WQ0004502_Monitoring - 03-2021_20210506

Page of
NON-DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE.USE ADDITIONAL PAGES AS NEEDED.
PERMIT NUMBER: WQ0004502 MONTH: March YEAR: 2021
FACILITY NAME: Hillsborough United Church of Christ COUNTY: Orange
Formulas:
Daily Loading(inches) _[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))
Maximum Hourly Loading(inches) =Daily Loading(inches)/[Time Irrigated(minutes)/60(minutes/hour)) Monthly Loading(inches) =Sum of Daily Loadings(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)/Number of days in the month(days/month)]x 7(days/week)
Did Irrigation Occur At This Facility: Did Irrigation Occur On This Field: Did Irrigation Occur On This Field:
Yes: [] No: j] Yes: ❑' No: [] Yes: [i No: ❑
FIELD NUMBER: 1 FIELD NUMBER:
AREA SPRAYED(acres): 2.6 AREA SPRAYED(acres):
COVER CROP: Deciduous-Conifer COVER CROP:
PERMITTED HOURLY RATE(inches): PERMITTED HOURLY RATE(inches):
D WEATHER CONDITIONS PERMITTED YEARLY RATE(inches): 26 PERMITTED YEARLY RATE(inches):
Storage
A Temper- Lagoon Maximum Maximum
Weather ature at Precipita- Free- Volume Time Daily Hourly Volume Time Daily Hourly
Code* application Lion boardApplied Irrigated LoadingLoadingApplied Irrigated LoadingLoading
E 9 9
(°F) inches feet gallons minutes inches inches gallons minutes inches inches
1 CI 58 0 2.75 0 0 0.00 #DIV/0!
2
3
4
5
6
7
8 C 54 0 2.5 0 0 0.00 #DIV/0!
9
10
11
12
13
14
15 CI 46 0 2.25 8520 240 0.12 0.03
16
17
18
19
20
21
22 PC 62 0 2.5 0 0 0.00 #DIV/0!
23
24
25
26
27
28
29
30 C 58 0 2.5 8520 240 0.12 0.03
31
Total Gallons/Monthly Loading(inches) 17040 0.24 0 0.00
12 Month Floating Total(inches) 2.98
Average Weekly Loading(inches) 0.054467 0
*Weather Codes: C-clear,PC-partly cloudy,Cl-cloudy,R-rain,Sn-snow,SI-sleet
Spray Irrigation Operator in Responsible Charge(ORC): James W Gooch Phone: [phone]
ORC Certification Number: SI 987567 Check Box if ORC Has Chan d: ❑
Mail ORIGINAL and TWO COPIES to:
ATTN:Non-Discharge Compliance Unit
DENR
Division of Water Quality d� IG TORE 0 0 E TO ESPONSIBLE ARGE)
1617 Mail Service Center �� B HIS SIGNATURE,ICE FY THAT THIS REPORT IS ACCURATE AND COMPLETE
RALEIGH,NC 27699-1617Oz. s �, 0 THE BEST OF MY KNO LEDGE.
r 6P
1O his O �j�
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DENR FORM NDAR-1(5/2003)

Page_of
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. )
Corn•liant Y,N)
1.The application rate(s)did not exceed the limit(s)specified in the permit. Y
2.Adequate measures were taken to prevent wastewater runoff from the site(s). Y
3.A suitable vegetative cover was maintained on the site(s)in accordance with the permit. Y
4.All buffer zones as specified in the permit were maintained during each application. Y
5.The freeboard in the treatment and/or storage lagoon(s)was not less than the limit(s) Y
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 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."
d //� Russell Knop
Ple
(Si n to of Permitte ate (Name of Signing Official-Please print or type)
Hillsborough United Ch' ch of Christ Chair of Trustees
(Permittee-Please print or type) (Position or Title)
919-732-9183 4/30/2021
200 Davis Rd. (Phone Number) (Permit Exp.Date)
Hillsborough NC 27278
(Permittee Address)
*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).
OENR FORM NDAR-1(5/2003)

