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HomeMy WebLinkAboutWQ0016966_Residual Annual Report 2019_20200218Initial Review INITIAL REVIEW Reviewer Williams, Kendall Is this submital an application?* r Yes r No Annual Report 2019 Year* Date Paper Copy 2/18/2020 Received:* Project Number* WQ0016966 Email Notifications ................................................................................................... Does this need O Yes review by the a No hydrogeologist? * Regional Office CO Reviewer Admin Reviewer Kendall.Williams@ncdenr.gov Submitted Form Project Contact Information Rease provide information on the person to be contacted by NJB Staff regarding electronic submittal, confirmation of receipt, and other issues. .................................................................................................................................................................................................................................................................................................................................................................................................... Name * Troy Branch Email Address* troy. branch@townofdenton.com Project Information ........................................................................................................................................................................ Submittal Type* f New Permit Application r Renewal r Annual Report Permit Type * r Wastewater Irrigation r Other Wastewater r Closed -Loop Recycle r Single -Family Residence Wastewater Irrigation Is a paper copy of the application being submitted?* r Yes r Nor N/A Permit Number* WQ0016966 Applicant\Permittee * Town of Denton Facility Name * Town of Denton WWTP Phone Number* 3368594460 r Modification (Major or Minor) r Additional Information r Other r High -Rate Infiltration r Reclaimed Water r Residuals r Other Please provide comments/notes on your current submittal below. Please attach all information required or requested for this submittal to be review here. Application Form Engineering Rans, Specifications, Calculations, Etc.) 2019 Annual Report_ 20200210_0001.pdf 1.26MB upload only 1 RJF document. Maniple documents rust be combined into one RJF file. For new and modification permit applications, a paper copy may be required. If you have any questions about what is required, please contact the reviewer or Tessa Monday. If a paper application is required, be advised, applications accepted for pre -review until both the paper and electronic copies have been received. The paper copy shall include the following: o Application Form o All relevant attachments (caIcs, sails report, specs, etc. 0 one full-size engineering plan set 0 one 11x17" engineering plan set 0 one extra set of specifications o Fee (if required} Mailine address: Division of Water Resources Division of Water Resources Non -Discharge Branch I Non -Discharge Branch ---- --- - --- - --- ------------ ------------------------------------i---------------------------------------------------------------------------- 1617 Mail -service Center Att: Nathaniel Thornburg, Y" Floor, Office #942W ---- -NC �-- - -------------------------------------------- ------------------------------------------------ Raleih, 7699-1617 512 N. SaVisbury St For questions or problems contact Tessa Monday at tessa.monday@ncdenr.Qov or 919.707.3660. * W By checking this box I acknowledge that I understand the application will not be accepted for pre -review until the paper copy (if required) and fee (if required) have been received by the Non -Discharge Branch. I also confirm that the uploaded document is a single PDF with all parts of the application in correct order (as specified by the application). Signature P -t,5 %O t~rI;IfI; Submission Date 2/11/2020 2019 Town of Denton 2019 Annual Report Land Application Program Permit No. WQ0016966 ANNUAL LAND APPLICATION CERTIFICATION FORM WQ Permit#: W00016966 County: Davidson Year: Facility Name (as shown on permit): Town of Denton Land Application Operator: 2019 Southern Soil Builders, Inc Phone: 336-957-7871 Land 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 Summary: Total number ofapplication fields in thepermit: 15 Total number of fields utilized for land application during the year: 4 Total amount of dry tons applied during the year for all application sites: 78.37 Total number of acres utilizes for land application during the year: 45.2 Part B - Annual Compiance Statement: Facility was compliant during calendar year 2019 with all conditions of the land application permit (including but not limited to items 1-13 below) issued by the Division of Water Resources. 0 Yes 0 No If no please, provide a written description why the facility was not compliant, the dates, and explain corrective action taken. I ) 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 .I 105(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.] I I I 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 Resources. 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. 1 1) 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." Permittee Name and Title (type or print) Signature of Permittee Date a-4-7.yu Signature of Preparer* Date 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 SAMPLING 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: W00016966 Facility Name: Residual Source WQ # or NPDES #: WWTP Name: Residual Analvsis Data Town of Denton NCO026689 Denton WWTP Laboratory: 1) 2) 3) 4) 5) Meritech Parameter Percent Solids(%) 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: W00016966 Laboratory: Facility Name: Town of Denton Residual Source NPDES # or WQ#: WWTP Name: Residual Analvsis Data NCO026689 Denton WWTP 1) 2) 3) 4) 5) Meritech Parameter OWN ----------- "I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly 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) ANNUAL RESIDUAL SAMPLING 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: W00016966 Facility Name: Town of Denton Residual Source WQ # or NCO082949 NPDES1h WWTP Name: Denton WTP Residual Analysis Data Laboratory: 