WQ0000520_Residual Annual Report 2015 - Part 1_20160217

City of Burlington — WQ0000520
Biosolids Land Application Program
Annual Report
Table of Contents
1. Annual Land Application Certification Form
a. RSSF Forms
2. MFLSF Forms
a. FSF Forms
3. Residuals Analysis Lab Sheets
a. TCLP Lab Sheets
4. PVRF Forms
a. Pathogen & Vector Attraction Reduction Lab Sheets
5. Soils Analyses
6. Zimpro Ash
v C\j

ANNUAL LAND APPLICATION CERTIFICATION FORM
WQ Permit#: WQ0000520 County:
Facility Name (as shown on permit):
Land Application Operator:
Alamance
Year: 2015
City of Burlington
EMA Resources Inc. Phone: [phone]
,and application of residuals as allowed by the permit occurred during the past calendar year?
8 Yes ❑ 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 Summarv:
Total number of application fields in thepermit:
208
Total number of fields utilized for land application during the year:
89
Total amount of dry tons applied during the year for all application sites:
3,704.94
Total number of acres utilizes for land application during the year:
1590
Part B - Annual Compiance Statement:
Facility was compliant during calendar year 2015 with all conditions of the land application permit
(including but not limited to items 1-13 below) issued by the Division of Water Quality. 0 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 .1105(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 .1111 were complied with (applicable to 40 CFR Part
503 regulated facilities).
9) All operations and maintenance requirements in the permit were complied with or, in the case of a deviation, prior
authorization was received from the Division of Water Quality.
10) No contravention of Ground Water Quality Standards occurred at a monitoring well or explanations of violations are
attached to include appropriate actions and remediations.
11) Vegetative cover was maintained and proper crop management was performed on each site receing residuals, as
specified in the permit.
12) No runoff of residuals from the application sites onto adjacent property or nearby surface waters has occurred.
13) All buffer requirements as specified on the permit were maintained during each application of residuals.
Part C - Certification:
"I certify, under penalty of law, that the above information is, to the best of my 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."
Shane Fletcher - Residuals Coordinator r / 2 CA
ermittee Name and Title (type or print) Signature of Permittee Date
1/14/2016
Signature of Preparer* Date Signature of Land Applier Date
(if different from Permittee) (if different from Permittee and Preparer)
* Preparer is defined in 40 CFR Part 503.9 (r) and 15A NCAC 02T .1102 (26) DENR FORM ACF (12/2006)

ANNUAL RESIDUAL SANIYLING SUMMARY FORM
Please note that your permit may contain additional parameters to be analyzed. The parameters can be reported in FORM RSSF - B
WQ Permit Number:
Facility Name:
Residual Source WQ # or
NPDES #:
WWTP Name:
Residual Analvsis Data
WQ0000520 Laboratory:
City of Burlington
NCO023868
Eastside WWTP
1)
2)
3)
4)
5)
A&L Laboratories
Parameter
(mg/kg)
Cone.
Limit
(m ,/ko)a
Sample or Composite Date
12/8/14
1/12/15
2/16/15
3/16/15
4/13/15
5/11/15
6/8/15
7/13/15
8/10/15
9/8/15
10/12/15
11/9/15
Percent Solids (%)
NA
5
5.72
4.92
5.7
4.53
4.32
3.99
3.92
1.25
3.6
2.78
4.14
Arsenic
75
3
3
3
3
3
3
3
3
3
3
3
3
Cadmium
85
2
2
2
2
2
2
2
2
2
2
2
2
Copper
4,300
220
210
194
194
145
171
143
168
126
315
238
147
Chromium
NA
29
40
37
40
39
50
47
52
32
48
46
51
Lead
840
25
20
15
17
14
16
13
31
9
13
12
15
Mercury
57
0.4
0.4
0.4
0.4
1.1
1.1
0.5
0.4
0.4
0.4
0.4
0.5
Molybdenum
75
5
5
5
5
5
5
5
5
5
5
5
5
Nickel
420
12
13
13
15
14
22
14
12
7
9
8
10
Selenium
100
5
5
5
5
5
5
5
5
5
5
5
5
Zinc
7,500
542
474
438
483
428
555
427
591
363
582
478
409
Total Phosphorus
NA
9720
10900
11300
10800
10800
10400
12000
9570
6860
8830
11600
14500
TKN
NA
26000
28100
31500
29300
26500
23600
27300
24700
19200
23100
26600
30700
Amrnonia-Nitrogen
NA
3000
1750
3460
2630
1550
2780
4010
3060
6400
3060
6470
4110
Nitrate and Nitrite
NA
2
2
2
2
108
2
2
2
404
2
2
2
a For surface disposal facilities the ceiling concentration limits listed in this form are not applicable. Reference the individual permit for metals limits.
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed
to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant
penalties f x-sukmitting false information, including the possibility of fines and imprisonment for knowing violations."
Signature of Preparer *
11;ZF11_
Date
*Preparer is defined in 40 CFR Part 503.9(r) and 15A NCAC 2T .1102 (26) DENR FORM RSSF (12/2006)

ANNUAL RESIDUAL SAMPLING SUMMARY FORM - B
Report all sampling analysis results for parameters not listed in FORM RSSF that are part of the WQ permit or were analyzed for over the past
calendar year. Use additional forms as needed.
WQ Permit Number:
WQ0000520
Facility Name: City of Burlington
Residual Source
NPDES # or WQ#:
WWTP Name:
Residual Anal.N.-sis Data
NCO023868
Eastside W WTP
Laboratory:
1)
2)
3)
4)
5)
A&L Laboratories
Sample or Composite Date
Parameter
(mg/kg)
12/8/14
1/12/15
2/16/15
3/16/15
4/13/15
5/11/15
6/8/15
7/13/15
8/10/15
9/8/15
10/12/15
11/9/15
Aluminum
39900
25900
29800
29500
42100
29800
35800
34100
45200
34600
38400
25700
Calcium
117000
93700
101000
99600
107000
111000
122000
121000
144000
158000
131000
98500
Magnesium
3040
3040
3060
3070
3140
3490
3630
3180
2490
3240
3260
3500
Potassium
1250
1600
1660
1730
1460
3590
1560
1030
1090
1020
1070
1660
Sodium
4490
3260
3350
3200
2680
3300
3410
3350
6290
5240
4380
3740
SAR
0.79
0.68
0.63
0.65
0.47
0.55
0.52
0.51
0.5
0.68
0.54
0.65
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system
designed to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are
significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
Signature of Preparer *
*Preparer is defined in 40 CFR Part 503.9(r) and 15A NCAC 2T .1102 (26)
/ -2-A
Date
DENR FORM RSSF - B (12/2006)

ANNUAL RESIDUAL SANrt LING SUMMARY FORM
Please note that your permit may contain additional parameters to be analyzed. The parameters can be reported in FORM RSSF - B
WQ Permit Number: WQ0000520 Laboratory:
Facility Name: City of Burlington
Residual Source WQ # or
NPDES #:
WWTP Name:
Residual Analvsis Data
NCO023876
Southside WWTP
1)
2)
3)
4)
5)
A&L Laboratories
Parameter
(mg/kg)
Conc.
Limit
(m,,,/k,,))a
Sample or Composite Date
12/8/14
1/12/15
2/16/15
3/16/15
4/13/15
5/11/15
6/8/15
7/13/15
8/10/15
9/8/15
10/12/15
11/9/15
Percent Solids (%)
NA
3.71
3.8
4.26
3.86
4.19
4.19
4.16
4.3
3.81
2.7
2.54
2.87
Arsenic
75
3
3
3
3
3
3
3
3
3
3
3
3
Cadmium
85
2
2
2
2
2
2
2
2
2
2
2
2
Copper
4,300
198
157
140
136
152
184
236
214
213
303
231
188
Chromium
NA
335
268
190
196
237
257
239
247
214
238
241
218
Lead
840
13
11
10
10
11
13
21
15
15
26
16
16
Mercury
57
0.4
1.2
0.6
0.4
0.5
0.4
1.9
0.4
0.5
1.3
0.8
0.9
Molybdenum
75
5
5
5
5
5
5
5
5
5
6
5
6
Nickel
420
11
10
9
8
9
16
17
13
12
21
12
12
Selenium
100
5
5
5
5
5
5
5
5
5
5
5
5
Zinc
7,500
439
382
289
323
322
414
474
493
422
489
428
376
Total Phosphorus
NA
26200
22000
21400
21500
21300
23800
23100
23300
25200
40600
29800
24100
TKN
NA
66800
63400
62400
63500
66100
72800
50200
60900
55900
65200
62600
59200
Ammonia -Nitrogen
NA
27000
5260
6810
8290
7880
30500
19000
13000
15000
24100
31100
28600
Nitrate and Nitrite
NA
2
2
2
2
69.2
2
48.1
2
2
2
2
2
a For surface disposal facilities the ceiling concentration limits listed in this form are not applicable. Reference the individual permit for metals limits.
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed
to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant
penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
1/zF/4
Signature of Preparer *
Date
*Preparer is defined in 40 CFR Part 503.9(r) and 15A NCAC 2T .1102 (26) DENR FORM RSSF (12/2006)

ANNUAL RESIDUAL SAMPL.IIG SUMMARY FORM - B
Report all sampling analysis results for parameters not listed in FORM RSSF that are part of the WQ permit or were analyzed for over the past
calendar year. Use additional forms as needed.
WQ Permit Number:
Facility Name:
Residual Source
NPDES # or WQ#:
WWTP Name:
Residual Analvsis Data
WQ0000520
City of Burlington
NCO023876
Southside WWTP
Laboratory: 1) A&L Laboratories
2)
3)
4)
5)
Parameter
(mg/kg)
Sample or Com osite Date
12/8/14
1/12/15
2/16/15
3/16/15
4/13/15
5/11/15
6/8/15
7/13/15
8/10/15
9/8/15
10/12/15
11/9/15
Aluminum
5900
7200
11700
8400
8200
7000
10500
7900
8500
10100
6100
7200
Calcium
100000
82700
98700
92300
81700
74800
119000
109000
104000
58600
119000
87400
Magnesium
6490
5800
5420
5470
5050
5440
8410
6230
7230
18400
8900
6090
Potassium
8120
6470
6050
7270
6300
8290
4040
6100
6570
5210
5880
6350
Sodium
5540
4520
3470
4050
3200
4170
3110
3990
5360
5800
5830
5820
SAR
0.88
0.8
0.6
0.69
0.6
0.81
0.48
0.66
0.84
0.88
0.7
0.87
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system
designed to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are
significant penal ws-(or submitting false information, including the possibility of fines and imprisonment for knowing violations."
Signature of Preparer *
*Preparer is defined in 40 CFR Part 503.9(r) and 15A NCAC 2T .1102 (26)
L"
4&
ate
DENR FORM RSSF - B (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual):
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
�`ator: Kenneth Culberson Owner: Kenneth Culberson Predominant Soil Series:
A%.. -es Used: 7.5 Acres Permitted: 7.5 Site #: AM002 Field #:
34.67
DbB
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
11
EB
2/16/15
2
3
141
L 5j
L617
8
91
10
111
12 1
% Solids
4.92
Arsenic
3
Cadmium
2
Copper
194
Chromium
37
Lead
15
Mercury
1 0.4
Molyb-
denum
5
Nickel
13
Selenium
5
Zinc
438
Total
Phos-
6horus
11300
al Heavy Metal Field Loadings (Calculated in lbs/acre):
Total
1
31
4,1
5
7
8
9
10
11
12
DT/Ac./
-z-1
_6
0
App.
1
Event
4.62
Arsenic
0.028
0.000
1 0.000
0.000
0.000
0.000
1 0.00,0
0.00,0
0.000
1 0.000
0.000
0.000
0.028
Cadmium
0.018
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1 0:.000
0.000
0.000
0.018
Copper
1.794
0.000
0.000
0.000
0.000
0.000
0.000
0`.000
0.000
0.000
0.000
6.000
1.794
Chromiumr
0.342
0.000
0.000
0.000
0.00.0
0.000
0;000
0.000
0.000
0.000
6.000
0.000
0.342
Lead
0.139
0.000
0.000
0.000
0.000
0.000
0.000
0-.000
0.000
0.000
0:000
0.000
0.139
Mercury
0.004
0.000
0.000
0.000
0.0.00
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.004
Molyb-
0.046
0.'000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.046
denum
Nickel
0.120
0.000
_
0.000
0.0.00
0.000
0.000
0.000
0.000
0.000
0:.000
0.000
0.000
0.120
Selenium
0.046
0:000
0.000 1
0.000
0.000
0.000
0.000 1
0.000
0.000
0.000
0.000
0.000
0.046
Zinc
4.0.5.0
0.000
0.000
0.000
0.000
0.000
0.000
0.000 1
0.000
0..000
0.000
0.000
4.050
Total
Phos-
104.480
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
104.480
Chorus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
il' 'sonment for knowing violations".
1/14/2016
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION x rELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: City of Burlington WQ Permit #: WQ0000520 Field #: 1 Acres Utilized: 7.5
Land Owner: Kenneth Culberson Annual Dry Tons Applied: 3467 `' Site #: AM002 Acres Permitted: 7.5
Operator: Kenneth Culberson Predominant Soil Series: DbB Cation Exchange Capacity (non 503): 0
Crop 1 Name: Fescue -Hay Crop 1 Max. PAN: 237 Crop 2 Name: Crop 2 Max. PAN:
1)
Q°
Volume applied
{enter one) Solids/
Li9wd
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/AC)
Residual Sources
(NPDES # WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
We '
Moist)
Precip.
Past 24
Hrs.
inches
�Y
a '5
5 �
*
o
* w
o'
Z
w� `;
* N
�` o
d
TKN
mg/kg
Z Y
o
w
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop I
Cr.,p 2
Crop 1
Crop 2
3/17
169000
4.92
4,:623
East Burlington
D
<.5"
S
0.5
0.3
31500
3460
?
93.792
NA
Fescue
0000
0.000
0.0o0
0.000
0.000.
0.11(lo
0 00Q
0.606
0.0oo
0 000'
0.000
0A011
0;00.0
0.000
0A00
0 000
0.000 `
0moo
0:000' ''
0.000
0,000
0 000
0.000
0.000
0 000
0.000
o,00o
0;0.00
0.000
omoo
0 000;„
0.000
0.00o
.
0
0
",0 000'
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000
0.U110
TOTALS:
n
c,�,r>i�0
::::::::::::::
As
Cd
Cu
Cr
Pb
H��
Mo
Ni
Se
Zn
P
93,792
0.(uin
Lime A> ,lied
Annual lbs/acre
0 02$ "
O.OY8
•1.794
0,342'
0.139
0 004 ;
0 04C
0`i20
0,046
`4 O50 '
104.480 :,::. , ::, :_ ,':..::.:. :::::
•;
,... .............. .....
Date
lbs/ac
Prior Years Cumulative lbs/ac
0
0
0
0
0
0
0
0
0
0
Current Cumulative lbs/ac
0 02°8
0 OT8,
1.794
0.342
' 0.139'
0.0Q4'
0 0'46
A.120
0;:046 .
, +4.050
Permitted C. P. L. R.****
36
34
1338
2 77
15
374
89
2498
Permit PAN Limit lst/2nd Crop237
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
ZYZ 4,®j/ *Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier
Date
*** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual):
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
1,ator: Kenneth Culberson Owner: Kenneth Culberson Predominant Soil Series:
A,. es Used: 13 Acres Permitted: 13 Site #: AM002 Field #:
31.88
DbB
2
Residual Analysis Data (Heavy Metals and Total Phosphorus use mzU. % Solids use Raw Percent ft
Sample or
Com-
posite
Date
1
SB
1/12/15
2 j
EB
2/16/15
31
4
L5J
6
171
LBJ
9
10
11
12
% Solids
3.8
4.92
Arsenic
3
1 3
Cadmium
2
2
Copper
157
194
ChromiLiiii
268
37
Lead
11
15
Mercury
1.2
0.4
Molyb-
denum
5
5
Nickel
10
13
Selenium
5 1
5
Zinc
382
438
Total
Phos-
nh onus
22000
11300
'ial Heavy Metal Field Loadings (Calculated in lbs/acre):
1 otal
1
2
3j
4
5
6 j
7 j
8
9
10
11
12
DT/Ac./
App.
7
Event
1.43
1.03
Arsenic
0.009
0.006
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1 0.015
Cadmium
0.006
0.004
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.010
Copper
0.448
0.398
0.000
0.000
0.00.0
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.846
Chromium
0.764
0.076
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.600
6.000
0.840
Lead
0.031
0.031
0.0.00
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.062
Mercury
O.Q03
0.001
0..000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.006
0.004
Molyb-
0.014
0.010
0.000
0000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.025
denum
Nickel
0.029
0.027
0.000
0.000
0.0.00
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.055
Selenium
0.014
0..010
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.025
Zinc
1.089
0.899
0.000
0.000
0.000
0..000
0.000
0.000
0.000
0.000
0.000
0.000
1.988
Total
Phos-
62.744
23.188
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
85.932
horus
"1 certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
- isonment for knowing violations".
\ /_�
_ - _ 1/14/2016
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
ANNUAL LAND APPLICATION i­rr:LD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
City of Burlington WQ Permit #: WQ0000520 Field #: 2 Acres Utilized:
Kenneth Culberson Annual Dry Tons Applied: 31 8:8 Site #: AM002 Acres Permitted:
Operator: Kenneth Culberson
Crop 1 Name: Fescue -Hay
Predominant Soil Series:
Crop 1 Max. PAN: 237
DbB
Crop 2 Name:
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
13
13
0
A
Volume applied
PP
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/AC)
Residual Sources
(NPDES #, WQ#
'
Fert., Animal
Waste, etc)
Soil
Cond.
(D�'
Wet,
Moist)
Precip.
Past 24
Hrs.
inches
Y
�* '�
o
a o.
o
%° ',
�
* N'
0
�
;b
w
;
* N
#
TKN
mg/kg
Z �
o
MR o
: �.
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
lbs/acre
( )
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
2/9
117000
3.8
1.426 •
South Burlington
D
<.5'.
S
0.5 1
0.3
63400
5260
2
57:257
NA".
Fescue
3/13
65000
4.92
1.02
East Burlington
D
<.5"
S
0.5
0.3
31500
3460
2
-20:812
NA
Fescue
o.000
0.00o
0'000:
OA00
..0:00o
0.000
o oo
0.000
'- 0 000
0 0w
0:000
11000 .
0;,000
0.000
0000'
0:000
0:000 '
OU00'
0.000
110. ,000
&,000
0.000
< 0:000' .
O
n
0:000
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
O'.iu10
0.000
TOTALS:
182000
As
Cd
Cu
Cr
Pb
HP_
Mo
Ni
Se
Zn
P
78.069 -
' 0.000 '
Lime Applied
Annual lbs/acre
:0 015
" 0.0'10
0:8,46
0.84,t3 =
0,062 :
t► 004 a
'` 0`0257-;
`OA,55
0.025
. 1988
&5.93Z : > .:............ ..
:.::::::.':::: :.:
.................. ........
................
Date
lbs/ac
Prior Years Cumulative lbs/ac
0,0392
0.0321
3.4755
1.44
0,26.14
0.0127
0.0943
0.247
0.06
7,3459
Current Cumulative lbs/ac
0 054
_ 0 04,2
4;321..
_
2,280
0. 327 a,
0 017
:'_ .0.119
0:.302; ,
_ 0.08,5
-9.334
Permitted C. P. L. R.****
36
1 34
1 1338
267
15
374
1 89
1 2498
PAN AN Li 2 Limit 1st/ nd Crop
-
237
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date
*** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (1212006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual):
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
e"- ator: Kenneth Culberson Owner: Kenneth Culberson Predominant Soil Series:
A,. es Used: 5.9 Acres Permitted: 5.9 Site #: AM002 Field #:
13.85
DbB
3
Residual Analvsis Data (Heavv Metals and Total Phosphorus use me/ke. % Solids use Raw Percent 9):
Sample or
Com-
posite
Date
1
SB
2/16/15
_2j
3
4
5
6
7]
L81
L9
10
11
12
% Solids
4.26
Arsenic
3
Cadmium
2
Copper
140
Chromium
190
Lead
10
Mercury
0.6
Molyb-
denum
5
Nickel
9
Selenium
5
Zinc
289
Total
Phos-
n..horus
21400
.ial Heavy Metal Field Loadings (Calculated in lbs/acre):
1 otal
1
2
3
4 1
5
6
7
8
9
10
11
12
DT/Ac./
App •
P
Event
2.35
Arsenic
0.014
0.000
0.000
0.000
0.000
0.000
0.000
1 0.000
0.000
0.000
0.000
0.000
0.014
Cadmium
0.009
0.000
0.000
0.000
0.000
.0.000
0.000
0.000
0.000
0.000
0.000
0.000
1 0.009
Copper
0.657
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.657
Chromiuni
0.892
0.000
0.000
0.000
0.000
0.000
0.000
0.000
.0.000
0.000
0.000
0.000
0.892
Lead
0.047
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.006
0.000
0.047
Mercury
0.003
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.003
Molyb-
0.023
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.023
denum
Nickel
0.042
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.042
Selenium
0.023
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.023
Zinc
1.357
0.000
.0.0,00
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000 1
1.357
Total
Phos-
100.494
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
100.494
horus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
it •isonment for knowing violations".
;e:f-e 1/14/2016
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION i -ALD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: City of Burlington WQ Permit #: WQ0000520 Field #: 3 Acres Utilized: 5.9
Land Owner: Kenneth Culberson Annual Dry Tons Applied: 13.85 Site #: AM002 Acres Permitted: 5.9
Operator: Kenneth Culberson Predominant Soil Series: DbB Cation Exchange Capacity (non 503): 0
Crop 1 Name: Fescue -Hay Crop 1 Max. PAN: 237 Crop 2 Name: Crop 2 Max. PAN:
°
Q
Volume applied
PP
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry'
Wet'
Moist)
Precip.
Past 24
Hrs.
inches
a
ro �7
°per
C
o
w
�*
* w'
M co
w
* v
TKN
mg/kg
Z a
i t
o
C
�•
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
( lbs/acre)
Name of Crop T
p Type
Receiving Residual
Application
Crop I
Crop 2
Crop 1
Crop 2
3/18
78000
4.26
2° 34$
South Burlington
D
<.5"
S
0.5
0.3
62400
6810
2
94.334
NA
Fescue
0:000
0.000
0.000
6.900
0.000
0.000
a.000
0.000
(1000
0.000
0.000
0000`
0.000
o.000
0.600 '
0.000
0,000
6:0601
0.000
0.000
o:000:
0.000
0.000
.o' 00o
0.000
0.000
0!'090
0.000
0.000
0.000
0.000
0.
>..:
0 000 -
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form ):
0.000
o.000
TOTALS.
01
As
Cd
Cu
Cr
Pb
H
Mo
Ni
Sae
P
94.334<
0.000
Lime A . died
Annual lbs/acre
Q.0't4
0.049
0.6'57
"y,0892
4.647,
b 003`.
0 023
0 04't
AA1,00.494
:;:.':.: ' ::..::
. ... ..Current
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.0353
0.0365
3.4644
1.72-11
0.353
0.0144
0.0913
0.2431
0.0',.
Cumulative lbs/ac
0.049
0:046
4.122
2;.0I6
0. tt11►';
0 017°.:
0 115.
0.285
0 0...........Permitted
C. P. L. R.****
36
34
1338
267
15
374
8
i Perm t PAN Limit 2nd Crop
t 1st/
.......::::•:•..•....•.•.•.•.•.......:::::::...•........•..............•..•.•.
237
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 "Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual):
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
% 'rator: Kenneth Culberson Owner: Kenneth Culberson Predominant Soil Series:
A.:, -es Used: 7.7 Acres Permitted: 7.7 Site #: AM002 Field #:
12.74
DbB
4
Residual Analvsis Data (Heavy Metals and Total Phosuhorus use ma/ka. % Solids use Raw Percent ft
Com-
posite
Date
Total
Phos-
mM
)zal Heavv Metal Field Loadings (Calculated in lbs/acre):
Total
11
12131
L4-1
L 51
6
7
L-8-j
91
11ol11
12
DT/Ac./
y
o�
App.
y
Event
1.20
0.45
Arsenic
0.007
0.003
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.010
Cadmium
0.005
0.002
0.000
0..000
0.000
0.000
0.000
0.000
0.000
0:000
0.000
0.000
0.007
Copper
0.378
0.126
0.000
0.000
0.000
0.000
0..0.00
0.000
0.600
0.000
0.000
0.000
0.504
Chromium
0.645
0.171
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.816
Lead
0.026
0.009
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.006
0.000
0.035
Mercury
0.003
0.001
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.003
Molyb-
0.012
0.005
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.060
0.000
0.000
0.017
denum
Nickel
0.024
0:008
0.000:
0.000
0.000
0.000
0.000
0.600
0.000
0.000
0.000
0.000
0.032
Selenium
0.012
0.005
0.000
0.000
0.000
0.000
0.000
0.000
0.060
0.000
0.000
0.000
0.017
Zinc
0.920
0.260
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1.180
Total
Phos-
52.976
19.260
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
72.236
chorus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
ljsonment for knowing violations".
z.i 1/14/2016
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
Operator:
ANNUAL LAND APPLICATION tELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
City of Burlington WQ Permit #: WQ0000520 Field #: 4 Acres Utilized:
Kenneth Culberson Annual Dry Tons Applied:: ,12 74, Site #: AM002 Acres Permitted:
Kenneth Culberson Predominant Soil Series: DbB Cation Exchange Capacity (non 503):
Crop 1 Name: Fescue -Hay Crop 1 Max. PAN: 237 Crop 2 Name: Crop 2 Max. PAN:
7.7
7.7
0
o
o
Q
Volume applied
PP
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry,
Wet,
Moist)
Precip.
Past 24
Hrs.
inches
a
o
b
o w
a o
-
o
%° K
-
N
* t
0
�
w
o L
* N
* w
TKN
mg/kg
Z �'
o
o w'
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop I
Crop 2
Crop I
Crop 2
2/9
58500
3.8
T 2Q4,
South Burlington
D
<.5"
S
0.5
0.3
63400
5260
2
48.334
NA
Fescue
3/18
19500
4.26
0.450. ' '
South Burlington
D
<.5"
S
0.5
0.3
62400
6810
2
18c070
NA
Fescue
0:.000
0:000
0.000
0`0.00
0.006
0.1100
0,000
0.000
0.000
0..000'
0.000
0.000
Oi000
0.00;0
o.000
0 000 '
(1,000
0.000
1`0.006 `a`
0.000
0.000
0 0.00 -
0,000
0.000
0.000
omo
0 000
0.000. >
0.000
0
0
0:000 "''
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form►:
0.006
o.000
TOTALS:
' ` #n
'" s000
As
Cd
Cu
Cr
Pb
Hg,
Mo
Ni
Se
Zn
P
66:404`
a.U00
Lime Applied
Annual lbs/acre
0 010
0 067 .,
0.504
.. 0.:816
0.035
"0:017
,. 1.180
t,12.236 : ,. :
::: :: :: :::.::::::::::
...........................
:::
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.0314
0.0291
3.1332
1.6581
0.2733
0.0121
0.0783
0.1966
0.0524
6.9264
Current Cumulative lbs/ac
Q, 041
• 0036
37637
2;474 '
0,3.09
0.016 `
0.095:
, 0.22Q
0;069
: 8.106
Permitted C. P. L. R.****
36
34
1 1338
267
1 15 J
1 374
89
1 2498
i Perm t PAN Limit is 2n r tl d Crop
p
237
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual):
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
r )ator: Kenneth Culberson Owner: Kenneth Culberson Predominant Soil Series:
A.., es Used: 8.2 Acres Permitted: 8.2 Site #: AM002 Field #:
24.88
IaB
5
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
.-1
Com-
posite
Date
Total
.++
��
,ial Heavy Metal Field Loadings (Calculated in lbs/acre):
100
11
L3]4
5
6
7
8
9
10
11 J
12
DT/Ac./
o
App.
Event
1.41
1.63
Arsenic
0.008
1 0.010
0.000 1
0.000
0.000
0.000
1 0.000
0.000
0.000
0.000
0.000
0.000
0.018
Cadmium
0.006
0.007.
0.000
0.000
0.000
0:000
0.000
0.000
0.000
0.000
0.000
0.000
0.012
Copper
0.394
0.631
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1.025
Chromiun
0.535
0.120
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.655
Lead
0.028
0.049
0.000
0.000
0.000
0:000
0.000
1 0.000
0.000
0.000
0.000
0.000
1 0.077
Mercury
0.002
0.001
0.000
0.000
0.000
0..000
0.000
0.000,
0.000
0.000
0.000
0.000
0.003
Molyb-
0.014
0.01.6
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.030
denum
Nickel
0.025
0.042
0.000 1
0.000
0.000
0..000 1
0.000
0.000
0.000
0.000
0.000
0.000
0.068
Selenium
0.014
0.016
0.000
0.000
0.0001
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.030
Zinc
0.814
1.424
0.000
0.000
0.000
0.000
.0.000
0.000
0.000
0.000
0.000
0.000
2.238
Total
Phos-
60.262
36.748
0.000
0.000
0.000.
0.000
0.000
0.000
0.000
0.000
0.000
0.000
97.010
horus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
IV ,sonment for knowing violations".
Xj. 1 / 14/2016
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
Operator:
ANNUAL LAND APPLICATION i ArELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
City of Burlington
Kenneth Culberson
Kenneth Culberson
Crop 1 Name:
Fescue -Pasture
WQ Permit #: WQ0000520 Field #:
Annual Dry Tons Applied:,' j. 248`'8 Site #:
Predominant Soil Series: faB
Crop 1 Max. PAN: 90 Crop 2 Name:
Acres Utilized: 8.2
AM002 Acres Permitted: 8.2
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
o
o
Q
Volume applied
Pp
(enter one) Solids/
Liduid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/AC)
Residual Sources
(NPDES #, WQ#
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry,
Wet,
Moist)
Precip.
Past 24
Hrs.
inches
Y
-0
'0
o ?,
a o.
o
%`� P_
N
* I~.
p
' 0 �
w �,
* N
* �+
TKN
mg/kg
Z Y
4
o
�;
R w
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
( Ibs/acre)
Name of Crop Type
Receiving Residual
Application
Crop I
Crop 2
Crop 1
Crop 2
3/18
65000
4.26
1„408
South Burlington
D
<.5"
S
0.5 1
0.3
62400
6810
2
56.562
NA
Fescue
3/19
65000
4.92
1.626
East Burlington
D
<.5"
S
0.5
0.3
31500
3460
2
32.994
'NA
Fescue
0.000'
0.000
0.000
0.000
0:000.'
0.00.0
.000.
0.0m) .
0.000
0 0,00
0.000
0.600
01,000
0,000
0.00.0
0.000
.0.00o '
0.000
0 000 .
0.00o
6.006 >
0 000
0.000' `
. 000
6.000
0.00.0
0.000'
0.000
0.000
0.006.
0
0
0 000
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000
0.000
TOTALS
xs �+
13ut1ao
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
5556
u.u00
Lime Applied
Annual lbs/acre
0 01;&
0.,012.
1:025 R
O:655
0.077 _
. 0 003
0 03Q; x
0:068
0.030
2 238
a 97 0 ±0•` ::.. .:.:: ::::::?::.:; :':::
........ .. .
Date
Ibs/ac
Prior Years Cumulative lbs/ac
0.0327
0.0173
1.9858
0.5197
0.1753
0.0097
0.0563
0.1413
0.0553
4.6473
Current Cumulative lbs/ac
0.051'
0.024'.
3.01'.1 ..
`' 1:.175 .
_.
.0 252� {
....
' 0.013' '
10 087
0 20:9
0 086'
6:886
Permitted C. P. L. R.****
36
34
1338
267
15
374
89
2498
Permit P rt 1 st2 AN Lim' / nd Crop
90
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual):
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
("--';ator: Kenneth Culberson Owner: Kenneth Culberson Predominant Soil Series:
A.. zs Used: 8.6 Acres Permitted: 8.6 Site #: AM002 Field #:
15.10
0
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
.m
..
Date
yj0®____-_____
Total
Pbos-
-ohorusmMENEEMENEEN
+aal Heavy Metal Field Loadings (Calculated in lbs/acre):
1 otal
11
L2]3
4
5
6
7
8
10
11
12
DT/Ac./
_9j
App-
Event
0.67
1.09
"
Arsenic
0.004
0.007
0.000
0.000
0.000
0.0.00
0.000
0.000
0.000
0.000
0.000
0.000
0.011
Cadmium
0.003
0-004
0.000
0.000
0.00.0
0..0.00
1 0-.000
0.000. ;
0.000
1 0::000
0.000
0.000
1 0.007
Copper
0.18'8
0-421
0.000
0.0.00
0..000
0.-000.
0 Q00
0.000
0.000
0.000
0.000
0.000
0.6.09
Chromium
0.255
0 080
0.000
0.000
0;000'
0.000
f 0.00.0
0 000
0.000
0.006
0.000
0.000
0.335
Lead
0.013
0.033
0.000
0.000
0.000
0.000
0.0.00
0.000
0.000
0.000
0.000
0:000
0.046
Mercury
0.001
0.001
0.000
0.00..0
0.000`
0.0.00
0.000
0.000
0.00.0
0.000
0.000
0.000
0.002
Molyb-
0.007
0.011
0.000
0.000
0.000
0.000
0.000
0.060
0.00.0
0.000
0::000
0.000
0.018
enum
Nickel
0.012
0.028
0.000
0.000
0.000
0.000
0.000
0.0-00
0.000
0.0.00
0.000
0.000
0.040
Selenium
0.007.
0..011
0.000
0.000
0.000
0.000
0.000
0.00.0
0.000
0.000
0.000
0..0.00
0:018
Zinc
0.388
0:950
0:.000
0.000
0.000
0.000
0.000
0.000.
0.000
0.000
0.000
0.00.0
1.338
Total
Phos-
28.719
24.521
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
51240
horus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
•isonment for knowing violations".
Signature of Land Applier
1/14/2016
Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
Operator:
ANNUAL LAND APPLICATION � ,ELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
City of Burlington
Kenneth Culberson
Kenneth Culberson
Crop 1 Name:
Fescue -Pasture
WQ Permit #: WQ0000520
Annual Dry Tons Applied:
Predominant Soil Series: IaB
Field #:
Site #: AM002
Crop 1 Max. PAN: 90 Crop 2 Name:
Acres Utilized: 8.6
Acres Permitted: 8.6
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
°
°
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/AC)
Residual Sources
(NPDES # WQ#
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry'
Wet,
Moist)
Precip.
Past 24
Hrs.
inches
Y
�
o w
a
*
C
o
�*
N'
#
o'
❑
wCD _
N
TKN
mg/kg
Z a
o
p 5
5.
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop
p Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
3/18
32500
4.26
`'0 671
South Burlington
D
<.5"
S
0.5
0.3
62400
6810
2
26.966
NA
Fescue
3/19
32500
4.92
0 775•;
East Burlington
D
<.5"
S
0.5
0.3
31500
3460
2
15.730
NA'-,'
Fescue
3/23
13000
4.92
01
East Burlington
D
<.5"
S
0.5
0.3
31500
3460
2
6.292
NA ,„
Fescue
:0 000
0.000
0 00..0
0 000.'
0.000 ,
, am-O.- '
0 000 .
0.000
1400a
0,000
0.000 `'
0.000..
0 ,000
0.000
0.060 `
. 0 000 -
0.000
0.000 '
0 000
0.000 '
0.000:•
0 000
0.000
QA00
0 000
0.000
'0.000
0
0
0 000. • 11
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.0,00
1.01111
TOTALS:
As
Cd
Cu
Cr
Pb
H 1
Mo
Ni
Se
Zn
P
48:989
ti.noo
Lime Applied
Annual lbs/acre
0 011 ° =r0.0402
.007`
0 6Q9
Q 33� "
: 0 04.(i.
D 00ti�
`0 01s3
0;040
0 018
;1.119;,
�53.240 :.
: ::::: :::::.........I.....................................I....
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.0262
1.7144
0.8948
0.2796
0.006
0.0523
0.2851
0.0304
5.1102
Current Cumulative lbs/ac
0 039.;.047
2:323
1,2311
0 a?.f�
0.008"'
0 07U
0.325
0:048
"6.448
Permitted C. P. L. R.****
36
34
1338
267
15
374
8 9
2498
Permit PAN 2 Limit 1st/ nd Crop
90
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual): 34.07
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
gyrator: Joseph Johnson Owner: Jaime Graves Predominant Soil Series: GaB
A_- es Used: 13.6 Acres Permitted: 27.2 Site #: AM003 Field #: 1
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
SB
4/13/15
2
3
4
5
6
7
8
9
10
11
12
% Solids
4.19
Arsenic
3
Cadmium
2
Copper
152
Chromium
237
Lead
11
Mercury
0.5
Molyb-
denum
5
Nickel
9
Selenium
5
Zinc
322
Total
Phos-
nh_orus
21300
ual Heavy Metal Field Loadings (Calculated in lbs/acre):
i otal
1 11
1
31
4
5
6
7
8j
9
ILOJ
11 j
12
DT/Ac./
°may
App.
Event
2.51
Arsenic
0.015
1 0.000
0.000 1
0.000
0.000
0.000
1 0.000
0.000
0.000
1 0.000
0.000
0.000
1 0.015
Cadmium
0.010
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.010
Copper
0.762
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.762
Chromium,
1.187
0.006
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1.187
Lead
0.055
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1 0.000
0.000
0.055
Mercury
0.003
0.000
0.000
-0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.003
Molyb-
0.025
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.025
denum
Nickel
0.045
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.045
Selenium
0.025
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000 1
0.000
0.000
0.025
Zinc
1.613
0.00.0
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000 1
0.000
0.000
1.613
Total
Phos-
196.713
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
106.713
phorus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
i •isonment for knowing violations".
1/14/2016
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION -.iELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: City of Burlington WQ Permit #: WQ0000520 Field #: 1 Acres Utilized:
Land Owner: Jaime Graves Annual Dry Tons Applied: 34.07 Site #: AM003 Acres Permitted:
Operator: Joseph Johnson Predominant Soil Series: GaB Cation Exchange Capacity (non 503):
Crop 1 Name: Soybeans Crop 1 Max. PAN: 190 Crop 2 Name: Crop 2 Max. PAN:
13.6
27.2
0
.�
0 +�
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES # WQ#
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry'
Wet'
Moist)
Precip.
Past 24
Hrs.
inches
Y
cc 'L'
0
c. ..
o
%°
x �'
w
o
0
po
w •,
Sn
*
* o'
TKN
mg/kg
Z
q
o
o0 0
w
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
( lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop I
Crop 2
Crop 1
Crop 2
5/18
195000
4.19
2.505; .
South Burlington
Dry
<.5"
S
0.5
0.3
66100 1
7880
69?
107.600
NA
Beans
0:000
0.000
0.000
0.000
0.000
0.000
0A00
0.000
0.000
.'0i000
0.0W
0.000
fl 0Q0 •
0.000
0-000
O000,
0.000
o,0oo
000.0:
0.000
0.000
0,000
0.000
0.000
0.00:0
0.000
0.000
:000
0,000
0.000
0 000;,
0.000
0.000
0
o
!"0.000 000 "
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form ):
0.000
0.000
TOTALS:
C�
�1s,tx►��
::::: ;:::;
As
Cd
Cu
Cr
Pb
Ha
Mo
Ni
Se
Zn P
107.6001
o,o00
Lime Applied
Annual lbs/acre
0. 0157 '
0.010
0 762
1" ] 87
0.055
0 003:
`<0.025;'
r 0.045
0:�25 {
:613 106.71.3.:::' .. ;':: `-'
6.5256 :::::::::::::
...........................
............................
" '
8.139 .
1 2498
Date
Ibs/ac
Prior Years Cumulative lbs/ac
0.0397
0.0422
3.3465
1.4096
0.3169
0.0116
0.0946
0.2322
0.0431
Current Cumulative Ibs/ac
A055
0 052
4.108
2.597+�
^,.
0 3'72
0 01,4'`
0 120 "
; 0.277
O:Q68
Permitted C. P. L. R.****
36
1 34
1338
1 267
15
1
374
1 89
Permit PAN Limit 1 st/2nd Crop
90
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
4�'--LLB''-- �j - *Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation -1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual):
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
`ator: Joseph Johnson Owner: Jaime Graves Predominant Soil Series:
At -es Used: 26.2 Acres Permitted: 26.2 Site #: AM003 Field #:
94.98
GaB
2
Residual Analvsis Data (Heave Metals and Total Phosphorus use me/kg. % Solids use Raw Percent #):
-,
Com-
posite,
Date -
o
©
a
o
0
o
min
Total
Phos-
rhorusmMENEEMENEEN
lal Heavv Metal Field Loadings (Calculated in lbs/acre):
T60
1
1 21
3
4
5
6
71
8
9
10
11
12
DT/Ac./
0
App.
Event
2.69
0.94
Arsenic
0.016
0.006
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.022
Cadmium
0.011
0 004-
0.000
0.000
.0.000
0.000
0.000
0.00.6
0.000
0.000
0.000
0.000
0.015
Copper
0.917,
0.272
0.000
0.000
0.000
0.000
0.0.00
.0.000
0.000
0.000
0.000
0.000
1.089
Chromimi
1.274
0.073
0.000
0.000
0:000
0.000
0.000
`0.000
0.000
0.000
Q.000
0.000
1.347
Lead
0.059
0.026
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.085
Mercury
0.003
0.002
0.000
0.000
0000
0.000
0.000
0.000
0.000
0.000
0.000
0.000'
0.005,
Molyb-
0.027
0.009
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0..000
0.000
0.036
denurn
Nickel I
0..04E
0.026
0.000
0.000
0.000..
0.000 -
0.000
0`.000
0.0.00
0.000
0.00.0
0-.000
0.075
Selenium
0.027
0.009.
0.000
0.000
0.000 `
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.036
Zinc
1.731
0.802
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.00.0
0.000
2.533
Total
Phos-
114.509
20.239
0:000
0.000
0.00.0
0.000
0.000
0.000
0.000
0.000
0.000
0.000
134.748
horus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
iT sonment for knowing violations".
4;2_ 1/14/2016
Signature of Land AppIier
Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
Operator:
ANNUAL LAND APPLICATION t .rELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
City of Burlington WQ Permit #: WQ0000520 Field #: 2 Acres Utilized:
Jaime Graves Annual Dry Tons Applied: 94:9$, Site #: AM003 Acres Permitted:
Joseph Johnson Predominant Soil Series: GaB Cation Exchange Capacity (non 503):
Crop 1 Name: Soybeans Crop 1 Max. PAN: 190 Crop 2 Name: Crop 2 Max. PAN:
26.2
26.2
0
° y
° °
Q
Volume applied
enter one Solids/
( )
Liquid
Cu. Yds Gallons
o
/o
Solids
Volume
Applied per
PP p
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry,
Wet
Moist)
Precip.
Past 24
Hrs.
inches
y
o
*o
o
X ?
4
-4
g "
'=
* N
T'KN
mg/kg
Z
o
w.
mg/kg
Nitrate
and
Nitrite
mgtkg
PAN Applied
(]bs/acre)
Name of Crop Type
Receiving Residual
g
Application
Crop 1
Crop 2
Crop I
Crop 2
5/12
169000
4.19
1:127
South Burlington
Dry
<.5"
S
0.5
0.3
66100
7880
69.2
.48.406
NA
Beans
5/12
52000
4.53
0:375
East Burlington
Dry
<.5"
S
0.5
0.3
26500
1550
108
6.275
NA
Beans
5/19
234000
4.19
1.561
South Burlington
Dry
<.5"
S
0.5
0.3
66100
7880
69.2
67.024
NA "
Beans
5/20
78000
4.53
6.562
East Burlington
Dry
<.5"
S
0.5
0.3
26500
1550
108
9.41`2 `'
NA• . I
Beans
0.000' •
'' 0.0001,
0.000:
O'000
0.00o
•0.000 ° .
OA00
0 00.0'
0.000
0.000
0.000, ",
:0.000'.
O'.0o0 :
0.000 .
°- 0.000 :
0:000
0.000,
0.00o
"0.000
0
0
ap
0 .°,re
Residuals Applications totals on FORM
FSF supp (attach FORM FSF supp
to this form):
O:OUO
u.000
TOTALS:
nI
As
Cd
Cu
Cr
Pb
M4
Mo
Ni
Se
Zn P
131.11
0 000
Lime Applied
Annual lbs/acre
0 022 '
° 0 01:5'
To-9
h t;,347
6:�►85
_,
t�A05 .:
0 03f '
0..075 '
O.a36•
_
2,533 . _ 131.748
10.5186
.
13.052'
2498
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.064
0.047
4.5465
2.0562
0.5512
0.0165
0.1285
0.4267
0.0503
Current Cumulative lbs/ac
0 086
0.062
5.6;3'S
3;403
0.637
0 021
0.165
0:501
0:087
Permitted C. P. L. R.****
36
34
1338
267
15
374
89
Permit PAN Limit 1st/2nd Crop
190.
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation -1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual): 63.81
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
r '-ator: Joseph Johnson Owner: Jaime Graves Predominant Soil Series: GaB
Asses Used: 22.7 Acres Permitted: 22.7 Site #: AM003 Field #: 4
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Com-
posite
won
0
W
Molyb-
denum
Total
Phos-
mM
ual Heavy Metal Field Loadings (Calculated in lbs/acre):
Total
1 11
L2]3
4
5
6
7
8
9
10
11
12
DT/Ac./
c
App.
y
Event
1.35
1.46
Arsenic
0.00.8
0.009
0.000
0.000
1 0.000
0.0.00
0.000
0.000
0.000
0.000
0.000
0.000
0.017
Cadmium
0.005
0.006
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.00.0
0.011
Copper
07411
0.423
0.000
0.000
0.000
0.000
0.000
0.000,
0.000
0.000
0.000
0.000
0.834
Chromium
0.640
0.114
0.000
0.000
0.000
0.000
0.000
0.00.0
0.000
0.000
0.000
0.000
0.754
Lead
0.030
0.041
0.000
0.000
1 0.000
0.000
U.000
0.000
0.000
0.000
0.000
0..000
0.971
Mercury
0.001
1 0.003
0.000
0.000
0.000
0.00.0
0.000
1 0.000
0.0ft
0.000
1 0.000
0.000
1 0.005
Molyb-
0.014
0.015
0.000
0.000
0.000
0..000
0.000
0.000
0.000
0.000'
0.000
0.000
0.029
denum
Nickel
0.024
0.041
0.000
0:000
0.000
0 000
0.000
06000
0.000
0.000
0.000
0.000
0.065
Selenium
0.014
0.015
0.000.
0,000
0.000
0.000 1
0.0001
0.000
0.000
0.000
0.000
0.000
0.028.
0:870
1.250
0,000
0.000
0.000
0.000
0.000
0.000
0.000.
0.000
0.000
0.000
2.120
L
57.553
31.536
0.000.
0.000
0.000
0-000
0.000
0.000
0..000
0.000
0.000
0.000
89.089
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
�r �sonment for knowing violations".
;95fz
_ 1/14I2016
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
Operator:
ANNUAL LAND APPLICATION j,..:ELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
City of Burlington
Jaime Graves
Joseph Johnson
WQ Permit #: WQ0000520 Field #:
Annual Dry Tons Applied: " 6381 Site #:
Predominant Soil Series: GaB
4
AM003
Acres Utilized: 22.7
Acres Permitted: 22.7
Cation Exchange Capacity (non 503):
Crop 1 Name: Soybeans Crop 1 Max. PAN: 190 Crop 2 Name: Crop 2 Max. PAN:
L
�; c
Q
Volume lied
applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
"�a
Solids
Volume
Applied per
PP P
Acre
(Dry Tons/AC)
Residual Sources
(NPDES # WQ#
Fert., Animal
Waste, etc)
Soil
Cond.
D
(Dry,
Moist)
Precip.
Past 24
Hrs.
inches
a
410
a
C
o
w
�,
*
w ti
;
N
TKN
mg/kg
z Y
o
ac o
w.
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
p yp
Receiving Residual
Application
Crop I
Crop 2
Crop 1
Crop 2
5/20
130000
4.53
1:082.
East Burlington
Dry
<.5"
S
0.5
0.3
26500
1550
108
18..105
.. NA'
Beans
5/21
45500
4.53
0:3 79` -.
East Burlington
Dry
<.5"
S
0.5
0.3
26500
1550
108
6.337
pNA
Beans
5/21
19500
4.19
0.150
South Burlington
Dry
<,5"
S
0.5
0.3
66100
7880
69.2
6.447 .
` . NA
Beans
5/22
156000
4.19
1.201
South Burlington
Dry
<,5"
S
0.5
0.3
66100
7880
69.2
51 572 ,
B NA...
Beans
0000 '
0 000
t9000 . > .
''0.000
0,066,
0000
0.000
9.000
0000
0.00o
a.0.00
O Ooo . ``
0:000
d 000
0.000
0.000
0.00.0.
0.000
0.000
0'
§ 0;;000 •
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000
-0.000?
TOTALS:
n
n ` 351 urn
• ;: ' ; ;:
As
Cd
Cu
Cr
Pb
Ha
Mo
Ni
Se
Zn
P
= 82.461 '
0 000:':"
Lime A > ,lied
Annual lbs/acre
6.0417 '
0 0i1
0 834
0 S4
p 0.7..1,
0005� ,
0 OZ$,
0 065
0 028
....
2 120
-'89.089 :;: :: :.::;"::; ::»
::::::: :: :: ::.::::::::
...........................
............................
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.0605
0.051
4.745
1.7396
0.4682
0.0203
0.135
0.3593
0.0797
10.6421
Current Cumulative lbs/ac
6.077
0 062;
5.579
2:47.1
0,53)
0 025 '
0.143
0 424 »
O.J'
12.762
Pennitted C. P. L. R.****
36
34
1338
267
15
374
89
2498
P it P 2 erm AN Limit 1 t/ nd Crop
90 .
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual):
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
P- '�ator: Tom Neal Owner: Walter Hessenthaler Predominant Soil Series:
A.,. es Used: 18.6 Acres Permitted: 18.6 Site #: AM006 Field #:
51.48
AbB
2
Residual Analvsis Data (Heavy Metals and Total Phosphorus use melka, % Solids use Raw Percent #):
posite•:
Date
9/8/15
©
E�
Total
Phos-
::
M
ul Heavv Metal Field Loadings (Calculated in lbs/acre):
1 otal
11
2
31
14]5
6
7j
L8J
9
LOJ
11
12
DT/Ac./
App.
Event
2.57
0.20
Arsenic
0..015
0.001
0.006
0-.0001
0.000
0.000
-0.000
0.000
0.000
0.00.0
0.000
0.000
0.017
Cadmium
0.010
0.001.
0.000'
0.000
0.000
0.000
0.000
0:00.0
0.000
0:000
0.000
0.000
0.011
Copper
1.620
0.119
0.000
0.000
0.000
0.000-
0.000
0.000
0.000
0,000 -
0.0-00
0.0.00
1.739
Chromium
0.247
0 094
0:000
0.000
0.000
0.A00.
0.000
0.000
0.000
0.000
0.000
0.'000
0.341
Lead
0.067
O 010
0.000
0.000
0 00„0
0.0010.
0.000
0.000
0.000,
0.000
0.000
0..000
0.077
0:002
0..001
0..0.00
0.00:0
0.000
0.000
0.000
0.000
0.000.
0.000.
0.000
0A00
0,003
0.026
0.002
0..000
0.000
0.000
0.000_
0.0.00
0.000
0.000
0.000
0.000
0.000
0.02'8
0.046
0.008
OA:00:
0..0.00
0.000"
0.000
0.000
0.000`
0.:000
0.000
O'000
0.000
0..055
Idenum
0.026
0.002
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.028
2 993
0:193--
0.060 ;
0.0.00
0.000
0.000.
0.000
'0 000
0.000
0,00.0
0.000
0.000
3.18:5
45.404
15.996
0.000
0.000
0.000
0.000
0:000
0.000
0:000
0.000
0.000
0.000
61.400
horus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
i� Isonment for knowing violations".
i
1/14/2016
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
Operator:
ANNUAL LAND APPLICATION -.-1ELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
City of Burlington WQ Permit #: WQ0000520 Field #: 2 Acres Utilized:
Walter Hessenthaler Annual Dry Tons Applied: 5.1.48 Site #: AM006 Acres Permitted:
Tom Neal Predominant Soil Series: AbB Cation Exchange Capacity (non 503):
Crop 1 Name: Fescue -Hay Crop 1 Max. PAN: 237 Crop 2 Name: Crop 2 Max. PAN:
18.6
18.6
0
°
Q
Volume applied
enter one Solids/
( )
Liquid
Cu. Yds Gallons
o
/o
Solids
Volume
A hed er
pp p
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, W #,
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry,
e '
Moist)
Precip.
Past 24
Hrs.
inches
Y
co
o
o� w
* o
o
w
3
w w
;,
TKN
mg/kg
z
0 o
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
pp
(lbs/acre)
Name of Crop Type
ReceivingResidual
Application
Crop I
Crop 2
Crop 1
Crop 2
10/12
169000
3.6
: 1'3-64
East Burlington
D
<.5"
S
0.5
0.3
23100
3060
2
20.580
NA
Fescue
10/13
149500
3.6
1107
East Burlington
D
<.5"
S
0.5
0.3
23100
3060
2
19-205
NA
Fescue
10/14
32500
2.7
0',19.7' `'
South Burlington
D
<.5"
S
0.5
0.3
65200
24100
2
9.593
NA
Fescue
0 0601
0.0111)
0.000
0.000
0.000
'0`..000 '
0.000
0.000
'Oc000
0.000
0.000
0 000
0.000
0.000
0.000
0.000
0.000
omw
9L.%0
0.000
0.000
0
0
6 000
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
6.600
0.000
TOTALS.
`, , 0
3S l itl)0
;'•';' : ;'.
As
Cd
Cu
Cr
Pb
H �•
Mo
Ni
Se
Zn
P
48.379 `
1 000
Lime Applied
Annual lbs/acre
0 Ol Z ' °
775777, t
1.739
0.341
0.077
0 003 a°
0 02;8
* 0:0.55
C :f128 r
SJ85 '
61.400 ` :;>::: ; ;`'; ; : ; :'`: ;>:::
.. .. .. .,
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.0995
1 0.0747
7.0473
3.0134
0.7153
0.0272
0.1787
0.4944
0.1048
18.591
Current Cumulative lbs/ac
011'16 '
0 U86
8..786
3:354
0 7y2
0.030_,
" 0.207
=0;549 '
0132
21.776
Permitted C. P. L. R.****
36
34
1.338
267
15
374
89
1 2498
it P Perm AN Limit s 1 t/ 2n d Crop
2 .
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R,: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name:
Permit #:
',ator:
A, es Used:
City of Burlington Total Dry Tons Applied (Annual):
WQ0000520 Cation Exchange Capacity (non 503 only):
Walter Hessenthaler Owner: Tom Neal Predominant Soil Series:
10.4 Acres Permitted:
10.4
Site #: AM006 Field #:
13.90
AbB
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
SB
9/8/15
2
3
4
5
6
7 j
8j
9j
10
11
12
% Solids
2.7
Arsenic
1 3
Cadmium
2
Copper
303
Chromiim
238
Lead
26
Mercury
1.3
Molyb-
denum
6
Nickel
21
Selenium
5
Zinc
489
Total
Phos-
phorus
40600
ial Heavy Metal Field Loadings (Calculated in lbs/acre):
1 otal
1
L2J
3
L4J
5
6
7
8
9
10
11
12
DT/Ac./
App.
Event
1.34
14
Arsenic
0.008.
0.000
0.00.0 1
0..000
0.000
A-000
1 0.000
0.0.00
0.000
1 0.000
0.000
0.000
0.008
Cadmium
0.005
0.060
0.000
0.000
0.000
0.000
0.000
0.000
0 000
0.000
0:000
0.000
0.005
Copper
0.810
0.000
0.000
0.000
0:09..0
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.810
Chromium
0.63E
0.000
0.000
0.000
0.000
0.000;
0.000
0.000,
-0.000
0.000
0.000
0.000
= 0.63.6
Lead
0.070
0.000-
0.000
0.000
0.000
0.000
0..000
0.000
0.000
0.000
0.000
0.006
0.070
Mercury
0.003
0.000
0.000
0.000
0.000.
0,00o
0:000
0.000
0.00Q. ,
0.000
0.000
0.00.0
0.003
Molyb-
0:016
0:000-
U.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0:000
0.016
denum
Nickel
0,056
0..000
0.000
0.000
0.000
0..0.0.0
0.000
0.000
0,000
0,000
0.000
0.000.
0.056
Selenium
0.0113
0 000
0.000
0.000
0.000,
0.000
0.000
0:000'
0.000 1
0.000
0.000
0,000
0.013
Zinc
1.308
0.000
0.000
0.000
0.000
.0.000.
0.000
0.000;
0.000
0.000
0.000
0.000
1.308
Total
Phos-
108.564
0.000-
0.000
0.000
0.000
0.000
6.000
0.000
0.000
0.000
0.000
0.000
108.564
horus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
�sonment for knowing violations".
42!y-e 4:2�_ 1/14/2016
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
Operator:
1
ANNUAL LAND APPLICATION x--tELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
City of Burlington WQ Permit #: WQ0000520 Field #: 8 Acres Utilized:
Tom Neal Annual Dry Tons Applied: 13.90'' Site #: AM006 Acres Permitted:
Walter Hessenthaler Predominant Soil Series: AbB Cation Exchange Capacity (non 503):
Crop 1 Name: Fescue -Pasture Crop 1 Max. PAN: 177 Crop 2 Name: Crop 2 Max. PAN:
10.4
10.4
0
�
o =
o
o
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
o
�u
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry,
Wet
Moist)
Precip.
Past 24
Hrs.
inches
�
cu b
°c. w
#o
o
w
�.
�-
70
w ti
c P_
* w
*cr.
°o
TKN
mg/kg
Z >
o
ova
p �•
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop I
Crop 2
10/14
123500
2.7
1.337
South Burlington
D
<.5"
S
0.5
0.3
65200
24100
2
65.198
NA
Fescue
0.000
0,000
0 000 ' "
0.006 '
0.000
0 000
0.000
0.000
0.000,
0.000
0.000
:0 000
0.000
0.000
0 000::
0.000 '
0.000
OVI000' `
0.000
0.000
0`000
0.000
0.000
0.000
0.000
0.000
o.000 `
o.000
o.o00
{)'
0`
0 000 .= .
Residuals Applications totals on FORM
FSF supp (attach FORM FSF supp
to this form):
0.000.
0.000
TOTALS:
n
113500
;:::: ;:::::
As
Cd
Cu
Cr
Pb
Hu
Mo
Ni
Se
Zn
P
65.198.
r►.ouc►
Lime A i lied
Annual lbs/acre
Q 008'"
0 005
0.810
Os,636
0.070
c 0 003.v'
'`0.010
U:56 `
0013-
P 3,08 .''1t}8:564
:.:' ::: ? ::: >::::
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.0397
0.0203
2.9034
1.7764
0.2554
0.0085
0.0693
0.1665
0.0496
6.105
Cumulative lbs/ac
0 048'
0:026
3i:714
"°2413 .:T
—77=Current
0 32'S
o 012::'
s0.08..5
0:223°
0063
7 413:
Permitted C. P. L. R. ****
36
34
1 1338
1
1 267
15
1
374
89
1 2498
i Perm t PAN Li 2 Limit 1st/ nd Crop
177`
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual):
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
`ator: Walter Hessenthaler Owner: Tom Neal Predominant Soil Series:
A.., es Used: 18 Acres Permitted: 18 Site #: AM006 Field #:
7.33
AbB
9
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
SB
9/8/15
2
3
4
L5J
1617
$ J
9
LOJ
11
12
% Solids
2.7
Arsenic
3
Cadmium
2
Copper
303
ChromiLlIn
238
Lead
26
Mercury
1.3
Molyb-
denum
6
Nickel
21
Selenium
5
Zinc
489
Total
Phos-
chorus
40600
vial Heavy Metal Field Loadings (Calculated in lbs/acre):
1 otal
11
2
3
4
5
6
7
8
9
10
11
12
DT/Ac./
0
App.
y
Event
0.41
Arsenic
0.002
0.000
0.000
0.000
1 0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.002
Cadmium
0.002
1 0.000
0.000
0.00.0
0.000
0.000
0.000
1 0.000
0.000
0.000
0.000
0.000
0.002
Copper
0.247
0.000
0.000
0.000
0.000:
0.000
0.000
0.00.0
0.000
0.000
0.000
0.000
0.247
Chromium
0.194
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.194
Lead
0.021
0.000
0.000
0..000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1 0.021
Mercury
0.001
0.000
0.000
0.000
0.000
0.000;
0.000
0.000
0:000
0.000
0.000
0.0.00
0.001
Molyb-
0.005
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.005
denum
Nickel
0.017
0.000
0,000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.017
Selenium
0.004
0.000
0.000
0.000
0 000
0.000
0.600
0.000
0.000
0.000
0.000
0.000 1
0.004
Zinc
0.398
0.000
0.000
0..000
0.000
0.000 1
0.000
0.000
0.000
0.000
0.000
0.000
0.398
Total
Phos-
33.048
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
33.048
horus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
iT i,,sonment for knowing violations".
''9!:�z 1/14/2016
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
Operator:
ANNUAL LAND APPLICATION -x.&LD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
City of Burlington WQ Permit #: WQ0000520 Field #: 9 Acres Utilized:
Tom Neal Annual Dry Tons Applied: r; _ r` 7;33_. Site #: AM006 Acres Permitted:
Walter Hessenthaler
Crop 1 Name: Fescue -Pasture
Predominant Soil Series:
Crop 1 Max. PAN: 177
AbB
Crop 2 Name:
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
18
18
0
o ,
r.
QLiquid
Volume applied
(enter one) Solids/
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
W
Moist)
Precip.
Past 24
Hrs.
inches
Y
F
o
;c w
w �.
o
7y
w q
CD
* w
o
TKN
mg/kg
Z
r
o
ao o
w.
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop I
Crap 2
Crop 1
Crop 2
10/15
65000
2.7
0.407
South Burlington
D
<.5"
S
0.5
0.3
65200
24100
2
19.826
NA
Fescue
0000
0.000
0.0oo
0.000'.
0.006
0.000
0 000
0.000
0_000
0 000
0.000
o.000
a.Qao`
0:00.0
0.0oo
0.000
0.000
omoo
0 000`
0.000
omo0
0 000 •
0.000
twoo
6_006
0.000
i1.0oo
0.000.
0.000
o.00o
0.00.0
0.000
0.0o0
0
o
0 000
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000
0,000
TOTALS:
0
6s000
As
Cd
Cu
Cr
Pb
14,
Mo
Ni
Se
Zn
P
19.826
[[.uo[i
Lime A > >lied
Annual lbs/acre
' "02
0 002
0.247
0194
0.021
0.001`
0 003
° 0.0;17
0.004
0 398 -
33.048 :: > : .:
..........•.•..• ..
.. ........ ..... .. ...
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.0211
0.0113
1.5554
0.8913
0.1319
0.0053
0.0369
0.093
0.0285
3.3166
Current Cumulative lbs/ac
0 024
0.01°:3.
1:,8.02
1:085
0.153'.
oA06'
6.042
_
0 ,1;10 t
0.033
3.715
Permitted C. P. L. R.****
36
34
1338
267
15
374
89
2498
Permit PAN Limit 1st/2nd Crop
17T '
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
*** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
Signature of Land Applier Date aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual):
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
( Bator: Michael Teague Owner: Michael Teague Predominant Soil Series:
A,. es Used: 16.4 Acres Permitted: 16.4 Site #: AM007 Field #:
46.35
MbB2
1
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1 1
EB
3/16/15
2 j
31
L4 I
L516
7
8
9
L01
11
12
% Solids
5.7
Arsenic
3
Cadmium
2
Copper
194
Chromium ,
40
Lead
17
Mercury
0.4
Molyb-
denum
5
Nickel
15
Selenium
5
Zinc
483
Total
Phos-
ohorus
10800
',tal Heavy Metal Field Loadings (Calculated in lbs/acre):
1 otal
1 1
1. 2
3
4 j
5 j
1 6
7 j
8
9
10
11
12
DT/Ac./
App.
Event
2.83
Arsenic
0.017
1 0.000
0.000 1
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1 0.000
0.017
Cadmium
0.011
0.000
0.000
0.000
0.000.
0.000
0.0.60
0.000
0.000
0.000
0.000
0.000
0.011
Copper
1.096
0.000
0.000
0.000
0.000
0.060
0.000
0.000
0.000
0.000
0.000
0.000
1.0.96
Chromiu11,
0.226
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.226
Lead
0.096
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.096
Mercury
0,002
0.00.0
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.002.
Molyb-
0.028
0.000
0.000
0.000
0.000
0.000
0.00.0
0.000
0.000
0.000
0.000
0.000
0.028
denum
Nickel
0.085
0.-000
0.000
0.000
0.000
0.000 1
0.000
0.000
0.000
0.000
0.000
0.000
1 0.085
Selenium
0.028
0.000-
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.028
Zinc
2.730
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
2.730
Total
Phos-
:61-042LO-000
0.000
0.000
0.000 _
0.000
0.000
0.000
0.000
0.000
0.000
0.000
61.042
7horus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
i�r ;sonment for knowing violations".
1/14/2016
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

