WQ0014785_Monitoring 2016_20161215

NON DISCHARGE WASTEWATER MONITORING REPORT Page . of
PERMIT NUMBER: W00014785
FACILITY NAME: Midway Middle School
MONTH: Ali V YEAR: ?pu,
COUNTY: Sampson
-.
■
..--
5141=1110M mzm -.
■
■
Daily
..-.. (Flow) into
„Treatment:..
System
coliform
. .
Daily Maximum
Daily Minimum
Composite (C) Grab (G)
Operator in Responsible Charge (ORC):
Check Box if ORC Has Changed: ❑
Certified Laboratories (1):
Person(s) Collecting Samples:
Mail ORIGINAL and TWO COPIES to:
DENR
Division of Water Quality
ATTN: Information Processing Unit
1617 Mail Service Center
RALEIGH, NC 27699-1617
Robert Carroll Grade: S Phone: [phone]
ORC Certification Number:
EHC
Rober Carroll
(2):
(SIGNATURE OF OPERATOR IN RESPONSIBLE CHARGE)
BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS ACCURATE
AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
nanin cnn.e ,.in•.n � ie+,nnnc%

Page of
NON DISCHARGE WASTEWATER MONITORING REPORT
Facility Status:
Please answer the following question:
Compliant (Y,N)
1. Does all monitoring data and sampling frequencies meet permit requirements?
If the facility is non-compliant, please explain in the space below the reason(s) the facility was not in compliance
with its permit. Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s)
taken. Attach additional sheets if necessary.
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that all qualified personnel properly gathered and
evaluated the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my
knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting
false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee)* Date
(Permittee -Please print or type)
PO Box 439
Clinton, NC 28329
(Permittee Address)
Parameter Codes:
(Name of Signing Official -Please,'print or type)
(Position or Title)
[phone]
(Phone Number)
.(Permit Exp. Date)
01002 Arsenic
31504 Coliform, Total
00600 Nitrogen, Total
00929 Sodium
01022 Baron
00094 Conductivity
00630 N028NO3
00931 SAR
00310 BODS
01042 Copper
00620 NO3
00745 Sulfide
01027 Cadmium
00300 Dissolved Oxygen
00556 Oil -Grease
70295 TDS
00916 Calcium
31616 Fecal Coliform
WQ09 PAN (Plant Available)
00010 Temperature .
00940 Chloride
01051 Lead
00400 pH
00625 TKN
50060 Chlorine, Total
Residual
00927 Magnesium
71900 Mercury
32730 Phenols
00665 Phosphorus, Total
00680 TOC
00530 TSS/TSR
01034 Chromium
00610 NH3asN
00937 Potassium
00076 Turbidity
00340 COD
01067 Nickel
00545 Settleable Matter _
01092 Zinc
Parameter Code assistance may be obtained by calling the Water Quality Land Application Unit at [phone].
The monthly average for Fecal Coliform is to be reported as a GEOMETRIC mean. Use only the units designated in the reporting
facility's permit for reporting.data.
` If signed by other than the permittee, delegation of signatory authority must be on file with the state per 15A NCAC 28.0506 (b)(2)(D).
DENR FORM NDMR-1 (11/2005)

