WQ0023213_Monitoring - 11-2016_20170103

A
' NON DISCHARGE WASTEWATER MONITORING REPORT Page_of_
PERMR NUMBER: WQ0023213 MONTH: NOVBfilbBf YEAR: 2016
FAGLRY NAME: L8XIf1S1iOf1 GOIf CAUBB COUNTY: DBVIdSOf1
Operaror in Responsibk Cha�ga (ORC): Tefllik8 WBfdIOW Orade: SVW WII I Phone: 336-24&3970
Check Box 'rf ORC Has Changed: ❑ ORC Certifieatbn Number: SI994835
Cartified taborarorks (t): CiN of Lexinaton �2►: Environment 1
PersaKs) Colke�ng Samples:
Mail ORIGINAL and TWO COPIES to:
DENR
Division of Waler Quality
ATTN: I�ortnatlon Processing Unit
7817 Mail Service Center
(816N�RE tlF OPERATOR IN RESPONSIBLE CHAROE)
BY TH SIONATURE, I CER7IFY TXAT THIS REPORT IS ACCURATE
AND C MPLETE TO THE BEST OF MY KNOWLEDGE.
DENR FORM NDMR-1 (11/2005)

Page of
NON DISCHARGE WASTEWATER MONITORING REPORT
Facilitv Status:
Please answer the following question:
Compiiant (Y,N)
1. Does all monitoring data and sampling frequencies meet permit requirements? DY
If the facility is non-comaliant, 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 sign�cant penalties for submifting
false information, including the possibility of fines and imprisonment for knowing violations."
�
� - �� Wesley Kimbell
(Signatur f Permittee)* Date (Name of Signing Official-Please print or type)
City Of Lexington
(Permittee-Please print or type)
28 West Center St
Lexington, NC 27292
(Permittee Address)
Parameter Codes:
Civil Engineer
(Position or Title)
336-248-3970 30-Nov-17
(Phone Number) (Permit Exp. Date)
Parameter Code assistance may be obtained by calling the Water Quality Land Application Unit at [phone].
The monthly average for Fecal Coliform is to be reported as a GEOMETRIC mean. Use only the units desiqnated in the reportin4
facilitv's permit for reporting data.
" If signed by other fhan the permittee, delegation of signatory authority must be on file with the state per 15A NCAC 2B.Q506 (b)(2)(D).
DENR FORfVI NDMR-1 (11/2005)

NON-DISCHARGE APPLICATION REPORT Page ot
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDITIONAL PAGES AS NEEDED.
PERMIT NUMBER: WQ0023213 MONTH:. NOVefilb@f YEAR: 2016 �
FACILITY NAME: LeXlflgtOfl GOIf COUf58 COUw'nr: Davidson
Formulas:
Qaily Loading (inches) _[Volume Applied (gallons) x 0.1336 (cubic feeVgallon).x'12 (inches/foot)] /[Area Spreyed (acres) x 43,560 (square feeUacre)] OR
= Volume Applied (gallons) /[Area Sprayed (acres) x 27,152 (gallons/acre-inch)]
Maximum Hourly Loading (inches) = Daily Loading (inches) /[fime 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 �� month's Monthly Loadings (inches)
Average Weekly Loading (inches) _[Monthry Loading (inches/month)/ Number of days in the month (days/month)] x 7(days/week)
Did Irrigation occur at 7his Facility: Did Irrigation Occur On This Fleld: Did Irrigation Occur On Thls Field: r
Yes: ❑ No: ❑p Yes: ❑ No: ❑p Yes: ❑ No: ❑p
! FIELD NUMBER: ZOfle 1 FIELD NUMBER: ZOf18 2
AREA SPRAYED acres : 18.01 AREA SPRAYED acres : 9.17
COVER CROP: f'ASS COVER CROP: f'ASS
PERMITTED HOURLY RATE (inches): 0.2 PERMITTED HOURLY RATE (inches): 0.15
p WEATHER CONDITIONS PERMITTED YEARLY RATE inches : PERMITTED YEARLY RATE inches :
A stora9e Maximum Maximum
Weather Temper- Wgoon
T ature at Precipita- Free- Volume Tlme Uaily Hourly Volume Time Daily Hourly
E coae* applicatlon tion noam A lied Irri ated Loadin Loadin A lied Irri ated Loadin Loadin
l°F) inches feet gallons minutes inches inches gallons minutes inches inches
1
2
3 �
4
3
6
7
8
9
10
1T
12
13
14
15
16 _ `
17
18'
19
20
21
22
23
24
25
26
27
28
29.
