SLAS7821_APPLICATION_RENEWAL_2024

APPLICATION FOR A PERMIT TO OPERATE A SEPTAGE LAND APPLICATION SITE
North Carolina Department of Environmental 4uardy
Division of Waste Management — Sold Waste Section
1646 Mail Service Center, Raleigh, NC 27699-1646
Site and Operator
1• Applicant
Address
Phone ,
2. Contact person for site operation (if different from applicant):
Title or position � - 4 ` Phone qJ0 '
Address---
r s'H
3. Landowner
Address
4. Site Location: County
Directions to site: 1 r
5. Indicate whether request is: new _ _ renewal ✓ mod fippon
For a permit renewal or modification, provide the following information:
Existing site permit number:�Y �? 1 permit expiration date:
6. Number of acres meeting the requirements of the N.C. Septage Management Rules: Y. Y acres.
7. Su other than septage or grease trap pumpings previously disposed of on the site:
(a) one , or @) Attach a list indicating other substances, the amounts discharged
and dates of discharge.
8. Attach written, notarized landowner authorization to operate a septage disposal site signed by the
landowner (if the permit applicant does not own the property). If a corporation owns the land
use a corporate landowner suthorization form, ff limited Liability Company owns the land,
use a limited liability company landowner authorization form.
9. Attach site evaluation report including aerial photograph and soil analysis with metals results,
unless the Division prepared the report.
10. Attach a vicinity map (county road map showing site location).
(over?

Site Management Information:
I. The following information shall be included with the application form:
(a) Nutrient Management Plan
(b) Soil Erosion and Runoff Control Plan
2. Altemdw plan for disposali (de� tion fad permit number or treatment pkmt
author¢abon): C Jcl t.h'd "s Mak r� • I �� Pig 1u1� k'; .!
R
f'b-rP ?Irf!
3. Types of Septage proposed to be discharged at the site (check all that apply):
(a) Domestic sePtage pumped from septic tanks
(b) Grease trap pumpings
W Portable toilet waste
(d) Commercial 1 industrial septage
4. Proposed treatment method of each type of�eptage to bland applied (use additional der to
xpW if necessary): J'e,w,o s „4 r J4� r -0 .... -.4 � -A, '9 s
6. Demonstration from the appropriate state or federal government agency that the land application
site complies with the Endangered Species Law** or if any part of the site specified is not
agricuWral land (use additional paper to explain �f necessary): d si e
III. Certification
I hereby certify that:
1. The information provided on this application is he, complete, and correct to the best of my
knowledge.
2. 1 have read and understand the N.C. Septage Management Rules, and
3. 1 am aware of the potential consequences, including penalties and permit revocation, for failing
follo:aflappfic ble rules and the conditions of a Septage Land Application Site permit.
Sure (Sf aornPa►ry o�rc►a1 required) � _ Date ' 6� 3 z� �
Print name Title
Nnbe: Tills application Wie not be reviewed until all parts of the app0cation are complete.
`Refer to Section .0837(e) of the W.C. Septage Management Rules.
' Refer to section .0837(g) of the N.C. Septage Management Rules.
S:SOPC Writeldalsepiageltam MAS.APPliwom & AuftrizeuonASLAS Pennir Applico0on-Jan 2016.dD=
Rev 01-07-16

Landowner's Authorization to Operate a- Septage Land Application Site
North Carolina Department of Environment and Natural Resources
Division of Waste Management - Solid Waste Section
"tom Ma97'Service Center Raidgh,-NC27699-4646
(name of site owner) hereby certify that I am -the owner of
acres of land -located
and identiW by �L (book and page of recorded deed
or tax map parcel) and that 1 agree to allow 14 �� � �''^ (name of site
operator)-to°use said land for septage land application for a period of j n % �-(length
of time), beginning' ' /y =a' (month, day-andlear)-md at l.have.r.ead the
North Carolina Septage Management Rules *, and I understand and agree to maintain the restrictions on
land use after septage land application ends I further understand that no septage may be land applied
until the Division of Waste Management has issued a permit for a septage'land application site. ' The above
de`scrib P tyJsDwned sWely-by~rne orl antly.wth, Joy, .e-
(names of_all:co-owners,..orstate none).
Signature of landowner V L".,..a L Date = �`
Sworn to and subscribed before me this day of 20
(Notary. Public)
My Commission expires: o i ` toI doig
* 1$A'N:C.Adi�in Cddii118'Section'08D0
**As required by Rule .0843
�''-P#tttf9

QUALITY SEPTIC LLC
On -Site waste water Inspection
Inspector Notes
Due to health reasons Jimmie L Carter
can not travel to notary we have used the one included
it was for � �'�����a►��h �;d.
',4�� r'icri �ecion ;Thanks Jimmie M
Carter.
12-10-2022

