WQ0000520_Residual Annual Report 2016 - Part 1_20170228

City of Burlington — WQ0000520
Biosolids Land Application Program ��v�
Annual Report �,
rtb 8 7017
Information Processing Unit
Table of Contents pW , Section
1. Annual Land Application Certification Form
a. RSSF Forms
2. WLSF Forms
a. FSF Forms RECEIVEDINCDECIDWR
3. Residuals Analysis Lab Sheets
a. TCLP Lab Sheets MAR - 1 2017
4. PVRF Forms Non -Discharge
a. Pathogen & Vector Attraction Reduction Lab §WRVg Unit
5. Soils Analyses
6. Zimpro Ash
w

ANNUAL LAND APPLICATION CERTIFICATION FORM
WQ Permit#: WQ0000520 County: Alamance Year:
B
Facility Name (as shown on permit):
Land Application Operator:
City of Burlington
ENIA Resources Inc. Phone:
T,and application of residuals as allowed by the permit occurred during the past calendar year?
'0 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 Summar :
336-751-1441
Total number of application fields in thepermit:
208
Total number of fields utilized for land application during the year:
80
Total amount of dry tons applied during the year for all application sites:
3,644.72
Total number of acres utilizes for land application during the year:
1450.9
Part B - Annual Compiance Statement:
Facility was compliant during calendar year 2016 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 - - c-7
,>rmittee Name and Title (type or print) Signature of Permittee Date
Z�f 1/23/2017
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 SANreLING SUMMARY FORM
Please note that your permit may contain additional parameters to be analyzed. The parameters can be reported in FORM RSSF - E
WQ Permit Number:
WQ0000520
Facility Name: City of Burlington
Residual Source WQ # or
NPDES #:
WWTP Name:
Residual Analysis Data
NCO023868
Eastside WWTP
Laboratory: 1) Waypoint Analytical
2)
3)
4)
5)
Parameter
Parameter
Cone.
Limit
(mg/kgLimit
a
Sample or Composite Date
12/7/15
1/11/16
2/8/16
3/14/16
4/11/16
5/9/16
6/13/16
7/11/16
8/8/16
9/12/16
10/10/16
11/7/16
Percent Solids (%)
NA
4.6
3.23
5.17
6.23
4.98
5.16
3.54
3.96
4.07
3.95
3.11
4.58
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
157
98
133
122
131
123
210
228
261
266
174
168
Chromium
NA
52
48
56
61
67
51
56
50
46
59.8
55
53.3
Lead
840
15
12
14
15
14
12
13
14
9
12.8
11.7
15.2
Mercury
57
1
0.4
0.4
0.4
0.8
0.6
0.4
0.4
0.4
0.4
0.4
0.4
Molybdenum
75
5
5
5
5
5
5
5
5
5
5
5
5
Nickel
420
25
11
15
18
19
12
12
11
11
15.1
14
18.8
Selenium
100
5
5
5
5
5
5
5
5
5
5
5
5
Zinc
7,500
484
343
403
433
492
416
367
525
487
489
412
473
Total Phosphorus
NA
9420
6040
10700
9780
11300
12300
8780
8220
6880
15500
6470
8110
TKN
NA
27600
19800
26500
26000
29500
29700
22000
31100
20400
28000
27900
19200
Ammonia -Nitrogen
NA
3700
6500
1740
3050
3010
3880
3670
3540
1470
5050
4810
1960
Nitrate and Nitrite
NA
2
1 2
2
2
75.1
2
2
1 2
2
8
346
11.1
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."
Signor f 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 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
Laboratory: 1)
Facility Name:
City of Burlington
2)
Residual Source
NCO023868
3)
NPDES # or WQ#:
4)
WWTP Name:
Eastside WWTP
5)
Residual Analysis Data
Waypoint Analytical
Parameter
(mg/kg)
Sam le or Composite Date
12/7/15
1/11/16
2/8/16
3/14/16
4/11/16
5/9/16
6/13/16
7/11/16
8/8/16
9/12/16
10/10/16
11/7/16
Aluminum
28500
45700
33300
31600
31200
31500
44900
39700
37800
34800
44200
36500
Calcium
105000
139000
101000
97500
99500
114000
116000
141000
169000
133000
177000
151000
Magnesium
2820
2650
2920
2710
3290
3240
3140
3100
3060
3890
3060
2810
Potassium
1210
1230
1460
1510
1580
2420
1270
889
916
1200
1060
1140
Sodium
2340
1230
1020
1270
2450
2380
2350
1440
2430
2480
3890
4120
pH
11.62
11.5
11.32
11.69
11.4
11.75
11.82
11.8
11.78
11.89
12.01
12
SAR
0.42
0.16
0.2
0.27
0.46
0.43
0.35
0.21
0.32
0.36
0.44
0.61
"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."
- Z'fz�rll-7
Signature of Preparer * Date
*Preparer is defined in 40 CFR Part 503.9(r) and 15A NCAC 2T .1102 (26)
DENR FORM RSSF - B (1.2/2006)

ANNUAL RESIDUAL SAN-ceLING 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: 1) Waypoint Analytical
Facility Name: City of Burlington 2)
Residual Source WQ # or 3)
NPDES #: NC0023876 4
WWTP Name: Southside WWTP 5)
Residual Analvsis Data
Parameter
(mg/kg)
Conc.
Limit
ml,,,/k a
Sample or Composite Date
12/7/15
1/11/16
3/14/16
4/11/16
5/9/16
6/13/16
7/11/16
8/8/16
9/12/16
10/10/16
Percent Solids (%)
NA
2.74
2.55
3.55
3.79
4.42
4.5
2.52
3.62
3.25
3.46
Arsenic
75
3
3
3
3
3
3
3
3
3
3
Cadmium
85
2
2
2
2
2
2
2
2
2
2
Copper
4,300
215
232
186
199
160
157
98
160
158
195
Chromium
NA
247
244
1 201
190
156
168
97
135
164
209
Lead
840
19
15
15
13
10
12
6
12
13.6
11.5
Mercury
57
0.4
0.6
0.4
0.5
1.1
0.4
0.4
0.4
0.5
0.4
Molybdenum
75
7
5
5
5
5
5
5
5
5
5.14
Nickel
420
64
12
9
11
7
8
6
8
8.42
9.25
Selenium
100
5
5
5
5
5
5
5
5
5
5
Zinc
7,500
462
425
345
404
333
359
215
352
300
376
Total Phosphorus
NA
27000
28500
27400
28600
20400
19600
21900
21200
21400
23600
TKN
NA
67200
66300
62000
69100
57900
1 57600
1 30800
55200
58300
61400
Ammonia -Nitrogen
NA
28500
32500
22300
29300
9730
1 8890
9960
10800
19000
17600
Nitrate and Nitrite
NA
2
2
2
2
2
2
2
68
8
579
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."
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 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 Analvsis Data
NCO023876
Southside WWTP
Laboratory: 1) Waypoint Analytical
2)
3)
4)
5)
Parameter
(mg/kg)
Sample or Com osite Date
12/7/15
1/11/16
3/14/16
4/11/16
5/9/16
6/13/16
7/11/16
8/8/16
9/12/16
10/10/16
0
0
Aluminum
7200
8300
11700
7300
6900
12400
12400
22900
14000
5420
Calcium
97800
104000
98700
84100
91100
101000
106000
206000
118000
115000
Magnesium
6740
7100
5420
6150
6750
5400
5050
6750
6190
6000
Potassium
5640
6520
6050
5360
8790
6670
5190
4880
6230
6390
Sodium
5450
5360
3470
3100
3050
3390
2470
2370
3650
4950
pH
8.49
7.7
9.05
8.62
11.99
12.22
12.1
12.17
9.73
9.67
SAR
0.75
0.69
0.6
0.52
0.51
0.59
0.43
0.22
0.53
0.69
"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)
-4-1Z31j7
Date
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): 44..34
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
C' ;ator: Tom Neal Owner: Walter Hessenthaler Predominant Soil Series: HbB
A, -s Used: 17 Acres Permitted: 17 Site #: AM006 Field #: 1
Residual Analvsis Data (Heavy Metals and Total Phosphorus use m0kg, % Solids use Raw Percent ft
Com-
posite
Date
Total
Phos-
'MENEENEENEEN
F Vital
Heavy ivietat riela Loaclings
(Ualculateci in lbs/acre):
utal
1
L2j
L3
4
5
6
7
8
9
10
11
12
DT/Ac./
App.
y
Event
2.61
Arsenic
0 0j6
0._00-0
0.000
0.000
D.00'0
0:000
0.000
0_0`00
0.000.:
0.000
0.000
0.0-00
0.016
Cadmium
0 410
0A00
4 000.
0.060
0:000
0..0oo
0.000
O.b 0 1
0.000
0.000
0.:000
o:000 :
- 0.010
Copper
0.835
0 000
I 0.0. o
'„0 000
0.000
0' 000
"`0 000
_ 0.000
0.000_ :;
0 .
0 00:4
0..000
0.835
Chromium
0.814
0.000
0 009
0 000
0 000
0: 000
0 000;
0 000
Q:OOQ
o OQO
0 000.
0.000
0 814
Lead
0.05'2
0::0Coo
0 00:0 ,°
0.000:
0.06.9,
0:000 '
.oi0oo
0.0:00:
0.60,0
, 0 000:
0:000
0,000
0.452
I Molyb- I 0 02:6 10.000 L. 0 000 . 0 000 0:000 I- .0 000` 0 OOQ, 0.0'00 10;:000 I 0 000 ( 0.000 10:000`. :0.025 I
Nickel
0 037
0 000
0 000
' 0 DO'0
0 000
, O000 ;'
0 OOQ=
D:QgO
0 000 :
0 000
0 0Q .
0 000
0.037 .
Selenium
0 02;6
0 000
0 000
0 000
0 0:00,
Q 000. _`
0 000_
4 000
0:000.,.
. 0 000.
0:000
0..000
_.
0.026
Zinc
1.7
4 Q40
0 000 :'
0 004
0 000
0 000
0 OOfl
0 (D0
0:000 ;.
4 000'.
0 004
0.0.00
1.737
Total
_.
Phos-
106.406'
00:00
0.0.40
0.0001.
o.Q`oa
0:.000'
0.000.
0.000
0.04o'
0 00.0'
0.66 0
0:400
4:0.6.40
nhorus
"I certifv. under nenaltv 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
ir--isonment for knowing violations".
;e 1/10/2017
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
Operator:
ANNUAL LAND APPLICATION i. .ELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "NIA" IN A BLANK OR BOX WHEN NOT APPLICABLE.
City of Burlington
Walter Hessenthaler
Tom Neal
WQ Permit #: WQ0000520 Field #:
Annual Dry Tons Applied: 44.34' Site #:
Predominant Soil Series: HbB
Crop 1 Name: Fescue -Hay Crop 1 Max. PAN: 169 Crop 2 Name:
Acres Utilized: 17
AM006 Acres Permitted: 17
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
$..
° '[
°
A
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied r
PP per
Acre
(Dry Tons/AC)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry'
Moist)
Precip.
Past 24
Hrs.
inches
a
co
o w
O
o
;y
N'
w
°.
4
0
w •�
+� P-
*
* P'
TKN
mglkg
Z 1
4
VQ o
5.
mg/kg
Nitrate
and
Nitrite
mglkg
PAN Applied
Ibs/acre
( )
Name of Crop Type
Receiving Residual
Application
Crop ]
Crop 2
Crop 1
Crop 2
6/30
240500
4.42
2>608
South Burlington
D
<.5"
S
0.5
0.3
57900
9730
2
100.743
1A
Fescue
ar000
0.000
a o00
OfJOQ...a
0.000
0"000
9000Af
aaaa�
0000
o tloo :
o3a�a..
000a .< :
o,000,
o boa
h °0..000
0;000
Oz000k .
4
.............
......
0
: ..-
0
v..,........
3`OOOp ''
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
QU00
0,000
.........
TOTALs.
Ci
zaoopo
As
Cd
Cu
Cr
Pb
H
Mo
Ni
5e
Zn
P
100,743
+] 00a '
Lime A lied
Annual lbs/acres
UdO�
0 O10 .Oti$14
o.u52
O Ob6:
0 026 .t
037 "0.02ft1:737tf16.40f;
.
---------------
:.:::.:::.:: : .:=::.:.:.:.:.:.:.::: =:::
...........................
............................
Date
Ibs/ac
Prior Years Cumulative lbs/ac
0.0921
0.0724
5.8306
2.9018
0.6796
0.014
0.1461
0.4135
O.1082
I4.7786
Current Cumulative lbs/ac
to ;bJ08 =
_t).o81 Y
6f6
3 715ti
(73 : $
:A. 1)20 -
0172
_....
0 450 _
0 I. 4 y
1fa 5 (i
Permitted C. P. L. R.****
36
34
1 1338
267
15
374.
2498
Permit PAN Limit lst/2nd Crop
..._ . ....89.
.....................
..........
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
1/10/2017 **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 Loadina, 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): 5.8.55
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
C ;ator: Tom Neal Owner: Walter Hessenthaler Predominant Soil Series: AbB
A.._ es Used: 18.6 Acres Permitted: 18.6 Site #: AM006 Field #: 2
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kiz, % Solids use Raw Percent #):
r*r-1W,1u-W9fl
Corn-
posite
Date
a
on
MENEM
TotalINEENEW
Phos-
M
uai
heavy ivietai it ieia l,oaaings
(Laicuiatea in ins/acre):
1 otal
1
2
3j
4
5
6
7
8
9
10
11
12
DT/Ac./
0
App.
Event
3.15
Arsenic
0 0.)9
9'..000
0.000
0.000
-0.000-
0 00:0
0.000
0.000
0.000 .
0 000
0.000
0.000
0.-019
Cadmium
0 07:3
0.000
0OOU
0-000
0.0:00
0..060
0:000
0.000
0.000
0.000-
0.000
0 000
0.013
Copper
0 98-$
0.0,0.0
"0 006 :.
0.00.0
p:000
t- 0 000
co. ,
0.000
0.006
0 000
0.000
0.000.
. 0:988
Chromium
1 058
0,000
0.000-
0,00.0
0:000 ;
0 000
0 000
0.000
0 000 `
0 0.00
0.000
0.000
1 05$
Lead
0 06
0::000
0.000
0 000
00- 00
-0.000
0 000
0.000
- •0.000,
0 000:
0 0;00
0.000
. - 0.076
Mercury
0 003
0.000
0.000
0.000
0,000
0 000
0 00#
- 0.000
0;.000
0.000'
0.060
0.000
0.003
Molyb-
0.03=1
0:000
0.000
0.000
0000
0 000`
0 000
0..000
0.000
0.000
0.000
O.000
0.031
den
-
.
Nickel
O.OSO
0000
0 000
0.0,00
0..0:00
- 6 00.0` .
0 000
0000
0,000-
0 000
0 000
0.0.00
0.05.0
Selenium
0.031
0A00
0 000
0.000
0.000
O.000=
0 000-
0 000
0;000 ':.
0.060
0, 0:0:0
Q:.000
0.031
Zinc
2.260
0:000 ;
- 0 000 .
O Q00
0 000
0,000 ,
0 000.
0.000,
0.000
` 0 OQO
0.000
0..00
2.260 -
Total
Phos-
123:402
` 0,000
0.000
0.000
0-000 :
0.000
0.000
0.000
0.000
0..000
0.000
0.000
123.402
❑horus
"I eertifv. under nenalty of law• that thic document wac nrenared ender my direetinn nr cnnervkinn in aecnrdanee
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;Ce
1/10/2017
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION i-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: Walter Hessenthaler Annual Dry Tons Applied: " 58;155, Site #:
Operator: Tom Neal Predominant Soil Series: AbB
Crop 1 Name: Fescue -Hay Crop 1 Max. PAN: 237 Crop 2 Name:
2
AM006
Acres Utilized: 18.6
Acres Permitted: 18.6
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.
(D�'
Wet
Moist)
Precip.
past 24
Hrs.
inches
�Y
� b
w
*
o
Zf-PAN
w -�
#
o'
p
4
w CD
w
* N
w
TKN
mg/kg
z Y
o
w o
mg/kg
Nitrate
and
Nitrite
mg/kg
Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
7/1
247000
4.5
r 1492
South Burlington
D
<,5"
S
0.5
0.3
57600
8890
2
44 942'•`
Nk
Fescue
7/6
65000
4.5
0 65ta .'
South Burlington
D
<.5"
S
0.5
0.3
57600
8890
2
` 24.998 '
NA ,`
Fescue
0000 , •.
0.000
0 000 '
0 000
.0.000
U 000:
0 wo
F 0 000
D:A�00
0000
OR000
0:000 ` :
" 0 000`
o:oo0
0:000
tt
'. 0-r
d.Q00
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0-000
0.000
TOTALS:
w ol
342000,
: : :.:
As
Cd
Cu
Cr
Pb
Hsi
Mo
Ni
Se
Zn
P
119.989
n.0U0 A:
Lime A ''lied
Annual lbs/acre,_019
. `rOh©)3
0988ti`
18
0.07ta
00tt4
003:7µ.
0l}50Q01
2'b0i25.402
:;.''>:;::.:.:.
... ... . .:
.. ..... ..............
Date
Ibs/ac
Prior Years Cumulative Ibs/ac
0.116
0.086
8.786
3.354
0.792
0.03
0.207
0.549
0.132
21.776
Current Cumulative Ibs/ac
os135
OA99;
9 774
.
, 4a412
0,868
0 033
0 238',
0 599
0 I,63
24'03
Permitted C. P. L. R.****
36
34
1 1338
267
15
1
1 374
89
2498
t
Perms PAN Lim' t/2n
rt 1 s d Crop P
23
"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
1/10/2017 **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: Walter Hessenthaler Owner: Tom Neal Predominant Soil Series:
A... es Used: 10.4 Acres Permitted: 10.4 Site #: AM006 Field #:
26.83
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
SB
6.13.16
_2j
3
4
5
6
7
8
9
10
IIJ
12
% Solids
4.5
Arsenic
3
Cadmium
2
Copper
157
Chromium
168
Lead
12
Mercury
0.4
Molyb-
denum
5
Nickel
8
Selenium
5
Zinc
359
Total
Phos-
ph onus
19600
gal Heavy Metal Field Loadings (Calculated in lbs/acre):
'Dotal
11
L2J3
L4J
L 5
L6J
7
8
9
LOJ
11
12
DT/Ac./
oy*
App.
Event
2.58
Arsenic
0.015
0.0.00
0.00.0
0,000
0.000
0.0,00
1 0.000
0.000
0.000
0.000
0.000
0.000
0.015
Cadmium
0.010
0.000_
0.600 ,
0.000
0.�0.0
0.000
0:000
O:Ooo
0.00.0
0.000
0.000
0 000
0.010
Copper
0.810
0.000
. 6.000
0.000
0.600
0.000
0.0-00
0.0001
o:00o
0.000-
0.000
0.000
0.910
Chromium
0.867
0.000
-0.000
0.000
0..000 ,
O.00o
0.000-
0.00o
0.00.0
0 000
0.000
0.000
0.867
Lead
0 062
0.000
0.000
0.000
0.000
0.000
0.000
0;,0:00
0:000
0.0.00
0.000
0.000
0.0.62
Mercury
0.002
O.:Q00 .
0.000
0.000
0.000
0.000,
0.000
0::000
0 0010
0.0.00
0.000
0.000
0.002
Molyb-
0.026
0.00.0 .
0.000,
01000
0.000
0.000
0.000
0.0.00
0 000
0.000
0:000
0.000
0.026
deaum
Nickel
0:041
0s,000
0-.000
0.000
0.000
0 00.0.:
0 0.00
0 000
0` 00:0
. 0 000
0.000
0.000.,
0.041
Selenium
0.026
0:000
0 000
0.000
O.00-o
0 000
0 000
0.-000-
0-.OoO ..
0.000
0.000
0..000
0.026
Zinc
1,852
0.600
0.000'
.0.00.0
0.000` ;
0:000
0,000
0 000
0.000
0.000.
0.000
0.000
1..852
Total
Phos-
101.136..0.000
0.000
0:040
0.000
0.000
0.000
0,000
0.000
0;000
0.000
0:000
10.1.136
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".
''e::�e 1/10/2017
Signature of Land Applier
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
Tom Neal
WQ Permit #: WQ0000520 Field #: 8
Annual Dry Tons Applied: 26A1 Site #: AM006
Operator: Walter Hessenthaler Predominant Soil Series: AbB
Crop 1 Name:
Fescue -Pasture
Crop 1 Max. PAN: 177 Crop 2 Name:
Acres Utilized: 10.4
Acres Permitted: 10.4
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
o �
5
c� 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,
Wet,
Moist)
Precip.
Past 24
Hrs.
inches
a
b
" b
� =
m
* 0
o
x' 0
--
*
o.
p
4
w 9
Ev
* w
TKN
mg/kg
z
q
o
I °
0 w'
mgJkg
Nitrate
and
Nitrite
mg/kg
PAN Applied
( lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
7/6
45500
4.5
0;821 y
South Burlington
D
<.5"
S
0.5
0.3
57600
8890
2
312.95 .
NA"
Fescue
7/7
97500
4.5
1:75
South Burlington
D
<.5"
S
0.5
0.3
57600
8890
2
67.061
NA 4'°
Fescue
op
'0.000
0 oi�Op`
n:000
0000
0 0Q0-
,'0.000 N
0 000
o 000 _
o 000
(500
x Q b00
0000
00 e,
0 000
6:000-
0 000:
^0.000
0,000
(1
0"
:.::,`Q',000
`
Residuals Applications totals on FORM
FSF supp (attach FORM FSF supp
to this form):
11.000
0.000
:: >:_:::. ? '
'' '
TOTALS
c�
"14a0uo
;::.::::::::
As
Cd
Cu
Cr
Pb
H�
Mo
Ni
Se
Zn
P
98.357
0 Ob0'
Lime Applied
Annual lbs/acre
Oao=1a
# 0 81i
0867
0.062
00;
A 02b;0-04
•�4�03b52
1Q1.13G :::;:::::'::..::.:::.: ::;::
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.048
0.026
3.714
2.413
0.325
0.012
0.085
0.223
0.063
7.413
Current Cumulative lbs/ac
" ' , 0 ,063
i 4 036 .
9" 24
r 3:280
0.387
0" 01
,0 1) l :'
0 264
O Q:89 '
? r-9..265
Permitted C. P. L. R.****
36
34
1 1338
1
1 267
15
374
891
2498
Permit PAN Limit 1 s 2n Crop t/ d
ffi,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
1/10/2017 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, annerobially 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): 12.20
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
r ,,ator: Walter Hessenthaler Owner: Tom Neal Predominant Soil Series: AbB
A, -is Used: 6 Acres Permitted: 18 Site #: AM006 Field #: 9
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Com-
posite
Date
Total
Phos-
7 ,ial
Heavy
Metal Field Loadings
(Calculated in lbs/acre):
1 otal
1
2
3
4
5
6
7
8
9
10
11
12
DT/Ac./
oy*
App.
y
Event
2.03
0.000
0:000
0.000
0:000
0.000
0..,000
0:000..
0.000
0.000
0:000
000.0
0.012
6.009
0.000
0.000
.0.606.
.0.000
0.Q00
0,000
0.0.00
0.000
0.000
0.000
0.000,
0.00`8
0 6-38
0:.000.
0.000 :
0..000
0.000
0.000
0.000
0:000
0.0.00 '
, 0.000
0.000
-0.000
0.639
Men0:012
0.683.
0.000'
0.000°
0.000
0.000
0:000
0.000
0.000
0.000
0.000
0.000
0.000
0.683
0.049
0.000
0 000
0.000
0.;000
0:000
0 000
0.000
0.000
0.0.0.0
0:0.00
0:000
0.049
0 002
0.000
0 000
0 000
0.000
0.000
0.000
0 0"00
.01000
0 000
0:000
0.000
0.002:
.0..020
6.000
0 000 ,
0.000
0.000.
0.000:
' 0 000"
0:00.0
0 0.00
0:000
0:000
0.020'
m
.0.000
Nickel
0.033
0..000 _
0 OOn
_ 0'.0001
0.000
--0.000,
0 000
0.000
0.000
0.000 '
-.0.000
0.000
0,033
Selenium
0 020
0.000 :
0.000
0 000
0.000
0:0010
Q OQO
0..000
Q- 00:0
0.000
0 :00.0
O.000 .
0._020
Zinc
1.4,60
0-000 -
.- 0 900
0.000
0 t):00
0.000
0.000,
0.000_
0.000
0.000
0:000
0:000
1 460
Total
Phos-
79.69.4
0.009
0.000.
0.00.0
0.000•
0.000
0.000
0-000
0.000
0.000
0.000
0.000
79.694
nhorus
"I certify. under nenalty of law. that this document was nrenared under my direction or sunervision 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 • l{ sonment for knowing violations".
Z.-z 1/10/2017
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
Tom Neal
Walter Hessenthaler
Crop 1 Name:
Fescue -Pasture
WQ Permit #: WQ0000520 Field #:
Annual Dry Tons Applied: 12 20 Site #:
Predominant Soil Series: AbB
Crop 1 Max. PAN:
177
Crop 2 Name:
Acres Utilized:
AM006 Acres Permitted
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
18
0
o
o
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
ado
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
cD '5
0 o"
Q o
0
o
w �'
* w
F
p
7y
,.
R
n
* w
sr.
0
TKN
mg/kg
z
ct
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
7/6
65000
4.5
2n.U33
South Burlington
D
<.5"
S
0.5
0.3
57600
8890
2
`77.493`'
IqA ..r
Fescue
A':000=70000
1
a ooa"
0000
0 ova
:,bop
o.ot�U
o
.A. dpoq 't
0.000
T 0
9,000
di
0.90
" o ;000
01000
0 00b-"
, Q;"bOQ ^ _
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.
0:000
TOTALS
, :'� ., o
.,F t:t1c,
......:.
As
Cd
Cu
Cr
PbrHMo
Ni
Se
Zn
P
77.493
0 oqa=
Lime A lied
Annual lbs/acre
'':'0'�
0 008
0 638
1 Q83
0.0490
020`.694
:_':-::;::::"
:
Date
Ibs/ac
Prior Years Cumulative lbs/ac
0.024
0.013
1.802
1.085
0.153
0.042
0.11
0.033
3.715Current
Cumulative Ibs/ac
b o36
Qa 1�:"�
(f
4 6,8,` W
0.202
0 0
2"
Permitted C. P. L. R.****
36
34
1338
267
374
89
2498
2
Permit PAN Limit 1st/ nd Crop
P
. 19
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
1/10/2017 **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): 63.06
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
(" ator: Jimmy Staley Owner: Jimmy Staley Predominant Soil Series: EdC2
A.,. es Used: 15.6 Acres Permitted: 15.6 Site #: AM008 Field #: 1
Residual Analvsis Data (Heavy Metals and Total Phosphorus use mg/kz. % Solids use Raw Percent ft
•
.•
f 1:
• -• •i
M-----------
To
' •
. •
1 11
pal
Heavy 1vletal ricia Loaunigs
(l,alculareu In !Ds/acre):
1 otal
1
L2
3L_j
L4J
L5
6
7
8
9
10
11
12
DT/Ac./
0
App.
Event
4.04
Arsenic
0.024
0:000
0.000
0.000
0.000
0:00.0.
-0.000
0 0.00
-0.000
0.000
0.000`
0".000
1 0;024
Cadmium
0.016
0.000
0.000
0.000
0.000
0 000'
0.00p,
0.0-00
0..0.00
0.000
0 000
0.000
0.016
Copper
1 075
0 00.0
0 000 ;
0.000
0.000
0 000;
' 0 000:
0.000
0,000
0 000
0:0;00-
0.000.
1.075
Chromiu
0 453
0:000
0 00..0
0.000
0.000 "
O 00.0'
0 000
0.000
0 000
' 0.000
0 0:00
0.000 .
0.453
0.1.13_
:-
0 000
0.000 .'
0 000
0.006
0,000
0 000
. 0.000..
0 000
0 000
0,000
0,000
-.0.113
0.003
0:000
; 0 000 :
0 00.0
O Q00 '
. ,0 O00
0 000
0.000
0.000
0:000
0 000
0.000
0..003
0.,00.0 -
0 000
0 000.
O'.000`
0 000
0 000
0.000
0,000
0000
0.000
0.000
0.040
M0.040
0 1 1
0 000
Q 000: '
0.000
0.000
10
0 000
000
0:00:.
•. 0 *-
0 000
0000
0121
0:04:0
0 000
_
Q OOO
0 000
0 000
0.000
0 000"
0:.000 .
0-.000'_
0 00:0
0.000
0000
0 040
3:259
0.000
9 000 .
0.000
0:000
O.O.OU
0 0.00.
0A00
0,.000
0 000
0:000
0,000
_ 3 258
86.499 :
.0.0000 .
0.000
0:000
0.000
: 0 000
.0.000
0;0.00.
0..00Q
0.000-
0.000
0.000
86.499
ohorus
"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- sonment for knowing violations".
1/10/2017
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
Jimmy Staley
Operator: Jimmy Staley
Crop 1 Name: Fescue -Hay
WQ Permit #: WQ0000520 Field #:
Annual Dry Tons Applied: &10.64 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:
5
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
co *E
5 �'
o� o
0
o
w
* w
o
w n
�.
* o
TKN
mglkg
Z Y
ct
o
°Q d
�•
mglkg
Nitrate
and
Nitrite
mglkg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop I
Crop 2
3/8
110500
5.17
L527
East Burlington
Dry
<,5"
S
0.5
0.3
26500
1740
2
25 350
-jq-A -
Fescue
3/9
182000
5.17
2.515
East Burlington
Dry
<.5"
S
0.5
0.3
26500
1740
2
41.752 :
' NA.
Fescue
0 000
0.0oo
F 0 000
` ,:000
0 000
Q 000
6 000
Q000
}aoo
o.000
o:000
0 000
OdQO
`0 000�
0 000'4
`0.000
'* 0.000
l 06j000
' 0,000
0M00
0
0
OOQO
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000
0.000
TOTALs:
; : `" o
29250o
:;:::::::;:
As
Cd
Cu
Cr
Pb
Rq
Mo
Ni
Se
Zn
P
67.102
omo
Lime Applied
Annual lbs/acre
G1YQ2�
Q OI6
1075 '
3 0�453
0,1 l3
0 n03
._ 0r040 -
` 012tj
0 04
`3w 58
G 499
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.102
0.065
7.726
4.453
0.722
0.032
0.2
0.498
0.115
17.139
Current Cumulative lbs/ac
O'lti6' . `
0 081
8 80L4
9;06
0' 85
0 035 .'•
; 0 240a
0 619
O,ISS 1
20 39T `
Permitted C. P. L. R.****
36
34
1338
267
15
374
89
2498
Permit PAN Limit 1 s 2nd Cro,
t/ p
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
1/10/2017 **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): 68.67
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
C- -,ator: James Hadley Owner: Kay Goldsworthy Predominant Soil Series: Ga-B
A_-:s Used: 12.3 Acres Permitted: 12.3 Site #: AM013 Field #: I
Residual Analvsis Data (Heavy Metals and Total Phosuhorus use m0ke. % Solids use Raw Percent #l:
o
Niii
Total
Phos-
MiiiiriiiiEi
r aai
heavy xtetat rieia Loaamgs
(uaicuiatea in ias/acre):
otal
III
2 J
31
4
5
L6J
7 J
8
9
10
11
12
DT/Ac./
0
App.
Event
5.58
Arsenic l
0',033
6.000'
0.000
0.000
0.00'0:
0.000
0.000
-0.000
0.600
0.060
- 0.06
-0.0b.Q
#6A33
Cadmium
0 022
0000 .:
'0 OOQ`
0 OOQ,
0..000
0 OQO
0 000
0 U00
0.000
0.000
0 OCiO
0:00:0
0.022
Copper
1 4$:5
0 000,
`0 000
0 004
0 Q00
k 0 000
`' 0,000;
0 O00
,0: 000
0 000
0 000
0,0'00
1 485
Chromium
0 625
0 000
0 000
0 OQ:O
0:000,
U 000 ._
000 .'
d.0 0:0-
0 000
0;000 .
0.625
LeadLo
1Sfi
0 000
0 000
0 000
0 000
0 000 ,`
0 000
0 (00
0 OOfl .;
fl 000;
0 OGitl
0000
0r156
Mercury0Q00
0 000
0 000
0 0:00
0 000
0 OOQ
0 000
0 000
0 000°
0 000
0;;000 _
-,0 004Molyb-
OS<6
0.000
0 000
0 00:
0.000
Q�000
0 00(�
0 Q:00
0 000
0 000
0:000
0:0:56
denum
1
.
Nickel
0 167
O fl00
OrQOfl
0 000
O.Q;00
Q ODO .
0 OOOv
0 000
0000
0 -00'
0 000
0,000
0 167'
Selenium
0 O'S
0 Q00
b 000'
0 000
0 000
0 000
t OOQ
0 0�0
0-.000
: 0 OOQ
0 OQO
O Q00
0 fl5G
j0
Zinc
4 5'Or
0 000
a 004
:: 0 000
0 000
4 000
0 000
0 OQO
0.000 '
' 0 000,
0 00.0
0,000 :
` 4 50.Q
Total
r
Phos-
119 4'
0.000
0 0,9F :
0 00"0
0 O:UO
,. 0.000
- 0 .U00
0 000
0:000
y 0 000
0 090
0 ' 00
11,9.476
"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".
_ 1/10/2017
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
Kay Goldsworthy
James Hadley
Crop 1 Name: Fescue -Hay
WQ Permit #: WQ0000520 Field #:
Annual Dry Tons Applied: G8- Site #:
Predominant Soil Series: GaB
Crop I 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
Q
Volume applied
enter one Solids/
( )
Liquid
Cu. Yds Gallons
a
/a
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry,
Wet,
Moist)
Precip.
Past 24
I-Irs.
inches
Y
a w
o
;d w
m �•
�. --
*
o'
p
9.
iU c,
w -,
*
* o'
TKN
mg/kg
Z
o
as o
w'
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
PP
( lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
3/10
195000
5.17
A.4I8
East Burlington
Dry
<.5"
S
0.5
0.3
26500
1740
2
55.737
_'NA '.
Fescue
3/i6
123500
5.17
2165 . '
East Burlington
Dry
<.5"
S
0.5
0.3
26500
1740
2
'35 933
1,f-
Fescue
O 000
0'.000.41
0 000
0!n0o
0 bUU ;
Q O00
0.000
0 ¢A
001;(
O 000 '.
0Q4;
f n 000 .
o.000
o 000"Y:
0 000;
0.000
a 000
U
U ..
b ;,Q OOA' ('
Residuals Applications totals on FORM
PP
FSF su attach FORM FSF su
PP (
to this form):
PP )
0.t10U
0 OQO`
"'
TOTALS
; " 0
3 xiex�
As
Cd
Cu
Cr
Pb
Hm
Mo
Ni
Se
Zn
P
92.670
0 000
Lime A lied
Annual lbs/acre
033
0 022 "
4$5
0` 625
U J Sfi ':
U DO`4 m'
0 056
p. L7 ;
Q Q�6
4:500
1.19.476 .:
.............
...................
:::::::::::::::.:.::: ;.:;:: ;• ::::.:::
Date
lb s/ac
Prior Years Cumulative lbs/ac
0.204
0.392
43.92I
19.975
6.817
0.112
0.494
3.308
0.198
61.534
Current Cumulative lbs/ac
Q 237
b 414
4 ;4:06
20'.60U. x"'
f,973
0 116;.
0 550
3 475
0. 54
6'6 034?
Permitted C. P. L. R.****
36
34
1338
267
15
374
89
2498X.
Permit PAN Limit ' 2 r 1st/nd Crop
1 2 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 /10/2017 **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): 9.67
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
V -�ator: James Hadley Owner: Ernest Goldworthy Predominant Soil Series: GaB
A.._ cs Used: 14 Acres Permitted: 14 Site #: AM013 Field #: 2
Residual Analvsis Data (Heavy Metals and Total Phosphorus use mg/ka. % Solids use Raw Percent ft
.. .o
Com-
posite
Date
©
A
a
©
o
0
0
0
Total
h
,.
: ��
f ;tat
tieavy ivletai r ieia i.oaaings
(t aicutatea to Ws/acre):
i otal
111
1213
4
L5J
6
7
8
9
10
11 j
12
DT/Ac./
App.
„oy,
Event
0.69
Arsenic
0.004.
0,000 `
0 000 :
- 0.000
0.000
0.000,
0.000 .
0.1000
,
0.000
0.000
0 000.
0.000
0.004
Cadmium
0.003
OAUO
_0 000
0:000
0 000`
0.000
0.000.
0 000
0:000
0 0.00
0:000
0.000
6.003.
Copper
0.3-11
6.000
0 000
:.01'000
0 000
'0.000,
0 000y
0 U00
0;000
0.0.00
0.000
0.000 =
0.321
Chromium0.337,
0:000
0.000
6.000
0 0d00
0 000' '
0.00:0
0 000
0.000
0 OQ0
0.000
0.000
fl:337
Lead
0.02:1
O Q00
0 000<
0."
0.000 :
0.000
0 00,0
0.000
O'.000 :
' 0.000
0 Q;bO.
0 000
0.021
Mercury
0.001
0.00.0
0,660
0 000
0 0:00
0 000
0 00.0
0 0Q0
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 n00
0.000 .
• 0. 000
0.000
0 000'
` '0.007
denum
.
Nickel
0.047
0::000
0 000
:. 0.000
0 000
0 000
0 000
0 Q:00
O'.000 ''
. 0 000
Y
0.000
0 000
0.017
Selenium
0,001111
0.0.00
0 000`
0:000
0 0:00
0 OQO
0.00'0
0.0:00
0::00.0
' 0 004
. 0 OQ'0 ;
0:000
`; 0..007
Zinc
0 587
0.00Q
0 000-
. 6.000
0.000
fl 000 :;
0 00'0
0 000-
0.000'
: 0 000_
0 000 :,
0.000
Q587
Total
Phos-
39.387
0.000.
0.00.0
0.000
0:000.
0.400
0.000
OA66
0.000
0:000
6.000
0.000 ;
' 39.387
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
it -i,sonment for knowing violatioonnss".
9s l yet..'
1/10/2017
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION j,-.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: 14
Land Owner: Ernest Goldworthy Annual Dry Tons Applied: 9 67 Site #: AM013 Acres Permitted: a 14
Operator: James Hadley Predominant Soil Series: GaB Cation Exchange Capacity (non 503): 0
Crop 1 Name: Wheat Crop 1 Max. PAN: 113 Crop 2 Name: Crop 2 Max. PAN:
o
QLiquid
Volume applied
(enter one) Solids/
Cu. Yds Gallons
"�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
Ms.
inches
a
4 Ts
�* b
a
0
o
?�'
~r
*
tj
Z
7y
m .,
'* w
* N
0
TKN
mg/kg
Z Y
o
o0 0
w.
mglkg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
2
Crop 1
Crop 2
3/12
91000
2.55
0= 691 11"'
South Burlington
D
<.5"
S
0.5
0.3
66300
32500
2
Wheat
0 000
:36-4f8
o
00`0:
'.
0 000 Y
0-000„
1)=a000
' 0 000 .
Oi000
0000
O OOQ>
Q000
0000
0.0W ;
id.
0b
Y O'000 °
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000
0.000
o
T;,9WOO
'.::::::::::
As
Cd
Cu
Cr
Pb
H
Mo
Ni
Se
Zn
P
36.483
0 000' i
Lime Applied
Annual lbs/acre
d Q004� ` °
0 003
0;lp
0 337
[).02]
0 001 •0,07+{0'3s9.38
.........
::6...................
::
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.1039
0.2011
22.9677
7.1457
2.4381
0.0732
0.4011
1.4312
0.1206
38.8885
Current Cumulative lbs/ac
0::108
O'2b4`;
2 288
Z183
2.459
0 074
0 40;& `
) 44$
; 0.128
3.947�
Permitted C. P. L. R.****
36
34
-
267
15
374
89
2498
PAN Limit lst/2nd Crop
.Permit
"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
1/10/2017 **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): 29.72
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
C" %tor: James Hadley Owner: Ernest Goldworthy Predominant Soil Series: GaB
AL. es Used: 34.8 Acres Permitted: 34.8 Site #: AM013 Field #: 3
Residual Analvsis Data (Heavv Metals and Total Phosphorus use mE/lig, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1 1
SB
1/11/16
2
3
4
5
6
7
8
9
10
11
12
% Solids
2.55
Arsenic
3
Cadmium
2
Copper
232
Chromiuni
244
Lead
15
Mercury
0.6
Molyb-
denum
5
Nickel
12
Selenium
5
Zinc
425
Total
Phos-
L_phorus
28500
E vial heavy metal vieia Loaaings (ualcuiatea in ins/acre):
l otal 1 L2J 3 4 5 6] 171 L8J9 10 11 12
H
DT/Ac./ rt
App.
Event 0.85
Arsenic 0.005 9'.000.. 0 006, 0 Q00 0.0001 0- 00A 0.:000 0.000 0.000 bmd 0.0000.000 0.005
Cadmium .o O:U00 0.000 0.000 U00 0.660 0.000' 0 Q:QO Q-000' 0.000 0.000 0.000 ...0.00,3
0417 1
Lead
Mercury
0 001
0:000
: 0 000 _
0 Q00
0 tlQO
0 000
0;000
0.000
, ,Q, ft Q ,
0:000
0 0.0P
0.-000
:. 0.001
Molyb-0.:000
0 D00{
0,60"0
0.400
0 OQ0
D 000;-
0 000
0.000.
0 00.0.
0 000
0..000:
denum
.
Nickel
0.020
0 OOOf
0 00A.„`
0 60
0:000
0. OOQ
_ 0 (100
0 000
O'.000,
" 0, 000.
0 OQO
' 0 000 .
0.020
Selenium
0 009
0 000
0 000 `'
0 OOzO
0 OQ0
Q 000
0 000
0 Q00
0.000
,;, 0 00
0.000
0:000
Zinc
0 72
o 000
0.()Q o
o ooQ
0 0ao
000
' 0 000
0 000
0 00:
0.72
Total
Phos-
48.678
� .0-.000.
U.OflO
0.000
0 OOA
0.000
0.0. 0
0:000
.000 ;
0 000
O.OffO
DODO
.48.678
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 violations".
,9!:�e 1/10/2017
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: Ernest Goldworthy
Operator: James Hadley
Crop I Name: Wheat
WQ Permit #: WQ0000520 Field #:
Annual Dry Tons Applied:!,29.72%,,.. Site #:
Predominant Soil Series: GAB
Crop 1 Max. PAN:
116
Crop 2 Name:
Acres Utilized: 34.8
AM013 Acres Permitted: 34.8
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
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
Hrs.
inches
y
'�
c
o
o� w
o
w
o
p
7d
w -�
0
TKN
mg/kg
Z Y
i;
o 5
o f•
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
3/11
221000
2.55
Q.675
South Burlington
D
<.5"
S 1
0.5
0.3 1
66300
32500
2
35 644 <
NA.
Wheat
3/12
58500
2.55
C ;Q'179
South Burlington
D
<.5"
S
0.5
0.3
66300
32500
2
9.435
Wheat
o oo0
u00
0 ooq
o oo0
6,000
a o00 f
0000
a�otl
yahoo
o.000 :4o
Q'.000
0.000a
00 '
0.000
0.000
O OOb"
'0'
t 0.000 `" 's
Residuals Applications totals on FORM
FSF supp (attach FORM FSF supp
to this form):
0.000
0.000
TOTALS
01
279500
..:.::: ;:;:;
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
45.080
0 004;`?
Lime Applied
Annual lbs/acre
Uu(105
ti0�p0
0 39 t
' Q El l 7
0.026
O OOaT
0 009
0 02Q
a 0 2r
"",U;�26
*4 .678 :::::::::::.... ::
..... ..
'::::: ''''' ....
.............
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.137
0.227
26.457
10.377
2.854
0.09
0.375
1.902
0.143
40,631
Current Cumulative lbs/ac
0 142
0 230
26 $53
10.794;
2.880
0 091
D 384
Tk922
0 �5,
41'. 357
Permitted C. P. L. R.****
36
34
1338
267
15
374
89
2498
Permit PAN Limit lst/2nd Cro p
:::::::::::::::::::::::::::::::::::::::::::. I ..:::::::::::::_:::::::::::::::::;:::::::':'::'::':':':':':':':':':':':':':':':':'::':::':'::':'::':::':'':':':':':':'::: :
116
"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
1/10/2017 **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): 4.1.26
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
C" ;ator: James Roney Owner: James Roney Predominant Soil Series: HbC2
A, es Used: 12.5 Acres Permitted: 12.5 Site #: AM014 Field #: 2
Residual Analvsis Data (Heavv Metals and Total Phosphorus use ni&kz. % Solids use Raw Percent #):
Com-
posite
Date
Total
Phos-
_phorus'MENEENEENEEN
jai
heavy ivietat vieia i,oaaings
(t_;aicuiatea in iasiacre):
1 otal
1
2 J
3
4
5
6j
7 J
8 J
9
10
11
12
DT/Ac./
APP•
Event
3.30
Arsenic 1
0.020'
0".00"0
0.000
.000
0.000.
0 000:
0.000
0.000.
0 000
0 000
0.0=0fl .
Q.000
0.020
Cadmium
0..013
0 :000
0.000
0.0`0:0
0 0'0:0
0.000
0.000
O.OQ-O
0..000
O.OQ.O
0:000
0.000:
0 OB,
Conner
0'-00.0:
0.000
0.00.0 ,
QA
:10.000
1 0.9100
0.000 .
0.000
I. 6--a
0.60.0
1 0000
I1 38
.3
Lead
0 08bj
0-.000
0 000 Ir
0,000
1 QO 3{I
0"040,
0 00.0
0 flOQ _..
0, 0:00..
" 0.000
0 0.0,
1. 0::00.
0 0$6 _
Mercury
0 00
0.000
0 000
0 000
9.009.
6.000
0 000:
0 000
'0 000 '
0.000
0.000
0 000
-'0 003-
denum
0 03'3
0 000
0 000:.
0 000
0 0:00
Q 000- _
0 OOQ
k
0 Q'00 "..0
000
0 000
0 000
0;000
0.033
Nickel
0 079
0 :000
0.OQ0`
0 000
0 0011
0 000
` 0 000"
0 000
0.000. "
0 000
0 000
0.000
0.079.
Selenium
0 0 3
0.000
0 000 �
0 0od
0.000
0 OOQ
0 000•
0:000 .
Q° 000.
' 0 000.
0 000 .
0:000
0.03"3
Zinc
2 42
0 :000 .
.0 000
O OOQ
0 000
0 000 "
0 OOQ_,
0 000
0 Ot10' ''
0 OQO
0 OQO
0:000
2.43
Total
Phos-
nhorus
57.966
0 000
Q 000:
0 0.00
0.00b. ,
0.060
OA00
O'.000
0.000:
0.0,00.
.- 0.000
`'S7 9b6
"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:4e Z `�' 1/10/2017
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION r-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
Land Owner: James Roney
Operator: James Roney
Crop 1 Name:
Fescue -Pasture
WQ Permit #: WQ0000520 Field #:
Annual Dry Tons Applied: " 41 26 - Site #:
Predominant Soil Series: HbC2
Crop 1 Max. PAN:
118
Crop 2 Name:
Acres Utilized: 12.5
AM014 Acres Permitted: 12.5
Cation Exchange Capacity (non 503): 0
Crop 2 Max. PAN:
°
°
Q 0
Volume applied
pP �
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
A lied er
PP P
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
( ry
D
Wet,
Moist)
Precip.
