WQ0004166_Residual Annual Report 2020_20210221

Initial Review
Reviewer Thornburg, Nathaniel
Is this submittal an application? (Excluding additional information.)*
r Yes r No
If not an application what is the submittal type?* r Annual Report
r Residual Annual Report
r Additional Information
r Other
Annual Report Year* 2020
Permit Number (IR)* WQ0004166
Applicant/Permittee Town of Jefferson
Email Notifications
Does this need review by the hydrogeologist?* 0 Yes r No
Regional Office Winston-Salem
CO Reviewer
Admin Reviewer

Submittal Form
Project Contact Information
Rease provide inforration on the person to be contacted by N B Staff
Name * Tim Church
Email Address*
[e-mail]
electronic subnittal, confirmation of receipt, and other correspondence.
Project Information
........ ......... ....................................................................................................................................... .
Application/Document Type* r New (Fee Req ui red)
r Modification - Major (Fee Required)
r Renewal with Major Modification (Fee
Required)
r Annual Report
r Additional Information
r Other
Phone Number*
336 246-2165
O Modification - Minor
C Renewal
C GW-59, NDMR, NDMLR, NDAR-1,
NDAR-2
r Residual Annual Report
r Change of Ownership
We no longer accept these monitoring reports through this portal. Please click on the link below and it will take you to the correct form.
https://edocs.deq.nc.gov/Forms/NonDischarge_Monitoring_Report
Permit Type:*
r Wastewater Irrigation
r High -Rate Infiltration
r Other Wastewater
r Reclaimed Water
r Closed -Loop Recycle
r Residuals
r Single -Family Residence Wastewater
r Other
Irrigation
Permit Number:*
W00004166
Fbs Current Existing perrrit number
Applicant/Permittee Address*
P.O. Box 67 Jefferson, NC28640
Facility Name *
Town of Jefferson RLAP
Please provide comments/notes on your current submittal below.
At this time, paper copies are no longer required. If you have any questions about what is required, please contact Nathaniel Thornburg
at [e-mail].
Please attach all information required or requested for this submittal to be reviewed here.*
(Application Form Engineering Rans, Specifications, Calculations, Bc.)
Residuals Report B 202020210220_18482314.pdf 3.49MB
Upload only 1 FLFdocurrent (less than 250 fvB). NLRiple documents rust be confined into one FDFfile unless file is larger than
upload limit.
* V By checking this box, I acknowledge that I understand the application will not be
accepted for pre -review until the fee (if required) has been received by the Non -
Discharge Branch. Application fees must be submitted by check or money order
and made payable to the North Carolina Department of Environmental Quality
(NCDEQ). 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).
Mail payment to:
NCDEQ — Division of Water Resources
Attn: Non -Discharge Branch
1617 Mail Service Center
Raleigh, NC 27699-1617
Signature
Submission Date 2/21/2021

ANNUAL LAND APPLICATION CERTIFICATION FORM
WQ Permit#: WQ0004166 County:
Year: 2020
Facility Name (as shown on permit): Town of Jefferson
Land Application Operator: Tim Church Phone: [phone]
Land application of residuals as allowed by the permit occurred during the past calendar year?
0 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.
Part A - Residuals Application Summary:
Total number of a2plication fields in thepermit:
3
Total number of fields utilized for land application during the year:
3
Total amount of dry tons applied during the year for all application sites:
21.8
Total number of acres utilizes for land application during the year:
43
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 Resources. 0 Yes El 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 lime 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 .1105(a) or the Pollutant
Loading Rates in 15A NCAC 02T .1105(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 .L111 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 Resources.
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 pen -nit.
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.
Part 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."
Tim Church, Water Resources Director
Permittee Name and Title (type or print) Signature of Permittee Date
Signature of Preparer* Date Signature of Land Applier Date
(if different from Permittee) (if different from Permittee and Preparer)
* Preparer is defined in 40 CFR Part 503.9 (r) and 15A NCAC 02T .1102 (26) DENR FORM ACF (12/2006)

ANNUAL RESIDUAL SAMPLING SUMMARY FORM
Please note that your permit may contain additional parameters to be analyzed. The parameters can be reported in FORM RSSF - B
WQ Permit Number: WQ0004166
Facility Name:
Residual Source WQ # or
NPDES #:
WWTP Name:
7 —M..nl A—h—c "n*o
Town of Jefferson WWTP
NCO021709
Jefferson WWTP
Laboratory:
1)
2)
3)
4)
5)
Meritech, Inc.
Parameter
Conc.•
Limit
! or ! ! • '
• ,
M0MMMW
MOMM
I
—Chromium
Total Phosphorus
' For surface disposal facilities the ceiling concentration limits listed in this form are not applicable. Reference the individual permit for metals limits.
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed
to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant
penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
Signature of Preparer * Date
*Preparer is defined in 40 CFR Part 503.9(r) and 15A NCAC 2T .1102 (26)
DENR FORM RSSF (12I2006)

