WQ0004972_Monitoring - 11-2021_20211229

Monitoring Report Submittal
Permit Number #*
Name of Facility:*
Month: * November
Report Information
WQ0004972
Forest Lakes Preserve ELS
Type *
NDMR, NDAR-1, NDAR-2, NDMLR
Confirmation Email Address:*
Name of Submitter: *
Signature:
Date of submittal:
Initial Review
Year:* 2021
Upload Document*
Forest Lakes_November.pdf 1.31MB
PDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
[e-mail]
Jessica Mize
jemdf & lip
Reviewer: Zhong, Vivien
12/29/2021
This will be filled in automatically

Is the project number correct?* WQ0004972
Is the monitoring report accepted?* Yes No
Regional Office* Winston-Salem
Accepted Date:
1 /21 /2022

Page 1 of 2
NON -DISCHARGE WASTE WATER MONITORING REPORT
PER,VIIT NUMBER: W00004972 MONTH: November YEAR: 2021
FACILITY NAME: Forest Lakes Preserve ELS COUNTY: Davie
Flow Monitoring Point: Effluent: W Influent:
Parameter Monitoring Point: Effluent: Influent: U Surface Water SW): SW Code/Name: Lj
Was There Effluent Flow for this Month Generated At This Facility: Yes: W No:
D
A
T
L
Operator
Amval
Time
2400
Clock
Operator
Time on
Site
ORC
on
Site?
50050
00400
50060
0031D
00610
00530
31616
00665
D0625
00630
00600
0a620
70300
00940
Daily Rate
(Flow) Into
Treatment
System
pH
Itesidual
Chlorin
BOD-5
2011C
NH-3-N
TSS
Focal
Colirorrn
tGeo-tneinc
Mont
Total
Phos
Total
lyelaml
Nitrogen
NO2*NO3
Tonal
Nit[vgm
Nitrate
NO3-N
Total
Dissolved
Solids
chk idc
HRS
Y/N
GPD
LNITS
myL
%[GL
%$G,L
hIG,L
11 MML
NIG,L
hIG,L
MUL
%16,1L
tIG,L
MU
M(I 1.
Cdl[Ingali
cek
-allily
onl y
nnIq
nl y
qnl y
qn[ t
ntthlt
qnt, y
1
1415
1 0.25
Y
8,000
6.4
<0.01
1219
[7.25
V
8.000
6.5
<0dil
3
1535
0.25
V
8,000
6.4
<0.01
4
1455
0.25
Y
8.000
6.3
<0.01
s
1205
0.25
Y
8,0()0
6.1
<0.01
6
8.000
7
8,000
P
1 1335
1 0,25
Y
8.000
6.0
<0d11
9
1200
0.25
Y
8.000
6.2
<0.111
10
0940
0.25
Y
8,0011
6.2
<0.111
I t
0945
0.25
Y
8,000
6A
<0.01
12
1235
0.25
Y
8.001)
6.0
<0.01
13
8,000
14
8,000
1s
1 1455
1 0.25
Y
8,000
6.0
<0.01
[6
1005
0.25
Y
8.000
5.9
<0.01
17
1505
0.25
y
8,004)
5.9
<0.01
Is
0745
0.25
Y
8.001)
5.9
<0.01
32.2
69.4
18.2
2.120
7.3
98.4
<0•1140
88.4
0.041
2141
54.8
19
1405
0.25
V
8,000
6.0
<0.01
z0
8,000
z1
8,000
22 1
0815
0.25
It
8,001)
6.1
1 <0.01
231
0923
0,25
Y
8.000
6.0
<0.01
24
1200
11.25
}'
8.0011
6.0
<0.01
Is8.000
Holiday ----------------------------------- ---------------- ------ ----------------------__--___..._.
74
8.0U0
IIoliday --- --------------------------- ------ ------ -------------- ----------------- -------- ---- ------------------
MIL
8,000
28
8,000
29
1033
U.25
Y
8,0011
6.1
<0.01
30
1035
0.25
Y
N.I1111)
6.2
<0.01
t1
.�n•rtgc
8,0110
<0.01
6t .
.-
4..11
7.3
88.4
uL11411
88.4
R.11
l
�4.
Dail) M3.Wauat
8.000
6.5
<0.01 1
32.2
6 .4
18.2
24211
1 7.3
88.4
<O.1140
8.4
I1.0
- 1
.
Daily Nfinimttm
8,000
5.9
<0.01
32.2
69.4
18.2 1
2420
1 7.3
88.4
<0.040
88.4
0.043
281
54.8
JIunllllyl.irnilsW
24400
Cnmposile 3I Grab (G)
* ESTIMATED FLOW, FLOWMETER INOPERABLE
Operator in Responsible Charge (ORC): Glenn Price Grade. 11 Phone: [phone]
Check Box if ORC Has Changed: ❑ ORC Certification Number: 987931/20771
Certified Laboratories (1): Pace Analytical Serivees (2):
Person(s) Collecting Samples: Glulln Price
Mail ORIGINAL and Two COPIES to;
ATTN: Non -Discharge Compliance Unit Y
DENR (SIGNATURE OF OPERATOR IN RESPONSIBLE CHAR(;E)
Division of Water Quality By this signature, I certify that this report is accurate and
1617 Mail Service Center complete to the best of my knowledge.
RALEIGH, NC 27699-1617
DENR Form NDAR-1 (5/2003)

