WQ0003090_Monitoring - 12-2020_20210126

Monitoring Report Submittal
Permit Number #* wg0003090
Name of Facility:* town of liberty wastewater plant
Month:* December Year:* 2020
Report Information
Type* Upload Document*
NDMR, NDAR-1, NDAR-2, NDMLR december 2020 spray report 1.52MB
- Copy.pdf
PDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
Confirmation Email Address:* [e-mail]
Name of Submitter:* tremaine fike
Signature:
si lzr�w &
Date of submittal: 1/26/2021
This w ill be filled in automatically
Initial Review
Reviewer: Williams, Kendall

Is the project number correct?* WQ0003090
Is the monitoring report t: Yes r No
accepted?*
Regional Office* Winston-Salem
Accepted Date: 1/26/2021

FORM: NDMR 10-13
Permit No.: W00003090 Facility
PPI: Flow Measuring Point:
Parameter Code 1-1 50050 00400
c
E E x
VU) a
24-hr hrs GIRD su
Name:
E Influent
00310
G
m
m 1L
Town Of
❑ Effluent
00610
o€
mg/L
NON
Liberty -
❑
00630
N
m IL
-DISCHARGE
Wastewater
No flow generated
31613
U. o
#1100 mL
MONITORING REPORT (NDMR)
County: Randolph
Parameter Monitoring Point: ❑ Influent
T M20 00625 o056b 50060 00600
a
m o . c m
a Z s pZ Zp
mg/L mg/L mg/L mg/L mWL
Month:
0 Effluent
70300
v
y w
mglL
December
❑ Groundwater Lowering
00940 00630
+$
z
Page _1_ of
year: 2020
❑ surface water
W010
L°
A
mg/L mg/L
°C
1
7:00 8
1,099,000
2
7:00 8
586,000
3
7:00 8
441,000
7.54
13.4
12
6.6
2420
ND
11.6
2.1
0.2
11.6
0.062
4
7:00 8
458,000
5
10:00 2
1 1,001,000
6
11:00 2
429,000
7
7:00 8
429,000
6
7:00 8
497,000
9
7:00 8
498,000
10
7:00 8
461,D00
7.1
0.22
11
7:00 8
398,000
12
10:00 2
340,000
13
14:00 2
479,000
14
7:00 1 8
400,000
15
7:00 8
1,7D5,000
■
16
::00 8
11,175,000
17
7:00 8
1,835,000
7.66
15.1
12.5
13
687
ND
13.4
2
0.56
13.5
0.086
18
7:00 8
935,000
19
752,000
20
718,000
21
1,188,000
22
7:00 8
806,000
23
652,000
7.55
0.11
24
530,000
25
1,555,000
26
944,000
27
687,000
28
7:00 8
505,000
29
7:00 8
568,000
7.91
0.25
30
7:00 8
500,000
31
7:00 8
628,000
Average:
745,129
14.25
12.25
9.80
1,289.40
0.00
#REF!
2.05
0.27
12.55
0.07
Daily Maximum:
1,835,000
7.91
15.10
12.50
13.00
2,420.00
0.00
#REF1
2.10
0.56
13.50
0.09
Daily Minimum:
340,000
7.10
13.40
12.00
6.60
687. 00
0.00
#REF!
2.00
0.11
11.60
0.06
Sampling Type:
Recorder
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Monthly Avg. Limit:
Daily Limit: 1
550,000 .
Sample Frequency:1
11
weekly
2x month
2x month
2xmonth
2x month
2x mont±Wm�onthZrnorith
weekly
2x month
3x year L
3x year
2x month

FORM: NDMR 10-13
NON -DISCHARGE MONITORING REPORT (NDMR)
Sampling Person(s) Certified Laboratories '
Name: GLENN PRICE Name: RESEARCH & ANALYSIS LABORATORIES, INC
Name: GARRETT DREYER Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? ❑ Compliant 21 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.
ion compliant on the date of 12/1 12/2 12/5 12/15 12/16 12/17 12/18 12/19 12/20 12/21 12/22 12/23 12/25 12/26 12/27 12/29 and 12/31
:ause of I&I
Operator In Responsible Charge (ORC) Certification
ORC: E1ix Tremaine Fike
Certification No.: 989290
Grade: SI Phone Number: 336 622 2990
Has the ORC changed since the previous NDMR? ❑ Yes Q w
Signature Date
By this signature, I certify that this report is accumate and complete to the best of my knowledge.
Permittee Certification
Permittee: William Doerfer
Signing Official:
Signing Official's Title: Town Manager
Phone Number: 336 622 4276
9
Permit Expiration: 8/31 /2024
i nature Date
I certify, under penalty of law, than this document and all attachments were prepared under my direction or supervision in
accordance with a system desi :red 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 i
gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I I
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment
T_ 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

