WQ0016966_Renewal Application_20191104

Initial Review
INITIAL REVIEW
Reviewer Thornburg, Nathaniel
Is this submital an
application? *
r Yes r No
Is this a complete
application? *
r Yes r No
Project Number* WQ0016966
Applicant/Permittee Town of Denton
Applicant/Permittee PO Box 306, Denton, NC 27239
Address
Is the owner in BIMS?
r Yes r No
Owner Type
Facility Name
County
Municipal
Town of Denton RLAP
Davidson
Complete App Date
11 /04/2019
Is the facility in BIMS?
r Yes r No
Fee Category Fee Amount
Minor 0
Signature Authority Ken Gamble
Signature Authority Title Town Manager
Signature Authority Email [e-mail]
Document Type (if
non -application)
Email Notifications
Does this need r Yes
review by the r No
hydrogeologist? *
Regional Office Winston-Salem

CO Reviewer Poonam Giri: eads\pagiri
Admin Reviewer [e-mail]
Below list any additional email address that need notification about a new project.
Email Address
Comments to be added to email notification
Comments for Kendall
Comments for RO
Comments for Reviewer
Comments for Applicant

Submitted Form
Project Contact Information
Rease provide inforrration on the person to be contacted by f DB Staff regarding electronic subrrittal, confirrration of receipt, and other issues.
.......................................................................................................................................................................................................................................................................................................................................................................
Name * Zach Key
Email Address*
[e-mail]
Project Information
Submittal Type* r New Permit Application
r Renewal
r Annual Report
Permit Type * r Wastewater Irrigation
r Other Wastewater
• Closed -Loop Recycle
r Single -Family Residence
Wastewater Irrigation
Is a paper copy of the application being submitted?*
r Yes r Nor N/A
Permit Number WQ0016966
currently has project
Applicant\Permittee * Town of Denton
Applicant/Permittee PO Box 306 Denton, NC 27239
Address*
Facility Name * Town of Denton
Phone Number*
3369577871
• Modification (Major or Minor)
r Additional Information
r Other
r High -Rate Infiltration
• Reclaimed Water
r Residuals
r Other
Please provide comments/notes on your current submittal below.
Land Application Renewal for the Town of Denton, Permit No. WQ0016966
Please attach all information required or requested for this submittal to be review here.
Application Form Engineering Rans, Specifications, Calculations, Etc.)
Denton 2019 Renewal.pdf 4.6MB
Wload only 1 FDF docurrent. N/Ultiple docurrents rrust be cortbined into one PDF file.

For new and modification permit applications, a paper copy may be required. If YGL' have any questions
about what is required, please contactthe reviewer or Tessa Monday. If a aaoe- a1,o1:cation is required,
be advised, applications accepted far pre -review until both the paper and eIect-c-i_ col. es -,ave been
received. The paper copy shall include the following:
o Application Form
o All relevant attachments (cales, soils
report, specs, etc.)
o One full-size engineering plan set
o One 11x27" engineering plan set
o One extra set of specifications
o Fee (if required)
Mailing address:
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
By U.S. Postal Service
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
By Courier/Special Delivery:
�----------------------------------------------------------------------------
---------------------------
❑ivision of Water Resources
i Division of Water Resources
-------------- - ---- ----- -----------------------------------
Non -Discharge Branch
1---------
Non -Discharge Branch
1617 Mail Service Center
i Aft: Nathaniel Thornburg, 90 Floor, O f`uce #942W
Raleigh. NC 27699-1617
512 N. Salisbury St.
Far questions or problems contact Tessa Monday [e-mail] or 919.707.3560.
* I;W By checking this box I acknowledge that I understand the application will not be accepted
for pre -review until the paper copy (if required) and fee (if required) have been received by
the Non -Discharge Branch. I also confirm that the uploaded document is a single PDF with
all parts of the application in correct order (as specified by the application).
Signature
Submission Date 10/28/2019

S Southern
S Soil
B Builders, Inc.
Monday, October 28, 2019
958 Hoots Road Roaring River, NC 28669
Zach Key 336-957-7871 • Fax [phone]
Email: [e-mail]
North Carolina Department of Environment Quality
Division of Water Resources
Water Quality Permitting Section
Non -Discharge Permitting Unit
1617 Mail Service Center
Raleigh, NC 27699-1617
Reference: Permit Renewal for the Town of Denton
Land Application Permit No. WQ0016966
Southern Soil Builders, Inc. is assisting the Town of Denton in applying for a renewal to its current land
application permit WQ0016966.
There are no changes in this permit renewal, apart from small changes in field acreage due to updated
maps.
Your attention to this permit application package is greatly appreciated. If you have any questions or
concerns, please feel free to contact me at 336-957-7871 or at [e-mail]
Sincerely,
Zach Key
Southern Soil Builders, Inc.

State of North Carolina
DWR
Department of Environmental Quality
Division of Water Resources
Division of Water Resources 15A NCAC 02T .1100 — RESIDUALS LAND APPLICATION PROGRAM
INSTRUCTIONS FOR FORM: RLAP 06-16 & SUPPORTING DOCUMENTATION
Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted the Aoplicant shall submit one on final and two copies of the application and
supporting documentation
For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting Uni[
General —This application is for treatment, storage, transport, and/or land application of Class B residuals (may include residuals that
are generated from a water treatment plant or other type facilities) on the proposed or currently approved land application site(s) under
15A NCAC 02T 1100.
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Residuals Land Application Program (FORM: RLAP 06-I6) Application: (All Application Packages):
❑ Submit the completed and appropriately executed Residuals Land Application Program (FORM: RLAP 06-16) form. Please
do not make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to
the application may be made, as long as the attachments are numbered to correspond to the section and item to which they
refer.
❑ The Applicant's Certification on Page 5 of this form shall be signed in accordance with 15A NCAC 02T 0I06(b). An alternate
person may be designated as the signing official if a delegation letter is provided from a person who meets the criteria in 15A
NCAC 02T 0I06(b). —
❑ If this project is for a modification of an existing permit, submit one copy of the existing permit.
❑ Please submit this application form at least 180 days prior to the expiration date on the existing permit, or 90 days prior to
operation of proposed facility(ies) for application packages involving new or changes to treatment and storage units.
B. Application Fee (New and Major Modification Application Packages)
❑ Submit a check, money order or electronic funds transfer made payable to: North Carolina Department of Environmental
Quality (NCDEQ).
Facility Classification New Permit Major Modification'
Major (land are permitted for > 300 acres) $1,310 $395
Minor (land are permitted for < 300 acres) $810 $245
_..
A major modification shall be defined as any permit modification that: increases the generating facility's residuals dry tonnage;
adds additional land application areas not previously approved for that particular program [including transferring of field(s) from
one program to another]; adds additional residuals sources; or includes the addition of new treatment or storage units/processes not
previously permitted. There is no fee for minor modifications to a permit.
C. Cover Letter (All Application Packages)
List all items included in the application package, as well as a brief description of the requested permitting action.
D. Environmental Assessments (May be Required — See 15A NCAC I C .0300)
Submit a copy of the Findings of No Significant Impact (FONSI) or Environmental Impact Statement (EIS). Also, include
information on any mitigating factor(s) from the Environmental Assessment (EA) that impact the construction of the residuals
treatment and storage facilities. An EA may also be required for private systems if any public funds and/or lands are used for
the construction of the subject facilities.
INSTRUCTIONS FOR FORM•. RLAP 06-16 Page I of 3

E. Operation and Maintenance Plan (New and Renewal Application Packages)
❑ For Modification Application, if there are any changes to the existing plan, submit an updated O&M plan.
❑ Submit the O&M Plan in accordance with 15A NCAC 02T.I 110 and include at a minimum:
❑ Operational functions; describe the operation of the program to show what operations are necessary for the program to
function and by whom the functions are to be conducted.
❑ Maintenance schedules; may include equipment calibration, maintenance of signs, etc.
❑ Safety measures; may include safety training program, manuals, signs, etc.
Spill response plan; including control, containment, remediation, emergency contact information, etc.
❑ Inspection plan including the following information;
❑ Names and titles of personnel responsible for conducting the inspections.
❑ Frequency and location of inspections, including those to be conducted by the ORC, and procedures to assure that the
selected location(s) and inspection frequency are representative of the residuals management program.
❑ Detailed description of inspection procedures including record keeping and actions to be taken by the inspector in the event
that noncompliance is observed.
❑ Sampling and monitoring plan including the following information;
Names and titles of personnel responsible for conducting the sampling and monitoring.
❑ Detailed description of monitoring procedures including parameters to be monitored.
❑ Sampling frequency and procedures to assure that representative samples are being collected. Fluctuation in temperature,
Flow, and other operating conditions can affect the quality of the residuals gathered during a particular sampling event. The
sampling plan shall account for any foreseen fluctuations in residuals quality and indicate the most limiting times for
residuals to meet pathogen and vector attraction reduction requirements (e.g. facilities that land apply multiple times per
year but have an annual sampling frequency, may need to sample during winter months when pathogen reduction is most
likely to be negatively affected by cold temperatures.
THE FOLLOWING ADDITIONAL ITEMS (G to M) ARE REQUIRED FOR DEDICATED PROGRAM ONLY.
F. Program Determination
❑ Dedicated residuals land application programs are ones in which land application sites meet the criteria in 15A NCAC 02T
❑.1 102021. Specifically, a residuals land application program is designated as dedicated if any of the following are applicable:
Any land application site certified for the residuals land application program that receives residuals at rates or frequencies
greater than agronomic rates.
❑ Any land application site certified for the residuals land application program that is used primarily for residuals disposal,
and agricultural crop production is of secondary importance.
Any land application site certified for the residuals land application program that receives residuals through fixed irrigation
facilities or irrigation facilities fed through a fixed supply system.
❑ Please contact the Non -Discharge Permitting Unit if you need any assistance in determining whether your residuals program
falls under the dedicated program definitions.
G. Program Information
❑ Provide an explanation of why a dedicated system is required instead of a conventional non -dedicated system.
❑ Provide an explanation of the dedicated system and its operation.
H. Detailed Site Maps (All New or Modification Application Packages)
❑ Submit three (3) sets of standard size plans and two (2) sets of 1 1 " by 17" plans (electronic format is acceptable - Adobe PDF
only). For Modifications, submit plans specific to the modification(s) only.
Plans must include the following minimum items:
❑ A general location map, a vicinity map and a topographic map with contours not exceeding 10 feet or 25% of the total site
relief and showing all facility related structures and fences within the land application area.
The location of all wells (including usage and construction details if available), streams (ephemeral, intermittent, and
perennial), springs, lakes, ponds, and other surface drainage features within 500 feet of the land application site(s).
0 Delineation of the review and compliance boundaries
Ej Setbacks as required by 15A NCAC 02T .l 108
Site property boundaries within 500 feet of all waste treatment, storage, and disposal site(s).
A map showing the entire irrigation area with an overlay of the suitable irrigation area depicted by the soil scientist's
evaluation. The irrigation plans shall show each nozzle/emitter and wetted area (when applicable). Clearly label spray
irrigation zones as they will be operated.
❑ Plans must depict a completed design and not be labeled with preliminary phrases (e.g., FOR REVIEW ONLY, NOT FOR
CONSTRUCTION, etc.) that indicate that they are anything other than final plans. However, the plans maybe labeled with
the phrase: FINAL DESIGN - NOT RELEASED FOR CONSTRUCTION
INSTRUCTIONS FOR FORM: RI -AP 06-16 Page 2 of 3

I. Project Evaluation and Receiver Site Management Plan (All New Application Packages or Modifications that include new sites)
❑ Submit a project evaluation and a receiver site management plan (if applicable) with recommendations concerning cover crops
and their ability to accept the proposed application rates.
J. Hydrogeologic Report (All New Application Packages or Modifications involving increasing the total design capacity)
❑ Submit a detailed hydrogeologic evaluation in accordance with 15A NCAC 02T 1104(d)(4) and current Division Policy
available at: http://www.ncwater,org/Rules Policies and Regulations/. The document shall be signed, sealed and dated by a
qualified professional.
K. Engineering Design Documents (All New or Modification Application Packages with fixed irrigation facilities or irrigation
facilities fed through fixed supply system)
❑ Submit engineering design documents that have been signed, sealed, and dated by a NC licensed Professional Engineer and/or
Professional Land Surveyor in accordance with 15A NCAC 02T 1 104(d)(2). For Modifications, submit an updated site map
specific to the modification(s) only.
❑ The design documents must include the following minimum items:
❑ Engineering plans for the facility and equipment except those previously permitted unless they are directly tied into the new
units or are critical to the understanding of the complete process;
❑ Specifications describing materials to be used, method of construction, and means for ensuring quality and integrity of the
finished product including leaking testing; and
❑ Engineering calculations including hydraulic and pollutant loading, sizing criteria, hydraulic profile, total dynamic head
curve analysis for each pump, and irrigation design.
❑ Soil mapping units shown on all disposal sites.
L. Water Balance (All New Application Packages or Modifications that include new sites utilizing fixed irrigation facilities or
irrigation facilities fed through fixed supply systems)
❑ Submit a completed and accurate water balance in accordance with 15A NCAC 02T 1 104(d)(5) and current Division Policy
available at: http://www.newater.org/Ruies Policies and Regulations .
M. Property Ownership Documentation (All New or Modification Application Packages involving new and/or relocated treatment
or irrigation components)
❑ Property ownership documentation shall consist of one of the following:
Legal documentation of ownership (i.e., GIS, deed or article of incorporation), or
Written notarized intent to purchase agreement signed by both parties with a plat or survey map, or
❑ An easement running with the land specifically indicating the intended use of the property and meeting the requirements of
15A NCAC 02L 0107(f), or
❑ A written notarized lease agreement signed by both parties, indicating the intended use of the property, as well as a plat or
survey map.
ONE ORIGINAL AND TWO COPIES OF THE COMPLETED APPLICATION PACKAGE, INCLUDING ALL
SUPPORTING INFORMATION AND MATERIALS, SHALL BE SENT TO THE FOLLOWING ADDRESS:
NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF WATER RESOURCES
WATER QUALITY PERMITTING SECTION
NON -DISCHARGE PERMITTING UNIT
By U.S. Postal Service:
1617 MAIL SERVICE CENTER
RALEIGH, NORTH CAROLINA 27699-1617
TELEPHONE NUMBER: [phone]
By Courier/Special Delivery:
512 N. SALISBURY STREET
RALEIGH, NORTH CAROLINA 27604
FAX NUMBER: [phone]
INSTRUCTIONS FOR FORM: RLAP 06-16 Page 3 of 3

DDepartment
WR
Division of Water Resources
15A NCAC 02T.1100 —
State of North Carolina
of Environmental Quality
Division of Water Resources
RESIDUALS LAND APPLICATION PROGRAM
FORM: RLAP 06-16
I. APPLICANT INFORMATION:
I. Applicant's name: Town of Denton
Applicant type: ❑ Individual
❑ Corporation ❑ General Partnership
❑ Privately -Owned Public Utility
❑ Federal
❑ State Z Municipal
❑ County
Signature authority's name per 15A NCAC 02T .0106: Ken Gamble
Title: Town Manager
Applicant's mailing address: PO Box 306
City: Denton State: NC
Zip: 27239
Telephone number: [phone]
Email Address: ken amblegtownofdenton
com
2. Consultant's name: Zach Kev
License Number (for P.E.): _
Affiliation: ❑ On Staff Retained (Firm: Southern Soil Builders.
Inc.)
Consultant's mailing address: 1151
Wagon Ridge Road
City: Roarinp River
State: NC Zip: 28669
Telephone number: 336) 957-7871
Email Address: zkeyPsouthemsoiulbuilders com
3. Agronomist's name:_
License Number:
Affiliation: ❑ N/A ❑ On Staff
❑ Retained (Firm: _)
Agronomist's mailing address:
City: _ State: _
Zip:
Telephone number: (_) _ _
Email Address: _
4. Soil Scientist's name: —
License Number:
Affiliation: ❑ N/A ❑ On Staff
❑ Retained (Firm:
Soil Scientist's mailing address:
City:— State: _
Zip: _
Telephone number: (_) _ _
Email Address: _
5. Fee submitted: _(See Instruction
B)
11. PERMIT INFORMATION:
1. Application is for (check all that apply): ❑ new, ❑ modified, 0 renewed permit
2. If this application is being submitted to renew or modify an existing permit, provide the following:
Permit number: W00016966
Date of most -recently issued permit: 3-19-2015
Date of most -recently certified Attachment A (if different than the permit): 3-19-2015
Date of most -recently certified Attachment B (if different than the permit): 3-19-2015
FORM: RLAP 06-16 Page 1 of 5

