WQ0007144_Monitoring - 07-2021_20210826

Monitoring Report Submittal
............................................................................................................................................
Permit Number #* WQ0007144
Name of Facility:* Camp Seafarer
Month:* July
Report Information
Type *
GW-59
NDMR, NDAR-1, NDAR-2, NDMLR
Confirmation Email Address:*
Name of Submitter:*
Signature:
Date of submittal:
Year:* 2021
Upload Document*
GW-59 July 2021.pdf 406.76KB
FDF Only
Non -Discharge Reports July 764.89KB
2021.pdf
FDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-7, NDAR-2, NDMLR, GW-59).
[e-mail]
Stanley Eudy
8/26/2021
This will be filled in automatically

Initial Review
Reviewer: Plummer, Lauren
Is the project number correct?* WQ0007144
Is the monitoring report r Yes r No
accepted?*
Regional Office* Washington
Accepted Date: 8/31/2021

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page of
Permit No.: WQ0007144
Facility Name:
Camp Seafarer
county:
Pamlico
Month:
July
Year: 2021
PPI:
001
Flow Measuring Point:
C]Inluent ❑Effluent ❑No flow generated
Parameter Monitoring Point:
❑Influent
❑Effluent
❑Groundwater Lowering ❑Surface Water
Parameter Code
5d05D,:".
00310
0()940
5006D
31616"
00610
OD625 :;
0D620
QD40D ;?
70300
00530
00600
O
a
0°
`
O
p
�Gf
w:
`
is
C 'yC..
is �Tc
°
o
°
o°
mM.�°
E
}
o N°
I"" y
U'
d'U
Z
o
O
a ,
24-hr
hrs
Gl?D„ -
mg1L
9J.:.
m IL
g
#!1"DQ,.m,L"
m IL
g
etgll_.:
mg
s
mglL
tnglL;,;
mglL
ng1L;:.;
1
07:30
1
30,7$0 "j
0.92
2
07:00
1
17tiT10".:;
3
4
5
07:00
1
i:9,360
1 09
6
7
07:00
1
77fit,04
nv,
9
42,240'
10
121
07:00
1
4t351,�"
1.06
`
9 54
13
11:15
1
27,509 : `
1 04
9.7fi
14
08:45
1
2,$„441 :;
8.8
5 is ,...:
1.18
<1 .. .;;
0.31
2 45.....
<0.04
9 65 ,
260
20 ..:;
2.45
15
07:00
1
25 729..
:"
1.0
9;61"
16
;
17
1877.
19
20
27,900 ;"7777
21
22
07:15
1
27 275
1.07
,
23
29631,:;';i
241
�.
26
07:40
1
2D,7D1 ,°°<
1.12
27
28,6p0,
„
28
29
30
07:00
1
28,001",
31-
29.6.30..:'
`..:
'
Average
27,341;
8.80
51.00 , ,
1.07
[ DD;:, i-
D.31
2 45 " .''1
0.00
,, :.
260.00
120 OD ' .1
2.45
Daily Maximum
42,240, `:
8.80
51.(30
1.18
1" 04 ::-,
0.31
0.04
Daily Minimum
""::9 329 :
8.80
51 t70 ,,
0.92
1 00 ' :
0.31
2 45
0.04
2fi0A0
:'"`;
2.45
Q34
Sampling Type.
Recorder''`
Gram
Grab `:
Grab
? . "Grab :,
Grab
Grab ;-
Grab
GKab .:
Grab
Grab ;- "r:
Grab
Grab .
Monthly Limit. .1,650,ODp.
Daily Lima
Sample Frequency Co fi�uous' 4 x Year 3 x.Year 5 x Week 4 x Year; 4 x Year 4 x Year „ 4 x Year 5 x UVeek, 3 x Year ± ,4 xYea6;

FORM: NDMR 03-12 NON-D15CHARGE MONITORING REPORT (NDMR) Page of
Sampling Person(s) Certified Laboratories
Name: S�j� l✓Lr �up�� Name: Environment 1
Name: Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? 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.