ANNUAL RESIDUAL SAMPLING SUMMARY FORM - B
Report all sampling analysis results for parameters not listed in FORM RSSF that are part of the WQ permit or were analyzed for over the past
calendar year. Use additional forms as needed.
WQ Permit Number: WQ0004166
Facility Name: Town of Jefferson WWTP
Residual Source NCO021709
NPDES # or WQ#:
WWTP Name:
Laboratory:
1)
2)
3)
4)
5)
Meritech, Inc.
Parameter
(mg/kg)
Sample or Composite Date
1 / 14/20
Aluminum
5540
Calcium
15400
Magnesium
4600
Sodium
3160
Potassium
4940
PAN
16842
pH
6
SAR
0.61
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system
designed to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are
significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
y • -
Signature of Preparer *
*Preparer is defined in 40 CFR Part 503.9(r) and 15A NCAC 2T .1102 (26)
Z11 j
ate
DENR FORM RSSF - B (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM`
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: Town of Jefferson WWTP Total Dry Tons Applied (Annual): 12.22
Permit #: WQ0004166 Cation Exchange Capacity (non 503 only): 14.6
Operator: Tim Church Owner: Fred Walters Predominant Soil Series: Watauga
Acres Used: 26 Acres Permitted: 26 Site #: Fred Walters Field #: 1
Residual Analvsis Data (Heavy Metals and Total Phosuhorus use mp/ka. % Solids use Raw Percent #):
Com-
posite
i
D. te
•
i
Total
Phos-
I -rus,MENEENEENEEN
• •
Annual Heavv Metal Field Loadings (Calculated in lbs/acre):
! iri
r rli
1 ir!
i il!
! it
r rii
rii
i ill
1 ilr
! 111
! rlr
1 irr
1 il�
re.•
i it
MEN
i lir
1 ill
r rir
! !rr
r r!i
r rll
ffor,ii
i rii
won in
1 ri
•M
I •
r rrl
i rri
i rli
r irr
r ril
1 rii
! ril
r ill
m,l
ff! ma in
i !Ir
i
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i rll
I irl
r li►
r rlr
r rii
r rri
i !11
r i!r
r 1!r
i 1!1
! !rr
r rli
i i I
1 rll
r rri
i irl
i Iri
i rri
r rii
1 Ili
r lir
i Iir
i I11
i rrr
i t 1
! !r!
Kira
ffinr
ffor,il
! rli
i !ri
ff# mr
iri
I lir
i !ir
ffITIT1711
•
i !r
i rli
r 1!1
1 rll
r rlr
! rl!
1 rli
rill
1 Ilr
! !ir
i rlr
i !rr
i rl
•
i i
r rii
r iri
i ill
i ilr
1 iti
1 rl!
rill
i ill
! iii
! rlr
i iri
i !
i 11�
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1 iri
i ili
i iir
i rii
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r il!
i Iir
r rir
r rlr
iri
®�
r rrl
! lii
WIT, gi
1 Irr
r rrl
or, 1711fflwffl
r irl
r Iir
i 111
r r!1
��1
Total
•O
1 !Ir
r il!
i 111
1 i!i
! !11
1 rl!
! i!i
1 !!1
i (ir
1 1i1
i Ilr
•i
• •
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gathered and evaluated the information submitted. I am
aware that there are significant penalties for submitting false information, including the possibility of fines and
imprisonment for knowing violations".
f4r�, 0" t ;>, /// lew
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: Town of Jefferson WWTP
WQ Permit #: WQ0004166 Field #:
Acres Utilized: 26
Land Owner: Fred Walters Annual Dry Tons Applied: 12.5380 Site #: Fred Waiters Acres Permitted: 26
Operator: Tim Church Predominant Soil Series: Watauga Cation Exchange Capacity (non 503): 14.6
Crop 1 Name: Fescue hay Crop 1 Max. PAN: 155 Crop 2 Name:
Crop 2 Max. PAN:
`�
0 C
°
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
Flo
Solids
Volume
Applied Per
Acre
(Dry Tons/Ao}
Residual Sources
PDES #, W
Fert., Animal'
Waste, etc)
Soil
Cond.
Wet,
Moist)
Precip.
Past 24
131s.
inches
can 6
=-
w
o
"
'�
* c
4
:t
a
;
TKN
mg/kg
� �
o 5
as o
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
( lbs/acre )
Name of Crop Type
Receiving Residual
g
Application
Crop 1
Crop 2
Crop 1
Crop 2
January
36000
L 16
0.067
NCO021709
dry
0
s
0.5
30%
50700
1 862
1460
2.256
NA
fescue
0,000
0.000
0,000
March
36000
1.16
0.067
NCO021709
dry
0
s
0.5
30%
50700
862
1460
2.256
NA
fescue
April
32400
L 16
0.060
NCO021709
dry
0
s
0.5
30%
50700
862
1460
2.030
NA
fescue
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0,000
August
18000
1.16
0,033
NCO021709
dry
0
s
0.5
30%
50700
862
1460
1.128
NA
fescue
0.000
0.000
0,000
October
39600
1.16
0,074
NCO021709
dry
0
s
1 0.5
1 30%
50700
862
1460
2.482
NA
fescue
Novemb
97200
1.16
0.181
NCO021709
dry
0
s
0.5
30%
1 50700
1 862
1460
6.091
NA
fescue
0.000
0.000
0.000
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form):
........
...........
TOTALS:
01
259200
:>:<>:_:<
As
Cd
Cu
Cr
Pb
Hiz
Mo
Ni
Se
Zn
P
16.244
0.000
Lime Applied
Annual lbs/acre
0,004
0,687
0.691
36
0.001
0,145
0.146
34
0.362
27.239
27.601
1338
0,000
0.000
n/a
0.010
1,604
1.614
267
0.000
0,032
0.032
13
0.005
0.728
0.733
n/a
0.013
1.36
1.373
374
0.004
1.069
1.073
89
0.511
85.195
85.706
2498
17.390 ::::::::: ::::.: ::> :::
;:`;:..::.::` _ >:" :::: _ :: `_ :::: :
>:
Date
lbs/ac
Prior Years Cumulative lbs/ac
Current Cumulative lbs/ac
Permitted C. P. L. R.****
Permit PAN Limit 1sU2nd Crop
<
G4I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
Signature of Land Applier
*Application Method: S - Surface, IN - Injection, INC - Incorporation
IL **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name:
Permit #:
Operator:
Acres Used:
Town of Jefferson WWTP Total Dry Tons Applied (Annual): 0.40
WQ0004166 Cation Exchange Capacity (non 503 only): 15.1
Tim Church Owner: Town. of Jefferson Predominant Soil Series: Watauga
8 Acres Permitted:
Site #: Bower Walters Field #: 3
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
►-.
Com-
positer.
i1!
©
E3
r
i0
I Total
Phos-
pho-rus—IMENEENEENEEN
Annual Heavy Metal Field Loadings (Calculated in lbs/acre):
i
1 i
i fii
f {11
KIT,if
f !Ii
1 Iff
! {If
1 ill
f if!
row,
1 f11
i 111
'
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ill{
f fli
KOTIT#i
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1 111
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.+�
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KIM02
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i 1 •
1 !11
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ff#TIT#i
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f iii
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III
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ff#T#=WIT,
i
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1 Iii
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+•
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1 ill
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1 ii!
1 ii1
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KIT#T#i
ff#T#Tli
ff two M,
IT, fl
fff f!i
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ffITIT,i
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WIT, 11
�..
$TIM,
a iti
ffITIT,!
ffITIT,l
1 Iff
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ffI iIi
r, 111
ff! f
Total
' •
1
{ 111
{ !11
i 111
i Itl
i Ilf
1 iil
111!
{ !1f
! ii1
! !If
! !il
1
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gathered and evaluated the information submitted. I am
aware that there are significant penalties for submitting false information, including the possibility of fines and
imprisonment for knowing violations".
f . A
UtV4,,
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
Facility Name: Town of Jefferson WWTP
Land Owner: Fred Walters
Operator: Tim Church
Crop 1 Name: Fescue
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
WQ Permit #: WQ0004166 Field #: 3
Annual Dry Tons Applied: 0.4353 Site #: Bower Walters
Predominant Soil Series: Watauga
Crop 1 Max. PAN: 155 Crop 2 Name:
Acres Utilized: 8
Acres Permitted: 8
Cation Exchange Capacity (non 503): 15.1
Crop 2 Max. PAN:
° '5
Q> r
A
Volume applied
pp
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied er
p
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, Wt2#,
Fert., Animal(Dq'
Waste, etc)
Soil
C°nd.
Moist)
Precip.
pit 24
firs.
inches
Y
c
0 o
o
w
*
Z
�,
#
TIN
mg/kg
z
° o
; 15
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
lbs/acre
( )
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
January
9000
1.16
0.054
NCO021709
dry
0
s
1 0.5
30%
50704
1 862
1460
1.833
NA
fescue
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1
0.000
0.000
0.000
0.000
0.000
0.000
1
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.004
1
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form):
TOTALS:
01
As
Cd
Cu
Cr
Pb
HP
Mo
Ni
Se
I Zn P
1.833
0.000
Lime Applied
Annuallbs/acre
0.000
0.408
0.408
36
0.000
0.129
0.129
34
0.039
22.371
22.410
1338
0.000
na
#######
na
0.001
1.278
1.279
267
0.000
0.031
0.031
13
0.001
0.717
0.718
na
0.001
1.209
1.210
374
0.000
0.863
0.863
89
0.054 1.850 ::
80.347 ................................
.................................
80.401
2498
Date
lbs/ac
Prior Years Cumulative lbs/ac
Current Cumulative lbs/ac
Permitted C. P. L. R.****
Permit PAN Limit l st/2nd Crop
...... ..... - ...... :. .... .... ... . .. ;:
1.55PA
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
t j1 *Application Method: S -Surface, IN -Injection, INC -Incorporation
/ t* **Volatilization Rate: Surface - 0.5, Injection/incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost-0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name:
Permit #:
Operator:
Acres Used:
Town of Jefferson WWTP Total Dry Tons Applied (Annual):
WQ0004166 Cation Exchange Capacity (non 503 only):
Tim Church Owner: Johnny Walters
9 Acres Permitted: 9 Site #:
Predominant Soil Series:
8.70
13.6
Watauga
Johnny Walters Field #: 5
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
ftXkWP1jW#1j1
Com-
posite
Date
+
P
Annual Heavy Metal Field Loadings (Calculated in lbs/acre):
• .
�!
©
min
4 11:
1 14t
i 4it
1 f41
1111
i !4t
i t1i
f t11
fill
f flt
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4 11f
i ,
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t 4 I
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4 141
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wa,f
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1 111
i 141
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i 1tt
i 1!1KIT,?,t
KITIT,1
4 itt
I t44
KITIT#f
fft 1f1
f fii
Total
s
f
1 ill
i ilf
1 Ifi
i ttf
f !!t
1 111
I if4
1 Ili
i ii!
i fif
i fii
i
•rus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gathered and evaluated the information submitted. I am
aware that there are significant penalties for submitting false information, including the possibility of fines and
imprisonment for knowing violations".
Signature of Land Applier
2-
Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "NIA" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: Town of Jefferson WWTP WQ Permit #: WQ0004166 Field #: S Acres Utilized: 9
Land Owner: Johnny Walters Annual Dry Tons Applied: 8.8811 Site #: Johnny Walter., Acres Permitted: 9
Operator: Tim Church Predominant Soil Series: Watauga Cation Exchange Capacity (non 503): 13.6
Crop 1 Name: fescue Crop 1 Max. PAN: 155 Crop 2 Name: Crop 2 Max. PAN:
o
O
Q
Volume applied
Pp
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
(Dry Tons/AG)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry,
wet,Hrs.
Moist)
Precip.
Past 24
inches
�y
to
o�
* p
*
°n
6;
*
�.
°o
TKN
mg/kg
5
�.
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbslacre)
Name of Crap Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
April
126,000
L16
0.677
NCO021709
dry
0
s
0.5
30%
50700
862
1460
22.812
NA
fescue
0.000
0.000
0.000
0,000
0.000
0.000
0,000
0.000
0.000
0.000
0.000
0.000
October
57600
1.16
0.310
NCO021709
dry
0
s
0.5
30%
50700
862
1460
10,428
NA
fescue
0.000
0.000
0.000
0,000
0.000
0.000
0A00
0.000
0.000
Residuals Applications totals on FORM FSF supp ( attach FORM
FSF supp to this form):
TOTALS:.
01
183600
.'` .:::
A5
I Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
33.240
omo
Lime Applli,ed
Annual lbs/acre
0.008
0,447
0.455
0.002
0.026
0.028
0.739
10.108
10.847
0.000
na
#######
0.020
0.583
0.603
0.001
0.005
0.006
0.010
0.035
0.045
0.027
0.358
0.385
0.008
0,376
0.384
1,044
15,771
16.815
35.520 :;:::.>:..::::::: .:
::.
_....... _.....................
Date
lbs/ac
Prior Years Cumulative lbs/ac
10.5
2384
Current Cumulative lbs/ac
Permitted C, P. L. R. * * *
Permit PAN Limit l st/2nd Crop
SDI certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
Signature of Land Applier
/1 /�� *Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