NON -DISCHARGE APPLICATION REPORT Page of
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDITIONAL PAGES AS NEEDED.
PERMIT NUMBER: W00014785
MONTH: Mod YEAR:m%1,
FACILITY NAME: Midway Middle School COUNTY: _ Sampson
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)] OR
= Volume Acplied (gallons)! [Area Sprayed (acres) x 27,152 (gallcns/acre-inch)]
Monthly Hourly Loading (inches) = maximum inches applied over a one hour period for that day
Monthly Loading (inches) = Sum of Daly Loadings (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 (inches/manth) / Number of days in the month (days/month)] x 7 (daysAveek)
Did Irrigation Occur At This Facility:
Yes: ❑ No: ❑
Did Irrigation Occur On This Field: Did Irrigation Occur On This Field:
Yes: ❑ No: ❑ Yes: ❑ No: ❑
......................................
FIELD NUMBER: 1 FIELD NUMBER:
AREA SPRAYED (acres): 3.47 AREA SPRAYED (acres):
COVER CROP: R e COVER CROP:
PERMITTED HOURLY RATE (inches): 0.16 PERMITTED HOURLY RATE (inches):
WEATHER CONDITIONS
PERMITTED YEARLY RATE (inches): 39 PERMITTED YEARLY RATE (inches):
D
A
T
E
Storage
Temper- Lagoon
Weather
afore at Precipita- Free-
code' application tion board
Volume Time
Applied Irrigated
Maximum
Dail Hourly Volume Time Dail
Y Y Y
Loading Loading Applied Irrigated 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
p
11
12
13
14
. Q
15
16
17
18
=
19
20
21
L'� a
22
7 t �'
23
•1' t C3�®_
24
25
26
27
119
28
ID
29
30
31
Total Gallons/Monthly Loading (inches)
[ ® 0 0.00
12 Month Floating Total (inches)
;:;:;:;::::::::::::::::::::::::::::::::::::;:; ;:;:
Average Weekly Loading (inches),:::::"""'*""-'-'-""'-
0
Weather Codes: C -clear, PC -partly cloudy, CI -cloudy, R -rain, Sn-snow, SI -sleet
Spray Irrigation Operator in Responsible Charge (ORC):
ORC Certification Number:
Mail ORIGINAL and TWO COPIES to:
DENR
Division of Water Quality
ATTN: Information Processing Unit
1617 Mail Service Center
RALEIGH, NC 27699-1617
Robert Carroll
26341 Check Box if ORC Has Changed:
0
Phone: [phone]
izjm� ar,4�L�
(SIGNATURE OF OPERATOR IN RESPONSIBLE CHARGE)
BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS ACCURATE AND
COMPLETE TO THE BEST OF MY KNOWLEDGE.
DENR FORM NDAR-1 (11/2005)

NON -DISCHARGE APPLICATION REPORT Page of
SPRAY IRRIGATION SITE(S)
Facility Status:
Please indicate ( by inserting Y(es) or N(o) in the appropriate box ) whether the facility has been compliant
with the following permit requirements: (Note: if a requirement does not apply to your facility put (NA) in the
compliant box. - )
Compliant (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).
3. A suitable vegetative cover was maintained on the site(s) in accordance with the permit. t�J
4. All buffer zones as specified in the permit were maintained during each application.
5. The freeboard in the treatment and/or storage lagoon(s) was not less than the limit(s) 4
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."
(Signature of Permittee)* Date
(Permittee -Please print or type)
PO Box 439
Clinton, NC 28329
(Permittee Address)
(Name of Signing Official -Please print or type)
(Position or Title)
[phone].�/4
(Phone Number) (Permit Exp. Date)
If signed by other than the permittee, delegation of signatory authority must be on file with the state per 15A NCAC 213.0506 (b)(2)(D).
DENR FORM NDAR-1 (1112005)