30
31
Total Gallons/Monthly Loading (inches) 0 0.00 0 0.00
12 Month Floatin Total inc es :'�
h
9 ( ) ..�:�:�:2�:�>:�:�::?�'�:�:� ::�:�:�:�:�:�:�:�:>�:�:�:
5.02 3.53
Avera e Weekl Loadin lnches :
9 Y 9( ).::::�>::::::�:�::�>:�:-:�:� i ::.:.:::::.:.>:.:.'» �
.
. . ... . . .............. .............
.............. ................ ..............
;:.:..�.�.•.:.�:..•. .•:..�:.•.•.•.�.�.�::.�::..:.•.:.•.�:.�.•:...... � ...........
.. .......... .... ..............
........ ............ �..�.�...•.�.�.•.�.•.•.�.•..•..�.•.•.�.•..�:•.•..�.�.�.�. .�..�.�.�.•.�.•.•.•.•.•.•.
" Weather Codes: C�clear, PC-partly cloudy, Clcloudy, R-rain, Sn-snow, SI-sleet
Spray Irrigation Operator in Responsible Charge (ORC):
ORC Certification Number: SI994835/ WUV993795
Mail ORIGINAL and TWO COPIES to:
DENR
Division of Water Quality
ATTN: Information Processing Unit
1617 Mail Senrice Center
RALEIGH, NC 27699-1677
Tamika Wardlow
Check Box if ORC Has Changed: ❑
Phone: [phone]
C�
(SIGNA RE OF OPERATOR IN RESPONSIBLE CHARGE)
BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS ACCURATE AND
COMPLETE TO THE BEST OF MY KNOWLEDGE.
DENR FORM NDAR-1 (11/2005)

, ' , '
PERMIT NUMBER:
NON-DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDITIONAL PAGES AS NEEDED.
WQ0023213 monl'rH: November
Page of
Y�art: 2016
FACILITY NAME: LeXlilgt0� GOIf COUfSe couNrv: Davidson
Formulas:
Daily Loading (inches) _[Voiume Applied (gailons) x 0,1336 (cubic feeUgallon) x'12 (inches{foot)j /[Area Sprayed (ecres) x 43,560 (square feeUacre)] OR ,
= Volume Applied (gallons) /[Area Sprayed (acres) x 27,�52 (gallons/acre-inch)]
Maximum Hourly Loading (inches) = Dairy Loading (inches) /[fime Irrigated (minutes) / 60 (minutes/hour)] Monthly Loading (inches) = Sum of Daiy Loadings (nches)
12 Month Floating Total (inches) = Sum of this moMh's MoMhly Loading (inches) and previous �� moMh's Monthty Loadings (inches)
Average Weekly Loading (inches} _[Monthly Loading (inches/month ! Number of days in the mordh (days/month)] x 7(days/week)
Did Irrigation occur At 7his Facility: Did Irrlgation Occur On This Field: Dld Irrlgatlon Occur On Thls Fletd:
Yes: ❑ No: ❑� Yes: ❑ No: ❑r Yes: ❑ No: �
FIELD NUMBER: Z0�@ 3 FIELD NUMBER: ZOfle 4
AREA SPRAYED acres : 7.74 AREA SPRAYED acres : 19.76
COVER CROP: feSS COVER CROP: I'eSS
PERMITTED HOURLY RATE (inches): 0.5 PERMITTED HOURLY RATE (inches): 0.2
p WEATHER CONDITIONS PERMITTED YEARLY RATE Inches : PERMITTED YEARLY RATE inches :
A ssoraee Maximum Maxlmum
Weather Temper- Lagoon
T atureat Precipita- Free. Volume Tlme Daily Hourly Volume Time Dafly Hourly
E Code` appllcaUon eon noara A Iled Irri ated Loadin Loadin A lied Irri ated Loadln Loadin
i°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
19
20
21
22
23
24 '
25
26
27
28
29
30
31
Total Gallons/Monthly Loadfng (inches) 0 0.00 0 0.00
12 Month FloaUn Total inches :�:�
9 ( ) ..�:�:�:�:�:�:�:;�:�:�:�:�:�:� :� :::::::::::::::::::::::::
•.•.•.•.•.�.•.�.�.�.�.�.�.�. •.•.•.•.•..•.•.•.�.�:.�.