I
Facility Name:
Land Owner:
Operator:
ANNUAL LAND APPLICATION -.--tELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
City of Burlington WQ Permit #: WQ0000520 Field #: 1 Acres Utilized:
Michael Teague Annual Dry Tons Applied:: 46-35 Site #: AM007 Acres Permitted:
Michael Teague Predominant Soil Series: MbB2 Cation Exchange Capacity (non 503):
Crop 1 Name: Fescue -Pasture Crop 1 Max. PAN: 145 Crop 2 Name: Crop 2 Max. PAN:
16.4
16.4
0
o
o
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
ova
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
PDES #, W #,
(N Q
Fert., Animal
Waste, etc)
Soil
Cord.
(Dry,
Wet,
Moist)
Precip.
Past 24
Hrs.
inches
a
b
n 'a
5 �'
a w
* °y
o
�:
; y
*
o'
-
7
w ,
, N
o'
TKN
mg/kg
Z Y
o
�; w•
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
4/1
52000
5.7
0:754
East Burlington
D
<.5"
S
0.5
0.3
29300
2630
2
14:045
NA
Fescue
4/2
143000
5.7
2.073
East Burlington
D
<.5"
S
0.5
0.3
29300
2630
2
A624 `
NA
Fescue
009
0.000 "
0:00.0 '
Q. 60.0.
Q',00n
0.00.0--:.
0:.000
0:�►0o r
0 040
0, OOQ
0.0o0
0.00.0
Q 000 .
0.000
0 0016
0 6Q.0:
0.000
0 000'
0 000
0.000
0 000...
0 000
(y000. `
'01.000
0 bo0
0.000
0 000
o Ooo
o.o0o
0 000
0000,
!
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000
0.0on
TOTALS:
0
195.000'
AS
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
52.669
0.000"'
Lime A > ,lied
Annual lbs/acre
0 Ot 7 '"
0 4l
1.096
0:226
`0;,(Wo
0..002
0 028
5
0 08`5
4 0 0 8
" 2330 ""
61.042 :;: ;
......:...... ..
... ::::
'.':': .:.:: ' '
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.0536
0.0543
4.8245
1.9561
0.5192
0.0155
0.1528
0.4204
0.073
9.6551
Current Cumulative lbs/ac
0.071
0.066,
5.921
2:182
0 615
0 0 $ -
0 187°.
g 0:505 + .
,. 0.141
;12 383
Permitted C. P. L. R.****
36
34
1338
267
15
374
89
1 2498
Permit PAN Limit l t/2 nd Crop
14 5
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual):
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
("'�';ator: Michael Teague Owner: Michael Teague Predominant Soil Series:
A,. es Used: 18.5 Acres Permitted: 18.5 Site #: AM007 Field #:
59.61
MbB2
2
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1 1
EB
2/16/15
2
EB
3/16/15
31
4
5
6
L 71
8
9
10 1
111
12
% Solids
4.92
5.7
Arsenic
1 3
3
Cadmium
2
2
Copper
194
194
Chromium
37
40
Lead
15
17
Mercury
0.4
0.4
Molyb-
denum
5
5
Nickel
13
15
Selenium
5
5
Zinc
438
483
Total
Phos-
nhorus
11300
10800
}al Heavy Metal Field Loadings (Calculated in lbs/acre):
1 otal
11
L2]3]
4
5
6
7
8
9
10
11
12
DT/Ac./
y
0
App.
Event
1.80
1.42
14
Arsenic
0.011
0.009
0.000
0.000
0.000
0.000
1 0.000
0.0.00
0.000
0.000
0.000
0.000
1 0.019
Cadmium
0.007
0.006
0.000
0.000
0.000
0.000
0,000
0.000
1 0.000
0.000
0.000.
0.000
0.013
Copper
0.699
0.551
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1.250
Chromium
0.133
0.114
0.000
0.006
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.247
Lead
0.054
0.048
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.102
Mercury
0.001
0.001
0.000
0.000
0.000
0.000
6.000
0.000
0.1000
0.000
0.000
0.000
0.003
Molyb-
0.018
0.014
0.000
0.000
0.000
0.000
'0.000
0.000
0.000
0.000
0.000
0.000
0.032
denum
Nickel
0.047
0.043
0.000
0.000
0.000
0.000
0..000
0.000
0.000
0.000
0.000
0.000
0.089
Selenium
0.018
0.014
0.000
0,000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.032
Zinc 1
1.579
1.372
0.000 1
0.000
0.000
0.000
A000
0.006
0.000
0.000
0.000
0.000
2.950
Total
Phos-
40.725
30.672
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
71.397
horus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
V 7sonment for knowing violations".
L�rZy't-
Signature of Land Applier
1/14/2016
Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
Operator:
ANNUAL LAND APPLICATION . -.�:LD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
City of Burlington WQ Permit #: WQ0000520 Field #: 2 Acres Utilized:
Michael Teague Annual Dry Tons Applied: ` 5-9::6I Site #: AM007 Acres Permitted:
Michael Teague Predominant Soil Series: MbB2 Cation Exchange Capacity (non 503):
Crop 1 Name: Fescue -Pasture Crop 1 Max. PAN: 145 Crop 2 Name: Crop 2 Max. PAN:
18.5
18.5
0
o
A
Volume applied
pp
(enter one) Solids/
Liquid
Cu. Yds Gallons
ova
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
Wet,
Moist)
Precip.
Past 24
Hrs.
inches
Y
Ts
c: 1
on m
*o
o
C
o
�'
�
7y c,
w
�J
TKN
mg/kg
Z Y
�
o 5
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
p yp
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
3/30 1
39000
4.92
0 433
East Burlington
D
<.5"
S
0.5 1
0.3
31500 1
3460
2
8.77i
NA " :
Fescue
3/31
123500
4.92
1, 70'
East Burlington
D
<.5"
S
0.5
0.3
31500
3460
2
27.787
NA:
Fescue
4/1
110500
5.7
'¶'1 420 .'
East Burlington
D
<.5"
S
0.5
0.3
29300
2630
2
26,458
NA
Fescue
0.000
0.000'
0 00o
g000
0.000.,
0.000;
0s000
.0.000
Or000
0.000
0 000.
0.00n
a o.0
0.000
0:000
0:000
0
0
0 000 "'
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
'0.000
TOTALS:
a
27 /`�0o
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
-63_019
0.000_
Lime A died
Annual lbs/acre
0 019 g'°.
0 013 m
L250 ,
� 0 247
0.1 o2
60 003
0 03
0 O8
h0.032
2:950
`=71397` :.... .:.
:::::=:':::::::::::::
............................
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.0414
0.0329
3.5456
1.1745
0.2792
0.0125
0.0858
0.2757
0.0238
6.4247
Current Cumulative lbs/ac
0,001
_
0.046
4 79,6
" 1.421
0. 382
0 01�
kit
40 365 `
_ _._..
� 0:056
_ .
9.375
Permitted C. P. L. R.****
36
34
1338
267
15
374
89
2498
Permit PAN Limit2 1st/ nd Crop
`145.
" I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual):
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
gyrator: Jimmy Staley Owner: Jimmy Staley Predominant Soil Series:
A__ es Used: 15.6 Acres Permitted: 15.6 Site #: AM008 Field #:
64.47
EdC2
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
.m
posite
Date
618115--1
0000100000
Total
xal Heavy Metal Field Loadings (Calculated in lbs/acre):
i otal
I 1 1
1 2
3€
41
5
6
7
81
9
10
11
12
DT/Ac./
App.
Event
1.92
2.22
Arsenic
0.011
0.013
1 0.000.
0.000
0.000
1 0.000"
0.000
0.000
0.000
0.000
0.000
0.0.00
- 0.025
Cadmium
0.0008
0.0"09
0.000
0..000
0.000
0..000
0:000
0.000
0.00.0
0:000
0.0.00
0.000
0.017
Copper
0:601
0.634
0.000.
0.000
O'.000 -
0.000
0.000
0.00
0.000
0.000
0.000
0.000
1.236
Chromium
1.020
0.208
0.000
0.00.0
0.000-
0.0W
0.000
02000
0.000
0.000-
0.000
0..006
1.23"5
Lead
0.042
0:058
0.000
0.000
0.000.
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.100
Mercury
0.005 "
0002
0.000
0.000
_
0.000
0.000
0.000
o:000.
' 0.000 _
0.000
0.000
o".000
o.00? .
Molybdenum
0.0-19
0.022
0.000.
0.000.
0.:000
0.000
0.000
0.000
0..0W
0.000
0.000
0.000
U:041
den
Nickel
0.0--
0t.06-2
0 000
0.000
0 000
0 Oo:O.
0.000
0.000
040.0
0.000
0.000
. 000
0.100
Selenium
0.019
0.022
0.000
0.006
-0.000
0.000
0.000
0:000
'0.000
0.000
0".000
0.000
0.041
Zinc
1.463
1.894
-0.000
0.600
0.000
OWN
0.000
0.00.0
0.00.0
0.000
0.000
0.000.
3.357
Total
Phos-
841260
53.232
0.000
0.000
0.000
0.000
0.000"
0.00-0
0.000
0.000
0.000
0.000
137.492
chorus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
i -Isonment for knowing violations".
1/14/2016
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
Operator:
ANNUAL LAND APPLICATION -.-tELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
City of Burlington
Jimmy Staley
Jimmy Staley
Crop 1 Name: Fescue -Hay
WQ Permit #: WQ0000520 Field #:
Annual Dry Tons Applied: K'47 Site #:
Predominant Soil Series: EdC2
Crop 1 Max. PAN: 162 Crop 2 Name:
Acres Utilized: 15.6
AM008 Acres Permitted: 15.6
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
�
o
° °
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
oho
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
PDES #, W #
Q
Fert., Animal
Waste, etc)
SoilPrecip.
Cond.
(Dry'
Wet,
Moist)
Past 24
Hrs.
inches
y
cc
�'
o a
a ...t�,
# 0
x''
m—
* N'
o•
❑
7y
w .,
w
* N
* o
o
TKN
mg/kg
o
ao o
w
mglkg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
g
Application
Crop I
Crop 2
Crop l
Crop 2
2/8
188500
3.8
L: 45
South Burlington
Dry
<.5"
S
0.5
0.3
63400
5260 1
2
76.872
NA
Fescue
7/16
143000
3.99
1525 "
East Burlington
Dry
<,5"
S
0.5
0.3
27300
4010
2
27,435
NA.
Fescue
7/17
65000
3.99
0 0,,3 ` '
East Burlington
Dry
<.5"
S
0.5
0.3
27300
4010
2
12.170
NA` `
Fescue
Q 000 ``'
0.000 .
0 00,0
a 000
0.000 -
0.000.
0 000
o.l11to
0:000.
9.000
A000
01090`£,
0.., 000
0:000
0 :000
01.1000
0.000
0.00.0-'
0:000
0.000 =
0.000 ..
;;4.000
6.000 `
0.000
0_
f t
0.000'.� "
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000
O.00W
TOTALS:
0
396Soo
As
Cd
Cu
Cr
Pb
H�
Mo
Ni
Se
Zn
P
116378
, 0.000»
Lime Applied
Annuallbs/acre
0025 =1'
4017
1.236
1235
.1=+a
0007`
0:04t
'4104
0:041�
3357
137.492 ....:::':...::..... ;
.. ...... ..... ... .
.,:.........
.:.:.. .:"
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.077
0.048
6.49
3.218
0.622
0.025
0.159
0.398
0.074
13.782
Current Cumulative lbs/ac
0.102> „
" 0.065 .
, T:726'
4453 a:
0.722t
'. 0 032'
0.200
0.:49.8 t
. 0.115;
17.139
Permitted C. P. L. R.****
36
34
1338
267
15
374
89
2498
Permit PAN L' t/2nd Cr Limit is Crop
162
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual): 36.06
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
Orator: James Hadley Owner: Ernest Goldworthy Predominant Soil Series: GaB
A. -.s Used: 12.3 Acres Permitted: 12.3 Site #: AM013 Field #: 1
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Com-
posite
Date
Total
Phos-
_P�0-rusmMENEEMENEEN
lial Heavy Metal Field Loadings (Calculated in lbs/acre):
offal
1
1 21
3
4
5j
L6]71
8
9
10
11
12
DT/Ac./
App.
y
Event
0.87
2.07
"
Arsenic
0.005
0.012
0.000
0.000
0.0.00
0.000
0.900
0.000
0.000
0..000
0,000
0.000
1 0.018
Cadmium
0.003
O.008
0.000
0.000
0..000
0.000
0.000
0.000:
.0.000
0.000
0:000
0.000
.0.012
Copper
0.336
0.578
0.000 ,
0.000
0.000
0.000
0.000-
0-.000
0.000
0.000
0.000
0.000
0.915
Chromium
0.064
0.185
0.000
0.000
.0.000
0.0,00..
_ 0.000
0.000
0.000
0.000
0:000
0.000
0.S49
Lead
0.026
0.041
0.000
0..000
0.000
Q.000
0.000
0.000
0:000
0:000
0.000
0.000
'0.067
Mercury
0.001
0.002
0.00-0
0.000
1 0:000
0.000.
0.000
0.000
0.000
0.000
O.Q00
0.000
0.003
Molyb-
0.009
0.021
0.000
0.000
0:000
0 000
O.00Q
0.000
0.000
0.000
..
0.000-
0.000
0.029
de
.
:.; .
Nickel
0.023
0.037
0.000
0.000
0.000
0.000
0.000
0.000
0.:000.
0.000
. 0;000:
0:000
0.060
Selenium
0:009ry
0.021
0.000
0.000
0:000
0.000 ;:
0.000
10.006
1 0.000
0.000
0.000
0.000
0.029
Zinc
0;759
1.194-
0.000-
0.000
0.000
0.000 _
0.000
0.000
0.000
0,000
O.QOO
0.000
1.9.53 .
Total
Phos-
19.594
88.382
0.000
0.000
0.0.00
0.000
0.000
0.000
0.000
0.000
0.000
0.000
107,976
phorus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
it -isonment for knowing violations".
Z�fz 4;2�f-
1/14/2016
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION --:GELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: City of Burlington WQ Permit #: WQ0000520 Field #:
Land Owner: Ernest Goldworthy Annual Dry Tons Applied: 36..06 Site #:
Operator: James Hadley
Crop I Name: Fescue -Hay
Predominant Soil Series: GaB
Crop 1 Max. PAN: 211 Crop 2 Name:
AM013
Acres Utilized: 12.3
Acres Permitted: 12.3
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
o y
°
L1
Volume applied
(enter one) Solids/
Liquid
4
Cu. Yds Gallons
ova
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
D
( ry'
Wet,
Moist)
Precip.
Past 24
lh's.
inches
y
t+
c� �?
o
o w
ao.
o
o
-
i N
*�*.�►
�
Pd
w -,
C°
N
a
TKN
mg/kg
Z
q
o -
0° °
o
m
mg(kg
Nitrate
and
Nitrite
mglkg
PAN Applied
(ibs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
3/23
52000
4.92
0 867
East Burlington
D
<.5"
S
0.5
0.3
31500
3460
2
f7:597
NA
Fescue
3/24
143000
4.26
2 b65 " "'
South Burlington
D
<.5"
S
0.5
0.3
62400
6810
2
' 82,958
NA "
Fescue
0 000
V000 ..
0.000:
6 000
0:ooO
0000
0:00o
0.000
Ooao
0oou
0.00o
0.000
0 000 '
oo,:
0 `000°
0:000
0.00:0
0.000
0 000
o.,000
-o:000
0.006 ,..
0 000
0_000
0.000:
0
0
0.000:
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000
0.000
TOTALS:
As
Cd
Cu
Cr
Pb
H T
Mo
Ni
Se
Zn
P
1110.115
0.000
Lime Applied
Annual lbs/acre
0 018 "
O.QL
0.9:15
0849
4.067 .<
U 003 '
0 0 `;
29
0060
Q-Q29
...
"i 953 _
... .
<107.976 ..... ...:::.::
::: >::: ;::::::: ;::=::::
............................
....
"" " " " :" " .
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.1868
0.3806
43.0062
19.1258
6.7494
0.1084
0.4647
3.2479
0.1691
59.5813
Current Cumulative lbs/ac
o 204'
0.392
* 43�2119.9^4
li.8 f 7
tl 112
= 0.4Q4
3•.308
0.198
611 534
Pennitted C. P. L. R.****
36
34
1338
267
15
1 374
1 89
1 2498
i 2 Permit PAN Limit 1st/ nd Crop P
211 is
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation -1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual):
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
(�_"'-ator: James Hadley Owner: Ernest Goldworthy Predominant Soil Series:
ti !s Used: 20 Acres Permitted:
34.8 Site #:
AM013 Field #:
39.26
GaB
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
SB
2/16/15
2 1
31
4
5
61
1 71
8
1 9
10
1111
1121
% Solids
4.26
Arsenic
3
Cadmium
2
Copper
140
Chromiuni
190
Lead
10
Mercury
0.6
Molyb-
denum
5
Nickel
9
Selenium
5
Zinc
289
Total
Phos-
horus
21400
) al Heavy Metal Field Loadings (Calculated in lbs/acre):
oal
1 1
1 21
1 31
1 41
L5J
6
7 j
L8J
9
Loj
11
1121
DT/Ac./
y
o
App.
Event
1.96
Arsenic
0.012
0:000
0.000
0.000
0.000
0:000
0.000
0.000
0.000
0.000
0.000
0.000
0.012
Cadmium
0.008
0.000
0.000
0.000
0.000
0:000
0.000
0.000
0.000
0.000
0.000
0.000
0.008
Copper
0.550
0.000,
0..000
0.000,
0.000
0.00.0
0.0.00,
0.000
0.000
0.000
0.000
0.000
0.550
Chromiu
0.746,
0-.000
0.000
0.000
0.000.
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.746
Lead
0..039
0.006
0.000
0.000
0.000.
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.039
Mercury
0.002
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0:002
Molyb-
0.020
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0,000
0.000
0.000
0.000
0.020
denum
Nickel
0.035
0.000
0.0.00
0.000
0.000
0.000
0.000
O.U.00
0,000
0.000
0;000
0.000
9:035
Selenium
0.020
0.000
0:000
0.00.0
0.000
0.000
0.00.0
0.000
0.000
0.000
0.000
0.000
0.020
Zinc
1.135
0.000
0.000
0.000
0.00:0
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1.135
Total
Phos-
84.0-16
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
84.016
horus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
i�-isonment for knowing violations".
4_ 1/14/2016
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION LD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: City of Burlington WQ Permit #: WQ0000520 Field #: 3 Acres Utilized: 20
Land Owner: Ernest Goldworthy Annual Dry Tons Applied- 39.16 Site #: AM013 Acres Permitted: 34.8
Operator: James Hadley Predominant Soil Series: GaB Cation Exchange Capacity (non 503): 0
Crop 1 Name: Sudex Crop 1 Max. PAN: 223 Crop 2 Name: Crop 2 Max. PAN:
.s~
�
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Anima]
Waste, etc)
Soil
Cond.
(Dry'
Wet,
Moist)
Precip.
Past 24
I3rs.
inches
Y
d
o w
o
Z.
* Z.
6'
r4
0
TKN
mg/kg
Z
o
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop I
Crop 2
Crop 1
Crop 2
3/24
117000
j 4.26
1':039 "
South Burlington
D
<.5"
S
0.5
0.3
62400
6810
2
41.743
NA
Sudex
3/25
104000
4.26
0 924
South Burlington
D
<5"
S
0.5
0.3
62400
6810
2
37.105
N A
Sudex
b 0,00
0.000
0.000
0 666 ...
0.000 '
0.00u
0 000'% '
0.000
0.000
" :
0.000 `
o.000
0 000'
0.0.00
0.000
0.000
0.000
0 000
0.000 -
0-000
o 000
0.000
(►.oc►o
0.400•
0.004
0.000
000
0.000
(Lilo()
0
0
:::
„o, 0 000 -.
Residuals Applications totals on FORM
FSF supp (attach FORM FSF supp
to this form):
0.900 '
0.000
..... ..
..
TOTALS:
Olt
&'221
As
Cd
Cu
Cr
Pb
H--
Mo
Ni
Se
Zn
P
78.848`'
o.000
Lime Applied
Annual lbs/acre
0 012
0 008 .
Q;5'S0
Ek.746
0 01w
0.002<"
0:U20
0.035'
0020
'.j 135
:84.0.16
:::::::::
...........................
................_.
•: <:
... .. .... :. .::..
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.125
0.2193
25.9069
9.6312
2.815
0.0876
0.3552
1.8667
0.1232
39.4962
Current Cumulative lbs/ac
0137`
0.221,
26, 457
�10.377
Z,834 '
0 0O0.
6 375
1:90
01143
"4:063)
Permitted C. P. L. R.****
36
34
1338
267
15
1
1 374
89
2498
Permit PAN Limit 1 st/2nd Crop
223...
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation -1.0
Signature of Land Applier Date '" Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual): 34.96
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
-ator: James Roney Owner: James Roney Predominant Soil Series: HbC2
A, .:'s Used: 12.5 Acres Permitted: 12.5 Site #: AM014 Field #: 2
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
SB
7/13/15
2
3
4j
5
6j
7
8 j
9 j
10
Ill 1
12
% Solids
4.3
Arsenic
3
Cadmium
2
Copper
214
Chromium
247
Lead
15
Mercury
0.4
Molyb-
denum
5
Nickel
13
Selenium
5
Zinc
493
Total
Phos-
�tll prUS
23300
,ial Heavy Metal Field Loadings (Calculated in lbs/acre):
1 otal
11
2
3
4
5
6
7
8
9
10
11 j
IRJ
DT/Ac./
App.
y
Event
2.80
Arsenic
0.017
1 0.000
0:000
0..00.0
0.000
1 0.000
0.000
0.000
0.000
0.000
0.000
1 0.000
0:017
Cadmium
0.011
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000.
0.000
0.000
0.01.1.
Copper
1.107
0.000
0.060'
0.000
0.000
0.000
0.000
0.000
0.000.
0.000
0.000.
0.000
1.197
Chromiun
1.382
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0..000.
0.000
0.000
0.000
1.382
Lead
0.084
0:'000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1 0.000
0 000
0..000
0.084
Mercury
0.002
0.000
0 000'
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000 .
0.002
0 :028
0:000
0.000
0.000
0.000
0..000
0.000
0.000
0.000
0.000
0.000
0.000
0.028
denum
enum
Nickel
0.073
0.000
0-.000.
0.000
0.000
0:000
0.000-
0:000
. 0.000:
0.000
0:000
0.000 1
0 073
Selenium
0..028
0.000
0.000
0.0`00 _
0:000
0.0.00
0.000
0.000
0.0w
0:000
0.000
0.000
0.028
Zinc
2.758
0.000
0.000
0.000
0.00.
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1758
Total
Phos-
130.340
0:000
0.000
0.000
0.000
0.000
0.000
0.000
0-.000
0.000
0:000
0.000
130.340
horus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
iI -1isonment for knowing violations".
2���
e Gam`/ 1/14/2016
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION 11:4ELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: City of Burlington WQ Permit #: WQ0000520 Field #:
Land Owner: James Roney Annual Dry Tons Applied:," 34.96 Site #:
Operator: James Roney
2
AM014
Acres Utilized: 12.5
Acres Permitted: 12.5
Predominant Soil Series: HbC2 Cation Exchange Capacity (non 503):
Crop 1 Name: Fescue -Hay Crop I Max. PAN:
158 Crop 2 Name:
Crop 2 Max. PAN:
61
y
Q 0
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
"�o
Solids
Volume
Applied per
P
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry'
Wet,
Moist)
Precip.
Past 24
HTS.
inches
Y
N
o w
a o.
o
;� �;
�,
N'
ro
?=
N
*
TKN
mg/kg
Z
.;
oF, o
a .
mgJkg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Cror 1
Crop 2
Crop 1
Crop 2
8/6
104000
4.3
1 492
South Burlington
Dry
<.5"
S
0.5
0.3
60900
13000
2
' 6217(1.
NA,:
Fescue
8/10
91000
4.3
13
South Burlington
Dry
<.5"
S
0.5
0.3
60900
13000
2
54.492
NA .''
Fescue
0:.000 ...
0.000`
0.000
Q 00,0
.,. 0.000 ,.
0.606;
0 000
0. 000
0 000 n:
"U.000
0.000
0 000
alto
o o00
0 000 x
0.0:00
a 000
0 000 `
0:000
.a 000
0,00D
o 000
0 oa0
0:000"
0.0.00 .
0°
0.
0 OOOa , _
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
n.Don
o.000
TOTALS]
a
1951)(H1
:::: ;;::
As
Cd
Cu
Cr
Pb
H,�
MoM
Se
Zn
P
116.768
000)
Lime A lied
Annual lbs/acre
0 017 `a:
` Q o11
l k97
Le ; .
U.D84
0.002"
0 02:8`£
0028
ti.758
' �':'10.340 ': .......
...::
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.027
0.018
2.213
2.029
0.176
0.005
0.0450.045
5.596
Current Cumulative lbs/ac
U 044. "
0 029
3 4':10
� 3.41 1
0.260
0,.007
0 073`0
,073.
8.354
Permitted C. P. L. R.****
36
34
1338
267
15
89
2498
Permit PAN Limitlst/2n d Crop
158'
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual): 15.90
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
0" ator: James Roney Owner: James Roney Predominant Soil Series: 14bB
i, _!s Used: 9.6 Acres Permitted: 9.6 Site #: AM014 Field #: 3
Residual Analysis Data (Heavy Metals and Total Phosphorus use m/kz % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
SB
5111115
2
3'
4 1
5
6 1
7
8 1
9
10 -
11 j
12
% Solids
4.19
Arsenic
3
Cadmium
2
Copper
184
ChminiMii
257
Lead
13
Mercury
0.4
Molyb-
denum
5
Nickel
1 16
Selenium
5
Zinc
414
Total
Phos-
',1 1arus
23800
lia1
Heavy iwetal view Loaaings
(ualculatea In ins/acre):
� offal
1
1 2
3
i 4
5 j
L6]7
i
8
10]
:111
12
DT/Ac./
App.
Event 1
1.66
Arsenic
0.01.0
0.000
0,000
0.000
0.000..0.000
0.000
0.000
1 0.000
0.000
0.00.0
1 0.000
0.010
Cadmium
0:007
0.000
.0.00`0
0.000
0:000
0.00.0_
0.000
0.000
0.000
0.000
0.000
. 0.000
0.007
Copper
0.60.9 .
0.000
: ' 0.000
0.000
0.000 :
` 0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.-609
Chromiis,11
0.851
0.000
0.000
0.000
0.000'.
` 0.000
9.0001
0.000
0.6,00
0.000
0.600
0.000
0.S51
Lead
0.043
.0.006
. 0.000
0...0:0
0.000
0.000
0.000
0.000.
0A00 `
.0:000
1 0.000
0.000
0.043
Mercury
0.001
0.000
0,000
0 000
0.000
0.000.
0.000
0:0o0 .
0.000
0.00.0
0.000
0.000
0.001
Molyb-
0.017
0.0.00,
0.000
0.000
0.000
0.000
0.000
0.000
0.000
01000
0.000
0.000
-0.017
denum
Nickel
0.053 .
0.000
0.000
0.000
0.600
0.000
0.000-,
0.000
0. 0.00
0,000
0.000
0.000 ..0.053
Selenium
0.017-
0.000
-0.000
0:000
0.0.00
0.000
0.000
0.000
0.000
0.0.00
0.000
'0.000
0:01-7
Zinc
1.371.
0.000
0.000
0.006
OM00
0..000
0.000
0.000
0.000
0.000
0.000
0.000
1.371
Total
Phos-
78.826
0.0.00
0.000
0.000
0,0.00
0.000
0.000
0.000
0.000
0.000
0.000
0.000
78.826
chorus
"I certifv. under penalty of law. that this document was nrenared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
�isonment for knowing violations".z�
4�% 1/14/2016
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
Operator:
ANNUAL LAND APPLICATION - ALD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
City of Burlington
James Roney
James Roney
Crop 1 Name: Fescue -Hay
WQ Permit #: WQ0000520 Field #:
Annual Dry Tons Applied:' 15.9Q Site #:
Predominant Soil Series: HbB
Crop 1 Max. PAN: 169 Crop 2 Name:
Acres Utilized: 9.6
AM014 Acres Permitted: 9.6
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
=
�
o
A
Volume applied
PP
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
NPDES #, W #,
( Q
Fert., Animal
Waste, etc)
Soil
Cond.
D
(Dry,
Moist)
Precip.
Past 24
Hrs.
inches
�
�?
on w,
* .°y
o
%�
o
p
�
?j
* w
o
TKN
mg/kg
Z��
�o o
R.
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop _
Crop 1
Crop 2
6/15
91000
4.19
1.656
South Burlington
Dry
<.5"
S
0.5
0.3 1
72800
30500
'
92.557,
NA
Fescue
0,0.0:0
0.000
0.000
o.boo
0.000
0.000
O'000
0.000
0.000
0400
1
0:000
0.000
0 000
0.000
0.000
0 000'
0.000
0.000
0 ooa `
0.000 '
0,000
o.00a :
0.000
0,000
0,000 :
0.000
O.00.Q'
0.000 :
0.000
0 006''
0.000
0.000
0
0
0 000 ° i''
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000.
o.00o
TOTALS
0
• 9t000
As
Cd
Cu
Cr
Pb
Hz'
Mo
Ni
Se
Zn
P
92.557
o.oun
Lime Applied
Annual lbslacre
"a 01U __.
OA07
_
` 0:609'
_.
"::U.8�1 _
c 0 04 <
_.......
-0.0.0]' ,
0:017
; 0 053
0.0 --7 F,
r 1 371 -'
78.826
,.: . ...
::'.: .: :::
..............
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.039
0.026
2.877
2.206
0.263
0.006
0.065
0.176
0.065
7.571
Current Cumulative lbs/ac'
0.949, .`
0.033 r
3.486
3".0s?-"'
0.3iK�
�0.007 .1
0.082
_.
0.229'
i Q. 082'
8 942
Permitted C. P. L. R.
36
34
1338
267
15
374
89
2498
Permit PAN Limit 1 s t/2nd Crop
169'
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual): 61.76
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
f'-``-ator: James Roney Owner: Carolyn Turner Predominant Soil Series: HbB
A :s Used: 28.7 Acres Permitted: 28.7 Site #: AM014 Field #: 4
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1 1
SB
7/13/15
__2j
3
4
5
6]
L7J
L819
10
11 j
12
% Solids
4.3
Arsenic
3
Cadmium
2
Copper
214
Chromium
247
Lead
15
Mercury
0.4
Molyb-
den
5
Nickel
13
Selenium
5
Zinc
493
Total
Phos-
phorus
23300
��al Heavy Metal Field Loadings (Calculated in lbs/acre):
goal
1
1 2j
L3]4
5
6 j
7
8
91
10
11 j
12
DT/Ac./
c
App.
Event
2.15
Arsenic
0013
0:000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1 0.013
Cadmium
0.009
1 0.000
0.000
0.000
1 0.000..
0..000
0.000
0.000
0.000
0.000
0.000
0.000
0.009
Copper
0.921
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000 -
0..000
. 0.00.0 :
0.921
Chromium
1.063
0.000
0.000
0.000
0..000
.0.000.
0.000
0.000
0.000
0:000
0.000
0:000 .
" 1.063"
Lead
0.065"
0.000
0.000
0.000
0..000
0.0:00
0.0-00
0.000
0.000
0..000
0.000
0.000
0.065
Mercury
0.002
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.002
Molyb-
0,022
0.000
0.000.
0.000
0.000
0.000
0.000
0.000
0..000
0.000
0.000
0.000
0.022
denum
Nickel
0.056
0.000
0.000
0.000`
0.000
0.000
0.000
0 000
0.000
0..000t
0.000
0:000
0.056
Selenium
0.022
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0:000
0.022
Zinc
2.122
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
2.122
Total
Phos-
100.283
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0-000
0.000
100.283
phorus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
it -isonment for knowing violations".
;ee 1-2� - 1 / 14/2016
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION -.iELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: City of Burlington WQ Permit #: WQ0000520 Field #:
Land Owner: Carolyn Turner Annual Dry Tons Applied: 64.76 Site #:
Operator: James Roney Predominant Soil Series: HbB
Crop 1 Name: Fescue -Pasture Crop 1 Max. PAN: 127 Crop 2 Name:
AM014
Acres Utilized: 28.7
Acres Permitted: 28.7
Cation Exchange Capacity (non 503): 0
Crop 2 Max. PAN:
1.Volume
o y
Q
applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
( ry
Wet
Moist)
Precip.
Past 24
Hrs.
inches
a
4 c?
0 w,
c
m,
N
o'
;e
w RL
* N
o
TKN
mg/kg
Z
q
o o
a
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop I
Crop _
Crop 1
Crop 2
8/11
188500
4.3
;1.178
South Burlington
Dry
<.5"
S
0.5
0.3
60900
13000
2
49,1.6.
N#\,,.
Fescue
8/12
156000
4.3
0 975 ' _
South Burlington
Dry
<.5"
S
0.5
0.3
60900
13000
2
40 586
NA
Fescue
�0 0.60
0,000
0 p00
0 000 - rt
o.000
0 000"
0.666 •
0.000
0 006 -;
0 000 ° ,
0.000
0.000
b o00
0,00()"
. 0.00()
0 00.o
omo
0 oqo
0.000,:
0.000.:
0 000 .
0.000.1
0 000
0 000
0.000
0 UOQ;
0 000,
o.00o
.0:004
.•.....
0
0
::;::..::
0.004,
Residuals Applications totals on FORM
FSF supp (attach FORM FSF supp
to this form):
0.000
0.OU0
TOTALS:.:,"
01
344500
:::::::::::::
As
Cd
Cu
Cr
Ph
HL,
Mo
Ni
Se
Zn
P
89.817
0,(�0w
Lime A > ,lied
Annual lbs/acre
0 013 .
$ 0 0
0:921 ,
3 1.':(►63
0.065
O.OQ2 '
. 0:022
- 0.056
1I.022
2 1' 2
100.283 ' : :. ;:: :. ' :.
>.
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.03
0.018
2,196
1,587
0. l93
0.007
0.053
0.134
0.042
5.891
Current Cumulative lbs/ac
0 043....
0:027
3'.117
`772;65O
0 ?SS '`
0.009-y
0 0?5
0.1;90 .
0;.064 ,
8 013
Permitted C. P. L. R.****
36
34
1338
1
1 267
15
374
89
2498
Permit PAN Limit 1st/2nd Crop
12.
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L,R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual):
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
C ~ator: James Roney Owner: Jame Roney Predominant Soil Series:
A... es Used: 21.8 Acres Permitted: 21.8 Site #: AM014 Field #:
46.02
EdC2
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1 1
SB
5111115
2
SB
7/13/15
3
4j
L5JL6J
L 7
8
9
10J
11
12
% Solids
4.19
4.3
Arsenic
3
3
Cadmium
2
2
Copper
184
214
Chromiuiii
257
247
Lead
13
15
Mercury
0.4
0.4
Molyb-
denum
5
5
Nickel
16
13
Selenium
5
5
Zinc
414
493
Total
Phos-
nhorus
23800
23300
;gal Heavy Metal Field Loadings (Calculated in lbs/acre):
"l otal
1 11
2
3�
4j
15]6
7
8
9
10
11
12
H
DT/Ac./
App-
14
Event
1.04
1.07
Arsenic
0.006
0.006
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1 0.000
0.000
0.000
0.013
Cadmium
0.004
0.004
0.000
0.000
0.000
.0.000
0.000
0.000
0.000
1 0.000
0.000
0.000
0.008
Copper
0.383
0.4.58
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.841
Chromiui
0.536
0.528
0.000
0.006
0.000
0.000
0.000
0.000
0.000
0.000 1
0.000
0.000
1.064
Lead
0.027
0.032
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.059
Mercury
0.001
0.001
0.000
0.000
0.000
0.000
0.000
0.0:00
0.000
0.000
0.000
0.000
0.002
Molyb-
0.010
0.011
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.021
denum
Nickel
0.033
0.028
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.060
0.000
0.061
Selenium
0.010
0.011
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.021
Zinc 1
0.863
1.054
0.000 1
0.000
0.000.
0.000
0.000
0.000
0.000
0.000
0.000
0.000 1
1.917
Total
Phos-
49.599
49.815
0.000
0.000
0.600
0.000
0.000
0.000
0.000
0.000
0.000
0.000
99.415
horus ,
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
i' sonment for knowing violations".
1/14/2016
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
Operator:
ANNUAL LAND APPLICATION x GELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
City of Burlington WQ Permit #: WQ0000520 Field #: 5 Acres Utilized:
Jame Roney Annual Dry Tons Applied: 46:02 Site #: AM014 Acres Permitted:
James Roney Predominant Soil Series: EdC2 Cation Exchange Capacity (non 503):
Crop I Name: Fescue -Pasture Crop 1 Max. PAN: 122 Crop 2 Name: Crop 2 Max. PAN:
21.8
21.8
0
�
°
Q
Volume applied
(enter one) Solids/
Li Liquid
9
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry,
Wet,
Moist)
precip.
Past 24
Hrs.
inches
a
b
� o
5
a w
o
w
w ti
CD
TKN
mglkg
Z
c7
o a
°0 0
w.
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop I
Crop 2
Crop 1
Crop 2
6/15
71500
4.19
0: S73 '
South Burlington
Dry
<.5"
S
0.5
0.3
72800
30500
2
32.025
NA '
Fescue
6/16
58500
4.19
0 469
South Burlington
Dry
<,5"
S
0.5
0.3
72800
30500
2
26.'02
NA „
Fescue
8/10
130000
4.3
1069
South Burlington
Dry
<.5"
S
0.5
0.3
60900
13000
2
44,636.
NA,:
Fescue
0 000 , r:.
0.000 ' :
0.000 .,
0:0oo
0.006
(} 000 r ,
0.000
0 000 '
0.000
6 00n ,
0.'000
0 000' "`
0.000'..
U.o00
0.000
0 000
0 000'I
t
4.000
0 U00 `'
0.000
0.000
0.000',.
0.000
0.000
"0.006
U
0+...
Q 000 ? y;
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
O:OoI)
0.1100
TOTALS:
"01
As
Cd
Cu
Cr
Pb
Her
Mo
Ni
Se
Zn
P
1 IO2.963
0.000;'
Lime Ailied
Annual lbs/acre
0 013 {'`t°
° 0 008
'.0.841
1. 064 •
', QJ►:59 -
0 002 `
0 O21
0:061
0 021
1' 917'
.' 99.4 t 5 ; ;:::::` ::"::::_:: ::
.": :". "'
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.03
0.02
2.268
1.807
0.165
0.006
0.05
0.127
0.05
6
Current Cumulative Ibs/ac
0 043: .x.
0.028`
3:..1 Q9+
2:>871
;0 224 +'
0 008 '"
0.071
0:188
OQ71
7:91Z'
Permitted C. P. L. R.****
36
34
1338
267
15
374
89
2498
tP Perms AN Limits 1 t/ 2n d Crop
122
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual): 27.26
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
f'_'�rator: Charlie Wyatt Owner: Charlie Wyatt Predominant Soil Series: VbC3
tom_ _ es Used: 13.1 Acres Permitted: 13.1 Site #: AM015 Field #: 1
Residual Analvsis Data (Heavy Metals and Total Phosphorus use m0kiz, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
SB
5111115
2
3
4
L 5
6 i
L7
8'
9
10
11
12
% Solids
1 4.19
Arsenic
3
Cadmium
2
Copper
184
ChromiUni
257
Lead
13
Mercury
0.4
Molyb-
denum
5
Nickel
16
Selenium
5
Zinc
414
Total
Phos-
phorus
23800
im
meavy metal riew Loaaings
((,calculated in ms/acre):
vial
1
1 21
3
4
5
6j
L81
9
10
11
12
DT/Ac./
App.
Event
2.08
14
Arsenic
9.012
O.000
0.000
0.000
0::000
0.000
0.000
0.000
0.000
," 0-000
0.000-
0.000
0.012
Cadmium
0.008
0 000
0.000
0.000
- 0.000
0.000-
0.000
0.00. -
0.000
0.000
0.000
0.000
0.008
Copper
0.766
0.000 ".
_ 0.000
0.000
0.000.
0.000
- . 0.000
0:000
0.000:
O.QOO
Q.000 .
0.000
0.766
Chromiuc
1.07°0.
0.000
. 0.000
0.000
01000
0.000
0.000- .
0.000 -
0.000 `
0.000
0.000 -
0.000
1.070
Lead
0.654
0 000
0.000
0.0.00
0.000
0.000
0.000
0 000
0.000
0.000
0.000
0..00-0
..
0..054
Mercury
0.002
0,9.00
0 000
0.00.0
0.000
=:0.000
_ 0.000
- 0.000
0 000'
.; 0.000
.0.000 .
0.000
0.002.
Molyb-
en
0A21
0:000
0.000
_
0.0.0
0.000
000
0 0
0.000
0 000
0 000.
0.000
0.000
0.600.
14021.
Nickel
0.067
0:000
0 000
Q.000
0,000
0:000
` 0.000
0.000
0.000 ,
` 0.000.
0.0000.000.
' 0.067
Selenium
0,021.
0.000
0.000 `
0.000
0.000
0 00.0-
0.0004
0.0.00
0 000 ,
0.000
0.000
0..000
0.021
Zinc
1.723
01000
0,00or
0, 000
0.000
0".000..
0,000
0.000
0. 000
0.000
0,000
0.000
1.723
Total
Phos-
99.056
0.000
0.0,0.0
0.000
0.000
0.000
0.000.
0.000,
0.000
0.000`
0:000
0.000
- 99.056
"1 certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
i( Isonment for knowing violations".
1/14/2016
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
Operator:
ANNUAL LAND APPLICATION - IELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
City of Burlington
Charlie Wyatt
Charlie Wyatt
WQ Permit #: WQ0000520 Field #:
Annual Dry Tons Applied: 27.26 Site #:
Predominant Soil Series: VbC3
Crop 1 Name: Fescue -Hay Crop 1 Max. PAN
182
Crop 2 Name:
AM015
Acres Utilized: 13.1
Acres Permitted: 13.1
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
°
° 0
Q
Volume applied
Pp
enter one Solids/
( )
Liquid
Cu. Yds Gallons
o
/o
Solids
Volume
A hed er
pp P
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry,
Wet,
Moist I
Precip.
Past 24
11rs.
inches
Y
o
o w,
C
o
;,y
N'
0
5'
:h �
w
* N
TKN
mg/kg
z a
q
o
0 0
w.
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
p yp
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
6/16
123500
4.19
164 - `.
South Burlington
Dry
<.5"
S
0.5
0.3
72800
30500
2
92.052
NA
Fescue
6/17
32500
4.19
-A,433
South Burlington
Dry
<.5"
S
0.5
0.3
72800
30500
2
24.224
NA
Fescue
" 0:
0.000 :
0.000
0 000 '
0,000
0.000
0 000' "`
0.000
0.000
0 000
0.000
0.000
6,0.00
0.000
0,000
0.000; "
0.000
1 0.000
0 000 -
0.000" ;
omo
6 0,00
0.000 :
0.000
%000
0.000-
0.000
0 000
0.000
0,000
0
0
>..:
'!) 000 " °`?
Residuals Applications totals on FORM
FSF supp (attach FORM FSF supp
to this form ):
0.000
0.000
TOTALS:
` " n
156000
As
Cd
Cu
Cr
Pb
Hg,
Mo
Ni
Se
Zn
('
116.27
0.000
Lime A died
Annual lbs/acre
Q 612
�' 0.008 •
` "0.766
1070 -
' 0 ►�►•54t
0 �02 .
0:d2 ,
— 67
0 4�1
<1723 `r
9, 056 :
...........................
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.0443
0.0256
2.7382
1.0072
0.2963
0.0102
0.0779
0.209
0.0593
8.7844
Current Cumulative lbs/ac
0.057
0.034'
3'.504
' - 2.077
"' 0.351;
" 0 01.2'"
0.099
0 276.
. 0:080
_. .
10 507
Permitted C. P. L. R.****
36
34
1 1338
267
15
374
89
1 2498
Pe it PAN Limit 2n trrt t 1 st/ d Crop
8 1 2
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface- 0.5, Injection/Incorporation - 1.0
Signature of Land Applier
Date
*** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual): 20.44
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
V"� Bator: Charlie Wyatt Owner: Charlie Wyatt Predominant Soil Series: EdC2
A__:.s Used: 12.1 Acres Permitted: 12.1 Site #: AM015 Field #: 2
Residual Analvsis Data (Heavv Metals and Total Phosuhorus use mz/k2, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1 1
SB
5111115
2
31
41
5
6
8
9!
10
11
12
% Solids
4.19
Arsenic
3
Cadmium
2
Copper
184
Chromiun;
257
Lead
13
Mercury
0.4
Molyb-
denum
5
Nickel
16
Selenium
5
Zinc
414
Total
Phos-
chorus
23800
iai rneavy ivietai r ieia L,oaaings kt-aictuatea in iasiacre):
1 otal 1-1 1 21 1 3,1 4 5, 61 7 ] 9 10 11 j 12
DT/Ac./ oy,
App.
Event 1.69
Arsenic 0.010 0.000 0:000 1 0.000 0.000 0.,000 0,.000 0.000 0.000 0.000 0.000 0.000 0.010
Cadmium 0.007 ',0.000 0.000 0.000 0.000 0.000 0.000 --0.0.00 0:000' 0.000 0.000 0..000 0.007
Copper
0.622
0.000
4.00.0.'
0,000
04000
A000
0,000
0.000
0.0010
0.000
0.000
0.0.00
0.622
Chromium
0,868
0..000
0.000
0.000
0.000,
0.000.
0.000
0.000
0.000
0.00.0
0.000
'0.000
0.868
Lead
0.044
0.000
0.000
0.000
0.000
0.000 °
0.00:0.
0.000
0.000
0.000
0.000
0.000
0.044
Mercury
0.001
0.000
0.000.
0.000
0:000:
0.000
" 0.000"
0.000
O,OOQ
0.000
0.0,00
.0.000
0:001
Molyb-
denurn
0.017
0.000-
0.000
0.000
0.000
0.000
0.000
0.000
`.00-0
0-.000
0.000
0.000
0 017
Nickel
0 i. 054 .
0.000
0..00:0
0.000
0.00.0
0.000-
0.000
0..009,
0.000
0.000
0.000
0.000
0.054
Selenium
0.017
0.000
0.000
0.000
0.000
0.000
0.000
.0.000
'. 0.000
0.000
0.000
0.000
0.0"17
Zinc
1.398
0.000
0.000
0:000'
0.000
0.0.00
0.000
0.000
0.000
0.000
0.000
0.000
1.39`8
Total
Phos-
80.396
0.000'
0.000.
0.000
0.000
0.600
0.000 1
0.000
0.000
0.000
0.000
0.000
80.396
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
tI-isonment for knowing violations".
1/14/2016
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION � _tELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: City of Burlington
Land Owner: Charlie Wyatt
Operator: Charlie Wyatt
Crop 1 Name:
Fescue -Pasture
WQ Permit #: WQ0000520 Field #:
Annual Dry Tons Applied: „ 20.44 r. Site #:
Predominant Soil Series: EdC2
Crop 1 Max. PAN:
122
Crop 2 Name:
AM015
Acres Utilized: 12.1
Acres Permitted: 12.1
Cation Exchange Capacity (non 503): 0
Crop 2 Max. PAN:
o
QLiquid
Volume applied
(enter one) Solids/
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry TonstAc)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
W t'
Moist)
Precip.
Past 24
Iirs.
inches
7a
°ate w
* �
o
qy
1 —
#
X
7
w -,
w
* 0
TKN
mg/kg
Z a
o
w o
g P.
mg/kg
Nitrate
and
Nitrite
mgtkg
PAN Applied
(Ibs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
6/17
117000
4.19
1
South Burlington
Dry
<.5"
S
0.5 1
0.3
72800
30500
2
94A. 4
' NA-
Fescue
, 0 000 ; , * `
':0 00o
.0.000'4,066
-
o.000 �
0000
o.o0a:
0 000
0.000
o 000 ,
0000
0.000..,
a:o0o
4 000 .,
o.0u0
0 06'0 ,
0 000
0.000
0;000
0.000: P.
Q cio0;
0 000
"0 fl00
0.0oo .
0.000.
0'00
0.0o0
0.000
ITOTALS:11.
0
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.(Joo
ojgp)
. ""01
As
Cd
Cu
Cr
Pb
Hg;
Mo
Ni
Se
Zn
P
94.41•4
u.00u
Lime Applied
Annual lbs/acre
_.
`0:010 .,
0 Oa7
0..622
^�,0 868
; 0 044.._a
. 0 001`''"
0 017'
0.054 ¢
0A17
1:,398.
` 8ti.s96 " `
...........................
.......................
............................
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.0295
0.017
1.9062
1.0782
0.2152
0.0085
0.0625
0.1546
0.0305
6.0798
Current Cumulative lbs/ac
0.040, "
0.024 °.
2.528 `
1:94G
:'0'S�1
0010'
0:079; -
10:209"�
.0
0:047
7.478
Permitted C. P. L. R.****
36
34
1 1338
267
15
374
89
1 2498
N emit is Crop
Permit PA L t/2nd r1.
p
122 F
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
,C�•�- 1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual):
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
K "' ator: Charlie Wyatt Owner: Charlie Wyatt Predominant Soil Series:
A.._ es Used: 10.1 Acres Permitted: 10.1 Site #: AM015 Field #:
29.10
EdC
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1 1
SB
5111115
21
EB
5111115
31
4!
5
6;
7
8
9;
10
11
12
% Solids
4.19
1 4.32
Arsenic
3
3
Cadmium
2
2
Copper
184
171
Chromium
257
50
Lead
13
16
Mercury
0.4
1.1
Molyb-
denum
5
5
Nickel
16
22
Selenium
5
5
Zinc
414
555
Total
Phos-
phorus
23800
10400
ial Heavy Metal Field Loadings (Calculated in lbs/acre):
i otal
7r
2
3
L4J
L5J
L6J
1,718
9
10 j
11 J
12
DT/Ac./
0
App.
14
Event
0.56
2.32
Arsenic
0.003
0.014
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1 0.000
0.000
0.000
0,017
Cadmium
0.002
0:009
0.000
0.000"
0.000
0.000
0.000
0.000
0.000
1 0.000
0.000
0.000
0.012
Copper
0.207
0.793
0.000
0.090
0.000.
0.000
0.600
0.000
0.000
0.000
0.000
0.000
1.000
Chromium
0.289
0.232
0 000
0.000
0.000
0.000
0.000
0:000".
0.000
0.000
0.000-
0.000
0.521
Lead
0.015
0.074
0.000
0.000
0.000 -
0.000
0.000
0.000
0.000
0.00"0
0..000
0.000
0.089
Mercury
0.000
0.0105.
0.000
0.000
0.000,
0.000
0.000
0.000
0:000
0.000
0A00
0000
'0.006
Molyb-
0.006
0.023
0.000-
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.029
denum
Nickel
0.018
0.1102 `
0..000
0.000
0:000,
0.600
0.000
0:00"0
_
0.000
0.000
0.000
0.000
0.120
Selenium
0.006
0-.023.
0.000
0,000
0.009
0.000
0.0.00
0.0.00 .
` 0.000
0.000.
0.000
0000
0.029.
Zinc
0.465
1574
0.000
0.000
0:000
0.000
0.000
0.000
0.000
0.000
0.000
0".000
3.039
Total
Phos-
26.751
48.235
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
74.986
phorus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
i,, •isonment for knowing violations".
Z" tz 4; � � 4e-
Signature of Land Applier
1/14/2016
Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION - tELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: City of Burlington WQ Permit #: WQ0000520 Field #: 3 Acres Utilized:
Land Owner: Charlie Wyatt Annual Dry Tons Applied: 29.10 Site #: AM015 Acres Permitted:
Operator:
Charlie Wyatt
Crop 1 Name: Fescue -Pasture
Predominant Soil Series:
Crop 1 Max. PAN: 122
EdC
Crop 2 Name:
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
10.1
10.1
0
$..
o
° °
p
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES # WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
wry'
Wet'
Moist)
Precip.
Past 24
Hrs.
inches
Y
4 '�
o
x' �',
*
o'
p
w •,
* N
4
TKN
mg/kg
Z Y
q R
o
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
6/17
32500
4.19
0.5.62
South Burlington
Dry
<.5"
S
0.5
0.3
72800
30500
2
3.1.42o'
NA
Fescue
6/25
130000
4.32
2.319
East Burlington
Dry
<.5"
S
0.5
0.3
23600
2780
2
354201
NA
Fescue
0.000
0,00u .
0.000
0.000.
0.000
k 0.000
0 000'
0:000 *
0:000
0.000
0:00o
0.660
0 000 °
0:004
01000 '.
o 000
.o:000 -
" 6000 ..
0 0,00
.0.000
6.6046
0 006
0:000
0.006
0 000
0:000
0.006:
.
> ; :. ,
0 000 ., i
Residuals Applications totals on FORM
FSF supp (attach FORM FSF supp
to this form):
0-ow0:000
TOTALS:
` n
tF��oo
As
Cd
Cu
Cr
Pb
H�
Mo
Ni
Se
Zn
P
66.840
0.0007,
Lime Applied
Annual lbs/acre
0 017
}0:012
_' L0:00 3
0. 521
0.089 "':
x 0.006 ,
0.029,
� O i .61
",0 029 °
M3 039
'4.986 ::::::::::.:.. "::::::;:;':;:::;
:. .. .
..... .. ..... .. ..
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.0173
0.0084
1.127
0.6253
0.0984
0.0073
0.0299
0.0742
0.0187
2.7832
Current Cumulative lbs/ac
0.03'S
0.020
2.127
'' 114h .-
, 0.1 R^'
0 011-1
•0.05',9,
' 0.194
�0,:048
5.823
Permitted C. P. L. R.****
36
34
1338
267
15
1 374
89
1 2498
it PA Perm N Lim' 2 �t is t/ nd Crop
"
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual):
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
fo'�_ _ator: Charlie Wyatt Owner: Charlie Wyatt Predominant Soil Series:
A_ _is Used: 15.8 Acres Permitted: 15.8 Site #: AM015 Field #:
27.44
CbB2
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
SB
5111115
_2j
EB
5111115
3
4
5
6
7J
L_Bj
L9J10
I
11
12
% Solids
4.19
4.32
Arsenic
3
3
Cadmium
2
2
Copper
184
171
Chromium
257
50
Lead
13
16
Mercury
0.4
1.1
Molyb-
enum
5
5
Nickel
16
22
Selenium
5
5
Zinc
414
555
Total
Phos-
phorus
23800
10400
1ial Heavy Metal Field Loadings (Calculated in lbs/acre):
otal
1
L2J
3
4
5
6
7
8 J
9
10
Ij
1121
DT/Ac./
oy,
App.
Event
1.37
0.37
Arsenic
0.008
1 0.002
0.00.0
0.000
0.00.0
0.000
0:.000
1 0.000
0.000
0,000
1 0.000
0.000
0.010
Cadmium
0.005
0:001
0.000
0.000,
0.000
0.000
0..0.00
0.000
0.000
0.000-1
0.000
0.000
0.007
Copper
0.503 _
0.127
0.000
0.000
.0.600
0.09Q:
0_000
0.000
0.000,
6.000
0.000
0.000
0.63.0
Chromiuni
0.702
0.037
0.000
0.000
0000
0.0001
0.000
0.000
0.000 ;
0.000
0.000
0.000
0.739
Lead
0.036
0.012
0.000
0.000
0.000
0.000
0.000
0.000
0.000
'0.00.0
0.000
0,000
0.047
Mercury
0.001
0.001
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.002
Molyb-
0.01.4
0.004
0.0:00
0.000
0.000
0.000
0.000
0.000
0.00"0
0.000
0.000
0.017
denum
'0..000
Nickel
0.044
0.01;6
.00
00�
0.000
0.000
0.000
0.000
0000
0.00:0
0.000
0.000 .'
0.000
0.060.
Selenium
.0.0.14
0.004
0.000' 1
0.000
0.000
0.000
0.000
0.00.0,
0.000
0.060
0.000
0.017
Zinc
1.131
0.412
0.000
0.000
0.000
0.000 1
0.000
0,000
0.000
0.000
0..000
0.000
1.543
Total
Phos-
65.022
7.717
0.000
0.000
0..000
0.000
0.000
0.000
0,000
0.000
0.000
0.000
72.738
horus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
i7- ~isonment for knowing violations".
Z�f4;:�41/14/2016
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
Operator:
ANNUAL LAND APPLICATION- .1ELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
City of Burlington WQ Permit #: WQ0000520 Field #: 4 Acres Utilized:
Charlie Wyatt Annual Dry Tons Applied:27.44 Site #: AM015 Acres Permitted:
Charlie Wyatt Predominant Soil Series: CbB2 Cation Exchange Capacity (non 503):
Crop 1 Name: Fescue -Hay Crop 1 Max. PAN: 216 Crop 2 Name: Crop 2 Max. PAN:
15.8
15.8
0
o Y
j °
Q
Volume applied
(enter one) Solids/
Li uid
n
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry,
Wet
Moist)
Precip.
Past 24
Hrs.
inches
Y
�? b
o
oL
o
o
w w
c� —'
7y
f°
TKN
mglkg
Z
cl
o
°;
w
mglkg
Nitrate
and
Nitrite
mglkg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
6/24
104000
4.19
1..150
South Burlington
Dry
<.5"
S
0.5
0.3
72800
30500
2
6.1.271
NA
Fescue
6/25
19500
4.19
0 216 ::. ''
South Burlington
Dry
<5"
S
0.5
0.3
72800
30500
2
12.05 !
NA '.
Fescue
6/25
32500
4.32
0 371
East Burlington
Dry
<.5"
S
0.5
0.3
23600
2780
2
5.667
5.661-
00
000"^
0.000,.: '
o.000
0:000
0 000 '
"0.000 ,
0.000
o.000 "" "
o.000
o.000
0:000:
0.000 '
0:060.
0.000
0:000
0t000 `.
-0 000.
0.000
O.,000
0.000
0:000
s 0.000
t 0
0
0 000 " :;
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000
0.0.00 '
TOTALS:
n
5 ,000,
:.:
As
Cd
Cu
Cr
Pb
H�
Mo
Ni
Se
Zn
P
81.982
5.661-^
Lime A i plied
Annual lbs/acre
0 0]0
0 ?(j'7"' .
0 636
, 9,:b.739
0.047
-0 002^"
0.01-7
0 060
6 61'7 '_
-1 543 3 .:
31738 ..........::.:.:..::::..
............
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.03
0.018
2.016
1.673
0.167
0.011
0.052
0.133
0.043
4.994
Current Cumulative lbs/ac
0 040.
0.025
2;646
'2 412
0.21°4,
0 0.13 w
O;g69
0..193
0,060
6 S37
Permitted C. P. L. R.****
36
34
1338
267
15
374
89
2498
Permit PAN 1 Limit it st/2nd Crop
2 16
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual):
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
P___""ator: Michael Hadley Owner: C.L. Hadley Predominant Soil Series:
,�, A Used: 30.5 Acres Permitted: 30.5 Site #: AM016 Field #:
74.97
HdC2
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
SB
4/13/15
2
3
4 1
5
6
L7i
81
9
0
.11
12'
% Solids
4.19
Arsenic
3
Cadmium
2
Copper
152
ChromiuMr
237
Lead
11
Mercury
0.5
Molyb-
denum
5
Nickel
9
Selenium
5
Zinc
322
Total
Phos-
p ; orus
21300
,,ial Heavy Metal Field Loadings (Calculated in lbs/acre):
..,ial
1
2
3
4
5
6
7
8
9
10
11
12
-
-
DT/Ac./
0
App-
Event
2.46
Arsenic
0.015
1 0.000
0.000 _
0.000
1 0.000
0.000
0.000
1 0.000
0.000
0.000
0.000
0.000
0.015
Cadmium
0.0.10
10 000
0.000
0.000
0.000
01.1000
.0.000
0.000
0.000
0.000
0.0-00
0.000
0.010
Copper
0.747
0.000 °
0.000
0.000
0.000
0.000
0.000
0.000'
0.000
0.000
000
0.000
0.747'
Chromic
1.165.
0.000
0.000
0.000
0.000
0.000
0.000
0.000:
0.000
0.000
0.000
0.000
1.165
Lead
0.054
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.0.00
0.000
0.000
0.000
0:054
Mercury
0..0.02
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.0.00
0.000
0..000
0,002
Molyb-
0.025
0.000
0.0,00
0:000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.025
denum
Nickel
0.044
0.000
0:00.0
0.000
0.000
0.000
0.000
0.000:
0.000-.
0.000
0.0.00.
0:000
0.044
Selenium
0.025
0.000
0.000
0.006
0.000
0.000
0.000
0.006-
0.000
0.000
0.000
0.000
0.025
Zinc
1.583
0:000
0.000
0.000
0.000.
0.000
0.000
0.000
0.000
0.600
0.000
0.00.0.
.1.583
Total
Phos-
104.711
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
104.711
nhorus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
ir-isonment for knowing violations".
rC�e 4;2:� 1/14/2016
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
ANNUAL LAND APPLICATION .-tELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
City of Burlington
C.L. Hadley
WQ Permit #: WQ0000520 Field #:
Annual Dry Tons Applied:: 74.97Site #:
Operator: Michael Hadley Predominant Soil Series:
Crop 1 Name: Fescue -Hay Crop 1 Max. PAN:
198
HdC2
Crop 2 Name:
AM016
Acres Utilized: 30.5
Acres Permitted: 30.5
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
o =
0 r.o
ce
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
D
( ry'
Wet,
Moist)
Precip.
Past 24
Hrs.
inches
a
4 b
cc
� �.
o w
*
o
;v w
�,
P- .f
D N
o'
-,
� w
o
TKN
mg/kg
7 a
�
�o o
mg/kg
Nitrate
and
Nitrite
mglkg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
g
Application
Crop I
Crop _
Crop 1
Crop 2
5/26
52000
4.19
0,298
South Burlington
Dry
<.5"
S
0.5
0.3
66100
7880
69.2
12.794
NA
Fescue
5/27
188500
4.19
1>0.8,0
South Burlington
Dry
<.5"
S
0.5
0.3
66100
7880
69.2
46.380 -
NA
Fescue
5/29
188500
4.19
1 080
South Burlington
Dry
<.5"
S
0.5
0.3
66100
7880
69.246.380
NA
Fescue
0.000 `
0.000
0 000:` .,
0.000 '
0.000
0 D00
0.000
0-000
ooQo:
0.000
0.000
0 oQo
0.000
0.000
0.000 ',: _°
0.000
omo
0.000
0.000
0,000
0000.
0.000.
o.000
0•0001
0.000
0.000
...
0
0
0 00 0,#
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000
u•+Ii10
TOTALS:
n
.., .1�rjuoo
As
Cd
Cu
Cr
Pb
Hag
Mo
Ni
Se
Zn
P
105.554
0.+9►0
Lime Applied
Annual lbs/acre
0 015 `",
0 01:0
z 0.747'
i.165
0.054
0.002
t-, O D 'S
0 044
" 0 025 rt;
,k, 1.583 r
`104.711 :... .:::.::.:::::::::`:"
.. ..... .. ..
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.0106
0.0071
0.7564
0.7457
0.0639
0.0014
0.0177
0.0355
0.0177
1.4844
Current Cumulative lbs/ac
0.025; :
0 017
1;504
1911
0 118 •,,`
0 00-4:
, 0 042'
0 0$0
-0,'042
3 067
Permitted C. P. L. R.****
36
1 34
1 1338
1
1 267
1 15
1
374
89
1 2498
PA Permit it m N Limit 1 st/2nd Crop
Y,gg
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date
*** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual): 5.67
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
e" �rator: Michael Hadley Owner: C.L. Hadley Predominant Soil Series: AaB
A .is Used: 25.1 Acres Permitted: 25.1 Site #: AM016 Field #: 2
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
SB
4/13/15
2
3
4 j
L5]6
71
8 j
L9J10
11
12
% Solids
4.19
Arsenic
3
Cadmium
2
Copper
152
Chromium
237
Lead
11
Mercury
0.5
Molyb-
denum
5
Nickel
9
Selenium
5
Zinc
322
Total
Phos-
],'I orus
21300
ial Heavy Metal Field Loadings (Calculated in lbs/acre):
utal
11
21
1 31
4
5
6
8
10
11
12
.L
.71
.91
DT/Ac./
oy,
App.
14
Event
0.23
Arsenic
0.001
0.,000
0.000 1
0.000
0.000
0.000
0.000
0.000
0.000
1 0.000
0.000
0.000
6.001
Cadmium
0:001
1 0.000
0.000
0.000
0.000
0.000
0.000
0.000
0:000
0.000
0.000
0.000
0.001
Copper
0.069
0.000
0.000
0.000
0.060
0.000
6.000
0.000
0.000.
0.000
0.000
0.000
0.069
Chromium
0.107
0:000
0.000
0_000
0.000
0.000 1
0.000
0.000
0.000
0.000
0.000
0.000
0.107
Lead
0.005
0.000
0..000
0.000
0.000
0.000
0.000.
0.000
O.000
0.000
0.000
0.000
0.005
Mercury
0.000
0..000
0.000
0.000
0.000
0.000
0.000
0:000.
0.000
0.000
0.000
0.000
0.000
Molyb-
0.002
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0:000
0.000
0.000
0.002
denum
Nickel
0.004
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.004
Selenium
0.002
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.00.0
0.000
0.000
0.000
0.002
Zinc
0.146
0.000
-0.000
0.000
0.600
0.000
0.000
0.000
0:000
0.000
0.000
0.000
0.146
Total
Phos-
9.628
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
9.628
:}horus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
v " Isonment for knowing violations".
Signature of Land Applier
1/14/2016
Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
ANNUAL LAND APPLICATION ., ELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
City of Burlington WQ Permit #: WQ0000520 Field #: 2 Acres Utilized:
C.L. Hadley Annual Dry Tons Applied:: 516:7 Site #: AM016 Acres Permitted:
Operator: Michael Hadley Predominant Soil Series: AaB Cation Exchange Capacity (non 503):
Crop 1 Name: Fescue -Hay Crop 1 Max. PAN: 190 Crop 2 Name: Crop 2 Max. PAN:
J
25.1
25.1
0
o
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
A lied er
Pp � p
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES # W #,
Q
Fert., Animal
Waste, etc)
Soil
Cond.
W
Moist)
Precip.
Past 24
Hrs.
inches
Y
b
cn d
C w,
*o
o
%n
�ry,,
*
7y
w -,
RL
*iT
0
TKN
mg/kg
Z a
o �
w•
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre}
Name of Crop Type
Receiving Residual
Application
Crop I
Crop 2
Crop 1
Crop 2
5/29
32500
4.19
0 226 `
South Burlington
Dry
C5"
S
0.5
0.3
66100
7880
69.2
9.717
NA
Fescue
0.000
0.000
0:009
0.000
0.000
o;:00.6
0.000
o.00o
` Or. 000,
0.000
0.000
6�qo-o
0.000
0.000
0 00q
0.000
0.000
0:b00;
0.000
0.000
O'.000
0.000
0.000
0.000
0.000
O:OO:Q`
0.000
0.000
0000
0.000
0.000
..........
�0:
0'
: ;• ::
r. 0 0,00 ` "°
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000
0.000
TOTALS:
o
.r o6.::....:::::
As
Cd
Cu
Cr
PbM
Mo
Ni
Se
Zn
P
9.717
0,000
Lime Applied
Annual lbs/acre
0 00
0.001
s 0A69 .
`0 107 , =
0 00� :O
O,Q2
O:Q04
0.:.002
0 146 ''
: 9:628 ` .: •..:.... ....:::
::..
.Permitted
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.0271
0.0164
2.1599
1.2315
0.1670.0536
0.1209
0.0386
4.9409
Current Cumulative lbs/ac
0.028 "
U.017
2:229. b
: '1.339 ''
O{ 1 ?2
-0.456
0.125
' 0.:041
5 086
C. P. L. R.****
36
34
1338
267
374
89
2498
Permit PAN Limit tl2n is d Crop
190 .
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date -11-* Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual): 27.26
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
K_"'•ator: Michael Hadley Owner: C.L. Hadley Predominant Soil Series: GaB2
f_ s Used: 23.5 Acres Permitted: 23.5 Site #: AM016 Field #: 3
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
SB
4/13/15
_2j
3
4
5
6
7
8
9
10
11 1
12
% Solids
4.19
Arsenic
3
Cadmium
2
Copper
152
Chromium
237
Lead
11
Mercury
0.5
Molyb-
denum
5
Nickel
9
Selenium
5
Zinc
322
Total
Phos-
DI10rus
21300
1Aal Heavy Metal Field Loadings (Calculated in lbs/acre):
..,tal
1
2
3
4
5
6
7
8 1
9
10
11
12
DT/Ac./
0
App.
W.
Event
1.16
Arsenic
Q.007
0.000
0.000
0.000
1 0.000.
' 0.000
0.00.0
1 0.000
0.000`
1 0..000
0.000
0.000
0.007
Cadmium
0.005
0.000
0.0.00
0.000
0.000-
.0.1000.1.
0.000
0.000
0:000
0.000
0.000
0.000
0.005
Copper
0.353
0.000
0.00.0
0.000
0.000
0.000
0.000
0.000
0.000.
0.000
0.000
0.000
0.353
Chromium
0.550
0.000
0.000
0.0.00
0.000
-0.000
0.000
0.000
0.000
0.000
-0.000
0.000 :
0.550
Lead
0.026
0.000
0.000
0.000
6.000
0.000
0.000
0.000
0.00.0
0.000
0.006
0.000
0,026
Mercury
0.001
0.000
0.000;
0.000
0;000
0,000
0.000
0,000
0.000
0:000
0.000
0.00.0
0.001
Molyb-
0.012
0.000
0.000
0.000
0.000'
0.000
0.000
0.000
0.0.00
0.000
.0.000
0.000
0.012
denum
denum
Nickel
0..02"1
0 000
0.0M.
0.000
0.Q0.Q
0.000
0.000
0.0:00
0.000
0.00.0
0.-000 :
0.000 .
0.02_;1
Selenium
0.0.12
0.000
0.000
0.000
0.000
0.000
0:000
0.000
0.000=
0.0.00
0.000
0:000
0.012
Zinc
0.747
0.000
0.000
0.000
0,000
0.000
0.000
0.000
0.000
0.000
.0.0.00
0.000
0.747
Total
Phos-
49.416-
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
49.416
horus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
i(--isonment for knowing violations".
Z-z 1/14/2016
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION tELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: City of Burlington WQ Permit #: WQ0000520 Field #: 3 Acres Utilized: 23.5
Land Owner: C.L. Hadley Annual Dry Tons Applied: 27.26; Site #: AM016 Acres Permitted: 23.5
Operator: Michael Hadley Predominant Soil Series: GaB2 Cation Exchange Capacity (non 503): 0
Crop 1 Name: Fescue -Hay Crop 1 Max. PAN: 211 Crop 2 Name: Crop 2 Max. PAN:
o
-! ; o
Q 75
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, W #
Q'
Fert., Animal
Waste, etc)
Soil
Cond.
D
( ry'
Wet,
Moist)
Precip.
Past 24
Hrs.
inches
c
co
0 0
o w
a �•
*
o
%`�
0-
N
7y c,
w �,
o ?r
« �•
* m
TKN
mg/kg
Z�
4
o
vo o
�'
o �,
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
ReceivingResidual
Application
Crop I
Crop 2
Crop 1
Crop 2
5/26
156000
4.19
-1. L60
South Burlington
Dry
<.5"
S
0.5
0.3 1
66100
7880 1
69.2
49.817
NA
Fescue
0.000
0.000
0.000
0:0.00 "
0.000
0.000
0000..
0.000
0.000
0 000
0.000
(UHH)
:0.000
0.000
0_000
0'000' .
0.000
0.000
0;.000
0.000
0.000
0 000
0.000
0.000
0.000
0.000
0.000
f 0000
0.000
0.000
01000.
0.000
O.o(10
•0
0
0.000.
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000
0.(100
TOTALS:
ol
1 6000
;:::::; :::.:
As
Cd
Cu
Cr
Pb
H ,
Mo
Ni
Se
Zn 1'
49.817
0.000
Lime Applied
Annual lbs/acre
0 OQ7
0:005
0:353 .
0.530
0.026<
0 OQ;I >
0 012 °
0:021 •
. 0:012
' 0 747 .', 49.41b :::<::.:::.:.:....
2.6076 >'=` :'::::::=:
...........................
............................
3.35'S ............................... ..
1 2498
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.0137
0.0081
1.1214
0.5697
0.0855
0.0034
0.028
0.0638
0.0187
Current Cumulative lbs/ac
0.021
0.013
'JA74'
1.120
_
' 0:l lt'
0.005
_..
0.040
0>085
0.030 �.
Permitted C. P. L. R. ****
36
34
1338
267
15
374
1 89
Permit PAN Limit 1st/2nd Crop
2 11
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual):
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
(F,--' ,;ator: Michael Hadley Owner: Russell Hadley Predominant Soil Series:
A- -s Used: 33.1 Acres Permitted: 33.1 Site #: AM016 Field #:
43.09
HdC2
4
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
SB
6/8/15
2
3
4
5
6 1
7
8
9
10
11
12
% Solids
4.16
Arsenic
3
Cadmium
2
Copper
236
Chromium
239
Lead
21
Mercury
1.9
Molyb-
denum
5
Nickel
17
Selenium
5
Zinc
474
Total
Phos-
phorus
23100
,dal Heavy Metal Field Loadings (Calculated in lbs/acre):
1. otal
1
1211
4
5
6
7
8
9
10 J
[12
DT/Ac./
App.
r°y+
Event
1.33
Arsenic
0.008
1 0.000
0.000
0;0.00
0.000
0.000
1 0.000
0.000
0.00.0
0.000
0.000,
0.000
0.008
Cadmium
0.005
0.000.
0.000
0.000
0.000
0.000
0.000
0.000
0.000
*0.0.00
0,000
0.000
1 0.005
Copper
0.621
0:000
0.000
0.000
0.000
0.000
0.000
0;000
0.000
0.000
0.000
0.000
0.627
Chromium
0.6.35
0.000
0.000
0.000
0.00Q'
0.000
0".000
" 0.000
0.000
0.000
0.000
0.006
0.635
Lead
0.056
0.000
0.000
0.000
0.000
0.000
0.00-0
01000
0.000
0.000
1 0,000
0.000
0".056
0.005
0:0"00
0.0-00
0.000
0.000
0;000
0".000
0.000
0.000
0.000
0:000
0.000
0.005
0.013
Q:000
0.000
0.000
0:000
0:000
0.000
0:000
0.000
.0.000
0.000
0.000
0:013
0.045
0.000
.0.000
0 000
0 000
0.000
0.000
0.000"
0.000
0.000
0.000; :
0,000
.0;045
qNickel
0.013
O.Q00
O:U00
0.000
0.000
0.000
0,000
0.000
0.000
0.000
0:000
0.000
0.013
1.260
0.000
0.000
0.000
0 000
0.000.
0.000
0-000
0.000
0.000
0.000
0.000
1.260
61.400
0.000
0.000
0.000
0.000
0.000
0.000
0:00.0
0.000
0.060
0.000-
0.000
61.400
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
it -isonment for knowing violations".
Signature of Land Applier
1/14/2016
Date
DENR FORM MFLSF (12/2006)

