WQ0024577_Monitoring - 09-2023_20231106

Monitoring Report Submittal
...................................................
Permit Number#* WQ0024577
Name of Facility:* Sutton's Retirement Center, Inc.
Month: * September Year: * 2023
Report Information
Type* Upload Document*
NDMR, NDAR-1, NDAR-2, NDMLR WQ0024577 NDAR & N D M R sept 2023.pdf 566.05KB
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: * Kristen Tingen
Signature:
0io;WMV k4w-y
Date of submittal: 11/6/2023
This will be filled in automatically
Initial Review
Reviewer: Wanda.Gerald

Is the project number correct?* W00024577
Is the monitoring report accepted?* Yes NO
Regional Office* Washington
Reviewer: _anonymous
Review Date: 11/7/2023

FORM: NDAR-1 05-16 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page
Permit No.: WQ0024577
Facility Name: Sutton's Retirement Center WWTF
County: Wayne
Month: September
Year: 2023
Did irrigation
Field Name:
1
Field Name:
Field Name:
Field Name:
occur
Area (acres):
1
Area (acres):
Area (acres):
Area (acres):
at this facility?
Cover Crop:Coastal
Ha & Rye
Y Y
Cover Crop:
p�
Cover Crop:
p�
Cover Crop:
p:
YES No
Hourly Rate (in):
0.5
Hourly Rate (in):
Hourly Rate (in):
Hourly Rate (in):
Annual Rate (in):
20
Annual Rate (in):
Annual Rate (in):
Annual Rate (in):
Weather
Freeboard
Field Irrigated?
❑ YES ❑ No
Field Irrigated?
❑ YES ❑ No
Field Irrigated?
❑ YES ❑ No
Field Irrigated.
❑ YES ❑ No
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Monthly Loading:
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FORM: NDAR-1 05-16 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? ❑� 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 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: Gary C Sutton
Permittee:
Sutton's Rest Home
Certification No.: 989283
Signing Official: Gary C Sutton
Grade: SI Phone Number: 919-738-2236
Signing Official's Title: Owner
Has the ORC changed since the previous NDAR-1? ❑ Yes 0 No
Phone Number: 919-738-2236 Permit Exp.: 1/1/24
l
21-1
10/31 /23
0 _ 1 l 10/31 /23
Signatur 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

FORM: NDAR-1 05-16 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of
Raleigh, North Carolina 27699-1617

FORM: NDMR 05-16 NON -DISCHARGE MONITORING REPORT (NDMR) Page of
Sampling Person(s) Certified Laboratories
Name: Gary C Sutton Name: Environment One
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: Gary C Sutton
Permittee: Sutton's Rest Home
Certification No.: 989283
Signing Official: Gary C Sutton
Grade: SI Phone Number: 919-738-2236
Signing Official's Title: Owner
Has the ORC changed since the previous NDMR? ❑ Yes El No
Phone Number: 919-738-2236 Permit Expiration: 1/1/2024
( �1—\
`�
10/31/2023
10/31/2023
Signatur 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

FORM: NDMR 05-16 NON -DISCHARGE MONITORING REPORT (NDMR) Page
Permit No.: WQ0024577
Facility Name: Sutton's Retirement Center WWTF
County: Wayne
Month: September
Year: 2023
PPI: 001
Flow Measuring Point: Influent ❑� Effluent No flow generated
Parameter Monitoring Point: Influent ❑ Effluent ❑ Groundwater Lowering Surface Water
Parameter Code 0.
50050
00310
00940
50060
31616
00610
00625
00620
00600
00400
00665
70300
00530
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24-hr
hrs
GPD
mg/L
I mg/L
mg/L
#/100 mL
mg/L
mg/L
mg/L
mg/L
su
mg/L
mg/L
mg/L
1
09:00
1
1,642
2
1,642
3
1,642
4
1,642
5
1,642
6
1,642
7
09:30
6
1,642
0.004
6.9
8
1,642
9
1,642
10
1,642
11
1,642
121
1,642
13
09:00
1
1,642
14
1,642
15
1,642
16
1,642
17
1,642
181
09:00
30 min
1,642
19
1,642
20
1,642
21
1,642
22
1,642
23
1,642
241
09:00
1
1,642
25
1,642
26
1,642
27
1,642
28
1,642
29
09:00
1
1,642
301
09:00
30 min
1,642
31
Average:
1,642
0.00
Daily Maximum:
1,642
0.00
6.90
Daily Minimum:
1,642
0.00
6.90
Sampling Type:
Estimate
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Monthly Limit:
4,920
Daily Limit:
Sample Frequency:
Monthly
3 X Year
3 X Year
Per Event
3 X Year
3 X Year
3 X Year
3 X Year
3 X Year
Per Event
3 X Year
3 X Year
3 X Year