HomeMy WebLinkAboutWQ0002096_Monitoring - 05-2020_20200623FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page
Permit No.: WQ0002096
Facility Name: Pinewood Manor Rest Home
County: Hertford
Month: May
Year: 2020
PPI: 001
Flow Measuring Point: ❑ influent ❑ Effluent ❑ No flow generated
Parameter Monitoring Point: ❑ tnfluent 7 Effluent ❑ Groundwater Lowering ❑ Surface Water
Parameter Code 0
50050
00400
00310
31616
00530
00610
00625
00630
00665
f0
O
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o
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U
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7
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0
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= -
Z Z
(n
,'a oc
O N
~ O
24-hr
hrs
GPD
su
mg/L
#/100 mL
mg/L
mg/L
mg/L
mg/L
mg/L
1
5,707
2
5,707
3
5,707
4
08:30
0.5
5,707
5
09:00
0.5
5,707
6
08:00
0.5
5,707
7
5,707
8
09:00
0.5
5,707
9
5,707
10
5,707
11
5,707
121
5,707
13
5,707
14
08:00
0.5
5,707
15
09:00
0.5
5,707
16
08:00
0.5
5,707
17
09:00
0.5
5,707
18
5,707
19
5,707
20
5,707
21
5,707
22
08:00
0.5
5,707
231
09:00
0.5
5,707
24
5,707
25
5,707
26
5,707
27
08:00
0.5
5,707
28
09:00
0.5
5,707
29
5,707
30
5,707
31
5,707
Average:
5,707
Daily Maximum:
5,707
Daily Minimum:
5,707
Sampling Type:
Estimate
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Monthly Avg. Limit:
7,500
Daily Limit:
Sample Frequency:
continuous
3/year
3/year
3/year
3/year
3/year
3/year
3/year
3/year
01V KOT I a] LVA :11*5%
NON -DISCHARGE MONITORING REPORT (NDMR)
Page of -
Sampling Person(s) Certified Laboratories
Name: Randy Parker Name: Environment 1, Inc.
Name: Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? O 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.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Randall Parker
Permittee: Pinewood Manor Rest Home
Certification No.: 996843
Signing Official: Paula Armstrong
Grade: SI Phone Number: 252-287-4153
Signing Official's Title: Administrator
Has the ORC changed since the previous NDMR? ❑ Yes Q No
Phone Number: 252-513-8591 Permit Expiration: 4/30/2020
2�
Signature Date
Signature Dat
1
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 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page
Permit No.: W00002096
Facility Name: Pinewood Manor Rest Home
County: Hertford
Month: May
Year: 2020
Did irrigation occur
Field Name:
Site1
Field Name:
Site 2
Field Name:
Site 3
Field Name:
Site 4
this facility?
Area (acres):
1.75
Area (acres):
1.33
Area (acres):
1.35
Area (acres):
1.5
at
Cover Crop:Trees
Cover Crop:
p:
Trees
Cover Crop:
p:
Trees/Bermuda
Cover Crop:
p:
Bermuda
YES NO
Hourly Rate (in):
0.25
Hourly Rate (in):
0.25
Hourly Rate (in):
0.25
Hourly Rate (in):
0.25
Annual Rate (in):
31.5
Annual Rate (in):
31.5
Annual Rate (in):
18
Annual Rate (in):
18
Weather
Freeboard
Field Irrigated?
= YES G NO
Field Irrigated?
❑ YES C. NO
Field Irrigated?
E YES No
Field Irrigated?
O YES ❑ NO
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=J3
°F
in
ft
ft
gal
min
in
in
gal
min
in
in
gal
min
in
in
gal
min
in
in
1
CL
55
1.59
2
C
50
0.02
3
C
58
4
C
68
1
1 1.75
36,000
360
1.00
0.17
5
C
57
6
1 CL
53
0.08
7
C
48
0.07
8
C
44
2.16
9
C
42
0.02
10
C
38
11
C
57
12
C
43
13
C
46
14
CL
57
1.83
23,400
234
0.64
0.16
151
C
64
16
C
64
7,800
78
0.19
0.15
17
C
64
2.08
18
R
64
0.14
19
R
57
0.02
20
CL
54
0.45
211
CL
1 61
0.11
221
R
1 68
1.04
23
C
64
0.01
2.16
24
C
63
25
CL
59
26
C
62
27
C
64
46,800
468
0.98
0,13
281
CL
1 75
0.29
2.08
29
CL
76
0.25
30
C
73
0.04
31
C
64
0.97
0.19
14,01
Monthly Loading:1
46,800
0.98
10.94
36,000
1.00
13.01
23,400
3.64
9.16
7,800
12 Month Floating Total (in):
FORM. NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of
Did the application rates exceed the limits in Attachment B of your permit?
El Compliant ❑ Non -Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites? O Compliant ❑ Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit? O Compliant ❑ Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site? 0 Compliant ❑ Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? OCompliant El 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 II Permittee Certification I
ORC: Randall Parker
Certification No.: 996843
Grade: SI Phone Number: 252-287-4153
Has the ORC changed since the previous NDAR-1? ❑ Yes 0 No
Permittee:
Pinewood Manor Rest Home
Signing Official: Paula Armstrong
Signing Official's Title: Administrator
Phone Number: 252-513-8591 Permit Exp.: 4/30/20
Signature Date i Signature ✓ '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 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page
Permit No.: WQ0002096
Facility Name: Pinewood Manor Rest Home
County: Hertford
Month: May
Year: 2020
Did irrigation
Field Name:
Site 5
Field Name:
Field Name:
Field Name:
occur
facility?
Area (acres):
1.94
Area (acres):
Area (acres):
Area (acres):
at this
Cover Crop:Bermuda
Cover Crop:
P�
Cover Crop:
p�
Cover Crop:
p:
❑ YES NO
Hourly Rate (in):
0.25
Hourly Rate (in):
Hourly Rate (in):
Hourly Rate (in):
Annual Rate (in):
18
Annual Rate (in):
Annual Rate (in):
Annual Rate (in):
Weather
Freeboard
Field Irrigated?
YES ❑ NO
Field Irrigated?
❑ YES ❑ NO
Field Irrigated?
❑ YES ❑ NO
Field Irrigated?
❑ YES ❑ NO
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J
OF
in
ft
ft
gal
min
in
in
gal
min
in
in
gal
min
in
in
gal
min
in
in
1
2
3
4
5
6
28,200
282
0.54
0.11
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
30,000
300
0.57
0.11
23
24
25
26
27
28
29
30
31
Monthly Loading:
58,200
1.10
0
0.00
<a
0
0.00
0
0.00
12 Month Floating Total (in):
u a i
,'
10.67
'
e
i ,ems
i
FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of '
j
Did the application rates exceed the limits in Attachment B of your permit?
O Compliant ❑ Non -Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites? O Compliant ❑ Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit? OCompliant El Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site? 121 Compliant El Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? 121 Compliant El 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 Certification
ORC: Randall Parker
Permittee:
Pinewood Manor Rest Home
Certification No.: 996843
Signing Official: Paula Armstrong
Grade: SI Phone Number: 252-287-4153
Signing Official's Title: Administrator
Has the ORC changed since the previous NDAR-1? ❑ Yes O No
Phone Number: 252-513-8591 Permit Exp.: 4/30/20
A/V� al
Signature Date
Signat a 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 docume 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