WQ0024577_Monitoring - 12-2020_20210407

Monitoring Report Submittal
.............................................................................................................................................
Permit Number #* WW0024577
Name of Facility:*
Month:* December
Report Information
Suttons Retirement Center
Type *
Revised - NDMR, NDAR-1, NDAR-2,
NDMLR
Confirmation Email Address:*
Name of Submitter:*
Signature:
Date of submittal:
Initial Review
Year:* 2020
Upload Document*
WQ0024577 NDAR & NDMR 441 KB
revised Dec 2020.pdf
PDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
[e-mail]
Kristen Tingen
Reviewer: Williams, Kendall
4/6/2021
This w ill be filled in automatically

Is the project number correct?* WQ0024577
Is the monitoring report t: Yes r No
accepted?*
Regional Office* Washington
Accepted Date: 4/7/2021

FORM: NDAR-1 05-16 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page
Permit No.: Q11
•
December1
1
irrigation
• occur
at this facility?
..
El YES F-1 NO
Hourly Rate (in):
Hourly Rate (in):
Hourly Rate (in):
Hourly Rate (in):
Annual Rate (in):
1Annual
Rate (in):
Annual Rate (in):
Annual Rate (in):
0 •Field
-•
•
•
- • -•
•

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?
Were adequate measures taken to prevent effluent ponding in or runoff from the sites?
Was a suitable vegetative cover maintained on all sites as specified in your permit?
Were all setbacks listed in your permit maintained for every application to each permitted site?
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
❑ Compliant ❑ Non -Compliant
❑ Compliant ❑ Non -Compliant
❑ Compliant ❑ Non -Compliant
❑ Compliant ❑ Non -Compliant
❑ 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: Gary C Sutton
Permittee:
Sutton's Rest Home
Certification No.: 989283
Signing Official: Gary C Sutton
Grade: SI Phone Number: 919-738-2236
Signing Official's Title: Owner
Has the ORC changed since the previous NDAR-1? ❑ Yes El No
Phone Number: 919-738-2236 Permit Exp.: 1/1/24
03/28/201
3/28/21
Si ature Date
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

FORM: NDAR-1 05-16 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of
Raleigh, North Carolina 27699-1617

FORM: NDMR 05-16 NON -DISCHARGE MONITORING REPORT (NDMR) Page of
Sampling Person(s) Certified Laboratories
Name: Gary C Sutton Name: Environment One
Name: Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? E 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: Gary C Sutton
Permittee: Sutton's Rest Home
Certification No.: 989283
Signing Official: Gary C Sutton
Grade: SI Phone Number: 919-738-2236
Signing Official's Title: Owner
Has the ORC changed since the previous NDMR? ❑ Yes 0 No
Phone Number: 919-738-2236 Permit Expiration: 1/1/2024
G3/28/2021
0328/2021
A
Signature Date
ig 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: NDMR 05-16 NON -DISCHARGE MONITORING REPORT (NDMR) Page
Permit No.: WQ0024577
Facility Name: Sutton's Retirement Center WWTF
County: Wayne
Month: December
Year: 2020
PPI: 001
Flow Measuring Point: ❑ Influent ❑ Effluent ❑ No flow generated
Parameter Monitoring Point: ❑ Influent ❑ Effluent ❑ Groundwater Lowering ❑ Surface Water
Parameter Code 10.
50050
00310
00940
50060
31616
00610
00625
00620
00600
00400
00665
70300
00530
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24-hr
I hrs
GPD
mg/L
I mg/L
mg/L
#/100 mL
mg/L
mg/L
mg/L
mg/L
su
mg/L
mg/L
mg/L
1
08:00
1 hr 30 mii
2,519
2
2,519
3
2,519
4
2,519
5
2,519
6
2,519
7
08:00
1 hr 30 mii
2,519
8
2,519
9
2,519
10
2,519
11
08:00
1 hr
2,519
12
2,519
13
2,519
14
2,519
15
2,519
161
2,519
17
08:00
30 min
2,519
18
2,519
19
08:00
1 hr
2,519
20
2,519
21
08:00
30 min
2,519
221
2,519
23
2,519
24
2,519
25
2,519
26
2,519
27
2,519
281
2,519
29
08:00
1 hr
2,519
30
2,519
31
09:00
1 hr
2,519
Average:
2,519
Daily Maximum:
2,519
Daily Minimum:
2,519
Sampling Type:
Estimate
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Monthly Limit:
4,920
Daily Limit:
Sample Frequency:
Monthly
3 X Year
3 X Year
Per Event
3 X Year
3 X Year
3 X Year
3 X Year
3 X Year
Per Event
3 X Year
3 X Year
3 X Year