25
Daily.,lMaximum
3110
7;27
1360 70
' 0
0
1
0
0.52
4.68
11.7.
81
Daily Minimum
200
7.15
750 70
0
0
0
0
0.52
4.68
11.7
76
Monthly Limit(s)
IG
Composite (C) / Grab (G) -
G
G G
G
G
G
G G
G
Operator in Responsible Charge (ORC):: Dale Lee Mathews Grade: Spray Phone: [phone] '
Check Box if ORC Has Changed:. ORC Certification Number- 22794
Certified Laborator1es,•(1):: - Meritech (2):- NCDA & CS Agronomic Division-
Person(s) Collecting Samples: • Dale Lee Mathews
•.c., '
,Mail ORIGINAL,and TWO COPIES to:
(SIGNAT RE"OF OPERATORIN RESPONSIBLE CHARGE) "
;Divisiori of JNaYer'Qiaality` "=�,;z:: BY THIS SIGNATURE; fCERTIFY-THAT-THIS REPORT IS ACCURATE
ATTN:.InformationProcessing,Unit --AND COMPLETE TO THE -BEST OF -MY KNOWLEDGE:- - • -
1617 Mail Service Center. -
RALEIGH, NC
enter.RALEIGH,.NC 27699-1617..
DENR FORM NDMR=1 (11/2005)

Page Z of v
NON DISCHARGE WASTEWATER MONITORING REPORT
Facility Status:
Please answer the following question:
Compliant (Y,N)
1.,Does all mopitoring data and Sampling frequencies meet, permit,requirements? 0
If the facility is non-compliant,:please explain in the space below the reason(s) the facifity,was nofin'coriipliance
with -its permit. Provide. in your -,explanation the date(s) of the non-compliance and describe the'correictive actions) =
taken: Attach additional .sheets if necessary.'
"I certif i,`Lf id6r'penalf) of lav,"iKtit this doct:n ent and a!! attachments.vreire-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."
1�,2!Z0,1 Alan Glover
Signature of Permittee)* Date (Name of Signing Official -Please print or type)
Alan Glover Facility Manager
(Permittee:Please print or type) -
Oak Hill Fellowship Center
3824 Barrett Drive; Raleigh, NC 27609
(Permittee Address)
Parameter Codes:
(Position or Title) -
919-691-3883 31 -Jul -19
(Phone Number) (Permit Exp. Date)
01002 Arsenic
31504 Coliform, Total
00600 Nitrogen, Total
00929 Sodium
01022 Boron
00094 Conductivity
00630 NO2&NO3
00931 SAR
00310 BOD5
01042 Copper
00620 NO3
00745 Sulfide
01027 Cadmium
00300 Dissolved Oxygen
00556 Oil -Grease
70295 TDS
00916 Calcium
31616 Fecal Coliform
WQ09 PAN Plant Available)
00010 Temperature
00940 Chloride
01051 Lead
00400 pH "-
00625 TKN
50060 Chlorine, Total
- '- Residual'
00927 Magnesium
71900 Mercury -
32730 Phenols
'- 00665 Pho. phorus, Total -
00680 TOC
00530,TSSITSR -?-
01034 Chromium
00610 NH3asN
00937 Potassium
00076 Turbidity
00340 COD
01067 Nickel
00545 Settleable Matter
01092 Zinc
Parameter Code assistance may be obtained by calling the Water Quality Land Application Unit at [phone].
The monthly average for Fecal Coliform is to be reported as a GEOMETRIC mean. Use only the units designated in the reporting facility's
permit for reportingdata.
ata.
* 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).
DENR FORM NDMR-1 (11/2005)