1) Waypoint 2) 3) 4) 5) I Parameter Sample or Composite Date ®--- ' 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 * *Preparer is defined in 40 CFR Part 503.9(r) and 15A NCAC 2T .1 102 (26) Date 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: W00016966 Facility Name: Residual Source NPDES # or WQ#: WWTP Name: Residual Analysis Data Town of Denton NCO082949 Denton WTP Laboratory: I) Waypoint 2) 3) 4) 5) -Sample or Composite •. te Parameter "I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly 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 * Dale *Preparer is defined in 40 CFR Part 503.9(r) and 15A NCAC 2T .1102 (26) 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: Permit #: Operator: Acres Used: Town of Denton W00016966 Joel Sexton Owner: 6.7 Acres Permitted Total Dry Tons Applied (Annual): 39.62 Cation Exchange Capacity (non 503 only): Joel Sexton Predominant Soil Series: BaD 6.7 Site #: 2 Field #: 1 Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #): Annual Heavy Metal Field Loadings (Calculated in Ibs/acre): 1 11: 1 1. 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 1 '® 1 11 1 11: 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 1 ®" 1 • 1 111 1111 1 111 1111 1 111 1111 1111 1 111 1111 1111 ��•• WI�911Y91L'�®' 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 1 1` 1 .: 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 1 11 1 1 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 11 ' 1 1 1 1 ` 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 1 �' ® 11• 1 • 1 111 1111 1 111 1 111 1111 1111 1111 1 111 1 111 1 111 1 `. ® 1 11: 1 1 ' 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 1�. ®® 1• 1 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 ® •� 1111 1 111 1111 1 111 1111 1 111 1 111 1 111 1 111 1 111 '•. "I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly 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". / mrm �/ Sigi ture of LAW 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: Town of Denton Total Dry Tons Applied (Annual): 3.90 Permit #: W00016966 Cation Exchange Capacity (non 503 only): Operator: Joel Sexton Owner: Joel Sexton Predominant Soil Series: MeB Acres Used: 11.3 Acres Permitted: 11.3 Site #: 2 Field #: 3 Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #): MINI'MENEEMENEEN Annual Heavy Metal Field Loadings (Calculated in Ibs/acre): 1 11 1 ® 1 111 1 11. 1 111 1 111 1 111 1 111 1 111 1 111 1 Itl 1 111 1 111 1 111 1 11. '® 1 111 1 11 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 11 111 1 1 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 1 '® 1 111 1 1 1 1 111 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 1 1 ®' 1 111 1 1 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 1 ® 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 11 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 11 1 111 1 1 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 1 ® 1 111 1 11 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 11 ® 1 111 1 1 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 1 ' 1 111 ® 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 • "I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly 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-V lx Signa ure of Land A pplier %y-26.L8 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: Town of Denton Total Dry Tons Applied (Annual): 10.06 Permit #: Operator: Acres Used: Cation Exchange Capacity (non 503 only): Joel Sexton Predominant Soil Series: BaD 16.6 Acres Permitted: 16.6 Site #: W00016966 Joel Sexton Owner: Field #: Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #): Annual heavy Metal Field Loadings (Calculated in Ibs/acre): 1 • 1 11 1 11 1 111 1 111 1 111 1 111 1 111 1 111 1 11 t 1 111 1 111 1 111 1 111 1 11 '® 1 11 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 11 1. 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 �. ® 1 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 1 ®'' l l 1 111 1 111 1 111 1 111 1 111 1111 1 111 1 111 1 111 1 111 1 111 1 1 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 ® 1 11 1 111 1111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 11� ® 1 1 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 1 1 11 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 11 ® 1 ' . 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 ' ® 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 ' , ..1 certuy, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly 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 Land Applier Date DENR FORM MFLSF (12/2006) ANNUAL METALS FIELD LOADING SUMMARY FORM* Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report Facility Name: Permit #: Operator: Acres Used: Town of Denton Total Dry Tons Applied (Annual): 24.81 W00016966 Cation Exchange Capacity (non 503 only): Joel Sexton Owner: 10.6 Acres Permitted: Joel Sexton 1• Site #: Predominant Soil Series: 2 Field #: ME Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #): Annual Heavy Metal Field Loadings (Calculated in Ibs/acre): 1 ® 1 11 1 1 : 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 1 '® 1 111 1 11' 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 11 ® 1 1 1 � 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 ` ® 1 11: 1` 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 .. 