WQ0003090_Monitoring - 09-2023_20240102

Monitoring Report Submittal
Permit Number#* wg0003090
Name of Facility:* town of liberty wwtp
Month: * September Year: * 2023
Report Information
Type* Upload Document*
NDMR, NDAR-1, NDAR-2, NDMLR September 23 Spray Report.pdf 3.89MB
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: 1/2/2024
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: 1/24/2024

FORM: NDMR 10-13 NON -DISCHARGE MONITORING REPORT (NDMR) Page_l_of_l_
Permit No.: W00003090
I Facility Name: Town Of Liberty - Wastewater
I County: Randolph
I Month: September _T
Year: 2023
PPI: 002
Flow Measuring Point: influent [:] Effluent ❑ No flow generated Parameter Monitoring Point: El Influent [Z Effluent El Groundwater Lowering ❑ Surface Water
Parameter Code
00400
0
00610
31613
00625
50060
70300
00630
g
0
cc
>
E
z Q
+
0
.0
E
E
LL 0
0
F- :2
1 U) 0
0
0
0
j
1i
24-hr
hirs
su
mg/L
*/100 mL
mg/L
mg/L
mg/L
mg/L
2
j
3
4
unums
. . . . . . . . . . . . ...
5
7:00
8
6
7:00
8
INS,
7
7:00
8
210,
1
8
7:00
8
9
6.37
8.7
2420
63.4
0.15
Ei
<0.040
10
A
11
7:00
8
"
151,
12
7:00
8
A
13
7:00
8
"
V*
14
7:00
8
6.9
KEE=
VIM 1 0.15
15
7:00
16
16:30
2
All
ISM
17
9:30
2
R
18
7:00
8
r, I =1 1,191m,
INS
IN
19
7:00
8
KIN't
IN
20
7:00
8
at=
21
7:00
8
6.61
7.6
2420
14.3
0.05
11"1
A,
<0.040
221
7:00
8
X M
23
9:30
2
24
13:00
2
25
7:00
8
26
7:00
8
Z/
_UU
8
6.41
0.13
28,
7:00
8
0
1
WIN
R
9
MM
0
!3lt=
tam
SUN,
U4
Um
Average:
8.15
2,42000
#REF!!
0.12
IN 0.00
Daily Maximum:
6.90
8.70
2,420.00
#REF!
0.15
0.04
Daily Minimum:
6.37
7.60
2,420.00
#REF!
0,05
0.04
q
Sampling Type:
Grab
Grab
Grab
Grab
Grab
Monthly Avg. Limit:
Daily Limit:
Sample Frequency:
weekly
"I"

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? 2 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 0 No
Phone Number: 336 622 4276 Permit Expiration: 8/31/2024
y
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

�Yace'
Tremaine Fike
Town of Liberty
PO Box 1006
Liberty, NC 27298
Project: Town of Liberty - Effluent
Pace Project No.: 92686341
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 365.1 Rev 2.0 1993
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
Nitrogen, Ammonia
Nitrogen, Kjeldahl, Total
Phosphorus
Laboratory Report
Pace Analytical Services, LLC
1377 South Park Drive
Kernersville, NC 27284
[phone]
Page 1 of 1
Report Date: 09/19/2023
Date Received: 09/06/2023
Lab ID: 92686341001 Collected: 09/06/23 13:35 Matrix: Water
Results
1911
ND
ND
0.045
13.8
2420
PACE
Garrett
Dreyer
09/06/23
1335
6.37
0.15
63.4
8.7
63.4
3.2
Units
mg/L
mg/L
mg/L
mg/L
mg/L
MPN/100ml-
Sid. Units
mg/L
mg/L
mg/L
mg/L
mg/L
Report Limit
Analyzed Qualifiers
7.4
09107/2311:04
0.040
09/07/23 09:23
0.040
09/07/23 09:23
0.040
09/07/23 09:23
2.0
09/12/2312:56
1.0
09/07/2313:29 El
09/06/23 13:35
09/06/23 13:35
09/06/23 13:35
09/06/23 13:35
09/06/23 13:35
09/06/23 13:35
0.040
09/19/2316:05
0.10 09/15/2312:46
2.5 09/19/23 06:53
0.050 09/18/2313:43
ANALYTE QUALIFIERS
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.
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 4

