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Home My WebLink AboutWQ0002096_Monitoring - 05-2023_20230628Monitoring Report Submittal Permit Number#* Name of Facility:* Month: * May WQ0002096 Ahoskie Assisted Living Report Information Type * NDMR, NDAR-1, NDAR-2, NDMLR Confirmation Email Address: Name of Submitter: * Signature: Date of submittal: Initial Review Year:* 2023 Upload Document* Waste Water Reports May 2023.PDF 268.41 KB PDF Only Please upload one PDF containing all applicable monitoring reports (i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59). armstrongmgt2@gmail.com Paula G Armstrong c�nula (,��ar4Gtary Reviewer: Wanda.Gerald 6/28/2023 This will be filled in automatically Is the project number correct?* W00002096 Is the monitoring report accepted?* Yes NO Regional Office* Washington Reviewer: _anonymous Review Date: 7/13/2023 FORM. NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page Permit No.: WQ0002096 Facility Name: Ahoskie Assisted Living County: Hertford Month: May Year: 2023 PPI: 001 Flow Measuring Point: Q Influent ❑ Effluent ❑ No flow generated Parameter Monitoring Point: ❑ Influent [ Effluent ❑ Groundwater Lowering Tj Surface Water Parameter Code --► 50050 00400 00310 31616 00530 00610 00625 00630 00665 50060 00940 70300 00620 00600 00615 U c O E � O O 1L o .y o CLoE F- o a M' +E 4 o c 0 ro o° No E' 0zoz o •Co- zo .a`. zz 24-hr hrs GPD su mg1L #1100 mL mglL mg1L mglL mglL mglL mglL mg1L mglL mglL mglL mglL 1 10:00 0.5 1,428 7 0.12 2 10:00 0.5 1,428 3 10:00 0.5 1,428 4 10:00 0.5 1,428 5 10:00 0.5 1,428 6 1,428 7 1,428 8 1,428 9 10:00 0.5 1,428 10 1,428 11 1,428 12 1,428 13 1,428 14 1,428 15 1,428 16 10:00 0.5 1,428 17 1,428 18 10:00 0.5 1,428 6.9 0.62 19 10:00 0.5 1,428 20 10:00 0.5 1,428 211 1,428 22 1,428 23 1,428 24 1,428 25 1,428 26 1,428 271 10:00 0.5 1,428 281 1,428 29 1,428 30 1,428 31 1,428 Average: 1,428 0,37 Daily Maximum: 1,428 7.00 0.62 Daily Minimum: 1,428 6.90 0,12 Sampling Type: Estimate Grab Grab Grab Grab Grab Grab Calculated Grab Grab Grab Grab Grab Calculated Grab Monthly Avg. Limit: 7,500 Daily Limit: Sample Frequency: Continuous Weekly 31year 3/year 31year 3/year 31year 31year 31year Weekly 3/year 31year 31year 3/year 3/year FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page of Sampling Person(s) Certified Laboratories Name: Randy Parker Name: Environment 1, Inc. Name: Name: Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? ❑� Compliant ❑ 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. Operator in Responsible Charge (ORC) Certification Permittee Certification ORC: Randall Parker Permittee: Ahoskie Assisted Living Certification No.: 996843 Signing Official: Paula Armstrong Grade: SI Phone Number: 252-287-4153 Signing Official's Title: Administrator Has the ORC changed since the previous NDMR? ❑ Yes 21 No Phone Number: 252-513-8591 Permit Expiration: 4/30/2025 w � 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 penally 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 Were 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 of Permit No.: VVQ0002096 FacilityName: AhoskieAssisted Living County: Hertford me, M.. a Did irrigation occur • • ''I - . • -G .�. this facility? �® Area (acres):' �® at YES NO 0.25 Hourly Rate (in)� 18 gi ll mmml,mmm w w Monthly Loadjng:y--c,� r�, 1 1 1 :" ate' 1 0 n 1 1 1 l FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of Did the application rates exceed the limits in Attachment B of your permit? Q Compliant ❑ Non -Compliant Were adequate measures taken to prevent effluent ponding in or runoff from the sites? ❑r Compliant ❑ Non -Compliant Was a suitable vegetative cover maintained on all sites as specified in your permit? 0 Compliant ❑ Non -Compliant Were all setbacks listed in your permit maintained for every application to each permitted site? ❑� Compliant ❑ Non -Compliant Were all freeboards maintained in accordance with the specified freeboard heights in your permit? ❑Q 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 ORC: Randall Parker Certification No.: 996843 Grade: SI Phone Number: 252-287-4153 Has the ORC changed since the pr DAR-1? ❑ Yes 7 No 7. Signature Date By this signature, I certify that this report is accurrate and complete to the best of my knowledge. Permittee Certification Permittee: Ahoskie Assisted Living Signing Official: Paula Armstrong Signing Officials Title: Administrator Phone Number: 252-513-8591 Permit Exp.: 4/30/25 �. ')�1�3 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) rage of Permit No.: VVQ0002096 Facility Name: Ahoskie Assisted Living County: Hertford Month: May irrigation • occur at this facility? Annual (in):Field -- Irrigated? m_-___ •� .1 a -�-_ ____ mmmmmm ®__--- ®mmmmm mmmmmm �r■■�� Loading:Monthly .• •,• - ,,. Ammo •,- • ♦ _ • • %$%i�� 23�iY:m.._,]�G_'is ��.„�- '�� -� "^..lv'.-•...wu � ��-'''Y"'ri Y Y..r..,x.'�; �} ��'� iY '� °� ✓i ��c�' �'Y�y'�f `�T �� R'r�ygCiWr"' ..--�'J�e��'�. FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page 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 Q 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 Parker Permittee: Ahoskie Assisted Living Certification No.: 996843 Signing Official: Paula Armstrong Grade: SI Phone Number: 252-287-4153 Signing Official's Title: Administrator Has the ORC changed since the previous NDAR-1? ❑ Yes F/� No Phone Number: 252-513-8591 Permit Exp.: 4/30/25 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