WQ0022870_Monitoring - 08-2016_20161004

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDITIONAL PAGES AS NEEDED.
PERMIT NUMBER: WQ0022870 MONTH: August YEAR: 2016
FACILITY NAME: Buck Mountain Development COUNTY: Chatham
Formulas:
Daily Loading (inches) = [Volume Applied (gallons) x 0.1336 (cubic feetigallon) x 12 (inches/foot)] /[Area Sprayed (acres) x 43,560 (square feet/acre)] OR
= Volume Applied (gallons) / [Area Sprayed (acres) x 27,152 (gallons/acre-inch)]
Maximum Hourly Loading (inches) =Daily Loading (inches) / [Time Irrigated (minutes) 160 (minutes/hour)] Monthly Loading (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 finches/month) / Number of days in the month (days/month)] x 7 (days/week)
Did Irrigation Occur At This Facility:
Yes: x
No:
Did Irrigation Occur On This Field:
Yes: x No:
Did Irrigation Occur On This Field:
Yes: No:
x
...............................
........................................
:':'
FIELD NUMBER: F1
A SPRAYED acres : 11.4
COVER CROP: turf rays
ITTED HOURLY RATE (inches): 0.1
FIELD NUMBER: F2
EA SPRAYED (acres): 5.56
COVER CROP: turf rass
WITTED HOURLY RATE (inches): 0.1
WEATHER CONDITIONS
ITTED YEARLY RATE (inches):
20.47
kMITTED YEARLY RATE (inches):
20.47
D
A
T
E
Weather
Code'
Temper-
store at
application
Storage
Prectpita- Lagoon
tion Free -board
Volume
Applied
Time
Irrigated
Dail Y
Loading
Maximum
Hourly
Y
Loading
Volume Time
lApplied Irri ated I
Dail Y
Loading
Maximu
m Hourly
Y
Loading
(°F)
inches feet
gallons
minutes
Inches
inches
gallons minutes
inches
inches
1
loft
2
3
4
5
6
7
8
9
10
CL
72
0
25200
240
0.06
0.02
5400 10
0.04
0.10
11
12
13
14
R
1 74
0.01
25200
240
0.06
0.02
5400 10
0.04
0.10
15
16
17
R
74
0.01
25200
240
0.06
0.02
5400 10
0.04
0.10
18
C
74
0
25200
240
0.06
0.02
5400 10
0.04
0.10
19
R
74
0.79
25200
240 1
0.06
0.02
5400 10
0.04
0.10
20
R
74
0.01
25200
240
0.06
0.02
5400 10
0.04
0.10
21
R
1 74
0.01
25200
240
0.06
0.02
5400 10 1
0.04
0.10
22
C
67
0
25200
240
0.06
0.02
5400 10
0.04
0.10
23
C
62
0
25200
240
0.06
0.02
5400 10
0.04
0.10
24
25
26
27
28
29
30
C
65
0
25200
240
0.06
0.02
5400 10
0.04
0.10
31
Total Gallons/Monthly Loading (inches) 252000:
0.60
54000 :::::::
0.40
12 Month Floating Total (inches)
::::::::::::::::::::::.:::.:::.
3.18
7 7
2.17
Average Weekly Loading (inches),:::::::::
::::::::::::
0.14
0.09
Weather Codes: C -clear, PC -partly cloudy, CI -cloudy, R -rain, Sn-snow, SI -sleet
Spray Irrigation Operator in Responsible Charge (ORC): Brian Peters Phone: [phone]
ORC Certification Number: 987582 Check Box if ORjatias,Changed:
Mail ORIGINAL and TWO COPIES to:
ATTN: Non -Discharge Compliance Unit
DENR WfA_!�kp
Division of Water Quality (SIGNATURE 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
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. )
Compliant (Y,N)
1. The application rate(s) did not exceed the limit(s) specified in the permit. Y
2. Adequate measures were taken to prevent wastewater runoff from the site(s). YO
3. A suitable vegetative cover was maintained on the site(s) in accordance with the p Y�
4. All buffer zones as specified in the permit were maintained during each applicatior0
5. The freeboard in the treatment and/or storage lagoon(s) was not less than the limit Y�
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 imprisonmen for knowing violations."
Roger B. Tupps
.Oenature o mitteey Date (Name of Signing Official -Please print or type)
Aqua North Carolina
(Permittee -Please print or type)
202 MacKenan Ct
Cary NC. 27511
(Permittee Address)
Waste Water Supervisor
(Position or Title)
919-467-8712
(Phone Number)
If signed by other than the permittee, delegation of signatory authority must be on file with the state per 15A NCAC 26.0506 (b)(2)(D).

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDITIONAL PAGES AS NEEDED.
PERMIT NUMBER: WQ0022870 MONTH: August YEAR: 2016
FACILITY NAME: Buck Mountain Development COUNTY: Chatham
Formulas:
Daily Loading (Inches) = [Volume Applied (gallons) x 0.1336 (cubic feet/gallon) x 12 Cinches/foot)] / (Area Sprayed (acres) x43,560 (square feet/acre)]
=Volume Applied (gallons) / [Area Sprayed (acres) x27,152 (gallons/acre-inch)]
Maximum Hourly Loading (inches) =Daily Loading Cinches) /[Time Irrigated (minutes) /60 (minutes/hour))nthly Loading (inches)
12 Month Floating Total (inches) =Sum of this month's Monthly Loading (inches) and previous 11 month's Monlhty 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: x No:
Did Irrigation Occur On This Field:
Yes: x No:
Did Irrigation Occur On This Field:
Yes: No: x
.,A
FIELD NUMBER: F2B
SPRAYED (acres): 4.22
COVER CROP: I turkc rass
TTED HOURLY RATE (inches): 0.1
FIELD NUMBER: F3
A SPRAYED (acres),' 10.66
COVER CROP: turf raSS
ITTED HOURLY RATE (inches): 0.1
D
WEATHER CONDITIONS
ITTED YEARLY RATE (inches):
7.43
(TTED YEARLY RATE (inches):
20.47
A
T
E
Temper- Storage
Weather atureat Precipita- Lagoon
Code* application tion Free -hoard
Volume
A lied
Time
Irri ated
Daily
LoadingLoadingated
Maximum
Hourly
me
Daily.
LoadingLoading
Maximum
Hourly
(°F) Inches feet
gallons
minutes
inches
inches
oliedirri
utes
inches
Inches
1
2
3
4
5
6
7
8
9
10
1 1
8550
240
0.08
0.03
22500 1
240
0.06
0.01
11
12
13
14
8550
240
0.08
0.03
22500
240
0.06
0.01
15
16
17
8550
240
0.08
0.03
22500
240
0.06
0.01
18
8550
240
0.08
0.03
22500 1
240
0.06
0.01
19
8550
240
0.08
0.03
22500
240
0.06
0.01
20
85501
240
0.08 1
0.03
22500
240
0.06
0.01
21
8550
240
0.08
0.03
22500
240
0.06
0.01
22
8550
240
0.08
0.03
22500
240
0.06
0.01
23
8550
240
0.08
0.03
22500
240
0.06
0.01
24
25
26
27
28
29
30
8550
240
0.08
0.03
22500
240
0.06
0.01
31
1 14
Tota] Gallons/Monthly Loading (inches)
85500
>
0.80
225000
""'1
0.60
12 Month Floating Tota( (inches)
::::.::::::::::::::::::::::
::
2.25
3.13
Average Weekly Loading (inches)
::::::::::::::: :::::::::::::::
0.18
0.14
Weather Codes: C -clear, PC -partly cloudy, CI -cloudy, R -rain, Sn-snow, SI -sleet
Spray Irrigation Operator in Responsible Charge (ORC): Brian Peters Phone: [phone]
ORC Certification Number: 987582 Check Box if QRC H s C andd:
Mail ORIGINAL and TWO COPIES to:
ATTN: Non -Discharge Compliance Unit
DENR
Division of Water Quality (SIG ATURE 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
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. )
Com liant Y,N)
1. The application rate(s) did not exceed the limit(s) specified in the permit. ly
2. Adequate measures were taken to prevent wastewater runoff from the site(s). YO
3. A suitable vegetative cover was maintained on the site(s) in accordance with Y�
4. All buffer zones as specified in the permit were maintained during each appli�
5. The freeboard in the treatment and/or storage lagoon(s) was not less than th�l
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 fo nowing violations"
Roger B. Tupps
(S' ature ofer ittee)* Date (Name of Signing Official -Please print or type)
Aqua North Carolina Waste Water Supervisor
(Permittee -Please print or type) (Position or Title)
919-467-8712
202 MacKenan Ct (Phone Number)
Cary NC. 27511
(Permittee Address)
If signed by other than the permittee, delegation of signatory authority must be on file with the state per 15A NCAC 26.0506 (b)(2)(D).

