WQ0020881_Regional Office Historical File Pre 2018 (4)

FORM: NDAR-1 10-13
RECE1V;:l_`NCUENR1DWR-
NOV 0,2020
NON -DISCHARGE APPLICATION REPORT (NDAR-1) WQROS Page 1 of
MOORESVIIIFQGr±InA1n
PermitNo.: W00020881
Facility Name: Div. Of Parks & Rae (Lake Norman SP)
County: Iredell
Month: September
Year: 2026
Did irrigation occur
atthiSfacility?
® YES a No
Fiji Ntatw
$'M ;r+,4 r g
Raid Name:
2
Id' •nttfs
Mid Name:
r,w �
Arca(aereaJ:
t.715
("""vk
Area(aeree):
T All1Crop5
01� .,
Cover Crop:
Woodland
t; Crjt
Cover Crop,
'x[Icut Rlib (i .
""
Hourly Rate (in):
0.4
H NOT
Hourly Rate (in):
At)t►t1� rid)
,
3" ' '�
Annual Rate (in):
30.16
{ AnP46t '°'(G
Annual Rate (in):
Weather
Freeboard
�J2
,
��j k �
CYCS
� i •'yam '��tx,
^; "?
Field Irrigated?
s� ��
a YES m NO
c � e
11, s
-v
Fletd Irrigated?
� ogig
CL
G YES - ONO
•F
in
R
ft
SOMAN WWI
5`1-11O x 5
gal
min
in
In
"'f
*'If11f1l
?, t1li'ipo ( tis"
I
min
In
in
1
CL
71
0.75
3.35
a "3k
�e 6.
t z
ga
2
r
' � "'s+t
�_ y
g
3
-
4
4y
"z: 3cnr.
6�"aa.:
'
yjti
.
NAM Nam
I
71
C
1 76
0.8
3.35
ec 'tr�iw
UMw ft0_wlMQw
MOM
x+
9
mow.. ��
� a�
gRs
s37St1'�4:}
C'R �j
,r '�'
�?ri;'•
'
20
Mom" awftll
13
•
5�-,
&itFj'.M... )'+f .,'
a�qyp ,:
fiM•.C*.+y .1T. �,, .,
)�
��:h
^'n:-l'Si
� sz;:
/
[y. .-
._
1�
14,_
1ti
tY i f5
a,
Pqk,6
�i
ai
18
C
1 70
1 0.2
3.25 1
1iWI N-si "'
w=
17
WW
.mot
�.Mw
Wu' t
� .
22
,....., n
- _.r ..
gg
,
w"Myo
MOM
23
C
1 75 1
1.36
3.4
7
"
09fti M04&.
14
_... v,
25
26
.-
$>'_ fix.
-
5.
"� ..
27
a' :�Rch':t�
�^
A 7
28,E„'
29
R
68
2
325
"
30
;
:,...
31
Monthly
loading.
?'='
t>D
0
0.00
0
O;iJ05lk
k�
0
0100
12 Month Floating
Total Unt:
"i
�,l

FORM: NDAR-1 10.13 NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Page 2 of 2
Did the application rates exceed the limits in Attachment B of your permit? r;,
IN compliant C Ron -compliant
Were adequate measures taken to prevent effluent ponding In or runoff from the sites?
a compliant O Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit?
a compnanc a Noncompllant
Were all setbacks listed in your permit maintained for every application to each permitted site?
a Compliant a "on -compliant
Were all freeboards maintained In accordance with the specified freeboard heights in your permit?
a Compliant o Non -compliant
If the facility is non-c omorrant. please explain in the space below the mason(s) the facility was not in compliance. Pfovide in your wiplanation.the date(s) of the ton -compliance and describe the corrective
action(s) taken. Attach additional sheets If necessary.
operator In Responsible Charge (ORC) Certification Porrnktee Certifleatlon
ORC: Chip White Permitlee: Div. Of Pants & Rec (Lake Norman SP)
Certification No.: 1004687 Signing official: Malcolm Scott Avis
Grade: S2 Phone Number.. 336-50-8990 Signing Of iclars Title: Park Superintendent
Has the ORC,ehsypd since the previous NDAR-12�, o yes a No Phone Number.. 704-528-6350 = Permit Exp.: 9/30/20
Signature Date
ay via siWwwa. I awry the this rapow is w irrola wW complete to ltr best of my lomwledpe.
.d-
I artily. under pwaky or Iar, that Bib docunarr end as aQetlanema awe pmpared un<IN my dedion of suporvlelen let acoadana
rktr a systarn daeiyned to asela Ihsl 0prrfiM psraaaad PAN 1�d aced ayskssled Iha Ydem+avan sub mivad. Based an my
kqu" at ft person or parsons rice marope 1M System. at tlwa Osrram diro ft mspotnbls for 96"wkv tM WOMISUM tM
Mormstion suemead is. to tM Mat of my Mown" end Mlraf. sus, aatafaM and Can PWO. I am ewers dM Owe sm sWaimm
p"Ims for ribmi ing (Siva irramisvon,_ kwkift via possbiRy of titres and imprisonment for krovrkrp vW Wiona.
t
Mail Original and 7Wo Copies to:
Division of Water Resources
Information Processing unit
:. 1617 Mall Service Center
Raleigh, North Carolina 27699-1617

FORM: NDMR 10-13 NON -DISCHARGE MONITORING REPORT (NDMR) Page I of 2
Permit No.: W00020881
I Facility Name: Div. of Parks & Rec (Lake Norman SP)
I County: Iredell
Month: September
your, 2020
PPI:
Flaw Measuring Point: 1R'n— 13E- 13 No Row WemW
Parameter Monitoring Point 13 MflUerit Effkxmt 0 GrwwwmaW Lowering 0 SLNftce wager
Parameter Code ---a-
60060
OQ WO
C0310
00610
00620
00530
4
co
0
0
U)
0
g-,
aA
t7i0
A
0.
V
all
ki
Nr 1W
W
24-hr
firs
P045,
mg/c
mg&
1
10:20
0.5
.1
0
2
4
�5
W-
V,
7
12:00
0.5
771893771
6
Ail
ij-
P
4-5
10
12
3'
13
il,211 M
14
25
"I'l-V "M I,
, ,
—
N,11%1�;,N_P'
IZ71,ct'lil_
16
13:30
0.5
a
?"3911F_q
10
t W",
13.22
;','T 3',.';g
<0.1
19
20
g7,1
.L2a
891,
.23
15:10
0.25
0.01
5k
24
2
z
AS
Lai-
27
9�_
L"i U
28
V
'L
_:
29
13:30
01.25
0
Y:';'s
30
311
1
Average:
0.00
10.00
1:3.22
g13.22
0.00
8.31
Daily Maximum:
0.01
00
3.22
tn
0.10
8.31
Doll Minimum:
0.00
�Wa;w
_10.00
:V
8.31
rw
Sampling Type;
Grab
Grab
crab
W;44
Grab
TWRRA _§5fr�n,
#E�14'0,61T
I
Monthly Avg. Limit:
3,
Daily Um1t:V1
Sample
mon
4XYear
4x Year
_,4
_1V4k
4xYear

FORM: NDMR 10-13 NON -DISCHARGE MONITORING REPORT (NDMR) Page 2 of 2
Sampling Persorgs) Ce"Iflad Laboratories
Name: Chip White Name: Statesville Analytical, Inc.
Name: Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? UR 0 won-Do111item
It the faclity is nlmtompliant, please explain in the space below the resson(s) the facility was not in compliance. Provide in your explanation the date(s) of the non•compilence and describe the corrective
aaoorgei catten. Palaan aaamanat aneem n
Operator in Responsible Charge (ORC) certifk®tion
Permittee Certification
ORC: Chip White
Pennlitee: Div. Of Parks & Rec (Lake Norman SP)
Certification No.:
Signing Official: Malcolm Scott Avis
Grade: S2 Phone Number. 336-549-8990 _
Signing Officiars Title: Park Superintendent
Has since the previous NDAR a yes 6 No
Phone Number. 704-528-6350 Permit Expiration:
yORRCnged
O-
Signature Date
Signature ate
By ""signature. 1 caf ft 8st M raport is acnarata aid cmeptale to Me bast at my Wwakdge.
I cadify, undo panty of bar. that dae document end as snadnerts were prepared under my dh Oka or wrpervlston in
accordance wxh a aphun deslN to naos art N CUmftd pwsonrai prdpm galMarad and evaLMed IM tnformatten
sutfmMd, eased on my hquilry of an parm orpesorm who manage The system. or Ume pwons dYaWpr r*11M la for
yeSheAg ft Ylfams"t, ft Mammon stlaeiiled Is. to to bow or my loorladpa end bOW Uwe. aeraaata, and eamptela. lam
aware tW owe w sgrYftearH penaxNe for subrelf trg Islas I ft stlen. Inehrift the possbft orf nes WA Irnpdsosnera for
1tnVA g violation.
Mail Original and Two Copies to:
Division of Water Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 276MIG17

10-13 NON -DISCHARGE MONITORING REPORT (NDMR) C� Page of
e000.:
.. Hill Airpark-.wan
Month: Septembe
FloW:Measuring Point: fiInfluent 13 Effluent E3 No flowgenerated
- Parameter Monitoring Point: Ginfluent
•
•
! ti
OR 11
1 /
-----------®-'
,
1.
®---------------
Daily Minimum:
NEWT-
f

R 10-13 NON -DISCHARGE MONITORING -REPORT (NDMR)-- -- -- -- —Page— __ of_
e: John Ciolino
Sampling Person(s) Certified Laboratories
Name:
Name: Name:
Zoes--ali monitoring data and sampling frequencies -,meet the requirements in Attachment A of your permit?. ° Compliant o Non -Compliant
A :Ifdhe facility. is- non -compliant, please explain in the space below the reason(s) the facilitywas not incompliance. Provide in your explanation the date(s). of the non-compliance and describe the corrective
-...:- action(s) taken. Attach additional sheets if necessary.
Operator in Responsible Charge (ORC) Certification:.:: =. _.
Permittee Certification
ORC: John Ciolino - _
Permittee: Gold Hill Airpark
Certification No.: 999877
Signing Official: John Ciolino
Grade: Phone.Number: 704-209-1062
Signing Official's Title: ORC
Has the ORC changed since the previous NDMR? °Yes ° No - _ .-_ ".
Phone.Number: 704-209-1962 Permit Expiration: 9/30/20
143/20
10/3/20
Usignature Date
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
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.
Mail Original and Two Copies to:
Division of Water Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

AR-1 10-13
NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Page of
.: W00003687
Facility Name: Gold Hill Airpark
County: Rowan
Month: September
Year: 2020
-- -
igation--occur
his -facility? -
jFat= - _
® YES. _-.❑ Np'
Field Name:
1
Field Name:
Field Name:
Field Name:
Area (acres):
4.868
Area (acres):
Area (acres):
Area (acres):
Cover P�
Grass
Cover Crop:
P:
Cover Crop:
P�
Cover Crop:
P:
Hourly Rate (in):
0.02
Hourly Rate (in):
Hourly Rate (in):
Hourly Rate (in):
Annual Rate (in):
31.2
Annual Rate (in):
Annual Rate (in):
Annual Rate (in):
Weather_. --. ;
Freeboard
Field Irrigated?
° YES ❑ NO
Field Irrigated?
° YES ❑ NO
Field Irrigated?
° YES ° No
Field Irrigated?
° YES Cl NO
o
�w
w
E
Nv
f-
°m
-z
n
-
T a
N °>
�' °
m-C
a
rn
co
oo
J
E
f5
E
Oc
gxJi
E T
o
'
c
Ea°
x0
cy
J
E2
Q°
!
-o
'V
°
Jrn
v
o
E TJco
Oo
1:
EE Qm
°
ECD
rnc
cx°
E -Tc
Jm
CO°
°F I
in
ft
ft
gal
min
in
in
gal
min
in
in
gal
min
in
in
gal
min
in
in
1
R
80
0.27
2
R
79
0.06
3
C
83
14,400
360
0.11
0,02
4
C
83�
14,400
360
0.11
0.02
5
C
72
14,400
360
0.11
0:02
6
C
73 1
_
14,400
360
0.11
0.02
7
C
74
14,400
360
0.11
0.02
.8
C
76
4.9
14,400
360
0.11
0.02
9
R
77
0.49
10
R
81
0.01
11
PC
77
12
CL
79
14,400
360
0.11
0,02
13
PC
78
14,400
360
0.11
0,02
14
PC
72
5
14,400
360
0.11
0,02
15
C
68
14,400
360
0.11
0.02
16
PC
68
14,400
360
0.11
0.02
171
R
1 71
1.81
181
R
1 63
0.01
19
PC
58
20
C
59
14,400
360
0.11
0.02
21
C
59
4.9
14,400
360
0.11
0,02
22
C
59
1
1
5,300
132
0.04
002
23
C
64
24
R
66
0.05
25
R
64
0.93
26
CL
66
27
PC
66
28
PC
72
29
R
70
0.2
30
C
62
4.9
31
Monthly L;ading:l
192,500
1.46
0
''
0.00
"'`
0
0.00
0
0.00
12 Month Floating Total (in):
21.09
3,gg i�c1�4,°

10-13 NON -DISCHARGE APPLICATION-REPORT--(NDAR-I)--
_Page of
pplication rates exceed the limits in Attachment B of your permit?
ra Compliant ❑ Non -Compliant
quatemeasures taken to prevent effluent ponding in or runoff from the sites?
F
A Compliant ❑ Non -Compliant
itable:vegetative cover maintained on all sites as specified in your permit? _..
Compliant n Non Compliant
«=Were --all-'setbacks 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 ❑ Non Compliant
Ifthe.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.
Operator in Responsible Charge (ORC) Certification'_--- :_:_ =
Permittee Certification
ORC: John Ciolino
Permittee:
Gold Hill Airpark
Certification No.: 999877
Signing Official: John Clolino
Grade: •-- . Phone Number: 704-209-1962
Signing Official's Title: ORC
Has the ORC changed since the previous NDAR-17 ❑ Yes © No -
Phone Number: 704-209-1962 Permit Exp.: 9/30/20
10/3/20
10/3/20
Signature Date
gnature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
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

FORM: NDMR 10-13 NON -DISCHARGE MONITORING REPORT (NDMR)
Sampling Personls) Certified Laboratories
Name: Chip White Name: Statesville Analytical, Inc.
Name: Name:
Page 2 of 2
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? 0 Compiant ° Non-compbrit
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
actions) taken. Attach additional sheets if necessary.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Chip White
Permittee: Div. Of Parks & Rec (Lake Norman SP)
Certification No.:
Signing Official: Malcolm Scott Avis --
Grade: S2 Phone Number:. 336-549-8990
Signing official's Title: Park Superintendent
Has the OR gad since the previous NDM 0 yes ® No
Phone Number. 704-52M350 Permit Expiration:
Signature Date
Signature Date
By this s4rdmxe. I certdy that this report is onurate aW aemptste to cite bet of my lmowl6d".
i cattily, fader persM of law, that two deamera and as eltedmeMs wen prepare! War my cw ion ar supervision In
eeeerdarm with a systern designed to assure Bra av rµnGfed peraom w F."oly gathered and evaanlea ate Mormatton
submitted. Based an my iipu:ry or the person or persons who mange the system. or eese persons d'netH tasponslbb for
gaftAM the I dormaliM the k%or fish t submitted Is, to the bet of my, loaadedga and bePM. hue, eauMe. aW complete. I am
aw a that then we sigr ifeem peruallas for submitting take inlormelion, eeardwg the pms"ty of frees aW Irnprisomment few
"Mir p vioreiorm.
— Mail Original and Two Copies to:
Division of Water Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 278994617

FORM: NDMR 10-13 NON -DISCHARGE MONITORING REPORT (NDMR)
Page I of
Permit No.: W00020881
Facility Name., Div. of Parks & Rec (Lake Norman SP)
County: Iredell
Month: August
Year. 2020
PPI,.
Flow Measuring Point; M Influmt, 13 Ent mt 13 No now oemrated
Parameter Monitoring Point: 0 InSuent 13 Efterit 13 Groundwater to OMP 0 surface water
Parameter Code ---v-
50060
e,—, 0�5
C0310
1, OF
OOGIO
00620
�—�,OWpgwj
00530
Zooks;x
Y,
-.o
0
P
0
0
42
0nt
n.
Ktz
fM1 v.
0
M
W,
z
24-hr
hre
fA'00,!D'?,T.
MAIL
mgL
'01O41i1L-1
MOL
.,141—L
MWL
mgrL
2
14
IVA"
3
3
-FRT
10:15
0.5
0.01
S,
6
6
7
7
10
11:10
0.5
�t-.rV462.,'71
0
P1�Vj482T�j
12
13
. . . . . .
14
6
N�
17
18
09:35
0.5
4
4", 02
0
*fr8t82f,
19
20
211
1
22
23
24
;,w n,
y-
2
13:25
0. 5
.01
A
n
A
M.
WIR
Xv
.L7
28
29
30
0.
311
Average:
0.01
plr,&��t-r�
Daily Maximum:
�_�-%�_482VM
0.01
PA-,G-ivz`49
Daily minimum:
0-00
Sampling Type;
Rb6cftrq.
Grab
Grab
ra
Grab
It: Monthly Avg. Urn
U, "N
Daily Limit:
Sample Frequency:
0*6!
Monthly
3Mttrek.r
4x Year
"I
_Ix Year
4xY@ar

FORM: NDAR-1 10.13 NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Page 2 of 2
Did the application rates exceed the limits in Attachment B of your permit?
®cen+r cant o NomCempllaM
Were adequate measures taken tdprevent effluent ponding in or runoff from the sites?
m compliant CI Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit?
0 Compliant o Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site?
o compliant O NarComplla t
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
0 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.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Chip White
P°n"in°BC Div, Of Parks & Rec (Lake Norman SP)
Certification No.: 1004687
Signing Official: Malcolm Scott AAS
Grade: S2 Phone Number.:; 336-549-8990
Signing Officiars Title: Park Supefintendent
Has the ORC c anged since the previous NDAR-1? o yes la No
Phone Number: 704-528-6350 Permit Exp.: MOM
Signature Date
Signature Date
By this signekae. I eerily that thk roper!, k ocaarats andcomplate to the bust of my krwmWdge.
I ean7y, under penalty of tour, that this doeumad and al stasehmerea were prepared under my direction or supervision In aeeaMartee
well a system designed to assure [hat all pua6ried personnel properly gmhefird and wall med the Information submitted Based on my
'r"116ty of the person or pmons who manage Inn system, or those persons d'rselly responsible For gaeerng the imormet'bn, the
infermation submitted Is. to the best of my knowleiige sod bellaf, tne, separate, and compete. 1 sm ware that there six slgNreaat
.
porelhos fa submitting rake I km a %,indudi g the possibility of fees and Yttprisomnant for krawing violations.
Mail Original and Two Copies to: , -
Division of water Resource$
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

RECEWED/NMENRIDWR
NOV 0 4 2020
FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page I of 2
Permit No.: W00020881
Facility Name: Div. Of Parks & Rec (Lake Norman SP)
County: Iredell 14RA&WILMOMON/
L Map2020
Did Irrigation occur
at this facility?
® YES a NO
Field Name;
2
'Iowa
Field Name:
Area (acres):
1.715
F
Area (acres):
Cover Crop.
Woodland
p: Cover Cro
v,
Hourly Rate (in):
0.4
ate
Hourly R (in)
Annual Rate (in):
30.16
a <
ti
Annual Rate (in)
Weather
Freeboard
Field I gated?
0 YES ONO
led?
Field irrigated?
0 YES ONO
O
5
2
2
C
03
CL
(D 90
CL
>
V
10,
.S
x
.
Z� 1,
, I
CL
Z CL
>
V
_j
E
j
F
In
ft
It
4.11,Wh'
gal
min
In
in
�.P50:,"IrP
gal
min
In
In
C
72
275
T4
6
A
81
9
Rt
10
C
78
1.35
3'3
41f,'
28.600
225
0.61
0.16
-5,
12
T
777 z1
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17
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231
24
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84
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28
29
30
31
lz !Vlm�
Monthly Loading
` '2 M'l
0.5 6::�2
28,600
0.61
0
0.00
12 Month Floating Total Uni.,

j
FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Page 2 of 2
Did the application rates exceed the limits In Attachment B of your permit?
i
a CompiteM D Nah CompllaM
Were
adequate measures taken to prevent effluent ponding in or runoff from the sites?
a t:omptlant D Norh-ComptleM
Was
Were
la suitable vegetative cover maintained on all, sites as specified in your permit?
all setbacks listed in your permit maintained for every application to each permitted site?
a comoant D Non-c mp lant
a Complier* D NomCompgant
were
all freeboards maintained in accordance with the specified freeboard heights in your permit?
a c mpWA D Non{bmplWd
N the
facility Is noncompitant, please.expialn In the space below the reason(&) the facility was not in compliance. Provide in your explattation the date(a) of the non-compliance and describe the corrective
acllon(s) taken. Attach additional sheets if necessary.
NC I)" Of 8nvironrnentai
A m 3 2020
1?OZ
Operator In Responsible Charge (ORC) Cemdatlop : Parmlttee Certification 1(
oRc: Chip Vlfittte Pennktea: Div. Of Parks & Rec (Lake Norman SP)
certlfleaUon No.: 1004687 signing.official: Malcolm Scott Avis
Grade; S2 Phone Number. •336-54941990 Signing Official's nee: Park Superintendent
Has the ORC changed since the previous NDAR-1? D let a No Phone Number: 704-52"350 Permit Exp.: _ 9/30/20
�'— 7 /7-
7 / 7 �zo,Zo
Signature Date Signature Date
9y Oils signsus. I eartly that mN report is &mush and eanplet• to the bast of my krhowwoe• _ t tally. mhder penstly at Wis. eat Oft deehment WA a1 atlAdmerts wen prepared under my dtraden or stpoviaton In seeordsnee
With a system dsalgrad to ass" OW all gwaW Wow" properly gathered and evskaw ea WMmsuon submRua aced an my
Ingmry or the parson a persons who marmite the system. or mete peons dkeetly to peMEY for gst1wi g the klel sib h. Oe
Information stbmilted Is. to fat bast of my khws9edgs and bslW. ire, accosts, and caapWa. I am aware that then art sion kart
Pr OM for admitting fees aformstkw% andufng am pesb ay of man and knpdsomnerht for krewkq vtdadore.
Mail Original and Two Copies to:
Division of Water Reacumes
Infons ation Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 276MIS17

Did irrigation occur Field Name: 2
at this facility? Area (&ores): 1.715
Cover Crop: Woodland
® YES o No Hourly Rate (In), 0.4
Annual Rate (in): 30.16
IMaaftr Freeboard Fleld Irrfgsted7 u ng o No
3 F- o. +� v
•F in ft ft I min I in in
_____y`.�-- - ter- -- ., _f---_^---- - - -- —�• -----j—�--
iiiiiii1lllllll, lllllll, lllllll, lllllll, ".., »-- - �... _ .. ._-•,I-iiiiiiiiii, iiiiiiiiiii, iiiiiiiiiiii1 r`•. - _ • _ _-_ _ �

FORM: NDMR 10-13
NON -DISCHARGE MONITORING REPORT (NDMR)
Sampling person(s) Certified laboratories
Name: Chip White Name: Statesville Analytical, Inc.
Name: Name:
Page 2 of 2
noes all monitoring data and sampling frequencies most the requirements In Attachment A of your permit? m con"ant o aan•tanpnertt
If the facility is non -compliant, please explain in the space below the reason(s) the fact ty was not in compliance. Provide in your explanation the date(s) of the non-compliance and describe the aorettive
action(s) taken. Attach additional sheets if necessary.
Operator In Responsible Charge (ORC) Certification
Pen nittee Certification
ORC: Chip White
Pertntttee: Div. Of Parks 3 Rec (Lake Norman SP)
Certification No.:
Signing Official: Malcolm Scott Avis
Grade: S2 Phone Number. 336-549-8990
Signing Officlare Idle: Park Superintendent
Has the ORC c since the previous NDMR? ° Yes ® No
Phone Number. 704-528-6350 Permit Explretion:
-`�7 Zd
727117020
Signature Date
Signature Date
By IMF egnsue . I "niy tlm etls report Is secwrate aid compote to the beat of my krowhedpe.
I arnfy, uMer pordAY of low, mat this documaN and al atteamems wen
aeeww" With a $"Ism destpned to ant" eat al worm pwmml o wrier my dkedlort or he War g In
prop" griMrad sari awaatad Ifte Warm gun
stbmited. Based en my ktgtriry ar the pwsen crpwwne wtta mernpe me system. or n,a s nere, diredly rosponsbb far .
0 the t hnna0 m, qe wAft t Ban submiled b, to Me beat army hw4leoge and baler. true, awrft mid compuft. t am
wan that men we aipnikard pwakias for w6mitlkq false Wm, &I! , in kmft the pmbft of rwaa and knprBonment far
Wlm" tifebnata.
Mail Original and Two Copies to:
Division of Water Resources
Infomtatfon Processing unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

Was

9: NDMR 10-13 NON -DISCHARGE MONITORING REPORT (NDMR)W Page 1 of 2
Facility Name: , Div. of Parks & Rec (Lake Norman SP)
County: Iredell
Month: February
IRWT.�.ZIWII
ffW00020881
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FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page 2 of 2
Did the application rates exceed the limits in Attachment B of your permit?
t+ Compliant u Non•Compt!ant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites? o Compliant o Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit? L� Compliant U Non-Cortotant
Were all setbacks listed in your permit maintained for every application to each permitted site? a Compliant 0 Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? 0 compliant z 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•comptiance and describe the corrective
nrtinnW taken ANarh additional sheets if necessary.
Operator in Responsible Charge (ORC) Certification
ORC: Chip White
Certification No.: 1004687
Grade: S2 Phone Number. 336-549-8990
Has the ORC­cKa_n9e)I since the previous NDAR-17 ^, n Ties a No
Signature Date
13y Ih:s s:g: alure. 1 certdy that Ids M.O. a acau,rate arW complete to the Lest of my knowledge
Permittee Certification
Permittee: Div. Of Parks & Rec (Lake Norman SP)
Signing Official: -'o� A
Rueflt— C. t %
Signing Official's Title: Park Ramer (acting Park Superintendent)
Phone Number: 704-528-6350 Permit Exp.: 9/30/20
Signature Date
I comity, under penalty of law, that ]his document and all attachments were prepared antler my daedtron or superv,sron n acccfdance
with a system resigned to assure that all quathed personnel propety gathered and evaluated the inrormatan submitted, eased a, my
rwuay of the Verson of persons who manage the system, or those parsons deectly responsible !ur gatharvud 11ur nlormalmn. the
:nformatmn suommed ,s, to the best of my knowledge and bet?ef, itue, accurate, and complete t am aware that (here aro svndicant
penaR,es for submitlir g false ntcrrnafion, nxtuding the pOssrhAdy of Iwos and !mpnsonmeni for knowing v:dlatm^s
Mail Original and Two Copies to:
Division of Water Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

10-13 NON -DISCHARGE MONITORING REPORT (NDMR) Page 1 of
o.: WQ0020881
Facility Name: Div. of Parks & Rec (Lake Norman SP)
County: Iredell
Month: January
Year: 2020
PI:
Flow Measuring Point: a Influent ° Effluent ° No flow generated
Parameter Monitoring Point: ° Influent 0 Effluent a Groundwater Lowering ° Surface Water
ammeter Code —r
`..'
S0060
"{�
C0310
'0 '
00610
00620
-
00530
66, c
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for:
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ar
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24-hr
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9
m mg/L
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2 WO
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MM M
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Average:
0.02
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��- 0.00
V �_���� ` 67.50
0
Dail Y Maximum:
._ Y - _ 0.02
� � � .: 9.60
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~��, , ; � s� 67.50
Daily Minimum:
.: 0.00
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-..... 67.50
(?
Sampling Type:
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' i Grab
i
Grab
,..
a `
b GrabMonthly
Avg. Limit:
^�•
•LDaily
Limit:
;, 1
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hSample
Own"
Frequency:
Monthly
8 4x Year141-10
r Jai
4x Year
`
X _ 4xYear
5J-
!ICE

FFDMR t0-13
Name: Chip White
Name:
Sampling Person(s)
NON -DISCHARGE MONITORING REPORT (NDMR)
Certified Laboratories
Name: Statesville Analytical, Inc.
Name:
Page 2 of 2
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of 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.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC:
Chip White
Permittee: Div. Of Parks & Rec (Lake Norman SP)
Certification No.:
Signing Official: Will Ruark
Grade:
S2 Phone Number: 336-549-8990
Signing Official's Title: Park Ranger (Acting Park Superintendent)
Ha7theO
anged since the prev' us ND R? a Yes 0 No
Phone Number: 704-528-6350 Permit Expiration:
Signature Date
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
I certify, under penally of law, that this document and ell 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

10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page 1 of 2
No.: : WQ0020881
Facility Name: Div. Of Parks & Rec (Lake Norman SP)
County: Iredell
Month: January
Year: 2020
ir
id irrigation occur
Field Name:
2
Field Name:
Area (acres):
1.715
q IWOM
P no IR
Area (acres):
t t
at this facility?
Cover Crop:
Woodland
terCover
Crop:
Hourly Rate (in):
0.4
Hourly Rate (in
YES
NO
WINVO,
MIN,
Annual Rate (I n):
30.16
n
Annual Rate (in):
Weather
Freeboard
Field Irrigated?
13 YES m NO
2
Field Irrigated?
YES m NO
a
a
CL M
a) 13
cm
E 0)
MAN
W 13
13
cn
E co
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MIT)
0
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12 Month Float

10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Dn rates exceed the limits in Attachment B of your permit?
ieasures taken to prevent effluent ponding in or runoff from the sites?
egetative 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?
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
Page 2 of 2
0 Compliant o Non -Compliant
o Compliant a Non -Compliant
o Compliant 13 Non -Compliant
ra Compliant u Non -Compliant
ra 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.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORc: Chip White
Permittee: Div. Of Parks & Rec (Lake Norman SP) -
Certification No.: 1004687
Signing Official: Will Ruark
Grade: S2 Phone Number: 336-549-8990
Signing Official's Title: Park Ranger (Acting Park Superintendent)
Has the ORC changed since the previous NDAR-1? a Yes 0 No
Phone er: 4-528-6350 Permit Exp.: 9/30/20
'% ,/6)
C/
Signature Date
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
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 an 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

AR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page 1 of 2
Permit No.: WQ0020881
Facility Name: Div. Of' Parks & Rec (Lake {Norman SP)
County: Irede9 Month: March
Year: 2020
Did irrigation, occur
�
' ai(d ADa[t19
�� �€ �
'F1 ,'
�� ��
Field Name:
—
?.
fir ld£�larq'
,
t,r
���
Field Name:.
1 Kea �GYeeB}
��
§ �t'ii5
__
Area (acres):
1,715
�' rfl sti 9
� � ,� }
` � �. �, ,;
Area (acres):
at this facility.
nr t�vgiCsoplllfootllaitivr
Cover Crop:
--
Woodland
Cover Crop:
YES
Weather Freeboard
"
04
Hourly Rate (in):
t Fie da(tigateir145w
Annual Rate (in):
Field irrigated?
30.18
m YES NO
"Apt#tta) i2 t)j
F r �XF(ttljirr�ed?�tps
i�
`" a
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Field Irrigated?
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12 Month Floating Total (in):

NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1)
15id 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?
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
Page 2 of 2
- Compliant Q Non -Compliant
to compl;art 0 Non compliant
V complart 0 Non -Compliant
- compliant - r4on-rornpliant
Q Curnp1jant 0 l4on-Compliani,
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,
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC.-_ Chip White
Permittee:
Div. Of Parks & Rec (Lake Norman SP)
Certification No,: 1004687
Signing Official: Malcolm Scott Avis
MAIA
Grade: S2 Phone Number: 336-549-8990
Signing Official's Title: Pa+-RangeftAefing Park Superintendent)
Has the ORC changed since the previous NDAR-1? 0 Yes a No
Phone Numbdr: 704-528-6350 Permit Exp.: 9/30120
ILI 7 7
Signature Date
Signature Date
By this Siflnithire. I rectify that this repoitni arcu,ale and =noletew In- best of my kriowh�dgo
I ce(VV. under penafty of law, that INN document and ail attachmems were prepared urivef toy dirriclion or supervision .ri accordance
with a rystern designed to assre that a qualified personnel Properly gathered and evaluated the information submitted. eased on my
irjqu;ry of the person or persons who manage me system, of those persons directly rosponsolL for gathering the information. ma
information submitted is, to the best of my knowledge ana belief, True, accurate, and complutu, lern aware that there are significant
penalties lot submitting false mformabon, inaiudirig the possibilay of tines 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

R 10-13 NON -DISCHARGE MONITORING REPORT (NDMR)
Page I of 2
It No.: WQ0020881
Facility Name- Div. of Parks & Rec (Lake Norman SP)
County: Iredell
Month: March
Year:
1 2020
7 P1
Flow Measuring Point: a influent c, Effluent 13 No flow generated
Parameter Monitoring Point: Influent 0 Effluent 0 Groundwater Lowering Surface Water
Parameter Code I.
Par,pme
MOM
50060
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Sample Frequenc
%kM
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4x Year
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Y�54
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IDWR
L OFFIC
1%1-75 o.L%12- G-56

NDMR 10-13 NON -DISCHARGE MONITORING REPORT (NDMR) Page 2 of 2
Sampling Person(s) 11 Certified Laboratories
Name: Chip White II Name: Statesville Analytical, Inc.
Name: Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? a 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.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Chip White
Permittee: Div. Of Parks & Rec (Lake Norman SP)
Certification No.:
Signing Official: Malcolm Scott Avis
A40A
Grade: S2 Phone Number: 336-549-8990
Signing Official's Title: Park Superintendent)
Has the ORC changed since the previ us NDMR? ° Yes m No
Phone.Number: 704-528-6350 Permit Expiration:
10
19
Signature Date
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
I certify, under penalty of low, 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, [rue, 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
RECEIVED/NCDENR/DWR
MAY 04 2020
WQROS
MOORESVILLE REGIONAL OFFICE

1-13 NON -DISCHARGE MONITORING REPORT (NDMR)
Page 1 of 2
Q0020881 _T
Facility Name: Div. of Parks & Rec (Lake Norman SP)
County: Iredell
Month: May 7
Year: 2020
I rter
1 Flow Measuring Point: 111 Influent 13 Effluent 0 No flow generated
Parameter Monitoring Point: 13 Influent 13 Effluent 0 Groundwater Lowering 0 Surface water
Code b-
50060
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1101A,

10-13 NON -DISCHARGE MONITORING REPORT (NDMR) Page 2 of
Chip White
Name:
Sampling Person(s)
Certified Laboratories
Name: Statesville Analytical, Inc.
Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? o 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.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Chip White
Permittee: Div. Of Parks & Rec (Lake Norman SP)
Certification No.:
Signing Official: Malcolm Scott Avis 7 Le ai-C re v I S e
Grade: S2 Phone Number: 336-649-8990
Signing Official's Title: PaFk o,^^9r (e�VPark Superintendent)
Has the ORC changed ce the previous NDMR? Yes o No
Phone Number: 704-528-6350 Permit Expiration:
Signature
Date
Signature Date
By this signature, I certify that this report is accurrale and complete to the best of my
knowledge.
I certify, under penally 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 an 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

NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Page I of 2
WQ0020881
Facility Name: Div. Of Parks & Rec (Lake Norman SP)
County: Iredell
Month: May
Year: 2020
rrigation occur
i I rrig'
at this facility?
[a YES 0 NO
�K
Field Name:
2
Field Name:
t %
Area (acres):
1.715
Area (acres):
AR 101V R
Cover Crop:
Woodland
Cover Crop:
Hourly Rate (in):
0.4
15i NON't 'A' OF
Annual Rate (in):
30.16
Annual Rate (in):
Weather
Freeboardfir
5'
, !
Field Irrigated?
0 YES 0 NO
Field Irrigated?
0 YES NO
WS
CD
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12 Month Floating Total (in):1
NUNN
rm"1110%

10-13
NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Page 2 of 2
n rates exceed the limits in Attachment B of your permit?
measures taken to prevent effluent ponding in or runoff from the sites?
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?
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
O Compliant ❑ Non -Compliant
O Compliant O Non -Compliant
o Compliant O Non -Compliant
0 Compliant ❑ Non -Compliant
O 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.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Chip White
Permittee:
Div. Of Parks & Rec (Lake Norman SP)
Certification No.: 1004687
Signing Official: Malcolm Scott AviseaS{ i' a vf�S c
Grade: S2 Phone Number: 336-549-8990
Signing Official's Title:-Par-'(FR3Rg g Park Superintendent)
Has the ORC c nged since the previous NDAR-1? O Yes O No
Phone Number: 704-528-6350 Permit Exp.: 9/30/20
(- R3
Signature Date
Signature Date
By this signature, I certify that this report is accurrale and complete to the best of my knowledge.
I certify, under penally 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.
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 1 of 2
Perm!tNo.: W00020881
Facility Name: Div. Of Parks & Rec (Lake Norman SP)
County: Iredell Month: April
Year: 2020
Did irrigation occur
at this facility?
o YES a noHourly
LIMA "I'MON
�'.' , ", . I " - " - I , ,
Field Name:
2
. ­
Field Name:
Area (acres):
1.715
ABOR BE
Moffise
Area (acres):
Cover Crop:
Woodland
, w
Awc­ -
Cover Crop:
Rate(n:
0.4
IN
=
Hourly Rate (in.
Annual Rate (in):
30.16
Annual Rate (in):
Weather
Freeboard
Fieldrr g
NO
'' =
y)' r -"
Field Irrigated?
0 vEs 4 NO
E
fn
06
>4
Cb
-
'E
a M
E
5
m
a MEN. 1415
Man
0,0
15-2
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Monthly Loading:
0
0.00
0.00
2 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?
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?
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
Page 2 of 2
• Compliant
o Non -Compliant
m Compliant
u Non -Compliant
a Compliant
❑ Non -Compliant
a Compliant
© Non -Compliant
m 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(sl taken. Attach addifinnal shoot. if ... a --
Operator In Responsible Charge (ORC) Certification
Permittee Certification
oRC: Chip White
Permittee:
Div. Of Parks & Rec (Lake Norman SP)
Certification No.: 1004687
Signing official: Malcolm Scott Avis
Grade: S2 Phone Number: 336-549-8990
Signing Official's Title: Park- RengeHri letiftg Park Superintendent)
Has the ORC ch nce the previous NDAR-1? o y a No
Phone Number: 704-528-6350 Permit Exp.: 9/30/20
JQ(.oao
Signature Date
Signature Date
By mis signature, I certify trial th'.s report is accurrato and cemplolo to tho boll of my knowledge
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 submlaed, Based on my
inquiry of the poison 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 kncwing violations
Mail Original and Two Copies to:
Division of Water Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

FORM: NDMR 10-13 NON -DISCHARGE MONITORING REPORT (NDMR) Page 1 of 2
Permit No.: WQ0020881
Facility Name: Div. of Parks & Rec (Lake Norman SP)
County: Iredell
Month: April
Year: 2020
PPI:
Flow Measuring Point: m influent o Effluent o No flow generated
Parameter Monitoring Point: ° influent u Effluent o Groundwater Lowering C Surface Water
Parameter Code —i
50060
C0310
00610
10 ,:
00620
"t
00530
jw
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t]
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t
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m
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mg/L
mg/L
_
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f '
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Ak t
Month) Avg; Limit
Daily Limit
Sampie Frequency:
Monthly
k
U Year
f E <i
4x Year
:"
;e4
lx Year
s

FORM: NDMR 10-13 NON -DISCHARGE MONITORING REPORT (NDMR) Page 2 of 2
Sampling Person(s) Certified Laboratories
Name: Chip White Name: Statesville Analytical, Inc.
Name: Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? c 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.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Chip White
Permittee: Div. Of Parks & Rec (Lake Norman SP)
Certification No.:
Signing Official: Malcolm Scott Avis
Grade: S2 Phone Number: 336-549-8990
Signing Official's Title: Pak -Rangep (Acting Park Superintendent)
Has the OR nged since the previous NDMR? o Yes m No
Phone Number: 704-528-6350 Permit Expiration:
,2U,za
Signature Date
Signature Date
By this signature, I certify that this report is eccurrate and complete to the best of my knowledge.
I candy, under penalty of raw, that this doaumont and at attachments were prepared under my direction or supervision in
accordanao with a system designed to assure that all qualified personnel property gathered and evaluated the information
subrnitlod. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible tar
gathering the Information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I em
aware that there are significant penalties for submitting false information, inauding the possibiifty 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

)MR 10-13 NON -DISCHARGE MONITORING REPORT (NDIVIR) - Page I of 2
PrPe,miCNo.: WQ0020881
Facility Name: Div. of Parks & Rec (Lake Norman SP)
County: Iredell
Month: March
Year: 2020
ppl,
Flow Measuring Point: GlInfluent- 0 Effluent 0 f4o flow generated
Parameter Monitoring Point: 0 Influent Effluent 0 Groundwater Lowering n Surface %^rater
Parameter Code
>
CI
0 0
�.4
<
— �;;'�`
50060
10-
U,
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Sampling Type:
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Daily Limit:
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Sample Frequency,
�00'41!
4x Year
A
4x Year
4)(Year

NDMR 10-13 NON -DISCHARGE MONITORING REPORT (NDMR) Page 2of2
Sampling Person(s) 11 Certified Laboratories
Name: Chip White 11 Name: Statesville Analytical, Inc,
Name: II Name;
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? 0 Compliant o Non -Compliant
If the facility is non -compliant. please explain in the spare below the reasonis) 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 it necessary,
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Chip White
Permittee: Div, Of Parks 3 Rec (Lake Norman SP)
Certification No.:
Signing Official: Malcolm Scott Avis
W116A
Grade: 82 Phone Number: 336-549-8990
Signing Official's Title: Park Superintendent)
Has the ORC changed since the prev! qus NDNIR? ° Yes r- No
Phone Number: 704-528-6350 Permit Expiration:
Signature Date
Signature Date
By this signature. I cenily that this report is accun ate and complete to the hest of my knowledge
t cenify, 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 gteaBved pa: sonnet properly gathered anp evaluatod the it unation
'
submawd Based on my inquiry of the perSon or persons who manage the system, or those persorm dirervy responsible for
gathering the inforrrfat'ion, the information submitted is, to the hest of my knowledge and belief, m:e, accurate, and complete. I am
aware that there aie signdicant Penatl:es for suomibing fma in'ormalian, mcfuding the possibility of finds and imprisonment for
knovra KJ Yitilmions.
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
Did the application rates exceed the limits in Attachment B of your permit?
m Compliant o Nan -Compliant
Were adequate measures taken to prevent effluent ponding ,in or runoff from the sites?
m Compliant o Nan -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit?
® Compliant o Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site?
m Compliant o Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
m 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-comaliance and describe the corrective
taKen. Atracn acottionai sneets It necessary,
Operator In Responsible Charge (ORC) Certification
Permittee Certification
ORC: Chip White
Perrnittee:. Div. Of Parks & Rec (Lake Norman SP)
certification No.: 1004687
Signing Official: Malcolm Scott Avis
Grade: S2 Phone Number: 336-549-8990
signing Official's Title: PeHFReaser-(AielftPark Superintendent)
Has the ORC ch ce the previous NDAR-17 o r m No
Phone Number: 704-528-6350 Permit Exp.: 9/30/20
Signature Date
Signature Date
By this signature. I certify that thls report to accurrate and complete to the best of my knowledge.
I certify, under penalty of law, that this document and all alloohmenta 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 la, to the beat 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 lines 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: NDMR 10-13 NON -DISCHARGE MONITORING REPORT (NDMR) Page 2 of 2
Sampling Person(s) Certified Laboratories
Name: Chip White Name: Statesville Analytical, Inc.
Name: Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? 'a 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.
Operator in Responsible Charge (ORC) Certification Permittee Certlficatlon
ORC: Chip White Permittee: Div. Of Parks & Rae (Lake Norman SP)
Certification No.: Signing Official: Malcolm Scott Avis
Grade: S2 Phone Number: 336-549-8990 Signing Official's Title: Park Superintendent)
Has the ORC cfpnged since the previous NDMR? o Yes ra No Phone Number: 704-528-6350 Permit Expiration:
S- s- 0
Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
Signature Date
I certify, under penally 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 direogy responsible for
3thering the Information, the Information submitted is, to the bast 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

