WQ0013676_Monitoring - 09-2023_20231101

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NON-DISCHARGE APPLICATION REPORT Page 3 01
SPRAY IRRIGATION SITE(S)
� THERE ARE TWO APPLICATION FIELDS PER PAGE.USE ADDITIONAL PAGES AS NEEDED.
PERMIT NUMBER: Wqqes{ i 3 .�
�-7(o MONTH: � ktJ ,1re1' YEAR: 202
FACILITY NAME: a�S KP_Cr C:. COUNTY: C 0,44-r k-
Formulas:
Daily loading(inches) •)Volume Applied(gallons)■o.1335(cubic(eeppaeon)x 12(incnesMooi))I(Area Spayed(acres)143.560(souare(eevacreflR
.Volume Applied(patrons)I(Area Sprayed(acres)a 27.152 tgasonsnve-inch))
Maximum Hourly Loading)inches) •Daily loading finches)1(Time InillMd(0111010es)160(minylesrhourp Monthly Loading(inches) .Sum of Daily Lcadings(inches)
12 Month Floating Total flinches) .Sum c1Ras monihs Monthly Lee"(001")and previWs I mom%mmwyLoadings Inches)
Avenoe Weekly Loadin linchesl .IM*nm Los"rndresAkonthl/Number o1 dars in eke month(ds►aenonthll a 7(WrsA.tekl
Did Irrigation occur At This Facility: Did Irrigation cc On This Field: Did trrigation Occur On This Field:
Yes ❑ No: ❑ Yes• - No: ❑ Yes: 0 No: ❑
FIELD NUMBER:I I FIELD NUMBER:
AREA SPRAYED acres): 1 2 AREA SPRAYED acres:
COVER CROP COVER CiIOP:
PERMITTED HOURLY RATE finchesi: PERMITTED HOURLY RATE(inches):
WEATHER CONDITIONS PERMITTED YEARLY RATE inches: PERMITTED YEARLY RATE inches:
D
Maximum Maximum
Tweather T•�;�1� Pr•ctplts- Loragoon Volume Time Daffy Hourly Volume Time Daily Hourly
CoOi' 111"Zg•n lion Freaioar Applied irrigated LoadingLoadingApplied Irr aged Load Loads
ng I
E M klches Net gallons minutes inches inches gallons minutes inches Inches
1 '1:3i7 t
2
3 -7
4
s `7 01
6 C Et
s
e so
g C 1 •7
io 76
11
12 C 1 -7
13
14 C
Is
16 C- L y
17 C '7 O
1s
1Y t7
20 -7 3 tJ
2, PC 3'� l
2:
2s S,
24 '7
25
21 `7
21 E
21 1
30 C I
31
Total GallonsiMonthly Loading(inches)
12 Month Floating Total(inches)
Avenge Weekly Loading(Inches)
'Weather Codes: Cclear,PC-partly cloudy,Citloudy,R-rain,Snsnow,SI-sleety
Spray Irrigation Operator in Responsible Charge(ORC): ;>pry (,Y�`G Phone: �-
ORC Certification Number: -7;p` \ Check Box if ORC Has Changed: ❑
Mail ORIGINAL and TWO COPIES to:
ATTN:Non-Discharge Compliance Unit nn
DENR CID-,
Division of Water Quality (SIGNATUME OF OPERATOR IN RESPONSIBLE CHARGE)
1617 Mail Service Center BY THIS SIGNATURE,I CERTIFY THAT THIS REPORT IS ACCURATE AND COMPLETE
RALEIGH,NC 27699-1617 TO THE BEST OF MY KNOWLEDGE.

NON-DISCHARGE APPLICATION REPORT Page of
SPRAY IRRIGATION SITE(S)
Facility Status:
Please indicate(by inserting Y(es)or N(o)in the appropriate box)whether the facility has beecomoliant
with the following permit requirements: (Vote: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.Addquate 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 pwrnit.
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.
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."
(Signature of Ppermittele-)` Date (Name Signing Official-Please print or type)
'3e c, a % ►\'eGG�1 �r.t A%m. ��1C.. L'erw%-'t r-
(Permittee-Please print or type) (Position or Title)
�.D .dcac QNg
(Phone Number) (Permit Exp.Date)
4"0JV'-_ &0' , -J A c
(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).