WQ0007283_Monitoring - 12-2020_20210203

RM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page 1 of 1
Permit No.: WQ0007283
Facility Name: TOWN of POLLOCKSVILLE
County: Jones
Month: December
Year: 2020
PPI: 002
Flow Measuring Point: Influent ❑ Effluent ❑ No Flow generated
Parameter Monitoring Point: I1 influent ❑ Effluent ❑ Groundwater Lowering Surface water
Parameter Code ->
50050
00310 11
00665
31616
00610
00620
00400
70300
00530
00931
00916
00625
00927
50060
d
r F
f0
y A
Q`
O
a
r
O N
` C
d O
O. d
O E
P
.d
VI
O
U
O
C
LL
O
m
N
C
O N
F-- O
s
a.
E
0
y "-
LL O
U
O
E
E
Q
GI
10
.+
Z
2
O.
O N
.R+
O N O
H y rn
p
'a
'O N
w C 'O
O O. O
f-- N fn
C
E 2
3 G V
O
Q
E
« .3
O V
F U
L
N
Y
E_
C
O C
~
C
y
O N
~ U 0'
E
3
O
co
24-hr
hrs
*YIN/BIH
GPD
mg/L
#N/A
1 #/100 mL
mg/L
mg/L
su
mg/L
mg/L
mg/L
#N/A
mg/L
mg/L
mg/L
ug/L
1
09:45
3.0
Y
64,000
2
9:15
4.0
Y
69,000
20
3.56
17000
21.5
<0 04
26
1.60
92201
22.94
129006
63162
3
10:10
3.5
Y
54,000
4
11:50
3.0
Y
59,000
5
09:20
2.5
Y
52,000
6
1 09:10
2.0
Y
85.000
7
09:30
3.0
Y
53,000
8
09:50
3.5
Y
63,000
9
09:45
3.0
Y
62,000
10
09:00
3.0
Y
77,000
11
09:15
2.5
Y
76,000
12
10:00
3.0
Y
52,000
13
10:30
1.0
Y
26,000
14
09:45
4.0
Y
23,000
15
08:45
3.0
Y
39,000
16
10:10
4.0
Y
41,000
17
09:30
3.0
Y
39,000
181
10:00
3.0
Y
36,000
19
10:30
3.0
Y
33,000
20
10:15
1.0
Y
32,000
21
09:10
2.0
Y
34,000
22
09:15
3.5
Y
40,000
23
11:00
2.0
Y
35,000
24
10:30
6.0
Y
35,000
25
08:30
4.0
Y
20,000
26
08:00
8.0
Y
41,000
27
10:50
2.0
Y
34,000
28
13:00
3.0
Y
124,000
291
09:44
3.0
Y
51,000
301
09:00
5.0
Y
72,000
311
09:30
0:00
Y
58,000
Average:
50,935
22
0.81
<1
0.29
<0.04
33
2.00
58618
22.94
129006
0.0
60730
Daily Maximum:
124,000
22
0.81
<1
0.29
<0.04
33.0
2.00
58618
22.94
129006
0.0
60730
Daily Minimum:
20,000
22
0.81
1 <1
0.29
<0.04
33.0
2,00
58618
22.94
129006
0.0
60730
Sampling Type:
Recorder
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Monthly Avg. Limit:
102,000
Daily Limit:
N/A
Sample Frequency:1
Continuous I
IMar,JuLNov
per Event
�Y!ES (N)O. iB)ACK UP ORC, (H)OLIDAY

