WQ0001026_Application_20191212

Central Files: APS _ SWP _
12/13/2019
Permit Numot WQ0001026 Permit Tracking Slip
Program Category
Status
Project Type
Non -discharge
In review
Renewal
Permit Type
Version
Permit Clast aicatioti
Land Application of Residual Solids (503)
D
Individual
Primary Reviewer
Permit Contact Affiliation
erickson.saunders
Clint D. Williams
Coastal SWRule
122 W Main St
Williamston
NC 27892977E
Permitted Flow
Facility
Facility Name
Major/Minor Region
City of Washington RLAP
Major Washington
Location Address
County
PO Box 1988
Beaufort
Washington NC 278891988
Owner
Facility Contact Affiliation
Stephen Adam Waters II
Director Public Works
PO Box 1988
Washington NC 278891981
Owner Name Owner Type
City of Washington Government - Municipal
Owner Affiliation
Dodge Franklin Buck Jr.
793 Ave Rd
Dates/Events Washington NC 27889403
Scheduled
Orig Issue App Received Draft Initiated Issuance Public Notice Issue Effective Expiration
1 /12/1983 12/12/2019
Regulated Activities Requested /Received Events
Wastewater treatment and disposal Region comments on draft requested
Region comments on draft received
RO staff report received
RO staff report requested 12/13/19
Outfall
Waterbody Name Streamindex Number Current Class Subbasin

Resources,
RECEIVEDINCDEQIDwR
DEC1�2019
Non-Disch Un
Kermit Renewal Application permitting
For The
Land Application of Residuals
From The
City of Washington, NC
Wastewater Treatment Plant
WQ0001026
Prepared By:
EMA Resources Inc.
December 11, 2019
Phone [phone] — Fax 336*751.1442
755 Yadkinville Road — Mocksville, NC 27028

Y-4
--Resources, Inc.
December 11, 2019
Division of Water Resources
Aquifer Protection Section
Land Application Unit
512 N. Salisbury Street
Raleigh, NC 27604
RE: Permit Renewal Application, Permit No. WQ0001026
Mr. Nathanial Thornburg, Branch Chief
RECEIVEO/NCnC,pUslR
DEC 1 2 2019
Non -Discharge
Permitting Unit
On behalf of City of Washington, NC, you will find included in this permit renewal
application the folf6wing: Cover Letter, RLAP Form, RSC Form, LASC Form, Existing
Permit, Operations & Maintenance Plan, Site Cumulative Loadings and Individuals Site
Maps. Please note that each form is supplemented with its accompanying attachments
and are clearly identified on the accompanying tab.
If you have any questions concerning this application, please contact Roy Whitaker at:
office: 336-751-1441 or mobile: [phone].
Respectfully,
EMA Resources Inc.
F
Roy L. Whitaker
Director Business Development/Operations
Phone 336*751 *1441 — Fax [phone]
755 Yadkinville Road — Mocksville, NC 27028

RLAP FORM
EXISTING PERMIT
O&MPLAN
RSC FORM
WWTP VICINITY MAP & PROCESS FLOW
QUANTITATIVE JUSTIFICATION
LABORATORY ANALYSIS
LASC FORM
MARJORIE R. BARNHILL
WILL CONGLETON
HUNTER'S ROOST FARMS
CUMULATIVE LOADINGS REPORTS

DWR
State of North Carolina
Department of Environmental Quality
Division of Water Resources
Divf sbn of Water Resources 15A NCAC 02T .1100 — RESIDUALS LAND APPLICATION PROGRAM
FORM: RLAP 06-16
L A.PPLICANT INFORMATION:
1 _ Applicant's name: City of Washington. NC
Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership ❑ Privately -Owned Public Utility
❑ Federal ❑ State g Municipal ❑ County
Signature authority's name per 15A NCAC 02T .0106: Adam Waters Title: Public Works Director
Applicant's mailing address: P.O. Box 1988
City: Washington State: NC Zip: 27889-
Telephone number: [phone] Email Address: [e-mail]
2- Consultant's name: Rov Whitaker License Number (for RE.): NA
Affiliation: ❑ On Staff ® Retained (Firm: EMA Resources. Inc.)
Consultant's mailing address: 755 Yadkinville Road
City: Mocksville State: NC
Zip: 27028-__
Telephone number: 336) 751-1441
Email Address: rov.whitakernu_ emaresourcesine.com
3.. Agronomist's name: Rov Whitaker
License Number: NA
Affiliation: ❑ N/A ❑ On Staff
0 Retained (Firm: EMA Resources,_ Inc.)
Agronomist's mailing address: 755 Yadkinville Road
City: Mocksville State: NC
Zip: 27028-__
Telephone number: [phone]
Email Address: rov.whitakera emaresourcesinc.com
4. Soil Scientist's name: Rob Willcox, LSS License Number: 1098
Affiliation: ❑ N/A ❑ On Staff
® Retained (Firm: Willcox & Mabe Soil Solutions, PLLC)
Soil Scientist's mailing address: 7231-B Summerfield Road
City: Summerfreld
State: NC Zip: 27358-
Telephone number: [phone]
Email Address: Rob@,WILLCOXMABESOII,.COM
5. Fee submitted: NA (See Instruction B)
1I. PERMIT INFORMATION:
1. Application is for (check all that apply): ❑ new, ❑ modified, ® renewed permit
RE.CEIVENNCDEQIDWR
2. If this application is being submitted to renew or modify an existing permit, provide the following:
Permit number: W 0001026
Date of most -recently issued permit: Janu4U 23. 2015
Date of most -recently certified Attachment A (if different than the permit): Januan 23. 2015
Date of most -recently certified Attachment B (if different than the permit): January 23. 2015
DEC 1 2 2019
Non -Discharge
Permitting Unit
FORM: RLAP 06-16 Page 1 of 5

III. RESIDUALS LAND APPLICATION PROGRAM INFORMATION:
1. Residuals Processing Facility's physical address: 1399 W. 2nd Street
City: Washingion State: NC Zip: 27889- v
Coordinates: Latitude: 35' 33' 08.12"N Longitude: 77' 04' 20.08"W
Datum: NAD83 Level of accuracy: .0 1"
Method of measurement: GPA
2. County where residuals land application program is headquartered: Beaufort
3. List the Operator In Responsible Charge (ORC) and all Back -Up ORCs for the residuals land application program, their
certification numbers, and their affiliations in the following table:
Designation Name Affiliation Certification Number
ORC Roy Whitaker EMA Resources, Inc. LA13283
Back -Up ORC Brent Collins EMA Resources, Inc. LA27651
Additional Back -Up
ORCs
if applicable) J
If an ORC and at least one Back -Up ORC are not currently designated for this residuals land application program, provide the
candidates' names, affiliations, and an estimated time schedule for each candidate's completion of the required training school
and certification test:
4 Complete the following tables regarding management of the residuals land application program:
a. Plant Available Nitrm en Summan : Determine the maximum plant available nitrogen (PAN) generated by all residuals
source -generating facilities as currently certified and proposed for certification with this application and list the results in the
following table:
Maximum amount of residuals to be certified: 625 dry tons per year.
PAN Pounds of PAN per Dry Ton Pounds of PAN per Year
(Weighted Average)
Surface Incorporation Surface Incorporation
or Injection or Injection
First -Year 20.87 30.18 13,044 18,862
Five -Year Maximum Adjusted 1 28.88 38.18 J 18,050 I 23,862
b. Land Application Site Use Summan-: Summarize information regarding the land application sites as currently certified and
proposed for certification with this application:
Category
Use
Acres Comments
Crops
Forest or Plantation
0
Row Crops
618.48
Hay
0
Pasture
63.7
Total:
682.18
Methods
Surface
682.18
Incorporation or Injection
0
Total:
682.18
FORM: RLAP 06-16 Page 2 of 5

c. Residuals Land Aly 1lication Summary: Determine the minimum acreage required to land apply the residuals as currently
certified and proposed for certification assuming the scenarios listed in the following table:
Assumed Acres Required Using Acres Required Using
Application Rate First -Year PAN Concentrations Five -Year Maximum Adjusted PAN
(lbs PANIac yr) Concentrations
Surface Incorporation or Surface Incorporation or
Injection Injection
50 261 377 361 478
100 1 131 I 189 1 181 1 239
1 150 1 87 1 126 1 121 159 1
200 ' 66 { 95 ' 91 120
6. If applicable, provide a plan and a schedule to resolve any ]mown issues that would prevent land application of the proposed
residuals due to the violation of North Carolina Administrative Code (e.g. not enough storage, not enough land, vector reduction
practices not in place, etc.): NA
7. Specify type of residuals program (See Instruction F): Z Non -dedicated ❑ Dedicated
If Dedicated. specify the following (check all that apply):
❑ Residuals program contains any land application site(s) that receives residuals at rates or frequencies greater than agronomic
rates, explain; .
❑ Residuals program contains any land application site(s) that is used primarily for residuals disposal, and agricultural crop
production is of secondary importance, explain;
❑ Residuals program contains any land application site(s) that receives residuals through fixed irrigation facilities or irrigation
facilities fed through a fixed supply system, explain;
IV. RESIDUALS SOURCE INFORMATION: (Required for all new, renewed, or modified residuals source)
Complete and submit the following Residuals Source Certification and all associated documentation.
9W an
Residuals Source
Certification
V. LAND APPLICATION SITE INFORMATION: (Required for all new, renewed, or modified land application site)
Complete and submit the following Land Applications Site Certification and all associated documentation.
Land Application Siite
Certification. doc
FORM: RLAP 06-16 Page 3 of 5

rlote: Item VI. Applicable to Dedicated Program with fixed irrigation system only.
VI. DESIGN INFORMATION FOR FIXED IRRIGATION SYSTEM
1 • The irrigation system is: ❑ Spray ❑ Drip
Z. Disposal system is: ❑ existing ❑ proposed.
3 • Minimum depth to mean seasonal high water table (SHWT) within irrigation sites(s) per Soil Scientist's Evaluation: _ feet
below ground surface. Rules 15A NCAC 02T .0505i 7 requires at least one -foot vertical separation between SHWT and ground
surface.
4. Are there any artificial drainage or water movement structures within 200 feet of any irrigation area?
❑ Yes or [] No If Yes, please explain if the soil scientist report addresses artificial structures and please indicate if
structures are to be maintained or modified:
5. Loading rates recommended by the Soil Scientist Evaluation:
Recommended Recommended
Soil Series Fields within Soil Area Loading Rate Loading Rate
(in/hr) _ in/% rl _
6 Design loading rates are equal or less than the loading rates recommended by Soil Scientist?
71 Yes or ❑ No If No, explain why 15A NCAC 02T .0505(,.: is not met:
7. Non -dedicated System Design (fill in the appropriate information for either a spray or drip irrigation system):
Field / Zone Design Area Number of Maximum Application Design Annual Loading
(ft) Nozzles Rate (gallons/hry Rate {gallons/r ri
Total
Spray Irrigation Design Element Plan Sheet SpecificationNumber Page Number
Wetted diameter of nozzles ft
Wetted area of nozzles ft' l
Nozzle capacity gpm --
Nozzle manufacturer / model !
i Elevation of highest nozzle ft
FORIV:: RLAP 06-16 Page 4 of 5

Applicant's Certification (signing authority must be in compliance with 15A NCAC 02T .0106):
TI'3e applicant or any affiliate has not been convicted of an environmental crime, has not abandoned a wastewater facility without proper
closure, does not have an outstanding civil penalty where all appeals have been exhausted or abandoned, are compliant with any active
ccrrnpliance schedule, and do not have any overdue annual fees under Rule 15A NCAC 02T .0105.
Yes [] No, Explain:
I, Adam Waters— Public Works Director
(Signature Authority's Name — PLEASE PRINT) (Title)
attest that this application for Liq of Washi mton
(Facility Name)
has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that the Division of Water Resources
may not conduct a technical review of this program and approval does not constitute a variance to any rules or statutes unless specifically
granted in the permit. Further, any discharge of residuals to surface waters or the land will result in an immediate enforcement action,
which may include civil penalties, injunctive relief, and/or criminal prosecution. I will make no claim against the Division of Water
Resources should a condition of this permit be violated. I also understand that if all required parts of this application are not completed
and that if all required supporting information and attachments are not included, this application package will be returned to me as
incomplete.
Note: In accordance with North Carolina General Statutes § 143-215.6A and § 143-215.613, any person who knowingly makes any false
statement, representation, or certification in any application shall be guilty of a Class 2 misdemeanor, which may in a fine not to
exceed $10,000 as well as civil penalties up to $25,000 per violation.
Signature: _,rz_
_ Date:
FORR-4: RLAP 06-16 Page 5 of 5

NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
February 2, 2015
Stephen Adam Waters, H
Superintendent of the Water Resources Division
City of Washington
P.O. Box 1988
Washington, NC 27889
Dear Mr. Waters:
Donald R. van der Vaart
Subject: Permit No. WQ0001026
Correction
Washington City - Sludge
Land Application of Class B Residuals (Non -Dedicated)
Beaufort County
Secretary
In accordance with an oral request received February 2, 2015, from Will Hart of the Washington
Regional Office, we are forwarding herewith corrected Permit No. WQ0001026 issued January 23, 2015.
The corrections to the subject permit are as follows:
1. The Regional Office to contact is the Washington (and not the Fayetteville) RO on page 1 of
the letter.
2. The effective date of the permit shall be January 23, 2015, and not May 1, 2015.
3. The end date of the permit shall be December 31, 2019, and not April 30, 2020.
Please replace Pages 1 and 2 of the Cover Letter and Pages 1 and 2 of Permit No.
WQ0001026 issued January 23 with the enclosed corrected pages.
If you need additional information concerning this permit correction, please contact Troy Doby at
[phone] or [e-mail].
Sincerely,
unmerman Acting g Director
icDivision of Water Resources
cc: Beaufort County Health Department
Washington Regional Office, Water Quality Regional Operations Section
Beth Buffington, Public Water Supply Section — Protection and Enforcement Branch
Permit File WQ0001026
Notebook File WQ0001026
Non-Discnarge Permitting Unit
1617 P,1ad Service Center, Ralegh, North Carolina 27699-+617
Phone 9'9-807$4641Inwriet htr).Pportal.ncdenrorgfweblwg
=_.ua! CP6_:. ^ iy c!rr cya• -'.tale Da t *s e;,yc V,

.�. A
NCDENR
North Carolina Department of Environment and Natural Resources
Pat k4cCrory Donald R. van der Vaart
Governor Secretary
January 23, 2015
Stephen Adam Waters, H
Superintendent of the Water Resources Division
City of Washington
P.O. Box 1988
Washington, NC 27889
Subject: Permit No. WQ0001026
Washington City - Sludge
Land Application of Class B / Residuals (Non -Dedicated)
Beaufort County
Dear Mr. Waters:
In accordance with your permit renewal and major modification request received December 3,
2014, we are forwarding herewith Permit No. WQ0001026 dated January 23, 2015, to City of
Washington for the continued operation of the subject residuals management program.
Modifications to the subject permit are as follows:
1. Removal of Fields from Attachment B of the May 9, 2006 permit and February 8, 2007
modified permit: NC-BF-202-02, NC-BF-207-03, NC-BF-207-04, NC-PI-03-02, NC-PI-11-
01 through 09, NC-PI-164-01 through 05, and NC-PI-200-05 through 11.
2. Addition of Fields to Attachment B: NC-BF-210-01 through 16.
3. Various changes to field descriptions including landowner, dominant soil series, and acreages
to Fields in Attachment B.
This permit shall be effective from January 23, 2015, until December 31, 2019, shall void Permit
No. WQ0001026 issued May 9, 2006 and modified February 8, 2007, and shall be subject to the
conditions and limitations as specified therein. Please pay particular attention to the monitoring
requirements listed in Attachments A and B for they may differ from the previous permit issuance.
Failure to establish an adequate system for collecting and maintaining the required operational
information shall result in future compliance problems.
Please note the following permit conditions are new since the last permit issuance:
1. Condition 1_2: By August 1, 2015, the Permittee shall notify the Washington Regional Office
48 hours prior to each land application of residuals.
2. Condition I.3: By November 1, 2015, the Permittee shall be in compliance with signage
requirements.
3. Condition H.5: This is similar to Conditions 1.6 and 11.8 of the 2006 permit, but methods for
determining compliance with Cumulative Pollutant Loading Rates (CPLR) are specified.
4. Condition 11.9: Similar to Condition 13 of 2006 permit, but methods of Realistic Yield
Expectations (RYE) from Plant Available Nitrogen (PAN) specified,
Non -Discharge Permitting Unit
1617 Mad Service Center, Raleigh, North Carolina 27699-1617
Phone- 919-807-64641 Internet, h1tD:/+portai.nWenr.crglwebWg
_-LJ Gppor . =!y r .. T.amz ,.. ..-Frrvar- .V,acer. pac w_; eyVe.. _e

5. Condition 1II.2: Same as Condition L 10 and I.11 of the 2006 permit, except now 48-hour
notice rather than 24-hour notice provided to local government official and Washington
Regional Office for initial land application of residuals.
6. Condition lII.3: The Washington Regional Office shall be informed 24 hours prior to each
land application of residuals.
7. Condition IIIA: Requirement for an O&M Plan.
8. Condition 111.6: Similar to Condition 11.4 of 2006 permit, but now copy of O&M Plan must
also be on site during application.
9. Condition III.I La, b, j and k: Bulk residuals shall not be land applied if an endangered
species adversely affected, prolonged nuisance conditions are created, the distance is too
small between the surface and the seasonal high water table and/or bedrock, respectively.
10. Condition M.13: Signage requirements to prohibit public access.
11. Condition V.1: Permittee must provide adequate inspection and maintenance.
12, Condition VI.6: Similar to Condition VI.6 of 2006 permit, but now 60-day notice given of
revocation.
13. Condition VI.7: Expansion of residuals program not allowed if Permittee has exhibited
improper conduct unless a variance granted.
Please note that on September 1, 2006, North Carolina Administrative Code Title 15A
Subchapter 02T — Waste not Discharged to Surface Waters was adopted. The previous permit was issued
before this date. Accordingly, this permit incorporates the requirements of these rules which are reflected
in the changes listed above.
If any parts, requirements or limitations contained in this permit are unacceptable, the Permittee
has the right to request an adjudicatory hearing upon written request within 30 days following receipt of
this permit. This request shall be in the form of a written petition, conforming to Chapter 150B of the
North Carolina General Statutes, and filed with the Office of Administrative Hearings at 6714 Mail
Service Center, Raleigh, NC 27699-6714. Unless such demands are made, this permit shall be final and
binding.
If you need additional information concerning this matter, please contact Troy Doby at (919) 807-
6336 or [e-mail].
Sincerely,
iJayimerman, Acting Director
Division of Water Resources
cc: Beaufort County Health Department - 'ames.madsonCubchd.net (Electronic Copy)
Washington Regional Office, Water Quality Regional Operations Section (Electronic Copy)
Roy Whitaker — roy.ivhitakerra:emaresourcesinc.com (Electronic Copy)
Rob Wilcox, LSS — RW ilcox4a��smeinc.com (Electronic Copy)
Beth Buffington — Protection and Enforcement Branch (Electronic Copy)
Digital Permit Archive (Electronic Copy)
Central Files
Non-D? charge Pcrmitong Unit
1617 Mad Service Center, Raleigh, North Carolina 27699-1517
Phore� 919-K7-64641 Internet ht►pJ/portaI.ncdwr.onI&eIAQ
-� c"a '-Fra tc� ;y = rma;•v? Action dyer Va3e in rah *it -cyc�ea :3C=r

NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENT AND NATURAL
RALEIGH
LAND APPLICATION OF CLASS B RESIDUALS PERMIT (NON -DEDICATED)
In accordance with the provisions of Article 21 of Chapter 143, General Statutes of North Carolina as
amended, and other applicable Laws, Rules, and Regulations
PERMISSION IS HEREBY GRANTED TO
City of Washington
Beaufort County
FOR THE
continued operation of a residuals management program for City of Washington and consisting of the
land application of Class B residuals generated by the approved facilities listed in Attachment A to the
approved sites listed in Attachment B with no discharge of wastes to surface waters, pursuant to the
application received December 3, 2015, and in conformity with other supporting data subsequently filed
and approved by the Department of Environment and Natural Resources and considered a part of this
permit. The use and disposal of residuals are regulated under Title 40 Code of Federal Regulations Part
503. This permit does not exempt the Permittee from complying with the federal regulations.
This permit shall be effective from January 23, 2015, until December 31, 2019, shall void Permit No.
WQ0001026 issued May 9, 2006, and shall be subject to the following specified conditions and
limitations:
I. SCHEDULES
No later than six months prior to the expiration of this permit, the Permittee shall request renewal of
this permit on official Division forms. Upon receipt of the request, the Division will review the
adequacy of the facilities described therein, and if warranted, will renew the permit for such period of
time and under such conditions and limitations as it may deem appropriate. Please note Rule 15A
NCAC 02T .0105(d) requires an updated site map to be submitted with the permit renewal
application. [15A NCAC 02T .0108(b)(2), 02T .105(d), 02T .0109)
2. The Permittee shall be in full compliance with the regional office notification requirements
established in Condition 111.3. by August 1, 2015. [15A NCAC 02T .0108(b)(2)]
3. The Permittee shall be in full compliance with the signage requirements established in Condition
111.13. by November 1, 2015. [15A NCAC 02T .0108(bx2)]
WQ0001026 Version 3.0 Shell Version 150101 Page 1 of 12

II. PERFORMANCE STANDA R D S
1. The subject residuals management program shall be effectively maintained and operated at all times
so there is no discharge to surface waters, nor any contravention of groundwater or surface water
standards. In the event the facilities fail to perform satisfactorily, including the creation of nuisance
conditions due to improper operation and maintenance, the Permittee shall immediately cease land
applying residuals to the site, contact the Washington regional office supervisor, and take any
immediate corrective actions. [G.S. 143-215.1]
2. This permit shall not relieve the Permittee of responsibility for damages to groundwater or surface
water resulting from the operation of this residuals management program. [15A NCAC 02B .0200,
02L .0100]
3. Only residuals generated by the facilities listed in Attachment A are approved for land application in
accordance with this permit. [G.S. 143-215.11
4. Only the sites listed in Attachment B are approved for residuals land application. [G.S. 143-215.11
5. Pollutant concentrations in residuals applied to land application sites listed in Attachment B shall not
exceed the following Ceiling Concentrations (i.e., dry weight basis) or Cumulative Pollutant
Loading Rates (CPLRs): [15A NCAC 02T .1105]
Parameter
Ceiling Concentration
(milligrams per kilogram)
75
CPLR
(pounds per acre)
36
Arsenic
Cadmium
85
34
Copper
4,300
1,338
Lead
840
267
Mercury
57
15
Molybdenum
75
n/a
Nickel
420
` 374
Selenium
100 89
7,500 2,498
Zinc
The Permittee shall determine compliance with the CPLRs using one of the following methods:
a. By calculating the existing cumulative level of pollutants using actual analytical data from all
historical land application events of residuals, or
b. For land where residuals application have not occurred or for which the required data is
incomplete, by determining background concentrations through representative soil sampling.
6. Residuals that are land applied shall meet Class B pathogen reduction requirements in 15A NCAC
02T .1106 (a) and (b)(2). Exceptions to this requirement shall be specified in Attachment A. [15A
NCAC 02T .1106]
7. Biological residuals (i.e. residuals generated during the treatment of domestic or animal processing
wastewater, or the biological treatment of industrial wastewater, and as identified in Attachment A)
that are land applied shall meet one of the vector attraction reduction alternatives in 15A NCAC 02T
.1107(a). Exceptions to this requirement shall be specified in Attachment A. [15A NCAC 02T .1107]
8. When land applying residuals to any land application site, the following buffer zones shall be
maintained at all times:
WQ0001026 Version 3.0 Shell Version 150101 Page 2 of 12

a. 400 feet from residences or places of public assembly under separate ownership for surface
application methods; however, the buffer zone requirement may be reduced to a minimum of
100 feet upon written consent of the owner and approval from the Aquifer Protection Section
of the appropriate Division's regional office in Attachment B of this permit;
b. 200 feet from residences or places of public assembly under separate ownership for
subsurface application methods; however, the buffer zone requirement may be reduced to a
minimum of 100 feet upon written consent of the owner and approval from the Aquifer
Protection Section of the appropriate Division's regional office in Attachment B of this
permit;
c. 100 feet from any public or private water supply source, waters classified as SA or SB, and
any Class I or Class H impounded reservoir used as a source of drinking water for both
methods;
d. 100 feet from any streams classified as WS or B, any other stream, canal, marsh or coastal
waters and any other lake or impoundment for surface application;
e. 50 feet from any streams classified as WS or B, any other stream, canal, marsh or coastal
waters and any other lake or impoundment for subsurface application;
f. 50 feet from property lines for both surface and subsurface application methods;
g. 50 feet from public right of ways for both surface and subsurface application methods;
h. 10 feet from upslope interceptor drains and surface water diversions for both surface and
subsurface application methods; and
i. 25 feet from downsiope interceptor drains, surface water diversions, groundwater drainage
systems, and surface drainage ditches for both surface and subsurface application methods.
Some of the buffers specified above may not have been included in previous permits for this residuals
land application program. However, any land application sites that are listed in the most recently -
certified Attachment B of this permit, but were approved with different buffers shall be reflagged to
comply with these buffers. Land application areas shall be clearly marked on each site prior to and
during any residuals application event. [15A NCAC 02H .0219OX5)]
9. Bulk residuals and other sources of Plant Available Nitrogen (PAN) shall not be applied in
exceedance of agronomic rates. Appropriate agronomic rates shall be calculated using expected
nitrogen requirements based on the determined Realistic Yield Expectations (RYE) using any of the
following methods: [15A NCAC 02T .1109(b)(1)(k)]
a. Division's pre -approved site specific historical data for specific crop or soil types by calculating
the mean of the best three yields of the last five consecutive crop harvests for each field.
b. North Carolina Historical Data for specific crop and soil types as provided by North Carolina
State University Department of Soil Science (ht�L:jllnutrients.sail.nesu.edw'yieldsiindex.phA).
A copy shall be kept on file and reprinted every five years in accordance with Condition IV.S.
c. If the RYE cannot be determined using methods (a) or (b) above, the Permittee may use the RYE
and appropriate nutrient application rates reported in any of the following documents:
i. Crop management plan as outlined by the local Cooperative Extension Office, the North
Carolina Department of Agriculture and Consumer Services, the Natural Resource
Conservation Service, or other agronomist.
ii. Waste Utilization Plan as outlined by the Senate Bill 1217 Interagency Group - Guidance
Document: Chapter 1
(httt):/,Iw,,A v.neaer.--o,,:-SVVC/teci /documents;9th Guidance Doc 100109.pdt}.
iii. Certified Nutrient Management Plan as outlined by the Natural Resources Conservation
Services (NRCS). These plans must meet the USDA-NRCS 590 Nutrient Management

Standards (fip:,','ftp-fc.sc.egov.usda.gov/NHO _iftp-fc.sc.egov.usda.gov/NHO practice-standards.'standardsi590.pd).
d. If the RYE and appropriate -nutrient application rates cannot be determined, the Permittee shall
contact the Division to determine necessary action.
10. When residuals are land applied to grazed pasture, hay crop realistic nitrogen rate shall be reduced by
25% in accordance with the USDA-NRCS 590 Nutrient Management Standards. [15A NCAC 02T
.0108(bxl)]
11. If land application sites are to be over -seeded or double -cropped (e.g., bermuda grass in the summer
and rye grass in the winter with both crops to receive residuals), then the second crop can receive an
application of PAN at a rate not to exceed 50 pounds per acre per year (lbs/acfyr). This practice may
be allowed as long as the second crop is to be harvested or grazed. If the second crop is to be planted
for erosion control only and is to be tilled into the soil, then no additional PAN shall be applied. [15A
NCAC 02T .0108(bxl)]
12. Prior to land application of residuals containing a sodium adsorption ratio (SAR) of 10 or higher, the
Permittee shall obtain and implement recommendations from at least one of the following: the local
Cooperative Extension Office; the Department of Agriculture and Consumer Services; the Natural
Resource Conservation Service; a North Carolina Licensed Soil Scientist; or an agronomist. The
recommendations shall address the sodium application rate, soil amendments (e.g., gypsum, etc.), or a
mechanism for maintaining site integrity and conditions conducive to crop growth. The Permittee
shall maintain written records of these recommendations and details of their implementation. [15A
NCAC 02T .0108(b)(1)]
13. These residuals land application sites were individually permitted on or after December 30, 1983;
therefore, the compliance boundary is established at either 250 feet from the residual land application
area, or 50 feet within the property boundary, whichever is closest to the residual land application
area. An exceedance of groundwater standards at or beyond the compliance boundary is subject to
remediation action according to 15A NCAC 02L .0106(dx2) as well as enforcement actions in
accordance with North Carolina General Statute 143-215.6A through 143-215.6C. Any approved
relocation of the COMPLIANCE BOUNDARY will be noted in Attachment B. [15A NCAC 02L
.0107(a)]
14. The review boundary shall be established midway between the compliance boundary and the residual
land application area. Any exceedance of groundwater standards at the review boundary shall require
action in accordance with 15A NCAC 02L .0106. [15A NCAC 02L .0108]
M. OPERATION AND MAINTENANCE REQUEREMENTS
The residuals management program shall be properly maintained and operated at all times. The
program shall be effectively maintained and operated as a non -discharge system to prevent any
contravention of surface water or groundwater standards. [ 15A NCAC 02T .1110]
The Washington Regional Office, telephone number [phone], and the appropriate local
government official (i.e., county manager, city manager, or health director) shall be notified at least
48 hours prior to the initial residuals land application to any new land application site. Notification to
the regional supervisor shall be made from 8:00 a.m. until 5:00 p.m. on Monday through Friday,
excluding State Holidays. [15A NCAC 02T .0108(b)(1)]
3. The Washington Regional Office shall be notified via email or telephone, [phone], at least 24
hours prior to conducting any land application activity. Such notification shall indicate, at a
minimum, the anticipated application times, field IDs, and location of land application activities. If it
becomes necessary to apply to additional fields due to unforeseen events, the Regional Office shall be
notified prior to commencing the application to those fields. [15A NCAC 02T .0108(b)(1)]

