WQ0014543_Residual Annual Report 2014_20150220

GENERAL INFORMATION
LAND 'APPLICATION
CALENDAR YEAR: 2014
.. ....
Permit No. WQ0014543
FACILITY:NAME:
Fourth Creek WWTP-NPDES NCO031836
Third Creek WWTP- NPDES NCO020591
LOCATION:
693 Bell Farm Rd.
444 Third Creek Rd.
MAILING ADDRESS:::::
P. O. Box 1111
Statesville, NC 28687-1111.
[phone]
[phone]
RESPONSIBLE:OFFICIAL:
.: I✓. F. "Joe'.'.:Hudson Jr. Director
Dept. of Water Resources
P.O.Box 1111
Statesville, NC 28687-111.1
(764) 878-343.8..
;FACILITYOPERATOR:
Andy Smith
P. 0. Box 1111
Statesville;,NC 28687-1111
(704) 87873438
RESIDUALS ORQ _
Andy; Smith
P.. O: Box I I I
Statesville, NC 28687-1111
[phone]
APPLICATION:
Land Application
NoResiduals land applied in 2014

ANNUALLAND .
'AND AEPLICATLON CERTIFICATION FORM
WQ P.ermit#: 'WQ0014543 :County:': Iredell Year: 201.4
Facility Name (as shown on permit): ... . Fourth Creek WWTP .
,Land Application Operator:. :; Andy, Smith Phone: 704=878-3438
Land application of residuals :as :allowed by the permit occurred during, the past calendar year?
..
0.. Yes 21 :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 Numma
Total-, number, of: application: fields in-thepermit: :
:Total number of fields utilized for land application during the year:
Total, amount of dry tons applied during -the year for all application sites:
:.. Total number of acres utilizes: for land application during the year.F
Part B' Annual'Compiance Statement:
Facility was compliant during calendar year .:: with all conditions of theIand application permit
(including :but not limited to items 1-13 below) issued by the Division of Water Quality. ": ® Yes0. No
:If no please. -provide a written :description why the facility was not compliant, the dates, and:eaplain 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 permitand reported during the year as regiiired 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 NC AC. 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 re uirements in.15A NCA.02T.1 1.1.1. were complied with (applicable. to 40 CFR Part 503 . .
g p . g q,. .
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 sitexeceirig residuals, as..
specified in the permit.:
12):No runoff of residuals from the application: sit es 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'genalties for submitting false information; inc luding'the
possibility of fines and imprisonment :for knowing violations." "
Perm' ee ame an .Titl (ty ox print) : 'Signature, of Permittee : Date
S g ature Preparer ' Date ... Signature of Land Applier ... Date ..
(if differe t from Permittee) :: (if different from Permittee and Preparer)
* Preparer is defined in 40. CFR Part 503.9 (r) and f5A NCAC 02T .1102 (26) : DENR FORM ACF (12/2006)