Nutrient Management Plan For Septage to
Coastal Bermudagrass and SmallSrpllcaflons
ains
Prepared for:
Jimmy Michael Carter
Quality Septic, LLC
2337 Smith Mill Rd.
Lumberton, NC 28358
(910) 740 - 0688
A. General information
1. Sampling of septage for waste analysis, NCDA & CS soil sample for nutrient and
metals to be done annually.
2. Total of 5 acres is the septage application site and will be treated as one field.
3. Dominant soil series is Wagram (WaB).
4. Septage will not be applied where the site is"untrafficable or a loaded truck
leaves a depression 3 inches or greater and/or soil moisture is too great to
adequately absorb the septage.
5. Septage storage shall be provided to account for the average volume of septage
pumped per week, or an alternative plan, such as disposal at a waste water
treatment plant, should be in place.
B. Crops. to be grown and appro)dmate planting and harvesting times.
1. The field is already -established in hybrid bermudagrass. The recommended rate
of Nitrogen to apply is between 40-60 pounds per acre after each cutting of hay
to maintain the stand. This would be 3-4 times or 120-180 pounds per year. If
septic waste meets this requirement, then no additional nitrogen is
recommended.
2. Areas that develop with less than 80% groundcover by Bermuda will be re- -
sprigged with bermuada at a rate of 40-60 bushels per acre in the month of April:
Sufficient ground cover of -the approved crop (Bermuda/small grains) js-required
for land application to occur.
3. Each year thereafter, the field will be overseeded with annual rye grass or wheat
at a rate of 100-120 lbs per acre in October or November.

C. Nitrogen needs for crops grown
R.Y.E. = Realistic Yield Expectations
N application rate = suggested N application rate based on RYE for soil type
Crop R.Y.E. _ N ar).� rate lbs/acre
Small grains
Wheat or Rye 39 bushels%acre x 2.32 Ibs/bushel = 90.48
Hybrid bermudagrass 5.4 tons/acre x 49 Ibs/ton = 264.6
Total possible N application = 355.08 Ibs/acre
D. Relative application rates for the field
Month
Field
January
Low
February
Low
March
Medium
April
High
May
Medium
June
High
July
High
August
Medium
September
Medium
October
Low
November
Low
December
Low
None = 0 gallons; Low = 5,000 gallons; Medium = 10,000 gallons; High=15,000
gallons
NOTE: Cumulative application rate is not to exceed the permitted application rate.
Annual application rate is not to exceed 50,000 gallons per acre.
E. Application Method
The preceding information is based on septage being evenly applied over the entire
permitted site using normal septage application equipment.
F. Additional Fertility Requirements
Additional nitrogen supplied will not exceed the Total N requirement of the crop.
Phosphorus and potassium will be added in accordance with the soil test results for
the crops grown.

G. Harvest of the crops and their use
The bermuda grass will be cut as hay and baled whenever it reaches
approximately 12-18 inches in height or roughly every 4 to 6 weeks beginning in
June. At least three harvests will be made from each field each year unless
under drought conditions.
2. The small grains will be cut as hay and baled in March - May of each year
3. Records and amounts of round or square bales harvested from site will be kept,
as will yields from the small grains after each harvest.
4. The septage applied forage will be harvested by contracting a third party to cut
and harvest the hay for animal feed.
5. A 30-day waiting period must be observed between the last application of
septage and harvest. This site is managed as one field and the required 30-day
waiting period shall be followed by utilizing an alternative disposal location such
as a wastewater treatment plant.
H. Weed Conffoi
Weed control may be needed in order to maintain 80% groundcover and to
produce the realistic yield expectations for the approved crop stand. Weed
control may be obtained through different methods (mowing or herbicides) or a
combination of methods. For specific recommendations, proper identification of
the weed or weeds is necessary. The local cooperative extension agent or
regional agronomist may be contacted for advice.
I. Buffers
1. Soil erosion and runoff control plan - Given that slopes on this site do not exceed
five percent, a 50 foot buffer, planted in bermuda and small grains, should suffice
to prevent septage waste from migrating off of the fields. (More severe site
conditions could require that soil erosion structures be installed before septage
can be applied).

a
Submitted by: Quality Septic, LLC
Signature:
Date:. - w iy''1
Signature: _ _ Date:
Plan prepared by: Taylor Chavis Date: 06-13-16
Robeson County
Livestock Extension Agent
P.O. Box 2280
Lumberton, NC 28359
910-671 3276
Emall: taylor chavisCan u.edu
y, e
1'
Signature: ; �,� S Date: r 3 1 i to
�E '

SEPTAGE LAND APPLICATION LOG
CERTIFICATION
Site Operator.
SLAS Permit #: % rrr-
Site Location: -3;;� Z 014h".-� eve
cam 60►ess rM ft ah g Rude and bVitude)
Number of acres permitted:
Permitted" application rate: o vim'
t�M roe �� very
Crot)(s): AA V d' W V'r .� F
Crop nitrogen requirerr(ent(s):
b nper mm)
CERTIFICATION:
"I certify, under penalty of law, that the pathogen requirements In (insert either
503.32 (cx1) or 503.32 (cX2)) and the vector attraction reduction requirements in
(insert 503.33 (b)(9), 503.33 (b)(10) or 503.33 (b)(12)) have been met. This
determination has been made under my direction and supervision In accordance
with the system designed to ensure that qualified personnel property gather and
evaluate the Information used to determine that the pathogen requirements and
vector attraction reduction requirements have been met I am aware that there
are significant penalties for false certification including the possibility of fine and
imprisonment."
!ram ,boa
(signature) (date)
S:tSorfd WasteWrslseptagelf—%SLAS-AppgcaUon 6 AufhoftWorMll SLAB L."Aoc