Ill. RESIDUALS LAND APPLICATION PROGRAM INFORMATION:
1. Residuals Processing Facility's physical address: 300 Council Access Road
City: Denton State: NC Zip: 28630
Coordinates: Latitude: 35' 37' I S_62" Longitude: 80' 70' 36.77"
Datum: WGS84 Level of accuracy: .01
Method of measurement: MAP
2. County where residuals land application program is headquartered: Davidson
3. List the Operator In Responsible Charge (ORC) and all Back -Up ORCs for the residuals land application program, their
certification numbers, and their affiliations in the following table:
Designation
Name
Affiliation
Certification Number
ORC
Troy Branch
Town of Dobson
22733
Back -Up ORC
Zach Key
Southern Soil Builders, Inc.
27660
Additional Back -Up
ORCs
(if applicable)
If an ORC and at least one Back -Up ORC are not currently designated for this residuals land application program, provide the
candidates' names, affiliations, and an estimated time schedule for each candidate's completion of the required training school
and certification test:
4. Complete the following tables regarding management of the residuals land application program:
a. Plant Available Nitrogen Summary: Determine the maximum plant available nitrogen (PAN) generated by all residuals
source -generating facilities as currently certified and proposed for certification with this application and list the results in the
following table:
Maximum amount of residuals to be certified: 360 dry tons per year.
PAN
Pounds of PAN per Dry Ton
(Weighted Average)
Pounds of PAN per Year
Surface
Incorporation
or Injection
Surface
Incorporation
or Injection
First -Year
30.0284
40.0834
10810.2
14430
Five -Year Maximum Adjusted
32.1
42.88
11556
15436.8
b. Land Application Site Use Summary: Summarize information regarding the land application sites as currently certified and
proposed for certification with this application:
Category
Use
Acres
Comments
Crops
Forest or Plantation
0
Row Crops
0
Hay
50.11
Pasture
91.41
Total.
141.52
Methods
Surface
141.52
Incorporation or Injection
0
Total:
141.52
FORM: RLAP 06-16 Page 2 of 5

C. Residuals Land ADDlication Summary: Determine the minimum acreage required to land apply the residuals as currently
certified and proposed for certification assuming the scenarios listed in the following table:
Assumed
Application Rate
(Ibs PAN/ac-yr)
Acres Required Using
First -Year PAN Concentrations
Acres Required Using
Five -Year Maximum Adjusted PAN
Concentrations
Surface
Incorporation or
Injection
Surface
Incorporation or
Injection
50
216.2
288.6
231.12
288.6
100
108.1
144.3
115.56
144.3
150
72.1
96.2
77.04
102.9
200
54.1
72.15
57.78
72.15
6. If applicable, provide a plan and a schedule to resolve any known issues that would prevent land application of the proposed
residuals due to the violation of North Carolina Administrative Code (e.g. not enough storage, not enough land, vector reduction
practices not in place, etc.):
7. Specify type of residuals program (See Instruction F): ® Non -dedicated ❑ Dedicated
If Dedicated, specify the following (check all that apply):
El Residuals program contains any land application site(s) that receives residuals at rates or frequencies greater than agronomic
rates, explain; _
Residuals program contains any land application site(s) that is used primarily for residuals disposal, and agricultural crop
production is of secondary importance, explain; _
Residuals program contains any land application site(s) that receives residuals through fixed irrigation facilities or irrigation
facilities fed through a fixed supply system, explain;_
IV. RESIDUALS SOURCE INFORMATION: (Required for all new, renewed, or modified residuals source)
Complete and submit the following Residuals Source Certification and all associated documentation.
Fti ,.
Residuals Source
Certification
V. LAND APPLICATION SITE INFORMATION: (Required for all new, renewed, or modified land application site)
Complete and submit the following Land Applications Site Certification and all associated documentation.
Land Application Site
Certification.doc
FORM: RLAP 06-16 Page 3 of 5

Note: Item VI. Applicable to Dedicated Program with fixed irrigation system only.
VI. DESIGN INFORMATION FOR FIXED IRRIGATION SYSTEM
I. The irrigation system is: ❑ Spray ❑ Drip
2. Disposal system is: ❑ existing ❑ proposed.
3. Minimum depth to mean seasonal high water table (SH WT) within irrigation sites(s) per Soil Scientist's Evaluation: feet
below ground surface. Rules 15A NCAC 02T 0505(0) requires at least one -foot vertical separation between SH WT and ground
surface.
4. Are there any artificial drainage or water movement structures within 200 feet of any irrigation area?
❑ Yes or ❑ No If Yes, please explain if the soil scientist report addresses artificial structures and please indicate if
structures are to be maintained or modified:
5. Loading rates recommended by the Soil Scientist Evaluation:
Soil Series Fields within Soil Area
6. Design loading rates are equal or less than the loading rates r
❑ Yes or ❑ No If No, explain why 15A NCAC 02T .050.
7. Non -dedicated System Design (fill in the appropriate informE
Field / Zone
Design Area
(ftZ
Number of
Nozzles
Maxim
Rate
Total
Spray Irrigation Design Element
Wetted diameter of nozzles
ft
Wetted area of nozzles
ftz
Nozzle capacity
gpr
Nozzle manufacturer / model
Elevation of highest nozzle
ft
FORM: RLAP 06-16

Applicant's Certification (signing authority must be in compliance with ISA NCAC 02T .0106):
The applicant or any affiliate has not been convicted of an environmental crime, has not abandoned a wastewater facility without proper
closure, does not have an outstanding civil penalty where all appeals have been exhausted or abandoned, are compliant with any active
compliance schedule, and do not have any overdue annual fees under Rule 15A NCAC 02T .0105.
❑ Yes ❑ No, Explain;
1, Ken Gamble Town Manager
(Signature Authority's Name — PLEASE PRINT) (Title)
attest that this application for
(Facility Name)
has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that the Division of Water Resources
may not conduct a technical review of this program and approval does not constitute a variance to any rules or statutes unless specifically
granted in the permit. Further, any discharge of residuals to surface waters or the land will result in an immediate enforcement action,
which may include civil penalties, injunctive relief, and/or criminal prosecution. I will make no claim against the Division of Water
Resources should a condition of this permit be violated. I also understand that if all required parts of this application are not completed
and that if all required supporting information and attachments are not included, this application package will be returned to me as
incomplete.
Note: In accordance with North Carolina General Statutes § 143-215.6A and §143-215.613, any person who knowingly makes any false
statement, representation, or certification in any application shall be guilty of a Class 2 misdemeanor, which may include a fine not to
exceed $10,000 as well as civi9gnalties up)o $25,000 per violation.
v 'Z Zo
Signature: � pate: / O
FORM: RLAP 06-16 Page 5 of 5

Operation and Maintenance Plan
Town of Denton, NC
Permit No.WQ0016966
In accordance to the requirements set forth by the North Carolina
Department of Environmental and Natural Resources using
NCGS 143-215.1 and 143-215.3(a) based on 15A NCAC 02T .1 10, The Town
of Denton . is implementing this Operation and Maintenance Plan.
The project manager of the land application event will make sure a daily
check off is performed at the start of each work day. This inspection is to
prevent any spills, leaks, or run-offs.
The daily check -off will consist of inspection the following items:
1. Access to the facility will be controlled with a locked gate and
signs to prevent any unauthorized entry into the complex.
2. All pumps and hose will be checked at the start of each day for
leaks or loose fittings.
3. All tanker valves are closed prior to loading and lids are closed
prior to transport.
4. All dump trailers or dump trucks gates are tightly fastened and
do not leak prior to transport.
5. All on road equipment is check as per DOT regulations for any
safety or mechanical hazards or issues.
6. All equipment is secured at the end of each working day to
prevent any tampering or unauthorized use.
The ORC or back up ORC will inspect the field after each land application
event to make sure all regulations as required by the permit are followed.
Also the project manager at the end of each working day during a land
application event will make sure that all gates if present are closed.
All samples shall be taken as early as possible before the first application
event of the calendar year to make sure the facility is compliance.
The samples will be taken in a matter that is representative of the residuals
and all grab samples will be mixed prior to be placed in to the containers

that will go to the laboratory. These samples must be collected and
transported as outlined in the Sampling Plan attached to this O&M Plan.
All records of these laboratory results as well as the annual report and
loading rates will be kept on file for a minimum of five (5) years.
Also, in the unlikely event of a spill or unintended release of residuals,
actions should be immediately taken as outlined in a copy of the
spill control plan attached.

TOWN OF DENTON, NC
WWTP SAMPLING PLAN
WQ0016966
Annually, if a land application event occurs, grab samples are collected from the aerobic
digester. Samples from the digester will be combined to form individual grab samples to be sent
to a laboratory for analysis. If a land application event is to occur in the early part of a calendar
year (i.e. January or early February) these samples may have to be taken in December so results
can be obtained before the land application event, as some results take 30+ days to receive.
These individual grab samples are collected and tested for nutrient analysis and pH
monitoring to meet the requirements of Alternative 6, Alkaline Stabilization. These tests will be
taken by Troy Branch of the Town of Denton. All samples will be taken to Meritech, Inc. All
samples taken will be taken in the same condition as the residuals are to be land applied.
The volatile solids and fecal coliform will be achieved using sufficient alkaline to meet
option 6 [503.33(b)(6)), commonly known as lime stabilization.
Annually, if land application occurs, a composite residual sample will be analyzed, prior
to a land application event for:
Cadmium, Copper, Lead, Mercury, Molybdenum, Nickel, Selenium, Zinc, Aluminum,
Ammonia Nitrogen, Calcium, Nitrate Nitrogen, Magnesium, % total Solids, pH, Phosphorus,
Potassium, TKN, Sodium
From this information, the Plant Available Nitrogen (PAN) and a Sodium Absorption
Ratio (SAR) will be calculated. This sample will collected in a non -breakable container, at least
one quart in size. This sample will be taken from the aeration tank.
Once per permit cycle, a Toxicity Characteristics Leaching procedure (TCLP) analysis as
well as an ignitability, corrosivity, and reactivity test shall be done.

SPILL CONTROL PLAN- Southern Soil Builders, Inc.
Town of Denton - Permit WQ0016966
In the event of a spill, the following should be taken IMMEDITALY.
1. Make sure all personal and bystanders are safe- if not contact emergency
services
2. Halt the source of the spill- overturned truck, leaking valve, ruptured tank.
3. Contain the spill. Use straw bales or earthen barrier to form a dike to
contain the spill.
4. Cleanup. Employ vacuum trucks, dump trucks, and loaders to remove as
much of the spilled material as possible. Use straw to soak -up the
remaining material. Dispose of the same in a landfill.
5. Flush the roadways with water if needed. If the spill occurred on a tillable
area, till the same into the soil and spread lime if necessary. If a spill occurs
on private property, final clean-up should be to the satisfaction of the
owner.
6. Notification. (This should be done as soon as safely possible.)
A. Southern Soil Builders, Inc. [phone]
B. Town of Denton WWTP [phone]

C. NCDEQ-Winston Regional Office [phone]
D. County Emergency Services (Sheriff, Fire Dept.) 911
7. Reporting:
The Permittee shall report by telephone to the Winston Regional Office,
telephone number [phone], as soon as possible, but in no case
more than 24 hours or on the next working day following the occurrence
or first knowledge of the occurrence of any of the following:
A. Surface disposal of residuals abnormal in quantity or characteristic.
B. Any failure of the surface disposal program resulting in a release of
material to surface waters.
C. Any time self -monitoring indicates the facility has gone out of
compliance with its permit limitations.
D. Any process unit failure, due to known or unknown reasons,
rendering the facility incapable of adequate residual treatment
E. Any spill or discharge from a vehicle or piping system during
residuals transportation.
Any emergency requiring immediate reporting (e.g., discharges to
surface waters, imminent failure of a storage structure, etc.) outside of
normal business hours shall be reported to the Division's Emergency
Response personnel at telephone number [phone], [phone],
or [phone]. Persons reporting such occurrences by telephone shall
also file a written report in letter form within five days following first
knowledge of the occurrence. This report shall outline the actions taken or
proposed to be taken to ensure that the problem does not recur.
8. Spill Prevention. The easiest way to clean a spill is to prevent one.
A. Ensure loading personal watch the vehicle being loaded.
B. Ensure all valves and lids are closed
C. Inspect all seals and replace if necessary.

Divlsion of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
RESIDUALS SOURCE CERTIFICATION
INSTRUCTIONS FOR FORM: RSC 06-16
Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted the Applicant shall submit one original and two copies of the application and
supporting documentation
For more information, visit the Water Quality Permitting Section's Non-Discharee Permitting Unit
General — This certification provides detailed information of residuals source generating facility and its residuals quality for land
application, distribution, or disposal in accordance with 15A NCAC 02T .I 100. Do not submit this certification for review without
a corresponding application form (FORM: RLAP I I-15, FORM: DCAR 11-15, or FORM: SDR 11-15).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Residuals Source Certification (FORM: RSC 11-15):
❑ Submit the completed and appropriately executed Residuals Source Certification (FORM: RSC 11-15) form. Please do not
make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to the
application may be made, as long as the attachments are numbered to correspond to the section and item to which they refer.
❑ For new or renewed permits, submit a separate certification for each source facility.
❑ For modified permits, submit a separate certification for only those facilities that are affected by the proposed modification.
❑ Complete the residuals source facility summary page. List all new, renewed, or modified facilities.
B. Residuals Source -Generating Facility Information:
❑ For each source facility, attach the following:
❑ Vicinity map - A vicinity map that shows the location of the facility and meets all of the criteria in the "Map Guidance for
Residuals Land Application Permits".
❑ Process Flow diagram and/or narrative - A detailed narrative and/or process flow diagram that describes how the residuals
are to be generated, treated, processed, and stored at the facility.
❑ Quantitative justification for residuals production rate - A quantitative justification for the value provided in Item 1. 8.
Ensure that the amount of residuals listed is the maximum amount expected to be generated by the facility for the life of
the permit. In addition, ensure that this amount is equivalent to that which is actually to be land applied, distributed,
and/or disposed, including any chemicals, amendments, or other additives that are added to the residuals during
processing.
❑ Sampling plan - A detailed sampling plan for the residuals source -generating facility. Ensure that the plan identifies
sampling points, sampling frequency, sample type, as well as the Division -certified laboratory to be used. In addition,
ensure that the plan details how the facility and/or the residuals are monitored for any applicable pathogen reduction and
vector attraction reduction requirements. Note that all sampling and monitoring must be completed on the residuals as
they are to be land applied, distributed, and/or disposed.
C. Residuals Quality Information:
❑ For each source facility, attach the following:
❑ Laboratory analytical reports and operational data- reports for all laboratory analyses used to complete this certification.
❑ Documentation that the facility complies and/or the residuals comply with any applicable pathogen reduction and vector
attraction reduction requirements.
❑ For new facility that may have not yet been constructed and analytical results of residuals cannot be obtained, please
attach analytical results of residuals generated from a similar facility along with the description of similarities of the two
facilities.
INSTRUCTIONS FOR FORM: RSC 06-16 Page 1 of I

L
�
U
�•
a
o
�
L
a
o
a
y
C
O
T
E
o
a
_
R
L
O
N
U
u
a
rn
rn
E
O0
z
N
ONO
E
O
V
O
v
v
z
z
a
C
�
�
U
---------------------
Z
F
a
=
3
9
p
c
G
C
G
o
0
a
T
3
3
h
�n U

Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
RESIDUALS SOURCE CERTIFICATION
FORM: RSC 06-16
RESIDUALS SOURCE -GENERATING FACILITY INFORMATION (See Instruction B.):
I. Facility Name: Town of Denton
2. Facility permit holder is: 0 Federal, 0 State, Local Government, or 0 Private.
Facility permit issued by: [] Div. of Water Resources, 0 Div. of Environmental Health,
or Other (explain: __).
3. Facility contact person and title: Heather Hicks
Complete mailing address: PO Box 306
City: Denton
Telephone number: 336 859-3139
State: NC
Zip: 27239
E-mail address: dentonwaterplant(a),windstream.net
4. Facility physical address: 3049 Brin Ig a Ferry Road
City: Denton State: NC Zip: 27239
Coordinates: Latitude: 35' 35' 53 54" Longitude: 80. 13' 25 17"
Datum: NAD83 Level of accuracy: 0.01
Method of measurement: MAP
5. Purpose of the facility:
[� treatment of municipal wastewater, 0 treatment of 100% domestic wastewater,
treatment of potable water, 0 treatment of 100% industrial wastewater,
0 treatment of industrial wastewater mixed with domestic wastewater,
(approximate percentages: — % industrial and % domestic)
0 other (explain: � ).
6. Does the facility have an approved pretreatment program: 0 Yes 0 No
7. Facility permitted/design flow: 2.25 MGD and facility average daily Flow: I MGD
8. Average amount of residuals being generated at this facility 20 dry tons per year.
9. Specify the following regarding treatment and storage volumes available at the facility:
Type and volume of residuals treatment: One (1) 200' x 150' holdine pond
Type and volume of residuals storage (i.e., outside of residuals treatment units): two (2) 40' 8 120' drvine beds
RESIDUALS QUALITY INFORMATION (See Instruction C.):
I. Specify if residuals are regulated under:
0 40 CFR Part 503 or 40 CFR Part 257.
Note: Only residuals that are generated during domestic/municipal wastewater treatment processes are regulated under 40
CFR Part 503, otherwise, the residuals are regulated under 40 CFR Part 257.
2. Specify if residuals are defined under 15A NCAC 02T.1 102(6) as:
Q Biological E Non -Biological
Note: Biological residuals are residuals that have been generated during the treatment of domestic wastewater, animal
processing wastewater, or the biological treatment of industrial wastewater (biological treatment is a system that utilizes
biological processes including lagoons, activated sludge systems, extended aeration systems, and fixed film systems).
FORM: RSC 06-I6 Page I of 5