E�b�t� p try Pyc
Vv1gSH 1N6 ID"
9EG f a/V 14L
*Ff1CC=
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC;- Stanley Eudy
Permittee: YMCA of the Triangle Area, ]no
Certification No.: Si 994723
Signing Official: Mike Askew
Grade: Phone Number: 252-249-1212
Signing Official's Title: Director of Facilities and Boating Operations
Has the ORC changed since the previous NDMR? ❑ Yes ❑ No
Phone Number: 252-249-1212 Permit Expiration: June 30 2021
ZOPLI
Signature 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 €aw, that this document and alLattachments were prepared under my direction or supervision in
accordanoe with a system designed to assure that all.qualif3ed personnel properly gathered and evaluated the information
submitted. Based on my inquiry of the person or persons who manage the system, or those persons direct€y responsible for
gathering the Information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. E 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 Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1 ) Page of
Permit No.:
WQ0007144
Facility Name: Camp Seafarer
County: Pamlico A
Month:
July
Year: 2021
Field Name
1
Field Name:
2
E=geld Name
3
Field Name:
Did irrigation occur
Area (acres}
5 $
Area (acres):
5.8
Area (acres}
6 4
Area (acres):
at this
BCIlIty!oyerrop
gees
Cover Crop:
Grass/Trees
CoverCrup
Trees
CoverCrop:
21 rEs
❑rvo
Hourly Rates{n)
Hourly Rate (in):
Hourly Rate tin}
Hourly Rate (in):
Annual R ie#rn}
54.
Annual Rate (in):
83.2
Annual Ra (n]
694
Annual Rate (in):
Weather
Freeboard
Field lrngated?
❑YES ENO
Field Irrigated?
AYES
❑No
Field Irngated?
[jYEs ❑Np
Field Irrigated?
❑YEs ❑No
O
`s
i�
°
w
m
fl' V
ti
O
}� C
lW a�;
7 C
y O
67
a
N
rn
7• C
E t7y
O` C
as
G?
a
O w
a1
`� C
1= of
3 }' C-
a
N
a
N .p+
a,
T C
E a,
3_
},
`
Q>
fl-
'a
_
a0,
Q
„p,
E
~
•!9
❑
7
¢;
[�'.:.
G
D II.
1- •y
❑ O
= 4
N
,.0.
fA
�q Q
❑
O '.Q
Q
h" : c.
r.
❑ O
. `cc
R i O
O
`� Q
•`
p
T p
O
"
k"
O
-. =
�!
f-
`
a
,
°F
in
ft
ft~�n
gal
min
in
in
gal
min
in
m
gal
min
in
in
1
PC
74
0
4.33
64,523
180
0.41
0.14
2
PC
79
0
4.25028
3
4
5
C
70
0.61
4.25
64,523
180
0.41
0.14
72 2$a,
6
7
C
72
0
4.25
64,623
180
0.41
0.14
8
9
10
11
12
C
79
0.34
4.33
120,468
340" "
0',69
014
13
PC
80
0.42
4.33
64,523
180
0.41
0.14
14
PC
81
0
4.33
014
15
C
77
0
4.42
43,015
120
0.27
0.14
4$„t$7
12U
028
014
16
17
18
77777
19
20
777-7
777
21
22
C
71
2.51
4.25
43,015
120
0.27
0.14
0 14:..:,1
23
24
25
25
C
74
0
4.33
��
...
43,015
120
0.27
0.14
27
28
29
<
30
PC
77
2.8
4.25
31
Monthly Loading:
„0;
387,137
2.46
548;
12 Month Floating Total (in):
15.20

FORM: NDAR-1 48-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of
Did the application rates exceed the limits in Attachment B of your permit? [Z Compliant ❑ Non -Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites? Q Compliant ❑ Non -Compliant
Was a suitable vegetative cover maintained on all sites ;as specified in your permit? ❑ Compliant ❑ Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site? p Compliant ❑ Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? 21 Compliant ❑ Non -Compliant
If the facility is non -compliant, please explain in the space below the reason(s) the facilitywas 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
0RC: Stanley Eudy
Permittee: YMCA of the Triangle Area, Inc
Certification No.: SI 994723
Signing Official. Mike Askew
Grade: Phone Number: 252-249-1212
Signing Official's Title: Director of Facilities and Boating Operations
Has the ORC changed since the previous NDARA? ❑ yaS I7-' No
Phone Number: 252-249-1212 Permit Exp.: June 30 2021
Signature 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. $aced 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 Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27690-1617

Monitoring Report Submittal
............................................................................................................................................
