WQ0002096_Monitoring - 09-2023_20231023

Monitoring Report Submittal
.....................................................
Permit Number#* WQ0002096
Name of Facility:*
Month: * September
Report Information
Ahoskie Assisted Living
Year:* 2023
Type* Upload Document*
NDMR, NDAR-1, NDAR-2, NDMLR NDMR Sept 2023.PDF 206.9KB
PDF Only
GW-59 Compliance Report Sept 2023.PDF 2.66MB
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: * Paula G Armstrong
Signature:
Date of submittal: 10/23/2023
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: _anonymous
Review Date: 10/23/2023

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page of
Permit No.: WQ0002096
Facility Name: Ahoskie Assisted Living
County: Hertford
Month: September
Year: 2023
PPI: 001
Flow Measuring Point: ❑ Innuent ElEffluent El No Flow generated
Parameter Monitoring Point: ❑ InP,uent ❑ Effluent ❑ Groundwater Lowering ❑ Surface Water
Parameter Code - 0
50050
00400
00310
31616
00530
00610
00625
00630
00665
50060
00940
70300
00620
00600
00615
m
E
q
O
- O
a
-a
ro
r
Z
m
o
aF-
N
of 0
U
O N- '
�ZU
O O
-
ZO
.`_•
24-hr
hrs
GPD
su
mg1L
#1100 mL
mg1L
mg1L I
mg1L
mg/L
mglL
mg1L
mg/L
mg1L
mg/L
mg1L
mg1L
1
1,601
77
2
1,601
3
1,601
4
1,601
5
10:00
0.5
1,601
6.9
0.46
'
6
10:00
0.5
1,601
7
10:00
0.5
1,601
8
10:00
0.5
1,601
9
1,601
10
1,601
11
07:00
1.5
1,601
6.8
32
6
54
8.5
17.6
0.14
2.34
2.2
46
330
0.1
17.74
0.04
121
10:00
0.5
1.601
13
10:00
0.5
1,601
14
1,601
15
1,601
16
1,601
17
10:00
0.5
1,601
18
1,601
19
1,601
20
1,601
21
1,601
22
1,601
231
1,601
241
10:00
0.5
1,601
251
1,601
26
10:00
0.5
1,601
6.9
0.2
27
10:00
0.5
1,601
28
10:00
0.5
1,601
29
1,601
30
10:00
0.5
1,601
31
Average:
1,601
32.00
6.00
54,00
8.50
17.60
0.14
2.34
0.95
46.00
330,00
0.10
17.74
0.04
Daily Maximum:
1,601
6,90
32.00
6.00
54.00
8.50
17.60
0.14
2.34
2,20
46.00
330.00
0.10
17.74
0.04
Daily Minimum:
1,601
6.80
32.00
6.00
54.00
8.50
17.60
0.14
2.34
0.20
46,00
330.00
0.10
17,74
0.04
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
I 3/year
3lyear
3/year
3/year
3/year
Weekly
3/year
3lyear
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: Waypoint Analytical
Name: Name:
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.
Qualification of lab data: All QC requirements were not met; Total Dissolved Residue- Laboratory control sample exceeded control limits. Blank result exceeded method constant weight criteria.
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 Ci No
Phone Number: 252-513-8591 Permit Expiration: 4/30/2025
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 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
of
Permit No.: WQ0002096
Facility Name:
Ahoskie Assisted
Living
County: Hertford
Month:
September
Year; 2023
Did irrigation occur
Field Name:
Site1
Field Name:
Site 2
Field Name:
Site 3
Field Name:
Site 4
Area (acres):
1.75
Area (acres):
1.33
Area (acres):
1.36
Area (acres):
1.5
at this facility?
Cover Cro .
p
Trees
CoverCro p:
Trees
. Cover.:Crop:
:. Trees/Bermuda,
Cover Crop:
Bermuda
(] YES ❑ No
Hourly.Rate.(in):
0.25
Hourly Rate (in):
0.25
Hourly:Rate (in):
0.25
Hourly Rate (in):
0.25
Annual Rate (in):
';;`:i8.a:: -,i # °:=
Annual Rate (in}:
18
Anrivai Zate (iri): '.<:.;
::= 315 : <:' :.':
Annual Rate (in):
31.5
Weather
Freeboard
Field Irrigated?
i] YES []NO ..
Field Irrigated?
i] YES
❑ No
Field Irrigated?
. i, YES . Elmo
Field Irrigated?
it YES ❑ No
y4
.,.
..::,:......:
ti..: .....
:...�O,?Jp�;.:.:,
.,c9 .•.
e
; •v
.a'a.;aEi
-
E �'oe� .
m o
w
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rcon
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E
.'9
M
.�kkro
E 2
a.
:m
Em
E
arnc
.a,
E
°GC
o
E
a
,v
OaE...:.�a.`aC
':..
p
S
O G
.
p
GCL.J
p
•EG
0aE
j
r•n+
i�, ts
.
.
�
=
J
,
IL
°F
in
ft
ft
..gal ;':.....min
.:
in
in
gal
min
in
in
:gal :: ,`.;'min:::::.
In
in
gal
min
in
in
2
3
4
5
C
89
1.66
27,600
: 240 `
: 0.58 :i'
.. 0.15
6
G
90
48,300 :.::
`420 :.:
1.02 ;':
'. 0.15
7
C
82
sw
48,300
420
1.34
0,19
8
C
88
41,400
360
1.15
0.19
9
0.5
101
1
0.1
11
CL
82
20,700
180
' '0.56
0.19
12
CL
82
2.16
13,800
.120
....0.38 :::.:'
0.19
13
CL
80
0.4
14
15
16
17
C
79
2
18
19E.
20
;
21
22
1.5
23
1
24
CL
74
1.75
25
26
CL
69
34,500
300
0.94
';'.0.19
27
CL
67
20,700
180
0.51
0.17
28
CL
68
27,600
240
0.66
0.17
29
30
CL
70
2.16
31
Monthly Loading:
75,900
1.60
89,700
2.48
69,000 '
1.88
48,300
1.19
12 Month Floating Total (in):
2.18
4.97
fi.77
7.14

FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of
Did the application rates exceed the limits in Attachment 6 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?
Q Compliant ❑ Non -Compliant
Q Compliant ❑ Non -Compliant
Q Compliant ❑ Non -Compliant
Q Compliant ❑ Non -Compliant
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
Permittee Certification
ORC: Randall Parker
Permittee:
Ahoskie Assisted living
Certification No.: 996843
Signing Official: Paula Armstrong
Grade: SI Phone Number: 252-287-4153
Signing Officials Title: Administrator
Has the ORC changed since the previous NDAR-17 ❑ Yes [] 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 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 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 of
Permit No.: WQ0002096
Facility Name: Ahoskie Assisted Living
County: Hertford Month: September
Year: 2023
Did irrigation occur
at this facility?
R1 YES ❑ No
Field Name:
Site 5
Field Name:
Field Name:
Field Name:
Area (acres):.
1.94
Area (acres):
-Area'('acres):
Area (acres):
Cover Crop:
Bermuda
Cover Crop:
Coder Crop:,Cover
Crop:
Hourly Rate (in):
0.25
Hourly Rate (in):
Hourly Rate (in):
Hourly Rate (in):
Annual Rate (in):
: 3. 1 5 .++' ';":
Annual Rate (in):
Annual':Rate'{in)c:
'
Annual Rate (in):
Weather
Freeboard
Field Irrigated?
j] YES ❑ No
Field Irrigated?
❑ YES ❑ NO
Field _Irrigated?
El YES ❑ NO
Field Irrigated?
❑ YES ❑ No
o
m
m
o
DL
o
CO
o�
CL
a
Ea
E
moy
a
v
i=
tM
�
O
0
°
Eam
3
a
.
m as.
E
'
c
.
,
£ m°
o Q
E
m
rn>,
5
a mn
°F
in
ft
ft
gal .'.
min
In .:'.
in
gal
min
in
in
gal
min
1n
in
gal
min
in
in
1
2
3
4
5
6
7
-
8
-
9
10
..
11
12
13
;
::.....:. .. :...::
14
16
17
18
19
20
21
k.
22
23
24
p
25
26
27
28
29
30
27,600
240
0.52
0.13
317d
I
I
Monthly
Loading:1
00
0.52
0
0.00
0
0.00
0
s-.
0.00
V.
12 Month Floating Iota! (in):
6.40
-

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?
[] Compliant
❑ Non -Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites?
❑� 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?
Q 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.
IOperator in Responsible Charge (ORC) Certification I Permittee Certification I
ORC: Randall Parker
Certification No.: 996843
Grade: S1 Phone Number: 252-287-4153
Has the ORC changed since the pre3jQus NDAR-1? ❑ Yes ❑ No
Permittee:
Ahoskie Assisted Living
Signing Official: Paula Armstrong
Signing Official's Title: Administrator
Phone Number: 252-513-8591 Permit Exp.: 4130/25
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