P
ANNUAL LAND APPLICATION . ELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: City of Burlington WQ Permit #: WQ0000520 Field #: 4 Acres Utilized: 33.1
Land Owner: Russell Hadley Annual Dry Tons Applied:: < 43.99 Site #: AM016 Acres Permitted: 33.1
Operator: Michael Hadley Predominant Soil Series: HdC2 Cation Exchange Capacity (non 503): 0
Crop 1 Name: Fescue -Pasture Crop 1 Max. PAN: 149 Crop 2 Name: Crop 2 Max. PAN:
o y
+; o
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds G8110r1S
oho
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, W #
Q '
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry,
Wet'
Moist)
Precip.
Past 24
Hrs.
Inches
>
b
o
o w,
a
* �
o
%�
=
* N'
w
o
w
�'
* ,
�` �•
TKN
mg/kg
Y
o
o 5.
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
7/13
97500
4.16
0.511.
South Burlington
Dry
<.5"
S
0.5
0.3
50200
19000
48.1
19.323
NA
Fescue
7/15
156000
4.16
' D 818 '
South Burlington
Dry
<.5"
S
0.5
0.3
50200
19000
48.1
301917
NA
Fescue
0.000
0,000
.. 0.000 '
0.000
0.000 "
' 6.0'00
`0 00'0
0.000 ,
, 0,000
0 000
0.000
0.000:
0 000 : "
n.000""
0.000•'
0 000
0.0U0 ;
0.000 `
0 000 ,a,
0 000
0.000.
0.000 '
0.060
0 000
D oao
0.000 -
10.606'
0.6 `
0 000
0.000
.'.'.. • •
0
0
"+:0 000 `
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0:000 '
r-' 0:000
TOTALS:
0I
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
50.2-11
0.0:00
Lime A > >lied
Annual lbs/acre
0.008
D 005
' 6'27
0,035=..
0: 05b .
ya 0.005
0.013
O:Q45
-i 0 0,13-
,' .1.260,'.
61.400
.
;. ...................
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.04
0.025
2.801
1.887
0.328
0.009
0.075
0.176
0.052
7.768
Current Cumulative lbs/ac
`0.048 '
'0.030
3,.428
y. 2 522^ -
0.384,
0 014­
. 0.0881—
. Or221 ,
., 0�065
.94028
Permitted C. P. L. R.****
36
34
1 1338
1 267
1 15
1
1 374
89
2498
PAN Li t Permitmrt 1 s / 2 nd CroP
p
149 -
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/incorporation - 1.0
Signature of Land Applier Date
*** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

