WQ0013808_Monitoring - 09-2020_20201021

NON -DISCHARGE APPLICATION REPORT Page _of
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDITIONAL PAGES AS NEEDED.
PERMIT NUMBER: WQ0013808 MONTH: September YEAR: 2020
FACILITY NAME: Summerf!eld Constructed Wetlands COUNTY: Guilford
Formulas:
Daily Loading (inches) = [Volume Applied (gallons) x 0.1336 (cubic feetigallon) x 12 (inchestfoot)] I (Area Sprayed (acres) x 43,560 (square feet/acre)] OR
= Volume Applied (gallons) / [Area Sprayed (acres) x 27,152 (gallons/acre-inch)]
Maximum Hourly Loading (inches) = Daily Loading (inches) / (Time Irrigated (minutes) / 60 (minutesrhour)) 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)
Did Irrigation Occur At This Facility:
Yes: No:
Did Irrigation Occur On This Field:
Yes: No:
Did Irrigation Occur On This Field:
Yes: No:
• • • •
FIELD NUMBER:
1
FIELD NUMBER:
2
AREA SPRAYED (acres): 1
0.71
AREA SPRAYED (acres):
0.52
COVER CROP:
Grass/Forest
COVER CROP:
Grass/Forest
PERMITTED HOURLY RATE (inches):
0.3
PERMITTED HOURLY RATE (inches):
0.3
D
A
T
E
WEATHER CONDITIONS
storage
Lagoon
Free -board
PERMITTED YEARLY RATE (inches):
34.75
PERMITTED YEARLY RATE (inches):
34.75
Weather
COW
Temper-atum
at application
Precipitafion
Volume
Applied
Time
Irri gag
Daily
Loadln
Maximum
Hourly
Loading
Volume
Applied
Time
Irri ated
Daily
Loading
Maximum
Hourly
Loading
("F)
inches
feet
gallons
minutes
inches
inches
gallons
minutes
inches
inches
1
C
75
2.1
3
0
0
0.00
#DIV/0!
0
0
0.00
#DIV/0!
2
CI
75
0
0
0.00
#DIV/0!
0
0
0.00
#DIV/0!
3
CI
75
1500
50
0.08
0.09
1000
33
0.07
0.13
4
C
75
1500
50
0.08
0.09
1000
33
0.07
0.13
5
CI
75
1500
50
0.08
0.09
1000
33
0.07
0.13
6
C
75
1500
50
0.08
0.09
1000
33
0.07
0.13
7
C
75
1500
50
0.08
0.09
1000
33
0.07
0.13
a
PC
75
0.05
3
2000
67
0.10
0.09
1000
33
0.07
0.13
9
CI
76
2000
67
1 0.10
0.09
1000
33
0.07
0.13
i0I
Cl
76
2000
67
0.10
0.09
1000
33
0.07
0.13
11
C
76
2000
67
0.10
0.09
1000
33
0.07
0.13
12
CI
76
2000
67
0.10
0.09
1000
33
0.07
0.13
13
CI
76
2000
67
0.10
0.09
1000
33
0.07
0.13
14
Cl
76
2000
67
0.10
0.09
1000
33
0.07
0.13
15
C
78
0.5
2.7
2000
67
0.10
0.09
1000
33
0.07
0.13
16
Cl
76
1
1 2000
67
0.10
0.09
1000
33
0.07
0.13
17
Cl
76
2000
67
0.10
0.09
1000
33
0.07
0'13
lei
CI
76
0
0
0.00
#DIV/0!
0
0
0.00
#DIV/0!
19
Cl
76
0
0
0.00
#DIV10!
0
0
0.00
#DIV/0!
20
CI
76
2000
67
0.10
0.09
1000
33
0.07
0.13
21
CI
76
2000
67
0.10
0.09
1000
33
0.07
0.13
22
C
70
2.2
2.3
2000
67
1 0.10
0.09
1000
33
0.07
0.13
23
CI
75
2000
67
1 0.10
0.09
1000
33
0.07
0.13
24
CI
75
0
0
0.00
#DIV/0!
0
0
0.00
#DIV/0!
25
CI
75
0
0
0.00
#DIV/0!
0
0
0.00
#DIV/0!
