WQ0003090_Monitoring - 03-2022_20220421

ti
�� 4
DWR - NonDischarge Monitoring Report Submittal ti . . F
NORTH CAROLINA
ERYYranm@nlrtl Quafily
Monitoring Report Submittal
Permit Number#* WQ0003090
Name of Facility:* Town of liberty WWTP
Month:* March Year:* 2022
Report Information
Type* Upload Document*
NDMR, NDAR-1, NDAR-2, NDMLR spray report 3 22.pdf 3.99MB
PDF Only
GW-59 gw 59 322.pdf 2.91 MB
PDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR,GW-59).
Confirmation Email Address:* tfike©townoflibertync.org
Name of Submitter:* Elix Fike
Signature:
Date of submittal: 4/21/2022
This will be filled in automatically
Initial Review

Reviewer: Gerald,Wanda
Is the project number correct?* WQ0003090
Is the monitoring report accepted?* Yes No
Regional Office* Winston-Salem
Accepted Date: 4/26/2022

FORM:NDMR 10-13 NON-DISCHARGE MONITORING REPORT(NDMR) Page_1_of_1_
Permit No.: WQ0003090 Facility Name: Town Of Liberty-Wastewater County: Randolph Month: March Year: 2022 ,
PPI: 002 I Flow Measuring Point: Q✓ Influent ❑Effluent ❑No flow generated Parameter Monitoring Point: ❑Influent p✓ Effluent ❑Groundwater Lowering ❑Surface Water
Parameter Code -* 50050 00400 00310 00610 00530 31613 00620 00625 00665 50060 00600 70300 00640 00630 00010
c a r m _ e
c 0 E o e _ Y° o,Q o y o o 'E o w E o"
� � Uw rt. m E
E, u 0 -6 2._.
►- WO 2 ~ ja 0 zz E
0 0 °�
24-hr his GPO su mg/L`, mg/L mg/L #/100 mL rng/L : mg/L mg/L mg/L mg/L mg/L mg/L' mg/L °C
1 7:00 8 299,000
2 7:00 8 280,000
3 7:00 8 198,000 9.04 17.8` 14 13.2. 345 0.052 17.2 2;9 ., 0.29 17.3 191 25.6 0.12
4 7:00 8 240,000
5 10:00 3 257,000 ,
6 10:00 3 218,000 ,
7 7:00 8 .233,000
8 7:00 8 292,000
9 7:00 8 935,000
10 7:00 8 1,119,000 7.84 0.04
11 7:00 8 535,000
12 762,000
13 1,452,000
14 7:00 8 415,000
15 7:00 8 415,000
16 7:00 8 409,000
17 7:00 8 2,006 000 7.94 8:7 10.3 4.8 205 0.042` 12.6 2 0.06 12.7 0.087
-
18 7:00 8 1,153,000
19 635,000
20 439,000 _ _
21 7:00 8 468,000 8.16 25.2 11.4 22.1 2420 0.078' 16.1 2.5 0.62 162 195 21.2 0.11
22 7:00 8 310,000
23 7:00 8 356,000
-24 7:00 8 380,000 _ ,
25 7:00 8 428,000
26 10:00 3 312,000
27 12:00 3 320,000
28 7:00 8 254,000 _ ,
29 7:00 8 256,000 _
30 7:00 8 266,000
31 7:00 8 272,000 7.43 _ 0.07
Average: 513,355 17,23 11.90 13:37 555.22 0,06 #REF! 2.47 ' 0.22 /5.40 193.00 23.40 0.11
Daily Maximum: 2,006,000 9.04 25,20 14.00 22.10 2,420.00 0,08 #REF! 2.90 0.62 17.30 195.00 25,60 0.12
Daily Minimum: 198,000 7.43 8.70, 10.30 4,80` 205.00 0.04 #REF! 2.00 0.04 - 12.70 191.00 21.20 0.09
Sampling Type: Recorder Grab Grab Grab Grab Grab Grab Grab Grab Grab Grab Grab
Monthly Avg.Limit:
Daily Limit: 550,000
Sample Frequency: Daily weekly ' 2x month 2x month 2xmonth 2x month 2x month 2x month 2x month weekly 2x month 3x year 3x year 2x month

FORM:NDMR 10-13 NON-DISCHARGE MONITORING REPORT(NDMR)
Sampling Person(s) Certified Laboratories
Name: GLENN PRICE Name: PACE ANALYTICAL
Name: GARRETT DREYER Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? 0 Compliant El 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.
NON COMPLIANT ON THE DATES OF 3/9 3/10 3/12 3/13 3/17 3/18 and 3/19
RAINFALL I&I
Operator in Responsible Charge(ORC)Certification Permittee Certification
ORC: Elix Tremaine Fike Permittee: Scott Kidd
Certification No.: 989290 Signing Official:
Grade: SI Phone Number. 336 622 2990 Signing Official's Title: Town Manager
Has the ORC changed since the previous NDMR? El Yes 2 No Phone Number: 336 622 4276 Permit Expiration: 8/31/2024
Li"/2 /Z2___
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 Resources
Information Processing Unit
1617 Mail Service Center
Raleigh,North Carolina 27699-1617

Pace Analytical Services,LLC
� 1377 South Park Drive
aGeAnalytica! Kernersville,NC 27284
www.pacelabs.com [phone]
Page 1 of 1
Laboratory Report
Tremaine Fike Report Date: 03/17/2022
Town of Liberty Date Received: 03/03/2022
PO Box 1006
Liberty, NC 27298
Project: Town of Liberty
Pace Project No.:92591210
Sample: Effluent Lab ID: 92591210001 Collected: 03/03/22 11:50 Matrix: Water
Method Parameters Results Units Report Limit Analyzed Qualifiers
SM 2540C-2015 Total Dissolved Solids 191 mg/L 25.0 03/07/22 12:59
SM 2540D-2015 Total Suspended Solids 13.2 mg/L 6.8 03/04/22 14:29
EPA 353.2 Rev 2.0 1993 Nitrogen,NO2 plus NO3 0.12 mg/L 0.040 03/03/22 15:51
EPA 353.2 Rev 2.0 1993 Nitrogen,Nitrate 0.052 mg/L 0.040 03/03/22 15:51
SM 5210B-2016 BOD,5 day 17.8 mglL 2.0 03/08/22 22:52
Colilert-18 Fecal Coliforms 345 MPN/100mL 1.0 03/04/22 10:55
Performed by Pace 03/03/22 11:50
Collected By Garrett 03/03/22 11:50
Dreyer
Collected Date 03/03/2022 03/03/22 11:50
Collected Time 1150 03/03/22 11:50
pH 9.04 Std.Units 03/03/22 11:50
Chlorine,Total Residual 0.29 mg/L 03/03/22 11:50
TKN+NO3+NO2 Total Nitrogen 17.3 mg/L 0.52 03/16/22 16:18
Calculation
EPA 300.0 Rev 2.1 1993 Chloride 25.6 mg/L 1.0 03/04/22 17:55
EPA 350.1 Rev 2.0 1993 Nitrogen,Ammonia 14.0 mg/L 0.20 03/11/22 18:34
EPA 351.2 Rev 2.0 1993 Nitrogen,Kjeldahl,Total 17.2 mg/L 0.50 03/16/22 03:15
EPA 365.1 Rev 2.0 1993 Phosphorussp 2.9 mg/L 0.050 03/15/22 12:06
Reviewed by: C u���lieaJ
Stephanie Knott
704-977-0981
[e-mail]
Pace Analytical Services Asheville
2225 Riverside Drive,Asheville,NC 28804 South Carolina Laboratory ID:99030
Florida/NELAP Certification#:E87648 South Carolina Certification#:99030001
North Carolina Drinking Water Certification#:37712 VirginiaNELAP Certification#:460222
North Carolina Wastewater Certification#:40
Pace Analytical Services Eden
205 East Meadow Road Suite A,Eden,NC 27288 North Carolina Wastewater Certification#:633
North Carolina Drinking Water Certification#:37738 VirginiaNELAP Certification#:460025

