WQ0002857_Monitoring - 09-2016_20161101

i
Page 2 of 3
NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITES)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDIDTIONAL PAGES AS NEEDED
PERMIT NUMBER: W00002857 MONTH: September YEAR: 2016
FACILITY NAME: Piedmont Custom Meats WWTF COUNTY: Caswell
Formulas:
Daily Loading (inches) = (Volume Applied (gallons) x 0.1336 (cubic feet/gallon) x 12 (inches/foot)] / [Area Sprayed (acres) x 43,560 (square feettacre) 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 Loading (inches)
12 Month Floating Total (Inches) = Sum of this month's Monthly Loading (inches) and previous 11 month's Monthly Loadings (inches)
Average Weekly Loading (inches) = [Monthly Loading (Inches/month) / Number of days in the month (days/month )] x 7 (days/week)
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
Cover Crop: Fescue
Permitted Hourly Rate (inches):
Field Number: 2
Area Sprayed (acres): 1
Cover Crop: lFescue
0.2 Permitted Hourly Rate (inches):
0.2
WEATHER CONDITIONS
Permitted Yearly Rate (inches):
52 Permitted Yearly Rale (Inches):
52
D
A
T
Weather Temperature
Code' at Precipita-
application tion
Storage
Lagoon Volume Time Daily
Frec-board Applied lrrigat.d Loading
Maximum
Hourly Volum. Time Daily
Loading Applied l rigated Loading
Maximum
Ilourly
Loading
ff) inches
feet gallons minulcs inches
inches gallons minutes inches
inches
2
4
tv
6
. a 'r ,'li
s
; ire7 7- r: 7°7
"77777
8
9:`
c u% °; -'8s°... ;:; o-�:. r .� 2:z .� 1'asoo"�� ., ...300 ` o.ao .act
..° 0:08,x° , .. X10800 " 300 ra °0.40m _
:,^0:08', _
10
12
14
C 75 0
2.3 10800 300 0.40
0.08 10800 300 0.40
0.08
81
hi 10800 >°; - 3Q0' 0.40,0.0&',
16
17
18
20
.21+P
z xtr~49&r i�lhgiu+a PLSi tam. P r. xa )hnriL.'7i
22
CI 70 1 0
2.5 10800 300 0.4
0.08 10800 300 0.4
0.08
24
25
26
C 74 0
2.7 10800 300 0.4
0.08 10800 300 0.4
0:08
27
eN
28
qg
30
31,=,
, , r •
r �s,is;y<,
a
Tolal Callons/Monthly Loading (inches)
12 Month Floating Total (inches)
Average weekly Loading(in.hee)
2.0
25.07
0.466'
2.0
22.67
_. 0.466
ffig
"Weather Codes: C -clear, PC -partly cloudy, CI -cloudy, R -rain, Sn-snow, SI -sleet
Spray Irrigation Operator in Responsible Charge (ORC): Steven Yarbrough Phone: [phone]
ORC Certification Number: 986612 Check B if ORC Has Changed: ❑
Mail ORIGINAL and Two COPIES to:
ATTN: Non -Discharge Compliance Unit X
DENR (SIGNA�g.�.t.re.,
PERATOR IN RESPONSIBLE CHARGE)
Division of Water Quality By this I certify that this report is accurate and
1617 Mail Service Center complete to the best of my knowledge.
RALEIGH, NC 27699-1617
DENR Form NDAR-1 (5/2003)

