WQ0004166_Residual Annual Report 2014_20150126

Town of Jefferson Water Resources
BIOSOLIDS PROGRAM
Activity Report for the Calendar Year 2014
CLASS B Pennit Number WQ0004166
Liquid Sludge Land Applied by Truck
Contact: Tim Church [phone]

Town of Jefferson 1 atW ReSottr'ccew
P.O. Box 67 1233 NC Highway 16 South Jefferson, NC 28640 [phone]
"Protect'mg, &lNew 1Ziver8a4Ln"
Cathy Howell, Town Manager
January 20, 2015
NC Division of Water Resources
1617 Mail Service Center
Information Processing Center
Raleigh, NC 27699-1617
Dear Staff:
Tim Church, Director
JAN 2 6 2015
DVVR SECTION
9NFORMATIO d PROC SSInG UNIT
Please find enclosed three (3) copies of the Town of Jefferson Water Resources Annual
Report for the land application of biosolids for the Calendar Year 2014. This mailing
contains the report foiCass = iquid sludge, while the report for Class A dry solids will -
be sent in a separate mailing. An additional copy of each has been sent to the US EPA
regional office. If you have questions or require additional information, please call me at
[phone].
Respectfully,
Tim Church
Water Resources Director
110Z4
R�yr�oNp�o�T�o� S
c�ss��GUNi�
[e-mail]

Town of Jefferson Water Reotwcek
P.O. Box 67 1233 NC Highway 16 South' Jefferson, NC 28640 [phone]
"Prot'eCt- th& Ne v RCrey 18a,&�
Cathy Howell, Town Manager
January 20, 2015
NC Division of Water Resources
1617 Mail Service Center -
Information Processing Center
Raleigh, NC 27699-1617
Dear Staff:
Tim Church, Director
Please find enclosed three (3) copies of the Town of Jefferson Water Resources Annual
Report for the land application of biosolids for the Calendar Year 2014. This mailing
contains the report fort s - solids, while the report for Class B liquid sludge will
be sent in a separate mailing. An additional copy of each has been sent to the US EPA
regional office. If you have questions or require additional information, please call me at
[phone].
Respectfully,
Tim Church
Water Resources Director
jeffwr.s@centii'rylink.net

ANNUAL LAND APPLICATION CERTIFICATION FORM
Permit#: m
J(o(o_ County: e, - Year: ZQl'�FacilityNan on permit): efs6n
Land Application Operator: Phone:`33�,y�—zJ S
-� and a placation of residual solids as allowed by the permit occurred during the past calendar year?
0Ycs ❑ No if No, skip Part A, and Part I3 and proceed to the certification. Also, if residuals Nvere
generated but not land applied, please attach sin explanation on how the residuals were handled.
Part A!
Total number of application fields in permit:
Total number of fields land application occurred during the year:
z,
Total amount of dry tons applied during the year for all application sites:
Total number of acres land application occurred during the year:
Part 13:
Facility was compliant during calendar year 2,01%vith all conditions of the land application permit
(including but not limited to items 1-12 below) issued by the Division of NYater Quality. ® Yes ❑ No
It' no please, provide a written description wli•Y the facility was not compliant, the dates, and explain
corrective action taken.
l . Only residuals approved for this permit were applied to the permitted sites.
'. Soil pl-I 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 oflaboratory results are attached.
4. Annual TCLP analysis was performed and three (3) copies of ceriified laboratory results are attached.
Al I other monitoring was performed in accordance with the permit and reported during the year as required
and three (3) copies ofeertified laboratory results are attached.
6. The facility did not exceed any of the Pollutant Concentration Limits in 'fable I of 40 CFR Part 503.13 or the
Pollutant Loading Rates in Table 2 of•40 CFR part 503.13 (applicable to 40 CFR Part -S03 regulated facilities).
7_. All general requirements in 40 CFR Part 503.12 and management practices in 40 CFR Part 5.03.14 were
complied ,vith (applicable to 40 CFR Part 503 regulated facilities).
S. All operations and maintenance requirements inthe permit were complied Nvith or, in the case of a deviation,
prior authorization was received from the Division of Water Quality.
9. \o contravention of Ground Water Quality Standards occurred at a monitoring well or explanations of
violations are attached to include appropriate actions and remediations.
10. Vegetative cover as specified in the permit was maintained on this site and the crops grown were removed
in accordance with the crop management plan.
11. No runoff of residuals froin the application sites onto adjacent property or nearby surface waters has occurred.
12. All buffer requirements as specified on the permit were maintained during each application of residuals.
"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 tines and imprisonment for )snowing violations."
Resour for _f ,
Tim 861urr�, Wra�er ces � y,
Permittee Name and Title (type or print) Signature of Permittee Date
L L
Signature of Preparer` Date
(if -different from Permitter)
Preparer is defined in 40 CFR Part 503.9 (r)
Signature of Land Applier Date
(if different from Permittee and Preparer)
DENR FORM ACF (5/2003)