Past 24
Hrs.
inches
,oY
b
�.
o w
o.
C
o
�, t
N'
g
7d 4
RL
* N'
TKN
mg/kg
z
o �
o0 0
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of CropType
�
Receiving Residual
g
Application
Crop 1
Crop 2
Crop 1
Crop 2
7/7
19500
3.54
0!23p '"'.
East Burlington
Dry
<.5"
S
0.5
0.3
22000
3670
2
,x -099
N1A."
Fescue
7/8
260000
3.54
'3070 -'
East Burlington
Dry
<.5"
S
0.5
0.3
22000
3670
2
.45J050.',
NA,. ,
Fescue
—0.000
O 000 4
0 00o
0.000..,.
0: 000
Q 000
000
O.000
i040i ',
0.000
0.000
4t0�
0.000000.
. 0.000
0 000;v,
gk 000
0.000
OJ000F;,
0
0
;0 OU "°'_
Residuals Applications totals on FORM
FSF supp (attach FORM FSF supp
to this form):
0.000
0 00
TOTALS
s ol
279500
.:::::::::
As
Cd
Cu
Cr
Pb
H�
Mo
Ni
Se
Zn
P
48.428
0 o.0-
Lime A lied
Annual Ibs/acre
&Tr
77
`) 3864O
i70
0 U6
0 00t
Q;G13
," Gra;
z @(i3 ;
„235
r 966 ' :;::::::;::•:::.; ::
........ . .... .,
...........
::::.::>:.:::.:::> :: ::.:::
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.044
0.029
3.41
3.411
0.26
0.007
0.073
0.204
0.073
8.354
Current Cumulative lbs/ac
4 064x
�fI A42.
4 79.6
3' 8i '
0.346
0 010
g 0146
0 83
0 06
1 777
Permitted C. P. L. R.****
36
34
1338
267
15
374
89
2498
i Limit
Perm t PAN tmrt l st/2nd Crop
. ................. .....
...'.
118
"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
1/10/2017 **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): 75.85
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
C" `ator: James Roney Owner: Carolyn Turner Predominant Soil Series: HbB
A... es Used: 28.7 Acres Permitted: 28.7 Site #: AM014 Field #: 4
Residual Analysis Data (Heave Metals and Total Phosphorus use mg/kL-, % Solids use Raw Percent #):
Com-
posite
Date
Total
• .
..
•.��
:�
'ual
Heavy Metal Field Loadings
(Calculated in lbs/acre):
io# i
1
2
L3j
4
L5J
L6J
L7J
8
L9J
Ll Oj
11j
12
DT/Ac./
0
APP •
y
Event
1.11
1.54
Arsenic
0 007 "
0"O00
ji `0.000.
0,000
0,9Q0:
0 000'
0.000
OMO
0.000
0:000'
. 0.000
.0.000
1 0:016
Cadmium
0 004
0..006
0 000
0:000
O.00Q. -
. O.OflU.
00,0
U.UUO
0:000
0 OOU
0.000
0.`000
0.011
Copper
0.347
0 6:4,6
0.000
0 000
0.000
` 0 000 "'
0 OQO
0 0:00
0 000,
' 0 000'
0 00Q
0..000
0 993
Chromiwn
0 3 ;1
0 17 .
0 000.
0 00`.0
O:U00
U 000 :;
` 0-OOU
0,000
0 000:
. 0 000
0 000
6.000
0 544
Lead
0 027
60 40
.
> 0 000 _-
0 Q00
0' 000
0 000,
0 OOU
-
. 0.000
_:
0 - 0
0 Oo0'
fl "000
fl 00.0
0 067
Mercury
0 001
0 001
0.0. 00..
0 Q00
0.- Qfl0
0'. 000 `_,
0 000,
0.00a
0 000
`. 0 000
0,000
0 000
0.002
Molyb-
0.01'1
0. 015 :
-0 006% `
0.000
0 000
0 000 "
^ 0.000
0 000
0.000
0.000
0.000
- 0 000
0.026
den
r ..:
, ..
Nickel
0 018
0.037`
0 000, _
0:000
0 0:00
0 000
0 000.
0 0,00
0 000 '
0 000'
0 000
0.000
0 0.55
Selenium
0 O, 1
0._015 ..
+0 OOU _;
0 OOU
0..:000
0 000
0 000
0,:000
0= 000 :;
0 00:0
0.000
Q.00:0
0 026'
Zinc
0,793
1.12�
0 000..',
0 000
O,Q00 .
0 000'',
0 OOQ
0:000
0 000 ''
..
0:000
O..00,0
0000
1.9221
Total
Phos-
43.3`16,
; 27° 007 ,:,.
0 000..
' 0.000
0.:000
-_-�amb
0,000
0,000 _
� 0,000 '
0.600'
fl-000
0 000
70.323
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 1/10/2017
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): 44.14
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
(` -,ator: James Roney Owner: James Roney Predominant Soil Series: HbB
A- _ : s Used: 9.6 Acres Permitted: 9.6 Site #: AM014 Field #: 3
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1 J
EB
6/13/16
2
3
4
5
6
7
8'
9
10
11
12
% Solids
3.54
Arsenic
3
Cadmium
2
Copper
210
ChminiLlin
56
Lead
13
Mercury
0.4
Molyb-
denum
5
Nickel
12
Selenium
5
Zinc
367
Total
Phos-
L_Rhorus
8780
iai Heavy ivietai r ieia l,oaaings kuaicuiatea in ins acre):
i utal
1
2
3
4
5
6
7 J
8
9 J
10
11 J
12
DT/Ac./
App.
„oy
4
Event
4.60
Arsenic
0.02$
0.000
0 00:0
0.000
0.000
.0.000', _u00
0.000
01.000
0.000
6.000
0.000
0.028
Cadmium
0.018
0.&0,
0.000`
0.000
o.000
0.000
0.-000
00
:00
0,000.
0.000
0:000
0.000
0.018
Copper
1 93,1
0.:0.0.0
0 000 `
0.:000
0:30001
0- 000.
0.000.
0.0.00
0.000.
0 000
0:000
0...000
1.931
Chromiur,a
0.515
0:000
0 000.
o.o:o0
0..00a
o 000
0 0.00
0 0:00
0.000
o.00.o
0.00
0.00.0.
osls
Lead
0 12`0 .
, 0.000
0.00.0' '
-0.0.00
0:000 •
. Q.000
0 000
0.0:00
0.000
0.000
0.000
0:000
0.120
Mercury
0.004
0,000
,. 0 000 ,
0 00.0
0.0010
0.000
0 000
0,000
0.000 '
; 0.090
0 Q00
0.000 .
` 6.004
Molyb-
0.04.6
0:000
' -0 000
0.000
0 A00-
0 000
0,006
0:000
0.000
0,040
ONO
0:000:.
0.646
denum
Nickel
0 11=0
0 ODO
0.000 '
0.00;0
0.000 '
0 000 "
0 000
0.000 .
O:Q00
". 0 000
0.000
U:000,
0.1-10
Selenium
0.04:6
0 Q00
'0 000.
0..000
0..000 .
0 000' ::
0 000
0 000
O':000 ',
0 000`
0.00:0
0:000
4 0.046
Zinc
3.375
0.:000
0 000,
0.000
0.000
0 000„
0 000
0.0`00
0:000 ..
0 000
0 000
0:000
3..375
Total
Phos-
80.741
0.000
0.0.00
0.000
Q.000,
0 00.=0.,
0.000 ..
0.000
0.000 ;
. 0.000
0.000..
0.000.
80.741
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
iir Isonment for knowing violations".
;9�eG;2_ 1/10/2017
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
James Roney
James Roney
WQ Permit #: WQ0000520 Field #:
Annual Dry Tons Applied: 44.14 .. Site #:
Predominant Soil Series: HbB
Crop 1 Name: Fescue -Hay 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:
°
v
Q 0
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Pp P
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
Wei'
Moist)
Precip.
Past 24
Hrs.
inches
Y
0 o
o
* il'
.*.
*
o
TKN
mg/kg
Z Y
n
�o o
w-
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
7/14
208000
3.54
i 3.198 ;
East Burlington
Dry
<.5"
S
0.5
0.3
22000
3670
2
46:927
NNE
Fescue
7/19
91000
3.54
r399
East Burlington
Dry
<5"
S
0.5
0.3
22000
3670
2
� 20:530
NA .
Fescue
''gagbo
0 000
0 000
0000
"
no 000
0 00 1 r
b o60'
o aonEsa
oDT
' o-aoobr �`
�a000
o�loo�
' b b00
0,000
) Oo0 E
oo
0.000
ao.000
40" 000
0.000
w 0
U
ti, p00 "+
Residuals Applications totals on FORM
FSF supp (attach FORM FSF supp
to this form):
U.00U
D.QUO
TOTALS.'
'4,;, OT
294000
As
Cd
Cu
Cr
Pb
H
Mo
Ni
Se
Zn
P
67.457
0 OQQ;'"
Lime Applied
Annual lbs/acre
r„ :0"02$' Yam;
0 Q1S,n
T '1
x , Q 515
0,12(1
,U 004
O O k�
b 1:d
0 046
, 3 3 75
`$0.741 ::.:.:.:::.:::.:.::: : : ::: : :::::
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.049
0.033
3.486
3.057
0306
0.007
0.082
0.229
0.082
8.942
Current Cumulative lbs/ac
077 `
.f! (15 _
6 1
c3 572
0.426
OOIl
012.8",
Permitted C. P. L. R.****
36
34
1338
267
15
374
89
2498
Permit i t PAN Limit lst/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
1/10/2017 **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 .-.&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:
Carolyn Turner Annual Dry Tons Applied: 75 ";85 Site #: AM014 Acres Permitted:
James Roney 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:
28.7
28.7
0
-�
° +�
U 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
co '�
o w,
o
�
o
� °'
� �
* w'
0
�
w �,
co
* N
0
TKN
mg/kg
Z a
ac o
o �
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
7/12
110500
4.5
Q,722 ".
South Burlington
D
<.5"
S 1
0.5
0.3
57600
8890
2
27.541,
NA
Fescue
7/13
58500
4.5
0.382
South Burlington
D
<.5"
S
0.5
0.3
57600
8890
2
`°1'4 581•
NA
'Fescue
7/13
195000
3.54
1° 003
East Burlington
Dry
<.5"
S
0.5
0.3
22000
3670
2
14 716:„
NA
Fescue
7/14
104000
3.54
0 53, +
East Burlington
Dry
<.5"
S
0.5
0.3
22000
3670
2
7.848
1�1A
Fescue
Q."000
0.000
0.000
0;,000.i
0.000
Q� 000
0.000
q�,00
0.0tl0
0M00
0`000
0.000
0.000
U00
b o00
0 opo :
0,000
0
0 `
....:
q; 000 , .
Residuals Applications totals on FORM
FSF supp (attach FORM FSF supp
to this form)
0,000 ;
l).00iI
........
:::::::::
.•;;;:•::.:>
TOTALS
~ , o
a�ssnnn
As
Cd
Cu
Cr
Pb
H
Mo
Ni
Se
Zn
P
64 68,6'
0.000
Lime A, plied
Annual lbs/acre
Q Ot16
t 0"01! 1
0 993
Oe544
:0 061
0 002?
O UZ6
0 055
0 0;26'
1922„
'70 323` :; • , . , ,.;``;`;
:::::::.:::::::..:.::::::::::.::.:::
...
=
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.043
0.027
3.117
2.65
0.258
0.009
0.075
0.19
0.064
8.013
Current Cumulative lbs/ac
Q 059
0 038.+.
4 110
3 194
0`.325
0 Ol Y
0 101`
tl 24;5
0 Q90
9935
Permitted C. P. L. R.****
36
34
1338
267
15
374
89
2498
Permit PAN Limit lst/2nd Crop
p
..... ............................................:...................................:. ....... .
........ . 12.•T"
"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
1/10/2017 **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): 62.39
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
C' ,,ator: James Roney Owner: Jame Roney Predominant Soil Series: EdC2
A.._ es Used: 21.8 Acres Permitted: 21.8 Site #: AM014 Field #: 5
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
EB
6/13/16
2
SB
6.13.16
3
4
51
6
7
8
9
10
11
12
% Solids
1 3.54
4.5
Arsenic
3
3
Cadmium
2
2
Copper
210
157
Chromium
56
168
Lead
13
12
Mercury
0.4
0.4
Molyb=
de um
5
5
Nickel
12
8
Selenium
5
5
Zinc
367
359
Total
Phos-
chorus
8780
19600
r Am rteavy ivletai r ieia Eoaaings kt aicuiatea in ins/acre):
1 oia-7 77 2 1 3 4 5 6 7 8 9 10 1j 12
DT/Ac./
App.
Event 0.79 2.07
Arsenic 0.0 0:012 0.000 0.0100 0.000 0.000 0 0;00 O 000 1 0.000 0:000 0.000 0.000 0.017
Cadmium 0.003, 0.:008 0.00.0 ' '0.000 1 0.:000 1 "000 0.400° 0:0=0.0 0.000 0.000 0:000 0.000 01011
Chromium
0 Q.89
0:;696 ;
'0 000'
0 000
0 000
U 000
0"OOQ
0 000 ,
0 000
0 000`
0.000..
0 000 ,
0,784
Lead
0 021
0 050
0 000 '
0 000
O,Q'00 ,
0 OOQ
0 OOU
0 000
0' 00"0 :
_ 0 000
0 000
0 000 .`
0.070 ;
Mercury
0 OD1
0 002
0 000,
0.000
0.Q;00 ,
0 000
0 000
0 0'00
0. 000O:000
6.000
0 002:
Molyb-
denum
0 098
0 921
0 000
0 OOU
0 0,00
0 000
0 000
0 0:00
e
0 000
I 0 000
0;000
0:000
-
0.029
Nickel
0 0i
0 033
Q 000.
' 0 000
0 0=00
0 000
; 0 000'
0 OQO
0. 000
0 QOD`
0.000
0.000'
Selenium
0 OQ8 ,
0 Q21
"0 00�0 '
0 0•UO
0 000
0 000
0.00'0'
0 000
0-Q00.
0 000
0 000
0000
0.029
Zinc
0 5$'1
1:486
b 000'
0 000
0 000
0 000
0 000„
0 000
0 000
=" 0 000
O.Q0.0
0:000
Phos- 13 9b$ . _ 81.144 0 Wo - 0 000 U.000 0.000 0 00.0' 0 000 0..000 " 0.000 0 O:qU 0:,000" 95..052
"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: 1/10/2017
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION FIELD 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: 21.8
Land Owner: Jame Roney Annual Dry Tons Applied: 62191. Site #: AM014 Acres Permitted: 21.8
Operator: James Roney Predominant Soil Series: EdC2 Cation Exchange Capacity (non 503): 0
Crop 1 Name: Fescue -Pasture Crop 1 Max. PAN: 122 Crop 2 Name: Crop 2 Max. PAN:
1.0 �
*, 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,
Wet,
Moist)
precip.
Past 24
Hrs.
inches
Y
� 'b
co '5
7. 8•
w
o
w
;
o
7y coo
w •,
co
TKN
mglkg
Z >
� �
o
CD p 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
7/9
117000
3.54
0782 "'
East Burlington
Dry
<.5"
S
0.5
0.3
22000
3670
2
11624
DNA '"i
Fescue
7/11
130000
4.5
1.119
South Burlington
D
<5"
S
0.5
0.3
57600
8890 1
2
42 657
NA ,r'
Fescue
7/12
110500
4.5
0 951
South Burlington
D
<.5"
S
0.5
0.3
57600
8890
2
36 2S`8,,
IAA -'°
Fescue
.0.000
`0 000
0 000 `r
0.000
6.000
©o00
�o
. o�opb y
o•000
oan
� _� 0,000
0.000
0 000
°t0 ob0 t'.
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)
Q 000
a! 0 000 ',
:....
TOTALS
.: o,
n; 3sasoo--
.
As
Cd
Cu
Cr
Pb
H T
Mo
Ni
Se
Zn
P
90;5'39Fi'0000a,''.
Lime Applied
Annual lbs/acre
0.017
0] 1) l {,`.
0 983,
0 7$4
0 070 .;
0.002
0,029
0.052
0 029
2 `Q'68
9-5.oS2 ;:.: :.:.::::::::
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.043
0.028
3.109
2.871
0.224
0.008
0.071
0.188
0.071
7.917
Current Cumulative lbs/ac
0060"
0.039 '
4 092
3 6'S5
0_>294
;,: 0 010 ;
' 0 100 .
0 240`
0 100
9 985
Permitted C. P. L. R.****
36
34
1338
267
15
374
89
2498
Permit PAN Limit 1st/2nd Crop
p
,...........::...:....:........:.. .
l22,
"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
1/10/2017 **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 1. 13
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
C' -,ator: Charlie Wyatt Owner: Charlie Wyatt Predominant Soil Series: VbC3
A, - �s Used: 13.1 Acres Permitted: 13.1 Site #: AM015 Field #: 1
Residual Analvsis Data (Heave Metals and Total Phosuhorus use mg/ke. % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
EB
6/13/16
_2j
SB
7/11/16
3
SB
10/10/16
4
5
6
7
8
9
10
11
12
% Solids
3.54
2.52
3.46
Arsenic
3
3
3
Cadmium
2
2
2
Copper
210
98
195
Chromium
56
97
209
Lead
13
6
11.5
Mercury
0.4
0.4
0.4
Molyb-
de
5
5
5.14
Nickel
12
6
9.25
Selenium
5
5
5
Zinc
367
215
376
Total
Phos-
L_phorus
8780
21900
23600
F tal meavy xtetai v wia i,oaaings (uaicuiatea in iasiacre):
1 otal
1
1 21
L3J
L4J
L5J
L6J
7
8
9
1101
11 J
12
DT/Ac./
o
App.
Event
1.61
1.15
1.15
Arsenic
G,wvj
0.0.07
0100 "
04000
0400.0.
0.000
0 00`0
O.Q00
0.000..0
000
0.000
0.000
0.023
Cadmium
0 006
0:0
0.005
0.000
0.000'
0.000
0.000
0.000
0.00, .`
0;000
UAW
0.000
U 016
Copper
0 677
1122
U 44Z'.:;
0.000
Q 000 '
0 000
.: 0 000�
0.000
O':000r
. 0 000.
0 0;00
0.000-
1. 48
Chromium
0 18.'0
0.223
0 479
0 000
0 000
.0 000
0 000
0 UUO
0000
:; 0 000
4 00
0.000 ".:
4 882,_.
Lead
0 042
0.014
U 02,6
0 000
0 000
"0 000.-
0 000
0 000
01000
Mercury
0 001
0 QOl
0 OQ1
0,000`
0 000
=0 000'
0 OOQ'
0 000
U;.000
0 000,
0 000
0..00.0
0 003'
Molyb-
0 O1'`6
0 011
.0 012
0 000
0 Q00
0. 000 ";
0 �00
0 QAO
0":000
. 0 OOQ
0.000
0.000
0.0 9"
denum
.
Nickel
0 039
K
0 614
0 021 -
Oy00:0:
Q 000 -
_
0 OQO'
0 000:
0 000
Q:.000
0 OOQ
0.000
0000
: 0 074
Selenium
000
0`
`
0 fl"00
0 000
0 039 .
Zinc
1 1 &
Q 0W
- 0 851 :
0 000
0 004 '.
a
0.0 0
0 000
0 00(l
0.000, ,
<. 0 OOD
fl 000
0 000 .:
2 5 7
Total
Phos-
28.289
50.239
5 444'
O.OUO
0:00.0
O OOQ
0 000
00.00
-
0,000 .=
O OOQ
0-000
0.000
32.572
ohorus
"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
irr isonment for knowing viola��tiviolations".Z.e 4`'2- 1/10/2017
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:
Charlie Wyatt Annual Dry Tons Applied:.51 ,iF Site #: AM015 Acres Permitted:
Charlie Wyatt Predominant Soil Series: VbC3 Cation Exchange Capacity (non 503):
Crop 1 Name: Fescue -Hay Crop 1 Max. PAN: 182 Crop 2 Name: Crop 2 Max. PAN:
13.1
13.1
0
o
a�
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.
D
( rY,
Moist)
Precip.
Past 24
Hrs.
inches
a
cu d,
a w
* o
o
w °'
* w
R
0
7y
w .,
N
* w
TKN
mg/kg
Z Y
w
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
7/26
143000
3.541
611
East Burlington
D
<.5"
S
0.5
0.3
22000
3670
2
.23:642
,N/1
Fescue
8/2
143000
2.52
1.141" t ..
South Burlington
D
<.5"
S
0.5
0.3
30800
9960
2
25.773
ETA,
Fescue
11/2
104000
3.46
� ' 145 .'
South Burlington
D
<.5"
S
0.5
0.3
61400
17600
579
51.589
NA ..
Fescue
'000�
0.000
0 000a
ir QU
0.000
0 IiAOa
,Q.r006,
0.000OffO
tFst000
0.000
0.000
0.000
0.000
6,000
Q 6,00
.0 000
o o'op
0.000
o boo
�Fo00
0 000
0
0
(� OQO°r
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0,000
0.000
TOTALS
E
;' c;
'390000
;:: ;:.:;:
As
Cd
Cu
Cr
Pb
He
Mo
Ni
Se
Zn
P
101,004
QOQ' ',,
Lime A Iied
Annual lbs/acre
023
o Or15
1 4°8
A ;$82
0,082
0.003
0 039''
Q o9
"0, 039
i2''S 7 t
132.572 ? ::::?::.::::::::
'>: >:::::=:: ;; :::::::::::::::::: :
::-------------------
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.057
0.034
3.504
2.077
0.351
0.012
0,099
0,276
0.08
10.507
Current Cumulative lbslac
"Or080
0 50:
..
x*8052
2 959
v0.43-
0 013-
013'8.
Permitted C. P. L. R.****
36
34
1 1338
1 267
1 15
1 374
89
2498
Permit PA Limit lst/2nd Crop
N L C p
- 182
"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
1/10/2017 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date
*** Mineralization Rates: Compost -0.1, anaerobialiy 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: Charlie Wyatt Owner: Charlie Wyatt Predominant Soil Series:
A.._ es Used: 12.1 Acres Permitted: 12.1 Site #: AM015 Field #:
36.69
EdC2
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Com-
posite
Date
1402
rum
Total
h
..
•.��
:�
;ual Heavy Metal Field Loadings (Calculated in lbs/acre):
i otal
1 I
L2JL3J
L4J
L5J6
7
8
9
10
11
12
DT/Ac./
a
App.
Event
2.32
0.71
Arsenic
0.014
0.004�
0:0.00
0.00:0
0.000.
0.000
0.000.
0.000
0.000
0.000
0:000
0.000
.0.018
Cadmium
Q.009
0.1003
0.000
0..000
0.000
0.000
0.000
0.060
0.000
0,000
0.000-
0.000
0.032
Copper
0.728
0..300
0-000
0.:000
0.000,
0.000
0.000
0.000
0:00`0
0.000
0.000
0.0.00
1.028
Chromium.
0.779
0.080
0.000
0,000
6.000
6.060
0.000
0000
0;060
0.000
0.000
0.000.
-0.859
Lead
0.056
0.019
1 0.00:6
0.00.0
0.0.0:0
0,0100
0.000
0:000.
0.000
` 0 000
0:000
0 000
0.074
Mercury
0.002
0.001
0.000
0.000
0 000
0.000
0.000
0.000
6'.000
0.006
0,000
0.000
.0.002
Molyb-
0.023
0,007
0.000
0.000
0.0-
0:0
0.000
0,000
0:000
0.000
0 000
0: 000
0.030
den
.0.000
Nickel
0.037
0:017
0,000
0.0.00
0.000
0.00°0
0 000
0.000 ;
0.000a
0 000
0.1000
0.000
0:054
Selenium
0.023
0-007
0.000
0.000
0.00.0
6.0001
0.000
0.000,
0.000
0.000,
0.0.00
0.000'
0.030
Zinc
1..664
0..524
0,000:
0..000
0.000
0.000
0..000
0.000
0.000
0.000
0:000
0.000
2.188
Total
Phos-
90.866
12.538
0.000
0.000
0.000
0.000
0.000
0.000
0.0.00
0:000
.0.000
0.000
103.401
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- --.j sonment for knowing violations".
Z.z G; --- 1/10/2017
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
ANNUAL LAND APPLICATION s-- 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
Charlie Wyatt
Operator: Charlie Wyatt
Crop 1 Name:
Fescue -Pasture
WQ Permit #: WQ0000520
Annual Dry Tons Applied: 36. ;69
Predominant Soil Series: EdC2
Crop 1 Max. PAN:
Field #:
Site #: AM015
122 Crop 2 Name:
Acres Utilized: 12.1
Acres Permitted:
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
12.1
0
f, 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
a
'o
cc S%°
�•
0.
* 0
R.
tt
o
�
� =
w -,
CD
w
0
o
TKN
mg/kg
Z
q
o
a ZCD .
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
7/22
149500
4.5
2' 318 •. '
South Burlington
D
<.5"
S
0.5
0.3
57600
8890
2
:.8-8.591
NA•,,
Fescue
7/26
58500
3.54
y 0:m "
East Burlington
D
<.5"
S
0.5
0.3
22000
3670
2
I0.471
NA "•
Fescue
0 000
.0.000
a oog
O'000
a., 0,boo
0 0017*
Q 000
6 OU0
0,
Ni o00
o.aoa
0 066'
Q000
0 000'
0 ffQ4.
fJ Od0
0:000
0.000o
000
0
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000
0.000
TOTALS:
:; 0
As
Cd
Cu
Cr
Pb
H
Mo
Ni
Se
Zn
P
98.852
0 OOQ
Lime Applied
Annual lbs/acre
p a 8
�•Q12
1 t) _8
�0;859
0.074
0.002
0` F3 }:
0 0 4
_Qp11 0��
,'2'188
" 03:403 ;.:
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.04
0.024
2.528
1.946
0.2 9
0.01
0.079
0.209
0.047
7.478
Current Cumulative lbs/ac
0 058 `
0 03C
3 5,6
2'805
0 333''`
0 012, ``0
109.
0 263
0 077a
9.666''
Permitted C. P. L. R.****
36
1 34
1338
1
1 267
15
374
89
2498
Permit PAN Limit lst/2nd 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
1/10/2017 **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): 15.17
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
P ,ator: Charlie Wyatt Owner: Charlie Wyatt Predominant Soil Series: EdC
A— es Used: 10.1 Acres Permitted: 10.1 Site #: AM015 Field #: 3
Residual Analvsis Data (Heavv Metals and Total Phosphorus use make, % Solids use Raw Percent ft
Com-
posite
Date
1
1
IMEM
0
I ITotal
Phos-
_phorusMEMENEENEENE
jai
heavy ivietai r iew l,oaaings
k uaicuiarea in instacre):
jo;a-11
1 1
2 J
L3J
4
5
6
7
8 J
L9JLOJ
11 J
12
DT/Ac./
App-
Event
1.50
Arsenic
0.009
0.000
0.000
0.000
0.000
0.000-
,. 0.000
0 Q"00
0.�000
0:000
0.00©
0`0000
0.009
Cadmium
0.006
0.000
0.000
0,600
0 004
0.000
0.000
0 0:00
0 . , 0 ';>
0.000
0.000
0.000,.
--a Q06
Capper
0.5
0 000
0 000 `'
0 OQ0
0 0:00
0 000:`
0 O0
Q 0OQ .
0}000 ;'
0 OOD'
0 600
O.QQO`
-
_0 523;'
Chromic
0 16k
0 04Q
0 000 ;:
0 000
t
0 060
00
r 0 000
0 -000
Q 000
0 000
000
0;000
:0 I6
Lead
0 0:5
O fl00
0 000"
0 000
OrflOt
0 x000
0 00„0C?0
0:.040
£ Q 400
0 O:Qfl
d:000
Mercury
0 OQ.1
0 Q00
0 000
0 QQ
0 000 ,
-Q Q00
0 Q00
0 0'00
Of000
: 0 004,
0 000
0.000,,
`0 001.
Molyb-
0 415
400
0 000
0 00U
0 000
0 000
0 OQ ?'
0 000
0 000
_
0 0-0
0 000
_.
0.000
-.Q. O1
denum
_.
Nickel
0 042
0.000
0 000
` `0 OQO.
0 OQD
0 000F.
0 000
0 fl00
0::040
000,`
' 0 0o0
Q.000
Selenium
0 015
0 000
U 000
0 000'
0 d04
000
0 OQU ;
On4U
0:000
U 00titi:
0 OQO
800i1
0=015
Zinc
1.23;$
0_Q00
Q 000 .`
0 O9O;
0 000
0 00
' 0 04 :�
0 000
O.:Q00
0 000 ,
0 000
O::ODd ,
1 234
Total
Y
Phos-
19.4�6
0 00Q
.0 000
0>00.0
0 "Obb
.0 OQO
0 000.
0.,040
QA4Q
:. 0 b00:
0.00`0
0'.0
9-.43G
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".
Z�f 1/10/2017
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
Operator:
ANNUAL LAND APPLICATION -xGELD 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
Crop 1 Name:
Fescue -Pasture
WQ Permit #: WQ0000520
Annual Dry Tons Applied:! ` J-5;;17
Predominant Soil Series: EdC
Field #:
Acres Utilized: 10.1
Site #: AM015 Acres Permitted: 10.1
Crop 1 Max. PAN: 122 Crop 2 Name:
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
o Y
Y 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
°
o'
..
R. w
o
w
�,
* w
w •,
N
*�
TKN
mg/kg
z a
c"t S
° 5
°
w
mgfkg
Nitrate
and
Nitrite
mg/kg
PAN Applied
( Ibs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
11/1
52000
3.11
0, 668,
East Burlington
D
<.5"
S 1
0.5
0.3 1
27900
4810
346
12,924
Fescue
l 1/2
65000
3.11
k "0 $35
East Burlington
D
<.5"
S
0.5
0.3
27900
4810
346
16 155
NA' .
Fescue
:o 000
o 00o
a oo
o aclo '
o ooa'
0 000
0.000
0 004 ,.
0 000
,� 0 000
=`0 00EY.
0 000
0t,000 '
0 000
i Q00
O.000
0 000 „
0.0oo
0 000`
v o00
o:000
0.000
0
ll
000 ka
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000
OQ
TOTALS:
1. .„ 0
-4.17oQ
As
Cd
Cu
Cr
Pb
He
Mo
Ni
Se
Zn
P
29.079
1 0004
Lime Applied
Annual lbs/acre
a0(19 ,,..
'O QQ
O S23
Q,_165
0.035
3 d01
4015
0 042
b b1-5
1238
19.436 .::.:. : .:..::'.::.:.::
Date
lbs/ac
Prior Years Cumulative Ibs/ac
0.035
0.02
2.127
1.146
0.187
0.013
0.059
0.194
0.048
5.823
Current Cumulative lbs/ac
r ,Q 044'
d Qb'
2 6Sa
1:31.1
05222
0 014°.
LL1
0 074
, 0, 23.6
Q.063
T:Q61„
Permitted C. P. L. R.****
36
34
1338
267
15
1 374
1
2498
it P
Perm AN Limit 1 2nd Crop
st/ P
.
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
1/10/2017 **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 (12l2006)

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): 34.81
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
(' !gtor: Charlie Wyatt Owner: Charlie Wyatt Predominant Soil Series: CbB2
A,_ .s Used: 15.8 Acres Permitted: 15.8 Site #: AM015 Field #: 4
Residual Analvsis Data (Heave Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
SB
9/12/16
_2j
EB
9/12/16
3j
EB
10/10/16
L4J
L5J
6j
L7J
8j
9
10
11 j
1121
% Solids
3.25
3.95
3.11
Arsenic
3
1 3
3
Cadmium
2
2
2
Copper
158
266
174
Chromium
164
59.8
55
Lead
13.6
12.8
11.7
Mercury
0.5
0.4
0.4
Molyb-
denuin
5
5
5
Nickel
8.42
15.1
14
Selenium
1 5
5
5
Zinc
300
489
412
Total
Phos-
phorus
21400
15500
6470
F lal Heavy lvletal view hoaaings (ualculatea in ins/acre):
i otal
1 1 1
L2J
3
4
5
6
7
8
10
11
12
DT/Ac./
°may
App.
ro
Event
0.17
0.54
1.49
Arsenic
0.001
0.003"
0.0.09
0.000
0.0.00 '
.0:000
0:000
0;00'0.00.0
0 000
0.:000
0.000
..0.013
Cadmium
0:001
0.002
U 006
0.000
0,000
0.000
0.000
0..000
0.000
0.000
0:000
0;000
0.009 -
Copper
0 053
0.288
0 520' "
; 0.000:
0:000
Q 000
0 000
0.000•
6.00.6
0.0.00
0".000
0.000
0.861
Chromium
O..OSS
0-065
0.164
: 0.0.00
0.040'
0. 0.00.,
0 000-
0 000
0 000 :
0.000
0 0.00
0.000
0 2s4
Lead 1
0.005
0-014
0.035
0.000
0.000
0 00U
0.600
0 000
0,000 ,
0 00:0
0.000 "
, 0 000
0 053
Mercury
0-.000
0.0`00
0.0,01
0 000..
0 000
0: 000
0 000=
0.000
0.000,
0 OQ0
0.0.00
0.000
0,002,
Molyb-
0.00.2
0 005
..
0.015
0.00.0.
0..000
0.000
0 000,
0.000
`0.000
1- 0.0.00
0.000
9,000�
„ .
0.022
den
Nickel
Q. 003
0.04 6 •
0 042..
; 0,000
0 .
' .0 000
. 0 000
0 000
0.000-
6 000 .
0.000
0.000
: 0.0:6 i.
Selenium
0 002
0.:005
` 0 015
0..00'0
0.000
:.0,D00
0 000
6;000
0,;000
" 0.000
0.006
0 000
0.022
Zinc
0.160
,.
#l, 330.
`1.231. ;
0 000
0.10
;-6.060.
0.000
0.000
0.000.
;, 0.000-
0.000
0.00.0
1.861
Total
Phos-
7.148
16.."2
19.332
0.000
0..000
0.000
0.000
0.000 =
.0.000
0.000
A-0:00
0 00-0-.
_ 43.282
horus
V:.
"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 1/10/2017
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
Operator:
ANNUAL LAND APPLICATION i 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:
Charlie Wyatt Annual Dry Tons Applied: 48;1. 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
I..
° '�
°
p
Volume applied
(enter one) Solids(
Liquid
Cu Yds Gallons
%
Solids
Volume
Applied r
pp pe
Acre
{Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
Wei'
Moist)
Precip.
Past 24
Hrs.
inches
Y
4 b
aCD
o
�,
61
7y
w
* w
0
TKN
mglkg
z Y
.;
�o O
0
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
10/31
19500
3.25
.6:167•
South Burlington
D
<.5"
S
0.5
0.3
58300
19000
8
.` Ti4`5 ;:
Nk
Fescue
10/31
52000
3.95
0:542 .
East Burlington
D
<.5"
S
0.5
0.3
28000
5050
8
'4,0.21,1'
NA ':
Fescue
11/1
182000
3.11
.1 94
East Burlington
D
<.5"
S
0.5
0.3
27900
4810
346
'� 28.915
NA`,;
Fescue
0:000
0 ,
Ut,000
0000
0 000
0,000,ft
NO';000
01000 ;BYO
ai00".
o 600h
0 000
0 QQQ
o�o0
0o00
0 000
0:000
6'000
0 000 °
6 000
0 Wo
(ebb "
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
�0:000
0.000
TOTALS
'' 0
253500
...:.:':'::
As
Cd
Cu
Cr
Pb
H T
Mo
Ni
Se
Zn
P
46.251
0 OQ0
Lime A died
Annual lbs/acre
�` 'O OI3 `+
0 009
0 Sbl
O';284
O.i153 ;,
0 00
M0 022''
0 061
0 022
L,
*�43 28T` :::.::.::::=>::: -
:::>':».:{.. .:. • . -:
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.04
0.025
2.646
2.412
0.214
0.013
0.069
0.193
0.06
6.537
Current Cumulative lbs/ac
6.053
0{ 34:
3 51t7
2<696
a207
0t11
�091„
0 5'4
Gi`D 2
8;398
Permitted C. P. L. R.****
36
34
1338
267
15
374
89
2498
Permit PAN Limit 1st/2nd Crop
216
"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
1/10/2017 **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): 95.31
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
V ,ator: Michael Hadley Owner: C.L. Hadley Predominant Soil Series: HdC2
A,. es Used: 30.5 Acres Permitted: 30.5 Site #: AM016 Field #: 1
Residual Analvsis Data (Heavv Metals and Total Phosphorus use mg/ke. % Solids use Raw Percent ft
Com-
posite
Date
.
' .
i•• .
ua► tieavy ivietai r 1e10 Loaaings (uaicuiatea in iasiacre):
1071-111 2 L3 4 5 6 7 8 9 10 11 12
DT/Ac./ °may
APP•
Event 0.24 2.89
Arsenic 6.001 0.017 0 OOQ 0.000 0:0007 ` 0 000' 0.000 0.60.0, 0.000 0.000, c000 0.000 0 019�
Cadmium 1 0.'601 1 6'.012 ° b'.000_ 0.0061. 1 0 -696 1 0.000 0.000 0.0:00 0.000 0.000' . 0..000 1 0.000 6.013
Lead I
0.00:6
0 069
: 0 000
0 OOQ
O'000;
0 000
0 000''
0.000
0.00.0
0 000;:
Q.. 0
.0.000,
o.0 s
Mercury
0 00.0
6 03
0 000 -
0 00;0
0 Q00
0 OOQ'
Q 000
0 0:00
0.000
0 000
0.000
_ O.0.00
0 0.04 .
Molyb-
0 002
0.029
0 OOQ: '
0 000
0,000
0 000'
0 000'
0.000
0.000,
„ 0,660
0..000
0:000
0. 03:L
ciemim
.
Nickel I
0, QQS
0069
0.000
0 000
0.0-00
0 000 ;°
0 ip,00
0,000
Q. 000
0 000`
0 000
0;000
0 0 5
Selenium
0 00
0 029
0 10,00
0 000
O.OliO
0 000 .
0 000
0.000
0 000 .
0 000
0 000
0:000 ,
0.031
Zinc
0 19°l
2.404
0 000 .
0 OQO
0 000
0 ODO :,
0 000
0:000
0.000
0 OOU
0 0:00
0,000,.
2.594
Total
Phos-
13.499
71:_069 _.
_0.0.0-0
0.006 .
0.000 ,
0.000'
0.000.- 1
0:000
-0.000 '
0.000
A000-
0.000-1
84.569
nhorus
T
-
"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".
;?!fe G;:�e 1/10/2017
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
C.L. Hadley
Michael Hadley
Crop 1 Name: Fescue -Hay
WQ Permit #: WQ0000520
Annual Dry Tons Applied:, 95.3`1
Predominant Soil Series: HdC2
Field #:
Acres Utilized: 30.5
Site #: AM016 Acres Permitted: 30.5
Crop 1 Max. PAN: 198 Crop 2 Name:
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
PDES #, W #
Q >
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry'
Wet'
Moist)
Precip.
Past 24
Hrs.
inches
Y
cu
aP.
o w,
* �
o
w
N'
o
0
w .�
;
* N
* o'
TKN
mg/kg
Z Y
rt
o
oc 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
5/31
45500
3.79
Q236
South Burlington
D
<.5"
S
0.5
0.3
69100
29300
2
T1539
NA~.':
Fescue
6/1
234000
5.16
1.65`1
East Burlington
Dry
<.5"
S
0.5
0.3
29700
3880
2
3Y 986
NA :,
Fescue
6/2
175500
5.16
1`.238 .,
East Burlington
Dry
<.5"
S
0.5
0.3
29700
3880
2
" 23 990 ;
` NA
Fescue
Og000
b.00tt °
N, O.0 .'
0 000:
0.000
O Ofl0 ..
0.000
0 000
.000
0 flbfh'=
0:000
0-ow "
to 00t
i.000 ..::
0
AIN 0.,".
0.000
0
0 °`
0 000 ten.
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
omoo
0 OUQs' '
.........
..
'
TOTALS
; o
: 45,ociu
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
68.515
0 000 "
Lime Applied
Annual lbs/acre
W 0 014
0 013
J 0 80'S
' 0 384
0 f 5 ._--"
b 004 '
0 031
0 0 5
t 1�031
a : 941
84.569 < :->::::< :< ::.::::::::
::
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.025
1 0.017
1.504
1.911
0.118
0.004
0.042
0.08
0.042
3.067
Current Cumulative lbs/ac
"U 044:
0 030`
,....
209
` 2>95
13 _
,r 0 QOS
0 073
0 153
0.73
5.6G1
Permitted C. P. L. R.****
36
34
1338
267
15
374
89
2498
Permit PAN Limit 1 st/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
1/10/2017 **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): 65.41
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
r `ator: Michael Hadley Owner: C.L. Hadley Predominant Soil Series: AaB
A.._ es 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 #):
Com-
posite..
Date
•.
Total
Phos-
.phorus,MMENEEMENEEN
f ial
heavy ivietai rieia L,oaatngs
(Laicuiatea in tnsiacre):
l otal
111
L2J
L3J
4
5
6
7 J
L8J
L9J
10
11
12
DT/Ac./
App-
,oyr
Event
1.99
0.61
14
Arsenic
0.012
0..004
0..000
0..000
0:000:
0.006
0.000
0.000
0.000
0.000
0 00.0.
0.000
0.016
Cadmium
0.009
0,662
0.000
0.000
0.000
0,000
0.000
0.1000
0:00.0
0.00:0
0;00-0
0.000.:
0.010
Copper
0.741
0.151
0.000
0.000
0.000
0.100.6
0.000
01000
0.000 .
, 0.000
0.000
0.000
0.892
Chromium
0.801
0..063 .
0.000
0.000
0..1000
Q OQ.O
0.000;,I.
0:.000
-0.000. -
0.000
0,000,
0.0.00-
' 0.864
Lead
0.060
0.015
0 0,00
0 000
0.000-
ta.opp,
0 000
0 000
: 0.:000
0.00.0
0.000
0.000
0..075 .
Mercury
0.002
0.001
0.000°
0.000
0:000
0.004.1
° 0 000
0.0.00
1 0.000
0.000
0.0,00
0.000-
6,602.
Molyb-
0.02`0
0:006
0400.
0.0,0-0_
0A00
0.000-
0.000
0.0,00
0.000.
0.00:0
0 000
0"000
0.026
denutn
Nickel
0,036
0s015
0 000.'°:
0.000
0 0:00
0. 000
` b 000
0..000
0.000
: 0 000
0 Cr
0.000.
0.051
Selenium
0.020
0:00.6
0 00`0
0.000
0.00.0
0 00:0
0.000
0.000
0.000
`4 0 00:0
0 0.00
-0.00..0
0 026
Zinc
1.375
0.510
0.000
0:000
0.0.00
0.000.1 .,
0,00'0
0.000
0.000 -
. 0.:000
0.009
OA00_
1.885
Total-
,
Phos-
1094216-
15.080
0.000-
0.000
0.000
0..000
0.000
0,000 "
0.000
0.000
0 000
- 0.000
124.296:
ohorus
"I certify. 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
it =sonment for knowing violations".
Gam' 1/10/2017
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
ANNUAL LAND APPLICATION x-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.
City of Burlington
C.L. Hadley
Operator: Michael Hadley
Crop 1 Name:
Fescue -Pasture
WQ Permit #: WQ0000520 Field #: 2
Annual Dry Tons Applied:,' 65-41' Site #: AM016
Predominant Soil Series:
Crop 1 Max. PAN:
143
AaB
Crop 2 Name:
Acres Utilized: 25.1
Acres Permitted: 25.1
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.
Wet
Moist)
Precip.
Past 24
Hrs.
inches
Y
'
61
0.
* o
o
c
w
*
TKN
mg/kg
Z a
Gt
o
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
4/21
130000
3.55
0 76
South Burlington
Dry
<.5"
S
0.5
0.3
62000
22300
2
35:364
N_<
Fescue
4/25
208000
3.55
1 227
South Burlington
Dry
<.5"
S
0.5
0.3
62000
22300
2
5&582
NA' ,; ;
Fescue
6/9
39000
5.16
�' U'3�34 d
East Burlington
Dry
<.5"
S
0.5
0.3
29700
3880
2
6 478 ;'
NA,. '
Fescue
6/10
32500
5.16
�O 27 '"
East Burlington
Dry
<5"
S
0.5
0.3
29700
3880
2
." 5-:•3'98
NA,''"
Fescue
p doo
o:eoo
0 000 =
o 000
0"000 -•
- 0 000„
0 t101�„
.. ;;
00Q• ''
0 t)00
t 0 OOQ;
g; o0o
u 0000 ry
oo¢oe
o 000 "'
:• 0000 '�'i3`otltt`
rt
'a 0o0
a 000;::Z
. '. ••
u 0
O i•'
<
Q, , 60�
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000
0 000"
..... .
TOTALS
! ,.
As
Cd
Cu
Cr
Pb
Hfo
Mo
Ni
Se
Zn
P
103.8231
0 Qft
Lime Applied
Annual lbs/acre
,Q O1G •_�.:
, OE01Q „
0 89
864
0.075
0 002
0 02C
0 05:1
026
1885'
,1121.29G ::.::..`::`::::::::.::::
,• '
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.028
0.017
2.229
1.339
0.172
0.006
0.056
0.125
0.041
5.086
Current Cumulative Ibs/ac
Q44;
0 027•
3 11
2;203
A4
0 008'
6E082
0 iZ6
O'067
6971''
Permitted C. P. L. R.****
36
34
1338
267
15
374
89
2498
Permit P AN Limit 1 st/2nd Crop
p
- --
-
`143
"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
1/10/2017 **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): 173.69
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
C' -7ator: Michael Hadley Owner: C.L. Hadley Predominant Soil Series: GaB2
A_ .;'s Used: 23.5 Acres Permitted: 23.5 Site #: AM016 Field #: 3
Residual Analvsis Data (Heavv Metals and Total Phosphorus use mg/ke, % Solids use Raw Percent ft
Sample or
Com-
posite
Date
11
EB
5/9/16
1 21
SB
10/10/16
3j
EB
11/7/16
L4J
5
6
7
8
9
10
11
12
% Solids
5.16
3.46
4.58
Arsenic
3
3
3
Cadmium
2
2
2
Copper
123
195
168
Chromium
51
209
53.3
Lead
12
11.5
15.2
Mercury
0.6
0.4
0.4
Molyb-
denum
5
5.14
5
Nickel
12
9.25
18.8
Selenium
5
5
5
Zinc
416 1
376
473
Total
Phos-
L.phorus
12300
23600
8110
F ;lai Heavy Metal rlela Loaaings (uaicu►atea in insiacre):
i otal 1 1 2 1 1 31 1 41 1 51 1 61 7
DT/Ac./
App.
Event
3.21
0.48
3.70
Arsenic
0.01;9.
0.003.
1 0.022
0:000
0.000
0.0.00.
0 000
0A00
0.000
0.000
6..000
0:000
0.044
Cadmium
0.913
0.002
0.015'
0.000
0.000- '
0.000
0,0001
0.000
0.000
0.000
0.00 07
0.000 :.
0.03.0.
Copper
6.791
0.1$7.
1143
0..000
0,00,0
0 000
0 000
0.000
0.000
0.000
"0.000
0.000
2.220
Chromi
0 3.2$
0.200 :
0.394
0.000
0: 000. ;,
0,000.
0.000
0..000
0A00 :
0-606
0,000
0:000
0.922
Lead
0.077
0 011
U.11'2
0 060
0.000 _
Q 000:
0.000.
