WQ0018146_Monitoring - 09-2016_20161101

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDITIONAL PAGES AS NEEDED.
;y
PERMIT NUMBER: V�19-01910E"Illb MONTH: @jC-MjRbj5t
FACILITY NAME: 1-4e FUSER46- Al -Jb"44 UW4 COUNTY: CH
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)]
Page l of
YEAR: 2-0/6
Maximum Hourly Loading (Inches) = Daily Loading (Inches) / [rime Irrigated (minutes) / 60 (minuteslhour)] Monthly Loading (inches) = Sum of Daily Loadings (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/manthll x 7 (days/weekl
Did Irrigation Occur t This Facility:
Yes: [ No: ❑ .'
Did Irrigation Occ On This Field:
Yes: No:
Did Irrigation Occ}dr On This Field:
Yes: p/ No: ❑
FIELD NUMBER: 7F I
AREA SPRAYED (acres): -6.5,AREA
COVER CROP:
PERMITTED HOURLY RATE (inches):
S
D.
FIELD NUMBER:
SPRAYED (acres)-
COVER CROP: V
PERMITTED HOURLY RATE (inches):
O,
D
WEATHER CONDITIONS
PERMITTED YEARLY RATE (inches):
t o
PERMITTED YEARLY RATE (inches):
l Q.
A
T
E
Weather Temper-ature Storage
Code. at Precipita- Lagoon
application tion Free -board
Volume Time Daily
Applied Irrigated Loading
Maximum
Hourly
Loading
Volume Time Daily
Applied Irriciated Loading
Maximum
Hourly
Loading
('F) inches feet
gallons minutes Inches
inches
gallons minutes inches
Inches
1
2
3
4
5
i 6
[,
7
8
9
10
11
12
13
14
15
16
17
18
&L bs
®
.�
19
20
21
c
22
23
24
25
28
CX- '7 0
Y50625 Y00
27
28
29
30
31
Total Gallons/Monthly Loading (inches)
12 Month Floating Total (inches) :::::::::::::::::::::::::::::::::::::
:::::::::::::
Average Weekly Loading (inches)::::::::::::•:•:•:•
:•:•:•; ; ;•;•:•;•:•;•
s D
=ail ...... I- Iwal, r%.-paluy clouuy, Ci-ciouay, K -ram, sn-snow, Sl -sleet
Spray Irrigation Operator in Responsible Charge (ORC): 59+*sl ? 5 Phone: 171Q--$f5--2"j
ORC Certification Number: '?078 2. Check Box if ORP Has Ch n'g d . ❑
Mail ORIGINAL and TWO COPIES to:
DENR
Division of Water Quality
ATTN: Information Processing Unit (SIGNATURE OF OPERATOR IN RESPONSIBLE CHARGE)
1617 Mail Service Center BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS ACCURATE AND
RALEIGH, NC 27699-1617 COMPLETE TO THE BEST OF MY KNOWLEDGE.
DENR FORM NDAR-1 (11/2005)

;t 1 NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
THERE 'ARE TWO APPLICATION FIELDS PER PAGE. USE ADDITIONAL PAGES AS NEEDED.
^PERMIT NUMBER: W JO 1 to MONTH:
Page 2- of 5
YEAR: 2.01 >G
FACILITY NAME: THO Fr-6SgAv6- Ar— ;n u4i4< COUNTY: CH404441
Formulas:
Daily Loading (inches) = (Volume Applied (gallons) x 0.1336 (cubic feet/gallon) x 12 (inchestfoot)] / [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 of this month's Monthly Loading (inches) and previous 11 month's Monthly Loadings (inches)
Average Weekly Loading (Inches) = [Monthly Loadino (inches/month) / Number of days in the mnnth mavuft—thli r 7 1 nvs/weekt
Did Irrigation 0;7 At This Facility:
Yes: No: ❑
Did Irrigation Oc r On This Field:
Yes: No:
❑
Did Irrigation Oc r On This Field:
Yes: No: ❑
......................................
FIELD NUMBER:
AREA SPRAYED (acres):
COVER CROP:
PERMITTED HOURLY RATE (inches): (%,
FIELD NUMBER:
AREA SPRAYED (acres): lGfe
COVER CROP: I �rw 06-FMVM
PERMITTED HOURLY RATE (inches): ©, j
D
A
T
E
WEATHER CONDITIONS
Temper-ature storage
WeathCodeer at Precipita- Lagoon
• application tion Free -board
PERMITTED YEARLY RATE inches : B �
Maximum
Volume Time Daily Hourly
Applied Irrigated Loading Loading
PERMITTED YEARLY RATE (inches):
Volume Time Daily
Applied Irrigated Loading
,
Maximum
Hourly
Loading
(°F) Inches feet
gallons minutes
inches
inches
gallons minutes inches
Inches
1
2
3
4
5
6
(-
7
8
9
10
11
12
13
14
15
16
17
18
CA_U
O IZeJ
O'
'015
19
20
21
22
23
24
25
26
J() O
, [so
401 -5-
27
28
29
30
31
Total Gallons/Monthly Loading (inches)-
179 06..........
o �
12 Month Floating Total (inches) ::::::::::
: : : ::::. :::::::::::::::::::::
...........
...............
Average Weekly Loading (inches) :::::::::::::::::::::::::::::::::::'
';';';' ' ' '
. JJD
d
c ear, ry-Nam L douuy, �r-Gluuuy, R -ram, Jn-snow, si-sleet
Spray Irrigation Operator in Responsible Charge (ORC): Phone
ORC Certification Number: 9675S2— Check Box if ORC Has Change
Mail ORIGINAL and TWO COPIES to:
DENR
Division of Water Quality 1A
ATTN: Information Processing Unit (SI NATUR OF OPERATOR IN RESPO SIBLE RGE)
1617 Mail Service Center BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS ACCURATE AND
RALEIGH, NC 27699-1617 COMPLETE TO THE BEST OF MY KNOWLEDGE.
DENR FORM NDAR-1 (11/2005)

NON -DISCHARGE APPLICATION REPORT - Page of
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
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. Complia t Y,N)
2. Adequate measures were taken to prevent wastewater runoff from the site(s).
I 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.
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."
( ature of Pem3jVl1 e)" Date
*aL4 Ajam K Cggou.J4
(Permittee -Please print or type)
2O2- C:,r;
(Name of Signing Official -Please print or type)
(Position or Title)
r (Phone Number) (Permit Exp. Date)
—1� jL
—...—
(Permittee Address)
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).
DENR FORM NDAR.1 (i 1120051