3. Hazardous Waste Determination: Complete the following to demonstrate that the residuals are non -hazardous under
RCRA: (Note - this item does not have to be completed for facilities that are less than 0.5 MGD in design flow that treat
100%non-municipal, domestic wastewater only)
a. Are the residuals listed in 40 CFR §261.31-§261.33: yes Eno.
If yes, list the number(s):
b. Specify whether or not the residuals exhibit any of the characteristics defined by 40 CFR §261.21-
261.24: Q yes 0 no.
Fill in the following tables with the results of the latest toxicity characteristic leaching procedure (TCLP) analysis as
well as those for corrosivity, ignitability, and reactivity:
Laboratory: Pace Analytical and Date of analysis: 3-14-2016
Passed corrosivity test: E' yes Q no. pH: s.u. (2 < pH < 12.5)
Passed ignitability test: E yes E] no. Flashpoint: 200 OF (> 140°F)
Passed reactivity test: Eyes Mno. HCN: ND mg/kg (<250) & H2S: ND mg/kg (<500)
TCLP Parameter
Limit
(mg/1)
Result
(mg//)
TCLP Parameter
Limit
(mg/1)
Result
(mg//)
Arsenic
5.0
ND
Hexachlorobenzene
0.13
ND
Barium
100.0
ND
Hexachloro-1,3-Butadiene
0.5
ND
Benzene
0.5
ND
Hexachloroethane
3.0
ND
Cadmium
1.0
ND
Lead
5.0
ND
Carbon Tetrachloride
0.5
ND
Lindane
0.4
ND
Chlordane
0.03
ND
Mercury
0.2
ND
Chlorobenzene
100.0
ND
Methoxychlor
10.0
ND
Chloroform
6.0
ND
Methyl Ethyl Ketone
200.0
NO
Chromium
5.0
ND
Nitrobenzene
2.0
ND
m-Cresol
200.0
ND
Pentachlorophenol
100.0
ND
o-Cresol
200.0
ND
Pyridine
5.0
ND
p-Cresol
200.0
ND
Selenium
1.0
ND
Cresol
200.0
ND
Silver
5.0
ND
2,4-D
10.0
ND
Tetrachloroethylene
0.7
ND
1,4-Dichlorobenzene
7.5
ND
Toxaphene
0.5
ND
1,2-Dichloroethane
0.5
ND
Trichloroethylene
0.5
ND
I,l-Dichloroethylene
0.7
ND
2,4,5-Trichlorophenol
400.0
ND
2,4-Dinitrotoluene
0.13
ND
2,4,6-Trichlorophenol
2.0
ND
Endrin
0.02
ND
2,4,5-TP (Silvex)
1.0
ND
Heptachlor and its Hydroxide
0.008
ND
Vinyl Chloride
0.2
ND
FORM: RSC 06-16 Page 2 of 5

4. Metals Determination: Complete one of the following tables (i.e., as applicable) to demonstrate that the residuals do not
violate the ceiling concentrations for metals regulated under 15A NCAC 02T .1105.
a. For Distribution/Land Application: Fill in the following table with the results of the latest analyses (i.e., on a dry weight
basis) for the following metal parameters:
Laboratory: Waypoint Analytical and Date of analysis: 8-25-2019
Parameter
Ceiling
Concentration Limits
(ClassA & ClassB)
(mg/kg)
Monthly Average
Concentration Limits
(Class A Only)
(mg/kg)
Result
(mg/kg)
Arsenic
75
41
8.61
Cadmium
85
39
1
Copper
4,300
1,500
48.5
Lead
840
300
21.7
Mercury
57
17
0.0585
Molybdenum
75
n/a
2.5
Nickel
420
420
17.5
Selenium
100
100
5
Zinc
7,500
2,800
77.5
b. For Surface Disposal Unit (landfill): Fill in the following table with the results of the latest analyses (i.e., on a dry weight
basis) for the following metal parameters:
Laboratory: _ and Date of analysis:
Distance from Disposal
Unit to Boundary to
Closest Property Line
(meters, check one)
Arsenic
(mg/kg)
Chromium
(mg/kg)
Nickel
(mg/kg)
> 0 but < 25
30
200
210
Q > 25 but < 50
34
220
240
f ? 50 but < 75
39
260
270
> 75 but < 100
46
300
320
Ej > 100 but < 125
53
360
390
> 125
62
450
420
Result (mg/kg)
FORM: RSC 06-16 Page 3 of 5

5. Nutrient/Micronutrient Determination: Complete the following:
a. Total solids: 4.79 %.
b. Fill in the following table with the results of the latest analyses (i.e., on a dry weight basis) for the following nutrient and
micronutrient parameters:
Laboratory: Wavooint Analytical and Date of analysis: 8-25-2019
Parameter
Result
(mg/kg)
Aluminum
152000
Ammonia -Nitrogen
2920
Calcium
2810
Magnesium
1430
Nitrate -Nitrite Nitrogen
4.63
pH (Standard Unit)
6.5
Phosphorus
1840
Potassium
982
Sodium
297
Total Kjeldahl Nitrogen
9790
c. Using the results listed in Item 11. 5b. above, calculate the sodium adsorption ration (SAR): 0.247
[Note: If residuals contain SAR of 10 or higher, the applicant shall obtain recommendations from the local Cooperative
Extension Office, the Department of Agriculture and Consumer Services, the Natural Resource Conservation Service, a
North Carolina Licensed Soil Scientist, or an agronomist, prior to land application of residuals. The recommendations shall
address the sodium application rate, soil amendments (e.g., gypsum, etc.), or a mechanism for maintaining site integrity
and conditions conducive to crop growth].
d. Specify the mineralization rate to be used in calculating the plant available nitrogen (PAN) of the residuals: 40 %. This
rate is a (check one): 0 default value, or actually established.
If the residuals are not generated from the treatment of municipal or domestic wastewater, explain or provide technical
justification as to why the selected default value is appropriate to be applied to these residuals: Non Processed residuals
e. Calculate the PAN for the residuals (i.e., on a dry weight basis) and fill the results in the following table:
Application Method
First (111) Year PAN
Five -Year
Maximum Adjusted PAN
(mglkg)
(mg/kg)
Surface
4212.63
4507.21
Injection/Incorporation
5672.63
6069.71
6. Other Pollutants Determination: Specify whether or not there are any other pollutants of concern in the residuals and provide
the results of the latest analyses:
FORM: RSC 06-16 Page 4 of 5

7. Pathogen Reduction: Per 15A NCAC 02T.1106, specify how residuals will meet the pathogen reduction requirements:
a. For Distribution/Land Application of Class A or Equivalent:
A fecal coliform density that is demonstrated to be less than 1,000 MPN per gram of total dry solids,
or
A salmonella sp. density that is demonstration to be less than 3 MPN per 4 grams of total dry solids.
AND one of the followings (except for non -biological residuals):
0 Alternative I [ 15A NCAC 02T.1 106(b)(3)(A)] - Time/Temperature Compliance.
E] Alternative 2 [15A NCAC 02T.1 106(b)(3)(13)] - Alkaline Treatment.
Q Alternative 3 [ 15A NCAC 02T.I 106(b)(3)(C)] - Prior Testing for Enteric Virus/Viable Helminth Ova.
Q Alternative 4 [15A NCAC 02T.1 106(b)(3)(D)] - No Prior Testing for Enteric Virus/Viable Helminth Ova.
Q Alternative 5 [15A NCAC 02T.I 106(b)(3)(E)-(K)] - Process to Further Reduce Pathogens (PFRP).
Specify one: n composting, Q heat drying, n heat treatment,
0thermophilic aerobic digestion, Q beta ray irradiation,
C] gamma ray irradiation, or 0 pasteurization.
b. For Land Application of Class B:
Q Alternative 1 [15A NCAC 02T.1106(c)(1)] - Fecal Coliform Density Demonstration.
0 Alternative 2 [15A NCAC 02T.1 106(c)(2)] - Process to Significantly Reduce Pathogens (PSRP).
Specify one: M aerobic digestion, [] air drying, Q anaerobic digestion,
composting, or j lime stabilization.
c. For Surface Disposal:
n Select One of the Class A or Equivalent Pathogen Reduction Alternatives in Item 11. 7a. above.
Select One of the Class B or Equivalent Pathogen Reduction Alternatives in Item II. 7b. above.
El Exempt -If Daily Cover Alternative is chosen in Item [1.8. below [15A NCAC 02T.1106(a)(2)].
0 Not Applicable - Non -Biological Residuals with NO Domestic Wastewater Contribution.
8. Vector Attraction Reduction (VAR): Per 15A NCAC 02T.1 107, specify how residuals will meet the VAR requirements:
Q Alternative I [15A NCAC 02T.1107(a)(1)] - 38% Volatile Solids Reduction (Aerobic/Anaerobic Digestion).
0 Alternative 2 [15A NCAC 02T.I 107(a)(2)] - 40-Day Bench Scale Test (Anaerobic Digestion).
Alternative 3 [15A NCAC 02T.1107(a)(3)] - 30-Day Bench Scale Test (Aerobic Digestion).
} Alternative 4 [15A NCAC 02T.I 107(a)(4)] - Specific Oxygen Uptake Rate Test (Aerobic Digestion).
{ Alternative 5 [15A NCAC 02T.1107(a)(5)1- 14-Day Aerobic Processes.
0 Alternative 6 [15A NCAC 02T.1107(a)(6)] - Alkaline Stabilization.
M Alternative 7 [15A NCAC 02T.1 107(a)(7)] - Drying of Stabilized Residuals.
E] Alternative 8 [15A NCAC 02T.I 107(a)(8)] - Drying of Unstabilized Residuals.
Q Alternative 9 [15A NCAC 02T.I 107(a)(9)] - Injection.
Q Alternative 10 [15A NCAC 02T.I 107(a)(10)] - Incorporation.
Q Alternative for Surface Disposal Units Only - Soil/Other Material Cover [ 15A NCAC 02T.I 107(b)(2)].
0 Not Applicable - Non -Biological Residuals with NO Domestic Wastewater Contribution.
Note: For animal processing residuals, only alternatives 9 or 10 may be chosen due to the nuisance conditions that typically
occur when these residuals are applied and lets on the land surface.
FORM: RSC 06-16 Page 5 of 5

DWR
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
RESIDUALS SOURCE CERTIFICATION
FORM: RSC 06-16
RESIDUALS SOURCE -GENERATING FACILITY INFORMATION (See Instruction B.):
I. Facility Name: Town of Denton
2. Facility permit holder is: 0 Federal, Q State, 0 Local Government, or n Private.
Facility permit issued by: [] Div. of Water Resources, [] Div. of Environmental Health,
or Other (explain: _).
3. Facility contact person and title: Troy Branch
Complete mailing address: PO Box 306
City: Denton
Telephone number: [phone]
State: NC
Zip: 28630
E-mail address: [e-mail]
4. Facility physical address: 300 Councl Access Road
City: Denton State: NC Zip: 27239
Coordinates: Latitude: 35' 37' 16 62" Longitude: 80. 37' 15 62"
Datum: WGS84 Level of accuracy: .01
Method of measurement: MAP
5. Purpose of the facility:
ED treatment of municipal wastewater, n treatment of 100% domestic wastewater,
treatment of potable water, Q treatment of 100% industrial wastewater,
Q treatment of industrial wastewater mixed with domestic wastewater,
(approximate percentages: ,I % industrial and _ % domestic)
n other (explain: ).
6. Does the facility have an approved pretreatment program: 0 Yes Q No
7. Facility permitted/design flow: 0.8 MGD and facility average daily flow: 0_4 MGD
8. Average amount of residuals being generated at this facility 4697 dry tons per year.
9. Specify the following regarding treatment and storage volumes available at the facility:
Type and volume of residuals treatment: Aerobic Digesters 127.355 Gallons
Type and volume of residuals storage (i.e., outside of residuals treatment units):
RESIDUALS QUALITY INFORMATION (See Instruction C.):
I. Specify if residuals are regulated under:
E3 40 CFR Part 503 or El 40 CFR Part 257.
Note: Only residuals that are generated during domestic/municipal wastewater treatment processes are regulated under 40
CFR Part 503, otherwise, the residuals are regulated under 40 CFR Part 257.
2. Specify if residuals are defined under 15A NCAC 02T.1 102(6) as:
0 Biological Fj Non -Biological
Note: Biological residuals are residuals that have been generated during the treatment of domestic wastewater, animal
processing wastewater, or the biological treatment of industrial wastewater (biological treatment is a system that utilizes
biological processes including lagoons, activated sludge systems, extended aeration systems, and fixed film systems).
FORM: RSC 06-16 Page I of 5

3. Hazardous Waste Determination: Complete the following to demonstrate that the residuals are non -hazardous under
RCRA: (Note - this item does not have to be completed for facilities that are less than 0.5 MGD in design flow that treat
100% non -municipal, domestic wastewater only)
a. Are the residuals listed in 40 CFR §261.31-§261.33: El yes no.
If yes, list the number(s):
b. Specify whether or not the residuals exhibit any of the characteristics defined by 40 CFR §261.21-
261.24: Q yes 0 no.
Fill in the following tables with the results of the latest toxicity characteristic leaching procedure (TCLP) analysis as
well as those for corrosivity, ignitability, and reactivity:
Laboratory: Meritech, Inc. and Date of analysis: 1-22-2016
Passed corrosivity test: yes no. pH: s.u. (2 <pH < 12.5)
Passed ignitability test: yes Q no. Flashpoint 200 OF (> 140°F)
Passed reactivity test: Z yes Ono. HCN: OS mg/kg (<250) & H,S: 10 mg/kg (<500)
TCLP Parameter
Limit
(mg/1)
Result
(mg/1)
TCLP Parameter
Limit
(mgR)
Result
(mg/1)
Arsenic
5.0
.01
Hexachlorobenzene
0.13
0.10
Barium
100.0
0.283
Hexachloro-1,3-Butadiene
0.5
0.10
Benzene
0.5
0.01
Hexachloroethane
3.0
0.10
Cadmium
1.0
0.002
Lead
5.0
0.01
Carbon Tetrachloride
0.5
0.01
Lindane
0.4
0.04
Chlordane
0.03
0.003
Mercury
0.2
0.02
Chlorobenzene
100.0
0.01
Methoxychlor
10.0
1.0
Chloroform
6.0
0.01
Methyl Ethyl Ketone
200.0
0.10
Chromium
5.0
0.005
Nitrobenzene
2.0
0.10
m-Cresol
200.0
0.2
Pentachlorophenol
100.0
0.5
o-Cresol
200.0
0.1
Pyridine
5.0
0.10
p-Cresol
200.0
0.2
Selenium
1.0
0.01
Cresol
200.0
0.3
Silver
5.0
0.005
2,4-D
10.0
1.0
Tetrachloroethylene
0.7
0.01
1,4-Dichlorobenzene
7.5
0.1
Toxaphene
0.5
0.05
1,2-Dichloroethane
0.5
0.01
Trichloroethylene
0.5
0.01
I,I-Dichloroethylene
0.7
0.01
2,4,5-Trichlorophenol
400.0
0.10
2,4-Dinitrotoluene
0.13
0.10
2,4,6-Trichlorophenol
2.0
0.10
Endrin
0.02
0.002
2,4,5-TP (Silvex)
1.0
0.10
Heptachlor and its Hydroxide
0.008
0.0008
Vinyl Chloride
0.2
0.02
FORM: RSC 06-16 Page 2 of 5

