WQ0000520_More Information Received_20220622

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
Permit Number (IR)* WQ0000520
ApplicantlPermittee City of Burlington
Email Notifications
Does this need review by the hydrogeologist?* Yes No
Regional Office
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* Robert Roth
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*
13364034324
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
Permit Type:*
Wastewater Irrigation
High -Rate Infiltration
Other Wastewater
Reclaimed Water
Closed -Loop Recycle
Residuals
Single -Family Residence Wastewater
Other
Irrigation
Permit Number: *
WQ0000520
Has Current Existing permit number
Applicant/Permittee Address*
PO Box 1358, Burlington NC 27216
Facility Name*
City of Burlington Class B Residuals Program
Please provide comments/notes on your current submittal below.
Additional info for the Renewal of Class B permit.
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.)
City of Burlington WQ0000520 Add Info.pdf 18.28MB
Upload only 1 PDF document (less than 250 MB). 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
Submission Date 6/22/2022

SY'NAGRO
June 8, 2022
NCDENR-DEQ
Division of Water Resources
Land Application Permitting and Compliance Unit
Aquifer Protection Section
1636 Mail Service Center
Raleigh, NC 27699-1636
ATTENTION: Mr. Erick Saunders
REFERENCE: Application No. WQ0000520
Additional Information Request
City of Burlington RLAP
Alamance County
Dear Mr. Saunders:
As a response to the additional information request received May 4 h, 2022, please see the
following information attached to this letter in PDF format:
F. Land Application Site Certification:
As requested, routine soil sample analysis for all new fields are attached to this letter.
Additionally, as directed by Caitlin Caudle of the Winston Salem regional office,
sample 19-04 can be utilized as a representative sample for fields AM- 19-4A and AM-
19-413 due to the composite sampling strategy utilized across each field.
2. Initially submitted CPLRs are the most recent accounts for each field listed in the
permit renewal. Previous land applier forms and previous annual reports forms are
provided for fields that have been applied in the past while the absence of either means
the field has yet to receive any application of residuals.
3. Updated maps for each of the listed sites are attached to this letter. Also an updated
LASC is included to account for any change in acreages.
4. An updated map for this site is included. This change in mapping did not yield any
change in permitted acreage.
5. Maps for fields AM-16-01, 02A, 02B, 04A, and 04B are now included with this letter.
6. Updated maps for each of the listed sites are attached to this letter. Also an updated
LASC is included to account for any change in acreages.
7. See attached documents from Chris Murray regarding the suitability of the areas in
question at NC-AM-16-2B and NC-AM-16-4A. Per our conversation NC-AM-110-01,
284 Boger Road, Mocksville, NC 27028 9 Phone: [phone]

SY'NAGRO
AM-126-02 and NC-AM-126-03 were not evaluated because the areas in question
were permitted in previous permits.
8. See attached documents from Chris Murray regarding the suitability of the areas in
question at NC-CS-36-08 and NC-CS-36-09.
9. An updated map for site CH-251 is provided which now includes the required buffer
for an offsite house. Changes in acreage are reflected on the updated LASC.
G. Landowner Agreement Form:
Clearer scans of the LOAs for fields CS-113-1,2 and CS-113-6A,6B are included. The
notary stamp is now visible on these forms.
2. NC-AM-55-5 was sold in late December 2021. Anew LOA with the current
landowner signature is included along with an updated LASC.
Field AM-126-9A will be deleted and the updated LASC is included. Additionally
updated maps are included which now omit this field.
Additionally, as discussed with yourself and Shane Fletcher of the City of Burlington, an
updated map is included for field AM-16-03 because of recent parcel line changes which
occurred after initial submittal. The attached LASC reflects the acreage for this field and does
not include any areas which weren't previously permitted.
If you require additional information or have further questions, please contact me at
[phone] or rroth _,syna rg o.com. Thank you in advance for the timely and efficient
review of this modification application.
Sincerely,
/11 ��4, vle�l )�
284 Boger Road, Mocksville, NC 27028 9 Phone: [phone]

Page 1 of 1
Report No: 22-014-0618
Account No: 46622
Advisor: Synagro Central LLC/ Technical
Mary Brewer
284 Boger Road
Mocksville NC 27028
Waypointo
ANALYTICAL
Client: Nate Roth
336-403-4324
Alamance
iJt i I1 . •,r t. i1+ .++.
Farm:
Date Received: 01 /14/2022
Date of Report: 01/17/2022
Lab No Field ID
Sample ID
Soil Class HM% W/V
pH
Ac
P-1
K-1
S-1
Mn-I
Mn-All Mn-Al2
Zn-I
Zn-AI
Cur-1
CEC
BS%
Ca%
Mg%
ESP
Na
14249
19-01
MIN
6.5
0.6
73
16
25
363
0 0
120
120
180
8.5
93
75
16
0.8
0.1
14250
19-02
MIN
6.5
0.4
33
30
37
656
0 0
63
63
65
5.9
93
83
7
1.0
0.1
14251
19-03
MIN
6.7
0.5
127
26
21
206
0 0
120
120
230
11.0
96
81
12
0.9
0.1
14252
19-04
MIN
6.1
0.9
57
41
17
819
0 0
108
108
195
6.4
86
69
13
0.8
0.1
Comment
Test result units = CEC and Na in meq/100cm3; NO3 N in mg/dm3; W/V in g/cm3
North Carolina Division of Water Quality Certification #257, Analysis and fertility recommendations shown on this report are performed in accordance within NCDA guidelines, Analysis prepared by: Waypoint Analytical Virginia, Inc.

Page 1 of 1
Report No: 22-014-9620
Account No: 46622
Advisor: Synagro Central LLC/ Technical
Mary Brewer
284 Boger Road
Mocksville NC 27028
Main .ir; 4•401 8146.i-
www.waypointanalytical.com
Date Received: 01 /14/2022
Date of Report: 05/09/2022
Lab No Field ID Sample ID Soil Class HM% W/V pH Ac P-1 K-1 S-1 Mn-I Mn-All Mn-Al2 Zn-I Zn-AI Cu-1 CEC BS% Ca% Mg% ESP Na
14256 128-1 MIN 0.9 6.2 0.6 102 13 29 244 0 0 110 110 30 5.1 88 73 12 1.4 0.1
Comment
Test result units = CEC and Na in meq/100cm3; NO3 N in mg/dm3; W/V in g/cm3
North Carolina Division of Water Quality Certification #257, Analysis and fertility recommendations shown on this report are performed in accordance within NCDA guidelines, Analysis prepared by: Waypoint Analytical Virginia, Inc.

Page 1 of 1
Report No: 22-014-0619
Account No: 46622
Advisor: Synagro Central LLC/ Technical
Mary Brewer
284 Boger Road
Mocksville NC 27028
Main .ir; 4•401 8146.i-
www.waypointanalytical.com
Date Received: 01 /14/2022
Date of Report: 01/17/2022
Lab No Field ID
Sample ID
Soil Class HM% W/V
pH
Ac
P-1
K-1
S-1
Mn-I
Mn-All Mn-Al2
Zn-I
Zn-AI
Cu-1
CEC
BS%
Ca%
Mg%
ESP
Na
14253
1136A
MIN
6.1
0.7
8
34
27
819
0 0
65
65
75
4.9
85
69
11
1.2
0.1
14255
1136B
MIN
6.0
0.7
7
20
27
181
0 0
33
33
35
4.6
84
69
11
1.4
0.1
Comment:
Test result units = CEC and Na in meq/100cm3; NO3 N in mg/dm3; W/V in g/cm3
North Carolina Division of Water Quality Certification #257, Analysis and fertility recommendations shown on this report are performed in accordance within NCDA guidelines, Analysis prepared by: Waypoint Analytical Virginia, Inc.

Site: NC-AM-100; Fields 1-2
Application Area Map
tin=500ft
1(' 4000",
Streams
Disclaimer:
— Drains
This map was compiled from the GIS resources of the Burlington
Regional GIS Partnership for public planning and agency support
C�
purposes. These resources include public information sources of
Surface Water
different scale, time, origin, definition and accuracy, which aspects
Flood Zones'
produce inconsistencies among features represented together on
'
this map. Neither the City of Burlington nor the Partnership shall
AE
be held liable for any errors in this map or supporting data. Primary
public information sces from which this map was compiled, in
our
Floodway (AE)
conjunction with feld surveys where required, must be consulted
0.2%Annual Chance Flood Hazard for the verification ofthe information contained within this map.

