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WQ0010583_Modification_20210615
Initial Review Reviewer Thornburg, Nathaniel D Is this submittal an application? (Excluding additional information.)* r Yes r No Permit Number (IR)* WQ0010583 Applicant/Permittee Davie County Applicant/Permittee Address 123 S. Main St. Mocksville NC 27028 Is the owner in BIMS? r Yes r No Is the facility in BIMS? r Yes r No Owner Type County Facility Name Davie County RLAP County Davie Fee Category Major Fee Amount $395 Is this a complete application?* r Yes r No Complete App Date 06/15/2021 Signature Authority Signature Authority Title Signature Authority Email Document Type (if non -application) Email Notifications Does this need review bythe hydrogeologist?* r Yes r No Regional Office CO Reviewer Admin Reviewer Below list any additional email address that need notification about a new project. Email Address Comments to be added to email notfication Comments for Admin Comments for RO Comments for Reviewer Comments for Applicant Submittal Form Project Contact Information Rease provide information on the person to be contacted by N B Staff Name * Brent Collins Email Address* brent.collins@emaresourcesinc.com electronic subnittal, confirmation of receipt, and other correspondence. Phone Number* 336-399-3646 Project Information ............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................... Application/Document Type* r New (Fee Req ui red) c Modification - Major (Fee Required) r Renewal with Major Modification (Fee Required) r Annual Report r Additional Information r Other 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:* WQ0010583 Fbs Current Existing permt number Applicant/Permittee* Davie County Applicant/Permittee Address* 123 S. Main St. Mocksville NC 27028 Facility Name * Davie County 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 nathaniel.thornburg@ncdenr.gov. Please attach all information required or requested for this submittal to be reviewed here.* (Application Form Engineering Rans, Spec'rfications, Calculations, Rc.) Permit Modification - Davie County WQ00105836.pdf 36.28MB Upload only 1 R7Fdocurnent (less than 250 NS). Multiple documents nest be corrbined into one R7Ffile unless file is larger than upload limit. * W 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 ff &Oaw 6/8/2021 June 7, 2021 Division of Water Resources Water Quality Permitting Section Non -Discharge Permitting Unit 1617 Mail Services Center Raleigh, NC 27699-1617 RE: Permit Modification — WQ00105836 To Whom it May Concern: EMA Resources is submitting the included permit modification the Davie County permit - WQ00105836. This modification will add 3 new land application sites (4 fields) to their permit. We are also requesting a dry ton increase to handle a cleanout of their lagoon due to storm damage. Davie County is working with FEMA on the cleanout process and this land and the dry ton increase are needed as soon as possible. A check for $395 for the modification fee will be mailed today as well. If you have any questions concerning this renewal, please contact Brent Collins — Director of Technical Services Respectfully, Z:�e4;2:� Brent Collins Director of Technical Services brent.collins(cr�,emaresourcesinc.com (336) 399-3646 Phone 336.751.1441 — Fax 336975191442 755 Yadkinville Rd — Mocksville, NC 27028 g Inc. Permit Modification Application For Davie County WQ00105836 Land Application of Residuals Prepared By: EMA Resources Inc. 755 Yadkinville Road Mocksville, NC 27028 336-751-1441 June 7th, 2021 Phone 336975191441 — Fax 336975191442 755 Yadkinville Road — Mocksville, NC 27028 Table of Contents 1) RLAP Form a) Current Permit 2) RSC Form a) Vicinity Map b) Process Flow Diagram c) Quantitative Justification d) Operation and Maintenance Plan — Including Sampling Plan e) Residuals Quality Information i) Laboratory Analytical Reports ii) Residuals Information Sheet 3) LASC Form a) County Commissioner Notification Information b) Landowner Agreement c) Setback Waiver Where Applicable (1 included) d) Vicinity Map e) Aerial/Application Map f) Topo Map g) Soil Map h) Background Soil Sample and Heavy Metals i) Soil Scientist Evaluation 1) RLAP Form 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 FORM: RLAP 06-16 L APPLICANT INFORMATION: 1. Applicant's name: Davie County Applicant type: ❑ Individual Corporation ❑ General Partnership ❑ Privately -Owned Public Utility ❑ Federal E7State ❑ Municipal ® County Signature authority's name per 15A NCAC 02T .0106: Johnny Lambert Title: Utilities Director Applicant's mailing address: 123 South Main St City: Mocksville State: NC Zip: 27028- Telephone number: (336) 753-6001 Email Address: jlambert&daviecoiMnc.gov 2. Consultant's name: Brent Collins License Number (for P.E.): Affiliation: ❑ On Staff ® Retained (Firm: EMA Resources Inc.) Consultant's mailing address: 755 Yadkinville Rd City: Mocksville State: NC Zip: 27028- Telephone number: (336) 751-1441 Email Address: brent.collinskemaresourcesinc.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: Rob Wilcox License Number: 1098 Affiliation: ❑ N/A ❑ On Staff ❑ Retained (Firm: Wilcox & Mabe Soil Solutions) Soil Scientist's mailing address: 7231B Summerfield Rd City: Summerfield State: NC Zip: 27358- Telephone number: (336) 339-9128 Email Address: robkwilcoxmabesoil.com 5. Fee submitted: 395 (See Instruction B) IL PERMIT INFORMATION: 1. Application is for (check all that apply): ❑ new, ® modified, ❑ renewed permit 2. If this application is being submitted to renew or modify an existing permit, provide the following: Permit number: W000105836 Date of most -recently issued permit: 05/19/2017 Date of most -recently certified Attachment A (if different than the permit): 05/19/2017 Date of most -recently certified Attachment B (if different than the permit): 12/21/2018 FORM: RLAP 06-16 Page 1 of 5 III. RESIDUALS LAND APPLICATION PROGRAM INFORMATION: 1. Residuals Processing Facility's physical address: 175 Hwy 801 South City: Cooleemee State: NC Zip: 27014- Coordinates: Latitude: 35° 48' 15" Longitude: 80. 33' 40" Datum: NAD83 Method of measurement: GPS Level of accuracy: nearest second 2. County where residuals land application program is headquartered: Davie 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 Roy Whitaker EMA Resources Inc. 13283 Back -Up ORC Brent Collins EMA Resources Inc. 27651 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: 1149 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 2.09 3.299 2401 3791 Five -Year Maximum Adjusted 2.589 3.799 2975 4365 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 21.7 Hay/Pasture 341.44 Total: 363.14 Methods Surface 363.14 Incorporation or Injection 0 Total: 363.14 FORM: RLAP 06-16 Page 2 of 5 c. Residuals Land Application 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 (lbs 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 48.02 75.82 59.5 87.3 100 24.01 37.91 29.75 43.65 150 16 25.27 19.8 29.1 200 12 18.95 14.87 21.83 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): 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. 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. MAI Land Application Siite 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 1. The irrigation system is: 17 Spray F1 Drip 2. Disposal system is: ❑ existing proposed. 3. Minimum depth to mean seasonal high water table (SHWT) within irrigation sites(s) per Soil Scientist's Evaluation: feet below ground surface. Rules 15A NCAC 02T .0505(p) requires at least one -foot vertical separation between SHWT 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 Recommended Loading Rate in/hr Recommended Loading Rate in/vr 6. Design loading rates are equal or less than the loading rates recommended by Soil Scientist? ❑ Yes or ❑ No If No, explain why 15A NCAC 02T .0505(n) is not met: 7. Non -dedicated System Design (fill in the appropriate information for either a spray or drip irrigation system): Field / Zone Design Area W Number of Nozzles Maximum Application Rate allons/hr Design Annual Loading Rate allons/ r Total Spray Irrigation Design Element Plan Sheet Number Specification Pa a Number Wetted diameter of nozzles ft Wetted area of nozzles It, Nozzle capacity gpm Nozzle manufacturer / model / Elevation of highest nozzle ft FORM: RLAP 06-16 Page 4 of 5 Applicant's Certification (signing authority must he in compliance with 15A 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 ISA NCAC 02T .0105. ® Yes ❑ No, Explain; I, Johnny Lambert —Utilities Director (Signature Authority's Name — PLEASE PRINT) (Title) attest that this application for Davie County (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 § 143-215.6B, 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 civil penalties up to $25,000 per violation. Signature: Date: le - r2�Zl FORM: RLAP 06-16 Page 5 of 5 la) Current Permit Wafer Resources ENVIRONMENTAL QUALITY May 19, 2017 JOHNNY LAMBERT — UTILITIES DIRECTOR DAVIE COUNTY 123 SOUTH MAIN STREET MOCKSVILLE, NORTH CAROLINA 27029 Dear Mr. Lambert: ROY COOPER Governor MIC1 AEL S. REGAN secrerary S. JAY ZIMMERMAN Director Subject: Permit No. WQ0010583 Davie County RLAP Land Application of Class B Residuals Davie County In accordance with your permit renewal request received March 13, 2017, and subsequent additional information received May 12, 2017, we are forwarding herewith Permit No. WQ0010583 dated May 19, 2017, to Davie County for the continued operation of the subject residuals management program. Modifications to the subject permit are as follows: (1) A net decrease in residuals sources from 533 tons/year to 315 tons/year by removal of Sparks Road WTP and Coo leemee WTP as residual sources while increasing Cooleemee WWTP from 279 to 315 tons/year. (2) A net decrease in land application acreage from 247.85 acres to 119.85 acres with the removal of 34.00 acres from Davie County (NC-DV-005-01 and NC-DV-006-01) and 94 acres from Rowan County (NC-RA-008-01 to -04 and NC-RA-009-01). This permit shall be effective from the date of issuance until April 30, 2022, shall void Permit No. WQ0010583 issued January 21, 2008, and shall be subject to the conditions and limitations as specified therein. Please pay particular attention to the monitoring requirements listed in Attachment A for they may differ from the previous permit issuance. Failure to establish an adequate system for collecting and maintaining the required operational information shall result in future compliance problems. Please note the following permit conditions have been removed since the last permit issuance dated January 21, 2008: ➢ Old Condition II1.9.h. — Removed since redundant and covered by agronomic rate requirements. ➢ Old Condition IV.9. —Length of time records keeping required is part of individual condition. - ->'Nothing Compares :--, State of North Carolina � Environmental Quality j Water Resources I Water Quality Permitting i Non -Discharge Permitting 1617 Mail Service Center i Raleigh. North Carolina 27699-1617 919-907-6332 Mr. Johnny Lambert May 19, 2017 Page 2 of 2 Please note the following permit conditions are new since the last permit issuance dated January 21, 2008: ➢ Condition 1.2. — Compliance within 90 days of Condition 111.3. for notification of application of residuals. ➢ Condition 1.3. —Compliance within 180 days of signage requirements of Condition 1H.12. ➢ Condition II.11. —Grazed pasture land shall have a 25% reduction in hay crop realistic nitrogen rate. ➢ Condition III.3. — Regional Office to be notified at least 24 hours before application onto field. ➢ Condition IRA. -- Operation & Maintenance (O&M) Plan requirements are specified. ➢ Condition 11L6. — Similar to Old Condition IH.5., but now copy of O&M Plan required on site. Note: Copy may include electronic copy. ➢ Condition H1.11. — Requirement for suitable vegetative cover. ➢ Condition III_13. — Signs to be posted on application fields. ➢ Condition Vi.6. — Similar to Old Condition VI.6., but now 60-day notice required before modification or revocation. ➢ Condition VI.7 — Expansion of facility not permitted without variance if Permittee exhibits behavior detrimental to environment. If any parts, requirements or limitations contained in this permit are unacceptable, the Permittee has the right to request an adjudicatory hearing upon written request within 30 days following receipt of this permit. This request shall be in the form of a written petition, conforming to Chapter 150B of the North Carolina General Statutes, and filed with the Office of Administrative Hearings at 6714 Mail Service Center, Raleigh, NC 27699-6714. Unless such demands are made, this permit shall be final and binding. If you need additional information concerning this permit, please contact Troy Doby at (919) 807- 6336 or troy.doby@ncdenr.gov. Sincerely, 78. Jay Zimmerman, P.G., Director Division of Water Resources cc: Davie County Health Department (Electronic Copy) Winston-Salem Regional Office, Water Quality Regional Operations Section (Electronic Copy) Roy L. Whitaker — EMA Resources, Inc. (Electronic Copy) Beth Buffington — Protection and Enforcement Branch (Electronic Copy) Digital Permit Archive (Electronic Copy) Central Files NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION DEPARTMENT OF ENVIRONMENTAL QUALITY RALEIGH LAND APPLICATION OF CLASS B RESIDUALS PERMIT In accordance with the provisions of Article 21 of Chapter 143, General Statutes of North Carolina as amended, and other applicable Laws, Rules, and Regulations PERMISSION IS HEREBY GRANTED TO Davie County Davie County FOR THE continued operation of a residuals management program for Davie County and consisting of the land application of Class B residuals generated by the approved facility listed in Attachment A to the approved fields listed in Attachment B with no discharge of wastes to surface waters, pursuant to the application received March 13, 2017, and subsequent additional information received by the Division of Water Resources, and in conformity with other supporting data subsequently filed and approved by the Department of Environmental Quality and considered a part of this permit. The use and disposal of residuals are regulated under Title 40 Code of Federal Regulations Part 503. This permit does not exempt the Permittee from complying with the federal regulations. This permit shall be effective from the date of issuance until April 30, 2022, shall void Permit No. WQ0010583 issued January 21, 2008, and shall be subject to the following specified conditions and limitations: I. SCHEDULES No later than six months prior to the expiration of this permit, the Permittee shall request renewal of this permit on official Division forms. Upon receipt of the request, the Division will review the adequacy of the facilities described therein, and if warranted, will renew the permit for such period of time and under such conditions and limitations as it may deem appropriate. Please note Rule 15A NCAC 02T .0105(d) requires an updated site map to be submitted with the permit renewal application. (15A NCAC 02T .0108(b)(2), 02T .0105(d), 02T .0109] 2. The Permittee shall be in full compliance with the regional office notification requirements established in Condition 111.3. within 90 days of the effective date of this permit. [ 15A NCAC 02T .0108(b)(2)] 3. The Permittee shall be in full compliance with the signage requirements established in Condition IlI.13. within 180 days of the effective date of this permit. [15A NCAC 02T .0108(b)(2)] WQ0010583 Version 3.0 Shell Version 160210 Page 1 of 12 II. PERFORMANCE STANDARDS 1. The subject residuals management program shall be effectively maintained and operated at all times so there is no discharge to surface waters, nor any contravention of groundwater or surface water standards. In the event the facilities fail to perform satisfactorily, including the creation of prolonged nuisance conditions due to improper operation and maintenance, the Permittee shall immediately cease land applying residuals to the site, contact the Winston-Salem Regional Office supervisor, and take any immediate corrective actions. [G.S. 143-215.1] 2. This permit shall not relieve the Permittee of responsibility for damages to groundwater or surface water resulting from the operation of this residuals management program. [15A NCAC 02B .0200, 02L .0100] 3. Only residuals generated by the facility listed in Attachment A are approved for land application in accordance with this permit. [G.S. 143-215.1] 4. Only the Melds listed in Attachment B are approved for residuals land application. [G.S. 143-215.1] 5. Pollutant concentrations in residuals applied to land application sites listed in Attachment B shall not exceed the following Ceiling Concentrations (i.e., dry weight basis) or Cumulative Pollutant Loading Rates (CPLRs): Parameter Ceiling Concentration (milligrams per kilogram) CPLR (pounds per acre) Arsenic 75 36 Cadmium 85 34 Copper 4,300 1,338 Lead 840 267 Mercury 57 15 Molybdenum 75 n/a Nickel 420 374 Selenium f 00 89 Zinc 7,500 2,498 The Permittee shall determine compliance with the CPLRs using one of the following methods: a. By calculating the existing cumulative level of pollutants using actual analytical data from all historical land application events of residuals, or b. For land where residuals application has not occurred or for which the required data is incomplete, by determining background concentrations through representative soil sampling. [15A NCAC 02T .1105] 6. Residuals that are land applied shall meet Class B pathogen reduction requirements in 15A NCAC 02T .1106 (a) and (c). Exceptions to this requirement shall be specified in Attachment A. [15A NCAC 02T .1106] 7. Biological residuals (i.e. residuals generated during the treatment of domestic or animal processing wastewater, or the biological treatment of industrial wastewater, and as identified in Attachment A) that are distributed shall meet one of the vector attraction reduction alternatives in 15A NCAC 02T .1107(a). Exceptions to this requirement shall be specified in Attachment A. [ 15A NCAC 02T . 