111• 11`• 1 111 1111 1 111 1111 1 111 1111 1111 1 111 1111 1 111 1 1 ® 1 111 1 11 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 11 1 11 1 1 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 1 ® 1 11` 1 1 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 1: �® 1 11 1 1 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 1 ®�� 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1111 1 111 1 MMMMMMMMMMMMMM ' 1 "t certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly 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 Land Applier )-Al-) �) V 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: Town of Denton Land Owner: Joel Sexton Operator: Joel Sexton Crop 1 Name: Fescue WQ Permit #: WQ0016966 Field #: 02 01 Annual Dry Tons Applied: 39.6140 Site #: 02 01 Predominant Soil Series: BaD Crop I Max. PAN: 138 Crop 2 Name: Acres Utilized: 6.7 Acres Permitted: 6.7 Cation Exchange Capacity (non 503): Crop 2 Max. PAN: L ° ° 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 K � m o m d ,.. * ' o ;9 2 m _ : N t m w ry TKN mg/kg z D 9 '0 3 �' ? o N mg/kg Nitrate and Nitrite mg/kg PAN Applied Name of Crop Type Receiving Residual Application PP Crop 1 Crop 2 Crop I Crop 2 3-2019 123500 2.65 2.037 WWTP dry 0 s 0.5 0.3 21200 377 1230 31.228 NA Fescue 8-2019 130000 4.79 3.876 WTP dry 0 s 0.5 0.4 9790 2920 4.63 32.653 NA Fescue 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 1 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form): TOTALS: 0 253500 As Cd Cu Cr Pb H Mo Ni Se Zn P 63.881 0.000 Lime A lied Annual lbs/acre 0.074 0.014 1.944 0.449 0.263 0.005 0.032 0.196 0.046 3.815 85.966 Date Ibs/ac Prior Years Cumulative Ibs/ac 0.174 0.052 10.877 0.922 0.739 0.025 0.09 0.618 0.121 29.697 0 Current Cumulative Ibs/ac 0.248 0.066 12.821 1.371 1.002 0.030 0.122 0.814 0.167 33.512 Permitted C. P. L. R.**** 36 34 1338 NA 267 15 NA 374 89 2498 Permit PAN Limit 1st/2nd Crop 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 tines and imprisonment for knowing violations." Signature of Land Applier )-y Date *Application Method: S - Surface, IN - Injection, INC - Incorporation **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0 *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2, aerobically digested -0.3, raw sludge -0.4 ****C.P.L.R.: Cumulative Pollutant Loading Rate DENR FORM FSF (12/2006) ANNUAL LAND APPLICATION 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: Town of Denton Land Owner: Joel Sexton Operator: Joel Sexton Crop 1 Name: Fescue WQ Permit#: W00016966 Field #: 02 03 Acres Utilized: 11.3 Annual Dry Tons Applied: 3.8950 Site #: 02 03 Acres Permitted: 11.3 Predominant Soil Series: MeB Cation Exchange Capacity (non 503): Crop 1 Max. PAN: 188 Crop 2 Name: Crop 2 Max. PAN: ° Volume applied (enter one) Solids/ Liquid Cu. Yds Gallons "�u Solids Volume Applied per Acre (Dry Tons/Ac) Residual Sources (NPDES g, WQ#. Fen., Animal Waste, etc) Soil Cond. (Dr}, Wet, Moist) Preci P Past24 Hrs. inches D K a ;; a c .mod'. ° ° a N K. z - m ^' 5 TKN mg/kg Z D = "oo o ° ° a G. mg/kg Nitrate and Nitrite mg/kg PAN Applied ( pp) Ihs/acre Name of Crop Type Receiving Residual Application Crop 1 Crop 2 Crop 1 Crop 2 08-2019 19500 4.79 0.345 WTP dry 0 s 0.5 0.4 9790 2920 4.63 2.904 NA Fescue 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form): TOTALSI 01 As Cd Cu Cr Pb I Ha Mo I Ni I Se I Zn P 1 2.904 0.000 Lime Applied Annual Ibs/acre 0.006 0.001 0.033 0.030 0.015 0.000 0.002 0.012 0.003 0.053 1.270 Date lbs/ac Prior Years Cumulative Ibs/ac 0.961 0.967 36 0.035 0.036 34 5.157 5.190 NA 0.189 0.219 1338 0.472 0.487 267 0.03 0.030 15 0.01 0.012 NA 0.353 0.365 374 0.069 0.072 89 13.673 13.726 2498 0 Current Cumulative Ibs/ac Permitted C. P. L. R.**** Permit PAN Limit I st/2nd Crop 188 "I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly 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 Land Applier *Application Method: S - Surface, IN - Injection, INC - Incorporation **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0 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 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: Town of Denton Land Owner: Joel Sexton Operator: Joel Sexton Crop 1 Name: Fescue WQ Permit #: WQ0016966 Field #: 02 04 Annual Dry Tons Applied: 10.0560 Site #: 02 04 Predominant Soil Series: $aD Crop 1 Max. PAN: 204 Crop 2 Name: Acres Utilized: 16.6 Acres Permitted: 16.6 Cation Exchange Capacity (non 503): Crop 2 Max. PAN: o t m �° Volume a lied PP (enter one) Solids/ Liquid Cu. Yds Gallons % Solids Volume Applied per Acre (Dry TonslAc) Residual Sources (NPDES #. WQ#, Fert., Animal Waste, etc) Soil Cord. Wets Moist) Precip. Past 24 Hrs. inches Y K � T * 'M < o w m w' d m m * o TKN mg/kg z D 3 d 3 °o ° mg/kg Nitrate and Nitrite mg/kg PAN Applied (Ibs/acre) Name of Crop Type Receiving Residual Application Crop I Crop 2 Crop 1 Crop 2 8-2019 91000 2.65 0.606 WWTP dry 0 s 0.5 03 21200 377 1230 9.287 NA Fescue 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 Residuals Applications totals on FORM ESE supp ( attach FORM ESE supp to this form): TOTALS4 01 91000 As Cd Cu Cr Pb H Mo Ni Se Zn P 9.287 0.000 Lime Applied Annuallbs/acre 0.002 0.002 0.467 0.034 0.028 0.000 0.004 0.018 0.002 0.956 21.331 Date Ibs/ac Prior Years Cumulative Ibs/ac 0.154 0.027 5.129 0.253 0.366 0.016 0.013 0.448 0.065 11.02 0.156 0.029 5.596 0.287 0.394 0.016 0.017 0.466 0.067 11.976 36 34 1338 NA 267 15 NA 374 89 2498 2pq 9-2019 2000 Current Cumulative Ibs/ac Permitted C. P. L. R.**** Permit PAN Limit Ist/2nd Crop "I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." Signature of Land Applier *Application Method: S - Surface, IN - Injection, INC - Incorporation aJJO **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0 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 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: Town of Denton Land Owner: Joel Sexton Operator: Joel Sexton Crop 1 Name: Fescue WQ Permit #: WQ0016966 Field #: 02 05 Acres Utilized: 10.6 Annual Dry Tons Applied: 24.8065 Site #: 02 05 Acres Permitted: 10.6 Predominant Soil Series: HeB Cation Exchange Capacity (non 503): Crop 1 Max. PAN: 204 Crop 2 Name: Crop 2 Max. PAN: o t 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 D � S 'o c W o o w = d' $ a ' q TKN mg/kg z D w o mg/kg Nitrate and Nitrite mg/kg PAN Applied Ibs/acme ( ) Name of Crop Type Receiving Residual Application Crop 1 Crop 2 Crop I Crop 2 08-2019 13000 2.65 0.136 WWTP dry 0 s 0.5 0.3 21200 377 1230 2.078 NA Fescue 08-2019 117000 4.79 2.205 WTP dry 0 s 0.5 0.4 9790 2920 4.63 18.575 NA Fescue 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 1 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 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): TOTALS: 01 130000 As Cd Cu Cr Pb Hg Mo Ni Se Zn P 20.653 1 o.000 Lime Applied Annual Ibs/acre 0.038 0.005 0.319 0.199 0.102 0.003 0.012 0.081 0.023 0.556 12.902 Date Ibs/ac Prior Years Cumulative Ibs/ac 0.078 0.042 7.472 0.246 0.633 0.03 0.043 0.406 0.088 20.242 0.116 0.047 7.791 0.445 0.735 0.033 0.055 0.487 0.111 20.798 36 34 1338 NA 267 15 NA 374 89 2498 204 0 Current Cumulative Ibs/ac Permitted C. P. L. R.