6` do
0.000
0, 000
0:000
0.060
0.201
Mercury
0.004
0.600
0.003
0 000
0..000
0 000
0.000
0:000
0.00.0
0 000
0.000
0.000
0.007
Molyb-
denum
0, K
0.005
0. 037
0.000
0.000
0.000
0.000
0 0:00
0.000
0:000
0:000
0.:000
0.07-4
Nickel
0 0:77
0 0.09
0.139
0 00.0
0.000
0__000
0 - 0.
0 000-
0:000
0 000
0.000
0:000
0:225
Selenium
0 032
0-:00.5
0 03`7
0.000
0..000
Q 000
0.000
0.000
- 0.000
0.0 0:0
0.000
0.000
0.074
Zinc
2.614
0.360
3.49$
00000
0 OOU
0 000 "
0 000
O.OQO
O:O.OU
0.000
. - 0.000
0.000
6,533
Total
Phos- 79 064 22.609 59.982 0.000 . 0,000 0..000, 0.000 1 0 0.00 0.000 0.000 0.000 0.000 161.655
-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
iw isonment for knowing violations".
;95L� 1/10/2017
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
C.L. Hadley
Michael Hadley
Crop 1 Name: Fescue -Hay
WQ Permit #: WQ0000520 Field #:
Annual Dry Tons Applied: 173 U. Site #'
Predominant Soil Series: GaB2
Crop 1 Max. PAN:
211
Crop 2 Name:
AM016
Acres Utilized: 23.5
Acres Permitted: 23.5
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
o
A
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
a
4
5:
�'
o w
o
x w
w
; N
7y
w
�
* N
o
d
TKN
mg/kg
Z
ct
o
aR p
� 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
6/3
208000
5.16
1s 6 -
East Burlington
Dry
<.5"
S
0.5
0.3
29700
3880
2
-36 902
14
Fescue
6/10
143000
5.16
1.309
East Burlington
Dry
<.5"
S
0.5
0.3
29700
3880
2
25:370
I�IA.P
Fescue
12/22
78000
3.46
South Burlington
Dry
<.5"
S
0.5
0.3
61400
17600
579
�=21 5'68�
NA ,..
Fescue
12/22
58500
4.58
East Burlington
Dry
<.5"
S
0.5
0.3
19200
1960
11 15,860
NA °'
,.
Fescue
12/27
227500
4.58
1 849
East Burlington
Dry
<.5"
S
0.5
0.3
19200
1960
11.1
�2.790
i NA:.01
Fescue
12/30
169000
4.583
East Burlington
Dry
<.5"
S
0.5
0.3
19200
1960
11.1
16.930
NA: ``.
Fescue
U'�©6
.000 `.
O 000
0:000
O ODJJ :.
0 000
6000
o00 "
0.000
000 . W
. 0,000
0 -aoo
0 000 " `
0:0oo
v aoo
(D
0
::::: '
�Q 000 .;
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.00(}
TOTALS:
` ii
ss4000
:.:::::
As
Cd
Cu
Cr
Pb
H
Mo
Ni
Se
Zn P
129.420
b OOQi"'
Lime A lied
Annual lbs/acre
A 0440
0
030
Z 2?Za
t1922
,;;(1=20 kx
0£Qo7k
0 Q7�4;
4 22s5
rvt as74
6=53 ib1.655 :::::::.::::::::`
3.355
::.:..: :. ... .
�� 9888 •
1 2498
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.021
0.013
1.474
1.12
0.111
0.005
0.04
0.085
0.03
Current Cumulative lbs/ac
0�65
0 043
3 6,:94
2 042.a,
U 32,
0 Or12
0 114
0 310°,
0 I04
Permitted C. P. L. R.****
36
34
1338
1
1 267
15
374
89
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
1/10/2017 **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: Michael Hadley Owner: Russell Hadley Predominant Soil Series:
A.._ cs Used: 33.1 Acres Permitted: 33.1 Site #: AM016 Field #:
110.32
HdC2
4
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
EB
3/14/16
2
SB
3/14/16
3j
EB
5/9/16
L4]5
6 J
L7J
8
9
LOJ
11
12
% Solids
1 6.23
3.55
5.16
Arsenic
3
3
3
Cadmium
2
2
2
Copper
122
186
123
Chromium
67
201
51
Lead
15
15
12
Mercury
0.4
0.4
0.6
Molyb-
denumi
5
5
5
Nickel
18
9
12
Selenium
5
5
5
Zinc
433
345
416
Total
Phos-
horus
9780
27400
12300
'ial Heavy Metal Field Loadings (Calculated in lbs/acre):
1 otal
1
2
3
4
5
6
7
8
9
10
11
12
DT/Ac./
rt
App.
14
Event
1.89
0.73
0.72
Arsenic
0.0.11
1 0...004
0:::004 1
0.000
0;000
0.000
0.000
0.000
0:000
0,00:0
0:000'
0.000
0.020
Cadmium
0.008
0.003 ,
-0.063
0'.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0,000
0.0,13
Copper
0461
0.270
0177
0.090
0.0-00
0.000
0.000
0:00.0
0.000
0.900
0.:000
0.000
0.908
Chromium
0.253
0:292
;- 0.073
0.000
0.000
01.000-
0.000
0.000
0.000
0.0.00
0.000
0.:000
Lead.
0 057
0.022 ;:
0 U17
0.000
0,.000
6.006
0..000
0.000 :
0.000
0..000
0.000
0.000
0.096
Mercury
0 002
0_ 001
0.001
0.000
.0.-000
0 00'0::
0.000
0.000
0 000
0.000
0.000
0.000
0.003
Molyb-
0 019
0.07
0.007
0.000
0.000
0.000
0.000
0.000
0..000
0.000
0.0.0.0..
0.000
0.033.
denum
.
Nickel
0.068
O613
,0.017
0.000
0.000
0 0Q0
0.000.
0,000
0..000
0.00-0
0.000
0::000
0.099
Selenium
0.019
0.007
0.007
0.000
0.0.00
0.000
0 Q00
0.000
0.0-00
0.000
0.000
0.000
' '0.033
Zinc
1.635
0:,502
0.597
0.0.00
O'.QOO
0:000.
0 000-
0 000
0:000
0.000
0.000
0.000
2.734
Total
Phos-
36.929
39.840
17.663
0.000
'0:000
0.000
0.000
0.000
0.0-00
0.000
0.000
0..000
94.432
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".
Z 4_ 1/10/2017
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
Russell Hadley
Michael Hadley
Crop 1 Name:
Fescue -Pasture
WQ Permit #: WQ0000520 Field #: 4
Annual Dry Tons Applied: -1:3032: ' Site #: AM016
Acres Utilized: 33.1
Acres Permitted: 33.1
Predominant Soil Series: HdC2 Cation Exchange Capacity (non 503):
Crop 1 Max. PAN: 149 Crop 2 Name:
Crop 2 Max. PAN:
1) 14enter
o
Q
Volume applied
one Solids/
( )
Liquid
Cu. Yds Gallons
u
/o
Solids
Volume
Applied per
PP P
Acre
(Dry TonslAc)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry,
Wet,
Moist)
Precip.
Past 24
Hrs.
inches
a
�
c�
o• o
o h
ao•
Z
o
7y
A _,
; —
N
.
w
*
*�
TKN
mg/kg
Z a
o o
�.
�
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbslacre)
Name of Crop Type
Receiving Residual
g
Application
Crop 1
Crop 2
Crop 1
Crop 2
4/16
52000
6.23
Q 40,8
East Burlington
Dry
<5"
S
0.5
0.3
26000
3050
2
6 866
NA .'
Fescue
4/18
188500
6.23
"1479 `
East Burlington
Dry
<.5"
S
0.5
0.3
26000
3050
2
24.891
N .
Fescue
4/19
97500
3.55
;U 436
South Burlington
Dry
<.5"
S
0.5
0.3
62000
22300
2
20,113t
NA ''
Fescue
4/25
65000
3.55
Q 291 "
South Burlington
Dry
<.5"
S
0.5
0.3
62000
22300
2
1i3.408TPa
,• '
Fescue
6/9
110500
5.16
, (? 71E8
East Burlington
Dry
<5"
S
0.5
0.3
29700
3880
2
13918
Nei ' ,
Fescue
s© 00a
O'000
0 0.4b
0 000
0,0o0
0 000
0°000.
0:0oo
0 006 `
o oo©
0:000
0 obb~
0
db
Q00 . y'
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
o.0oo
TOTALS:
- 01
As
Cd
Cu
Cr
Pb
H g
Mo
Ni
Se
Zn
P
79.196
[A.000`£`
Lime Applied
Annual lbs/acre
`'0 020
0 Oa1.3
0 208
0: 618 "
;0 0.9�u _,
0 003a `
0 fl33
Q Q $t'
0
`94.432
:•:• •:.' ::..:•.•:... .....
::.• . .. . :.:
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.048
0.03
3.428
2.522
0.384
0.014
0.088
0.221
0.065
9.028
Current Cumulative lbs/ac
U 068
0 043
4 3:36
3..140
=0.-180
0 017
0 72:1
0119 k9
0a098
: 1'I 762�
Permitted C. P. L. R.****
36
34
1 267
1 15
374
89
2498
erm' P rt PAN Li 2nd Cr
Limit 1st/ 0P
1 49
"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
1/10/2017 **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): 43.71
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
C' Bator: Albert Mills Owner: Albert Mills Predominant Soil Series: lbB2
A.,. es Used: 28 Acres Permitted: 28 Site #: AM018 Field #: 1
Residual Analvsis Data (Heavy Metals and Total Phosphorus use mff/kg. % Solids use Raw Percent #):
Com-
posite
Date
Total
h
..
•�i
L iat
Heavy ivletal r ieta Eoactings
(Laicutatea in ins/acre):
I otal
11
2]
131
L4J5j
L6J
7
8
9j
10
11
12
DT/Ac./
oy,
App.
y
Event
1.56
Arsenic
0.009
0.000
0.000
0 000
0.0:0.0.
0 000
0.000
0.000
0:000
0.0.00
0.00 -
0,000.
0.0.09
Cadmium
0.00b
0.000
0.000
0.000
0:000
0,000'
0 000.
0.000.
0 - -
0.000
0 000`
0.000
6.0016
Copper
0 306
O..U00,
0.000
0 000
0- -00
0 000 `
0.000
O.:O:OQ
0.000
0 000
O.OaO
0.000
0.306
Chromiui
0 303
0.000
.0 00V
0 000
0 000
0 000'
0 000:
0.000
0,.000
0 000
0 Ofl0
0.000 <
0 303..
Lead
0.019,
0:,000
6.000
U. ,
0::000' `'
'0.00:0
6.660
0.:000
0-.000 .
0:000
0..00
0.00.0
0.b19
Mercury 0.001 0 :000` 0.000 0:000 0:000 0 000 0 000` 0.0,00 0.000 ` 0.000: f0,0
0- 0.00.0:... 0.0.01
Molyb-
denum 0.016 0 000 0 600 0..000 O.U00 0 00.0 0 000 0.000 0.000 0 000 0,000 0.000: 0.016
Nickel
0419
0 000
0.000 f.
0.000
0460
- 0 000''
0 000
0.0`00
0.000
0 000:,.
1 0.90
0 000f
0.01.9
Selenium
0.016
0.000
. Q.000
0 00:0
0.000
D 000 ,.
0.000-
0.,000
0.00:0 ;
0.000
0.900
.
0:.000
,.-0 016
Zinc
0.671
Q:000
0 006
0 000
O, ):00
0 Q00 ,
0 000�
0.000, ;
0,60 :
0 000
0 0:00_
Q. 000
0.:671
Total
Phos-
phorus
68.372
0 0-.00
0.000
0.000
0.:000
'Q 000
0.00.0
'oorool
6.000 '
0.000.
0D00
-0.000.
68.372
"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".
zyz G;:�r 1/10/2017
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION i..&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: 28
Land Owner: Albert Mills Annual Dry Tons Applied: ... "43 71 Site #: AM018 Acres Permitted: 28
Operator: Albert Mills Predominant Soil Series: IbB2 Cation Exchange Capacity (non 503): 0
Crop 1 Name: Fescue -Hay Crop 1 Max. PAN: 123 Crop 2 Name: Crop 2 Max. PAN:
° �
s i
°
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
o m,
a o
o
w ?:•
#
* �'•
$
7y �,
� y
* N
# w
0
TKN
mg/kg
Z
o6 o
w
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
PP
(lbs/acre )
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
8/29
169000
2.52
qr6 4
South Burlington
Dry
<.5"
S
0.5
0.3
30800
9960
2
14 25A.
NA:-
Fescue
8/30
201500
2.52
" p`756
South Burlington
Dry
<5"
S
0.5
0.3
30800
9960
2
' 16.99 I
N.
Fescue
8/31
45500
2.52
"r 51)sL'71
South Burlington
Dry
<.5"
S
0.5
0.3
30800
9960
2
3.837
N+s
Fescue
00o
0
�,r�ogo
``"o:000
o ago
p d6'
1400o
a 609",
ti;000
0000
oe000:
00
0 000.
o c�oa w
o ioo
0 000 .
0 660- "
TAW
`
0:000
J0
raov'
(Woo
o doo
0+OOQ
fin'.;
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.O00
0.000
TOTALS
;: 01
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
35.078
0f00��y
Lime A lied
Annual ]bs/acre
©; 009
0 006'
0 3C 6"
0,303
0.019
11001
'� 0 Oa16
`�©OT
� ;'!1 �
�©6710
�G8 372.` ::
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.065
0.04
4.445
3.131
0.366
0.012
0.112
0.275
0.096
11.238
Current Cumulative lbs/ac
D 0 T4 -'
0 016
v4 751
3':434
0.385",#'013:
p 128
094�
tl l`t2
119U9
Permitted C. P. L. R.****
36
34
1338
2 77
15
1
1 374
89
1 2498
Permit PAN Limit 1st/2nd Crop
:... 123 ""
"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."
;efe.ff I *Application Method: S - Surface, IN - Injection, INC - Incorporation
1/10/2017 **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): 12.98
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
C '14tor: Albert Mills Owner: Albert Mills Predominant Soil Series: IbB2
A.. es Used: 8.2 Acres Permitted: 8.2 Site #: AM018 Field #: 2
Residual Analvsis Data (Heavy Metals and Total PhosAhorus use mg/ka. % Solids use Raw Percent ft
Com-
posite
Total
.,,
f ;iai
Heavy ivietai r ieia i oaaings
(uaicuiatea in ins/acre):
Total
11
2
L3J
4
L5
6
7
8
9
10
11
12
DT/Ac./
App.
,oy,
Event
1.58
14
Arsenic
0.0.0.9
0.000
0.000,
0.000
0:000
0..000
0.000
0.000
0.00:0
0.000
0.000,
0.000:
0:009°
Cadmium
0.006
0 000.:
0.000'
.0.000
0.-000
0.000
0.000
6.000
0.000
0:000:
0;000
0.000
0.006
Copper
0 31`0"
0:.000
0.000.
0A00
0 000 .
0,000 :
0,000
0200
0.000
0.000
0.000, .
0.00.0
0.310
Chromium
0.307
0000
"0 00.0
0.000
0 000
01.000.,
0 0.00
0.000
0:00:0 :
, 0.000
0 0:00 .
0.000
.0 307
Lead
0.019
0.000.:'
0 00'0
0.000
O O:06
0 000'- 00.400
0":000
0;.000
0 0.00 .
0400
90,00 .
0.019
Mercury
0 001
0.000
0 06-0.
. 0.000
0,000
0.000 ,
0 D00
0.000
0.00'0
0 000
0:000
0:000
0.001
Molyb-
0.016
0.00.0
10 00.0"
y 0.000.
0.00:0
0.000..
0.0.00
.0..00.0
0.000
0.00
0"
0.060
0.060
OA 16
den
.
_
Nickel
0.019
0;000
0 400 '
0 000
0:000.
0 000
0.000
0 0'00
0.004,
. 0 Goa
0. 000
0.000 ....
"0,019
Selenium
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
Zinc
0.681
0.000
0,606
::0.000.-
0.0001.
0,000
0.000
0:000
0.00.0
I 0 000,
0,000
0.000
0 ,681
Total
Phos-
69.33`5
0.000
0 0.0:0,
" 0.000
0;..0.00
0.00&
0 0.00
0.:000
0.0.00
0'.000
0:000
-0._000
6;9.335
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
it isonment for knowing violations".
Z:t
1/10/2 017
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
Operator:
ANNUAL LAND APPLICATION t ,ciLD 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
Albert Mills
Albert Mills
Crop 1 Name:
Fescue -Pasture
WQ Permit #: WQ0000520 Field #:
Annual Dry Tons Applied: 12.98 Site #:
Predominant Soil Series: IbB2
Crop 1 Max. PAN: 92 Crop 2 Name:
Acres Utilized: 8.2
AM018 Acres Permitted: 8.2
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
o
5
ca o
A
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
oho
Solids
Volume
Applied r
PP 1�
Acre
(Dry TonstAc)
Residual Sources
(NPDES #, W #,
Q
Fert., Animal
Waste, etc)
Soil
Cond.
D
( ry'
Wet,
Moist
Precip.
Past 24
Hrs.
inches
a
4 '�
5 6'
o go
a*o
o
w -
* N
:e
w ,
�' w
� N
TKN
mglkg
Z Y
Ft
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
8/31
123500
2.52
1.583.
South Burlington
Dry
<.5"
S
0.5
0.3
30800
9960
2
•35 559."
NA"
Fescue
U..OQO
0 000
0 000"
o<000
0-000
a000
0;000
0 000
411000110•.:000
" 0 000`
"O o00
0 000
@000°
``.0 Duo'
� O,,bd0
'0 090
0 00a
Q 000•=
0 0o
; 0 400-
0:�000
0:000
0 000 '
0:,000.
0.000
0.000
11%111.0000 "
Residuals Applications totals on FORM
FSF supp (attach FORM FSF supp
to this form):
0.000
0.000
TOTALS
."47 o
r:,350(l
As
Cd
Cu
Cr
Pb
Hk
Mo
Ni
Se
Zn
P
35.559
b 000:
Lime A lied
Annual lbs/acre
0`p09 ` . `
0 006 x
0 31,Q
�Qt)7
ll.o.(EI
0001 A:
001.ti-u
, 0019
001�
0; 81 �,
6g335 :.:.:.:...:...:
.... ..... .. .....
............:........:....:..:.:.
:•'•
•.•...•.•.•........................ .
Date
Ibs/ac
Prior Years Cumulative Ibs/ac
0.061
0.036
3.993
2.751
0.328
0.011
0.102
0.252
0.088
10.703
Current Cumulative lbs/ac
0,.076 ;'
' .0 042..'
4 303
3.0,
0,347
0 012 .
0 T18,
` fl 2 1
0104 s
t1384 `
Permitted C. P. L. R.****
36
34
1338
267
15
374
89
2498
Permit PANLimit lst/2nd Crop
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
1/10/2017 **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): 33.77
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
C ;ator: Joe Rice Owner: Joe Rice Predominant Soil Series: GaB
A, es Used: 9.2 Acres Permitted: 9.2 Site #: AM035 Field #: 2
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kL,, % Solids use Raw Percent #):
Com-
posite
Date
MOM
!jai
heavy ivietai r ieia Loaaings
(t_;aicuiatea in tps/acre):
1 otal
1
2 J
3
4
5
6
7
8
9
10
11
12
DT/Ac./
App.
y
Event
3.67
Arsenic
0.022
0.000
`0.000
0.000
9..00;0
0.000
0 000
0,000
0.000
0.00'0
O.000
0.: 000
0.01
Cadmium
0.015
0.00"0
0.006
0.000
0:000
0 O0.0-
6.600
0.0.00 .
'0.000
.0.000--
0.000
0:000
off
Copper
0.89:6
.0:000 ',
GAN
0.600
G.000
Q 000
0:000
0.000
0.000
0 000', -
0:000
0.000'
0.8.!
Chromiu
0 492
0 000
0.00Q I
0 OOU
0.000
_ 0-.000
0 000 ,
0.000
000 ;
; 0.000
0 000
0:0001
0.492
Lead
0,11
0. ,♦000
0 000' _
0.000
0:000
-0 000
0 000
0.000
0.000
0 000
0.000
0::000 .
6.110,
Mercury
0.003
0.000
: 0.0
0 Q0:0
0.000'
0 00:0
0.066
0.000.
0,900
.. 0.000
0 OQO
0,000
0..003
Molyb-
denum
0.03'7
0.000
0 000
:. - .
0:.000 .
' 0.000
0 000`- :
0.000
O:Q00 ',
0.000
0 000
0.000
0.:000
0 0.37
Nickel
0 132
0.:000
` 0 000
0.000
0.000
0 000
0.000
0,900.
0 000 1
0 000
0 000
0,000- '
0.132
Selenium
0 037
0 00"0
0 000 .
O:Q00
U_.000
. 0 000
0 000
O..
0 000 `'
Q .
0 600
` 0 000
0 000
0.000
-0 037
Zinc
3.119
0:.000:
0 00-0 `
0.000
0:0;00
0 000
0 00.0
0.000
O O00
0:000
0:000 ;
,0.00:0
3.179
Total
Phos-
horus-
71 805
0.00.0
0.000
0.000-
0.000
-1
0.000
0.000
0:.000
f
0.00Q
0.000
OA-00.
0.000
, 71.805
"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".
i25:�e 1/10/2017
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
Operator:
ANNUAL LAND APPLICATION N xiLD 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
Joe Rice
Crop 1 Name:
Joe Rice
Fescue -Pasture
WQ Permit #: WQ0000520 Field #:
Annual Dry Tons Applied: 3:7T Site #:
Predominant Soil Series: GaB
Crop 1 Max. PAN:
158
Crop 2 Name:
2 Acres Utilized: 9.2
AM035 Acres Permitted: 9.2
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)
Soil
Cond.
(Dry,
e '
Moist)
Precip.
Past 24
Hrs.
inches
Y
Ts
d
cr
ory w
*
o
%° �'.
4
S•
; w
* N
* 0
TKN
mg/kg
Z
o
ac o
w
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN A lied
pp
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop I
Crop 2
Crop I
Crop 2
4/15
65000
6.23
4 1;.&35 -
East Burlington
Dry
<.5"
S
0.5
0.3
26000
3050
2
30.880
NA
Fescue
4/16
65000
6.23
-L
East Burlington
Dry
<5"
S
0.5
0.3
26000
3050
2
30.880
NA
Fescue
41- O'i000
0.000
0 fl00 -
0"Q00
0.0oo
Q Y00
0 000 ";i.fl
000;
0 000
0 000 "
` 0:000' ;
0.009
0;000
0 000„
0.000
0.000
0.000
0.000 1-
0.000
0000
0.000
. • 0.000
-' 0
0'
t �O:000,
Residuals Applications totals on FORM
FSF supp (attach FORM FSF supp
to this form):
0.000 _
;U:000
TOTALS
'' u
13oon�7
:::.::.;:
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
6066'
' o.000
Lime A died
Annual lbslacre
(7-022 4
0 013 -
0 89b
492
0.110
U 0"
11
::::::::::::: ::
...........................
............................
.
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.096
0.2531
25.833
10.5969
4.2528
0.0827
0.2251
1.6073
0.0706
32.0117
Current Cumulative lbs/ac
fl.118
0 268
26 773 4A,
ll 089
4.303
n 0 ,
? 0 262
1 739"
0 1Q'7
35'191``
Permitted C. P. L. R.****
36
34
1338
1
267
1 15
374
89
1 2498
2 C Permit PAN Limit 1 t/ nd Crop o
P
L..S
"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
1/10/2017 **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): 67.55
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
V Bator: Joe Rice Owner: Joe Rice Predominant Soil Series: GaB
A.._e"s Used: 18.3 Acres Permitted: 18.3 Site #: AM035 Field #: 3
Residual Analvsis Data (Heave Metals and Total Phosphorus use maJklr. % Solids use Raw Percent ft
Com-
posite
-Date
Total
Phos-
_phorusMENEENEENEEN
I 4al
Heavy
Metal Field Loadings
(Calculated
in lbs/acre):
1 otal
1
2
3
4
5
6
7
8
9
10
11j
12
DT/Ac./
App.
Event 1
3.69
14
[Arsenic
0.022
0.000
0.000
0.000
0.000
0 000
0.000
0.000
0.600,
0.000
0.000
0.000
0.022
Cadmium
0.015
0,000
0 000
0.060
0.1000-1
0.000
0.000 .
0-0'00
0.000
0 000
0.000
0 000
0.0,15
Copper
0 901
0.000
0.000
0.000
0.0,00
0 000
0 000
0.000
0.000'
0.000
0.0.00
0.000
0.9001
Chromiun
0.495
0.000
0,000
0.000
Q ,000
0.000
0 00&
0,000
0.000
0 00.0
0_000
0.00:0
0.495
Lead 1
0.1.11
0:000
0.000
0 000
0.000 .
0 OOQ ,
0.000
0.060
0.000 _
. 0..000
OAUO
0.000
0.11.1
Mercury
0.003
0:000'
0.000
0 000
0- 00
0.000
0 000:
91.000
0.000 ,
0.00.0
0A00
01.000
0.003
Molyb-
0.037
0-000
0.000-
0.00.0
0.000
0.000
0.006
0.000
0.000
0-0,00
0.000
0,000
0.037
denum
Nickel
0 13;
0.OA0
0 000'
` 0.00:0
0 000
0 O" ''"
0 000
0.000
0.000
0 Q00
0.000
0.000
0 13=3
Selenium
0.037
0.000
0.000 ;
0.000
6.000`
0.000.-
- 0 000
0.000-
: 0.000
} 0.000
O.Q00
0:000
0:037
Zinc
3.196
0.000. ,
0 000 ,
0 000
0.•000
0.,000 ,
0 000
0.000
0.000
6.000
0.000
0.000
3.196
Total
Phos-
72.196
0.000
0.000
0.000
0.000
0.0001:0.000
0.000
0:0.00
0.000
0.000
0.000
72,.196
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�f� 2
s 1/10/ 017
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
Operator:
ANNUAL LAND APPLICATION k—_.cELD 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:
Joe Rice Annual Dry Tons Applied: 6755. Site #: AM035 Acres Permitted:
Joe 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:
18.3
18.3
0
°
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.
(pry,
Wet
Moist
Precip.
Past 24
His.
inches
Y
4'
F
a m
+ o
o
w
�,
;
* w
'� �
c �,
c, w
* N
0
TKN
mg/kg
Z B
o 0
a�
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
4/14
156000
6.23
2 215
East Burlington
Dry
<.5"
S
0.5
0.3
26000
3050
2
37: 59
NAA
Fescue
4/15
104000
6.23
1.475
East Burlington
Dry
<.5"
S
0.5
0.3
26000
3050
2
Z4.839
Fescue
6:000'
0700(1 r
0 000
Q:t000
0.000 ,
0 b00'
&000 `
0 OUO
Q:000 .
- ' 6.000
0 000. ,
Orb00:
0:002.
�0:0'00
0 OQ.O'WOW'
4.060-
0 000
o Goo `
aFbQO';
000'a
0.000
0 00
0
0
. `b,O00
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
"O.000
TOTALS:
01
260000
�:::::::::
As
Cd
Cu
Cr
Pb
He
Mo
Ni
Se
Zn
P
62098
0 OOfI
Lime Applied
Annual lb5/acre
Ur,022
0 015
0 901
0,4495
a 011 l-•-
` ..
a 00
0 037
Ot 133
0.,037
3 ;196 `
..
`i 72.196 ::
:..:..:.::::.::::....:::..::::::
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.1208
0.3081
32.6809A
12 4668
4.88(Ji
IJ.0858
0.3383
1.9565
0.0864
41.3881
Current Cumulative lbs/ac
Q W �'
A 32
33 382
12961
0 �89
0.375'
2 089
013
44.585
Permitted C. P. L. A.****
36
34
1338
267
15
374
89
2498
Permit
Pe t PA Limit 1 tl2nd Crop N s C
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
1/10/2017 **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): 33.77
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
C' -ator: Harold Justice Owner: Harold Justice Predominant Soil Series: GaB2
A, - .-.s Used: 10 Acres Permitted: 10 Site #: AM072 Field #: 2
Residual Analvsis Data (Heavy Metals and Total Phosphorus use m0ku. % Solids use Raw Percent #l:
Sample or
Com-
posite
Date
1 I
EB
3/14/16
L2
3
4
5
6
7
8
9
10
11
12
% Solids
6.23
Arsenic
3
Cadmium
2
Copper
122
Chromium
67
Lead
15
Mercury
0.4
Molyb-
denum
5
Nickel
18
Selenium
5
Zinc
433
Total
Phos-
L_phorus
9780
f uai heavy metal r iew Loaaings tuaicuiatea in ins/acre):
i otal 1 L2 3 4 5 6 7 8 9 LOJ 11 12
DT/Ac./ 0
App.
Event 3.38
Arsenic 0.020 O,UUO '0.000 0.00:0 0.000 0.000` 0 000 0.000 0.000 0.000 0.000 0.000 0.020
Cadmiumit 014 0.:000 Q.`000 (►.0.00 0 0070 0.000 0 00 . .0.000 0.000, 0.000 0.000 0:'00.0 O.Ot:4
Conner 10.824 10.000 I. 0..000 1 0.000 1. 0:00.0 10.000 1 0.00.0. V 0:.0:00 10.0.00: h_ 0 000' I 0 0.00 1 .0.:000 4 0.8-241:I
Lead
Molyb-
0.034
0. 0.0:
,F, 0 000
0 000
0.,0:00
'` 0 000 ;
0 000
0 000
0-:000 '.
0 000
0 000
O':000
`. '0 034 '
denum
Nickel
0 122
0:000
0 000
; A 000
O 0A0
0 000
`. 0 000
0 090
O;.Q00
' 0 000'"
0 000
0..000
0 122
Selenium
0 034
0 a00
0 000
o OOQ
0 °000
0 000
0 000
0 Qo�
0:00
0.000
=0 034. `
Zinc
2 924
0 000
„0 000
0 000
0 0_00
0 000.
0„000
0 Ok00
0,000
0 00Q
0 00`0
0;000
2 924
Total
Phos-
66 05'4
0 000-
. 0 000' '
: 0 Q-00
- 0.000.
` 0..000
0 000
0:.:000
0.000
;, 4 000
0.:000
-.0.000'
: 66.054
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
it Isonment for knowing violations".
1/10/2017
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 #: 2 Acres Utilized: 10
Land Owner: Harold Justice Annual Dry Tons Applied: :• " ,33 771', Site #: AM072 Acres Permitted: 10
Operator: Harold Justice Predominant Soil Series: GaB2 Cation Exchange Capacity (non 503): 0
Crop 1 Name: Fescue -Pasture Crop 1 Max. PAN: 148 Crop 2 Name: Crop 2 Max. PAN:
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,
Moist)
Precip.
past 24
Hrs.
inches
Y
`�
a w.
o
%�
w "
*
w g
TKN
mg/kg
z Y
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
4/19
130000
6.23
3:,.'377 ,;
East Burlington
Dry
<.5"
S
0.5
0.3
26000
3050 1
2
" 5'6" 819"
NA' ..:
Fescue
Q'OQO
0:000
0.000"
` 400
0,000
0.(H)o
alo aoo" "%
0:000
0.000
0000
0 000
0
0.000
0.000
` OAO
0=000
0 000
` 0:000
0.000 ^
0 Ob0
omo
0
0
� b bz(� 0 _ ."
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000
0.000
TOTALS"
o
i zoac�u
;:;:; ;:;:::
As
Cd
Cu
Cr
Pb
H
Mo
Ni
Se
Zn
P
56.819
0 ObO"
Lime A lied
Annual lbs/acre
' 0.020
0 0�14�
0 824
Q°453
0.101
0 003 .f
0 034*
' 0122
_,
0 034°
�2`924
66 054 :::::::::.::..:.....::..
::: ::::::::::::::::::: :
.."...... .....................
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.0856
0.2337
20.7695
7.0187
3.014
0.0641
0.4309
1.0853
0.0925
23,7227
Current Cumulative lbs/ac
A.d 06 Nn
.. 24
2J 593
r 7:471
° 3.115
0 0f7'
0 465
1420 T
. _
4t1(
_..
26 54 �i
..._
Permitted C. P. L. R.****
36
34
1338
267
15
374
89
2498
Permit PAN Limit lst/2nd Crop1
.
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 tines and imprisonment for knowing violations."
4�"jf, *Application Method: S - Surface, IN - Injection, INC - Incorporation
rr�G�'�— 1/10/2017 **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): 20.37
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
C' 'utor: Leonidas Newlin Owner: Leonidas Newlin Predominant Soil Series: GaB
A,_:s Used: 8.2 Acres Permitted: 8.2 Site #: AM073 Field #: 3
Residual Analvsis Data (Heavy Metals and Total Phosphorus use mg/ka. % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
SB
5/9/16
2
3
4
5
6
7
8
9
10
11
12
% Solids
4.42
Arsenic
3
Cadmium
2
Copper
160
Chromium
156
Lead
10
Mercury
1.1
Molyb-
denum
5
Nickel
7
Selenium
5
Zinc
333
Total
Phos-
chorus
20400
I )jai
heavy ivietai r ieia i.oaaings
<<.atcuiatea in iasiacre):
1 otal
1
2
L3J
L 4
5
L6J
L7J
L8J9
LOJ
11
12
DT/Ac./
0
App.
y
Event
2.48
Arsenic
0.0.15
0.000
0.000
0.000
0.000
0.000:
- 0.000
0.1000 -
` 6.0-00
0.00.0
0:000
0.000
0.015-
Cadmium
0.010
0.000
0 60.0 ,
0 000
0:000.
0.000
0 000°
0.000
0 000
0.000
0.000
0.000
0.010
Copper
.0.795
0 000. ,:
0.000
6.00
0.000 ''
0.600
10,00
0,090,14
0000. _
0.000
O..U00
0.000
0..795
Lead
0 650
O:OOQ`
::0 00'0
0 00:0
0 00.0.:
60.00 .1
0.00
6-000-1
0.000 -'
0 000'
0.:000
-0.000
0.050.
Mercury
0:0:0.5
0.000 :
0.066
0 40-0
0.000
0.006,
0.00,01,
0.600
0: 000..
0.000
O.QUO
0:000
0A05
Molyb-
denum
0 025
0 006
0 000" '
A00
0.-000
0 000
0 OOQ
�0.000 `
-0 D00'.
0.0 00
0 000
0 00.0 .
0 025
Nickel
0 0.35
014 00 ,
0 000' _`
0 000
0 U;00
0 000
0 000` ,
01.9 00
0-:000,,
0 OOQ'
0 000
0000
= . 0 035
Selenium
0 025
0:000
0 000 :
O`000
0 UOU
..
0 000 ,
0 000
O:OUO
0:000
= 0.000.
0.0 00
0-000' ;
0.025
Zinc
1 654
0 000
0 OOU :.
0 000
0.000
0 000
: 0 000
„0 0:00
0:.000
0.000-
0.000
0,000 :
1.654
Total
Phos-
chorus
101`0347
0 000 ,
6.000
0..00:0
0.000.
0 00.0-'..
0.000,
.0.000
0.000
0.000
0.000
0.006
101.347
"I certify. under penalty of law. that this document was nrenared under my direction or sunervision 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 1/10/2017
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

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.
Facility Name: City of Burlington WQ Permit #: WQ0000520 Field #: 3 Acres Utilized: 8.2
Land Owner: Leonidas Newlin Annual Dry Tons Applied: a. .2'U:37. 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:
`" �
° li•
�; o
Q
Volume applied
PP
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
DES #, W #,
Q
Fert., Animal
Waste, etc)*
Soil
Cond.
(Dry,
Wet,Hrs.
Moist)
Preci P•
Past 24
inches
Y
4 �
cc 'S
o•
a �
5
C
o
%�
CD K-
# h.
o
p
7y coo
w .,
c -
* �'
0
TKN
mg/kg
Z Y
� �
o
o �•
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
( Ibs/acre)
Name of Crop T
P Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
6/9
110500
4.42
2.484
South Burlington
D
<.5"
S
0.5
0.3
57900
9730
2
95 9b2
NA-: `
Fescue
oaoo
o:000
a 000
9: o00
o:.oaa
0`:000.
. 0 000
Ow
0' 000
9.000
q00Q'
0000
0:000
_ 0 OOU' .
o,;aoa
0.000
a 000
u,;.000
0.000
0 obo-
o-000
'.0.000
a 000
omo
s Q::000
0.00o
O Q00_
00, � •
0:o00
0 006
>: U
a10000
A.
Residuals Applications totals on FORM
FSF supp (attach FORM FSF supp
to this form):
QOOU
0.000"
:. >: ..:
:.::. •:.:
TOTALS
o
rloSou
::;:::
As
Cd
Cu
Cr
Pb
H,1
Mo
Ni
Se
Zn
P
95.962
0 0.00'';'
Lime A lied
Annual lbs/acre
Q 015
0 O10_A
795
D:7 75
"0 O50_ ,
0 O05 r
20 025
0 035(1025
�� i.b54
711 347 >........ :.... .........
::.:
................
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.195
0.147
23.625
7.626
3.098
0.089
0.843
1.561
0.207
38.447
Current Cumulative Ibs/ac
Q.210
0 157 .
24.420
8:4n1
s3 1448 •
0 094
0 868'
1 59b
0.232
40,101
Permitted C. P. L. R.****
36
34
1338
267
15
374
89
2498
Permit PAN Limit 1 st/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
1/10/2017 **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): 36.13
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
P ',ator: Terry McPherson Owner: Terry McPherson Predominant Soil Series: CbB
A.,. es Used: 27 Acres Permitted: 27 Site #: AM100 Field #: 1
Residual Analvsis Data (Heavv Metals and Total Phosphorus use mu/kiz. % Solids use Raw Percent ft
Com-
posite
Date
Total
..M
..-ENEENEENEEN
I jai
Heavy ivietai rieta i,oaamgs
tuatcuiatea in iasiacre):
`Total
1
2
3
4
5
6
7
8
9
10
11
12
DT/Ac./
App.
m
Event
1.34
Arsenic
0.008
0.000
0..000
0.000
0:000
0.000
01.0.00
0.000
9000
0.000
0.000
-0.000
.0.008
Cadmium
0.605 "
0.000
0.009
0 000�
0:000
. 0.000
0.000 ..
0.000
0.000,
. - 0.000
0.00.0
0,000.
0.005
Copper
0.423
0,00
0 000"
0.00' 0
0 000 _
0 000 .
` 0.600'
0.000
0.000
0.000
0:000,
0;000 .
0.423
Chromic
0.439.
0.00.0
.0 0Q'0 :,'
0.000
0.000
0.000;
0.000
0.0,00
0 OOQ.
0;000
0.000.
' 0 oo
0.439
Lead
0.036
.mo'
0 000
0:000
0,000
..0 000 ,
.. 6 000
b.000
0;00.0
0
0.000
0 0 00
U00
0 036
Mercury
0.001
0.000
O000.
_ 010M
0.000
0.000,
0,900
0.000
0:000
0 QQQ
0.000
0..000
0.00.1
Molyb-
denum
0.0,13
0:000 .
0 000 :..
0.o-o0
0,000
0 000
- 0.000
0:060.
0,0010
0 o 0
0.00
0:000
0.013
Nickel
0.023
0;000.
. 0 OOQ ;
0 000
0.000 :
0 000 ``_
0 0003
0.fl00
0 000 =:
0 00.0
0 U:00
0.060
0.023
Selenium
0.01:3
0 000 :
,0 000�
0.000
0.0.00
�0 000-
. 0 000
0:000_
.. 0.00:0
­ 6000
0.000
0.000
0.013
Zinc
0.803
0.000
0 000
0 000
0.000
6,006
, 0.000 .
0. 0 7
0A00 _.
_ 0.0.00
0.000
0..000-
0.803
Tota
Phosi k7.2-66j'0.0,6o'..-['
0 006 ' 10.000 10.000 10,000 10.000 10.000 104000 10.000 10.000 10.000 157.266
"I certify, under penalty of law,
was prepared under my direction or
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".
;afe 1/10/2017
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
Terry McPherson
WQ Permit #: WQ0000520 Field #:
Annual Dry Tons Applied: • .36.13- Site #:
Acres Utilized: 27
AM100 Acres Permitted: 27
Terry McPherson 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:
° '°
°
A-°
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
��u
Solids
Volume
Applied per
pP P
Acre
(Dry TonslAc)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
W
Moist)
Precip.
Past 24
Hrs.
inches
a
°a
cry,00
0 w,
* �
o
;� w
w �.
�
F -
o
�
TKN
mg/kg
Z
o o
�•
mg/kg
Nitrate
and
Nitrite
mglicg
PAN Applied
(Ibs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
10/28
104000
3.25
O,.S22
South Burlington
D
<.5"
S
0.5
0.3
5$300
19000
8
. 22.236
FlA....
Fescue
10/29
78000
3.25
93924
South Burlington
D
<.5"
S
0.5
0.3
58300
19000
8
-16.677
NA
Fescue
10/31
84500
3.25
a4dti424 -
South Burlington
D
<.5"
S
0.5
0.3
58300
19000
8
1&067 i
t-k
Fescue
Q; �00
0000
0 000:,"
0 0`UO
0:000
O Orb'
Q�000
_
a:oao
0
ooa_
U,OpO
0:000
0
000.
U� 000
4:000
(100fl:
b o00
=a:oo0
o c oQ
'o obo'
`'0000
� 000
s, o; o00
goon
a000
(1
0°--."
k'p=0(10,
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
'O`.000
om(
TOTALS:
U
266500
:.:..::::
As
Cd
Cu
Cr
Pb
Hg,
Mo
Ni
Se
Zn
P
56.980
0 oo0 °
Lime Applied
Annual Ibs/acre
"I" 'a0 00&
fl0 005
0.423
Q;439
'RO 036=;,
0 001
1 0 013•r
0 Otis
0 0`13 ti
`0°803
57.266" :.:.......::::>..::::::::.::
:.: • ...• ................:: .:: .::.
........................
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.112
0.046
8.471
3.966
1.536
0.035
0.377
0.569
0.074
15.442
Current Cumulative lbs/ac
Q 120
Ot 051
8 894
4::405
"1.572
0 036
= 0 39Q
0 592
4087
14. 2451
Permitted C. P. L. R.****
36
34
1 1338
267
1 15
1
374
89
2498
Permit PAN Limit 2 d Crop
t 1 st/ n C P
- . - 1 62.
"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
1/10/2017 **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): 3.5.03
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
C' ,,ator: Lonnie Thompson Owner: Chapman McQueen Predominant Soil Series: HcB
A,_ds Used: 11.4 Acres Permitted: 11.4 Site #: AM109 Field #: 1
Residual Analvsis Data (Heavv Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
11
EB
02.08.16
21
31
411
5'
6
7f
81
9f
10.1
11
12
% Solids
5.17
Arsenic
3
Cadmium
2
Copper
133
ChrOMiLffli
56
Lead
14
Mercury
0.4
Molyb-
denum
5
Nickel
15
Selenium
5
Zinc
403
Total
Phos-
L_phorus
10700
Id
lvletal r ield Loaclings (Ualculated in ins/acre):
1 otal 1 L2J L 3j L4J L5 f 61 7 8 9 10 11112
DT/Ac./ C
App.
Event 3.07
Arsenic 0.018 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 1 0.000 1 0.000 1 0.018
Cadmium 1 0.012 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 1 ° 0:000 ' 0.000 1 0.000 1 0.012
Lead
0 08.6
0 000
0 000.,
` 0 000
O OOU
0.000 '
N 0 OOQ:
0 UClO
0.000-
` 0,0010
U UUU.
U:DUO,U16
Mercury
0 OU2
0 000
0 000 :
0 000
0 Q00
0.000 ,
0 000
0 000
0.000.
0
000:..
0 000
0000
0 002`
Molyb-
denum
0 03`1
.:1
O.QOQ
-,"
0 000 .
..-;4
0 000 .
. 0 Q00
0: 000
0 OOQ
0 0.00
0 000
0 000"
0.000
0 000.
0 03I
Nickel
0 092
0 000
0 000
- 0 OOQ
0 0.00
0' 000
0 000
0 000000
"b 000'.
0 000
0.000
Selenium
0 03=1
0 000
0 000
' 0 000'
0:000
0 000
0 000
0 000
O;OOQ
0 000
0 000
0000
0 031
Zinc
2 477
Oa000
:0 000
0.000
0 Q00
0.000
0 000`
0 000
Q;:000
0 OQO`
0 000
0.000
2 4.73
Total
Phos-
phorus
65 762
0.000
0 000
0 000
0;000
0 000 .
0 00.0
0 OUO
0.000
0 00.0
0 000
0000
65.762
"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
irr 'isonment for knowing violations".
Z�f 1/10/2017
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 #: 1 Acres Utilized: 11.4
Land Owner: Chapman McQueen Annual Dry Tons Applied:: ::35 03•'' Site #: AM109 Acres Permitted: 11.4
Operator: Lonnie Thompson Predominant Soil Series: HcB Cation Exchange Capacity (non 503): 0
Crop I Name: Fescue -Hay Crop 1 Max. PAN: 169 Crop 2 Name: Crop 2 Max. PAN:
I..
oEL
cd
Q �
Volume applied
(enter one) Solids(
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
PP P
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
D
(Dry,
Wet,
Moist)
Precip.
Past 24
Hrs.
inches
Y
K 10
c 'd
o w
�J
c
N•
K
'l� �
* —
0
TKN
mg/kg
Z >
8 c
LD
w
mglkg
Nitrate
and
Nitrite
mg/kg
PAN Applied
lbslacre
Name of Crop Type
Receiving Residual
Application
Crop I
Crop 2
Crop I
Crop 2
3/7
162500
5.17
' ' .3..07 ;'.
East Burlington
Dry
<.5"
S
0.5
0.3
26500 1
1740
2
51.013
NA
Fescue
b99
0,000
0.000'
o.000
;0 000
0.000
. 0:00o
o;ooa
0.000
0.000
p000 ``
o.000
0.000 '
0.000
0.000
o;oo0
0.000
0,000
0;000
0.000
0.000
F 0;:01�-0 '
0.000
0.000
OQO "
0 000
Q000
0
{1°'
Q„bOQ ;'
Residuals Applications totals on FORM
FSF supp (attach FORM FSF supp
to this form):
0 000 `
, 0,000
TOTAL
u's'°` [a
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
-`5 013 �'
, 0:000'
Lime Applied
Annual lbs/acre
`6i.0�18 ''
0 012`
0 17
0:�44 '
: 0.086
.° 0 002
.0 03x1`.ik
0 092 °
0 031i
2+477
b5 762' :.:.:..:•;;:.:_ ::.:•`::.;:.:.
..............
> ::: `::::>:::.:
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.269
0.258
28.902
9.078
4.062
0.106
0,961
2.962
0.26
50.984
Current Cumulative lbs/ac
" U'287
Q 27.E9l719
r
< 942�
. 4 148
0 >Lfi18
'
di 9Q2
3 OS`4
�p 291'
LL89
S3.461,
Permitted C. P. L. R.****
36
34
1338
267
15
374
2498
Permit PAN Limit lst/2nd Crop
.. I69`
"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
1/10/2017 **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): 16.82
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
C" ­ator: Lonnie Thompson Owner: Chapman McQueen Predominant Soil Series: HcB
A... es Used: 6.1 Acres Permitted: 6.1 Site #: AM109 Field #: 2
Residual Analvsis Data (Heavv Metals and Total Phosphorus use me/ke. % Solids use Raw Percent ft
Sample or
Com-
posite
Date
1
EB
02.08.16
_2j
3
41
L5J
6
7
181
9j
0
11
12
% Solids
5.17
Arsenic
3
Cadmium
2
Copper
133
Chromium
56
Lead
14
Mercury
0.4
Molyb-
denum
5
Nickel
15
Selenium
5
Zinc
403
Total
Phos-
phorus
10700
L tal
heavy 1vleTal r ieia Loauings
kualcuiatea in ios/acre):
l otal
11
2
L3J
4
5
L6J
7
8
9
10
11 j
12
DT/Ac./
o
App.