laceAnalyficale
www.paedabs.cm
Pace Analytical Services, LLC
106 Short St.
Kernersville, NC 27284
336-996-2841
Tremaine Fike
Town of Liberty
PO Box 1006
Liberty, NC 27298
Project: Effluent
Pace Project No.: 92509401
Sample: Effluent
Laboratory Report
Lab ID: 92509401001
Page 1 of 1
Report Date: 12/30/2020
Date Received: 12/03/2020
Collected: 12/03/20 11:55 Matrix: Water
Method Parameters
Results
Units Report Limit
Analyzed
HACH 10206 Nitrogen, Nitrate
ND
mg/L
0.30
12/04/20 10:12
SM 254OD-2011 Total Suspended Solids
6.6
mg/L
2.5
12/04/20 11:31
SM 521OB-2011 BOD, 5 day
13.4
mg/L
2.0
12/09/20 15:37
Colilert-18 Fecal Coliforms
2420
MPN/100ml-
1.0
12/04/20 12:44 El
Performed by
PACE
12/03/20 11:55
Collected By
Garrett
12/03/20 11:55
Dreyer
Collected Date
121003120
12/03/20 11:55
Collected Time
11:55
12/03/20 11:55
pH
7.54
Std. Units
12/03/20 11:55
TKN+NO3+NO2 Total Nitrogen
11.6
mg/L
0.52
12/17/20 15:48
Calculation
EPA 350.1 Rev 2.0 1993 Nitrogen, Ammonia
12.0
mg/L
0.30
12/11/20 13:15
EPA 351.2 Rev 2.0 1993 Nitrogen, Kjeldahl, Total
11.6
mg/L
0.50
12/17/20 06:25
EPA 353.2 Rev 2.0 1993 Nitrogen, NO2 plus NO3
0.062
mg/L
0.040
12/09/20 12:26
EPA 365.1 Rev 2.0 1993 Phosphorus
2.1
mg/L
0.050
12/11/20 18:41
ANALYTE QUALIFIERS
El Reported value should be considered a minimum estimate since it is the maximum reportable
number for this method
based on the sample volume used. The true
value is likely greater than the value reported.
Reviewed by:
Kevin Herring for
Stephanie Knott
336-996-2841
[e-mail]
Pace Analytical Services Asheville
2225 Riverside Drive, Asheville, NC 28804 North Carolina Wastewater Certification #: 40
Florida/NELAP Certification #: E87648 South Carolina Certification #: 99030001
North Carolina Drinking Water Certification #: 37712 Virginia/VELAP Certification #: 460222
Pace Analytical Services Eden
205 East Meadow Road Suite A, Eden, NC 27288 North Carolina Wastewater Certification #: 633
North Carolina Drinking Water Certification #: 37738 Virginia/VELAP Certification #: 460025
Qualifiers

