WQ0003090_Monitoring (2) - 11-2020_20201222

Monitoring Report Submittal
Permit Number #*
Name of Facility:*
Month:* November
Report Information
Type *
GW-59
wg0003090
town of liberty wastewater plant
NDMR, NDAR-1, NDAR-2, NDMLR
Confirmation Email Address:*
Name of Submitter:*
Signature:
Date of submittal:
Year:* 2020
Upload Document*
nov 2020 groundwater 1.68MB
result.pdf
PDF Only
nov spray report (2).pdf 1.3MB
FDF only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-7, NDAR-2, NDMLR, GW-59).
[e-mail]
tremaine fike
12/22/2020
This will be filled in &Aorratically

Initial Review
Reviewer: Williams, Kendall
Is the project number correct?* WQ0003090
Is the monitoring report r Yes r No
accepted?*
Regional Office* Winston-Salem
Accepted Date: 12/22/2020

FORM: NDMR 10-13 NON -DISCHARGE MONITORING REPORT (NDMR) Page _1_ of _1_
Permit No.: WQ0003090
Facility Name: Town Of Liberty - Wastewater
County: Randolph
Month: november
Year: 2020
PPI:
Flow Measuring Point: [21 influent ❑ Effluent ❑ No Flow generated
Parameter Monitoring Point: ❑ influent ❑J Effluent ❑ Groundwater Lowering ❑ Surface water
Parameter Code -►
S0050
00400
00310
00610
00530
31613
00620
00625
00665
50060
00600
70300
00940
00630
00010
g
o
O
O
Hy
O
U.
a
O
m
o
E
E
��e�
o
[- p
d!
ecoi
m
LL O
O
z
°' �
Y
o z
o
t.. 1p
o yo
f ai L
oQY1
H ,�+
2
0r0p
f' M y
p'
to
= Z
z
i
24-hr
hrs
GPD
su
mg/L
mg/L
/L
#1100 mL
mg/L _,
mg/L
L
mg/L
in L
mg/L
MOIL
mg/L
C
1
491,000
2
7:00
8
591,000
3
7:00
8
460,000
4
7:00
8
328,000
5
7:00
8
320,000
7.08
19,4
12.4
23.8
2420
ND
13
2.3
0.12
13
1
ND
6
7:00
8
328,000
7
1 10:00
2
354,000
81
12:00
2
315,000
91
7:00
8
309,000
10
7:00
8
283,000
11
7:00
8
329,000
12
7:00
8
674,000
7.21
0
13
7:00
8
1,669,000
14
9:30
2
931,000
16
15:30
2
700,000
16
7:00
8
315,000
17
7:00
8
446,000
18
7:00 1
8
401,000
19
7:00
8
367,000
7.34
16
13.3
14.2
1050
0.33
12.4
1.9
0.26
12.6
0.12
20
367,000
21
382,000
22
350,000
23
7:00
8
311,000
7.11
10.2
13
28.1
2420
ND
10.8
2.2
0.1
10.8
175
19.6
ND
24
7:00
8
328,000
25
7:00
8
340,000
26
404,000
271
355,000
28
298,000
291
313,000
30
7:00
8
1,195,000
31
Average:
475,133
15.20
12.90
22.03
1,832.06
0.11
*REF!
2.13
0.12
12.13
175.00
19.60
0.04
Daily Maximum:
1,669,000
7.34
19.40
13.30
28.10
2,420.00
0.33
#REF1
2.30
0.26
13.00
175.00
19.60
0.12
Daily Minimum:
283,000
7.08
10.20
12.40
14.20
1,050.00
0.33
#REF!
1.90
0.00
10.80
175.00
19.60
0.12
Sampling Type:
Recorder
Monthly Avg. Limit:
Daily Limit:
550,000
Sample Frequency: 1
Daily
weekly
2x month
2x month
L2xmonth
2x month I
2x month
2x month
2x month
weekly
2x month I
3x year
3x year
2x month

