WQ0014785_Monitoring - 03-2023_20240314

Monitoring Report Submittal
Permit Number#* WQ0014785
Name of Facility:* Midway Middle School
Month: * March Year: * 2023
Report Information
Type* Upload Document*
NDMR, NDAR-1, NDAR-2, NDMLR March 2023.pdf 5.47MB
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: * Robert Carroll
Signature:
Date of submittal: 3/14/2024
This will be filled in automatically
Initial Review
Reviewer: Wanda.Gerald

Is the project number correct?* WQ0014785
Is the monitoring report accepted?* Yes No
Regional Office* Fayetteville
Reviewer: _anonymous
Review Date: 3/18/2024

FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page
Permit No.: W00014785
Facility Name: Midway Middle School
County: Sampson
Month: March
Year: 2023
Did irrigation occur
Field Name:
1
Field Name:
2
Field Name:
3
Field Name:
4
at this facility?
Area (acres):
0.435
Area (acres):
0.435
Area (acres):
0A35
Area (acres):
0.435
Cover Crop:
Cover Crop:
Cover Crop:
Cover Crop:
DYES ❑No
Hourly Rate (in):
0.16
Hourly Rate (in):
0.16
Hourly Rate (in):
0.16
Hourly Rate (in):
0.16
Annual Rate (in):
39
Annual Rate (in):
39
Annual Rate (in):
39
Annual Rate (in):
39
Weather
Freeboard
Field Irrigated?
L-1YES ONO
Field Irrigated?
EYES ❑No
Field Irrigated?
DYES ONO
Field Irrigated?
OYES El NO
oUL
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in
ft
ft
gal
min
in
in
gal
min
in
in
gal
min
in
in
gal
min
in
in
1
C
55
0
6.5
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0,11
2
C
70
0
6.5
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
3
C
75
0
6.5
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
4
CL
72
0
6.5
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
5
C
58
0
6.5
1.250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
6
C
61
0
6.5
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
7
C
68
0
1 6.5
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
8
C
45
0
6.5
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
9
C
47
0
6.5
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
10
CL
49
0
6
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
11
C
52
0
6
1,250
20
1 0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
12
CL
48
0
6
1,250
20
0,11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
13
C
48
0
6
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
14
C
51
0
6
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
15
C
41
0
6
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
16
CL
43
0
6
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11 1
0.11
1,250
20
0.11
0.11
17
C
74
0
6
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
18
C
50
0
6
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
CA 1
0.11
1,250
20
0.11
0.11
19
C
55
0
6
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20 1
0.11
0.11
20
CL
35
0
6
1,250
20
0.11
0.11
1,250
20
0.11 1
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
21
C
47 1
0
6
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11 1
0.11
1,250
20
0.11
0.11
22
C
51
0
6
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
23
C
75
0
5.5
1.250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
24
C
78
0
5.5
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
25
CL
81
0
5.5
1.250
20
0.11
0.11
1,250 1
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
26
CL
80
0
5.5
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
27
C
78
0
7
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0,11
0.11
1,250
20
0.11
0.11
28
C
70
0
7
1,250
20
0.11
0.11
1,250
20
0,11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
29
C
54
0
7
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
30
C
54
0
7
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
311
CL
54
0
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
#REF!
1,250 1
20
0.11
0.11
Monthly Loading:
38,750
3.28
38,750
3.28
38,750
3.28
38,750
M
3.28
12 Month Floating Total (in):
4.23
4.23
4.23
4.23

FORM: NDAR-1 08-11 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?
R Compliant ❑ Non -Compliant
2) Compliant ❑ Non -Compliant
O Compliant ❑ Non -Compliant
O Compliant ❑ Non -Compliant
71 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 (CRC) Certification
Permittee Certification
ORC: JASON DICKINSON
Permittee:
SAMPSON COUNTY SCHOOLS
Certification No.: 1007291
Signing Official: JASON DICKINSON
Grade: SI Phone Number: 910-385-4915
Signing Official's Title: ORC
Has the ORC changed since the previous NDAR-1? El Yes ONo
Phone Number: 910-385-4915 Permit Exp.: 10/31/28
r 2 Co .Z 3
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 Quality
Information Processing Unit
1617 Mail Service Center

FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page
Permit No.: WQ0014785
Facility Name: Midway Middle School
County: Sampson
Month: March
Year: 2023
Field Name:
5
Field Name:
6
Field Name:
7
Field Name:
8
Did irrigation occur
Area (acres):
0.435
Area (acres):
0.435
Area (acres):
0.435
Area (acres):
0.435
at this facility?
Cover Crop:Cover
Crop:
P�
Cover Crop:
p�
Cover Crop:
P:
❑ YES ❑ No
Hourly Rate (in):
0.16
Hourly Rate (in):
0.16
Hourly Rate (in):
0.16
Hourly Rate (in):
0.16
Annual Rate (in):
39
Annual Rate (in):
39
Annual Rate (in):
39
Annual Rate (in):
39
Weather
Freeboard
Field Irrigated?
'DYES ❑No
Field Irrigated?
❑YEs ONO
Field Irrigated?
EYES ❑No
Field Irrigated?
OYES ❑NO
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° a
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in
ft
ft
gal
min
in
in
gal
min
in
in
gal
min
in
in
gal
min
in
in
1
C
55
0
6.5
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
2
C
70
0
6.5
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
3
C
75
0
6.5
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
4
CL
72
0
6.5
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
5
C
58
0
6.5
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
6
C
61
0
6.5
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
7
C
68
0
6.5
11250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
8
C
45
0
6.5
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
9
C
47
0
6.5
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
10
CL
49
0
6
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
11
C
52
0
6
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
12
CL
48
0
6
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
13
C
48
0
6
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
14
C
51
0
6
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
15
C
41
0
6
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
16
CL
43
0
6
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
17
C
74
0
6
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
1 0.11
1,250
20
0.11
0.11
18
C
50
0
6
1,250
20
011
0.11
1,250
20
0.11
0.11
1,250
20
0,11
0.11
1,250
20
0.11
0.11
19
C
55
0
6
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1.250
20
0,11
0.11
1,250
20
0.11
0.11
20
CL
35
0
6
1.250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0,11
0.11
1,250
20
0.11
0.11
21
C
47
0
6
1,250
20
0.11
0.11
1,250
1 20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
22
C
51
0
6
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
23
C
75
0
5.5
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1.250
20
0.11
0.11
1,250
20
0.11
0.11
24
C
78
0
5.5
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
25
CL
81
0
5.5
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1.250
20
0,11
0.11
1,250
20
0.11
0.11
26
CL
80
0
5.5
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
27
C
78
0
7
j
1,250
20
0,11
0.11
1,250
1 20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
1 0.11
28
C
70
0
7
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0,11
0.11
1,250
1 20
0.11
0.11
29
C
54
0
7
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
20
0.11
0.11
30
C
54
0
7
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
F 20-1
0.11
0.11
1,250
20
0.11
0.11
31
CL
54
0
1,250
20
0.11
0.11
1,250
20
0.11
0.11
1,250
r 20
0.11
#REFI
1,250
20
0.11
0.11
Monthly Loading:
38,750
3,28
=1
38,750
3.28
38,750
3.28
38,750
3.28
12 Month Floating Total (in):
4.23
4.23
4.23
4.23

FORM: NDAR-1 08-11 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?
O Compliant ❑ Non -Compliant
O Compliant ❑ Non -Compliant
O Compliant ❑ Non -Compliant
O Compliant ❑ Non -Compliant
O Compliant Ll 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: JASON DICKINSON
Permittee: SAMPSON COUNTY SCHOOLS
Certification No.: 1007291
Signing Official: JASON DICKINSON
Grade: SI Phone Number: 910-385-4915
Signing Official's Title: ORC
Has the ORC changed since the p evious NDAR-1? ❑ves JNo
Phone Number: 910-385-4915 Permit Exp.: 10/31/28
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 Quality
Information Processing Unit
1617 Mail Service Center