-P1
P=- L=do' Rtrq.ested (rity/Statel,
lyii�i MC CHAIN -OF -CUSTODY Analytical Request Document
1��ace Pa,k Or, Ke,r,m,ille, NC 272134 fha;n,of-ivztadv is a LEGAL DOCUMENT - Corriptett a rut�anr fief&,
LAS USEONLY• Afnk Workord;Wl". L.15.1
WO#:92686341
CIDj 1111111111111111111111
92686341
cornpa-.Y 14— Town of Uberry
Street ACCIMS: PC So> 1006, 1 NC 27298
Pl-j� Nafmt; Town of Ub-rT,1 - EVelv 2 WeeiCS
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Yace�
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: Town of Liberty
Pace Project No.: 92687993
Page 1 of 1
Report Date: 09/14/2023
Date Received: 09/14/2023
Sample: Effluent
Method Parameters
Lab ID: 92687993001 Collected: 09/14/23 14:30 Matrix:
Results Units Report Limit
Water
Analyzed Qualifiers
Performed by
Pace
09/14/23 17:02
Collected By
Garrett
09/14/23 17:02
Dreyer
Collected Date
09/14/2023
09/14/23 17:02
Collected Time
1430
09/14/23 17:02
pH
6.90 Std. Units
09/14/23 17:02
Chlorine, Total Residual
0.15 mg/L
09/14/23 17:02
nzPru�`�erY
Reviewed by:
Stephanie Knott
704-977-0981
[e-mail]
Page 1 of 2

�aceAnalytical
mpany:'
dress:
port To:
py To:
stomil —Project Name/Number:
Chain-of-Custodv is a LEGAL DOCUMENT - Complete all relevent fields
Email To:
Site Co'lection Info/Address:
State., County/City:
W #*92687993
ALL SHADED AF
2 Container Preservative Ziei.IL-,
_L - J_[ � 92687993
—Preservative Types: (1) nitric acid, (2) sulfuric acid, (:'1­1
(6) methanol, (7) sodium bisulfate, (S) ;od'k m thiasulf ate, (9) hexane, (A) ascorbic acid, (8) ammonium nitrate,
(C) ammonium hydroxide, (D) TSP, (U) Unpreserved, (0) Other
Analyses Lab Profile/Line:
Time Zone Collected: Lab Sample Receggt thecklist:
JPT[ JMTJ ICT ET
Custody Seals Present/Intact Y N NA
one.
Site/Facility ID #:
Compliance Monitoring?
rail:
If
I blloYes [ ]NO
Ile By (print):
Purchase Order
DW PWS ID #:
Quote #
DW Location Code:
)—Ict d 8
Tg.rraround Date Required:
lmme:ate ly Packed on ice:
]Yes ]No
nple Disposal:
Rush:
Field Filtered (if applicable):
Dispose as appropriate I ]Return
Same Day Next Day
[ ] Yes ]No
Archive:
12Day [ ]3Day J 14Day 5 Day
Analysis:
HoH, -
(Expedite Charges Apply)
Custody Signati;ires Present
Y N NA
Collector Signature Present
Y N NA
Sottles Intact
Y N Na
Correct Bottles
Y N NA
Sufficient Volume
Y N 14A
Samples Received on Ice
'it N NA
VDA - Readspace Acceptable
Y N NA
USDA Regulated Soils
Y N NA
Samples in Holding Time
Y X Rik
Residual Chlorine Present
Y'N NIZ,
C1 Strips:
Sample pfl Acceptable
y x NA
PH strips:
Sulli'de Present
Y K U71
Aatrix Codes (insert in Matrix box below): Drink'ng Water (DW), Ground Water (GW), Wastewater (WW), Lead Aaetate Strips:
roduct (P), Soil/Solid (SQ, Oil (OL), Wipe (WP), Air (AR), Tissue (TS), Bioassay (9), Vapor (V), Other (OT)
LAB USE ONLY
Lab Sample-f Comments -
Comp Collected (or Res # of
Composite End Cl Ct
istomer Sample ID Matrix Grab Cam positeStart� Cl Ctns
Date Time Date I Time
7--
><
...........
......... . ..... ..... 4—
stamer Remarks / Special Conditions / Possible Hazards:
linquighed by/Company:
r'.)
0
4nqu'shed by/Company:
Type of Ice Used-, Wet Blue Dry None
!SHORT HOLDS R tESENT(<72 hours); Y N N/A
Lab Sample Temperature info:
. ....... . ...
Packing Material Used.
Lab Tracking #:
Temp Blank Received: Y N NA
Therm ID#-.
Cooler I Temp Upon Receipt: oC
Samples received via.
Cooler I Therm Corr. Factor, _oC
Radchem sample(s) screened (<500 cpnn): Y N 11 NA
FEDEX UPS Client
Courier Pace Courier
Cooler I Corrected Temp: pC,
Time: R i d b /C mpany- Sig Lure)
Date/Time:
MTJL LAB USE ONLY
— --------
Comments:
-
I
la ble 9
-c—-
Acctnurn*
,me: Receive y: tignature)
�4llmpiil
Da te/Time
Template:
Trip Blank Received: Y N NA
Prelogin:
MCL MeOH TSP Other
Date/Time: f Received by/Company: (Signature) rP m.- Non Cianforma nce(s): ;Page:

Yace,
Laboratory Report
Tremaine Fike
Town of Liberty
PO Box 1006
Liberty, NC 27298
Project: Town of Liberty
Pace Project No.: 92689267
Pace Analytical Services, LLC
1377 South Park Drive
Kernersville, NC 27284
[phone]
Page 1 of 1
Report Date: 10/03/2023
Date Received: 09/21 /2023
Sample: Effluent
Method Parameters
Lab ID: 92689267001 Collected: 09/21/23 11:30 Matrix:
Results Units Report Limit
Water
Analyzed Qualifiers
SM 2540D-2015 Total Suspended Solids
54.6
mg/L
10.4
09/25/23 11:58
EPA 353.2 Rev 2.0 1993 Nitrogen, NO2 plus NO3
ND
mg/L
0.040
09/22/23 12:00
EPA 353.2 Rev 2.0 1993 Nitrogen, Nitrate
ND
mg/L
0.040
09/22/23 12:00
EPA 353.2 Rev 2.0 1993 Nitrogen, Nitrite
0.045
mg/L
0.040
09/22/23 12:00
SM 521 OB-2016 BOD, 5 day
20.7
mg/L
2.0
09/27/23 14:03
Colilert-18 Fecal Coliforms
2420
MPN/100mL
1.0
09/22/23 12:29 El
Performed by
PACE
09/21/23 11:30
Collected By
Garrett
09/21/23 11:30
Dreyer
Collected Date
09/21/23
09/21/23 11:30
Collected Time
1130
09/21/23 11:30
pH
6.61
Std. Units
09/21/23 11:30
Chlorine, Total Residual
0.05
mg/L
09/21/23 11:30
TKN+NO3+NO2 Total Nitrogen
14.3
mg/L
0.040
10/03/23 18:43
Calculation
EPA 350.1 Rev 2.0 1993 Nitrogen, Ammonia
7.6
mg/L
0.10
09/30/23 08:50
EPA 351.2 Rev 2.0 1993 Nitrogen, Kjeldahl, Total
14.3
mg/L
0.50
09/30/23 03:55
EPA 365.1 Rev 2.0 1993 Phosphorus
2.3
mg/L
0.050
10/02/23 12:57
ANALYTE QUALIFIERS
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.
Reviewed by:
Stephanie Knott
704-977-0981
[e-mail]
Pace Analytical Services Asheville
2225 Riverside Drive, Asheville, NC 28804
South Carolina Laboratory ID: 99030
Florida/NELAP Certification #: E87648
South Carolina Certification #: 99030001
North Carolina Drinking Water Certification #: 37712
Virginia/VELAP Certification #: 460222
North Carolina Wastewater Certification #: 40
Pace Analytical Services Eden
205 East Meadow Road Suite A, Eden, NC 27288
North Carolina Wastewater Certification #: 633
North Carolina Drinking Water Certification #: 37738
Virginia/VELAP Certification #: 460025
Page 1 of 4