1,Site:NC-CH-039; Fields 1-4 Application Area Mapl
tin=660ft
1110 230 460 690 920eet
�:ryrON Legend
RSite Boundary
G.I.S. /0
Property Line
GIs Division
Application Area
Date: 6/9/2022
® Unsuitable
*Note: Acreage calculated in GIS
X — Fence
10 S.W.A.
°°°® Streams
Disclaimer:
On Site House
Di
Drains
This map was compiled from the GIS resources of the Burlington
Regional GIS Partnership for public planning and agency support
Off Site House
C� Surface Water
purposes. These resources include public information sources of
different scale, time, origin, definition and accuracy, which aspects
IOutbuildings
g
��
Flood Zones'
produce inconsistencies among features represented together on
this map. Neither the City of Burlington nor the Partnership shall
Oil Site Well
0- Off Site Well
j AE be held liable for any errors in this map or supporting data. Primary
��� FIOOdWay (AF) public information sources from which this map was compiled, in
p conjunction with field surveys where required, must be consulted
0.2/oAnnual Chance Flood Hazard for the verification ofthe information contained within this map.

Site: NC-CH-040; Field 1 Application Area Mapl
ft tin=660
Feet
230 460 690 920
�:ryrON Legend
RSite Boundary
G.I.S. /0
Property Line
GIs Division
Application Area
Date: 6/9/2022
® Unsuitable
*Note: Acreage calculated in GIS
X — Fence
10 S.W.A.
°°°® Streams
Disclaimer:
On Site House
Di
Drains
This map was compiled from the GIS resources of the Burlington
Regional GIS Partnership for public planning and agency support
Off Site House
C� Surface Water
purposes. These resources include public information sources of
different scale, time, origin, definition and accuracy, which aspects
IOutbuildings
g
Flood Zones'
produce inconsistencies among features represented together on
this map. Neither the City of Burlington nor the Partnership shall
On Site Well
Off Site Well
AE be held liable for any errors in this map or supporting data. Primary
FIOOdWay (AF) public information sources from which this map was compiled, in
p conjunction with field surveys where required, must be consulted
0.2/oAnnual Chance Flood Hazard for the verification ofthe information contained within this map.

PIEDMONT
EU7 " ✓/ R. 0 "14 14!W UIII/VWY ' NIIIIIIIII IIIIIIIIIIIIIIA
June 17, 2022
City of Burlington, NC
c/o: Mr. Shane Fletcher,
Residuals Management Coordinator
2741 Boywood Rd.
Graham, NC 27253
Project 4 3481
RE: Soil Evaluation for Various Properties, City of Burlington Residuals Application
Permit, WQ 0000520 - NC-AM-016 Fields 2 and 4 Expanded Areas
This report is being prepared to satisfy requirements set forth in 15A NCAC 02T .1104
(2) concerning the soil evaluation for the application of residuals. Specifically, we
wanted to ensure that soils in expanded areas of the above referenced fields were suitable
and comprised the same soil series as the surrounding fields.
Soil evaluations were conducted by Piedmont Environmental Associates, P.A. in areas
recently added to NC-AM-016 Fields 2 and 4. The boring location and application fields
are shown in the attached soil/site map (Attachment 1).
The evaluations consisted of hand auger borings and soil profile descriptions of the soils
within the application sites. Soil profile descriptions are given in Attachment 2. All
documents related to the soil evaluation included in this package were prepared by G.
Christopher Murray, L.S.S. of Piedmont Environmental Associates. All other work was
conducted by The City of Burlington, NC.
For each application field site, representative soil borings were conducted to confirm the
soil series designation provided on the USDA/NRCS soil survey data, which is used to
determine the realistic yield expectation application rates according to the NCSU nutrient
management database. It was assumed that areas unsuitable to slope or a seasonally
high-water table are not included in the application area for any of these fields.
Table 1 lists the soil series mapped for each permitted field as well as the soil series of
the newly evaluated areas:
Table 1. - Expanded Area Soils Information, NC-AM-016 Fields 2 and 4
Field Orig. Permitted Series Expanded Area Series
NC-AM-016 - Field 2 Alamance Alamance
NC-AM-016 - Field 4 Herndon Herndon
216 S. Swing Rd, Suite 1 . Greensboro, NC 27409 . 336-662-5487

The soils of the newly expanded areas for NC-AM-016 Fields 2 and 4 were found to be
suitable for residuals application and most similar to those of the surrounding fields.
Piedmont Environmental Associates is pleased to be of service in this matter. If you have
questions or require additional information, please feel free to call [phone].
Sincerely,
G. Christopher Murray
NC Licensed Soil Scientist 41284
Piedmont Environmental Associates, PA
List of Attachments:
-Attachment 1 — Soil and Site Map
-Attachment 2 — Soil Profile Descriptions

Soil Profile Descriptions in Field Locations
Project: City of Burlington (WQ 0000520) % Slope:
3%
Site: NC-AM-016, Field 2 Expansion Crop:
Forage/Pasture
Field: 2 Conducted By:
GC Murray
Date:
6/14/2022
Soil Series:
Alamance
O
y
O
O
v
=
O
O
c
(U
(U
O
K
y
N
2 0
PIEDMONT
E _ _ --
P
ASSOCI AT ES, P. A.
W w
w
p NILa=i
V a 0 V5 Ln
C
7 N C _
N O CO
CO
a�
a� a� x
�' U
is is A
K 7 7 7 y
^2 ^2 � 1�— A A A ^2
A
0-6
10YR 5/3
-
-
-
-
moist
sl
mod
med
gr
fr
ns
np
Bt
12-34
10YR 5/4
-
-
-
-
moist
cl
mod
med
sbk
fi
I ss
sp
C
43-48
7.5YR 5/6
-
-
-
-
moist
I
structureless, massive parent material
Legend:
Texture
Structure Grade
Structure Type
Structure Size
s
sand
wk weak
gr
granular
f fine
I
loam
m moderate
pl
platy
med medium
si
silt
str strong
pr
prismatic
sil
silt loam
cpr
columnar
c
clay
abk
angular blocky
cl
clay loam
sbk
subangular blocky
Moist Consisten
scl
sandy clay loam
sg
single grained
fr friable
sl
sandy loam
ma
massive
vfr very friable
sicl
silty clay loam
fi firm
vfi very firm
Seasonal High Water Table:
Depth (") Type (apparent/perched)

Soil Profile Descriptions in Field Locations
Project: City of Burlington (WQ 0000520) % Slope:
3%
Site: NC-AM-016, Field 4 Expansion Crop:
Forage/Pasture
Field: 4 Conducted By:
GC Murray
Date:
6/14/2022
Soil Series:
Herndon
O
y
O
O
v
=
O
O
c
(U
(U
O
K
y
N
2 0
PIEDMONT
E _ _ --
P
ASSOCI AT ES, P. A.
W w
w
p NILa=i
V a 0 V5 Ln
C
7 N C _
N O CO
CO
a�
a� a� x
�' U
is is A
K 7 7 7 y
^2 ^2 � 1�— A A A ^2
A
0-5
10YR 5/3
1 -
-
I -
-
I moist
sl
mod
med
gr
fr
ns
np
Bt
5-28
7.5YR 5/6
5YR 4/2
few
faint
Dep.
moist
c
mod
med
sbk
fi
I s
p
C
43-48
7.5YR 5/6
-
-
-
-
moist
Sid
structureless, massive parent material
Legend:
Texture
Structure Grade
Structure Type
s
sand
wk weak
gr
granular
I
loam
m moderate
pl
platy
si
silt
str strong
pr
prismatic
sil
silt loam
cpr
columnar
c
clay
abk
angular blocky
cl
clay loam
sbk
subangular blocky
scl
sandy clay loam
sg
single grained
sl
sandy loam
ma
massive
sicl
silty clay loam
Seasonal High Water Table:
Structure Size Depth (") Type (apparent/perched)
f fine 24 1 perched
med medium *faint redox features observed from 24-32"
Moist Consisten
fr friable
vfr very friable
fi firm
vfi very firm

PIEDMONT
EU7 " ✓/ R. 0 "14 14!W UIII/VWY ' NIIIIIIIII IIIIIIIIIIIIIIA
June 17, 2022
City of Burlington, NC
c/o: Mr. Shane Fletcher,
Residuals Management Coordinator
2741 Boywood Rd.
Graham, NC 27253
Project 4 3481
RE: Soil Evaluation for Various Properties, City of Burlington Residuals Application
Permit, WQ 0000520 - NC-CS-036 Fields 8 and 9 Expanded Areas
This report is being prepared to satisfy requirements set forth in 15A NCAC 02T .1104
(2) concerning the soil evaluation for the application of residuals. Specifically, we
wanted to ensure that soils in expanded areas of the above referenced fields were suitable
and comprised the same soil series as the surrounding fields.
Soil evaluations were conducted by Piedmont Environmental Associates, P.A. in areas
recently added to NC-CS-036 Fields 8 and 9. The boring location and application fields
are shown in the attached soil/site map (Attachment 1).
The evaluations consisted of hand auger borings and soil profile descriptions of the soils
within the application sites. Soil profile descriptions are given in Attachment 2. All
documents related to the soil evaluation included in this package were prepared by G.
Christopher Murray, L.S.S. of Piedmont Environmental Associates. All other work was
conducted by The City of Burlington, NC.
For each application field site, representative soil borings were conducted to confirm the
soil series designation provided on the USDA/NRCS soil survey data, which is used to
determine the realistic yield expectation application rates according to the NCSU nutrient
management database. It was assumed that areas unsuitable to slope or a seasonally
high-water table are not included in the application area for any of these fields.
Table 1 lists the soil series mapped for each permitted field as well as the soil series of
the newly evaluated areas:
Table 1. - Expanded Area Soils Information, NC-CS-036 Fields 8 and 9
Field Orig. Permitted Series Expanded Area Series
NC-CS-036 - Field 8 Frogsboro Frogsboro
NC-CS-036 - Field 9 (A&B) Frogsboro Frogsboro
216 S. Swing Rd, Suite 1 . Greensboro, NC 27409 . 336-662-5487