Facility Name:
Land Owner:
Operator:
ANNUAL LAND APPLICATION . tELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
City of Burlington WQ Permit #: WQ0000520 Field #: 2 Acres Utilized:
Albert Mills Annual Dry Tons Applied:16.32 Site #: AM018 Acres Permitted:
Albert Mills
Crop 1 Name: Fescue -Pasture
Predominant Soil Series:
Crop 1 Max. PAN: 92
IbI32
Crop 2 Name:
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
8.2
8.2
0
o
A
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NpDES #, WQ#,
Fert. Animal
Waste, etc)
Soil
Cond.
(Dry,
e '
,
Moist)
precip.
Past 24
Hrs.
inches
Y
t?
o w
n Q
o
w+
* N'
*
�
w,
w
N
TKN
mg/kg
z a
o
tl° o
c w
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
{ Ibs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
8/29
91000
4.3
1.990
South Burlington
Dry
<.5"
S
0.5
0.3
60900
13000
2
1 83.667
NA
Fescue
0.000
10.,600
.Q tl0.0:.
0.600'
0.000
9.060. s
0:000',.
0.06'0
0.9,00
r 0-ttc►a .
0 Q00:•
0 0* .
0:000:'
6.606".
a o00
or:000 3
o:t�oo'`:
0 000
0.Mo `
O.W01.1
- 0.000
..0.000
0.000
. 0.0 .W.
0:0(lo
0.060
'o.000
0,600
° 0.0,06'
-0 QOQ', ''
Residuals Applications totals on FORM
FSF supp (attach FORM FSF supp
to this form):
O:Otl�/
0:000'
TOTALS]
As
Cd
Cu
Cr
Pb
H.
Mo
Ni
Se
Zn
P
83.067
0.000'.
Lime A i plied
Annual lbs/acre
0 012 - :,
0.0Q&
: 0;852
`" 0 �i83
0.Obr�
`� 0 062.
S 0.620
9.051
-� 0 020 "
`' 1:96.2
92 73'4' :...::.::.:.:<.:::::::::::::
:':
:: ............
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.049
0.028
3.141
1.7r.8
0.268
0.009
0.082
0.2
0.068
8.741
Current Cumulative lbs/ac
0,06 > •,
0 Q :6
3 99� '
2:751.
0 32S ' `
.O:Oi
O.1Q2
0.252
4 088
10 703
Permitted C. P. L. R.****
36
34
1 1338
267
15
374
89
2498
Permit PAN Limit 1 st/2nd Crop
P
...................................... .. ... .........................
92 "
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual):
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
f"�ator: Joseph Rice Owner: Joseph Rice Predominant Soil Series:
A A Used: 13.2 Acres Permitted: 13.2 Site #: AM055 Field #:
41.94
GaB
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
om-
posite
Date
Total
Phos-
-phorusmMENEEMENEEN
vial Heavy Metal Field Loadings (Calculated in lbs/acre):
� "cal
1
2
L3J
4
5
6
7
8
9
10
11
12
DT/Ac./
o
App.
Event
1.52
1.66
"
Arsenic
0.009
0.010
0.000
0.000
0.000
0.000
0..000
1 0,.000
0.000
0.000
0.00.0
0.000
0.019
Cadmium
0.006
0.007
0.000
0.000
1 0.000
0.000
0.000
0.000
0.000
1 0.000
O.Q00
0.000
0.013
Copper
6.588
6.46-5
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1.053
Chromitini
0.112
0.632„
0.000
0.000
0.000-
0.000
0.000
0.000 -
0.000
0.000
0.000
0.000
0.744
Lead
0.04.5
0.033
0:000
0.000
0.000
0.000
0.000
0.000
0.600
0.000
0..000
0.000
.0.079
Mercury
0.001
1 O.OQ2
0.000
.0.000
1 0.000
0.000
0.000-
1 0.00-0 ;
0.000
0.000
1 0.000
0.000
0.003
Molyb-
0.015
0.017
0.000
0.000
0.000
0.000
0.000
0:000
0.000
0.000
0.000
0.000
0.032
denum
Nickel
0.039
0.030
0.00.0
0.000
0.000-
0.000
0.000.
0.000
0.000
0.00.0
0.000
0.000.
0.O0
Selenium
0.015
0.017
0.000.
0.000
0.000
0.000
0.000
0.000.
0.000
0.000
0.000
0.000.
0.032.
Zinc
i.327
0.961
0.000
0.000
0.000
0.000
0.0010
-0.000
0.000
0.000-
0.000
0.000
2.288
Total
Phos-
34.239
71.134
0.000
6.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0:000
105.373
horus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
Misonment for knowing violations".
2!!f-e 1/14/2016
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
Operator:
ANNUAL LAND APPLICATION �, -iELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
City of Burlington WQ Permit #: WQ0000520 Field #: 5 Acres Utilized:
Joseph Rice Annual Dry Tons Applied: 41:94 Site #: AM055 Acres Permitted:
Joseph Rice Predominant Soil Series: GaB Cation Exchange Capacity (non 503):
Crop 1 Name: Fescue -Pasture Crop 1 Max. PAN: 158 Crop 2 Name: Crop 2 Max. PAN:
13.2
13.2
0
o y
° °
Q �
Volume applied
(enter one) Solids/
Liquid
q
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)o'
Soil
Cond.
(Dry,
wet,
Moist)
Precip.
Past 24
Hrs.
inches
Y
o
0
a. �
o
w —
# �'
::3
9,
7y ��
w -,
CD
* �•
" o
TKN
mg/kg
Z a
q �
o
�0
� w.
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop _
Crop 1
Crop 2
3/23
97500
4.92
1.545 ',
East Burlington
D
<.5"
S
0.5
0.3
31500
3460
2
30.745
NA
Fescue
3/24
123500
4.26
a1G�i2 .,
South Burlington
D
<.5"
S
0.5
0.3
62400
6810
2
66.760
NA
Fescue
0 000 , ` '
0.000 : `
0.000
0,000
0.000
0c00.0
0.000
0.000
='0;•QOQ.
0.000
0.000
0,600
0.000
0.000
,0 000 '`
0.000
0.000
�0 000
0.000
0.000
0 000
0.000
t1.000
O:OUO'
0.000
0.000
0.060 .
0.000
>0
0
0 Q00' . ,;
Residuals Applications totals on FORM
FSF supp (attach FORM FSF supp
to this form):
0.000
0.00t1
TOTALS:
,' ii
2a<ruoo
As
Cd
Cu
Cr
Pb
H g
Mo
Ni
Se
Zn
P
97T457T
0.000
Lime Applied
Annual lbs/acre
0 019
0 OI3
•1053
Q744
(107�1
0 003*
a 0 03
0.069
0:032' .
` 2 288 v.
'145.3Z3 : ? _ : :.: ; :: :: :.`.
.. ......
.. .. ...
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.1225
0.3004
18.8363
7 9.142
2.5551
0.0645
0.2797
1.2406
0.0692
26.5495
Current Cumulative lbs/ac
0.142
0:313
?19:$89
" r °8.68.8
2.63.4
0 068
„
0 311
1;310
0,:1°O1 "
• 28 831
Permitted C. P. L. R.****
36
1 34
1338
1
1 267
15
1
1 374
1 89
1 2498
Permit 2 erm PAN Limit 1st/ nd Crop P
158'
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation -1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual):
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
(`-ator: Leonidas Newlin Owner: Leonidas Newlin Predominant Soil Series:
A_ s Used: 13.2 Acres Permitted: 13.2 Site #: AM073 Field #:
39.24
TaB
1
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
SB
8/10/15
3
4
5
6
7
8 1
9
10
111
121
% Solids
3.81
Arsenic
3
Cadmium
2
Copper
213
Chromium
214
Lead
15
Mercury
0.5
Molyb-
denu .
5
Nickel
12
Selenium
5
Zinc
422
Total
Phos-
nhorus
25200
tzal Heavy Metal Field Loadings (Calculated in lbs/acre):
�tal
1
2
3
4
5
6
7
8
9
10
11 (
12
DT/Ac./
App.
Event
2.97
Arsenic
-0.018
0.000 -
0.000
0.000
0:000
6.000
0.000
0.000
0.00.0
0:000
0.000
0.000
0.018
Cadmium
0.012
0.000
0.00.0
0.000
0.000.
0.000
0.000.
0.000
0:00.0
0.000_
01000
0.000
0.012
Copper
1.266
0 000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
' 0.000
0.0.00
0.000
1.266
ChrOnliUni
1.272
0.000
-0.000
0.000
0.000
0.000
0.000
0.000
0.000
.0.000
0.000
0.000
1.272
Lead
0.089
0 000'
0.000
0.000
0.000
0.000
0.000
0.0000
0.000,
' 0.000
0.000-
0.000
.0 089
Mercury
0.003
0:000
0.000
0.000
0.000
0.0-00
0.000
0:000.
0.000
0.000
0.00.0
0.000
0.003
Molyb-
0.030-
0.000
0.000
0.000.
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000 1-0.030
denum
Nickel
0.071
0.00.0
0.000
0.000
0.000
0.000
0.00.0
0..000
0.000
0.000
0.000
0.000
.6.071
Selenium
0,.030-
0.000
0.000 '
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0:000
0,000
0.030
Zinc
2.50.9
0:000
0.000
0.000
0.060
0.000
0.000
0.000
0.000
0.000.
0;000
0.000
2.509
Total
Phos-
149.839
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
: 0.000
0.000
0.000
149.839
horns
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
iT ~isonment for knowing violations".
Z-1-e 1/14/2016
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION. 1ELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: City of Burlington
Land Owner: Leonidas Newlin
Operator: Leonidas Newlin
Crop 1 Name:
Fescue -Pasture
WQ Permit #: WQ0000520 Field #:
Annual Dry Tons Applied: '39:24 Site #:
Predominant Soil Series: TaB
Crop 1 Max. PAN:
142
Crop 2 Name:
AM073
Acres Utilized: 13.2
Acres Permitted: 13.2
Cation Exchange Capacity (non 503): 0
Crop 2 Max. PAN:
$-.
o =
° °
A
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry,
gist)
Precip.
Past 24
Hrs.
inches
Y
c m
o
o
»,
*
p
4
;0R
w
c,
*
TKN
mg/kg
Z Y
.; El
o El
w o
m'
mg/kg
Nitrate
and
Nitrite
mglkg
PAN Applied
( Ibs/acre)
Name of Crop Type
Receiving Residual
Application
Crop I
Crop 2
Crop 1
Crop 2
9/14
247000
3.81
<2.973
South Burlington
D
<r
S
0.5
0.3 1
55900
15000
?
1 17.561
NA
Fescue
0000, "
0.000
0.000
O:OOp''
0.000
0.000
0,000
0.000
'0 000
0,000
0.000
0 000
0.000
0.000
0 0002`
0.000
0.000
� o 000
0.000
0.000
0 000'
0.000
0.000
Q'000'
0.000
0.000
0:.00:0 ' .
0.000
0.000
~'` 0 000'
0,000
0.000
0
0 OOO r
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000
0.000.....
I ........
TOTALS:
0
_ 17n0(a.
::::::
As
Cd
Cu
Cr
Pb
H
Mo
Ni
Se
Zn
P
1 17.5(,1
o wo
Lime Applied
Annual lbs/acre
0.018
`.0..012 '
,A.266
�y � ?r2,
O nlcy
0.0.034
0:Q34
0.071
U'030'
', 2i509
`]49.839 .:=..:....::.: :.
: �';:-.:::..::: >:-.: >`:: ;:::.::: :
...........................
............................
.. .. ..
:::::... ................
Date
lbs/ac
Prior Years Cumulative Ibs/ac
0.1102
0.088
15.973
4.8346
2.3501
0.0567
0.641
1.3664
0.1081
25.507
Current Cumulative lbs/ac
0.128
6.10,0
1T:239
6.107
2A39, .
0 060
0.671
1,.43$
.
0J38-
' 28.016
Permitted C. P. L. R.****
36
34
1338
1 267
15
374
89
2498
Permit PAN Limit 1 st/2nd Crop
P
142
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual):
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
f"�rator: Leonidas Newlin Owner: Leonidas Newlin Predominant Soil Series:
A_ ..;s Used: 8.2 Acres Permitted: 8.2 Site #: AM073 Field #:
29.75.
GaB
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
EB
7/13/15
2
3
4
5
6j
7
8
9
10 i
11
12
% Solids
1 3.92
Arsenic
3
Cadmium
2
Copper
168
Chromium
52
Lead
31
Mercury
0.4
Molyb-
denum
5
Nickel
12
Selenium
5
Zinc
591
Total
Phos-
phorus
9570
dal Heavy Metal Field Loadings (Calculated in lbs/acre):
i oial
I 1 I
L2
3
4
5
6]
[7j
L8 I
9
9 1
111
12
DT/Ac./
App.
Event
3.63
Arsenic
0.022
1 0.000
0.000
0.000
0.000
0.000
1 0.000
0.000
0.000
0.000
0.000
0.000
1 0.022
Cadmium
0.015
0.006
0.000:
_ 0.000
0.000 .
0.000
0.000
0.000
0.000
0.600
0.000
0.000
0.015
Copper
1.219.
0.0.00
0.000
0.000
0 00.0
0.000
0.000
0.000
0.000
0.000
0.0.00
0.000
1.219
ChmtniUni
0.377
0 000
0.600
0.000
0.000'
0.000
0.000
0.000
0.0.00
= 0.000
0.000
0.000
0.377
Lead
0.225
0.060
0.000
0.000
0.000
0.000
0.000
0.000
0.00.0
0.000
0.000
0.000
0.225
Mercury
0.003
0.000
0.000
0.000
O.000
0.000
0.000
0.000
0.000.
0.000
0.000
0.000
0.003
Molyb-
0.036
0.000
0.000
0.0.00
0.000
06'000
0.000
0.000
0.000
0.000
0.000
0.000
0.036
denum
Nickel
0.087
0.000
0.0.00
0.000
0.000
0:000
0.000
0.000
0.000
0.000
0.000
0_000
0..087
Selenium
0.036
0'..0,00
0.000-
0.000
0.0100
0.000
0.000
0.000
0.000
0:000
0.000
0.600
0.036
Zinc
4.288 1
0-.000
0.000
0.000
0.000
0.000
0.000
W000
0.000
0.000
0.0-00
0.000
4.288
Total
Phos-
69.440
0.000
0.000
0.000
.0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
69.440
horus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
ir' -1sonment for knowing violations".
Z e u�x_
Signature of Land Applier
1/14/2016
Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION .tELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: City of Burlington WQ Permit #: WQ0000520 Field #: 3 Acres Utilized: 8.2
Land Owner: Leonidas Newlin Annual Dry Tons Applied: 29.75 Site #: AM073 Acres Permitted: 8.2
Operator: Leonidas Newlin Predominant Soil Series: GaB Cation Exchange Capacity (non 503): 0
Crop 1 Name: Fescue -Hay Crop 1 Max. PAN: 211 Crop 2 Name: Crop 2 Max. PAN:
a; o
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds GeIIOnS
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES # WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
(D
Wet,
Moist)
Precip.
Past 24
Hrs.
inches
a
410
� `5
� F,
0. m
o
�,
#
7y �
w -,
?
*
TKN
mg/kg
Zz Y
�
o
M o
g R.
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop I
Crop 2
9/16
156000
3.92
3.110
East Burlington
D
<.5"
S
0.5
0.3
24700
3060
2
49.906
NA
Fescue
9/17
26000
3.92
0.5,18 -
East Burlington
D
<.5"
S
0.5
0.3
24700
3060
2
8.318 •
' .NA
Fescue
0.000'
0.000
0 0.00:
0 000
O.00n
0.00:0
0:000
0.000
0;0.00
4 00.0' .
0':000
0.000 .
0;000
0:000
0 00.0
0.600
0000"
0.000-
0 000;
0.00W,
0.000
0 000
0:000 .
� „0.000
0-.000
0:000
0:000
0 000 `
0.000
0.000'•
0
0:
0 000 :.,?.„
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0:000
0•.000,`
.....:::'
.
TOTALS:
n
l szoo0
As
Cd
Cu
Cr
Pb
HP-
Mo
Ni
Se
Zn
P
58124].,
" 0.000 :
Lime Applied
Annual lbs/acre
0.022
0:015'"`•
1.219
-0.377
0 , 5 :;
0.003..
0 035 �:'
0.087
0;,036
4.288 =
:69.440 .. ;::. =..: ,
:
:: .. .. .. .. .......
Date
Ibs/ac
Prior Years Cumulative lbs/ac
0.1732
0.1328
22.4063
7.2483
2.9726
0.0859
0.8066
1.4738
0.1706
34.1589`'::
Current Cumulative lbs/ac
0 195..„
0.1.47
23' b25.
7.626
3 098
; 0.089'
0.843 `
1.561"
0; 207 '
38 447
Permitted C. P. L. R.****
36
34
1338
267
15
374
89
2498
Permit PAN Limit lst/2nd Crop
P
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation -1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual): 49.95
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
e 'Mator: Terry McPherson Owner: Terry McPherson Predominant Soil Series: CbB
h . s Used: 27 Acres Permitted: 27 Site #: AM100 Field #: 1
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
IJ
EB
7/13/15
2
3]
L4J
L5J_6j
L7J8
1
9
1101
11 j
12
% Solids
3.92
Arsenic
3
Cadmium
2
Copper
168
Chromitini
52
Lead
31
Mercury
0.4
Molyb-
denum
5
Nickel
12
Selenium
5
Zinc
591
Total
Phos-
pl;orus
9570
�Aal Heavy Metal Field Loadings (Calculated in lbs/acre):
Otal
I 1 I
L21
3
4j
5
6
7 j8
9
10
11
12
DT/Ac./
y
o
App-
Event
1.85
Arsenic
0.011
0.000
0.006
0:000:
0.0.00
0.000
0.000
0.000
0.000
0:000
0.000
0.000
0.011
Cadmium
0.007
0::0.00
0.000
0.000
0.000
0.000
0.000:
0:.000,
0.000
0.000
0.000:
0:000
0:0071
Copper
0.622
0..000
0.000
0.060
0000
0.000
0:000
0:000
0.000
0:000
0.000
0.000
0.622
Chromiun
0.192
0:00.0
0.000
0.000
0 00-&
0.000
0.000
0..000
0.000
0.000
0.000,
0.000
0:192
Lead
0.115
0.000
0,000
0.000
0.000
0.000
.0.000
0.000
`0.000
11 9.000
0.000
0.000
0.115
Mercury
0.001
0.000
0.000
0.000
0.000
Q 000.; ;
. 0.000
O..000
0.000'
0..000
0.000
0,000
0.001
Molyb-
0..019
0.000
0.00'0
0.000
0.000
0.000 `
0.000
0.000
0.000
`:0.000
0.000
0.0:00
0.019
denum
Nickel
0.044
0.000
0.000
0.000
0:000
0.00o..;j
0.000
0.006
0.000
0.000
0.000
.0.000
` - 0.0:44
Selenium
0.019
0.000
0.000
0.000
0. 000
-.0 000' .
0.000
0.000
0.000
0.000
0.000
0:000
0.019
Zinc
2.187
0`:OOO
0.000
0.000
0.000
0.000,
0.000
0.000
0 000
0.000
0.000
0.000
2.197
Total
Phos-
35.409
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
35.409
horns
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
1-isonment for knowing violations".
Z.Y 1/14/2016
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION LD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: City of Burlington WQ Permit #: WQ0000520 Field #: I Acres Utilized: 27
Land Owner: Terry McPherson Annual Dry Tons Applied: i 49 95. Site #: AM100 Acres Permitted: 27
Operator: Terry McPherson Predominant Soil Series: CbB Cation Exchange Capacity (non 503): 0
Crop 1 Name: Fescue -Pasture Crop 1 Max. PAN: 162 Crop 2 Name: Crop 2 Max. PAN:
o
p
Volume applied
(enter one) Solids)
Li Liquid
Q
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NpDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
D
(Dry,
Moist)
Precip.
Past 24
Hrs.
inches
Y
L+
cD
5- �•
w
o
%y �»,
* rT
o
o
7y
w
°'—
* N•
°
TKN
mglkg
Z Y
o 3
°Q °
w'
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop I
Crop 2
Crop 1
Crop 2
9/17
117000
3.92
`' .0.708
East Burlington
D
<.5"
S
0.5
0.3
24700
3060
2
11.36S;
IAA-. •
Fescue
9/18
188500
3.92
i,141
East Burlington
D
<.5"
S
0.5
0.3
24700
3060
2
18:3 [ 4
", hEE" '
Fescue
0 o0a `
o 000
o'ooq .
..
,,, : 0 000 .;
.0.000,
�b.000 .
=;agog
0.000
.0;000,.
6.000,
Q:OOb:'f'
0 000
0.0o0
O.000`x`
0:000
40.000'
Q:UU.O`
0,000
0 00
0.000
0:0.00
0
"0
4000777
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0,000
0.000
TOTALS:
k ol
3 05oo
As
Cd
Cu
Cr
Pb
H­
Mo
Ni
Se
Zn
P
29.682
1 0.000b-,
Lime Applied
Annual lbs/acre
0 011:
O:OQ7
0;622
0.192
0.115
0 001'
r0012
0:044
_©OZ
; 2 187 �:.'35.409''
:<:: "::::::::::::::::::::::::::
::::::::::::::::::::::::::::::::
...........................
.:::.::: >::::':=:::::::=:=::=:: >'»::
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.1011
0.0387
7.8498
3.7739
1.421
0.0334
0.3587
0.5248
0.0555
13.2557
Current Cumulative lbs/ac
0 112
�.0.,046
8,47i,
• °'"3 966;'"F'
" `1.536
0 03i5'
0.370`
. O.S;6�
` `0.074 J
-15 442
Permitted C. P. L. R.
36
34
1338
267
1 15
1 374
89
1 2498
Permit 2 Perm PAN Limit lstJ nd Crop p
162
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual):
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
C Bator: Lonnie Thompson Owner: Chapman McQueen Predominant Soil Series:
A .;'s Used: 11.4 Acres Permitted: 11.4 Site #: AM109 Field #:
56.69
HcB
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or11
Com-
posite
Date
EB
3/16/15
21
SB
8/10/15
3,
41
5�
6
71
81
J
10
11
12
% Solids
5.7
1 3.81
Arsenic
3
3
Cadmium
2
2
Copper
194
213
Chromium
40
214
Lead
17
15
Mercury
0.4
0.5
Molyb-
denum
5
5
Nickel
15
12
_
Selenium
5
5
Zinc
483
422
Total
Phos-
horus
10800
25200
,,zal Heavy Metal Field Loadings (Calculated in lbs/acre):
ctal
1
1 21
3 J
1 4J
5
6
7
8
9
10 j
11 j
12 j
-
y
DT/Ac./
0
APp•
Event
3.52
1.45
Arsenic
0.021
0.009
0.000 1
0.000
0;.000
0.000
0.000
1 0.000
0.000
0.000
1 0.000
0.000
0.030
Cadmium
0.0`14
0.006
0.000
0.000
0.000
6.000
0.0.00
0.000
0.000
0.000
1 0.000
0:000
0.020
Copper
1.367
0.617
0.000
6.000
6 000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1.985
ChrOlniMli
0.282
0.620
0.000
0.000
-0.000
0.000
0.000
0.000
0.000
0:000
0.000
0.000
0.902
Lead
0.120
0.043
0.000
0.000
0.000
0.000
0.000
0.00.0
1 0.000
0.000
0.000
0.000
0.163
Mercury
0:003
0.00-
0.000
0.000
0:000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.004
Molyb-
0.035
0.0-14
0.000
0.000
0.000
0.000
'0.000
0.000
0.00.0,
0.000
0:000
0.000
0.050
enum denum
Nickel
0.106
0.035
0..0.00
0.000,
0.006
0.000
1 0.000
0.000
0.00.0
0.000
0.000
0.000
0.140
Selenium
0.035
0.01.4
0w.000
0.000
0.009'
0.000.
0.000
0.0.00
0.000.
0.000
0:000
0.000
0.050
Zinc
3.404
1.223
0,000
0.000
0.000
0.0.00
0.000
0.000
0.600
0.000
0.000
0.000
4.627
Total
Phos-
76.118
73.030
0.000
0:000
0.000
0.000
0.000
0;000
0.000
0.000
0.000
0.000.
149.148
horus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
it -isonment for knowing violations".
Z.Y 4;-_24_ 1/14/2016
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION t .tELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WREN NOT APPLICABLE.
Facility Name: City of Burlington WQ Permit #: WQ0000520 Field #:
Land Owner: Chapman McQueen Annual Dry Tons Applied: ; 56.,69 • Site #:
Operator: Lonnie Thompson Predominant Soil Series: HcB
Crop 1 Name: Fescue -Hay Crop 1 Max. PAN: 169 Crop 2 Name:
1 Acres Utilized: 11.4
AM109 Acres Permitted: 11.4
Cation Exchange Capacity (non 503): 0
Crop 2 Max. PAN:
l
p ;[
0
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
oho
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
D
(Dry,
e '
Moist)
Precip.
Past 24
Hrs.
inches
a
4,
'
»o
c
2
4
70 �
w
TKN
mgtkg
z a
4
o
�•
mg/kg
Nitrate
and
Nitrite
mglkg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
4/8
65000
5.7
L355•
East Burlington
Dry
<.5"
S
0.5
0.3
29300
2630
_
25.256
NA
Fescue
4/13
104000
5.7
2-.168-
East Burlington
Dry
<.5"
S
0.5
0.3
29300
2630
2
40.410
NA
Fescue
9/19
104000
3.81
+1 449 ,>
South Burlington
Dry
<.5"
S
0.5
0.3
55900
15000
2
57.315
NA
Fescue
0 000 . •!
0.000
0.000
0.006 _:
0.000
0.000
a:0o4
0.000
0.000
0 000 .
0.000 i
0.000
0.000
0 000: ' ,
0.000
0.000
0.000
0.000
f1.000 -
0.000
0.000
0-000
`0.000
0.u0o
0
0
"0 000, , `°'
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000
0.000
TOTALS:
a
-27.gi)oo
As
Cd
Cu
Cr
Pb
H
Mo
Ni
Se
Zn
I'
122.982`
0.00o
Lime A lied
Annual lbs/acre
4 030 :
.0.02U .
" 1.985
0;902
0 163,: `
0004 d
' 0 050
6.140
'�oasa
a _ 4627
149.148' .. :"::..:::.:... :.::
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.239
0.238
26.917
8.176
3.899
0.102
0.911
2.822
0.21
46.357
Current Cumulative lbs/ac
0 269 '°
0,258
28:902
9u0.8
4.0t,2..`
0 166 ,
0.961
2.962"
1,0.260
50.9841
Permitted C. P. L. R.****
36
34
1 1338
1
267
15
374
89
1 2498
Permit PAN Limit 1st/2nd Crop
P
16 9
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual):
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
-Bator: Lonnie Thompson Owner: Chapman McQueen Predominant Soil Series:
A_ _ .;s Used: 6.1 Acres Permitted: 6.1 Site #: AM109 Field #:
36.07
HcB
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Com-
posite+
Date
. .
. ,
+:+,
++
ial Heavy Metal Field Loadings (Calculated in lbs/acre):
utal
11
1 21
31
4
5 1
6
7
8
9
10
11
12
DT/Ac./
0
App.
Event
4.56
1 1.35
Arsenic
0.027
0.009
1 0.000-
0.000
0.000
0.000
0..000
0.000
0.000
1 0.000
0 000
0.000
0.035
Cadmium
0.018
0005
0.100.0
0.000
0.000
0.000
0.000
0.0.00
0.000
0.000
0.00-0
0.000
0.024
Copper
1.769
6.517
0.0.00
0-060
0.0.00`
0.000
0.000
0.000
0.000-
0.000
0.000
0.000
2.346
Chromium
6.365
0.580
0.000
0.'000
0.000-
0.000
0.000
0.000
0.000
0.060
0.000
0.000
0.044
Lead
0.155
0.041
0.000
0.000
0.000
0.000
0.000
0.0.00
0.00.0
0.000
0.000
0.000
0.196
Mercury
0.004
-0.001.
0,.000
0.000
0.000
0:000`
0.00.0
0.000
0.000
0:000.
0.000
0.000
0.005
Molyb-
0.046
0.014
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.00.0
0.059
denum
denum
Nickel
0.137
0.032
0.0.00
0.000
00000
0.000'
' 0.0.00
0.000
0,000:
0.000
0.600
0,000
0..169
Selenium
0.046
0-014
0.000
0:000
0.000
0.000.
0.0400
0.000
0.000
0.000
0.0.00
0.000
0.059
Zinc
4.404
1.143
0:000
0.-000
0 000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
5.547
Total
Phos-
98.474'
68.242
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
166.716
horus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
Isonment for knowing violations".
;e�f-e 4;:�4r_
Signature of Land Applier
1/14/2016
Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
Operator:
ANNUAL LAND APPLICATION .-tELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
City of Burlington
Chapman McQueen
Lonnie Thompson
Crop 1 Name: Fescue -Hay
WQ Permit #: WQ0000520 Field #:
Annual Dry Tons Applied: 3'6',':07;, Site #:
Predominant Soil Series: HcB
Crop I Max. PAN
169
Crop 2 Name:
2 Acres Utilized: 6.1
AM109 Acres Permitted: 6.1
Cation Exchange Capacity (non 503): 0
Crop 2 Max. PAN:
o
,
ots°
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES # WQ#
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry'
vest)
Precip.
Past 24
Hrs.
inches
Y
b
5 r,
oa w
o
w
Ro•
P
*
4
7y 9
w -,
;
N
TKN
mglkg
Z Y
9
o
� o
p 2.
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
( lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop I
Crop 2
4/8
45500
5.7
L773
East Burlington
Dry
<.5"
S
0.5
0.3
29300
2630
2
33,04.0.NA-
Fescue
4/13
71500
5.7
2.786 .
East Burlington
Dry
<5"
S
0.5
0.3
29300
2630
2
51.9M
'.'NA.
Fescue
9/19
52000
3.81
.1.354 '
South Burlington
Dry
<.5"
S
0.5
0.3
55900
15000
2
53.55T
NA.
Fescue
0 0.00
0,600 •
0.00011
0 00.0,
0.000
0A0.0 .
0.-000.
0.000 `
` 6.006,
0 ova
0,000
0 000
0.00(i.
0.000
6.000
0:000
0AW
0000
0 000
000
0 000
0,000 H
0.000
0.006,
0.600
0.000"
0
0
-`0 000
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.0 0
0.000 °
.
TOTALS:
0
169000
As
Cd
Cu
Cr
Pb
H,
Mo
Ni
Se
Zn
P
138 518
0.000^°
Lime Applied
Annual lbs/acre
0035:
0.024
2.346
r :0.94.1
0 196 �
: 0:005`
00`59
0..169
0:059 :
5.547 .'
166.716 >:....:.::.:.::::::.:.
: ". . :
: .: � '•
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.25
0.276
29.439
8.612
3.927
0.123
0.958
2.75
0.229
52.962
Current Cumulative lbs/ac
°0.285
-0.300
31.785
9 556'•
E. 4.121
A28
L017
2.919
.• 0288
58.509
Permitted C. P. L. R. ****
36
34
1338
1
1 267
15
374
1 89
1 2498
it Perm PAN Limitst/2n 1 d Crop
-
169
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual):
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
Orator: Leonidas Newlin Owner: Leonidas Newlin Predominant Soil Series:
1 s Used: 19.3 Acres Permitted: 19.3 Site #: AM110 Field #:
36.34
GaB
1
Residual Analysis Data (Heavy Metals and Total Phosphorus use nizgiz % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1 1
SB
8/10/15
21
EB
7/13/15
3
4
51
1 61
7
8
9
LO-1
11
12
% Solids
3.81
1 3.92
Arsenic
3
3
Cadmium
2
2
Copper
213
168
Chromiuni
214
52
Lead
15
31
Mercury
0.5
0.4
Molyb-
denum
5
5
Nickel
12
12
Selenium
5
5
Zinc
422
591
Total
Phos-
phorus
25200
9570
1 'lial Heavy Metal Field Loadings (Calculated in lbs/acre):
..,cal
1
2
3
4
5
6
7
8
9
10
11
12
DT/Ac./
App.
Event
1.50
0.39
Arsenic
0.009
0.002
0.000
0.000
0.000
0.000
1 0.000
0.000
0.000
0.000
0.000
0.000
0.011
Cadmium
0.006
0.002
0.000
0.000
1 0.000
0.000
0.000
1 0.000
0.000
0.,000
.0.000
0.000
1 0.008
Copper
0.638
0-1 2'9
0.000
0.000
0.000
Q.000
0.000 .
6.006
0.000 _
0.000
0,00
-0.000
0.768
Chromium
0.641
0.040
0.000
0.000
0.000
0.000
0.000
0.000
0.000 '
0-000
0.000
0.000
0.681
Lead
0.045
0.024
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0 000
0.000
0.069
Mercury
0.001
0.006
0.060
0.000
0.000
0.000
0.000
0.000
0.000.'
0.000
0.000
0.000
0.002
Molyb-
0 015
0.004
GAG
0.000
0.000
0.000
0.000
0,000
0.000
0.006
0.000
0.000
0.019
denum
.
Nickel
0.03.6
0_009
0.000
0.000
0.000
0.000-
0.000
0.00.0
.0.0:00.
0.000
0.000
0:000
0.045
Selenium
0.015
OA04
0.0:00
0.000
0..000
0.000
0.000
0.000
U.000
0.000
0.000
0.000
0.019
Zinc
1.264
6.455
0.000
0.000
0:000
0.000
0.000
Et,000
0.0001
0.000-
0.0.00
0.000
1.719
Total
Phos-
75.499
7.369
0.000
0,000
0.000
0.000
0.000
0.000
0..000
0.000
0.000
0.000
82..868
phorus
"1 certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
i- Misonment for knowing violations".
1/14/2016
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
ANNUAL LAND APPLICATION-. ALD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
City of Burlington
Leonidas Newlin
Operator: Leonidas Newlin
WQ Permit #: WQ0000520 Field #:
Annual Dry Tons Applied: 36:34 Site #:
Predominant Soil Series: GaB
Crop 1 Name: Fescue -Hay Crop 1 Max. PAN:
211
Crop 2 Name:
Acres Utilized: 19.3
AM110 Acres Permitted:
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
19.3
0
S.
o �
Q
Volume applied
PP
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry,
e '
Moist)
Precip.
Past 24
firs.
inches
y
co
a w
o
w
o
po =
TKN
mg/kg
Z >
F 3
�o o
R.
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
lbs/acre
( )
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
9/15
182000
3.81
1498
South Burlington
D
<.5"
S
0.5
0.3
55900
15000
2
.5924b
NA .
Fescue
9/16
45500
3.92
-0 '95"
East Burlington
D
<.5"
S
0.5
0.3
24700
3060
2
6:184
NA "
Fescue
0 000
OOUO
0.000
0 000'.
0.000
0•.000
0 000
0000
0.000
O o00
0,0o0 '
4006
0 000
0:0of?
0 600, •`'
0 000-°
a° 0.000
0.000
o.000
o:o00,
0.000
0.000
t).000
f0:000
0.000
0:000
0 000:
0.060'�
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0:0u,1
0.000
TOTALS:
n
ry?. goo
As
Cd
Cu
Cr
Pb
Mo
Ni
Se
Zn P
65.43n
0.000:.:
Lime A plied
Annual lbs/acre
0 01t.:
0.00 �
0,768
0 b81
U.U69 "
0 0:19
•�' 0..04577
O d19,
•`l 719 82.868 :....:....
29.3065:::::::.................................Current
�' 3:1 026Permitted
2498
Datelbs/ac
Prior Years Cumulative lbs/ac
0.1682
0.13
16.8477
5.4524
3.3692
rH
0.7502
1.8102
0.1356
Cumulative lbs/ac
0.179 ' °
° 01138
17c615
`' 6.134
.1 14 38 ,''
0369
1:8.5� 1,
, 0.154 ��
C. P. L. R.****
36
34
1338
267
1
1 374
1 89
it PA Perm N Limit st/2nd Cr L rt1 0 P
.2 11
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0:1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual): 11.36
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
(' '�yator: Leonidas Newlin Owner: Leonidas Newlin Predominant Soil Series: GaB
A__ A Used: 5 Acres Permitted: 5 Site #: AM110 Field #: 2
Residual Analvsis Data (Heavv Metals and Total Phosphorus use mg/kE. % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
SB
8/10/15
2
3
4
5
6
7
8
9
10
11
12
% Solids
1 3.81
Arsenic
3
Cadmium
2
Copper
213
Chromium
214
Lead
15
Mercury
0.5
Molyb-
denum
5
Nickel
12
Selenium
5
Zinc
422
Total
Phos-
rbMlss
25200
ial
ileavy lvletal riela Loadings
(calculated in ins/acre):
i oial
1
L21
L 3j
L4]5
6
7
8
9
Lj
Li12
DT/Ac,/
App.
Event
2.27
Arsenic
0..0.14
0.000
0.000
0.000
0.000
0.000
0.000
0.000.
0.000
0.000
0.000
0..000
1 0.014
Cadmium
0.009
:0.000
0.1000i
0.000
0.000
0.000`
0.000
0.0.00
0.000
0.000
0.000
0.000
0.009
Copper
0.968
A.000
. 0.000
O.000
0..000
0:000
0.000
0 000
0.0.00
0.000
0.000
0.000
0.968
Chromiun,
0.9t
0.000
0.00.0..
0.000
0.000
0 000'
. 0.0.00
0.000
0 "000 :
0.000
0.000
0.000
0.972:
Lead
0.068
0.00.0
0.000
0.000
0.000
0.000
0000
0.000
0.000
0.000
0.000
0.000
0.068
Mercury
0002
0.000
0.,000 :
0.000
0.000
0.00D
0.000
0.000 -
0..006
0.000
0.000
0.000.
0.002
Molyb-
denum
0.023
0..000
0.000 '
0.000,
0.000
0 000
0.000
0:000
0.000
0.000
0.000
0.000
0.023
Nickel
0.055
0900`
0 000
0.000
0.00.0
0.000 :
O.00Q
0.000
0.000.
0.000
O.O:QO
0,000
0:055
Selenium
0 023
0:0.06
0 000
O.000
0.000
-0.000
0.00:0
0.0'00 '
0.000
0.0:00.
0 00.0
0.000
0:023
Zinc
LM9
Moo
0 000 ,
. 0.00.0
0.000
- 0.0.00
0.000
0;006
0.000
0.000
0.-000
0.000
1.918
Total
Phos-
114.509
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
114.509
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
i isonment for knowing violations".
Z�z 4�` 1/14/2016
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
Operator:
ANNUAL LAND APPLICATION t-ALD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
City of Burlington WQ Permit #: WQ0000520 Field #: 2 Acres Utilized:
Leonidas Newlin Annual Dry Tons Applied: l L,36 Site #: AM110 Acres Permitted:
Leonidas Newlin Predominant Soil Series: GaB Cation Exchange Capacity (non 503):
Crop 1 Name: Fescue -Hay Crop 1 Max. PAN: 211 Crop 2 Name: Crop 2 Max. PAN:
5
5
0
A
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/AC)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
Wet,
Moist)
Precip.
Past 24
Hrs•
inches
y
41 -
ca 1
x i;
a w
* o
c
* ^'
0
;a
N .,
ca
* �,'
'.
0
TKN
mglkg
z ��
q
o n
vo o
w'
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
( lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
9/15
71500
3.81
2.272 •
South Burlington
D
<.5"
S
0.5
0.3
55900
15000
2
89.842
NA
Fescue
O' U:00
0.000
0.000
0.000
0.000
0,0:00:
0.000
0.000
.0'0,0.6
0.000
0.000
0;000
0,000
0.000
0.000
0.000
0.000
0:•UQp :
0.000
0.000
0 0Q0°
0 000
0,000
o aoo
0,001
0.000
.0000
0.000
0.000
11.000
0 000
0
t}
O.b00,.' `,
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
OJi00
0.000
TOTALS:
o
i ��10
::::::::::::::
As
Cd
Cu
Cr
Pb
H
Mo
Ni
Se
Zn
P
89.842
0.0n0
Lime A > ,lied
Annual lbs/acre
0.014^ `
0.009
6i968
Q 972
0:068:
0.002 '
`•0.023
0.0.55i
0 023 '
.,." 91,8 .'
114.5t►y >: '
::::::: :.............. : .
...........................
............................
Date
Ibs/ac
Prior Years Cumulative lbs/ac
0.1595
0.12
14.9686
5.0723
2.5987
0.0573
0.7193
1.6879
0.1342
27.2078
Current Cumulative lbslac
0,173
0129
15::936
6.045
2 6n.7 _
_.
0 066
.. . ,._
0.742
1.742
-157
29 125
Permitted C. P. L. R.****
36
34
1338
267
15
374
89
2498
i 1 s 2n N Limit t/ d Crop
1
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual): 33.15
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
/' 'rator: David Ridlin Owner: H.W. Byrd Predominant Soil Series: GaB
A, es Used: 16.3 Acres Permitted: 16.3 Site #: AM116 Field #: 1
Residual Analvsis Data (Heavy Metals and Total Phosphorus use mg/ka, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
11
SB
4/13/15
2
EB
4/13/15
3j
4
5
1.61
7 1
81
101
11
12
% Solids
4.19
1 4.53
Arsenic
3
3
Cadmium
2
2
Copper
152
145
Chromir.rrii
237
39
Lead
11
14
Mercury
0.5
1.1
Molyb-
denum
5
5
Nickel
9
14
Selenium
5
5
Zinc
322
428
Total
Phos-
phorus
21300
10800
`aal
Heavy
Metal Field Loadings
(Calculated in lbs/acre):
1 otal
1
1 2 j
1 3j
4
15 1
1 6 J
7
L8
9
10 j
11 j
12
0-3
DT/Ac./
,0
App-
Event
2.03
Arsenic
0.012
0.000
0.000
0.00.:0
0.000
0.000
0A00
.0_000'
0.000
0.000'
0 000
1 0.000
04012
Cadmium
0.008
0 000
- 0.000
0.00.o
0.000
0..000
omo
0.000
0.000
0.000
0.000
0.000
0.008
Copper
0.618
0.:000
0 000
0.000 .
0,000
WOW-
0.000
0.000.
0.000
�.0.000..
0 000'"
0:000
0.618
Chromiun
0.964
0`000
='`0.000
0.000
0:0100
0:000
0 00.0"
0.000.
0.000
0.006,
,0.000.
0.000
0.9.64
Lead
0".045
O.000
" 0.000
0.000 `
; 0.000
- 0..000
0:000
0":000
0.000
' 0.000
0 000
0.000
0.045
Mercury
0.002
OAOO
0.000
0.000
0.000
0.000
0.000
0..000
0 000 -
. 0.000 `
" 0,000'
0.000
0.0.02
Molyb-
0.020
0;000
0.000
0.000
0.000
.' 0.000
0.000
0:000 ,
0 00-0
0..000
0:000'
0.000
0.020
denum
.
,
{
Nickel
0.037
0.000
0 000
0 000
0.000
0.000.
; 0.000 1
0:000 ;
0.000
0.000>
0.9001,
0.000 1
0.037.
Selenium
0.020
: 0000
0:000 ,
0.000
0.00.0
0.000 "=
O'.00 0
0.000
U.000 .
0.000
" 0.000
0.000
0.020
Zinc
1.310
0.000
0000
0.000
_ 0".000
0 000; "
0.000
0:0-00
0 O00
`; 0.000
: 0.000
0.000 '
,1.310
Total
Phos-
86.648
0.000
0.000
0.00,0
0.000-:
° 0.000
6,000
0.000
0.0.00.;
0.000
'0.000
0.000.
86.648
7horus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
i, •isonment for knowing violations".
ze�z 1 / 14/2016
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name:
Permit #:
C_"`;ator:
A__ cs Used:
City of Burlington Total Dry Tons Applied (Annual): 94.46
WQ0000520 Cation Exchange Capacity (non 503 only):
David Ridlin
Owner: H.W. Byrd Predominant Soil Series:
46.1 Acres Permitted: 46.1 Site #: AM116 Field #:
GaB
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
W1 wpm .
Com-
posite,
Date
. -' nr
©©----------
Total
Phos-
_7h�r_US_MMEE=EEEEEE
ial Heavy Metal Field Loadings (Calculated in lbs/acre):
i otal
[11
2
3
4
5
6
7
8
9
10
11
12
DT/Ac./
App.
,oy*
14
Event
1.33
0.72
"
Arsenic
0.009
0.004
0.000
0.000
0.00.0
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.012
Cadmium
0,005
1 0.003
0.000
0.000
1 U0.0
0.000
0.000
0.000
1 0.000
0.000
0.000
1 0.000
0.008
Copper
0.404
0.209
0-.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.613
Chromium
0.630
0.056
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.687
Lead
0.029
0.020
0.000
0.000
0.000
0.000
6.000
0.000
0.000
0.000
0.000.
0.000
0.049
Mercury
0.001
0.002
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1 0.003
Molyb-
0.013
0.0.07
0.000
0,000
0.000
0.000
0.000
1 0.000
0.000
0.000
0.000
0.000
0.020
denum
Nickel
0.024
0.020
0.000
0.000
0-;000
.0.000
0.000
0.000
0.000
0.000
0.000.
0.000
0.044
Selenium
0.013
0.007
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.020
Zinc
0:857
0.615
0.000
0.000
0.000
0.000 1
0.000
0.000
0.000 1
0.000
0.000
0.000
1.472
Total
Phos-
56.658
15.530
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
72.188
phorus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
il• •isonment for knowing violations".
;e�d Lam►
1/14/2016
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION .-iELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: City of Burlington WQ Permit #: WQ0000520 Field #: 3 Acres Utilized: 46.1
Land Owner: H.W. Byrd Annual Dry Tons Applied: 94.46 ' Site #: AM116 Acres Permitted: 46.1
Operator: David Ridlin Predominant Soil Series: GaB Cation Exchange Capacity (non 503): 0
Crop I Name: Soybeans Crop I Max. PAN: 190 Crop 2 Name: Crop 2 Max. PAN:
$-.
o a
° 0
°
(�
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
��u
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, W #
Q >
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry'
Wet,
Moist)
Precip.
Past 24
Hrs.
inches
>
4�
co
o w
o
w
_
1,
N'
Z
:n
w "
�
N
TKN
mg/kg
Z Y
B
o 0
ao o
iE
�.
mg/kg
Nitrate
and
Nitrite
mglkg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop I
Crop 2
Crop I
Crop 2
5/14
175500
4.53
_.0.7`19
East Burlington
Dry
<.5"
S
0.5
0.3
26500
1550
108
12.035
NA
Beans
5/15
240500
4.19
0 912 ...
South Burlington
Dry
<.5"
S
0.5
0.3
66100
7880
69.2
39.150
NA
Beans
5/28
110500
4.19
0 419 .'
South Burlington
Dry
<.5"
S
0.5
0.3
66100
7880
69.2
17.988
NA
Beans
0 OOb
0.000
0.000
0000-
0.000 '
0.000
0:00.0'
0.000
0.000
" 0.000
0.000 `
0.00o
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0:000
0.000
0.000
0 000
0.000 '
0.000
0
0
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000
1 0,000
TOTALS:0
52r,,t,o;
_:::::::::
As
Cd
Cu
Cr
Pb
Hs
Mo
Ni
Se
Zn
P
69.173 `
o.000
Lime A > ,lied
Annual lbs/acre
O oaz
O.OQ8
0.613
Qai87
.0..0.1t�
0 003"
0'02 k'
,-6.044
0 020 n
1472
' 72.188
.:.< ..' ` :". . . < : . . .
.......... ... .. .. ..
............................
.................................
:>.
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.0679
0.0441
5.6399
2.24.5 l
0.7207
0.0249
0.1719
0.7504
0.0549
11.3497
Current Cumulative lbs/ac
0.080
0..052 .
6.253
2.Q32 "'
0.77Q"
u.028
0:192
' 0 794
0:075'
112.822
Permitted C. P. L. R.****
36
1 34
1 1338
1
267
15
1
1 374
1 89
1 2498
Permit PAN
N Limit is t/2nd Crop
190
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name:
Permit #:
("' rator:
A---�s Used:
City of Burlington Total Dry Tons Applied (Annual):
WQ0000520 Cation Exchange Capacity (non 503 only):
David Ridlin Owner: H.W. Byrd
17.4 Acres Permitted: 17.4 Site #:
Predominant Soil Series:
Emil
GaB
AM116 Field #: 4
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
com-
posite
Total
Phos-
-phorus-MMENEEMENEEN
zal Heavy Metal Field Loadings (Calculated in lbs/acre):
i otal
11
1 2j
3
4
5
6
7j
8
9
LOJ
11 j
12
DT/Ac./
e
App.
Event
0.91
1.76
Arsenic
0,005
0.011
0.000
0.000
0.000
0:000
0.000
0.000
0.000
0.000
0.000
0.000
0.016
Cadmium
0.004
1 0.007
0.000
0.000
0,000
0.000
I 0A0
0.000
0.000
1 0.000
0.000
0.000
0.011-
Copper
0.278
0.512
0..000
0.000
000 -
0.000
0.000
0.000
0.00.0
0.000
0.000
0.000
0389
Chromium
0.433
0.138
0.000
0.000
0.000
0.000
0.000
0.000
0.00:0
0.000
0-000
0.000
0.571
Lead
0.020
0.049
0.000
0.000
0.000
0.000
0.000
0:000
0.000
0.000
0.000
0.000
0.070
Mercury
0.001
0.004
0.000
0.000
0.000
-0.000
°0.000
0.000
0.000
0.000
0.000
0.000
0.005
Molyb-
0..009
0.018
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.027
denum
.0.000
Nickel
0..016
0.049
0.000
0.000
0.000
-0.000
0.000
0.000
0.000.
0.000
0.000
0.000
0.066
Selenium
0.009
0.018
0.000
0.000
0.000
0.000
0.000
0.000
0.00:0
0.000
0.000
0.000
0.027
Zinc
01,589
1.51-0
0.060
0.000
0.000
0.00.0
0.000
0.000
000
0.000
0.006
0.000
2.090
Total
Phos-
38.936
38.102
0.000
0.000
0.000
0.000
0.000
0.000
6.000
0.000
0.000
0.000
77.039
horus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
isonment for knowing violations".
1/14/2016
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
Operator:
ANNUAL LAND APPLICATION-. &LD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
City of Burlington WQ Permit #: WQ0000520 Field #: 4 Acres Utilized:
H.W. Byrd Annual Dry Tons Applied: 46.60 Site #: AM116 Acres Permitted:
David Ridlin Predominant Soil Series: GaB Cation Exchange Capacity (non 503):
Crop 1 Name: Soybeans Crop 1 Max. PAN: 190 Crop 2 Name: Crop 2 Max. PAN:
17.4
17.4
0
1. .ClCond.
i
w o
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
(Dry,
Wet
Moist)
Precip.
Past 24
Ws.
inches
a
o'
a w
o
�,
£u
#
'�
w
*
0
TKN
mg/kg
- a
Fl
o
R 0
w.
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
lbs/acre
( )
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
5/13
162500
4.53
1.764
East Burlington
Dry
<.5"
S
0.5
0.3
26500
1550
108
29.525'
NA-."
.
Beans
5/28
91000
4.19
' 0 914.
South Burlington
Dry
<.5"
S
0.5
0.3
66100
7880
69.2
39.24T:
".NA -
Beans
0.000
0:000 `
0000
0.006
0..000 `
0.000:
OA00
0.000'
101000
0.0:io
0 000
0.000
o:ao0.
0 000­,
� 0.000,
0.000
0.060
o.000
0000
0.000:
0
0
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0-000
, 0.060 ,
.
TOTALS..:'.
n
� 3so0
As
Cd
Cu
Cr
Pb
Ht
Mo
Ni
Se
Zn
P
68 772
1::,-•
0:000! `
Lime A > ,lied
Annual lbs/acre
O:OY6
O:OLl _
-0.789
0.571
o.07u
0.Q05`
00 7
0:.066 •
`0427
K2 09-9 ;
;_,'17.039
.................
.... .. .. .................
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.0467
0.0396
4.6441
1.8.16
0.,;'65
0.0214
0.1348
0.7228
0.0451
9.3388
Current Cumulative lbs/ac
0.063
0.050
5.434
2 4.us
0.596 '
0 02¢''
0.162
0.789 .
h 0:072 .
`'11.437
Permitted C. P. L. R.****
36
34
1338
267
15
374
89
2498
it PAN Limit lst/2nd Perm Crop
190.' °-
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date
*** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name:
Permit #:
Q"�ator:
A .:'s Used:
City of Burlington Total Dry Tons Applied (Annual)
WQ0000520 Cation Exchange Capacity (non 503 only):
David Ridlin
86.7
Owner: H.W. Byrd
Acres Permitted: 86.7 Site #:
Predominant Soil Series:
AM 116 Field #:
222.04
TaB
7
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1 1
EB
3/16/15
2 j
SB
3/16/15
3
SB
4/13/15
L 4
5
6 j
7
8
9
10
L1j
12
% Solids
5.7
3.86
4.19
Arsenic
1 3
3
3
Cadmium
2
2
2
Copper
194
136
152
Chromium
40
196
237
Lead
17
10
11
Mercury
0.4
0.4
0.5
Molyb-
denum
5
5
5
Nickel
15 1
8
9
Selenium
5
5
5
Zinc
483
323
322
Total
Phos-
Aliorus
10800
21500
21300
'ual Heavy Metal Field Loadings (Calculated in lbs/acre):
otal
1
2
31
14]5
6
7
8
9
191
ill
12
DT/Ac./
App.
Event
1.53
0.54
0.49
Arsenic
0.009
1 0.003
0.003 1
0.0.00
0.000
0.000
0.000
1 0:0'00
0;000
0.000
0.000
0.000
0..015
Cadmium
0.006
0.002
0.002
0.000
0.000
0.000
0.000
0,000
0.000-
0.000
i0.000
0.000
0:.010
Copper
0.595
0.148
0.147
0.000
0.1000
0.000
4.000
0.000
0.000
0:000
0:000
_ 0.000
0.890.
Chromiuiii
0323
0:213
0.230
0.000
0:000
0:060
0.000
0.000-
0.000
0.0.00
0-000
0.000
0.565
Lead
0.052
0.011
0.011
0.000
0.000
0; 000
0.0,00.
0.000
0.000
0.000
0.7000
0.000 .
0,074
Mercury
0.00°1
0.000
'0.000
0.000
0.000
0.000
0.000
0.0,00
0.000
0.000
0..000
0.000
UO2
Molyb-
0.015
0.005
0.005
0.000
0.000
0.000
0.,000
0.000
0.000
0.000
0.000
0000
0.026
denum
Nickel
0.046
0.009
0:009
0.000
0.000
0 00:0..
0.000
0.0,00
0.000
0.000
0.000
1 0..000
0.063
Selenium
0.015
0.005
0.0.05
0 000
0.000.
0.000
0.000
0.000
0.000
0.0.00
0.000
.0.000
0.026.
Zinc
1.481
0.35`1
0312 1.
0.000
0.000
Q.000
0.000
0.000
0.000
0.000
0.000
0.000
.2.144
Total
Phos-
33.113
23.349
20.66.1
0.000
0.000
0.000
0.006
0.000
0.000
0.000
0.000
0.000
77.123
horns
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
iI ,-isonment for knowing violations".
Signature of Land Appiier
1/14/2016
Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
Operator:
ANNUAL LAND APPLICATION x iELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
City of Burlington
H.W. Byrd
David Ridlin
Crop 1 Name: Soybeans
WQ Permit #: WQ0000520
Annual Dry Tons Applied:222:,04
Predominant Soil Series: TaB
Crop 1 Max. PAN:
171
Field #: 7
Site #: AM116
Crop 2 Name:
Acres Utilized: 86.7
Acres Permitted: 86.7
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
°
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry'
gist)
Precip.
Past 24
Hrs.
inches
y
n
a 'v,
* o
o
CDCD
* w'
r
w
* N
w
TKN
mg/kg
z Y
o
oc o
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
ReceivingResidual
Application
Crop 1
l mp 2
Crop 1
Crop 2
4/13
84500
5.7
":012
East Burlington
Dry
<.5"
S
0.5
0.3
29300
2630
2
.4.317
ANA,:a•.
Beans
4/14
91000
5.7
0 249 °'
East Burlington
Dry
<.5"
S
0.5
0.3
29300
2630
2
4.649
; NA ""
Beans
4/23
292500
3.86
0 543 ` ."
South Burlington
Dry
<5"
S
0.5
0.3
63500
8290
2
22.493
NA<;;,
Beans
4/24
201500
5.7
0 552
East Burlington
Dry
<5"
S
0.5
0.3
29300
2630
2
10 295,'
NA" ''
Beans
4/29
182000
5.7
0 499 ' `t
East Burlington
Dry
<,5"
S
0.5
0.3
29300
2630
2
9.299 .
J •NA
Beans
5/5
240500
4.19
0 485 "" .'
South Burlington
Dry
<.5"
1 S
0.5
0.3
66100
7880
69.2
20.817=
I NA' .
Beans
0.000
' 0.000 -
0 000•.` `
0.000 g
0.000`
0.000'
0.000-"i
a 000'
0.000
0.000-
0.000
0:000 .°
` 0 000
0.000
10.000
0
0
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000x
..........
O.00Q
:..... ..
TOTALSI
ol
10w006
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
71.8b0
0.000.
Lime A died
Annual lbs/acre
9.015 '
0:010
0.890565
a
0.ti71
0 !)02
A.026
0.0 3
�4:026
2.1441=.
=77.123 :: `.
:::::::::.::::::.:::.:.....:': :
...........................
............................
Date
lbslac
Prior Years Cumulative lbs/ac
0.0722
0.0614
6.9332
2.8786
0.8454
0.0417
0.2483
0.4701
0.0752
12.7981
Current Cumulative lbs/ac
0 088
- 0.072
7;$23 •.
3 444' `.,
' 0 919 "
0 044'
0.274
0'.5.34'
Q.10P °
14.942
Permitted C. P. L. R.****
36
34
1 1338
1 267
15
374
89
2498
Permit P st/2nd r erm AN Limit 1 Crop p
171
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
�1 *Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual): 138.87
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
C'-,ator: David Ridlin Owner: H.W. Byrd Predominant Soil Series: TaB
A_ -;s Used: 66.7 Acres Permitted: 66.7 Site #: AM116 Field #: 8
Residual Analysis Data (Heavy Metals and Total Phosphorus use me/ku, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
EB
3/16/15
2
SB
3/16/15
3
SB
4/13/15
L4J
5
6j
7
8
9
10
11
12
% Solids
5.7
3.86
4.19
Arsenic
3
3
3
Cadmium
2
2
2
Copper
194
136
152
Chromiwn
40
196
237
Lead
17
10
11
Mercury
0.4
0.4
0.5
Molyb-
denum
5
5
5
Nickel
15 1
8
9
Selenium
5
5
5
Zinc
483
323
322
Total
Phos-
t?horus
10800
21500
21300
vial
Heavy
Metal Field Loadings
(Calculated
in lbs/acre):
.L otal
1
2
3
4
5
6
7 j8
9
10
11
12
DT/Ac./
oyr
App.
y
Event
0.60
0.82
0.66
Arsenic
0.004
0.005.
0.004 1
0.000
0. 000
0.000
1 0.0.00
0..000
0,0.00
1 0 000
0.000.
0.000
0.012
Cadmium
0.002
.0-003
0.003..
0.000
0.000
0.000
0:006
0.060
0:000
0.000
0.000
0.000
0.008'
Copper
0.234'
0.222` °
0202
0.000
0.000
0.000
u00
0.000
0 000
0.000
0:000
0.000
0.657
Chromiun
0,04$ •
0.320
.. 0 315
< 0.000
0 000
0.000-
0.-000
0:000
0.000
• •0.00:0
0.000
0:000
0.683
Lead
0.020
0 016
0.015
0.000
0,060'
0.000,
0.000
0.000
0.000
0.000
0:000
0.000
0.051
Mercury
0.000
0.001
0.001
0.000
0.0%
0.000 .
0.000
Aio.00
0.000
0.000-
0.000
0.000
0 002:
Molyb-
0.0.06
0:008-
0.007.
0.000
0.,000
0.000 `
0.000'
0:000
0.00:.0
0.000
0,000
0.000
0.021
denum
Nickel
0.018c
O.Q13
-0,01.2
0.,-000
0,000
0.000 _,
0 006
. 0.000,
0.000 '
0.000.
0.'000
0.000
0.043
Selenium
-0.006
0008
0.007
0.000
0.000
0.000 .
0.000,
, 0:000
0.000
0..000
0.000
0.000
0.021
Zinc
0..582
0.527
0.428
0.000
0 000
0.00.0
0 000.
0,000
0.000
0.000
0.000-
0.000
1.536
Total
Phos-
13.003
3.5.088
`28.286
0.000
0..060
0.000
0.000
0.000
0.000
0.000
0.000
0.000
76.378
chorus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
-1sonment for knowing violations".
1/14/2016
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
ANNUAL LAND APPLICATION Y-.[ELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
City of Burlington
H.W. Byrd
Operator: David Ridlin
Crop 1 Name: Soybeans
WQ Permit #: WQ0000520 Field #:
Annual Dry Tons Applied: ' °a.13'8,87 Site #:
Predominant Soil Series:
Crop 1 Max. PAN:
171
TaB
Crop 2 Name:
Acres Utilized: 66.7
AM116 Acres Permitted: 66.7
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
a, 0
(�
Volume applied
enter one Solids/
( )
Liquid
Cu. Yds Gallons
o
/o
Solids
Volume
Applied per
pP P
Acre
(Dry Tans/Ac)
Residual Sources
PDES #, W #,
Q
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry'
Wet,
Moist)
Precip.
Past 24
Hrs.
inches
o
rD
o w
a
°
o
N'
4
w ,
; RL
* F
TKN
mg/kg
Z
,�
o 0
vac o
p
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
( lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop I
Crop 2
Crop l
Crop 2
4/25
117000
3.86
0282•--
South Burlington
Dry
<.5"
S
0.5
0.3
63500
8290
2
11.:695
NA'
Beans
4/28
221000
3.86
0 533„
South Burlington
Dry
<.5"
S
0.5
0.3
63500
8290
2
22 090
NA'.
Beans
4/30
169000
5.7
0 602'
East Burlington
Dry
<.5"
S
0.5
0.3
29300
2630
2
11.223
NA
Beans
5/6
253500
4.19
.0.664
South Burlington
Dry
<.5"
S
0.5
0.3
66100
7880
69.2
28.521
NA,%
Beans
0.000
0:000 _
0 000
0-0o0
0:000 .
"°0 ooa '
0.000
0.000
0 000 '
01000
0.000'
0.000
0000. `
' 0.000
0.000
'0.000
o:oo0
0--00o
0.000`
0.000°
-0.00.0
0:000 `.
0 .
0
0 000' ,
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.u00
0.000
.......
TOTALS:
J
760500
:::::
As
Cd
Cu
Cr
Pb
H,4
Mo
Ni
Se
Zn
P
73.530
6.000''
Lime A. -died
Annual lbs/acre
0 012 `.
0.008 :.
0:637
' b.683
0.051
0 002
0.021�
0.043"
(021 ,
.1..53.fi''.
76:.378 ::; ::; ;:;';'::;:;' :; ::;:; ;:
:`• ....... .. ...
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.0595
0.0417
5.0545
2.2551
0.6339
0.0356
0.1541
0.3045
0.0546
9.6849
Current Cumulative lbs/ac
0 072'� ` ',
0..050
5,J12`•
" 2.938
0.h85
0 037 .
-Q.I 5
0.348 :
'.0;075
:1`i 221
Permitted C. P. L. R.****
36
34
1 1338
267
15
374
89
2498
2
Permit PAN Limit lst/ nd CroP
p
-
171
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date
*** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual):
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
('�*ator: David Ridlin Owner: H.W. Byrd Predominant Soil Series:
A_ es Used: 42.8 Acres Permitted: 42.8 Site #: AM116 Field #:
76.10
GaB
13
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
SB
4/13/15
2 j
EB
4/13/15
3
4]
[_5j
6
7
8 1
9 f
10
1�
12
% Solids
4.19
4.53
Arsenic
3
3
Cadmium
2
2
Copper
152
145
Chromium
237
39
Lead
11
14
Mercury
0.5
1.1
Molyb-
denum
5
5
Nickel
9
14
Selenium
5
5
Zinc
322
428
Total
Phos-
nhorus
21300
10800
',jai Heavy Metal Field Loadings (Calculated in lbs/acre):
1 otal
1
2
3
4j
5
6
7
L8J
9
10
11
12
DT/Ac./
App.
n
Event
1.78
Arsenic
0.011
0.000
0.00.0
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0:000
0.000
0.011
Cadmium
0.007
0.000
0.000
0.000
0:000:
0.000`,
0:000
0000
0.000'
0.000
0.000
0.000
0.007
Copper
0.541
0.000
0.000
0:000
0.:000
0.000
0.0'Q0
0..000
0,660
0.00;0
0;000
0.000
0.54-1
Chromium
0.843
0.060 .
0.000 :
0.000
0.000
0.000,
0.000
0-.000-
0.000 .
' 0A.00
0:000,
0.000
0.843
Lead
0.039,
0.600
0.000 ;
0.000
0.00-0
0 000_ ':
0.000
0.000
0.000
0.000
0.006
0.000
0.039
Mercury
0:002
0000
0 00.0
0.000
0.000
0.000
0.000
1 0.000
0.000
0.000,
0.000
0.000
0.002
Molyb-
0.01$
0.000-
0.000
0.000
0:000
0.000
0.000
0.000,
0.000
0.000
0.000
0.000
0.018
denum
denum
Nickel
0.032
0.000
0.000
0.000
0..000
..0.000 4
0.,000
0.0:00
0.000-4�
0.000
0.000
0.000-
0:032
Selenium
0:01$
0.000
0.000
0..000
0.000
A 000
0.000
0.000
:0.000
' 0.000
0 000.
0..000
-0:018
Zinc
1.14.5
0.000
0.000
0 0,0.0
0-.000
0.000 .
0.000.
0:000
0,.000
0.000
0.000
0.000
1.145
Total
Phos-
75.743
0.000
0.000
0.000
0.000
0.000
0.00.0
0.000
0.000
0.000
0.000
0.000
75.743
phorus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
k •isonment for knowing violations".
Z�f 1/14/2016
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
Operator:
ANNUAL LAND APPLICATION -.-ALD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
City of Burlington WQ Permit #: WQ0000520 Field #: 13 Acres Utilized:
H.W. Byrd Annual Dry Tons Applied 76.10 Site #: AM116 Acres Permitted:
David Ridlin
Crop I Name: Soybeans
Predominant Soil Series:
Crop I Max. PAN: 190
Gall
Crop 2 Name:
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
42.8
42.8
0
o
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre(Dry,�
(Dry Tons/Ac)
Residual Sources
PDES #, W #
Fert., Animal
Waste, etc)
Soil
Cond.
Moist)
Precip.
Past 24
Hrs.
inches
y
410
con
a m
* o
o
o
%° »,
�
*
-
7y
w -�
f' w
# w
�,
TKN
mglkg
z Y
o 9
°� $
o w
mg/kg
Nitrate
and
Nitrite
mglkg
PAN Applied
( lbs/acre)
Name of Crop Type
ReceivingResidual
Application
Crop 1
Crop 2
Crop I
Crop 2
5/8
175500
4.19
0:746'
South Burlington
Dry
<.5"
S 1
0.5
0.3
66100
7880
69.2
30,772
NA-.
Beans
5/11
260000
4.19
1 06.1 -
South Burlington
Dry
<.5"
S
0.5
0.3
66100
7880
69.2
45.588'-
. NA "'
Beans
' 0.000 .
0.000
0.600>.
0 000
A.000'
0 000;
6 Q00 '`
0 000
0.004.
0 000 ` °
0.000 '-
0.000
0 000, :. '
0.Oua
0,000
0 000'
0 000
0 00.0'
0 000 '.
6.600
0 000
0 060 --
0_.0.00
Q 000
0.000 :
0:000 -
0 000 s
;`:O o0o
0.000'
0
0
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000
0A00
TOTALS:
n
4?5500
::::<
As
Cd
Cu
Cr
Pb
H1!
Mo
Ni
P
76.359
0.00i)
LimeApplied
Annual Ibs/acre
0.011:
0..007
:,, 0.541
0.843
" 0' Ia:19
0 002?�:
0.6.18
0.0,32
Q:
75.743 >'
.... ..... . ...........
.Permitted ...............
Date
lbs/ac
Prior Years Cumulative Ibs/ac
0.0464
0.0343
5.0616
1.8344
0.3633
0.0213
0.1262
0.3205
0.
I....
Current Cumulative Ibs/ac
0 057 : ,t
0•.041:
. 5.602 .
' i.677,
;'0.402
0.023 `
' 0.144 '
` 0.3.53
••0
C. P. L. R.****
36
34
1338
267
15
374
7r
Permit PAN Limitt/2nd Cr 1s Crop
190
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date
** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual): 72,88
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
("�,ator: Simon Stephens Owner: Simon Stephens Predominant Soil Series: HdB
A__ o's Used: 25.2 Acres Permitted: 25.2 Site #: AM118 Field #: 1
Residual Analvsis Data (Heavv Metals and Total Phosahorus use mom, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
EB
1/12/15
2
3 j4
5
6
7
8
9
10
11
12 1
% Solids
5.72
Arsenic
1 3
Cadmium
2
Copper
210
Chromitmi
40
Lead
20
Mercury
0.4
Molyb-
denum
5
Nickel
13
Selenium
5
Zinc
474
Total
Phos-
j?horus
10900
iai
rneavy ivletai r ieia uoaaings
kt-aicuiatea in ins/acre):
utal
1 I
2
3
4
5
6
7
8
9
10
11
12
DT/Ac./
App.
Event
2.89
Arsenic
0:017
0M00
0.000
0.000
0.000
-0 000
0.000
0.000
-0.000
0:000
0.000
0..00.0.
0.017
Cadmium
OA 12
3 0.000
0..000
0.000
;0,000
0.000
0.000
0.000 .
0.000f
0.000
0.000
0 00.0'
0.01.2
Copper
1.215­
0.000
- 0..000 .
, 0:000
0. 000
:wo 00 -..
0..000
0..000
0 000_
0.-000 .
0a1.00
. 0-;000
1.215
Lead 1 0.1-16 1- . 0.:000 1= 0.00.0` 10..000 10.0:0.0 :. 10.000 -1 '0r.000- 10.000 .:l ...0.000 F 0.000 10.000' 10.000 1 0.1.16
Molyb-
denum
0:029
0 000
. 0 000.
0 000
0 000
Q 000 ,
0.000
0.000°
0.0 -.0-0
0.000
0.000
0:000
0.029
Nickel
0 075
0;900.
0 000
0 000
0.000
0 000 ;,.
0 00:0
O:Q00
0; OOYO
:. 0:000
0.000
Q 000,
'' 0.075.
Selenium
0 029
0.000 .
,�.0 000.
0 000,
0.0Q0
0 000.;
0 000`
OUO
0 00O
0 000'
0.000
0.000 .
0.020`
Zinc
2.742
0.000
0 000
'0.000
0 000.
0 000
= 0 000
0 000
0' 000`
O.W.
0.000
0:000
2.742
Total
Phos-
horus
61-046 .
0 0.0.0
. 0.000
0.000
0.000
0 000 .
0.00:0
'
0 000.
0 000
0.000:
0.000
'0.000
63.046
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
il- Isonment for knowing violations".
Z�f 1/14/2016
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
Operator:
ANNUAL LAND APPLICATION -K j&LD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
City of Burlington WQ Permit #: WQ0000520 Field #: 1 Acres Utilized:
Simon Stephens Annual Dry Tons Applied:' 7288 Site #: AM118 Acres Permitted:
Simon Stephens
Crop 1 Name: Fescue -Pasture
Predominant Soil Series:
Crop 1 Max. PAN: 158
HdB
Crop 2 Name:
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
25.2
25.2
0
o =
1
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
( Dn''
Moist)
Precip.
Pit 24
Hrs.
inches
a
r. 'b
o w
0
* o
o
_ 2 .
� N
i7•
rw
0
4
7y
- '"
N'
0
TKN
mg/kg
Z�
o R
`��°
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
2/6
156000
5.72
1 477
East Burlington
D
<.5"
S
0.5
0.3
28100
1750
2
25.935
NA.
Fescue
2/7
149500
5.72
1415
East Burlington
D
<.5"
S
0.5
0.3
28100
1750
2
24'.8il1
'_NA
Fescue
0 000
0.000
0.00.0
0 000>
0.000
0.000 Y
tl 000 ` , ,
0,000
0:000:
0 00:-0
0.000
o:000
0 000 •,
0.000
1 9,900
0 000 _
.0;060
omoo
0000
0000
11.000
0.000
o.000
120.000
0.000 "
0.0.00
70.606 .
000
0.000
0.000
0
0
0,000
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000.
0,000'
.' .` '
TOTALS:
01
305500
::::::
As
Cd
Cu
Cr
Pb
HL
Mor374
Se
Zn
P
50.789
° 0-,00o
Lime A died
Annual lbs/acre
0 017 '' : °
°, 0,012
1.215
0.231
U 116`
0 002u
0.029 `'0,;02.9
�T
2.742 .
.63.0d� :.::..-.'::.:
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.1161
0.1344
15.7078
4.5153
2.4587
0.0617
0.5231
0.1254
26.895
Current Cumulative lbs/ac
0.1330
146
l•6922
: ' 4.7d7
2.5? 1
0 064_,.
0:552T54Permitted
C. P. L. R.****
36
34
1338
267
15
1 89
2498
PermitPAN Limit 1 stl2nd Crop P
158
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual): 27.15
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
V_�,ator: Simon Stephens Owner: Simon Stephens Predominant Soil Series: HdB
A - is Used: 12.3 Acres Permitted: 12.3 Site #: AM118 Field #: 2
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
SB
12/8/14
2 j
3
L4J
L5J
6 J
L7J8]
Oj
ill
121
% Solids
1 3.71
Arsenic
3
Cadmium
2
Copper
198
Chromium
335
Lead
13
Mercury
0.4
Molyb-
denum
5
Nickel
11
Selenium
5
Zinc
439
Total
Phos-
Gt110ru5
26200
ial Heavy Metal Field Loadings (Calculated in lbs/acre):
I oial
1 11
1 21
L 3 f
4
6
7
8
9
10
11
12
DT/Ac./
App.
Event
2.21
Arsenic
0.013
0.000
0.000
0.000
1 0.000
0.000.
1 0.000
0,000
0.000
0.000
0.000
0.000
1 0.013
Cadmium
0.009
0..000
0.000
0.000
0.000
0.060
0.000
0.000
0.000
0.000
0.000
0.000
0.009
Copper
0..974
0:000
0.000
0.000
0.000
0.000
0.000-
0.000
0.000
0.000
0 =000
0.000
0.874
Chromium
1.479
0:000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
.0.000
0.000
1.479
Lead
6.057
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
.0.057
Mercury
0.002
0.600
0,000
0.000
0.000
0.000'
0.000
0.000
0.000
0.000
0.00.0
0.000-1
0.002
Molyb-
0.022
0.0.00
0.00.0
0.000
0.000
0.00.0
0.000
0.000
0.00-0
0.000
0.000
0.000
0.022
denum
Nickel
0.049
0.0.00
0.000
0.000
0.000:
0.000
0.000
0.000
0.000
0.000
0.00.0
0.000
0.049
Selenium
0.022
6.000
0.000
0.000
0.000
0.000
0.000 1
0.000
0:000
0.000 1
0.000
0:000
0.022
Zinc
1.938
, 0.000.
0.000
0.000
0.000 1
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1.939
Total
Phos-
115.647"
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
115.647
horus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
i(" •isonment for knowing violations".
zv 1/14/2016
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
Operator:
ANNUAL LAND APPLICATION-. rELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
City of Burlington WQ Permit #: WQ0000520 Field #: 2 Acres Utilized:
Simon Stephens Annual Dry Tons Applied: `. 27.°15Site #: AM118 Acres Permitted:
Simon Stephens Predominant Soil Series: HdB Cation Exchange Capacity (non 503):
Crop 1 Name: Fescue -Pasture Crop 1 Max. PAN: 158 Crop 2 Name: Crop 2 Max. PAN:
12.3
12.3
0
o
Q
Volume applied
PP
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
Wet'
Moist)
Precip.
Past 24
Hrs.
inches
Y
4 :0
?
CL w
* 5
<
o
o
3
7* 0
w
* w
0
TKN
mg/kg
z Y
e
o o
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre )
Name of Crop
p Type
Receiving Residual
Application
Crop I
Crop 2
Crop I
Crop 2
1/10
175500
3.71
2.207
South Burlington
D
<.5"
S
0.5
0.3
66800
27000
2
-112.322
" NA
Fescue
U.000'
0.000` _1
0.000,
0.0M
.0,000'-
0.000,
0.000,
0:000 . _
0.0001" `.
"0 000
0-0oo
0..000
0 000 ".
0.000
0.000
0 000; Z
0.0oo ;
0.000,
o.000 M
0:000 "
. 0.000
0 000
0 000
6.001. .
Ift
0.000
o.0o0
0 000,
0.000
u.000
.....
0
0
0 000
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
n.(io0
0,()()()
..
TOTALS:
As
Cd
Cu
Cr
Pb
1­111�
Mo
Ni
Se
Zn
P
112.322
0.000
Lime Applied
Annual lbs/acre
0 013:
0 049
.0.874
F 1 479
0 0s7-'
0, Q62;'.
0 022
; . 0:049
b 4 022
1938
`11 S.ba7 .:::.. ;:::: >:=..... ? ::
::::::::::::::::::::::::::
...........................
........... ..... .
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.0866
0.085
13.4127
3.7146
2.18_13
0.0409
0.4119
0.8768
0.1245
20.1618
Current Cumulative lbs/ac
0:100 "
0.094
14.287,
55: 193
2._140
0.043
0 43,4
0.925
0.147
22.100
Permitted C. P. L. R.****
36
34
1338
267
15
374
89
2498
Permit PAN Li s 2 Limit 1 t/ nd Crop
158'.
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
e*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation -1.0
Signature of Land Applier Date
*** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual):
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
'rator: Simon Stephens Owner: Simon Stephens Predominant Soil Series:
A_. es Used: 14.8 Acres Permitted: 14.8 Site #: AM118 Field #:
50.63
HdB
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
11
EB
12/8/14
2
SB
12/8/14
3
L4J
L516
7
8
9
10
1j
12
% Solids
5
3.71
Arsenic
3
3
Cadmium
2
2
Copper
220
198
Chromium
29
335
Lead
25
13
Mercury
0.4
0.4
Molyb-
denum
5
5
Nickel
12
11
Selenium
5
5
Zinc
542
439
Total
Phos-
pborus
9720
26200
'zal Heavy Metal Field Loadings (Calculated in lbs/acre):
i otal
1 11
L?j
L3J
L4
L5J
6
7
8
9
10 1
11
12
DT/Ac./
App.
Event
2.20
1.22
"
Arsenic
0.013
1 0..007
0.000 1
0.000
0.00.0
0.000
1 0.000
0.000
0.000
1 0.000
0.000
0.000
0.021
Cadmium
0.009
0.005
0.000
0;000
0.000
0.000
0.000
0.000
0.000
0.000
0000
0.000
0.014
Copper
0.967
0.484
0.000
0.000
0.00-0
0.000
0.000
0.0.00
0.000.
0.000
0.000
0.000
1.451
Chromiw
0.127
0.819
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.947
Lead
0.110
0.032
0.000
0.000
0.000
0.0.00
0.000
0.000
0.0.00
0.000
1 0.000
0.000
0.142
Mercury
0..002
0.061
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.003
Molyb-
0.022
0.012
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.034
denum
Nickel
0.053
0.027
0.000
0..000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.080
Selenium
0.022
0.0.12
0.000
0.000 1
0.000
0.000
0.000
0:000
0.000
0.000
0.000
0.000
0.034
Zinc 1
2.383_
1.074
0.000
0.000
0.006
0.000
0.000
0.000
0.000
0.0.00
0.000
0.000
3.456
Total
Phos-
42.729
64.085
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
106.814
phorus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
u•isonment for knowing violations".
1/14/2016
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

