WQ0001868_Monitoring - 03-2021_20210504 (2)

. FORM NDMR 08 I I NON-DISCHARGE MONITORING REPORT (NDMR) "'' "I
Permit No.: W00001868 Facility Name: Town of Severn County. Northampton Month: Mal, Year: ,/
I
PPI: 001 Flow Measuring Point: 0 Inn..ent 0 Effluent 0 No 3enerated Parameter Monitoring Point: 0 inn„ei,i t7:..,,en, ❑,..,ot.,,,..,ce .:,,e,u'q ❑>..•.,.e.•.
Parameter Code - ► 50050 00400 00310 00610 00530 31616 00600 00625 00665
C — _— --. - N —�
sel it
%
a _ '�
G/ _ _
c E E o = ° y ycr u _o . 3 vt a, p, 3 L o,10 i` a Q V
m U F- ~ N IL n m E o a 7 m H — O H a a► — ~
C U Q j ° Z :° Z ° V O
O O to 0 a Z V {i►9s<
24-hr hrs GPD su mg/L mg/L rng/L #,100 mL mg/L mg/L mg/L
4 A '5 4 410
5 A i 6 50 0
`7 7A r f )
944 -
9 7A c f. 30o T
10 7A ',S' !3oa .
13 7A , r 3GZPJ0 MAY p 4`20?1
14 7A , , 5" ¢tiro o .
,5 7A S 3*aO NRSF; .JQ0
16 7A '3' fl/a" - NFORMATION PROCFqtair,i toil
17 7A 3,7 _
18 7A ¢9/0 0 __, •
19 7 1 4 3 -
20 7A , c 43 0o
21 7 A .1 4900 .
22 7A 23 c %oo, 6rY 7 .,p .17 imp thl,v 44 o5 - M 1+ 10
z480 ,___
25 7!A t 3ggoo — . _
26 7,1 ' : 31300 - _
7-
_27 - rD 331.66
28 _ ''�— i''i
29 ,4 , S e7306
30 7 A_ ' .3000 -
31 7 f. `S"' -42 50b
-
Average: 4'1,0./3 ',VALUE' #VALUE! #VALUE' #VALUE! #VALUE' #VALUE! #VALUE' //VALUE! #VALUE' *VALUE! #VALUE' %VALUE! #VA.LUE' IVALUE!
— Daily Maximum:C'y O y
Daily Minimum: 3/360
/�
Sampling Type:
Monthly Limit: *33/
Daily Limit: / dOd
_
Sample Frequency:

.74
C Sampling Person(s) Certified Laboratories
-�fl
Name: F- 151 l�i Name:Env+ rcin nhe T
Name:
Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? ❑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)of the non-compliance and describe the corrective acttc
Attach additional sheets if necessary.
h
Operator in Responsible Charge(ORC)Certification Permittee Certification
ORC: '� 44-5-5//e Permittee: 11'A see/
Certification No.: 2_0¢96 Jg—T 7 P94 Signing Official: M• E L a{jcs,'�ef
Grade: C Phone Number: 5 ? 5 85 'O9"l t Signing Official's Title: R !�
Has the ORC changed since the previous NDMR? 0 yes Phone Number: � -`�0 S �' J �l Permit Expiration: 73/— o`C J�
014
Signature Date Signature DE
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
with a system designed to assure that all qualified personnel property gathered and evaluated the information submitted
inquiry of the person or persons who manage the system,or those persons directly responsible for gathering the infoi
information submitted is,to the best of my knowledge and belief,true,accurate,and complete I am aware that there a
penalties for submitting false information,including the possibility of fines and imprisonment for knowing violat
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