The soils of the newly expanded areas for NC-CS-036 Fields 8 and 9 were found to be
suitable for residuals application and most similar to those of the surrounding fields.
Piedmont Environmental Associates is pleased to be of service in this matter. If you have
questions or require additional information, please feel free to call [phone].
Sincerely,
G. Christopher Murray
NC Licensed Soil Scientist 41284
Piedmont Environmental Associates, PA
List of Attachments:
-Attachment 1 — Soil and Site Map
-Attachment 2 — Soil Profile Descriptions

Soil Profile Descriptions in Field Locations
Project: City of Burlington (WQ 0000520) % Slope: 3%
Site: NC-CS-036, Field 8 Expansion Crop: Forage/Pasture
Field: 8 Conducted By: GC Murray
Date: 6/14/2022
Soil Series: Iredell (Frogsboro)
O
y
O
O
v
=
O
O
c
L)
L)
O
K
y
N
2 0
ASSOCP PIEDMONT
NAT ES, P. A.
w
w
p NILa=i
a C9 U y
C V
7 N C I _
N O
Q v) :.: o
a�
a� a� x 3 L L)
U U U
is is N K 7 7 7 0
^2 ^2 W
A
0-2
10YR 5/3
-
-
-
-
moist
sl
mod med I gr I fr I ns np
Bw
2-48
10YR 5/4
-
-
-
-
moist
various/c
weakly structured, variable fill material
*This boring contained various textured materials present due to the filling of a pond. Soils are most similar to the Frogsboro series based on
color and texture. R.Y.E. application rate based on Iredell (Frogsboro) is recommended.
Legend:
Texture
s
sand
I
loam
si
silt
sil
silt loam
c
clay
cl
clay loam
scl
sandy clay loam
sl
sandy loam
sicl
silty clay loam
Structure Grade
wk weak
m moderate
str strong
Structure Type
gr
granular
pl
platy
pr
prismatic
cpr
columnar
abk
angular blocky
sbk
subangular blocky
sg
single grained
ma
massive
Structure Size
f fine
med medium
Moist Consistencv
fr
friable
vfr
very friable
fi
firm
vfi
very firm
Seasonal High Water Table:
Depth (") ype (apparent/perche

Soil Profile Descriptions in Field Locations
Project: City of Burlington (WQ 0000520) % Slope: 3%
Site: NC-CS-036, Field 9A Expansion Crop: Forage/Pasture
Field: 9A Conducted By: GC Murray
Date: 6/14/2022
Soil Series: Iredell (Frogsboro)
O
y
O
O
v
=
O
O
c
(U
(U
O
K
y
N
2 0
PIEDMONT
E _ _ --
P
ASSOCI AT ES, P. A.
W w
w
p NILa=i
V a 0 V5 Ln
C
7 N C _
N O CO
CO
a�
a� a� x
�' U
is is A
K 7 7 7 y
^2 ^2 � 1�— A A A ^2
A
0-5
10YR 5/3
1 -
-
I -
-
I moist
sl
mod
med
gr
fr
ns
np
Bt
5-29
10YR 5/6
10 YR 6/2
few
faint
Dep.
moist
c
mod
med
sbk
vfi
I vs
vp
C
29-48
7.5YR 5/6
-
-
-
-
moist
I
structureless, massive parent material
Legend:
Texture
Structure Grade
Structure Type
Structure Size
s
sand
wk weak
gr
granular
f fine
I
loam
m moderate
pl
platy
med medium
si
silt
str strong
pr
prismatic
sil
silt loam
cpr
columnar
c
clay
abk
angular blocky
cl
clay loam
sbk
subangular blocky
Moist Consisten
scl
sandy clay loam
sg
single grained
fr friable
sl
sandy loam
ma
massive
vfr very friable
sicl
silty clay loam
fi firm
vfi very firm
Seasonal High Water Table:
Depth (") Type (apparent/perched)
18 perched

Soil Profile Descriptions in Field Locations
Project: City of Burlington (WQ 0000520) % Slope: 3%
Site: NC-CS-036, Field 9A Expansion Crop: Forage/Pasture
Field: 9B Conducted By: GC Murray
Date: 6/14/2022
Soil Series: Iredell (Frogsboro)
O
y
O
O
v
=
O
O
c
(U
(U
O
K
y
N
2 0
PIEDMONT
E _ _ --
P
ASSOCI AT ES, P. A.
W w
w
p NILa=i
V a 0 V5 Ln
C
7 N C _
N O CO
CO
a�
a� a� x
�' U
is is A
K 7 7 7 y
^2 ^2 � 1�— A A A ^2
A
0-5
10YR 5/3
1 -
-
I -
-
I moist
sl
mod
med
gr
fr
ns
np
Bt
5-27
10YR 5/6
10 YR 6/2
few
faint
Dep.
moist
c
mod
med
sbk
vfi
vs
vp
BC
27-34
10YR 5/4
10 YR 6/2
few
faint
Dep.
moist
cl
wk
med
sbk
fi
s
p
C
29-48
7.5YR 5/6
-
-
-
-
moist
sil
structureless, massive parent material
Legend:
Texture
s
sand
I
loam
si
silt
sil
silt loam
c
clay
cl
clay loam
scl
sandy clay loam
sl
sandy loam
sicl
silty clay loam
Structure Grade
Structure Type
wk weak
gr
granular
m moderate
pl
platy
str strong
pr
prismatic
cpr
columnar
abk
angular blocky
sbk
subangular blocky
sg
single grained
ma
massive
Structure Size
f fine
med medium
Moist Consistencv
fr friable
vfr very friable
fi firm
vfi very firm
Seasonal High Water Table:
Depth (") Type (apparent/perched)
19 perched

I certify that I am a deeded landowner of the above -referenced land application sitc(s) and am authorized to make decisions
regarding the use of the land application site(s) on behalf of other deeded landowners OR that 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 anothermunicipality, contractor, or other pennitted entity. Fuilhenriore, 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.
Landownername:
Address: Z) c202 f2 0
City: State: Zip: Z 12, d
Phone: J cc 02 4 E-nail
Signature: 6', 711- 11 '-21
T r-(Z'i, h-'S Date: 12 /S-
NORTH CAROLINA, COUNTY
1, the undersigned Notary Public do hereby certify that J-1, (Y) m cA 31, A reA
i
personally appeared before me this day and acknowledged the due execution of the forgoing instrument.
W1 TNI
day of
Signati
My col
Lessee's/Operator's Certification:
I certify that have read this Agre rne
Lcssee/operat 1-name:
Address:
t and do hereby agree to abideby the stipulations and restrictions as specified herein.
City: State: zip:
PhoneE-mail address:
: 3.;1, -
Signature: 7/ Date:
Permittee's Certification:
I certify that I have read this Agreement and clohereby agree to abide by the stipulations and restrictions as specified herein.
Signing official name: hod--t- 0e,+cJ\4,
Signature: Date:
FORM: LOA 06-16 Page 3 o1`3

I certify that I am a deeded landowner of the above -referenced land application sitc(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 orother legal delegation, to make decisions regarding the use of the land application site(s) on behalf of tile
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. Furthennore, I certify thatl 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 pennission to the Pennittee to land apply residuals to the land application site(s) as specified
herein.
Landownername:
Address:
Ck (i
IN
City: Llcn State: Zip: -4
Phone: E-mail address:
Signature: Date:
NORTH C. LINA, COUNTY
1, the undersigned Notary Public do hereby certify that Elzab!fAh Lyiw'ons K)9 *6U
personally appeared before me this day and acknowledged the due execution Of
WITNESS my hand and official seal this the r _4g .10 - I I d
Tayof
Signature and sea]:
My commission expires: LAJ ( A
Lessee's/Operator's Certification:
I certify that l have readthis A
Lessee/operatorname: I'll I
forgoing instrument.
120 2-7-
an'd do hereby agreeW abideby the stipulations and restrictions as specified herein.
Address: I'< J/ 40m
C �E , I
City: State: Zip: _4
f C., , V - el"
Phone: 73 41 V 9' Ir' E-mail address:
Signature: Date: /I —
11
Permittee's Certification:
I certify that I have read this Agreement and dohereby agree to abide by the stipulations and restrictions as specified herein.
Signing official name: VQ-*,
Signature: Date
FORM: LOA 06-16 Page 3 of 3

Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .1100 — 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: City Of BUi'lin2ton
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)
AM55-05
No
Hay/Pasture
Animal Feed
The landowner or his representative receives, in consideration, full use of the nutrient value of the applied residuals while the
Permittee receives, in consideration, the use of the land application site(s) described above for the disposal of the residuals.
This Agreement shall remain in effect for the length of the Division's permit for the residuals land application program and
shall be renewed each time this permit is renewed.
The undersigned landowner or his representative and the Permittee agree to abide with the following restrictions and
stipulations until such time as written notification, given 30 calendar days in advance, modifies or cancels this Agreement.
FORM: LOA 06-16 Page 1 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 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.
IL 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.
IILALTERNATIVES FOR WATER SUPPLY WELLS INSIDE THE COMPLIANCE BOUNDARY: (please check one)
15A NCAC 02L .0107(d) prohibits water supply wells within the compliance boundary. However, 15A NCAC 02T .0105(h) allows the compliance
boundary to be placed closer to the waste disposal area, such that the water supply well is situated outside of the compliance boundary provided
the groundwater standards can be met at the newly -established compliance boundary. Please mark one of the following;
❑ A re -defined compliance boundary is needed for field(s) ID:
(Please include the rationale for the requested re -location of the compliance boundary and attach a map showing the newly proposed compliance
boundary to the application package)
® A re -defined compliance boundary is not needed for this site.
IV. ACKNOWLEDGEMENT OF FIELD TRANSFER: (if needed)
❑ The land application field(s) ID: I is currently permitted under another
residuals land application program; Permit Number WQ: The land owner hereby acknowledge that by signing this
agreement, he/she is requesting that the field(s) be removed from the previously permitted residuals land application program and transferred
into the new program;
(Name of the new program)
FORM: LOA 06-16 Page 2 of 3

Landowner's Certification:
I certify that I am a deeded landowner of the above -referenced land application site(s) and am authorized to make decisions
regarding the use of the land application site(s) on behalf of other deeded landowners OR that I am otherwise authorized, through
a power of attorney or other legal delegation, to make decisions regarding the use of the land application site(s) on behalf of the
deeded landowners. 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: a
Address: 1-(.'2 VaL,_-e(q �qqs-(,j /-a
City 6 Cj �_ State: —Zip:
Phone: E-mail address: 0 06- _N ev A-
SignatDate: 2--2—
NORTH CAROLINA, COUNTY
'5' ,
1, the undersigned Notary Public do hereby certify that , q M :,L- J rsaz,
personally appeared before me this day and acknowledged the due execution of the forgoing instrument.
op E
WITNESS my hand and official seal this the
day of "Je 20 2 4
Z
Signature and seal:
%
2q /6 1ZZe
My commission expires: :�
A/C E G o,"
Lessee' s/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,
Lessee/operator name:
Address:
City: State: Zip:
Phone: E-mail address:
Signature: Date:
Perinittee's Certification:
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Signing official name:
Signature: f> Date:
FORM: LOA 06-16 Page of3

Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
LAND APPLICATION SITE CERTIFICATION
INSTRUCTIONS FOR FORM: LASC 06-16
Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted, the Applicant shall submit one original and two copies of the application and
supporting documentation
For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting Unit
General — This certification provides detailed information of receiving sites for land application of Class B residuals (may include water
treatment plant or other type residuals) in accordance with 15A NCAC 02T .1100. Do not submit this certification for review without
a corresponding application form (FORM: RLAP 06-16 or FORM: SDR 06-16).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Land Application Site Certification (FORM: LASC 06-16):
® Submit the completed and appropriately executed Land Application Site Certification (FORM: LASC 06-16) form. Please do
not make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to
the application may be made, as long as the attachments are numbered to correspond to the section and item to which they
refer.
® For new or renewed permits, submit the requested information for all land application sites.
® For modified permits, submit the requested information for only those sites that are new, transferred or affected by the proposed
modification.
B. Land Application Site Information:
® The status of the land application site with respect to this residuals land application program must be provided in table I. The
status categories and their corresponding codes are as follows:
♦ New (N) ♦ Renewed (R) ♦ Modified (M) ♦ Transferred (T) ♦ Deleted (D)
® Attach the following in accordance with each status code:
Status Code
Required Item
N
R
T
M
IIIII����
IG � V
✓
County Board
Notification. doc
q PWW'Vi
✓
✓
✓
'I=
Land Owner
Agreement
(If applicable)
q PWW'V
✓
✓
✓
✓
Setback Waiver
Agreement
An updated vicinity/setback map in accordance with the "Mljp �.juichtnce
for Res CA,IsI.LdA - )Iicaion Permits" .._.......
✓
✓
✓
A soils and agronomic evaluation in accordance with the "s±��,1sce;n;fist;
✓
INSTRUCTIONS FOR FORM: LASC 06-161'age 1 of

An updated accounting of the land application site's cumulative pollutant
loading rates (CPLRs)
Status Code
Required Item
N
R
T
M
For previously permitted sites without a soil series name indicated in the
Attachment B, submit County Soil Survey Map (or equivalent) clearly
indicate the location of the land application site and in accordance with
the soil map requirements in the "`soil Sic.°artist Fvaluaatiml 11olir,v"°
Acknowledgement of field transfer from Land Owner (Fields may not be
permitted to multiple Permittees over the same timeperiod)
* This item may be required for land application site with a states code "M", please contact the Division if you need assistant in
determining attachment requirements.
® Crop Type should include the most likely crop types for the life of the permit (five years).
® Predominant Soils Series Name must be either the name of the soil indicated in Attachment " B" of the existing permit, or name
of the soil series as provided by the licensed soil scientist.
® Predominant Soil Mapping Unit or Representative Slope: Either the Soil Mapping Unit or the representative slope of each site
must be provided. The predominant soil -mapping unit must be consistent with the predominant soil series name. Please note
that the soil mapping units are variable between Counties, so care should be taken in properly identifying the correct mapping
unit. If a representative slope is provided, it must be determined accordingly:
® For sites previously permitted for use, but do not have an established soil mapping unit (the mapping unit provides
information on both the soil series name and the slope of the soil), the Applicant may determine the representative slope
by using the average slope provided in the County Soil Survey (or equivalent). A soil type with a slope range of 4 - 8%
would have a representative slope of 6%.
® New Sites to be permitted must have slopes determined as part of the soils report prepared by a licensed soil scientist.
® Acceptable methods for determining location coordinates (i.e., latitude and longitude) and their corresponding codes are as
follows:
• Address Matching (ADD)
• Aerial Photography with Ground Control (AER)
• Cadastral Survey (SUR)
• Conversion from Coordinate Plane (CP)
• Conversion from Township -Section -Range (TSR)
• Conversion from Universal Trans Merc (UTM)
• Map Interpretation by Digital or Manual Extraction (MAP)
C. Waterbody and Classifications Information: (new sites only)
• Digital or Raw Photo Extraction (EXT)
• Geodetic Quality GPS Survey (GEO)
• LORAN-C Navigation Device (LOR)
• Navigation Quality GPS (GPS)
• Remote Sensing (RS)
• Zip Code Centroid (ZIP)
® Use an 8.5 by 11-inch copy of the portion of a 7.5-minute USGS Topographic Map to identify the location where the residuals
program activities are planned to occur as well as the closest downslope surface waters as clearly as possible. Each map portion
must be labeled with the map name and number, the identified location, and be of clear and reproducible quality.
® Surface water body classifications information may be found at: hltp://deg.nc.�4ov/about/divisions/water-
resources/planning/class ification- standard s/classifications
® Any questions concerning the waterbody and its classification, please contact the Division's regional offices.
® A list of the Division's regional offices, their county coverage, and their contact information may be downloaded at:
hltp://deg.nc. Gov/contact/re�4ional-offices
® General Instructions: There are 17 river basins in North Carolina. Each basin has associated waterbodies with assigned
subbasins, location descriptions, stream index numbers and established classifications.
1. Identify the project area on a 7.5 minute USGS topographical map (an 8.5 x 11-inch sheet showing the project area
should be submitted with the permit application regardless of whether a Stream classification was completed).
2. Determine the names of all the closest down slope surface waters from the project site. For unnamed tributaries, see
Table 1: Unnamed Tributaries Entering Other States or for Specific Basin Areas. Label any unnamed tributaries as "UT
to stream name" as the waterbody name.
Open the link hap://deq.nc.gov/about/divisions/water-resources/planning/classification-standards/classifications.
® Stream Classification Process: One of the options below may be used depending on the known initial project information.
® KNOWN BASIN WHERE CLOSEST DOWN SLOPE SURFACE WATER IS LOCATED
1. Select proper basin from the List all Waterbodies in Basin sorted report. Sort hydrologically as this will provide
the proper location descriptions if multiple runs.
INSTRUCTIONS FOR FORM: LASC 06-16Page 2 of 3

