WQ0003351_Modification_20230921

Initial Review
Reviewer nathaniel.thorn burg
Is this submittal an application? (Excluding additional information.) *
Yes No
Permit Number (IR) * WQ0003351
Applicant/Permittee Town of Mocksville
Applicant/Permittee Address 171 Clement Street, Mocksville, NC 27028
Is the owner in BIMS? Yes ) NO Is the facility in BIMS?
Owner Type
Facility Name
County
Fee Category Minor
Is this a complete application?*
Yes No
Signature Authority
Signature Authority Title
Signature Authority Email
Document Type (if non -application)
Email Notifications
Municipal
Town of Mocksville Class B Residuals Program
Davie
Does this need review by the hydrogeologist? * Yes No
Regional Office
CO Reviewer
Admin Reviewer
Fee Amount
Complete App Date
09/21 /2023
Yes No
$245
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
Please provide information on the person to be contacted by NDB Staff regarding electronic submittal, confirmation of receipt, and other correspondence.
Name* Brent Collins
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*
336-399-3646
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.
https://edoes.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:*
WQ0003351
Has Current Existing permit number
Applicant/Permittee *
Town of Mocksville
Applicant/Permittee Address*
171 Clement Street, Mocksville, NC 27028
Facility Name*
Town of Mocksville 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.)
Town of Mocksville Permit Modification - WQ0003351.pdf 27.91 MB
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
fftA4e&AQfd
9/14/2023

g
Permit Modification Application
For the Town of Mocksville WWTP
WQ0003351
Land Application of Residual Solids
Prepared By:
EMA Resources Inc.
755 Yadkinville Road
Mocksville, NC 27028
336-751-1441

September 13, 2023
Division of Water Resources
Water Quality Permitting Section
Non -Discharge Permitting Unit
1617 Mail Services Center
Raleigh, NC 27699-1617
RE: Permit Modification — WQ0003351
To Whom it May Concern:
EMA Resources is submitting the included permit modification for the Town of
Mocksville - WQ0003351. This modification will add 7 fields totaling 111.82 acres. A
check totaling $245 will be mailed priority mail with tracking separately.
If you have any questions concerning this modification, please contact Brent Collins —
Director of Technical Services
Respectfully,
Brent Collins
Director of Technical Services
brent.collinskemaresourcesinc.com
[phone]
Phone [phone] — Fax [phone]
755 Yadkinville Rd — Mocksville, NC 27028

Table of Contents
1) RLAP Form
a) Current Permit
2) LASC Form
a) County Commissioner Notification Information
b) Landowner Agreement
c) Vicinity Map
d) Aerial/Application Map
e) Topo Map
f) Soil Map
g) Background Soil Sample
3) Soil Scientist Evaluation

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
I. APPLICANT INFORMATION:
1. Applicant's name: Town of Mocksville
Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership Privately -Owned Public Utility
❑ Federal 0 State ® Municipal County
Signature authority's name per 15A NCAC 02T .0106: Ken Gamble Title: Town Manager
Applicant's mailing address: 171 Clement St
City: Mocksville State: NC Zip: 27028-__Wj
Telephone number: [phone] Email Address: [e-mail]
2. Consultant's name: Brent Collins License Number (for RE.): k
Affiliation: ❑ On Staff ® Retained (Firm: EMA Resources Inc.)
Consultant's mailing address: 755 Yadkinville Rd
City: Mocksville State: NC Zip: 27028-
Telephone number: [phone] Email Address: breast.collinskemaresourcesinc.com
3. Agronomist's name: License Number: 1098
Affiliation: ❑ N/A [j On Staff 0 Retained (Firm:')
Agronomist's mailing address: MR
City: `A State: Zip: W-no
Telephone number: c�_) = Email Address:
4. Soil Scientist's name: Rob Wilcox License Number: 1098
Affiliation: ❑ N/A ❑ On Staff 0 Retained (Firm: Willcox & Mabe Soil Solutions)
Soil Scientist's mailing address: 7231B Summerfield Rd
City: Summerfield State: NC Zip: 27358
Telephone number: [phone] Email Address: robp_willcoxmabesoil.com
5. Fee submitted: $395 (See Instruction B)
IL PERMIT INFORMATION:
1. Application is for (check all that apply): 0 new, 0 modified, El renewed permit
2. If this application is being submitted to renew or modify an existing permit, provide the following:
Permit number: W00003351
Date of most -recently issued permit: 07/08/2022
Date of most -recently certified Attachment A (if different than the permit): 07/08/2022
Date of most -recently certified Attachment B (if different than the permit): 10/06/2022
FORM: RLAP 06-16 Page 1 of 5

III. RESIDUALS LAND APPLICATION PROGRAM INFORMATION:
1. Residuals Processing Facility's physical address: 291 Garwood Rd
City: Mocksville State: NC Zip: 27028-.
Coordinates: Latitude: 35' 53' 30" Longitude: 80. 30' 06"
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: 250 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
50.62
56.79
12655
14197
Five -Year Maximum Adjusted
76.79
82.96
19197
20740
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
0
Hay/Pasture
212.63
Total:
212.63
Methods
Surface
212.63
Incorporation or Injection
0
Total:
212.63
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
253.1
283.94
383.94
414.8
100
126.55
141.97
191.97
207.4
150
84.36
94.65
127.98
138.27
200
63.28
70.99
95.99
103.7
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): JZ 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; I_
❑ Residuals program contains any land application site(s) that is used primarily for residuals disposal, and agricultural crop
production is of secondary importance, explain; "-'9r
❑ 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; -A
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.
R
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.
IR
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: ❑ Spray ❑ 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(n) 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
(ftZ
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
ft2
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 be 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 15A NCAC 02T .0105.
® Yes ❑ No, Explain;
I, Ken Gamble Town Manager
(Signature Authority's Name — PLEASE PRINT) (Title)
attest that this application for Town of Mocksville
(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: Ken .bl�(Sep13,2D2311:46EDT) Date: Sep 13, 2023
FORM: RLAP 06-16 Page 5 of 5

ROY COOPER
Governor
ELIZABETH S. BISER
Secretary
RICHARD E. ROGERS, JR.
Director
KENNETH W. GAMBLE — TOWN MANAGER
TOWN OF MOCKSVILLE
171 CLEMENT STREET
MOCKSVILLE, NORTH CAROLINA 27028
Dear Mr. Gamble:
NORTH CAROLINA
Environmental Quality
October 6, 2022
Subject: Permit No. WQ0003351
Town of Mocksville Class B
Residuals Program
Attachment B Certification
Davie County
In accordance with your permit major modification requests received August 25, 2022 and
September 6, 2022, we are forwarding herewith a modified Attachment B certified October 6, 2022, to the
Town of Mocksville for the subject residuals management program.
Modifications to the subject Attachment B are as follows:
➢ The transfer of Field NC-DV-008-08 from Permit No. WQ0010583, resulting in an increase of
17.09 acres.
➢ The addition of Field NC-MK-006-01, resulting in an increase of 12.79 acres.
The modified Attachment B shall be effective from the date of certification until December 31,
2028 (i.e., expiration date of the current permit), shall replace Attachment B of Permit No. WQ0003351
issued July 8, 2022, and shall be subject to the conditions and limitations as specified therein, as well as
those specified in the above -referenced permit. Please replace Attachment B of Permit No. WQ0003351
that was issued July 8, 2022, with the modified Attachment B. Please note that the Permittee shall submit
a renewal application no later than July 4, 2028.
Please note that only the maps for new land application sites are attached to this letter. It is the
Permittee's responsibility to ensure that a complete permit is created by inserting these documents into the
previously issued permit.
If any parts, requirements, or limitations contained in this certification 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. Otherwise, this certification shall be final and binding.
D ��� North Carolina Department of Environmental Quality I Division of Water Resources
512 North Salisbury Street 11617 Mail Service Center I Raleigh, North Carolina 27699-1617
NORTH CAROLINI�
oewdeM er imen,e„ai a�ainv 919,707,9000

Mr. Kenneth W. Gamble
October 6, 2022
Page 2 of 2
If you need any additional information concerning this matter, please contact Zachary Mega at
[phone] or zachM.mcRa&ncdenr.gov.
Sincerely,
Richard E. Rogers, Jr., Director
Division of Water Resources
cc: Davie County Health Department (Electronic Copy)
Winston-Salem Regional Office, Water Quality Regional Operations Section (Electronic Copy)
Brent Collins — EMA Resources (Electronic Copy)
Laserfiche File (Electronic Copy)
Digital Permit Archive (Electronic Copy

ROY COOPER
Governor
ELIZABETH S. BISER
Secretary
RICHARD E. ROGERS, JR.
Director
KENNETH W. GAMBLE — TOWN MANAGER
TOWN OF MOCKSVILLE
171 CLEMENT STREET
MOCKSVILLE, NORTH CAROLINA 27028
Dear Mr. Gamble:
NORTH CAROLINA
Environmental Quality
July 8, 2022
Subject: Permit No. WQ0003351
Town of Mocksville Class B
Residuals Program
Land Application of
Class B Residuals
Davie County
In accordance with your permit renewal request received March 31, 2022, and subsequent
additional information received June 30, 2022, we are forwarding herewith Permit No. WQ0003351 dated
July 8, 2022, to the Town of Mocksville for the continued operation of the subject residuals management
program.
Modifications to the subject permit are as follows:
➢ The removal of all fields within NC-DV-05 in Davie County, resulting in a reduction of 25.5
acres.
➢ The adjustment of acreages associated with the remaining fields to account for more accurate
mapping methods, resulting in a net change of 0.63 acres.
This permit shall be effective from the date of issuance through December 31, 2028, shall replace
Permit No. WQ0003351 issued January 8, 2018, and shall be subject to the conditions and limitations as
specified therein. The Permittee shall submit a renewal application no later than July 4, 2028.
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 that on September 1, 2018, North Carolina Administrative Code Title 15A Subchapter
02T — Waste not Discharged to Surface Waters was readopted. Accordingly, this permit incorporates the
requirements of these rules, therefore, please take the time to review this permit thoroughly.
D � North Carolina Department of Environmental Quality i Division of Water Resources
512 North Salisbury Street 11617 Mail Service Center I Raleigh, North Carolina 27699-1617
NOR�HCAROLINA
©0w0_0
or 919,707,9000

Mr. Kenneth W. Gamble
July 8, 2022
Page 2 of 2
The Division has removed the following permit conditions since the last permit issuance dated
January 8, 2018:
➢ Old Conditions L2. and L3. — These conditions have been removed because the schedules have
been met.
➢ Old Condition IL8. —This condition has been removed because there are no treatment or storage
facilities covered in this permit.
➢ Old Condition IIL10. — This condition has been removed because it is covered under the new
Condition III.10.h.
➢ Old Condition II1.13. —This condition has been removed.
➢ Old Condition VL2. — This condition has been removed because this permit is not voidable
The following permit conditions are new since the last permit issuance dated January 8, 2018:
➢ Condition IIL10.1. — Residual land application may not occur if the land application sites are
located within a WS-1 watershed pursuant to 15A NCAC 02B .0212 or within the Critical Area
of a WS-II, WS-III, or WS-IV watershed.
➢ Condition II1.1I.e. — Dedicated land sites are to have public access restricted continuously
while the land is under permit and for one year afterward. Note, there are no dedicated land
sites in the current permit.
➢ Condition VL8. — This permit shall not be renewed if the Permittee or any affiliation has not
paid the required annual fee
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. Otherwise, this permit shall be final and binding.
If you need additional information concerning this permit, please contact Erick Saunders at (919)
707-3659 or erickson.saunderskncdenr.gov.
Sincerely,
Richard E. Rogers, Jr., Director
Division of Water Resources
cc: Davie County Health Department (Electronic Copy)
Winston-Salem Regional Office, Water Quality Regional Operations Section (Electronic Copy)
Brent Collins — EMA Resources (Electronic Copy)
Protection and Enforcement Branch (Electronic Copy)
Laserfiche File (Electronic Copy)
Digital Permit Archive (Electronic Copy)

