WQ0014543_Residual Annual Report 2020_20210112

Initial Review
INITIAL REVIEW
Reviewer Williams, Kendall
Is this submittal an application? (Excluding additional information.)*
r Yes r No
If not an application r Annual Report
what is the submittal r Residual Annual Report
type?* r Additional Information
r Other
Annual Report 2020
Year*
Project Number* WQ0014543
Email Notifications
Does this need review by the hydrogeologist?*
r Yes r No
Regional Office Mooresville
CO Reviewer
Admin Reviewer [e-mail]

Submitted Form
Project Contact Information
Rease provide information on the person to be contacted by NDB Staff regarding electronic submittal, confirmation of receipt, and other issues.
..........................................................................................................................................................................................................................................................................................................................................................................
Name * Ken Galloway
Email Address*
[e-mail]
Project Information
.........................................................................................
Submittal Type* r New Permit Application
r Renewal
r Annual Report
r Other
Permit Type * r Wastewater Irrigation
r Other Wastewater
r Closed -Loop Recycle
r Single -Family Residence
Wastewater Irrigation
Permit Number* WQ0014543
ApplicantTermittee * City of Statesville
Facility Name * City of Statesville
Phone Number*
7048783438
Modification (Major or Minor)
r Additional Information
r Residual Annual Report
r High -Rate Infiltration
r Reclaimed Water
(- Residuals
r Other
Application
Please provide comments/notes on your current submittal below.
Please attach all information required or requested for this submittal to be review here.
Application Form Engineering Flans, Specifications, Calculations, Etc.)
2020 Land App.pdf 835.63KB
Upload only 1 FDF document. ivM@iple documents must be combined into one FDF file.
For new and modification permit applications, a paper copy may be required. If you have any questions
about what is required, please contact the reviewer or Tessa Monday. If a paper application is req uired,
be advised, applications accepted for pre -review until both the paper and electronic copies have been
received. The paper copy shall include the following:
o Application Form
o All relevant attachments (caIcs, soils report, specs, etc.)
o One full-size engineering plan set
o One 11x17" engineering plan set
o One extra set of specifications
o Fee (if required)
Mailing address:
By U.S. Postal Service
I ByCourier/Special Delivery;
Division of Water Resources
1 Division of Water Resources
----------------------------------------------------------------------
Non-Discharge Branch
-----
I Non -Discharge Branch
1617 Mail Service Center
1 Att: Nathaniel Thornburg, 9"' Floor, Office #942W
----------------------------------------------------------------------
1 Raleigh, NC 27699-1617
1 512 N. SalisburySt.
-----------------------------------------------------------------------'-Raleigh,
NC27604-1170
For questions or problems contact Tessa Monday [e-mail] or 9 19.7 07.3 660.

* 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 1/12/2021

1 CITE.' of
f e
NORTH CAROLINA
January 12, 2021
Attention; Nathaniel Thornburg
NCD WR
Water Quality Nan -Discharge Permitting Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1636
RE: Annual Report for 2020
City of Statesville Land Application (WQ0014543)
Dear Mr. Thornburg:
Enclosed, you will find a copy of the required forms and lab data for the City of Statesville Land
Application, permit #WQ0014543. This land application program has never been utilized. However, the
City of Statesville wishes to keep this permit active in case of an emergency.
This permit was compliant for the year.
Should you require more information, or if further action is required, please contact me at 704- 878-3438.
Sincerely,
Ken Galloway
WWTP Supervisor, Fourth Creek WWTP
PO Box ll11 • Statesville, NC 28687 • ci.statesvillemr.us

GENERAL INFORMATION
LAND APPLICATION
CALENDAR YEAR 2020
Permit No. WQ0014543
FACILITY NAME: Fourth Creek WWTP-NPDES NCO031836
Third Creek W WTP- NPDES NCO020591
LOCATION: 693 Bell Farm Rd.
444 Third Creek Rd.
MAILING ADDRESS: P. O. Box 1 111
Statesville, NC 28687-1111
[phone]
[phone]
RESPONSIBLE OFFICIAL: Andy Smith, Operations Manager
Dept. of Water Resources
P. O. Box 1 111
Statesville, NC 28687-11 I 1
[phone]
FACILITY OPERATOR: Ken Galloway
P.O.Box I I I I
Statesville, NC 28687-1111
[phone]
RESIDUALS ORC: Ken Galloway
P. O. Box 1 111
Statesville, NC 28687-1111
[phone]
APPLICATION: Land Application
No Residuals land applied in 2020.

