WQ0022870_Monitoring - 10-2016_20161207

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDITIONAL PAGES AS NEEDED...,
PERMIT NUMBER:' "F00022870* MONTH:: October YEAR: 2016
FACILITY NAME: Buck Mountain Development COUNTY: Chatham
Formulas:
Daily Loading (inches) = [VdumeApplied (gallons) x 0.1330 (mbicfeet/gallon) x 12 (inchestfoat)] I [Arm Sprayed (acres) x 43,500 (square feetlacr.)] OR
= Volume Applied (gallons) I [Arm Sprayed (acres) x 27,152 (gallons/acre-Inch)]
Maximum Hourly Loading (inches) = Daily Loading (inches) / [Time Irrigated (minutes) / 60 (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)
I
Average Weekly Loading (inches) =[Monthly Loading (inches/morith)INumber of days in the month (days/month)] x7 (days/week)
Did Irrigation Occur At This Facility:
Did Irrigation Occur On This Field:
Did Irrigation Occur On This Field:
Yes: X, No.
Yes: x No:
..Yes- No: X.
........
....... . . . . .
.......... .........
FIELD NUMBER: F1,
FIELD NUMBER: F2
. ..... .. .. . .. .
.......... ........ ..................
... . ........
......
...........
.........
A SPRAYED (acres): I - - ' 11.4
REA SPRAYED (acres): 5.56
.... ... .. . . ........
........... ..........
COVER CROP: to qrass
'COVER CROP: turfarass
...............
....................
.......
. ..... ..............
........ ......... ... .......
- a ... ....
ITTED HOURLY RATE (inches): 0.1
�Ml TTED HOURLY RATE inches)- 0.1
WEATHER CONDITIONS
ITTED YEARLY RATE(inches): 20A7
tMITTED YEARLY RATE (inches): 20;47
D
Maximum
M2AMU
--T
Tornper-
Weather
-atureat. Procipita-
19g.o
Volume, Time D ally Hourly
Volume Time Daily rn Hourly*
�E
C.de�l
application' tion-
-n
rr..b.ard
LAE024 I. irriaated Loading Loading
Applied irrigated Loading 'Loading
inches -
CF)m
feet.'.gallons
minutes, inches -inches
gallons :minutes inches inches
2
�Li
$
F
6
20
Total GallonslMorttitly Loading (inches) 00.00 0 >::>:>::::
:: .......... . .
w �; wwwwrwww
12 Month Floating Total (inches)
2.901.90
(inches) :........... . ... ... . ......... ......
Average Weekly Loading
............... 0.00 ....... x.: 0.00, ..
................... .......
Spray Irrigation Operator In Responsible Charge (ORC): Brian Peters Phone: [phone]
ORC Certification Number: 987582 Check Box if ORC Has Changed:
Mail ORIGINAL and TWO COPIES to:
ATTN: Non -Discharge. Compliance Unit
DENR
Division of Water Quality (SIGNATURE OF OPERATOR IN RESPONSIBLE CHARGE)
1617 Mail Service Center BY THIS SIGNATURE, I CERTIFYTHAT THIS REPORT IS ACCURATE AND COMPLETE
RALEIGH, NG 27699-1617. TO THE BEST OF MY KNOWLEDGE.

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATIO.N-SITE(S)
Facility Statust .
Please indicate (by inserting Y(es) or N(o) in the appropriate.. box) whether the facility has bammpliant
with the following permit requirements: dote: if a requirement does not apply to your facility putlpA) in the
compliant box. )
Com liant(YN)
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 the per .
4. All buffer zones as specified in the permit were mamtait ed during each appltcatio :
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 isnon-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 submi ' false information, including the possibility of fines
and imprisonmen or owing violations."
tgnature 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 213.0500 (b)(2)(D).

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
THERE ARE:TWO APPLICATION FIELDS PER PAGE. USE ADDrrIONAL PAGES AS NEEDED:
PERMIT NUMBER: WQO .
022870 MONTHS October `': 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 feetlacn
=Volume Applied (gallons) / [Area Sprayed (acres) x 27,152 (gallonslacre-Inch)]
Maximum Hourly Loading (inches) =Daily Loading (inches) / [rime Irrigated (minutes) / 60 (minutes/houmthly Loading (inches)
Spray Irrigation Operator in Responsible Charge (ORC): Brian Peters Phone: [phone]
ORC Certification Number: 987582 Check Box if ORC Has Changed:
Mail ORIGINAL and TWO COPIES to:
ATTN: Non -Discharge Compliance Unit
DENR
Division of Water Quality (SIGNATURE OF OPERATOR IN RESPONSIBLE CHARGE)
1617 Mail Service Center BY THIS SIGNATURE, I CERTIFYTHAT THIS REPORT IS ACCURATE AND COMPLETE
RALEIGH, NC 27699-1617 TO THE BEST OF MY KNOWLEDGE.

NON -DISCHARGE APPLICATION REPORT
SPRAY,LRRIGA LION SITES)
Facility -Status:
Please Indicate( by. inserting Y(es) or N(o) in the appropriate box) whether the facility has b'awmnliant
with the following permit requirements: Vote: if a requirement does not apply to your facility putl4A) in the
compliant box. )
Comphent 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)�
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-thanAh
specified in the permit:
If the facility isnon-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 thecorrective 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 Iny knowledge and belief, true, accurate, and
complete. I am aware that there are significant penalties for submittin Ise information, including the possibility of fines
and i4risonment for knowing violations."
,4w,,5 ///&/Z// f 34'e �/ o� r R T_• -pg
(Signature of Permittee)* 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)
* [feigned by other than the permidee, delegation of signatory authority must be on file with the state per 15A NCAC 2B.0500 (b)(2)(D).

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDITIONAL PAGESAS. NEEDED.
