WQ0018708_WQ0018708 Non Discharge Monitoring Report January 2016_20160101

AR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1)
PitVNoO018708
WQ
Facility Name: Lake Creek Corporation
County:
Did irrigation occur
19,
U
Field Name:
-
Area (acres):
this facility?
at
Cove r Crop:
EYES El NO
Hourly Rate (in):
rl*�#
Annual Rate (in):
Field Irrigated?
DYES ONO
101W
eather
Freeboard
CL
ca
CD
Or
in
ft
A
min
in
in
Vil
10
Page ___of___
I Field Name:
Area
Cover Crop:
Hourly Rate
Annual Rate (in):
Field Irrigated?
OYES ONO
Z.
11
gal
min
I in
in
30
31
z
If

Did the application rates exceed the limits in Attachment B of your permit?
Were adequate measures taken to prevent effluent pdnding 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?
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 Certlficatlon
ORC: Chip White Permittee:
YMCA of Greensboro
Certification No.: Signing Official: Greg Jones
Grade: Phone Number. 252-235-4900 Signing Official's Title: President/CECI
Has the ORC changed since the previous NDAR-.1? Phone Number. 3368548410 Permit Exp.: 9/30/15
` I
Signature Date Signature 4 Date
�epare
By this signature, I certify that this report is axurrate and complete to the best of my knowledge. I certify, under penalty of law, that this document and all attachmener 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.
Mall Original and Two Copies to:

03-12
NON -DISCHARGE MONITORING REPORT (NDMR)
Page 1 of 2
�t NFaciiityName:
7WQ001
Lake Creek Corporation
County:
Bladen
Month:
January
Year: 2016
PPI:Flow
Measurin
9 oP ent uent o ow generat
n en
Parame er ont onng
run wa er owering
oinParameter►
u ce
a er
; 50050 �.
00400
, 50960
31616
"`"00530 ,:
00610
06625 '
00600
00620
00940
'0031.0 -:
70300
60630` °'
00620
>
` '
,-
f0
•— _'
3�'.
--
C.
O 'y. 0
��
y-
�c
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C
a) '
O o•
i_
o_
,
p
f"
U C
X O
LL
H d' L
N_
LL O
O
F- .y-=�
o°°
t- = ''
�`
Z.
O
t
L%J
F- y o
•+
r+
p�.
=,..
24-hr
hrs
GPD_�
su
-.ing/L
#/100 mL
ing/L',
mg/L
mg/L "'
mglL
�mglL.
mg/L
mglL,
mg/L
mgfL_.,;
mg/L
1
H
54;223 .
2
54,223 ,� ';
s
3
• 54,223.. ;.
`.
4
08:30
0.5
5
31;228 m-
7
32,654
8
9
31;741,
10
31,741��_
11
06:00
1
24,893
7
0.812
-
14
28,169 ,
15
'W09216
17
^ "36;992:
18
26,506; ;
,
20
i r24;27,8.-
21
25,939�', 1
22
34,927 ::,,
23
34,927
24
:° 34 �27;.,.
25
14:00
0.5
: ' 29x999
26
3Q670:
27
28;361 °
28
29
30
31
Average:
°"32;228"
0 80
Daily Maximum:
; 54,223 ':
7.00
0:80
Daily Minimum:
2 t TE9_"
7.00
0:80 ..
,_ �_°:, ;
'••-M.
; `_
Sampling Type:
o Recoctler =
Grab
Grab
Grab
Grab
Grab
_
:. Grab •�_
Grab
• ,
„Grab
Grab
Grab"'
Grab
,
Monthly Limit:.,;
20009,E
`•'
= ;;•
Daily Limit:
Sample Frequency:
Coritinubu,!
2/month
' 2/month...
4Near
4Near
4Near
;,4/Year
4/Year
4/Year -.
3/Year
4/Year, ;,
3/Year

FORM: NDMR 03-12
NON -DISCHARGE MONITORING REPORT (NDMR)
Page 2 of 2
Sampling Person(s) Certified Laboratories
Name: Tony Baldwin Name: :Environment 1
UCompliaLJNon-
hlame: Name:
Dares aii monitoring data and sai'> pPing frequencies meet the. requirements its Attachment A of your permit?
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 necessarv.
Operator in (Responsible Charge (ORG) Certification
Parmittee Certification
ORG: -Irony Baldwin
Permittee: Lake Creek Corporation
Certification No.: 29101
Signing Official:
Grade: SI Phone Number: 252-235.4900
1
Signing Official's Title: p1�eSl�le�a'�-
Has the ORC changed since the previous NDMR?
Phone Number: 704-576-8462 Permit Expiration: 6/30/2016
'� %` ✓ Signature Date
Signature S(CY-)�1'� �t 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 tattachments 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 or Water Quality
Information Processing Unit
1617 Mail SeDvica Center
Raleigh, North Carolina 27699.1617