4. Metals Determination: Complete one of the following tables (i.e., as applicable) to demonstrate that the residuals do not
violate the ceiling concentrations for metals regulated under 15A NCAC 02T .1105.
a. For Distribution/Land Application: Fill in the following table with the results of the latest analyses (i.e., on a dry weight
basis) for the following metal parameters:
Laboratory: Meritech. Inc. and Date of analysis: 6/5/2018
Parameter
Ceiling
Concentration Limits
(ClassA & ClassB)
(mg/kg)
Monthly Average
Concentration Limits
(Class A Only)
(mg/kg)
Result
(mg/kg)
Arsenic
75
41
1.38
Cadmium
85
39
1.08
Copper
4,300
1,500
488
Lead
840
300
19.1
Mercury
57
17
0.262
Molybdenum
75
n/a
2.22
Nickel
420
420
14.1
Selenium
100
100
1.38
Zinc
7,500
2,800
917
b. For Surface Disposal Unit (landfi/D: Fill in the following table with the results of the latest analyses (i.e., on a dry weight
basis) for the following metal parameters:
Laboratory: and Date of analysis:_
Distance from Disposal
Unit to Boundary to
Closest Property Line
(meters, check one)
Arsenic
(mg/kg)
Chromium
(mg/kg)
Nickel
(mg/kg)
> 0 but < 25
30
200
210
> 25 but < 50
34
220
240
> 50 but < 75
39
260
270
Q > 75 but < 100
46
300
320
Q > 100 but < 125
53
360
390
Q > 125
62
450
420
Result (mg/kg)
FORM: RSC 06-16 Page 3 of 5

5. Nutrient/Micronutrient Determination: Complete the following:
a. Total solids: 3.63 %.
b. Fill in the following table with the results of the latest analyses (i.e., on a dry weight basis) for the following nutrient and
micronutrient parameters:
Laboratory: Meritech, Inc. and Date of analysis: 6-5-2018
Parameter
Result
(mg/kg)
Aluminum
11270
Ammon is-N itrogen
10055
Calcium
Magnesium
3440
Nitrate -Nitrite Nitrogen
276
pH (Standard Unit)
7.1
Phosphorus
10800
Potassium
4300
Sodium
5900
Total Kjeldahl Nitrogen
42424
c. Using the results listed in Item 11. 5b. above, calculate the sodium adsorption ration (SAR):
[Note: If residuals contain SAR of 10 or higher, the applicant shall obtain recommendations from the local Cooperative
Extension Office, the Department of Agriculture and Consumer Services, the Natural Resource Conservation Service, a
North Carolina Licensed Soil Scientist, or an agronomist, prior to land application of residuals. The recommendations shall
address the sodium application rate, soil amendments (e.g., gypsum, etc.), or a mechanism for maintaining site integrity
and conditions conducive to crop growth].
d. Specify the mineralization rate to be used in calculating the plant available nitrogen (PAN) of the residuals: 30 %. This
rate is a (check one): 0 default value, or El actually established.
If the residuals are not generated from the treatment of municipal or domestic wastewater, explain or provide technical
justification as to why the selected default value is appropriate to be applied to these residuals: —
e. Calculate the PAN for the residuals (i.e., on a dry weight basis) and fill the results in the following table:
Application Method
First (t") Year PAN
Five -Year
Maximum Adjusted PAN
(mglkg)
(mglkg)
Surface
15014.2
16065
Injection/Incorporation
20041.7
21444
6. Other Pollutants Determination: Specify whether or not there are any other pollutants of concern in the residuals and provide
the results of the latest analyses:
FORM: RSC 06-16 Page 4 of 5

7. Pathogen Reduction: Per 15A NCAC 02T.1106, specify how residuals will meet the pathogen reduction requirements:
a. For Distribution/Land Application of Class A or Equivalent:
A fecal colifor n density that is demonstrated to be less than 1,000 MPN per gram of total dry solids,
or
0 A salmonella sp. density that is demonstration to be less than 3 MPN per 4 grams of total dry solids.
AND one of the followings (except for non -biological residuals):
Q Alternative I [15A NCAC 02T.1106(b)(3)(A)] - Time/Temperature Compliance.
[] Alternative 2 [15A NCAC 02T.1 106(b)(3)(B)] - Alkaline Treatment.
Q Alternative 3 [15A NCAC 02T.I 106(b)(3)(C)] - Prior Testing for Enteric Virus/Viable Helminth Ova.
Q Alternative 4 [15A NCAC 02T.1 106(b)(3)(D)] - No Prior Testing for Enteric Virus/Viable Helminth Ova.
Q Alternative 5 [15A NCAC 02T.I 106(b)(3)(E)-(K)] - Process to Further Reduce Pathogens (PFRP).
Specify one: ❑ composting, 0 heat drying, Q heat treatment,
thermophilic aerobic digestion, beta ray irradiation,
gamma ray irradiation, or Q pasteurization.
b. For Land Application of Class 8:
Q Alternative I [15A NCAC 02T.1106(c)(1)] -Fecal Coliform Density Demonstration.
Alternative 2 [15A NCAC 02T.1 106(c)(2)] -Process to Significantly Reduce Pathogens (PSRP).
Specify one: aerobic digestion, [ air drying, E anaerobic digestion,
composting, or lime stabilization.
c. For Surface Disposal.,
F1 Select One of the Class A or Equivalent Pathogen Reduction Alternatives in Item 11. 7a. above.
Q Select One of the Class B or Equivalent Pathogen Reduction Alternatives in Item 11. 7b. above.
E] Exempt- If Daily Cover Alternative is chosen in Item 11.8. below [15A NCAC 02T.I 106(a)(2)].
r Not Applicable - Non -Biological Residuals with NO Domestic Wastewater Contribution.
8. Vector Attraction Reduction (VAR): Per 15A NCAC 02T.1107, specify how residuals will meet the VAR requirements:
Q Alternative 1 [15A NCAC 02T.I 107(a)(1)] - 38% Volatile Solids Reduction (Aerobic/Anaerobic Digestion).
Alternative 2 [15A NCAC 02T.I 107(a)(2)] - 40-Day Bench Scale Test (Anaerobic Digestion).
Alternative 3 [15A NCAC 02T.I 107(a)(3)] - 30-Day Bench Scale Test (Aerobic Digestion).
Q Alternative 4 [15A NCAC 02T.I 107(a)(4)] - Specific Oxygen Uptake Rate Test (Aerobic Digestion).
Alternative 5 [15A NCAC 02T.1107(a)(5)] - 14-Day Aerobic Processes.
Alternative 6 [15A NCAC 02T.I 107(a)(6)] - Alkaline Stabilization.
n Alternative 7 [15A NCAC 02T.1107(a)(7)] - Drying of Stabilized Residuals.
J Alternative 8 [15A NCAC 02T.I 107(a)(8)] - Drying of Unstabilized Residuals.
Alternative 9 [15A NCAC 02T.I 107(a)(9)] - Injection.
Q Alternative 10 [15A NCAC 02T.I 107(a)(l0)] - Incorporation.
Q Alternative for Surface Disposal Units Only - Soil/Other Material Cover [15A NCAC 02T.1 107(b)(2)].
Q. Not Applicable - Non -Biological Residuals with NO Domestic Wastewater Contribution.
Note: For animal processing residuals, only alternatives 9 or 10 may be chosen due to the nuisance conditions that typically
occur when these residuals are applied and left on the land surface.
FORM: RSC 06-16 Page 5 of 5

Pe
ICI
nY
�My
V - `
e'r
E
c)
_ rAl eisee
J

O
O
rn
110
00
N
U
Z
C
O
+J
C
N
ru
ro
Of
N
v
v
Q
'v
c
O
V
0
0
rn
a-
F-
0
M
C.
A
Cr
1:
N

Clarifiers
Infllent
® Bar Screen
I T)iurcter iunernntnnt
Return Activated Sludge
Pump Station
ci..,toa Aerobic
Digester

WTP Process Flow Narrative:
The Town of Denton's Water Treatment Plant receives its water from the Tuckertown Reservoir
which is in the Yadkin River basin. We have a conventional drinking water treatment plant.
Depending on the quality of the incoming raw water, treatment facilities use a variety of
processes to make the water safe to drink. At our plant workers first add alum, caustic, potassium
permanganate, and when conditions call for it, carbon, to the incoming water. These chemicals
coagulate suspended particles, algae, protozoa, viruses, bacteria, iron and manganese into larger
particles that settle to the bottom of the settling basins. This process also reduces the turbidity as
the water flows through the basins. Water then comes to the entrance of the filters, (if plant
operations are optimized, the turbidity entering the filters is at 10% of the original raw water
turbidity entering the plant). Facility workers then add chlorine into the water, on top of the
filters, to kill bacteria, viruses, and protozoa. This chlorine then goes through the filters, keeping
the filters free from bacteria. Next, they use activated carbon filters to remove organic
compounds and any suspended particles still in the water. After filtration, chlorine is added again
to satisfy any demand on chlorine by the water, (to keep within the regulations set forth by the
State and E.P.A.) and kills any remaining bacteria that may have entered the water during the
filtration process.
The next step is the addition of phosphates to help to control the corrosion that happens in
every distribution system (Water + metals = corrosion). The final step involves adjusting the
water's pH level to limit corrosion in the public water system and, in some communities, adding
fluoride to help fight tooth decay in the population. We do add Fluoride at an average of 1.0
ppm. During the whole treatment process, the plant operators constantly monitor the water
moving through the treatment plant, and its various different processes. After the water has gone
through the treatment process, there is a solids waste (Alum Sludge) that is produced and has to
be removed and disposed of in accordance with our discharge permit.

Quantitative Justification for Residuals Production Rate
The Town of Denton has produced the following Dry Tons in the past 5 years:
2018 54.11
2017 18.85
2016 51.28
2015 50.22
2014 60.41
This averages to 46.97 Dry Tons per year: which is less than the requested Dry Tons allowed by
the permit.

TOWN OF DENTON, NC
WWTP SAMPLING PLAN
WQ0016966
Annually, if a land application event occurs, grab samples are collected from the aerobic
digester. Samples from the digester will be combined to form individual grab samples to be sent
to a laboratory for analysis. If a land application event is to occur in the early part of a calendar
year (i.e. January or early February) these samples may have to be taken in December so results
can be obtained before the land application event, as some results take 30+ days to receive.
These individual grab samples are collected and tested for nutrient analysis and pH
monitoring to meet the requirements of Alternative 6, Alkaline Stabilization. These tests will be
taken by Troy Branch of the Town of Denton. All samples will be taken to Meritech, Inc. All
samples taken will be taken in the same condition as the residuals are to be land applied.
The volatile solids and fecal coliform will be achieved using sufficient alkaline to meet
option 6 [503.33(b)(6)], commonly known as lime stabilization.
Annually, if land application occurs, a composite residual sample will be analyzed, prior
to a land application event for:
Cadmium, Copper, Lead, Mercury, Molybdenum, Nickel, Selenium, Zinc, Aluminum,
Ammonia Nitrogen, Calcium, Nitrate Nitrogen, Magnesium, % total Solids, pH, Phosphorus,
Potassium, TKN, Sodium
From this information, the Plant Available Nitrogen (PAN) and a Sodium Absorption
Ratio (SAR) will be calculated. This sample will collected in a non -breakable container, at least
one quart in size. This sample will be taken from the aeration tank.
Once per permit cycle, a Toxicity Characteristics Leaching procedure (TCLP) analysis as
well as an ignitability, corrosivity, and reactivity test shall be done.

Town of Denton WTP
SAMPLING PLAN
Annually, if a land application event occurs, grab samples are collected from the holding pond.
Samples from the pond will be combined to form individual grab samples to be sent to a laboratory for
analysis. If a land application event is to occur in the early part of a calendar year (i.e. January or early
February) these samples may have to be taken in December so results can be obtained before the land
application event, as some results take 30+ days to receive.
These individual grab samples are collected and tested for nutrient analysis, and a TCLP test.
These tests will be taken by Southern Soil Builders, Inc. All samples will be taken to Statesville Analytical.
All samples taken will be taken in the same condition as the residuals are to be land applied.
Annually, if land application occurs, a composite residual sample will be analyzed, prior to a land
application event for:
Cadmium, Copper, Lead, Mercury, Molybdenum, Nickel, Selenium, Zinc, Aluminum, Ammonia
Nitrogen, Calcium, Nitrate Nitrogen, Magnesium, % total Solids, pH, Phosphorus, Potassium, TKN,
Sodium
From this information, the Plant Available Nitrogen (PAN) and a Sodium Absorption Ratio (SAR)
will be calculated. This sample will collected in a non -breakable container, at least one quart in size. This
sample will be taken from the digester.
Once per permit cycle, a TCLP test will be ran.

h 1C E
N C b
M tG
N '
E m
M
m
C
u o G
O N
N
d
OJ
O
m 91 3
N N
s MQ
N
m o
0
3
E d
O
L
O
O
� N
p0
a U
z
a
F
-
E Y o m
d o
m
r
e
d
E
a
E
o d e o
D
�
m ❑ W fC
d
�
Z
d
6
U
a
d
Z
Y
~ U Z
O U m
O N
v a = o ❑ o ❑ ❑ o ❑ ❑ ❑ ❑ ❑ Z
N to Z O_ O O O O O O O O O p Q LL
N N O 0 0 0 0 0 0 0 0 0 0 0 � ❑ O
p (O (O (p (D t0 (p (O (p (D (D (O U Z
� � V
(A �
r o m m m m m m m co m m m o 0 A N O lA N N In N N N y {U N UJ O O N
Oi of of 66 vi 6
a rn rn rn rn rn rn rn rn rn rn rn m m m m rn
V N N N N N N N N N N N N N N N N
J O V M m m m M M M V fh M m lA V V h m O O O O O O O O O O O O O O O
o m rn rn rn rn rn rn rn rn rn rn rn rn m rn rn J o 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
❑ a r- F- F- F- r t- t- H F- am
0 0 0 o D o m
0 YO') N O iA t0
0
o m m o m ro v m
rn
m
O C
d
Z o Z
L « N
E 3 w z c
E d m z z
d d L E N J C c U
O«
0 o s o m m o o m o c E d
F- a a m u 2 U) Q U g Q 0 Z

M tD
N H N
� O�
N o
O
D
O
0
�
m
�
�
0
�
Z•
0 3
f0
3
e
a a
a
of
of
of
rn
of
o
rn
of
t �
� p
o.
o
3 10
N��
rn
rn
rn
rn
rn
rn
rn
rn
rn
%:—
'+
d
rn
rn
rn
rn
rn
rn
rn
rn
m
F
o
0
0
0
0
0
0
0
o
m
c
D
0
N
a
N
^
Q
N
b
Q
Z
O
v
LJL
O
N
N
O
O
O
N
N
N
(h
N
O
N
N
O
Q
z
a
o
N
o
V
N
m
m
N
V
V
O
a
�
E
N
N
�
T
C
a
0
a
O
O
t
C
'O
N
N
O
a
m
U
X
�
N
m
f6
D
N
f0
t
Y
C
O
N
N
rn
m
a
`o
�
f/I
E
Y O
rn
c
a
v
ch
E
c
C
E
p
d
'c
o
2
f
D
T
a
E
O o
c
a
y
a
,�
a
m
z
Q
U)
n
a

0
0
01
jn
p�
u
u
u
h
u
N
N
O
O
N
O
O
O
x
x
Z
m
m
N
_Y
m
m
O
E
Z
E
z
+
Cl)
O
M
Z
_
Z
+
M
N
2
+
z
M
rj
z
z
Y
Y
H
H
Z
Q
d
cu
m
0
0
0
c
0
0
0
O
0
N
m
LL
O
2
ae
as
N
a�
I
d tJ6
d d
d
«
«
� c
N

SAR
Sodium Absorption Ratio
Na: Sodium (Mg/L) Equivalent weight: 23
Ca: Calcium (Mg/L) Equivalent weight: 20
Mg : Magnesium (Mg/L) Equivalent weight: 12
Milli Equivalent = Mg/L / Equivalent weight
Na M /L
Ca M /L
M M /L
14.22
1 134.59
1 68.49
Na ME
(ME)
0.618261
6a2MEMo
The amour
SAR= Na Milli Equivalent/[0.5 X (Ca Milli Equivalent + Mg Milli equivalent)]0.5 power amount of t
SAR = —0 24793 (From Mg/L entered above) Permitting
SAR= 0,247905 (From ME entered below)
NaMCaME Mg (E
0.618 M
6

