WQ0003090_Monitoring - 06-2023_20230727

Monitoring Report Submittal
Permit Number#* wg0003090
Name of Facility:* town of liberty wwtp
Month: * June Year: * 2023
Report Information
Type* Upload Document*
NDMR, NDAR-1, NDAR-2, NDMLR june 2023.pdf 6.86MB
PDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
Confirmation Email Address: * [e-mail]
Name of Submitter: * Elix Fike
Signature:
Date of submittal: 7/27/2023
This will be filled in automatically
Initial Review
Reviewer: Wanda.Gerald

Is the project number correct?* wg0003090
Is the monitoring report accepted?* Yes No
Regional Office* Winston-Salem
Reviewer: _anonymous
Review Date: 8/7/2023

FORM: NDMR 10-13 NON -DISCHARGE MONITORING REPORT (NDMR) Page_1_ of_1_
Permit No.: W00003090
Facility Name: Town Of Liberty - Wastewater
County: Randolph
Month: June
Year: 2023
PPI: 002
Flow Measuring Point: 0 influent ❑ Effluent ❑ No flow generated
Parameter Monitoring Point: ❑ influent ❑✓ Effluent ❑ Groundwater Lowering ❑ Surface Water
Parameter Code - 10
50050
00400
00310
00610
00530
31613
00620
00625
00665
50060
00600
70300
00940
00630
00010
O
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O
°
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U
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ON
-'�-
°E
~per
mm
V
+
Z Z
2
p
F-
24-hr
hrs
GPD
su
mg/L
mg/L
mg1L
#/100 mL
mg..f
mg/L
mql
mg/L
mg/L
mg/L
mg/L
mg/L
°C
1
7:00
8
307,000
2
7:00
8
292,000
3
11:00
2
337,000
4
11:00
2
331,000
5
7:00
8
340,000
6
7:00
8
286,000
7
7:00
8
300,000
8
7:00
8
298,000
7.23
13.6
9.4
27.5
2420
<0.040
15.1
2.5
0.01
15.2
0.073
9
7:00
8
260,000
10
303,000
11
279,000
12
7:00
8
160,000
13
7:00
8
279,000
14
7:00
8
241,000
15
7:00
8
309.000
7.01
0
16
7:00
8
240,000
17
203,000
18
231,000
19
7:00
8
216,000
20
7:00
8
320.000
21
7:00
8
389,000
22
7:00
8
317,000
7.09
40
11.9
20.3
1550
<0.040
15.7
2.8
0.09
15.7
<0.040
23
7:00
8
1,160,000
24
11:00
2
416,000
251
11:00
2
324,000
26
7:00
8
219,000
27
7:00
8
262,000
28
7:00
8
265,000
29
7:00
8
223,000
6.39
0
30
7:00
8
220,000
31
Average:
310,900
26.80
10.65
23.90
1,936.75
0.00
#REF!
2,65
0.03
15.45
0.04
Daily Maximum:
1,160.000
7.23
40.00
11.90
27.50
2,420.00
0.04
#REF!
2.80
0.09
15.70
0.07
Daily Minimum:
160,000
6.39
13.60
9.40
20.30
1,550.00
0.04
#REF!
2,50
0.00
15.20
0.04
Sampling Type:
Recorder
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Monthly Avg. Limit:
Daily Limit:j
550,000
Sample Frequency:1
Daily
weekly
2x month
2x month
2xmo. h
2x month
2x month
2x month
2x month
I weekly
1 2x month
3x year
3x year
2x month

FORM: NDMR 10-13
NON -DISCHARGE MONITORING REPORT (NDMR)
Sampling Person(s) Certified Laboratories
Name: GLENN PRICE Name: PACE ANALYTICAL
Name: GARRETT DREYER Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? El 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:
Elix Tremaine Fike
Permittee: Scott Kidd
Certification
No.: 989290
Signing Official:
Grade:
SI Phone Number: 336 622 2990
Signing Official's Title: Town Manager
Has the ORC changed since the previous NDMR? ❑ Yes El No
Phone Number: 336 622 4276 Permit Expiration: 8/31/2024
Z 3
Signature Date
Signature Da
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

