WQ0002857_Monitoring - 12-2016_20170203

Page 1 of 3
NON -DISCHARGE WASTE WATER MONITORING REPORT
PERMIT NUMBER: W00002857 MONTH: December YEAR: 2016
FACILITY NAME: Piedmont Custom Meats WWTF COUNTY: Caswell
* Sample analyzed out of hold time due to laboratory error
Operator in Responsible Charge (ORC): Steven Yarbrough Grade: SI Phone: [phone]
Check Box if ORC Has Changed: F] ORC Certification Number: 986612
Certified Laboratories (1): R & A Laboratories, Inc. (2):
Person(s) Collecting Samples: Steven Yarbrough
Mail ORIGINAL and Two COPIES to:
ATTN: Non -Discharge Compliance Unit X
DENR IGNAT OPERATOR IN RESPONSIBLE CHARGE)
Division of Water Quality By this signature, I certify that this report is accurate an
1617 Mail Service Center complete to the best of my knowledge.
;
RALEIGH, NC 27699-1617 FER ® 3 q, I?
' r
' .�1i1 ^�
11"'!TRA4ATJ' 10N
DENR Form NDAR-1 (5/2003)

NON DISCHARGE WASTEWATER MONITORING REPORT
FACILITY STATUS:
Please answer the following question:
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.
ComTian ,N)
"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 a qualified personnel properly gather and evaluate 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
informanfor
bmitted is, to the best of my knowledge and belief true, accurate, and complete. I am aware that there are significant
penaltiebmitting falsfo�nation, including the possibility of fines and imprisonment for knowing violations."
of
(Permittee -Please print or type)
9683 Kerr's Chapel Road
Gibsonville. NC
(Permittee Address)
01002 Arsenic
01022 Boron
00310 BOD5
01027 Cadmium
00916 Calcium
00940 Chloride
50060 Chlorine, Total
Residual
01034 Chromium
00340 COD
PARAMETER CODES
31504
Coliform, Total
00094
Conductivity
01042
Copper
00300
Dissolved Oxygen
31616
Fecal Coliform
01051
Lead
00927
Magnesium
71900
Mercury
00610
NH3 as N
01067
Nickel
James M. Cheshire
(Name of Signing Official -Please print or type)
President R & A Laboratories
(Position or Title)
336-582-8247
(Phone Number)
00600. Nitrogen, Total
00630 NO2 & NO3
00620 NO3
00556 Oil & Grease
WQ09 PAN Plant Available
00400 pH
32730 Phenols
00665 Phosphorus, Total
00937 Potassium
00545 Settleable Matter
03/31/21
(Permit Exp. Date)
00929
Sodium
00931
SAR
00745
Sulfide
00515
- TDS
00010
Temperature
00625
TKN
00680
TOC
00530
TSS/TSR
00076
Turbidity
01092
Zinc
Parameter Code assistance may be obtained by calling the Water Quality Compliance/Enforcement Unit at [phone], extension 529.
The monthly average for Fecal Coliform is to be reported as a GEOMETRIC mean. Use only 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 2B.0506 (b) (2) (D).

Page 2 of 3
NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDIDTIONAL PAGES AS NEEDED
PERMIT NUMBER: W00002857 MONTH: December YEAR: 2016
FACILITY NAME: Piedmont Custom Meats WWTF COUNTY: Caswell
Formulas:
Dally Loading (inches) _ [Volume Applied (gallons) x 0.1336 (cubic feettgallon) x 12 (inches/foot)] / [Area Sprayed (acres) x 43,560 (square feet/acre) or
= [Volume Applied (gallons) / [Area Sprayed (acres) x 27,152 (gallons/acre-inch).
Maximum Hourly Loading (inches) = Daily Loading (inches) / [Time irrigated (minutes) / 60 (minutes/hour)] Monthly Loading (inches) =Sum of Daily Loading (inches)
12 Month Floating Total (inches) = Sum of this month's Monthly Loading (inches) and previous 11 month's Monthly Loadings (inches)
Average Weekly Loading (inches) = [Monthly Loading (inches/month) / Number of days in the month (days/month )] x 7 (days/week)
Did Irrigation Occur At This Facility:
Did Irrigation Occur On This Field:
Did Irrigation Occur On This Field:
am mm�
Yes: ❑
No: ❑
Yes: ❑ No: ❑
Yes: ❑
No: ❑
Field Number: 1
Field Number:
2
Area Sprayed (acres): 1
Area Sprayed (acres):
11
Cover Crop: Fescue
Cover Crop:
lFescue
®
I
Permitted Hourly Rate (inches):
10.2
Permitted Hourly Rate (inches):
0.2
WEATHER CONDITIONS
Permitted Yearly Rate (Inches):
52
Permitted Yearly
Rate (inches):
52
D
I:II
II I •I I I: I;IIMENII
I'Imlmmm
I:�
A
Weather
Temperature
Storage
Maximum
Maximum
T
Code"
at Precipiia-
Lagoon
Volume Time Daily
Hourly
Volume Time
Daily
Hourly
E
applicadmi lion
Fr—Imard
Applied Irrigated Loading
Loading
Applied Irrigated
Loading
Loading
(°F) Inches
feet
gallons minutes inches
inches
gallons minutes
inches
inches
C .. o:.
_ _40 .. � w. 0
' .: u2.4 -
'; 8640- = ' ` ` 240 `:.."� : ^ ° 0.32- .. ,,
- ' 0:08'x' °
., �r, 8640 - . _t .';. - '240 "
.. :. x •0:32 -
., - . , -:0.08 -
z
Total Gallons/Monthly Leading (inches)
12 Month Floating Total (inches)
Average Weekly Loading (inches)
. a §-- � •��..s"�c�.a.,r�i'
. ;.� .. .� � n�II.`ALs :.n�
b ° W . t ,. :41--i
"7
, °
TEMM"',
*Weather Codes: C -clear, PC -partly cloudy, CI -cloudy, R-raln, Sn-snow, SI -sleet
Spray Irrigation Operator in Responsible Charge (ORC): Steven Yarbrough Phone: [phone]
ORC Certification Number: 986612 Check Bo2xjf ORC Has Changed: ❑
Mail ORIGINAL and Two COPIES to:
ATTN: Non -Discharge Compliance Unit X
DENR (SIGNATU OPERATOR IN RESPONSIBLE CHARGE)
Division of Water Quality By this signature, I certify that this report is accurate and
1617 Mail Service Center complete to the best of my knowledge.
RALEIGH, NC 27699-1617
DENR Form NDAR-1 (5/2003)
am mm�
mmI I l is I;II II I I
I1:
0
®
I
: r• I
• I 1 1 1: � I
• I I I I
®
I
I:II
II I •I I I: I;IIMENII
I'Imlmmm
I:�
Total Gallons/Monthly Leading (inches)
12 Month Floating Total (inches)
Average Weekly Loading (inches)
. a §-- � •��..s"�c�.a.,r�i'
. ;.� .. .� � n�II.`ALs :.n�
b ° W . t ,. :41--i
"7
, °
TEMM"',
*Weather Codes: C -clear, PC -partly cloudy, CI -cloudy, R-raln, Sn-snow, SI -sleet
Spray Irrigation Operator in Responsible Charge (ORC): Steven Yarbrough Phone: [phone]
ORC Certification Number: 986612 Check Bo2xjf ORC Has Changed: ❑
Mail ORIGINAL and Two COPIES to:
ATTN: Non -Discharge Compliance Unit X
DENR (SIGNATU OPERATOR IN RESPONSIBLE CHARGE)
Division of Water Quality By this signature, I certify that this report is accurate and
1617 Mail Service Center complete to the best of my knowledge.
RALEIGH, NC 27699-1617
DENR Form NDAR-1 (5/2003)