PERMIT NUMBER: WQ0022870 MONTH: October 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 feet/acre
= Volume Applied (gallons) / [Area Sprayed (acres) x 27,152 (gallonslacre-inch)]
Maximum Hourly Loading (inches) = Daily Loading (inches) / [Time Irrigated (minutes) 160 (minutes/houlnthly Loading (inches)
12 Month Floating Total (Inches) = Sum of this month's Monthly Loading (Inches) and previous 11 month's Monthly Loadings (Inche
1 12
AT I I THIS
Average weekly Loading (inches) _ [Monthly Loading (incheslmonth) / Number of days in the month (days/month)].x.7 (days/week) -
Did Irrigation Occur At This Facility:
Did Irrigation Occur On This Field:
Did Irrigation Occur On This Field:
Yes: x No:
Yes: x No: -
Yes: x No:
_.......:...__....._._
.................................._.......:.....
FIELD NUMBER: F3B
FIELD NUMBER: F4
SPAYED (acres): 3.01
SPRAYED acres 7.18
turf s
ras
COVER CROP: turf rassoP.
Total Gallons/Monthly Loading (inches)
12 Month Floating Total (inches)
TED HOURLY RATE (inches). 0 1.1
( 1
TTED HOURLY RATE(inches): 0
WEATHER CONDITIONS
TTED YEARLY RATE (inches): 7.43
ITTED YEARLY RATE (inches): 20.47
D
A
Tamper-
storage
Maximu
Maximu
T
weatner Precipita•
Lagoon
Volume Time Dai m Hourly
IY Y
Volume Time Dai m Hourly
- IY Y
E
Code•atureat
application tion
'Freeboard
i.
Applied- Irrigated Loading Loading
Applied Irri ated Loading Loading
inches
_-.feet-
. minutes Inches inches
gallons ;, minutes inches inches
1 12
AT I I THIS
Spray Irrigation Operator in Responsible Charge (ORC): Brian Peters Phone: [phone]
ORC Certification Number: 987582 Check Box if ORC Has Changed:
Mail ORIGINAL and TWO COPIES to:
ATTN: Non -Discharge Compliance Unit
DENR
Division of Water Quality (SIGNATURE OF OPERATOR IN RESPONSIBLE CHARGE)
1617 Mail Service Center BY THIS SIGNATURE, I CERTIFYTHAT THIS REPORT IS ACCURATE AND COMPLETE
RALEIGH, NC 276 99-1 61 7 TO THE BEST OF MY KNOWLEDGE.
Total Gallons/Monthly Loading (inches)
12 Month Floating Total (inches)
Average Weekly Loading (inz"
Weather Codes: C -clear. PC -partly cloudy, Cl -cloudy, R -rain, Sn-snow, SI-slest
Spray Irrigation Operator in Responsible Charge (ORC): Brian Peters Phone: [phone]
ORC Certification Number: 987582 Check Box if ORC Has Changed:
Mail ORIGINAL and TWO COPIES to:
ATTN: Non -Discharge Compliance Unit
DENR
Division of Water Quality (SIGNATURE OF OPERATOR IN RESPONSIBLE CHARGE)
1617 Mail Service Center BY THIS SIGNATURE, I CERTIFYTHAT 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 SITES)
Facility Status:
Please indicate ( by inserting Y(es) or N(o) in the appropriate box )whether the facility. has bewmuliant
with the following permit requirements: dote: if a requirement does not apply to your facifityputlgA) in the
compliant box. )
Com liant N)
1. The application rate(s) did not exceed the limit(s) specified in the permit. lyp
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 0
4. All. buffer zonesas specified in the permit were maintained.during each appliJY
S.,The freeboard in the treatment and/or storage lagoon(s) was not.less.than thcy
specified in the permit.
If the facilityisnon-complianplease explain in the s ace below the reasons the .facility was not in compliance with its .,.
permit..Provide, in your: explanation the date(s) of the nori�ompliance and describe the corrective action(s) taken. Attach
additional sheets if necessary
1 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 imprisonme fo owing violations."
_zqSign e o ermittee)* Date (Name of Signing Official -Please print or type)
Aqua North Carolina
(Permittee -Please print or type)
202 MacKenan Ct
Cary NC. 27611
(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 2B.0509 (b)(2ND).

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION.SITE(S)
THERE ARETWOAPPLICATION.FIELDS PER PAGE. USE ADDITIONAL PAGES AS NEEDED.
PERMIT NUMBER: WQ0022870 MONTH: October 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 feetlacre
= Volume Applied (gallons) / [Area Sprayed (acres) x 27,152 (gdlons/acreinch)]
Maximum Hourly Loading (inches) = Daily Loading (inches) / [Time Irrigated (minutes)160 (minutes/hounnthly Loading (inches)
12 Month Floating Total (inches) = Sum of this month's Monthly Loading (inches) and previous 11 month's Monthly Loadings (inches'
' 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 Has Changed:
Mail ORIGINAL and TWO COPIES to:
ATTN: Non -Discharge Compliance Unit
DENR
Division of Water Quality (SIGNATURE OF OPERATOR IN RESPONSIBLE CHARGE)
1617 Mail Service Center BY THIS SIGNATURE, I CERTIFYTHAT THIS REPORT IS ACCURATE AND COMPLETE
RALEIGH, NC 27699-1617 TO THE BEST OF MY KNOWLEDGE.
- ' Average Weekly Loading (inches) -_ [Monthly Loading (inches/month) / Number of days in fire month (dayslmonth)] x 7 (daysAvsek)
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:.; -
<...
... ".. ..'>>>`: «
FIELDNUMBER: F
SPRAYED acres : 13.22 .-
COVER CROP- turfy rass
TTED HOURLY(inches):RATE 0:1TED
FIELD NUMBER:'' " - F-6
SPRAYED acres : 4.94
COVER'CROPt turf rass::.'"
HOURLY RATE inhes:
"0::r:»>'>>;
D
. A..
T _"-
WEATHER CONDITIONS
.Temper-' - storage-
. Weather
alure at �Preapita! lagoon
Code•-." .application. '_= hon: - " Free-tioard
IT TED YEARLY RATE (inches): 20.47 ITTED YEARLY RATE (inches): 20.47
".'. :.- -Maximo Maximu
Volume Time Daily. m.Hourly Volume Time - • Daily"_ m _Hourly
:A lied .'Irrigated LoadingLoading Applied Irriated Loading-� :Loadin
(°F) inches feat..:.
gallons.. minutest ,inches"" -'inches.
.gallons 'minutes `.''inches
:.. Inches.