MI V f1®BAtea►O
Fayetteville Division
Certificate of Analysis
Sampson Co. Schools
Date Reported: 11/21/16
Mr. Robert Carroll Project: Sed. Pond Sample - Midway Middle, Qtrly
Date Received: 11/14/16
Post Office Box 439
Date Sampled- 11/14/16
Clinton NC, 28328
Sampled By: Carroll
Lagoon, Grab
K6K0596-01
Analyte Result Units Analyzed Analyzed By Method Qualifier
Field Data
pH
7.6
pH Units
11/14/16 10:45
Carroll
pH
Temperature
14.2.
°C
11/14/16 10:45
Carroll
Field
Analyzed by: Microbac Laboratories, Inc. - Fayetteville
Ammonia as N
8.67
mg/L
11/14/16 12:30
DSK.
SM 4500 NH3 C-1997
BOD
15.8
mg/L,
11/14/16 15:00
ELM
SM 5210 B-2011
Coliform, Fecal
2400
per 100 mL
11/14/16 15:09
JR
SM 9222 D-1997
Nitrate as N
<0.0500
mg/L
11/15/16 09:42
AC
EPA 300.0, Rev. 2.1 (1993)
pH
7.7
pH Units
11/15/16 17:10
ELM
SM 4500 H+B-2000
H
(Aqueous)
Total Suspended Solids
45.0
mg/L
11/15/16 11:06
JR
SM 2540 D-1997
Total Kjeldahl Nitrogen
12.2
mg/L
11/15%16 08:23
AC
SM 4500-Norg C-1997
QC Batch Run - (Microbac Laboratories, Lic. - Fayetteville)
Analyte
Result
Units
Source
RPD
Limit
Ammonia as N
ND
mg/L
K6K0371
20
Ammonia as N
ND
mg/L
K6K0389
20
Ammonia as N
ND
mg/L
K6K0447
20
Ammonia as N
NO
mg/L
K6K0470
20
pH
4.8
pH Units
K6K0660
0
200
130D
1110
mg/L'
K6K0574
0.2
20 .
Total Suspended Solids
2.00
mg/L
K6K0589
0
5
Total Suspended Solids
52.0
mg/L
K6K0634
14
5
Total Suspended Solids
79.0
ing/L
K6K0640
7
5
Total Kjeldahl Nitrogen
7.77
mg/L
K6K0453
4
20
pH
4.3
pH Units
K6K0660
0
200
pH
5.3
pH Units
K6K0660
0
200
Nitrate as N
7.62
mg/L
K6K0604
0.5
200
'Microbac Laboratories; Inc. 77-1
Page 1 of 3
2592 Hope Mills Road I Fayetteville, NC 28306 1910.864.1920 p 1910.864.8774 f I www.microbac.com

., NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDITIONAL PAGES AS NEEDED.
PERMIT NUMBER: WQ0014785
Page of
MONTH: Oe.�` YEAR: WI
FACILITY NAME: Midway Middle School COUNTY: Sampson
Formulas:
Daily Loading (inches) = [Volume.4pplied (gallons) x 0.1336 (cubic feet/gallon) x 12 (inches/foot)] /[Area Sprayed (acres) x 43,560 (square feet/acre)) OR
< = Volume Acplied (gallons) I [Area Sprayed (acres) x 27,152 (gallons/acre-inch)]
Monthly Hourly Loading (inches) = maximum inches applied over a one hour period for that day
Monthly Loading (inches) = Sum of Daily Loadings (inches)
12 Month Floating Total (inches) = Sum of this month's Monthly Loading (inches) and previous 11 month's Monthly Loadings Cinches)
Average Weekly Loading (inches) = (Monthly Loading Cinchestmonth) / Number of days in the month (davVmonth)] x 7 (daysAveek)
Did Irrigation Occur At This. Facility:
Yes: E)No: 2
Did Irrigation Occur On This Field:
Yes: ❑ No:
Did Irrigation Occur On This Field:
Yes: ❑ No: El
......................................
FIELD NUMBER: 1
AREA SPRAYED (acres): 3.47
COVER CROP: R e
PERMITTED HOURLY RATE (inches): 0.16
FIELD NUMBER:
AREA SPRAYED (acres):
COVER CROP:
PERMITTED HOURLY RATE (inches):
WEATHER CONDITIONS
PERMITTED YEARLY RATE (inches): 39
PERMITTED YEARLY RATE (inches):
D
A
T
E
Storage
Weather Temper- Lagoon
, ature at Precipita- Free-
Code application tion board
Volume Time Daily
Applied Irrigated Loading_Loading
Maximum
Hourly
Volume Time Daily
Applied Irrigated 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
III
ID
,
12
13
14
15
16
17
18
_......_.._.,
19
20
i
21
22
23
,
24
25
�O
26
p
27
6�
28
i
29
Q
30
31
Total Gallons/Monthly Loading (inches)
0 0.00
12 Month Floating Total (inches) ;
; :::::::::; : ; ; ; :: ; ::: ; ; ::;:;:; ;
j
Average Weekly Loading (inches) :::::::::::::::::::::::::::::::::::::::::::::::::::
.........
Q
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:
DENR
Division of Water Quality
ATTN: Information Processing Unit
1617 Mail Service Center
RALEIGH, NC 27699-1617
Robert Carroll
26341 Check Box if ORC Has Changed: ❑
Phone: [phone]
(SIGNATURE OF OPERATOR IN RESPONSIBLE CHARGE)
BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS ACCURATE AND
COMPLETE TO THE BEST OF MY KNOWLEDGE.
DENR FORM NDAR-1 (11/2005)