FORM: NDMR 10-13
NON -DISCHARGE MONITORING REPORT (NDMR)
Sampling Person(s)
Name: GLENN PRICE
Name: GARRETT DREYER
Certified Laboratories
Name: RESEARCH & ANALYSIS LABORATORIES, INC
Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? 21 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.
non compliant on the date of 11/12 11/13 11/14 11/15 AND 11/30
cause of I&I
THE DATE OF11/12 PACE ANALYTICAL COME DOWN AND DO THE PH AND CHLORINE RESIDUAL ON THAT DAY 1T RAIN 3.0 INCHES AND THE LAGOON WAS SPILLING
Operator In Responsible Charge (ORC) Certification
ORC: Elix Tremaine Fike
Certification No.: 989290
Grade: SI Phone Number: 336 622 2990
Has the ORC changed since the previous NDMR? ❑ Yes El No
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
Permittee Certification
Permittee: William Doerfer
Signing Official:
Signing Official's Title: Town Manager
Phone Number: 336 622 4276 Permit Expiration: 8/31/2024
1�
nature Date
I certify, under penalty of law, tr 71this 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 Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

aceAnalytical
www.pacdabs.com
Laboratory Report
Tremaine Fike
Town of Liberty
PO Box 1006
Liberty, NC 27298
Project: Effluent
Pace Project No.: 92504350
Pace Analytical Services, LLC
106 Short St.
Kernersville, NC 27284
336-996-2841
Page 1 of 1
Report Date: 11/30/2020
Date Received: 11 /05/2020
Sample: Effluent
Lab ID: 92504350001 Collected: 11/05/20 11:45 Matrix: Water
Method
Parameters
Results
Units
Report Limit
Analyzed Qualifiers
SM 254OD-2011
Total Suspended Solids
23.8
mg/L
7.8
11/06/20 11:17
SM 521OB-2011
BOD, 5 day
19.4
mg/L
2.0
11/11/20 10:29 L1
Colilert-18
Fecal Coliforms
2420
MPN/100mL
1.0
11/06/20 12:30 1g,El
TKN+NO3+NO2
Total Nitrogen
13.0
mg/L
0.52
11/23/20 15:17
Calculation
EPA 350.1 Rev 2.0 1993
Nitrogen, Ammonia
12.4
mg/L
0.30
11/17/20 16:39
EPA 351.2 Rev 2.0 1993
Nitrogen, Kjeldahl, Total
13.0
mg/L
0.50
11/19/20 00:38
EPA 353.2 Rev 2.0 1993
Nitrogen, NO2 plus NO3
ND
mg/L
0.040
11/23/20 11:07
EPA365.1 Rev 2.0 1993
Phosphorus
2.3
mg/L
0.050
11/12/20 21:43
ANALYTE QUALIFIERS
lg >2419.6
El Reported value should be considered a minimum estimate since it is the maximum reportable number for this method
based on the sample volume used. The true value is likely greater than the value reported.
L1 Analyte recovery in the laboratory control sample (LCS) was above QC limits. Results for this analyte in associated
samples may be biased high.
Reviewed by:
-/< -
Kevin Herring for
Stephanie Knott
336-996-2841
[e-mail]
Pace Analytical Services Asheville
2225 Riverside Drive, Asheville, NC 28804
Fiorida/NELAP Certification #: E87648
North Carolina Drinking Water Certification #: 37712
Pace Analytical Services Eden
205 East Meadow Road Suite A, Eden, NC 27288
North Carolina Drinking Water Certification #: 37738
North Carolina Wastewater Certification #: 40
South Carolina Certification #: 99030001
VirginiaNELAP Certification #: 460222
North Carolina Wastewater Certification M 633
VirginiaNELAP Certification #: 460025