2,•;,
4 ..
5.
8
7
8
9
10
11
NO IRRIGATION
APPLIED
12
13
14
15
18
AT THIS
TIME
17
18
19
20
ALL FIELDS
21
22
23
24
25
28
27
28
29
30
31
Total Gallons/Monthly Loading (inches)
0 0.00
0 :::::::::>::::::>::>::::::
0.00
0 Floating Month FI aLn Total inches
12.12
4. 7
3
Avera a Weekly YLoadin9 (inches)
» 0.00
_ ......
0.00 ._..........-
' 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 Has Changed:
Mail ORIGINAL and TWO COPIES to:
ATTN: Non -Discharge Compliance Unit
DENR
Division of Water Quality (SIGNATURE OF OPERATOR IN RESPONSIBLE CHARGE)
1617 Mail Service Center BY THIS SIGNATURE, I CERTIFYTHAT 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 beeirrnoliant
with the following permit requirements: Note: if a requirement does not apply to your facility putIOA) in the
compliant box. )
Compliant N)
1. The application rate(s) did not exceed the limit(s) specified in the permit. I Y
2. Adequate measures were taken to prevent wastewater runoff from the site(
3. A suitable vegetative cover was maintained on the site(s) in accordance with
4All,tiuffer zones! as specifed in;the permit'were maintained during eacWappli ..
5..The freeboard in the treatment and/or storage lagoons) was"nof.less:than the�
specified in the permit..:.
If the facility isnon-comoliant 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 gatheringthe 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 submittin false information, including the possibility of fines
and imprisonment for owing violations."
' / � `i V �RBQY• R�� nP5
tgnat e o ermittee)* 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.0500 (b)(2ND).

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
- - THERE ARE,TWO.APPLICATION FIELDS PER PAGE. USE ADDITIONAL. PAGES AS NEEDED. _
PERMITNUMBER: WQ0022870 MONTH:Obtober 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 feetlacre:
= Volume Applied (gallons) / [Area Sprayed (acres) x 27,152 (gallons/acreinch)]
Maximum Hourly Loading (inches) = Daily Loading (inches) / [Time Irrigated (minutes) / 60 (minutesRmur)nthly Loading (inches) _
. 12 Month Floating Tota[ (inches) = Sum of this month's Monthly Loading (inches) and previous 11 month's Monthly Loadings (inchet ..
of days in the mono, (days/month)) x 7 (days/week)
This Field: Did. Irrigation Occur On This Field:
No: '' Yes: x No:
F-7- FIELD NUMBER:.: F=8'
®I
f1tiY�f1_f1_� � •-1:1:1[C7G\gl\J►-_19JN(ae��f'
Total GallonslMonthly Loading
12 Month Floating Tota[
Spray Irrigation Operator in Responsible Charge (ORC): Brian Peters Phone: [phone]
ORC Certification Number: 987582 Check Box if ORC Has Changed:
Mail ORIGINAL and TWO COPIES to:
ATTN: Non -Discharge Compliance Unit
DENR
Division of Water Quality (SIGNATURE OF OPERATOR IN RESPONSIBLE CHARGE)
1617 Mail Service Center BY THIS SIGNATURE, I CERTIFYTHAT THIS REPORT IS ACCURATE AND COMPLETE
RALEIGH, NC 2769971617 TO THE BEST OF MY KNOWLEDGE. .
" COVER CROP: turfy rass -
COVER CROP: turf rass .
..............
.............
..... .. ......
ITTED HOURLY RATE (inches):
0.1
TED HOURLY RATE (inches): • 0.1
WEATHER CONDITIONS
ITTED YEARLY RATE (inches):
20.47.
ITTED YEARLY RATE inches : 20.47
D
A
temper-
storage
Maximu
Maximu
T. :
weatner �atureat„ :Precipita-
Lagoon
Volume Time Daily
m.Hourly
Volume Time Daily m.Hourly
..,E :.
Code, : appiication .. tion
Freeboard
A lied' Irri ated, -LoadingLoadingApplied
Irri ated Lcadifig Loading
'('F) ".'-,:inches
feet `-
:-gallons':' minutes ,.;inches >,..-Inches•
..gallons:`. minutes:inches:inches
1
,
2
3..
4
5
f1tiY�f1_f1_� � •-1:1:1[C7G\gl\J►-_19JN(ae��f'
Total GallonslMonthly Loading
12 Month Floating Tota[
Spray Irrigation Operator in Responsible Charge (ORC): Brian Peters Phone: [phone]
ORC Certification Number: 987582 Check Box if ORC Has Changed:
Mail ORIGINAL and TWO COPIES to:
ATTN: Non -Discharge Compliance Unit
DENR
Division of Water Quality (SIGNATURE OF OPERATOR IN RESPONSIBLE CHARGE)
1617 Mail Service Center BY THIS SIGNATURE, I CERTIFYTHAT THIS REPORT IS ACCURATE AND COMPLETE
RALEIGH, NC 2769971617 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 beatnoliant
with the following permit requirements: tVote: if a requirement does not apply to your facility put MA) in the
compliant box. )
Comphent 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(sF
3 A suitable vegetative cover: was. maintained on the site(s) in accordance with
4. All buffer zones as specified in thepermit were maintained;dunng each appli
5 The::freeboard`in the treatment and/or storage lagoon(s)was not less than.the
specified. in the permit:
If the facility.isnon-comolianl 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 imprisonm t nowing violations."
ignat a of ermittee)" 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.0500 (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: October YEAR:: 2016
FACILITY NAME: Buck Mountain Development COUNTY: Chatham
Formulas:
Daily Loading (inches) =NdumeApplied(gallons)x0.133a(cubic1,ef/gallon)x12(inchesil t)]/[AreaSprayed(aaes)x 43,560(squaral-/acre)] OR .
