WQ0022785_Monitoring - 07-2021_20210905

DWR - NonDischarge Monitoring Report Submittal
NORTH CAROLINA
Ertrlranmrrttat Quaffty
Monitoring Report Submittal
Permit Number #*
Name of Facility:*
Month:* July
Report Information
Type*
WQ0022785
Lattisville Grove Church
NDMR, NDAR-1, NDAR-2, NDMLR
Confirmation Email Address:*
Name of Submitter:*
Signature:
Year:* 2021
Upload Document*
LMBC_ND_ 2107 .pdf
ME oily
253.23KB
Please upload one PDF containing all applicable monitoring reports
[e-mail]
Lattisville Grove Church
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
Date of submittal: 9/5/2021
This will be filled in autonatically
Initial Review
Reviewer: Giri, Poonam a

Is the project number correct?* WQ0022785
Is the monitoring report
accepted? *
Regional Office*
Yes r No
Raleigh
Accepted Date: 9/9/2021

NON DISCHARGE WASTEWATER MONITORING REPORT
Page of
PERMIT NUMBER:
FACILITY NAME:
WQ0022785
Lattisville Grove Baptist Church
MONTH: July
COUNTY:
YEAR: 2021
Orange
Flow Monitoring Point: Effluent: U Influent: a , , , , , , , , , , , , , , , , , , , , , , , , , , , ,
Parameter Monitoring Point: Effluent: 0 Influent: ❑ Surface Water (SW):
SW Code/Name:
Was There Effluent Flow For This Month Generated At This Facility: Yes: 0 No:
: : : : : : : : : : : : : : : : : : : ,
D
A
T
E
Operator
Arrival
Time 2400
Clock
Operator
Time On
Site
ORC
on
Site?
50050
00400
50060
00310
00610
00530
31616
00625
00630
00665
000620
00600
Daily Rate (Flow)
into Treatment
System
pH
Residual
Chlorine
BOD-5
20°C
NH3-N
TSS
Fecal
Coliform (Geo
metric Mean")
TKN
Nitrate +
Nitrite
Total
Phosph
orus
Total
Nitrate
as (N)
Total
Nitrogen
(as N)
HRS
Y/N
GALLONS
UNITS
UG/L
MG/L
MG/L
MG/L
/100ML
MG/L
MG/L
MG/L
MG/L
MG/L
1
13:35
0.27
N
129
6.77
0.37
2
129
3
129
4
129
5
129
6
129
7
129
8
13:30
0.25
N
129
6.4
0.3
9
157
10
157
11
157
12
157
13
157
14
157
15
17;10
0.33
N
157
6.57
0.22
16
200
17
200
18
200
19
200
20
200
21
17:00
0.33
Y
200
6.81
0.33
22
88
23
88
24
88
25
88
26
88
27
88
28
88
29
12:00
0.33
N
88
6.71
0.35
30
143
31
143
Average
139.3871
; :; :; :; :'
0.314
#DIV/0!
#DIV/0!
#DIV/0!
#NUM!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
Daily Maximum
200
6.81
0.37
0
0
0
0
0
0
0
0
0
Daily Minimum
88
6.4
0.22
0
0
0
0
0
0
0
0
0
Monthly Limit(s)
956 GPD
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
Composite (C) / Grab (G)
G
G
G
G
G
G
G
G
G
G
G
Operator in Responsible Charge (ORC):
Check Box if ORC Has Changed:
Certified Laboratories (1):
Person(s) Collecting Samples:
Chad Leinbach
Grade: SI Phone: [phone]
ORC Certification Number:
23928
Conner Consulting, LLC (Field) (2): ENCO, Inc. (Lab)
Chad Leinbach
Mail ORIGINAL and TWO COPIES to:
ATTN: Non -Discharge Compliance Unit
DENR
Division of Water Quality
1617 Mail Service Center
RALEIGH, NC 27699-1617
(SIGNATURE OF OPERATOR IN RESPONSIBLE CHARGE)
BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS ACCURATE
AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
DENR FORM NDMR-1 (5/2003)

