WQ0004972_Monitoring - 06-2020_20200730

Monitoring Report Submittal
............................................................................................................................................
Permit Number #* WQ0004972
Name of Facility:* Forest Lakes Preserve ELS
Month:* June
Report Information
Type *
NDMR, NDAR-1, NDAR-2, NDMLR
Year:* 2020
Upload Document*
Forest Lakes_June.pdf
FDF Only
Please upload only one combined pdf document. Upload GW-59 individually.
Confirmation Email Address:* [e-mail]
Name of Submitter:*
Signature:*
Date of submittal:
Initial Review
Jessica Mize
Reviewer: Williams, Kendall
Is the project number correct?* WQ0004972
7/30/2020
This will be filled in autorratically
1.44MB

Is the monitoring report Yes r No
accepted?*
Regional Office* Winston-Salem
Accepted Date: 7/30/2020

Page t of 2
NON -DISCHARGE WASTE WATER MONITORING REPORT
PERMIT NUMBER: W00004972 MONTH: June YEAR: 2020
>r n rrt rTv NAME- Fnrest Lakes Preserve ELS COUNTY: Davie
R ■
■ ■
D
t .,
..(Flow) into
systc
Operator in ResponsibleCharge (ORC): Glenn Price Grade: 11 Phone: [phone]
Check Box if ORC Has Changed: ❑ ORC Certification Number: 987931/20771
Certified Laboratories (1): R & A Laboratories, Inc. (2}:
Person(s) Collecting Samples: Glenn Price
Mail ORIGINAL and Two COPIES to:
ATTN: Non -Discharge Compliance Unit X �
DENR (SIGNATURE OF OPERATOR IN RESPONSIBLE ARGE)
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 Farm NDAR-1 (512003)

NON DISCHARGE WASTEWATER MONITORING REPORT
FACILITY STATUS:
Please answer the following question: Com liant ,N)
1. Does all monitoring data and sampling frequencies meet permit requirements?
If the facility is non-compllant, 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
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 'ncluding the possibility of fines and imprisonment for knowing violations."
G-, r _ Baron Neal McDuffie
(Signa a of Permitee)* Date (Name of Signing Official -Please print or type)
Baron Neal McDuffie (Authorred Agent) Field Services Director {R & A Laboratories. Inc.
(Permittee-Please print or type)
2N Riverside Plaza Suite 800
Chicago. Il 60606
(Permittee Address)
01002 Arsenic
01022 Boron
00310 BOD5
01027 Cadmium
00916 Calcium
00940 Chloride
50060 Chlorine, Total
Residual
01034 Chromium
100340 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
(Position or Title)
3/31/21
(Permit Exp. Date)
00600 Nitrogen, Total
00630 NO2 & NO3
00620 NO3
00556 Oil & Grease
W 09 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: W52004972 MONTH: ,tune YEAR: 2020
FACILITY NAME: Forest Lakes Preserve ELS. COUNTY: Davic
Formulas:
Daily Loading (inches) = [Volume Applied (gallons) x 0,1336 (cubic feat/gallon) x 12 (incheslrooq)1 [Area Sprayed (acres) x 43,560 (square feetlacre) or
= [Volume Applied ;gallons) f [Area Sprayed (was) x 27.152 (gallonslecre-inch).
Maximum Hourly Loading (inches) = Daily Loading (inches) f [Time irrigated (minutes)160 (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 monlh's Monthly Loadings (inches)
Average Weekly Loading (inches) = [Monthly
Loading (Incheslmonfh) I Number of days in the month (daysfmonth )) x 7 (dsysMeek[
Did Irrigation Occur At This Fatality:
Did Irrigation Occur On This Field: Did Irrigation Occur On This Field:
❑ NO: ❑
Yes: Q No: ❑
Yes: © No: ❑ Yes:
Field Number. Field Number.
Area Sprayed (aces): 7.0 Area Sprayed (acresY
Cover Crop: Cover Crop:
Permitted Hourly Rate (inches) Q.11 Permitted Hourly Rate (inches):
WEATHER CONDVTIONS
Permitted Yearly Rate (inches): 46,6 Permitted Yearly Rate (inches):
1)
M-in,mn
A W� Oh" Tampera,ure Storage
C at Preelpita- Lagoon
Muimum
Vol- lime Daily 1lewrly v�,icme Time catty
ndr.'
1'. nPPl:cnn„ lien Rc 4-rd
Aprhrd hure -d UUdmc L ad,n ,SPPlitt Irr p,e d l uJing
.., .., +,!b.r;.
feeding
1 (' 75 r.0E 2.7
PC 62 II 2.6
31'Pi4 '_dll IL1$ 11.113
C 89 0 3.1
C 88 It 391
s PC 87 0 3.0
I,
r H6 0 2.3
33.984 2411 0.18 0.03
PC: 85 0 2.8
I(I PC 84 11 2.7
n
Cl
86
0
0
0
0's
0
0
0
0
0.2
0
2.6
2.5
2A
2.2
2.2
3.0
2.9
2.3
2.2
2,1)
33,984
33,984
33.994
240
240
2lll
0.18
LI8
If.18
11,03
(1.03
[I.113
I'.
CI
78
11
14
60
57
67
74
69
H3
76
82
1s
CI
R
CI
it,
17
I�
CI
C'1
14
21
22
CI
R
U
13
24
z5
C
68
0
3.0
�h
17
29
C
901
0
2.1
33,984
241)
0,18
9.03
86
II
2.4
25A88
1811
0,13
0.113
1.21
13.31
12 ytnoth FWiling To,nl (inncEd
0
0.24
Avarua 1Y'eehl) (inehl.
`W'earher Codes: C-clear, PC -partly cloudy, Cil cloudy, R-raln, Sa-mow, St -sleet
Spray Irrigation Operator in Responsible Charge (ORC): Glenn Price Phone: [phone]
ORC Certification Number: 987931/20771 Cheek Box if ORC Has C anged: ❑
Mail ORIGINAL and Two COPIES to:
ATTN: Nan -Discharge Compliance Unit
X l G'
(SIGNATURE OF OPERATOR IN RESPONSIBLE CIIARGE)
DENR
By this signature, I certify that this report Is accurate and
Division of Water Quality
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. 171
2. Adequate measures were taken to prevent wastewater runoff from the site(s). 4
3. A suitable vegetative cover was maintained on the site(s) in accordance with the permit. Q
4. All buffer zones as specified in the permit were maintained during each application. E:T_1
S. The freeboard in the treatment and/or storage lagoon(s) was not less than the Elp
limit(s) specified in the permit.
If the facility is noncompliant ,please explain in the space below the reasons) 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
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, inclu 'ng the possibility of fines and imprisonment for knowing violations."
Baron Neal McDuffie
(Signature of Permttee)* IT 4VDate (Name of Signing Official -Please print or type)
Baron Neal McDuffie (Authorized Agent)
(Permittee-Please print or type)
2N Riverside Plaza Suite 800
Chicago. Il 60606
(Permittee Address)
Field Services Director (R & A Laboratories. Inc)
(Position or Title)
3/31/2021
(Permit Exp. Date)
* 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) (D).