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samples originate'. a clo arant no, zone within thy: United
Y £°S ��NC�
States. CA, ;NY, or 5C (rlcck r;)aps;�
Drd sarrapies originate from a Foreign znr,rce (ua;er7na; nrrrr� v
Enduding Ha,,43i) and Puerto Rice)? Elyes JN,�
i Clain of Custody Pre sent?
! Sarnplc�sArrivedvv�rlin Hoiri YIrr1P`? _�_ [rs— �"jra� �jCdJn_ 2
( akrtart ton<aI o d Tlo�re- ysis (<'92 tar.j? Yes C�Nc E]N/A~ 3
Rush Turn Around Time Requested?
--- JN/A l
Sufficient t/olunte?
C s u C iron DN/A s
Correct Containers Uwd? �es C�N nN/A 5
-Pace Conwiners Used? es [ No [Irv1A
Cantainrrslntar.
l Dissolves! anaiysas; Samples Fiekd Filtered? ,yo N,rA_ 8.
,ample Libels tvlatch COC? �T _�a, �nN,) I]NIA � x� __ ._—
I
Includes Date/imp/ID/Analysis Matrix;
I leadspace in VOA Vials ('r5.Gmrra)? vcs [,JNo [ N/A tp,
T r;ia Blank f Present?
l�lYes
nPJo
T rira E3! tnk Custody Seals i reSenda eye5 a N/A
- ,._—,p....,....__ ,�...�... ___.._..._ _...n.,.w_....,,_....-------..__..-_._-___........_-----_._......—.__...__�__._-
CCThf1M PITS SAMPLE L)-1 C— £PA�I� S Field Data Required? l�]Yes
T errap Lois: Temp rnurt Ire maintained
at <6 C during login, rec and tenap
every ZD miasut€as,
Tlrr7r gra n d: ('" f. p Ternp; , ?p
Time; ! yJ 2� � taut in cr3aler
Time: Temp;
t'c',rSUr�Gt1iaCC(.Ci: _..
Project Manager SCURF Review:
Project Manager SRF Review:
Quall(ax Dc)cu(nvn( Ifs, 70677
Lot ICE of split containers:
..............
CLILN F NOTIFICATION/RESOLUTION
Dace:
Page 1 of 2
Page 3 of 4

2aceAnaiXical'
Document Name:
Bottle Identiflcation Form
Document No.:
F-CAR CS Q43•Rev.01
*Check mark top half of box if pH and/or dechlorination is Project if
verified and within the acceptance range for preservation
samples.
Exceptions: VOA, Coliform, TOC, oil and Grease, DRO/Bo15 (water) DOC, LLHg
**Bottom half of box is to list number of battles
Document Issued: November 15, 2021
Page 1 of 1
Issuing Authority:
Pace Carolinas Quality Office
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------=--pH Adjustment lob for Preserved samples
Sample ID
Type of Preservative
pH upon receipt
Date preservation adjusted
Time preservation
adjusted
Amount of Preservative
added
Lott)
G e: ..,, it'"t f m—c 1� a ulst.eepdm y dnecisng Norin Carolina compliance samples, a copy of this form will be sent to the North Carolina DEHNR Certification OfficQ (1,e.
Out of hold, incorrect preservative, out of temp, Incorrect containers.
Page 4 of 4

Laboratory Report
Tremaine Fike
Town of Liberty
PO Box 1006
Liberty, NC 27298
Project: Town of Liberty WWTP
Pace Project No.: 92690241
Pace Analytical Services, LLC
1377 South Park Drive
Kernersville, NC 27284
[phone]
Page 1 of 1
Report Date: 09/27/2023
Date Received: 09/27/2023
Sample: Effluent
Method Parameters
Lab ID: 92690241001 Collected: 09/27/23 11:35 Matrix:
Results Units Report Limit
Water
Analyzed Qualifiers
Performed by
Pace
09/27/23 16:32
Collected By
Garrett
09/27/23 16:32
Dreyer
Collected Date
09/27/2023
09/27/23 16:32
Collected Time
1135
09/27/23 16:32
pH
6.41 Std. Units
09/27/23 16:32
Chlorine, Total Residual
0.13 mg/L
09/27/23 16:32
Reviewed by:
Stephanie Knott
704-977-0981
[e-mail]
Page 1 of 2