FORM NDAR-1 08-11 NON-DISCHARGE APPLICATION REPORT (NDAR-1) Page 1 of 4-
Permit No.: WQ0001868 Facility Name: Town of Severn WWTF County: Northampton Month: a fch Year: DWZ,
Field Name: 1 Field Name: 2 Field Name: 3 Field Name: 4
Did irrigation occur Area(acres): 2.5 Area(acres): 2.5 Area(acres): 2 Area(acres): 2.5
- at this facility? Cover Crop: r. p i 1 ) , Cover Crop: ;etirtvd ♦ Cover Crop: 4,_, Mddo Cover Crop: mach' Are
V. Yes ❑NO Hourly Rate(in): 0.4 Hourly Rate(in): 0.4 Hourly Rate(in): 0.4 Hourly Rate(in): 0.4
Annual Rate(in): 46.8 Annual Rate(in): 46.8 Annual Rate(in): 46.8 Annual Rate(in): 46.8
Weather Freeboard Field Irrigated? / ES ❑NO Field Irrigated? G YES ❑NO Field Irrigated? G YES ❑NO Field Irrigated? -YES ❑NO
w
o .3 rn a s a, 5 d ii >, c 3 >' _ E ' d >,13 c 3 ` 0) E w d i ?,.E `.c E . 0, a >`•c m
m ° '6 - 2 am E .. is :o E o -o E •v E = 'v E m v E 3v 3 a E �o ,� v .E
O o. a o > u p Oa. i-E-. Pc! 0 g •x ,1-8 O a i= 0 g M O o a 1- c a x ' oO o a 1- •m 0 0 m i 0
O
L E e u) O m > < J J > Q .. J = J > < J = J > Q = J J
10 F- a
� u,
°F in ft ft . gal min in in gal min in in gal min in in gal min in in
1 .," i _& /Poo Zo ,22. ?-2, /4 a© Go r a¢ l50°0 bG •24 •2-K I100 60 ,/g 4.8v _
/.6 /6��0 &o •a 4'
3�i . „ 0 .a 4- 'A- 1 SOO Gov •13 ,A3 /
� tuolU `1 q
� 1„. ,a . 4- br `2.3 ' 7- '• DI
5 WA1 d 0 d o I I 1 i il • 2.4- 13 APY> o ' ¢ #vc> .1 6- .�2.121O its
N
7 MI
8 4. FARM ESWPMFMEria ' 0 P 0 11311111IF3> I a irmini .,20
9 ` 7 MIIM O Irr iM O r coo , E IIIIf311LM]1125a �� ' 1 a0 • O WPM -
10 6, an fli'�/�M�I MI 10 0 � i. t'o =I •a.
11 Ert9 t+ ad rTaMMII ' 40v -0 •,.42 ,Ag- / kill 6 0 '3a .30
12 C. ..1,o / i M «' .2 .6 0 O .A4- -A9— .di 60 -It
13 C ' ; x10 ..2-1-MEI '2f 57-40 60 'a I- ,x2. 1<cboo 60 47 11110_),00 (t.) 05 ./.
14
1165 EN MI A o o MIA
is Y'i ? 1S-
- �a� t +-v z i220o ',C) 1.
18,7 �,�W - III /l0av .1 '1/774 /6,-04 60 •24" • 2-9- 14ao d 60 IN `/�
19
20 LEI ;-'d II■I t5-i D r,,© raM •a3 ooriallIPIE1111M1� UM ,0 EMI
21 --__IIIIN
23 C_ _ IF3ll IIIIMM /.° farlitnirai r 7 e d Wailair
'
24 4 • G� 13c�= MilMirial. IN./ aUM � i 6 C��a 1
25 5130 IVAI od i 4-lde. Me M_�
cicbeLMFRII . PrP41111Wriniiiiim m 0 moil=
26 Mil ME EMI
27 '- '51 io'300 'C) griAlffill MO IDIIIMMIll TIMIMIIIIMPAIIMIll war ,,2.3 P-11
28
29 C 3•Ta_ 1.11FErni /0 EMAIIIKal 0 o Milialliffiall •
1 • 6 1t # ,'1r
q110r o MaMonthly Loading 3.? /Iv 1 / �/ 0 0t2 '�� /9,67V, 4� ������4 / �12 Month FloatingTol (in): /�� F3 14,r 'V ' �� �/ 4 5T% v�������������f������ rU����M