26
CI
75
1500
50
0.08
0.09
1000
33
0.07
0.13
27
CI
75
1500
50
0.08
0.09
1000
33
0.07
0.13
29
CI
75
1500
50
0.08
0.09
1000
33
0.07
0.13
29
CI
75
1.6
2.2
1500
50
0.08
0.09
1000
33
0.07
0.13
30
C
75
1500
50
0.08
0.09
1000
33
0.07
0.13
31
Total Ga]IonsJMonthly Loading (inches)
43000
2.23
24000
1.70
12 Month Floating Total (inches)
•
30.86
�O.520099�8
39.38
Average Weekly Loading (inches)
;
0.3963552
Yveaurol L.uuea. L.�-IC , ra.-NnlLly 41YYYy, a.l-L:IYYYyR-lulll, JII-aII VY, JI-aICCL
Spray Irrigation Operator in Responsible Charge (ORC): Chad Leinbach Phone: [phone]
ORC Certification Number: _23928 Check/Box if ORC Has Changed:
Mail ORIGINAL and TWO COPIES to: ;
ATTN: Non -Discharge Compliance Unit '
DENR
Division of Water Quality (SIGNATURE OF OPERATOR IN RESPONSIBLE -CHARGE)
1617 Mail Service Center BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS ACCURATE AND COMPLETE
RALEIGH, NC 27699-1617 TO THE BEST OF MY KNOWLEDGE.
stcl Q�'O
�Ppl`c�s,�,
/veG �
DENR FORM NDAR-1 (5/2003)

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. )
Compliant YN
1. The application rate(s) did not exceed the limits) specified in the permit.
N
2. Adequate measures were taken to prevent wastewater runoff from the site(s).
0
3. A suitable vegetative cover was maintained on the site(s) in accordance with the permit.
YY
4. All buffer zones as specified in the permit were maintained during each application.
YY
5. The freeboard in the treatment and/or storage lagoon(s) was not less than the limits)
N
specified in the permit.
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 non-compliance and describe the corrective action(s) taken. Attach
additional sheets if necessary.
ZONE 1 COMPLIANT - ZONE 2 NON -COMPLIANT for application rate, Freeboard compliant at end of month - 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"
Y
l
i `� �/j }(/ �_— Chad Leinbach az Z�_
(Signature of Permitteer Date • (Name of Signing Official -Please print or type)
Kotis Properties, Inc.
(Permittee-Please print or type)
Post Office Box 9296
Greensboro, NC 27429
(Permittee Address)
ORC
(Position or Title)
919 260-7301
(Phone Number)
If signed by otherthan the permittee, delegation of signatory authority must be on file with the state per 15A NCAC 2B.0506 (b)(2)(D).
7131 /23
(Permit Exp. Date)
DENR FORM NDAR-1 (512003)

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDITIONAL PAGES AS NEEDED.
Page _ of
PERMIT NUMBER: WQ0013808
MONTH: September YEAR:
FACILITY NAME: Summerfield Constructed Wetlands COUNTY: Guilford
Form ulas:
Daily Load ing(inches) =(Volume Applied (gallons) x 0. 1336 (cubic feet/gallon)x 12(inchestfoot)]/[Area Sprayed (acres) x 43,560(square feetfacre)) OR
= Volume Applied (gallons) / [Area Sprayed (acres) x 27,152 (gallons/acre-inch)]
Maximum Hourly Loading (inches) =Daily Loading (inches)/[Toe Irrigated(minutes)/ 60(minutesrtmur)) 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)
2020
.......... ......... _.._..... ..._..__ ,..._.._.., ____._e
Did Irrigation Occur At This Facility:
Yes: No:
...._..__._____... ..
Did Irrigation Occur On This Field:
Yes: No:
Did Irrigation Occur On This Field:
Yes: No:
...
FIELD NUMBER:
3
FIELD NUMBER:
AREA SPRAYED (acres):
0.17
AREA SPRAYED (acres):
COVER CROP:
Grass/Forest
COVER CROP:
PERMITTED HOURLY RATE (inches):
0.3
PERMITTED HOURLY RATE (inches):
D
A
T
WEATHER CONDITIONS
storage
Lagoon
Freeboard
PERMITTED YEARLY RATE (inches):
34.75
PERMITTED YEARLY RATE (inches):
Weather
Code*
Temper -allure
at application
Precipita-tion
Volume
ADDlied
Time
Irrigated
Daily
Loading
Maximum
Hourly
Loading
Volume
Applied
Time
Irrigated
Daily
Loading
Maximum
Hourly
Loading
E
(°F)
inches
feet
gallons
minutes
inches
inches
gallons
minutes
inches
inches
1
C
75
2.1
3
0
0
0.00 1
#DIV/O!
