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Home My WebLink AboutWQ0002096_Monitoring - 06-2023_20230726 (4)Monitoring Report Submittal ..................................................... Permit Number#* WQ0002096 Name of Facility:* Month:* June Report Information Ahoskie Assisted Living Year:* 2023 Type* Upload Document* NDMR, NDAR-1, NDAR-2, NDMLR Waste Water NDMR June 2023.PDF 272.67KB PDF Only GW-59 Compliance Report Form June 2023.PDF 2.7MB PDF Only Please upload one PDF containing all applicable monitoring reports (i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59). Confirmation Email Address: * armstrongmgt2@gmail.com Name of Submitter: * Paula Armstrong Signature: Date of submittal: 7/26/2023 This will be filled in automatically Initial Review Reviewer: Wanda.Gerald Is the project number correct?* WQ0002096 Is the monitoring report accepted?* Yes No Regional Office* Washington Reviewer: Review Date: FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page of Permit No.: W00002096 Facility Name: Ahoskie Assisted Living County: Hertford Month: June Year: 2023 PPI: 001 Flow Measuring Point: [Q Influent ❑ Effluent ❑ No flow generated Parameter Monitoring Point: ❑ influent Q Effluent ❑ Groundwater Lowering ❑ Surface water Parameter Code -► 50050 00400 00310 31616 00630 00610 00625 00630 00665 50060 00940 70300 00620 00600 00615 76 p C 0 E2 W O o O in 0w m_ �U~�� a �'0 Vf (Vv O a p o E Q L z*£ 9 d orM 0 a+ z N 30 O a j O ii 2 2 > oO y 0 o O z Z 24-hr hrs GPD su mg/L #/100 mL mg/L mg/L mg/L mg/L mg1L mg/L mg1L mg1L mg1L mg/L mg/L 1 1,500 2 1,500 3 10:00 0.5 1,500 4 1,500 5 1,500 6 1,500 7 1,500 8 1,500 9 1,500 10 10:00 0.5 1,500 11 1,500 12 1,500 13 1,500 14 1,500 15 1,500 16 1,500 17 10:00 0.5 1,500 18 1,500 19 10:00 1.5 1,500 6.7 34 5300 94 6.38 19.35 0.11 2.51 0.02 32 370 <0.04 19.46 0.11 20 10:00 0.5 1,500 21 1,500 22 1,500 23 1,500 24 1,500 25 1,500 26 10:00 0.5 1,500 27 1,500 28 1,500 29 1,500 30 10:00 0.5 1,500 31 Average: 1,500 34,00 5,300.00 94.00 6.38 19.35 0.11 2.51 0.02 32.00 370.00 0.00 19.46 0.11 Daily Maximum: 1,500 6.70 34.00 5,300.00 94.00 6.38 19.35 0.11 2.51 0.02 32.00 370.00 0.04 19.46 0.11 Daily Minimum: 1,500 6.70 34.00 5,300.00 94.00 6.38 19.35 0.11 2.51 0.02 32.00 370.00 0.04 1 19.46 0.11 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 3/year 31year 3/year 31year 31year 3/year 3/year Weekly 3/year 3/year 3/year 3/year 31year 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? (D 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. Qualification of lab data; All QC requirements were not met: BOD 6/19/23 Replicate varied by more than 30%. 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: 252-2874153 Signing Officials Title: Administrator Has the ORC ed since the previous NDMR? ❑ Yes [21 No f Phone Number: 252-513-8591 Permit Expiration: 4/30/2025 Signature Date Signature Date By this signature, l 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 FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page Permit No.: WQ0002096 Facility Name: Ahoskie Assisted Living County: Hertford Month: June Field Nam�, Did irrigation occur Area (a6i�; Area (acres): Area (acres): at this facility? cover Crop: YES N D Ka Hourly te (in): Hourly te Ra oil M MMM MM-11M 11=11M 0=11M Mw MMIMEM - 0=11=11=11M Mm m mm OMAN= ME MM11=11=11M : � � --- M m 0=11=11=11m 11=11M , mmmmmm 11=11=11M MIM 11=11M MM 11M mmmmm 11=11=11M ME 11M Mmmm 11=11=11M W=11=11=11M ME mmmm 11=11=11M 11=11M 11=11M mmmm m 11=11M 11M ME ME M��mmmm ME 0=11=1 Sam=== ME 011=11M mmmm 11=11M 11=11M ....��. W= ME 0=11=11=11M 0=11=11M 11M MMII=IM�11= Monthly Loading:', WN WR �Iwl VE W-0 12 Month F[Trafik+t Tital (in)- womm MEM 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? ❑s Compliant ❑ Non -Compliant Were adequate measures taken to prevent effluent ponding in or runoff from the sites? 0 Compliant ❑ Non -Compliant Was a suitable vegetative cover maintained on all sites as specified in your permit? Q Compliant ❑ Non -Compliant Were all setbacks listed in your permit maintained for every application to each permitted site? Q Compliant ❑ Non -Compliant Were all freeboards maintained in accordance with the specified freeboard heights in your permit? 21Compliant ❑ 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 ch ad since the previous NDAR-1? ❑ Yes 21 No Phone Number: 252-513-8591 Permit Exp.: 4/30/25 " 11A '7,2 �73 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 FORUM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of Permit No.: WQ0002096 Facility Name: Ahoskie Assisted Living County: Hertford kyj M*E I irrigation • occur Area (acre at this facility? Cover Crop. Cover Crop:; YES NO Hourly Rate (in): Hourly Rate (in): . -... .. • .. •.�Field Irrigated?■ .. -. ■ ■ s - __AIM mMMM mm mmmmmm IMMMM ANNE m....m MEN Monthly Loading: • ,. o . •. ,� • •, o • •. ♦ ♦ . • • ��& Qa.L�z .i=? MO�-,a�rmi zs� :��.vY�M;�?�' _ � �zs SMINNE 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? i] Compliant ❑ Non -Compliant Q Compliant ❑ Non -Compliant ED Compliant ❑ Non -Compliant El Compliant ❑ Non -Compliant 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 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 [] No Phone Number: 252-513-8591 Permit Exp.: 4/30/25 r 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 knit 1617 Mail Service Center Raleigh, North Carolina 27699-1617