NON DISCHARGE WASTEWATER MONITORING REPORT
FACILITY STATUS:
Please answer the following question: Compliant ,N)
1. Does all monitoring data and sampling frequencies meet permit requirements?
If the facility is non-comofta , 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.
FLOW ESTIMATED FLOWMETER INOPERABLE
"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 a qualified personnel properly gather and evaluate 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."
' ), �( `a2 Baron Neal McDuffie
(Signature of Permitee)* ate (Name of Signing Official -Please print or type)
Baron Neal McDuffie (Authorized Agent)
(Permittee-Please print or type)
2N Riverside Plaza Suite 800
Chicago, Il 60606
(Permittee Address)
01002 Arsenic
01022 Boron
00310 BOD5
01027 Cadmium
00916 Calcium
00940 Chloride
50060 Chlorine, Total
Residual
01034 Chromium
00340 COD
31504
Coliform, Total
00094
Conductivity
01042
Copper
00300
Dissolved Oxygen
31616
Fecal Coliform
01051
Lead
00927
Magnesium
71900
Mercury
00610
NH3 as N
01067
Nickel
Field Services Director (Pace Analytical Services)
(Position or Title)
3/31/21
(Permit Exp. Date)
00600 Nitrogen, Total
00630 NO2 & NO3
00620 NO3
00556 Oil & Grease
W 09 PAN Plant Available)
00400 pH
32730 Phenols
00665 Phosphorus, Total
00937 Potassium
00545 Settleable Matter
00929
Sodium
00931
SAR
00745
Sulfide
00515
TDS
00010
Temperature
00625
TKN
00680
TOC
00530
TSS/TSR
00076
Turbidity
01092
Zinc
Parameter Code assistance may be obtained by calling the Water Quality Compliance/Enforcement Unit at [phone], extension 529.
The monthly average for Fecal Coliform is to be reported as a GEOMETRIC mean. Use only 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 rile with the state per 15A NCAC 2B.0506 (b) (2) (D).