CHAIN -OF -CUSTODY Analytical Request Document
;ZeAnalydcal " �
W O# : (�2509 �! 01
*�+ YYI/ `t
t Pace Workorder Number or
Complete all relevent fields
Chain -of -Custody is a LEGAL DOCUMENT - Comlete...._.._._..-._._..__.___.__..._.,._.._._._
dd 1(J
Town of [-i`1Eriy g Infol mation:
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Preservative Types: (1) nitric acid, (2) sulfuric acid,13) hydrochloric acid, (4) sodium hydroxide, (5) zinc acetate,
_......_ . ........... .. ........ _.._.._...__......__._,..,._.«,__«_ (6)
methanul, (7) sudium bisulfate, (8) suchuui Lhiusui(ale, (9) hexane, (A) dscurbic acid, (e) anununn iu, sul(ale,
(Site Collection Info/Address: (C)
ammonium hydroxide, (D)TSP, (U) Unpreserved, (0) Other
,, ; . ,w ___...._, .... _______ .._. _._.... _ .._._............_._.._?
/N
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p r Grah i Compcsite Start) I CI ; Ctns 0
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Par.king Mate i ial Used:
❑cot Monitoring
V)cyr-C
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;SHORT HCAUS PRESf NT (c72 hours): L Y N N/A
lab Trul,kiIV, 11:
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led oy/Lonlpuny: (SiRninurl) Dalc /'I iI u : kucoved tr l cinir.;ny: (slr;l alum) Uak,i; irre:
led by/Company: (Signature) ±Date/Time:
Received by/Company: (Signatu
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IDate/Time: [PM:
ij TS:
Lab Sample Temperature Info: �r
Tomp Iflank Rvrrivo& Y N INAl
TherlTI iDW V_j 2-1 C. L,
Cuulrr .1 Temp Upon Rot oipl:uC.
Conlur 1 Thant Corr, rut tin: C,tj oC
coolrr1 Corun'lod'(r•rvl! 7 i-�_•. .o('
L1.11T1171CIIt S:
H0. Mcl)IJ ISP Willi,
Non Conformatrce(s): Page:
YES /(_NO' of: _�_

laceAnaljdical
www.pacelabs.com
Pace Analytical Services, LLC
106 Short St.
Kemersville, NC 27284
336-996-2841
Laboratory Report
Tremaine Fike
Town of Liberty
PO Box 1006
Liberty, NC 27298
Project: Liberty - Field Data
Pace Project No.: 92514995
Page 1 of 1
Report Date: 01 /06/2021
Date Received: 01/06/2021
Sample: Effluent Grab Lab ID: 92514995001 Collected: 12/10/20 10:12 Matrix: Water
` Method Parameters Results Units Report Limit Analyzed Qualifiers
Performed by PACE 12/10/20 10:12
Collected By Glenn Price 12/10/20 10:12
Collected Date 12/10/20 12/10/20 10:12
Collected Time 10:20 12/10/20 10:12
pH 7.10 Std. Units 12/10/20 10:12
Chlorine, Total Residual 0.22 mg/L 12/10/20 10:12
Reviewed by:
Stephanie Knott
336-996-2841
[e-mail]

CHAIN -OF -CUSTODY Analytical Request Document
WO#:92514995
wder Number or
.V.5ceAnalXical
.Jhain-cf-Ctisludy �s & LEI -.Al POCUMEN'l - Complete nil rofeveitt fields
1'
-.k-r)w!i ol:l-it.ierly 'Billing, Infoi ination:
III
�I111
I��I
I
I11111111
4LY
92514995
To: EwJI To:
....... .... . .. .......
f?'�efw"ihwlypf�': (1) nitlic acid, (2�.S"Ifutiv acill, (3) ilyfliod'1101 it �10d, (4) so4iilni hydri,xide, (5) lintaceiale,
....... ... . .....
(GI ll(p'haool' "i) s06'1111 bisulfate, (3)
SUdhJlTl thi('SUIiate, (9) hexane, (A) ascuiblu add, (13) al.11111(JI)IL1111 sulfate,
;Site i-xlIh-cilon Inft)/AdCbe,.,.,;:
(C) iiinlivillitillhydroxide, (D) MP, (1.1)
Unpreserverl, (0) Other
Analyses
Lab Profile/Line:
ier Projor! Nnnic"Nitnih!,r: C County/City, Tirnc ;,.onc Colirci-rd:
Leb Suakplu Reca-ipl;
}PI[ 1\4 I- r-T 1 j ET
1.c H. "Corripliancc Mutilluring"?
rA
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Si'jl.'.AL,iiL-E: Pr�auvul-
jfyLs
-'u.1 I eLc j. 1412"ItILILE' Pl* L 11 lip.
Cdj�pf'�r�Aiot):I Purchae Ordor !JI: DW PWS M 4:
Opote il: OW Lacat'o-i
Y 9 WA
CoLn.-:t rr-Ltlec 4 :1 VA
"Ill. VC131im'! 7 M MA
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NA
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;SHORT HOLDS PRESENT (<72 hours): Y N N/A I,ab Sample Ternperahire Info:
Packing Material Used:
Lab Truck• ing 41:
Temp Blank Received: Y IN NA
Therm ID#:
ffluent Moniiolip�u
Coulet I Tenip Upon Re oc
Radchvn (,5110 crrn): Y IV, NA
Samples received via:
rl:f)l:x 1.1 P" f liprit
Cooler I Therm Corr. ractcr: oc
Courier Pace Colorer Cooler I Corrected'I ernp:_ (ic
ishod 0. 11111
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7 Date/Ti me:
[PM: Non Conformance(s): Page:
P8: YES / NO of:

rr
zeAnalytical
www.pacdabs.can
Pace Analytical Services, LLC
106 Short St.
Kemersville, NC 27284
336-996-2841
Tremaine Fike
Town of Liberty
PO Box 1006
Liberty, NC 27298
Project: Effluent
Pace Project No.: 92512534
Sample: Effluent
Method
HACH 10206
SM 254OD-2011
SM 521OB-2011
Colilert-18
TKN+NO3+NO2
Calculation
EPA 350.1 Rev 2.0 1993
EPA 351.2 Rev 2.0 1993
EPA 353.2 Rev 2.0 1993
EPA 365.1 Rev 2.0 1993
Reviewed by:
Parameters
Nitrogen, Nitrate
Total Suspended Solids
BOD, 5 day
Fecal Coliforms
Total Nitrogen
Nitrogen, Ammo
Nitrogen, Kjelda
Nitrogen, NO2 p
Phosphorus
plus
�M M17011
Laboratory Report
Page 1 of 1
Report Date: 12/30/2020
Date Received: 12/17/2020
Lab ID: 92512534001 Collected: 12/17/20 13:05 Matrix: Water
Results
Units
Report Limit
Analyzed Qualifiers
ND
mg/L
0.30
12/18/2010:56
13.0
mg/L
4.2
12/21/2011:03
15.1
mg/L
2.0
12/23/2010:05
687
MPN/100ml-
1.0
12/18/2012:43
13.5
mg/L
0.52
12/30/2016:29
Ammonia 12.5 mg/L 0.30 12/22/2012:14
hl, Total 13.4 mg/L 0.50 12/30/20 03:51
NO3 0.086 mg/L 0.040 12/23/20 09:38
2.0 mg/L 0.050 12/29/20 20:40
Stephanie Knott
336-996-2841
[e-mail]
Pace Analytical Services Asheville
2226 Riverside Drive, Asheville, NC 28804
Florida/NELAP Certification #: E87648
North Carolina Drinking Water Certification #: 37712
Pace Analytical Services Eden
205 East Meadow Road Suite A, Eden, NC 27288
North Carolina Drinking Water Certification #: 37738
North Carolina Wastewater Certification #: 40
South Carolina Certification #: 99030001
Virginia/VELAP Certification #: 460222
North Carolina Wastewater Certification #: 633
Virginia/VELAP Certification #: 460025
Stephanie Knott
336-996-2841
[e-mail]
Pace Analytical Services Asheville
2226 Riverside Drive, Asheville, NC 28804
Florida/NELAP Certification #: E87648
North Carolina Drinking Water Certification #: 37712
Pace Analytical Services Eden
205 East Meadow Road Suite A, Eden, NC 27288
North Carolina Drinking Water Certification #: 37738
North Carolina Wastewater Certification #: 40
South Carolina Certification #: 99030001
Virginia/VELAP Certification #: 460222
North Carolina Wastewater Certification #: 633
Virginia/VELAP Certification #: 460025

CHAIN -OF -CUSTODY Analytical Request Document i
W0#5134
rderNumberor
aceAnalytical
Chain -of -Custody sa LEGAL DOCUMENT- Complete all re'2vent fields
5•i
ly: T,`.Sr,;; .-,f i-i['„-lift
f Illrigl h4 f- ma;ioii,u.
92°512°534
nlau r u:
6
" Preservative Types: yp {_)nitric acid.. (_) sUIturic acid, (3) hydrochloric add, (9) sodium hydroxide, (5) zinc acetate.
•-•--•-•- •••-• •-- - - -.
_.,_......... _ _ .» _. »..
._.._. „.....
R (b) u,eLllanui. (7) sudium biaulfdle, 8) sudium Lhivsulfdle, (9) hexane, (A) dSLW bif. dud, (B) dnuaunium sulfdLe,
i Site Collection Info/Address:
[ (C) ammonium hydroxide, (U) 1SP, (U) Unpreserved, (0) Other
er Project Name/Number:
_ »..» .. _... .. .._., ...
State: County/City: Time Zone Collected:
_ Analyses
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Non Conforma,�je(s): i Page:
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YES /,m--N of:
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NA