CHAIN-OF-CUSTODY Analytical Request Document LAB USE ONLY-Affix Workorder/Login Label Here or List Pace Workorder Number or
NITJL Log-in Number Here
aceAnalytical }
Chain-of-Custody is a LEGAL DOCUMENT-Complete all relevent fields
ipany: Town of LibertyBilling Information: °
ALL SHA
1 2 a ( ( 1111111ress: Container Preservative 1I I
art To: Email To: "Preservative Types:(1)nitric acid,(2)s 92591210
(6)methanol,(7)sodium bisulfate,(B)sod:,.. _._______,,_,.._- ,..,..,...,..,.,..i,,,wr enmwiv an suxate,
If To: Site Collection Info/Address: (C)ammonium hydroxide,(D)TSP,(U)Unpreserved,(0)Other
Analyses Lab Profile/Line:
omer Project Name/Number: State: County/City: Time Zone Collected: Lab Sample Receipt Checklist:
/ [ ]PT[ ]MT( ]CT [ ]ET
Custody Seals Present/Intact Y;tt NA
le• Site/Facility ID#: Compliance Monitoring? Custody Signatures Present jY.N NA
il: ['Yes [ ]No N i Collector Signature Present X,N NA
Bottles Intact N NA
ected By tJ: Purchase Order#: DW PWS ID#: ✓"1 Correct Bottles Y N NA
Quote#: DW Location Code: CO
� ) Sufficient Volume }? N NA
Virdfr-ODnat ice- , • ❑ Samples Received on Ice (X,N NA
9C ' natur Turnaround Date Required: Immediately Packed on Ice: o O- — VOA - Headspace Acceptable Y N K4
--- [ ]No ma 'S N USDA.Re in Holdingd s Y;Nj NA
[ ]Yes p v Samples: in Holding Time Y,,N NA
O
pie Disposal: Rush: Field Filtered(if applicable): ~ N Residual Chlorine Present Y N`)NA
iispose as appropriate ( ]Return [ J Same Day [ J Next Day [ ]Yes [ ]No ,0 Z °3-" .e Cl Strips: Cn;In
:rchive: [ ]2 Day [ ]3 Day [ ]4 Day [ ]5 Day Z �o 0 `O Sample pH Acceptable m (y,N NA
lold: (Expedite Charges Apply)
Analysis: AO - ..0 pH Strips: , ,9;^fir ./ t,,,4
0 F— 0 Sulfide Present Y N ta
ttrix Codes(Insert in Matrix box below):Drinking Water(DW),Ground Water(GW),Wastewater(WW), Z Z1
ula Lead Acetate Strips:
)duct(P),Soil/Solid(SL),Oil(OL),Wipe(WP),Air(AR),Tissue(TS),Bioassay(B),Vapor(V),Other(OT) Cl,` Y 71 '
CD I— -a to i LAB USE ONLY:
i Comp/ Collected(or Res #of I-- Z •_ cn P. Lab Sample 4 / Comments:
Composite End -
:omer Sample ID Matrix" Grab Composite Start) ClCtns C i A o
0 _
U; Z 0
Date Time i Date m Z u: Q. 1—
uent g
1111111111111=1111111=11111111111mmiNimm=11111111.00701111 1.1111111:1111ahmorammIll, 1
111111111111111111111
IIMIIIIA ,
, 11111111111111111M1111111 mom -1
.v. kvAkIrAmil
maiinummuilimum um si. ,
,..„„,...... „,„, ii, _ _
7
...
omer Remarks/Special Conditions/Possible Hazards: Type of Ice Used: Wet) Blue Dry None SHORT HOLDS PRESENT(<72 hours) Y 9N N/A Lab Sample Temperature Info:
-""""""-- M" r Temp Blank Received Y N- NA
Packing Material Use•. r Lab Tracking#:
Therm ID#: r€;l
Effluent Monitoring ! am Cooler 1 Temp Upon Receipt: oC I
_ Samples received via: --- - ---,, Cooler 1 Therm Corr.Factor: /' oC
Radchem sample(s)screened(<500 rpm): Y N NA IFEDEX UPS Client Courier Pace Courier ' Cooler 1 Corrected Temp: b•• oC
quished by&pan . Signature) Date/Time: Received by/Company:(Signature) IDate/Time: MTJL LA NLY Comments:
%' 7 l' Table#: �
Acctnum:
ed by/Company:(Signature) D t Time: Received by/Company:(Signature) Date/Time: TripBlank Received: Y NA
1 Template:
> i HCL McOH TSP Other
a Prelogin: I
Ijuished by/Company:(Signature) II Date/Time: Received by/Company:(Signature) I Date/Time:
`PM: Non Conformance(s): Page: 1
a
PB: YES / NO Jof:
r

F C CS _. - _ '- _ _
rr --
•. •_-' . . a__ , __..._ r,--.� f.:r Erse. :3:,_,.
.-. _ ':_-,C !L:: _..C113 .,, ,f _,__J(. i. `)1_c !!_-3 C .m.m \ 1 r
ha!f cf Loxis to I;s: r.u,m' . cf Lc.. �
s I J
— _ = _ \ \ i — I 1 <
- - r- _ - F. _ - < L - - _ I
- I - - _ _ < C _ - _ _ - _ < ,
I 1. C l^. ''..."
a: 1 < ', '- '- - = 1
C - l: 1_ yi -
I . \ \I\ \\
\ \ \ \NI \. \\\ I\N
\ \ \ \ \I \, \\\I \I\.
\ \I\\\ \ \\\I \I\I
1 \ \\ \ N \\I\ \ \
\ \I\ \I\ \I \\, \ \\ I
\ \ \\\I \ NI\\\I \\,
\. I \ \.\I\ \ \ \\ 1 1 \,I\I I
\ 1\\.\\; I Irv\I INN \I I \i\I
\ \I\I\\ \I N\N \\
\ 1\\I\\i \ I\I\\ i\I\
\ L \\\ \I.\, \\I\ \��
pH Adjustment Lc. frr Pres_reed Samples
!ID Ty:a2 -r?raserv;:iv- I p',-'..,..Inr _aipc Ca:a.pre;.2-'J3:.cn3d;us:ed Time pr-,°ar :ion Aincur. or?:eerv,-.va lc '
ad;'J`_t'_d added
I I
'2" •.0'i^2.2 S a d.::.'-:J-.C/a!!"!! :-.,,j,:,,,;:l c3..CICC3 C.-arnp!i3'C',j. ;:.di.a= r'/: .:... ':r.i]'Sa_-..:i=::•a.,an:a Car2i.r3 CI_.,:,?Ca': -E(,.g
I.:,Irc 7r:-_ pri,_^l3:.I-a,c'JC of:eM,,ir,..:r c:n;airer;.