Research & Analytical
Laboratories,inc.
Analytical / Process Consultations
Phone [phone]
CHAIN OF CUSTODY RECORD
Dated
wastewater
misc.
Company wnqf Li.6er4,
Job No.
06
.6
M
0
>
'6
r.
C
9
z
Street Axidress
Project Effluent (1st and Ad weeks)
City, State, Zip,
Sapitr Napie _-1please Print)
Contact
Phone.
Sampt
ul
.Sample Number Penny —Res. 7—hiorine �Sample
(J'ab Uk Only) Date Time Comp:' Grab, C Cl. Removed Matrix Sample Location/ I.D.
--YorN (Sork
Requested Analsis
x
10
W
Effluent
0
BOD, TS& NH3N, F.Coll,
TKN, NO3-N, T. Nitrogen
T. Phosphorus
Efflitent
pH:
TRC:
41k kyed By
0 IV x
Reinarks: March, July, November: Add Cl- and TDS to Effsampting Is-t Wk
7,901inquistted lly
.2eeceived Ify
on tee,
Sompte Temperat"re at receipt -C

raceAna1j&a1
WM.pacalatismim
Laboratory Report
Kevin Coble(AP)
Town of Liberty
PO Box 1006
Liberty, NC 27298
Project: Effluent
Pace Project No.: 92505645
Pace Analytical Services, LLC
106 Short St.
Kemersville, NC 27284
336-996-2841
Page 1 of 1
Report Date: 11/16/2020
Date Received: 11/12/2020
Sample: Effluent
Lab ID: 92505645001 Collected: 11/12/20 11:35 Matrix: Water
Method Parameters
Results Units
Report Limit Analyzed Qualifiers
Performed by
Pace
11/16/20 17:04
Collected By
Garrett
11/16/20 17:04
Dreyer
Collected Date
11/12120
11/16/20 17:04
Collected Time
11:35
11/16/20 17:04
pH
7.21 Std. Units
11/16/20 17:04
Chlorine, Total Residual
0.00 mg/L
11/16/20 17:04
Reviewed by:
Stephanie Knott
336-996-2841
[e-mail]

JL�
Research & Analytical
Laboratories, Inc.
Analytical / Process Consultations
Phone [phone]
ISO# : 92505f 45
1111111111111111111111
'N OF CUSTODY RECORD
_
u Water
E
�, a
O
q. _
i t7
O m
N �{
/ Wastewater
c
d s
W
v d
�? v -�
Ln
a a u
tr - U
ry a a a
o
x
b
x
Ci
E
a =
t U
v C:
C7 d
Misc.
Company Towle of ber4,
Strect Address
Job No.
Project Effluent (2nd., 4th and Sth weeks)
City, State, Zip
Samp�Nanic ,{Phase Print)
Contact Phone
Sampler SLpawre
Sample Sumner
(t.ah Use Onl3')
Date
Time
('nrnp
(;rah
Temp
°C
Res.
C1.
Chlorine
Removed
V or N
Sample
Matrix
S or W1
Sample Location / I.D.
Ret nested Analvs
£
S
W
Effluent
o
No sample - pH, TRC
Effluent
PH: 2
TRC: d C� c
R;a lid.-O—K ied ,,
Date/Time
Received Sy
Remarks
Relinquished By
/ i Date/Time
Received By
On Ice
Sample Temperature at s•eceipt Oc