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
City of Mocksville
Davie County
FOR THE
continued operation of a residuals management program for the City of Mocksville 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 31, 2022, subsequent additional information received June 30, 2022, 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 disposal of residuals is regulated under
Title 40 Code of Federal Regulations Part 503. This permit does not exempt the Permittee from complying
with Federal Regulation 40 CFR Part 503.
This permit shall be effective from the date of issuance through December 31, 2028, shall replace Permit
No. WQ0003351 issued January 8, 2018, and shall be subject to the following conditions and limitations:
I. SCHEDULES
1. The Permittee shall request renewal of this permit on Division -approved forms no later than July 4,
2028. [15A NCAC 02T .0105(b), 02T .0109]
II. PERFORMANCE STANDARDS
The Permittee shall maintain and operate the subject residuals management program so there is no
discharge to surface waters, nor any contravention of groundwater or surface water standards. In the
event the residuals management program fails to perform satisfactorily, including the creation of
nuisance conditions due to improper operation and maintenance, the Permittee shall immediately cease
land applying residuals, take immediate corrective actions, and contact the Winston-Salem Regional
Office supervisor. [15A NCAC 02T .0108(b)(1)(A)]
2. This permit shall not relieve the Permittee of their responsibility for damages to groundwater or surface
water resulting from the operation of this residuals management program. [15A NCAC 02T
.0108(b)(1)(A)]
3. Only residuals generated by the facility listed in Attachment A are approved for land application in
accordance with this permit. [15A NCAC 02T .1101]
WQ0003351 Version 4.0 Shell Version 210928 Page 1 of 12

4. Only the fields listed in Attachment B are approved for residuals land application. [G.S. 143-
215.1(a)(9)]
5. Pollutant concentrations in residuals land applied to the sites listed in Attachment B shall not exceed
the following Ceiling Concentrations or Cumulative Pollutant Loading Rates (CPLRs), on a dry
weight basis:
Parameter
Ceiling
Concentration
Cumulative Pollutant Loading Rates
(mg/kg)
(kg/ha)
(lbs/ac)
Arsenic
75
41
36
Cadmium
85
39
34
Copper
4,300
1,500
1,338
Lead
840
300
267
Mercury
57
17
15
Molybdenum
75
N/A
N/A
Nickel
420
420
374
Selenium
100
100
89
Zinc
7,500
2,800
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. I 105(a), 02T .1105(b)]
6. Class B biological residuals shall meet the pathogen reduction requirements in 15A NCAC 02T .1106
(b). Exemptions to this requirement shall be specified in Attachment A. [15A NCAC 02T .1106(b),
02T .1106(d)]
7. Class B biological residuals shall meet one of the vector attraction reduction alternatives in 15A NCAC
02T .1107(a). Exemptions to this requirement shall be specified in Attachment A. [15A NCAC 02T
.1107(a), 02T .1107(c)]
WQ0003351 Version 4.0 Shell Version 210928 Page 2 of 12

8. The facilities and sites herein were permitted per the following setbacks:
a. Setbacks for Class B land application sites are as follows (all distances in feet):
i. Each habitable residence or place of assembly
under separate ownership:
ii. Each habitable residence or places of assembly
owned by the Permittee, the owner of the land,
or the lessee or operator of the land:
In. Each property line:
iv. Public right of way:
v. Each private or public water supply source:
vi. Surface waters such as intermittent and
perennial streams, perennial waterbodies, and
wetlands:
vii. Surface water diversions such as ephemeral
streams, waterways, and ditches:
viii. Groundwater lowering ditches where the
bottom of the ditch intersects the SHWT:
ix. Subsurface groundwater lowering systems:
x. Each well with exception of monitoring wells:
xi. Bedrock outcrops:
xii. Top of slope of embankments or cuts of two
feet or more in vertical height:
xiii. Each building foundation or basement:
xiv. Each water line:
xv. Nitrification field:
Surface Irrigation Injection /
Application Surface
by Vehicle Application Incorporation
400
400
200
0
200
0
501
150'
50'
50
50
50
100
100
100
32.8
32.8
32.8
25
25
25
25
100
25
0
100
0
100
100
100
25
25
25
15
15
15
0
15
0
0
10
0
0
20
0
' Setbacks to property lines are not applicable when the Permittee, the entity from which the
Permittee is leasing, or the entity that executed the notarized landowner agreement, owns both
parcels separated by the property line.
[I5A NCAC 02T .I 108(c)]
9. Class B land application areas shall be clearly marked on each site prior to and during any residuals
application event. [15A NCAC 02T .1110(g)]
WQ0003351 Version 4.0 Shell Version 210928 Page 3 of 12

10. 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.soll.ncsu.edi /yields/index.php). A copy
shall be kept on file and reprinted every five years in accordance with Condition IV.6.
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).
In. Certified Nutrient Management Plan as outlined by the Natural Resources Conservation
Services (MRCS). These plans must meet the USDA-NRCS 590 Nutrient Management
Standards(ftp://ftp-fc.sc.egov.usda.gov/NHQ/practice-standards/standards/590.pdf).
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(a)(1)(K)]
11. When residuals are land applied to grazed pasture, hay crop realistic nitrogen rate shall be reduced by
25%. [15A NCAC 02T .0108(b)(1)(A)]
12. If residuals 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 (lbs/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)(A)]
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)(A)]
14. Residuals land application fields permitted on or after December 30, 1983 have a compliance boundary
that is either 250 feet from the residual land application area, or 50 feet within the property boundary,
whichever is closest to the residual land application area. Any exceedance of groundwater standards
at or beyond the compliance boundary shall require corrective action. Division -approved relocation of
the compliance boundary shall be noted in Attachment B. Multiple contiguous properties under
common ownership and permitted for use as a disposal system shall be treated as a single property with
regard to determination of a compliance boundary. [15A NCAC 02L .0106(d)(2), 02L .0107(b), 02T
.0105(h), G.S. 143-215.1(1), G.S. 143-215.1(k)]
WQ0003351 Version 4.0 Shell Version 210928 Page 4 of 12

15. The review boundary is midway between the compliance boundary and the residual land application
area. Any exceedance of groundwater standards at or beyond the review boundary shall require
preventative action. [15A NCAC 02L .0106(d)(1), 02L .0108]
III. OPERATION AND MAINTENANCE REQUIREMENTS
1. The Permittee shall operate and maintain the residuals management program as anon -d 1 scharge system.
[15A NCAC 02T. I 100]
2. The Permittee shall notify the Winston-Salem Regional Office, telephone number [phone], and
the appropriate local government official (i.e., county manager, city manager, or health director) at least
two business days in advance of a site's initial residuals land application event. [15A NCAC 02T
.0108(b)(1)(A)]
The Permittee shall notify the Winston-Salem Regional Office, telephone number [phone], at
least one business day in advance of conducting any land application activity. Notification shall include
the anticipated application date, time, and field name as listed in Attachment B. Exceptions to this
requirement shall be approved by the Winston-Salem Regional Office. [15A NCAC 02T
.0108(b)(1)(A)]
4. The Permittee shall maintain a Division -approved Operation and Maintenance Plan that shall include:
a. Description of the program, and associated facilities and equipment, in sufficient detail to show
what operations are necessary for the program to function and by whom the functions are to be
conducted;
b. Description of anticipated maintenance of facilities and equipment associated with the program;
c. Include provisions for safety measures, including restriction of access to sites and equipment;
d. Spill control provisions:
I. Response to upsets and bypasses including control, containment, and remediation; and
ii. Contact information for plant personnel, emergency responders, and regulatory agencies;
e. Detailed inspection procedures:
i. Names or titles of personnel responsible for conducting inspections;
ii. Frequency and location of inspections, and procedures to assure that the selected locations and
inspection frequency are representative of the residuals management program; and
iii. Description of record keeping and actions to be taken by the inspector in the event that
noncompliance is observed;
f Detailed sampling and monitoring procedures:
I. Names or titles of personnel responsible for conducting sampling and monitoring;
ii. Description of monitoring procedures including parameters to be monitored; and
iii. Sampling frequency and procedures to assure that representative samples are 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.
[15A NCAC 02T. I I I0(a)]
WQ0003351 Version 4.0 Shell Version 210928 Page 5 of 12

5. Upon the Water Pollution Control System Operators Certification Commission's (WPCSOCC)
classification of the residuals management program, the Permittee shall designate and employ a
certified operator in responsible charge (ORC), and one or more certified operators as back-up ORCs.
The ORC or their back-up shall visit the facilities in accordance with 15A NCAC 08G 0204 and shall
comply with all other requirement in 15A NCAC 08G 0204. [15A NCAC 02T .0117, 08G .0204]
6. The Permittee shall ensure that a copy of this permit and the Division -approved Operation and
Maintenance Plan is available when land applying residuals. [15A NCAC 02T .1110(b)]
7. The Permittee shall ensure that spill control provisions are available when transporting or land applying
residuals. [15A NCAC 02T .1110(a)(4)]
8. Class B residuals shall not be stored or staged at any land application site without prior written approval
from the Division. Class B residuals approved for storage shall be stored or staged in a manner to
prevent runoff of leachate and other wastewaters generated. [ 15A NCAC 02T .1110(c), 02T .1110(e)]
9. Adequate measures shall be taken to prevent wind erosion and runoff from the land application sites
listed in Attachment B. [15A NCAC 02T .0108(b)(1)(A)]
10. Class B 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 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 100-year flood elevation, unless the residuals are injected or incorporated within a 24-
hour period following a residuals land application event;
£ During precipitation events, or within 24 hours following a rainfall event of 0.5 inches or greater
in a 24-hour period;
g. If the slope of the land is greater than 10% when liquid residuals are surface applied, or if the slope
of the land is greater than 18% when liquid residuals are injected or incorporated;
h. If the land does not have an established vegetative cover crop unless the land is a Division -approved
no -till site, or the residuals are injected, or incorporated within a 24-hour period following the
application of residuals;
i. If the vertical separation of the seasonal high water table and the depth of residuals application is
less than one foot;
j. If the vertical separation of the depth to bedrock and the depth of residuals application is less than
one foot;
k. If the application exceeds agronomic rates; or
1. If the land application sites are located within a WS-I watershed pursuant to 15A NCAC 02B .0212
or within the Critical Area of a WS-II pursuant to Sub -Item (4)(g) of Rule 15A NCAC 02B .0212,
or within the Critical Area of a WS-III or WS-IV watershed pursuant to Sub -Item (4)(h) of Rules
15A NCAC 02B .0215, and .0216.
[15A NCAC 02T .1109(a)(1)]
WQ0003351 Version 4.0 Shell Version 210928 Page 6 of 12

