WQ0007026_Monitoring - 10-2022_20221125

Monitoring Report Submittal
Permit Number #*
Name of Facility:*
Month: * October
Report Information
WQ0007026
Sanford Health & Rehabilitation
Type *
NDMR, NDAR-1, NDAR-2, NDMLR
Confirmation Email Address:*
Name of Submitter: *
Signature:
Date of submittal:
Initial Review
[e-mail]
Randall Jarrell
Reviewer: Gerald, Wanda
Year:* 2022
Upload Document*
SHR NDMR 10-22.pdf
PDF Only
2.92M B
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
11 /25/2022
This will be filled in automatically

Is the project number correct?* WQ0007026
Is the monitoring report accepted?* Yes No
Regional Office* Raleigh
Reviewer: _anonymous
Review Date: 11/28/2022

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page L of
Permit No.: W00007026
Facility Name: Sanford Health & Rehabilitation
County: Chatham
Month: October
Year: 2022
PPI:
Flow Measuring Point: ❑ Influent [21 Effluent ❑ No flow generated
Parameter Monitoring Point: 7 influent Effluent ❑ Groundwater Lowering ❑ surface Water
Parameter Code -►
50050
00400
50060
00310
00610
00530
31616
00620
00625
70300
00665
00940
c
O
LL
=
CL
is m
'c
:a C
O
QU
L
0
m
c
O
£
a m
caC M
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Cn
E
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O
:
s
c
0
.eS
0
a
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am
? 'aO
F y p
y
cc
.
F
O
a
m
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24-hr
hrs
GPD
su
mg/L
mg/L
mg/L
mg/L
#/100 mL
mg/L
mg/L
mg/L
mg/L
mg/L
1
8,690
2
8,690
3
09:20
0.42
8,690
6.51
0.26
4
14:05
1
2,785
5
09:00
0.75
2,785
6
2,785
7
2,785
8
2,785
9
16:25
0.5
2,785
6.64
0.24
10
5,312
11
5,312
12
5,312
13
5,312
14
5,312
15
5,312
16
5,312
17
09:45
0.42
1 5,312
6.57
0.34
18
6,066
191
6,066
20
6,066
21
6,066
22
6,066
23
6,066
24
09:30
0.42
6,066
6.74
0.17
251
3,415
26
3,415
27
3,415
28
3,415
29
3,415
30
3,415
311
09:50 1
0.5
3,415
6.71
0.21
Average:
4,892
0.24
Daily Maximum:
8,690
6.74
0.34
Daily Minimum:
2,785
6.51
0.17
Sampling Type:
Monthly Avg. Limit:
Daily Limit:
Sample Frequency:

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page 2- of s"
Sampling Person(s) 11 Certified Laboratories
Name: Randall Jarrell Name: Eurofins (591)
Name: Name: Wastewater Management, L.L.C. (5038)
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? [21 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 11 Permittee Certification
ORC: Randall Jarrell
Certification No.: 7937, 23925
Grade: WW4, SI Phone Number: 919-210-2500
Has the ORC changed since the previous NDMR? ❑ Yes E No
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
Permittee: Jordan Wall
Signing Official: Randall Jarrell
Signing Official's Title: ORC
Phone Number: 919-210-2500
Permit Expiration: 2/28/2022
Signature Date
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: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page 3 of S
Permit No.:•000.
Facility Name: Sanford Health & Rehabilitation
C•
•1
October
Did irrigationoccur
L Field Name:
at this facility?
Area (acre
Cover Crop.
Cover Crop.
ve
F_,1 YES NO
MIT R-WINIMM
#
Hourly Rate (in):
HourlMate (in):
OEM Melr=.
out
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1 11
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FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page `7 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
E 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: Randall Jarrell
Permittee:
Jordan Wall
Certification No.: 7937, 23925
Signing Official: Randall Jarrell
Grade: WW4, SI Phone Number: 919-210-2500
Signing Official's Title: ORC
Has the ORC changed since the previous NDAR-1? ❑ Yes El No
Phone Number: 919-210-2500 Permit Exp.: 5/31/27
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

Sanford Health And Rehabilitation
12 Month Rolling Total Application In Inches
2022 2022 2022 2022 2022 2022 2022 2022 2022 2022 2021 2021 2022
Field Jan Feb March April May June July August Sept Oct Nov Dec Total
1 1.38 1.38 1.38 1.38 1.38 1.28 1.38 1.55 1.38 1.76 1.73 1.38 16.36