2. Locate the name of the identified waterbody (from General Directions) on the list.
3. For multiple listings of the same waterbody name in the report, select and verify the location description. The term
"source" in the description means the beginning of the waterbody segment (most upstream point).
4. Record all Basins, Stream Index Numbers and Classifications applicable to the project.
® KNOWN COUNTY WHERE CLOSEST DOWN SLOPE SURFACE WATER IS LOCATED
1. Select the proper county from the List all Waterbodies in county, hydrologically report.
2. Locate the name of the identified waterbody (from General Directions) on the list.
3. For multiple listings of the same waterbody name in the report, select and verify the location description. The term
"source" in the description means the beginning of the waterbody segment (most upstream point).
4. Record all Basins, Stream Index Numbers and Classifications applicable to the project.
® UNKNOWN BASIN WHERE CLOSEST DOWN SLOPE SURFACE WATER IS LOCATED
1. Use the Clickable basin map to hydrologically sorted list report.
2. Click on the approximate project location to bring up the hydrologically sorted list.
3. Locate the name of the identified waterbody (from General Directions) on the list.
4. For multiple listings of the same waterbody name in the report, select and verify the location description. The term
"source" in the description means the beginning of the waterbody segment (most upstream point).
5. Record all Basins, Stream Index Numbers and Classifications applicable to the project.
® Notes on index number and unnamed streams:
Unnamed Streams 15A NCAC 02B .0301(i).
® Any stream which is not named in the schedule of stream classifications carries the same classification as that assigned
to the stream segment to which it is tributary (at the point of entry) except:
(A) unnamed streams specifically described in the schedule of classifications;
(B) unnamed freshwaters tributary to tidal saltwaters will be classified "C"; or
(C) after November 1, 1986, any newly created areas of tidal saltwater which are connected to Class SA waters by
approved dredging projects will be classified "SC" unless case -by -case reclassification proceedings are conducted.
® The following river basins have different policies for unnamed streams entering other states or for specific areas of the
basin:
Unnamed Tributaries Entering Other States or for Specific Basin Areas
Hiwassee River Basin
Streams entering Georgia or Tennessee shall be classified "C Tr."
Little Tennesse River
Basin And Savannah
River Drainage Area
Streams entering Georgia or Tennessee shall be classified "C Tr." Such streams in the Savannah
River drainage area entering South Carolina shall be classified "B Tr."
French Broad River
Basin
Streams entering Tennessee will be classified "B."
Watauga River Basin
Streams entering the State of Tennessee are classified "C."
Broad River Basin
Streams entering South Carolina are classified "C."
New River Basin
Streams entering the State of Tennessee are classified "C."
Catawba River Basin
Streams entering South Carolina are classified "C."
Yadkin -Pee Dee River
Basin
Streams entering Virginia are classified "C," and such streams entering South Carolina are
classified "C."
Lumber River Basin
Streams entering South Carolina are classified "C Sw."
Roanoke River Basin
Streams entering Virginia are classified "C." Except that all backwaters of John H. Kerr Reservoir
and the North Carolina portion of streams tributary thereto not otherwise named or described
shall carry the classification "B," and all backwaters of Lake Gaston and the North Carolina
portion of streams tributary thereto not otherwise named or described shall carry the classification
"C and B."
Chowan River Basin
Streams entering Virginia are classified "C."
Tar -Pamlico River
Basin
All drainage canals not noted in the schedule are classified "C Sw." except the main drainage
canals to Pamlico Sound and its bays which shall be classified "SC."
Pas uotank River Basin
All drainage canals not noted in the schedule are classified "C."
INSTRUCTIONS FOR FORM: LASC 06-161'age 3 of

LAND APPLICATION SITE CERTIFICATION
Applicant's name: City of Burlington NC
Land application sites currently certified: 2,995.90 net acres and Total to be certified: 1984.14 net acres.
I. LAND APPLICATION SITE INFORMATION (See Instruction B):
Status
Codea
Site/Field
ID
Landowner(s) s
Lessee(s) Operator(s) or O s)
Net Acres
CountyCrop(s)
Predominant Soil
Series Nameb
Mapping Unit
or Rep. Slope°
N
AM19-01
Wyatte, Walter B
Aldridge, Marvin M
2.82
Alamance
Fescue / Hay
Iredell
N
AM19-02
Wyatte, Walter B
Aldridge, Marvin M
6.04
Alamance
Fescue / Hay
Cullen
N
AM19-03
Wyatte, Walter B
Aldridge, Marvin M
12.17
Alamance
Fescue / Hay
Iredell
N
AM19-04A
Wyatte, Walter B
Aldridge, Marvin M
4.14
Alamance
Fescue / Hay
Iredell
N
AM19-04B
Wyatte, Walter B
Aldridge, Marvin M
9.31
Alamance
Fescue / Hay
Enon Clay Loam
N
AM128-01
Drechsel, Shirley
Blair Thompson
12.26
Alamance
Fescue / Hay
Helena
N
CS 113-6A
Allred, Jimmy D
Kirby, Tony
3.93
Caswell
Fescue / Hay
Cullen
N
CS 113-6B
Allred, Jimmy D
Kirby, Tony
5.78
Caswell
Fescue / Hay
Cullen
a Status Code for land application sites are: ♦ N (New) ♦ R (Renewed) ♦ M (Modified) ♦ T (Transferred) ♦ D (Deleted)
b Soil Series Name (i.e. Appling, Cecil, etc.)
° Mapping Unit must be consistent with those used in the County Soil Survey (i.e. for a 2-8% slope Cecil in Anson County the mapping unit is CeB2)
II. WATERBODY AND CLASSIFICATIONS INFORMATION (See Instruction C):
Site/Field ID
Latitude
Longitude
Location
Datum
Location Method Code
Location Accuracy
Waterbody Subbasin and
Stream Index No.
Current and Proposed
p
Class
AM19-01
360 09' 15"
790 18' 58"
NAD 83
MAP
Nearest Second
Scrub Creek, 16-18-(1.5)
WS-II
WS-II
AM19-02
360 09' 18"
790 18' 57"
NAD 83
MAP
Nearest Second
Scrub Creek, 16-18-(1.5)
WS-II
WS-II
AM19-03
360 09' 43"
790 18' 56"
NAD 83
MAP
Nearest Second
Scrub Creek, 16-18-(1.5)
WS-II
WS-II
AM19-04A
360 09' 43"
79 ° 18' 30"
NAD 83
MAP
Nearest Second
Scrub Creek, 16-18-(1.5)
WS-II
WS-II
AM194B
360 09' 39"
790 18' 45"
NAD 83
MAP
Nearest Second
Scrub Creek, 16-18-(1.5)
WS-II
WS-II
AM128-01
350 57' 43"
790 21' 53"
NAD 83
MAP
Nearest Second
Whiteheat Creek, 16-24
WS-V
WS-V
CS113-6A
360 18' 56"
790 26' 17"
NAD 83
MAP
Nearest Second
Stony Creek, 16-14-(1)
WS-II
WS-II
CS113-613
360 18' 03"
790 26' 07"
NAD 83
MAP
Nearest Second
Stony Creek, 16-14-(1)
WS-II
WS-II
Note: Please keep the site information (L) and waterbody information (IL) of the same field on the same page.
FORM: LASC 06-16 Page 1

LAND APPLICATION SITE CERTIFICATION
Applicant's name: City of Burlington
Land application sites currently certified: 2,995.90 net acres and Total to be certified: 1,927.69 net acres.
III. LAND APPLICATION SITE INFORMATION (See Instruction B):
Status
Codea
Site/Field
ID
Landowner(s) s
Lessee(s) Operator(s) or O s)
Net Acres
CountyP�
Cro s)
Predominant Soil
Series Nameb
Mapping Unit
or Rep. Slope°
M
AM02-1
Culberson, Kenneth C
8.14
Alamance
Fescue Hay/Pasture
Davidson
DdB
M
AM02-2
Culberson, Kenneth C
12.28
Alamance
Fescue Hay/Pasture
Davidson
DdB
M
AM02-3
Culberson, Kenneth C
6.05
Alamance
Fescue Hay/Pasture
Davidson
DdB
M
AM02-4
Culberson, Kenneth C
7.68
Alamance
Fescue Hay/Pasture
Davidson
DdB
M
AM02-5
Culberson, Kenneth C
7.87
Alamance
Fescue Hay/Pasture
Iredell
IaB
M
AM02-6
Culberson, Kenneth C
8.27
Alamance
Fescue Hay/Pasture
Iredell
IaB
M
AM02-7
Culberson, Kenneth C
6.62
Alamance
Fescue Hay/Pasture
Iredell
IaB
M
AM02-8
Culberson, Kenneth C
4.48
Alamance
Fescue Hay/Pasture
Iredell
IaB
M
AM02-9
Culberson, Kenneth C
4.92
Alamance
Fescue Hay/Pasture
Iredell
IaB
D
AM03-1
Graves,Jaime McPhersonjames
Lawerence McPherson
27.20
Alamance
Fescue Hay/Pasture
Georgeville
GeB
D
AM03-2
Graves,Jaime MCPhersonjames
Lawerence McPherson
26.20
Alamance
Corn/Soybeans
Lignum
CmD
D
AM03-3
Graves,Jaime MCPhersonjames
Lawerence McPherson
22.70
Alamance
Corn/Soybeans
Lignum
CmD
M
AM05-1
Larry Griffin
1.73
Alamance
Fescue Hay/Pasture
Lignum
CmD
M
AM05-2
Larry Griffin
9.96
Alamance
Fescue Hay/Pasture
Lignum
CmD
M
AM06-1
Hessenthaler, Walter F
16.51
Alamance
Fescue Hay
Helena
HbB
M
AM06-2
Hessenthaler, Walter F
13.71
Alamance
Fescue Hay
Appling
AbB
M
AM06-8
Neal, William T
9.17
Alamance
Fescue Hay/Pasture
Durham
DdB2
M
AM06-9A
Neal, William T
4.38
Alamance
Fescue Hay/Pasture
Durham
DdB2
M
AM06-9B
Neal, William T
7.05
Alamance
Fescue Hay/Pasture
Durham
DdB2
FORM: LASC 06-16 Page 2