- 1
NON DISCHARGE WASTEWATER MONITORING REPORT Page of
PERMIT NUMBER: W00004502 MONTH: March YEAR: 2021
FACILITY NAME: Hillsborough United Church of Christ COUNTY: Orange
Flow Monitoring Point: Effluent: ❑ Influent: 7d
Parameter Monitoring Point: Effluent: RI Influent: ❑ Surface Water(SW): LI SW Code/Name:
Was There Effluent Flow For This Month Generated At This Facility: Yes: ❑ No: [I
50050 00400 50060 00310 00610 00530 31616 665 625 630 600
Operator
D Arrival Daily Rate Fecal
A Time Operator ORC (Flow)into Coliform
T 2400 Time On on Treatment Residual BOD-5 (Geo-metric TOT NO2- TOT N
E Clock Site Site? System pH Chlorine 20°C NH3-N TSS Mean') Phos TKN No3 C Calc
HRS Y/N GALLONS UNITS UG/L MG/L MG/L MG/L /100ML MG/L MG/L MGIL MG/L
1 11:40 0.25 Y 220
2 260
3 260
4 260
5 260
6 260
7 260
8 13:45 0.25 Y 260
9 290
10 290
11 290
12 290
13 290
14 290
15 9:10 0.75 Y 290 6.9 0
16 225
17 225
18 225
19 225
20 225
21 225
22 11:55 0.25 Y 225
23 240
24 240
25 240
26 240
27 240
28 240
29 240
30 9:54 0.75 Y 240 6.9 0
31 210
Average 250.8065 0 ##I### 111111111f Itttltlt/f #NUM! I/I/I/IIIt #DIV/0! ##### #ttttlttlt
Daily Maximum 290 6.9 0 0 0 0 0 0 0 0 0
Daily Minimum 210 6.9 0 0 0 0 0 0 0 0 0
Monthly Limit(s) 0.00156
Composite(C)I Grab(G)
Operator in Responsible Charge(ORC): James W Gooch Grade: IV Phone: [phone]
Check Box if ORC Has Changed: [1 ORC Certification Number: 988035
Certified Laboratories(1): (2):
Person(s)Collecting Samples:
Mail ORIGINAL and TWO COPIES to:
ATTN: Non-Discharge Compliance Unit ( GNATURE F OP OR IN RES ONSIBLE CHARGE)
DENR Y THIS SIGNATUR I ERTIFY TH T THIS REPORT IS ACCURATE
Division of Water Quality AND COMPLETE T HE BEST OF MY KNOWLEDGE.
1617 Mail Service Center
RALEIGH, NC 27699-1617
DENR FORM NDMR-1 (5/2003)

Page of
NON DISCHARGE WASTEWATER MONITORING REPORT
Facility Status:
Please answer the following question:
Compliant(Y,N)
1. Does all monitoring data and sampling frequencies meet permit requirements? Y
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
fal information, including the possibility of fines and imprisonment for knowing violations."
— Russell Knop
(Sin ure of Pe m,ttee* Date (Name of Signing Official-Please print or type)
Hillsborough United Church of Christ Chair of Trustees
(Permittee-Please print or type) (Position or Title)
200 Davis Rd. 919-732-9183 4/30/2021
(Phone Number) (Permit Exp. Date)
Hillsborough NC 27278
(Permittee Address)
Parameter Codes:
01002 Arsenic 31504 Coliform,Total 00600 Nitrogen,Total 00929 Sodium
01022 Boron 00094 Conductivity 00630 NO2&NO3 00931 SAR
00310 HODS 01042 Copper 00620 NO3 00745 Sulfide
01027 Cadmium 00300 Dissolved Oxygen 00556 Oil-Grease 70295 TDS
00916 Calcium 31616 Fecal Coliform W009 PAN(Plant Available) 00010 Temperature
00940 Chloride 01051 Lead 00400 pH 00625 TKN
50060 Chlorine,Total 00927 Magnesium 32730 Phenols 00680 TOC
Residual 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(919)733-5083 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)