WQ0022224_Monitoring - 01-2022_20220331

Monitoring Report Submittal
........ ......... ......... ......... .........
Permit Number #* WQ0022224
Name of Facility:* Sam's Branch WRF
Month: * January Year: * 2022
Report Information
Type* Upload Document*
Revised - NDMR, NDAR-1, NDAR-2, January Signed.pdf 2.52MB
NDMLR PDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
Confirmation Email Address:* [e-mail]
Name of Submitter: * william R Simpson
Signature:
Date of submittal: 3/31/2022
This will be filled in automatically
Initial Review
Reviewer: Gerald, Wanda

Is the project number correct?* WQ0022224
Is the monitoring report accepted?* Yes No
Regional Office* Raleigh
Accepted Date:
4/18/2022

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page/ of __3�_
Permit No.: W00022224
Facility Name: Sam's Branch WRF
County: Johnston
Month: January
Year: 2022
PPI: 001
Flow Measuring Point: ❑ Influent ❑ Effluent [J No flow generated
Parameter Monitoring Point: ❑ Influent ❑Effluent ❑Groundwater Lowering ❑ Surface Water
Parameter Code 0
00310
31616
00610
00530
00076
ra
p
t d
U
W
O
c
E d
H
L)
WO
p
m
E
p
LL o
v
c
o
E
E
Q
a w
M c a
FYo— N p
to
o
24-hr
hrs
mg/L
#/100 mL
mg/L
mg/L
NTU
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Average:
Daily Maximum:
Daily Minimum:
Sampling Type:
Composite
Grab
Composite
Composite
Recorder
Monthly Avg. Limit:
10
14
4
5
Daily Limit:
15
25
6
10
10
Sample Frequency:
2-Week
Monthly
2 x Week
2 x Week
Continuous

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page Z of 3
Permit No.: W00022224
Facility Name: Sam's Branch WRF
County: Johnston
Month: January
Year: 2022
PPI: 002
Flow Measuring Point: ❑ Influent ❑ Effluent [] No flow generated
Parameter Monitoring Point: _] Influent ❑ Effluent ❑ Groundwater Lowering ❑ Surface Water
Parameter Code — ►
WQ01
�
._
m
V F
O
OO
�,
E
0
v
m
o
24-hr
hrs
gallons
1
00:00
2
3
4
5
6
7
8
9
a
10
m
11
12
0
13
d
14
15
v
m
16
E
17
g
18
191
r
20
0
21
22
0
23
ir'
24
25
26
27
28
29
30
31
Average:
Daily Maximum:
Daily Minimum:
Sampling Type:
Estimate
Monthly Avg. Limit:
Daily Limit:
Sample Frequency:
Monthly

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page 3 of L
Sampling Person(s) Certified Laboratories
Name: David Atkinson, Salvador Valdiviezo, Chad Wallace Name: Environmet 1 Inc., Meritech Inc., Cameron Testing Services
Name: Mattie Frazier, Stefania Marroquin 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: William R Simpson
Permittee: Town of Clayton
Certification No.: 1001099
Signing Official: William R Simpson
Grade: Grade 4 Bio. Phone Number: 919-553-1536
Signing Official's Title: Water reclamation Superintendent
Has the ORC changed since the previous NDMR? ❑ yes 2 No
Phone Number: 919-553-1536 Permit Expiration: 10/31/2026
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. 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