2
Cl
75
0
0
0.00
#DIV/O!
3
Cl
75
300
15
0.06
0.26
4
C
75
300
15
0.06
0.26
5
Cl
75
600
30
0.13
0.26
6
C
75
300
15
0.06
0.26
7
C
75
300
15
1 0.06
0.26
6
PC
75
0.05
3
600
30
0.13
0.26
9
Cl
76
300
15
0.06
0.26
1 o
Cl
76
300
15
0.06
0.26
11
C
76
600
30
0.13
0.26
121
Cl
76
1 300
15
0.06
0.26
131
Cl
76
1
300
15
0.06
0.26
141
Cl
76
600
30
0.13
0.26
151
C
78
0.5
2.7
300
15
0.06
0.26
16
CI
76
300
15
0.06
0.26
17
Cl
76
600
30
0.13
0.26
19
Cl
76
0
0
0.00
#DIV/O!
1 g
CI
76
300
15
0.06
0.26
20
Cl
76
300
15
0.06
0.26
21
Cl
76
1
600
30
0.13
0.26
22
C
70
2.2
2.3
300
15
0.06
0.26
231
Cl
75
300
15
0.06
0.26
24
Cl
75
600
30
0.13
0.26
25
CI
75
0
0
0.00
#DIV/O!
26
CI
75
0
0
0.00
#DIV/O!
27
CI
75
0
0
0.00
#DIV/O!
28
CI
75
300
15
0.06
0.26
29
Cl
75
1.6
2.2
300
15
0.06
0.26
30
C
75
0
0
0.00
#DIV/O!
31
Total GallonsfMonthly Loading (inches)
9000
1.95
0
0.00
12 Month Floating Total (inches)
;
13.69
Average Weekly Loading (inches)
;
0.4546427
0
raeaurer woes. �.crear, -Paruy croauy, --ruuuy, n-ia no , r-arcs.
Spray Irrigation Operator in Responsible Charge (ORC):
Chad Leinbach
Phone: [phone]
ORC Certification Number: 23928 Check Box if ORC Has Changed: ❑
f
Mail ORIGINAL and TWO COPIES to:
ATTN: Non -Discharge Compliance Unit
DENR
Division of Water Quality (SIGNATURE OF OPERATOR IN RESPO HARGE)
1617 Mail Service Center BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS ACCURATE AND COMPLETE
RALEIGH, NC 27699-1617 TO THE BEST OF MY KNOWLEDGE.
DENR FORM NDAR-1 (5/2003)

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
Com liant YN
application rate(s) did not exceed the limit(s) specified in the permit.
Y
2. Adequate measures were taken to prevent wastewater runoff from the site(s).
0
3. A suitable vegetative cover was maintained on the site(s) in accordance with the permit.
y
4. All buffer zones as specified in the permit were maintained during each application.
YY
5. The freeboard in the treatment and/or storage lagoon(s) was not less than the limit(s)
NN
specified in the permit
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 non-compliance and describe the corrective action(s)
taken. Attach
additional sheets if necessary.
See notes on other page.
"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 sign card penalties for submitting false information, including the possibility of fines
and imprisonment for knowing violations."
/10 0Chad Leinbach
(Signature of Permitteer F Oatj(Name of Signing Official -Please print or type)
Kotis Properties, Inc.
(Permittee-Please print or type)
(Position or Title)
919 260-7301
Post Office Box 9296 (Phone Number)
Greensboro, NC 27429
(Permittee Address)
ORC
' If signed by otherthan the permittee, delegation of signatory authority must be on file with the state per 15A NCAC 213.0506 (b)(2)(D).
