WQ0028806_Residual Annual Report 2019_20200224

Initial Review
INITIAL REVIEW
Reviewer Williams, Kendall
Is this submittal an application? (Excluding additional information.)*
r Yes r No
If not an application r Annual Report
what is the submittal r Residual Annual Report
type?* r Additional Information
r Other
Annual Report 2019
Year*
Date Paper Copy 2/24/2020
Received:*
Project Number* WQ0028806
Email Notifications
Does this need review by the hydrogeologist?*
r Yes r No
Regional Office
CO Reviewer
Admin Reviewer [e-mail]

Submitted Form
Project Contact Information
Rease provide information on the person to be contacted by MB Staff regarding electronic subnittal, confirmation of receipt, and other issues.
..........................................................................................................................................................................................................................................................................................................................................................................
Name * Brent Collins
Email Address*
[e-mail]
Project Information
.......................................................................................
Submittal Type* r New Permit Application
r Renewal
r Annual Report
r Other
Permit Type * r Wastewater Irrigation
r Other Wastewater
r Closed -Loop Recycle
r Single -Family Residence
Wastewater Irrigation
Is a paper copy of the application being submitted?
r Yes r Nor N/A
Permit Number* WQ0028806
Phone Number*
336-751-1441
r Modification (Major or Minor)
r Additional Information
r Residual Annual Report
r High -Rate Infiltration
r Reclaimed Water
r Residuals
r Other
Applicant\Permittee * Davie County - Sparks Road Water Treatment Plant
Facility Name * Sparks Road Water Treatment Plant
Please provide comments/notes on your current submittal below.
No land application for 2019
Please attach all information required or requested for this submittal to be review here.
Application Form Engineering Rans, Specifications, Calculations, Etc.)
2019 Davie County Sparks Road WTP Annual
313.84KB
Report - WQ0028806.pdf
upload only 1 RDF docurrent. NLltiple docurrents rust be corrbined into one RDF file.

For new and modification permit applications, a paper copy may be required. If you have any questions
about what is required, please contactthe reviewer or Tessa Monday. If a paper 2-pol cation is required,
be advised, applications accepted for pre -review until both the paper and elect-c-ii.- --ol:ies have been
received. The paper copy shall include the following:
o Application Form
o All relevant attachments {talcs, soils report, specs, etc.]
o One full-size engineering plan set
o One 11x17" engineering plan set
o One extra set of specifications
o Fee (if required)
Mailine address:
Division of Water Resources ! Division of Water Resources
Non -Discharge Branch I Non -Discharge Branch
1617 Mail Service Center I Att: Nathaniel Thornburg, P Floor, Office #942W
- =
Raleigh, NC 27699-1617 S12 N.5alisburySt.
For questions or problems contact Tessa Monday attessa.monday@)ncdenr.Qov or 919.707.3560.
* rJ By checking this box I acknowledge that I understand the application will not be accepted
for pre -review until the paper copy (if required) and fee (if required) have been received by
the Non -Discharge Branch. I also confirm that the uploaded document is a single PDF with
all parts of the application in correct order (as specified by the application).
Signature
Submission Date 2/24/2020

CLASS A ANNUAL DISTRIBUTION AND MARKETING/ SURFACE DISPOSAL CERTIFICATION AND SUMMARY FORM
WQ PERMIT #: WQ0028806 FACILITY NAME: Davie County Sparks Rd WTP
PHONE: COUNTY: Davie OPERATOR: Davie County
FACILITY TYPE (please check one): ❑ Surface Disposal (complete Part A (Source(s) and "Residual In" Volume only) and Part C)
l7 Distribution and Marketing (complete Parts A, B, and C)
Was the facility in operation during the past calendar year? Yes r❑ No ❑ —► If No skip parts A, B, C and certify form below
Part A*:
Part B*:
Month
Sources(s) (include NPDES # if
applicable)
Volume (dry tons)
Recipient information
Amendment/
Bulking Agent
Residual In
Product Out
Name(s)
Volume (dry tons)
Intended use(s)
January
February
March
April
May
June
July
August
September
October
November
December
Total from FORM DMSDF (sup)
0
0
0
0
Totals:
Annual d tons):
0
0
0
0
Amendments used: Bulkin A ent s used:
* If more space is required, attach additional information sheets (FORM DMSDF (supp)): Total Number of Form DMSDF (Supp)l 0
Part C:
Facility was compliant during the past calendar year with all conditions of the land application permit r❑ Yes
(including but not limited to items 1-3 below) issued by the Division of Water Quality: ❑ No ► If No, Explain in Narritive
1. All monitoring was done in accordance with the permit and reported for the year as required and three (3) copies of certified laboratory results are attached.
2. All operation and maintenance requirements were compiled with or, in the case of a deviation, prior authorization was received from the Division of Water Quality.
No contravention of Ground Water Quality Standards occurred at a monitoring well.
"1 certify, under penalty of law, that the above information 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."
1 /7 2ozG
ignature of Permittee Date
**Preparer is defined in 40 CFR Part 503.9(r) and 15A NCAC 2T .1102 (26)
Signature of Preparer**
(if different from Permittee)
Date
DENR FORM DMSDF (12/2006)