WQ0000265_Monitoring - 03-2020_20200424

DocuSign Envelope ID: EC35EADF-973D-46E8-BEB9-38DA93749025
FORK NDAR-1 05-16 NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Did the application rates exceed the limits in Attachment B of your permit?
Were adequate measures taken to prevent effluent ponding in or runoff from the sites?
Page of
DCompliant ❑Non -Compliant
ECompliant ❑Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit? ❑Compliant ❑Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site? ❑Compliant ❑Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? ECompliant [_]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
ORC: Brad Gosser
Certification No.: 1002069
Grade: SI Phone Number: 252-796-1085
Has the ORC changed since the previous NDAR-1? [-]Yes ENO
Permittee Certification
Permittee: Department of Pudic Safety
Signing Official: Jeffrey T. O'Briant, PE, PLS
Signing Official's Title: Director, DPS Central Engineering
Phone Number: 919-716-3400 Permit Exp.: 10/31/22
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Signature Bate '--F2C52F8A8CAD4BE... Signature {.late
By this signature. I certify that this report is accurrate and complete to the best of my knowiedge 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 Wief, true, accurate, and complete. I am aware that there are sirgnlficant
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
38:r.

DocuSign Envelope ID: EC35EADF-973D-46E8-BEB9-38DA93749025
FORM: NDAR-1 05-16 NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Page of
Permit No.: WQ0000265
Facility Name: Washington Correctional Center WWTF
County: Washington
Month: March
Year: 2020
Did irrigation
Field Name:
i
Field Name:
2
Field Name:
3
Field Name:
4
occur
Area {acres):
4.6
Area (acres):
46
Area (acres):
4.6
Area (acres):
4.6
at this facility?
Cover Crop:Cover
Crop:
P�
Cover Crop:
P�
Cover Crop:
P:
DYES Dno
Hourly Rate (in):
0.25
Hourly Rate (in):
0.25
Hourly Rate (in):
0.25
Hourly Rate (in):
025
Annual Rate (in):
15.6
Annual Rate (in):
15.6
Annual Rate (in):
15.6
Annual Rate (in):
15.6
Weather
Freeboard
Field Irrigated?
❑YES ❑NO
Field Irrigated?
❑YES LINO
Field Irrigated?
DYES [ENO
Field Irrigated?
❑YES ❑� NO
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42,150
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0.05
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31
Monthly Loading:
42,150
0.34
1 42.150
0.34
0.65
0
0.00
0.00
0
0.00
0.00
12 Month Floating Total

DocuSign Envelope ID: EC35EADF-973D-46E8-BEB9-38DA93749025
FORM: NDAR-1 05-16 NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Page of
Permit No.: 01111 .Washington•
- •Washington1
1
D irrigation
• occur
at this facilit)
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Monthly Loading:12
Month Floating Total (in):-

DocuSign Envelope ID: EC35EADF-973D-46E8-BEB9-38DA93749025
FORM NDMR 05-16 NON -DISCHARGE MONITORING REPORT (NDMR)
Page of
Sampling Person(s) Certified Laboratories
Name: Brad Gosser Name: #5676
Name: Dena Meyers Name: Statesville Analytical
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your hermit? O]Compliant ❑Non-Ccmpliant
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: Brad Gosser
Permittee: Department of Public Safety
Certification No.: 1002069
Signing Official: Jeffrey T. O' Briant, PE, PLS
Grade: SI Phone Number: 252-796-1085
Signing Official's Title: Director, DPS Central Engineering
Has the ORC changed since the previous NDMR? ❑Yes ❑l No
Phone Number: 919-716-3400 Permit Expiration: 10/31/2022
'2 a
DocuSigned by:
tLt E,¢' lawU 1 4/21/2020 1 05:
?
Signature Date
FK521`8AKANBE. 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 superwsion 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 imprisonmentfor
knowing violations.
Mail Original and Two Copies to:
Division of Water Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
8 : 5 7

DocuSign Envelope ID: EC35EADF-973D-46E8-BEB9-38DA93749025
FORM: NDMR 05-16 NON -DISCHARGE MONITORING REPORT (NDMR) Page of
Permit No.: WQ0000265
Facility Name: Washington Correctional Center WWTF
County: Washington Month: March
Year: 2020
PPI: 001
Plow Measuring Point: ❑Influent ❑� Effluent ❑No Flow generated
Parameter Monitoring Point: ❑Influent ❑� Ffluent ❑Groundwater Lowering []Surface Water
Parameter Code 10
50050
00310
00940
50060
31616
00610
00625
00620
00600
00400
00665
70300
00530
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QC
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O O O
7
N
24-hr
hrs
GPD
mg/L
mg/L
mg1L
9/100 mL
mg/L
mg1L
mg/L
rng/L
su
mg/L
mg/L
mg/L
1
4,200
2
09:00
7
3,079
0.6
7,02
3
3,079
4
3,079
5
3,079
6
3,079
7
3,079
8
3,079
9
09100
1
1,777
10
1,777
11
1,777
12
1,777
13
1,777
14
1,777
15
1,777
16
09:00
1
1,131
171
1,131
181
1,131
191
1,131
20
1,131
21
1,131
22
1,131
23
09:00
1 1
7,136
24
7,136
25
7,136
26
7,136
27
7,136
28
7,136
29
7,136
301
09:00
1
6,593
311
6,593
Average:
3,524
0.60
Daily Maximum:
7,136
0.60
7.02
Daily Minimum:
1,131
0.60
7.02
Sampling Type:
Recorder
Grab
Grab
Grab
Grab j
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Monthly Limit:
25,000
Daily Limit:
Sample Frequency:
I Continuous
4 X Year
Annually
Per Event
4 X Year
4 X Year
4 X Year
4 X Year
4 X Year
Per Event
4 X Year
Annually
4 X Year