"J!!�/
aceAna]yIical
imparry:
1dress:
,port To:
1py To -
-
NO
CHAIWOF-CUSTODY Analytical Request Document
Chain -of -Custody is a LEGAL DOCUMENT - Complete all relevent fields
�[ Billing Information:
Emait To:
Site Collection Info/Address,
LAZ; U_bt UPSLY- A777.19 VV0TXCrc1er/4LCgiD LaDel Nef-- CC L15Z t-aCe wUr3;UJ`=r ­v;;mss
­
WN I n-iw—"-
wo#-92690241
ALL SH
Container Preservativ=
2 = 926 241
* * Preservative Types: (1) n tric acid, (2). ID) anc acetate.
16) methanol, (7) sodium bisulfate, (8) sodium thiosulfate, (9) hexane, (A) ascorbic acid, (6) ammonium sulfate,
(C) ammon um hydroxide, (D) TSP, (U) Unpreserved, (0) Other
istomer Project Name/Number: [State: County/City. Time Zone Collected:
]PT( JMT( ]Cl f ]ET
ione, Site/Facility ID it' Compliance Monitoring?
Site/Facility 'ty'D Fa':"
nail: Oes ]No
By (print): Purchase Order DW PWS ID 9:
Illec Purchase Order #:
'w-d
Q . .
Quote #: DW Location Code:
)Ilected 0, 1• TurnMiund Date Required: imm tately Pac! ea onIce:
( I Yes I )NO
Rush; Field Filtered (if applicable):
I Dispose as appropriate Return ( ) Same Day f J Next Day [ ] Yes ]No
I Archive: 12Day f 13Day [ 14Day 1 15 Day
Analysis:
0'
Hold, (Expedite Charges Apply)
matrix Codes (insert in Matrix box below): Drinking Water (DW), Ground Water (GW), Wastewater (WW),
:'roduct (P), Soil/Solid (SQ, Oil (OL), Wipe (WP), Air (AR), Tissue (TS), Bioassay (B), Vapor (V), Other (OT)
Comp J Collected (or
Composite End
Res of
istomer Sample ID Matrix Grab Composite Start)
CI Ctns
pate Time Date Time
— ---------
T-
istomer Remarks Special Conditions Possible Hazards: Type of Ice Used; Wet Blue Dry None
SHORT HOLDS PRESENT (472
Packing Material Used.
Lab Track[ng
ISamples received Via.
[Radd-tern 500 cpm). Y N NA
sampfe(s) screened
t FEDEX . UPS
Chen
-Date/Time: Recei by/Company: tu re)
ale/ I ime:
D M
'1�7 k3 0�;.V
Wceil
�db
R e v e y lCom "y: (Sign'_,W'�e)
Dmpany-. (Signature) t'y/C.
Date/Time:
,linquished by/Company: (Signature) 0�ate/Tirrie: Received by/Company: (Signature)
Date/Time:
Lab Profile/Line.-
Sample Receipt t
Custody Seals Present/intact Y N 94%
,custody signatures Present y a lap.
Collector Signature Present Y N NA
Bottles Intact Y N NA,
Correct Bottles Y N DIX-
sufficient Volume y N NA
Samples Received on Ice Y N NA.
VOA - Peadspace Acceptable Y N NA
USDA Regulated Soils y N NA
Samples in Holding Time �Y N H&
Residual Chlorine Present Y N NA
01 Strips -
Sample PH Acceptable Ts NA
PH Strips:
Sultide Present e� Y N NA
Lead Acetate Strips:
LAB USE ONLY:
I.
iab'Sample Comments:
...... ....
hours).- Y ,
N, N/A Lab Sample Temperature Info:
Temp Blank Received: Y N NA
Therm ID#.
CxxAer 1 Temp Upon Receipt: pC
Cooler 1 Therm Carr. Factor. pC
t Courier
Pace Courier Cooler I Corrected Ternp, CC
MTJL LAB USE ONLY
Table
Acctrium:
Template.
prelogin-
h Trip Blank Received. Y N NA
HCL MeOH TSP Other
IPM:
Pior, Conformance(s): Page:

®ATE
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
September 2023
Liberty N.C.W.W.T.F.
Freeboard Lagoon Inches
20
19 3/4
20 1 /2
21 3/4
21
22
23
24
25 R 1.0
23 1 /2
23
22 1 /2
23 1 /2
24
24 1 /2
25
25 1 /2 R 0.3
25
24 1 /2
25 1 /2
26 1 /2
27
28 1 /2 R 0.5
27 3/4
27 1 /2
28
28 1 /2
29
29 1 /2
30
TOTAL 1.8