4. The Permittee shall maintain an approved Operation and Maintenance Plan (O&M Plan).
Modifications to the O&M Plan shall be approved by the Division prior to utilization of the new plan.
The O&M Plan, at the minimum, shall include: [15A NCAC 02T .1100]
a) Operational functions;
b) Maintenance schedules;
c) Safety measures;
d) Spill response plan;
e) Inspection plan including the following information:
i. Names and/or titles of personnel responsible for conducting the inspections;
ii. Frequency and location of inspections, including those to be conducted by the ORC, and
procedures to assure that the selected location(s) and inspection frequency are representative
of the residuals management program;
iii. Detailed description of inspection procedures including record keeping and actions to be
taken by the inspector in the event that noncompliance is observed pursuant to the
noncompliance notification requirements under the monitoring and reporting section of the
permit;
f) Sampling and monitoring plan including the following information: .
i. Names and/or titles of personnel responsible for conducting the sampling and monitoring;
ii. Detailed description of monitoring procedures including parameters to be monitored;
iii. Sampling frequency and procedures to assure that representative samples are being collected.
Fluctuation in temperature, flow, and other operating conditions can affect the quality of the
residuals gathered during a particular sampling event. The sampling plan shall account for
any foreseen fluctuations in residuals quality and indicate the most limiting times for
residuals to meet pathogen and vector attraction reduction requirements (e.g. facilities that
land apply multiple times per year but have an annual sampling frequency, may need to
sample during winter months when pathogen reduction is most likely to be negatively
affected by cold temperatures).
Upon the Water Pollution Control System Operators Certification Commission's (WPCSOCC)
classification of the facility, the Permittee shall designate and employ a certified operator in
responsible charge (ORC) and one or more certified operators as back-up ORCs in accordance with
15A NCAC 08G .0201. The ORC or their back-up shall visit the facilities in accordance with 15A
NCAC 08G. 0204, or as specified in the most recently approved O&M plan (i.e., see Condition III.
4.), and shall comply with all other conditions of 15A NCAC 08G. 0204. For more information
regarding classification and designation requirements, please contact the Division of Water
Resources' Technical Assistance & Certification Unit at [phone]. [15A NCAC 02T .0117]
6. When the Permittee land applies bulk residuals, a copy of this permit and a copy of O&M Plan shall
be maintained at the land application sites during land application activities. [15A NCAC 02T
.0108(bXl)]
7. When the Permittee transports or land applies bulk residuals, the spill control provisions shall be
maintained in all residuals transport and application vehicles. [15A NCAC 02T .1110]
8. Residuals shall not be stored at any land application site, unless written approval has been requested
and received from the Division. [G.S. 143-215.1 ]
9. When the Permittee land applies bulk residuals, adequate measures shall be taken to prevent wind
erosion and surface runoff from conveying residuals from the land application sites onto adjacent
properties or into surface waters. [G.S. 143-215.1]

10. When the Permittee land applies bulk residuals, a suitable vegetative cover shall be maintained on
land application sites onto which residuals are applied, or application shall be in accordance with the
crop management plan outlined by the local Cooperative Extension Office, the Department of
Agriculture and Consumer Services, the Natural Resource Conservation Service, or an agronomist
and as approved by the Division. [15A NCAC 02T .1109ftl)]
11. Bulk residuals shall not be land applied under the following conditions: [I5A NCAC 02T .1109]
a. If the residuals are likely to adversely affect a threatened or endangered species listed under
section 4 of the Endangered Species Act or its designated critical habitat;
b. If the application causes prolonged nuisance conditions;
c. If the land fails to assimilate the bulk residuals or the application causes the contravention of
surface water or groundwater standards;
d. If the land is flooded, frozen or snow-covered, or is otherwise in a condition such that runoff of
the residuals would occur;
e. Within the 100-year flood elevation, unless the bulk residuals are injected or incorporated within
a 24-hour period following a residuals land application event;
f. During a measurable precipitation event (i.e., greater than 0.01 inch per hour), or within 24 hours
following a rainfall event of 0.5 inches or greater in a 24-bour period;
g. If the slope is greater than 10% for surface applied liquid residuals, or if the slope is greater than
18% for injected or incorporated bulk liquid residuals;
h If the soil pH is not maintained at 6.0 or greater, unless sufficient amounts of lime are applied to
achieve a final soil pH of at least 6.0, or if an agronomist provides information indicating that the
pH of the soil, residuals and lime mixture is suitable for the specified crop. Any approved
variations to the acceptable soil pH (6.0) will be noted in this permit;
i. If the land does not have an established vegetative cover unless the residuals are incorporated or
injected within a 24-hour period following a residuals land application event. Any field that is in
a USDA no -till program shall be exempted from meeting this vegetative cover requirement;
j. If the vertical separation between the seasonal high water table and the depth of residuals
application is less than one foot;
k. If the vertical separation of bedrock and the depth of residuals application is less than one foot;
1. Application exceeds agronomic rates.
12. The following public access restrictions apply to residual land application sites: [15A NCAC 02T
1109(b)(2)]
a. Public access to public contact sites (e.g., golf courses, parks, ball fields, etc.) shall be restricted
for 365 days after a residuals land application event;
b. Public access to non-public contact sites shall be restricted for 30 days after a residuals land
application event.
13. Public access controls shall include the posting of signs with a minimum area of 3 square feet (e.g.,
1.5' x 2'). Each sign shall indicate the activities conducted at each site, permit number, and name and
contact information, including the Permittee or applicator's telephone number. Signs shall be posted
in a clearly visible and conspicuous manner at the entrance to each land application site during a land
application event, and for as long as the public access restrictions required under [11.12 apply. [15A
NCAC 02T .0108(b)(1)]
14. The following harvesting and grazing restrictions apply to residual land application sites after each
land application event: [ 15A NCAC 02T . 1109(b)(3)]

Harvesting and Grazing Description Restricted
Duration
Animals shall not be allowed to graze during land application activities and
restricted period. Sites that are to be used for grazing shall have fencing to
30 days
prevent access after each land application event.
Food crops, feed crops and fiber crops shall not be harvested for:
30 days
Turf grown on land where residuals have been applied shall not be harvested for.
12 months
Food crops with harvested parts that touch the residual/soil mixture and are
totally above the land surface (e.g., tobacco, melons, cucumbers, squash, etc.)
14 months
shall not be harvested for:
When the residuals remain on the land surface for four months or longer prior to
incorporation into the soil, food crops with harvested parts below the land
20 months
surface (e.g., root crops such as potatoes, carrots, radishes, etc.) shall not be
harvested for:
When the residuals remain on the land surface for less than four months prior to
incorporation into the soil, food crops with harvested parts below the land
38 months
surface shall not be harvested for:
15. The Permittee shall acquire from each landowner or lessee/operator a statement detailing the volume
of other nutrient sources (i.e., manufactured fertilizers, manures, or other animal waste products) that
have been applied to the site, and a copy of the most recent Nutrient Management Plan (NNW) for
those operations where a NUT is required by the US Department of Agriculture — National Resources
Conservation Service (MRCS) or other State Agencies. The Permittee shall calculate allowable
nutrient loading rates based on the provided information and use appropriate reductions.
For the purpose of this permit condition, a Crop Management Plan (CMP), Waste Utilization Plan
(WUP) or Certified Nutrient Management Plan (CNMP) shall also be considered a Nutrient
Management Plan. [15A NCAC 02T .0108(b)(1), 02T .1104(c)(4)]
16. No residuals shall be land applied unless the submitted Land Owner Agreement Attachment (LOAA)
between the Permittee and landowners or lessees/operators of the land application site is in full force
and effect. These agreements shall be considered expired concurrent with the permit expiration date,
and shall be renewed during the permit renewal process. [15A NCAC 02T .1104(c)(4)]
IV. MONITORING AND REPORTING REQUIREMENTS
1. Any Division required monitoring (including groundwater, plant tissue, soil and surface water
analyses) necessary to ensure groundwater and surface water protection shall be established, and an
acceptable sample reporting schedule shall be followed. [15A NCAC 02T .0108(c)]
2. Residuals shall be analyzed to demonstrate they are non -hazardous under the Resource Conservation
and Recovery Act (RCRA). The analyses [corrosivity, ignitability, reactivity, and toxicity
characteristic leaching procedure (TCLP)l shall be performed at the frequency specified in
Attachment A, and the Permittee shall maintain these results for a minimum of five years. Any
exceptions from the requirements in this condition shall be specified in Attachment A.
The TCLP analysis shall include the following parameters (the regulatory level in milligrams per liter
is in parentheses): [15A NCAC 13A .0102(b), 02T .1101, 02T .1105]

Arsenic (5.0)
1,4-Dichiorobenaene (7.5)
Nitrobenzene (2.0)
Barium (100.0)
1,2-Dichloroethane (0.5)
Pentachlorophenol (100.0)
Benzene (0.5)
1,1-Dichloroethylene (0.7)
Pyridine (5.0)
Cadmium (1.0)
2,4-Dinitrotoluene (0.13)
Selenium (1.0)
Carbon tetrachloride (0.5)
Endrin (0.02) Silver (5.0)
Hexachlorobenzene (0.13) Tetrachloroethylene (0.7)
Heptachlor (and its hydroxide) 0.008 Toxaphene (0.5)
Chlordane (6.03)
Chlorobenzene (100.0)
Chloroform (6.0)
Hexachloro-1,3-butadiene (0.5) Trichloroethylene (0.5)
Chromium (5.0)
Hexachloroethane (3.0)
2,4,5-Trichlorophenol (400.0)
m-Cresol (200.0)
Lead (5.0)
2,4,6-Trichlorophenol (2.0)
2,4,5-TP (Silvex) (1.0)
o-Cresol (200.0)
Lindane (0.4)
p-Cresol (200.0)
Mercury (0.2)
Vinyl chloride (0.2)
Cresol (200.0)
Methoxychlor (10.0)
Methyl ethyl ketone (200.0)
2,4-D (10.0)
Once the residuals have been monitored for two years at the frequency specified in Attachment A,
the Permittee may submit a permit modification request to reduce the frequency of this monitoring
requirement. In no case shall the monitoring frequency be less than once per permit cycle.
3 An analysis shall be conducted on residuals from each source generating facility at the frequency
specified in Attachment A, and the Permittee shall maintain the results for a minimum of five years.
The analysis shall include the following parameters: 15A NCAC 02T .1101
Aluminum Mercury Potassium
Ammonia -Nitrogen Molybdenum Selenium
Arsenic Nickel Sodium
Cadmium
Calcium
Copper
Lead
Magnesium
Nitrate -Nitrite Nitrogen
Percent Total Solids
pH
Phosphorus
Plant Available Nitrogen
(by calculation)
Sodium Adsorption Ratio
(SAR)
TKN
Zinc
4. Residuals shall be monitored for compliance with pathogen and vector attraction reduction
requirements at the frequency specified in Attachment A, and at the time indicated in the sampling
and monitoring sections of the approved O&M plan. The required data shall be specific to the
stabilization process utilized, and sufficient to demonstrate compliance with the Class B pathogen
reduction requirements in 15A NCAC 02T .1106 (a) and (b)(2), and one vector attraction reduction
requirement in 15A NCAC 02T .1107 (a) shall be met. Any exceptions from the requirements in this
condition shall be specified in Attachment A. [15A NCAC 02T .1106, 02T 1107, 02T .11 l 1(c)]
wl nnnI n1l; VP ;Ql 'A n V-11 eta....:.,., 1 cni m n..__ 0 _r i,$

8. Three copies of an annual report shall be submitted on or before March 1'. The annual report shall
meet the requirements described in the Instructions for Residuals Application Annual Rep�g
Forms. Instructions for reporting and annual report forms are available at
htip://px)rtal.ncdenr.orgiweb/v,:gfaps/lau/rer, rtin�. or can be obtained by contacting the Land
Application Unit directly. The annual report shall be submitted to the following address: [15A
NCAC 02T .1111(a)]
Division of Water Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
9. Noncompliance Notification
The Permittee shall report by telephone to the Washington Regional Office, telephone number (252)
946-6481, as soon as possible, but in no case more than 24 hours or on the next working day
following the occurrence or first knowledge of the occurrence of any of the following: [15A NCAC
02T .0105(1), 02T .0108(b)(1)]
a. Any occurrence with the land application program resulting in the land application of significant
amounts of wastes that are abnormal in quantity or characteristic.
b. Any failure of the land application program resulting in a release of material to surface waters.
Any time self -monitoring indicates the facility has gone out of compliance with its permit
limitations.
d. Any process unit failure, due to known or unknown reasons, rendering the facility incapable of
adequate residual treatment.
e. Any spill or discharge from a vehicle or piping system during residuals transportation.
Any emergency requiring immediate reporting (e.g., discharges to surface waters, imminent failure of
a storage structure, etc.) outside normal business hours shall be reported to the Division's Emergency
Response personnel at telephone number [phone], [phone], or [phone].Persons
reporting such occurrences by telephone shall also file a written report in letter form within five days
following first knowledge of the occurrence. This report shall outline the actions taken or proposed to
be taken to ensure that the problem does not recur.
V. INSPECTIONS
1. The Permittee shall provide adequate inspection and maintenance to ensure proper operation of the
subject facilities and shall be in accordance with the approved O&M Plan. [15A NCAC 02T
.0108(b)]
2. Prior to each bulk residuals land application event, the Permittee or his designee shall inspect the
residuals storage, transport and application facilities to prevent malfunctions, facility deterioration
and operator errors resulting in discharges, which may cause the release of wastes to the
environment, a threat to human health or a public nuisance. The Permittee shall maintain an
inspection log that includes, at a minimum, the date and time of inspection, observations made, and
any maintenance, repairs, or corrective actions taken. The Permittee shall maintain this inspection log
for a period of five years from the date of inspection, and this log shall be made available to the
Division upon request. [15A NCAC 02T .0108(b)]

5. An annual representative soils analysis (i.e., Standard Soil Fertility Analysis) shall be conducted on
each land application site listed in Attachment B on which a residuals land application event will
occur in the respective calendar year. This analysis shall be in accordance with the "Guidance on Soil
Sampling" located in the Sampling Instructions section of the NC Department of Agriculture &.
Consumer Services' website (http://vvw-v.neagr.gov/agronomi/pubs.htm). The Permittee shall
maintain these results and a description of the sampling methodologies used to determine soil fertility
for a period of no less than five years, and shall be made available to the Division upon request. At a
minimum, the Standard Soil Fertility Analysis shall include the following parameters: [15A NCAC
02T .1111(d)]
Acidity Exchangeable Sodium Percentage Phosphorus
Base Saturation (by calculation) Magnesium Potassium
Calcium Manganese Sodium
Cation Exchange Capacity Percent Humic Matter Zinc
Copper I pH
6. Laboratory parameter analyses shall be performed on the residuals as they are land applied, and shall
be in accordance with the monitoring requirements in 15A NCAC 02B .0505
The Permittee shall maintain records tracking all residual land application events. At a minimum,
these records shall include the following: [15A NCAC 02T .0109(a)]
a. Source of residuals;
b. Date of land application;
c. Location of land application (i.e., site, field, or zone number as listed in Attachment B);
d. Approximate areas applied to (acres);
e. Method of land application;
f. Weather conditions (e.g., sunny, cloudy, raining, etc.);
g. Predominant Soil Mapping Unit (e.g., CbB2);
b. Soil conditions (e.g., dry, wet, frozen, etc.);
i. Type of crop or crops to be grown on field;
j. Nitrogen Application Rate based on RYEs (if using data obtained from the North Carolina State
University Department of Soil Science Website, the printout page shall be kept on file and
reprinted every five years);
k. Volume of residuals land applied in gallons per acre, cubic yard per acre, dry tons per acre, or wet
ton per acre;
1. Volume of animal waste or other nutrient source applied in gallons per acre, dry ton per acre, or
wet tons per acre;
m. Volume of soil amendments (e.g., lone, gypsum, etc.) applied in gallons per acre, dry ton per
acre, or wet tons per acre; and
n. Annual and cumulative totals in dry tons per acre of residuals as well as animal waste and other
sources of nutrients (e.g., if applicable), annual and cumulative pounds per acre of each heavy
metal (e.g., shall include, but shall not be limited to, arsenic, cadmium, copper, lead, mercury,
molybdenum, nickel, selenium, and zinc), annual pounds per acre of PAN, and annual pounds per
acre of phosphorus applied to each field.

3. Any duly authorized Division representative may, upon presentation of credentials, enter and inspect
any property, premises or place on or related to the land application sites or facilities permitted herein
at any reasonable time for the purpose of determining compliance with this permit; may inspect or
copy any records required to be maintained under the terms and conditions of this permit; and may
collect groundwater, surface water or leachate samples. [G.S. 143-215.3(ax2)]
VI. GENERAL CONDITIONS
1. Failure to comply with the conditions and limitations contained herein may subject the Permittee to
an enforcement action by the Division in accordance with North Carolina General Statutes 143-
215.6A to 143-215.6C.
2. This permit shall become voidable if the residuals land application events are not carried out in
accordance with the conditions of this permit. [15A NCAC 02T .0110]
3. This permit is effective only with respect to the nature and volume of residuals described in the
permit application and other supporting documentation. [G.S. 143-215.11
4. The issuance of this permit does not exempt the Permittee from complying with any and all statutes,
rules, regulations, or ordinances, which may be imposed by other jurisdictional government agencies
(e.g., local, state, and federal). Of particular concern to the Division are applicable river buffer rules
in 15A NCAC 02B .0200; erosion and sedimentation control requirements in 15A NCAC Chapter 4
and under the Division's General Permit NCG010000; any requirements pertaining to wetlands under
15A NCAC 02B .0200 and 02H .0500; and documentation of compliance with Article 21 Part 6 of
Chapter 143 of the General Statutes.
5 In the event the residuals program changes ownership or the Permittee changes their name, a formal
permit modification request shall be submitted to the Division. This request shall be made on official
Division forms, and shall include appropriate documentation from the parties involved and other
supporting documentation as necessary. The Permittee of record shall remain fully responsible for
maintaining and operating the residuals program permitted herein until a permit is issued to the new
owner. [15A NCAC 02T .0104]
6. This permit is subject to revocation or unilateral modification upon 60 days notice from the Division
Director, in whole or part for the requirements listed in 15A NCAC 02T .0110.
7. Unless the Division Director grants a variance, expansion of the permitted residuals program
contained herein shall not be granted if the Permittee exemplifies any of the criteria in 15A NCAC
02T .0120(b).
8. The Permittee shall pay the annual fee within 30 days after being billed by the Division. Failure to
pay the annual fee accordingly shall be cause for the Division to revoke this permit. [I SA NCAC 02T
.0105(e)(3))

Permit issued this the 23'd day of January, 2015
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
J " Zimmerman, Acting Director -- - - -
Division of Water Resources
By Authority of the Environmental Management Commission
Permit Number WQOOOI026
"TI AAA I f%"G , - -

ATTACHMENT A - Approved Residual Sources
City of Washington
Permit Biological' Maximum
Owner Facility Name County Number Residuals Dry Tons
Per Year r
City of Washington Washington City - Sludge Beaufort NC0020648 Yes 625
Total 1 1 625
Certification Date: January 23, 2015
Permit Number- WOODO1026
Version: 3.0
Monitoring
Monitoring
Monitoring
Frequency for
Frequency for
Frequency for
Approved
Non -hazardous
Metals and
Pathogen &
Mineralization
Characteristics 1
Nutrients s. S
Vector Attraction
Rate
-
Redactions 4, a 6
Annually
See Table Below
See Table Below
0.30
I
1. Maximum Dry Tons per Year is the amount of residuals approved for land application from each permitted facility.
2. Analyses to demonstrate that residuals are non -hazardous (i.e., TCLP, ignitability, reactivity, and corrosivity) as stipulated under permit Condition IV.2.
3. 'resting of metals and nutrients as stipulated under permit Condition IV.3.
4. Analyses of pathogen and vector attraction reductions as stipulated under permit Condition IVA.
5. Monitoring frequencies are based on the actual dry tons applied per year using the table below, unless specified above.
Dry Tons Generated Monitoring Frequency
short tons per ear Established in 40 CFR 503 and 15A NCA_C 02T .1111
<319 1/Year
=>319 - <I 650 1/ Quarter L4 times per ear
_> 1,650 - <16 500 1 /60 Da 6 times per ear
=>16 500 I/month 12 times per ear
If no land application events occur during a required sampling period (e.g. no land application occur during an entire year when annual monitoring is required), then no
sampling data is required during the period of inactivity. The annual report shall include an explanation for missing sampling data. Those required to submit the annual
report to EPA may be required to make up the missed sampling, contact the EPA for additional information and clarification.
Page I of 1

Approved Land Application Sites
:3ty of Wasniugtov
Field/ Site
NC-BF-202-11
NC-BF-202-31
NC-BF-202-32
NC-BF-202-72
N C-BF-202-73
NC-BF-204-71
NC-BF-204-72
NC-PI-03-01.
NC-PI-03-03
NC-PI-03-04
NC-PI-03-05
NC-PI-03-06
NC-PI-03-07
NC-PI-03-08
NC-PI-03-09
NC-PI-200-01
NC-PI-200-02
NC-PI-200-03
NC-P1-200-04
NC-P1-201-01
NC-PI-201-02
NC-PI-201-03
NC-PI-201-04
NC-PI-201-05
NC-PI-201-06
NC-PI-201-07
Owner
Briley, J D
Briley, J D
Briley, J D
Briley, J D
Briley, J D
Briley, J D
Briley, J D
Briley, J D
Briley, J D
Briley, J D
Briley, J D
Briley, J D
Briley, J D
Briley, J D
Briley, J D
Barnhill, Marjorie R.
Barnhill, Marjorie R.
Barnhill, Marjorie R.
Barnhill, Marjorie R.
T Congleton Farms
Congleton Farms
Congleton Famis
Congleton Fauns
Congleton Fauns
Congleton Fauns
Congleton Farms
Permit Number: WQM1026 ♦ pion: 3..
Lessee County
Latitude
Longitude
A Net a
Dominant Soft S'erles
N'igure
Beaufort
350 35' 43"
77° 05' 15"
17.50
Lenoir
1
Beaufort
350 35' 50"
770 05' 39"
9.60
Exum
2
Beaufort
350 35' 39"
770 05' 42"
30.60
Lenoir
2
Beaufort
350 35' 28"
770 05' 55"
6.70
Goldsboro
2
Beaufort
350 35' 23"
770 05' 51"
4.90
Tarboro sand, 0 to 5% slopes
2
Beaufort
350 35' 57"
770 04' 45"
8.80
Leaf silt loam
3
Beaufort
350 36' 15"
770 04' 53"
34.50
Lynchburg fine sandy loam
3
Pitt
35" 38' 26"
770 12' 04"
69.90
Olustee Variant
4
Pitt
350 39' 10"
770 11' 36"
74.40
Lynchburg
5
Pitt
350 39' 05"
770 11' 22"
45.60
Lynchburg
5
Pitt
35" 38' 20"
770 11' 37"
20.50
Lynchburg
4
Pitt
350 37' 19"
770 IT 25"
164.00
Pactolus
6
Pitt
350 37' 22"
770 18' 13"
66.30
Osier
7
Pitt
350 37' 38"
77" IT 09"
59.60
Alaga
8
Pitt
350 37' 51"
770 16' 42"
59.60
Altavista
9
Pitt
35" 41' 51"
770 12' 39"
27.20
Lenoir
t0
Pitt
350 41' 45"
770 IT 08"
7.30
ExUm
10
Pitt
350 41.' 42"
770 12' 17"
13.40
Lenoir
10
Pitt
350 41' 38"
770 12' 15"
6.70
Craven
10
Pitt
350 43' 56"
770 15' 39"
13.30
Lenoir
11
Pitt
350 43' 48"
770 15' 53"
30.40
Exum
I
Pitt
350 43' 53"
770 15' 54"
7.70
Lenoir
t 1
Pitt
350 43' 53"
770 16' 02"
35.40
Goldsboro
11
Pitt
350 43' 57"
770 16' IT'
5.90
Goldsboro
1 t
Pitt
350 44' 03"
770 16' 10"
3.80
Lenoir
t 1
Pitt
35° 43' 59"
77° 14' 30"
33.20
Lenoir
12
G

certircation Date: January 23,'
City of Washington
Permit Number: WQ0001026 Version: 3.0
NC-PI-201-08
Congleton Farms
Pitt
350 43' 50"
770 14' 36"
4.70
Lenoir 12
NC-PI-201-09
Congleton Farms
Pitt
350 44' 44"
770 14' 11"
1.80
Exum 13
NC-PI-201-10
Congleton Farms
Pitt
350 44' 48"
770 14' 16"
7.80
Exum
13
NC-PI-201-11
Congleton Farms
Pitt
350 45' 00"
770 14' 20"
12.00
Exum
13
NC-PI-201-12
Congleton Farms
Pitt
350 44' 51"
770 14' 14"
9.00
Exum
13
NC-PI-201-13
Congleton Fars
Pitt
350 44' 59"
770 14' 07"
6.70
Exum
13
NC-PI-201-14
Congleton Farms
Pitt
350 45' 10"
770 14' 09"
36.60
Exum
13,14
NC-PI-201-15
Congleton Farms
Pitt
Pitt
350 42' 42"
35' 42' 37"
770 15' 19"
770 15' 09"
8.80
Goldsboro
15
NC-PI-201-16
Congleton Farms
Congleton Farms
Congleton Farms
3.80
Craven
Goldsboro
Goldsboro
15
NC-PI-201-17
NC-PI-201-18
Pitt
350 42' 37"
770 15' 01"
5.30
15
Pitt
350 42' 27"
770 15' 02"
14.20
15
NC-BF-210-01
Hunters Roost Farms
Beaufort
350 3724.8"
770 03' 50.0"
16.50
Craven
16
NC-BF-210-02
Hunters Roost Farms
Beaufort
350 3720.0"
77" 03' 56.6"
27.50
Goldsboro
16
NC-BF-210-23
Hunters Roost Farms
Beaufort
350 37' 9.2"
770 04' 00.4"
13.00
Lynchburg
18
NC-BF-210-03
NC-BF-210-04
NC-BF-210-05
Hunters Roost Farms
Hunters Roost Farms
Beaufort
350 37 27"
770 04' 25"
8.50
Goldsboro
Goldsboro
Rains
17
Beaufort
35° 37' 09"
770 04' 35"
77° 04' 04.7'"
65.50
17
Hunters .Roost Farms
Beaufort
350 37' 01.2"
16.00
18
NC-BF-210-06
Hunters Roost Farms
Beaufort
350 37' 08.2"
770 03' 35.5"
15.50
Lenoir
19
NC-BF-210-07
Hunters Roost Farms
Beaufort
350 37' 17.4"
770 03' 39.1"
13.50
Lenoir
19
NC-BF-210-09
Hunters Roost Farms
Beaufort
350 37" 18.5"
770 03' 17.8"
17.50
Lenoir
20
NC-BF-210-09
Hunters Roost Farms
Beaufort
Beaufort
Beaufort
Beaufort
350 38' 46.0"
35" 38' 39.6"
350 38' 30.3"
350 37' 28.8"
770 04' 18.5"
77' 04' 39.0"
770 04' 45.0"
27.00
13.00
Craven
Craven
21
22
NC-BF-210-10
Hunters Roost Farms
NC-BF-210-11
Hunters Roost Farms
9.00
Craven
22
NC-BF-210-12
Hunters Roost Farms
770 05' 21.3"
27.50
Goldsboro
23
NC-BF-210-13
Hunters Roost Farms
Beaufort
350 37' 36.5"
770 05' 32.8"
26.50
Craven
23
NC-BF-210-14
Hunters Roost Farms
Beaufort
350 37' 39.4"
770 05' 26.7"
6.00
Goldsboro
23
NC-BF-210-15
Hunters Roost Farms
Beaufort
350 37' 24.0"
77° 05' 33.9"
13.00
Lynchburg
23

Permit Number: WQOOO ud6
0
-.T �\ _pproved Land APnlication ,ttes
FACIR
_ Beaufort 35° 41' ,41 All 77° 10` 13.2" 25-50
(C-BF-210-16 Hunters Roost Farms � 1,308.50
Total
Craven
24

Standard Operating Procedure and Operation and
Maintenance Plan for the Washington WWTP Land
Application Program
1. Purpose
a. Ensure the requirements of the Washington WWTP Land Application of
Residuals Permit# WQ0001026 are met.
2. Personnel
a. The following is a list of personnel in order they are to be contacted when
information needs to be shared.
i. EMA Resources Inc.
1. Jeff Thompson - Project Manager
2. Boger Hartsell - Project Manager
3. Roy Whitaker - Director of Business Development
4. Brent Collins -Director of Technical Services
ii. City of Washington, NC
1. Adam Waters, Public Work Director
2. Hope Woolard, WWTP Superintendent
3. Operational Functions
a. The operational function of this project it going to involve mixing the storage
basins with a tractor powered Houle pump to achieve a well -mixed and
consistent material that is suitable for land application. It is going to be
spread at agronomic rates that are determined using the Realistic Yield
Expectations (RYE) as outlined in the permit, the amount of other nutrient
sources the landowner and operator has applied, and the residuals nutrient
and metal sample that is current for that monitoring period. It is going to be
spread with a liquid applicator that will use pressure to spread the material
in such a way as to achieve a consistent spread pattern. The material is
going to be land applied on fields that have row crops or pasture.