**** Permit PAN Limit Ist/2nd Crop "I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." / *Application Method: S - Surface, IN - Injection, INC - Incorporation **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 Report Number: 19-240-0010 Account Number: 46381 Send To: Southern Soil Builders Dennis Key 958 Hoots Road Roaring River, NC 28669 Lab Number: 67986 Sample Id: Denton WTP Waypoint,06 . ANALYTICAL Project: Denton WTP REPORT OFANALYSIS 7621 Whitepine Road, Richmond, VA 23237 Main 804-743-9401 ° fax 804-271-6446 www.waypointanalytical.com Date Sampled: 8/25/2019 11:52:00 Date Received: 08/28/2019 00:00 Date Reported: 09/06/2019 Total Solids ` 4.79 ADM 08/30/2019 15:57 SM-254OG Moisture . 95.20 ADM 08/30/2019 15:57 SM-2540G Total Kjeldahl Nitrogen 0.98 9790 250 JPJ 09/04/2019 13:00 SM-4500-NH3C-TKN Phosphorus 0.18 1840 50.0 JTR 09/03/2019 19:53 6010D Potassium 0.10 982 50.0 JTR 09/03/2019 19:53 6010D Sulfur 0.33 3260 50.0 JTR 09/03/2019 19:53 6010D Calcium 0.28 2810 250 JTR 09/03/2019 19:53 6010D Magnesium 0.14 1430 50.0 JTR 09/03/2019 19:53 6010D Sodium 0.03 297 250 JTR 09103/201919:53 6010D Iron 36500 50.0 JTR 09/03/2019 19:53 6010D Aluminum 152000 500 JTR 09/04/201917:46 6010D Manganese 2700 5.00 JTR 09/03/2019 19:53 6010D Copper 48.5 2.50 JTR 09/03/2019 19:53 6010D Zinc 77.5 12.5 JTR 09/03/2019 19:53 6010D Ammonia Nitrogen 0.29 2920 100 JPJ 09/05/2019 13:00 SM-4500-NI3C Organic N 0.69 6870 250 09/04/2019 13:00 CALCULATION Nitrate+Nitrite-N c4.63 4.63 ZBD 09/04/201915:21 4500NO3F-2011 All values are on a dry weight basis except as noted by asterisk. Detection limit on all N series is on a wet basis. B-Analyte detected in blank H - Beyond holding time Pauric McGroary Agronomist Page 3 of 6 Report Number: 19-240-0010 Account Number: 46381 Send To: Southern Soil Builders Dennis Key 958 Hoots Road Roaring River, NC 28669 Lab Number: 67986 Sample Id : Denton WTP Cadmium Chromium Nickel Lead Arsenic Mercury Selenium pH' Molybdenum Comments: Waypoint,(DO, . ANALYTICAL Project : Denton WTP REPORT OF ANALYSIS 7621 Whitepine Road, Richmond, VA 29237 Main 804-743-9401 ° fax 804-271-6446 www.waypointanalytical.com Date Sampled: 8/25/2019 11:52:00 Date Received: 08/28/2019 00:00 Date Reported: 09/06/2019 <1.00 1.00 JTR 09/03/2019 19:53 6010D 43.3 2.50 JTR 09/03/2019 19:53 6010D 17.5 2.50 JTR 09/03/2019 19:53 6010D 21.7 3.00 JTR 09/03/2019 19:53 6010D 8.61 5.00 JTR 09/03/2019 19:53 601OD 0.0585 _ 0.0141 TJS 09/03/2019 14:49 SW-7471B <5.00 5.00 JTR 09/03/2019 19:53 601OD 6.5 JSL 09/03/2019 05:31 9045D <2.50 2.50 JTR 09/03/2019 19:53 6010D All values are on a dry weight basis except as noted by asterisk. Detection limit on all N series is on a wet basis. B-Analyte detected in blank H - Beyond holding time Por« mC G� Pauric McGroary Agronomist Page 4 of 6 PAN Mineralization as decimal Total dry Acres Rate 0.4 TKN 9790 NH3 2920 NO3 4.63 NO2 0 % Solids 0.0479 tonslyear Applied on PAN Surface 4212.63 me /k 8.42526 lbs/dry ton 0 11bs total PAN #DIV/0! Ibs PAN/acre PAN Injection 5672.63 m /k 11.34526 lbs/dry ton 0 Ibs total PAN #DIV/0! Ibs PAN/acre Dry T2ns/1000 gal. 0.199743 1st year PAN Surface Ibs. 0 1st year PAN Injected 0 Ibs./acre Surface #DIV/01 Ibs./acre Injected #DIVl01 MR(TKN-NH3)+ + .5(NH3)+NO3+NO2 =mg/kg mg/kg x .002 =Ibs/dry ton MR(TKN-NH3) + l(NH3)+NO3+NO2 =mg/kg mg/kg x .002 =Ibs/dry ton 1000 X 8.34 X %solids X sp. gravity '=dry tons/1000gal." 2000 SAR Sodium Absorption Ratio Na: Sodium (Mg/L) Equivalent weight: 23 Ca: Calcium (Mg/L) Equivalent weight: 20 Mg : Magnesium (Mg/L) Equivalent weight: 12 Milli Equivalent = Mg/L / Equivalent weight Na M /L Ca M /L M M /L 14.22 134.6 68.49 Na_jME) I Cam MIME) 0.618261 6.73 5.7075 SAR= Na Milli Equivalent/[0.5 X (Ca Milli Equivalent + Mg Milli equivalent)10.5 power SAR = 0.247925 (From Mg/L entered above) SAR= 0.248597 (From ME entered below) Na (ME) Ca (ME) M ME 0.62 1 6.73 1 5.71 The amour amount of f Permitting! Meritech, Inc. ;• Environmental Laboratory Laboratory Certification No. 165 -11 I ow Contact: Mr. Troy Branch Report Date: 1/6/2020 Client: Town of Denton NPDES#: NC0026689 P.O. Box 306 Project#: Sludge 2019 Denton, NC 27239 Date Sample Rcvd: 12/17/2019 Meritech Work Order # 12171931 Sample: Sludge/Digester 42 Grab 12/17/2019 Parameters Result Analysis Date Re o�gLimit Method %Solids 2.65 % 12/18/19 0.2 % SM 2540B Ammonia, Nitrogen <377 mg/kg 12/23/19 377 mg/kg EPA 350.1 TKN 21200 mg/kg 12/24/19 20 mg/kg EPA 351.1 Nitrate/Nitrite, Nitrogen 1230 mg/kg 12/20/19 31.3 mg/kg EPA 353.2 Aluminum, total 9580 mg/kg 12/27/19 2.50 mg/kg EPA 200.7 Arsenic, total <1.89 mg/kg 12/27/19 1.89 mg/kg EPA 200.7 Cadmium, total 1.61 mg/kg 12/27/19 0200 mg/kg EPA 200.7 Chromium, total 27.8 mg/kg 12/27/19 0.250 mg/kg EPA 200.7 Copper, total 385 mg/kg 12/27/19 1.00 mg/kg EPA 200.7 Lead, total 23.3 mg/kg 12/27/19 0.500 mg/kg EPA 200.7 Magnesium, total 4490 mg/kg 12/27/19 10.0 mg/kg EPA 200.7 Mercury, total 0.151 mg/kg 12/24/19 0.02 mg/kg EPA 245A Molybdenum, total 3.20 mg/kg 12/27/19 0.500 mg/kg EPA 200.7 Nickel, total 14.9 mg/kg 12/27/19 2.0 mg/kg EPA 200.7 Phosphorus, total 17600 mg/kg 12/30/19 2.00 mg/kg EPA 200.7 Potassium, total 5280 mg/kg 12/27/19 20.0 mg/kg EPA 200.7 Selenium, total <1.89 mg/kg 12/27/19 1.89 mg/kg EPA 200.7 Sodium, total 551.0 mg/kg 12/27/19 20.0 mg/kg EPA 200.7 Zinc, total 789 mg/kg 12/27/19 0.500 mg/kg EPA 200.7 Cyanide, total <18.9 mg/kg 12/27/19 18.9 mg/kg EPA 335.4 Sulfide <377 mg/kg 12/23/19 377 mg/kg SW 846 9038 Ignitability >140 OF 12/24/19 EPA 1.030 Corrositivity, (pH) 7.1 S.U. 12/18/19 1.0 - 14.0 S.U. SM 4500 HB I hereby certify that I have reviewed and approve these data. CA)_ Laboratory Repr sentative 642 Tamco Road, Reidsville, North Carolina 27320 tel.(336)342-4748 fax.