..............
. . . . . . . ... . . . . . ......... ............... . . . . . . ... . ............... .
•:•:�::•:�:�:�.•:�:�::�:�: •.•::.•:•.•.•:.....•.•:.•. •.�.� ...:.:...: ...: ..•.
`:;.>:::, :�.�_•_�??:_
............. . .............. ..........•.•.•.•:.�.•. �.�.•......•...•.�.�. . 1 .......
Average Weekly Loading (inches) :�:�::�:�:-:�:�:�:�:�:�:�:�:�:�: �:�:�:�:�:�:�:�:�:�:�:�:�: 0 0
* Weather Codes: C�lear, PC-partly cloudy, CI-cloudy, R-rain, Sn-snow, SI-sleet
Spray Irrigation Operator in Responsible Charge (ORC); Tamika Wardlow Phone: [phone]
ORC Certification Number: SI994835/ WW993795
Mail ORIGINAL and TWO COPIES to:
DENR
._. Division of Water Quality
ATTN: Information Processing Unit
1617 Mail Service Center
RALEIGH, NC 27699-1617
Check Box if ORC Has Changed: ❑
(J� �
(SIGNAT OF PE OR IN RESPONSIBLE CHARGE)
BY THIS SIGNATURE,1 CERTIFY THAT THIS REPORT IS ACCURATE AND
COMPLETE TO THE BEST OF MY KNOWLEDGE.
DENR FORM NDAR-1 (11/2005)
/

�' , ' NON-DISCHARGE APPLICATION REPORT Pege of
SPRAY IRRIGATION SITE(S)
THERE ARE TVYO APPLICATION FIELDS PER PAGE. USE ADDITIOfiIAL PAGES AS NEEDED.
