WQ0022785_Monitoring - 04-2020_20200611

NON DISCHARGE WASTEWATER MONITORING REPORT Page of
PERMIT NUMBER: VVQ0022785 MONTH: April YEAR: 2020
FACILITY NAME: Lattisville Grove Baptist Church COUNTY: Orange
Monitoring -
Parameter Monitoring Point: Effluent:
Nitrate +
I —Nitrite
..
..
0
Daily Maximum
Operator in Responsible Charge (ORC): _
Check Box if ORC Has Changed:
Chad Leinbach Grade: SI
ORC Certification Number:
Phone: [phone]
23928
Certified Laboratories (1): Conner Consulting, LLC (Field) (2): ENCO, Inc. (Lab)
Person(s) Collecting Samples: Chad Leinbach
Mail ORIGINAL and TWO COPIES to:
ATTN: Non -Discharge Compliance Unit ry
DENR ._ N
Division of Water Quality ='
1617 Mail Service Center
RALEIGH, NC 27699-1617
s� o
s
C
(SIGNATURE 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 NDMR-1 (5/2003)

NON DISCHARGE WASTEWATER MONITORING REPORT
Page of
FacilityStatus:
—
Please answer the following question:
Compliant YIN)
1. Does all monitoring data and sampling frequencies meet permit requirements? I Y
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.
No inflow from well water reported due to usage at softball field during summer. Chad-ORC
"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, in luding the possibility of fines and imprisonment for knowing violations."
J �v Chad Leinbach
(Signature of Permittee)* Date (Name of Signing Official -Please print or type)
Lattisville Grove Baptist Church
(Permittee-Please print or type)
1701 Jimmy Ed Road
Hurdle Mills, NC 27541
(Permittee Address)
Parameter Codes:
ORC
(Position or Title)
[phone]
(Phone Number)
01002 Arsenic
31504 Colitorm 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
32730 Phenols
00680 TOC
71900 Mercury
00665 Phosphorus, Total
00530 TSSlTSR
01034 Chromium
00610 NH3asN
00937 Potassium
00076 Turbldl
00340 COD
01067 Nickel
00545 Settleable Matter
01092 Zinc
10131 /23
(Permit Exp. Date)
Parameter Code assistance may be obtained by calling the Water Quality Compliance/Enforcement Unit at [phone] ext. 529.
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)(D).
DENR FORM NDMR-1 (5/2003)

NON -DISCHARGE APPLICATION REPORT Page
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDITIONAL PAGES AS NEEDED.
Of
PERMIT NUMBER: W00022785
MONTH: April YEAR:
FACILITY NAME: Lattisville Grove Baptist Church COUNTY: Orange
Formulas:
Daily Loading (Inches) = [Volume Applied (gallons) x 0.1336 (cubic feet/gallon) x 12 (inches/foot)] / [Area Sprayed (acres) x 43,560 (square feetlaae)] OR
= Volume Applied (gallons) I [Area Sprayed (acres) x 27,152 (galionslaae-inch)]
Max lmum Hourly Loading (Inches) = Daily Loading (inches) /[rime Inigated (minutes)160 (minutesRiour)] 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)
Averacie Weekly LOadlno (Inches) =!Monthly Loading (inchestmonth) /Number of days in the month (dayslmonth)] x 7 (days/week)
2020
Did Irrigation Occur At This Facility:
Yes: No:
Did Irrigation Occur On is Field:
Yes: No:
Did Irrigation Occur On This Field:
Yes: F1 No:
FIELD NUMBER:j
FIELD NUMBER:
AREA SPRAYED (acres):
1.04
AREA SPRAYED (acres):
COVERCROP:1
Fescue, Rye
COVER CROP:
PERMITTED HOURLY RATE (inches):
0.2
PERMITTED HOURLY RATE (inches):
D
T
E
WEATHER CONDITIONS
Lagoon
Freeboard
PERMITTED YEARLY RATE (inches):
23.75
PERMITTED YEARLY RATE (inches):
Weather
Code*
Temper -atone
at application
Precipkadion
Volume
Applied
Time
Irr' ated
Daily
Loading
Maximum
Hourly
Loading
Volume
Applied
Time
Irrigated
Daily
Loading
Maximum
Hourly
Loading
("F)
Inches
feet
gallons
minutes
Inches
Inches
gallons
minutes
Inches
Inches
1
CI
55
0.08
NA
143
5
0.01
0.06
2
NA
100
3
0.00
0.07
3
NA
100
3
0.00
au
4
NA
100
3
0.00
0.07
5
NA
100
3
0.00
0.07
6
NA
100
3
0.00
0.07
7
NA
100
3
0.00
0.07
8
C
75
0.14
NA
100
3
0.00
0.07
9
NA
0
0
0.00
#DIV/0!
10
NA
0
0
0.00
#DIV/0!
11
NA
0
0
0.00
#DIV/0!
12
NA
0
0
0.00
#DIV/0!
13
NA
0
0
0.00
1 #DIV/0!
14
NA
0
0
0.00
#DIV/0!
15
C
60
1.8
NA
0
0
0.00
#DIV/0!
161
NA
113
4
0.00
0.06
171
NA
113
4
0.00
0.06
181
NA
113
4
0.00
0.06
191
NA
113
4
0.00
0.06
201
1
NA
113
4
0.00
1 0.06
21
NA
113
4
0.00
0.06
22
NA
113
4
0.00
0.06
23
R
55
0.91
NA
113
4
0.00
0.06
24
NA
0
0
0.00
#DIV/0!
25
NA
0
0
0.00
#DIV/0!
26
NA
0
0
0.00
#DIV/0!
271
1
NA
0
0
0.00
1 #DIV/0!
28
NA
0
0
0.00
#DIV/0!
29
C
75
0.48
NA
0
0
0.00
#DIV/0!
30
NA
0
0
0.00
#DIV/0!
31
NA
Total Gallons/Monthly Loading
(inches)
1747
0.06
0
0.00
12 Month Floating Total (inches)
3.03
Average Weekly Loading (inches)
0.0144257
0.4
Weather Codes: Clear, PC -partly cloudy, Cl-cloudy, R-rain, Sn-snow, SI-sleet
Spray Irrigation Operator in Responsible Charge (ORC): Chad Leinbach
ORC Certification Number:
Mail ORIGINAL and TWO COPIES to:
ATTN: Non -Discharge Compliance Unit
DENR
Division of Water Quality
1617 Mail Service Center
RALEIGH, NC 27699-1617
23928 Check Box if ORC Has Changed
0
Phone: [phone]
(SIGNATURE 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 (52003)

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
Page of
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. )
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.
Co liant N
Y
0
NA
If the facility is noncompliant, 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 noncompliance and describe the corrective action(s) taken. Attach
additional sheets if necessary.
There is an infiltration problem at this site although at present it does not seem to affect the running average of the irrigation.
Chad - ORC
"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."
(Signature o ermittee)• Date
Lattisville Grove Baptist Church
(Permittee-Please print or type)
1701 Jimmy Ed Road
Hurdle Mills, NC 27541
(Permittee Address)
Chad Leinbach
(Name of Signing Official -Please print or type)
ORC
(Position or Title)
[phone]
(Phone Number)
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).
10/31 /23
(Permit Exp. Date)
DENR FORM NDAR-1 (5/2003)