11071 WQ0010583 Version 3.0 Shell Version 160210 Page 2 of 12 8, Setbacks for Class B land application sites shall be as follows: Setback by application type (feet) Setback Description Vehicular Irrigation Injection / Surface Surface Incorporation Application Application Habitable residence or place of public assembly under separate ownership or not to be maintained as part of 400 400 200 the project site Habitable residence or places of public assembly owned by the Permittee, the owner of the land, or the 0 200 0 lessee/operator of the land to be maintained as part of the project site Property lines 50 150 50 Public right of way 50 50 50 Private or public water supply 100 100 100 Surface waters (streams — intermittent and perennial, 100 100 50 perennial waterbodies, and wetlands Surface water diversions (ephemeral streams, 25 100 25 waterways, ditches) Groundwater lowering ditches (where the bottom of 25 100 25 the ditch intersects the SHWT Subsurface groundwater lowering system 0 100 0 Wells with exception to monitoring wells 100 100 100 Bedrock outcrops 25 25 25 Top of slope of embankments or cuts of two feet or 15 15 15 more in vertical height Building foundations or basements 0 15 0 Water lines 0 10 0 Swimming pools 100 100 100 Nitrification fields 0 20 0 [I5A NCAC 02T .1109] 9. Land application areas shall be clearly marked on each site prior to and during any residuals application event. [15A NCAC 02T .0108(b)(1)] WQ0010583 Version 3.0 SheIl Version 160210 Page 3 of 12 10. Bulk residuals and other sources of Plant Available Nitrogen (PAN) shall not be applied in exceedance of agronomic rates. Appropriate agronomic rates shall be calculated using expected nitrogen requirements based on the determined Realistic Yield Expectations (RYE) using any of the following methods: a. Division's pre -approved site specific historical data for specific crop or soil types by calculating the mean of the best three yields of the last five consecutive crop harvests for each field. b. North Carolina Historical Data for specific crop and soil types as provided by North Carolina State University Department of Soil Science (http;//nutrients.soil. ncsu.edu/yields/index.phn). A copy shall be kept on file and reprinted every five years in accordance with Condition IVA c. If the RYE cannot be determined using methods (a) or (b) above, the Permittee may use the RYE and appropriate nutrient application rates reported in any of the following documents: i. Crop management plan as outlined by the local Cooperative Extension Office, the North Carolina Department of Agriculture and Consumer Services, the Natural Resource Conservation Service, or other agronomist. ii. Waste Utilization Plan as outlined by the Senate Bill 1217 Interagency Group - Guidance Document: Chapter 1 (http://www.ncagr.gov/SWC/tech/documents/9th Guidance Doc 100109.pdf). iii. Certified Nutrient Management Plan as outlined by the Natural Resources Conservation Services (NRCS). These plans must meet the USDA-NRCS 590 Nutrient Management Standards(ftp://ftp-fc.se.egov.usda.gov/NHO/practice-standards/standards/590.R&. d. If the RYE and appropriate nutrient application rates cannot be determined, the Permittee shall contact the Division to determine necessary action. [ 15A NCAC 02T. I 109(b)(1)(k)] 11. When residuals are land applied to grazed pasture, hay crop realistic nitrogen rate shall be reduced by 25% in accordance with the USDA-NRCS 590 Nutrient Management Standards. [15A NCAC 02T .0108(b)(1)] 12. If land application sites are to be over -seeded or double -cropped (e.g., bermuda grass in the summer and rye grass in the winter with both crops to receive residuals), then the second crop can receive an application of PAN at a rate not to exceed 50 pounds per acre per year (ibs/ac/yr). This practice may be allowed as long as the second crop is to be harvested or grazed. If the second crop is to be planted for erosion control only and is to be tilled into the soil, then no additional PAN shall be applied. [15A NCAC 02T .0108(b)(1)j 13. Prior to land application of residuals containing a sodium adsorption ratio (SAR) of 10 or higher, the Permittee shall obtain and implement recommendations from at least one of the following: 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. 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. The Permittee shall maintain written records of these recommendations and details of their implementation. [ 15A NCAC 02T .0108(b)(1)] 14. These residuals land application sites were individually permitted on or after December 30, 1983; therefore, the compliance boundary is established at either 250 feet from the residual land application area, or 50 feet within the property boundary, whichever is closest to the residual land area. An exceedance of groundwater standards at or beyond the compliance boundary is subject to remediation action according to 15A NCAC 02L .0106(dx2) as well as enforcement actions in accordance with North Carolina General Statute 143-215.6A through 143-215.6C. Any approved relocation of the COMPLIANCE BOUNDARY will be noted in Attachment B. [15A NCAC 02L .0107(a)] WQ0010583 Version 3.0 Shell Version 160210 Page 4 of 12 15. The review boundary shall be established midway between the compliance boundary and the residual land application area. Any exceedance of groundwater standards at the review boundary shall require action in accordance with 15A NCAC 02L .0106. [15A NCAC 02L .0108] M. OPERATION AND MAINTENANCE REQUIREMENTS The residuals management program shall be properly maintained and operated at all times. The program shall be effectively maintained and operated as a non -discharge system to prevent any contravention of surface water or groundwater standards. [ 15A NCAC 02T . 1110] 2. The Winston-Salem Regional Office, telephone number (336) 776-9800, and the appropriate local government official (i.e., county manager, city manager, or health director) shall be notified at least 48 hours prior to the initial residuals land application to any new land application site. Notification to the regional supervisor shall be made from 8:00 a.m. until 5:00 p.m. on Monday through Friday, excluding State Holidays. [15A NCAC 02T .0108(b)(1)] 3. The Winston-Salem Regional Office shall be notified via email or telephone, (336) 776-9800, at least 24 hours prior to conducting any land application activity_ Such notification shall indicate, at a minimum, the anticipated application times, field IDs, and location of land application activities. If it becomes necessary to apply to additional fields due to unforeseen events, the Regional Office shall be notified prior to commencing the application to those fields. [15A NCAC 02T .0108(b)(l)] 4. The Permittee shall maintain an approved Operation and Maintenance Plan (O&M Plan) Modifications to the O&M Plan shall be approved by the Division prior to utilization of the new plan. The O&M Plan, at the minimum, shall include: a. Operational functions; b. Maintenance schedules; c. Safety measures; d. Spill response plan; e. Inspection plan including the following information: L Names and/or titles of personnel responsible for conducting the inspections; ii. 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; iii. Detailed description of inspection procedures including record keeping and actions to be taken by the inspector in the event that noncompliance is observed pursuant to the noncompliance notification requirements under the monitoring and reporting section of the permit; f. Sampling and monitoring plan including the following information: i. Names and/or titles of personnel responsible for conducting the sampling and monitoring; ii. Detailed description of monitoring procedures including parameters to be monitored; iii. 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). [ 15A NCAC 02T . 1100] WQ0010583 Version 3.0 Shell Version 160210 Page 5 of 12 5. Upon the Water Pollution Control System Operators Certification Commission's (WPCSOCC) classification of the facility, the Permittee shall designate and employ a certified operator in responsible charge (ORC) and one or more certified operators as back-up ORCs in accordance with l5A NCAC 08G .0201. The ORC or his back-up shall visit the facilities in accordance with 15A NCAC 08G. 0204, or as specified in the most recently approved O&M plan (i.e., see Condition IIIA.), and shall comply with all other conditions of 15A NCAC 08G. 0204. For more information regarding classification and designation requirements, please contact the Division of Water Resources' Protection and Enforcement Branch at (919) 707-9105. [ 15A NCAC 02T .0117] 6. When the Permittee land applies bulk residuals, a copy of this permit and a copy of O&M Plan shall be maintained at the land application sites during land application activities. [15A NCAC 02T .0108(b)(1)) When the Permittee transports or land applies bulk residuals, the spill control provisions shall be maintained in all residuals transport and application vehicles. [15A NCAC 02T .1 I 101 8. Residuals shall not be stored at any land application site, unless written approval has been requested and received from the Division. [G.S. 143-215.11 9. When the Permittee land applies bulk residuals, adequate measures shall be taken to prevent wind erosion and surface runoff from conveying residuals from the land application sites onto adjacent properties or into surface waters. [G.S. 143-215.1] 10. When the Permittee land applies bulk residuals, a suitable vegetative cover shall be maintained on land application sites onto which residuals are applied, or application shall be in accordance with the crop management plan outlined by the local Cooperative Extension Office, the Department of Agriculture and Consumer Services, the Natural Resource Conservation Service, or an agronomist and as approved by the Division. [15A NCAC 02T .1109(b)(1)] 11. Bulk residuals shall not be land applied under the following conditions: a. If the residuals are likely to adversely affect a threatened or endangered species listed under section 4 of the Endangered Species Act or its designated critical habitat; b. If the application causes prolonged nuisance conditions; c. If the land fails to assimilate the bulk residuals or the application causes the contravention of surface water or groundwater standards; d. If the land is flooded, frozen or snow-covered, or is otherwise in a condition such that runoff of the residuals would occur; e. Within the I00-year flood elevation, unless the bulk residuals are injected or incorporated within a 24-hour period following a residuals land application event; £ During a measurable precipitation event (i.e., greater than 0.01 inch per hour), or within 24 hours following a rainfall event of 0.5 inches or greater in a 24-hour period; g. If the slope is greater than 10% for surface applied liquid residuals, or if the slope is greater than 18% for injected or incorporated bulk liquid residuals; h. If the land does not have an established vegetative cover unless the residuals are incorporated or injected within a 24-hour period following a residuals land application event. Any field that is in a USDA no -till program shall be exempted from meeting this vegetative cover requirement; i. If the vertical separation between the seasonal high water table and the depth of residuals application is less than one foot; j. If the vertical separation of bedrock and the depth of residuals application is less than one foot; k. Application exceeds agronomic rates. WQ0010583 Version 3.0 Shell Version 160210 Page 6 of 12 [ 15A NCAC 02T .1109] 12. The following public access restrictions apply to residual land application sites: a. Public access to public contact sites (e.g., golf courses, parks, ball fields, etc.) shall be restricted for 365 days after a residuals land application event; b. Public access to non-public contact sites shall be restricted for 30 days after a residuals land application event. [ 15A NCAC 02T .1109(b)(2)] 13. Public access controls shall include the posting of signs with a minimum area of 3 square feet (e.g., 1.5' x 2'). Each sign shall indicate the activities conducted at each site, permit number, and name and contact information, including the Permittee or applicator's telephone number. Signs shall be posted in a clearly visible and conspicuous manner at the entrance to each land application site during a land application event, and for as long as the public access restrictions required under Condition I11.12. apply. (15A NCAC 02T .0108(bx])] 14. The following harvesting and grazing restrictions apply to residual land application sites after each land application event: Harvesting and Grazing Description Restricted Duration Animals shall not be allowed to graze during land application activities and restricted period. Sites that are to be used for grazing shall have fencing to 30 days prevent access after each land application event. Food crops, feed crops and fiber crops shall not be harvested for. 30 days Turf grown on land where residuals have been applied shall not be harvested for: 12 months Food crops with harvested parts that touch the residual/soil mixture and are totally above the land surface (e.g., tobacco, melons, cucumbers, squash, etc.) 14 months shall not be harvested for: When the residuals remain on the land surface for four months or longer prior to incorporation into the soil, food crops with harvested parts below the land 20 months surface (e.g., root crops such as potatoes, carrots, radishes, etc.) shall not be harvested for: When the residuals remain on the land surface for less than four months prior to incorporation into the soil, food crops with harvested parts below the land 3 8 months surface shall not be harvested for: [15A NCAC 02T. I 109(b)(3)] 15. The Permittee shall acquire from each landowner or lessee/operator a statement detailing the volume of other nutrient sources (i.e., manufactured fertilizers, manures, or other animal waste products) that have been applied to the site, and a copy of the most recent Nutrient Management Plan (NMP) for those operations where a NMP is required by the US Department of Agriculture — National Resources Conservation Service (MRCS) or other State Agencies. The Permittee shall calculate allowable nutrient loading rates based on the provided information and use appropriate reductions. For the purpose of this permit condition, a Crop Management Plan (CMP), Waste Utilization Plan (WUP) or Certified Nutrient Management Plan (CLAMP) shall also be considered a Nutrient Management Plan. [15A NCAC 02T .0108(b)(l), 02T .1104(c)(3)] WQ0010583 Version 3.0 Shell Version 160210 Page 7 of 12 16. No residuals shall be land applied unless the submitted Land Owner Agreement between the Permittee and landowners or lessees/operators of the land application site is in full force and effect. These agreements shall be considered expired concurrent with the permit expiration date, and shall be renewed during the permit renewal process. [ 15A NCAC 02T .1104(c)(4)] IV. MONITORING AND REPORTING REQUIREMENTS 1. Any Division -required monitoring (including groundwater, plant tissue, soil and surface water analyses) necessary to ensure groundwater and surface water protection shall be established, and an acceptable sample reporting schedule shall be followed. [ 15A NCAC 02T .0108(c)] Residuals shall be analyzed to demonstrate they are non -hazardous under the Resource Conservation and Recovery Act (RCRA). Residuals that tests or is classified as a hazardous or toxic waste under 40 CFR Part 261 shall not be used or disposed under this permit. The analyses [corrosivity, ignitahility, reactivity, and toxicity characteristic leaching procedure (TCLP)J shall be performed at the frequency specified in Attachment A, and the Permittee shall maintain these results for a minimum of five years. Any exceptions from the requirements in this condition shall be specified in Attachment A. The TCLP analysis shall include the following parameters (the regulatory level in milligrams per liter is in parentheses): Arsenic (5.0) 1,4-Dichiorobenzene (7.5) Nitrobenzene (2.0) Barium (100.0) 1,2-Dichloroethane (0.5) Pentachlorophenol (100.0) Benzene (0.5) 1, 1 -Dichloroethylene (0.7) Pyridine (5.0) Cadmium. (1.0) 2,4-Dinitrotoluene (0.13) Selenium (1.0) Carbon tetrachloride (0.5) Endrin (0.02) Silver (5.0) Chlordane (0.03) Hexachlorobenzene (0.13) Tetrachloroethylene (0.7) Chlorobenzene (100.0) Heptachlor (and its hydroxide) 0.00$ Toxaphene (0.5) Chloroform (6.0) Hexachloro-1,3-butadiene (0.5) Trichloroethylene (0.5) Chromium (5.0) Hexachloroethane (3.0) 2,4,5-Trichlorophenol (400.0) m-Cresol (200.0) Lead (5.0) 2,4,6-Trichlorophenol (2,0) o-Cresol (200.0) Lindane (0.4) 2,4,5-TP (Silvex) (1.0) p-Cresol (200.0) Mercury (0.2) Vinyl chloride (0.2) Cresol (200.0) Methoxychlor (10.0) 2,4-D (10.0) Methyl ethyl ketone (200.0) Once the residuals have been monitored for two years at the frequency specified in Attachment A, the Permittee may submit a permit modification request to reduce the frequency of this monitoring requirement. In no case shall the monitoring frequency be less than once per permit cycle. [15A NCAC 13A .0102(b), 02T .1101, 02T .1105] WQ0010583 Version 3.0 Shell Version 160210 Page 8 of 12 3. An analysis shall be conducted on residuals from each source generating facility at the frequency specified in Attachment A, and the Permittee shall maintain the results for a minimum of five years. The analysis shall include the following parameters: Aluminum Mercury Potassium Ammonia -Nitrogen Molybdenum Selenium Arsenic Nickel Sodium Cadmium Nitrate -Nitrite Nitrogen Sodium Adsorption Ratio (SAR) Calcium Percent Total Solids TKN Copper pH Zinc Lead Phosphorus Magnesium Plant Available Nitrogen (by calculation) [15A NCAC 02T .1101] 4. Residuals shall be monitored for compliance with pathogen and vector attraction reduction requirements at the frequency specified in Attachment A, and at the time indicated in the sampling and monitoring sections of the approved O&M plan. The required data shall be specific to the stabilization process utilized, and sufficient to demonstrate compliance with the Class B. pathogen reduction requirements in 15A NCAC 02T .1106 (a) and (c), and one vector attraction reduction requirement in 15A NCAC 02T .1107 (a) shall be met. Any exceptions from the requirements in this condition shall be specified in Attachment A. [15A NCAC 02T .1106, 02T .1107, 02T .1111(c)] An annual representative soils analysis (i.e., Standard Soil Fertility Analysis) shall be conducted on each land application site listed in Attachment B on which a residuals land application event will occur in the respective calendar year. This analysis shall be in accordance with the "Guidance on Soil Sampling" located in the Sampling Instructions section of the NC Department of Agriculture & Consumer Services' website(hqp://www.ncagr.gov/agronomi/pubs.htm). The Permittee shall maintain these results and a description of the sampling methodologies used to determine soil fertility for a period of no less than five years, and shall be made available to the Division upon request. At a minimum, the Standard Soil Fertility Analysis shall include the following parameters: Acidity Exchangeable Sodium Percentage Phosphorus Base Saturation (by calculation) Magnesium Potassium Calcium Manganese Sodium Cation Exchange Capacity Percent Humic Matter Zinc Copper pH [15A NCAC 02T .0108(c), 15A NCAC 02T .1111(d)] 6. Laboratory parameter analyses shall be performed on the residuals as they are land applied, and shall be in accordance with the monitoring requirements in 15A NCAC 02B .0505. [15A NCAC 02B .0505] WQ0010583 Version 3.0 Shell Version 160210 Page 9 of 12 7. The Permittee shall maintain records tracking all residual land application events. At a minimum, these records shall include the following: a. Source of residuals; b. Date of land application; c. Location of land application (i.e., site, field, or zone number as listed in Attachment B); d. Approximate areas applied to (acres); e. Method of land application; f. Weather conditions (e.g., sunny, cloudy, raining, etc.); g. Predominant Soil Mapping Unit (e.g., CbB2); h. Soil conditions (e.g., dry, wet, frozen, etc.); i. Type of crop or crops to be grown on field; j. Nitrogen Application Rate based on RYES (if using data obtained from the North Carolina State University Department of Soil Science Website, the printout page shall be kept on file and reprinted every five years); k. Volume of residuals land applied in gallons per acre, cubic yard per acre, dry tons per acre, or wet ton per acre; 1. Volume of animal waste or other nutrient source applied in gallons per acre, dry ton per acre, or wet tons per acre; in. Volume of soil amendments (e.g., lime, gypsum, etc.) applied in gallons per acre, dry ton per acre, or wet tons per acre; and n. Annual and cumulative totals in dry tons per acre of residuals as well as animal waste and other sources of nutrients (e.g., if applicable), annual and cumulative pounds per acre of each heavy metal (e.g., shall include, but shall not be limited to, arsenic, cadmium, copper, lead, mercury, molybdenum, nickel, selenium, and zinc), annual pounds per acre of PAN, and annual pounds per acre of phosphorus applied to each field. [15A NCAC 02T .0109(a)] 8. Three copies of an annual report shall be submitted on or before March 111. The annual report shall meet the requirements described in the Instructions for Residuals Application Annual ReportingF. Instructions for reporting and annual report forms are available at http://den.ne.gov/about/divisions/water-resources/water-resources permits/wastewater-branch/non- discharste-permitting-unit/reportinng _fortes, or can be obtained by contacting the Non -Discharge Permitting Unit directly. The annual report shall be submitted to the following address: Division of Water Resources Information Processing Unit 1617 Mail Service Center Raleigh, North Carolina 27699-1617 [ 15A NCAC 02T A 111(a)] WQ0010583 Version 3.0 Shell Version 160210 Page 10 of 12 V. 9. Noncompliance Notification The Permittee shall report by telephone to the Winston-Salem Regional Office, telephone number (336) 776-9800, 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. Land application of residuals abnormal in quantity or characteristic. b. Any failure of the land application 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 normal business hours shall be reported to the Division's Emergency Response personnel at telephone number (800) 662-7956, (800) 858-0368, or (919) 733-3300.