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.)
Compliant (Y,N)
1. The application rate(s) did not exceed the limit(s) specified in the permit. qL
2. Adequate measures were taken to prevent wastewater runoff from the site(s). EF
3. A suitable vegetative cover was maintained on the site(s) in accordance with the permit. EV
4. All buffer zones as specified in the permit were maintained during each application.
S. The freeboard in the treatment and/or storage lagoon(s) was not less than the EV
limit(s) specified in the permit.
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 a qualified personnel properly gather and evaluate 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
info bmitted is, to the best of my knowledge and belief true, accurate, and complete. I am aware that there are significant
pen ties for s bmitting false/iqoynTation, including the possibility of fines and imprisonment for knowing violations."
2
(Permittee -Please print or type)
9683 Kerr's Chapel Road
Gibsonville. NC
(Penmittee Address)
James M. Cheshire
(Name of Signing Official -Please print or type)
President R & A Laboratories
(Position or Title)
336-582-8247
(Phone Number)
03/31/21
(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).
DENR Form NDAR-1 (5/2003)

a
Page 3 of 3
NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITES)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDIDTIONAL PAGES AS NEEDED
PERMIT NUMBER: W00002857 MONTH: September YEAR: 2016
FACILITY NAME: Piedmont Custom Meats WWTF COUNTY: Caswell
Formulas:
Daily 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 Dally Loading (Inches)
12 Month Floating Total (inches) = Sum of this month's Monthly Loading (inches) and previous 11 month's Monthly Loadings (inches)
Average Weekly Loading (Inches) = [Monthly Loading (inches/month) / Number of days in the month (days/month )] x 7 (days/week)
Did Irrigation Occur At This Facility: Did Irrigation Occur On This Field:
Yes: ❑ No: ❑ Yes: ❑ No: ❑
Did Irrigation Occur On This Field:
Yes: ❑ No: ❑
Field Number: 3
Area Sprayed (acres): 1
Cover Crop: Fescue
Permitted Hourly Rale (inches): 0.2
Field Number: 4
Area Sprayed (acres): 11
Cover Crop: lFescue
Permitted Hourly Rate (inches):
0.2
D
A
T
Ni
WEATHER CONDITIONS Permitted Yearly Rate (Inches): 52
Weather Temperature Storage
Code' at Precipila- Lagoon Volume Time Daily
application lion Free -board Applied Irrigated Loading
Permitted Yearly Rate (inches):
Maximum
Hourly Volume Time Daily
Loading Applied Irrigated Loading
52
Maximum
Hourly
loading
ff) inches f t gallons minutes inches
inches gallons minutes inches
inches
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Total Gallons/Monthly Loading (inches) "` 0WAI
12 Month Floating Total (inches) I 5.27
Average Weekly Loading (inches) 0
_ " p 2.0
,- - - 21.72
0.466
*Weather Codes: C -clear, PC -partly cloudy, CI -cloudy, R -rain, Sn-snow, SI -sleet
Spray Irrigation Operator in Responsible Charge (ORC): Steven Yarbrough Phone: [phone]
ORC Certification Number: 986612 Check Box i ORC Has Changed: ❑
Mail ORIGINAL and Two COPIES to:
ATTN: Non -Discharge Compliance Unit X
DENR (SIGNATU OPERATOR IN RESPONSIBLE CHARGE)
Division of Water Quality By this sWature, I certify that this report is accurate and
1617 Mail Service Center complete to the best of my knowledge.
RALEIGH, NC 27699-1617
DENR Form NDAR-1 (5/2003)

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.)
Compliant (Y,N)
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.
EP
S. The freeboard in the treatment and/or storage lagoon(s) was not less than the
E
limit(s) specified in the permit.
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 a qualified personnel properly gather and evaluate 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
informa4torrs,ubmitted is, to the best of my knowledge and belief true, accurate, and complete. I am aware that there are significant
penal ies for s bmitting fal�rfo fmation, including the possibility of fines and imprisonment for knowing violations."
'a
of
(Permittee -Please print or type)
9683 Kerr's Chapel Road
Gibsonville, NC
(Permittee Address)
James M. Cheshire
(Name of Signing Official -Please print or type)
President R & A Laboratories
(Position or Title)
336-582-8247
(Phone Number)
03/31/21
(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).
DENR Form NDAR-1 (5/2003)