i ANNUAL RESIDUAL SAMPLING SUMMARY FORM E
Please note that your permit may contain additional parameters to be analyzed. The parameters can be reported in FORM RSSF - 13
WQ Permit Number: Laboratory: 1) � TO
Facility Name: Town of 3eHer-s oy, - 1NVtEP 2)
Residual Source WQ # or 3)
NPDES #:_ `l)
N'VNVTP Name: S)
Residual Analysis Data
Parameter
(mg/kg)
Conc.
[limit
(m ., )a
Sample or Composite Date
Y1011q
Percent Solids (%)
NA
IL
Arsenic
75
((p , Co
Cadmium
85
Copper
Chromium
4300
NA
I -cad
840
Q.3r1
Mercury
57
o'. 6
Molybdenum
75
0.03
Nickel
420
/1./
Selenium
100
15.1
Zinc
7,500
_Q50.
Total Phosphorus
NA
TKN
NA
3 6
Ammonia -Nitrogen
NA
700.
Nitrate and Nitrite
NA
tf (�g,
a For surface disposal facilities the ceiling concentration limits listed in this farm are not applicable. Reference the individual pernut for metals limits.
"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 gathercd 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 *
1 "
Date
*Preparer is defined in 40 CFR ['art 5039(r) and 15A NCAC 2T .I 102 (26) DENR FORM RSSF (12/2006)

3 ANNUAL RESE UAL 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: W (p Laboratory:
Facility Name: ,, WTP
Residual Source
NPDES # or WQ#:(��p �(
WWTP Name: _7E JfS6`ft
1)
2)
3)
4)
Residual Analysis Data
Sam le or Com osite Date
Parameter /0/ILA
(mglkg)--------------
.7
es►u 5 Di8
s
PAN
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."
ate ti
Signature of Preparer j
*Prepw ) defined in 40 CFR Part 503.9(r) and 15A NC AC 2T .1102 (26) Ij DENR FORM RSSF - l ..")/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: TOwn J Je,Wer56n WVEP Total Dry Tons Applied (Annual):r.
Pp -it #: Cation Exchange Capacity (non 503 0'nl-y):
d"jator: Ton �' ucr�. Owner: Ff'Q.� WollTerS
Acres Used: 30 Acres Permitted: Site #: i~fpd ' 4Field #: j
Total
P •
!l,
Aiti_;rual Heaw Metal Field Loadings (Calculated in Ibs/acre):
Total
Phos-
horusNEENEENEENEEM.
"I certify, under penalty of law, that this document was prepared under my direction or supervision in
accordance with a system designed to assure that qualified personnel properly gathered and evaluated the
im cation submitted. I am aware that there are significant penalties for submitting false information,
including the possibility of fines and imprisonment for knowing violations"
l2DVA6L
Signature of Land Applier Date
* See bottom of FSF Form for helpful instructions for this MFLSF Form and the mathematically linked FSF Form
nFtiQ �nRnn nn�� c� r�r�nn��

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: owt, of 5 I ear an wwi7P Total Dry Tons Applied (Annual):
Pe ;t #: Cation Exchange Capacity (non 503 only): f 5,
al OrBator: "jam V' Owner:. �d W�-S
Acres Used: S Acres Permitted: ^Site #: ,QnwQ(' Field #:
'
1 .
r r
r r i it �
� � r
+
• . .
001IIIIIIIIIII
URI
•:
Tt
• .
• .
Phos-
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
iri,_ nation submitted. I am aware that there are significant penalties for submitting false information,
including the possibility of fines and imprisonment for knowing violations"
I. AIML Ms,�1
Signature of Land Applier Date
See bottom of FSF Form for helpful instructions for this MFLSF Form and the mathematically linked FSF Form
r1CAI0 CnORA KAM CG /r./innal