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 betaken to ensure that the problem does not recur. [15A NCAC 02T .0105(1), 02T .0108(b)(1)] 1. The Permittee shall provide adequate inspection and maintenance to ensure proper operation of the subject facilities and shall be in accordance with the approved O&M Plan. [15A NCAC 02T .0108(b)] 2. Prior to each bulk residuals land application event, the Permittee or his designee shall inspect the residuals storage, transport and application facilities to identify malfunctions, facility deterioration and operator errors that could result in discharges to the environment, a threat to human health or a public nuisance. The Permittee shall maintain an inspection log that includes, at a minimum, the date and time of inspection, observations made, and any maintenance, repairs, or corrective actions taken. The Permittee shall maintain this inspection log for a period of five years from the date of inspection, and this log shall be made available to the Division upon request. [15A NCAC 02T .0108(b)] 3. Any duly authorized Division representative may, upon presentation of credentials, enter and inspect any property, premises or place on or related to the land application sites or facilities permitted herein at any reasonable time for the purpose of determining compliance with this permit; may inspect or copy any records required to be maintained under the terms and conditions of this permit; and may collect groundwater, surface water or leachate samples. [G.S. 143-215.3(a)(2)] VI. GENERAL CONDITIONS 1. Failure to comply with the conditions and limitations contained herein may subject the Permittee to an enforcement action by the Division in accordance with North Carolina General Statutes 143-215.6A to 143-215.6C. [G.S. 143-215.6A to 143-215.6C] 2. This permit shall become voidable if the residuals land application events are not carried out in accordance with the conditions of this permit. [15A NCAC 02T A 110] 3. This permit is effective only with respect to the nature and volume of residuals described in the permit application and other supporting documentation. [G.S. 143-215.1] WQOO10583 Version 3.0 Shell Version 160210 Page 11 of 12 4. The issuance of this permit does not exempt the Permittee from complying with any and all statutes, rules, regulations, or ordinances, which may be imposed by other jurisdictional government agencies (e.g., local, state, and federal). Of particular concern to the Division are applicable river buffer rules in 15A NCAC 02B .0200; erosion and sedimentation control requirements in 15A NCAC Chapter 4 and under the Division's General Permit NCG010000; any requirements pertaining to wetlands under 15A NCAC 02B .0200 and 02H .0500; and documentation of compliance with Article 21 Part 6 of Chapter 143 of the General Statutes. [ 15A NCAC 02T .0105(c)(6)] In the event the residuals program changes ownership or the Permittee changes his name, a formal permit modification request shall be submitted to the Division. This request shall be made on official Division forms, and shall include appropriate documentation from the parties involved and other supporting documentation as necessary. The Permittee of record shall remain fully responsible for maintaining and operating the residuals program permitted herein until a permit is issued to the new owner. [15A NCAC 02T .0104] 6. This permit is subject to revocation or unilateral modification upon 60-day notice from the Division Director, in whole or part for the requirements listed in 15A NCAC 02T .0110. [ 15A NCAC 02T .0110] 7. Unless the Division Director grants a variance, expansion of the permitted residuals program contained herein shall not be granted if the Permittee exemplifies any of the criteria in 15A NCAC 02T .0120(b). [15A NCAC 02T .0120] 8. The Permittee shall pay the annual fee within 30 days after being billed by the Division. Failure to pay the annual fee accordingly shall be cause for the Division to revoke this permit. [I 5A NCAC 02T .0105(e)(3 )] Permit issued this the 19' day of May 2017 NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION -rS. ]ay Zimmerman, P.G., Director Division of Water Resources By Authority of the Environmental Management Commission Permit Number WQ0010583 WQ0010583 Version 3.0 Shell Version 160210 Page 12 of 12 M r �a a y d o in M +' O nj N W ao on on en eu � on oo on oA en � •{� °? �i a� aye aye � � U U aye .-ay•ey 5y�,.,.j o ��ayy� v _U C U U U U U ro ro ro U U U U U U U ,� C p U d N I I N � I 0.1 Oa O V N N N N +^r y y O N N N N N N N U U N d C O O O O C N C O C O C O O O t` O O O kn kn N y y O O n pOp kn Y. 00 w O � 00 IC 01 v'i '-' O\ rl' N � Q ^w CDkn .--i M 00 'tt N M M N \O 00 V1 M �O 00 C 00 Q\ a1 M N v1 M v) N \O .--� O_ O 00 \c O M "o IC kn OM N N OM N •� vNi M Vl iA v� vi �n \O IO �n �n kn V1 Vl v'l �n �n kn 0 0 CD o 0 0 0 0 0 6 6 6 a 0? 0? 00 N O � O O N 00 � m � Qi r t-00 V1 � `p `o kn M 00 O M O a to kn W) V1 to kn kn Wn V1 Wn V1 v1 in to to kn V1 kn v'1 M M M M M M M M M M M M M M M M M M M 5 > > > > > > > > > > > > > > > c ro A ro A ro A ro A ro A ro A ro A ro A ro A ro A ro A ro A ro A ro A ro A ro A ro A ro A ro A U d a x x x x x x x ro ro ro ro ro 'on 'ao 'own 'o��n 'o��n a. 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O C M Q pOr 'C ro ro 3 ro o w 24 c4 d W N �400 U W N ww o i CX 'A .a d ri ri 4 kt N 4-i 0 U a U Cd Q u 0 aD U Q 116 2) RSC Form L � a C O H A � a � M V L � N zN � z a o Q U U CC � � w � U L x � o a � Q U e� w :y 0 rig U Q ISO L: State of North Carolina DWR Department of Environmental Quality Division of Water Resources Division of Water Resources RESIDUALS SOURCE CERTIFICATION FORM: RSC 06-16 I. RESIDUALS SOURCE -GENERATING FACILITY INFORMATION (See Instruction B.): 1. Facility Name: Cooleemee WWTP 2. Facility permit holder is: ❑ Federal, ❑ State, ® Local Government, or ❑ Private. Facility permit issued by: ❑ Div. of Water Resources, ❑ Div. of Environmental Health, or ❑ Other (explain: _). 3. Facility contact person and title: Tim Smith - ORC Complete mailing address: 123 South Main St City: Mocksville State: NC Zip: 27028- Telephone number: (336) 751-2635 E-mail address: tlsmith&daviecountync.gov 4. Facility physical address: 175 Hwy 801 S. City: Cooleemee State: NC Zip: 27028- Coordinates: Latitude: 35' 48' 15" Longitude: 80. 33' 40" Datum: NAD83 Level of accuracy: nearest second Method of measurement: GPS 5. Purpose of the facility: ® treatment of municipal wastewater, ❑ treatment of 100% domestic wastewater, ❑ treatment of potable water, ❑ treatment of 100% industrial wastewater, ❑ treatment of industrial wastewater mixed with domestic wastewater, (approximate percentages: __E % industrial and % domestic) ❑ other (explain: ). 6. Does the facility have an approved pretreatment program: ® Yes ❑ No 7. Facility permitted/design flow: 1_5 MGD and facility average daily flow: 0_5 MGD 8. Average amount of residuals being generated at this facility 315 dry tons per year. 9. Specify the following regarding treatment and storage volumes available at the facility: Type and volume of residuals treatment: Aerobic Digester — 150,000 gallons Type and volume of residuals storage (i.e., outside of residuals treatment units): 1.5 MG concrete basin and 3MG concrete basin II. RESIDUALS QUALITY INFORMATION (See Instruction C.): 1. Specify if residuals are regulated under: ® 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.1102(6) as: ® Biological ❑ Non -Biological FORM: RSC 06-16 Page 1 of 5 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). 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 ® 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: ❑ yes ® 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: 04/26/2021 Passed corrosivity test: ® yes ❑ no. pH: s.u. (2 < pH < 12.5) Passed ignitability test: ® yes W no. Flashpoint: >170 OF (> 140°F) Passed reactivity test: W yes Ono. HCN: <0.25 mg/kg (<250) & H2S: <25 mg/kg (<500) TCLP Parameter Limit (mgfi) Result (mgfi) TCLP Parameter Limit (mgfi) Result (mgfi) Arsenic 5.0 ND Hexachlorobenzene 0.13 ND Barium 100.0 0.25 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 ND 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 1,1-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 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: 12/2/2020 Parameter Ceiling Concentration Limits (ClassA & ClassB) (mglkg) Monthly Average Concentration Limits (Class A Only) (mglkg) Result (mglkg) Arsenic 75 41 7.5 Cadmium 85 39 1.45 Copper 4,300 11500 74 Lead 840 300 37.8 Mercury 57 17 0.242 Molybdenum 75 n/a 2.68 Nickel 420 420 27.2 Selenium 100 100 <1.67 Zinc 7,500 2,800 203 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 ❑ > 25 but < 50 34 220 240 ❑ > 50 but < 75 39 260 270 ❑ > 75 but < 100 46 300 320 ❑ > 100 but < 125 53 360 390 ❑ > 125 62 450 420 Result (mg/kg) 5. Nutrient/Micronutrient Determination: Complete the following: a. Total solids: 19.3 %. 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: Waypoint Analytical and Date of analysis: 12/2/2020 Parameter Result (mg/kg) Aluminum 48800 Ammonia -Nitrogen 1210 Calcium 2920 Magnesium 3130 Nitrate -Nitrite Nitrogen <25.4 pH (Standard Unit) 7.4 Phosphorus 2860 Potassium 2140 Sodium 479 Total Kjeldahl Nitrogen 2590 c. Using the results listed in Item IL 5b. above, calculate the sodium adsorption ration (SAR): 0.64 [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): M 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: 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 (ls) Year PAN Five -Year Maximum Adjusted PAN (mg/kg) (mg/kg) Surface 1045 1294.5 Injection/Incorporation 1649.5 1899.5 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: 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): ❑ Alternative 1 [15A NCAC 02T.I 106(b)(3)(A)] - Time/Temperature Compliance. ❑ Alternative 2 [15A NCAC 02T.I 106(b)(3)(B)] - Alkaline Treatment. ❑ Alternative 3 [15A NCAC 02T. 1106(b)(3)(C)] - Prior Testing for Enteric Virus/Viable Helminth Ova. ❑ Alternative 4 [15A NCAC 02T. 1106(b)(3)(D)] - No Prior Testing for Enteric Virus/Viable Helminth Ova. ❑ Alternative 5 [15A NCAC 02T.I 106(b)(3)(E)-(K)] - Process to Further Reduce Pathogens (PFRP). Specify one: composting, ❑ heat drying, heat treatment, thermophilic aerobic digestion, F beta ray irradiation, ❑ gamma ray irradiation, or ❑ pasteurization. b. For Land Application of Class B: ® Alternative 1 [15A NCAC 02T.I 106(c)(1)] - Fecal Coliform Density Demonstration. ❑ Alternative 2 [15A NCAC 02T.I 106(c)(2)] - Process to Significantly Reduce Pathogens (PSRP). Specify one: ❑ aerobic digestion, ❑ air drying, ❑ anaerobic digestion, ❑ composting, or ❑ lime stabilization. c. For Surface Disposal: ❑ Select One of the Class A or Equivalent Pathogen Reduction Alternatives in Item II. 7a. above. ❑ Select One of the Class B or Equivalent Pathogen Reduction Alternatives in Item II. 7b. above. ❑ Exempt -If Daily Cover Alternative is chosen in Item II.8. below [15A NCAC 02T.1106(a)(2)]. ❑ 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: ® Alternative 1 [15A NCAC 02T.1107(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). ❑ Alternative 4 [15A NCAC 02T.I 107(a)(4)] - Specific Oxygen Uptake Rate Test (Aerobic Digestion). ❑ Alternative 5 [15A NCAC 02T.I 107(a)(5)] - 14-Day Aerobic Processes. ❑ Alternative 6 [15A NCAC 02T.I 107(a)(6)] - Alkaline Stabilization. ❑ Alternative 7 [15A NCAC 02T.I 107(a)(7)] - Drying of Stabilized Residuals. ❑ Alternative 8 [15A NCAC 02T.I 107(a)(8)] - Drying of Unstabilized Residuals. ❑ Alternative 9 [15A NCAC 02T.I 107(a)(9)] - Injection. ❑ Alternative 10 [15A NCAC 02T.I107(a)(10)] - Incorporation. ❑ Alternative for Surface Disposal Units Only - Soil/Other Material Cover [15A NCAC 02T.I 107(b)(2)]. ❑ 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. 2a) Vicinity Map 2b) Process Flow Diagram CL2 TANK DECHLOR TANK I SLUDGE �C z TO LAND E w J APPLICATION LL U m Iw— 1$ O () m O w 0 � ao 24" w w LL Q J U w Lu z Q w � r ,,$" U c i Lta&� L— I 1 24" J Q Z) 0r w 'GREY ENGINEERING, INC Civil Design and Surveying P.O. Box 9 Mocksville, N.C. 27028 greyengineering.com (336)751-2110 DRAWN BY: G. BULLARD PROJ. NU.: 102.101.X DESIGN BY: G- BULLARD DATE: 09/21/07 _ 6" SLUDGE_ —E WASTING F—\ i 8" SLUDGE co HEAVY �� 4 SLUDGE 6" SCUM 00 I 6" SCUM V) 4" SLUDGE Ow HEAVY 8" SLUDGE ¢w o in 12" SLUDGE RECIRCULATION TO SOUTH YADKIN 24" RIVER LEGEND INFLUENT/MIX LIQUOR SLUDGE EFFLUENT — — WASTING/SCUM `r FROM NORTH INTERCEPTOR DAVIE COUNTY COOLEEMEE WWTP PROCESS SCHEMATIC SHEET 2 OF 3 2c) Quantitative Justification Davie County Quantitative Justification for Residuals Production Rate Davie County is working with FEMA to address damage to the holding basin's wall. They are currently permitted for 315 dry tons a year. Based on EMA Resource's survey of the basin, there are approximately 834 dry tons of material at 20% solids. We are requesting an increase from 315 to 1149 dry tons to take care of the cleanout. Once this has been accomplished their dry ton numbers can return to 315. The annual dry ton calculation is based on the percent solids of the analysis and the removal of 950,000 gallons per year. Gallons lbs/Gal. %Solids Dry lbs. lbs/ton Dry Tons 1,000,000x 8.34 x 0.20 = 1,588,870 / 2000 = 834 New 315 Old 1149 Total 2d) Operation and Maintenance Plan Standard Operating Procedure and Operation and Maintenance Plan for the Davie County — Land Application Program 1. Purpose a. Ensure the requirements of the Davie County Non -Discharge Permit# WQ0010583 are met. 2. Personnel a. The following is a list of personnel in o rder they are to be contacted when information needs to be shared. i. EMA Resources inc. 1. Jeff Thompson - Project Manager 336-477-4078 2. Roy Whitaker- Director of Bus.Dvlpmt./Ops. 336-909-1718 3. Brent Collins - Director of Technical Services 336-399-3646 ii. Davie County 1. David Bone - County Manager 336-753-6001 2. Johnny Lambert- Utilities Director 336-749-6313 3. Tim Smith-ORC Cooleemee WWTP 336-477-5096 3. Operational Functions a. . The operational function of this project it going to involve mixing the lagoon with a tractor powered Houle pump to achieve a well -mixed and consistent material that is suitable for land application. It is going to be spread at agronomic rates that are determined using the Realistic Yield Expectations (RYE) as outlined in the permit, the amount of other nutrient sources the landowner and operator has applied, and the residuals nutrient and metal sample that is current for that monitoring period. It is going to be spread with a liquid applicator that will use pressure to spread the material in such a way as to achieve a consistent spread pattern. The material is going to be land applied on fields that have a crop growing on them that are going to either be grazed or cut for animal feed. Application rates will be reduced by25% on fields that are primarily used for grazing in accordance with USDA NRCS 590. Grazed fields will be determined by the farmers and EMA project managers. 4. Maintenance Schedule a. EMA Resources Inc. will follow the maintenance schedule as recommended by the EMA Resources Operations Manager (Mike Collins) for the equipment necessary to complete the job. 5. Safety Measures a. Davie County and EMA Resources Inc. believe in operating in a safety conscious manner and all employees participate in safety training that is designed to help employees recognize safety issues and take steps to prevent accidents from occurring. In addition, EMA Resources employees have the authority to stop operations if they think any aspect of the operation is going to cause environmental or personal harm. 6. Spill Response Plan a. In the unlikely event of a spill, the following action shall be taken immediately. i. Management of Spill Clean-up Activities: The EMA Resources Project Manager shall take immediate charge and initiate clean-up activities.EMA Resources labor and equipment is to be utilized. In the event additional labor and equipment is required, assistance may be requested from Davie County, The NC Department of Transportation, and other private contractors, as necessary. ii. Halt the Source of the Spill: Such as a ruptured container or damaged transport unit. In. Contain the Spill: Form a barrier. Sufficient quantities of straw shall be used for such purposes. Earthen barriers may be constructed to augment the straw bale containment area of the spill. The Operations Manager or the person in charge on the spill site will be advise the clean-up personnel where to get the straw, lime, and other items necessary to complete the clean-up operation. le. local farmers, farm supply centers, nurseries. iv. Initial Clean -Up: Employ front-end loaders, vacuum equipment, sludge application vehicles, and/or local septic tank service to remove as much of the spilled material as possible. Straw and/or sand should be scattered in the spill area to soak up the remaining material. The straw and sand -soaked material will be collected and removed to a disposal area approved by representatives of the state regulatory agency. v. Final Clean -Up: Employ rotary brush sweeper if needed and apply lime to the spill area upon the approval of the clean-up efforts by the state regulatory representative. If the event occurs on private property, the clean-up will be completed to the, satisfactory of the property owner and state regulatory representatives. The ultimate goal will berestoring the spill area to its original condition if possible. vi. Notification: As soon as possible after the spill occurs, the EMA Resources Project Manager or designee will notify the Davie County and the EMA Resources main office. EMA Resources office staff are then responsible for notifying other key EMA Resources personnel. vii. Reporting:, EMA Resources staff will notify the Winston Salem regional office of the NCDENR by telephone (336) 771-5000 as soon as possible, but not more than 24 hours after, or on the next working day following the occurrence. The EMA Project Manager shall provide awritten report with 48 hours of the spill to the EMA Resources Director of Technical Services and Davie County staff. The report shall list all relative information and actions taken. With the assistance of EMA Resources personnel, and the Davie County personnel, a written report will be filed with the Winston Salem regional office within 5 days of the occurrence. For after-hours reporting, the Division's emergency number shall be called to report all incidences (800) 662- 7956. 