WQ0038087_Residual Annual Report Form 2021_20220301

Initial Review
Reviewer
Thornburg, Nathaniel D
Is this submittal an application? (Excluding additional information.)*
Yes No
If not an application what is the submittal type?* Annual Report
Residual Annual Report
Additional Information
Other
Annual Report Year* 2021
Permit Number (IR) * WQ0038087
ApplicantlPermittee Terra Renewal Services, Inc.
Email Notifications
Does this need review by the hydrogeologist?* Yes • No
Regional Office Winston-Salem
CO Reviewer
Admin Reviewer

Submittal Form
Project Contact Information
Please provide information on the person to be contacted by NDB Staff regarding electronic submittal, confirmation of receipt, and other correspondence.
............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................
Name* Terra Renewal Services, Inc
Email Address*
[e-mail]
Project Information
Application/Document Type*
New (Fee Required)
Modification - Major (Fee Required)
Renewal with Major Modification (Fee
Required)
Annual Report
Additional Information
Other
Phone Number*
479-747-8192
Modification - Minor
Renewal
GW-59, NDMR, NDMLR, NDAR-1,
N DAR-2
Residual Annual Report
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.
hftps://edocs.deq.nc.gov/Forms/NonDischarge_Monitoring_Report
Perm it Type:*
Wastewater Irrigation
High -Rate Infiltration
Other Wastewater
Reclaimed Water
Closed -Loop Recycle
Residuals
Single -Family Residence Wastewater
Other
Irrigation
Permit Number: *
WQ0038087
Has Current Existing permit number
Applicant/Permittee Address*
PO Box 1746 Watkinsville, GA 30677
Facility Name*
Terra Renewal Services Class B Residuals Program
Please provide comments/notes on your current submittal below.
This is the annual report for RLAP permit # WQ0038087 for land sites in Wilkes and Yadkin
Counties. Permittee: Terra Renewal Services, Inc. If questions, complications, or requests for
additional information, please contact David Coyle @ 479-747-8192 or
[e-mail].
At this time, paper copies are no longer required. If you have any questions about what is required, please contact Nathaniel Thornburg
at [e-mail].
Please attach all information required or requested for this submittal to be reviewed here.
(Application Form, Engineering Plans, Specifications, Calculations, Etc.)
NC—WQ0038087—Terra Renewal _AnnualReport_2021.pdf 37.63MB
Upload only 1 PDF document (less than 250 Me). Multiple documents must be combined into one PDF file unless file is larger
than upload limit.
* 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
0 G? o

Submission Date 3/l/2022