Application rates will be reduced by 25% on fields that are primarily used for
grazing in accordance with USDA-NRCS 590. Grazed fields will be
determined by the farmers and EMA project managers.
4. Maintenance Schedule
a. EMA Resources Inc. will follow the maintenance schedule as recommended
by the EMA Resources Operations Manager (Mike Collins) for the equipment
necessary to complete the job.
5. Safety Measures
a. City of Washington, NC and EMA Resources Inc. believe in operating in a
safety conscious manner and all employees participate in safety training that
is designed to help employees recognize safety issues and take steps to
prevent accidents from occurring. In addition, EMA Resources employees
have the authority to stop operations if they think any aspect of the operation
is going to cause environmental or personal harm.
6. Spill Response Plan
a. In the unlikely event of a spill, the following action shall be taken
immediately.
i. Management of Spill Clean-up Activities: The EMA Resources Project
Manager shall take immediate charge and initiate clean-up activities.
EMA Resources labor and equipment is to be utilized. In the event
additional labor and equipment is required, assistance may be
requested from City of Washington, NC, The NC Department of
Transportation, and other private contractors as necessary.
ii Halt the Source of the Spill: Such as a ruptured container or damaged
transport unit.
iii. Contain the Spill: Form a barrier. Sufficient quantities of straw shall
be used for such purposes. Earthen barriers may be constructed to
augment the straw bale containment area of the spill. The
Operations Manager or the person in charge on the spill site will be
advise the clean-up personnel where to get the straw, lime, and other
items necessary to complete the clean-up operation. le. local
farmers, farm supply centers, nurseries.

iv. Initial Clean -Up: Employ front-end loaders, vacuum equipment,
sludge application vehicles, and/or local septic tank service to
remove as much of the spilled material as possible. Straw and/or
sand should be scattered in the spill area to soak up the remaining
material. The straw and sand soaked material will be collected and
removed to a disposal area approved by representatives of the state
regulatory agency.
v. Final Clean-U: Employ rotary brush sweeper if needed and apply
lime to the spill area upon the approval of the clean-up efforts by the
state regulatory representative. If the event occurs on private
property, the clean-up will be completed to the satisfactory of the
property owner and state regulatory representatives. The ultimate
goal will be restore the spill area to its original condition if possible.
vi. Notification: As soon as possible after the spill occurs, the EMA
Resources Project Manager or designee will notify the City of
Washington, NC and the EMA Resources main office. EMA
Resources office staff is then responsible for notifying other key EMA
Resources personnel.
vii. Reporting_ EMA Resources staff will notify the Washington regional
office of the NCDENR by telephone [phone] as soon as
possible, but not more than 24 hours after, or on the next working day
following the occurrence. The EMA Project Manager shall provide a
written report with 48 hours of the spill to the EMA Resources Director
of Technical Services and City of Washington, NC staff. The report
shall list all relative information and actions taken. With the
assistance of EMA Resources personnel, and the City of Washington,
NC personnel, a written report will be filed with the Washington
regional office within 5 days of the occurrence. For after hours
reporting, the Division's emergency number shall be called to report
all incidences [phone]

7 Inspection Plan
a. Inspection for the land application of residuals will conducted on a minimum
of a weekly basis at the land application site during land application
activities. The inspection frequency is based on the time frame that it is going
to take to complete the project and the amount of dry tons to be land
applied from this facility. The inspections will consist of inspecting a current
field that is being applied as well as inspecting random fields that have been
completed. Inspections will be conducted by Jeff Thompson - Project
Manager, and Boger Hartsell - Project Manager. These inspections will
consist of the following:
i. Verifying the application rates for each field that plan on receiving
material.
ii. Checking the calculated loads to ensure the correct amount of
residuals are being land applied.
iii. Ensure that all manned equipment has a copy of the permit and the
operation and maintenance plan.
iv. Ensure that the field has been flagged properly and that all buffers
are being adhered to.
v. Ensure proper signage has been posted
vi. Verify that the proper number of samples of the residuals has been
taken and that it meets the criteria for land application.
vii. The records will be kept in the EMA Resources project files in the main
office. Copies of all analyses and records will be forwarded to
Washington WWTP and kept on file.
viii. EMA Resources and Washington WWTP staff will immediately inform
the other party if any of the following conditions are noted.
1. Any occurrence with the distribution program resulting in the
land application of significant amounts of material that is
abnormal in quantity or characteristics.
2. Any failure of the distribution system that results in the release
to surface waters.
3. Any time that self -monitoring indicates that the facility has
gone out of compliance with the permit.
4. Any process failure that results in the system not adequately
treating the residuals.

5 Any spill or discharge from a vehicle or piping system during
residuals transportation.
6. Any release that requires immediate reporting outside normal
business hours shall be called in by EMA Resources staff to
DENR at [phone]. This number is to be called in the
event of a release to surface waters or imminent failure of a
storage system when the event occurs outside of normal
business hours.
8. Sampling and Monitoring Plan
a. Sampling for this project consists of sampling the residuals prior to land
application occurring_ in order to ensure that the residuals are suitable for
land application.
b. The samples will be collected from the storage lagoon that holds the
residuals
c. Jeff Thompson, Boger Hartsell, Brent Collins, Roy Whitaker or other designee
will be responsible for sample collection for nutrient and metal, TCLP, and
fecal coliform.
d. Nutrient, metal and TCLP sample aliquots will be collected randomly and
consist of at least 7 individual aliquots mixed together in order to get the
composite sample for these parameters.
e. The residuals will be sampled annually for TCLP including the RClls.
f. Metal and nutrient parameters will be collected and analyzed based on the
requested dry ton numbers in the permit application.
g. Residuals will be sampled for fecal coliform to demonstrate pathogen
requirements have been met. Seven separate samples will be collected and
analyzed.
9 Environmental Impacts
a. The environmental impacts for residuals may be affected by this procedure.
b. This procedure helps assure that land application is conducted in a safe and
efficient manner while ensuring compliance with the laws and regulations
and to minimize exposure, negative environmental impacts and public
relation concerns.

RESIDUALS SOURCE FACILITY SUMMARY
Applicant's name: City Mash
NC
'Status Code for source facility are: ♦ N (New) ♦ R (Renewed) ♦ M (Modified) ♦ D (Deleted)
" The amount of residuals currently permitted for distribution, land application, or disposal (i.e, not applicable to new facility).
SUMMARY FOR FORM: RSC 06-16 Page I

I)WR
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
RESIDUALS SOURCE CERTIFICATION
FORM: RSC 06-16
I. RESIDUALS SOURCE -GENERATING FACILITY INFORMATION (See Instruction B.):
1. FacilityName: Washin:! on WWTP
2. Facility permit holder is: ❑ Federal, ❑ State, 0 Local Government, or ❑ Private.
Facility permit issued by: Div. of Water Resources, [} Div. of Environmental Health,
or Other (explain: ).
3. Facility contact person and title: Adam Waters, Public Works Director
Complete mailing address: P.O. Box 1988
City: Washin-Lon State: NC Zip: 27889-.
Telephone number: 2( 52) 975-9310 E-mail address: awatersRwashingtonnc.+ov
4. Facility physical address: 1399 W. 2nd Street
City: Washington State: NC Zip: 27889-
Coordinates: Latitude: 35' 33' 08.12"N Longitude: 77' 04' 20.08"W
Datt4i :"NAD83 Level of accuracy: .01"
Method of measurement: GPS
5. Purpose of the facility:
0 treatment of municipal wastewater, ❑ treatment of 100% domestic wastewater,
treatment of potable water, ❑ treatment of 100% industrial wastewater,
treatment of industrial wastewater mixed with domestic wastewater,
(approximate percentages: % industrial and ' % domestic)
other (explain: " ).
6. Does the facility have an approved pretreatment program: 1Z Yes [] No
7. Facility permitted/design flow: 2.65 MGD and facility average daily flow: 1_9 MGD
8. Average amount of residuals being generated at this facility 625 dry tons per year.
9. Specify the following regarding treatment and storage volumes available at the facility:
Type and volume of residuals treatment: Two Aerobic Thickeners/Di-.esters
Type and volume of residuals storage (i.e., outside of residuals treatment units): Four Concrete Basins, 400,000 gallons
each for a total of 1.6 MG.
II. RESIDUALS QUALITY INFORMATION (See Instruction C.):
1. Specify if residuals are regulated under:
Z 40 CFR Part503 or n 40 CFR Part 257.
Note: Only residuals that are generated during domestic/municipal wastewater treatment processes are regulated under 40
CFR Part 503, otherwise, the residuals are regulated under 40 CFR Part 257.
2. Specify if residuals are defined under ' A NCAC 02T.110216 i as:
0 Biological ❑ Non -Biological
FORM: RSC 06-16 Pagel of 5

x
Note: Biological residuals are residuals that have been generated during the treatment of domestic wastewater, animal
processing wastewater, or the biological treatment of industrial wastewater (biological treatment is a system that utilizes
biological processes including lagoons, activated sludge systems, extended aeration systems, and fixed film systems).
3. Hazardous Waste Determination: Complete the following to demonstrate that the residuals are non -hazardous under
RCRA: (Note - this item does not have to be completed for facilities that are less than 0.5 MGD in design flow that treat
100% non -municipal, domestic wastewater only)
a. Are the residuals listed in 40 CFR §261.31-§261.33: Q yes no.
If yes, list the number(s): - 7
b. Specify whether or not the residuals exhibit any of the characteristics defined by 40 CFR §261.21-
261.24: 0 yes 0 no.
Fill in the following tables with the results of the latest toxicity characteristic leaching procedure (TCLP) analysis as
well as those for corrosivity, ignitability, and reactivity:
Laboratory: Pace Analytical and Date of analysis: 3/19/2019
Passed corrosivity test: 0 yes Q no. pH: s.u. (2 < pH < 12.5)
Passed ignitability test: tD yes F1 no. Flashpoint: > 170 OF (> 140°F)
Passed reactivity test: 0 yes Ono. HCN: ND mg/kg (<250) & H2S: 66.8 mg/kg (<500)
TCLP Parameter
Limit
(Mg/1)
Result TCLP Parameter
(m8/1)
Limit
(Mg/1)
Result
(m917)
Arsenic
5.0
ND
Hexachlorobenzene
0.13
ND
Barium
1 00.0
ND
Hexachloro-1,3-Butadiene
0.5
ND
Benzene
0.5
ND
Hexachloroethane
3.0
ND
Cadmium
1.0
ND
Lead
5.0
ND
Carbon Tetrachloride
0.5
ND
Lindane
0.4
ND
Chlordane
0.03
ND
Mercury
0.2
10.0
ND
ND
Chlorobenzene
100.0
6.0
ND
ND
Methoxychlor
Methyl Ethyl Ketone
Chloroform
Chromium
200.0
2.0
ND
ND
5.0
ND
Nitrobenzene
m-Cresol
200.0
ND
Pentachlorophenol
100.0
ND
o-Cresol
200.0
ND
Pyridine
5.0
ND
p-Cresol
200.0
ND
Selenium
1.0
ND
Cresol
200.0
ND
Silver
5.0
ND
2,4-D
10.0
ND
Tetrachloroethylene
0.7
0.5
ND
1,4-Dichlorobenzene
7.5
ND
Toxaphene
Trichloroethylene
2,4,5-Trichlorophenol
ND
ND
ND
1,2-Dichloroethane
0.5
0.7
ND
ND
0.5
1, 1 -Dichloroethylene
400.0
2,4-Dinitrotoluene
0.13
ND
2,4,6-Trichlorophenol
2.0
ND
Endrin
0.02
ND
2,4,5-TP (Silvex)
1.0
ND
Heptachlor and its Hydroxide
0.008
ND
Vinyl Chloride
0.2
ND
FORM: RSC 06-16 Page 2 of 5

r }w
4. Metals Determination: Complete one of the following tables (i.e., as applicable) to demonstrate that the residuals do not
violate the ceiling concentrations for metals regulated under 15A NCAC 02T .1105.
a. For Distribution/Land Arplicadon: Fill in the following table with the results of the latest analyses (i.e., on a dry weight
basis) for the following metal parameters:
Laboratory: Waypoint Analytical and Date of analysis: 10/31/2019
_—_—_—____ �........b ..ay..au.J --.r'a.
Concentration Limits Concentration Limits
(ClassA & ClassB) (Class A Only)
(mg1kg) (m91k9)
Arsenic 75 41
1�GJU1.
(mg1kg)
<11.3
Cadmium
85
39
<1.34
Copper
4,300
1,500
124
Lead
840
300
17.8
Mercury
57
17
0.884
Molybdenum
75
n/a
<3.51
Nickel
420
420
13.6
Selenium
100
100
<13.2
Zinc
7,500
2,800
370
b. For Surface Dis osal Unit land ill : Fill in the following table with the results of the latest analyses (i.e., on a dry weight
basis) for the following metal parameters:
Laboratory: * ., and Date of analysis:
Distance from Disposal Arsenic
Chromium Nickel
Unit to Boundary to
Closest Property Line
(meters, check one) (mg/kg)
(mg/kg) (mg/kg)
> 0 but < 25 30
200 210
> 25 but < 50
34
220
240
Q > 50 but < 75
39
260
270
[] > 75 but < 100
46
300
320
> 100 but < 125
53
360
390
[� >_ 125
62
450
420
Result (mg/kg)
FORM: RSC 06-16 Page 3 of 5

5. 1Vutrient/Micronutrient Determination: Complete the following:
a. Total solids: 3.75 %.
b. Fill in the following table with the results of the latest analyses (i.e., on a dry weight basis) for the following nutrient and
micronutrient parameters:
Laboratory: Wayuoint Analytical and Date of analysis: 10/31/2019
Parameter
Result
(mg/kg)
Aluminum
34300
Ammonia -Nitrogen
9300
Calcium
13500
Magnesium
2140
Nitrate -Nitrite Nitrogen
<128
pH (Standard Unit)
7.1
Phosphorus
15400
2260
2730
37600
Potassium
Sodium
Total Kjeldahl Nitrogen
C. Using the results listed in Item II. 5b. above, calculate the sodium adsorption ration (SAR): 1.13
[Note: If residuals contain SAR of 10 or higher, the applicant shall obtain recommendations from the local Cooperative
Extension Office, the Department of Agriculture and Consumer Services, the Natural Resource Conservation Service, a
North Carolina Licensed Soil Scientist, or an agronomist, prior to land application of residuals. The recommendations shall
address the sodium application rate, soil amendments (e.g., gypsum, etc.), or a mechanism for maintaining site integrity
and conditions conducive to crop growth].
d. Specify the mineralization rate to be used in calculating the plant available nitrogen (PAN) of the residuals: .2 %. This
rate is a (check one): 0 default value, or ❑ actually established.
If the residuals are not generated from the treatment of municipal or domestic wastewater, explain or provide technical
justification as to why the selected default value is appropriate to be applied to these residuals: NA
e. Calculate the PAN for the residuals (i.e., on a dry weight basis) and fill the results in the following table:
Application Method First (111) Year PAN Five -Year
Maximum Adjusted PAN
(mg�k� (mglkg)
Surface 10438 14441
Injection/Incorporation 15090 19091
6. Other Pollutants Determination: Specify whether or not there are any other pollutants of concern in the residuals and provide
the results of the latest analyses: NA
FORM: RSC 06-16 Page 4 of 5

7. 1',Itho en Reduction: Per 15A NCAC 02T.1106. specify how residuals will meet the pathogen reduction requirements:
s For Distribution/Land Application of Class A or Equivalent:
A fecal coliform density that is demonstrated to be less than 1,000 MPN per gram of total dry solids,
or
A salmonella sp. density that is demonstration to be less than 3 MPN per 4 grams of total dry solids.
AND one of the followings (except for non -biological residuals):
Alternative 1 [15A NCAC 02T.I 106(b)(3)(A)] - Time/Temperature Compliance.
❑ Alternative 2 [15A NCAC 02T.I 106(b)(3)(B)] - Alkaline Treatment.
❑ Alternative 3 [15A NCAC 02T.1106(b)(3)(C)] - Prior Testing for Enteric Virus/Viable Helm inth Ova.
❑ Alternative 4 [15A NCAC 02T.I 106(b)(3)(D)] - No Prior Testing for Enteric Virus/Viable Helminth Ova.
❑ Alternative 5 [15A NCAC 02T.I 106(b)(3)(E)-(K)] - Process to Further Reduce Pathogens (PFRP).
Specify one: ❑ composting, ❑ heat drying, ❑ heat treatment,
❑ thermophilic aerobic digestion, ❑ beta ray irradiation,
gamma ray irradiation, or ❑ pasteurization.
b. For Land Application of Class B:
R Alternative 1 [15A NCAC 02T.1106(c)(1)] - Fecal Coliform Density Demonstration.
❑ Alternative 2 [15A NCAC 02T.1106(c)(2)] -Process to Significantly Reduce Pathogens (PSRP).
Specify one: ❑ aerobic digestion, ❑ air drying, ❑ anaerobic digestion,
❑ composting, or ❑ lime stabilization.
c. For Surface Disposal:
❑ Select One of the Class A or Equivalent Pathogen Reduction Alternatives in Item lI. 7a. above
❑ Select One of the Class B or Equivalent Pathogen Reduction Alternatives in Item 11. 7b. above.
❑ Exempt -If Daily Cover Alternative is chosen in Item 11.8. below [15A NCAC 02T.1106(a)(2)].
❑ Not Applicable - Non -Biological Residuals with NO Domestic Wastewater Contribution.
8. Vector Attraction Reduction (VAR): Per 15A NCAC 02T.1107. specify how residuals will meet the VAR requirements:
® Alternative 1 [15A NCAC 02T.1107(a)(1)] - 38% Volatile Solids Reduction (Aerobic/Anaerobic Digestion).
❑ Alternative 2 [15A NCAC 02T.I 107(a)(2)] - 40-Day Bench Scale Test (Anaerobic Digestion).
Alternative 3 [15A NCAC 02T.I 107(a)(3)] - 30-Day Bench Scale Test (Aerobic Digestion).
❑ Alternative 4 [15A NCAC 02T.1107(a)(4)] - Specific Oxygen Uptake Rate Test (Aerobic Digestion).
❑ Alternative 5 [15A NCAC 02T.1107(a)(5)] - 14-Day Aerobic Processes.
❑ Alternative 6 [15A NCAC 02T.1107(a)(6)] - Alkaline Stabilization.
❑ Alternative 7 [15A NCAC 02T.1107(a)(7)] - Drying of Stabilized Residuals.
❑ Alternative 8 [15A NCAC 02T.1107(a)(8)] - Drying of Unstabilized Residuals.
[] Alternative 9 [15A NCAC 02T.1107(a)(9)] - Injection.
❑ Alternative 10 [15A NCAC 02T.I 107(a)(I0)] - Incorporation.
❑ Alternative for Surface Disposal Units Only - Soil/Other Material Cover [15A NCAC 02T.I 107(b)(2)].
❑ Not Applicable - Non -Biological Residuals with NO Domestic Wastewater Contribution.
Note: For animal processing residuals, only alternatives 9 or 10 may be chosen due to the nuisance conditions that typically
occur when these residuals are applied and left on the land surface.
FORM: RSC 06-16 Page 5 of

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17 0.1L1471ONMCHAASCE.L41490 9CEMLS
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EL AWX OF allM0.9 08.5i4L A177B7 AAD 8CPE{NA.E9
L: P S EC)AGAI. OWPLAN
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E'-4 POAMZOIE COMB AM I-A.EVA7OM AAD 8CA WS
E5 COAfIAOL-affLAELLAMW
" $CYAMM
C-7 COADLRAAD CABLEGVAMZEE
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&V RABPLa BrAAONAAD CLARIFIER ELECM-4f.
E-D ELEC77WAL DIMA18
ER B sCIACAL DETAL8
WASTEWA TER TREATMENT
PLANT EXPANSION
PHASE lIA
FOR 7�E
CITY OF WASHINGTON
BEAUFORT COUNTY, NORTH CAROLINA
CONTRACT I — GENERAL CONSTRUCTION
PROJECT NO. CS 370521-04
RECORD DR4WINGS
4 Rtprs A-2M
9 .., 1 OET. !IAAOit W2:
OC1atP.B, Engineers
•s`+ u4 Sine G e HUes N.C.dSt 27868 planners j
1 Iola (E52) 752-4135 Surveyors
wre 4� DRAWING NO. W-2607RD SHEET NO. 1 of 22 & . Ef - Ell

wo8r^
�axssa,
1 _ —
_ a Q
a
UQM FLOW Sd1EMAMC
�Wt42'1612x xKA11pI f'Wll WAI6LY - fw1 T
OF WASWNCTM
ttl15CN.E V-2607RD 1 3 s 22

Washington WWTP
Quantitative Justification for Residuals Production Rate
The annual dry ton calculation is based on the percent solids of the analysis and the
maximum removal of 3MG per year and projected percent solids of 5%.
Gallons lbs/Gal. %Solids Dry lbs. lbs/ton D_ry Tons
3,000,000 x 8.34 x 0.05 = 1,251,000 =2000 = 625

��ceAnalytical
ANALYTICAL REPORT
^atiord Center for Tc _,. , tnnovaA-,n March 26, 2019
EMA Resources
Sample Delivery Group: L1079944
Samples Received: 03/19/2019
Project Number:
Description: Washington
Report To: Mr. Brent Collins
755 Yadkinville Road
Mocksville, NC 27028
Entire Report Reviewed By: 1
, mw��a ?��
Cassandra Foster
Project ;tanager
Results relate only to the items tested or calibrated and are reported as rounded values. This test report shall not be
reproduced, except in full, without written approval of the laboratory. Where applicable, sampling conducted by Pace National
performed oer guidance provided In laboratory starddrd operating procedires: 960302, CK303, and 060304.
* r-yam
f4e`'

moommom
TABLE OF CONTENTS ONE LAB. NATIONWIDE.
Pao.
Ss: Sample Summary
Cn: Case Narrative
Ji: Jaiiiiiie K suers
WASHINGTON L1079944-01
Qc: Quality Control Summary
Wet Chemistry by Method 9012 B
Wet Chemistry by Method 9034-9030B
Wet Chemistry by Method 9045D
Wet Chemistry by Method D93/1010A
Mercury by Method 7470A
Metals (ICP) by Method 6010D
Volatile Organic Compounds (GC/MS) by Method 8260D
Chlorinated Acid Herbicides (GC) by Method 8151A
Pesticides (GC) by Method 8081B
Semi Volatile Organic Compounds (GC/MS) by Method 8270E
GI: Glossary of Terms
2
3
4
5
5
7
7
8
9
10
11
12
13
15
16
17
19
Sc: Sample Chain of Custody 21

SAMPLE SUMMARY ONE LAB NATIONWIDE.
Collected by
Collected dateltime
Received date/time
,ASHINGTON L1079944-01 Waste
Brent Collins
03l18A908:30
03/1911908:30
Method
Batch
Dilution Preparation
Analysis
Analyst
Location
dateltime
date/time
Preparatiofl bYMethod 1311
WG1252668
1 03/20A911:48
03/2011911:48
RT
Mt Juliet, TN
Preparation bYMethod 1311
WG1253413
1 03121/1914:51
0312111914:51
CGD
Mt Juliet, TN
Wet Chemistryby Method 9012 B
WG1253125
1 03/21/1910:44
03/22/1911:00
SDL
Mt Juliet, TN
Wet Chemistryby Method 9034-9030B
WG1254957
1 03/26/1914:32
03/26/1914:32
MJA
Mt. Juliet, TN
Wet Chemistryby Method 9045D
WG1252575
1 03121/1910:55
03121,1911:21
JZW
Mt Juliet, TN
Wet Chemistr/by Method D93/1010A
WG1254956
1 0312511914:43
03/2511914:43
BAM
Mt. Juliet, TN
Mercury by Method 7470A
WG1254006
1 03122/1913:12
03/22/19 21:21
TCT
Mt Juliet, TN
Metals (ICP) hyMethod 6010D
WG1254729
1 03/25/19 00:01
03/25/1919:09
CCE
Mt Juliet, TN
Volatile Organic Ccmpounds (GC/MS) by Method 8260D
WG1253188
1 03/21/1.917:02
03/21P,917:02
JHH
ML Juliet, TN
Chlorinated Acid Herbicides (Gq by Method 8151A
WG1254854
1 03/25/19 07:03
03/25/1918:23
KLM
Mt Juliet, TN
Pesticides (Ggby Method 80813
WG1254114
1 03/22/1916:51
03/23/1912:03
LEL
Mt. Juliet, TN
Semi Volatile Organic Compounds (GC/MS) by Method 8270E
WG1254111
1 03/23/19 06: 5
03,124i1915:22
LEA
ML Juliet, TN

CASE NARRATIVE
ONE LAB. NAT1oNwIDE. 0
All sample aliquots were received at the correct temperature, in the proper containers, with the
appropriate preservatives, and within method specified holding times, unless qualified or notated within
the report. Where applicable, all MDL (LOD) and RDL (LOQ) values reported for environmental samples
have been corrected for the dilution factor used in the analysis. All Method and Batch Quality Control IT C
are within established criteria except where addressed in this case narrative, a non-conformance form r
--
or properly qualified within the sample results. By my digital signature below, I affirm to the best of my Ss
knowledge, all problems/anomalies observed by the laboratory as having the potential to affect the �
quality of the data have been identified by the laboratory, and no information or data have been
knowingly withheld that would affect the quality of the data.
FS
%] ra
C
Cassandra Foster [AlProject Manager
Project Narrative `Sc
All Reactive Cyanide results reported in the attached report were determined as totals using method 9012B.
All Reactive Sulfide results reported in the attached report were determined as totals using method 9034/90308.

