WQ0019504_2023 Residual Annual Report_20240219 (2)

Initial Review
Reviewer
nathaniel.thornburg
Is this submittal an application? (Excluding additional information.) *
Yes No
If not an application what is the submittal type?* Annual Report
Residual Annual Report
Additional Information
Other
Annual Report Year* 2023
Permit Number (IR) * WQ0019504
Applicant/Permittee City of Belmont
Email Notifications
Does this need review by the hydrogeologist? * Yes No
Regional Office Mooresville
CO Reviewer
Admin Reviewer Wanda Gerald

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* Jennifer Gibson
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*
17049012077
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:*
WQ0019504
Has Current Existing permit number
Applicant/Permittee Address*
PO Box 431 Belmont NC, 28012
Facility Name*
City of Belmont Class A 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.)
2023 Land Application Report signed.pdf 1.37MB
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 2/19/2024

ANNUAL LAND APPLICATION CERTIFICATION FORM
WQ Permit#: WQ0019504 County:
Facility Name (as shown on permit):
Gaston
Year: 2023
City of Belmont, WIT
Land Application Operator: U.S. Biosolids, Inc. Phone:
Land application of residuals as allowed by the permit occurred during the past calendar year?
IJ Yes 0 No - If No, skip Part A, and Part B and proceed to Part C. Also, If residuals were
generated but not land applied, please attach an explanation on how the residuals were handled.
Part A - Residuals Application Summary:
336-777-6909
Total number of application fields in thepermit:
NA
Total number of fields utilized for land application during the year:
0
Total amount of dry tons applied during the year for all application sites:
0
Total number of acres utilizes for land application during the year:
0
Part B - Annual Compiance Statement:
Facility was compliant during calendar year 2023 with all conditions of the land application permit
(including but not limited to items 1-13 below) issued by the Division of Water Resources. B Yes ® No
If no please, provide a written description why the facility was not compliant, the dates, and explain corrective action
taken.
1) Only residuals approved for this permit were applied to the permitted sites.
2) Soil pH was adjusted as specified in the permit and lime was applied (if needed) to achieve a soil pH of at least 6.0 or
the limit specified in the permit.
3) Annual soils analysis were performed on each site receiving residuals during the past calendar year and three (3) copies
of laboratory results are attached.
4) Annual TCLP analysis (if required) was performed and three (3) copies of certified laboratory results are attached.
5) All other monitoring was performed in accordance with the permit and reported during the year as required and three
(3) copies of certified laboratory results are attached.
6) The facility did not exceed any of the Pollutant Concentration Limits in 15A NCAC 02T .1105(a) or the Pollutant
Loading Rates in 15A NCAC 02T. I 105(b) (applicable to 40 CFR Part 503 regulated facilities).
7) All general requirements in as specified in the Land Application Permit were complied with (applicable to 40 CFR Part
503 regulated facilities).
8) All monitoring and reporting requirements in 15A NCAC 02T A I I I were complied with (applicable to 40 CFR Part
503 regulated facilities).
9) All operations and maintenance requirements in the permit were complied with or, in the case of a deviation, prior
authorization was received from the Division of Water Resources.
1.0) No contravention of Ground Water Quality Standards occurred at a monitoring well or explanations of violations are
attached to include appropriate actions and remediations.
11) Vegetative cover was maintained and proper crop management was perfonned on each site receing residuals, as
specified in the permit.
12) No runoff of residuals from the application sites onto adjacent property or nearby surface waters has occurred.
13) All buffer requirements as specified on the permit were maintained during each application of residuals.
Part C - Certification:
"I certify, under penalty of law, that the above information is, to the best of my knowledge and belief, true, accurate,
and complete. I am aware that there are significant penalties for submitting false information, including the
possibility of fines and imprisonment for knowing violations."
Permittee Name and Title (type or print) Signature 4 Permittee Date
Signature of Preparer'' Date
(if different from Permittee)
Preparer is defined in 40 CFR Part 5039 (r) and 15A NCAC 02T
of Land Applier
2-19-2023
Date
(if different from Permittee and Preparer)
.1102 (26) DENR FORM ACF (12/2006)

All of the residuals produced by the City of Belmont's Water Treatment Plant where stored in the
clarifier at the Plant.