WQ0019782_Monitoring - 11-2021_20220105

Monitoring Report Submittal
Permit Number #*
Name of Facility:*
Month: * November
Report Information
WQ0019782
YMCA Camp Weaver
Type *
NDMR, NDAR-1, NDAR-2, NDMLR
Confirmation Email Address: *
Name of Submitter: *
Signature:
Date of submittal:
Initial Review
Year:* 2021
Upload Document*
11-2021 Camp Weaver 1.1MB
(signed).pdf
PDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
[e-mail]
Madelyn Mills
�rr��� clot
Reviewer: Saunders, Erickson G
1 /5/2022
This will be filled in automatically

Is the project number correct?* WQ0019782
Is the monitoring report accepted?* Yes No
Regional Office* Winston-Salem
Accepted Date: 1/19/2022

FORM: NDMR 10-13
NON -DISCHARGE MONITORING REPORT (NDMR)
Page I of
2
Permit No.: WQ001 9782
Facility Name:
YMCA-CAMPWEAVER
T-c-ty-
Guilford
Month:
November
PPI: 001
_F_
Flow Measuring Point.- 12 influent 13 Effluent 0 No flow generated
Parameter Monitoring Point:
Influent
EJ Effluent
0 Groundwater Lowering
Year: 2021
0 Surface Water
Parameter Code 10
Parameter Code -55656
'W56�..
_00400
1: 501160::,
00310
70300
00916
1--�.0062511]
00665
00620
�,V(102T�:
1
00600
ji.i_9093
00929
M
0
U3
E
E
S%
r
E
0,
0
E
0
E
CL
0
0
E:
z
W Ir,
0
to
24-hr
hrs
su
MOILmg/Lmg/L
7.._mgx..
W100 m4
mg1L
mg/L'
mg/L
1
-2
13:20
-17--40
0.5
339i!92;�­;
6.92
0.01:-
�i
IL Mg
mgfL
Ratio"
mg/L
0.5
::310
3
12:30
-
0.5
77F77
4
15.45
0.5
277
5
11:30
0.5
Z120
6
�08-300.5
2,120
14
_55,,:
7.0
0
9
17:25
0.5
240
10
1315
0.5
.360i':
11
16:15
0. 5
0�t
1-5 0:
1-2
77-15
995
13
.995,
r
14
9-95
Is
15:25
0.5
7.07
16
15:15
0.5
375
17
14:15
0.5
390
is
17:00
0.5
430L
19
13:30
0.5
539, L
. .......
;20
539
21
539
2-2
T3_-45
0-5
730
7.01
0
T3
13:30
0-5
5.45--
24
12:30
0.5
433
25
H
H
L�:L 4�
26
H
H
L' 433
27
28
433�
T9
.35
75:
0.5
6.97
0_02'�
3 3 01
14:30 1
0.5
311
Average:
701
0.01 L L
Daily Maximum:
2120
7.07
0.02
Daily Minimum:
150L rL
6.92
0.00 T
Sampling Type: .�:Recorder
Grab
Grab
:Grab L L L
Grab
Grab r r
Grab
Grab
Grab
Monthly Avg. Limit:
7
Daily Limit:
.,3,67.0
Sample Frequency;j:r
r : 22 r
11week
Aveek
3x Year
3X Year
3x Year
tYear
3x Year
3x Year
3x Year

FORM: NDMR 10-13 NON -DISCHARGE MONITORING REPORT (NDMR)
Page 2 of 2
Sampling Person(s) Certified Laboratories
Name: Operators Name: Statesville Analytical
Name:
Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? o Compliant o 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
c1 c tc if nnra­A—
,2,
Operator in Responsible Charge (ORC) Certification Permittee Certification
ORC: Todd Robinson Permittee: YMCA of Greensboro
Certification No.: 1006252 Signing official: Rhonda Anderson
Grade: SI Phone Number: 252-235-8809 Signing Official's Title: President/CEO
Has the ORC changed since the previous NDMR? ° Yes o No Phone Number: Permit Expiration: 12/31/2026
r p
T
Signature Date Signature Date
By this signature, I certify that this report is accurate and complete to the best of my knowledge. 1 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 property 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 1 of 2
PermitNo.: WQ0019782 Facility Name- YMCA -
tY CAMP WEAVER County: Guilford Month: November Year: 2021
Did irrigation occur
at this facility?
YES ❑ Np
field Name:
1
Field Name:
2
Field Name:
3
Field Name:
Area (acres):
Cover Crop:
Hourly Rate (in):
4
Area (acres);
CoverCrop;
Hourly Rate (in):
Annual Rate (in);
0.3719
Natural Forest
0.4
38.3
Area (acres):
Cover Crop:
Hourly Rate (in):
Annual Rate (in):
0.3719
Natural Forest
0.4
38.3
Area (acres}
Cover Crap:
Hou Rate m
riy ( ).
;Annual Rate (in}
0.4477
r• Natural Forest •
0 4 , .. -
38 3
0.4477
Natural Forest
0.4
Weather
Freeboard
Field irrigatedT
❑YES
a Np ;
Fieid irrigated?
❑ YES
a
Annual Rate (in):
38.3
❑YES '?
Field Irrigated? gated?❑
YES
a No
No
Field lrri
®
❑mN.2]
�
mEm
3r
Cm
scmi
_,mLQ
o`vi
•,yR
0E
ain
c
s4.
m
TC
C-.
�d m�m
c
•.
❑ M
> Q
R
=
.�
M o
-
o'
CL
=Q
G
X�O R
'F
in
ft
ft
gal
min .
in
in:
gal
min
in
in
gal
min
{n
i
1
C
66
O.fl4
8-5
in
gal
min
in
in
MMms,_
C
54
0
8.52
d15
16
C
60
�67
0
8.21
17
C
0
8.21
18
PC
64
0
8.21
19
C
51
0
8.52
20
21
22
C
54
0.2
8.21
23
C
46
0
8.52
24
C
46
0
8.52
T25
H
H
H
26
27
H
H
H
291_fq_L 46 1 0 1 821
301 C 1 57 0.1 8.1 i
31
12 Month Floating Total
t x,n.C�we fa

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?
Were all setbacks listed in your permit maintained for every application to each permitted site?
o Compliant
❑ Non -Compliant
a Compliant
❑ Non -Compliant
El Compliant
❑ Non -Compliant
o Compliant
0 Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? 9 Compliant 11 Nan -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. Il
Operator In Responsible Charge (ORC) Certification Permittee Certification
ORC: Todd Robinson Permittee. YMCA of Greensboro
Certification No.: 1006252 signing official: Rhonda Anderson
Grade: SI Phone Number: 252-235-8809 Signing Official's Title: President/CEO
Has the ORC changed since the previous NDAR-17 ❑ Yes o No Phone Number: Permit Exp.: 12/31/26
v
Signature
Date Signature Date
er my
ection
By this signature. I certify that this report Is accurrate and complete to the best of my knowledge. I certify, with a systemedesigned tonalty of iassure that aw, that thisa qualified personnel properly gathered socument and all attachments were and evared luated the rinformatlon supervision
Based on y
Inquiry of the person or persons who manage the system, or those persons directly responsible for gaCredng 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