11. Class B land application sites shall have the following public access restrictions:
a. Public access to public contact sites shall be restricted for one calendar year 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;
c. Public access to land associated with a dedicated land application site shall be restricted
continuously while the land is permitted for active use, and for one calendar year after the final
land application of residuals.
[15A NCAC 02T .1109(a)(2)]
12. Class B land application sites shall have the following harvesting and grazing restrictions:
a. Animals shall not be allowed to graze on land for 30 calendar days after any land application of
residuals;
b. Food crops, feed crops, and fiber crops shall not be harvested for 30 calendar days after any land
application of residuals;
c. Food crops with harvested parts that touch the mixture of residuals and soil and are totally above
the land surface shall not be harvested for 14 months after any land application of residuals;
d. Food crops with harvested parts below the land surface shall not be harvested for 20 months after
any land application of residuals if the residuals remain on the land surface for four months or
longer prior to incorporation into the soil;
e. Food crops with harvested parts below the land surface shall not be harvested for 38 months after
any land application of residuals if the residuals remain on the land surface for less than four months
prior to incorporation into the soil; and
f Turf grown on land where residuals are applied shall not be harvested for one calendar year after
any land application of residuals.
[15A NCAC 02T .1109(a)(3)]
13. 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 (CNMP) shall also be considered a Nutrient
Management Plan. [15A NCAC 02T .0108(b)(1)(A), 02T .1104(c)(3)]
14. Class B residuals shall not be land applied to the fields listed in Attachment B unless the Landowner
Agreement between the Permittee and the respective field owners or lessees/operators of the land
application site is valid. The Landowner Agreements shall expire concurrent with the permit expiration
date of December 31, 2028. [15A NCAC 02T .1104(c)(4)]
WQ0003351 Version 4.0 Shell Version 210928 Page 7 of 12

IV. MONITORING AND REPORTING REQUIREMENTS
1. The Permittee shall conduct and report any Division required monitoring necessary to evaluate this
program's impact on groundwater and surface water. [15A NCAC 02T .0108(c)]
2. The residuals from each source generating facility shall be analyzed to demonstrate they are non-
hazardous under the Resource Conservation and Recovery Act (RCRA). Residuals that test or are
classified as a hazardous or toxic waste under 40 CFR Part 261 shall not be land applied. The analyses
(i.e., corrosivity, ignitability, reactivity, and toxicity characteristic leaching procedure (TCLP)) shall be
performed at the frequency specified in Attachment A, and the Permittee shall maintain these results
for five years. Any exemptions from the requirements in this condition shall be specified in Attachment
A. The TCLP analysis shall include the following parameters, and the Federal regulatory level (mg/L)
is in parentheses:
Arsenic (5.0)
1,4-Dichlorobenzene (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)
Heptachlor (and its epoxide)
0.008
Tetrachloroethylene (0.7)
Chlorobenzene (100.0)
Hexachlorobenzene (0.13)
Toxaphene (0.5)
Chloroform (6.0)
Hexachlorobutadiene (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)
214,5-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]
WQ0003351 Version 4.0 Shell Version 210928 Page 8 of 12

The residuals from each source generating facility shall be analyzed at the frequency specified in
Attachment A, and the Permittee shall maintain the results for a minimum of five years. Each 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. The monitoring results shall specify the
stabilization process utilized, and demonstrate compliance with the Class B pathogen reduction
requirements in 15A NCAC 02T .1106(b), and one vector attraction reduction requirement in 15A
NCAC 02T .1107(a) shall be met. Any exemptions from the requirements in this condition shall be
specified in Attachment A. [15A NCAC 02T .1106(b), 02T .1107(a), 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 that received residuals during the calendar year. This
analysis shall be in accordance with the soil sampling guidance located in the Sampling Instructions
section of the NC Department of Agriculture & Consumer Services' website
(http://www.ncagr.gov/agronomi/pubs.htm). The Permittee shall maintain these results for a period of
no less than five years, and these results shall be made available to the Division upon request. Each
Standard Soil Fertility Analysis shall include the following parameters:
Acidity
Exchangeable Sodium Percentagc
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 .1I I I(d)]
6. Representative samples of residuals that are prepared for land application shall be collected and
analyzed. [15A NCAC 02T .1111(a)]
WQ0003351 Version 4.0 Shell Version 210928 Page 9 of 12

7. The Permittee shall maintain records for all residual land application events. These records shall
include the following:
a. Residuals source (as listed in Attachment A);
b. Date of application;
c. Location of land application (field name as listed in Attachment B);
d. Approximate acreage applied;
e. Method of application;
f. Weather conditions;
g. Dominant soil series;
h. Soil conditions;
i. Proposed crop;
j. Nitrogen Application Rate based on RYES;
k. Volume of residuals applied per acre in gallons, cubic yards, dry tons, or wet tons;
1. Volume of animal waste or other nutrient source applied per acre in gallons, cubic yards, dry tons,
or wet tons;
in. Volume of soil amendments applied per acre in gallons, cubic yards, dry tons, or wet tons; and
n. Annual and cumulative totals applied to each field for the following:
I. Class A and Class B residuals (dry tons per acre);
ii. Animal waste and other sources of nutrients (dry tons per acre);
iii. Heavy metals as specified in Condition IL5. (pounds per acre);
iv. Plant available nitrogen (pounds per acre); and
v. Phosphorus (pounds per acre).
[I5A NCAC 02T .0108(c)]
8. One hard copy and one electronic copy of an annual report shall be submitted on or before March 1st
The annual report shall meet the requirements described in the Instructions for Residuals Application
Annual Reporting Forms. Instructions for reporting and annual report forms are available at
hlt 2:Hdeg.nc.gov/about/divisions/water-resources/water-resources-permits/wastewater-branch/non-
discharge-permitting-unit/reporting-forms, or can be obtained by contacting the Non -Discharge Branch
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 .1111(d)]
9. Noncompliance Notification
The Permittee shall report to the Winston-Salem Regional Office, telephone number [phone],
within 24 hours of first knowledge of the:
a. Any process unit failure (e.g., mechanical, electrical, etc.) rendering the facility incapable of
adequate residual treatment.
b. Any failure resulting in a discharge to surface waters.
c. Any time self -monitoring indicates the program has gone out of compliance with its permit
limitations.
d. Land application of residuals abnormal in quantity or characteristic.
e. Any discharge from a vehicle or piping system transporting residuals.
Emergencies requiring reporting outside normal business hours shall call the Division's Emergency
Response personnel at telephone number [phone], [phone], or [phone]. All
noncompliance notifications shall file a written report to the Winston-Salem Regional Office within
five days of first knowledge of the occurrence, and this report shall outline the actions proposed or
taken to ensure the problem does not recur. [15A NCAC 02T .0108(b)(1)(A)]
WQ0003351 Version 4.0 Shell Version 210928 Page 10 of 12

V. INSPECTIONS
1. The Permittee shall perform inspections and maintenance to ensure proper operation of the Permittee's
storage, distribution, and application facilities. [15A NCAC 02T .1110(f)]
2. The Permittee shall inspect the Permittee's residuals storage, transport, and application facilities to
prevent malfunctions, facility deterioration, and operator errors that may result in discharges of wastes
to the environment, threats to human health, or public nuisances. The Permittee shall maintain an
inspection log that includes the date and time of inspection, observations made, and 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)(1)(A), 02T .I I I0(f)]
Division authorized representatives may, upon presentation of credentials, enter and inspect any
property, premises, or place related to the land application sites or facilities permitted herein at any
reasonable time for determining compliance with this permit. Division authorized representatives may
inspect or copy records 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 a
Division enforcement action. [G.S. 143-215.6A, 143-215.613, 143-215.6C]
2. This permit is effective only with respect to the nature and volume of wastes described in the permit
application, and Division -approved plans and specifications. [G.S. 143-215.1(d)]
3. Unless specifically requested and approved in this permit, there are no variances to administrative codes
or general statutes governing the construction or operation of the facilities permitted herein. [15A
NCAC 02T .0105(n)]
4. The issuance of this permit does not exempt the Permittee from complying with all statutes, rules,
regulations, or ordinances that other jurisdictional government agencies (e.g., local, state, and federal)
may require. [15A NCAC 02T .0105(c)(6)]
If the permitted residuals program change ownership, or the Permittee changes their name, the
Permittee shall submit a permit modification request on Division -approved forms. The Permittee shall
comply with all terms and conditions of this permit until the permit is transferred to the successor -
owner. [G.S. 143-215.1(d3)]
WQ0003351 Version 4.0 Shell Version 210928 Page 11 of 12

6. This permit is subject to revocation or modification upon 60-day notice from the Division Director, in
whole or part for:
a. violation of any terms or conditions of this permit or Administrative Code Title 15A Subchapter
02T;
b. obtaining a permit by misrepresentation or failure to disclose all relevant facts;
c. the Permittee's refusal to allow authorized Department employees upon presentation of credentials:
I. to enter the Permittee's premises where a system is located or where any records are required
to be kept;
ii. to have access to any permit required documents and records;
iii. to inspect any monitoring equipment or method as required in this permit; or
iv. to sample any pollutants;
d. the Permittee's failure to pay the annual fee for administering and compliance monitoring; or
e. a Division determination that the conditions of this permit are in conflict with North Carolina
Administrative Code or General Statutes.
[15A NCAC 02T .0110]
7. Unless the Division Director grants a variance, expansion of the facilities permitted herein shall not
occur if any of the following apply:
a. The Permittee or any parent, subsidiary, or other affiliate of the Permittee has been convicted of
environmental crimes under G.S. 143-215.613, or under Federal law that would otherwise be
prosecuted under G.S. 143-215.613, and all appeals of this conviction have been abandoned or
exhausted.
b. The Permittee or any parent, subsidiary, or other affiliate of the Permittee has previously abandoned
a wastewater treatment facility without properly closing the facility.
c. The Permittee or any parent, subsidiary, or other affiliate of the Permittee has not paid a civil
penalty, and all appeals of this penalty have been abandoned or exhausted.
d. The Permittee or any parent, subsidiary, or other affiliate of the Permittee is currently not compliant
with any compliance schedule in a permit, settlement agreement, or order.
e. The Permittee or any parent, subsidiary, or other affiliate of the Permittee has not paid an annual
fee.
[15A NCAC 02T .0120(b), 02T .0120(d)]
8. This permit shall not be renewed if the Permittee or any affiliation has not paid the required annual fee.
[15A NCAC 02T .0120(c)]
Permit issued this the 8tn day of July 2022
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
- 7"� �D' ST��� —
Richard E. Rogers, Jr., Director
Division of Water Resources
By Authority of the Environmental Management Commission
Permit Number WQ0003351
WQ0003351 Version 4.0 Shell Version 210928 Page 12 of 12