Page 2 of 2
NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADOIDTIONAL PAGES AS NEEDED
PERMIT NUMBER: W0004972 MONTH: November YEAR: 2021
FACILITY NAME: Forest Lakes Preserve ELS. COUNTY: Davie
Formulas:
Daily Loading (inches) = [Volume Applied (gallons) x 0.1336 (cubic feetlgailon) x 12 (incheslfoet)) I [Area Sprayed (acres) x 43.560 (square feetlacre) or
= [Volume Applied (gallons) I [Area Sprayed (acres) x 27,152 (gallonslacre-inch).
Maximum Hourly Loading (inches) = Daily Loading (inches) I rrlme irrigated (minutes) 160 (minutes hour)) Monthly Loading (inches( »Sum of Daily Loading (inches)
12 Month Floating Total (inches) = Sum of this month's Monthly Loading (inches) and previous 11 month's Monthly Loadings (inches)
Average Weekly Loading (inches) = [Monthly Loading (inches/month) I Number of days in the month (dayslmonth )) x 7 (daysAveek)
Did Irrigation Occur At This Facility:
Yes No[]
Did Irrigation Occur On This Field;
yefy� No: ❑
Did Irrigation Occur On This Field:
Ye1 No: ❑
Field Number:
Field Number;
Area Sprayed (acres):
3,4
Area Sprayed (acres):
Cover Crop:
Cover Crop:
Permitted Hour
y ate (Inc es):
0.11
Permitted Hourly Rate +nc es ;
D
A
T
ti
WEATHER CONDITIONS
ston0,
Lagoon
Permitted Yearly Rafe {inches):
46.8
Permitted Yearly Rate (inches):
Weather
Cade-
Ternpent-
at
,Irpli�:,tiun
Pr rpea-
tian
Volume
App€i.l
Time
trolly
lLvrly
I, .'11-
Volume
AT11113
IDnw
IrtiE,tul
Daily
I.uJinp
Mauarum
Hr iy
Lvrkin>:
Fru-rv"i,„,
cFI
tnchea
ru.
pil.s
.. •..,
.,,
... ..-
..., ..,
urnula
rnch�
in�lr.,
I
PC
48
t)
2.4
PC
49
(1
2.2
42.480
3110
0.46
0.00
C
52
0
3.0
4
C I
44
0
19
5
PC-
4(1
(1
2.8
6
7
N
Cl
48
0
2.4
9
Cl
2
0
2.3
ul
PC3
0
2.1
42,480
301)
0.46
0.09
I t
PC1
0
2.9
12
C6
0
2.9
t3
E44
la
Is
C
0
2.6
16
PC2
0
2.4
42.430
3110
0.46
11.I19
17
C8
1)
2.9
IN
PC
43
1)
2.9
19
PC
46
0
2.8
-
28
21
,2
PC
1 44)
0
2.4
23
PC
52
1)
2 2
42.480 1
300
0.46
0.09
14
CI
54
25
HOlidav-------------- -- ----
26
llolida%----------------- --_------------------- - ---------- ------ -- ------------------- - ----- W_-
27
�n
29
PC
46
1)
2.1 1
42.484) 1 300 0.46
().09
u)
PC
40
1t
3.0
31
Toral Galloe..\Iwukl� Loadi.Owhnl
12 .�1anrA t'loalin,l Taral linnc�,f
A.rraxr %rkly Loading (1.6o)
2.30
29.65
r
-
0.46
-,Y comer-un; �-crear, m-panty clouuy, L. Iauuy, K-rain, In-5oau, DI -steel
Spray Irrigation Operator in Responsible Charge (ORC): Glenn Price Phone: [phone]
ORC Certification Number: 987931/20771 Check Box if ORC Has Changed:
Mail ORIGINAL and Two COPIES to:
ATTN. Non -Discharge Compliance Unit X_
DENR (SIGNATURE OF OPERATOR IN RESPONSIBLE CHARGE)
Division of Water Quality By this signature, 1 certify that this report is accurate and
1617 Mail Service Center complete to the best of my knowledge.
RALEIGH, NC 27699-1617
DENR Form NDAR-1 (5/2003)

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
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.)
Compliant (Y,N)
1. The application rate(s) did not exceed the limit(s) specified in the permit.
Z 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. F_7_1_7
4. All buffer zones as specified in the permit were maintained during each application. F
5. The freeboard in the treatment and/or storage lagoon(s) was not less than the
limit(s) specified in the permit.
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 a qualified personnel properly gather and evaluate 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."
,0_1 Aa-
(Signature of Permitee Date
Baron Neal McDuffie (Authorized Agent)
(Permittee-Please print or type)
2N. Riverside Plaza, Suite 800
Chicago, II 60606
(Permittee Address)
Baron Neal McDuffie
(Name of Signing Official -Please print or type)
Field Services Director (Pace Analytical Services)
(Position or Title)
3/31 /2021
(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).