(336)342-1522 PAN Mineralization as decimal Total dry Acres Rate 0.3 TKN 21200 NH3 377 NO3 1230 NO2 0 % Solids 0.0265 tons/year Applied on PAN Surface 7665.41mg/kg 15.3308 lbs/dry ton 0 1 Ibs total PAN #DIV/0! jibs PAN/acre PAN Injection 7853.91mg/kg 1 15.7078 lbs/dry ton Olt total PAN #DIV/0! Ibs PAN/acre Dry T2ns11000 al. 0.110505 1st year PAN Surface Ibs. 0 1st year PAN Injected 1 0 Ibs./acre Surface #DIV/0! lbs./acre Injected #DIV/01 MR(TKN-NH3)+ + .5(NH3)+NO3+NO2 =mg/kg mg/kg x .002 =Ibs/dry ton MR(TKN-NH3) + l(NH3)+NO3+NO2 =mg/kg mg/kg x .002 =Ibs/dry ton 1000 X 8.34 X %solids X so. gravity "=dry tons/1000gal." 2000 Analytical Results Southern Soil Builders 958 Hoots Road Roaring River, NC 28669 Receive Date: 09/10/2019 Reported: 09/12/2019 For: Denton WTP Comments: <435 MPN/g TATFSVI I n ANALYMAL E Sample Number Parameter Sample ID Result Unit Method Analyzed Analyst 190910-37-01 Fecal Coliforms 1 <490 MPN/g SM92210E-2006 09/11/2019 WC 190910-37-01 Percent Solids 1 4.08 % SM254oB-2011 09/11/2019 WC 190910-37-02 Fecal Coliforms 2 <348 MPN/g SM92210E-zoos 09/11/2019 WC 190910-37-02 Percent Solids 2 5.74 % SWWB-2011 09/11/2019 WC 190910-37-03 Fecal Coliforms 3 <442 MPN/g SM92210E-2006 09/11/2019 WC 190910-37-03 Percent Solids 3 4.52 % SM2540B-2011 09/11/2019 WC 190910-37-04 Fecal Coliforms 4 <424 MPN/g SM92210E-2006 09/11/2019 WC 190910-37-04 Percent Solids 4 4.72 % SM2640B-2011 09/11/2019 WC 190910-37-05 Fecal Coliforms 5 <476 MPN/g SM92210E-2006 09/11/2019 WC 190910-37-05 Percent Solids 5 4.20 % SM2540B-2011 09/11/2019 WC 190910-37-06 Fecal Coliforms 6 <435 MPN/g SM92210E-2006 09/11/2019 WC 190910-37-06 Percent Solids 6 4.60 % SM254oB-2011 09/11/2019 WC 190910-37-07 Fecal Coliforms 7 <443 MPN/g SM92210E-2oo6 09/11/2019 WC 190910-37-07 Percent Solids 7 4.51 % SM2540e.2011 09/11/2019 WC Respectfully submitted, Dena Myers NC Cert #440, NCDW Cart #37755, EPA #NC00909 PO Box 228 • Statesville, NC 28687 • 704/872/4697 Page 1 of 4 Condition of Receipt Sample Number 190910-37-01 Temp on Arrival: 3.2 Parameter Schedule: Percent Solids Received on Ice Parameter Schedule: Fecal Coliforms Sodium Thiosulfate Received on Ice Chemicals in containers, lab Sample Number 190910-37-02 Temp on Arrival: 3.2 Parameter Schedule: Percent Solids Received on Ice Parameter Schedule: Fecal Coliforms Sodium Thiosulfate Received on Ice Chemicals in containers, lab Sample Number 190910-37-03 Temp on Arrival: 3.2 Parameter Schedule: Percent Solids Received on Ice Parameter Schedule: Fecal Coliforms Sodium Thiosulfate Received on Ice Chemicals in containers, lab Sample Number 190910-37-04 Temp on Arrival: 3.2 Parameter Schedule: Percent Solids Received on Ice Parameter Schedule: Fecal Coliforms Sodium Thiosulfate Received on Ice Chemicals in containers, lab Sample Number 190910-37-05 Temp on Arrival: 3.2 Parameter Schedule: Percent Solids Received on Ice PO Box 228 • Statesville, NC 28687 • 704/872/4697 Page 2 of 4 Parameter Schedule: Fecal Coliforms Sodium Thiosulfate Received on Ice Chemicals in containers, lab Sample Number 190910-37-06 Temp on Arrival: 3.2 Parameter Schedule: Percent Solids Received on Ice Parameter Schedule: Fecal Coliforms Sodium Thiosulfate Received on Ice Chemicals in containers, lab Sample Number 190910-37-07 Temp on Arrival: 3.2 Parameter Schedule: Percent Solids Received on Ice Parameter Schedule: Fecal Coliforms Sodium Thiosulfate Received on Ice Chemicals in containers, lab PO Box 228 • Statesville, NC 28687 • 704/872/4697 Page 3 of 4 t �ClienL 4J " J0�' W,li{ of STATEMLLB ANALYTICAL 122 Can Street • PO. Box 228 Sme VHK NC 28637 Address ((�� ^ ----- -- --- 158 Aof- Rd L 211669 (704)8724W 'a r Contact Peraon: Phone tt cl V�4L. 336" gs'1 -'2�'11 FAXN 336-ar? _,8yy; chain Of Custody Record ro x Requisitioned by: O�) BamPWIDe _. LaoIDI tG�ONO aeSNyleo ! x A181nx rv, PasiWasnparaC)a nW"ie i.� wfP (: I u c a I k j0 UtC r x _. o k C U k Relinquished by: Time )1)5 am, & Date j JL/-� Sampled by: �7,,,, At:- Received by: _ Time/ am, pm Date L 1` / Transported by: r� Relinquished by: Time am, pm Date _ice_ Holding times met: Received by:—,-,— - Time am, pm Date J_J_ _ ✓ Compliance work: Composite Sam Itt: Time begin. _ am, pm Date _/_/_ Non-compliance work: Time end am, pm Date —J--J_ ta6 Comments: Samples Transported On In: Compoake Samolina k _ Time begin am, pm Date Time end__ am, pm Date _/_/_ I IMada: NCDABCS Agronomic Division Phone: (919) 733-2655 Website: w .ncagr.gov/agronomi/ Report No. FY20-SL013922 ` } Client: Joel Sexton Advisor: Zach Key ; Predictive t 1129 Gallimore Road Southern Soil Builders, Soil Report Mehlich-3Extraction Denton, NC 27239 Inc. 958Hoots Rd Sampled County : Davidson Roaring River, NC 28669 Links to Helpful Information Client ID: 444521 Advisor 10: 231531 Sampled: 10/28/2019 Received: 11/06/2019 Completed: 11/19I2019 Farm: Sample ID: JS1 Recommendations: Lime Nutrients (Ib/acre) More Crop (tons/acre) N P2O5 K2O Mg S Mn Zn Cu B Information Lime History: 1-Fescue/OGrass/Tim, M 0.0 120-200 0 0 0 0 0 0 0 0 Note: 12 2 - 0.0 I Test Results [units - WN in g/cm3; CEC and Na in meg1100 cm3; NO3-N in mgldm3]: Soil Class: Mineral HM% WN CEC BS% Ac pH P-1 K-1 Ca% Mg% S-1 Mn-I Mn-All Mn-Al2 Zn-I Zn-AI Cu-I Na ESP SS -I NO3-N 0.36 0.88 11.3 92 0.9 6.5 143 82 69 19 38 334 210 372 372 354 0.1 1 Sample ID: JS3 Recommendations: Lime Nutrients (Ib/acre) More Crop (tonslacre) N P2O5 K2O Mg S Mn Zn Cu B Information Lime History: 1-Fescue/OGrass/Tim, M 0.0 120-200 0 0 0 0 pH$ 0 0 0 Note: 12 Note: 2 - 0.0 Test Results [units - W/V in g1cm3; CEC and Na in meq/100 cm3; NO3-N in mgldrr j: Soil Class: Mineral HM% WN CEC BS% Ac pH P-1 K-1 Ca% Mg°/ S-1 Mn-I Mn-All Mn-AI2 Zn-I Zn-AI Cu-I Na ESP SS-1 NO3-N 0.51 0.85 12.0 93 0.9 6.6 170 99 72 17 41 299 188 327 327 293 0.1 1 Sample ID: JS4A Recommendations: Lime Nutrients (lb/acre) More Crop (tonslacre) N P2O5 K2O Mg S Mn Zn Cu B Information Lime History: 1-Fescue/OGrass/Tim, M 0.0 120-200 0 0 0 0 pH$ 0 0 0 Note: 12 Note: 2 - 0.0 Test Results [units -WIV in g/cm3; CEC and Na in meg1100 cm3; NO3-N in mg/drrt3]: Soil Class: Mineral HM%n WN CEC BS% Ac pH P-1 K-1 Ca% Mg% S-1 Mn-I Mn-All Mn-AI2 Zn-I Zn-AI Cu-I Na ESP SS-1 NO3-N 0.46 0.77 12.7 93 0.9 6.6 110 183 57 29 41 137 91 403 403 223 0.1 1 North Carolina Ail ±,u�., Itn� c •Yn.....