ATTACHMENT A — APPROVED RESIDUAL SOURCES
Town of Mocksville
Certification Date: July 8, 2022
Permit Number: WQ0003351 Version: 4.0
Monitoring
Monitoring
Monitoring
Permit
Biological
Maximum
Frequency for
Frequency for
Frequency for
Approved
Owner
Facility Name
County
Number
Residuals
Dry Tons
Non -hazardous
Metals and
Pathogen &
Mineralization
per Year 1
Characteristics
Nutrients
Vector Attraction
Rate
Reductions a, 5
Town of Mocksville
Dutchman's Creek WWTP
Davie
NCO021491
Yes
250
Annually
Annually
Annually
0.3
Total
250
1. Maximum Dry Tons per Year is the amount of residuals approved for land application from each permitted facility.
2. Analyses to demonstrate that residuals are non -hazardous (i.e., TCLP, ignitability, reactivity, and corrosivity) as stipulated under permit Condition IV.2.
3. Testing of metals and nutrients as stipulated under permit Condition IV.3.
4. Analyses of pathogen reductions as stipulated under permit Condition IVA.
5. Monitoring frequencies are based on the actual dry tons applied per year using the table below, unless specified above.
Dry Tons Applied
Monitoring Frequency
Dry Tons Applied (metric tons)
(short tons per year)
(40 CFR 503 and 15A NCAC 02T
.1111 c
< 290
< 319
Once per year (Annually)
> 290 to < 1,500
> 319 to < 1,650
Once per quarter (4 x Year)
> 1,500 to < 15,000
> 1,650 to < 16,500
Once per 60 days (6 x Year)
> 15,000
> 16,500
Once per month (12 x Year)
If no land application events occur during a required sampling period (e.g., no land application occur during an entire year when annual monitoring is required), then no sampling data is
required during the period of inactivity. The annual report shall include an explanation for missing sampling data. Those required to submit the annual report to United States Environmental
Protection Agency (US EPA) may be required to make up the missed sampling. Contact the US EPA for additional information.
WQ0003351 Version 4.0 Attachment A Page 1 of 1

ATTACHMENT B — APPROVED LAND APPLICATION SITES
Town of Mocksville Class B Residual Program
Certification Date: October 6, 2022
Permit Number: WQ0003351 Version: 4.1
Field
Owner
Lessee
County
Latitude
Longitude
Net Acreage
Dominant Soil Series
Footnotes
NC-DV-008-01
Spillman, Roger P.; Spillman, Deborah A.
Davie
35.851333'
-80.532053'
22.92
Ce132 - Cecil
1
NC-DV-008-08
Spillman, Roger P.
Davie
35.864378'
-80.552880°
17.09
MrB2 - Mecklenburg
5,7
NC-DV-011-01
Dooley, Gregory Wesley
Davie
35.911097'
-80.640439°
10.39
CE32 - Clifford
2
NC-DV-011-02
Dooley, Gregory Wesley
Davie
35.911472°
-80.638861'
12.79
FeC2 - Fairfield
2
NC-MK-001-01
Clarence B. Rupard Heirs
Davie
35.878708'
-80.506408'
4.07
GnB2 - Gaston
3
NC-NM-001-02
Rupard, C. B. & Sons, Inc.
Davie
35.874953'
-80.506653'
12.04
MsB - Mocksville
3
NC-NM-005-01
Town of Mocksville
Davie
35.859011'
-80.578881'
4.12
Ce132 - Cecil
4
NC-NM-005-02
Town of Mocksville
Davie
35.858931'
-80.577906°
4.6
C132 - Clifford
4
NC-NM-006-01
Whitaker, Kenneth R.; Whitaker, Irene C.
Davie
35.888060°
-80.628060°
12.79
EnB - Enon
6
Total
100.81
1-6. See Figures 1-6, respectively.
7. A re -defined compliance boundary has been approved for this land application site. This re -defined compliance boundary is located 50 feet from the water supply well on the property. Note that
the 100-foot setback between wells and the land application area shall still be met.
WQ0003351 Version 4.1 Attachment B Page 1 of 1

LAND APPLICATION SITE CERTIFICATION
Applicant's name: Town of Mocksville
Land application sites currently certified: 100.81 net acres and Total to be certified: 212.63 net acres.
L LAND APPLICATION SITE INFORMATION (See Instruction B):
Status
Codes
Site/Field
ID
Landowners
O
Lessees or Operator(s)
O
Net Acres
County
ry
Crop(s) s
PO
Predominant Soil
Series Nameb
Mapping Unit
or Rep. Slope°
N
DV-13-01
Bonnie Miller
10.68
Davie
Fescue
Tomlin
ToB2
N
DV-13-02
Bonnie Miller
7.61
Davie
Fescue
Pacolet
PcB2
N
DV-13-03
Bonnie Miller
15.47
Davie
Fescue
Pacolet
PcB2
N
DV-14-01
Virginia Myers
35.01
Davie
Fescue
Pacolet
PcB2
N
DV-14-02
Virginia Myers
17.48
Davie
Fescue
Rowan
RyB
N
DV-14-03
Virginia Myers
12.23
Davie
Fescue
Pacolet
PcB2
N
DV-15-01
Bob Crews
13.34
Davie
Fescue
Pacolet
PcB2
'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)
Note: Please keep the site information (I.) and waterbody information (II.) of the same field on the same page.
IL 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
NC-DV-13-01
350 54' 57"
800 27' 08"
NAD83
GPS
Nearest Second
12-102-16.5-(1) Ellsworth Creek
B
NC-DV-13-02
350 47' 47"
800 29' 54"
NAD83
GPS
Nearest Second
12-108-(19.5) South Yadkin River
C
NC-DV-13-03
350 47' 45"
800 29' 46"
NAD83
GPS
Nearest Second
12-108-(19.5) South Yadkin River
C
NC-DV-14-01
350 55' 21"
800 26' 30"
NAD83
GPS
Nearest Second
12-102-17 No Creek
C
NC-DV-14-02
350 55' 09"
800 26' 44"
NAD83
GPS
Nearest Second
12-102-17 No Creek
C
NC-DV-14-03
350 55' 04"
800 26' 57"
NAD83
GPS
Nearest Second
12-102-17 No Creek
C
NC-DV-15-01
350 47' 40"
80031' 39"
NAD83
GPS
Nearest Second
12-108-(19.5) South Yadkin River
C
Note: Please keep the site information (I.) and waterbody information (IL) of the same field on the same page.
FORM: LASC 06-16 Page 1

North Carolina Department of Environmental Quality
Pat McCrory Donald R. van der Vaart
Governor Secretary
Date: 08/17/2023
To: Name of Chairman to the Board of County Commissioners: Mark Jones
Complete mailing address: 123 South Main St.
City: Mocksville State: NC Zip: 27028
County where land application sites are located: Davie
From: Applicant's name: Town of Mocksville (on behalf of the Division of Water Resources in accordance with Session
Law 2013-340)
Contact person and title: Brent Collins — Director of Technical Services — EMA Resources Inc.
Complete mailing address: 755 Yadkinville Rd
City: Mocksville State: NC Zip: 27028
Telephone number: [phone] E-mail address: brent.collinskemaresourcesinc.com
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: [phone]
Expected date of application submission: 8/24/2023
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: [phone] \ Internet: httyflPortal.ncdenr.org/web/wg
An Equal Opportunity \ Affirmative Action Employer— Made in part with recycled paper FORM: CBN 06-16

I Complete items 1, 2, and 3.
I Print your name and address on the reverse
so that we can return the card to you.
I Attach this card to the back of the mailpiece,
or on the front if space permits.
Article Addressed to:
11,e�i{ a. eOMAF.5Sa1y4el-5
A,ocj<"0)L nJL 'Z702`d
11111111111111111111111111111111111111111111111
9590 9402 8099 2349 7263 59
Article Number {Transfer from service
5 Form 3811, July 2020 PSN 7530-02-000-9053
A. Signature
B ceived by (Printed I
t )( Lo
D. Is delivery address difft
If YES, enter delivery ,
❑ Agent
❑ Addressee
Cate of qellvery
l D
n item 17 © Yes
below: p No
3. Service Type
❑ priority Mall Express®
❑ Adult Signature
1-3RegisteredMeiITM
❑ Adult Signature Restricted Delivery
Cl Registered Mail Restricted
9(tertiiled Mai:®
Delivery
❑ certified Mail Restricted Delivery
❑ Signature ConfirmationT
❑ Collect on Delivery
❑ Signature Confirmation
❑ collect on Delivery f1lestricted Delivery
Restricted delivery
❑ Insured MM
ailatt
❑ Ensured Restricted Delivery
namestic Return Receipt
a
ari
( �I
CO
¢ w 41
i' C E
CDm c=i a a
m¢rcaaaq i6 Im
ci .u❑©❑❑❑� few es�n Icn
2fr6l E2ET 2000 02L2 120?-
Lc) to
� l U 1 6 C�fl O Cl) to M, I LO 1 LO I
will
- I L 1 0 M CD ''T C') r— r r--1 r—
LO f:a QS fa
CD , 1
I I CO r I (n I
LO I 1 N I
N 1 U l cm im LO ID
M (6
I 1
1 1 -� r 1 7 to I I l0 }+
—1 N 1• I (i ( -a M N I I N O
lii �r X U
J H r— 00 I ! a)
J } N 1 I
H Z tf) I a I 00 M C CV CD
�l H U f• I i--j I CO I 1
V} Y Z C, 1 O 1 —4 ,--r O M Q I X [� ,--r �
Z< Iza I I n a N Q O CV i I X C-3 to ,
U¢ -CD 1 I N LO O O (n 1 XOr--4
I� 07»L10 I I mN •[� -'N ••Cr 1 I QXr— M 7
Z R
i J— i I U \ ice- — 04
ri i--F I I _ i--4 ri [II zmr UCD I , �l X U W I
rf } I I CD ff3 i L N 9-- M I i .. r ICE, LU !
r. to t? M m n c0 o to a> .... 41 5 C3 I
I — «— m o �aI �G r— �[in OC m 3C o
U I 13 r L -i�� U T U U I f ?_ CD Q I
O 1 ! IZ ro W n5 m (U (Q I ! f6 i-+ R U O C!) I
i Cam) I I M:>Ti-'L16 i?`f L C L II I LZC> WQH I
CIA1 1— QL L L ) 0 U LI— 1 i-� I M Z3 O (1)?!
� � I Q 1 U •t3 C1 L S_ •• I
i I f I (a 1 (Q U r6 CL to L + H I L O Q CUM -- 1
=iy- O^ X C (D W I i +' (a U t? L H- I
L M11 LLE H C3 cc 1 1-�C>¢Q>—Q¢ !
- co ICD I L

DWR
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
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: Town of Mocksville
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)
NC-DV13-(1-3)
No
Hay/Pasture
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

L 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 terns and conditions of the permit; take necessary leachate, surface water, groundwater, or soil samples during the
tern 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.
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(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: NC-DV13-03
(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: 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 useof 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 Pennittee. to land apply residuals to the land application site(s) as specified
herein.
Landowner name: Y
Address: cL-d
City: A Li ta c e State: Zip: 27028
Phone: E-mail address: ` ., t �A
hq
e
)C, Signature: Date:
NORTH CAROLINA, - -o ( e, COUNTY
1, the undersigned Notary Public do hereby certify that n; r- A)/ el -
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 �y
Signature and seal:
My commission expires: V10,
Lessee's/Operator's Certification:
I M.
,20Z3
M. Brent Collins
NOTARY PUBLl
My Commission Expires March 30, 2026
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:
Perwittee'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.
Ken Gamble
Signing official name:
Signature. Kenneth Gambl,(S,p 13, 202311:46 EDT)
Date.
Sep 13, 2023
FORM: LOA 06-16 Page 3 of 3

The compliance boundary is established either 250 ft from the residuals application area or 50 ft within the property boundary, whichever is closest to the application area. The review boundary
is established midway between the compliance boundary and the perimeter of the residuals application area.