Permit Number #* WQ0007144
Name of Facility:* Camp Seafarer
Month:* July
Report Information
Type *
GW-59
NDMR, NDAR-1, NDAR-2, NDMLR
Confirmation Email Address:*
Name of Submitter:*
Signature:
Date of submittal:
Year:* 2021
Upload Document*
GW-59 July 2021.pdf 406.76KB
FDF Only
Non -Discharge Reports July 764.89KB
2021.pdf
FDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-7, NDAR-2, NDMLR, GW-59).
[e-mail]
Stanley Eudy
8/26/2021
This will be filled in automatically

Initial Review
Reviewer: Plummer, Lauren
Is the project number correct?* WQ0007144
Is the monitoring report r Yes r No
accepted?*
Regional Office* Washington
Accepted Date: 8/31/2021

SUBMIT FORM ON YELLOW PAPER ONLY
DEPARTMENT 0)=. ENVIRONMENTAL QUALITY Dlv OF WATER RESOD RCES
GROUNDWATER QUALITY MONITORING:
INFORMA TIONPROCESSINGifNIT:
COMPLIANCE REPORT FORM
1617nnAILSERV[CECENTt=R RALHIGH, NG27699161Z Phone 919-807-s306 „
_
FACILITY INFORMATION P)easePrfntCleadyor7ype
PERMIT Number: Expiration Date. CL
Facility Name: Camp Seafarer
Non -Discharge WQ0007144 UIC
Permit Name (if diifferent): YMCA of the Triangle Area, INC.
NPDES Other
Facility Address: 2744 Seafarer Rd Arapahoe
NO 28510
TYPE OF PERMITTED OPERATION BEING MONITORED
2744 Seafarer Rd Arapahoe (S7reenNC 28510
County Pamlico
Lagoon ❑ Remediation: Infiltration Gallery
(City) iState} iZIP)
_
❑Spray Field ❑Remediation:
Contact Person: Mike Askew
Telephone#: [phone]
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: Lagoon
No. of wells to be sampled: 5
❑ Water Source Heat Pump ❑ Other:
{from Permi()
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): Well 2
Date sample collected:
FIELD ANALYSES:
WAS
Well Depth: 20 ft.
Well Diameter: 2
in.
pH 00400: r7-17nits Temp. 00010: P?, Ir°C
DRY at
Depth to Water Level 62546: 1+; - f . below measuring point Screened Interval: 10
ft. to 20 ft.
Spec. Cond. 00094: z.j f µMhos
time of
sampling,
Measuring Point is 1.9 ft, above land surface
Relative M.P. Elevation: 24.2
ft.