ANNUAL LAND APPLICATION F1
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLET.
PLACE A "NIA" IN A BLANK OR BOX
Facility Name: Je-cferson WWTP WQ Permit#: WC)000 416
Land Owner: Fred Walter$ Annual Dry Tons Applied:
Operator: Tim Church Predominant Soil Series: Watau
Crop I Name: Fa._ _lip Crop I Max. PAN: �.$
,D SUMMARY FORM
AND SUBMITTED FOR EACH FIELD APPLIED ON
EN NOT APPLICABLE.
Field #: 1 Acres Utilized: S O
Site #:
2 Name:
Fred 1 Acres Permitted: �Q
Cation Exchange Capacity (non 503): Lb
Crop 2 Max. PAN:
(en -ter one) Soli&ql
•I
Applied per
AcreAnimal
w&vppAW,)1gm•PAN
Waste. etc)
and
Applied
Ibil(bumul-FE05"
,
�
_
• HMO •
r
11 _ l
_�
l�;II�•3J
II
��
IA fill
's
B rim w nam,
i an
. , !1
�lli7�.LL`!�
� �
�,���
�
•LL'rl7ia•�
��Ft�lr�ii_
. 4 � .: I
: .
�� � •'�. 'ti
[LRLL••fL � :�4�{r
1i�.� »�+.�5,�.::
�.*-�'iY'.
Y �+} .Y. J...u.' �.
J-'
't certify, under penally of law, that this document was prepared under in), direction or supervision in accordance with a systern designed to assure that
jualified personnel properly gathered and e%-aluated the information submitted. I ar': aware that there are significant penalties for submitting false
nformation, Including the possibility of fines and imprisonment for knowing violations."
1 j 'Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volatilization Rate: Surface - 0.5. Iniection/Incornoration - 1.0
Signature of land Applier Date I " Mineralization Rates: Compost -0.1, anaerobiatly digested -0.2,
aerobically digested -0.3, raw sludge -0.4
'•"C.P.L.I2.: Cumulative Pollutant Loadine Rate
r( npmp i:nant Pc, )rnnnm

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
["LEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "NIA" IN A BLANK Olt BOX WHEN NOT APPLICABLE.
Facility Name: Jefferson WWTP wQ Permit n: WQ 0 0 0 416 6 Field #: 1 Acres Utilized:
Land Owner: Fred Walters Annual Dry Tons Applied: & Site Ih -3 Bower Acres Permitted:
Operator: Tim Church Predominant Soil Series: Fannin Cation Exchange Capacity (non 503):
Crop I Name: R5clhe-, Crop I Max. PAN: Crop 2 Name: Crop 2 Max. PAN:
Volurne applied
(enter one) Solid%/
l.iquid
Gallon Cu. Yds
Volunle
[Applied per•
Acre
Cond.
(Dry
1 1,00ist)
and
Nitri(c
mglkg
PAN Applicd
lbshacrc)
.1 mlm
••
_I
MIM-
llwt
ova
"i$
MWA
I Mon'
11"idinds Appli-catiods totals on F0101 FSF supp (altach FORINI
FSF supp to this fo rni):
Annual
lbs/acre
ft
Emu==
MUM
gnit
Current Cumulative lbs/
Permitted C. P. L. R.*Ot**
w
Permit PAN Limit I st/2nd Crop
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a systein designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that (here are significant penalties for submitting false
information, including the possibility of Fines and imprisonment for knowing violations."
Signature of Land Applier
'Application Method.- S - Surface, IN - Injection, INC - Incorporation
-4Volatilization Rate: Surface - 0.5. Iniection/incornorition - 1.0
*"* Mineralization Rates: Compost -0-1, anacrobially digested -0.2,
Date aerobically digested -0.3, raw sludge -0.4
*'**C.P.L.H-: Cumulative Pollutant Loadine Rate
r)r:t,jp Pr)pm PO,

Blue r ge.Labs--
PO Box 2940
NC 28645
828-728-U49 b][e-mail]
ale
Client:
Water Quality Labs
P. 0.13ox 1167
Banner Elk, NC -1&604
Attention:
MT. P. Is 0,1ftOr
Dates Received,
12-Mar- 14
Report Date,
26-Mar-14
Sample Date'
10-Mar-14
BRL-2014-0130
Lab Sample 1D.1
LSID.;2014-00,704
Client sa.mplc,IU; Jefferson Sludge
Analysis
AbAlysis
Parameter
Result
MQL Unit Method
Time'
Date
Analyst
A]
27.6
02 nigil EPA 200.7
16:19
3/1312014
jecj
Ca
231
011 mg/1 EPA 200.7
16:19
3113/2014
K0
Cd
0.0083
0.0008 mg/1 EPA 200.7
16:19
3/1312014
kCj
CU
2N
0.0004 mg11 EPA 200.7
16:19
1/13/2014
KCJ
K
70.1
0.02 mg/1 EPA 200.7
16q9
3113120I4
KCJ
mg,
80.3
0102 tag)l EPA 200.7
1&19
310I2014
l<Cj
Ma
0.001 mo EPA 200.7
16:19
3113/2014
KCY
Na
183
O'l mg/1 EPA 200.7
16-,19
1/1312014
KCJ
Ni
0.178
0.004 mg/1 'EPA 200.7
16:0 -
I/I3/2014
KCJ
Pb
a0.0.1
Mg/l EPA'2003
16:19 1
3/1312014
14cj
Se
0.082
0.01 Mg/1 EPA 200.7
16,19
3113/2014
KCJ
TotaFPhbqph6T(1-9
129
0.,08 n1e.1 EPA 200.7
16:19
3/1312014
KCJ
Zri
7.27
0.004 mgjl EPA 200.7
16:19
3/1312014
KCJ
Hg
0,0016
0.0003 mgn EPA 245.1
14:59
3/1-712014
KCJ
As
0,267
0.04 mg/l EPA-200.7
16:19
3/1312014
KCJ
2".
Reported By:
S, J. son, D,.R. Wessinger.
Concentrations are
below Minimum Quortfirien.tion Limit except where
rioted,
NC Laboratory Certificate No. 275
Pace 4 of I I