NON DISCHARGE WASTEWATER MONITORING REPORT
Page of
Facility Status:
Please answer the following question:
1. Does all monitoring data and sampling frequencies meet permit requirements?
Compliant (Y,N)
If the facility is non -compliant, please explain in the space below the reason(s) the facility was not in compliance
with its permit. Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s)
taken. Attach additional sheets if necessary.
"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."
C'iacG.Cez;z6ac.4
(Signature of Permittee)*
8/30/21
Date
Lattisville Grove Baptist Church
(Permittee-Please print or type)
1701 Jimmy Ed Road
Hurdle Mills, NC 27541
(Permittee Address)
Parameter Codes:
Chad Leinbach
(Name of Signing Official -Please print or type)
ORC
(Position or Title)
[phone] 10/31/23
(Phone Number) (Permit Exp. Date)
01002 Arsenic
31504 Coliform, Total
00600 Nitrogen, Total
00929 Sodium
01022 Boron
00094 Conductivity
00630 NO2&NO3
00931 SAR
00310 BOD5
01042 Copper
00620 NO3
00745 Sulfide
01027 Cadmium
00300 Dissolved Oxygen
00556 Oil -Grease
70295 TDS
00916 Calcium
31616 Fecal Coliform
WQ09 PAN (Plant Available)
00010 Temperature
00940 Chloride
01051 Lead
00400 pH
00625 TKN
50060 Chlorine, Total
Residual
00927 Magnesium
32730 Phenols
00680 TOC
71900 Mercury
00665 Phosphorus, Total
00530 TSS/TSR
01034 Chromium
00610 NH3asN
00937 Potassium
00076 Turbidity
00340 COD
01067 Nickel
00545 Settleable Matter
01092 Zinc
Parameter Code assistance may be obtained by calling the Water Quality Compliance/Enforcement Unit at [phone] ext. 529.
The monthly average for Fecal Coliform is to be reported as a GEOMETRIC mean. Use only the units designated in the reporting facility's
permit for reporting data.
* If signed by other than the permittee, delegation of signatory authority must be on file with the state per 15A NCAC 2B.0506 (b)(2)(D).
DENR FORM NDMR-1 (5/2003)