/
Mer°tecK_ Inc.
Environmental Laboratory
Laboratory Certification No. 165
Client: Town of JcOersonVVVV7P
P.0.Box 67
Jefferson, NC28G40
Report Date:
I/30/2020
NP0ES#�
N[O02I709
Project:
Sludge
Date Sample Rcvd:
1/16/2020
Meritech Work Order# 01152004 Sample: Digester Sludge Grab 1/14/20
Paramcters
Restilts
Analysis Date
Reporting Limit
Method
96Total Solids
1.16%
1/16/2020
0'10096
SNZ540B
Ammonia, Nitrogen
<862 cu-/k-
1/21/2020
862 rng/ks
CpA350.1
TKN
50700 m-/k-
1/I7/2020
0.20mg/k-
EPA351.1
Nitrate/NitriLe.Nicrognn
1460 mg/ka
1/22/3020
31.3 mg/kg
SPA353.2
A|umiounn'toto|
5540 mA/k�
1/22/2O20
2�S m�/��
CP&28O.7
Arsenic, total
<431 rng/kg
I/23/2020
4�31 on�/k�
EP&%0O.7
Cadmium, total
<0.862rng/ko
1/23/2020
8�862 nnQ/ko
EPA 20O.7
Calcium, total
15400 mg/k-
1/2-3/2020
10.0rng/kg
EP&2O0.7
Copper, total
385 mg/kg
1/23/2020
1.00 nn-/k-
PPA2007
Lead, total
10.3rng/kg
1/29/2020
0.500 nog/k-
GPAZ0O7
Magnesium, total
4600 mg/kg
1/23/2020
10.0 mg/kg
EPA200.7
K4ercury'\nta|
0302mg/ku
1/21/2020
0.100 mg/kg
EPA24S.l
Mo|ybdenom'�oL�|
S�28n��/ks
1/23/2038
U�S0O mg/k�
EPAZ007
Nickel, total
I3.9mug/ko
1/23/2020
Z.Dmg/ku
EPA2UO7
Phosphorus, total
185UUcug/kg
1/23/2020
Z.00rog/kg
EPAZ0U.7
Potassium, total
4940 cng/ko
1/23/2020
20.0 nig/ko
CPA2U0.7
Selenium, total
<4.3I nng/k-
1/29/2020
4.31 mg/kg
EPA20O.7
Sodiun\Lwta|
3160 nug/k-
1/23/2020
20.0 mg/ko
EPA2UO.7
Zinc, total
544 m�/k�
l/2�/J828
O��AO mo�/k�
EP&2UO.7
o
} hereby certify that / have reviewed and approve these data.
642]'aoicoRoad, Reidsville, Nortb C

