The URL can be used to link to this page

Home My WebLink AboutWQ0002096_Monitoring - 07-2023_20231023Monitoring Report Submittal Permit Number#* Name of Facility:* Month:* July 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* NDMR July 2023.PDF 272.99KB 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 ��.w.f!-�bwy Reviewer: Wanda.Gerald 10/23/2023 This will be filled in automatically Is the project number correct?* WQ0002096 Is the monitoring report accepted?* Yes No Regional Office* Washington Reviewer: _anonymous Review Date: 10/27/2023 FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page of Permit No.: WQ0002096 Facility Name: Ahoskie Assisted Living County: Hertford Month: July Year: 2023 PPI: 001 Flow Measuring Point: ❑✓ Influent ❑ Effluent ❑ No flow generated Parameter Monitoring Point: ❑ Influent Q Effluent ❑ Groundwater Lowering ❑ Surface Water Parameter Code 10 50050 00400 00310 31616 00530 00610 00625 00630 00666 50060 00940 T0300 00620 00600 00615 O c- E U a O 3 _ a o O -o � V 0 - O CL 0 a o Q -d CD fmY..% Z p Z+ � Z 3 r O _�m c U �ad Lo OO yZW a L.+ �F.� z z_ 24-hr hrs GPD su mg1L #1100 mL mg1L mg1L mg1L mg1L mg1L mg/L mg1L mg1L mg1L mg/L mg1L 1 1,445 2 1,445 3 1,445 4 1,445 5 1,445 6 1,445 7 10:00 1 1,445 8 1,445 9 1,445 10 10:00 0.5 1,445 6.7 <0.1 11 10:00 0.5 1,445 12 10:00 0.5 1,445 13 1,445 14 1,445 15 1,445 16 1,445 171 1,445 181 1,445 191 10:00 0.5 1,445 20 1,445 21 1,445 22 1,445 23 1,445 24 1.445 25 1,445 26 10:00 0.5 1,445 27 1,445 28 1,445 29 1,445 301 1,445 31 10:00 0.5 1,445 Average: 1,445 0.00 Daily Maximum: 1,445 6.70 0.10 Daily Minimum: 1,445 6.70 0.10 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 3/year 31year 3lyear I 3lyear 3/year 3/year Weekly 3/year 3/year 31year 31year 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 ❑ 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 c d since the pr us NDMR? ❑Yes (� No Phone Number: 252-513-8591 Permit Expiration: 4/30/2025 Signature Date ignature Date By this signature, I certify that this report is accurrate and complete to the best of my knowledge. I certify, under penally of 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 Permit No.: Q0000•. Facility Name: Ahoskie Assisted Living Hertford July � .I Did irrigation occur at this facility.? oYES . Mild .. -.. .. -. , . .. Annual Rate (in):;� MOM Field Irrigated? Field Irrigated? Field Irrigated?:�� ammmmm AMIN m�mIMM mmmm�� ■ �� ■�MWEIMIIN �Am� m�mm�� m■�� m��m� mmmm�� ■i■m� m■��m�� ®Monthly �mm�� m ■��. momm�r■■�r ��m��rr �r�mr■ Loading, lei m4-'✓%-- z"`"'"s,.Ses.i''/�. Y�'.:>'._.,..s ®�t��i�f��i6_'s+Y'1„'s..t'%.Y.r:e�_-:->��v°: 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? 0 Compliant ❑ Non -Compliant E Compliant ❑ Non -Compliant ❑✓ 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? ❑� 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 dates) 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 previous NDAR- w 1?❑Yes ❑ No 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 2/ , �j 61 Signature Date I certify, under penalty of taw, 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 No.: WQ0002096 Facility Name: Ahoskie Assisted Living County: Hertford me, irrigationPermit Did ��at -_ this facility? Cover .. - .. YES No Hourly Rate (in): Annual Rate (iny.! Field IrrigateV : MM MM M MN 0=11MME ® __MIMI==-_-- 11MME -__- m--_-- __-- m _ M 11=11MME __-_ MEME __-_ m__--_MIMIMMME -_-- -_-- m--_ --__ __-- M_-_0=11MME _-_ -�_- ®--__- -___ __-- ®_-___ -_-_ _- m __--_MEMINEMM-- -_-- m____- _-__ ____ m_____NM MN Ml - -_-___ -_= M _-_� -__- d - $, 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? D Compliant ❑ Non -Compliant Were adequate measures taken to prevent effluent ponding in or runoff from the sites? l] Compliant ❑ Non -Compliant Was a suitable vegetative cover maintained on all sites as specified in your permit? El Compliant ❑ Non -Compliant Were all setbacks listed in your permit maintained for every application to each permitted site? 0 Compliant ❑ Non -Compliant Were all freeboards maintained in accordance with the specified freeboard heights in 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 sheet- if nere--ary 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 chipped since the previous NDAR-1? ❑ Yes Q No Phone Number: 252-513-8591 Permit Exp.: 4/30/25 Signature Date Signature Date at By this signature, I certify that this report Is accurrate and complete to the best of my knowledge. I certify, under penalty of law.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