i
ANNUAL LAND APPLICATION iELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: City of Burlington WQ Permit #: WQ0000520 Field #: 3 Acres Utilized: 14.8
Land Owner: Simon Stephens Annual Dry Tons Applied:'., 50.63- Site #: AM118 Acres Permitted: 14.8
Operator: Simon Stephens Predominant Soil Series: HdB Cation Exchange Capacity (non 503): 0
Crop 1 Name: Fescue -Pasture Crop 1 Max. PAN: 158 Crop 2 Name: Crop 2 Max. PAN:
°
° °
Q
Volume applied
enter one Solids/
( )
Liquid
Cu. Yds Gallons
o
/o
Solids
Volume
Applied per
PP P
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry'
Wet,
Moist)
Precip.
Past 24
Hrs.
inches
a
4 "
�
�*
o 11
a 0
* Z
o
�*
N'
* 'rt
o
�
;h 9
w ti
; ?:
* N
*
0
o
TKN
mglkg
Z n
S
o a
R w.
❑
mglkg
Nitrate
and
Nitrite
mg/kg
PAN Applied
lbs/acre
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
1/9
156000
5
2,1918
East Burlington
D
<J.'
S
0.5 1
0.3
26000
3000 1
2
36.930
NA
Fescue
1/11
117000
3.71
1.223
South Burlington
D
<.5"
S
0.5
0.3
66800
27000
2
62 232
NA
Fescue
0.000,
0.000
0.000
0.600:
0,000
0.000
'00.0`
0.000
0.000
-0.006
0.000
0.000
0.000
0.000
0. 00,01
0.060 ;'
0.000
0 000
0.000,
o.000
0.000
0.000
0.000
0.000.
0.000
0.000
0-000
0.000
0.000
0
0,
:::::
0.060
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000"
0.000
TOTALS:
, +�
27 a+++r
::::::::::::::
As
Cd
Cu
Cr
Pb
Hi!
Mo
Ni
Se
Zn
P
1 99.162
w)00
Lime Applied
Annual lbs/acre
0 021' ` '
0.014
" L451
6.947
0. I 12 _
O.003
0 034 '
" O:Q$0
0;034
3 456'
. tO6:814 :::: ':::::.:::>:::.::::
:':::=:':'::: >::::: ......:::
...........................
........................
::..:• •" .
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.0995
0.084
13.315
3.6044
2.232
0.0466
0.3744
0.7583
0.131
21.0346
Current Cumulative lbs/ac
0.42,0 '.
0.098
14:766
• ., 4.55.1-
2 3 r4 `P
: •0:049
0.409
" OMS
0.165
24.491
Permitted C. P. L. R.****
36
34
1 1338
1 267
15
1
374
1 89
1 2498
P it PAN Li ertn mtt 1 st/2nd Cr 0 P
15$
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/incorporation -1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual): 6.04
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
V" ";ator: Simon Stephens Owner: Simon Stephens Predominant Soil Series: HdB
A,_ .;s Used: 9.2 Acres Permitted: 9.2 Site #: AM118 Field #: 8
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
11
SB
12/8/14
2
_3_1
1 41
5
6
7
S
9
10
11
12]
% Solids
3.71
Arsenic
3
Cadmium
2
Copper
198
ChronliUrn
335
Lead
13
Mercury
0.4
Molyb-
denum
5
Nickel
11
Selenium
5
Zinc
439
Total
Phos-
phorus
26200
,ial Heavy Metal Field Loadings (Calculated in lbs/acre):
i otal
1
2
3
4
5
6
7
8
9
10
11
12
DT/Ac./
App.
y
Event
0.66
Arsenic
0.004
0.0, 00
0.000
0.000
0.000
0.000
0.00.0
0.000
0.000
0.00'0
0.000
0.000
0.004
Cadmium
0.003
0:000
0.000
0.000
0.000
0.000
0.060
0.000
0.000
0.000
0.000
0.000
0.003
Copper
0. 60
0.000
0.000-
0.000
01.000
0..000
0.000
.0.000
0.000
0.00.0
0:000
0 000
6.260
Chromiun
0.440
0,000
0..000
0.600
0.000
0.000
0.000
0..000
0.000
0.000
0.000
0.000
0.440
Lead
0.017
0.000
0..000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.01-7
Mercury
0.00_1
0.00.0
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.001
Molyb-
0.007
0.000
0.000
0.000
0.000
0.000
0.000
0;000
.0.000
0.000
.0.000
0.000
0.007
denum
Nickel
0.;014
0.0.00-
0.000
0.000
0;000,
0.000
'0.000
0.000
0..000
0.000
0.000
0.000'
0.014
Selenium
0.007
0-.000
0.000
0.000 1
0.000
0.000
0.000
0.000
0:000
0.000
0.000
0.000
0.007
Zinc
0.576
0.000
0.000
0.000
0.000
0.000:
0.000
0.000
0.000 1
0.00.0
0.000
0.000
0.576
Total
Phos-
34.374
0.000
0.000
0.000
0..000
0.000
0.000
6.000
0.000
0.000
0.000
0.000
34.374
horus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
-isonment for knowing violations".
1/14/2016
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
Operator:
ANNUAL LAND APPLICATION x-iELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
City of Burlington WQ Permit #: WQ0000520 Field #: 8 Acres Utilized:
Simon Stephens Annual Dry Tons Applied: 6:0.4 Site #: AM118 Acres Permitted:
Simon Stephens Predominant Soil Series: HdB Cation Exchange Capacity (non 503):
Crop 1 Name: Fescue -Hay Crop 1 Max. PAN: 211 Crop 2 Name: Crop 2 Max. PAN:
9.2
9.2
0
o
°
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry TonslAc)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
(D�'
Moist)
Precip.
Past 24
Hrs.
inches
y
co �?
w
;+�
w
* N
*
TKN
mg/kg
z
�o El
w
mg/kg
Nitrate
and
Nitrite
mglkg
lbs/acre PAN Applied
( )
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
1/11
39000
3.71
0.'656--
South Burlington
D
<.5"
S
0.5
0.3
66800
27000
2
33..371'
NA
Fescue
0.0.00
0•.000
0.000
0.000
0:000 '
0.000
0.000
0 000-,:.
0,000,
0.006
0 000,- -
0''000!
4000'
0.000 `
' 0.000
0 000"
, '0.000
01000,
6.000
0.000
0.000
0 000
0:000
6.000
0.000
0.000
0.000`
0.000
0.00:0
0.000
0.000
0,000
0
0
-6.000
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.0011
0.000
TOTALS:
n
^'30000,:`:::::::.::
As
Cd
Cu
Cr
Pb
Hg
I Mo
Ni
Se
Zn
P
33,371
''"0.00:0`'
Lime Applied
Annual lbs/acre
0.004
0 003-
0.260
#A411 '".
n 017 '
0.061,E
0 007
0.014
0 007
6.516
` 34 3:'74 :? >
: : : :::::::::::: `: : >: >:
....................
.......
............................
Date
lbs/ac
Prior Years Cumulative Ibs/ac
0.188
0.158
20.819
6.319
2.284
0.055
0.509
1.373
0.192
33.664
Current Cumulative lbs/ac
0.192'`.0.161
'
, 21.079
6:759
2;3n9 °
„ 0 056 ':
0.516 °
1.3$7 .
0199
34.240
Permitted C. P. L. R.****
36
34
1338
267
15
374
89
2498
PAN Li 2 met 1st/ nd Cro P
inPermit
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier
Date
*** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual):
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
("_��ator: Simon Stephens Owner: Simon Stephens Predominant Soil Series:
A__:s Used: 19.7 Acres Permitted: 19.7 Site #: AM118 Field #:
38.22
Aa
9
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
SB
12/8/14
2
L4J
L5J6
7
81
9
10
1�
12
% Solids
3.71
Arsenic
3
Cadmium
2
Copper
198
Chromium
335
Lead
13
Mercury
0.4
Molyb-
de urn
5
Nickel
11
Selenium
5
Zinc
439
Total
Phos-
ghorus
26200
I 'ual Heavy Metal Field Loadings (Calculated in lbs/acre):
otal
1
2
L-3-1
4
L5.j
6
L81
9
LoJ
11
12
DT/Ac./
-71
y
App.
Event
1.94
Arsenic
0..012
1 0.000.
0.000
0.000
0.000
0.000
0.000.
0.000
1 0.000
0.000
0.000
1 0.000
0:012
Cadmium
0.008
0-00.0
0.000
0-000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.-008
Copper
0.768
0.00.0
0.000
0.000
0.000
0.000%
0.000
01000
0.000
0.000
0.000
0,000
0.768
Chromium
1.300
'0.000
0.0010
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0:000
1,300
Lead
0.050
0..000
0.000 ,
0.000
0-.000
0.000
0.000
0:000
0.000
0.000
0.000
0.000
0.050
Mercury
0.002
0.000
0.000
0.000
0° 00Q
0.00,0:
0.000
0.000
0.000
0.000
0M00
0.000
0.002
Molyb-
0.019
0.000
0.000
0.000
0:000
0.000
0.000
0.000
0M00_
0..000
0.000
0:000
0.019
denum
Nickel
0.043
0.000
0.000
0.000
0.000
0.000
0,00.0
0.000.0.000
0.000
0.000
0.00.0
0.043
Selenium
0.019
0.000
0.00.0
0..000
0.000
0.000
0.000
0.00'0 1
0.0-00 1
0.000
0.000
0.000
0.019
Zinc
1.703
0.000
0.000
0:000
0.000
0.000
0,000
0.000
0.000
0.00.0
0000
0.000
1.703
Total
Phos-
101.656
0.00.0
0.000
0.000
0.000
0.000
0.600
0.000
0.000
0.000
0.000
0.000
,01,656
horus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
it ~isonment for knowing violations".
Z. z z;:; � �1_
1/14/2016
Date
Signature of Land Applier
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
Operator:
ANNUAL LAND APPLICATION -GELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
City of Burlington WQ Permit #: WQ0000520 Field #: 9 Acres Utilized:
Simon Stephens Annual Dry Tons Applied: 38.22 Site #: AM118 Acres Permitted:
Simon Stephens Predominant Soil Series: Aa Cation Exchange Capacity (non 503):
Crop 1 Name: Fescue -Pasture Crop 1 Max. PAN: 138 Crop 2 Name: Crop 2 Max. PAN:
19.7
19.7
0
o
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry TonslAc)
Residual Sources
(NPDES #, WQ#,Past
Fert., Animal
Waste, etc)
Cond.itPrecip.
(Dry,
e '
Moist)
24
Hrs.
inches
Y
cn '5
"wR. ,
o
o
w w
0
TKN
mg/kg
z ��
a o
a
mg/kg
Nitrate
and
Nitrite
mglkg
PAN Applied
lbs/acre
( )
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
1/31
247000
3.71
1:940 '
South Burlington
D
<.5"
S
0.5
0.3
66800
27000
2
98,701
NA
Fescue
0:'000
0.000
0.000
0;000
0:000
0,000
0 000
0.000
0.000
0.000
0.000
0.000
0:000
0.000
0.000
0000
-0.000
0.000
0.0.00.
0.000
0.000
0.000
0..000
0.000
0.000
0.000
0.000
0.000 ,.,
0.000
Dann
I'ToTALS:
0
0
0.00a
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000
0.00U
0
247000
::.::
As
Cd
Cu
Cr
Pb
H:,
Mo
Nir89
Zn
P
98.701
0.000
Lime Applied
Annual lbs/acre
0.012
0A,08
0.768
1 3(►0
0.050
0.002''•
' 0..019i
"0.043,;
1.703 .
101.656 >::::...::.
::::::::::::::::::
...........................
..........................
:: :. -X.
,.........................
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.2019
0.1558
20.1633
6.4403
2.7328
0.0664
0.6382
1.34736.0878
Current Cumulative ]bs/ac
0.214
0.164
20.932
9'.740
2.78t' `
0:068 •.
•0:658
1.390
37 79`1
Permitted C. P. L. R.****
36
34
1338
267
15
3742498
eLimit P rmit PAN 12n st/ d Crop
.........................................I................. ...............................
13 8
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual): 58.48
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
P� '-ator: Simon Stephens Owner: Nelda Kiser Predominant Soil Series: HdB
A_ es Used: 17 Acres Permitted: 17 Site #: AM119 Field #: 2
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
EB
12/8/14
2
SB
12/8/14
3
SB
1/12/15
4
5
6
7
8
9
10
11
12
% Solids
5
3.71
3.8
Arsenic
3
3
3
Cadmium
2
2
2
Copper
220
198
157
Chromiuni
29
335
268
Lead
25
13
11
Mercury
0.4
0.4
1.2
Molyb-
denum
5
5
5
Nickel
12
11
10
Selenium
5
5
5
Zinc
542
439
382
Total
Phos-
ahorus
9720
26200
22000
,xal Heavy Metal Field Loadings (Calculated in lbs/acre):
iota]
1 11
L 2
3
4
5
6
7
8
9
10
11
12
DT/Ac./
0
App.
Event
1.52
0.59
1.33
Arsenic
0.009
1 0.004
0.008 1
0.000
0 000
0.000
1 0.000
0.000
0.000
0.000
0,000.
0.000
0.021
Cadmium
0.00.6.
0.002
0.005
0.000
0:000-
0.000
0.000
0.:000
0.000
0.000
0.000
0,000
0.0-14 -
Copper
0.667
0.234
0.419
0.000
0.000
-0.000
0.000-
0_000 :
0.000
0.000-
0,000.
4.000
1.320
Chromium
COOS
0.391
'0.714 .
0.0.00
0.000'
0.000
0.000
0 000
0,000-
0.00.0
0.000
0.000
1.199
Lead
0.076
0.045
0.029
0.000
0.000
0.060
0.0.00
0.000
0:000
0.000
0.000
0.000
0.120
Mercury
0.001
0.600.
0.003
0.000
0.000
0.000" '
0.000
0.000;
• .0.000,
0.000
0.000
0.000
0.005.
Molyb-
0.015
0.006
0.0:13
0.000
0.000
0.00.01
0.000
0.000
0.060
0:000
0.000
0.000
0.034
denum
..
Nickel
0.03E
0:013 ..'0.027
O.00Q
0;:000
0 00.0
0.000
0.000
0.000
.. 0:000=
0:000
0:000
0.076
Selenium
0.015
0. 006
0.013
0.000
0.000
0.000 ;
0.00;6
0:000-
0.00"0
0.000
0.00.0
0.000
0.034
Zinc
1.642
0.520
': 1.0:18
0.000
0.6.00
0.000
' 0.000
0.000
0.000..
0.000
0:000
0.000 `
3._:180
Total
Phos-
29.452
31.021
58.652
0..000
0:000
0.000
0.00.0
0.00.0
0.0:00
0.000
0.000
0.000
119.124
_ horus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
it 'sonment for knowing violations".
Z�f 1/14/2016
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION x� iELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: City of Burlington WQ Permit #: WQ0000520 Field #:
Land Owner: Nelda Kiser Annual Dry Tons Applied:: 58.48 Site #:
Operator: Simon Stephens Predominant Soil Series: HdB
Crop 1 Name: Fescue -Hay Crop 1 Max. PAN: 211 Crop 2 Name:
Acres Utilized: 17
AM119 Acres Permitted: 17
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
°
a3 o
Q
Volume applied
enter one Solids/
( )
Liquid
Cu. Yds Gallons
o
fo
Solids
Volume
Applied per
Acre
(Dry Tons/nc)
Residual Sources
(NPDES #, W #,
Q
Fert., Animal
Waste, etc)
Soil
Cond.
(D
Wei
Moist
Precip.
Past 24
Ilrs.
inches
>
K
cc
5 o—
a -
*o
-
;cy >v
�.
*
$
:�
*
0
TKN
mg/kg
z
q
o R
w o
g w
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
( lbs/acre)
Name of Crop Type
Receiving Residual
g
Application
Crop 1
Crop 2
Crop 1
Crop 2
1/22
123500
5
1:515
East Burlington
D
<.5"
S
0.5
0.3
26000
3000
2
25.453
NA
Fescue
1/23
65000
3.71
0.502
South Burlington
D
<.5"
S
0.5
0.3
66800
27000
2
30.099
NA
Fescue
2/1
143000
3.8
1: 33
South Burlington
D
<.5"
S
0.5
0.3
63400
5260
2
53.514
NA
Fescue
o::000`
0.000
0.000
..0:00.0
0.000
0.000
6.m0 =,. -
0.000
0.000
0,0.0.0 `.y
0.000
(000
Q.000
0.000
0,000
0:000' ,
0.000 ''
0.000
0.000- ..
0,000
0.000
0.000.
0.000
0.000
0 0Q0
0A100
o.000
0
0
r;Q 000
Residuals Applications totals on FORM
FSF supp (attach FORM FSF supp
to this form}:
0.000
0,000
TOTALS:
01
3315no
::::"; ;:;:
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
109.067`
0-0u00
Lime Applied
Annual lbs/acre
0.021 `
"0.014 "
L320
I •'1.1,)
0:120.
0.QQ5
10.034
0:076Y
0034
�3.180 `
110.124
.
.............. . ...........Permitted
Date
Ibs/ac
Prior Years Cumulative Ibs/ac
0.1921
0.1723
20.4967
6.8953
2.7545
0.0718
0.577
1.5236
0.2662
37.9032
Current Cumulative lbs/ac
0.2.1'3
0 18'6
21::81;6 .
8•U94
2.875
-0.077
0.611 <
1:640
0301
.41.084.
C. P. L. R.****
36
34
1338
1
1 267
1 15
374
89
2498
Pep...........................................................................
rmit PA Limit st/2nd Crop
N 1
-..-.,............................................................................
211
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual): 12.75
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
';ator: Terry McPherson Owner: Billy McPherson Predominant Soil Series: TaB
A.._ es Used: 4.2 Acres Permitted: 4.2 Site #: AM125 Field #: 4
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
11
EB
7/13/15
21
31
141-5
6 1
7 1
1 8
9
10 I
11
12
% Solids
3.92
Arsenic
3
Cadmium
2
Copper
168
Chromium
52
Lead
31
Mercury
0.4
Molyb-
denum
5
Nickel
12
Selenium
5
Zinc
591
Total
Phos-
nhorus
9570
';gal Heavy Metal Field Loadings (Calculated in lbs/acre):
1 otal
1 1 1
2
3
4
5
6
L7J
8
9j
0
11
12
DT/Ac./
App.
Event
3.04
Arsenic
0.018
0.000
0.000
0.000-
0.000
0.000-
.0.000
0.000
0.000
0.000
0.000
0.000
0.018:
Cadmium
0.012
0.000
0 000. -
0.000
0:000
O:g00
0.000
0.:000
0.000
O.i►00
0-000
0:000
0.012
Copper
1.02'0
0.000
" 0.000 :
0.000
0.000
0.000
0.000
0.000
q.000
0.000
0.000
0.000
1:020
Chromiumt
0.316
0.006
0.000
0.000
0.006
0.00Q
0.000
0.060
0.000
0.000
0.000
0-.000
0.316
Lead
0.188
0.000
0.000
0.00.0
0.000
0:000 _
0..000
0.000
0.000 ,
6.000
6.000
0..000 -
0.1881
Mercury
0.002 '
0.000
0 000
0.060
6.000
0.0.00
0.000
0.000
0.000
0.000
1. 0.000
0.000
0.002
Molyb-
0 03.0
0.000
0.000
0.000
0.0-00
0.000
0.000
t 0.000
0.000
0.000
0.000
0:000
0.030
denum
Nickel
0.073
0 000
0.000,
0.000
0.000.
0..000
0.00.0'
0:000 :
0.000
0.0.00
0.000
0.00.0
0..073
Selenium
0.030
0.000­..
0.000-
0.000
0..000 ,
0.000'
0.000
0.000
0.000 1
0.000
0.000
0.000
0.030
Zinc
3.589 .
0.000
0.000'
0.000
0.000
.0.000 .'
- 0.000
0.000-
0:.000
0.000
0.000
0.000 .
- 3.589
Total
Phos-
58::109
0.000
0.000
0.000
0..00.0
0.000
0.000
0.000
0.000
0.000
0.000
0.000
58.109
horus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
'sonment for knowing violations".
i2;�e 1/14/2016
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION —i rELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: City of Burlington WQ Permit #: WQ0000520 Field #: 4 Acres Utilized: 4.2
Land Owner: Billy McPherson Annual Dry Tons Applied::- 12.,75 Site #: AM125 Acres Permitted: 4.2
Operator: Terry McPherson Predominant Soil Series: TaB Cation Exchange Capacity (non 503): 0
Crop 1 Name: Fescue -Hay Crop 1 Max. PAN: 190 Crop 2 Name: Crop 2 Max. PAN:
o �
w o
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry,
Wet
Moist)
Precip.
Past 24
Hrs.
inches
Y
4'0
o
oa
*
o
;n
w
;
* h
o
o
7�
w -�
w
-
o`o
TKN
mg/kg
Z
o
n �.
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
9/17
1
78000
3.92 1
1036 ;
East Burlington
D
<.5"
S
0.5
0.3
24700 1
3060
2
-48.718
;''..NA-'.
Fescue
0 000 - .
0.000'
: 0.000
0.000
t 0,0 00`
0.000 ,
0 OOQ'
6.000
O.00Q
0.000-' •
0:000
0.0:00
0.000 • '
.k 0.00.0
0 00.0
0.000
0.000...
-9 000' ....
0.000 ->
r 0.000'...
0 000..
0.000 `
0.009
0 000
0.00o
0.000,
0 000 -
0.000
0 000
0 600
o.000
0:000'
0
0
U OQO'"
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0 00,0'.
0.ono
TOTALS:
na000
::::::::::::
As
Cd
Cu
Cr
Pb
H�
Mo
Ni
Se
Zn
P
48,Is
o.lioo
Lime A lied
Annual lbs/acre
0.01$
0 Oslo
1.020
0 3 16
0 189 :
0 00.2
0 030
0 a73
0 030
3 5-9,0
:" 38.109
.:: .. .. .. ....... .
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.0412
0.0152
2.97
1.0601
0.273
0.0158
0.0764
0.1607
0.0268
7.2925
Current Cumulative lbs/ac
0.059 '
„ 0:02T"
3.990
1.376 Fr
'' 0 461t;,
° 0 OI:i3:',:.
O.t07 t
. 0:234'
O'057 '
• 10 881
Permitted C. P. L. R.****
36
34
1 1338
267
15
1 374
1 89
1 2498
i Perm t PA Lim
it mrt 1st/2nd Crop
-
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual):
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
(,'-��,ator: Ross Wood Owner: Sasser Farms Predominant Soil Series:
A_- zs Used: 10 Acres Permitted:
10 Site #: AM128 Field #:
13.10
AdC
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
SB
10/12/15
_2j
3
4
5
6
7
8
91
10
11
121
% Solids
2.54
Arsenic
3
Cadmium
2
Copper
231
Chromium
241
Lead
16
Mercury
0.8
Molyb-
denum
5
Nickel
12
Selenium
5
Zinc
428
Total
Phos-
Ithorus
29800
IAal Heavy Metal Field Loadings (Calculated in lbs/acre):
i otal
Ill
L21
3
4
5
6
7
8
9
10
11
12
DT/Ac./
App.
Event
1.31
Arsenic
0.048
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1 0.000
0.000
0.000
0.000
0.008
Cadmium
0.005
0 000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.0000..000
0.005
Copper
0 6-
0A00
0.000
0.000
0.000
0.000
0.000
0.000
0.000`
0.000
0.0-00.
0.000
0.605
Chromiwr
0.631
0:000
0.000:
0.000 -
0.000-
` '0.000.
0.000
0.000
0.000..
0.000
0.000
0.000
0.631
Lead
0.042
0.000
0.000
0.000
0.000
0.000
0.000
0,000
0.000.
0.000
0.000
0.000
0.042
Mercury
0.002
0.000-
0 000:
0.0.00
0;000
0.000
0.000
.0.000
0.000 .
0.000
0.000
0.000
0.002
Molyb-
0.013
0.000-
0.000
0.000
0.00.0
0:000
0.000.
0.000
0.000
0.000
0.000
0.013
denum
.0.000
Nickel
0.031
0.000
0.000
0.000
0:000
0.000
0.000
0.000,'
- 0.000 ',
0.000
0.000-
0:000
0.031
Selenium
0.013
0:000
0.00.0
0.000
0.000
0.000
0.000
0.000
0.000
0.000.
0-000
0.000
0.013
Zinc
1.121
0.000
0.000
0.000
0.000'
0.000
0.000.
0.000.
0,000
0..000'
0.00.0
0.000
1.121
Total
Phos-
78.076
.0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
78.076
chorus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
•isonment for knowing violations".
; e 4�e 1/14/2016
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
Operator:
ANNUAL LAND APPLICATION --YELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
City of Burlington WQ Permit #: WQ0000520 Field #: 3 Acres Utilized:
Sasser Farms Annual Dry Tons Applied: 1.3;1:U Site #: AM128 Acres Permitted:
Ross Wood
Crop 1 Name: Fescue -Hay
Predominant Soil Series:
Crop 1 Max. PAN: 121
AdC
Crop 2 Name:
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
10
10
0
0 �
p
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry TonslAc)
Residual Sources
(NPDES #, WQ#
Fert., Animal
Waste, etc)
SO1l
Cond.
(Dry,
M Wet,
Precip.
Past 24
Hrs.
inches
>
� �
co '�
o
a
o
w �,
* N
°�
--
70
w
; w
*
TKN
mglkg
Z
o
o0 0
g w'
mg/kg
Nitrate
and
Nitrite
Mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop I
Crop !
Crop 1
Crop 2
10/26
123500
2.54
1.308
South Burlington
D
<.5"
S
0.5
0.3
62600
31100 1
2
65.410
NA
Fescue
0.00.0
0.000
0.000
0000:
0.000
o.0o0
:0.000
0:000
o.000
A6001
0.000
0.00o
000
0.000
o.000
0.000`
.0.000 '
omo
0.000'
0.000
(Loot►
0 0,00
0.000
oj)O()
0.000
0.000
0.000
0.:0:00
0.000
omoo
0.000
0.000
l wo0
0"
o.
:
0 000 '
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000
u.uuo
.
.
TOTALs
0
123500
.::::::':�
As
Cd
Cu
Cr
Pb
H-
Mo
Ni
Se
Zn
P
65.410
u.000
Lime A died
Annual lbs/acre
0 {108
6.00'5.
°: �0:605 ,
Q:631
.0;n42
0.002'
0 0Y3'
0 031
10 013�
A,121
8:076 :.::::::::::.:: ....:'
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.058
0.025
1.225
1.138
0.103
0.007
0.071
0.363
0.066
3.035
Current Cumulative lbs/ac
Q 066
0.03:0
1.830
1369 , ;
0.145: '
`' 0.0,09
0.08.4
0.394
Q;079;
4.156
Permitted C. P. L. R.****
36
34
1 1338
267
1 15
1 374
1 89
2498
Permit PAN Limit 1st/2nd Crop121
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual):
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
f"7ator: Ross Wood Owner: Sasser Farms Predominant Soil Series:
A__::s Used: 10 Acres Permitted:
10 Site #: AM128 Field #:
25.10
IaB2
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Com-
posite•:
Date
�:
Total
Pbos-
ial Heavy Metal Field Loadings (Calculated in lbs/acre):
i otal
1
2
3
4
5
6
7
8
9
1 o
11
12
DT/Ac./
App.
Event
1.85
0.66
Arsenic
0.011
0.:004.
0.000 1
0.000
0.000
-0.000
0.000
0.000
0.000
.0.000
0.000
0.000
0.015
Cadmium
0.007
0..003
0.000
0.000
0.000
0.000
0.0.00
0.000
0.000
0.000
0.000
0.000
0.010
Copper
1.16.6
0,400
0.000
0.000
0:00.0
0.000
0.00.0
0.000
0000
0.00.0
0.000
0.000
1.565
Chromium
0.178
0.314
0,000
0.000
0..000
0.0Q.0 .:
6.000
0.000
a.000
0.000
0 000
0.000
" A9.2
Lead
0.0 48
0.034
0.000
0.000
0.000.
_ 0:000
0000
0.000.
0_000
0.000
6.000
0.000
0.082
Mercury
0.001
0.002
0.00,0,
0.000
0.000
0 000`
0.000
0.000
0.000
0.000
0.000
0.000
0.003
Molyb-
0.01.9
-0.008
0:000
0.000
0;000
0.000
0.000
0.000
O.000
0.000
O.OQO
0.000
0.026
denum
Nickel
07.033,
0.028
0.000'
0.000
0.000
0.000
0.000
0.000
1 0.000:
0.000 1
0.000
0.000
0.061
Selenium
0.019
0,007
0.000
0.000
0.:000 .
0.000
0.000
0.000
0.00L
0.000
0.000
0.000.
0..025
Zinc
2.153
0.6.45
0.000
0.000
0.000
0.0.00'
0.000
0.000
0.000
0.000
0.000
0.000
2.799
Total
Phos-
32.671
53.592
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
86.263
.horus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
it -isonment for knowing violations".
_ 1/14/2016
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION . tELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: City of Burlington WQ Permit #: WQ0000520 Field #: 4 Acres Utilized: 10
Land Owner: Sasser Farms Annual Dry Tons Applied: 25':10 Site #: AM128 Acres Permitted: 10
Operator: Ross Wood Predominant Soil Series: IaB2 Cation Exchange Capacity (non 503): 0
Crop 1 Name: Fescue -Hay Crop 1 Max. PAN: 121 Crop 2 Name: Crop 2 Max. PAN:
x.
o
p
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert. Animal
Waste, etc)
Soil
Cond.
(Dry'
Wet,
Moist)
Precip.
Past 24
Hrs.
inches
Y
o w
o
o
N'
*
4
w �;,
*.
TKN
mg/kg
Z a
o
c°4o
w
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
10/24
123500
3.6
t.854:1'
East Burlington
D
<.5"
S
0.5
0.3
24700
3060
2
29.753
NA
Fescue
10/26
58500
2.7
0 6.5i9; "
South Burlington
D
<.5"
S
0.5
0.3
65200
24100
2
Q.1 18
NA
Fescue
0A001
0.000
0.(100
0:000
0.000
0.000
0.000
0.000
0.000
0 00..0
0;000
0.000
0,.0�00
0.000
0.0M
000
0.000
0.000
0:000
0.000
0.000
040
0.000
0.000
0.000
0.000
0.000
0.000
0.00.0
0
0
0 000`'
Residuals Applications totals on FORM
FSF supp (attach FORM FSF supp
to this form):
0.000
0.0u(1
TOTALS:J
0
1820110'
As
Cd
Cu
Cr
Pb
H,
Mo
Ni
Se
Zn
P
61.871
0.000
Lime A > )lied
Annual lbs/acre
6.015".
0 010
1.565
0:49?
O c�x2
0 003'`
a:026
0.061
0:025
_ 2 799
,86.263 ::::: ..:. .. :::::::::.
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.078
0.033
0.609
1.312
0.082
0.007
0.082
0.506
0.09
2.146
Current Cumulative lbs/ac
0.093`
0.043
2:174
q 1.804
n.1,64,
0.0.10' .;
0-108
0.5;67
0:115
4.945
Permitted C. P. L. R.****
36
34
1338
1 267
15
374
89
2498
Permit PAN L• 2 emit 1 t/ nd Cro s P
21
1.
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date
*** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual):
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
C '*ator: James Brewer Owner: James Brewer Predominant Soil Series:
A,. es Used: 14.5 Acres Permitted: 14.5 Site #: CH039 Field #:
47.13
GaB
1
Residual Analvsis Data (Heavy Metals and Total Phosphorus use m2/k2, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
EB
11/9/15
2
_3j
L4j
5
6-1
L7J8
j
9
10
11 1
12
% Solids
4.14
Arsenic
3
Cadmium
2
Copper
147
Chromiuni
51
Lead
15
Mercury
0.5
Molyb-
denum
5
Nickel
10
Selenium
5
Zinc
409
Total
Phos-
chorus
14500
t ul Heald Metal Field Loadings (Calculated in lbs/acre):
1 otal
1
2
3j
4
5
L6J
7 J
L8J
9
10
11
12
DT/Ac./
oy*
App.
Event
3.25
Arsenic
0.020
0..000
0.000'
0,000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.020
Cadmium
0:013
0-.000
0.000
0.000
0.0:00
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.013
Copper
0.956
0.000
0.000
0.000
0.000
0.000-
0.000
0.000
06000
0.000
0.000
0.000
0.956.
Chromium
0.332
0.000
0.600
0.000
-0.000
0.000
0.000
0.000
0.000
0.000
0..060
0.000
0.332
Lead
0.098
0.000
0.000
0.000
0.000
0..000
0.000
0.0.00
1 0.000
0.000
0.000
0.000
0.098
Mercury
0.003
0.000
0.000
0.000
0.000
6.000
0.000
0.000
0.000
0.000
0.000
0.000
0.003
Molyb-
0.033
0.000
0.000
0.000
0.000
0.000
0.000
0..000
0.000
0.000
0.000
0,000
0.033
den
Nickel
0.065
0.000
0.000
0.000.
0.000
0.00.0
0.000
.0:000
0.000
0.000
0.000
0.000
0.0.65
Selenium
0.033
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.0.00
0.000
0.033
Zinc
2.659
0.000
0.000
0.006
0.000
0.000`
0..0.00
0.000
0.000
0.000,
0.000
0.000
2.659
Total
Phos-
94.250
0:000
0.000
0.000
0.000
0.000
0:000
0:000
0.000
0.000
0.000
0.000
94.250
horus
"i certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
t'sonment for knowing violations".
zv 1/14/2016
Signature of Land Applier
Date
DENR FORM MFLSF (1212006)