7. Inspection Plan a. Inspection for the land application of residuals will conducted on a minimum of a weekly basis at the land application site during land application activities. The inspection frequency is based on the time frame that it is going to take to complete the project and the number of dry tons to be land applied from this facility. The inspections will consist of inspecting a current field that is being applied as well as inspecting random fields that have been completed. Inspections will be conducted by Jeff Thompson - Project Manager. These inspections will consist of the following: i. Verifying the application rates for each field that plan on receiving material. ii. Checking the calculated loads to ensure the correct amount of residuals are being land applied. In. Ensure that all manned equipment has a copy of the permit and the operation and maintenance plan. iv. Ensure that the field has been flagged properly and that all buffers are being adhered to. v. Verify that the proper number of samples of the residuals have beentaken and that it meets the criteria for land application. vi. The records will be kept in the EMA Resources project files in the mainoffice. Copies of all analyses and records will be forwarded to DavieCounty and kept on file. vii. EMA Resources and Davie County staff will immediately inform the other part if any of the following conditions are noted. 1. Any occurrence with the distribution program resulting in the land application of significant amounts of material that is abnormal in quantity or characteristics. 2. Any failure of the distribution system that results in the release to surface waters. 3. Any time that self -monitoring indicates that the facility has gone out of compliance with the permit. 4. Any process failure that results in the system not adequately treating the residuals. 5. Any spill or discharge from a vehicle or piping system during residuals transportation. 6. Any release that requires immediate reporting outside normal business hours shall be called in by EMA Resources staff to DENR at (800) 66 2-7956. This number is to be called in the event of a release to surface waters or imminent failure of a storage system when the event occurs outside of normalbusiness hours. 8. Sampling and Monitoring Plan a. Sampling for this project consists of sampling the residuals prior to land application occurring to ensure that the residuals are suitable for land application. b. The samples will be collected from the storage lagoon that holds the residuals. c. Jeff Thompson, Brent Collins, or other designee will be responsible for sample collection for nutrient and metal, TCLP, and fecal coliform. d. Nutrient, metal and TCLP sample aliquots will be collected randomly and consist of at least 7 individual aliquots mixed together in order to get the composite sample for these parameters. e. The residuals will be sampled annually for TCLP including the RClls. f. Metal and nutrient parameters will be collected and analyzed based on the requested dry ton numbers in the permit application. g. Residuals will be sampled for fecal coliform to demonstrate pathogen requirements have been met. Seven separate samples will be collected and analyzed. 9. Environmental Impacts a. The environmental impacts for residuals may be affected by this procedure. b. This procedure helps assure that land application is conducted in a safe and efficient manner while ensuring compliance with the laws and regulations and to minimize exposure, negative environmental impacts, and public relation concerns. 2ei) Laboratory Analytical Reports Waypointo ANALYTICAL 12/11 /2020 EMA Resources Inc Mr. Brent Collins 755 Yadkinville Rd Mocksville, NC, 27028 Ref: Analytical Testing Lab Report Number: 20-338-0097 Client Project Description: Davie County Cooleemee, NC 2790 Whitten Road, Memphis, TN 38133 Main 901.213.2400 ° Fax 901.213.2440 www.waypointanalytical.com Dear Mr. Brent Collins: Waypoint Analytical, LLC. received sample(s) on 12/3/2020 for the analyses presented in the following report. The above referenced project has been analyzed per your instructions. The analyses were performed in accordance with the applicable analytical method. Where the laboratory was not responsible for the sampling stage (refer to the chain of custody) results apply to the sample as received. The analytical data has been validated using standard quality control measures performed as required by the analytical method. Quality Assurance, method validations, instrumentation maintenance and calibration for all parameters (NELAP and non-NELAP) were performed in accordance with guidelines established by the USEPA (including 40 CFR 136 Method Update Rule August 2017) and NELAC unless otherwise indicated. Any parameter for which the laboratory is not officially NELAP accredited is indicated by a '—'symbol. These are not included in the scope because NELAP accreditation is either not available or has not been applied for. Additional certifications may be held/are available for parameters, where NELAP accreditation is not required or applicable. A full list of certifications is available upon request. Certain parameters (chlorine, pH, dissolved oxygen, sulfite...) are required to be analyzed within 15 minutes of sampling. Usually, but not always, any field parameter analyzed at the laboratory is outside of this holding time. Refer to sample analysis time for confirmation of holding time compliance. The results are shown on the attached Report of Analysis(s). Results for solid matrices are reported on an as - received basis unless otherwise indicated. This report shall not be reproduced except in full and relates only to the samples included in this report. Please do not hesitate to contact me or client services if you have any questions or need additional information. Sincerely, Danyale Love Project Manager Laboratory's liability in any claim relating to analyses performed shall be limited to, at laboratory's option, repeating the analysis in question at laboratory's expense, or the refund of the charges paid for performance of said analysis. Ijp, Page 1 of 8 Waypointo ANALYTICAL 2790 Whitten Road, Memphis, TN 38133 Main 901.213.2400 0 Fax 901.213.2440 www.waypointanalytical.com Certification Summary Laboratory ID: WP MTN: Waypoint Analytical, LLC., Memphis, TN State Program Lab ID Expiration Date Alabama State Program 40750 02/28/2021 Arkansas State Program 88-0650 02/07/2021 California State Program 2904 06/30/2021 Florida State Program - NELAP E871157 06/30/2021 Georgia State Program C044 02/18/2023 Georgia State Program 04015 06/30/2021 Illinois State Program - NELAP 200078 10/10/2021 Kentucky State Program 80215 06/30/2021 Kentucky State Program KY90047 12/31/2020 Louisiana State Program - NELAP LA037 12/31/2020 Louisiana State Program - NELAP 04015 06/30/2021 Mississippi State Program MS 02/11/2023 North Carolina State Program 415 12/31/2020 Oklahoma State Program 9311 08/31/2021 Pennsylvania State Program - NELAP 68-03195 05/31/2021 South Carolina State Program 84002 06/30/2021 South Carolina State Program 84002 06/30/2021 Tennessee State Program 02027 02/11/2023 Tennessee A21LA ISO 17025:2017 4313.01 10/31/2021 Texas State Program - NELAP T104704180 09/30/2021 Virginia State Program 00106 06/30/2021 Virginia State Program - NELAP 460181 09/14/2021 Page 1 of 1 00001/20-338-0097 Page 2 of 8 Waypoint ANALYTICAL Report Number: 20-338-0097 Client Project Description: Davie County Cooleemee, NC Lab No Client Sample ID 89786 Cooleemee V TP Sludge 2790 Whitten Road, Memphis, TN 38133 Main 901.213.2400 ° Fax 901.213.2440 www.waypointanalytical.com Sample Summary Table Matrix Date Collected Solids 12/02/202014:45 Date Received 12/03/2020 Page 3 of 8 Waypointo ANALYTICAL Client: EMA Resources Inc Project: Davie County Lab Report Number: 20-338-0097 Date: 12/11 /2020 2790 Whitten Road, Memphis, TN 38133 Main 901.213.2400 0 fax 901.213.2440 www.waypointanalytical.com CASE NARRATIVE Metals Analysis Method 601 OD Sample 89892 Analyte: Calcium QC Batch No: L526420 The matrix spike and/or the matrix spike duplicate was outside quality control acceptance ranges. A dilution test was performed and passed quality control acceptance ranges. No matrix interference is suspected. Analyte: Potassium QC Batch No: L526125 This analyte was analyzed at a dilution due to IEC interference/matrix interference. Analyte: Potassium QC Batch No: L526420 The matrix spike and/or the matrix spike duplicate was outside quality control acceptance ranges. A dilution test was performed and passed quality control acceptance ranges. No matrix interference is suspected. Analyte: Magnesium QC Batch No: L525778 The matrix spike and/or the matrix spike duplicate was outside quality control acceptance ranges. A dilution test was performed and passed quality control acceptance ranges. No matrix interference is suspected. Analyte: Phosphorus QC Batch No: L525778 The matrix spike and/or the matrix spike duplicate was outside quality control acceptance ranges. A dilution test was performed and passed quality control acceptance ranges. No matrix interference is suspected. Analyte: Sulfur QC Batch No: L526420 The matrix spike and/or the matrix spike duplicate was outside quality control acceptance ranges. A dilution test was performed and passed quality control acceptance ranges. No matrix interference is suspected. Analyte: Selenium QC Batch No: L525778 The matrix spike and/or the matrix spike duplicate was outside quality control acceptance ranges. A post digestion spike was performed and passed quality control acceptance ranges. No matrix interference is suspected. Analyte: Arsenic QC Batch No: 1-525778/1-525619 C1 failed +/-20% low for As (TJS) Page 4 of 8 waypANALYTICAL 46245 EMA Resources Inc Mr. Brent Collins 755 Yadkinville Rd Mocksville , NC 27028 Report Number : 20-338-0097 Lab No : 89786 Sample ID : Cooleemee WTP Sludge 2790 Whitten Road, Memphis, TN 38133 Main 901.213.2400 ° Fax 901.213.2440 www.waypointanalytical.com Project Davie County Information : Cooleemee, NC REPORT OFANALYSIS Report Date : 12/11/2020 Received : 12/03/2020 Danyale Love Project Manager Matrix: Solids Sampled: 12/ 2/ 2020 14:45 Test Results Units MDL MQL DF Date / Time Analyzed By Analytical Method Moisture 80.8 % 1 12/18/2017:15 FMM SW-DRYWT Ammonia Nitrogen 1210 mg/Kg - dry 130 130 1 12/07/20 10:00 JPJ 4500NH3C-2011 Nitrate+Nitrite-N <25.4 mg/Kg - dry 25.4 25.4 1 12/07/20 15:54 ZBD 4500NO3F-2011 Organic N 1380 mg/Kg - dry 260.4 1 12/07/20 10:00 CALCULATION pH 7.4 S.U. 1 12/04/2015:18 ADM 9045D Total Solids 19.3 % 0.010 0.010 1 12/07/20 16:13 FMM 2540G-2011 Total Volatile Solids 20.4 % 0.010 0.010 1 12/07/20 16:13 FMM 2540G-2011 Total Kjeldahl Nitrogen 2590 mg/Kg - dry 260 1 12/08/20 15:47 CLP 4500NORGD-2011 Phosphorus 2860 mg/Kg - dry 14.4 26.0 1 12/09/20 04:07 DADS 6010D Aluminum 48800 mg/Kg - dry 24.1 26.0 1 12/09/20 04:07 DADS 6010D Arsenic 7.50 mg/Kg - dry 1.25 2.60 1 12/10/20 20:21 DADS 6010D Cadmium 1.45 mg/Kg - dry 0.104 0.521 1 12/09/20 04:07 DADS 6010D Calcium 2920 mg/Kg - dry 202 260 1 12/09/20 04:07 DADS 6010D Chromium 62.0 mg/Kg - dry 1.23 1.30 1 12/09/20 04:07 DADS 6010D Copper 74.0 mg/Kg - dry 1.61 2.60 1 12/09/20 04:07 DADS 6010D Iron 132000 mg/Kg - dry 222 260 5 12/10/20 20:36 DADS 6010D Lead 37.8 mg/Kg - dry 0.937 1.56 1 12/09/20 04:07 DADS 6010D Magnesium 3130 mg/Kg - dry 13.4 26.0 1 12/09/20 04:07 DADS 6010D Manganese 667 mg/Kg - dry 1.69 2.60 1 12/09/20 04:07 DADS 6010D Mercury 0.242 mg/Kg - dry 0.0182 0.0823 1 12/08/20 10:25 DDB 7471A Molybdenum 2.68 mg/Kg - dry 0.703 1.30 1 12/09/20 04:07 DADS 6010D Nickel 27.2 mg/Kg - dry 0.625 1.30 1 12/09/20 04:07 DADS 6010D Potassium 2140 mg/Kg - dry 32.2 52.1 1 12/09/20 04:07 DADS 6010D Qualifiers/ DF Dilution Factor L Limit Exceeded Definitions MQL Method Quantitation Limit Page 5 of 8 waypANALYTICAL 46245 EMA Resources Inc Mr. Brent Collins 755 Yadkinville Rd Mocksville , NC 27028 Report Number : 20-338-0097 Lab No : 89786 Sample ID : Cooleemee WTP Sludge 2790 Whitten Road, Memphis, TN 38133 Main 901.213.2400 ° Fax 901.213.2440 www.waypointanalytical.com Project Davie County Information : Cooleemee, NC REPORT OFANALYSIS Report Date : 12/11/2020 Received : 12/03/2020 Danyale Love Project Manager Matrix: Solids Sampled: 12/ 2/ 2020 14:45 Test Results Units MDL MQL DF Date / Time Analyzed By Analytical Method Selenium <1.67 mg/Kg - dry 1.67 2.60 1 12/09/20 04:07 3ADS 6010D Sodium 479 mg/Kg - dry 67.7 130 1 12/09/20 04:07 3ADS 6010D Zinc 203 mg/Kg - dry 4.22 6.51 1 12/09/20 04:07 3ADS 6010D Sulfur 1990 mg/Kg - dry 27.0 52.1 1 12/09/20 04:07 3ADS 6010D Sodium Absorption Ratio 0.64 Ratio 0.01 0.01 1 12/09/20 04:07 CALCULATION Qualifiers/ DF Dilution Factor Definitions L Limit Exceeded Page 6 of 8 s WayPAoi nt ..(2) �79p Whitten Road,3.240 Memphis, TN 38133 21.2440 Main 901.213.240fl °Fax 901.213.2440 N A LYT I C A L www.waypointanalytical.com Shipment Receipt Form Customer Number: 46245 Customer Name: EMA Resources Inc Report Number: 20-338-0097 Shipping Method ® Fed Ex 0 US Postal 0 Lab 0 UPS 0 Client 0 Courier 0 Other: Thermometer ID: T99 Shipping container/cooler uncompromised? 0 Yes 0 No Number of coolers/boxes received F-71 Custody seals intact on shipping container/cooler? 0 Yes 0 No ! Not Present Custody seals intact on sample bottles? 0 Yes 0 No ® Not Present Chain of Custody (COC) present? 0 Yes 0 No COC agrees with sample label(s)? 0 Yes 0 No COC properly completed 0 Yes 0 No Samples in proper containers? 0 Yes 0 No Sample containers intact? 0 Yes 0 No Sufficient sample volume for indicated test(s)? 0 Yes 0 No All samples received within holding time? 0 Yes 0 No Cooler temperature in compliance? 0 Yes 0 No Cooler/Samples arrived at the laboratory on ice. Samples were considered acceptable as cooling process had begun. 0 Yes 0 No Water - Sample containers properly preserved 0 Yes 0 No ® N/A Water - VOA vials free of headspace 0 Yes 0 No ® N/A Trip Blanks received with VOAs 0 Yes 0 No N/A Soil VOA method 5035 — compliance criteria met 0 Yes 0 No 0 N/A F_ High concentration container (48 hr) F_ High concentration pre -weighed (methanol -14 d) F_ Low concentration EnCore samplers (48 hr) F_ Low conc pre -weighed vials (Sod Bis -14 d) Special precautions or instructions included? 0 Yes ® No Comments: Signature: IHannah R. Brown Date & Time: 12/03/2020 15:49:23 Page 7 of 8 Nt N d N tli _ a T {] a s U �. fV �� rn C?40 E E r E� F o a qA 3 o ry ry�R >' agzzq cw E U Z ❑] X g �w P S n O _ — ❑ y op = O a o c G a fl o 0 azz°zi=sc°i Q O }r L a Q — a x3°o w faa 2 0. in 6 m u ❑ W w C7 2 ._ qJ � � � ••• ••• _ w a: —�� T 0 ° a a 7 E 3 E C/) C C a❑0 2 ° k kn o W "- ❑ Sni Qa Hd- cfl m o U sp los [elo.L 0 C N 7 d o N Oiue6JO/gle4N m N CD a ° E eluOWLU d/NAl �y I _ a (00 i 09) sPie A g ° a` P, aaisodlao(�j l0 4�(9� 2 CO rJ m M l C'! V N �Z � E 3 m a) @ N C 2 yQ y 2 � ° uj f` 2 a` d (AaA 03 ia;ay) xiileVU saauie;uO:) p iaqumN 1 -�— � a � � M 0 < �a ,z E w 3 r^ R a � � ��2 M �w r" i� i d E T U A 0 a a A O N d m � VLV E u a 0 Ili Page 8 of 8 Analytical Results EMA Resources, Inc. 755 Yadkinville Rd. Mocksville, NC 27028 Receive Date: 12/07/2020 Reported: 12/08/2020 For: Cooleemee Comments: GEOMETRIC MEAN: 391 MPN/g STATESVILLE C ANALYTICAL Sample Number Parameter Sample ID Result Unit Method Analyzed Analyst 201207-09-01 Fecal Coliforms 1 370 MPN/g SM92210E-2006 12/07/2020 MD 201207-09-01 Percent Solids 1 18.9 % SM2540B-2011 12/07/2020 MD 201207-09-02 Fecal Coliforms 2 367 MPN/g SM92210E-2006 12/07/2020 MD 201207-09-02 Percent Solids 2 19.07 % SM2540B-2011 12/07/2020 MD 201207-09-03 Fecal Coliforms 3 898 MPN/g SM92210E-2006 12/07/2020 MD 201207-09-03 Percent Solids 3 18.94 % SM2540B-2011 12/07/2020 MD 201207-09-04 Fecal Coliforms 4 571 MPN/g SM92210E-2006 12/07/2020 MD 201207-09-04 Percent Solids 4 19.1 % SM2540B-2011 12/07/2020 MD 201207-09-05 Fecal Coliforms 5 157 MPN/g SM92210E-2006 12/07/2020 MD 201207-09-05 Percent Solids 5 19.06 % SM2540B-2011 12/07/2020 MD 201207-09-06 Fecal Coliforms 6 588 MPN/g SM92210E-2006 12/07/2020 MD 201207-09-06 Percent Solids 6 18.7 % SM2540B-2011 12/07/2020 MD 201207-09-07 Fecal Coliforms 7 262 MPN/g SM92210E-2006 12/07/2020 MD 201207-09-07 Percent Solids 7 19.06 % SM2540B-2011 12/07/2020 MD Respectfully submitted, Dena Myers NC Cert #440, NCDW Cert #37755, EPA #NC00909 PO Box 228 • Statesville, NC 28687 • 704/872/4697 Page 1 of 4 Condition of Receipt Sample Number 201207-09-01 Temp on Arrival: 3.0 Parameter Schedule: Percent Solids Received on Ice Parameter Schedule: Fecal Coliforms Sodium Thiosulfate Received on Ice Sample Number 201207-09-02 Temp on Arrival: 3.0 Parameter Schedule: Percent Solids Received on Ice Parameter Schedule: Fecal Coliforms Sodium Thiosulfate Received on Ice Sample Number 201207-09-03 Temp on Arrival: 3.0 Parameter Schedule: Percent Solids Received on Ice Parameter Schedule: Fecal Coliforms Sodium Thiosulfate Received on Ice Sample Number 201207-09-04 Temp on Arrival: 3.0 Parameter Schedule: Percent Solids Received on Ice Parameter Schedule: Fecal Coliforms Sodium Thiosulfate Received on Ice Sample Number 201207-09-05 Temp on Arrival: 3.0 Parameter Schedule: Percent Solids Received on Ice Parameter Schedule: Fecal Coliforms Sodium Thiosulfate Received on Ice Sample Number 201207-09-06 Temp on Arrival: 3.0 PO Box 228 • Statesville, NC 28687 • 704/872/4697 Page 2 of 4 Parameter Schedule: Percent Solids Received on Ice Parameter Schedule: Fecal Coliforms Sodium Thiosulfate Received on Ice Sample Number 201207-09-07 Temp on Arrival: 3.0 Parameter Schedule: Percent Solids Received on Ice Parameter Schedule: Fecal Coliforms Sodium Thiosulfate Received on Ice PO Box 228 • Statesville, NC 28687 • 704/872/4697 Page 3 of 4 3 3°/ƒ°\ \ E J o C ' CD m m m■@ E @ o ƒ_ C' a & 2 m E � £_ [ E _ 4 « E . : ' ■ k f k ® | % E 9 W § ƒ ƒ _ � _ j j j S ( - ) 7 7 3 " K U E E CDE 7 § � Ilk � .� �. r � ! 0 w o■ % - E k 3 a 9 d a ! m ) m 2 \rmb . \ \ j ) ) 7 ] 3 `$ 9 . | 2 / � \ & ƒ / 0 ƒ � J 2 i ° Su2 2 3 m m` c \ = �)k ƒ(k m § x, 7 \ {/m/ �£7§ PO Bo 2289 Statesville, NC 28687970 / 72 4 97 Page 4y4 Analytical Results EMA Resources, Inc. 755 Yadkinville Rd. Mocksville, NC 27028 Receive Date: 04/22/2021 Reported: 06/07/2021 For: COOLEEMEE Comments: Sample Number Parameter Sample ID Result 210422-31-01 30 Day Benchscale Cooleemee 7.96 Respectfully submitted, X�- � � " �-' J, ;'� Melissa Myers NC Cert #440, NCDW Cert #37755, EPA #NC00909 STATESVILLE ANALYTICAL 4w Unit Method Analyzed Analyst EPA625-R-92/0 04/22/2021 MD PO Box 228 • Statesville, NC 28687 • 704/872/4697 Page 1 of 5 Condition of Receipt Sample Number 210422-31-01 Temp on Arrival: 3.0 Parameter Schedule: Received on Ice PO Box 228 • Statesville, NC 28687 • 704/872/4697 Page 2 of 5 // 0// 0 7 I � I f( ° 0 m e 3 CD CD 3£ e G E I. - A a co k k cr m/ i A $. - e� g CID, ,. 7 / E ca r � § / ) % _ . . _ E E E E $ " § R{ « Q � } ■ / 0 \� 0} CD / - ) a ® 9 e ] $ ƒ ) 2 3 3 3 3 _\ E [ E E ( o \ ƒ ƒ . . \ k ZI 0. \; ° E f / k 7 �A @ 9 ((} . k � Qh ■� §f�( §u74 \ §ƒ; PO Bo 2289 Statesville, NC 28687970 / 72 4 97 STATESVILLE 4 ANALYTICAL Analytical Results EMA RESOURCES, INC. For: COOLEEMEE 755 Yadkinville Rd Mocksville, NC 27028 Entered: 4/22/21 Reported: 6/7/21 Sample ID: 210422-31-01 PARAMETER: Vector Attraction Reduction/Aerobically Digested Sludge (30day) Total Solids Volatile Solids % Volatile Solids Week 1 1.38 0.28 0.2029 Week 2 1.31 0.27 0.2061 Week 3 1.30 0.26 0.2000 Week 4 1.30 0.26 0.2000 Week 5 1.40 0.26 01857 Week 6 1.37 0.26 01898 Volatile Solids Reduction: 0.5410 - 0.5220 X 100 = 0.5410 - (0.5410 X 0.5220) 7.96 % Respectfully submitted, Melissa Myers Statesville Analytical, Inc. NC WW Cert.