PaceAnalj&cal
www.paeelabs earn
Laboratory Report
Tremaine Fike
Town of Liberty
PO Box 1006
Liberty, NC 27298
Project: Effluent
Pace Project No.: 92507269
Pace Analytical Services, LLC
106 Short St
Kernersville, NC 27284
336-996-2841
Page 1 of 1
Report Date: 12/09/2020
Date Received: 11/19/2020
Sample: Effluent
Method
Parameters
Lab ID: 92507269001 Collected: 11/19/20 11:50 Matrix:
Results Units Report Limit
Water
Analyzed
HACH 10206
Nitrogen, Nitrate
0.33
mg/L
0.30
11/20/20 16:26
SM 254OD-2011
Total Suspended Solids
14.2
mg/L
5.6
11/21/20 09:48
SM 521OB-2011
BOD, 5 day
16.0
mg/L
2.0
11/25/20 14:15
Colilert-18
Fecal Coliforms
1050
MPN/100ml-
1.0
11/20/20 13:04
D6
Performed by
PACE
11/19/20 11:50
Collected By
Garret Dryer
11/19/20 11:50
Collected Date
11/19/20
11/19/20 11:50
Collected Time
1150
11/19/20 11:50
pH
7.34
Std. Units
11/19/20 11:50
Chlorine, Total Residual
0.26
mg/L
11/19/20 11:50
TKN+NO3+NO2
Total Nitrogen
12.6
mg/L
0.52
12/08/20 13:01
Calculation
EPA 350.1 Rev 2.0 1993
Nitrogen, Ammonia
13.3
mg/L
0.30
12/04/20 13:07
P4
EPA 351.2 Rev 2.0 1993
Nitrogen, Kjeldahl, Total
12.4
mg/L
0.50
12/06/20 14:05
M1
EPA 353.2 Rev 2.0 1993
Nitrogen, NO2 plus NO3
0.12
mg/L
0.040
12/07/20 11:20
P4
EPA 365.1 Rev 2.0 1993
Phosphorus
1.9
mg/L
0.050
12/07/20 22:28
P4
ANALYTE QUALIFIERS
D6 The precision between the sample and sample duplicate exceeded laboratory control limits.
M1 Matrix
spike recovery exceeded QC limits. Batch accepted based
on laboratory control sample (LCS)
recovery.
P4 Sample field preservation does not
meet EPA or method recommendations for this analysis.
Reviewed by: CD�l
Stephanie Knott
336-996-2841
[e-mail]
Pace Analytical Services Asheville
2225 Riverside Drive, Asheville, NC 28804
Florida/NELAP Certification #: E87648
North Carolina Drinking Water Certification #: 37712
Pace Analytical Services Eden
205 East Meadow Road Suite A, Eden, NC 27288
North Carolina Drinking Water Certification #: 37738
North Carolina Wastewater Certification #: 40
South Carolina Certification #: 99030001
VirginialVELAP Certification #: 460222
North Carolina Wastewater Certification #: 633
VirginiaNELAP Certification #: 460025
Qualifiers

Company down
Street Address
City, State, zip
Sample Numher l
Date(Lab[use (?uly)
Rc iltquiskd By
F Relinquished By
Research & Analytic WO# : 92507269
Laboratories, Inc. I I I r
Analytical / Process Consultations
Phone [phone] 92507269 11 1111
Phone
Time
Date/Time
Date/Time
ffAIN OF CUSTODY RECORD
W(der / Wasteivatei:' I Misr.
Project
Effluent (1st and 3r'd weeks)
c
L
�
O
sampler
affl (Ple' Lr Print)
O
a
d
a;
Sawpler
'e a Ftp`e
' e
�-
4
E
_
G`
O
Q
q
ri
c Ci
Temp Res.
('hlorine Sample
m
a
a
a
rah u� Cl.
RemovedMatrix:9:linl?IC I..aC:ttton / I.b.
z
j
�,
y
,
•C
d
/L
Ur N (S o!' W)
N
N
N
N
.a
�.
Cn
X
16,E
10,vJ
I W
Effluent 1
0 1
1
1
1
1 3 1
1 1'
1
17
d By Remarks:
On Ice .
Requested Analysi-
13011, TSS, NH3N, FA
TKN, NO3-N, T. Nitre
T.Phosphorus
Effluent
H: ac,
TRC: 0 • Z b
** March, ,Duly, November: Add Cl- and TDS to Eff sampling 1st Wk ,
Sample Temperature at receipt