FORM: NDAR-1 10-13
NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Did the application rates exceed the limits in Attachment B of your permit?
Q Compliant ❑ Non -Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites? ❑✓ Compliant ❑ Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit? 21 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 0 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 NDARA? ❑ Yes 0 No
Phone Number: 336 622 4276 Permit Exp.: 8/31/24
Signature Date
L77—
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: September
Year: 2023
_ Y jfiti
Field Name:
6
# tt a
5 Y
#�� ��
Field Name:
8
Did irrigation occur
i �€'$Y �2 k .ri.WL� ,- i l• v- i�
Area (acres):
15.1
Y{ t �;� `� t Si S � lal. � Y t >
Area (acres):
---...._
21.68
at this facility
Cover Crop:
FESCUE
Cover Crop:
FESCUE
❑ El
Hourly Rate (in):
0.21
4Ki#YbiyY: 4 tY df Z k{ 4 ,1+?^i �.
���z{
Hourly Rate
YES NO
}t
Annual Rate (in):
52
E,��4� -
Annual Rate (in):
52
Weather
Freeboard
`� f
Field Irrigated?
❑ YES ❑ NO
�
$° "
��'��t� ���s�i+
Field Irrigated?
0 YES ❑ NO
. YA
At 2. 34, Yki>, v.5 t i.`�4�ua?°i
o
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U # a
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'v t
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t` 1P/'�j.,;�u'.
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ASi'U`a tr f• t $ \ L�SF ti
i Q
L
_
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e J
C
~
a
r
.�t h>NYY S
°F
in
ft
I ft
gal
min
in
in
,, ys "„ n�
gal
min
in
in
2
3
4
5
C
94
1.75
6
71
C
71
1.75
180
0.59
0.20
���, �„ �; , tt,r �• Ut��x �, ;„� ,Y �,,,
350,000
8
1 C
89
2`�
420,000
300
1.02
0.20u,4��_
9
R
1
10
12�x,�`,i
13
C
80
1.75
420,000
300
1.02
0.20
.>
141
C
75
2
151
C
70
2
16
C
83
2
�' ,� "�.��' � t �7� �, �E '
'4 �` `` 7 4
';F "' . ?Y.
584,000
300
0.99
0.20
17
R
0.3
18
19
C
80
2
R'
20
C
72
2
420,000
300
1.02
0.20
,�0`..;. i r:.,. s x„�..# 1 A. t §•x'` t
21
C
68
2
0.99
0.20
22
23
R
0.5flN�
24
25
C
80
2.25
420,000
420,000
300
1.02
0.20I'lliisft.a)
:.€":
..1.
26
CL
70
2.25
1, 4..
27
C
74
2.25
28i
29
PC
61
2.25
420,000
300
1.02
0.20`��Y�.E
30
PC
70
2.5
{f . Aua?at a ut<s
t :`��t� is
311
2,100,000
5.12,;
2,102,000
Monthly Loading,
3.57
12 Month Floating Total (in):"�`
a s��#
29.28
� �.��" �'` a t
#
23.58

FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-11) Page _1_ of _2_
Permit No.: W00003090
Facility Name: Town of Liberty - Wastewater
County: Randolph
Month: September
Year: 2023
Field Name:
2
Field Name:
4
Did irrigation occur
Area (acres):
19.7
Area (acres):
17.02
at this facility?
Cover Crop:
FESCUE
Cover Crop:
FESCUE
7 El
V
Hourly Rate (in):
0.21
Hourly Rate
YES NO
120
Annual Rate (in):
52
1,1 1
Annual Rate (in):
52
Weather
Freeboard
Field irrigated?
❑ YES ❑ NO
Field Irrigated?
[21 YES
D NO
. . . . . . . . . .
'em
'a
0
Q
CLCi
.2
>1
E .22
CL
E
6 M .—
x 0
0
0 0.
E
E
. =
X 0
E
CL
CL
>
0 0
>
0
cc 0
a
O
g al
min
in
in
F
in
ft
ft
2M
2
C
75
1.5
3
C
80
1.5
US
545,000
300
1.02
0.20
4
P
5
C
72
1.5
6
C
74
1.75
545,000
300
1.02
0.20
7
C
86
1.75
8
C
71
2
9
R
1
10.
12
CL
70
1.75
z
545,000
300
1.02
0.20
13
14
15.
16
17
R
0.3
18
2
19
C
74
2
20
1113
21
22
C
76
2.25
468,000
300
1.01
0.20
23
R
0.5
24
&
25
26
MWA
27
28
C
76
2.25
468,000
300
1.01
0.20
29
301
0, X01
311
1
1
1
7635,000
Monthly Loading:
3.06
12 Month Floating Total (in):

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? Q 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? 2 Compliant ❑ Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? ❑ Compliant Q 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 NDAR-1? ❑ Yes 0 No
Phone Number: 336 622 4276 Permit Exp.: 8/31/24
/
s
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