WQ0004972_Monitoring - 08-2020_20201001

Monitoring Report Submittal
............................................................................................................................................
Permit Number #* WQ0004972
Name of Facility:*
Month:* August
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 Lakes_August.pdf 1.27MB
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
jus l oil
Reviewer: Williams, Kendall
9/30/2020
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: 10/1/2020

Page 1 of 2
NON -DISCHARGE WASTE WATER MONITORING REPORT
PERMIT NUMBER: W 0004972 MONTH: Aueust YEAR: 2020
FACILITY NAME: Forest Lakes Preserve ELS COUNTY: Davie
Flow Monitoring Point: Effluent: Influent: Li❑
Parameter Monitoring Point: Effluent: N Influent: Surface Water (SW): SW CodelName:
Was There Effluent Flow for this Month Generated At This Facility: Yes: Ljd No: Li
50050 00400 50060 00310 00310 0053o 31616 00665 00625 0p630 00600 00620 70300 00940
Operator
Fecal
Dail Role
D Arrival Y Total
Total
A Colifurm
Time ORC (Flow) into Total Nilralc Dl,01-1
(Gm -metric Tnlal KjclJhal
'[' 2400 lime on on Treatment RcsiJaal BUD-5
Time
TSS Mean•) Phns Nitrocrn NOZIN03 Nilrogm \03-N Solid, Oil- c
E Cluck Site Site? Systun PIT Chlorine ?0°C NH-3-N
MCiII. SSCiIL fI00Ml. MGrI. N36T MGIL MGlL tvlCiil. h1GrL MGIL
EII;g YfN CPU L'VITS UG%L ASG7l.
%1n 0,ly 6lomhly 5lnmhly hlunihly Monthly >lomhly hlonlhly 3lvcar 3lvcar
5: 55'eck .5,'WV' k Afanlhh .'.Sualhly
L:npl]:IIIn4L -
13,312
13,312
2
:3
1453
0,15
13
R
13,312
8,767
9.329
8,777
- 5.99
6.04
5.97
5.95
<10
<10
<10.
<10
4
1515
0.15
5
1534
0.15
t3
6
1516
0.15
13
-.7
- 1320
0.50
Y
9,831
10,198
10 19R
10,198
5.88
5.63
<10
<10
y
s
to
1243
41,15
13
-1[
1535
O.So
13
1'
7,604
8,216
8,831
8,912
M2 37
12,337
12,337
9,763
9,904
9,006
7,888
t 0,O l l
10,011
10,011
8,963
14,526
1 5.72
5.71
5.75
5.80
5.73
5.76
5.81
5.75
5.73 -
5.86
5,82
5.84
<10
<10
<10
<10
<10
<10
<19
<10
<10`
<10
<10
<10
12
0707
0.25
13
1145
0.50
V
14
1140
0.25
Y
15
E1
13
Il
Y
Y
EL
It
13
16
17
1050
0,25
to
1544
0.15
0.15
0.15
0,15
19
1015
2u
1417
21
0858
23
0.15
0.15
0,15
24
1340
is.
1600
26
1334
21 1327 0.25 Y 14 181
-- -5.88
-' <I O
28 0800 1L511 Y 12,009
5.93
<10
29 11,129
30 11,129
3T 0720 0.25 Y I E t29
5.92 .'
<10 :
=" 11.9
51,2
5.6
>2420
6,68
62.3
<0.05
623
<0.05
Average 10,563
<10
11.9
51.2
5.6
>2420
6.68
62.3
<0.05
62.3
<0.05
Daily Nlaihnum 14,526
6.04
<10
11.9
51.2
5.6
>2420
6.68
62.3
10.05
62.3
Daily Minimum 7,604
5.63
<10
11.9
51.2
5.6
>2421i
6.68
62.3
<0.05
62.3
<4I.05
dlanlhly Limits (sl 24400
Composile Y91 Gra4 (C)
Operator in Responsible Charge (ORC): Glenn Price Grade: IT 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'1'1vo COPIES to:
ATTN: Non -Discharge Compliance Unit 7+
DENR (SIGNATURE Or OPEIZATOR IN RESPONSIBLE CHARGE)
Division of Waler Quality By this signature, 1 certify Iltat 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 WASTEWATER MONITORING REPORT
FACILITY STATUS:
Please answer the following question: Compliant ,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, in uding the possibility of fines and imprisonment for knowing violations."
Baron Neal McDuff'ie
(Signature of Petmitee)* 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 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
(Position or Title)
3/31/21
(Permit Exp. Date)
00600 Nitrogen, en, 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: W 004972 MONTH: August YEAR: 2020
FACILITY NAME: Forest Lakes Preserve ELS. COUNTY: Davie
Formulas:
Daily Loading (inches) = [Volume Applied (gallons} x 0.1336 (cubic feeVgallon) x 12 (inchesKooll]! [Area Sprayed (acres) x 43.560 (square feeltacre) or
= [Volume Applied (gallons)! [Area Sprayed (acres) x 27,152 (gaaonslacre-inch}.
Mapmum Hourly Loading (inches) = Daily Loading (inchosl A [Time irrigated (minutes) l60 (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) l Number of days in the month (dayslmonth )1 x 7 (daysAwoak)
Did Irrigation Occur At This Facility', Did Irrigation occur On This Fields 'Did Imigation Occur On This Field:
❑ No ❑
Yes: ❑ No: ❑ Yes: © No: ❑ Yes:
Field Number. Field Number.
Area Sprayed (acres): 7.0 Area Sprayed (acres).
Cover Crop: Cover Crop,