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDITIONAL PAGES AS NEEDED.
PERMIT NUMBER: WQ0022870
FACILITY NAME: Buck Mountain Development
MONTH: August YEAR: 2016
COUNTY: Chatham
Formulas:
Dally Loading (Inches) = [Volume Applied (gallons) x 0.1336 (cubic feeVgallon) x 12 (inches/foot)] /[Area Sprayed (acres) x 43,560 (square feeVacre)]
=Volume Applied (gallons) /[Area Sprayed (acres) x27,152 (gallons/acre4nch)]
Maximum Hourly Loading (Inches) =Daily Loading (inches) / [Time Irrigated (minutes) /60 (minutes/hour))nthly Loading (inches)
12 Month Floating Total (Inches) =Sum of this month's Monthly Loading (inches) and previous 11 month's Monthly Loadings Cinches)
Average Weekly Loading (inches) = [Monthly Loading (inchestmonth) /Number of days in the month (days/month)] x 7 (days/week)
Did Irrigation Occur At This Facility:
Yes: x No:
Did Irrigation Occur On This Field:
Yes: x No:
Did Irrigation Occur On This Field:
Yes: x No:
FIELD NUMBER: F3B
A SPRAYED (acres): 3.01
COVER CROP: tuff raSSCOVER
TTED HOURLY RATE (inches): 0.1
FIELD NUMBER: F4
A SPRAYED (acres): 7.18
CROP: tuff raSS
ITTED HOURLY RATE (inches): 0.1
WEATHER CONDITIONS
ITTED YEARLY RATE (inches):
7.43
ITTED YEARLY RATE (inches):
20.47
D
A
T
E
Temper- Storage
Weather
Code• azure at Precipita- Lagoon
application tion Free -board
Volume
Applied
Time
Irrigated
Dail Y
Loading
Maximum
Hourl y
Loading
Volume
Applied
Time
Irrigated
Dail Y
Loadin
Maximum
Hourly
Y
Loading
PF) inches feet
minutes
inches
inches
gallons
minutes
inches
Inches
1
2
3
4
5
6
7
8
9
10
1
713501
180
0.08
0.03
20700
360
0.10
0.02
11
12
13
14
7650
180
0.08
0.03
20700
360
0.10
0.02
15
16
17
7650
180
0.08
0.03
20700
360
0.10
0.02
18
76501
180
0.08
0.03
20700
360
0.10
0.02
19
76501
180
0.08
0.03
207001
360
0.10
0.02
20
7650
180
0.08
0.03
207001
360
0.10 1
0.02
21
7650
180
0.08
0.03
20700
360
0.10
0.02
22
7650
180
0.08 1
0.03
20700
360
0.10
0.02
23
7650
180
0.08
0.03
20700
360
0.10
0.02
24
25
26
27
28
29
30
7650
180
0.08
0.03
20700
360
0.10
0.02
31
Total Gallons/Monthly Loading (inches)
76500
0.80
207000
::::::::
1.00
12 Month Floating Total (inches)
:;:;:;. !`::.::.:.::::::::::::
2,22
3.96
Average Weekly Loading (inches)
::::::::::::::::::::::::::::::.
0.18
0.23
Weather Codes: C -clear, PC -partly cloudy, CI -cloudy, R -rain, Sn-snow, SI -sleet
Spray Irrigation Operator in Responsible Charge (ORC):
Brian Peters Phone: [phone]
ORC Certification Number: 987582 Check Box if ORC HA-clhanged:
Mail ORIGINAL and TWO COPIES to: yjr)i��
ATTN: Non -Discharge Compliance Unit
DENR
Division of Water Quality (SIGNATURE 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
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. )
compliant (Y,N)
1. The application rate(s) did not exceed the limit(s) specified in the permit. ly
2. Adequate measures were taken to prevent wastewater runoff from the site(s).0
3. A suitable vegetative cover was maintained on the site(s) in accordance with Y�
4. All buffer zones as specified in the permit were maintained during each appli�
5. The freeboard in the treatment and/or storage lagoon(s) was not less than th9 l
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.
Drought conditions during summer required extra irrigation to maintain healthy turfgrass.
"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 sub ' Ing false information, including the possibility of fines
and imprisonment f6 -knowing violations."
ature o ittee)* Date (Name of Signing Official -Please print or type)
Aqua North Carolina
Waste Water
(Permittee -Please print or type)
(Position or Title)
919-467-8712
202 MacKenan Ct
(Phone Number)
Cary NC. 27511
(Permittee Address)
* If signed by other than the permittee, delegation of signatory authority must be on file with the state per 15A NCAC 26.0506 (b)(2)(D).