NON -DISCHARGE APPLICATION REPORT Page of r
SPRAY IRRIGATION SITE(S)
f
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.
2. Adequate measures were taken to prevent wastewater runoff from the site(s).
3. A suitable vegetative cover was maintained on the site(s) in accordance with the permit.
4. All buffer zones as specified in the permit were maintained during each application.
5. The freeboard in the treatment and/or storage lagoons) was not less than the limit(s)
specified in the permit.
If the facility is non-compliant, please explain in the space below the reason(s) the facility was not in compliance with its
permit. Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s) taken. Attach
additional sheets if necessary.
"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." ; .
111-rl- 1114;%A01olej
(Sig ,pture.of Permittee)* Date (Name of Signing Official -Please print or type)
(Permittee -Please Prirft or type) (Position or Title) .'
[phone]
PO Box 439 (Phone Number) (Permit Exp. Date) _
Clinton, NC '28329
(Permittee Address)
If signed by other than the permittee, delegation of signatory authority must be on rile with the state per 15A NCAC 213.0506 (b)(2)(D).
DENR FORM NDAR-1 (1112005)

PERMIT NUMBER:
NON DISCHARGE WASTEWATER MONITORING REPORT
W 00014785
FACILITY NAME: Midway Middle School
Page of
MONTH: QC7- YEAR: ZQ/G
COUNTY: Sampson
-.
. -.
■
..
. ..
■
Arrival Daily
Time..... .-(Flow) int
00 Treatment-
Clock
BOD -5
coliroan
nMnM&V-
• . -
Daily Maximum
Daily Minimum
Composite (C) Grab (G
Operator in Responsible Charge (ORC): Robert Carroll Grade: S Phone: [phone]
Check Box if ORC Has Changed: ❑ ORC Certification Number:
Certified Laboratories (1):
Person(s) Collecting Samples:
Mail ORIGINAL and TWO COPIES to:
DENR
Division of Water Quality
ATTN: Information Processing Unit
1617 Mail Service Center
RALEIGH, NC 27699-1617
EHC
Rober Carroll
(2):
(SIGNATURE OF OPERATOR IN RESPONSIBLE CHARGE)
BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS ACCURATE
AND COMPLETE TO THE BEST OF MY KNOWLEDGE.

NON DISCHARGE WASTEWATER MONITORING REPORT
Facility Status:
Page of .
Please answer the following question:
Compliant (Y,N)
1. Does all monitoring data and sampling frequencies meet permit requirements? T
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."
JAWzaWt,&j"WA A_V__A__1A 7 X 0 0 0 Wi. K _5
(Sig ature of Permittee) Date (Name of Signing Official -Please pint or type)
(Permittee -Please print or type) (Position or Title)
PO Box 439
Clinton, NC 28329
(Permittee Address)
Parameter Codes:
[phone]
(Phone Number) (Permit Exp. Date)
01002 Arsenic
31504 Coliform, Total
00600 Nitrogen, Total
00929 Sodium
01022 Boron
00094 Conductivity
00630 NO2&NO3
00931 SAR
00310 B0D5
01042 Copper
00620 NO3
00745 Sulfide
01027 Cadmium
00300 Dissolved Oxygen
00556 Oil -Grease
70295 TDS
00916 Calcium
31616 Fecal Coliform
WQ09 PAN (Plant Available)
00010 Temperature
00940 Chloride
01051 Lead
00400 pH
00625 TKN
50060 Chlorine, Total
Residual
00927 Magnesium
71900 Mercury
32730 Phenols
00665 Phosphorus, Total
00660 TOC
00530 TSS/TSR
01034 Chromium
00610 NH3asN
00937 Potassium
00076 Turbidity
00340 COD
01067 Nickel
00545 Settleable Matter
01092 Zinc
Parameter Code assistance may be obtained by calling the Water Quality Land Application Unit at [phone].
The monthly average for Fecal Coliform is to be reported as a GEOMETRIC mean. Use only the units designated in the reporting
facility's permit for reporting data.
` If signed by other than the permittee, delegation of signatory authority must be on file with the state per 15A NCAC 28.0506 (b)(2)(D).
DENR FORM NDMR-1 (11/2005)