ANNUAL LAND APPLICATION -x-GELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: City of Burlington WQ Permit #: WQ0000520 Field #: I Acres Utilized: 14.5
Land Owner: James Brewer Annual Dry Tons Applied: 47.13 Site #: CH039 Acres Permitted: 14.5
Operator: James Brewer Predominant Soil Series: GaB Cation Exchange Capacity (non 503): 0
Crop I Name: Fescue -Pasture Crop 1 Max. PAN: 157 Crop 2 Name: Crop 2 Max. PAN:
o .1
N o
°
A
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
{pry TonslAc)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry'
pest)
Precip.
Past 24
Hrs.
inches
y
cc `0
�'
o w
a o.
n
c
� �.
*
x
� 0
* N'
w
* 0
TKN
mgtkg
z
�#
8 o
t3
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
lbs/acre
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
12/8
149500
4.14
1,780
East Burlington
Dry
<.5"
S
0.5
0.3
30700
4110
2
35,720
NA
Fescue
12/9
123500
4.14
1 470' "
East Burlington
Dry
<.5"
S
0.5
0.3
30700
4110
2
29508
NA
Fescue
0.000
' 0,00 r '
0 000
0.000
0.000
0.000,
0 090
0.600:
0.000 ,
0 000 -
' 0.000
6 000
0 000;
0:000:
' 0.000
0 0:00
0 000
0.000 '`
0:000
0.000
0.6m
0.006
0.001-
uoo :
0.000
0 000 -
0.0.00
0.0*_­
0'00u
o.000'
:.:...:....
o .:
0 000,.
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000
;0.000-
. .
• '•
.
TOTALS:a
`"' 273i30o
As
Cd
Cu
Cr
Pb
Hs,
Mo
Ni
Se
Zn
P
65.228
h 0 ooa"
Lime A > >lied
Annual lbs/acre
q:020
6b8,
0332,
0 098 • `,
; 0.003„
0.033
4065
0 033 ,
2.b59
94.250•":.::':::;:.:::.:_:::.:_:.:.:::.::::
>:
-
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.061
0.027
4.448
3.044
0.391
0.017
0.125
0.237
0.069
9.344
Current Cumulative lbs/ac
0;081"
0 04U
5.404
. .
3.. +'t+
Os4$l t.
0 A20 ,
Q.158
Q,302
0.102
- 12 0-----------------
03
Permitted C. P. L. R.****
36
34
1338
267
1 15
1
374
1 89
2498
Permi Limit
t PAN L m t l st/2nd Crop
157
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
4;:2j . *Application Method: S - Surface, IN - Injection, INC - Incorporation
rr--*'�`-- 1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier
Date
*** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual):
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
gyrator: James Brewer Owner: James Brewer Predominant Soil Series:
A_- es Used: 13 Acres Permitted: 13 Site #: CH039 Field #:
42.64
GaB
2
Residual Analvsis Data (Heave Metals and Total Phosphorus use miz/kLr. % Solids use Raw Percent ft
Sample or
Com-
posite
Date
1 I
EB
11/9/15
2
3
4
5
6
7
8
9
10
11
12
% Solids
1 4.14
Arsenic
3
Cadmium
2
Copper
147
Chromium
51
Lead
15
Mercury
0,5
Molyb-
denum
5
Nickel
10
Selenium
5
Zinc
409
Total
Phos-
phorus
14500
'ixal Heavy Metal Field Loadings (Calculated in lbs/acre):
1 otal
1
L2J
L3J
L4J
5
6
L7J
8
9
LOJ
11
12
DT/Ac./
App.
Event
3.28
14
Arsenic
0.020
0 000
0.000
0.000
0.000.
0 0.00.
0.000
0.000
0.000
0.000
0.000
0:000
0.020
Cadmium
0.013
0.000
1 0.000
0.000
0..000
1 0.000
0.000
0.000
1 0.000
0.000
0.000
1 0.0-00
0.013
Copper
0.964,
0:000
0,000
0.000
0,000
0.000
0..000
GM00
0.000
0:000
0.000
0.000:
0.9.64
Chromium
0335
6,000
0,000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0,335
Lead
0.098,
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0,0.00
-0.000
0:O09
0.060
0.098
Mercury
0.6.03
0:000
0.000
0.000
0,.01001
0.000
0.000
0.000
0:000
0.000
0000
0.000
0.003
Molyb-
0.033
0.000
0,000
u00
0.000
0.060
0.000
0.00.0
0.000
0.000%
0.000
0.000
0.033
denum
Nickel
0.066
0,000-
0.000
0.000.
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0..000
0:066
Selenium
0.033
0.000
0.000
0.000
0.00-0
0.000
0.000
0,000
0.000
0.000
0.000
0.000
0.033
Zinc
1683
0 000
0,000
0.000
0.000
0.000
0.000
0.000
0.000
0A00
0:0.00
0A00
2.683
Total
Phos-
95.120
0.000
0.000
0.000
0.000
0,000
0.000
0.000
0.000
0.000
0.000
0.000
95.120
)horus
"1 certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
v •isonment for knowing violations".
Z-;,� 1/14/2016
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION A,-iELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: City of Burlington WQ Permit #: WQ0000520 Field #: 2 Acres Utilized: 13
Land Owner: James Brewer Annual Dry Tons Applied: 42:64 Site #: CH039 Acres Permitted: 13
Operator: James Brewer Predominant Soil Series: GaB Cation Exchange Capacity (non 503): 0
Crop 1 Name: Fescue -Pasture Crop 1 Max. PAN: 157 Crop 2 Name: Crop 2 Max. PAN:
o
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc}
Soil
Cond.
(Dry,
Wet
Moist)
Precip.
Past 24
Hrs.
inches
Y
b
rc
a
*
o
'
=
* N'
°p
7d
w �,
co iv
* r, -
o
TKN
mg/kg
z
o
R �
�•
mg/kg
Nitrate
and
Nitrite
mgtkg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
12/9
19500
4.14
.0.25.0
East Burlington
Dry
<.5"
S
0.5
0.3
30700
4110
1 2
S 197 _
NA
Fescue
12/10
149500
4.14
1985''
East Burlington
Dry
<.5"
S
0.5
0.3
30700
4110
2
39:842
NA . "
Fescue
12/11
78000
4.14
1.036
East Burlington
Dry
<.5"
S
0.5
0.3
30700
4110
2
20.787
NA"
Fescue
0:000
0.000
0.000
0 000.
0.00 0`
A000
000.0
0.001)
0:'060'•11,
0 000
0..000
' 0:000
0 000
0 0W,
0:000:
0.000
0 00.0
0 000
9M.00.0.
0.000
0.000
0.000
0.000 "
0.000
0
00
000. '„
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000
omo
TOTALS:
01
As
Cd
Cu
Cr
Pb
He
Mo
Ni
Se
Zn P
65:825
0.000
Lime Applied
Annual lbs/acre
0 02.0 '
0 013
0;964
�� 0 335
0 0��s
0..00-3 '
0:033
�.0.066.
0 033
2 683 :"95. t20 ' ::
10.358 . ........ .. ....
1;3 041
2498 - -
Date
]bs/ac
Prior Years Cumulative lbs/ac
0.064
0.031
5.214
3.645
0.447
0.022
0.143
0.281
0.081
Current Cumulative Ibs/ac
0.084.
y',0.044
6;17$•
3':980
0.545
0 05
0.176
0.341
0114,
Pennitted C. P. L. R.****
36
34
1 1338
1
1 267
15
374
89
Permit PAN Limit 1st/2nd Crop
157 "
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual):
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
Orator: James Brewer Owner: James Brewer Predominant Soil Series:
Ei_ s Used: 14.3 Acres Permitted: 14.3 Site #: CH039 Field #:
29.32
CmB
3
Residual Analvsis Data (Heavv Metals and Total Phosphorus use me/kLy, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
11
SB
6/8/15
21
3
41
51
6'
71
8
9
10
11 1
12
% Solids
4.16
Arsenic
3
Cadmium
2
Copper
236
ChrOMiLIM
239
Lead
21
Mercury
1.9
Molyb-
denum
5
Nickel
17
Selenium
5
Zinc
474
Total
Phos-
pliorus
23100
f 'tial Heavv Metal Field Loadines (Calculated in lbs/acre):
otal
1 1
21
31
4!
5,
6 j
7
8
9
10
11
12
-
-
-
-
DT/Ac./
,y
App.
14
Event
2.05
Arsenic
0.012
0.000,
0.0.00 1
0.000
0.00.0
0.000
1 0.000.
0.000
0.000
0.000.,
0:000
1 0.000
0.012
Cadmium
0.003
0,.000
.0.000.
0.000
0.000
0.000
0.000
0.000,
0.000
0.000
0:000
0.000.
0.008
Copper
0 968
0.000c ,
. _ -0.000
0.000
0,064
0.000
0:000
6.0.00
0.000
0.000
0.000
0.000
0.968
Chromium
0.980,
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.00.0
0.000.
0.980
Lead
0.096
0.060
'0.000
0:000
0.00.0
0.000
0.000
0.000
0.0.00
1 0.000
0.000
0.000
0.0.8"
Mercury
0.008
0.000
0.000
0;000
0.000
..
0.000'
0.000
0.000
0.000
0. 000
0.000
0.000
0.008
Molyb-
0.021
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000.
0.000
0.000
0.021
denum
Nickel
0.070
0.000 '
0.000
0.000
0:000
0.000
0.000
0.000
0:000
0.000
'0.000
0.000
0.070
Selenium
0.021
0.000
0.000
0.000
0..000
0.0.00
0.00.0
0:000
0.000
0.000
0.000
0.000
0.021
Zinc
1.943.,
0.00.0
0.000
0.000
0.000
0.000
0.000
0.000 .
0.000 . _
0.000
O.000
0.000
1.943
Total
Phos-
94,710
0.000
0.000.
0.000
0.000
01.000
0.000
0.000
0.000
0.000
0.000
0.000
94.710
chorus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
k -isonment for knowing violations".
1/14/2016
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
Operator:
ANNUAL LAND APPLICATION-. -iELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
City of Burlington
James Brewer
James Brewer
Crop 1 Name: Fescue -Hay
WQ Permit #: WQ0000520 Field #:
Annual Dry Tons Applied:'—.- 29.32 ' Site #:
Predominant Soil Series: CmB
Crop 1 Max. PAN:
189
Crop 2 Name:
3 Acres Utilized: 14.3
CH039 Acres Permitted: 14.3
Cation Exchange Capacity (non 503): 0
Crop 2 Max. PAN:
�
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
SoilPrecip.
Cond.
(Dry'
Wet,
Moist)
Past 24
Hrs.
inches
a
4 'b
a '5
o w'
a -•
* N'
>*
o'
7y
r
C°
TKN
mg/kg
o
aq
w
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
7/17
58500
4.16
0.710
South Burlington
Dry
<.5"
S
0.5
0.3
50200 1
19000
48.1
26.837
NA
Fescue
7/20
110500
4.16
1 34Q'',
South Burlington
Dry
<.5"
S
0.5
0.3
50200
19000
48. I
50.691 '
NA
Fescue
0 000
0,000 .
0,000
01000
0.000 ,;
0.000
0:000
0.000
0.000
Oi000
0.000 .
0.000
0,000
0.000
t and .k
0.006
0.000
00,000
0.000
0.000
0 000 '
0.00.0
0A00
0.000.::
0.000
0.000
0 60.0
0.000
0.000
...... ..
0
0
:.: ': .:
0.000 '
Residuals Applications totals on FORM
FSF supp (attach FORM FSF supp
to this form ):
0.000 -
0,000
.... ....
...........
TOTALS:
o
• 1 "J000
As
Cd
Cu
Cr
Pb
H14
Mo
Ni
Se
Zn
P
77.528
0.00o
Lime Applied
Annual lbs/acre
0 012 � b,
0.00$
0:968
O eBci. _.
0:08t,
0,068
0.021
0.070
N O.g21.E
R 1.943 ,<
`94.710' :.:.::. : . : . . : : :::
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.0183
0.0125
1.6
0.85
0.1685
0.007
0.0342
0.0765
0.0204
3.2246
Current Cumulative Ibs/ac
0.03'1
2i i
2.5.68
1.830 „ ''
_...
0.25:5
0 Of5 h
..
' 0.055 '
0.146
_.
0.041'
r 5 168
Permitted C. P. L. R.****
36
ff34:�]
1338
1
126.7115
374
89
1 2498
Permit PAN Limit 1 st/2nd Crop
P
19
8-
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R,: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual):
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
1,ator: James Brewer Owner: James Brewer Predominant Soil Series:
A_ _.s Used: 20.1 Acres Permitted: 20.1 Site #: CH039 Field #:
43.98
GaB
4
Residual Analvsis Data (Heavv Metals and Total Phosphorus use mglkg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
SB
6/8/15
2
3
4
5
6
7
8
9
10
11
121
% Solids
4.16
Arsenic
1 3
Cadmium
2
Copper
236
Chromiuni
239
Lead
21
Mercury
1.9
Molyb-
denum
5
Nickel
17
Selenium
5
Zinc
474
Total
Phos-
nhorus
23100
Ilial Heavv Metal Field Loadings (Calculated in lbs/acre):
otal
1
2
3
41
5
6
7
8
9
10
"J
12
DT/Ac./
c
App.
Event
2.19
Arsenic
0.013
01060
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0..013
Cadmium
0.009
0 000 _
. 0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1 0.000
0.009
Copper
1.033
1 0.000
0 060.
o.000
0 000
0.000
0.000
0-.000
0.000
0.000
0.000
0A00
1.033
ChrOMR1111
1.046
0.060
0.000
0.000
0.000
0.000
0.006
0.000
0.000
0.000
0 000
0.000
1:046
Lead
0:092
0..0;00
0.000
0.000
0.000
0000
0.0.00
0.000
0.000
0.000
0.000
0.00.0
0.092
Mercury
0.0:08
0:000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.008
Molyb-
0.022.
0.000 `
0.000
0.000
0.000
0.000
0.00.0
0.000
0.000
0.000
0.000
0.000
0.022
denum
Nickel
0.07-4
0.000
0.006
0.000
0.000
0.0001
0,000
0.000
6.000
0:000
0.000
0.000
0.074
Selenium
0.022
0.000
0.0.00
0.000
0.000
0.000.
0.000
0.000
0.000
0.000
0.000
0.000
0.022
Zinc
2.074
0'.00.0
0.000
0000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000 1.1.074.
Total
Phos-
101.086
0.000
0.000
0.0.00
0.000
0.000
0..000
0.000
0.000
0.000
0.000
0.000
101.086
horus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
~isonment for knowing violations".
1/14/2016
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
Operator:
ANNUAL LAND APPLICATION x ALD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
City of Burlington WQ Permit #: WQ0000520 Field #: 4 Acres Utilized:
James Brewer Annual Dry Tons Applied: 41',98'Site #: CH039 Acres Permitted:
James Brewer Predominant Soil Series: GaB Cation Exchange Capacity (non 503):
Crop 1 Name: Fescue -Pasture Crop 1 Max. PAN: 158 Crop 2 Name: Crop 2 Max. PAN:
20.1
20.1
0
o �
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry'
Wet,
Moist)
Precip.
Past 24
Hrs.
inches
Y
4 '0
cu '5!_
o w
a o
0
o
° N'
* I;
07
7�
w �,
w
* w•
TKN
mg/kg
Z
o B
°co°
0 w'
mg/kg
Nitrate
and
Nitrite
mgncg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
7/20
117000
4.16
•1010. "'
South Burlington
Dry
<.5"
S
0.5
0.3 1
50200
19000 1
48.1
38.185 '
NA_' .>
Fescue
7/21
136500
4.16
1< 178 �
South Burlington
Dry
<5"
S
0.5
0.3
50200
19000
48.1
44.550
NA
Fescue
0.000
0.000
O.000
...
:..-
0006:
Q 060
0.000
0.000•
0:000..
Q00.0 .
Q Q0Q . .',
Q:000
Q.QQQ
''Q 000 ' •
0 OOOr
0.000 .
0.000,
0 000
„ o.000
ti Q00
0'000
0.000
O.A00 .-
0.000
, 0:000`
0
ll
.":...
0 000, a.�,,..,.
Residuals Applications totals on FORM
FSF supp (attach FORM FSF supp
to this form):
0.000
F.
0.000
..........1....
TO
As
Cd
Cu
Cr
Pb
He
Mor37
Se
Zn
P
82.735
0.000.
Lime Applied
Annual lbs/acre
0.013 ':.
0 009 '
= 1:033
` 1.746
0.092
0.00.8
0 022
0 "022
f':2.074 '
to 1.086 :_::'?; ; ;:;:;:; • . ....:::
...........................
............................
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.009
0.0067
0.9331
0.3223
0.0721
0.0051
0.018
0.0045
1.8167
Current Cumulative lbs/ac
0 022 ._ .,•
. 0.015
1.966
13�,8
O.l 641
;; 0 013"
0,.04b
• 0.026
3891
Permitted C. P. L. R.****
36
34
1338
267
15
89
2498
t PA
Perm>iN Limit ist/2n d Crop
158
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation -1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual):
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
'vator: James Brewer Owner: James Brewer Predominant Soil Series:
A__:s Used: 30.7 Acres Permitted: 30.7 Site #: CH040 Field #:
88.72
GaB
1
Residual Analvsis Data (Heavv Metals and Total Phosphorus use mg-/kE. % Solids use Raw Percent #):
.,o
Com-
Positei
Date
©©
o©
o
0
0
o
m
m
Total
Phos-
-iihorus,MMENEEMENEEN
'ual Heavv Metal Field Loadinus (Calculated in lbs/acre):
otal
I 1 I
2
3
4 j
5
6
7
8
9
10
11
12
DT/Ac./
oyr
App.
Event
2.09
0.80
14
Arsenic 1
0.013
0.005
0.000 1
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1 0.000
0.000
0.017
Cadmium
0.008
0-003
0.m
0:000
0:00.0
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.012
Copper
0.993
0.236
0.000
0.000
0.000
0.000
0.000
0,000
0:000
0:000
07000
0.000
1.229
Chromiun
0.192 '
0.082
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.274
Lead
0.050
0.024
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.074
Mercury
0.002
0.00.1
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.002
Molyb-
0.021
0.008
0.000
0.000
0.000
0:00'0
0.000
0.000
0.000
0.000
0.000
0.000
0.029
e
Nickel
0.033
.0.016
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.00-0
0.000
0.049
Selenium
0.021
0.008:-
0.000
0.000
0.000
0.000'
0.000
0.000
0.000
0.000
0.000
0..000
0.029
Zinc
1.994
0.658
0.000
0.000 1
0.000
.0.000
0.000
0.000
0.000
0.000
0.000
0.000
2.652
Total
Phos-
48.395
23316
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
71.711
phorus
"1 certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
r' -isonment for knowing violations".
_ _ 1/14/2016
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual):
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
K__`�'rator: Bobby Cooper Owner: William Brookbank Jr. Predominant Soil Series:
A_ -is Used: 5.1 Acres Permitted: 5.1 Site #: CH098 Field #:
4.49
BdB
2
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
11
EB
11/9/15
21
3
_4_1
5j
L6J7
8
9
10
11IJ
12
% Solids
4.14
Arsenic
3
Cadmium
2
Copper
147
Chromium
51
Lead
15
Mercury
0.5
Molyb-
denum
5
Nickel
10
Selenium
5
Zinc
409
Total
Phos-
phorus
14500
zal Heavy Metal Field Loadings (Calculated in lbs/acre):
x otal
1
2
3
4
5
6
7
8
9
10
11
12
DT/Ac./
App.
Event
0.88
14
Arsenic
0.005
O.OQO
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.005
Cadmium
0.004
1 0.000.
0.000
0.000
0.000
0.000
1 0.000
0.000
0.00.0
1 0.000
0.000
0.000
0.004
Copper
0.259
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.259
Chromium
0.090
0.000
0.0.00
0.000
0.000 -
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.090
Lead
0.026
0.000
0.000
0.000
0.000
0.0.00
0.000
0:000
0.000
0.000
0.000
0.000
0..026
Mercury
0:001
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0..000
0.000
0..000
0.000
1 0.001
Molyb-
0 009
0.000
0.000
0.00-0
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.009
denwn
Nickel
0.018
0.000
0.000
0.000
0.000
0.000
0.000
0.600
0.000
0.000
0.000
0.000
0.018
Selenium
0.009
0.000
0.000
0.000
0.000
0.006
0.000
0.000
0.000
0.000
0.000:
0.000
0.009
Zinc
0.720
0.000-
0.000
0.000
0.600
0.000
0.000
0.000
0.000 1
0.000
0.000
0.000
0.720
Total
Phos-
25.520
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
25.520
horus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
u " ~isonment for knowing violations".
2!:�e 1/14/2016
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
Operator:
)
ANNUAL LAND APPLICATION .tELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
City of Burlington WQ Permit #: WQ0000520 Field #: 1 Acres Utilized:
James Brewer Annual Dry Tons Applied: 88.72 Site #: CH040 Acres Permitted:
James Brewer
Crop 1 Name: Fescue -Pasture
Predominant Soil Series:
Crop 1 Max. PAN: 158
ME
Crop 2 Name:
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
30.7
30.7
0
o �
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/AC)
Residual Sources
PDES #, W #
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry'
Wet'
Moist)
Precip.
Past 24
Hrs.
inches
>
� �
cv
o w
� �
o
01 x' 10
N'
* w
o
o
;r:
w �
* �
* o
o
TKN
mg/kg
Z Y
o
c°4u P
� P.
mglkg
Nitrate
and
Nitrite
mglkg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
11/16
84500
2.78
0.319
East Burlington
Dry
<.5"
S
0.5
0.3
26600
6470
2
5':920 `
NA
Fescue
l 1/17
110500
2.78
•0 417
East Burlington
Dry
<.5"
S
0.5
0.3
26600
6470
2
7.741.,
NA
Fescue
11/18
104000
2.78
0 393 =`' `
East Burlington
Dry
<.5"
S
0.5
0.3
26600
6470
2
7.286
NA,
Fescue
11/27
84500
2.78
0.319 .
East Burlington
Dry
<.5"
S
0.5
0.3
26600
6470
2
5.420 :.:
NA
Fescue
11/28
71500
2.78
0 270
East Burlington
Dry
<.5"
S
0.5
0.3
26600
6470
2
5.009 "
•, NA
Fescue
11/29
97500
2,78
0 368
East Burlington
Dry
<.5"
S
0.5
0.3
26600
6470
2
6.830
NA '"':
Fescue
12/7
1
143000
4.14
0 804
East Burlington
Dry
<.5"
S
0.5
0.3
30700
4110
2
16.138 ;
NA
Fescue
0.000
0.000
0:0001
0.00.0
0.000,
0.000 •
0.000
0.0.00
0:000.
0 006
0.0100
0:000
0.000.
0;000
0.000
.
0
0
....
;0.000
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000
0:000
TOTALS:
0
69i300
As
Cd
Cu
Cr
Pb
H,
Mo
Ni
Se
Zn
P
54.842
0.0001'
Lime A iplied
Annual lbs/acre
O..Ol7
0.012
1229
Ok? 74
).0 74
0 002::
"O.Q29
0.049 a
C:Q29
2.652 <'
i 1.711
: : >:::::: :
...........................
............................
•`:
.
.. ..........
Date
]bslac
Prior Years Cumulative lbs/ac
0.126
0.075
12.876
4 981
1.109
0.053
0.32
0.777
0.127
22.004
Current Cumulative lbs/ac
0:143
0.087
14.105 .
-5.255°
1.183`.
0.05-5
0.349
0..826
O.e156
24,656
Permitted C. P. L. R.****
36
34
1338
1 267
1 15
1 374
89
2498
Permit PAN Limit 1 st/2nd Crop
158
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date "** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL LAND APPLICATION -MELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: City of Burlington WQ Permit #: WQ0000520 Field #: 2 Acres Utilized: 5.1
Land Owner: William Brookbank Jr. Annual Dry Tons Applied: 4.49 Site #: CH098 Acres Permitted: 5.1
Operator: Bobby Cooper Predominant Soil Series: BdB Cation Exchange Capacity (non 503): 0
Crop 1 Name: Fescue -Pasture Crop 1 Max. PAN: 128 Crop 2 Name: Crop 2 Max. PAN:
°
Q
Volume applied
(enter one) Solids/
Li Liquid
9
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tans/Ac)
Residual Sources
(NpDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry,
Wet
Moist)
precip.
Past 24
Hrs.
inches
Y
�
?
o w
0 y
* o
o
N
* �'
w ,
*
TKN
mg/kg
Z a
q
o 9
�' w•
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
12/15
26000
4.14
0880
East Burlington
Dry
<.5"
S
0.5
0.3
30700
4110
2
17..662
NA
Fescue
0.000
0.000
.0.000
0.000
0.000
`'.0:000
0.000
0.000
0.000,
0:000
0.000
0.00.0
0.00w
0.000
0.000
0:.000
0.000
0000
0.00.0
0.006
o;000
0:0o0
0.000
0.000
0000 .
0.000
. 0.000
0.000
0.00o
0.000
6.000
0.000
0.000
0
0
0:000
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000 •
o.000
TOTALS]
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
17.662<
u,oiiii
Lime Applied
Annual lbs/acre
0.065
0.004
0.250
0" 090
0.026
0.001 :
' 0,009 ,
• 0,018
a 069 _
0 720 '
25.520 :::::: '::.:::.:::::: ::
:. ... . ......,.
.'.'.'..'..'..'. ........ I .. ' . ' '
» >
Date
lbs/ac
Prior Years Cuumulative lbs/ac
0.128
0.027
2.911
0.982
0.248
0.016
0.087
0.21
0.079
7.895
Current Cumulative lbs/ac
0.133
0 031
3..17.0
1:072
0.274
0`..017
0.096
0.:228.
01088`
8.6.15
Permitted C. P. L. R. ****
36
34
1338
267
15
374
89
2498
i 2 Perm t PAN Limit 1st/ nd r t Co p
2
I8
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name:
Permit #:
,ator:
A,. es Used:
City of Burlington
WQ0000520
Bobby Cooper Owner:
8.7 Acres Permitted:
Total Dry Tons Applied (Annual):
Cation Exchange Capacity (non 503 only):
William Brookbank Jr. Predominant Soil Series:
8.7 Site #: CH098 Field #:
19.08
CmB
3
Residual Analvsis Data (Heavy Metals and Total Phosnhorus use mLy/ksE, % Solids use Raw Percent ft
Sample or
Com-
posite
Date
1 1
EB
11/9/15
2
a
5
6
7 j
8
9
10 1
11 j
12
% Solids
1 4.14
Arsenic
3
Cadmium
2
Copper
147
Chromhun
51
Lead
15
Mercury
0.5
Molyb-
denum
5
Nickel
10
Selenium
5
Zinc
409
Total
Phos-
oh onus
14500
1 xal Heavv Metal Field Loadines (Calculated in lbs/acre):
l otal
1
1 21
1 31
4.
51
1 61
71
81
19_11
12
�9
DT/Ac./
0
App.
y
Event
2.19
Arsenic
0.01.3
1 0..00.0
0.000
0 000
ObOO
0.000
0.000
1 0.000
0.000
0.000
0.000
0.000
0.0`13
Cadmium
0.009
0.000
0.000
01000
0.000
0.000
0.000
0.000
0..Q00
0.000
0.000
0.0.00
0.009
Copper
0.645
0.000
0.0001
0.000
0.000
0..000
0.000
0.000
0-.000
0.000
0.000
0.000
0.645
Chromimi
0.224
0000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.224
Lead
0.066
0:000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
6.000
0.000
0.000
0.066
Mercury
0.002
0.000
0.000
0.000
0.000
0.000
O':000
0.000
0 DOO
0.000
0.000'
0.000
0.002
Molyb-
O'.022
0.000
0.000
0.000
0.000`
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.022
denum
Nickel
0;044�
0.000
0.000
0.000
0.0-00
0.000-
0.000
0.000
0.000
0.000
0.000
0.0010
0.044
Selenium
0.022
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000.
0.022
Zinc
1.794
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.600
0.000
0.000
0.000
1.794
Total
Phos-
63.597
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.00.0
0.000
0.0.00
0.000
63.597
horus
"1 certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
r " -isonment for knowing violations".
1/14/2016
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION i fELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: City of Burlington WQ Permit #: WQ0000520 Field #: 3 Acres Utilized: 8.7
Land Owner: William Brookbank Jr. Annual Dry Tons Applied: 19.08 Site #: CH098 Acres Permitted: 8.7
Operator: Bobby Cooper Predominant Soil Series: CmB Cation Exchange Capacity (non 503): 0
Crop 1 Name: Fescue -Pasture Crop 1 Max. PAN: 141 Crop 2 Name: Crop 2 Max. PAN:
�
o Y
;, o
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
a
/p
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, W #
Q '
Fert, Animal
Waste, etc)
Soil
Cond.
(Dry,
WetHrs.
Moist)
Precip.
Past 24
inches
>
4 b
w
o
;� 2
�•
-
*
o
p
4
; w
* N
* o
8
TKN
mglkg
Z Y
a B
ov o
w'
mglkg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
g
Application
Crop 1
Crop 2
Crop 1
Crop 2
12/15
110500
4.14
2:193
East Burlington
Dry
<.5"
S
0.5
0.3
30700
4110
2
44.003
NA
Fescue
0b00 ,
0.000
0.000 ..
0.000
0..000
0,.000
0:000
•0.000. `
'0.000
0.000.
0.006
0.000
O.00a
0.000
0.600.
O.00D
0.000
0:000
0.000
.0.000
0.006
0,000
0.000
0.000
0.000
-0.000
0.000
000.0
0.000
0.000
0 000
0.000
o:oou
0
0
.:
0A60
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.0(1(1
0.000.
TOTALS:
U
to�R Q
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
1 44003
'0.000 :.
Lime Applied
Annual lbs/acre
0:013
O 009.4
0 W
' 0.2_4 .
. 0.0et, `'
'A002 ='
' 0.023
�0 044°
0.022
1.794"
' 63.597
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.104
0.026
2.966
1.958
0.516
0.013
0.08
0.229
0.074
8.588
Current Cumulative lbs/ac
0.117
0.035
3:6:1.1'
2.`182 ::
- 0 58-' '
AM5,,
0.102
0:273
0.096
10 382
Permitted C. P. L. R.****
36
34
1338
267
1 15
374
89
1 2498
,Permit i Perms N Limit 1 2nd t s / Crop
141:
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual): 80.80
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
;ator: Bobby Cooper Owner: William Brookbank Jr. Predominant Soil Series: CmB
A.._ es Used: 31.8 Acres Permitted: 31.8 Site N: CH098 Field #: 10
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
EB
11/9/15
2
3L4J
5
6
7
8
9
10 I
Ij
12
% Solids
4.14
Arsenic
3
Cadmium
2
Copper
147
Chromitini
51
Lead
15
Mercury
0.5
Molyb-
denum
5
Nickel
10
Selenium
5
Zinc
409
Total
Phos-
t?horus
14500
)al Heavy Metal Field Loadings (Calculated in lbs/acre):
1 otal
1
21
L314
L 5j
6 J
L7J
8
9
10
11
12
DT/Ac./
oy'
App.
Event
2.54
14
Arsenic
0.015
0.000
0.000
0.000
0.000
0.:0.00
0.000
0.000
0.000
1 0.000
0.000
0.000
0.015
Cadmium
0.010
0.000
0.000
0.000
0,000_
. 0.000
0.000
0.000
0.000
0.00.0
0.00.0
1 0.000
0.010
Copper
0.747
0:000
0.0.00
0.000
0.000
0.000
0.000
t7.000
0.000
0.000
0.000
1 0.000
0.747
Chromiun
0.259
0:.000
0 000'
0.006
0 000
0.000
0.000
0.000
0.000
-.0.000
0.000
0.000
0.259
Lead
0.076
0,000
0.000
0700:0
0.000
0.:000
C000
0.000
0.000
0.000
0.000
0.000
0.076
Mercury
0.003
0.000
0000
O.OQO
0.0.00
0.000.1
0.000
0.000
0.000
0.000
0.000
0.000
0.003
Molyb-
O 02.5
0-000
0.000 - :
0.000
0.000
0.000`
0:000
0..000
0.000
0.000
0.0:00
0.000
0.025
denum
Nickel
0 051
0.000
0,006
0.000.
0.000
0.000
0.000
01000
_0.00ro ..
0.000
0.000
.0.000
0.051
Selenium
0.025
0.000
0.000
0.000
0.000
0.000
0.000
0.0.00
0.000
0.000
0.000
0.000
0..025
Zinc
2.079
0.000
0.000
0:000
0.000
0.000
0.000
_ .0-.000
0.1000
0.000
0.000
0.000
2.079
Total
Phos-
73.689
0.000
0.000
'0.000
0.000
0.000
0..000
0.000
0.000
0.000
0.000
0.000
73.689
horus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
V isonment for knowing violations".
zfv 1/14/2016
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
Operator:
~1
ANNUAL LAND APPLICATION .-YELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
City of Burlington WQ Permit #: WQ0000520 Field #: 10 Acres Utilized:
William Brookbank Jr. Annual Dry Tons Applied: 8'080 Site #: CH098 Acres Permitted:
Bobby Cooper
Crop 1 Name: Fescue -Pasture
Predominant Soil Series: CmB Cation Exchange Capacity (non 503):
Crop 1 Max. PAN: 141 Crop 2 Name: Crop 2 Max. PAN:
31.8
31.8
0
a
°
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
ova
Solids
Volume
Applied per
Acre
(Dry TonslAc)
Residual Sources
(NPDES #, WQ#
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry'
Moist)
Precip.
Past 24
Hrs.
incnes
Y
410
o w
ao.
�
o
%`� w
N'
C
77 =
w
* N
TKN
mglkg
z Y
q B
o H
mg/kg
Nitrate
and
Nitrite
mglkg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
12/11
110500
4.14
0.660
East Burlington
Dry
<.5"
S
0.5
0.3
30700
4110
2
12.039
NA
Fescue
12/12
156000
4.14
0847
East Burlington
Dry
<.5"
S
0.5
0.3
30700
4110
2
16.996
NA
Fescue
12/13
123500
4.14
.0.670
East Burlington
Dry
<.5"
S
0.5
0.3
30700
4110
2
13.455
NA
Fescue
12/14
78000
4.14
6.423
East Burlington
Dry
<.5"
S
0.5
0.3
30700
4110
2
$.498
NA
Fescue
0::600
0.000
0:000•
0-000
0.000
0.000
0:,Qoo
0.00(1
' ;0.000
0.000
0.000
0.000
0.000.
0.000
0.000
0.000
0.000
0.000
0.00.0
0.000
0:006.
0.000 '
0.000,
0.0.00
kAnnual
0
0
0400
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.0��0
0.000 "
TOTALS:
0
468009
As
Cd
Cu
Cr
Pb
H,,
Mo
Ni
Se
Zn
P
56.997
OA00
Lime Applied
lbs/acre
Q 015 -
0,010,
0-147
,0_259
0 17o -
0 003 .-
. 0.025.
1 0.05:1
0.0k5
` - 2.:079
13.689 :::::.:..::::.::. .. . .::::
;:
. ..... ..... .....
: :
:........... ..............
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.171
0.092
10.628
4.538
L698
0.042
0.27
1.225
0.165
30.626
Current Cumulative lbs/ac
0:1-86
0:102
11.375
4.797
1.774
0:.045
0.295
1.276
• O.190
32.705
Permitted C. P. L. R.****
36
34
1338
267
15
1 374
89
1 2498
Permit PAN Limit t/2 1 s nd Crop
11
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name:
Permit #:
(K�„ator:
ti_ . es Used:
City of Burlington
WQ0000520
Charles Lutterloh Owner:
27.8 Acres Permitted:
Total Dry Tons Applied (Annual):
Cation Exchange Capacity (non 503 only):
Charles Lutterloh Predominant Soil Series:
27.8 Site #: CH251 Field #:
52.3.2
GaB
3
Residual Analvsis Data (Heave Metals and Total Phosphorus use me/kit. % Solids use Raw Percent ft
Sample or
Com-
posite
Date
1
SB
3/16/15
2 j
31
1 41
L51
61
71
1 81
L9110
1
11 1
121
% Solids
3.86
Arsenic
3
Cadmium
2
Copper
136
Chromiii in
196
Lead
10
Mercury
0.4
Molyb-
denum
5
Nickel
8
Selenium
5
Zinc
323
Total
Phos-
T)horus
21500
�.tal Heave Metal Field Loadines (Calculated in lbs/acre):
1 utal
1 11
12)3
4
5
6
7
8]
L91
10
11
12
DT/Ac./
oyr
App.
Event
1.88
'
Arsenic
0.011
0.000
0.000
0.000
0.000
0.000
0.000
1 0.000
0.000
0.000
1 0.000
0.000
0.011.
Cadmium
0.008
0000
0.0.00
0.000
0.000
0.000
0.000"
0.000
.0.000
0.00.0
0.000
0.000
0.008
Copper
0.512
0.000
0.000 1.0.000
0.000
0.000
.900
0.000
0.000
0.000
0.000
0.000
0.512
Chromium
0.738
0.0.00
0.000
0.000
0.000
0.000
0:000
6.000
0:.000
0.000
0.000
0.000
0.738
Lead
0.03
0 000
0.,000
0.1000
U00
0.000-
0.000
0.000
0.000
0..000
0.000
0.000
0.038
Mercury
0.002
0.000
0.000
0.000
0:000
0.000
0.0.00,
0.000
0.000
0.000
0.000
0.000.
0.002
Molyb-
0.019
0'.000
01.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0:019
denum
Nickel
0.030.
0.060
0.000
0.000
0.000
0.000
0.000.
0.000
0.000
0.000
0:000
0,000
0.030
Selenium
0.019
0.000_
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0,000,
0.000
0.:000
1 0.019
Zinc
1.216
0.000
0.600
0.000
0.000
0.000
0.000
0:000
0.000
0.000
0.000
0.000
1.216
Total
Phos-
90.926
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
80.926
horus
"1 certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
4' Isonment for knowing violations". 1/14/2016
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
Operator:
ANNUAL LAND APPLICATION —. iELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
City of Burlington WQ Permit #: WQ0000520 Field #: 3 Acres Utilized:
Charles Lutterloh Annual Dry Tons Applied: 52,32 Site #: CH251 Acres Permitted:
Charles Lutterloh Predominant Soil Series: GaB Cation Exchange Capacity (non 503):
Crop 1 Name: Fescue -Pasture Crop 1 Max. PAN: 158 Crop 2 Name: Crop 2 Max. PAN:
27.8
27.8
0
o =
+�
°
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
PP p
Acre
(Dry Tons/AC)
Residual Sources
(NPDES #, W #,
Q
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry'
Moist)
Precip.
Past 24
Hrs.
inches
>
0 a
x o
;h 2
� y.
0
77
* y
w
* 0
TKN
mgtkg
Z Y
o 5
o
2.
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
4/3
227500
3.86
1.317
South Burlington
D
<.5"
S
0.5 1
0.3
63500
8290
2
54.559
NA
Fescue
4/6
13000
3.86
0..;075
South Burlington
D
<.5"
S
0.5
0.3
63500
8290
2
3.118
NA
Fescue
4/8
84500
3.86
0489
South Burlington
D
<.5"
S
0.5
0.3
63500
8290
2
20.265
NA
Fescue
0.000
0.000
0:000
0.000
0.000
0.000 '
0.000
r' 0..000
0.00.0
0.000
0.000 "
0.000
0�000
0.000
0,000
0 000
0.000
0.000
.0,.000
0.000
0.000
0;000
0.000
0.000
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000 '
0-000
TOTALS:
_701
35,5060
As
Cd
Cu
Cr
Pb
H>;
Mo
Ni
Se
Zn
P
77.942`
0.000
Lime A > >lied
Annual lbs/acre
0.01'1
0:008'.
0.5'12
0.738
0:038
0002`*
0.019
°0.030
�•O.Q19.,
i,121G
80,926 :::. :....:.<;...:;.:>:_
..................
... ....................
: ;: ;: ;::: ;:: »:: `::=>:=:: =
...........................
............................
.....
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.2049
0.2403
25.0561
9.5075
1.901 t,
0.1029
0.9247
1.7888
0.1789
43.9402
Current Cumulative lbs/ac
0.216
0 24:8
25568 -
, 10.245 .
-y 1.939 �
0 104=
0 944_
1819 .
..0:19�8
45.156
Permitted C. P. L. R.****
36
34
1338
1
267
15
374
89
2498
Permit PAN Limit Ist/2nd Crop
158
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual):
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
(�'_ ';ator: Charles Lutterloh Owner: Charles Lutterloh Predominant Soil Series:
A. zs Used: 4.9 Acres Permitted: 4.9 Site #: CH251 Field #:
8.37
NaB
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
SB
3/16/15
2
_3j
L4J_5j
6
7 j
L819
J
10
11
12
% Solids
3.86
Arsenic
3
Cadmium
2
Copper
136
Chromium
196
Lead
10
Mercury
0.4
Molyb-
denum
5
Nickel
8
Selenium
5
Zinc
323
Total
Phos-
n.horus
21500
ual Heavy Metal Field Loadings (Calculated in lbs/acre):
1 otal
11
2 J
L3]_4j
Ij
6
7
8
9
10
11
12
DT/Ac./
oyr
App.
Event
1.71
Arsenic
0.010
1 0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.010
Cadmium
0.007
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.007
Copper
0.465
0.000
0.000
0.000
.0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.465
Chromiuni
0.670
0.000
0.000
0.0.00
0.000
0.000
0.000
0.060
0.000
0.000
0.000
0.000
0.670
Lead
0.034
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.006
0.000
0.000
0.000
0.034
Mercury
0.001
0.000
0.000
0.000
01.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.001
Molyb-
0.017
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.017
denum
Nickel
0.027
0.000
0.000
0.000
0.000
0.000
0.000
0.0.00
0.00.0
0.000
0.000
0.000
0.027
Selenium
0.017
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.017
Zinc
1.103
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
.1.103
Total
Phos-
73.444
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
73.444
horus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
k •isonment for knowing violations".
1/14/2016
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
Operator:
ANNUAL LAND APPLICATION . iELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
City of Burlington
Charles Lutterloh
Charles Lutterloh
Crop 1 Name:
Fescue -Pasture
WQ Permit #: WQ0000520 Field #:
Annual Dry Tons Applied: 841 Site #:
Predominant Soil Series: NaB
Crop 1 Max. PAN: 135 Crop 2 Name:
Acres Utilized: 4.9
CH251 Acres Permitted: 4.9
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
o
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry'
Wet,
Moist)
Precip.
Past 24
Hrs.
inches
Y
r°
o w
a o.
�3
c
w
* N'
0mg/kg
7y
+ N
TKN
Z a
�o o
cc
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop I
Crop 2
Crop 1
Crop 2
4/6
52000
3.86
1.708
South Burlington
D
<.5"
S
0.5
0.3
63500
8290
2
70.752
NA
Fescue
0.00.0
0.000
0.000
0.0,00'
0.000
0.000
0.000
0.000
0.000
0 000
0.000
0.000
a:000 .
0.000
0.000
o;000 .:
o.00a
0.000
0.0;00
0.000
0.000
0:0,00
0.000
0.000
a:000
0.000
0.000
6�0.,00
1
0.000
0.000
A:000
0.000
0.000
0
0
O:MW
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000
0.000
TOTALS:
As
Cd
Cu
Cr
Pb
Hag
Mo
Ni
Se
Zn
P
70.752
O.00u
Lime A > ,lied
Annual lbs/acre
&0.10
0.00. Tt
'0146.5
0.670
0.034
0 001
0 017
0.027
0 047
• .1.103:.
73.444 ::..:::.::::::::::::' = ` ::;
::'...........
...........................
............................
..
................
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.1246
0.0822
9.5612
3.8162
1.1222
0.0419
0.3016
0.949
0.1298
17.8902
Current Cumulative lbs/ac
0.135 ;
0.089
10- 026 '
4.486 .'
.
L156 .
0 043 ;
• , 0.3 k.9
0.9.76
0.147 . '
`1:8'994
Permitted C. P. L. R.****
36
34
1 1338
1
1 267
15
374
89
2498
Permit PA Li st/2nd r N mrt1 Crop
=
135
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation -1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual):
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
C`�ator: Charles Lutterloh Owner: Charles Lutterloh Predominant Soil Series:
A- -is Used: 16.2 Acres Permitted: 16.2 Site #: CH251 Field #:
31.40
NaB
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
SB
3/16/15
__2j
3j
L4J
5
61
7
8
9
10
11
12 1
% Solids
3.86
Arsenic
3
Cadmium
2
Copper
136
Chromiuiii
196
Lead
10
Mercury
0.4
Molyb-
denum
5
Nickel
8
Selenium
5
Zinc
323
Total
Phos-
phorus
21500
ual Heavy Metal Field Loadings (Calculated in lbs/acre):
I otal
1
2
3
4
51
6
7
8
9
10
11
12
DT/Ac./
App.
Event
1.94
Arsenic
0.012
0.000
0.000
0.000 '
0.000
0.000
0.000
0.000
0.000
0,000'
. 0.000
0:00.0
0.012
Cadmium
0.009
0.000
0.00:0
0.000
0.000
0.00.0
0.000
0.000
0.00.0
0.000
0:000
0.00.0
0.009
Copper
0.527
0;600
0 000
0.000
0:000
0.000
0.000
01000
0.000
0.000
0.000
0..000
0.527
Chromiun
. 0.760
0.00.0
0.000
0.000
0.000 '
0.000
0.000
0.000
0:000
0.000
0.00-0
0.000.
0.760
Lead
0.039
0 00,0
0.060
0.060
0:000
0.00.0.
0.000
0.000
0.000
0.000
0.000
0.000
0.039
Mercury
0.002
0.00.0,
. 0 000
0.000
0.000F
0.000_
. 0..000
0000
0.000
0.000
0.000
0.000
0.002
Molyb-
0.0-19
0:000
0.000
0.000
0:000
0.000
0.000
0.000,0.000
0.000
0.000
0;000
0.019
denum
Nickel
0.931
0.000
0 00
0.000
0.000 ''
0.000
0.000
0.000 .
0.000
0.O'00
' 0.000'
0.000
0.031
Selenium
0.01.9
0:000
0,000,
0.00.0
01.000
0.000
0.000
0.000
O.000
0.000
0.000
0.000
0.019
Zinc
1.252
0.006
-0.00:*0
, 0.000
0.000
0.000
0.000
0'000
0.000.
0.000
0;000 :
0:.000
1.252
Total
Phos-
83.334
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
83.334
horus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
it •isonment for knowing violations".
z- 1/14/2016
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION x GELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: City of Burlington WQ Permit #: WQ0000520 Field #: 5 Acres Utilized: 16.2
Land Owner: Charles Lutterloh Annual Dry Tons Applied: 31.40 Site #: CH251 Acres Permitted: 16.2
Operator: Charles Lutterloh Predominant Soil Series: NaB Cation Exchange Capacity (non 503): 0
Crop 1 Name: Fescue -Pasture Crop 1 Max. PAN: 135 Crop 2 Name: Crop 2 Max. PAN:
o
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Xds Gallons
o
�u
Solids
Volume
Applied per
PP P
Acre
(Dry TonsJAc)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
Wet'
Moist)
Precip.
Past 24
Hrs.
inches
�
4.o
cu
n w
c
iv
�,
_ ,_
* w
0
�
w �,
� "'
* N
m
0
TKN
mg/kg
Z Y
o
� o
g w
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
PP
lbs/acre
( )
Name of Crop Type
ReceivingResidual
Application
Crop 1
Crop 2
Crop 1
Crop 2
4/6
195000
3.86
1.938
South Burlington
D
<.5"
S 1
0.5
0.3
63500 1
8290
2
80`.251
NA :
Fescue
0.000
0.000
0.000
0.000.
0.000
0.000
0'.000
0.000
0,0.00
0.000
0:0000:00.0
0.000
0s000 ° .
0.006.
01,0,00
0:000
0.000
0000
0:000
0,000
0 000
0.000 `
0.000
0.000'
0.000
0.000
0.000
0.000
0.000 .
0,000.
0.000
L0.060.
0.
0
0,00q
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
1 0.000
0 00,0-;
TOTALS:
n
195titri/
. ;:::::
As
Cd
Cu
Cr
Pb
H­
Mo
Ni
Se
Zn
P
80.251
6-000,
Lime Applied
Annual lbs/acre
0.012 ::`.'
0.008
0,527 7777777759
0.002
0.019
0.03.1 "
0 0`19 ,
11.252"
83.334 :
'>:< >::::::: >::»:: >:::::: >:
:.'•: < :::::::::`.: ;:::::::::::::
Date
Ibs/ac
Prior Years Cumulative lbs/ac
0.0682
0.053
6.6578
2.3698
0.6933
0.0275
0.2031
0.4776
0.0786
11.7536
Current Cumulative lbs/ac
6.680
GO
7.i85
. " 3',129
0.732 _
0029
0.222
0.509
0.:098,
13.006
Permitted C. P. L. R.***
1 36
1 34
1338
1
267
15
374
1 89
2498
Permit PAN Limit 1 st/2nd Crop
135
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual):
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
I�rator: Ross Wood Owner: Sasser Farms Predominant Soil Series:
A-- es Used: 31 Acres Permitted: 31 Site #: CS017 Field #:
103.08
CbB
2
Residual Analvsis Data (Heave Metals and Total Phosphorus use m0ke. % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
EB
7/13/15
2
_3j
L4
5j6
L7J
1 8
9
10
11 j
12
% Solids
3.92
Arsenic
3
Cadmium
2
Copper
168
Chrorniffln
52
Lead
31
Mercury
0.4
Molyb-
denum
5
Nickel
12
Selenium
5
Zinc
591
Total
Phos-
nhorus
9570
Lal Heave Metal Field Loadings (Calculated in lbs/acre):
i otal
1
21
L3J4
5 J
L6]7
8 j
L 9j
10 J
11 1
12
DT/Ac./
App.
Event
3.33
Arsenic
0.020
6.000
0.000
0.000
0.000
0.000
0.00.0
0.000
0.000
0.000_
0.000
0,000
1 0.020
Cadmium
0.013
0.000
0.000
0.000
1 0.000
0.000
1 0.000
0-.000
0.000
0.000
0.000
0.000
1 0.013
Copper
1.117
0.000
0.000
0.000
0.000
0.0.00:
0..00.0
0.000
0.000
0.000
0.000
0.000
1..117
Chromium
0.346
0.000
0.000
0.000
0.0090
0.00.0
0.000
0.000
0.00.0
0�000
O.000
0.000
0.346
Lead
0.20;6
0.000
0.000
.0.00-0
0.000
0.0.00
0.000
0.000
0.000
0.000
0.000
0.000
0.206
Mercury
0..003
0.000
0.000
0.000
0.000
0.000
OAD
0.000
0.000
0.000
0.000
0.000-
0.003
Molyb-
0.033
0.000
0.000.
0.000
0.000
0.000
0.000
0:000
0.000.
0.000
0.000 :
0.000
0.03.3
denum
Nickel
0.0-80
0.000
0.000
0.000
0.000
0.0.0
0 ,000
0.000
0.000
0.000
0.000
0.000
0.080
Selenium
0.033
0.000
0.000
0.000
0.000 :
` 0.000
0.000.
0:000
0.000
0.000
0;0.00
0.000
0.033
Zinc
3.930
0.000
0.00-0
.0.000
0.000
0.000
0.000
0.000
0.000
0.000 `
0.000
0.000
3.930
Total
Phos-
63.641
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0..000
0.000°
0.000
63.641
horus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
i -isonment for knowing violations".
.e�s
_ 1/14/2016
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
Operator:
ANNUAL LAND APPLICATION`- _tELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
City of Burlington WQ Permit #: WQ0000520 Field #: 2 Acres Utilized:
Sasser Farms Annual Dry Tons Applied: 103:08"- . Site #: CS017 Acres Permitted:
Ross Wood Predominant Soil Series: CbB Cation Exchange Capacity (non 503):
Crop 1 Name: Fescue -Pasture Crop 1 Max. PAN: 162 Crop 2 Name: Crop 2 Max. PAN:
31
31
0
o
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
D Tons/Ac
(Dry )
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry,
Wet'
Moist)
Precip.
Past 24
Hrs.
inches
Y
]
o w
a o
o
w
* N
4
�
N
*
�
TKN
m /k
9 9
Z
o R
w
m /k
9 9
Nitrate
and
Nitrite
m /k
9 9
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
crop 1
P
Cro 2
P
Crop 1
P
Crop 2
P
8/3
221000
3.92
L16:5.
East Burlington
Dry
<.5"
S
0.5
0.3
24700
3060
2
M701
NA
Fescue
8/4
201500
3.92
1.063
East Burlington
Dry
<.5"
S
0.5
0.3 1
24700
3060 1
2
17:051
NA
Fescue
8/5
130000
3.92
0 685 � ,
East Burlington
Dry
<.5"
S
0.5
0.3
24700
3060
2
11.004
NA
Fescue
8/6
78000
3.92
"0 411
East Burlington
Dry
<.5"
S
0.5
0.3
24700
3060
2
6:600
NA
Fescue
0a000' .,
0.000'
0.00.0`
0 000 `
;`0.000
.6.000,
''um
0.000
0 000 •
0.000
0.0.00 ;
'0.000
O. b00
0.60.0"
0.000
0.000
0.0Q,6
0.000
0.0(o
0.006
'_0:000
0.000
0.00.0' '
000°,
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0:000
'"O.00Q,
TOTALS:
; 01
r,;r i,ci
As
Cd
Cu
Cr
Pb
H r
Mo
Ni
Se
Zn
P
53.354
0,600 `
Lime A p plied
Annual 1bs/acre
�'0.020
0.013
1 117
0 34�
0 _06` :
0 003
0 03
0.480
0033
3 930 ,'
,63.641 .., . < : :.:;
..................
:::::::::::::::::::: ".". - % -.
...........................
..........................
............
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.0306
0.0218
2.1736
1.2114
0.1984
0.0091
0.0706
0.161
0.0507
6.4886
Current Cumulative lbs/ac
0 05:1,
0.035
3.2911
• ' 1.557
' 0.4c15
r 0 012
0.1,04
0;2,4/
0.084
10 419
Permitted C. P. L. R.****
36
34
1338
267
15
374
89
2498
Permit PAN Limit 1st/2nd Crop
:.. .::.:.: '.:...: •: ... 162
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
4;: *Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual):
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
Bator: Ross Wood Owner: Sasser Farms Predominant Soil Series:
A_ A Used: 19.6 Acres Permitted: 19.6 Site #: CS017 Field #:
27.81
HbB
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
SB
9/8/15
2!
3
4
5;
61
71
8i
91
10I
11
12
% Solids
2.7
Arsenic
3
Cadmium
2
Copper
303
Chromitm
238
Lead
26
Mercury
1.3
Molyb-
denum
6
Nickel
21
Selenium
5
Zinc
489
Total
Phos-
r�borus
40600
ial Heavy Metal Field Loadings (Calculated in lbs/acre):
'I Otal
1
21
3
4
5 1
IL6]7
8
9(
10 f
11
12
DT/Ac./
,oy,
App-
4
Event
1.42
Arsenic
0.009
0.000
0.000 1
0.000
0.000
0.000
0.000
0.000
0.000
1 0.000
0.000
0.000
1 0.009
Cadmium
0.006
0.000
0.00.0
0.000
0.000
0.000
0.000
0.000
0.000
1 0.000
0.000
0.000
0.006
Copper
0.860
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.860
Chromium
0.675
0.000
0.000
0.000
0.000
0.000
0_000
0.000
0.000
0.:000
0.000
0.006
0.615
Lead
0.074
0.000.
0.000
'0.000
0.000
0.000
0.000
0.00.0
0.000
0.000
0.000
0.000
0.074
Mercury
0.004
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0,000
0.000
0.004
Molyb-
0.017
0.00.0
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.017
denum
Nickel
0.0,60
0.000
0.000
0.000
0.000
0.0.00,
0.000
0.000
0.000.
0.000
0.000
0.000
0.060
Selenium
0.014
0.000
0.000
0.000
6.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.014
Zinc
1.388
0.000
0.000
0.000
0.000.
0.00.0
0.000
0.000
0.000
0.000
0.000
0.000
1.388
Total
Phos-
115.223
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
115.223
nhorus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
i ~isonment for knowing violatii�ooinns/s".
;9!:;i:e L;ram`
1/14/2016
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
Operator:
ANNUAL LAND APPLICATION-r ]+ LD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
City of Burlington
Sasser Farms
Ross Wood
Crop I Name:
Fescue -Pasture
WQ Permit #: WQ0000520 Field #:
Annual Dry Tons Applied: 27.81 Site #:
Predominant Soil Series:
Crop 1 Max. PAN
127
HbB
Crop 2 Name:
Acres Utilized: 19.6
CS017 Acres Permitted: 19.6
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
0
A
Volume applied
Pp
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
�pDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry,
Wet,
Moist)
Precip.
Past 24
Hrs.
inches
� Y
cc 'Ts
o w
a
*0
<
o
� �•
N
x
w .�
?j
* N
*
0
TKN
mg/kg
'Z a
F# 5
o �
" �
o w
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
PP
(lbs/acre}
Name of CropT
Type
Receiving Residua[
Application
Crop 1
Crop 2
Crop 1
Crop 2
10/22
182000
2.7
•1.045
South Burlington
Dry
<.5"
S
0.5
0.3
65200
24100
2
50.982
NA
Fescue
10/23
65000
2.7
0.373
South Burlington
Dry
<.5"
S
0.5
0.3
65200
24100
2
18:208
NA,
Fescue
0.00,0
0:000
0.000
0.0.00
0.000-
0:00:0
0..000
0;000 .
0.006
0.000
0.000
0.000
0 000
O OOu
0.00Q
0.00017
0.000 -
0.000
0'.000
0.000 .
0.000
0.000
0.000
0.000
0000
. 0.000
0.000
0. oou '
0.060'..
0
0
0MO-'
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000
0.000
TOTALS:
0
24700o
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
64.ts9
0.000,,'
Lime A died
Annual lbs/acre
0;009
0.606
, 0 860
0.:675
0.074
0 Q04'
b0.017
0:060 .
0.014
1.388
'115 223 :? :, ; . ::.::.::
.............................
`" `""
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.0323
0.0191
1.8125
1.1263
0.1776
0.006
0.0539
0.1257
0.0429
5.079
Current Cumulative lbs/ac
0.041
0.025
` 2.672 .
' 1,8u2. ' -
0.254
0.0,10''
0.07`1
0.185
,.0c057
6 467
Permitted C. P. L. R.****
36
34
1338
267
15
374
89
2498
Permit PAN Limit 1st/2nd Crop
p
12 7
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name:
Permit #:
�'°rator:
i, -.'s Used:
City of Burlington
WQ0000520
Ross Wood Owner:
40.6 Acres Permitted:
Total Dry Tons Applied (Annual):
Cation Exchange Capacity (non 503 only):
Sasser Farms Predominant Soil Series:
40.6 Site #: CS 117 Field #:
107.83
Q
Residual Analvsis Data (Heavy Metals and Total Phosphorus use me/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
11
EB
9/8/15
21
SB
9/8/15
3
4
S_
6
7
81
9
10
11
121
% Solids
1 3.6
2.7
Arsenic
3
3
Cadmium
2
2
Copper
315
303
Chromikim
48
238
Lead
13
26
Mercury
0.4
13
Molyb-
denum
5
6
Nickel
1 9
21
Selenium
5
5
Zinc
582
489
Total
Phos-
oorus
8830
40600
I }gal Heavv Metal Field LoadinEs (Calculated in lbs/acre):
metal
1 1
21
3
4
5
7
8 1
9
10
11
12
DT/Ac./
App.
Event
2.48
0.18
Arsenic
0.015
0.001
0.000
0.000
0.000
0.000'
0.000
1 0.000
0.000
1 0.000
0.000
0.000
0.016
Cadmium
0.01.0
6'.001
0.000
0,000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.011
Copper
1.560
0.109
O.00Q
0.000
0.000
0.000 .
0o..0,
0.000
0.000:
0.000.
0-0.00.
0.000
1 A69
Chromium
0,23,8
0.086
0.066
0.000
0.000
0.000
0.000
0.000
0.000
0.000_ 1
0.000
0.00.0
1 0.323
Lead
0.064
0.009 `
0.000
04000.
0.000'
0.000
0.000
0.000
0.000 :
0.0.00
0.000
0.000 '
0.074
Mercury
0.0.02
0.000
0.000
0.000
0.000
0.000" ;
0..000
0.000
0.000
0.000
0.000
0.000
. 0.002
Molyb-
0.025
0.002
0.000
0.000_.
0.000
0.000
0.000
0.000
0.060
0.000
0.000
0.000
0.027
denum
Nickel
0;04$
0,008
0.000'
O.OQO
0.000
0:000
0.000
0.000
0.000
0.000
0.000
`0.000>
0.052
Selenium
0.025
6.002
0.000:
0.000 1
0.000
0.000
0.000
0.000
0.000
`0.000
0.000
0.000
0.027
Zinc
2.8,82
0.176
0.000
0.000
0.000
0.000
' 0.000
0.000
0.000
0.000
.0.000
0.000
3.058
Total
Phos-
43.726
14.616
0.000
0.000
0.000
0.000
0.000
0:000
0.000,
0.000
0.000
0.000
58.342
_horus
"1 certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
ir-isonment for knowing violations".
{ ;6-re Li ��'�'ti'
1/14/2016
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
Operator:
ANNUAL LAND APPLICATION .-GELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
City of Burlington WQ Permit #: WQ0000520 Field #: 4 Acres Utilized:
Sasser Farms Annual Dry Tons Applied: 107.83 Site #: CS117 Acres Permitted:
Ross Wood Predominant Soil Series: HbB Cation Exchange Capacity (non 503):
Crop 1 Name: Fescue -Pasture Crop 1 Max. PAN: 127 Crop 2 Name: Crop 2 Max. PAN:
40.6
40.6
0
;�
o y
°1 o
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, W #,
Q
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry,
Wet
Moist)
Precip
Past 24
Hrs.
inches
a
'b
`�
�'
n w
o
o
�,
-
* �.
7y c°,
w
?=
* N
*
TKN
mg/kg
Z
o
ac o
w
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
( Ibs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
10/19
182000
3.6
0.673'
East Burlington
Dry
<.5"
S
0.5
0.3
23100
3060
2
10.153
NA'
Fescue
10/20
214500
3.6
0.793
East Burlington
Dry
<•5"
S
0.5
0.3
23100
3060
2
11.967
NA'
Fescue
10/21
273000
3.6
1 009
East Burlington
Dry
<.5"
S
0.5
0.3
23100
3060
2
15.230
NA
Fescue
10/23
65000
2.7
0 180
South Burlington
Dry
<.5"
S
0.5
0.3
65200
24100
2
8.790
NA
Fescue
0 000
0.000
0:000
.,0 0,'`
0-OW''
0.000
4.000
0.0.00 •
0.000
0.000
0 000
0.000
0:,006
0.000
0.060
0.000
0.000
0 000
'0.000
0.000'
0.000
0.000
0.000 •
0.000
0.000
0'
0
0.000
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0:000
0. 11
TOTALS:
0
73a50o
As
I Cd
Cu
Cr
Pb
H,-
Mo
Ni
Se
Zn
P
46:140
0:000 '
Lime Applied
Annual lbs/acre
0.qM
; 0.0.11
3,669
0 ,23 '
0;074
.0.002
' 0:027.`
0 052
.0027
3;058
58.342 -:
............................
Date
lbs/ac
Prior Years Cumulative Ibs/ac
0.0478
0.0272
2.4454
0.8898
0.26()2
0.0074
0.0797
0.1906
0.0612
7.1204':
Current Cumulative lbs/ac
0.064
0.038
4.`114
' " 1.21.:3
0334
0.010
I p 10.7
Q,243
- 0 088
10 179
Permitted C. P. L. R.****
36
34
133$
1 267
15
1
1 374
89
2498
Permit PA s 2 N Limit 1 t/ nd Crop P
127
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name:
Permit #:
Orator:
h A Used:
City of Burlington Total Dry Tons Applied (Annual): 81.96
WQ0000520 Cation Exchange Capacity (non 503 only):
Dennis Simmons Owner: Delmar Allred Predominant Soil Series: ApB
28.9 Acres Permitted: 28.9 Site #: CS018 Field #: 1
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
EB
5111115
2
31
41
5.
6
71
L8]91
10 i
11 ;
121
% Solids
4.32
Arsenic
3
Cadmium
2
Copper
171
Chromium
50
Lead
16
Mercury
1.1
Molyb-
denum
5
Nickel
22
Selenium
5
Zinc
555
Total
Phos-
t)horus
10400
ual Heavy Metal Field Loadings (Calculated in lbs/acre):
1 etal
1 1 1
121
3
4
51
6 J
1 7 J
9
10 I
11
12
DT/Ac./
_81
App.
Event
2.84
14
Arsenic
0.017
1 0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1 0.000
0.000
0.017
Cadmium
0011
0.000
0.000
0000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.011
Copper
0.9.70
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.970
Chromi
0.284
0.600
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.284
Lead
0.09.1
0.000
0.000
0.000 1
0.000
0.000
0.000
0.00.0
0.000
0.000
0.000
0.000
0.091
Mercury
0.006
0.000
0.000
0:000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.006
Molyb-
0.028
0.000
0.000
0.000
0.00.0
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.028
denum
Nickel
0.125
0.000
0.000
0.000
0.000
0.000
0.000'
0.000
0.000
0.000
0.000
0.000
0.125
Selenium
0.028
0.000
0.000
0.000
0.000
0:000
0.000
0.000
0.000
0.000
0.060
0.000
0.028
Zinc
3.148
0.000
0.000
0.000
0.000
0.000
0.00.0
0.000
0.000
0.000
0.000
0.000
3.148
Total
Phos-
58.989
0.000
0.000
0.000
0.000
0.000
0.000
0:000
0.000
0.000
0.000
0.000
58.989
chorus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
it --isonment for knowing violations".
1/14/2016
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
Operator:
ANNUAL LAND APPLICATION .- ALD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
City of Burlington WQ Permit #: WQ0000520 Field #: 1 Acres Utilized:
Delmar Allred Annual Dry Tons Applied: 81.6 Site #: CS018 Acres Permitted:
Dennis Simmons Predominant Soil Series: ApB Cation Exchange Capacity (non 503):
Crop 1 Name: Fescue -Pasture Crop 1 Max. PAN: 178 Crop 2 Name: Crop 2 Max. PAN:
28.9
28.9
0
Y
o
Q
Volume applied
enter one Solids/
( )
Liquid
Cu. Yds Gallons
o
/o
Solids
Volume
Applied per
pp p
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry,
Wet,
Moist)
Precip.
Past 24
Hrs.
inches
a �
co
0 0'
o w
o �•
� o
o
o
7y w
�,
0 N'
w
�
a •,
* -
*
TKN
mgncg
Z ��
o
�;
o
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
6/18
123500
4.32
0.770
East Burlington
Dry
<.5"
S
0.5
0.3
23600
2780
2
13.760-
NA
Fescue
6/19
201500
4.32
1256
East Burlington
Dry
<.5"
S
0.5
0.3
23600
2780
2
19. L'87
NA
Fescue
6/22
130000
4.32
0416,
East Burlington
Dry
<.5"
S
0.5
0.3
23600
2780
2
12.379'
NA, .,
Fescue
0 000
0000 ._
0.000
a o0.0
0:000
0.000
0 000'
0.000
0.00o .',
0 000
0.000
0.006
O.Q00
6.0.00 "•
; •0.000
0 000
0.000
0.000
,0 000:
0.00o
0 000."
0.000
0.000
0.000
0 000 `
0.000
0.000
• ' ' .
0
0
0 000` "„
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
OAOU
0.000
TOTALS:
0
455006
::::
As
Cd
Cu
Cr
Pb
Mo
Ni
Se
Zn
P
43.325
0.000.`
Lime Applied
Annual lbs/acre
0.017
0.01.i
0:970
0:?s4
0.091
. 01028
0.125
0::028.:
3.148 ''
5.8.489 ::
...... .
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.042
0.029
2.613
1.164
0.244
r0`0021
0.087
0.215
0.071
8.315
Current Cumulative lbs/ac
0 059
`' 0.040
3. S•83
1.44$ '
` .0.33'S;
0.1TS
0;340'
0,099'
11 463
Permitted C. P. L. R.****
36
34
1338
267
374
89
2498
,Permit rt PA 2n r N Limit tt 1st/ d Crop P
178
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name:
Permit #:
`Nator:
A- _ s Used:
City of Burlington
WQ0000520
Dennis Simmons Owner:
3.9 Acres Permitted:
Total Dry Tons Applied (Annual):
Cation Exchange Capacity (non 503 only):
Dennis Simmons Predominant Soil Series:
3.9 Site #: CS036 Field #:
12.88
CfB
1
Residual Analvsis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent ft
Sample or
Com-
posite
Date
1 1
EB
5111115
21
3i,
41
5
6_
7i
81
9
10
11 1
12
% Solids
4.32
Arsenic
3
Cadmium
2
Copper
171
Chromium
50
Lead
16
Mercury
1.1
Molyb-
denum
5
Nickel
22
Selenium
5
Zinc
555
Total
Phos-
n.Jjorus
10400
t dial Heavy Metal Field Loadings (Calculated in lbs/acre):
utal
1
2
3
4
5
6
7
8
9
10
11
12
DT/Ac./
App.
Event
3.30
14
Arsenic
0.020
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1 0.000
0.000
0.020
Cadmium
0.013
0.000
0.000
0.000
0.000
0.000
0.000
0.000.
0.000
0.000
0.000
0.000
1 0.013
Copper
1.130
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1.130
ChromiuEn
0.33:0
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.330
Lead
0.106
0.000
0.000
0.000
0.000
0.000
0.000
0:000
0.000
0.000
0.000
0.000
0.106
Mercury
0.007
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.007
Molyb-
0.033
0.000
0.000
0.000
0.000
0.000
0.000
0.000.
0.000
0.000
0.000
0.000
0.033
denum
-
Nickel
0.145
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.145
Selenium
0.033
0.000
0.000
0.000
0.000
0.000
0.000
0..000
0.000
0.000
0.000
0.000
0.033
Zinc
3.666
0.000
0.000
0.600
0.000
0.060
0.000
0.000
0.000
0.000
0.000
0.00.0
3.666
L
68.702
0.000
0.000
0.000
0..000
0.000
0.000
0.000
0.000
0.000
0.000
0000
68.702
"1 certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
k-isonment for knowing violations".
./ 1/14/2016
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION -x-tELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: City of Burlington WQ Permit #: WQ0000520 Field #: 1 Acres Utilized: 3.9
Land Owner: Dennis Simmons Annual Dry Tons Applied: 1.28:8 Site #: CS036 Acres Permitted: 3.9
Operator: Dennis Simmons Predominant Soil Series: C1B Cation Exchange Capacity (non 503): 0
Crop 1 Name: Fescue -Hay Crop 1 Max. PAN: 209 Crop 2 Name: Crop 2 Max. PAN:
o
m 0
Q
Volume applied
(enter one) Solids)
Liquid
9
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES # WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry'
Wet'
Moist)
Precip.
Past 24
Hrs.
inches
a
4 Id
�+
o
A
0
o
�v -
N'
o
o
7y
w .,
° ^'
* N
* o'
TKN
mg/kg
z Y
- R
o
Oq °
g ?
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
lbs/acre
( )
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop I
Crop 2
6/1
71500
4.32
3 303 .
East Burlington
Dry
<.5"
S
0.5
0.3
23600
2780
2
50.451
NA
Fescue
0.000
0.000 11
0.0100
0.000
0:000 :
0.600
0000
0.000
'0.000
0.000
-0.000
0 U00_
0.000 "
0:000•
0.000
0.00o
0.000
0.000
0 000
0:000'
0.000
0.000
0.0W
0.000
0.000 :
` 0.000
0.000 .
0..000
Q.00.0
0.1)uo
0,000
0
.0
:.:;.; ;
-0 000 ' >'
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000
O.00Q
...
..
.......... .
TOTALS:
a
tgoo
As
Cd
Cu
Cr
Pb
Mo
Ni
Se
Zn
P
50.451
0.000
Lime Applied
Annual lbs/acre
0:02.0
0.0.13
1!130
0; �3u
0: tab "-
0-0:03
10.1`45
• 0033 ..
''>3.666
68.702 .:;::.:..>:,;:,:::.::_ .::
::::::::::':::'::::':'::::::::':
...........................
........
Date
Ibs/ac
Prior Years Cumulative Ibs/ac
0.327
0.319
38.494
16.898
6.012
00.935
F
3.121
0.234
61.649
Current Cumulative lbs/ac
0.347
•0.332
39.624
.; T7 228,' :'
6.11&
00.9683.266
0.267
6;5 313Permitted
C. P. L. R.****
36
34
1338
267
374
89
2498
P it P erm AN .Li st/2nd Cr mtt 1 0 p
Z 09
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual):
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
(/,�_ator: Dennis Simmons Owner: Dennis Simmons Predominant Soil Series:
r_ 's Used: 3.6 Acres Permitted: 3.6 Site #: CS036 Field #:
IbB2
2
Residual Analysis Data (Heavy Metals and Total Phosphorus use me/ka. % Solids use Raw Percent ft
Sample or
Com-
posite
Date
1
EB
5111115
2 .
3
4
5'
6
7,
8 :
9.
10 :
11
1121
% Solids
j 4.32
Arsenic
3
Cadmium
2
Copper
171
Chromiittr
50
Lead
16
Mercury
1.1
Molyb-
denum
5
Nickel
22
Selenium
5
Zinc
555
Total
Phos-
tliorus
10400
f' iial Heavy Metal Field Loadings (Ualculated in lbs/acre):
..,ial
1
2
3j
4
5
6
7
8 j
91
1101111
12
DT/Ac./
App.
Event
3.25
14
Arsenic
0.020
0.000
0.000 1
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1 0.020
Cadmium
0.013
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.0.00
0.013
Copper
1.113
0.000
0.000
0.000
0.000
0.000
0.000
0.00.0
0.000
0.000
0.000
0.000
1.113
Chromiuin
0325
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0:000
0.325
Lead
0.104
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.104
Mercury
0.007
0.000
0.000
0.000
0.006
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0:007
Molyb-
0.033
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.033
den
Nickel
0.143
0.,000
0.000
0.000
0 000
0.000
0.000
0.000
0_000
0.000
0.000
0.000
0.143
Selenium
0.033
0.000
0.000 1
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
.0.000
0.033
Zinc
3.611
0.060
0.0.00
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
3.611
Total
Phos-
67.662
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
67.662
horus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
47 -isonment for knowing violations".
''?!:Zz 1/14/2016
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
Operator:
ANNUAL LAND APPLICATION .--tELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
City of Burlington WQ Permit #: WQ0000520 Field #: 2 Acres Utilized:
Dennis Simmons Annual Dry Tons Applied: " 11.71 Site #: CS036 Acres Permitted:
Dennis Simmons Predominant Soil Series: IbB2 Cation Exchange Capacity (non 503):
Crop 1 Name: Fescue -Hay Crop 1 Max. PAN: 121 Crop 2 Name: Crop 2 Max. PAN:
3.6
3.6
0
�..,
o Y
A
Volume applied
pp
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
{Dry TonslAc)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
Wet,
Moist
Precip.
Past 24
Hrs.
inches
Y
cu
a
o
<
o
�'
0
4
7V @
w ?r
0
TKIV
mg/kg
z El
o
mg/kg
Nitrate
and
Nitrite
mglkg
PAN Applied
lbs/acre
( )
Name of Crop
p Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
6/1
65000
4.32
3.253 -
East Burlington
Dry
<.5"
S
0.5
0.3
23600
2780
2
4,9.697.
NA
Fescue
0 000"
6.000 '
0.0.00
0 00.0
0 000.
0.000 '
0.000
moo
0.000 _
,0 000,
0.000,`
0;000
0 00:0
0.000
f 0.000
0 000 - '"`
0.000
0.000
0.000:.
0.006
0 000.
O:OOn
0.000 `
0:.000
0,000,
` 0.000
0:000
0.000'
.0.000
0:000
0.000
0:000
Q
0
0 040
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0:000
o-000
TOTALS:
o
bs000::::::::::::::
As
Cd
Cu
Cr
Pb
Mo
Ni
Se
Zn
P
49.687
0.000
Lime Applied
Annual lbs/acre
0 020' •
0.013
1:1'13
0.325
0.104
0 0.0T„
0.03'3'
0.143
0 033
3.611
' 67.662 :..:..:.....:..::;::..:.::
....... .
...................... .
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.267
0.259
37.319
13.602
4.942
0.095
0.82
2.732
0.206
52.941
Current Cumulative lbs/ac
0•.287 ,
0.272
38:432
13.927 =
_ 5 046 `
0 102' `
0 85=3 „
. 2:875
0239
56 552
Permitted C. P. L. R.****
36
34
1338
267
15
374
89
2498
Permit PAN Limit Ist/2nd Crop
- 121 .
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/incorporation - 1.0
*** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
Signature of Land Applier Date aerobically digested -0.3, raw sludge -0.4
****C.P.L.R: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual):
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
((--�\ator: Dennis Simmons Owner: Dennis Simmons Predominant Soil Series:
A :.s Used: 3.1 Acres Permitted: 3.1 Site #: CS036 Field #:
21.08
CfB
3
Residual Analvsis Data (Heavv Metals and Total Phosphorus use me-/ka, % Solids use Raw Percent ft
Sample or
Com-
posite
Date
1
EB
5111115
2 j
3j
L4J
5
6
7
L8J
L9J
LOJ
11 j
2
% Solids
4.32
Arsenic
3
Cadmium
2
Copper
171
Chromium
50
Lead
16
Mercury
1.1
Molyb-
denum
5
Nickel
22
Selenium
5
Zinc
555
Total
Phos-
p10rus
10400
ltal Heavv Metal Field LoadinEs (Calculated in lbs/acre):
� oial
1 11
2
3
4
5
6
7
8
9
10
11
12
DT/Ac./
0
App.
Event
6.80
Arsenic
0.041
0.000
0.000
0.000
0-000
0.000
0.000
0.000
0.000- .
0.000
0.000
0.000
0.041
Cadmium
0.027
q._000
0.000
0.0.00
0;000.
0.000
.0.000
0.000
0.000
0.000
0.000
0.000
0.027
Copperr
325,
O':000
0.00.0
0.000
0.000
0.000
0.000
0.QOQ
0.000:.
0.000
0:.000
0.000
2.325
Chromium680
0:000
0.000 :
0:00.0
0.000
0 000
0.000
0:000
0.000
0.00.0
0.00.0.
0:000
0.68'0.
Lead
21`8�
0:OQ.O
0.000.
0.000
0.000
0.000
0.000
0.00.0-
0:000_
0.000.
0.000
0.000
0.218
Mercury0:15
:
0:.000
0.000
: 0.000
0.000
0,000
O.00Q
0.000
0.000
0.000
0.000
0.000
-o.o s
Molyb-
0._.068
0 00.0
0.000
0.000
0.000
0.000
0.000
0.00,0
0.000
0.000
0.0:00
0.000
0.068
denum
Nickel
0.299
0:000
.0 Q0:0
0.000
0-000
0 000_: `
__ 0.000
0.000
Q..000
0.000
0.000
0.000
0.299
Selenium
0.06$
0:000 :
0.000
0.000
0.000
0.000
0.000
_
OAW` ,
_ 0.000
0.000
0.000
0:000
0.068
Zinc
7.547
-0.000
� .000 1
0.000
0..000
0.00.0.
0.000
0.000,.
0.000
0.000
0.000
Q;000
7.547
Total
Phos-
141.419
0.000
0.000
0.000
0-000
0.000
0.000
0.000
0.000
0.000
0.000
0.000,
141.419
phorus
"i certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
i- -isonment for knowing violations".
i
1/14/2016
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

r ,
ANNUAL LAND APPLICATION . IELD SUMMARY FORM
Facility Name:
Land Owner:
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
City of Burlington
Dennis Simmons
Operator: Dennis Simmons
Crop 1 Name: Fescue -Hay
WQ Permit #: WQ0000520 Field #:
Annual Dry Tons Applied:.. 2T:0:8 Site #:
Predominant Soil Series:
Crop 1 Max. PAN:
209
CfB
Crop 2 Name:
CS036
Acres Utilized:
Acres Permitted:
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
3.1
3.1
0 �
° +�
° ti
°
Volume applied
pP
enter one Solids/
( )
Liquid
Cu. Yds Gallons
o
/o
Solids
Volume
Applied per
pp p
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert,, Animal
Waste, etc)
Soil
Cond.
D
( ry'
Wet'
Moist)
Preci p•
Past 24
Hrs.
inches
� 'a
co b
o w.
a _.
.� a
C
o
x �
w
�. N'
+
o'
o
r
-w
# N•
w
.� o
TKN
mg/kg
Z Y
'�
o
°
� �
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(Ibs/acre)
Name of CropType
Yp
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
6/1
52000
4.32
3.022
East Burlington
Dry
<5"
S
0.5
0.3
23600
2780
2
46.161 `
NA
Fescue
6/8
65000
4.32
3 777
East Burlington
Dry
<.5"
S
0.5
0.3
23600
2780
2
57,701
NA` ''
Fescue
0.000
0,000
0.000
0.000
-.0.000
0.0.00
0.00(1•
; 6,060
0 000
0.000
0,000-
0.000
0 00o
0.000.
0.000 .
0:0oo .
0.000
0.0.00
0.00o
0;000
0.000
0.00o :
0.000
0.000
0.000
0.000
0 000, '
0:0oo '
'0.600
0
0
:::: >
0 000 r
Residuals Applications totals on FORM
FSF supp (attach FORM FSF supp
to this form):
0.000
T0,000
TOTALS:
a
: r000
As
Cd
Cu
Cr
Pb
H.g
Mo
Ni
Se
Zn
P
103.861
O:000
Lime Aliplied
Annual lbs/acre
0 041
0.027
2.325 ;
° 0.:6`t« .;.
0.2iR
Q 015 ��
r 0 0.68
0.299 -,
U 068
7.5,0
141-419 :::..:..::
. ..:::.. ..•...:•::
::::•::=:"::....•....... ... .. .: .
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.269
0.238
31.141
12,078
3.989
0.093
0.695
2.649
0.199
49.558
Current Cumulative lbs/ac
0 310
0.265
33.466
1,2,75ri
4 207"
0 108 «
0.7;63
2.948
0 267
S7 105
Permitted C. P. L, R.****
36
1 34
1338
1
267
15
1 374
89
2498
Permit PA L 2 P N Limit 1 nd Crop
st/ P
0
2 9
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (1212006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual): 15.22
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
("_�rator: Dennis Simmons Owner: Dennis Simmons Predominant Soil Series: CfB
A_ z9 Used: 4.7 Acres Permitted: 4.7 Site #: CS036 Field #: 4
Residual Analysis Data (Heavy Metals and Total Phosphorus use mz1g, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1 i
EB
5/11/15
Z
_3j
4 J
5
6
7
8
9
10
11
12
% Solids
4.32
Arsenic
3
Cadmium
2
Copper
171
ChromiLlizi
50
Lead
16
Mercury
1.1
Molyb-
denum
5
Nickel
22
Selenium
5
Zinc
555
Total
Phos-
rborus
10400
l )gal Heavy Metal Field Loadings (Calculated in lbs/acre):
otal
I 11
2j
3
4
5
6
7
8
9
10
11
12
DT/Ac./
App.
Event
3.24
14
Arsenic
0.019
1 0.000
0.000
0.000
0.000
1 0.000
0.000
0.000
1 0.000
0.000
0.000
0.000
0.019
Cadmium
0.013
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1 0.000
0.013
Copper
1.108
0.000
0.000
0.000`
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1.108
0.000
0.000
0.000
0.000
0.000
0.000
0.00D
Q.000
0.000
0.000
0.000
0.324
.104
0.000
0.400
0.000
0..000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.104
:007
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.007
.032
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.032
j.324
.143
D_000
O.000
0.0:00
0.000
0.000
0.000
0.000
0:000
0.000
0.000
0.000
0.143
.032
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.006
0.000
0.000
6.032
.595
0.000
0.060
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
3.595
Phos-
67.371
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000 `
0..000
0.000
0.000
67.371
jhorus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
ir, --isonment for knowing violations".
Z: 1/14/2016
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION r ELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: City of Burlington WQ Permit #: WQ0000520 Field #: 4 Acres Utilized: 4.7
Land Owner: Dennis Simmons Annual Dry Tons Applied:, 15.22 Site #: CS036 Acres Permitted: 4.7
Operator: Dennis Simmons Predominant Soil Series: CtB Cation Exchange Capacity (non 503): 0
Crop 1 Name: Fescue -Hay Crop 1 Max. PAN: 209 Crop 2 Name: Crop 2 Max. PAN:
o
15
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/AC)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry'
Wet,
Moist)
Precip.
Past 24
Hrs.
inches
a
0
o
C
e
?'•
* N•
�
;�
cc 'v
*
c
D
TKN
mg/kg
Z �
o
aQ O
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop T e
p Type
Receiving Residual
Application
Crop I
Crop 2
Crop 1
Crop 2
6/8
84500
4.32
3,.239'
East Burlington
Dry
<.5"
S
0.5
0.3
23600
2780
2
49.47*;
NA,
Fescue
0, 060
0.000
`6.660 ''
019011
0 00o
' 0.000 •-
0 000
0:000 ,
0 0,00
0 000"
" 0--0oo
0.000
6.900
0.0011 _ .
a 600 "
'0 600
0.006
0.000
0A0.6
0.000
0.000
0 000
6.00,0,`
0.000
0.000
0.0(lii
0:000 '
0.000
0.0110.
4000,
Q 000
o.000
0.000
0
0
:.:.:..
", Q 000
Residuals Applications totals on FORM
FSF supp (attach FORM FSF supp
to this form):
0.000 `
(1,00(J
TOTALS:
As
Cd
Cu
Cr
Pb
H
Mor18
Se
Zn
P
4r1.-175
0.000
Lime A died
Annual lbs/acre
0 019 >
' 0.013
1.-108
0 324
O.l,g4 "
0.007
0.032'
0;032.
: 3i:595;"
-§7.3'71 ;:::.:::.....::::.:.:. ..::
;:
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.364
0.312
45.84
18.818
7.141
0.121
1.391
0.282
70.174
Current Cumulative lbs/ac
0.383.
0.325
46:948•
19:14?`:--
7,?45"
0.428,
1:423':
'0:31-4`
73 769...............•:......
Permitted C. P. L. R.****
36
34
1338
267
15
89
2498
PAN Limit is /2nd Crop.
..............
... .. . . .Permit .2.09'
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date
** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual):
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
9�'rator: Dennis Simmons Owner: Dennis Simmons Predominant Soil Series:
t- ;s Used: 17.5 Acres Permitted: 17.5 Site #: CS036 Field #:
36.30
IbB2
5
Residual Analvsis Data (Heave Metals and Total Phosphorus use make. % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1 1
EB
5111115
21
31
4
5
6
7
8
9
10
11
12
% Solids
4.32
Arsenic
3
Cadmium
2
Copper
171
Chromiu1111
50
Lead
16
Mercury
1.1
Molyb-
denum
5
Nickel
22
Selenium
5
Zinc
555
Total
Phos-
ph onus
10400
,ial Heavv Metal Field Loadines (Calculated in lbs/acre):
�otal
1
L 2
3 J
4
5
61
7
8j
9
LOJ
11 J
12
DT/Ac./
App-
Event 1
2.07
Arsenic
0.012
Q..00.0
0.000
0..000
0.000.
0.000
1 0.000
0.000
0.000
1 0.000
0:000
.0.000
1 0.012
Cadmium
0.008
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0..00.0
0,.000
0.008
Copper
0.709
0:000
0.000
0.000
0:000
0.000
0.000
0.000
0..000
0:000
0.000
.0.000
0.709
ChromiLvm
0.207
0.000
0.000
0 �000
0.00.0
0.000
0.000
0:000
0.000
0 000
.0.000
0.000
0..207
Lead
0.066.
0.000
0.000
0.006
0.000
0.0.00
0.0-00
0.000
0.000
0.000
0.000
0.000
0.066
Mercury
0.005
0.000
0.000
0.000
0.00.0
0.000
0.000
0.000
0.000
0.000
0:000
0.000
0.005
Molyb-
0.021
0.000
0.00.0
0.000
0.000
0..000
0.000
0.00.0
0.000
0.000
0.006
0.000
0.021
denum
Nickel
0.091
0.000
0.000
0.00.0
0.600
0.000
0.000
0.000
0::000.
0.000
0.000
0,000
0.091
Selenium
0.021
0.000`
0.000 :
0.000
O.:OOQ`
0..O.OU
0.000
0.000
0.00.0
0.00:0
0.000
0.000
0.021
Zinc
2.3-02
0.000
0.000 ''
0.000
0.000
0.0000
0..000.
0.000 '
0.00-01
0.000.
0:000
0.000
2.302
Total
Phos-
43.139
0,000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
43.139
chorus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
i ~isonment for knowing violations".
t L��Z�"'
���"� 1/14/2016
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
Operator:
ANNUAL LAND APPLICATION .tELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
City of Burlington WQ Permit #: WQ0000520 Field #: 5 Acres Utilized:
Dennis Simmons Annual Dry 'cons Applied: 36.30 Site #: CS036 Acres Permitted:
Dennis Simmons
Crop 1 Name: Fescue -Hay
Predominant Soil Series:
Crop 1 Max. PAN: 121
IbB2
Crop 2 Name:
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
17.5
17.5
0
o
o
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry
Wet,
Moist)
Precip.
Past 24
Ilrs.
inches
>
o� w
* o
':
* N
w
*
TKN
mg/kg
z Y
El
o
� w
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
6/9
149500
4.32
1-5519
East Burlington
Dry
<.5"
S
0.5
0.3
23800
2770
111
24.023
NA
Fescue
6/10
52000
4.32
0:535
East Burlington
Dry
<51
S
0.5
0.3
23800
2770
111
8.356
NA
Fescue
0.000
0.000
0.000
0:00;0
0.000
o.000
0.006
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0:000
0.000
0.0oo
0.000
0.000
0.000
0.000
0.000
O.Ooo
0,000
0.000
0.000
O':000
0.000
0.000
0
0
0.0:00
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000 ,
w)on
TOTAL&::
01
201500:-"
; %: `-:
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
32.379
0000
Lime Applied
Annuallbs/acre
0.012
0.00.8
0.709
0 207
0:066
0 005
0.021`
0.091 ^
, 0,021
2.302
43.13.9 :; : .... ...
.. .. .................
. .
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.414
0.405
50.298
20.303
7.465
0.171
1.332
4.583
0.311
65.933
Current Cumulative lbs/ac
0.426 ,_
0.413
51.007'
20,516,
7.539
0.1T6
1.3'.53
;�4.674
0.332'
.68 235
Permitted C. P. L. R.****
36
34
1338
267
15
374
89
2498
Permit PAN Limit1 st/2 nd Crop
•12`1
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual): 23.38
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
(,"_�',ator: Dennis Simmons Owner: Dennis Simmons Predominant Soil Series: FaB3
A_ s Used: 21.1 Acres Permitted: 21.1 Site #: CS036 Field #: 6
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
EB
7/13/15
2 j
3
4 J
L5J6
7
8j
19!
LOJ
11 j
12
% Solids
3.92
Arsenic
3
Cadmium
2
Copper
168
Chromium
52
Lead
31
Mercury
0.4
Molyb-
denum
5
Nickel
12
Selenium
5
Zinc
591
Total
Phos-
phorus
9570
)Aal Heavy Metal Field Loadings (Calculated in lbs/acre):
otal
1 J
21
3 j
4 f
5 f
6
7
8
9
10
11
12
DT/Ac./
y
App.
n
Event
1.11
Arsenic
0.007
0.000
0.000
0.000
0..000
0.0.00
0.000
0.000
0.000
1 0.000
0.000
0.000
1 0.007
Cadmium
0.004
0.000
0..00.0
0.0.00
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.004
Copper
0.372
6.00.0
6.000
0.000
0.000
0.00.0
0.000
0.000
0.000
0,000
0.000
0.000
0.372
ChromiL1111
0.115
10.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.115
Lead
0.069
0.000
0.000
0.000
0.000
0.000
0.000
1 0.000
0.000
0.000
1 0.000
0.000
0.069
Merciuy
0-.001
0.000
0.000
0.000
0.000,
0.000.
0.000
0.000
0.000
0.000
0.00.0
0.000
0.001
Molyb-
0.011
0.000
0.000
0.000
0.00.0
0.000
0.000
0.000
1. 0.000
0.000
0.000
0.000
0.011
denurn
Nickel
0.027
0.000
0.000.
0.000
0.000
0.000
0..0.00
.. UK
0.000
0.000
0:000
0.000
0.027
Selenium
0.01 i
0.000
0.000
0 0:00
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.011
Zinc
1.310
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000'
0.000 1
0.000
1.310
Total
Phos-
21.207
0.000
0.0.00
0.000
0.00.0
0.000.
0.000
0.000
0.006
0.000
0.000
0.000
21.207
horus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
i'-isonment for knowing violations".
Z�Le 4;2�_
1/14/2016
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION :w lELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: City of Burlington WQ Permit #: WQ0000520 Field #:
Land Owner: Dennis Simmons Annual Dry Tons Applied: 2338 Site #:
Operator: Dennis Simmons Predominant Soil Series:
Crop 1 Name: Fescue -Pasture Crop 1 Max. PAN:
145
FaB3
Crop 2 Name:
Acres Utilized: 21.1
CS036 Acres Permitted: 21.1
Cation Exchange Capacity (non 503): 0
Crop 2 Max. PAN:
°
y
A
Volume applied
enter one Solids/
( )
Liquid
Cu. Yds Gallons
o
/o
Solids
Volume
A hed er
pp p
Acre
(Dry Tons/Ac)
Residual Sources
PDES #, W #
(N Q ,
Fert., Animal
Waste, etc)
Soil
Cond.
D
Wet,
Moist)
Precip.
Past 24
Hrs.
inches
a
o b
o�
6
o
%e
, .
-
o'
�'
* N
TKN
mg/kg
Z >
o
01 °
w
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(Ibs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
8/22
143000
3.92
1.108,
East Burlington
Dry
<.5"
S
0.5
0.3
24700
3060
2
17.771)
NA :
Fescue
•6.000
0;000
0.000
0.000
0.000
0.000
0:009
0.000
0.000 '-`
0:000
0.000
0.006
0:000
0.000
0.000
0:000`
0:000
0.000
0.000 , `
- O':000
0.000
0.000
0,000
0.040
0,000
0,000
0 000
0.000
0.00v
0.060
0 000'
0.000
0.0.0.0
0
0
0.000 .:''
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0:000
0.090
TOTALS:
0
14;GUa
;:: ; :.:::
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
17.7-)
1-0.000'
Lime Applied
Annual Ibs/acre
U.007
0.0.04
" .0.372 .
0.115
._
0.i)69
0 00.E '<
0.011,
0.027
0;011
`' 1`:51:0
'`21.207 ::
.•:
.....................•.•.........-......... .
Date
lbs/ac
Prior Yeats Cumulative lbs/ac
0.357
0.453
54.664
19.634
7.474
0.165
1.091
4.024
0.23
71.455
Current Cumulative lbs/ac
0.364
"0.457
55.036
19:7.19
T.543i
0.1.66
1.1,02
4.051
0:241'
72.765
Permitted C. P. L. R.****
36
34
1338
267
15
374
89
2498
rmit Pe PA Lim' / nd N it 1st 2 Crop
145
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (1212006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name:
Permit #:
f"�`�*ator:
A__ A Used:
of Burlington
WQ0000520
Dennis Simmons Owner:
17.7 Acres Permitted:
Total Dry Tons Applied (Annual):
Cation Exchange Capacity (non 503 only):
Dennis Simmons Predominant Soil Series:
17.7 Site #: CS036 Field #:
55.26
IbB2
7
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kiz, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
EB
7/13/15
2
3
4
5
6
7
8
9
10
11
12
% Solids
1 3.92
Arsenic
3
Cadmium
2
Copper
168
ChrOffliLlin
52
Lead
31
Mercury
0.4
Molyb-
denum
5
Nickel
12
Selenium
5
Zinc
591
Total
Phos-
42horus
9570
iml Heavy Metal Field Loadings (Calculated in lbs/acre):
1 otal
1]
121
3
4
5
6
7
8
9
10
11
12
DT/Ac./
App.
Event
3.12
Arsenic
0.019
0.000
0.00.0
0.0.00
0.000
0.000
0.000
0.000
0.0,00
0.000
0.000
0.000
0.019
Cadmium
0.012
Q.000
0.000
0.000
0.000
0.000
0.0.00
0.000
0.000
0.000
0.000
0.000
0.012
Copper
1.0.49
0.000
0.000
0.000
0.000
0.000
0.000
0.0.00
O,000
0.000
0.000
0.000
1.049
Chromium
0-.325
0.000
0.000.
0.000
0.000
0.000
0.000
0.600
0.600
0.000
0.000
0.000
0.325
Lead
0.194
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0..000
0.000
0:000
0.000
0.194
Mercury
0.002
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.002
Molyb-
0.031
0.000
0.000
0.000
.0.000
0.00.0
0.000
0:000
0.000
0.000
0.000
0.000
0.031
denum
Nickel
0.075
0.,000
00.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.0.00
0.075
Selenium
0.031
0.000
0.000
0.000
0.000
0.000 1
0.000
0.000
0.000
0.000
0.000
0.000
0.031
Zinc
3.690
0.000
0..000
0.000
0.000
0.000
6.000
0.000
0.000
0.000
0.000
0.000
3.690
Total
Phos-
59.755
0.:000
0.000
0.000
.0-.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
59.755
horus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
i,- -isonment for knowing violations".
Z�t4;2_ 1/14/2016
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
Operator:
ANNUAL LAND APPLICATION x-rELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
City of Burlington WQ Permit #: WQ0000520 Field #: 7 Acres Utilized:
Dennis Simmons Annual Dry Tons Applied:, 55.26 Site #: CS036 Acres Permitted:
Dennis Simmons Predominant Soil Series: IbB2 Cation Exchange Capacity (non 503):
Crop 1 Name: Fescue -Pasture
Crop I Max. PAN: 90
Crop 2 Name:
Crop 2 Max. PAN:
17.7
17.7
0
°
°
Q
Volume applied
enter one Solids/
( )
Liquid
Cu. Yds Gallons
o
/o
Solids
Volume
Applied per
Acre
(Dry Tons/AC)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc}
Soil
Cond.
( ry
Wet
Moist
Precip.
Past 24
Hrs.
inches
a
4
9
m
o
°
o
;� w
^:
* w
0
�
w
* N'
,�
TKN
mglkg
z
(o o
mg/kg
Nitrate
and
Nitrite
mglkg
PAN Applied
( Ibs/acre)
Name of Crop Type
Receiving Residual
Application
Crop I
Crop 2
Crop 1
Crop 2
8/20 1
104000 1
3.92
0.9.60
East Burlington
Dry
<.5"
S
0.5
0.3
24700 1
3060
2 115,414,
CIA I
Fescue
8/21
91000
3.92
0.840
East Burlington
Dry
<.5"
S
0.5
0.3
24700
3060
2
13.487
NA
Fescue
8/22
143000
3.92
1.321 °'
East Burlington
Dry
<.5"
S
0.5
0.3
24700
3060
2
21.194 '
NA
Fescue
0 000
0.000 .
' 0..000 `.
0.000
0.000 '
0.00.0
0.000
0.000'
a 000
0:000
0.000
0.000
0:000 " '
0.000
0.000
0.000
0.000
0.000
0:000
0.000
0;000
0.000
0.000
"0.:000
0
0
0..000
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000
n.hno
TOTALS:
u
33xuilo
As
Cd
Cu
Cr
Pb
Hu
Mo
Ni
Se
Zn
P
50.094
o.000
Lime Applied
Annual lbs/acre
0" O] 9' , .
0 01:2'
1.04"9
0.323
-0. I �?4
0 002.
0;031i'
' Oc075 "
� ',0:031 _,
'3:690
59.755 ::.......:.... ... . .
: " .:: ":
..
.. >...:.": " " " " "
. ... .. .. .
............................
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.37
0.416
52.197
16.421
7.004
0.14
1.196
3.975
0.243
69.302
Current Cumulative lbs/ac
0.389 :.
0.A28"
53.246
16.746 '
:7. 98
� 0"142 ...
1:227
� 4 050
0 2;74
72 992
Permitted C. P. L. R.****
36
34
1338
267
15
1 374
1 89
1 2498
Permit PAN L i met 1st/Znd Crop
90
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
*** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
Signature of Land Applier Date aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (1212006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name:
Permit #:
("­'"ator:
ti es Used:
City of Burlington
WQ0000520
Dennis Simmons Owner:
11
Acres Permitted:
Total Dry Tons Applied (Annual):
Cation Exchange Capacity (non 503 only):
Dennis Simmons Predominant Soil Series:
11 Site #: CS036 Field #:
30.81
IbB2
8
Residual Analvsis Data (Heavv Metals and Total Phosphorus use mg/k2, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
11
EB
7/13/15
21
3
4
5
61
7
8
9 1
10
1j
12
% Solids
1 3.92
Arsenic
3
Cadmium
� 2
Copper
168
Chromiuin
52
Lead
31
Mercury
0.4
Molyb-
denum
5
Nickel
12
Selenium
5
Zinc
591
Total
Phos-
p.liorus
9570
A 'ual Heavv Metal Field Loadings (Calculated in lbs/acre):
1 otal
1
2
3
4
5j
6
7j
L8
9
10
11
12
DT/Ac./
App.
Event
2.80
Arsenic
0.017
0.000
0.000 1
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.017
Cadmium
0.011
0.000
0.000
0.000
0.00.0
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0:011
Copper
0.941
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.941
Chromiun
0.291'
0.000
0.000
0.000
0.000
0.060
0.000
0.00.0
0.000
0.000
0.0:00
0.000
0.291
Lead
0.174
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0-000
0.000
0.000
0.174
Mercury
0.002
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0:002
Molyb-
0.028
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.028
denum
denum
Nickel
0..067
0.00-0
0.000
0.000`
0.000
0.000
0.000
0.000
0.000
0.000
0.000-
0.000
0.0.67
Selenium
0.028
0.000
0.000
0.000
0.000
0:000
0.000
0.000
0.000
0.000:
0.000
0.000
0.028
Zinc 1
3.311
0.000
0.000
01,000
0.000
9.000
0.000
0.000
0.000
0.060
0.000
0.000
3.311
Total
Phos-
53.611,
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
53.611
s,horus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
it ~isonment for knowing violations".
;95L 1/14/2016
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION - XLD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: City of Burlington WQ Permit #: WQ0000520 Field #:
Land Owner: Dennis Simmons Annual Dry Tons Applied: 30.81 Site #:
Operator: Dennis Simmons
Crop 1 Name
Fescue -Pasture
Predominant Soil Series: 1bB2
Crop 1 Max. PAN: 90 Crop 2 Name:
Acres Utilized: 11
CS036 Acres Permitted: 11
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
o
o °
Q
Volume applied
(enter one) Solids/
Liquid
n
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
SoilPrecip.
Cond.
(D
(Dry,
Dist)
Past 24
ems•
inches
y
=
° �,
a o.
°
o
w 'v
c� -
N'
w
w
CD
N'
«
TKN
mg/kg
Z a
B
o
°Q °
R.
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
lbs/acre
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop I
Crop 2
8/20
110500
j 3.92
1:642
East Burlington
Dry
<.5"
S
0.5
0.3
24700
3060
2
26:352
NA
Fescue
8/21
78000
3.92
L t5911
East Burlington
Dry
<,5"
S
0.5
0.3
24700
3060
2
18.60.1
18.6.61
0.0Q0
0.000 _
0.000
0:000
0.000
6.000
0:000
0.600
0:000
0000
0:000 -
0.000
0.606
0.000
0.000
0,000.
0.000
0 000
0:000
1
0.000
0.000
0.000
.0♦000
o_000
&Q00
0.000
0.000
0.000
0.000
0.000
0
0.000
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000
0.000
TOTALS:
o
l'ssso0
As
Cd
Cu
Cr
Pb
H�L,
Mo
Ni
Se
Zn
P
44.953 `
19.604 '
Lime Applied
Annual lbs/acre
0.0,1T, ''
0.011.
0.941
� 1,J 1
0.174
0 002
0.0�8 `
0:067
-0 428
1.311
' 53.611 ' ;' . ,' ', ;',', : ..: '; .'
::':':::: ': :: >; : : >: :
.............I.............
............................
. .................
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.332
0.435
53.941
17.923
7. ,51
0.147
1.065
3.833
0.228
69.357
Current Cumulative lbs/ac
0.349
0.44.6.
54.882
1.8.214
7.525`
0,149 .
.• 1.093 .
3.900
0.256
72.668
Permitted C. P. L. R.****
36
34
1338
1
267
15
374
89
2498
Permit PAN Limit ' 1 t/ s 2 nd Crop
90
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
,C *Application Method: S - Surface, IN - Injection, INC - Incorporation
•UU� 1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual): 22.31
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
C `ator: Dennis Simmons Owner: Dennis Simmons Predominant Soil Series: IbB2
A... es Used: 8.4 Acres Permitted: 8.4 Site #: CS036 Field #: 9
Residual Analvsis Data (Heave Metals and Total Phosphorus use ma/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
EB
7/13/15
_2j
3
4
5
6
7 1
8
9
10
111
12
% Solids
1 3.92
Arsenic
3
Cadmium
2
Copper
168
Chromium
52
Lead
31
Mercury
0.4
Molyb-
denum
5
Nickel
12
Selenium
5
Zinc
591
Total
Phos-
phorus
9570
I ul Heavv Metal Field Loadings (Calculated in lbs/acre):
l otal
1
2
3
4
5
6
7
8
9
10
11
12
DT/Ac./
0
APP-
14
Event
2.66
Arsenic
0.016
0.000
1 9.000
0.000
1 0.000
0.000
0.000
1 0.000
0.000
0.000
0.000
0.000
0.016
Cadmium
0.011
0.000
0.000,
0..000-
0..000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.011
Copper
0.892
0.000
0.00.0
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.1000
0.892
Chromiun,
0.276
0.000
0.000
0.00.0
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.276
Lead
0.165
0:000
0.000
0.006
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.165
Mercury
0.002
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.0.00
0.002
Molyb-
0.027
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
--0.027
mum
Nickel
0.064
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.064
Selenium
0.027
0.000
0.000.
0.000 1
0.000
0.000
0.000
1 0.000
0.000 1
0.000
0.000.
0.000
0.027
Zinc 1
3.139
0.000
0.000
0.000
0.000
0.000
0.000
0-:0.00
0.000
0:000
0.000
0.000
3.139
Total
Phos-
50.836
0.000
0.00.0
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
50.836
horus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
ij •isonment for knowing violations".
Z-e 4�/ �; 1/14/2016
Signature of Land Applier
Date
DENR FORM MFLSF (1212006)

