HomeMy WebLinkAboutWQ0007521_Monitoring - 11-2021_20210105FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page I of L
Permit No.:
Facility Name: tAqvftl F6olj
County: �f,\Jk,
Month-. Wovcm;(.
�Field Nam
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• irrigation occurat
Area (acres):
Area (acres):
Area (acresy
this facility?
Cover-Crop:..Crop.
..
5)/YES NO
Hourly Rate (in):
Hourly Rate (in):
Hourly Rate
Hourly Rate (in):
Annual Rate (in):
®�
Annual Rate (in):
Annual (in):
--Annual-
....
..
■� ■ .�Field
Irri..
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■ ■ •Field
Irrigated?■
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FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page Z of '2—
Did the application rates exceed the limits in Attachment B of your permit? [Compliant ❑ Non -Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites? LyCompliant ❑ Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit?
[Vompliant ❑ 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: J i� (�, LyhC�
Permittee: m0.X,q �001jfLLL
Certification No.: �� y� SZ
Signing Official: J „�� hI Lyr,CL,
Grade: ST Phone Number: "l 77 3 130
Signing Official's Title: C I
Has the ORC changed since the previous NDAR-1? ❑ Yes [t/'No
Phone Number: I 7 Y 3 130 Permit Exp.: I /JJ/ ZO2 3
) I Z 3d Zoe
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
FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page t of Z
Permit No.: WQ U Ua� y �1
Facility Name: I-oo !J � iv��tdc F
roc (� h/���►S f q�;�
County: h.L
Month: �✓U�_rK I C_
Year: tiv 2U
PPI:
Flow Measuring Point: El Influent ❑ Effluent ❑ No flow generated
Parameter Monitoring Point: ❑ Influent ❑ Effluent ❑ Groundwater Lowering ❑ Surface Water
Parameter Code —►
50050
a E
°
c
:L,
O
o
CL
PR N
24-hr
hrs
GPD
1
2
0
3
4
5
6
:OU
7
8
9
10
11
:�0
12
13
14
15
16
q;
t
17
18
19
20
21
22
23
24
�:ou
25
26
27
28
29
30
31
Average:
Daily Maximum:
Daily Minimum:
Sampling Type:
Monthly Avg. Limit:
Daily Limit:
Sample Frequency:
FORM: NDMR 03-12
Name: Nv, � GQr(rj
Name:
Sampling Person(s)
NON -DISCHARGE MONITORING REPORT (NDMR)
Name: NC V f l t C-S
Name:
Certified Laboratories
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit?
Page Z of 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: �.,,.t H. Llhc�
Permittee: Mkl/w-ckj I f (,6J)f LLB
Certification No.: 91 1 -7-5Z
Signing Official: Tj M0, L 7^ c�
Grade: S Phone Number: �� 3 (3 v
Signing Official's Title: F." ;,6 0%t" "ZI /Afvh�t yam —
Has the ORC changed since the previous NDMR? ❑ Yes U No
Phone Number: 4 Y 13 d Permit Expiration: �3 (�2 o L3
o'l �(- `-13, �z�
. � (Z vL2--
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
NPDES FORM IRR-2
Tract #
Field Size (acres) = (A)
Farm Owner
Owner's Address
Owner's Phone #
Field # 1
4.19
Maxwell Foods Inc.
P.O. Box 10009
Goldsboro, NC 27532
919-778-3130
Crop Type Small grain
/71 (21 (d1 (F1 (ri1
Lagoon Liquid Irrigation Fields Record
One Form for Each Field per Crop Cycle
Facility Number IWQ00075211-
Irrigation Operator Maxwell Foods Inc.