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDITIONAL PAGES AS NEEDED.
PERMIT NUMBER: W00022870
MONTH: August YEAR: 2016
FACILITY NAME: Buck Mountain Development COUNTY:
Chatham
Formulas:
Dally Loading (inches) _ (Volume Applied (gallons) x 0.1336 (cubic feet/gallon) x 12 (inches/fool)] /[Area Sprayed (acres) x43,560 (square feettacre)] C
= Volume Applied (gallons) /[Area Sprayed (acres) x27,152 (gallons/acre-inch)]
Maximum Hourly Loading (inches) =Daily Loading (inches) /(rime Irrigated (minutes)160 (minutes/hour)] inthly Loading (inches)
12 Month Floating Total (Inches) =Sum of this month's Monthly Loading (inches) and previous 11 month's Monthly Loadings (inches)
Average Weeklv Loadinq (Inches) = IMorthIV Loading Gnches/month) /Number of days in the month (days/month)] x 7 (daystweek)
Did Irrigation Occur At This Facility:
Yes: x No:
Did Irrigation Occur On This Field:
Yes: x No:
Did Irrigation Occur On This Field:
Yes: x No:
...•.................................
..
::
FIELD NUMBER: F-5
A SPRAYED (acres):1 13.22
COVER CROP: tUrfr rass
ITTED HOURLY RATE (inches): 0.1
FIELD NUMBER: F-6
A SPRAYED (acres): 4.94
COVER CROP: turfrass
TTED HOURLY RATE (inches): 0.1
D
WEATHER CONDITIONS
1ITTED YEARLY RATE (inches):
20.47
ITTED YEARLY RATE (inches):
20.47
A
T
E
Temper- Storage
weather
Code' ature at Precipita- Lagoon
application cion Free -board
Volume
Applied
Time
Irrigated
Dail Y
Loading
Maximum
Hourly
Y
Loading
Volume
Applied
Time
Irrigated
Dail Y
Loading
Maximum
Hourly
Y
Loading
(°F) inches feet
gallons
minutes
inches
inches
gallons
minutes
inches
inches
1
2
3
4
5
6
7
8
9
10
36000
360
0.10 1
0.02
17550
240
0.10 1
0.03
11
12
13
14
1
36000
360
0.10
0.02
17550
240
0.10
0.03
15
16
17
36000
360
0.10
0.02
17550
240
0.10
0.03
1s
36000
360
0.10
0.02
17550
240
0.10
0.03
19
36000
360
0.10
0.02
17550
240
0.10
0.03
20
36000
360
0.10
0.02
17550
240
0.10
0.03
21
1
36000
360
0.10
0.02
17550
240
0.10
0.03
22
36000
360
0.10
0.02
17550
240
0.10
0.03
23
1
360001
360
0.10
0.02
17550
240
0.10
0.03
24
25
26
27
28
29
30
36000
360
0.10
0.02
17550
240
0.10
0.03
31
Tota[ Gallons/Monthly Loading (inches) 3600001%:
1.00
1.00
12 Month Floating Total (inches)
:;:;:;:;:7:7:7.:7
::::.::::::::.
4.73
.1.7.5.5.0.
3.28
Average Weekly Loading (inches)
;.
0.23
0.23
• Weather Codes: C -clear, PC -partly cloudy, CI -cloudy, R -rain, Sn-snow, SI -sleet
Spray Irrigation Operator in Responsible Charge (ORC): Brian Peters Phone: [phone]
ORC Certification Number: 987582 Check Box if O C H s Cha ge • :
Mail ORIGINAL and TWO COPIES to:
ATTN: Non -Discharge Compliance Unit
DENR
Division of Water Quality (SIGNATURE OF OPE TOR 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
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. )
compliant (Y,N)
1. The application rate(s) did not exceed the limit(s) specified in the permit. Y
2. Adequate measures were taken to prevent wastewater runoff from the site(s). YO
3. A suitable vegetative cover was maintained on the site(s) in accordance with
4. All buffer zones as specified in the permit were maintained during each appli Yc�
5. The freeboard in the treatment and/or storage lagoon(s) was not less than the Y�
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 It£
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 awar that there are significant penalties for submitting false information, including the possibility of fines
and impriso a or knowing violations."
BUJ-4-�Pps
gnat a Permittee)* Date (Name of Signing Official -Please print or type)
Aqua North Carolina Waste Water Supervisor
(Permittee -Please print or type) (Position or Title)
919-467-8712
202 MacKenan Ct (Phone Number)
Cary NC. 27511
(Permittee Address)
* If signed by other than the permittee, delegation of signatory authority must be on file with the state per 15A NCAC 28.0506 (b)(2)(1)).

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDITIONAL PAGES AS NEEDED.
PERMIT NUMBER: WQ0022870
FACILITY NAME: Buck Mountain Development
MONTH: August YEAR: 2016
COUNTY: Chatham
Formulas:
Daily Loading (inches) _ (Volume Applied (gallons) x 0.1336 (cubic feet/gallon) x 12 (ncheslfoot)) /[Area Sprayed (acres) x 43,560 (square feettacre)]
=Volume Applied (gallons)! [Area Sprayed (acres) x27,152 (gallons/acre-inch))
Maximum Hourly Loading (inches) = Daily Loading (Inches) / [rime Irrigated (minutes) /60 (minutes/hour)bnthly Loading (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: x No:
Did Irrigation Occur On This Field:
Yes: x No:
Did Irrigation Occur On This Field:
Yes: x No:
.
FIELD NUMBER: F-7
A SPRAYED (acres): 16.48
COVER CROP: turff raSs
ITTED HOURLY RATE (inches): 0.1
FIELD NUMBER: F-8
A SPRAYED (acres): 4.06
COVER CROP: turftoss
ITTED HOURLY RATE (inches): 0.1
D
WEATHER CONDITIONS
AITTED YEARLY RATE (inches):
20.47
lITTED YEARLY RATE (inches):
20.47
A
T
E
Temper- Storage
Weather alureat Precipita- Lagoon
Code.
ode application tion Free -board
Volume
Applied
Time
Irrigated
Daily
Loading
Maximum
Hourly
Loading
Volume
A lied
Time
Irri aced
Daily
LoadingLoading
Maximum
Hourly
(°F) inches feet
gallons
minutes
inches
inches
gallons
minutes
inches
inches
1
2
3
4
5
6
7
8
9
10
11700
180
0.02
0.01
9450
180
0.07
0.02
11
12
13
14
11700
180
0.02
0.01
9450
180
0.07
0.02
15
16
17
11700
180
0.02
0.01
9450
180
0.07
0.02
18
11700
180
0.02
0.01
9450
180
0.07
0.02
19
117001
180
0.02
0.01
9450
180
0.07
0.02
20
11700
180
0.02
0.01
9450
180
0.07
0.02
21
11700
180
0.02
0.01
9450
180
0.07
0.02
22
11700
180
0.02
0.01
9450
180
0.07
0.02
23
11700
180
0.02
0.01
9450
180
0.07
0.02
24
25
26
27
28
29
30
11700
180
0.02
0.01
9450
180
0.07
0.02
31
Total Gallons/Monthly Loading (inches)
117000
0.20
94500::::::::
0.70
12 Month Floating Total (inches) ;:;
1.89
2.38
Average Weekly Loading (inches),:
7:7:7:7:-:7:7:
::::::•:•
0.05
0.16
Weather Codes: C -clear, PC -partly cloudy, CI -cloudy, R -rain, Sn-snow, SI -sleet
Spray Irrigation Operator in Responsible Charge (ORC)
Brian Peters Phone: [phone]
ORC Certification Number: 987582 Check Box if ORg4 as,Chapged:
Mail ORIGINAL and TWO COPIES to:
ATTN: Non -Discharge Compliance Unit kVTOZ)
DENR
Division of Water Quality (SIGNATURE 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

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. )
Compliant Y,N)
1. The application rate(s) did not exceed the limit(s) specified in the permit. Y
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
4. All buffer zones as specified in the permit were maintained during each appli�
5. The freeboard in the treatment and/or storage lagoon(s) was not less than the0
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 submitti false information, including the possibility of fines
and imprisonment for knowing violations."
Tupos
tgnature P ittee)* Date (Name of Signing Official -Please print or type)
Aqua North Carolina Waste Water Supervisor
(Permittee -Please print or type) (Position or Title)
919-467-8712
202 MacKenan Ct (Phone Number)
Cary NC. 27511
(Permittee Address)
*If signed by other than the permittee, delegation of signatory authority must be on file with the state per 15A NCAC 28.0506 (b)(2)(D).

