WQ0023213_Monitoring - 12-2016_20170203

NON DISCHARGE WASTEWATER MONITORING REPORT
PERMIT NUMBER: WQ0023213
FACILITY NAME: Lexington Golf Course
MONTH: December
COUNTY:
Page of
YEAR: 2016
Davidson
Flow Monitoring Point:---- Effluent:
- ■
■
■
■ ■
..-
'
Daily
(Flow) into
Treatment
System
:..
.
Composite (C) I Grab (G)
Operator in Responsible Charge (ORC): Tamika Wardlow Grade: SI/WWIII Phone: [phone]
Check Box if ORC Has Changed: ❑ - ORC Certification Number: SI994835
Certified Laboratories (1): City of Lexington (2): Environment 1
Person(s) Collecting Samples: Wardlow /
Mail ORIGINAL and TWO COPIES to:
DENR
Division of Water Quality
ATTN: Information Processing Unit
1617 Mail Service Center
(SIGNA RE OF OPERATOR IN RESPONSIBLE CHARGE)
BY THP SIGNATURE, I CERTIFY THAT THIS REPORT IS ACCURATE
AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
DENR FORM NDMR-1 (11/2005)

NON DISCHARGE WASTEWATER MONITORING REPORT
Facility Status:
Page of
Please answer the following question:
Compliant {Y,N)
1. Does all monitoring data and sampling frequencies meet permit requirements? 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."
IiZ4�'A L 7- 7
(Signatur of Permittee)* Date
City Of Lexington
.(Permittee -Please -print -or -type)
28 West Center St
Lexington, NC 27292
(Permittee Address)
Parameter Codes:
Wesley Kimbell
(Name of Signing Official -Please print or type)
Civil Engineer
-(Position or Title)
'336-248-3970
(Phone Number)
01002 Arsenic
31504 Coliform, Total
00600 Nitrogen, Total
00929 Sodium
01022 Boron
00094 Conductivity
00630 NO2&NO3
00931 SAR
00310 BOD5
01042 Copper
00620 NO3
00745 Sulfide
01027 Cadmium
00300 Dissolved Oxygen
00556 Oil -Grease
70295 TDS
00916 Calcium
31616 Fecal Coliform
WQ09 PAN Plant Available
00010 Temperature
00940 Chloride
01051 Lead
00400 pH
00625 TKN
50060 Chlorine, Total
Residual
00927 Magnesium
71900 Mercury
32730 Phenols
00665 Phosphorus, Total
00680 TOC
00530 TSSITSR
01034 Chromium
00610 NH3asN
00937 Potassium
00076 Turbidity
00340 COD
01067 Nickel
00545 Settleable Matter
01092 Zinc
30 -Nov -17
(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 designated in the reporting
facility's permit for reporting data.
* 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)(1)).
DENR FORM NDMR-1 (11/2005)

NON -DISCHARGE APPLICATION REPORT Page of
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDITIONAL PAGES AS NEEDED.
PERMIT NUMBER: WQ0023213 MONTH: December YEAR: 2016
FACILITY NAME: Lexington Golf Course COUNTY: Davidson
Formulas:
Daily Loading (inches) = [Volume Applied (gallons) x 0.1336 (cubic feetigallon) x 12 (inches/loot)] / [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 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 (inchestmonth) / Number of days in the month (days/month)] x 7 (days/week)
Did Irrigation Occur At This Facility:
Yes: ❑ No: (]
Did Irrigation Occur On This Field:
Yes: ❑ No: ❑e
Did Irrigation Occur On This Field:
Yes: ❑
No: I]
FIELD NUMBER:1 Zone 1
AREA SPRAYED (acres): 18.01
COVERCROP:1 grass
PERMITTED HOURLY RATE (inches): 0.2
FIELD NUMBER: Zone 2
AREA SPRAYED (acres): 9.17
COVER CROP:grass
PERMITTED HOURLY RATE (inches): 0.15
WEATHER CONDITIONS
PERMITTED YEARLY RATE (inches):
PERMITTED YEARLY RATE (inches):
D
A
T
E
Storage
Temper- Lagoon
weather ature at Precipita- Free-
code* application tion board
Maximum
Volume Time Daily Hourly
Applied Irrigated Loading Loading
Volume Time
Applied Irrigated
Maximum
Daily Hourly
Loading 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
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 Floating Total inches
5.02
3.53
Weekly Average inches
9 y Loadin 9( ).
0
0
Weather Codes: C -clear, PC -partly cloudy, Cl -cloudy, R -rain, Sn-snow, SI -sleet
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 Service Center
RALEIGH, NC 27699-1617
Tamika Wardlow Phone: [phone]
Check Box if ORC Has Changed: ❑
L t4�-
(SIGNA URE OF OPERATOR IN RESPONSIBLE CHARGE)
BY THIII SIGNATURE, I CERTIFY THAT THIS REPORT IS ACCURATE AND
COMPLETE TO THE BEST OF MY KNOWLEDGE.
DENR FORM NDAR-1 (11/2005)