Pace Analytical Services,LLC
7PceAAnalytical/ 1377 South Park Drive
1n alytica Kernersvilie,NC 27284
' www.pacelabs.com [phone]
Page 1 of 1
Laboratory Report
Tremaine Fike Report Date: 03/11/2022
Town of Liberty Date Received: 03/10/2022
PO Box 1006
Liberty, NC 27298
Project: Town of Liberty
Pace Project No.:92592683
Sample: Effluent Lab ID: 92592683001 Collected: 03/10/22 12:15 Matrix: Water
Method Parameters Results Units Report Limit Analyzed Qualifiers
Performed by PACE 03/10/22 12:15
Collected By Garrett 03/10/22 12:15
Dreyer
Collected Date 03/10/22 03/10/22 12:15
Collected Time 1215 03/10/22 12:15
pH 7.84 Std.Units 03/10/22 12:15
Chlorine,Total
Residual 0.04 mg/L 03/10/22 12:15
Reviewed by: 6
Stephanie Knott
704-977-0981
[e-mail]

CHAIN-OF-CUSTODY Analytical Request Document I LAB us" • 'umber or
6aceAnalyticalWO* °
Chain-of-Custody is a LEGAL DOCUMENT-Complete all relevant fields
npany: Town of Liberty Billing Information: III
II , I I I IIII
cress: Contaii 92592683 �.._ �v �_.1
( i :__.- 1 t —_.-I l i 6
tort To: Email To: °`Preservative Types:(1)nitric acid,{2)sulfuric acid,(3)hydrochloric acid,(4)sodium hydroxide,(5)zinc acetate, r
(6)methanol,(7)sodium bisulfate,(8)sodium thiosulfate,(9)hexane,(A)ascorbic acid,(B)ammonium sulfate,
ty To: Site Collection Info/Address: (C)ammonium hydroxide,(D)TSP,(U)Unpreserved,(0)Other {
Analyses Lab Profile/Line:
tomer Project Name/Number: State: County/City: Time Zone Collected: Lab Sample Receipt Checklist:
/ [ ]PT[ ]MT[ ]CT ( )ET I 1 Custody Seals Present/Intact YONA
me: Site/Facility ID#: Compliance Monitoring? Custody signatures Present Y( NA
ail: '['Yes [ ]No 0 Collector Signature Present 67N NA
Bottles Intact 6p.N NA
acted By( Purchase Order#: DW PWS ID#: Correct Botties (5,)N NA
Quote#: DW Location Code: it Sufficient Volume a N NA
�/ II ( Samples Received on Ice Yllr'NA
iA�tg - ature' .Turnaround Date Required: Immediately Packed on Ice: 1 - VOA - Headspacc Acceptable Y N t
[ ]Yes [ ]No N USDA Regulated Soils Y N<Ot
Samples in Holding 'Time <L N
1p e Disposal: Rush: Field Filtered(if applicable): Residual Chlorine Present Y N fNA
Dispose as appropriate ( ]Return; [ ]Same Day [ ]Next Day [ ]Yes [ ]No c Cl Strips:
Archive: ( (2 Day [ ]3 Day [ ]4 Day [ ]5 Day `o Sample pH Acceptable Y N,i
fold: Analysis: L pH Strips: �
(Expedite Charges Apply) per• U Sulfide Present Y NN74
atrix Codes(Insert in Matrix box below):Drinking Water(DW),Ground Water(OW),Wastewater(WW), III Lead Acetate Strips:
oduct(P),Soil/Solid(SL),Oil(OL),Wipe(WP),Air(AR),Tissue(TS),Bioassay(B),Vapor(V),Other(OT) ;a
( 2 + LAB USE ONLY:
Comp/ f Collected(or ( Res I #of Cl) Lab Sample # / Comments:
# Composite End v p 9d
tomer Sample ID Matrix Grab Composite Start) . Cl y Ctns
Date Time Date Time Q, [f--
luent a ( 1) A`e
i
I
--- - ------ €€
:omer Remarks/Special Conditions T e of Ice Used: Wet Blue Dry o. (SHORT HOLDS PRESENT(<72 hours
p Y N/A
_ _
p /Possible Hazards: Type ! _ (Lab Sample Temperature Info:
_ Temp Blank Received: Y N NA
Packing Material Used: i Lab Tracking It:
: Therm ID#:
'Effluent Monitoring — — --jP P
_ Cooler 1 Temp Upon Receipt: oC
;,L Samples received via: ; Cooler 1 Therm Corr.Factor: oC
dap
Radchem sample(s)screened(<500 cpm): Y N FEDEX UPS Cent Courier ce Cou' r ) Cooler 1 Corrected Temp: oC
iqui Compan • ture) Date/Time: I Received by/Company:(Si nature ^Date/Time: MTJLLA ONLY T Comments:
" ry Table#:
t
/ 7� 61� //L Acctnum:
dti I 7Com an (Signature) to Ime: eceived b /Com an (Signature) Date/Time:
�
Template: Trip Blank Received: Y N NA
i I ( HCL McDH TSP Other
a Prelogin:
(0uished by/Company:(Signature) (Date/Time: Received by/Company:(Signature) (Date/Time: $PM.
o Non Conformance(s): 'Page:
`PB: 1 YES / NO of:

Pace Analytical Services,LLC
/' Ace Analytical© 1377 South Park Drive
Kemersville,NC 27284
www,pacelabs.com
[phone]
Page 1 of 1
Laboratory Report
Tremaine Fike Report Date: 03/30/2022
Town of Liberty Date Received: 03/17/2022
PO Box 1006
Liberty, NC 27298
Project: Town of Liberty
Pace Project No.:92594064
Sample: Effluent Lab ID: 92594064001 Collected: 03/17/22 14:20 Matrix: Water
Method Parameters Results Units Report Limit Analyzed Qualifiers
SM 2540D-2015 Total Suspended Solids 4.8 mg/L 2.6 03/22/22 11:44
EPA 353.2 Rev 2.0 1993 Nitrogen,NO2 plus NO3 0.087 mg/L 0.040 03/18/22 15:30
EPA 353.2 Rev 2.0 1993 Nitrogen,Nitrate 0.042 mg/L 0.040 03/18/22 15:30
EPA 353.2 Rev 2.0 1993 Nitrogen,Nitrite 0.045 mg/L 0.040 03/18/22 15:30
SM 5210B-2016 BOD,5 day 8.7 mg/L 2.0 03/23/22 10:11
Colilert-18 Fecal Collforms 205 MPN/100mL 1.0 03/18/22 13:19
Performed by Pace 03/17/22 14:20
Collected By Garrett 03/17/22 14:20
Dreyer
Collected Date 03/17/2022 03/17/22 14:20
Collected Time 1420 03/17/22 14:20
pH 7.94 Std.Units 03/17/22 14:20
Chlorine,Total Residual 0.06 mg/L 03/17/22 14:20
TKN+NO3+NO2 Total Nitrogen 12.7 mg/L 0.040 03/29/22 11:09
Calculation
EPA 350.1 Rev 2.0 1993 Nitrogen,Ammonia 10.3 mg/L 0.20 03/30/22 15:39
EPA 351.2 Rev 2.0 1993 Nitrogen,Kjeldahl,Total 12.6 mg/L 0.50 03/26/22 04:29
EPA 353.2 Rev 2.0 1993 Nitrogen,NO2 plus NO3 0.078 mg/L 0.040 03/25/22 11:48
EPA 365.1 Rev 2.0 1993 Phosphorus 2.0 mg/L 0.050 03/25/22 17:59
Reviewed by: ��
Stephanie Knott
704-977-0981
[e-mail]
Pace Analytical Services Asheville
2225 Riverside Drive,Asheville,NC 28804 South Carolina Laboratory ID:99030
Florida/NELAP Certification#:E87648 South Carolina Certification#:99030001
North Carolina Drinking Water Certification#:37712 VirginiaNELAP Certification#:460222
North Carolina Wastewater Certification#:40
Pace Analytical Services Eden
205 East Meadow Road Suite A,Eden,NC 27288 North Carolina Wastewater Certification#:633
North Carolina Drinking Water Certification#:37738 VirginiaNELAP Certification#:460025

- LAB USE ONLY-Affix Wort 64 ,
CHAIN-OF-CUSTODY Analytical Request Document .
aceAnalyticai' 2594 �f'
Chain-of-Custody is a LEGAL DOCUMENT-Complete at relevent fields
)mpany: Town of Liberty 1Billing Information: ALL SHAD 111111 11111111 11111111 II 1
T�
ldress: Container Preservative
92584064
u12 ; 8 i 1 , 1 I. I
:port To: Email To: •'Preservative Types:(1)nitric acid,(2)sulfuric acid,(3)hydrochloric acid,(4)sodium hydroxide,(5)zinc acetate,
(6)methanol,(7)sodium bisulfate,(8)sodium thiosulfate,(9)hexane,(A)ascorbic acid,(B)ammonium sulfate,
tpy To: Site Collection Info/Address: (Cl ammonium hydroxide,(D)TSP,(U)Unpreserved,(0)Other
Analyses Lab Profile/Line:
stomer Project Name/Number: State: County/City: Time Zone Collected: Lab Sample Receipt Checklist,
/ [ )PT[ ]MT[ ]CT [ ]ET I -,
Custody Seals Present/Intact Y NJNA
one: Site/Facility ID#: Compliance Monitoring? ( 11 Custody Signatures Present X N NA
iail: [/Yes [ ]No ( Collector Signature Present rah N NA
i Bottles Intact Y N NA
Ilected By(print): Purchase Order#: DW PWS ID#: ) ( Correct Bottles , N NA
wv iii4.1"-ri 4,---- Quote#: DW Location Code: ( Sumpples Received on Ice Y N NA nt Volume N NA
)
lie e B at Turnaround Date Required: Immediately Packed on Ice: D.: Scam lee VOA - h'eadspace Acceptable Y N NA
( ]Yes ( )No w II Time
Regulated Soils Y.N,,NA
10 Samples in Holding SF N,NA
m'pf isposal: Rush: Field Filtered(if applicable): 1 Residual Chlorine Present Y Ni NA
I Dispose as appropriate [ ]Return d [ ]Same Day [ ]Next Day [ ]Yes [ ]No Z 3 Cl Strips: (17)
I Archive: [ )2 Day j ]3 Day [ ]4 Day [ ]5 Day 1 Z To i i Sample pH Acceptable �^t ,(4 N NA
1 Analysis: �• • pH Stripe: ? +-r
Hold: ( (Expedite Charges Apply) I a H P " Sulfide Present Y N NA
✓latrix Codes(Insert in Matrix box below):Drinking Water(DW),Ground Water(GW),Wastewater(WW), Z Z 11 I Lead Acetate stripe:
'roduct(P),Soil/Solid(SL),Oil(OL),Wipe(WP),Air(AR),Tissue(TS),Bioassay(B),Vapor(V),Other(OT) fA Y
(1) I— j LAB USE ONLY:
I Comp/ ' Collected(or ( Res #of 1- Z m Lab Sample # / Comments:
Istomer Sample ID i Matrix` Grab Composite Start) Composite End CI Ctns CS i
Z '
�U
Date Time Date Time c0 Z Li 1 Q, I 1— '
�/ �.J.,iiit �
fluent ww cg 1relfr7.- rc� 5
IIIIIIIIIIMIIIII
IIIIII
al 1 _
I
�
;tomer Remarks/Special Conditions/Possible Hazards: Type' of Ice Used: Wet Blue Dry None ' HOLDS PRESENT(<72 hours): Y N N/A lab Sample Temperature Info:
p --
Packing Material Used: 1 Lab Tracking It: Temp Blank Receixed Y i`N NA
1 Therm IDtt:i--1-1 _..;: ---
`Effluent Monitoring _ . I I Cooler 1 Temp Upon Receipt: r oC
1Samples received via: ! Cooler 1 Therm Corr.Factor: oC
Radchem sample(s)screened(<500 cpm): Y N NA 1 FEDEX UPS Client Courier Pace Courier Cooler 1 Corrected Temp: .+ oC
nquished iy/C pan�$i ) 1 Date/Time: 1 Received by/Company:(Signature) Date/Time: , : a,- 1 MT.IL LAB USE ONLY
Comments:
! 2 ( able#
_ _
��� -� T �_
/6y / 1�����J _Y/„�� 51 / Acctnurn:
ef. ed by ompany:(Signature) ate ime: 1 Received by/Company:(Signature) Date/Time: �_m�
Template: Trip Blank Received: Y N NA
o I Prelogin:
HCL McOH TSP Other
bquished by/Company:(Signature) i Date/Time: ~Received by/Company:(Signature) 1 Date/Time: PM: TPage:
a
Non Conformance(s):
I P iPB: ° YES / NO of:

