WQ0000986_Monitoring - 10-2016_20170111

NON -DISCHARGE APPLICATION REPORT Page of
HIGH RATE INFILTRATION SITE(S)
THERE ARE THREE SITES PER PAGE. USE ADDITIONAL PAGES AS NEEDED.
>ERMIT NUMBER: WQ0000986
FACILITY NAME: Island Beach and Racquet Club MONTH:
Formulas:
Daily Loading (gallons/square feet) = Volume Applied (gallons) / Site Area (square feet)
COUNTY: Carteret
October
YEAR: 2016
..•&--&f wuOS. U-ucar, FC-rsmy ciouay, Ci ciouoy, n -ram, on -snow, S1-areet
Operator in Responsible Charge (ORC): Stanley E. Buck Phone: [phone]
ORC Certification Number: 11339 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 9:
1
SITE is
2
SITE A:
SITE AREA (sq.R):
6936
SITE AREA (sq.ft):
4496
SITE AREA (sq.R):
p
WEATHER CONDITION
PERMIT RATE
d/a .fL
9.25
PERMIT RATE .fL
9.25
PERMIT RATE .fL
A
T
E
Tem -
w••a'' pen- Pracipi-
er wAfFl taxon
CoOa
Volume
Applied
Time
Irrt sled
Daily
Loading
Volume Time
A lied Irrigated
Daily
Loading
Volume Time
lied Irrigated
Daily
Loadin
Iorr Inches
gallons
minutesalfa
g 9� fL
gallons minutes
galJaq.ft
gallons minutes
gal./aq.ft
1
C
11105
1.60
11105
2.47
2
C
10115
1.46
10115
2.25
3
C
18055
2.60
18055
1 4.02
4
R
14000
2.02
1 14000
3.11
s
C
26100
3.76
26100
5.81
a
24085
3.47
24085
5.36
7
20820
3.00
20820
4.63
a
C
16680
2.40
16680
3.71
9
PC
17580
2.53
17580
3.91
10
C
15580
2.25
15580
3.47
11
C
23575
3.40
23575
5.24
12
C
25305
3.65
25305
5.63
_
13
25505
3.68
25505
5.67
14
21170
3.05
21170
4.71
1s
PC
17065
2.46
17065
3.80
16
C
17865
2.58
17865
3.97
17
C
20680
2.98
20680
4.60
,
18
C
20245
2.92
20245
4.50
19
C
24580
3.54
24580
5.47
20
22435
3.23
22435
4.99
21
C
11365
1.64
11365
2.53
r-
22
C
14905
2.15
14905
3.32
23
C
17095
2.46
17095
3.80
m _
24
22525
3.25
22525
5.01
25
C
22390
3.23
22390
4.98
26
R
22660
3.27
22660
5.04
27
15860
2.29
15860
3.53
2e
8525
1.23
8525
1.90
29
PC
14245
2.05
14245
3.17
30
R 1
15060
2.17
15060
3.35
31
Monthly Loading (gallons/sq.fL)
2.684-13
Year -To -Date Loading (gallons/sq.ft)
i
2. 531
3.91
..•&--&f wuOS. U-ucar, FC-rsmy ciouay, Ci ciouoy, n -ram, on -snow, S1-areet
Operator in Responsible Charge (ORC): Stanley E. Buck Phone: [phone]
ORC Certification Number: 11339 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) 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 your facility put (NA) in the
compliant box. )
Com Hant N)
1. The application rate(s) did not exceed the limit(s) specified in the permit
2. The site was kept free of vegetation and raked at intervals specified in permit 0
3. The automatically activated standby power source is on site and operational. DY
If the facility is noncompliant, 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 noncompliance 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."
, 9 ?A
of Permittee):
or
O D 25D k 6 teo
—w-kvo, &C a7,PY6
(Permittee Add ss)
(Name of Signing Official -Please print or type)
fire S
(Position or Title)
d Sa-�F13-92zv
(Phone Number)
(Permit Exp. Date)
if signed by other than the permittee, delegation of signatory authority must be on file with the stats per 15A NCAC 2B.0505 (bN2)(D).
DENR FORM NDAR-2 (5/2003)