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDITIONAL PAGES AS NEEDED.
PERMIT NUMBER: WQ0022870
FACILITY NAME: Buck Mountain Development
MONTH: August
COUNTY:
YEAR:. 2016
Chatham
Formulas:
Dally Loading (inches) = [Volume Applied (gallons) x 0.1336 (cubic feettgallon) x 12 (inches/foot)] /[Area Sprayed (acres) x 43,560 (square feel/acre)] OI
= Volume Applied (gallons) / [Area Sprayed (acres) x 27,152 (gallons/acre-inch)]
Maximum Hourly Loading (inches) = Daily Loading (inches) / [Time Irrigated (minutes) 160 (minutes/hour)jnthly Loading (inches)
12 Month Floating Total (Inches) = Sum of this month's Monthly Loading (inches) and previous 11 month's Monthly Loadings (inches
Average Weeklv Loading (inches) = [Monthly Loadinq (inches/month) / Number of days in the month (days/month)] x 7 (days/week)
Did Irrigation Occur At This Facility:
Yes: x No:
Did Irrigation Occur On This Field:
Yes: x No:
Did Irrigation Occur On This Field:
Yes: No:
x
FIELD NUMBER: F-9
A SPRAYED (acres):1 10.11
COVER CROP: tUfff faSS
ITTED HOURLY RATE (inches): 0.1
FIELD NUMBER: F-10
A SPRAYED (acres): 5.76
COVER CROP: tuff Pass
ZMITTED HOURLY RATE (inches): 0.1
WEATHER CONDITIONS
AITTEDYEARLY RATE (inches):
20.47 IRRMITTED
YEARLY RATE (inches):
20.47
D
A
T
E
temper- storage
weather atureat Precipita- Lagoon
code• application tion Free -board
Volume
A lied
Time
Irri ated
Daily
LoadIn
Maximum
Hourly
Loading
Volume
Applied
Time
Irrigated
Daily
LoadingLoading
Maximum
Hourly
(°F) Inches feet
gallons
minutes
inches
inches
gallons
minutes
inches
inches
1
2
3
4
5
6
7
8
9
10
19800
240
0.08
0.02
18000
180
0.12
0.04
11
12
13
14
19800
240
0.08
0.02
18000
180
0.12
0.04
15
16
17
19800
240 1
0.08
0.02
18000
180
0.12
0.04
16
19800
240
0.08
0.02 1
18000
180 1
0.12
0.04
19
19800
240
0.08
0.02
18000
180
0.12
0.04
20
19800
240
0.08
0.02
18000
180
0.12
0.04
21
19800
240
0.08
0.02
18000
180
0.12
0.04
22
19800
240
0.08
0.02
18000
180
0.12
0.04
23
19800
240
0.08
0.02
18000
180
0.12
0.04
24
25
26
27
28
29
30
19800
240
0.08
0.02
18000
180
0.12
0.04
31
Total Gallons/Monthly Loading (inches)
198000
0.80
180000
::::::::
1.20
12 Month Floating Tota[ (inches)
;;;;;;;;;;;;;;;;
;;;;;;;;;;;;;;;;
2,85
3.99
Average Weekly Loading (inches)
::::::::::::::::::::::::::::::::
0.18
0.27
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
Brian Peters
Phone: [phone]
987582 Check Box if OR as h aged:

Division of Water Quality (SIGNATURE 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
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. )
Com III ant Y,N)
1. The application rate(s) did not exceed the limit(s) specified in the permit. IY
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 0
4. All buffer zones as specified in the permit were maintained during each appli
5. The freeboard in the treatment and/or storage lagoon(s) was not less than th�
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 fa se information, including the possibility of fines
and imprisonment for knowing violations."
Ile- l� �lC—koger8-+v ps
ignature of rmitteer Date (Name of Signing Official -Please print or type)
Aqua North Carolina
(Permittee -Please print or type)
202 MacKenan Ct
Cary NC. 27511
(Permittee Address)
Waste Water Supervisor
(Position or Title)
919-467-8712
(Phone Number)
If signed by other than the permittee, delegation of signatory authority must be on file with the state per 15A NCAC 26.0506 (b)(2)(D).