/2 Document Nam e: Dc umen 15 d `o er,t er 15 2021
P Bottle Identification Form(BIF) ' PJ; 1 of. 1
NuBAI�7/�flC7r• Document No.: 13sumg 1 0, i•
F-CAR-05-0 3-Rev.01 Pace Ca'olina Q a'tl Orf ce
*Check mark top half of box if pH and/or dechlorination is Project #
verified and within the acceptance range for preservation
samples. 1
Exceptions:VOA,Conform,TOC,Oil and Grease,DR0/8015(water)DOC,LLHg
**Bottom half of box is to list number of bottles
i
n u u •
4-Z Z _ r`. Z r C , C z ._ _ '+1 > :
- i -o v v y A Z - v T a G Z < < v >
:' J - N N - V u c Y i' - y j u'
C. c c0 G < n u c - a O Q , M - U _ _ a �
3 m = e ID ? Z L = + E V' N < - N G G U� C G I C• 1
u V 3 U U U C ` G 9 4 _ E tJ ,� 7.2 .Sc .x ( c I • I
U _ Z
•
_, ct T. a c c _ < < G < G ry O > C > I c i a ,r i ,;, s
I E E i E E E E a c`. E - E < E E E E •-,Ti E ' E _ i c c _
•
r,". c o = 'n c `n ,„ 1 = = u-• — o l7 o c c a .; > ,.n I i
' N to ,-, N ,�. r; _ m T ^' I-1 N 0 V C q- C -_. M -, h „• <
N Z N Q] V. ..- N V1 C F-. G Y .y. I < = Z
, ti hl M m Cl GI Cl Cl < V. N 1-,..;
M Q
Y I c a a a. a a c'- va t7 l'J t7 `v l.^ 2 U to t7 d ` l7
c� c� m ci m m m S 4 C < 4 4 ¢ ? > 7 > v°-i vc'i I "- 1 G > i c
I ,
1 \ 3\\\\. \ _l__ . \\N
\
Z \ \ \\ \ \\\3 \ \ \ \\ -- \\!
el \ i \N\\ \ A \\1‘ I
\\NI \ \\N, \\I
6 \\\1
\\\\ 1. \
7 \N\ \ \ \\I ---\\
8
UNN*
\\\I
_„\ — —
\\ \\\N
9 N \\ \ \\\ \I\\\*\•—ill
10 ,
N ' 1
11 \ -\\\\ \ \ I \I
\ \ . \\N\N ,
12 \.\\ 1
- -
pH Adjustment Log for Preserved Samples
Sample ID Type of Preservative pH upon receipt Date preservation adjusted Time preservation Amount of Preservative lot a
adjusted added
ate. Whenever there is a discrepancy affecting North Carolina compliance samples,a copy of this form will be sent to the North Carolina DEHNR Certification Off.ce(,e
it of hold,incorrect preservative,out of temp,incorrect containers.

Pace Analytical Services,LLC
1377 South
aceAnalytical5 Ke nersv Ile,NC 27284
www.pacelabs.com [phone]
Page 1 of 1
Laboratory Report
Tremaine Fike Report Date: 03/30/2022
Town of Liberty Date Received: 03/21/2022
PO Box 1006
Liberty, NC 27298
Project: Town of Liberty-Effluent
Pace Project No.:92594432
Sample: Effluent Lab ID: 92594432001 Collected: 03/21/22 10:00 Matrix: Water
Method Parameters Results Units Report Limit Analyzed Qualifiers
SM 2540C-2015 Total Dissolved Solids 195 mg/L 25.0 03/22/22 11:09
SM 2540D-2015 Total Suspended Solids 22.1 mg/L 6.0 03/23/22 12:22
EPA 350.1 Rev 2.0 1993 Nitrogen,Ammonia 11.4 mg/L 0.50 03/25/22 14:43
EPA 353.2 Rev 2.0 1993 Nitrogen,NO2 plus NO3 0.14 mg/L 0.040 03/22/22 13:52
EPA 353.2 Rev 2.0 1993 Nitrogen,Nitrate 0.078 mg/L 0.040 03/22/22 13:52
EPA 353.2 Rev 2.0 1993 Nitrogen,Nitrite 0.067 mg/L 0.040 03/22/22 13:52
SM 5210B-2016 BOD,5 day 25.2 mg/L 2.0 03/27/22 16:01
Colilert-18 Fecal Coliforms 2420 MPN/100mL 1.0 03/22/22 10:03 El
Performed by Pace 03/21/22 10:00
Collected By Glenn Price 03/21/22 10:00
Collected Date 03/21/2022 03/21/22 10:00
Collected Time 1000 03/21/22 10:00
pH 8.16 Std.Units 03/21/22 10:00
Chlorine,Total Residual 0.62 mg/L 03/21/22 10:00
TKN+NO3+NO2 Total Nitrogen 16.2 mg/L 0.040 03/30/22 15:31
Calculation
EPA 300.0 Rev 2.1 1993 Chloride 21.2 mg/L 1.0 03/23/22 14:26
EPA 351.2 Rev 2.0 1993 Nitrogen,Kjeldahl,Total 16.1 mg/L 0.50 03/29/22 04:38
EPA 353.2 Rev 2.0 1993 Nitrogen,NO2 plus NO3 0.11 mg/L 0.040 03/28/22 12:48
EPA 365.1 Rev 2.0 1993 Phosphorus 2.5 mg/L 0.050 03/30/22 16:40 M1
ANALYTE QUALIFIERS
El Reported value should be considered a minimum estimate since it is the maximum reportable number for this method
based on the sample volume used.The true value is likely greater than the value reported.
M1 Matrix spike recovery exceeded QC limits. Batch accepted based on laboratory control sample(LCS)recovery.
Reviewed by: dVanu�j
Stephanie Knott
704-977-0981
[e-mail]
Pace Analytical Services Asheville
2225 Riverside Drive,Asheville,NC 28804 South Carolina Laboratory ID:99030
Florida/NELAP Certification#:E87648 South Carolina Certification#:99030001
North Carolina Drinking Water Certification#:37712 VirginiaNELAP Certification#:460222
North Carolina Wastewater Certification#:40
Pace Analytical Services Eden
205 East Meadow Road Suite A,Eden,NC 27288 North Carolina Wastewater Certification#:633
North Carolina Drinking Water Certification#:37738 VirginiaNELAP Certification#:460025