Odor coos:
check
Volume of water pumped/balled before sampling:.] d /)P-r gallons
Appearance
here:❑
Samples for metals were collected unfiltered: ❑ YES
❑ NO and field acidified: ❑ YES
❑ NO
LABORATORY INFORMATION
Date sample analyzed: . '7 III I 1
LaboratoryName: ��1 kG i�-ML �.r
1 Certification No. 1'C.>
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L
Nitrite (NO2) as N 00615
mg/L
Pb - Lead D1051 ug/L
Coliform: MF Fecal 31616 I` 1100mL
Nitrate (NO3) as N 00620 0 . mg/L
Zn -Zinc 01092 mg/L
Coliform: MF Total 31504 1100ml-
Phosphorus: Total as P 00665 Q ! 3 mg/L
(Note: Use MPN method forhlghlyturbid samples)
Orthophosphate 70507
mg/L
Other (Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 7" 1 G mg/L
Al -Aluminum o11c5
mg/L
pH (Lab) 00403 7 units
Ba - Barium oloo7
ug/L
TOC oosso mg/L
Ca - Calcium 0og16
mg/L
Chloride 00940 2.9 mg/L
Cd - Cadmium 01027
ug/L
Arsenic o1e02 ug/L
Chromium: Total 01034
ug/L
Grease and Oils 00552 mg/L
Cu - Copper 01042
mg/L
ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730 ug/L
Fe - Iron 01045
ug/L
(Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945 mg/L
Hg - Mercury 71900
ug/L
Lab Report Attached? ❑ Yes (1) ❑ No (0)
Specific Conductance 00095 µMhos
K - Potassium 00937
mg/L
VOC 7873 method #
Total Ammonia ooelo < mg/L
Mg - Magnesium 00227
mg1L
method #
(Ammonia Nitrogen; NHsas N; Ammonia Nitrogen, Total)
Mn - Manganese 01055
ug/L
method #
TKN as N 00625 mg/L
Ni - Nickel 01067
ug/L
method #
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal%
GW-59 Rev.05-02-2017

SUBMIT FORM ON YELLOW PAPER ONLY
.
�EPAR 1MENT OF ENViRONMEN7AL RIIALI'! Y D1V.,OF WA7ER RESDilRCE5
GROUNDWATER QUALITY MONITORING:
INFORMATION PRocFSSING uN1T
COMPLIANCE REPORT FORM
9617 MAIL SERVICE CENTER, RAI E1GH NC 27699 1517 '; Phone:.9 t9 307.63D6
FACILITY INFORMATION Please PrintCleadyorType
PERMIT Number: Expiration Date: G 2
Facility Name: Camp Seafarer
Non -Discharge WQ0007144 UIC
Permit Name (if different): YMCA of the Triange Area, INC.
NPDES Other
Facility Address: 2744 Seafarer Rd Arapahoe NC
28510
TYPE OF PERMITTED OPERATION BEING MONITORED
2744 Seafarer Rd Arapahoe NC 28510
County Pamlico
❑ Lagoon ❑ Remediation: Infiltration Gallery
(city) (slats) (zip)
Spray Field ❑ Remediation:
Contact Person: Mike Askew
Telephone#: [phone]
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: Spray Field 3
No. of wells to be sampled: 5
❑ Water Source Heat Pump ❑ Other:
(from Permit)
SAMPLING INFORMATION
0
If WELL
WAS
WELL ID NUMBER (from Permit): WELL 5
Date sample collected: 0-
FIELD ANALYSES: �}
Well Depth: 20 ft.
Well Diameter: 2 in.
pH 00400:..,Sj )nits Temp. 00010: I f &C
DRY at
time of
Depth to Water Level 62546: �s / q ft. below measuring Dint
. g p
Screened interval: 10 ft. to 20
Mhos
ft. Spec. Cond. 0o0g4: •�Gr �- �
sampling,
Measuring Point is 2.2 fL above land surface
Relative M.P. Elevation: 27-7 ft.
Odor 0D085: /-0/" —
check
Volume of water pumped/bailed before sampling: S — &4 K-gallons
Appearance R J,S /71
here:❑
Samples for metals were collected unfiltered: ❑ YES ❑ NO and field acidified: ❑ YES ❑ NO
LABORATORY INFORMATION J
Date sample analyzed: 1'1 I 2 _
Laboratory Name: Enviroment 1,INC.
Certification No. �Q
PARAMETERS NOTE: Values should reflect dissolved and
colloidal concentrations.