#440NC PO Box 228 • Statesville, NC 28687 • 704/872/4697 Page 4 of 5 30 Day Bench Worksheet Sample ID # 210422-31-01 WEEK 1 Samples Total Solids Volatile Solids % Volatile Fraction 1 1.39 0.28 2 1.38 0.28 3 1.36 0.28 -Average: 1.38 0.28 0.2029 WEEK 2 Samples I Total Solids Volatile Solids % Volatile Fraction 1 1.34 0.27 2 1.33 0.27 3 1.27 0.26 -Average: 1.31 0.27 0.2061 WEEK 3 Samples I Total Solids Volatile Solids % Volatile Fraction 1 1.26 0.26 2 1.38 0.278 3 1.27 0.25 Average: 1.3 0.26 0.2 WEEK 4 -Samples Total Solids Volatile Solids % Volatile Fraction 1 1.28 0.25 2 1.31 0.256 3 1.32 0.27 Average: 1.3 0.26 0.2 WEEK 5 -Samples Total Solids Volatile Solids % Volatile Fraction 1 1.38 0.26 2 1.40 0.25 3 1.41 0.27 Average: 1.4 0.26 0.1857 WEEK 6 Samples Total Solids Volatile Solids % Volatile Fraction 1 1.36 0.26 2 1.40 0.27 3 1.36 0.26 Average: 1.37 0.26 0.1898 Van Kleeck Reduction: 0.2029 - 0.1898 X 100 = % 0.2029 - ( 0.2029 X 0.1898) Final Result: 7.96% PO Box 228 • Statesville, NC 28687 • 704/872/4697 Page 5 of 5 (�7neAnalXical' ANALYTICAL REPORT May 07, 2021 EMA Resources Sample Delivery Group: L1344243 Samples Received: 04/27/2021 Project Number: COOLEEMEE Description: Sludge Report To: Mr. Brent Collins 755 Yadkinville Road Mocksville, NC 27028 Entire Report Reviewed By: Jw C4V1-- Justin Carr Project Manager Results relate only to the items tested or calibrated and are reported as rounded values. This test report shall not be reproduced, except in full, without written approval of the laboratory. Where applicable, sampling conducted by Pace Analytical National is performed per guidance provided in laboratory standard operating procedures ENV-SOP-MTJL-0067and ENV-SOP-MTJL-0068. Where sampling conducted by the customer, results relate to the accuracy of the information provided, and as the samples are received. N � T ACCOUNT: PROJECT: SDG: DATE/TIME: PAGE: EMA Resources COOLEEMEE L1344243 05/07/21 13:39 1 of 21 TABLE OF CONTENTS Cp: Cover Page Tc: Table of Contents 2 Ss: Sample Summary 3 Cn: Case Narrative 4 Sr: Sample Results 5 COOLEEMEE L1344243-01 5 Qc: Quality Control Summary 7 Wet Chemistry by Method 9012 B 7 Wet Chemistry by Method 9034-9030B 8 Wet Chemistry by Method 9045D 9 Wet Chemistry by Method D93/1010A 10 Mercury by Method 7470A 11 Metals (ICP) by Method 6010D 12 Volatile Organic Compounds (GC/MS) by Method 8260D 14 Chlorinated Acid Herbicides (GC) by Method 8151A 15 Pesticides (GC) by Method 8081B 16 Semi Volatile Organic Compounds (GC/MS) by Method 8270E 17 GI: Glossary of Terms 19 al: Accreditations & Locations 20 Sc: Sample Chain of Custody 21 ACCOUNT: PROJECT: SDG: DATE/TIME: PAGE: EMA Resources COOLEEMEE L1344243 05/07/21 13:39 2 of 21 SAMPLE SUMMARY COOLEEMEE L1344243-01 Waste Collected by Brent Collins Collected date/time 04/26/2107:00 Received date/time 04/27/2109:15 FP Method Batch Dilution Preparation Analysis Analyst Location date/time date/time F Preparation by Method 1311 WG1662761 1 05/02/21 09:54 05/02/21 09:54 TM Mt. Juliet, TN Preparation by Method 1311 WG1663076 1 05/03/2115:33 05/03/2115:33 IDW Mt. Juliet, TN Wet Chemistry by Method 9012 B WG1665185 1 05/06/21 09:54 05/06/21 22:31 JER Mt. Juliet, TN Wet Chemistry by Method 9034-9030B WG1661388 1 04/29/21 22:00 04/29/2122:00 LDT Mt. Juliet, TN Wet Chemistry by Method 9045D WG1662996 1 05/04/2117:58 05/04/21 2121 SAC Mt. Juliet, TN Fn Wet Chemistry by Method D93/1010A WG1663446 1 05/05/21 22:00 05/05/21 22:00 CO Mt. Juliet, TN Mercury by Method 7470A WG1663247 1 05/03/21 09:51 05/03/2117:55 SD Mt. Juliet, TN Metals (ICP) by Method 6010D WG1663404 1 05/03/2112:44 05/05/2103:08 EL Mt. Juliet, TN Fr Volatile Organic Compounds (GC/MS) by Method 8260D WG1663986 1 05/05/2115:09 05/05/2115:09 JAH Mt. Juliet, TN Chlorinated Acid Herbicides (GC) by Method 8151A WG1663776 1 05/04/21 22:52 05/05/2115:00 MT-1 Mt. Juliet, TN Rc Pesticides (GC) by Method 8081B WG1663712 1 05/04/21 07:31 05/05/21 09:46 HMH Mt. Juliet, TN Semi Volatile Organic Compounds (GC/MS) by Method 8270E WG1663508 1 05/03/2122:45 05/04/2116:30 SHG Mt. Juliet, TN GI F RC ACCOUNT: PROJECT: SDG: DATE/TIME: PAGE: EMA Resources COOLEEMEE L1344243 05/07/21 13:39 3 of 21 CASE NARRATIVE All sample aliquots were received at the correct temperature, in the proper containers, with the FP appropriate preservatives, and within method specified holding times, unless qualified or notated within the report. Where applicable, all MDL (LOD) and RDL (LOQ) values reported for environmental samples FC have been corrected for the dilution factor used in the analysis. All Method and Batch Quality Control are within established criteria except where addressed in this case narrative, a non-conformance form or properly qualified within the sample results. By my digital signature below, I affirm to the best of my FS knowledge, all problems/anomalies observed by the laboratory as having the potential to affect the quality of the data have been identified by the laboratory, and no information or data have been knowingly withheld that would affect the quality of the data. 0 Fr Rc GI Justin Carr [Al Project Manager RC Project Narrative All Reactive Cyanide results reported in the attached report were determined as totals using method 901213. All Reactive Sulfide results reported in the attached report were determined as totals using method 9034/903013. ACCOUNT: PROJECT: SDG: DATE/TIME: PAGE: EMA Resources COOLEEMEE L1344243 05/07/21 13:39 4 of 21 SAMPLE RESULTS - 01 L1344243 COOLEEMEE Collected date/time: 04/26/21 07:00 Preparation by Method 1311 Result Qualifier Prep Batch Analyte date / time TCLP Extraction 5/2/2021 9:54:21 AM WG1662761 TCLP ZHE Extraction - 5/3/2021 3:33:25 PM WG1663076 Fluid 1 5/2/2021 9:54:21 AM WG1662761 Initial pH 6.51 5/2/2021 9:54:21 AM WG1662761 Final pH 4.87 5/2/2021 9:54:21 AM WG1662761 Wet Chemistry by Method 9012 B Result Qualifier RDL Dilution Analysis Batch Analyte mg/kg mg/kg date / time Reactive Cyanide ND 0.250 1 05/06/2021 22:31 WG1665185 Wet Chemistry by Method 9034-9030B Result Qualifier RDL Analyte mg/kg mg/kg Reactive Sulfide ND 25.0 Wet Chemistry by Method 9045D Dilution Analysis Batch date / time 1 04/29/202122:00 WG1661388 Result Qualifier Dilution Analysis Batch Analyte su date / time Corrosivity by pH 7.04 T8 1 05/04/2021 2121 WG1662996 Sample Narrative: L1344243-01 WG1662996: 7.04 at24.7C Wet Chemistry by Method D93/1010A Result Analyte Deg. F Ignitability DNI at170 Mercury by Method 7470A Qualifier Dilution Analysis Batch date / time 1 05/05/202122:00 WG1663446 Result Qualifier RDL Limit Analyte mg/I mg/I mg/I Mercury ND 0.0100 0.20 Metals (ICP) by Method 6010D Result Qualifier RDL Limit Analyte mg/I mg/I mg/I Arsenic ND 0.100 5 Barium 0.250 0.100 100 Cadmium ND 0.100 1 Chromium ND 0.100 5 Lead ND 0.100 5 Selenium ND 0.100 1 Silver ND 0.100 5 Volatile Organic Compounds (GC/MS) by Method 8260D Result Qualifier RDL Limit Analyte mg/I mg/I mg/I Benzene ND 0.0500 0.50 Carbon tetrachloride ND 0.0500 0.50 Chlorobenzene ND 0.0500 100 Chloroform ND 0.250 6 ACCOUNT: PROJECT: EMA Resources COOLEEMEE Dilution Analysis Batch date / time 1 05/03/202117:55 WG1663247 Dilution Analysis Batch date / time 1 05/05/202103:08 WG1663404 1 05/05/202103:08 WG1663404 1 05/05/202103:08 WG1663404 1 05/05/202103:08 WG1663404 1 05/05/202103:08 WG1663404 1 05/05/202103:08 WG1663404 1 05/05/202103:08 WG1663404 Dilution Analysis Batch date / time 1 05/05/202115:09 WG1663986 1 05/05/202115:09 WG1663986 1 05/05/202115:09 WG1663986 1 05/05/202115:09 WG1663986 SDG: DATE/TIME: PAGE: L1344243 05/07/21 13:39 5 of 21 COOLEEMEE SAMPLE RESULTS Collected date/time: 04/26/21 07:00 L1344243 Volatile Organic Compounds (GC/MS) by Method 8260D - 01 Result Qualifier RDL Limit Dilution Analysis Batch Analyte mg/I mg/I mg/I date/time 1,2-Dichloroethane ND 0.0500 0.50 1 05/05/202115:09 WG1663986 1,1-Dichloroethene ND 0.0500 0.70 1 05/05/202115:09 WG1663986 2-Butanone (MEK) ND 0.500 200 1 05/05/202115:09 WG1663986 Tetrachloroethene ND C3 0.0500 0.70 1 05/05/202115:09 WG1663986 Trichloroethene ND 0.0500 0.50 1 05/05/202115:09 WG1663986 Vinyl chloride ND 0.0500 0.20 1 05/05/202115:09 WG1663986 (S) Toluene-dH 102 80.0-120 051051202115.09 WG1663986 (S) 4-Bromofluorobenzene 102 77.0-126 051051202115.09 WG1663986 (S) 1,2-Dichloroethane-d4 112 70.0-130 051051202115.09 WG1663986 Chlorinated Acid Herbicides (GC) by Method 8151A Result Analyte mg/I 2,4,5-TP (Silvex) ND 2,4-D ND (S)2,4-DichlorophenylAcetic Acid 73.6 Pesticides (GC) by Method 8081B Qualifier RDL mg/I 0.00200 0.00200 14.0-158 Limit mg/I 1 10 Dilution Analysis date/time 1 05/05/202115:00 1 05/05/202115:00 051051202115.00 Batch WG1663776 WG1663776 WG1663776 Result Qualifier RDL Limit Dilution Analysis Batch Analyte mg/I mg/I mg/I date/time Chlordane ND 0.00500 0.03 1 05/05/202109:46 WG1663712 Endrin ND 0.00500 0.02 1 05/05/20210946 WG1663712 Heptachlor ND 0.00500 0.0080 1 05/05/20210946 WG1663712 Lindane ND 0.00500 0.40 1 05/05/20210946 WG1663712 Methoxychlor ND 0.00500 10 1 05/05/20210946 WG1663712 Toxaphene ND 0.0100 0.50 1 05/05/20210946 WG1663712 (S) Decochlorobiphenyl 63.5 10.0-128 051051202109.46 WG1663712 (S) Tetrochloro-m-xylene 65.8 10.0-127 051051202109.46 WG1663712 Semi Volatile Organic Compounds (GC/MS) by Method 8270E Result Qualifier RDL Limit Dilution Analysis Batch Analyte mg/I mg/I mg/I date/time 1,4-Dichlorobenzene ND 0.100 7.50 1 05/04/202116:30 WG1663508 2,4-Dinitrotoluene ND 0.100 0.13 1 05/04/202116:30 WG1663508 Hexachlorobenzene ND 0.100 0.13 1 05/04/202116:30 WG1663508 Hexachloro-1,3-butadiene ND 0.100 0.50 1 05/04/202116:30 WG1663508 Hexachloroethane ND 0.100 3 1 05/04/202116:30 WG1663508 Nitrobenzene ND 0.100 2 1 05/04/202116:30 WG1663508 Pyridine ND J4 0.100 5 1 05/04/202116:30 WG1663508 3&4-Methyl Phenol ND 0.100 400 1 05/04/202116:30 WG1663508 2-Methylphenol ND 0.100 200 1 05/04/202116:30 WG1663508 Pentachlorophenol ND 0.100 100 1 05/04/202116:30 WG1663508 2,4,5-Trichlorophenol ND 0.100 400 1 05/04/202116:30 WG1663508 2,4,6-Trichlorophenol ND 0.100 2 1 05/04/202116:30 WG1663508 (S) 2-Fluorophenol 51.0 10.0-120 051041202116.30 WG1663508 (S) Phenol-d5 33.6 10.0-120 051041202116.30 WG1663508 (S) Nitrobenzene-d5 88.0 10.0-127 051041202116.30 WG1663508 (S) 2-Fluorobiphenyl 85.5 10.0-130 051041202116.30 WG1663508 (S)2,4,6-Tribromophenol 78.5 10.0-155 051041202116.30 WG1663508 (S) p-Terphenyl-d14 84.6 10.0-128 051041202116.30 WG1663508 ACCOUNT: PROJECT: SDG: DATE/TIME: PAGE: EMA Resources COOLEEMEE L1344243 05/07/21 13:39 6 of 21 EEEEZEEZE 2 t ƒ D � g _ o ID § 2 e ƒ / M \ c J � k J O 7 _ \ \ \ / ƒ 0 / \ \ a _ 2 x / - \ ® m EEEEZEEZE Cy Q U) J 0� Cy " v z� M 0 J U J Q 0 0 u� CO T � y >D U A2 O U O N O U N N J o W EEEEZEEZE Cy Q U) J 0� Cy " v z� M 0 J U J Q 0 i M O m� N V+ � T AM N T PC r s >D v E Q N O N 0 O O m O = co Q O L O co T O U M. 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O m O O O O O ID CD CD CD CD ID ID O_ O_ O_ o_ o_ o_ o_ o_ o 0 0 0 0 0 O O O O O O O O O O O O O O O O O O M M M M M M M M M M M M M M M M M M M M M M M M M M M M M M M M M M M M O O O O O O O O O O O O O O O O O O O O O O O O N � Co Cl L() m o E > > > > > > > > > > > > � � COM 't r� N O o c O � � t N o o 'o a o 0 a o o a a c E t Ln 0 a� w� s s o o O O O O O L O O O O co O O O O- L O V V O Co 4 � M 0_ N N E O� 0 0 0 0 0 0 0 0 0 0 o w U N � o C M C O M O C O't M't N -J O N M � M t M � 61 O O O N M M M M M ID N N M M M J E O IDO IDIDIDO O O O O O 0 0 E O O O O O O O O O O O O O CO — O O O O O O O O O O O O E o 0 0 0 0 0 0 0 0 0 0 0 N O Lo O a Q Q M L O L O O O - O o_ Q � O t CO O 2 O O O ' L T O L L -Q O Q M `o 2 `o `o `o fl Y `o a� E � � °J c�i Z N 4 U C 0 0 V V V YO :it 4 C a a s EEEEZEEZE E 0 E O Q M � c cn E N O O N O Lo O co � N � T U O J Q A2 p ID ID OM OM M M M M M p M O N M Ln M O O M CO ON � N � ON ON o 61 N O � p � N N O N fn E O N O O O O O O W O O ^ O of O O 0 O p — — U p c0 c0 O O (D CO M N N CO N co co O L() N n n M n M M ID O Ln � o Ln � cfl Ln Ln co c� Ln Ln co � cfl co n n N v n N O Lo U O Q) O O N O N CO O N O O N CO M CO (p L() L() CO d- L() N W ID O N CO I.t) C M N ^ L() o CO O I� cO n n O CO CO I� W I� Co CoM V CO N O Lo CO CO W W Ln n O E O O O O O O Z O O O O O Lo N Ln fn N m O L M m m N M p M M M M p OM M MM lzt M O O Z O ID ID ID Z O O O O O Lo O M 4 N fO O Lo O s p p p p p p p p p p p p co O E z z z z z z z z z z z z �0 E M Q O— o 0 0 0 0 0 0 0 0 0 0 0 �j .Q s Ln Ln Ln Ln Ln Ln Ln Ln Ln Ln Ln Ln N E O O O O O O O O O O O O N 4 O o 0 N O W - O a� a o 0 N o 0 0 0 0 o M o EJ j u 5 c�i cu cu � g co ~ ~ Z N 4 N N C 0 0 x, x, x O T .46 a :'a a :'a a a GLOSSARY OF TERMS Guide to Reading and Understanding Your Laboratory Report The information below is designed to better explain the various terms used in your report of analytical results from the Laboratory. This is not intended as a comprehensive explanation, and ifyou have additional questions please contactyour project representative. Results Disclaimer - Information that may be provided by the customer, and contained within this report, include Permit Limits, Project Name, Sample ID, Sample Matrix, Sample Preservation, Field Blanks, Field Spikes, Field Duplicates, On -Site Data, Sampling Collection Dates/Times, and Sampling Location. Results relate to the accuracy of this information provided, and as the samples are received. Abbreviations and Definitions u Fc Fss] MDL Method Detection Limit. ND Not detected at the Reporting Limit (or MDL where applicable). Fn RDL Reported Detection Limit. Rec. Recovery. Fr RPD Relative Percent Difference. SDG Sample Delivery Group. Surrogate (Surrogate Standard) - Analytes added to every blank, sample, Laboratory Control Sample/Duplicate and F (S) Matrix Spike/Duplicate; used to evaluate analytical efficiency by measuring recovery. Surrogates are not expected to be detected in all environmental media. U Not detected at the Reporting Limit (or MDL where applicable). Analyte The name ofthe particular compound or analysis performed. Some Analyses and Methods will have multiple analytes reported. Ifthe sample matrix contains an interfering material, the sample preparation volume or weight values differ from the F Dilution standard, or if concentrations of analytes in the sample are higher than the highest limit of concentration that the laboratory can accurately report, the sample may be diluted for analysis. If a value different than 1 is used in this field, the result reported has already been corrected for this factor. Rc These are the target % recovery ranges or % difference value that the laboratory has historically determined as normal Limits for the method and analyte being reported. Successful QC Sample analysis will target all analytes recovered or duplicated within these ranges. Original Sample The non -spiked sample in the prep batch used to determine the Relative Percent Difference (RPD) from a quality control sample. The Original Sample may not be included within the reported SDG. This column provides a letter and/or number designation that corresponds to additional information concerning the result Qualifier reported. If a Qualifier is present, a definition per Qualifier is provided within the Glossary and Definitions page and potentially a discussion of possible implications ofthe Qualifier in the Case Narrative if applicable. The actual analytical final result (corrected for any sample specific characteristics) reported for your sample. Ifthere was no measurable result returned for a specific analyte, the result in this column may state "ND" (Not Detected) or "BDL" Result (Below Detectable Levels). The information in the results column should always be accompanied by either an MDL (Method Detection Limit) or RDL (Reporting Detection Limit) that defines the lowest value that the laboratory could detect or report for this analyte. Uncertainty (Radiochemistry) Confidence level of 2 sigma. A brief discussion about the included sample results, including a discussion of any non -conformances to protocol Case Narrative (Cn) observed either at sample receipt by the laboratory from the field or during the analytical process. If present, there will be a section in the Case Narrative to discuss the meaning of any data qualifiers used in the report. Quality Control This section ofthe report includes the results ofthe laboratory quality control analyses required by procedure or Summary (Qc) analytical methods to assist in evaluating the validity ofthe results reported for your samples. These analyses are not being performed on your samples typically, but on laboratory generated material. This is the document created in the field when your samples were initially collected. This is used to verify the time and Sample Chain of date of collection, the person collecting the samples, and the analyses that the laboratory is requested to perform. This Custody (Sc) chain of custody also documents all persons (excluding commercial shippers) that have had control or possession ofthe samples from the time of collection until delivery to the laboratory for analysis. This section ofyour report will provide the results of all testing performed on your samples. These results are provided Sample Results (Sr) by sample ID and are separated by the analyses performed on each sample. The header line of each analysis section for each sample will provide the name and method number for the analysis reported. Sample Summary (Ss) This section ofthe Analytical Report defines the specific analyses performed for each sample ID, including the dates and times of preparation and/or analysis. Qualifier Description C3 The reported concentration is an estimate. The continuing calibration standard associated with this data responded low. Method sensitivity check is acceptable. J3 The associated batch QC was outside the established quality control range for precision. J4 The associated batch QC was outside the established quality control range for accuracy. J6 The sample matrix interfered with the ability to make any accurate determination, spike value is low. T8 Sample(s) received past/too close to holding time expiration. ACCOUNT: PROJECT: SDG: DATE/TIME: PAGE: EMA Resources COOLEEMEE L1344243 05/07/21 13:39 19 of 21 ACCREDITATIONS & LOCATIONS Pace Analytical National 12065 Lebanon Rd Mount Juliet, TN 37122 Alabama 40660 Nebraska N E-OS-15-05 Alaska 17-026 Nevada TN000032021-1 Arizona AZ0612 New Hampshire 2975 Arkansas 88-0469 New Jersey—NELAP TNO02 California 2932 New Mexico TN00003 Colorado TN00003 New York 11742 Connecticut PH-0197 North Carolina Env375 Florida E87487 North Carolina' DW21704 _ Georgia NELAP North Carolina 3 41 Georgia' 923 North Dakota R-140 Idaho TN00003 Ohio—VAP CL0069 Illinois 200008 Oklahoma 9915 Indiana C-TN-01 Oregon TN200002 Iowa 364 Pennsylvania 68-02979 Kansas E-10277 Rhode Island LA000356 Kentucky' 6 KY90010 South Carolina 84004002 Kentucky 2 16 South Dakota n/a Louisiana A130792 Tennessee'" 2006 Louisiana LA018 Texas T104704245-20-18 Maine TN00003 Texas5 LABO152 Maryland 324 Utah TN000032021-11 Massachusetts M-TNO03 Vermont VT2006 Michigan 9958 Virginia 110033 Minnesota 047-999-395 Washington C847 Mississippi TN00003 West Virginia 233 Missouri 340 Wisconsin 998093910 Montana CERT0086 Wyoming A2 LA A2LA— ISO 17025 1461.01 AIHA-LAP,LLC EMLAP 100789 A2 LA — ISO 17025 5 1461.02 DOD 1461.01 Canada 1461.01 USDA P330-15-00234 EPA—Crypto TN00003 Drinking Water 2 Underground Storage Tanks 3 Aquatic Toxicity "Chemical/Microbiological 5 Mold 6 Wastewater n/a Accreditation not applicable Not all certifications held by the laboratory are applicable to the results reported in the attached report. Accreditation is only applicable to the test methods specified on each scope of accreditation held by Pace Analytical. Rc ACCOUNT: PROJECT: SDG: DATE/TIME: EMA Resources COOLEEMEE L1344243 05/07/21 13:39 PAGE: 20 of 21 0 a lT�e-1 � � Q Ln LU rn .1 v Ln v t I1 L W a a LL W F- CO N t 9oz€ at j i n aEi o oao °1. d n t a 3 � � D N � � E � O c 4 r a vo I4 N y O R O O N pC N a y U E a` O — m m r c tn 0c c W A( m N r Ln 'D co u o o v CU a > Z O (J n u1 h n^11 E W �% y z 7 o N d M Q` a C o U-� n ? o C Cp Ln C cC� ¢ 2 'n a t.:.: L SaJdON-Jl:)-li i!O}-dl�il X S34dON-JID-11 ASba X T o z o c E O a z ai to `� 1Q O c W C OC N v � a z > o > ai y A 0 ~ ` VI M V kI m a 21x171 z1zZI zE;l U Z Y I Y y •• N 9A v N U 7 rl P 'CS U O W N N 0 tv o a 'cf w P x p N 7 N N -.i c u U a/ H V V] N.W W•+ N NN y p O oorQzj Win. O � 1 cL r 0 m F I c m L 4 n a m T `a_ � 7 u J x 0 QI W C O 3 LL a Y d � R n �II i .J O m p m c a`a s 3 u c a v a A0 s _--. s 2eii) Residuals Information Sheet Residuals Information Sheet Generator: Davie County Facility: Cooleemee WWTP Address: 175 Hwy 801 S Cooleemee, NC 27028 Phone: 336-751-2635 Contact: Tim Smith Land Application Contractor: EMA Resources Inc. 755 Yadkinville Rd Mocksville, NC 27028 Phone: 336-751-1441 Contact: Brent Collins Please Note: The application of these residuals is only allowed in accordance with subject permit. (WQ0002376) All applicable setbacks in accordance with 15A NCAC 02T .1108(b) will be adhered and is the responsibility of the land application contractor. Application rates shall be applied at agronomic rates for intended uses. No residuals shall be applied to any site that is flooded, frozen, or snow covered. Adequate procedures will be implemented to prevent surface runoff of residuals in any surface waters. The attached residuals analysis report is a summary of major and micro -nutrients available in the residuals. If you have any questions concerning this information, you may contact EMA Resources Inc, at the number listed above. 