Z-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) V\0 Page 1 of 2
it
it No.: WQ0020881
Facility Name: Div. Of Parks & Rec (Lake Norman SP)
County: Iredell
Month: July
Year: 2020
irrigation occur
at this facility?
0 YES 13 NO
M MAIZU
Field Name:
2
2
into
Field N
Name:
9K
2,10-
MEMO, � A,012.
Area (acres):
1.715
�1. �7
e'
Area (acres):
cover crop:
Woodland
Cover Crop:
Hourly Rate (in):
0.4
Hourly Rate (in):
ua1 date
IMERAN
Annual Rate (in):
30.16
Annual FAn Uf ft
Annual Rate (in):
Weather
Freeboard
Field Irrigated?
0 YES 13 NO
Field Irrigated?
0 YES G NO
M
0
0
CL
E
0
X
0
'n
CL
wo,
M
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0
0.00
12 Month Floating Total

NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Page 2 of 2
application rates exceed the limits in Attachment B of your permit?
re 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?
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
o Compliant ❑ Non -Compliant
9 Compliant ❑ Non -Compliant
0 Compliant O Non -Compliant
o Compliant o Non -Compliant
o 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.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Chip White
Permittee:
Div. Of Parks & Rec (Lake Norman SP)
Certification No.: 1004687
Signing Official: Malcolm Scott Avis
Grade: S2 Phone Number: 336-549-8990
Signing Official's Title: Park Superintendent
Has the ORC chan ed since the previous NDAR-1? ❑ Yes o No
Phone Number: 704-528-6350 Permit Exp.: 9/30/20
Signature Date
Signa ure Date
By this signature. I certify that this report is accurrate and complete to the best of my knowledge.
I certify. under penally 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 an 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

10-13 NON -DISCHARGE MONITORING REPORT (NDMR)
Page 1 of 2
No.: WQ0020881
Facility Name: Div. of Parks & Rec (Lake Norman SP)
County: Iredell
Month: July
Year: 2020
rPar,;pm;eter
Flow Measuring Point: o influent ❑ Effluent ❑ No now generated
Parameter Monitoring Point: Influent 0 Effluent ❑ Groundwater Lowering ❑ Surface Water
Code —►
5Q05tf
50060
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4x Year

NDMR 10-13 NON -DISCHARGE MONITORING REPORT (NDMR) Page 2 of
Sampling Person(s)
Name: Chip White
Name:
Certified Laboratories
Name: Statesville Analytical, Inc.
Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? [a 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.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Chip White
Permittee: Div. Of Parks & Rec (Lake Norman SP)
Certification No.:
Signing Official: Malcolm Scott Avis
Grade: S2 Phone Number: 336-549-8990
Signing Official's Title: Park Superintendent
Has the ORC changed since the previous NDMR? 0 Yes © No
Phone Number: 704-528-6350 Permit Expiration:
Signature Date
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
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

)MR 10-13 NON -DISCHARGE MONITORING REPORT (NDMR) Page 1 of 2
mit No.: W00020881
Facility Name: Div. of Parks & Rec (Lake Norman SP)
County: Iredell
Month: December
Year: 2019
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RM: NDMR 10-13
IV!
Name: Chip White
Name:
Sampling Person(s)
NON -DISCHARGE MONITORING REPORT (NDMR)
Certified Laboratories
Name: Statesville Analytical, Inc.
Name:
Page 2 of 2
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of 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.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Chip White
Permittee: Div. Of Parks & Rec (Lake Norman SP)
Certification No.:
Signing Official: Will Ruark
Grade: S2 Phone Number: 336-549-8990
Signing Official's Title: Park Ranger (Acting Park Superintendent)
Has the ORC ged since the previous NDMR? a Yes ° No
Phone Number: 704-528-6350 Permit Expiration:
`
l
Signature Date
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
I certify, under penalty of law, that this document and ail 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

)AR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page 1 of
ermit No.: WQ0020881
Facility Name: Div. Of Parks & Rec (Lake Norman SP)
County: Iredell
Month: December
Year: 2019
Did irrigation occur
�`� Id4hlaxme
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NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Page 2 of 2
Prid 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?
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
m Compliant 11 Non -Compliant
Compliant o Non-Compllant
o Compliant 13 Non -Compliant
0 Compliant n Non -Compliant
m 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.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Chip White
Permittee: Div. Of Parks & Rec (Lake Norman SP)
Certification No.: 1004687
Signing Official: Will Ruark
Grade: S2 Phone Number: 336-549-8990
Signing Official's Title: Park Ranger (Acting Park Superintendent)
Has the ORC c god since the previou R-1? o Yes a No
Phone Number: 704-528-6350 Permit Exp.: 9/30/20
-/7
� -3 -ao
Signature Date
Signature Date
By this signature, I certify that this report is accurrale and complete to the best of my knowledge.
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.
Mail Original and Two Copies to:
Division of Water Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

Page 1 of
10-13 NON -DISCHARGE MONITORING REPORT (NDMR"CZ T — -n )
�/
o.: WQ0020881
Facility Name: Div. of Parks & Rec (Lake Norman SP)
County: Iredell
Month: November
Year: 2019
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Flow Measuring Point: ° Influent o Effluent No Flow generated
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10-13 NON -DISCHARGE MONITORING REPORT (NDMR) Page 1 of
No.: WQ0020881
Facility Name: Div. of Parks & Ree (Lake Norman SP)
County: Iredell
Month: November
Year: 2019
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10-13 NON -DISCHARGE MONITORING REPORT (NDMR)
Page 2 of 2
Sampling Person(s)
Certified Laboratories
Name: Chip White 11 Name: Statesville Analytical, Inc.
Name:
Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? 0 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
a�uUutaj LONVIr. nuaWn aUumUnat rnrcata u
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Chip White
Permittee: Div. Of Parks & Rec (Lake Norman SP)
Certification No.:
Signing Official: Will Ruark
Grade: S2 Phone Numbe . 336-549-8990
Signing Official's Title: Park Ranger (Acting Park Superintendent)
HasZORangedsince the previous NDMR? 0 Yes 9 No
Phone Number: 704-528-6350 Permit Expiration:
1-7
Signature Date
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
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.
Mail Original and Two Copies to:
Division of Water Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

DAR-1 10-13
NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Page I of 2
t No.: WQ0020881
Facility Name: Div. Of Parks & Rec (Lake Norman SP)
County: Iredell
Month: November
Year: 2019
V
Field Name:
2
&
Field Nam e:
id irrigation occur
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at this facility?
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------

10-13 NON -DISCHARGE MONITORING REPORT (NDMR) 14
Page 1 of 2
No.: WQ0020881
Facility Name: Div. of Parks & Rec (Lake Norman SP)
County: Iredell /
Month: October
Year: 2019
PPI:
Flow Measuring Point: m Influent 13 Effluent o No flow generated
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WQROS
MOORESVILLE REGIONAL OFFICE >.

-13 NON -DISCHARGE MONITORING REPORT (NDMR)
Page 1 of 2
Facility Name: Div. of Parks & Rec (Lake Norman SP)
County: Iredell
Month: September
Year: 2019
low Measuring Point: 'a Influent o Effluent E3 No Flow generated
Parameter Monitoring Point: ° Influent 0 Effluent . o Groundwater Lowering a Surface Water
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10-13 NON -DISCHARGE MONITORING REPORT (NDMR) Page 2 of 2
Sampling Person(s) 11 Certified Laboratories
Fe: Chip White Name: Statesville Analytical, Inc.
Name: Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? 0 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.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Chip White
Permittee: Div. Of Parks & Rec (Lake Norman SP)
Certification No.:
Signing Official: Will Ruark
Grade: S2 Phone Number: 336-549-8990
Signing Official's Title: Park Ranger (Acting Park Superintendent)
Has the ORC c anged since the, evio s NDMR? o Yes m No
Phone Number: 704-528-6350 Permit Expiration:
Signature
Date
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
I certify, under penally 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.
Mail Original and Two Copies to:
Division of Water Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

10-13 NON -DISCHARGE MONITORING REPORT (NDMR) Page 1 of 2
it No.: W00020881
Facility Name: Div. of Parks & Rec (Lake Norman SP)
County: IredellIT
Month: September
Year: 2019
PPI:
Flow Measuring Point: m Influent o Effluent o No flow generated
Parameter Monitoring Point: ° Influent m Effluent o Groundwater Lowering o Surface Water
Parameter Code —�4DD
50060Oh090s0
C0310
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NDMR10-13 NON -DISCHARGE MONITORING REPORT (NDMR) Page 2of2
Sampling Person(s) Certified Laboratories
Name: Chip White Name: Statesville Analytical, Inc.
Name: 11 Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? ° 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(sl taken. Attach additional sheets if necessary.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Chip White
Permittee: Div. Of Parks & Rec (Lake Norman SP)
Certification No.:
Signing Official: Will Ruark
Grade: S2 Phone Number: 336-549-8990
Signing Official's Title: Park Ranger (Acting Park Superintendent)
Has the ORC changed since the previous NDMR? o yes 0 No
Phone Number: 704-528-6350 Permit Expiration:
Signature ate
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
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.
Mail Original and Two Copies to:
Division of Water Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

2_1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Page 1 of 2
m �No.:Q0020881
it 0.' w
Facility Name: Div. Of Parks & Rec (Lake Norman SP)
County: Rowan
Month: September
Year: 2019
, 2z zm 0,
Field Name:
2
Fr
Field Name:
Did irripation occur
r
i ri
k, g,
Area (acres):
1.715
Area acre
at this facility.
t is f
Cover Crop.
Woodland
Cover Crop:
N§
YES
Hourly Rate (in):
0.4
NO
Annual Rate (in):
30.1 6
Annual Rate (in
Weather
Freeboard
Field Irrigated?
YES N
*01
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P1.
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wis
'01 U IN
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1.40
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12 Month Floating Total (i

K NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page 2 of 2
application rates exceed the limits in Attachment B of your permit? m Compliant o Non -Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites? m Compliant o Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit? m Compliant o Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site? m Compliant o Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? m Compliant 13 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.
Operator in Responsible Charge (ORC) Certification
ORC: Chip White
Certification No., 1004687
I Grade: S2 Phone Number: 336-549-8990
i Has the ORC changed since the previous NDAR-1? m Yes m No
0 // 7
Signature
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
Permittee Certification
Permittee: Div. Of Parks & Rec (Lake Norman SP)
Signing Official: Will Ruark
Signing Officials Title: Park Ranger (Acting Park Superintendent) .
Phone Number: 704-528-6350 Permit Exp.: 9/30/20
Signature Date
I certify, under penally 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 submilled 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

OR 10-13 NON -DISCHARGE MONITORING REPORT (NDMR) 19--) Page I of 2
rm it No.: WQ0020881
it.N ­ WQOO'
F Facility Name: Div. of Parks & Rec (Lake Norman SP) I
County: Iredell ___1
I Month: August
Year: 2019
PI:
PP
Flow Measuring Point: o influent 0 Effluent No flow generated
Parameter Monitoring Point: 0 Influent m Effluent Groundwater Lowering Surface Water
Code
Parameter►-
--o
50060 kffi,
C031 0
00610
00620
00530
0
M
0
0
>1 < E
F-
0 0
0
24-hr
0
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l
"
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m
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2
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WE, M.11
WOMEN
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3
3
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. . . . . . . . . . . .
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6
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9 0.03
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8
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9
10
11
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...........
VISION
13
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16
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19
............... ............
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23
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26
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28
--0.02
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1 9
F15-31
31
Average:
0.03
Daily Maximum
9 0.05
Daily Minimum
0.01
Sampling Type
Grab
Grab
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Grab
Monthly Avg. Limit:
...........
Daily Limit.,12M
Frequency:
Sample Freque
Monthly
n,,:I#
7 4x Year
i ffi
4x Year

NDMR 10-13 NON -DISCHARGE MONITORING REPORT (NDMR) Page 2 of 2
Sampling Person(s) 11 Certified Laboratories
Name: Chip White 11 Name: Statesville Analytical, Inc.
Name: 11 Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? m Compliant U 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.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Chip White
Permittee: Div. Of Parks & Rec (Lake Norman SP)
Certification No.:
Signing Official: Greg Schneider
Grade: S2 Phone Number: 336-549-8990
Signing Official's Title: Park Superintendent
Has the ORC changed since the previo R? ° Yes m No
Phone Number: 704-528-6350 Permit Expiration:
Signature Date ,
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
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.
Mail Original and Two Copies to:
Division of Water Resources
Infonnation Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

M: NDAR-1 10A3
NON -DISCHARGE APPLICATION
REPORT
(NDAR-1)
1.rrmito.: WQ0020881
Facility Name: Div. Of Parks & Rec (Lake Norman
SP)
County
(tY�,ielid
2ARMS
Field Name:
N
Did irrigation occur
Area (acres):
1.715�
at this facility?
"j �"b'�M Zv{ N �.+�..a-L �S . AW A:✓^ari
q� y��
Cover Crop:
y �s�'" dry+ rii:
Woodlando
0.4
IM!&
� � � �>
Hourly Rate (in):
30.16
Y3+a5t L ,
m YES ° NO
_ t
Annual Rate (in):
° YES ° No
` rt
Weather Freeboard, �! t Field Irrigated?
C
m
yyT
m m
p «
W
O. N
,"f
- ' ".y "!r' a .y'. - .. - e
'a
E d
M
C
E
EM eO
'
p
u
°
r A
E m
CL
A
o
c
Wm
O
Q
m o
Lbv
I s $ I
a
in
in
nal min
22,900 0.49
12 Month Floating Total
Page 1 of 2
Rowan
Month: August
Year: 2019
Field Name:
es)
Area (acres):
Cover Crop:
Hourly Rate (in):
tl.
Annual Rate (in):
Field Irrigated?
° YES ° NO
w
y
a+e
E d
D
m P3
M
T
_ C
x
o
E rn
f0 m
K o Cc
J
= J
oal
min
in
in
D 0.00

NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Page 2 of 2
e 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?
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
m Compliant o Non -Compliant
m Compliant o Non -Compliant
m Compliant o Non -Compliant
m Compliant o Non -Compliant
m Compliant O Non -Compliant
If the facility is non -compliant, please explain in the space below the reason(s) the facility was not incompliance. Provide in your explanation the date(s) of the non-compliance and describe the corrective
action(s) taken. Attach additional sheets if necessary.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Chip White
Permittee: Div. Of Parks & Rec (Lake Norman SP)
Certification No.: 1004687
Signing Official: Greg Schneider
Grade: S2 Phone Number: 336-549-8990
Signing Official's Title: Park Superintendent
Has the ORC changed since the previ us NDAR-1? o Yes m No
Phone Number: 704-528-6350 Permit Exp.: 9/30/20
Signature Date
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
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. eased 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

WR03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page / Of
Permit No.: WQ0020881
Facility Name: Div. Of Parks & Rec (Lake Norman SP)
County: iredell
Month: July
Year: 2019
PPI•
Flow Measuring Point: Djnfluent ❑Effluent ❑Notlowgenerated
Parameter Monitoring Point: ❑Influent OErfluent ❑Groundwatertowedng ❑SurfaeWater
Parameter Code ►
50050
50060
00400
C0310
31616
00610
00630
00620
00625
00530
00666
ro
F=
0
C
O
,
on U
d
0
m
U. U
Q
y
Cv
�z
t°-
a)c° 9vE«
:
y
rn
h o
a
SIP
:UENR/D
b 19
24-hr
hrs
GPD
mg/L
su
mg/L
#l100 mL
mg/L
mgfL
mg/L
mglL
mglL
mg/L
ft!CZ
1Rcc�
• r
1
3,865
"c,
11UNAL C
2
10:45
0.5
3,865
0.03
7.28
3
3,865
4
3,865 .
5
3,865
6
.3,865
7
3,865 .
8
3.865
9
3,865
10
10:00
0.75
3,865
0.05
6.66
11
3.865
12
3,865
13
3,865
14
3,865
15
3 865
16
. 3,865
(117
17
3,865
18
10:45
0.75
3,865
0.06
6.44
19
3,865
20
.8,865-
21
09:45
0.5
3,865
0.01
6.55
22
3.865
23
3,865
24
3,865.
25
3,865
26
3,865
27
3,865
26
.3,866
29
3,885
30
10:45
0.5
3,865
0.05
6.53
31
3,865
Average:
3,865
0.04
Daily Maximum:
3,865
0.06
7.26
Daily Minimum:
, ,3,865
0.01
6.44
Sampling Type:
Recorder
Grab
Grab
Grab
Grab
Grab
Grab .
Grab
Grab
Grab
Monthly Limit:
Daily Limit:
Sample Frequency:
Continuous
Monthty
Weekly
4XYear
4XYear
4XYear
4XYear
4XYear
4XYear
4XYear
9R
FFICE

Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit?
O Compliant
17 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.
Operator in Responsible Charge (ORC) Certification
Permitteo Certification
ORC: Robert Charles White
Permittee: Div. Of Parks & rec (Lake Norman SP)
Certification No.:
Signing Official: Greg Schneider
Grade: S2 Phone Number: 336-549-8990
Signing Official's Title: Park Superintendent
Has the O changed since the revious NDMR1 Gves ONO
Phone Number: 704-528-6350 Permit Expiration:
Signature Date
Signature Date
By this signature, I certify that this report is acw tale and complete to the best of my knowledge.
I certify, under penally of law, that this document and all attachments were prepared tinder my direction or supervision in
accordance with a system designed to assure that all qualited personnel p. operly gathered and evaluated the information
submitted. Based on my inquiry of the person or persons vitro manage the system, or those persons directly responsible for
gathering the irdormat"Ion, 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 infonnalior., including the possibility of fines and imprisonment
for knowing vlolatlons.
Mail Original and Two Copies to:
Division of Water Quality
information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

4DAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page
e000•
-iredell
Month: July
Did irrigation occur
at this facility?
2 YES 13 NO
Cover Crob:�....
.Cover
Crop:....
.
Hourly Rate (in):,
1101
mM����
®mmo®M
OMM■®
MIMMIEM
WM®INM®
WMIEMMEME
mMMMMMIMMM
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Monthly Loading:
Yy ✓a.. '.}e=
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, „
Y/ 4 /„t{
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#rt.,.r.�.am- :iyn.�'�.a't.A
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.•- i. -+ 7+ ° yu] a..i
-
12 Month • • Total
r
tlx.c -.ti,;aFa
�t 7a�c°..FyriJti;
u}b
0sn

FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page —0— of ;�
Did the application rates exceed the limits in Attachment B of your permit?
B Compliant O Non -Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites? 21Compliant ONon-Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit? 91Compliant ❑Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site? OCompiant ❑Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? OCompliant 11Non-Compllant
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
Men. Auacn aocnlonal sneew n ne Lt:u5ary.
Operator In Responsible Charge (ORC) certification
Permlttee Certification
ORC: Robert Charles White
Permittes: Div. Of Parks 8r Rec (Lake Norman SP)
Certification No.: 1004687
signing official: Greg Schneider
Grade: S2 Phone Number: 336-549-8990
signing Official's Title: Park Superintendent
Has the OR changed since the prev us N ARA? O yes O No
Phone Number: 704-528-6350 Permit Exp,: 9/30120
9
Signature Date
Signature Date
By this signature, I cenify that this report is accurate and complete to the best of my knowledge.
I cart fy, under penalty of law, that this document and all attachments were prepared under my dimetion or supervis'.on in
accordance with a system designed to assure that all qualified personnel properly gathered and evaluated the information
submitted. Based an 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, We, accurate, andmmplele. 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 Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

M: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) 111� Page / of -a —
Permit No.: W00020881
Facility Name: Div. Of Parks & Rec (Lake Norman SP)
County: Iredell
Month: July
Year: 2019
PPI:
Flow Measuring Point: ElInnuent ❑Effluent ❑ No now generated
Parameter Monitoring Point: ❑Innuent IJEffluent ❑ Groundwater Lowering ❑Surface Water
Parameter Code
60060
50060
00400
C0310
31616
00610
00630
00620
00625
00530
00666
a
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C
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ev
~ CL
iq
2
�L
~ o
a
24-hr
hrs
GPD
mg/L
su
mg1L
#/100 mL
mg/L
mg/L
mg/L
mg/L
mg/L
mg(L
1
3,865
- —
lJr i L Ut
i1 F;/CJS"�Cx
21
10:45 1
0.5
3,865 .
0.03
7.26
31
1
3,865
4
3,865
b
3,865
i
Vf7)Pnc•
6
._3,865
l'^VU�E5vll
t
=ors
8
3,865
9
3,865
101
10:00
1 0.75
3,865
0.05
6.66
11
. 3,665
12
3,865
13
3.865
14
3,865
15
3;865
Ey
Hill
16
. 3,865
t^;
17
3,865
tilliJ.
di Ci t:. D •
s-
18
10:45
0.75
3,86.5
1 0.08
6.44
18
3,865
20
.3,865
21
09:45
0.5
.3.865
0.01
6.55
22
3,865
23
3,865
24
3,865 ..
25
3,865
26
3,865
27
3,865
28
.3,866
29
.3.865
30
10:45
0.5
3.865
0.05
6.53
311
1
3,865
Average:
3;865
0.04
Daily Maximum:
3,865
0.06
7.26
Daily Minimum:
3,665
0.01
6.44
Sampling Type:
Recorder
Grab
Grab
Grab
Grab
Grab
'Grab .
Grab
Grab
Grab
Monthly Limit:
Daily Limit:
Sample Frequency-.1
Continuous
I Monthly
I Weekly
4XYear
4XYear
4XYear
4XYear
4XYear
4XYear
4XYear

Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? o Compllant ❑ Non-cornpliant
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.
Operator in Responsible Charge (ORC) Certification
Permitteo Certification
ORC: Robert Charles White
Perrnittee: Div. Of Parks & rec (Lake Norman SP)
Certification No.:
Signing Off total: Greg Schneider
Grade: S2 Phone Number: 336-549-8990
Signing Official's Title: Park Superintendent
Has the O changed since the revlous NDMR1 Cves O No
Phone Number: 704-528-6350 Permit Expiration:
Signature Dale
Signature Date
By this signature, I certify that this report is accurate and complete to the bost'of my knowledge.
I certify, antler penalty of lave, that t'nis document and all allachments vmm prepared under my direction or supervision in
accordance vrhh a system designed to assure that all qualiried porsonnot properly gathered and evaluated the information
submitted. Based on my inquiry of the person or poisons who manage the system, or those persons directly resporsible for
gathering the trdormation; the information submitted is, to the best of my knowledge and belief. true, accurate, and complete. I
am aware flat there are significant penalties for submilling false information, including the possibility or fines and imprisonment
for knowng violations.
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

JFORM: NDAR-1 08-11
NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Page
Permit No.: WQ0020881
FacI14 Name: Lake Norman State Park
County: Iredell
Month: July
• irrigation occur
at this facility?
p YES ■ •
Field
__
-•
son N."M91,9111
. f
.... .
over Crop:....
.
. 3Cover
Crip!
1
1
-nwi
Hourly Rate (in):
1
1
®==
-y,
-*R
. ... .
11
®"'
�'i.""Yj -
i Vr 1
r
;®y
� ` �' tiFt�
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�}U'.§
1 +i.4

)RM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1)
I 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?
Were all freeboards maintained In accordance with the specified freeboard heights in your permit?
Page ' of
t7 Compliant
❑ Non -Compliant
OCompaant
❑Non -Compliant
0Compliant
❑Non -Compliant
0Compliant
❑Non -Compliant
O Compiant
❑ Non-Compllant
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
v UUU11taJ lPnvll. r�llvUll vUU111U1 lv1 ,1IVOlD 11
Operator In Responsible Charge (ORC) Certification
Permittee Certification
ORC: Robert Charles White
Permlttee:
Div. Of Parks 8l Rec (Lake Norman SP)
Certification No.: 1004687
signing Official: Greg Schneider
Grade- S2 Phone Number: 336-549-8990
Signing Official's Title: Park Superintendent
Has the OR changed since the prev us N AR-1? Ores ONO
Phone Number: 704-528-6350 Permit Exp.: 9/30120
Signature Date
Signature Date
By this signature, I cony that this report is acourrate and complete to the best of my knowledge.
I certify, under peneky of law, that this comment and all allachmenLs were prepared under my direction or supervision in
accordance with a system designed to ossum that all qualified personnel properly gathered and evaluated the information
wbmilled. 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 knowedge and belief. We, accurate, end complete. I am
aware that there are significant penalties for submitling false information, including Me possibility of fines and irnpnsonment for
knowing molalions.
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

ORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page / of_,2_
Permit No: W00020881 Facility Name: Div. of Parks & Rec. (Lake Norman SP)
County: Iredell Month: June 12019
PPI:
lFlow Measuring
Point: ❑ Influent
® Effluent ❑ No flow generated
Parameter monitoringPaint ❑ Influent m Effluent ❑ Gro ndwater,l,Qwering ❑ Surface Water
Parameter Code
50050
50060
00400
C0310
31616
00610
00630
00620
00625
00530
00665
d urr Ij N
}
>
E y
=<E �
o
�
°
`
R a
CL
2
€o
m
Zz
z
m
°
zo
7i
CL
r°a�c
K
a
AUG 5 2019
24-hr
hrs
GPD
mg1L
su
m /L
#100m/L
#1100mL
m /L
mg1L
mgfL
mgll
I mg/l
_
1
.1,767
2
1,767
3
1,767
4
10:30
0.75
1.767
<5
6.1
,
5
1,767
6
1,767
7
1,767
B
1,767
9
1,767
10
1,767
11
1.787
12
11:30
0.50
1,767
<5
6.82
[ e
13
1,767
14
1,767
15
1,767
s�
16
1,767
-
17
1,767
la
1.767
19
1,767
11.6
613.0 -
10.3
<0.1
13.6
, 7.5
3.6
20
1,787
21
09:00
0.5
1.767
<5
6.84
22
1,767
23
1,767
24
09:25
0.5
1.767
<5
7.2
25
1.767
26
1.767
27
1,767
28
1.767
29
1,767
30
1,767
31
0
Monthly Average
883
11.6
613
10.3
#DIV/01
13.55
7.5
3.6
Daily Maximum:
1767
0.0
11.6
613
10.3
<0.1
0
13.55
7.5
3.6Daily
Minimum:
0
0.011.6
613
10.3
<0.1
0
13.55
7.5
3.6
Sam ling Type:
Recorder
Grab
F674
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Monthly Llmlt:
Daily Limit:Sample
Frequency:
Continuous
Monthly
4xyear
4xyear
4xyear
4xyear
4xyear
4xyear
4xyear
'j/ fit
'ICE

ORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR)
Page aof 2
Sampling Person(s)
Certified Laboratories
Name: Robert Charles White
Name: Statesville Analytical, Inc.
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of 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 you explanation the date(s) of the non-compliance and describe the corrective
action(s) taken. Attach additional sheets it necessary.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Robert Charles White
Permittee: Div. of Parks & Rec. (Lake Norman SP)
Certification No.: 1004687
Signing Official: Greg Schneider
Grade:s2 Phone Number: 336-549-8990
Signing Official's Title: Perk u erintendent
/1
Has the 0' ; changed since t e previous NDMR? Yes No
Phone um er: 704-528-63 Permit Exp: 9/30/2020
71"
Sig ature ate
ign Date
By the signature, 1 certify that this report is accurate and complete to the best of my knowledge.
I ify, u aw, Ilwt this document and all attachment were prepared under my direction or supervision in accordance
wl 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 responsVe for gathering the Information, the
information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware the there are significant
penallies for submitting false information, including the possibAy of fines and imprisonment for knowing violations.
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
161T Mail Service Center
Raleigh, North Carolina 27699-1617

NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page / of
Permit No.: WQ0020881
Facility Name: Lake Norman State Park
County: Iredell
Month: June
Year: 2019
ga Did irrition occur
Field Name:
2
Field Name:
Area (acres):
1.715ti.
Area (acres);
at this facility?
2 YES ONO
5
Cover Crop:
Woodland
Cover Crop:
R
Hourly Rate (in):
0.4
Hourly Rate (in).
Annual Rate (in):
30.16
Annual Rate (in)*.
Weather
Freeboard
Field Irrigated?
BYES ONO
ty,Fieldirrigated?
OYES ONO
V
*4
CL
E
g
0
in.
j
2
0
r%
Ce
0.
IU CL
M
Lh
S f
,
M
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::66�
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-71
4,
E
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E
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.5 'Ca
w 0
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0.
>
M
M
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_j
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_j
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In
ft
It
�-!�Rll U
gal
min
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In
101g
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in
E.?1.0.31RIN
A,
3
4
C
71
0.15
3
2,800
6
10
%M13K
11
N
Z_NIO
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C
69
2.06
3
3
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131
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14
110
L6
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21
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75
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22
.23
C
28
02
3
_24
26
26
27
­V
30
§V11ME
Monthly Loading:
12 Month Floating Total (in),I

ORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1)
id the application rates exceed the limits in Attachment 8 of your permit?
Page of
OCompllant ❑Non -Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites?
OCompllant
ONon-Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit?
3Compliant
❑Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site?
OCompliant
❑Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
2)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.
Operator In Responsible Charge (ORC) Cerllficatlon N Permittee Certification
ORc: Robert Charles White
Certification No.: 1004687
Grade: S2 Phone Number,
Has the ORC•chanded since the
336-549-8990
i ❑Yes ONO
7`Oy/
Signature Date
By this signature, I cenity that this report is accurrate and complete to the best of my knowledge.
Permltteo: Div. Of Parks & Rec (Lake Norman SP)
Signing Official: Greg Schneider
Signing Officials Title: Park Sup�ritendent
r
Phone Num r:' 704-528-63 Permit Exp.: 9130120
co
Signature ate
I certify, er , lha! this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that all qualified personnal 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 sulxrtitted is, to the best of my krwmvledge and belief. true, acm vale, and complete, 1 am
aware that there are significant penalties for submitting false information, including the possibility of fees and Imprisonment for
knowing violations.
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

FORM' NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) / Page _jofIQ
Permit No.: WQ0020881
Facility Name: Lake Norman State Park
County: Iredell r
Month: May
Year: 2019
F
F(�td (yat»Q
1
Field Name:
2
n
Field Name:
Did irrigation occur
�a � �anr ai
� 715
Area (acres):
1.715
t
Area (acres).
at this facility?
`�
Cover Crop:
Woodland
coverCro p:
7 i F;1{dv3BrGp�
Hby�c+�;j „
,r `
HouHy Rate (in):
0.4
'riury Ftate`(in)i
x
Hourly Rate (In):
OYES El No
p,ltlj $� ��x���
x�'t
�`�c 0 1$r °s
Annual Rate (in):
30.16
ik►►IiUlil�aEg,�ln)t <;a
rt Vic,
Annual Rate (In):
Weather Freeboards��el(!l`K1gd(s
G�tyTZS �C7NE± '
Fieldlrrigatod7
OYES ❑NO)rQillta[Igd4>'d7})t(0
>* WS3
,
Fieldlrrigated?
❑YES ❑NO
Qt
CO
c .. t�Y
Yx 'F2t
�P4,
v-- f
-
+ r
�.e, >
.p
'C
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E
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rn
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as
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y
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roc
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7
-F
In
ft
ft
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3t11i(t1: `
; a:�!1. ,'r'�
),►1�1 .`
gal
min
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In
gal
min
in
In
2R9I�
3JUN
t
i
S l (
L
) S
1
a
y
6
iOORESIVILI
I
9
r P`w
tk
_(
101
C
66
0.5
3
.
12
". r e
t' z
13
of
14
IT-
18
C
67
1.55
3
n,eoa
133
0.38
1 0.17
L
17
�1
19
sd
A
SC
19
ti S
ii ti a-
2
Tx ��YR+:
ti
r,
<f
20
_3,r
21
22
.. �, ,y7 C
f f`?7 .t..
i"w -'1 ;f f� �Y '.
j �-x. � ♦`
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23
R
72
0.21
3
24Yrr
In
> C
' F
�ti
f
s W1
:+ :Fay i
y
26
,'cYa a
27,
29
C
80
0
3
0
0.00
monthlyLoading:
9
( 1
..�.,;t ; .f...:H.:
t ti,rlb,,,.
17,600
' '
EM
12 Month Floating Total (in):
DENR/DWR
2019
)S
'ZONAL OFFICE
Unit

FORM: NDAR-1 06-11
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?
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
Page ;Q of a
OCotrq:liant
❑Non•Compliant
OCompliant
❑Non -Compliant
O Comprmnt
❑ Non -Compliant
9 Compliant
❑ Nondontpllant
17 Compliant
❑ h'omcomplhllt
If the iacifiiy is non -compliant, please explain In the space below the reasons) 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 addilional sheets If necessary. a
Operator In Responsible Charge (ORC) Certification
Penhiltee Certification
ORC: Robert Charles White
Permittee: Div. Of Parks & Rec (Lake Norman SP)
Certification No.: 1004687
Signing official: Greg Schneider
Grade: S2 Phone Number: 336-549-8990
Signing Official's Title: Park Superinlendent
Has the ORC changed since t a previou NDAR-17 ayes p No
Phone Nu bo 704-52 -6 0 Permit Exp.: 9/30120
Signature Dale
Signature Date
By this signature, I ceflify that this report is arcurrale and complete to the best of my knowledge,
miry, u penally or law, that this document and all aftachrneri s vacs prepared under my direction or supervisijinactor
arcs vrilh a system designed to assure Mat all qualified personnel properly gathered end evaluated fho inform
subinilted. Based or my inquiry of dte pefsart or persons who manage the system or Vase persons directly responsible fcr
gathering Ilia information, the information submitted is. Io the best of my Knowledge and belief, true, accurate. and complete 1 am
avmfe that there are significant penalties for submdling false nfermaticn,'.ncluding the possibility of fines and imprisonment for
knrnnng violations.
Mail original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699.1617

NON -DISCHARGE MONITORING REPORT (NDMR) - ' 1 Page J of
Facility Name: Div. Of Parks & Rec (Lake Norman SP)
County: Iredell
Month: May
=V'l
�■

NON -DISCHARGE MONITORING REPORT (NDMR) Page_�2_of O ,
Sampling Person(s)
Certified Labom(ories
Name: Robert Charles White
Narne: Statesville Analytical, Inc.
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? PrCompliant ❑ Non-Cornpiiant
if the faeaily is non-complianl, please explain in the space belowthe reasons) the fadbly was not in compliance. Provide in you explanation the dates) of the non-compliance and describe the corrective
aehon(s) taken. Altarh additional sheets if necessary.
Operator in Responsible Charge (ORC) Certification
Permitlee Certification
ORC: Robert Charles White
Permitlee: Div. of Parks & Rec. (Lake Norman SP)
Certification No.: 1004687
Signing Official: Greg Schneider
Grade:S2 Phone Number: 336-549-8990
Signing Official's Title: Par - Superintendent
Has th C changed since the pr vious NDMR? Yes No
Pilo u ber: 704-528 35 Permit Exp: 9130/2020
Si nature Date
Ignature Date
By the signature, I certify that this report is accurate and complete to the best of my knowledge.
I ceriIII . law. that IhG document and al( ai(achmenl wEre prepared under my direction cr supervision in accordance
w.ilh a system designed to assure that a] qualified parsonnet properly galhered and evaluated Ibc information submitted. Based on
my inquiry of the person or porsons who manage the system. at those persons drecliy responsive for gathering the infonnaticn. the
infonralimi submitted is, to the best of my knoWedge and belief line. accurate, Pwd complete I ant u\vare line !here are significant
txnalres ti stiilmdt(ing less mtormalion, including the possibility of fines and imprisonment to. kncv+icg violations.
Mail Original and Two Copies to:
Division of Water Quality
Informntion Processing Unit
'1617 Mail Service Center
Raleigh, North Carolina 27699-1617

NON -DISCHARGE MONITORINGREPORT
,041 1••
Of
Flow Measuring Point:
37nfluent
■ Effluent ■ No flow generated
Parameter Monitoring Point:
■ Influent
n EffluentGroundwater Lowering ■ Surface Water
°Minthly
����
Sampling Type:,

NON -DISCHARGE MONITORING REPORT (NDMR)
Sampling Person(s) 11 - Certified Laboratories
Robert Charles White 11 Name: Statesville Analytical, Inc.
Name: II Name:
Page of
Does all monitoring data and sampling frequencies meet the requirements In Attachment A of your permit? 2)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.
Operator In Responsible Charge (ORC) Certification
Permittes Certification
ORC: Robert Charles White
Permittee: Div. Of Parks & rec (Lake Norman SP)
Certification No.:
Signing Official: Greg Schneider
Grade: S2 Phone Number: 336 549-8990
Signing Official's Title: Park Superintendent
Has the ORC changed since the prevl a NDMR? f]Yes NO
Phone Num r: 704-52 6350 Permit Expiration:
Signature Date
Signature Date
By this signature, I certify that this report is accurrale and complete to the best of my knowledge.
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 direolty responsible for
gathering the information, the information submitted is, to the best of my knowledge and belief, true, acrurete, 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 Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699.1617

NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Page of
application rates exceed the limits in Attachment IS of your permit?
Pereequate
aComp6arit ❑Non-Compllant
measures taken to prevent effluent ponding in or runoff from the sites?
0Compliant ❑Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit?
0Compliant ❑Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site?
0Compliant ❑Non•compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
0Compliant ❑Non-Compllant
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
laKBO. Mlltlurl duutautlai wiwwcw n r,cwaaa,y.
operator In Responsible Charge (ORC) Certification
Permittee Certification
ORC: Robert Charles White
Perrnittee: Div. Of Parks & Rec (Lake Norman SP)
Certification No.: 1004687
signing official: Greg Schneider
Grade: S2 Phone Number: 336-549-B990
Signing Official's Title: Park Superintendent
Has the ORC changed since the previous NDAR-1? ❑ye, p No
Phone Nu be : 704-528- 5 Permit Exp.: 9/30/20
Signature Dale
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
I cerwunderpanallyaw, that this document and all attachments were prepared under my direction or supervision in
With a system designed to assure that all qualified personnel property gathered and evaluated the information
accordance
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 Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

NON -DISCHARGE MONITORING REPORT (NDMR)
Page _ of _
!2
881
0881
07
Facility Name-
Div. Of Parks & Ree (Lake Norman SP)
County:
Iredell
Month:
March
ear: 2019
Flow Measuring Point: influent
Flow Mea
suring
Effluent
No flow generated
Parameter Monitoring Point:
intluent 2 Effluent
o Groundwater Lowering
Surface Water
Code --- 1-
50060
C0310
3l6l#.'­'
00610
00620
00530
-66
0
C
Z
E a,
w
0
-ru c .0
wpp
.2
u)
E
E
-wc,
o
x 0
-:� �i !�.+,+*-,�,:
0
+: + . 0 z
-.
z—,+, +'
** ­ , Z­
0
0
24-hr 1
hrs
mg/L
:V 664ki.
0
mg/L
mg/L
L
mg/L
WQROSI...-
K
M
U §WLE
REGIGNAl
Qfrm
2
3
.........
4
".45. 3 � ......
5
6
13:30
1.25
0
7
8
9
LO
11
11:10
0.75
0
�F,
12
13
ls
14
53+:
Is
Is
L /
17
f
18
-.4 3'1.
'4
_19
20
21
10:00
0.5
453­11+;
0.01
L
2
23
453"
. .. . ......
24
453'=
SEEN

NON -DISCHARGE MONITORING REPORT (NDMR) Page of
Sampling Person(s) 11 Certified Laboratories
Robert Charles White u Name: Statesville Analytical, Inc.
Name:
o Compliant a Non -Compliant
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit?
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.
ED TO INCLUDE QUARTERLY RESULTS ON THE 27TH THAT WERE INADVERENTLY LEFT OFF.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Robert Charles White
Permittee: Div. Of Parks & rec (Lake Norman SP)
Certification No.: 1004687
Signing Official: Greg Schneider
Grade: S2 Phone Number: 336-549-8990
Signing Official's Title: Park Superintendent
Has the ORC chang ce the previous ND °yes m No
7--
phone Numbe . 704-528-63 0 Permit Expiration:
gnature Date
Signature Do(.
By this signature, 1 certify that this report is accurrate and complete to the best of my knowledge.
r
I certify, un r ly of law t this document and all attachments were prepared under my direction or supervision in
accordancewith a sys meto 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 Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Page
of
Facility Name: lake Norman State Park
County: Iredell
Month:
March
Field Name:
n occur .0
L
I
Area (acres)::
fa ility?
•
Cover Crop:'
NO
Hourly Rate (iny.
lown.
Annual Rate (in)
TMMRF-lum
Field lrrigtedi���imxlsjm=-
Monthly Loading.
12 Month Floating Tttal

NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of
rates exceed the limits in Attachment B of your permit? a Compliant o Non -Compliant
pasuita7blevegetative
qasures taken to prevent effluent ponding in or runoff from the sites? 0 Compliant o Non -Compliant
Pas cover maintained on all sites as specified in your permit? G Compliant o Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site? 0 Compliant o Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? a Compliant 0 Non-Compgant
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 dates) of the non-compliance and describe the corrective
action(s) taken. Attach additional sheets if necessary.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Robert Charles White
Permittee:
Div. Of Parks & Rec (Lake Norman SP)
Certification No.: 1004687
Signing Official: Greg Schneider
Grade: S2 Phone Number: 336-549-8990
Signing Official' . itle: Park Superintendent
Has the ORC changed since the previous NDAR-17 a Yes a No
Phone Numbe : 704-528-635 Permit Exp.: 9/30/20
ZW/;Zz
/e.,;0
nature Date
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
I certify, under penally of law, that this document and all attachments were prepared under my direction or supervision in accortlanc
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 Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

NOPPMR 03-12 Ppij). -1 11
NON -DISCHARGE MONITORING REPORT (NDMR)
Page / of
PPFP Permit No.: WQ0020881 Facility Name: Div. Of Parks & Rec (Lake Norman SP) County: Iredell Month: March Year: 2019
PPI: - Flow Measuring Point: Oinfluent ❑Enfluent ❑Nofloavgenerated Parameter Monitoring Point: ❑Influent DEfnuent ❑Grwndwaterto%venng ❑ Surface Water
Parameter Code --d
.60050
50060 ii
0040D
C0310
31616
00610
00630
00620
00625
00630
00665
Q
t
U
00
c O
EP:
Co
0
a
m m
F0=
Q: U
a
pd
o
0
m
n.o
U
m
E
Q
+
2 'Z
_
Y
tip c
x�
H
m
Nao
2
1R0c
F0.
24-hr
hm
GPD
mg/L
su
mg/L
#/100 mL
mg/L
mglL
mg/L
mg/L
mg/L
mg/L
1
453
2
453
3
.453
4
453
5
453 '
6
13:30
1.25 1
453
0
6.3
7
.453
8
453.
9
453
¢
g
16
453
_
11
11:10
0.75
453
0
6.02
12
'
13
.453
a a;''t`J
"
14
453
15
.453
16
453
=) 'T
n
4 -
17
453
18
.453
19
453
-
20
453
`
ILL
21
10:00
0.5
453
0.01
6.45
22
453
23
453
24
453
26,
453
26
453
27
11:00
0.5
453
0.05
7.39
9
15
11.2
0,12
14,56
5.167
3,2
28
453
29
453
30
453
31
Average:
453
0.02
9.00
15.00
11.20
0.12 ,
14.56
5.17
3.20
Daily Maximum:
453
0.05
7.39
9.00
15.00
11.20
0,12
14.56
5.17
3,20
--
•------DBIty'MliiltssOttsr
�
D.DO'--'.._"8:0�'-
---9:00.....__._..1.�.0
—.1'1':20.___
""0;'tf'"
..-..._-......_-.
Sampling Type:
Recorder
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Monthly Llmlt:
Daily Limit:
Sample Frequency:
-continuous
Monthly
I We"eld
4XYear
4XYear
4XYear
4XYear
4Y.Year
4XYear
I 4XYear

03-12
Sampling Parson(s)
NON -DISCHARGE MONITORING REPORT (NDMR)
Certified Laboratories
Page -,2- of
Name: Robert Charles White Name: Statesville Analytical, Inc.
Name: Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? 111 Compliant ❑ Non -Compliant
If the facility is non -compliant, please explain in the space below the reasons) 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.
TO INCLUDE QUARTERLY RESULTS ON THE 27TH THAT WERE INADVERENTLY
Operator In Responsible Charge (ORC) Certification Permittee Certification
ORC: Robert Charles White Pennittee: Div. Of Parks & rec (Lake Norman SP)
Certification No.: 1004687 Signing Official: Greg Schneider
Grade: S2 Phone Number: 336-549-8990 Signing Official's Title: Park Superintendent
Has the ORC ehanged since the previous�NlSMw Yes � No Phone Num er: 704-528-6350 / ) Permit Expiration:
f
Signature Date
By this signature, I certify that Uiis report is accurrate and complete to the best of my knowledge.
Sjghature Dale
I cedity, under pens ow, that this document and all arachmenle were prepared under my direr ion of supervision
accordance with a system designed to assure that all qualified personnel pfoparly galhwed and evaluated the inrogr:
submitted. eased on my inquiry of Iha person or persons wtxr manage the system, or (hose pemons directly respn
gathering the information, the information submitted is, to the best of my knowledge and belief. l uo, accurate„
am aware that there are significant penalties for submitting false Information. Including the possibFily of nne
far knowing violations.
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of _
11
Facility Name: lake Norman State Park
County: Iredell
Month: March
IrrigationMpp-
occur
at this facility.?
YES NO
�ef.x�y'�ai
I� • • .
. - s .
.... .
. - ..
. - . .
� n
�
®
Field Irrigated?'
HIM....��.�.®..�....�...
........
HIM
110
m
HIM
r..®.�.��.....�
ME
®m��..®�...�...�.�
®...�...�......�...
AIM
HIM
...
.,�rrrr�rrrrrrr,,
;rrrrr,®rrrrr,;®rrrrrr®rrrrrr�,�;rrir,.���,
. ..
,�irriai.
W5ft/��rrrr0N/"�rririrr,�irrrr�,:��rrrrr�,�irirrr�
rrrrr
®rrrrrr,�,..arrrrr,�l�rrrri,��rrrri�,.

NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Page of
teed the limits in Attachment B of your permit? a Comotiant a Non�C.oiminiant
iken to prevent effluent ponding in or runoff from the sites? - Complkint c; Non-ODMpliant
Was a suitable vegetative cover maintained on all sites as specified in your permit? 0 Compliant . a Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site? a Compliant a Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? a 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
TaKeoll.
Operator in Responsible Charge (ORC) Certification Pernififtee Certification
I ORC: Robert Charles White
Certification No.: 1004687
Grade: S2 Phone Number:
I Has the ORC changed since the previous NDAR-17
Permittee:
Div, Of Parks & Rec (Lake Norman SP)
Signing official. Greg Schneider
336-549-8990 Signing
0 yes W No �1 Phone I
Park Superintendent
Permit Exp.: 9/30/20
Z �3
nature _ Date Signature Date
By this signalwe. I cLaily that this report is accurfale and Complete to the best of my knowleolje. z;erVy, under. penalty of law, that ibis dactatent and all attachments were prepared under my direction or supervision in accor0ance
with a system designed to assure that all quVifit2d PC(s0fincl properly gatnered and evaluated the information subrnined. Based on
my inquiry at the pwson or poisons who manage line system, or those persons directly responsible for gathering the infrirmaGon, IM
information submitmil is, to the best of my ktWMedge and bellef, true, accurate. and complete. I am aware that more are significant
penalties for submitting faNe information, including the possibility of lines and imprisonment for krwMng vlol8liOnS
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

NON -DISCHARGE MONITORING REPORT (NDMR)
Page — of __'.
WQ0020881 —7
Facility Name-. Div. Of Parks & Rec (Lake Norman SP)
County: Iredellmonth:
March
Year. 2019
p
PP
Fiow wring Point: - InAtient u Effluent. a No flow clenefated
Influent 2 Effluent a Groundwater lowerinq 0 5urface Water
parameter Monitoring Point:
Para!melier Code --o-
50050
$0060
00400
C0310
31616
00610
0006
00620
00625
00530
00665
>
>
04
0
0 72
L)
w
0
0
W
0rn
U.. 0
2
E
E
0 0.6
CL co
'o CL
I-0
4 -ph ro
hrs
GPD
mg/L
sil
mg/L
#1100 mL.
mg/L
ing/L
mg/L
mg/L
mg/L
mg1L
.,4.53
2
453
3
'453
4
4
453
5
5
'453
6.
13:30
1
4$3
0
7
453
453
453.
10
453
11
1110
0.75
453—
0
6,02
12
453
13.
4513
141
453.
15
453.
1
.45317
453
18
18
453
20
:,.453
21
10:00
0.5
4153,
0.01
645:
T2
-453,
231
453
24
453
25
453
26
45327
11:00
0.5
453,
"'.39"
28
453
291
453
301
1
453.
311
1
Average-.
453
0,02
Daily Maximum:
453
0,05
7.39
Daily Minimum:
45.3
0.00
6.02
Sampling Typo:
Recofder.
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Monthly Limit:
Daily Limit:..
----T-4xyear
_4X_Y.
Sample Frequency:
.
confinuo63
on""y,
Weekly.
4XYesr
4X Year
4XYear
4>�Year
4xye2r—

NON -DISCHARGE MONITORING REPORT (NDMR) Page of
Sampling Person(s) it Certified Laboratories
Name.Robert Charles White 11 Name: Statesville Analytical, Inc,
Name: H Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit?
If the facility is non compliant, pieasi 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.
TO INCLUDE {QUARTERLY RESULTS ON THE. 27TH THAT WERE INADVERENTLY LEFT OFF.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Robert Charles While
Permittee. Div. Of Parks & rec (Lake Norman SP)
Certification No.: 1004687
Signing Official: . Greg Schneider
Grade: S2 Phone Number: 336-549--8990
Signing Official's Title: Park Superintendent
q Yes NO
Has the ORC chang cethe previous ND_MRJ
Phone Numbe . 704-528-63 0 Permit Expiration:
Date
Signature
tl a
gnature
By tr;s signature, £ certify that this report_is accurraie and uornptete to the best of my
t
knowledge,
un t Qf lava t ! Y3 siacu ht i 2ntl� Y attach cnt6 were prepared udder my MLCAIM at suPeNision i�
ice
dy. sty
enea w try a 5 5 esr ned to assure that ail ua£;tie1 er'sonnel orq n atpered and evaluated the information
9
subml}ted. Based on my inquiry of the person of pwsons was manage the s/siem, or those pvrwns d£ mfly responsible for
gathering the anformalio ' the ifa40(rrlaGron. somitted is,. to the hest of my knowledge ,.a ndbetieC true. accurate, and comps ate. i
.
a"I aware lbal there are significant penalties for subrnit;£ng false rnrnrrnarion, inciuding the pwtysibiiRy it fines and imposer rent
.
for ka omng viotafions..
Mail Original and Two Copies to:,
Division of Water Quality
information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

NON -DISCHARGE MONITORING REPORT(NDIVIR) Page __L_ of
ponnit No., W00020881
Facility Narnal Div, Of Parks & Rec (Lake Norman SP)
County: Ifedell
Month: March
2019
ppl:
Flow Measuring Point: []influent C-lowent (.' Uo lkrw peawated
pararnater Monitoring Point: n InW�jij 61 9_ffl.r;nt Ll Grc tndvfafer Loeitrvj Cl Surface water
— --'
ParamaTWC;io
iC060
_T
60060-'r
E�4 6D
C&310
Fi16167
1
00630
00621)
00625
00530
00665
>1
'X
p
0
I.-M
0
0
9
M
Z
1 2
1X 0
06
02
0
=
o
L)
0
E
L:
+
Z
r
0
z
co
to &n
CL
24-h,
hrs
GPD
mg/L
su
mg/L
0100 m1
mg1L__
mg1l.
mqlL
mg1L
mg/L
mgi L
1
453
2
453
3
463
4
453
5
463
6
13:30
1,25
0
6.3
7
­453
453
8
453
9
453
10
453
11
11:10
0,75
453
0
6.02
12
453
13
453
14
463
Is
453
16
453
TT
453
Ts
453
is
453
201
453
211
10,00
0.5
453
O:Oi
6,45
221
453
23
453
24
453
25
453
26
453
27
11:00
0.5
453
0,05
7,39
9
is
11,2
012
14.56
_7.1_61
3>2
28
463
1 29
3110
31
463
453
Average.
463
0.02
9,00
15,00
11,2p
0.12
14.56
517
3.20
..... . . . .....
Daily Maximum;
453
0.05
7.39
9.00
45.00
11,20
0,12
. ... . .... ..........
00
nT
9:00
'11 :20
'IT.-
-­1-47
'55.17
'--3.'20'*+"-
Sampling Type-
Recorder
Grab
Grab
Grab
Graf)
Grab
Grab
Grab
Grab
Grab
Monthly Limit:
Pally Limit;
sample Frequency:
"Continuous
Wee
4XYear
4XYcar
4XYear_
4XYoar
4XYear
I

Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit?
� C,ocsy}3iyant
Nnn-Compt1ant
It 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.
AMENDED TO INCLUDE QUARTERLY RESULTS ON THE 27TH THAT WERE tNADVERENTLY LEFT OFF.
Operator In Responsible Charge iORC) Certification
Perfaittoo Certification
ORC: Robert Charles White
Pemiittee: Div. Of Parks 8L rec (take Narrnan SP)
Certification No.: 10046B7
Signing Official: Ufet3 Schneider
Grade: S2 Phone Number: 336-549-8990
Signing Official's Title: Park Superintendent
Has the ORC whariged since the previous: M Gtes 0f4o
Phone Nurrit ar. 704-528-6350 Permit Expiration;
f
L7 z— %G
r
Signature
Date
S' sture
Date
By (ilia s,lln©tnrE, I cenity slat ears re{xin ei amviate ono comv1 to to ink- best of ry knowledge.
nt ; n+. n; R,'n5 ocaxnent aid 09 e. dW,0nt4 i e e pi Jpaed umler ma e ro tian cr -wer4i;wll
.i..r"A ui31CR' L1il�t a 9p5SetIS •iCSrtlrlCtl to eau!-.tt 1ialS +iI LjJJ f.HL!, (; l°rYL)fVi1Gi piU(?N(3y .}�illaY (Mj it+.J
Z4J Watcd II it
<1ltirtliiiv:r Ralsod Lin my itiq.;y of the pef5on of riefSanS tt: r'i ni:?f 31z$< tilt sy5fear, iN tnntt for
;;rsia» Jsp the inlccmaGnn, the ;;dormo,r t Fub.RtitleA? ti.. IA t^r. arcE of nay knmYfadp4 and Aolief. 6^+to. ae'L>_�ase a -ad rcmrlc;r.•,
'o, 1:AlWo trial Moto Oro F.n(Yticant prinatllus fp3'i l+iilil-k1. 1� <9?SC mfofrL?xwf3. imiucrng oi6 at,
of it't)S (u..{pfX1-lil.Y,•fi?Pt
SJ( iU1:X4;f.,J 1'It`�8t1U+:s
Mall Original and Two Copies. to:
Division of Water Quality
Information Processing Unlit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

Page of a
NON -DISCHARGE
MONITORING
REPORT (NDMR)
Q0020881
FPlTF1.w7Mauem
Facility Name: Div. Of Parks & Rec (Lake Norman SP)
Facility
--Fcounty:
Iredell
Month:
February
Year: 2019
PI: Flow Measuring Point:
0 Influent
0 Effluent
0 No flow generated
Parameter Monitoring Point:
o Influent a Effluent
13 Groundwater Lowering 0 Surface Water
Parameter Code --io.
:-500k.'
50060
00400:'
C031
0 0610
00620
00530
ea
>
0
0
cv.i
2
0
.4
U)
.0
P R
V
<
0
�0
E
0
a
L)
..U.
S
U)
0
0
......
0
o
&
WQ F1 0
24-hr
hrs
rrigil-
mg/L
mg/L
mg/L
mg/L
..;m 9
L: G1
CE
1". 2114-
21
31
1
41
1
3.14
61
11:45 1
0.5
0.03
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6
6
7
10
...... .. . .
12
10:00
0.25
13
314:,
'14
16
.. .. ......
16
........... .. .
17
W.W.
18
19
10:00
0.5
314:
0.018
20
21
77
. . . . . . . ..........
22
23
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24
2
2
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13:00
0.5
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26
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28
29
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3
31
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Average:
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0.03
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Sampling Type:
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Monthly Limit:
Daily Limit:
Sample Frequency-
Monthly
J.'j

NON -DISCHARGE MONITORING REPORT (NDMR) Pagerj_ofa
' Sampling Person(s) Certified Laboratories
Name: Robert Charles White 11 Name: Statesville Analytical, Inc.
Name: II Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? o Compliant oNon-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.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Robert Charles White
Permittee: Div. Of Parks & rec (Lake Norman SP)
Certification No.: 1004687
Signing Official: Greg Schneider
Grade: S2 Phone Number: • 336-549-8990
Signing Official's Title: Park Superintendent
o yes o No
Has the ORC changed since the previous NDMR
Phone Nu er 704-528- 0 Permit Expiration:
Signature Date
Signature Date
By this signature. I certify that this report is accurrate and complete to the best of my knowledge.
Ice , u�ef,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. 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 Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

NON -DISCHARGE• -.- D•
w—VQ0020881
Facility Name: lake Norman State Park
Co - unty: Iredell
Month:
February
irrigationpp—
at this facility?
';II
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C,
NO
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Page O� of
I NON -DISCHARGE APPLICATION REPORT (NDAR-1)
application rates exceed the limits in Attachment B of your permit?
o Compliant o Non -Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites?
a Compliant o Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit?
o Compliant o Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site?
o Compliant o Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
o 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.
IOperator in Responsible Charge (ORC) Certification II Permittee Certification
ORC: Robert Charles White
Certification No.: 1004687
Grade: S2 Phone Number: 336-549-8990
Has the ORC chagged since the previous NDAR-1? o Yes o No
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
Pet-rttittee:
Div. Of Parks & Rec (Lake Norman SP)
Signing Official: Greg Schneider
Signing Official's Title:
Phone
Permit Exp.: 9130/20
Signature Date
I cerli nder enal law, that this document and all attachments were prepared under my direction or supervision in accordance
vith 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 Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

EEEWPO!12ppp�
NON-DISCHARGE MONITORING REPORT (NDMR) Page
It No.: WQ0020881
Facility Name: Div, Of Parks & Rec (Lake Norman SP)
County: Iredell
Month: JANUARY
Year: 2019
PPI:
Flow Measuring Point: Ofnfluent ❑ Effluent ❑ No flow generated
Parameter Monitoring ❑Influent l7 Effluent ❑Groundwater Lowering ❑Surface Water
g Point:
Parameter Code --►
50050
50060
00400
C0310
31616
00610
00630
00620
00625
00530
00666
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3
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6
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7
494
8
09:30
0.5
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9
10:15
0.5
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10
494
11
12:15
0.5
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6.89
12
494
13
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14
494
15
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16
10:45
0.5
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17
494
18
494
19
494
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:+
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494
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21
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494
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494
`
28
494
29
12:30
0.5
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494
31
494
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494
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494
0.01
6.89
Daily Minimum:
494
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6.20
Sampling Type:
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Grab
Grab
Monthly Limit:
Dally Limlt:

MR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page of
Sampling Person(s) Certified Laboratories
Name: Robert Charles White Name: Statesville Analytical, Inc.
Name: II Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? la 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.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Robert Charles White
Permittee: Div. Of Parks & rec (Lake Norman SP)
Certification No.: 1004687
Signing Official: Greg Schneider
Grade: S2 Phone Number: 336-549-8990
Signing Official's Title: Park Superintendent
Has the OR nged since the previous NbMR7 OY`�ENOPhonPermit
704-528 3 Expiration:
11
7Num
Signature Date
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
I certify, u . ry 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.
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center

NEEMPOP8-1plop-
NON-DISCHARGE APPLICATION REPORT (NDAR-1)
Page
_4b" WQ0020881
FacilityName: lake Norman State Park
County: Iredell
Month: January
01=iiiiiiiiiwal
r irrigation occur
at this facility?
2 YES 11 NO
Area (acres):'
Area (acre
Cover Crolp-:1
Cover Cro
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08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Page of
Mid the application rates exceed the limits in Attachment B of your permit?
0Compliant ❑Non -Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites?
@Compliant ❑Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit?
GCompliant El Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site?
0Compliant ❑Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
0Compliant ❑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.
Operator in Responsible Charge (ORC) Certification Permittee Certification I
I ORc: Robert Charles White
Certification No.: 1004687
Grade: S2 Phone Number: 336-549-8990
I Has the OBechafiged since the previous NDA,R-1? ❑Yes ID No
2Zvi
Signature Date
By Ibis signature. I certify that this report is accurraie and complete to the best of my knowledge.
Permittee: Div. Of Parks & Rec (Lake Norman SP)
Signing official: Greg Schneider
Signing Officials Title: Park Superintendent
Phone Numbin) 704-528-6350 / I Permit Exp.: 9/30/20
02
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 Quality
Information Processing Unit
1617 Mail Service Center

NON -DISCHARGE MONITORING REPORT (NDMR) ` Page / of
020881
.Facility Name: Div. Of Parks & Rec (Lake Norman SP)
county: Iredell
Month: December
Year: 2018
Flow Measuring Point 2Influent 0Eluent ❑Nonow generated
Parameter Monitoring Point: Oinfluent 0Effluent ❑Groundwater Lowering ❑Surface Water
arameter Code _ `
60050`
..
50060
00400
C0310
31616.
00610
00620
00626
00530
66600630
00
m
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•E p
U '=
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.
6
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-
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11
12
13
14
16
17
18
20
21
22
11:40
13:00
0.5
0.5
445:.,- =
A446:.,-,
446;.:
445...:.
445;,.- '
0
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10
12.2
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3,3
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23
24
-
26
26
13:15
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0.04
6;64
27
445• :;
2B
29
30
31
1
Average
445 ...
0.05
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.12.20...;
11.20
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] 5.01.
d,63
3 3
:.
Dally Maximum
446 . -, .
0,15
8,89 ..;
10.00
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..
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.
Daily Minimum
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445 :..
0.00
Grab
6 44.,, .
Grab..'
10.00
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1120,
Grab.'„.
11.20
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...
0:10 ,.
Graff
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4.63
Grab
Grad'.
.
Monthly Urnit:
;. .:: '
Daily Limit:.;::
Sample Frequency::_Mortttify �'j
Monthly
Week}y .
i

NON -DISCHARGE MONITORING REPORT (NDMR) Page
Sampling Person(s) Certified Laboratories
Robert Charles White 11 Name: Statesville Analytical, Inc.
Name: II Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment of your permit? 0Compliant ❑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.
AMENDED TO INCLUDE QUARTERLY RESULTS ON THE 14TH THAT WERE INADVERENTLY LEFT OFF.
Operator In Responsible Charge (ORC) Certification
Permittee Certification
ORC: Robert Charles White -
Permittee: Div. Of Parks & rec (Lake Norman SP)
Certification No.: 1004687
Signing Official: Greg Schneider
Grade: S2 Phone Number: 336-549-8990
Signing Official's Title: Park Su rintendent
Has the ORC c nged since the previous NDMf�? Eyes N°
Phone Nu er: 704-528-63 0 `, Permit Expiration:
'� Signature Date
Signature Date
By this signature, 1 certify that this report is accurrale and complete to the best of my knowledge.
/
I cent , td F , y of law, Ihat this document and all attachments were prepared under my direction or supervision in
aaordance wilh a system designed to assure that all qualified personnel property gathered and evaluated the information
submilled. 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 hest 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 Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

mew
' '
�
�
�
�
�
�
��

NON -DISCHARGE MONITORING REPORT (NDMR) Page of
Sampling Person(s) 11 Certified Laboratories
Name: Robert Charles White 11 Name: Statesville Analytical, Inc.
Name: 1II Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? compliant Don -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(p) of the non-compliance and describe the corrective action(s)
taken. Attach additional sheets if necessary.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Robert Charles White
Permittee: Div. Of Parks & rec (Lake Norman SP)
Certification No.: 1004687
Signing Official: Greg Schneider
Grade: S2 Phone Number: 1 336-549-8990
Signing Official's Title: Park Superintendent
Has the ORC changed since the previo NDMR? Ares Elo
Phone Numbe : 704-528 0 li Permit Expiration: 9//`3012020
Il
4
Signature Date
Zlaw,
Date
Signature
By this signature. I certify that this report is accurrate and complete to the best of my knowledge.
I certify, that this document and all attachments were prepared under my direction or supervision in
accordance Willi 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, tam
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 Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

NON -DISCHARGE APPLICATI ON REPORT (NDAR-1)
Page
of
Facility Name: lake Norman State Park
County: Iredell
Month:
December
ppp—
.en
occur
Field Name:.
Field Na e:1
ppp__
-As facility?
Area (acres
pp
pp
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logo
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mm-
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NNOW/1

NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page 2 of 2
exceed the limits in Attachment B of your permit? ❑� Compliant ❑Non -Compliant
ate measures taken to prevent effluent ponding in or runoff from the sites?
Pas 'asuitable
QCompllant
❑Non -Compliant
vegetative cover maintained on all sites as specified in your permit?
(]Compliant
❑Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site?
OCompliant
❑Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
[2]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.
Operator in Responsible Charge (ORC) Certification II Permittee Certification I
ORC: Chip White
I Certification No.:
Grade: Phone Number: 336-549-8990
Has the ORC changed since the pre-4ious NDAR-1? ❑Yes (]No
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
Permittee: Div. Of Parks & Rec (Lake Norman SP)
Signing Official: Greg Schneider
Signing Official's Title: Park Superintendent
Phone Nurkbr: 704-520-0350 Permit Exp.: 9/30/20
Signature Date
I cerlIN, undercnalry 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 possibllity, 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

._
NON-DISCHARGEpppp�
�.
MONITORING REPORT • - Page OfFacilityName:
Div. Of •
-.Month:
NOVEMBER
• .
a: ■ _
.._�.f.. �
Parameter Monitoring Point:■ o ■ ■
11.1
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,
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f

NON -DISCHARGE MONITORING REPORT (NDMR) Page . of a
Sampling Person(s) Certified Laboratories
Charles White li name: Statesville Analytical, Inc.
Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? G7Compitant _ 0Non-Wrpaant
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 descnbe the corrective
action(s) taken. Attach additional sheets if necessary.
Operator In Responsible Charge (ORC) Certification
Permittee Certification
ORC: Robert Charles White
Permittee. Div. Of Parks 8t rec (Lake Norman SP)
Certification No.: 1004687
Signing Official: Greg Schneider
Grade: S2 Phone Number: 336-549-8990
Signing Official's Title: Park Superintendent
Has the ORC changed since the previous NDMR? QYes M No
Phone N ber: 704-5 350 Permit Expiration:
i2^27-iS(
2 y �
Signature Date
Signature Date
By this slgnattere. I certlfy that this report is accurrale and complete to the best of my knowledge.
l , and ar law, that ItBs domtment and all atlactimenta were prepared under my &adlon orsupenvLoon in
accedence with a system designed to assum thal all qualified personnel proparly gathered and evaluated Me Information
submitted. Based on my hquily of the person or persons who manage Im system, or those persons dim* rewonabte for
gathering the InWmation. the bdormation submitted is, to the best of my knowledge and bellef, true, ecourate, and complete. ) am
aware that there are sIgnificant penalties for submil6ng false informatkm. brr3uding the possibility of runes and imprisonment For
knot" violations.
itiui) r�ri6.yi ri,;l aliii iLNtA i �:i ; ._: n• _
Iri:Urma!;on Proces£:rt:] '. i
1617 Mail Service Center

NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page �_ of a
Facility Name: - Norman State Park
,-Eton occur mom=,
.. . .
OYES 0 NO
a +
County: Iredell-
.- ji
-
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PPPNON-DISCHARGE APPLICATION REPORT (NDAR-1) Page o7 of c
tesceed exthe limits in Attachment B of your permit? acomptlant own -compliant
measures taken to prevent effluent ponding in or runoff from the sites? of ompiYant allon{omptlant
p0requate
Was a suitable vegetative cover maintained on all sites as specified in your permit? fa Compliant ❑Non-CamlAad
Were -,all setbaoks-iisted lityour permit maintained for everyappUcation to each -permitted site? acampliant ❑koaZamptlad
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? dcarlpbnt 0Non-compilara
If the facatty is non-comoiiant. Dlease explain in the space below the reason(s) the faciflty was not in compliance. Provide in your explanation the date(s) of the non-compliance and describe the corrective
action(s) taxen. Attacn soonionai aneets it
Operator In Responsible Charge (ORC) Certification
ORC: Robert Charles White
Certification No.: 1004687
Grade: 52 Phone Number. 336-549-8990
Has the ORC changed since the previous NDARA? ayes 0No
Signature Date
ey this signature, I dxrtlfil that this repon is extrintta and complete So the best of my kn=ledga.
Petm)ttee Certification
Permittee: Div. of Parks & Rec (Lake Norman SP)
Signing official: Greg Schneider
Signing OtficlOs Title: Park Superintendent
Phone Numobr:l 704-528-6350
Exp.: 9/30120
/ Ignature Date
I certHy, under pen fits dodxrmeM and all altadlments were prepared under my direction or supervision In aaaordenae
Wit a system designed to assure that all qualifled personnel p WeM gathered end evalualed the idormalWn submitted BMW on my
inquiry of (tie person or persons who matlage Me MOM er those persons directly rwpQrw&a forgathering the liffbmu l{ m. the
inrdNmafion submitted Is, to on best of my knrHdedge and bagel. troe, accurate, and complete. I am avrare that there are significant
perils for submitting false information. Wuding the possblydy of fines end Imprisonment for knawing vlolarans.
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
11617 Mail Service Center

NON -DISCHARGE MONITORING REPORT (NDMR) Page --I— Of �
Facility Name: Div. Of Parks & Rec (Lake Norman SP)
Month: October
Flow Measuring Point: Blrftwt ■ ■ No flOw ge"wted
Parameter Monitoring Point: 131nfMnt GEffluot ■ ■ -
- ,.�
.
®
,.�,:
, , :��iiiiiiiiiifMiiii■"iWY�iilfii
e
mom

NON -DISCHARGE MONITORING REPORT (NDMR)
Page e2 of
Sampling Person(s)
Certified Laboratories
(Name: Robert Charles White Name: Statesville Analytical, Inc.
Name:
Nerve:
Does all monitoring data and sampling frequencies meet the requirements In Attachment A of your permit?
If the -facility is non-comptlant, ptease-explain In-tffe -space below the reason(s) the facility was not in compliance. Provide in vour exblanarrnn rhn ttatarn% „o rke
taKen. Attach additional sheets if necessary.
Operator In Responsible Charge (ORC) Certifical
ORC: Robert Charles White
Certification No.: 1004687
Grade: S2 Phone Number: 336-549-8990
Has the ORC changed since the previous NDMR? Yes n nO
' Is
Signature Date
By this signature, I cedlfy that this report Is accwrate and oortplete to the bag of my knowledge.
Non -compliant
-- ---- ---••---••p......w ra.na---'w LIM 41;OrIH6pve
Permittee: Div. Of Parks & rec (Lake Korman SP)
Signing Official: Greg Schneider
Signing ONiciars Title: Park Superintendent
Phone Number: 704-528-6350 Permit Expiration:
Signature Date
I -'I*' under partly of law, that this document and all attachments were prepared under my direction or n pervlslon M accordance with a system designed to assure that eq greHed persOm®t VOy8111? get MW and evaluated Jim Information
submiBed. 88W on mY Nuly of die Pemon or persons Who menage the system, or arose persons d(recfly respons6te for gathering the trafomratfon. Ike information sulmtdied is, to the test Of my knowledge and boar, true, exurate, and umnpksie. I am
aware that there are *fficaot Penalties for sralmlttbV false information, Wdudn0 the PossibBky of flan and Im"onrnem for
knowing Wotations.
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1017 Mail Service Center

' NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Facility Name: .Lake Norman State Park County: Iredell Month:
Field Nance: A Pleld N
irrigation occur °me• t3 FiewNanre:
Pat this facility? Ares(acm): 1.716 Area (acres): 1.715 Ares4acim);
Cover Crop: Woodland Cover Crop: Woodland coven`s .
o YES 13No Ho4dy 12i�bs (in}: 0.4 Hourly Raba (in): 0.4 Hourly RAfe (IMl':
Annuet;itate(tn}: 30.18• AnnualRate(In): 30.16 Anntral.Raie:{iri)e
Weather Freeboard Fl@ld Irtigalied7� W�`� ❑ NO Field irrigated? YES ONO Field )rrl 'fsd?
r Is S
°F In R ft gal min in in gal min in in gal min in in
1
75
12
OE
0.28
236 1 0.68 I 0.17
155 1 0.44 1 0.17
1.12
5.38
Page _L of _Q_
October
Year. 2018
Field Name:
Area (acres):
Cover Crop:
Hourly Rate (1n):
Annual Rate gn):
Field Irrigated?
Ea
OYES O rro
E v
gal
min
In
in
0

NON -DISCHARGE APPLICATION REPORT (NDAR-1)
wd the limits in Attachment B of your permit?
an 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?
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
Page .0 of
O compliant
❑ Non-compllant
0 Compliant
❑ Non-cormrpuant
a Compliant
O Non -Compliant
M Compliant
❑ Non-Contphrit
ocompliant
oNmrCompllant
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 conective
action(s) taken. Attach additional sheets If necessarv.
ORC: Robert Charles White
Permittee: Div. Of Parks & Rec (Lake Norman SP)
Certification No.: 1004687
signing Official: Greg Schneider
Grade: 82 Phone Number. 336-549-8990
Signing Official's Title: Park Superintendent
Has the ORC changed since the previous NDAR-1? ❑yg MNo
Phone Number: 704-528-6350 Permit gxp.. MOM
Signature Date
Signature Date
lwm
By Ihts ahgnshae, I oaatry that this report is accurate and complete to the best of my knowledge.
certify, under penalty of taw, that this dowmast and all attaehmentswere prepared under my diredion or supwA&n in acoNdance
a system designed to assure that all "Illiied personnel property gagtered and evaluated the information suhm4fad Based ort roY
IngWrt of the person or persons who manage the system. or those persons directly responswe for gatherrbmp tits irtivrnaaon, the
information submitted is. to the best of my krAhv"e and belief, bun, aoaude, aril cmptete. I am aware that tkere ate aSgmtncam
Penalties for submitting raise htformaHM indu ft the possibility of tine and imprisonment for know ing vtgtatlam.
Mail Original and Two Copies ta:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center

QA
NON -DISCHARGE MONITORING REPORT (NDMR) `bu t J Page _Iof;_
Permit No.: WQ0020881
Facility Name: Div. Of Parks & Rec (Lake Norman SP)
county: . Iredell
Month: September
Year: 2018
PPi:
Flow Measuring Point: (]Influent ❑E(Fluent ❑Noflow generated
Parameter Monitoring Point: ❑Influent OEftluent ❑GroundwaterLowedng ❑Surface Water
Parameter Code
'.10060•.
...
50060
00400.,.
C0310
31618.
00610
00630
00620
00626.
00630
09865.
=unvl tJ
NR/bWf,'
C....,
o
U ..:.
¢
o z
V
y
m
A RR
�OROS.
hrs
.
mglL
mg/L
#1100:mL
mglL
...
mglL
mg4.::
mg/
mglL
..
VIALv'r24-hr
2
3
4
1020 ,.
8
1 A20..
6
10:30
1
1:020...
0.44
6.16 ,.
8
9
10
1;020:.:
11
1;tl24., ..
12
,1,020 .,.
13
09:30
1
..:l togo,.:.:.
0.6
6.54..
14
17
18
1;020.; •..
20
21
10:30
0.75
A A20..
0.6
6:88 "
22
23
1,020':'.:`'.�
24
1,020 ..
Q e
26
1.U20 ..,
�-
28
271
11:15
0.75
1 j620 ,.-
; 0.1
7.45 ..
23
>2419.6 ,
15.57
<0.1.
19.49
16.436
5.4
28
30
31
Average:
= .;..1'f)2Q'.,.;;
0.44
23.00
,1,00. ..
15.57
:0.00 ,
19,49...
16.44
5.40, ,..
Daily Maximum:
;:_..:1,020;,.,.
0.60
7,46.._.
23.00
0.00:•, -.
15.57
0:.1.0 ...
19.49,..
16.44
6,40
Daily Minimum
;1;020 ,:i
0.10
.6.16..
23.00
.0.00.; ,
15.57
Oi10 .,
19;49..
16.44
5t40
Sampling Type:
-.Re$oiiiet.'
Grab
.Grab
Grab
Greb'.
Grab
Y3reb
Grab :
Grab
Grab
Monthly Limit:
Daily Llmit:
.. ..:..:..... .
..
Sample Frequency:
Mo6t*.
Monthly
Weekly

R 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page _Q of
Sampling Person(s) Certified Laboratories
Name: Robert Charles White Name: Statesville Analytical, Inc.
Name: 11 Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? o 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 adriitinnal aheafs if not c—no
AMENDED TO INCLUDE QUARTERLY RESULTS ON THE 27TH THAT WERE INADVERENTLY LEFT OFF.
Operator In Responsible Charge (ORC) Certification
Permittee Certification
ORC: Robert Charles White
Permittee: Div. Of Parks & rec (Lake Norman SP)
Certification No.: 1004687
Signing Official: Greg Schneider
Grade: S2 Phone Number: 336-549-8990
Signing Officials Title: Park Superintendent
Has the ORC ch ad since the previous NDMR? yes O No
Phone Num r 704-528-63 Permit Expiration:
Signature Date
Signature Date
,�Pen.2w.
By Ihls signature, I certify Ihal Ihls report Is aecurrale and complete to the best of my knowc
e.t
(:,e.ledgThis document and all attachments were prepared under my direuion or supervision in
accordance with a system designed to assure Thal all qualified personnel properly gathered and evaluated the information
submilled. Based on my inquiry of the person or persons hho manage the system, orlhose persons directly responsible for
gathering the information, the Information submitted is, to the best of my knowledge and belief, We, accurate. and complete.
am aware that there are significant penalties for submitting fake information, including the possibility of fines and imprisonment
for knowing violations.
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

03-12 NON -DISCHARGE MONITORING REPORT
de, t No.: WQ0020881 Facility Name. Div. Of Parks
' .- Septe!Flow leasuringPoint: mber ■flow Ina
generated
El
El
©ter
- r
�r�+■■�w������®r�■���■
0.44
0.60
0.10

03-12 NON -DISCHARGE MONITORING REPORT (NDMR)
Page a of
Sampling Person(s)
Certified Laboratories
Name: Robert Charles White Name: Statesville Analytical, Inc. -
Name: Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? EICompliant °"°n-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.
Operator in Responsible Charge (ORC) Certification Permittee Certification
ORC: Robert Charles White Permittee: Div. Of Parks & rec (Lake Norman SP)
Certification No.: 1004687 Signing Official: Greg Schneider
Grade: S2 Phone Number: 336-549-8990 Signing Offic ai's Title: Park Superintendent
Has the ORC c ed since the t *,-- DMR? OYes oNo
g P Phone Nu b� . 704-528-6350 �� Permit Expiration:
/-�
191,
Signature
By this signature, 1 certtfy that this report Is accurate and complete to the best of my knowledge.
9 0 �b
Dai9e
te azty9lt� f Date
I cart er-pea that this document and all attachments were prepared under my direction or supervision in
accordance wish a system designed to assure that at qualdlotl personnel property gathered and evaluated the Womtaton
submitted. Based on my Inquiry of the person or persons who manage the system, or those persons direcity responsue for
galhering the htformanon, the Information submitted is, to the best of my VaMedge and bagel, true, accurate, and complete. I am
aware that there are significant penalties for submitting false information, including the po"bitity of fates end impdsormem for
knowrtg violations.
Mall Original and Two Copies to:
Division of Water Quality
Infonnatlon Processing unit
1617 Mail Service Center

MEMEMP, 06-11
NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Page _ — of �-
it No... W00020881
Facility Name. lake Norman State Park
More: September
.. irrigation.
° ONO
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,
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. .
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PP7PP'F0R11* NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page e2 of�
Did the application rates exceed the limits in Attachment B of your permit? Oc—pilant ❑Non-comaant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites? acornplient ❑warCompiiant
Was a suitable vegetative cover maintained on all sites as specified in your permit? 0 C=pgant ❑Noncompliant
Were -all etathar-kr. listed 'in your permit maintained for every appjicatiun to each permitted sIte7 Mcompiont ❑Nor Ca MIWt
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? acomptant ❑Non.Compiwa
if the facility is non -compliant, please explain in the space betary 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,
Operator in Responsible Charge (ORC) Certification
ORC: Robert Charles White
Certification No.: 1004687
Grade: S2 Phone Numbest 336-549-8990
Has the ORC�getf sln6 the prevlaus N A? El yes ONO
Signature Date
By this signature, I centfy that this report is 800MVe and complete to the best of my knowledge.
Permutes Certification
Permittee:
Div. Of Parks & Rec (Lake Norman SP)
Signing Official: Greg Schneider
Signing Official's Title: Park Superintendent
Phone
Permit Exp.: 9/30/20
ryrtawfe Date
i
I cenlfy, u � o a document and all attachments were prepared under my direction or supwWjon in accordance
with a system-Tslg"d to assure that allqualified personnel props* gathered and evaluated the Information submitted. Based on my
Ix1Wty of the person or persons who manage the system, or those persons directly respona@le for gains," the tnrorm uen, the
Information submitted is. to the best of my knowledge and belief. hue, ac ctl to. and complete. S am aware that there ens sigf =d
paneldas for submitting false information, tnctuding the possWIY of fines and Imprisonrneni for knowing violetkns.
Mail Original and Two Copies to:
Division of Water Quality
lnfonnation Processing Unit
1617 Mail Service Center

NON -DISCHARGE MONITORING REPORT (NDMR)
Page of
Q0020881 Facility Name: Div. Of Parks & Rec (Lake Norman SP) County: Iredell Month: July Year: 2018
I: Flow Measuring Point: ❑� Influent [-]Effluent ❑No flow generated Parameter Monitoring Point: ❑Influent DEffluent [-]Groundwater Lowering ❑Surface Water
RP
Parameter Code
` 50050
50060 +
`,00400;..
C0310
-31616.�
00610
t00630 6;
00620
` 00625 :,
00530
p
d i`-'
C
��
O
i€:.y
C
�',+�'
r
9 41 j
m.
N
O�.{�[
t
E=
yN.
OCT
v
F
o
v `o
s
a
rc, ° _,
E
.. :9 +
r
Y o
".
c m
I U)-
c a'
�v iE
N
u.
a�i r
v
p
li c
v`
¢
Z z
z
m
o,;z st
U
a,:
WQR
o
O
,'
U)
24-hr
hrs
-- GPD ,,
mg/L
su „
mglL
#1100 mL
mglL
mgIL
mgIL
mgll ;
mglL
f • .mglL , ,,
MOORE'VILLE
1
1,416 _-
i ..r
3
09:45
1
1,416
0.03
i114'
-
4
=;
51
g
1;416
-
71
1,416
$
1,416J- _
77
r
g
1,416''
z
10
10:30
2.75
1;416_;
0.04
6:07.,_'_
- =
12
1,416
13
1 416
14
15
161
17
12:30
1.25
1;416,
0.09
I r
18
f 1,416'
19
1,416,
-
20
'T.
s
"e
21
1�416"
22
1;416'
i-
23
10:30
1
1,416,_`;
0.06
24
25
T1,416'
27
�1,416'_
2811',416'
29
_
1,416
-
30
1;416,
-
31
13:00
0.5
1,416; ;
0.05
Average:
1,41'6:
0.05
Daily Maximum:
' 1-416
0.09
Daily Minimum:
1,416 '
0.03
Sampling Type:
Recorder:
Grab
Grab
_4 `
Monthly Limit:
-
Daily Limit:
_
Sample Frequency:
Monthly;"
Monthly
Weekly,
tr ,

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page of
Sampling Person(s)
Name: Robert Charles White
Name:
Certified Laboratories
Name: Statesville Analytical, Inc.
Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? 0 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
Men. Attacn aaaitionai sneets It
Operator In Responsible Charge (ORC) Certification
Permittee Certification
ORC: Robert Charles White
Permittee: Div. Of Parks & rec (Lake Norman SP)
Certification No.: 1004687
Slgning Official: Greg Schneider
Grade: S2 P 336-549-8990
Signing ial's Title: Park Superintendent
Has the O cha ed since the revious NDMR? ❑ Yes 2 No
Phone N m er: 704-, 8-6350 Permit Expiration:
Signature Date
Signature Date
/law,at
By this signature. I certify that this report Is accurrate and complete to the best of my knowledge.
I certify, under n 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.
bbbbbab,
Mail Original and Two Copies to:

OPermit. NDAR 8-11
8-11 7
-10
P, it Mo... 7
2
WQ7oo 0881
NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of
Facility Name: lake Norman State Park
County: Iredell
Month: July
Year: 2018
Did irrigation occur
Field NAme:
Field Name:
B
i e I d'N Oil i
Field Name:
Area (acres):
1.715
M 9 204 9 .
WAR S V,
MOM,
Area (acres):
at this facility?
. er, rop:..
' "C'-
Cover
Wotan
Woodland
Cover Crop:
Woodland
w
Cover Crop:
txaw
EYES ONO
obrly,l3at�Q(�p)g,,,_:
4­�4-.--�t�­,'�
Hourly Rate (in):
0.4
No' �'y
R'
"I
Hourly Rate tin):
Annual Rate (in)`
30 16
Annual Rate (in):
30.16
n Q V
P
Annual Rate (in):
Weather
Freeboard
Field lrngated2Field
Irrigated?
EYES E]No
C, %ift
'grl
Field Irrigated?
EIYES EINO
>1
0
0
4D
CL M
E_
'
�117).
r_ -
(D
E T
Z
-Z E
':fflE
0M
All-
E
CD
(D
CL
0
Ejd'
31
.2
A
E
co
I
i;,E �
Vx, _�o
a Q
> <
P L
0
0 cu
Cd x 0
0
10
w
0 CL
1_0
C1 0
K 0
Z: 0
I
CL
147 -
F
> <
oF
in
ft
It
gal
'Jm1w,
gal
min
in
in
q a I �I.W.
I WTq 'nA
gal
min
in
in
04�
w
2
ITI
3
R
72
5.1
2.25
24,900
.303
0.53
0.11
4
6
2JI!,
*-"g
7
8
�36.200
-.-,421,
14.!038
Aw_1
10
SN
79
0.68
2.75
18,400
140
0.40
OA7
I.,
1A I" -A
1�
121
13
*U
14
7
16
y
17
SN
88
0.64
2.6
._31700
32,
0.08"i
'­0.08:1'"
181
V '7'
20
21
&
12
23
SN
'72
1.17-
2._5
000
64­7_b�f57
�TA�_ �_A
I
24
25
26
Ln
27
'k
28
?. M00M
29
30
31
—
Monthly Loading:
-45:900-
. 099.
M
73 .30-0
_09-3
:0.00
0
0.00
12 Month Floating Total (in):
5.38

FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of
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?
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
Compliant ❑Non -Compliant
❑� Compliant []Non -Compliant
OCompliant []Non -Compliant
❑� Compliant ❑Non -Compliant
ElCompliant []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.
Operator in Responsible Charge (ORC) Certification Permittee Certification
ORC: Robert Charles White Permittee:
Div. Of Parks & Rec (Lake Norman SP)
Certification No.: 1004687 Signing Official: Greg Schneider
Grade: S2 Phone Number: 336-549-8990 Signing Official's Title: Park uperintendent
Has the ORC changed since-Ih previous NDAR-1? oye��Nd Phone Numb r: 704-528-635 Permit Exp.: 9/30120
Signature _ ..__ Date Signature
By this signature, I certify that this report is accurrate and complete to the best of my knowledge, I certify, Lpenalty.�aw 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 better, true, accurate, and complete. f am a✓oare that there are significant
penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations.