Event
2.76
Arsenic
0.0-17 .
0.000-
0.600
0 000
0:000 .
- 0.000
O:.000
-
0.000
0.000
0.000'
0.000.:
0.000
O:Q=17
Cadmium
0.011
0.060 :
` 0 000.:
0:000
0.000
0.000
0.000
0.000
0 000.
r
0.064
0.000
0:000
0.611
Copper
0 733 .
O':.00U
0 000:
0 OOQ
0 0.00 .
Q 000`.
0 000
0.0..00
0 000
0 000
0 QOD
" 0.000' :
0.733
Chromium0.3
9
0 0.00
0 000
fl Q00
QM
0 000 '>
0 000-
0 �000
0:.000
0.000
0.0.00
0.000
'0.309'
Lead
0. 077
0.:000
0.000
0" OQ0
0:000
Q- 000
0 000.
0 000
O.Q0:0
0 000
0 OU:O
Q 00U
0.07 7-
Mercury
0 OQ2
0..:000
Q OOn;
0 000
6 b
-0 000
0 000
0.000
4.000
0 09:0
0 0:00
0.000
0 002
Molyb-
0.02`8
0.:000
-- 000.
0 6
00:00
0 000
0.060
0.000
0:000
0 000
0 000
0.:000 ;'"
denum
Y .
.0.028
Nickel
0 083 ,
0.000
"0 000
0 00:0
0:000 ':I
0 P Q ;
RAP-,
0 000
"0::000
.; 0 0QQ
0 000 ,
0_000 :.
- 0 083­
Selenium
0 02`8
0 000
0 000
0 OOQ
0 O..OD
0 000
0 000`;
0 000
...000
0 0QQ
O.00Q
0_000
0 028 ,
Zinc
2 222
0000
0 000
0:.000
0 000
0 OOQ'
0 000
0.000
0 ,000
0000 1
2.222-
Total
Phos-
Phorus
:_
59.000
0::000
0 000
0.000.
0.000
q_
0.000
0.000=
0 000,
0.000,".
, .0000
0.00.0
0,.000o :
59.0-00
"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: 1/10/2017
Signature of Land Applier 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 WQ Permit #: WQ0000520 Field #: 2 Acres Utilized:
Chapman McQueen Annual Dry Tons Applied:. 16 8._ Site #: AM109 Acres Permitted:
Lonnie Thompson Predominant Soil Series: HcB Cation Exchange Capacity (non 503):
Crop 1 Name: Fescue -Hay Crop 1 Max. PAN: 169 Crop 2 Name: Crop 2 Max. PAN:
6.1
6.1
0
a>
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
a/o
Solids
Volume
A lied er
pP p
Acre
(Dry TonslAc)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
Wei'
Moist)
precip.
Past 24
Hrs.
inches
y
cc b
a w
c
;e
w
* w
CD
*
* 0
TKN
mg/kg
z
€#
UQ O
a Z.
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
3/8
78000
5.17
2 757
East Burlington
Dry
<.5"
S
0.5
0.3
26500
1740
2
45T6 t.
NA
Fescue
Q:�QOQ
0.000
0 000 .,
0 000
0.000
0 000
4. Q00
0:;000
" 0,000f
bo)o
w 0 000='
ti: OAO
000o
o 00!)
AAb
0:000
b.Qoo.;
0:000
0
0 �,
..:
0"body
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.U(10
0 OQQ'
.........
.........
TOTALS
o
�J;cJrxJ
;'.::..': ,.
As
Cd
Cu
Cr
Pb
H
Mo
Ni
Se
Zn
P
45.76t
Q.QO(fi:. '
Lime Applied
Annual lbs/acre
'd'017.
0 0 1
0 733
O'309
0.077
5
::':::::':::::=: »::::::::::::=:
...........................
.........................
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.285
0.3
31.785
9.556
4.123
0.128
1.017
2.919
0.288
58.509
Current Cumulative lbs/ac
s� U 302'
0 3
32.5.18
;g 865
4 200.
0130 _
1(145
.'Ot)2 3
1i �6
60 73
Permitted C. P. L. R.****
36
34
1338
267
15
374
89
2498
Permit PAN Limit 1 2 m st/ 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
1/10/2017 **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): 34.74
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
C' ator: Leonidas Newlin Owner: Leonidas Newlin Predominant Soil Series: GaB
A.,. es Used: 19.3 Acres Permitted: 19.3 Site #: AM110 Field #: 1
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Com-
posite
TotalDate
• _phorusM
E iat .ti.eavy
metal r ieia Loaaings
(uaicuiatea in iasiacre):
TOO
1 11
2
3
4
5 J
6
L7J
1819
LOJ
11
12
DT/Ac./
oyF
App.
Event
1.80
rA
Arsenic
0.-011
0.000
0.000
0.000
6.600`
0.000
1 0.000
0.000;
0-000
0.000.
0-00.0
0.000
0.011
Cadmium
0.007
0.000
0.000
0.000
0.000
0.000
0..000
0.0:0.0
0.000
0.000
0..000..
O;O:OU
0.007
Copper
0.576 ,1
0.600
,: 0 OOQ :
, 0:060
O:.lia0
0 000.....
0 OA_0
0 000
I 0.:000 .
0.00.0
0 009
0.00.0 ::
0 576;
Chromiu,
0 56Z
0 000
0 000
0 000
0 a00 '
0 ,00 '
. 0 00U
0 0O0
0.00Q
0.000
0 000
0`.000 ;
0.562
Lead
0 03:.6
0 000
0 000 ..`'
0 000
0,000
0 000
0 000:.
0 000
0:000.
0 O0Q
. 0.000
0..000
Mercury
0.004
0 000
0 000
0 000
0..:0;00
0. 000
0 000
0 000
0.00:0
0 000-
0 000
0.00-0 ..
0:004
Molyb-
0,018
0_0
0 000
0.060
0.000-
0.00
0 000
0.000
0.000 ''
0 011 00
0.000
0::000
denum
=:
.
Nickel
0,.025
0.000
0 000` '
0 00:0
0;000
0 000
'' 0 000
0:000
0.000
, 0 OQ0
k OOb
0..000
0 025 .
Selenium
0.018
0..000
' 0 000
' 0 000
0.0Ob
0: 000
. 0 0-0.0
0,200
0.000`.
-
0 000
0 000
0 000
0.018
Zinc
1 109
0 Q00
„ 0 000:
0 Pw
0 000
0 000.
_ 0 000'
0 U40
,
0.000
0 06
0 006
O 0
`' 1 199
Total
Phos-
734--40 ,
00-00 :
0 000..:
0 0.00
0.:000"
0.000
0.000
4:000
0.0.00
O'00:0
0000
0.000
73.44..0
nhorus
"I certifv. under Denaltv 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".
Zf. e
i/10/2017
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
Operator:
ANNUAL LAND APPLICATION -. _.�>JLD 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 #: I Acres Utilized:
Leonidas Newlin Annual Dry Tons Applied: =34.74; 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:
19.3
19.3
0
I..
o
A
Volume applied
PP
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Valume
Applied per
Acre
D Tons/Ac
(Dry )
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc )
Soil
Cond.
(Dry,
(
Wet,
Moist)
Precip.
Past 24
ems•
inches
Y
� a
co 'b
"
o ?:
la.
C
o
fD
# N
°p
7�
'4
TKN
m lk
9 9
Z
.;
o c
m'
m /k
9 9
Nitrate
and
Nitrite
m 9�9
PAN Applied
(Ibs/acre)
Name of Crop Type
p yp
Receiving Residual
Application
Crop I
Crop 2
Crop 1
Crop 2
6/10
188500
4.42
South Burlington
D
<.5"
S
0.5
0.3
57900
9730
2
69.551
NA
Fescue
A.44o
0.000
0.000
0.000
0.000
0.000
0.000
CAO00
0 000 `
0.000
o.000''
0.000
Q 000 t
0 000 "
0.000
Qi 000
0 000 .;
0.000
a 000 • " v
` 0 000"=
0.000
0.000;;:
0.000
0.000 .'
0.000
0
{1
0, 000'` ':+
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
Q.000
0.000
TOTALS
"� a
1885oo
.:.::;:;:'.;:
As
Cd
Cu
Cr
Pb
H
Mo
Ni
Se
Zn
P
69.5.51
0.0{10
Lime Applied
Annual lbs/acre
Q 011
�0 00.E
O. i G
Q 562
, .b 036
0 004 ,r
0 O1$14
" 0 02
0 018
1,;199
.,°73 440 . ':...........:.:.• ...
..
......
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.179
0.138
17.615
6.134
3.438
0.067
0.769
1.855
0.154
31.026
Current Cumulative lbs/ac
�'°0 19Q �
1 0 145
18 91
6:;696
3 474 ``
0 0�1
0 787
1$8,Q "
0 172
3`2t225'$`
Permitted C. P. L. R.****
36
34
1338
267
1 15
1
374
89
2498
Permit Limit
e mrt PAN imrt 2nd Crop 1st/
"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
1/10/2017 **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): 35.27
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
C" ;ator: David Ridlin Owner: H.W. Byrd Predominant Soil Series: GaB
A — es e's Used: 46.1 Acres Permitted: 46.1 Site #: AM116 Field #: 3
Residual Analvsis Data (Heave Metals and Total Phosphorus use me/ke. % Solids use Raw Percent ft
Com-
posite
Date
Total
Phos-
MENiiiriiiii
I ;.gal
Heavy
Metal Field Loadings
(Calculated
in lbs/acre):
1 otal
DT/Ac./
App.
Event
0.77
1 21
3j
L 4 j5
6
7
8
9
10
11
12
0
Arsenic
0.005
0 000
0.000
0.00.0
0:000
0.000
0.000
0.000
0.000
400-0
0.000
0.0 .9
1 D.005
Cadmium
0.0.03
0 000
0,000
0.000
0.000,
0.006.
'' 0.0100
0.000
O.r000
0.ono
0 000
0.0,00
0.003
Copper
0 355.
0.000
0.000 :
0 00;0
0.000
0 000 '
0 000
0 0:00,
Q::000
0 00:0
0 000
0.000„
0.3155
Chromium
0 3.73
0 000
U 000 .;
0 000
0:000-
0 000
0 000'
0:000
0 OOo
0.0
0..000
0 000''
0.3Z3.
Lead
0 023
O000
U 000
0.000.
0 000
" .0 000 .
° 0 000. ,
0..000
Q 000
6. 000.
0�006
0.00.0
0 023
Mercury
0 OU''1
0:000
0 000
:_ O.000
0 0.00
0 000 .
0 000,
0.000
0. 000
-t.
0 000:
0 0A
0 000
0:001,
Molyb-
0 o.
0.000.
0 000
0 0`00
0.000
0.000
0.000"
0.000
0;000' .'
O.0denum00 -
0,.000
0<000
O,OQ8
Nickel
0 Ol $
0 fl00
0 OOQ '
0 00:0
0 O-OB
0 000
0000
0 0:00:';
0.000
4 0 000
0 000
0.000
0 018°
Selenium
0.0.08.
0 000
-,
(i 000 =`
0 000
0 000 .
0, 000
," 0 000
0 000
0.000
0 000'
0 O0o
j
0 000
0 0 -8
Zinc
0 65`0
0.0_00
0 000 ;,
0 000 ,
0 0.00
0 000 '
_ 0 000'
0.000
0,000
0 00
0 000
' '&000
Total
Phos-
nhorus
43..605
0.000
'.:0 0W
0.000
0.000 :
s.
0.000
0000-
r 0.0-00
"--0.00.0
0.000
0.000
0.000 ;
43.605
"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�f 1/10/2017
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
Land Owner: H.W. Byrd
Operator: David Ridlin
Crop 1 Name: Corn
WQ Permit #: WQ0000520 Field #:
Annual Dry Tons Applied: Site #:
Predominant Soil Series: GaB
Crop 1 Max. PAN:
132
Crop 2 Name:
3 Acres Utilized: 46.1
AM116 Acres Permitted: 46.1
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
Volume applied
PP
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry TonSJAC)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste' etc)
Soil
Cond
(Dry'
Wet,
Moist
Precip.
past 24
Hrs.
inches
�
� �
o w
�.
Q o
=
C
�
w ?,
� N'
* w
p
4
w 0
* N
P
TKN
mg/kg
z Y
�
o 0
a w
mglkg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(ibs/acre)
Name of Crop
p Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
3/17
247000
2.55
Q; 5?0
South Burlington
D
<.5"
S
0.5
0.3
66300
32500
2
30:073
N�1 '.
Corn
3/22
84500
2.55
" ,rj'9�5�
South Burlington
D
<.5"
S
0.5
0.3
66300
32500
2
10.288
NA_,
Corn
RA, dU0
�- 0:000
0.000 ,.
0:000 <
Ito
0 000
0.000
aor_
o�oa©k
o;000aV-:
4oa
t©:000
;a 0000
0 000`v
*i 'Df000
O':000
0`OM.-
Rio poo
o:000
o aoo'
0
0 "
O q00
Residuals Applications totals on FORM
SF supp (attach FORM FSF supp
to this form):
0,000
0.0m
TOTAL
01
33 t --,uo
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
40.36 l
©, OOQ f ;
Lime Applied
Annual lbs/acre
0 0, 5 ' ._
0,
0 0,03:
0 35.5
Q:,373
0.023
0 001,
b008,at
, O Ot8 2t0
Q,08r
a;Q.65{3
43.605.:. ;:':'::::.::.
Date
Ibs/ac
Prior Years Cumulative lbs/ac
0.08
1 0.052
6.253
2.932
0.77
0.028
0.192
0.794
0.075
12.822
Current Cumulative Ibs/ac
d a Oi3 ,`
0 05
6 b9&�
" 3 305
.tl 9931
9 A2 '
E 0 2Q0:.
p 812
0eQ$3
Permitted C. P. L. R.****
36
34
8
1 13377
267
15
374
89
2498
Permit PA imit Ist/2n r NL dCo P
132 ,
"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
1/10/2017 **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): 61.94
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
Q Bator: David Ridlin Owner: H.W. Byrd Predominant Soil Series: GaB
A. .s Used: 17.4 Acres Permitted: 17.4 Site #: AM 116 Field #: 4
Residual Analvsis Data (Heave Metals and Total Phosphorus use ni&ka. % Solids use Raw Percent ft
Com-
posite
Date
Total
Phos-
_2�TUSMMENEEMENEEN
F ,iai .heavy ivietai riew i oaaings tt-aicuiatea in ins/acre):
i utal
1 J
1213j
L4J
L5J
6 J
7 J
L8
9 J
LOJ
11 J
12
DT/Ac./
0
APP-
y
Event
1.85
1.71
Arsenic
0 011
0.0 0
O.Ot)0`
" 0.0:00
0:000°
`0 000
0 000f
0.0.00
0.000
0 W
0.000
0'.000
0.021
Cadmium
-0.0071
0.061
0.000"
0.000
6.,600
0.000
I,,
0.000
0.000 .
0.000
0.000
0 0:00
0'.000;.
0 014
Copper
0.493
0.3 ..
19
0 000..
0.000
t 0.. , ,
0.000 '
_ 0 Oli'0
0.000-
0.00:0-.
0..OQO
0 600
0.000
1.98-5
Lead
0.02
.0'051 ":.:
0,000
0 t)00
O:gOt)
0 000: "
0 00.0
, :0.000
Q=:OOQ J.
0.000
0.000
0000
O..1D3
Mercury
0 00'1
0 002 ".
0 000
0 00'0
0 000
0 000 ;
0 000:
0:.000` -
_
0.000
0 000.
0 Q"00
0.
_
0 004.
Molyb-
denum
0 019
0. (17
0 000
'' 0 OQ0
0 0"00
0 000
0 000'
_
0 0,00 .
0.000
Q. 000:1-
0,000
0:000
..0 036
Nickel
0 056
0.041
Q 0041-0-OOQ
0 OOfl
4 Ot10
0 fl00
0 000
:.
0:000
0 000
0 OOfl
0-:000'
0 0J7
Selenium
0 019
O.Q17
0 000
;. 0 000
O.Q00
Q 000 s:
0 000
0 000
: 0000
0 000
0.0'00
0:000
0 036
Zinc
1 �493
1.452
0 00"0
0 00:0
0 Q00
_.
Q 000. `
0 004
0 Q'00
O.a)00
0 000
U.000,
0000 ..
2 945
Total
Phos-
nhorus
" -
39.633
97.356..
_
0 000:
0.000'
0.000 :
0. 000 .:
0 000
0.000
0:.000
0 0.O:Q
0.000
0.000
.136.989
"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 / 10/2017
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: H.W. Byrd
Operator: David Ridlin
Crop 1 Name: Corn
WQ Permit #: WQ0000520 Field #:
Annual Dry Tons Applied:' 61:94 Site #:
Predominant Soil Series: GaB
Crop 1 Max. PAN
132
Crop 2 Name:
AM116
Acres Utilized:
Acres Permitted:
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
17.4
17.4
$_.
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
� �
w
o
7y
� �
w
o'
0
w .,
� =
* w
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 1
Crop 2
Crop 1
Crop 2
3/18
149500
5.17
d $52 -
East Burlington
Dry
<.5"
S
0.5
0.3
26500
1740
2
30 74'9'
NA :
Corn
3119
71500
2.55
0r43?
South Burlington
D
<.5"
S
0.5
0.3
66300
32500
2
23 i064
NA
Corn
3/21
208000
2.55
1271
South Burlington
D
<.5"
S
0.5
0.3
66300
32500
2
67.095
NA '
Corn
Q 000
0:000
U 0,9,0.
Q 004s
0.000
Q a00
0.000
wo 000 '
0.000
aaQo
b 0 `
7 0moo
OwD00
0.
0004.00
O
fO�O�{c
0.000
0 ooa
(1
0
0 000 r_
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000
TOTALS:
,. 01
429000
; : ; ; ; ::
As
Cd
Cu
Cr
Pb
H"
Mo
Ni
Se
Zn
P
120.908
0 400 4`
Lime A pplied
Annual lbs/acre
d 02.
0 01=4
t 285„
t'041
0.103
1) 0fl4';
©03.4 -
`O BI F
` }'636"
2 94Sv
136.989 .:.:
:::::: :::::::: :::: :
...........................
............................
.: , ... ...... ............
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.063
0.05
5.434
2.405
0.596
0.026
0.162
0.789
0.072
11.437
Current Cumulative lbs/ac
s0 084
Q 064
6 119
�, 3.44(i
0.699
0 030
0 198
0.$$6
0 108
.:.
1;4 82P
Permitted C. P. L. R.****
36
34
1 1338
267
15
374
89
2498
Permit PAN Limit lst/2nd Crop
p
::::::':.. "•...`'............'....'.'...::•:•:•:.:..:.:::.:................:..:.. x:::`::::::::::.....:::::::::...:.:.:...:...> 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
1/10/2017 **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): 102..76
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
(,' -ator: David Ridlin Owner: H.W. Byrd Predominant Soil Series: GaB
A ::s Used: 42.8 Acres Permitted: 42.8 Site #: AM116 Field #: 13
Residual Analvsis Data (Heave Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
11
SB
10/10/16
21
EB
11/7/16
31
4
5
61
7
8
9
10
11
12
% Solids
3.46
4.58
Arsenic
3
3
Cadmium
2
2
Copper
195
168
Chromitun
209
53.3
Lead
11.5
15.2
Mercury
0.4
0.4
Molyb-
denum
5.14
5
Nickel
9.25
18.8
Selenium
5
5
Zinc
376
473
Total
Phos-
horus
23600
8110
1 !Aai rneavy ivietai r ieia
r, - T I -
t-aicuiatea in Ws/acre):
1 V WX
L-tj
L.::�j
I
L.=i
L_�fj
L=j
0
DT/Ac./
App.
F
F,
y
EventF
.11
2.29
Arsenic
0.001
0.000
0 000 .
0.000
0.000
0.000
0.000
0.000
0 00 .
0.000
-
0..000
0.014,
Cadmium
0 000
0.009.
0.000
kboQ
0.000
0.000
0 000 _
.0.000
[}, 000
0 000
0 000
0;:060
0 O10'
Copper
0.043
0: 770`.:
0 000.
0 00;0
0 000 ::'
:0 0.00
0.0170
0 000
0 000
.0 0.00
-000
6.0 00
Lead
I nnm I 0 001 0.023 1. 0 000 _ I. 0 00:0 O.o00 0 000 0 000 O.Q-00 `0 OOQ U.000 0 000 0.024
Nickel
0 00
0,:086,
;0 000 Y
0 Q,00 ,
0 Ow00
0 000 ;
, 0:! 000`'
0 U=00
0000
:: 0 000:
0 000
0_000
Selenium
o 001
0023
0 000
0 000
0". 000
0 000 .'
0 OOOs
0 0`00
0. 000
0 000`
0.000
0.=000
Zinc
0 0&3
2 167
0 000
0 00(1
0 0.00 .
0 000 ''
0 000T
0.000
Q:000'
; 0 000:
0 000
0.000
Total
Phos-
-,horns
5 19�
37`:16-6
` . 000
0 000
0.000
0 000-'
0 00.0.>
0 000 ...01000
0.000
0.000-
0.000,
: 42 3-52
"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, 1/10/2017
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 #: 13 Acres Utilized: 42.8
Land Owner: H.W. Byrd Annual Dry Tons Applied:,. .` 102 76:.,' Site #: AM116 Acres Permitted: 42.8
Operator: David Ridlin Predominant Soil Series: GaB Cation Exchange Capacity (non 503): 0
Crop 1 Name: Wheat Crop 1 Max. PAN: 113 Crop 2 Name: Crop 2 Max. PAN:
$..
o
t5
�, 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
cu
I o
o'
o
2
# w
o'
p
w
N
*
K.
* o
TKN
mg/kg
Z
o
p
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
12/14
13000
3.46
: 0 044 .. `
South Burlington
Dry
<.5"
S
0.5
0.3
61400
17600
579
1.974
NA
Wheat
12/14
201500
4.58
'0, 8�9
East Burlington
Dry
<.5"
S
0.5
0.3
19200
1960
11.1
11.083
NA
Wheat
12/15
188500
4.58"`A
841
East Burlington
Dry
<.5"
S
0.5
0.3
19200
1960
31.1
10.368
1 NA
Wheat
12/16
123500
4.58
0 55,1 W ,;
East Burlington
Dry
<.5"
S
0.5
0.3
19200
1960
11.1
6.793
NA
Wheat
12/16
19500
3.46
r30 06�' "' ';
South Burlington
Dry
<.5"
S
0.5
0.3
61400
17600
579
2 961''LL
NA
Wheat
0 000 , .
0 000 * `
0.000
`0 006,
0.000
0.000
0.000
0.000
0.000
v10 000
0 Q00 s -,
0.000
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form).
0.01)0
TOTAL&:
A�;4
00o
As
Cd
Cu
Cr
Pb
H
Mo
Ni
Se
Zn
P
33 1 $!.
0.000
Lime Applied
Annual lbs/acre
'0 014
0 b10
0 8+13 z
4. 290
0.072
� 0 OQ�'' '
0 OZ4
� O Q;88
0 024 ,
+ i2 250E
",,42.s52 :: ::: : :.:::....:::
:::= : >::::::::::::::::::::: >:=:
........................ .
Date
Ibs/ac
Prior Years Cumulative lbs/ac
0.057
0.041
5.602
2.677
0.402
0.023
0.144
0.353
0.088
10.296
Current Cumulative Ibs/ac
0.074
0 051
6415
2.96,1
0:474
10, 025
0 TC8
0 4"41
.0.112
I-2 546
Permitted C. P. L. R.****
36
34
1338
267
15
374
1 89
2498
Permit PA Limit 2 r N m 1st/ nd Crop
P
1 ;3, k
"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): 44.33
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
O- -7ator: Simon Stephens Owner: Simon Stephens Predominant Soil Series: HdB
A A Used: 25.2 Acres Permitted: 25:2 Site #: AM118 Field #: 1
Residual Analvsis Data (Heavv Metals and Total Phosphorus use me/ka. % Solids use Raw Percent ft
Sample or
Com-
posite
Date
11
SB
5/9/16
21
31
L4J
L516
7
8 j
9
10
11
12
% Solids
4.42
Arsenic
3
Cadmium
2
Copper
160
Chromium
156
Lead
10
Mercury
1.1
Molyb-
denum
Nickel
7
Selenium
5
Zinc
333
Total
Phos-
1horus
20400
f ial
heavy ivletal riclu Loaaings
kualculateu in ins/acre):
,,ial
1
2
3
4
5
6]
171
8
9
LOJ
11 j
12
DT/Ac./
APP•
Event
1.76
Arsenic
0 011'
0..000 1
0.000
0.000
0.000
- -6.000
0.000
0.000
0.:000.
OF 00
0.000
0.000• .
-0.0.1-1
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
0.5
0,01
01000 :
Qµ000 °,,.
0 090
0 .09
0 000
Chromiti
0 S49
0 Q00
0 000; ."
0 000
0 Q;00
0 000:
° 0 000'
0 000
0:.000
0
000.
0 000
00 .
0 549 _=
Lead
0 035
0..000 -:.
0 000
: 0 000
Y
0 Q00
Q 000
;vA 000
Q OQO
0:.000
` 0
000'.
' 0 00:0
0:000
:0 03 .
Mercury
0 004
OOQO
4 000
`. Q 000.
0 000 ,
0 000
0 000
0 000
0.000 :
0 000
0 00;0
O':000.
0 004.
Molyb-
0 018
0.:000
0 000."
' 0 000
0 000
Q OOfl
0 000'
O,OQO
0:000 .
0 000
0 000
0,000 ..
0.018
denum
t
-
Nickel
0 025
0 000
0 000�
0 000
0 000
0 000
'. AWL
O OUO
0:000O:flflO
0 025.
Selenium
0 018
0 000
0 000=
0 OOU
0.0.00
U fl00
.; 0 000
0 OC}0
0.000
0 OOQ
0 000
0.000
0 018
Zinc
1 171
0 U00
0 000
0 000
0 000
Q. 000
, fl Q00'
0 0'00
0,000
0 000
0 000
0.000
1 171
Total
Phos-
71.767
0.000
`U 000 ''
0 000
0 0:00
0.000
0 OOQ
0.000
0:000
0.000
0 OOA.
0 000
' 71 767
i-: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
iw---isonment for knowing violations".
z�z 1/10/2017
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
Operator:
ANNUAL LAND APPLICATION- �W-.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 #: 1 Acres Utilized:
Simon Stephens Annual Dry Tons Applied: ` 4' °°' 44 33 Site #: 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:
25.2
25.2
0
o
�
o
Q
Volume lied
p
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
COnrd
(D
wet, '
Moist)
Preci P•
Past 24
Hrs.
inches
4 b
a. �
o
�
, -.
* -ff..
7y 9
?L
* ^�,
z
TK1V
mg/kg
z
o
o
mg/kg
Nitrate
and
Nitrite
mgfkg
- PAN Applied
pp
(lbs/acre)
Name of CropType
yp
Receiving Residual
Application
Crop I
Crop 2
Crop 1
Crop 2
6/2
143000
4.42
South Burlington
D
<.5"
S
0.5
0.3
57900
9730
2
40 410:-'
NA
Fescue
6/3
97500
4.42
fit P713 `'
South Burlington
D
<,5"
S
0.5
0.3
57900
9730
2
27 552>
NA :
Fescue
0 000
"0 op4
0.000
0.000
0.000
0.000
4' 0011
0.000
0,000
0.000
0 0*:..
0.00(0�
0'
�'°0 ''
r f' ;0 000`.�
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.6
0.000 `
TOTALS.
`` 0
240500
;.;:;:':;.;:;:
As
Cd
Cu
Cr
Pb
H =
Mo
Ni
Se
Zn
P
67 962''
u.iu)o
Lime Applied
Annual lbs/acre
" 0 01fi "'
0 QO Z
0 563
549
0.035
0 004tl
R18
0 02?'
©((1&b
1? tl11:7b7
; :::::.;:.::; ::.: ::::::::::
........ ....:........ . .. .....
.
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.133
0.146
16.922
4.747
2.574
0.064
0.552
1.558
0.154
29.637
Current Cumulative lbs/ac
„`0 144 . `
0 153
1T 485
5 296
2P609 `'
0 068, =
0 570
1 5:83,'
O':172
30 808 t
Permitted C. P. L. R.****
36
34
1338
267
15
374
89
2498
Permit PAN Limit t st/2nd Crop
...................... .......... ........ ...................... :,.t ,.
]58'
"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
1/10/2017 **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): 66.14
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
C' rator: Simon Stephens Owner: Simon Stephens Predominant Soil Series: HdB
A .s Used: 16.4 Acres Permitted: 16.4 Site #: AM 118 Field #: 4
Residual Analvsis Data (Heavy Metals and Total Phosphorus use mg/ka. % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
EB
4/11/16
2 j
3]
L4J
5
6
7
8
9
10
11
12
% Solids
4.98
Arsenic
3
Cadmium
2
Copper
131
ChromWin
67
Lead
14
Mercury
0.8
Molyb-
denum
5
Nickel
19
Selenium
5
Zinc
492
Total
Phos-
horus
11300
ivietai vieia Loaaings tuaicutatea in ias/acre):
DT/Ac./
App.
w
Event
4.03
Arsenic
0.024
0.000
0.000
0.000
.0:000
0 000 '
0 0;0:0
0 QOU
0 0:00,
0.000
O;OOb
0.0:00
0.024
Cadmium
0.016
01A00
6 000`
0•.00`0:
. 6.006
0.000 :
0.00.0
0.000
0 000
0.000
0.000
0 000
0.016
Copper
1 QS'7 _
0.000
w.0 000;
0 Q00
0.000
0 000=.
0 QOQ
O:O:OQ
0 000:
" 0 Oa_0
0 OQO '_
0..0.00
1057
Chromium
0.54;0
..0:.000
0.000:.
0.00.0
0.000.
mo
0..000
0..000
0:000:
6.060
0.0.00
0.000
0.540
Lead
Molyb-
0',04-01
0.000
: -6000
'0.000
0 000
0 000
0.000
0.,000
0 000
0.00
0 Q00
0 000
0 040
denum
-
Nickel
0 15
0 QY10
0 000
0.00
E
0 00
0 Oi?0
0 004
0 Q00
0�000
0 OOtJ
Q. 000
0.000
0 153
Selenium
0 040
0 Q00 '
0 000
0 000
O.000
0 000 ._
` 0 000
0 000 .
0.000:
, 0 OO:U
0 0:00
0.000 .
,.. 0,040
Zinc
3 968
0. 0.-
U 060
0.000
0 000
Q 000 ._
0 00'Q
0 0:00
0.000
0 000.:
0 400
0 000 -
. 3.:968
Total
,-
Phos-
91.146
0.000
:0 OOU `
' _ 0.00.0
0 000 ;
0 000
0 000.
0 0.00
Q..000
0 000
0 000
0.00.0
91.146
ohorus
"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- -- risonment for knowing violations".
''?!f.e 1/10/2017
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
ANNUAL LAND APPLICATION - tFLD 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
Simon Stephens
Operator: Simon Stephens
WQ Permit #: WQ0000520 Field #:
Annual Dry Tons Applied: '< _ 66.14.:"� Site #•
Predominant Soil Series: HdB
Crop 1 Name: Fescue -Hay Crop 1 Max. PAN:
211 Crop 2 Name:
4
AM118
Acres Utilized: 16.4
Acres Permitted: 16.4
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
o
o 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,
Wet,
Moist)
Precip.
Past 24
Hrs.
inches
Y
'd
a o
o
o.
a
o
=
* >v
4
;h
w •,
!=
* N
TKN
mg/kg
Z
4
o
CD
�, 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
5/25
45500
4.98
4' 76
East Burlington
D
<.5"
S
0.5
0.3
29500
3010
75.1
10.978
NA
Fescue
5/26
136500
4.98
r 1° 728 ' '`
East Burlington
D
<.5"
S
0.5
0.3
29500
3010
75.1
32.934
NA
Fescue
5/27
136500
4.98
le 728 . .x
East Burlington
D
<.5"
S
0.5
1 0.3
29500
3010
75.1
32.934
NA
Fescue
?0 000
0.000
0.000
U�000
0.000
0.000
0.000
0.000
000 : x
0.000
0.000
0.000
0.000
0 000
0.000
0,000
Q00
0.000
0.000
aq 52_
0.000
0.000
` r
0.000
0.000
0
°� 0''>n
000
Residuals Applications totals on FORM
FSF supp (attach FORM FSF supp
to this form):
0.000
0.000
TOTALS:
` ; ti
318500
::::j:::::;:;:.
As
Cd
Cu
Cr
Pb
H 7
Mo
Ni
Se
Zn
P
76.846
0.000
Lime Applied
Annual lbs/acre
AO 024
g0 01
1 057
Vr040
0.113
�l Q46 _'Q
04U:
0 153
r 0 040
3968
J1.14b
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.1345
0.1492
15.1001
5.1259
2.4568
0.0495
0.4771
1.1936
0.1473
26.7348
Current Cumulative Ibs/ac
0 159 .K.
0 165
16 i1.57"
"e 5666
2.570
0 056 ,
0 51z
1:347 °
O'1:88
3`0 ,703
Permitted C. P. L. R.****
36
34
1 1338
1 267
1 15
1 374
89
2498
Permit PAN 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
1/10/2017 "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): 24.86
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
4 ,ator: Simon Stephens Owner: Simon Stephens Predominant Soil Series: HdB
A.. es Used: 9.7 Acres Permitted: 9.7 Site #: AM118 Field #: 5
Residual Analvsis Data (Heavv Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
11
SB
4/11/16
21
EB
4/11/16
3
4]
1 5]
L6J
L 7j
L8]9j
10
11
12
% Solids
3.79
4.98
Arsenic
3
3
Cadmium
2
2
Copper
199
131
ChronliLWI
190
67
Lead
13
14
Mercury
0.5
0.8
Molyb-
denum
5
5
Nickel
11
19
Selenium
5
5
Zinc
404
492
Total
Phos-
phorus
28600
11300
1 Iai
rteavy ivlerai r ieia L.oaaings
tt-aicuiaiea in ias/acre):
Total
1
2
3
4
5
6
7
8
9
LOJ
11 J
12
DT/Ac./
App.
Event
1.59
0.97
14
Arsenic
0:010
0:006
0.000
0.0,00
0:0.00
0.000
0 000,:
1 0,000
0.000
0:000
0.000
0.000
0.015
Cadmium
0:006
0.004
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0 00-0
0.0.00-
0.000
0.010
Copper
0..632
0.255
0.000
0.000
0.000
0.000.!,
0 00.0'
0.00.0
0.000
0 000
0.000
0:000
.0.888.
Chromium
0.604
0.1.31
0.000
0.000'
0.000
0,000
0.000
0.000
0.0.001
0 000
0.000
0:000
0.734
Lead
0.041
0.027
0.000-
0.000
0.000
0.000
0:000
0:000
0:000
0 0-00
0.000
0.000
:0.069
Mercury
0.002
0.'002
0.000_
0.00:0
0.000
0.000
0.000
0.000.
0.0000.0.0
0.000-
0.000
0..003
Molyb-
0.0`16.
0,610
Oao-W
O.'aw
0:00.0
0 000
` 0.000
0.000
0;.000
0.000
0.000
0.000
0 026
denum
Nickel
0 035
0-.03-7
0.000
0 000
0:4Q6
0.00-6
6.000
0.000'
0- :0.000 :
0..000
0.000
0.000
0:072
Selenium
0.016
0,010
0 000
0.0.00
0.000
0 00:0 ;
0.000
0,000-
0:.000
0.000
0.000
0:000
0.02 6
Zinc
1 29-4 1
0 958
0.600 .
0.000
0.000
0.000
0 0.00
0 000
0.000
.. 0.000
0.000
0.000
2.242
Total
Phos-
90:891
22.012-
0-Oft
0 000
0.00.0
0.000
0.000
0.000.
0.000
0.0-00
0.000
0.000
112.903
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".
Z;i: 1/10/2017
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION )k dMD 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: 9.7
Land Owner: Simon Stephens Annual Dry Tons Applied: 3_ f A .F24 8b... Site #: AM118 Acres Permitted: 9.7
Operator: Simon Stephens Predominant Soil Series: HdB Cation Exchange Capacity (non 503): 0
Crop 1 Name: Fescue -Hay Crop 1 Max. PAN: 211 Crop 2 Name: Crop 2 Max. PAN:
'"
Q
Volume applied
PP
(enter one) Solids/
Liquid
Cu. Yds Gallons
o/p
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
n
b
rt
o w'
a.
0
C
o
�
w
CD K'
o
4
w g
CD ELQa
* N
TKN
mg/kg
'o M
o o
�.
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 I
Crop 2
5/16
97500
3.79
1 589 ";
South Burlington
D
<.5"
S
0.5
0.3
69100 1
29300
2
84 487-
NA;,
Fescue
5/25
45500
4.98
e: 0,'974 a. -
East Burlington
D
<.5"
S
0.5
0.3
29500
3010
75-1
18 561';
NA'.' ;;
k"escue
O.b00
0 000 ,
0.000
0 OOb
0 000 �
4 000;.a'?
0
000
0 000,r;
0 00©
0,000
4 00.Q, .
0,0000
i00000
0
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this formlc
Q 00Q, :
",0 OdO::�;
TOTALS
,�," 01
343000
As
Cd
Cu
Cr
Pb
H 7
Mo
Ni
Se
Zn
E'
'1U3 0411
0).000
lime A plied
Annual lbs/acre
©015 ` '
0 OlQ FI
z D, 888
, 0;734
{),069
0 003, ;
0 026
Q 072
,#OaQ25
:.... .. . ...:
... .....
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.1
0.0978
11.0919
4.2182
1.8908
0.0308
0.3276
0.7717
0.1011
17.856
Current Cumulative lbs/ac
115
0 W
119Y80
_4:_953
1.1959
0 034
35 Q 3
0 844
0 127�
2U 098
Permitted C. P. L. R.****
36
34
1338
267
15
374
89
2498
Permit PAN Limit 1st/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
1/10/2017 **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): 13.62
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
C ;ator: Simon Stephens Owner: Simon Stephens Predominant Soil Series: HdB
A,._. "s Used: 5.5 Acres Permitted: 5.5 Site #: AM118 Field #: 7
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/k2, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
11
SB
4/11/16
21
EB
4/11/16
31
4.
5,
6 f
7
81
J
10
11J
12
% Solids
3.79
4.98
Arsenic
3
3
Cadmium
2
2
Copper
199
131
Chromiitiii
190
67
Lead
13
14
Mercury
0.5
0.8
Molyb-
denum
5
5
Nickel
11
19
Selenium
5
5
Zinc
404
492
Total
Phos-
Dhorus
28600
11300
F tai
heavy ivietai rieia i,oaaings
tt-aictuaiea in iDsiacre):
1 otal
1
L2j
FE
LT
5 1
71
771
787
9
10 J
Llj
12 Jy
DT/Ac./
rt
App.
Event
1.49
0.98
Arsenic
0.009
94006 :
" 0.000
0.000
0.000
Q ,009
0 004 _
„ 0000
0.000
0.000
0.000
0.000
0..015
Cadmium
0.006-
0.004.
0.000
0.000
0.,000
0:000`
0.00:0>
0.000
6, 00.0
0.000
0.0:66
0.000
6.010
Cooper
0.595
0.257
-0.000 :
0.0.00
0.0`0a
0,.00:0`
0.000
0.000 :
0:.000
1 0.000
0. 00
0.000
0.852 -
Lead
0,09
.° O:Q27
0 000
,. 0 000
0.000
0.000_
0 000
0.000
0:00:0.
0.000
, 0.000.
0.000
0 066
Mercury
0W
9 0R
,' 0 000_
_ 0.000
0.000
Q 000
0 000
0.00.0.
0.006
0.000.
. 0:000
0.000
.Q0
O3
Molyb-
denum
0.015
0..010
0.00,0
O.-GooO.O:OQ
0.000
:. 0 000
0.000
0.000
0.000
0.000.
0:000
0.0.25
Nickel
0 033
_.
0,037
0.000
0 000
0.000 ".
0 000
0 000`
0 000
0.000:
0 000
0.000
0.:000'
0.070
Selenium
0 O 15
0.010
0 O00 ;
. 0.00Q
0.000
0 000
0 000 i
0 O:QO 1.0,000
0 000
0 000
, 0:000
0 025
Zinc
I zw,
0.966
0,060 '
0 000
0.0:00 ,
0 00.0
0.0 00. '
0.000 .
O.000
0 000 .
0.000 .
_ 0:00.0
2._173
Total
Phos-
phorus
85.457 1
22.193 ."
0.000 :
0.000
0,000.
.. 6-000
0 000
0.000
0`.000 -
. 0.000
OAO-0
0.000
107.650
"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 'sonment for knowing violations".
;e: - 1/10/2017
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
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
Simon Stephens
Operator: Simon Stephens
Crop 1 Name: Fescue -Hay
WQ Permit #: WQ0000520 Field #:
Annual Dry Tons Applied:' ,'•,;13:52` Site #:
Predominant Soil Series:
Crop 1 Max. PAN:
211
HdB
Crop 2 Name:
Acres Utilized: 5.5
AM118 Acres Permitted: 5.5
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
O
N
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.
D
( ry'
Wet'
Moist)
precip.
Past 24
Hrs.
inches
Y
4 �
�
o'
o a+
a
*
o
qy w
w �,
'"
* N'
* w
o'
1
7y
w "
fD
* N
w
TKN
mg/kg
Z
:,
o El
0
�.
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
5l16
52000
3.79
1: 494. ''
South Burlington
D
<5"
S
0.5
0.3
69100
29300
2
79.469
NA .
Fescue
5/25
26000
4.98
0`'$2 .;
East Burlington
D
<.5"
S
0.5
0.3
29500
3010
75 1
1$,705
NA ;
Fescue
"�s000'
.W000
0 000
0,".0oo
0 000. ;,
0000 ,:
0000
i?000 M
6.000
;,0'000
0 000 '
; 0.000
000'
077
0 000
0,006,
" 0,000
o 000 `
000
'
0:000
a ©,
r it"000 `..,_.
0000
0 000;E;
0
Q'000!
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
U.000
0:000
`::: . . . .
::":<' ''
TOTALS
o
7$otw
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
98.174
0.000
Lime Applied
Annual lbs/acre
0 015 ,;
O O1Q
0 852
Q;E99
0.06b
U 003�
A 0 025
D-07p
r l 025
2173Q
'! 7.65U : ;' :::: ':`: :>
:': .......... .... .
. ' ' ..' ' ' ' ' '
Date
lbs/ac
Prior Years Cumulative Ibs/ac
0.0694
0.0687
5.1068
2.5624
0.6659
0.0157
0.1886
0.4544
0.0666
9.5422
Current Cumulative lbs/ac
0 0$4 �°
a 0 079.:
5 9 9
:262
U.732
t► O1
0,213''
i 0 SAS "
0 Q91
11':716
Permitted C. P. L. R.****
36
34
1 1338
267
15
374
1 89
1 2498
Permit PAN Limit Ist/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."
/{C *Application Method: S - Surface, IN - Injection, INC - Incorporation
,[�•� 1/10/2017 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anserobially 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 ' 'lator:
A.._ 49 Used:
City of Burlington Total Dry Tons Applied (Annual): 57.86
WQ0000520 Cation Exchange Capacity (non 503 only):
Simon Stephens Owner: Simon Stephens Predominant Soil Series: Aa
19.7 Acres Permitted: 19.7 Site #: AM118 Field #: 9
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
�.-.
Com-
posite
Date
Total
h
..
:.��
-��
J 'Aal Heavy Metal Field Loadings (Calculated in lbs/acre):
l otal
11
2
3j
4 J
5
6]
L7J
1819j
10
11 I
12
DT/Ac./
App.
Event
1.36
1.58
Arsenic
0.008
0.009
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
' •0.:000
0.000
0.01$
Cadmium
0.005
0.006
-0.000
0.000
0.000
0.000
0 OQ.0
1 4 60:0
0.00.0.
Wow
0.000
0.000
0.412
Copper
0.5,40
0-S06
0 0Q0 ,
O. —
0 :000
Q 00 .,'
K
_ 0 ,
0 0:00
O:OQO:.
0 000 .
0 00.0
0.;000
1 04b
Chromiu
Q 515
0 49
Q 000;
0 600
0 000
a t 00 ;
, 0 A(�A
0 (00
0,000
= 0 fi 00:
6,00
flm-0 .
`_ 1 w
Lead
0 035
�.,Q32
0 000 _;
0 Ob0
0 000
0 00 '=
o�00U
U_000
0:000
000
0 OOfl
O;,UOtiO
-
0 ¢67
Mercury
Q"
0„Q0
4 000
_
' fl
0 t1i10
0.000
_
41
fl 0 Q
a OQ
0 004',
0 0fl0
Q:.000
a-0fiS
Molyb-
0 014
0
r 0 00Q000
O:OLiU
0 Q00`
0 000
0:000
0 02 .
den
Nickel
0,03
.02
0 O�fl _;
O t09D
Q, {fii(
00
(ki
Qfl
U:Ob
` OiQ(=
t,18
B'.OII©_
0 U52 .
Selenium
0
016 _
` 0 (00 ,
: ®4?0
0Ofl
Q000 ,
`_ 4 01(1:
000
0 00
- 0 00.0
0' 00.©
OOQU
F O 029
Zinc
1TotalPhos-
.b e
77
0 OQO
0 QQD
0.flfiQ
00Q°
0 00-0
0 O.OQ
O:OQ®
: _ 0 O06
fl :OA0
0 00;0
142..06 --
horus
ffi.4:30
.
::
A
"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".
;?!:f e Z�24- 1/10/2017
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
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
Simon Stephens
Operator: Simon Stephens
Crop 1 Name:
Fescue -Pasture
WQ Permit #: WQ0000520 Field #:
Annual Dry Tons Applied:: 57.46 Site #:
Predominant Soil Series: Aa
Crop 1 Max. PAN:
138 Crop 2 Name:
9
AM118
Acres Utilized: 19.7
Acres Permitted: 19.7
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
o
a; o
A
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES # W #,
Q
Fert., Animal
Wasteetc)
,
Soil
Cond.
(Dry,
(D
Wet,
Moist)
Precip.
Past 24
Hrs.
inches
Y
4 'n
F 12
w
o
%`�
o
rJ
o
=1
; w
# N
R
TKN
mg/kg
Z a
o
IR 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
5/11
136500
3.79
1.09
South Burlington
D
<.5"
S
0.5
0.3
69100
29300
2
58.240
N 4.
Fescue
5/12
32500
3.79
J 261 . "
South Burlington
D
<.5"
S
0.5
0.3
69100
29300
2
13:867—NA­
�
Fescue
6/11
71500
4.42
Ot669
South Burlington
D
<5"
S
0.5
0.3
57900
9730
2
.-25.846 `
NA. ' <
Fescue
6/13
97500
4.42
Q'_912 "`;
South Burlington
D
<.5"
S
0.5
0.3
57900
9730
2
35.244
NAB
Fescue
fl:000
0000
0;000
0,000' '
0 000
O 000'
0.000
0.000, ,,
Q A00
0:000
0 000`4
OOAO
Oi000°
0-000•�'
0 000
0.000
0 000':..