ANNUAL LAND APPLICATION - iELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: City of Burlington
Land Owner: Dennis Simmons
Operator: Dennis Simmons
Crop 1 Name:
Fescue -Pasture
WQ Permit #: WQ0000520 Field #:
Annual Dry Tons Applied: .212.31 Site #:
Predominant Soil Series: IbB2
Crop 1 Max. PAN: 90 Crop 2 Name:
CS036
Acres Utilized: 8.4
Acres Permitted: 8.4
Cation Exchange Capacity (non 503); 0
Crop 2 Max. PAN:
.�
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
ado
Solids
Volume
Applied per
Acre
(Dry Tons/AC)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry'
Moist)
Precip.
Past 24
Hrs.
inches
y
��
F°
o w
o
h
N'
Z
7d
w y
* N
TKN
mg/kg
Z Y
�o c
mg/kg
Nitrate
and
Nitrite
mglkg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
8/21
136500
3.92
2.656
East Burlington
Dry
<.5"
S
0.5
0.3
24700
3060
2
NA
Fescue
p 00.0
0.000
0 000
r2JO
0.000
0 0,6
0.000
0.000
.
1 0.000
o OQo
0.000
0.000
0.000
0.000
0:000
0.000
0.000
0'.000
0.000
0.000
0 0.00
0.000
0.000
0:000
0.000
0.000
0;p,0:0
0.000
0.000
0
0
0:000"'"
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000
0.000
TOTALS:
0
136soo
As
Cd
Cu
Cr
Pb
HI!
Mo
Ni
Se
Zn
1'
42.628' °
0.000
Lime A plied
Annual lbs/acre
0.,
0.011
0.892
6476
0 :1h5
c� UO2'`
" 0 02,7 w
0.064
O:Q27. "
1139',
50:836 ::
::: <::'::: ::::
...........................
............................
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.1591
0.2428
32.4828
11.49,19
4.5429
0.1129
0.9769
2.144
0.1596
42.8496
Current Cumulative lbs/ac
0.175
0.253
33.3:75
11.771 .
4 708
; 0.415' `
L003
2.20$ :
0.186
45.989
Permitted C. P. L. R.****
36
1 34
1 1338
267
15
1
374
89
1 2498
tPANL 2 Perms �mrt 1 t/ nd r s Co p
9 0
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name:
Permit #:
f ;ator:
A... es Used:
City of Burlington Total Dry Tons Applied (Annual):
WQ0000520 Cation Exchange Capacity (non 503 only):
Dennis Simmons Owner:
14 Acres Permitted:
Dennis Simmons Predominant Soil Series:
14 Site #: CS036 Field #:
30.28
CM
10
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent ft
Sample or
Com-
posite
Date
11
EB
6/8/15
21
4 j
51
6
7
8
9
10
11 I
12
% Solids
3.99
Arsenic
3
Cadmium
2
Copper
143
Chromium
47
Lead
13
Mercury
0.5
Molyb-
denum
5
Nickel
14
Selenium
5
Zinc
427
Total
Phos-
nhorus
12000
ual Heavy Metal Field Loadings (Calculated in lbs/acre):
1 otal
1
2
3
4
5
6
L7J
8
9
10
11
12 j
DT/Ac./
y
M
App.
Event
2.16
"
Arsenic 1
0.013
0.000
0.000 1
0.000
0.000
0.000
1 0.000
0.000
1 0.000
0.000
0.000
0.000
0.013
Cadmium
0.009
0.0.00
0.000
0;000
0.000
0.000
0.000
0.000
1 0:000
0.000
0.000
0..000
0.009
Copper
0.619
0..000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.0.00
0-.619
Chromiuni
0.203
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.203
Lead
O.U56
0.000
0.000
0.000
0.000
0..000
0.000
0.000
0.000
1 0.000
0.000
0.000
1 0.056
Mercury
0.0.02
0..000
0.000
0.000
0.000
0.000
0.000-
0.000
0.000
0.000
0.000
0.000
0.002
Molyb-
0.022
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.022
denum
Nickel
0.061
0.000
0.0.00
0.000
0.000'
0.00:-0
0;000
0.000
0.000
0.000
0.000
0.000
0.061
Selenium
0.022
0..000
0.000
0.000
0.00.0
0.0.00
0.000
0:00.0
0.000
0.000
0.000
0.000
0.022
Zinc
1.847
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000 1
0.000
0.000
1.847
Total
Phos-
51.912
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
51:912
horus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
i,, •isonment for knowing violations".
ZJ: 4;2/ 1/14/2016
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
Operator:
ANNUAL LAND APPLICATION . iELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
City of Burlington WQ Permit #: WQ0000520 Field #: 10 Acres Utilized:
Dennis Simmons Annual Dry Tons Applied: 30'.28 Site #: CS036 Acres Permitted:
Dennis Simmons
Crop 1 Name: Fescue -Pasture
Predominant Soil Series:
Crop 1 Max. PAN: 156
CfB
Crop 2 Name:
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
14
14
0
o
N �
+ `0
c�
Q
Volume lied
applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc}
Soil
Cond.
(Dry,
Wet
'
Moist)
Precip:
Past 24
Firs.
inches
a
'�
� �
o� w
o
w K
o �-
o
p
=
70
w, •,
cc �
*
*
8
TKN
mglkg
Z
ct
o
o�ro �
�.
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(Ibs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
7/9
58500
3.99
0 695
East Burlington
Dry
<.5"
S
0.5
0.3
27300
4010
2
12.506
NA "
Fescue
7/10
123500
3.99
1.468
East Burlington
Dry
<.5"
S
0.5
0.3
27300
4010
2
26.402z
NA
Fescue
0:000
0.000
0:000
0 0.00.
0.000F
0.000
0.000
0.000000
0,0000.060,
0.0o00:0.00
0.0000.000
0.000-Q.000.0.000
Q,
0
0 000
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
11'000
0.00,0
.........
'
TOTALS:
(i
1s2000,::::::''::::;
As
Cd
Cu
Cr
Pb
Hof
Mo
Ni
Se
Zn
P
38.908
6.600
Lime A plied
Annual lbs/acre
0_613•
0.009
0.619
0 203,'
' 0 056
0 002
0:022
6.061
0 022.
1:847
51012 ::: :::.:: .:.:.:..:::;::
::::::::::::::::::::::::::':
...........................
... ......... .. ..
=: :
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.189
0.157
31.685
9.214
4.162
0.083
1.04
2.229
0.227
43.319
Current Cumulative lbs/ac
0.202
0.166
32.304
9.417
4.N$
0.085
1.062
. -•2.290
0,249
45.166
Permitted C. P. L. R.****
36
34
1338
267
15
374
89
2498
Permit PAN Limit lst/2nd CroP
p
156
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name:
Permit #:
c`�rator:
j, .!s Used:
of Burlington
WQ0000520
Dennis Simmons Owner:
18.8 Acres Permitted:
Total Dry Tons Applied (Annual):
Cation Exchange Capacity (non 503 only):
Dennis Simmons Predominant Soil Series:
18.8 Site #: CS036 Field #:
51.51
IbB2
11
Residual Analysis Data (Heavy Metals and Total Phosphorus use ma/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
11
EB
5111115
21
31
4
5
6
7
8 J
9
10 f
11
121
% Solids
4.32
Arsenic
3
Cadmium
2
Copper
171
Chromium
50
Lead
16
Mercury
1.1
Molyb-
denum
5
Nickel
22
Selenium
5
Zinc
555
Total
Phos-
p,h2rus
10400
dial Heavy Metal Field Loadings (Calculated in lbs/acre):
.,tal
1
2
3
4!
5
6
7
8
9
10
11
12
DT/Ac./
-
-
0
App.
Event
2.74
"
Arsenic
0.016
0.000
0.00.0
0..000
0.000
0.00'0
0.000
0:0.00
0.000
0.000
0.000
0.000
0.016
Cadmium
0.011
0.000
0.000 1
0.000
0.000
0.000
0.000
0.000
0.000
1 0.000
0.000
0.000
.0.01-1
Copper
0.937
0.000
0.000
0.000
0.000
0.000
`0.000
0.000
0.000
0.000
0.000
0.000
0.931
Chromium
'0.274
0.000
0.000
0.000
0.000
0.000
0.000
0_000
0.00
06000
0.000
0.000
0.274
Lead
0.088
0.000
0.000:
0.000
0.000
0.0.00
0.000
0.000
0.000
0.000
0:000
0.000
0.088
Mercury
0.006
0.000
0.000
0.00.0
0.000
0.000
0.000
0.000
0.000
0.000
0 000
0.000
0.006
Molyb-
0.027
0.000
0.000
0.000
0:000
0.000
0.000
0,000
0.00-0
0.000
0.000,
0.000
0.027
denum
Nickel
0.1-21
6.000
0.00.0
0.000
0.000
0.000
0.000
0,000
0.000
0.000
0.000
0.000
0.121
Selenium
0..027
0.000
0.600
0.000
0.000
0.000
0.000
O:000.
0.000
0.000
0.000
0.000
0.027
Zinc
3.0.41
0.000.
0.000 1
0.000
0.000
0.00.0
0.000
0.040
0.000
0:000
0.000
0..000
3.041
Total
Phos-
56.992
0.000E00
0.000
0.000
0.000
0.000
0.000
0.000`
0:00.0
0:000
0.000
56992
°",horus
"1 certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
i -isonment for knowing violations".
Z�t4;2_ 1/14/2016
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
Operator:
ANNUAL LAND APPLICATION iELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
City of Burlington WQ Permit #: WQ0000520 Field #: 11 Acres Utilized:
Dennis Simmons Annual Dry Tons Applied: 5L51 Site #: CS036 Acres Permitted:
Dennis Simmons Predominant Soil Series: TbR7 Cation Exchange Capacity (non 503):
Crop 1 Name: Fescue -Pasture
Crop 1 Max. PAN
91
Crop 2 Name:
Crop 2 Max. PAN:
18.8
18.8
0
°
y o
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
p
Acre
(Dry Tons/Ac)
Residual Sources
PDES #, W #
(N Q ,
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry,
Wet
Moist)
Precip.
Past 24
Hrs.
inches
y
b
o� w
* o
o
c
p
w
* N
* ?'.
TKN
mg/kg
Z
w'
mg/kg
Nitrate
and
Nitrite
mglkg
PAN Applied
pp
(lbs/acre}
Name of Crop Type
Receiving Residual
Application
Crop 1
Crap 2
Crop 1
Crop 2
6/11
123500
4.32
1,.183
East Burlington
Dry
<•5"
S
0.5
0.3
23600
2780
2
18.078
NA
Fescue
6/12
162500
4.32
1.5517
East Burlington
Dry
<.5"
S
0.5
0.3
23600
2780
2
23.786
NA
Fescue
0.000
0.000
0.000
Q000
0.000
0.000
0:00&
0.000
0.000
6.00b
0.000
0.000
OtdQO
0.000
0.000
0.000
0.000
0,000
0.000
0.000
0.000
O•000
0,000
0.000
6,000
0.000
0.000
0 000.
0.000
0.000
0
0'
0.:000
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000 ;
0.000
TOTALS:
0
2g6000
As
Cd
Cu
Cr
Pb
H<,,
Mo
Ni
Se
Zn
P
41.864
0,000
Lime Applied
Annual lbs/acre
0:0f6
0.0t1
0.937 '
Q 274
0.o8x
0.006
U.027
U L21
0:(i27
` 3 04:1
56.992 ;:;. .:::..:. >
..
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.135
0.107
11.511
3.103
1.752
0.035
0.363
1.273
0.125
25.13
Current Cumulative lbs/ac
0.151
0.118
12.448
3377
1'.1.940
0.041
0.390'
1.3.94
0.152
28.171
Permitted C. P. L. R.****
36
34
1338
267
15
374
89
2498
Permit PAN Limit 2n 1st/ d Crop
91
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual): 58.20
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
C�'�"ator: Dennis Simmons Owner: Dennis Simmons Predominant Soil Series: IbB2
ti__zs Used: 24.2 Acres Permitted: 24.2 Site #: CS036 Field #: 12
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Com-
..
Date's
I L2] EB
0000100
mom
on
Total
Phos-
_01iorusmMENEEMENEEN.
'ual Heavy Metal Field Loadings (Calculated in lbs/acre):
1 otal
1J
L_2_J
1 3
4
5
6 1
7
8
9
10
11
12
DT/Ac./
0
App -
14
Event
1.65
0.76
Arsenic
0.010
0.005
0 000
0.000
1 0,000
0.00:0
1 0.000
0.000
0.000_
0.000
0.000
0.000
0.014
Cadmium
0.007
0.003
0.000
0.000
0.-0.00
.0.000
0.000
0.000
0:000
0.000
0.000
0.000
0.010
Copper
0.563
0.217
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.780
Chroiniuin
0.165
0:071
0.000
0.000
0.000
0.000
0.000
'0.000
0.000
0.000
0.000
0.000
0:236
Lead
0.053
1 0.020
0.000
0.000
0.000
0.000:
0.0,00
O':000
0.000
0.000
0.000
0.000
0.072
Mercury
0.004
0_001
0.000
0.00,0
0.000
0.00-0
6.000
0.000
0.000
0.000
0.000
0.000
1 0.004
Molyb-
0,016
0..008
0.000
0.00.0
0.000
0.000
0.000
0.600
0.000
0.000
0.000
0.00.0
0.024
denum
.
Nickel
0.072
0.021
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1 0.000
0.000
0.094
Selenium
0.016
-0 008,
0.000.
0.000
0.000
0;000
0.000
0.000
0.000.
0.000
0.000
0.000
0.024
Zinc
1.826
0.649
0.000
0.000
0.000
0.000
0".000
0.000
0.000
0.000
0.000
0.000
2.475
Total
Phos-
34.216
18.240
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
'52.456
phorus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
i,? --isonment for knowing violations".
;e:: 4; / 1/14/2016
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
Operator:
ANNUAL LAND APPLICATION x YELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
City of Burlington WQ Permit #: WQ0000520 Field #: 12 Acres Utilized: 24.2
Dennis Simmons Annual Dry Tons Applied: 58`20 Site #: CS036 Acres Permitted: 24.2
Dennis Simmons Predominant Soil Series: IbB2 Cation Exchange Capacity (non 503): 0
Crop 1 Name: Fescue -Pasture
Crop 1 Max. PAN:
91
Crop 2 Name:
Crop 2 Max. PAN:
&"
o y
«� o
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
oho
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry,
Wet,
Moist)
Precip.
Past 24
Hrs'
inches
>
cs b
n'
o w
� ��
o
�;
�, �,
�,
* N
� o•
o
7y
w
* N
w
TKN
mglkg
Z Y
.; 9
aoa o
-
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
lbslacre
( )
Name of Crop Type
Receiving Residual
Application
Crop 1
Crap 2
Crop 1
Crop 2
6/10
162500
4.32
- 1.210
East Burlington
Dry
<.5"
S
0.5 1
0.3
23600
2780
2
18.479
NA
Fescue
6/11
58500
4.32
0.435
East Burlington
Dry
<5"
S
0.5
0.3
23600
2780
2
6.652
NA.
Fescue
7/9
110500
3.99
0,.760
East Burlington
Dry
<.5"
S
0.5
0.3
27300
4010
2
13.666
NA
Fescue
0:000
0.0%
0.000
0.000
0:000
0;000
00.00
0.000
0 000.
0..000
0.000 °'
0:00:0
0000`
0.000
0000
0.000
0.000
0:000
0.000
0.000
0.000
0,000
0.000
01.00.0
0 000
0.i00
0
0
0:00'0'_
Residuals Applications totals on FORM
FSF supp (attach FORM FSF supp
to this form):
O':000
U.000
TOTALS:
al
As
Cd
Cu
Cr
Pb
Hg,
Mo
Ni
Se
Zn
P
38.797
0.000
Lime Applied
Annual Ibs/acre
0:014
0.010
- 0:7$0 ;
©236
0.072
0 004,
6.024 -
0 09:4
0024
2.475-
52.456 ::::;.'::: :. ,
:.: . ....
....
.... .... ................
<
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.16
0.125
16.211
5.245
2.852
0.04 7
0.689
1.488
0.16
27.222
Current Cumulative lbs/ac
0.174
0.13?.,
16 Q91
5.481..
1924
0 0,5.4
0.713•
1.582
°' 0.184
29,697
Permitted C. P. L. R.****
36
34
1 1338
1 267
1 15
1 374
89
1 2498
' ' Permit PAN Limit 2nd Cr t 1st/ Crop
91
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual):
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
(_1___\,ator: Ervin Kimrey Owner: Ervin Kimrey Predominant Soil Series:
A__zs Used: 3.2 Acres Permitted: 3.2 Site #: OR007 Field #:
4.54
HrB
IA
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
SB
5111115
2
3
L4J
L5JL6J
7 J
L8J9
10
11
12
% Solids
4.19
Arsenic
3
Cadmium
2
Copper
184
Chromium
257
Lead
13
Mercury
0.4
Molyb-
denum
5
Nickel
16
Selenium
5
Zinc
414
Total
Phos- Ljiborus
Iual Heavy Metal Field Loadings (Calculated in lbs/acre):
i otal
1
2
3]
L4J
L5J
6
7
8
9j
LOJ
11 J
12
DT/Ac./
c
App.
y
Event
1.42
Arsenic
0.009
1 0.000
0.000
0.000
1 0.000
0.000
0.000
1 0.000
0.000
0.000
0.000
0.000
1 0.009
Cadmium
0.006
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0000
0.006
Copper
0.523
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.523
Chromium
0.730
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.7M
Lead
0.037
0.000
0.0.00
0:000
0.006
0.000
0.000
6.000
0.000
0.000
0.000
0.000
0.037
Mercury
0.001
O OOU
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.001
Molyb-
0.014
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
10.014.
denum
Nickel
0.045
0.000
0.000.
0.0.00
0.000
0.000
0.000:
0.000
0:000
0.000
0.060
0.000
0.045
Selenium
0.0.14
0.000
0.0.00
0.000
0.000
0.000 1
0.000
0.000
0.000
0.000 10:000
0.000
0.014
Zinc
1.176
0..000
0.0.00
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1.176
Total
Phos-
67.592
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
.0.000
67.592
horus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
i;° Isonment for knowing violations".
(��. 1/14/2016
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION i- tELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: City of Burlington WQ Permit #: WQ0000520 Field #: 1A Acres Utilized: 3.2
Land Owner: Ervin Kimrey Annual Dry Tons Applied: 4.54 Site #: OR007 Acres Permitted: 3.2
Operator: Ervin Kimrey Predominant Soil Series: HrB Cation Exchange Capacity (non 503): 0
Crop 1 Name: Fescue -Hay Crop 1 Max. PAN: 211 Crop 2 Name: Crop 2 Max. PAN:
o
r.a
A
Volume applied
PP
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
( ry
Wet
Moist)
Precip.
Past 24
Hrs.
inches
Y
¢ w
* o
�
C
o
w �'•
�.
CD
w "
* N
'*
0
TKN
mg/kg
z
q
o
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
PP
(Ibs/acre)
Name of CropType
yp
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
6/23
26000
4.19
1..420
South Burlington
Dry
<.5"
S
0.5
0.3
72800
30500
2
79334
NA .
Fescue
0:000
0.000
0.000
0.000
_0.000
0.000
0.066
0:000
0:,000
0.000
0.000 °
0.000
0.000'
:0.0c10
0-06..6'
0.096
0.00w .
0.00:0
0>00.0
0:000 '
ti.000• .
0:000
0.000".
0.000-
0000
0.000
-0moo..
0.000 `
0.0oo '
6s006 ,.
0
0'
0' 000
Residuals Applications totals on FORM
FSF supp (attach FORM FSF supp
to this form):
uao
0.000 ..•>:.:.:
>.
:..:` ::.;
TOTALS:
0
26000
:; ::.':.:::
As
Cd
Cu
Cr
Pb
H�
Mo
Ni
Se
Zn
P
79.331-
0:000
Lime Applied
Annual lbs/acre
0..00.9
6,606
0.523 .
0. i!30
0;03T
0:001
Q.014
0.04.5'
o:614
1.176 :
67 592 ::
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.026
0.016
1.821
1.651
0.141
0.006
0.044
0.094
0.038
4.221
Current Cumulative lbs/ac
0.035
0:022
2.344
2.38.1
0.178'
0.001
0058
0.1,3:9
0.052
5.397
Permitted C. P. L. R.****
36
34
1 1338
267
1 15
1
1 374
89
2498
it P Perm AN Limit 1st/ 2nd Crop
211
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, InjectioniIncorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual):
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
('^'�ator: Ervin Kimrey Owner: Ervin Kimrey Predominant Soil Series:
A__ es Used: 7.7 Acres Permitted: 7.7 Site #: OR007 Field #:
13.63
HrB
113
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
Ll J
SB
5111115
2
3j
14
5
6
7
8
9
10
11
12
% Solids
4.19
Arsenic
1 3
Cadmium
2
Copper
184
Chromium
257
Lead
13
Mercury
0.4
Molyb-
denum
5
Nickel
16
Selenium
5
Zinc
414
Total
Phos-
[)lxorasj
23800
I
I
t I
I
I
I
I
I
ial Heavy Metal Field Loadings (Calculated in lbs/acre):
i otal
1 11
2
31
4
5
L6J
7 J
L8J
9
10
11
12
DT/Ac./
App.
y
Event
1.77
Arsenic
0.011
1 0.000
0.000
0.000
0.000
0.006
0.000
0.000
0.000
0.000
0.00.0
.0.000
1 0.0.11
Cadmium
0.607
0.000
0.000
0:000
0.060
0.000
0.000
0.000
0000
0.000
0.000
0.000
0.007
Copper
0.651
0.000
0.000
0.0010
0.000
0.000
0.000
0..000
0.000
0..000
0.600'
0.000
0.651
Chromiuni
0.910
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0,0100
0.000
0.910
Lead
0.046
0.000
0.000
0.000
0.000
0.0.00
0.000
0.000
0.000
.0.000
0.000
0.000
0.046
Mercury
0.001
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.00.0
0.000
0.000
0.001
Molyb-
0.018
0.000
0.000
0.000
0.000
0.0.00
0.000
0.000
0:00.0
0.000
0.000
0.000
0.018
denum
Nickel
0.057
0.000
0:000
0.000
0.000
0.000
0.000
0.000
0.000
0:000
0.000
0.000
0.057
Selenium
0.018
0.000
0.000
0.000
0.000
0.600
0.000
0.000
0.000
0.000
0.000
0.000,
0.018
Zinc
1.466 1
0.000
0.000
0.000,1
0.000
0.060-
0.000
0.000
0.000
0..000
0.000
0.000
1.466
Total
Phos-
84.252
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
84.252
chorus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
it Isonment for knowing violations".
Zy 1/14/2016
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION - GELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: City of Burlington
Land Owner: Ervin Kimrey
Operator: Ervin Kimrey
Crop 1 Name: Fescue -Hay
WQ Permit #: WQ0000520 Field #:
Annual Dry Tons Applied: 13.63. Site #:
Predominant Soil Series: HrB
Crop 1 Max. PAN:
211 Crop 2 Name:
1B
Acres Utilized:
OR007 Acres Permitted:
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
7.7
7.7
0
$..
o=
y o
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
aka
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry,
Wet'
Moist)
Precip.
Past 24
Hrs.
inches
Y
r
d
oa
o
# w
o'
4
' c F
w
* N
0
TKN
mg/kg
Z
q
�•
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
lbs/acre
( )
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
6/24
78000
4.19
1.770
South Burlington
Dry
<.5"
S 1
0.5
0.3 1
72800
30500 1
2
98.910'
NA
Fescue
0.000
0:000
0:000
0.000
0 000
0.0001
0.000
0.000
0.0.00
;0.000
0.000
0:000
O;o00
0:000
0.600
0:000
6:000
0.000. "
0.000
0000
0.000_
.0.000
0,000''
0000:
o:000
0.000
0.000
O..Q00
O.000 `'
0.00
0
0
: > :
�'0.000
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000 '
0:000
TOTAt :
o
7a00o
As
Cd
Cu
Cr
Pb
H�;
Mo
Ni
Se
Zn
P
98.910
O.OQO "
Lime Applied
Annual lbs/acre
0.011
0 OQ7
0.6,51
0 910
u46
0.001
0.018
0 057
0:018
1466
84 252 :< :::.. .. .:.:.:::
."
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.024
0.012
1.464
1.052
0.13
0.005
0.039
0.083
0.027
3.495
Current Cumulative lbs/ac
0-.035
0.019
2.115
1.962
0.176, .,
0:066
4057
0.140-
0:045
4:961
Permitted C. R L. R.****
36
34
1 1338
1 267
1 15
1
374
89
1 2498
Permrt PAN Limiti t/2nd Crop
- -
2 it
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation -1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual):
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
f -ator: Ervin Kimrey Owner: Ervin Kimrey Predominant Soil Series:
A_ es Used: 18.8 Acres Permitted: 18.8 Site #: OR007 Field #:
34.07
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
SB
5111115
2 j
3
L4J
L5J
L6J
1718
9
LOJ
11
1121
% Solids
4.19
Arsenic
3
Cadmium
2
Copper
184
ChromiLun
257
Lead
13
Mercury
0.4
Molyb-
demun
5
Nickel
16
Selenium
5
zinc
414
Total
Phos-
phorus
23800
1xal Heavy Metal Field Loadings (Calculated in lbs/acre):
1 otal
1 11
L2]31
L4J
5
6
7
L8J
9
10
11
12
DT/Ac./
M
App.
Event
1.81
Arsenic
0.011
1 0.000
0.000
0.000
1 0.000
0.000
1 0:000
0.000
0.000
1 '0.000
0.000
0.000
1 0.011
Cadmium
0.0`07
0.0.00
0.000
0.000
0.000
0.000
0.000
0,000
0.000
0.000
0.,000
0.000
0.007
Copper
0:667
0.000
0.000
0,000
-0.000
0.000
0.000
0.000_
0.000
0.000
0.000
0.000
0.667
Chromium
0.931
0.000
0.000
0.000
0.000
0.000
0.000
0.00.0'
0.000
0.000
0.000
0.000
0..931
Lead
0.047
0.000
0.000
0.000
0,000
0.000
0.060
0.000
0.00.0
0.000
0.000
0.000
0..047
Mercury
0.001
0.000
0.000
0.00.0
0.060
0.000
0.000
0.000
.0.000
0.000
0.000
0.000
0.001
Molyb-
0.018
0.000
0.000
0.000
0.000
0.000
0.0W
0.000
0.000
0:000
0:000
0.0.00
0.018
denum
Nickel
0.058
0.0.00
0.:.000
0.000
0.00,6
0.000
0.000
0.000.
0.000
0.000
0.0.00
0.000
0.058
Selenium
0.018 1
0.000
0.000
0.000
06000 1
0.000
0:000
0.000 1
0.000
0.000
0.0 0
0.000
0.018
zinc
1.500
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.006
0.000
1.500
Total
Phos-
86.251
.0.000
0.000.
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
86.251
horus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
i.t i.sonment for knowing violations".
1/14/2016
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
Operator:
ANNUAL LAND APPLICATION x-ALD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
City of Burlington WQ Permit #: WQ0000520 Field #: 2 Acres Utilized:
Ervin Kimrey Annual Dry Tons Applied: `34.:07 Site #: OR007 Acres Permitted:
Ervin Kimrey
Crop 1 Name: Fescue -Hay
Predominant Soil Series: HrB Cation Exchange Capacity (non 503):
Crop 1 Max. PAN: 211 Crop 2 Name: Crop 2 Max. PAN:
18.8
18.8
0
o Y
Cd O
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry,
Wet
Moist)
Precip.
Past 24
Hrs.
inches
Y
'0
c� �?
w
o
w'
o'
Z
;�
N
m
0
TKN
mg/kg
Z Y
iy
aE o
w•
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
lbs/acre
( )
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
6/23
195000
4.19
1.812
South Burlington
Dry
<.5"
S
0.5 1
0.3
72800
30500
2
101178
NA
Fescue
0.000 •'
•0.000
0''.000
0:000
0.000
0.00:0
0.000
0.000 `
0.000
'0.000
0.000
0.000
-
A.000
0.000
0.000
0:000
0.000
0.000
0:000
0.00))
0:000` ,
0.000
0.00.0
0.000
OOQO
0.000
0.000,
0...000
0:000
0.000
.0.060,
0:000
" 0.000
0
0`
0:000 '
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0 0(10
0.000
TOTALS:
0
19.50.00
As
Cd
Cu
Cr
Pb
Hg.
Mor37
Se
Zn
P
1-01.278
Q.000
Lime Applied
Annual lbs/acre
koll
`0.00.7
0.667
0:931 ',
•0.047°
. •0001
00'18
0:618
1.500:
86.251 :: .:
.............. .....
.:
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.027
0.014
1.764
0.951
0.144
0.005
0.061
0.037
4.375
Current Cumulative lbs/ac
0:038
0.021
2.431
1.-.8.82
0 194-.
0.006
0.0'79
0.055'
5.875
Permitted C. P. L. R.****
36
34
1338
267
15
1 89
1 2498
PermitPAN Limit 1 st/2nd Crop p
211
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name:
Permit #:
rator:
ti__es Used:
City of Burlington Total Dry Tons Applied (Annual):
WQ0000520 Cation Exchange Capacity (non 503 only):
James Thompson Owner: James Thompson
15.6 Acres Permitted: 15.6 Site #:
Predominant Soil Series:
OR64 Field #:
32.64
GeB
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
SB
7/13/15
2
S
4 J
5
6
7
8
9
10
11
12
% Solids
4.3
Arsenic
3
Cadmium
2
Copper
214
Chromium
247
Lead
15
Mercury
0.4
Molyb-
denum
5
Nickel
13
Selenium
5
Zinc
493
Total
Phos-
phorus
23300
'ual Heavy Metal Field Loadings (Calculated in lbs/acre):
otal
1 11
2
3
4
5
L6J
L7J
8
9 J
10
11 j
12
DT/Ac./
0
App.
Event
2.09
Arsenic
0.013
1 0.000
0.000 1
0.000
0.000
0.000
1 0.000
0.000
0.000
0.000
0.000
0.000
0.013
Cadmium
0.008
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.008
Copper
0.895
0.000
0.000.
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.895
Chromium
1.033
0.000
0.000
0.000
0.600
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1.033
Lead
0.063
0.000
0.000
0.000
0000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.063
Mercury
0.002
0.000
0.000
0.000
0:000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.002
Molyb-
0.021
0.000
0.000
.0.000
0.000
0.000
0.000
0.:000
0.000
0.060
0.000
0.000
0.021
denum
Nickel
0.054
0.000
0.000
0.000
0.000
0.00.0
0.000
0:000
0.000
0.000
0.000
0.000
0.054
Selenium
0.021
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.021
Zinc
2.063
0..000
0.000
0.000
0.000
0.006
0.000
0.000
0.006
0.000
0.000
0.000
2.063
Total
Phos-
97.487
0.000
0.000
0.000
0.000
0.000
0.000
0:000
0.000
0.000
0.000
0.000
97.487
horns
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
i -isonment for knowing violations".
1/14/2016
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

1
Facility Name:
Land Owner:
Operator:
ANNUAL LAND APPLICATION ,&-iELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
City of Burlington WQ Permit #: WQ0000520 Field #: 3 Acres Utilized:
James Thompson Annual Dry Tons Applied: - 3.2.64 Site #: OR64 Acres Permitted:
James 'Thompson Predominant Soil Series: GeB Cation Exchange Capacity (non 503):
Crop 1 Name: Fescue -Pasture Crop 1 Max. PAN: 158 Crop 2 Name: Crop 2 Max. PAN:
15.6
15.6
0
1,
ALiquid
Volume applied
enter one Solids/
( )
Cu. Yds Gallons
o
/o
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry'
Wet'
Moist)
Precip.
Past 24
Hrs.
inches
y
ccD
w
* 8
c
qy
*� w
o'
0
4
7y �
?r
* N'
TKN
mg/kg
z ]�,
o
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
8/24
58500
4.3
0672
South Burlington
Dry
<.5"
S
0.5
0.3
60900
13000
2
28.069 '
. NA
Fescue
8/25
123500
4.3
I.420
South Burlington
Dry
<.5"
S
0.5
0.3
60900
13000
2
59.257
NA
Fescue
0:000
0.000
0 00.0 .
0:0:00
0.000
: 0000
0. 0*
omo0
0:000
0:0.00
0.000
> 0.000
0.000
0.000- ,
0.000 .
0:000
o.00o '
-0.600
0.000
0.000
0.00a
0:0.06
0.000
0.00.0
6,000
0.000 .:
0000
0:00.0
6.000
0.00.0
0"
0
0.000 fi` `!
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000
0.000
TOTALS:
0
182000
::::::::::::::
As
Cd
Cu
Cr
Pb
He
Mo
Ni
Se
Zn
P
87.326
1 0.000
Lime Applied
Annual lbs/acre
0.6b;
0.00:8:
0 895
1 033
(? 063
: 0 002 .
, 0 02
0.65'4
0 02,1
2.063 •
01.497 ::
:. .................
Date
1bs/ac
Prior Years Cumulative lbs/ac
0.252
0.21
27.851
10.063
3.863
0.082
0.871
1.872
0.209
42.287
Current Cumulative lbs/ac
0.265
0.218
2$.7'46 •
1.1.096
3.9.26
O'084
0:892
1.926
0.230
_ ..
`44.350
Permitted C. P. L. R.****
36
34
1338
267
IS
374
89
2498
Permit PAN Limit Ist/2nd Crop p
1ss
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
I/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual):
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
gyrator: James Thompson Owner: James Thompson Predominant Soil Series:
�, . zs Used: 21.9 Acres Permitted: 21.9 Site #: OR64 Field #:
46.63
GeB
4
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1 1
SB
7/13/15
__2j
3
L4J
5 J
L6J
7 J
8
9 J
10
11 j
12
% Solids
4.3
Arsenic
3
Cadmium
2
Copper
214
Chromium
247
Lead
15
Mercury
0.4
Molyb-
denurn
5
Nickel
13
Selenium
5
Zinc
493
Total
Phos-
nhorus
23300
'ual Heavy Metal Field Loadings (Calculated in lbs/acre):
otal
1
1 2
3
4
5
6
7
8
9
10
11
12
DT/Ac./
App.
r°y+
Event
2.13
14
Arsenic
0.013
0.000
0.000
0.000
1 0.000
0.000
0.000
0.0.0.0"
0.000
0.000
0.000
.0.000
0.013
Cadmium
0.009
0.000.
0.000
0.000
0.000
0.000
0.000
0.000.
0.000
1 0.000
0.000
0.000
1 0.009
Copper
0.9-11
0.0.00
0.000
0.000
.0.000
0.000
0.000
0.00:0
0.000
0.000
0.000
0.000
0.911
Chromium
1.052
0.000
0.000
0..000
0.000
0.000
0.000
0.000
0..0:001.
0.000
0.000
0.000
1.052
Lead
0.064
0.000
0.000
0.000
0000
0.000
0.000
0.000
0.000
0.000
0.000
0.00.0
0.064
Mercury
0.002
0.000.
0:00.0
0.000
0.000
0.000
0.000
0.000
0.000
0_0010
0.000
0.000
0.002
Molyb-
0:021
0.000
0.000
0..000
0.000
0.00.0
0.000.
0.000
0.000.
0.000
0.000
0.000
0.021
denum
Nickel
0..055
0.000
0.000
0..000
0.000
0.000
0.000
0.000
0.000
0.000
0.0.00
000
0.055
Selenium
0.021
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0000
0.000
0.021
Zinc
2.099
0.000
6.000.
0.000
0.000"
0.000
0.000
0.000
0..000
0:000
6.000
0-000
2.099
Total
Phos-
99.211
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
99.211
horus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
l--isonment for knowing violations".
; e �-' z 4: /0�_
Signature of Land Applier
1/14/2016
Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
ANNUAL LAND APPLICATION .-iELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
City of Burlington
James Thompson
WQ Permit #: WQ0000520 Field #:
Annual Dry Tons Applied: 46.63.. Site #:
OR64
Acres Utilized: 21.9
Acres Permitted: 21.9
Operator: James Thompson Predominant Soil Series: GeB Cation Exchange Capacity (non 503): 0
Crop 1 Name:
Fescue -Pasture
Crop 1 Max. PAN: 158 Crop 2 Name:
Crop 2 Max. PAN:
o
Q 0
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#
Fert., Animal
Waste, etc )
Soil
Cond.
(Dry,
Wet ,
Moist
Precip.
Past 24
Hrs.
inches
Y
" �
5 =
o w
o
� =
N'
:1mg/kg
w .��,
aL
* N
TICN
Z Y
mglkg
Nitrate
and
Nitrite
mgtkg
PAN Applied
( lbs/acre)
Name of Crop Type
ReceivingResidual
Application
Crap 1
Crop 2
Crop 1
Crop 2
8/25
136500
4.3
1.118
South Burlington
Dry
<.5"
S
0.5
0.3
60900
13000
2
46.654
NA
Fescue
8/26
123500
4.3
1;011
South Burlington
Dry
<.5"
S
0.5
0.3
60900
13000
2
42.211
NA
Fescue
0.6,00 '
0.000
0.000
0000.
0.000
0,000
4:000
0.000
u.00u
o:000
o.000
0.000
a Qod.
0.000
0.000
0;000.
n.0oo
0.000
0:000
0.000
0.000
0 0:00
`0.000
0.000
0.0.00
0.000
0.000
0.0001
0.000
0_000
0
0
'Q>000
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0:000'
I omoo
TOTALS:
,.
2'60000
:::::
As
Cd
Cu
Cr
Pb
H g,Mo
Ni
5e
Zn
l'
88.864'.
o.000
Lime Applied
Annual lbs/acre
U4,13
o.009 .
0.,911
l.0'52
04064,
0_QQ2
0 621•
0.05$
0.021
2`.099
99.211 :;:.::,'::::::
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.301
0.303
41.495
14.866
5.132
0.132
1.255
2.847
0.238
54.208
Current Cumulative lbs/ac
0.514
0.312
42.4,06
.15.918
5.196
61-3-4
1.276
2.902
0.259.
56;307
Permitted C. P. L. R.****
36
34
1338
267
15
374
89
2498
Permit PAN Limit 1st/2nd Crop
158 `-
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name:
Permit #:
A.._ es Used:
WQ0000520
James Thompson
of Burlington Total Dry Tons Applied (Annual):
Cation Exchange Capacity (non 503 only):
Owner: James Thompson Predominant Soil Series:
18.9 Acres Permitted: 18.9 Site #: OR64 Field #:
12.81
GeB
7
Residual Analvsis Data (Heavy Metals and Total Phosphorus use m2/k2, % Solids use Raw Percent ft
Sample or
Com-
posite
Date
11
SB
7/13/15
2
3
41
5
6 j
L7J8
9
10
11
121
% Solids
4.3
Arsenic
3
Cadmium
2
Copper
214
Chromi[im
247
Lead
15
Mercury
0.4
Molyb-
denum
5
Nickel
13
Selenium
5
Zinc
493
Total
Phos-
phorus
23300
I vial Heavv Metal Field Loadings (Calculated in lbs/acre):
i otal
1
2
3
4
5
6
7
8
9
10
11
12
DT/Ac./
0
App.
Event
0.68
Arsenic
0.004
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0..000
6.000
0.000
0:000
0.004'
Cadmium
0.003-
0..000
0.000
0.000
0.000_
0.000
0.000
0.000
0.000
.0:000
0,000
0.00.0
0.003
Copper
0.29.0
0.0W
0.000
0.000
0.000
0.000
0.000
0.000
0..000
0.00.0
0.000
0.000
0.290.
Chromiuiii
0.335
0.000
0.000
0.000
0.:000
0.000
0.000
" 0.000
0.000
0.00.0
0..00.0
0.000
0.335
Lead
0.020
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.020
Mercury
0.001
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000:
0.001
Molyb-
6.0.67
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.007
denum
Nickel
0.04 8
0.000
0.000
0.0.00
0.000
0.000
0.000
1 0.0,00
0.000
0.000
0.000
0,000
0.018
Selenium
0.007
0.000
0.000.
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.007
Zinc
0.669
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.669
Total
Phos-
31.595
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000 '
0.000
0.000
31.595
phorus
"1 certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
i� irnment for knowing vvviolations".`9!: *in4'�ti, 1/14/2016
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
Operator:
ANNUAL LAND APPLICATION -x-ALD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
City of Burlington WQ Permit #: WQ0000520 Field #: 7 Acres Utilized:
James Thompson Annual Dry Tons Applied: - 12.8:1 Site #: OR64 Acres Permitted:
James Thompson
Crop 1 Name: Fescue -Hay
Predominant Soil Series:
Crop 1 Max. PAN: 211
GeB Cation Exchange Capacity (non 503):
Crop 2 Name: Crop 2 Max. PAN:
18.9
18.9
0'
o =
5
o
Q
Volume applied
PP
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/AC)
Residual Sources
(NPDFS #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry,
Wet
Moist)
Precip.
Past 24
Hrs.
inches
a
K ',
ca �?
o
ory
o
w
o
4
� �
w K
TKN
mg/kg
z a
ct
o
w
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
( lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
8/24
71500
4.3
0c678
South Burlington
Dry
<.5"
S
0.5
0.3
60900
13000
2
28.317
NA
Fescue
0.000
0.000
0.000
0 t000
0.000
0.000
0,066
0.000
0,000
0,606
0.000
0.000
0;000
0.000
0.000
0"_0'00
0.000
0.000
0' 000
0.000
0.000
0,0,0:0,
U00
0.000
0000
0.000
1 0.000
0 000
0.000
0.000
QA00.
0.000
0.000
0
'0
0000
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000
1 0.000
TOTALS:
0
`'71S00i':::::::::::::
As
Cd
Cu
Cr
Pb
H T
Mo
Ni
Se
Zn
P
29.317
OMO
Lime A lied
Annual lbs/acre
0;004
0 003 ,
0.290
0.335
A020
0 001.
0 007
0 018
0.007
` 0.6:69
31 595 .::::::::::.:::::::: ::.:::
::::::::.:....................
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.322
0.323
47.859
14.694
7.033
0.082
0.934
2.843
0.179
60.198
Current Cumulative lbs/ac
0.3.26
0 326.
48.149
t5:029
7.053
0.083
0,94-1
2.861
0.486
60.967
Permitted C. P. L. R.****
36
34
1338
1
267
1 15
374
89
2498
Permit A t 1 / PAN Limit st 2nd Crop P
-
' 211
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: City of Burlington Total Dry Tons Applied (Annual): 18.65
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
'-ator: James Thompson Owner: James Thompson Predominant Soil Series: GeB
h__ rs Used: 8.4 Acres Permitted: 8.4 Site #: OR64 Field #: 10
Residual Analvsis Data (Heavv Metals and Total Phosuhorus use tn&kiz, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
SB
7/13/15
_2j
3j
4
5
6
7 j8
9
1 Q
11
12
% Solids
4.3
Arsenic
3
Cadmium
2
Copper
214
Chromium
247
Lead
15
Mercury
0.4
Molyb-
denum
5
Nickel
13
Selenium
5
Zinc
493
Total
Phos-
phorus
23300
'ual
Heavy Metal Field Loadings
(Calculated
in lbs/acre):
otal
1
L_2j
L3j
741
5
6]
L7J
8
9
10
11
12
DT/Ac./
c
App.
Event
2.22
4
Arsenic
0.013
0 00.0
0.000 1
0..000
0-.000-
0.00.0,
1 0,000
0,000
0.000.
0.000
O.00Q
O.O.QO
0.013
Cadmium
0 0,09
0000
O:000
0.000
0.000
0:000
0:00.0
0.0.00
0.00.0
0.000
0..000'
0.000
0..009
Copper
0.050
0 000
' iO 000
O�.00:O
0.000
0.000
0.00.0
0.0.00'
' 0.000
0.000;
- 0.00.0-
0.000.
0.950
Chromium
1.0-97
O_`000 :
0.000
0.000
0..000
O:OOO
0:000.
0:000 <
0.000 :
0:000,
0.006_
0.000
1.097
Lead
0.067
0:000
0 000 .,
0.000
0.000
0.000
0:000
0.006 "
0 00.0:
F. 0:000'
0.000
0.000
0.067
Mercury
0.002
0 000
0 000
�0.0:00
0::000
0.000
0:000
0.000 .
6.060 .,
: O.ODO
0.0'00'
0.000
0.002
Molyb-
olyb
0.022
0.` 000
0,000
0.000
0.000
�
0.000
0:000
0.000
0: 000 ,
"
' 0.000
0 000
0.000
0.022
denum
,
Nickel
O.;O8
0.000
0 000 ;
..0 000
0.000
0,900.
0.000
0,000
03000
0000.v
0 000
0.000
0.058
Selenium
0.022
0:000
04.099 ;
0.000
0 000
- 0,000
0.000
0.000
0; 000
: 0.0007
0 00-0
0.000 1
0.022
Zinc
2.189
0000
_ 0 O00
0.000
0 000{
, 0 000
A ;0.000
0000
Q 000
0.000-
_0.000
0`MO .;
2.189
Total
Phos-
103.452.
0. 000
0.0.00
0.00.0
0.000
0 0001
O.OU:O
0.000
0.000
.0.000-
0.1000
0.000
-103.452
horus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
i, Isonment for knowing violations".
zl�l4;:�10`_ 1/14/2016
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name:
Permit #:
gyrator:
A-- es Used:
City of Burlington Total Dry Tons Applied (Annual): 38.05
WQ0000520 Cation Exchange Capacity (non 503 only):
James Thompson Owner: James Thompson Predominant Soil Series:
23.2 Acres Permitted: 23.2 Site #: OR64 Field #:
GeB
12
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
SB
9/8/15
_2j
3j
4
L5J
6
L7J
LSJ
L9J
LOJ
11
12
% Solids
2.7
Arsenic
1 3
Cadmium
2
Copper
303
ChromiUln
238
Lead
26
Mercury
1.3
Molyb-
denum
6
Nickel
21
Selenium
5
Zinc
489
Total
Phos-
phorus
40600
I ;ial Heavy Metal Field Loadings (Calculated in lbs/acre):
i otal
1
2
3
4
L5J
6
7
8
9
10
11
12
DT/Ac./
0
App.
y
Event
1.64
Arsenic
6
0.0.00
0.0W
0.000
0.000
0.00.0 =
0.000
0.000
0:000
0.000-
0.000
0.000
0.010
Cadmium
0.000_
0"000..
" 0.0.00
0.000
Q 600
O.Q00
0.000
0.000
0.000,
0.000
0.000
0.007
Copper
0000 .-.0
000'
0,000
0 0:00
0 000
0.-000
O'000
0-.000
0 000
0.000
0:000
0.994
Chromium
V06.*7
0 006
6.060
0 060
0.000
0.000
0.000
0:000
0..000'
0.000.
0.000
0.600
0.381
Lead
. 0.000.
0.000
0.000
0.00
0.000
0 000.
0.000
0.000
0:.000'
0.000
0:000
0.085
Mercury
0,000
0.00.0
0.000
0.000`
0.000
0.000.
0.000
0.000.
0:00;0
0.000
0.000
0.004
Molyb-
0.020
0 000
0.0 .0
0.0"00
0.000 .
6.000
0."000
0.0,00
0".000
0.000
0.000
U,000"
0.020
m denu
Nickel
0 0¢9
0,000,
0 000
0 00"Q
Q1.000
, 0 600
- 0.000"
0.060i
0.000
0 OOQ
0:000 -,
0;400
.0.069
Selenium
0.016
0.000
:0.600
0.000
0.600
0 000 .
0.000
0.OQ"0
0.000 .-:
0 UOQ
- 0.00Q
0000
0 016
Zinc
1 604
0 000
0.000
0.000
0:000
0.000,
0.O0O
0:000
0.000-
. 0 0"00
0.000
0.000
1.604
Total
Phos-
133.168
0.000
0:000
0.000
0.000
0.000.
0.000
0.000
0.000
0.000
0.000
0.000
133.168
horus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
it sonment for knowing violations".
Z.Y4;2�_
Signature of Land Applier
1/14/2016
Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION ELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: City of Burlington WQ Permit #: WQ0000520 Field #: 12 Acres Utilized: 23.2
Land Owner: James Thompson Annual Dry Tons Applied: 38.05 Site #: OR64 Acres Permitted: 23.2
Operator: James Thompson Predominant Soil Series: GeB Cation Exchange Capacity (non 503): 0
Crop 1 Name: Fescue -Pasture Crop 1 Max. PAN: 158 Crop 2 Name: Crop 2 Max. PAN:
o =
+,
a
p
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
"�o
Solids
Volume
Applied per
pp P
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES # WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry,
Wet,
Moist)
Precip.
Past 24
Hrs.
inches
Y
cc
-. 'd
a o
o
° o
o
w
�,
�, -
N'
°p
;e
w •,
co V
* 4.
# �,
TKN
mg/kg
Z
c
o c
R 7
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(Ibs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
10/15
65000
2.7
0.315
South Burlington
D
<.5"
S
0.5
0.3
65200
24100
2
15.382
NA
Fescue
10/16
201500
2.7
0.998
South Burlington
D
<.5"
S
0.5
0.3
65200
24100
2
47.695
NA
Fescue
10/17
71500
2.7
034T
South Burlington
D
<.5"
S
0.5
0.3
65200
24100
2
16.921
NA
Fescue
0.000
0,000
0.000
0.000
0.000
0.1000
0A00
0.000
0.000
0:000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0 600
o:oa0
0.000
0.600
0.000
0.000
0.000
0.000
0.000
0.000
.....
0
0
0:000
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0000
(1.000
......
TOTALS:
As
Cd
Cu
Cr
Pb
Hg
I Ma
Ni
Se
Zn
P
7089<>
0.000
Lime A plied
Annual lbs/acre
0.10-10
"0 0
0.994
0 781
0.08�
- O Q0.4
0.026
0.069
0.016
.1 G04 `
133 168 .................
:"
...:...... ::.::.::.:. . .:
. ;;:::::.•:•:•:::::........... ..
' .. • • . . ....... • ..... .
Date
Ibs/ac
Prior Years Cumulative lbs/ac
0.25
0.224
38.563
12.714
5.184
0.134
0.942
2.642
0.197
53.111
Current Cumulative lbs/ac
0 260
0.231
39.557
1�3.495
5.264-a
0.138
0.962
2.7.11 °
0..213
54.71'S
Permitted C. P. L. R.****
36
34
1338
267
IS
374
89
2498
Permi PAN Limi 1s d Cr t t t/2n o p
158
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/14/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
""C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (1212006)