NON -DISCHARGE APPLICATION REPORT Page of
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDITIONAL PAGES AS NEEDED.
PERMIT NUMBER: WQ0023213
MONTH: December YEAR: 2016
FACILITY NAME: Lexington Golf Course COUNTY:
Formulas:
Daily Loading (inches) = [Volume Applied (gallons) x D.1336 (cubic feet/gallon) x 12 (inches/foot)] /[Area Sprayed (acres) x 43,560 (square feet/acre)]
= Volume Applied (gallons) / [Area Sprayed (acres) x 27,152 (gallons/acre-inch)]
Davidson
OR
Maximum Hourly Loading (inches) =Daily Loading (inches) / [Time Irrigated (minutes)/ 60 (minutes/hour)] 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)
Cvarana Waakly Lnndina finrhesl = rMnnthly I nadinn (inches/month) / Number of days in the month fdays/monthll x 7 (days/week)
Did Irrigation occur At This Facility:
Yes: ❑ No:
Did Irrigation Occur On This Field:
Yes: ❑ No:
Did Irrigation Occur On This Field:
Yes: ❑
No: Q
... ... ..
FIELD NUMBER: Zone 3
AREA SPRAYED (acres): 7.74
COVER CROP: grass
ERMITTED HOURLY RATE (Inches): 0.5
FIELD NUMBER: Zone 4
AREA SPRAYED (acres): 19.76
COVER CROP:grass
PERMITTED HOURLY RATE (inches): 0.2
D
A
T
E
WEATHER CONDITIONS
storage
Weather Temper- Lagoon
ature at Precipita- Free-rA0P
Code' application tion board
PERMITTED YEARLY RATE (inches):
Maximum
Vlume Time Daily Hourly
lied Irrigated Loading Loading
PERMITTED YEARLY RATE (inches):
Maximum
Volume Time Daily Hourly
Applied Irrigated Loading 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
1s
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 Floatln Total inches)..
9 ( )
.:.::.:.:.:::.:.:.:.:.::.:.:_ .:.:.:.:.:.:::.: : 6.60
3.41
Average Weekly Loading inches
9 y 9 ( )
.:::::::::::::::: ::::::::::::: 0
0
Weather Codes: C -clear, PC -partly cloudy, CI -cloudy, R-raln, Sn-snow, SI -sleet
Spray Irrigation Operator in Responsible Charge (ORC): Tamika Wardlow
ORC Certification Number: SI994835/ WW993795 Check Box if ORC Has Changed: ❑
Phone: [phone]
Mail ORIGINAL and TWO COPIES to:
DENR /f
Division of Water Quality �%
ATTN: Information Processing Unit (SIGNATU 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 Page
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDITIONAL PAGES AS NEEDED.
PERMIT NUMBER: W00023213
MONTH: Decem
Of
YEAR: 2016
FACILITY NAME: Lexington Golf Course COUNTY: Davidson
Formulas:
Daily Loading (inches) = [Volume Applied (gallons) x 0.1336 (cubic feet/gallon) x 12 (inches/foot)] / [Area Sprayed (acres) x43,560 (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) 160 (minutes/hourp 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/month)] x 7 (daysAveek)
Did Irrigation Occur At This Facility:
Yes: ❑ No: ❑�
Did Irrigation Occur On This Field:
Yes: ❑ No: 0
Did Irrigation Occur On This Field:
Yes: ❑
No:
........
FIELD NUMBER:1 Zone 5
AREA SPRAYED (acres): 1 6.34
COVER CROP: grass
PERMITTED HOURLY RATE (inches): 0.3
FIELD NUMBER: Zone 6
AREA SPRAYED (acres): 10.89
COVER CROP: grass
PERMITTED HOURLY RATE (inches): 0.25
WEATHER CONDITIONS
PERMITTED YEARLY RATE (inches):
PERMITTED YEARLY RATE (inches):
D
A
T
E
Storage
Weather Temper- Lagoon
ature at Precipita- Free -
Code tion board
Maximum
Volume Time Daily Hourly
Applied Irrigated Loading Loading
Volume Time
Applied Irrigated
Maximum
Daily Hourly
Loading 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
19
20
21
22
23
24
25
26
27
28
29
30
31
Total GallonslMonthly Loading (inches)
0 0.00 X1,
0
0.00
12 Month FloatingTotal inches
(inches)
.:::::::::::::::::::::::::: 5.05
5.53
Average Weekly Loading inches
( )
0
0
Weather Codes: Cclear, PC -partly cloudy, CI -cloudy, R -rain, Sn-snow, SI -sleet
Spray Irrigation Operator in Responsible Charge (ORC): Tamika Wardiow
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: ❑
Phone: [phone]
(SIGNATU lll5F OPERATOR IN RESPONSIBLE CHARGE)
BY THIS S NATURE, I CERTIFY THAT THIS REPORT IS ACCURATE AND
COMPLETE TO THE BEST OF MY KNOWLEDGE.
DENR FORM NDAR-1 (11/2005)