The compliance boundary is established either 250 ft from the residuals application area or 50 ft within the property boundary, whichever is closest to the application area. The review boundary for field DV13-03 has been
modified to allow for application up to 100 feet from on -site water supply well
Field Total Acres Applicable Acres
2 9.49 7.61
3 16.1 15.47
SCALE: 1 „ = 388 ' % ._ N-
DATE: 09-13-23
DRAWN BY: BC
�'•��� .�
)73
Well
Q
■ Off Site Dwelling
x — x - Fenceline
Buffer
Field Boundary
Q
tw = y
Property Boundary
Source: Esri, M gar, GeoE�ye, E rthstar
USDA, USGS, Aer'REM, IGN, nd the
_.._. _ Stream
GarlTlln, (c) Open%M2"Map contributors,
Town of Mocksville FIGURE NO.
EZAHAI Land Application Program 2
s ources, Inc.
oil NC-DV-13
Bonnie Miller

NCDA&CS Agronomic Division Phone: [phone] Website: www.ncagr.gov/agronomi/ Report No. FY24-SL003485
Client: Bonnie Miller Advisor: Brent Collins
Heavy Metals 1438 Fork Bixby Rd EMA Resources Inc
Advance, NC 27006 755 Yadkinville Rd
# ' Soil Report-3 Extraction Mocksville, NC 27028
_ Sampled County : Davie
Links to Helpful Information
Client ID: 546780 Advisor ID: 405413
Sampled: 07/20/2023 Received: 09/07/2023 Completed: 09/12/2023 Farm: DV13
Agronomist's Comments:
This report contains both routine soil test information as well as heavy metals data in a section labeled as Heavy Metals under soil test lab results. Using Mehlich 3 as a
soil test extractant, background levels of these metals typically seen in NC soils when analyzed are as follows: arsenic (As)- 4.5 ppm, cadmium (Cd)- 0.1 ppm, chromium
(Cr)- 0.2 ppm, lead (Pb)- 4.2 ppm, nickel (Ni)- 0.8 ppm, & selenium (Se)- 0.2 ppm (FY2005-2007). Lead levels for sample 00002 appear to be higher than typically found in
our database. Although the above metals here are not believed to pose a concern for plant growth, continue to monitor these and note where elevated above background
levels. Note any lime and fertilizer recommendations. Where soil test phosphorus (P) is very high (P-I > 100), crops will not respond to additional P applied. Please let me
know if there are any concerns. David H. Hardy, Agronomist, September 12, 2023
Sample ID: 00001
Recommendations: Lime Nutrients (lb/acre)
More
Crop (tons/acre) N P2O5 K2O Mg S Mn Zn Cu B
Information
Lime History:
1-Fescue/OGrass/Tim, M 1.7 120-200 90 0 0 0 0 0 0 0
Note: 12
2 - 0.0
Test Results [units - W/V in g/cm3; CEC and Na in meq/100 cm3; NO3-N in mg/dm3]: Soil Class: Mineral
HM% W/V CEC BS% Ac pH P-1 K-1 Ca% Mg% S-1 Mn-I Mn-All Mn-Al2 Zn-I Zn-AI Cu-I Na ESP SS-1 NO3-N
0.22 0.93 5.4 50 2.7 4.9 21 84 28 14 71 1708 1042 34 34 130 0.0
Heavy Metals (parts per million): Arsenic, 0.1 Cadmium, 0.0 Nickel, 0.1 Chromium, 0.1 Lead, 3.1 Selenium, 0.2
Sample ID: 00002
Recommendations: Lime Nutrients (lb/acre)
More
Crop (tons/acre) N P2O5 K2O Mg S Mn Zn Cu B
Information
Lime History:
1 -Fescue/OGrass/Tim, M 0.0 120-200 10 10 0 20 0 0 0 0
Note: 12
2 - 0.0
Test Results [units - W/V in g/cm3; CEC and Na in meq/100 cm3; NO3-N in mg/dm3]: Soil Class: Mineral
HM% W/V CEC BS% Ac pH P-1 K-1 Ca% Mg% S-1 Mn-I Mn-All Mn-AI2 Zn-I Zn-AI Cu-I Na ESP SS-1 NO3-N
0.36 1.24 7.1 85 1.1 6.2 59 73 65 14 23 288 187 387 387 89 0.0
North Carolina
J
Tcbatcu (rusk f umi Cixnmisslan
Reprogramming of the laboratory -information -management system that makes this report possible is being funded
through a grant from the North Carolina Tobacco Trust Fund Commission.
Thank you for using agronomic services to manage nutrients and safeguard environmental quality.
- Steve Troxler, Commissioner of Agriculture

NCDA&CS Agronomic Division Phone: [phone] Website: www.ncagr.gov/agronomi/
Report No.
FY24-SL003485
Bonnie Miller
Page 2 of 3
Heavy Metals (parts per million): Arsenic, 0.2 Cadmium, 0.1
Nickel, 0.2
Chromium, 0.2
Lead,
11.0 Selenium, 0.2
Sample ID: 00003
Lime History:
Recommendations: Lime
Crop (tons/acre) N P2O5
1-Fescue/OGrass/Tim, M 0.0 120-200 0
2 - 0.0
K2O
20
Nutrients (lb/acre)
Mg S
0 0
Mn
0
Zn
0
Cu B
0 0
More
Information
Note: 12
Test Results [units - W/V in g/cm3; CEC and Na in meq/100 cm3; NO3-N in mg/dm3]:
HM% W/V CEC BS% Ac pH P-1 K-1 Ca% Mg%
0.32 1.25 8.4 88 1.0 6.4 113 67 68 15
S-1 Mn-I
29 190
Soil Class:
Mn-All Mn-Al2
125
Mineral
Zn-I Zn-AI
472 472
Cu-I Na ESP SS-1 NO3-N
73 0.0
Heavy Metals (parts per million): Arsenic, 0.1 Cadmium, 0.1
Nickel, 0.2
Chromium, 0.3
Lead,
8.3 Selenium, 0.0

DWR
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
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: Town of Mocksville
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)
NC-DV14-(1-3)
No
Hay/Pasture
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

L 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 terns and conditions of the permit; take necessary leachate, surface water, groundwater, or soil samples during the
tern 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.
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: NC-DV14-(1-3)
(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: 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. Furthen-nore, 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:" v
Address:/53
City: State:
W
Phone: , 15 r-,- J _ E-mail address:
Zip:
o` U t1 CA
�-
Signature: +� /_ yeci � Date:
NORTH CAROLINA, . 60,v e, _ COUNTY B0-41�
I, the undersigned Notary Public do hereby certify that V r9i'+ �a Lsyl l mxye-s.
personally appeared before me this day and acknowledged the due execution of the forgoing instrument.
WITNESS my hand and official sea] this the IsfA
day of_ &S'Is f
Signature and seal:
My commission expires: 3�34�=Ca
Lessee's/Operator's Certification:
3
M. 13rent Collins
My CommWon Expires March 30, 2026
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 name: Ken Gamble
Signature: Kenneth GamhleeSepl3,z42311:46EDn Date: Sep 13, 2023
FORM: LOA 06-16 Page 3 of 3

The compliance boundary is established either 250 it from the residuals application area or 50 it within the property boundary, whichever is closest to the application area. The review boundary for field DV14-(1-2) has been
modified to allow for application up to 100 feet from on -site water supply well
-d ■
c ■- ■
N
i
_ s
i� 210
A
IIX
� I 1. �r Fr{� C••f F l .
Structure N
r,
Well
.21
Abandoned Structure
V
Field Total Acres Applicable Acres
1 43.21 35.01
2 20.57 17.48
SCALE:
1 "=440' A
DATE : 09-13-23 .GR
DRAWN BY: BC .Resources, Inc.
+� On Site Dwelling
4
IK� ■ Off Site Dwelling
R
Drain
�.
Y
— Stream
U
Field Boundary
o
1
® Buffer
U)
Q
Pond
E
�.�.�.
Esri, M ar, GeoE�ye, E rthst - ' Property Boundary
g
US_GS, Aer3MR&II IG"NNW, , nd t
Town of Mocksville
FIGURE NO.
Land Application Program
2
b
NC-DV-14
Virginia Myers

The compliance boundary is established either 250 ft from the residuals application area or 50 ft within the property boundary, whichever is closest to the application area. The review boundary for field DV14-03 has been
modified to allow for application up to 100 feet from on -site water supply well
,%
1I
3
Field Total Acres Applicable Acres
3 17.54 12.23
SCALE:
1 " = 388 ' i v�
DATE : 09-13-23 w
DRAWN BY: BC .Resources, Inc.
lip
t�
s o
'•1
............ k i
y F l
i
""���hhh t , 2 ,!•
.M P. jj,Y •
�-
1,
A Structure
Well
■ Off Site Dwelling
Drain
■
Stream
Field Boundary
® Buffer
Pond
Source: Esri, M •ar, GeoE-ye, E rthstar Property Boundary
USDA, 1KE'S AereZ01IP IG6N, ndthe �
Town of Mocksville FIGURE NO.
Land Application Program 2
NC-DV-14
Virginia Myers
E

NCDA&CS Agronomic Division Phone: [phone] Website: www.ncagr.gov/agronomi/ Report No. FY24-SL003483
Client: Mark Myers Advisor: Brent Collins
Heavy Metals 153 Bixby School Rd EMA Resources Inc
Advance, NC 27006 755 Yadkinville Rd
# ' Soil Report-3 Extraction Mocksville, NC 27028
_ Sampled County : Davie
Links to Helpful Information
Client ID: 546777 Advisor ID: 405413
Sampled: 06/27/2023 Received: 09/07/2023 Completed: 09/12/2023 Farm: DV14
Agronomist's Comments:
This report contains both routine soil test information as well as heavy metals data in a section labeled as Heavy Metals under soil test lab results. Using Mehlich 3 as a
soil test extractant, background levels of these metals typically seen in NC soils when analyzed are as follows: arsenic (As)- 4.5 ppm, cadmium (Cd)- 0.1 ppm, chromium
(Cr)- 0.2 ppm, lead (Pb)- 4.2 ppm, nickel (Ni)- 0.8 ppm, & selenium (Se)- 0.2 ppm (FY2005-2007). Lead levels for sample 00001 appear to be higher than typically found in
our database. Although the above metals here are not believed to pose a concern for plant growth, continue to monitor these and note where elevated above background
levels. This report was also flagged with a "C" and/or "Z" to alert you that copper and/or zinc have accumulated in the soil and are approaching a level that could be
detrimental to crop production. The C and Z symbols are printed on your report for soil test index levels of 2000 or more; for peanuts with zinc, the level is 300. This note is
designed to be a "trigger" that allows enough time to either reduce the rate of application or find another field for application of biosolids and/or waste water. The CTL
(critical toxic level) for Cu & Zn has been set at 3000 index; for peanuts with zinc, the level is 500. These levels are used by DENR as a benchmark to determine when
application of waste products should be stopped. The CTL for copper and zinc was set to prevent levels from accumulating to the point where they become toxic to crops
grown on a field. Note any lime and fertilizer recommendations. Where soil test phosphorus (P) is very high (P-I > 100), crops will not respond to additional P applied.
Tissue testing is advised where soil pH is elevated and where Zn and Cu levels are of concern as in samples found here. Please let me know if there are concerns. David H.
Hardy, Agronomist, Se tember 12, 2023
Sample ID: 00001
Recommendations: Lime Nutrients (lb/acre)
More
Crop (tons/acre) N P2O5 K2O Mg S Mn Zn Cu B
Information
Lime History:
1-Fescue/OGrass/Tim, M 0.0 120-200 0 0 0 0 pH$ 0 0 0
Note: 12 Note:
2 - 0.0
Test Results [units - W/V in g/cm3; CEC and Na in meq/100 cm3; NO3-N in mg/dm3]: Soil Class: Mineral
HM% W/V CEC BS% Ac pH P-1 K-1 Ca% Mg% S-1 Mn-I Mn-All Mn-Al2 Zn-I Zn-AI Cu-I Na ESP SS-1 NO3-N
0.66 1.08 17.4 95 0.9 6.8 592 220 71 18 39 380 233 1944 1944 811 0.2 1
Heavy Metals (parts per million): Arsenic, 0.1 Cadmium, 0.5 Nickel, 0.9 Chromium, 0.3 Lead, 12.3 Selenium, 0.1
North Carolina
Am.
AL
TcbaatLP IfOt f imd Cix ASSkA
Reprogramming of the laboratory -information -management system that makes this report possible is being funded
through a grant from the North Carolina Tobacco Trust Fund Commission.
Thank you for using agronomic services to manage nutrients and safeguard environmental quality.
- Steve Troxler, Commissioner of Agriculture