NON -DISCHARGE MONITORING REPORT (NDMR) 0_
1
Page t of
020881
Facility Name: Div. Of Parks & Rec (Lake Norman SP)
County: Iredell
Month: July
Year: 2018
Flow Measuring Point: ElInfluent ❑Effluent ❑No flow generated
Parameter Monitoring Point: ❑Influent Effluent ❑Groundwater Lowering ❑Surface Water
ter Code
50050s '
50060
- 0040Q ,=
C0310
316,16' :;
00610
00630
00620
00625
00530
'
m
•zG 't`n
P t„„
y Y`.,2 dk'x tt
V.
,„Tg£
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s
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=
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m
24-hr
hrs
_ GPD,,
mg/L
Hsu_
mg/L
#/100mL'-
mg/L
",mg/L4='1
mg/L
„,'mg/L ^,
mg IL
2
4
5
12:30
0.5
20,77 -$
0.03
,
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81
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z
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23
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w
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:!
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Monthly Limit:a�
Daily Limit:
Sample Frequency
Monthly
Monthly
Weekl

I
NDMR 03.12 NON -DISCHARGE MONITORING REPORT (NDMR) Page 3 of r
Sampling Person(s)
Certified Laboratories
Name: Robert Charles White Name: Statesville Analytical, Inc.
Name: Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? Qcompliant ❑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.
Operator in Responsible Charge (ORC) Certification Pennittee Certification
ORC: Robert Charles White Permittee: Div. Of Parks & rec (Lake Norman SP)
Certification No.: 1004687 Signing Official: Greg Schneider
Grade: S2 Phone Number: 336-549-8990 Signing Off icj rl' Title: Park Superi dent
/ I
Has the ORC hanged since the g evious NDMR? ❑yes QNo Phone Number: 704-528-6350Permit Expiration:
Signature Date S�fiature Date
By this signature. I certify that this report is accurrale and complete to the best of my knowledge. Lde enalty of law, thadocument and all attachments were prepared under my direction or supervision in
accordance with a s i ned 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.

-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page ( of3—
Q0020881
Facility Name: Lake Norman State Park
county: Iredell
Month: July
Year: 2018
F�eldfName
Field Name:
B
Field Name:
Area (acres)
�r "1 715
Area (acres):
1.715
Area (acresj�
Area (acres):
rrig ,tion occur
r,
at this facility?
a Cover Crop
Woodland �
Cover Crop:
Woodland'CoverCrop
Cover Crop:
Ones [--]NOHourly;Rate
(m)
0 4 6N
Hourly Rate (in):
0.4
HouHy Rate(m);
we
-'
Hourly Rate (in):
Annual�Rate (m)
16 ' `
Annual Rate (in):
30.16
Annual Rate (ink
Annual Rate (in):
v_30
Weather
Freeboard
_ `Field mgatetl?
QYes; ; ! QNOx
Field Irrigated?
❑YES ❑No
Feld Irrigated?
QYESQNO
Field Irrigated?
Qves ❑wo
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12 Month Floating Total (in):
::
5.38
i," .635
a

NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1)
d the application rates exceed the limits in Attachment B of your permit?
Page a of a
[Compliant ❑Non -Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites? ElComphan[ ]Non -compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit? [']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? ElCompliant ❑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.
Operator in Responsible Charge (ORC) Certification
Penoittee Certification
ORC: Robert Charles White
Permittee:
Div. Of Parks & Rec (Lake Norman SP)
Certification No.:
1004687
Signing Official: Greg Schneider
Grade: S2
Phone Number: 336-549-8990
Signing O icial's Title: Park Superintendent
Has the OR a
ed since the previous ? DAR-Q? ❑Yes EJ-No
Phone um er: 704-5 8 6350 Permit Exp.: 9/30/20
/ / Signature Date
Signature Date
By this signature. I certify that this report is accurrate and complete to the best of my knowledge.
I c 'under pe of taw, that this document and a7 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

NON -DISCHARGE MONITORING REPORT (NDMR) Page
W00020881
Facility Name: Div. Of Parks & Rec (Lake Norman SP)
County: Iredell
Month: June
Year: 2018
F.ram7etierCode
Flow Measuring Point: �Inf uent []Effluent ❑No flow generated
Parameter Monitoring Point: ❑[nauent (]Effluent ❑Groundwater Lowering 05urface Water
--►
56050 _'
50060 ..00400
C0310
31616
00610
00630
00620
00625
00530
00665
> O¢
�
O
0
E2
o •
'U''
C)vc
,°
=
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c
0
ro
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'a
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JUL
ENRIDW
P 2078
24-hr
hrs
,GPD
mg/L
su
mg/L
#1100 mL
mg/L
mg/L
mg/L
mg/L
mg/L
mg/L
1
10:25
0.5
2,417
0.05
6.35
2
2,417
3
2,417
4
2,417
5
2,417
6
14:25
2.1
2,417
1 0.06
6.4
7
1 .10:20
4.1
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6.47
8
08:30
2,417
-9-
-2,417-
-
-
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-
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-
11
2,417
T
12
2,417�-
13
2,417
141
14:40
0.5
2,417
0.07
6.38
Ajj
3
15
2,417
16
2,417
11 7
2,417
18
2,417
19
2,417
201
10:10
1.5
2,417
0.03
6.21
21
2,417
22
2,417
23
-2,417
24
2,417
25
2,417
11.6
88.2
8.51
0.28
14.34
14.62
<16.667
6.6
261
2,417
27
2,417
28
2,417
29
11:15
1
2,417
0.09
6.25
30
2,417
31
Average:
2,417
0.06
11.60
88.20
8.51
0.28
14.34
14.62
0.00
6.60
Daily Maximum:
2,417
0.09
6.47
11.60
1 88.20
8.51
0.28
14.34
14.62
16.67
6.60
Daily Minimum:
2,417
0.03
6.21
11.60
88.20
8.51
0.28
14.34
14.62
16.67
6.60
Sampling Type:
Recorder
Grab
Grab
Monthly Limit:
Daily Limit:
Sample Frequency:
Monthly
Monthly
Weekly

NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page of
Sampling Person(s) Certified Laboratories
Name: Robert Charles White Name: Statesville Analytical, Inc.
Name: Name:
i
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? ❑� Compliant Nan -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
actionts) taken. Attach additional sheets if necessary.
Operator in Responsible Charge (ORC) Certification Permittee Certification
ORC: Robert Charles White Permittee: Div. Of Parks & rec (Lake Norman SP)
Certification No.: 1004687 Signing Official: Greg Schneider
Grade: S2 Phone Number: 336-549-8990 Signing Official's Title: P - uperintendent
Has the ORC�hanged since the 9 evious NDMR? ❑Yes EINo Phone Num4r-
57-
0;;1,
Signature Date
1 certify, u el penalty of law, that this document and aU attachments were prepared under my direction or supervision in
accord ce 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 impnsonment for
knowing violations.

NEI
V81
NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page
Facility Name: lake Norman State Park
County: Iredell
Month: June
.. • occurArea
at this facility?
21YES E:1N0
Field Name.
Field NamZ
Field Name:
(acres):
Area (acra
Area (acres):,
.....
.... .
�.
-.
.Annual
Rate
■ ■ •
0 ■ •
■ ■ •
:.
■ ■ •

1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Page of
Pwthe application rates exceed the limits in Attachment B of your permit? ❑Compliant [_iNon-Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites? (]Compliant ❑Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit? ❑Compliant ❑Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site? j]Compliant ❑NDn-Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? OCompliant ❑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.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Robert Charles White
Permittee:
Div. Of Parks & Rec (Lake Norman SP)
Certification No.: 1004687
Signing Official: Greg Schneider
Grade: S2 Phone Number: 336-549-8990
Signing Official's Title: Park Superintendent
Has the OR ha ed since the previous NDARA? ❑yes ❑No
Phone Num er: 704- -6 50 Permit Exp.: 9/30/20
7Z
Signature Date
Signature Date
By this signature. 1 certify that this report is accurrate and complete to the best of my knowledge.
I certify, under penalty of law, that this document and ail 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 gathenng the information, the
information submitted is. to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are signitiwnt
penalties for submitting false Information, inducting the possibility of fines and imprisonment for knowing violations.

IYVI\-UIJVfIMf\V6 It IVl\11 VrVl\V r\C.r Vr\I k1m La my
'AAW"'] Facility Name: Div. Of Parks & Rec (Lake Norman SP)
•
Daily Maximum:
Sampling Type:
Monthly l-imit
Sample Frequency:

NON -DISCHARGE MONITORING REPORT (NDMR)
Page of
Sampling Person(s) II Certified Laboratories
Charles White 11 Name: Statesville Analytical, Inc.
Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? (]Compliant [—]Non-com pliant
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 dates) of the non-compliance and describe the corrective
action(s) taken. Attach additional sheets if necessary.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Robert Charles White
Permittee: Div. Of Parks & rec (Lake Norman SP)
Certification No.: 1004687
Signing Official: Greg Schneider
Grade: S2 Phone Number: 336-549-8990
Signing Official's Title: Park Superintendent
Has the ORC hanged since the Obvious NDMR? ❑Yes ENO
Phone N m er: 04- 8-6350 Permit Expiration:
Signature Date
Signature Date
By this signature. I certify that this report is accurrale and complete to the best of my knowledge.
I cert�nder altyof 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.

County: Iredell Month: May
r;,7,ild Nam
Facility Name: lake Norman State Park
,ion occur
Area (acres):
Area (acres):
..
.... .
. ..
.... .
. ..:
Giver Cr..
• .
-.
• •
-.
PIYES ■ •
•
. .Annual
Rate (in):
Annual Rate (i
Fiel
Monthly Loadi

NON -DISCHARGE APPLICATION REPORT (NDAR-1) .
Page of
rsuitable
on rates exceed the limits in Attachment-B of your permit? Compliant ❑Non -Compliant
easures taken to prevent effluent ponding in or runoff from the sites? Compliant ❑Non -Compliant
Faegetativecover maintained on all sites as specified in your permit? Compliant ❑Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site? F21compliant ❑Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? (]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
—C, fol fnkan Aftarh arirminnal chPets if necessary.
Operator in Responsible Charge (ORC) Certification
ORC: Robert Charles White
Certification No.: 1004687
Grade: S2 Phone Number: 336-549-8990
Has the ORC, 6ar;jed since the previous gaAR=J? ❑Yes ❑No
/ ,f %,— G . � 7- 10
Permittee Certification
Permittee: Div. Of Parks & Rec (Lake Norman SP)
Signing official: Greg Schneider
Signing Official's Title: Park Superintendent
Phone Number: 704-528-635,Q Permit Exp.: 9/30/20
Signature Date r Signature Date
By this signature. I certify that this report is accurrate and complete to the best of my knowledge. I certify, under 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.

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FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR)
f -
Sampling Person(s) Certified Laboratories
i
Name: Robert'CharlesWhite Name: Statesville Analytical, Inc.
Name: 11 Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? ❑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-additinnal sheets if nececcary
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Robert Charles White
Permittee: Div. Of Parks & rec (Lake Norman SP)
Certification No.: 1004687
Signing Official: Greg Schneider
Grade: S2 Phone Number: 336-549-8990
Signing Official's Title: Park Superintendent
Has the ORC c since the previo ❑Yes ONo
Phon _ u bej : 704-528 50 Permit Expiration: 3/18/1900
Signa Date
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
I certify, un 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.

NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Page I of 9
881
on occur
IS faCIIIty
DYES ❑No
Facility Name: Lake Norman State Park =
County: Iredell
Month: April
Year: 2018
Field Name:
A.:
Field Name:
B
Field Name:
Field Name:
Area (acres):
=, 14.715-'- ° ,
Area (acres):
1.715
= Area'(acres):
Area (acres):
Cover Crop:,
Woodland .. .:
Cover Crop:
Woodland
= Cover:Crop
-
Cover Crop:
,
Hourly Rat in):
0:4: - . ,. ;
Hourly Rate (in):
0.4
t `,Hourly Rate (In):
_ =_ ...:, , -.., ., : `
Hourly Rate (in):
:Annual Rate (in)::..',.•
.30'
Annual Rate (in):
30.16
= Annual'Rate.(in)
Annual Rate (in):
Weather
Freeboard
'Field -Irrigated?.
', ❑YEs : , ❑No..
Field Irrigated?
❑YES ❑No
Field irrigated?
'` ❑YEs`-, ; ,~❑NO
Field Irrigated?
❑YEs [:]NO
G
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9
10
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131
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15
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191
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3
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21
=
22
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R
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0.17
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24
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25
26
27
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28
29
30
31
Monthly Loading:
r 0
0.00•
•'6:46.
0
0.00
6.40
0
000
0
0.00
12 Month Floating Total (in):

FORM: NDAR-1 08-11
NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Did the application rates exceed the limits in Attachment B of your permit?
❑✓ Compliant
❑Non
Were adequate measures taken to prevent effluent ponding in or runoff from the sites?
❑✓ compliant
❑Non -Compliant
Was a suitable vegetative cover maintained. on all sites as specified in your permit?
2Compliant
❑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?
_2 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
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORc: Robert Charles White
Permittee:
Div. Of Parks & Rec (Lake Norman SP)
Certification No.: 1004687
Signing official: - Greg Schneider
Grade: S2 Phone Number: 336-549-8990
Signing Official's Title: Park Superintendent
Has t ORC anged since the pr vious NDAR-1? ❑Yes ONO
Phone Num r: 704-528-63 0 : Permit Exp.: 9/30/20
Signature Date
- Signature Date
By this signature, I certify that this report is accunate and complete to the best of my knowledge.
I certify, under penalty w, -that 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.

NON -DISCHARGE MONITORING REPORT (NDMR)
Page _L_ of
Facility Name: Div. Of Parks & Rec (Lake Norman SP)
County: Iredell
Month: March
Year: 2018
Flow Measuring Point: 2influent ❑Effluent [:]No Flow generated
Parameter Monitoring Point: ❑Influent ❑.r Effluent ❑Groundwater Lowering ❑Surface Water
50050
50060
00400
C0310
31616 .
00610
00630
00620
00625
00530
1 00665
o
1
c
> Q
cai P: ~ �'
U
Q 0
24-hr hrs
LL`
GPD
623
m
' �
0
mg/L
a
su "
c
O
Q
mg/L
p
LL°
p
U
#/100 mL
E
E
Q
mg/L
�
z z
mg/L
z
mg/L
A
Y_ o
=
z
mg/L
.p
0 0
F CL
7
mg/L
w
o n
F w
.p0
IL
mg/L
MOOF
Vt
II�AY
_ WC
ESVILLE REGIONAL
uC;17 L
� LOB
ROS
R
DFFICE
2
623 -
3
623
4
623
5
11:50
1.92
623
6
623
7
623
8
623
9
09:25
3.08
623
0.41
6.92
10
623
_.
111
623
12
623
13
623
14
12:30
1
623
0
8.03
15
623
16
623
17
623
n
18
-623
- ; •
19
623
20
623
�•, '
21
623
221
623
231
10:00
4.17
623
0.007
7.17
13
<1
8.4
<0.1'
11.2
11
28
241
623
25
623
26
623
27
623
28
623
29
12:15
5
623
0.007
7.51
30
623
311
623
Average:
623
0.11
13.00
1.00'
8.40
0.00
11.20
11.00
28.00
Daily Maximum:
623
0.41
8.03
13.00
1.00
8.40
0.10
11.20
11.00
-28.00
Daily Minimum:
623
0.00
6.92
13.00
1.00
8.40 1
0.10
11.20
11.00
28.00
Sampling Type:
Recorder
Grab
Grab
Monthly Limit:
Daily Limit:
Sample Frequency:
Monthly
Monthly
Weekly

FORM: NDMR 03-12
NON -DISCHARGE MONITORING REPORT (NDMR)
Sampling Person(s) Certified Laboratories
Name: Robert Charles White Name: Statesville Analytical, Inc.71
Name: Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? ❑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
Operator in Responsible Charge (ORC) Certification Permittee Certification
ORC: Robert Charles White Permittee: Div. Of Parks & rec (Lake Norman SP)
Certification No.: 1004687 Signing Official: Greg Schneider
Grade: S2 Phone Number: 336-549-8990 Signing Official's Title: Park Superintendent
Has the 9,EC changed since the3jEevious NDMR? ❑Yes RINo Phone Numbera 704-528-riAn Permit Frniratinn• q/1 R/1 ann
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
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 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.

NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page_ of
Facility Name: .Lake Norman State Park County: Iredell Month: March Year: 2018
Field Name: A Field Name: B Field Name: - Field Name:
n occur
Area (acres): `1.715 Area (acres): 1.715 Area (acres): Area (acres):
is facility? Cover Crop: Woodland Cover Crop: Woodland Cover,Crop: Cover Crop:
❑✓ YES ❑NO
Hourly Rate (in):
0.4
Hourly Rate (in):
0.4
Hourly Rate (In):
Hourly Rate (in):
Annual Rate (in):
30.16
Annual Rate (in):
30.16
Annual Rate (in):
Annual Rate (in):
Weather
Freeboard
Field Irrigated?
[EYES ❑No
Field Irrigated?
[ZYES ❑No
Field Irrigated?
DYES ❑NO
Field Irrigated?
DYES [:]NO
m
o
c
U
y
«
'
L°
o
E
Fes-
°
m
d
d
o
�
o
u
a,a
°' °
E 2
°
> Q CL
°
E o►
-=
°'
--S
'°m
Cb J
E A°�
E b
xoA
�o _
my
E °'
oa
> Q
v
d
Eon
N
�,c
�A
p
Earn
` 5
E�'v
M= 0
rL
m�
.E d
tea.
> Q
a
�.°'.'
E.a
�- -2
o�
'�,c
�v
G C
J
E_ rn.
o >,
E�.'v
_ G
.� J
�
�a
a
�! Q
m
E�
'�
c
�o
G o
J
3 c
Ego
= o
J
OF
in
ft
ft
gal
min
in I
in
gal
min
in
in
gal
min
in,
1n
gal
min
in
in
1
2
3
4
5
C
52
0.14
2.45
9,100
85
0.20
0.14
6
7
8
9
C
49
0
2.5
19,300
144
0.41
0.17
10
11
12
13
14
C
39
0
2.55
15
16
17
18
19
20
21
22
_
--
23
C
43
0
2.55
29,800
232
0.64
0.17
24
25
26
27
28
29
C
70
0
2.8
25,900
257
0.56
0.13
30
31
Monthly Loading:
12 Month Floating Total (in):
35,000
0.75
6.46
49,100
1.05
0
0.00
0
0.00
f
6.40

FORM: NDAR-1 08-11
NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Did the application rates exceed the limits in'Attachment B of your permit?
.i
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? I
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
❑✓ an Com p ❑Non- Compliant
❑Compliant ❑Non -Compliant \,
OCompliant ❑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.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Robert Charles White
Permittee:
Div. Of Parks & Rec (Lake Norman SP)
Certification No.: 1004687
Signing -Official: Greg Schneider
Grade: S2 Phone Number: 336-549-8990
Signing Officials Title: Park -Superintendent
Has the OR nged since the previous NDAR-1? ' ❑Yes ❑� No
Phone N mb r: 704- 2M350 _ Permit Exp.: 9/30/20
!�J/C
Jr —
Signature Date
r Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
I certify, unde a ty 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.

NON -DISCHARGE MONITORING REPORT (NDMR) Page of �;
881 Facility Name: Div. Of Parks & Rec (Lake Norman SP) county: Iredell Month: January Year: 2018
Flow Measuring Point: ❑p influent ❑Effluent ❑No Flow generated
Parameter Monitoring
Point: ❑tnfluent ❑� Effluent ❑Groundwater Lowering []surface Water
ode — 0
50050
50060
- 00460,-
C0310
-3i616, r
00610
00630';`
00620
00625_ .°
00530
' 00665
C
O
�, d
a'o
O O
C
x
O
Cs
O
m
pp
C
� ,o
10
C
E
a
r_ t -
�o
ZZ
-
m
Z2..
t0
"1m
d rn
10—
'00 W
c a
W
N ,•
�' ;.
r;
N
�.
CL
RECEI�
" "I
A i
L.I. JCDE(�
' .I -,
d6a11f R .
24-hr
hrs
."GPD
mglL
su
mg/L
#1100 m_ L
mg/L
;mg/L`_-
mglL
frg/L;:1_
mg/L
mgll.
NOROS
1
.1,580 .
fVl(
U4{���ll�_!
_ REGION
;LOFrJC
2
1;580.
_
3
1.,580
K.
.-
4
`1,58Q
5
16:00
0.25
--1,580
0.07
T.05'.
7
1,580
8
9
10
1,580
r�
11
1,580
12
16:20
1
1,,580
0.027
6.97
7.
13
1;580
-
14
15
1;580
16
16:10
2
.1580
0.038
fi.94 '
17
1,580
18
''1;580
19
1.,580
20
1,580
21
-1,580
22
1;5W
23
16:00
1
'1,580
0.057
24
•1;580
-
25
:1.,580.
26
T,580.-
_
-
.t
27
28
1;580
29
1 i580`
'.
30
16:00
1
1,580-,
0.036
:7.48,
31
16:00
1
1,580
=
Average:
1580
0.05
Daily Maximum:
1,5150
0.07
1.52.'
Daily Minimum:
1;580
0.03
-'6 94'
Sampling Type:
Recorder
Grab
Grab
;
Monthly Limit:
Daily Limit:
-
Sample Frequency:
�Mi nfhly
Monthly
Weekly..

NON -DISCHARGE MONITORING REPORT (NDMR)
Page "d) of 2)
Sampling Person(s)
Bryan Cartner
Certified Laboratories
Name: Statesville Analytical, Inc.
Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit?
❑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.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORc: Matthew Bryan Cartner
Permittee: Div. Of Parks & rec (Lake Norman SP)
Certification No.: 995910
Signing Official: Jarid Church
Grade: S1 Phone Number: 704-880-4373
Signing Officials Title: Park Ranger
Has the ORC changed since the previous NDMR? ❑Yes []No
Phone Number: 704-528-6350 Permit Expiration: 3/18/1900
t'�'[/
(�L14,-DC0_n__
Signature Date
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
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.
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center

NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Page I of all
0881
occurField
tio
IS ility
❑YEs ONO
Facility Name: .Lake Norman State Park
County: Iredell
Month: January
Year: 2018
Name:
; ' A':,;-'; =
Field Name:
B
" Field_Name•
Field Name•
Area (acres):
= - 1;715"' "
Area (acres):
1.715
Area.(acres)
.
Area (acres):
Cover Cro p:
•, . Woodland, ' .:
Cover Crop:
Woodland
- Cover Crop:
'Hourly
=
Cover Crop:
hourly Rete'(in)':
0.4° ., ; _ '.:
Hourly Rate (in):
0.4
= Rate (in):
-
Hourly Rate (in):
Annbal'Rate (in):
3016 ., _
Annual Rate (in):
30.16
: AnnualRate (in):
Annual Rate (in):
Weather
Freeboard
Field Irrigated?
DYES ❑ryo
Field Irrigated?
EYES ONO
Field' Irr'I ated?'
9.
:❑YES - . ❑No.
Field Irrigated?
OYES ONO
C
U
w
o
o
�
M.
o
pC
E
x c
°E
a
E°
;m'
Eo
o oc
.
E
CL
d
>oc o
m
J=Jt
E Im
Emc
a�o
M
°F
in
ft
ft
gal
min- _"
In
'ingal
min
in
in
gal
min
in
in
gal
min
in
In
2
3
4
5
C
40
2.7
6
7
_
8
,.• _
g
10
12
CL
64
2.65
8,900
60
0.19
0.19
13
_
14
16
CL
32
2.7
-"19,200
120: ,
: •;0:41
:-0.21, >,
17
18
19
20
21
22
231
C
61
2.65
7,700
60
0.17
0.17
24
25
26
27
28
29
30
C
34
2.65
;; 8,600
60 , -
.'.: 0:18, :
_ A;18
-
31 C 32 2.7
Monthly Loading:
12 Month Floating Total (in):
8,200
^ 36,000
0.77
6:30
__• . 0:18
16,600
0.36
? 0'
0:00
0
0.00

PV NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page —2—) of
rates exceed the limits in Attachment B of your permit? ❑� Compliant ❑Non -Compliant
Vate measures taken to prevent effluent ponding in or runoff from the sites? PICompliant ❑Non -Compliant
ble vegetative cover maintained on all sites as specified in your permit? ❑� Compliant []Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site? ❑p Compliant ❑Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? ❑✓ 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.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Matthew B. Cartner Permittee:
Div. Of Parks & Rec (Lake Norman SP)
Certification No.: 995910 Signing Official: Jarid Church
Grade: S1 Phone Number: 704-880-4373 Signing Officials Title: Park Ranger
Has the ORC changed since the previous NDAR-1? ❑ves ONo Phone Number: 704-528-6350 Permit Exp.: 9/30/20
G-/
Signature Date Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge. 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 Quality
Information Processing Unit
1617 Mail Service Center

Analytical Results
Lake Norman State Park
759 State Park Road
Troutman, NC 28166
Receive Date
Reported:
For:
Comments:
09/27/2018
10/04/2018
Sample Number Parameter Sample'ID Result Unit Method Analyzed Analyst
180927-20-01
Ammonia Nitrogen
Eff
15.57
mg/L
SM4500NH3C-2011
10/01/2018
CL
180927-20-01
BOD
Eff
23
mg/L
SM521OB-2011
09/29/2018
MD
180927-20-01
Fecal Coliforms
Eff
>2419.6
MPN/100 ml IDEXX Comert 18 MPN
09/27/2018
WC
180927-20-01
Nitrate/Nitrite
Eff
<0.1
mg/L
SM450OF-2011
10/01/2018
CL
180927-20-01
T. Phosphorous
Eff
5.4
mg/L
SM45COPE-2011
10/01/2018
CL
180927-20-01
TKN
Eff
19.49
mg/L
SM4500Norg8-2011
09/28/2018
CL
180927-20-01
TSS
Eff
16.436
mg/L
SM254OD-2011
09/28/2018
WC
Respectfully submitted,
Dena Myers -
NC Cert #440,
NCDW Cert #37755,
EPA #NC00909
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 1 of 3

Condition of Receipt
Sample Number 180927-20-01 Temp on Arrival: 2.3
Parameter Schedule: TSS
Received on Ice
Parameter Schedule: BOD
Received on Ice
Parameter Schedule: Fecal Coliforms
Sodium Thiosulfate Received on Ice
pH on Arrival: <2 Parameter Schedule: TKN
Sulfuric Acid Received on Ice
Chemicals in containers, lab
pH on Arrival: <2 Parameter Schedule: Ammonia Nitrogen
Sulfuric Acid Received on Ice
Chemicals in containers, lab
pH on Arrival: <2 Parameter Schedule: Nitrate/Nitrite
Sulfuric Acid Received on Ice
Chemicals in containers, lab
.pH on Arrival: <2 Parameter Schedule: T. Phosphorous
Sulfuric Acid Received on Ice
Chemicals in containers, lab
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 2 of 3

_
CliOnt:_
_..........
STATMILLF. A NALYTICAL.
122 Court Street P.O. Box 228
Address:
Slatmiile,NC 2R687
(704) 8724697
Chain of
Contact Person: Phone # FAX#;
PO � Requisitioned by:(Time Dale)
Custody Record
Customer
sample I
tab iD6
Tina Sampled
(Grab Only)
Date Sampled .
(Grab Only)
a
@
Matrix
,� 1s w -ww
- ammeters n+ggested for malysis '
_
RIDS
D
Relinquished by:
_ Time jp la , pm Date
Sampled by;
Received b. UV t
Y
Time j t 5 t im Date t 0
r,.
Transported by:
Relinquished by;
Time am, pm Date _!_/_
Holding times met:
Received by
Time am, pm Dale _/
Compliance work:
Compositp—Smilirip # f:
.Time beg(n___am, pm Date ..........
Non-compliance work:
Time end am, pm Date ,.-!_--!_
_.,.
Lab Comments: Samples
Transported On Ice:
Gojrll i ling #2: _.....__
Time begin am, pm Date ......_._l-1_
Time end, am, 'pm Date
.
Initiate:
,....l......_ - ............ .
m
N o
C+)
0
o a
•
00
t,D
00
N
U
Z
ai
N
ar
t%
•
00
N
N
X
O
m
0.
t1

NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page __L of
81 Facility Name: .Lake Norman State Park County: Iredell Month: December Year: 2017
Field Name: A Field Name: B Field Name: Field Name:
pation occur
Area (acres): 1.715 , Area (acres): 1.715 Area (acres): Area (acres):
Ptthis foci Ilty? Cover Crop: Woodland Cover Crop: Woodland Cover CropCover Crop:
DYES []NO Hourly Rate (in): 0.4._ - Hourly Rate (in). 0.4 Hourly Rafe (in): Hourly Rate (in):
•' Annual•Rate (In): • 30.1,6Annual Rate (in): 30.16 AnnuaPRate (inj Annual Rate (in):
Weather
Freeboard
Field Irrigated?
EYES _. ❑No
Field Irrigated?
EYES []NO
Field'Irrigated4
❑YES -ONO
Field Irrigated?
[]YES []NO
p
1
mCL
U
t
3m
C
a
m
d
F
°F
57
o
a
in
°f
o�
ft
2.75
vs �=
ft
`
E
�
gal
:�
C
min
c
a
in . -,"
C.
o:6
=o
,,
_ in
oa
�N
gal
E
�
min
o
o
J
in
�
E c
o
ooa
0
J
in
.
•
gal . -
E
;min
C-'
In
E
�!
in,
m o
E
.
gal
o
E
min
,
p
'
•�E�rno
.oco
O
in
in
2
3
41
n
51
6-FEB
7
r) nnan
Ui L l
0�
Ny
8
SN
32
2.5
VVURUS
10
11
�� S'
-
121
C
48
2.5
13
141
15
16
17
18
20
21
221
CL
45
2.5
=
24,300
180
0.52
0.17
L
23
24
25
26
27
28
29
C
40
2.5
30
31
Monthly Loading:
0
0.00
5.i35
24,300
jO.52
0
0.012
Month Floating Total (in):

NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page P of _A
rates exceed the limits in Attachment B of your permit? (]Compliant ❑Non -Compliant
uate measures taken to prevent effluent ponding in or runoff from the sites? Compliant ❑Non -Compliant
Pasa suitable vegetative cover maintained on all sites as specified in your permit? ❑� Compliant ❑Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site? ❑r Compliant ❑Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? ❑� 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 necessarv.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Matthew B. Cartner
Permittee:
Div. Of Parks & Rec (Lake Norman SP)
Certification No.: 995910
Signing Official: Jarid Church
Grade: S1 Phone Number: 704-880-4373
Signing Officials Title: Park Ranger
Has the ORC changed since the previous NDAR-7? ❑Yes ❑�No
Phone Number: 704-528-6350 Permit Ex 9/30/20
p..
o� )
© o,c
Signature Date
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
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.
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center

eee�eeeseeeeemeomc
�..
I
ResidualTotal
.
I���
II�I�IIIII�
II
I�III
I
IIII�II
ate
IYN

Sampling Person(s)
NON -DISCHARGE MONITORING REPORT (NDMR)
Certified Laboratories
Pagey i of ")
Bryan Cartner
Name: Statesville Analytical, Inc.
r 1.a1110: II Name: I
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? ❑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
Operator in Responsible Charge (ORC) Certification
ORC: Matthew Bryan Cartner
Certification No.: 995910
Grade: S1 Phone Number: 704-880-4373
Has the ORC changed since the previous NDMR? ❑Yes ❑� No
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
Permittee Certification
Permittee: Div. Of Parks & rec (Lake Norman SP)
Signing Official: Jarid Church
Signing Official's Title: Park Ranger
Phone Number: 704-528-6350 Permit Expiration: 3/18/1900
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 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 Quality
Information Processing Unit
1617 Mail Service Center

pp- NON -DISCHARGE MONITORING REPORT (NDMR) Page I of —(6-
81 _T Facility Name: Div. Of Parks & Rec (Lake Norman SP) I County: Iredel Month: November T Year: 2017
IterpCod
Flow Measuring Point: Fz] Influent [:] Effluent E] No flow generated
—
Parameter Monitoring Point: E] Influent Q Effluent undwater Lowering El Surface Water
e er Code
50060
0'
C0310
00610
-,006,30".':
0062 0
00.62�_-,
00530
00666-
>
E
0
0
.9
L)
0
0
f
0
XL
0
0
M
0
E
E
0.
C :2
4)
CL
M
ja
24-hr
hirs;
_GRD
mg/L
SU
mg/L
Ki bgmL�
mg/L
MOIL., '0z
mg/L
mg/L
mg/t.
---------
2
490
3
4
16:00
3
490,
4.90
0.43
RECEIVEI
!N_tor_Np
/DWR
5
6
490
490
JARI
7
490..
WQROS
8
9
490-
h
MUC
ReSVILLE
10
16:10
1.5
450,
0.15
.4
11
490
12
490"
7
13
490
-
14
15
16
16:51
2.5
�,49o
0.06
7. 4.7
17
18
19
49.0
20
-400
0.
0.25
490
490
0.16
.7.4
����a®
maw
RF,4
Sampling Type:
Monthly

NON -DISCHARGE MONITORING REPORT (NDMR) Page d-� of
Sampling Person(s) II Certified Laboratories
Matthew Bryan Cartner II Name: Statesville Analytical, Inc.
Name: II Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? ❑ Compliant ❑ Non -Con
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 col
action(s) taken. Attach additional sheets if necessary.
Operator in Responsible Charge (ORC) Certification
ORC: Matthew Bryan Cartner
Certification No.: 995910
Grade: S1 Phone Number: 704-880-4373
Has the ORC changed since the previous NDMR? ❑ Yes 0 No
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
Permittee Certification
Permittee: Div. Of Parks & rec (Lake Norman SP)
Signing Official: Jarid Church
Signing Officials Title: Park Ranger
Phone Number: 704-528-6350 Permit Expiration: 3/18/190(
/ Z7 oq
Signature De
certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision
with a system designed to assure that all qualified personnel properly gathered and evaluated the information submitt,
my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the in
information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there
penalties for submitting false information, including the possibility of fines and imprisonment for knowing violat
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center

NON -DISCHARGE• • -
- Norman State -•-ll Month: Novemberppp� Field Name., Field Name, Field Name:
.,&ation occur
Area (acres):
- Rtt�is facility? P
ppp' ENEMA, T =45-6 i FrITO Cover Crop- 'EMERY T =*a sj� CoverCrop:,
F/1 YES ■ NO 1Miff= zFT1'
1 . 1
Monthly Loading:I
1 1 1
i i %%
s. %%:i�%���/,/./iJ%
1 1
. 1 1jj�j//.
j�/��/�jj��j/�
li
jjjjjj�
t�i /O. i��
%
fi% ..
1 11
-�
,:�
%�.�: ir,',
i j�jjj/
/�jjj�-NM
!/f/�✓%i/�/�G

NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Page aA of _
rates exceed the limits in Attachment B of your permit?
measures taken to prevent effluent ponding in or runoff from the sites?
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?
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
21 Compliant ❑ Non -Compliant
2 Compliant ❑ Non -Compliant
2 Compliant ❑ Non -Compliant
❑✓ Compliant ❑ Non -Compliant
❑� 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.
Operator in Responsible Charge (ORC) Certification Permittee Certification
ORC: Matthew B. Cartner Permittee:
Div. Of Parks & Rec (Lake Norman SP)
Certification No.: 995910 Signing Official: Jarid Church
Grade: S1 Phone Number: 704-880-4373 Signing Official's Title: Park Ranger
Has the ORC changed since the previous NDAR-1? ❑ Yes 0 No Phone Number: 704-528-6350 Permit Exp.: 9/30/20
LIZ 2ti1�
Signature Date Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge. 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.
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

NON -DISCHARGE MONITORING REPORT (NDMR)
Panes A of
pp"150620881 Facility Name: Div. Of Parks & Rec (Lake •Iredell Month: October
Flow Measuring Point: Qinfluent DEffluent 0No flow generated
OEM
®----®®----�----
0
13
_--
m
_--
®------------�--
©--
®---5---_--�-
Average:
11117,7W
NOW
MM
DailiLilt-

Matthew Bryan Cartner
Name:
Sampling Person(s)
NON -DISCHARGE MONITORING REPORT (NDMR)
Certified Laboratories
Name: Statesville Analytical, Inc.
Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit?
Page _,a of
❑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.
Operator In Responsible Charge (ORC) Certification Permittee Certification
ORC: Matthew Bryan Cartner Permittee: Div, Of Parks & rec,(Lake Norman SP)
Certification No.: 995910 Signing Official: Jarid Church
Grade: S1 Phone Number: 704-880-4373 Signing Official's Title: Park Ranger
Has the ORC changed since the previous NDMR? ❑Yes MNo Phone Number: 704-528-6350 Permit Expiration: 3/18/1900
-�
Signature Date Signature Date
By this signature, I certify that this report Is accurratd and complete to the best of my knowledge. 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 Quality
Information Processing Unit
1617 Mail Service Center

P58-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page __1___ of 1)
WQ0020881 Facility Name: .Lake Norman State Park County: Ire
ell Month: October Year: 2017
id irrigation occur
Field Name:
A
Field Name:
B
Field Name:
Field Name:
Area (acres):
1.715
Area (acres):
1.715
Area (acres):
Area (acres):
at this facility?
Cover Crop:
Woodland
Cover Crop:
Woodland
Cover Crop:
Cover Crop:
[21YES ❑NO
Hourly Rate (in):
0.4
Hourly Rate (in):
0.4
Hourly Rate (In):
Hourly Rate (in):
Annual Rate (in):
30.16
Annual Rate (in):
30.16
Annual Rate in
( )
Annual Rate (in):
Weather
.�
Field irrigated?
BYES ❑NO
Field Irrigated?
❑✓ YEs ONO
Field Irrigated?.
❑YES ❑NO
Field Irrigated?
❑YES [:]NO
Kreeboard
o '
mam
m4V
a E
V E aro
Em m
E_ d ro
E�
E` rn
—',c o_ C
EoAo
19 m
e t
�'— �'`
m� v
m d m
Im
o� Er°
a
oa �°�
c
CL c
10�
Ear
>a
v Eon
�a E�
vEf-aft
g
j
>o0
gal
min
In
In
gal
min
in
In
al
min
°F in
In
In
1
gal
min
in
in
CL 1 79 1 i 3.25
C 1 66 1 12.75
C 1 59 I 13.25
100 1 2 1 0.00 0.00
120 1 0.39 1 0.20
75 1 0.22 1 0.18
1,600 1 15 1 0.03 1 0.03
...�.�.r 0.60 11,900 0.26 0 0.00 0 0.00
12 Month Floating Total (in): 6.36 a

NON -DISCHARGE APPLICATION REPORT (NDAR-1)
xceed the limits in Attachment B of your permit?
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?
Page A of ;),
i]Compliant
❑Non -Compliant
(]Compliant
❑Non -Compliant
(]Compliant
❑Non -Compliant
[21Compliant ❑Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
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.
Operator in Responsible Charge (ORC) Certification
ORC: Matthew B. Cartner
Certification No.: 995910
Grade: S1 Phone Number: 704-880-4373
Has the ORC changed since the previous NDAR-1?
Dyes i]No
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
Permittee Certification
Permittee:
Div. Of Parks & Rec (Lake Norman SP)
Signing Official: Jarid Church
Signing Official's Title: Park Ranger
Phone Number: 704-528-6350 Permit Exp.: 9/30/20
L)a_Of L:�)
r 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 Quality
Information Processing Unit
1617 Mail Service Center

NON -DISCHARGE MONITORING REPORT (NDMR)
Page of
881
Facility Name: Div. Of Parks & Rec (Lake Norman SP)
County: Iredell
Month: September
Year: 2017
Flow Measuring Point: ❑� Influent ❑Effluent ❑No flow generated
Parameter Monitoring Point: ❑Influent OEffluent []Groundwater Lowering ❑Surface Water
meter Code —►
'„`50050-;
50060
0040�
C0310
3161'6 -
00610
00630 _
00620"t)0625+
00530�,0065
5
NNW
o
v l=
O
~ N
p
>u � :
`�
0
E° L
�v Y
v a� .�r r�4
a
v
LO
m
41,02�
i s %p
Q
a�
Z.
,�;Y
Z
i
0
�- in
w
0
F'
a
24-hr
hrs
GPD
mg/L
f'sut:� 1
mg/L
IkN00 mL
mg/L
iYtg/L r
mg/L
" '
mg
m _a
MOW
2
917,
&^
t ,
syz
�s�
MEW
low-
4
917`
ems.
5
917-
6
TM
8
16:20
0.5
g
10
917
11
16:30
2
917 ;:
&89,:.
.
�-
12
13
14
..i
17
19
20
917A6
s.
21
91a7
22
16:00
0.5
a 9�r7,' `, _r
"f - m 8 '
<2
,19
<0 5
'2°6
1.57
WNW
<6.25
3
23
24
25MEW
ILN
26
27
«,a
29
16:20
0.25
; 917, .# �.
,,•v s�' F•:
�.w. �.��'3�r
=;r y�� �„�«:
�.x'
-
30
i
NEWL..
mm
31
. _,'Pt ql
,� �
'Row,
Average
_ 91,7N -
y n, '
0.00
-, n1r79 Q0.
0.00
"12 60
1.57
' 4
0.00
Daily Maximum
4W 80 ;a:
2.00
1 _€0_0
0.50
ti 6Q
1.57
l =
6.25
Daily Minimum
4 y917;?':
6v84;,:
2.00
0.50260
;;'
1.57
4fip7
6.25
Sampling Type
Ftecorde
Grab
,;rGrab
x„� . t
X; _b.., `, i
Monthly Limit
Daily Limit:
:
Sample Frequency
Monthly,
Monthly

NON -DISCHARGE MONITORING REPORT'(NDMR) Page of
Sampling Person(s) II Certified Laboratories
Matthew Bryan Cartner II Name: Statesville Analytical, Inc.
Name: II Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? ❑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.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: -Matthew Bryan Cartner
Permittee: Div. Of Parks & rec (Lake Norman SP)
Certification No.: 995910
Signing Official: Jarld Church
Grade: S1 Phone Number: 704-880-4373
Signing Official's Title: Park Ranger
Has the ORC changed since the previous NDMR? ❑Yes [ANo
Phone Number: 704-528-6350 Permit Expiration: 3/18/11900
Signature Date
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
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.
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

User Friendly Name
Official Parameter Name
DWQ Accepted Units
00010
Temperature
Temperature, Water Deg. Centigrade
°C
00076
Turbidity
Turbidity, HCH Turbidimeter
NTU
00092
Flow - Maximum
Flow, Maximum Flow Range
GPD
00094
Conductivity
Conductivity
pa
00125
Dichlorobenzene
Dichlorobenzene (Isomers) M/P In Water ug/l
pg/L
00300
Dissolved Oxygen
DO, Oxygen, Dissolved
mg/L
00310
BOD5
BOD, 5-Day (20 Deg. C)
mg/L
00340
COD
COD, Oxygen Demand, Chem. (High Level)
mg/L
00400
pH
pH
su
00480
Salinity
Salinity
mg/L
00515
Total Filterable Residue
Residue, Tot Fltrble (dried at 105C)
mg/L
00530
Total Suspended Solids
Solids, Total Suspended
mg/L
00545
Settleable Solids
Solids, Settleable
mL/L
00556
Oil Et Grease
Oil Et Grease
mg/L
00600
Total Nitrogen .
Nitrogen, Total (as N)
mg/L
00610
Ammonia
Nitrogen, Ammonia Total (as N)
mg/L
00615
Nitrite
Nitrogen, Nitrite Total (as N)
mg/L
00620.
Nitrate
Nitrogen, Nitrate Total (as N)
mg/L
00625
Total Kjeldahl Nitrogen
Nitrogen, Kjeldahl, Total (as N)
mg/L
00630
Nitrite + Nitrate
Nitrite plus Nitrate Total 1 DET. (as N)
mg/L
00660
Ortho Phosphate
Phosphate, Ortho (as PO4)
mg/L
00665
Total Phosphorus
Phosphorus, Total (as P)
mg/L
00670
Organic Phosphorus
Phosphorous, Total Organic (as P)
mg/L
00680
Total Organic Carbon
Carbon, Tot Organic (TOC)
mg/L
00681
Dissolved Organic Carbon
Carbon, Dissolved Organic (As C)
mg/L
00916
Calcium
Calcium, Total (as Ca)
mg/L
00927
Magnesium
Magnesium, Total (as Mg)
mg/L
00929
Sodium
Sodium, Total (as Na)
mg/L
00931
Sodium Adsorption Ratio
Sodium Adsorption Ratio
Ratio
00937
Potassium
Potassium, Total (as K)
mg/L
00940
Chloride
Chloride (as Cl)
mg/L
00945
Sulfate
Sulfate, Total (as SO4)
mg/L
01002
Arsenic
Arsenic, Total (as As)
mg/L
01007
Barium
Barium, Total (as Ba)
mg/L
01022
Boron
Boron, Total (as B)
mg/L
01027
Cadmium
Cadmium, Total (as Cd)
mg/L
61034
Chromium
Chromium, Total (as Cr)
mg/L
01042
Copper
Copper, Total (as Cu)
mg/L
01045
Iron
Iron, Total (as Fe)
mg/L
01051
Lead
Lead, Total (as Pb)
mg/L
01055
Manganese
Manganese, Total (as Mn)
mg/L
01067
Nickel ,
Nickel, Total (as Ni)
mg/L
01077
Silver
Silver, Total (as Ag)
mg/L
01092
Zinc
Zinc, Total (as Zn)
mg/L
01147
Selenium
Selenium, Total (as Se)
mg/L
01284
ND Application Rate
Non -Discharge Application Rate
in/yr
31504
Total Coliform
Coliform, Total MF, Immed,LES Endo Agar
#/100 mL
31505
Total Coliform
Coliform, Tot, MPN, Completed, (100 mL)
MPN/100 mL
-31613
Fecal Coliform
Coliform, Fecal MF, M-FC Agar,44.5C,24hr
#/100 mL
31616
Fecal Coliform
Coliform, Fecal MF, M-FC Broth,44.5C
#/100 mL
2106
Chloroform
Chloroform
mg/L

