WQ0007283_Monitoring - 03-2020_20200511 (2)

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page 1 of 1
Permit No.: W00007283
Facility Name: TOWN of POLLOCKSVILLE
County: Jones
Month: March
Year: 2020
PPI: 002
Flow Measuring Point: El influent ❑ Effluent ❑ No Flow generated
Parameter Monitoring Point: ❑ tnfluent [ l Effluent ❑ Groundwater Lowering ❑ Surface Water
Parameter Code
50050
00940
00353
00353
00600
T
p10
m
d A
C`
O
Q
m
y 0
a m
O E
F-
m
O
U
O
o
ILL
o
z
, 0
z o
z
z
m
z o
z
o o
z
c�
Q
24-hr
hrs
*Y/N/B/H
GPD
#NIA
mg/l
mg/I
mg/I
UG/L
1
11:30
1.0
Y
70,000
2
9:20
3.0
Y
129,000
3
10:30
4.0
Y
51,000
4
12:10
2.0
Y
59,000
5
08:30
3.0
Y
57,000
6
08:35
2.5
Y
153,000
7
1 09:45
3.0
Y
115,000
1 43
0.23
0.06
25.19
8
12:00
1.0
Y
84,000
9
09:50
2.0
Y
67,000
10
09:54
3.5
Y
60,000
11
10:00
2.0
Y
52,000
12
10:30
5.0
Y
56,000
131
09:30
3.0
Y
54,000
14
10:15
2.0
Y
54,000
-
15
10:50
1.5
Y
61,000
(�
16
09:10
3.0
Y
60,000
17
10:00
2.5
Y
61,000
18
10:45
2.0
Y
60,000
4tcr,
191
09:25
3.0
Y
51,000
201
09:10
2.0
Y
47,000
21
08:45
1.0
Y
50,000
22
12:00
1.0
Y
68,000
23
09:20
3.0
Y
63,000
24
09:40
2.0
Y
54,000
25
09:30
4.0
Y
76,000
261
12:30
2.0
Y
80,000
27
09:20
2.0
Y
56,000
28
09:45
1.0
Y
48,000
29
08:30
1.0
Y
38,000
30
07:50 1
3.0
Y
45,000
31
09:15 1
12:00
Y
59,000
Average:
65,742
22
0.81
<1
0.29 1
<0.04
1 33
2.00
58618
1
0.0
60730
Daily Maximum:
153,000
22
0.81 1
<1
0.29
<0.04
33.0
2.00
58618
0.0
60730
Daily Minimum:
38,000
22
0.81
<1
0.29
<0.04
33.0
2.00
58618
1
0.0
60730
Sampling Type:
Recorder
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Monthly Avg. Limit:
102,000
Daily Limit:
N/A
Sample Frequency:1
Continuous I
jmar,Ju1,Novlper
Event
-(Y)ES, (N)O, (B)ACK UP ORC, (H)OLIDAY