3) LASC Form �t � a O� 0. ° d o o o 4 y U U U U Or U U U U U w w W. W. y 6� M N V) � 00 z y+ O i+ 6� O. O 0 y 6� y ICI O En rn v� 00 O� 01 � .fir .fir A O > C O > O'er O C O O rA z z z z ci it z z z z a QI y � V A U U U it V N o U O Oct O 3 z z �a u XVO O O 0 o z z z z I� tj "C O u 0 d�n CA CA CA C,7 C7 C7 C7 C.' O O u 0 a 0 00 00 00 00 •� O M M M M u ^O O O O M M M M ^ O O O O q o0 01 Q1 � O 0 0 0 0 Q Q Q x z z z z to O N 4=y Lv-- 3a) County Commissioner Notification Information North Carolina Department of Environmental Quality Pat McCrory Donald R. van der Vaart Governor Secretary From: Applicant's name: Davie County Public Works (on behalf of the Division of Water Resources in accordance with Session Law 2013-340) Contact person and title: Johnny Lambert Complete mailing address: 123 South Main Street City: Mocksville State: NC Zip: 27028- Telephone number: 336) 753-6090 E-mail address: jlambertkdaviecountync.gov Subject: Notification of residual land application site proposal This is to notify you that the Applicant listed above will be submitting an application to the Division of Water Resources for the land application of residual solids to site(s) located in your county. During this review, the Division will ensure that all federal and state regulations are enforced. Attached to this form is information regarding residuals -generating sources and locations of the proposed land application sites. Please forward this letter and its associated attachments to the appropriate Department within your County (i.e., Health or Environmental Health Department and Planning Department) if applicable. More information of the land application sites included in this application will be available at the following Division of Water Resources Regional Office: Name of appropriate regional office: Winston Salem Regional Office Complete mailing address: 450 West Hanes Mill Rd, Suite 300 City: Winston Salem State: NC Zip: 27105- Telephone number: 336) 776-9800 Expected date of application submission: 5/25/2021 Should you desire to comment on this application, please do so no later than 30 calendar days following the expected application submission date. If you have any questions or comments about this notification, or if you would like more information, please contact the appropriate regional office at the telephone number provided above. Thank you in advance for your attention to this matter. Enclosures: Source Facility Summary Land Application Site Summary Maps Non -Discharge Permitting Unit 1617 Mail Service Center, Raleigh, North Carolina 27699-1617 Phone: 919-807-6464 \ Internet: http://Portal.ncdenr.org/webtwg An Equal Opportunity \ Affirmative Action Employer — Made in part with recycled paper FORM: CBN 06-16 UNITED STATES MSTAL SERVrr-E. MOCKSVILLE 1119 YADKINVILLE RD MOCKSVILLE, NC 27028-2565 (800)275-8777 05/17/2021 12:57 PM Product Oty Unit Price Price -------------- --- Priority Mall® 1-Dav 1 $7.95 Flat Rate Env Mocksville, NC 27028 Flat Rate Expected Delivery Date Tue 05/18/2021 Certified Mail® $3.60 Tracking #: 70191640000187812942 Return Receipt $2.85 Tracking #; 9590 9402 6014 0069 9601 33 Total $14.40 ------------------- Grand Total: $14.40 ---------------------- Credit Card Remitted $14 40 Card Name: VISA Account #: XXXXXXXXXXXX8707 Approval #: 65552G Transaction #: 779 AID: AOOOOQO0031010 Chip AL: VISA CREDIT PIN_ Not Required *** Mt************************************ USPS is experiencing unprecedented volume increases and limited employee availability due to the impacts of COVID-19. We appreciate your patience. Text your tracking number to 28777 (2USPS) to get the latest status. Standard Message and Data rates may apply. You may also visit www.usps.com USPS Tracking of- call 1-800-222-1811. Save this receipt as evidence of insurance. For information on filing an insurance claim go to https://Www.usps.com/help/claims.htm Preview your Mail Track your Packages Sign up for FREE https://informeddelivery.usps.com All sales final on staltips-and postage. Refunds for guar eed ser ices only. Thank v foef, r votnbuAlness. Tell s about your 11* ence. Go to: h ps://pos-talexperien e.coln/Pos or scan t is code with your mob'le device, 16 ru Domestic ir n, For. visit " AL USE rOCerH°ed Mail Fee 3 . d0 0028 ao s 04 Eldm aryres & Few &W-k bm Wd foe Sr" 4� t� J MAOxn Recdptoald-ph $ ' �� rq p ❑ Rdwn Realpt (swim *) i I Postmark O ❑COMW Metl R.W.W DeUw y $ to -no Here O ❑AdwtarentueR.gwrd i $0.0 O ❑AAA ftnahnFi etrkbd°dMry i $7.95 -A 05/17/2021 Total Postage and W4.40 �l r-i $ a, N Sent7b /efr I 11104Y ar y - ------------------------------ Siieile ""dAp2 orF�O gar ------------- .. Z v :i N �o- -0 ^ coo Li 0 O annown a - O— o0= C3 � CO rn = a� to ru n.l❑❑❑t9❑❑P 0 a 1 ❑❑ ❑ ❑❑E w � 0 0 if =r CL q CD CC3 a e, m a 130 mao. N at o �? m o m �o m m 3b) Landowner Agreement State of North Carolina D Department of Environmental Quality R Division of Water Resources Divbloo of Warr 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 06-16). 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: Davie- ev^4't 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) I Yvo08-04 A10 d/F.b•e co. 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 of 3 I. STIPULATIONS: 1. The landowner or his representative shall not enter into any additional residuals application contracts or agreements with another permitted entity for the site(s) 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, a description ofthe 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 site(s) 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 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. H. RESTRICTIONS: 1. 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 evert. HI.ALTERNATIVES 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(hl 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. W.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 Landowner's Certification: I certify that 1 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 a 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 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 specked herein. Landowner name,: r�A-0 -r Address: T' 0 fJC]K 739 City: Coo er�»e-e State: AX Zip: 271DI Phone: 33(v - 9/r5"- 6060 E-mail address: ti Signature: X pate: S%! A? 1 NORTH CAROLMA, COUNTY I, the undersigned Notary Public do hereby certify that K 05, I I I MO l personally appeared before me this day and acknowledged the due execution of the forgoing instrument. sf WITNESS my hand and official seal this the a day of Signature and seal: /7) My commission expires: 3A30��(0 Lessee's/Operator's Certification: ,20Z1 M.BMCONN 0� * EVku Imh 3k = I 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: Permittee's Certification: State: E-mail Date: Zip: I certify that I have read this Agreement and! do hereby agree to abide by the stipulations and restrictions as specified herein. Signing official"e: Ann ! 0"brr� ot;l;�;[s t);rec4-* Signature: Date: G • c;- ' 2,9L I T FORM: LOA 06-16 Page 3 of 3 3c) Setback Waiver FILED DAVIE COUNTY NC KELLY C. FUNDERBURK REGISTER OF DEEDS FILED Jun 01, 2021 AT 09:57 am BOOK 01181 START PAGE 0826 END PAGE 0827 INSTRUMENT # 03891 EXCISE TAX (None) State of North Carolina Department of Environmental Quality Division of Water Resources NON -DISCHARGE RESIDUALS MANAGEMENT PROGRAM WAIVER FOR THE APPLICATION OF CLASS B RESIDUALS AGREEMENT TO WAIVE SETBACKS PURSUANT TO 15A NCAC 02T .1108(c) I, riW kcertify that I am a deeded owner of the property located at: Address: 1 �3 n 60G [1r D1 Parcel No.: PIy0000003lpo7- City: 0) 6Cj -y(jL U ' State: N= Zip Codet? _2O �-8 County: p- t E Furthermore, I certify that I am authorized to make decisions regarding this property, and that I do hereby agree that the setback distances cited below be granted to the Applicant/Permittee listed on the following page. D R For the parcel identified above, I consent to a reduced setback from 1feet to feet, thereby allowing the application of Class B residuals as near as 0 feet from my property line. 2-'F"or the parcel identified above, I consent to a reduced setback from 4VP feet to 1,949 feet, thereby allowing the application of Class B residuals as near as /D0 feet from my residence. "THIS WAIVER SHALL BE TERMINATED UPON CHANGE OF OWNERSHIP OF ANY PARTIES INVOLVED" Signature: ftj4�Date: S—A_a FORM: NDRMPW-LAS 11-1 a �t 755 � Page 1 of 2 Applicant/Permittee: ba v i r- el-11 Address: 12 3 5. Ala: , 5Jr. . Parcel No.: H y 000 0003460 2. City: 1r oC'V_Sv+ 11 f_ State: A)C Zip Code: a702-$' County: Z�cv' e NORTH CAROLINA, I- a-, t COUNTY I, /►'1 • I3A-114- 611,'^S , a Notary Public for 7a.j; e- County, North Carolina, do hereby certify that Fr,d Wh;-6k•r personally appeared before me this day and acknowledged the due execution of the foregoing instrument. Witness my hand and official seal, this the 2$ik day of /V� 1 ,_.2021 EAL R Bfi911t WTARY PUBLIC My OonMtllssb i E*= March 90, 2= Signature of Notary Public My commission expires 3/30/2& Once notarized, this form shall be recorded at the Register of Deeds in the county or counties in which the described properties are located. A copy of the recorded waiver shall be sent to the following address: Division of Water Resources Non -Discharge Branch 1617 Mail Service Center Raleigh, North Carolina 27699-1617 FORM: NDRMPW-LAS 11-18 Page 2 of 2 Kelly C. Funderburk Davie County Register of Deeds 123 South Main Street Mocksville, NC 27028 (336) 753-6080 Receipt For: EMA RESOURCES Instrument Type : WVR Instrument # : 03891 Book/Page : 01181 / 0826-00827 Pages : 2 1st Grantor : FRED WHITAKER 1st Grantee : FRED WHITAKER Description: AGMT TO WAIVE SETBACKS Description Oty General Instruments - first 15 pages 1 Unit Cost 26.00 Document 1 Grand Total Check 31003 Balance Receipted By: Beverly A. McDaniel Receipt # : 2021-038701 Date : 06/01/2021 09:57am Document: 1 of 1 Extended 26.00 26.00 26.00 -26.00 0.00 Customer Copy 3d) Vicinity Map 3e) Aerial/Application Map 3f) Topo Map 3g) Soil Map 3h) Background Soil Sample and Heavy Metals Z r 0 a CO W o OR c� C P7 ol U LO ol co m rn _ _ U N N W O O O V W N N V 00 LO L V LO O O Y r > CL Q CO p N N v o N v cQ C 04 Q C C) M CO �C m a °r) Q 0 — U cz C v1 O C O O O N a LO cOi U OD >z LO c Lo Lb C0 N (V > o 0 T V Q >- 3.2 U N LO O y ++ O W I- r O Z o Z _ C O Z O E U) N O O > m v C d m Q Q iJ N �% i a E 0 a- o_ a� 0 0 c 0 t 0 E E 0 (D U s= � Z a N M- E a 0 E a ri s= � z OM 0 z M' U U O N O a 0 � E � O N z a s m o U c W o U 0 I I w � w. o 0 U t N 0 H z Waypointo ANALYTICAL 5/24/2021 EMA Resources Inc 755 Yadkinville Road Mocksville, NC, 27028 Ref: Analytical Testing 7621 Whitepine Road, Richmond, VA 23237 Main 804-743-9401 0 Fax 804-271-6446 www.waypointanalytical.com Report Number: 21-134-0007 Project Description: Roger Spillman Waypoint Analytical Virginia, Inc. received sample(s) on 5/14/2021 for the analyses presented in the following report. The above referenced project has been analyzed per your instructions. The analyses were performed in accordance with the applicable analytical method. Sub -contracted testing is noted on the Sample Summary Table if applicable. The analytical data has been validated using standard quality control measures performed as required by the analytical method. Quality Assurance, method validations, instrumentation maintenance and calibration for all parameters (NELAP and non-NELAP) were performed in accordance with guidelines established by the USEPA (including 40 CFR 136 Method Update Rule May 2012) and NELAC unless otherwise indicated. Certain parameters (chlorine, pH, dissolved oxygen, sulfite...) are required to be analyzed within 15 minutes of sampling. Usually, but not always, any field parameter analyzed at the laboratory is outside of this holding time Refer to sample analysis time for confirmation of holding time compliance. The results are shown on the attached Report of Analysis(s). Results for solid matrices are reported on an as - received basis unless otherwise indicated. This report shall not be reproduced except in full and relates only to the samples included in this report. Please do not hesitate to contact me or client services if you have any questions or need additional information Sincerely, �aw,c M( G10"r Pauric McGroary Agronomist Laboratory's liability in any claim relating to analyses performed shall be limited to, at laboratory's option, repeating the analysis in question at laboratory's expense, or the refund of the charges paid for performance of said analysis. Page 1 of 6 • 7621 Whitepine Road, Richmond, VA 23237 Waypoint Main 804-743-9401 0 Fax 804-271-6446 ANALYTICAL www.waypointanalytical.com Sample Summary Table Report Number: 21-134-0007 Client Project Description: Roger Spillman Lab No Client Sample ID Matrix Date Collected Date Received Method Lab ID 76349 09 Solids 05/14/2021 SW-7471B WP MTN 76349 09 Solids 05/14/2021 6010D WP MTN WP MTN - Memphis, TN: Waypoint Analytical - TN, Memphis, TN Page 2 of 6 �' WayP 7621 Whitepine Road, Richmond, VA 23237 Main 804-743-9401 Fax 804-271-6446 ANALYTICAL www.waypointanalytical.com 46245 EMA Resources Inc Project Roger Spillman 755 Yadkinville Road Report Date : 05/24/2021 Information : Received : 05/14/2021 Mocksville , NC 27028 �oau� �� Grow Pauric Mc Groary Ph.D., CPA Report Number : 21-134-0007 REPORT OFANALYSIS Agronomist Lab No : 76349 Matrix: Solids Sample ID : 09 Sampled: Test Results Units MQL DF Date / Time By Analytical Analyzed Method Nickel 22.4 mg/Kg 1.25 5 05/21/2115:10 JTR 6010D Mercury 0.0515 mg/Kg 0.0151 1 05/19/2115:07 DDB SW-7471B Selenium <2.50 mg/Kg 2.50 5 05/21/2115:10 JTR 6010D Test Results Units MQL DF Date / Time By Analytical Analyzed Method Arsenic <2.50 mg/Kg 2.50 5 05/21/2115:10 JTR 6010D Cadmium 0.541 mg/Kg 0.500 5 05/21/2115:10 JTR 6010D Chromium 53.0 mg/Kg 1.25 5 05/21/2115:10 JTR 6010D Lead 39.4 mg/Kg 1.50 5 05/21/2115:10 JTR 6010D Molybdenum <1.25 mg/Kg 1.25 5 05/21/2115:10 JTR 6010D Qualifiers/ DF Dilution Factor Definitions MQL Method Quantitation Limit L Limit Exceeded Page 3 of 6 Waypointo ANALYTICAL Client: EMA Resources Inc Project: Roger Spillman Lab Report Number: 21-134-0007 Date: 5/21 /2021 7621 Whitepine Road, Richmond, VA 23237 Main 804-743-9401 0 Fax 804-271-6446 www.waypointanalytical.com CASE NARRATIVE Metals Analysis Method 601 OD Sample 76349 (09) QC Batch No: L554373/L553736 One or more Internal Standards are outside method acceptance criteria. Re -analysis and/or sample dilutions are required. Page 4 of 6 WayPAoInt.. NALYTICAL 7621 Whitepine Road, Richmond, VA 23237 Main 804-743-9401 0 Fax 804-271-6446 www.waypointanalytical.com Shipment Receipt Form Customer Number: 46245 Customer Name: EMA Resources Inc Report Number: 21-134-0007 Shipping Method 0 Fed Ex 0 US Postal 0 Lab ® UPS 0 Client 0 Courier 0 Other: Thermometer ID: Shipping container/cooler uncompromised? 0 Yes 0 No Number of coolers/boxes received F-71 Custody seals intact on shipping container/cooler? 0 Yes 0 No ! Not Present Custody seals intact on sample bottles? 0 Yes 0 No ® Not Present Chain of Custody (COC) present? 0 Yes 0 No COC agrees with sample label(s)? 0 Yes 0 No COC properly completed 0 Yes 0 No Samples in proper containers? 0 Yes 0 No Sample containers intact? 0 Yes 0 No Sufficient sample volume for indicated test(s)? 0 Yes 0 No All samples received within holding time? 0 Yes 0 No Cooler temperature in compliance? 0 Yes ® No Cooler/Samples arrived at the laboratory on ice. Samples were considered acceptable as cooling process had begun. 0 Yes ® No Water - Sample containers properly preserved 0 Yes 0 No ® N/A Water - VOA vials free of headspace 0 Yes 0 No ® N/A Trip Blanks received with VOAs 0 Yes 0 No N/A Soil VOA method 5035 — compliance criteria met 0 Yes 0 No 0 N/A F_ High concentration container (48 hr) F_ High concentration pre -weighed (methanol -14 d) F_ Low concentration EnCore samplers (48 hr) F_ Low conc pre -weighed vials (Sod Bis -14 d) Special precautions or instructions included? 0 Yes ® No Comments: Signature: lBrandi Watson Date & Time: 05/14/2021 14:22:03 Page 5 of 6 �- 7621 Whitepine Road Richmond, VA 23237 fax t8O4} 211-8466 8f]4} 743-94a1 real i i.0 m ,�.wa ale Way ��� �IVFaRMaTI�N SHEET S��L GROWER tNFORMA7fON 'gNALYTICAL SAMPLE 1 ri m,voMER INFORMATION K DA J ',y ~ EMA Resources Inc • re 7$�j 1'adltinville Rd. Send Report to a -matt address Bnt.collitts@emaresourCesinC•com J 0 O!B Field 10 � � MO &sville, NC 27428 Farm ID Grower too info box t)elO vloua AGCnunt # 46245 ease indicated , and.dbtLMe- ddAo Yield p C � Additlonsl intended Yield Cre Code Crc Yield Cro les in column rovided if Herbicide or Nematode anal sis5oeuhlsste x fr He a T8513 Cro Code Cro use chock sam ample ID 54µ . $ ec1 Add'I Tarts - S zn 530 Salta Texture N�3-N Tab Number g chars. max 55N1 B Cu Fa Hen Ns - t.ab Use On1 i } 09 l } i � t } I S } I ;a m }} s n Magnesium, pH, Buffer pH Copper. Each additional test (abo Calcium, Manganese. iron, c Matter, Phosphorous, Potassium, Q1S Sim - organ, fthe following: Sodium. Sulfate Sulfur, Boron, Zinc, lyJIENDAYidRS ARE RE er. S2M StM plus any two a CpM name in the or _ ;us all of the followin '• Sod O u8E USED IF IFERTILiZER RE ❑ rite the cro S3m - S'M CRop CODE ..,n for which ou would like recorrtm�o 0 CROPS listed, w . 6'I Coastal Bermuda Hay 1, Barley 5, Cartola 10, Com beans Rotation 11. CorNSoY i2, Com - No Till 13, Com Silage 2p, Cotton 21. Cotton - No Till 25, Grain Sorghum 30. oats 32. Peanuts 34. Popcorn 35. Rapeseed 36. Rice 39. Rye 45 Soybeans 46, Soybeans - No Till 51- Sugarcane - Plant 52. Sugarcane - Stubble 62. Tobacco - Burley 63. Tobacco Dark 64. Tobacco -Flue Cured 15. Wheat 78. Wheat S;IagelCorn Silage -_ SCDA FORMAT a 101. 103' Alfalta Hay Alfalfa/Cool Season Grass ran Grasss Hay' 10E. Aifalfa Warm 116. 11� BahiagrHay aapiagrass pasture 1z1. Common Bermuda Hay Bermuda Pasturea 121 123. Common Hay Common BermudafLeg awsS 124. Common Bermudez TYPE OF t 1 162, Coastal Bermuda Pasture Grass Pasture 172 Cool Season Grass HaY 171 181. Cool Fescue nay 152. 1133. Fescue Pasture Fescuelt-egume 184. Fescue/Leg ume Pasture L:Mr VEGETABLE GRO Beans tuna 381. Spinach 382. S4uash berries3p7. us309. Beans - ShaA Cabbage 383. Sweet Cornpes32d, Sweet Patat0[toaches322. LAppleles Cantaloupe 3$4 391. SweetPotato(bcans33p. Cucumbers 385 Tomatoes34p- awberries398 Garden Watermelons368. Peppers ..���.t,.fnrmatfon 512. Bahiagr 513. Bahiag - 517. Bentgr 521, Bermu 522. Berms - 523. Berms - 524. Berme a ut t i 525, Berm' o 1a 526. Berm`^ 533. Blue( O 534. Btu& N ti 546. Cent 547. CeN 561. Fes, 563. Fes"- - Product 564. Fescue Sad 576. St. Augustine Lawn ` 577. st. Augustine Sod Production y l 563, Zosiagrass Lawn l 584, Zoyslagrass Sod Productor Additiona+ 1 Bow -- analy Additionally these samples need to e Mercuryzed for: Arsenic, Cadmium, Chromium, Nickel and Selenium �i�+out Molybdenum prices are subject to r}lange lance of our terms and conditions. procedures. n sheet to WaYpoinI Analytical. Inc• }s aCcilent if sampte requires additional preparation AdditLonal fees may be charged to Page 6 of 6 3b) Landowner Agreement State of North Carolina Department of Environmental Quality RXR Division of Water Resources Division Water Resoarr� 15A NCAC 02T .1100 — LAND OWNER AGREEMENT nf 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 sunnorting 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: �wui L a-,od-j 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) tic -DJ-009-of ,V0 A-esc,e- / /� Fug[/FS 74,.E a,/41 ac-bv - 001-oz No 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 of 3 I. STIPULATIONS: 1. The landowner or his representative shall not enter into any additional residuals application contracts or agreements with another permitted entity for the site(s) 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-DWI;, 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, a description 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 site(s) 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 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. H. RESTRICTIONS: 1. 