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page 1 of 1
Permit No.: WQ0007283
Facility Name: TOWN of POLLOCKSVILLE
County: Jones
Month: December
Year: 2020
PPI: 002
Flow Measuring Point: 0 Influent J Effluent L l No Flow generated
Parameter Monitoring Point: ❑ Influent n Effluent ❑ Groundwater Lowering U Surface Water
Parameter Code -
50050
00940
1 00363
00353
00600
p
m
o f
R~
y -Fa
°`
O
Q
m
o
N C
O E
m
N
C
O
O
3
LL
72
o
r
U
m z
w R
z C V
y m
L p v
z z
z
N M
_ C
�_
z o
z
&
_ E_
R U
o a m
o
z
24-hr
hrs
'Y/N/BIH
GPD
#N/A
mg/1
mg/I
mgll
1
0945
3.0
Y
64,000
2
915
4.0
Y
69,000
0.05
0,05
22.99
3
10:10
3.5
Y
54,000
4
11:50
3.0
Y
59,000
5
09:20
2.5
Y
52,000
6
09:10
2.0
Y
85,000
7
09:30
1 3.0
Y
53,000
8
09:50
3.5
Y
63,000
9
09:45
3.0
Y
62,000
10
09:00
3.0
Y
77,000
11
09:15
2.5
Y
76,000
12
10:00
3.0
Y
52,000
13
10:30
1.0
Y
26,000
14
09:45
4.0
Y
23,000
15
0845
3.0
Y
39,000
16
10:10
4.0
1 Y
41,000
17
09:30
3.0
Y
39,000
18
10:00
3.0
Y
36,000
19
10:30
3.0
Y
33,000
20
10:15
1.0
Y
32,000
21
09:10
2.0
Y
34,000
22
09:15
3.5
Y
40.000
23
11:00
2.0
Y
35,000
241
10:30
6.0
Y
35,000
25
08:30
4.0
Y
20,000
26
0800
8.0
Y
41,000
27
10:50
2.0
Y
34,000
28
1100
3.0
Y
124,000
29
09:44
3.0
Y
51,000
30
09:00
5.0
Y
72,000
311
09:30 1
0:00
Y
58,000
Average:
50,935
22
0.81
<1
0.29
<0.04
33
2.00
58618
0.0
60730
Daily Maximum:
124.000
22
0.81
<1
0.29
<0.04
33.0
2.00
58618
0.0
60730
Daily Minimum:
20,000
22
0.81
<1
0.29
<0.04
33.0
2.00
58618
0.0
60730
Sampling Type:
Recorder
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Monthly Avg. Limit:
102,000
Daily Limit:
N/A
Sample Frequency:
Continuous
imar,Jul,Novl
Iper
Event
`.Y)ES (NCO. �.BtACK UP ORC (H!OLIDAY

FORM: NDMR 03-12
NON -DISCHARGE MONITORING REPORT (NDMR)
Sampling Person(s) Certified Laboratories
Name: Operator on Duty Name: Environment 1
Name: Johnnie J. Chadwick/ORC 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
taken. Anacn aaaltlonal sneers Il
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: JOHNNIE J. CHADWICK
Permittee: Town of Pollocksville
Certification No.: SS-11861 /WW2-9579
Signing Official: James Bender Jr.
Grade: SS/WW-2 Phone Number: 252-617-1692
Signing Official's Title: Mayor
Has the ORC changed since the previous NDMR? ❑ Yes o No
Phone mber 252-224-9831 Permit Expiration: JULY 31,2021
1/25/2021
Signature Date
Signature Date
By thi 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

FORM. NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Permit No.: WQ0007283
Facility Name: TOWN of POLLOCKSVILLE
County: Jones
Month: December
Year: 2020
Field Name:
ONE
Field Name:
TWO
Field Name:
THREE
Field Name:
FOUR
Did irrigation occur
Area (acres):
3.5
Area (acres):
3.5
Area (acres):
4
Area (acres):
4
at this facility?
Cover Crop:Bermuda/Rye
Y e
Cover Crop:
P�
Bermuda/Rye e
Y
Cover Crop:
p:
Bermuda/Rye e
Y
Cover Crop:
p�
Bermuda/Rye
Y e
❑ YES NO
Hourly Rate (in):
0.7
Hourly Rate (in):
0.7
Hourly Rate (in):
0.7
Hourly Rate (in):
0.7
Annual Rate (in):
92.56
Annual Rate (in):
92.56
Annual Rate (in):
92.56
Annual Rate (in):
92.56
Weather
Freeboard
Field Irrigated?
YES NO
Field Irrigated?
r_ YES NO
Field Irrigated?
; YES NO
Field Irrigated?
❑ YES NO
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°F
in
ft
ft
gal
min
in
in
gal
min
in
in
gal
min
in
in
gal
min
in
in
1
PC
46
0.0
2.8
2
C
38
0.0
2.8
3
CL
46
0.0
2.8
4
PC
57
0.0
2.8
5
R
54
0.2
2.8
6
C 1
39
0.0
2.8
7
R
46
0.1
2.8
8
C
37
0.0
2.8
9
CL
36
0.0
2.9
10
C
39
0.0
2.9
11
CL
52
0.0
2.9
121
CL
1 52
0.0
1 2.9
13
R
64
1.0
2.9
14
PC
63
0.0
2.8
15
R
34
0.4
2.8
16
R
48
0.2
2.8
17
CL
41
0.0
2.8
18
C
43
0.0
2.8
19
C
41
0.0
2.8
20
R
45
0.2
2.8
21
R
46
0.8
27
22
C
45
0.0
2.7
23
C
52
0.0
2 7
241
CL
48
0.0
2.7
25
R
39
0.5
2.7
26
C
36
0.0
2.7
27
C
45
0.0
2.7
28
C
52
0.0
2.7
29
C
48
0.0
2.8
30
C
36
0.0
2.8
311
CL
1 68
0.0
2.8
12 Month Floatin Total in :
9 ( )
33.61
/ �! ' /
%/i//%
28.12
e
21.74
13.30