32730
Phenolics - Recoverable
Phenolics, Total Recoverable
mg/L
32730
Phenols
mg/L
34469
Pyrene
Pyrene
pg/L
34694
Phenol - Single
Phenol, Single Compound
mg/L
38260
Surfactants
Surfactants (MBAS)
mg/L
50050
Flow
Flow, in conduit or thru treatment plant
GPD
50060
Total Residual Chlorine
Chlorine, Total Residual
mg/L
70295
Total Dissolved Solids
Solids, Total Dissolved
mg/L
70300
Total Dissolved Solids
Solids, Total Dissolved-'180 Deg.0
mg/L
70318
% Solids
Solids, Total, Percent
%
71880
Formaldehyde
Formaldehyde
mg/L
71900
Mercury
Mercury, Total (as Hg)
mg/L
78732
Volatile Compounds
Volatile Compounds, (GUMS)
Yes/No
80082
Carbonaceous BOD
BOD, Carbonaceous 05 Day, 20C
mg/L
81639
Total Kjeldahl Nitrogen
Nitrogen Kjeldalh, Total (TKN)
lbs/ac
81688
Ethylene Glycol
Ethylene glycol
pg/L
82385
Nitrogen Oxides
Nitrogen Oxides (as N)
mg/L
82546
Water Level
Water level, distance from measuring point
ft
C0310
BOD5 - Conc.
BOD, 5-Day (20 Deg. C) - Concentration
mg/L
CO530
TSS - Conc.
Solids, Total Suspended - Concentration
mg/L
CO600
Total Nitrogen - Conc.
Nitrogen, Total (as N) - Concentration
mg/L
CO610
Ammonia - Conc.
Nitrogen, Ammonia Total (as N) - Concentration'
mg/L .
CO665
Total Phosphorus - Conc.
Phosphorus, Total (as P) - Concentration
mg/L
WQ09
Plant Available Nitrogen
Plant Available Nitrogen - Loading
mg/L

W60,08�0ARPE'' MONITORINGREPORT (NOMR)
P64e i5f A
a.: WQOG20,881
'0­
Facility Name: Dfv.;, Of",'ParksA ke6(Lake -N'O"90,115p)',
County:
Month:` , onth,* September
Year: 2017
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NON -DISCHARGE MONITORING REPORT,(NDNIR)
Page .01 of
Name:
Name:
Matthew Bryan'Carfner
Sampling,person(s)
Certified Laboratories
'Name: Statesville Analytical, Inc.
Name:
Does al[monitoring data and sampling frequencies meet the requirements' in AttachiOdnt'.A "of your permit?
OCompliant. O - n-Compliant
If the facllity'is riori-rorirptiarit, please explain. in the space below the reason(s) the faciltty was not.in compliance. Provide in your explanation the date(s) of the non -compliance -and describe the corrective
necessary.
Operator in Responsible'Chaege (ORC) Certification
Permittee Certification
oRC: Matthew "Bryan Canner
Permittee: Div, .Of Parks & rec`(Lake Norman:SP)
Certification No.: 996910
Signing Official: Jarid Church
Grade: S1 Phone -Number: 7047880-4373-
'Signing Official's Titles. Park Ranger"
Has the WC changed since the previous NDMR7 F1yeS L N%
Phone Number: 704-528-6350 Perini# Expiration: 3718/1900
0
Signatur.'e Date
Signature -Date
`by this signature, I certify that this report is accurrate and complete'to the best of my knowledge:
f certtfy, under penalty of law, that this document and, all attachments were prepared under my direcfion,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 peison 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 befref, true, accurate, and'coinplete. 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 Quality
Information"Processing Unit
1617 Mail Service Center

001P P-1 !8-1-ippp-
NON-DISCHARGE APPLICATION REPORT (NbARA).,
Page I of 2
itNb.: WQ6026681,
Facillty'NIorha.*, lake Noftnan State Park
County: 1rede'll
Month: september
Year: 20117
7D!d
i- !Fleld,Nbffd:1
Al I
Field Name:
B
Field Name:
irrigation occur
17, 5"
aT
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1.7,15
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at tills'aliity2CoverrCrop
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Cover Crop:
Woodland
i�l I 7
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Des I]no
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Hourly Rate (in):
0.4
IT-
Hourly Rate fln)t
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30.16
Annual Rate (in):
ft�th&
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Plaid Irrigated!
QYES EINO
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Fidid Irrigated?
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� I, -'J

APPLICATION REPORT (NDAR-1)
Page -2 :of
. r. - —2
Aoolicafidh rates exc'eedthe 1knits, in Aftachmerif's of your permit!'
WOe addqUaite measures taken to-preyeriteffluent pondirig in or runoff fiwwthwbiles?
'Was a suitable vegetative cover maintained on -ail sites as s pecified in your permit?
Were ;all setbacks ,listed, in ypur,pernrift maintained for -every application to each perthitt6daltO
Were all fieeboard& maintained .in :accordarwcd 'With the,toodified becibqAtd heights in your permit?,
llfftid,fadlfty.is, ho'. n-compliant, , please explailmin,tine space below the
Prav!46
E]Corr011ant
E]Nbn-Compliant
R "pliant
[3114owCornpliant
2bornpbnt
E1NonjCpmpllarr I t
[2]bornpllant.
EINOWcornpliant
n- 6rnpllart,
nNoncompilant
bf,the non compliance and descrobb the'corrective
Operator In'RdsObnsibIeCharge (ORCYCOitiftatiolit
Fiermittee Certhficatibn
OIRCM Mafthow.R.Carther
ftermitt'ee:
Dlvbf PaIrks.,&IReq (Lake, Klorman SP),`
C606ation'! No 995910
Signing'Official.- Jarld t,,hurch,
Grade: - SI I PhonwN . umber: 704-88o-4373
Signing Offlididl'ii TIthEk: Park !Ran-96r
Has the OVkC c6q(O since the 0006uf. NDAR-17 oyes j2jNd
Phon,eilhldrrib,bi. 704-628-6350 Permit rzxp.: 9/30120
(V
bate
Signatuw Date:
,'6y.ihiestgnatureiicaft,thM,tWis,reportisac.buttatdend cbrhplaieto.Ufdb&t,ofifiykn4M6dge.I
upervision in-a=rdance
under my direction or supervision
this document andVAP , sornpnls were preparedvaluated
witlfa 4j�slbrn designed 6=2 the
inquiry' of the person or persons who manage tfie system o"r tfiose personas Ctredty iesponst'bie for gathering the IMorrnation ttie
'la�ge^dnd b6lidi.libia , abwrit6i �and`
i(66railan subirnitted]s"to.the beat oftny Complete. I am`aware ritficant
penalties es forsubmilting false'146rrnlatlon, including the possibility of rineig*id ini0ft6nment for knowing Vidafform.
Mail'OhgInsiVand two, Copies -to:
DiVil0dil of WMdO Quality
Infoft rf PrdtOS�M lrfg,ullit
I , #UO , -
1617 Ma11.Se.rvIcP.Cdnter

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NON-DISCHARGE"MONITORING REPORT (NDMR)
Page
Name:
'Name:
Zampliog,persop(p)
Matthew. Brypn,,,CPrtner
Cortified,Laboratowles
Name: Statesville Analytical, Inc.
!�t
-Aamw.
Does. all monitoring: data ,,eindsampling; frequencies meet the rqqui.irementsin Atta(.q4mon*,Aofyour ,p',ermit?'
If the=facility is non-compbrytj please explain -in the -space belowthe
PC6fnpffpnt Qftwr-moho�
Permit , t6e.Cer0cation
QRC:MatthewBryan Gartner
Oermitteo: Di1y.,,.O.f'Par4,A,rpc,,(LaK NOMA;
M n _SP,,
,Certification No.. 59591.0
signiffo d411.1, Jefrid ChUrdIrt
Grade: S1, Pbpnb,N4 704-880-4M
41ignJnqQM,cial* Title* Pat* FWnger
Has t,heQRqchanged ',,sin'6i..,.'the,,'Orevi,o;j,s,NDMI(?, :Dyes i]NO
Phone Number: 704-528-6350 P I ennit-Expiration:. .
912z.
annatu, gnptgre, Date;
Signature. Date:
By th% slq6akurej I ced.'batft iepod'jeaccu rate and ooifioo!q,ffi'a )Rowqeop�
i certiry urutac penally of law, that ih1,44mmepi Md all attachments weragepared Ubder.my.dirWim."ot.st4*Wsion%td
aq c ordance with a'sy,stqm,designedtp,asswothat ,allqqg',edpefsqRelpopodygathered, and 4v4",,.the'informapo) �
,
do" my 'N'y of
L!Mi�s
th. ,fr..�,thebf am
tt,th�..-,
Mail Original and Two.'COO!os to.,
Division of Water Quality,
Ififormation.; Processing -Unit
1617 Mail Service Center..

ENIP-11or
NON -DISCHARGE APPLICATION REPORT (NPAR=4)-
Page -1 Of
W00020881
Facility Name: lake Norman State
te Park
County: Ir6deil' Month: August
Year. '2017
P
Field'NY
Field Name:
B
Field Name:
Did irrigation
'1 15,
Area (acres):
1.715
"T­
Area {acres):
occur
at this facility?
Cover Crop
00
Cover Crop:
Woodland
Cover Crop.
2YES EINO
-— -------
Hourl Rate (in):
y
0A,
Hourly Rate,(in)
Annual Rate (in).
30.16
_/A
j
Annual ftW (in):
Weather
Freeboard
F 'd'_1_
Field Irrigate ?
d
2Y� EINO
Field irrigated?_
EIYEs. E]NO
'g
.2
:E
D1'
E
z., T
0
0
LIS
03
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CL W
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12 Month Floating Total (in):

�a

NON -DISCHARGE APPLICATION REPORT (NDAR-1)
the limits in Attachment B of your permit?
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?
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
Page A of a
QCompllant EINon-Complant
[]✓ Compliant QNon-Compliant
Compliant QNon-Compliant
Compliant QNon-Compliant
Compliant ilNon-E+mpilant
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
Nttacn aooitionai sneets it necessary.
Operator in Responsible Charge (ORC) Certification
P,ermittee Certification
ORC: Matthew B. Cartner
Permittee:
Div. Of Parks & Rec (Lake Norman SP)
Certification No.: 995910
Signing Official: Jarid Church
Grade: S1 Phone Number: 704-880-4373
Signing Official's Title: Park Ranger
Has the ORC changed since the previous NDAR-1? DYes ENo
Phone Number: 704-528$350 Permit Exp.: 9/30/20
Signature- Date
Signature Date
By this signature, I certify that this,report is accurrate and complete to the best of my knowledge,
I certify, under penalty of taw, that this documentand 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 informatonsubmitted, 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 Quality
Information Processing.Vnit
1617 Mail Service Center

M: NDAR 1 b8=9i1'
NON DISCHARGE APPL,ICATION REPORT (NDAR='#)
DId the.application;rates �excned"tlte l mitts,iri Afiacfi`m'en ..B ofyour`parmit?' ant
Were.adequates me,asuteW t.lken too, prevent effluenf ponding iri;or .runoff "fror4 th+a sites? p on,pitaot_ 000compian-t;
1Nas. a su'taible geg taiiv+ caveir maintained on..allsites-as spdcifwd n. oui' permit?CkflmP�ianc �No� c�„ra��k.
r
WOre.aill�s$tbacks: lis ecl:in yourpermit.�nair tamed forevery pplicatlan to each;pereriitted, a te2" pconriatlt Norttdomp6rr
U4lbre atlfteettidard mairt#ained `in acc+nrdace with tt►especified freebaarci heights im:your permit?' Cic,iarit>iaonc«mPa.
Operator in Resptirt sibie Charge (ORC) Cerlificat%os : Permittee,bertificat on
ORC Mdtth6W'B`. Cartrie"r' ;tserm+ttee
Did!;, Of Parks; & kw kL pke Norman SP,j
Certiticelon Noa , Sign€ng, offig al ,Jar d Church;
Grade: 91 dtkl, F bh&r
Nas tiie.ORC cihanged sm(e the pzeviaus NL1AR,1?= [pYes pivo Phone Ntimber: 704;-S28-6350 Permit i p
Stgrtature; mate
t3yUiis signature,__I#ceiNiythat hie"report`is`8cairreie grid compiefe:to the best pf my,knowledg$
Mail ®rooi U., "Tw.o Gaps tos
Di rision of Water Duality
info7iiation>Pracesstng Unit;
1617 Mail Setvi+ce-.Center
Signature`
baw%

NON -DISCHARGE MONITORING REPORT (NDMR) Page I of
881 Facility Name: Div. Of Parks & Rec (Lake Norman SP) County: Iredell Month: August Year: 2017
Flow Measuring Point: ❑influent ❑Effluent []No flow generated Parameter Monitoring Point: ❑tnfluent Qffnuent ❑Groundwater Lowering ❑Surface Water
1F,,,te,C,de
-►
50050
50060
00400
C0310
31616
00610
00630
81639
00600
00530
00665
U
c
O
° c
°
c
m
i
c)
`e
a
+
Z
v c
z
f°-
c
o
~
a9i
a W
o
U)n
CO)
2
o a0
to
IL
RECEIt'ED/NCDE
Jn/DWR
1
24-hr
hrs
GPD
1,809
mg/L
su
mg/L
#1100 mL
mg/L
mg/L
Ibs/ac
mglL
mg/L
mg/L
U
1 I LI _dTU11
2
31
4
16:00
1.75
1,809
1,809
1,809
7
sv
uUW_;;° ':
`_�10
Ii1L OFFICE
5
1,809
6
1,809
7
1,809
8
1,809
9
1 16:20
0.25
1,809
7.1
10
16:10
2.25
1,809
0.41
6.83
11
1,809
12
1,809
13
1,809
14
1,809
151
1,809
-
tj
161
16:20
0.25
1,809
6.93
,
6�
171
1,809
-
181
1,809
r,.
19
1,809
201
1,809
/r , •: ••�
211
1,809
221
1,809
n iv
231
1,809
241
16:00
0.25 1
1,809
6.68
25
1,809
26
1,809
27
1,809
28
16:10
0.75
1,809
6.97
29
1,809
301
1,809
311
1,809
Average:
1,809
0.41
Daily Maximum:
1,809
0.41
7.10
Daily Minimum:
1,809
0.41
6.68
Sampling Type:
Recorder
Grab
Grab
Monthly Limit:
Daily Limit -
Sample Frequency:
Monthly
Monthly I
Weekly

NON -DISCHARGE MONITORING REPORT (NDMR)
Page V� of
Matthew Bryan Cartner
Name:
Sampling Person(s)
Certified Laboratories
Name: Statesville Analytical, Inc.
Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? ❑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.
Operator in Responsible Charge (ORC) Certification Permittee Certification
ORC: Matthew Bryan Cartner Permittee: Div. Of Parks & rec (Lake Norman SP)
Certification No.: 995910 Signing Official: Jarid Church
Grade: S1 Phone Number: 704-880-4373 Signing Official's Title: Park Ranger
Has the ORC changed since the previous NDMR? Elyes ONo Phone Number: 704-528-6350 Permit Expiration: 3/18/1900
f
17 ..
lu 0 zW
Ignature Date Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge. 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.
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center

NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Page 1 of A
Mid
Name: lake Norman State Park
County: Iredell
Month: August
FieldFacility
.Field
Area (acresy
Area (acres):
Cover Crop:
21YES []NO
Hourly Rate (in):
Annual Rate (i n):
1
1
MonthlyLoading:
12 Month FloatingTotal
5 4..
f .^t' d
k "° '4•� .A ���� ;ri;�.
.# �
i
N' ry..
'i'
1's i .{

NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Page —2 of 91
n rates exceed the limits in Attachment B of your permit?
measures taken to prevent effluent ponding in or runoff from the sites?
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?
❑� Compliant ❑Non -Compliant
❑� Compliant ❑Non -Compliant
❑� Compliant ❑Non -Compliant
Compliant ❑Non -Compliant
Were all freeboards maintained in accordance With the specified freeboard heights in your permit? OCompliant []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.
Operator in Responsible Charge (ORC) Certification Permittee Certification
ORC: Matthew B. Cartner Permittee:
Div. Of Parks & Rec (Lake Norman SP)
Certification No.: 995910 Signing Official: Jarid Church
Grade: S1 Phone Number: 704-880-4373 Signing Officials Title: Park Ranger
Has the ORC changed since the previous NDAR-1? ❑Yes EINo Phone Number: 704-528-6350 Permit Exp.: 9/30/20
9 i� Q 2 zCl
Signature Date Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge. 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.
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center

•
i
© 11

NON -DISCHARGE MONITORING REPORT (NDMR)
Page V of
Sampling Person(s)
Matthew Bryan Cartner
Certified Laboratories
Name: Statesville Analytical, Inc.
Name:
Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? Ocompiiant ❑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.
Operator in Responsible Charge (ORC) Certification
ORC: Matthew Bryan Cartner
Certification No.: 995910
Grade: S1 Phone Number: 704-880-4373
Has the ORC changed since the previous NDMR? ❑Yes ONO
Permittee Certification
Permittee: Div. Of Parks & rec (Lake Norman SP)
Signing Official: Jarid Church
Signing Officials Title: Park Ranger
Phone Number: 704-528-6350 Permit Expiration: 3/18/1900
Signature
Date Signature
Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge. 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 Quality
Information Processing Unit
1617 Mail Service Center

0020881
Firriation occurame:
s facility?
DYES ONO
NON -DISCHARGE
APPLICATION
REPORT
(NDAR-1)
Page
F of
e: Lake Norman State
A
nArea
Park
Field Name:
B
County: Iredell Month:
Field Name:
Area acres
(acres):
Cover Crop:
Hourly Rate (in):
Annual Rate in
( )
July
Year: 2017
Field Name:
res):
1.715
Area (acres):
1.715
Area (acres):
Cover Crop:
Woodland
Cover Crop:
Woodland
Cover Crop:
Hourly Rate (In):
0.4
Hourly Rate (in):
0.4
Hourly Rate (in):
Annual Rate (in):
30.16
Annual Rate (in):
30.16
Annual Rate (in):
�1
Weather
Freeboard
Field Irrigated?
DYES ONO
Field Irrigated?
DYES ❑No
Field Irrigated?
9
OYES ❑NO .
Field Irrigated?
DYES ONO
d
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2
3
4
5
6
7
C
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80
85
2.1
2
8,400
4,700
60
0.75
0.18
0.10
0.18
0 .10
8,500
2,300
60
0.25
0.18
0.05
0.18
0.05
8
9
10
C
87
2.25
11
12
13
14
15
16
17
18
19
20
21
22
C
C
83
89
2.2
2.25
15,900
16,200
1.92
1.83
0.34
0.35
0.34
0.35
23
24
C
86
25
26
27
28
29V31
30
0
0.00
12
Monthly Loading:
Month Floating Total (in):
131100
0.28
4.93
42,900
0.92
5.97
0
0.00

NON -DISCHARGE APPLICATION REPORT (NDAR-1)
rates exceed the limits in Attachment B of your permit?
Isures taken to prevent effluent ponding in or runoff from the sites?
W.a-0 a aulwuile 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?
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
Page A of
RICompliant ❑Non -Compliant
[21compiiant ❑Non -Compliant
PICompliant ❑Non -Compliant
Compliant ❑Non -Compliant
ElCompliant ❑N C
on- omphant
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.
Operator in Responsible Charge (ORC)-Certification Permittee Certification
ORc: Matthew B. Gartner Permittee:
Div. Of Parks & Rec (Lake Norman SP)
Certification No.: 995910 Signing Official: Jarid Church
Grade: S1 Phone Number: 704-880-4373 Signing Official's Title: Park Ranger
Has the ORC changed since the previous NDAR-1? ❑Yes 21No Phone Number: 704-528-6350 Permit Ex
P•: 9/30/20
Signature Date Signature
Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge. 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.
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center

_
01
"UT
CL
Ibshic�
IL
77,777,
7777
0
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bad up i,t

FORILUNOM,k'03wi2
NOWNS4HAdt M010TOOING, REPbRT I (NDMR);
Raleigh,,N'Orih carolina'2769­946V
Page G

NON -DISCHARGE MONITORING, REPORT (NDMR)
SamplinP.Person(s) Certified Laboratories.
Name- Matthew Bryan Cartner � Name: 'Statesville Analytical, Inc.
Name: 11 Name:
Does all monitoring data and sampling frequencies meet the requilrements in AttachmentA of yp4r,pormit?
1 0—
Page �/l of
[]Compliant _F)Non-Compjlant.
If the facility isLion-compliant; please explain in the, space below the reason(s. ) thefacillty was not in"compliande. Provide, in your expIanatfon tI:I date ) qi�jhe nod Pa '-r - qr(b ,o a
a, '(s mp1jince and des ejIte corredfiv
paticini(s) taken. Attach additional sheets if.reqessay.
CiperatorAh ResponsibleCh.argp (011C) CeqifipatIpq
Permittee Certification
ORC; Matthew,Brypn q
ortner
Div,�Of ParksA req,(Lpk, e lorman
Perm! tees SR)
CertifiqatIon No.; 995910
Sigh . ing officiall:. Jarid Church.
Grade: S1 Phone.Number: 704$80-4V,8
signing CiffiPark Ranger
Has the ORC,chenged. since the previous NDMR'?.. Oyes [-2]No,
Phone.,'Number: 704Z28-6350 Permit Expiration: W18/1906
Simature Qate,
Signature Pate
43y this,stgnature, I ceffify that this re orl Is accumte and com late to the best of,my knowledge.
p Y owlq pe.
ry,, undatj penalty of law,'thaUll document and all attachments warp prepared,unddirmy,direction.or a
i pert! upervision it,
a6cordsftice with a system designed to assure that all quajq!qd personnel.property gathered and eval4ated the.intormalori
­person'or'06rsbm
suiimltted.Basado6 Mylnq (Yofliher whomanagethe syspem,��or thqseperaqns ditedly responsIble,f6r,
gathering knowledge and belief, true, 16, accurate;and complete, I am
aware that,thprearaslgntflcantp fats " into Includirigthipd llillltyof flneis`end ImprisobiTignt for
-onalties for"rubmitIft e rmatlonj`
knowing" violations:.
Mail Prigkinaland Two;
C'Oplos, to
Division of. Water QUality
Information Processin-q , Unit
1617 Mail Center
­ - i . , "

NOWDISCHARGE APPLICATION REPORT (NDARA) Page F of
W00020889
Facility Name: .Lake Normans State Park
county: Irede(I
Month: Juty
Year: 2017
„ .�
t
Field idame'
t
Field Name:
B
fFeetdI�ame�
Field Name:
d ,rrrt'gab
A on.accur
Area
-------*
Z8
_ . . -
' Area,( res}:
--_
1.T15'
rArea (acres)
Area (acres):
a thisfaci6Q?
Cover'Csrop'_
Woodlands"
Cover Crop:
Woodland
Cover Crop
Cover Crap:
x
CIYs []tip
Fourly'Rate:(in)
rt�.?_v�
F; Q 4 '.,
Mauriy.Rate (in):
0.4
' g}!o sty
ate(a?i
��
Hourly Rate (in)
AnuatRate (inJ4
Ft®tdilrrigated?
`30�6� ° ;
J�vEs _Qyo
Annual Rate (in j;
30:16
AnnualF2ate7nj
Annual Rate (in)
weather ,
Freeboard
Fetd Irrigated?gyres
[�tso
letdlrnc
atedZ
YES
Field Irrigated?
[firs []No
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NON -DISCHARGE APPLIC ATION; REPORT, (NDA114)
rates exceed the limits in Ma0ment'O of your permit?"
taken to, prevent effluent pQnding in orrunoft fromAhesites?
Was a suitable vegetative coast maintained
Were.all setbacks, listed in your permit-maintalbed fore.ifery application to each vermitted siltqI
Were ail Ireeboards, maintained.in accordance with the specified freeboard heights in -your permit?
le I C 0 Pro if thefacilityis nonrcompliant; 0 ese'exp explain inthespece below.*e nsason(sYlhe-fa Ifity,wap'nq�'In c rnpl!qpqe'� i P VIcIqA!yypureWqn0f!on the
M-/, Compliant
-E3*nIr 4DMpllafit
Ploo.fop";
E]Non-OknpW
[21C)oMpliant:
'ONorrGompfiant
nt
rnpuapt-"
QCojnprlant
[]NorrComphant
Operator In R0ppqns.jbIe.'Chrqp (qftC),q-er0fIca0an
PermIftee CoMfIcalfion
PRp: Matthew .& .,Canner
Peffnittee. D I i . V. Parks- Rieo,(Lqko.,14qrMjpn,S13)
Pertification.Nw', 995910-
I Siqninq,,0ffidlaI: J4riO Church
brade: Sl,, Phone Number: 7014-8801-4373'
Ziqnln4'qffj0ia.l`0 Title: Park Raqpr
Has the ORO changed .since ,th�e,gtievidtI NDAR4? ,nYetZ19
's ,4
�Phone NurnbeC 7,04.528-6350, Pennit Exp.:-
Signature
:%g0atyre, Date
By Iftfs"Signatuni, I,cedW thatthis,ropdrt lifacciihati and complete to-tfio Post of my knowledge.
:1certify ,under penalty oq na n oon! accordance
ii a,systern designed to:ass I mthat;,ao qua!�ieo:pa*no properlygathered,snd evaluateit the information submitted. Based on my
tnquiry`Qf file persod'or persons,who-magane the system; or those persons dlr>3dly cespons�te for gattedtig the iiitpmaatiRn, ttie�
'&F4ie '
J*rMaU",SuWdted.1s,Ao#ie beat of�rfiy*nowledqe and Pawlr44, a6cutatd, and- te.11,am
portalties for sit mitiing:fatse, '16cWng the pow'bfflly.of fines and frnposomnahtfiar knowing vkgeOws.
Moil,Origi.nAlAnj TW,0,CQ0,los t
Qivisl000water Quality-,
information"Pr,6dessing;.,Unit
,
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FORM: NDMR 03,-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page- of
Raleigh; Norih.Caroliria:27699-161T

FORM: NDMR 03-12 NON -DISCHARGE MONITORING. REPORT (NDMRY, Page ,
-H —of 9
Sampling:Person(s)dertified, Laboratories
Name: ma,fthew'Bryan-Cartner Name: St.atesville'Analyt - ical Inc.
'Name:
.Does 7all. monitoring data and samplin'girequencies ineetthe requirements: in Attachment A& your permit? Lica—MIAlant . EjNdn-Compllerit
.If the'facility i§.,non_.Cohip!jafit; pleia,se< 6*4in in: the,space- below the'reason(s) thefacillty was not in -'compliance: Provide in your'explanation the dat6(s) ofthe ridii-corn' -p liarfee -and describe the corrective
-actions) taken.. Attach,addltional sheets
Operator In -Retobinsible Cftai(g(o (PRC)'Ceffifidatloh
Permittee Certification
oRd: Mafthew. Bryan Cartner
Permittee; Div.Of Parks & rec'(Lake'Norman SP),
Ceetiffl0ation Nbat 095910
Signing Official.*. Jared Church
;Wa&:S1 Ohone,:Number- 704-880437;3
Signing Oftiiiil's Title: Park R6n&r'
kaslhe,bFib 'changed:since4he- previous NDMk? :0.yes vivo.
Phone Number: 704"-62&635& Oermlt;Ejtpiratioh3/18/1900
6-12
Date
'Signature, Date
0y'this .,so-t6ture; I ce0y.that this report w66Wrrate.andcor1hplat6t6 the,best ofrny,knowtbddd.
i cerfiry,,under penalty of law, that this document and all attachments Were'prepared under my direction or -supervision 16
accordance %Atith:a'systern designed to assure that all qualified`personnel property gathered and evaluated the Information
'submitted, Based on1my.1pquiry of the ,p6rson or persons who manage the system, or,thosa,persons tffredl�r'responslble for
gathering the Infoirnation,:the infafmati6nr ,, submitted is; the, best of my,"19olge and belief, true, accurate, and complete. I am
aware that -there aresignificanCpenaltieg for s6bmlfflr�d false information, including the possibility of fines and imprisonment for
knowing violations.
Mail OrldiftaViand'Two 'Copies -to:
Division� (�
' df,WAbauality
Information Proqesslin§ Unit
1617 Mail Ser--Vic'e Center

FORM NPARA 018-11 NON-DISCHARGEAPPLICATION REPORT (NDARA) Page of
-2i
P&n.ift No.: W00020881
Facility-Narne: lake Norman State Park
County: Iredell
Month: July
Year: 2017
,Did irrigation actur
Fie1dName
w
Fieldt4arne:
B
10 0 ft
'Field Name;
Area (acresy
1.7M
Area (acres):
at this facility?
Cover"
Cover Crop:
Woodland
C A
Cover Crop:
2YES
1, TO
Hourly Rate in):
0.4
Hourly Rate (in)`
Annual ff ie�C
, T1,,%
Annual Rate(n):
30416
I
N
Annual Rate,(n).
'
Weather,,
Freeboard ].
I
ELI
Field Irrigated?
2rEs EINO
—4MIR, 'M
Field Irrigated?
O�s EINO
9— J
L
0
0
E
E,
&
r=
UZI
JE
E 2
E
®
CL
M CL
A d�, , ,
,-
-Az ��c
1
o
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Q 0
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x 10
0 0
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>
>
I= _j
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in
ft
ft
�dpl
nrAn
In
in
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in
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7
2.1
A
8,500
6
18
OA8,;
6C
85
2
51.T
-N
0.25,
0.05
.,0.05.
N
'G.
87
—.7
U
-42
'13
14
11:
16
J
7 F
20
C'
:93
2Z
1.92
0.34
0.34
r
21
C
2.26
0, oQ-
1.48
0.35
0.35,
22
21,
77iT
24
C
-86
25
26
A
J
I
27-
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28
20
3O
1, 7
LL
Monthly1badifig
42,ROO
0,92'
12 Month Floating. - al (In-),
T-,-'XQ73j
6.97

NON -DISCHARGE MONITORING REPORT (NDMR) Page ' of
Facility Name: Div. Of Parks & Rec (Lake Norman SP) county: Iredell Month: June Year: 2017
Floe✓ Measuring Point: ZInfluent ❑Effluent ❑No Flow generated
Parameter Monitoring Point: ❑Influent ElEffluent ❑Groundwater Lowering ❑Surface Water
rCode 1-1
50050
50060
00400
C0310
31616
00610
00630
81639
00600
00530
00665•
i0
>
m
c
O
~
d
3F
C C
V
C
10
c
f0
M
90
0
cm
�
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c 'O
H
2
Tay t
M
o
V H
v
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y
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H
",
U.
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y
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O
�v
o
O
V
E
a
z z
o z
z
F°
i°-
o
m
~
N
IL
24-hr
hrs
GPD
mg/L
su
mg/L
#/100 mL
mg/L
mg/L
Ibs/ac
mg/L
mg/L
mg/L
ss
1
3,100
r e
_
21
16:20
1
3,100
0.4
7.1
31
3,100
0
1
4
3,100
5
3,100
`- N
6
16:30
1.17
3,100
0.52
7.2
MOOR
P-
c
7
3,100
8
3,100
9
3,100
10
3,100
s �'
11
3,100
�y
12
16:25
1.5
3,100
7
13
3,100
j
14
16:15
1
3,100
7
4.3
167 -
7.39
<0.1
10.8
10.8.
5.3
5.3
151
3,100
16
3,100
G'
�
17
3,100
18
3,100�
19
3,100
20
16:20
1.25
3,100
7.1
211
3,100
221
3,100
231
3,100
241
3,100
25
3,100
26
3,100
-
27
16:20
1.75
3,100
7
28
16:20
1
3,100
6.9
29
3,100
301
3,100
31
Average:
3,100
0.46
4.30
167.00
7.39
0.00
10.80
10.80.
5.30
5.30
Daily Maximum:
3,100
0.52
7.20
4.30
167.00
7.39
0.10
10.80
10.80
5.30
5.30
Daily Minimum:
3,100 -
0.40
6.90
4.30
167.00
7.39
0.10
10.80
10.80
5.30
5.30
Sampling Type:
Recorder
Grab
Grab
Monthly Limit:
Daily Limit:
Sample Frequency:
Monthly
Monthly
Weekly

FORM: NDMR 03-12
NON -DISCHARGE MONITORING REPORT (NDMR)
Sampling Person(s)
Name: Matthew Bryan Cartner
Name:
Certified Laboratories
Name: Statesville Analytical, Inc.
Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? ❑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.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Matthew Bryan Cartner._
Permittee: Div. Of Parks & rec (Lake Norman SP)
Certification No.: 995910
Signing Official: Jarid Church
Grade: S1 Phone Number: 704-880-4373
Signing Official's Title: Park Ranger
Has the ORC changed since the previous NDMR? ❑yes [ZNo
Phone Number: 704-528-6350 Permit Expiration: 9/30/2020
I
Signature Date
Signature Date
By this signature, I certify that this report Is accurrate and complete to the best of my knowledge.
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 Quality
Information Processing Unit
1617 Mail Service Center

NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Page I of 21
81
rlgation occur
at this facility'
DYES ONO
Facility Name:
.Lake Norman State Park
County: Iredell
Month: June
Year: 2017
Field Name:
A
Field Name:
B
Field Name:
FPield Name:
Area (acres):
1.715
Area (acres):
1.715
Area (acres):
Area (acres):
Cover Crop:
Woodland
Cover Crop:
Woodland
Cover Crop:
Cover Crop:
Hourly Rate (in):
0.4'
Hourly Rate (in):
0.4
Hourly Rate (in):
Hourly Rate (in):
Annual Rate (In):
30.16
Annual Rate (in):
30.16
Annual Rate (in):
Annual Rate (in):
Weather
Freeboard
Field Irrigated?
DYES ONO
Field Irrigated?
DYES ONO
Field Irrigated?
g
DYES ONO
Field Irrigated?
DYES ONO
T
m
c
c
2
'
10
CL
E
~
°
a
a
avi
`
a
m
Qf
2
w
m
oo
as
G M
Lb
mo
d
°a
> Q
v�f
Gl .r'�
E�
rn
�.0
'gym
O o
J
EAo)
7� C
boo
= p
J
m'o
Gf
'a
o a
� Q
v
dad..
E�
H °7
o)
aC
,��
D o
J
EA cm
7_ C
Env
2 0
J
�fl
01
Ea
o a_
i Q
d
E16
j= .�
E
C
�S
p o
J
E
�C
rr
is o. co
= J
N�
?a
o a
� Q
E�
°�
01
T�
p �a
J
E TOI
E»
>c o m
= J
OF:
in
ft
ft
gal
min
In
In
gal
min
in
in
gal
min
In
in
gal
min
in
in
1
2
CL
78
2.3
9,000
60
0.19
0.19
3
4
5
6
C
79
2.2
8,300
70
0.18
0.15
7
8
9
10
11
12
C
81
2.2
13,300
1.5
0.29
0.29
13
141
C
83
2.25
8,300
60
0.18
0.18
15
16
17
11,600
1.5
0.25
0.25
3,300
0.5
0.07
0.07
18
19
201
CL
72
2.25
9,800
1.25
0.21
0.21
21
22
23
24
25
26
27
CL
74
2.3
12,400
1.75
0.27
0.27
28
CL
75
2.35
8,900
1
0.19
0.19
29
30
31
0.00
Monthly Loading:
12 Month Floating Total (in):
40,600
0.87
4.85
44,300
0.95
5.46
0
0.00
0

FORM: NDAR-1 08-11
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?
Were all freeboards maintained in accordance with the specified freeboard heights in your permit!
UCompliant LjNon-Compliant
i]Compliant ❑Non -Compliant
i]Compliant ❑Non -Compliant
i]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.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Matthew B. Cartner
Permittee'
Div. Of Parks & Rec (Lake Norman SP)
Certification No.: 995910
Signing Official: Jarid Church
Grade: S1 Phone Number: 704-880-4373
Signing Official's Title: Park Ranger
Has the ORC changed since the previous NDAR-1? ❑Yes 21No
Phone Number: 704-528-6350 Permit Exp.: 9/30/20
Signature Date
IF k Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
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 knowledga,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 Quality
Information Processing Unit
1617 Mail Service Center

pppppp—
NON -DISCHARGE MONITORING REPORT (NDMR) Page I of
0881 Facility Name: Div. Of Parks & Rec (Lake Norman SP) county: Iredell Month: April Year: 2017
Flow Measuring Point: [ZInfluent ❑Effiuent ❑No Flow generated Parameter Monitoring Point: ❑Influent [2]Effluent ❑Groundwater Lowering ❑Surface Water
Parameter Code — ►
om
N
pM U
0 W
0
•. SOW
LL
50060
To
'
9)
00400.
C0310
°
p
to
31616
i o
V
00610
o
E
a
00630
+atL
Z Z
81639
9°'
�,z•rn_•
Y°
00600
°
� z•rn• _.
00530
c°°
�E
H0°a
v)
00665
1\I
W0305
E
` INiRj l/�[
!WR
1
24-hr
hrs
GPD
2,,003
mg/L
#/100 mL
mg/L
mg/L
Ibs/ac
mg/L
mg/L
mglL�n',VILLE
r;
_
2
"` Z003
31
2;003. .
4
`' 2,003
5
16:00
1
2,003
0.3
7.2
6
2,003
7
2,003
8
91
2,003
2,003
101
2,003
11
.Z0.03
12
2,003
9
13
2,003
VIP,CP
.
14
16:30
1.25
-2,003 -
0.4
7: -
!C3; %
15
2,003-
16
21003
W
17
2-003
S�
181
2,003
j
19
2,003
20
2,003
21
16:30
1.25
2,003
7.1
22
',2,003
23
2,003'
241
16:25
0.25
--.•.2,003
7.
25
2,003
26
'.'.. Z003 -'
27
2,003
28
2,003,
29
2,003
30
2,003
31
Average:
-2,003
0.35
Daily Maximum:.
2,003
0.40
T20
Daily Minimum:
.-2,003
0.30
7.00
Sampling Type:
_Recorder
Grab
Grab -
Monthly Limit:
Daily Limit:.
Sample Frequency:
Monthly ._
Monthly
Weekly,,

NON -DISCHARGE MONITORING REPORT (NDMR)
Page 9 of
Sampling Person(s)
Matthew Bryan Cartner
Certified Laboratories
Name: Statesville Analytical, Inc.
I Name: II I
Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? ❑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 arir itinnal shoat¢ if narm—n—
Operator in Responsible Charge (ORC) Certification
ORC: Matthew Bryan Cartner
Certification No.: 995910
Grade: S1 Phone Number: 704-880-4373
Has the ORC changed since the previous NDMR? ❑Yes ❑� No
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
Permittee Certification
Permittee: Div. Of Parks & rec (Lake Norman SP)
Signing official: Jarid Church
Signing Officials Title: Park Ranger
Phone Number: 704-528-6350 Permit Expiration: 9/30/2020
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 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 Quality
Information Processing Unit
1617 Mail Service Center

pppppp-
NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page I of ?%
020881 Facility Name: Lake Norman State Park County: Iredell Month: April Year: 2017
irrigationoccurEIeId::Name:
at this facility?
pYEs ONO
' A' =
Field Name:
B
Fleld`Name
Field Name
Area,(acres);
1 71.5
Area (acres):
1.715
Area.(aeres):
Area (acres):
Dover Crop:
1lVoodland . -;
Cover Crop:
Woodland
Cover Crop::.
Cover Crop:
HouH Rat®, in
y.. ( ):-
'•. ' '0:4 -
Hourly Rate (in):
0.4
=
_:-.-Houtly.Rate (In):.
',
Hourly Rate (in):
Annual Rate (in):
''.- _=30.16 . ":'
Annual Rate (in):
30.16
. ,Annual Rate (Iri):
'
Annual Rate (in):
Weather
Freeboard
Field Irrigated?
i]YEs : y []No ..`
Field Irrigated?
9
DYes ONO
_ .,Field irrigated?
OYES -. -ONO-. .,
Field Irrigated?
OYES ONO
m
2
CL
E
c
y
�i4
o
>
E c
tS
+e
. �
E2
°"
—'
Im
`
m=
`
•
E
m
�
eE•
•o
E.�
oaE
.
m
°o
EEatM
c c
�
°F
in
ft
ft
gal -'-`min
In,
in,
gal
min
in
in
,. al
min,
- In
In
gal
min
in
in
21
-
-
3
_
s
4
:::
61
CL
72
0
3.25
" '
5,000
30
0.11
0.11
6
_
,
7
81
9-
_
10
L _
11
..4
12
13
141
C
56
0
1 3
83002..
60 ''
018,
15
,
16
77
17
-.
18
19
:.
201
211
CL
76
0
3
77_
9,000
75
0.19
0.15
22
23
241
R
49
4.9
2.75
25
26 1_
27
28
29
30
31
Monthly Loading::
12 Month Floating Total (in):
8;300
0.18
14,000
0.30
4.86
0
0.00'
0
0.00

NON -DISCHARGE APPLICATION REPORT (NDAR-1)
limits in Attachment B of your permit?
revent 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?
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
Page A of
❑� Compliant
❑s Compliant
❑� Compliant
❑r Compliant
❑� Compliant
❑Non -Compliant
❑Non -Compliant
❑Non -Compliant
❑Non -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 neressary
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Matthew B. Cartner
Permittee:
Div. Of Parks & Rec (Lake Norman SP)
Certification No.: 995910
Signing Official: Jarid Church
Grade: S1 Phone Number: 704-880-4373
Signing Officials Title: Park Ranger
Has the ORC changed since the previous NDAR-1? ❑Yes RINo
Phone Number: 704-528-6350 Permit Exp.: 9/30/20
zi--Q
d5 z7ut
Signature Date
Signature Date
By this signature, I certify that this report Is accurrate and complete to the best of my knowledge.
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.
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center