WASHINGTON
CollecteC% dal'/!Ime: 03/18/19 08:30
epar-atiDn by Method 1311
Result
Analyte
TCLP Extra4&M
TCLP ZHE (Extraction
Fluid 1
Initial pH 7
Final pH 5
Wet Chemistry by Method 9012 B
SAMPLE RESULTS - 01 ONE LAB. NATIONWIDE.
L1079944
Qualifier Prep
Batch
date / time
3/21/2019 2:5113 PM
WG1253413
3/20/201911:48:34 AM
WG1252668
3/21/2019 2:5113 PM
WG1253413
3121/2019 2:51:13 PM
WG1253413
3/21/2019 2:51:13 PM
WG1253413
Result Qualifier
RDL
Analyte
mg/kg
mg/kg
Reactive Cyanide
ND
C.250
Wet Chemistry by
Method 9034-9C`- -
Result Qualifier
RDL
Analyte
mg/kg
Tglxg
Reactive Su Ifide
66.8
25.0
Wet Chemistry by Method 904b.-
Dilution Analysis Batch
date /time
1 03/221201911:00 WG1253125
Dilution Analysis Batch
date 1 time
1 03/26/2019 14:32 WG1254957
Result Qualifier
Dilution Analysis
Batch
Analyte su
date i t;me
Corosivity by pH 7.20 _
1 03/21201911:21
WG1252575
'•mple Narrative:
079944 01 WG1252575: 7.2 at 19.5"
Wet Chemistry by Method D93/1010A
Result Qualifier
Dilution Analysis
Batch
Analyte Deg. F
date i time
.g"I` 'Jity DNI at 17C
1 03251201914:43
WG1254956
�mt �-w'y Cy
Result Qualifier
Analyte mg'I
Mercuy ND
Metals (ICP) by Method 6010D
RDL
mgil
0.?100
Limit
mgii
20
Dilution Analysis
date; time
1 03/22;2019 21:21
Batch
WG1254006
Result Qualifier
RDL
Limit
Dilution Analysis
Batch
Analyte mill
-ag;l
mgll
date i time
Arsenic ND
0.10C
5
t 03/25r201919:09
WG1254729
Barium ND
0.00
100
03251201919:09
WG1254729
G dmium ND
0.105
1
G325i201919:09
WG1254729
Chromium ND
0 00
5
t 031251201919:09
WG1254729
a ] ND
C'OG
03125i2019 19:09
WG1254729
Sejer nl ND
C.100
1 03.1251201919:09
WG1254729
Shier ND
1X
5
9325;201919:09
WG1254729
Volatile Organic COMPOL.nds (GC/MS) by Method
826("1
Result Qualifier RDL
Limit
Dilution Analysis
Batch
xfialyte
mR%I mg/I
mgA
date i time
Benzene
ND
1 Q3121r"2019 17:02
WG1253188
Carboy. tetrachlor,de
ND -
0.50
1 03121/2019 17:02
WG1253188
Chlorobenzene
ND
100
1 C3i2s/201917:02
WG1253188
CN=form
ND 0.250
6
1 03/21201917:02
WG1253188

WASHINGTON
SAMPLE RESULTS
- 01
ONE LAB. NATIONWIDE.
Collected date/time: 03/18/19
08:30
L1079944
-)latile Organic Compounds (GC/MS) by Method 8260D
Result
Qualifier RDL Limit Dilution
Analysis
Batch
Analyte
mgA
mgn mg/l
date / time
_
1,2-Dichloroethane
ND
0.0500 0.50 1
03/211201917:02
WG1253188
1,1-Dichlorcrethene
ND
0.0500 0.70 1
03/21/201917:02
WG1253188
2-Butanone (MFK
ND
0.500 200 1
03/21/201917,02
WG1253188
Tetrachloraetheoe
ND
0.0500 0.70 1
03/21/201917:02
WG1253188
Fs
Trichloroettlene
ND
0.0500 0.50 1
03121/201917:02
WG1253188
Vinyl chloride
ND
0.0500 0.20 1
03121/2019 T7:02
WG1253188
FCn
(S) Toluene-2
91.1
8G.0-120
03211201917:02
WG1253188
(S)a,a,a-TriAuntoluene
88.7
80.0-120
032N201917-02
WG1253188
;'S) 4-BrofioUrobenzene
93.8
77.0-12.6
03211201917:02
WG1253188
(S)1,2-D Ch10r0ethane-d4
121
70.0-130
037217201917:02
WG1253188
Chlorin ated Acid Herbicides (GC) by Method 8151A
Result
Analyte mgll
2,4,5-TP (Silvez ND
2,4-D ND
(S) 2,4-0iehlorophenyl Acetic Acid 59-4
Pesticides (GC) by Method 80818
Qualifier RDL
mg/1
0.00200
0.00200
14.0-158
Limit
mg]
1
10
Dilution
1
1
Analysis
date /time
03/25/201918:23
03125/201918:23
031251201918:23
Batch
WG1254854
WG1254854
WG1254854
Al
Result
Qualifier RDL
Limit
Dilution
Analysis
Batch
Analyte
mgA
mg/1
mg/1
date / time
1-hlordane
ND
0.00500
G.03
1
03/23,1201912:03
WG1254114
in
ND
0.00500
0.02
1
03/23/201912:03
WG1254114
.ptacNor
ND
U0500
0.0080
1
03/23/201912:03
WG1254114
Undar.e
ND
0.00500
0.40
03/23/201912:03
WG1254114
Methoxychlor
ND
0.00500
10
103/23/201912:03
WG1254114
Tcxaphe^.e
ND
0.0100
0.50
1
031231201912:03
WG1254114
/S) Dec actilorobiphen14
78.2
10.0-128
031231201912:03
WG1254114
(S Tetrachlorr,-rr,-xylene
874
10.0-127
0323201912:03
WG1254114
Semi Volatile Organic Compounds
(GC/MS) by Method 8270E
Result
Qualifier RDL
Limit
Dilution
Analysis
Batch
Analyte
mg.11
mg/i
mg/1
d.ite, time
.A-Dichiorobenzece
ND
0.100
7.50
1
03124/201915:22
WG1254111
2,4-Dinitrotoluene
ND
0.100
0'3
1
03/24/201915:22
WG1254111
Hexachlorobe nzene
ND
0.100
0.13
1
03124/201915:22
WG1254111
Hexachioro-13-butadiene
ND
0.100
0.50
1
03/24001915:22
WG1254111
Hexachloroethane
ND
0'Co
3
03/24/201915:22
WG1254111
Nitrobenzene
ND
GAGG
2
1
03/24/201915:22
WG1254111
Pyr d ne
ND
0.100
5
1
G3i24/201915:22
WG1254111
3&4-Methyl Phenol
ND
0.100
400
03124/201915:22
WG1254111
2-Methylp-enol
ND
910G
2 0
03/24/20n915:22
WG1254111
Pe zachto,ophenoi
ND
0.10C
100
1
03/241201915:22
WG1254111
2,4, Trichlorophen0l
ND
C. 1. 01 0
400
1
C3124,201915:22
WG1254111
2,4,6-Trichiorophenoi
ND
0.10C
2
i
03/241201915:22
WG1254111
IS) 2-Fluorooher9l
44.8
10.0-12C
03/24120191522
WG1254111
(S,• Fhe"101-015
25.1
10.0-12C
032420191522
WG1254111
(S)Nitrcbenzene-d5
670
10.0-127
03247201915.-22
WG1254111
2-F/uorobipheryi
70.9
10.0-130
03124201915:22
WG1254111
5)2,4,6-Tribrorroohepol
64.G
10.0-155
03/24201915.22
WG1254111
(S)p-Ferpheryl-d14
78.4
10.0-128
0312412019 15:22
WG1254111

WG125 3125 QUALITY CONTROL SUMMARY
Wet Chemis'"Y h•i Method 9012 9
(MB) R339417£ _' C.,22,'19 10:46
MB Result MB Qualifier MB MDL MB ROL
Analyte mgfkg mg/kg mglkg
Reactive Cyarsid - U 0.0390 0.250
S�
;OS) L'08043E;-i 1 :3;22,19 11:04 • (DUP) R3394178-5 03/2211911:05
Original Result DUP Result Dilution DUP RPD DUP Quaker
OUP RPD
Analyte mgAcg mg/kg %
Limits
%
P.eactvP Cyanide ND 0.000 1 0 000
20
r, s5_. � ..:r n 5a r, 1
Lll.l� tt] � 11 -11p1 ui15J . Qe}Flr•^die 1 l-l� y
!05)-i08062F.-.-02 03122191116 • (DUP) R3394178-6 CT22r911:07
Original Result DUP Result Dilution DUP RPD DUP Qualifier
DUP RPD
Limns
J 1
e mog mwl(g %
%
Peact:e Cyar:de NO 0.000 1 0.000
20
l ,
t.
I_a;Jaratory -C•'itrol SarnPl•- ILCSr
(LCS) R3394178-2 ^3,22A910-47
Spike Amourt LCS Result LCS Rec Rec. Limits LCS Qualifier
Anatyte mgkg mg°kg % %
React ,e C a-& 2.50 2-4.4 97.5 50 0-150
007991E-0' ❑rigIrt2l St} nplc (051 • Matrix S-prl, —"�i . I,1+3tn - F�r•it ..
.1L�.Ir::,; 1MSD)
(OS, L'079918-01 03122A910:54 - (MS; R3394178-3 03122,191055 • ;MSD) R3394178 03 22119 10 56
Spike Amount Original Result MS Result MSD Result MS Rec.
MSD Rec.
Dilution Rec-Limits MS Qualifier
MSD Oualifier RPD
RPD Limits
Analyte mgikg mglkg mg.4tg mg,'kg %
„
%
%
7=-"'•-- :, .- 1.67 NO 1.28 1.27 76.6
763
75.0-125
0.416
20
{OS-28C555-C2 01'22,.911'0 •(MS) R3394178? Oa22.179It:" - tMSD) R3394178-8 03,22,1911.12
Spike Amount Original Result MS Result MSD Result MS Rec
MSD Rec.
Dilution Rec Limits MS Qualifier
MSD Qualifier RPD
RPD Limits
Analyte r-.glkg mgrkg mg,Kg mg,kg %
%
%
%
%
gib., NO ;.37 u8 324
T.,
' 75.0-125
149
20
ACCOUNT: PROJECT:
SDG:
DATEMME:
PAGE:
DIM Rew..:r_es
L'.C79944

WG1254957
QUALITY CONTROL SUMMARY
Wet ChemisS VY by Method 9034-90308
L1079944-01
iAelfi10ij s • : ..);
(MB) R3395202-1=12611914:32
M8 Resuit MB Qualifier
MB MDL
MB RDL
Anayte Mg/kg
mg/kg
mgrkg
Rea-Ne Sulfide U
7.53
25.0
(OS) -108123- -C3 :3,26/1914:32 • (D'JPj R3395262-3
03125M914-32
I c.
Original Result DUP Result
Dilution
DUP RPD
DUP Dualifier OUP RPD
_
L"imRs
Analyte tnggkg m9Ag
%
%
React^ a Sulfide 54-6 54.6
1
0.000
20
(LCS) R3395262-2 03/26/19 1432
rl
Spike Anount LCS Result
LCS Rer-
Rec. Limits LCS Qualifier
rcgrkg mglkg
%
%
-
.ae Sulfide 100 ?2.9
72.9
70.0-130
-
ACCOUNT: PROJECT: SDG:
DATE/ rw:
G: C1,191525
PAGE:
E of7

WG12E 25155 QUALITY CONTROL SUMMARY ONE LAB NATIONWIDE JO
Wet Chemis ry b, Method 90450
ll . (05j • Dupkratf
;05) 1-7019918-01 GT21,191121 • PUP) R3393737-2 03/21/19 7121
Original Result DUP Result Ddutlon DUP RPD DUP Oualffier DUP RPD
Limm;
Anayte su su % %
Corosiwty by pH >13 7.42 i 2.40 1
Sample Narrative:
OS: 760 at 19.5C
DUP: 7.42 at 19.4C
(LCS) R.33937371 C.21i'1911:21.
Spike Amount LCS Result
Analyte su su
COrrosivity by pl - 100 9.98
e Narrate e :
S: 9.98 at' S.6•-
LCS Rec. Rec. Limits LCS Ouallfier
99.8 99.0-101
ACCOUNT: PROD EC: SDG:
EVA 4eso,,:res U.C79944
DATEITIME:
PAGE
r
r
Es 1
1
E

WG1254956 QUALITY CONTROL SUMMARY
Wet Chemistry by Method D9311010A L1079944-01
LKV9944 -01 ".'1gtrlaI San-tpli_ (0SJ - Dupiirate (D�
(OS) L1079944-01 03f2511914;43 • (DU9 R3394881-2 03;25/19 14:43
Original Result DUP Result Dilution DUP RPD OUP Oualifier DUP RPD
Limits
Analyte Deg, F Deg. F A m
IgadabiNty DNI at 170 DNI at T70 1 0.000 10
(LCS) R3394881-1 C? 25191443
Spike Amount LCS Result LCS Rec Rec, Limits LCS Qualifier
Analyte Deg. F Deg. F % %
19nitabdmj 82.0 83.3 102 96.0-104
ACCCUNT; PRojEc r: SDG: DATE/TIME; PAGE:
E.AA Pes��-ces 079944
02r2611.515.5
3$
r

WG1254006 QUALITY CONTROL SUMMARY
Mercury by &Method 7470A L1079944.01
Method B! 7r• (MB)
(MB) R3394372-1 ;3/22/19 20:54
-
-
MS Result Result MB Qualifier MB MDL MB RDL
Analyte mgA mg,1 m0,1
Mercury d 0.00330 0.0100
3J
t.ahoratnr5, Z :.nlrol SarnpiG (!..CS) • Laowatory Conti DI Sample buoicat(-� tLC5-C:)
(LCS) R3394372-2 0122/19 20:57 • r CSD) R3394372-3 03/22/19 20.59
CI
Spike Amount LCS Result LCSD Result LCS Rec LCSD Rec. Rec Limits LCS Qualifier LCSD Qualifier RPD
RPD Limits
Analyte mgll mg;1 mgl! % % % %
%
I Sr
Mercur 0.0300 0.0297 0.0289 99.0 96.2 80.0-120 2.86
20
L
(OS) L108069,-02 1122.!19 21:02 - (MS' R3394372-4 03/221:9 21:04 • (rASD, R3394372-5 Ca22r 19 21:11
Spike Amount Original Result MS Result MSD Result MS Rec. MSD Rec. Dilution Rec. Limits MS Qualifier
MSD Qualifier RPD RPD Limits
+n mg/I mg/l m9n % %
% %
0.0300 NC C-0316 98.8 i 75.0-125
5.48 2C
ACCOUNT: PRO;EC7: SDG: DATE.TIME: PAGE:

WG1254729
QUALITY CONTROL SUMMARY
ONE LAB.MATIOMVIDE
Metals (ICP) by Method 6010D
L1079944-01
(ME], R3395O114 O3125,'1918'50
MB Result
MB Quali6er MB MDL
MB RDL
Analyte mg/1
mgA
m9A
Arsenic 0
0.0330
0-M
Barium U
0.0330
0.100
Cadmium U
0.0330
0.100L_'
Chromium U
0.0330
0.100
Lead U
0.0330
0.100
) l-I
Selenium 0.0352
J 0.0330
0.1.00
�
S-,lae; U
0.0330
G.1C0
F,-
Labar atary Control Sample (LCS) • Laboralvey Control Sanpie Uupl(Cate (LCSDi
(LCS) R3395011-2 03/25119118.53 • (LCSD) R3395O11.3 03'251918:56
Spike Amount
LCS Result
LCSD Result
LCS Rec.
LCSD Rec.
Rec. Limits
Analyte
ingA
mgi(
mgA
%
%
%
100
103
10.2
103
102
80.0-120
I
10.0
10.3
10.2
103
102
80.0-120
.__....um
10.0
103
10.3
103
103
80.0-120
Chrormum
1:0.0
9.98
10.0
99.8
10C
80.0-120
Lead
10.0
1.0.3
110.3
103
103
80.0-120
Selenium
10.0
10.6
10 5
706
105
80-0-120
Shier
2.00
7.95
1.95
977
97.6
80.0-120
1051 L1O79918-01 D
C9'.8.58 • (MS) R3'95 ,'.-5 03:25i191S,•:04
. V-:'- R3395Ct1-5
03,2519 19 06
Spike Amount
Original Result MS Result
MSD Result
MS Rec.
MSD Rec-
Analyte
mgA
mgA mg5
mg-1
%
%
Arsenic
10-0
ND 10.2
%.2
102
102
Barium
10.0
ND 103
i0.3
103
103
Cadmium
TO.0
ND 10.3
10-2
103
102
Chromium
10.0
Na 10.1
10.0
101
100
Lead
10.0
NO ICA
1C.3
104
103
Selemum
10.0
0.15? 10.6
105
104
103
Silver
200
ND 1.96
1.96
978
979
LCS Qualifier LCSD Quairler RPD
RPD Lnnits
0.478
20
0458
20
0.525
20
0.234
20
0.442
20
0.930
20
0.0736
20
Dilution
Rec. Limts
MS Qualifier MSD Oual er RPD
RPD Limits
%
%
75Sr125
0.361
20
1
75.0.125
0.544
20
75.0-125
0.300
2C
1
75.0.125
0.0767
20
1
75.0-1.25
0.349
20
1
75.0.125
1.02
20
1
?5.0-125
0.103
20
ACCouYc: PROJECT: SDC:
EM.A Rest ces L1073944
DA"6TIME:
PACE:
•2 0` 21

WG125r3188
Volatile Org amc Compounds
(GC/MS) by Method 8250D
lAe;hc-d 8!=!r ?!A!3y
IMS) P.3393818-3 03J21r99 11:32
MB Result
MB Oualft MB MDL
Analyte
mgA
mgll
Benzene
r
0.0167
Carbon tetrachlarkle
U
0.0167
Chlorobenzene
U
0.0167
Chloroform
U
0.0833
1,2-Dichloroethane
U
0.0167
1,1-0[chloroethene
U
0.0167
2-Butanone (MEK)
U
0.167
TetracMoroethene
U
0.0167
Trich!oroethene
U
0.0167
vinJlchlonde
U
0.0167
,1S) rn?uene-d8
850
0 ",o-Tofuorctoluene 88.9
(S)4-9mmoP,uorohewere 934
T' Z2-D2hforoethcned4 120
QUALITY CONTROL SUMMARY
MB RDL
mgr1
0.05D0
0.0500
0.0500
0.250
0.0500
0.0500
0.500
0.0500
00500
0.0500
80.0-120
80.0-120
770-126
70.0-20
L tn•:1t �t. r}r Con.rat S rnple (LC SI • LibDir atory Conicnl 5aI-1011e C�u;11i•= !e �LC5G1
(:.CS; R3393818-1 03/21.11.9
09:02 • tCSG; R3393818-2 ON21/19 09:22
Spike Amount
LCS Result
LCSD ResuH
LCS Rec.
LCSD Rec.
Rec. Limits
LCS Qualifier LCSD Qualifier RPD
RPD Limits
Anayte
Mg1
mcyl
mg!1
%
%
%
%
%
Benzene
0.025G
0.0267
0.0266
107
107
70.0023
0.171
2D
Carbonte!rachlorlde
0.0250
0.0244
0.0247
97.5
98.6
68.D-126
1.14
20
Chtorobenzene
0.0250
0.0208
0.0204
83-0
617
80.0-1.21
164
2C
Chiomforre
0025C
00240
0.0244.
96.1
97.S
73.V..20
1.77
1,2-D:calomeJlane
0.0250
0.0259
0.0255
104
YJ2
70.0-128
143
20
1.1-D!chtoroethene
0.0250
0.0213
0.0219
85.2
87.5
710-124
2.63
20
2-ButanonejMElq
0.:25
0.:91
0.187
153
149
44.0-160
2.32
2C
Tetrachkxoetilene
0.0250
0.0188
0.G184
75.3
73.8
72.0-132
147
20
: nct:!oraetFene
00250
C 0227
0.0227
90.7
90.9
76.3= 24
0.234
20
Jinyl chlontle
0.0260
0.0275
0-0283
110
113
67.0-21
2.90
20
IS) ra'uere-c8
950
91.9
80.0420
(Sja.o,o-ToOvorotoluene
85.7
84.9
800-120
;'514-Eromo!'uornbenzere
90.6
92.2
77 0- 126
(S 1.2-0lchloroethcne-0
115
122
70.0-130
ACCOUNT: PROJECT: SDG: DATEMME: PAGE:
EIdA Resources <079944 C912C 1916:25 _
C
C

WG12E 3188 QUALITY CONTROL SUMMARY
Volatile Orga Compounds (GC7MS) by Method 8260D L1079944-01
L1G78760 )r191nal 5amPle (05, . Ma,r1x Spin = w5i • Man ix Sp ILt 1)upIIcaty (MSD)
;CS) LiD78760-0103f211191421 • (MS) R3393818-4 03/21/19 19:43 • (MSD) R3393818-5 03/21;19 20:03
Spike Amount
Original Result MS Result
MSD Result
MS Rm
MSD Rec.
Anelyte
mg71
17199
mg4
mgil
%
%
Benzene
125
ND
0.851
1.34
68.1
107
Carbon tetrachloride
125
ND
0.524
1.23
41.9
98.2
Chlorcbeezere
1.25
ND
0702
1.02
56.2
81.2
Chloroform
1.25
ND
0.910
1.20
72.8
957
12-Dichloroethane
1.25
ND
115
1.32
92.0
105
1,1-Dichkuoethene
1.25
ND
0.512
1.14
41.0
91.5
2-8utanone(ME[)
6.25
ND
921
9.67
147
155
Tetrachklroethene
1.25
ND
OA21
0.892
33.7
T.4
Trictiorcethere
125
ND
0.589
1.09
471
86.5
Vinyl chloride
1.25
N0
0,667
154
53.3
123
!S) T k:ene-dS
95.5
95.2
(Sy oxa-ThfidafltWuere
94.6
9t0
,Q 4-&omoflaorobenzene
90.5
83.8
K1 1,2-Dichforoethone d4
1!8
119
06?8833-0 )tigmal Sample (051 . Spike IN S
(OS, 1-1078633-01 03 2171915:21 • (MS) R3393818 6 012V19 20:23
Dilution
Rec. Limits
MS Oualr6er MSD Oualitier RPD
1
17.0 �58
44.5
1
23.0-159
80.3
1
33.0-152
36.5
29.0-154
27.1
1
29.0-151
13.5
1
11.0-160
76.3
1
10 0-160
4.89
1
10.0-150
- 71.7
1
10.0-160
- 589
1
10.0-160
79.3
90.0-120
80.0-120
77.0.126
70.0-130
Spike Amount
Original Result MS Result
MS Rec.
Dilution
Rec Limits MS Oualifier
Analyte
m91
mg,4
mgd
%
%
Benzene
1.25
ND
134
i07
1
17.0-158
Carboc tetrachloride
1.25
ND
1.25
100
1
23-0-159
Chlorobenzene
1.25
ND
0977
782
1
23 0-152
Chlorofcrr.
1.25
ND
1.28
102
29.0-154
1,2-u^:cNoroethane
1.25
ND
1.31
105
29.5-'.51
1,1-D1cillcroethene
1.25
ND
1.27
102
1
11.0-160
2-Butanone(MEiQ
6.25
ND
102
163
J5
Tetrachloroethene
125
ND
C.840
67.2
i'0.0-16C
Trichlorce4.ene
1.25
ND
1.06
94.5
i10.0-160
Vinyl chlcride
1.25
ND
1.67
134
lD.O-16C
5) To ;ere-c5
94.1
8C.0-12?
(Sc.c.o-TnRuory uere
88.6
80.0-120
,S,"�mofuorcbFnzere
897
7.G-126
(Si 1,2-,1ch!broethcne-d4
!22
700-1-V
ACCOUNT:
PROJECT:
SDG:
=MA
R..5 wces
�tp'7ca44
DATE7TIME:
RPD Limits
%
27
28
27
28
27
29
32
27
25
27
?AGE:
E
F
Sr
rG

WENEWEENEWEENNEw-
WG1254854
C1110drieted Acid Herbicides (GC) by Method 0151A
i1()Ci e�;^l
0,481 R3395119-1 U25/1916:58
MB Result
Analyte mgA
2,4-D U
2,4,5-TP(ciiveX• U
'SJ2,4-Dich/oroc.'e:-4ceft 56.6
Acid
QUALITY CONTROL SUMMARY
L 1079944.01
MB Qualifier MB MDL
MB ROL
mgA
mgA
0.000667
0.0020C
0.00%67
0.00200
14.415E
(LCS) R3395113-2 031251191713
Spike Amount
LCS Result
LCS Rec.
Rec. Limits LCS Qualifier
Analyte mgA
mg/1
%
%
2,4-D 0.0500
0.0390
78.0
50.V.20
2.4,5-TP(S4ve); 0.050C
0.0421
34.2
50.0-125
(5) 2,4-DichioropnenylAcehc
742
14 U158
Acid
,_w7�L.z10 CJ] C"giral Sample (OS5 . M441A 5plkt-(M`a - '.lain:- Spike Duplicate iMSD)
(051 L1079916-01 DW51917:27 • (.MS; R33951. 3-3 03/2511917,4'. • (MS^v) R3395113-4 0325/19 17:55
Spike Amount
Original Result MS Result
MSD Result
MS Rec.
MSD Rec.
Dilution Rec Lunrts
MS Qualifier MSD Qualifier RPD
RPD Limits
Analyte
mg/1
mg,1 mgA
m9A
%
%
%
%
2,4-D
0.0500
ND 0.0395
0.0387
79.0
77.4
S0.0-120
2.05
2D
2,4,5-'.Pisivex)
0.0500
ND 0.0425
3.0419
85.0
83.8
i 53.0-125
1.42
20
15;2,4-Di&,orophery1Acevc
73.0
75.6
14.0456
Acc
ACCOUNT: PROJECT: SDG:
EVA ReGOL. Cef:
DATErTIME:
J312&19 !P25
PAGE
ct 2'

W G12 5 4114
Pesticides (GClby Method 80818
W170o H I -- P.gl
(MB) R3394554-1 03l21:9 09.59
MB Result
MB Qualifier MB MDL
Analyle
nigil
mg/1
Gamma BHC
U
0-00167
Endrin
U
O-GO167
Heptachlor
U
0.00167
Methcaychlor
U
0.00167
Chlordane
J
0.00167
Tozapheee
U
0-00333
(5) Decechlorobrpnelyl 92.5
(S) Tet echloro-m xf ne 90.9
LaharF. '=e-lrol SarnPh- (LCS)
QUALITY CONTROL SUMMARY ONE LAB NATIONWIDE
L1079944-01
MB RDL
0-00500
0.00500
0.00500
0.00500
0-00500
0.0100
10.0-128
10.0.127
(LCS) R3394554-2 03/23/1910:24
Spike Amount
LCS Result
LCS Rec.
Rec Limits LCS Oual'Ifrer
I -Ate
m9A
mgil
%
.o
BHC
0.0100
0.00904
90.4
55.0-129
1
0.0100
0.00967
95.7
57.0-134
Heptachlor
0.0100
0.13%3
91.3
270132
Melhoxy(;hlor
0.0100
0.00899
89.9
54.0155
�Si occccivorobiphen),
84.1
10.0428
!S i-etvchtoro-m-r7lere
91.1
10.0.127
L 1i•' l3' i �1 Crg.rial S-irnple ro51 • M-31fix �.Plke It-ls) . matii.c $prk CR7ptif8,e Ro1SDj
O5 -'G'9$9i-01 3+23%1?';.^i
• (h'S) R339455 -3
^?"73•-191114 • (M50; P.3394554 4 03.'% 19
"2E
Spike Amount
Original Result MS Result
MSD Result
MS Rec
MSD Rec.
Analyte
mV.
.7!V
ingil
mgrl
%
%
Gamma BH;;
OA100
ND
0.00993
0.0091E
99.3
918
Endrin
0.0160
ND
0.0102
0.00954
102
95.4
Heptachlor
00100
ND
0.00975
0.00901
9'.5
90.1
Metho)Cghlor
0.0100
N❑
0.00979
0.00894
97.9
89.4
(S) Oecco orobrpher.;
89.2
80.4
(S) Tetrochloro-m-ir7fere
97.5
89.0
Dilution
Rec. Limits
MS Qualfer 'ASD Qualifier RPD
RPD Limits
%
%
b
1
A.0141
7.85
40
1
10.0460
6.69
39
1
16.0-136
7.89
40
1
10.0-160
9.08
34
`01-128
f0 0 127
ACCOUN17. PROJECT: SDG:
DATEITIME
"M25/•q 16 -5
PAGE
15 of 21

WG1254111 QUALITY CONTROL SUMMARY NAT101,4W10,
Semi Volatil C-oric Compounds (GC/MS) by Method 8270E L1079944-01
(MB) R339464-9-2 OY24i.911:00
MB Result
MB Qualifier MB MDL
MB RDL
Analyte
mgA
mgA
1,4-Dchlorobenzere
U
0,0333
0.100
2,4-Dini rotoluene
U
C.0333
0.100
Hexachlorobenzene
U
0.0333
0100
Hexachbro-13-butadi,-. e
U
0.0333
0.100
a
Hexachloroetharfe
U
0.0333
0.100
Ct
Nitrobenzene
U
0.0333
0.100
Pyridine
U
0.0333
0.100
24Aethylphenel
U
0.0333
0.100
3&4-Methyl Phenol
U
0.0333
0.100
Peatachlorophenol
U
0.0333
0.100
2,4,5-Thchloraphenol
'1
0.0333
0.100
2,4,6.Trichlorophenol
U
0.0333
0.100
(S) Nitrobenzene-e5
72.6
10.0-127
2-Fluorobipd7eny
72.5
10.0-130
Teiphen)4 eti
824
10.0-128
.,hMpd5
29.7
10.0-120
(S)2-Flumphenci
492
10.0420
(5) 2,4, 6-Trobrornophenal
73.0
10.0-155
LsGr,•±aT:11y rCi'luof Su�R)e {LCS�
r'LCSj R3394641-1 03/24'19 1036
Splice Amount ''-CS Result
LCS Rec.
Rec. Limits
Analyte
,ngil
Tg11
%
%
1,40ichlorobeczene
0 6500
5.0383
76.6
18.G120
2.4-Dimtrotoluene
0.0500
0.9445
89.0
49.E 124
Hexacnlarobe,zene
O.C500
0.0450
90.0
44.0-120
Hexacnioro-13-butarlene
0-0500
0.0381
76.2
19.G120
Hexacnlcroethane
00500
0.038'
76.2
15.G'.20
N,bobenzere
0-0500
0.0354
70.8
27.0-120
Pyrid,ne
0.0500
0.0163
32,6
t0.0-120
2-Meth.ophenol
00500
0.0351
70.2
28.0-120
3&4-Methy4 Phenol
O.C500
0.037E
756
31.G120
Pemachlarophenol
0.0500
0.043E
87.66
23.G120
2,4,5-'nchlorophenol
0.0500
C.0453
90.6
44.012C
2,4,5-Tnchlorephenol
0.05CO
0,0463
92.6
42.G120
!S,"Nitrobenzene-h5
73.3
10.012,
(512-F,uorabipheny/
33.;
10413C
r,-Temhenyl-d74
83..3
rri3-'28
LCS Oueltfier
ACCOUNT: PRO.ECT: SDG:
-'JA V--.. -- -r :C79s44
DATFJTHE'
C3r2£i19 i645
PAGE:
17 c`2'.