LAND APPLICATION SITE CERTIFICATION
M
AM06-9C
Neal, William T
5.58
Alamance
Fescue Hay/Pasture
Durham
DdB2
M
AM07-1
Teague, Michael C
17.43
Alamance
Fescue Hay/Pasture
Mecklenburg
MbB2
M
AM07-2
Teague, Michael C
18.68
Alamance
Fescue Hay/Pasture
Mecklenburg
MbB2
M
AM08-1
Staley, Jimmy & Sandra
15.53
Alamance
Fescue Hay
Enon
EdC2
D
AM009-01
Allen, John
38.44
Alamance
Fescue Hay/Pasture
Herndon
HdB2
D
AM009-02
Allen, John
14.83
Alamance
Fescue Hay/Pasture
Orange
ObB
D
AM009-03
Allen, John
24.44
Alamance
Fescue Hay/Pasture
Orange
ObB
M
AM10-01
Cheek, Robert
22.80
Alamance
Fescue Hay
Davidson
DbB
M
AM10-02
Cheek, Robert
17.40
Alamance
Soybeans/Corn
Davidson
DbB
M
AM10-03
Cheek, Robert
26.21
Alamance
Fescue Hay/Pasture
Davidson
DbB
D
AM013-01
Conroy, Atny;, Owens, icKay;Mazejka,
Ray; Owens, Michelle
James Hadley
9.18
Alamance
Soybeans/Wheat/Fescue Hay
Tarrus
TaB2
D
AM013-02
Conroy, Amy; Goldsworthy, Kay; Michelle
Owens
James Hadley
11.67
Alamance
Soybeans/Wheat/Fescue Hay
Tarrus
TaB2
D
AM013-03
Conroy, Amy; Owens, Michelle; Tinnin,
Andrew Morgan
James Hadley
30.49
Alamance
Soybeans/Wheat/Fescue Hay
Tarrus
TaB2
M
AM014-01
Roney, James A Jr; Roney, Carolyn
29.14
Alamance
Fescue Hay/Pasture
Helena
HbB
M
AM014-02
Roney, James A Jr; Roney, Carolyn
12.96
Alamance
Fescue Hay/Pasture
Helena
HbC2
M
AM014-03
Roney, James A Jr; Roney, Carolyn
9.56
Alamance
Fescue Hay
Helena
HbB
D
AM014-04
Turner, Carolyn R
James Roney
28.82
Alamance
Fescue Hay/Pasture
Helena
HbB
M
AM14-05A
Roney, James A Jr; Roney, Carolyn
16.89
Alamance
Fescue Hay/Pasture
Enon
EdC2
M
AM14-05B
Roney, James A Jr; Roney, Carolyn
6.19
Alamance
Fescue Hay/Pasture
Enon
EdC2
M
AM14-06
Roney, James Jr; Roney, Carolyn
10.38
Alamance
Fescue Hay
Appling
AbB
M
AM15-01
Wyatt, Charlie A.
12.26
Alamance
Fescue Hay
Vance
VbC3
M
AM15-02
Wyatt, Charlie A.
11.74
Alamance
Fescue Hay/Pasture
Enon
EdC2
M
AM15-03
Wyatt, Charlie A.
10.54
Alamance
Fescue Hay/Pasture
Enon
EdC
M
AM15-04
Wyatt, Charlie A.
5.88
Alamance
Fescue Hay
Cecil
CbB2
M
AM16-01
Hadley, William Earl
29.07
Alamance
Fescue Hay
Herndon
HdC2
M
AM16-02A
Hadley, Michael Todd
4.68
Alamance
Fescue Hay/Pasture
Alamance
AaB
M
AM16-02B
Hadley, Michael Todd
19.34
Alamance
Fescue Hay/Pasture
Alamance
AaB
M
AM16-03
Hadley, William Earl;Hadley,Andrew
22.05
Alamance
Fescue Hay
Georgeville
GaB2
FORM: LASC 06-16 Page 3

LAND APPLICATION SITE CERTIFICATION
M
AM16-04A
Hadley, Michael T
7.25
Alamance
Fescue Hay/Pasture
Herndon
HdC2
M
AM16-04B
Hadley, Michael T
39.74
Alamance
Fescue Hay/Pasture
Herndon
HdC2
M
AM016-05
Hadley, Michael T
12.03
Alamance
Fescue Hay/Pasture
Georgeville
GaB2
M
AM016-06
Neal, Cathy Hadley
18.25
Alamance
Fescue Hay
Herndon
HdB2
D
AM017-01
Sasser Farms LLC
12.05
Alamance
Fescue Hay/Pasture
Iredell
IbA
D
AM017-02
Sasser Farms LLC
26.97
Alamance
Fescue Hay/Pasture
Iredell
IbA
D
AM017-03
Sasser Farms LLC
22.52
Alamance
Fescue Hay/Pasture
Iredell
IbB
D
AM017-04
Sasser Farms LLC
3.61
Alamance
Fescue Hay/Pasture
Helena
HbB2
M
A 418-OIA
Mills, Albert S Jr; Mills, Robin T
7.49
Alamance
Fescue Hay/Pasture
Iredell
IbB2
M
AM18-OIB
Mills, Albert S Jr; Mills, Robin T
6.08
Alamance
Fescue Hay
Iredell
IbB2
M
A 418-OIC
Mills, Albert S Jr; Mills, Robin T
10.18
Alamance
Fescue Hay
Iredell
IbB2
M
A 418-02A
Mills, Albert S Jr; Mills, Robin T
6.98
Alamance
Fescue Hay/Pasture
Iredell
IbB2
M
A 418-02B
Mills, Albert S Jr; Mills, Robin T
4.98
Alamance
Fescue Hay/Pasture
Iredell
IbB2
M
A 418-03
Mills, Albert S Jr; Mills, Robin T
10.44
Alamance
Fescue Hay
Iredell
IbB2
M
AM35-01
Rice, Joseph Marshall Revocable Rice, Mary Elizabeth Revocable Trust'
4.57
Alamance
Fescue Hay/Pasture
y ure
Georgeville
GaB
M
AM35-02
Rice, Joseph Marshall Revocable Trust,
Rice, Mary Elizabeth Revocable Trust
9.12
Alamance
Fescue Hay/Pasture
y
Georgeville
g
GaB
M
A035-03
Rice, Joseph Marshall Revocable Rice, Mary Elizabeth Revocable Trust'
17.68
Alamance
Fescue Hay/Pasture
y ure
Georgeville
GaB
M
AM35-04
Rice, Joseph Marshall Revocable Trust,
Rice, Mary Elizabeth Revocable Trust
17.05
Alamance
Fescue Hay/Pasture
y
Georgeville
g
GaB
M
AM35-05
Rice, Joseph Marshall Revocable Trust,
Rice, Mary Elizabeth Revocable Trust
24.53
Alamance
Fescue Hay/Pasture
y
Georgeville
g
GaB
M
AM35-06
Rice, Joseph Marshall Revocable Trust,
Rice, Mary Elizabeth Revocable Trust
16.45
Alamance
Fescue Ha y
eor g
Georgeville
GaB
M
AM55-5
Kiser, Samuel
16.57
Alamance
Fescue Hay/Pasture
Georgeville
GaB
D
AM72-01
Justice, Alpha M
Justice, Jerry
6.23
Alamance
Fescue Hay/Pasture
Georgeville
GaC2
D
AM72-02
Justice, Alpha M
Justice, Jerry
11.79
Alamance
Fescue Hay/Pasture
Georgeville
GaB2
M
AM73-01
Newlin, Leonidas Blair
10.42
Alamance
Fescue Hay/Pasture
Tirzah
TaB
M
AM73-02
Newlin, Leonidas Blair
5.66
Alamance
Fescue Hay/Pasture
Georgeville
GaB
M
AM73-03
Newlin, Ronny Hadley
Newlin, Leonidas Blair
7.31
Alamance
Fescue Hay
Georgeville
GaB
D
AM98-01
McPherson, Eric J
16.00
Alamance
Fescue Hay/Pasture
Georgeville
GaB
D
AM98-04
McPherson, Eric J
33.60
Alamance
Fescue Hay/Pasture
Georgeville
GaB
M
AMI00-01
McPherson, Terry GC e; McPherson, Lynn
22.69
Alamance
Fescue Hay/Pasture
Cecil
CbB2
FORM: LASC 06-16 Page 4