= Vdume Applied (gallons) / [Area Sprayed (aaes) x 27,152 (gallans/aae-inch)]
Maximum Hourly Loading (inches) =Dally Loading (inches)/ [Time Irrigated (minutes)/e0(minutes/hour)] nthly Loading (inches) ,
12 Month Floating Tota[ (inches) =Sum of this month's Monthly Loading (inches) and p -A ws 11 month's Monthly Loadings (inches)
Total Gallons/Monthly Loading o
12 Month Floating Total (inches'
Average Weekly Loading a
..r ..r
Spray Irrigation Operator in Responsible Charge (ORC): Brian Peters Phone: [phone]
ORC Certification Number: 987582 Check Box if ORC Has Changed:
Mail ORIGINAL and TWO COPIES to:
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.
Average Weekly Loading (inches) =[Monthly Loading (inches/month)/ Number of days in the month(days/month)] x 7(daydweek).
Did Irrigation
Occur At This FaciliH:
Did Irrigation Occur On This Field:
Did Irrigation Occur On This Field:.
Yes: xNo.-::
Yes:: ','X .. . No:
Yes: No:,:.. z, "..
FIELD NUMBER: F-9
FIELD NUMBER: F710
........................ "
SPRAYED acres): 1011
SPRAYED acresj: ' 5.76
COVER CROP:' tUrfl rass'.
COVER CROP: tUrf lass
-
:;.: -: ;: ITTED-HOURLY.RATE (inches): 0.1.
MITTED HOURLY :RATE.(inches)t ' , .: 0.1.
U
WEATHER CONDITIONS
ITTED YEARLY RATE (inches): .20.47
MITTED YEARLY RATE (inches): . 20.47
A
Maximum
Maximum
T ',
To pa.-
Weathor P
etur.at Prodpita.
storeee
Volume ` Time Dai] y
Lagoon Free y' Hourly'
Volume Time . Dai] Hourl
y y
E
application Alen. "`
'board ' Applied . Irrigated Loading -. Loading
A lied- Irrigated Loading g• Loadin
(°F) .. _.Inches.
feet-...' "gallons... 'minutes•. inches' _ inches._
gallons minutes -'..inches
Total Gallons/Monthly Loading o
12 Month Floating Total (inches'
Average Weekly Loading a
..r ..r
Spray Irrigation Operator in Responsible Charge (ORC): Brian Peters Phone: [phone]
ORC Certification Number: 987582 Check Box if ORC Has Changed:
Mail ORIGINAL and TWO COPIES to:
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 beencomoliant
with the following permit requirements: (Note., if a requirement does not apply to your facility put( WA) in the
compliant box. )
Com liant N)
1. The application rate(s) did not exceed the limit(s) specified in the permit. FY -
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 applic
5. The freeboard in the.treatment and/or storage lagoon(s) was not less than the 0 -
specified in,the permit:
If the facility is non-compliant please explain in 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 submittin Ise information, including the possibility of fines
and imprisonm t owing vi tions."
s
tgn re of ermitteer Date (Name of Signing Official -Please print or type)
Aqua North Carolina Waste Water Supervisor
(Permittee -Please print or type) (Position or Title)
202 MacKenan Ct
919-467-8712
(Phone Number)
Cary NC. 27511
(Permittee Address)
* If signed by otherthan 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.
PERMITNUMBER: WQ0022870 MONTH: October 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
= VolumeApplied (gallons) / [Area Sprayed (acres) x 27,152 (gallons/acre-inch)]
Maximum Hourly Loading (inches) = Daily Loading (inches) / [Time Irrigated (minutes) / 60 (minuteslhoulnthly Loading (inches)
12 Month Floating Total (inches) = Sum of this month's Monthly Loading (inches). and previous 11 month's Monthly Loadings (inche
-
- Average Weekly Loading (inches) = [Monthly Loading (inches/month) / 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:
»''`«L' i
.:...... .;.
FIELD NUMBER: F -10B
SPRAYED acres .5.69
COVER CROP: aurfr rass
TED HOURLY RATEinches - 0.1
FIELD NUMBERc F-11
k SPRAYED (acres); 4.69.
COVER CROP: - turf rass
TTED HOURLY RLY RATE inches 0:1
D
A -
T
-
E .
WEATHER CONDITIONS
- 'Temper- - Storage
Weath er
Code• - atureat .Precipita- .Lagoon
application tion'.-. Fme-board
ITTED YEARLY RATE inches : 7.43 TTED.YEARLY RATE (inches): 20.47
. . . Maximu - � Maximu. -
Volume Time Daily m Hourly Volume Time Daily mHourly
Applied Irrigated--Loadn. iLoadingApplied, Irrigated LoadingLoading
Inches
Inches -".feel
gallons .minutes y` -'inches , inches
gallons minutes ;`---inches
- :.inches
3
_
4 .
5
8
7
8
9
10
11
NO IRRIGATION APPLIED
12
13
14
16
16
AT THIS
TIME
17
18
19
20
ALL FIELDS
21
22
23
24
25
26
27
28
29
30
31
Total GallonslMorrtirly Loading (inches)
0 0.00
0 i :::
0.00
12 Month Floating Total (inches) )
. >:::......... »»»>c:.:.><:> 2.06 >'
0.79;M
Average Weekly Loading (inches)
.: 0.00
0.00
. 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 Has Changed:
Mail ORIGINAL and TWO COPIES to:
ATTN: Non -Discharge Compliance Unit
DENR
Division of Water Quality (SIGNATURE OF OPERATOR IN RESPONSIBLE CHARGE)
1617 Mail Service Center, BY THIS SIGNATURE, I CERTIFYTHAT THIS REPORT IS ACCURATE AND COMPLETE
RALEIGH, NC 27699-1617 TO THE BEST OF MY KNOWLEDGE.

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE
Facility Status:
Please indicate (by inserting,Y(es) or N(o) in the appropriate box') whether the. facility has baiumpliant
with the following permit requirements: kVote: if a requirement does not apply to your facility put 41A) in the
compliant box. )
Compliant 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(t)�
;3s A suitable vegetative cover was maintained on the site(s) in accordance with
4: All buffer zones:as specified in the permitWere maintained duringeach appli
5 -The freeboard ;in the treatment and/or storage lagoons) was not less than thjy,
specified in the permit:
If the facility isnon-coniplian# please explain in the space below the reason(s) the facility was not 1n 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 Ise information, including the possibility of fines
and imprison t knowing violations."
Teens
Sig ter 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 28.0508 (b)(2ND).