FORM: NDMR 03-12
NON -DISCHARGE MONITORING REPORT (NDMR)
Sampling Person(s) Certified Laboratories
Name: Operator on Duty Name: Environment 1
Name: Johnnie J. Chadwick/ORC Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? El Compliant ❑ Non -Compliant
If the facility is non -compliant, please explain in the space below the reason(s) the facility was not in compliance. Provide in your explanation the date(s) of the non-compliance and describe the corrective
action(s) taken. Attach additional sheets if necessaryjk
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: JOHNNIE J. CHADWICK
Permittee: Town of Pollocksville
Certification No.: SS-11861/WW2-9579
Signing Official: James Bender Jr.
Grade: SS/WW-2 Phone Number: 252-617-1692
Signing Official's Title: Mayor
Has the ORC changed since the previous NDMR? ❑ Yes El No
Phone Numb 252-224-9831 Permit Expiration: JULY 31,2021
4/27/2020
7W Signature Date
Signature Date
By this si lure, I certify that this report is accurrate and complete to the best of my knowledge.
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.
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page 1 of 1
Permit No.: WQ0007283
Facility Name: TOWN of POLLOCKSVILLE
County: Jones
Month: March
Year: 2020
PPI: 002
Flow Measuring Point: 2 Influent ❑ Effluent ❑ No flow generated
Parameter Monitoring Point: ❑ Influent ❑ Effluent ❑ Groundwater Lowering ❑ Surface Water
Parameter Code -11o.
50050
00310
00665
31616
00610
00620
00400
70300
00530
00931
00916
00625
00927
50060
T
A~QE
C- ?
O
l6 NC
O0
C
OE
P
W
O
3
.2
LL
N
O
r
O
a
£
U. 0
C
0
Q
O
F-
«
F
Cn
E 2
O
E
Ft
r
2
r y
G
5
r O0
7
0
r
24-hr
hrs
'Y/N/B/H
GPD
mg/L
#N/A
#/100 mL
mg/L
mg/L
su
mg/L
mg/L
mg/L
#N/A
mg/L
mg/L
mg/L
ug/L
1
11:30
1.0
Y
70,000
2
9:20
3.0
Y
129,000
3
10:30
4.0
Y
51,000
4
12:10
2.0
Y
59,000
5
08:30
3.0
Y
57,000
6
08:35
2.5
Y
153,000
7
09:45
3.0
Y
115,000
8 1
12.00
1.0
Y
84,000
9
09:50
2.0
Y
67,000
10
09:54
3.5
Y
60,000
11
10:00
2.0
Y
52,000
12
10:30
5.0
Y
56,000
32
2.74
2400
13.68
0,23
538
88
1.40
96238
24.9
9038
52790
13
09:30
3.0
Y
54,000
141
10:15
1 2.0
Y 1
54,000
15
10:50
1.5
Y
61,000
16
09:10
3.0
Y
60,000
17
10:00
2.5
Y
61,000
18
10:45
2.0
Y
60,000
19
09:25
3.0
Y
51,000
20
09:10
2.0
Y
47,000
21
08:45
1.0
Y
50,000
22
12:00
1.0
Y
68,000
23
09:20
3.0
Y
63,000
24
09:40
2.0
Y
54,000
251
09:30 1
4.0
Y
76,000
26
12:30
2.0
Y
80,000
27
09:20
2.0
Y
56,000
28
09:45
1.0
Y
48,000
29
08:30
1.0
Y
38,000
30
07:50
3.0
Y
45,000
31
09:15
12:00 1
Y
59,000
Average:
65,742
22
0.81
<1
0.29
<0.04
33
2.00
58618
24.90
9038
0.0
60730
Daily Maximum:
153,000
22
0.81
<1
0.29
<0.04
33.0
2.00
1 58618
24.90
9038
1 0.0
60730
Daily Minimum:
38,000
22
0.81
1 <1
0.29
<0.04
33.0
2.00
58618
24.90
9038
0.0
60730
Sampling Type:
Recorder
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Monthly Avg. Limit:
102,000
Daily Limit:
N/A
Sample Frequency:
Continuous
Mar,Jul,Nov
per Event
-(Y)ES (N)O, (B)ACK UP ORC. (H)OLIDAY

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Vo
G
Sampling Person(s) Certified Laboratories
Name: Operator on Duty Name: Environment 1
Name: Johnnie J. Chadwick/ORC Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? El Compliant ❑ Non -Compliant
If the facility is non -compliant, please explain in the space below the reason(s) the facility was not in compliance. Provide in your explanation the date(s) of the non-compliance and describe the corrective
action(s) taken. Attach additional sheets if necessary.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: JOHNNIE J. CHADWICK
Permittee: Town of Pollocksville
Certification No.: SS-11861/WW2-9579
Signing Official: James Bender Jr.
Grade: SS/WW-2 Phone Number: 252-617-1692
Signing Official's Title: Mayor
Has the ORC changed since the previous NDMR? ❑ Yes O No
Phone Nu er: 252-224-9831 Permit Expiration: JULY 31,2021
4/27/2020
Signature Date
Signature Date
ByXig.awr., I certify that this report is accurrate and complete to the best of my knowledge.
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
in aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment
for knowing violations.
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Permit No.: W00007283
Facility Name: TOWN of POLLOCKSVILLE
County: Jones
Month: March
Year: 2020
Did irrigation
Field Name:
ONE
Field Name:
TWO
Field Name:
THREE
Field Name:
FOUR
occur
Area (acres):
3.5
Area (acres):
3.5
Area (acres):
4
Area (acres):
4
at this facility?
Cover Crop:
Bermuda/Rye
Cover Crop:
Bermuda/Rye
Cover Crop:
Bermuda/Rye
Cover Crop:
Bermuda/Rye
❑ YES a NO
Hourly Rate (in):
0.7
Hourly Rate (in):
0.7
Hourly Rate (in):
0.7
Hourly Rate (in):
0.7
Annual Rate (in):
92.56
Annual Rate (in):
92.56
Annual Rate (in):
92.56
Annual Rate (in):
92.56
Weather
Freeboard
Field Irrigated?
❑ YES n No
Field Irrigated?
❑ YES E No
Field Irrigated?
❑ YES L NO
Field Irrigated?
❑ YES O No
R
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= O
CD
°F
in
ft
ft
gal
min
in
in
gal
min
in
in
gal
min
in
in
gal
min
in
in
1
C
42
0.0
2.5
2
C
42
0.0
2.5
3
PC
63
0.0
2.5
4
CL
70
0.0
2.5
5
CL
64
0.0
2.5
61
R
60
1.2
2.5
7
PC
41
0.0
2.4
8
C
48
0.0
2.3
9
C
44
0.0
2.3
10
PC
55
0.0
2.3
11
C
61
0.0
2.4
12
C
66
0.0
2.4
13
CL
60
0.0
2A
14
C
48
0.0
2.4
15
CL
47
0.0
2.4
16
R
46
0.3
2.4
17
R
50
0.2
2.4
18
PC
60
0.0
2.4
19
CL
72
0.0
2A
20
PC
68
0.0
2.4
21
CL
65
0.0
2.5
22
CL
52
0.0
2.5
23
PC
51
0.1
2.5
24
PC
55
0.0
2.5
25
CL
60
1.2
2.4
26
C
55
&0
2.4
27
CL
63
&0
2.4
28
C
66
0.0
2.4
29
C
68
0.0
2.4
30
CL
68
0.0
2.4
_
311
CL 1
56 1
0.0 1
2.4
w=
arm0
0.00
J&
0
0.00
0�
12 Month Floating Total (in):
'
33.61
28.12
21.74
1330