Blue.Ridge Labs
PO Box 2940
Le#o1r,jNC 28646
8.28-728-0.149
Woerld gela bsl erl&6 grha i I -COM
Client: Water Quality. Labs
P. O. Box 1167
Banner Elk, NC 29604
Attention: Mr; P. Isenhour
D Ato Received. 12-Mar-14
Report Date: 26-M4r-J4
Sample Date: I 0-Mar- 14
13RL#; BRL-20-14-0130
Lab Sample ID: LSID'�2014-00=
Client SAmPle'M; lefferson Sludge
Analysis
Analysis
Parameter Result INIQ L
unit Method Tlmo!
Date Analyst
Nitrate +Nitrite Nitrogen (N2+ 39.5 5.1
8MI94500-N, 17-,56
3/20/2014 KCJ
Total I�elddhl Nitrogen (TKN) 508 1A
mg/1 SM19 4500-N 12:16
3/20/2014 KCJ
-
Reported BY: M,
S..J ;1iiU11,11R.Wessinger w
Concefitraticiis are below MinimilM Wajjtjr1<aOo1i Unilt eicept whereboWd.
Nc Laboratory Certificate- No. 275
Page.2 of - 11

Blue Ridge Labs
PO'Box 2940-
lIgpoir, IVC 28645 828-728-0149 blue ridgela Wenol r(Opn ail.com
Clielit'.
Water Quality Labs
P. ,o, Box 11.67
Barnlei Elk, NC 28604
Attentiolft.
Mr.. P. Ise-AhOw,
Date Received:
I 2-Mar. 1.4
Report,I)aft-
26-Mar- 14
SaII)pIoDatt;
I O-Mar- 14
UAL 9:
BRL-2014-0130
La,b,BamplQID;
LSID-2014-0070'3
Client 5timple ID.,-
Jefferson Sludge
AnOysis Analysis
Pnrafflater
Result MQL Unit Method Time Date Analyst
ArnmonlaNI tr6gen
11.2 3.4 mgjj Ammonia 10;21 3/21/2014 kei
Reported Ily:
I n -9n, D.R. Wessinger
are below Minimum Quantification Unit except wllei.e, noted.
NC Laboratory CeftiflestO NO-173
Pap 3 6f I I

s
Blue Ridge Labs
PO Box 2940
L-er:air; NC 28645
• - 828-728-0149
blueri'[e-mail]
Client ; Water Quality Labs
P. O, Box 1167
Banner.Elk, NC 28604
Attention: Mr, P. Isenhour
Date Racelwed: I2-Mar.-14
Report Date: 08-Apr•-14
Sample Date: 10 Mar-17
BRL' #: 13RL-2614-0130
Reissued to a typographical error,
tab Sample ID: LSID-1034-00701
. Client Sample ID: Jefferson Sludge
•M1 � .._..__
_. _.._.____ —----._.._. __�._• � _�; ._•_ _._ _ ��_____-- --
Analysis Analysis
'-
MQL Unit M — ✓ Method _—Titne ••T _ Date_ w Analyst
—Parameter _Result
% Solids 1,56
i '•
0.1 % OK Solids 13:15 3/1312014 I<CJ
Reported By:
$. J linstii , D.R. Wessinger
*Concentrations are
below Minimum Quantifientlou Limit except where noted.
NC Laboratory Certificate No. 275
Page I of I I

