WQ0005173_Monitoring - 11-2016_20170117

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Paget of2
Permit No.: WQ0005173
Facility Name:
CAPE ROYALL DOLPHIN WWTF
County:
Carteret
Month:
November
Year:
2016
PPI: 001
❑ Influent Q Effluent ❑ No flow generated
Parameter Monitoring Point:
❑ Influent
Q Effluent
❑ Groundwater Lowering
❑ Surface Water
Parameter Code -opj
50050
00400
50060
00310
00530
31613
00610
00620
00630
00625
00600
00940
70300
00545
00680
00615
c
O
{r E
O
°
a
o
O
o
°�
10
LL 0
O
E
E
d0
Z+
t
co
C
CM
O
c
CM
d
v
O
°H
- p
FNN
m
oi=
W
u
c
N C
dVE
O
3
O0
F-
+
+C
Z312
24 -hr hrs
GPD
su
mg/L
mg/L
mg/L
#1100 mL
mg/L
mg/L
mg/L
mg/L
mg/L
mg/L
mg/L
mUL
mg/L
mg/L
1
12:20
6,000
7.7
5.7
<0.5
2
11:51
7,000
7.7
4.8
<0.5
3
12:03
5,000
7.7
3.3
<0.5
4
12:02
8,000
7.6
5.1
<0.5
5
08:45
4,000
61
10:15
8,000
7
11:16
8,000
7.4
0.5
<0.5
8
08:15
5,000
7.7
8.8
<2
<2.7
<5
<0.2
61.4
61.4
194
931
<0.5
9.6
<0.02
9
11:28
8,000
7.6
8.8
<0.5
10
08:58
4,000
7.6
8.8
<0.5
11
08:30
7,000
7.5
8.8
<0.5
121
09:29
5,000
13
09:15
6,000
14
13:01
10,000
7.6
8.8
<0.5
15
11:40
5,000
7.7
8.8
<0.5
16
13:14
8,000
7.5
8.8
<0.5
17
12:21
7,000
7.5
8.8
0
<0.5
18
11:59
6,000
7.7
8.89
<0.5
19
10:10
6,000
20
10:00
6,000
21
12:42
80,200
7.5
8.8
l t
<0.5
22
12:05
6,000
7.7
8.8
<0.5
23
8:46
6,000
7.7
6.5
18
<2.7
<5
<0.2
<0.5
24
9:16
8,000
HOLIDAY
HOLIDAY
HOLIDAY
25
10:40
8,000
7.7
5.5
<0.5
26
9:45
8,000
27
10:30
7,000
28
12:41
8,000
7.7
4
<0.5
29
11:30
5,000
7.6
8.8
<0.5
30
10:16
6,000
7.6
8.8
<0.5
37
Average:
9,040
4.84
3.00
0.00
1.00
0.00
30.70
61.40
97.00
310.33
0.00
9.60
0.00
Daily Maximum:
80,200
7.70
8.89
18.00
2.70
5.00
0.20
61.40
61.40
194.00
931.00
0.50
9.60
0.02
Daily Minimum:
4,000
7.40
0.50
2.00
2.70
5.00
0.20
61.40
61.40
194.00
931.00
0.50
9.60
0.02
Sampling Type:
Recorder
Grab
Grab
Composite
Composite
Grab
Composite
Composite
Composite
Composite
Calculated
Grab
Grab
Monthly Limit, month avg 50000 gpd
10
20
14
4
10
Daily Limit:
6.0-9.0
143
Sample Frequency:
Continuous
5 x week
5 x week
(S)2x month(S)2xMonth (S)2xMonth(S)2xMonth (S)3x Year
3X Year
3x Year
3x Year
3x Year

Sampling Person(s)
Name: Daniel E. Fortin
Name
Name:
Name:
Certified Laboratories
Environmental Chemists, Inc.
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit?
❑ 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 (ORC) Certification
Permittee Certification
ORC: Daniel E. Fortin
Permittee: CAPE ROYALL DOLPHIN ASSOCIATION WWTF
Certification No.: 7180
Signing Official: Daniel E. Fortin
Grade: WW II Phone Number: 252-393-8720
Signing Official's Title: Operator Responsible in Charge
Has the ORC changed since the previous NDMR? ❑ Yes Q No
Phone Number: 252-393-8720 Permit Expiration: 4/30/2010
19--31-16
S. . -3
Signature Date
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
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.
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