� 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 ofAariculture NCDABCS Agronomic Division Phone: (919) 733-2655 Website: www.ncagr.gov/agronomi/ Report No. FY20-SL013922 Joel Sexton Page 2 of 4 Sample ID: 0201T2- mendations: Lime Nutrients (lb/acre) More (tons/acre) N P2O5 K2O Mg S Mn Zn Cu B Information Lime History: cue/OGrass/Tim, M 0.0 120-200 0 40 0 0 pH$ 0 0 0 Note: 12 Note: 0.0 Test Results [units - WN in g/cm3; CEC and Na in meq/100 cm3; NO3-N in mg1dm3]: Soil Class: Mineral HM% WN CEC BS% Ac pH P-1 K-1 Ca% Mg% S-1 Mn-I Mn-All Mn-Al2 Zn-I Zn-AI Cu-I Na ESP SS-1 NO3-N 0.41 0.83 24.1 100 0.0 7.5 314 54 92 7 63 351 205 1049 1049 438 0.1 0 Sample ID: 0202 Recommendations: Lime Nutrients (lb/acre) More Crop (tons/acre) N P2O5 K2O Mg S Mn in Cu B Information Lime History: 1-Fescue/OGrass/Tim, M 0.0 120-200 0 0 0 0 pH$ 0 0 0 Note: 12 Note: 1.00 tons/acre; 9/2019 2 - 0.0 Test Results [units - WN in g/cm3; CEC and Na in meg1100 cm3; NO3-N in mg/dm3]: Soil Class: Mineral HM% WN CEC BS% Ac pH P-1 K-1 Ca% Mg% S-1 Mn-I Mn-All Mn-AI2 Zn-I Zn-AI Cu-I Na ESP SS-1 NO3-N 0.41 0.90 16.4 95 0.8 6.9 259 109 78 14 62 1588 957 578 578 267 0.2 1 Sample ID: 0203 Recommendations: Lime Nutrients (lb/acre) More Crop (tons/acre) N P2O5 K2O Mg S Mn Zn Cu B Information Lime History: 1 -Fescue/OGrass/Tim, M 0.0 120-200 0 90 0 0 pH$ 0 0 0 Note: 12 Note: 2 - 0.0 Test Results [units - WN in g/cm3; CEC and Na in meq/100 cm3; NO3-N in mg/drna]: Soil Class: Mineral HM% WN CEC BS% Ac pH P-1 K-1 Ca% Mg% S-1 Mn-I Mn-Alt Mn-AI2 Zn-I Zn-AI Cu-I Na ESP SS-1 NO3-N 0.51 0.85 17.7 98 0.3 7.2 298 26 88 10 56 372 222 679 679 435 0.2 1 Sample ID: 0204 Recommendations: Lime Nutrients (lb/acre) More Crop (tonslacre) N P2O5 K2O Mg S Mn Zn Cu B Information Lime History: 1-Fescue/OGrass/Tim, M 0.0 120-200 0 0 0 0 pH$ 0 0 0 Note: 12 Note: 2 - 0.0 Test Results [units - WN in g/cm3; CEC and Na in meq/100 cm3; NO3-N in mgldm3]: Soil Class: Mineral HM% WN CEC BS% Ac pH P-1 K-1 Ca % Mg% S-1 Mn-I Mn-All Mn-AI2 Zn-I Zn-AI Cu-I Na ESP SS-1 NO3-N 0.46 0.77 23.0 100 0.1 7.5 444 159 85 11 67 240 139 1074 1074 572 0.2 1 NCDABCS Agronomic Division Phone: (919) 733-2655 Website: w .ncagr.gov/agronomi/ Report No. FY20-SL013922 Joel Sexton Page 3 of 4 Sample ID: 0205 Recommendations: Lime Nutrients (lb/acre) More Crop (tons/acre) N P2O5 K2O Mg S Mn Zn Cu B Information Lime History: 1 -Fescue/OGrass/Tim, M 0.0 120-200 0 60 0 0 pH$ 0 0 0 Note: 12 Note: 2 - 0.0 Test Results [units - WN in g/cm3; CEC and Na in meq/100 cm3; NO3-N in mg/dm3]: Soil Class: Mineral HM°/ WN CEC BS% Ac pH P-1 K-1 Ca°/ Mg% S-1 Mn-I Mn-AN Mn-AI2 Zn-I Zn-AI Cu-1 Na ESP SS-1 NO3-N 0.41 0.82 26.2 100 0.0 7.6 367 39 93 7 73 398 232 960 960 518 0.2 1 NCDA&CS Agronomic Division Phone: (919) 733-2655 Website: www.ncagr.gov/agronomi/ Report No. FY20-SLO13922 Joel Sexton Page 4 of 4 Understanding the Soil Report: explanation of measurements, abbreviations and units Recommendations Report Abbreviations Lime Ac exchangeable acidity If testing finds that soil pH is too low for the crop(s) indicated, a lime recommendation will be given in units of either B boron ton/acre or Ib/1000 sq ft. For best results, mix the lime into the top 6 to 8 inches of soil several months before planting. BS°/ % CEC occupied by basic cations For no -till or established plantings where this is not possible, apply no more than 1 to 1.5 ton/acre (50 Ib/1000 sq ft) at on Ca% % CEC occupied by calcium time, even if the report recommends more. You can apply the rest in similar increments every six months until the full rate CEC cation exchange capacity is applied. If MG is recommended and lime is needed, use dolomitric lime. Cu-I copper index ESP exchangeable sodium percent Fertilizer HM% percent humic matter Recommendations for field crops or other large areas are listed separately for each nutrient to be added (in units of K-1 potassium index lb/acre unless otherwise specified). Recommendations for N (and sometimes for B) are based on research/field studies K20 potash for the crop being grown, not on soil test results. K-1 and P-1 values are based on test results and should be > 50. If they Mg% % CEC occupied by magnesium are not, follow the fertilizer recommendations given. If Mg is needed and no lime is recommended, 0-0-22 (11.5% Mg) is MIN mineral soil class an excellent source; 175 to 250 lb per acre alone or in a fertilizer blend will usually satisfy crop needs, SS -I levels appear Mn manganese only on reports for greenhouse soil or problem samples. Mn-All Mn-availability index for crop 1 Mn-Al2 Mn-availability index for crop 2 Farmers and other commercial producers should pay special attention to micronutrient levels. If $, pH$, $pH, C or Z Mn-I manganese index notations appear on the soil report, refer to Mote: Secondary Nutrients and Micronutrients In general, homeowners do not M-0 N mineral -organic soil class need to be concerned about micronutrients. Various crop notes also address lime fertilizer needs; visit Na nitrogen sodium ncagr.gov/agronomi/pubs.htm. NO3-N nitrate nitrogen ORG organic soil class Recommendations for small areas, such as home lawns/gardens, are listed in units of Ib/1000 sq ft. If you cannot find pH current soil pH the exact fertilizer grade recommended on the report, visit www ncaar oov/aoronomi/oboart4 htmgis£nd information that P-1 phosphorus index may help you choose a comparable alternate. For more information, read A Homeowner's Guide to Fertilizer. P205 phosphate S-1 sulfur index Test Results SS-1 soluble salt index WN weight per volume The first seven values [soil class, HM%, W/V, CEC, BS%, Ac and pH] describe the soil and its degree of acidity. The Zn-AI zinc availability index remaining 16 [P-I, K-I, Ca%, Mg%, Mn-I, Mn-All, Mn-AI2, Zn-I, Zn-AI, Cu-I, S-I, SS -I, Na, ESP, SS-1, NO3-N (not routine) 01st Zn-I zinc index available)] indicate levels of plant nutrients or other fertility measurement. Visit www.ncaaroov/aarono htm Agronomic Division Phone: (919) 733-2655 Website: www.ncagr.gov/agronomi/ ReportNo. FY20-SL013922 rNCDA&CS� Predictive Soil Report Mehlich-3 Extraction _'.v Links to Helpful Information