Did the application rates exceed the limits in Attachment B of your permit? ❑Compliant Non-Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites? Ptt7npliant ❑Non-Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit? ompliant ❑Non-Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site? Compliant LI Non-Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? 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)of the non-compliance and describe the corrective
action(s)taken.Attach additional sheets if necessary. .
5t9h / Field It / hack /z hl°,17 1 1Vta1 of .5-3y6; iq `` oh , Ff,t"ov„r 1,`rI/*
, 7/ .:o,.._ ✓ r'- // /e- /r .P9' 6 7�f 3-r7r1 r r /r
re- (- 3 �- 7/ (V. 54, �s� 7,�`r
i f .t q- /1 ,7 // 7/' // ,', 9 % ,1
Operator in Responsible Charge(ORC)Certification Permittee Certification
ORC: pi. E / /a_4: 7 ei- L Permittee: (]w -1 e F 5 r/el-Pi L
4-1 Certification No.: 20496. - 7 /��� Signing Official: C lj ��557 7 e�
� 1�� �- ice`
Grade: / Phone Number: 25 .�0`� D rl Signing Official's Title: (/
Has the ORC changed since the previous NDAR-1? ❑Yes No Phone Number:o2.5 `5 i '� �l Permit Exp.: 7 ,3/-0"`-"2
7P4-1- .46.1.„.....X.-"1--' 4-v "-0V- 7/1& ----- 1-T-11
Signature Date Signature Date
ay this signature.I certify that this report is accurrale and complete to the best of my knowledge I certify.under penally 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 impnsonmenl 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

t i•t.N N1,t.n I vo . NUN•VIJur1Hr(ht N-'YLll.HIIVIV rscr'_."1 tt.v,.,.- .r r! .7-
•
Permit No.: W00001863 Facility Name: Town of Severn WWTF
County: Northampton I Monthilla rc'ii Year: 2,(
Field Name:
Field Name: 5 Field Name: Field Namo:—_ �----- ----
Did irrigation occur --- 38 Area(acres): Area(acres): -- - --_- Area(acres):
Area(acres):
at this facility? — _ Cover Crop: Cover Crop: Cover Crop:
— Y� ewer crop: evm Ys'. - --___-----
Hourly Rate(in): 0 4 Hourly Rate(in): Hourly Nate(In). �`l
`1t• I I No Annual Rate(in): Annual Rate(In):
Annual Rate(in): 46 8 Annual Rate(in):
-
,._,,�� Field Irrigated? ❑v s ❑NO Field Irrigated? ❑YES Ll No Field Irrigated? ❑its ONO
_ Weather Freeboard i Field Irrigated? It�res C�NO 9
v to E rn
a, �' I V a, D rn E rn a, a v rn E T w a+ v y r �' E c Cu 0 a > c E c
v 3 w o c t w r E E 0 a «. L m E _ 'v
0 O) y E W E T C E N 'O �E( 7 o 7 i E w ro N E O o p a 1- al
p H o �O
N U y S 6 , V 3 a E_ OI •b A 'E O O a i-E to
-- � D O -t0 S O a ~ •.�. 0 0 ro S J > Q _ J = J
t E N m n > Q _ J
--
'r in ft ft gal min in in gal min in in gal min in in gal min In in
2 7.0 9 I, G yA Too -.r� '/6 ,/(, -- --: .
4 l dO I4i 1/f(._ — --- �— — — -
L a4-7 J, J_6r) �1 / 'j ---- —
12 � -I11 is Z'v, ,J 4 HQ_- . ,t ,I t _ _ —T
13-C. -13-0 ,2t0 /76GU.._6 a •1_7 _ Ili__ - --
;4 r -- _ --
—15-- ----t-4-f----1-1-d—77-7 7L0*72 -CL-----7- 71 Lil
18 F —
C fi 7 .. .. .G2.4'�._-- 94avv,...-. . ..
. ---
'- - --.D_-- . .....-
2 • — __ .._— . ._ . .. - -----
28 Off - ---� __ -.-- -._ - -_
30 (_,.. . at-
- - . .. .. . .
/no._i_ ___...i./.._ ti , __ _ . __ _—
Monthly Load,n(J. / b ������� %������/ � ���iimr
��.� ������������� ������������� �� ----
t/ Month Floating Total lit) 7 i �/,%�����/t„+r ����//i��������

FORM NDAR•t 10 13 NON-DISCHARGE APPLICATION REPORT(NDAR-1)
Page i of_I
te,pigt
Did the application rates exceed the limits in Attachment B of your permit? �/`- �!
Comdunl L. . • ompkant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites? �/
Ie Compliant 0 Non•Compkant
Was a suitable vegetative cover maintained on all sites as specified in your permit? ,�//
U Compliant 0 Non-Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site?
Compliant Oelon-Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
Compliant 0Non-Compbant
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 descnbe the corrective action(s)
taken.Attach additional sheets if necessary.
Operator in Responsible Charge(ORC)Certification
Permittee Certification
ORC: /, (is: e_�-�r Q / Permittee: /UI:U h d � 5e(/c�/'n '
c2'9
Certification No.:2 '? ' A (i � //�C' Signing Official: N, L- ,La 'f/ tef
3rade: t Phone Number: ,Z 5 pZ`-'5 ' C).014/ ,,
Signing Official's Title: a fxC_-
-las the ORC changed since the previous NDAR-1? 0 Yes l7 No Phone Number: a 4---2 -3 a 4-1
/ Permit Lip.: 2-,jl- /(Ja
77//{d--04"---61,1-4.--%s --P—-— ,I`K ,,Z) -
v ,1_ ---0271
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 H 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 property 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 knowng violations
Mail Original and Two Copies to:
Division of Water Resources
Information Processing Unit
1617 Mail Service Center

d?nviroinnent 1, Inc. CHAIN O i' CUSTODY RECORD 1 1
P.O. Box 70ti5, 114 Oakmont Dr. Page .__ of
Greenville,NC 27558
environment Iin( :ow DISINFECTION CHLORINE NEUTRALIZED AT COLLECTION
Phone[phone]U • Fax [phone]
190 Week: 14 Li ('tII)ORINE
CLIENT: 6- 4.2 c2 a.2 s� ---dv pH-CHECK(LAB)
j UV _
SEVERN WATER&SEWER PPP p p p p p p p p p p p
MR.M.E.LASSITER Li NO N L:; CONTAINER TYPE,PIG
P.O.BOX 401 .-
SEVERN NC 27877Li A A GACCC ACC A A A CHEMICAL PRESERVATION
cp0 ,� up A-NONE D-NAOH
[phone] w v �� cr) 2 :: w
_z `-L w z m 0 e Z 1 � � B HN0 E HCL
a J a O Z I 'd n[
8
j o b o w C•H,SQ, F-ZINC ACETATE/NAOH
wt`i.
COLLECTION a o'_ o o0 x C 1 g i
i a a C A A a, P a G-NATHIOSULFATE
' 1-- 0 o a a7 w El E I Z Z EF E. U Ey ,l 2
SAMPLE LOCATION DATE TIME (2 o '''� n. _., Tt <
Effluent /�1 g,.�� ��r c 8 ?u � .- > z' ::<.>
( d to
CLASSIFICATION:
Well#5 ✓ D id!' 7 • 1.}
Li WASTEWATER(NPDES)
IC Well u8 (/ q,e' 1 s(- 7 v ::1:-._ — i. ' • il Ssg -
Well#10 / g.-4 /3 c- i Si ^ :} ALi DRINKING WATER
_-_ ._. ,. DWR/GW
Well#12 p ; +,,:o —�
/ .! 13 7 .a: E ,x : .M1 5'36 Li SOLID WASTE SECTION
Well J/13 1 T 7 a:.�r� t• :< ;� •":ti ja CHAIN OF CUSTODY(SEAL)MAINTAINED
p
v J `�� DURING SHIPMENT/DELIVERY
6) N
SAMPLES COLLECTED BY:
(Please Print)
M' F., LaSSJ 7 r
SAMPLES RECEIVED IN LAB AT f). .. C
RELINQ I4 Y SIG. SAMPLER) 3/ DATE/TME REC IV D BY IG.) DATFJTIMi COMMENTS:
ti
14F17,01
RELINQUISHED BY(SIG.) DATE/TIME REC VED BY(SIG.) DATE/TI�E
RELINQUISHED BY(SIG.) DATE/TIME RECEIVED BY(SIG.) DATE/TIME
PLEASE READ Instructions for completing this form on the reverse side. Sampler must place a"C"for composite sample or a"G"for N° 396906
FORM#5 Grab sample in the blocks above for each parameter requested.