a ° , of Custody Record (COCj
,<tlrt
� NP[)I_Stt:_�-
1
IMERITECH, INC.
Cllt.rtt:_uj 0WR 61- 4 _i'ri.��-(;Y ,S .CI-. _ Phone . ( 1 l �.::_._.
:,. ENVIRONMENTAL. LABORATORIES
a+
-.._.._._ ��C:�` ��`�tSY1, �'�� l�� ll� �r W11S l�l�__!-1� !�
6 s2 Tarn Rd. Phone: 3.3C 3A7.-�174f3
G
_____.___ — ______`_. _ ._.._ _ ----. Project: ,
Reidsville NC 27320 Fax: [phone]
P 0.11:
Email: [e-mail]
Attention: Turn Around Time*
1Nww.ti-ie1"ItC'.C:hlab torn
*HUSH Work needs irnor api>r+n ri
Flow would you like your report sent? Q tr v,; ni piv
( std 10da s) s- , u1y
Circle all that apply: Email itrntirrrdl , Fa)x, Mail �---� J
Sampling Dates S,R Times
Person
Person T aing Sample (Sign/Print):
k
Use Only
&)Triple I-tJCc3tiotl andlor ![? It
Start
End
Comp?
Hof
Test(s) Required
On Ice?
pi -I OK?
Date
Time
Date
Time
Grab?
Cont.
y
.Ye'«`J No
(,) OK?
C
1ISA
TofatSo) i.S
W11,51 IfY f zy
1
_.
Zinc-)
Temperature Upon
Method of
'`k Qechlorination (<D.S ppin) of Amnioni,, Cyanide, Phenol aril TKN samples must be done in the field prior to preservation.
Comments:
Compositor 4Shipment:
[ { UPS1....—uE
It
Fed -Ex
� ..� Hand Delivery
�
It Are then. results for regulatory purposes? Yes ' •--� No --� Report results in: mg/t (._f` mglkg ug/t i
elimiuishe-d try: Date: dime: `/ �~S__ Received by' [late:
��.�
—� Other
�.
elinttuishrd by date: Time, Received by: Date: Tine,
Relinrµushed by Date, Time: Reteid 17y"[b s t t�)�t Ttu)T
1