1
Analytical Results
Southern Soil Builders
958 Hoots Road
Roaring River, NC 28669
Receive Date: 03/14/2016
Reported: 03/30/2016
For: Denton WTP
Comments:
Sample Number
Parameter
Sample ID
Result
160314-14-01 Fecal Coliforms
1
Unit
Method
Analyzed
Analyst
160314-14-01
Percent Solids
1
<2,667
MPN/g
SM92210E-2006
03/14/2016
WL
160314-14-02
p
Fecal
2
0.75
%
SM25408-1997
03/14/2016
WL
160314-14-02
Percent Solids
2
<8,696
MPN/g
SM92210E-2006
03/14/2016
WL
760314-14-03
Fecal Coliforms
3
0.23
%
SM25408-1997
03/14/2016
WL
160314-14-03
Percent Solids
3
<6,060
MPN/g
SM92210E-2006
03/14/2016
WL
160314-14-04
Fecal Coliforms
q
0.33
%
SM25408-1997
03/14l2016
WL
160314-14-04
Percent Solids
q
<3,125
MPN/g
SM92210E-2006
03/14/2016
WL
160314-14-OS
Fecal Colifonns
5
0.64
%
SM25408-1997
03/14/2016
WL
160314-14-05
Percent Solids
5
<2,247
MPN/g
SM92210E-2006
03/14/2016
WL
160314-14-06
Fecal Coliforms
6
0.89
SM2540B-1997
03/14/2016
WL
160314-14.06
Percent Solids
6
<3,846
MPN/ 9
SM92210E-2006
03/14/2016
WL
160314-14-08
Corrosivity
Denton WTP
0.52
See
SM2540B-1997
03/14/2016
WL
Attached
SW-846
03/14/2016
PACE
160314-14-08
Igrlitability
Denton WTP
See
1010M
Attached
03/14/2016
PACE
160314-14-08
Reactivity
Denton WTp
See
SW-846
Attached
03/14/2016
PACE
160314-14-08
TCLP
Denton WTP
See
as Noted
03/14/2016
PACE
Attached
Respectfully submitted,
Dena Myers
NC Cert #440,
NCDW Gen 93TT55,
EPANNC00909
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 1 of 1

s
aceAnalytical Pace Analytical servicN Ine
'""wNcareAtoam 9800 Kinsey Ave. Suite 100
Humersville, NC 28078
[phone]
ANALYTICAL RESULTS
Project: 160314-14-08
Pace Project No.: 9229DO83
Sample: 160314-14.08
Lab ID:
92290083001
Collected:
Parameters
03/14/1607:45
Received; 03/15/1610:00 Matrix: Water
Results
Units
Report Limit
OF
Prepared Analyzed
8270 MSSV TCLP Sep Funnel
y CAS No. Qual
Ma
Analytical Mathod: EPA 8270 Preparation
Method: EPA
Leachate Method/Date: EPA 1311; 03/26/16
3510
Hexachloro- 1,3-butadiene
14:00
Hexachlorobanzene
NO
NO
ug/L
ug/L
50.0
1
03128/1611:25 03/28/16 17:40 87-68.3
HexaChlomethane
2-Methylphenol(o-Cresol)
NO
ug/L
50.0
50.0
1
1
03/28/16 11:25 03/28/16 17:40 118-74.1
03/28/16
3&4-Methylphenol(m&p Cresol)
ND
ug/L
50.0
1
11:25 03/28/16 17:40 67-72-1
03/28/16 11:25
Nitrobenzene
NO
NO
ug/L
50.0
1
03/28/16 17:40 95-48-7
03128/1611:25 03/28/1617.40
Pentaohlorophenol
NO
ug/L
ug/L
50.0
1
03128/1611:25 03/28/16 17:40 98-96-3
Pyridine
NO
ug/L
100
1
03/28l1611:25 03/28/1617:40 87-86-5
2,4,5-Trichlorophenol
NO
ug/L
50.0
1
03l28/161L25 0328/1617:40 110.865
Surrogate orophenol
Surrogates
N2
u%
50.0
50.0
1
03/28/1611;25 0328/1617:40 95-95-4
Nitrobenzene-d5 (S)
1
03/28/16 11:25 03728/16 17:40 88-06-2
2-Fluorobiphenyl (S)
72
74
%
12-102
1
03/28/16 11:25 03/28/16 17;40 4165-60.0
TerphenylEl4(S)
99
%
13-107
1
03/28/16 11:25 032811617:40 321-60.8
Phenl(S)
26
%10.110
21-132
1
03/2811611:25 0312811617:40 1718-51-0
2-Fluorophenol (S)
40
%
1
03/28/1611:25 0328/1617:40 13127-88-3
2,4.6-Tribromophenol (S)
63
%
10-110
1
03/28/16 11:25 03/28/16 17:40 W7.12-4
8260 Ill TCLP
27-108
1
03/28/16 11:25 03/28/16 17:40 118-79-6
Analytical Method: EPA 8260
Leachate Method/Date:
EPA 1311; 03/16/16 10:42
Benzene
2-Butanone (MEK)
NO
NO
ug/L
ug/L
100
20
03/22/16 00:31 71-43.2
Carbon tetrachloride
NO
ug/L
200
20
03/22/16 00:31 78-93-3
Chlorobenzene
NO
ug/L
100
20
03/22/16 00:31 56-23.5
Chloroform
NO
ug/L
100
20
03/22/16 00:31 108-90-7
1,4-Dichlorobenzene
ND
ug/L
100
20
03122/1600:31 67-66-3
1,2-DiChlorpethane
NO
ug/L
100
20
03/22/16 00:31 106.46.7
1,1-Dichioroethene
�
100
20
0322/16 00:31 -2
Tetradlloroethene
ND
ug/L
100
100
20
03/22/16 00:31 75-35- 4
Teich(Droe*Iene
NO
ug/L
100
zo
o3/z2ns 00:31 z7-16-4
127-1
Vinyl chloride
NO
ug/L
100
20
20
03/22/16 00:31 79-01.6
Sunogazes
03/22/16 00:31 75-01-4
1,2-DiCllloroetl18ne-04(S)
Toluene-d8 (S)
107
%
70-130
20
03/22/1600:37 770fi0-07-0
4-BromoBuorobenzene (S)
98
99
%
%
67-135
70.130
20
03/22/16 00:31 2037-26-5
20
03/22/16 00:31 460-004
Wit FlasApdel,Clee.d Cup
Analytical Method: EPA 1010
Flashpoint
>200
deg F
70.0
1
03/27/16 12:15
9045 pH Sal
Analytical Method:
EPA 9045
pH at 26 009raca C
6.8
Std. Units
0.10
1
03/18/16 14:35 H6
9095 Paint FOW Liquid Test
Analytical Method: EPA 9095
Free Laft
FAIL
1.0
1
03/17/16 14:40
Date: 03129i 04:40 PM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in tul,
without the written consent of Pace Analytical Sarvkes, Inc..
Page 5 of 26

s
aceAnalXical Pace Analytical Servicq, Inc.
ewwpra SUcca, 9800 Kincey Ave. Suite too
r Hurxersville, NC 28078
(704)8759092
ANALYTICAL RESULTS
Project: 160314-14-08
Pace Project No.: 92290083
Sample: 160314,14-08
Lab ID: 92290083001 umected: 03/1411607:45 Received:
Parameters
Results
03/15/1610:OD Matrix: Water
Units Report Limit OF Prepared
P Analyzed_ CAS No.
6081 GCS Pesticides, TCLP
Analytical Method; EPA 8081 Preparation
�-- Qual
Method:
Leachate Method/Date: EPA 1311: 03/26/16
EPA 3510
gamma-BHC (Lindane)
14:00
Chlordane (Technical)
NO ug/L 0.50 1
NO ug/L
03/28/16 12:50 03/28/16 18:37 58-89-9
Enddn
3.0 1
NO ug/L
03/28/1612:50 03128/1618:37 57.74-9
Heptachlor epoxide
0.50 1
NO ug/L
03/28/16 12:50 03/28/16 18:37 72-20-8
Methoxychlor
Toxaphene
0.50 1
NO ug/L 1000
03/28/16 12:50 03/28/16 18:37 1024-57-3
Surrogates
1
NO ug/L 3.0 1
03/2811612:50 03/28/16 18:37 72-43-5
Decachlorobiphenyi (S)
03/28/16 12:50 03/28/16 18:37 8001-35.2
(S)
50 %Tetrachlorobipheene 10-138 1
75 %
03/281161250 03/29/1618:37 20j1-24-3
8082 GCS PCB
10-110 1
03/28/16 12:50 03/28/16 18:37 877-09-8
Analytical Method: EPA 8082 Preparation Method: EPA
3510
PC13-1016 (Arodor 1016)
PCB-1221(Arodor 1221)
Nug/L 0.50 1
NDO ug/L
03/1811609:07 03/18/16 20:26 12674-11-2
PCB-1232 (Arodor 1232)
0.50 1
NO ug/L
03/18/16 09:07 03/18/16 20:26 11104-28-2
PCB-1242 (Arodor 1242)
0.50 1
NO ug/L
03/18/16 09:07 03/18/16 20:26 11141-16-5
PCB-1248 (Arodor 1248)
0.50 1
NO ug/L
03/18/16 09:07 03/18/16 20:26 53469-21-9
PCB-1254 (Arodor 1254)
0.50 1
Nug/L
03/18/16 09:07 03/18/16 20:26 12672.29-6
PCB-1260 (Arodor 1260)
0.50 1
NDO ug/L
03/18/16 09:07 03/18/16 20:26 11097-69-1
Surrogates
0.50 1
03/18/16 09:07 03/18/16 20:26 11096-82-5
Decachloroblphenyl (S)
45 %
10-132 1
03/18/16 09:07 03/18/16 20:26 2051.24.3
81 Si Chlorinate Herbicide TCLP
Analytical Method: EPA 8151 Preparation Method: EPA 3510
2,4-D
2,4,5-TP (Sivex)
NO mg/L 0.010 1
NO
03/24/16 12:55 03/26/16 02:58 94-75.7
Surrogaw"
mg/L 0.010 1
03/24/16 12:55 03/26/16 02:58 93-72-1
2,4-DCAA(5)
99 % 42-142 1
03/2411612:55 03/26/16 02:58 19719-28-9
6010 MET ICP, TCLP
Analytical Method: EPA 6010 Preparation Method: EPA 3010A
Leaohate Method/Date: EPA 1311; 03/22/16 03:00 Initial pH: 5; Final pH: 5
Arsenic
NO m9/L 0.050 1
03/23/16 03:00 03/23/16 13:57 7440-38-2
eadum
NO mg/L 0.25 1
03/23/16 03:00 03/23/16 13:57 7440-39-3
cadmum
NO mg/L 0.0050 1
03/23/16 03:00 03/23/16 13:57 744043-9
Chrornium
NO mg/L 0.025 1
03/23/16 03:00 03/23/16 13:57 7440-47-3
Lead
NO mg/L 0,025 1
03/23/16 0100 03/23/16 13:57 7439.92-1
Selenium
NO mg/L 0.10 1
03/23116 03:00 03/23/16 13:57 7782-49-2
Silver
ND mg/L 0.025 1
03123/1603:00 03/23/16 13:57 7440-22-0
7470 Mercury, TCLP
Analytical Method: EPA 7470 Preparation Method: EPA 7470
Lwchate Method/Date: EPA 1311: 03/22/16 03:00 Initial pH: 5; Final pH: 5
Mercury
NO mg/L 0.00020 1
03/23/16 11:00 03/23/16 14:15 7439-97-6
8270 MSSV TCLP Sep Funnel
Analytical Method: EPA 8270 Preparation Method: EPA 3510
Lwchate Method/Date: EPA 1311: 03/26/16 14:00
1,4-Ddlomberizene
NO, ug/L 50.0 1
03/28/1611:25 03/28/1617:40 106.46-7
2,q&Sgohlene
NO ug/L 50.0 1
03/28/16 11:25 03/28/16 17:40 121A4-2
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced. except ie rul.
1604.40 PM w1 outlhe wnban consent d Pace Anaty kal 5eN ces. Inc.. Page 4 of 25
Ds1� R1f19fA

aceAnapical
avw.PsoNrbs.mrrl
Project 160314-14-08
Pace Project No.: 92290083
SamPle: 160314.14-08
Parameters
733C Reactive Cyanide
Cyanide, Reactive
734E Reactive Sulflde
Sulfide, Reactive
DM. Wn(2016 04'.40 PM
ANALYTICAL RESULTS
t-ab ID: 92290083001 Collected: 03/14/16 07:
Results Units Report Limit DF
Analytical Method: SW-846 7.3.3.2
ND mg/L 0,010 1
Analytical Method: SW-846 7.3.4.2
ND mg/L 1.0 1
ecerved: 03/15/16 10:00
Prepared Analyzed
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced. except. in fuB.
without the written consent of Fare Anahhcal Services. inc..
Pace Analytical Services, Ind.
9800 Kincey Ave. Suite too
Huntersville, NC 28078
[phone]
Matrix: Water
CAS No. Qual
03/21/16 21:40
03/21/16 18:20
Page 6 of 25

Meritech, Inc.
Environmental Laboratory
-.?
Laboratory Certification No. 165
Contact: Mr. Troy Branch
Client: Town of Denton
Report Date:
6/5/2018
P.O. Box 306
Denton, NC 27239
NPDES#:
NCO026689
Project#:
Sludge 2018
Date Sample Rcvd:
5/25/2018
Meritech Work Order # 05251848
Sample:
Sludge/Digester #2 Grab
Parameters
5/25/2018
R sult
Analysis ate
Reuort�mit
to
%Solids
Ammonia, Nitrogen
TKN
10055 m h
5/25/18
0
0.0 /o
SM 25408
Nitrate/Nitrite, Nitrogen
42424 mg/kg
S 29 18 6/1/18
/ /
10 mg/kg
20 mg/kg
EPA 350.1
Aluminum, total
276 mg/kg
71270 mk
g/
5/31/1B
31.3 mg/kg
EPA 351.1
EPA 353.2
Arsenic, total
Cadmium, total
d
<1.38 mg/kg
5/30/18
5/30/18
2.50 m
mg/kg g
EPA 200.7
Chromium, total
1.08 m k
g/ g
24.8
5/30/18
1.38 mg/kg
0.398 mg/kg
EPA 200.7
Copper, total
m k
466 mg/kg
g/
5/30/16
0.250 mg/kg
EPA 200.7
EPA 200.7
Lead, total
Magnesium, total
g
19.1 nrg/kg
3440
5/30/18
5/30/18
1.00 m k
g/ g
1.99 mg/kg
EPA 200.7
Mercury, total
m k
0 262 mg/kg
g/
5/ 8
10.0 mg/kg
EPA 200.7
EPA 200.7
1lolybdenum, total
Nickel, total
g
2.22 m k
6/5/18
5/1
5/30/18
0,154 mg/kg
EPA 245.1
Phosphorus. total
14.1 mg/kg
10800 tng/kg
g/
5/30/18
3.84 mg/kg
2.0 rng/kg
EPA 200.7
EPA 200.7
Potassiu±n, total
Selenium. total
g
Ong/kg
5/30/18
5/30/18
2.00 nrg/kg
20.0 mg/kg
EPA 200.7
Sodium, tots;
<1.38
5900 mg/kg
5/30/18
1.38 mg/kg
EPA 200.7
EPA 200.7
Zinc, Eota
Cyanide, total
917 mg/k8
5/30/18
5/30/18
20.0 mg/kg
O.SOO mg/kg
EPA 200.7
EPA
Sulfide
<1 nrV 'O
<27 mg/kg
5//18
/29/18
13.6 mg/kg
200.7
EPA 335.4
Ignitabait
>140 of
5/31/18
275 mg/kg
SW8469038
Corrositi,-ty(pH,
7.1 S.U.
5/26/18
-
1.0 - 14.0 S.U.
EPA 1030
SM 4500 HB
/hereby certify that 1 have reviewed and approve these data. 7 //'
Laboratory Representative
6421'amco Road, Reidsville, North Carolina 27320
tel.[phone]fax.[phone]

M
m
0
0
0
0
N
c
c
O
O
O
p
N O
T
r
X N
Y
'0
Y
D
N
E
II
E
N
II
II
II
O N
O O
O
X x
rn N m
O
rn rn
E M E
O
Z
co
2
Z
co
2
Z
Z
Y
F-
ry
Z
IL
o
-
o
0
0
o
"
Lo
z
Z
¢
a N
s
H
Lo
a s
a
m u
R m
00