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
.THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDITIONAL PAGES AS NEEDED.:
PERMIT NUMBER: WQ0022870 MONTH: October 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)] I [Area Sprayed (acres) x 43,560 (square feet/acre
=Volume Applied (gallons) / [Area Sprayed (acres) x 27,152 (gallons/acre-inch)]
Maximum Hourly Loading (inches) =Daily Loading (inches) / [Time Irrigated (minutes) / 60 (minuteslhouhnthly Loading (inches)
12 Month Floating Tota] (inches) = Sum.of this month's Monthly Loading (inches) and previous 11 month's Monthly Loadings (inchE
-
Average Weekly Loading (inches) --[Monthly Loading (inches/month) / 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: No: x
Did Irrigation Occur On This Field:
Yes: No: x
X.
_
FIELD NUMBER: F-11 B
SPRAYED(acres): 4.2' .9.37
COVER CROP: turfy rass
TED HOURLY RATE (inches): 0.1
FIELD NUMBER: F-11 G
SPRAYED(acres):
COVER CROP: turf rass
TTED HOURLY RATE (inches): 0.1
D
A
T
E
WEATHER CONDITIONS
Tamper-' Storage
Weather '
Walure at:pracipita- lagoon
Code*+ - application ,tion. - Fina -board
TTED YEARLY RATE (inches): 20.47 TTED YEARLY RATE (inches): 7.43
Maximu Maximu.
Volume Time Daily m Hourly Volume Time Daily m Hourly
A:pplied- Irrigated Loading .Loading Applied Irrigated Loading Loading
inches feet =
gallons` ..minutes, inches Inches
:gallons" -minutes-
,inches _inches.-. .
2 .
3
>
4
5
8
7
8
9
10
NO IRRIGATION APPLIED
11
12
13
14'
1s
AT THIS
TIME
18
17
18
18
ALL FIELDS
20
21
22
23
24
25
28
27
28
29
30
31
Total Gallons/Monthly Loading (inches)
0 0.00
0 :»:i<:
0.00
12 Month FloatingTotal inches
(inches)
.] 2.72
3.32
Average Weekly Loading (inches)
.' ... ;: 0.00 F`.:.,.:.:.:.:.: ... ;
....... ....... ..
0.00 :`
. Weather Codes: C -clear, PC -partly cloudy, Cl -cloudy, R -rain, Snsnow, SI -sleet
Spray Irrigation Operator in Responsible Charge (ORC): Brian Peters Phone: [phone]
ORC Certification Number: 987582 Check Box if ORC Has Changed:
Mail ORIGINAL and TWO COPIES to:
ATTN: Non -Discharge Compliance Unit
DENR
Division of Water Quality (SIGNATURE OF OPERATOR IN RESPONSIBLE CHARGE)
1617 Mail Service Center BY THIS SIGNATURE, I CERTIFYTHATTHIS REPORT IS ACCURATE AND COMPLETE
RALEIGH, NC 27699-1 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 )tyhethor the facility has ba'anrtolianf -
with the following permit requirements: Vote: if a requirement does not apply to your facility put t0A) in the
compliant box. )
Com liant 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)Fy---]
.3. A suitable Vegetative. cover was maintained on the site.0)'in accordance with 0
4.. All buffer zones as. s ecified,in the ermit were maintained during each a II Y
p .. P g. , pP i
5. The freeboard in the treatment and/or storage lagoons):was not less than thFY7
specified in the permit:
If the facility isnon-compliant please explain in the space below the reason(s)the facility was not in compliance with its `
permit.Provide in -your explariation 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 imprisonm nt for knowing violations."
s
gnata of P mittee)* 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 213.0500 (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: October 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/foot)) /[Area Sprayed (acres) x 43,566 (square feet/acre
=Volume Applied (gallons) / [Area Sprayed (acres) x 27,152 (gallons/acreinch)]
Maximum Hourly Loading (inches) = Daily Loading (inches) / [rime Irrigated (minutes) / 60 (minutes/houhnthly Loading (inches)
12 Month Floating Total (inches) = Sum of this month's Monthly Loading (inches) and previous 11 month's Monthly Loadings (inche
. Weather Codes: C -clear, PC -partly cloudy, Cl -cloudy, R-ra[n, Sn-snow, SI -sleet
Spray Irrigation Operator in Responsible Charge (ORC): Brian Peters Phone: [phone]
ORC Certification Number: 987582 Check Box if ORC Has Changed:
Mail ORIGINAL and TWO COPIES to:
ATTN: Non -Discharge Compliance Unit
DENR
Division of Water Quality (SIGNATURE OF OPERATOR IN RESPONSIBLE CHARGE)
1617 Mail Service Center BY THIS SIGNATURE, I CERTIFYTHAT THIS REPORT IS ACCURATE AND COMPLETE
RALEIGH, NC 27699-1617 TO THE BEST OF MY KNOWLEDGE.
Average Weekly Loading (inches) = [Monthy Loading (Inches/month) / Number of days in the month (days/month)] x 7 (dayshveek)
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:.
" ...:.::>::... .... .:::::
. ......................
"""""""''%"''' " ' "' '
.::.
?.;<ag?;:;:;;»>
3
FIELD NUMBER: F-12
SPRAYED (acres): I2.62;
COVER CROP: turfy rass
TED HOURLY RATE (inches):: 0.1TED
FIELD.NUMBER: F -12B
IkSPRAYED (acres)* 1.54 '
COVER CROP:. turf rass
HOURLY RATE (inches): ' -0.1
p
T
E..',
WEATHER CONDITIONS
Temper- � Storage
Weather eture at .. Precipita- Lagoon
.Codel' application - -tion Frea-b.ud
'
ITTED YEARLY RATE (inches), 20.47 TTED YEARLY RATE (inches): 7.43
Maximu Maximu
Volume Time Daily m Hourly Volume Time Daily m Hourly
Applied Irrigated Loading. -Loading -.A - lied �Irrigated 'Load[n� Loading
- :...
.. . .
(°F) '' ' inches- - - feet -'-
'.gallons .minutes., inches:;:. '':.inches-
-
gallons:.. minutes
-
-.'inches' � � 'inches..'