::
0
0
U 000 .'°'
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0:000
0.000
TOTALS:
n
, ­338ono
As
Cd
Cu
Cr
Pbr(H
Mo
Ni
Se
Zn
P
133.197
0 004j'^.
Lime A lied
Annual lbs/acre
:Q. 018
0 012
1 0}6
l:=©09
Q 067
0 029 F
0 951
1} 029
214�`
%i2.068 :.:::...:::::::=:::: >::::::
. .
Date
lbs/ac
Prior Years Cumulative ibs/ac
0.214
0.164
20.932
7.74
2.783
0.658
1.39
0.227
37.791Current
Cumulative lbs/ac
b 232
0 17G
21.
8 749
?� 8.50
0 68:T
1 442
0 256
39 94Permitted
C. P. L. R.****
36
34
1338
267
374
1 89
1 2498
Permit PAN Limit lst/2nd Crop
P
...
138
"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
1/10/2017 **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..94
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
C" Igtor: Simon Stephens Owner: Nelda Kiser Predominant Soil Series: HdB
A,.,es Used: 17 Acres Permitted: 17 Site #: AM119 Field #: 2
Residual Analvsis Data (Heave Metals and Total Phosphorus use inaNg, % Solids use Raw Percent #):
Sample or..
Com-
posite
Date
1J
SB
4/11/16
21
31
L4]51
6
7
8
9
10
11
12
% Solids
3.79
Arsenic
3
Cadmium
2
Copper
199
Chromi
190
Lead
13
Mercury
0.5
Molyb-
denum
5
Nickel
11
Selenium
5
Zinc
404
Total
Phos-
chorus
28600
E ial
rieavy inetal r ielct Loadings
(c aicuiatea in idsiacre):
1 otal
1
72j
731
4
5
6
7]
L8J
9
10
11
12
DT/Ac./
C
App.
Event
2.06
Arsenic
. 0.012
0000
0.000
O.000
O.D00
0°000
0.000
.000
0:000
0 00:4
0.000
0.000
0.012
Cadmium
0.008
0 0,00
0.000
0 000:
0 Q00
0,000
0,000
0.000
0.060
0.006
0.000
0.000
0.008
Copper
0 818
0 0000
000_r
3 0 004
0, 0:00
0.' 000
0 000
0 000
0:000
0 000
0 000
0..000
° : 0 818:
ChromitiQ
0 781„
0 O;OOt
0 000 ,"`
0 ObQ.
0 0'00
Or000
0 000
0 000
Q..000
:'0 000
0 000
OA00
781
Lead
0 053
0 000
Q 000 '
_0 000
4W,
0000
OQO=
0 OU0
O000
0 4�0_,
0 000
040
:Q 053
Mercury
0 00
0 0:00
0 OOo,-
0 000
0 000
0-.000`
0 000
0 OUO
0:000
0 000,
0 00
0 000
: '0 002
Molyb-
0 021
0 000
0 000-
,L� O 000
0 000
0 000
0 000=
=
0 000
0 000
r
o 000
0,000
0 0 l
denum
- .
Nickel
' 0 04
0,000
`0 000
0 000
0 00 t
OOv00
0 Q00'
6 000
0 00 0:
;, 0 000
0 000
0 U00
=` 0 045-
Selenium
0 021
0 q:00
0 000
f 0 000'
0 000`
0r000
0 OOb.
U 000
0.000
` 0 000 =
0 000
0.000
9 021.
Zinc
1 660
0 000
0. 000
0 OOOs
0 400
0;:000
0 000=
0 000
0 000
, 0 000'
0 000
0.000
1 6.6 .
Total
Phos-
117546
0 000
> 0 00:0
0 000,
. O':000�
` 0 OOQ'
0 Q00
0.;000
0 000 .
0 00:0
0..000
1.17.546
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".
;!::�e 1/10/2017
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
Operator:
ANNUAL LAND APPLICATION i-.&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:
Nelda Kiser Annual Dry Tons Applied:;. 34:91. Site #: AM119 Acres Permitted:
Simon Stephens
Crop 1 Name: Fescue -Hay
Predominant Soil Series: HdB
Crop 1 Max. PAN: 211 Crop 2 Name:
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
17
17
0
°
°
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
o/a
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
>
c�
a a .
* o
o
w w
J
* �'
�.
%�
w ,
`°
* N•
*
TKN
mg/kg
Z ��
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
5/28
110500
3.79
1`;02.7 -
South Burlington
D
<.5"
S
0.5
0.3
69100
29300
2
54 635
NA
Fescue
5/31
110500
3.79
1:027
South Burlington
D
<.5"
S
0.5
0.3
69100
29300
2
54;635
NA
Fescue
Og000
0:o00
0 000'•„
O, OQO
0000
U':OOQ
0.000,
6,066 ".
Q<000
0000
y O'000 �
=0•.000
0 000.E
= q.000
_06000
OzoQ;U
0.000
000
of000
0 .
0 '
0000
Residuals Applications totals on FORM
FSF supp (attach FORM FSF supp
to this form):
0:000
0 000',
TOTALS
" 0
22 i nnis
.....:::::::::
As
Cd
Cu
Cr
Pb
Hi!
Mo
Ni
Se
Zn
P
1109.2701
Q 000` "
Lime Applied
Annual lbs/acre
0:012
0 Op8 °
0 81:8
O781
0.053
0.002 ;
0•. 021
0 045
0 021,
1 660
�1 ] 7.546, .:%' %%: 7::::
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.213
1 0.186
21.816
8.094
2.875
0.077
0.611
1.6
0.301
41.084
Current Cumulative lbs/ac
�:"0225
0.194.
22 634
8:875
2.928
632;:
1 645
0 322
42.744
Permitted C. P. L. R.****
36
34
1338
267
15
374
89
2498
Permit PAN Limit lst/2nd Crop
p
2t1
"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
1/10/2017 **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): 8;81
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
CC' Bator: Terry McPherson Owner: Billy McPherson Predominant Soil Series: TaB
A,..:s Used: 4.2 Acres Permitted: 4.2 Site #: AM125 Field #: 4
Residual Analvsis Data (Heavy Metals and Total Phosuhorus use niz&a. % Solids use Raw Percent ft
com-
posite
Date
Total
os
Miiiiiiiiiii
F iai rneavy ivietai r ieia
aicuiatea in iDsiacre):
Total
L,
2
3
4
5
6
7
DT/Ac./
App.
„oyr
Event
2.10
Arsenic 1
0.01.3
0.000.
0.000
0.000
0.000
0.000
0 OOA
0-Goo,
O.00q :
0.000
0.00:0
0:000
0.013
Cadmium
0.008
0.000
0:000
0.000
0:000"
0.000
0.000
0.000
0.000 :'
0,009
0..000
0.000
0.008
Copper
0 66T3
0.000
040
0 00.0
Q. 00 '
0 6.00
0 000
0.00.0
0.000
0 006.
0 000
0.000
0.663
Chromium
0..6.8:8
` 0 000
0.060
O.000
o.000 <
0.6, 0
6.006
0.000
0 00.0
0.000
0 u, .
0.006,
0.6-88
Lead 1 0.057 1 0000 q oa:o 0 000 0:.000 0 000 0 000` 0.000 0,000 0 000` 0 000 00.00 0 OS T
Mercury 0.002 0.000 0 000 : 0 666 0.000 0= 000 ; 0 O6. 0 0.. 0;000 - 0 000 0 000 0 000° 0..002.
Molyb- 0.021 0.000 0.010 0.000 0.0:00 0 OOQ o.000 0.000 0.000 0.000 0.000 . 0:.000 0.021
rlamim -
Nickel
0.035
0 000
f,.
' .0 000 :
0.000
0.000
0 000"
,' 0 000
0.000
0:000
' 0 OQU'
0 000
0.000 .
0 ,035
Selenium
0 021.
0.000
' _0 000 ..
0.000
0.000.
0 000 :
0 000.
0.000
0.600 _
. 0 000 .
0.000
0,000 ..
0.021
Zinc
1.258
0 a_00
0 00b.1'.
0,000
0.000
0 OOQ
° 0 000
0 O,0
0 000 '
,0 000
0.00:0
0.000
1.258 -.
Total
Phos-
chorus
89.752
0_.000
-0.000,
0..000
0.000
.'.0.000.,
0.000
6,006
0.000
'0.000
0.060
0.000 -
89.752
"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".
25 1/10/2017
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
ANNUAL LAND APPLICATION siLD 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
Billy McPherson
Operator: Terry McPherson
WQ Permit #: WQ0000520 Field #:
Annual Dry Tons Applied: `< 8 8'1 Site #:
Predominant Soil Series: TaB
Crop 1 Name: Fescue -Hay Crop 1 Max. PAN:
190
Crop 2 Name:
4
AM125
Acres Utilized: 4.2
Acres Permitted: 4.2
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
�
o
g O
(�
Volume applied
(enter one) Solids)
Liquid
Cu. Yds Gallons
"�o
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
co b
o w
o
70 w
�,
N'
7�
w .,
0
TKN
mg/kg
z a
o
Q 0
p
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
10/28
65000
3.25
`2:Q7 `_`•
South Burlington
D
<,5"
S
0.5
0.3
58300
19000
8
89.341
-1��1t'
Fescue
0 000
Ur000
0400
Q:OOt)
0000
U00
0000
0 OOQ,
pO
3 RQb
Q Q66`~
0's.000'
OOOU
O OOQ',
0:000
0000
0.00o
a boo'
0000
`
0.000
0.000
'
0"
U •' ;;
b 0 000 r `
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
o.000
(} 00.,0= ;
•:
::. :
TOTALS:
0
6soci
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
89.341
OW
Lime APplied
Annual lbs/acre
0:013 .,:
~ `0 OQ$.t
0 663
ti 0.688
A057
0 002
'� 0 021„A
d35 `
4 021
1; 58'
; 89 7>� " " ` <:
.
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.059
0.027
3.99
1.376
0.461
0.018
0.107
0.234
0.057
10.881
Current Cumulative lbs/ac
0072
0 035.`''
4 653
2064
0�1$,
0 020, .
0128
0 269
0 078
1..2.139
Permitted C. P. L. R.****
36
34
1338
267
15
374
89
2498
t 2 Perms PAN Limit 1 s nd Cro
p o
P
9
10
"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;2:� *Application Method: S - Surface, IN - Injection, INC - Incorporation
1/10/2017 **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):
C" ';ator: Larry Fogleman Owner: Larry Fogleman Predominant Soil Series:
A.._ cs Used: 6.3 Acres Permitted: 6.3 Site #: AM126 Field #:
9.38
GaB
2
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
SB
10/10/16
2
3
4
5
6
7
8
9
10
11
12
% Solids
1 3.46
Arsenic
3
Cadmium
2
Copper
195
Chromium
209
Lead
11.5
Mercury
0.4
Molyb-
denum
5.14
Nickel
9.25
Selenium
5
Zinc
376
Total
Phos-
horus
23600
Y xal Heavy Metal Field Loadings (Calculated in lbs/acre):
10
1
L2J
3 J
4
L5J
L6J
7
L8J
9 J
10 j11
12
DT/Ac./
App.
Event
1.49
Arsenic 1
0.009
0.000
0.000
0.000
0.066~
0.000
0 000
0.000: '
0 dQo.
0.000
0.000
0.00.0
0 OW
Cadmium
0.006
0.000
0.060 .
0. 00ra.
0.000".
0.00.
0.006
o oo
RA
a oo0-
0.000
0:000
0 0"
Copper
0, 8.i
W0 000
0 0�Q
0 0 0
0:00
Q OQO '
- 0.Qa0
0.0�00
0 OOQ :.
0 4QQ'
Q Q00
O OOQ
Chromi
0�22 ,
t O:OOb
0 Q00"
O lOn
000
( 4fi1
': 4 000
^ ©,Q - 0
0_WOQh .
= 0 OAO°
();00
UQOQ
0 &2�
Lead
W34
0 Q00
0 00
O,WOO
OrO00�
. 0 00(t
W O0tl0
0 000
0; OOQ":.
0 000
h0z000
0 (lam ,
Mercury
0�0(11fl
00�0
=Q 0 0
0 0Q0
0!000
0,�0
_ %1;(y0�0O;flQ0v(l&
0,00
Ut000
0 041, __
Molyb-
O-(15
0 O01)§ `"
0 00:Q
U ODO
0 00©
0�b0
W OOOr '
' 000
0 0 A
0 00.0
, .0000 '
k} 01.5
en
u _
}«
.0
Nickel
Ih 028
SJ-0"WOF
= 0 OW�O
0 Q00
0 00
f OA
O�fl(
Q t}Q0
(#.OF
° O,OfiIA
0 OQO
_�000'
r 0 Qg`
Selenium
©0fS
0 000
0 OOQ„ "
00
Or000
0 00�
ram_
:. 0 0()0°
0 000
a OOb .
_ 00
Qr00`0
0."00r
A �31
Zino
t
W ,boo
0 0�.. °
` 0 Wok
( QOQ
. 0.0��
. cl coo "
0. o
Total
..... -
..,
`
Phos-
70 $1
W 00
A 04Q
- O41,
O.10
0: I flOz. ;
O OQQ.
D b
0.OWA
0 A�nl`
fl d0A
::D 0fl0
71i,2 :1
horus
v
"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".
2yd 1/10/2017
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 #: 2 Acres Utilized: 6.3
Land Owner: Larry Fogleman Annual Dry Tons Applied: ; " 9 38 Site #: AM126 Acres Permitted: 6.3
Operator: Larry Fogleman 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:
c
�
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
0 o
o
;� �,
w
#
�
7y C
w
c, w
w
TKN
mg/kg
Z
q
o
0
�-
mglkg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbslacre)
Name of Crop Type
Receiving Residual
Application
Crop I
Crop 2
Crop 1
Crop 2
12/20
65000
3.46
1.489 •
South Burlington
Dry
<.5"
S
0.5
0.3
61400
17600
579
67 045 `'_`NA-,
Fescue
0`:Q00
w000 .:
0 OQO `
o a,0oTal
000,
0000
' Ot04)0
, 0000�
�
:0.000'11
"0OOb.
A"
0 00o x.
0:000
0.000
0 000
"o:0oo
0 oob° .
0 ooaa
V000
a obo
0.000
0 000�
o �qo
0.000
o 0.9-
0.000
U
0
0. OQO ._"
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0,000
11.004,
TOTALS:
Q
650Ui�
::::::.::
As
Cd
Cu
Cr
Pb
H g
Mo
Ni
Se
Zn
P
67.045
0 OOO.rt`'
Lime Applied
Annual lbs/acre
0 009
0 OQ6
0 58I
0 622
«0 3 t `;
0 001 ,"
a OIS
0 28'�
01113A
F 1:1�Q
1� i70.281 :.
::::::::::::::::::::::::::::::::::::::::: :
.. .. ..... ,., .:..:....
Date
lbs/ac
Prior Years Cumulative lbs/ac
0,078
0.06
6.117
3.86
0.588
0.024
0.186
0.404
0.081
11.632
Current Cumulative lbs/ac
.'0 08T
�01. 066 k
6 6' 8
4,482
U 622
;. 0 025
O.ZO:L^
U432
0 096
lE2 752
Permitted C. P. L. R.****
36
34
1338
1
267
1 15
1
1 374
89
2498
t/
Permit PAN Limit 1 s 2nd Crop
P
15 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
1/10/2017 **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): 51.57
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
C '*or: Larry Fogleman Owner: Larry Fogleman Predominant Soil Series: GaB
A.._ es Used: 27.1 Acres Permitted: 27.1 Site #: AM126 Field #: 3
Residual Analvsis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or.
Com-
posite
Date
11
SB
10/10/16
2
3j
L4J
5
6
7
8 j
9
10
11
12
% Solids
3.46
Arsenic
3
Cadmium
2
Copper
195
Chromium
209
Lead
11.5
Mercury
0.4
Molyb-
denum
5.14
Nickel
9.25
Selenium
5
Zinc
1 376
Total
Phos-
)horus
23600
.1 iai
heavy lvietal r iew Loa(iings
kualculatect in ins/acre):
1 otal
1
2
3
4j
5
L61
7
8J
L9_J
LoJ
11
12
0
DT/Ac./
App.
y
Event
1.90
Arsenic
0.011
0.:00Q
0.000
O,000
0.000
0,000
0.0-0:0
0.000
0.000
0.000
.0.000
0.000
1 0.011
Cadmium
0.00K
0.:000
0.000
0.000
0,00.0
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.008
Copper
0.742
0 00:0
0..000
0.0.00
PAM,
000.
0.00:0
0.0.00
0.000 :
0t.000
0.000
.0,0.00
0.742 -
Chromiu
0.795
0 00.0
0.00-0
0.000
0.000
0.000
0 000
0.000
0.000
. 0.000
0.000
0.060
0.705
Lead
0.044
0 000-
0.000
0.000
0,000
0.000,
0 000
0.000
0.000
0.000
0.000.
0.000
0.044
Mercury
0.002
0.000'
0.000
. 0:000
0.0.00
0 00.0 ;
0.00.0.
0.000
0.000 '
0.000
0.000
0.000
0.002
Molyb-
0:020
0.0.00.
0_00,0
0.000
0:000
0.000
0.000
0 0.00.
0.000
0.000°
0.000
0.000
0.020
denum
Nickel
0.035
0.000
0.000;
0.000
0-,000
0 00:0 .
0 '
0 ;0:00
0.000
0 000 .:
0.000
0 000
0.035
Selenium
0.0-19
0..0.00
0.0.00
0.0.00 '
0,1000
0.000
0.000
0 0.0.0
0.000
0.000
0.000
0..00.0
0.019
Zinc
1.431
0:000
0:000
0.000
0.000
0 000.
0 006
0.000
0..000
0 00-0.
0.000
0. 000
1.431
Total
Phos-
99.822
0.;000
0.000
0.000
0,000
0.00 0
0.000
0..000
0.000
0.000-
0.000
0.000
.89:822
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 4sonment for knowing violations".
4; _ 1/10/2017
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
Operator:
ANNUAL LAND APPLICATION �v -,i-1;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 #: 3 Acres Utilized:
Larry Fogleman Annual Dry Tons Applied: 51.57 . Site #: AM126 Acres Permitted:
Larry Fogleman Predominant Soil Series: GaB Cation Exchange Capacity (non 503):
Crop 1 Name: Fescue -Pasture Crop 1 Max. PAN: 157 Crop 2 Name: Crop 2 Max. PAN:
27.1
27.1
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.
D
W
Moist)
Precip.
Past 24
Hrs.
inches
a
r;
o
o I
ao
o
o
w �»
—
N
*
7v =
w
N
*
�
TKN
mg/kg
z
i~ 5
o
oq o
-
U.
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
12/20
1
201500
3.46
,.
073
South Burlington
Dry
<.5"
S
0.5
0.3 1
61400
17600 1
579
48 31`7lA
' ='
Fescue
12/21
156000
3.46
31.
South Burlington
Dry
<.5"
S
0.5
0.3
61400
17600
579
37 406:
NA. °
Fescue
yo boo
0 0a0 ;
o oqo
U 000 " :
OOOU
0 000:
�V"000 "
0 000
0,9091
o a0'o
a 000:
o 000
oboo.
0.000
0 00:0
4 004
0 QOtY `
0 6; 0,".
0.000•
,,
0 000;
0.000
:•:•:•:
0
0,"
0 0001
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000
0:000`l
.....:.
TOTALS:
01
357SO0.::::::::::::::
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
85.723
J 9.96 • ;
Lime Applied
Annual lbs/acre
0 011 '
0 00$
0 742
0.795 ' °
•° 0.044
U 002
0 02
0.03:5
Oa019
1,.4 1
.:$9.822 :.: <? :::
::: :.:::::: :::::::::::: ::::
...........................
............................
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.132
0.08
7.471
4.005
0.742
0.022
0.223
0.572
0.126
15.664
Current Cumulative lbs/ac
S 1'43
0 088
,81 13
4,800
''0 786`
0 024
0 243
0 607
0 145
17 095
Permitted C. P. L. R.****
36
1 34
1 1338
1 267
1 15
1
374
89
1 2498
Permit PAN Limit 1 sd2nd Crop
P
.
-
57 ..
I.
"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
1/10/2017 **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): 20.40
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
C Bator: Larry Fogleman Owner: Larry Fogleman Predominant Soil Series: GaB
A.. es Used: 13.5 Acres Permitted: 13.5 Site #: AM126 Field #: 9
Residual Analvsis Data (Heave Metals and Total Phosahorus use m$/kg, % Solids use Raw Percent ft
h"EMPOW15
Com-
posite
Date
W
Total
Phos-
f iat tieavy ivietat r ieia
in ins/acre):
1 otal
1
2
3
4 J
101n
J
7
y
i u
_i _U
i z
DT/Ac./
App.
v
Event
1.28
0.23
Arsenic
0.00.8
0:001
0.000
0.000
0.000
0.00:0
0.000.
0•.0.00
0.000
0.000
0.0.0.0
0.000
0.009
Cadmium
0.00.5
0,001
0.000,
01-000
0-000
0A00
0.0.00-
0.00.0
=0.000.
0.000
0.000
0.000
0.006
Copper
0.47-7
0:091
. ; 0.000
coo
0.000- ,
0,000,
.: 0.000
0 000
0.000'
0 000
0.00.0
0.000
0.56:.8
Chromiun
0.516
0,:087
0.000
0.000
1 0..000- `...
0.000
0.000`
I 0.000.
0.000
0.000
0 000
0.000-
0.602
Lead
0.038
0 006"
0.000 ;;
0:000
0.000
" 0.000` ".
0.000 .
0.000
0.000
� 0.000
PAW:
1 0.0000
0.044
Mercury
0.001111 ,
0::000
0 000
0..000
0.000
0 000 .'
0 ODO
0.000
0,000
0 000
0.000
0:000
0.0,01
Molyb-
denum
0.013
0:002
0 000
0.000
0.000
0 000
01000
0.000
0:00.0
0 000.
. 0.000
0.000
0.015
Nickel
0 02-3
0.005
0.000 '
0 000
000006
b 0-00
` 0 000
0.000
0.000
0.000-
0, 000
U0:0
0.028
Selenium
0 Q13
0.002`
0.000.
0.000
0 0:00
0.000
0.00.0
0 060 11 .
0:000
0 000
0,000
0.0.0.0
0.015
Zinc 0.885 0.194 6.060 0..000 0.000 0 000 . 6.006 0 0;00 0..000 0.000 0:000 -0.,000 1.059
Total
Phos- 70308 11042 0.000 0.000 0-.000 0.000 0.00.0 0.000. 0.000 0.000 0.000 0:000 83.350
, 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
irsonment for knowing violations".
,Z�e 1/10/2017
Signature of Land Applier
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
Larry Fogleman
Operator: Larry Fogleman
Crop 1 Name:
Fescue -Pasture
WQ Permit #: WQ0000520 Field #:
Annual Dry Tons Applied: r• 20 40- Site #:
Predominant Soil Series:
Crop 1 Max. PAN:
162
GaB
Crop 2 Name:
9
AM126
Acres Utilized:
Acres Permitted:
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
13.5
13.5
0
Volume applied
Volume
Residual Sources
Soil
Precip.
c
Z
Nitrate
Name of Crop Type
(enter one) Solids/
%
Applied per
DES #, W #,
Q
Cond.
Past 24
�Y
C �
',
w `;
TKN
o
and
PAN Applied
Receiving Residual
f; o
Liquid
Solids
Acre
Fert., Animal
(Dry,
ems'
5 8'
¢ 'v.
*
* ;
�.
Nitrite
(lbs/acre)
Application
Q
Cu. Yds Gallons
(Dry Tons/Ac)
Waste, etc)
Wet,
Moist)
inches
o
°a
0
mg/kg
mg/kg
mg)kg
Crop 1
Crop 2
Crop 1
Crop 2
4/27
117000
3.55
1;_2
South Burlington
Dry
<.5"
S
0.5
0.3
62000
22300
2
59.176
NA
Fescue
5/12
19500
3.79
40` 228
South Burlington
D
<.5"
S
0.5
0.3
69100
29300
2
12.141 '
NA
Fescue
6 000 '`.,
0.000
0.000
0 000
0.000 '
0.000
0.000
s Q Q00'
0.000
0.000
T'0 000
0.0661
0.000
�To.oao "
0.000 `
0.000
o 000
0.600 '`
0.000
0.000 ,
0.000
0.006 ,
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.
0
13ci50G..::::
;:; ;:
As
Cd
Cu
Cr
Pb I
Hg
Mo
Ni
Se
Zn
i'
71.317'`
0.000
Lime Applied
Annual lbs/acre
009
0 b06
0 SK8 3
" 0 :602
0.044
0 002
Q 05
` 0 028 ,.
{) Q15
lk:p69
{ 83.350'
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.143
0.071
7.255
5.768
0.853
0.032
0.245
0.948
0.12_
15.426
Current Cumulative Ibs/ac
0 152 '
0 077
7,:83
637o
R897
0 U33"'
026Q,,
0 9y¢,�
0135
l6 495
Permitted C. P. L. R.****
36
34
1 1338
267
15
1
374
89
2498
Permit PAN Limit 1st/2nd 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
1/10/2017 **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 Loadinji 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' ,,ator:
A._ s Used:
City of Burlington Total Dry Tons Applied (Annual):
WQ0000520 Cation Exchange Capacity (non 503 only):
Larry Fogleman Owner: Larry Fogleman Predominant Soil Series:
26.4 Acres Permitted: 26.4 Site #: AM126
DbB
Field #: 10
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
SB
3/14/16
2
3
4
5
6
7
8
9
10
11
12
% Solids
1 3.55
Arsenic
3
Cadmium
2
Copper
186
Chromium
201
Lead
15
Mercury
0.4
Molyb-
denum
5
Nickel
9
Selenium
5
Zinc
345
Total
Phos-
horus
27400
al Heavy Metal Field Loadings (Calculated in lbs/acre):
t otal
1
L2J
L3J
4
L5
6
7j
L8J
9
LOJ
11 J
12
DT/Ac./
0
App-
y
Event
1.53
Arsenic
0.009�
0.0m
0 0"00
0.000
0.000
0 00Q.
0.000
0.000
0.000
aoo
0.000
;.O.-Ow'.
,0.004
Cadmium
0006
0.000
10.000.
�0.000
" Q::
0.000
0.000%
`0.000
A.000
0.000
0.000
01.000
.006
Copper
fl 5Q
QIOD
(J04
Q OUI
( Q00
D. Q01
_ 0 {�00=:
0:1:0:04}
..,
,
.. ;
Chromium0
61
0 000
0 OOQ`,
00�
0 U00
OQQ
0 OOQ
0 000
0:.000
0 Q00
0, 0bQ
010D
63 5:
,,0
Lead
0 Off a
fl ODO
0 OQQ ;
�,flQ
O.Q:00.
0 0"w
Q fl01_
0 Q00
0: 00(
OrQ40`
0 fl00
0t-0D0
` ;0 ®�#f
Mercury
0 U11
b (I008
?-(3©0:.�.
@.OQ _
aa,
yQQfl..;
Qi
00U
. 4011fl
Moriyb
0 O15
41
0 000
0 000
�` 0 OOU
0 0;00'
0 000
000;p
000
h000
�0,000
0 00.0
0:Q00
0 015
„Q
�0
Nickel
0
(0
()
(1(11
0:1fQ
0 �fl
8 QOfi
©8
0015o
w0.0
-A
Selenium
0 01,E
0 000R
©00 :
3 6 000
s�
0 QOQ
0 000=
T
Q 000
b 000.,000
©fl0.
QD0
; 000f
° 0 Q 15
,
Zinc
1 �56
, O.;OQO
Oa00i
00�0
0 000
�DOQ;
t OflO'
A 0:003000
t1000;''
gf0U40
] OSf:
Total.
f
p
. '
Phos-
$3 899
0 Q00
: '0 000
0 00Q:
0 000
0 000
0 000
0 QO(1000
0 O(f0
0 000
Q:.UOQ
8 899
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".
1/10/2017
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
Operator:
ANNUAL LAND APPLICATION y- 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
Larry Fogleman
Larry Fogleman
Crop 1 Name:
Fescue -Pasture
WQ Permit #: WQ0000520 Field #:
Annual Dry Tons Applied:.40A2 Site #:
Predominant Soil Series: DbB
Crop 1 Max. PAN
177
Crop 2 Name:
10 Acres Utilized: 26.4
AM126 Acres Permitted: 26.4
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
o
9
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,
Wet
Moist)
Precip.
Past 24
Hrs.
inches
Y
x o'
°a w,
*
o
;n h
1 -W
;
* w
Z
C
w
K
* N
*
TKN
mg/kg
Z
o
as o
w.
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1 1
Crop 2
Crop 1
Crop 2
4/26
214500
3.55
1.203
South Burlington
Dry
<.5"
S
0.5
0.3
62000
22300
2
55.477
NA
Fescue
4/27
58500
3.55
, 0:328 `:
South Burlington
Dry
<.5"
S
0.5
0.3
62000
22300
2
15.130
NA
Fescue
0.000
0.000
U 00.0
0.000 r,,
0.000
0 000
0 Q00:
0.000
0.000-
0.000
1100
0 000`
0.000
0 000
0.000
0.000
0.000
0.000
`o goo'
0.000
0.000
" °-oo-
0.000 :
o.000
'0 000
0.000 .
0.000
0
0
R 000
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000- -
o.0oo
TOTALS:
` 01
273(
As
Cd
Cu
Cr
Pb
H T
Mo
Ni
Se
Zn
P
70.607
0.000
Lime Applied
Annual lbs/acre
w;U 009
©Q0f
O S j0
0 615
0.046
O�OGi1;.
0 01r5.
O:Q28
U O15
I':056
F83.899'
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.196
0.092
8.506
7.2
1.03
0.035
0.303
0.881
0.164
17.886
Current Cumulative lbs/ac
:-;0_205
0 R. .
9 07¢
7 8'15
1.. ,W
U o3;6;.
0 31,$,
0.9Q9
0 179
1.8 942
Permitted C. P. L. R.****
36
34
1338
1 267
1 15
1
374
89
1 2498
Permit PAN Limit l st/2nd Crop
1?
..:.....................................................:...:........................................ .................... .
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
1/10/2017 **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): 29.07
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
C' Bator: James Brewer Owner: James Brewer Predominant Soil Series:
A.._ :,s Used: 14.5 Acres Permitted: 14.5 Site #: CH039 Field #:
GaB
i
Residual Analvsis Data (Heave Metals and Total Phosphorus use in&kg, % Solids use Raw Percent ft
Sample or
Com-
posite
Date
1
SB
10/10/16
_2j
3j
L.11L5J
6
L7J
L8
9
10
11
12
% Solids
3.46
Arsenic
3
Cadmium
2
Copper
195
Chromium
209
Lead
11.5
Mercury
0.4
Molyb-
5.14
Nickel
9.25
Selenium
5
Zinc
376
Total
Phos-
L_phorus
23600
I lal Heavv Metal field Loadings (Calculated in lbs/acre):
1 otal
1
2
3
4
5
6
7
8
9
10
11
12
DT/Ac./
c
App.
Event
2.01
Arsenic
0.' f
t�D.000
0.000 1
0.000
0.000
0.000
1 0.000
0.000
0A00
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
1 0.000
0.000
a:Q64
d-.V08
Copper
„0 "7$
t7;Q40
_ ..
k 0 40a
t� ��,.
(� Orb _ '
` 0 (�A0
� Q(?O
�- OU�
x 0 09D
D 4�0
-_
D OOS
� �5��`
Chromiu
0 83Z
0 OQO
0`000�,
OQ(i
0 00
0
0 O n
©Qtl
4 fl 0
0
f'(Q
...
...
.:
.:..
Lead
046
A"
s
Mercury
0 (U
Ok000
0 00.
000
0 000
O QfiO"
O�UQ
0 000
Q<('U
0(i0
Molyb-
yb
0 0
0 Q:00
0 00
Q 000'
0 000
0<00�a
= Qs
0 000
0 0,00
Oh000
0 000
0,0
0 0
denum
f
h
E.
�•.•:
Nickel
C)
0 000
0: Ol
` yr¢OUt
fl 000 a
0QM
(i
0 OQO
O A00
ty
Selenium
-An
,fl ®00
_ D:1J00.�i0
A OQ9
0 Q10 _'
b 0
Zinc
�f1i0
t 40.
0 Op
4 411D
0
508
,QUO
Total
-�
--
F.
='
Phos-
94 f
D 400
() 0 (,
0 O t •
00Q
t)� a `
® 09
0 RD
i1 QQO ._'
`0 000 _
0.060
0 :r 00 ::
94.6.36
7
horu$
r
,;
�
"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�.e 4;:�e_ 1 / 10/2017
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
Operator:
ANNUAL LAND APPLICATION Y 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
James Brewer
James Brewer
Crop 1 Name:
Fescue -Pasture
WQ Permit #: WQ0000520 Field #:
Annual Dry Tons Applied: „ ` 29 OP7 Site #:
Predominant Soil Series: GaB
Crop 1 Max. PAN: 157 Crop 2 Name:
CH039
Acres Utilized: 14.5
Acres Permitted: 14.5
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
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. Anima!
Waste, etc}
Soil
Cond.
(Dry'
Wet,
Moist)
Precip.
Past 24
Hrs.
inches
Y
c�
o w
o
c
w �;
N'
*
w
* w
*
TKN
mg/kg
Z Y
o
�•
mg/kg
Nitrate
and
Nitrite
mgikg
PAN Applied
(lbs/acre)
Name of Crop Type
p yp
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
11/28
156000
3.46
,1 552
South Burlington
Dry
<.5"
S
0.5
0.3
61400
17600
579
69 911 .
NA `.=
Fescue
11/30
45500
3.46
South Burlington
Dry
<.5"
S
0.5
0.3
61400
17600
579
20:'391
Nth. ,
Fescue
OGj�00
000 `
0 j(}OOa
60
P, ,100Q.k
0.000
Ot000$
"0 bfUeO
:0.000
.0.000 .
noo
b 00Q:
70.000
0.000o
ooa
roo
0.000
b b
Q oon
0.0000$06
0.000
Cl
0'
Residuals Applications totals on FORM
FSF supp (attach FORM FSF supp
to this form):
0.000
0.000
TOTALS.
"; ol
201500
; ;::::
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
90.302
0 0Q0 -
Lime Applied
Annual lbs/acre
br012
Q QO';$
0 782
0 838
0.046
0 002'
�° 0 021
0 037�,
t0_b20
1 508
1'94.636 :
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.081
0.04
5.404
3.376
0.481
0.02
0.158
0.302
0.102
12.003
Current Cumulative lbs/ac
0 093
©048
6 86
t 214
0.527
4022'.
0 179
0 339a
0122
13 51
Permitted C. P. L. R.****
36
34
1 1338
267
15
374
89
2498
Permit A Limit 2 P N L tt 1st! 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
1/10/2017 **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): 27.20
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
C" ,ator: James Brewer Owner: James Brewer Predominant Soil Series: GaB
A, 4s Used: 13 Acres Permitted: 13 Site #: CH039 Field #: 2
Residual Analvsis Data (Heavy Metals and Total Phosphorus use mg/ka, % Solids use Raw Percent #):
Com-
positei
ate
.
Total
P
..
.��
P }ai heavy ivietai rieia l,oaaings ki-aicuiarea in ips/acre):
1 ot;7 1 _2j L3J 4 5 6 7 J 8 9 [101 11 J 12
DT/Ac./ oy,
App.
Event 2.09
Arsenic 0.01.3 1 0.000 '0.000 0.000 0000 0.000 0.000 9,000 , 0.00.0 0.00.0 0.000 0.000 1, -0.013
Cadmium 0 008 0.000 0.000 0.000 0.000 0.000 0.000 0.00or 0.000' 0..000 0.000 0.000
Lead
Mercury 1 0 ,0 0:.000 0 OOQ a; 0 0 .0 0:000 U;000 . 0 00 0.000 0 000 0 000. 0.000 0:000 O.QO
Molyb- /y
Aan„rri 0 022 O.000. 0 000• 0 00"0 O.O:gO 0,0.00 0 OoO. 0 0,00, 0000 000 0000
Nickel 1
0,039
0 Q:00
0.000. `
' 0 000
0.000
0.000.
U ODU
0 0;00
0.000_
.,0 OU0
D.00'0
O OUO
0 U39=;
Selenium
0 021_
0 000
0 0�0 :
_ o 000
o aoo
o.oao
0 000
o oao
0;000 `
'0 000 -
0 Od0
11U00
~` 0 021
zinc
1 5 73
O, Ono000
` 0 004
0DOF
- 0:000 ;
' 0 000:
0 OQOv
0.000
; 0 000
0 df7t3
' 0:000"
_ 1 573
Total
Phos-
ohorus
98.342
0..000
.0.00.0
0.000
0:0,00
4.000'
0.000
0:.000
0:.000
� •0.000
0.0;00
000
98.742
"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
in- 'sonment for knowing violations".
;e-1,e z;-: `' 1/10/2017
Signature of Land Applier 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
James Brewer
James Brewer
Crop 1 Name:
Fescue -Pasture
WQ Permit #: WQ0000520 Field #:
Annual Dry Tons Applied: 27 20 Site #:
Predominant Soil Series: GaB
Crop 1 Max. PAN: 157 Crop 2 Name:
Acres Utilized: 13
CH039 Acres Permitted: 13
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
o =
A0
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)
Sail
Cond.
(Dry,
Moist)
Precip.
Past 24
Hrs.
inches
y
� 'n
�*
w
-�
o
%e
-
* rt'
7y
P
" ??
* w•
TKN
mg/kg
Z
ct
o
ao C
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
11/30
58500
3.46
0 649:
South Burlington
Dry
<.5"
S 1
0.5
0.3
61400
17600
579
19(.A2,°'
NA:: -
Fescue
12/2
130000
3.46
1.443
South Burlington
Dry
<,5"
S
0.5
0.3
61400
17600
579
• .64.W2'
- NA ,
Fescue
006
0:000
0 000'
b Q: 6 :.:,
0;000 "
t O Ooal,
0,.000
0:000
0 000r
abo
• O'000
a oao
osao
o 000
0.000
0 00,0�,
aao :.
'0.000:--
o
0-00
l)
0
� !
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
O.Df)0
0.OU0
TOTALS:
, : , 01
18850(1
:?:.:.:;:.:;:
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
94.224
o.000
Lime Applied
Annual lbs/acre
Q; U43 *,
`" xO�O8
0 81`6
0 874•,
U 048 -
0 002 ;
0 022:M
0 039
0 t) 1
,' 1513
{ 98.742 .:::::.::. :.:::::: :.: : :
.......... .
......:.::.....:.:::.:.'
::::.•
Date
Ibs/ac
Prior Years Cumulative Ibs/ac
0.084
0.044
6.178
3.98
0.545
0.025
0.176
0.347
0.114
13.041
Current Cumulative Ibs/ac
0.097
0.052
6 944k
4854
0.593
0 027A ':
0198
0 38
0135
14:614
Permitted C. P. L. R.****
36
34
1 1338
1
267
1 15
374
89
2498
Permit PAN Limit 1st/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
1/10/2017 **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): 10.31
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
C' -ator: James Brewer Owner: James Brewer Predominant Soil Series: GaB
A—s Used: 20.1 Acres Permitted: 20.1 Site #: CH039 Field #: 4
Residual Analvsis Data (Heave Metals and Total Phosphorus use mg/kz % Solids use Raw Percent #):
871prIVE
com-
posite
Date
©
©
©
0
Total
P
�.
.i�
E al
Heavy
Metal Field Loadings
(Calculated in lbs/acre):
1 otal
11
L2
3
4
5
6
7
8
91
10
11
12
DT/Ac./
0
App-
14
Event
0.51
Arsenic
O.d03
0 000
0.000
0.000
0.000
0.000
` 0 009=
0.000
0:000
0.000
0.000
0.000
0.003
Cadmium
0.002'.
:6.000
' 0 000.:`"
0 :000
0.000
. 0 `000
0.000
0.000
0.000
0.000
O.00U
0.000
0.002.
Copper
0 2�qQ
0,000
0 000
0,000
0 ,000
0.000
0 OOQ!
0 OOfl
0;000
'. 0 OOOa
0 000
0.000
e 0 2Q.
Chromium
0 214
O.000, ,
0 ,000
" , 0 000
0 0;00
Q.. 000
0 D00':
0 OUO
0`.000
.` 0 OOQ
0 Q00
0 0�00
0 214:
Lead
0 RI,
0 000 ,
Q 04fl
0 OQU
a a00 :.
00#?0
0 000
O.::OflO _.
QOOQr
fl OOQ
fl (300
, 0 01
Mercury
0 00.Q
0 000
U 000
r 0 000;
0 0,00
0; 000 y
" 0 000=
0 000
Q.000
_ 0 000 ,
0 000
0000
0 00
Malyb-
0 Q
0 000
Q 000�
0 Q00
0 000
0denum.000
0 OOO.r
0 0.00
O:A00
0 0.00
0 000
0:000
0 005
,
Nickel
0 009
0 Q00
.QL OoQ
. 0 000
0 (:iaQ
D=OOfly :
` 0 000.
0 000
Qt000
0 000'
0 000
0 :000
U 009
Selenium
0 00:
0 000
U 000
0 000'
0 000
0.000
0 ooq
0 0.Ofl
O;d00 .
0 000
0t000
0:.000"
A 005 .
Zinc
0 38fH
0 0.00
„ 0 000
0 000%
o 000
0 000
0 000.
o 000
0::000
o 000
0 000
0000
a 386
Totalv.
1'hos-
24 214
O Q00
. 0 OOa
0 fl00
q..000
0:'000 .
0 00.0
0.0,00
0:000
0 000
0 000
0..000_ .>
24,214'
horus
s
=
"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�f4;�- 1/10/2017
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
Operator:
ANNUAL LAND APPLICATION . xi,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:
James Brewer Annual Dry Tons Applied: 1:03:1 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
y �
Q°
Volume applied
enter one Solids/
( )
Liquid
Cu. Yds Gallons
o
10
Solids
Volume
Applied per
pp • p
Acre
(Dry Tons/AC)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry,
e '
Moist)
Precip.
Past 24
Hrs.
inches
a
co 'F
a P
o
7y w
�,
* w'
�
w -,
r
*
TKN
mg/kg
z��
o R
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
11/28
39000
3.46
Q280.
South Burlington
Dry
<.5"
S
0.5
0.3
61400
17600
579
12.608
NA
Fescue
12/2
32500
3.46
` ":3
South Burlington
Dry
<.5"
S
0.5
0.3
61400
17600
579
10507
NA
Fescue
,0 000 =
0.000
0.000
0.000
0,000
kd 000;.
0.000
0.000
oo"
0.000
0.000
0 000;
0.000
0.000
'
0.000
0.000
0000. V
0.000
0.000
"o 000
0.000
0.000
0.000
0.000
0 OOU
0.00o
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:
ti
71500
::::::::::::::
As
Cd
Cu
Cr
Pb
Hg,
Mo
Ni
Se
Zn
f
23. ► 15
0.000
Lime Applied
Annual lbs/acre
�" 0 OA3
tl 00.2 '
0.2Q0
k Q: 14
0.012
0 000°
x 0 00
0 OQ9 '
O b05
_ Q:386
` � 2l4 : :::::::::::. :` ; ;:;
..................
Date
lbslac
Prior Years Cumulative lbs/ac
0.022
0.015
1.966
1.368
0.164
0.013
0.04
0.122
0.026
3.891
Current Cumulative lbs/ac
`0 025 .
0 017
2.1'¢
1.582
0 176
0 013,
... 0 045
0.131
. .
0>031
4 2Z7
Permitted C. P. L. R.****
36
34
1338
267
15
374
89
2498
Permit PAN Limit 1 st/2nd Crop
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
1/10/2017 **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): 79.73
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
f +ator: James Brewer Owner: James Brewer Predominant Soil Series: GaB
A. es Used: 30.7 Acres Permitted: 30.7 Site #: CH040 Field #: 1
Residual Analvsis Data (Heavy Metals and Total Phosphorus use m2/k2, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
SB
10/10/16
2
3
4 1
5
6
7
8
9
10
Li12
% Solids
3.46
Arsenic
3
Cadmium
2
Copper
195
Chromiwn
209
Lead
11.5
Mercury
0.4
Molyb-
denum
5.14
Nickel
9.25
Selenium
5
Zinc
376
Total
Phos-
chorus
23600
F Im heavy iweiai r ieia Loaaings kL aicuiaiea 1n IDsiacre):
Tot 77 F17 2 3 L4J L5J 6 7 8 9 j LOJ 11 j 12
DT/Ac./
App-
Event 2.60
Arsenic 1 0.016 1 0.000 0.000 0.000 0.000 1 0.000 0.000 0.000 0.000 0.000 0,000 0.000 0.016
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
Lead
0 060
0 0:00
"'0 000 :
0 000:
0 Q:00
0 000,
' 0 OOp.,
0 (100
0000 ''
0 OOU`
0 000
0. 000
, . 0 060-
Mercury
0 002
0 000
0 000
`' 0 000'
0 U'00
0' 000
0 000=
0 0.00
OOOQ
r 0 0Q0:'
0 00'0
0 000
0
Molyb-
0 027
0 000
gr
0 000" ,
0 000
0 000
n
0 000
`0 000
0 000
0 000
0 00
z
0 000
0.000
0 027
denum
_.,
Nickel
' 0 04$
0 U'00
4 000
' 0 00.0
0 000
0 000
0 000 =
0 000
0000
" 0 000
0 000
0 000
0 048
Selenium
0 "26
000
0 000
0 000
0 600
O':000
0 000
0 000
0;000
: " 0 000?
0 OQ:O
0000
0 026'.
Zinc
1 953
0 Q00
„Q." 000
- 0 000?
0 O;UO
0; 000
_ 0 000
0 000
0.000
w, 0 0,00
0 00;0
0 000
a 95'3-,
Total
Phos-
122 5'78
0 .000
y 0.004.. .'
0 000
0 000
0 000
X' 0 000
0 040
Q 000 -
0,000-1
0 0'00
0` 000
1 22.578
,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".
/e� 1/10/2017
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
ANNUAL LAND APPLICATION ik: LLD 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
Operator: James Brewer
Crop 1 Name:
Fescue -Pasture
WQ Permit #: WQ0000520 Field #:
Annual Dry Tons Applied: 79 73 Site #:
Predominant Soil Series: GaB
Crop 1 Max. PAN:
158
Crop 2 Name:
CH040
Acres Utilized: 30.7
Acres Permitted: 30.7
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
O
Q
Volume applied
enter one Solids/
( )
Liquid
Cu. Yds Gallons
o
/a
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
>
r;
c m
* o
c
7y �•
-
* N
4
w
*
�3
TKN
mg/kg
Z
o
M 0
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
12/2
13000
3.46
0:01
South Burlington
Dry
<.5"
S
0.5
0.3
61400
17600
579
.26752
NA'.
Fescue
12/3
208000
3.46
0:978 "`
South Burlington
Dry
<.5"
S
0.5
0.3
61400
17600
579
'�44:02T `
r N,
Fescue
12/10
156000
3.46
0..73,3 „
South Burlington
Dry
<.5"
S
0.5
0.3
61400
17600
579
33,020
°°t l ,'"
Fescue
12/13
175500
3.46A;825
: '
South Burlington
Dry
<.5"
S
0.5
0.3
61400
17600
579
37.148
NA
Fescue
o:000 ''
n.000
0 ooQ�:
o boo
a�tr o
'o o°d
0A0o
bE©ov '
0.000 '
000: Y
0.000
0 000`
0' 000
0.000
0`00f3
0' 000
0,000
0 000
d00 .r
0.000
0,000
it
0tp.Q,O
Residuals Applications totals on FORM
FSF supp (attach FORM FSF supp
to this form):
0.000
0.000
...