LAND APPLICATION SITE CERTIFICATION
M
AM100-02
McPherson, Terry G;
4.77
Alamance
Fescue Hay
Georgeville
GaB2
M
AM109-01
McQueen, ChapinanD; McQueen, Shannon
Blair Thompson
10.91
Alamance
Fescue Hay
Helena
HCB
M
AM109-02
McQueen, Chapman T, McQueen, Shannon
Blair Thompson
5.66
Alamance
Fescue Hay
Helena
HCB
M
AM110-01
Newlin, Leonidas Blair; Newlin, Treva cBae
cBan
22.33
Alamance
Fescue Hay
Georgeville
GaB
M
AM110-02
Crutchfield, Pam; Branner, Gail F
Leonidas Newlin
3.00
Alamance
Fescue Hay
Georgeville
GaB
D
AM116-01
HVWB Family Limited Partnership
Frank Small
10.58
Alamance
Corn/Soybeans/Wheat
Georgeville
GaB
M
AM116-03
HVWB Family Limited Partnership
Frank Small
57.40
Alamance
Corn/Soybeans/Wheat
Georgeville
GaB
M
AM116-04
HVWB Family Limited Partnership
Frank Small
Alamance
Corn/Soybeans/Wheat
Georgeville
GaB
M
AM116-05
HVWB Family Limited Partnership
Frank Small
11.47
Alamance
Corn/Soybeans/Wheat
Georgeville
GaB
M
AM116-06
HVWB Family Limited Partnership
Frank Small
Alamance
Corn/Soybeans/Wheat
Georgeville
GaB
M
AM116-07
HVWB Family Limited Partnership
Frank Small
162.27
Alamance
Corn/Soybeans/Wheat
Tirzah
TaB
M
AM116-08
HVWB Family Limited Partnership
Frank Small
Alamance
Corn/Soybeans/Wheat
Tirzah
TaB
M
AM116-09
HVWB Family Limited Partnership
Frank Small
38.99
Alamance
Corn/Soybeans/Wheat
Georgeville
GaB
M
AM116-10
HVWB Family Limited Partnership
Frank Small
Alamance
Corn/Soybeans/Wheat
Georgeville
GaB
M
AM116-11
HVWB Family Limited Partnership
Frank Small
79.29
Alamance
Corn/Soybeans/Wheat
Georgeville
GaB
M
AM116-12
HVWB Family Limited Partnership
Frank Small
Alamance
Corn/Soybeans/Wheat
Georgeville
GaB
M
AM116-13
HVWB Family Limited Partnership
Frank Small
39.54
Alamance
Corn/Soybeans/Wheat
Georgeville
GaB
D
AM118-01
Stephens, Simon Ross Jr
25.19
Alamance
Fescue Hay/Pasture
Herndon
HdB
M
AM118-02
Stephens, Simon Ross Jr
12.88
Alamance
Corn/Soybeans/Wheat
Herndon
HdB
M
AM118-03
Stephens, Simon Ross Jr
15.20
Alamance
Corn/Soybeans/Wheat
Herndon
HdB
M
AM118-04
Stephens, Simon Ross Jr
17.01
Alamance
Corn/Soybeans/Wheat
Herndon
HdB
M
AM118-05
Stephens, Simon Ross Jr
9.45
Alamance
Fescue Hay/Pasture
Herndon
HdB
M
AM118-07
Stephens, Simon Ross Jr
5.05
Alamance
Fescue Hay/Pasture
Herndon
HdB
M
AM118-08
Stephens, Simon Ross Jr
8.80
Alamance
Fescue Hay/Pasture
Herndon
HdB
M
AM118-09
Stephens, Simon Ross; Rogers, Sylvia Stephen
s
17.92
Alamance
Fescue Hay/Pasture
Altavista
Aa
M
AM119-01
Kiser, Nelda Lee Stephens
19.88
Alamance
Fescue Hay
Herndon
HdB
M
AM119-02
Kiser, Nelda Lee Stephens
16.71
Alamance
Fescue Hay
Herndon
HdB
D
AM120-01
rartner, Max Russell; Cartner Deboar
3.4
Alamance
Fescue Hay/Pasture
Helena
HCB
D
AM121-01
Cashwell, Edgar All Irrevocable
Trust
$.71
Alamance
Fescue Hay/Pasture
Helena
HCB
FORM: LASC 06-16 Page 5

LAND APPLICATION SITE CERTIFICATION
D
AM123-01
Wright, Stephen D; Wright, Angelica J
4.34
Alamance
Fescue Hay/Pasture
Durham
DdB
M
AM125-01
McPherson, Billy; McPherson Joann
15.71
Alamance
Corn/Soybeans/Small Grain
Georgeville
GaB
M
A 4125-02
McPherson, Billy; McPherson Joann
6.39
Alamance
Corn/Soybeans/Small Grain
Tirzah
TaB
M
AM125-03
McPherson, Billy; McPherson Joann
10.32
Alamance
Corn/Soybeans/Small Grain
Georgeville
GaB
M
AM125-04
McPherson, Billy; McPherson Joann
4.26
Alamance
Fescue Hay
Tirzah
TaB
M
AM126-01
B Seven Farms LLC
5.34
Alamance
Fescue Hay
Durham
DdB
M
AM126-02
B Seven Farms LLC
4.94
Alamance
Fescue Hay
Georgeville
GaB
M
AM126-03
B Seven Farms LLC
25.90
Alamance
Fescue Hay/Pasture
Georgeville
GaB
M
AM126-05
Fogleman, Larry L; Fogleman, Connie F
6.47
Alamance
Fescue Hay/Pasture
Durham
DdB
M
AM126-06
Fogleman, Larry L; Fogleman, Connie F
7.62
Alamance
Fescue Hay/Pasture
Durham
DdB
M
AM126-07
Fogleman, Larry L, Fogleman, Connie F
5.6
Alamance
Fescue Hay/Pasture
Georgeville
GaB
M
AM126-08
Fogleman, Travis Chad
12.24
Alamance
Fescue Hay/Pasture
Durham
DdB
D
AM126-09A
Ashley, Thomas Alvah
6.16
Alamance
Fescue Hay/Pasture
Appling
AdB2
M
AM126-09B
Ashley, Thomas Alvah
6.22
Alamance
Fescue Hay/Pasture
Appling
AdB2
M
AM126-IOA
Ashley, Thomas Alvah
15.32
Alamance
Fescue Hay/Pasture
Davidson
DbB
M
AM126-IOB
Ashley, Thomas Alvah
12.58
Alamance
Fescue Hay/Pasture
Davidson
DbB
D
AM127-01
Felton, Gene T; Thompson Sabert; Larry P
Norwood Reversible Living Trust
Blair Thompson
8.67
Alamance
Fescue Hay/Pasture
Helena
HcB
M
CS18-01
Allred, Delmar W.
Simmons, Dennis A
28.42
Caswell
Fescue Hay/Pasture
Enon
EnB
M
CS36-06
Simmons, Dennis A
22.76
Caswell
Fescue Hay/Pasture
Frogsboro
FgB
M
CS36-07
Simmons, Dennis A
17.45
Caswell
Fescue Hay/Pasture
Frogsboro
FgB
M
CS36-08
Simmons, Dennis A
11.78
Caswell
Fescue Hay/Pasture
Frogsboro
FgB
M
CS36-09
Simmons, Dennis A
8.76
Caswell
Fescue Hay/Pasture
Frogsboro
FgB
M
CS36-10
Simmons, Dennis A
14.26
Caswell
Fescue Hay/Pasture
Frogsboro
FgB
M
CS36-11
Simmons, Dennis A
18.09
Caswell
Fescue Hay/Pasture
Frogsboro
FgB
M
CS36-12
Simmons, Dennis A
24.73
Caswell
Fescue Hay/Pasture
Frogsboro
FgB
M
CS113-01
Kirby, Elizabeth Simmons
Tony Kirby
14.87
Caswell
Fescue Hay/Pasture
Frogsboro
FgB
M
CS113-02
Kirby, Elizabeth Simmons
Tony Kirby
13.02
Caswell
Fescue Hay/Pasture
Cullen
CuB2
M
CS113-03A
Cox, Linda Simmons
Tony Kirby
11.55
Caswell
Fescue Hay
Cullen
CuB2
M
CS113-03B
Cox, Linda Simmons
Tony Kirby
9.19
Caswell
Corn/Soybeans/Grain
Cullen
CuB2
FORM: LASC 06-16 Page 6