NON -DISCHARGE APPLICATION REPORT Page of
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDITIONAL PAGES AS NEEDED.
a
PERMITNUMBER: W00014785 MONTH: Sep YEAR: we/G
FACILITY NAME: Midway Middle School COUNTY: _ Sampson
Formulas:
Daily Loading (inches) = [Volume Applied (gallons) x 0.1336 (cubic feeligallon) x 12 (inches/foot)) /[Area Sprayed (acres) x 43,560 (square feet/acre)] OR
= Volume Applied (gallons), [Area Sprayed (acres) x 27,152 (galicnslacre-inch)]
Monthly Hourly Loading (inches) = maximum inches applied over one hour period for that day
Monthly Loading (inches) = Sum of Daily Loadings (inches)
12 Month Floating Total (inches) = Sum of this month's Monthly Loading (inches) and previous 11 month's Monthly Loadings (inches)
Average Weekly Loading (inches) = [Monthly Loading (inches/month) / Number of days in the month (days/month)] x 7 (days/week)
Did Irrigation Occur At This Facility: _/
Yes: EJNo: (�
Did Irrigation Occur On This Field: Did Irrigation Occur On This Field:
Yes: ❑ No: 0, Yes: ❑ No: ❑
......................................
FIELD NUMBER: 1
AREA SPRAYED (acres): 3.47
COVER CROP: R e
PERMITTED HOURLY RATE (inches): 0.16
FIELD NUMBER:
AREA SPRAYED (acres):
COVER CROP:
PERMITTED HOURLY RATE (inches):
WEATHER CONDITIONS
PERMITTED YEARLY RATE (inches): 39
PERMITTED YEARLY RATE (inches):
D Storage
A Temper- Lagoon
T weather atureat Precipita- Free-
E code' application tion board
Maximum
Volume Time Daily Hourly
Applied Irrigated Loading Loading
Volume Time Daily
Applied Irrigated Loading
Maximum
Hourly
Loading
PF) inches feet
gallons minutes inches inches
gallons minutes inches
inches
1
Q
2 &S,
a
3
Q
4
5
6
7
8
d
9
10
Q
11
Q.
12
13
G Q
14
15
16
17
18
�..- _,......_......
_ ..-. . __ .
t
19
6
20
21�,,
22�
23
24
25
V
26
27
28 to
29 V
30 to
31
Tota[ Gallons/Monthly Loading (inches)
p
0 0.00
12 Month Floating Total (inches)
Average Weekly Loading (inches)
::::::::::::::::::::::::::::::::::::::::::::::::::
0
Weather Codes: C -clear, PC -partly cloudy, CI -cloudy, R -rain, Sn-snow, SI -sleet
Spray Irrigation Operator in Responsible Charge (ORC): Robert Carroll Phone: [phone]
ORC Certification Number:
Mail ORIGINAL and TWO COPIES to:
DENR
Division of Water Quality
ATTN: Information Processing Unit
1617 Mail Service Center
RALEIGH, NC 27699-1617
26341 Check Box if ORC Has Changed: ❑
(SIGNATURE OF OPERATOR IN RESPONSIBLE CHARGE)
BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS ACCURATE AND
COMPLETE TO THE BEST OF MY KNOWLEDGE.
DENR FORM NDAR-1 (11/2005)