/�YalceAnalyfical'
www,pacelabs.com
Pace Analytical Services, LLC
1377 South Park Drive
Kernersville, NC 27284
[phone]
Tremaine Fike
Town of Liberty
PO Box 1006
Liberty, NC 27298
Project: Town of Liberty
Pace Project No.: 92671398
Sample: Effluent
Method
SM 2540D-2015
EPA 353.2 Rev 2.0 1993
EPA 353.2 Rev 2.0 1993
EPA 353.2 Rev 2.0 1993
SM 521OB-2016
Colilert-18
TKN+NO3+NO2
Calculation
EPA 350.1 Rev 2.0 1993
EPA 351.2 Rev 2.0 1993
EPA 353.2 Rev 2.0 1993
EPA 365.1 Rev 2.0 1993
ANALYTE QUALIFIERS
Parameters
Total Suspended Solids
Nitrogen, NO2 plus NO3
Nitrogen, Nitrate
Nitrogen, Nitrite
BOD, 5 day
Fecal Coliforms
Performed by
Collected By
Collected Date
Collected Time
pH
Chlorine, Total Residual
Total Nitrogen
Laboratory Report
Page 1 of 1
Report Date: 06/22/2023
Date Received: 06/08/2023
Lab ID: 92671398001 Collected: 06/08/23 12:25 Matrix: Water
Results
Units
27.5
mg/L
0.073
mg/L
ND
mg/L
0.063
mg/L
13.6
mg/L
2420
MPN/100mL
Pace
Garrett
Dreyer
06/08/2023
1225
7.23
Std. Units
0.01
mg/L
15.2
mg/L
Report Limit
12.5
0.040
0.040
0.040
2.0
1.0
Analyzed
06/12/23 13:00
06/09/23 11:14
06/09/23 11:14
06/09/23 11:14
06/14/23 14:15
06/09/23 12:27
06/08/23 16:35
06/08/23 16:35
06/08/23 16:35
06/08/23 16:35
06/08/23 16:35
06/08/23 16:35
0.040 06/21/2316:24
Nitrogen, Ammonia
9.4
mg/L
0.10
06/22/23 13:10
Nitrogen, Kjeldahl, Total
15.1
mg/L
0.50
06/21/23 03:23
Nitrogen, NO2 plus NO3
0.063
mg/L
0.040
06/20/23 15:07
Phosphorus
2.5
mg/L
0.050
06/20/23 00:04
D6 The precision between the sample and sample duplicate exceeded laboratory control limits.
El Reported value should be considered a minimum estimate since it is the maximum reportable number for this method
based on the sample volume used. The true value is likely greater than the value reported.
R6 The RPD between valid sample dilutions exceeded 30%.
Reviewed by:
nCwtt[.�y`�ll.t2,�
Stephanie Knott
704-977-0981
[e-mail]
Pace Analytical Services Asheville
2225 Riverside Drive, Asheville, NC 28804
Florida/NELAP Certification #: E87648
North Carolina Drinking Water Certification #: 37712
North Carolina Wastewater Certification #: 40
Pace Analytical Services Eden
205 East Meadow Road Suite A, Eden, NC 27288
North Carolina Drinking Water Certification #: 37738
South Carolina Laboratory ID: 99030
South Carolina Certification #: 99030001
VirginiaNELAP Certification #: 460222
North Carolina Wastewater Certification #: 633
Virginia/VELAP Certification #: 460025
Qualifiers
R6
D6,El
Page 1 of 4