PERMIT NUMBER: WQ0023213 MONTH: NOV2filbEP YEAR: 2016
FACILITY NAME: L2XII1gtOf1 GOIf COUP5e couNrr: Davidson
Formulas: `
Daily Loading (inches) = jVolume Applied (gallons) x 0.1336 (cubic feeUgallon) x 12 (inchesffoot)] h[Area Sprey,ed�(acres) x 43,560 (square feeVacre)] OR
= Volume Applied (gallons)/ [Area Sprayed (acres) x 27,'152 (gallons/acre-inch)]
MaXimum Hourly�Loading (inches) = Daiiy Loading (inches) /.�me Irzigated (minutes) / 60 (minuteslhour)]. Monthly Loading (inches) = Sum of Daiy Loadings (inches)
12 Month Floating Total (inches) = Sum bf this month's MoMhy Loading (inches) and previous'11 mortth's MoMhy Loatlings (inches)
Ave�age Weekly Loading (inches) _[Monthly Laading (inches/month) / Number of days in the morrth (dayslmordh)] x 7(days/week)
Did Inigation occur At This Pacil'ay: Dld Irrlgation Occur On This Fleld: Dld Irrigation Occur On Thls Fleld:
Yes: ❑ No: � Yes: ❑ No: � Yes: ❑ No: �
FIELD NUMBER: ZOfI@ 5 FIELD NUMBER: Z0112.6
AREA SPRAYED acres : 6.34 AREA SPRAYED acres : 10.89
COVER CROP: fBSS COVER CROP: 1'8SS
PERMITTED HOURLY RATE (inches): 0.3 PERMITTED HOURLY RATE (inches): , 0.25
p WEATHER CONDITIONS PERMITTED YEARLY RATE Inches : PERMITTED YEARLY RATE inches :
A storage Maximum Maximum
Weatf�er Temper- Lagoon
T ature at Precipita- Free- VOIURIC . Ti1172 Dally Hourly Volume Time Daily Houriy
E Code* application non board A lied Irri ated Loadin - Loadin A lied Irri ated Loadin Loadin
�°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
18
17
18
19
20 •
21
22
23
24
25
26
27
Z8 ' �
29
30
31
ToWI Gallons/Monthly Loading (inches) 0 0.00 0 0.00
12 Month Floatin Total inches »
9 i ) ..�:�>:�:�:�:�:�:�:�:�:::,;> ; :.:.:.:.:.:.::.:.:y.:.:
..............
.......-_...•.•.•. •.•.•.•.•.•.•.�.•.�.�...�.
. . . . .. ... ........... .. . .. .. . .. . . . ....... ...... ..... . . . .. . .. :.�.�.�.�.�.�.�. .. . .:
... . ............ 5.05 :�:�:� •:•:•:•:� :�:�:�:�;:�:: :�:�: ��>:<�:�:�'�: 5.53 ......
Average Weekiy Loading (Inches) ::::::::::::::�;::�:�:�>:�:�:�:� :�:�:�:�:�:�::�:?�:�:�:�: Q
... . .
. . ..:.......:.....,,.... ....................,............ .,,,..._.............,. . . . . . . . ., . . . . .
........ . .............. ................ :.:.:.:.:.:.:.:.:.:.:.:.:.:. � .;.:.�.�.•.•.•.•.•:..•:.
' Weather Codes: Ccleay PC-partly cloudy, Clcloudy, R-raln, Sn-snow, SI-sleet
Spray Irrigation Operator in Responsible Charge (ORC): Tamika Wardlow Phone: [phone]
ORC Cectification Number: SI994835/ WW993795 Check Box if ORC Has Changed: ❑ -
Mail ORIGINAL and TWO COPIES to:
DENR
Division of Water Quality ,
ATTN: IllfOtiildtlOfl PI'OGBSSIfIg Utllt (SIGMA URE OF OPERATOR IN RESPONSIBLE CHARGE)
1617 Mail SeNiCe Center BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS ACCURATE AND
RALEIGH, IVC 27699-7617 COMPLETE TO THE BEST OF MY KNOWLEDGE.
DENR'FORM NDAR-1 (11/2005)

r ' 1 NON-DISCH14RGE APPLICATION REPORT Page of
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDITIONAL PAGES AS NEEDED.