aceAnalytical
www.paeelabsxw
Pace Analytical Services, LLC
106 Short St.
Kemersville, NC 27284
336-996-2841
Laboratory Report
Tremaine Fike
Town of Liberty
PO Box 1006
Liberty, NC 27298
Project: Town of Liberty
Pace Project No.: 92513667
Page 1 of 1
Report Date: 01/11/2021
Date Received: 12/23/2020
Sample: Effluent Lab ID: 92513667001 Collected: 12/23/20 09:55 Matrix: Water
Method Parameters Results Units Report Limit Analyzed Qualifiers
Performed by PACE 12/23/20 09:55
Collected By Garrett 12/23/20 09:55
Dreyer
Collected Date 12123120 12/23/20 09:55
Collected Time 09:55 12/23/20 09:55
pH 7.55 Std. Units 12/23/20 09:55
Chlorine, Total Residual 0.11 mg/L 12/23/20 09:55
Reviewed by:
Stephanie Knott
336-996-2841
[e-mail]
Page 1 of 2

CHAIN -OF -CUSTODY Analytical Request Document lAO USE ONLY -Affix Worknrrl,,Is i. r
aceAnalytical E wo# . („ 25 i 3667 ��.
Chain-of-Grstody is a LEGAL DOCUMENT- Complete all relevent fields
company: i-OVVI1 of Liberty P,illirrN Information:
AEI_
.Addr,.55; ___..-._.... C,c...._...in.ei llre1selrvnl onta
92513667
Repu't Tu: Email To. Pr es rrvntivn Types: (1) nitric add,(2) silJrtwn acid, (3) tn';rlmehloric acid. (4) sodium hydiaxide, (S) zincacetitp,
_ _... .. „ (G) methanul, (7) sodium bisu!(ale, (8) sodium thiosulrau" (9) hexane, (A) ascorbic add, (B) anunonium sulfate,
t'IrY i'< , Site f_oller (ir'nt info/Address: IQ ammonium hydrnxide, (r,) TSP, W) Unpreserved, (0) Other
Analyses Lab Profile/Erne:
Customer Project Name/Number: .Mate: County/City: Time Zone Collected: --------
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� � f iJ:H irti L, 11Nf:,Y:
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Sample 11) Nlatri!; " Cowlju.ite Fi:d �
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Customer Remarks / SpeC ial Condition_ / Possible Hazards: :Type ur ILL Used: Wet Blue Dry None 'SHORT HOLDS PRESENT (02 hours): Y N N/A ; Lab Sample Temperature Info:
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HCL Me0H TSP Other
Relinquished by/Company: (Signature) ------' Date/Time: i Received by/Company: (Signature) Date/Time: PM: --- "~ -# — — —
d Non Conformance(s): Page:
_ ............ PB: YES / NO of:

aceAnalytical
www.paceiabs.com
Pace Analytical Services, LLC
106 Short St.
Kemersville, NC 27284
336-996-2841
Tremaine Fike
Town of Liberty
PO Box 1006
Liberty, NC 27298
Project: Town of Liberty Effluent
Pace Project No.: 92514405
Sample: Effluent
Method
Reviewed by:
Parameters
Performed by
Collected By
Collected Date
Collected Time
pH
Chlorine, Total Residual
A�er�
Stephanie Knott
336-996-2841
[e-mail]
Laboratory Report
Page 1 of 1
Report Date: 01/18/2021
Date Received: 12/31/2020
Lab ID: 92514405001 Collected: 12/31/20 11:30 Matrix: Water
Results Units
Report Limit Analyzed
PACE
12/31/20 11:30
Garrett
12/31/20 11:30
Dreyer
12/31120
12/31/20 11:30
11:30
12/31/20 11:30
7.91 Std. Units
12/31/20 11:30
0.25 mg/L
12/3112011:30
Qualifiers
Page 1 of 2