FORM: NDAR-1 08-11
NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Did the application rates exceed the limits in Attachment B of your permit?
o Compliant
❑ Non -Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites?
21 Compliant
❑ Non-Compiiant
Was a suitable vegetative cover maintained on all sites as specified in your permit?
O Compliant
❑ Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site?
O Compliant
❑ Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
O Compliant
❑ Non -Compliant
If the facility is non -compliant, please explain in the space below the reason(s) the facility was not in compliance. Provide in your explanation the date(s) of the non-compliance and describe the corrective
action(s) taken. Attach additional sheets if necessary.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: JOHNNIE J_ CHADWICK
Permittee:
Town of Pollocksville
Certification No.: SS-11861/WW2-9579
Signing Official: James Bender Jr.
Grade: SS/WW2 Phone Number: [phone]
Signing Official's Title: Mayor
Has the ORC changed since the previous NDARA? ❑ Yes O No
Phone Number: 52) 224-9831 Permit Exp.: JULY 31,2021
A� ';'ClEal
�/�
4/27/20
Signature Date
Signa re Date
By this sig re, 1 certify that this report is accurrate and complete to the best of my knowledge.
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.
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

FORM: NDAR-1 08-11
NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Permit No.: WQ0007283
Facility Name: TOWN of POLLOCKSVILLE
County: Jones
Month: March
Year: 2020
Did irrigation occur
Field Name:
FIVE
Field Name:
SIX
Field Name:
Field Name:
Area (acres):
4
Area (acres):
4.2
Area (acres):
Area (acres):
at this facility?
Cover Crop:
Bermuda/Rye
Cover Crop:
Bermuda/Rye
Cover Crop:
Cover Crop:
❑ YES ❑ NO
Hourly Rate (in):
0.7
Hourly Rate (in):
0.7
Hourly Rate (in):
Hourly Rate (in):
Annual Rate (in):
92.56
Annual Rate (in):
92.56
Annual Rate (in):
Annual Rate (in):
Weather
Freeboard
Field Irrigated?
Ci YES NO
Field Irrigated?
❑ YES ❑ NO
Field Irrigated?
'❑ YES ❑ NO
Field Irrigated?
❑ YES O NO
T
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00
to 0 O
J
°F
in
ft
ft
gal
min
in
in
gal
min
in
in
gal
min
in
in
gal
min
in
I in
1
C
42
0.0
2.5
2
C
42
0.0
2.5
3
PC
63
0.0
2.5
4
CL
70
0.0
2.5
5
CL
64
0.0
2.5
6
R
60
1.2
2.5
7
1 PC
1 41 1
0.0
2.4
8
C
48
0.0
2.3
9
C
44
0.0
2.3
10
PC
55
0.0
2.3
11
C
61
0.0
2.4
12
C
66
0.0
2.4
131
CL
60
0.0
2.4
141
C
48
0.0
2.4
15
CL
47
0.0
2.4
16
R
46
0.3
2.4
17
R
50
0.2
2.4
18
PC
60
0.0
2.4
19
CL
72
0.0
2.4
201
PC
68
0.0
2.4
211
CL
65
0.0
2.5
221
CL
1 52 1
0.0
2.5
23
PC
51
0.1
25
24
PC
55
0.0
2.5
25
CL
60
1.2
2.4
26
C
55
0.0
2.4
27
CL
63
0.0
2.4
281
C
66
0.0
2.4
C
68
0.0
2.4
129
30
CL
68
0.0
2.4
311
CL
1 56
1 0.0
2.4
Monthly Loading:
0
0.00
0.00
0.00
0
0.00
12 Month Floating Total (in):
35.42
34.70
0.00
0
0.00

FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1)
>r
Did the application rates exceed the limits in Attachment B of your permit?
0 Compliant
❑ Non -Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites?
El Compliant
❑ Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit?
O Compliant
❑ Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site?
p Compliant
❑ Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
El Compliant
❑ Non -Compliant
If the facility is non -compliant, please explain in the space below the reason(s) the facility was not in compliance. Provide in your explanation the date(s) of the non-compliance and describe the corrective
action(s) taken. Attach additional sheets if necessary.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: JOHNNIE J. CHADWICK
Permittee:
Town of Pollocksville
Certification No.: SS-11861/WW2-9579
Signing Official: James Bender Jr.
Grade: SS/WW2 Phone Number: [phone]
Signing Official's Title: Mayor
Has the ORC changed since the previous NDA -1? ❑ yes O No
Phone Nu ber: [phone] Permit Exp.: JULY 31,2021
' , 4/27/20
ature Date
Signa ure Date
By this signature, rtrfy that this report is accurrate and complete to the best of my knowledge.
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.
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

TOWN OF POLLOCKSVILLE (EFFLUENT)
ATTN: JAMES BENDER, JR.
P.O. BOX 97
POLLOCKSVILLE ,NC 28573
PARAMETERS
BOD, mg/I
Fecal Coliform (MF), /100 Mls
Total Suspended Residue, mg/l
Ammonia Nitrogen as N, mg/l
Total Kjeldahl Nitrogen as N,mg/I
Nitrate -Nitrite as N, mg/l (calc)
Nitrate Nitrogen as N, mg/l
Nitrite Nitrogen as N, mg/l
Total Phosphorus as P, mg/l
Chloride, mg/l
Total Dissolved Residue, mg/l
Calcium, ug/l
Magnesium, ug/l
Sodium, ug/I
Sodium Adsorption Ratio (calc)
Total Nitrogen, mg/l (calc)
`➢FSAtev}itter iD i' 10
PHONE [phone]
FAX [phone]
ID#: 319
DATE COLLECTED: 03/12/20
DATE REPORTED : 04/23/20
REVIEWED BY:
Effluent
Analysis
Method
Date Analyst
Code
32
03/12/20
MAR
521OB-11
2400
03/12/20
HJO
9222D-06
88
03/13/20
WO
2540D-11
13.68
03/13/20
BLD
350.1 R2-93
24.90
03/18/20
TLH
351.2 R2-93
0.29
353.2 R2-93
0.23
03/13/20
TLH
353.2 112-93
0.06
03/12/20
BLD
353.2 112-93
2.74
03/18/20
BLD
365.4-74
43
03/16/20
KDS
4500CLB-11
538
03/19/20
GNB
2540C-11
96238
03/18/20
LF.J
EPA200.7
9038
03/18/20
LFJ
EPA200.7
52790
04/22/20
NAB
3111B-11
1.4
25.19

f.mironment 1, Inc. CHAIN F CUSTODY RECORD
P.O. Box 7085. 114 Oakmont Dr. Page 1 of 1
Gie:.:;r12 NC 27858
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C,TION
Phone [phone] • Fas [phone]ORINE
yL
CHLORINENEUTRALIZEDATCOLLECTION
CLIENT: 319 Week: 13
UV
pH CHECK (LAB)
P
P
P
P
P
P
P
P
P
P
P
P
CONTAINER TYPE, P/G
TOWN OF POLLOCKSVILLE (EFFLUENT)
❑ NON
ATTN: JAMES BENDER, JR.
P.O. BOX 97
POLLOCKSVILLE NC 28573
❑ i
A
G
A
C
C
C
A
A
C
A
A
A
A
CHEMICAL PRESERVATION
A -NONE D-NAOH
E
[phone]
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U
cc
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m
w
B - HNO E - HCL
00
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¢
a
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a
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0
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LU C - H,SO4 F -ZINC ACETATE/NAOH
LU
COLLECTION
a
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w
AO
G
a,
o.
=
G
o
< G- NATHIOSULFATE
SAMPLE LOCATION
DATE
TIME
o 0
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F
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CLASSIFICATION:
WASTEWATER(NPDES)
FA DRINKING WATER
DWR/GW
Lj SOLID WASTE SECTION
CHAIN OF CUSTODY (SEAL) MAINTAINED
DURING SHIPMENT/DELIVERY
N
SAMPLES COL TEED BY:
(PI ��"
I'
SAMPLES RECEIVED IN LABAT � 'C
(SIG.) AMPLER)
DATE/TIME
D BY (SIG.)
DATEITIME
COMMENTS:
MUNQUISHtEDBY
�RCEI
.�
(SIG.)
DATEMME
CEIVED BY (SIG.)
DATEITIME
RELINQUISHED BY (SIG.)
DATKIME
RECEIVED BY (SIG.)
DATKIME
PLEASE READ Instructions for completing this form on the reverse side. Sampler must place a "C" for composite sample or a "G" for
FORM ;s Grab sample in the blocks above for each parameter reauested. A110 7 7 7 0 7 7