WQ0004502_Monitoring - 11-2016_20161222

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NON DISCHARGE WASTEWATER MONITORING REPORT Page of
PERMIT NUMBER: WQ0004502
FACILITY NAME: Hillsborough United Church of Christ
MONTH: !November YEAR:
gr11 R
COUNTY: Orange
Flow Monitoring Point:
Effluent:
❑ Influent:
❑
Parameter Monitoring Point: Effluent: ❑
Influent:
Q
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 630V
600
D
A
T
E
Operator
Arrival
Time operator ORC
2400 Time On on
Clock Site Site?
Daily Rate
(Flow) into
Treatment
System
Residual
pH Chlorine
BOD -5
20°C
NH3-N
Fecal
Coliform
(Geo -metric
TSS Mean.)
TOT
Phos
NO2-
TKN No3
TOT N
C Calc
HRS YIN
GALLONS
UNITS UGIL
MGL
MG/L
MGIL /100ML
MG/L.
MG/L MG/L
MG/L
1
9:57 0.25 Y
209
2
278
3
278
4
278
5
278
6
278
7
9:41 0.25 Y
278
8
332
9
332
10
332
11
332
12
1
332
13
332
141
332
15
332
16
332
17
14:02 0-25 Y
332
18
1
252
19
252
201
252
211
1
252
22
12:40 0.25 Y
252
23
145
24
145
25
145
26
145
27
145
28
14:32 0.25 Y
145
29
417
30
417
31
Average
272:0333
r #
#
#####
#NUM!
#####
#DIV/0!
Daily Maximum
417
0 0
0
0 0 0
0
0 0
0
Daily Minimum
145
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
.lames W Gooch Grade: IV Phone: [phone]
ORC Certification Number: 988035
(2):
� IGNelURE Ole OPE"TOR IN RESPONSIBLE CHARGE)
BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS ACCURATE
AND COMPLETE 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? 0
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
2e information, including the possibility of fines and imprisonment for knowing violations."
Russell Knop
(Signature of Permitttneid
* ate (Name of Signing Official -Please print or type)
Hillsborough 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 N028NO3
00931 SAR
00310 BODS
01042 Copper
00620 NO3
00745 Suffide
01027 Cadmium
00300 Dissolved Oxygen
00556 Oil -Grease
70295 TDS
00916 Calcium
31616 Fecal Coliform
W009 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/rSR
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.
ata_
* 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 NDMR-1 (5/2003)