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. �p
2. Adequate measures were taken to prevent wastewater runoff from the site(s). ET
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.
"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 a qualified personnel properly gather and evaluate 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
info
rmati submitted is, to the best of my knowledge and belief true, accurate, and complete. I am aware that there are significant
penal 'es for submitting fgmation, including the possibility of fines and imprisonment for knowing violations."
G 2c/ James M. Cheshire
(Si na e of Permite * D e (Name of Signing Official -Please print or type)
James M. Cheshire (Authorized James M. Cheshire (Authorized Ate) President R & A Laboratories
(Permittee -Please print or type) (Position or Title)
9683 Kerr's Chapel Road 336-582-8247 03/31/21
Gibsonville, NC (Phone Number) (Permit Exp. Date)
(Permittee Address)
* 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 (5/2003)

Page 3 of 3
NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDIDTIONAL PAGES AS NEEDED
PERMIT NUMBER: W00002857 MONTH: December YEAR: 2016
FACILITY NAME: Piedmont Custom Meats WWTF COUNTY: Caswell
Formulas:
Daily Loading (inches) = [Volume Applied (gallons) x 0.1336 (cubic feet/gallon) x 12 (inches/foot)] / [Area Sprayed (acres) x 43,560 (square feettacre) or
= [Volume Applied (gallons) / [Area Sprayed (acres) x 27,152 (gallons/acre-inch).
Maximum Hourly Loading (inches) = Daily Loading (inches) / [Time irrigated (minutes) / 60 (minutes/hour)] Monthly Loading (inches) =Sum of Daily Loading (inches)
12 Month Floating Total (inches) = Sum of this month's Monthly Loading (inches) and previous 11 month's Monthly Loadings (inches)
Average Weekly Loading (inches) = [Monthly Loading (inches/month) / Number of days in the month (days/month )] x 7 (days/week)
*Weather Codes: C -clear, PC -partly cloudy, CI -cloudy, R -rain, Sn-snow, SI -sleet
Spray Irrigation Operator in Responsible Charge (ORC): Steven Yarbrough Phone: [phone]
ORC Certification Number: 986612 Check
Mail ORIGINAL and Two COPIES to:
ATTN: Non -Discharge Compliance Unit X
ORC Has Changed: 0
DENR (SIGNAT F OPERATOR IN RESPONSIBLE CHARGE)
Division of Water Quality By this signature, I certify that this report is accurate and
1617 Mail Service Center complete to the best of my knowledge.
RALEIGH, NC 27699-1617
DENR Form NDAR-1 (5/2003)

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. T]
2. Adequate measures were taken to prevent wastewater runoff from the site(s). EP
3. A suitable vegetative cover was maintained on the site(s) in accordance with the permit. EP
4. All buffer zones as specified in the permit were maintained during each application. ETI
S. 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.
"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 a qualified personnel properly gather and evaluate 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
pen ies r submitting fa e n rmation, including the possibility of fines and imprisonment for knowing violations."
James M. Cheshire
*gn9ke of Permi e)* ate (Name of Signing Official -Please print or type)
James M. Cheshire (Authorized Agent) President R & A Laboratories
(Permittee -Please print or type) (Position or Title)
9683 Kerr's Chapel Road 336-582-8247 03/31/21
Gibsonville, NC (Phone Number) (Permit Exp. Date)
(Permittee Address)
* 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 (5/2003)