WG1254111 QUALITY CONTROL SUMMARY
Semi Volatile Organic Compounds (GC/MS) by Method 827C
I.an�rato;y ''-..rltlnf �am(�IM iLCS)
!LCS) R3394641= 03/24.11910:36
Spike Amount LCS Result
LCS Rec.
Rec Limits LCS Qualifier
Analyte mgA mgrl
%
%
0 Phenol45
3C 1
10.0-120
(5) 2-Fluorapheroi
56.5
10.0-120
(S) 2,4.6-Tribromptim,
94.5
io.0-155
L ID79695-01 ;�tlglrlal Sample (OSj • t4atr+x Spike RAS) • Matrix Spike Duplicate ZM5G)
(0S) L1079695-01 03124119 12:12 • (MS) R3394641-3 03/2411912:36 • (.MSD) R3394641-4 03/24,19 12,59
Spike Amount
Original Result MS Result
MSD Result
MS Rec
MSD Rec.
Dilution
Rec Limits
Analyte
mg/1
mg,1
mgA
mg,9
%
%
%
U-DiOlbrobenzene
0.500
ND
0363
0357
72.6
71.4
t
Z0-12G
2,4-Din4rotoluene
0.500
NO
0.423
0.418
PA.6
83.6
r
39.0-45
Hexachlorobenzene
0.500
ND
OA34
0.424
8&8
84.8
1
35.G722
Hexachlao-1.3-butadiene
0.500
ND
0382
0.374
76.4
74.8
1
12.0-120
-Noroethane
0500
N0
0,390
0364
76.0
72.8
1
10.0-120
Vene
0.500
ND
0.341
0.340
68.2
68.0
1
12b-12C
..,.ne
C 500
ND
0.163
0.190
32.6
38.0
1
I0.0-120
2-Methylphenol
0.500
NO
0.326
0.334
65.2
66.8
1
10.0-120
3&4-Methyl Phenol
0.500
ND
0.351
0.363
70.2
72.6
1
tO.D-120
Pentachlorophenol
0.500
NO
0414
0A38
88.8
87.6
1
10.0-128
2,4,5-irichlorophenol
0.500
NO
0A37
0.441
87.4
88-2
i
33.0-120
2,4,6-Trkhkxopheno4
0.500
NO
0.446
0.458
89.2
91.6
1
26.0-120
(S) N.arabenzene-c5
743
7j.6
!0 0 127
�42-Fluorob!phenN
73.9
74.4
10.0-130
isi a-ie!phenyl-d14
.527
all
19.0-125
IS)PhenoFd5
32.6
34.3
!00.120
jS)2-F.corophencr
5175
52,0
100-120
(5)2,4.6-T7bmmophenol
91.5
90.5
190-155
UNL LAO .
MS Qualifier MSD Qualifier RPD
RPD Limps
1.67
40
1.19
25
2.33
24
2.12
34
430
40
0.294
30
153
37
2.42
30
336
36
136
37
0.9+.'
31
2.65
31
ACCOUNT: PROJECT; SOG: DATE/TIME: PAGE
2MA .4eswnc.5 ;3:2ei: +r-•^.= 18 of 21

GLOSSARY OF TERMS
Guide to Reading and Understanding Your Laboratory Report
ONE LAB. NATIONWIDE.
The information below is designed to better explain the various terms used in your report of analytical results from the Laboratory. This is not
intended as a comprehensive explanation, and if you have additional questions please contact your project representative.
Abbreviations and Definitions
_
Ffr
MDL
Method Detection Limit.
ND
Not detected at the Reporting Limit (or MDL where applicable).
FS
RDL
Reported Detection Limit
Rec.
Recovery.
RPD
Relative Percent Difference.
FCn
SDG
Sample Delivery Group.
(S)
Surrogate (Surrogate Standard) - Analytes added to every blank, sample, Laboratory Control Sample/Duplicate and
Matrix Spike/Duplicate; used to evaluate analytical efficiency by measuring recovery. Surrogates to be
'Sr
are not expected
detected in all environmental media.
U
Not detected at the Reporting Limit (or MDL where applicable).
QC
F
Analyte
The name of the articular compound or analysis
P P lysis performed. Some Analyses and Methods will have multiple analytes
reported.
Dilution
If the sample matrix contains an interfering material, the sample preparation volume or weight values differ from the
standard, or if concentrations of analytes in the sample are higher than the highest limit of concentration that the
laboratory can accurately report, the sample may be diluted for analysis. If a value different than 1 is used in this field, the
result reported has already been corrected for this factor.
cAi
These are the target % recovery ranges or % difference value that the laboratory has historically determined as normal
Limits
for the method and analyte being reported. Successful QC Sample analysis will target all analytes recovered or
duplicated within these ranges.
Original Sample
The non -spiked sample in the prep batch used to determine the Relative Percent Difference (RPD) from a quality control
jC
sample. The Original Sample may not be included within the reported SDG.
This column provides a letter and/or number designation that corresponds to additional information concerning the result
Qualifier
reported. If a Qualifier is present, a definition per Qualifier is provided within the Glossary and Definitions page and
potentially a discussion, of possible implications of the Qualifier in the Case Narrative if applicable.
The actual analytical final result (corrected for any sample specific characteristics) reported for your sample. If there was
no measurable result returned for a specific analyte, the result in this column may state "ND" (Not Detected) or "BDL"
Result
(Below Detectable Levels). The information in the results column should always be accompanied by either ar, MDL
(Method Detection Limit) or RDL (Reporting Detection Limit) that defines the lowest value that the laboratory could detect
or report for this analyte.
Uncertainty
(Radiochemistry)
Confidence level of 2 sigma.
A brief discussion about the included sample results, including a discussion of any non -conformances to protocol
Case Narrative (Cn)
observed either at sample receipt by the laboratory from the field or during the analytical process. If present, there will
be a section in the Case Narrative to discuss the meaning of any data qualifiers used in the report.
Quality Control
This section of the report includes the results of the laboratory quality control analyses required by procedure or
Summary 'Q ,
analytical methods to assist in evaluating the validity of the results reported for your samples. These analyses are not
being performed on your samples typically, but on laboratory generated material.
This is the document created in the field when your samples were initially collected. This is used to verify the time and
Sample Chain of
date of collection, the person collecting the samples, and the analyses that the laboratory is requested to perform. This
Custody (Sc)
chain of custody also documents all persons (excluding commercial shippers) that have had control or possession of the
samples from the time of collection until delivery to the laboratory for analysis.
This section of your report will provide the results of all testing performed on your samples. These results are provided
Sample Results (Sr)
by sample ID and are separated by the analyses performed on each sample. The header line of each analysis section for
each sample will provide the name and method number for the analysis reported.
Sample Summary (Ss)
This section of the Analytical Report defines the specific analyses performed for each sample ID, including the dates and
times of preparation and/or analysis.
Qualifier
Flsc;iptor
J
The identification ofthe analyte is acceptable; the reported value is an estimate.
J3
The associated batch QC was outside the established quality control range for precision.
15
The sample matrix interfered with the ability to make any accurate determination; spike value is high.
J6
The sample matrix interfered with the ability to make any accurate determination; spike value is low.
TE
Sample(s) received past -too close to holding time expiration.

E
ACCREDITATIONS &
LOCATIONS
ONE LAB. NATIONWIDE.
pS- Nftnal is the only environmental laboratory accredited/certlfied to supportyour work nationwide from one location. One phone call, one point of contact, one laboratory. No other lab is as
a0cessillk or prepared to handle your needs throughout the country. Our capacity and capability from our single location laboratory is comparable to the collective totals of the network
la0crataies in our industry. The most significant benefit to our one location design is the design of our laboratory campus. The model is conducive to accelerated productivity, decreasing
tu01-3r%nd time, and preventing cross contamination, thus protecting sample integrity_ Our focus on premium quality and prompt service allows us to be
YOUR LAB OF CHOICE.
40t all Certifications held by the laboratory are applicable to the results reported In the attached report
' Akoaredkation is only applicable to the test methods specified on each scope of accreditation held by Pace National.
Alt, Sam• 40660
Nebraska
NEOS-15-05
SS
r
A oska 17-026
Nevada
TN-03-2002-34
Arizona AZ0612
New Hampshire
2975
Arttcansas 88-0469
New Jetsey-NELAP
TNO02
FC
Ci0fifomia 2932
New Mexico'
nla
CQ;orado TN00003
New York
11742
-
Cannedlcut PH-0197
North Carolina
Env375
Florida E87487
North Carolina
DW21704
Georgia NELAP
North Carolina 3
41
Georgia 923
North Dakota
R-140
Idaho TN00003
Ohio-VAP
CL0069
Illinols 200008
Indiana C-TN-01
Oklahoma
Oregon
9915
TN200002
Iowa 364
Pennsylvania
68-02979
Kansas E-10277
Rhode Island
LA000356
Kentucky' a 90010
South Carolina
84004
Kentucky' 16
South Dakota
Na
Louisiana A130792
Tennessee' °
2006
Louisiana' LA180010
Texas
T104704245-18-15
Maine TN0002
Texas'
LA80152
Maryland 324
Utah
TN00003
Massachusetts M-TNO03
Vermont
VT2006
Michigan 9958
Virginia
460132
Minnesota 047-999-395
Washington
C847
Mississippi TN00003
West Virginia
233
Missouri 340
Wisconsin
9980939910
Montana CERT0086
Wyoming
A21A
A2LA- ISO 17025 1461.01
A]HA-LAP,LLC EMLAP
100789
A2LA- ISO 17025' 1461.02
DOD
1461.01
Canada 1461.01
USDA
P330-15-00234
EPA-Crypto TN00003
' Drinking Water 'Underground Storage Tanks 3 Aquatic Toxicity ° ChemicaUMicroNological `Mold 'Wastewater nla Accreditation not applicable
Pace National has sixty-four client support centers that provide sample pickup and/o, the delivery of sampling supplies. If you would like assistance from one of our support offices, please contact
our main office. Pace National performs all testing at our central laboratory.
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NV �
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Billing Information:
MaiWsis/Container
Preservative
:pain of Custody Page _of_
EMA ttesourees
Mr. Brent Collins Pres
755 Yadkinvjlle Road Chk
{
755 Yadhlnville Road
Mocksville, NC 27028
Mocksvaf3le, NC 27028
12M t<wmnw QE
Report to- Email To: brentcollins€uemaresourcesimcan
Mr. Brent Collins
laaet TN a712Phone: 615-75a.5a5!
Project CityJState ,-I
WQtM411` 4,a-
r1i—ZM76z-�9f fa,:6lsna-5es9 ❑�,
', Collected:
Descrippo•n'NfJs^'^s��
L ■
1 7A
Phone: [phone]
Client Project p
Lab Project g
Fax: [phone]
"
d
Collected Foy (print):
Site/Facility ID it
P.O. a
.-
ifenum; (MARES
Trrrlplate:TS1413
'collected t�sy (signature):
2uote #
Rush. (Lab MUST Bee Notified)
v
Same Day _Five Day
J
P7loi?�i.' P684634
_ Next Day _ 5 Day (Rid Onpl Date Results Needed
zi
-
TSRt M -Ca pdra. Fayter'
Immediately /
_ Two Day _ 10 Day (Rid Only) No
7
I
PEI:-1 F'
Packedon Ice N_ Y v
_Three Day of
o
.,
-
*ppedV� FedEX4rourtd �
Sample ID
Comp/Grab
Matrix' Depth
Date
Time
.ntrs
U
nem,rb samPteapah oNyl
- —
l
t-
-
55
8'�PM"'
2
%
X
_�
.
I; i
3_
-
11
r
1 ___1
I — —
11
Matrix:Remarks:
sdrola Re io# crt
SS -Soil AIR -Air F- Filter
pH Temp
{R'6 &va$t-Piea$rtt 1!0t_ t •,—Y -P
3Qn.¢lAceuzatep
GW - Groundwater B - Sioassay
- —F
tiatt3*a arY;va intiCCt1 f„R �,p
WIN -Wastewater
Flow Other
F.orr�tt:liotttas used3'_ .�-.
OW - Drinkin at
OT - Otherri
Samp)esr vfa: _
FedEx.
SUitficlent oSmme-rents" �S N-
_lips 1y -Courier, _ - TrackFrt¢k
-_ � _�
Ifiaurvatiot xlctfc5heckgpol.,,.
Relinquishedb (Signature)
Date:
Time:
Received by: (Signature)
t1 Blank Received. Yes No
HL[Nreofl
TBR
Relinquished by; (Signature)
Date:
Time:
Received by: (Signature)
IpmR .; C t 141Reahied:'
If PreserJatfon required by Logim 0ite/Time
Relinquished by: (Signaturel
Date.
Time
Received forts )
TWO: -.Hold:-
rate-. }}
-,
_
y

Washington WWTP
TKN
37600
mg/kg
2nd yr min. rate
NH3
9300
mg/kg
3rd yr min. rate
Organic N
28300
mg/kg
4th yr min. rate
NO2NO3
128
mg/kg
5th yr min. rate
1st yr min. rate
0.2
%
I st year PAN Calculation (Surface)
Lbs/DT PAN = [min. rate x (TKN - NH3) + (.5NH3) + NO2NO31 x .002
Lbs/DT = 0.2 28300 4650 128 x .002
Lbs/DT = 20.876
Zind year Residual PAN Calculation
L bs/DT PAN = [min. rate yr 2 x (1st yr organic N - 2nd yr mineralized organic N)] x .002
Lbs/DT = 1 0.10 28300 5660 x .002
Lbs/DT = L 4.53
3rd year Residual PAN Calculation
Lbs/DT PAN = [min. rate yr 3 x 2nd yr organic N - 3rd yr mineralized organic N)] x .002
Lbs/DT = 0.05 22640 2264 x .002
Lbs/DT = 2.04
4th year Residual PAN Calculation
Lbs/DT PAN = [min. rate yr 4 x (3rd yr organic N - 4th yr mineralized organic N)] x .002
Lbs/DT = 0.025 20376 1019 x .002
Lbs/DT = 0.97
5th year Residual PAN Calculation
Lbs/DT PAN = [min. rate yr 5 x (4th yr organic N - 5th yr mineralized organic N)] x .002
Lbs/DT = 0.0125 19357 484 x 002
Lbs/DT = 0.47
Five Year Maximum Adjusted PAN = 28.88 Lbs/DT
Five Year Maximum Adjusted PAN = 14441 mg/kg
0.1
0.05
0.025
0.0125

L_ Washington WWTP
TKN
37600
mg/kg
2nd yr min. rate
NH3
9300
mg/kg
3rd yr min. rate
Organic N
28300
mg/kg
4th yr min. rate
NO2NO3
128
mg/kg
5th yr min. rate
1st yr min. rate
0.2
%
7styear PAN Calculation (injection)
Lbs/DT PAN = [min. rate x (TKN - NH3) + NH3 + NO2NO31 x .002
Lbs/DT = 0.2 28300 9300 128 x .002
Lbs/DT = 30.18
2nd year Residual PAN Calculation
Lbs/DT PAN = (min. rate yr 2 x (1 st yr organic N - 2nd yr mineralized organic N ] x .002
Lbs/DT = 0.10 28300 5660 x .002
Lbs/DT = 4.53
3rd year Residual PAN Calculation
Lbs/DT PAN = [min. rate yr 3 x (2nd yr organic N - 3rd yr mineralized organic NJ x .002
Lbs/DT = 0.05 22640 2264 x .002
Lbs/DT = 2.04
4th year Residual PAN Calculation
Lbs/DT PAN = [min. rate yr 4 x (3rd yr organic N - 4th yr mineralized organic N) x .002
Lbs/DT = 0.025 20376 1019 1 x .002
Lbs/DT = I 0.97
5th year Residual PAN Calculation
Lbs/DT PAN = [min. rate yr 5 x (4th yr or anic N - 5th yr mineralized organic N) x .002
Lbs/DT = 0.0126 19357 484 1 x .002
Lbs/DT = 0.47
Five Year Maximum Adjusted PAN = F 38.18 1 Lbs/DT
Five Year Maximum Adjusted PAN = 19091 mg/kg
0.1
0.05
0.025
0.0125

Waypointo
ANALYTICAL
11 /12/2019
EMA Resources Inc
Mr. Brent Collins
755 Yadkinville Rd
Mccicsville, NC, 27028
Re?: Analytical Testing
Lab Report Number: 19-305-0044
Client Project Description: Washington
2790 Whitten !toad, Memphis, TN 38133
Main 901.213.2400 0 Fax [phone]
www.waypointana"ca Isom
Dear Mr. Brent Collins:
Waypoint Analytical, LLC. received sample(s) on 11/1/2019 for the analyses presented in the following report.
The above referenced project has been analyzed per your instructions. The analyses were performed in
accordance with the applicable analytical method. Where the laboratory was not responsible for the sampling
stage (refer to the chain of custody) results apply to the sample as received.
The analytical data has been validated using standard quality control measures performed as required by the
analytical method. Quality Assurance, method validations, instrumentation maintenance and calibration for all
parameters (NELAP and non-NELAP) were performed in accordance with guidelines established by the USEPA
(including 40 CFR 136 Method Update Rule August 2017) and NELAC unless otherwise indicated. Any
parameter for which the laboratory is not officially NELAP accredited is indicated by a' —'symbol. These are not
included in the scope because NELAP accreditation is either not available or has not been applied for. Additional
certifications may be held/are available for parameters, where NELAP accreditation is not required or applicable.
A full list of certifications is available upon request.
Certain parameters (chlorine, pH, dissolved oxygen, sulfite...) are required to be analyzed within 15 minutes of
sampling. Usually, but not always, any field parameter analyzed at the laboratory is outside of this holding time.
Refer to sample analysis time for confirmation of holding time compliance.
The results are shown on the attached Report of Analysis(s). Results for solid matrices are reported on an as -
received basis unless otherwise indicated. This report shall not be reproduced except in full and relates only to
the samples included in this report.
Please do not hesitate to contact me or client services if you have any questions or need additional information.
Sincerely,
Danyale Love
Project Manager
Laboratory's liability in any claim relating to analyses performed shall be limited to, at laboratory's option, repeating the
analysis in question at laboratory's expense, or the refund of the charges paid for performance of said analysis.
Alabama #40750 Louisiana #04015 VA NELAP #460181 Texas #T104704180 Arkansas #88-0650
Misssssippl California #2904 NC #415 Oklahoma #9311 SC #84002
Kentucky #90047 Tennessee #TN02027 EPA #TN00012 Kentucky UST #80215 PA DEP #68-03195
it i -

SAR
SAR Calculation
Na Ca Mg SAR
-�.451 25.313 6.688 1.113
Enter Enter .% TS
Data L--Na mg/kg
Ca mg/kg
Mg mg/kg
;Job Name: Washington WWTP
Page 1
Na mg/I
!Ca mg/l
Mg mg/I
102.375
506.25
80.25
Na mil eq
Ca mil eq
[Mg mil eq
4.451
25.313
J 6.688
3.75
2730
13500
2140

Waypoint.0
ANALYTICAL
Client: EMA Resources Inc
Project: Washington
Lab Report Number: 19-305-0044
Date: 11 /12/2019
2790 Whitten Road, Memphis, TN 38133
Main 901.213.2400 V Fax [phone]
www.waypointanalyt#cal.com
CASE NARRATIVE
Metals Analysis Method 6010D
Sample 88457 (Washington)
Analyte: Aluminum
QC Batch No: L462827/1-462465
The matrix spike and/or the matrix spike duplicate was outside quality control acceptance ranges. A dilution test
was performed and passed quality control acceptance ranges. No matrix interference is suspected.
Analyte: Calcium
CC Batch No: 1-462827/1-462465
The matrix spike and/or the matrix spike duplicate was outside quality control acceptance ranges. A post
digestion spike was performed and passed quality control acceptance ranges. No matrix interference is
suspected.
Analyte: Iron
CC Batch No: 1-462827/1-462465
The matrix spike and/or the matrix spike duplicate was outside quality control acceptance ranges. A dilution test
was performed and passed quality control acceptance ranges. No matrix interference is suspected.
Analyte: Potassium
QC Batch No: L463094/1-462465
The matrix spike and/or the matrix spike duplicate was outside quality control acceptance ranges. A post
digestion spike was performed and passed quality control acceptance ranges. No matrix interference is
suspected.
Analyte: Manganese
QC Batch No: 1-462827/1-462465
The matrix spike and/or the matrix spike duplicate was outside quality control acceptance ranges. A dilution test
was performed and passed quality control acceptance ranges. No matrix interference is suspected.
Analyte: Zinc
QC Batch No: 1-462827/1-462465
The matrix spike and/or the matrix spike duplicate was outside quality control acceptance ranges. A post
digestion spike was performed and passed quality control acceptance ranges. No matrix interference is
suspected.

a�
Waypoint
2790 Whitten Road, Memphis, Tip 38133
Main
901.213.2400 0 Fax [phone]
ANALYTICAL
wsww.waypointanalytical.com
46245
E"A Resources Inc
Mr_ Brent Collins
Project Washington
Report Date : 11/12/2019
755 Yadkinville Rd
Information :
Received : 11/01/2019
MacksMle , NC 27028
K)
Danyale Love
Report Number :19-305-0044
REPORTOFAMALYSIS
Project Manager
Lab No : 88457
Matrix:
Solids
Sample ID: Washington
Sampled: 10/31/2019 8:30
Test
Results
Units
MDL
MQL
DF
Date ! Time
By Analytical
Analyzed
Method
Moisture
96.3
%
0.010
1
11/04/1917:45
ADM SW-DRYWT
Ammonia Nitrogen
9300
mg/Kg - dry
676
1
11/12/19 15:00
JPJ 4500NH3C-2011
Nitrate+Nitrite-N
<128
mg/Kg - dry
128
128
1
11/06/19 14:24
ZBD 4500NO3F-2011
Organic N
28270
mg/Kg - dry
37.84
1886
1
11/12/19 15:00
CALCULATION
pH
7.1
S.U.
1
11/11/19 06:22
JSL 9045D
Total Solids
3.75
%
0.010
0.010
1
1l/04/19 17:45
ADM 254OG-2011
Total Volatile Solids
45.6
%
0.010
0.010
1
11/04/19 17:45
ADM 254OG-2011
Total Kjeldahl Nitrogen
37600
mg/Kg - dry
1890
1
11/12/19 15:38
CLP 4500NORGD-2011
Phosphorus
15400
mg/Kg - dry
69.5
135
1
11/06/19 01:54
KKM 6010D
Aluminum
34300
mg/Kg - dry
54.9
135
1
11/06/19 01:54
KKM 6010D
Arsenic
<11.3
mg/Kg - dry
11.3
13.5
1
11/06/19 01:54
KKM 6010D
Cadmium
<1.34
mg/Kg - dry
1.34
2.70
1
11/06/19 01:54
KKM 6010D
Calcium
13500
mg/Kg - dry
454
676
1
11/06/19 01:54
KKM 6010D
Chromium
26.5
mg/Kg - dry
5.14
6.76
1
11/06/19 01:54
KKM 6010D
Copper
124
mg/Kg - dry
3.92
6.76
1
11/06/19 01:54
KKM 6010D
Iron
17000
mg/Kg - dry
115
135
1
11/06/19 01:54
KKM 6010D
Lead
17.8
mg/Kg - dry
4.03
8.11
1
11/06/19 18:51
BKN 6010D
Magnesium
2140
mg/Kg - dry
60.0
135
1
11/06/19 01:54
KKM 6010D
Manganese
411
mg/Kg - dry
4.95
13.5
1
11/06/19 01:54
KKM 6010D
Mercury
0.884
mg/Kg - dry
0.0900
0.408
1
11/06/19 14:57
-US 7471A
Molybdenum
<3.51
mg/Kg - dry
3.51
6.76
1
11/06/19 01:54
KKM 6010D
Nickel
13.6
mg/Kg - dry
4.46
6.76
1
11/06/19 01:54
KKM 6010D
Potassium
2260
mg/Kg - dry
80.5
135
1
11/06/19 18:51
BKN 6010D
Qualifiers/ DF
Dilution Factor
L
Limit Exceeded
Definitions MQL
Method Quantitation Limit

Waypoint "
ANALYTICAL
46245
E14A Resources Inc
Mr. Brent Collins Project Washington
755 Yadkinviile Rd Information
MoCks*e , NC 27028
Report Number :19-305-0044
Lab iVo : 88457
Sample ID : Washington
Test
2790 Whitten Road, Memphis, TN 38133
Main 901.213.2400 0 Fax [phone]
www.waypointanalytical.com
Report Date : 11/12/2019
--Received : 11/01/2019
Via' `6Q - Q-ug-
Danyale Love
Project Manager
Matrix: Solids
Sampled: 10/31/2019 8:30
Results Units MDL MQL DF Date / Time By Analytical
Analyzed Method
REPORT OFANALYMS
Selenium
<13.2
mg/Kg - dry
13.2
13.5
1
11/06/19 01:54
KKM
6010D
Sodium
2730
mg/Kg - dry
209
676
1
11/06/19 01:54
KKM
6010D
Zinc
370
mg/Kg - dry
29.2
33.8
1
11/06/19 01:54
KKM
6010D
Sulfur
4950
mg/Kg - dry
132
135
1
11/06/19 01:54
KKM
6010D
Sodium Absorption Ratio
<2.22
Ratio
2.22
5.00
1
11/06/19 01:54
CALCULATION
Quaf Piers/ DF
Definidons
Dilution Factor
L Limit Exceeded

ANALYTICAL
2790 Whitten Road, Memphis, TN 38133
Bain 901.213.2400 'Fax [phone]
www.waypointanalytical.com
Cooler Receipt Form
Customer Number: 46245
Customer Name: EMA Resources Inc
Report Number: 19-305-0044
Shipping Method
10 Fed Ex U US Postal U Lab
U UPS U Client U Courier
U Other
Thermometer ID:
r56
Shipping container/cooler uncompromised?
Yes
U No
Number of coolers received
1
Custody seals intact on shipping container/cooler?
U Yes
U No
Not Required
Custody seals intact on sample bottles?
U Yes
U No
Not Required
Chain of Custody (COC) present?
• Yes
U No
COC agrees with sample label(s)?
0 Yes
U No
COC properly completed
• Yes
U No
Samples in proper containers?
Yes
No
Sample containers intact?
Yes
U No
Sufficient sample volume for indicated test(s)?
0 Yes
U No
All samples received within holding time?
i Yes
U No
Cooler temperature in compliance?
* Yes
U No
Cooler/Samples arrived at the laboratory on ice.
Samples were considered acceptable as cooling
process had begun.
! Yes
U No
Water - Sample containers properly preserved
U Yes
U No
N/A
Water - VOA vials free of headspace
U Yes
U No
N/A
Trip Blanks received with VOAs
U Yes
U No
0 N/A
Soil VOA method 5035 — compliance criteria met
C Yes
U No
N/A
High concentration container (48 hr) Low concentration EnCore samplers (48 hr)
High concentration pre -weighed (methanol -14 d) Low conc pre -weighed vials (Sod Bis -14 d)
Soecial precautions or instructions included?
Yes
No
Comments
Signature: ''Sovanchampa Yos Date & Time: 11/01/2019 09:49:56

G1entN--mejAddress
client Project Manager/Contact
Stiffing Information
( For Laboratory Use Only
EMA R40-Sources Inc
Brent Collins
Account #46245
755 YadkinviAe Rd
MoCkSwille, NC 27028
Project caetoiption
Project/Site Location (Cdy/State)
RUSH-Additionat charges apply
Special Umit(s)
Me of Shi nt Mat& Rey
Fed Ea UPS ❑USPS WW -Wastewater GW- Groundwater
Date Results Needed
s.ItsDeteNeeded
rier Client Drop Off DW-Drinking Water S- Soil/Solld O-Oil
P - Product M • Misc
Other
Project r4,umber
Project Manager Phone 11
Project Manager Em"
Purchase Order Number Ste/FacilityIb a
336-399-3646
[e-mail]
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Date
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Sample Identification
Required
Analysts/preservative
Commends/Notes
)013(
b'3D
4s
141C
✓
✓
✓
✓
✓
✓
Metals:Al,As,Ca,Cd,Cr,Cu,Fe,Pb
M n, M g, Mo, Hg , N i, Se, Na, P, S, K, 2n
35
;
f
ashin Wm 094915
For
tabormtory Use Only
Sampled by (Name - Print)
Ra cJl6r�k.r
Client Remarks/Comments
Sludge Samples -Report Dry Weight
j�e
Custody
Sea
lab Comment;
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Relinqui :( ,NA E)
—
Date Time
ReQt by [SIGNATURE)
Date Time
Blank/C rr mp
RekO d Y: (Slr A
Date Time
Received by: (SIGNATURE)
Date Time
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bate Time
Receive by: I GN U RE)
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Page 6 of 6