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 residuaWsoil 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. III. ALTERNATIVES 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) 2/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 oroeram. (Name of the new program) FORM: LOA 06-16 Page 2 of 3 1 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. 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 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. I ff'' � Landowner name: 4S 1✓4, S Ill Address: 8 n{ r LO n L City: A(Vcuvi itC_ State: Nc- zip: 2 702 S' Phone: E-m 1 address: Signature: Date: _,r1ZT z I NORTH CAROLINA, +Jovi C COUNTY I, the undersigned Notary Public do hereby certify that 71,A14$ k ".4 k*f" — personally appeared before me this day and acknowledged the due execution of the forgoing instrument. WITNESS my hand and official seal this the day of A Signature and seal: My commission expires: Lessee's/Operator's Certification: 313oACo 26 {A M. Brent Collins Mraan"bnooresNard, I 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: Permittee's Certification: State: E-mail address: Date: Zip: I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein, Signing official Signature: Date: (0� Fr- Zo 21 FORM: LOA 06-16 Page 3 of 3 3d) Vicinity Map 3e) Aerial/Application Map I h1 Pik �lAr ,� •� � `� Gam. OP,. s Gov �M ■ 4 _ �y 2 �� it 'y •�� L L Barn f�" �' y ■r `�'��4th f'�" �; 0 Off Site Dwelling - Waiver sk �,■'fig `" Y `� • Well • '• • �, iA 1■ ; �'` -, a ■ Off Site Dwelling WV --.►_-�, • r�x. }. ,;i, _.._.._ Stream x — x - Fenceline 6 F s M �r ", •�h. ®Buffer ,fir 1• 4 Field Total Acres Applicable Acres Field Boundary 1 7.47 6.48 ` Source: Esri, DigitalGlobe, Geo ! Property Boundary 2 16.07 15.75 DS, USDA, USGS,AeroGRl©, I ��� _ o SCALE: 1 ^ = 440 ' Davie County FIGURE NO. i DATE: 05-10-21 EMA Land Application Program DRAWN BY: BC --Resources, Inc. 2 'ROJECT NO: NC-DV-009 LAinnninrwz Thomas Whitaker 3f) Topo Map 3g) Soil Map t jlr k ��`�' �� p1�AH� � •�� i,� til bra• �� ,a- • �: V--�,� �'� y• •1r � � To132 Tomlin clay loam, 2-8% slopes, moderately eroded RaB Rasalo fine sandy loam, 2-8% slopes Ds, us SCALE 14 5' " It 41 ® Hand Auger Boring Soils Field Boundary 1 = 440 Davie County FIGURE NO. DATE: 05-10-21 EMA Land Application Program DRAWN BY: BC --Resources, Inc. PROJECT NO: NC-DV-009 lAinnninrw'z Thomas Whitaker N 3h) Background Soil Sample and Heavy Metals cn N -e O N I N O O N F a)N N O V OD O p � i ❑ O O E m c E a. u o O R > Q O cc o w G1 00 L c-I N tD n U cz � I-_ O O O N (1) (1) co U >z LO c _O t at'i N L O O W r r O Z o Z •• +� fA O3 O V 0- ma 'a a m Z O O Nv co W o 0 ol C N �O U C0 v N m rn m co cn U o m r O Uo cn r 't G LO OD N O O N o 0 N r 04 Q c O O Q cC O O C c N CO C r V r O fn M N C0 I� �C LO a o v r c0 Q V N O Lo Lo ol o0 v N r y m Z Z U �o 0 fn O O �l Z 000 00 Q V V J N N U C C6 a E O N O_ a� 0 0 0 N 0 E E 0 (D U Z a N M- E a 0 E a ri z Om 0 z m E .� U o N U _a a 0 � E � � O z a m o U c w o U 0 u > w d c E w o E w 0 U O L N C V g z Waypointo ANALYTICAL 5/24/2021 EMA Resources Inc 755 Yadkinville Road Mocksville, NC, 27028 Ref: Analytical Testing 7621 Whitepine Road, Richmond, VA 23237 Main 804-743-9401 0 Fax 804-271-6446 www.waypointanalytical.com Report Number: 21-134-0008 Project Description: Thomas Whitaker Waypoint Analytical Virginia, Inc. received sample(s) on 5/14/2021 for the analyses presented in the following report. The above referenced project has been analyzed per your instructions. The analyses were performed in accordance with the applicable analytical method. Sub -contracted testing is noted on the Sample Summary Table if applicable. The analytical data has been validated using standard quality control measures performed as required by the analytical method. Quality Assurance, method validations, instrumentation maintenance and calibration for all parameters (NELAP and non-NELAP) were performed in accordance with guidelines established by the USEPA (including 40 CFR 136 Method Update Rule May 2012) and NELAC unless otherwise indicated. Certain parameters (chlorine, pH, dissolved oxygen, sulfite...) are required to be analyzed within 15 minutes of sampling. Usually, but not always, any field parameter analyzed at the laboratory is outside of this holding time Refer to sample analysis time for confirmation of holding time compliance. The results are shown on the attached Report of Analysis(s). Results for solid matrices are reported on an as - received basis unless otherwise indicated. This report shall not be reproduced except in full and relates only to the samples included in this report. Please do not hesitate to contact me or client services if you have any questions or need additional information Sincerely, �aw,c M( G10"r Pauric McGroary Agronomist Laboratory's liability in any claim relating to analyses performed shall be limited to, at laboratory's option, repeating the analysis in question at laboratory's expense, or the refund of the charges paid for performance of said analysis. Page 1 of 7 • Waypoint 7621 Whitepine Road, Richmond, VA 23237 Main 804-743-9401 0 Fax 804-271-6446 ANALYTICAL www.waypointanalytical.com Sample Summary Table Report Number: 21-134-0008 Client Project Description: Thomas Whitaker Lab No Client Sample ID Matrix Date Collected Date Received Method Lab ID 76350 01 Solids 05/14/2021 6010D WP MTN 76350 01 Solids 05/14/2021 SW-7471B WP MTN 76351 02 Solids 05/14/2021 6010D WP MTN 76351 02 Solids 05/14/2021 SW-7471B WP MTN WP MTN - Memphis, TN: Waypoint Analytical - TN, Memphis, TN Page 2 of 7 �' WayP 7621 Whitepine Road, Richmond, VA 23237 Main 804-743-9401 Fax 804-271-6446 ANALYTICAL www.waypointanalytical.com 46245 EMA Resources Inc Project Thomas Whitaker 755 Yadkinville Road Report Date : 05/24/2021 Information : Received : 05/14/2021 Mocksville , NC 27028 �oau� �� Grow Pauric Mc Groary Ph.D., CPA Report Number : 21-134-0008 REPORT OFANALYSIS Agronomist Lab No : 76350 Matrix: Solids Sample ID : 01 Sampled: Test Results Units MQL DF Date / Time By Analytical Analyzed Method Nickel 6.44 mg/Kg 0.250 1 05/20/2119:46 JTR 6010D Mercury 0.0322 mg/Kg 0.0149 1 05/19/2115:08 DDB SW-7471B Selenium <2.50 mg/Kg 2.50 5 05/21/2115:15 JTR 6010D Test Results Units MQL DF Date / Time By Analytical Analyzed Method Arsenic 1.85 mg/Kg 0.500 1 05/20/2119:46 JTR 6010D Cadmium 0.446 mg/Kg 0.100 1 05/20/2119:46 JTR 6010D Chromium 36.6 mg/Kg 0.250 1 05/20/2119:46 JTR 6010D Lead 21.9 mg/Kg 0.300 1 05/20/2119:46 JTR 6010D Molybdenum 0.397 mg/Kg 0.250 1 05/20/2119:46 JTR 6010D Qualifiers/ DF Dilution Factor Definitions MQL Method Quantitation Limit L Limit Exceeded Page 3 of 7 �' WayP 7621 Whitepine Road, Richmond, VA 23237 Main 804-743-9401 Fax 804-271-6446 ANALYTICAL www.waypointanalytical.com 46245 EMA Resources Inc Project Thomas Whitaker 755 Yadkinville Road Report Date : 05/24/2021 Information : Received : 05/14/2021 Mocksville , NC 27028 �oau� �� Grow Pauric Mc Groary Ph.D., CPA Report Number : 21-134-0008 REPORT OFANALYSIS Agronomist Lab No : 76351 Matrix: Solids Sample ID : 02 Sampled: Test Results Units MQL DF Date / Time By Analytical Analyzed Method Nickel 8.76 mg/Kg 1.25 5 05/21/2115:20 JTR 6010D Mercury 0.0308 mg/Kg 0.0158 1 05/19/2115:09 DDB SW-7471B Selenium <2.50 mg/Kg 2.50 5 05/21/2115:20 JTR 6010D Test Results Units MQL DF Date / Time By Analytical Analyzed Method Arsenic <2.50 mg/Kg 2.50 5 05/21/2115:20 JTR 6010D Cadmium <0.500 mg/Kg 0.500 5 05/21/2115:20 JTR 6010D Chromium 24.9 mg/Kg 1.25 5 05/21/2115:20 JTR 6010D Lead 18.1 mg/Kg 1.50 5 05/21/2115:20 JTR 6010D Molybdenum <1.25 mg/Kg 1.25 5 05/21/2115:20 JTR 6010D Qualifiers/ DF Dilution Factor Definitions MQL Method Quantitation Limit L Limit Exceeded Page 4 of 7 Waypointo ANALYTICAL Client: EMA Resources Inc Project: Thomas Whitaker Lab Report Number: 21-134-0008 Date: 5/21 /2021 7621 Whitepine Road, Richmond, VA 23237 Main 804-743-9401 0 Fax 804-271-6446 www.waypointanalytical.com CASE NARRATIVE Metals Analysis Method 601 OD Sample 76351 (02) QC Batch No: L554373/L553736 One or more Internal Standards are outside method acceptance criteria. Re -analysis and/or sample dilutions are required. Page 5 of 7 WayPAoInt.. NALYTICAL 7621 Whitepine Road, Richmond, VA 23237 Main 804-743-9401 0 Fax 804-271-6446 www.waypointanalytical.com Shipment Receipt Form Customer Number: 46245 Customer Name: EMA Resources Inc Report Number: 21-134-0008 Shipping Method 0 Fed Ex 0 US Postal 0 Lab ® UPS 0 Client 0 Courier 0 Other: Thermometer ID: Shipping container/cooler uncompromised? 0 Yes 0 No Number of coolers/boxes received F-71 Custody seals intact on shipping container/cooler? 0 Yes 0 No ! Not Present Custody seals intact on sample bottles? 0 Yes 0 No ® Not Present Chain of Custody (COC) present? 0 Yes 0 No COC agrees with sample label(s)? 0 Yes 0 No COC properly completed 0 Yes 0 No Samples in proper containers? 0 Yes 0 No Sample containers intact? 0 Yes 0 No Sufficient sample volume for indicated test(s)? 0 Yes 0 No All samples received within holding time? 0 Yes 0 No Cooler temperature in compliance? 0 Yes ® No Cooler/Samples arrived at the laboratory on ice. Samples were considered acceptable as cooling process had begun. 0 Yes ® No Water - Sample containers properly preserved 0 Yes 0 No ® N/A Water - VOA vials free of headspace 0 Yes 0 No ® N/A Trip Blanks received with VOAs 0 Yes 0 No N/A Soil VOA method 5035 — compliance criteria met 0 Yes 0 No 0 N/A F_ High concentration container (48 hr) F_ High concentration pre -weighed (methanol -14 d) F_ Low concentration EnCore samplers (48 hr) F_ Low conc pre -weighed vials (Sod Bis -14 d) Special precautions or instructions included? 0 Yes ® No Comments: Signature: lBrandi Watson Date & Time: 05/14/2021 14:23:22 Page 6 of 7 r way 01INFORMATION SHEET �NALYTiCAI- SolL SAMPLE �Rt *14s WAS EMA Resources Inc. 755 Yadkinville Rd' Mocksville, NC 27028 �.,G"O. r lD Account # 46245 Solub Se check sam les Scolumn ampl SA rovided if xm Sd0 Or Add'I Tgatoduln $3Me anal 5 Sate -ab Number mn Hf Siµ B Gu Fa llaa only). 8 chart. mr>< i 7621 Whitepine Road Richmond. VA 23231 t804y 743-9441 a • Fax t804}271-6466 _ W wa ointanal tiCai.Cam Send Report to a -mail address brent•cullinsC�emaresourcesinc•cu� `V Farm lP Q0 9 Field aD m u U. ¢ box 10 Intended Altemate Altemeta PraYltt steel. If Herbicide. loess indicate name of Herbicide in Add'l Inforita b Cm i Additional Intended - - -A r oo Cads Gro SiM _ grganio Matter• Phosphorous. potassium, Caleium. Magnesium, p H, auf#er pH an two of the fvilawing. Sodium, Sulfate-Sultur• Boron• z+nc, Manganese, iron. CoRPer Each additlan 52M - 51 M plus r Y., �G 1 E6 IF FERTILIZER RECO FNOAi10N5 A cllvl ❑lus all of the follawin : Sodium- Sulfate•Sulfur, Boron. Zinc• Man anew. Iron. o e _ .. _._r __,ja the Crop rlaf If 1, Barley 5. Canola io. Com 11. CorrdSoybeans Rotation 12. Corn - No Till i3. Com Silage 20• Cotton No Till 21. Cotton 25 Grain Sorghum 30. Oats 32. Peanuts 34. P❑pcorrt 35. Rapeseed 36, Rice 39. Rye 45. Soybeans 46• Soybeans - No Till 51. Sugarcane • Plant 52. Sugarcane - Stubble fit. Tobacco Burley 63. Tobacco Dark CA Tobacco - flue Cured 75. Wheat 78. VVheat SilageiCorn Silage NCI]A FORMAT like s is n 101 103. Alfalfa Bay A!#alfafCeol Season Grass Hay Grass Hay 106. AlfalfaMlarm Season jj6Bahla9rasss Pasture 117. 17. Bahiag Bermuda Hay 121. 122. Common Common Bermuda Pasture Hay 123, Bermuda/Legume Common me Pasture 124. CommonBermudrlc TYPE OF GRA r. Coastal Bermuda HaY Coastal Bermuda Pasture 162. 172. Cool Season Grass Pasture Grass Hay 173. Cool Season 181. Fescue Hay 1 B2. Fescue Pasture Hay 183. 184. FeScueA_egume Fescue/Legume Pasture 237. R e rass �I m VEGETABLE CROP5 400. Apples 307, Beans - Lima 381. Sp' mach 38.3 Squash 410. Blueberries 309. Beans - Snap 383. Sweet Corn 420- 430. Citrus Grapes 320. 322, Cabbage Cantaloupe 3B4- Sweet to on) Sweet Potato(bu) 474. Peaches 330. Cucumbers 391 355. Tomatoes 475 490. pecans Strawberries 34o. Garden 398. Watermelons pe pers o r r 62.00. n 1 � m � t bOlceO ,SS 1 2 reduction tiletic Field rway 'en d PreduCtlon N A� �duc5on N O w :)dut:ti°n eld fiction 51ti. z5t• Augustine Lawn Sod Production 577, St. Augustine 583. 2oysiagrass Lawn Sod Production 584. xoysiagress 369- P Additional Tests ❑r Other=obe ation Additionally these samples needanalyzedfor: Arsenic, Cadmium, Chromium, Lead, Mercury, in Nickel, and Selenium Molybdenu , Al! rites are suulr lrrmsd s additional preparation Procedures et to WayPeint Analytical. Inc. is acceptance of Our terms anconditions Additional fees may be charged to �1ent it samp to ch na 9e withau: Page 7 of 7 3a) County Commissioner Notification Information North Carolina Department of Environmental Quality Pat McCrory Donald R. van der Vaart Governor Secretary Date: 5/17/2021 To: Name of Chairman to the Board of County Commissioners: Gregg Edds Complete mailing address: Administration Building, 130 W. Innes St. City: Salisbury State: NC Zip: 28144 County where land application sites are located: Rowan County From: Applicant's name: Davie County Public Works (on behalf of the Division of Water Resources in accordance with Session Law 2013-340) Contact person and title: Johnny Lambert Complete mailing address: 123 South Main Street City: Mocksville State: NC Zip: 27028- Telephone number: 336) 753-6090 E-mail address: jlambertkdaviecoun , nc._ov Subject: Notification of residual land application site proposal This is to notify you that the Applicant listed above will be submitting an application to the Division of Water Resources for the land application of residual solids to site(s) located in your county. During this review, the Division will ensure that all federal and state regulations are enforced. Attached to this form is information regarding residuals -generating sources and locations of the proposed land application sites. Please forward this letter and its associated attachments to the appropriate Department within your County (i.e., Health or Environmental Health Department and Planning Department) if applicable. More information of the land application sites included in this application will be available at the following Division of Water Resources Regional Office: Name of appropriate regional office: Winston Salem Regional Office Complete mailing address: 450 West Hanes Mill Rd, Suite 300 City: Winston Salem State: NC Zip: 27105- Telephone number: 336) 776-9800 Expected date of application submission: 5/25/2021 Should you desire to comment on this application, please do so no later than 30 calendar days following the expected application submission date. If you have any questions or comments about this notification, or if you would like more information, please contact the appropriate regional office at the telephone number provided above. Thank you in advance for your attention to this matter. Enclosures: Source Facility Summary Land Application Site Summary Maps Non -Discharge Permitting Unit 1617 Mail Service Center, Raleigh, North Carolina 27699-1617 Phone: 919-807-6464 \ Internet: http://Portal.ncdenr.org/webtwg An Equal Opportunity \ Affirmative Action Employer — Made in part with recycled paper FORM: CBN 06-16 ---------------------•---•-- *f tali' B Wo fsFrvLy -,� pp ........... ----•-•-......-- - -- -°J!C 4d'4:' 0 Clot JUGS TZOZ/LT/O oii8'"° L, Gb'L3 eBOWd -= suaaw�vwdunaudev❑ 0 VW El O 4MUWMd i 1 ! OWMP) WOOrd Uffawd p O s c.ww��.n�,❑ N tO tw1 d` owva. -q'p a BZOO O9*2$ "siron POD OO CP �wrr-ra rim 3e 04isgarn ono ps�n •uopeauorur /Jan110p J0=1 AIUO Irew opsaurop ldl303a n-IIHW ml-11 I !-la1 i -a CO 0 ca 00 J C— C? CA v Cn z 0 [UNITED STATES POSTAL SERVICE. MOCKSVILLE 1119 yArIKINVILLE J '.uCKSVILLE, NC 27028-2565 (800)275-8777 05/17'2021 01:54 PM ---------------- ----- P+ oduct G i y it It Price Fr I ce Priority Mai10 2-Day 1--- $7.95 Flat Rate Env Salisbury, NC 28144 Flat Rate Expected Delivery Da.e Thu 05/20/2021 Certified Mail® $3.60 Tracking #: 70191640000187812959 Return Receipt $2.85 Tracking #: 9590 9402 6014 0069 9601 26 Total $14.40 -----'- - Grand Total:$14.40 ------------------------------------------- Credit Card Remitted $14.40 Card Name: VISA Account #: XXXXXXXXXXXX8707 Approval #: 4160OG Transaction #: 782 AID: AOOOOO00031010 Chip AL: VISA CREDIT PIN: Not Required zzzzzzzzzzzzzzzzzzzzzzz*z�c�rzzzzzzzzzzxzzzz LISPS is experiencing unprecedented volume 'Increases and limited employee availability due to the impacts of COVID-19. We appreciate your patience. �t yc7c7K 7t 1C 7C ;C 1LYf 7tYCY[ Yf Y� ft �k Yt It 7C 7C :X 1� 7tYCYCXYf 1C %7C )C7r YC 1f 1f X 7t Yf 1k Yf 7( Text your tracking number to 28777 (2USPS) 'to get the latest staters. Standard Message and Data rates may apply. You may also visit www.usps.com USPS Tracking or call 1-800-222-1811. Save this receipt as evidence of Insurance, For information on filing an insurance claim go to https://www.usps.com/help/claims.htm Preview your Mail Track your Packages Sign up for FREE 13 https://informedde very.usps-com All sales fin,Oron stamp?;nd po? Refunds for uaranteed ser ices c Than you for your business. Tel)/ us about your experience. Go to: Kitps://pos-talexperience.com/P s or scan this code with your mobile device. 9 3b) Landowner Agreement mmw� Dlvblon 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 06-16). 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 hisrepresentativehereby permits: Applicant's name: Z�ov; e, (c'74.44 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 o (optional) Special note (no-till/over-seed/ pasture) AX -RO -001-O 1 No C ,%+ 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 of 3 I. STIPULATIONS: 1. The landowner or his representative shall not enter into any additional residuals application contracts or agreements with another permitted entity for the site(s) 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 I1) 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, a description 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 site(s) 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 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. U. RESTRICTIONS: 1. 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. III. ALTERNATIVES 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) ❑is currently permitted under another The land application field(s) ID: 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 I 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 Iandowners. 