WQ0006941_Monitoring - 10-2016_20161202

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NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDIDTIONAL PAGES AS NEEDED
PERMIT NUMBER: W00006941 MONTH: October YEAR: 2016
FACILITY NAME: Stoney Creek Elem. School 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)
IrrigationYes:R ■
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Permitted Hourly Rate (inches):
Area Sprayed (acres�
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"N'eather 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 if ORC Has Changed: ❑
ATTN: Non -Discharge Compliance Unit
DENR (SIGNA F OPERATOR IN RESPONSIBLE CHARGE)
Division of Water Quality By Is 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)

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
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.
EP
2. Adequate measures were taken to prevent wastewater runoff from the site(s).
W
3. A suitable vegetative cover was maintained on the site(s) in accordance with the permit.
EP
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
777
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 submitted is, to the best of my knowledge and belief true, accurate, and complete. I am aware that there are significant
penal fo submitting se ' formation, including the possibility of fines and imprisonment for knowing violations."
/ Z 2-11J. James M. Cheshire
(Signatur of Pe tee) Da (Name of Signing Official -Please print or type)
(Permittee -Please print or type)
P.O. Box 160
Yancevville, NC 27329
(Permittee Address)
President R & A Laboratories
(Position or Title)
336-694-4116 06/30/2012
(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).