NCDA&CS Agronomic Division Phone: [phone] Website: www.ncagr.gov/agronomi/
Report No.
FY24-SL003483
Mark Myers
Page 2 of 3
Sample ID: 00002
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tons/acre) N P2O5
K2O
Mg S
Mn
Zn
Cu
B
Information
Lime History:
1-Fescue/OGrass/Tim, M 0.0 120-200 0
0
0 0
pH$
0
0
0
Note: 12 Note: $
2 - 0.0
Test Results [units - W/V in g/cm3; CEC and Na in meq/100 cm3; NO3-N in mg/dm3]:
Soil Class:
Mineral
HM% W/V CEC BS% Ac pH P-1 K-1 Ca% Mg%
S-1 Mn-I
Mn-All Mn-Al2
Zn-I
Zn-AI
Cu-I
Na ESP
SS-1 NO3-N
0.36 1.11 15.0 94 0.8 6.8 444 308 68 16
34 704
428
887
887
519
0.1
1
Heavy Metals (parts per million): Arsenic, 0.1 Cadmium, 0.1
Nickel, 0.4
Chromium, 0.2
Lead,
6.9
Selenium, 0.0
Sample ID: 00003
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tons/acre) N P2O5
K2O
Mg S
Mn
Zn
Cu
B
Information
Lime History:
1 -Fescue/OGrass/Tim, M 0.0 120-200 0
0
0 20
pH$
0
0
0
Note: 12 Note: $
2 - 0.0
Test Results [units - W/V in g/cm3; CEC and Na in meq/100 cm3; NO3-N in mg/dm3]:
Soil Class:
Mineral
HM% W/V CEC BS% Ac pH P-1 K-1 Ca% Mg%
S-1 Mn-I
Mn-All Mn-AI2
Zn-I
Zn-AI
Cu-I
Na ESP
SS-1 NO3-N
0.32 1.19 8.1 93 0.6 6.7 152 79 63 25
18 768
467
537
537
164
0.0
Heavy Metals (parts per million): Arsenic, 0.1 Cadmium, 0.1
Nickel, 0.3
Chromium, 0.3
Lead,
5.2
Selenium, 0.1

Waypointo
ANALYTICAL
8/8/2023
EMA Resources Inc
755 Yadkinville Road
Mocksville, NC, 27028
Ref: Analytical Testing
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 0 Fax [phone]
www.waypointanalytical.com
Report Number: 23-214-0003
Project Description: Mark Myer/DV14
Waypoint Analytical Virginia, Inc. received sample(s) on 8/2/2023 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,
&'. "- e, -k 1, 6 c: _-�
Brandi Watson
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 8

•
Waypoint
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 0 Fax [phone]
ANALYTICAL
www.waypointanalytical.com
Sample Summary Table
Report Number: 23-214-0003
Client Project Description: Mark Myer/DV14
Lab No
Client Sample ID
Matrix
Date Collected Date Received Method
Lab ID
63001
01
Solids
08/02/2023 SW-7471B
WP MTN
63001
01
Solids
08/02/2023 6010D
WP MTN
63002
02
Solids
08/02/2023 6010D
WP MTN
63002
02
Solids
08/02/2023 SW-7471B
WP MTN
63003
03
Solids
08/02/2023 SW-7471B
WP MTN
63003
03
Solids
08/02/2023 6010D
WP MTN
WP MTN - Memphis, TN: Waypoint Analytical - TN, Memphis, TN
Page 2 of 8

WayP
�' 7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 Fax [phone]
ANALYTICAL www.waypointanalytical.com
46245
EMA Resources Inc Project Mark Myer/DV14
755 Yadkinville Road Report Date : 08/08/2023
Information : Received : 08/02/2023
Mocksville , NC 27028
Brandi Watson
Report Number : 23-214-0003 REPORT OFANALYSIS
Lab No : 63001 Matrix: Solids
Sample ID : 01 Sampled:
Test Results Units MQL DF Date / Time By Analytical
Analyzed Method
Mercury <0.177 mg/Kg 0.177 1 08/07/2310:44 FDS SW-7471B
Molybdenum 1.11 mg/Kg 0.250 1 08/07/2319:18 TJS 6010D
Qualifiers/ DF Dilution Factor
Definitions
MQL Method Quantitation Limit
Page 3 of 8

WayP
�' 7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 Fax [phone]
ANALYTICAL www.waypointanalytical.com
46245
EMA Resources Inc Project Mark Myer/DV14
755 Yadkinville Road Report Date : 08/08/2023
Information : Received : 08/02/2023
Mocksville , NC 27028
Brandi Watson
Report Number : 23-214-0003 REPORT OFANALYSIS
Lab No : 63002 Matrix: Solids
Sample ID : 02 Sampled:
Test Results Units MQL DF Date / Time By Analytical
Analyzed Method
Molybdenum 0.634 mg/Kg 0.250 1 08/07/2319:23 TJS 6010D
Mercury <0.192 mg/Kg 0.192 1 08/07/2310:46 FDS SW-7471B
Qualifiers/ DF Dilution Factor
Definitions
MQL Method Quantitation Limit
Page 4 of 8

WayP
�' 7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 Fax [phone]
ANALYTICAL www.waypointanalytical.com
46245
EMA Resources Inc Project Mark Myer/DV14
755 Yadkinville Road Report Date : 08/08/2023
Information : Received : 08/02/2023
Mocksville , NC 27028
Brandi Watson
Report Number : 23-214-0003 REPORT OFANALYSIS
Lab No : 63003 Matrix: Solids
Sample ID : 03 Sampled:
Test Results Units MQL DF Date / Time By Analytical
Analyzed Method
Mercury <0.164 mg/Kg 0.164 1 08/07/2310:47 FDS SW-7471B
Molybdenum 0.276 mg/Kg 0.250 1 08/07/2319:29 TJS 6010D
Qualifiers/ DF Dilution Factor
Definitions
MQL Method Quantitation Limit
Page 5 of 8

Waypointo
ANALYTICAL
Client: EMA Resources Inc
Project: Mark Myer/DV14
Lab Report Number: 23-214-0003
Date: 8/8/2023
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 0 Fax [phone]
www.waypointanalytical.com
CASE NARRATIVE
Solids Total Mercury Analysis - CVAA Method 7471A
Sample 63000 (Lagoon #1)
Analyte: Mercury
QC Batch No: 1-697126/1-696944
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.
Page 6 of 8

WayPAoInt..
NALYTICAL
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 0 Fax [phone]
www.waypointanalytical.com
Shipment Receipt Form
Customer Number: 46245
Customer Name: EMA Resources Inc
Report Number: 23-214-0003
Shipping Method
0 Fed Ex 0 US Postal 0 Lab
0 UPS 0 Client 0 Courier
0 Other:
Thermometer ID:
Shipping container/cooler uncompromised?
* Yes
0 No
Number of coolers/boxes received
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?
# Yes
0 No
COC agrees with sample label(s)?
# Yes
0 No
COC properly completed
# Yes
0 No
Samples in proper containers?
# Yes
0 No
Sample containers intact?
# Yes
0 No
Sufficient sample volume for indicated test(s)?
# Yes
0 No
All samples received within holding time?
# 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: IDavid Lennon Date & Time: 08/02/2023 12:30:20
Page 7 of 8

P
Mocksville, NC 27028
A -cant ie 1 46245 1 Grower ID
Farm ip I D V 14 j I Field IO
hlrnrt prided If Marbiclde or ►lernatode •na m r uestad- M Herhkidr lease Indicate name of Herbicide in Add9 Info boa
If] s2Y • Add1 Teas SekrbN Addltlartal rgsrrdsd IrAsrtdsd lu --W Ituerttsse
Tests Crap Cade Crap YMd Crop Code C YINd
son
S1M - Organic Matter, Phosphorous, I'otasst urn, u.aluum. magnowum, pit, ounvi p-
62M - S1M plus any two of the fdlovwng. Sodium, Sulfate -Sulfur, Bonin, Zinc, MangarleM, irW1• Copper. Each additional test !above lwoj cost
S3M - SIM pius all of the Following Sodium, Sulfale-Sulfur, E!OM", Zinc, Man nest. Iron.
CROP CODES TO BE USED IF FERTILIZER RECOMMENDATIONS ARE REQUESTE1
if the uv for which u would like recommendations is not listed, write the uo name in the crop cods
FIELD CROPS I FORAGE CROPS
1- Barley
5. Canolarn 10. Co
11 ComlSoybeans Rotator)12, Cam - No Till
13. Cam Silage
20- Cotton
21. Callon - No Till
25. Grain Sorghum
30. Oats
32. Peanuts
34. Popcom
35. Rapeseed
36 Rice
39. Rye
45. Soybeans
46. Soybeans - No Till
51- Sugarcane - Plant
52. Sugarcane - Stubble
62. Tobacco - Butey
63. Tobacco - Dark
64 Tobacco - Flue Cured
75 Wheat
78. Wheat SilageiCom Silage
92. W heallBeans Double Crol
NCDA FORMAT
101.
Allaifa Hay
103-
AftllalCcd Season Grass Hay
106-
Aifatfamarm Season Grass Hay
116
Bahlagrass May
117
Bahiagrass Pasturem
121.
Comon Bermuda Hay
122
Common Bermuda Pasture
123.
Common BermudalLagurne Hay
124-
Common BermudalLegume Pas'
R HAY
B. OTHER PASTURE
9 CRP
161
Coastal Bermuda Hay
162-
Coastal Bermuda Pasture
172.
Cod Season Grass Pasture
173.
Cool Season Grass Hay
181.
Fescue Hay
192,
Fescue Pasture
193-
Fescue'Logume Hay
184
Fescue/Legume Pasture
307.
Beans • Lima
381- Spinach
400
Apples
309.
Beans - Snap
382. Squash
41C
Blueberries
320.
Cabbage
383- Sweet Com
420
Citrus
322.
Cantaloupe
384. Sweet Potaloitolnj
430
Grapes
330.
Cucumbers
391. Sweet Potalo(bu)
470.
Peaches
340
Garden
385 Tomatoes
475.
Pecans
369
Peppers
398. Watermelons
490.
Stra vbernes
Additional
es a
er Inlon, tion
t ese samples need to be analyzi
ercury and Molybdenum
! id
S
TURFGRA
512
Bahiagrass Lawn
^
513
Bah-agrass Sod Pr
517
Bentgrass Green
N j $
521
Bermudagrass Athl
u' N
522
Bermudagrass Fair
w w
523-
Bermudagrass Grat
524
Bermudagrass LavA
525.
Berrriudagrass Sad
526
BemAAagrass Tee
533
Bluegrass Lawn
534
Bluegrass Sod Production
546
Centipede Lawn
547-
Centipede Sod Producton
561.
Fescue Athletic Freld
563.
Fescue Lawn
564,
Fescue Sod Production
57e,
St Augustine Lawn
577.
St Augustine Sod Production
583.
Zoysiagrass -awn
554.
Zoysiagrass Sod Production
of informat'on sheaf to Waypoint Analytical, Inc 1s acceptance of our Iatms and condibons. Ail pnces aro subject to change without notice
Additional fees may be charged to dlent if sample requires additional Preparation procedures
Page 8 of 8