Page 1
Contact: Tim Church Report Date: 9/10/2020
Client: Town ofJefferson WW7P NPDS8#: NC0021709
P.O.Box 67 Project: Class Sludge
Jefferson, NCZ804O Date Sample Rcvd: 8/18/2020
&1mritechWork Order # 08182062 Sample: Sludge Digester Grab 8/18/20
Paramete
���
Analysis Date
Det. Limit
Reg. Limi
Method
Arsenic
<0.100oor/L
8/37/2020
0,100
5.0
8R43O0.7
Barium
0.144mo/L
8/27/2020
0.050
100.0
EPAZ0O.7
Cadmium
<0.020oug/L
8/27/2020
0.820
1.0
DPA200.7
[brooniuou
x0.05800g/L
8/27/3020
0.050
5.0
B9A30O.7
Lead
<0.100 mg/l
8/27/2020
0.100
5.0
EPA 2O0.7
Mercury
x0.02mug/L
9/1/2020
0.03
0.2
EPA 245.1
Selenium
<0.100 mug/L
8/27/2020
0J00
1.0
2PA2OU.7
Silver
<0.060 nmg/L
8/27/3020
0.050
5,0
EPA3OO.7
TCLPOrganics
Parameter
Results
Analysis Date Reporting Limit
Method
Volaties8260
Attached
8/28/2030 -
8260
TestsOther
Parameter ResultsAnalysis Da Reporting Limit Method
Cyanide, total x0.Q5O ozm/ko 8/2S/2020 0.050rmn/ko EPA 3354
Sulfide <1.08 mg/kg 8/25/2020 1.00mg/bg SK44500S2D8
Flash Point >1400P 8/21/2020 - EPAID208
Corroohjvity(p8) 3�9 S.U. 8/24/2020 1.0 ' I4.O S,D. 3M45O08B
6421[mmocoRoad, Reidsville, Nmrtb Cmc*0mm3732M

Meritech, Inc.
Environmental Laboratory
Laboratory Certification No. 165
Page 2
Contact: Tim Church Report Date: 9/10/2020
Client: Town of Jefferson WWTP NPDES#: NC0021709
P.O. Box 67 Project: Class B Sludge
Jefferson, NC 28640 Date Sample Rcvd: 8/18/2020
Meritech Work Order# 08182062 Sample: Sludge Digester Grab
1311 - TCLP Pesticides & Herbicides
Pesticide - SW-846 8081A
Parameter Results Analysi5Dpte DetAimit Reis. irni Dilution Factor
Endrin Attached
Chlordane Attached
Toxaphene Attached
Methoxychlor Attached
Heptachlor Attached
Lindane Attached
Herbicides - SW-846 8151A
Parameter Results Analysis Date Det. Limit Reg. Limit Dilution Facto
2,4-D Attached
2AS-TP (Silvex) Attached
10
I hereby certify that I have reviewed and approve these data.
Laboratory Representative
642 Tamco Road, Reidsville, North Carolina 27320
tel.[phone] fax.[phone]

E ET'E , INC.
Environmental Laboratories
Laboratory Certificate #165
Client: Jefferson WWTP
Project: Class B Sludoe
C
Client Sample ID: Sludge Digester
Sample Collection: 08/18/20
Meritech Sample ID: 08182062
1311 - TCLP Organics
Volatiles: SNV-846 8260
Analysis: 08/25/20
Extraction:
08/20/20
Analyst: VWrV
Report Date.
09/01/20
Parameter
Result
Units
Det Limit
Rea. Limit
Dilution Factor
Benzene
< 0.0100
m goil-
0.0100
0.50
10
Carbon Tetrachloride
< 0.0100
mgfL
0.0100
0.50
10
Chlorobenzene
< 0.0100
mg/L
0.0100
100
10
Chloroform
< 0.0100
mg/L
0,0100
6.0
10
I..2-Dichloroethane
< 0.0100
mg/L
0.0100
0.50
10
I,I-Dichloroethene
< 0.0 100
mgfL
0.0100
0.70
10
Methyl Ethyl Ketone
< 0.100
mg/L
0.100
200
10
TetraGhloroethylene
< 0.0100
mZJL
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
Semi-Volatiles: SW-846 8270
Analysis: 08/28/20
Extraction:
08/20/20
Analyst: PM
Report Date:
09/01/20
Parameter
Result
Units
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
Hexachl oro- 1.3 -butadi ene
<0.100
mg/L
0.100
0.5
10
Hexachloroethane
<OMO
mg/L
0.100
3.00
10
O-Cresol
<0. 100
mg,"L
0.100
200
10
m&p-cresol
<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
10
Pentachlorophenol
<0.500
mg/L
0.500
100
10
Pyridine
<0. 100
m -",
0.100
5.0
10
2,4,5-Trichlorophenol
<0. 100
mg/L
0.100
400
10
2,4,6-Trichlorophenol
<0. 100
mg/L
0.100
100
10
2.4-Dinitrotoluene
<0. 100
in-"
0.100
O. 13
10
I hereby certify that I have reviewed and approve these data. �/" - ;",/,
Laboratory Representative
642 Tamco Road * Reidsville, NC 27320
[phone] * [e-mail]

RESUARCh & ANAIYT*ICAI
I-AboRATORiIES, INC.
Analytical/Process Consultations
Toxicity Chaj
Characteristic Leachate Procedure (TCL P) Analysis
Melt
for itech, Inc., collected 12 & 18 August 2020)
08182045
08182062
EPA HW
Quaiftitation
Results
Results
Characteristic
Number Contaminant
Liniit(mg/L)
(ma/L)
(mg/L)
Level(ing/L)
EPA Method
Anal ys
1. TCLP PESTICIDES/HER'BICIDES
D-020 Chlordiae
0.003
BQL
BQL
0,030
8081
MG
D-016 2,4-D
1.000
BQL
BQL
10.0
8151
MG
D-0 12 r--ndriii
0.002
BQL
BQL
0.020
8081
MG
D-031 Fleptachlor
010008
BQL
BQL
0.008
8081
MG
D-013 Lind aiie
0.040
BQL
BQL
0.400
8081
MG
D-014 Methoxychlor
1.000
BQL
BQL
10.0
8081
MG
D-015 Toxaphene
0.05
BQL
BQL
0.500
8081
MG
D-017 2,4,5-TP(Silvex)
0.100
BQL
BQl,
1.00
8151
MG
Sample Numbej-
86342-01
86342-02
Sample Date
08/12/20
08/18/20
Sample Time (ht-s)
1315
0900
Sample Matrix
Sludge
Sludge
Date Aualyyed
08/27-09/09/2020
08/27-09/09/2020