Client: Joel Sexton 1129 Gallimore RoadSouthern Denton, NC 27239 Sampled County : Davidson Advisor: Zach Key Soil Builders, Inc. 958 Hoots Rd Roaring River. NC 28669 Sampled: 10/28/2019 Received: 11/06/2019 Completed: 11/19/2019 Farm: Client ID: 444521 Advisor ID: 231531 Sample ID: JS1 Lime History: Recommendations: Lime Crop (tons/acre) 1-Fescue/OGrass/Tim, M 0.0 2 - 0.0 N P2O5 120-200 0 K2O 0 Nutrients (lb/acre) Mg S Mn 0 0 0 Zn 0 Cu 0 iO More Information Note: 12 Test Results [units - WN in g/cm3; CEC and Na in meq/100 cm3; NO3-N in mg/dm3]: Soil Class: Mineral HM% WfV CEC BS% Ac pH P-1 K-1 Ca% Mg% S-1 Mn-I Mn-All Mn-AI2 Zn-I Zn-AI Cu-1 Na ESP SS-1 NO3-N 0.36 0.88 11.3 92 0.9 6.5 143 82 69 19 38 334 210 372 372 354 0.1 1 Sample ID: JS3 Lime History: Recommendations: Lime Crop (tons/acre) 1-Fescue/OGrass/Tim, M 0.0 2 - 0.0 N P2O5 120-200 0 K2O 0 Nutrients (lb/acre) Mg S Mn 0 0 pH$ Zn 0 Cu 0 B 0 More Information Note: 12 Note: Test Results [units - W/V in g/cm3; CEC and Na in meq/100 cm3; NO3-N in mg/dm3]: Soil Class: Mineral HM% W/V CEC BS°/ Ac pH P-1 K-1 Ca% Mg°/ S-1 Mn-I Mn-All Mn-AI2 Zn-I Zn-AI Cu-I Na ESP SS-1 NO3-N 0.51 0.85 12.0 93 0.9 6.6 170 99 Sample ID: JS4A Recommendations: Lime Crop (tonsfacre) Lime History: 1- Fescue/OGrass/Tim, M 0.0 2 - 0.0 72 17 41 N P2O5 120-200 0 299 K2O 0 188 327 Nutrients (lb/acre) Mg S Mn 0 0 pH$ 327 Zn 0 293 Cu 0 0.1 1 More B Information 0 Note: 12 Note: Test Results [units - WN in glcm3; CEC and Na in meq/100 cm3; NO3-N in mg/dm3]: Soil Class: Mineral HM% W/V CEC BS% Ac pH P-1 K-I Ca% Mg% S-1 Mn-1 Mn-All Mn-Al2 Zn4 Zn-AI Cu.] Na ESP SS-1 NO3-N 0.46 0.77 12.7 93 0.9 6.6 110 183 57 29 41 137 91 403 403 223 0.1 1 North Carolina 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 Trox/er. Commissioner ofAgricu/ture NCDABCS Agronomic Division Phone: (919) 733-2655 Website: w .ncagr.gov/agronomi/ Report No. FY20-SL0 33922 Joel Sexton Page 2 of 4 Sample ID: 0201 mendations: Lime Nutrients (lb/acre) More (tons/acre) T2- N P2O5 K2O Mg S Mn Zn Cu B Information Lime History: ue/OGrass/Tim. M 0.0 120-200 0 40 0 0 pH$ 0 0 0 Note: 12 Note: 0.0 Test Results [units - WN in g/cm3; CEC and Na in meq/100 cm3; NO3-N in mg/dm3]: Soil Class: Mineral HM% WN CEC BS% Ac pH P-1 K-1 Ca% Mg% S-1 Mn-I Mn-All Mn-Al2 Zn-I Zn-AI Cu-I Na ESP SS-1 NO3-N 0.41 0.83 24.1 100 0.0 7.5 314 54 92 7 63 351 205 1049 1049 438 0.1 0 Sample ID: 0202 Recommendations: Lime Nutrients (lb/acre) More Crop (tons/acre) N P2O5 K2O Mg S Mn Zn Cu B Information Lime History: 1-Fescue/OGrass/Tim, M 0.0 120-200 0 0 0 0 pH$ 0 0 0 Note: 12 Note: 1.00 tons/acre; 9/2019 2 - 0.0 Test Results [units - WN in g/cm3; CEC and Na in meq/100 cm3; NO3-N in mg/dm3]: Soil Class: Mineral HM% WN CEC BS% Ac pH P-1 K-1 Ca% Mg°/ S-1 Mn-I Mn-All Mn-AI2 Zn-I Zn-AI Cu-I Na ESP SS-1 NO3-N 0.41 0.90 16.4 95 0.8 6.9 259 109 78 14 62 1588 957 578 578 267 0.2 1 Sample ID: 0203 endations: Lime Nutrients (lb/acre) More (tons/acre) T2- N P2O5 K2O Mg S Mn Zn Cu B Information Lime History: ue/OGrass/Tim, M 0.0 120-200 0 90 0 0 pH$ 0 0 0 Note: 12 Note: 0.0 Test Results [units - WN in g/cm3; CEC and Na in meq/100 cm3; NO3-N in mg/dm3]: Soil Class: Mineral HM% WN CEC BS% Ac pH P-1 K-1 Ca% Mg% S-1 Mn-I Mn-All Mn-AI2 Zn-1 Zn-AI Cu-1 Na ESP SS-1 NO3-N 0.51 0.85 17.7 98 0.3 7.2 298 26 88 10 56 372 222 679 679 435 0.2 1 Sample ID: 0204 Recommendations: Lime Nutrients (lb/acre) More Crop (tons/acre) N P2O5 K2O Mg S Mn Zn Cu B Information Lime History: 1-Fescue/OGrass/Tim, M 0.0 120-200 0 0 0 0 pH$ 0 0 0 Note: 12 Note: 2 - 0.0 Test Results [units - W/V in g/cm3; CEC and Na in meq/100 cm3; NO3-N in mg/dm3]: Soil Class: Mineral HM% WN CEC BS% Ac pH P-1 K-1 Ca% Mg% S-1 Mn-I Mn-All Mn-AI2 Zn-I Zn-AI Cu-I Na ESP SS-1 NO3-N 0.46 0.77 23.0 100 0.1 7.5 444 159 85 11 67 240 139 1074 1074 572 0.2 1 NCDA&CS Agronomic Division Phone: (919) 733-2655 Website: www.ncagr.gov/agronomi/ Report No. FY20-SL013922 Joel Sexton Page 3 of 4 Sample ID: 0205 Recommendations: Lime Nutrients (lb/acre) More Crop (tonslacre) N P2O5 K2O Mg S Mn Zn Cu B Information Lime History: 1 -Fescue/OGrass(fim, M 0.0 120-200 0 60 0 0 pH$ 0 0 0 Note: 12 Note: 2 - 0.0 Test Results [units - WN in g/cm3; CEC and Na in meq/100 cm3; NO3-N in mg/dm3]: Soil Class: Mineral HM% WN CEC BS% Ac pH P-1 K-1 Ca% Mg% S-1 Mn-I Mn-All Mn-AI2 Zn-I Zn-AI Cu-I Na ESP SS-1 NO3-N 0.41 0.82 26.2 100 0.0 7.6 367 39 93 7 73 398 232 960 960 518 0.2 1 NCDABCS Agronomic Division Phone: (919) 733-2655 Website: www.ncagr.gov/agronomi/ Report No. FY20-SLO13922 Joel Sexton Page 4 of 4 Understanding the Soil Report: explanation of measurements, abbreviations and units - Recommendations Report Abbreviations Lime Ac exchangeable acidity If testing finds that soil pH is too low for the crop(s) indicated, a lime recommendation will be given in units of either B boron ton/acre or Ib/1000 sq ft. For best results, mix the lime into the top 6 to 8 inches of soil several months before planting. BS% % CEC occupied by basic cations For no -till or established plantings where this is not possible, apply no more than 1 to 1.5 ton/acre (50 Ib/1000 sq ft) at oni Ca% % CEC occupied by calcium time, even if the report recommends more. You can apply the rest in similar increments every six months until the full rate CEC cation exchange capacity is applied. If MG is recommended and lime is needed, use dolomitric lime. Cu-I copper index ESP exchangeable sodium percent Fertilizer HM% percent humic matter Recommendations for field crops or other large areas are listed separately for each nutrient to be added (in units of K-1 potassium index lb/acre unless otherwise specified). Recommendations for N (and sometimes for B) are based on research/field studies K20 potash for the crop being grown, not on soil test results. K-1 and P-1 values are based on test results and should be > 50. If they Mg % % CEC occupied by magnesium are not, follow the fertilizer recommendations given. If Mg is needed and no lime is recommended, 0-0-22 (11.5% Mg) is MIN mineral soil class an excellent source; 175 to 250 lb per acre alone or in a fertilizer blend will usually satisfy crop needs, SS-1 