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDITIONAL PAGES AS NEEDED.
PERMIT NUMBER: W00023213 MONTH: December
Page of
YEAR: 2016
FACILITY NAME: Lexington Golf Course COUNTY: Davidson
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 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 Weeklv Loadinq (inches) = (MonthN Loadinq (inches/month) / Number of days in the month (days/month)] x 7 (daysAveek)
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: Zone 7
AREA SPRAYED (acres): 5.38
COVER CROP: grass
PERMITTED HOURLY RATE (Inches): 0.15
FIELD NUMBER: Zone 8
AREA SPRAYED (acres): 9.71
COVER CROP: rays
PERMITTED HOURLY RATE (Inches): 0.3
WEATHER CONDITIONS
PERMITTED YEARLY RATE (inches):
PERMITTED YEARLY RATE (inches):
D
A
T
E
storage
Weather Temper- Lagoon
afore at Preclptta- Free -
code' application tion board
Maximum
Volume Time Daily Hourly
Applied Irrigated Loading Loading
Volume Time
Applied Irrigated
Maximum
Daily Hourly
Loading 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
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 FloatingTotal inches
.1
3.91
Average Weekly Loading (inches)
:' :2` :::` ::` :::< :::" : >::`« :: 0
0
" Weather Codes: C -clear, PC -partly cloudy, Cl -cloudy, R -rain, Sn-snow, SI -sleet
Spray Irrigation Operator in Responsible Charge (ORC): Tamika Wardlow Phone: [phone]
ORC Certification Number: SI994835/ WW993795 Check Box if ORC Has Changed: ❑
Mail ORIGINAL and TWO COPIES to:
DENR
Division of Water Quality
ATTN: Information Processing Unit (SI ATURE OF OPERATOR IN RESPONSIBLE CHARGE)
1617 Mail Service Center BY HIS SIGNATURE, I CERTIFY THAT THIS REPORT IS ACCURATE AND
RALEIGH, NC 27699-1617 COMPLETE TO THE BEST OF MY KNOWLEDGE.
DENR FORM NDAR-1 (11/21305)

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. )
Page of
"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."
( ignatur f Permittee)* Date
City of Lexington
(Permittee -Please print or type)
28 West Center St
Lexington, NC 27292
(Permittee Address)
Weslev 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 15A NCAC 28.0506 (b)(2)(D).
DENR FORM NDAR-1 (11/2005)
Com liant ,N)
1. The application rate(s) did not exceed the limit(s) specified in the permit.
Y
2. Adequate measures were taken to prevent wastewater runoff from the site(s).
0
3. A suitable vegetative cover was maintained on the site(s) in accordance with the permit.
0
4. All buffer zones as specified in the permit were maintained during each application.
0
S. The freeboard in the treatment and/or storage lagoon(s) was not less than the limit(s)
0
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."
( ignatur f Permittee)* Date
City of Lexington
(Permittee -Please print or type)
28 West Center St
Lexington, NC 27292
(Permittee Address)
Weslev 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 15A NCAC 28.0506 (b)(2)(D).
DENR FORM NDAR-1 (11/2005)