WQ0006941_Monitoring - 12-2016_20170203

Page 1 of 2
NON -DISCHARGE WASTE WATER MONITORING REPORT
PERMIT NUMBER: W00006941 MONTH: December YEAR: 2016
FACILITY NAME: Caswell County Schools/ Stoney Creek Elem. School COUNTY: Caswell
Flow Monitoring Point: Effluent: Ll
Influent:
MOM
Parameter Monitoring Point: Effluent: ©
Influent:
❑
ISurface Water (SW): Ll
ISW Code/Name:
Was There Effluent Flow for this Month Generated At This Facility:
Yes:
Li No:
Operator 50050
D Arrival Daily Rate
A Time Operator ORC (Flow) Into
'I' 2400 Time on on Treatment
�. Clock Site Site? System pH
00310
BOD -5
20'C
00610
Ammonia
Nitrogen
(as N)
00530 31616
Fecal
Coliform
(Geo -metric
TSS Mean•)
00625
Total
Kjeldhal
Nitrogen
(as N)
00630
Total
Nitrate+
Nitrite
(as N)
00665
Total
Phoshorus
(as N)
00600
Total
Nitrogen
(as N)
HRS YIN GALLONS UNITS
MGIL
MG/L
MG/L /100ML
MOIL
MG/L
MG/L
MG/L
t1r750`
2 1 1600 1 0.50 1 Y 1 1.750 1 6.7
i
1530 0.50 Y 1
Operator in Responsible Charge (ORC): Steven Yarbrough Grade: II Phone: [phone]
Check Box if ORC Has Changed: ❑ ORC Certification Number: 986612
Certified Laboratories (1): R & A Laboratories, Inc. (2):
Person(s) Collecting Samples: Steven Yarbrough
Mail ORIGINAL and Two COPIES to:
ATTN: Non -Discharge Compliance Unit X
DENR (SIGNATURE 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�F
�E9 0'3 2017
DENR Form NDAR-1 (5/2003)
MOM
r ®
I I
-------Composite
-
0 Grab (G)
Operator in Responsible Charge (ORC): Steven Yarbrough Grade: II Phone: [phone]
Check Box if ORC Has Changed: ❑ ORC Certification Number: 986612
Certified Laboratories (1): R & A Laboratories, Inc. (2):
Person(s) Collecting Samples: Steven Yarbrough
Mail ORIGINAL and Two COPIES to:
ATTN: Non -Discharge Compliance Unit X
DENR (SIGNATURE 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�F
�E9 0'3 2017
DENR Form NDAR-1 (5/2003)

NON DISCHARGE WASTEWATER MONITORING REPORT
FACILITY STATUS:
Please answer the following question:
1. Does all monitoring data and sampling frequencies meet permit requirements?
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.
rJ
Com Tian ,N)
"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
inform submitted is, to the best of my knowledge and belief true, accurate, and complete. I am aware that there are significant
pen ties for ubmitting e ' formation, including the possibility of fines and imprisonment for knowing violations."
. ><:;"- A_9r1_1117 James M. Cheshire
(S'gna e of Permi e) Date (Name of Signing Official -Please print or type)
James M. Cheshire (Authorized Agent) President R & A Laboratories
(Permittee -Please print or type) (Position or Title)
P.O. Box 160 336-694-4116 06/30/2012
Yanceyville, NC 27329 (Phone Number) (Permit Exp. Date)
(Permittee Address)
01002 Arsenic
01022 Boron
00310 BOD5
01027 Cadmium
00916 Calcium
00940 Chloride
50060 Chlorine, Total
Residual
01034 Chromium
00340 COD
31504
Coliform, Total
00094
Conductivity
01042
Copper
00300
Dissolved Oxygen
31616
Fecal Coliform
01051
Lead
00927
Magnesium
71900
Mercury
00610
NH3 as N
01067
Nickel
00600 Nitrogen, Total
00630 NO2 & NO3
00620 NO3
00556 Oil & Grease
WQ09 PAN (Plant Available)
00400 pH
32730 Phenols
00665 Phosphorus, Total
00937 Potassium
00545 Settleable Matter
00929
Sodium
00931
SAR
00745
Sulfide
00515
TDS
00010
Temperature
00625
TKN
00680
TOC
00530
TSS/TSR
00076
Turbidity
01092
Zinc
Parameter Code assistance may be obtained by calling the Water Quality Compliance/Enforcement Unit at [phone], extension 529.
The monthly average for Fecal Coliform is to be reported as a GEOMETRIC mean. Use only 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 213.0506 (b) (2) (D).

Page 2 of 2
NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDIDTIONAL PAGES AS NEEDED
PERMIT NUMBER: W00006941 MONTH: December YEAR: 2016
FACILITY NAME: Stoney Creek Elem. School COUNTY: Caswell
Formulas:
Daily Loading (inches) = [Volume Applied (gallons) x 0.1336 (cubic feettgallon) 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 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: ❑ No: ❑
Did Irrigation Occur On This Field:
Yes: ❑ No: ®
Did Irrigation Occur On This Field:
Yes: ❑
No: ❑
Field Number: 11
Area Sprayed (acres): 13.12
Cover Crop: Woods
Permitted Hourly Rate (inches):
0.30
Field Number:
Area Sprayed (acres):
Cover Crop:
Permitted Hourly Rate (inches):
WEATHER CONDITIONS
Permitted Yearly Rate (inches):
0.36
Permitted Yearly Rate (inches):
D
A
TPrecipita-
Etion
TCe.ftT.mer.t...r.
Storage
Lagoon
F.,bnard
Volume Time Daily
Applied Irrigated Loading
Maximum
Hourly Volume Time
Loading Applied Irrigated
Daily
Loading
Maximum
Hourly
Loading
Inches
feet
gallons mmutes inches
inches
gallons i-tes
inches
inches
1
2
C
58 0
4.00
£.•.
4
5
C -.r
55 0. ,,
4.00 '
Total (3,11ons/Monthly Loading (inches)
12 Month Floating Total (Inches)
A—age Weekly ,.
w
:a r�a....•a°fie
�: �.W�w
a
..
.tl §° 4 .. �,. SF.. E.
6
._i
8
CI
60 0
4.00
,w 1
*Weather 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 B if ORC Changed: ❑
ATTN: Non -Discharge Compliance Unit X
DENR (SIGNATURE OF ERATOR 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
Total (3,11ons/Monthly Loading (inches)
12 Month Floating Total (Inches)
A—age Weekly ,.
w
:a r�a....•a°fie
�: �.W�w
a
..
.tl §° 4 .. �,. SF.. E.
*Weather 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 B if ORC Changed: ❑
ATTN: Non -Discharge Compliance Unit X
DENR (SIGNATURE OF ERATOR 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)

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.
1 17 1
2. Adequate measures were taken to prevent wastewater runoff from the site(s)..
EP
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
I—F
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 n submitted is, to the best of my knowledge and belief true, accurate, and complete. I am aware that there are significant
pen ties Abr submittin is nformation, including the possibility of fines and imprisonment for knowing violations."
James M. Cheshire
(S' tore of Perm' ee D e (Name of Signing Official -Please print or type)
James M. Cheshire (Authorized A ent) President R & A Laboratories
(Permittee -Please print or type)
P.O. Box 160
Yanceyville, NC 27329
(Permittee Address)
(Position or Title)
336-694-4116
(Phone Number)
06/30/2012
(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).