WQ0019782_Monitoring - 12-2016_20170203

FORM: NDMR 10-13 NON -DISCHARGE MONITORING REPORT (NDMR) Page 1 of 2
Permit No.: W00019782
Facility Name:
YMCA -CAMP WEAVER
County:
Guilford
Month:
December
Year: 2016
PPI: 001
Flow Measuring Point:
❑O Influent []Effluent
❑No flow generated
Parameter Monitoring Point:
❑Influent
ElEfflue t
❑Groundwater Lowering ❑Surface Water
Parameter Code --0
50050
00400
50060
00310
00610
00530
31616
00630
00625
00665
00010
00620
00615
00600
m
p
E �;
p
O O
c
�
O
c
E
C
H
c
0U)
o
E
0
+ 2
;LY44
m y
o
z
y
c
C
a
z�
Fo- w
z
24 -hr hrs
GPD
su
mg/L
mg/L
mg/L
mg/L
#(100 mL
mg/L
mg/L
mg/L
°C _
mg/L
mg/L
mg/L
1
16:45 0.5
820
2
15:05 0.25
3
621
4
621
5
16:15 0.5
620
61
16:00 0.5
697
7
08:30 0.5
'300
8
17:55 0.5
757.°
°
9
10:45 0.5
287
7.38
0
°
10
826
11
826
12
13:00 0.5
827
131
13:38 0.5
770
°
_
141
08:00 0.5
'7°420
l
15
17:30 0.5
1,307
7.37 1
0
3.3
14.36 '
2.5
2
2.33
16,84
2.88
2.11
0_
19.17
16
12:00 0.5
787
17
2,419
18
16:30 0.5
2,419
19
13:00 0.5
570
201
15:00 0.5
780
21
13:45 0.5
'445
7.49
0
22
535
1
;
23
18:15 0.5
535
1A 't
24
727
�4 O
25`
„727
;6
261
13:30 0.5
'. 727
27
12:45 0.5
'380
n -A.
4
28
12:00 0.5
690
29
12:00 0.5
582
2
30
11:00 0.5
:400
7.52
0.11
°
G
31
.200�°
n
�,
Average:
_741
0.03
3.30
14.36 =
2.50
2:00
2.33
16.84
2.88
2.17
0.1'6
19.17
Daily Maximum:
2,419
7.52
0.11
3.30
14.36
2.50
2:00
2.33
16:84
2.88
2.17
0.16
19.17
Daily Minimum:
200
7.37
0.00
1 3.30
14.36
2.50
2.00
2.33
16.84
2.88
2.17
0:1.6
19.17
Sampling Type:
Recorder
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab ,
Monthly Avg. Limit: 1,, 3,679
Daily Limit:
3,670
Sample Frequency:
1/week
1/week
3x Year
3x Year
3x Year
3x Year
3x Year
3x Year
3x Year

FORM: NDMR 10-13 NON -DISCHARGE MONITORING REPORT (NDMR) Page 2 of 2
Sampling Person(s) Certified Laboratories
Name: Chip White Name: Environment 1
Name: Anthony Branch 11 Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit?f, OCompliant ❑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 th''F non-compliance and describe the corrective
O� U1 qa/ unci 1. r LLa I auunwi iai -IV— a nc­­ Y. I
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Chip White
Permittee: YMCA of Greensboro
Certification No.:
Signing Official: Greg Jones
Grade: Phone Number: 252-235-4900
Signing Official's Title: President/CEO
Has the RC changed since the previous NDMR? ElYes El No
Phone Number: 3368548410 r, Permit Expiration: 9/30/2020
Signature Date
Signature VVVU t_" JJPL& 0t/� 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 and7wo Copies to:
Division of Water Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Page 1 of 2
oil
Facility Name:
YMCA -CAMP WEAVER
Did irrigation occur
at this facility?
N I Forest
..
(DYES■ .atura
Annual Rate (in):
■ ■ •
r
■
v .
®
■
■ •
®
■
■ .
----
-_--
-®-�
-_--
mmm
Om-®-®------®®----
M
mmm 0_
--®-
----
-_®-
----
®MIM_
0_
-_-®
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®-®-
----
®mm_
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----
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----
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mm_m_-_---_--__------

• FORM: NDAR-1 10-13
NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Did the application rates exceed the limits in Attachment B of your permit?
I Page 2 of 2
J
El Compliant ❑Non-Compllant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites? El Compliant ❑Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit? OCompliant ❑Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site? oCompliant ❑Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? I (]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) o the non-compliance and describe the corrective
action(s) taken. Attach additional sheets if necessary.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Chip White
Permittee: YMCA of Greensboro I
Certification No.:
Signing Official: Greg Jones
Grade: Phone Number: 252-235-4900
Signing Official's Title: President/CEO
Has the OR changed since the previous NDAR-1? RIYes ONO
Phone Number: 3368548410 Permit Exp.: 9/30/20
5/•(7
I
..I/IQi:C
Signature Date
Signature (Xy( Q� Date
ince
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 di on or supervision
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 Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617