FORM: NDMLR 08-11 NON -DISCHARGE MASS LOADING REPORT (NDMLR) Page of
Permit No.: VVQ0014785
Facility Name: Midway Middle School
County: Sampson
Month: March
Year: 2023
Field Name:
1
Field Name:
2
Field Name:
3
Field Name:
4
Field Name:
5
Area (acres):
0,435
Area (acres):
0.435
Area (acres):
0.435
Area (acres):
0.435
Area (acres):
0.435
Cover Crop:
Cover Crop:
Cover Crop:
Cover Crop:
Cover Crop:
Load Type:
PAN
Load Type:
PAN
Load Type:
PAN
Load Type:
PAN
Load Type:
PAN
Field Loaded?
El YES ❑NO
Field Loaded?
ElYES ❑NO
Field Loaded?
OYES ❑NO
Field Loaded?
OYES El NO
Field Loaded?
DYES El NO
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gal
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Ibslac
gal
rng/L
Ibs/ac
Ibs/ac
gal
mg/L
Ibs/ac
Ibslac
gal
mg/L
Ibslac
Ibs/ac
gal
mg/L
Ibslac
Ibs/ac
April
May
June
July
August
September
October
November
December
January
February
March
38,750
9.29
6.9
6.9
38,750
9.29
6.9
6.9
38,750
9.29
6.9
6.9
38,750
9.29
6.9
6.9
38,750
9.29
6.9
6.9
12 Month Floating PAN Load
6.9
6.9
6.9
V-4-
M
ffl-
6.9
6.9
(Ibs/ac/yr):
Annual PAN Load Limit
785
7.85
7.85
7.85
7.85
(Ibs/ac/yr):

FORM: NDMLR 08-11 NON -DISCHARGE MASS LOADING REPORT (NDMLR) Page of
Did the mass loading rates exceed the limits in Attachment B of your permit? 3Compliant ❑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 11 Permittee Certification I
ORC: JASON DICKINSON
Certification Number: 1007291
Grade: SI Phone Number: 910-385-4915
Has the ORC changed since the previous NDMLR? ❑Yes o No
r
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
Permittee: SAMPSON COUNTY SCHOOLS
Signing Official: JASON DICKINSON
Signing Official's Title: ORC
Phone No.: 910-385-4915 Permit Exp.: 10/31/28
1
Signature Date
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 Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

FORM: NDMLR 08-11 NON -DISCHARGE MASS LOADING REPORT (NDMLR) Page
Permit No.: W00014785
Facility Name: Midway Middle School
County: Sampson
Month: March
Year: 2023
Field Name:
6
Field Name:
7
Field Name:
8
Field Name:
Field Name:
Area (acres):
0.435
Area (acres):
0.435
Area (acres):
0.435
Area (acres):
Area (acres):
Cover Crop:
Cover Crop:
Cover Crop:
Cover Crop:
Cover Crop:
Load Type:
PAN
Load Type:
PAN
Load Type:
PAN
Load Type:
PAN
Load Type:
PAN
Field Loaded?
DYES ❑NO
Field Loaded?
❑YES ONO
Field Loaded?
OYES ❑NO
Field Loaded?
OYES El NO
Field Loaded?
rYFS ONO
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Ibslac
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Ibs/ac
gal
mg/L
Ibs/ac
Ibs/ac
gal
mg/L
Ibs/ac
Ibs/ac
April
May
June
July
August
September
October
November
December
January
February
March
38,750
9.29
6.9
6.9
38.750
9.29
6.9
6.9
38,750
9.29
6.9
6.9
12 Month Floating PAN Load
6.9
6.9
6.9
0.0
0.0
(Ibs/ac/yr):
Annual PAN Load Limit
7 85
7.85
7.85
(Ibs/ac/yr):

