WQ0022785_Monitoring - 09-2023_20231225 (2)

Monitoring Report Submittal
Permit Number#*
Name of Facility:*
Month: * September
WQ0022785
Lattisville Grove Church
Report Information
Type *
NDMR, NDAR-1, NDAR-2, NDMLR
Confirmation Email Address:
Name of Submitter: *
Signature:
Date of submittal:
Initial Review
Year:* 2023
Upload Document*
LGBC_ND 2309.pdf 260.63KB
PDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
[e-mail]
Lattisville Grove Church
Reviewer: Wanda.Gerald
12/25/2023
This will be filled in automatically

Is the project number correct?* W00022785
Is the monitoring report accepted?* Yes NO
Regional Office* Raleigh
Reviewer: _anonymous
Review Date: 1/16/2024

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDITIONAL PAGES AS NEEDED.
Page of
PERMIT NUMBER: WQ0022785
MONTH: September
YEAR: 2023
FACILITY NAME: Lattisville Grove Baptist Church 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/acref 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:
Yes: No:
Did Irrigation Occur On This Field:
Yes: No:
Did Irrigation Occur On This Field:
Yes: No:
FIELD NUMBER:
1
FIELD NUMBER:
AREA SPRAYED (acres):
1.04
AREA SPRAYED (acres):
COVER CROP:
Fescue, Rye
COVER CROP:
PERMITTED HOURLY RATE (inches):
0.2
PERMITTED HOURLY RATE (inches):
D
A
T
E
WEATHER CONDITIONS
Storage
Lagoon
Free -board
PERMITTED YEARLY RATE (inches):
23.75
PERMITTED YEARLY RATE (inches):
weather
Code*
Temper-ature
at application
Precipita-tion
Volume
Applied
Time
Irrigated
Daily
Loading
Maximum
Hourly
Loading
Volume
Applied
Time
Irrigated
Daily
Loading
Maximum
Hourly
Loading
ff)
inches
feet
gallons
minutes
inches
inches
gallons
minutes
inches
inches
1
NA
0
0
0.00
#DIV/0!
2
NA
0
0
0.00
#DIV/0!
3
NA
0
0
0.00
#DIV/0!
4
NA
0
1 0
0.00
#DIV/0!
5
NA
0
0
0.00
#DIV/0!
6
CI
97
0
NA
0
0
0.00
#DIV/0!
7
NA
0
0
0.00
#DIV/0!
8
NA
0
0
0.00
#DIV/0!
9
NA
0
0
0.00
#DIV/0!
10
NA
0
0
0.00
#DIV/0!
ill
I NA
0
0
0.00
#DIV/0!
12
CI
84
1.2
NA
0
0
0.00
#DIV/0!
13
NA
0
0
0.00
#DIV/0!
14
NA
0
0
0.00
#DIV/0!
15
NA
0
0
0.00
#DIV/0!
16
NA
0
0
0.00
#DIV/0!
17
NA
0
0
0.00
#DIV/0!
18
NA
0
0
0.00
#DIV/0!
19
NA
0
0
0.00
#DIV/0!
201
CI
84
0.2
NA
0
0
0.00
#DIV/0!
21
NA
0
0
0.00
#DIV/0!
22
NA
0
0
0.00
#DIV/0!
23
NA
0
0
0.00
#DIV/0!
24
NA
0
0
0.00
#DIV/0!
25
NA
0
0
0.00
#DIV/0!
26
NA
0
0
0.00
#DIV/0!
271
CI
68
0.8
NA
0
0
0.00
#DIV/0!
NA
0
0
0.00
#DIV/0!
29
NA
0
0
0.00
#DIV/0!
30
L3128
NA
0
0
0.00
#DIV/0!
NA
Total Gallons/Monthly Loading
(inches)
0
0.00
0
0.00
12 Month Floating Total (inches)
1.65
Average Weekly Loading (inches)
0
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:
Mail ORIGINAL and TWO COPIES to:
ATTN: Non -Discharge Compliance Unit
DENR
Division of Water Quality
1617 Mail Service Center
RALEIGH, NC 27699-1617
Chad Leinbach Phone: [phone]
23928 Check Box if ORC Has Changed: ❑
(?/&_� Le�ac_.�
(SIGNATURE OF OPERATOR IN RESPONSIBLE CHARGE)
BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS ACCURATE AND COMPLETE
TO THE BEST OF MY KNOWLEDGE.
DENR FORM NDAR-1 (5/2003)