2_..
.:
3
4
S
8
7
8
9
10
11
NO IRRIGATION APPLIED
12
13
14
15
18
AT THIS
TIME
17
18
19
20
ALL FIELDS
21
22
23
24
25
28
27
28
29
30
31
Total GallonslMonthly Loading (inches)
0 0.00
0 ::::::::::::>:>:::::::::
0.00
12 Month FloatingTotal (inches)
3.10
2.51
Avera a Wee inches
9 Weekly Loading (inches)
..:::::>:>:::_:::>:> ::_:>:::: 0.00 ` .............................................:
0.00 :..............
. Weather Codes: C -clear, PC -partly cloudy, Cl -cloudy, R-ra[n, Sn-snow, SI -sleet
Spray Irrigation Operator in Responsible Charge (ORC): Brian Peters Phone: [phone]
ORC Certification Number: 987582 Check Box if ORC Has Changed:
Mail ORIGINAL and TWO COPIES to:
ATTN: Non -Discharge Compliance Unit
DENR
Division of Water Quality (SIGNATURE OF OPERATOR IN RESPONSIBLE CHARGE)
1617 Mail Service Center BY THIS SIGNATURE, I CERTIFYTHAT 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 bcomoliant
with the following permit requirements:,(Vote: if a requirement does not apply to your facility putNA) in the
compliant box. )
Com liant(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)i l
3. A suitable vegetative cover was maintained on the site(s) in accordance with.l
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 isnon-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 correcfive 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 or wing violations."
s
ignat a of rmittee)* Date (Name of Signing Official -Please print or type)
Aqua North Carolina Waste Water Superyisor
(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)(1)).

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS, PER PAGE. USE ADDITIONAL PAGES AS NEEDED.
PERMIT NUMBER: WQ0022870 MONTH: October. r YEAR: 2016 .
FACILITY NAME: Buck Mountain Development COUNTY: Chatham
Formulas:
Daily Loading (inches) = [Volume Applied (gallons) x 0.1336 (cubic feet gallon) x 12 (incheslfoot)]! [Area Sprayed (acres) x 43,560 (square feetlaue
= Vdume Applied (gallons)! [Area Sprayed (acres) x 27,152 (gallons/acretinch)]
Maximum Hourly Loading (inches) = Daily Loading (inches) / [Time Irrigated (minutes) / 66 (minutesihoumthly Loading (inches)
12 Month Floating Tota[ (inches) = Sum of this month's Monthly Loading (Inches) and previous 11 month's Monthly Loadings (inche
. Weather Codes: C -clear, PC -partly cloudy, Cl -cloudy, R-ra[n, Sn-snow, SI -sleet
Spray Irrigation Operator in Responsible Charge (ORC): Brian Peters Phone: [phone]
ORC Certification Number: 987582 Check Box if ORC Has Changed:
Mail ORIGINAL and TWO COPIES to:
ATTN: Non -Discharge Compliance Unit
DENR
Division of Water Quality (SIGNATURE OF OPERATOR IN RESPONSIBLE CHARGE)
1617 Mail Service Center BY THIS SIGNATURE, I CERTIFYTHAT THIS REPORT IS ACCURATE AND COMPLETE
RALEIGH, NC 27699-1617 TO THE BEST OF MY KNOWLEDGE.
. Average Weekly Loading (inches) _. [Monthly Loading (incheslmonth) / Numberof days in the month (dayslmonth)] x 7 (days/week)
-
Did Irrigation Occur At This Facility: -
Yes: z.-. No: _'
Did Irrigation Occur On This Field:
Yes: x ..: No:
Did Irrigation Occur On This Field:
Yes:. No: x .
XX :;;
.......
`'''
' FIELD NUMBER: - F-13 '
SPRAYED acres): 8.49
COVER CROP: tuff. rass
e
TED HOURLY RATE inch s . 0:1TED
FIELD NUMBER: F-13BX ' .
SPRAYED acres): 2.2'
COVER CROP: turf rasS
HOURLY RATE finches): 0.1
A
T
. E
WEATHER CONDITIONS ITTED YEARLY RATE (inches): 20.47. TTED YEARLY RATE (inches): - . 7.43
Temper-' storage Maximus Maximus
Weather atureat. 'Precipita. :Lagopn Volume Time Daily' mHourly Volume Time,. Daily _ rnHourly
Code• -application tion ;.-: Free -hoard Apilolied Irrigated. LoadinLoading Applied. Irrigated :Loading - Loadin
(°F):'!• .' inches :. feet--'
..gallons,-- minutes ,.inches:-, inches -
:gallons'..minutes:-
inches- inches
.. .-_:
2
3. .
4
5
8
7
6
9
10
11
NO IRRIGATION APPLIED
12
13
14
15
16
AT THIS
TIME
17
1s
19
20
ALL FIELDS
21
22
23
24
25
28
27
28
29
30
31
Total GallonslMonthly Loading (inches)
0 0.00
0 ::.....':::::;:::
0.00
12 Month to Total (inches) 1**
alto T n
9 ( )
-.*.*.*%.*.'.'.-.*.'.*.........-..
.>»<»>>«<:>>> 2.23
1 86
Average Wee Loadin inches
9 Weekly 9l )
..>': >:>:>'>:>>>................
..... 0.00
_...........................;:
0.00 :_...........
. Weather Codes: C -clear, PC -partly cloudy, Cl -cloudy, R-ra[n, Sn-snow, SI -sleet
Spray Irrigation Operator in Responsible Charge (ORC): Brian Peters Phone: [phone]
ORC Certification Number: 987582 Check Box if ORC Has Changed:
Mail ORIGINAL and TWO COPIES to:
ATTN: Non -Discharge Compliance Unit
DENR
Division of Water Quality (SIGNATURE OF OPERATOR IN RESPONSIBLE CHARGE)
1617 Mail Service Center BY THIS SIGNATURE, I CERTIFYTHAT THIS REPORT IS ACCURATE AND COMPLETE
RALEIGH, NC 27699-1617 TO THE BEST OF MY KNOWLEDGE.

NON -DISCHARGE APPLICATION REPORT
.SPRAY IRRIGATION SITES)
Facility Status:.