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CHAIN -OF -CUSTODY t Analytical
f � f ace The Chain -of -Custody is a LEGAL DOCUMENT. All r
I Submitting a sample via thrs chain of custody constitutes acknowledgment and acceptance of the Pace Terms and Conditions fat
Section A
Required Client information:
Section e
Required Project Infomtation:
Section C
invoice information -
WO# : 92671e 398
111111111111111111111111
omCanyTown Of Lioery port To. Tramatne F2ke
dress: �O Box 1066 xr To•
rbeny. NC 27298
ancron:
parry Name:
ddress;
R
mail. try'k &ownof ibe rly= org rchase Order #� ace Ourne:
hone - i336)622-d276 Fax. I Mar* Town of Ube* - Every 2 Weeks ace Project Manager: stephanie.kn am Wbs.com,
aquerted Due Data: aer. x ace Profile Rt: 13077
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;heville E] Eden [I GreenwoodL..�jHuntersville Raleigh"
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Receipt M Project H
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arrier Tracking Number:
ustody Sea(Present? []Yes BNO Seals Intact? Dyes 010
Date/initials Person Examining Contents-
aterial: irking M JBubb,e W,ap C]Subbie Bags []Ione [] Other Biological 'tissue Frozen?
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Chain of Custody Present?
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Samples Ar-Ned within i-f6d Trile?
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Temp Log; Temp must be maintained
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Time opened:] q D Temp:
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Project Manager SCURF Review-.
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Page 3 of 4

[}ocu„u nt N r, i (ltsrurnant ttiuerf Nnvorntzwr I5, 2021 —
Bottle Identification Form (61F) I tape 1 of t
Document No„ siuint; Aothoi,vl:
P•tAR•CS-043-Rev.01 Pace. Carolina, Quality Oif,c::
*Check mark top half of box if pH and/or dechlorination is Project 4
verified and within the acceptance ranger for preservation
samples.
Exceptions. V± %A, Coliform, TOC, Oil and Grease, DRO/9015 (water) DOC, Wig
'*Bottom half of box is to list number of bottles 1 —
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Log for Preserved Samples
_ _ _ _
Sample ID Type of Preservative pH upon receiptTMv
IIIIII
Date preservation adjusted
time preservation
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Amount of Preservative
added
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tot q
tvote. vvnenever tnere,s a u,scrzpancy attecttng North C *roue,* ir, r;F;l;;;rsrr ,amples, a copy of this form will be sent ur the Morlh Carolina DCNNR Cert;fwatinn ('after= t+ e.
out of hold, incorrect presevot've, nut of temo, inr,or.e..t contamoel,
Page 4 of 4

_�aceAnalytical
www.pacolabs.com
Pace Analytical Services, LLC
1377 South Park Drive
Kernersville, NC 27284
[phone]
Laboratory Report
Tremaine Fike
Town of Liberty
PO Box 1006
Liberty, NC 27298
Project: Liberty WWTP
Pace Project No.: 92672745
Page 1 of 1
Report Date: 06/21/2023
Date Received: 06/15/2023
Sample: Effluent Lab ID: 92672745001 Collected: 06/15/23 11:40 Matrix: Water
Method Parameters Results Units Report Limit Analyzed Qualifiers
Performed by Pace 06/15/23 15:53
Collected By Garrett 06/15/23 15:53
Dreyer
Collected Date 06/15/2023 06/15/23 15:53
Collected Time 1140 06/15/23 15:53
pH 7.01 Std. Units 06/15/23 15:53
a� Chlorine, Total
Residual 0 mg/L 06/15/23 15:53
Gre�r�Zr ���liX2�%
Reviewed by:
Stephanie Knott
704-977-0981
[e-mail]
Page 1 of 2

