WQ0014543_2022 Residual Annual Report_20230103 (2)

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* 2022
Permit Number (IR) * WQ0014543
ApplicantlPermittee City of Statesville
Email Notifications
Does this need review by the hydrogeologist?* Yes No
Regional Office Mooresville
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* Ken Galloway
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*
7048783438
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: *
WQ0014543
Has Current Existing permit number
Applicant/Permittee Address*
PO Box 1111 Statesville, NC 28687
Facility Name*
City of Statesville Class B Residuals Program
Please provide comments/notes on your current submittal below.
At this time, paper copies are no longer required. If you have any questions about what is required, please contact Nathaniel Thornburg
at [e-mail].
Please attach all information required or requested for this submittal to be reviewed here.
(Application Form, Engineering Plans, Specifications, Calculations, Etc.)
D00010323-01032023080921.pdf 211.99KB
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
Bil �4�IOX�
Submission Date 1/3/2023

January 3, 2023
Attention: NCDWR
Water Quality Non -Discharge Permitting Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1636
RE: Annual Report for 2022
City of Statesville Land Application (WQ0014543)
To Whom It May Concern:
Enclosed, you will find a copy of the required forms and lab data for the City of Statesville Land
Application, pennit #WQ0014543. This land application program has never been utilized. However, the
City of Statesville wishes to keep this permit active in case of an emergency.
This permit was compliant for the year.
Should you require more infomtation, or if further action is required, please contact me at 704- 878-3438,
Sincer I
Ken Galloway
WWTP Supervisor, Fourth Creek WWTP

GENERAL INFORMATION
LAND APPLICATION
CALENDAR YEAR 2022
Permit No. WQ0014543
FACILITY NAME: Fourth Creek WWTP-NPDES NCO031836
Third Creels WWTP-NPDES NCO020591
LOCATION: 693 Bell Fann Rd.
444 Third Creek Rd.
MAILING ADDRESS: P. O. Box I I I I
Statesville, NC 28687-1111
[phone]
[phone]
RESPONSIBLE OFFICIAL: Andy Smith, Operations Manager
Dept. of Water Resow•ees
P.O. Box i 111
Statesville, NC 28687-1111
[phone]
FACILITY OPERATOR: Ken Galloway
P.O. Box 1111
Statesville, NC 28687-111 1
[phone]
RESIDUALS ORC: Ken Galloway
P.O.Box IIII
Statesville, NC 28687-1111
[phone]
APPLICATION: Land Application
No Residuals land applied in 2022.

ANNUAL LAND APPLICATION CERTIFICATION FORM
WQ Permit#: WQ0014543
County:
Iredell
Year: 2022
Facility Name (as shown on permit):
Land Application Operator:
Fourth Creek WWTP
Ken Galloway Phone: [phone]
Land application of residuals as allowed by the permit occurred (luring the past calendar year?
❑ Yes R1 No - If No, skip Part A, and Part B and proceed to Part C. Also, If residuals were
generated but not land applied, please attach an explanation on how the residuals were handled.
- tcesruuais ADDucation
I Total number of application fields in the oermit:l I
Total number of fields utilized for land application during the year:
Total amount of dry tons applied during the year for all application sites:
Total number of acres utilizes for land application during the year:
Part B - Annual Compiance Statement:
Facility was compliant during calendar year 2022 with all conditions of the land application permit
(including but not limited to items 1-13 below-) issued by the Division of Water Quality. ❑ Yes ❑ No
If no please, provide a written description why the facility was not compliant, the dates, and explain corrective action
taken.
1) Only residuals approved for this permit were applied to the permitted sites.
2) Soil pH was adjusted as specified in the permit and lime was applied (if needed) to achieve a soil pH of at least 6.0 or
the limit specified in the permit.
3) Annual soils analysis were performed on each site receiving residuals during the past calendar year and three (3) copies
of laboratory results are attached.
4) Annual TCLP analysis (if required) was performed and three (3) copies of certified laboratory results are attached.
5) All other monitoring was performed in accordance with the permit and reported during the year as required and three
(3) copies of certified laboratory results are attached.
6) The facility did not exceed any of the Pollutant Concentration Limits in 15A NCAC 02T .1105(a) or the Pollutant
Loading Rates in 15A NCAC 02T .1 105(b) (applicable to 40 CFR Part 503 regulated facilities).
7) All general requirements in as specified in the Land Application Permit were complied with (applicable to 40 CFR Part
503 regulated facilities).
8) All monitoring and reporting requirements in 15A NCAC 02T . 111 1 were complied with (applicable to 40 CFR Part
503 regulated facilities).
9) All operations and maintenance requirements in the permit were complied with or, in the case of a deviation, prior
authorization was received from the Division of Water Quality.
10) No contravention of Ground Water Quality Standards occurred at a monitoring well or explanations of violations are
attached to include appropriate actions and remediations.
11) Vegetative cover was maintained and proper crop management was performed on each site receing residuals, as
specified in the permit.
12) No runoff of residuals from the application sites onto adjacent property or nearby surface waters has occurred.
13) All buffer requirements as specified on the permit were maintained during each application of residuals.
Part C - Certification:
"I certify, under penalty of law, that the above information is, to the best of my kno-Vrledge and belief, true, accurate,
and complete. I am aware that there are significant penalties for submitting false information, including the
possibility of fines and imprisonment for knowing violations."
Permittee Name and Title�Age or print)
Signature of Preparer" v
(if different from Permittee)
* Preparer is defined in 40 CFR Part 503.9 (r) and
Signature of Permittee
Date Signature of Land Applier
Date
Date
(if different fi•om Permittee and Preparer)
15A NCAC 02T .1102 (26) DEN FORM ACF (12/2006)

4th CREBK& 3rd0REEK WWTP SLUDGE NARRATIVE
Ken Galloway
Both WWTP's generate biosolids that are currently stabilized' using an aerobic digester and clewatered
using belt press. After dew/atering,the residuals are tramsferred tothe StaUme |imestabiUizatimn
process area where the biosoUds are set aside for contract land application away from the plant site,
The contractor is Synagro and they hold permit # WQ0016247 for this. The primary method of biosolids
disposal isthe StaUmeprocess and that permit #isWQOUOG245.