WATER QUALi a Y LAB & OPEPATIOhS, INC.
P.O. BOX 1167, BANNER ELK, NC. 29604
(828)-898.6277
fax (82S'.898.6255
CHAIN OF CUSTODY
SAMPLE TYPE: WASTEWATER
LOCATION: Jefferson IDGG
FACILITY ID#: NCO021709
SAMPLER NAME: Tim Church
•PRESERVATION CODE
�c 1 - H2SO4, 2 - HNO3. 3 - HCL"
4 • NAOH, 5 • NONE, 6 • COOL ICE
7 • NAM03, 8.OTHER
Rn NOUISHED BY: VATE I TIME_ I RECEIVED tir: 1 u^' 6 I -
�WAA ... l�sl'1ir �t�l�►��I/lLir�r
El
�. .
1
'.Laboratory preservation is cnsured by &ddition of prescrvatiwes pear to sample
containers leaving the lab, ualeu ot+'ser%',,ise noted.
CL2-D-CU- Cb o&e ebeck end deCbiorL'Ud00 verifiettion.
PRESERVATION:
() COOL 4C : BOD, RPSIDUE, CONflLJCTCVITY. MBAS. COLOR, ALKALIMTY, CR, VI, TM17DITY
() COOL 4C, PH<2X2SO4 : NH3, NO2-NO3, TM. O&rj. TOC, COD. HAAD�tSS. PHENOLS. TOT PHOS
{) COOL 4C, PH<2 HNO3 : METALS except CIL, VI SAJdPLE DEVIATION -
NONE: CHLORIDE, PH. FLUORIDE
OTHER:
() COOL 4C, NA?$203 - COLIFORbt BACTERIA
NOTIFICATION:

ANNUAL PATHOGEN AND VECTOR ATTRACTION REDUCTION FORM (02T Rules)
Facility Name: ldWI'l �f V'je7TG('S(Nl WEE . WQ Permit Number: VIM (AJV �I I-WfZ1
WWTP Name: NPDES Number:..YC602,17D9
Monitoring Period: From To .1
Pathogen Reduction (15A NCAC 02T .1106) - Please indicate level achieved and alternative performed:
Class A: Alt. A (time/temp) ❑ Alt B (Alk Treatment) ❑ Alt. C (Prior Testing)
A1t.D (No Prior Test) I Process to Further Reduce Pathogengs ❑
If applicable to alternative performed
Compost ❑ Heat Drying
Beta Ray ❑ Gamma Ray
Class B: Alt. (1) Fecal Dens]:
If applicable to alternative performed
Lime Stabilization ❑
Anaerobic Digestion ❑
If applicable to alternative perforn
Parameter Allowable Level
in Sludge M
2 x 10 to the MPN
6th power
per gram of CFU
Fecal Coliform total solids
1000 mpn per gram
of total solid (dry
+Salmonella bacteria 3 MPN per 4 grams
I (in lieu of fecal total solid (dry
coliform weight)
�� . .. A a+.....+;,... n,.a..,.+..... !l t
Class A only) indicate "Process to Further Reduce
❑ Heat Treatment ❑ Th
❑ Pasteurization ❑
W I Alt. (2) Process to Significantly Reduce Pathogens ❑
(Class B only) indicate "Process to Significantly Reduce Pathogens":
Air Drying ❑ Composting ❑ Aerobic Digestion ❑
ied (Class A or Class B) complete the following monitoringdata:
Pathogen Density Number of Frequency Sample Analytical
Exc(e- of Analysis Type Tech-
inimu Geo. Mean Maxim Units
91W
N('At' A')T 11071 _ PloncP indicate n
o f1y G q/Vk
native performed:
Alt.1 (VS reduction) ❑
Alt. 2 (40-day bench) ❑
Alt. 3 (30-day bench) Alt. 4 (Spec. OZ uptake) ❑
I
Alt. 5 (14-Day Aerobic) ❑
Alt. 6 (Alk. Stabilization ❑
Alt 7 (Drying - Stable) ❑ Alt. 8 (Drying - Unstable) ❑
Alt. 9 (Injection) ❑
Alt. 10 (Incorporation) ❑
No vector attraction reduction alternatives were performed ❑
CERTIFICATION STATEMENT- (please cnecic the appropriate -statement)
"I certify, under penalty of law, that the pathogen requirements in 15A NCAC 02T .1106 and the
vector attraction reduction requirement in 15A NCAC 02T .1107 have been met."
❑ "I certify, under penalty of law, that the pathogen requirements in 15A NCAC 02T .1106 and the
vector attraction reduction requirement in 15A NCAC 02T .1107 have not been met." (Please note
if you check this statement attach an explanation why you have not met one or both of the
requirements.)
"This determination has been made under my direction and supervision in accordance with the system
designed to ensure that qualified personnel properly gather and evaluate the information used to determine
that the pathogen and vector attraction reduction requirements have been met. I am aware that there are
significant penalties for false certification including fine and imprisonment."
11m N4 wad r pawnI es blfPr
Preparer Name and Title (type or print) Land Applier Name and Title (if applicable)(type or print)
Signature of Preparer* Date Signature of Land Applier (if applicable) Date
*Preparer is defined in 40 CFR Part 503.9(r) and 15A NCAC 2T .1102 (26)
rIFNR FORM P\/RF n7T (17/7M)AN