COD o0335 mg/L
Nitrite (NO2) as N oos15
mg/L Pb - Lead 01051 ugIL
Coliform: MF Fecal 31616 1100mL
Nitrate (NO3) as N om2c C}. O
mg/L Zn -Zinc olo92 mg/L
Coliform: MF Total 31604 1100mL Phosphorus: Total as P oo665 O r O G
mg/L
(Note: use MPN method for highly turbid samples)
Orthophosphate 70507
mg/L Other (Specify Compounds and Concentration Units):
issolved Solids:Total 70300 4-C mg/L
AI - Aluminum c11o5
mg/L
pH (Lab) 00403 : t units
Ba - Barium 01007
ug/L
TOC oosso . mg/L
Ca - Calcium oog16
mg1L
Chloride 00940mg/L
Cd - Cadmium o1o27
ug/L
Arsenic o1002 ug[L
Chromium: Total 01034
ug/L
Grease and Oils 00552 smg/L
Cu - Copper 01042
mg/L ORGANICS: (by GC, GC/MS, HPLC)
Phenol 3273D ug/L
Fe - Iron 01045
ug/L (Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945 mg/L
Hg - Mercury 71900
uglL Lab Report Attached? ❑ Yes (1) .. ❑' No (0)
Specific Conductance 000m µMhos
K - Potassium oogs7
mg/L VOC 7878 method #
Total Ammonia coslo ®. 10 mg/L
Mg - Magnesium oo927
mg/L
method #
(Ammonia Nitrogen; NH3 as N; Ammonia Nitrogen, Total)
Mn - Manganese o1 o55
ug/L , method #
TKN as N 00625 mg/L
Ni - Nickel 01067
ug/L method #
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VUL; Removal is
GW 59 Rev. 05-02-2017

SUBMIT FORM ON YELLOW PAPER ONLY
DEPAR;TM.ENT O.F,ENVIRD. NMENTAL QUALl1Y ©IV OF WATER RES0UKCES
GROUNDWATER QUALITY MONITORING:
1NFORMA170N PROCESSING IJNI7
COMPLIANCE REPORT FORM
161 MAIL SERVICE CENTER, RALEIGH, NC 27699-1647. Phone: Rlgr807-6306
FACILITY INFORMATION Please Print Clearly or Type
PERMIT Number: ExpirationDate. 0 2
Facility Name: Camp Seafarer
Non -Discharge WQ0007144 UIC
Permit Name (if different): YMCA of the Triangle Area, INC.
NPDES Other
Facility Address: 2744 Seafarer Rd Arapahoe
NC 28510
TYPE OF PERMITTED OPERATION BEING MONITORED
2744 Seafarer Rd Arapahoe NC 28510
County Pamlico
❑ Lagoon ❑ Remediation: Infiltration Gallery
{city; say) (ZIP'
Spray Field ❑ Remediation:
Contact Person: Mike Askew
Telephone#: [phone]
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: Spray Field 3
No. of wells to be sampled: 5
❑ Water Source Heat Pump ❑ Other:
(from Permit)
SAMPLING INFORMATION
r�
If WELL
WELL ID NUMBER (from Permit): Well 6
Date sample collected: 1,/�' ,-
FIELD ANALYSES:
- °C
WAS
DRY at
Well Depth: 20 ft.
Well Diameter: 2 in.
pH 00400:LS--G.lnits Temp. ocolo:
time of
Depth to Water Level 32546: G. s7¢- ft. below measuring point Screened Interval: 10 lit: to 20
ft. Spec. Cond. 00094: (� pMhos
sampling,
Measuring Point is 2•75 ft. above land surface
Relative M.P_ Elevation: 20.2 ft.
Odor 00085: !L-O
check
Volume of water pumped/bailed before sampling: /0
gallons
Appearance CG r:7J, L;L
here:❑
Samples for metals were collected unfiltered: EYES
❑ NO and field acidified: ❑ YES ❑ NO
LABORATORY INFORMATION
rf
f
Date sample analyzed: ( / 2-
Laboratory Name: Enviroment 1,WC.
Certification No.