aceAnalj6cal
ww.ycelaba.wm
Laboratory Report
Pace Analytical Services, LLC
106 Short St.
Kernersville, NC 27284
336-996-2841
Page 1 of 1
Tremaine Fike
Town of Liberty
PO Box 1006
Liberty, NC 27298
Project: Effluent (1st & 3rd Week)
Pace Project No.: 92507729
Report Date: 12/09/2020
Date Received: 11/23/2020
Sample: Grab
Lab ID. 92507729001 Collected: 11/23/20 11:38 Matrix: Water
Method
Parameters
Results
Units
Report Limit
Analyzed Qualifiers
HACH 10206
Nitrogen, Nitrate
ND
mg/L
0.30
11/25/20 14:52 H3
SM 254OC-2011
Total Dissolved Solids
175
mg/L
25.0
11/23/20 15:37
SM 254OD-2011
Total Suspended Solids
28.1
mg/L
8.1
11/24/20 08:18
SM 521OB-2011
BOD, 5 day
10.2
mg/L
2.0
11/29/20 13:01 1-2,116
Colilert-18
Fecal Coliforms
2420
MPN/100mL
1.0
11/24/20 12:55 El
Performed by
PACE
11/23/20 11:38
Collected By
Glenn Price
11/23/20 11:38
Collected Date
11123/20
11/23/20 11:38
Collected Time
11:38
11/23/20 11:38
pH
7.11
Std. Units
11/23/20 11:38
Chlorine, Total Residual
0.10
mg/L
11/23/20 11:38
TKN+NO3+NO2
Total Nitrogen
10.8
mg/L
0.52
12/08/20 13:01
Calculation
EPA 300.0 Rev 2.1 1993
Chloride
19.6
mg/L
1.0
12/03/20 16:33
EPA 350.1 Rev 2.0 1993
Nitrogen, Ammonia
13.0
mg/L
0.30
12/05/20 15:44
EPA 351.2 Rev 2.0 1993
Nitrogen, Kjeldahl, Total
10.8
mg/L
0.50
12/06/20 13:39
EPA 353.2 Rev 2.0 1993
Nitrogen, NO2 plus NO3
ND
mg/L
0.040
12/02/20 12:26
EPA 365.1 Rev 2.0 1993
Phosphorus
2.2
mg/L
0.050
12/03/20 18:36
ANALYTE QUALIFIERS
El Reported value should be considered a minimum estimate since it is the maximum reportable number for this method
based on the sample volume used. The true value is likely greater than the value reported.
H3 Sample was received or analysis requested beyond the recognized method holding time.
L2 Analyte recovery in the laboratory control sample (LCS) was below QC limits. Results for this analyte in associated
samples may be biased low.
R6 The RPD between valid sample dilutions exceeded 30%.
Reviewed by: -
Stephanie Knott
336-996-2841
[e-mail]
Pace Analytical Services Asheville
2225 Riverside Drive, Asheville, NC 28804
Florida/NELAP Certification #: E87648
North Carolina Drinking Water Certification #: 37712
Pace Analytical Services Eden
205 East Meadow Road Suite A, Eden, NC 27288
North Carolina Drinking Water Certification #: 37738
North Carolina Wastewater Certification #: 40
South Carolina Certification #: 99030001
Virginia/VELAP Certification #: 460222
North Carolina Wastewater Certification #: 633
Virginia/VELAP Certification #; 460025

Research & Analytical
�. Laboratories, Inc.
Analytical / Process Consultations
"bone [phone]
smears} Town Jf Libertp JobNa. �
L'
CHAIN OF CUSTODY RECORD
Vv'ater; E 'rrstclvcrtFcr' E 'A'a c.
reef Address Project EffF►►ent (I.st and 3rd weeks)
.o o'
Ey, Stale, Elf' Sampler Name (ltlease Prirltl
llltaet Pf!ten_e Sa!eIpler SI;;!!atL.re
tmplr Number
.ab Use Only) Rate Time
Relinquished By j 1 j^ Watc/Time
Relinquished By l)atefl'ime
x
e m p 12es. Chlorine Sample
o w
rah
�C. CI Removrd Matrix Sample Location / I.R.
Z a o � o
a:
�
a o:
a;
i'urN SorW
N
a
a a
a
x
W EPOueret
0
3
i
I
Receivi ( Z 3 Remarks:
/Lx e By I
Rer AvW Itv
liet ueSIM Analysis \
DOD, TSS, NI-I3N, IFCoff,
TKN, NO3-N, T. Nitrogeai
T Mi'milhon us
Effluent
PH:
March, .luly,-Noven 66i -Add Cl- and TDS to Eff sampling Ist Wk **
'..r!nlrie�'F'�tr!rlr�•t'.�t�w' •,i ,•�,.i�,f � �. �� _—_�..
K