ANNUAL LAND APPLICATION CERTIFICATION FORM
WQ Permit#: WQ0014543 County: Iredell Year:
2020
Facility Name (as shown on permit): Fourth Creek W WTP
Land Application Operator: Ken Galloway Phone:
Land application of residuals as allowed by the permit occurred during the past calendar year?
❑ Yes 0 No - If No, skip Part A, and Part B and proceed to Part C. Also, If residuals were
generated but not land applied, please attach an explanation on how the residuals were handled.
Fart A - Residuals A
Total number of application fields in thepermit:
Total number of fields utilized for land application during the year:
Total amount of dry tons applied during the year for all application sites:
Total number of acres utilizes for land application during the year:
704-878-3438
Part B - Annual Compiance Statement:
Facility was compliant during calendar year 2020 with all conditions of the land application permit
(including but not limited to items 1-13 below) issued by the Division of Water Quality. ❑ Yes ❑ No
If no please, provide a written description why the facility was not compliant, the dates, and explain corrective action
taken.
1) Only residuals approved for this permit were applied to the permitted sites.
2) Soil pH was adjusted as specified in the permit and time was applied (if needed) to achieve a soil pH of at least 6.0 or
the limit specified in the permit.
3) Annual soils analysis were performed on each site receiving residuals during the past calendar year and three (3) copies
of laboratory results are attached.
4) Annual TCLP analysis (if required) was performed and three (3) copies of certified laboratory results are attached.
5) All other monitoring was performed in accordance with the permit and reported during the year as required and three (3)
copies of certified laboratory results are attached.
6) The facility did not exceed any of the Pollutant Concentration Limits in 15A NCAC 02T .I 105(a) or the Pollutant
Loading Rates in 15A NCAC 02T .I 105(b) (applicable to 40 CFR Part 503 regulated facilities).
7) All general requirements in as specified in the Land Application Permit were complied with (applicable to 40 CFR Part
503 regulated facilities).
8) All monitoring and reporting requirements in 15A NCAC 02T .1 I 1 I were complied with (applicable to 40 CFR Part
503 regulated facilities).
9) All operations and maintenance requirements in the permit were complied with or, in the case of a deviation, prior
authorization was received from the Division of Water Quality.
10) No contravention of Ground Water Quality Standards occurred at a monitoring well or explanations of violations are
attached to include appropriate actions and remediations.
11) Vegetative cover was maintained and proper crop management was performed on each site receing residuals, as
specified in the permit.
12) No runoff of residuals from the application sites onto adjacent property or nearby surface waters has occurred.
13) All buffer requirements as specified on the permit were maintained during each application of residuals.
C - Certification:
"I certify, under penalty of law, that the above information is, to the best of my knowledge and belief, true, accurate,
and complete. I am aware that there are significant penalties for submitting false information, including the
possibility of fines and imprisonment for knowing violations."
Permittee Name and Title (type or print)
z-LI
Signature of Permittee
Date
Signature of
Date Signature of Land Applier
Date
(if different from Permittee) (if different from Permittee and Preparer)
x Preparer is defined in 40 CFR Part 503.9 (r) and 15A NCAC 02T .1102 (26) DENR FORM ACF (12/2006)

CITY of ,`�
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ya e
NORTH CAROLINi.
4th CREEK & 3rd CREEK WWTP SLUDGE NARRATIVE
Ken Galloway
Both WWTP's generate biosolids that are currently stabilized using an aerobic digester and dewatered
using a belt press. After dewatering, the residuals are transferred to the Sta Lime lime stabilization
process area where the biosolids are set aside for contract land application away from the plant site.
The contractor is Synagro and they hold permit # WQ0016247 for this. The primary method of biosolids
disposal is the StaLime process and that permit # is WQ0006245.
PO Box 1111 • Statesville, NC 28687 • ci.statesville.nc.us