WQ0014046_Monitoring - 12-2016_20170117

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page _2- of 2-
,1_ J .. Sampling Person(s) Certified Laboratories VCIWW A( 145
Name: 4jtiA 'T%%QA. / o /-% B �L C' �� f O
Name: M.2.Q y r.RC%t •.J-^iC
4N�ao_II1r�P!n_04;, l
Name: Name: 11?g B -s VA/ /_ /Jt/ ol'7-�
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? Q-Mpllant ❑ Noncompkant
If the facility is non-compliant, please explain in the space below the the facility was not in compliance. Provide In your explanation the date(s) of the non-compliance and describe the corrective
duroutsf hdnen. rvudut auwuunai sneers IT necessary.
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Operator in Responsible Charge (ORC) Certification
ORC: 1 Ci lei
I
Certification No.: 9 u50 4
9/5 169,
Grade: !j Phone Number:
9l9.69.3, KcwG c/yxrc�
Has the ORC changed since the previous NDMR? ❑ yes No
Signature Date
By this signature, 1084#10 that this report Is aCprmate and Complete to the best of my kooMedge.
Permittee Certification
Permittee: T 09,17 ct/ -5 roLhI L C"IZ 7--�'
Signing Official:J lc N.,2 ! C 04t_ 've
Signing Official's Title: IY9 A VO
SP�d tRd�-��:Ti•i.
Phone Number: 9/ c? - 693 jo.4 Permit Expiration: /-?_ j If -dN p
V SivIetdre Date
I Andy, under penally of law, that this document and all agaMments were prepared under my direction or supervision in
amoman with a system designed to assure that an Qualified personnel properly gathered and evaluated the lnfurmalion
submitted. eased on my Inquiry of the person or persons who manage the system, or those persons erectly responsible for
gathering the Information, the Information submitted is, to the best of my krwvAedge and belief, true, accurate, and complete. I am
aware that there are signncam penalties for submitting false information, including the possibility of three and Imprisonment for
knowing violations.
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mall Service Center
Raleigh, North Carolina 27699-1617

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FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) ✓ Page / of -4—
Permit No.dewD
Facility Nanur s FCi� ia1
r
County:
Monti):
Year:p?(j!`
pl
Did irrigation occur
Field Name:! _ �.
Field Name:
,Fie#1"Name:
-
Field Name:
at this facility?
Area (acres[, -
Area (acres):^
`Area (acres):
•�
Area (acres):
-.
Cover Capp CC
Cover Crop:
,r,Y.ver Crop
-
Cover Crop:
Q/Y[ED) No
Hourly Rate (in) I _
Hourly Rate (in):
•
nurirq<Rate (in)
�-
Hourly Rate (in):
Annuai'Ratc (m): _9'
Annual Rate (in):
a nualRRate (in)
-
Annual Rate (In):
'
Weather Freeboard
Fietd irrigated—, o`+�
Field Irrigated?
FES No
Fie dlrrigatedv
jukES [ rv0
Field Irrigated?
wE5
❑ NO
c
„._ai'
r°k
c.i_E'E�tt `
Eo mE
>�, Er c
w
aaQ
a
c
E
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c
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o =
=
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o a❑'m
�Jmm
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Jm
F-
3
°F in ft ft
galII min. 1 in in
gal min
in in
gaL min
in in
gal min
in
in
1r AjAlf o
2
6
7
Iwo7
-
8
9
10 /•
11
12 f
13 �1 F
4
1S
16 O
171
18 /•
T9
20 f
21 0 f
23
7
24
..
26
27
28
28
30 �i•0
-
31Yv
Monthly Loading:
Y.--�
DtC �y ,.
-
43
12 Month Floating Total (in):
'�
�,r * T•k°
}� -
,_
4+,? 1
,...

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IJr7AKUr Al't LINA I IVN KLIPUK I (NUAK-1) Page_Of
FoRMw {IDAiQ 1 d!I11 N
,VO JJ_'04ChQ1'¢ yPPLic¢ria V xxjuIII- CAJD4-f
Did the application rates exceed the limits in Attachment B of your permit? Lil•Ccllpllant ❑ Non -Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites? pliant ❑ Non-Gomphant
Was a -suitable vegetative cover maintained on all sites as specified in your permit? E yt pliant ❑ Noncamplant
Were all setbacks listed in your permit maintained for every application to each permitted site? �mpliant ❑ Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? [P'Compliant ❑ Non-Camplant
If the facility is non-compliant, please explain in the space below the reason(s) the facility was not in compliance. Provide in your explanation the date(s) of the non-compliance and describe the corrective
tenon. Mlarn aoprtional streets IT
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC:
yNfL /�L2� 1 v /�7
Permittee: Tu9 cl dYeST O �� a rrax� f, sk.eike sRe�T,C
Certification No.: 9iEl SQiQ
.�y
Signing Official: v A IuT
Grade: s T Phone Number: 9/ 9-6 93- A44W � ' O#'•(..4
.1 4/9-464- s344•0_e,QQ
Signing Official's Title: &M709
Has the ORC changed since the previous NDAR-1? ❑ yg U -m •
Phone Number:(/ Q- L 93 - HG r.} Permit Exp.: 4 •3 j . aio /
O/C
la"' 11N t -ii -V1
Signature Date
0 ignature Date
By this signature. I certify that this report Is accurate and complete to the best of my knowledge.
1 Wily. under penally of law, that the document and as attachments were prepared under my direction or supervision in accordance
with a system designed to assure that NI quarled personnel property gathered and evaluated the information submitted. Based on my
Inquiry of the person or persons who manage Ne system, or those persons dlmctty responsible for gathering the information, the
information submitted Is, to are best of my knowledge and belle( We, accurate, and complete. I am swan that there are sigrownl
penalties for submiling false Information. hlUding the p03slbN4 of fees and Imprisonment for knowing violations.
Mall Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