Merltech, Inc.
Environmental Laboratory
WOO Laboratory Certification No.165
Contact: Brent Collins
Report Date: 4/24/2019
Client: EMA Resources, Inc
755 Yadkinville Road
Mocksville, NC 27028
Date Sample Rcvd: 3/18/2019
Vector Attraction Reduction
1 Aerobically Digested Sludge (30 Day Test)
Meritech Work Order # 03181954
Sample: Washington Composite 3/18/19
Total Solids
Volatile Solids
% Volatile Solids
Wek 1 1.13
0.700
0.620
Week Z 1.20
0.750
0.626
Week 3 1.26
0.750
0.591
Week 4 0.830
0.530
0.641
Week 5 0.870
0.560
0.640
Pliss or Fail
Van Kleek Reduction (%): -9.12
Pass
I hereby certify that I have reviewed and approve these data.
Laboratory Representative
642 Tamco Road, Reidsville, North Carolina 27320
tel.[phone] fax.[phone]

s
Chain of Custody Record (COC)
NPDES#:
Client: EMA Resources Inc. Phone:
336-751-1441
ME RITCIG INC.
DAddress:
755 Yadkinville Rd Fax:
336-751-1442
ENVIRONMENTAL LABORATORIES
Mocksville NC 27028 Email:13)ejri
642 Tamco Rd. Phone: [phone]
Project:
Reidsville NC 27320 Fax: [phone]
P.O.#:
Email: [e-mail]
Attention:_ Brent Collins
Turn Around Time`
How would you like your report sent?
*RUSH work needs prior approval.
11 W .meritechiabs.irom
Circle all that appi Email referred), Fax, Mail
Strd(10da ) 3=5 Da s 24-4914n
Sampling Dates & Times
person Taking Sample (Sign/print):
Lab Use Only
Sample location and/or ID #
Start
End
Comp?
#of
Test(s) Required
On Ice?
pH OK?
Date
Time
Date
Time
Grab?
Cont.
Yes / No
CI OK?
hiai%x+ n ��t�vtn�
3%IFf/19
8 }r3�i,�
C
t
Temperature upon
Method Of
Receipt .
"i° Dechlorination (<0.5 prn) of Ammonia. anide, Phenol and TKN samples must be done in the field prior to preservation.
Shipment_
Comments:
Compositor #
Imo: UPS
--
#
Fed Ex
Are these results for regulatory purposes? Yes
"-Jug
� No C Report results in: mg/L mg/kg t.�� ug/L
Wand Relive rY
R mq ' d -- -"— ""- Date:
// ?Do+r
Tirr�e: Received by:
17;1 //9
Dat : Time:
Other
Relinquis Da e:
3��8� 9
Time: Received by:
�: 03 .►.
Date: Time:,
Rarrnqu shed by. oate:
rime: Receivedb Lab:
J `
Dad'-l.irne: I �.
Y

Date: 10/1 /2019
Location #
1
3
A
5
6
7
Summary Sheet
Fecal Coliforms
Pathogen Reduction
MPN/g
3688.5
4192.9
4500
3550.3_
3742.2
4235.3
3765.7
Log
3.5668
3.6225
3.6532
3.5503
3.5731
3.6269
3.5758
3940
Geometric Means/g
Total Dry Solids
Signature

AXE DATE / TIME
sampled By —" C 5
teceived By (% Vi
►nalyzed By 48 hr. CheckI�
:
alculated By / ✓ �a /�_' �` ! /_ r-
:hccked By
FECAL COLIFORM TEST
Standard Methods 9221 C E-2006(MPN)(Aqueous)
Presumptive Test
72 hr. Check 10-y--I�q.0�
24 hr. Check
'.T
J
1rFf . s- 0 c
Sample Location SIQd�C_# j
Sample Type: Grab x Composite
Preservation: _ NONE
mL Sample 0.001 0.0001 0.00001 0.000001 0.0000001 0.00000001 MPN
24 hours t -1- ELL
•— — — + — — — — — —
I I j
48 hours —
Fecal Coliform Test
mL Sample 0.001 0.0001 0.00001 0.000001 0.0000001 0.00000001 MPN
24 hours •— — — < 1.
VIPN Fecal Coliform/g = 10 x MPN index / 100 ml
largest volume X % dry solids tested
Sterility Control
Quality Control Tubes 10 mL
Double Strength (DS Control : NCH v-e
Single Strength (SS) Control {' ,i
EC Broth Control
devised 5-23-16
MPN/g = 10 x 1_� __ _ %b � �O � • � �!°,�i/k
Ddol X �i-S�- �! • �Q�
t
Fecal Coliform Test
mL Sample 0.001 0.0001 0.00001 0.000001 0.0000001 0.00000001 MPN
24 hours •— — — < 1.
VIPN Fecal Coliform/g = 10 x MPN index / 100 ml
largest volume X % dry solids tested
Sterility Control
Quality Control Tubes 10 mL
Double Strength (DS Control : NCH v-e
Single Strength (SS) Control {' ,i
EC Broth Control
devised 5-23-16
MPN/g = 10 x 1_� __ _ %b � �O � • � �!°,�i/k
Ddol X �i-S�- �! • �Q�
t
devised 5-23-16
MPN/g = 10 x 1_� __ _ %b � �O � • � �!°,�i/k
Ddol X �i-S�- �! • �Q�
t

sampled
C�AE
DATE 1 TIME
By
j 0-11 q
Zeceived By
analyzed BY
Ldciu
10-1-1 �j7 l n a `�
calculated By
:�heckedBy
-/6 /CT�
24 hr. Check - �49
48 hr. Check 0 0 #
72 hr. Check Ip +1 3-; ZtJ
Temp �5�� °C
Sample Location sludl e # -�
Sample Type: Grab x Composite
Preservation:. NONE
FECAL COLIFORM TEST
Standard Methods 9221 C E-2006(MPN)(Aqueous)
PreeumnfivP Taef
ple0.001
0.0001
0.00001
0.000001
00000001
0.00000001
MPN
rs
f24
-f
�-
—
—
—
—
—
+—rs
—
—
--
mL Sample j 0.001 0.0001
24 hours — F-Y
VIPN Fecal Coliform/g = _ _. _ _10 x MPN index / 100 ml_.
largest volume X % dry solids tested
Sterilitv Control
Fecal Coliform Test
0.00001 1 0.000001 0.0000001
Quality Control Tubes
10 mL
Double Strength (DS Control
4.v-e
Single Strength (SS) Control
'{ -1 ' A
EC Broth Control
L�
Zevised 5-23-16
MPN/g = 10 x
©• c�ol�c. -� 11 0.OQ��I
0.00000001 MPN
•� i , e
I
t

Li
DATE / TIME
iem °C
Sampled By
� • _ _ _ e
JkL 9 —9 p
Sample Location Slu file #
c.
—
Zeceived By
1 r , -•,
24 hr. Check - _ cj $�
r� q _ Sample Type: Grab x Composite
Ualyzed By
/9-I -I �jT/ �.
48 hr. Check -, ffib Preservation: NONE
--
calculated By
�q�
�L
t7 C7
72 hr. Check 10-iF��p34-,-�-�w
::hecked By
h2-10 9. / 5-1
FECAL COLIFORM TEST
Standard Methods 922I C E-2006(MPN)(Agueous)
Presumptive Test
mL Sample
0.001
0.0001
0.00001 0.000001 0.0000001
0.00000001 MPN
24 hours —
_ — +
— —
— — — — _
48 hours
—.
—
—_ _
Fecal Coliform Test
mL Sample
0.001-1
0.0001
0.00001 0.000001 0.0000001 1
0.00000001 MPN
24 hours
-r — —
MPN Fecal Coliform/g = _ 10 x M.PN index / 100 ml _. -
largest volume X % dry solids tested
MPN/g = IO x , 0
00l i `,
�7
(j
Sterility Control
Quality Control Tubes
10 mL
Double Strength (DS) Control
t .'V-e
Single Stren
ih (SS) Control
r -.
EC Broth Control
Q i
Revised 5-23-16
a
9

� A� DATE / TIME
Sampled By �_ J r) !-1 �1 y S ip
Received BY �. _ _ _ _ ' U`}_+� 1� !0 l -t �� U4
Analyzed By , p
Calculated By i•„(,r'
Checked By 1D /D��i 15SD1
24 hr. Check -_.;(-, 01,�$i
48 hr. Checkli-;.1
72 hr. Check Ip-�}�3T� si.J
Sample Location Sludge #
Sample Type: Grab x Composite
Preservation: • NONE
FECAL COLIFORM TEST
Standard Methods 9221 C E-2006(MPN)(Aqueous)
Presumptive Test
mL Sample 0.001 0.0001 0.00001 0.000001 0.0000001 0.00000001 MPN
24 hours — — — — — — 48 hours �"Ell —
Fecal Coliform Test
mL Sample 0.001 0.0001 0.00001 0.000001 0.0000001 0.00000001 MPN
24 hours — —
MPN Fecal Coliform/g = 10 x MPN index / 100 ml
largest volume X % dry solids tested
Sterility Control
Quality Control Tubes 10 mL
Double Strength (DS) Control v�
Single Strength (SS) Control 1 •1 wC
EC Broth Control r ��
Revised 5-23-16
MPN/g = 10 x / d j� DC) 1 I��l
0 00/ !y. 0p p ©©1 ' 1

j4, 5
°C
i A E
DATE / TIME
T imp
sampled By
CJ�c/i���l-�
t
� - �
g ,-`'--
Sample Location SIUft
e #
Received By
'•� UJ ���
� / -I �! �a�
�-
24 hr. Check �
11L�-►1, Sample Type: Grab x
Composite
Analyzed By
1
�D-i�1 �� �a-I
48 hr. Check �' 1 p
� 1�{� Preservation: NONE
Calculated By
^ '
/d q 163P
72 hr. Check�)q, 1�7ot.)
Checked By
��J �cr 1 53D I
FECAL COLIFORM TEST
Standard Methods 9221 C E-2006(MPN)(Aqueous)
Presumptive Test
mL Sample
0.001
0.0001
0.00001 0.000001 0.0000001
0.0000:::P� 0001 MPN
24 hours �
-}- _
_ _ _
48 hours
—
— . f- _
_ _
Fecal Coliform Test
mL Sample
24 hours
0.001
_
0.0001
0.00001 0.000001 0.0000001
MPN
F.0.00000001
<1_SS
MPN Fecal Coliform/g = -__ 10 x M.PN index / 100 ml
largest volume X % dry solids tested
Sterilitv Control
Quality Control Tubes
10 mL
Double Strength S) Control
, Wfl, of
Single Strength (SS) Control
I.{4• - .
EC Broth Control
-
Revised 5-23-16
MPN/g = 10 x 49

7
Tmp
aC
�%G�i
DATE / TIME
'
�-� .s
0c
Sampled By
)_ a j
Sample Location stud e
#
teceived By
n�
f`�
r ( �%,�
24 hr. Check f Q_ q Sample Type: Grab x Composite _.
knalyzed By
,
I p-1 Ji a r) 4
48 hr. Check / _-zPreservation: NONE
lalculated By
fQd--L. DL
10.1 %9 4:- . r
72 hr. Check )p-y-j� zn: -FruJ
Mecked By
to �0 /q� I5
FECAL COLIFORM TEST
Standard
Methods 9221 C E-2006(MPN)(Aqueous)
Presumptive Test
mL Sample
0.001
0.0001
0.00001
0.000001
0.0000001
0.00000001
MPN
24 hours
-
-
-
-
-
-
-
-
-
-
-
-
]]
48 hours
4-
-
14
1 -
-1
-
-
-1
1
1
1
1
1
1
1
1
I-z I
Fecal Coliform Test
mL Sample
0.001
0.0001
0.00001
0.000001
0.0000001
0.00000001
MPN
24 hours
- -
-
-
VIPN Fecal Coliform/g = _ 10 x MPN index / 100 ml
largest volume X % dry solids tested
Sterilitv Control
Quality Control Tubes
10 mL
Double Strength (DS) Control
' o- ; N -V-0-
Sin le Strength (SS) Control
A ; A
EC Broth Control
, iz y I'Lo-
Revised 5-23-16
MPN/g = 10 x / 9 _ 19 _

DATE /TIME
Sampled By
C�A
JIB I.1 l 1�0
Received By
��JJ
- � ' 4-
knalyzed By
Calculated By
Checked By
Temp 95.c; °C
.aA,5 °C
Sample Location _ Sjudg,e #
24 hr. Check !n,2-►(11, 94(X Sample Type: Grab x Composite -_
48 hr. Check jf2l��2
. _. AD Preservation:, NONE_
_ .
72 hr. Check 10 s1-14. l0 3 iv -lfjtJ
FECAL COLIFORAI TEST
Standard Methods 9221 C E-2006(MPN)(Aqueous)
Presumptive Test
mL Sample 0.001 0.0001 0.00001 0.000001 0.0000001
24 hours -;- — {- — — — — — — — — —
48 hours — —
0.00000001 1 MPN
Fecal Coliform Test
mL Sample 0.001 0.0001 0.00001 0.000001 0.0000001 0.00000001 MPN
24 hours
MPN Fecal Coliform/g = 10 x MPN index / 100 ml
largest volume X % dry solids tested
Sterilitv Control
Quality Control Tubes
10 mL
Double Strength (DS) Control
Single Strength (SS) Control
EC Broth Control
J
Revised 5-23-16
MPN/g = 10 x _ _ _
X ,5 o
r

NAPE DATE / TIME
Sampled By �i��-' .G jo 1 Ig nq
Received BY � � Z/J�r� �p•�-/� ���
Analyzed By I Q 1-1',-fit 1
Calculated By,
Checked BY
24 hr. Check
48 hr. Check; Tlhaz AT)
72 hr. Check Ip /a
44.5
Temp h °C
4,4,s Oc
Sample Location Slud ie # -+
Sample Type: Grab x Composite
Preservation: NONE
FECAL COLIFORM TEST
Standard Methods 4221 C E-2006(MPN)(Aqueous)
Praemm"fiva T"f
mL Sample
24 hours
0.001
— —
0.0001
—
0.00001
IL
0.000001
0.0000001
0.00000001
48 hours
—
mL Samp]
24 hours
Fecal Coliform Test
0.001 0.0001 0.00001 0.000001 0.0000001 0.00000001
MPN Fecal Coliform/g = 10 x MPN index / 100 ml
largest volume X % dry solids tested
Sterility Control
Quality Control Tubes 10 mL
Double Strength (DS) Control .t ; 'Ve
Sin!le Strength (SS) Control
EC Broth Control J� •(� ��
Revised 5-23-16
MPN
MPN
-.e, r i
MPN/g = 10 x %� � — — � � � �.J � � .� • � ��Rl�
I

CITY OF WHSHINGTON
SLUDGE
Standard Methods 2540 G-201 1 (Aqueous)
Name
Date/Time
Sampled By
Received By
�,
:i"t
Analyzed By
4
►O d` 1
Calculated By
Checked By
�'�,
ld
9.;2fj
Time on water bath
I
Time in oven
s
Time out of oven
�► �1
Time weighed
1st
'
2nd
io38��oi+i
DTI'
C•.
Sm#
aple Si-
Evaporating Dish #
Sample #
Evaporating Dish #
r
Wet Weight + Dish Weight
0113. 1
Wet Weight + Dish Weight
i as ZC1% I
Dish Weight
-IL-AV al�,Ji
Dish Weight
-1160-1(a , q
i Wet Weight
5C �''� : �i
Wet Weight
--
1 st Dry Weight +Dish Weight
, —� b
1st Dry Weight +Dish Weight
L Li
011
2nd Dry Weight + Dish Weight
la `�j
2nd Dry Weight + Dish Weight
Difference in 1st & 2nd Dry Weight+
Dish Weight (2nd - 1st
�,-:
Difference in 1st & 2nd Dry Weight+
Dish Weight (2nd - 1st)
6 .
Dry Weight (2nd Dry Weight + Dish
Weight - Dish Weight)
_
� -H ,�
Dry Weight (2nd Dry Weight+ Dish
Weight -Dish Weight)
ar:�Gy , 5
% Dry Solids ((Dry Weight / Wet
„
y
% Dry Solids ((Dry Weight / Wet
Weight) x 100)
i
5,1{ 1Y/•
Weight) x 100)
���
"Note -Differences should agree within 4% or 0.5 mg, which ever is less
Revised 9/26/19 JDW

N
Sampled By
(�
Received Byy�'
Analyzed By�i
Calculated By
Checked By
Sample #
Wet Weight +
Dish Weight
CITY OF WASHINGTON
SLUDGE
Standard Methods 2540 G-201 1 (Aqueous)
DateMme
ratina Dish # I N
Dish Weight %'7'��J�a.1
Wet Weight
1st Dry Weight +Dish Weight
2nd Dry Weight + Dish Weight
Difference in 1st & 2nd Dry Weight+
Dish Weight (2nd - 1st)
Dry Weight (2nd Dry Weight+ Dish
Weight - Dish Weight)
% Dry Solids ((Dry Weight / Wet
Weight) x 100)
1
�SP�&'o�3�`q
0. 0
Time on water bath
Time in over
Time out of over
Time weighec
Sample #
Wet Weight + Dish W
Dish
Wet Weight
1 st Dry Weight + Dish Weight
2nd Dry Weight+ Dish Weight
Difference in 1st & 2nd Dry Weight +
Dish Weight (2nd -1st)
Dry Weight (2nd Dry Weight+ Dish
Weight- Dish Weight)
% Dry Solids ((Dry Weight 1 Wet
Weight) x 100)
'Note -Differences should agree within 4% or 0.5 mg, which ever is less
Revised 9126119 JDW
1st
2nd
EvaDoratina Dish # �
4i

CITY OF WHSHINGTON
SLUDGE
Standard Methods 2540 G-201 1(Aqueous)
Name Date/Time
Sampled By
Received By
Analyzed By
Calculated By
Checked By
Time on water batF
Time in over
Time out of over
Time weighec
1st
2nd
(A'33 Goµ
CAI -
3 i
L c la
-k\
Sample # �'
Evaporating Dish # 1 t�
Sample #
Evaporating Dish #
Wet Weight + Dish Weight
i 1 �7 y.�
Wet Weight + Dish Weight
Dish Weight
-159
Dish Weight
Wet Weight
Wet Weight
1 st Dry Weight + Dish Weight
a�
1st Dry Weight + Dish Weight
2nd Dry Weight + Dish Weight
2nd Dry Weight + Dish Weight
Difference in 1 st & 2nd Dry Weight +
Dish Wei Fit (2nd - 1st)
-�
Difference in list & 2nd Dry Weight+
Dish Weight (2nd -1st)
Dry Weight (2nd Dry Weight+ Dish
Weight - Dish Weight)
1
Dry Weight (2nd Dry Weight+ Dish
Weight - Dish Weight)
% Dry Solids ((Dry Weight I Wet
Weight) x 100)
% Dry Solids ((Dry Weight / Wet
Weight) x 100)
*Mote -Differences should agree within 4% or 0.5 mg, which ever is less
Revised 9126119 JDW
1
.a

Sampled By
Received By
Analyzed By
Calculated By
Checked By
Sample #
Wet Weight
CITY OF M-k6HINGTON
SLUDGE
Standard Methods 2540 G-201 1 (Aqueous)
%� Date/Time
W
2Yita" � �I i t_t-f _I? �. - Time on water bath
3 ' �1td Time in over
Time out of over
Time weighec
+ Dish Weight
Dish Weight
Wet Weight
1 st Dry Weight + Dish Weight
� � t
:vaporating Dish # I
but 0-7 . -
2nd Dry Weight + Dish Weight I b 6^"'a1 '55 �-
Difference in 1st & 2nd Dry Weight + I
_ Dish Weight (2nd -1st) V • 1
Dry Weight (2nd Dry Weight+ Dish
Weight - Dish Weight)
% Dry Solids ((Dry Weight r wet y 1
Weight) x 100)
*Note -Differences should agree within 4% or 0.5 mg, which ever is less
Revised 9/26/19 JDW
Sample #
Wet Weight + Dish Weight
Dish Weight
Wet Weight
1 st Dry Weight + Dish Weight
2nd Dry Weight + Dish Weight
Difference in 1 st & 2nd Dry Weight +
Dish Weight (2nd - 1st)
Dry Weight (2nd Dry Weight+ Dish
Weight- Dish Weight)
% Dry Solids ((Dry Weight / Wet
Weight) x 100)
1st
2nd
orating Dish #

CITY OF ",.1.)'HINGTON
SLUDGE
Standard Methods 2540 G-201 1 (Aqueous)
Name Date/Time
Sampled By _ 10/,
Received By 1c,1111i Z7,2i Time on water bath
Analyzed By ic?1 4l L Time in oven
Calculated By Time out of oven
Checked By p�p�, /p 9 Time weighed
1st 2nd
ca
i t
tl`�l 1v-t j
Sample #
5L:9-7
Evaporating Dish #
G
Sample #
Evaporating Dish #
9l 14, _�
Wet Weight + Dish Weight
Wet Weight + Dish Weight
Dish Weight
.-IIIA 233. to
Dish Weight
Wet Weight
SO 4,9
Wet Weight
1 st Dry Weight + Dish Weight
1 st Dry Weight + Dish Weight
i
2nd Dry Weight+ Dish Weight
2nd Dry Weight+ Dish Weight
Difference in 1st & 2nd Dry Weight +
0D
Difference in 1st & 2nd Dry Weight +
Dish Weight (2nd - 1st)
• y
Dish Weight (2nd -1st)
Dry Weight (2nd Dry Weight+ Dish
Dry Weight (2nd Dry Weight+ Dish
Weight - Dish Weight)
�` ��� o
Weight - Dish Weight)
% Dry Solids ((Dry Weight ! Wet
Weight) x 1DO)
% Dry Solids ((Dry Weight / Wet
% Weight) 100)
x
*Note -Differences should agree within 4% or 0.5 mg, which ever is less
Revised 9/26/19 JDW

LAND APPLICATION SITE CERTIFICATION
Applicant's name: City of Washington
Land application sites currently certified: 1308.50 net acres and Total to be certified: 682.18 net acres.
1. LAND APPLICATION SITE INFORMATION (See Instruction B):
Status
Code'
D
Site/Field
ID
BF202-11
Landowner(s)
Lessee(s) or Operator(s)
Net Acres
17.50
County
Beaufort
Crop(s)
Predominant Soil
Mapping Unit
Series Nameb
or Rep. Slope°
J.D. Briley
D
BF202-31
J.D. Briley
9.60
Beaufort
D
BF202-32
J.D. Briley
30.60
Beaufort
D
BF202-72
J.D. Briley
6.70
Beaufort
D
BF202-73
J.D. Briley
4.90
Beaufort
J
D
BF204-71
J.D. Briley
8.80
Beaufort
D
BF204-72
J.D. Briley
34.50
Beaufort
M
BF210-01
Hunter's Roost Farms
14.22
Beaufort
Com/Beans/Small Grain
Craven
CrB
M
BF210-02
BF210-03
BF210-04
Hunter's Roost Farms
26.81
Beaufort
Corn/Beans/Small Grain
Com/Beans/Small Grain
Goldsboro
Goldsboro
Goldsboro
GoA
M
Hunter's Roost Farms
7.72
Beaufort
Beaufort
GoA
M
Hunter's Roost Farms
64.02
Corn/Beans/Small Grain
GoA
M
BF210-05
Hunter's Roost Farms
15.92
Beaufort
Hay/Pasture
Rains
Ra
M
BF210-06
Hunter's Roost Farms
15.14
Beaufort
Corn/Beans/Small Grain
Lenoir
Le
M
BF210-07
Hunter's Roost Farms
11.82
Beaufort
Corn/Beans/Small Grain
Lenoir
Le
M
BF210-08
Hunter's Roost Farms
19.21
Beaufort
Com/Beans/Small Grain
Lenoir
Le
M BF210-09
M BF210-10
M BF210-11
Hunter's Roost Farms
Hunter's Roost Farms
Hunter's Roost Farms
23.41
Beaufort
Beaufort
Beaufort
Corn/Beans/Small Grain
Craven
CrA
14.33
Hay/Pasture
Craven
CrA
8.46
Hay/Pasture
Craven
CrA
M BF210-12
Hunter's Roost Farms
29.08
Beaufort
Corn/Beans/Small Grain
Goldsboro
GoA
M
BF210-13
Hunter's Roost Farms
24.99
Beaufort
Hay/Pasture
Craven
CrB
M
BF210-14
Hunter's Roost Farms
6.32
Beaufort
Com/Beans/Small Grain
Goldsboro
GoA
M
BF210-15
Hunter's Roost Farms
13.48
Beaufort
Corn/Beans/Small Grain
Lynchburg
Ly
FORM: LASC 06-16 Page l

LAN® APPLICATION SITE CERTIFICATION
I`r M
BF 210-16
Hunter's Roost farms
! M
B 210-23
1lunter's Roast Farmm
1
-���---D
P103-01
J.D. Briley
-
- -
D -
P103-03--
J.D. Briley
—
1)
P103-04
J.U. Briley
U
P103-05
J.D. Briley
1)
1)103-06
J.D. Briley
- _-
I)
P103-07
J.D. Briley
1)
P103-08
J.D. Briley
D
P103-09
J.D. Briley
M
P1200-01
Marjorie Barnhill
M
P1200-02
Marjorie Barnhill
M
P1200-03
Marjorie Barnhill
M
P1200-04
Marjorie Barnhill
M
P1201-01
Congleton Fauns
T T
M
P1201-02
Congleton Farms
M
i P1201-03
Congleton Farms
M
P1201-04
Congleton Farms
M
P1201-05
Congleton Farms
M
P1201-06
Congleton Fauns
M
P1201-07
Congleton Farms
M
PI201-08
Congleton Farms
M
P1201-09
Congleton Farms
M
P1201-10
Congleton Farms
M
P1201-11
Congleton Farms
M
P1201-12
}
Congleton Farms
- f
i
E M
P1201-13
Congleton Farms
M
P1.201- l4
Congleton Farms
M
P1201-15
Congleton Fauns
25.44
Beaufort
Beaufort
CornlBea Amall Grain Craven
Conn/Beans/Small Grain ' Lynchburg
12.73
69.90
Pitt
74.40
Pitt
45.60
Pitt
20.50
Pitt
164.00
Pitt
66.30
Pitt
—
59.60
Pitt
59.60
Pitt
20.13
Pitt
Corn/Beans/Small Grain
Lenoir
14.75
Pitt
Corn/Beans/Small Grain
Exum
8.36
Pitt
Corn/Beans/Small Grain
Lenoir
8.58
Pitt
Corn/Beans/Small Grain
Craven
7.46
Pitt
Corn/Beans/Small Grain
Lenoir
49.40
Pitt
Corn/Beans/Small Grain
Extun
7.25
Pitt
Corn/Beans/Small Grain
Lenoir
41.04
Pitt
ConVBeans/Small Grain
Goldsboro
4.23
Pitt
Corn/Beans/Small Grain
Goldsboro
3.75
48.69
Pitt
Pitt
Corn/Beans/Small Grain
Lenoir
Conn/Beans/Small Grain
Lenoir
8.74
Pitt
Corn/Beans/Small Grain
Lenoir
4.87
Pitt
Corn/Beans/Small Grain
Exum
10.07
Pitt
Conn/Beans/Small Grain
Exum
17.64
Pitt
Corn/Beans/Small Grain
Exum
12.33
Pitt
Corn/Beans/Small Grain
Exum
9.15
Pitt
Corn/Beans/Small Grain
Exum
39.93
Pitt
Com/Beans/Small Grain
Exum
6.92
Pitt
Corn/Beans/Small Grain
Goldsboro
M,`
Ly
LoA
ExA
LoA
CrB
LoA
ExA
LoA
GoA
GoB
LoA
LoA
LoA
ExA
ExA
ExA
ExA
ExA
ExA
GoA
FORM: LASC 06-I6 - - —� — �— - — — Page 2

LAND APPLICATION SITE CERTIFICATION _
NM P1201-16 Congleton Farms 5.37 Pitt
4 P1201-17 Congleton Farmsf 10.44 Pitt
ff
I M PI201-18 Congleton Farms 9.98 Pitt
�'o1 lCkeaasi�mallOrain Craven r•"r�
Corn/Beans/Small Grain Goldsboro GoA
Corn/Beansi/Small Grain Goldsboro GoA
FORM: LASC 06- l6 Page 3