DWR
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
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: Town of Mocksville
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)
NC-DV15-01
No
Hay/Pasture
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

L 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 terns and conditions of the permit; take necessary leachate, surface water, groundwater, or soil samples during the
tern 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.
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(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: NC-DV15-01
(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: 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

Aft
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. ____ti
Landowner name: 1 1
Address:
City:' '��� State:.- Zip:
Phone:S (} E-ma' address:_
Signature: /.,/ Date:
NORTH CAROLINA, �, +ti e- COUNTY
[,the undersigned Notary Public do hereby certify that J24Dbe - W UA04 C.n/�
eet-► S _
personally appeared before me this day and acknowledged the due execution of the forgoing instrument.
WITNESS my hand and official sea] this the
day of My s \)c
Signature and seal:
My commission expires:
Lessee's/Operator's Certification:
,20 23
Davie Caw4 NO
My Commbsion Expires Match 30, 2026
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:
M
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:
Ken Gamble
R
Signature: Kenneth Gamble (Sep 13, 2U2311:46 EDT)
Date: Sep 13, 2023
FORM: LOA 06-16 Page 3 of 3

The compliance boundary is established either 250 ft from the residuals application area or 50 ft within the property boundary, whichever is closest to the application area. The review boundary for field DV15-01 has been
modified to allow for application up to 100 feet from on -site water supply well
G
+
� ' •i
k
1 �
w�%fie �:• a � Qa \_� �►.'.. ./ � ,dtir � 1 �' �✓..�.i
I:.Ail
f
* i- .y
�1 e
•Oslo
Ik
is , t _ , , �fY-.' + ., � I^ � •r `�'!k:
'sir. r
+
_VWell
aV
On Site Dwelling
�•�I 1�.. ems: ;,k� � 't h�
0 Off Site Dwelling
Stream
Property Boundary
Buffer
ooCao6Field:. ..
Town of • -
DATE 08-15-23 Land Application Program
AMA
—Resources, Inc. NC-DV-1 5
.... Bob
E
U
m

NCDA&CS Agronomic Division Phone: [phone] Website: www.ncagr.gov/agronomi/ Report No. FY24-SL003484
k5i I"14'4+;4, Client: Bob Crews Advisor: Brent Collins
Heavy Metals 291 Tatum Rd EMA Resources Inc
°± f' Mocksville, NC 27028 755 Yadkinville Rd
�- Soil Report Mehlich-3 Extraction Mocksville, NC 27028
Sampled County : Davie
_
Links to Helpful Information
Client ID: 546779 Advisor ID: 405413
Sampled: Received: 09/07/2023 Completed: 09/12/2023 Farm: DV15
Agronomist's Comments:
This report contains both routine soil test information as well as heavy metals data in a section labeled as Heavy Metals under soil test lab results. Using Mehlich 3 as a
soil test extractant, background levels of these metals typically seen in NC soils when analyzed are as follows: arsenic (As)- 4.5 ppm, cadmium (Cd)- 0.1 ppm, chromium
(Cr)- 0.2 ppm, lead (Pb)- 4.2 ppm, nickel (Ni)- 0.8 ppm, & selenium (Se)- 0.2 ppm (FY2005-2007). Although the above metals here are not believed to pose a concern for
plant growth, continue to monitor these and note where elevated above background levels. Note any lime and fertilizer recommendations. Please let me know if there are
any concerns. David H. Hard , Agronomist, September 12, 2023
Sample ID: 00001
Recommendations: Lime Nutrients (lb/acre)
More
Crop (tons/acre) N P2O5 K2O Mg S Mn Zn Cu B
Information
Lime History:
1-Fescue/OGrass/Tim, E 1.3 50-70 130 0 0 20 0 0 0 0
Note: 12
2 - Fescue/OGrass/Tim, M 0.0 120-200 130 40 0 20 0 0 0 0
Note: 12
Test Results [units - W/V in g/cm3; CEC and Na in meq/100 cm3; NO3-N in mg/dm3]: Soil Class: Mineral
HM% W/V CEC BS% Ac pH P-1 K-1 Ca% Mg% S-1 Mn-I Mn-All Mn-Al2 Zn-I Zn-AI Cu-I Na ESP SS-1 NO3-N
0.32 1.06 4.0 65 1.4 5.5 7 51 39 20 15 319 201 208 100 100 64 0.0
Heavy Metals (parts per million): Arsenic, 0.2 Cadmium, 0.0 Nickel, 0.1 Chromium, 0.1 Lead, 5.9 Selenium, 0.1
North Carolina
Tcbwiv Truk f and Ct wmisskm
Reprogramming of the laboratory -information -management system that makes this report possible is being funded
through a grant from the North Carolina Tobacco Trust Fund Commission.
Thank you for using agronomic services to manage nutrients and safeguard environmental quality.
- Steve Troxler, Commissioner of Agriculture

Waypointo
ANALYTICAL
8/29/2023
EMA Resources Inc
755 Yadkinville Road
Mocksville, NC, 27028
Ref: Analytical Testing
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 0 Fax [phone]
www.waypointanalytical.com
Report Number: 23-234-0003
Project Description: Bob Crews/Dvis
Waypoint Analytical Virginia, Inc. received sample(s) on 8/22/2023 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,
&'. "- e, -k L_' � c: _-�
Brandi Watson
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 [phone]
ANALYTICAL www.waypointanalytical.com
Sample Summary Table
Report Number: 23-234-0003
Client Project Description: Bob Crews/Dvis
Lab No Client Sample ID Matrix Date Collected Date Received Method Lab ID
63131 01 Solids 08/22/2023 SW-7471B WP MTN
63131 01 Solids 08/22/2023 6010D WP MTN
WP MTN - Memphis, TN: Waypoint Analytical - TN, Memphis, TN
Page 2 of 6

•
7621 0 Whitepine Road, Richmond, VA 23237
Waypoint
Main 804-743-9401 0 Fax [phone]
ANALYTICAL www.waypointanalytical.com
46245
EMA Resources Inc Project Bob Crews/Dvis
755 Yadkinville Road Report Date : 08/29/2023
Information : Received : 08/22/2023
Mocksville , NC 27028
Brandi Watson
Report Number : 23-234-0003 REPORT OFANALYSIS
Lab No : 63131 Matrix: Solids
Sample ID : 01 Sampled:
Test Results Units MQL DF Date / Time By Analytical
Analyzed Method
Mercury <0.188 mg/Kg 0.188 1 08/28/2311:20 MRE SW-7471B
Test Results Units MQL DF Date / Time By Analytical
Analyzed Method
Molybdenum
Qualifiers/ DF Dilution Factor
Definitions
<1.25 mg/Kg 1.25 5 08/28/23 21:45 TJS 6010D
MQL Method Quantitation Limit
Page 3 of 6

Waypointo
ANALYTICAL
Client: EMA Resources Inc
Project: Bob Crews/Dvis
Lab Report Number: 23-234-0003
Date: 8/29/2023
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 0 Fax [phone]
www.waypointanalytical.com
CASE NARRATIVE
Metals Analysis Method 601 OD
Sample 63131 (01)
QC Batch No: L701089/L700556
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 [phone]
www.waypointanalytical.com
Shipment Receipt Form
Customer Number: 46245
Customer Name: EMA Resources Inc
Report Number: 23-234-0003
Shipping Method
0 Fed Ex 0 US Postal 0 Lab
0 UPS 0 Client 0 Courier
0 Other:
Thermometer ID:
Shipping container/cooler uncompromised?
* Yes
0 No
Number of coolers/boxes received
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?
# Yes
0 No
COC agrees with sample label(s)?
# Yes
0 No
COC properly completed
# Yes
0 No
Samples in proper containers?
# Yes
0 No
Sample containers intact?
# Yes
0 No
Sufficient sample volume for indicated test(s)?
# Yes
0 No
All samples received within holding time?
# 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: IDavid Lennon Date & Time: 08/22/2023 08:13:25
Page 5 of 6