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDITIONAL PAGES AS NEEDED.
PERMIT NUMBER: WQ0022870 MONTH: August YEAR: 2016
FACILITY NAME: Buck Mountain Development COUNTY: Chatham
Formulas:
Daily Loading (Inches) = [Volume Applied (gallons) x 0.1336 (cubic feet/gallon) x 12 (inches/foot)] / [Area Sprayed (acres) x43,560 (square feet/acre)]
=Volume Applied (gallons) / (Area Sprayed (acres) x27,152 (gallons/acre-inch)]
Maximum Hourly Loading (inches) = Daily Loading (inches) I [Time Irrigated (minutes) /60 (minutes/hour)}nthly Loading (Inches)
12 Month Floating Total (inches) = Sum of this month's Monthly Loading Cinches) and previous 11 month's Monthly Loadings (inches)
Avwranw Wwwlrly I narfinn fl -heel = rid-thly 1 -lion linrhac/mnnthl f Nnmhnr off- in fhe month tdays/mnnthll x 7 fdaysWeekl
Did Irrigation Occur At This Facility:
Yes: x No:
Did Irrigation Occur On This Field:
Yes: x No:
Did Irrigation Occur On This Field:
Yes: x No:
..
FIELD NUMBER: F -10B
A SPRAYED (acres): 5.69
COVER CROP: turfr rays
ITTED HOURLY RATE (inches): 0.1
FIELD NUMBER: F-11
A SPRAYED (acres): 4.69
COVER CROP: turf rass
ITTED HOURLY RATE (inches): 0.1
WEATHER CONDITIONS
ITTED YEARLY RATE (inches):
7.43
ITTED YEARLY RATE (inches):
20.47
D
A
T
Temper- Storage
Weather
Coe' ature at Precipita- Lagoon
Code application tion Free -board
Volume
Applied
Time
Irri aced
Dail Y
Loading
Maximum
Hourly
Y
Loadin
Volume
Applied
Time
Irrigated
Daily
Y
Loadin
Maximum
Hourly
Y
Loading
(°F) inches feet
gallons
minutes
inches
inches
gallons
minutes
Inches
Inches
1
2
3
4
5
6
7
8
9
10
9450
180
0.05
0.02
3600
120
0.03
0.01
11
12
13
14
9450
180
0.05
0.02
3600
120
0.03
0.01
15
16
17
9450
180
0.05
0.02
3600
120
0.03
0.01
18
9450
180
0.05
0.02
3600
120
0.03
0.01
19
94501
180
0.05
0.02
3600
120
0.03
0.01
20
9450
180
0.05
0.02
3600
1 120
0.03
0.01
21
9450
180
0.05
0.02
3600
120
0.03
0.01
22
9450
180
0.05
0.02
3600
120
0.03
0.01
23
1
9450
180
0.05 1
0.02
3600
120
0.03
0.01
24
25
26
27
28
29
30
9450
180
0.05
0.02
3600
120
0.03
0.01
31
Total Gallons/Monthly Loading (inches)
94500
0.50
36000
........
0.30
12 Month Floating Total (inches)
.::::::::::::::::.:.:::::::.:.
2,37
1.16
Average Weekly Loading (inches)
::::::::::::::: :::::::::::::::
0.11
0.07
Weather Codes: C -clear, PC -partly cloudy, CI -cloudy, R -rain, Sn-snow, SI -sleet
Spray Irrigation Operator in Responsible Charge (ORC): Brian Peters Phone: [phone]
ORC Certification Number: 987582 Check BoAORCas ed:
Mail ORIGINAL and TWO COPIES to:
ATTN: Non -Discharge Compliance Unit
DENR
Division of Water Quality (SIG ATURE 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
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. )
Compliant (Y,N)
1. The application rate(s) did not exceed the limit(s) specified in the permit. ly
2. Adequate measures were taken to prevent wastewater runoff from the site(s). YO
3. A suitable vegetative cover was maintained on the site(s) in accordance with Y�
4. All buffer zones as specified in the permit were maintained during each appli�
5. The freeboard in the treatment and/or storage lagoon(s) was not less than th Yt�
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 f r knowing violations."
Rcgml-�s
Ignature P itteer Date (Name of Signing Official -Please print or type)
Aqua North Carolina Waste Water Supervisor
(Permittee -Please print or type) (Position or Title)
919-467-8712
202 MacKenan Ct (Phone Number)
Cary NC. 27511
(Permittee Address)
. If signed by other than the permittee, delegation of signatory authority must be on file with the state per 15A NCAC 28.0506 (b)(2)(D).

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDITIONAL PAGES AS NEEDED.
PERMIT NUMBER: WQ0022870 MONTH: August YEAR: 2016
FACILITY NAME: Buck Mountain Development COUNTY:
Chatham
Formulas:
Daily Loading (inches) _[Volume Applied (gallons) x 0.1336 (cubic feet/gallon) x 12 (inches/foot)] /[Area Sprayed (acres) x 43,560 (square feettacre))
=Volume Applied (gallons) / [Area Sprayed (acres) x27,152 (gallons/acre-inch)]
Maximum Hourly Loading (inches) = Daily Loading Cinches) / [Time Irrigated (minutes) /60 (minutesmour))nthly Loading (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 Cinchestmonth) I Number of days in the month (days/month)] x 7 (days/week)
Did Irrigation Occur At This Facility:
Yes: x No:
Did Irrigation Occur On This Field:
Yes: No: x
Did Irrigation Occur On This Field:
Yes: No: x
FIELD NUMBER: F-11 B
A SPRAYED (acres): 4.2
COVERCROP:1 turfr rass
ITTED HOURLY RATE (inches): 0.1
FIELD NUMBER: F-11 C
A SPRAYED (acres): 9.37
COVER CROP: turfc rass
ITTED HOURLY RATE (inches): 0.1
WEATHER CONDITIONS
ITTED YEARLY RATE (inches):
20.47
ITTED YEARLY RATE (inches):
7.43
D
A
T
E
Temper- Storage
Weather
atureat Precipita- lagoon
code• application tion Free -board
Volume
Applied
Time
Irrigated
Daily
Loading
Maximum
Hourly
Loading
Volume
Applied
Time
Irrigated
Daily
Loading
Maximum
Hourly
Loading
(°F) inches feet
gallons
minutes
Inches
inches
gallons
minutes
inches
inches
1
2
3
4
5
6
7
8
9
10
9000
180
0.08
0.03
21600
240
0.08
0.02
11
12
13
14
9000
180
0.08
0.03
21600
240
0.08
0.02
15
16
17
9000
180
0.08
0.03
21600
240
0.08
0.02
18
9000
180
0.08
0.03
21600
240
0.08
0.02
19
1 1
9000
180
0.08
0.03
21600
240
0.08
0.02
20
9000
180
0.08
0.03
21600
240
0.08 1
0.02
21
9000
180
0.08
0.03
21600
240
0.08 1
0.02
22
9000
180
0.08 1
0.03
21600
240
0.08
0.02
23
9000
180
0.08
0.03
21600
240
0.08
0.02
24
25
26
27
28
29
50
9000
180
0.08
0.03
21600
240
0.08
0.02
31
EEL=-
Total GallonslMonthly Loading (inches)
90000
0.80
216000
0.80
12 Month Floating Tota] (inches)
::::::.:::::.::::::::.::::::::
2,94
3.54
Average Weekly Loading (inches)
::::::::::::::: :::::::::::::::
0.18
0.18
Weather Codes: C -clear, PC -partly cloudy, CI -cloudy, R -rain, Sn-snow, SI -sleet
Spray Irrigation Operator in Responsible Charge (ORC): Brian Peters Phone: [phone]
ORC Certification Number: 987582 Check Box if ORC as h ged:
Mail ORIGINAL and TWO COPIES to:
ATTN: Non -Discharge Compliance Unit
DENR
Division of Water Quality (SIG ATURE 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
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. )
compliant (Y,N)
1. The application rate(s) did not exceed the limit(s) specified in the permit. N
2. Adequate measures were taken to prevent wastewater runoff from the site(s). YO
3. A suitable vegetative cover was maintained on the site(s) in accordance with
4. All buffer zones as specified in the permit were maintained during each appli�
5. The freeboard in the treatment and/or storage lagoon(s) was not less than th�
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.
Drought during the summer required extra irrigation to maintain healthy turgrass.
"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 or knowing violations" �fjJ A
�, A r""V,5
q vy(G RegaLB 1upps
nature(rmittee)* Date (Name of Signing Official -Please print or type)
Aqua North Carolina Waste Water Supervisor
(Permittee -Please print or type) (Position or Title)
919-467-8712
202 MacKenan Ct (Phone Number)
Cary NC. 27511
(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).