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD oo335 mg/L
Nitrite (NO2) as N co615
mg/L Pb - Lead o1c51 ug1L
Coliform: MF Fecal 31616 3 110flmL
Nitrate'(NO3) as N 00620 0+
mg/L Zn -Zinc olc92 mg/L
Coliform: MF Total 31504 /100mL
Phosphorus: Total as P oms5 O. 0? 9
mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
mg/L Other (Specify Compounds and Concentration Units):
issolved Solids:Total 70300 / 7 - mg/L
Al - Aluminum o11o5
mg/L
pH (Lab) 00403 units
Ba - Barium 01007
ug/L
TOC oosso mg/L
Ca - Calcium 00916
mg/L
Chloride 00940 Z mg1L
Cd - Cadmium o1c27
ug/L
Arsenic 01002 ug/L
Chromium: Total 01034
ug/L
Grease and Oils 00552 mg/L
Cu - Copper 01042
mg/L ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730 ug/L
Fe - Iron 01045
ug/L (Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945 mg/L
Hg - Mercury 71900
ug/L Lab Report Attached? ❑ Yes (1) ❑ No (0)
Specific Conductance 00095 µMhos
K - Potassium e0937
mg1L VOC 7$73 method #
Total Ammonia o0810 O . C) Q- mg1L
Mg - Magnesium o0927
mg/L method #
(Ammonia Nitrogen; NH,as N; Ammon[a Nitrogen, Tatal)
Mn - Manganese o1 o56
ug1L method #
TKN as N 00626 mg/L
Ni - Nickel 01067
ug/L method #
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal%
GW-59 Rev.05-02-2017

Sl,!BMJ I rUKIVi UN YtLLUVV YHWtK UtNLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Facility Name: Camp Seafarer
Permit Name (if different): YMCA OF THE Triangle Area, INC.
Facility Address: 2744 Seafarer Rd Arapahoe NC 28510
2744 Seafarer Rd Arapahoe 'street) NC 28510 County Pamlico
(City) (Stale) (Zrp)
(Contact Person: Mike Askew
Well Location/Site Name: Spray Field 2
Telephone#: [phone]
No. of wells to be sampled:.5
PERMIT Number: Expiration Date: b 'S a I X I
Non -Discharge WQ0007144 UIC
NPDES Other
TYPE OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon ❑ Remediation: Infiltration Gallery
® Spray Field ❑ Remediation:
❑ Rotary Distributor ❑ Land Application of Sludge
❑ Water Source Heat Pump ❑ Other:
SAMPLING INFORMATION
WELL 1D NUMBER (from Permit): WELL 7 Date sample collected: 7/41xi
Well Depth: 12 ft. Well Diameter: 2 in.
Depth to Water Level 82546: qw-3-- ft. below measuring point Screened Interval: 2 ft. to 12 ft.
Measuring Point is 1 ft above land surface Relative M.P. Elevation: 25.8 ft.
Volume of water pumped/bailed before sampling: C—tR r gallcns
Samples for metals were collected unfiltered: ❑ YES ❑ NO and field acidified: ❑ YES ❑ NO
FIELD ANALYSES: C� d
pH oo4aa:�t�`�units Temp. a0o1o:� /. 7 °C
Spec. Cond. 000s4: �% , G pMhos
Odor 00085: 0116-
Appearance C
If WELL
WAS
DRY at
time samplili ng,
check
here:❑
LABORATORY INFORMATION �1
Date sample analyzed: .1/ /1^0- 1 LaboratoryName: Enviroment 1,INC.
Certification No. d
PARAMETERS NOTE: Values should eeflect dissolved
and colloidal concentrations.
COD 00335 mg/L
Nitrite (NO2) as N oosls
mg/L
Pb - Lead o1051 ug1L
Coliform: MF Fecal 31615 1104mL
Nitrate (NO3) as N 00620 (}, O
mg/L.
Zn - Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL
Phosphorus: Total as P oc665 < 0. O
mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
mg1L
Other (Specify Compounds and Concentration Units):
issolved Solids:Total 70300 b mg/L
A[ - Aluminum o11os
mg/L
pH (Lab) 00403 p units
Ba - Barium 01007
ug/L
TOC 00680 mg1L
Ca - Calcium 00916
mg/L
Chloride 0094C 7 -L mg/L
Cd - Cadmium o1o27
ug/L
Arsenic 01002 ug1L
Chromium: Total 01034
ug/L
Grease and Oils oc552 mg/L
Cu - Copper 01042
mg/L
ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730 ug1L
Fe - Iron o-to45
ug/L
(Specify test and method #. ATTACH LAB REPORT.)