a,vna Chain of Custody Record (COC)
NPDES#: NMcQ-170q
Client: e'&fS0n VU VU I Phonef33(P) 2,)
Address:NNw • W Fax:
-��`- � , �� �� Ematl1,1
� tZ{ S(�Y`�a_ � �U Project: C--Ja�55 B SIUJ Z_
P.O.#:
Turn Around Time*
Attention:
*RUSH work needs prior approval,
Haw would you like your report sent? c, es n
Email� Sid 10clays) 3-5 Di s 2 s
Circle all that apply: :{pre#erred) , Fax, Mail
am E RITECH
1 L'1r. B • INC
ENVIRONMENTAL LABORATORIES
�., OR ES
642 Tamco Rd. Phone: [phone]
r
Reidsville NC 27320 Fax: [phone]
A Email: [e-mail]
www.meritechlabs.com
Sample Location and/or ICI #
Sampling Dates & Times
person Taking Sample (Sign/Print):
Lab Use Only
Start
End
Camps
Grab?
Nof
Cont.
Test(s) Required 4 L!ied
ice?
Yes / No
pOn H OK?
ClCOK?
Date
Time
Date
Time
(
I
Temperature Upon
Receipt:
Method Of
Shipment:
*** Dechlorination (<0.5 p m) of Ammonia, Cyanide, Phenol and TY.N samples must be done in the field prior to preservation. ***
Comments:
Compositor #
UPS
Jug #
Fed Ex
Are these results for regulatory purposes? Yes 10, No Q
Report results in: mg/L [ j mg/kg C ug/L i
'Hand Delivery
Relinquished by: Date: Time: �h
19 2
Received by: Date: Time:
�y.
t f 1
U. Other
U.
Relin sXe by: ' D�te .. mm Time:
Received by: Date: Time:
Relinquished by: Date: Time:
Received by tab rj Date: Time:

SAR for Biosolids or Wastewater
Sodium Absorption Ratio
Na : Sodium (Mg/Q Equivalent weight: 23
Ca: Calcium (Mg/Q Equivalent weight: 20
Mg: Magnesium (Mg/L) Equivalent weight: 12
Milli Equivalent= Mg/I. /Equivalent weight
Iq / Z02,0
Na(Mg/L) Ca(Mg/L) MgLMg/L _Q
36.6 1 178.6 53.3
1 .59'1 304
8.93
4 441667
SAR= Na Milli Equivalent/[0.5 X (Ca Milli Equivalent + Mg Milli equivalent)]0.5 power
I S,,�,R = =,,Frcm NIgIlL entered above)
If your lab reports In Milli Equivalents enter Na, Ca, & Mg below:
SAR= #DIWO! j(Proin ME entered belowl)
I N�q_ (ME I Ca (MEN I
Exchangeable Sodium Percentage (FOR SOIL SAMPLE RESULTS)
ESP = Na (Milli Equivalents) / CEC X 100
%
Na on NC soil test is expressed as meq.
The percentage of sodium ions occupying the

ANNUAL PATHOGEN AND VECTOR ATTRACTION REDUCTION FORM (02T Rules)
Facility Name: Tim Church
WWTP Name: Town of Jefferson WWTP
WQ Permit Number: WQ0004166
NPDES Number: NCO021709
Monitoring Period: From l/1/2020 To 12/31/2020
Pathogen Reduction (15A NCAC 02T.1106) - Please indicate level achieved and alternative performed:
Class A:
Alt. A (time/temp) 0—T—Alt
B (Alk Treatment) Ej
Alt. C (Prior Testing)EI
Alt.D (No Prior Test) ❑
Process to Further Reduce Patho-engs LI
If applicable to alternative performed (Class A only) indicate "Process to Further Reduce Pathogens":
Compost 11
Heat Drying 0
Heat Treatment El
-niermophille. 0
Beta Ray cl
Gamma Ray C1
Pasteurization D
Class B:
jAlt. (1) Fecal Density 21
71t. (2) Process to Significantly Red -Lice Pathogens D
If applicable to alternative performed (Class B only) indicate "Process to Significantly Reduce Pathogens":
Lime Stabilization ❑
Air Drying 0
Composting 0
Aerobic Digestion Z
Anaerobic Digestion 11
If applicable to alternative performed (Class A or Class B) complete the following monitoring data:
Parameter
Allowable Level
in Sludge
Pathogen Density
Number ol
Excee-
dences
Frequency
of Analysis
Sample
Type
Analytical
Tech -
niaue
Minimum
Geo. Mean
Maximurr
Units
Fecal Coliform
2 x 10 to the
6th power
per gram of
total solids
MPN
CFU
4748
11138
29550
CFU
0
Daily
Grab
SM9222D
1000 mpn per gram
of total solid (dry
weight)
Salmonella bacteria
(in lieu of fecal
coliform)
3 MPN per 4 grams
total solid (dry
weight)
Vector Attraction Reduction (15A NCAC 02T .1107) - Please indicate alternative performed:
Alt. I (VS reduction) El
Alt. 2 (40-day bench) El
Alt. 3 30-day bench) FTIt:74
(Spec. 02 uptake) L]
Alt. 5 (14-Day Aerobic) [I
Alt. 6 (Alk. Stabilization [3
Alt 7 (Drying - Stable) 0
JAR. 8 (Drying - Unstable) El
Alt. 9 (Injection) El
Alt. 10 (Incorporation) [I
No vector attraction reduction alternatives were performed El
CERTIFICATION STATEMENT (please check the appropriate statement)
"I certify, under penalty of law, that the pathogen requirements in 15A NCAC 02T.1106 and the
vector attraction reduction requirement in 15A NCAC 02T.1107 have been met."
"I certify, under penalty of law, that the pathogen requirements in 15A NCAC 02T.1106 and the
vector attraction reduction requirement in 15A NCAC 02T.1107 have not been met." (Please note
if you check this statement attach an explanation why you have not met one or both of the
requirements.)
"This determination has been made under my direction and supervision in accordance with the system
designed to ensure that qualified personnel properly gather and evaluate the information used to determine
that the pathogen and vector attraction reduction requirements have been met. I am aware that there are
significant penalties for false certification including fine and imprisonment."
Tim Church, Water Resources Director
Preparer e and Title (type or print)
uf6"J�
Signature of Preparer* Date
Land Applier Name and Title (if applicable)(type or print)
Signature of Land Applier (if applicable) Date
*Preparer is defined in 40 CFR Part 503.9(r) and 15A NCAC 2T. 1102 (26)
DENR FORM PVRF 02T (12/2006)