•
EMWriliroR 1 lio liTRIT
Ws#teratfr.SD: 10
114 OAKMONT DRIVE PHONE [phone]
GREENVILLE, N.C. 27858 FAX [phone]
ID#: 190
SEVERN WATER & SEWER
MR. M.E. LASSITER
P.O. BOX 401 DATE COLLECTED: 03/23/21
SEVERN ,NC 27877 DATE REPORTED : 04/26/21
I
i
2 REVIEWED BY:
i
Effluent Well #5 Well #8 Well #10 Well #11 Analysis Method
PARAMETERS Date Analyst Code
1
PH (not to be used for reporting) 6.3 6.1 5.8 5.2 5.2 03/23/21 EMS 4500HB-11
BOD, mg/1 1/76 03/23/21 .MS 5210B-11
Fecal Coliform (MF), /100 Mls /68180 <1 <1 <1 <1 03/23/21 BLV 9222D-06
Total Suspended Residue, mg/1 V 17 03/24/21 IBLV 2540D-11
Ammonia Nitrogen as N, mg/I 9.86 03/24/21 pTL 350.1 R2-93
Ammonia Nitrogen as N, mg/1 f' 1.77 <0.04 0.05 0.05 03/23/21 PTLL� 350.1 R2-93
Total Kjeldahl Nitrogen as N,mg/1 14.20 03/30/21 kES 351.2 R2-93
Nitrate+Nitrite as N, mg/1 .0.05 03/24/21 DTL 353.2 R2-93
Nitrate Nitrogen as N, mg/1 0.05 <0.04 0.17 0.14 03/23/21 pTL 353.2 R2-93
Total Phosphorus as P, mg/1 1.64 03/30/21 TLH 365.4-74
Total Organic Carbon, mg/I 19.14 <1.00 <1.00 4.23 03/23/21 (DS 5310C-11
Chloride, mg/1 24 69 266 770 130 03/29/21 BLV 4500CLB-11
Total Dissolved Residue, mg/1 M 180 M 390 M 580 M 1400 M 690 03/25/21 ) LV D5907-13
Sodium, ug/1 37750 04/23/21 $AB 3111B-11
All QC requirements were not met: M Blank result exceeded method constant weight criteria.

. EWOTEDIERE _or [EC)Tpgifffli@di
1 :2 { F ki .#�!t-y'� ., Y 2 �.}�c� � ^kf LI'SF f('x`3'q.� yl, Hwy
�. .,t 4 -{ #3� + <.<ar6 (� :�1 � d ��N' to r 3
wssr a4tr ;ID: 10
114 OAKMONT DRIVE PHONE [phone]
GREENVILLE, N.C. 27858 FAX [phone]
ID#: 190
SEVERN WATER & SEWER
MR. M.E. LASSITER
P.O. BOX 401 DATE COLLECTED: 03/23/21
SEVERN ,NC 27877 DATE REPORTED : 04/2921
REVIEWED BY:
Well #12 Well #13 Analysis Method
PARAMETERS Date Analyst Code
PH (not to be used for reporting) 5.4 5.0 03/23/21 JMS 4500HB-11
Fecal Coliform (MF), /100 Mls <1 <1 03/23/21 BLV 9222D-06
Ammonia Nitrogen as N, mg/I 0.07 <0.04 03/23/21 DTL 350.1 R2-93
Nitrate Nitrogen as N, mg/I <0.04 0.27 03/23/21 DTL 353.2 R2-93
Total Organic Carbon, mg/I 1.38 1.39 03/23/21 KDS 5310C-11
Chloride, mg/I 555 4 03/29/21 BLV 4500CLB-11
Total Dissolved Residue, mg/I M 1200 M 91 03/25/21 BLV D5907-13
All QC requirements were not met: M Blank result exceeded method constant weight criteria.