Sulfate oos45 mg/L
Hg - Mercury 71soo
ug1L
Lab Report Attached? ❑ Yes (1) ❑ No (0)
pecific Conductance 00095 I.LMhos
K - Potassium C0937
mg/L
VOC 7873 method #
Total Ammonia oDa10 < mg/L
Mg - Magnesium oo927
mg/L
method #
{Ammonia Nitrogen; NH, as N; Ammonia Nitrogen, Total)
Mn - Manganese 01055
ug1L
method #
TKN as N oo625 mg/L
Ni - Nickel 01067
ug/L
method #
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOL; Removal%
GW-59 Rev.05-02-2017

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
r 11 NryPlease Print Cfeady or
Facility Name: Camp Seafarer
Permit Name (if different): YMCA of the Triangl Area, INC.
Facility Address: 2744 Seafarer Rd Arapahoe NC 28510
2744 Seafarer Rd Arapahoe street] NC 28510 County Pamlico
(City) (Stale} (tip)
Contact Person: Mike Askew Te€ephone#: 252-249-1212
Well LocationlSite Name: Spray Field 2 No. of wells to be sampled: 5
PERMIT Number: Expiration Date:
Non -Discharge WQ0007144 UIC
NPDES Other
TYPE OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon ❑ Remediation: Infiltration Gallery
❑■. Spray Field ❑ Remediation:
❑ Rotary Distributor ❑ Land Application of Sludge
El Water Source Heat Pump ❑ Other:
SAMPLING INFORMATION
WELL ID NUMBER (from Permit): Well 8 Date sample collected: ( C
Well Depth: 12 ft. Well Diameter: 2 in.
Depth to Water Level 82545: 27, ft. below measuring paint Screened Interval: 2 ft. to 12 ft.
Measuring Point is 1 ft. above land surface Relative M.P. Elevation: 15.3 ft.
Volume of water pumped/bailed before sampling:. !Q ! gallons
Samples for metals were collected unfiltered: ❑ YES ❑ NO and field acidified: ❑ YES ❑ NO
FIELD ANALYSES:
pH o040o:�units Temp. oonlo:-Z�� 3 °C
Spec_ Cond. 00094: %2, 7 µMhas
Odor 00085: iVGA'6-
Appearance
If WELL
WAS
DRY at
time of
sampling,
check
here:❑
LABORATORY INFORMATION �
Date sample analyzed: ( 7 / a Laboratory Name: Enviroment 1, INC.
Certification No. >�(�
PARAMETERS NOTE: Values should/reflect dissolved
and colloidal concentrations.
COD oo335 mg/L
Nitrite (NO,) as N oo615
mg/L
Pb - Lead 01051 uglL
Coliform: MF Fecal 31616 < 1100mi-
Nitrate (NO3) as N 00620 C 0, 04-.mg/L
Zn - Zinc o1092 mg/L
Coliform: MF Total 31504 /100mL
Phosphorus: Total as P 00665_ Q . {
mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
mg/L
Other (Specify Compounds and Concentration Units):
issolved Solids:Tctal70300 1 0 mg/L
A[ -Aluminum o11o5
mg/L
pH (Lab) 00403 373 units
Ba - Barium 01007
ug1L
TOC 00660 mg/L
Ca - Ca[cium 00916
mg/L
Chloride 00940 mg/L
Cd - Cadmium o1o27
ug/L
Arsenic 01002 ug/L
Chromium: Total o1034
ug/L
Grease and 0€I8 00552 mg/L
Cu - Copper 01C42
mg/L
ORGANICS: (by GC, GCIMS, HPLC)
Phenol 32730 ug/L
Fe - Iron o1045
ug/L
(Specify test and method #.ATTACH LAB REPORT.)