WATER QUALITY LAB & OPERATION, INC.
P.O. BOX 1167,BANNER ELK, NC 28604.
(828} 898-6277
CLIENT: JEFFERSON LOGIN TIME: 3:50 Pm
ADDRESS: SAMPLER:
CITY: �16 Z 1� COLLECTED DATE: 26-Mar-14
STATE REPORTED DATE: 8-Apr-14
A -ALY0,
:7 7
..........
'T
.
... .
......
.............
-00,f
A00
TOTAL SOLIDS
1.6
%
FECAL COLIFORM
8896
1
CFU's
SLUDGE
27-Mar-14
SM-9222D
WPS
REPORTED BY: NC CERTIFIED LAB 9 544
.PAUL ISENHOUR, SUPERVISOR
nom
let'
J
89R(.0
3/7- �
zoso
.313,
312-54m
jqlz
S7�,gZ3
�J10
tlk/
$meic mew

CLIENT: JEFFERSON
'ADDRESS:
'CITY:
:STATE:
In4b
WATER QUALITY LAB & OPERATION, INC.
P.O. BOX 1167.BANNER ELK, NC 28604.
[phone]
LOGIN TIME: 2:05 PM
SAMPLER:
COLLECTED DATE: 31-Mar-14
REPORTED DATE: 8-Apr-14
'ANA
'y.
-M L e
-A N
............
TOTAL SOLIDS
1.6
%
FECAL COLIFORM
4750
1
CFU's
SLUDGE
1 -Apr-1 4
SM-9222D
WPS
:REPORTED BY: NC CERTIFIED LAB # 544
PAUL ISENHOUR, SUPERVISOR

JAN/15/2015/THU 11:59 AM FAX No. P.002/002
CLIENT: 1 JEFFERSON
ADDRESS:
CITY:
STATE:
ID#:
WATER QUALITY LAS & OPERATION, INC.
P.O. BOX 1167,BANNER ELK, NC 28604
[phone]
LOGIN TIME: 3:15 PM
SAMPLER:
COLLECTED DATP-: 2-Apr-14
REPORTED DATE: 10-Apr-14._
VNJTAL-�
F
T
..............
......
TOTAL SOLIDS
1.6
%
FECAL COLIFORM
312500
1
CFU's
SLUDGE
3-Apr-14...
SM-9222D
vvpS
REPORTED BY: NC CERTIFIED LAB It 544
PAUL ISENHOUR, SUPERVISOR

CLIENTJEFFERSON
ADDRESS:
CITY-
STATE:.
ID# -
WATER QUALITY LAB & OPERATION, INC.
P.O. BOX 1167,13ANNER ELK, NO 28604
[phone]
LOGIN TIME: 3:25 PM
SAMPLER:
COLLECTED DATE: 8-Apr-14
REPORTED DATE:' 9-May-14
f N A' . 1;5"
...... .Y.
..... ......
. .. ........... . .....
....... ... .
..............
............... .....................
.......
TOTAL SOLIDS
1.4
FECAL COLIFORM
385714
1
CFU's
SLUDGE
8-Apr-1 4
SM-9221D
wpS
REPORTED BY: NC CERTIFIED LAB # 544
PAUL ISENHOUR, SUPERVISOR

CLIENT: JEFFERSON
ADDRESS:
CITY:
STATE:
.I D#:
WATER QUALITY LAB & OPERATION, INC.
P.O. BOX 1167,13ANNER ELK, NC 28604
[phone]
LOGIN TIME: 2:45 PM
SAMPLER:
COLLECTED DATE: 10-Apr-14
REPORTED DATE: 9-May-14
TOTAL SQLIDS 1.3
FECAL COLIFORM B76923
REPORTED BY: NC CERTIFIED LAB # 644
PAUL ISENHOUR, SUPERVISOR
1 1 CFU's I SLUDGE j 11-Apr-14
SM-9221D i WPS