Page: 1 of 2
Report Number: 14-345-0214
Account Number: 45475
Submitted By: SHANE FLETCHER
Send To: CITY OF BURLINGTON
SHANE FLETCHER
POB 1358
BURLINGTON , NC 27216-1358
Lab Number: 59202
Sample Id : #SB012015
A AFL Eastern Laboratories, Inc.
7621 Whitepine Road Richmond, Virginia 23237 [phone] Fax (804) 271-WG
www.aleastern.com
Project : #SB012015
NC CERT#257
REPORT OF ANALYSIS Date Sampled: 12/8/2014 05:21:00
Date Received: 12/11/2014 00:00
Date Reported: 12/19/2014
Total Solids
3.71
37100
100.0
DH
12/12/2014 13:59
SM-254OG
Moisture "
96.29
100.0
DH
12/12/2014 13:59
SM-2540G
Total Kjeldahl Nitrogen
6.68
66800
10.0
JM
12/17/2014 08:10
SM-4500-NH3C-TKN
Total Phosphorus
2.62
26200
100
KM
12/12/2014 12:36
SW 6010C
Total Potassium
0.81
8120
100
KM
12/12/2014 12:36
SW 6010C
Total Sulfur
0.74
7380
100
KM
12/12/2014 12:36
SW 6010C
Total Calcium
10.00
100000
100
KM
12/12/2014 12:36
SW 6010C
Total Magnesium
0.65
6490
100
KM
12/12/2014 12:36
SW 6010C
Total Sodium
0.55
5540
100
KM
12/12/2014 12:36
SW 6010C
Total Iron
7630
100
KM
12/12/2014 12:36
SW 6010C
Total Aluminum
5900
100
KM
12/12/2014 12:36
SW 6010C
Total Manganese
262
5
KM
12/12/2014 12:36
SW 6010C
Total Copper
198
5
KM
12/12/2014 12:36
SW 6010C
Total Zinc
439
5
KM
12/12/2014 12:36
SW 6010C
Ammonia Nitrogen
2.70
27000
10.0
JM
12/15/2014 09:04
SM-4500-NH3C
Organic N
3.98
39800
10.0
12115/2014 09:04
CALCULATION
Nitrate+ N itrite-N
<2.00
2.00
JM
12/12/2014 09:05
SM-450ONO3F
Total Cadmium
<2.0
2.0
KM
12/12/2014 12:36
SW 6010C
All values are on a dry weight basis except as noted by asterisk. Detection limit on all N series is on a wet basis.
Our reports and letters are for the exclusive and confidential use of our clients, and may not be reproduced in whole or part, nor may any reference be made
to the work, the results, or the company in any advertising, news release, or other public announcements without obtaining our prior written authorization.
Debbie Holt

1
Page: 2 of 2
Report Number: 14-345-0214
Account Number: 45475
Submitted By: SHANE FLETCHER
Send To: CITY OF BURLINGTON
SHANEFLETCHER
POB 1358
BURLINGTON , NC 27216-1358
Lab Number: 59202
Sample Id : #SB012015
�L A&L Eastern Laboratories, Inc.
7621 Whitepine Road Richmond, Virginia 23237 [phone] Fax (a04) 271-6"S
wwwaleastern.com
Project: #SB012015
NC CERT#257
REPORT OF ANALYSIS Date Sampled: 12/8/2014 05:21:00
Date Received: 12/11 /2014 00:00
Date Reported: 12/19/2014
Total Chromium
335
5
KM
12/12/2014 12:36
SW 6010C
Total Nickel
11
5
KM
12/12/2014 12:36
SW 6010C
Total Lead
13
5
KM
12/12/2014 12:36
SW 6010C
Total Arsenic
<3.0
3.0
KM
12/12/2014 12:36
SW 6010C
Total Mercury
0.4
0.4
KM
12/12/2014 09:00
SW-7471 B
Total Selenium
<5.0
5.0
KM
12/12/2014 12:36
SW 6010C
Calcium Carbonate Equivalent
11.20 112000
100
JM
12/16/201413:50
AOAC 955.01
Total Volatile Solids
65.91 659100
100.0
DH
12/12/2014 13:59
SM-2540G
Total Molybdenum
<5
5
KM
12/12/2014 12:36
SW 6010C
Comments:
CCE, SULFUR AND ORGANIC NITROGEN NOT FOR COMPLIANCE PURPOSES.
All values are on a dry weight basis except as noted by asterisk. Detection limit on all N series is on a wet basis
Our reports and letters are for the exclusive and confidential use of our clients, and may not be reproduced in whole or part nor may any reference be made
to the worts, the results, or the company in any advertising, news release, or other public announcements without obtaining ourprior written authorization.
Debbie Holt

SAMPLE TRANSMM
A&L East
7621 Whiteuine Road
III�II�IIIINNI�INIUN�NI�IINNiIN�«II!! t i126i4Q
0 Y0FHURUNGTON
#88011015 13:25:47
Office (nforntation
Rept#
Submitted By Charge To
Copy To
Project
Shane Fleischer City, of 9aritln ton
Acct #45475
POB1368
:Email
Burlington NO 27216-1358:
erlstcheraci.burtnalon.ne.us
Lab Number (Lab Use Only)
Sample ID
Container Type
Sampled Date:
[ -: r5
Date Recd'.
12 ;r
'"
5
Glass Yes or
Sampled Time:
S (
Time Recd.,
0*15-
Plastic
ester VoL
Sampled By
6vrTcr
Recd By:
Relin uished. By., (Signature)
We
Time
Received B : (Signature-)
Date
Tim
c=,
jz/tj/tq
Please Place
a "X" by Desired Tests
Internal Lab Code:
SLBURL
Solids %
TKN
P
K
S
Ca
Mg
Na
Fe
Al
Mn
Cu
Zn
NH4-i
.Nb3-N
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
Cd
Cr
Ni
Pb
As
Hg
Se
PR
CaCO3
E
Volatile
Solids l
Cl
B
Ba
x
x
x
x
x
x
x
x
x
x
x
804
Ag
Sb
Co
Sn
Ti
V.
Be
ALK
SS
Avail P
Sol K
Cond
WIN
SOL B
SOL NA
0&C
S134R.
TSS
Sleve#20
Sieve"o
Sleve#1oo
ASH
CaO
CaCO3
M CO3-
'MgO
C/N
TOC
Env
_
,.
TOTAL
P205
TOTAL
K20
TN
TKNW
NH4W
NO3W
ORGN-W
PA CERT
AZ GERT
STU
PCBS
REACT
CN
FECAL
TCLP
iCR
State Certification Needed:
NC
Special Instructions
or Remarks
Comments

Page: 1 of 2
Report Number: 15-027-0203
Account Number: 45475
Submitted By: SHANE FLETCHER
Send To: CITY OF BURLINGTON
SHANEFLETCHER
POB 1358
BURLINGTON , NC 27216-1358
Lab Number: 59871
Sample Id: #SB022015
A&L Eastern Laboratories, Inc.
T621 Whitepine Road Richmond, Virginia 23237 [phone] Fax [phone]
wwwaleastem.com
Project: #SB022015/NC CERT#257
REPORT OF ANALYSIS Date Sampled: 1/12/2015 06:20:00
Date Received: 01/27/2015 00:00
Date Reported: 01/29/2015
Total Solids *
3.80
38000
100.0
JM
01127/2015 15:15
SM-254OG
Moisture *
96.20
100.0
JM
01/27/2015 15:15
SM-254OG
Total Kjeldahl Nitrogen
6.34
63400
10.0
JM
01/28/2015 09:24
SM-4500-NH3C-TKN
Total Phosphorus
2.20
22000
100
KM
01128/201514:42
SW 6010C
Total Potassium
0.65
6470
100
KM
01/28/2015 14:42
SW 6010C
Total Sulfur
0.61
6110
100
KM
01/28/2015 14:42
SW 6010C
Total Calcium
8.27
82700
100
KM
01/28/2015 14:42
SW 6010C
Total Magnesium
0.58
5800
100
KM
01/28/2015 14:42
SW 6010C
Total Sodium
0.45
4520
100
KM
01/28/2015 14:42
SW 6010C
Total Iron
6180
100
KM
01/28/2015 14:42
SW 6010C
Total Aluminum
7200
100
KM
01/28/2015 14:42
SW 6010C
Total Manganese
213
5
KM
01/28/2015 14:42
SW 6010C
Total Copper
157
5
KM
01/28/2015 14:42
SW 6010C
Total Zinc
382
5
KM
01/28/2015 14:42
SW 6010C
Ammonia Nitrogen
0.53
5260
10.0
JM
01/28/2015 10:20
SM-4500-NH3C
Organic N
5.81
58140
10.0
01/28/2015 09:24
CALCULATION
Nitrate+Nitrite-N
<2.00
2.00
JM
01/28/2015 09:25
SM-450ONO3F
Total Cadmium
<2.0
2.0
KM
01/28/2015 14:42
SW 6010C
All values are on a dry weight basis except as noted by asterisk. Detection limit on all N series is on a wet basis.%-�
Our reports and letters are for the exclusive and confidential use of our clients, and may not be reproduced in whole or part, not, may any reference be made
to the work, the results, or the company in any advertising, news release, or otherpublic announcements without obtaining our prior written authorization.
Debbie Holt

Page: 2 of 2
Report Number: 15-027-0203
Account Number: 45475
Submitted By: SHANE FLETCHER
Send To: CITY OF BURLINGTON
SHANE FLETCHER
POB 1358
BURLINGTON , NC 27216-1358
Lab Number: 59871
Sample Id : #SB022015
A&L Eastern Laboratories, Inc.
7621 Whitepine Road Richmond, Virginia 23237 [phone] Fax (804) 271-G446
www.aleastern.com
Project: #SB022015/NC CERT#257
REPORT OFANALYSIS Date Sampled: 1/12/2015 06:20:00
Date Received: 01/27/2015 00:00
Date Reported: 01/29/2015
Total Chromium 268
5
KM
01/28/2015 14:42
SW 6010C
Total Nickel 10
5
KM
01/28/2015 14:42
SW 6010C
Total Lead 11
5
KM
01/28/2015 14:42
SW 6010C
Total Arsenic <3.0
3.0
KM
01/28/2016 14:42
SW 6010C
Total Mercury 1.2
0.4
KM
01/28/201509:00
SW-7471B
Total Selenium <5.0
5.0
KM
01/28/2015 14:42
SW 6010C
Calcium Carbonate Equivalent 13.40 134000
100
CZ
01/29/2015 02:15
AOAC 955.01
Total Volatile Solids 68.86 688600
100.0
JM
01/27/2015 15:15
SM-254OG
Total Molybdenum <5
5
KM
01/28/2015 14:42
SW 6010C
Comments:
CCE, SULFUR AND ORGANIC NITROGEN NOT FOR COMPLIANCE PURPOSES.
QUALIFIER: THE RPD FOR "NO3/NO2-N" WAS OUT OF LIMITS. THE LRB WAS OUT OF LIMITS FOR "Mn". THE
MATRIX SPIKE WAS OUT
OF LIMITS FOR
"AI", "As" , "Fe" AND "P". ALL OTHER QC DATA IS ACCEPTABLE.
All values are on a dry weight basis except as noted by asterisk. Detection limit on all N series is on a wet basis.
Our reports and letters are for the exclusive and confidential use of our clients, and may not be reproduced in whole or part, nor may any reference be made
to the work, the results, or the company in any advertising, news release, or other public announcements without obtaining our prior written authorization.
Debbie Holt

SAMPLE TRANSMITTAL
A&L Easter. a
7621 Whitenine Road Wrhm,
202
53
G!'PY OF 811RLWdTLtNGTONiJ
#5 M22aYSQgG'CERT'267 12.44-25
Office Information
c.us��,..,.....-•-- �_
Submitted Ry Char e Tn Copy To Project
Dept#
Shane Fletcher City of Burlington
Acci #45475
POS 135It
Email
Burlington NC 27216-1358
snatcher®cl.burBngtOn-mus
Lab Number (Lab Use Only)
mpie-ID
Container Type
Sampled Date,
/-!'Z-1
Date Reod:
-/- P S
Glass Yes or
Sam led Time:
06Zo
Time Reed:
Plastic or No
Sampled By-
%:,,- C-
Recd By:
.�
Reli:n ul5hed By: �Si .nature
Date
Time
ReceiV.od B : (Signature)
Date
Time
'2
1�3.
Please Palace a "',&" by Desired .Tests
Internal Lab coft.
Solids %
TKN
P
K
S
Ca
Mg
Na
Fe
Al
Mn
Cu.
Zn
NH4-N
NOS N
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
Cd
Cr
NI
Pb
As
Hg
Se
pH.
CaCO3
Eq. %
Volatile
Solids %
Or ,N
Mo
CI
B
Ba
x
x
x
x
x
x
x
x
x
x
x
S0.4
A
Sb
Co
Sn
TI
V
Be
ALK
SS
Avall P
Sol K
Cond
WIN
SOL B
SOL NA
O&G
SPQR.
TSS
Sieve#2o
Sievaeo
Sieve#ioo
ASH
CaO
CaCO3
M. CO3
MgO
C/N
TOC
Env
TOTAL
P205
TOTAL
K20
TN
TKNW
NH4W
NO3W
ORGN-W
PA CERT
AZ CERT
BTU
PCBS
REACT
CN
FECAL
TCLP
ICR
State Certification Needed:
NC
Special Instructions
or Remarks
Comments

Page: 1 of 2
Report Number: 15-054-0204
Account Number: 45475
Submitted By: SHANE FLETCHER
Send To: CITY OF BURLINGTON
SHANEFLETCHER
POB 1358
BURLINGTON , NC 27216-1358
Lab Number: 60334
Sample Id : #SB032015
A &L Eastern Laboratories, Inc.
7621 Whitepine Road Richmond, Virginia 23237 (a04) 743-9401 Fax [phone]
www.aleastern.com
Project : #SB032015
NC CERT#257
REPORT OFANALYSIS Date Sampled: 2116/2015 07:05:00
Date Received: 02/23/2015 00:00
Date Reported: 02/27/2015
Total Solids *
4.26
42600
100.0
RD
02/23/2015 14:35
SM-2540G
Moisture *
95.74
100.0
RD
02/23/2015 14:35
SM-254OG
Total Kjeldahl Nitrogen
6.24
62400
10.0
JM
02/24/2015 08:50
SM-4500-NH3C-TKN
Total Phosphorus
2.14
21400
100
KM
02/24/2015 12:26
SW 6010C
Total Potassium
0.61
6050
100
KM
02/24/2015 12:26
SW 6010C
Total Sulfur
0.58
5760
100
KM
02/24/2015 12:26
SW 6010C
Total Calcium
9.87
98700
100
KM
02/24/2015 12:26
SW 6010C
Total Magnesium
0.54
5420
100
KM
02/24/2015 12:26
SW 6010C
Total Sodium
0.35
3470
100
KM
02/24/2015 12:26
SW 6010C
Total Iron
6740
100
KM
02/24/2015 12:26
SW 6010C
Total Aluminum
11700
100
KM
02124/201512:26
SW 6010C
Total Manganese
181
5
KM
02/24/2015 12:26
SW 6010C
Total Copper
140
5
KM
02/24/2015 12:26
SW 6010C
Total Zinc
289
5
KM
02/24/2015 12:26
SW 6010C
Ammonia Nitrogen
0.68
6810
10.0
JM
02/24/2015 08:50
SM-4500-NH3C
Organic N
5.56
55590
10.0
02/24/2015 08:50
CALCULATION
Nitrate+Nitrite-N
<2.00
2.00
JM
02/24/2015 08:50
SM-450ONO3F
Total Cadmium
<2.0
2.0
KM
02/24/2015 12:26
SW 6010C
All values are on a dry weight basis except as noted by asterisk. Detection limit on all N series is on a wet basis.
Our reports and letters are for the exclusive and confidential use of our clients, and may not be reproduced in whole or part, nor may any reference be made
to the work, the results, or the company in any advertising, news release, or other public announcements without obtaining our prior written authorization.
Debbie Holt

Page: 2 of 2
Report Number: 15-054-0204
Account Number: 45475
Submitted By: SHANE FLETCHER
Send To: CITY OF BURLINGTON
SHANEFLETCHER
POB 1358
BURLINGTON , NC 27216-1358
Lab Number: 60334
Sample Id : #SB032015
A&L Eastern Laboratories, Inc.
7821 Whitepine Road Richmond, Virginia 23237 [phone] Fax [phone]
www.aleastern.com
Project : #SB032015
INC CERT#257
REPORT OF ANALYSIS Date Sampled: 2/16/2015 07:05:00
Date Received: 02/23/2015 00:00
Date Reported: 02/27/2015
Total Chromium
190
5
KM
02/24/2015 12:26
SW 6010C
Total Nickel
9
5
KM
02/24/2015 12:26
SW 6010C
Total Lead
10
5
KM
02/24/2015 12:26
SW 6010C
Total Arsenic
<3.0
3.0
KM
02/24/2015 12:26
SW 6010C
Total Mercury
0.6
0.4
KM
02/24/2015 09:00
SW-7471B
Total Selenium
<5.0
5.0
KM
02/24/2015 12:26
SW 6010C
Calcium Carbonate Equivalent
17.80 178000
100
CZ
02/26/2015 23:15
AOAC 955.01
Total Volatile Solids
65.49 654900
100.0
RD
02/23/2015 14:35
SM-254OG
Total Molybdenum
<5
5
KM
02/24/2015 12:26
SW 6010C
Comments:
CCE, SULFUR AND ORGANIC NITROGEN NOT FOR COMPLIANCE PURPOSES.
QUALIFIER: THE LRB WAS OUT OF LIMITS FOR "Mn". THE MATRIX SPIKE WAS OUT OF LIMITS FOR "As" AND "Zn". ALL OTHER QC DATA IS
ACCEPTABLE.
All values are on a dry weight basis except as noted by asterisk. Detection limit on all N series is on a wet basis
Our reports and letters are for the exclusive and confidential use of our clients, and may not be reproduced in whole or part, nor may any reference be made
to the work, the results, or the company in any advertising, news release, or other public announcements without obtaining our prior written authorization.
Debbie Holt

SAMPLE TRAN"
A&L
IIIIITY �I�II�IUdiU�Ill�lll'I��II�I�III��URlOof4
7621 Whiten
*SEM32016
Office Information
Rept#
Submilted By: Charge To
Copy To
Project
Shane Fletcher City of Buriington
Acct #45475
POS 1356
5-mali
Burling NC 27216-1368
sfletchfuft.burflnoloa au
Lab Number .(Lab .Use Only)
SampleM
Gontalner Type
Sampled 08itet.
Z-1 x (5
Date Recd.
32a1
Glass es or
Sampled Time:
O?or
Time Recd:
-mo.
d*' 6 y'p
Plastic r No _
5arrt )sd S :
-„ •
Recd 13
Relinquished B -, (Signature)
Date
Tlme
Recelved By: (Signature)
Date
Time
Please Place a °xtt by Desired Tests
Internal Lab Code:
SLBURL
Solids %
TKN
P
K
S
Ca
Y
Na
Fe
Al
Mn
'Cu
Zn
N144=N
NO3-N
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
Cd
Cr
Ni
Pb
As
H9
Se
pH,
CaCO3
E . %
Volatile
Solids %
Org-N
Mo
CI
B
Ba
x
x
x
x
x
x
x
x
x
x
x
SO4
Ap
Sb
Co
Sn
Tl
V
Be
ALK
SS
Avail F
Sol K
Cond
WIN
SOL B
SOL NA
0&G
SP,G.R.,
TSS
Sleve#20
Sleve#60
Ster►e#100
ASH
CaO
CaCO3
M CO3
M D
CIN
TOC
Env
TOTAL
P205
TOTAL
K20
TN
TKNW
NH4W
NO3W.
ORGN-W
PA CERT
AZ CERT
BTU
PCBS
REACT
CN',FECAL
TCLP
ICR
State Certification Needed:
NC
Special Instructions
or Remarks
Comments

Page: 1 of 2
Report Number: 15-084-0211
Account Number: 45475
Submitted By: SHANE FLETCHER
Send To: CITY OF BURLINGTON
SHANE FLETCHER
POB 1358
BURLINGTON , NC 27216-1358
Lab Number: 60886
Sample id: #SB042015
L A&L Eastern Laboratories, Inc.
7621 Whitepine Road Richmond, Virginia 23237 [phone] Fax [phone]US
www,aleastefn.com
Project: #SB042015/NC CERT#257
REPORT OF ANALYSIS Date Sampled: 3/16/2015 07:00:00
Date Received: 03/25/2015 00:00
Date Reported: 03/31/2015
Total Solids *
3.86
38600
100.0
BW
03/25/2015 14:44
SM-2540G
Moisture *
96.14
100.0
BW
03/25/2015 14:44
SM-2540G
Total Kjeldahl Nitrogen
6.35
63500
10.0
JM
03/27/2015 09:24
SM-4500-NH3C-TKN
Total Phosphorus
2.15
21500
100
KM
03/26/2015 11:21
SW 6010C
Total Potassium
0.73
7270
100
KM
03/26/2015 11:21
SW 6010C
Total Sulfur
0.59
5850
100
KM
03/26/2015 11:21
SW 6010C
Total Calcium
9.23
92300
100
KM
03/26/2015 11:21
SW 6010C
Total Magnesium
0.55
5470
100
KM
03/26/2015 11:21
SW 6010C
Total Sodium
0.41
4050
100
KM
03/26/2015 11:21
SW 6010C
Total Iron
6820
100
KM
03/26/2015 11:21
SW 6010C
Total Aluminum
8400
100
KM
03/26/2015 11:21
SW 601 OC
Total Manganese
179
5
KM
03/26/2015 11:21
SW 6010C
Total Copper
136
5
KM
03/26/2015 11:21
SW 6010C
Total Zinc
323
5
KM
03/26/2015 11:21
SW 6010C
Ammonia Nitrogen
0.83
8290
10.0
JM
03/26/2015 09:29
SM-4500-NH3C
Organic N
5.52
55210
10.0
03/26/2015 09:29
CALCULATION
Nitrate+ N itrite-N
<2.00
2.00
JM
03/26/2015 09:30
SM-450ONO3F
Total Cadmium
<2.0
2.0
KM
03/26/2015 11:21
SW 6010C
All values are on a dry weight basis except as noted by asterisk. Detection limit on all N series is on a wet basis.
Our reports and letters are for the exclusive and confidential use of our clients, and may not be reproduced in whole or part. nor may any reference be made
to the work, the resufts, or the company in any advertising, news release, or other public announcements without obtaining our prior written authorization.
Debbie Holt

Page: 2 of 2
Report Number: 15-084-0211
Account Number: 45475
Submitted By: SHANE FLETCHER
Send To: CITY OF BURLINGTON
SHANE FLETCHER
POB 1358
BURLINGTON , NC 27216-1358
Lab Number: 60886
Sample Id: #SB042015
L A&L Eastern Laboratories, Inc.
7621 Whitepine Road Richmond, Virginia 23237 [phone] Fax [phone]
e
www.aleastern.com
Project: #SB042015/NC CERT#257
REPORT OFANALYSIS Date Sampled: 3/16/2015 07:00:00
Date Received: 03/25/2015 00:00
Date Reported: 03/31/2015
Total Chromium
196
5
KM
03/26/2015 11:21
SW 6010C
Total Nickel
8
5
KM
03/26/2015 11:21
SW 6010C
Total Lead
10
5
KM
03/261201511:21
SW 6010C
Total Arsenic
<3.0
3.0
KM
03/26/2015 11:21
SW 6010C
Total Mercury
<0A
0.4
KM
03/26/2015 09:00
SW-7471B
Total Selenium
<5.0
5.0
KM
03/26/2015 11:21
SW 6010C
Calcium Carbonate Equivalent
13.60 136000
100
JM
03/30/2015 13:39
AOAC 955.01
Total Volatile Solids
66.57 665700
100.0
BW
03/25/2015 14:44
SM-2540G
Total Molybdenum
<5
5
KM
03/26/2015 11:21
SW 6010C
Comments:
CCE, SULFUR AND ORGANIC NITROGEN NOT FOR COMPLIANCE PURPOSES.
All values are on a dry weight basis except as noted by asterisk. Detection limit on all N series is on a wet basis.
Our reports and letters are for the exclusive and confidential use of our clients, and may not be reproduced in whole or part, nor may any reference be made
to the work, the results, or the company in any advertising, news release, or other public announcements without obtaining our prior written authorization.
Il • T7Cain[i

SAMPLE TRANSMITTAL FORM/C
A&L Eastem. Laborato
7621 Wbitevinc Road Richmond VA 23237
11111111111111111 N III liiiiiiiiiiii IS-W-02ti I
CITY OF BURLING-TON O1129:0R,5201r,
7
Office Information
Custoff
Submitted By. Char TO - Aj
Rapt#
Shane Fletcher Cfty.of Burlington
Acct#46475
I
POP 135.8
Email
SurfingtortUC 272116-1368
mheruol.burOngton-nc.us
Lab Number (Lab Ilse only)
Sample ID
Container TyPe
Sam pted Date-
1943-
Date Reed'.
(J3
dtj?,6(!r
Glass (Yes or
Sam plod -pmw�
j5:�ad
Time Recd,
Plastic r No
Sampled By:
,, pA. Je-
Recd By*
Relinquished By: :(Signature)
Date
Time
Recekad� By: Si nature).
Date
Time
�X-
�
J:9 I! M
' "
Please Place a "X' by Desired Tests
Internal Lab Code.,
SLBURL
Solids %
TKN
p
K
S
Ca
Mg
Na
Fe
All
Mn
Cu
Zn
NH4-;N
NO3-N
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
Cd
Cr
Ni
Pb
As
H
so
pH.
CaCO3,
E. %
Volatile
SoUds %
Org-N
Mo
Cl
B
Ba
x
x
x
x
x
x
x
x
x
x
x
I
SO4_
Ag
Sb
co
Sn
Ti
V
Be
ALK
SS
Avail P
Sol K
Cond
WIN
SOL 9
SOL NA
-O&G
MGR.
TSS
Sleveno
Sleve#60,
Sim4foo
ASH
CaO
CaCO3
MgCO3
MgO
C/N
TOC
Env
TOTAL
P205
TOTAL
K20
TN
TKNW
NI 4W
NO3W
ORGN-W
PA CERT
AZ CERT,
BTU
PCBS
REACT
CN
FECAL
TCLP
ICR
State Certification Needed:
NC
Special'Instructions
or Remarks
Comments

Page: 1 of 2
Report Number: 15-106-0212
Account Number: 45475
Submitted By: SHANE FLETCHER
Send To: CITY OF BURLINGTON
SHANEFLETCHER
POB 1358
BURLINGTON , NC 27216-1358
Lab Number: 61422
Sample Id: SBO52015
@D.A&L EasternLaboratories, Inc.
7621 Whitepine Road Richmond, Virginia 23237 [phone] Fax (804) 271-WB
wwwaleastem.co t
Project: SB 052015/NC CERT#257
REPORT OF ANALYSIS Date Sampled: 4/13/2015 07:15:00
Date Received: 04/16/2015 00:00
Date Reported: 04/21 /2015
Total Solids `
4.19
41900
100.0
JM
04/16/2015 16:00
SM-2540G
Moisture *
95.81
100.0
JM
04/16/2015 16:00
SM-254OG
Total Kjeldahl Nitrogen
6.61
66100
10.0
JM
04117/2015 09:24
SM-4500-NH3C-TKN
Total Phosphorus
2.13
21300
100
KM
04/17/2015 00:00
SW 6010C
Total Potassium
0.63
6300
100
KM
04/17/2015 00:00
SW 6010C
Total Sulfur
0.59
5920
100
KM
04/17/2015 00:00
SW 6010C
Total Calcium
8.17
81700
100
KM
04/17/2015 00:00
SW 6010C
Total Magnesium
0.51
5050
100
KM
04/17/2015 00:00
SW 6010C
Total Sodium
0.32
3200
100
KM
04/17/2015 00:00
SW 6010C
Total Iron
7690
100
KM
04/17/2015 00:00
SW 6010C
Total Aluminum
8200
100
KM
04/17/2015 00:00
SW 6010C
Total Manganese
177
5
KM
04/17/2015 00:00
SW 6010C
Total Copper
152
5
KM
04/17/2015 00:00
SW 6010C
Total Zinc
322
5
KM
04/17/2015 00:00
SW 6010C
Ammonia Nitrogen
0.79
7880
10.0
JM
04/20/2015 07:59
SM-4500-NH3C
Organic N
5.82
58220
10.0
04/17/2015 09:24
CALCULATION
Nitrate+Nitrite-N
69.2
2.00
JM
04/17/2015 09:25
SM-450ONO3F
Total Cadmium
<2.0
2.0
KM
04/17/2015 00:00
SW 6010C
All values are on a dry weight basis except as noted by asterisk. Detection limit on all N series is on a wet basis.
Our reports and letters are for the exclusive and confidential use of our clients, and may not be reproduced in whole or part, nor may any reference be made
to the work, the results, or the company in any advertising, news release, or other public announcements without obtaining our prior written authorization.
Debbie Holt

Page: 2 of 2
Report Number: 15-106-0212
Account Number: 45475
Submitted By: SHANE FLETCHER
Send To: CITY OF BURLINGTON
SHANE FLETCHER
POB 1358
BURLINGTON , NC 27216-1358
Lab Number: 61422
Sample Id : SB052015
99. AFL Eastern Laboratories, Inc.
7621 Whitepine Road Richmond, Virginia 23237 (8041743-9401 Fax [phone]
www,akaslem com
Project: SB 052015/NC CERT#257
REPORT OF ANALYSIS Date Sampled: 4/13/2015 07:15:00
Date Received: 04/16/2015 00:00
Date Reported: 04/21/2015
Total Chromium
237
5
KM
04/17/2015 00:00
SW 6010C
Total Nickel
9
5
KM
04/17/2015 00:00
SW 6010C
Total Lead
11
5
KM
04/17/2015 00:00
SW 6010C
Total Arsenic
<3.0
3.0
KM
04/17/2015 00:00
SW 6010C
Total Mercury
0.5
0.4
KM
04/20/2015 09:00
SW-7471 B
Total Selenium
<5.0
5.0
KM
04/17/2015 00:00
SW 6010C
Calcium Carbonate Equivalent
12.00 120000
100
JM
04/17/2015 13:30
AOAC 955.01
Total Volatile Solids
69.99 699900
100.0
JM
04/16/2015 16:00
SM-254OG
Total Molybdenum
<5
5
KM
04/17/2015 00:00
SW 6010C
Comments:
CCE, SULFUR AND ORGANIC NITROGEN NOT FOR COMPLIANCE PURPOSES.
All values are on a dry weight basis except as noted by asterisk. Detection limit on all N series is on a wet basis.
Our rsports and letters are for the exclusive and confidential use of our clients, and may not be reproduced in whole or part, nor may any reference be made
to the work, the results, or the company in any advertising, news release, or other public announcements without obtaining our prior written authorization.

15-i
SAWLE TRAM SNUTTAL .I Im�lllallil���, l l�l�llm� I��i��llll�l� 9 15Z
ormoF ISURLINGTON 13:44:42
A&L Eastem 1 SB 6520151M CERT*257
7621 VWhiten4ne Rnad Richmnr:v try. 6uy+-rwi-!mui
Office Information
Customer 'information
Rept#
Submitted By Ch trp To
Copy To
Project
Shane Fletcher CRY of, Budin ton
acot #46475
P"O.S 1350:
Email
Budington NC 272161358
Efldchar®d.wrllnu:on.nc.ue
Lab Number (Lab Use Only)
Sample ID
Container Type
Sampled Date:
— j
Date Recdt
aq'
B d �`�
Glass Yes or No)
plastic s or No
Sampled Time:
Sampled B :
Tame Recd.,l
Recd B .
R+e In uished By: nature.
Date
Time
Received B. (Signature)
Date
Time
Please Place a 'W b)y Desired Tests
internal Lab Code:
SLBURL
Solids %
TKN
P
K
S
Ca
Mg
Na
Fe
AI
Mn
cu.
Zn
NH4-14
NO3-N
x
x
x
x
x
x
X
x
x
x
x
x
x
x
x
Cd
Cr
Ni
Pb
As
Hg
Se
pH
CaCO3
Eqk %
Volatile.
Solids %
Or -N
Mo
CI
B
Ba
X
X
x
X
x
x
X
X
X
x
x
SO4
Ag
5b
Co
Sin
Ti
v
Be
ALK
$S
Avail P
Sol K
Cond
WIN
SQL B.
SOL NA
O&G
SP.GR.
TSS
Sieve#20
Sleve"o
Sievefloo
ASH
CaO
CaCO3
M CO3
M O
CIN
TOC
Eov
TOTAL
P205
TOTAL
K20
TN
TKNW
NH4W
NO3W
ORGN-W
PA CERT
AZ CERT
BTU
PCBS
REACT
CN
FECAL
TCLP
1CR
State Certification Needled:
NC
Special instructions
or Remarks
G mments
�^ i3, IC3

Page: 1 of 2
Report Number: 15-138-0201
Account Number: 45475
Submitted By: SHANE FLETCHER
Send To: CITY OF BURLINGTON
SHANE FLETCHER
POB 1358
BURLINGTON , NC 27216-1358
Lab Number: 62030
Sample Id: #SB062015
�L A&L Eastern Laboratories, Inc.
7621 Whitepine Road Richmond, Virginia 23237 [phone] Fax [phone]
www,ainstern.com
Project: #SB062015/NC CERT#257
REPORT OF ANALYSIS Date Sampled: 5/11/2015 07:05:00
Hate Received: 05/1812015 00:00
Date Reported: 05/22/2015
Total Solids
4.19
41900
100.0
JM
05/18/2015 15:29
SM-2540G
Moisture *
95.81
100.0
JM
05/18/2015 15:29
SM-254OG
Total Kjeldahl Nitrogen
7.28
72800
10.0
JM
05/19/2015 09:40
SM-4500-NH3C-TKN
Total Phosphorus
2.38
23800
100
KM
05/19/2015 14:03
SW 6010C
Total Potassium
0.83
8290
100
KM
05/19/2015 14:03
SW 6010C
Total Sulfur
0.70
7010
100
KM
05/19/2015 14:03
SW 6010C
Total Calcium
7.48
74800
100
KM
05/19/2015 14:03
SW 6010C
Total Magnesium
0.54
5440
100
KM
05/19/2015 14:03
SW 6010C
Total Sodium
0.42
4170
100
KM
05/19/2015 14:03
SW 6010C
Total Iron
8740
100
KM
05/19/2015 14:03
SW 6010C
Total Aluminum
7000
100
KM
05/19/2015 14:03
SW 6010C
Total Manganese
255
5
KM
05/19/2015 14:03
SW 6010C
Total Copper
184
5
KM
05/19/2015 14:03
SW 6010C
Total Zinc
414
5
KM
05/19/2015 14:03
SW 6010C
Ammonia Nitrogen
3.05
30500
10.0
JM
05/22/2015 10:30
SM-4500-NH3C
Organic N
4.23
42300
10.0
05/19/2015 09:40
CALCULATION
Nitrate+Nitrite-N
<2.00
2.00
JM
05/19/2015 09:40
SM-450ONO3F
Total Cadmium
<2.0
2.0
KM
05/19/2015 14:03
SW 6010C
All values are on a dry weight basis except as noted by asterisk. Detection limit on all N series is on a wet basis.
Our reports and letters are for the exclusive and confidential use of our clients, and may not be reproduced in whole or part, nor may any reference be made
to the work, the results, or the company in any advertising, news release, or other public announcements without obtaining our prior written authorization.
Debbie Holt

Page: 2 of 2
Report Number: 15-138-0201
Account Number: 45475
Submitted By: SHANE FLETCHER
Send To: CITY OF BURLINGTON
SHANE FLETCHER
POB 1358
BURLINGTON , NC 27216-1358
Lab Number: 62030
Sample Id: #SB062015
A&L Eastern Laboratories, Inc.
7621 Whitepine Road Richmond, Virginia 23237 [phone] Fax (804) 271-WS
www.aleastern.com
Project: #SB062015/NC CERT#257
REPORT OFANALYSIS Date Sampled: 5/11/2015 07:05:00
Date Received: 05/18/2015 00:00
Date Reported: 05/22/2015
Total Chromium
257
5
KM
05/19/2015 14:03
SW 6010C
Total Nickel
16
5
KM
05/19/2015 14:03
SW 6010C
Total Lead
13
5
KM
05/19/2015 14:03
SW 6010C
Total Arsenic
<3.0
3.0
KM
05/1912015 14:03
SW 6010C
Total Mercury
0.4
0.4
KM
05/19/2015 09:00
SW-7471 B
Total Selenium
<5.0
5.0
KM
05/19/2015 14:03
SW 6010C
Calcium Carbonate Equivalent
7.00 70000
100
CZ
05/20/2015 00:15
AOAC 955.01
Total Volatile Solids
70.80 708000
100.0
JM
05/18/2015 15:29
SM-2540G
Total Molybdenum
<5
5
KM
05/19/2015 14:03
SW 6010C
Comments:
CCE, SULFUR AND ORGANIC NITROGEN NOT FOR COMPLIANCE PURPOSES.
QUALIFIER: THE MATRIX SPIKE WAS OUT OF LIMITS FOR "Al", "Ca", "K", AND "Na ALL OTHER QC DATA IS ACCEPTABLE.
NOTE: CUSTOMER REQUESTED "NH4-N" RERUN 05/22/15.
All values are on a dry weight basis except as noted by asterisk. Detection limit on all N series is on a wet basis.
Our reports and letters are for the exclusive and confidential use of our clients, and may not be reproduced in whole or part, nor may any reference be made
to the work, the results, a the company in any advertising, news release, or other public announcements without obtaining our prior written authorization.
Debbie Holt

I
SAMPLE TRANSAIITTAL
lCITY OF 11�IIIIflfIII�INI�fsllfll�I�N���ll 4M20;St
S6u82015 NG C RT*257 13:10,1Q
A&L East+: m Laboratonus,
7691 'W'h fi-ninP Roam RTchmnnd VA 237-37 Tel- RM-143694W
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Office information
customer, Infibt'rti�ation
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Subrhitted ChargeTo
`Cop To
Project
Shone FletcG of 80dington
ACTA #45475
POS 1358 -
El
EMall
B�uriingfoti NC 27216-1358
[e-mail]`a
Lab Number (Lab Use Only}
Sample ID
ContainerType
Sampled Date:
� fl�15r
DaWAecd:
S--It-)3
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Glass es o
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0?0:r
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Lai c
Reed By:
A II uish Si nature
Date
Time
Received B S'" nature)
Date
'Time
Please Place a " X" by Desired Tests
Intemai Lab Code:
SLOURL
Soiiyds %
`i"IM
P
K
S,
Ce
All
Na
re
Al
Min,
Cu
Zn
NH4-N
NO3-N
x
x
x
x
x
x
x
x
x
x
x
x
x
x
Cd
Cr
Nl
Pb
As
Hg
Se
pH
GaG03
Eq. `S6
Vvilatlle
Solids %
Org-N
Mo
Cl.
B
Ba
x
x
x
x
x
x
x
x
x
x
x
Soo
Ag
Sb
Co
Sn
Ti
V
Be
AL:K
SS
Avall P
Sol K
Cond
WIN
SOL B
SOL NA
O&C,i
MOR.
TSS
sieve=
Sleve"o.
Sieved oo
ASH
CaO
CatCO3
M CO3
M O
C/N
TOC
Etty
TOTAL
P205
TOTAL
K20
TN
TKNW
NH4W
NO3W
ORGN-W
PA CERT
AZ CERT
BTU
PCBS
REACT
CN
FECAL
TCL:P
JCR
State +Cortitication Needed.-
NC
SPa+al', nstructi©ns
or Remarks
Comments

Page: 1 of 2
Report Number: 15-166-0200
Account Number: 45475
Submitted By: SHANE FLETCHER
Send To: CITY OF BURLINGTON
SHANE FLETCHER
POB 1358
BURLINGTON , NC 27216-1358
Lab Number: 62455
Sample Id: #SB072015
A&L Eastern Laboratories, Inc.
7621 Whitepine Road Richmond, Virginia 23237 [phone] Fax [phone]
www.aLastern.com
Project : #SB072015
NC CERT#257
REPORT OFANALYSIS Date Sampled: 6/8/2015 06:00:00
Date Received: 06/15/2015 00:00
Date Reported: 06/19/2015
Total Solids `
4.16
41600
100.0
JM
06/15/2015 15:00
SM-2540G
Moisture'`
95.84
100.0
JM
06/15/201515:00
SM-254OG
Total Kjeldahl Nitrogen
5.02
50200
10.0
JM
06/16/2015 09:09
SM-4500-NH3C-TKN
Total Phosphorus
2.31
23100
100
KM
06/16/2015 14:26
SW 6010C
Total Potassium
0.40
4040
100
KM
06/16/2015 14:26
SW 6010C
Total Sulfur
0.73
7270
100
KM
06/16/2015 14:26
SW 601OC
Total Calcium
11.90
119000
100
KM
06/16/2015 14:26
SW 6010C
Total Magnesium
0.84
8410
100
KM
06/16/2015 14:26
SW 6010C
Total Sodium
0.31
3110
100
KM
06/16/2015 14:26
SW 6010C
Total Iron
12000
100
KM
06/16/2015 14:26
SW 6010C
Total Aluminum
10500
100
KM
06/16/2015 14:26
SW 6010C
Total Manganese
489
5
KM
06/16/2015 14:26
SW 6010C
Total Copper
236
5
KM
06/16/2015 14:26
SW 6010C
Total Zinc
474
5
KM
06/16/2015 14:26
SW 6010C
Ammonia Nitrogen
1.90
19000
10.0
JM
06/16/2015 09:09
SM-4500-NH3C
Organic N
3.12
31200
10.0
06/16/2015 09:09
CALCULATION
Nitrate+ N itrite-N
48.1
2.00
JM
06/17/2015 08:50
SM-450ONO3F
Total Cadmium
<2.0
2.0
KM
06/16/2015 14:26
SW 6010C
All values are on a dry weight basis except as noted by asterisk. Detection limit on all N series is on a wet basis.
Our reports and fetters are for the exclusive and confidential use of our clients, and may not be reproduced in whole or part nor may any reference be made
to the work, the results, or the company in any advertising, news release, or other public announcements without obtaining our prior written authorization.
Debbie Holt

Page: 2 of 2
Report Number: 15-166-0200
Account Number: 45475
Submitted By: SHANE FLETCHER
Send To: CITY OF BURLINGTON
SHANE FLETCHER
POB 1358
BURLINGTON , NC 27216-1358
Lab Number: 62455
Sample ld : #SB072015
A&L Eastern Laboratories, Inc.
7621 Whitepine Road Richmond, Virginia 23237 [phone] Fax (804) 271-W6
e
wwwaleastem.com
Project : #SB072015
NC CERT#257
REPORT OF ANALYSIS Date Sampled: 6/8/2015 06:00:00
Date Received: 06/15/2015 00:00
Date Reported: 06/19/2015
Total Chromium
239
5
KM
06/161201514:26
SW 6010C
Total Nickel
17
5
KM
06/16/2015 14:26
SW 6010C
Total Lead
21
5
KM
06/16/2015 14:26
SW 6010C
Total Arsenic
<3.0
3.0
KM
06/16/2015 14:26
SW 6010C
Total Mercury
1.9
0.4
KM
06/16/2015 09:00
SW-7471 B
Total Selenium
<5.0
5.0
KM
06/16/2015 14:26
SW 6010C
Calcium Carbonate Equivalent
22.70 227000
100
JM
06/16/201513:30
AOAC 955.01
Total Volatile Solids
51.31 513100
100.0
JM
06/15/2015 15:00
SM-254OG
Total Molybdenum
5
5
KM
06/16/2015 14:26
SW 6010C
Comments:
CCE, SULFUR AND ORGANIC NITROGEN NOT FOR COMPLIANCE PURPOSES.
QUALIFIER: THE MATRIX SPIKE WAS OUT OF LIMITS FOR "Ca". ALL OTHER QC DATA IS ACCEPTABLE.
All values are on a dry weight basis except as noted by asterisk. Detection limit on all N series is on a wet basis.
Our repots and fetters are for the exclusive and confidential use of our clients, and may not be reproduced in whole or part, nor may any reference be made
to the work, the results, or the company in any advertising, news release, or other public announcements without obtaining our prior written authorization.
Debbie Holt

SAWLE TRANSMITTAI
A&L Eastern
17fi71, Whit,...,. Rri.,vuinh.
RON 11111111111 . 1 15-1'6�-0200
CIT,y OF OUMINGTON
ASOOM45
Office Information
Qjeftbm. or information
Rept#
Submitted By chat To
Co Tb
'Shang Flacihor CIty of Surflngton
POB 1358
, 7flvn
Acct #45476
Burlington :IBC .27216-1358
Lab Number (Lab -U ,e of�lyj
Container Type
Sampled Date:-
Date Reed:
UZ45is-
5
Glass (Yesor;
sampled 11ine:
10,06
rime Recd.
Plasoo 'ix No
Sampled BY:
L:�
tj&�k-
Reed By:
Relinquished By: (S!pnature)
Data
lime
Rowtved By: (SignOurq)
Date
Tlme
I Lo 115
Please Place "a "X'u by Desired Tests
lrftmali Lab Codw,
SLIEW RL
SoIlde; %
TKN
P
K
S
Ca
Mg
Na
Fe
Al
Un I
Cu
Zn
NH4-N,
NO3-k
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
Cd
er
Ni
Pb
As
HIS
Be
pH
CWC—O3
Ett., %
Vollidille
So Oda %
-
Org-N
Mo
Cl
B
Ba
x
X
x
x
x
x
x
x
x
x
x
SO4
Ag
5b
00
S"
71
v
Be
ALK
SS
AVall P
Sol K
Cond
WIN
SOL 8
SOL-NA.
OAQ I
SPAR..
TSS
gleve#26
OmM#60
Stomoloo
ASH
SAO
C19CO3
MgCQ3
I Mgo
CIN
TOC
Env
—!UfA—L—
P205
Tam-
K20
TN
TKIMW
NH4W
NOSW
ORGN-W
PA Crffff
AZ CERT,
STU
-PCBS
RA
C14
FECAL
TCLP
ICR
$JMtO,-C6d,I,flCOt,Jojn Needed:
NC
SpecW,-lh9&ucqonv
or'Mroarks
commeft,

Page: 1 of 2
Report Number: 15-196-0204
Account Number: 45475
Submitted By: SHANE FLETCHER
Send To: CITY OF BURLINGTON
SHANE FLETCHER
POB 1358
BURLINGTON , NC 27216-1358
Lab Number: 62913
Sample Id: SB082015
Waypoint(2)
ANALYTICAL
Project: SBO82015
NC CERT#257
REPORT OFANALYSIS
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 ° Fax [phone]
www.waypointanalytical.com
Date Sampled: 7/13/2015 06:05:00
Date Received: 07/15/2015 00:00
Date Reported: 07/20/2015
Total Solids *
4.30
43000
100.0
RD
07/15/2015 15:24
SM-254OG
Moisture *
95.70
100.0
RD
07/15/2015 15:24
SM-254OG
Total Kjeldahl Nitrogen
6.09
60900
10.0
.!M
07/16/2015 09:35
SM-4500-NH3C-TKN
Total Phosphorus
2.33
23300
100
BW
07/16/2015 09:00
SW 6010C
Total Potassium
0.61
6100
100
BW
07/16/2015 09:00
SW 6010C
Total Sulfur
0.82
8200
100
BW
07/16/2015 09:00
SW 6010C
Total Calcium
10.90
109000
100
BW
07/16/2015 09:00
SW 6010C
Total Magnesium
0.62
6230
100
BW
07/16/2015 09:00
SW 6010C
Total Sodium
0.40
3990
100
BW
07/16/2015 09:00
SW 6010C
Total Iron
8190
100
BW
07/16/2015 09:00
SW 6010C
Total Aluminum
7900
100
BW
07/16/2015 09:00
SW 6010C
Total Manganese
288
5
BW
07/16/2015 09:00
SW 6010C
Total Copper
214
5
BW
07/16/2015 09:00
SW 6010C
Total Zinc
493
5
BW
07/16/2015 09:00
SW 6010C
Ammonia Nitrogen
1.30
13000
10.0
JM
07/16/2015 09:35
SM-4500-NH3C
Organic N
4.79
47900
10.0
07/1612015 09:35
CALCULATION
Nitrate+Nitrite-N
<2.00
2.00
JM
07/16/2015 09:35
SM-450ONO3F
Total Cadmium
<2.0
2.0
BW
07/16/2015 09:00
SW 6010C
All values are on a dry weight basis except as noted by asterisk. Detection limit on all N series is on a wet basis.
9Our repots and letters are for the exclusive and confidential use of our clients, and may not be reproduced in whole or part, nor may any reference be made , fta'�
to the work, the results, or the company in any advertising, news release, or other public announcements without obtaining our prior written authorization.
Debbie Holt

Page: 2 of 2
Report Number: 15-196-0204
Account Number: 45475
Submitted By: SHANE FLETCHER
Send To: CITY OF BURLINGTON
SHANEFLETCHER
POB 1358
BURLINGTON , NC 27216-1358
Lab Number: 62913
Sample Id : SB082015
o
Waypoint.�
ANALYTICAL
Project: SB082015
NC CERT#257
REPORT OFANALYSIS
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 ° Fax [phone]
www.waypointanalytical.com
Date Sampled: 7/13/2015 06:05:00
Date Received: 07/15/2015 00:00
Date Reported: 07/20/2015
Total Chromium
247
5
BW
07/16/2015 09:00
SW 6010C
Total Nickel
13
5
BW
07/16/2015 09:00
SW 6010C
Total Lead
15
5
BW
07/16/2015 09:00
SW 6010C
Total Arsenic
<3.0
3.0
BW
07/16/2015 09:00
SW 6010C
Total Mercury
<0.4
0.4
JM
07/17/201511:45
SW-7471B
Total Selenium
<5.0
5.0
BW
07/16/2015 09:00
SW 6010C
Calcium Carbonate Equivalent
18.70 187000
100
CZ
07/16/2015 11:30
AOAC 955.01
Total Volatile Solids
61.91 619100
100.0
RD
07/15/2015 15:24
SM-254OG
Total Molybdenum
5
5
BW
07/16/2015 09:00
SW 6010C
Comments:
CCE, SULFUR AND ORGANIC NITROGEN NOT FOR COMPLIANCE PURPOSES.
All values are on a dry weight basis except as noted by asterisk. Detection limit on all N series is on a wet basis.
Our reports and letters are for the exclusive and confidential use of our clients, and may not be reproduced in whole or part, nor may any reference be made
to the work, the results, or the company in any advertising, news release, or other public announcements without obtaining our prior written authorization.
Debbie Holt

6-1965
SAMPLE TRANSMn. rA1
454i ois4
C]TY Or BURLINGTON 13:2820
},,
A {7rT Eas l.�j
380820'15
in
Ml—
76?1 WhItenineRondRich.
Office,Information
Customer Information
Fie tk
Submitted By Charge To
Copy To
Project
Shane Fletcher City of Burlington
,.
Acct 445475
POB 1355
Email
Burlington NC 27216.13155
sfletcher�ci.ix�rlinatan.n�.us
Lab Number (Lab Use Only)
Sample ID
Container Type
Sample Date:
15,15_
Date Reed:
-I -
+✓'� (�
��'
Glass (Yes or Pgi4
SaM led Time:
�
Time 'Reed:
Q t_
Plastic,
rNo
Sampled By!
rC4
Recd B
eli (Si nature)
Date
Time
Recanred By; (Signature)
Date
Time
—
Please Place a "X" by Desired Tests
Internal Lab Code:
SLBUAL
5olidss a
TKN
P
K
S
Ca
Mg
Na
Fe
AJ
Mn
Cu
Zn
NHMN
NO3-N
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
Cd
Cr
Nl
Pb
As
Hg
Se
pH
CaCO3
E . %
Volatile
Solids %
Org-N
Mo
Cl
B
Ba
x
x
x
x
x
x
x
x
x
x
x
SO4
Ag
Sb
Co
So
Tl
V
Be
ALK
SS
Avail P
Sol K
Conti
WIN
SOL B
SOL NA
O&G
MGM
TSS_.
Move=
sievem
sieve#1od
ASH
CaO
CaCO3
MgCO3
MgO
C/N
TOC
Env
TOTAL
P20S
TOTAL
1 20
TN
TKNW
NH4W
NO3W
QRGWW
PA CERT
AZCERT
STU
PCBS
REACT
CN
FECAL
TCLP
ICR
State Certification Needed.,
NC
` Special Instructions
or Remarks
Comments
d
d

Page. 1 of 2
Report Number: 15-224-0214
Account Number: 45475
Submitted By: SHANE FLETCHER
Send To: CITY OF BURLINGTON
SHANE FLETCHER
POB 1358
BURLINGTON , NC 27216-1358
Lab Number: 63509
Sample Id : #SB092015
(2)
Waypoi nt .,
ANALYTICAL
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 ° Fax [phone]
www.waypointanalytical.com
Project: #SB092015/NC CERT#257
REPORT OFANALYSIS Date Sampled: 8/10/2015 06:05:00
Date Received: 08/12/2015 00:00
Date Reported: 08/20/2015
Total Solids
3.81
38100
100.0
RD
08/12/2015 15:29
SM-254OG
Moisture "
96.19
100.0
RD
08/12/2015 15:29
SM-254OG
Total Kjeldahl Nitrogen
5.59
55900
10.0
SIB
08/13/2015 08:30
SM-4500-NH3C-TKN
Total Phosphorus
2.52
25200
100
KM
08/13/2015 00:00
SW 6010C
Total Potassium
0.66
6570
100
KM
08/13/2015 00:00
SW 6010C
Total Sulfur
0.78
7790
100
KM
08/13/2015 00:00
SW 6010C
Total Calcium
10.40
104000
100
KM
08113/2015 00:00
SW 6010C
Total Magnesium
0.72
7230
100
KM
08/13/2015 00:00
SW 6010C
Total Sodium
0.54
5360
100
KM
08/13/2015 00:00
SW 6010C
Total Iron
8820
100
KM
08/13/2015 00:00
SW 6010C
Total Aluminum
8500
100
KM
08/13/2015 00:00
SW 6010C
Total Manganese
228
5
KM
08/13/2015 00:00
SW 6010C
Total Copper
213
5
KM
08/13/2015 00:00
SW 6010C
Total Zinc
422
5
KM
08/13/2015 00:00
SW 6010C
Ammonia Nitrogen
1.50
15000
10.0
SIB
08/18/2015 12:29
SM-4500-NH3C
Organic N
4.09
40900
10.0
08/13/2015 08:30
CALCULATION
Nitrate+Nitrite-N
<2.00
2.00
SB
08/13/2015 08:30
SM-450ONO3F
Total Cadmium
<2.0
2.0
KM
08/13/2015 00:00
SW 6010C
All values are on a dry weight basis except as noted by asterisk. Detection limit on all N series is on a wet basis.
Our reports and letters are for the exclusive and confidential use of our clients, and may not be reproduced in whole or part, nor may any reference be made
to the work, the results, or the company in any advertising, news release, or other public announcements without obtaining our prior written authorization.
Debbie Holt

Page: 2 of 2
Report Number: 15-224-0214
Account Number: 45475
Submitted By: SHANE FLETCHER
Send To: CITY OF BURLINGTON
SHANE FLETCHER
POB 1358
BURLINGTON , NC 27216-1358
Lab Number: 63509
Sample Id: #SB092015
D
Waypoin(t.�
ANALYTICAL
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 ° Fax [phone]
www.waypointanalytical.com
Project: #SB092015/NC CERT#257
REPORT OF ANALYSIS Date Sampled: 8/10/2015 06:05:00
Date Received: 08/12/2015 00:00
Date Reported: 08/20/2015
Total Chromium
214
5
KM
08/13/2015 00:00
SW 6010C
Total Nickel
12
5
KM
08/13/2015 00:00
SW 6010C
Total Lead
15
5
KM
08/13/2015 00:00
SW 6010C
Total Arsenic
<3.0
3.0
KM
08/13/2015 00:00
SW 6010C
Total Mercury
0.5
0.4
KM
08/13/201509:00
SW-7471B
Total Selenium
<5.0
5.0
KM
08/13/2015 00:00
SW 6010C
Calcium Carbonate Equivalent
14.00 140000
100
SB/CZ
08/13/2015 01:20
AOAC 955.01
Total Volatile Solids
62.51 625100
100.0
RD
08/12/2015 15:29
SM-2540G
Total Molybdenum
<5
5
KM
08/13/2015 00:00
SW 6010C
Comments:
CCE, SULFUR AND ORGANIC NITROGEN NOT FOR COMPLIANCE PURPOSES.
QUALIFIER: THE MATRIX SPIKE WAS OUT OF LIMITS FOR "Al", "Fe" AND "K". ALL OTHER QC DATA IS ACCEPTABLE.
All values are on a dry weight basis except as noted by asterisk. Detection limit on all N series is on a wet basis.
Our reports and letters are for the exclusive and confidential use of our clients, and may not be reproduced in whole or part, nor may any reference be made
to the work, the results, or the company in any advertising, news release, or other public announcements without obtaining our prior written authorization.
Debbie Holt