WQ0002015_Monitoring - 11-2016_20161208 (2)

a. NON -DISCHARGE APPLICATION REPORT Page ,l of Z
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDITIONAL PAGES AS NEEDED.
PERMIT NUMBER: WQ0002015 MONTH: November YEAR:
FACILITY NAME: Oak Hill Fellowship Center COUNTY: Granville
Formulas:
Dally Loading (Inches) = [Volume Applied (gallons) x 0.1336 (cubic feet/gallon) x 12 Cinches/fool)] / [Area Sprayed (acres) x 43,500 (square feet/acre)] OR
=Volume Applied (gallons) / [Area Sprayed (acres) x 27,152 (gallons/acre-Inch)]
Maximum Hourly Loading (Inches) = Daily Loading Cinches) / [rime Irrigated (minutes) / 00 (minutes/hour)] Monthly Loading (Inches) =Sum of Daily Loadings Cinches)
12 Month Floating Total (Inches) = Sum of this month's Monthly Loading (inches) and previous 11 month's Monthly Loadings (inches)
.... r111--6I..1--.✓I 1—h— — 1 ....1-- 1 ­._ -.- .. --.-.. m.. ,.ehu-nL\
2016
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): 1.07
COVERCROP:j Fescue
PERMITTED HOURLY RATE (Inches): 0.25
FIELD NUMBER:
AREA SPRAYED (acres):
COVER CROP:
PERMITTED HOURLY RATE (Inches):
WEATHER CONDITIONS
D
A storage
T weather Temperature Lagoon
E Code at application Precip'da-tton Free -board
PERMITTED YEARLY RATE (inches):
Volume Time Dally
Applied Irrigated LoadingLoadingApplied
52
Maximum
Hourly
PERMITTED YEARLY RATE (Inches):
Volume Time Daily
Irrigated LoadingLoadin
Maximum
Hourly
(°F) inches feet
gallons minutes
Inches
Inches
gallons minutes
inches
Inches
1 C
2 C
3 C
4 C 67 3.2
4032 240
0.14
0.03
5 C
6 PC
7 CL 3.3
8 CL
9 CL
10 R 0.5 3.3
11 CL
12 C
13 C
14 C
151 C 1 1 3.3
16 PC
17 C 3.4
�(
18 C
4
19 PC
t d
20 C
?
21 C 3.4
221 PC I
4P ' ®�
23 CL
U.
4
24 PC
25 R 0.5
i 4? v X11
26 CL
t_w
27 CL
28 CL 3.4
2s; 1.1..PC
301 C
311 1
Total Gallons/Monthly Loading (inches)
4032
0.14
0
0.00
12 Month Floating Total (inches)
2.78
Average Weekly Loading (inches)
0.0323604
0
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Spray Irrigation Operator In Responsible Charge (ORC): Dale Lee Mathews Phone: [phone]
ORC Certification Number: 22794 Check Box if ORC Has Changed: ❑
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)

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. )
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.
Page ;? of 2-
Compliant
Z
Com liant YN
Y
0
0
0
0
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."
/? /w
(Signature of Permittee)* I Date
Alan Glover
(Permittee -Please print or type)
Alan Glover
(Name of Signing Official -Please print or type)
Facility Manager
(Position or Title)
[phone] 31 -Jul -19
Oak Hill Fellowship Center (Phone Number) (Permit Exp. Date)
3824 Barrett Drive; Raleigh, NC 27609
(Permittee Address)
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 (11/2005)