Irrigation Operator's P. O. Box 10009
Address Goldsboro, NC 27532
Operator's Phone # 919 778 3130
From Waste Utilization Plan
Recommended PAN 100
Loading (lb/acre) = (B)
(71 (8) (9) (101 (11)
Lagoon ID
Date
(mm/dd/yr)
Irrigation
Waste
Analysis
PAN
(lb/1000 gal)
PAN Applied
(lb/acre)
(8) x (9)
1000
Nitrogen
Balance
(lb/acre)
(B) - (10)
Weather
code*
Inspections
(Initials)**
Start
Time
End
Time
Total
Minutes
(3) - (2)
# of
Sprinklers
Operating
Flow
Rate
(gal/min)
Total Volume
(gallons)
(6) x (5) x (4)
Volume
per Acre
(gal/acre)
(7) / (A)
6= 100
Lagoon 2
10/07/20
12:30
13:30
60
32
12.8
24576
5865.39
0.5
2.93
97.07
c
t
Lagoon 2
10/14/20
13:00
14:00
60
32
12.8
24576
5865.39
0.5
2.93
94.13
c
t
Lagoon 2
10/21 /20
8:00
9:00
60
32
12.8
24576
5865.39
0.5
2.93
91.20
c
t
Lagoon 2
10/28/20
9:00
10:00
60
32
12.8
24576
5865.39
0.5
2.93
88.27
c
t
La oon 2
11 /06/20
8:00
9:00
60
32
12.8
24576
5865.39
0.5
2.93
85.34
p
ji
Lagoon 2
11 /11 /20
8:00
9:00
60
32
12.8
24576
5865.39
0.5
2.93
82.40
PC
ji
Lagoon 2
11 /24/20
8:00
9:00
60
32
12.8
24576
5865.39
0.5
2.93
79.47
PC
ji
Lagoon 2
11/30/20
8:00
9:00
60
32
12.8
24576
5865.39
0.5
2.93
76.54
PC
ji
crop cycle i otatsl -I ybbub I
Owner's Signature
Certified Operator (Print) Jim H Lynch
I L3.40
Operator's Signature
Operator's Certification No.
Weather Codes: C-Clear, PC -Partly Cloudy, CL-Cloudy, R-Rain, S-Snow/Sleet, W-Windy
** Persons completing the irrigation inspections must initial to signify that inspections were completed at least every 120 minutes.
991752
NPDES FORM IRR-2
Lagoon Liquid Irrigation Fields Record
One Form for Each Field per Crop Cycle
Tract #
Field Size (acres) = (A)
Farm Owner
Owner's Address
Owner's Phone #
Field # 1
4.19
Maxwell Foods Inc.
P.O. Box 10009
Goldsboro, NC 27532
919-778-3130
Facility Number IWQ00075211-
Irrigation Operator Maxwell Foods Inc.
Irrigation Operator's P. O. Box 10009
Address Goldsboro, NC 27532
Operator's Phone # 919 778 3130
From Waste Utilization Plan
Crop Type Small grain Recommended PAN 100
Loading (lb/acre) = (B)
(11 (2) (3) (4) (5) (6) (7) (8) (9) (10) 0 1)
Lagoon ID
Date
(mm/dd/yr)
Irrigation
Waste
Analysis
PAN
(lb/1000 gal)
PAN Applied
(lb/acre)
(8) x (9)
1000
Nitrogen
Balance
(lb/acre)
(B) - (10)
Weather
code`
Inspections
(Initials)"
Start
Time
End
Time
Total
Minutes
(3) - (2)
# of
Sprinklers
Operating
Flow
Rate
(gal/min)
Total Volume
(gallons)
(6) x (5) x (4)
Volume
per Acre
(gal/acre)
(7) / (A)
6=
Crop Cycle Totals) U 1
Owner's Signature
Certified Operator (Print) Jim H Lynch
I U.UU 1
Operator's Signature
Operator's Certification No.
Weather Codes: C-Clear, PC -Partly Cloudy, CL-Cloudy, R-Rain, S-Snow/Sleet, W-Windy
" Persons completing the irrigation inspections must initial to signify that inspections were completed at least every 120 minutes.
991752
NPDES FORM IRR-2
Tract #
Field Size (acres) = (A)
Farm Owner
Owner's Address
Owner's Phone #
Field # 2
6.62
Maxwell Foods Inc.
P.O. Box 10009
Goldsboro, NC 27532
919-778-3130
Lagoon Liquid Irrigation Fields Record
One Form for Each Field per Crop Cycle
Facility Number IWQ00075211-
Irrigation Operator Maxwell Foods Inc.