Sulfate 00945 mg/L
Hg - Mercury 71900
ug/L
Lab Report Attached? ❑ Yes (1) ❑ No (0)
pecific Conductance ocom µMhos
K - Potassium 00937
mg1L
VOC 7873 , method #
Total Ammonia coslo 0. mg/L
Mg - Magnesium 00927
mg/L
.method #
{Ammonia Nitrogen; NH3as N: Ammonia Nitrogen, Total)
Mn - Manganese 01055
ug1L
method #
TKN as N oos25 mg/L
Ni - Nickel 01067
ug/L
method #
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal%
Mike Askew, D'rector of Facilities and Boating Operations
Permittee (or Authorized Agent) Name and Title - Please print or type Signature of Permittee {or Authorized Agent)
GW 59 Rev. 05-02-2017
w ;2.7—

GW-59A COMPLIANCE REPORT FORM Permit # W o o 71 f �
(Submil one each monitoring.period wish GW-59forms.)
Enter date monitoring results were duo. (4A31 Will this monitoring report (GW-59 and GW-59A)
YES
NO
be submitted after the established due date.
2
Was any required information missing on the GW-59 report forms?
YES
N
IF the answer to question I or 2 is "YES", list in the space provided below the well identification numbers) and
explain the problems encountered in obtaining the required information.
3
Are any of the monitor wells in need of repair or maintenance (damaged casing, unlocked or missing cap, missing
YES
NO
identification plate, area overgrown, etc.)? 1f the answer is "Yes", contact the .Regional Office for guidance.
4
Are any monitored constituents equal to or above the established standards?
YAK
NO
If the answer to question 4 is `NO", skip to section 8.
If the answer to question 4 is "YES" list the affected wells individually with constituent(s) and concentration(s)
exceeding standards in the space provided below.
w it on I- o `-- pig 5r q G
In��cc j ILO j Lo v- P/1 5, 5 C
5
For the constituents identified in, question 4 above, have standards been exceeded previously for the..
YES,
NO,
same constituents) in the same well(s) in the last two years?
If the answer to question 5 is "NO", skip to section 8.
If the answer to question 5 is "YES", list in the space provided below, each well with constituent(s) exceeding
standards, concentration(s) reported, and sample collection date for each occurrence (for the last two years).
w4W. 1S .co w,Pll 3 s,9 71 �7,(,� � s• /3, to 134-0 -54t 'N$ol� 1 4,. 5' f.
I
4ot, Ply 3J/8/aG, lk. 7Id- !la� �Ca is /3�/Ju 3Y7'�/ 41301JI S-,v 3'
1 j
w ZC # Got� 5 5G r% J S; 6� IZ 3/ .�H `�� `� 3o J 3"� v
Are the monitoring wells listed in sec ion 5 located at orb yond the review oun ary.
YES
N
If the answer is "YES", a groundwater quality problem maybe occurring, CONTACT THE REGIONAL
OFFICE IMMEDIATELY FOR GUIDANCE. If the answer is "NO". monitoring wells maybe improperly
located; contact the Regional Office.
7
Is the permittee implementing previously approved actions required by the Division involving this
YES
NO
groundwater quality problem?
If the answer to question 7 is "YES", describe those actions in the space provided below.
gional Office within 90 da s� an evaluation maybe
If the answer to question 7 is. "NO'; contact the Reg
required to determine the impact the waste disposal s stem is having at the review and compliance
boundaries surroundinq this facilit . Failure to do so maV subject the ermittee to a Notice of Violation
fines, and/or penalties.
Co rq4C"tGAj Ylrtor,l/) �1) � ��7`l� •
lZ Gl o-t-71 L 11r-J1 P-O&O M) MI&S
g
The person completing this portion (GW-59A) of the monitoring report should sign below and submit this
form with GW-59 forms for required wells to the address provided at the top of the current GW-59 form.
I hereby acknowledge that the above information was evaluated and the information submitted in this
reiaart (Compliance Report GW-59A) is true and complete to the best of my knowledge:
Signature of Permittee (or Authorized Agent) Date
f
i
GW-59A 12/812003