NON -DISCHARGE APPLICATION REPORT Page
SPRAY IRRIGATION SITE(S)
Facility Status:
-Please indicate ( by inserting Y(es).pr 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.
2. Adequate measures were taken to prevent wastewater runoff from the site(s).
3. A suitable vegetative cover was maintained on the site(s) in accordance with the permit.
4. All buffer zones as specified in the permit were maintained during each application.
5. The freeboard in the treatment and/or storage lagoon(s) was not less than the limit(s)
specified in the permit.
If the facility is non-compliant, please explain in the space below the reason(s) the facility was not in compliance with its
permit. Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s) taken. Attach
additional sheets if necessary.
do -
"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.c irectly 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."
/00V
(Signature of Permittee)* Date
I.AZ �1ii� is
(Permittee -Please print or type)
PO Box 439
Clinton, NC 28329
(Permittee Address)
(Name of Signing Official -Please print or type)
(Position or Title)
[phone].
(Phone Number) (Permit Exp. Date)
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).
DENR FORM NDAR-1 (11/2005)

NON DISCHARGE WASTBIVATER MONITORING REPORT Page of
PERMIT NUMBER: WQ0014785 MONTH: ! A YEAR: 7_b1 �c
FACILITY NAME: Midway Middle School COUNTY: Sampson
Operator in Responsible Charge (ORC)
Check Box if ORC Has Changed
Certified Laboratories (1):
Persons) Collecting Samples:
Mail ORIGINAL and TWO COPIES to:
DENR
Division of Water Quality
ATTN: Information Processing Unit
1617 Mail Service Center
RALEIGH, NC 27699-1617
I
Robert Carroll Grade: S Phone: [phone]
ORC Certification Number: 2 Z'
EHC
Rober Carroll
(2):
(SIGNATURE OF OPERATOR IN RESPONSIBLE CHARGE)
BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS ACCURATE
AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
nakin c-nh. --n � f44 rn Vlc%
--------------
-.
■
..
..- .. •- .
Treatment
System
Residual
BOD -5
20'C NH3-N
TSS
�.
-
• •
Operator in Responsible Charge (ORC)
Check Box if ORC Has Changed
Certified Laboratories (1):
Persons) Collecting Samples:
Mail ORIGINAL and TWO COPIES to:
DENR
Division of Water Quality
ATTN: Information Processing Unit
1617 Mail Service Center
RALEIGH, NC 27699-1617
I
Robert Carroll Grade: S Phone: [phone]
ORC Certification Number: 2 Z'
EHC
Rober Carroll
(2):
(SIGNATURE OF OPERATOR IN RESPONSIBLE CHARGE)
BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS ACCURATE
AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
nakin c-nh. --n � f44 rn Vlc%

NON DISCHARGE WASTEWATER MONITORING REPORT
FaciiitV Status:
Page 'of
Please answer the following question:
Compliant (Y,N)
1. Does all monitoring data and sampling frequencies meet permit requirements? SIJ
If the facility is non-compliant, please 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 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."
�0
Aao;� ;
,',. I or -
(Signature of Permittee)* Date
(Permittee -Please print or type)
PO Box 439
. Clinton, NC 28329
(Permittee Address)
Parama4ar Cnrlas'
(Name of Signing Official -Please print or type)
(Position or Title)
[phone]
(Phone Number) (Permit Exp. Date)
01002 Arsenic
31504 Coliform, Total
00600 Nitrogen, Total
00929 Sodium
01022 Boron
00094 Conductivity
00630 NO2&NO3
00931 SAR -
00310 BODS
01042 Copper
00620 NO3
00745 Sulfide
01027 Cadmium
00300 Dissolved Oxygen
00556 Oil -Grease
70295 TDS
00916 Calcium
31616 Fecal Coliform
WQ09 PAN (Plant Available)
00010 Temperature
00940 Chloride
01051 Lead
00400 pH
00625 TKN
50060 Chlorine, Total
Residual
00927 Magnesium
71900 Mercury
32730 Phenols
00665 Phosphorus, Total
00680 TOC
00530 TSS/TSR
01034 Chromium
00610 NH3asN
00937 Potassium
00076 Turbidity
00340 COD
01067 Nickel
00545 Settleable Matter
01092 Zinc
Parameter Code assistance may be obtained by calling the Water Quality Land Application Unit at [phone].
The monthly average for Fecal Coliform is to be reported as a GEOMETRIC mean. Use only the units designated in the reporting
facility's permit for reporting data.
If signed by other than the permittee, delegation of signatory authority must be on file with the state per 15A NCAC 213.0506 (b)(2)(D).
DENR FORM NDMR-1 (11/2005)