CHAIN-OF-CUSTODY Analytical Request Document LAB USE ONLY-Affix Workorder/Logic'-�I uo•p nr List Pace Workorder Number or ,,,
'aceAnalytical' Nail L ! . . e
Chain-of-Custody is a LEGAL DOCUMENT-Complete all relevent fields
ipany: Town of Liberty Billing Information: ALL SHADED ARE II il 1111111
1 II 11
Ill
ress: [ Container Preservative T •e** 92
584432
Emiuuimammmm
ort To: Email To: '"Preservative Types:(1)nitric acid,(2)sulfuric acid,(3)hydrochloric acts,(`1 suuwm„y..,..,...._,,_,_
I (5)methanol,(7)sodium bisulfate,(S)sodium thiosulfate,(9)hexane,(A)ascorbic acid,(13)ammonium sulfate,
y To: Site Collection Info/Address: (C)ammonium hydroxide,(DI TSP,(U)Unpreserved,(0)Other
Analyses Lab Profile/Line:
:omer Project Name/Number: State: County/City: Time Zone Collected: i,s�ti I Lab Sample Receipt Checklist:
/ [ ]PT[ ]MT[ ]CT [ ]ET ®.-,i /`��'y
( i i ] Custody Seals Present/Intact Y N`t 1
ne: Site/Facility ID#: Compliance Monitoring? 9 ( Custody Signatures Present (xj N NA
ul: [If es [ ]No : ( Collector Signature Present -v)N NA
I ( Bottles Intact N NA
e/qe y(print. Purchase Order#: DW PWS ID#: Correct Bottles N NA
to i Sufficient Volume (Y)N NA
Quote#: DW Location Code: p
7I-_,. • II Samples Received on Ice N -
Immediately Packed on Ice: i1 ( VOA - Heads Acceptable Y N
xce
ected By{signature): Turnaround Date Required: aS o
[ (Yes [ J No tv USDA Regulated Soils N A
[ Samples
O in Holding Time 0 N NA
iple Disposal: J Rush: Field Filtered(if applicable): _ ~ I a) : i Residual Chlorine Pre t Y 6,)NA
)ispose as appropriate [ ]Return [ ]Same Day [ ]Next Day [ ]Yes [ I No 0 Z 1 Nt ,e cl scrips:
ZTi -
Irchive: [ ]2 Day [ ]3 Day [ ]4 Day [ J 5 Day I � `o Sample pH.Acs�Pt• e N NA
iold: Analysis: c7 0 ` pH Strips: {-1 ��t,,-(1)
(Expedite Charges Apply) cD f- 0 1 Sulfide Present Y N Ne
atrix Codes(Insert in Matrix box below):Drinking Water(DW),Ground Water(GW),Wastewater(1NW), Z Z u ]
Lead Acetate Strips:
sduct(P),Soil/Solid(SL),Oil(OL),Wipe(WP),Air(AR),Tissue(TS),Bioassay(B),Vapor(V),Other(OT) (cd MSLAB USE ONLY:
Comp/ I Collected(or Res #of I- Z ._ ,.N d ! § I Lab Sample i / Comments:
Composite End v
tomer Sample ID Matrix* Grab Composite Start) Cl Ctns ro V Ta
at Time Date Time 0 Z u- �o Flo-/
uent ww g 7/�, /460 5 X X XiXj i
5 i a
d
( I
1 '
i ((1 i ( ! .�. ._ __.. i
.
omer Remarks/Special Conditions/Possible Hazards: Type of Ice Used: Net Blue Dry None SHORT HOLDS PRESENT(<72 hours): Y N N/A Lab Sample Temperature Info:
Packing Material Used: II-Lab Tracking#: Temp Blank Recei` da:� , Y N NA
I Therm ID#: l��YL t��
Effluent Monitoring _ _ _ _ „. Cooler 1 Temp pon Receipta�j oC
Sam les received via: Cooler 1 Therm Corr.Factor: oC
Radchem sample(s)screened(<500 cpm): Y N NA p
FEDEX UPS Client Courier Pace Courier Cooler 1 Corrected Temp: oC
,quished by/Co pany:(Signature) 7/Ti e: 1 Receiv by/Company:(Si nature) Date/Time: \ MIX USE ONLY Comments: i
1
(p7� i Table#: 1
Z2 d J',1 [Acctnum: 3 i
uished by Company:(Sign ure) Date/Time: Received by Company: Signature) Date/Time: Template: Trip Blank Received: Y N NA
i 6 j HCL McOH TSP Other
s ¢ ,Prelogin: ,
' uished by/Company: Si nature Date/Time: Received by/Company: Si nature Date/Time: 1 L._ .._______.f
q (Signature)} ((Signature) 1 PM: g Non Conformance(s): 1 Page:
YES / NO I of:
a r PB ._._ �__ i i

�/) Document Name. ! DocL, ,.err lased: !a e er 15. 2021
Y / Bottle Identification Form(BIF) I Pc e o 1
PaCeA,r7, tIC ` _
Document No.: I3sJirg H o. ,,,
F-CAR-05-043-Rev.01 I Pace Ca clicas Qua'ity Of.cc
"Check mark top half of box if pH and/or dechlorination is Project n
verified and within the acceptance range for preservation
samples.
Exceptions:VOA,Conform,TGC,Oil and Grease,DRO/2315(water)DOC,LLHd �� )
"Bottom half of box is to list number of bottles i—� ) ('( ' ,
%Z o z"z -
Ia v v a: O ? ^ v c V -, � <
> > > c Ct L -? u �, 1 < L N C o o > i T z I e
l: U L. U - na V J S U i c rn _ r G G I _ ' -
.� Y 0 -0 j E - z _ -. y = n
E _ cam. _c W, � - E E < E < ry O < O ' c. '- , 5 _ _
c.- G G < > > > I s v
E E i E E E E -a _uII:I p E -- - g ' ., < -E' '' - c J
r ^ 0 M ! . ^eM Ill , .. Clr. ri -i 7Vr+ N 'I - .1. "- `- - eqI - , >>`ci• ctc3N Z N 2 3 r Vl ul '- !- D C. ' , - ' E _ ,EC m m (, (0 ' c m O , rti mV l y cc� a a m ai G a V V V V OV O Gn a-, - , < ,N
_
f \"\\\_ \ \\.\\ i \\N
H I
2 \\\\ —
3 \NN\ \
-_ 4 \ \ \ \\\,,
\ \\ \ N \\\ _ NN
6' \ \\\\. N NNN - - -\\!
\\.\\\___\
\ \\\,\\ \ -T-
9 \NN \\ \ \N ''''
\ A \\!
10 \ \\, \ i \ ;
I
11 \\ \ \ ! \ 1— - -__
I \
,
12 \\1\N \ J -- "
l \ \
pH Adjustment Log for Preserved Samples
Sample ID Type of Preservative pH upon receipt Date preservation adjusted Time preservation Amount of Preservative Lot it
adjusted added
I
tte. Whenever there is a discrepancy affecting North Carolina compliance samples,a copy of this form will bo sect to the North Carolina DEilNR Certification Ohice( e
it of hold,incorrect preservatwe,out of temp,incorrect containers.

Pace Analytical Services,LLC
co
1377 South Park Drive
ace Analytical
Kernersville,NC 27284
www,pacelabs.com
[phone]
Page 1 of 1
Laboratory Report
Tremaine Fike Report Date: 03/31/2022
Town of Liberty Date Received: 03/31/2022
PO Box 1006
Liberty, NC 27298
Project: Town of Liberty
Pace Project No.:92596382
Sample: Effluent Lab ID: 92596382001 Collected: 03/31/22 11:00 Matrix: Water
Method Parameters Results Units Report Limit Analyzed Qualifiers
Performed by PACE 03/31/22 11:00
Collected By Garrett 03/31/22 11:00
Dreyer
Collected Date 03/31/22 03/31/22 11:00
Collected Time 1100 03/31/22 11:00
pH 7.43 Std.Units 03/31/22 11:00
Chlorine,Total Residual 0.07 mg/L 03/31/22 11:00
Reviewed by: 9/Azigti
Stephanie Knott
704-977-0981
[e-mail]

