WQ0002015_Monitoring - 08-2016_20160919

NON -DISCHARGE APPLICATION REPORT Page _of
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDITIONAL PAGES AS NEEDED.
PERMIT NUMBER: W00002015
MONTH: August YEAR: 2016
FACILITY NAME: Oak Hill Fellowship Center COUNTY: Granville
Formulas:
Dally Loading (inches) = [Volume Applied (gallons) x 0.1336 (cubic feet/gallon) x 12 (inches/foot)] /(Area Sprayed (acres) x 43,560 (square feet/acre)] OR
= Volume Applied (gallons) / [Area Sprayed (acres) x 27.152 (gallons/acre-inch)]
Maximum Hourly Loading (inches) = Daily Loading (inches) / [Time Irrigated (minutes) / 60 (minutes/hour)] Monthly Loading (inches) =Sum of Daily Loadings (inches)
12 Month Floating Tota[ (Inches) = Sum ofthis month's Monthly Loading (inches) and previous 11 month's Monthly Loadings (inches)
Did Irrigation Occur At This Facility:
Yes: No:
Did Irrigation Occur On This Field:
Yes:
No:
Did Irrigation Occur On This Field:
Yes:
No:
FIELD NUMBER: 1
AREA SPRAYED (acres): 1.07
COVER CROP: Fescue
PERMITTED HOURLY RATE (inches): 0.25
FIELD NUMBER:
AREA SPRAYED (acres):
COVER CROP:
PERMITTED HOURLY RATE (inches):
D WEATHER CONDITIONS
PERMITTED YEARLY RATE (inches):
52
PERMITTED YEARLY RATE (inches):
A storage
T Weather Temperature Lagoon
E Cade' at application Precipita-tion Free -board
Volume Time
A lied Irri ated
Daily
Loadin
Maximum
Hourly
Loading
Volume Time
Applied Irrigated
Daily
Loading
Maximum
Hourly
Loading
VF) inches feet
gallons minutes
inches
inches
gallons minutes
inches
inches
1 C 3
2 CL
3 R 1
4 R 1
5 CL 2.8
6 C
7 C
8 CL 2.8
9 PC
10 C
11 C 84 2.8
4032 240
0.14
0.03
12 C
13 C
14 C
15 C 2.9
16 C
17 C
18 C 85 3
4032 240
0.14
0.03
19 PC
20 C
21 C
22 C 3.1
23 PC
24 C
25 C 3.15
26 C
27 C
28 C _
29 C 3.2
se C.
31 PC
Total Gallons/Monthly Loading (inches)
8064
0.28
0
0.00
12 Month Floating Total (inches)
4.62
Average Weekly Loading (inches)
0.062633
0
weatner %.ones: %.-clear, r%.-paruy clouuy, %d`clouuy, R -ram, JII-SIIVW, JI- 1—
Spray.lrrigation Operator in,Responsible Charge (ORC):
ORC Certification Number:
Mail ORIGINAL and TWO COPIES to:
DENR
Division of Water Quality
ATTN: Information Processing Unit
1617 Mail Service Center
RALEIGH, NC 27699-1617
Dale Lee Mathews
22794 Checn-,
f ORC Has Changed: El
-P.. a
Phone: [phone]
(SIGNAWRE OF OPERATOR IN RESPONSIBLE CHARGE)
BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS ACCURATE AND
COMPLETE TO THE BEST OF MY KNOWLEDGE.
DENR FORM NDAR-1 (11/2005)

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
Facility Status:
Please indicate ( by inserting Y(es) or N(o) in the, appropriate box) whether the facility has been compliant .
withthe following permit requirements: (Note: if a requirement does not apply to your facility put (NA) in the
compliant box.) '
1. The application rate(s) did not exceed the limit(s) specified in the permit.
2. Adequate measures were taken to prevent wastewater runoff from the site(s).
3..A suitable vegetative cover was maintained on the site(s) in accordance with the permit.
4. -All buffer zones as specified in the permit were maintained during each application.
5. The freeboard in the treatment and/or storage lagoon(s) was not less than the limit(s)
specified in the permit.
Pageof= - - -
'Compliant YN
Y
0
0
0
0
If the facility is non-compliant, please explain in the space below the reason(s) the facility was not in compliance with its
permit. Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s) taken. Attach
additional sheets if necessary.
"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."
Alan Glover
(Signature of Permittee)* t Date (Name of Signing Official -Please print or type)
Alan Glover
(Permittee -Please print or type)
Oak Hill Fellowship Center
3824 Barrett Drive; Raleigh, NC 27609
(Permittee Address)
Facility Manager
(Position or Title)
[phone]
(Phone Number)
. If signed by other than the permittee, delegation of signatory authority must be on file with the state per 15A NCAC 2B.0506 (b)(2)(D).
31 -Jul -19
(Permit Exp. Date)
DENR FORM NDAR-1 (11/2005)