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 been compliant
with the following permit requirements: (Note: 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. 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.
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.
This system is getting infiltration during rain events. Also, the irrigation meters appear to be malfunctioning so Irrigation is
estimated from average water usage. Chad - ORC
"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."
[?/, Z-,ur a.cf 10/15/23
(Signature of Permittee)* Date
Lattisville Grove Baptist Church
(Permittee-Please print or type)
1701 Jimmy Ed Road
Hurdle Mills, NC 27541
(Permittee Address)
Chad Leinbach
(Name of Signing Official -Please print or type)
ORC
(Position or Title)
[phone]
(Phone Number)
* If signed by other than the permittee, delegation of signatory authority must be on file with the state per 15A NCAC 213.0506 (b)(2)(1)).
10/31 /23
(Permit Exp. Date)
DENR FORM NDAR-1 (5/2003)

NON DISCHARGE WASTEWATER MONITORING REPORT Page of
PERMIT NUMBER:
FACILITY NAME:
WQ0022785
Lattisville Grove Baptist Church
MONTH: September YEAR: 2023
COUNTY: Orange
Flow Monitoring Point: Effluent: Influent:
Parameter Monitoring Point: Effluent: X Influent: Surface Water (SW):
SW Code/Name:
Was There Effluent Flow For This Month Generated At This Facility: Yes: N No:
50050
00400
50060
00310
00610
00530
31616
1 00625
00630
00665
000620
00600
D
A
T
E
Operator
Arrival
Time 2400
Clock
Operator
Time On
site
ORC
on
Site?
Daily Rate (Flow)
into Treatment
System
pH
Residual
Chlorine
BOD-5
20oC
NH3-N
TSS
Fecal
Coliform (Geo
metric Mean*)
TKN
Nitrate +
Nitrite
Total
Phosph
Orus
Total
Nitrate
as N
Total
Nitrogen
as N
HRS
Y/N
GALLONS
UNITS
UG/L
MG/L
MG/L
MG/L
/100ML
MG/L
MG/L
MG/L
MG/L
MG/L
1
129
2
129
3
129
4
129
5
129
6
14:15
0.33
N
129
6.76
0.31
7
33
s
33
9
33
10
33
11
33
12
14:45
0.33
N
33
6.83
0.29
13
225
14
225
15
225
161
225
17
225
18
225
19
225
20
13:05
0.33
N
225
6.93
0.24
21
143
221
143
23
143
24
143
25
143
26
143
27
13:20
0.33
Y
143
6.98
0.14
281
286
29
286
30
286
31
EL
Average
154.36667
0.245
#DIV/0!
#DIV/0!
#DIV/0!
#NUM!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
#DIV/0!
Daily Maximum
286
6.98
0.311
01
01
0
0
0
0
0
0
0
Daily Minimum
1 33
6.76
0.14
01
0
01
0
0
01
0
01
0
Monthly Limit(s)
956 GPD
NA
IG
NA
NAI
NA
NA
NA
NA
NA
NA
NA
NA
Composite (C) / Grab (G)
G
G
G
G
G
G
G
G
G
G
Operator in Responsible Charge (ORC): Chad Leinbach Grade: SI
Check Box if ORC Has Changed: ORC Certification Number:
Certified Laboratories (1): Conner Consulting, LLC (Field)
Person(s) Collecting Samples: Chad Leinbach
Mail ORIGINAL and TWO COPIES to:
ATTN: Non -Discharge Compliance Unit
DENR
Division of Water Quality
1617 Mail Service Center
RALEIGH, NC 27699-1617
Phone: [phone]
23928
(2): ENCO, Inc. (Lab)
�W4l Z_94/u4alc�
(SIGNATURE OF OPERATOR IN RESPONSIBLE CHARGE)
BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS ACCURATE
AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
DENR FORM NDMR-1 (5/2003)

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? OY
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."
10/15/23
(Signature of Permittee)* Date
Lattisville Grove Baptist Church
(Permittee-Please print or type)
1701 Jimmv Ed Road
Hurdle Mills, NC 27541
(Permittee Address)
Parameter Codes:
Chad Leinbach
(Name of Signing Official -Please print or type)
(Position or Title)
[phone]
(Phone Number)
ORC
01002 Arsenic
31504 Coliform, Total
00600 Nitrogen, Total
00929 Sodium
01022 Boron
00094 Conductivity
00630 NO2&NO3
00931 SAR
00310 BOD5
01042 Copper
00620 NO3
00745 Sulfide
01027 Cadmium
00300 Dissolved Oxygen
00556 Oil -Grease
70295 TDS
00916 Calcium
31616 Fecal Coliform
WQ09 PAN Plant Available
00010 Temperature
00940 Chloride
01051 Lead
00400 pH
00625 TKN
50060 Chlorine, Total
Residual
00927 Magnesium
32730 Phenols
00680 TOC
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
10/31 /23
(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.
* If signed by other than the permittee, delegation of signatory authority must be on file with the state per 15A NCAC 213.0506 (b)(2)(D).
DENR FORM NDMR-1 (5/2003)