N
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�~ ICHAI OF -CUSTODY analytical Request document
Cha n.of-Custody s a LEGAL DOCUMENT- Complete all ,elevent fields
Company I Billing Information:
Address: '
Report To: EmailTo:
Copy To: Site Colle,
Customer Project Name/Number.
State: County/City: Time Zone Collected:
rr ( IPT[ IMT( ]CI` ( ]ET
Phone-
Site/Facility ID #:
Compliance Monitoring?
Email-
[ Yes [ ] No
Collected By ( t):
Purchase order #:
OW PANS ID #:
(/J
Quote tr
DW Location Code:
Collect sr n
Turnaround Date Required:
Immediately Packed on Ice:
( [ Yes L I Na
Sr�t osaL
Rush:
Field Filtered (if applicable):
[ I Dispose as appropriate I I Return
( j Same Day [ ( Next Day
f ] Yes [ ]No
( I Archive: ..... . . .....
( (Z Day [ 13 Day ( 14 Day [ 15 Day
Analysis:
[ I Hold:
(Expedite Charges Apply)
Matrix Codes (Insert in Matrix box below): Drinking Water (DW), Ground Water (GW), Wastewater (WW),
Product (P), Soil/Solid (SL), Oil (OL), Wipe (WP), Air (AR), Tissue (TS), bioassay (3), Vapor (V), Other (OTl
Comp /
Collected (or
Composite End
Res
# of
Customer Sample ID
Matrix
Grab
Compositestartl
CI
Ctns
Date
rime
Date
Time
Customer Remarks / Special Conditions 1 Possible Hazards:
(Signature)
Relinquished by/Company: (Signature)
of Ice Used: Wet Blue Dry None
nR Material Used:
samples) screened (4500 cpm): Y N NA
Receiyeii! by/Campany-(Signature)
tri/Company: (Signature)
LAS USE ONLY- AfEGc Worlrorder/Loein Labei Here or List Pace wWorkorder Number cr
WO# ' 92672 f 45
Container YAL �SHe` res11111111111111111111111
2 1 92672745
— Preservative Types: (1) n'tric acd, [2) sulfuric aC;d. I3) nvorocnitnc acio, jai soorum nyor--, t7r cta. oe. am,
(6) methano!, (7) sodium bisulfate, (BI sodium thicsu[tate, ; 9) hexane, (a) ascorbic and, (B) ammonium sulfate.
(CI ammonium hydroxide, (0) TSP, (U) Unpreserved, to) Other,,,,,,,, ,,,,,,, ...
..<,,,
SHORT HOLDS PRESENT (<72 hours): Y N N/A
Lab Tracking 9-,
ples received via:
FEDEX UPS Client
DateJT:me:
T
At
Date/Time:
Te
Pr
Date/Time: Pt,
Lab Sample Recelpet Checklist-
Custody Seals Present/SntaCt Y N NA
Custody Signatures Present
v N NA
Collecto. Signature Present
Y N NA
Bottles Sutact
Y R MA
Correct Bottles
Y N NA
Ss:;dicient volume
v X NA
Samples Received on Ice
Y N NA
S,GA - Readcpsce Acceptable
Y N NA
USDA Regulated Soils
Y N KA
Samples in Rold .ng Time
Y t. NA
Resid:sal Chlorine Present
Y N 1
Cl Strips:
Sample PH Acceptable
Y N KA
pli Strip%;
sulfide Present
Y S NA
Lead Acetate Strips:
LiO USE C LY-
Lab Sample # /.counts=
Courier Pace Courier
MTIL LAB USE ONLY
Lab Sample Temperature Info:
Temp Blank Received: Y N NA
Therm ID#:
Cooler 1 Temp Upon Receipt: iaC
Cooler 1 Therm Corr. Factor: oC
Cooler 1 Corre: ed Temp: oC
Comments":
Trip Blank Received: Y N NA
HCL McOH TSP Other
Non Conformaace(s): Page:

Laboratory Report
Tremaine Fike
Town of Liberty
PO Box 1006
Liberty, NC 27298
Project: Town of Liberty
Pace Project No.: 92673932
Pace Analytical Services, LLC
1377 South Park Drive
Kernersville, NC 27284
[phone]
Page 1 of 1
Report Date: 07/05/2023
Date Received: 06/22/2023
Sample: Effluent
Method
Parameters
Lab ID: 92673932001 Collected: 06/22/23 10:30 Matrix:
Results Units Report Limit
Water
Analyzed Qualifiers
SM 2540D-2015
Total Suspended Solids
20.3
mg/L
8.6
06/23/23 09:37
EPA 353.2 Rev 2.0 1993
Nitrogen, NO2 plus NO3
ND
mg/L
0.040
06/23/23 10:29
EPA 353.2 Rev 2.0 1993
Nitrogen, Nitrate
ND
mg/L
0.040
06/23/23 10:29
EPA 353.2 Rev 2.0 1993
Nitrogen, Nitrite
ND
mg/L
0.040
06/23/23 10:29
SM 521OB-2016
BOD, 5 day
40.0
mg/L
2.0
06/28/23 10:48 B1
Colilert-18
Fecal Coliforms
1550
MPN/100ml-
1.0
06/23/23 08:22
Performed by
PACE
06/22/23 10:30
Collected By
Glenn Price
06/22/23 10:30
Collected Date
06/22/23
06/22/23 10:30
Collected Time
1030
06/22/23 10:30
pH
7.09
Std. Units
06/22/23 10:30
Chlorine, Total Residual
0.09
mg/L
06/22/23 10:30
TKN+NO3+NO2
Total Nitrogen
15.7
mg/L
0.040
07/03/23 12:42
Calculation
EPA 350.1 Rev 2.0 1993
Nitrogen, Ammonia
11.9
mg/L
0.20
07/05/23 14:44
EPA 351.2 Rev 2.0 1993
Nitrogen, Kjeldahl, Total
15.7
mg/L
0.50
06/30/23 06:21
EPA 365.1 Rev 2.0 1993
Phosphorus
2.8
mg/L
0.050
06/29/23 14:42
ANALYTE QUALIFIERS
B1 Less than 1.0 mg/L DO remained for all dilutions set. The reported value is an estimated greater than value and is
calculated for the dilution using the least amount of sample.
Reviewed by:
Stephanie Knott
704-977-0981
[e-mail]
Pace Analytical Services Asheville
2225 Riverside Drive, Asheville, NC 28804
Florida/NELAP Certification #: E87648
North Carolina Drinking Water Certification #: 37712
North Carolina Wastewater Certification #: 40
Pace Analytical Services Eden
205 East Meadow Road Suite A, Eden, NC 27288
North Carolina Drinking Water Certification #: 37738
South Carolina Laboratory ID: 99030
South Carolina Certification #: 99030001
Virginia/VELAP Certification #: 460222
North Carolina Wastewater Certification #: 633
Virginia[VELAP Certification #: 460025
Page 1 of 3

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Document Name:
Document Issued: November 15, 2021
eAnal fCc?�
.
Bottle Identification Form (BIF)
Page 1 of 1
Document No.:
Issuing Authority:
F-CAR-CS-043-Rev.01
Pace Carolinas Quality Office
*Check mark top half of box if pH and/or dechlorination is
verified and within the acceptance range for preservation
samples.
Exceptions: VOA, Coliform, TOC, Oil and Grease, DRO/8015 (water} DOC, LLHg
**Bottom half of box is to list number of bottles
Project #
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Sample ID
Type of Preservative
pH upon receipt
Date preservation adjusted
Time preservation
adjusted
Amount of Preservative
added
Lott#
Note: wnenever mere is a discrepancy attecting North Carolina compliance samples, a copy of this form will be sent to the North Carolina OEHNR Certification Office (i.e.
Out of hold, incorrect preservative, out of ternp, incorrect containers.
Page 3 of 3