NON DISCHARGE APPLICATION REPORT
HIGH RATE INFILTRATION SITE(S)
THERE ARE THREE SITES PER PAGE. USE ADDITIONAL PAGES AS NEEDED.
Page 2 of 2
PERMIT NUMBER W00005173 COUNTY: Carteret
FACILITY NAME: Cape Royall Dolphin CLASS: 11 MONTH: NOV. YEAR 2016
Formulas:
Daily Loadina (aallons/square feet)=Volume ADolied(aallons)/Site Area (square feet)
* Weather Codes: S - sunny, PC - partly cloudy, Cl - cloudy, R - rain, Sn - snow, SI - sleet
OPERATOR IN RESPONSIBLE CHARGE (OF Daniel E. Fortin
ORC Certification Number: 7180
Mail ORIGINAL and TWO COPIES to:
ATTN: Non -Discharge Compliance Unit
DENR
Division of Water Quality
1617 Mail Service Center
RALEIGH, NC 27699-1617
GRADE: II PHONE: [phone]
CHECK BOX IF ORC HAS CHANGED
X
(SIGNATURE OF OPERATOR IN RESPONSIBLE CHARGE)
BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS ACCURATE
AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
DENR FORM NDAR-2(5/2003)
SITE NUMBE Zone 1
SITE NUMBE Zone 2
SITE NUMBE.
SITE AREA (sq. ft.):
5,024
SITE AREA (sq. ft.):
5,024
SITE AREA (sq. ft.):
WEATHER CONDTIONS PERMITTED RATE (gpd/sp.
5
PERMITTED RATE (gpd/sp
5
PERMITTED RATE (gpd/sp.ft.):
A
T
E
Temp. Precip
Weather Volume Time
Code * i Applied Irrigated
(*F)tation
Daily Loading
Volume Time
Applied Irrigated
Daily Loading
Volume Time Daily
Applied Irrigated Loading
low inches gallons minutes
gallons/sq. ft.
gallons minutes
gallons/sq. ft.
gallons minutes gallons/sq. ft.
1
30007
33769
3 7
2
3500
0.69665605
3500
0.69665605
3
2500
0.49761146
2500
0.49761146
4
4000
0.79617834
4000
0.79617834
5
2000
0.39808917
2000
0.39808917
6
4000
0.79617834
4000
0.79617834
7
4000
0.79617834
4000
0.79617834
8
2500
0.49761146.
2500
0.49761146
9
4000
0.79617834
4000
0.79617834
10
2000
0.39808917
2000
0.39808917
11
3500
0.69665605
3500
0.69665605
12
2500
0.49761146
2500
0.49761146
13
3000
0.59713376
3000
0.59713376
14
5000
0.99522293
5000
0.99522293
15
2500
0.49761146
2500
0.49761146
16
4000
0.79617834
4000
0.79617834
17
3500
0.69665605
3500
0.69665605
18
3000
0.59713376
3000
0.59713376
19
3000
0.59713376
3000
0.59713376
20
3000
0.59713376
3000
0.59713376
21
4000
0.79617834
4000
0.79617834
22
3000
0.59713376
3000
0.59713376
23
3000
0.59713376
3000
0.59713376
24
4000
0.79617834
4000
0.79617834
25
4000
0.79617834
4000
0.79617834
26
4000
0.79617834
4000
0.79617834
27
3500
0.69665605
3500
0.69665605
28
1 4000
0.79617834
4000
0.79617834
29
2500
0.49761146
2500
0.49761146
30
3000
0.59713376
3000
0.59713376
31
0
0
ont y oa Ing ga ons sq.
.8 4
Year -To -Date Loading (gallons/sq.
231.23,237.23
* Weather Codes: S - sunny, PC - partly cloudy, Cl - cloudy, R - rain, Sn - snow, SI - sleet
OPERATOR IN RESPONSIBLE CHARGE (OF Daniel E. Fortin
ORC Certification Number: 7180
Mail ORIGINAL and TWO COPIES to:
ATTN: Non -Discharge Compliance Unit
DENR
Division of Water Quality
1617 Mail Service Center
RALEIGH, NC 27699-1617
GRADE: II PHONE: [phone]
CHECK BOX IF ORC HAS CHANGED
X
(SIGNATURE OF OPERATOR IN RESPONSIBLE CHARGE)
BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS ACCURATE
AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
DENR FORM NDAR-2(5/2003)

NON -DISCHARGE APPLICATION REPORT
ti
HIGH RATE INFILTRATION SITE(S)
„
FACILITY STATUS:
T
the following permit requirements: (Note: If a requirement does not apply to your facility put "Win the compliant
box.
Compliant (Y,N)
1. The application tate(s) did not exceed the limit(s) specified in the permit.
2. The site was kept free of vegetation and raked at intervals specified 0
in the permit.
3. The Automatically Activated Standby power source is on site and 0
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 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 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 knowin violations."
-0,%�- 31-1� Daniel E. Fortin
Signature of Permittee * Date (Name of Signing Official -Please print or type)
Daniel E. Fortin
Permittee - Please print or type
P.O. Box 4188
Emerald Isle, NC 28594
Permittee Address
Operator Responsible in Charge
(Position or Title)
252-393-8720 02/28/2019
(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 28.0506 (b) (2) (D).
DENR FORM NDAAR-2(5/2003)