WQ0002857_Monitoring - 10-2016_20161202

Page 2 of 3
NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDIDTIONAL PAGES AS NEEDED
PERMIT NUMBER: W00002857 MONTH: October 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 feetlacre) 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 Al This Facility:
Did Irrigation Occur On This Field:
Did Irrigation Occur On This Field:
11
Yes: ❑ No: ❑
Yes: ❑ No: ❑
Yes: ❑ No: ❑
ixii I I
Field Number: 1
Field Number: 2
Area Sprayed (acres): 1
Area Sprayed (acres): 1
Cover Crop: Fescue
Cover Crop: IFescue
Permitted Hourly Rate (inches): 0.2
Permitted Hourly Rate (Inches): 0.2
WEATHER CONDITIONS
Permitted Yearly Rate (inches): 52
Permitted Yearly Rate (Inches): 52
D
A
Weather Temperature
Storage Maximum
Maximum
T
Code' at Preeipita-
Lagoon Volume Time Daily Hourly
Volume Time Daily Hourly
application lion
Fr—board Applied Irrigated Loading Loading
Applied Irrigated Loading Loading
IT) Inches
Cee, gallons minutes inches inches
gallons armats inch. inches
®®
I
I I: I I
11
I I
I I: �fII:IIIIONERLILI
ixii I I
EMISSIONS
EM
MEMEMEM
1
I:II II
11
I I: I:II01110000Average
Weekly Loading (inches)
sn
e=
*Weather Codes: C -clear, PC -partly cloudy, CI -cloudy, R -rain, Su -snow, SI -sleet
Spray Irrigation Operator in Responsible Charge (ORC): Steven Yarbrough Phone: [phone]
ORC Certification Number: 986612 Chee C Has Changed: ❑
Mail ORIGINAL and Two COPIES to:
ATTN: Non -Discharge Compliance Unit X
DENR (SIGERATOR IN RESPONSIBLE CHARGE)
Division of Water Quality By t i�gs�ig.at.re,tify 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. 71
2. Adequate measures were taken to prevent wastewater runoff from the site(s). rn
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. EYD
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 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
in ati in submitted is, to the best of my knowledge and belief true, accurate, and complete. I am aware that there are significant
p alties r submittingt)seAformation, including the possibility of fines and imprisonment for knowing violations."
f�
of
James M. Cheshire (Authorized Aeent
(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 2B.0506 (b) (2) (D).
DENR Form NDAR-1 (5/2003)

r
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: October 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/fool)] /[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) / [rime 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: Q No: ❑
Did Irrigation Occur On This Field:
Yes: ❑ No: 19
Field Number: 13
Area Sprayed (acres): 11
Cover Crop: Fescue
Permitted Hourly Rate (Inches).
Irrigation Occur On This Field:
Yes: 12 No: ❑
Field Number: 4
3 Sprayed (acres): 11
Cover Crop: IFescue
Permitted Hourly Rate (inches): 0.2
Permitted Yearly Rate (inches): 52
Maximum
Volume Time Daily Hourly
Applied Irrigated Loading Loading
gallons minutes inches inch.
WEATHER CONDITIONS
Permitted Year Rate (inches):
152
D
A
Weather Temperature
Storage
Maximum
T
Code' at Precipita-
Lagoon
Volume Time Daily
knurly
application tion
Free -board
Applied Irrigared Loading
Loading
(°F1 inches
fete
gallons minutes inch.
inches
Irrigation Occur On This Field:
Yes: 12 No: ❑
Field Number: 4
3 Sprayed (acres): 11
Cover Crop: IFescue
Permitted Hourly Rate (inches): 0.2
Permitted Yearly Rate (inches): 52
Maximum
Volume Time Daily Hourly
Applied Irrigated Loading Loading
gallons minutes inches inch.
Weather Codes: C -clear, PC -partly cloudy, CI -cloudy, R -rain, Su -snow, SI -sleet
Spray Irrigation Operator in Responsible Charge (ORC): Steven Yarbrough Phone: [phone]
ORC Certification Number: 986612 Check Box if ORC Has Changed: ❑
Mail ORIGINAL and Two COPIES to:
ATTN: Non -Discharge Compliance Unit X
DENR (SIGNAT OPERATOR IN RESPONSIBLE CHARGE)
Division of Water Quality By this signature, 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)
I
I:II
II I •I t I:
Total GWI—IM-thly Loading (inehe,)
Average Weekkv Loading (inches)
4
Weather Codes: C -clear, PC -partly cloudy, CI -cloudy, R -rain, Su -snow, SI -sleet
Spray Irrigation Operator in Responsible Charge (ORC): Steven Yarbrough Phone: [phone]
ORC Certification Number: 986612 Check Box if ORC Has Changed: ❑
Mail ORIGINAL and Two COPIES to:
ATTN: Non -Discharge Compliance Unit X
DENR (SIGNAT OPERATOR IN RESPONSIBLE CHARGE)
Division of Water Quality By this signature, 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. EF
2. Adequate measures were taken to prevent wastewater runoff from the site(s). ET
3. A suitable vegetative cover was maintained on the site(s) in accordance with the permit. EF
4. All buffer zones as specified in the permit were maintained during each application. EF
5. The freeboard in the treatment and/or storage lagoon(s) was not less than the EF
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 tion ubmitted is, to the best of my knowledge and belief true, accurate, and complete. I am aware that there are significant
pen lties for ubmitting fAe/>?ormation, including the possibility of fines and imprisonment for knowing violations."
of
(Permittee -Please print or type)
9683 Kerr's Chapel Road
Gibsonville, NC
(Pennittee 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
(Pen -nit 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)