Please indicate ( by inserting Y(es) or N(o) in the appropriate box) whether the facility has bwmoliant
with the following permit requirements: Note: if a requirement does not apply to your facility putlhA) in the
compliant box. )
Com liant 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 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 isnon-comoliant. pleas e explain in the space below the reasons) the facility was'not in compliance with its
permit. Provide in your explanation the:date(s) of the nonmcompliance 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 k owing violations."
R69a&& Fapps
gnat o ermittee)* 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)
• lfsigned 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 PERTAGEJISE ADDITIONAL PAGESASNEEDED:
PERMIT NUMBER: WQ0022870 _- -MONTH::: October YEAR: 2016
FACILITY NAME: Buck Mountain Development COUNTY: Chatham
Formulas:
Daily Loading (inches) =[vdumeApplied (gallons).0.1336(cubicfeet/gallon)x12(inchesRaot))/[A,-Spraged(aQes)x43.500(squareteelfa )] of
= Volume Applied (gallons) / WP Sprayed (aces) x 27,152 (gallonsraceinch)l
Maximum Hourly Loading (inches) = Dally Loading (Inches)/[rmelmgated(minutes)/a0(minutes/hour))lonthly Loading (inches)
12 Month Floating .Total(inches) =Sum ofwa month's Monthly Loading(inchas) and previous 11 month's Monthly Leadings(inches)
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 Has Changed:
Mail ORIGINAL and TWO COPIES to:
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.
Average Weekly Loading (inches) =[Monthly Loading inches/month)/Number of days in the month(daye/month)) x 7(dayshveek).
.
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:
i'ii
»::•: ? < :
.:... ..
X.
.
FIELD NUMBER: ' F=14
A SPRAYED acres : 9.91
COVER CROP: aUrfr rass ,:
ITTED.HOURLY RATE (inches): 0.1
FIELD NUMBER:17-15
tEA SPRAYED acres : 4.79'
COVER CROP: turf rass
MITTED HOURLYRATE(inches): . 0.1
D
AT—or
T
E .
WEATHER CONDITIONS AITTED YEARLY RATE (Inches):1 20.47
. go Maximum
woalhor. . aturoet Predplta- Lagoon ree'Volume ' Time. Daly Hourly
code• application ' -eon- board A lied Irrigated LoadingLoadingApplied
WITTED YEARLY RATE (inches): 20.47
Maximum
Volume Time Daily Hourly
Irrigated Loading: Loading
....
.,-(°F) .. Inches" feet
gallons ; minutes. Inches Inches;
. '
-gallons minutes .
,inches inches
2.
3..:.
4
5
6
7
8
9
10
11
12
NO IRRIGATION APPLIED
13
14
15
16
17
AT THIS
TIME
18
19
20
21
ALL FIELDS
22
23
24
25
26
27
28
29
30
31
Total Gallons/Monthly Loading (inches
0 0.00
01
0.00
12 Month Floating Total (inches:::::::::;
:< 3.30
1.16
Average Weekly Loading (inches
:::........................... 0.00 ...............
0.01
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 Has Changed:
Mail ORIGINAL and TWO COPIES to:
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 beencornPip t'
with the following permit requirements: (Note., if a requirement does not apply to your facility put( NA) in the
compliant box. )
Co�.m, liant ,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). YO
3. A suitable vegetative cover was maintained on the site(s) in accordance with th0
4 All buffer zones as specified in the permit were maintained during each applica
5 The freeboard in the treatment and/or storage lagoon(s) was not less than the HEY
-specified in 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 explanationthe 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."
dg4nat4.fitt..)-��
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 ADDrrIONAL PAGES. AS NEEDED.,
PERMIT NUMBER: W00022870 MONTH: Octobei YEAR:, 2016
FACILITY NAME: Buck Mountain Development COUNTY: Chatham
Formulas:
Daily Loading (inches) = [Volume Applied (gallons) x0.1336 (cubic feettgallon) x 12 (Inches/foot)]/ [Area Sprayed (acres) x 43,560 (square feettacre
= Volume Applied (gallons) / [Area Sprayed (acres) x 27,152 (gallons/aererineh)]
Maximum Hourly Loading (inches) = Daily Loading (inches) / [Time Irrigated (minutes) / 60 (minuteslhouhnthly Loading (inches)
12 Month Floating Total (inches) = Sum of this month's Monthly Loading (inches) and previous 11 month's,Monthly Loadings (inche
• Weather Codes: C -clear, PC-partiy cloudy, Cl -cloudy, R -rain, Sin -snow, SI -sleet
Spray Irrigation Operator in Responsible Charge (ORC): Brian Peters Phone: [phone]
ORC Certification Number: 987582 Check Box if ORC Has Changed:
Mail ORIGINAL and TWO COPIES to:
ATTN: Non -Discharge Compliance Unit
DEN
Division of Water Quality (SIGNATURE OF OPERATOR IN RESPONSIBLE CHARGE)
1617 Mail Service Center BY THIS SIGNATURE, I CERTIFYTHATTHIS REPORT IS ACCURATE AND COMPLETE
RALEIGH, NC 2 76 99-1 61 7 TO THE BEST OF MY KNOWLEDGE.
Average Weekly. Loading (inches) -_ [Monthly Loading (inches(month) / Number of days in the month (dayslmonth)] x7 (daysMeek)
-
Did Irrigation Occur At This Facilityi
Yes: x . . Not. - <..
Did Irrigation Occur On:This Field:
Yes: x .: No:
Did Irrigation Occur On This Field:
Yes: x No:
" ::
_.._..............."........................................_....__.....
........
"' r;'; .:;`
.. . .
..... : .....
o;;......:zr.
.. .. .... ...... ...... .... .. " '- "
- FIELD NUMBER: F=16
SPRAYED (acres): 9.05
.COVER.CROP: turfr rass ' -
TED HOURLY RATE (Inches): 0.1
FIELD NUMBER:, F-17
SPRAYED` (acres)d 5.37
COVER CROP: turfrass
TED HOURLY,RATE (inches): 0.1
A
T
WEATHER CONDITIONS
Temper- storage
Weather P
atureat Preci Its. IF
" Code• .application Jon '.. Free-bbaid
"
ITTED YEARLY RATE (inches): 20.47 TTED YEARLY RATE (inches): 20.47
Maximu Maximu
b m Hdurl Volume Time Dai m Hourly
Volume Time Dai y Daily y
-A lied..lm sled- LoadingLoading " Applied Irrigated Loading'Loading
(°F):.:,'•inches. .�"fast : ..,.gallons,
minutes -inches-' inches'
'gallons, minutes;
inches--: inches-
4.