November 2020
Liberty N.C.W.W.T.F.
Freeboard Lagoon Inches
DATE
1
0
R
1.0
2
0
3
0
4
0
5
0
6
0
7
0
8
0
9
0
10
0
11
0
R
0.5
12
0
R
3.0
13
0
14
0
15
0
16
0
17
0
18
0
19
0
20
0
21
0
22
0
23
0
24
0
25
0
26
0
R
0.2
27
0
28
0
29
0
30
0
R
1.5
TOTAL 6.2

FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page _1_of_2_
Permit No.: W00003090
Did irrigation occur
at this facility?
Facility Name: Town of Liberty - Wastewater
Field Name: 1 Field Name: 2
County: Randolph IMonth: November
Field Name: 3 Field Name:
Year: 2020
4
Area (acres):
19.56
Area (acres):
19.54
Area (acres):
18.98
Area (acres):
16.78
Cover Crop:
FESCUE
Cover Crop:
FESCUE
Cover Crop:
FESCUE
Cover Crop:
FESCUE
0 YES ❑ No
Weather Freeboard
Hourly Rate (in):
0.21
Hourly Rate (In):
0.21
Hourly Rate (in):
0.21
Hourly Rate (in):
0.21
Annual Rate (in):
Field Irrigated?
52
YES No
Annual Rate (in):
Field Irrigated?
52
❑ YES 0 NO
Annual Rate (in):
Field Irrigated?
52
❑ YES No
Annual Rate (In):
Field Irrigated?
52
YESEl No
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°F
in
1
ft
ft
gal
min
In
In
gal
min
to
In
gal
min
In
in
gal
min
in
In
2
C
54
0
326,000
180
0.63
0.21
3
PC
52
0
140,500
90
0.31
0.21
4
5
C
70
0
325,000
180
0.63
0.21
6
7
C
78
0
140,500
90
0.31
0.21
6
9
10
C
74
0
325,000
180
0.63
0.21
11
R
0.5
121
R
3
13
14
15
C
70
0
325,000
180
0.63
0.21
16
17
18
PC
34
0
162,500
90
0.32
0.21
281,000
180
0.62
0.21
19
C
58
0
162,500
90
0.32
0.21
20
21
C
65
0
281,000
180
0.62
0.21
22
C
60
0
325,000
160
0.63
0.21
23
24
26
36
0
325,000
180
0.63
0.21
281,000
180
0.62
0.21
26
R
R
0.2
i
27
28
29
30
R
1.5
31
Monthly
Loading:
0
O.OD
43.44
0
0.00
43.58
2,275,0110
4.41
25.22
1,124,OOD
2.47
33.71
12 Month Floating Total (In):