Fw--3
WATER QUALITY LAB & OPERATION, INC.
P.O. BOX 1167,13ANNER ELK, NC 28604
[phone]
CLIENT: JEFFERSON SLUDGE LOGIN TIME: 9:00 AM
SAMPLER: TIM CHURCH
COLLECTED DATE: 9-Jan-20
REPORTED DATE: 6-Feb-20
InIt,
w ANA10YS T -ANALYSlS:,mQL'slUNjT$:
4::4AMP�eT..A.
NALY$
:MET
......
LoCAllo
f 00. M PL rzT- E 0
C
TOTAL SOLIDS
0.88
%
FECAL COLIFORM
29550
1
CFU's
1
1 O-Jan-20
SM-9222D
WPS
REPOR I ED BY: NC ULK I IFIFU LAIJ 4 b44
PAUL ISENHOUR, SUPERVISOR
DATE C-Fit s
11
' ul,
115. zo
43.
7,631
Z9- 210
/�1' q 0 1
ZII. IZ71
Z.-I 3Z77
Y. M8
7
DO
Ge me4r►-c, Run /;�47

CLIENT: JEFFERSON SLUDGE
ADDRESS:
CITY:
STATE:
ID#:
WATER QUALITY LAB & OPERATION, INC.
P.O. BOX 1167,13ANNER ELK, NC 28604
[phone]
LOGIN TIME:
11:00 AM
SAMPLER:
TIM CHURCH
COLLECTED DATE:
14-Jan-20
REPORTED DATE:
6-Feb-20
ANALYSIS
ANALYSIS
MQL's
UNITS
SAMPLE
ANALYSIS
METHOD
INT
RESULTS.
LOCATION
COMPLETED
CODE
TOTAL SOLIDS
0.9
%
FECAL COLIFORM
8200
1
CFU's
2
15-Jan-20
SM-9222D
WPS
REPORTED BY: NC CERTIFIED LAB # 544
PAUL ISENHOUR, SUPERVISOR

CLIENT: JEFFERSON SLUDGE
ADDRESS:
CITY:
STATE:
rv"
WATER QUALITY LAB & OPERATION, INC.
P.O. BOX 1167,BANNER ELK, NC 28604
[phone]
LOGIN TIME:
10:50 AM
SAMPLER:
TIM CHURCH
COLLECTED DATE:
15-Jan-20
REPORTED DATE:
6-Fe5-20
ANALYSIS
ANALYSIS
M,QL's
UNITS
SAMPLE
AWALYSIS'.,
METHO D
INT
RESULTS-
LOCATION
COMPLETED
CODE.
TOTAL SOLIDS
0.9
%
FECAL COLIFORM
13601
1
CFU's
3
16-Jan-20
SM-9222D
WPS
REPORTED BY: NU GLK I IFILU LAb;; 544
"m
rammMG
PAUL ISENHOUR, SUPERVISOR

CLIENT: JEFFERSON SLUDGE
ADDRESS:
CITY:
STATE:
ID#:
WATER QUALITY LAB & OPERATION, INC.
P.O. BOX 1167,BANNER ELK, NC 28604
[phone]
LOGIN TIME:
10: 30 AM
SAMPLER:
TIM CHURCH
COLLECTED DATE:
21 -Jan-20
REPORTED DATE:
6-Feb-20
ANALYSIS
ANALYSIS
-MQL's
UNITS
SAMPLE
ANALYSIS, METHOD
INT
RESULTS
10CATION
COMPLETED 'CODE
TOTAL SOLIDS
0,92
%
FECAL COLIFORM
13306
1
CFU's
4
22-Jan-20 SM-9222D
WPS
Kt:NUK I tU bY: NU ULK I It-ItU LAb # 544
PAUL ISENHOUR, SUPERVISOR

CLIENT: JEFFERSON SLUDGE
ADDRESS:
CITY:
STATE:
I D#:
WATER QUALITY LAB & OPERATION, INC.
P.O. BOX 1167,BANNER ELK, NC 28604
[phone]
LOGIN TIME:
12:00 PM
SAMPLER:
TIM CHURCH
COLLECTED DATE:
23-Jan-20
REPORTED DATE:
6-Feb-20
ANALYSIS
ANALYSIS
moos
UNITS
SAMPLE
: ANALYSIS
METHOD
INT
RESULTS
LOCATION
COMPLETED .
CO . DIE.
TOTAL SOLIDS
0.92
%
FECAL COLIFORM
7631
1
CFU's
5
24-Jan-20
SM-9222D
WIPS
Mt=t-Utl 1 tU BY: NU UtK I IFItL) LAt3 A 544
PAUL ISENHOUR, SUPERVISOR

CLIENT: JEFFERSON SLUDGE
ADDRESS:
CITY:
STATE:
in'4-
WATER QUALITY LAB & OPERATION, INC.
P.O. BOX 1167,BANNER ELK, NC 28604
[phone]
LOGIN TIME:
11:00 AM
SAMPLER:
TIM CHURCH
COLLECTED DATE:
28-Jan-20
REPORTED DATE:
6-Feb-20
LT.
ANALYSIS
ANALYSIS
MQL's
UNITS
SAMPLE
ANALYSISMETHOD
, INT
RESULTS
LOC ATION'
COMPLETED
'CODE
TOTAL SOLIDS
0.91
%
FECAL COLIFORM
4748
1
CFO's
6
29-Jan-20
SM-9222D
WPS
REPORTED BY: NC CERTIFIED LAB # 544
PAUL ISENHOUR, SUPERVISOR