'
CHAIN-OF-CUSTODY fai ieai Request Document LAB USE ONLY-Affix Work
0
a eAnaIytica/
`- Chain-of-Custody is a LEGAL DOCUMENT-Complete all relevent fields
a
BillingInformation: ( 111111111
\11 �
ompany: Town of LibertySHAD,
ddress:
Container Preservative Tyr 92595382
[
sport To: €Email To: ; "Preservative Types:(1)nitric acid,(2)sulfuric acid,(3)hydrochloric acid,(4)sodium hydroxide,(5)zinc acetate,
i (6)methanol,(7)sodium bisulfate,(B)sodium thiosulfate,(9)hexane,(A)ascorbic acid,(B)ammonium sulfate,
opy To: Site Collection Info/Address: I (C)ammonium hydroxide,(D)TSP,(U)Unpreserved,(0)Other
Analyses 'Lab Profile/Line:
ustomer Project Name/Number: State: County/City: Time Zone Collected: illillitlit Lab Sample Receipt Checklist:
/ [ ]PT[ ]MT[ ]CT [ ]ET'
1 g Custody_ Seals Present/intact Y N N.
'tone: ;Site/Facility IDC: I Compliance Monitoring? N Custody Signatures Preoent : N f.
tail: 3 [, Yes [ ]No % 2 c to g te Pres -t Y N s
Alec ed By{pri tt_ I Purchase Order#: 1 DW PWS ID»: CorrectBo LL "
3
Quote xi: I DW Location Code: Sufficient um
€ f IS - } Sample Received Ice Y N
;immediately Packed on Ice: Job He ns e Acceptable p Y- NA
Turnaround Date Required: o I
I I 1 - 1 = USDA Regulated ed So t NA
}[ ]Yes ( ]No
pi Disposal: I Rush: 1 Field Filtered{if applicable): _ 1 m Residual Chlorine P ent NA
]Dispose as appropriate I ]Return ( ]Same Day [ ]Next Day ,[ (Yes ( ]No : '= l i Strips:
(Archive: I [ j 2 Day [ ]3 Day [ ]4Day [ ]5 day Anal sis e H ,ce pta-t'J_ s NA
)Hold: ( (Expedite Charges Apply) [ y - E [ _ 3 i ul-_v_ Present 'u' N NA
Ground Water(GW),Wastewater(WW), ` ea Acetate Stripe:
Matrix Codes(insert in Matrix box below):Drinking Water(DW), r 1 li I
Product(P),Soil/Solid(SL),Oil(OL),Wipe(WP),Air(AR),Tissue(T S),Bioassay(B),Vapor(V),Other(OT) ),� I'a 1 I 3 I i I 3 f LAS USE ONLY,
f I Comp/ I Collected(or Res #of
ustomer Sample ID Matrix" Grab Composite Start)IComposite End Cl Ctns ' to
Date € Time Date Time -- Q ,
i i
e
"'fluent [W4V Ig I/1 I? If 00 [ a i '
r 1 1 ;
i 3 a ! I 3 3
1 I
i x
€ I ,E 1 : - I E--
t 1 1(
f i
s
I i 3
t
starrier Remarks/Special Conditions/Possible Hazards: 'Type of ice Used: Wet Blue Dry None SHORT HOLDS PRESENT(<72 hours): Y N N/A 1 Lab Sample Temperature info:
PackingMaterial Used: Lab Tracking#: Temp Blank Received: Y N NA
Therm ID :
Effluent Monitoring 4 Cooler i Temp Upon Receipt oC
`
Samples received via: Cooler 1 Therm Corr.Factor: cC
Radchem sample(s)screened(<500 cpm): Y N NA FEDEX UPS Client Courier-3 Pace CourierCooler 1 Corrected Temp: ® oC
jdbature'n ) date/Time: €Received by/Company:(Signature) ; aterime: MTJL LAB USE ONLY Comments:
i" r `� * ll' / I -1 DS Table#:
33 31 3 Acctnum:
„pany:(Signature) I Date/Time: [Received by/Corn an :(Signature) I Date/Time: TripBlank Received: Y N NA
> !
o =Prelogin: CCL N�ieOH TSP Other
€ !Template:
]inquished by/Company:(Signature) 3 date/Time: `Received by/Company:(Signature) 'Date/Time: PM: 1
Non Conformance(s): '.Page:
YES / NO of:
PB:

March 2022
Liberty N.C.W.W.T.F.
Freeboard Lagoon Inches
DATE
1 91/2
2 10
3 101/2
4 103/4
5 11
6 11
7 11 R 0.3
8 12
9 13 R 1.5
10 10
11 81/2
12 9 R 1.1
13 6
14 6
15 6 3/4
16 71/2 R 2.2
17 0
18 0
19 0
20 0
21 0
22 0
23 0 R 0.3
24 0
25 0
26 0
27 0
28 0
29 0
30 0
31 0 R 0.4
TOTAL 5.8

FORM:NDAR-1 10-13 NON-DISCHARGE APPLICATION REPORT(NDAR-1) Page_1_of___2
Permit No.: WQ0003090 I Facility Name: Town of Liberty-Wastewater I County: Randolph Month: 1\1\0.AQY\ Year: 2022 ,
1. Field Name:, 1 Field Name: 2 Field Name: 3 Field Name: 4
Did irrigation occur "
Area(acres):, 20.2 Area(acres): 19.7 Area(acres): 1994 " " Area(acres): 17.02
at this facility? Cover Cro FESCUE CoverFESCUE CoverFESCUE CoverFESCUE
p Crop: Crop: Crop:
0 YES ❑NO Hourly Rate(in): 0.21 Hourly Rate(in): 0.21 Hourly Rate(In) 0.21 " Hourly Rate(in): 0.21
Annual Rate(in)„ 52 Annual Rate(in): 52 Annual Rate(In) 52 " Annual Rate(in): 52
Weather Freeboard Field Irrigated? [�YES Ono Field Irrigated? (]YES ❑No Field Irrigated?'. Q YEs ❑No Field Irrigated? Q YES ❑NO
a> F2 a Lc
is so E co 0 a
0. =co to' m o r' E ac 0 a ,c; c Ea_, mI a , a . >+ = Ed m a c ` c
v a o c° N ga gam c E "t. E ?+� E •
Es E =, E I . :cc mn ,5Ec �
p F E c �,� n S a ;r a i= m aa R o ak=,'� e a"4O o aa 1= a� w0 K S a
, aq . piG 0o a •c o as S 0 I- � >s E m (n i a >< z. -1 i S ,a > Q 2:: -I 2 2ct = 2
ai Im it a'
"'
°F in ft ft gal ruin In in gal min in in gal min In in gal min in in
1
2 C 50 0.75 325,000 , 180 ' 0,60 0.20 281,000 180 0.61 0.20
3
4
5 CL 57 0.75 281,000 180 0.61 0.20
6 C 61 0.75 _ 325,000 180 0.60 020
7 C 0/0.3
8 PC 55 1 325,000 180 0.60 020 281,000 180 0.61 0.20
9 R 1.5
10
-11
12 R 1.1
13
14 C 65 0.5 327,000 180 . 0,60 0.20 -
15 C 60 0.5 321,000 180 0.60 0.20
16 C 50 0/2.2 0.5 _ 325,000 180" 0.60 0.20
17
18
19 CL 60 0 281,000 180 0.61 0.20
20
21 C 54 0 327,000 180060 0.20 I -
22 PC 52 0 321,000 180 0.60 0.20 325,000 " 180 ; :"0,60; 0.20.
23 R 0.3 _
-
24
25 C 50 0 281,000 180 0.61 0.20
26
27 C 65 0 327,000 180 x 0,60 ;0.20
28 C 55 0 _ 321,000 180 0.60 0.20 325,000� 180. 0,60;" 0.20
29 C 34 0 _ _ 281,000 180 0.61 0.20
30 C 42 0 327,000 180> 0.60 0.20
31 C 66 0 321,000 180 0.60 0.20
Monthly Loading: 1,308,000 2.38 1,284,000 , 2.40 1,950,000 3.60 1,686,000 , 3.65 , > "'k',
12 Month Floating Total(in) 28.53 °> h.,.,'_ .a ;.:' 28.88 ... ., 38.52 ,w