(D
Waypoint
ANALYTICAL SOIL SAMPLE INFORMATION SHEET
CUBTOMER INFORMATION GROV
EMA Resources Inc.
755 Yadkinville Rd.
Mocksville, NC 27028
Account N 1 46245 10rower 10
Plee►e check sam rem in column Ylded if Warble Ida or
Lab Number Sample ID I 112M
l tb UIS a chum. MaAl 81 M B I Cu I fe Iatn
�r,31� 01
millmatooe a
Aden Teen
7621 Whbtepine Road
Richmond, VA 23237
[phone] - Fax (804) 271-W6
www oln anal i I- m
5
Send Report to e-mail address, 1►rent.coilinsPcmaresaurccsi
Farm I❑ 1 6 %—j I SField Ip
Israq uested- If Herbicide, plaiiiao Ind lc ate name of Herbicide In Add'l Info bo)i below -
selubre AddM►orW li tended 'ima. ed Aawneta AtMmew Prrrlvu
Safts Tonturo M03-N Togo C Cede G Yield CropCodo Yleld CrW
a
-�o -- _..
gom—
n �
—
C
SIM - Organic Maner, Phosphorous- Potassium. Calcium, Magnesium, pH. Buffer pH
S2M S 1 M plus any two of the }snowing Scoum. Sutfata-Sulfur. Boron, Zinc. Manganese. Iron Copper Each additional
iesi
iabovt r
5310 - 51M plus all of the follows N
Sodium 5ulfate-Suffur. Boron, Zinc Manganese, Iron. Copper
CROP CODES TO BE USED IF FERTILIZER RECOMMENDATIONS ARE REQ �
If the crofor whichyou would like recommendations is not listed write the cro Hume in
the . ^'
FIELD CROPS
FORAGE CROP
I Barley
101 Alfalfa Hay 161 Coastal Bermuda Hay
c i
5. Canoia
103 AlfaftalCool Season Grass Hay 162 Coastal Bermuda Pasture
10 Corn
106 AftaftalWarrn Season Grass Hay 172. Cool Season Grass Pasture
512 Bahili w
11 CornlSoyDeans Rotation
116 Bahiagrass Hay 173 Coal Season Grass Hay
513 Bah+,
12 Corn - No Till
117 Bahiagrass Pasture 181 Fescue Hay
517. Bentg
13 Com Silage
121 Common Bermuda Hay 182 Fescue Pasture
521
eerm•
20 Cotton
122. Common Bermuda Pasture 183 FesGuelLegume Hay
522 Bermudagrass t-im, e,
21 Cotton - No Till
123- Common Berrnudafl-egurrle Hay 184 Fescue/Legume Pasture
523 Bermudagrass Green
25 Gram S oghum
124- Gammon BermudalLacume Pasture 237 Ryegrass
524 Bermudagrass Lawn
30 Oats
INDICATE TYPE OF GRASS AND/OR LEGUME
525 Bermuciagmss Sod Production
32 Peanuts
526 Bermudagrass Tee
34 Popcorn
297. OTHER HAY
533 Bluegrass Lawn
35 Rapeseed
534. Bluegrass Sod Production
36. Rice
298 OTHER PASTURE
546 Centipede Lawn
39 Rye
547 Centipede Sod Production
45 Soybeans
299. CRP
561 Fescue AthIetiC Field
46. Soybeans - No Till
VEGETABLE CROPS FRUIT d NUT CROPS
563 Fescue Lawn
51 Sugarcane - Plant
307 Beans - Lima 381 Spinach 400 Apples
564- Fescue Sod Production
52. Sugarcane - Stubble
309 Beans - Snap 382 S4uash 410 Blueberries
576- St Augustine Lawn
fit. Tobacco - Burley
320 Cabbage 383 Sweet Gorn 420 Citrus
577- St Augustine Sod Production
63 Tobacco - Dark
322. Cantaloupe 384 Sweet Potato(ton) 430 Grapes
583 Ioysiagrass Lawn
64 Tobacco - Flue Cured
330. Cucumbers 391 Sweet Potatoibuy 470 Peaches
584 Zoysia grass Sad Production
75 Wheat
340- Garden 385 Tomatoes 475 Pecans
78 Wheat SilagelCorn Silage
369- Peppers 396 Watermelons 490 Strawberries
NCDA FORMAT These samples need (o be analyzed for:
and Molybdenum
sheet to Waypoint Analytical, Ine is acceptance of our terms and condiiions All prices are subject to change without notice
Additional tees may be charged to client if sample requires additional preparation procedures
Page 6 of 6

willcox&mate
SO I L SOL U T I ON S
August 16, 2023
EMA Resources, Inc.
755 Yadkinville Road
Mocksville, North Carolina 27028
Attention: Mr. Brent Collins
Director of Technical Services
Article I. Reference: Soil Scientist Services for Permit Application
Town of Mocksville Land Application Program
WMSS Project No. 15-06, Phase: 02
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
.1104(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 11 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
/& /W4 4r/4ao�z_
Martin Mabe Rob Willcox, L.S.S.
Agronomist Soil Scientist
Attachments: Appendix I — Summary Table
Appendix II — Maps, Soil Profile Description Sheets
Shared\WMSS Projects\2015\15-06 EMA Resources\Phase 02 - Mocksville\2023 Modification\Phase 02 Soil Scientist
Report - Mocksville Land Application Program.doc
Willcox & Mabe Soil Solutions, PLLC / 7231 B Summerfield Road / Summerfield, NC 27358 / Rob 336.339.9128 or Martin
336.312.1396 / www.willcoxmabesoil.com

APPENDIX I - SUMMARY TABLE

On August 15, 2023, 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:
Project
County
Site No.
Field
No.
Predominant Soil Series /
Mapping Unit
Town of
Mocksville
Davie
NC-DV-13
1
Tomlin — ToB2
2
Pacolet — PcB2
3
Pacolet — PcB2
NC-DV-14
1
Pacolet — PcB2
2
Rowan — RyB
3
Pacolet — PcB2
NC-DV-15
1
Pacolet — PcB2
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 the Town of
Mocksville, North Carolina. All fields evaluated were found to be suitable for land
application activities. Please reference the attached maps for hand auger boring locations
(noted by a green circle with an x) and subsequent soil profile descriptions.
SOIL SC\
wlt.< C' 'L
mh?�� 0
cn O co;.
\O 1098 P�O�
F NO RTH
Rob Willcox
NC Licensed Soil Scientist 4 1098

APPENDIX II - MAPS, SOIL PROFILE DESCRIPTION SHEETS

WILLCOX & MABE SOIL SOLUTIONS, PLLC
SITE/SOIL EVALUATION
Project No.
J.5-v_' Pf. C) _ Phone No.
Date:
r`
i �J
Location
�a,-„� I f 7 ;-1 r f �.Y Pin
County: U Je
Property Size
Proposed Facility: �_ r`, •. �� 'FUfll.Water Supply:
Described By:
Weather: �fo S Antecedent Moisture
On -Site Well ❑ Evaluation: Auger Boring
Community ❑ Pit ❑
Public ❑ Cut ❑
Surface Water:
FACTORS
PROFILE
PROFILE
PROFILE
PROFILE
Landscape Position %
9 _1l1]�
}/%
Horizon Depth I
Color Munsell
J
?•�-=' .: .
Texture
Structure
c
Consistence
Boundary
Horizon Depth II
.r
Color — MunseIl
Texture
Mottles
Structure
Consistence
'
Boundary
Horizon Depth III
Color—Munsell
Texture
Mottles
J:
Structure
Consistence
Boundary
Horizon Depth IV
Color—Munsell
'1,
Texture
Mottles
�;
Structure
!: F
Consistence
-
Boundary
Soil Wetness
Restrictive Horizon-
Saprolite
LTAR
Classification
.J /UC Dv-13- l
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
A
sandy loam
l
loam
si
silt
sit
silt loam
Biel
silty clay loam
cl
clay loam
set
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
f,
firm
vfi
Very firm
STRUCTURE
sg
single grain
m
massive
cr
crumb
gr
granular
sbk
subangular blocky
abk
angular blocky
pt
plat`
pr
prismatic

WILLCOX & MABE SOIL SOLUTIONS, PLLC
SITE/SOIL EVALUATION
Project No. ) iD6 );p Phone No.
Locations ,.�, Pin
Proposed Facility: ,q tPA Water Supply:
Described By:
Weather: ?0"5 Antecedent Moisture
Date: Y 15---� 3'
County:)A-we Property Size
On -Site Well ❑ Evaluation: Auger Boring ❑
Community ❑ Pit ❑
Public ❑ Cut ❑
1(1''n4Surface Water:
FACTORS
PROFILE
-01
PROFILE
PROFILE
PROFILE
�l
Landscape Position %
IL
L z j n of
&-Is%
Horizon Depth I
t� -[a!
r -- Is
Color Munsell
J Q S/A5
f!
il':'YX 1
Texture
p
Structurelt}r_
Consistence
!? %7 `�
11 <% A 9w
F-,O- .
Boundary
Horizon Depth II
Color-Munsell
l0 y,Q 4;/
, .� Yw �%L
p� �U
t/
1915 J AZ "I
Texture
Mottles
Structure
l j �'
w,A6k-
Consistence
Y1 hQ -�.-
4� rx/F .
Boundary
Horizon Depth III
119
Color- Munsell
JD wz /(-
'2,^a YoE'a��
Texture
`r
_
Mottles
Y�
C ��.5 l �s�F
i eV V91
-�: � 3 �i� �Jtri
• 7, Yx � e
Structure
yv 6
1> 4-
-Consistence
Mxv Ems%
j
;' iLa
1_? .510' F.k4
Boundary
Horizon Depth IV
: - T—')
_.-3,5..
,-? -
Color-Munsell7.Y4�.a
Texture
1e j
1
7
Mottles
-I"'C 3 �
'� � �• � rtr- 1,.....
Jr d +�r. ! k
-�• �.• 1.
Structure
Consistence
r ] !1d°
A-? rl tF' i'..
"�.
1,- -
Boundary
Soil Wetness
f
Restrictive Horizon
jiz�.G�,; +f.'
11,.�;,t
Saprolite
J I sip F4
)" artt} k'
LTAR
Classification
�rrr��u:F�.��. �rr�.�
f�k,�._
��1� �c �
.�-to1��-- •��'?
��I�r' .-���'�
JUC,-tv-'1q`a2 NC -Dv`;_/ .- 'Ile -Dv-I'f-/
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
I
loam
si
silt
sil
silt loam
sicl
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
vfr
Very friable
rr
friable
fi
firm
v8
Very firm
STRUCTURE
sg
single grain
m
massive
cr
crumb
gr
granular
sbk
subangular blocky
abk
angular blocky
pl
platy
Pr
prismatic

WILLCOX & MABE SOIL SOLUTIONS, PLLC
SITE/SOIL EVALUATION
Project No. ;), C',-, Phone No.
Location 606 C re ,,,, Pin County:
Proposed Facility: Water Supply:
r�(
Described By:
Weather: S« A,; ��fs Antecedent Moisture
_ Date:
E), Je
Property Size
On -Site Well ❑ Evaluation: Auger Boring
Community ❑ Pit ❑
Public ❑ Cut ❑
Surface Water:
FACTORS
PROFILE
PROFILE
PROFILE
PROFILE
Landscape Position %
L 4/_( of
Horizon Depth I
Color Munsell
Q H/
Texture
C
Structure
,, .k56k-
Consistence
Boundary
Horizon Depth lI
1-
Color -Munsell
Texture
Mottles
l- -7 ZY1_7 air
Structure
Consistence
Boundary
Horizon Depth III
3 j
Color- Munseli
7 YzJ�
Texture
�.
Mottles
Structure
Consistence
Boundary
Horizon Depth IV
2/g
Color-Munsell
Texturej,
Mottles
�--
Structure
I'k.,
Consistence
Boundary
Soil Wetness
Restrictive Horizon
Saprolite
LTAR
Classification
ve--D v-1S —1
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
1
loam
si
silt
sil
silt loam
sicl
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
vfr
Very friable
fr
friable
fi
firm
vfi
Very firm
STRUCTURE
sg
single grain
In
massive
cr
crumb
gr
granular
sbk
subangular blocky
abk
angular blocky
pl
platy
pr
prismatic

Pages from Town of Mocksville Permit
Modification - WQ0003351
Final Audit Report 2023-09-13
Created: 2023-09-13
By: Brent Collins ([e-mail])
Status: Signed
Transaction ID: CBJCHBCAABAAr22zjoZEyYUeNvTCMRhbV9L9rScCG91a
"Pages from Town of Mocksville Permit Modification - WQ00033
51" History
Document created by Brent Collins ([e-mail])
2023-09-13 - 3:24:23 PM GMT- IP address: 206.85.202.26
E—�!, Document emailed to [e-mail] for signature
2023-09-13 - 3:25:16 PM GMT
Email viewed by [e-mail]
2023-09-13 - 3:44:48 PM GMT- IP address: 166.137.175.47
Signer [e-mail] entered name at signing as Kenneth Gamble
2023-09-13 - 3:46:06 PM GMT- IP address: 166.137.175.47
C5 Document e-signed by Kenneth Gamble ([e-mail])
Signature Date: 2023-09-13 - 3:46:08 PM GMT - Time Source: server- IP address: 166.137.175.47
Q Agreement completed.
2023-09-13 - 3:46:08 PM GMT
0 Adobe Acrobat Sign