CLIENT:i JEFFERSON
ADDRESS:
CITY:
STATE:
ID# -
WATER QUALITY LAB & OPERATION, INC.
P.O. BOX 1167,BANNER ELK, NC 28604
[phone]
LOGIN TIME: 3:10 Pm
SAMPLER:
COLLECTED DATE: 14-Apr-I 4
REPORTED DATE: 9-May-14
..........
A . S!
NA '
..........
'SAMPLI
- .'.
. ......... - . '
..;:- : ' -.' 1— . 1-11-1
::::
TX... -H
. - .."
. T
.........................
......... ..........
............
................
..............
MA.
L 'T .4
�':*'AMLY-4-18�".:
...........
OWE
TOTAL SOLIDS
1.2
o/.
FECAL COLIFORM
6500
1
CFU's
SLUDGE
15-Apr-14
SM-9222D
wps
r%t=t-'UMl't-L) t5T: NU f,;tKI H-ItU LAb 4 044
4-2
PAUL ISENHOUR, SUPERVISOR

WATER QUALITY LAB & OPERATION, INC.
P.O. BOX 1167,BANNeR ELK, NO 28604
[phone]
LOGIN TIME: 3:00 PM
CLIENT: , JEFFERSON SAMPLER:
ADDRESS: COLLECTED DATE: 15-Apr-14
CITY: STATE: REPORTED DATE: 9-May-14
ID#:
7 TOTAL SOLIDS
FECAL CbLIFORM
CON
!16-A!pi-m
141.3
406
'Ito
CFUs
SLUDGE
pr-Apr
SM-9222D
REPORTED BY: NC CERTIFIED LAB # 644
PAUL ISENHOUR, SUPERVISOR

WATER QUALITY LAB & OPERATION, INC.
P.O. BOX 1167,13ANNER ELK, NC 28604
[phone]
CLIENT: JEFFERSON Z Slull-
ADDRESS: SAMPLER: TIM CHURCH
CITY: JEFFERSON COLLECTED DATE: �,!" 2-Jun-14
STATE: NC REPORTED DATE: 11-Jul-14
[M41 NC0020451
:kN.;''
L•
:.It1PSt� tdCAIQNQ#?kB'1'
30 DAY BENCH SCALE
START
TOTAL SOLIDS
1.10
0.1
%
SLUDGE
6-Jun-14
PI
START
VOLITILE SOLIDS
72.00
0.1
%
SLUDGE
6-Jun-14
PI
END
TOTAL SOLIDS
1.00
0.1
%
SLUDGE
8-Jul-14
PI
END
VOLITILE SOLIDS
68.00
0.1
%
SLUDGE
8-Jul-14
PI
c md ,; ,
FT"" fi
4 1-ceI 1r P (,
REPORTED BY: NC CERTIFIED LAB # 544
PAUL ISENHOUR, SUPERVISOR

t
WATER QUALITY LAB &- DPERATIONS, INC.
P.O. BOX 1167, BAgNER ELK, NC. 28604
(828)-898.6277
fax (828;•393•6255
Class 15,5644p,
SAMPLE TYPE:
WASTEWATER
LOCATION:
FACILMY MN: NCO021709
SAMPLER NAME: Tim Church
CHAIN OF CUSTODY
,PRESERVATION CODE
1.• H2SO4, 2 - HNO3, 3 • HCL,
a . NAOH, 5 • NGNE, 6 - COOL ICE
7 • NA2S203, 8 - OTHER
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NNE mA
•
IN
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DATE
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14.Abnratory pruervauon 13 cnsurcd by addition of Prtservitivct Pnor to umplc
eotUinen leswiag the jib, unitss o6cmise noted.
CLI-D-CLI" C�4rihCtbtrk od dCLWofinAtioo VtA6UiJon,
PkESERVATION:
() COOL 4C ; DOD, R.ESLUUE, CONDUt:TIVM, MBAS, COLOR, ALKAUNITY, CR, VI, TVT'LBIDITY
(.) COOL 4C , Pliclln$04; NH.3, NO2-HO3. TXN, 0&0, TOC. COD, HA=,"ESS, PHENOLS, TOT PROS
() COOL {C, PH<! 14NO3 : METALS exctpt CR, Vl
()NONE, CHLORIDE, PH, FLUORIDE SAMPLE DEVIATION*
OT�MR:
{ )COOL <C, W IS201: COLI1'CR?•i 8,kC ERLk_--
NOTif ICATION: _ -