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page _ ot_
Permit No.: I(,�G,LID 00 $
Facility Name:
Island Beach and Raquet Club
ICounty:
Carteret
Month: November
Year: 2016
PPI: 001
Flow Measuring Point:
❑ Influent 0 Effluent ❑ No flow generated
Parameter Monitoring Point:
❑ influent ❑+ Effluent ❑ Gmundwater lmvedng ❑ Surface Water
Parameter Code b
50060
00400
5OD60
00310
00810
00630 1
31616
00620
00600
70295
1 00940
c
t�ilE'-, Fin
OW
M
o.
o f
U
m
E
<
g$ o
N N
m no;
LLo
V
�°
Z
c
of
Z
09
pa
m o
C y
m
o
U
24•hr hrs
GPD-
su
mglL
mj#L
mg/L
m L #/100 mL
mglL
mglL
m L
mg1L
1
12:00 1
22,210
7.93
0.38
2
12:00 1
20,230
7.81
0.5
3
1 11:00 1
36,110
7.79
0.56
41
12:00 1 1
28,000
1 7.84
0.61
51
12:00 1 1
52,200
7.98
0.54
6
48,170
7
41,840
8
06:00 1
33,360
7.86
0.21
<2
0.08
6.4
<1
8.84
9
14:00 1
35,160.
7.89
0.18
10
14:00 1
31,160
7.82
0.24
11
11:00 1
47,150
7.88
0.41
12
07:00 1
50,610 -
7.85
0.38
13
51,010
14
42,340
16
11:30 1
34,130-
7.73
0.09
16
11:30 1
.35,730
7.84
0.49
_
17
11.:30 1
41,360
7.79
0.54
18
11:30 1
40,490
7.78
0.87
19
11:30 1
49,160
7.72
0.69
20
44,870
21
11:45 1
22,730
7.82
0.21
22
11:00 1
29,810
7.79
0.5-
<2
0.11
6.2
<1
2.84
4.14
231
12:30 1 1
34,190
7.81
0.5
24
H
45,050
H
H
25
14:45 1
44,780
7.79
0.41
26
13:00 1
45,320
7.85
0.39
1-
-
27
31,720
28
17,050
29
12:00 1
28,490
7.81
0.51
- -
30
14:45 1
30,120.
7.9 -
0.52
31
Average:
37,145
0.42
O.Do
0.10
6.30
- 1.00
5.84
7.14
Daily Maximum:
52,200
7.98
0.87
2.00
0.11
6.40
1.00
8.84
10.13
Dally Minimum:
17,050
7.72
0.09
2.00
0.08
6.20
1.00
2.84
4.14
Sampling Type:
Rewnfer
Grab
Greb
Monthly Avg. Limit:
10
4
20
14
10
Dally Limit:
43
_
Sample Frequency:

. FORM: NDMR 03.12 NON -DISCHARGE MONITORING REPORT (NDMR) Page _ of
Sampling Persons) Certified Laboratories
Name: Stanley E. Buck III Name: Environment 1, Inc.
Name: Name:
vucs an monitoring aara ana sampling frequencies meet the requirements in Attachment A of your permit? O 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 (DRC) Certification
Permittee Certification
ORC: Stanley E. Buck III
Permlttee: Enviracon Utilities Inc.
Certification No.: 993396
signing Official: James Proctor
Grade: 3 Phone Number: 252-503-5307
Signing Official's Tile:
Has the ORC changed since the previous NDMR? Yes El No
Phone Number: 252-883-9220 Permit Expiration: 1/31/2017
5. f -d
-,� /-a-1
Signature Date
Signature Date
By this signalare, I certify that Nis report Is eauaate and complete to the beat of my knowredge.
I eartHy, under penalty Of law, that tive dowmenl and all attachmems Ware prepam mdm my dream or sup"Won in
amordanw with a system deelpad to cisme that a quaned pan=* properly asthmad and evaluated the Information
submitted. Basad on my Inquiry of the person err pareom who manage the system, or those persona directly responsible for
gatherkp the Information, the knforrnatlmt submitted Is, to the beat of my kaCwtedge and betef, true, ammsaa, sad complete. I am
aware that there are elgrytryM panatles for subnitMg false Information, Including Ne possibility of Mea and haprlaomnrmt for
knowing violations.
Mall Original and Two Copies to:
Division of Water Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699.1617