NON -DISCHARGE MONITORING REPORT (NDMR)
Page _L_ of
20881
Facility Name: Div. Of Parks & Rec (Lake Norman SP)
County: Iredell
Month: March
Year: 2017
I: Flow Measuring Point: ❑� influent ❑Effluent []No flow generated
Parameter Monitoring Point: ❑Influent ❑� Effluent ❑Groundwater Lowering ❑Surface Water
Parameter Code No
50050
50060
00400
C0310
31616
00610
00630
81639
00600
00530
00666
>
a E
i-
c
G1
E :'
1= �
o
3
°
uL
M d
v
0 'FA �
F-
=
CL
O
v
,�
o
m
G
C
� c
m=
�` 0
A
c
E
a
t
w
z z
� C
� rn
Y°
'z
�
-
C
t
°
~ z
N
c�
o o. o
~ 0 rn
y
_
_
0
0 0.
~ s
a'
PI=CEIVI
_DMCDEN
R/DWR
24-hr
hrs
GPD
mg/L
su
mg/L
#1100 mL
mg/L
mg/L
Ibs/ac
mg/L
mg/L
mg/L
PAY
1
716
2
716
WQROS
3
716
W
ORESVIL
E REGIOP
JAL OFFIC
=
4
716
51
716
6
716
7
716
6
7.4
<0.5
2.22
1.46
3.68
<2.9
5.6
8
716
9
716
10
16:30
0.5
716
0.03
7.3
11
716
12
716
13
716
14
716
15
716
16
716
171
16:30
1
716
7.2
18
716
i
19
716
20
716
IV
21
716
22
16:30
0.64
716
7.2
231
716
24
716
25
716
26
716
27
716
28
716
29
16:25
1
716
7.3
30
716
31
716
Average:
716
0.03
6.00
7.40
0.00
2.22
1.46
3.68
0.00
5.60
Daily Maximum:
716
0.03
7.30
6.00
7.40
0.50
2.22
1.46
3.68
2.90
5.60
Daily Minimum:
716
0.03
7.20
6.00
7.40
0.50
2.22
1.46
3.68
2.90
5.60
Sampling Type:
Recorder
Grab
Grab
Monthly Limit:
Daily Limit:
Sample Frequency:1
Monthly
Monthly
Weekly

NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Page I of
Q0020881
Occur
Rid irrigation occur
at this facility?
21YES EINO
Facility Name: .Lake Norman
Freid ame
dely-Rate c.(in),.,
Anhj ki (in) 6A ate
Weather
Freeboard
._,_FIiId,_IrrIgatdd?
-'[�YEs Elk6;,-*
0
CL
r
0
CL
CM
I
U, A
CL '0
= .2
CL
9 cc
90 !t
S,
'0
Cd
�j
OF
in
ft
ft
V
'min
lrf.�
`in
V
2
3
r.
4
5
6
7
8
9
10 C
55
0
3.25
12
13
14
.7,
... ...
15
16
17 C
57
0
3.25
7,060�;'
18
19
10
!2 CL
65
0
3.25
T
!3
!4
Z.
!6
!8
!9 C
70
0
3.25
7,466.L�-
_j6b
016.
0
State Park County: Iredell Month: March Year: 2017
Field Name: B z -'Field "Nime: Field Name:
Area (acres):
Area (acres): 1.715
Cover Crop: Woodland --p.6 �,Ctop` - Cover Crop:
Hourly Rate (in): 0.4 K46 (In Hourly Rate (in):
Y
Annual Rate (in): 30.16 Annual Rate (in):
Field Irrigated? E]YES EINO Field Field Irrigated? DYES DNO
E E
CM C0
E 21) 3 ::ft
E 2 S
E E V
-6 CL .2 U w 0 M
p Mm
0 rL Im 0 0
> _j 5, 0
E.1, 0
>
_j _j
gal min in in gal' m In n gal min In in
4,800 30 0.10 0.10
6,000 40 0.13 0.13
.4�
w
r
12 Month Floating Total
M U.45 _,UrUU u U.UU
= 4.95
12 Month Floating Total
M U.45 _,UrUU u U.UU
= 4.95

NON -DISCHARGE APPLICATION REPORT (NDAR-1)
i limits in Attachment B of your permit?
irevent effluent ponding in or runoff from the sites?
Was a suitable vegetative cover maintained on all sites as specified in your permit?
Page 2) of 21
Compliant ❑Non -Compliant
(]Compliant ❑Non -Compliant
(]Compliant ❑Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site? OCompliant ❑Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? (]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.
Operator in Responsible Charge (ORC) Certification
I ORC: Matthew B. Cartner
Certification No.: 995910
Grade: S1 Phone Number: 704-880-4373
Has the ORC changed since the previous NDAR-1? ❑Yes ❑� No
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
Permittee Certification
Permittee:
Div. Of Parks & Rec (Lake Norman SP)
Signing Official: Jarid Church
Signing Officials Title: Park Ranger
Phone Number: 704-528-6350 Permit Exp.: 9/30/20
�2_
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 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 Quality
Information Processing Unit
1617 Mail Service Center

NON -DISCHARGE MONITORING REPORT (NDMR)
Page of
Facility Name: Div. Of Parks & Rec (Lake Norman SP)
County: Iredell
Month: June
Year: 2017
rFl;7;Meisuring Point: ❑� Influent ❑Effluent ❑No flow generated
Parameter Monitoring Point: ❑Influent ❑� Effluent ❑Groundwater Lowering ❑Surface Water
`
50060
;00400 '
C0310
31616
00610
.00630 =
00620
00600
00530i66k
E
c�
E„
d
c
1°
p
_ C
f �p�;
p
_ d
cry c v
24-hr
hrs
GPD y:
mg/L
su
mg/L
#11,00".mL
mg/L
mg/Lss .;,
mg/L
mfln=�,:.I
mg/L
A4_ rk-
m`
1
3,100
2
16:20
1
3,100'-
0.4
71, "-
Wize-
3
3100
4
5
3,100
H�-=
-r
6
16:30
1.17
3,100
0.52
T2
7
3,100
8
2;"100
9
3'1�ti
.-:.
10
3,100°'
ct ='
11
3,100.
12
16:25
1.5
3',100;
7':
13
3,100.
z
14
16:15
1
`'3 100
7 -
u
4.3
167, `'.
7.39
<0 1 ",
10.8
1:Q 8_s ''
5.3
?3
"
15
3,100
16
3,100
17
3..ODt
,.*,r �z„i.'
`s._�..
18`•3'
100
19
j.s4 .
201
16:20
1.25r3;a�,00
21
22
3,106-
2331,00,.'�>
24
3,100 :
kT
25
�.3,100
26
3,100'-
-;
' 4
{
27
16:20
1.75
28
16:20
1
3,100`=
AM&
29
3,100,
30
31
Average
3;100
0.46
4.30I'67
QO
7.39
''0 00
10.80
5.30
Daily Maximum
s3r10Q'.
0.52
....
4.30
167'00:--
7.39
010•'�.`
10.80
0 0F.
.f :. ,. ,.-.._ a
5.30
_... -.-.
_ ...
Daily Minimum:
3,1Q0 ',
0.40
6 90" . '
4.30
167;00 .
7.39
b 10,:
10.80
10'80x
5.30
3d f
Sampling Type
;Recorder.
Grab
m a
Monthly Limit:
_
V'
Daily LimitF--
Sample Frequency:
Monthty
Monthly

NON -DISCHARGE MONITORING REPORT (NDMR) Page of
PPP Sampling Person(s) Certified Laboratories
atthew Bryan Cartner Name: Statesville Analytical, Inc.
rName: II Name: I
I(Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? ❑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.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Matthew Bryan Cartner
Permittee: Div. Of Parks & rec -(Lake Norman SP)
Certification No.: 995910
Signing Official: Jared Church
Grade: S1 Phone Number: 704-880-4373
Signing Official's Title: Park Ranger
Has the ORC changed since the previous NDMR? ❑Yes [Z No
Phone Number: 704-528-6350 Permit Expiration: 9/30/2020
Signature Date
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
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 Quality .
Information Processing Unit
1617 Mail Service Center .-
Raleigh, North Carolina 27699-1617

User Friendly Name
Official Parameter Name
DWQ Accepted Units
00010
Temperature
Temperature, Water Deg. Centigrade
°C
00076
Turbidity
Turbidity, HCH Turbidimeter
NTU
00092
Flow - Maximum
Flow, Maximum Flow Range
GPD
00094
Conductivity
Conductivity
PO
00125
Dichlorobenzene
Dichlorobenzene (Isomers) M/P In Water ug/L
Ng/L
00300
Dissolved Oxygen
DO, Oxygen, Dissolved
mg/L
00310
BODS
BOD, 5-Day (20 Deg. C)
mg/L
00340
COD
COD, Oxygen Demand, Chem. (High Level)
mg/L
00400
pH
pH
su
00480
Salinity
Salinity
mg/L
00515
Total Filterable Residue
Residue, Tot Fltrble (dried at 105C)
mg/L
00530
Total Suspended Solids
Solids, Total Suspended
mg/L
00545
Settleable Solids
Solids, Settleable
mL/L
00556
Oil Ft Grease
Oil Et Grease
mg/L
00600
Total Nitrogen
Nitrogen, Total (as N)
mg/L
00610
Ammonia
Nitrogen, Ammonia Total (as N)
mg/L
00615
Nitrite
Nitrogen, Nitrite Total (as N)
mg/L
00620
Nitrate
Nitrogen, Nitrate Total (as N)
mg/L
00625
Total Kjeldahl Nitrogen
Nitrogen, Kjeldahl, Total (as N)
mg/L
00630
Nitrite + Nitrate
Nitrite plus Nitrate Total 1 DET. (as N)
mg/L
00660
Ortho Phosphate
Phosphate, Ortho (as PO4)
mg/L
00665
Total Phosphorus
Phosphorus, Total (as P)
mg/L
00670
Organic Phosphorus
Phosphorous, Total Organic (as P)
mg/L
00680
Total Organic Carbon
Carbon, Tot Organic (TOC)
mg/L
00681
Dissolved Organic Carbon
Carbon, Dissolved Organic (As C)
mg/L
00916
Calcium
Calcium, Total (as Ca)
mg/L
00927
Magnesium
Magnesium, Total (as Mg)
mg/L
00929
Sodium
Sodium, Total (as Na)
mg/L
00931
Sodium Adsorption Ratio
Sodium Adsorption Ratio
Ratio
00937
Potassium
Potassium, Total (as K)
mg/L
00940
Chloride
Chloride (as Cl)
mg/L
00945
Sulfate
Sulfate, Total (as SO4)
mg/L
01002
Arsenic
Arsenic, Total (as As)
mg/L
01007
Barium
Barium, Total (as Ba)
mg/L
01022
Boron
Boron, Total (as B)
mg/L
01027
Cadmium
Cadmium, Total (as Cd)
mg/L
01034
Chromium
Chromium, Total (as Cr)
mg/L
01042
Copper
Copper, Total (as Cu)
mg/L
01045
Iron
Iron, Total (as Fe)
mg/L
01051
Lead
Lead, Total (as Pb)
mg/L
01055
Manganese
Manganese, Total (as Mn)
mg/L
01067
Nickel
Nickel, Total (as Ni)
mg/L
01077
Silver
Silver, Total (as Ag)
mg/L
01092
Zinc
Zinc, Total (as Zn)
mg/L
01147
Selenium
Selenium, Total (as Se)
mg/L
01284
ND Application Rate
Non -Discharge Application Rate
in/yr
31504
Total Coliform
Coliform, Total MF, Immed,LES Endo Agar
#/100 mL
31505
Total Coliform
Coliform, Tot, MPN, Completed, (100 mL)
MPN/100 mL
1613
Fecal Coliform
Coliform, Fecal MF, M-FC Agar,44.5C,24hr
#/100 mL
616
Fecal Coliform
Coliform, Fecal MF, M-FC Broth,44.5C
#/100 mL
6
Chloroform
Chloroform
mg/L

32730
Phenolics - Recoverable
Phenolics, Total Recoverable
mg/L
32730
Phenols
mg/L
34469
Pyrene
Pyrene
pg/L
34694
Phenol - Single
Phenol, Single Compound
mg/L
38260
Surfactants
Surfactants (MBAS)
mg/L
50050
Flow
Flow, in conduit or thru treatment plant
GPD
50060
Total Residual Chlorine
Chlorine, Total Residual
mg/L
70295
Total Dissolved Solids
Solids, Total Dissolved
mg/L
70300
Total Dissolved Solids
Solids, Total Dissolved- 180 Deg.0
mg/L
70318
% Solids
Solids, Total, Percent
%
71880
Formaldehyde
Formaldehyde
mg/L
71900
Mercury
Mercury, Total (as Hg)
mg/L
78732
Volatile Compounds
Volatile Compounds, (GUMS)
Yes/No
80082
Carbonaceous BOD
BOD, Carbonaceous 05 Day, 20C
mg/L
81639
Total Kjeldahl Nitrogen
Nitrogen Kjeldalh, Total (TKN)
lbs/ac
81688
Ethylene Glycol
Ethylene glycol
pg/L
82385
Nitrogen Oxides
Nitrogen Oxides (as N)
mg/L
82546
Water Level
Water level, distance from measuring point
ft
C0310
BOD5 - Conc.
BOD, 5-Day (20 Deg. C) - Concentration
mg/L
CO530
TSS - Conc.
Solids, Total Suspended - Concentration
mg/L
CO600
Total Nitrogen - Conc.
Nitrogen, Total (as N) - Concentration
mg/L
CO610
Ammonia - Conc.
Nitrogen, Ammonia Total (as N) - Concentration
mg/L
CO665
Total. Phosphorus - Conc.
Phosphorus, Total (as?) - Concentration
mg/L
WQ09
Plant Available Nitrogen
Plant Available Nitrogen - Loading
mg/L

NON -DISCHARGE MONITORING REPORT (NDMR)
Page
Facility Name: Div. Of Parks & Rec (Lake Norman SP)
County: Iredell
Month: March
Year: 2017
Flow Measuring Point: ❑� Influent ❑Effluent ❑No Flow generated
Parameter Monitoring Point: ❑Influent ❑� Effluent ❑Groundwater Lowering ❑Surface Water
r Code
50056: t
:..
50060
M
C0310
,fix 6, 6ht
00610
x0U6
r«ter
81639
00530
O
O
oICU U)
aLO
E
al
Y°
o
24-hr
hrs
�;GPDr <
mg/L
°' i
mg/L11�OOriL;
mg/L
;;_nig/L
Ibs/ac
mg/LRa
f,
k
2
r
716 ,
.
3
4
7
,.t 7y16
..
6
7d4&
<0 5
m 2 "Y
1.46
<2.9
91
10
16:30
0.5
„F716'-
0.03
7g'
5,r
f,
11
� 6: <r
`&
12
s �:w
ems%'
,•i1'_*{� r;•
,�.
J�6ar?
��,{ +','}5
14
157s�`6:`
vr•_`
16'.6�,,
171
16:30
1
A &7Z16' ,
AM
18
6`MAN
19
20
211
' I 6
221
16:30
0.64
231241
6
re
'ot
25
n7
26
76
27
I
28
29
16:25
1
30
6
31ij6
0.00
Average:
0.03
all= 6.00
0
0.00
1.46
Daily Maximum:
jffgffl
0.03
6.00
0.50
1.46
2.90
Daily Minimum:
0.03
6.00
0.50
1.46
2.90
Sampling Type:
,jR o
GrabMom{_
Monthly Limit:"
Daily Limit:
Sample Frequency:."
. , >`.
Monthly
MAM

NON -DISCHARGE MONITORING REPORT (NDMR) Page of
Sampling Person(s) II Certified Laboratories
atthew Bryan Cartner II Name: Statesville Analytical, Inc.
P'Name: II Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? ❑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.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Matthew Bryan Cartner
Permittee: Div. Of Parks & rec (Lake Norman SP)
Certification No.: 995910
Signing Official: Jarid Church
Grade: S1 Phone Number: 704-880-4373
Signing Official's Title: Park Ranger
Has the ORC changed since the previous NDMR? ❑Yes [ANo
Phone Number: 704-528-6350 Permit Expiration: 9/30/2020
Signature Date
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
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 Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

User Friendly Name
Official Parameter Name
DWQ Accepted Units
00010
Temperature
Temperature, Water Deg. Centigrade
;C
00076
Turbidity
Turbidity, HCH Turbidimeter
NTU
00092
Flow - Maximum
Flow, Maximum Flow Range
GPD
00094
Conductivity
Conductivity
NO
00125
Dichlorobenzene
Dichlorobenzene (Isomers) M/P In Water ug/t
pg/L
00300
Dissolved Oxygen
DO, Oxygen, Dissolved
mg/L
00310
BODs
BOD, 5-Day (20 Deg. C)
mg/L
00340
COD
COD, Oxygen Demand, Chem. (High Level)
mg/L
00400
pH
pH
su
00480
Salinity
Salinity
mg/ L
00515
Total Filterable Residue
Residue, Tot Fltrble (dried at .105C)
mg/L
00530
Total Suspended Solids
Solids, Total Suspended
mg/L.
00545
Settleable Solids
Solids, Settleable
mL/L
00556
Oil Et Grease
Oil Et Grease
mg/L
00600
Total Nitrogen
Nitrogen, Total (as N)
mg/L
00610
Ammonia
Nitrogen, Ammonia Total (as N)
mg/L
00615
Nitrite
Nitrogen, Nitrite Total (as N)
mg/L
00620
Nitrate
Nitrogen, Nitrate Total (as N)
mg/L
00625
Total Kjeldahl Nitrogen
Nitrogen, Kjeldahl, Total (as N)
mg/L
00630
Nitrite + Nitrate
Nitrite plus Nitrate Total 1 DET. (as N)
mg/L
00660
Ortho Phosphate
Phosphate, Ortho (as PO4)
mg/L
00665
Total Phosphorus
Phosphorus, Total (as P)
mg/L
00670
Organic Phosphorus
Phosphorous, Total Organic (as P)
mg/L
00680
Total Organic Carbon
Carbon, Tot Organic (TOC)
mg/L
00681
Dissolved Organic Carbon
Carbon, Dissolved Organic (As C)
mg/L
00916
Calcium
Calcium, Total (as Ca)
mg/L
00927
Magnesium
Magnesium, Total (as Mg)
mg/L
00929
Sodium
Sodium, Total (as Na)
mg/L
00931
Sodium Adsorption Ratio
Sodium Adsorption Ratio
Ratio
00937
Potassium
Potassium, Total (as K)
mg/L
00940
Chloride
Chloride (as Cl)
mg/L
00945
Sulfate
Sulfate, Total (as SO4)
mg/L
01002
Arsenic
Arsenic, Total (as As)
mg/L
01007
Barium
Barium, Total (as Ba)
mg/L
01022
Boron
Boron, Total (as B)
mg/L
01027
Cadmium
Cadmium, Total (as Cd)
mg/L
01034
Chromium
Chromium, Total (as Cr)
mg/L
01042
Copper
Copper, Total (as Cu)
mg/L
01045
Iron
Iron, Total (as Fe)
mg/L
01051
Lead
Lead, Total (as Pb).
mg/L
01055
Manganese
Manganese, Total (as Mn)
mg/L
01067
Nickel
Nickel, Total (as Ni)
mg/L
01077
Silver
Silver, Total (as Ag)
mg/L
01092
Zinc
Zinc, Total (as Zn)
mg/L
01147
Selenium
Selenium, Total (as Se)
mg/L
01284
ND Application Rate
Non Discharge Application Rate
in/yr
31504
Total Coliform
Coliform, Total MF, Immed,LES Endo Agar
#/100 mL
31505
Total Coliform
Coliform, Tot, MPN, Completed, (100 mL)
MPN/100 mL
31613
Fecal Coliform
Coliform, Fecal MF, M-FC Agar,44.5C,24hr
#/100 mL
616
Fecal Coliform
Coliform, Fecal MF, M-FC Broth,44.5C
#/100 mL
6
Chloroform
Chloroform
mg/L

32730
Phenolics - Recoverable
Phenolics, Total Recoverable
mg/L
32730
Phenols
mg/L
34469
Pyrene
Pyrene
pg/L
34694
Phenol - Single
Phenol, Single Compound
mg/L
38260
Surfactants
Surfactants (MBAS)
mg/L
50050
Flow
Flow, in conduit or thru treatment plant
GPD
50060
Total Residual Chlorine
Chlorine, Total Residual
mg/L
70295
Total Dissolved Solids
Solids, Total Dissolved
mg/L
70300
Total Dissolved Solids
Solids, Total Dissolved- 180 Deg.0
mg/L
70318
% Solids
Solids, Total, Percent
%
71880
Formaldehyde
Formaldehyde
mg/L
71900
Mercury
Mercury, Total (as Hg)
mg/L
78732
Volatile Compounds
Volatile Compounds, (GUMS)
Yes/No
80082
Carbonaceous BOD
BOD, Carbonaceous 05 Day, 20C
mg/L
81639
Total Kjeldahl Nitrogen
Nitrogen Kjeldalh, Total (TKN)
lbs/ac
81688
Ethylene Glycol
Ethylene glycol
pg/L
82385
Nitrogen Oxides
Nitrogen Oxides (as N)
mg/L
82546
Water Level
Water level, distance from measuring point
ft
CO310
BOD5 - Conc.
BOD, 5-Day (20 Deg. C) - Concentration
mg/L
CO530
TSS - Conc.
Solids, Total Suspended - Concentration
mg/L
CO600
Total Nitrogen - Conc.
Nitrogen, Total (as N) - Concentration
mg/L
C0610
Ammonia - Conc.
Nitrogen, Ammonia Total (as N) - Concentration
mg/L
CO665
Total Phosphorus - Conc.
Phosphorus, Total (as P) - Concentration
mg/L
WQ09
Plant Available Nitrogen
Plant Available Nitrogen - Loading
mg/L

NON -DISCHARGE MONITORING REPORT (NDMR) Page of A
0020881 Facility Name: Div. Of Parks & Rec (Lake Norman SP) County: Iredell Month: February Year: 2017
Flow Measuring Point: ❑� Influent ❑Effluent ❑No flow generated
Parameter Monitoring Point: ❑influent ❑✓ Effluent ❑Groundwater Lowering ❑Surface water
arameterCode
--►
50050
50060
00400
C0310
31616
00610
00630
81639
00600
00530
00665
p
1
2
a
U0
O
c
UE
o
ai t
m
O
o
=~
Z Z
Y122
.Z
Z
o—
N~
w
_
oE
Cta)
IL.
R=CEIVED/I
ICD;E.
NcRl/lDr
UF
24-hr
16:00
hrs
1
GPD
1,182nTu!
1,182
mg/L
0.4
su
7.3
mg/L
#/100 mL
mg/L
mg/L
Ibs/ac
mg/L
mg/L
mg/L
`JF1L'
�f 10E
3
1,182
4
1,182
5
1,182
61
1,182
7
1,182
8
1,182
9
16:30
0.75
1,182
7.1
10
1,182
11
1,182
12
1,182
13
14
15
16
17
16
19
20
21
16:00
1.33
1,182
1,182
1,182
1,182
1,182
1,182
1;182
1,182
1,182
0.5
7.1
�� A
�'I LCr,�
I'
I, Eifi
�,•
22
16:30
1
1,182
7
0,
23
1,182
24
1,182
25
1,182
26
1,182
27
1,182
16:30
0.5
1,182
7.1
29
V28
30
31
Average:
1,182
0.45
Daily Maximum:
1,182
0.50
7.30
Daily Minimum:
1,182
0.40
7.00
Sampling Type:
Recorder
Grab
Grab
Monthly Limit:
Daily Limit:
Sample Frequency:1
Monthly
Monthly
Weekly

NON -DISCHARGE MONITORING REPORT (NDMR)
Page A of
Matthew Bryan Cartner
Name:
Sampling Person(s)
Certified Laboratories
Name: Statesville Analytical, Inc.
Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit?
❑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
actionts) taken Attach nrirfitinnal choose if norncc—
Operator in Responsible Charge (ORC) Certification Permittee Certification
ORC: Matthew Bryan Cartner Permittee: Div. Of Parks & rec (Lake Norman SP)
Certification No.: 995910 Signing Official: Jarid Church
Grade: S1 Phone Number: 704-880-4373 Signing Officials Title: Park Ranger
Has the ORC changed since the previous NDMR? ❑Yes I]No Phone Number: 704-528-6350 Permit Expiration: 9/30/2020
1, Aojpil� L �—,
Signature Date Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge. 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.
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center

NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page) of
Q0020881 Facility Name: .Lake Norman State Park County: Iredell Month: February Year: 2017
irrigation occur
at this facility?
❑✓ YES ❑No
Field Name:
- , ;A'...
Field Name:
B
Field Name:.
Field Name:
Area (acres)r
. 1.715'
Area (acres):
1.715
= •Area:(acres):.:'
Area (acres):
Cover.Crop:
;:, Woodland -
Cover Crop:
Woodland
CoverCrop:
= _
Cover Crop:
Hourly Rafe,(in):
,=' _ . `0.4' . '
Hourly Rate (in):
0.4
:; Hourly.,Rate (in)::
Hourly Rate (in):
:. `Annual Rate (in):
i ;, :.,
3016- -
Annual Rate (in):
30.16
Annual Rate (in):
Annual Rate (in):
Weather
Freeboard
= Field Irrigated?
= pYEs.. ONO
Field Irrigated?
DYES ONO
Field, Irrigated?
. ❑YES ' - '',ONO .
Field Irrigated?
OYES ONO
>,
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=
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WEO.4912
47
Monthly Loading:
Month Floating Total (in):
' 13,000-.,
0.28
-4.82
22,900

NON -DISCHARGE APPLICATION REPORT (NDAR-1)
the limits in Attachment B of your permit?
to prevent effluent ponding in or runoff from the sites?
Page A of ;�
[2]Compliant ❑Non -Compliant'
[]Compliant [--]Non-compliant
Was a suitable vegetative cover maintained on all sites as specified in your. permit? ElCompliant ❑Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site? pCompliant []Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? 2Compliant []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
arfinn(s) tnkan A44nrh —Mic., 1 tie_+ ;c _,.----__
illitilii�f
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Matthew B. Cartner
Permittee:
Div. Of Parks & Rec (Lake Norman SP)
Certification No.: 995910
Signing Official: Jarid Church
Grade: S1 Phone Number: 704-880-4373
Signing Officials Title: Park Ranger
Has the ORC changed since the previous NDAR-1? Elyes ONO
Phone Number: 704-528-6350 Permit Exp.: 9/30/20
Signature Date
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
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 Quality
Information Processing Unit
1617 Mail Service Center

NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page I of-2 _
Q0020881
Facility Name: Lake Norman State Park
County: Iredell
Month: January
Year: 2017
ci irrigation occur
at this facility?
AYES ❑NO
Field Name:
A
Field Name:
B
Field Name:
Field Name:
Area (acres):
1.71.5
Area (acres):
1.715
Area (acres):
Area (acres):
Cover Crop:Woodland
Cover Crop:
p:
Woodland
Cover Crop:
p:
Cover Crop:
p:
Hourly Rate (in):
0.4-
Hourly Rate (in):
0.4
Hourly Rate (In):
Hourly Rate (in):
Annual Rate (in):
30.16.
Annual Rate (in):
30.16
Annual Rate (in):
Annual Rate (in):
Weather
Freeboard
Field Irrigated?
DYES ❑NO
Field Irrigated?
DYES ❑NO
Field Irrigated?
❑YES ❑NO
Field Irrigated?
❑YES []NO
❑
0
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9
10
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0.17
0.17
14
15
E
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17
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19
20
21
C
64
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9,300
1 65
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23
24
25
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27
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0
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7,000
60
0.15
1 0.15
28
29
30
31
Monthly Loading:
12 Month Floating Total (in):
14.800
0.32
4.89,
19,400
0.42
5.56
0
0.00
0
0.00Rim

Q0020881 Facility Name: .Lake Norman State Park County: Iredell Month: January Year: 2017
PdgNON -DISCHARGE APPLICATION REPORT (NDAR-1) Page I of 2_
ation occur
at this facility?
EYES ONO
Field Name:
=
Field Name:
B
:'Field Name:
;
Field Name:
Area.(acres):
1'.71.5 '.' ' •.:
Area (acres):
1.715
Area (acres):
Area (acres):
t over Crop;,
: Woodland ' :
Cover Crop:
Woodland
_
Cover Crop:
=
Cover Crop:
= Hourly Rate, (Iri):
;' 0:4. , ; ." .
Hourly Rate (in):
0.4
= . Mourly.Rate (In):.
Hourly Rate (in):
'Annual Rate. (ln)c
3Q:16 -f--.
Annual Rate (in):
30.16
Annua(;Rate (in):
Annual Rate (in):
Weather
Freeboard
Fleld,frrigated?
: EYES' ; - ONO ' .
Field Irrigated?
EYES ❑No
-,.Fieldlrrigated7
' ❑YES ONO :•y
Field Irrigated?
DYES [:]NO
p
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0:17
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16
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19
=
20
21
C
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=
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9,300
65
0.20
0.18
23
24
25
26
27
C
50
0
3
7;000._, ,
60
.6.15
_0,15:
28
29
30
H_-4-
31
0.42
5.56
Monthly Loading:
12 Month Floating Total (in)-1
14,80Q :.
6 32
4.89•
19,400
0
0.00 ,
0
0.00

NON -DISCHARGE APPLICATION REPORT (NDAR-1)
d the limits in Attachment B of your permit?
I 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?
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
Page 91— of Ol
❑e Compliant ❑Non -Compliant
❑� Compliant [—]Non-compliant
❑� Compliant [—]Non-compliant
❑� Compliant ❑Non -Compliant
[ZCompliant ❑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.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Matthew B. Cartner
Permittee:
Div. Of Parks & Rec (Lake Norman SP)
Certification No.: 995910
Signing Official: Jarid Church
Grade: S1 Phone Number: 704-880-4373
Signing Officials Title: Park Ranger
Has the ORC changed since the previous NDAR-1? []Yes 2No
Phone Number: 704-528-6350 Permit Exp.: 9/30/20
qLVA,
7D rrl
- Signature Date
Signature D to
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
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.
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center

jr0020881
2 NON -DISCHARGE MONITORING REPORT NDMR age _ of.
I � t'���A rt Cd7 CIS �f
Facility Name: Div. Of Parks & Rec (Lake Norman SP) County: Iredell Month: December Year: 2016
IOw Measuring Point: EInfluent ❑Effluent [:]No flow generated Paraam. eter Monitorriihq Point: ❑Influent ❑r Effluent ❑Groundwater Lowering ❑Surface waber
Code 10 50050 50060 00400 C0310 31616 00610 00630 /81639,,� 00600 �/ 00530 00665
c
ti '
>_ 0 m c € K 0
E E °2 o '� J. � x U u o o :: � m o� � of � c v � 0 (I�EI'EIVEb/iU bf±NF�/Dll� F$
U I— F N y, 'g t a ,� li _ E = Y o o o..o 2 0.
o E Z = H" f— rn v) �- N!
0 0 fx U °m 0 a z o z z rn a FEB - 5`".1;"
24-hr hrs l:Dnl ..n .n Bunn ��
Sampling

NON -DISCHARGE MONITORING REPORT (NDMR)
Page A of 2L
Sampling Person(s)
Bryan Cartner
Certified Laboratories
Name: Statesville Analytical, Inc.
IIName:
all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? ❑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.
Operator in Responsible Charge (ORC) Certification Permittee Certification
ORC: Matthew Bryan Cartner Permittee: Div. Of Parks & rec (Lake Norman SP)
Certification No.: 995910 Signing Official: Jarid Church
Grade: S1 Phone Number: 704-880-4373 Signing Official's Title: Park Ranger
Has the ORC changed since the previous NDMR? ❑Yes ONO Phone Number: 704-528-6350 Permit Expiration: 9/30/2020
Signature Date
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge. 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.
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center

GE APPLICATION REPORT (NDAR-1) Page ) of
VVQU020881
Facility Name: .Lake Norman State Park
County: Iredell
Month: December
Year: 2016
igation occur
t this facility?
❑� YES ❑No
Weather
Field Name:
A
Field Name:
8
Field Name:
Field Name:
Area (acres):
Cover Crop:
Hourly Rate (in):
Area (acres):
1.715
Area (acres):
1.715
Area (acres):
Cover Crop:
Woodland
Cover Crop:
Woodland
Cover Crop:
Hourly Rate (in):.
0.4
Hourly Rate (in):
0.4
Hourly Rate (in):
Annual Rate (in):
30.16
Annual Rate (in):
30.16
Annual Rate (in):
Annual Rate (in):
1
2
v
C
U
m
ca
C
,,,
a
E
m
H
o
a
0
a
Freeboard
m
c
y
d—
to a
��
�. a
m a
��
N v
Field Irrigated?
�°_�-'
o
o a
>Q
°'�
E m
�'a
=
DYES
a��
E
p 0
J
❑NO
7 0
,i c o
f _j
Field Irrigated?
E2°_'
—
o a
>Q
m�
E m
°'
DYES
a.c
o co
o
J
❑No
=>c
E
x'o
m=o
J
Field Irrigated?
Ed
? c
oa
> Q
�y
E o�
i=c
DYES
❑No
Field Irrigated?
DYES
[:]NO
a�
oo
J
>>+�
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Ex° M
N20
2 J
my
E 2
z a
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rn
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o_ c
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M 2 J
°F
45
in
0
ft
3.25
ft
gal
min
In
in
gal
12,300
min
90
in
0.26
in
0.18
gal
min
in
in
gal
min
in
I in
3
4
5
6
7
8
_0_r
9
C
41
3
5,500
45
0.12
0.12
10
11
12
13
14
15
C
46
0
3.25
8,000
60
0.17
0.17
16
17
18
19
20
21
C
39
0
3.25
7,500
60
0.16
0.16
22
23
24
25
26
27
28
C
42
0
3.25
29
30
31
L
Monthly Loading: 13,000
12 Month Floating Total (in):
0.28
20,300
0.44
0.00
0
0.00
4.91
5.53

08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Page of
rates exceed the limits in Attachment B of your permit?
uate measures taken to prevent effluent ponding in or runoff from the sites?
suitable vegetative cover maintained on all sites as specified in your permit?
all setbacks listed in your permit maintained for every application to each permitted site?
Compliant ❑Non -Compliant
2Compliant ❑Nan -Compliant
2Compliant ❑Non -Compliant
i]Compliant ❑Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? ❑r 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.
Operator in Responsible Charge (ORC) Certification Permittee Certification
ORC: Matthew B. Cartner Permittee:
Div. Of Parks & Rec (Lake Norman SP)
Certification No.: 995910 Signing Official: Jarid Church
Grade: S1 Phone Number: 704-8804373 Signing Officials Title: Park Ranger
Has the ORC changed since the previous NDAR-1? ❑Yes ❑� No Phone Number: 704-528-6350 Permit Ex
p•: 9/30/20
c� I 61
Signature Date Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge. 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.
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center

08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page__� __of020881 Facility Name: .Lake Norman State Park County: Iredell Month: November Year: 2016
r
n occur
ility?
Field Name:
A
Field Name:
B
Field Name:
Field Name:
Area (acres):
1.715
Area (acres):
1.715
Area (acres):
Area (acres):
Cover Crop:
Woodland
Cover Crop:
Woodland
Cover Crop:
Cover Crop:
❑✓ YES ❑No
Hourly Rate (in):
0.4
Hourly Rate (in):
0.4
Hourly Rate (in):
Hourly Rate (in):
Annual Rate (in):
30.16
Annual Rate (in):
30.16
Annual Rate (in):
Annual Rate (in):
Weather
Freeboard
Fleld Irrigated?
❑✓ YES ❑NO
Field Irrigated?
9
DYES ❑No
Field Irrigated?
DYES ❑No
Field Irrigated?
DYES []NO
p
01
D r
M
a)
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E
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0
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gal
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in
2
3
41
5
C
65
0
3
9,600
75
0.21
0,16
EtECEI�!%
/PU :7�ri�
�nnrR
61
7
nF'
? in
niR
s
91
10
C
63
0
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10,300
1 75
0.22
0.18
FAO
)RESVII I '
rtr-ren
as nr_�er
11
12
13
14
15
16
C
67
0
3.25
7,000
60
0.15
0.15
A
*�
17
n.
18
19
75-7
21
22
�•,
U
23
24
25
-
26
C
50
0
3.5
8,000
60
0.17
0.17
27
28
29
30
31
joi
Monthly Loading:
12 Month Floating Total (in),
1 24,600
0.53
5.00
10,300
0.22
5.30
0.00
0
0.00

NON -DISCHARGE APPLICATION REPORT (NDAR-1)
n rates exceed the limits in Attachment B of your permit?
easures taken to prevent effluent ponding in or runoff from the sites?
getative 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?
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
Page A of
RICompliant ❑Non -Compliant
Elcompliant ❑Non -Compliant
PICompliant ❑Non -Compliant
ElCompliant ❑Non -Compliant
ElCompliant ❑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 nPr.Pccary
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Matthew B. Cartner
Permittee:
Div. Of Parks & Rec (Lake Norman SP)
Certification No.: 995910
Signing Official: Jarid Church
Grade: S1 Phone Number: 704-880-4373
Signing Official's Title: Park Superintendent
Has the ORC changed since the previous NDAR-1? ❑Yes [2]No
Phone Number: 704-528-6350 Permit Exp.: 9/30/20
Z.oI
Signature Date
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
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.
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center

NON -DISCHARGE MONITORING REPORT (NDMR)
Page I of
of
Facility Name: Div. Of Parks & Rec (Lake Norman SP)
County: Iredell
Month: November
Year: 2016
Flow Measuring Point: ElInfluent ■ ■ -
■ p ■ ■

12 NON -DISCHARGE MONITORING REPORT (NDMR) Page-Aof
Sampling Person(s) 11 Certified Laboratories
Matthew Bryan Cartner II Name: Statesville Analytical, Inc.
Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? ❑Compliant ❑Non-Compllant
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 nenessarv_
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Matthew Bryan Cartner
Permittee: Div. Of Parks & rec (Lake Norman SP)
Certification No.: 995910
Signing Official: Jarid Church -
Grade: S1 Phone Number: 704-880-4373
Signing Officials Title: Park Ranger
Has the ORC changed since the previous NDMR? ❑yes RINo
Phone Number: 704-528-6350 Permit Expiration: 9/30/2020
Signature Date
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
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.
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center

NON -DISCHARGE MONITORING REPORT (NDMR)
Page I of 25�
81 Facility Name: Div. Of Parks & Rec (Lake Norman SP) County: Iredell Month: October Year: 2016
Flow Measuring Point: 2influent ❑Effluent [:]No Flow generated Parameter Monitoring Point: ❑Influent ❑� Effluent ❑Groundwater Lowering [:]Surface Water
PmeterCode
—►
50050
50060
00400
C0310
31616
00610
00630
81639
00600
00530
00665
o
E
0
c
O
C
a)
ais
°
m
°
0
E
,9 0
zz
z
o
fmT
f
z
do'w
C
-Ci
y
tc
-y
a
tECEVE
DE
?/NCr1ENP
-•20Q
.L
/L)w+
1
2
24-hr
hrs
GPD
894
894
mg1L
su
mg/L
#1100 mL
mg/L
mg/L
Ibs/ac
mg/L
mg/L
mg/L
Mnr
RF=Q%,,
31
894
4
894
5
16:15
1.25
894
7.2
6
894
7
894
8
894
91
894
10
894
11
894
12
894
13
16:30
1
894
0.3
7.3
141
894
15
894
16
894
17
894
18
894
19
894
201
894
211
894
221
16:15
1.25
894
7.1
23
894.`r+:
f
24
894
25
894
i7v;
26
894
271
894
281
16:30
1
894
7.1
29
894
30
894
311
894
Average:
894
0.30
Daily Maximum:
894
0.30
7.30
Daily Minimum:
894
0.30
7.10
Sampling Type:1
Recorder
Grab
Grab
Monthly Limit:
Daily Limit:
Sample Frequency:
Monthly
Monthly
Weekly

Sampling Person(s)
NON -DISCHARGE MONITORING REPORT (NDMR)
Page /) of
Matthew Bryan Cartner
Name:
Certified Laboratories
Name: Statesville Analytical, Inc.
Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit?
❑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 necessarv.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Matthew Bryan Cartner
Permittee: Div. Of Parks & rec (Lake Norman SP)
Certification No.: 995910
Signing Official: William C. Rhinehardt, Jr. '3A;t D A, c'4+u ►2C t4
Grade: S1 Phone Number: 704-880-4373
Signing Officials Title: Park Superintendent -Pwv- �'ti�`1t✓�
Has the ORC changed since the previous NDMR? ❑Yes EINo
Phone Number: 704-528-6350 Permit Expiration: 9/30/2014
Signature Date
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
1 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.
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center

NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Page _ _ of
0881
�gation occur
lat!this facility 7
[]NO
Facility Name:
.Lake Norman State Park
County: Iredell
Month: October
Year: 2016
Field Name:.
-A-"
Field Name:
B
Tield Name:
Field Name:
Area,(acres):
1.715 .
Area (acres):
1.715
Area'(acres):
Area (acres):
Cover crop:
Woodland
Cover Crop:
WoodlandCover
Crop:
-
Cover Crop:
Hourly Rate (in):
0.4 -
Hourly Rate (in):
0.4
Hourly.Rate (In):
Hourly Rate (in):
Annual Rate (in):
30.16-
Annual Rate (in):
30.16
Annual Rate (in):
Annual Rate (In):
Weather
Freeboard
Field Irrigated?
_l]YES [:]NO
Field Irrigated?
❑� YES [:]NO
Field Irri ated?
g
❑YES ❑No.
Field Irrigated?
❑YES ❑No
T
m
c
c.
.
E
CO)
m m
t
9
0
a
E�
--O
c
RO
-
_E
E��
x O
J
o
�
E
E
O
=J
—
i
Em
C4
o
oE
—.cc
_�o
O N
OE
m o
y
A
~•
rn
O
E
�C`
OF
in
ft
ft
gal -
min
in
In
gal
min
in
in
gal
min
In
In
gal
min
in
in
1
_
2
3
_
4
5
CL
74
0
3
1
10,000
75
0.21
0.17
6
7
8
9
10
11
12
13
C
76
0
3
9,300
60
0.20
0.20
14
15
16
17
18
19
20
21
22
C
70
0
3
1 10,600
75
-0.23,
0.18
23
24
25
26
27
28
C
74
0
3
8,500
60
0.18
0.18
29
30
31
Monthly
Loading:
20,600
0.44
4.88
17,800
0.38
5.47
0
0.00
0
0.00
12 Month Floating Total (in):

NON -DISCHARGE APPLICATION REPORT (NDAR-1)
eed the limits in Attachment B of your permit?
;en to prevent effluent ponding in or runoff from the sites?
Page — r of 1
(]Compliant ❑Non -Compliant
(]Compliant ❑Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit? (]Compliant []Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site? ElCompliant ❑Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? ECompliant ❑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.
Operator in Responsible Charge (ORC) Certification
ORC: Matthew B. Cartner
Certification No.: 995910
Grade: S1 Phone Number: 704-880-4373
Has the ORC changed since the previous NDAR-1? Dyes ❑No
91
Permittee Certification
Permittee:
Div. Of Parks & Rec (Lake Norman SP)
Signing official: William C. Rhinehardt, Jr. t7 Gt­k� 126r-f
Signing Official's Title: Park Superintendent -pMev- R Av-t�j cit_-X
Phone Number: 704-528-6350 Permit Exp.: 9130/15
Signature Date ` Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge. 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.
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center