..........
TOTA1
°" 01
552500
, ,.::, ,..,:
As
Cd
Cu
Cr
Pb
FigMo
Ni
Se
Zn
P
116.946
0t000`
Lime A died
Annual lbs/acre
Q` Olc6 '
= 0 01t.0 '
1013
1086
;O pFt°)O
OOP ,t
0 027
hhQ48'
((1, U26 r
+� 1 `953
;1:22.578 ::
: >: >::=: :=":= :::::=:::= < :='
................. ........
.............I..............
.. ....
Date
Ibs/ac
Prior Years Cumulative lbs/ac
0.143
0.087
14.105
5.255
1.183
0.055
0.349
0.826
0.156
24.656
Current Cumulative lbs/ac
0 159
0 097
.. _
15 118
6 341 Y'
L 2437
- 057"
,.
0 3 76;
0 8T4
'„ 01
26 609
Permitted C. P. L. R.****
36
34
1338
267
15
374
89
2498
Permit PAN Limit lst/2nd Crop
p
,............ ....................... ,.... ,.
15g .
"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
1/10/2017 **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): 15.3:9
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
C-' 7ator: Bobby Cooper Owner: William Brookbank Jr. Predominant Soil Series: CmB
A_ 6s Used: 13.2 Acres Permitted: 13.2 Site #: CH098 Field #: 7
Residual Analysis Data (Heavy Metals and Total Phosphorus use m0kiz, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
SB
3/14/16
_jj
3j
4 J
151L6J
7
81
9
10 j
11
12
% Solids
3.55
Arsenic
3
Cadmium
2
Copper
186
Chromiuni
201
Lead
15
Mercury
0.4
Molyb-
de um
5
Nickel
9
Selenium
5
Zinc
345
Total
Phos-
horus
27400
E ai
heavy ivietar r ieia Loaaings
kt-aicuiarea in iasiacre):
1 otal
Ej
2
4]
L51
6
7
8
9
10
Li12
DT/Ac./
y
o
App.
Event
1.17
Arsenic
0 007'
0.000
0.000
0.000
0:.000 -
O.-o
0:000
O.00O
0.000
0.000
0 00.0
0:00;0
0.01
Cadmium
0 -005
0.000
0.000
0.000
0.000
0.000
'0 0'00
0.000
0.000
0.000
0:000
0.000
0.01
Copper
0 45.4
0 000
0 000
. 0 000
0 q;00
"0 000 ,
- 0 000
0-000 .
,0` 0•QO
0 000,;.
Q-A
0 000
';: 0.4
Lead
Molyb-
0 012
.. ,
0 000
0 000 ;;
0 000'
0 OUO
0 000 -
`, 0 000'
0 000
0;000
0 000 "
> O 00'0
0000
0 012,
denum
Nickel
0 021
0 000
"0 000,
` 0, 0000
000,
000
:> 0 000
Q 000
O'000
000
0 00:0
0000
0 021
,fl
Selenium
0 02
0
000
0 000
'
0 OOO
0 0"00
0 000
` 0 000N:
0 000
0000
0 000 -
0 00:0
0 000
0 -012
Zinc
0 SOS
0
Q00 ;
Q 00.0
0 000;
O.OoO
0: 000 ,
0 000
0 000
0.000
0 000.
0 000
0.000
0 805.
Total
s
£
Phos-
63 $97
0 060
b `
0 000'
0 000
a O:.000
0 00
0 000
0`.000
' 0 OOQ_
0 00.0
0,.000
63 8,97.
horus
a
"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".
1/10/2017
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 #: 7 Acres Utilized: 13.2
Land Owner: William Brookbank Jr. Annual Dry Tons Applied..,' ' 15 39 Site # CH098 Acres Permitted: 13.2
Operator: Bobby Cooper Predominant Soil Series: CmB Cation Exchange Capacity (non 503): 0
Crop 1 Name: Fescue -Hay Crop 1 Max. PAN: 189 Crop 2 Name: Crop 2 Max. PAN:
°
o
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.
(Dry,
Wet,
Moist)
Precip.
Past 24
Hrs.
inches
y
�'
w,
o
;v
w
7y �
w
* N
TKN
mglkg
Z a
a
o
°�
�•
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop ]
Crop 2
Crop 1
Crop 2
4/9
104000
3.55
!''1.166� n
South Burlington
Dry
<.5"
S
0.5
0.3
62000
22300
2
53.796
NA':
Fescue
Q6000...
0.o00.O.00O
T
o` 000
0.000
0.000
�a 000
0.000
a000
. .
O,OOo `.
0.000
0.00o
6 =
0.000
0.00-0,. n
.x00o
0.000
;i000
0.000
' Oab00
0.000
O.OQp,
0,000
0 606Aw
0�000"
0.000
0 oboes
d Qoa s
0.000
0.000
>.......
0
xd .0..,.
::
;, 0,0'0 ,�a
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000
0.000
.. .. .
....
TOTALS:
01
104000
;•:;:;•::::::
As
Cd
Cu
Cr
Pb
H"
Mo
Ni
Se
Zn
P
53.79F,
0 Ool'':;
Lime Applied
Annual lbs/acre'Oo
30`OUS
4 44 F
.. 0;469
0.035
0 Qo2'..
�K?l
0 021x ..
. f#I2
' 08053:897
. ::.:.:::: ....
............
......... ........ .
...........
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.031
0.019
2.191
1.854
0.358
0.008
0.048
0.134
0.048
5.166
Current Cumulative lbs/ac
4 b3�
tb,02?4
2'625
2:323
0 3931.
-- 0 00
0 060
0 15`Sr t
>Q:060 ,
'a:971
Permitted C. P. L. R.****
36
1 34
1 1338
1
1 267
15
374
89
2498
rmit PA i 2 Pe N Limit 1 st/ nd Crop
........
18 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 property 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
1/10/2017 **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): 24.06
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
C" 'ator: Bobby Cooper Owner: William Brookbank Jr. Predominant Soil Series: CmB
A... e"s Used: 17.1 Acres Permitted: 17.1 Site #: CH098 Field #: 8
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
SB
3/14/16
_2j
3j
4
5
6
7
1 81
L9 J
10
11
12
% Solids
3.55
Arsenic
3
Cadmium
2
Copper
186
Chromium
201
Lead
15
Mercury
0.4
Molyb-
enum
5
Nickel
9
Selenium
5
Zinc
345
Total
Phos-
horus
27400
.1 tai
tieavy metal view i�oaaings
(uatcuiatea in iusiacre):
i otal
11
2 J
3
4 J
5]
L6J
L7J
8
9
10 j
11 j
12
DT/Ac./
0
App.
Event
1.41
14
Arsenic
0.009:
0.000
0.0001
0 00:0
0.,000
- `0.000
0.000
0.000
0.000
0.000
. 6.00fl
0.000
0.008
Cadmium
0.006
0000
.. 0.000'
0.000
0:0.00 ..
:0.0.00
0.000'
0..000
0.000
0.000
0.000
0.000 '
0:006
Copper
0 523
0,000'
0.000
. 0 000.
0.000 ,
00.0
_ 0 00.0`
0.000
O',0.0U
0 000
0.000
0:000,
0.523
Chromium
0 56;6
0000 :
0 000 ,
0 1000
0 000
0 000
0 000:
0:0`00
-0:000.
0 000
0.000
0.000
0.566
Lead
0 042
0 400
0 000
0 000
O Oa0
0 OOa:.
` 0 000`
0.000
Q.000;
0 0oo
0.000
0.000
1 0:042
Mercury
0.
0_ 0 000 ,
0 000
0 000
0 0:00
0.000
„ 0 000
0 0'00
0000
0 0-00'
0:0.00
0.000
Molyb-
0 0 4
0:000
0 000 .
0.00-0
0.0:00
0 000
" 0 00`0
0_000
0..000._
0 00.0
O.00:U
0:000
0.014.
denum
Nickel
0 025
b 0.000
;.
0 000 .
0.. 00.0
0 000
0; 000`
. 0 000°
0 000
O':000
0 000°
0 0:0`0
0:000
0 025 .
Selenium
OT 014
0:000
0 000
0 OO..
6.64.
f 0: 000
0 000
0.000
6000 .
` 0 000
0.0Q0
0:000
0.014
Zinc
0 971.
0 000
0 000
0 000,
0 Q:00
0 000 .
0 000
0 000
0 ;000 '
0 00:0 .
0 00:0
0000
0.971
Total...
.
Phos-
77.t04
0;000
0 000
= 0.000
0-6003j
0.000
0 GO.-
0.000
0.000
0.000
0..000
0 000
.77.104
ohorus
"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".
2!y_ _ 1/10/2017
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
William Brookbank Jr.
Bobby Cooper
WQ Permit #: WQ0000520
Annual Dry Tons Applied:,,,
24 06
Predominant Soil Series: CmB
Crop 1 Name: Fescue -Hay Crop 1 Max. PAN
Field #:
Acres Utilized: 17.1
Site #: CH098 Acres Permitted: 17.1
189 Crop 2 Name:
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
'115.(enter
+- o
Q
Volume applied
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
Ms.
inches
a
T�
a b
o'
o
o
`-
0
K
PJ
w
CD F-
0
TKN
mg/kg
Z
ct
o
°�
CD w.
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(1bs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
4/11
162500
3.55
407
South Burlington
Dry
<.5"
S
0.5
0.3
62000
22300
2
64.886'
N .:
Fescue
0 Ooo
0 OOd
000
0.0,4
0 000 . "
0000
9,11100
0,000
0 40A
Oc00()
0.00o
n
0.000
7.0 40U
6:000
k000
0..,_
" '0 .._:
�+;0 000
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
O'A00
OfOo
TOTA1 :
"' u
I Uzst�o
;:; ::::::::
As
Cd
Cu
Cr
Pb
H
Mo
Ni
Se
Zn
P
6'4.H8b
O;A<Q0 `
Lime Applied
Annual lbs/acre
*.Oy008
`0 0t).Fr
0 Sg3
4;566
()A42
C� OOII
�0. a1r
li}'la
t�-0?fl14 i
fT9
77.to4 ..:::..: ,
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.028
0.018
1,847
1.677
0.278
0.006
0.045
0.119
0.045
4.808
Current Cumulative lbs/ac
} ° Oy036
s.
_..
320
0 007
0 059 °'
b 1;4d
0 ;059
5 779
Permitted C. P. L. R.****
36
1 34
1 1338
1
1 267
15
1
1 374
89
2498
Permit PAN Limit lst/2nd Crop
..:.. .
189
"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
1/10/2017 **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: Bobby Cooper Owner: William Brookbank Jr. Predominant Soil Series:
A,_.s Used: 20.4 Acres Permitted: 20.4 Site #: CH098 Field #:
22.50
CmB
9
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
SB
10/10/16
2 j
_3j
4
L5J
6
7
8
9
10
11
12
% Solids
1 3.46
Arsenic
3
Cadmium
2
Copper
195
Chromium
209
Lead
11.5
Mercury
0.4
Molyb-
en
5.14
Nickel
9.25
Selenium
5
Zinc
376
Total
Phos-
horus
23600
"lal Heavy Metal Field Loadings (Calculated in lbs/acre):
x Otal
11
7
21
3
4
5
6
7
8
9
10
11
12
DT/Ac./
0
App-
Event
1.10
14
Arsenic
- 0.007
D ODD.,
0.000
0.000'
�0.000
0.000
n fl 000
fl D00
0.0000,000
0.000
0.000
0.007
Cadmium
g.- 04
0.00v
0.000
0.000 -
0.000
0.000
0.000
0.000
0.000
0.Ct Q.-�
0.000
0400 .
O.Uf 4"
Copper4flfl
(rQQ00
l.t#A
Q
0 QliO
0 flOt)
(©.
0 aElt
0 0
0:,0
;
,.
;
µ�
Chromium0
461
9d0
d(..:_.
OOCI
0v0
0;0.0..
�.-
0 6
D nOD;°Qlll
;3.0ti
fl II1T
0 40 .
1
Lead
fl 025
000
f! ©fly:''
fl �()
D 000
Oi '�t3QO
0Ofl
6 03
Mercury
©0�_1
0.000
U 4 r�
p 40f
0 00
0:
0��`
0 0 Q
0;0 0..°.
OQ,a;
O'QOaO
D=.fl00
X
-.s-'
Molyb-
D 011
x
0 OOD
��
Q 0
3,
O,Ot O
D ODD
D: _Q
, �:
OD
0 OOD
D,OOD
u
�0 0Dr
D OQO
D OflQ
Or01�1
Nickel
OMO2O°
D.000
fl DD+
}' QDD�
0 OQOO
D
t#f r0
3 D DOD
D':,D3D
D DDD
D
Selenium
{
03 Offa
. 0_QQ;I
,
;
zinc
fl
y ®aa,
, ©<Q
D _
,_o
fl o
:
.4.flQ
o�
- `0s
Total
Phos-
52z'(lb
0.00(I
0 00(
O�OIIfl
0 flOfl
004
(100°
y 0(i0�
QDO©;
O�flD _flb
(1 _D00
fl
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
fir -;$onment for knowing violations".
;!!YY 45"_ 1/10/2017
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

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.
Facility Name: City of Burlington WQ Permit #: WQ0000520 Field #: 9 Acres Utilized: 20.4
Land Owner: William Brookbank Jr. Annual Dry Tons Applied::. 22, 50k a Site #: CH098 Acres Permitted: 20.4
Operator: Bobby Cooper Predominant Soil Series: CmB Cation Exchange Capacity (non 503): 0
Crop 1 Name: Fescue -Hay Crop 1 Max. PAN: 189 Crop 2 Name: Crop 2 Max. PAN:
0
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(DryTons/Ac)
Residual Sources
(NpDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry,
Wet,
Moist)
Precip.
Past 24
Hrs.
inches
Y
4 'b
s; a
0 w
o
o
w
•*.
�
7y
°o
TKN
mglkg
Z �
=t
o
mglkg
Nitrate
and
Nitrite
mg/kg
PAN Applied
1bsJacre
( )
Name of Crop Type
Receiving Residual
Application
Crnp 1
Crop 2
Crop 1
Crop 2
12/31
156000
3.46
il..l':0.3; ;`
East Burlington
Dry
<.5"
S
0.5
0.3
61400
17600
579
49.692
NA
Fescue
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0,000
000
0.000
0,000
0.000
0.000
anouT ="
0.000
0,000
l) 0;0'0 ' ,
0.000
0,000
;oao4ar
.."
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
0.000
TOTALS:"'
n
i 6i oo:::::::::::::
As
Cd
Cu
Cr
Pb
H
Mo
Ni
Se
Zn
P
49.692
o.000
Lime Applied
Annual lbs/acre
0.0250
00
q 6I1
0 020
�0 D110
82I,
;52.062 :::::::.::< ::
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.028
0.018
1.828
1.654
0.276
0.006
0.044
0.118
0.044
4.765
Current Cumulative lbs/ac
n 4.;0 Q3
a0 02
2 28 r.115
0.301
OS1R:_
a;QS
U3i?
55 Y5
54
Permitted C. P. L. R.****
36
34
1338
267
15
374
89
2498
Permit PAN Limit 1 stl2nd Crop
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
1/10/2017 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobialIy digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loadine 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): 20.21
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
C' `ator: Bobby Cooper Owner: William Brookbank Jr. Predominant Soil Series: CmB
A,_ A Used: 10 Acres Permitted: 31.8 Site #: CH098 Field #: 10
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
—11
SB
3/14/16
21
31
41
5
6
7 1.
8
9
10 1
11
1�
% Solids
3.55
Arsenic
3
Cadmium
2
Copper
186
Chromium
201
Lead
15
Mercury
0.4
Molyb-
denum
5
Nickel
9
Selenium
5
Zinc
345
Total
Phos-
[)horns
27400
f iai
heavy ivietai r ieia l.oaaings
(uaicuiatea in ins/acre):
i otal
1
L2J
L3J
L4J
5
6
7
8
9
10
11
12
DT/Ac./
0
App.
Event
2.02
Arsenic
0.012
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0:000
0:0100
0.000.
q 01-2
Cadmium
0. 008
..-
O:Qo"Q°'
0.00
0.000
0.000
0.000
0 0.00
0:000
0i.000
;. 0,000
0..000
° 0:000
#" �0,008
Copper
Q.752,
- 0.00,0
U 000
` . 0 000
9.000
6000 ,,,
; 0.000
0.0:00"
0.000 .<!.
0 000
0.:000
O;;000 ,
.. 0 752 '
romiu
Lead
Molyb-
0 020
0.000
s,
Q 000 :
0.00
0 000
0 000
0 000``
0.0°OQ
0000 `:
0 0.00
0 OQ0
0 000
.
0 020
den UM
Nickel
0 03G
0 U00
0 000
OW
0 0°00
0 000
0 000
0 O60
0000`
0 000
0 00.0
0:000
, '0 036
Selenium
0 020
0 000,
0 000
0 000,
0 Q00
0- 000
0 000
0.0b0
0;000 =
0,000-
0 000
O:Q00
0 02Q
Zinc
1 394
0 000
0 000.
0 00.0
0 Q0o
0` (f00
: r 0 000
0, OQ0
Q 000
0 OOQ
0 00:0
0 Q00
;: 1 394;,
Total
Phos-
110..751
. 0 000
0 000 ,
0.0'00
0,00
0 0D0 :
T_ 0 000
0.:0:00
11'.000
. 0mo
0 OQO
0.000
110 751:
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
iir ;sonment for knowing violations".
t�f4:2` _ 1/14/2016
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
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
William Brookbank Jr.
Operator: Bobby Cooper
Crop 1 Name:
Fescue -Pasture
WQ Permit #: WQ0000520 Field #:
Annual Dry Tons Applied ' Y; =20 21- Site #:
Predominant Soil Series: CmB
Crop 1 Max. PAN:
141
Crop 2 Name:
10 Acres Utilized: 10
CH098 Acres Permitted: 31.8
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
Volume applied
pP
Volume
Residual Sources
Soil
Cond.
Precip.
Y
b
C
o
�
Z Y
�*' �
Nitrate
PAN Applied
Name of Crop Type
p yp
0 5
(enter one) Solids/
%
Applied per
(NPDES #, WQ#,
Past 24
4 'd
w
m
TKN
8 o
and
(lbs/acre}
Receiving Residual
A
Liquid
Solids
Acre
Fert., Animal
(Dry'
Hrs.
0
* v
0
Nitrite
Application
Cu. Yds Gallons
(Dry Tons/Ac)
Waste, etc)
Wet,
Moist)
inches
* o
°
4
mg/kg
mg/kg
mg/kg
Crop 1
Crop 2
Crop 1
Crop 2
4/8
136500
3.55s021
:•
South Burlington
Dry
<,5"
S
0.5
0.3
62000
22300
2
93.202
1�IA; .._
Fescue
0.000
0.00%
O OOa
0.000
0
o Qoo
o.000
Q, oot?
0.000
� o`ao�3
0.000
o Q iO ,
,,Ooo
o.t►00
o obb *a
0.000
30 00,0'
'o 000 ':
0.000
k000
0.000
b oao"'
:'b Aoo
o.000
0 ooa
r d OOQ
0.000
16
4-o
0... W 4";
0 000
Residuals Applications totals on FORM
FSF supp (attach FORM FSF supp
to this form):
0.000
0-000
TOTALS.
136500
;:;:.:; :; ::
As
Cd
Cu
Cr
PbrHMo
Ni
Se
Zn
P
93.202
�0 00,
Lime A lied
Annual lbs/acre
O �d :.
�'°0 oQ8
0 7
Q:812 f''b,061
0m2Q
{}43
(Yt120
, 1394�
1,410.751 ..:>%..:.::::..:.:..:%
:::::::::::::::::::::::::::::::::::::::::':FCurrent
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.186
0.102
11.375
4.797
1.774
0.295
1.276
0.19
32.705:
Cumulative lbs/ac
198 . .
0 11024127
5,6Q9
1.835
Q 31
13i2"
0;210z
34 099Permitted
C. P. L. R.****
36
34
1338
267
1
374
89
2498
ermi Limit
P t PAN >m> t/2nd Crop
t 1s
4 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."
�1 *Application Method: S - Surface, IN - Injection, INC - Incorporation
z� 1/10/2017 **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): 51.97
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
C" 'lator: Charles Lutterloh Owner: Charles Lutterloh Predominant Soil Series: NaB
A._ .;s Used: 22.2 Acres Permitted: 22.2 Site #: CH251 Field #: 1
Residual Analvsis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Com-
posite
Date;10000000M
NONE
Total
P
ii
E 'ial
Heavy Metal Field Loadings
(Ualculated in lbs/acre):
1 otal
1
2
3
4
5
6
7
8
9
10
11
12
DT/Ac./
App.
v
Event
2.34
Arsenic
0.0 14
0.0"00
0>000
0,0:00
0Q.00
0 000°
..0.000
0.000
0.000
0.000
0.000
000"0
0.014
Cadmium
0 009
0.000 :
0 000
0.000
0.000 .
0 000
:" 0, 000
0.'000
0.00'0
0 00-0
0".000
0::000
0.009
Capper
0 87
0:000
0 000 ':
0 000
0 a00
0 000
0.000
0 Q00
0.000
0 OOfl:
0 00.0
. 0..000..
0.8,71
Chromiu
0.941
' 00
_ Q. 000.
0 00:0
0 Q00
0. 000
'" 0 OO i`
0 ao0.
Q.00O
0 OQO
0 0. S0
0.000 :.
0 94.1
Lead
0 074
0:000
0 000 '
0 OQ.O
0.000
0 000
0 000
0 000
0:000
0 000
0 OOO
0000
0 070
Mercury
0 002
D 000
` `6 000
0 Q00
0.000
0 OOA
0 000
0..000
0.00:0 °
0.000'
0 000
0 ;000 "
-. 0 002
Molyb-
0 023
0:000
0 OQO
0.000
0 0:00
0 000 ;
` 0.00:0.
0 0;00
0.000
Q:000
0 000
.0,000
0.02
d
1.
Nickel
0 042
0 Q00
Q 000 ',
0 000
0 OQO
0 000 ':
0 000
0.,000
0"000`
0 000
0 000
" 0".D00
0 042
Selenium
0 02.3
0 000
Q 000
0 000
0.000
0.60 0
0 OQ0
0.0'00
0.000 '
` 0 000
0.000
- 0.000
0 023.
Zinc
1 615
0.000
0 000 '
0 000
_.
0 000
' 0 400"
0 000"
0 0a0 ,
0:000
0.000
0 000
U.000
1 615`
Total
Phos-
128 2-87
0i000
0 00Q
= 0.000
o..U°o0 _
{l00
0 oao
1j.OQ0
. `o.Ooo
0.000
a 000
0000 112
Uhorus
1.0
"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
it -isonment for knowing violations".
Z� 4�e- 1/10/2017
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
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
Charles Lutterloh
WQ Permit #: WQ0000520 Field #:
Annual Dry Tons Applied: "51.97s,. Site #:
Operator: Charles Lutterloh Predominant Soil Series:
Crop 1 Name:
Fescue -Pasture
Crop 1 Max. PAN:
135
NaB
Crop 2 Name:
CH251
Acres Utilized: 22.2
Acres Permitted: 22.2
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)
Residua] Sources
(NpDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
(DrY
Wet
Moist)
Precip.
Past 24
Hrs.
inches
b
°
0
* 0
o
* w
w m
* N
�m
p
TKN
mg/kg
Z
w
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN A lied
(lbs/acPe)
Name of Crop T
p Type
Receiving Residual
Application
Crop I
Crop 2
Crop 1
Crop 2
4/24
234000
3.55}.''1
560 '."
South Burlington
D
<.5"
S
0.5
0.3
62000
22300
2
71 970'--
NA°" '
Fescue
4/21
117000
3.55
0 7,SU
South Burlington
D
<5"
S
0.5
0.3
62000
22300
2
33985
CIA=` iz`
Fescue
„ 0 000
. 0i400.•,
4,000`
�a00:o
,0 r000
0.000
0 00 -
x �w0' OOQ
° . 0 oo4
0 40I)W
0 00o d `..
w000
U'000
O7000
Q 0Ot). .
h� '0 OOp w
' ` 0.004
4.0o0
o.000
0
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0,000
0,000
TOTALS
01
351000
As
Cd
Cu
Cr
Pb
H V,
Mo
Ni
Se
Zn
P
107.956
0 000--"
Lime Applied
Annual lbs/acre
0 014 ;..
�0 0*5.
�rQ 871
Q„941
0.070
tl 002L"
! 4 023
©426`023�
;Y 675"I
X'28.287
.:::::::::: ;_ ::::`>:
?
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.1836
0.1819
28.3199
10.5736
3.3556
0.0996
0,872
2.1874
0.1617
44.8468
Current Cumulative lbs/ac
4 19$
©IJ1
29 =1191
411515
3-426
0 LOi
0 &�
2 230 x
0 SB5
4b 4ti2
Permitted C. P. L. R.****
36
34
1338
267
15
374
89
2498
ermit P Limit nd Cr P AN L t l st/2 0 p
-
3 "
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
1/10/2017 **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): 45..81
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
C '�ator: Charles Lutterloh Owner: Charles Lutterloh Predominant Soil Series: GaB
A... es Used: 27.8 Acres Permitted: 27.8 Site #: CH251 Field #: 3
Residual Analvsis Data (Heave Metals and Total Phosphorus use me/ke, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
SB
9/12/16
2
3
4
5
6
7
8
9
10
11 ;
121
% Solids
3.25
Arsenic
3
Cadmium
2
Copper
158
Chromiuni
164
Lead
13.6
Mercury
0.5
Molyb-
denum
5
Nickel
8.42
Selenium
5
Zinc
300
Total
Phos-
phorus
21400
f iai heavy lvtetal r iela
i-aicuiatea in ips/acre):
Total
LID
L 2 1
3
4
Lbj
6
7
a
V
2u
2z
DT/Ac./
0
App.
Event
1.65
Arsenic
0..010
0,000
0 000
O.00:Q.
0.000
0.000
..
' 0.000
0.000
O.OU.O .
" 0.000
0 000
0,00o
uw
Cadmium
0..007
0.000 .
, `0.o00
0600
0 000 '
._0.:000
0.000
0..600
0,o00
0.000.
0:000
0,000
' 0:007
Copper
0.52`1
=_0::000
0 000
0 0.00
0:000
UK
1O.000:
0.0 . 001
0:000`
0 000
Q. 0;00
0.000
. 0.52
Chromium
0.541,
0 00.0 ,
0 9 0.
0.600
6.000
0 000
0 000.
o o
0:000
0 000.'
0 0:00
0-.�000
' 0.541
Lead
0.045
0:000•
0 000°
0 000
0-000 ..
0 0,
0 006
0 000
0.000
0.000
0 000 „
0.000
0.045
Mercury
0 002 .
0.600
0.000
0.00:0
0,.000 -
0 000. ;
0 Q00
0 000
6.000
0.000`
0 00;0
0 000
0:002
Molyb-
denum
0.01;6
0.000
0.000
0.000
0.00;0
0.000.
0.000,
0.000
0.000 ..
9.000
0.000
0.000
-0.016:
Nickel
0 02`8
0.000
Q OOQ
„ 0.000
0..000
0 000 ;''
_ 0 000''
0.000
0.000
0.000
0.0000._000
.: 0.0218
Selenium
0.016
6.000
0.000.
0 0.00
0:000
O. 000
O.00Q
0600
.0.000
6.060
0.000
0:000
'' 0.016
Zinc
0.989 .
0:000
0 60,0 !
O:000
0.000
0 000
0 000.
0 OQO
0:.000
0.000
0.000
0 000
0.999
Total
Phos-
70.534
0.000
0 QQO
0.00.0
0.000
0.00.0:.
0.000
0.000
0.000
0.000
0.000
.0.000- .
7-0.534
"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".
1/10/2017
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
ANNUAL LAND APPLICATION � LLD 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
Operator: Charles Lutterloh
Crop 1 Name:
Fescue -Pasture
WQ Permit #: WQ0000520 Field #:
Annual Dry Tons Applied: 45 81' Site #:
Predominant Soil Series: GaB
Crop 1 Max. PAN:
158
Crop 2 Name:
Acres Utilized: 27.8
CH251 Acres Permitted: 27.8
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
-75
r.(enter
Q
Volume applied
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
�Y
'�
o
0.* o•
o
w
'"
N
* rt
4
w `ti°
CD
* N
*
TKN
mg/kg
Z >
o �
5
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
10/26
162500
3.25
0 792 '
South Burlington
D
<5"
S
0.5
0.3
58300
19000
8
33:.744
NAB,."
Fescue
10/27
175500
3.25
South Burlington
D
<.5"
S
0.5
0.3
58300
19000
8
36 444
36 444�
A 000
'"0:000
U 000.
�U 000,
K 0 000
0.:000
0 Ob , :.
O'000'
0` 000'
0 OOQ r
0 000
0t060 c
0 OQQ,
0
n-``'
0 OOiI • ,
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0,000
0.000
TOTALS:
0
338U0[1
, • • •::::;:
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
70.188
36 444''
Lime Applied
Annual lbs/acre
0 010 , :
0 007
0 521
0541
0,.045
0 002;..
0 016
0 028
O'016
Q 989
^0.534 :::::::::::::::::::: ::::
:::::::::::: :::::'::.:'>:....::._.......
:......... .. ....
:.:.::.:.:.:.::::::: • :::::::: • :::
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.216
0.248
25.568
10.245
1.939
0.104
0.944
1.819
0.198
45.156
Current Cumulative lbs/ac26
Q89
x LQ 78(Y
' 1,84 F,
: 0 106
0 960
) 847
0214'
46 14
Permitted C. P. L. R.****
36
34
1338
267
1 15
1
1 374
1 89
1 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."
1 *Application Method: S - Surface, IN - Injection, INC - Incorporation
1/10/2017 **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: Charles Lutterloh Owner: Charles Lutterloh Predominant Soil Series: NaB
A_ A Used: 4.9 Acres Permitted: 4.9 Site #: CH251 Field #: 4
Residual Analvsis Data (Heave Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
..1_121
SB
9/12/16
3
4j
L6J
L7j
1 81
L9_1
10
11 '
12
% Solids
3.25
Arsenic
3
Cadmium
2
Copper
158
Chromium
164
Lead
13.6
Mercury
0.5
Molyb-
denum
5
Nickel
8.42
Selenium
5
Zinc
300
Total
Phos-
chorus
21400
F tai
meavy lvletai Meld Loaaings
(uaiculatea in ins/acre):
1 otal
1
2
3
4
5
6]
7
8
9
10
11
12
DT/Ac./
App-
Event
1.80
Arsenic
0.011
0.000
0.000
0.000 1
0.000
0.000
0.000
0.000
0.000
= flz o:
0,000
O':000
0.011
Cadmium
0.007
0.000
0.000
0.000
0,000
0.000
0.000
0.000
0.000
0.000
0.00.0
0.000
0.007
Copper
0 56$
O Q00
0 000 ,_
9 OQ0
0 000
U 000
0 000.
90.00
0099
" 0 000
0 00.0
0;;000
0 56$.
Chromium
0 59Q
050:00
U 000 .
0 OO:U
0:0:00
0; 000: `
0 000:
0 000
0.000
` 0 OnQ
0 00:0
U:000
''=U 590.;
Lead
0 049
O.000
0 000
" 0 00.0
0„000
0900
0 000.
0 000
0.090 ,,
` 0 000 '
0 000
0 ;UbO
0 049 `
Mercuryr.
0 002
0 000
Q 000
> 0 OOQ
0 000
0
000
0 000"=
030Q0
0000
0 000
0 00'0
0 000
0 002'
Molyb-
0 01$
0 000
0 000
0 OOOL
0 O00
0 000
0 000
0 000
0;000
`g 0 000
, 0,006
0.000
;0 O1$.
denum
,
Nickel
0 030
0 000
0 000
'` 0 000
0 000
O 000
0 000:
U t)00
OODO
`'0 OYJO
0 000
000
Selenium
0 018
0000
0 Q00 .
} 0 000'
0 OOQ
-A.- 000
_` 0 000
0 0;00
0:000
0 000
0 00:0
0.000
Zinc
1,07
0.900
000
0 004
0 OW
U 000
7 0 r00Q; .
"0 6Q6
0,00�
: 0 000-
Total
F
_
Phos-
7C 94
0 000
0 000
0 00.0
0.0:00
0:000
s 0 00.0
O.Q00
0000 ,
0 000:
0..0-0
0;<000
76,954
phorus
J.
"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
hr -sonment for knowing violations".
;e!f 1/10/2017
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner.
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
Charles Lutterloh
Operator: Charles Lutterloh
Crop I Name:
Fescue -Pasture
WQ Permit #: WQ0000520 Field #:
Annual Dry Tons Applied: 8:81 Site #:
Predominant Soil Series:
Crop 1 Max. PAN:
135
NaB
Crop 2 Name:
Acres Utilized:
CH251 Acres Permitted
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
4.9
4.9
0
�
Q
Volume applied
enter one Solids/
( )
Liquid
Cu. Yds Gallons
o
/o
Solids
Volume
A lied er
pp P
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
SoilPrecip.
Cond.
(Dry,
Moist)
Past 24
ems.
inches
a
b
� i
0 w,
7y ?:
�
* w
%`�
�
* F
lgN
mg/kg
o
r
1 Z.
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
10/25
65000
3,25
1798
South Burlington
D
<.5"
S
0.5
0.3
58300
19000
8
76.578
NA
Fescue
0 000 :,,
, 0.000
0 09:0
0 000:
U 000 `
0 000:.
0.000
0 000
a 000 '
a 60o Y
0.000
o a0o=.
o 000 :
o aoo
a ooa =
o 000
0 000 :
0:000
0 00�
0000
0.000
0
0
a'"
'0 000 `
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000
o.Uoo
TOTALS:
01
65000
;:::::;:::;'
As
Cd
Cu
Cr
Hg
Mo
Ni
Se
Zn
P
76.578
0.000
Lime A lied
Annual lb5/acre
d.568
- 590
0°002
_.
aF018?
0 a 0
�0-:U18
1 79..
� 6.954 ::
::::::::::::::::::::::::::::::::::
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.135
0.089
10.026
4.486
r267
0.043
0.319
0.976
0.147
18.994
Current Cumulative lbs/ac
(1146
0 096
10'4
5.:07F'
0 045 `
0'33
10©6
0;.1:65
20 0�3
Permitted C. P. L. R.****
36
34
1338
15
1
1 374
89
1 2498
Permit
Pe PAN Limit 2nd Cr 1 st/ o
..........
S 13
"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
1/10/2017 **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):. 32.59
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
C" *or: Charles Lutterloh Owner: Charles Lutterloh Predominant Soil Series: NaB
A... cs Used: 16.2 Acres Permitted: 16.2 Site #: CH251 Field #: 5
Residual Analvsis Data (Heavy Metals and Total Phosuhorus use mg/ke. % Solids use Raw Percent ft
Sample or
Com-
posite
Date
1
SB
9/12/16
_2j
3j
L4JL5J
6 j
L 7
8
9
LOJ
11 J
12
% Solids
1 3.25
Arsenic
3
Cadmium
2
Copper
158
Chromiuni
164
Lead
13.6
Mercury
0.5
Molyb-
denum
5
Nickel
8.42
Selenium
5
Zinc
300
Total
Phos-
nh orus
21400
E iai .Heavy
lvletai r 1eia Loaaings
kuaiculatea in ws/acre):
Total
1
2
3
4
5
6
7
8
9
10
11
12
DT/Ac./
App-
Event
2.01
14
Arsenic
0.0`l2
0.000
0.000
0.000
0.600 :
0 000•
0.00.0.
0.000
0.000,
0.000
0.000
1 0:000
0.012
Cadmium
O.OU`8
0.000
0 000
0, 000
0.000
0 0"00
0.00:0
0.000
0.00.0
0.000
0.000
0000 ..
0.008
Copper
0.63.E •
0.00.0;
0.000.
a.000
0.000
. 0000 :
0.00:0
0.000
0.000.
0.000.
0 006
0.000-
0.636
Chromium
0.66.0
000
0 000
0..,000
0.000. `.
"0.000 .'
0.000'
0.000.
0. 00.0
0.000
0.000
0.000 .
0.666
Lead
0.655
0:000
0 060°"
0.000 .
0:000'
0 OOQ'
0. 00.0
O:000
o.000
0 000
, 0:000
0:000
0055
Mercury
0 002
0 000
0:000
0-000 "
0.000 .
0 000
0 00.0-.
Q°:0.00
Q. 060
0.060'
- 0.006
0.000
0.002
Molyb-
0 02.0
0.0.00
0.000
0 0'06
0.000
0.000�•'
° 0 00.0,
0 0"00
0.000
O..000
0.,00_Q
0.0.00
0.020
de um
Nickel
0 034
0 000
0 00;0.
0000
. `U 000 .
0 000
0.000
0.000
0.000
0:000
1 0:000
0 034
Selenium
0.020
0.000 -
0 000 .
0.000
0.000
.. 000
0 000
0...000
_ 0.000 _;
0.000
0.000
0:000
0.020
Zinc
1.207
0.000
0.000-
000
0.060
0.0.00.
0.000
0..000
0..000 _
0 090
q.000
0.:000
1.207
Total
1I II .I000 .0001 0100Phoss- 86.114 0.000 0 000 0.00-0 0.060 00 10.00.0 10.000 I 0,006 186.114
"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/.10/2017
Signature of Land Applier 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
Land Owner: Charles Lutterloh Annual Dry Tons Applied: _ 32.59
Operator: Charles Lutterloh Predominant Soil Series: NaB
Crop 1 Name:
Fescue -Pasture
Field #:
Site #: CH251
Crop 1 Max. PAN: 135 Crop 2 Name:
Acres Utilized: 16.2
Acres Permitted: 16.2
Cation Exchange Capacity (non 503)
Crop 2 Max. PAN:
o �
N
.� °
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.
(Dry'
Wet,
Moist)
Precip.
Past 24
Hrs.
inches
,D
coo '�
a
C
o
p:
* w'
�.
t
:h
_ •,
*
TKN
mg/kg
Z
ct
o
�•
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
10/24
156000
3.25
: i. 3.,'OS
South Burlington
D
<.5"
S
0.5
0.3
58300
19000
8
" 55 5.9U
NA ''.
Fescue
10/25
84500
3.25
A 707
South Burlington
D
<.5"
S
0.5
0.358300
19000
8
Fescue
0 Q00 .
0 000
0 000'
0.000
0 000
Q 000 •
0.000
0 000
qvqd
;.;
" d 000
0 000 ­ ,
� 0 OOQ
0
U (?00
:0000
0 OOQ"
0 000
0000
0 0110
6.o0o 70
obo
....
0
..,..
4'
,.: rr
�� 'Q OOb,
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000
..
b iIOQ'a
.....
. .
........
TOTALS::;
0
ZaoSoo
As
Cd
Cu
Cr
Pb
H T
Mo
Ni
Se
Zn
P
85>70 t
0 000
Lime Applied
Annual ibs/acre
t1 oX2>
0<008
0.66
0:660
0.055
0 ilA2
OYD20
6 D34002fl�
1's2Q7
86.1 I4 ::::: ': > : ::: ? :
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.08
0.061
7.185
3.129
0.732
0.029
0.222
0.509
0.098
13.006:::::::::::::::::::::
Current Cumulative lbs/ac
0.092*`
0 069°
1.821
3''.'789
0.787
0.031
0 242
0 5'43
0-118
}4.4 213
Permitted C. P. L. R.****
36
34
1 1338
267
1 15
1
374
89
2498
,Permit PAN Limit 1st/2n d Crop
134, .
"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
1/10/2017 **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): 91.05
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
',ator: Ross Wood Owner: Sasser Farms Predominant Soil Series: CbB
A.,. es Used: 31 Acres Permitted: 31 Site #: CS017 Field #: 2
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
11
EB
6/13/16
1 21
SB
6/13/16
3
4
51
6
7
8
9
10 1
11 1
12
% Solids
3.54
4.5
Arsenic
3
3
Cadmium
2
2
Copper
210
157
Chromium
56
168
Lead
13
12
Mercury
0.4
0.4
Molyb-
denum
5
5
Nickel
12
8
Selenium
5
5
Zinc
1 367
359
Total
Phos-
ph orus
8780
19600
j tai
Heavy metal r ieia Loaaings
(t aicuiatea in ins/acre):
Total
1 J
L3J
4
51
6
7
8
9
10
11
12
DT/Ac./
--a]
e
H
App-
Event
0.34
2.60
Arsenic
0.002,
0 016
0.000
0-000
0.000
0,000
0.0,100.
0.000
0.00011
0:000
0.000
0A00
0.018
Cadmium
0 00i
0 010
01000,
0.000
0.000
0.000
0 000
0.000
0.000
0.0.00
0.0.00.
0.000
0:012
Copper
01`43
0.815
0.000'
0.0„00
0.:0'00`
: 0 000
0 OOQ:
0.000 ''
0::000
0.000
0.000 '
0.000
0.958
Chromiwri
0.038
0.873
0.000 ,
0:000
0.0:00 ,
0. 000 :
0.000
0.000
0"00.0
0.000
0.000
0.000
0 911
Lead
0 009
0 :062
0 000.,
0.000
1 0:000
0.000-- ;
0.000
0.000.
0 000
01-000
1 0..000,
0-960
0.07-1
Mercury
0.000 :
0.002
0.000
0 000
0.000
0 000.. '
RAO .
0.000
Q.
0 000
0.000
0.00.0
0.002'
Molyb-
denum
0.00"3
O:Q26
: .
0.000
0.00,0
O.OUO :,
U 000
0.000_
0 0,00
0.00.0
0,00"0
0 000
Q.000
0".029
Nickel
0.008
0.042
0 000. ;'
0JJD00
F
0..000
0 000'
0 :000`
0.000
0.000
0.000
0,06
0-000
0.050
Selenium
0 0,03
0,026
0.000- ''
0.000
.0.000-
0. 00'0
0 000
0 00"0
0.000 :
0.0.00
0.000
0..000 ..
6.029.
Zinc
0 25:0 t
1 $65
1 ..
0 000
0 "000
0.0:00
0.0000
000
0.09.0
0.000 ;
0.000
0-000 "
0.000
2.114
Total
Phos-
5.970
1,0..802
0 000
0.000
0.0'0.0
0.000
0.000
0:000.
0:000
0.0-00
0.000
0.000 '
1.07.77
"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".
.2�e 'r''u"`_ 1/10/2017
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION . GELD SUMIYIARY 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: 31
Land Owner: Sasser Farms Annual Dry Tons Applied:. 91105 i, Site #: CS017 Acres Permitted: 31
Operator: Ross Wood 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:
y
a4 0
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
a/o
Solids
Volume
A lied er
pp p
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES # WQ#,
Fem, Animal
Waste, etc)
Soil
Cond.
(Dry,
Moist)
Precip.
Past 24
I4rs.
inches
a
4
�
t
a w
ao
c
;v w
..
?+ :
*
!
m
:�
* N
*�+
TKN
mg/kg
Z a
.;
o
as o
g 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
7/19
71500
3.54
0.-�40.
East Burlington
Dry
<5"
S
0.5
0.3
22000
3670
2
4.995
NA
Fescue
7/19
52000
4.5
Q' 15
South Burlington
D
<.5"
S
0.5
0.3
57600
8890
2
11.9.99`
NA
Fescue
7/20
175500
4.5
l Od2'
South Burlington
D
<5"
S
0.5
0.3
57600
8890
2
40.4.96
NA
Fescue
7/21
201500
4.5
. '2Q= . "
South Burlington
D
<.5"
S
0.5
0.3
57600
8890
2
46.496
NA
Fescue
0.009 :
0.000
0 000"
0.066
0.000
°''o aao.
0.000
0.000
o aoo
0.000
0.000
MOP,
0.000". ,
0.000
o aoa.
o o00 ,
0,000
o0o Y.
0,004
0.000
8 0,000°
0.006 '
0.000
0
U
t)000°'
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0 000<<
0.000
TOTALS:
01
As
Cd
Cu
Cr
Pb
H
Mo
Ni
Se
Zn
P
103 987=°
0.000
Lime A lied
Annual lbs/acre
='0`018 `
0 012
0.958
Q 91 l
0.071
0 002
0 029`
M
b 029
� 114
=107.713
:? ............
>: .. ..
<
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
b Q4.8
n 034
3 ,132
2,122
, ©270"
01T
O.1:U0
0 211
;A80
: 8 603
Permitted C. P. L. R.****
36
34
1338
267
15
374
89
2498
PAN Limit l s /2nd Crop
.................................. ...•:..:: >
. :::.:::::::"".::............... .... .:< .62
.... ..........Permit
"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
1/10/2017 **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): 29.38
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
C" ,ator: Ross Wood Owner: Sasser Farms Predominant Soil Series: HbB
A. �s Used: 19.6 Acres Permitted: 19.6 Site #: CS017 Field #: 3
Residual Analvsis Data (Heavy Metals and Total Phosphorus use me/ka, % Solids use Raw Percent #):
Sample or_
Com-
posite
Date
1 1
SB
7/11/16
21
3�
4
5
6�
7f
8�
9
10
111
121
% Solids
2.52
Arsenic
3
Cadmium
2
Copper
98
Chromic i rl
97
Lead
6
Mercury
0.4
Molyb-
denum
5
Nickel
6
Selenium
5
Zinc
215
Total
Phos-
chorus
21900
.9 }ai heavy ivtetai r ieia Loaaings <<:aicuiatea in iosiacre):
i otal
1
2]
L3J
4
L5J
6
7
10
11
12
DT/Ac./
_8_1
App-
Event
1.50
Arsenic
0 009
:.0.000
.0 000
0 OOQ
0.000
Q.000,
0 00:0
0.000:000,
1'6-0;00-
0.000
0.000
9.000
0.,009
Cadmium
0,066
0.:000
0 000
0.000.
0.000
0.0010
0..000..
- 0,000.000
0.000
o.-.m ,
0. 000
0.006
Copper
0 294
0.000
0 00.0
0 OQO
0.0"00
0 000
0 0,00
0.0°00,000
'
0 000:
0.000
0.000
0 294"
Chromium0.291
0.000
0.000 ' `
0.000
6.6 0
0,000
0..00:0
0:0"00"0
000'
0.0.00
0.000 :
0.291
Lead 1 041-S 10.000 1, 0.00.0- -1- 0.000 .I 0.000 1' 0.000.:I 0.000 1 0.000 I: 0-A0.0 I 0 00, 10.0.00 1 9.000 L 0 01$ .
Molyb-
0.015
0:000
0. 000 '
0,000
0.0;00
0.000
0 OOU:
0.000
0 `000 .
0.000
0 000:
0-00.0
0.015
denum
.
Nickel
0 O T$
0 000
0 000
0 000
0 nQ0
0 000
0 000
0 000
0000
0 000?
0 000
0.000 :
0 018°
Selenium
0 0,15
0 000
0 000
0 000
0.0:00
0.000
0 000
O.Q00
0: 000
0 000
0.00:0
0-.000
0.015
Zinc
0 645
0_-A00
0 000
0 000"
0 U00
. 0:.000 ,
0.006
0.