�'
CHAIN -OF -CUSTODY Analytical Request document
LAB USE ONLY -Affix Workorder/Login Label Here or List Pace Workorder Number or
:;�ceAna lytieal
MTJL Log -in Number Here
hrain-of-Cw:1orly is n Lf-GAJ X)COWNT- Cnlnpletr• ,IP m
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SHORT HOLDS PRESENT (<72 how s): Y N N/A
Lab Tracking 8: _ ....- _._....._.__.._ .. -
Shcuple received via:
rI:L1F.x UPS
Latent Courier Pace Courier
Catty/Time:
CJr17L LAB USE ONLY
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PB:
Lab Sample Temperature Info:
Temp Blank Received: Y N NA
Therm IDW _
Cooler 1 Temp Upon Receipt: �nC
Cooler 1 Therm Corr. Factor: _ oC
Cooler 1 Corrected Temp:
Cmmnlents:
y• slanb: ilwc diVL'd: Y 11 NA
IICL MorM TSP Other
Non Conformance(s): Page:
YES / NO of:

December 2020
Liberty N.C.W.W.T.F.
Freeboard Lagoon Inches
DATE
1
0
2
0
3
0
4
0
5
0
R
0.7
6
0
7
0
R
0.7
8
0
9
0
10
0
11
0
12
0
R
0.5
13
0
14
0
R
1.3
15
0
16
0
R
1.2
17
0
18
0
19
0
20
0
R
0.8
21
0
22
0
23
0
24
0
R
0.7
25
0
26
0
27
0
28
0
29
0
30
0
31
0
R
0.6
TOTAL 6.5

FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page_1_ ofi_2_
Permit No.: WQ0003090 Facility Name: Town of Liberty - Wastewater County: Randolph Month: December Year: 2020
Field Name- 1 4Annual
me: 2 Field Name: 3 Field Name: 4
Did irrigation occur
Area (acres): 19.56 res): 19.54 Area (acres): 18.98 Area (acres): 16.78
at this facility? Cover Crop; FESCUErop: FESCUE Cover Crop: FESCUE Cover Crop: FESCUE
0 YES ❑ NO Hourly Rate (in): 0.21 (in): 0.21 Hourly Rate (in): 0.21 Hourly Rate (in); 0.21
Annual Rate (in); 52 (in): 52 Annual Rate (in): 52 Annual Rate (In): 52
Weather Freeboard Field in (gated? [] YES [i NOted? YES ❑ NO Meld Irrigated? YES D'NO Field Irrigated? YES ❑ NO
o
'° E or a sA E rAE md �5 ° c o c m m
o `m E is E 3� o n E W �a Ewe o- �o s E o o �- _ �o 'v E ov
c E u N W a �a I`£ o$ �_� °a i=w oo c� ca �°° p seo a E� '°
OF: In ft ft gal min In j In gal I min In in gal min In in gal min In In
1
2 C 35 0 281,000 180 0.62 0.21
3 C 38 0 325,000 180 0.63 0.21
4
5 R 0.7
6
7 R 0.7
8 PC 35 0 325,000 180 0.63 0.21 281,000 180 0.62 0.21
9
10 C 1 33 0 1 327,000 180 0.62 0.21 321,000 180 0.61 1 0.20
11 PC 32 0 325,000 180 0.63 0.21 281,000 180 0.62 0.21
12 R 0.5
13
14 R 1.3
15
16 R 1.2
17
18 C 36 0 321,000 180 0.61 0.20
19 C 40 0 327,000 180 0.62 0.21
20 R 0.8
21
22 PC 38 0 327,000 180 0.62 0.21 321,000 180 0.61 0.20
23
24 R 0.7
25
26
27 C 40 0 325,000 180 0.63 0.21
28 C 34 0 281,000 180 0.62 0.21
29 PC 36 0 327,000 180 1 0.62 0.21 321,000 180 0.61 0.20
30 CL 45 0 325,000 1 180 0.63 0.21
31 R 0.6
Monthly Loading: LIL308,000 2.46 1,284,000 2.4241 1,625.000 3.15 1,924,000 2.47
12 Month Floating Total (In); 42.83 41.51 26.45 33.56