NCI)F18C$Agronomic Division Phone: [phone]
Website: vaww.ncagr.govlagronomU
Report No.
FY15-SL000894
Client:
Town of Jefferson
Advisor:
J Predictive
PO Box 67
302 East Main St
Mehlich-3 Extraction
�- - Soil Report
Jefferson, NC 28640
-.
Sampled County:
Ashe
saris Eetl-0711:q/2QJ!13 Received: 07/16/2014
completed: 07/25/2014
Farm:
Links to Helpful Information
Sample ID: BWALT
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tonslacre)
N P205
K20
Mg S
Mn
Zn
Cu B
information
Lime History:
1 - Fescue/OGrass/Tim, 1 0.0
50-70 0
10
0 0
0
0
0 0.
1.30 tons/acre; 7/2014
2 - Fescue/OGrass/Tim, 0.0
120-200 0
50
0
Note: 12
0
0
0
0 0
Note: 12
Test Results [units - WN in g/cnr ; CEC and Na in meq/100 cnr3; NO3-N in mg/drrP ]:
Soil Class:
Mineral
HM% W/V CEC BS°/. Ac pH P4 K4
Ca% Mg%
S4 Mn-I
Mn-All Mn-Al2
Zn-I
Zn-AI
Cu-I Na ESP SS-1 NO3-N
0.46 0.83 15.1 89 1.6 6.3 87 45
57 31
59 228
146 150
536
536
314 0.2
1
Sample ID: FWALT
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tons/acre)
N P20s
I K20
Mg S
Mn
Zn
Cu B
Information
Lime History:
1-Fescue/OGrass/Tim,1 0.0
60-70 0
.0
0 0
0
0
0 0
Note: 12
1.30 tons/acre; 7/2014
2-Fescue/OGrass/Tim, 0.0
120-200 0
0
0 0
0
0
0 0
Note: 12
Test Results [units - W1V in g/crn�; CEC and Na in meq/100 CO; NO3-N in mg/dd]:
Soil Class:
Mineral
HM% W/V CEC BS% Ac pH P-1 K-1
Ca% Mg%
S-1 Mn-I
Mn-Ail Mn-Al2
Zn-I
Zn-AI
Cu-I Na ESP SS-1 NO3-N
0.51 0.83 15.8 95 0.7 6.5 82 84
61 32
64 256
163 164
915
915
418 0.3
2
North Carolina
- i
`�,,� Tv�x�ce'Ir� • F]r::�d C��.�Ar .s;� ;s
Reprogramming of the laboratory -information -management system that makes this report possible is being funded
through a grant from the North Carolina Tobacco Trust Fund Commission.
Thank you for using agronomic services to manage nutrients and safeguard environmental quality.
- Steve Troxter, Commissioner of Agriculture
5

i,k, gNUAL DISTRIBUTION AND MARKETING/ SURFACi, DISPOSAL CERTIFICATION AND SUMMARY FORM
'ERMIT #: Wy OW i j (o FACILITY NAME: 2
PHONE: - COUNTY: AShe OPERATOR:
FACILITY TYPE (please check one): ® Surface Disposal (complete Part A (Source(s) and "Residual In" Volume only) and Part C)
❑ Distribution and Marketing (complete Parts A, B, and C)
Nas the facility in operation durine the past calendar year? ❑ Yes ❑No No If No skip parts A, B, C and certify form below
- - Part A*:
Part B*:
Month
Sources s (include NPDES # if
applicable)
Volume (dry tons)
Recipient Information
Admendment/
Bulking Agent
Residual In
Product Out
Name(s)
Volume (dry tons).
Intended use
January
WWTP CQ (
(.31
February
Warch
ril
S.0
Wayl
.
Tune
Jul
ku ust
%
3e tember
%
October
November
December
Totals:
Annual (dry tons):,.$
Admendment(s) used:]
Bulking A ent(s) used:
* If more space than given is required, please attach additional information sheet(s). ❑ Check box if additional sheet(s) are attached
Part C:
Facility was compliant during calendar yearwith all conditions of the permit (including but not limited to items I-3 below) issued by the
Division of Water Quality. ® Yes ❑ No If No, please provide a written description why the facility was not compliant.
1. All monitoring was done in accordance with the permit and reported for the year as required and three (3) copies of certified laboratory results are attacl
2. All operation and maintenance requirements were compiled with or, in the case of a deviation, prior authorization was received from the Division of W:
Quality.
3. No contravention of Ground Water Quality Standards occurred at a monitoring well.
"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
tha, ere are sig ificant penalties for submitting false informatton, including the possibility of fines and imprisonment for knowing violations."
Signature of Permitter Date Signature of Preparer** Date 1
(r�erer�r "-rent from nFNRORMD SDF
m ['crmittec) **Preparer is defined
./ 9
n,,,a„�n. 021