0.000
0 000 1
0.000
0.000
. 0 64
Total
Phos-
65.656
0.000
X_0 000 :
0.0:00
0.0:00
0.000'
0 000'
0.-000
0000
0..000_
0.000
0,000
6.5.656
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
in, -;sonment for knowing violations".
;e�Le 1/10/2017
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
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
Sasser Farms
Operator: Ross Wood
Crop 1 Name:
Fescue -Pasture
WQ Permit #: WQ0000520 Field #: 3
Annual Dry Tons Applied: '29 38.: Site #: CS017
Acres Utilized: 19.6
Acres Permitted: 19.6
Predominant Soil Series: HbB Cation Exchange Capacity (non 503):
Crop 1 Max. PAN: 127 Crop 2 Name:
Crop 2 Max. PAN:
0
}.
o
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,
Wet
Moist)
precip.
Past 24
Hrs.
inches
>
410
cc
�� �'
a
* o
0
o
�'.
—
0
7y
w .,
" R.
a
TKN
mg/kg
z Y
o B
ao o
R.
mg/kg
Nitrate
and
Nitrite
mgfkg
PAN Applied
( lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
8/10
65000
2.52
0 3'48`
South Burlington
Dry
<.5"
S
0.5
0.3
30800
9960 1
2
7.830
NA
Fescue
8/11
78000
2.52
fl 43=8 -
South Burlington
Dry
<.5"
S
0.5
0.3
30800
9960
2
9.396
NA
Fescue
8/12
136500
2.52
0 732`
South Burlington
Dry
<.5"
S
0.5
0.3
30800
9960
2
16.443
NA
Fescue
w,666 "�
0.000
0.000
0 000"
0.000
0.000
0.000
0.000
U 000 '
0.000 ; `.
0.000
bj000 '..
0 000
0.000
000
0 000'`
0.000
4. Boa
o 000 __
0.000
o bQo- .
0.000 '
0.000
0
Q''
Q b00'„
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0 000'
0.000
TOTALS:
(IT
z79ssi0
; :;:::::
As
Cd
Cu
Cr
Pb
Ha
Mo
Ni
Se
Zn
P
33_669"
0.000
Lime Applied
Annual lbs/acreQ09
rU"QUA
0-.*4'�
7`a 29l
0.018
�0 04i<r
0 t1�15'�
p 018
O QI
0,645
?,b5.656'" :... . .....:.::::;:.`::<:
Date
1bsJac
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,: 02`
2 1.06 `
1<417U
1�i6
0 067"
0 069
0 1!44
0:058
5.114
Permitted C. P. L. R.****
36
34
1338
267
15
374
89
2498
Permit PAN Limit 1 st/2nd Crop
P
i27
"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
1/10/2017 **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): W-15
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
Q Bator: Ross Wood Owner: Sasser Farms Predominant Soil Series: HbB
A_ A Used: 40.6 Acres Permitted: 40.6 Site #: CS017 Field #: 4
Residual Analvsis Data (Heave Metals and Total Phosphorus use mvjU, % Solids use Raw Percent #):
Com-
posite
Date
Total
h
phorus
,? vial Heaw Metal Field Loadings (Calculated in lbs/acre):
t utal
1
2 J
3 J
4 J
5 J
6
7
L8J
9
11
12
DT/Ac./
_O
APP•
„�yr
Event
0.45
1.67
Arsenic
; 'b.003
0.010_'
0.000
1 0.000-
0.00or
C4.000
1 0.000
0A00
0.000
0 00(1
0.000
0.000
0.013-
Cadmium
b,002
0.007
0.000
0.000
0.000
`b.000
0.000
0.000
0.000
0.000
0.000
0.000
0.008
Copper
.. 0.9 ,&
e 0=5
. 0=QO,�
s .
; .O.t_O.QO
.:.
aAD
, .4<0�0°.
1 (IUily
aQQO ;
0 (?0:
tkO OQ
ChromiumQ;$
0450.
_ -;Q R�.:..
& 0
QuQ?DO
#)Q0
Oz-000'
Lead
ar00S ,.
0 040.
>.:fl ,:-
@ RO�,1I0(
0�0p :1.
r.. iQ00:
80E
Q0011
_
QUO
e
#1(?
945.
Mercury
0
0 i(10 ;
Q 0
0 000
0,90 a
Q00:
Q40
0.00
Q00}
0 0�
©Q.
:001
Mol b-
0�005
0 917�
0 , 0
Oµ000
0 Q`00
¢ Od
` 0 000
0 000
O'.000
0 000
0 000
0 Q00
0 Q2 .
denum
a, ..
Nickel
r
005
Q�7'-`
QQO
=°0;0
0 Q:.00
0 000
0000
0 000-
0 000
0 OQ
UO2':
.r.. _
.0
_......,
,
Selenium
0' 05
0 01,7
0f�;
fl (Dfl
b00
Q
0 flQ0
f1OQ10h:
.
y
Zinc
419
LAW
QO
a 060
40a
Q.00_ON:..-.
t
Total
_y:'
Phosj19
85
7{3
OyO
{Q AOb,
0 0013
Q00(q
={;0
0 0
OAO 'horu
a
,
"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".
d-e 1/10/2017
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: Sasser Farms Annual Dry Tons Applied: 86.15 Site #:
Operator:
Crop 1 Name:
Ross Wood
Fescue -Pasture
Predominant Soil Series:
Crop 1 Max. PAN:
127
HbB
Crop 2 Name:
Acres Utilized:
CS017 Acres Permitted:
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
40.6
40.6
0
o
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,
Wet,
Moist)
Precip.
Past 24
Hrs.
inches
y
b
cob
o 4
a o.
W0
o
-
K.
w,R.
7d -
�'
* G
TKN
mg/kg
Z
o
°;
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbslacre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
8/10
71500
2.52
South Burlington
Dry
<.5"
S 1
0.5
0.3
30800
9960 1
2
4.158
NA
Fescue
8/11
65000
2.52
U168
South Burlington
Dry
<.5"
S
0.5
0.3
30800
9960
2
3.780
NA
Fescue
8/15
39000
2.52
M.1v
South Burlington
Dry
<.5"
S
0.5
0.3
30800
9960
2
2.268
NA
Fescue
9/8
39000
3.62
South Burlington
Dry
<.5"
S
0.5
0.3
55200
10800
68
5.449
NA
Fescue
9/9
175500
3.62
`0 653 ,.
South Burlington
Dry
<.5"
S
0.5
0.3
55200
10800
68
24.519
NA
Fescue
9/12
1
149500
3.62
0:556
South Burlington
Dry
<.5"
S
0.5
0.3
55200
10800
68
20.887
NA
Fescue
9/13
84500
3.62
`Q?314
South Burlington
Dry
<.5"
S
0.5
0.3
55200
10800
68
11.806
NA
Fescue
OQOA
0.000
0.000
Q1J00"''.
0.000
0.000
coruoo.:
0.000
0.000
o:oo0
0.000
0.000
o:o©o'
0.000
0.000
0
0
'";000p"
°
Residuals Applications totals on FORM
FSF supp (attach FORM FSF supp
to this form):
0.000
0,000
TOTALS:
01
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
72.866
0.000
Lime Applied
Annual lbs/acre
9; 013
0 OD:B.
0 62
0 r53R
0 U45
,,= 0002- .
0 021°
0 032
0 t121
�A�369 �
`90 608 ' :.:::. :.:.:.::.:::::. : .::::
::::::::::::::::::::::::::::::::::::::
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.0478
0.0272
2.4454
0.8898
0.2602
0.0074
0.0797
0.1906
0.0612
7.1204
Current Cumulative lbs/ac
O'.06.t
0 03f.
K'66;8
f;428
0 306 {;
0�009
0 101
0 223
0 082
8:490
Permitted C. P. L. R.****
36
34
1338
267
15
374
89
2498
Permit L' 2 Pe PAN Limit 1 t/ nd Crop
s 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
1/10/2017 **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): 93.87
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
C" ',,ator: Dennis Simmons Owner: Delmar Allred Predominant Soil Series: ApB
A... es Used: 28.9 Acres Permitted: 28.9 Site #: CS018 Field #: 1
Residual Analvsis Data (Heavv Metals and Total Phosphorus use mOkLi, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
EB
7/11/16
2
SB
7/11/16
3
141
5
6
7 J
8
9
10
11
12
% Solids
3.96
2.52
Arsenic
1 3
3
Cadmiuml
2
2
Copper
228
98
Chromium
50
97
Lead
14
6
Mercury
0.4
0.4
Molyb-
denum
5
5
Nickel
11
6
Selenium
5
5
Zinc
1 525
215
Total
Phos-
h orus
8220
I
21900
I I
Ll
I
i
I
1
-1
E ial
Heavy Metal Field Loadings
(Calculated in lbs/acre):
Dotal
1
2
3
4
5
6
7
8
9
10
11
12
DT/Ac./
0
App-
Event
3.08
0.17
Arsenic 1
0.01$'
0:001
0.000
0.000
0:..000
` 0.000
0.000 .
1 0.000
0.0001
0.000
;" U.000
0:000.
. 0.019',
Cadmium
0.012
"0 0.0.,1
0.000
0-000
-0.00.0
0.000
0.006
. 0.000
0 000 -
0.006
0 000 .
0-000-'
S.0 013
Copper
1 4QG
0 032
0 000
- 0 000
Q.000
0.000
0 000,.
0.000
O.000V ,:0
00:0
0 OUQ
0.000
1 43"8
Chromitu»
0 30$
0 032
0 000 '
0 00.0`
0.000
0 000„
0 000
0 000
0.000
0 OOQ
0.000
0`:000
0 34:0
Lead
0 0&6 ,
0 002 ,
0 000
0 000
0.0.00
0' 000
0 000
0:000
0.000
0 000
0 00-0
0000
,_ 0:08$`
Mercury
0 00
0 000
0 000
0 000-
0.000
0 000
0 00.0
0 000
0,:000 :
, 0 000
0 000
0.000
0.003
Molyb-
p 031
0 "002.
- 0.000
; 0 000
0 000,
0,00.0
0.000.
0.000
0.000,
0 000
0 000
0:000
0.032°
denum
Nickel
0„Q $
0 002
0 000
0 OU0`
0 000 -
0`000
0 000
0 000 ;
0;000
.-0 OUO
0 000
0:,000
0 Va.
Selenium
0 031
0 0:02
0 000
0 000
0.000
O:O -9 ;=
0 000`
0.000
0:000
0 000
0 000
0 000
Zinc
3 237
0071
0 Q00" _
0 000
0"Q_00
0' 000 '.
0 000`=
0 0;00
Q.,000
0 000
0 Q0.0
0.000
3,308
Total
=
Phos-
50 E$S
7.27
0" 000
0.000"
0.000
0.000
0.000:
0 000
0000 ,,
0.000
0 0:00
0:000. T
57.912
,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
it 'sonment for knowing violations".
Ze a 1/10/2017
Signature of Land Applier 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
Delmar Allred
Dennis Simmons
Crop 1 Name
Fescue -Pasture
WQ Permit #: WQ0000520 Field #:
Annual Dry Tons Applied:'' .9- :87 Site #:
Predominant Soil Series: ApB
Crop 1 Max. PAN:
178 Crop 2 Name:
Acres Utilized: 28.9
CS018 Acres Permitted: 28.9
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.
Wet,
Moist)
Precip.
Past 24
Hrs.
inches
y
Ks
w
c
w c
* w
5
r 2,
* �,'
T N
mg/kg
z
o
w
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
8115
117000
3.96
0 669
East Burlington
Dry
<.5"
S
0.5 1
0.3
31100
3540
2
13:424 '
NA -'
Fescue
8/16
104000
3.96
,'0 594
East Burlington
Dry
<.5"
S
0.5
0.3
31100
3540
2
11".932 .^;
NA:
Fescue
8/17
97500
3.96
0 5$7
East Burlington
Dry
<.5"
S
0.5
0.3
31100
3540
2
11 187 ,.
NA
Fescue
8/19
91000
3.96
0 $211
East Burlington
Dry
<.5"
S
0.5
0.3
31100
3540
2
10.441
NA _
Fescue
8/20
52000
3.96
0
297
East Burlington
Dry
<.5"
S
0.5
0.3
31100
3540
2
5.966
Fescue
8/20
19500
2.52
0,Q7t.
South Burlington
Dry
<.5"
S
0.5
0.3
30800
9960
2
1'S93
4NA -
Fescue
8/23
26000
2.52
Q 095
South Burlington
Dry
<.5"
S
0.5
0.3
30800
9960
2
2,124 -`
NA
Fescue
8/23
78000
3.96
i"0 44. * °
East Burlington
Dry
<.5"
S
0.5
0.3
31100
3540
2
8 949`
I+TJA
Fescue
0 000
moo
�,
Q 000�•
0 000';;
0000',�
0 000•
0.000
0
0
;'0 OUi) .x4.:
Residuals Applications totals on FORM
FSF supp (attach FORM FSF supp
to this form):
l).ODU
0 000 ``
.'..: ;: ; .
:.:.'..::':
TOTALS:
o
585000
:.::" :::;:;:
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
65.617
0 OOQ; '
Lime Applied
Annual lbs/acre
O.OX9
0.0.13`
..1.4,38
0:`34U
{).U88
0 003,.
0 02"
0.070
0:Q32
3308
157,9 i 2 _.". . _. _. _;.:. > =.:_ :.:.:
. _. •........ "................ . .
.; :: '> :: "::::. ':
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.059
0.04
3.583
1.448
0.335
0.021
0.115
0.34
0.099
11.463
Current Cumulative lbs/ac
x'0 07$
.-
�A 053_
5 01
1.788 `k
0 4Z3
s4 024
0,14*7 .
0 4 .
O T:31
14 771
Permitted C. P. L. R.****
36
34
1 1338
267
15
374
89
2498
mi
Permit PAN Li t 1 st/2nd Crop
- 17 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
1/10/2017 **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): 52.:0.1
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
C 7ator: Dennis Simmons Owner: Dennis Simmons Predominant Soil Series: FaB3
A ,s Used: 21.1 Acres Permitted: 21.1 Site #: CS036 Field #: 6
Residual Analvsis Data (Heave Metals and Total Phosahorus use mg/kg, % Solids use Raw Percent ft
Sample or
Com-
posite
Date
1
SB
9/12/16
EB
9/12/16
3J
L4__J
L5J
6
7
L8J
9 J
10
11
12
% Solids
3.25
3.95
Arsenic
3
3
Cadmium
2
2
Copper
158
266
Chromium
164
59.8
Lead
13.6
12.8
Mercury
0.5
0.4
Molyb-
denum
5
5
Nickel
8.42
15.1
Selenium
5
5
Zinc
300
489
Total
Phos-
horus
21400
15500
P tal Heavv Metal Field Loadings (Calculated in lbs/acre):
1 .cj
1
2
3
4
5
6
7 j
8
9
10
11
112J
DT/Ac./
App.
w
Event
0.33
2.13
Arsenic
0.602
0.013
` b 0 -0 1
0.000
0.000
0.000
0.000
0.000
0::000
1 0.000
0.000
0.000
0'.15
' *
Cadmium
0.001
0.009
0.000
*.0.000
0.000
0.000
0.000
Q:,000
0:000
0.000
0.000
0.000
0.010
Coppler
0 1
1
0 00'
r 00 _
O.Q00
0; Q00�`"
0 ' ' Q);_
0 ©
aQ(/0�0( °
. 010'L-A(
,. OOOQ,3�p
hromiu�
0 0
3 0 255
®00
0�0
0 �00'
0 � L
O
0 00
O: (10 .
} (J 0
1) 0
Ea�O -
+ IQA
alfii
a
V
S
Lead
0
i50
I40fl:©0
r 0(`:
e 8A
1 A0.0
;064
Mercury
Q 000
0 U0�
Q 000'
�Q(r
0 QbO,
0 0(
q,000:,
0 000
0 UQj
bEO(
0 OD`0
(1.:Uo0
1? Q
Molyb-
0 003
0 021
4 000
" Q QOQ
0 0:00�
0 000
"'�00
0 000
0 000
QrO�.�
denim
«.
�
Nickel
410QS)QQ"
©16(i
0'da('
Selenium
0 t�
Zinc
0..�
Total:.
x
x;
Phos-
: 1
�� .6
c 0
of oa
fl.� - --
{1!.flQQ
a
o �
©ofl0
cr
©
0. 00
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
im--isonment for knowing violations".
2 eZ;2t _ 1/10/2017
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 #: 6 Acres Utilized: 21.1
Land Owner: Dennis Simmons Annual Dry Tons Applied:. 52,01 Site #: CS036 Acres Permitted: 21.1
Operator: Dennis Simmons Predominant Soil Series: FaB3 Cation Exchange Capacity (non 503): 0
Crop 1 Name: Fescue -Pasture Crop 1 Max. PAN: 145 Crop 2 Name: Crop 2 Max. PAN:
�,
°
° r.5
Q
Volume applied
PP �
enter one Solids)
( )
Liquid
Cu. Yds Gallons
o
/o
Solids
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
a
� '2
0
*
o
iv
�,
0
�
7y
w ?�
* w
0
TKN
mg/kg
Z Y
�o o
mg/kg
Nitrate
and
Nitrite
mgikg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Prop I
Crop 2
Crop 1
Crop 2
10/3
32500
3.25
0` 209
South Burlington
Dry
<.5"
S
0.5
0.3
58300
19000
2
8.899
NA
Fescue
10/3
143000
3.95
1 115
East Burlington
Dry
<.5"
S
0.5
0.3
28000
5050
8
21.027
NA
Fescue
10/4
19500
3.25
0125
South Burlington
Dry
<.5"
S
0.5
0.3
58300
19000
2
5.334 -
NA
Fescue
10/4
130000
3.95
1 01'
East Burlington
Dry
<5"
S
0.5
0.3
28000
5050
8
19.115'''
NA
Fescue
0�.000
0.000
0 �OQ
0.000 '
0.000
O OQO
6.060
0.000
0.000-
0.000
0 000
0.000 "
0.000
"a 000
0.060
0.000
''o 000
0.000
0.000
0 oao
0:000 '
0.000
0
0
:: >:
}0 000
Residuals Applications totals on FORM
FSF supp (attach FORM FSF supp
to this form):
OA0.0
0.000
TOTALS:
01
325000
:::::::":' ::
As
Cd
Cu
Cr
PbrHI11
Mo
Ni
Se
Zn
P
54.365
0,000
Lime A -lied
Annual lbs/acre
0 015.
0 O10
1239
0064
't 064
0 0 5 11-11
0 Q70
0}025
2 28
+80.356 : ::::::::.....::::.:.:.`
::Permitted = ...........
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.364
0.457
55.036
19.749
7.543
1.102
4.051
0.241
72.765
Current Cumulative lbs/ac
A 3;79
0 4G7
56275
2Q 113`
7 6.07
1.12-7
4...121
1i 2,
75 OSQ
C. P. L. R,****
36
34
1338
267
374
89
2498
Permit PAN Limit lst/2nd 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
1/10/2017 **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): 76-50
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
C Bator: Dennis Simmons Owner: Dennis Simmons Predominant Soil Series: 1bB2
A_ .S Used: 17.7 Acres Permitted: 17.7 Site #: CS036 Field #: 7
Residual Analvsis Data (Heave Metals and Total Phosuhorus use mz/ka, % Solids use Raw Percent ft
Com-
posite
Total
h.::,
.,
E ;iai
meavy metal riew Loaaings
(ualcuiatea in lbs/acre):
i ot77
Lij
2
L3J
L4J5
6
7 J
8
9
10
11
12
DT/Ac./
App-
Event
3.99
0.33
Arsenic
0.024
1 0.002
0.000
0.000
0.000
0.000
0.000
0.000
1 0.000
0.000
0.000
0.000'.
• 0.026
Cadmium
0 01 f,
0.001
0,000
0 000
0. 000
0 000=
0.000
0:: 000
'obdo
0.000�_
0.000
. 0.000
0.017
Copper
2 0&
0 :1.07
:0 000
0 00,0
0 4=:00
0 000
0 000
0 000
0.,000 ;
0 000
0 000
O::ODU
2 189'.
Chromium
0 3G7
0 Q90
0 000
` 0 000
:.
0 090
0 000
s' 0 OOp.`�
O 000
Q,000
0 000
0.000
0.:000
'0 4*7,
Lead
0 072
O.Oi18
0 OflU
0 0'00
0-000
g, Q 000
0 000
4 064
0.000
0 000
0 000
-0; 000
Mercury
0 003
0 000'0
000.
_ 0 000
0.0:00 °
° q 000
0 000;
0 Q00
0::000
". 0 000
0.000
0:000
0 003:.
Molyb-
0 040
0 003
0 000
0 0.00'
0:0:00
6,06.. 0..
£ 0.000
0.000
0.000
0 000`
0 OQO
0.;000
0 043
denum
. ,.
Nickel
0 088r
0©5
0 000
` 0 000
0 000
0: 000
` 0 000
0 000
0000 .
r 0 000k
0 OQ"0
0000
Selenium
0- 00
0 003
U 000
0 OOQ
0 0€00
0-000
"= 0 OOU:
0 000
0;000
(140fl0
0 0i
Q_000
0.043 `
Zinc
3 885
034
0 000
0 000
0 0-00
!0 ODO
0 000
0 000,
Q000 ,
; 0 000
0 OdO
0.000
4 12Q
Total
;..
;^
Phos-
50:90
14.119
0 000
¢.000
0 0=00
. 0 000
,. 0 000`
0.0:00
0.000
0.00.0
0:0.00
0:000
69,0108
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�t 1/10/2017
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
Dennis Simmons
Dennis Simmons
Crop 1 Name:
Fescue -Pasture
WQ Permit #: WQ0000520 Field #:
Annual Dry Tons Applied: Site #:
Predominant Soil Series: 1UB2
Crop I Max. PAN:
90
Crop 2 Name:
7
CS036
Acres Utilized: 17.7
Acres Permitted: 17.7
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
0
o
Q
Volume applied
PP
(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.
W
Moist)
Precip.
Past 24
Hrs.
inches
�
_
co 'b
0CD
o
o
o
w �ry,,
w -,
w
0
T.
mg/kg
Z
Ft
o
m-
mg/kg
Nitrate
and
Nitrite
mglkg
PAN Applied
PP
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop I
Crop 2
Crop I
Crop 2
9/13
39000
4.07
"0 374
East Burlington
Dry
<.5"
S
0.5
0.3
20400
1470
2
4.799-
NA
Fescue
9/14
117000
4.07
East Burlington
Dry
<.5"
S
0.5
0.3
20400
1470
2
14.396
NA :<'
Fescue
9/15
97500
4.07
-;:Q 935
East Burlington
Dry
<.5"
S
0.5
0.3
20400
1470
2
11.997
NA ='
Fescue
9/16
162500
4.07
w 1=558: "
East Burlington
Dry
<.5"
S
0.5
0.3
20400
1470
2
19:994`
NA:.
Fescue
9/16
39000
3.62
''Ok33* "'°
South Burlington
Dry
<.5"
S
0.5
0.3
55200
10800
68
12.498
NA
Fescue
0.000 '
0.006
000
6.000 :.
0.006
1+q 000
0.000
0.000 :=
0.000
0.000
000.:
0.000
0.000
0.600
0.000
01
0
0F`00,0 '
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form).
0.000`.``
0.000
TOTALS
-. to
455000
:<'':::':
As
Cd
Cu
Cr
Pb
Hn
Mo
Ni
Se
Zn
P
63.683'
0.000 ;'
Lime Applied
Annual lbs/acre
0 026 "°
0 91°2
k 9
0 457
0.080
0 QQJ
U3
0 0R 1,
,1)4
412Q
$69.008"
:::::::: >.::::::::::::::'::: :::
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.389
0.428
53.246
16.746
7.198
0.142
1.227
4.05
0.274
72.992
Current Cumulative lbs/ac
0 4<1S '`
"4M 0 445
, S5 435
17.203
1`278
0 145
127Of `
, 4'.143 i
x 0;317;7
..
112
Permitted C. P. L. R.****
36
34
1338
267
15
374
89
2498
er 2 P mrt P Limit 1 t/ nd r AN s 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
1/10/2017 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier
Date I
****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): 33.59
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
C' Bator: Dennis Simmons Owner: Dennis Simmons Predominant Soil Series: IbB2
A. _s Used: 11 Acres Permitted: 11 Site #: CS036 Field #: 8
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
EB
8/8/16
2
SB
8/8/16
3
4
5 1
6
7
8
9 J
10
11 J
1121
% Solids
4.07
3.62
Arsenic
3
3
Cadmium
2
2
Copper
261
160
Chromium
46
135
Lead
9
12
Mercury
0.4
0.4
Molyb-
denum
Nickel
11
8
Selenium
5
5
Zinc
487
352
Total
Phos-
horus
6880
21200
F }ai heavy ivietai v ieia l.oaaings (uaicuiatea in ins/acre):
i utal
1 1 1
2-1
31
41
5 f
6
71
La-19
EUJ
11111
Z
H
DT/Ac./
App.
14
Event
2.61
0.45
Arsenic
0.01+6
0.003
0.000
0,000
0.000
-0.000
0.000
0.000
0.000
- 0 000
0.000
0.000
0.019
Cadmium
' 0.010
0;0:02"
9,0
0 00:0
0.000
0:000
0.000
0.000
Q::000
0.000
0.0:00
U;000
0..012
Copper
1 36;1
O;,a43
0 00,0
0 000
0,000
OA000
0 000
0 0;00
q;:000
' O:OQQ'
0 000.
0.000
1 504°
Chromium
0 240
'0..120
Q 000
0.;000
0 000
0' 000
0 000
0 O00 .
Q.000
0.000
6,906
0000
Lead
0 04-
0,61l
0 600:_
0 OOD.
0 0:00 :
0`,000
0 000
0 0.00 "
0{000
0.000
0 00.0
..0.000 .
0 O5.$
Mercury
" 0 OU2
0 000
_ 0 000 11
0 000-
0 000
0' 000 ';.,,
0 dOQ
0 000
0:000
0 000
0 000
0r000
Molyb-
0 026
0 004
0 U00.
0..600
00'00
0; 000
° 0,00
0.000
0: 000`
0 000
0 00=0
0.;000. '
0 03.1.
denum
.
Nickel
0 057
0 007
Q 000
0 00.0'
0 0:00
0 OS00
a 0 000`
0 000
0 000
=. 0 000'
0.000
0:000
-0 065
Seleniuun
0 02G
0:0'04
0 000.
0 OOQ
0 -000
0.. 000
= A 000'
0 O00
0::000
:.0
0.000
000.0'
0 03
Zinc
2 54"0
0 3;;14
Q, 000 .
0 O00_
0 OQO
0.000
0 000"
0 000:
0,000.
0 O00
0:000
0:00"0
2.854
Total
_.
Phos-
35-88-6
- 18.910
` 0 000.
0.0.00'
O':000
O,fl00°
;. 0.000
0:000
0-000.
0 OOQ:
0.000
0:00'0
54.796
t1horus
"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
hr •1sonment for knowing violations".
1/10/2017
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
Operator:
ANNUAL LAND APPLICATION Y 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 #: 8 Acres Utilized:
Dennis Simmons Annual Dry Tons Applied: 33.59 Site #: CS036 Acres Permitted:
Dennis Simmons Predominant Soil Series: IbB2 Cation Exchange Capacity (non 503):
Crop 1 Name: Fescue -Pasture Crop 1 Max. PAN: 90 Crop 2 Name: Crop 2 Max. PAN:
0
°
y
°
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
oho
Solids
Volume
Applied per
Pp p
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry,
Wet,Hrs.
Moist)
Precip.
Past 24
inches
a
co
� o
00 w
0
o
;o w
j
0 =
* w
� '
w
. Iv.
* N
TKN
mg/kg
Z I
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
9/14
84500
1 4.07
1 304
East Burlington
Dry
<.5"
S
0.5
0.3
20400
1470
2
16.730
NA
Fescue
9/15
84500
4.07
L 304"
East Burlington
Dry
<.5"
S
0.5
0.3
20400
1470
2
16 730
NA "'
Fescue
9/15
32500
3.62
"` 0 446
South Burlington
Dry
<.5"
S
0.5
0.3
55200
10800
68
16':759
NA
Fescue
Q 006
0:000.
Q 000
6,000
0 000
000.
0.000
;0�000
0.000,
0 000'
0
04.,0'#000
N.'{
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000
0.0`bU;
TOTALS:
; ' 0
20150o
As
Cd
Cu
Cr
Ph
H 7
Mo
Ni
Se
Zn
P
50.21 R
0 00';`
Lime Applied
Annual Ibs/acre^)
5b4
i).360 .'
^0.058
0 002°
0 431 M
0.065�
, Q;031
2 $5r4
54:796 :: <» :::::::: •:.:2?::
::'
Date
Ibs/ac
Prior Years Cumulative lbs/ac
0,349
0.446
54.882
18.214
7.525
0.149
1.093
3.9
0.256
72.668
Current Cumulative lbs/ac
067
0 458
56.386
18-574
7.583
01i
1 1.24
3965
0�287
75 522K
Permitted C. P. L. R.****
36
1 34
1 1338
267
15
374
1 89
1 2498
Permit PAN Limit 1 st/2nd Crop 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 /10/2017 **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): 41.08
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
(I -rator: Dennis Simmons Owner: Dennis Simmons Predominant Soil Series: CfB
EL ,s Used: 14 Acres Permitted: 14 Site #: CS036 Field #: 10
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
SB
8/8/16
21
EB
8/8/16
3
1. 41
5
6
71
81
9
10 j
11
12
% Solids
3.62
4.07
Arsenic
3
3
Cadmium
2
2
Copper
160
261
Chromium
135
46
Lead
12
9
Mercury
0.4
0.4
Molyb-
denum
5
5
Nickel
8
11
Selenium
5
5
Zinc
352
487
Total
Phos-
)horns
21200
6880
F ial
Heavy Metal Field Loadings
(Ualculated in lbs/acre):
1
2
3]
L-41
L 51
L6J
7 J
8
9
10
11
12
f-,,cal
DT/Ac./
-
_
-
o
App.
Event
0.49
2.44
Arsenic
0.003
U:015
.0.000
0.000
0.000
0 000"
0 000
0, 000 .
O OU,Q
0 000.
0.000
"0.0.00
0.01`8.
Cadmium
0".00 2
6.010
Omw
0.000
0.000
0 000
0 OOQ
0.000
0.000
0.000
0.00-0
0.000
0.012 .
Copper
0 157
1:275
0.6
0.000.
0.0:00
0.000`
0 000.
0_000
0:.0.00
0 OOQ.
0.000
O'.000 .
1.432
Chromiu
0.133
0,225
0 000
0 000
O.000
-
0. 000
. 0 000'
0:000
0.000
0 000
0 000 ,
0.000 '
0.35 T
Lead
0 012
0-;044
0 000
.
0 000:
0;000
_ -0 004 '
0 OOD'
0 0:00
0.000
0 "000
0 000
0000
0 056
Mercury
0.000
0 0-02
..0.000',
0.000
0 0.00
0..000
0 W.
0 OAO
Q,00,0
0.0
0 000
f 0;000
0 002
Molyb-
0.005
0.;p24 "
. 0 000 '
0.000:
0.1006
0 000
0.000 .
0.000
0.000'
0 000
0.000
0-.000
0 029
denum
Nickel
0.0 8
0.054
6 000
0 -000
0;0:00
0-000
0 000
0 000
0.000
:: 0.000=
0 00`0
0 000
0.062
Selenium
0 005
0.024 :'
0 000
O OQ0
0.000
0 000
." 0 000 1
0.00.0
0.006
0 00
0,000.
0.000
0.029..
Zinc
0.346
2.379
0 000
0.000
6.000
Q 00"0
0 OOU`.
0 000
0 000
0 000
0 0,.00
0-:000
2.725
Total
Phos-
20.818
31.616
0 000 .
0.0,0
6.000
6.000 `
1 0:000
0.000
0.:000
0.00.0.
0.00_0
0..000
54.434
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
im-isonment for knowing violations".
. _ 1/10/2017
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 #: 10 Acres Utilized: 14
Land Owner: Dennis Simmons Annual Dry Tons Applied: 41.A$ Site #• CS036 Acres Permitted: 14
Operator: Dennis Simmons Predominant Soil Series: CfB Cation Exchange Capacity (non 503): 0
Crop 1 Name: Fescue -Pasture Crop 1 Max. PAN: 156 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.
W
Moist)
Precip.
Past 24
Rrs.
inches
y
b
cc b
o w
e
Z
o
m
N'
#
0
4
7
w
0
TKN
mg/kg
Z �
q
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
9/6
45500
3.62
0,491
South Burlington
Dry
<.5"
S
0.5
0.3
55200
10800
68
18.435
NA
Fescue
9/6
201500
4.07
"-=2>;4:3
East Burlington
Dry
<.5"
S
0.5
0.3
20400
1470
2
31.345
NA
Fescue
0.000
0.000
0 000
0..000 '
0.000
"a;oaa
0.000
0.000
0.000
0.000
0.000
0.000
0.000 -
0.000
600.
0.000
0.000
;ItooO
0.000
0.000
"0 ooa
o.aoo'
0.000
:0 060 - .:v
0.000 .
0.000
0
0
05000 "` '
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.060
0.000
TOTALS.
ti
2�17[>na
::... ..
As
Cd
Cu
Cr
Pb
Ha,
Mo
Ni
Ser.78
P
49.780 '
0.000
Lime Applied
Annuallbs/acre
";'0Oi8
y0012
14245n43:0i1S6
'04
�g029.
,<Or4G2
�0;4954.434
:;:':.:.:.:..:":.•:•;%:: ":
`:;::::::''::::'::::::::::::::::::::::: >:::
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.202
0.166
32.304
9.417
4.219
0.085
1.062
2.29
0.249
Current Cumulative lbs/ac
U 220 _ .
0.178
3336
9�,77.1
4 274.'
0 087
1 691
2.352
0 278
Permitted C. P. L. R.****
36
34
1338
267
15
374
89
2498
Permit PAN Limit 1st/2n dCr0
5 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."
1 *Application Method: S - Surface, IN - Injection, INC - Incorporation
�(�•�- 1/10/2017 **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): 62.51
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
C, -ator: Dennis Simmons Owner: Dennis Simmons Predominant Soil Series: IbB2
A. ,3 Used: 18.8 Acres Permitted: 18.8 Site #: CS036 Field #: 11
Residual Analvsis Data (Heavy Metals and Total Phosphorus use me/ks, % Solids use Raw Percent #):
com-
posite
Date
f !Yai
f !Yai
heavy inetai rieia Loaaings
tuaicuiatea in ias/acre):
i001-1
1
L2J
3
4
L5J
L6
7
8
9
10
11
12
DT/Ac./
0
App.
Event
0.63
2.70
Arsenic
0.004
0a016
0.000'
0.000
0;-000.
0:000-
0.000
0.0:00
0000
0:000
.006
0.000
0:020
Cadmium
0.003
0.011
0.000'
6.600
0.000
0.000
0.000 .
0.000
0.00,0° '
0.000.
0.:000
0.006
0.013
Copper
0.266
1:409
:0 00.0
0 000
0.0
0 000.
0 00,0
0.0-00>
O.UQ:O'
0 00.0.
0 0;00.
0:000 ;
-1.609
Chromium
0 164
0.*0
000;`
0.000
0 000
0 000
. 0 000
` 0:.000
O.00b:
0 000
0 000:
0:000
0.417
Lead
0.0 .5
0,-.049.
0 000--.
0..00.0
O.A00..
0 OOA
0 000
0.000
0::000:
0 00.0
0 0;00 .
0- 000-
0.064>
Molyb-
0.006
O':027
'0 000 '"
0 OQ:O
0.000
` �0 000�.
0 0
0.000
0.000
0.000:
0.0:00
0::00.0
0.033
denum
Nickel
0,010
0 OS9
O fl0U
0 000
„ 0 000
0 000
0 000
6 000
0.000 `=
0, 000
0.0.00
0 0.00.
0.069
Selenium
0 006
0 027
0 ' 6
,. 0 -
_ _.
0..000
0. 000 '
0 000
6.000
" 0,.000" .
0 000
0 000
0:000
0A3�3.
Zinc
0 441
2:629
0 000
0,000
0 000 °
:D OOU: ;"PROP.:0.000
0n000.: _
= 0 OOQ_
0.000
0.000,
3:070
Total
-..
Phos-
26':542
37`:13$
'. 0 OQ.O
0.0;00.
0.000
0.000,
0 M-
0.000
• .0.000
0_000 _
0:000.
0.00.0
63-.6:$1
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".
1/10/2017
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATIOlN, — 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 #: 11 Acres Utilized: 18.8
Land Owner: Dennis Simmons Annual Dry Tons Applied: : "G2.51 Site #: CS036 Acres Permitted: 18.8
Operator: Dennis Simmons
Crop 1 Name:
Fescue -Pasture
Predominant Soil Series:
Crop 1 Max. PAN: 91
IbB2
Crop 2 Name:
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
a�
Volume applied
enter one Solids/
( )
Liquid
Cu. Yds Gallons
o
/o
Solids
Volume
A lied er
Pp P
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, W #,
Fert., Animal
Waste, etc)
SoilPrecip.
Cond.
wry'
et,
Moist)
Past 24
Hrs.
inches
y
cc
w,
o*.
°
o
w
�,
#
K
7d
w
N
0
TKN
mg/kg
Z >
o
m
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lhslacre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
9/7
39000
3.62
0„ 333
South Burlington
Dry
<.5"
S
0.5
0.3
55200
10800 1
68
11.767
NA
Fescue
9/7
149500
4.07
T35.0-
East Burlington
Dry
<.5"
S
0.5
0.3
20400
1470
2
17.318
NA
Fescue
9/8
39000
3.62
:.0 313
South Burlington
Dry
<.5"
S
0.5
0.3
55200
10800
68
l l.767
NA
Fescue
9/8
149500
4.07
1 350,
East Burlington
Dry
<.5"
S
0.5
0.3
20400
1470
2
17.318
NA
Fescue
0 00b`
0.000
0.000
O O,Ob
0.000
0.00.0
Or00;0
0.000
0.000
Q'U;QO
0.000
0,000
A
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 :
U.ODU
'`
TOTALS:
01
3770ffl
::::•:::::::
As
Cd
Cu
Cr
Pb
Hi4
Mo
Ni
Se
Zn
P
:m.47'I'l
0.000
Lime A lied
Annual lbs/acre
0 020
q 013
X 6p9
0s41T „
Q+064`
0 003
t 033
00693
0:033
` >3=07U
'63.681 ::..:.:::.: .:: :::
................... .......
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.151
0.118
12.448
3.377
1.84
0.041
0.39
1.394
0.152
28.171
Current Cumulative lbs/ac
U 171
0 131
14 Q 57
;3,.794
1 90 u
0:0:44
0.423.
1:463
O i85
3.1241
Permitted C. P. L. R.****
36
34
1338
267
15
374
89
2498
Permit PAN Limit 1 s 2nr t/d Crop
P
9i
"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
1/10/2017 **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- -Yator: Dennis Simmons Owner: Dennis Simmons Predominant Soil Series:
A A Used: 24.2 Acres Permitted: 24.2 Site #: CS036 Field #:
63.48
IbB2
12
Residual Analysis Data (Heavy Metals and Total Phosphorus use ma/kg, % Solids use Raw Percent #l:
Sample or
Com-
posite
Date
1
EB
7/11/16
2
EB
9/12/16
3j
SB
9/12/16
4
L 5j
L6J
L7J
L8
9
10
11
12
% Solids
1 3.96
3.95
3.25
Arsenic
3
3
3
Cadmium
2
2
2
Copper
228
266
158
Chromium
50
59.8
164
Lead
14
12.8
13.6
Mercury
0.4
0.4
0.5
Molyb-
denum
5
5
5
Nickel
11
15.1
8.42
Selenium
5
5
5
Zinc
525
489
300
Total
Phos-
horus
8220
15500
21400
'vial Heavy Metal Field Loadings (Calculated in lbs/acre):
� otal
1
2
3
4
5
6
7
8
9
1 o
11
12
DT/Ac./
0
App.
y
Event
0.84
1.42
0.36
Arsenic
0.OA5.
0.008
0 002
0.000
. _ 0.000' `.
0 OD0
0 900
.0.000
1 '0:.0001,640
0 000
0.000
0.016
Cadmium
0.003
0.006
`0 00 �°
. 0 OOQ,.
0.000
O':000
OQO
Wow;
0.000
' O:OUIl
0.000
0.60
Copper
0,84
0
0
0 OOQ
OYOO
Q,O
0 C30
0 U00
- : O.Q09 "
. 0 OU fl _
ON
0404
1:23
Chromiumo
�
o `
t roo
o_o o
akQ�a _.:
oc o4-
o o©
ovQQ
o 000
0 0 0
6,00
0 7
Lead
0 02'4
0 036
OsO t(�
- 0 000
O OOP
0
3
li Q Q
Oh44�
-0:Q©0 ;
.: U 00
(l 0UA
0:40i
47V
Mercury
��O(
0„00�
00.
0 OQU
O.00n.
. Q 000
;_ ,O ADO"
0 Q00
0:900
`" 0 00`0
0 090
O:Ai
0,002. .
Molyb-
OAS
0 014
0 000
0 Q00
il. OQO
'� 0 tl.00
0 OQO
0
000
0 A`�G
denum
z
3 µ
;000
Nickel
U QI'
0 043
fl O(�
OA,00-
0:000
O�QOO
FQ 000
D..QO©
Ofl
OODO=
0 000
O DOf}
4 06 .
Selenium
4 00$
O'014
-. ©OQ?I
ty(00
O tS00
OOil ..
0 OOQ
0 Ofl
OD00
'f 0 0'Ob'
0 000
0-.040
Zinc
0.$$5
i.3II5
a1 3`
_.
NQ 04Q .
kl 0'00
_s(00(i, ;_
o 0�0.
p. 0 O(1©
0, (1Q0
F,sO0;4:(I00(i
a„Qfl.
2 4$.
Total
Phos-
13 > 5'�
43;8 6
Y
APO,
0.000
01.10 Oti
0 600
0 000
() OOfl
0 01�{1
O-.QflO
73 334.
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
iir -- -isonment for knowing violations".
1/10/2017
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 #: 12 Acres Utilized:
Dennis Simmons Annual Dry Tons Applied: 63A8 Site #: CS036 Acres Permitted:
Dennis Simmons Predominant Soil Series: 1bB2 Cation Exchange Capacity (non 503):
Crop 1 Name: Fescue -Pasture Crop 1 Max. PAN: 91 Crop 2 Name: Crop 2 Max. PAN:
24.2
24.2
0
o -
y �
Q °
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
oho
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
Hrs.
inches
Y
co
o� a;
*o
o
w
�
�
* w
C
w
* P.
+�,
0
TKN
mg/kg
Z
s#
o
c°qo
�•
mgtkg
Nitrate
and
Nitrite
mglkg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop I
Crop 2
Crop 1
Crop 2
8/19
65000
3.96
0.`444
East Burlington
Dry
<.5"
S
0.5
0.3
31100
3540
2
8.906
NA
Fescue
8/23
58500
3.96
East Burlington
Dry
<.5"
S
0.5
0.3
31100
3540
2
8.016
NA
Fescue
10/13
32500
3.25
0182
South Burlington
Dry
<.5"
S
0.5
0.3
58300
19000
8
T753
NA
Fescue
10/13
143000
3.95
East Burlington
Dry
<.5"
S
0.5
0.3
28000
5050
8
18.333
NA I
Fescue
10/14
32500
3.25
0;182
South Burlington
Dry
<.5"
S
0.5
0.3
58300
19000
8
7.753
NA
Fescue
10/14
65000
3.95
Q 442
East Burlington
Dry
<.5"
S
0.5
0.3
28000
5050
8
8.333
NA
Fescue
0 01.
0.000
0.000
0 000
0.000
0.000
0 000
0.000
0.000
0 OOU'
0.000
0.000
0 000
0 000";
0.000
0 00b"
o.ono
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0`000 "
0.000
TOTALS:
•.a "�" 0
396500
As
Cd
Cu
Cr
Pb
H
Mo
Ni
Se
Zn
P
59 094;
0.000
Lime Applied
Annual lbs/acre
0"01.6
0 01Q
12'S.3
0373
0,07U
0 002
0 026
0 067
0 026
24`88
73
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.174
0190
36
0.135
01.4.5
34
16.991
18 244
1338
5.481
5'854 ,
2.924
_`� 994 `
267
0.051
0,053:.
15
0.713
•0.739.
1.582
1°.6:49
374
0.184
0.`210
89
29.697
` 32.185 '
2498
........... ..
:•.:..•::
Current Cumulative Ibs/ac
Permitted C. P. L. R.****
Permit PAN N Limit lst/2nd Crop
P
.. .. ...•....:.............................::..::. ,::... ,..::..::.....::::::::;:. ,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
;d-e 4;2;� 1/10/2017 **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): 76.30
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
O- -rator: Chad Randleman Owner: Blanch Jefferies Predominant Soil Series: CeB2
h s Used: 16.9 Acres Permitted: 169 Site #: CS117 Field #: 1
Residual Analvsis Data (Heavy Metals and Total Phosphorus use m2/k2, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
EB
5/9/16
2
SB
5/9/16
3]
L4J
5
6
7
8
9
10
11
12
% Solids
5.16
4.42
Arsenic
3
3
Cadmium
2
2
Copper
123
160
ChromiujT4
51
156
Lead
12
10
Mercury
0.6
1.1
Molyb-
5
5
Nickel
12
7
Selenium
5
5
Zinc
416
333
Total
Phos-
horus
12300
20400
Id
Metal Meld Loadings (Calculated 1n lbs/acre):
1 V MI
-
_
_�
-
-
-
-
-
-
0
DT/Ac./
App.
o
Event[2.32
2.20
Arsenic
'0-.014
0, 013.
0 000
0.000
OA00
0.000
0.000
0 00`0
0.000..
.0 0 0
0.000 .'
0.000
6 02
Cadmium
0.009
0`.0.000
0.000
0.000
0.000
0.000
0.666
6.000.
1�.00I3-
0. 0�0
0:000:
0.01&
Copper
0 576
_ 0,303:
0
0 �0U
t%000
aO1J� _
> 0400
0 OpO
Q 000
(:00Q.:
Of04.0
0 000
Q:'00:0
1 273:
Lead
I Moly'b- 0 02.3 10 022 a 0,00x I 60�Q 0.6:00 :0°.000 X 0 Q00 I .0.000 0->0()0 ` 0 006 a s -goo C O Ot1d. 0 I
Nickel
0 v4
0 031
0 OORe:
0 d _
0'(}0
a�000„ '
090
..Q(tDti
a<,010
., 0 020'
9f4
8..000
Selenium
0
ff .12
�
0 lY ©
;. 0 000
0.Qa0
O.00�p
� L) .
,
O Q00
0 ((fi�00
0 0
0 0.0
a U00
04
Zinc
1 92g
1 A64
t60W
` ao (t .
Total
e...
a.
Phos-
56 8
89<678
l; 000
U:0•Q,Q>
OA.
O.Q00
. - 000.-
0:t)0
0.000 .-
' 0 004 .
it OQO.
Q U
14 .5"17
ohorus
_
..
`
"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
im--isonment for knowing violations".
zl�z 41_2�/ 1/10/2017
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 #: 1 Acres Utilized:
Blanch Jefferies Annual Dry Tons Applied:, 76s3. Site #: CS 117 Acres Permitted:
Chad Randleman Predominant Soil Series: CeB2 Cation Exchange Capacity (non 503):
Crop 1 Name: Fescue -Pasture Crop 1 Max. PAN: 162 Crop 2 Name: Crop 2 Max. PAN:
16.9
16.9
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
Hrs.
inches
Y
co
�
o0 w
# -
o
w �,
; -
# P.
�
7�
w
F'o ?'