laceAnalyficalo
www.pecelabs.com
Pace Analytical Services, LLC
1377 South Park Drive
Kernersville, NC 27284
[phone]
Laboratory Report
Tremaine Fike
Town of Liberty
PO Box 1006
Liberty, NC 27298
Project: Liberty WWTP
Pace Project No.: 92675084
Page 1 of 1
Report Date: 06/29/2023
Date Received: 06/29/2023
Sample: Effluent Lab ID: 92675084001 Collected: 06/29/23 09:20 Matrix: Water
Method Parameters Results Units Report Limit Analyzed Qualifiers
Performed by PACE 06/29/23 09:20
Collected By Garrett 06/29/23 09:20
Dreyer
Collected Date 06/29/23 06/29/23 09:20
Collected Time 0920 06/29/23 09:20
pH 6.39 Std. Units 06/29/23 09:20
Chlorine, Total Residual 0.00 mg/L 06/29/23 09:20
Reviewed by: �u��4ixJ
Stephanie Knott
704-977-0981
[e-mail]
Page 1 of 2

f CHAIN -OF -CUSTODY Analytical Request Document .
aceAnalytical
Chain-of•Custody s a LEGAL DOCUMENT- Complete all reteven2 fields '
LAB USE ONLY -Affix Workorder/Login Label Here or list Pace Workorder Number or
—in Number Here
0.
ALL SHA
Address: �
Container Preservative j �[1����/
j� !l�
9 2 i 780a
�
11 �
Report To: j Ema I To:
• • Preservative Types (1) nitric arid, (2) sue..
(6) methanol, (7) sodium bisulfate, (S) sodium thiosuffate, t>, .._
Copy To: I Site Collection Info/Address:
(C) ammonium hydroxide, (D) TSP, (U) Unpreserved, (0) Other
_
Analyses
Lab Profile/Line:
[Customer Project Name/Number: (State: County/City: T me Zone Collected:
Lab Sample Receipt Claacklist.
( IPT1 IMT[ :CT ( JET
( 2
Custody Seals Present Intact Y N NA
Phone: Sae/Faci ity ID #: Compliance Monitor`ng?
;.
Custody Signatures Present Y N NA
Email: [ 4Yes [ ) No
i'
Collector Signature Present Y N NA
Bottles Intact Y N NA
Coped 8y ( ' Purchase Order It: DW PWS iD #:
Carreet Bottles Y N NA
( Quote #: DW Location Code:
sufficient volume Y N NA
#
Samples Received on Ice Y N NA
C01'ect urnaround Date Required: Immediate y P t on Ice:
voA - Headsgace Acceptable Y N NA
( )Yes [ ]No
USDA Regulated soils Y N NA
Samples in Holding Time Y N NA
Rush: Field Filtered (:f apprcable):
{ rj
Residual Chlorine Present Y N NA
( J Dispose as appropriate [ J Return [ ; Same Day [ J Next Day [ ] Yes ( ] No
[\ °
V (
Cl Strips:
( ] archive: [ 12 Day [ 13 Day [ ] 4 Day [ ] 5 Day
+. ,
Sample pH Acceptable Y N NA
[ JHold: ;Expedite Charges Apply} Analysis:V„__......._:....___.
t }
pH Strips!
Sulfide Present Y N NA
Matrix Codes (Insert in Matrix box be ow): Drinking Water (DW), Ground Water (GW), Wastewater (WW),
Lead Acetate Strips:
Product (P), Soil/Solid (SQ, Oil (OL), Wipe (WP), Air (AR), Tssue (TS), Bioassay (8), Vapor (V), Other (OT)
LAB USE ONLY -
Comp/ Collected (or Res # of
"�
Lab Sample # Comments:
Customer Sample ID Matrix' Composite End
p Grab Composite Start) Cl Ctns
Date Time Date i Time
i
1
t
i
a
i
Customer Remarks / Special Conditions! Possible Hazards: Type of Ice Used: Wet Blue Dry None SHORT HOLDS PRESENT (<72 hours): Y N N/A I Lab Sample Temperature Info:
Packing Material Used:
Lab Tracking#:
Temp Blank Received: Y N NA
i Therm ID##:
Cooler 1 Temp Upon Receipt: oC
kSampees received via:
Cooler 1 Therm Corr. Factor., CC
Radchem sample(s) screened (<SDO cpmj Y N NA
FEDEX UPS Client Courier Pace Courier Cooler 1 Corrected Temp: oC
Reli m ...._
,Sig urejT +_ .. _ Date/Time: Receive /Company: (Sign! e)
L tZ��
0"is
Date/Time: MT1L LAB USE ONLY Comments:
brj91� Table#: [
Acctnum: j
by/Company: (Signature) attt/Trme: #Recei /Compan igna re) j
CD
r Re i ished by/Company: (Signature) Date/Ti ie: Received by/Company: (Signature)
"PM:
Date/Time:
Template:
Prelogin:
i Date/Time:
Trip Blank Received: Y N NA
HCL McOff TSP Other
Non Conformance(s): Page:
PB:
t YES / NO of:

DATE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
June 2023
Liberty N.C.W.W.T.F.
Freeboard Lagoon Inches
0
0
1
2 1/4
2 1/2
4 1/2
5 1/4
5 3/4
6 1 /2
7 1 /4
8
8 1/2
9
10
10 1/2
11
12
13
14 R 1.0
14 R 0.5
12 1 /4 R trace
12 1 /4 R 2.4
10 3/4
10
5
3
1
1 1/2
2
2 1/2
TOTAL 3.9

FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page_1_ of _2_
Permit No.: W00003090
Facility Name: Town of Liberty - Wastewater
County: Randolph
Month: June
Year: 2023
Did irrigation
Field Name:
1
Field Name:
2
Field Name:
3
Field Name:
4
occur
-
Area (acres):
20.2
Area (acres):
19.7
Area (acres):
--
19.94
Area (acres):
17.02
at this facility?
Cover Crop:
P�
FESCUE
Cover P�
FESCUE
Cover Crop:
FESCUE
Cover P�
FESCUE
❑� YES ❑ NO
Hourly Rate (in):
0.21
Hourly Rate (in):
0.21
Hourly Rate (in):
0.21
Hourly Rate (in):
0.21
Annual Rate (in):
52
Annual Rate (in):
52
Annual Rate (in):
52
Annual Rate (in):
52
Weather
Freeboard
Field Irrigated?
Q YES ❑ No
Field Irrigated?
0 YES ❑ NO
Field Irrigated?
❑ YES ❑ NO
Field Irrigated?
0 YES ❑ No
a
U
CC
W
3
F
2
v
a
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o R
>
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>
a
s=
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m
E
a
o C.
>
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1-
co
0
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?0^ a
O
Ca= J
°F
in
ft
It
gal
min
in
in
gal
min
in
in
gal
min
in
in
gal
min
in
in
1
2
C
70
0
535,000
300
1.00
0.20
3
4
5
C
69
0
545,000
300
0,99
0.20
6
C
68
0.25
535,000
300
1.00
0.20
7
C
72
0.25
468,000
300
1.01
0.20
8
C
68
0.25
545,000
300
0.99
0.20
9
C
55
0.5
535,000
300
1.00
0.20
10
C
75
0.5
541,000
300
1.00
0.20
11
C
80
0.5
468,000
300
1.01
0.20
12
13
C
78
0.75
535,000
300
1.00
0.20
14
15
C
76
0.75
545,000
300
0.99
0.20
16
C
80
0.75
541,000
300
1.00
020
17
C
75
1
468,000
300
1.01
0.20
18
19
R
1
20
R
0.5
21
R
TRACE
22
R
2.4
23
24
25
C
80
0
1
468,000
300
1.01
0.20
26
27
C
83 1
0 1
1
545,000
300
0.99
0.20
28
29
C
75
0
535,000
300
1.00
0.20
30
31
�
Monthly Loading:
2.1$0,000
3.97
2,675,000
5.00
1.082,000
2.00
1,872,000
4.05
12 Month Floating Total (in):
30.21
1
31.47
25.60
135.57

