WQ0000986_Monitoring - 09-2016_20161108

U
'NON -DISCHARGE APPLICATION REPORT Page,_of-
HIGH RATE INFILTRATION SITE(S)
THERE ARE THREE SITES,PER PAGE: USE ADDITIONAL PAGES AS NEEDED:
?ERMIT NUMBER: W60000986
COUNTY: Carteret
FACILITY NAME: Island Beach and Racquet Club MONTH: September YEAR: 2016
Formulas:
Daily Loading (gallonesquare feet) = Volume Applied (gallons) / Site Area (square feet)
Weather Codes.: C -clear, PC -partly cloudy, CI -cloudy, R -rain, Sn-snow, SI -sleet`
Operator in Responsible Charge (ORC): Stanley E. Buck Phone: [phone]
ORC Certification Number: h933 � . Check Sox if ORC Has Changed: 0
Mail ORIGINAL and TWO COPIES to:
ATTN: Non -Discharge Compliance Unit (SIGNATURE`OF OPERATOR IN RESPONSIBLE CHARGE)
DENR BY THIS SIGNATURE; I 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 #: 2
SITE#:
SITE AREA (sq.ft.):
6936.
SITE AREA (sq.ftj:
4496
SITE AREA (sq.ft.);
D
WEATHER CONDITIONE
PERMIT RATE (gpd/sq:ft)
9.25
PERMIT RATE ( pd/sq.ft)
9.25
PERMIT RATE.( d/sq.ft.)
A
T
Tem-
Weath-
er pera- Pred '
ture.(F) tation
Volume Time
Irrigated,
Daily
Loadin
Volume Time
Applied Irrigated
Daily
Loading
Volume Time Daily
Applied Irrigated Loading
E
Codo"
lour inches
_Applied
gallons minutes
gal.lsq.ft
gallons minutes
gat./sq.ft
gallons minutes gal./sq.ft.
1
PC
18210
2.63
18210
4.05
2
R
24565
3.54
24565
.5.46
3
R
27480
3.96
27480
6.11
4
30430
4.39
30430
6.77
5
21455'
3.09
21455
4.77
s
C
24540
3.54
24540
5.46
7
PC
26510.
3.82
26510
5.90
s
PC
22200
3.20
22200
4:94
s
C
23290
3.36
23290
5.18
10
C
25970
3.74
25970_.
5.78
11
31880
4.60
31880
7.09
12
27850.
4.02
-27850
6.19
13
C
24270
3.50
24270
5.40
14
R
24955
3.60
24955
5.55
is
R
24615
3.55
24615
5.47
16
PC
24755
3.57
'24755
5:51
17
PC
27600
'3.98
'27600
6.14
18
-.26500
3.82
26500
5.89
19
23175
3.34
23175
5.15
20
R
20995
3.03
20995
4.67
21.
C
28090
4.05
28090
6.25_
22
C
22175
3.20
22175
4.93
23
R
'25890
3.73
:25890
5.76
24
C
32085 -
4.63 _
32085
7.14
25
_ _
18360
2.65
18360
4.08
26
17465
2.52 -
17465
3.88'
27
R
18600
2.68
18600
4.14
28
C
20680
2.98
20680
4.60
29
PC,
25120
3.62
25120
5.59
30
R
27625
3.98
27625
6.14
31
Monthly Loading (gallonslsq.ft)
3.54
-
5.47
- - =. #DIV/0!
=-.
Year -To -Date Loadingq ) v
(gallons/s..ft
2.78
-
Weather Codes.: C -clear, PC -partly cloudy, CI -cloudy, R -rain, Sn-snow, SI -sleet`
Operator in Responsible Charge (ORC): Stanley E. Buck Phone: [phone]
ORC Certification Number: h933 � . Check Sox if ORC Has Changed: 0
Mail ORIGINAL and TWO COPIES to:
ATTN: Non -Discharge Compliance Unit (SIGNATURE`OF OPERATOR IN RESPONSIBLE CHARGE)
DENR BY THIS SIGNATURE; I 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)

1+�
NON -DISCHARGE APPLICATION REPORT Page ,_of_
HIGH RATE INFILTRATION SITE(S)
Facility Status:
Please indicate (by inserting Y(es) or N(o) in the appropriate box) whether the facility has been.compliant
with the following permit requirements: (Note: if a requirement does not apply to yourfacility put (NA) in the
compliant box. )
Compliant Y,N)
1. The application rate(s) did not exceed the limit(s) specified in the permit. u
2. The site was kept free of vegetation and raked at intervals specified in permit. l '
3. The automatically activated standby power source is on site and operational.
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."
-/- /
( ignature of Permittee)* Date
.)oMeS POC���
(Permittee -Please print or type)
I a r b o r o I A) C a-7 8Et
(Permittee Addre s)
(Name of Signing Official -Please print or type)
(Position or Title)
352 -9 -R3 -522v
(Phone Number)
(Permit Exp. Date)
If signed by other than the permittee, delegation of signatory authority must be on file with the state per 15A NCAC 26.0506 (b)(2)(D).
DENR FORM NDAR-2 (512003)