FORM: NDAR-1 08-11
NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Did the application rates exceed the limits in Attachment B of your permit?
O Compliant ❑ Non -Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites? 9 Compliant ❑ 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? 0 Compliant ❑ Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? [D 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.
IOperator in Responsible Charge (ORC) Certification ( Permittee Certification I
I ORC: JOHNNIE J. CHADWICK
Certification No.: SS-11861/WW2-9579
Grade: SS/WW2 Phone Number: [phone]
Permittee: Town of Pollocksville
Signing Official: James Bender Jr.
Signing Official's Title: Mayor
Has the ORC changed since the previous NDAR-1? ❑ Yes o No 11 Phoe Nurl [phone] Permit Exp.: JULY 31,2021
• ' 1 /25/21
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
Y 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
Raleigh, North Carolina 27699-1617

FORM: NDAR-1 08-11
NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Permit No.: WQ0007283
Facility Name: TOWN of POLLOCKSVILLE
County: Jones
Month: December
Year: 2020
Did irrigation
Field Name:
FIVE
Field Name:
six
Field Name:
Field Name:
occur
Area (acres):
4
Area (acres):
4.2
Area (acres):
-
Area (acres):
at this facility?
Cover Crop:Bermuda/Rye
Cover Crop:
P�
Bermuda/Rye
Cover Crop:
P�
Cover Crop:
P:
❑ YES ❑ NO
Hourly Rate (in):
0.7
Hourly Rate (in):
0.7
Hourly Rate (in):
Hourly Rate (in):
Annual Rate (in):
92.56
Annual Rate (in):
92.56
Annual Rate (in):
Annual Rate (in):
Weather
Freeboard
Field Irrigated?
❑ YES (] No
Field Irrigated?
❑ YES NO
Field Irrigated?
❑ YES NO
Field Irrigated?
❑ YES ❑ NO
13
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°F
in
ft
ft
gal
min
in
in
gal
min
in
in
gal
I min
in
I in
gal
I min
I in
in
1
PC
46
0.0
2.8
2
1 C
38
0.0
2.8
3
CL
46
0.0
2.8
4
PC
57
0.0
2.8
5
R
54
0.2
2.8
6
C
39
0.0
2.8
7
R
46
0.1
2.8
8
1 C
37
0.0
2.8
9
CL
36
0.0
2.9
10
C
39
0.0
2.9
11
CL
52
0.0
2.9
12
CL
52
1 0.0
2.9
13
R
64
1.0
2.9
141
PC
63
0.0
2.8
15
R
34
0.4
2.8
16
R
48
0.2
2.8
17
CL
41
0.0
2.8
18
C
43
1 0.0
2.8
19
C
41
0.0
2.8
201
R
45
0.2
2.8
21
R
46
0.8
2.7
22
C
45
0.0
2.7
23
C
52
0.0
2.7
24
CL
48 1
0.0
2.7
25
R
39
0.5
2.7
261
C
36
0.0
2.7
27
C
45
0.0
2.7
28
C
52
0.0
2.7
29
C
48
0.0
2.8
30
C
1 36
0.0
2.8
31
CL
1 68
0.0
2.8
Monthly Loading:
12 Month Floating Total (in):
0
0.00
35.42�'"
%%i%
/,/j
0.00
3470
0.00
0.00
°°„
p
0
.
,,,, ,,,
0.00
0.00

