WQ0004502_Monitoring - 09-2016_20161024 (2)

NON DISCHARGE WASTEWATER MONITORING REPORT Page of
a.
PERMIT NUMBER: WQ0004502 MONTH: September YEAR: 2016
FACILITY NAME: Hillsborough United Church of Christ COUNTY: Orange
Flow Monitoring Point:
Effluent:
❑
Influent:
11
Parameter Monitoring Point: Effluent:
❑
Influent:
El
Surface Water (SW): ❑
SW Code/Name:
Was There Effluent Flow For This Month Generated At This Facility:
Yes:
❑
No: ❑
:.;
50050
00400
50060
00310
00610
00530
31616
665
625
630 600
D
A
T
E I
Operator
Arrival
Time Operator ORC
2400 Time On on
Clock Site Site?
Daily Rate
(Flow) into
Treatment
System
pH
Residual
Chlorine
BOD -5
20°C
NH3-N
TSS
Fecal
Coliform
(Geo -metric
Mean')
TOT
Phos
TKN
NQ2- TOT N
No3 C Calc
HRS Y/N
GALLONS
UNITS
UG/L
MGIL
MG/L
MGIL
1100ML
MG/L
MG/L
MG/L MG/L
1
320
2
320
3
320
4
320
5
10:08 0.25 Y
320
6
235
7
235
8
235
9
235
10
235
11
235
121
235
13
9:55 0.75 Y
235
14
327
15
327
16
327
17
327
181
327
19
11:14 0.25 Y
327
20
318
21
318
22
318
0
23
318
241
318
251
1
318
26
9:27 0.25 Y
318
27
334
2s
334
29
334
30
334
31
Average
300.1333
###(##
#NUM!
#D(V/0!
##### ###
Daily Maximum
334
0
0
01
0
0
0
01
0
0 0
Daily Minimum
235
0
0
0
0
0
0
0
0
0 0
Monthly Limit(s)
0.00156
Composite (C) / Grab (G)
Operator in Responsible Charge (ORC)
Check Box if ORC Has Changed
Certified Laboratories (1):
Person(s) Collecting Samples:
Mail ORIGINAL and TWO COPIES to:
ATTN: Non -Discharge Compliance Unit
DENR
Division of Water Quality
1617 Mail Service Center
RALEIGH, NC 27699-1617
James W Gooch Grade:
ORC Certification Number:
(2):
IV Phone: [phone]
988035
(SIGN,ATU OF OPERATOF3 tM RESPONSIBLE CHARGE)
BY/ IS IGNATURE, I CERTIFY THAT THIS REPORT IS ACCURATE
AND MPLETE TO THE BEST OF MY KNOWLEDGE.
DENR FORM NDMR-1 (5/2003)

NON DISCHARGE WASTEWATER MONITORING REPORT
Facility Status:
Page of
Please answer the following question:
Compliant (Y,N)
1. Does all monitoring data and sampling frequencies meet permit requirements? �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
Fal a formation, including the possibi ' of fines and imprisonment for knowing violations."
Russell Knop
ignature of Permittee)*' Date (Name of Signing Official -Please print or type)
Hillsborough United Church of Christ Chair of Trustees
(Permittee -Please print or type) (Position or Title)
200 Davis Rd.
Hillsborough NC 27278
(Permittee Address)
Parameter Codes:
919-732-9183 9/30/2018
(Phone Number) (Permit Exp. Date)
01002 Arsenic
31504 Coliform, Total
00600 Nitrogen, Total
00929 Sodium
01022 Boron
00094 Conductivity
00630 NO2&NO3
00931 SAR
00310 BODS
01042 Copper
00620 NO3
00745 Sulfide
01027 Cadmium
00300 Dissolved Oxygen
00556 Oil -Grease
70295 TDS
00916 Calcium
31616 Fecal Coliform
WQ09 PAN (Plant Available)
00010 Temperature
00940 Chloride
01051 Lead
00400 pH
00625 TKN
50060 Chlorine, Total
Residual
00927 Magnesium
71900 Mercury
32730 Phenols
00665 Phosphorus, Total
00680 TOC
00530 TSS/TSR
01034 Chromium
00610 NH3asN
00937 Potassium
00076 Turbidity
00340 COD
01067 Nickel
00545 Settleable Matter
01092 Zinc
Parameter Code assistance may be obtained by calling the Water Quality Compliance/Enforcement Unit at [phone] ext. 529.
The monthly average for Fecal Coliform is to be reported as a GEOMETRIC mean. Use only the units designated in the reporting
facility's permit for reporting data.
If signed by other than the permittee, delegation of signatory authority must be on file with the state per 15A NCAC 213.0506 (b)(2)(D).
DENR FORM NDMR-1 (5/2003)