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 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: T 'es I_ 7a l or Address: 3190 ro-r4 t. 44re a V_ b r • _ city: Wood I c a F state: ,JC Zip: A Phone: 'x Signature: Ic -,174Date, x le lllal NORT CAROLINA, Nvt C COUNTY I, the undersigned Notary Public do hereby certify that . TOM cs personally appeared before me this day and acknowledged the due execution of the forgoing instrument. WITNESS my hand and official seal this the '' day of J. Ikf_ , 2021 Signature and seal: 31301202 (+NARYPUBUD My commission expires: _ MYOanmbsM E*= Mlillh 90, 2= Lessee Is/Operator's Certification: I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein. Lessec/operator name: Address: City: Phone: Signature: Permittee's Certification: State: E-mail address: Date: Zip: I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein. Signing official e: Signature: (7,11 Date:.,._Zte - L_-areZ FORM: LOA 06-16 page 3 of 3 3c) Setback Waiver iiiiiiiitiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii1iiiiiiiiiiuiiiiii 1 Doc ID: 014728660002 Type: CRP Recorded: 06/07/2021 at 02:14:32 PM Fee Amt: $26.00 Page 1 of 2 Rowan, NC J. E. Brindle Register of Deeds BK 1376 PG717 State of North Carolina Department of Environmental Quality Division of Water Resources NON -DISCHARGE RESIDUALS MANAGEMENT PROGRAM WAIVER FOR THE APPLICATION OF CLASS B RESIDUALS AGREEMENT TO WAIVE SETBACKS PURSUANT TO 15A NCAC 02T .1108(c) I, A d en Tay to r , certify that I am a deeded owner of the property located at: Address: 14760 NC Sal �4 City: wood(caF Parcel No.: 8 ) 9 093 State: /✓C Zip Code: ;t7oSy County: _ rowan Furthermore, I certify that I am authorized to make decisions regarding this property, and that I do hereby agree that the setback distances cited below be granted to the Applicant/Permittee listed on the following page. [✓ For the parcel identified above, I consent to a reduced setback from SO feet to D feet, thereby allowing the application of Class B residuals as near as Z) feet from my property line. [v2"For the parcel identified above, I consent to a reduced setback from Moo feet to 200 feet, thereby allowing the application of Class B residuals as near as /00 feet from my residence. "THIS WAIVER SHALL BE TERMINATED UPON CHANGE OF OWNERSHIP OF ANY PARTIES INVOLVED" Signature: x jo9_t Date: FORM:NDRMPW-LAS 11-18 Pagel of2 Applicant/Permittee: Address: 125 50u%4 Ma.y1 SJ. Parcel No.: S/ 9 09Y City: _ /►' asvilic- State: NX- Zip Code: 270Z8- County: 40&ya'G NORTH CAROLINA, D-*,J t COUNTY I, In, grYn �li.,�s , a Notary Public for 64+. e County, North Carolina, do hereby certify that /`ip/4N? Z,*'y &r personally appeared before me this day and acknowledged the due execution of the foregoing instrument. Witness my hand and official seal, this the 7+11 day of Znz SEAL A. BW CiAN NOTARY PUBLIC D" COW% NO My Cc Nide loi Expires Match SO, 2M 0.4 Signature of Notary Public My commission expires 313 0 1Z o2-4 Once notarized, this form shall be recorded at the Register of Deeds in the county or counties in which the described properties are located. A copy of the recorded waiver shall be sent to the following address: Division of Water Resources Non -Discharge Branch 1617 Mail Service Center Raleigh, North Carolina 27699-1617 FORM: NDRMPW-LAS 11-18 Page 2 of 3d) Vicinity Map 3e) Aerial/Application Map Field Total Acres Applicable Acres 1 23.35 18.99 SCALE: - r 1 440' f *—R =DATE: 05-11-21DRAWN BY: BCesources, Inc. t,. h �"" ► Structure h.r Well `t��"`0 Off Site Dwelling - Waiver ■ Off Site Dwelling Stream ® Buffer E- HERE, OOO Field Boundary S . E D,• I ���+ Property Boundary Davie County FIGURE NO. Land Application Program 2 NC-RO-001 James Taylor 3f) Topo Map 3g) Soil Map 3h) Background Soil Sample and Heavy Metals N O M LD � N N T p O CD O co to m E U O Q R -4 � lL � CD 3 o 3 cc a c ^� 3 Q o v co Y t2 r- J � c-I N tD n ZO a CO Lo W OR c� C N ol U v ol M U W m O O V N N N V 00 O O V LO -a Y > CL Q ) N O V O 04 0 cQ C O Q C C) M fn N LO �C CO a N V (.0 Q o 0 - U cz � v1 O I-_O O O N r` L)i U >z LO c O CO N (V > n 0 T V Q >- 3.2 U N LO LLO O y ++ O W I- T O Z o Z O O Z N U) N O O > m ODE v O d m Q Q iJ N �% a E O N O_ a� 0 Q 0 0 c 0 t 0 E E 0 (D E a U s= � Z a N M- E a 0 E a ri s= � z OM 0 z M' U U O N O a 0 � E � O N z a s m o U c LU o U 0 I I w � w. o N � 0 U t N 0 H z Waypointo ANALYTICAL 5/21/2021 EMA Resources Inc 755 Yadkinville Road Mocksville, NC, 27028 Ref: Analytical Testing 7621 Whitepine Road, Richmond, VA 23237 Main 804-743-9401 0 Fax 804-271-6446 www.waypointanalytical.com Report Number: 21-134-0009 Project Description: James Taylor Waypoint Analytical Virginia, Inc. received sample(s) on 5/14/2021 for the analyses presented in the following report. The above referenced project has been analyzed per your instructions. The analyses were performed in accordance with the applicable analytical method. Sub -contracted testing is noted on the Sample Summary Table if applicable. The analytical data has been validated using standard quality control measures performed as required by the analytical method. Quality Assurance, method validations, instrumentation maintenance and calibration for all parameters (NELAP and non-NELAP) were performed in accordance with guidelines established by the USEPA (including 40 CFR 136 Method Update Rule May 2012) and NELAC unless otherwise indicated. Certain parameters (chlorine, pH, dissolved oxygen, sulfite...) are required to be analyzed within 15 minutes of sampling. Usually, but not always, any field parameter analyzed at the laboratory is outside of this holding time Refer to sample analysis time for confirmation of holding time compliance. The results are shown on the attached Report of Analysis(s). Results for solid matrices are reported on an as - received basis unless otherwise indicated. This report shall not be reproduced except in full and relates only to the samples included in this report. Please do not hesitate to contact me or client services if you have any questions or need additional information Sincerely, �aw,c M( G10"r Pauric McGroary Agronomist Laboratory's liability in any claim relating to analyses performed shall be limited to, at laboratory's option, repeating the analysis in question at laboratory's expense, or the refund of the charges paid for performance of said analysis. Page 1 of 5 • 7621 Whitepine Road, Richmond, VA 23237 Waypoint Main 804-743-9401 0 Fax 804-271-6446 ANALYTICAL www.waypointanalytical.com Sample Summary Table Report Number: 21-134-0009 Client Project Description: James Taylor Lab No Client Sample ID Matrix Date Collected Date Received Method Lab ID 76352 01 Solids 05/14/2021 SW-7471B WP MTN 76352 01 Solids 05/14/2021 6010D WP MTN WP MTN - Memphis, TN: Waypoint Analytical - TN, Memphis, TN Page 2 of 5 • 0 Waypoint 7621 Whitepine Road, Richmond, VA 23237 Main 804-743-9401 0 Fax 804-271-6446 ANALYTICAL www.waypointanalytical.com 46245 EMA Resources Inc Project James Taylor 755 Yadkinville Road Report Date : 05/21/2021 Information : Received : 05/14/2021 Mocksville , NC 27028 �oau� �� Grow Pauric Mc Groary Ph.D., CPA Report Number : 21-134-0009 REPORT OFANALYSIS Agronomist Lab No : 76352 Matrix: Solids Sample ID : 01 Sampled: Test Results Units MQL DF Date / Time By Analytical Analyzed Method Nickel 1.89 mg/Kg 0.250 1 05/20/2119:57 JTR 6010D Mercury 0.0233 mg/Kg 0.0138 1 05/19/2115:10 DDB SW-7471B Selenium <0.500 mg/Kg 0.500 1 05/20/2119:57 JTR 6010D Test Results Units MQL DF Date / Time By Analytical Analyzed Method Arsenic 1.72 mg/Kg 0.500 1 05/20/2119:57 JTR 6010D Cadmium <0.100 mg/Kg 0.100 1 05/20/2119:57 JTR 6010D Chromium 5.43 mg/Kg 0.250 1 05/20/2119:57 JTR 6010D Lead 14.3 mg/Kg 0.300 1 05/20/21 19:57 JTR 6010D Molybdenum 0.303 mg/Kg 0.250 1 05/20/2119:57 JTR 6010D Qualifiers/ DF Dilution Factor Definitions MQL Method Quantitation Limit L Limit Exceeded Page 3 of 5 WayPAoInt.. NALYTICAL 7621 Whitepine Road, Richmond, VA 23237 Main 804-743-9401 0 Fax 804-271-6446 www.waypointanalytical.com Shipment Receipt Form Customer Number: 46245 Customer Name: EMA Resources Inc Report Number: 21-134-0009 Shipping Method 0 Fed Ex 0 US Postal 0 Lab ® UPS 0 Client 0 Courier 0 Other: Thermometer ID: Shipping container/cooler uncompromised? 0 Yes 0 No Number of coolers/boxes received F-71 Custody seals intact on shipping container/cooler? 0 Yes 0 No ! Not Present Custody seals intact on sample bottles? 0 Yes 0 No ® Not Present Chain of Custody (COC) present? 0 Yes 0 No COC agrees with sample label(s)? 0 Yes 0 No COC properly completed 0 Yes 0 No Samples in proper containers? 0 Yes 0 No Sample containers intact? 0 Yes 0 No Sufficient sample volume for indicated test(s)? 0 Yes 0 No All samples received within holding time? 0 Yes 0 No Cooler temperature in compliance? 0 Yes ® No Cooler/Samples arrived at the laboratory on ice. Samples were considered acceptable as cooling process had begun. 0 Yes ® No Water - Sample containers properly preserved 0 Yes 0 No ® N/A Water - VOA vials free of headspace 0 Yes 0 No ® N/A Trip Blanks received with VOAs 0 Yes 0 No N/A Soil VOA method 5035 — compliance criteria met 0 Yes 0 No 0 N/A F_ High concentration container (48 hr) F_ High concentration pre -weighed (methanol -14 d) F_ Low concentration EnCore samplers (48 hr) F_ Low conc pre -weighed vials (Sod Bis -14 d) Special precautions or instructions included? 0 Yes ® No Comments: Signature: lBrandi Watson Date & Time: 05/14/2021 14:24:39 Page 4 of 5 Acc~aunt# 46245 �Column kmnle f R ---- - ----- 7621 Whitepine Road Richmond, VA 73237 • [8D4] 743-g401 •Fax tll 271-6466 WWW.wa Din ant iGal. Qrn ■ w'�oin SAMPLE INFORMATION SHEER wlI INFQRMATtaN ,waypoint, SOIL rk ka70MER INFORMA"0N t5 �a EMA Resources lnc• 755 Yadkinville Rd. mocksville, NC 27028 Grower to Ida or Ne Send Report to e•mall address 6rerit.cpllinsC�e117ares°urcesinu•eom �� r rs{ � Field ID m Farm If] 4�'_ lease indicate name d �I7tcigdStarnatBddAlt mate'I Into x Preoflus sted. if Herbicide, --- . 1A crag COda Cra Yteid era a gdditkanal intended 3 m o } f 1 Buffer pK n Calcium Magnesium, p Cooper Each additional test [above two] r ` Manganese, Iron, Potassium, S1M -organic Matter, Ph❑sphorous, Sodium, Sulfate-sut�r Boron. AAan anese, iron. Co er RS ARE sulfur, Boron. zinc, any tw❑ of the foll❑wing: MEND he REQDES era S2M . 511n plus core name in the 51M lus ail of the lollowin : Sodium. sulfate 13E5 TO gE USED IF FERTILI�$ is oEC;D 53M - Co CROP for which ou would like recammFORAGF CROPS Coastal Bermuda Kay _ TUF If the ero FIELD CROPS 161- 101. Alfalfa Hay 162. Coastal Bermuda Pasture Grass HaY Cool Season Grass Pasture 512 Bahiag rass 513 Sahiagrass 1, Barley 103. AlfalfalCo4l Season }72- farm Season Grass Hay 173. Cool Season Grass Hay 517, Bentgrass g. Canola tip. Com Rotator' 1p6- Atfal i16. Bahiag rass Hay 181. Fescue Kay Pasture }82. Fescue Pasture 521. Bermudagi 522. Bermudag A� 2 11 Corril5❑ybeans 12. Corn - No Till 117. Bahiagrass y21, Common Bermuda Hay 163. Fescueltegume flay pasture Fescue/Legume Pasture 523. Bermudag a r4 is 524 BQm-,uda� N ,;,`" t3. Corn Silage 122. Common Bermuda me liaY 184. Bermudalte9u 237. R e rass Bermudas 525 N 2fl, Cotton Cotton No Till }23. Common 124- Common 8ermudalLe time Pasture SS ANol LEGLfME TYPE OF GRA 526 rmuda! Bluegrass 2}- 25. Grain Sorghum tNpiCATE ... "" 533. glue ras 534. 9 - 3D. oats 32, Peanuts 297. OTki R kiAY....................... ... w ..... _-...... ............w._........... .......... ......�•....... .. W -- -.... 546 CenbPed gal- Gentipeo� ..-- Athletic Fie lcl 34. PoPCO^' Rapeseed 35. Rap 298. ...... tE �..„...... ...� ........... w --- 551. Fescue 563 Fescue Lawn 36. Rice ,OTHER FRUIT g, NUT CROPS 564. Fescue Sod Production 39. Rye soybeans 299- CRP VEGETABLE CROPS ADO. APp1es 381. Spinach Blueberries 576. St, Augustine Lawn St, Augustine Sod production 45. 46. Soybeans - No Till - Plant 410. 307. Beans Lima 382. pquash 420 Citrus 3D9. Beans - Snap Sweet Carn Grapes 577, 583. Zoysiag rass Lawn Sod Production 51. sugarcane 52. sugarcane - Stubble Burley 383. 43D• 32D. Cabbage 3$4 g,Heet Potato(ton) 470. Peaches 322. Cantaloupe Sweet Patato(bu) 584. 2❑ys;agrass 62. T1b8C00 63- Toby - Dark Cured 391 475, Pans 330, Cucumbers 385, Tvmatves 490 Strawberries 64. Tobacco Flue 75. Wheat 340. Garden 398. Watermelons 369. Peppers Information JB. Wheat kea a Oo b eilCr❑ gy, Wheatll3 Add;tiona Tests or Othef to be analyzed for: ditionally these samples need Ad Lead, Mercury, NCDA FORMAT Cadmium, Chromium, Arsenic, Nickel, and Selenium a without no to change LMolybdenum, l ap onepra�durbesct [ante ❑f our terms and condkti❑n a All Inc. is acceP le reRuires additional p P Dint Analytical, fees may be charged to ctient if same Submittal of information sheet to WayP Additional Page 5 of 5 3i) Soil Scientist Evaluation wilicox&mabe SOIL SOLUTIONS May 17, 2021 EMA Resources, Inc. 755 Yadkinville Road Mocksville, North Carolina 27028 Attention: Mr. Brent Collins Reference: Soil Scientist Services for Permit Application Davie County Land Application Program WMSS Project No. 15-06, Phase: 03 Dear Mr. Collins: Willcox & Mabe Soil Solutions, PLLC (WMSS) has conducted a Soil Scientist Evaluation on behalf of EMA Resources, Inc. (EMA). The evaluation was performed to provide information for submitting a modification to a non -discharge permit to the North Carolina Department of Environmental Quality (NCDEQ) — Division of Water Resources (DWR), Non -Discharge Permitting Unit (NDPU) in accordance with 15A NCAC 2T .I 104(c)(2)(A)_ The evaluation was conducted to assess the soil properties of the proposed acreage and to determine suitability for land application activities in the referenced permit application. WMSS has included our findings in Appendix I and II in order for this information to be incorporated into the permit modification package being prepared by EMA. The Appendices summarize our evaluations, findings, and recommendations. Should you have any questions or comments about this report please feel free to contact us at (336) 312-1396. Sincerely, Willcox & Mabe Soil Solutions, PLLC A r" 4/41alr_� Martin Mabe Rob Willcox, L.S.S. Agronomist Soil Scientist Attachments: Appendix I — Summary Table Appendix II — Maps, Soil Profile Description Sheets Shared\WMSS Projects12015\15-06 EMA Resources\Phase 03 - Davie County\Phase 03 Soil Scientist Report - Davie County Land Application Program.doc Willcox & Mabe Soil Solutions, PLLC / 7231 B Summerfield Road / Summerfield, IBC 27358 / Rob336.339.9128 or Martin 336.312.1396/www.willcoxmabesoil.com . APPENDIX I - SUMMARY TABLE On April 29, 2021, a Willcox & Mabe Soil Solutions, PLLC (WMSS) licensed soil scientist, or a representative under the direct supervision of, performed hand auger borings on the following sites and determined that the noted predominant soil series was present for each of the following fields: Field Predominant Soil Project County Site No. No. Series / Mapping Unit NC-DV-009 1 Tomlin / ToB2 NC-DV-009 2 TomIin / ToB2 Davie Davie NC-DV-008 9 Mecklenburg / County MrB2 Rowan I NC-RO-001 1 Appling / ApB The hand auger borings were performed to determine if the proposed land application sites were suitable for land application activities in accordance with 15A NCAC 2T .1104(c)(2)(A) and to be incorporated into a permit modification package for Davie County, North Carolina. All fields evaluated were found to be suitable for land application activities. Please reference the attached maps for hand auger boring Iocations (noted by a green circle with an x) and subsequent soil profile descriptions. SOIL SC� W !t4 /fiy �nfiryG' f A ULn �- p:1'F OF 109$ NO RTB GP/ Rob Willcox NC Licensed Soil Scientist # 1098 APPENDIX II - MAPS, SOIL PROFILE DESCRIPTION SHEETS tip. -�� ., �z ri: v w r e'•f'yyrr :,s,�� - fi, '��b� a�as�, �'� • F ��e'►"� � �' of r. V 4p #k 2 14 R Alt Hand Auger Boring Sons ToB2 Tomlin clay loam, 2-8%slopes, moderately eroded So�uur,ce?Esri, DfgitalGlol7e?Geo€ye;.Ear RaB Rasa I o fi ne sa ndy loam, 2-8%slopes DS IJ DA, USGS,'F�eroGRID{IGN.,'arid Field Boundary SCALE: 1 , = 440 , _ '� FIGURE NO, Davie County DATE: 05_10_21 Land Application Program DRAWN BY. BC —Resources, Inc. 4 PROJECT NO: NC-DV-009 L W00010583 Thomas Whitaker 7� A 40� 37 E6. Hand Auger Boring the fr Stream 41, Soils 7/7 Buffer Wet Area Field Boundary MrB2 Mecklenburg clay loam, 2-89/8 slopes, moderately eroded MEMO= 9i.40j.IG lobe, Ge6Ey.e, Ear Property Boundary EnB Enon fine sandy loam, 2-8% slopes OIL.ONE AeroGRIE),, IGN, an SCALE: DATE: 1 310' Davie County FIGURE NO. 05-10-21A Land Application Program —Res DRAWN BY BC_ it ounces, hic. 2 PROJECT NO; NC-DV-008 L_ W0001 0583 Roger Spillman ^i 11. r •a't � 1 •i f h P �J t � r:'4. T .rid �ti'a .� .. '" -• - 'r+_: : '�, t; Vt } r+ 4 r 1�h,' 1 yt . ;�„'�j h .- S ��•�- Jr "^t�'1 ,y'.�/ %/VI .. �r `r j c' ► i- n t a . xx • Pew r. 441 r ^_ . ■ _ .,lY- r 11ri r r' �r, ',Tyr i �•e�.*'a`� r�, '7,• "•C►.,Y�� K3�r�� _7 � ,'1 1 .'.r y �� 'k'iP<}`;r:.r - •ter H r yes tj r ,�j` k`i '' +`. •' '� �` � �+� rY. 'ram 6 ,• -' z r`�+s <� �� :` i! u r :•.11� ��•- . ® Hand Auger Boring ApB Appling sandy loam, 2-6% slopes ► ;;t•C�::r. Soils h"pN RnC Rion-Wedoww complex, 8-1576 slopes �` Soure EnB Enon fine sandy loam, 2-89/6 slopes u SCALE: 1 ^ = 440 ' DATE: 05-11-21 E DRAWN BY: BC --Resources, Inc. Jh%��•F �, rr h � ��' r�' SS Field Boundary Davie County FIGUREN6. Land Application Program NC-RO-001 James Taylor E WILLCOX & MABE SOIL SOLUTIONS, PLLC SITE/SOIL EVALUATION Project No. Phone No. Date: .Z/_aq i3� / Location (J,-r1 V-5 Pin County: Property Size Proposed Facility: rAA- f , Water Supply: On -Site Well ❑ Evaluation: Auger Boring ❑ Community ❑ Pit ❑ Described Byre-t Public ❑ Cut ❑ Weather: j, ., ; Antecedent Moisture Surface Water: FACTORS PROFILE PROFILE PROFILE PROFILE 'PV Landscape Position % Horizon Depth I Color Munsell Texture f -Y Structure r Consistence 1,/Yi� 1't FCC Boundary Horizon Depth II Color -- Munsell '], • `t, .j Ga I / �1 2 !� Texture �° L Mottles Structure pt t ci t r� Jrl AL r l Consistence Boundary Horizon Depth III Color - Munsell �,rj ylf_;�, 3 & Texture C Mottles 1 , , a 3 -j r /i:' �_' /. GS JD Ye_ a/� Structure Consistence �J 5 d, '! �' •:� t ' �� -� '� 14 Boundary Horizon Depth IV ?T 3 `1 Color - Munsell Texture G E Mottles •-F .? a Y /[� i�, ft :5 n// _2//_. Structure Consistence j� yj� y? a�'`! 1•Ja i.;1 �.> ;%f -•7% a'. Boundary f Soil Wetness T7,32w:.3 j Restrictive Horizon jL/ 1.,.f' �� '/� �Ja'/ 5'.�JIJ i Saprolite LIAR Classification ) T i"'�-11 h � t�l�h —y / d s+.._I i n • �•l i/ =�J � k� � �✓ C� N -• 1+4� �%L�-t a �L � ✓ i 0j i ..! :, g ! G C- LV bv- crxi .? .A/C f�L'- .. c LEGEND LANDSCAPE POSITION R Ridge Intertluve S Shoulder L Linear Slope FS Foot Slope N Nose Slope H Head Slope Cc Concave Slope Cv Convex Slope T Terrace P Flood Plain TEXTURE s sand Is loamy sand sl sandy loam I loam si silt sil silt loam sid silty clay loam cl clay loam scl sandy clay loam sc sandy clay sic silty clay c clay CONSISTENCE WET Ns non -sticky Ss slightly sticky S sticky Vs very sticky Np non -plastic Sp slightly plastic P plastic Vp very plastic MOIST V& Very friable fr friable fi firm vfi Very firm STRUCTURE sg single grain m massive cr crumb gr granular sbk subangular blacky abk angular blocky pl platy pr prismatic WILLCOX & MABE SOIL SOLUTIONS, PLLC SITE/SOIL EVALUATION Project No. f;)�-rC. P7t;0-3' Phone No. Date: Location _�,-; ate.. , Pin County: Proposed Facility: �/�'�, _ �,�� Co. Water Supply: Described By:��'-t Weather: �..,2n rs Antecedent Moisture On -Site Well Community Public Property Size ❑ Evaluation: El Surface Water: Auger Boring] Pit ❑ Cut ❑ FACTORS PROFILE PROFILE PROFILE PROFILE Landscape Position % 7 Horizon Depth I n - JY 4- Color Munsell (� j�,� �-j/`� D YK-57-5 Texture 5 ctraac.l r_ Structure I,0k ,n4 G Consistence f� �� 5 r FP— -115 Jb 61 1;Z 5 1i Boundary Horizon Depth II j 1< Color —Munsell J (? �,F'. '1l_r jD lt� tc� Texture C �� Mottles rL rt-n Structure Consistence VS VP F4 S Boundary Horizon Depth III )r _ 0 Color — Munsell Jq t,�- Texture Mottles t/e 2 ! V kll ;' Structure Consistence vi t/7 Yr V., v o Boundary Horizon Depth IV fl— ti� j =f -. a S'° Color — MunselljJ SDK Texture Mottles Structure Inn��1j� J1 Consistence oc_ V,3 VP )�--m Boundary Soil Wetness fly' Restrictive Horizon �jt 1 i ?L Lt, j Saprolite LTAR E E-2 a t 4,d I Classification c n / w oq4 LEGEND LANDSCAPE POSITION R Ridge Interfluve S Shoulder L Linear Slope FS Foot Slope N Nose Slope H Head Slope Cc Concave Slope Cv Convex Slope T Terrace P Flood Plain TEXTURE s sand Is loamy sand sl sandy loam ] loam si silt sil silt loam sic] silty clay loam Cl clay loam sel sandy clay loam Sc sandy clay sic silty clay c clay CONSISTENCE WET Ns non -sticky Ss slightly sticky S sticky Vs very sticky Np non -plastic Sp slightly plastic P plastic Vp very plastic MOIST vfr Very friable fr Friable fi firm 411 Very firm STRUCTURE sg single grain m massive :r crumb ;r granular >bk subangular blocky ibk angular blocky 31 platy 7r prismatic _