FORM: NDAR-1 08-11
NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Did the application rates exceed the limits in Attachment B of your permit?
Q Compliant
❑ Non -Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites?
O 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?
Q Compliant
❑ Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
D 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: JOHNNIE J. CHADWICK Permittee:
Town of Pollocksville
Certification No.: SS-11861/WW2-9579 Signing Official: James Bender Jr.
Grade: SS/WW2 Phone Number: [phone] Signing Official's Title: Mayor
Has the ORC changed since the previous NDAR-1? ❑ Yes 2 No PhgKe Num r: [phone] Permit Exp.: JULY 31,2021
• ' 1 /25/21
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
kSignature ' 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
Raleigh, North Carolina 27699-1617

Efid'UnflEM Flo hwPuMd
114 OAKMONT DRIVE,
GREENVILLE, N.C. 27858
TOWN OF POLLOCKSVILLE (EFFLUENT)
ATTN: JAMES BENDER, JR.
P.O. BOX 97
POLLOCKSVILLE ,NC 28573
PARAMETERS
BOD, mg/1
Fecal Coliform (MF), /100 Mls
Total Suspended Residue, mg/l
. Ammonia Nitrogen as N, mg/l
Total Kjeldahl Nitrogen as N,mg/l
Nitrate -Nitrite as N, mg/l (calc)
Nitrate Nitrogen as N, mg/l
• Nitrite Nitrogen as N, mg/1
Total Phosphorus as P, mg/I
• Calcium, ug/1
• Magnesium, ug/l
• Sodium, ug/I
Sodium Adsorption Ratio (calc)
• Total Nitrogen, mg/l (calc)
��j•� ID#: 319
Effluent Analysis Method
Date Analyst Code
20
12/02/20
TMR
521OB-11
17000
12/02/20
HJO
9222D-06
26
12/03/20
HJO
2540D-11
21.50
12/03/20
KES
350.1 R2-93
22.94
12/09/20
TLH
351.2 R2-93
0.05
353.2 112-93
<0.04
12/03/20
DTL
353.2 R2-93
0.05
12/02/20
DTL
353.2 R2-93
3.56
12/10/20
DTL
365.4-74
92201
12/10/20
LFJ
EPA200.7
12906
12/10/20
LFJ
EPA200.7
63162
12/10/20
LFJ
EPA200.7
1.6
22.99
waeaewarer•_iv: ru
PHONE [phone]
FAX [phone]
DATE COLLECTED: 12/02/20
DATE REPORTED : 12/21/20
REVIEWED BY:

Environment 1, Inc. CHAIN OF CUSTODY RECORD
P.O_ Box 7085, 114 Oakmont Dr. Pa I of I
Greenville, NC 27858 Page —
eavironmentlinc.com
DISI CTION
Phone [phone] • Fax [phone]
CHLORINE NEUTRALIZED AT COLLECTION
CHLQRINE
LZ
pH CHECK (LAB)
CLIENT: 319 Week:1
UV
P
P
P
P
P
P
P
P
P
P
CONTAINER TYPE, PIG
DVVII OF POLLOCKSVILLE (EFFLUENT)
NONE
rTN: JAMES BENDER, JR.
A
G
A
C
C
C
A
A
C
A
A
CHEMICAL PRESERVATION
O. BOX 97
DLLOCKSVILLE NC 28573
❑
A -NONE D-NAOH
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52) 224-9831
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x Jo
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=r
C HF ZINC ACETATElNAOH
w I4
COLLECTION
Cn
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z
xy
E
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a
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G NATHIOSULFATE�
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SAMPLE LOCATION
DATE
TIME
Effluent
D
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I
6
JIM..
...
.....
....
CLASSIFICATION:
WASTEWATER(NPDES)
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DRINKING WATER
DWR/GW
SOLID WASTE SECTION
CHAIN OF CUSTODY (SEAL) MAINTAINED
DURIN IPMENT/DELIVERY
Y N
SAMPLES COLLECTED BY:
(PIP ' 1�
:tt
SAMPLES RECEIVED IN LAB AT _°C
ISHED Y (S ) (SAMPLER)
DATE/TIME
R IVED BY (SIG.)
DATE/TIME
COMMENTS:
I
2?-z
-
1 2 , a
ELINQUISHED BY (SIG.)
DATE/TIME
RECEIVED BY (SIG.)
DATEITIME
RELINQUISHED BY (SIG.)
DATE/TIME
RECEIVED �Y (SIG.)
DATUIME
PLEASE READ Instructions for completing this form on the reverse side. Sampler must place a "C" for composite sample or a "G for
FORM #5 Grab samDle in the hlorks nhnva fnr aarh narnmotor rornioctori pi ,i G n _ryAIf;