*
p
TKN
mg/kg
Z
q
o
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
6/13
182000
5.16
- i3:17•
East Burlington
Dry
<.5"
S
0.5
0.3
29700
3880
2
44.899
NA
Fescue
6/13
6500
4.42
a.071
South Burlington
D
<.5"
S
0.5
0.3
57900
9730
2
2.739
NA
Fescue
6/14
195000
4.42
2 121 .,;'
South Burlington
D
<.5"
S
0.5
0.3
57900
9730
2
81167
NA
Fescue
0.000
0.000
0 b0.0
0.000
0.000
o. oo0
0.000
0.()O0
o 000
0.000
0.000
o 000 `
0.000
0.000
}tx0f000 ..
0.000
0.000
0 000.
0.000
0.0o0
0000
0.000
0.000
o.000
0.000
0
A"
..:::•.,`
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000
5.000
TOTALS:
01
383500
t:::::!:::; :
As
Cd
Cu
Cr
Pb
H g
Mo
Ni
Se
Zn
P
129.8051
0.000
Lime A plied
Annual lbs/acre
0 027
O Q1
1273
``;.922
O`.100
Q 008'
0 045
O30,6
b5
3 392
46.677 ::::>.:::::::::::::.:::::::::
:.....
.. . ..::. ..:........
>
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.246
0.131
12.461
5.195
2.5o5
0.045
0.852
1.485
0.214
24.342
Current Cumulative lbs/ac
,4t,.,
0 27
0 149137
,r
2 �h5,.^'
0 053
0 8Q7
L:571
0;259
27 734
Permitted C. P. L. R.****
36
34
1338
267
15
374
89
2498
Perm PAN Limit 1 s t/
it 2nd Cr 0p
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."
Z.-Z 4:2�_ *Application Method: S - Surface, IN - Injection, INC - Incorporation
1/10/2017 **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): 41.96
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
C' ,ator: Chad Randleman Owner: Blanch Jefferies _ Predominant Soil Series: IrB
A_ .;s Used: 9.6 Acres Permitted: 9.6 Site #: CS 117 Field #: 2
Residual Analvsis Data (Heave Metals and Total Phosphorus use ma/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
_1_J
EB
5/9/16
21
3j
L4J
L 5 1
L6 I
L71
8
9
10
ft-11
112
% Solids
5.16
Arsenic
3
Cadmium
2
Copper
123
Chromium
51
Lead
12
Mercury
0.6
Molyb-
denum
5
Nickel
12
Selenium
5
Zinc
416
Total
Phos-
horus
12300
E ,iai
heavy ivietai riew Eoaaings
kt aicuiatea in ias/acre):
utal
1
2
3
4
5
6
7
8
9
10
Li12
DT/Ac./
0
App.
Event
4.37
Arsenic
0:026
0:.000'
0 000
0 000
0.:0:00'
0.000
0 000
0.000
0.000`
0.000'
::0.000
.0.000
0.026
Cadmium
0.01.7
0.000• .
0.000 .
0 000
0.000
0.000
OA00
0.000
0:000
" 0.006
0:000
0.000
0 017
Co pper
1 075
0.000
i
0 000
0 000
0 600
0.000= :
0 0,00
0:000
0:000
0 000:
0 000
0:000""
, .1 075 .
Chromium,0
446
O..00Q
0 000 "
0 000
O.000
0: 000
(.v 0 000
0 000
Q;000
0 000
0.000
0000
446
Lead
0.105
0 000
0 000
0 000
0 000
0' 000
0, 000
0 OUO
Q 000
0 0011
0 000
0000= "
` 0 105 ° ,
Mercury
0 005
0 000
0 000
0 000
0 Q00
0 000 •'
0 000b
0 000
0.000 ,;
; 0 000
0 00-0
0 000
- 0 00-5
Molyb-
0 044
0 0.00 a
0.0,
0 000'
0 000
0 000
0 0`00'
Or 0;00
0:000
0 000''
0 000
0..000
0 044
denum
R,
Nickel
0 105
0 000
0 000
0 OQ0
0 0'00
0 000
0 009.
0 000
0.000
-0 000°
0 000
0:000
0 105
Selenium
0„044
0 000
Q OOQ`
0 OO;Q,
0 000
0 040
0 000"
0 "0'00
0..000 ;
,. 0 000
0 0.0.0
0:000
044"
Zinc
3 67
0 Q:00
0 000 `
0 000;
0 0:00
" 0 00D
0"000
0.000
0,000
= 0 000"
0 00'Q
O'000
„ 3.637,
Total1.4
Phos-
107 527
0:000 :
_;
0 000
0 000
0 000 :.
"0,00"0
"` 0 000
0000
0.000 ::
0.0,60
0 000 ,
0:¢00_
y107 527
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- ~isonment for knowing violations".
.4 1/10/2017
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
Operator:
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.
City of Burlington WQ Permit #: WQ0000520 Field #: 2 Acres Utilized:
Blanch Jefferies Annual Dry Tons Applied: 41.96• Site #: CS117 Acres Permitted:
Chad Randleman
Crop 1 Name: Fescue -Pasture
Predominant Soil Series:
Crop 1 Max. PAN: 92
IrB
Crop 2 Name:
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
9.6
9_6
0
o
+1 o
A
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
oho
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, W #
Q '
Fert., Animal
Waste, etc)
Soil
Cond.
(D
Wet,
Moist)
Precip.
Past 24
Hrs.
inches
y
'�
co
`"
a
*
o
A' �+,
..
5.
;U
w
* N"
* R.
TKN
mg/kg
z
q
o
w
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
( lbs/acre)
Name of Crop Type
ReceivingResidual
Application
Crop 1
Crop 2
Crop 1
Crop 2
6/11
117000
5.16
2 622
East Burlington
Dry
<.5"
S
0.5 1
0.3
29700
3880
2
50 81'-
NA> •'
Fescue
6/13
78000
5.16
Jl f48
East Burlington
Dry
<.5"
S
0.5
0.3
29700
3880
2
`33.875
A''
Fescue
"O 000
-'O.00o
b 000 .
0.000
0 OOQ''
U;Ooo '
Or lOb`
0.000.1
F 0 000
6000
fl 000"
0.000
o 000
,V0000
o bod
0 000
0--000 tx
o ao t-
0.000
0.000
[1
..;p,:.,
" i0 0110',-`x
Residuals Applications totals on FORM
FSF supp (attach FORM FSF supp
to this form):
(1.(100
0,000
TOTALS:
0
1'i5(}UU
::::::::::: ::.
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
$4.686
0 00
_-
Lime A > ,lied
Annual lbs/acre
0 Q26 '
0 0.17
1.75
` U'446
0.105
0 005
0 044�'
0 1:45
o Q44
63707.527:::::>
:-:::. :
=
... ....
:. .
':::: : • ::
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.069
0.036
2.507
1.754
0.261
0.012
0.105
0,286
0.085
6.951
Current Cumulative lbs/ac
0 095.
0 OS!3
3 582
2;,'0UO:y129
n_
.:10 588
Permitted C. P. L. R.****
36
34
1338
267
15
374
89
2498
Permit PAN Limit 1st/2nd 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
1/10/2017 **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): 36.74
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
C" ,,ator: Chad Randleman Owner: Blanch Jefferies Predominant Soil Series: IrB
A-.;s Used: 25.8 Acres Permitted: 25.8 Site #: CS117 Field #: 3
Residual Analvsis Data (Heavy Metals and Total Phosphorus use my/kE, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
11
SB
10/10/16
21
EB
10/10/16
31
14]
5
6j
7
Sj
91
1101
ill
12
% Solids
3.46
3.11
Arsenic
3
3
Cadmium
2
2
Copper
195
174
Chromium
209
55
Lead
11.5
11.7
Mercury
0.4
0.4
Molyb-
denum
5.14
5
Nickel
9.25
14
Selenium
5
5
Zinc
376
412
Total
Phos-
,,horus
23600
6470
f Iial Heavy ivletal. vreiti Loaciings (lualcuiateci in ins/acre):
1 otal 1 J 2 3 4 5 6 7 8 9 10 11 12
DT/Ac./ rt
App.
Event 0.18 1.24
Arsenic 0.001 0.007 0.000 1 0.000 0.000 0,000 0.000 1. 0..000 0-.000 0 000 0;0"00 0,000 1 0 a09..
Cadmium 0.001 0.005 0.000 0.000 I 0.000 0.000 0.000--1 0.000 0.000 0;000 0.060 0.000 .0.006
IChromiuni 0:076 1 0::137 1 0 001'0 0.000 10.M00 .I 0. 0.0:0 °j 0 U00 1 0.000 10:000 1 000.0.1 0.000F.-I 0.00°0' 10:21
Lead
Molyb-
0 062
0 U-12
0 000
0 000
0--boo
0.000.'
0 000
0.000
0.060
- 0 000'
0 00.0
0.000. -
0 0.14-
denum
.
;
Nickel
0 003
0 035
. ;0 000
° 0 000
0.000
O.00Q
" 0 000.
0 000
0.:000
0 000
0 000
0,;000
0.038
Selenium
0 00,2
0 012
0 000 ,
_ 0 OOU
0.000
0.000
0.000
0 000
0 000
Q 000
0.014
Zinc
0 13.7
1 023
Q 000',.
0 000
10.000 -
,° 0 000,:
0 0:00
0:000
; 0.000`
0..000
0,000
1.160
Total
Phos-
8 590 .
16A71
0 00:0 "
0.0.00.
0.,000
0:.000
0 000
0.00.0
0.000
1 0.000
0.0:00
0:000
24.66-2 ,
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
irr -;sonment for knowing violations".
ZI: 1/10/2017
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
Blanch Jefferies
Chad Randleman
Crop 1 Name:
Fescue -Pasture
WQ Permit #: WQ0000520 Field #:
Annual Dry Tons Applied:. fi 34.74 Site #:
Predominant Soil Series: IrB
Crop 1 Max. PAN: 92 Crop 2 Name:
CS117
Acres Utilized: 25.8
Acres Permitted: 25.8
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
o
o °
A
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.
(D
(Dry,
Wet,
Moist)
precip.
Past 24
Hrs.
inches
y
n
0
o P.
a a.
o
o
�«,
—
# N'
5
4
7�
w -,
"
N
*
TKN
mglkg
Z
o 5
5
p w'
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
11/22
19500
3.46
:.01d9 ..
South Burlington
Dry
<.5"
S
0.5
0.3
61400
17600
579
4.911
NA
Fescue
11/22
136500
3.11
0 686
East Burlington
Dry
<.5"
S
0.5
0.3
27900
4810
346
13.281
NA
Fescue
11/23
13000
3.46
South Burlington
Dry
<.5"
S
0.5
0.3
61400
17600
579
3.274 _
NA
Fescue
11/23
110500
3.11
S5'
East Burlington
Dry
<.5"
S
0.5
0.3
27900
4810
346
10.751 '.
NA
Fescue
Q'Q00 :.
0.000 '
0.000
100
0.000
0.000
D 00Q,`
0.000 `.
0.000
0 000:
0.000
0.000
0 00:0:
0.000
o.000
lW ;
0.000 `,
0,000
0.000
0.00 )
o_000> ...
0.000
0.000
.
0
0
::.;:;
_.
QD00; . •.
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000'
0.0(10
. .
TOTALS:
" ° 01
279500
As
Cd
Cu
Cr
Pb
H >
Mo
Ni
Se
Zn
p
32.218.
0-000
Lime Applied -
Annual lbs/acre
0.033
r QOA1•r
Or014
0038'
fl14
f`l<0
.24.662 >
. :. •.
::' :>:`
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.323
0.203
19.822
8.704
3.923
0.062
1.104
1.632
0.235
31.743
Current Cumulative lbs/ac
b 332
0 2094,
20ZS
8i)17
, 3,.956
063 ,:
1 1t81
G7Q
0:249?
903
Permitted C. P. L. R.****
36
1 34
1 1338
1
1 267
1 15
1
1 374
1 89
1 2498
Permit PAN Limit 1st/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
1/10/2017 **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): 17.15
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
¢ -Yator: Chad Randleman Owner: Blanch Jefferies Predominant Soil Series: IrB
A ,S Used: 10.9 Acres Permitted: 10.9 Site #: CS 117 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
10/10/16
21
EB
10/10/16.
31
4'
51
6
7J
L-81
L9J
ILol.111
12 1
% Solids
1 3.46
3.11
Arsenic
3
3
Cadmium
2
2
Copper
195
174
Chromitiiii
209
55
Lead
11.5
11.7
Mercury
0.4
0.4
Molyb-
denum
5.14
5
Nickel
9.25
14
Selenium
5
5
Zinc
376
412
Total
Phos-
horus
23600
6470
P ',ial
Heavy Metal Field Loadings
(Calculated in lbs/acre):
..,[al
1
1 21
3]
1 41
1 51
61
7
9
10
11
12
DT/Ac./
_8j
H
0
App.
Event
0.26
1.32
Arsenic
0.002
1 0:008
0.000 1
4,.000
0.00 ,
0.600
1,0.000
0.000
1 0°.0001
0.0001
1 0,000-
0.000
0.009
Cadmium
0.001
0.005
0.000 1
0.000
0.0;00
0.000
. D.00U
0.000
0.000
0, D00
0.000
0.000
. 0 66G
Copper
0 101
0 458
0 000':
0 DOO
0.0.00. ,
O OOQ,
. 0 000"
0.000.
0.000
0 000,
0 000.
0:000-
0 5.58
Chromium0
10.8
0 145
0 000, ;
0 000
0 ,000
0 000
' 0 000;:
0.0.00
0000
0 OOQ
0 000 .
0.000
0.252
Lead
0 006
0 Q31
Q 000.:
- 0 000: _
0:000
0 000,
_ 0 000
0 000
O'.000-
; 0, 000%
0„OQO-
0000.
0 037
Mercury
0 OO:U
0 001
0 000
. 0 000
0.000
0 000
0 00.0
0 000
- Q:Q00
- 0 OOQ.
0 000 `
0:000
0 001.
Molyb-
0 003
0:'013.
0 000
0 00.0:
0:0:00
0.:000 .
0 000
0 0:00 -,
0.000
0 000;:
0-000
0.'000
0 016,
denum
:.
Nickel
0 005
0.037
0 000 `
0 000
0 000
_ Q 000
'' 0 000'
0 Q°00
0000
0 000
0.000
O:D00
' 0 042Y
Selenium
0 00
0 013
0 OOQ
0 000
0 000,.
0 000, -
;- 61,606
0 000
0000,.
0 000 -
0.000
0:000
0..016
Zinc
0 194
1 084
0 000
0 OOQ.
0 000
0 000;.
.0. 000.
0.000
0°000
y' 0 000
0 000 ,
0.000
1 278
Total
Phos-
12.1fi8
17.016
' . 0 000. '
" 000:0
0000
0.000
.. 0 O.Q.O
0-000
0000 :
0.000
0.000
0.000
29.194
nhorus
"I certify. 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
in, -~isonment for knowing violations".
XJ: 1/10/2017
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 #:
Land Owner: Blanch 7efferies Annual Dry Tons Applied: 171:5 Site #:
Operator: Chad Randleman
Crop 1 Name:
Fescue -Pasture
Predominant Soil Series:
Crop I Max. PAN:
92
IrB
Crop 2 Name:
4
CS117
Acres Utilized: 10.9
Acres Permitted: 10.9
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
° -1
y 1
°
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.
(D
(Dry,
Wet,
Moist)
Precip.
Past 24
Hrs.
inches
Y
C b
co
re'
o w,
a
o
w
N'
* ?
o'
p
w -i
c w
* ^
x �'
o
TKN
mg/kg
Z Y
o
CD 0
>v•
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
l l/21
19500
3.46.23'8
South Burlington
Dry
<,5"
S
0.5
0.3
61400
17600
579
11625 "
NA'
Fescue
11/21
110500
3.11
1'31'S
East Burlington
Dry
<.5"
S
0.5
0.3
27900
4810
346
i5-,448,'
NA;
Fescue
0:000 •
0.000
0 OQ�..
0000 `
0.000
o aoo'
0000
0.000
a' noo .
IW000
0 oo0x
A ooa
o 000 -
o 000
o.000
0 000. °
o 006 °.
woaa � :"
0.000 ..
ov,
0
0
E Q'.000
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000
060,
:: :::•:
•:?< »:
TOTALS:
01
130000'
As
Cd
Cu
Cr
Pb
Ha
Mo
Ni
Se
Zn
P
37.073
0 OOA_''`:
Lime Applied
Annual Ibs/acre
Q_p09
0 006_.
0 558
0"252
-037
Q 001;.
0 01;6
0 042
O:d?l k
T 278
24.194 ::'::.'::':::;:::::::`::::;.'>'
::::::::::: : :::::':::
...........................
............................
Date
lbs/ac
Prior Years Cumulative Ibs/ac
0.17
0.137
14.292
5.384
2.036
0.058
0.51
1.036
0.173
25.412
Current Cumulative lbs/ac
0,179
0 143
14 $50.
5.636
z 2 073.- -
0 059 .
0 .26.
1.079
0 T89
26.690
Permitted C. P. L. R.****
36
34
1338
267
15
1
1 374
1 89
1 2498
Permit PAN Limit l 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."
,C *Application Method: S - Surface, IN - Injection, INC - Incorporation
1/10/2017 **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): 4.84
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
O" -ntor: Ervin Kimrey Owner: Ervin Kimrey Predominant Soil Series: HrB
A._ -, Used: 3.2 Acres Permitted: 3.2 Site #: OR007 Field #: IA
Residual Analysis Data (Heavy Metals and Total Phosphorus use me/ka, % Solids use Raw Percent #):
Com-
posite
Date
Total
Phos-
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./
0
App-
R.
W
Event
1.51
Arsenic
0.00:0
0.o0o,
0.000
0.000
.0.000 .
0.000'
' 0.000
0:000
0.000
0,900
0,00,0.
1 0.000
0 009'
Cadmium
0.006
_ 0.000
0 * ,
0..000
0:-0.00 .,
. 0.00o
6A00:
0:0.00
0-.000
1 6.000
0.0oo
0..000
0.006.,
Copper
0,702
0.010.0
0.000.
o 000
. 0..000
..0 000
= 0 000°
0 000
. 0..00.0
: 0 000-
0 000
0.000
0..702
hromiun
0 738
0:000.
Q 00.0 ''
0 00.0
O,.000
0 000
0 004
0 OQO.
0,000
6.06
0.000
0:000
0.718
Lead
0.04-5
0 000
0 Q00
: O Og0
0,0:00
0 000;
0 0.00.
0.000
0.000
6,00
0 040
0 000
:`' 0 04 -
Mercury
0 002
0 000,
. -0 000
O.00.0
0;:000
0. 0.00 '`
0 o00`
0:0g0
0:000
0 000.
0r000
0.00.
0.002.
Molyb-
0.015
O.OoQ
0 o00?
' 0..000
o a6b
0 000
: 0.000'
0.000
0 000
0 000_
0AOO
0.000
0.015-
denum
; .
Nickel
0 036
Q OQO ,
0 000
:' 0000
0 Q00
0.000
. 0 000
0 OOQ
0..000
, 0 OOU'
0 00:0
0,000
0 03fi°
Selenium
6.0.15
0 0 _o
U Oqq-
0 000 .
0.000
0 00.0 ,
0:000
6:Q.00
0.000.:
0 ODO`
0 000
0.000
0.015
Zinc
14
0 000
0 00.0 .:
0 0.00
0000
0 000::'
0 OOQ'
0 000
Q;:000 -
: 0.000
0 0:00
0 40.0,
l 285
Total
Phos-
86.184
0.000
0.000'
,Q:000
OA00
0.00.01
0.000
O Q00
0.00.0 .
- 0.000
_ O.U'00
0.00"0
:86.184
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
ir-isonment for knowing violations".
;eLe 1/10/2017
Signature of Land Applier 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
Ervin Kimrey
Operator: Ervin Kimrey
Crop 1 Name:
Fescue -Pasture
WQ Permit #: WQ0000520 Field #:
Annual Dry Tons Applied:'. 4:84`. Site #:
IA Acres Utilized: 3.2
OR007 Acres Permitted: 3.2
Predominant Soil Series: HTB Cation Exchange Capacity (non 503):
Crop 1 Max. PAN:
158
Crop 2 Name:
Crop 2 Max. PAN:
t.
,0 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
a
10
co I�
o'
0 2. art
�` o
o
%`�
7y
w -:
; m
TKN
mglkg
Z a
g 5
o 5
R.
mg/kg
Nitrate
and
Nitrite
mglkg
PAN Applied
(Ibs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop I
Crop 2
3/31
45500
2.55
1:512
South Burlington
Dry
<.5"
S
0.5
0.3
66300
32500
2
79.807
NA
Fescue
°0 0o0
0.040
o:000`
0.00o
0 000"
Q,;004
0 000
0 000..'
o.000 .
0.000 :
0 00o
f1;,Q00
-0:00o
0 00.4
O;OOQ
omo
0 400
0 -b '
01.0 00°
0 004 "
0.000
0
0 "• a '
� ;U b00
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0 000-
0.000'
...
... ..
TOTALS.
" ` 0
45soo
As
Cd
Cu
Cr
Pb
H"
Mo
Ni
Se
Zn
P
79.807 _
0 OQo"
Lime Applied
Annual lbslacre
n' 0` 009'
0 006'
0 7Q2
0<?38
0 04�
4 002
0 0> r
{f.o6
0 015
" I285
8618 : :::.:::::.:::: :;
-
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.035
0.022
2.344
2.381
0.178
0.007
0.058
0.139
0.052
5.397
Current Cumulative lbs/ac
0 044
Q 028} "
06
3::119
h_ 0' 223
0 009 m;
0 073:
0 15 "
0 067
6682
Permitted C. P. L. R.****
36
34
1 1338
267
15
374
89
2498
,Permit PAN Limit l st/2nd Crop
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
1/10/2017 **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-.06
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
C' ,ator: Ervin Kimrey Owner: Ervin Kimrey Predominant Soil Series: HrB
A_ _S Used: 7.7 Acres Permitted: 7.7 Site #: OR007 Field #: 1B
Residual Analvsis Data (Heavv Metals and Total Phosphorus use mff/ku. % Solids use Raw Percent #):
Sample or
Com-
posite
Date
11
SB
1/11/16
_11
4
5
L 6
7
-8-1
L9J
Loj
111
12
% Solids
2.55
Arsenic
3
Cadmium
2
Copper
232
Chromiioii
244
Lead
15
Mercury
0.6
Molyb-
denum
5
Nickel
12
Selenium
5
Zinc
425
Total
Phos-
horus
28500
F ial
rieavy iwetal r lew Loaaings
(ualculatea In ins/acre):
i otal
L2J
3 J
5j
LBJ
7
8
9
10
11
12
_4j
H
DT/Ac./
0
rt
App-
Event
1.44
Arsenic 1
0;009
0.000
0.000
0 000'
0.000
0 000.
0.00'0
0.000:
0.000 .
' 0:000
0.000
0_000
0 009 ;
Cadmium
; 0.006
0.000,
-0"-`000 ..
0.006.0.000
'•0.000
0.000
0.000
0`.00'0'
0 000
0.00.0
0:000
0.006
Copper
0. 666 "
0:000 ;
0 000°.
0 00<0
0 000 ,
0 000
0 OOQ
O:QOQ""
0.000 `.
0 000
0,00:0
000"0
0 b6.6-
10
Lead
Molyb-
0 01.4
0 000
.0 006 -
0 000
0..0-00
0;000 '
0 000
0 0U0
0.000
0 000
0.000
0.00.0
0.014
denum
_
.
Nickel
0 034
0 000
0 000 °
0 000
0 0'00
0000 °
0 000"
0 000,
0000
0.000
0 00;0
0 000
0 034
Selenium
0 014 ,
0.09
0 000
0 OOb
0 0,00
0,000
0,00'0
0 U00
0 000
0 00'::
0 0.0'0
.0;000
'0 01?4".
Zinc
1.221
0 000
Q 000 ;
0 000
0 000.
0.000
0 000
0 00 ,
0 000
. „0 OO.Q
0 00:0
0:000.
i.221
Total
Phos- 81 85 0..0.00 _" 0 000 0,00:0 0 000 . '0-:000 . 0 00.0 0 0.06 0`:000 : 0.000 , 0.0,0.0 0.000 _8L852
phorus
"I certifv. 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
in- Isonment for knowing violations".
2!�Le 1/10/2017
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

Facility Name:
Land Owner:
Operator:
ANNUAL LAND APPLICATION i _,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 #: 113 Acres Utilized:
Ervin Kimrey Annual Dry Tons Applied: 1,1.06 Site #: OR007 Acres Permitted:
Ervin Kimrey
Crop 1 Name: Fescue -Pasture
Predominant Soil Series:
Crop 1 Max. PAN: 158
M
Crop 2 Name:
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
7.7
7.7
0
o =
N
A
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
o/p
Solids
Volume
Applied per
Acre
(Dry TonslAc)
Residual Sources
(NPDES #, WQ#,
Fert, Animal
Waste, etc)
Soil
Cond.
(Dry,
Wet
Moist)
Precip.
Past 24
Hrs.
inches
Y
4 '0
^o 'T�
0 P_
* O
o
w'
� -
�.
�
4
;V5.
w
cc !v
*
TKN
mg/kg
z
4
o
o 0.
mg/kg
Nitrate
and
Nitrite
mgtkg
PAN Applied
( lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop I
Crop 2
Crop 1
Crop 2
3/31
104000
2.55
1:.430
South Burlington
Dry
<.5"
S
0.5
0.3
66300
32500
2
75.809,
NA
Fescue
:9:000
0.000
0.000
0 000
0 000'
0.000
000
o:og0
0.000
a o00
0.000 ''
o.000
a oov
0.000O ;
0.000
0 000
0.000
0.000
0 000,
0.000 '
o.000
0.000 +
0.0o0
'U 000
0.000
0.000
0 060
0.000
0,000
o aoo
0.000 '
0.000
U
0
b 000"
,,,
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0007
omoo
TOTALS::
if
104000
. , ; ;:::;:;:
As
Cd
Cu
Cr
Pb
H ,
Mo
Ni
Se
Zn
P
7$.809':.
0.000
Lime A lied
Annual lbs/acre
°U 009
0 Oq6
01666
0,:�01 �>
;., 043
U 002
0 0.14
0.034
4.34
1 2211.SSZ
.. . . . . . ..:..:.:...:.:.:.:.:.
. • ....:...:...:.:.......::... . ........
; :...... . . .
....... .. ..... .. ...
...........................
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.035
0.019
2.115
1.962
0.176
0.006
0.057
0.14
0.045
4.961
Current Cumulative lbs/ac
0 044'
0 025
2 7;81 :
' 2.66 +
` 0? Ly ::
0°oa T
0 0T1
0.174
Q,059, .
, :6 182 '
Permitted C. P. L. R.****
36
1 34
1 1338
267
1 15
1
1 374
89
2498
Permit PAN Limit lst/2nd Crop
A
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
1/10/2017 **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): 24.20
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
C' Bator: Ervin Kimrey Owner: Ervin Kimrey Predominant Soil Series: f1rB
A_ A Used: 15 Acres Permitted: 18.8 Site #: OR007 Field #: 2
Residual Analvsis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Com-
posite
Date
os
_ahorusMENEENEENEEN
'}al
Heavy Metal Field Loadings
(Calculated in lbs/acre):
dotal
1
2
L3J
L4J5
6
L7
8
9
10
11 j
12
DT/Ac./
rt
App.
Event
1.61
Arsenic
0.010
1 0.000
0.000
0.000
1 0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000`,
0.010
Cadmium
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
Copper
6. 7S'
_._40,
0 000
; 0 000
flfl
©00
' 0 000
O fl04 ,
U;,00,
„0 000`
0 04i�
r 0 000
A 748 ,:
Chromium
0 7$7
0 D00
0 00�
: 0 00Q:
0 OQO
0` QQO
,: 0 OOOs
0 000
0000
0 fl00;
0 0.00
0 000
Q Z87
Lead(1000'
0 000
0-0b0,
;;; 0 OQO
0 000
0:000
0 000
0 Ofl:O
OrQ00
0 0,48;
Mercury
0 Q02
PAC
0 000?
0,000
OW0
O60
0 000..
0 000
0000
0 000:
0 000
0
0 002;
:Q00,
-
0 016
00001.
0 000�0
flOQ
0 000
O: Ofl0
0 000:
0 000
O.FOOfl
0 000
0 000
0 U00
9.016.
denum
Nickel
Q 039
Os Q00
0 Otti '
r..
dY00Q
0 000
Oi 000
0 000
-
0 000
O=OOOY
0 00(3
; 0 OQO
0 Ff00
0 039
Selenium
0 01G
0 O.dO
0 00Q,
„ 0 000
0 Qf}0
0 OOU
0 OOD::
0 000
0;000
'_5
U 00i7
0 0
0 4100
0 016
Zinc
L 37I
00
0 000
0 40U.
fl QQD
0 000
l 371
Total
M_
..
-
-
Phos-
9,1941
0'00
OQO :;
0 000
0100,0
0: 000
0 000 .
0,Q00 .
0:000
'`: 0 000= :
0.000
0 000
1.941.
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
in- -sonment for knowing violations".
1/10/2017
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
Land Owner: Ervin Kimrey
Operator: Ervin Kimrey
Crop I Name:
Fescue -Pasture
WQ Permit #: WQ0000520 Field #:
Annual Dry Tons Applied: 24:20 Site #:
Predominant Soil Series: HrB
Crop 1 Max. PAN:
158
Crop 2 Name:
OR007
Acres Utilized: 15
Acres Permitted: 18.8
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
t 5
Q
Volume applied
PP
(enter one) Solids/
Liquid
Cu. Yds G8110nS
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Wasteetc)
,
Soil
Cond.
,
Wet
Moist)
Precip.
Past 24
Hrs.
inches
c 10
a o'
n w,
*
o
w,
W
o'
4
w `;
?'
* N
0
TKN
mg/kg
z �
o .0
0 w
mglkg
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
227500
2.55
1::6.13
South Burlington
Dry
<,5"
S 1
0.5
0.3
66300
32500
2
85.127
NA
Fescue
0.0.00 -
o mo
0; oo
0.000 .'
0.000
0 000
0:000
0.000
Q;000
0.000
o,000
lao `
0.000
0.00o
ooba
o000
0.000
0 000 '
0.000 -
0.000
0.000
omo
0 000
0.000
0_000
:a
000
0.000 -
0.000
0'
000
0.000
0.000
,0
0
Q OQO,
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
TOTALS:
, .... (11
As
Cd
Cu
Cr
Ph
H >
Mo
Ni
Se
Zn
P
85:127
o.)0n
Lime Applied
Annual lbs/acre
0 010
0.(106
0:74$
787
OA48
0 0
F 0 016
OVA
0 :0t6
_. _.
1:3' 1
_I I '. 1 ; :;:::::::::?:::'::::: ' ::
-
Date
lbs/ac
Prior Years Cumulative ibs/ac
0.038
0.021
2.431
1.882
0.191
0.006
0.079
0.181
0.055
5.875
Current Cumulative lbs/ac
q 048
0 027
3 1"19
2669
" 0 23A
0 008 ..
.0 OA5°
0 220
007i'
7.246
Permitted C. P. L. R.****
36
34
1 1338
1 267
15
374
89
2498
2 Permit PAN Limit 1 st/ nd Crop
..............................•.•.•..-.•....-•.•....................... ............................. . 1: g.
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
1/10/2017 **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): 143.79
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
C' `ator: Andy Thompson Owner: James Thompson Predominant Soil Series: GeB
A.,_ .;s Used: 31.7 Acres Permitted: 31.7 Site #: OR64 Field #: 1
Residual Analysis Data (Heavy Metals and Total Phosphorus use ma/ka, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
EB
3/14/16
2
SB
3/14/16
3
SB
9/12/16
4
5
6
7
8
9
10
Ill
12
% Solids
6.23
3.55
3.25
Arsenic
1 3
3
3
Cadmium
2
2
2
Copper
122
186
158
Chromium
67
201
164
Lead
15
15
13.6
Mercury
0.4
0.4
0.5
Molyb-
denum
5
5
5
Nickel
18
9
8.42
Selenium
1 5
5
5
Zinc
433
345
300
Total
Phos-
horus
9780
27400
21400
1 lal
heavy Metal r'lela Loaaings
(ualculatea In ms/acre):
1 otal
EU
L 2
3
4
5
6
7
8
9
10
11
12
DT/Ac./
oy
App.
Event
2.72
0.15
1.67
Arsenic
0,016
0:001
0.010'
0 00.0
0.000,
0.600
0..000
0.000
0,000
0 000
0.000
0.000
0..027
Cadmium
0: 011
0.001
0007
0-060
`0.0od
0.6 0
640100.
0:000
0.00.0:
0.000
0.000.
0.000
0.018.
Copper
O.663
0,057,
0.527..
0:000
0.000
0.0010
0,000
9, 000
,- 0;000,
0.000
0 000
0:000
1.246
Chromium
0 364
0 061 `
. 0.547
0.600
0.000 '
:0 000
0 000
0 000
_ O:OO;U
0.0.00
0 000
0..000
0 972
Lead 1
0.082
0.005 .
0 045
0.000
0.000
0.000
0:00-0
0.000
0:000;..;
0.00.0
' 0.000
0,000
1 0.134
Mercury
0 002
0.,000
0 002 ::
0 000
0000
U 00,0 :
0 Oq.Q:
0 O:UO
0,000
0 000.
0.000
0.000
0.004
Molyb-
h
0.027
0 0`02
0 017 ;;
0..000 ,
O.000
0 000 .
0 000.
0.000
0.000
` 0 000.
0.000
0:000:
0.045
denum
denum
Nickel
0 098
0 403
0 02$
0 000
0 000
.- 0 O�oO.:
; 0 000
0 OU0
U,000 :
0.000 _
0 000
0:000
0 129
Selenium
0 027
O.Q02
0 017:
0.000
O.000
0 000
0 OOU
UAW
0 000
0.0 0
0.000
0:000
0 045
Zinc
2 353
0.10
000 .
0 000'
B.000
O:000
0 000
0 000
0.000
0 000.
0 00:0 .
0.000
" 3.458
Total
Phos-
53.1.45
8.330
71 34$
0.000.,
0.000,
O:OGQ, `
0 000
0..000
0:000
0.000
' 0.0_QQ-
0.000-
132.822
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".
zl�z 4;5 1/10/2017
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 #: 1 Acres Utilized:
James Thompson Annual Dry Tons Applied: 143.79 Site #: OR64 Acres Permitted:
Andy Thompson Predominant Soil Series: GeB Cation Exchange Capacity (non 503):
Crop 1 Name: Fescue -Hay Crop 1 Max. PAN: 211 Crop 2 Name: Crop 2 Max. PAN:
31.7
31.7
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
Firs.
inches
a
� 's
a w,
o
�.,
*
�
7y �,
w
N'
TKN
mg/kg
Z >
Ft
o H
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
4/4
52000
6.23
'0.426' .,
East Burlington
Dry
<.5"
S
0.5
0.3
26000
3050
2
7.170
NA I
Fescue
4/5
149500
6.23
` ' . 1.225
East Burlington
Dry
<.5"
S
0.5
0.3
26000
3050
2
20.613,
NA
Fescue
4/5
32500
3.55
'0.12.
South Burlington
Dry
<.5"
S
0.5
0.3
62000
22300
2
7.000
NA
Fescue
4/6
130000
6.23
1.065
East Burlington
Dry
<.5"
S
0.5
0.3
26000
3050
2
17.924"
NA
Fescue
10/5
45500
3.25
.9,1.195
South Burlington
Dry
<.5"
S
0.5
0.3
58300
19000
2
8.284
NA
Fescue
10/6
247000
3.25
4.056"
South Burlington
Dry
<.5"
S
0.5
1 0.3
58300
19000
2
44.969
NA
Fescue
10/17
97500
3.25
0,417
South Burlington
Dry
<.5"
S
0.5
0.3
58300
19000
2
17.751
NA
Fescue
0;000
0.000 ,
0.000
0:000
0.000 '
0A00
0 000'
0.000
0.000
0 000 , "
0.000
0.000
`G
0.000
0.000
0
0
QY000 �,
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000
0.000
. ...
........ .
TOTALS:
D
754000
::::::::::.:::
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
123:709:
0.000
Lime Applied
Annual lbs/acre
O•027' _
0 01$•
r 1246
0 972
0 l Z (.1
0 004 "
Q D45`
0 129
0 0;45
3:;458 ,
;132.822 ::: : : :::::::::::::::
;::::::: > :: ': >:: >::: >:<:::
...........................
............................
..........................
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.635
0.453
63.666
21.683
12.295
0.237
3.115
5.079
0.414
130.643
Current Cumulative lbs/ac
0 662
Q.471
64912
22.655,
12 4 Ci.
0 241
3 160
_
5 2Q
Permitted C. P. L. R.****
36
34
1338
267
15
1 374
1 89
2498
Permit PAN Limit 2nd Cr 1st/ o 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
1/10/2017 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
Signature of Land Applies 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): 20.83
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
C rator: James Thompson Owner: James Thompson Predominant Soil Series: GeB
,z� -s Used: 15.6 Acres Permitted: 15.6 Site #: OR64 Field #: 3
Residual Analvsis Data (Heavv Metals and Total Phosphorus use mg/ki& % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
SB
9/12/16
21
31
L4]5
6
7
8
9
10
11 j
12 j
% Solids
3.25
Arsenic
3
Cadmium
2
Copper
158
Chmini u r i
164
Lead
13.6
Mercury
0.5
Molyb-
denum
5
Nickel
8.42
Selenium
5
Zinc
300
Total
Phos-
horus
21400
F iai
tieavy ivletai r ieia Loaamgs
(t_;aicuiatea in ins/acre):
,.,ial
1
171
L3J
L4J
L5J
L6J
L7J
L8J
L9J
LOJ
111]12
j
DT/Ac./
y
App•
E
Event
1.34
Arsenic
0.008
0:000
1 0 00:0
j0.000
0:00.0
0A00
0;000
0:,000
1 0.000
1 0.000
I 0.000
j 0.000
0.008.
Cadmium
0..005
0000
I Q 000
0.000
0.000
0.00'0 '
0 000.
0A00
0:000
0.000
0 00.0
0:000
0:005
Copper
0.422
0:000- .
0:000
0.600
0°:000
0 000
0.000
0:.;0.00
1, 0::000
J,0,000_
0 0:0:0
1 0.000_ .
0.422.
Chromiun4
0.438
0:000
0 000'1
0 000
0.000
. 0. 006-
. 0 000
0,000
0-0,00 .1
0.000
0.000
1 0,000
0.438
Lead
0.03,E
0::000
0 000
0.000 ..
0 000
0-000
0 000.
0-000
0.000
0 000`
0.00:0
0.00:0
0 035
Mercury
0.001
0:000
0 000
0,000
0.000
0..0.00
Q.0010
0.000
0_000
0.060 -
0.009
- 0.000
0.001
Molyb-
denum
0.013
0.0
O.O.OQ
0.0.00
0.0`00.
0: 000 :.0
000
_
0 000 ",
_
0.4000,
0 000.•
0.000
0.000
0.013
Nickel
0.022
0 000
0 000 :
0 000
0.000
6.060 '
` 0 000
0 000
11 000
0 000-
0 ,
0:000
0.022-
Selenium
0.0-13
0.:000
-`0:000
0 000
0:000
0 000 =.
0 000.
0.000
0000 `.
0.000
0.000
0.060
0..013'
Zinc
0 80z1
0-.000
0.060
0.000
0000
0..000 ,:
0 00:0
0 0':00
0.000
0 000
0.90.0
0.000
10.801
T
otal
Phos- 57.13-81 0.000.1 0.000 0,000 0,000 0.0.0 0.0.0:0 0,000 0.000 01.000 0:000 0.000 57.138
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
in, -~isonment for knowing violations".
;e:f 1/10/2017
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
James Thompson
James Thompson
Crop 1 Name
Fescue -Pasture
WQ Permit #: WQ0000520 Field #:
Annual Dry Tons Applied:: 26183 Site #:
Predominant Soil Series: GeB
Crop 1 Max. PAN: 158 Crop 2 Name:
Acres Utilized: 15.6
OR64 Acres Permitted: 15.6
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
°
°
Q
Volume applied
enter one Solids/
( )
Liquid
Cu. Yds Gallons
o
/p
Solids
Volume
Applied er
P
Acre
(Dry TORS/AC)
Residual Sources
(NPDES # W #
Q
Fert., Animal
Waste, etc)
Soil
Cond.
D
Wei'
Moist)
Precip.
Past 24
Hrs.
inches
a
'a
co �
o'
o w
Q
9F Q
o
, w
* K'
* w
R.
7d
w -
° P•
N
TKN
mg/kg
z Y
o
°� °�
�.
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
10/17
78000
3.25
0s678'
South Burlington
Dry
<.5"
S
0.5
0.3
58300
19000
2 1
28:856
CIA =:
Fescue
10/18
78000
3.25
0,678
South Burlington
Dry
<5"
S
0.5
0.3
58300
19000
2
28:856
NA
Fescue
O�OQQ
0:000
0 00Q
O'w000'
0:'OUO
0 Q00;
0:000
0 o6.0
0000
o:000
0:000,
o 000''
0
'o:oo0
0.00o
o o0,a
4.660 .
O'000`-
Q 000- .
0.000
ADOO
0 000 -
o: 000,
0.000
0 000.
O
0
;:.':
O,QOO
Residuals Applications totals on FORM
FSF supp (attach FORM FSF supp
to this form):
O';OUO
0 0009;F'
TOTALS:
01
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
57.712
O::Q,oO_:
Lime Applied
Annual lbs/acre
Q,.008,
0 005:.'
0 42L
O:A38
OU36
0 001 °,
0 01:3:
0 022
0.01
0801
;5'7.138 >: >
. .. .. ..................
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.265
0.218
28.746
11.096
3.926
0.084
0.892
1.926
0.23
44.35
Current Cumulative Ibs/ac
U.:273
0 223
29168
11:534
3 962 .
< 0 Q'85
0 905
19.48,
4
0 243
4S. )51
Permitted C. P. L. R.****
36
34
1338
1
267
15
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
1/10/2017 **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): 29..06
Permit #: WQ0000520 Cation Exchange Capacity (non 503 only):
C' -�ator: James Thompson Owner: James Thompson Predominant Soil Series: GeB
A__ 49 Used: 21.9 Acres Permitted: 21.9 Site #: OR64 Field #: 4
Residual Analvsis Data (Heavv Metals and Total Phosnhorus use mLy/ke. % Solids use Raw Percent #):
Sample or
Com-
posite
Date
?
SB
9/12/16
21
L-31
L41
5
61
L-7-1
_8J
9
1oi
11 J
112
% Solids
3.25
Arsenic
3
Cadmium
2
Copper
158
Chromiuiii
164
Lead
13.6
Mercury
0.5
Molyb-
denum
5
Nickel
8.42
Selenium
5
Zinc
300
Total
Phos-
chorus
21400
f iai
tteavy ivietai r ieia i oaaings
(uaicuiatea in ids/acre):
i otal
71
121
731
547
5
6 J
7
LL8jj
9
10
11 I
12
DT/Ac./
0
App.
Event
1.33
Arsenic
0.00!8
0:A00
1 -0.000
0.000
0:00.0
1 0.000
0,000
0:000
01000
0.:000
1 0.000
0.000
1 0.008
Cadmium
0.005
0.000
0.0016
0.000
0.000
0.000
0.00.0
0.000
0.000
0.000"
0.0'00
0.000
0.005
Copper
0.419
0.000
0,000
0.0-00
0.000
Q 000"
0.000
0.000
0:000
.- 0 00.0"
0.09:9
0.000
:0.419
Chromiu
0.435
0M.0 "
' 0.040 ",
0-0001
0.600
0.000--
- 0.000
O.OgO
0.000
0.000:.
0.000
0-.000
" 0.41
Lead
0.036
0.000
' 0 000 '
0,000 ,
0.00 - ""
0 000 ;=
0.0"00'
0.400
0:.000
0AO
0 OUO
0.000
0.036
Mercury
Merc
0.001
0..000 -
0.00 0
0.000
0.000
0" 000
0 000 "
0.0;00
0:000 "
- 0.000
0.0.00
0.000
0, 001
Molyb-
0.013
0.0-00
0.000
0.000
0.000.
0 000
0,000
0.000
0:000
0.000
0:00.0
0.000
.0.013
denum
.:
Nickel
0.022
0'.0-00 ,
0 000
0.000
PAQ-Oe
0 000 r-
0 000
O.g00
0 000 '
0 00.0
0.000
0,000
. 0.022
Selenium
0..0,13
-0 000
- 0 000
0 :000
0..000
0a,000.
. 0.000.-
0.0,00
0.000
0.000
0.009
0,000
0.013
Zinc
0 796
0.000
0 000;
0.000"
6_000.
0.000
- 0,000"1
0.000 :
0.00,0
,. 0.000
0..000
0.:000
0.796
Total
. .
Phos-
56.796
0.000
0.000
0.000
0.00.0
0.000
0.000
0.600
-0-000
0.000
0.000'
0.000
.56.796
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".
''%e 1/10/2017
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: _
James Thompson Annual Dry Tons Applied:' tiQ.0:6 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:
21.9
21.9
0
Q°
Volume applied
enter one Solids/
( )
Liquid
Cu. Yds Gallons
u
/o
Solids
Volume
Applied per
Pp P
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil.
Cond.
W
Moist)
Precip.
Past 24
firs.
inches
?>
�
o w
� �
* 5
o
7y
N'
� �
o'
p
� 9
:' �,
* �
0
TKN
mg/kg
Z
o
.aq °��
� �.
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
10/18
91000
3.25
D.563
South Burlington
Dry
<.5"
S
0.5
0.3
58300
19000
2
23 98'1 :".,.NA-;':
Fescue
10/19
123500
3.25
0:764.
South Burlington
Dry
<.5"
S
0.5
0.3
58300
19000
2
32.545
NA, '
Fescue
o,oa0
o:ona
o 00.0
o:ooa.
o .000
0:000:
-000
x%0'100
o;oo0
0.000
U'�000
0' o00
0 000,
s 0.000
0.000.
fk 000.
0:000
0 0oa
0:000 !
Q 000 _
0000
0 000 `.
0
U` `
d, 000
Residuals Applications totals on FORM
FSF supp (attach FORM FSF supp
to this form):
O.00U
0.000 `°
>..•. ..:
:'::.': .
TOTALS:
"" 0
2?4500
:.:'::::•::
As
Cd
Cu
Cr
Pb
H
Mo
Ni
Se
P
56.526
0 000`'
Lime A lied
Annual Ibs/acre
9 00>
0 005
0 41'9
0.935
0 03� :
0 t101+
Y 0 tl13'
,,. :.....
0 022
„_.
U4913
...
�� S:�i.796 ::::?.:::.:.::.
..................Prior
::: ::::::::::::::':::=::::::=:...........I.............Current
<
Date
lbs/ac
Years Cumulative lbs/ac
0.314
0.312
42.406
15.918
5.196
0.134
1.276
2.902
0.259
r
Cumulative Ibs/acPermitted
C. P. L. R.****
36
34
1338
267
15
374
89
rmit Limit
Pe PAN L mtt 2nd Cro
p o
P
5 1 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
1/10/2017 **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)