Meritech, Inc.
Environmental Laboratory
Laboratory Certification No.165
Contact: Mr, Troy Branch Page 2
Client: Town of Denton Report Date: 11/22/2016
P.O. Box 306 NPDES#; N00026689
Denton, NC 27239 Project#: October 2016
Date Sample Rcvd: 10/25/2016
Meritech Work Ord #
er
10251692
Sample: Digester Grab
10/25/2016
1311 - TCLP Metals
Pat ameter
Results
Anal_vs�
Arsenic
Pet, Limit Re Lim!
— —�
M—elhod
Barium
Cadmium
<0.010 rng/L
0.283 mg/L
11/10/16
11/10/16
/ /16
0.010 5,0
EPA 200.7
Chromium
<0.002 m L
11/10/16
00.
0.002 11.0
0.002 1.0
EPA 200.7
Lead
<0.005 mg/L
g/
11/10/16
0.005 5.0
EPA 200.7
Mercury
<0.010 mg/L
11/1D/16
0.010
EPA 200.7
Selenium
<0.02 mg/L
11 1 16
002 0.2
EPA
Silver
<0.010 mg/L
11/10/161007
0,010
EPA 2245.
.1
<0,005 m g/L
11/10/16
.0
0.005 5,0
EPA 200.7
EPA 200.7
TCLP Or anics
u me a
Results
Altalvsis Date
R Morttl,a r,l..c«
Method
Volatiles 8260
Semi Vol, 8270
Attached
11/2/16
Attached
11/3/16
8260
8270
Other Tests
Parameter
Results
Analysiste
Renortis lml
1Vlethod
Cyanide, total
Sulfide
<10.0 mg/kg10/28/16
010.0
EPA 335.4
Ignitability
Will Not Ignite
11/4/16
g/ g
mg/
SW 846 9038
Corrositivity(pH)
5.4 S.U.
11/7/16
1.0 - 14.0 S.U.
EPA 1030
SM 4500 HB
642 Tamco Road, Reidsville, North Carolina 27320
tel.[phone] fax.[phone]

Meritech, Inc,
._ Environmental Laboratory
Laboratory Certification No.165
Contact: Mr. Troy Branch
Client: Town of Denton
Report Date:
Page 3
P.O. Box306
NPDES#:
11/22/2016
NCO026689
Denton, NC 27239
Project#:
October2016
Date Sample Rcvd:
10/25/2016
Meritech Worlt Order #
10251692
Sample; Digester Grab
10/25/2016
1311 - TCLP Pesticides & Herbicides
Re-Aicide - SW-8� lA
ParaMeter
Results
Analysis Date
peLimit imit
Dilution_ Factor
Endrin
Chlordane
<0.002 mg/L
<0.003 m L
g/
11 3-5 16
/ /
0.002 0.03
_
1
Toxaphene
Methoxychlor
<0.050 mg/L
11/3-5/16
11/3-5/16
0.050 0.5
0.050
1
Heptachlor
<1,00 mg/L
<0.0008 mg/L
11/3-5/16
1.0010.00 5
1
1
Lindane
<0.040 mg/L
11 3-5 16
/ /
11/3.5/16
O.000II 0.008
1
0.040 0.4
1
Flerbicides - W g�,
Parameter
Results
AItalYs_ t�& 12et. Liml Reg, Limit
Dilution�ttor
2,4-D
2,4,5-TP (Silvex)
<1.00 mg/L
<0.100 m K/L
11/3-5/16
1.00 10.0
1
11/3-5/16
0.100 1,0
1
I hereby certify that I have reviewed and approve these data. it
Laboratory Representative
6421'amco Road, Reidsville, North Carolina 27320
tel.[phone] fax,[phone]

MERI TECH, /NC.
Environmental Laboratories
A Division of Water Technology and Controls, Inc.
Client: Town of Denton
Project: October 2016
Client Sample ID: Digester
Sample Collection: 10/25/16
Meritech Sample ID; 10251692
1311 - TCLP Organics
VOlatiles• SW-846 8260
Analysis: 11/02/16 Date Extracted: 10/27/16
Analyst: VWV
Parameter
Result
units
Det. Limit
Reg, Lintit
Dilution Factor
Benzene
<0.0100
mg/L
0.0100
0.50
Carbon Tetrachloride
<0.0100
m
0.0100
10
Chlorobenzene
< 0.0100
nr 1,
mg/L
�
0.0100
100
100
10
Chloroform
<0.0100
mg/L
0.0100
6.0
10
1,2-Dichloroethane
<0.0100
mg/L
0.0100
0.50
10
1,1-Dichloroethene
< 0,0100
m L
00
10
Methyl Ethyl Ketone
<0.100
mg/L
B/
0.1
0.100
200
200
10
Tetrachloruethylene
< 0.0100
mg/L
0.0100
0.70
10
Trichloroethene
< 0.0100
mg/L
0.0100
0.50
10
Vinyl Chloride
<0.0200
mg/L
0.020
0.20
10
10
Semi-Volatiles: SW846 8270
Extraction: 10/31/16
Analysis: 11/03/16
Analyst:
PM
Parameter
Result
Luits
Det. Limit
Reg. Limit
Dilution Factor
1,4-Dichlorobenzene
<0.100
mg/L.
0.100
7.5
10
Hexachlorobenzene
<0.100
mg/L
0.100
0.13
10
Hexachlore-1,3-buladiene
<0,100
mg/L
0.100
0.5
10
Hexechlomethane
<0.100
mg/L
0.100
3.00
10
o-crewl
<0.100
mg/L
0.100
200
10
rn&;, r )
<0.200
mg/L
0.200
200
10
Total cresols
<0.300
mg/L
0,300
200
10
Nitrobenzene
<0.100
mg/L
0.100
2.00
to
Pentachloro*!nol
<0.500
mg/L
0.500
100
10
Pyridine
<0.100
mg/L
0.100
5.0
10
2,4,5-Trichlorophenol
<0.100
nig/L
0,100
400
10
2,4,6-Tridtlorophenof
<0.100
mg/L
0.100
2.00
10
2,4-Dinitrotoluene
<0.100
nrg/L
0.100
0.13
10
I hereby eertlly that I have reviewed and approve these data,
Laboratory Representative
642 Tarneo
Road * Reidsville, NC 27320
[phone] Ph * [phone] Fax

rku
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
LAND APPLICATION SITE CERTIFICATION
INSTRUCTIONS FOR FORM: LASC 06-16
Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted the Applicant shall submit one original and two copies of the application and
supporting documentation
For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting Unit
General — This certification provides detailed information of receiving sites for land application of Class B residuals (may include
water treatment plant or other type residuals) in accordance with 15A NCAC 02T .1100. Do not submit this certification for review
without a corresponding application form (FORM: RLAP 06-16 or FORM: SDR 06-16).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Land Application Site Certification (FORM: LASC 06-16):
❑ Submit the completed and appropriately executed Land Application Site Certification (FORM: LASC 06-16) form. Please
do not make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments
to the application may be made, as long as the attachments are numbered to correspond to the section and item to which they
refer.
❑ For new or renewed permits, submit the requested information for all land application sites.
❑ For modified permits, submit the requested information for only those sites that are new, transferred or affected by the
proposed modification.
B. Land Application Site Information:
❑ The status of the land application site with respect to this residuals land application program must be provided in table I. The
status categories and their corresponding codes are as follows:
♦ New (N) ♦ Renewed (R) ♦ Modified (M) ♦ Transferred (T) ♦ Deleted (D)
❑ Attach the following in accordance with each status code:
Status Code
Required Item
N
R
T
M
County Board
Notification.doc
Inv A
Land Owner
Agreement
able)
(If applic)
t"
-'
✓
✓
✓
✓
�l
Setback Waiver
Agreement
An updated vicinity/setback map in accordance with the ",Map,, Guidance
✓
✓
for Residuals Land Application Permits"
✓
A soils and agronomic evaluation in accordance with the "Soil Scientist
✓
Evaluation Policy"
INSTRUCTIONS FOR FORM: LASC 06-16 Page I of 3

An updated accounting of the land application site's cumulative
Dollutant loading rates (CPLRs)
Status Code
Required Item N TrT M
For previously permitted sites without a soil series name indicated in the
Attachment B, submit County Soil Survey Map (or equivalent) clearly
indicate the location of the land application site and in accordance with
the soil map requirements in the "Soil Scientist Evaluation Policy"
Acknowledgement of field transfer from Land Owner (Fields may not
be permitted to multiple Permittees over the same timeperiod)
' This item may be required for land application site with a status code "M", please contact the Division if you need assistant in
determining attachment requirements.
❑ Crop Type should include the most likely crop types for the life of the permit (five years).
❑ Predominant Soils Series Name must be either the name of the soil indicated in Attachment "B" of the existing permit, or
name of the soil series as provided by the licensed soil scientist.
❑ Predominant Soil Mapping Unit or Representative Slope: Either the Soil Mapping Unit or the representative slope of each
site must be provided. The predominant soil -mapping unit must be consistent with the predominant soil series name. Please
note that the soil mapping units are variable between Counties, so care should be taken in properly identifying the correct
mapping unit. If a representative slope is provided, it must be determined accordingly:
❑ For sites previously permitted for use, but do not have an established soil mapping unit (the mapping unit provides
information on both the soil series name and the slope of the soil), the Applicant may determine the representative slope
by using the average slope provided in the County Soil Survey (or equivalent). A soil type with a slope range of 4 - 8%
would have a representative slope of 6%.
❑ New Sites to be permitted must have slopes determined as part of the soils report prepared by a licensed soil scientist.
❑ Acceptable methods for determining location coordinates (i.e., latitude and longitude) and their corresponding codes are as
follows:
• Address Matching (ADD) • Digital or Raw Photo Extraction (EXT)
• Aerial Photography with Ground Control (AER) • Geodetic Quality GPS Survey (GEO)
• Cadastral Survey (SUR) • LORAN-C Navigation Device (LOR)
• Conversion from Coordinate Plane (CP) • Navigation Quality GPS (GPS)
• Conversion from Township -Section -Range (TSR) • Remote Sensing (RS)
• Conversion from Universal Trans Mere (UTM) • Zip Code Centroid (ZIP)
• Map Interpretation by Digital or Manual Extraction (MAP)
C. Waterbody and Classifications Information: (new sites only)
❑ Use an 8.5 by I I -inch copy of the portion of a 7.5-minute USGS Topographic Map to identify the location where the
residuals program activities are planned to occur as well as the closest downslope surface waters as clearly as possible. Each
map portion must be labeled with the map name and number, the identified location, and be of clear and reproducible quality.
❑ Surface water body classifications information may be found at: httn://deci.nc.rov/abouUdivisions/water-
resources/plann ing/classi fication-standards/classifications
❑ Any questions concerning the waterbody and its classification, please contact the Division's regional offices.
❑ A list of the Division's regional offices, their county coverage, and their contact information may be downloaded at:
http://deq.nc.gov/contact/regional-off'ices
❑ General Instructions: There are 17 river basins in North Carolina. Each basin has associated waterbodies with assigned
subbasins, location descriptions, stream index numbers and established classifications.
I. Identify the project area on a 7.5 minute USGS topographical map (an 8.5 x I ]-inch sheet showing the project area
should be submitted with the permit application regardless of whether a Stream classification was completed).
2. Determine the names of all the closest down slope surface waters from the project site. For unnamed tributaries, see
Table I: Unnamed Tributaries Entering Other States or for Specific Basin Areas. Label any unnamed tributaries as
"UT to stream name" as the waterbody name.
3. Open the link http //deg.nc.gov/abouUdivisions/water-resources/planning/classification-standards/classifications.
❑ Stream Classification Process: One of the options below may be used depending on the known initial project information.
❑ KNOWN BASIN WHERE CLOSEST DOWN SLOPE SURFACE WATER IS LOCATED
I. Select proper basin from the List all Waterbodies in Basin sorted report. Sort hydrologically as this will provide
the proper location descriptions if multiple runs.
INSTRUCTIONS FOR FORM: LASC 06-16 Page 2 of 3

2. Locate the name of the identified waterbody (from General Directions) on the list.
3. For multiple listings of the same waterbody name in the report, select and verify the location description. The term
"source" in the description means the beginning of the waterbody segment (most upstream point).
4. Record all Basins, Stream Index Numbers and Classifications applicable to the project.
❑ KNOWN COUNTY WHERE CLOSEST DOWN SLOPE SURFACE WATER IS LOCATED
I. Select the proper county from the List all Waterbodies in county, hydrologically report.
2. Locate the name of the identified waterbody (from General Directions) on the list.
3. For multiple listings of the same waterbody name in the report, select and verify the location description. The term
"source" in the description means the beginning of the waterbody segment (most upstream point).
4. Record all Basins, Stream Index Numbers and Classifications applicable to the project.
❑ UNKNOWN BASIN WHERE CLOSEST DOWN SLOPE SURFACE WATER IS LOCATED
1. Use the Clickable basin map to hydrologically sorted list report.
2.Click on the approximate project location to bring up the hydrologically sorted list.
3. Locate the name of the identified waterbody (from General Directions) on the list.
4. For multiple listings of the same waterbody name in the report, select and verify the location description. The term
"source" in the description means the beginning of the waterbody segment (most upstream point).
5. Record all Basins, Stream Index Numbers and Classifications applicable to the project.
❑ Notes on index number and unnamed streams:
Unnamed Streams 15A NCAC 02B .0301(i).
❑ Any stream which is not named in the schedule of stream classifications carries the same classification as that assigned
to the stream segment to which it is tributary (at the point of entry) except:
(A) unnamed streams specifically described in the schedule of classifications;
(B) unnamed freshwaters tributary to tidal saltwaters will be classified "C'; or
(C) after November 1, 1986, any newly created areas of tidal saltwater which are connected to Class SA waters by
approved dredging projects will be classified "SC" unless case -by -case reclassification proceedings are conducted.
❑ The following river basins have different policies for unnamed streams entering other states or for specific areas of the
basin:
Unnamed Tributaries Entering Other States or for Specific Basin Areas
Hiwassee River Basin
Streams entering Georgia or Tennessee shall be classified "C Tr."
Little Tennesse River
Basin And Savannah
River Drainage Area
Streams entering Georgia or Tennessee shall be classified "C Tr." Such streams in the Savannah
River drainage area entering South Carolina shall be classified "B Tr."
French Broad River
Basin
Streams entering Tennessee will be classified "B."
Watauga River Basin
Streams entering the State of Tennessee are classified "C."
Broad River Basin
Streams entering South Carolina are classified "C."
New River Basin
Streams entering the State of Tennessee are classified "C."
Catawba River Basin
Streams entering South Carolina are classified "C."
Yadkin -Pee Dee River
Basin
Streams entering Virginia are classified "C," and such streams entering South Carolina are
classified "C."
Lumber River Basin
Streams entering South Carolina are classified "C Sw."
Roanoke River Basin
Streams entering Virginia are classified "C." Except that all backwaters of John H. Kerr
Reservoir and the North Carolina portion of streams tributary thereto not otherwise named or
described shall carry the classification "B," and all backwaters of Lake Gaston and the North
Carolina portion of streams tributary thereto not otherwise named or described shall carry the
classification "C and B."
Chowan River Basin
Streams enterin Virginia are classified "C."
Tar -Pamlico River
Basin
All drainage canals not noted in the schedule are classified "C Sw." except the main drainage
canals to Pamlico Sound and its bays which shall be classified "SC."
Pas uotank River Basin
All drainage canals not noted in the schedule are classified "C."
INSTRUCTIONS FOR FORM: LASC 06-16 Page 3 of 3

w
zl
c a
o
�
� o
d
E
c
c
a
cO
c
v
c
c
a
Z
U
U°
O
L
c
s
s
.c.
v0,
U
U
�
R
A
m
m
U
m
m
N
N
N
N
N
Y
N
N
L
N
N
N
N
N
N
N
N
-2
'2
-2
-o
-o
'o
'o
'o
U
p
p
p
p
p
p
p
G
d
Z
m
d
O
O
v
m
d
o
0
0
0
0$
o
°o
a
�
O
O
O
O
O
o
Q
o
R
_9
d
N
M
C
Vl
N
M
� v
R O
h U
C
CC
CG
y'
�'
CG
CC
CC
N
v
n
i
a
3
3
3
3
3
3
3
3
N
3
3
3
3
3
3
3
3
U
a
c e
r
r
r
R
a y
r
r
r
r
r
N
N
N
Y
Y
Y
Y
Y
Y
m
Y
O
Y
m
L
L
0 R
N
N
N
N
U
U
U
01
U
V
V
U
V
c
c
c
R
C
`
c
L
C
L
c
G
E
0.f
(6
tO
3
U
U
U
F
F
F
[-0
`r0-
u
N
V
U
N
U
N
U
N
U
N
V
N
V
U
V
N
U
N
Q
(A
V]
(n
VI
V]
fn
Vl
N
0
V
N
N
N
Y
N
U
N
ti
z
z
z
z
z
z
z
z
a
U
0
0
C
o E
w
o`"o
oMo
oMo
o`"o
o`no
o`"o
o`"o
u m
G
G
G
z
<
z
4
z
<
z
0
z
0
z
z
z
C
N
N
N
N
0
0
o
O
0
0
0
0
�
o
0
0
0
0
0
0
0
00
00
00
00
00
00
00
00
y
V1
Vl
^•
M
�O
N
V
�D
p
V
V
V
M
N
M
N
N
.R
M
f�1
M
M
M
M
M
M
M
(1
M
M
Ol
M
M
M
G
d
o
0
0
0
0
3
3
3
v
o
0
0
0
o
p
p
p
ro
a
M

z
a
�o
�
w
� o
E
•E
°'
o
u
E
v
c
a
Z
aci
A
m
U
A
A
�
c
m
m
m
m
m
d
U
m
y
v
v
v
v
v
v
v
c
>
>
c
c
>
>
O
N
N
4]
N
N
N
N
C
C
C
C
c
c
T
O
O
0
O
O
O
O-
'O
'O
'O
'O
'O
'O
'O
O
>
>
>
R
R
>
>
u
y
00
00
N
V1
N
Z
L
ear
V
0
0
u
v
i
O
O
O
O
O
O
O
9
R
—
F
❑
❑
O
O
O
O
O
9
N
� V
LA U
z
z
z
z
z
z
z
z
a(4
V�
(A
CA
a
3
3
3
3
3
3
3
N
3
3
3
3
3
3
3
U
a
F
7
7
7
V
V
c o._ z
N
N
—
—
—
—
'_'
m
V
V
o y
U
U
U
U
U
U
U
n
m
m
E
E
E
E
E
3
U
U
F
F
F
F
F
V
0
0
0
0
0
0
O
0
0
A
F
F
F
F
F
F
CJ
z
z
z
z
z
z
z
z
V
U
0
t
o
0
0
0
0
0
0
0
�V•'
o
o
Q
o
0
0
0
0
C
F
0
C
o E
M
o0
M
00
M
00
M
0o
M
z
M
ao
M
oc
M
o0
Wm
O
G
o
M
O
❑
O
Q
Q
Q
Q
Q
Q
Q
Q
0
0
0
0
O
0
0
0
0
o
0
0
o
O
00
00
00
00
—
•p
V1
h
M
O
M
O
M
O
M
O
M
O
O
M
M
v)
V)
M
In
M
In
f
M
InM
c
a
C
¢
m
Y
❑
❑
M
0
R