FORM: NDAR-1 10-13
NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Did the application rates exceed the limits in Attachment B of your permit?
I] Compliant ❑ Non -Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites?
Q Compliant ❑Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit?
Q Compliant ❑ Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site?
El Compliant ❑ Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
❑ Compliant El 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
THE LAGOON FREEBOARD IS NON COMPLIANT CAUSE OF RAINFALL AND I&I. of 6.5 Raifall
Operator in Responsible Charge (ORC) Certification
ORC: Elix Tremaine Fike
Certification No.: 989290
Grade: SI Phone Number: 336 622 2990
Has the ORC changed since the previous NDAR-17 ❑ yes 21 No
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
Permittee Certiflcatlon
Permittee. William Doerfer
Signing Official:
Signing Official's Title: Town Manager
Phone Number: 336 622 4276 Permit Exp.: 8/31/24
Signature Date
I certify, under penalty of law, that:: is 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 _2_ of_2_
Permit No.: W00003090 Facility Name: Town of Liberty - Wastewater county: Randolph Month: December Year: 2020
Field Name: 5 Field Name: 6 Field Name: 7 FAnnualRate
: 8
Did irrigation occur
Area (acres): 18.3 Area (acres): 15.1 Area (acres): 22.12: 21.68
at this facility? Cover Crop: FESCUE Cover Crop: FESCUE Cover Crop: FESCUE: FESCUE
0 YES ❑ NO Hourly Rate (in): 0.21 Hourly Rate (In): 0.21 Hourly Rate (in): 0.21 : 0.21
Annual Rate (in): 52 Annual Rate (in): 52 Annual Rate (in): 52 : 52
Weather Freeboard Field Irrigated? [ YES [,} NO Field Irrigated? YEs ❑ NO Field irrigated? ( YES NO Field Irrigated? YES NO
9 0 _m
C
4 �a E
co v cm EE �mEE OE 4
cJ s3° a'C '
W
°F In It ft gal min In In gal min in in gal min In in gal min In in
1
2 C 40 0 299,000 180 0.60 0.20
S C 42 0 252,000 180 0.61 0.20 370,000 180 0.62 0.21
4 C 39To
350,000 180 0.59 0.20
5 R 67 R8 C 44 299,000 180 0.60 0.20
9 C 37 0 252,000 180 0.61 0.20 350,000 180 0.59 0.20
10 C 41 0 370,000 180 0.62 0.21
11 C 38 0 299,000 180 1 0.60 0.20
12 R 0.5
13
14 R 1.3
15
16 R 1.2
17
18 C 37 0 350,000 180 0.59 0.20
19
20 R 0.8
21
22
23 C 48 0 299,000 180 0.60 0.20
24 R 0.7
25
26 C 1 37 0 252,000 180 0.61 0.20
27
2a C 57 0 370,000 180 0.62 0.21
29 C 1 53 0 350,000 180 0.59 0.20
301 C 1 35 0 299,000 180 0.60 0.20 252,000 180 0.61 1 0.20
311 R 0.6
Monthly Loading: 1,495.000 3.01 1,008,000 2.46 1,110,000 1 85 1,400,000 2.38
12 Month Floating Total (in): =33.61 41.46 42,gg 29 89

FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Did the application rates exceed the limits in Attachment B of your permit? El Compliant ❑ Non -Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites? 0 Compliant ❑ Non -compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit? O 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 El Non -Compliant
If the facility is non -compliant, please explain in the space below the reason(s) the facility was not in compliance. Provide in your explanation the date(s) of the non-compliance and describe the corrective
action(s) taken. Attach additional sheets if necessary.
THE LAGOON FREEBOARD IS NON COMPLIANT CAUSE OF RAINFALL AND I&l. Rai
of 6.5
Operator in Responsible Charge (ORC) Certification
ORC: Elix Tremaine Fike
Certification No.: 989290
Grade: SI Phone Number: 336 622 2990
Has the ORC changed since the previous NDAR-1? ❑ Yes 0 No
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Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
Permittee Certification
Permittee:
William Doerfer
Signing Official:
Signing Official's Title: Town Manager
Phone Number: 336 622 4276 Permit Exp.: 8/31 /24
nature Date
I certify, under penalty of law, that this cement 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