7/31123
(Permit Exp. Date)
DENR FORM NDAR-1 (512003)

NON DISCHARGE WASTEWATER MONITORING REPORT Page of
PERMIT NUMBER:
FACILITY NAME:
WQ0013808
Summerfield Constructed Wetlands
MONTH: September YEAR: 2020
COUNTY: Guilford
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Flow Monitoring Point: Effluent: Influent:
Parameter Monitoring Point: Effluent: N Influent: Surface Water (SW):
SW Code/Name:
Was There Effluent Flow For This Month Generated At This Facility: Yes: XNo:
D I
A
T
E
Operator
Arrival
Time 2400
Clock
operator
Time On
site
ORC
on
Site?
60050
00400
50060
00310
00610
00530
31616
00625
00620
00665 1
00600
Dairy Rate (Flow)
into Treatment
System
pH
Residual
Chlorine
BOD-5
20`C
NH3-N
TSS
Fecal
Colif.— (Ge
metric Mean')
TKN
Total
Nitrate
Total
Phosph
orus
Total
Nitrogen
HRS
YIN
GALLONS
UNITS
UG/L
MG/L
MGIL
MG/L
1100ML
MG/L
MG/L
MG/L
MG/L
1
1420
1
Y 1
1371
6.78
0.24
2
1243
3
1243
4
1243
5
1243
6
1243
7
1243
8
14:25
0.75
Y
1243
7.09
0.51
9
1271
10
1271
11
1271
12
1271
13
1271
14
1271
15
13:40
1.25
Y
1271
6.67
0.1
16
1286
17
1286
181
1286
19
1286
20
1286
21
1286
22
11:00
2
Y
1286
6.75
0.53
23
1286
241
1286
25
1286
26
1286
27
1286
2s
1286
29
10:30
2
Y
1286
6.8
1 0.99
30
1429
31
1429
Average
1284.871
0.474
#DIV/01
#DIV/0!
#DIV/0!
#NUM!
#DIV/0!
#DIV/0!
#DIV/01
#DIV/0!
Daily Maximum
1429
7.09
0.99
0
0
0
0
0
0
0
0
Daily Minimum
1243
6.67
0.1
0
0
0
0
0
0
0
0
Monthly Limit(s)
31821
NAI
NAI
NAI
NA
NA
NA
NA
NAI
NA
NA
Composite (C) /Grab (G)
IG
IG
IG
IG
G
G
IG
G
IG
Operator in Responsible Charge (ORC): Chad Lelnbach Grade: ll/SI
Check Box if ORC Has Changed:
Certified Laboratories (1): Conner Consulting, LLC
Person(s) Collecting Samples: Chad Lelnbach
ORC Certification Number
(2):
Phone: [phone]
23928
ENCO
r �
Mail ORIGINAL and TWO COPIES to:��
ATTN: Non -Discharge Compliance Unit (SIGNATURE OF OPERATOR IN RESPONSIBLE CHARGE)
DENR BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS ACCURATE
Division of Water Quality AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
1617 Mail Service Center
RALEIGH, NC 27699-1617
DENR FORM NDMR-1 (5/2003)

NON DISCHARGE WASTEWATER MONITORING REPORT
Page of
Facility Status:
Please answer the following question:
com I.ant (Y,N)
1. Does all monitoring data and sampling frequencies meet permit requirements? 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.
Inflow numbers are estimated from July 1st to July 14th because the solenoid was stuck open and dumping water beside the
grocery store. This water did not enter the wastewater system. 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, cluding the possibility of fines and imprisonment for knowing violations."
,OWI`�. / 7L
0/2 J Chad Leinbach
(Signature of Permittee)* D e (Name of Signing Official -Please print or type)
Kotis Properties, Inc.
(Permittee-Please print or type)
Post Office Box 9296
Greensboro, NC 27429
(Permittee Address)
Parameter Codes:
(Position or Title)
[phone]
(Phone Number)
ORC
01002 Arsenic
31504 Coliform Total
00600 Nitrogen, Total
00929 Sodium
01022 Boron
00094 Conductivity
00630 NO2&NO3
00931 SAR
00310 BOD5
01042 Copper
00620 NO3
00745 SuH,de
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 Ma nesium
32730 Phenols
00680 TO
71900 Mercur
00665 Phosphorus, Total
00530 TSS/TSR
01034 Chromium
00610 NH3asN
00937 Potassium
00076 Turbid,
00340 COD
01067 Nickel
00545 Settleable Matter
01092 Zinc
7/31 /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 16A NCAC 26.0506 (b)(2)(D).
DENR FORM NDMR-1 (5/2003)