WQ0004972_Monitoring - 07-2020_20200828

Monitoring Report Submittal
............................................................................................................................................
Permit Number #* WQ0004972
Name of Facility:*
Month:* July
Report Information
Forest Lakes Preserve ELS
Type *
NDMR, NDAR-1, NDAR-2, NDMLR
Confirmation Email Address:*
Name of Submitter:*
Signature:*
Date of submittal:
Initial Review
Year:* 2020
Upload Document*
Forest Lake_July.pdf 1.65MB
FDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-t, NDAR-2, NDMLR, GW-59).
[e-mail]
Jessica mize
Reviewer: Williams, Kendall
8/28/2020
This will be filled in automatically

Is the project number correct? * WQ0004972
Is the monitoring report r Yes r No
accepted?*
Regional Office * Winston-Salem
Accepted Date: 8/28/2020

Page 1 of 2
NON -DISCHARGE WASTE WATER MONITORING REPORT
PERMIT NUMBER: W 0004972 MONTH: Julv YEAR: 2020
FACILITY NAME: Forest Lakes Preserve ELS COUNTY: Davie
Flow Monitoring Point: Effluent: U Influent: 71
❑
Parameter Monitoring Point: Effluent: ❑ Influent: Surface Water (SW)71 SW Code/Name:
was There Effluent Flow for this Month Generated At This Facility: Yes: No'
50050 00400 60060 C0310 C0610 00536 31615 00655 00625 00630 00600 00520 70300 00940
Operator
D Arrival Daily Rate Fecal "1'u1.1
Catifi,:m Total
,.1, Time Operate, ORC (Flow) into
jGco mei:m Tot:d Kjcldl,.l Tot.! Siv.le Dissolved
-I' 2400 Time on on Treatment Residual BOD-5
INS Mc.n'} Ph" Nlirogcn NO3+1,ll Nitta€en NO3-N S.lids Chlcridc
E Clock Sim Sile7 tiy.,I pll Chlnrinc 20°C hit-3-N
MClr i- ;IOUMI_ �IGiI- hfGlL k1(:fL !,IGfL htG1L MG7L
y;jCg YIN C. i;NrIS UGA. h1GIL }SLi7I.
�1unthly �lon•.hiy tilnmhly 1h,vtl!ly �lunthly Irfo:vhlc 31ec itycx
CunOiiwvus Srtt'cr's c: 54'« �1nntl,iy \1on:hi, Uamhh
t 1534 .0.15 Y 10,613 6,11 <30
2 1220 0.25 l' 10,613 fi.02 <l0
------
3 10,613 Holiday -------'---------_....-----------'-»__----
1 111,6] 3
10,613
n 1111 0.75 B 10,613 6.00 <10
7 1531 U,15 Y 9,13t 6.08 <10
s
1549
U.15
li
11,28G
12,229
16,412
6.113
6.00
5.99
<10
<10
<30
9
0630
0.50
Y
to-
1150
0.511
Y
11
14,192
12
Y
14,192
14,192
10.214
5.96
5.99
<10
<10
1--
1115
0.15
14
0930
0.25
Y
15
1500
0.25
Y
10,222
6.00
<10
16
1510
if. 25.
Y
11,088
6.34
<10
17
1507
015
Y
11,467
13,333
6.28
<10
Is
19
1).25
Y
13,333
13,333
6.03
<lU
2"
1155
21
1236
U.25
U.50
0.25
Y
Y
Y
14,714
21,211
19,199
6.18
6.09
6.19
<10
-�-10
<10
22
U711U
23
1344
24
fill
ILSU
1'
16,332
6.03
<111
.
25
12,766
_
26
12,76(,
t
1102
0.25
Y
12,766
6.06
_
<10
as
0655
LIM
Y
11,131
5.99
<10
6.20
>2420
10.3
66.1
<0,05
66.1
<0.05
304
,5.5
29
0950
1.25
Y
10,843
5.97
<)0
16.81
49.7
so
1529
0.35
B
]2,')12
5.99
<10
3t 1517 U.15 B
10,683
5.99
<10
16.8
49.7
6.20
>2420
10.3
66.1
<U.05
66.1
<O.IIS
304
55.5
Average
12,698
6.34
<10
<10
16.8
49.7
G.2U
>2420
111.3
66.1
<0.115
66.1
<I).(15
3U4
SS.S
Du.ily Ataximwn
21,211
49.7
6.20
>2420
10.3
66.1
<0.05
66.i
<0.U5
304
55.5
Drift Minimum
9,131
5,96
<10
16.8
Monthly Limits (s)
24400
Composite V 1 Crab (G)
Operatur in Responsible Charge (ORC): Glenn Price
Check Bus if ORC Has Changed: 11
Grade: 11 Phone: [phone]
ORC Certification Number: 987931/20771
Certified Laboratories (1): R & A Laboratories. Inc. (2):
Person(s) Collecting Samples: Glenn Price
Mail ORIGINAL and'lfwu COPIES to:
ATTN. Non-Dischnrge Compliance Unit X
DENR (SIGNATURE OF OPERA'I'OR IN RESPONSIBLE CHARGE)
Division of Water Quality By this signature, I certify that tltis report is accurate and
1617 Nlail Sert'ice Center complete to the best of my knowledge.
RALEIGH, NC 27699-1617
DENR Form NDAR-1 (5/2003)

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 -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
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."
S"21 '-) tO Baron Neal McDuffie
(Signature of Permitee)* Date (Name of Signing Official -Please print or type)
Baron Neal McDuffie (Authorized 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 BODS
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
(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 t SA NCAC 2B.0506 (b) (2) (D).

