WQ0016165_Monitoring - 08-2016_20161004

NON DISCHARGE APPLICATION REPORT Page of
SPRAY IRRIGATION FIELDS
There are two application fields per page. Use additional pages as needed.
PERMIT NUMBER: WQ0016165 MONTH: August YEAR: 2016
FACILITY NAME: LEXINGTON REGIONAL WWTP COUNTY: Davidson
Formulas
Daily LoadmP�',(mChe9)� _ [Volume Applied (gallons) x 0.1336 (cubic feet/gallon) x 12 (inches/foot)] / [Area Sprayed (acres) x 43,560 (aquina feeUacre)]
Ivlaxtmtmi Huur}y L oading(inches) =Da ly Load og Inches) ([T me Irr gated (m wtes) / 60 (m nutesdtour)] r 'µY _.1
Monthly Loading (mrdie@), = 3um of Daily Loadings (inches)
= Sum of this month's Monthly Loading (inches) and previous 11 momh's Monthly Loadings (inches)
= [Monthly Loading (inches/month) / Number of days in the month (dayelmonth)] x 7 (days/week)
Weather Codes: C -clear, PC -partly cloudy, CI -cloudy, R -rain, Sn-snow, SI -sleet
Spray Irrigation Operator in Responsible Charge (ORC): Jeff Walser Phone: [phone]
ORC Certification Number: 989973
Mail ORIGINAL and TWO COPIES to:
ATTN: Non -Discharge Compliance Unit
DENR X
Division of Water Quality (SIGN"R F OPERATOR ESPONSIBLE CHARV)'
1617 Mail Service Center BY THIS SIGNATURE, I CERTYY THAT THIS REPORT IS ACCURATE AND COMPLETE
RALEIGH, NC 27699-1617 TO THE BEST OF MY KNOWLEDGE.
NDAR (2/98)

NON DISCHARGE APPLICATION REPORT Page of
SPRAY IRRIGATION FIELDS
There are two application fields per page. Use additional pages as needed.
Facility Status:
Please indicate ( by inserting Y(es) or N(o) in the appropriate box) whether the facility has been compliant
with the 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.
Com liantY N)
Q
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 informationsubmitted 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."
CITY OF LEXINGTON
28 WEST CENTER ST LEXINGTON, N.C.
(Permittee Address)
Wes Kimbrell
(Permittee -Please print or type)
kAk 9-Z9 -i�
(Signatur of Permittee)' Date
336-243-2489 12/31/2017
(Phone Number) (Permit Exp Date)
' If signed by other than the permittee, delegation of signatory authority must be on file with the state per 15A NCAC 213.0506 (b)(2)(D).
NDAR (2/98)