PERMIT NUMBER: WQ0023213 MONTH: NOVERIbef YEAR: 2016
Faciurv Name: Lexington Golf Course couNrv: Davidson
Formulas:
Daily Loading (inches) _[Volume Applied (gallons) x 0.1336 (cubic feeVgallon) 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) /[fime Irrigated (minutes) / 60 (minuteslhour)] Monthly Loading (inches) = Sum of Daity Loadings (inches)
12 Month Floating Total (inches) = Sum of this month's Monthy Loading (inches) and previous 11 moMh's Monthy Loadings (inches)
Average Weekly Loading (inches) _[Monthly Loading (inches/month) / Number of days in the month (days/moMh)] x 7(daysAveek)
Did Irrigation occur At 7his Facility: Dld Irrlgation Occur On This Field: Did Irrigation Occur On This Fieid:
Yes: ❑ No: � Yes: ❑ No: � Yes: ❑ No: �
FIELD NUMBER: ZOfle 7 FIELD NUMBER: ZOtte 8
AREA SPRAYED acres : 5.38 AREA SPRAYED acres : 9.71
COVER CROP: feSS COVER CROP: feSS
PERMITTED HOURLY RATE (inches): 0.15 PERMITTED HOURLY RATE (inches): 0.3
p WEATHER CONDITIONS PERMITTED YEARLY RATE inches : PERMITTED YEARLY RATE inches :
Storage
A Maximum Maximum
Weather Temper- Lagoon
T ature at Precipffa- Free• VOIUrtIe Time Daily Hourly Volume Time Daily Hourly
E code• application eon board A lied Irri ated Loadln Loadin A lied irri ated Loadin Loading
�°F) inches feet gallons minutes inches inches gallons minutes inches inches
1
2
3 '
4
5
6
7
8
9
70
71
72
13
14
15
16
17
18
19
20
27
22
23
24
25
26
27
28
29
30
31
Total Gallons/Monthly Loading (Inches) 0 0.00 0 0.00
12 Month Fioatin Total inches :�:�
9
� ) ..:�:�:�::�:�:�::�:�:�:�:�:� :�:�:�:�'�:�:�:�'�::�:�':
6.11 3.91
Average Weekly Loading (Inches) �:�:�:�:�:�::�:�:�::�:�::�:�:� :�:�:�:�:�:�:�:�:�:�:�:�:�: Q
. ...... .............
�:�:�:�:�::�:�::�:�::�:: •:�::�:�::�:•::�:�:�:�:�:�:�:� '•'� •'•''•'•'•'�.,........ ..........:..
................. ............. :�:�:�:�:�:�:•:•:•:•::•:�:�' 0 :�:�:�:�:�:�:�:�:�::�:�::
' Weather Codes: C�lear, PC-partly cloudy, Cl�loudy, R-rain, Sn-snow, SI-sieet
Spray Irrigation Operator in Responsible Charge (ORC):
ORC Certification Number: SI994835/ WW993795
Mail ORIGINAL and TWO COPIES to:
DENR
Division of Water Quality
ATTN: Information Processing Unit
1617 Mail Seroice Center
RALEIGH, NC 27699-1617
Tamika Wardlow
Check Box if ORC Has Changed
�
Phone: [phone]
WA,.l�o
(SIGNA U F OPERATOR IN RESPOIVSIBLE CHARGE)
BY THIS SI NATURE, I CERTIFY THAT THIS REPORT IS ACCURATE AND
COMPLETE TO THE BEST OF MY KNOWLEDGE.
DENR FORM NDAR-1 (11/2005)

� 1'
` NON-DISCHARGE APPLICATION REPORT Page of
SPRAY IRRIGATION SITE(S)
Facilitv Status:
Piease indicate ( by inserting Y(es) or N(o) in the appropriate box ) whether the facility has been compliant
with the following permit requirements: (lVote: if a requirement does not apply to your facility puf (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. �
Com Ilant ,N)
Y
0'
If the facility is non-compliant, please explain in the space below the reason(s) the facility was not in com�liance 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 forsubmitting false information, including the possibility of fines
and imprisonment for knowing violations."
� i7 -ZS-(
(Signatu of Permittee)* Date
City of Lexington
(Permittee-Please print or type)
28 West Center St
Lexington, NC_27292
(Permittee Address)
Wesley Kimbell
(Name of Signing Official-Please print or type)
Civil Engineer
(Position or Title)
336-248-3970 30-Nov-17
(Phone Number) (Permit Exp. Date)
" If signed by other than the permittee, delegation of signatory authority must be on file with the state per 16A NCAC 2B.0506 (b)(2)(D).
DENR FORM NDAR-1 (11/2005)