NON -DISCHARGE MONITORING REPORT (NDMR) Page of
00020881
Facility Name: Div. Of Parks & Rec (Lake Norman SP)
County: Iredell
Month: September
Year: 2016
PI:
Flow Measuring Point: O Influent ❑ Effluent ❑ No flow generated
Parameter Monitoring Point: ❑ Influent 0 Effluent ❑ Groundwater Lowering ❑ Surface Water
Parameter Code —►
- 50050-,,
50060
_�
00400
C0310
31¢16�
00610
�� '
00630 =�
81639
b b
OU600 ��
00530
00665'-
>_
a
0
d
V
_
w
�a d
O N •O_Q.
-
I
E~e..
d pss,
+ d
-t, R -
t d
..�. 'O O
a�..,�, ,�
v N'
ate.. d
CL
`C
O. ,:,r•
i"EDINCDE
..;
4RfL3'
':.
_
24-hr
hrs
GPD '. ,�
mg/L
sum
mg/L
#/100 m�.
mglL
-
� .mgtL -e.
Ibslac
, mg(L �
mglL
� .mg/L�.
�
tnrn c
1
1,006
A,+,
wl
I r R�(`1
NIA-1r��
3
1,006
4
-1,006 `
5
1,006 -
6
15:00
1
`1,006r
0.5
7
7
09:55
1
�1,006
8
s�1,006
-
9
.1-,006
10
`1,006
11
,�'ti1;006 '=
12
�,006
13
14
16:30
1.25
=1.,006:�.7.1'
t
z1 '-'
1.01�n�0.558
-
2.58
3.:14 `
4.47
7J "
15
1,006
16
17
>1,006~
18
19
.1,006
20=1,006.
Y -
-
21
16:30
1
--1,066 , ;
7.2
22-_1,006'-
:.;,
;._
23
1,006 '
e -n E
^T ill. % `
n
24
`
25
='1,006: `'
.< <
rasp a `eT
n 3
261"006p4
,
k
.
�K
'SW�"r
1
28
�1,006'
29
16:30
1
,006
30
.A QQ6u
-
31
a
Average:
, 1,006yP,
0.50
`;�
1.00''
1.01
` .0.6&
2.58
3:14� "
4.47
7.00
Daily Maximum:
;1,006.' "
0.50
'7.20�1:00="
`
1.01
' 0 56`
2.58
3i14'
4.47
: `° 7.90 `
Daily Minimum:
_`1,006"
0.50
'T:Ob
TOo--.'
1.01
656
2.58
-3.14°
4.47
Sampling Type:
;. Recorder' =
Grab
=:Grab
Monthly Limit:
a
Daily Limit:
4,
_
Sample Frequency
a, (Monthly',:
Monthly
_ INeekly.�
". -„

NON -DISCHARGE MONITORING REPORT (NDMR) Page _2�,_ of 9-1
Sampling Person(s) 11 Certified Laboratories
Matthew Bryan Cartner II Name: Statesville Analytical, Inc.
Name: 11 Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? ❑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 necessarv.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Matthew Bryan Cartner
Permittee: Div. Of Parks & rec (Lake Norman SP)
Certification No.: 995910
Signing Official: William C. Rhinehardt, Jr.—3.v2-,,-O e,44_�
Grade: S1 Phone Number: 704-880-4373
Signing Officials Title: Park Superintendent _Pi{- 2,V_ i?Ac*16t632
Has the ORC changed since the previous NDMR? ❑Yes RINo
Phone Number: 704-528-6350 Permit Expiration: 9/30/2014
LA�chv.�, n7k—l"
Signature Date
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
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
If
knowing vlolations.
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center

NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Page 1— of
WQ0020881
Ppidlprrigalion
Facility Name: .Lake Norman State Park
County. Iredell
Month: September Year: 2016
occur
at this facility?
AYES ❑No
Field Name:
A
Field Name:
B
. "' Field Name
Field Name:
.
Area'
1.;715fH,
Area (acres):
1.715
Area (acres).
Area (acres):
Cover Crop:
Woodldrid.-Cover
Crop:
Woodland
= - . _Cover Crop:
Cover Crop:
Hourly Rate (In):.
_ :,-'0 :4 :•
urly Rate (in):
0.4
:Hourly Rate;(in).
_. -
Hourly Rate (in):
Annual.Rate'(in);
30.16. -
Annual Rate (in):
30.16
"Annual, Rate (in)s;
" ' -
Annual Rate (in):
Weather
Freeboard
Field,lrrigated?
DYES - ❑NO' -,
Field Irrigated?
DYES -]NO
.='Field -Irrigated?
= ❑YES.:- ❑NOS, -:
Field Irrigated?
DYES ❑NO
V
3
a
IL
°
L°
?
c
wo
p
G o
,
--
E
A
�G'
•
J
c'
o
= a
., `
.
>
�
m
`
E
x
Oa„:
- ;
ER
" i=
.I
0
o
E
p mi
io',a
E—C
o
E
pE
c
0av
G
xa`vc_+
Eg
p _0G
J>
OF
in
ft
ft
gal
min
in
in .
gal
min
in
in
:gal
min ",
'In.. •
in
gal
min
in
in
2
_
3
4
5
6
C
90
0
2.5
1
9,300
60
0.20
0.20
7
C
84
0
2.5
1. 3,700�
J 60 '"
= 0:08 :.
0:08
=
g
9
10
:-
12
13
14
C
82
0 1
2.75
9,200
75
0.20
0.16
15
-
16
17
18
-
19
20
21
CL
80
0
3
7,300• .-
60
0116
0:16
22
23
-
24
25
7,_.
.
26
27
28
_
29
C
77
0
3
8,500
60
0.18
0.18
30
31
_
Monthly Loading:
1-1,000
Os24_'
4.65
27,000
0.58
0_ 0.00
0 0.00
12 Month Floating Total (in):

NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of
ionP rates exceed the limits in Attachment B of your permit? Compliant ❑Non -Compliant
Ppereadeqpuate measures taken to prevent effluent ponding in or runoff from the sites? RICompliant ❑Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit? pcompliant ❑Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site? i]Compliant ❑Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? (]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 necessarv.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Matthew B. Cartner
Permittee:
Div. Of Parks & Rec (Lake Norman SP)
Certification No.: 995910
Signing Official: William C. Rhinehardt, Jr. .ut)�,�
Grade: S1 Phone Number: 704-880-4373
Signing Officials Title: Park Superintendent '"P,A,4_tL iZEr7&
Has the ORC changed since the previous NDAR-1? ❑yes ❑� No
Phone Number: 704-528-6350 Permit Exp.: 9/30/15
&btZ - D-IA
Qa. fZA
I
Signature Date
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervislon )n 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 Quality
Information Processing Unit
1617 Mail Service Center

NON -DISCHARGE MONITORING REPORT (NDMR)
Page ! of
020881
Facility Name: Div. Of Parks & Rec (Lake Norman SP)
county: Iredell
Month: August
Year: 2016
rammeter
Flow/ Measuring Point: [DInfluent ❑Effluent ❑No flow generated
Parameter Monitoring Point: ❑Influent ❑.r Effluent ❑Groundwater Lowering ❑surface Water
50050
50060
00400 _
C0310
31616
00610
00630
81639
00600
00530
00665
O
°
�~
0
O
y
L
O
m
€J2+
i
°E
E
°
.91 •
Z
c
t'Ma-
Y
1c
c
°
y
°
y NaO
i
y
_
1
24-hr
hrs
GPD
1,142
mg/L
su
mg/L
#1100 mL
mg/L
mg/L ".
Ibs/ac
mg/L
mg/L
mg/L
2
3
16:20
1,142
1,142
.7.1
F
ECEIVED/
JCDENRI
WR
41
51
1,142
1,142
U -
'"
_ 3 L UIt
61
1,142
W
QROS
7
8
1,142
_ 1,142
a
ra_
�.d�
UU
f;EG!ONAL
OFFICE
9
10
11
121
131
16:30
1,142
1,142
1,142
1,142
1,442
7.2
-
!F
141
1,142-
151
16:30
1
1,142
-
16F
1,142
17
10:00
1,142
0.4
7.2
Y
.
18
1,142
19
1,142
20
1,142
21
1,142
221
1,142
231
1,142
241
1,142
251
16:30
1,142
7.1
26
-1,142
27
1,142
28
10:00
1,142
7
29
1,142
301
16:30
1,142
7.1
31
1,142
Average:
1,142
0.40
Daily Maximum:
1,142
0.40
7.20
Daily Minimum:
1,142
0.40
7.00
Sampling Type:
Recorder
Grab
Grab
Monthly Limit:
Daily Limit:
Sample Frequency: 1
Monthly
Monthly
Weekly

NON -DISCHARGE MONITORING REPORT (NDMR)
Page t) of 9-1
Matthew Bryan Cartner
Name:
Sampling Person(s)
Certified Laboratories
Name: Statesville Analytical, Inc.
Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit?
❑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_ Aftarh aririifinnnl ahaMe if nnr &—m,
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Matthew Bryan Cartner
Permittee: Div. Of Parks & rec (Lake Norman SP)
Certification No.: 995910
Signing Official: William C. Rhinehardt, Jr.
Grade: S1 Phone Number: 704-880-4373
Signing Official's Title: Park Superintendent
Has the ORC changed since the previous NDMR? ❑yes I]No
Phone Num e : 704-5 -6 50 Permit Expiration: 9/30/2014
_... 9 _6-16
Signature Date
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
Ice n 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.
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center

NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page I of �1
Facility Name: .Lake Norman State Park County: Iredell Month: August Year: 2016
r
Pd
irrigation occur
Field Name:
A
Field Name:
B
Field Name:
Field Name:
at this facility?
Area (acres):
1.715
Area (acres):
1.715
Area (acres):
Area (acres):
Cover Crop:
Woodland
Cover Crop:
Woodland
Cover Crop:
Cover Crop:
AYES ❑No
Hourly Rate (in):
0.4
Hourly Rate (in):
0.4
Hourly Rate (in):
Hourly Rate (in):
Annual Rate (in):
30.16
Annual Rate (in):
30.16
Annual Rate (in):
Annual Rate (in):
Weather
Freeboard
Field Irrigated?
DYES ❑No
Field Irrigated?
❑� YES ❑No
Field Irrigated?
g
DYES ❑No
Field Irrigated?
DYES ❑No
o
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in
ft I
ft
gal
min
in
in
gal
min
in
in
gal
min
in
in
gal
min
in
in
1
2
3
CL
92
0
1 2.75
8,000
60
0.17
0.17
4
5
6
7
8
9
10
11
12
131
C
95
0
2.75
8,500
60
0.18
0.18
14
15
C
95
0
2.75
9,000
70
0.19
0.17
16
17
C
88
0
2.5
13,000
90
0.28
0.19
18
19
20
21
22
23
24
25
26
C
90
0
2.75
9,000
70
0.19
0.17
27
28
C
88
0
2.5
10,500
75
0.23
0.18
29
30
C
90
0
2.5
7,800
60
0.17
0.17
31
0.00
Monthly Loading:
12 Month Floating Total (in):
33,800
0.73
4.64
32,000
0.69
5.49
0
0.001,
0

Page al of
NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Pcation
rates exceed the limits in Attachment B of your permit? (]Compliant ❑Non -Compliant
Preequate measures taken to prevent effluent ponding in or runoff from the sites? ❑� Compliant ❑Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit? []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? Elcompliant ❑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 necessarv.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Matthew B. Cartner
Permittee:
Div. Of Parks & Rec (Lake Norman SP)
Certification No.: 995910
Signing Official: William C. Rhinehardt, Jr.
Grade: S1 Phone Number: 704-880-4373
Signing Officials Title: Park Superintendent
Has the ORC changed since the previous NDAR-17 2
❑Yes ❑No
Phone Nu b r: 704-528-6 5 Permit Ex 9/30/15
p„
9—MA
'0l�
Signature Date
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
r
I cert r e f 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.
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center

O,RC ON SITE
.
PLANT
MONTH �'
I
YEAR ,�;704
DAY
Arrival,Time
Departure
Operator -Time
Effluent
Signature
Time
on Site
Sampled
2
3
,
4
5
6
7
8
9
10
11,
-
12
13
14
15
J
16
17
18
19
20
21
22
23
24
25
26
27
28
2.9
30
16 30
, 73 Q
31

PH Calibration Log
yield Analysis
Month
l year

i u I OG"
Chlorine Meter Calibration Log HANNA Colorimeter Field Analysis
Month:- -,4,,C 1 1'�i Year:
-Z/ Ki��
Day
Check Std
ug/L
Time
Analyzed
Analyst Intial
Comments
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
ewed by: Date:

NON -DISCHARGE MONITORING REPORT (NDMR)
r et_ 6_�/v���
Page _L__ of
•�� �::
Of -
.-
.
Flow Measuring Point: DInfluent EjEffluent ■ _
■ o ■ ■

NON -DISCHARGE MONITORING REPORT (NDMR)
Page 21 of
Sampling Person(s)
Name: Matthew Bryan Cartner
Name:
Certified Laboratories
Name: Statesville Analytical, Inc.
Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit?
❑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 nerascary
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Matthew Bryan Cartner
Permittee: Div. Of Parks & rec (Lake Norman SP)
Certification No.: 995910
Signing Official: William C. Rhinehardt, Jr. 7A4U 1> e t-FA.e.,Zcttf
Grade: S1 Phone Number: 704-880-4373
Signing Officials Title: Park Superintendent
Has the ORC changed since the previous NDMR? ❑Yes ❑� No
Phone Number: 704-528-6350 Permit Expiration: 9/30/2014
111-2
22
Signature Date
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
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.
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center

-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of
o• W00020881 Facility Name: Lake Norman State Park County: Iredell Month: July Year: 2016
FDid
irDid irrigation occur
at this facility?
2YES [-]NO
Field Name:
A
Field Name:
B
Field Name:
Field Name:
Area (acres):
T.715
Area (acres):
1.715
"Area (acres):
Area (acres):
Cover Crop:
Woodland
Cover Crop:
Woodland
-Cover Crop:
Cover Crop:
_ Hourly Rate.(in):
0.4
Hourly Rate (in):
0.4
Hourly Rate (in):
•
Hourly Rate (in):
Annual Rate (in):
30.16
Annual Rate (in):
30.16
Annual Rate (In):.
Annual Rate (in):
Weather
Freeboard
Field Irrigated?
[21YEs • ❑No
Field Irrigated?
g
❑� YES ❑NO
Field Irrigated?
❑YES ❑NO
Field Irrigated?
❑YES -]NO
C
d
tm
o
C
O
u
IL
tv d
n
L6
_
—
o
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in
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-
min
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gal
min
in
in
gal
min -
In
in
gal
min
in
in
3
4
5
6
71
C
1 90
0
2.75
1,100
90 "
0.02
' 0.02
8
9
10
11
12
13
14
151
10,000
75
0.21
0.17
161
C
92
0
1 2.75
17
18
19
201
C
1 95
0
1 2.75
1
8,000
60�
0.17'
0.17
21
22
23
24
25
26
271
C
94
0
2.75
9,000
75
0.19
0.15
28
29
30
31
0.41
4.98
L
0.00
Monthly Loading:
12 Month Floating Total (in):
9,100
0.20
4.43
ML19,000
0.00
0

NON -DISCHARGE APPLICATION REPORT (NDAR-1)
,xceed the limits in Attachment B of your permit?
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?
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
Page p) of 9 �
12]Compliant ❑Non -Compliant
Compliant ❑Non -Compliant
(]Compliant ❑Non -Compliant
(]Compliant ❑Non -Compliant
ElCompliant ❑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 nriditinnal ehaafc if naraccnn.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Matthew B. Cartner
Permittee:
Div. Of Parks & Rec (Lake Norman SP)
Certification No.: 995910
Signing Official: William C. Rhinehardt, Jr. t2t p Lf{u✓L .
Grade: S1 Phone Number: 704-880-4373
Signing Official's Title: Park Superintendent
Has the ORC changed since the previous NDAR-1? ❑yes ONO
Phone Number: 704-528-6350 Permit Exp.: 9/30/15
cA� 27—f�—(
Signature Date
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
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.
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center

NON -DISCHARGE MONITORING REPORT (NDMR)
Page ( of 9,
NParameterCode
881 Facility Name: Div. Of Parks & Rec (Lake Norman SP) County: Iredell Month: June) Year: r 2016
Flow Measuring Point: ❑� Influent ❑Effluent ' []No Flow generated Parameter Monitoring Point: ❑Influent ❑� Effluent ❑Groundwater Lowering ❑Surface Water
50050
50060
00400.
C0310
31616
00610
00630
81639
00600'
00530
00665
y
`
() H
m
0t
0 �
Ea;
~ co
o
3
LL
C
'.9v�
F- W L
It U
x
ci
V
o
m
p
C
�o
LL O
U.
C
c
E
a
+ ,a;
`LO
z Z
r
� d
Yc
r+
z
�.
m
oc��
�_. 9
z
•�O fA
f" N U)
o
rn
G
gt
1"' N
e
a
24-hr
hrs
GPD
mg/L
su
mg/L
#/100 mL
mg/L
mg/L
Ibs/ac
mg/L
mg/L
mg/L
1
2,193
2
2,193
3
16:30
1
2,193
7.2
4
2,193
5
2,193
6
2,193
7
2,193
8
2,193
9
09:30
0.5 BU
2,193
0.4
7.2
12
<1
1.68
0.61,
4.14
4.75
<3.03
4.8
10
16:30
1.5
2,193
11
2,193
12
2,193
13
2,193
14
16:30
1
2,193
7.1
15
2,193
16
2,193
171
2,193�`
18
2,193
19
2,193
20
21
17:30
1.25
2,193
2,193
7.1
411.�'
lji
ap•�
22
2,19312,J
23
2,193
24
2,193
LAC` v
25
2,193
-"�Ji
26
2,193
27
17:30
1
2,193
7.2
li J
C 10
28
2,193
291
2,193
30
2,193
t t
FF
LE
1311
Average:
2,193
0.40
12.00
1.00
1.68
0.00
4.14
4.75
0.00
4.80
Daily Maximum:
2,193
0.40
7.20
12.00
1.00
1.68
0.00
4.14
4.75
3.03
4.80
Daily Minimum:
2,193
0.40
7.10
12.00
1.00
1.68
0.00
4.14
4.75
3.03
4.80
Sampling Type:
Recorder
Grab
Grab
-
Monthly Limit:
Daily Limit:
Sample Frequency:
-Monthly
Monthly
Weekly

NON -DISCHARGE MONITORING REPORT (NDMR) Page 15� of .1�
Sampling Person(s) 11 Certified Laboratories
Matthew Bryan Cartner 11 Name: Statesville Analytical, Inc.
Name: II Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? ❑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.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Matthew Bryan Cartner
Permittee: Div. Of Parks & rec (Lake Norman SP)
Certification No.: 995910
Signing Official: William C. Rhinehardt, Jr.
Grade: S1 Phone Number: 704-880-4373
Signing Official's Title: Park Superintendent
Has the ORC changed since the previous NDMR? ❑Yes ONo
Phone Num e : 704- 8-63 Permit Expiration: 9/30/2014
- (
o-7/
Signature Date
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
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 Quality
Information Processing Unit
1617 Mail Service Center

NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Page j, of R
0020881
Wirrigation
Facility Name: Lake Norman State Park
County: Iredell
Month: June Year: 2016
Mid OCCUR
at this flCllltj/?
❑� YES ❑NO
-Field Name:
- A' - -
Field Name:
B
Field Name.,
: '
Field Name:
Area (acres):
1.715
Area (acres):
1.715
= Area (acres):,
-
Area (acres):
Cover Cro P
Woodland
Cover Crop:
P'
Woodland
Cover Crop:cover
Crop:
p'
Hourly Rate (in):
0.4
Hourly Rate (in):
0.4
Hourly Rate (in):
Hourly Rate (in):
Annual Rate (in):
30.16
Annual Rate (in):
30.16
Annual Rate (in):
Annual Rate (in):
Weather
Freeboard
FielOrrigated?
DYES ❑NO
Field Irrigated?
❑� YES ❑NO
w•Field Irrigated?
• ❑YEs ONO
Field Irrigated? DYES ❑NO
�.
-C
•r
CD
a
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in
ft
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g al ''
min
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gal
min
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in
gal ',
min
- in,
•In:,
gal
min in
in
2
3
C
85
0
2.75
8,000
60
0.17
0.17
4
5
6
7
g
9
C
86
0
3
10
C
88
0
3
11,000
.90
0.24
-0.16
12
13
14
C
89
0
3
8,000
60
0.17
0.17
15
16
17
18
19
20
C
88
0
3
10,000:
° '75-
0,21:
0.17.,
21
22
77
23
24
25
26
27
C
80
0
3
28
7,500
60
0.16
0.16
29
30
31
=
0
Monthly Loading:
12 Month Floating Total (in):
r'21,000
0,45
4.54,
23,500
0.50
4.93
0.00
0
0.00

NON -DISCHARGE APPLICATION REPORT (NDAR-1)
limits in Attachment B of your permit?
revent effluent ponding in or runoff from the sites?
Page a of �
(]Compliant ❑Non -Compliant
Compliant ❑Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit? ❑� 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 ' ❑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.
Operator in Responsible Charge (ORC) Certification
I ORC: Matthew B. Cartner
Certification No.: 995910
Grade: S1 Phone Number: 704-880-4373
Has the ORC changed since the previous NDAR-1? ❑Yes RINo
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
Permittee Certification
Permittee: Div. Of Parks & Rec (Lake Norman SP)
Signing Official: William C. Rhinehardt, Jr.
Signing Official's Title: Park Superintendent
Phone Numb . 704-528 50 Permit Exp.: 9/30/15
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 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 Quality
Information Processing Unit
1617 Mail Service Center

17,
NON -DISCHARGE MONITORING REPORT (NDMR) (76,y j., i,-,a t r ,,17 g � , of
0881 Facility Name: Div. Of Parks & Rec (Lake Norman SP) County: Iredel� --= M th = May? Year: -2016s
Flow Measuring Point: EZInfluent ❑Effluent ❑No Flow generated
Parameter Monitoring Point: ❑Influent ❑� Effluent ❑Groundwater Lowering ❑Surface Water
Parameter Code -►
50050
50060
00400
C0310
31616
00610
00630
81639
00600
00530
00665
a.
Q E_
O
c
y
o:
O
o
y
`+4 o c
L
fYU
x
O.
Q
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m
u o
lL 0
U
ro
0
E
Q
ra
= Z
z
m
m rn
Y 1
iiZ
0
m
� w
Z
c y
~ CL
0
H
r
N
0
a
24-hr
1 hrs
GPD
mg/L
su
mg/L
#1100 mL
mg/L
mg/L
Ibs/ac
mg/L
mg/L
mg/L
11
2,287
2
-2,287
3
1
2,287
41
2,287
RECEIV
ED/NCDEP
f'/DV R
51
2,287
61
16:30
2,287
0.4
7.2
; l
I L !1 ,
7
2,287%
S Ir' GS
r/ l�'� a
BI
2,287
9
2,287
AIN i i
2015
Ib1(?Of�!:"-'t"
� i?=•i:l;1f'A,l_
�.=Flt_'::
101
2,287
ill
2,287
DIA] R' r,
U�li„)El
'r!C!N
121
16:30
2,287
7.2
I,Ira,�.IAiIQIN
P{?f-
f;L�t,SINs9 L
iVl l
131
2,287
141
2,287
15
16
2,287
2,287
17
2,287
s
18
19
16:30
2,287
2,287
7.2
1
n
AV. v
�.
201
211
2,287
2,287
�-Q
�v
o
221
2,287
231
2,287
241
2,287
14p
XL1
25
16:30
2,287
26
15:00
2,287
7.1
r r >
27
2,287
Z . 7f
28
2,287
��7
`�7
29
2,287
N30
2,287
31
2,287
Average:
2,287
0.40
Daily Maximum:
2,287
0.40
7.20
Daily Minimum:
2,287
0.40
7.10
Sampling Type:
Recorder
Grab
Grab
Monthly Limit:
Daily Limit:
L Sample Frequency:
Monthly
Monthly
Weekly.

Page of
NON -DISCHARGE APPLICATION REPORT (NDAR-1) Year: 2016
County: Iredell Month: May
Facility Name: Lake Norman State Park Field Name: Field Name:
0020881 Field Name: B
- .Field Name: A Area (acres):
1.715 Area (acres):
Id irrigation occur 1.715 Area (acres): Cover Crop:
g Area (acres): Woodland Cover Crop:
at this facility? Cover Crop: Woodland Cover Crop: Hourly Rate (in):
0.4 Hourly Rate (in):
Hourly Rate (in): Annual Rate (in):
0.4 Annual Rate (in): ONO
Hourly Rate (in): 30.16 Field Irrigated? DYES '
DYES ONo 30.16' Annual Rate (in):
Annual Rate (in): - Field Irrigated � DYES ONO
Weather Freeboard Field Irrigated? OYES ONO
Field Irrigated? EYES ONO
E TOf Gig N T� E 7•�
E o� dfl m �,c; nx5 Em �� �o x°m
s,� �?c E°' dw 'o E° �. °a rn c mxJ
m ° m a� > >. c m m «• E° `o c a� '� ca o o a 1= c
o d as m a d. a� �._. ia_ E �a �v m G o
A ° w ? so E d o E .o °' a i= °i p m o° o a i- c�x J >¢ =
a g
iv o 2- S m a °° f- .°' J umj>¢ J min in m
r E d N o m :>¢ min In in gal
m � a in in gal _
°F in ft tt gal min
in in gal min _
1 ,
2
3
4
5
6 CL 62 0 3 7,000 60. 0.15 0.15
7
8
9
10
11 1,300 90 0.03 0.02
i
C 80 1 0
R 1 70 1 2.5 1 3
C 79 1 0 __t3
C I 80 1 0 3
12 Month Floating Total
���
0.34
4.81
0.00

� I b-"-)-/ Co A—
NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of
20881
irrigation occur
at this facility?
DYES ❑No
Facility Name:
.Lake Norman State
Park
County: Iredell
Month: April Year: 2016'=
Field Name:
A
Field Name:
B
Field Name:
Field Name:
Area (acres):
1.715
Area (acres):
1.715P
Area (acres):
Area (acres):
Cover Crop:
Woodland
Cover Crop:
Woodland
Cover Crop:
Cover Crop:
Hourly Rate (in):
0.4
Hourly Rate (in):
0.4
Hourly Rate (in):
Hourly Rate (in):
Annual Rate (in):
• 30.16
Annual Rate (in):
30.16
Annual Rate (in):
Annual Rate (in):
Weather
Freeboard
Field Irrigated?
❑✓ YES -❑NO
Field Irrigated?
g
E]YES ❑No
Field Irrigated?
DYES [:]NO
Field Irrigated?
DYES ❑No
w
m
a
e
.0
a
a
°c0
0
CO0
.• ^
ra.
LA
iQ
.
t
o
c
E
occ
Em
oF
°
M
yE
M °
a
E
xom
=
E 2-
:3
o
!
E M
13
Eoc�,
cU
om
0
S
2
E ._
0CL
oM
M
E _ crn
E 5d
cvoa
2 J
OF
in
ft
ft
gal
min
in
in
gal
min
in
in
gal
min
in
-in
gal
min
in
in
1
2
3
,o�rr,
-ivr-n1N(2ENPIDkJP
4
6
it !ni
CI zu lh
7
C
64
0
3
7,000
60
0.15
0.15
\NC]
SOS
9
nnnr)_0r:
;ll I R=GIC
':�-
DrFICE
10
11
12
13
14
C
65
0
3
9,000
75
0.19
0.15
15
16
17
18
19
20
21
C
68
0
3.25
8,200
60
0.18
0.18
22
23
24
25
C
75
0
3.25
10,000
75
0.21
0.17
�C
80
0
3.25
9,000
75
0.19
0.15
boom
0.54
4•64
18,200
0.00
0.39
5.39
0
0.00
0

NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page, of %
ppp—
P
tion rates exceePPd the limits in Attachment B of your permit? 21Compliant ❑Non -Compliant
Pereadequate measures taken to prevent effluent ponding in or runoff from the sites? Compliant ❑Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit? Fy1compliant ❑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 ❑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 necessarv.
Operator in Responsible Charge (ORC) Certification
I ORC: Matthew B. Cartner
I Certification No.: 995910
Grade: S1 Phone Number: 704-880-4373
Has the ORC changed since the previous NDAR-1? ❑yes RINo
r
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
Permittee Certification
Permittee:
Div. Of Parks & Rec (Lake Norman SP)
Signing Official: r. *�3A�z✓Ltt7 C. =
Signing Official's Title: Park Seri^+ -mot
Phone Number: 704-528-6350 Permit Exp.: 9/30/15
Signature
Date
I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision I.n accordance
with a system designed to assure that all qualified personnel properly gathered and evaluated the information submitted. Based an 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 Quality
Information Processing Unit
1617 Mail Service Center
IBM

NON -DISCHARGE MONITORING REPORT (NDMR) Page I of
Facility Name: Div. Of Parks & Rec (Lake Norman Sp) County: -.- AprilFlow Measuring Point: ElInfluent ElEffluent L]No flow generated Parameter Monitoring Point: EjInfluent 2JEftluent ElGroundwater Lowering Elsurface water

NON -DISCHARGE MONITORING REPORT (NDMR)
Page A of O
Matthew Bryan Cartner
Name:
Sampling Person(s)
Certified Laboratories
Name: Statesville Analytical, Inc.
Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit?
❑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.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Matthew Bryan Cartner
Permittee: Div. Of Parks & rec (Lake Norman SP)
Certification No.: 995910
Signing Official: VVilliam C. Rhinehardt, Jr.-��
Grade: S1 Phone Number: 704-880-4373
Signing Official's Title: Park 3uperintendertt—� C?�'��Z
Has the ORC changed since the previous NDMR? ❑Yes ONo
Phone Number: 704-528-6350 Permit Expiration: 9/30/2014
T.
/NA�t�_ -
b)i Im, t
Signature Date
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
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.
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center

ORC ON SITE
PLANT MONTH YEAR -O
DAY
Arrival Time
Departure
Time
Operator Time
on Site
Effluent
Sampled
Signature
1
2
3
4
5
6
7
G
t
►�� Cyr.
8
9
10-
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
/Sob
(
I
26
27
28
29
30
31

NON -DISCHARGE MONITORING REPORT (NDMR)�f��, ��. btu Page of
U881 Facility Name: Div. Of Parks & Rec (Lake Norman SP) County: Iredell Month: March Year: 2016
Flow Measuring Point: DInFluent ❑Effluent ❑No Flow generated Parameter Monitoring Point: ❑Influent ❑✓ Effluent ❑Groundwater Lowering ❑Surface Water
Parameter Code 01
50050
50060
00400
C0310
31616
00610
00630
81639
00600
00530
00666
m
d
o
c
0
0
o
IxL)
=
u
t°cj
g
m
�..
01
a
a
22
r
m o�
z
Imo-
._0
�:
c
��
N
s
s
n.
€RECEIVES/uCDENFfDUUE�
h A`'
-2 2016
24-hr
hrs
GPD
mg/L
su
mg/L
#/100 mL
mg/L
mg/L
Ibslac
mg/L'
mg/L
-mg/L
1'JOROS
1
523
M0
7R'SVILL
N! - REGION,
aL OFFICE
2
523
3
16:30
1
523
7.1
4
523
5
523
6
523
7
523
8
16:30
1.25
523
9
09:20
0.42
523
0.5
7.1
<2
<1
<0.5
2.4
1.9
4.3
<3.13
7.1-
10
523
11
523
12
523
13
523
14
523
15
523
16
523
17
16:30
1.25
523 -
7.1
18
523
19
523
20
523
21
523
®
'
22
523
�4'�Jf
,.r
23
16:30
1
523
7
TfLiy't,n.
'rlrij
24
523
25
523
" `L7 0
26
523
27
523
28
523
29
523
30
16:30
1.33
523
7.1
31
523
Average:
523
0.50
0.00
1.00
0.00
2.40
1.90
4.30
0.00
7.10
Daily Maximum:
523
0.50
7.10
2.00
1.00
0.50
-2.40
1.90
4.30
3.13
7.10'
Daily Minimum:
523
0.50
7.00
2.00
1.00
0.50
2.40
1.90
4.30
3.13
7.10
Sampling Type:
Recorder
Grab
Grab
Monthly Limit:
Daily Limit:
Sample Frequency:1
Monthly
Monthly
Weekly

NON -DISCHARGE MONITORING REPORT (NDMR)
Page .2 of 9
Matthew Bryan Cartner
Name:
Sampling Person(s)
Certified Laboratories
Name: Statesville Analytical, Inc.
Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit?
(]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.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Matthew Bryan Cartner
Permittee: Div. Of Parks & rec (Lake Norman SP)
Certification No.: 995910
Signing Official: William C. Rhinehardt, Jr.
Grade: S1 Phone Number: 704-880-4373
Signing Official's Title: Park Superintendent
Has the ORC changed since the previous NDMR? ❑Yes ONo
Phone Numb r 704-528 50 Permit Expiration: 9/30/2014
-� 6
5 �
aye Z5
Signature Date
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
I cart! 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 Quality
Information Processing Unit
1617 Mail Service Center

PPMMM,W-
NON-DISCHARGE APPLICATION REPORT (NDAR-1)
Page ) of
WQ0020881
Facility Name: .Lake Norman State Park
county: Iredell
Month: March
Year: 2016
Did irrigation occur
at this facility?
AYES ❑NO
Field Name:
A
Field Name:
B
Field Name:
Field Name:
Area (acres):
1.715
Area (acres):
1.715
Area (acres):
Area (acres):
Cover Crop:Woodland
Cover Crop:
p:
Woodland
p•
Cover Crop:
Cover Crop:
p:
Hourly Rate (in):
0.4
Hourly Rate (in):
0.4
Hourly Rate (in):
Hourly Rate (in):
Annual Rate (in):
30.16
Annual Rate (in):
30.16
Annual Rate (in):
Annual Rate (in):
Weather
Freeboard
Field Irrigated?
❑� YES ❑NO
Field Irrigated?
DYES ❑NO
Field Irrigated?
❑YES [:]NO
Field Irrigated?
❑YES ❑NO
a)
E!
1T
°
a
a'c
y m
w
M
A
[A
E °
�
•
E,
~
CM
o
= C
E
2J
E °'
i
V
~t
�
Jm
E
�
E
O
E
r
C
E
OE
J
E d
_0.
o
Oa
Eo' rn
C-oa
.xC•
J
°F
in
ft
ft
gal
min
in
in
gal
min
in
in
gal
min
in
in
gal
min
in
in
1
2
3
C
45
0
2.5
8,500
60
0.18
0.18
4
5
6
7
8
C
65
0
3
9,300
75
0.20
0.16
9
C
64
0
3
10
11
12
13
14
15
16
17
C
75
0
3
15,000
75
0.32
0.26
18
19
20
21
22
23
C
67
0
3
7,300
60
0.16
0.16
24
25
26
27
28
29
30
C
66
0
3
+_
11,500
80
0.25
0.19
31
0
Monthly Loading: 1
12 Month Floating Total (in):
16,600 0.36
4.57
35,000
0.75
5.40
0.00
0
0.00

NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page A of?_
r_7_1.01-1cation rates exceed the limits in Attachment B of your permit? (]Compliant❑Non-Compliant
Were adeqte measures taken to prevent effluent ponding in or runoff from the sites? ❑� Compliant ❑Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit? ❑s Compliant ❑Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site? ❑r Compliant ❑Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? ❑� 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.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Matthew B. Cartner
Permittee:
Div. Of Parks & Rec (Lake Norman SP)
Certification No.: 995910
Signing Official: William C. Rhinehardt, Jr.
Grade: S1 Phone Number: 704-880-4373
Signing Officials Title: Park Superintendent
Has the ORC changed since the previous NDAR-1? ❑Yes RINo
Phone Numb 4-528-6350 Permit Exp.: 9/30/15
i 'J
Signature Date
Signature Date
By this signature, I certify that this report Is accurate and complete to the best of my knowledge.
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 Quality
Information Processing Unit
1617 Mail Service Center

. • - Y • -
NON -DISCHARGE REPORT I of
Ai
Parksge
Facility Namw. Div. Of -
�- 'Flow MeasurIng Point: - _Monitoring Point 0
:J
-�_®-
•
L •!
_
1
_
L
L
/ �
�

NON -DISCHARGE MONITORING REPORT (NDMR) Page -2—, of ;i
Sampling Person(a) 11 Certified Laboratories
Bryan Cartner II Name: Statesville Analytical, Inc.
Name: 11 Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? ❑Campllant ONon-compnant
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
OrMnnfa%4nknn AMnnh wAAlgww.,1 .. f.ww�
Operator in Responsible Charge (ORC) Certification Permlttee Certification
ORC: Matthew Bryan Cartner Permlttee: Div. Of Parks & rec (Lake Norman SP)
Certification No.: 995910 Signing Official: William C. Rhinehardt, Jr.
Grade: 81 Phone Number. 704-880-4373 Signing Official's Title: Park Superintendent
Has the ORC changed since the previous NDMR? Oyes LONG Phone 1�umb�r. 704-528A350 Permit Expiration: 9/30/2014
Signature Date
By ft signature. I certify, that this report Is aocurrato and complete to the bast of my knowledge.
Signature Date
t carifly, under penalty of taw. that this document and all attachmerds were prepared under my dltectlon or supervlalon to
accordance with a system designed to saaure that ag qualHied personnel properly gathered and evaluated the Infomm9on
submitted. Based on my inquiry of tha person or persons who manage the system, or Nose persons dlreatly responsible for
gatheft the Information, the Information submitted is, to the best of my knowledge and heifer, true, arcuate, and complete. I am
aware that there are slgnHhoant penalties for submitting false kdormation, tndudtng the poSaWly of finas and tmprtsonment for
kanwing vlolallone.
Mall Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center

NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of al
881 Facility Name: .Lake Norman State Park County: Iredell Month: February Year: 2016
gation occur .Fleld3Name: Pi' Field Name: B Field.Name: Field Name:
Area;{acres): - , . 1.715 Area (acres): 1.715 : Area;(acres):.. Area (acres):
at this facility? •
Cover•Crop:, ; ' . ;Woodland: Cover Crop: Woodland Cover:Crop - Cover Crop:
[DYES ❑No H6uriy. Rate'(in):: ,• 0:4 ,- „''. Hourly Rate (In): 0.4 Hourly-,Rate,(in): Hourly Rate (in):
AnnualRate_(In): -30,16' Annual Rate (in): 30.16 Annual�Rate;(In):` :' Annual Rate (In):
Weather
Freeboard
Field Irrigated?:
EYES. _QNo'•.
Field Irrigated?
EYES ❑No
Field Irrigated?
- Elws..:= J]No
Field Irrigated?
AYES []NO
ea
m
m
a
o
a
La
m m
m
u
:.
ai':ra.
_ . o•
m
rn
e
eo
' Eo:oc_
14
ER
a
iQ
m:
m
v
E
`e'
E i
.�
�
�
J,
1._
:'
y
wo
-2.
o�
a
i
m�C
�
p
_E;
c
J
=�.JC�
o0
1
in
ft
ft
gal
:`-.min -
;. ' in
-in -.
gal
min
In
in:min-.
in _
:.In
gal
min
In
in
2
3
-
_
-
4
5
C
47
2.5
10,000
75
0.21
0.17
7
C
40
2.5
9,000
.70
0:19
0"17
8
9
10
CL
42
2.5
„-
10,000
75
0.21
0.17
12
13
14
16
17
_
18
C
48
2.5
7,000
45
0.15
0.15
20
21
22
:.
23
24
-
25
26
C
47
2.5
71300
60--
27
28
29
30
31
Monthly Loading:
12 Month Floating Total (in):
' 16300;;
7,0:35•.-•.:
27,000
0.58
5•40
MRF-0.00

NON -DISCHARGE APPLICATION REPORT (NDAR4)
e limits in Attachment B of your permit?
prevent effluent ponding in or runoff from the sites?
Iintained on all sites as specified in your permit?
Were all setbacks listed in your permit maintained for every application to each permitted site?
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
Page of
I]Compliant [3Non{ompl[ant
flCompliant ONon-Compkant
(]Compliant []Non -Compliant
[]Compliant ❑Non -compliant
Mcompliant I]NOwCompliant
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-complianco and describe the corrective
action(s) taken. Attach additional sheets if necessary.
Operator In Responsible Charge (ORC) Certification Permtiltee Certification
oRC: Matthew B. Cartner Parnittee:
Div. Of Parks & Rec (Lake Norman SP)
Certification No.: 995910 Signing Official: William C. Rhinehardt, Jr.
Grade: S1 Phone Number: 704-880-4373 Signing Official's Title: Park Superintendent
Has the ARC changed since the previous NDAR-1? [{Yes QNo Phone Num 704-52H35 Permit Exp.: 9/30/15
Signature Date Signature Date
By this sfgnature, I certify (W this report is accurate and complete to the best or my knowledge. I caft under t Who document and all attachments were prepared under my direction or suporviston In aeoordace
with a system designed to assure that all quarried personnel properly galliened and evaluated the information submitted. Based on my
Inquiry of the person or persons who manage the system, or thosa persons dlredty 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 ere significant
penalties for submitting (also infomtatton, including the posO ft Of tines and Imprisonment for knowing violanotts.
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mall Service Center

e�e0�e�oeoeee�eeeeeeeeoeme0
111�1
Total
Residual
Chlorine
Coliform
i
Total
I
i

NON -DISCHARGE MONITORING REPORT (NDMR)
Page � of
Sampling Person(s)
Bryan Cartner
Certified Laboratories
Name: Statesville Analytical, Inc.
IIName:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit?
❑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.
Operator in Responsible Charge (ORC) Certification Permittee Certification
ORC: Matthew Bryan Cartner Permittee: Div. Of Parks & rec (Lake Norman SP)
Certification No.: 995910 Signing Official: William C. Rhinehardt, Jr.
Grade: S1 Phone Number: 704-880-4373 Signing Official's Title: Park Superintendent
Has the ORC changed since the previous NDMR? ❑Yes (]No Phone N er: 704-52 - 350 Permit Expiration: 9/30/2014
Signature Date Signature Date
By this signature, I certify that this report is accurate and complete to the best of my knowledge. Ice 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.
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center

NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Page I of
cur
Ptrhi1sfac?i1iZtY9
❑.r YES ❑NO
Facility Name: .Lake Norman State Park
County: Iredell
Month: January
Year: 2016
Field Name:
A
Field Name:
B
Field Name:
Field Name:
Area (acres):
= 1.715
Area (acres):
1.715
Area,(acres):
Area (acres):
Cover Crop:
Woodland
Cover Crop:
Woodland
Cover Crop:
Cover Crop:
Hourly Rate (in):
0.4'
Hourly Rate (in):
0.4
Hourly -Rate (hi):
-
Hourly Rate (in):
Annual Rate (in):
30.16
Annual Rate (in):
30.16
Annual;Rate (in):.
Annual Rate (in):
Weather
Freeboard
Field Irrigated?
�YEs -❑NO
Field Irrigated?
9
pYEs ❑No
Field .Irrigated?
. ❑YES ❑NO
Field Irrigated?
❑YES ONO
ea
G
1
V
d
m
a
E
OF
O
"
o.
6
y
in
rn
�o
0
a
� 2
_
�a
G too
ft
d
E ._
Via'
oa
> Q
gal
''
m«
E�
�°x
min
�, c
'�o
Gw
In,.
E ,�
°
Eo.a
om
. 2
- -in
m y
E LD
o-
a
> Q
gal
v
m ::
E�
~ rn
min
o�
a, c
'a
mm
O
in
E rn
o c-
Eov
-o�
A 2 O
in
m o
E m
°a
o a
-gal
a
m
-iv2 .
E�
i= '
min
,
o�
�.e
ate.
G o
in
E v�
a,
o c c
`E�o
S' o
in
d o
d
E-
�a
o a
gal
a
m;;
E�
i= .m
min
ai
a,c
a�
p c
in
E rn
� ac
�•-
Eov
o m
in
2
3
4
5
[2.5
-
6
C
40
0
- -
9,000
60
0.19
0.19
7
8
9
10
•
11
_
121
C
40
0
1 2.5
7,700
6G
0.17
0.17
13
14
16
17
18
-
19
20
21
C
42
0
2.5
9,000
60
0.19
0.19
22
23
24
-
25
26
27
281
CL
45
0
2.5
1
8,000
'60
0.17
0.17
29
30
t31
L
Monthly Loading:
12 Month Floating Total (in):
15,700
0.34
4.37
0.39
5.00
0
0.00
0
0.00

NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page 2L- of ;),
s exceed the limits in Attachment B of your permit? ❑� Compliant ❑Non -Compliant
e measures taken to prevent effluent ponding in or runoff from the sites? 21Compliant ❑Non -Compliant
a suitable vegetative cover maintained on all sites as specified in your permit? ❑r Compliant ❑Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site? ❑� Compllant []Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? ❑� 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.
Operator in Responsible Charge (ORC) Certification
ORC: Matthew B. Cartner
Certification No.: 995910
Grade: S1 Phone Number: 704-880-4373
IHas the ORC changed since the previous NDAR-1? ❑yes ENo
Permittee Certification
Permittee:
Div. Of Parks & Rec (Lake Norman SP)
Signing Official: William C. Rhinehardt, Jr.
Signing Official's Title:
Phone
Superintendent
Permit Exp.: 9/30/15
D
Signature Date Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge. I cert4systemasigned
y of law, that this document and all attachments were prepared under my direction or supervision In accordance
with a 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 Quality
Information Processing Unit
1617 Mail Service Center

erCode - 0
f / a
NON -DISCHARGE MONITORING REPORT (NDMR) �PI �r/ �(� % Page of
Facility Name: Div. Of Parks & Rec (Lake Norman SP) County: Iredell Month: becembei) Year: :Y-201A
Flow Measuring Point: ❑p Influent ❑Effluent ❑No Flow generated
Parameter Monitoring
Point: ❑tnfluent DEffluent ❑Groundwater Lowering ❑Surface Water
50050
50060
60400
C0310
31616 .
00610
�00630:
81639
00600'
00530
"00665:.
'
_
`
07
a E
c
d
E
�N
3
o;
�c
14 0 'c
°"c
=
a_
c
V
a.
°
o
E
+
m
2
�«
�c
m a�
YE
c
�
02
e 'a
oK"
°
l9r,
oa.
RECE
IVFD/NCD
_NPIDWR
24-hr
hrs
GPD -
mg/L
su
mg/L
0/100-mL.
mg/L
mglL°,:
Ibs/ac
,mglL
mglL
mglL.'
1
319
w• :v
2
319
3
319
4
16:30
1
31gr
0.2
7.1
5
319
6
31.9
7
319
8
319
9
3:19
10
16:20
1.17
319
7.1
5.6
<1
<0.5
2:87"
1.79
4.66:
7.2
4.5
11
319
121
319
13
319
14
319'
_ _ . .•
15
319
16
319_
17
16:40
0.33
31.9
7.2
18
319
19
319
20
319"'
�.
21
16:15
1.25
31,9
7.1
22
319
231
319.;
24
319
25
319
_
26
'319
..:.
27
319
28
3.19
291
319
30
-3,19
311
16:30
0.33
319.
7
Average:
319
0.20
5.60
1:00
0.00
2.87
1.79
4.66
7.20
4.50
Daily Maximum:
319
0.20
7.20
5.60
1.00
0.50
2.87 `:
1.79
4.66
7.20
4.50
Daily Minimum:
„ 319. °
0.20
7.00
5.60
1.00
0.50
:2.87
1.79
4.66'
7.20
456
Sampling Type:
Recorder
Grab
Grab",
Monthly Limit:
Daily Limit:
Sample Frequency:
.:Monthly
1 Monthly
Weekly

NON -DISCHARGE MONITORING REPORT (NDMR)
Page � of
Bryan Cartner
Name:
Sampling Person(s)
Certified Laboratories
Name: Statesville Analytical, Inc.
Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? ❑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.
Operator in Responsible Charge (ORC) Certification Permittee Certification
ORC: Matthew Bryan Cartner Permittee: Div. Of Parks & rec (Lake Norman SP)
Certification No.: 995910 Signing Official: William C. Rhinehardt, Jr.
Grade: S1 Phone Number: 704-880-4373 Signing Officials Title: Park Superintendent
Has the ORC changed since the previous NDMR? ❑Yes ❑� No Phone Numb 704-528-6350 Permit Expiration: 9/30/2014
Signature Date �IVignature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge. I certify, under enalty of I ,that this document and all attachments were prepared under my direction or supervision In
accor ance i a s designed to assure that all qualified personnel property gathered and evaluated the information
submitte , ased 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 Quality
Information Processing Unit
1617 Mail Service Center

-DISCHARGE APPLICATION REPORT (NDAR-1)
Page
of
pNON
Facility Name:
.Lake Norman State Park
County: Iredell
Month:
December
Year:
2015
n
occur
Field Name:
A
Field Name:
B
Field Name:
Field Name:
tthis facility
Area (acres):
-Crop:
- "1.715
Area (acres):
1.715
Area acres
(acres):
Area (acres):
cover
:Woodland
Cover Crop:
Woodland
Cover Crop:,
Cover Crop:
OYES
❑No
Hourly Rate (in):
0.4
Hourly Rate (in):
0.4
Hourly Rate (in):
Hourly Rate (in):
Annual Rate (in):
30.16
Annual Rate (in):
30.16
Annual. Rate (in):
Annual Rate (in):
Weather
Freeboard
Field Irrigated?
DYES
❑No
Field Irrigated?
DYES ]NO
Field. Irrigated?
❑YES
❑No
Field Irrigated?
❑YES
❑NO
d
m
0
d m
U
"
rn
c
m o
E- 2
o
rn.
E.
m
and
c�
Ed
E oE
010
o
E op
'+ep
tm
a
E
a
CD
o o
Ea rn
E
or
a
Ec
M
d
m
Q=
J
i
><
F
J
x
0
O
O
KE
O GO
=31-
d
=
a
—
J
MJ
1
OF
in
ft
ft
gal
- min
.in
in -
gal
min
in
in
gal
min
_ in -
in
gal
min
in
in
2
D�llll�l0©■� :111 ���7������IIIIIIIIIi'III��llllllllllllll�.�■
�m�
®■
• � 1 1
®
1 1
®1
Monthly12 Month Floating Total (in):
r
0.00

NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Page 21 of
exceed the limits in Attachment B of your permit?
measures taken to prevent effluent ponding in or runoff from the sites?
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?
[2]Compliant ❑Non -Compliant
❑� Compliant ❑Non -Compliant
(]Compliant ❑Non -Compliant
(]Compliant ❑Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? pCompliant ❑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.
Operator in Responsible Charge (ORC) Certification Permittee Certification
ORC: Matthew B. Cartner Permittee:
Div. Of Parks & Rec (Lake Norman SP)
Certification No.: 995910 Signing Official: William C. Rhinehardt, Jr.
Grade: S1 Phone Number: 704-880-4373 Signing Officials Title: Park Superintendent
Has the ORC changed since the previous NDAR-1? ❑Yes I]No Phone Nu r: 704-528-6350 Permit Exp.: 9/30/15
Signature Date Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge. I ceLify,undeotyofat this document and all attachments were prepared under my direction or supervision in accordance
with e 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 Quality
Information Processing Unit
1617 Mail Service Center

NON -DISCHARGE APPLICATION REPORT (NDAR-1) &o f7�G
Facility Name: .Lake Norman State Park County: Iredell Month: ;Novembers Year: � 2015
Field Name' A Field Name: B 'Field, Name:. Field Name:
ion occur
,? Area (acres):. 1.715 - Area (acres): 1.715 Area,(acres) Area (acres):
t this facility Cover Crop: Woodland Cover Crop: Woodland Cover,Crop: _ Cover Crop:
❑� YES ❑No Hourly Rate (in): 0.4 -, Hourly Rate (in): 0.4 _Hourly Rate (m) , .. Hourly Rate (in):
.Annual Rate (m) 30 16 Annual Rate (in): 30.16 Annual Ra4e m , '
( ) - Annual Rate (in):
Weather Freeboard Field Mgated?. ' DYEs ❑No Field Irrigated? AYES g ❑NO ' Field Irrigated? DYES ❑No
9 ❑No Field Irri ated? `❑YES
d c .+ y
c «' ° d a.0 d o t, o� E o�: m o v
,� C) m �� 8°f m°: ac ' ��,c m rn EAR db o m E
G a �� E� 9, Ewe- �°' m� ac a E Ed d� s.c a e, ER and �,c � c
m a o >. a .' w o �o a E E o o-- E E
t u coo oa F-... G x.o. m a E �o �i's' o E� v E
.. E y to G C > 8 J '. '° 2 �' >° Q ~ E O m 2 0 o a F. C C K o C `' a C) M x
.:
OF in ft ft gal mm`', in in,.• '
1 gal min in in gal mm. m, .m -': gal min in in
2
3
4
5
5
7
8
9
10
11
12
R
C
59
68
2
3
3
8,000'
60
017
-
,
.
0.1,7
L
a
<
�
G tk(
Eh1�D/N
� ENR/D'
NR
IVI N K
), U I f�
VVQ
OS
JVJ(1Ufi
ICP3ALc;t
FiCE
13
C
62
3
9,000
60
0.19
-
14
0.19
15
16
17
C
66
3.2
11,000-
90 ...
0:24;
016
18
19
zo
t1
-
i!2
!3
,.
rg
!7
C
64
3.2
9,000
60
0.19
0.19
!8
!9
10
12
Month
Monthly
Floating
Loading:.
Total
(in):
19,000
. 0,41
4.42
18,000
0.39
5.33
0
0.00
0
0.00

NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page owl of
P
exceed the limits in Attachment B of your permit? ❑s Compliant ❑Non -Compliant
ate measures taken to prevent effluent ponding in or runoff from the sites? ❑� Compliant ❑Non -Compliant
Pas suitable vegetative cover maintained on all sites as specified in your permit? 2Compliant ❑Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site? 2Compliant ❑Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? (]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 necessarv.
Operator in Responsible Charge (ORC) Certification Permittee Certification
ORC: Matthew B. Cartner Permittee:
Div. Of Parks & Rec (Lake Norman SP)
Certification No.: 995910 Signing Official: William C. Rhinehardt, Jr.
Grade: S1 Phone Number: 704-880-4373 Signing Officials Title: Park Superintendent
Has the ORC changed since the previous NDAR-1? ❑yes ❑� No PhoneLrr:704-528-635 Permit Exp.: 9/30/15
�
Signature Date ignature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge. I cer►ify, under pe of law, that this document and all attachments were prepared under my direction or supervision in accordance
with a s igned to ssur6 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 Quality
Information Processing Unit
1617 Mail Service Center

'' ElInfluent ■ [:]No flow generated•.
■ ■ ■ ■

NON -DISCHARGE MONITORING REPORT (NDMR)
Page d)i, of
Sampling Person(s)
Bryan Cartner
Certified Laboratories
Name: Statesville Analytical, Inc.
Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit?
❑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.
Operator in Responsible Charge (ORC) Certification Permittee Certification
ORC: Matthew Bryan Cartner Permittee: Div. Of Parks & rec (Lake Norman SP)
Certification No.: 995910 Signing Official: William C. Rhinehardt, Jr.
Grade: S1 Phone Number: 704-880-4373 Signing Officials Title: Park Superintendent
Has the ORC changed since the previous NDMR? ❑Yes pNo Phone Nu be: 704-528-63 0 Permit Expiration: 9/30/2014
cAki - -
L xk— &_
Signature Date S nature
Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge. Cce�rtffy, unde naltyof law, th this document and all attachments were prepared under my direction or supervision In
ce `th a syste .designed to assure that all qualified personnel property gathered and evaluated the information
submitted. Base 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 Quality
Information Processing Unit
1617 Mail Service Center

pppppp-
NON -DISCHARGE MONITORING REPORT (NDMR)° Page ( of ,�N
Facility Name: Div. Of Parks & Rec (Lake Norman SP) County: Iredell Month: �. October) Year: : ,2015i
Flow Measuring Point: Dinfluent ❑Effluent ❑No Flow generated Parameter Monitoring Point: []influent ❑r Effluent ❑Groundwater Lowering ❑Surface water
p1ranneter
Code iol 50050
50060
00400
C0310
-31616
00610
-00630
81639
00600
00530
00665
T
0
Q E
O
c
m
E a+
U fn
Q.
0
0.
�y
`0c
G .o
NO =
V
- 2
O.-
o
"
O
m
_€.
10 w
_
G.
10
.O
E
Q
+m
;"' �.
w Z
_mac
d p
Y w
Z
12
_c
+� co
-�
Z
_m
+Ri d
H N
7
m
2
,� .0
FO- 6
a
-
-
-
..
24-hr
hrs
GPD
mg/L
su
mg/L
#/100 mL
mg/L
I mg/L
Ibs/ac
mg/L
I mg/L
mg/L
1
16:30
0.33
739
7.1
2
3
739
739
4
5
739`
739
R A A D
6
7
8
16:30
1
739
739
739
0.32
7.2
N
Y
_ '
— d
��
IV:3�J1=
rG!/II
=Q..
5-
9
739
10
739
11
739
j
g
Zllj
12
739
13
739
'a
14
739
15
16:30
1.17
739
7.2
16
739
17
739
18
739
19
739
20
739
21
739
22
16:30
1
739
7.3
23
739
24
739
25
739
26
739
27
739
28
739
29
739
30
16:30
1
739
7.1
31
739
Average:
739
0.32
Daily Maximum:
739
0.32
7.30
Daily Minimum:
Sampling Type:
739
Recorder
0.32
Grab
7.10
Grab
Sample Frequency-.1 Monthly I Monthly

NON -DISCHARGE MONITORING REPORT (NDMR)
Page 2N of 2
Matthew Bryan Cartner
Name:
Sampling Person(s)
Certified Laboratories
Name: Statesville Analytical, Inc.
Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit?
❑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
aavali 1. .... G 1 QUUMV1101 0110CLO 11
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Matthew Bryan Cartner
Permittee: Div. Of Parks & rec (Lake Norman SP)
Certification No.: 995910
Signing Official: William C. Rhinehardt, Jr.
Grade: S1 Phone Number: 704-880-4373
Signing Official's Title: Park Superintendent
Has the ORC changed since the previous NDMR? ❑Yes ONo
Phone N mbe : 70 28-6350 Permit Expiration: 9/30/2014
04// 1,owle
Signature Date
Signature Date
0,tun
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
I 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.
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center

NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Page _ L__ of 9
881
PPig�pa
tionoccur7Area
t thfacility
❑� YES ONO
Facility Name: .Lake Norman State Park
County: Iredell
Month: October
Year: 2015
FIeId.Name:
A
Field Name:
B
Field -Name:
Field Name:
(acres):
1.715
Area (acres):
1.715Area
(acres):Area
(acres):
Cover Crop:
Woqdtapdl,
Cover Crop:
Woodland
Cover Crop:
Cover Crop:
Hourly Rate (in)E
0.4
Hourly Rate (in):
0.4
Hourly'Rate (in):
Hourly Rate (in):
An puaLRate (in)
30:16
Annual Rate (in):
30.16
Annual Rate -(In):
Annual Rate (in):
Weather
Freeboard
Field Irrigated?
DYES : ONO
Field Irrigated?
g
❑� YES ONO
Field Irrigated?
AYES [:]NO"-
Field Irrigated?
DYES ONO
p
m
c
V
m
m
a
E
Fes-
c
0
:r
n
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ui v
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9 Q
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= J
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R
OF
65
in
1
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3.75
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gal
min
:In
-in
gal
min
in
in
gal, .
.:min
in-
In .
g al
min
in
in
3
=
4
..
6
6
8,000 - -
60
0.17
0.1.7
7
C
75
0
3.75
8
9
10
12
13
14
15
C
70
1 0
1 3.75
10,000
70
0.21
0.18
16
17
18
19
20
21
22
C
74
0
3.75
7,000
60
0.15
0.15-
23
24
25
26
27
28
29
30
C
65
0
3.5
8,400
60
0.18
0.18
31
..
-
-
Monthly Loading:
12 Month Floating Total (in):
15,000
0.32'
4.32
18,400
0.40
5.33
0
0.00
0
0.00

NON -DISCHARGE APPLICATION REPORT (NDAR-1)
limits in Attachment B of your permit?
)revent 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?
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
Page ;k of
Compliant ❑Non -Compliant
Compliant ❑Non -Compliant
(]Compliant ❑Non -Compliant
ElCompliant ❑Non -Compliant
Compliant ❑Non-Com Ilant
p
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.
Operator in Responsible Charge (ORC) Certification Permittee Certification
ORC: Matthew B. Cartner Permittee:
Div. Of Parks & Rec (Lake Norman SP)
Certification No.: 995910 Signing Official: William C. Rhinehardt, Jr.
Grade: S1 Phone Number: 704-880-4373 Signing Official's Title: Park Superintendent
Has the ORC changed since the previous NDAR-1? Dyes 2NO Phone Nu er 704- -6350 Permit Exp.: 9/30/15
tJ
Signature /
Date Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge. Ice ' and penalty of law, that this document and all attachments were prepared under my direction or supervision In accordance
with a yst designed to assure that all qualified personnel properly gathered and evaluated the information submitted. Based on my
ingw 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 Quality
Information Processing Unit
1617 Mail Service Center

ppppp"
NON -DISCHARGE MONITORING REPORT (NDMR)(ii
7 t��
�� Page
I of
Facility Name:
Div. Of Parks & Rec (Lake Norman SP)
County:
Iredell
Month:
September'
Year: `-20151
Flow Measuring Point: ❑� Influent ❑Effluent ❑No Flow generated
Parameter Monitoring Point:
❑Influent DEffluent
❑Groundwater Lowering
❑Surface Water
ter Code
50050
50060
•00400
C0310
31616
00610
0063,0 .1
81639
00600,
00530
00665.
10
2
m
Q
-�c
17
3
C1
j
atO
_
NOo
w
o
leEiv
®/N
.E
'm O
�€
E
�
o
c o
o
c
r/DU
IRLL
ILL 0
24-hr
hrs
_GPD
mglL
:su ,
mg/L
_#1106 mL
mg/L
mg)L
Ibslac
mglL
mglL
mg1L:
1
2
16:30
1.17
• 870
870 -
0.36
7
, .
..
- -
3
870
•
10Pd:
-
-1r,
4
870`
6
870
7
870
rF
8
16:30
0.5
870�
;, ...
10
16:30
1.25
870
7.2
g
11
870J
12
8705
"
9
13
870
14
.870
15
870
16
16:30
1
870
7.2
y
17
870
18
870
:.
19
870
20
870 .
21
870
22
87,0
23
16:30
1
.870
7.2
t4
870
�5
870
...
t6
870
t7
870
!8
870
!9
870
_
10
09:30
0.33
870.
7.1, ;
2.3
<1 .:..
<0.5
2.33
1.9
423
7.5
7:1 z
Average:
870.
0.36
2.30
1.00
0.00
; 2.33.
1.90
4.23
7.50
7.1 Q
Daily Maximum:
' 870
0.36
7.20',
2.30
1.00
0.50
2.33
1.90
4.23 -
7.50
7.10.
Daily Minimum:.
,,870
0.36
7.00
2.30
1.00 .
0.50
<2.33 '
1.90
4.23
7.50
7.10
Sampling Type:
Recorder
Grab
Grab
"
Monthly Limit:
Daily Limit:
-
Sample Frequency:
Monthly
Monthly
•Weekly

NON -DISCHARGE MONITORING REPORT (NDMR)
Page �A of
Bryan Cartner
Name:
Sampling Person(s)
Certified Laboratories
Name: Statesville Analytical, Inc.
Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? DCompliant ❑Noncompliant
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.
Operator in Responsible Charge (ORC) Certification Permittee Certification
ORC: Matthew Bryan Cartner Permittee: Div. Of Parks & rec (Lake Norman SP)
Certification No.: 995910 Signing Official: William C. Rhinehardt, Jr.
Grade: S1 Phone Number: 704-880-4373 Signing Officlal's Title: P k Superintendent
Has the ORC changed since the previous NDMR? ❑Yes ONo ::Eb 704-528 0 Permit Expiration: 9/30/201,b—
O' /
'WIA'
Signature Date Y`
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge. enalty aw, that this document and all attachments were prepared under my direction or supervision In
a em designed to assure that all qualified personnel properly gathered and evaluated the Information
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 Quality
Information Processing Unit
1617 Mail Service Center

NON -DISCHARGE APPLICATION REPORT (NDAR-1)
e limits in Attachment B of your permit?
Page A of
❑✓ Compliant ❑Non -Compliant
�quate measures taken to prevent effluent ponding in or runoff from the sites?
❑r Compliant ❑Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit?
❑s 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?
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
action(s) taken. Attach additional sheets if necessarv.
❑r Compliant ❑Non -Compliant
the non-compliance and describe the corrective
Operator in Responsible Charge (ORC) Certification
ORC: Matthew B. Cartner
Certification No.: 995910
Grade: S1 Phone Number: 704-880-4373
IHas the ORC changed since the previous NDAR-1? ❑Yes ONO
ai1_qj=
Permittee Certification
Permittee:
Div. Of Parks & Rec (Lake Norman SP)
Signing Official: William C. Rhinehardt, Jr.
Signing Official's Title: Park
Phone
Permit Exp.: 9/30/15
Signature Date Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge. I ce ify, un r p alty of 1 , that this document and all attachments were prepared under my direction or supervision In accordance
with. syste esigne assure that all qualified personnel properly gathered and evaluated the information submitted. Based on my
ingw of t rson 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 Quality
Information Processing Unit
1617 Mail Service Center

NON -DISCHARGE MONITORING REPORT (NDMR)
Ales j���'���j Page -i— of
Facility Name:
Div. Of Parks & Rec (Lake Norman SP)
County:
Iredell
Month: lwAugu`s-4
1 Year: ' 2015
Flow Measuring Point:
[21innuent ❑Effluent ❑No Flow generated
Parameter Monitoring Point:
❑influent
❑r Effluent []Groundwater Lowering ❑Surface water
"7!!e:t�erCode
--►
;'S0050
50060
00400.
C0310
:3161fi ::
00610
00630;;
81639
00600:,
00530
00665-;
>
�d
e
O
dd
E ._
;
o
d
oc
19 0 'c
_
c
�j
C
C,
o
c
o
+�,
J:
m
�aci
m rn
m ..
y
.4
c v
y
2"
o,: .
eo
V
1= N
uL
'rn
a
,n
d=
E
Euai
�[ o
o. o
o m_
o, CL .
RECEI
JEDINCDE
NRID—IJVR
r°q
o
m
w
a ,..
,
�
n 1
24-hr
hrs
GPD.;.`
mg/L
su•
:. mg/L
41100mL•
mg/L
=mg/L:r
Ibs/ac
Mg
mg/L
,,
1
-1,652
2
.1,652.
3
1652`
_
4
16:30
1
1;652
0.3
7.1''
"
5
1,662
6
' 1,652'
7
1,652: ;
8
1'.652
9
1,652
_...
•
10
1;652
_
11
1,652 -
12
16:30
1
1,652:
7:1•, :•
14
1.,652.
15
11652,
n,
b
16
1„652'"�
17
102
18
1';652'
19
1,652
20
16:30
1
1.552
72 `.
21
1;652
22
1.652 .
23
1,652 .:
24
1,652
251
­1
26
= 1,652
27
16:30
1
-1;652:.
7
28
29
1652'
30
1;652
31
1,652'. .
Average:
.1•;652 -
0.30
Daily Maximum:
"`1,652
0.30
7.20
Daily Minimum:
'11652
0.30
7:00
Sampling Type:
°Recorder
Grab
Grab`
Monthly Limit:
Daily Limit:
Sample Frequency:
":Monthly
Monthly
Weekly

NON -DISCHARGE MONITORING REPORT (NDMR)
Page A of
Sampling Person(s)
Matthew Bryan Cartner
Certified Laboratories
Name: Statesville Analytical, Inc.
Name: 11 Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? ❑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
actinnfcl taken Aftach arlAtinn.l is
,e
Operator in Responsible Charge (ORC) Certification Permittee Certification
ORC: Matthew Bryan Cartner Permittee: Div. Of Parks & rec (Lake Norman SP)
Certification No.: 995910 Signing Official: William C. Rhinehardt, Jr.
Grade: S1 Phone Number: 704-880-4373 Signing Officials Title: Park Superintendent
Has the ORC changed since the previous NDMR? ❑Yes EINo Phone Nu byr: 704-52�i6 50 Permit Expiration: 9/30/2014
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
Signature Date
certi nd Zenalty of , that this document and all attachments were prepared under my direction or supervision In
a eem 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 Quality
Information Processing Unit
1617 Mail Service Center

pp"'Ov-
NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page J_ of 9)
81 Facility Name: .Lake Norman State Park County: Iredell Month: August Year: 2015
Field"Name "A Field Name: B Field Name Field Name:
ligation occur '-
9 Area.(acres), 1.-715 Area (acres): 1.715 Area (acres) Area (acres):
at this facility. Cover_::duo '
p: Woodland Cover Crop: Woodland Cover Crop ;., Cover Crop:
❑YES ❑NO Hourly Rate (iri); 0:4 -. Hourly Rate (in): 0.4 Hourly Rate(fn): Hourly Rate (in):
'Annual Rate (in); 10.16 : Annual Rate (in): 30.16 Annual Rate (in) Annual Rate (In):
Weather
Freeboard
Eield'Irngatad7
AYES:" ❑No' ;
Field Irrigated?
[]YES ❑No
Field .fir igated ?,
❑YES ❑No .'
Field Irrigated?
❑YES ❑No
T
0
a
w
c
a•o
m
o
Em
o
a
_
Eoc
xom
�o
=E
.
Ea
m2
E:o
, ec.
a
-11
E
o�'o
2
o
Ea
ar
p
oe
E o
ooc
OF
in
ft
ft
gal
On ,
in-
-In-.
gal
min
in
in
gal:'
min
in
In..
gal
min
in
in
1
2
3
_
4
C
93
0
3.75
8,100
=60
•0.17 .-
' 0'.17 '
5
J.
6
7
8
9
10
11
.
,
12
C
86
0
3.75
8,500
60
0.18 .
0..18 .
- -
13
14
15
16
17
19
201
CL
92
0
3.75
8,400
60
0.18
0.18
21
22
23
24
25
26
271
C
93
0 1
4
-;7 800
'60
' 0.17 "
' "0.17
28
29
30
31
:. .
Monthly Loading:
12 Month FloatingTotal fin)-
24400:
0 52 •-:
5.49 `;
8,400
0.18
5.80
Q;.
0:00
0
0.00

NON -DISCHARGE APPLICATION REPORT (NDAR-1)
he limits in Attachment B of your permit?
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?
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
Page A of
[ZCompliant ❑Non -Compliant
❑� Compliant ❑Non -Compliant
l]Compliant ❑Non -Compliant
l]Compliant ❑Non -Compliant
l]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.
Operator in Responsible Charge (ORC) Certification Permittee Certification
ORC: Matthew B. Cartner Permittee:
Div. Of Parks & Rec (Lake Norman SP)
Certification No.: 995910 Signing Official: William-C. Rhinehardt, Jr.
Grade: S1 Phone Number: 704-880-4373 Signing Official's Title: Park Superintendent
Has the ORC changed since the previous NDAR-1? ❑yes (]No Phone N�mb r: 704-5 6350 Permit Exp.: 9/30/15
Signature Date
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge. I ce4: penalty of la at this document and all attachments were prepared under my direction or supervision in accordance
with a system 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 Quality
Information Processing Unit
1617 Mail Service Center

NON -DISCHARGE MONITORING REPORT (NDMR) PIf 610" Page ' of
Facility Name: Div. Of Parks & Rec (Lake Norman SP) county: Iredell Month: 'July .', Year: .2015
Flow Measuring Point: QinFluent ❑Effluent []No Flow generated Parameter Monitoring Point: ❑Influent (]Effluent ❑Groundwater Lowering ❑Surface water
PeterCode
-- ► 50050
50060
00400
C0310
31616
00610
00630
81639
-00600
00530
00665
0
l9
H
0
24-hr
0
V fn
0
hrs
LL
GPD
F- aa) t
��
mglL
�'
su
C3
c
Q
m
mg/L
lL •O
_
#/100 mL
m
a
mg/L
+
"�-� Z '�
z
mglL
L
a c
Y +�+
oz
Ibs/ac
c
H 2.
z
mglL`
a)
C a
y`�
mg/L
O N
0
IL
mg/L
-
' �,uvv
1
2
2,290
2,290
7
flA/1
u
3
4
5
2,290
2,290
2,290
MCCf�i=^./11
� .= r_r. J-
-
�.-,,,,. _
, J,
6
2,290
71
2,290
8
16:30
1
2,290
0.5
7.1
9
2,290
10
2,290
11
2,290
s_ y
7
12
2,290
13
14
2,290
2,290
t ty
1i'
;
15
16:30
1
2,290
7
16
2,290
17
2,290
ix
v
181
1 2,290�
191
2,290�
201
2,290
.-
211
2,290
221
16:30
1
2,290
7.1
231
2,290
241
2,290
251
2,290
26
2,290
27
2,290
28
16:30
1
2,290
7.2
29
2,290
30
2,290
31
2,290
Average:
2,290
0.50
Daily Maximum:
2,290
0.50
7.20
Daily Minimum:
2,290
0.50
7.00
Sampling Type:
Recorder
Grab
Grab
Monthly Limit:
Daily Limit:
Sample Frequency:
Monthly
Monthly
• Weekly

NON -DISCHARGE MONITORING REPORT (NDMR)
Page 0\ of �l
Bryan Cartner
Name:
Sampling Person(s)
Certified Laboratories
Name: Statesville Analytical, Inc.
Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? ❑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.
Operator in Responsible Charge (ORC) Certification Permittee Certification
ORC: Matthew Bryan Cartner Permittee: Div. Of Parks & rec (Lake Norman SP)
Certification No.: 995910 Signing Official: William C. Rhinehardt, Jr.
Grade: S1 Phone Number: 704-880-4373 Signing Official's Title: Park Superintendent
Has the ORC changed since the previous NDMR? i]Yes I]No Phone Number- 704-528-6350 Permit Expiration: 9/30/2014
Signature Date S' nature
Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge. I cert' , under pe aw, that this docuLndl attachmenLereepared under my direction or supervision in
actor n 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 Quality
Information Processing Unit
1617 Mail Service Center

NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Page
of
Pat
1
Facility Name:
Lake Norman State Park
County: Iredell
Month:
July
Year:
ation occur
= -, Field Name:
A
Field Name:
B
Fleld Name:
Field Name:
2015
this facility 9
Area (acres):
1-..715
Area (acres):
( )
1.715
Area acres
( )
Area (acres):
Cover Crop:
- Woodland
Cover Crop:
Woodland
Cover Crop:
Cover Crop:
❑✓ YES
❑NO
Hourly'Rate (in):
=' -
0A
Hourly Rate (in):
0.4
'Hourly Rate (in):
Hourly Rate (in):
Annual Rate (in):
' 30.16
Annual Rate (in):
30.16
-..Annual, Ratein
_ ` ( )
Annual Rate (in):
Weather
Freeboard
'Field Irrigated?
---DYES
❑No.
Field Irrigated?
9
DYES
❑NO
,Field Irrigated?
-
❑YES .
[]No - ,
Field Irrigated?
DYES
❑NO
d
�, °
c
0
"
0)
L°
m m
o
• m •g
o
- 0
EC Z.
m o
E._
m.,
of
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E Im
° c
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mac
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12 Month Floating Total (in):
6.20
0
0.00

NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Page 1�k of 1�1`1
exceed the limits in Attachment B of your permit?
measures taken to prevent effluent ponding in or runoff from the sites?
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?
(]Compliant ❑Non -Compliant
(]Compliant ❑Non -Compliant
(]Compliant ❑Non -Compliant
(]Compliant ❑Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? OCompliant ❑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.
Operator in Responsible Charge (ORC) Certification Permittee Certification
ORC: Matthew B. Cartner Permittee:
Div. Of Parks & Rec (Lake Norman SP)
Certification No.: 995910 Signing Official: William C. Rhinehardt, Jr.
Grade: S1 Phone Number: 704-880-4373 Signing Officials Title: Park Superintendent
Has the ORC changed since the previous NDAR-1? ❑Yes ONO Phone ZNe 704-528- 0 Permit Exp.: 9/30/15
It
Signature Date Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge. I certify, under pe ty of I , that this document and all attachments were prepared under my direction or supervision in accordance
with a sys signed 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 Quality
Information Processing Unit
1617 Mail Service Center

1�41
NON -DISCHARGE APPLICRION REPORT (NDAR-1) Page of
0020881 Facility Name: .Lake Norman State Park County: Iredell Month: -'-Junes Year: 2015
PgArea(acres):
irrigation occur
at tills faClilty?
DYES ❑No
A =
Field Name:
B
Field Name:
Field Name:
1.715
Area (acres):
1.715
Area (acres):Area
(acres):
Wood'land
Cover Crop:
Woodland
Cover:Crop:Cover
Crop:
.0.4
Hourly Rate (in):
0.4
Hourly'Rate (in):
Hourly Rate (in):
Annual=Rate (In):
30.16 :
Annual Rate (in):
30.16
Annual Rate (in):
' ,
Annual Rate (in):
Weather
Freeboard
Field Irrigated?
DYES []NO . -
Field Irrigated?
DYES ❑No
Field,irrigated?
❑YES., , .❑No_'
Field Irrigated?
❑YES []NO
m
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Monthly Loading:
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33,700
0:72
5.91
25,200
0.54
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0'
.0:00
0
0.00

NON -DISCHARGE APPLICATION REPORT (NDAR-1)
.d the limits in Attachment B of your permit?
n 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?
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
Page 1 of
i]Compliant
i]Compliant
ElCompliant
[ZCompliant
(]Compliant
❑Non -Compliant
❑Non -Compliant
❑Non -Compliant
❑Non -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
Operator in Responsible Charge (ORC) Certification Permittee Certification
ORC: Matthew B. Cartner Permittee:
Div. Of Parks & Rec (Lake Norman SP)
Certification No.: 995910 Signing Official: , Jr. v A. 60-tit42G-.f
Grade: S1 Phone Number: 704-880-4373 Signing Official's Title: Axknpark Superintendent
Has the ORC changed since the previous NDAR-1? 2 Phone Number: 704-528-6350 Permit Ex
[]Yes ❑No p.: 9/30/15
CeZt5 8LA
S
Signature Date Signature Date
By this signature, I certify that this report is accumate and complete to the best of my knowledge. 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.
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center

NON -DISCHARGE MONITORING REPORT (NDMR)
-,
Page _j_ of
020881
E`
Facility Name: Div. Of Parks & Rec (Lake Norman SP)
County: Iredell
Month: June
Year: 2015
Flow Measuring Point: ❑� Influent ❑Effluent ❑No flow generated
Parameter Monitoring Point: ❑lnfluent ❑� Effluent ❑Groundwater Lowering ❑Surface water
Parameter Code --►
' 50050
50060
00400
C0310
31616
00610
.-00636'
81639
00600
00530
00665-
cc
a>
O
O
E°
VL
c
c
vm
02
a €
LL V0.
E
E
=Z'Zmmo
.
e
Z
}y
~~NU
Z.
H!
vy7
_,
t°E
O W~
i-
[LO
;
24-hr
hrs
GIRD
mg/L
-su
mg/L
91100 mL
mg/L
mg/L
Ibslac
-mg/L ,:
mg/L
mglL
1
1,600
2
1,600 ..
3
1,600
4
1,600
5
16:25
0.55
7.1
6
1,600
7
q251,600
.1,600
16:301,600
7
9
1,600
/
18
10
08:30
1,600
3.8 (
60.5.
,<6.5
3.36
2.13
5.49
6.5
6
11
1,600
\
J
12,1,600
13
.1,600
14
1,600
15
1,600
16
1,600
171
1,600
181
1,600
191
16:30
1
1,600
4
20
. 1,600
211
1,600
22
1;600
23
1,600
24
16:30
1
11600
7
25
1,600
26
1;600
271
1,600
28
1,600
29
1,600
30
16:30
1
1,600
7.1
31
Average:
1-,600
0.55
3.80
.60.50
0.00
3.36
2.13
5.49
6.50
6.00
Daily Maximum:
' 1,600
0.55
.7.10
3.80
60.50
0.50
-3.36
2.13
:5.49
6.50
6.00
Daily Minimum:
1,600
0.55
4.00'
3.80
60.50
0.50
3.36
2.13
5.49
6.50
6.00
Sampling Type:
Recorder
Grab
Grab
Monthly Limit:
'
Daily Limit:
Sample Frequency:1
Monthly I
Monthly
Weekly

NON -DISCHARGE MONITORING REPORT (NDMR)
� r
Page ``� of
Matthew Bryan Cartner
Name:
Sampling Person(s)
Certified Laboratories
Name: Statesville Analytical, Inc.
Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? ❑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. Aft2rh additinnal cheats if nartaccom
Operator in Responsible Charge (ORC) Certification
ORC: Matthew Bryan Cartner
Certification No.: 995910
Grade: S1 Phone Number: 704-880-4373
Has the ORC changed since the previous NDMR? ❑Yes (]No
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
Permittee Certification
Permittee: Div. Of Parks & rec (Lake Norman SP)
Signing Official: VTJ MzoC> lk 6AKX-9(,4
Signing Officials Title: lct`o�Park Superintendent
Phone Number: 704-528-6350 Permit Expiration: 9/30/2014
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 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 Quality
Information Processing Unit
1617 Mail Service Center

NnN_nISCHARGE MONITORING REPORT (NDMR) Page_I of �+
020881 1 Facility
Flow Measuring Poin
eter Code —►
50050
50060
c
-
� E
V H
- m L
O O
24-hr
hrs I
• GPD I
mg/L
16:20 1 1
16:30 I 1
16:30 1 1
16:15 I 1.5
Average:
Maximum:
Minimum:
2,616
2,616
2,616
2,616
2,616
2,616
2,616
2,616
2,616
2;616
2,616
2,616
2,616
2,616
2,616
2,616
2,616
2,616
2,616
2,616
2,616
Recorder
Monthly Limit:
Daily Limit: -
Sample Frequency: Monthly
0.4
0.40
0.40
0.40
Grab
Monthly
Name: Div. •f Parks & Rec (Lake Norman SP) County: -.- s
■ ■ ■ ■ ■
1
1
—�—®—®—�—
11 �'.1aL�'llu3ii3�]1�L`L:1�q»L•��

19,
NON -DISCHARGE MONITORING REPORT (NDMR) Page of
Sampling Person(s) II Certified Laboratories
Matthew Bryan Cartner II Name: Statesville Analytical, Inc.
Name: 11 Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? ❑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.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Matthew Bryan Cartner
Permittee: Div. Of Parks & rec (Lake Norman SP)
Certification No.: 995910
Signing Official: AF6119am G. Rhimehamt, r. hAA vc6_
Grade: S1 Phone Number: 704-880-4373
Signing Officials Title: kt4+4Park Superintendent
Has the ORC changed since the previous NDMR? ❑Yes ONo
Phone Number: 704-528-6350 Permit Expiration: 9/30/2014
&2:in rlo� 6-/ ,P!�_
A aal.L A (0 12--31ZOt
10/ Signature Date
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
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 Quality
Information Processing Unit
1617 Mail Service Center

PV
1 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of `
Q0020881—T Facility Name: .Lake Norman State Park County: Iredell Month: May Year: 2014
irrigation occur
at this facility?
Field Name:
A
Field Name:
B
Field Name:
Field Name:
Area (acres):
1.715
Area (acres):
1.715
Area (acres):
Area (acres):
Cover Crop:
Woodland
W
Cover Crop:
Woodland
Cover Crop:
Cover Crop:
❑� YES []NO
Rate (in):
0.4
Hourly Rate (in):
0.4
Hourly Rate (in):
Hourly Rate (in):
Annual
Annual Rate (in):
30.16
Annual Rate (in):
30.16
Annual Rate (in):
Annual Rate (in):
Weather
Freeboard
Field Irrigated?
❑� YES ❑NO
Field Irrigated?
21YES [:]NO
Field Irrigated?
❑YES ❑NO
Field Irrigated?
❑YES [:]NO
m
0
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min
in
in
gal
min
in
in
1
2
3
4
5
6
C
78
0
3.75
8,000
60
0.17
0.17
7
8
9
10
11
12
13
14
15
C
80
0
3.5
8,300
60
0.18
0.18
16
17
18
19
201
C
84
0
1 3.5
8,500
60
0.18
0.18
21
22
23
24
25
26
27
28
29
C
86
0
1 3.5
1
12,000
90
0.26
0.17
30
Li
31
Monthly Loading:
8,000
0.17
28,800
0.62
0.00
0
0.00
12 Month Floating Total (in):
6.04
WIN Issm
7.33
NEW

1 NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Page _L of
n rates exceed the limits in Attachment B of your permit?
.equate measures taken to prevent effluent ponding in or runoff from the sites?
a suitable vegetative cover maintained on all sites as specified in your permit?
i]Compliant ❑Non -Compliant
❑� Compliant ❑Non -Compliant
(]Compliant ❑Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site? i]Compliant []Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? i]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
4..1 . A++-,h oA iifin l aheofa if nortascaN-
IililiWlifi
Operator in Responsible Charge (ORC) Certification
ORC: Matthew B. Cartner
Certification No.: 995910
Grade: S1 Phone Number: 704-880-4373
Has the ORC changed since the previous NDAR-1? ❑yes P�No
G-
Permittee Certification
Permittee: Div. Of Parks & Rec (Lake Norman SP)
Signing official: XiGk 4 VCk
Signing Officials Title: kWv�Park Superintendent
Phone Number: 704-528-6350 Permit Exp.: 9/30/15
Signature
Date Signature Date
By this signature, I certify that this report Is accurrate and complete to the best of my knowledge. 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.
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center

NON -DISCHARGE MONITORING REPORT (NDMR) Page of
,•:
Of
Flow Measuring Point: ElInfluent []Effluent DNo flow generate, ----a
®moo
��®�■■�®��®�������
Wfly Maximum.,
Daily Limit:'

NON -DISCHARGE MONITORING REPORT (NDMR) Page O� of
Sampling Person(s) II Certified Laboratories
Matthew Bryan Cartner 11 Name: Statesville Analytical, Inc.
Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? ❑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.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Matthew Bryan Cartner
Permittee: Div. Of Parks & rec (Lake Norman SP)
Certification No.: 995910
Signing Official: Jr. `- A-aI D A_ C*-kCe_A-t
Grade: S1 Phone Number: 704-880-4373
Signing Official's Title: Park jQgj ntandwt IV711U6 PAfZV- 5L PLVV 1N'T+�U
Has the ORC changed since the previous NDMR? ❑Yes [2]No
Phone Number: 704-528-6350 Permit Expiration: 9/30/2014
Signature Date
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
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.
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center

NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page I_ of
0020881 Facility Name: Lake Norman State Park County: Iredell Month: April Year: 2015
Field Name: A. Field Name: B :.Field Name: Field Name:
r igation occur
Area (acres): 1:715. Area (acres): 1.715 Area (acres): Area (acres):
at this facility? Cover Crop: Woodland Cover Crop: Woodland Cover Crop: Cover Crop:
DYES ❑NO Hourly Rate (in) 0.4 - Hourly Rate (in): 0.4 Hourly -Rate (In): Hourly Rate (in):
Annual Rate (in).: .30.16 Annual Rate (in): 30.16 Annual Rate (in): Annual Rate (in):
Weather
Freeboard
Field Irrigated?
2YES =. []NO'
Field Irrigated?
❑� YES ❑NO
Field Irrigated?
❑YES ❑NO
Field Irrigated?
❑YES ❑NO
T
p
cGI
C.
mE
o
m
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�o
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o
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OF
in
ft
ft
gal
min
in
in
gal
min
in
in
-gal
min
in
-in
gal
min
in
in
2
3
4
5
6
7
8
C
80
4
8,000
60
0.17
0.17
10
11
19
12
13.
CL
75
4
8,000
-60
0.17
0.17
14
15
-
-
16
17
18
19
20
21
22
C
76
3.25
9,000
60
0.19
0.19
23
C
69
3.25
7,500
60--
0:16.
0.16
24
-
25
26
27
C
68
3.25
8,000
60
0.17
0.17
28
C
70
3.5
1 6,300
45
0.14
=0.14'
10,200
75
0.22
0.18
29
-
30
31
Monthly Loading:
21,800
0.47
6.68 ''
35,200
0.76
7.81
0
0.0
00
0
0.00
12 Month Floating Total (in):

NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page -4— of
ation rates exceed the limits in Attachment B of your permit? ❑� Compllant ❑Non -Compliant
equate measures taken to prevent effluent ponding in or runoff from the sites? ❑� Compliant ❑Non -Compliant
Pas suitable vegetative cover maintained on all sites as specified in your permit? ❑� 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 ❑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.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Matthew Bryan Cartner
Permittee:
Div. Of Parks & Rec (Lake Norman SP)
Certification No.: 999590
Signing Official: a �u ear• G611 t 12Gi +
Grade: S1 Phone Number: 704-880-4373
Signing Official's Title: E rk-Rupe-daten4ent
Has the ORC changed since the previous NDAR-1? ❑Yes RINo
Phone Number: 704-528-6350 Permit Exp.: 9/30/15
Signature Date
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
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.
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center
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