State of North Carolina
WR
Department of Environmental Quality
Division of Water Resources
` D15A NCAC 02T .1100 — LAND OWNER AGREEMENT
Division of Water Resources
FORM: LOA 06-16
Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted. the Applicant shall submit one original and two coNes of the application and
su ortin documentation
For more.information, visit the Water Quality Permitting Section's Non -Discharge Permitten Unit.
General — This document is an agreement between the Applicant and land owner(s) of residuals receiving sites for land application of
Class B residuals (may include water treatment plant or other type residuals) in accordance with 15A NCAC 02T .1100. Do not submit
this agreement for review without a corresponding application form (FORM: RLAP 06-16).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Land Owner Agreement (FORM: LOA 06-16):
❑ Submit the completed and appropriately executed Land Application Site Certification (FORM: LASC 06-16) form. Please do
not make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to
the application may be made, as long as the attachments are numbered to correspond to the section and item to which they
refer.
❑ Prepare a separate agreement for each set of land application sites that are owned or operated by an entity other than the
Applicant.
❑ A copy of the completed and appropriately executed agreement must be provided to the landowner and the lessee/operator.
AGREEMENT FOR THE LAND APPLICATION OF RESIDUALS TO PRIVATELY OWNED LAND
The undersigned landowner or his representative hereby permits:
Applicant's name: Cir. of Washington
hereinafter referred to as the Permittee, to land apply residuals from the following facility(ies) onto the following land
application site(s) (i.e., see attached setback maps) in accordance with the stipulations and restrictions as given in this
Agreement:
Site/Field ID
Lease
es/no
(Y )
+ Land Use or
Cropping Patterns
PP� g
Intended Use of Crops
Residuals Source Special note
(optional) (no-tilUover-seed/
pasture)
- s - o I
��
ew CRo�S
F -r-a t
-
- -abo- o
ROB
oo - 0
% 5
'J]�oLA) CRoPi -5
z - to - °
1 S
I
The landowner or his representative receives, in consideration, full use of the nutrient value of the applied residuals while the
Permittee receives, in consideration, the use of the land application site(s) described above for the disposal of the residuals.
This Agreement shall remain in effect for the length of the Division's permit for the residuals land application program and
shall be renewed each time this permit is renewed.
The undersigned landowner or his representative and the Permittee agree to abide with the following restrictions and
stipulations until such time as written notification, given 30 calendar days in advance, modifies or cancels this Agreement.
FORM: LOA 06-16 Page 1 of 3

j, STIPULATIONS:
1• The landowner or his representative shall not enter into any additional residuals application contracts or agreements with another permitted
entity for the site(s) specified by this Agreement.
2• Should the landowner or his representative lease or otherwise permit the use of the land application site(s) to a third party, the landowner shall
be responsible to ensure that the third party agrees and complies with the terms and conditions of this Agreement.
3• The landowner or his representative shall adhere to the provisions of this Agreement until all of the site restrictions (under Section II) are met.
4• Notification of cancellation of this Agreement shall be immediately forwarded to NCDENR-DWR, Non -Discharge Permitting Unit, 1617 Mail
Service Center, Raleigh, NC 27699-1617.
5. The Permittee must request and obtain a permit modification from the Division prior to a transfer of the land application site(s) to a new
landowner. In addition, the current landowner shall give a notice to the new landowner that gives full details of the residuals applied at the land
application site(s).
6• The Permittee has provided the landowner or his representative with information and data concerning the residuals land application program,
including an analysis of constituents of the residuals, residuals application methods, schedules for typical cropping patterns, a description of the
equipment used by the Permittee.
7. The Permittee will provide the landowner or his representative with a copy of the residuals permit prior to commencement of any residuals land
application event and a copy of the results of each soil analysis.
8. If the soil pH of the land application site(s) is not maintained at 6.0 or greater, sufficient amounts of lime shall be applied to achieve a final soil
pH of at least 6.0, unless an agronomist provides information indicating that the pH of the soil, residuals and lime mixture is suitable for the
specified crop.
9. The landowner or his representative and the Permittee will agree on residuals application rates and schedules based on crop patterns, results of
soil samples, and the permitted application limits.
10. The landowner or his representative will provide the Permittee with information regarding the amount and analysis of other sources of nutrients
(e.g., fertilizer, unregulated animal waste, etc.) that have been applied to the land application site(s).
11. The landowner or his representative will inform the Permittee of any revisions or modifications to the intended use and cropping patterns for
the land application site(s) prior to each planting season to enable the Permittee to amend this Agreement and schedule residuals land application
events at appropriate periods.
12. Specific residuals land application area boundaries shall be clearly marked on the land application site(s) by the Permittee, the landowner, or
his representative prior to and during a residuals land application event.
13. The landowner or his representative hereby authorizes the Permittee, local officials, and State officials or their representatives to; enter and
inspect any property, premises, or place on or related to the land application site(s) at any reasonable time for the purpose of determining
compliance with the permit; establish monitoring facilities on or near the land application site(s) as required by the permit; copy any records
that must be kept under the terms and conditions of the permit; take necessary leachate, surface water, groundwater, or soil samples during the
term of, and 12 months after termination of, this Agreement.
II. RESTRICTIONS:
I. Appropriate measures must be taken by the Permittee and/or the landowner or his representative to control public access to the land application
site(s) during active use and for the 12-month period following a residuals land application event. Such controls may include the posting of
signs that indicate the activities being conducted at the land application site(s).
2. Animals shall not be grazed on the land application site(s) for a 30-day period following a residuals land application event. Land application
sites that are to be used for grazing shall have fencing that will be used to prevent access during these periods after such residuals land application
events.
3. Food crops, feed crops, and fiber crops shall not be harvested for a 30-day period following a residuals land application event.
4. Food crops with harvested parts that touch the residuals/soil mixture and are totally above the land surface shall not be harvested for a 14-month
period following a residuals land application event.
5. Food crops with harvested parts below the surface of the land shall not be harvested for a 20-month period following a residuals land application
event when the residuals remain on the land surface for four months or longer prior to incorporation into the soil.
6. Food crops with harvested parts below the surface of the land shall not be harvested for a 38-month period following a residuals land application
event when the residuals remain on the land surface for less than four months prior to incorporation into the soil.
7. Turf grown on land where residuals are applied shall not be harvested for a 12-month period following a residuals land application event.
III. ALTERNATIVES FOR WATER SUPPLY WELLS INSIDE THE COMPLIANCE BOUNDARY: (please check one)
I5A NCAC 02L .0107(d) prohibits water supply wells within the compliance boundary. However, 15A NCAC 02T .01051h) allows the compliance
boundary to be placed closer to the waste disposal area, such that the water supply well is situated outside of the compliance boundary provided
the groundwater standards can be met at the newly -established compliance boundary. Please mark one of the following;
❑ A re -defined compliance boundary is needed for field(s) ID:
(Please include the rationale for the requested re -location of the compliance boundary and attach a map showing the newly proposed compliance
boundary to the application package)
® A re -defined compliance boundary is not needed for this site.
IV. ACKNOWLEDGEMENT OF FIELD TRANSFER: (if needed)
❑ The land application field(s) ID: is currently permitted under another
residuals land application program; Permit Number WQ: The land owner hereby acknowledge that by signing this
agreement, he/she is requesting that the field(s) be removed from the previously permitted residuals land application program and transferred
into the new nroeram:
(Name of the new program)
FORM LOA 06-16 Page 2 of 3

Landowner's Certification:
I certify that I am a deeded landowner of the above -referenced land application site(s) and am authorized to make decisions
regarding the use of the land application site(s) on behalf of other deeded landowners OR that I am otherwise authorized, through
a power of attorney or other legal delegation, to make decisions regarding the use of the land application site(s) on behalf of the
deeded landowners. I certify that the above -referenced land application site(s) are not included in any waste disposal contract or
agreement with another municipality, contractor, or other permitted entity. Furthermore, I certify that I have read this Agreement,
understand the stipulations, restrictions, alternatives for water supply wells inside the compliance boundary, acknowledgement of
field transfer, and do hereby grant permission to the Permittee to land apply residuals to the land application site(s) as specified
herein. `
Landowner name: A TO ZE IC _ 3/41? V 9ZC6
Address: t` is oX IO
City: _ S _ State: %Y C Zip:
Phone: ,2.S;Z - ! - -mail address:_
.0
Signature: Date: 1 - 2 I
NORTH CAROLINA, P. A- COUNTY
I, the undersigned Notary Public do hereby certify that _j; f lV10.4A; J1 _
personally appeared before me this day and acknowledged the due execution of the forgoing instrum `i ANT (;0
WITNESS my hand and official seal this the 2/ s� a� ``�'%���_
S � �pTAgy S
day of ��_iiouev�.� 20 / 9
Zgyp, ��
v�L�G (}
Signature and seal: 0-
My commission expires
Lessee's/Operator's Certification:
2/7/?v z I
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Lessee/operator name:
sic Gj N ;tTrWU es
Address: 11,5-A -7 R o
City: :� — K& 5 State
Permittee's Certification:
C Zip: -7 IN4
Date: //4_1 ,/ J
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Signing official name: Adam Waters - Public Works Director
Signature: AD&t
Date:_ It / ZD1/q
FORM: LOA 06-16 Page 3 of 3

SITE SUMMARY
Site ID:
NC-PI-200
Owner:
Marjorie R. Barnhill
Address:
P.O. Box 10
Stokes, NC 27884
Phone:
252-714-3584
Operator:
Tim Whitehurst
Address:
4527 Oakley Road
Stokes, NC 27884
Phone:
252-531-0233
Field#
Total Acres
Net Acres
Crop(s)
Soil Series
1
26.2
20.13
Row Crops
Lenoir
2
15.1
14.75
Row Crop
Exum
3
8.36
8.36
Row Crops
Lenoir
4
9.27
8.58
Row Crops
{ Goldsboro
Totals
58.93
51.82
Latitude &
Longitude
35°41'51" N
77°12'39" W
35°41'45" N
77°12'08" W
35°41'42" N
77'12'17" W
35°41'38" N
77"12'15" W

VICINITY MAP
Marjorie R. Barnhill
Site: NC-PI-200
Tm
r.lri �-.mm
Scale 1 25.000
i
11" 2,033.3 ft Data Zoom 1, 3-1.

Topo USA® 8
N 4.
N
-AL-
i I I p 6 -h d - D a M-' - Shepard
mn
=7
7.1tl
I ,e
TOPOGRAPHIC MAP
Mariorie R. Barr hiffl T.N :0 on Scale 1: 12,800
P.',N
Site: NC-PI-200 s,1 1,066.7 ft Data Zoom li --1
Fields: 1, 2, 3 & 4

f (-
i fIF
� FF33
fir
1/7 >011,
1
4
s� 4 y
. o
- + a
S Structure a
Field Total Acres Applicable Acres '
1 On Site Dwelling
26.2 20.13
2 15.1 14.75 ■ Off Site Dwelling
3 8.36 8.36 Buffer
4 _ 9.27 8.58 _
REFERENCE: Pond s
GIS DATA LAYERS WERE OBTAINED FROM XXXXXX. PLEASE NOTE THIS MAP IS FOR INFORMATIONAL
PURPOSES ONLY, IT IS NOT MEANT FOR DESIGN. LEGAL, OR ANY OTHER USES. THERE
RESPONSIBILITY
ARE NO
Field BoundaryGUARANT�ESABOUT;TSACC!'RACY EMARESOURCES :NC. ASSUMESFOR
E�
NO R ES PONSI BILITY FO R DECISION MADE OR ANYACTI-ONS TAKEN BY THE USER BASED UPON THIS INFORMATION.
scALE: Property Boundary
1 ° = 600,
FIGURE NO. E.
°"rF. 12-03-19
B�/r� City of Washington
11 �r�l Land Application Program
DRAT%N 8Y- C
-Resources, In.c.
'ROJECT N0 NC-PI-200
W 0 01026 Marjorie Barnhill

DWR
State of North Carolina
Department of Environmental Quality
Division of Water Resources
jilDlvlsion of Water Resources 15A NCAC 02T .1100 — LAND OWNER AGREEMENT
FORM: LOA 06-16
Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted. the Applicant shall submit one original and two co lies of the a > >lication and
su: porting, documentation
For more information, visit the TVater Quality Permitting Section's Xon-Dischange Permitting Unit.
General — This document is an agreement between the Applicant and land owner(s) of residuals receiving sites for land application of
Cl ass B residuals (may include water treatment plant or other type residuals) in accordance with 15A NCAC 02T .1100. Do not submit
this agreement for review without a corresponding application form (FORM: RLAP 06-16).
unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Land Owner Agreement (FORM: LOA 06-16):
❑ Submit the completed and appropriately executed Land Application Site Certification (FORA: LASC 06-16) form. Please do
not make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to
the application may be made, as long as the attachments are numbered to correspond to the section and item to which they
refer.
❑ Prepare a separate agreement for each set of land application sites that are owned or operated by an entity other than the
Applicant.
❑ A copy of the completed and appropriately executed agreement must be provided to the landowner and the lessee, operator.
AGREEMENT FOR THE LAND APPLICATION OF RESIDUALS TO PRIVATELY OWNED LAND
The undersigned landowner or his representative hereby permits:
Applicant's name: City of Washington
hereinafter referred to as the Permittee, to land apply residuals from the following facilitr•(ies) onto the following land
application site(s) (i.e., see attached setback maps) in accordance with the stipulations and restrictions as given in this
Agreement:
Lease Land Case or Residuals Source Special note `
Site/Field ID Intended Use of Crop
(yes/no) Cropping Patterns s no-tilUover-seed/
( (optional)
i pasture)
Q ll.o
2oLJ SOPS_ 1=LL7 ` -TAa 2
The landowner or his representative receives, in consideration, full use of the nutrient value of the applied residuals while the
Permittee receives, in consideration, the use of the land application site(s) described above for the disposal of the residuals.
This Agreement shall remain in effect for the iength of the Division's permit for the residuals land application program and
shall be renewed each time this permit is renewed.
The undersigned landowner or his representative and the Permittee agree to abide with the following restrictions and
stipulations until such time as written notification, given 30 calendar days in advance, modifies or cancels this Agreement.
FORM: LOA 06-16
Page l of

I. STIPULATIONS:
I • The landowner or his representative shall not enter into any additional residuals application contracts or agreements with another permitted
entity for the site(s) specified by this Agreement.
2. Should the landowner or his representative lease or otherwise permit the use of the land application site(s) to a third party, the landowner shall
be responsible to ensure that the third party agrees and complies with the terms and conditions of this Agreement.
3. The landowner or his representative shall adhere to the provisions of this Agreement until all of the site restrictions (under Section II) are met.
4. Notification of cancellation of this Agreement shall be immediately forwarded to NCDENR-DWR, Non -Discharge Permitting Unit, 1617 Mail
Service Center, Raleigh, NC 27699-1617.
5. The Permittee must request and obtain a permit modification from the Division prior to a transfer of the land application site(s) to a new
landowner. In addition, the current landowner shall give a notice to the new landowner that gives full details of the residuals applied at the land
application site(s).
6. The Permittee has provided the landowner or his representative with information and data concerning the residuals land application program,
including an analysis of constituents of the residuals, residuals application methods, schedules for typical cropping patterns, a description of the
equipment used by the Permittee.
7. The Permittee will provide the landowner or his representative with a copy of the residuals permit prior to commencement of any residuals land
application event and a copy of the results of each soil analysis.
8. If the soil pH of the land application site(s) is not maintained at 6.0 or greater, sufficient amounts of lime shall be applied to achieve a final soil
pH of at least 6.0, unless an agronomist provides information indicating that the pH of the soil, residuals and lime mixture is suitable for the
specified crop.
9. The landowner or his representative and the Permittee will agree on residuals application rates and schedules based on crop patterns, results of
soil samples, and the permitted application limits.
10. The landowner or his representative will provide the Permittee with information regarding the amount and analysis of other sources of nutrients
(e.g., fertilizer, unregulated animal waste, etc.) that have been applied to the land application site(s).
11. The landowner or his representative will inform the Permittee of any revisions or modifications to the intended use and cropping patterns for
the land application site(s) prior to each planting season to enable the Permittee to amend this Agreement and schedule residuals land application
events at appropriate periods.
12. Specific residuals land application area boundaries shall be clearly marked on the land application site(s) by the Permittee, the landowner, or
his representative prior to and during a residuals land application event.
13. The landowner or his representative hereby authorizes the Permittee, local officials, and State officials or their representatives to; enter and
inspect any property, premises; or place on or related to the land application site(s) at any reasonable time for the purpose of determining
compliance with the permit; establish monitoring facilities on or near the land application site(s) as required by the permit; copy any records
that must be kept under the terms and conditions of the permit; take necessary leachate, surface water, groundwater, or soil samples during the
term of, and 12 months after termination of, this Agreement.
II. RESTRICTIONS:
I. Appropriate measures must be taken by the Permittee and/or the landowner or his representative to control public access to the land application
site(s) during active use and for the 12-month period following a residuals land application event. Such controls may include the posting of
signs that indicate the activities being conducted at the land application site(s).
2. Animals shall not be grazed on the land application site(s) for a 30-day period following a residuals land application event. Land application
sites that are to be used for grazing shall have fencing that will be used to prevent access during these periods after such residuals land application
events.
3. Food crops, feed crops, and fiber crops shall not be harvested for a 30-day period following a residuals land application event.
4. Food crops with harvested parts that touch the residuals/soil mixture and are totally above the land surface shall not be harvested for a 14-month
period following a residuals land application event.
5. Food crops with harvested parts below the surface of the land shall not be harvested for a 20-month period following a residuals land application
event when the residuals remain on the land surface for four months or longer prior to incorporation into the soil.
6. Food crops with harvested parts below the surface of the land shall not be harvested for a 38-month period following a residuals land application
event when the residuals remain on the land surface for less than four months prior to incorporation into the soil.
7. Turf grown on land where residuals are applied shall not be harvested for a 12-month period following a residuals land application event.
III. ALTERNATIVES FOR WATER SUPPLY WELLS INSIDE THE COMPLIANCE BOUNDARY: (please check one)
15A NCAC 02L .0I07(d) prohibits water supply wells within the compliance boundary. However, 15A NCAC 02T .0105i hl. allows the compliance
boundary to be placed closer to the waste disposal area, such that the water supply well is situated outside of the compliance boundary provided
the groundwater standards can be met at the newly -established compliance boundary. Please mark one of the following;
❑ A re -defined compliance boundary is needed for field(s) ID:
(Please include the rationale for the requested re -location of the compliance boundary and attach a map showing the newly proposed compliance
boundary to the application package)
® A re -defined compliance boundary is not needed for this site.
IV. ACKNOWLEDGEMENT OF FIELD TRANSFER: (if needed)
❑ The land application field(s) ID: _ _ is currently permitted under another
residuals land application program; Permit Number WQ: The land owner hereby acknowledge that by signing this
agreement. he/she is requesting that the field(s) be removed from the previously permitted residuals land application program and transferred
into the new program_
(Name of the new program)
FORM: LOA 06-16 Page 2 of 3

Landowner's Certification:
1 certify that I am a deeded landowner of the above -referenced land application site(s) and am authorized to make decisions
regarding the use of the land application site(s) on behalf of other deeded landowners OR that I am otherwise authorized, through
a power of attorney or other legal delegation, to make decisions regarding the use of the land application site(s) on behalf of the
deeded landowners. I certify that the above -referenced land application site(s) are not included in any waste disposal contract or
agreement with another municipality, contractor, or other permitted entity. Furthermore, I certify that I have read this Agreement,
understand the stipulations, restrictions, alternatives for water supply wells inside the compliance boundary, acknowledgement of
field transfer, and do hereby grant permission to the Permittee to land apply residuals to the land application site(s) as specified
herein.
Landowner name: _ W :t G C L 0,nl C. r yo nI
Address: i?. O , BqX /S'.S
City: o xC—'S _ State: A/C
PhoneI 6_9 '7� ? 7 2 -mail address:
Signature: - - 4;;;�
JPr
NORTH CAROLINA, Y•f4-
COUNTY
-zip:$
Date: n /
I, the undersigned Notary Public do hereby certify that , (( n /s4* — - _ AtItV V14
personally appeared before me this day and acknowledged the due execution of the forgoing instrt�no 9�EN T C0`k'''
WITNESS my hand and official seal this the f ti
TA
day of _ llvv{woe- 20 / 9
--
Signature and seal: _ %7j� ?C)
My commission expires: _ �71Z OZ / "P;,1 �oU ,%,�,
Lessee's/Operator's Certification:
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Lessee/operator name: —
Address:
City:
Phone:
Signature: —
Permittee's Certification:
_ State: _ _ Zip: —
E-mail address:
Date:
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Signing official name: Adam Waters — Public Works Director
Signature:
FORM: LOA 06-16
Date: / O
Page 3 of 3

SITE SUMMARY
Site ID:
Owner:
Address:
Phone:
Operator:
Field#
1
NC-PI-201
Will Congleton
P.O. Box 155
Stokes, NC 27884
252-752-9129
Same
Total Acres
10.29
M:252-717-3722
Net Acres
7.46
2
50.24
49.4
3
7.79
7.25
4
42.67
41.04
5
5.86
4.23
6
4.86
3.75
7
50.9
48.69
8
8.98
8.74
9
7.89
4.87
10
11.39
10.07
11
18.94
17.64
12
12.8
12.33
13
10.83
9.15
14
56.01
39.93
15
9.37
6.92
16
8.55
5.37
17
10.87
10.44
18
17.32
9.98
TOTALS
345.56
297.26
Crop(s)
Row Crops
Row Crops
Row Crops
Row Crops
Row Crops
Row Crops
Row Crops
Row Crops
Row Crops
Row Crops
Row Crops
Row Crops
Row Crops
Row Crops
Row Crops
Row Crops
Row Crops
Soil Series
Latitude &
Longitude
Lenoir
35°43'56" N
77"15'39" W
Exum
35°43'48" N
77°15'53" W
Lenoir
35'43'53" N
77°15'54" W
Goldsboro
35'43'53" N
77"16'02" W
Goldsboro
35°43'57" N
77'16'12" W
Lenoir
35"44'03" N
77'16'10" W
Lenoir
35'43'59" N
_
77"14'30" W
Lenoir
35°43'50" N
77°14'36" W
Exum
35'44'44" N
77°14'11" W
Exum
35°44'48" N
77"14'16" W
Exum
_
35°44'59" N
77'14'20" W
Exum
35°44'51" N
77-14'14" W
Exum
35"44'59" N
77'14'07" W
Exum
35°45'10" N
77'14'09" W
Goldsboro
35'42'42" N
77'15'19" W
Craven
35'42'37" N
77"15'09" W
Goldsboro
35°42'27" N
77"15'01" W
Goldsboro
35'42'27" N
77°15'02" W

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REFERENCE:
GIS DATA LAYERS WERE OBTAINED FROM XXXXX.X. PLEASE NOTE. THIS MAP IS FOR INFORMATIONAL ® Buffer
PURPOSES CNLY. !T!S NOT MEANT FOR DESIGN LEGAL. OR ANY OTHER USES. THERE ARE NO _
GUARANTEES ABOUT ITS. ACCURACY. EMA RESOURCES INC ASSUMES NO RESPONSIBILITY FOR ANY -Isms • �
DECISION MADE OR ANYACTIONS TAKEN BY THE USER BASED UPON THIS INFORMATION.1 Property Boundary
440' ..ti. City of Washington FIGURE"°.
DATE 12.03-19 Land Application Program �
DRAWN BY: _ � 2
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State of North Carolina
DWR
Department of Environmental Quality
Division of Water Resources
pDivislon of Water Resources 15A NC AC 02T .1100 — LAND OWNER AGREEMENT
FORM: LOA 06-16
please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted. the Applicant shall submit one original and two copies of the RP Ilication and
su ortinQ documentation
For more information, visit the lfater Quality Permitting Section's Non -Discharge Permitting Unit.
General - This document is an agreement between the Applicant and land owner(s) of residuals receiving sites for land application of
Class B residuals (may include water treatment plant or other type residuals) in accordance with 15A NCAC 02T .1100. Do not submit
this agreement for review without a corresponding application form (FORM: RLAP 06-16).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Land Owner Agreement (FORM: LOA 06-16):
❑ Submit the completed and appropriately executed Land Application Site Certification (FORM: LASC 06-16) form. Please do
not make any unauthorized content changes to this form. If necessary for clarity- or due to space restrictions, attachments to
the application may be made, as long as the attachments are numbered to correspond to the section and item to which they
refer.
❑ Prepare a separate agreement for each set of land application sites that are owned or operated by an entity other than the
Applicant.
❑ A copy of the completed and appropriately executed agreement must be provided to the landowner and the lessee,'operator.
AGREEMENT FOR THE LAND APPLICATION OF RESIDUALS TO PRIVATELY OWNED LAND
The undersigned landowner or his representative hereby permits:
Applicant's name: City of Washington
hereinafter referred to as the Permittee, to land apply residuals from the following facility(ies) onto the following land
application site(s) (i.e., see attached setback maps) in accordance with the stipulations and restrictions as given in this
Agreement:
Site/Field III) Lease land Use or Intended Use of Crops
(yes/no) Cropping Patterns
t _
c-0 1,- (cRDP ��
>,,,z"
NC - (---_jIn -o y 1 ��s �o t,J CROP ir$\) 4 r
Residuals Source
(optional)
Special note
(no-till/over-seed/
pasture)
-Ito -07+01 `ies /Z0LA)C
e - 9(7- 10 - l0 1
i �L 5 S -r-izL %iR 3� l �3 !'9[� dZ?%% logwige
At - BF-Aw, 15-t Iio UPCf2c)(D Fd� * F-r-3 eq- �
The landowner or his representative receives, in consideration, full use of the nutrient value of the applied residuals while the
Permittee receives, in consideration, the use of the land application site(s) described above for the disposal of the residuals.
This Agreement shall remain in effect for the length of the Division's permit for the residuals land application program and
shall be renewed each time this permit is renewed.
The undersigned landowner or his representative and the Permittee agree to abide with the fo?lowing restrictions and
stipulations until such time as written notification, given 30 calendar days in advance, modifies or cancels this Agreement.
FORM: LOA 06-16
Page 1 of _'•

I. STIPULATIONS:
1. The landowner or his representative shall not enter into any additional residuals application contracts or agreements with another permitted
entity for the site(s) specified by this Agreement.
2. Should the landowner or his representative lease or otherwise permit the use of the land application site(s) to a third party, the landowner shall
be responsible to ensure that the third party agrees and complies with the terms and conditions of this Agreement.
3. The landowner or his representative shall adhere to the provisions of this Agreement until all of the site restrictions (under Section II) are met.
4. Notification of cancellation of this Agreement shall be immediately forwarded to NCDENR-D WR, Non -Discharge Permitting Unit, 1617 Mail
Service Center, Raleigh, NC 27699-1617.
5. The Permittee must request and obtain a permit modification from the Division prior to a transfer of the land application site(s) to a new
landowner. In addition, the current landowner shall give a notice to the new landowner that gives full details of the residuals applied at the land
application site(s).
6. The Permittee has provided the landowner or his representative with information and data concerning the residuals land application program,
including an analysis of constituents of the residuals, residuals application methods, schedules for typical cropping patterns, a description of the
equipment used by the Permittee.
7. The Permittee will provide the landowner or his representative with a copy of the residuals permit prior to commencement of any residuals land
application event and a copy of the results of each soil analysis.
8. If the soil pH of the land application site(s) is not maintained at 6.0 or greater, sufficient amounts of lime shall be applied to achieve a final soil
pH of at least 6.0, unless an agronomist provides information indicating that the pH of the soil, residuals and lime mixture is suitable for the
specified crop.
9. The landowner or his representative and the Permittee will agree on residuals application rates and schedules based on crop patterns, results of
soil samples, and the permitted application limits.
10. The landowner or his representative will provide the Permittee with information regarding the amount and analysis of other sources of nutrients
(e.g., fertilizer, unregulated animal waste, etc.) that have been applied to the land application site(s).
11. The landowner or his representative will inform the Permittee of any revisions or modifications to the intended use and cropping patterns for
the land application site(s) prior to each planting season to enable the Permittee to amend this Agreement and schedule residuals land application
events at appropriate periods.
12. Specific residuals land application area boundaries shall be clearly marked on the land application site(s) by the Permittee, the landowner, or
his representative prior to and during a residuals land application event.
13. The landowner or his representative hereby authorizes the Permittee, local officials, and State officials or their representatives to; enter and
inspect any property, premises, or place on or related to the land application site(s) at any reasonable time for the purpose of determining
compliance with the permit; establish monitoring facilities on or near the land application site(s) as required by the permit; copy any records
that must be kept under the terms and conditions of the permit; take necessary leachate, surface water, groundwater, or soil samples during the
term of, and 12 months after termination of, this Agreement.
H. RESTRICTIONS:
1. Appropriate measures must be taken by the Permittee and/or the landowner or his representative to control public access to the land application
site(s) during active use and for the 12-month period following a residuals land application event. Such controls may include the posting of
signs that indicate the activities being conducted at the land application site(s).
2. Animals shall not be grazed on the land application site(s) for a 30-day period following a residuals land application event. Land application
sites that are to be used for grazing shall have fencing that will be used to prevent access during these periods after such residuals land application
events.
3. Food crops, feed crops, and fiber crops shall not be harvested for a 30-day period following a residuals land application event.
4. Food crops with harvested parts that touch the residuals/soil mixture and are totally above the land surface shall not be harvested for a 14-month
period following a residuals land application event.
5. Food crops with harvested parts below the surface of the land shall not be harvested for a 20-month period following a residuals land application
event when the residuals remain on the land surface for four months or longer prior to incorporation into the soil.
6. Food crops with harvested parts below the surface of the land shall not be harvested for a 38-month period following a residuals land application
event when the residuals remain on the land surface for less than four months prior to incorporation into the soil.
7. Turf grown on land where residuals are applied shall not be harvested for a 12-month period following a residuals land application event.
III. ALTERNATIVES FOR WATER SUPPLY WELLS INSIDE THE COMPLIANCE BOUNDARY: (please check one)
15A NCAC 02L .0107(d) prohibits water supply wells within the compliance boundary. However, 15A NCAC 02T .0105(hi allows the compliance
boundary to be placed closer to the waste disposal area, such that the water supply well is situated outside of the compliance boundary provided
the groundwater standards can be met at the newly -established compliance boundary. Please mark one of the following;
❑ A re -defined compliance boundary is needed for field(s) ID:
(Please include the rationale for the requested re -location of the compliance boundary and attach a map showing the newly proposed compliance
boundary to the application package)
® A re -defined compliance boundary is not needed for this site.
IV. ACKNOWLEDGEMENT OF FIELD TRANSFER: (if needed)
❑ The land application field(s) ID: _ is currently permitted under another
residuals land application program. Permit Number WQ: The land owner hereby acknowledge that by signing this
agreement, he/she is requesting that the field(s) be removed from the previously permitted residuals land application program and transferred
into the new program:
(Name of the new program)
FORM: LOA 06-16 Page 2 of 3