10/23/2019 https://w .briggsfuneralhome.com/obituaries/print?o_id=6119191
Denton Chapel
Bill Sexton
( October 25, 1933 - March 16, 2019 )
Mr. William Harold (Bill) Sexton, age
85 of NC Hwy # 47 East Denton, NC
died Saturday, March 16 at Hinkle
Hospice House in Lexington.
A funeral service will be held at 4:00
PM Wednesday, March 20 at Central
United Methodist Church conducted by Rev. Scott Davis and Rev. Sandy
Young. Burial will follow at Mountain View Memorial Gardens.
The family wilt see friends Tuesday from 6:00 until 8:00 PM at Briggs
Funeral Home and other times will be at the residence on NC Hwy # 47.
Mr. Sexton was born October 25, 1933 in Davidson County to Henry
Harold (Pete) Sexton and Sallie Sue Snider Sexton. He was a member of
Siloam United Methodist Church where he had been a member of the
choir. He was a self-employed cattleman and was a member of the North
Carolina Cattleman's Association and the Davidson County Cattleman's
Association. He was a long time member of the Denton Lions Club and
active with the club's involvement with assisting the blind. He was
preceded in death by his parents and by a son, James (Jimmy) Sexton.
He is survived by his wife, Elizabeth Greene Sexton of the home; a son
Joel Sexton of Denton; daughter-in-law, Denise Sexton of Denton; step
sons Douglas Bullins and wife Mary of Asheboro and Michael Bullins
and wife Janice of Seagrove; brother Buddy Sexton and wife Nancy of
Denton; sisters Bobbie Ann Ridge and husband Lawrence of Denton and
Becky Rast and husband Ray of Stockbridge, GA; grandchildren, Brian
Sexton, Crystal Sexton and Allison Sexton; 2 great grandchildren; step
grandchildren, Micah Wilson, Jeremy Bullins, Joshua Bullins and
Heather Bullins; 5 step great grandchildren.
Memorials may be made to Hospice of Davidson County, 200 Hospice
Way, Lexington, NC 27292 or to Siloam United Methodist Church c/o
Linda Markham, PO Box 414, Denton, NC 27239.
https:l/w .briggsfuneralhome.com/obituaries/print?o_id=6119191 1/1

Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
I SA NCAC 02T .1100 — LAND OWNER AGREEMENT
FORM: LOA 06-16
Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted, the Applicant shall submit one original and two copies of the application and
supporting documentation
For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting Unit.
General — This document is an agreement between the Applicant and land owner(s) of residuals receiving sites for land application of
Class B residuals (may include water treatment plant or other type residuals) in accordance with 15A NCAC 02T .I 100. Do not submit
this agreement for review without a corresponding application form (FORM: RLAP 06-16).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Land Owner Agreement (FORM: LOA 06-16):
❑ Submit the completed and appropriately executed Land Application Site Certification (FORM: LASC 06-16) form. Please do
not make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to
the application may be made, as long as the attachments are numbered to correspond to the section and item to which they
refer.
❑ Prepare a separate agreement for each set of land application sites that are owned or operated by an entity other than the
Applicant.
❑ A copy of the completed and appropriately executed agreement must be provided to the landowner and the lessee/operator.
AGREEMENT FOR THE LAND APPLICATION OF RESIDUALS TO PRIVATELY OWNED LAND
The undersigned landowner or his representative hereby permits:
Applicant's name:
hereinafter referred to as the Permittee, to land apply residuals from the following facility(ies) onto the following land
application site(s) (i.e., see attached setback maps) in accordance with the stipulations and restrictions as given in this
Agreement:
Site/Field ID
Lease
(yes/no)
Land Use or
Cropping Patterns
Intended Use of Crops
Residuals Source
(optional)
Special note
(no-till/over-seed/
pasture)
02-01
no
Pasture
Animal Feed
02-02
no
Pasture
Animal Feed
02-03
no
Pasture
Animal Feed
02-04
no
Pasture
Animal Feed
02-5
no
Pasture
Animal Feed
JSI
no
Pasture
Animal Feed
JS2
no
Pasture
Animal Feed
The landowner or his representative receives, in consideration, full use of the nutrient value of the applied residuals while the
Permittee receives, in consideration, the use of the land application site(s) described above for the disposal of the residuals.
This Agreement shall remain in effect for the length of the Division's permit for the residuals land application program and
shall be renewed each time this permit is renewed.
The undersigned landowner or his representative and the Permittee agree to abide with the following restrictions and
stipulations until such time as written notification, given 30 calendar days in advance, modifies or cancels this Agreement.
FORM: LOA 06-16 Page I of

Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T.1100— LAND OWNER AGREEMENT
FORM: LOA 06-16
Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted, the Applicant shall submit one original and two copies of the application and
supporting documentation
For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting Unit.
General — This document is an agreement between the Applicant and land owner(s) of residuals receiving sites for land application of
Class B residuals (may include water treatment plant or other type residuals) in accordance with 15A NCAC 02T .1100. Do not submit
this agreement for review without a corresponding application form (FORM: RLAP 06-I6).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Land Owner Agreement (FORM: LOA 06-16):
❑ Submit the completed and appropriately executed Land Application Site Certification (FORM: LASC 06-16) form. Please do
not make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to
the application may be made, as long as the attachments are numbered to correspond to the section and item to which they
refer.
❑ Prepare a separate agreement for each set of land application sites that are owned or operated by an entity other than the
Applicant.
❑ A copy of the completed and appropriately executed agreement must be provided to the landowner and the lessee/operator.
AGREEMENT FOR THE LAND APPLICATION OF RESIDUALS TO PRIVATELY OWNED LAND
The undersigned landowner or his representative hereby permits:
Applicant's name:
hereinafter referred to as the Permittee, to land apply residuals from the following facility(ies) onto the following land
application sites) (i.e., see attached setback maps) in accordance with the stipulations and restrictions as given in this
Agreement:
Site/Field ID
Lease
(yes/no)
Land Use or
Cropping Patterns
Intended Use of Crops
Residuals Source
(optional)
Special note
(no-till/over-seed/
pasture)
JS3
no
Pasture
Animal Feed
JS4A
no
Pasture
Animal Feed
JS4B
no
Pasture
Animal Feed
The landowner or his representative receives, in consideration, full use of the nutrient value of the applied residuals while the
Permittee receives, in consideration, the use of the land application site(s) described above for the disposal of the residuals.
This Agreement shall remain in effect for the length of the Division's permit for the residuals land application program and
shall be renewed each time this permit is renewed.
The undersigned landowner or his representative and the Permittee agree to abide with the following restrictions and
stipulations until such time as written notification, given 30 calendar days in advance, modifies or cancels this Agreement.
FORM: LOA 06-16 Page I of 3

1. STIPULATIONS:
I. The landowner or his representative shall not enter into any additional residuals application contracts or agreements with another permitted
entity for the sites) specified by this Agreement.
2. Should the landowner or his representative lease or otherwise permit the use of the land application site(s) to a third party, the landowner shall
be responsible to ensure that the third party agrees and complies with the terms and conditions of this Agreement.
3. The landowner or his representative shall adhere to the provisions of this Agreement until all of the site restrictions (under Section II) are met.
4. Notification of cancellation of this Agreement shall be immediately forwarded to NCDENR-DWR, Non -Discharge Permitting Unit, 1617 Mail
Service Center, Raleigh, NC 27699-1617.
5. The Permittee must request and obtain a permit modification from the Division prior to a transfer of the land application site(s) to a new
landowner. In addition, the current landowner shall give a notice to the new landowner that gives full details of the residuals applied at the land
application site(s).
6. The Permittee has provided the landowner or his representative with information and data concerning the residuals land application program.
including an analysis of constituents of the residuals, residuals application methods, schedules for typical cropping patterns, adeseription of the
equipment used by the Permittee.
7. The Permittee will provide the landowner or his representative with a copy orthe residuals permit prior to commencement of any residuals land
application event and a copy of the results of each soil analysis.
8. If the soil pH of the land application sites) is not maintained at 6.0 or greater, sufficient amounts of lime shall be applied to achieve a final soil
pH of at least 6.0, unless an agronomist provides information indicating that the pH of the soil, residuals and lime mixture is suitable for the
specified crop.
9. The landowner or his representative and the Permittee will agree on residuals application rates and schedules based on crop patterns, results of
soil samples, and the permitted application limits.
10. The landowner or his representative will provide the Permittee with information regarding the amount and analysis of other sources of nutrients
(e.g., fertilizer, unregulated animal waste. etc.) that have been applied to the land application site(s).
11. The landowner or his representative will inform the Permittee of any revisions or modifications to the intended use and cropping patterns for
the land application site(s) prior to each planting season to enable the Permittee to amend this Agreement and schedule residuals land application
events at appropriate periods.
12, Specific residuals land application area boundaries shall be clearly marked on the land application site(s) by the Permittee, the landowner, or
his representative prior to and during a residuals land application event.
13. The landowner or his representative hereby authorizes the Permittee, local officials, and State officials or their representatives to: enter and
inspect any property, premises, or place on or related to the land application sites) at any reasonable time for the purpose of determining
compliance with the permit: establish monitoring facilities on or near the land application sites) as required by the permit; copy any records
that must be kept under the terms and conditions of the permit; take necessary leachate, surface water, groundwater, or soil samples during the
term of, and 12 months after termination of. this Agreement.
II. RESTRICTIONS:
I. Appropriate measures must betaken by the Permittee and/or the landowner or his representative to control public access to the land application
site(s) during active use and for the 12-month period following a residuals land application event. Such controls may include the posting of
signs that indicate the activities being conducted at the land application site(s).
2. Animals shall not be grazed on the land application site(s) for a 30-day period following a residuals land application event. Land application
sites that are to be used for grazing shall have fencing that will be used to prevent access during these periods after such residuals land application
events.
3. Food crops, feed crops, and fiber crops shall not be harvested for a 30-day period following a residuals land application event.
4. Food crops with harvested parts that touch the residuals/soil mixture and are totally above the land surface shall not be harvested for a 14-month
period following a residuals land application event.
5. Food crops with harvested parts below the surface of the land shall not be harvested for a 20-month period following a residuals land application
event when the residuals remain on the land surface for four months or longer prior to incorporation into the soil.
6. Food crops with harvested parts below the surface of the land shall not be harvested for a 38-month period following a residuals land application
event when the residuals remain on the land surface for less than four months prior to incorporation into the soil.
7. Turf grown on land where residuals are applied shall not be harvested for a 12-month period following a residuals land application event.
IILALTERNATIVES FOR WATER SUPPLY WELLS INSIDE THE COMPLIANCE BOUNDARY: (please check one)
15A NCAC 02L .0107(d) prohibits water supply wells within the compliance boundary. However, 15A NCAC 02T .0105(h) allows the compliance
boundary to be placed closer to the waste disposal area, such that the water supply well is situated outside of the compliance boundary provided
the groundwater standards can be met at the newly -established compliance boundary. Please mark one of the following;
❑ A re -defined compliance boundary is needed for field(s) ID:
(Please include the rationale for the requested re -location of the compliance boundary and attach a map showing the newly proposed compliance
boundary to the application package)
® A re -defined compliance boundary is not needed for this site.
IV. ACKNOWLEDGEMENT OF FIELD TRANSFER: (if needed)
❑ The land application field(s) ID: is currently permitted under another
residuals land application program: Permit Number WQ: . The land owner hereby acknowledge that by signing this
agreement, he/she is requesting that the field(s) be removed from the previously permitted residuals land application program and transferred
into the new program:
(Name of the new program)
FORM: LOA 06-16 Page 2 of 3

Landowner's Certification:
1 certify that I am a deeded landowner of the above -referenced land application site(s) and am authorized to make decisions
regarding the use of the land application site(s) on behalf of other deeded landowners OR that I am otherwise authorized, through
a power of attorney or other legal delegation, to make decisions regarding the use of the land application site(s) on behalf of the
deeded landowners. I certify that the above -referenced land application site(s) are not included in any waste disposal contract or
agreement with another municipality, contractor, or other permitted entity. Furthermore, I certify that 1 have read this Agreement,
understand the stipulations, restrictions, alternatives for water supply wells inside the compliance boundary, acknowledgement of
field transfer, and do hereby grant permission to the Permittee to land apply residuals to the land application site(s) as specified
herein.
Landowner name:
Address: 1129 GALLIMORE ROAD
City: Denton State: NC Zip:
Phone: [phone] E-mail address:
Signature: 81.EX �Q� 44� Date: 10-.24 a0(
NORTR CAROLINA, LJ4XvICJ1n COUNTY
1, the undersigned Notary Public do hereby certify that -7o e I S2 or%
personally appeared before me this day and acknowledged the due ex%"Jjp%,q the forgoing instrument.
WITNESS my hand and official seal this the a M ry' `�IO``%"1PCHERy
day of t' C 1* 6e - = N 20 '' � C1
Signature and seal: ? Co
'O
My commission expire : `'j" 9 �� °a3
q CA R IOL"`p`��•
Lessee's/Operator's Certification:
I certify that 1 have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Lessee/operator name:
Address:
City:
Phone:
Signature:
Permittee's Certification:
I certify that 1 have read this
Signing official name:
Signature:
State:
E-mail
Date:
Zip:
and do hereby agree to abide by the stipulations and restrictions as specified herein.
Date: 11�e ZT— ind
FORM: LOA 06-16 Page 3 of 3

Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .1100— LANDOWNER AGREEMENT
FORM: LOA 06-16
Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted, the Applicant shall submit one original and two copies of the application and
supporting documentation
For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting Unit.
General — This document is an agreement between the Applicant and land owner(s) of residuals receiving sites for land application of
Class B residuals (may include water treatment plant or other type residuals) in accordance with 15A NCAC 02T .1100. Do not submit
this agreement for review without a corresponding application form (FORM: RLAP 06-16).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Land Owner Agreement (FORM: LOA 06-16):
❑ Submit the completed and appropriately executed Land Application Site Certification (FORM: LASC 06-16) form. Please do
not make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to
the application may be made, as long as the attachments are numbered to correspond to the section and item to which they
refer.
❑ Prepare a separate agreement for each set of land application sites that are owned or operated by an entity other than the
Applicant.
❑ A copy of the completed and appropriately executed agreement must be provided to the landowner and the lessee/operator.
AGREEMENT FOR THE LAND APPLICATION OF RESIDUALS TO PRIVATELY OWNED LAND
The undersigned landowner or his representative hereby permits:
Applicant's name:
hereinafter referred to as the Permittee, to land apply residuals from the following facility(ies) onto the following land
application site(s) (i.e., see attached setback maps) in accordance with the stipulations and restrictions as given in this
Agreement:
Site/Field ID
Lease
(yes/no)
Land Use or
Cropping Patterns
Intended Use of Crops
Residuals Source
(optional)
Special note
(no-till/over-seed/
pasture)
DW-I
no
Animal Feed
DW-2
no
Animal Feed
DW-3
no
Animal Feed
DW-4
no
Animal Feed
DW-5
no
Animal Feed
The landowner or his representative receives, in consideration, full use of the nutrient value of the applied residuals while the
Permittee receives, in consideration, the use of the land application site(s) described above for the disposal of the residuals.
This Agreement shall remain in effect for the length of the Division's permit for the residuals land application program and
shall be renewed each time this permit is renewed.
The undersigned landowner or his representative and the Permittee agree to abide with the following restrictions and
stipulations until such time as written notification, given 30 calendar days in advance, modifies or cancels this Agreement.
FORM: LOA 06-16 Pagel of3