FORM: NDAR-1 10-13
NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Did the application rates exceed the limits in Attachment B of your permit?
2 Compliant ❑ Non -Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites? 21 Compliant ❑ Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit? 121 Compliant ❑ Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site? ❑✓ Compliant ❑ Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? ❑ Compliant 0 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.
THE LAGOON FREEBOARD IS NON COMPLIANT CAUSE OF RAINFALL AND I&I. Raifa :1
of 6.2
Operator in Responsible Charge (ORC) Certification
ORC: Elix Tremaine Fike
Certification No.: 989290
1 Grade: SI Phone Number: 336 622 2990
Has the ORC changed since the previous NDAR-1 ? ❑ Yes 2 No
Signature Date
By this signature, I certify that this report Is accurrate and complete to the best of my knowledge.
Permittee I
Permittee:
William Doerfer
Signing Official:
Signing Officials Title: Town Manager
Phone Number: 336 622 4276
Signature Date i
1 certify, under penalty of law, th[att this document and all attachments were prepared under my direction or supervision in accordance 4
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 forgathering the information, the
information submitted is, to the best of my knowledge and belief, true, accurate, and complete. 1 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 Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page _2_ of_2_
Permit No.: WQ0003090
Did irrigation occur
Facility Name: Town of Liberty - Wastewater
Field Name: Field Name: 6
County: Randolph Month: IIOvember
Field Name: 7 Field Name:
Year: 2020
8
at this facility?
Area (acres):
18.3
Area (acres):
15.1
Area (acres):
22.12
Area (acres):
21.68
Cover Crop:
FESCUE
Cover Crop:
FESCUE
Cover Crop:
FESCUE
Cover Crop:
i FESCUE
fO YES ❑ NO
Weather Freeboard
LD C
yC .2 m� >ii
a v E
G a i° �a
m ° �a
S I�E Co Q�. G us W
°F in ft It
Hourly Rate (in):
0.21
Hourly Rate (in):
0.21
Hourly Rate (In):
0.21
Hourly Rate (in):
0.21
Annual Rate (in):
Field irrigated?
m o
E m m�
oQ Era
c
,a
52
j 1 YES ED No
0 E a
�,c °2re
Ev Ez'a
$ o
aJ �xJ
Annual Rate (in):
Field Irrigated?
E� m°
og E
'oa i=-
�!Q t
52
Q YES ❑ No
>,e ��c'
'o Eov
o�pp
1 g=J
Annual Rate (in):
Field Irrigated? g
m
E� m ro
3- Em
oa i=
��F
52
YES ❑ NO
=_ _ i
E3a
a
�_
Annual Rate (in):
Field Irrigated?
m o o
E m 03
o-
oa fE-{O_p1
>Q `
52
0 YES ❑ NO
w E of
C o� c
_
Ga Eo°
J w = J
i�
al
min
in
in
gal
min
in
In
gal
min
In
In
gal
min
In
In
1
2
R
1
3
C
65
0
350,000
180
0.59
0.20
4
5
6
C
67
0
350,000
180
0.59
0.20
7
8
9
C
54
0
150,000
90
0.30
0.20
350,000
180
0.59
0.20
10
11
R
0.5
121
13
R
3
14
15
16
C
55
1
0
370,000
180
0.62
0.21
17
PC
56
1
0
160,000
90
0.30
0.20 1
252,000
180
0.61
0.20
18
19
C
54
0
370,000
180
0.62
0,21 1
350,000
180
0.59
0.20
20
PC
32
0
1
150,000
90
0.30
0.20
252,000
180
0.61
0.20
21
22
23
C
58
0
370,000
180
0.62
0.21
24
C 1
61
0
299,000
180
0.60
0.20
252,000
180
0.61
0.20
25
261
R
0.2
271
PC
60
0
370,000 1
180
0.82
0.21
28
C
64
0
350,000
180
0.59
0.20
291
C
51
0
252,000
18Q
0.61
0.20
30
R
F1.5
31
Monthly Loading:
12 Month Floating Total (In):
749,000
1.51
3,13
1,008,000
2.46
41.46
1,480.000
2.46
42.69
1,750,000
2.97
28.89

FORM: NDAR-1 10-13
NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Did the application rates exceed the limits in Attachment B of your permit?
Were adequate measures taken to prevent effluent ponding in or runoff from the sites?
Was a suitable vegetative cover maintained on all sites as specified in your permit?
Were all setbacks listed in your permit maintained for every application to each permitted site?
21 Compliant
❑ Non -Compliant
ED Compliant
❑ Non -Compliant
❑✓ Compliant
❑ Non -Compliant
❑� Compliant
❑ Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? ❑ Compliant ❑O 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.
THE LAGOON FREEBOARD IS NON COMPLIANT CAUSE OF RAINFALL AND W.
Df 6.2
Operator in Responsible Charge (ORC) Certification
ORC: Elix Tremaine Fike
Certification No.: 989290
Grade: SI Phone Number: 336 622 2990
Has the ORC changed since the previous NDAR-1? ❑ Yes 9 No
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
Permittee Certification
PermMee:
William Doerfer
Signing Official:
Signing officials Title: Town Manager
Phone Number: 336 622 4276 Permit Exp.: 8/31 /24
Signature Date
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 property 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 Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617