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDITIONAL PAGES AS NEEDED.
PERMIT NUMBER: WQ0022870
FACILITY NAME: Buck Mountain Development
MONTH: August
COUNTY:
YEAR: 2016
Chatham
Formulas:
Daily Loading (inches) _ (Volume Applied (gallons) x0.1336 (cubic feetgallon) x 12 Qnches/foot)] / Wea Sprayed (acres) x43,560 (square feet/acre))
=Volume Applied (gallons) / (Area Sprayed (acres) x27,152 (gallons/acre-Inch)]
Maximum Hourly Loading (inches) = Daily Loading (inches) / (Time Irrigated (minutes) /so (minutes/hour))nthly Loading (inches)
12 Month Floating Total (inches) - Sum of this month's Monthly Loading (inches) and previous 11 month's Monthly Loadings (inches)
Averana Wcrlriv 1 -fl- finnhnel = IMnnthly I nodi, nnnhec/mnnlhl / Nnmher of dews in the month fdays/monlhll x 7 (daystweek)
Did Irrigation Occur At This Facility:
Yes: x No:
Did Irrigation Occur On This Field:
Yes: No: x
Did Irrigation Occur On This Field:
Yes: x No:
:::
FIELD NUMBER: F-12
A SPRAYED (acres): 2.62
COVER CROP: turfr rass
TTED HOURLY RATE (inches): 0.1
FIELD NUMBER: F -12B
A SPRAYED (acres): 1.54
COVER CROP: turfE rays
ITTED HOURLY RATE (inches): 0.1
WEATHER CONDITIONS
(TTED YEARLY RATE (inches):
20.47
ITTED YEARLY RATE (inches):
7.43
D
A
T
E
Temper- Storage
Weather
Code ature at Precipita- Lagoon
application tion Free -board
Volume
Applied
Time
Irri ated
Dail Y
Loading
Maximum
Hourly
Y
Loadin
Volume
Apple
Time
Irri ated
Dail Y
Loading_Loading
Maximum
Hourly
Y
(°F) inches feet
gallons
minutes
inches
inches
gallons
minutes
Inches
inches
1
2
3
4
5
6
7
8
9
10
1
7200
120
0.10
0.05
4500
180
0.11
0.04
11
12
13
14
7200
120
0.10
0.05
4500
180
0.11
0.04
15
16
17
1
7200
120
0.10
0.05
45001
180
0:11
0.04
18
7200
120
0.10
0.05
4500
180
0.11
0.04
19
7200
120
0.10
0.05
4500
180
0.11
0.04
20
7200
120
0.10 1
0.05
4500
180
0.11
0.04
21
7200
120
0.10
0.05
4500
180
0.11
0.04
22
7200
120
0.10
0.05
4500
180
0.11
0.04
23
7200
120
0.10
0.05
4500
180
0.11
0.04
24
25
26
27
28
29
30
7200
120
0.10
0.05
4500
180
0.11
0.04
31
Tota) Gallons/Monthly Loading (inches)
72000 1
1.00
45000
::':':::::
1.10
12 Month Floating Total (inches)
::.:.:.:::::::.::.:::.:.:.:.:.:
3,19
2.64
Average Weekly Loading (inches) I
::::::::::::::::::::::::::::::
0.23
0.25
Weather Codes: C -clear, PC -partly cloudy, CI -cloudy, R-raln, Sn-snow, SI -sleet
Spray Irrigation Operator in Responsible Charge (ORC): Brian Peters /Phone: [phone]
ORC Certification Number: 987582 Check Box if ORC as hafiged:
Mail ORIGINAL and TWO COPIES to:
ATTN: Non -Discharge Compliance Unit
DENR
Division of Water Quality (SIGIfATURE 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
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. )
Compliant (Y,N)
1. The application rate(s) did not exceed the limit(s) specified in the permit. I N
2. Adequate measures were taken to prevent wastewater runoff from the site(s).0
3. A suitable vegetative cover was maintained on the site(s) in accordance with
4. All buffer zones as specified in the permit were maintained during each applicy____�
5. The freeboard in the treatment and/or storage lagoon(s) was not less than th�l
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.
Drought during the summer required extra irrigation to maintain healthy turfgrass.
"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 submitti alse information, including the possibility of fines
and imprisonment for k 'ng violations"
„s
nature of er ee)` Date (Name of Signing Official -Please print or type)
Aqua North Carolina Waste Water Supervisor
(Permittee -Please print or type) (Position or Title)
919-467-8712
202 MacKenan Ct (Phone Number)
Cary NC. 27511
(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).

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDITIONAL PAGES AS NEEDED.
PERMIT NUMBER: WQ0022870 MONTH: August YEAR: 2016
FACILITY NAME: Buck Mountain Development COUNTY: Chatham
Formulas:
Daily Loading (inches) = [Volume Applied (gallons) x 0.1336 (cubic feet/gallon) x 12 (inches/foot)) /[Area Sprayed (acres) x43,560 (square feettacre))
= Volume Applied (gallons) / [Area Sprayed (acres) x 27,152 (gallons/acre-inch))
Maximum Hourly Loading (Inches) = Daily Loading (inches)! frime Irrigated (minutes)160 (minutes/hour))nthly Loading (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 (daystweek)
Did Irrigation Occur At This Facility:
Yes: x No:
Did Irrigation Occur On This Field:
Yes: x No:
Did Irrigation Occur On This Field:
Yes: No: x
..
:::
FIELD NUMBER: F-13
A SPRAYED (acres): 8.49
COVER CROP: turfrigrass
TTED HOURLY RATE (inches): 0.1
FIELD NUMBER: F -13B
A SPRAYED (acres): 2.2
COVER CROP: tAc rass
ITTED HOURLY RATE (inches): 0.1
WEATHER CONDITIONS
ITTED YEARLY RATE (inches):
20.47
ITTED YEARLY RATE (inches):
7.43
D
A
T
E
Tamper- Storage
Weather
ature at Precipita- Lagoon
Code* application tion Freeboard
Volume
Applied
Time
Irrigated
Dail Y
LoadingLoadingApplied
Maximum
Hourly
Y-
Volume
Time
Irrigated
Dail Y
LoadingLoading
Maximum
Hourly
Y
(°F) Inches feet
gallons
minutes
Inches
inches
gallons
minutes
Inches
Inches
1
2
3
4
5
6
7
8
9
10
11
1
157501
240
0.05
0.01
45001
180
0.08
0.03
12
13
14
15750
240
0.05
0.01
4500
180
0.08
0.03
15
16
17
15750
240
0.05
0.01
4500
180
0.08
0.03
18
15750
240
0.05
0.01
45001
180
0.08
0.03
19
157501
240
0.05
0.01
45001
180
0.08
0.03
20
15750
240
0.05
0.01
4500
180
0.08
0.03
21
15750
240
0.05
0.01
4500
180
0.08
0.03
22
15750
240
0.05
0.01
4500
180
0.08
0.03
23
1
15750
240
0.05
0.01
4500
180
0.08
0.03
24
25
26
27
28
29
30
15750
240
0.05
0.01
4500
180
0.08
0.03
31
Total Gallons/Monthly Loading (inches)
157500::
0.50
45000
::::::::
0.80
12 Month Floating Total (inches)
::::::::::::::.:::::::::::::::
2.54
2.01
Average Weekly Loading (inches)
:::::::::::::::::::::::::::::::
0.11
0.18
' Weather Codes: C -clear, PC -partly cloudy, CI -cloudy, R -rain, Sn-snow, SI -sleet
Spray Irrigation Operator in Responsible Charge (ORC): Brian Peters Phone: [phone]
ORC Certification Number: 987582 Check Box if ORC as C nged:
Mail ORIGINAL and TWO COPIES to:
ATTN: Non -Discharge Compliance Unit
DENR
Division of Water Quality (SI ATURE OF OPERATOR IN RESPONSIBLE CHARGE)
1617 Mail Service Center BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS ACCURATE AND COMPLETE
RALEIGH, NC 276 99-1 61 7 TO THE BEST OF MY KNOWLEDGE.