LAND APPLICATION SITE CERTIFICATION
D
CS113-04
Franklin, Janice Simmons; Steele, Almeria
Simmons
22.05
Caswell
Fescue Hay/Pasture
Cullen
CuB2
M
CS113-05
Cox, Linda Simmons
Tony Kirby
8.40
Caswell
Corn/Beans/Small Grain
Vance
VaB2
D
CS117-02
Randleman, Chad
10.40
Caswell
Fescue Hay/Pasture
Enon
EBB
D
CS117-03
Randleman, Chad
25.80
Caswell
Fescue Hay/Pasture
Frogsboro
FgB
D
CS117-04
Randleman, Chad
10.20
Caswell
Fescue Hay/Pasture
Enon
EBB
D
CS117-05
Randleman, Chad
23.10
Caswell
Fescue Hay/Pasture
Frogsboro
FgB
D
CH001-01
Cooper, Sandra Petty
22.99
Chatham
Fescue Hay/Pasture
Lignum
Lg
D
CH001-02
dra
Hinshaw, Kaye Petty;Robert co Robert
Petty;Cooper,g
L
12.32
Chatham
Fescue Hay/Pasture
Li num
g
L
M
CH039-01
Brewer, James B; Brewer, Jenny P
14.65
Chatham
Fescue Hay/Pasture
Georgeville
GaB
M
CH039-02
Brewer, James B; Brewer, Jenny P
12.59
Chatham
Fescue Hay/Pasture
Georgeville
GaB
M
CH039-03
Brewer, James B; Brewer, Jenny P
16.17
Chatham
Fescue Hay/Pasture
Cid-Lignum
CmB
M
CH039-04
Brewer, James B; Brewer, Jenny P
16.98
Chatham
Fescue Hay/Pasture
Georgeville
GaB
M
CH040-01
Brewer, Brian L; Brewer, James B
35.84
Chatham
Fescue Hay/Pasture
Georgeville
GaB
D
CH095-01
Moon, Gary H.
16.9
Chatham
Fescue Hay/Pasture
Nanford Badin
NaD
D
CH095-02
Moon, Gary H.
9.1
Chatham
Fescue Hay/Pasture
Georgeville
GeB2
D
CH095-03
Moon, Gary H.
10.96
Chatham
Fescue Hay/Pasture
Georgeville
GeB2
D
CH095-04
Moon, Gary H.
10.54
Chatham
Fescue Hay/Pasture
Cid-Lignum
CmB
D
CH095-05
Moon, Gary H.
15.56
Chatham
Fescue Hay/Pasture
Cid-Lignum
CmB
D
CH095-06
Moon, Gary H.
7.69
Chatham
Fescue Hay/Pasture
Georgeville
GeB2
M
CH098-01
Brookbank, William x, Brookbank, Brenda
Robert Cooper
.96
Chatham
Fescue Hay/Pasture
Cid-Lignum
CmB
M
CH098-02
Brookbank, William x, Brookbank, Brenda
Robert Cooper
4.84
Chatham
Fescue Hay/Pasture
Badin-Tarrus
BdB
M
CH098-03
Brookbank, William x, Brookbank, Brenda
Robert Cooper
7.78
Chatham
Fescue Hay/Pasture
Cid-Lignum
CmB
M
CH098-04
Brookbank, William x, Brookbank, Brenda
Robert Cooper
11.53
Chatham
Fescue Hay/Pasture
Badin-Tarrus
BdB
M
CH098-05
Brookbank, William x, Brookbank, Brenda
Robert Cooper
5.19
Chatham
Fescue Hay/Pasture
Badin-Tarrus
BdB
M
CH098-06
Brookbank, William x, Brookbank, Brenda
Robert Cooper
8.87
Chatham
Fescue Hay/Pasture
Cid-Lignum
CmB
M
CH098-07
Brookbank, William x, Brookbank, Brenda
Robert Cooper
12.06
Chatham
Fescue Hay/Pasture
Cid-Lignum
CmB
M
CH098-08
Brookbank, William x, Brookbank, Brenda
Robert Cooper
15.61
Chatham
Fescue Hay/Pasture
Cid-Lignum
CmB
M
CH098-09
Brookbank, William x, Brookbank, Brenda
Robert Cooper
24.12
Chatham
Fescue Hay/Pasture
Cid-Lignum
CmB
M
CH098-10
Brookbank, William x, Brookbank, Brenda
Robert Cooper
30.99
Chatham
Fescue Hay/Pasture
Cid-Lignum
CmB
FORM: LASC 06-16 Page 7

LAND APPLICATION SITE CERTIFICATION
M
CH251-01
Lutterloh, Charles S
22.03
Chatham
Fescue Hay/Pasture
Nanford
NaB
M
CH251-02
Lutterloh, Charles E
5.76
Chatham
Fescue Hay/Pasture
Georgeville
GaB
M
CH251-03
Holt, Donna L
26.40
Chatham
Fescue Hay/Pasture
Georgeville
GaB
M
CH251-04
Holt, Donna L
4.49
Chatham
Fescue Hay/Pasture
Nanford
NaB
M
CH251-05
Holt, Donna L
12.53
Chatham
Fescue Hay/Pasture
Nanford
NaB
D
OR07-OIA
Kimrev, Ervin M Jr,Kimrey, Carla B
3.20
Orange
Fescue Hay/Pasture
Herndon
HrB
D
OR07-01 B
Kimrev, Ervin M Jr, Kimrev, Carla B
7.70
Orange
Fescue Hay/Pasture
Herndon
HrB
D
OR07-02
Kimrev, Ervin M Jr, Kimrev, Carla B
18.80
Orange
Fescue Hay/Pasture
Herndon
HrB
D
OR022-01
Foust Brother's Dairy LLC
12.80
Orange
Fescue Hay/Pasture
Herndon
HrB
D
OR022-02
Foust Brother's Dairy LLC
36.90
Orange
Fescue Hay/Pasture
Georgeville
GeB
D
OR064-01
Thom's Creek Farm, LLC
Thompson, Andy
33.52
Orange
Fescue Hay/Pasture
Georgeville
GeB
D
OR064-03
Thom's Creek Farm, LLC
Thompson, Andy
15.82
Orange
Fescue Hay/Pasture
Georgeville
GeB
D
OR064-04
Thom's Creek Farm, LLC
Thompson, Andy
21.43
Orange
Fescue Hay/Pasture
Georgeville
GeB
D
OR064-05
Thom's Creek Farm, LLC
Thompson, Andy
17.27
Orange
Fescue Hay/Pasture
Georgeville
GeB
D
OR064-06
Thom's Creek Farm, LLC
Thompson, Andy
14.08
Orange
Fescue Hay/Pasture
Georgeville
GeB
D
OR064-07
Thom's Creek Farm, LLC
Thompson, Andy
18.47
Orange
Fescue Hay/Pasture
Georgeville
GeB
D
OR064-08
Thom's Creek Farm, LLC
Thompson, Andy
23.43
Orange
Fescue Hay/Pasture
Georgeville
GeB
D
OR064-10
Thom's Creek Farm, LLC
Thompson, Andy
7.83
Orange
Fescue Hay/Pasture
Georgeville
GeB
D
OR064-11
Thompson, James Andrew, Thompson,
Susan Michelle
Thompson, Andy
8.47
Orange
Fescue Hay/Pasture
Herndon
HrB
D
OR064-12
Thom's Creek Farm, LLC
Thompson, Andy
22.79
Orange
Fescue Hay/Pasture
Georgeville
GeB
D
OR064-13
Thompson, James C, Thompson, Bettv A
Thompson, Andy
31.06
Orange
Fescue Hay/Pasture
Georgeville
GeB
D
OR064-14
Thom's Creek Farm, LLC
Thompson, Andy
27.98
Orange
Fescue Hay/Pasture
Lignum
Lg
D
OR079-01
Sykes Family Limited Partnership
7.45
Orange
Corn/Beans/Small Grain
Georgeville
GeB
D
OR079-02
Sykes Family Limited Partnership
17.83
Orange
Fescue Hay/Pasture
Georgeville
GeB
D
OR079-03
Sykes Family Limited Partnership
20.73
Orange
Corn/Beans/Small Grain
Herndon
HrB
D
OR079-04
Sykes Family Limited Partnership
15.42
Orange
Fescue Hay/Pasture
Herndon
HrB
D
OR079-05
Sykes Family Limited Partnership
23.89
Orange
Fescue Hay/Pasture
Georgeville
GeB
D
OR079-06
Sykes Family Limited Partnership
9.63
Orange
Corn/Beans/Small Grain
Herndon
HrB
FORM: LASC 06-16 Page 8