WQ0004502_Monitoring - 11-2023_20231215

Monitoring Report Submittal
Permit Number#* WQ0004502
Name of Facility:* Hillsborough United Church of Christ
Month: * November Year: * 2023
Report Information
Type *
NDMR, NDAR-1, NDAR-2, NDMLR
Confirmation Email Address:
Name of Submitter: *
Signature:
Date of submittal:
Initial Review
Upload Document*
11.2023.pdf
PDF Only
171.86KB
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
[e-mail]
Christy Gracia
cl?'"4Otrf Ftl"r r
Reviewer: Wanda.Gerald
12/15/2023
This will be filled in automatically

Is the project number correct?* W00004502
Is the monitoring report accepted?* Yes NO
Regional Office* Raleigh
Reviewer: _anonymous
Review Date: 12/18/2023

NON DISCHARGE WASTEWATER MONITORING REPORT Page of�
PERMIT NUMBER: WQ0004502 MONTH: November YEAR: 2023
FACILITY NAME: Hillsborough United Church of Christ COUNTY: Orange
Flow Monitoring Point:■
Point:Parameter Monitoring ■ ■
�1
, ■ ■
.'Treatment:..
(Flow) into
Dailylo
System
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1
Operator in Responsible Charge (ORC): James W Gooch Grade: IV Phone: [phone]
Check Box if ORC Has Changed: ❑ ORC Certification Number: 988035
Certified Laboratories (1):
Person(s) Collecting Samples:
Mail ORIGINAL and TWO COPIES to: d.
ATTN: Non -Discharge Compliance unit IG ATURE
DENR B THIS SIGI
Division of Water Quality AND COMPLI
1617 Mail Service Center
RALEIGH, NC 27699-1617
(2):
PtATOR IN RESPIONSIBLE CHARGE)
I CERTIFY THAT THIS REPORT IS ACCURATE
THE BEST OF MY KNOWLEDGE.
DENR FORM NDMR-1 (612003)

NON DISCHARGE WASTEWATER MONITORING REPORT
Page of
Facility Status:
Please answer the following question:
Compliant Y,N)
1. Does all monitoring data and sampling frequencies meet permit requirements?
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 pos,;ibilily of fines and imprisonment for knowing violations."
Of
HillsborougffUnited Church of Christ
ittee-Please print or type)
200 Davis Rd.
Hillsborough NC 27278
(Permittee Address)
Parameter Codes:
James W Gooch
(Name of Signing Official -Please print or type)
ORC for Spray and Wastewater
(Position or Title)
919-732-9183
(Phone Number)
01002 Afsentc
31504 Coliform, Total
00600 Nitrogen, Total
00929 Sodium
01022 Boron
00094 Conductivity
00630 N029NO3
00931 SAR
00310 BOD5
01042 Copper
00620 NO3
00746 Sulfide
01027 Cadmium
00300 Dissolved Oxygen
00556 011-Grease
70295 TDS
00916 Calcium
31616 Fecal Coliform
W009 PAN (Plant Available)
00010 Temperature
00940 Chlodde
01051 Lead
D0400 pH
OW25 TKN
50060 Chlorine, Total
Residual
00927 Magnesium
32730 Phenols
00680 TOC
71900 Mercury
00665 Phosphorus, Total
00530 TSS[TSR
01034 Chromium
00610 NH3asN
D0937 Potassium
00076 Turbidity
00340 COD
01067 Nickel
00545 Settleable Matter
01092 Zinc
4/30/2021
(Permit Exp. Date)
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.
t If signed by other than the permittee, delegation of signatory authority must be on file with the state per 15A NCAC 213.0606 (b)(2)(D).
DENR FORM NDMR-1 (6/2003)

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: November
YEAR: 2023
FACILITY NAME: Hillsborough United Church of Christ COUNTY: Orange
Formulas:
Daily Loading (Inches) = [Volume Applied (gagans) x0.1336 (cublc feetfgallon) x 12 (ncheslfool)] / Ikea Sprayed (acres) x 43,560 (square feellacm)] OR
= Volume Applied (gallons)/Wea Sprayed (acres) x 27,152 (gallonslacre-inch)]
Maximum Hourly Leading (inches) =Daily Loading (inches)/]Time Irrigated (minutes)/60(minulesthour)] Monthly Loading (inches) =Sum of Daily Loadings( inches)
12 Month Floating Total (inches) = Sum of this month's Monthly Loading finches) and previous 11 month's Monthly Loadings finches)
Average Weekly Loading (Inches) - Monthly Loading (Inches/month) /Humber of days In the month (days/month)) x7 (daysAwek)
Did Irrigation Occur At This Facility:
Yes: No:
Did Irrigation Occur On This Field:
Yes: No:
Did Irrigation Occur On This Field:
Yes: El 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);
OMWEATHERITIONS
AStorage
E
Lagoon
Free -Volume
board
PERMITTEDYEARLY RATE
inches :
26
PERMITTED YEARLY RATE Inches :
Preciphe-
lion
A plied
Time
Irri ated
Daily
Loadin
Maximum
Hourly
Loadin
Volume
A lied
Time
Irri ated
Daily
Loading
Maximum
Hourly
Loading
Inches
feet
gallons
minutes
Inches
inches
gallons
minutes
Inches
Inches
1
2
3
C
62
0
2.25
7920
240
1 0.11
0.03
4
5
6
7
8
9
10
CL
64
0
2.5
0
0
0.00
#DIV101
11
12
13
14
15
CL
48
0
2.26
7920
240
0.11
0.03
16
17
18
19
20
21
22
23
24
CL
46
0
2.75
0
0
0.00
#DIV/O!
25
26
27
28
29
30
J31
PC
56
0
2.5
0
0
0.00
#DIV/Oi
Total Gallons/Monthly Loading (inches)
15840
0.22
0
0.00
12 Month Floating Total (inches)l
2.30
Average Weekly Loading (inches)l
0.0523191
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: SI 987567
Mail ORIGINAL and TWO COPIES to:
ATTN: Non -Discharge Compliance Unit
DENR
Division of Water Quality
1617 Mail Service Center
RALEIGH, NC 27699.1617
James W Gooch
Check Box if ORC Has Changed: O
OF OPhPATOR
Phone: [phone]
tHIS SIGNATURE, I CERRFY THAT THIS REPO1f1lS ACCURATE AND COMPLETE
THE BEST OF MY KNOWLEDGE.
DENR FORM NDAR-t (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. )
in the
Com III Y N)
Y
1. The application rate(s) did not exceed the limit(s) specified permit.
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.
0
4. All buffer zones as specified in the permit were maintained during each application.
YO
6. The freeboard In the treatment and/or storage lagoon(s) was not less than the limit(s)
U
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."
dAJames Gooch
{ ure o Date {Name of Signing Official -Please print or type)
Hlitsborou0h United Church of Christ ORC for Spray and Wastewater
(Permlttee-Please print or type) (Position or Title)
200 Davis Rd.
Hillsborough NC 27278
(Permittee Address)
919.732-9183 4/30/2021
(Phone Number) (Permit Exp. Date)
*If signed by other than the permiHoo, delegation of signatory authority must be on filo with the state per 16A NCAC 2B.0506 (b)(2)(D),
DENR FORM NDAR-1 (5/2003)