6
6
7
8
9
10
11
NO IRRIGATION APPLIED
12
13
14
1s
16
AT THIS
TIME
17
18
19
20
ALL FIELDS
21
22
23
24
26
28
27
28
29
30
31
Tota[ Gallons/Monthly Loading (inches)
00.00
0 :::::::
0.00
12 Month FloatingTotal inches
(inches)
:::
..:>s::<:< 3.72
3.03 >
Average Wee Loading inches
e Weekly 91 )
0.00 . ................
.... ......... . .:
0.00
• Weather Codes: C -clear, PC-partiy cloudy, Cl -cloudy, R -rain, Sin -snow, SI -sleet
Spray Irrigation Operator in Responsible Charge (ORC): Brian Peters Phone: [phone]
ORC Certification Number: 987582 Check Box if ORC Has Changed:
Mail ORIGINAL and TWO COPIES to:
ATTN: Non -Discharge Compliance Unit
DEN
Division of Water Quality (SIGNATURE OF OPERATOR IN RESPONSIBLE CHARGE)
1617 Mail Service Center BY THIS SIGNATURE, I CERTIFYTHATTHIS REPORT IS ACCURATE AND COMPLETE
RALEIGH, NC 2 76 99-1 61 7 TO THE BEST OF MY KNOWLEDGE.

NOWDISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
Facility Status:
Pleaseindicate ( by inserting Y(es) or N(o) in the appropriate box )"whether the facility has besornoliant
with the following permit requirements: (Vote: if a requirement does not apply to your facility putlpA)'in the
compliant box. )
Compliant 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 th
specified in the permit.
if the facility isnon-comolianx please explain in the space below the reason(s) the facility was not in compliance with its
permit. Provide in your explanation' the dates) of the non-compliance and describe the correctiveaction(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 r knowing violations."
upps
Ignat a ermittee)* Date (Name of Signing Official -Please print or type)
Aqua North Carolina Waste Water Supervisor
(Permittee -Please print or type) (Position or Title) s
202 MacKenan Ct (Phone Number)
Cary NC. 27511
(Permittee Address)
• If signed by otherthan the permittee, delegation of signatory authority must be on file with the state per 15A NCAC 2B.0500 (b)(2)(D).
Il

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDITIONAL PAGES AS NEEDED.
PERMIT NUMBER: WQ6022870 - - MONTH: October .YEAR: 2016
FACILITY NAME: Buck Mountain Development COUNTY: Chatham
Formulas:
Daily Loading (inches) = Volume Applied (gallons) x 0.1338 (cubic feet/gallm) x 12 (inchesrfoot)] /[Arm Sprayed (acres) x 43,560 (square feet/aore)] OR
=Volume Applied (gallons) /[Area Sprayed (acres) x 27,152 (gallons/acr>inch)]
Maximum Hourly Loading (inches) =Daly Loading(inches)/[nmelydgated(minutes)/60(minuUmfhwr)] lthly Loading (inches)
12 Month Floating Tota[ (inches) Apol-
Spray Irrigation Operator in Responsible Charge (ORC): Brian Peters Phone: [phone]
ORC Certification Number: 987582 Check Box if ORC Has Changed:
Mail ORIGINAL and TWO COPIES to:
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
Average Weekly Loading (inches) =)Monthly Loading (inches/month)/ Number of days
in Bre menton(days/mcnth)] x 7(daysty k)
DidIrrigation 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: -
...-
,..
..
.:....
FIELDNUMBER:' F-18
AREA SPRAYED (acres)d 17.8
COVER CROP: tUrfr lass
PERMITTED HOURLY RATE inches : 0.1
-
FIELD NUMBER: DR
A SPRAYED (acres): 14.9.,
COVER CROP:. turf raSs
ITTED HOURLY RATE(inches): 0.1.
DWEATHER
T
CONDITIONS
wCeoadthae' r . Tamupaaex-` sewage
Pe4plta Lago
non F ­+ d
PERMITTED YEARLY RATE (inches): 20.47
Maximum
Volume Time Daily Hourly
Applied Irri ated Loadino Loading
ITTED YEARLY RATE (inches); 20.47
Maximum
Volume Time Daily Hourly..AE
Applied Irrigated Loading Loading
(°F) inches feet
-gallons - 'minutes
inches inches
-gallons minutes
.:Inches inches '
2
q.
5
6
7
8
9
10
11
NO
IRRIGATION APPLIED
12
13
14
15
16
AT
THIS
TIME
17
18
19
20
ALL
FIELDS
21
22
23
24
25
26
27
28
29
30
31
Total Gallons/Monthly Loading (Inches
_............
0
_.............
0.00
...............
0 ::<:<:3':::::
.......-
0.00 .::::::::::
12 Month FloatingTotal inches
: >:a : ...... ::a::Z:::::::
.:.:: . .::...
4.42 :.,: ; .:.
...
2.52
Average Weekly Loading (inches
;;:00
.
0.00
• Weather Codes: C -clear, PC -partly cloudy, C[ -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 Has Changed:
Mail ORIGINAL and TWO COPIES to:
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 insetting Y(es) or N(o) in the appropriate box) whether; the facility has beencomaliant
with the following permit requirements: (Note. if a requirement does not apply to your facility put( NA) in the
compliant box. )
Co�m liant (�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). YO
3. A suitable vegetative cover was maintained on the site(s) in accordance with the
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 limi
specified in the permit.
If the facility is non-comolianl-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." / 4
Signatof Pe ' ee)' Date (Name of Signing Official -Please print or type
Aqua North Carolina Waste Water Supervisor
(Permittee -Please print or type) (Position or Title)
202 MacKenan Ct
919-467-8712
(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)(1)).