Page 2 of 2
NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITES)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDIDTIONAL PAGES AS NEEDED
PERMIT NUMBER: W 004972 MONTH: J_ uIy_YEAR: 2020
FACILITY NAME: Forest Lakes Preserve ELS, COUNTY: Davie
Formulas:
Daily Loading (inrhesi = [Volume Applied (gallons) x 0.1336 (cubic featlgallon) x 12 (inchestfoot)I I (Area Sprayed (acres) x 43,560 (square feettacre) or
_ [Volume Applied (gallons) I [Area Sprayed (acres) x 27,152 (gailonslacreAnch),
Maximum Hourly Loading (inches) = Daily Loading (inches) I [Tmo irrigated (minutes) 160 (minuteslhdur)I 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)
Averafle Weakly Loading (inches) = [Monthly Loading (incheslmonth) I Number of days in the month (dayslmonth )] x 7 (daysMook)
■. Irrigation occur At This Favlily�
■. • •
•. • • n This Field:
�'Field
yes:
-
Number.
• • •
`Weather Codes: Ctlear, PC -partly cloudy, Cl-duudy, R-raln, Sn-rnaw, Sleleet
Spray Irrigation Operator in Responsible Charge (ORC): Glenn Price Phone: [phone]
ORC Certification Number: 987931/20771 Check Box if ORC Has Changed: ❑
Mail ORIGINAL and Two COPIES to:
ATTN: Non -Discharge Compliance UnIt
DENR
Division of Water Quality
1617 Mail Service Center
RALEIGH, NC 27699-1617
(SIGNATURE OF OPERATOR IN RESPONSIBLE CHARGEy
By this signature, I certify that this report is accurate and
complete to the best of my knowledge.
DENR Form NDAR-1 (512003)

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.
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.
S. The freeboard in the treatment and/or storage lagoon(s) was not less than the
limit(s) specified in the permit.
If the facility is non-com liant, 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, including the possibility of fines and imprisonment for knowing violations."
Baron Neal McDuffie
(Signature of Penmitee)* Date (Name of Signing Official -Please print or type)
Baron Neal McDuffie (Authorized Aaentl
(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).

z
RESEARCh & ANALyTICAI
F' .I LAORATORIES� INC.
For: Forest Lake Preserve
192 Thousand Trails Drive
Advance, NC 27006
Attn: John Keen
Client Sample ID: Effluent
Site: Forest Lakes
Parameter
Ammonia Nitrogen
BOD-5
Chloride
Dissolved Solids
Fecal Coliform QT
Nitrate + Nitrite
Nitrate Nitrogen
Total Kjedjahl Nitrogen
Total Nitrogen
Total Phosphorous
Total Suspended Solids
Method
SM 4500 NH3 D-2011
SM 5210 B-2011
SM 4500 Cl B-2011
SM 2540 C-2011
Colilert 18
SM 4500 NO3 E-2011
(SM 4500 NO3 E-2011)-(SM
4500 NO2 B-2011)
Hach10242
Calc
SM 4500 P E-2011
SM 2450 D-2011
Report of Analysis
8/12/2020
�+jy1�11f1�r,
bra NC#34
w NC #37701
10
Lab Sample ID:
85321-05
Collection Date:
7/29/2020 9:59
Result
Units
Rep Limi Ant Analysis DatelTime
49.7
mg/L
0.1
FK 7/30/2020
16.8
mg1L
2
HW 7/30/2020 1530
55.5
mg/L
1
EE 7/30/2020
304
mg/L
25
AW 7/30/2020
>2420
MPN/100m1
1
BJ 7/29/2020 1551
<0.05
mg/L
0.05
DW 7/29/2020 1600
<0.05
mg/L
0.05
DW 7/29/2020 1600
66.1
mg/L
1
FK 8/4/2020
66.1
mg/L
1
10.3
mg/L
0,05
BJ 8/2/2020
6.20
mg/L
5
LP 7/29/2020
NA = not analyzed
P.O. Box 473 106 Short Street Kernersville, North Carolina 27284 Tel: [phone] Fax: [phone] www.randalabs.com Page 1
..�1 {;oa basic vld

Research & Analytical
Laboratories, Inc.
Analytical / Process Consultations
Phone [phone]
CHAIN OF CUSTODY RECORD
Water Wastewater
Misc.
Company Forest Hake
Job No.
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N
N
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Street Address
Project
Growidwater sampling (March /July)
City, State, Zip
Sampler Name (Please P i t)
Contact
Phone
Sampler Signature
ti:nn�,h Nuurbcr
I I.;,b lisr Only l
Date
Time
Comp
Grab
Temp
°C
Res.
Cl.
Chlorine
Removed
V or N
Sample
Matrix
S or W
Sample Location / I.D.
o
o
Z
Reclue7d Analysis
MW-1
3
I
I
1
(F.coli, NO3-N, TOC, Cl-)
MW-2
3
I
I
1
M W-3
3
I
[
1
"
OQ(p
x
MW-4
3
1
I
1
„
Effluent
4
3
I
1
(BOD, TSS, NH3N, F.coli
NO3-N, Cl-, TDS, T.Nit,
TAWS.)
Rel
squish By
-� Ite/I'ime
L�Z.r GL
Receiv d Bx
,
Remarks: (VOC s @all Monitoring Welts in November ONLY)
** pH at Efflttettt and monitoring wells (please see attached field tog)
Relinquished By
D:rtclTime
Received By
On Ice Samplc Temperature at receipt "('