RESEARCh & ANA1YTICAL
LABORATORIES, INC.
Report of Analysis
7/9/2020
For: Forest Lake Preserve
192 Thousand Trails Drive
Advance, NC 27006
Attn: John Keen
..•`;�h ar�trr ��..
4••,G. �l�_��.
2�� 4-Ckq�A•.:
M NC#34 Z.
i = • w
NC #37701
•
`��ED;AA�R,`ti.
Client Sample ID: Effluent
Lab Sample ID:
84056-01
Site: Forest Lakes
Collection Date:
6/30/2020 13:13
Parameter
Method
Result
Units
Rep Limit Analyst Analysis Date[Time
Ammonia Nitrogen
-
SM 4500 NH3 D-2011
54.2
mg/L
0.1
FK 7/2/2020
BOD-5
SM 5210 B-2011
28.5
mg/L
2
HW 7/2/2020 1145
Fecal Coliform QT
Colilert 18
>2420
MPN1100ml
1
BJ 6/30/2020 1455
Nitrate + Nitrite
SM 4500 NO3 E-2011
<0.05
mg1L
0.05
DW 7/1/2020 1220
Nitrate Nitrogen
(SM 4500 NO3 E-2011)-(SM
<0.05
mg1L
0.05
DW 7/1/2020 1220
4500 NO2 B-2011)
Total Kjedjahl Nitrogen
Hach 10242
78.7
mg/L
1
FK 7/6/2020
Total Nitrogen
Calc
78.7
mg/L
1
Total Phosphorous
SM 4500 P E-2011
8.12
mg/L
0.05
LP 7/7/2020
Total Suspended Solids
SM 2450 D-2011
12.3
mg/L
5
AW 7/1/2020
NA = not analyzed
P.O. Box 473 106 Short Street Kernersville, North Carolina 27284 Tel: [phone] Fax: [phone] www.randalabs.com Page 1

Research & Analytical
Laboratories, Inc.
Analytical / Process Consultations
Phone [phone]
CHAIN OF CUSTODY RECORD
Water/ Wastewater
Misc.
Company Forest Lake
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Sampler Name (PI s Print)
Contact
Phone
Sampler Signature
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Sample Number
(Lab Use Only)
Date
Time
Comp
Grab
Temp
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Res.
Cl.
Chlorine
Removed
Y or N
Sample�-
Matrix
S or W
Sample Location / I.D.
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(BOD, TSS, NH3N, Ecoli
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Remarks:
Relinquished By
Date/Time
Receiv
On Ice
Sample Temperature at receipt
°C