Irrigation Operator's P. O. Box 10009
Address Goldsboro, NC 27532
Operator's Phone # 919 778 3130
From Waste Utilization Plan
Crop Type Small grain Recommended PAN 100
Loading (lb/acre) = (B)
10N /,IN (AN tr1 1Rl t71 /Rl (S)l (1n1 (111
Lagoon ID
Date
(mm/dd/yr)
Irrigation
Waste
Analysis
PAN
(lb/1000 gal)
PAN Applied
(lb/acre)
(8) x (9)
1000
Nitrogen
Balance
(lb/acre)
(B) - 00)
Weather
code*
Inspections
(Initials)**
Start
Time
End
Time
Total
Minutes
(3) - (2)
# of
Sprinklers
Operating
Flow
Rate
(gal/min)
Total Volume
(gallons)
(6) x (5) x (4)
Volume
per Acre
(gal/acre)
(7) / (A)
B= 100
Lagoon 2
10/07/20
14:00
15:00
60
1 50
12.8
38400
5800.60
0.5
2.90
97.10
c
t
Lagoon 2
10/14/20
14:15
15:15
60
50
12.8
38400
5800.60
0.5
2.90
94.20
c
t
Lagoon 2
10/21 /20
930
1030
60
50
12.8
38400
5800.60
0.5
2.90
91.30
c
t
La oon 2
10/28/20
10:30
11:30
60
50
12.8
38400
5800.60
0.5
2.90
88.40
c
t
Lagoon 2
11 /06/20
9:15
1015
60
50
12.8
38400
5800.60
0.5
2.90
85.50
PC
ji
Lagoon 2
11/11/20
9:15
10:15
60
50
12.8
38400
5800.60
0.5
2.90
82.60
PC
jI
Lagoon 2
11 /24/20
9:15
10:15
60
50
12.8
38400
5800.60
0.5
2.90
79.70
PC
ji
Lagoon 2
11/30/20
9:15
10:15
60
50
12.8
38400
5800.60
0.5
2.90
76.80
PC
ji
crop cycle Iotalsl 6u/zuu
Owner's Signature
Certified Operator (Print) Jim H Lynch
zo.LU
Operator's Signature
Operator's Certification No.
* Weather Codes: C-Clear, PC -Partly Cloudy, CL-Cloudy, R-Rain, S-Snow/Sleet, W-Windy
** Persons completing the irrigation inspections must initial to signify that inspections were completed at least every 120 minutes.
991752
NPDES FORM IRR-2
Lagoon Liquid Irrigation Fields Record
One Form for Each Field per Crop Cycle
Tract #
Field Size (acres) = (A)
Farm Owner
Owner's Address
Owner's Phone #
Field # 2
6.62
Maxwell Foods Inc.
P.O. Box 10009
Goldsboro, NC 27532
919-778-3130
Crop Type Small grain
(1) (2) (3) (4) (5) (6)
Facility Number W00007521 -
Irrigation Operator Maxwell Foods Inc.
Irrigation Operator's P. O. Box 10009
Address Goldsboro, NC 27532
Operator's Phone # 919 778 3130
From Waste Utilization Plan
Recommended PAN 100
Loading (lb/acre) = (B)
(7) (8) (9) (10) 0 1)
Lagoon ID
Date
(mm/dd/yr)
Irrigation
Waste
Analysis
PAN
(lb/1000 gal)
PAN Applied
(lb/acre)
8( ) x (9)
1000
Nitrogen
Balance
(lb/acre)
(B) - (10)
Weather
code*
Inspections
(Initials)**
Start
Time
End
Time
Total
Minutes
(3) - (2)
# of
Sprinklers
Operating
Flow
Rate
(gal/min)
Total Volume
(gallons)
(6) x (5) x (4)
Volume
per Acre
(gal/acre)
(7) / (A)
B=
Crop Cycle Totals] U
Owner's Signature
Certified Operator (Print) Jim H Lynch
�,M
Operator's Signature
Operator's Certification No.
* Weather Codes: C-Clear, PC -Partly Cloudy, CL-Cloudy, R-Rain, S-Snow/Sleet, W-Windy
** Persons completing the irrigation inspections must initial to signify that inspections were completed at least every 120 minutes.
991752