0
NON -DISCHARGE APPLICATION REPORT Page of
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDITIONAL PAGES AS NEEDED.
PERMITNUMBER: WQ0014785 MONTH: Ali-- YEAR: Zbl L
FACILITY NAME: Midway Middle School COUNTY: Sampson
Formulas:
Daily Loading (inches) = [Volume Applied (gallons) x 0.1336 (cubic feeugallon) x 12 (inches/foot)] /[Area Sprayed (acres) x 43,560 (square feelfacre)] OR
= Volume Acplied (gallons): [Area Sprayed (acres) x 27,152 (gallons/acre-inch)]
Monthly Hourly Loading (inches) = maximum inches applied over one hour period for that day
Monthly Loading (inches) = Sum of Daily Loadings (inches)
12 Month Floating Total (inches) = Sum of this month's Monthly Loading (inches) and previous 11 month's Monthly Loadings Cinches)
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: ElNo:
Did Irrigation Occur On This Field:
Yes: ElNo: 2
Did Irrigation Occur On This Field:
Yes: ❑ No: El
......................................
FIELD NUMBER: 1
AREA SPRAYED acres : 3.47
COVER CROP: R e
PERMITTED HOURLY RATE (inches): 0.16
FIELD NUMBER:
AREA SPRAYED (acres):
COVER CROP:
PERMITTED HOURLY RATE (inches):
WEATHER CONDITIONS
PERMITTED YEARLY RATE (inches): 39
PERMITTED YEARLY RATE (inches):
D
A
T
E
Storage
Temper- lagoon
weather atureat Precipita- Free-
Code' application don board
Maximum
Volume Time Daily Hourly
Applied Irrigated Loading Loadin
Volume Time Daily
Applied Irrigated 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
11
W,
12
13
14
15
C
16
17
18
19
20
21
22
fl
23
24
a
25
26
27
28
29
30
31
b
Total Gallons/Monthly Loading (inches)
0 0.00
12 Month Floating Total (inches)
::'
Average Weekly Loading (inches)
::::.::::::::::::::::::::%::::::::::.:::::::::::::::
0
Weather Codes: C -clear, PC -partly cloudy, CI -cloudy, R -rain, Sn-snow, SI -sleet
Spray Irrigation Operator in Responsible Charge (ORC): Robert Carroll Phone: [phone]
ORC Certification Number:
Mail ORIGINAL and TWO COPIES to:
DENR
Division of Water Quality
ATTN: Information Processing Unit
1617 Mail Service Center
RALEIGH, NC 27699-1617
26341 Check Box if ORC Has Changed: ❑
(SIGNATURE OF OPERATOR IN RESPONSIBLE CHARGE)
BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS ACCURATE AND
COMPLETE TO THE BEST OF MY KNOWLEDGE.
DENR FORM NDAR-1 (11/2005)

NON -DISCHARGE APPLICATION REPORT Page ' of `
SPRAY IRRIGATION SITE(S)
Facility Status:
Please indicate ( by inserting Y(es) or N(o) in the appropriate box ) whether the facility has been compliant
with the following permit requirements: (Note: if a requirement does not apply to your facility put (NA) in the
compliant box. )
Comliant 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).
3. A suitable vegetative cover was maintained on the site(s) in accordance with the permit.
4. All buffer zones as specified in the permit were maintained during each application.
5. The freeboard in the treatment and/or storage lagoon(s) was not less than the limit(s) 4
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:"
(Signature of Permittee)* Date
(Permittee -Please print or type)
PO Box 439
Clinton, NC 28329
(Permittee Address)
(Name of Signing Official -Please print or type)
(Position or Title)
[phone]' /,2-31 • ) L.
(Phone Number) (Permit Exp. Date)
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)).
DENR FORM NDAR-1 (11/2005)