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDITIONAL PAGES AS NEEDED.
Page of
PERMIT NUMBER:
FACILITY NAME:
Daily Loading (inches) =
WQ0022785
Lattisville Grove Baptist Church
Maximum Hourly Loading (inches) =
12 Month Floating Total (inches) =
Average Weekly Loading (inches) =
MONTH: July
COUNTY:
YEAR: 2021
Orange
Formulas:
[Volume Applied (gallons) x 0.1336 (cubic feet/gallon) x 12 (inches/foot)] / [Area Sprayed (acres) x 43,560 (square feet/acre)] OR
Volume Applied (gallons) / [Area Sprayed (acres) x 27,152 (gallons/acre-inch)]
Daily Loading (inches) / [Time Irrigated (minutes) / 60 (minutes/hour)]
Sum of this month's Monthly Loading (inches) and previous 11 month's Monthly Loadings (inches)
[Monthly Loading (inches/month) / Number of days in the month (days/month)] x 7 (days/week)
Monthly Loading (inches) = Sum of Daily Loadings (inches)
Did Irrigation Occur At This Facility:
Yes: 2 No: IE
Did Irrigation Occur On This Field:
Yes:
Did Irrigation Occur On This Field:
Yes: No:
No:
0
. . . . . . . . . . . . . . . . . .
.• .• .• .• .• .• .• .• .• .• .• .• .• .
FIELD NUMBER:
1
FIELD NUMBER:
AREA SPRAYED (acres):
1.04
AREA SPRAYED (acres):
COVER CROP:
Fescue, Rye
COVER CROP:
PERMITTED HOURLY RATE (inches):
0.2
PERMITTED HOURLY RATE (inches):
D
A
T
E
WEATHER CONDITIONS
storage
Lagoon
Free -board
PERMITTED YEARLY RATE (inches):
23.75
PERMITTED YEARLY RATE (inches):
Weather
Code"
Temper-ature
at application
Precipita-tion
Volume
Applied
Time
Irrigated
Daily
Loading
Maximum
Hourly
Loading
Volume
Applied
Time
Irrigated
Daily
Loading
Maximum
Hourly
Loading
(°F)
inches
feet
gallons
minutes
inches
inches
gallons
minutes
inches
inches
1
C
92
0
NA
0
0
0.00
#DIV/0!
2
NA
0
0
0.00
#DIV/0!
3
NA
0
0
0.00
#DIV/0!
4
NA
0
0
0.00
#DIV/0!
5
NA
0
0
0.00
#DIV/0!
6
NA
0
0
0.00
#DIV/0!
7
NA
0
0
0.00
#DIV/0!
8
R
80
1.63
NA
0
0
0.00
#DIV/0!
9
NA
0
0
0.00
#DIV/0!
10
NA
0
0
0.00
#DIV/0!
11
NA
0
0
0.00
#DIV/0!
12
NA
0
0
0.00
#DIV/0!
13
NA
0
0
0.00
#DIV/0!
14
NA
0
0
0.00
#DIV/0!
15
C
88
0.87
NA
0
0
0.00
#DIV/0!
16
NA
0
0
0.00
#DIV/0!
17
NA
0
0
0.00
#DIV/0!
18
NA
0
0
0.00
#DIV/0!
19
NA
0
0
0.00
#DIV/0!
20
NA
0
0
0.00
#DIV/0!
21
C
88
2.25
NA
0
0
0.00
#DIV/0!
22
NA
0
0
0.00
#DIV/0!
23
NA
0
0
0.00
#DIV/0!
24
NA
0
0
0.00
#DIV/0!
25
NA
0
0
0.00
#DIV/0!
26
NA
0
0
0.00
#DIV/0!
27
NA
0
0
0.00
#DIV/0!
28
NA
0
0
0.00
#DIV/0!
29
C
80
0
NA
0
0
0.00
#DIV/0!
30
NA
0
0
0.00
#DIV/0!
31
NA
0
0
0.00
#DIV/0!
Total Gallons/Monthly Loading (inches)
0
0.00
0
0.00
,
12 Month Floating Total (inches)
;
4.52
Average Weekly Loading (inches)
:
0
0
,
* Weather Codes: C-clear, PC -partly cloudy, CI -cloudy, R-rain, Sn-snow, SI-sleet
Spray Irrigation Operator in Responsible Charge (ORC):
ORC Certification Number:
Chad Leinbach
23928 Check Box if ORC Has Changed:
Mail ORIGINAL and TWO COPIES to:
ATTN: Non -Discharge Compliance Unit
DENR
Division of Water Quality
1617 Mail Service Center
RALEIGH, NC 27699-1617
Phone: [phone]
(SIGNATURE OF OPERATOR IN RESPONSIBLE CHARGE)
BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS ACCURATE AND COMPLETE
TO THE BEST OF MY KNOWLEDGE.
DENR FORM NDAR-1 (5/2003)

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
Page of
Facility Status:
Please indicate ( by inserting Y(es) or N(o) in the appropriate box ) whether the facility has been compliant
with the following permit requirements: (Note: if a requirement does not apply to your facility put (NA) in the
compliant box. )
1. The application rate(s) did not exceed the limit(s) specified in the permit.
2. Adequate measures were taken to prevent wastewater runoff from the site(s).
3. A suitable vegetative cover was maintained on the site(s) in accordance with the permit.
4. All buffer zones as specified in the permit were maintained during each application.
5. The freeboard in the treatment and/or storage lagoon(s) was not less than the limit(s)
specified in the permit.
Compliant (Y,N)
Y
NA
If the facility is non -compliant, please explain in the space below the reason(s) the facility was not in compliance with its
permit. Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s) taken. Attach
additional sheets if necessary.
This system is getting infiltration during rain events. Chad - ORC
"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."
Ci^t-di
(Signature of Permittee)*
Lattisville Grove Baptist Church
8/30/21
Date
Chad Leinbach
(Name of Signing Official -Please print or type)
ORC
(Permittee-Please print or type) (Position or Title)
1701 Jimmy Ed Road
Hurdle Mills, NC 27541
(Permittee Address)
[phone] 10/31/23
(Phone Number) (Permit Exp. Date)
* If signed by other than the permittee, delegation of signatory authority must be on file with the state per 15A NCAC 2B.0506 (b)(2)(D).
DENR FORM NDAR-1 (5/2003)