CLIENT: JEFFERSON SLUDGE
ADDRESS:
CITY:
STATE:
WATER QUALITY LAB & OPERATION, INC.
P.O. BOX 1167,BANNER ELK, NC 28604
[phone]
LOGIN TIME:
11:00 AM
SAMPLER:
TIM CHURCH
COLLECTED DATE:
29-Jan-20
REPORTED DATE:
6-Feb-20
ANALYSIS
ANALYSIS.-
MOL!s,
UNITS
SAMPLE
ANA4Y$i$
METH66,
INT
RESULT.S
TLO.CA-TION
.omp . tltto
coot: -
TOTAL SOLIDS
�FECAL COLIFORM
0.9
13401
1
%
CFU's
7
30-Jan-20
SM-9222D
WpS
REPORTED BY: NC CERTIFIED LAB # 544
PAUL ISENHOUR, SUPERVISOR

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LITY ID: JefTers"oll Wastewater, I 1.,r�.,llulwnt Pkint N'\ H. 3 - Cs
SA;",,I I'L E R NA M E: Tim Church N A 2 S' 0 UT;
COMPOSITE SAMPLE: START 11ME: S,FOP
SAMPLE \AC:
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2 S S9,� 27
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CLIENT:
ADDRESS:
CITY:
S/*/c
|Off-
WATER QUALITY LAB & OPERATION, INC.
PD.BOX 1167.BANNERELK, NC28GO4
[phone]
JEFFERS0N
SAMPLER� T|M CHURCH
JEFFERSON COLLECTED DATE: 3-Feb-20
NC REPORTED DATE: 10-Mmp20
30 DAY BENCH SCALE
START
END
VOL0LESOLIDS REDUCTION
1.60%
i \[~�
.YYL+ bp ~S i�� 4�~- V �C*C�16y�
� SM -
REPORTED BY: NCCERTIFIED LAB #544

WATER QUALITY LAB &OPERATIONS, INC.
LAB No. 544
30 DAY BENCH SCALE VAR OPTION 3
SM 2540 E
ANALYST: 1� S TIART SAT IE _z - 5 -2 ID
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NCDA&CS Agronomic Division Phone: [phone]
Website: www.ncagr.gov/agronomi/
Report No. FY21-SL007446
Predictive
Client:
Town of Jefferson
302 East Main St t PO Box 67
Advisor: Micah Offield
Ashe CES
V
Jefferson, NC 28640
134 Government Cir #202
Soil Ret)ort Mehlich-3 Extraction
Jefferson, NC 28640
Sampled County: Ashe
Links to Helpful Information
Client ID: 88367
Advisor ID: 482273
Sampled: 10/06/2020 Received: 10/08/2020 completed- 10/16/2020
Farm:
Sample ID: FWALT
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tons/acre)
N P2O5
K2O
Mg S
Mn
Zn
Cu 8
Information
Lime History:
1 - Fescue/OGrass/Tim, E 0.0
50-70 0
40
0 0
pH$
0
0 0
Note: 12 Note:
2 - Fescue/OGrass[Tim, M 0.0
120-200 0
80
0 0
pH$
0
0 0
Note: 12 Note., I
Test Results [units - W/V in g/crn3; CEC and Na in meq/100 cm3; NO3-N in mgidd]:
Soil Class:
Mineral
HM% W/V CEC BS% Ac pH P4 K4
Ca% Mg%
S4
Mn4
Mn-Ali Mn-Al2
Zn4
ZnAl
Cu-1 Na ESP SS-1 NO3-N
0.36 0.90 14.6 91 1.4 6.5 160 29
61 29
61
235
150 150
1059
1059
634 0.2 1
Sample ID: BWALT
Recommendations: Lime
Nutrients (Iblacre)
More
Crop (tons/acre)
N P2O5
K2O
Mg S
Mn
Zn
Cu B
Information
Lime History:
1 - Fescue/OGrass/Tim, E 0.0
50-70 0
30
0 0
pH$
0
0 0
Note: 12 Note: $
2 - Fescue/OGrass/Tim, M 0.0
120-200 0
70
0 0
pH$
0
0 0
Note: 12 Note* I
Test Results [units - W/V in gled; CEC and Na in meq/1 00 cm3; NO3-N in mg/drrii]:
Soil Class:
Mineral
HM% WIV CEC BS% Ac pH P4 K4
Ca% Mg%
S4
Mn4
Mn-All Mn-AI2
Zn4
Zn-A1
Cu-1 Na ESP SS-1 NO3-N
0.36 0.90 15.1 90 1,5 6.6 80 36
59 30
53
375
234 234
548
648
378 0.2 1
Sample ID: JWALT
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tons/acre)
N P2O5
K2O
Mg S
Mn
Zn
Cu B
Information
Lime History:
1 - Fescue/OGrass/Tim, E 1.1
50-70 30
20
0 0
0
0
0 0
Note: 12
2 - Fescue/OGrassiTim, M 0.0
120-200 10
60
0 0
0
0
0 0
Note: 12
Test Results [units - W/V in g/cn?; CEC and Na in meq/100 cm3; NO3-N in mg/dM3]:
Soil Class:
Mineral
HM% W/V CEC BS% Ac pH P-1 K-1
Ca% Mg%
S4
Mn4
Mn-All Mn-Al2
Zn4
Zn-Al
Cu-1 Na ESP SS-1 NO3-N
0.60 0.91 13.6 88 1.6 6.3 60 41
58 29
56
600
369 372
296
296
221 0.2 1
North Carolina
Reprogramming of the laboratory -information -management system that makes this report possible is being funded
through a grant from the North Carolina Tobacco Trust Fund Commission.
Thank you for using agronomic services to manage nutrients and safeguard environmental quality.
- Steve Troxier, Commissioner of Agriculture