WQ0000986_Monitoring - 08-2016_20161004

1_�, , -
NON -DISCHARGE APPLICATION REPORT Page _ of.
_
HIGH RATE INFILTRATION SITE(S)
THERE ARE THREE SITES PER PAGE. USE ADDITIONAL PAGES AS NEEDED.
DERMIT NUMBER: WQ0000986 COUNTY: Carteret
FACILITY NAME: Island Beach and Racquet Club MONTH: August YEAR: 2016
Formulas:
Daily Loading (gallons/square feet)- Volume Applied (gallons)/ Site Area (square feet)
* Weather Codes: C -clear, PC -partly cloudy, Cl -cloudy, R -rain, Sn-snow, Sl -sleet
Operator in Responsible. Charge (ORC): Stanley E. Buck Phone: [phone]
ORC Certification Number:. qq ,3 �(o Check Box if ORC Has Changed: ❑
Mail ORIGINAL and TWO COPIES to: (�
ATTN: Non -Discharge Compliance Unit . (SIGNATURE OF OPERATOR IN RESPONSIBLE CHARGE)'
DENR BY -THIS SIGNATURE, 1 CERTIFY THAT THIS REPORT IS ACCURATE
Division of Water Quality AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
1617 Mail Service Center
RALEIGH, NC 27699-1617
DENR FORM NDAR-2 "(5/2003)
SITE #: 1
SITE #:777 2
ISITE #:
SITE AREA (sq.ft:):
6936
SITE AREA (sq.ft):
4496
ISITE AREA (sgft):
D
WEATHER CONDITIONE
PERMIT RATE (gpd/sq.ft)
9.25
PERMIT RATE d/s .ft
9.25.
PERMIT RATE ( pd/sq.ft)
a
T
Tem-
weath-
er pera- Precipi-
ture (F) ration
Volume Time
Applied Irrigated
Dail Y
LoadingApplied
Volume Time
Irrigated
Dail Y
Loading
Volume Time
Applied irrigated
Dail Y
Loading
E
Code low inches
gallons minutes
gal./sq.ft
gallons minutes
galts •ft
gallons minutesgal./sq.ft.
1 ,
R
30550
4.40
30550
6.79
2
PC
29195
4.21
29195
6.49
3
R
29455
4.25
29455
6.55
4
PC
33185
4.78
33185
7.38
5
PC
31535
4.55
31535
7.01
6
PC
'33340
4.81
33340
7.42
7
39400
5.68
39400
8.76
8
29305 _
4.23
29305
6.52
9
C
33275
4.80
33275
'7.40
_
10
C
33580
4.84
33580
7.47
11
C
35340
5.10
35340
7186
12
PC
35745
5.15
35745
7.95
13
C
'35380
510
35380
7.87
o ►
14
1
37810
5.45
37810
8.41
15
28360
4.09
28360
6.31
16
C
28835
4.16
28835
6.41
y
17
C
30850
4.45
30850
6.86
18
C
26595
3.83
26595
5.92
19
R
26560
3.83
26560
5.91
20
R
35205
5.08
35205
7.83
21
35550.
5.13
35550
7.91
221
24580
3.54
24580
5.47
23
C
21670
3.12
21670
4.82 -
24
PC
20075
2.89
20075
4.47
25
C
20250
2:92 _
20250
4.50
26
C
27680
3.99
27680
6.16
27JC
32175
4.64
32175
7.16
283
26365
3.80
26365
5.86
29
23310
3.36
23310
5.18
30
24935
3.60
24935
5.55
31
20955
3.02
20955
4.66
Monthly Loading (gallons/sq.ft)
4.28
__
6:61
_= -
#DIV/O!
Year -To -Date Loading (gallons/sq.it) -, :_
2.78
4.3
_.. _
* Weather Codes: C -clear, PC -partly cloudy, Cl -cloudy, R -rain, Sn-snow, Sl -sleet
Operator in Responsible. Charge (ORC): Stanley E. Buck Phone: [phone]
ORC Certification Number:. qq ,3 �(o Check Box if ORC Has Changed: ❑
Mail ORIGINAL and TWO COPIES to: (�
ATTN: Non -Discharge Compliance Unit . (SIGNATURE OF OPERATOR IN RESPONSIBLE CHARGE)'
DENR BY -THIS SIGNATURE, 1 CERTIFY THAT THIS REPORT IS ACCURATE
Division of Water Quality AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
1617 Mail Service Center
RALEIGH, NC 27699-1617
DENR FORM NDAR-2 "(5/2003)

NON -DISCHARGE APPLICATION REPORT Page of
HIGH RATE INFILTRATION SITE(S)
Facility Status:
Please indicate ( by inserting Y(es) orN(o) in the'appropriate-box)Whetherthe facility has been compliant
with the following permit requirements: (Note: if a requirement does not apply to your facility put (NA) in the
compliant box. )
Compliant (Y,N)
1. The application rate(s) did not exceed the limits) specified in the permit. DY
2. The site was kept free of vegetation and raked at intervals specified in permit. OY
3. The automatically activated standby power source is on site and operational. �Y
If the facility is non-compliant, please explain in the space below the reason(s) the facility was not in compliance
with its permit. Provide in your explanation the date(s) of the non=compliance and describe the corrective action(s)
taken. Attach additional sheets if necessary.
"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."
Signature of Permittee)` Date (Name of Sig4ning Official -Please print or type)
�� c, rYI 2 S �� � � �C'2S "�
(Permittee -Please print or type) (Position or Title)
'� Asa-g83-�'22a
t, C), C) (Phone Number) (Permit Exp. Date)
(Permittee Addres )
* If signed by other than the permittee, delegation of signatory authority must be on file with the state per 15A NCAC 28.0506 (b)(2)(D).
DENR FORM NDAR-2 (5/2003)