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. )
Com liant Y,N)
1. The application rate(s) did not exceed the limit(s) specified in the permit. r-
2. Adequate measures were taken to prevent wastewater runoff from the site(s).0
3. A suitable vegetative cover was maintained on the site(s) in accordance with
4. All buffer zones as specified in the permit were maintained during each appl)�
5. The freeboard in the treatment and/or storage lagoon(s) was not less than th Y�
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 or knowing violations"
�Tupps
gnature ermittee)' Date (Name of Signing Official -Please print or type)
Aqua North Carolina
(Permittee -Please print or type)
202 MacKenan Ct
Cary NC. 27511
(Permittee Address)
Waste Water Supervisor
(Position or Title)
919-467-8712
(Phone Number)
If signed by other than the permittee, delegation of signatory authority must be on file with the state per 15A NCAC 26.0506 (b)(2)(1)).

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDITIONAL PAGES AS NEEDED.
PERMIT NUMBER: W00022870 MONTH: August YEAR: 2016
FACILITY NAME: Buck Mountain Development COUNTY:
Chatham
Formulas:
Daily Loading (inches) = (Volume Applied (gallons) x 0.1336 (cubic feettgallon) x 12 (inches/foot)] / (Area Sprayed (acres) x 43,560 (square feetlacre)] 0
= Volume Applied (gallons) / [Area Sprayed (acres) x 27,152 (gallons/acre-inch)]
Maximum Hourly Loading (inches) = Daily Loading (inches)! (Time Irrigated (minutes) 160 (minules/hour)Aonthly Loading (inches)
12 Month Floating Total (inches) = Sum of this month's Monthly Loading Cinches) and previous 11 month's Monthly Loadings (inches)
Ayeraoe Weekly Loadino (inches) = [Monthly Loadino (inches/month) / Number of days in the month (days/month)l x 7 (dayshyeek)
Did Irrigation Occur At This Facility:
Yes: x No:
Did Irrigation Occur On This Field:
Yes: x No:
Did Irrigation Occur On This Field:
Yes: x No:
::
FIELD NUMBER: F-14
A SPRAYED (acres): 9.91
COVER CROP: tufff rass
ITTED HOURLY RATE (inches): 0.1
FIELD NUMBER: F-15
EA SPRAYED (acres): 4.79
COVER CROP: turf rass
MITTED HOURLY RATE (Inches): 0.1
WEATHER CONDITIONS
AITTED YEARLY RATE (inches):
20.47
MITTED YEARLY RATE Inches :
20.47
D
A
T
E
Temper- Storage
weather ature at Precipita- Lagoon
code• application tion Free -board
Volume
Applied
Time
Irrigated
Daily
Loadin
Maximum
Hourly
Loadin
Volume
Applied
Time
Irrigated
Maximum
Daily Hourly
LoadingLoading
I°F) inches feet
gallons
minutes
Inches
inches
gallons
minutes
Inches
Inches
1
2
3
4
5
6
7
8
9
10
22950
360
0.07
0.01
11250
180
0.07
0.02
11
12
13
14
22950
360
0.07
0.01
11250
180
0.07
0.02
15
16
17
22950
360
0.07
0.01
11250
180
0.07
0.02
18
22950
360
0.07
0.01
11250
180
0.07
0.02
19
22950 1
360
0.07
0.01
11250
180
0.07
0.02
20
22950
360
0.07
0.01
11250
180
0.07
0.02
21
1
22950
360
0.07
0.01
11250
180
0.07
0.02
22
22950
360
0.07
0.01
11250
180
0.07
0.02
23
22950
360
0.07
0.01
11250
180
0.07
0.02
24
25
26
27
28
29
30
22950
360
0.07
0.01
11250
180
0.07
0.02
31
Total Gallons/Monthly Loading (inches) 229500
0.70
112500
0.70
12 Month Floating Total (inches) :7:7:7:7:;:;:;:;
7:;:;:;:7:7:7:;:
4.99
1.41
Average Weekly Loading (inches) ;:;:;:;:;:;:;:;::;::;:;:;:;:;:;
0.16
0.01
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
Brian Peters Phone: [phone]
987582 Check Box if ORC as ha� ed:
i

Division of Water Quality (SIGNATURE 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
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. )
Compliant Y,N)
1. The application rate(s) did not exceed the limit(s) specified in the permit. ly
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 t�Y�
4. All buffer zones as specified in the permit were maintained during each applic
S. The freeboard in the treatment and/or storage lagoon(s) was not less than the
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."
fi .7�eaer�- farms
Ignature P Itteer Date (Name of Signing Official -Please print or type)
Aqua North Carolina
(Permittee -Please print or type)
202 MacKenan Ct
Cary NC. 27511
(Permittee Address)
Waste Water Supervisor
(Position or Title)
919-467-8712
(Phone Number)
If signed by other than the permittee, delegation of signatory authority must be on file with the state per 15A NCAC 28.0506 (b)(2)(D).

