WQ0019782_Monitoring - 01-2021_20210304

FORM: NDMR 10-13 NON -DISCHARGE MONITORING REPORT (NDMR) Page 1 of
Permit No.: WQ0019782 Facility Name: YMCA -CAMP WEAVER
County: Guilford
Month: January
Year: 2021
PPI: 001
FIOW Measuring Point: Elinnuent O Effluent ❑ No flow generated Parameter Monitoring Point: o Influent a Effluent ❑ Groundwater Lowering ❑ Surface Wader
Parameter
Code
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00400046b#-
00310
O�b�
70300
00916
�Ob25
00665lr0
00620..
0060009¢
00929
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o
E
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IN
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1$
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A
O
O;N
u
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s,
jr
:OrNC
O
7
per,
d1
24-hr
hrs
;GPD su
gi
mg/L
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. mg/L
.ef�
0C1 0 L m /L
0 g
gym'
m L
9/
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mgIL
�9 W
mg/L
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H
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no
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r'
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FORM: NDMR 10-13 NON -DISCHARGE MONITORING REPORT (NDMR) Page 2 of 2
Sampling Person(s) Certified Laboratories
Name: Chip White Name: Statesville Analytical
Name:
Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? 0 Compliant 0 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: Chip White Permittee: YMCA of Greensboro
Certification No.: Signing Official: Rhonda Anderson
Grade: Phone Number: 336-549-8990 Signing Official's Title: President/CEO
Has the ORC changed since the previous NDMR? 13 Yes o No Phone Number: Permit Expiration: 12131 /2026
z
Signature Date Signature Date
By this signature, I certify that this report is accurrale 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
11
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 I of 2
Permit No.: W00019782
Facility Name: YMCA -CAMP WEAVER
County: Guilford
Month: January
Year: 2021
Did irrigation occur
Field Name:
2-
INC., . . . . . . . . . . . .
Field Name."
4
at this facility?
NOW -
Area (acres):
0.3719
210 WN'.
'Amw WO
§A,
Area (acres):
0.4477
Cover Crop:
Natural Forest
W .1 4 * .Mz4a _
140
Cover Crop:
Natural Forest
M YES 11 NO
- 01
OWN
11,11*11 0,10-A,
Hourly Rate (in)-
0.4
Hourly Rate (in):
0.4
06,
A
SIMI
Annual Rate (in):
38.3
4.10-
ON �11_
Annual Rate (in):
38.3
Weather
Freeboard
Field Irrigated?
C1 YES 3 NO
SM
Field Irrigated?
13 YES 0 NO
E
0
0
Q
rL M
A,
0
in
E
gg, -,
00
tffi6
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E a)
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.;6
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in
ft
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min
in
in
10.4"'w"Kh"ONA.'s
gal
min
in
in
Marg
hrm 6
.0,
I W,100.10.
14=0111041
Aft , i ,
XNAN&I
2
3
UNIM
A
4
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52
0
6.66
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0
633
2,669
74
0-22
0.18
6.
C
48
0
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%ab
01'�
to�
NOW
I
99900
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W
1 �
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1
7
CL
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00ft
gd,7i
mk
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- - ---
4
alit
4
2,767
76-
0.23
0.18
8
R
38
0.4
6.58
9
aft", 6"
10
MIN
11
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40
0.1
6.5
•gaw
RUN
W
. MON. 0vnr
A
12
C
47
0.2
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1 ft'd
MIN
13
C
55
1 0
6.5
1
14
-
C
55
1 0
6.42
"'A wl- "Ri,
AM to
a& N
41M.19
94%
16
R
48
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6.42
t=M'20't
do
17
2999W
ME MAIN
Al IM
18
C
46
0
6.5 1
1
90
a"019.
K.
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T9
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50
0
6.331
1
9ftm 0"
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0 N
a
NO.
1,727
47
0.14
0.14
20
C
52
0
6.42
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WWrA2 A 9
-I.". w
8,292
230
0.68
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21
CL
54
0
7.08
b
22
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39
6
6.5
MUN,
�110
em
23
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6
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0
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2
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0.8
6.75 1
NQM7
I.
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NO
27
C
55 _0
6.661
wig 101,00
110A
28
C
40
0.72
6.5
wg� g4 t-
Mp " "'
1
Hal .111.
1
1 1
1
29
C
25
0
6.42
30
..... . . . . . .
31
Monthly Loading:
W1 �11748r�
o-
-
0.00
127
12 Month Floating Total (in):
NO
23.7996
20.56

FORM: NDAR-1 10-13 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?
Was a suitable vegetative cover maintained on all sites as specified in your permit?
D Compliant D Non -Compliant
O Compliant ❑ Non -Compliant
M Compliant O Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site?
@ Compliant O Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? D 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: Chip White Permittee:
YMCA of Greensboro
Certification No.: signing official: Rhonda Anderson
Grade: Phone Number: 336-549-8990 Signing Official's Title: President/CEO
Has the ORC changed since the previous NDAR-1? ❑ Yes o No Phone Number: Permit Exp.: 12/31/26
CZ -2Z -2-1Z —z
Signature Date Signature Date
By this signature, 1 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. 1 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