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 Compliant ❑Non-Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites? i Compliant ❑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? ❑Compliant LI 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.
WE WENT OUT OF COMPLIANT ON THE DATE OF 01/03/2022 CAUSE OF RAINFALL. THE RAINFALL TOTAL OF 4.0 INCHES OVER TWO DAYS PERIOD.
Operator in Responsible Charge(ORC)Certification Permittee Certification
ORC: Elix Tremaine Fike Permittee:
Scott Kidd
Certification No.: 989290 Signing Official:
Grade: SI Phone Number: 336 622 2990 Signing Official's Title: Town Manager
Has the ORC changed since the previous NDAR-1? ❑Yes 0 No Phone Number: 336 622 4276 Permit Exp.: 8/31/24
?/?.
q- 2-Z(2-2
Signature Date Signature Date
By this signature,I certify that this report is accun ate 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 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_2_of_2__
Permit No.: WQ0003090 I Facility Name: Town of Liberty-Wastewater I County: Randolph Month: March Year: 2022
Field Name: 5 Field Name: 6 Field Name: 7 Field Name: 8
Did irrigation occur (acres):Area 18,3 Area(acres): 15.1 Area(acres): 22,12 Area(acres): 21.68
at this facility? ,
Cover CroO:' FESCUE Cover Crop: FESCUE Cover Crop: FESCUE Cover Crop: FESCUE
-
, Rate 0211 . Hourly Rate(in): 0.21
0 YES 0 NO Hourly R Hourly Hate(in): 0.21 Hourly Rate(in): 0.21
Annual Rate(In): 52 Annual Rate(in): 52 Annual Rate(In): 52 Annual Rate(in): 52
Weather Freeboard Field Irrigated? C3 YES 0 No Field Irrigated? [-.]YES 0 NO Field Irrigated? 1_-_,(71YES ir-1 NO Field Irrigated? L:4171 YES 0 NO
o E g ....... .
4- c) - E
0 CD - 4,1 13 1:1 CP ,.,CO d
cala, ›..5. '==....5.. E2 ca 2 _?.,.E .?....E - g ,=.s E .
co c-> .- • tv c'• n' z= E a =I= e = zt = .E. E 63 Teco E E :5 = ta. a a 7i 13 - =.13 = -6- .E a, m T.
0 ..-, a. .n?-1 sui =,,I"-, .r, a p:-9-',. a 8 Tim ,..0 r:: ",;-""c3 .„.-c-i..ra 17**c. al8 tIla ° 49" IE ° ° VI °
= E 6 re as E. >4 .- J. 2--I > ct ..-. -I m -i - --, _ ..1 2 _i
"
°F in ft ft gal min in in gal min in in . gal min in in gal min in in
1 C 36 0.75 299,000 180 0.60 0.20 252,000 180 0.61 0.20 350,000 180 0.59 0.20
2
3 C 50 0.75 252,000 180 0.61 0.20 370,000 180 0.62 \ 0.21 ..,
4 C 54 0.75 \ 299,000 180 0.60. 0.20 350,000 180 0.59 0.20
5 _
6 _ i
7 C 63 0/0.3 0.75 299,000 180 0.60 , 0.20 252,000 180 0.61 0.20 370,000 180 0,62 021
.
8 C 61 1 350,000 180 0.59 0.20
9 R 1.5
10
-
11 C 48 0.5 252,000 180 0.61 0.20 370,000 180 0.62 0.21
12 R 1.1
.. -
13 C 48 0.5 350,000 180 0.59 0.20
_
14 PC 60 0.5 299,000 180 0.60 0.20 - - -
15 C 40 0.5 252,000 180 0.61 0.20 370,000 180 0.62 0.21 ,
16 C 60 0/2.2 0.5 , „ ., 350,000 , 180 0.59 0.20
-
17 . ,
18 CL 65 0 299,000 180 0.60 0.20
19 .
20 C 49 0 370,000 180 0.62 . 021
21 C 42 0 252,000 180 0.61 0.20 _ 350,000 180 0.59 0.20
_
22
-
23 R 0.3 - ,
24 CL 66 0 299,000 180 0,60 0.20
25 C 65 0 ,
252 000 180 0.61 0.20 370,000 180 0.62 0.21
26 C 59 0 350,000 180 0.59 0.20
27
28 C 53 0 299,000 180 0.60 , 0,20 29 C 55 0 252,000 180 0.61 0.20
30 C 51 0 299,000 180 0.60 0.20 350,000 180 0.59 0.20
31
,, ., ,
Monthly Loading: Z , ,.,,',392,000 4.81 2,016,000 : . 4.92 .. ,,,, 2,220,000 3.70 2,800,000 ,, , , 4.78
12 Month Floating Total(in): 39.92 ',,, ' , :;l',1,:,,;1.:'„',,,M,' '1,„ ,,, 37.59 1,1, ,',,,: 32.91

FORM:NDAR-1 10-13 NON-DISCHARGE APPLICATION REPORT(NDAR-1)
Did the application rates exceed the limits in Attachment B of your permit? E Compliant ❑Non-Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites? ❑' Compliant ❑Non-Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit? 0 Compliant ❑Non-Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site? 0 Compliant ❑Non-Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? ❑Compliant LI 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.
WE WENT OUT OF COMPLIANT ON THE DATE OF 01/03/2022 CAUSE OF RAINFALL. THE RAINFALL TOTAL OF 4.0 INCHES OVER TWO DAYS PERIOD.
Operator in Responsible Charge(ORC)Certification Permittee Certification
ORC: Elix Tremaine Fike Permittee:
Scott Kidd
Certification No.: 989290 Signing Official:
Grade: Sl Phone Number: 336 622 2990 Signing Official's Title: Town Manager
Has the ORC changed since the previous NDAR-1? ❑Yes C]No Phone Number: 336 622 4276 Permit Exp.: 8/31/24
Ar" (22l2
Signature Date Signature Date
g g a
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 Resources
Information Processing Unit
1617 Mail Service Center
Raleigh,North Carolina 27699-1617