FORM: NDMLR 08-11 NON -DISCHARGE MASS LOADING REPORT (NDMLR) Page of
Did the mass loading rates exceed the limits in Attachment B of your permit? 171 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: JASON DICKINSON Permittee: SAMPSON COUNTY SCHOOLS
Certification Number: 1007291 Signing Official: JASON DICKINSON
Grade: SI Phone Number: 910-385-4915 Signing Official's Title: ORC
Has the ORC changed since the previous NDMLR? ❑Yes 121No Phone No.: 910-385-4915 Permit Exp.: 10/31/28
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 Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page
Permit No.: WQ0014785
Facility Name: Midway Middle School
County: Sampson
Month: March
Year: 2023
PPI: 001
Flow Measuring Point: L ] Influent fl Effluent ❑ No flow generated
Parameter Monitoring Point: 1-1 Influent C Effluent ElGroundwater Lowering ❑ Surface Water
Parameter Code b
50050
00400
00625
00310
00610
00530
31616
00665
00620
WQ09
00940
00600
70300
Q
c
E
O
t
p
Z
0
LO
O
C
p
Q
a
'a U)
N'a
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a)
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a. M
Z
m
'o
U
cC
N
2
ZO
U1
tC O 'O
Nnd
24-hr
hrs
GPD
su
mg/L
mg/L
mg/L
mg/L
#/100 mL
mg/L
mg/L
mg/L
mg/L
mg/L
mg/L
1
1,900
2
1,900
3
1,900
4
1,900
5
1,900
6
1,900
7
1.900
8
1,829
9
1,829
10
1,829
11
1,829
12
1,829
13
1,829
14
1,829
15
2,400
7.72
28
4840
16
2,400
18
17
2,400
18
2,400
19
2,400
20
2,400
0.31
21
2,400
22
1,614
26.8
20.8
23
1,614
24
1,614
25
1,614
26
1,614
27
1,614
28
1,614
29
1,614
30
1,614
27.2
31
1,614
Average:
1,905
26.80
28.00
20.80
18.00
4,840.00
0.31
27.20
Daily Maximum:
2,400
7.72
26.80
28.00
20.80
18.00
4,840.00
0.31
27.20
Daily Minimum:
1,614
7.72
26.80
28.00
20.80
18.00
4,840.00
0.31
27.20
Sampling Type:
Monthly Limit:
310,000
Daily Limit:

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page of
Sampling Person(s) Certified Laboratories
Name: Name:
Name: Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? 121 Compliant El 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
ORC: Jason Dickinson
Certification No.: 1007291
Grade: S Phone Number: 910-385-4915
Has the ORC changed since the pre ' us N MR? ❑ yes o No
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
Permittee Certification
Permittee: Sampson County Schools
Signing Official: Jason Dickinson
Signing Official's Title: ORC
Phone Number: 910-385-4915 Permit Expiration: 10/31/2028
Signature Date
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 Quality
Information Processing Unit
1617 Mail Service Center

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Arwh* l & Consulting Chemists
ENVIRONMENTAL CHEMISTS, INC
NCDENR: DWO CERTIFICATION * 94 NCDHHS: DLS CERTIFICATION 1137729
COLLECTION AND CHAIN OF CUSTODY
6602 Windmill Way Wilmington, NC 28405
OFFICE: 910392-0223 FAX [phone]
info Cenviron m entaichem ists.com
Client: Sampson County Schools
Project: Mi way Middle School/PPI 001 WWTF
REPORT NO: C;� 3 _
Address: 437 Rowan Road
CONTACT NAME: Robert Carrot
PO NO:
Clinton, NC 28328
REPORT TO: Robert Carroll
PHONE/FAX:
co : R Carroll rcarroll.blackdo mail.com
email: [e-mail]
Sampled Bv: dSa SAMPLE TYPE: I = Influent, E = Effluent, W = Well, ST = Stream, SO = Soil, SL = Sludge, Other:
Sample Identification
Collection
E F
W
E o
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=
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m
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PRESERVATION
ANALYSIS REQUESTED
Date
Time
Temp0
oo
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=
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n
=
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=
0
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Z
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z
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H field):
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G
G
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X
Fecal
G
G
C
P
Due: Mar, July, Nov
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G
G
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P
X
TDS, Chloride November only)
G
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C
P
G
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Standard Soil Fertility December only)
G
G
Transfer
Relinquished By.
Date/Time
Received By:
DateifTinte
1.
ovt lit ,
! Z ,40 M
2.
Temperature when Received °C: s , 7 Accepted: V
Delivered By:_ Received
Comments:
TURNAROUND:
Time-_