levels appear Mn manganese only on reports for greenhouse soil or problem samples. Mn-All Mn-availability index for crop 1 Mn-Al2 Mn-availability index for crop 2 Farmers and other commercial producers should pay special attention to micronutrient levels. If $, pH$, $pH, C or Z Mn-I manganese index notations appear on the soil report, refer to $Note: Secondary Nutrients and Micronutrients In general, homeowners do not M-0 mineral -organic soil class need to be concerned about micronutrients. Various crop notes also address lime fertilizer needs; visit N nitrogen ncagr.gov/agronomi/pubs.htm. Na sodium NOs-N nitrate nitrogen Recommendations for small areas, such as home lawns/gardens, are listed in units of Ib/1000 sq ft. If you cannot find ORG pH organic soil class current soil pH the exact fertilizer grade recommended on the report, visit www ncagr gov/agronomi/obgart4 hnd information that P-1 phosphorus index may help you choose a comparable alternate. For more information, read A Homeowner's Guide to Fertilizer. P205 phosphate S-1 sulfur index Test Results SS-1 soluble salt index WN weight per volume The first seven values [soil class, HM%, WN, CEC, BS%, Ac and pH] describe the soil and its degree of acidity. The Zn-AI zinc availability index remaining 16 [P-I, K-I, Ca%, Mg%, Mn-1, Mn-All, Mn-AI2, Zn-I, Zn-AI, Cu-I, S-1, SS -I, Na, ESP, SS -I, NO3-N (not routine/ Zn-I zinc index available)) indicate levels of plant nutrients or other fertility measurement. Visit www.ncaor.gov/agronomi/uvrst him ANNUAL PATHOGEN AND VECTOR ATTRACTION REDUCTION FORM (02T Rules) Facility Name: Town of Denton WWTPName: Denton WTP Monitoring Period: From I/l/2019 WQ Permit Number: W00016966 NPDES Number: NCO082949 To 12/31/2019 Pathogen Reduction (15A NCAC 02T .1106) - Please indicate level achieved and alternative performed: Class A: Alt. A (time/temp) ❑ I Alt B (Alk Treatment)❑ I Alt. C (Prior Testing)❑ Alt.D (No Prior Test) ❑ I Process to Further Reduce Pathogengs ❑ If applicable to alternative pet -formed (Class A only) indicate "Process to Further Reduce Pathogens": Compost ❑ Heat Drying ❑ Heat Treatment ❑ Thermophilic ❑ Beta Ray ❑ Gantma Ray ❑ Pasteurization ❑ Class B: Alt. (1) Fecal Density O Alt (2) Process to Significantly Reduce Pathogens ❑ If applicable to alternative performed (Class B only) indicate "Process to Significantly Reduce Pathogens": Lime Stabilization ❑ Air Drying ❑ Composting ❑ JAerobic Digestion ❑ Anaerobic Digestior ❑ If applicable to alternative performed (Class A or Class B) complete the following monitoring data: Parameter Allowable Level in Sludge Pathogen Density um er o Excee- ences Frequency lof Analysis Sample Type n ay nca Tech - Minimu Geo.MeanMaximu Units Fecal Coliform 2 x l0 to the 6th power per gram of total solids MPN 348 435 490 MPN/g 0 7 grab sm9221 CFU 1000 mpn per gram of total solid (dry wei ht) Salmonella bacteria (in lieu of fecal coliform) 3 MPN per 4 grams total solid (dry weight) Vector Attraction Reduction (15A NCAC 02T .1107) - Please indicate alternative performed: Alt.l (VS reduction) I It. 2 (40-day bench) ❑ jAlt. 3 (30-day bench) ❑ I Alt. 4 (Spec. Oz uptake) Alt. 5 (14-Day Aerobic) JAIL 6 (Alk. Stabilization Rl jAlt 7 (Drying - Stable) ❑ JAIL 8 (Drying - Unstable) ❑ Alt. 9 (Injection) ❑ jAft. 10 (Incorporation) ❑ INo vector attraction reduction alternatives were performed CER'I IFICATION STATEMENT (please check the appropriate statement) ❑ "1 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 "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." Preparer Name and Title (type or print) Signature of Preparer* Dennis Key Southern Soil Builders, Inc. Land Applier Name and Title (if applicable)(type or print) Date Signature of Land Applier (if applicable) Date *Preparer is defined in 40 CFR Part 503.9(r) and 15A NCAC 2T .l 102 (26) DENR FORM PVRF 02T (12/2006) ANNUAL PATHOGEN AND VECTOR ATTRACTION REDUCTION FORM (02T Rules) Facility Name: Town of Denton WWTP Name: Denton W WTP Monitoring Period: From 1/1/2019 WQ Permit Number: W00016966 NPDES Number: NCO026689 To 12/31/2019 Pathogen Reduction (15A NCAC 02T .1106) - Please indicate level achieved and alternative Derformed: Class A: Alt. A (time/temp) ❑ 1 Alt B (Alk Treauuent)❑ Alt. C (Prior Testing)❑ Alt.D (No Prior Test) ❑ I Process to Further Reduce Pathogengs ❑ If applicable to alternative performed (Class A only) indicate "Process to Further Reduce Pathogens": Compost ❑ Heat Drying ❑ Heat Treatment ❑ Thermophilic ❑ Beta Ray ❑ Gamma Ray ❑ Pasteurization ❑ Class B: jAlt. (1) Fecal Density ❑ Alt (2) Process to Significantly Reduce Pathogens Rl If applicable to alternative performed (Class B only) indicate "Process to Significantly Reduce Pathogens": Lime Stabilization p I Air Drying ❑ Composting ❑ jAerobic Digestion ❑ Anaerobic Digestior. ❑ If applicable to alternative performed (Class A or Class B) complete the following monitoring data: Parameter Allowable Level n Sludge Pathogen Density um er oAnalytical Excee- denceq Frequency of Analysis Sample Type Tech- moue Minimu Geo. MeanMaximu Units Fecal Coliform 2 x 10 to the 6th power per gram of total solids MPN CPU 1000 mpn per gram of total solid (dry weight) Salmonella bacteria (in lieu of fecal coliform 3 MPN per 4 grams total solid (dry weight) Vector Attraction Reduction (15A NC:AU OTT .1107) - Please indicate alternative Derformed: Alt.I (VS reduction) ❑ Alt. 2 (40-day bench) ❑ Alt. 3 (30-day bench) ❑ Alt. 4 (Spec. O, uptake) ❑ Alt. 5 (14-Day Aerobic) ❑ jAlt. 6 (Alk. Stabilization 21 Alt 7 (Drying - Stable) ❑ JAR. 8 (Drying - Unstable) ❑ Alt. 9 (Injection) ❑ I Alt. 10 (Incorporation) ❑ INo vector attraction reduction alternatives were performed ❑ CERUIUAT10N S'I'A'FEMENF (please check the appropriate statement) Rl "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." Preparer Name and Title (type or print) Signature of Preparer* Dennis Key Southern Soil Builders, Inc. Land Applier Name and Title (if applicable)(type or print) Date Signature of Land Applier (if applicable) Date *Preparer is defined in 40 CFR Part 503.9(r) and 15A NCAC 21'.I 102 (26) DENR FORM PVRF 02T (12/2006)