V.. Zvi..v I-. . U,I l
NUN-UWI.MAKUt AF't'L]t AI IUN Ktl'UKI (NUAK-9) / Page—j—ofA
PenlTtI Nd jPO
Facility
Name.. dR
County:
Month: Year:
Did irrigation occur,
a.. v'
Field Name:
s)'siltl'Nam�.
Field Name:
at this facility?
CY
Area (acres): . 5
�" 'e.�cQS)
Area (acres): 3.
^�@r
rop. Sr'..G(
_
Cover Crop---,'
„ � t`op
�64LD
Cover Crop:
VvES ❑ NO
e .Pu1(fi
ai,M�i ii)� s 'C f
Hourly Rate (in):
,gru1,kMQn'):
d S-
Hourly Rate (in): S
'
2 rgvaliRafer(mJ
r r
Annual Rate in :
( 1
al`fi tae In
3
Annual Rate (in):
Weather Freeboard
�� rirnga`t
ado
a EsFie
rrigated?l ❑ YES VNO
i I` Ir+r afed7
(–', re5. + 0
Field Irrigated? YEs�.rt6
O
wmG
s
t�k
ya rr�H^
-:c..Ar'•,
t *"g.ei
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o�n. m n
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> Q= J
h
r`#L�h
a.r
f ., 1
.1'�
.,.
°r in ft ft
` ,: a
,9`i ,
�`
a mins,
'�
.n Yip, --i
Iny-
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gal min in in
_.gal il. mm
iri:,=.,
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gal min in in
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2
3
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10
11
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19
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23
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✓ h.
26
27Vjt.
T9
1311 1
Monthly Loading
12 Month Floating Total (In):

FURM. NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page 14 of�
Did the application rates exceed the limits in Attachment B of your permit?
Were adequate measures taken to prevent effluent ponding in or runoff from the sites?
Was a -suitable vegetative cover maintained on all sites as specified in your permit?
Were all setbacks listed in your permit maintained for every application to each permitted site?
C?'1f.p1nmt [] Non-Compllant
anpllam ❑ Non-Compliant
-�npliant ❑ Non -Compliant
.12-1<pliant ❑ Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? pliant ❑ NorrComphant
If the facility is non-compliant, please explain in the space below the reason(s) the facility was not in compliance. Provide In your explanation the date(s) of the non-compliance and describe the corrective
action(s) taken. Attach additional sheets if necessary.
Operator in Responsible Charge (ORC) Certification
Certification Ne.: 99K506 _
qi4-/n43. riGAll ct�wc�
Grady 6.1- Phone Number: yf- c5-76fl C-CiCQ
Has the ORC changed since the previous NDAR-1? ❑ Yes Nd
/ /A I <
Signature Date
By INs sgnature, I cerlify, that this report Is accurrate and compete to the best of my knowledge.
Permittee Certification
Permittee.'?-) A+ e7-5 ioJn.A,L ukt.s?.e.[-tr'e s�
Signing Official: C-rCl A„1e f e - 4"ASCC /7'_
Signing Official's Title: A4-4-70&0
rQ
Phone Number: Q / Q • L 43 -ISG j44 Permit Exp.:15—
signature Date
I cerlity, under penally of law, that this doo anent and ell attachments were Prepared! under my direction or supervision In accordance
win a system designed to sensors that all quetified personnel property gathered and evaluated the Information sudmlted. Based of my
inquky of the person or parsons who manage the system, or those persons directly responsW for gathering the hformatlon, the
information submitted is, to the best of my knowledge and orale/, hue, aoouate, and complete. I am aware that there are sigrefiant
penalties for submilkg false information, IncWOing the possibility of lines and Imprisonment for kmwing'violamns.
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mall Service Center
Raleigh, North Carolina 27699-1617

Contact: Janet Parrot
Client: Town of Stovall
P.O. Box 100
Stovall, NC 27582
Meritech, Inc.
Environmental Laboratory
Laboratory Certification No. 165 � I
Report Date: 12/29/2016
Project: December
Samples
Date Sample Rcvd: 12/14/2016
Meritech Work Order # 12141670 Sample: Effluent Grab 12/14/16
Parameters
Result
Analysis Date
Reporting Limit
Method
/
BOD, 5 day
J 29.3 mg/L
12/15/16
2.0 mg/L
SM 5210 B
Total Suspended Solids
26 mg/L
12/15/16
2.5 mg/L
SM 2540 D
Total Dissolved Solids
✓316 mg/L
12/21/16
10.0 mg/L
SM 2540C
Ammonia, Nitrogen
✓0.7 mg/L
12/21/16
0.1 mg/L
EPA 350.1
Chloride
✓43.6 mg/L
12/20/16
0.1 mg/L
SM 4500 Cl B
TKN
✓ 7.24 mg/L
12/15/16
0.20 mg/L
EPA 351.1
Nitrite/Nitrate, Nitrogen
✓0.58 mg/L
)7.82
12/20/16
0.10 mg/L
EPA 353.2
Nitrogen, total
mg/L
12/22/16
0.20 mg/L
EPA 353.2
Phosphorus, total
✓0.944 mg/L
12/28/16
0.020 mg/L
EPA 200.7
Fecal Coliform
/ 2 col/100 ml
12/17/16
1 col/100 nil
SM 9222 D
I hereby certify that I have reviewed and approve these data. k,
Laboratory Representative
642 Tamco Road, Reidsville, North Carolina 27320
tel.[phone] fax.[phone]