FORM: NDAR-1 10-13
NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Did the application rates exceed the limits in Attachment B of your permit? 0 Compliant ❑ Non -Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites? 0 Compliant ❑ Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit? ❑✓ Compliant ❑ 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? ❑ 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.
AT 0 INCHES CAUSE OF I&I RAINFALL
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Elix Tremaine Fike
Permittee:
Scott Kidd
Certification No.: 989290
Signing Official:
Grade: SI Phone Number: 336 622 2990
Signing Official's Title: Town Manager
Has the ORC changed since the previous NDAR-1? ❑ Yes 21 No
Phone Number: 336 622 4276 Permit Exp.: 8/31/24
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: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page _2_ of _2_
Permit No.: W00003090
Facility Name: Town of Liberty - Wastewater
County: Randolph Month: June
Year: 2023
Did irrigation
Field Name:
5
Field Name:
6
Field Name:
7
Field Name:
8
occur
Area (acres):
18.3
Area (acres):
15.1
Area (acres):
22.12
Area (acres):
21.68
at this facility?
Cover Crop:FESCUE
Cover Crop:
P�
FESCUE
Cover Crop:
P�
FESCUE
Cover Crop:
P�
FESCUE
0 YES ❑ No
Hourly Rate (m):
0.21
Hourly Rate (in):
0.21
Hourly Rate (in):
0.21
Hourly Rate (in):
0.21
Annual Rate (in):
52
Annual Rate (in):
52
Annual Rate (in):
52
Annual Rate (in):
52
Weather
Freeboard
Field Irrigated?
Q YES ❑ No
Field Irrigated?
❑ YES ❑ NO
Field irrigated?
❑ yE, ❑ NO
Field Irrigated?
❑✓ YES ❑ NO
m
N
t
ami
m
H
=
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a
m
O
m °'
a R
4> pa_
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ci
m a
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-1
a,
-'' =
J
m O
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a=
0
%
v
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_
a�
a=
J
E a�
m a=
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a s
Q
a
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L=
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pp,
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_
m
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3 -' c
X pQ_ tb
aoO
JE
°F
in
ft
gal
min
in
in
gal
min
in
in
gal
min
in
in
gal
min
in
in
1
2
3
C
70
0
350,000
180
0.59
0.20
4
5
6
7
8
9
10
11
12
13
14
CL
80
0.75
350,000
180
0.59
0.20
15
16
17
498,000
300
1,00
0,20
18
191
R
1
20
R
0.5
21
R
TRACE
22
R
2.4
23
24
25
26
CL
70
0
498,000
300
1.00
0.20
27
28
29
30
CL
74
0
350,000
180
0.59
0.20
31
Monthly Loading:
996,000
2.00
0
0.00
0
0.00
1,050,000
1.78
Ls..,=
12 Month Floating Total (in):
37.09
22.52
23.62
20.19
_;

FORM: NDAR-1 10-13
NON -DISCHARGE APPLICATION REPORT (NDAR-1)
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? 2 Compliant ❑ Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit? ❑✓ Compliant ❑ 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? ❑ Compliant El 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.
FREEBOARD IS AT 0 INCHES CAUSE OF I&I RAINFALL
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Elix Tremaine Fike
Permittee:
Scott Kidd
Certification No.: 989290
Signing Official:
Grade: SI Phone Number: 336 622 2990
Signing Official's Title: Town Manager
Has the ORC changed since the previous NDAR-1? ❑ Yes [21 No
Phone Number: 336 622 4276 Permit Exp.: 8/31/24
-7
Zvi
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