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDITIONAL PAGES AS NEEDED.
PERMIT NUMBER: WQ0022870 MONTH: August YEAR: 2016
FACILITY NAME: Buck Mountain Development COUNTY:
Chatham
Formulas:
Dally Loading (inches) _ [Volume Applied (gallons) x 0.1336 (cubic feet/gallon) x 12 Cinches/foot)] / [Area Sprayed (acres) x43,560 (square feet/acre)]
= Volume Applied (gallons) /[Area Sprayed (acres) x27,152 (gallons/acre-inch)]
Maximum Hourly Loading (inches) = Daily Loading Cinches) / [Time Irrigated (minutes)160 (minutes/houOnthly Loading (inches)
12 Month Floating Tota[ (inches) = Sum of this month's Monthly Loading Cinches) 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: x No:
Did Irrigation Occur On This Field:
Yes: x No:
Did Irrigation Occur On This Field:
Yes: x No:
FIELD NUMBER: F-16
A SPRAYED (acres): 9.05
COVER CROP: turfr rass
ITTED HOURLY RATE (inches): 0.1
FIELD NUMBER: F-17
A SPRAYED (acres): 5.37
COVER CROP: turf rass
ITTED HOURLY RATE (inches): 0.1
WEATHER CONDITIONS
ITTED YEARLY RATE (inches):
20.47
ITTED YEARLY RATE (inches):
20.47
D
A
T
E
Temper- Storage
weather
Code• afore at Precipita- Lagoon
application tion Free -board
VolumeFirr.g.,.d
App lied
Dail Y
Loading
Maximum
Hourly
Y
Loading
Volume
Applied
Time
Irrigated
Dail Y
Loading
Maximum
Hourly
Y
Loading
(°F) Inches feet
gallons
minutes
Inches
Inches
gallons
minutes
inches
Inches
1
2
3
4
5
6
7
8
9
10
22950
240
0.09
0.02
17550
420
0.11
0.11
11
12
13
14
22950
240
0.09
0.02
17550
420
0.11
0.11
15
16
17
22950
240
0.09
0.02
17550
420
0.11
0.11
18
22950
240
0.09
0.02
17550
420
0.11
0.11
19
22950
240
0.09
0.02
17550
420
0.11
0.11
20
22950
240
0.09 1
0.02
17550
420
0.11 1
0.11
21
22950
240
0.09
0.02
17550
420
0.11
0.11
22
22950
240
0.09
0.02
17550
420
0.11
0.11
23
22950
240
0.09
0.02
17550
420
0.11
0.11
24
25
26
27
28
29
30
22950
240
0.09
0.02
17550
420
0.111
0.11
31
Tota[ Gallons/Monthly Loading (inches) 229500 ::
0.90
175500
::::::::
1.10
12 Month Floating Tota[ (inches)
::.:::.:::::::::::::::::::::::
3,91
3.16
Average Weekly Loading (inches)
;;;;;;;;;;;;;;; ;;;;;;;;;;;;;;;
0.20
0.25
` Weather Codes: C -clear, PC -partly cloudy, CI -cloudy, R -rain, Sn-snow, SI -sleet
Spray Irrigation Operator in Responsible Charge (ORC): Brian Peters Phone: [phone]
ORC Certification Number: 987582 Check Box if OR as C an d:
Mai[ ORIGINAL and TWO COPIES to:
ATTN: Non -Discharge Compliance Unit
DENR
Division of Water Quality (SIG 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
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. )
Com liant(Y,N)
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).0
3. A suitable vegetative cover was maintained on the site(s) in accordance with
4. All buffer zones as specified in the permit were maintained during each appli�
5. The freeboard in the treatment and/or storage lagoon(s) was not less than th�
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." �%
// � a -ow f �•�!-1�i�9��X
(S i g n a t u raOuenviTtee)• Date (Name of Signing Official -Please print or type)
Aqua North Carolina Waste Water Supervisor
(Permittee -Please print or type) (Position or Title)
919-467-8712
202 MacKenan Ct (Phone Number)
Cary NC. 27511
(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).

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDITIONAL PAGES AS NEEDED.
PERMIT NUMBER: WQ0022870 MONTH: August YEAR: 2016
FACILITY NAME: Buck Mountain Development COUNTY: Chatham
Formulas:
Daily Loading (inches) -[Volume Applied (gallons) x 0.1336 (cubic feet/gallon) x 12 (inchesifoot)] 1 [Area Sprayed (acres) x43,560 (square feet/acre)] OR
=Volume Applied (gallons) / IArea Sprayed (acres) x27,152 (gallons/acre-inch)]
Maximum Hourly Loading (inches) =Daily Loading (inches) / [Time Irrigated (minutes)/ 60 (minuteslhour)] onthly Loading (inches)
12 Month Floating Total (inches) April
Average Weekly Loading (inches) = [Monthly Loading (inches/month) l Number of days in the month (dayslmonth)] x 7 (days/week)
Did Irrigation Occur At This Facility:
Yes: x No:
Did Irrigation Occur On This Field:
Yes: x No:
Did Irrigation Occur On This Field:
Yes: x No:
FIELD NUMBER: F-18
AREA SPRAYED (acres): 17.8
COVER CROP: tUrff lass
ERM117ED HOURLY RATE (inches): 0.1
FIELD NUMBER: DR
A SPRAYED (acres): 14.9
COVER CROP: turfrass
ITTED HOURLY RATE (inches): 0.1
D
WEATHER CONDITIONS
PERMITTED YEARLY RATE (inches):
20.47
ITTED YEARLY RATE inches :
20.47
A
T
E
Weather Temper- Storage
atnreat Preeipita- Lagoon
Code • application tion Free -board
Volume Time
Applied Irrigated
Daily
LoadingLoadingApplied
Maximum
Hourly
Volume Time
I'I gate di
Daily
Loading
Maximum
Hourly
Loading
(°F) inches feet
gallons minutes
inches
inches
gallons minutes
inches
inches
1
2
3
4
5
6
7
8
9
10
38250 360
0.08
0.01
6300 180
0.02
0.01
11
12
13
14
38250 360
0.08
0.01
6300 180
0.02
0.01
15
16
17
38250 360
0.08
0.01
6300 180
0.02
0.01
18
38250 360
0.08
0.01
6300 180
0.02
1 0.01
19
1
38250 360
0.08
0.01
6300 180
0.02
0.01
20
38250 360
0.08
0.01
6300 180
0.02
0.01
21
38250 360
0.08
0.01
6300 180
0.02
0.01
22
1
38250 360
0.08
0.01
6300 180
0.02
0.01
23
38250 360
0.08
0.01
6300 180
0.02
0.01
24
25
26
27
28
29
30
38250 360
0.08
0.01
6300 180
0.02
0.01
31
Total Gallons/Monthly Loading (inches)
382500
0.80
63000 ::::::::::::.::
0.20
12 Month Floating Tota[ (inches) :•;•;•;•;•;•;•;•::::
4.64
2.92
Average Weekly Loading (inches) .::::::::::::::::::::::::.:::.:::::::::
0.18
0.05
Weather Codes: C -clear, PC -partly cloudy, CI -cloudy, R -rain, Sn-snow, SI -sleet
Spray Irrigation Operator in Responsible Charge (ORC): Brian Peters Phone: [phone]
ORC Certification Number: 987582 Check Box ifQ2,C Hs Cha gev/
Mail ORIGINAL and TWO COPIES to: ` )
ATTN: Non -Discharge Compliance Unit (//f
DENR
Division of Water Quality (SIGN TURE 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
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. )
Com liant(Y,N)
1. The application rate(s) did not exceed the limit(s) specified in the permit. Y
2. Adequate measures were taken to prevent wastewater runoff from the site(s). YO
3. A suitable vegetative cover was maintained on the site(s) in accordance with the N�
4. All buffer zones as specified in the permit were maintained during each applicatio YO
5. The freeboard in the treatment and/or storage lagoon(s) was not less than the limi YO
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."
//
u 9 �� ` O Roger B. Tupps
tgnature Pe ittee)" Date (Name of Signing Official -Please print or type)
Aqua North Carolina Waste Water Supervisor
(Permittee -Please print or type) (Position or Title)
919-467-8712
202 MacKenan Ct (Phone Number)
NC. 27511
(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)(1)).