*MICROBAC@
Fayetteville Division
Certificate of Analysis
Sampson Co. Schools Date Reported: 09/01/16
Mr. Robert Carroll Project: Sed. Pond Sample - Midway Middle, Qtrly Date Received: 08/18/16
Post Office Box 439 Date Sampled: 08/18/16
Clinton NC, 28328 Sampled By: Carroll
Lagoon, Grab
K6H0699-01
Analyte Result Units Analyzed Analyzed By Method Qualifier
Field Data
PH 7.6 pH Units 08/18/16 10:05 Carroll pH
Temperature 28.9 °C 08/18/16 10:05 Carroll Field
Analyzed by: Microbac Laboratories, Inc. - Fayetteville
Ammonia as N
15.1
mg/L
08/19/16 09:15
DSK
SM 4500 NH3 C-1997
BOD
9.09
mg/L
08/19/16 15:45
ELM
SM 5210 B-2011
Coliform, Fecal
20
per 100 mL
08/18/16 16:25
CCR
SM 9222 D-1997
Nitrate as N
0.226
mg/L
08/29/16 11:56
JAW
EPA 300.0, Rev. 2.1 (1993)
PH
7.5
pH Units
08/23/16 14:20
ELM
SM 4500 H+B-2000 H
(Aqueous)
Total Suspended Solids
54.0
mg/L
08/24/16 17:25
CCR
SM 2540 D-1997
Total Kjeldahl Nitrogen
22.5
Ing/L
08/23/16 08:30
SW
SM 4500-Norg C-1997
QC Batch Run - (MicrobacLaboratories, Inc. -Fayetteville)
Analyte
Result
Units
Source
RPD Limit
Total Kjeldahl Nitrogen
3.55
mg/L
K6H0771
29 20
Ammonia as N
ND
mg/L
K6H0728
20
Nitrate as N
2.42
mg/L
K6H0698
8 200
BOD
9.90
mg/L
K6110699
9 20
Total Suspended Solids
ND
mg/L
K6H0851
5
PH
6.8
pH Units
K6H0722
6 200
PH
3.6
pH Units
K6H0790
3 200
Total Suspended Solids
6.22
mg/L
K6H0727
4 5
Total Suspended Solids
11.0
mg/L
K6H0775
4 5
Notes and Definitions
H Analyte was prepared and/or analyzed outside of the analytical method holding time
Microbac Laboratories, Inc.
2592 Hope Mills Road I Fayetteville, PIC 28306 1910.864.1620 p 1910.864.8774 f I www.microbac.com

*K6H0699*
Fayetteville Division 2592 Hope Mills Road - Fayetteville, NC 28306 [phone] / 864
MIA IIV11�d111l�11�1�11�111181
� R 0 A IIIIIII��11 �I II
CHAIN OF.CUSTODY RECORDc`'�`
PAGE 1 OF 1
CLIENT
Sampson County Schools
Post Office Box 49
Clinton, NC 28329
PO#
PROJECT ILOCATION:
Midway Middle (Feb/May/Aug/Nov)
#OF
a
O
T
T
L
E
s
TYPE
OF ANALYSIS
PRESERVATION CODE
U
LLL
(
HO
d
m
z
Q
Z
y
Z
Date
Time
Received by* (Signature) Date
Time
3
CODE: A = <4°C ONLY
B = HNO3 (ph<2) + <4°C
C = H2SO4 (ph<2).+ <4°C
D = NaOH + <4°C
E = ZN Acetate + <4°C
F = Sodium Thio.
CONTACT PERSON:
Robert Carroll
PHONE:
910.592.5242
SAMPLER:
Carroll
DATE f METHOD OF SHIPMENT:
1 $�- 1 Client
LAB ID #
SAMPLE
TYPE
DATE,
TIME
COMP
crus
LAB pH
FIELD pH
TEMP °C
Time
6--1
Lagoon
7
X
1
F
3
A
A
1
C
Rellnquished by:
Date
Time
Recei ed byII}}(S_ignature) Date
Time
2 -1 1
01
Relinquished by:
Date
Time
Received by* (Signature) Date
Time
3
4
Relinquished by.
Date
Time
Received by: (Signature) Date
Time
5
6
Relinquished by.
Date
Time
Received by: (Signature) Date
Time
7
1 8
Comments or Special Hazards:
Field pH: 2, Z2_
q €REVIEWED
� :, 1 -- LL