aceAnalytical
www.pacelabs.com
Pace Analytical Services, LLC
1377 South Park Drive
Kernersville, NC 27284
[phone]
ANALYTICAL RESULTS
Project: Forest Lake
Pace Project No.: 92573183
Sample: Effluent Lab ID: 92573183005 Collected: 11/18/21 08:51 Received: 11/18/21 11:30 Matrix: Water
Parameters Results Units Report Limit OF Prepared Analyzed GAS No. Qual
2540C Total Dissolved Solids
Analytical Method: SM 2540C-2015
Pace Analytical Services - Eden
Total Dissolved Solids
281 mg/L 25.0
1
11/22/21 14:48
2540D Total Suspended Solids
Analytical Method: SM 2540D-2015
Pace Analytical Services - Eden
Total Suspended Solids
18.2 mg/L 5.7
1
11/22/21 08:37
353.2 NO2/NO3 unpres EDN
Analytical Method: EPA 353.2 Rev 2.0 1993
Pace Analytical Services - Eden
Nitrogen, Nitrate
0.043 mg/L 0.040
1
11/19/21 10:10 14797-55-8
5210E BOD, 5 day EDN
Analytical Method: SM 521OB-2016 Preparation
Method: SM 521 OB-2016
Pace Analytical Services - Eden
SOD, 5 day
32.2 mg/L 2.0
1 11/19/21 09:46
11/24/21 11:44
Colilert-18 Fecal Coliform EDN
Analytical Method: Colilert-18 Preparation Method: Colilert-18
Pace Analytical Services - Eden
Fecal Coliforms
2420 MPN/100mL 1.0
1 11/18/21 15:24
11/19/21 09:25
Total Nitrogen Calculation
Analytical Method: TKN+NO3+NO2 Calculation
Pace Analytical Services -Asheville
Total Nitrogen
88.4 mg/L 0.52
1
12/03/21 15:35
300.0 IC Anions 28 Days
Analytical Method: EPA 300.0 Rev 2.1 1993
Pace Analytical Services -Asheville
Chloride
54.8 mg/L 1.0
1
11/22/2111:01 16887-00-6
350.1 Ammonia
Analytical Method: EPA 350.1 Rev 2.0 1993
Pace Analytical Services -Asheville
Nitrogen, Ammonia
69.4 mg/L 1.0
10
11/30/21 12:17 7664-41-7
351.2 Total Kjeldahl Nitrogen
Analytical Method: EPA 351.2 Rev 2.01993 Preparation Method: EPA 351.2 Rev 2.01993
Pace Analytical Services - Asheville
Nitrogen, Kjeldahl, Total
88.4 mg1L 5.0
10 11/29/21 21:36
11/30/21 04:55 7727-37-9
3S3.2 Nitrogen, N021NO3 pros.
Analytical Method: EPA 353.2 Rev 2.0 1993
Pace Analytical Services - Asheville
Nitrogen, NO2 plus NO3
NO mg/L 0.040
1
12/03/21 12:45
365.1 Phosphorus, Total
Analytical Method: EPA 365.1 Rev 2.0 1993 Preparation Method: EPA 365.1 Rev 2.0 1993
Pace Analytical Services - Asheville
Phosphorus
7.3 mg/L 0.15
3 12/02/2112:55
12/03/2107:38 7723-14-0
Date: 12105/2021 10:00 AM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
131
El
Page 12 of 35

.. CHAIN -OF -CUSTODY Analytical Request Document
LAB USE ONLY -Affix Workorder/t —`--�-
MTV W010: 92,573 1 Q3
eAn
.. aC�lytiCal
Chain -of -Custody is a LEGAL DOCUMENT - Complete all relevent fields
{ 111111111111111company:
SHADED A��I�'I�
Forest Lakes
Billing information:ALL
Container Preservative Type •• 92573183
Address:
8 •:: u '.' o' 3 u 2
"• Preservative Types: (1) nitric acid, (2) suifuric add, (3) hydrochloric acid, (4) sodium hydroxide, IS) zinc acetate,
Report To:
Email To:
(6) methanol, (7) sodium bisulfate, (9) sodium thiosulfate, (9) hexane, (A) ascorbic add, (B) ammonium sulfate,
(C) ammonium hydroxide, (D) TSP, (U) Unpreserved, (0) Other
Copy To:
Site Collection Info/Address:
Analyses
Lab Proflle Line:Lab
Customer Project Name/Number.
State: County/City: Time Zone Collected:
sample Receipt Chockliat r
/ [ ]PT[ ]MT[ ]CT [ ]ET
Custody Seals Present/Intact (/NA1/�
Custody signatures Present N Tt7C
Phone:
Site/Facility ID M
Compliance Monitoring?
Email:
[ Yes [ ] No
Collector Signature Present H NA
Bottles intact N NA
Correct Bottles N NA
Collected {print):
Purchase Order 0:
OW PWS ID tf:
Quote M
DW Location Code-
sufficient volume H NA
Samples Received on Ice N,NA
VDA - Headapaee Acceptable N
Collected By (si nature):
Turnaround Date Required:
Immediately ace on ICE
( ]Yes [ ]No
USDA Regulated soila � N N
n-
Samples in Holding Time
Sample Disposal:
Rush:
Field Filtered (if applicable):
M
Residual Chlorin r nt Y t A
( ) Dispose as appropriate ( ) Return
[ ] Same Day [ I Next Day
[ I Yes ( ] No
Cl Strips:
( ] Archive:
[ ] 2 Day [ ] 3 Day [ ] 4 Oay [ I S Day
Analysis:
N
Sample pH Ace kilp, t r NA
Strips: �XV
( ) Hold:
(Expedite Charges Apply}
z
�p
0%
UQJ
R
_
Z
m
pH lit /y����
Sulfide Present Y N NA J `•
; Lead Acetate Strips t ,
` Matrix Codes {Insert in Matrix box below): Drinking Water (DW), Ground Water (GW), Wastewater (WW),
Product (P), SoiiJSolid (SL), Oil (OL), Wipe (WP), Air (AR), Tissue (T5}, Bioassay (B), Vapor (V), Other (OT)
z
di
LAB' t35B ONLY:
"
Comp /
Collected (or
Composite End
Res
tr of
_
a
,,
FP— :
Z
Lab sample It /Comments:
Customer Sample ID
Matrix
Grab
Composite Start)
Cl
Ctns
4
LL
U
O
O>
CAD
Z
Date
Time
Date
Time
MW-1
gw
g
(�� zr
Oqd 3
7
MW-2
gw
9
0 cf
7
XXX
MW-3
gw
g
7
MW4
gW
9
G "2-
7
J
Effluent
Ww
9
09S-1
4
Customer Remarks / Special Conditions J Possible Hazards:
Type of ice Used:. '
We " Blue Dry:; ::!, -None :
SHORT HOLDS PRESENT (<72 hours):
Y N . NIA
Lab Sample Temperature Info:
Temp Blank R 1 ed' N NA
Packing Material Used:
lab Tracking h:
Therm IDH: _
Groundwater Monitoring
Cosier i Temp Upon Receipt' oC
Samples received via:.
Gaoler i Therm Corr. Factor 0 oG
Radchem sample(s) screened j<S00 cpm): Y ` '. N A'
FEDE% UPS , Client v Courier Pace Courier
Cooler i Corrected Temp: —6-G oc
Comments:
Relinquished by/Compar : {Signature)
Drat/s�Ti e:
c d by/Co pany: (51 nat re)
Date/Time: j
MTJL LAB
Table it:
Reli Auished by/Company: (Signature)
Date/Time:
Received by mpany: (Si nature)
Date/I!me:
Acctnum:
Template:
Trip Blank Received: Y N NA
p
Pr
Prelogln:
PM:
HCL McOH TSP Other
Relirtguished by/Company: (Signature)
Date/Time:
Received by/Company: (Signature)
Date/Time:
Non Conformance(s):
Page:
pB;
YES / NO
of:

aceAnalytical "
www.pacelahs.eam
December 05, 2021
Tracy Overdurf
Forest Lake
192 Thousand Trails Dr.
Advance, NC 27006
RE: Project: Forest Lake
Pace Project No.: 92573183
Dear Tracy Overdurf:
Pace Analytical Services, LLC
1377 South Park Drive
Kernersville, NC 27284
(704 )977-0981
Enclosed are the analytical results for sample(s) received by the laboratory on November 18, 2021. The results relate only
to the samples included in this report- Results reported herein conform to the applicable TNIINELAC Standards and the
laboratory's Quality Manual, where applicable, unless otherwise noted in the body of the report.
The test results provided in this final report were generated by each of the following laboratories within the Pace Network:
• Pace Analytical Services -Asheville
• Pace Analytical Services - Charlotte
• Pace Analytical Services - Eden
If you have any questions concerning this report, please feel free to contact me.
Sincerely,
Stephanie Knott
[e-mail]
704-977-0981
Project Manager
Enclosures
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
Page 1 of 35

Jacmnalyticafo
www.pacelabs.com
Pace Analytical Services, LLC
1377 South Park Drive
Kernersville, NC 27284
[phone]
Project: Forest Lake
Pace Project No.: 92573183
Pace Analytical Services Charlotte
South Carolina Laboratory ID: 99006
9800 Kincey Ave. Ste 100, Huntersville, NC 28078
North Carolina Drinking Water Certification #: 37706
North Carolina Field Services Certification #: 5342
North Carolina Wastewater Certification #: 12
South Carolina Laboratory ID: 99006
Pace Analytical Services Asheville
CERTIFICATIONS
South Carolina Certification #: 99006001
South Carolina Drinking Water Cert. #: 99006003
Florida/NELAP Certification #: E87627
Kentucky UST Certification #: 84
Louisiana DoH Drinking Water #: LA029
UrginiaNELAP Certification #: 460221
2225 Riverside Drive, Asheville, NC 28804 South Carolina Laboratory ID: 99030
Florida/NELAP Certification #: E87648 South Carolina Certification #: 99030001
North Carolina Drinking Water Certification #: 37712 1lrginiaNELAP Certification #: 460222
North Carolina Wastewater Certification #: 40
Pace Analytical Services Eden
205 East Meadow Road Suite A, Eden, NC 27288
North Carolina Drinking Water Certification #: 37738
North Carolina Wastewater Certification #: 633
VirginiaNELAP Certification #: 460025
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC. Page 2 of 35