1. STIPULATIONS:
I. The landowner or his representative shall not enter into any additional residuals application contracts or agreements with another permitted
entity for the sites) specified by this Agreement.
2. Should the landowner or his representative lease or otherwise permit the use of the land application sites) to a third party, the landowner shall
be responsible to ensure that the third party agrees and complies with the terms and conditions of this Agreement.
3. The landowner or his representative shall adhere to the provisions of this Agreement until all of the site restrictions (under Section 11) are met.
4. Notification of cancellation of this Agreement shall be immediately forwarded to NCDENR-DWR, Non -Discharge Permitting Unit, 1617 Mail
Service Center, Raleigh, NC 27699-1617.
5. The Permittee must request and obtain a permit modification from the Division prior to a transfer of the land application sites) to a new
landowner. In addition, the current landowner shall give a notice to the new landowner that gives full details of the residuals applied at the land
application site(s).
6. The Permittee has provided the landowner or his representative with information and data concerning the residuals land application program,
including an analysis of constituents of the residuals, residuals application methods, schedules for typical cropping patterns, adescription of the
equipment used by the Permittee.
7. The Permittee will provide the landowner or his representative with a copy of the residuals permit prior to commencement of any residuals land
application event and a copy of the results of each soil analysis.
8. If the soil pH of the land application sites) is not maintained at 6.0 or greater, sufficient amounts of lime shall be applied to achieve a final soil
pH of at least 6.0, unless an agronomist provides information indicating that the pli of the soil, residuals and lime mixture is suitable for the
specified crop.
9. The landowner or his representative and the Permittee will agree on residuals application rates and schedules based on crop patterns, results of
soil samples, and the permitted application limits.
10. The landowner or his representative will provide the Permittee with information regarding the amount and analysis ol'other sources of nutrients
(e.g.. fertilizer, unregulated animal waste, etc.) that have been applied to the land application site(s).
11. The landowner or his representative will inform the Permittee of any revisions or modifications to the intended use and cropping patterns for
the land application site(s) prior to each planting season to enable the Permittee to amend this Agreement and schedule residuals land application
events at appropriate periods.
12. Specific residuals land application area boundaries shall be clearly marked on the land application site(s) by the Permittee, the landowner, or
his representative prior to and during a residuals land application event.
13. The landowner or his representative hereby authorizes the Permittee, local officials, and State officials or their representatives to; enter and
inspect any property, premises, or place on or related to the land application site(s) at any reasonable time for the purpose of determining
compliance with the permit; establish monitoring facilities on or near the land application site(s) as required by the permit: copy any records
that must be kept under the terms and conditions of the permit; take necessary leachate, surface water, groundwater, or soil samples during the
term of, and 12 months after termination of, this Agreement.
11. RESTRICTIONS:
I. Appropriate measures must be taken by the Permittee and/or the landowner or his representative to control public access to the land application
site(s) during active use and for the 12-month period following a residuals land application event. Such controls may include the posting of
signs that indicate the activities being conducted at the land application site(s).
2. Animals shall not be grazed on the land application site(s) for a 30-day period following a residuals land application event. Land application
sites that are to be used for grazing shall have fencing that will be used to prevent access during these periods after such residuals land application
events.
3. Food crops, feed crops, and fiber crops shall not be harvested for a 30-day period following a residuals land application event.
4. Food crops with harvested parts that touch the residuals/soil mixture and are totally above the land surface shall not be harvested for a 14-month
period following a residuals land application event.
5. Food crops with harvested parts below the surface of the land shall not be harvested for a 20-month period following a residuals land application
event when the residuals remain on the land surface for four months or longer prior to incorporation into the soil.
6. Food crops with harvested parts below the surface of the land shall not be harvested for a 38-month period following a residuals land application
event when the residuals remain on the land surface for less than four months prior to incorporation into the soil.
7. Turf grown on land where residuals are applied shall not be harvested for a 12-month period following a residuals land application event.
I LALTERNATIVES FOR WATER SUPPLY WELLS INSIDE THE COMPLIANCE BOUNDARY: (please check one)
15A NCAC 02L .0107(d) prohibits water supply wells within the compliance boundary. However, 15A NCAC 02T.0105(h) allows the compliance
boundary to be placed closer to the waste disposal area. such that the water supply well is situated outside of the compliance boundary provided
the groundwater standards can be met at the newly -established compliance boundary. Please mark one of the following;
❑ A re -defined compliance boundary is needed for field(s) ID:
(Please include the rationale for the requested re -location of the compliance boundary and attach a map showing the newly proposed compliance
boundary to the application package)
® A re -defined compliance boundary is not needed for this site.
IV. ACKNOWLEDGEMENT OF FIELD TRANSFER: (if needed)
❑ The land application field(s) ID: - is currently permitted under another
residuals land application program: Permit Number WQ: . The land owner hereby acknowledge that by signing this
agreement. he/she is requesting that the field(s) be removed from the previously permitted residuals land application program and transferred
into the new program:
(Name of the new program)
FORM: LOA 06-16 Page 2 of 3

Landowner's Certification:
I certify that I am a deeded landowner of the above -referenced land application site(s) and am authorized to make decisions
regarding the use of the land application site(s) on behalf of other deeded landowners OR that I am otherwise authorized, through
a power of attorney or other legal delegation, to make decisions regarding the use of the land application site(s) on behalf of the
deeded landowners. 1 certify that the above -referenced land application site(s) are not included in any waste disposal contract or
agreement with another municipality, contractor, or other permitted entity. Furthermore, I certify that I have read this Agreement,
understand the stipulations, restrictions, alternatives for water supply wells inside the compliance boundary, acknowledgement of
field transfer, and do hereby grant permission to the Permittee to land apply residuals to the land application site(s) as specified
herein.
Landowner name:
Address: 2308 VANDORA SPRING RD
City: GARNER State: NC Zip:
Phone: /r 9019-302-0549 E-mail address:
Signature: l/C l /` l/`G�yx/ Date:
NORTHCAROLINA, AA f.#tcrn COUNTY
I, the undersigned Notary Public do hereby certify that i t kgftan L✓ o a d
personally appeared before me this day and acknowledged the due execution of the forgoing instrument.
} �wuww
WITNESS my hand and official seal this the `I y ."%%%,C $W !i,
day of
otQTV Public
Signature and seal: h = 1.1"
IV —_ �tlS County
My commission exp es: % 2
Lessee's/Operator's Certification:
1 certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Lessee/operator name:
Address:
City:
Phone:
Signature:
Perm ittee's Certification:
certify that I have read this Agreeme
Signing official name*
Signature: azroz
State:
E-mail
Date:
Zip:
and do hereby agree to abide by the stipulations and restrictions as specified herein.
Date: r—o rr
FORM: LOA 06-16 Page 3 of 3

D
h
3•
`°
vac'
n j `,°
C-
»
c
o
C
7c p
a
•
�
�
p
n
a
y Qm
D
T3
O S T
gip'
� t'o ^
o
o
O
•w
d d
y < n
W
o
0
o
n
9
9 o a
1 d
z.o
O
�Oc�
O
' O O
�
� d
O
O
O
O n
vi
in
v
o
m
• d %
x D7 O
Y R X • a
3
•' X' < c w o
Z
o
0
0
c
_ n _ .d..
n +p
0
0
0
n
Vy_
-
n
a d
O O v
d iG
.o
a
o C
w
�
�
Date of
N
0
Month
w v'
0
o` e
W d
p D
O O O O O O O O O O O y D O
O O O O O O C O O O A
n �
F
} m 6
a
�
� n
IJ
A �'
+Po4�oW
uopnilddV
o ++ Diu, Tl
u, UogN,'Zl�glt�On
c +++aleTl
�, uonezpe.iauiW
A
A
� �
� X
z
o
3 u320111ly
v
Iv umouiuiv
a
0
0
0
0
0
0
0
o
0
0
0
0
0
0
0
O
0
0
o
u
w o
0
0
0
0
0
0
0
0
0
o
z
O
O
O
O
O
O
O
O
O
O
IJ
'n
N

n ? H
n
� 1. A
N IJ Q'
=VoLPoW
uotwoilddy
rn
w
E
n
d
IT
OR
m
n
y
c
N
a
J

C
�
-'!'1 y
--
z
o —
�
G
T%
c
—
n,
r
74
7
.ly
S S
Z
2 G
n
^ c
�
� 3
r »
�
f>
3
o
i
O
�
>y
_
Y
w
=
E. e
x
!
••
N
r 1
ram.
y
..
`z
z
f:
Z
c
� •i
74 r
N
Y
C
,
a
�
n
m
�I Dqtc or
I^ IJ
Month
O >
_
o _
n
J
�
N
>I I IiIIJI�I
s
7'
•0 3
-
- c
polllIN
uonumq JJy
"IN+w �llt21
uuq hu�gil�o/�
�+ +- uolprzgll�oul�
V�
3 ua 2glnl
unlowulV
c
IJ
—
o
o
-
r
D
�
-
3
D
_
F
—
m
D
n
r
Y
C
Dr
�-
�
Y
D
=
3
-
z
_
.9
IJg
for
x
D
W
^
w
p
r
Z
_
rl
r
Z
>
2
�
l�
zo�n
3
w
i
3
.�•.
�
Ti
T1
S
n
�
2
J�
"1
n
n
m
n
C
J
p
D
o
r
m
3
Z
Vr
G
G
O
..
7

T
0!
J
R
N
A .
PO9II W
uogeoijddV
A
3 UaOOJIIK
Lcl
eiuowuiy
r
Iv
0
z
w
b9
i
U
o Io
A �
T
IT
a
P.

T
PIW O2
0
0
0
N
J
U
d
Y_
D
N
P
O
P
O
N
O
O
V
H
O
O
D
0
A
0
'aO
0
�
O
W
N
_
O
9
�gwoz�,
v
e
9
u,
o
A
S
�
�
w
0
L
IJ N
o0
Date or
Month
c
� <
r c
0
m
0
o
n
m
0
a
orn
o
a
o D
O p
0
0
0
0
0
0
0
0
y D'90
D � n
Z F
O
O
O
O
N O
� >
P
a
O O tt N
O
O
H
S 7 n
y
A
*p01110"
VOlrUOijddy
O O *Pwm
VV, ❑Og11WHOU1On
0 0 ...Pleb
�� w uopezl�eiamW
N
N
F
F
3 uaOOJIIN
0
V�
Vi
0
Vr
Vi
1?IUOLUuly
N
J
N
J
3
� ^ O
� ry
,Dz
m D
c
o
0
0
0
0
0
0
o
Z
z
O
O
O
O
O
O
O
O
O
IJ
2
a
D=.�
o po C]
_ ry
O
9
z
O
w
a
0
a`
OT
L-2

LVA
o ti
0
m
z
m
O
.T1
3
T
Cl)
T
N
N
O
m
a o'
Date or
Month
n.n
(U
n
N �
O
U O
a
> w
H
n
y
000
O
0
0
0
�000x
m
00
0
0
0
9
D
o
o
0
0
**U;E�
n
A
J
v
N
�^
UOgEZI�11EI0A
G
O
A
p
o
n
Z Z,
0
***31EA
N
Po
- O
w
UOI)BZIIUIOUIIN
Ozi
a
n
0
0
0
a
N ?
A
N
�l
A
W
N
N
^�
o
;
b
0
0
�
o
a
N
O'
o
�
�
011111
A
3 z z
o
�
�
0
0
"v-
=
o
a
o
0
o
O
a
o
a
o
z
v
0
0
0
0
0
0
0
0
0
0
0
0
0
0
D •p
6
0
0
0
0
0
0
0
0
N
n
7-
0

T
av
ry
F
o
r
°
Date or
_
C
D
o
Month
.�
m
D n
m
n
C
y
N
n
i3
n
3 <
IJ k
pj
p
— R
o a d
N
0
O
D
p<
D O
P
A
O
A
O
O N
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
N
p
A
O
j v a
n
o
p
o
A
d
O
m
o
D m d
�.
Co
J
--•
'"
P
ry
-
ae
z
D
o
0
0
0
0
O
O
O
G
N
O
0
0
o
S
_
y
Fob
N
------------
A
+Po4laW
uoileapddy
0
3
X
7
D
n
rn
e
D
L101JUIMP,10n
O
w
9
N
A
hJi
G
z
w
71
J
W n
J
0
w
m
A
N
3 y
� �
A
to L
PIUOUluly
L,
J
� z w z
3
J
R ry
O
O
C
O
O
O
O
O
O
O
J
(i
0
0
0
0
0
0
0
0
0
0o
v
0
0
0
0
D
0
0
0
0
v D
0
0
0
0
0
0
0
0
0
o
n
n a
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
o
z
o
O
O
O
O
O
O
O
O
O
o
p
D
N
n
m

DBIC OI'
Month
0
znr'N
r
-
7 fr
G p
�
N
�
n
c
Vi
a
G
o >
v
y � c
-
c
A
Z
v G
x
=
Y
c
J
ICJ
'.'
N
Q.
❑
_
N
. uoglrn p:�auly�
Q
V
m
=
r
=
Y
-
m
O
r
la
m
D
n
c
�
D
�
c
D
z
r
O
z
z
Y
D
=
-
Z
N
c
u
:.
W
�
r
,
Imo^.
N
z
W
n
^•
Z
c
T.
^
ja
3
p
ram•,
�„
n
D
O
=.
r
T
m
m
5
=
jQ
m
n
n
m
D
r
O
D
r
I�I•='IW

O O O
D
V Vi A
6
,.,000c)�
J
A
W
d
Vi
A
--
V
+
O
9
z
o
0
o
c
S
O
O
O
a
iJ
Ut
A
T
O
O
O
b
O
-•]
O
!' Date of
N
0
Month
a
r c �
0
w
o
G)
Oo �1
p C
Z
0o N
a a
N
3
a` o
w a
o D
D O
O O
O
O
O
O
O
O
O
O
w ry' C
O O
O
O
O
O
O
O
O
O
N
O �
z �
o
� D
� N
G
N_ ry
O �
� N �
A
.POLIIaW
------------
u0ilpallddy
c
o
o
�
�
9
alea
D
o
0
0
o
u0neZ110210A
n
o'
d
N
0
0
0
z
z
N
J
N
L
y
a
N
O
v 3
J
w
A
A �
a co 'L
o uado.gl�j
L'IUOILLlLI �/
N a z w z
R (7
0 0
0
0
0
0
0
0
0
0
o n
0 0
0
0
0
0
0
0
0
0
O
V
0 0
0
0
0
0
0
0
0
o
a a
D
o. z
a
a 3
ro
D
m
o < g
A
O
_
O L
N (4
d'
0
O
0
0
Q
n
d
O
0
m
A
IT
a
A
c
a
PC
Go

0.
SEXTON, JOEL
1129 GALLIMORE ROAD
DENTON NC 27239
02-03
Fields: 02-01
02-02
02-03
Davidson County
Scale: 1" = 266.66 '

M
SEXTON, JOEL Fields: 02-04 Davidson County
1129 GALLIMORE ROAD 02-05 Scale: 1" = 266.66'
DENTON NC 27239

SEXTON, JOEL Fields: JS1 Davidson County
1129 GALLIMORE ROAD JS2 Scale: 1" = 266.66
DENTON NC 27239 J53

i JS4A
SEXTON, JOEL
1129 GALLIMORE ROAD
DENTON NC 27239
9 i
C�'
t
Fields: JS4A
JS48
Davidson County
Scale: 1" = 266.66 '

-,-
0
i
v t.
WOOD WHITMAN D
337 WHIT WOOD LN
DENTON NC 27239
DW2
DW1
Fields: DWI Davidson County
DW2 Scale: 1" = 266.66'
DW3
nwe