Permitted Hourly Rate (inches): 0.11 Permitted Hourly Rate (inches):
:VEATHER CONDITIONS Permitted Yearly Rate (inches}: 46.6 Permitted Yearly Rate (inches).
I1
Manimum
;\ LVea:hcr TemAefepre stolege Muim�n'
C.d" at Placcii Lagoon Vdum� I:r.�. Ilaily Ilnur}y \'„Iur:: l:nc Oaity
1lauly
1 I- 1' lion Frcx-Iwrm�l .�ppl�sJ hei,nrcJ I�uJinr I.uciny Appli:,! lir �; �,�r;,: tAuding
1' w rrrn � r:, F.c,
L di,,g
i�cl::•
t
.1 R 70 0 2,1
C 85 5 2.0 33.984 240 0.18 0.113
5 C., 85 0 2,3 33 984 240 0.18 0.03
r, C 86 n 3.0
7 171 81 0 2,4 25 488 180 0.13 0.03
>
nl C 84 0 2.,,
-]--PC 86 6 2.4 33,984 240 {I.18 0.03
2.3
tt PC 84 1) 2.2 .488 180 0.13 0.03
14 It tit 7 - 2.4
15
IG
IT C1 79 1) 2.1 25 488 180 0.13 IL03
Ix [' 84 II 2.3 33,984 gal) 0.18 11.03
19 C 8f1 II 3-0
2e C 79 II 2.9
21 CI 72 0 2.7
2y
24 PC 79 0 2.1 33,984 240 11.18 lLU3
25 C 88 0 2.9
err C 81 It 2.4
27 pC 93 0 2.5
s PC 71 1) 2.5 42.4810 -11}0 1).22 0.03
29
1tl
,t R 70 0 2.8
'� .v
1.51
I„t+I Golhrnl.]InnlhV,l�r+hinC (Vnthrct
14.2+4
]j llmlh Floanoa Tdai Ilnche+) n
0.38
hreraee Weekly I,e�dinF tinchesl
*Weather Codca: CKlcar, PC -partly cloudy, CI-etoudy, R-min, Sn-snow, 51-alcet
Spray Irrigation Operator in Responsible Charge (ORC): Glenn Price Phone: [phone]
ORC Certification Number: 987931/20771 Check Box if ORC Has Ch nged:
Mail ORIGINAL and Two COPIES to:
ATTN: Non -Discharge Compliance Unit X
(SIGNATURE OF OPERATOR IN RESPONSIBLE CHARGE)
DENR
By this signature, 1 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. E 7
Z Adequate measures were taken to prevent wastewater runoff from the site(s). Q
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. 4
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 -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, inc ding the possibility of fines and imprisonment for knowing violations."
--;Z ` Baron Neal McDuffie
{Signa re of Permitee)* Date (Name of Signing Official -Please print or type)
Baron Neal McDuffie (Authorize gent) Field Services Director (R & A Laboratories. Inc)
(Permittee-Please print or type) (Position or Title)
2N. Riverside Plaza Suite 800 3/31/2021
Chicago. Il 60606 (Permit Exp. Date)
(Permittee Address)
* 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 & ANA1yTfCA1 Report of Analysis
LA 4RATORI ESQ INC. 9/14/2020
t
lj '�
For: Forest Lake Preserve
.�' G�!••, • • .
192 Thousand Trails Drive
Advance, NC 27006
°C'to NC #34
• -
Attn: Tracy Overdurf
w NC #37701
-..
+tip
.f.�rA�,*'�
Client Sample ID: Effluent
Lab Sample ID:
86767-01
Site: Forest Lakes
Collection Date:
8/31/2020 7:35
Parameter
Method
Result
Units
Rep Limit Analyst Analysis Datelrime
Ammonia Nitrogen
SM 4500 NH3 D-2011
51.2
mglL
0.1
FK 9/8/2020
BOD-5
SM 5210 B-2011
11.9
mglL
2
HW 9/1/2020 1600
Fecal Coliform QT
Colilert 18
>2420
MPN1100ml
1
BJ 8/31/2020 1417
Nitrate + Nitrite
SM 4500 NO3 E-2011
<0.05
mg1L
0.05
SK 911/2020 1440
Nitrate Nitrogen
(SM 4500 NO3 E-2011)-(SM
<0.05
mg/L
0.05
SK 9/1/2020 1440
4500 N 02 B-2011)
Total Kjedjahl Nitrogen
Hach 10242
62.3
mglL
1
FK 9/1/2020
Total Nitrogen
Calc
62.3
mg/L
1
Total Phosphorous
SM 4500 P E-2011
6.68
mglL
0.05
BJ 9/9/2020
Total Suspended Solids
SM 2450 D-2011
5.60
mglL
5
AW 8/31/2020
NA = not analyzed
P.O. Box 473 106 Short Street Kernersville North Carolina 27284 TeL [phone] Fax: [phone] www.randalabs.com F3age 1

Research & Analytical
Laboratories, Inc.
Analytical / Process Consultations
Phone [phone]
Water / Wastewater
Misc.
Company Forest Lake
Job No.
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Street Address
Project
Monthly Effluent Sampling
City, State, Zip
Sampler Name (Pie Print}
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Contact
Phone
Sampler Signature
'IX
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Sample Number
(Lab Use Only)
Date
Time
Camp
Grab
Temp
oC
Res.
Cl.
Chlorine
Removed
Y or NI(SorW)lN
Sample
Matrix
Sample Location / I.D.
1Re nested Analysis
CQ i
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Effluent
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(BOD, TSS, NH3N, F.coli
NO3-N, T.Nit, T. Phos)
Refiqquish4 By
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Remarks:
Q .-
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Relinquished By
Date/Time
ec eve By
On Ice
Sample Temperature at receipt 1 °C