Landowner's Certification:
I certify that I am a deeded landowner of the above -referenced land application site(s) and am authorized to make decisions
regarding the use of the land application site(s) on behalf of other deeded landowners OR that I am otherwise authorized, through
a power of attorney or other legal delegation, to make decisions regarding the use of the land application site(s) on behalf of the
deeded landowners. I certify that the above -referenced land application site(s) are not included in any waste disposal contract or
agreement with another municipality, contractor, or other permitted entity. Furthermore, I certify that I have read this Agreement,
understand the stipulations, restrictions, alternatives for water supply wells inside the compliance boundary, acknowledgement of
field transfer, and do hereby grant permissiojto the Permittee to land a ply residuals to the land application site(s) as specified
herein. /
Landowner name:
Address:
2Zo n/
City: IJ e 51+7!" -7- WI/ State: WC_ _ Zip: *� 7 S ,& 5 _
Phone: — %`f s- ff 7 / E-mail address:
Signature: Date: / o
NORTH CAROLINA, Ben y 4w COUNTY % �0BENT I F#
I, the undersigned Notary Public do hereby certify that _ /441y ty IV;���$.�ton =�%�, << �
personally appeared before me this day and acknowledged the due execution of the forgoing instrulient.
WITNESS my hand and official seal this the 14
day of IyovemS ee , 20/ 9
/ji- 0
Signature and seal:
141111\\\
My commission expires:
Lessee's/Operator's Certification:
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
r
Lessee/operator name: (<N TC2 o o 67 2 wA-
Address: 17751 T6 n1 �/f % =o . Q)
City RS H err .Ca Joel State: 1 C Zip: ;2
Phone 6-2 " qq5_ r-7 /0 E-mail address:
Signature: d��7J� dG Date:
__o$�1441 ;c�
Permittee's Certification:
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Signing official name: Adam Waters — Public Works Director
Signature:
Date: / t Iz Z o f r
r
FORM: LOA 06-16 Page 3 of 3

"�, E� State of North Carolina
Department of Environmental Quality
#' { Division of Water Resources
DkIslon of Water Resources 15A NCAC 02T .1100 —LAND OWNER AGREEMENT
FORM: LOA 06-16
Tease use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
h0structions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
iffIfarmation requested. Failure to submit all of the required items will lead to additional processing and review time for the
prermit application. Unless otherwise noted. the &AIPlicant shall submit one on'Inal and two co ies of the a lication and
sei ortin documentation
For more information, visit the Water Quality Permitting Section's Aron-Discharve PermittinL. Unit.
General — This document is an agreement between the Applicant and land owner(s) of residuals receiving sites for land application of
Class B residuals (may include water treatment plant or other type residuals) in accordance with 15A NCAC 02T .1100. Do not submit
ttiis agreement for review without a corresponding application form (FORM: RLAP 06-16).
Umless Otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A_ Land Owner Agreement (FORM: LOA 06-16);
❑ Submit the completed and appropriately executed Land Application Site Certification (FORM: LASC 06-16) form. Please do
not make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to
the application may be made, as long as the attachments are numbered to correspond to the section and item to which they
refer.
Prepare a separate agreement for each set of land application sites that are owned or operated by an entity other than the
Applicant.
❑ A copy of the completed and appropriately executed agreement must be provided to the landowner and the lessee/operator.
AGREEMENT FOR THE LAND APPLICATION OF RESIDUALS TO PRIVATELY OWNED LAND
The undersigned landowner or his representative hereby permits:
Applicant's name: Cite of Washington
hereinafter referred to as the Permittee, to land apply residuals from the following facility(ies) onto the following land
application site(s) (i.e., see attached setback maps) in accordance with the stipulations and restrictions as given in this
Agreement:
Lease Land Use or Special note
Site/Field 1D Intended Use of Crops Residuals Source
(yes/no) Cropping Patterns (optional) (no-till/over-seed/
pasture)
-° 1 yes o�)ao
c - - - -0 y v - �o LZ CRo
ff�- -116 -07 f-DO qC3 RuLzC -eF 1D*
11C r3r I®-1 1 fit= 5 A5 7u,et rfiq S� C' rr -
C(2c�0 t
The landowner or his representative receives, in consideration, full use of the nutrient value of the applied residuals while the
Permittee receives, in consideration, the use of the land application site(s) described above for the disposal of the residuals.
This Agreement shall remain in effect for the length of the Division's permit for the residuals land application program and
shall be renewed each time this permit is renewed.
The undersigned landowner or his representative and the Permittee agree to abide with the following restrictions and
stipulations until such time as written notification, given 30 calendar days in advance, modifies or cancels this Agreement.
FORT 1: LOA 06-16 Page 1 of 3

I. STIPULATIONS:
1. The landowner or his representative shall not enter into any additional residuals application contracts or agreements with another permitted
entity for the site(s) specified by this Agreement.
2. Should the landowner or his representative lease or otherwise permit the use of the land application site(s) to a third party, the landowner shall
be responsible to ensure that the third party agrees and complies with the terms and conditions of this Agreement.
3. The landowner or his representative shall adhere to the provisions of this Agreement until all of the site restrictions (under Section II) are met.
4. Notification of cancellation of this Agreement shall be immediately forwarded to NCDENR-DWR, Non -Discharge Permitting Unit, 1617 Mail
Service Center, Raleigh, NC 27699-1617.
5. The Permittee must request and obtain a permit modification from the Division prior to a transfer of the land application site(s) to a new
landowner. In addition, the current landowner shall give a notice to the new landowner that gives full details of the residuals applied at the land
application site(s).
6. The Permittee has provided the landowner or his representative with information and data concerning the residuals land application program,
including an analysis of constituents of the residuals, residuals application methods, schedules for typical cropping patterns, a description of the
equipment used by the Permittee.
7. The Permittee will provide the landowner or his representative with a copy of the residuals permit prior to commencement of any residuals land
application event and a copy of the results of each soil analysis.
8. If the soil pH of the land application site(s) is not maintained at 6.0 or greater, sufficient amounts of lime shall be applied to achieve a final soil
pH of at least 6.0, unless an agronomist provides information indicating that the pH of the soil, residuals and lime mixture is suitable for the
specified crop.
9. The landowner or his representative and the Permittee will agree on residuals application rates and schedules based on crop patterns, results of
soil samples, and the permitted application limits.
10. The landowner or his representative will provide the Permittee with information regarding the amount and analysis of other sources of nutrients
(e.g., fertilizer, unregulated animal waste, etc.) that have been applied to the land application site(s).
11. The landowner or his representative will inform the Permittee of any revisions or modifications to the intended use and cropping patterns for
the land application site(s) prior to each planting season to enable the Permittee to amend this Agreement and schedule residuals land application
events at appropriate periods.
12. Specific residuals land application area boundaries shall be clearly marked on the land application site(s) by the Permittee, the landowner, or
his representative prior to and during a residuals land application event.
13. The landowner or his representative hereby authorizes the Permittee, local officials, and State officials or their representatives to; enter and
inspect any property, premises, or place on or related to the land application site(s) at any reasonable time for the purpose of determining
compliance with the permit; establish monitoring facilities on or near the land application site(s) as required by the permit; copy any records
that must be kept under the terms and conditions of the permit; take necessary leachate, surface water, groundwater, or soil samples during the
term of, and 12 months after termination of, this Agreement.
II. RESTRICTIONS:
1. Appropriate measures must be taken by the Permittee and/or the landowner or his representative to control public access to the land application
site(s) during active use and for the 12-month period following a residuals land application event. Such controls may include the posting of
signs that indicate the activities being conducted at the land application site(s).
2. Animals shall not be grazed on the land application site(s) for a 30-day period following a residuals land application event. Land application
sites that are to be used for grazing shall have fencing that will be used to prevent access during these periods after such residuals land application
events.
3. Food crops, feed crops, and fiber crops shall not be harvested for a 30-day period following a residuals land application event.
4. Food crops with harvested parts that touch the residuals/soil mixture and are totally above the land surface shall not be harvested for a 14-month
period following a residuals land application event.
5. Food crops with harvested parts below the surface of the land shall not be harvested for a 20-month period following a residuals land application
event when the residuals remain on the land surface for four months or longer prior to incorporation into the soil.
6. Food crops with harvested parts below the surface of the land shall not be harvested for a 38-month period following a residuals land application
event when the residuals remain on the land surface for less than four months prior to incorporation into the soil.
7. Turf grown on land where residuals are applied shall not be harvested for a 12-month period following a residuals land application event.
HLALTERNATIVES FOR WATER SUPPLY WELLS INSIDE THE COMPLIANCE BOUNDARY: (please check one)
15A NCAC 02L .0107(d) prohibits water supply wells within the compliance boundary. However, 15A NCAC 02T.0105ihi allows the compliance
boundary to be placed closer to the waste disposal area, such that the water supply well is situated outside of the compliance boundary provided
the groundwater standards can be met at the newly -established compliance boundary. Please mark one of the following;
❑ A re -defined compliance boundary is needed for field(s) ID:
(Please include the rationale for the requested re -location of the compliance boundary and attach a map showing the newly proposed compliance
boundary to the application package)
® A re -defined compliance boundary is not needed for this site.
IV. ACKNOWLEDGEMENT OF FIELD TRANSFER: (if needed)
❑ The land application field(s) ID: is currently permitted under another
residuals land application program: Permit Number WQ: The land owner hereby acknowledge that by signing this
agreement, he/she is requesting that the field(s) be removed from the previously permitted residuals land application program and transferred
into the new program;
(Name of the new program)
FORM: LOA 06-16 Page 2 of 3

Landowner's Certification:
I certify that I am a deeded landowner of the above -referenced land application site(s) and am authorized to make decisions
regarding the use of the land application site(s) on behalf of other deeded landowners OR that I am otherwise authorized, through
a power of attorney or other legal delegation, to make decisions regarding the use of the land application site(s) on behalf of the
deeded landowners. I certify that the above -referenced land application site(s) are not included in any waste disposal contract or
agreement with another municipality, contractor, or other permitted entity. Furthermore, I certify that I have read this Agreement,
understand the stipulations, restrictions, alternatives for water supply wells inside the compliance boundary, acknowledgement of
field transfer, and do hereby grant permission to the Permittee to land apply residuals to the land application site(s) as specified
herein.
Landowner name: of� lG Giw ,(--
Address: _ ZZ %_V ZJdA g-rorJ 5 "-- 25o^2 o o;t�>
City: AS IF Z�46 eW State: WC Zip: I i fi F g
Phone ' ASa, - ? q C - !�- 7 / C-1 E-mail address:
Date:
NORTH CAROLINA, 3,44W4.4 COUNTY
I, the undersigned Notary Public do hereby certify that 1 C i St p%>1- ;dt w• !on
personally appeared before me this day and acknowledged the due execution of the forgoing instrume,4i�NT 0i
WITNESS my hand and official seal this the
A
day of NO v,-.6 r
Signature and seal: _ II -el'
My commission expires:
Lessee's/Operator's Certification:
I certify that I have read this Agreement and do
Lessee/operator name:
`ten
, 20,E 9
Q BLOC' V ?
9. Z,
agree to abide by the stipulations and restrictions as specified herein.
Address: _ /7 V / /JZi&La -Toi✓ -5 -rz:70rtl �o y�,,>
City: _ Ill & 9 X;4 G State: %V(f- Zip: A7
Phone: r6-- 7/ E-mail address:
Signature:A41 44 ✓! Date: /( - A 0/
Permittee's Certification:
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Signing official name: Adam Waters - Public Works Director _
Signature: _ Date: / (Z O /
FORM: LOA 06-16 Page 3 of 3

State of North Carolina
DWR
Department of Environmental Quality
Division of Water Resources
Division of Water Resources 15A NCAC 02T .1100 — LAND OWNER AGREEMENT
FORM: LOA 06-16
Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted. the Applicant shall submit one original and two conies_ of the application and
sur)-yortim, documentation
For more information, visit the Water Quality Permitting Section's A'on-Dischar-! e Permittin--, Unit.
General — This document is an agreement between the Applicant and land owner(s) of residuals receiving sites for land application of
Class B residuals (may include water treatment plant or other type residuals) in accordance with 15A NCAC 02T .1100. Do not submit
this agreement for review without a corresponding application form (FORM: RLAP 06-16).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Land Owner Agreement (FORM: LOA 06-16):
❑ Submit the completed and appropriately executed Land Application Site Certification (FORM: LASC 06-16) form. Please do
not make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to
the application may be made, as long as the attachments are numbered to correspond to the section and item to which they
refer.
❑ Prepare a separate agreement for each set of land application sites that are owned or operated by an entity other than the
Applicant.
❑ A copy of the completed and appropriately executed agreement must be provided to the landowner and the lessee/operator.
AGREEMENT FOR THE LAND APPLICATION OF RESIDUALS TO PRIVATELY OWNED LAND
The undersigned landowner or his representative hereby permits:
Applicant's name: Cir, of Washington _
hereinafter referred to as the Permittee, to land apply residuals from the following facility(ies) onto the following land
application site(s) (i.e., see attached setback maps) in accordance with the stipulations and restrictions as given in this
Agreement:
Lease Land Use or Residuals Source Special note
Site/Field ID es/no Cropping Patterns Intended Use of Crops (no-till/over-seed/
(yes/no PP� S (optional)
pasture)
The landowner or his representative receives, in consideration, full use of the nutrient value of the applied residuals while the
Permittee receives, in consideration, the use of the land application site(s) described above for the disposal of the residuals.
This Agreement shall remain in effect for the length of the Division's permit for the residuals land application program and
shall be renewed each time this permit is renewed.
The undersigned landowner or his representative and the Permittee agree to abide with the following restrictions and
stipulations until such time as written notification, given 30 calendar days in advance, modifies or cancels this Agreement.
FOR1V1: LOA 06-16 Page 1 of 3

I. STIPULATIONS:
1. The landowner or his representative shall not enter into any additional residuals application contracts or agreements with another permitted
entity for the site(s) specified by this Agreement.
2. Should the landowner or his representative lease or otherwise permit the use of the land application site(s) to a third party, the landowner shall
be responsible to ensure that the third party agrees and complies with the terms and conditions of this Agreement.
3. The landowner or his representative shall adhere to the provisions of this Agreement until all of the site restrictions (under Section II) are met.
4. Notification of cancellation of this Agreement shall be immediately forwarded to NCDENR-DWR, Non -Discharge Permitting Unit, 1617 Mail
Service Center, Raleigh, NC 27699-1617.
5. The Permittee must request and obtain a permit modification from the Division prior to a transfer of the land application site(s) to a new
landowner. In addition, the current landowner shall give a notice to the new landowner that gives full details of the residuals applied at the land
application site(s).
6. The Permittee has provided the landowner or his representative with information and data concerning the residuals land application program,
including an analysis of constituents of the residuals, residuals application methods, schedules for typical cropping patterns, a description of the
equipment used by the Permittee.
7. The Permittee will provide the landowner or his representative with a copy of the residuals permit prior to commencement of any residuals land
application event and a copy of the results of each soil analysis.
8. If the soil pH of the land application site(s) is not maintained at 6.0 or greater, sufficient amounts of lime shall be applied to achieve a final soil
pH of at least 6.0, unless an agronomist provides information indicating that the pH of the soil, residuals and lime mixture is suitable for the
specified crop.
9. The landowner or his representative and the Permittee will agree on residuals application rates and schedules based on crop patterns, results of
soil samples, and the permitted application limits.
10. The landowner or his representative will provide the Permittee with information regarding the amount and analysis of other sources of nutrients
(e.g., fertilizer, unregulated animal waste, etc.) that have been applied to the land application site(s).
11. The landowner or his representative will inform the Permittee of any revisions or modifications to the intended use and cropping patterns for
the land application site(s) prior to each planting season to enable the Permittee to amend this Agreement and schedule residuals land application
events at appropriate periods.
12. Specific residuals land application area boundaries shall be clearly marked on the land application site(s) by the Permittee, the landowner, or
his representative prior to and during a residuals land application event.
13. The landowner or his representative hereby authorizes the Permittee, local officials, and State officials or their representatives to; enter and
inspect any property, premises, or place on or related to the land application site(s) at any reasonable time for the purpose of determining
compliance with the permit; establish monitoring facilities on or near the land application site(s) as required by the permit; copy any records
that must be kept under the terms and conditions of the permit; take necessary leachate, surface water, groundwater, or soil samples during the
term of, and 12 months after termination of, this Agreement.
II. RESTRICTIONS:
1. Appropriate measures must be taken by the Permittee and/or the landowner or his representative to control public access to the land application
site(s) during active use and for the 12-month period following a residuals land application event. Such controls may include the posting of
signs that indicate the activities being conducted at the land application site(s).
2. Animals shall not be grazed on the land application site(s) for a 30-day period following a residuals land application event. Land application
sites that are to be used for grazing shall have fencing that will be used to prevent access during these periods after such residuals land application
events.
3. Food crops, feed crops, and fiber crops shall not be harvested for a 30-day period following a residuals land application event.
4. Food crops with harvested parts that touch the residuals/soil mixture and are totally above the land surface shall not be harvested for a 14-month
period following a residuals land application event.
5. Food crops with harvested parts below the surface of the land shall not be harvested for a 20-month period following a residuals land application
event when the residuals remain on the land surface for four months or longer prior to incorporation into the soil.
6. Food crops with harvested parts below the surface of the land shall not be harvested for a 38-month period following a residuals land application
event when the residuals remain on the land surface for less than four months prior to incorporation into the soil.
7. Turf grown on land where residuals are applied shall not be harvested for a 12-month period following a residuals land application event.
III. ALTERNATIVES FOR WATER SUPPLY WELLS INSIDE THE COMPLIANCE BOUNDARY: (please check one)
15A NCAC 02L .0107(d) prohibits water supply wells within the compliance boundary. However, 15A NCAC 02T .0105th1 allows the compliance
boundary to be placed closer to the waste disposal area, such that the water supply well is situated outside of the compliance boundary provided
the groundwater standards can be met at the newly -established compliance boundary. Please mark one of the following;
❑ A re -defined compliance boundary is needed for field(s) ID: _
(Please include the rationale for the requested re -location of the compliance boundary and attach a map showing the newly proposed compliance
boundary to the application package)
® A re -defined compliance boundary is not needed for this site.
IV. ACKNOWLEDGEMENT OF FIELD TRANSFER: (if needed)
❑ The land application field(s) ID: is currently permitted under another
residuals land application program; Permit Number WQ: The land owner hereby acknowledge that by signing this
agreement, he/she is requesting that the field(s) be removed from the previously permitted residuals land application program and transferred
into the new program:
(Name of the new program)
FORM: LOA 06-16 Page 2 of 3

Landowner's Certification:
I certify that I am a deeded landowner of the above -referenced land application site(s) and am authorized to make decisions
regarding the use of the land application site(s) on behalf of other deeded landowners OR that I am otherwise authorized, through
a power of attorney or other legal delegation, to make decisions regarding the use of the land application site(s) on behalf of the
deeded landowners. I certify that the above -referenced land application site(s) are not included in any waste disposal contract or
agreement with another municipality, contractor, or other permitted entity. Furthermore, I certify that I have read this Agreement,
understand the stipulations, restrictions, alternatives for water supply wells inside the compliance boundary, acknowledgement of
field transfer, and do hereby grant permission to the Permittee to land apply residuals to the land application site(s) as specified
herein. ^� A {
Landowner name: ;:5, t,(D 1_GU1
Address: /7ZV A)M, ZOO✓ 5• ;r-W 1�60!?7>
City: a1j!vf;z e, 70!!%06 State: _ � Zip: �-27
Phone: E-mail address:
Signature:
NORTH CAROLINA, ___eu Aw H COUNTY
Date: '/ L.w 1
I, the undersigned Notary Public do hereby certify that _ 54y_, ^w,•G GJ/ 11 'c wry -7
personally appeared before me this day and acknowledged the due execution of the forgoing instrument.
WITNESS my hand and official sea] this the
7/h
loll
4T
day of _ Nov�_ b_r , 20 / 9 = N�
Signature and seal:
My commission expires: _ _ 21717OZ / _7, �
%
soCOUN-�,,%O
Lessee's/Operator's Certification:
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Lessee/operator name: 11`� k N -rz, 2 � ' sCoY
J � L_iS o 5 T �f} 2 w�S� .��iC _ _ _ 7 _
Addr
City:
Phone: S �- 1� 5 - O E-mail address:
Signature: �.
Permittee's Certification:
p:
Date: //- Z 7-1c%
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Signing official name: Adam Waters - Public Works Director
Signature: _ Date:
/t/'20
FORM: LOA 06-16 Page 3 of 3

State of North Carolina
DWR
Department of Environmental (duality
Division of Water Resources
Odslon of Water Resources 15A NCAC 02T .1100 — LAND OWNER AGREEMENT
FORM: LOA 06-16
Pease use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
intutructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
in -formation requested. Failure to submit all of the required items will lead to additional processing'and review time for the
permit application. Unless otherwise noted, the A )licant shall submit one original and two copies of the a i lication and
sxkartine documentation
For more information, visit the ffater Quality Permitting Section's A--on-Discharge Permitting Unit.
Gioneral — This document is an agreement between the Applicant and land owner(s) of residuals receiving sites for land application of
C1 ass B residuals (may include water treatment plant or other type residuals) in accordance with 15A NCAC 02T .I 100. Do not submit
this agreement for review without a corresponding application form (FORM: RLAP 06-16).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Land Owner Agreement (FORM: LOA 06-16):
❑ Submit the completed and appropriately executed Land Application Site Certification (FORM: LASC 06-16) form. Please do
not make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to
the application may be made, as long as the attachments are numbered to correspond to the section and item to which they
refer.
❑ Prepare a separate agreement for each set of land application sites that are owned or operated by an entity other than the
Applicant.
❑ A copy of the completed and appropriately executed agreement must be provided to the landowner and the lessee. -operator -
AGREEMENT FOR THE LAND APPLICATION OF RESIDUALS TO PRIVATELY OWNED LAND
The undersigned landowner or his representative hereby permits:
Applicant's name: Cite of Washington
hereinafter referred to as the Permittee, to land apply residuals from the following facility(ies) onto the following land
application site(s) (i.e., see attached setback maps) in accordance with the stipulations and restrictions as given in this
Agreement:
Site/Field ID Lease Land Use or Intended Use of Crops
(yes/no) Cropping Patterns
-- - +--
c -�3 F -P 60 -D 4 U26
Cl2.op f—io> * FzBep-
Residuals Source
(optional)
_r
Special note
(no-till/over-seed!
pasture)
The landowner or his representative receives, in consideration, full use of the nutrient value of the applied residuals while the
Permittee receives, in consideration, the use of the land application site(s) described above for the disposal of the residuals.
This Agreement shall remain in effect for the length of the Division's permit for the residuals land application program and
shall be renewed each time this permit is renewed.
The undersigned landowner or his representative and the Permittee agree to abide with the following restrictions and
stipulations until such time as written notification. given 30 calendar days in advance, modifies or cancels this Agreement.
FORA: LOA 06-16 Pa-e l of 3

I, STIPULATIONS:
1. The landowner or his representative shall not enter into any additional residuals application contracts or agreements with another permitted
entity for the site(s) specified by this Agreement.
2. Should the landowner or his representative lease or otherwise permit the use of the land application site(s) to a third party, the landowner shall
be responsible to ensure that the third party agrees and complies with the terms and conditions of this Agreement.
3. The landowner or his representative shall adhere to the provisions of this Agreement until all of the site restrictions (under Section II) are met.
4. Notification of cancellation of this Agreement shall be immediately forwarded to NCDENR-DWR, Non -Discharge Permitting Unit, 1617 Mail
Service Center, Raleigh, NC 27699-1617.
5. The Permittee must request and obtain a permit modification from the Division prior to a transfer of the land application site(s) to a new
landowner. In addition, the current landowner shall give a notice to the new landowner that gives full details of the residuals applied at the land
application site(s).
6. The Permittee has provided the landowner or his representative with information and data concerning the residuals land application program,
including an analysis of constituents of the residuals, residuals application methods, schedules for typical cropping patterns, a description of the
equipment used by the Permittee.
7. The Penmittee will provide the landowner or his representative with a copy of the residuals permit prior to commencement of any residuals land
application event and a copy of the results of each soil analysis.
8. If the soil pH of the land application site(s) is not maintained at 6.0 or greater, sufficient amounts of lime shall be applied to achieve a final soil
pH of at least 6.0, unless an agronomist provides information indicating that the pH of the soil, residuals and lime mixture is suitable for the
specified crop.
9. The landowner or his representative and the Permittee will agree on residuals application rates and schedules based on crop patterns, results of
soil samples, and the permitted application limits.
10. The landowner or his representative will provide the Permittee with information regarding the amount and analysis of other sources of nutrients
(e.g., fertilizer, unregulated animal waste, etc.) that have been applied to the land application site(s).
11. The landowner or his representative will inform the Permittee of any revisions or modifications to the intended use and cropping patterns for
the land application site(s) prior to each planting season to enable the Permittee to amend this Agreement and schedule residuals land application
events at appropriate periods.
12. Specific residuals land application area boundaries shall be clearly marked on the land application site(s) by the Permittee, the landowner, or
his representative prior to and during a residuals land application event.
13. The landowner or his representative hereby authorizes the Permittee, local officials, and State officials or their representatives to; enter and
inspect any property, premises, or place on or related to the land application site(s) at any reasonable time for the purpose of determining
compliance with the permit; establish monitoring facilities on or near the land application site(s) as required by the permit; copy any records
that must be kept under the terms and conditions of the permit; take necessary leachate, surface water, groundwater, or soil samples during the
term of, and 12 months after termination of, this Agreement.
H. RESTRICTIONS:
1. Appropriate measures must be taken by the Permittee and/or the landowner or his representative to control public access to the land application
site(s) during active use and for the 12-month period following a residuals land application event. Such controls may include the posting of
signs that indicate the activities being conducted at the land application site(s).
2. Animals shall not be grazed on the land application site(s) for a 30-day period following a residuals land application event. Land application
sites that are to be used for grazing shall have fencing that will be used to prevent access during these periods after such residuals land application
events.
3. Food crops, feed crops, and fiber crops shall not be harvested for a 30-day period following a residuals land application event.
4. Food crops with harvested parts that touch the residuals/soil mixture and are totally above the land surface shall not be harvested for a 14-month
period following a residuals land application event.
5. Food crops with harvested parts below the surface of the land shall not be harvested for a 20-month period following a residuals land application
event when the residuals remain on the land surface for four months or longer prior to incorporation into the soil.
6. Food crops with harvested parts below the surface of the land shall not be harvested for a 38-month period following a residuals land application
event when the residuals remain on the land surface for less than four months prior to incorporation into the soil.
7. Turf grown on land where residuals are applied shall not be harvested for a 12-month period following a residuals land application event.
III. ALTERNATIVES FOR WATER SUPPLY WELLS INSIDE THE COMPLIANCE BOUNDARY: (please check one)
15A NCAC 02L .0107(d) prohibits water supply wells within the compliance boundary. However, 15A NCAC 02T .0105 h allows the compliance
boundary to be placed closer to the waste disposal area, such that the water supply well is situated outside of the compliance boundary provided
the groundwater standards can be met at the newly -established compliance boundary. Please mark one of the following;
❑ A re -defined compliance boundary is needed for field(s) ID:
(Please include the rationale for the requested re -location of the compliance boundary and attach a map showing the newly proposed compliance
boundary to the application package)
® A re -defined compliance boundary is not needed for this site.
IV. ACKNOWLEDGEMENT OF FIELD TRANSFER: (if needed)
❑ The land application field(s) ID: is currently permitted under another
residuals land application program; Permit Number WQ: The land owner hereby acknowledge that by signing this
agreement, he/she is requesting that the field(s) be removed from the previously permitted residuals land application program and transferred
into the new nroeram:
(Name of the new program)
FORM: LOA 06-16 Page 2 of 3

Landowner's Certification:
I certify that I am a deeded landowner of the above -referenced land application site(s) and am authorized to make decisions
regarding the use of the land application site(s) on behalf of other deeded landowners OR that I am otherwise authorized, through
a power of attorney or other legal delegation, to make decisions regarding the use of the land application site(s) on behalf of the
deeded landowners. I certify that the above -referenced land application site(s) are not included in any waste disposal contract or
agreement with another municipality, contractor, or other permitted entity. Furthermore, I certify that I have read this Agreement,
understand the stipulations, restrictions, alternatives for water supply wells inside the compliance boundary, acknowledgement of
field transfer, and do hereby grant permission to the Permittee to land apply residuals to the land application site(s) as specified
herein. _
Landowner name:
Address: 1 w : RfL7o /V
City: ljfisc if-x-WG 7o -V State: WC Zip: FL
Phone: C/ - 7w sj�� E-mail address:
Signature t , �J Zl v Date: v'Z o // 9
NORTH CAROLINA, AA J-4T COUNTY
I, the undersigned Notary Public do hereby certify that /'l&A c
personally appeared before me this day and acknowledged the due execution of the forgoing instrument. `��N T C fi�'
WITNESS my hand and official seal this the A � �� Z
day of 20 I9 r10Tg9� N
Signature and seal:
iM
My commission expires: _ Z I712,07
I11rrr�S' N0��
Lessee's/Operator's Certification:
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Lessee/operator name: 14 1 9 4 N r L--a S o o S T 2 Vtti_ 1
Address: /% 10dAZ%a W ,,✓I `J?oA-,
City: A-.S ff x,-►f e�. Z a ry- _ State: _ � 1! C_ Zip: 2 7 rrrL F
Phone: 02 ' - % D E-mail address:
Signature: Ar-tS Date:
Permittee's Certification:
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Signing official name: Adam Waters - Public Works Director
Signature: Win.•. a Date: / t / Z 0LL4'
FORM: LOA 06-16 Page 3 of 3

SITE SUMMARY
Site ID:
NC-BF-210
Owner:
Hunters Roost Farms
Harvey, Scott, Stephanie & Marsha Williamson
Address:
1774 Wharton
Station Road
Washington,
NC 27889
Phone:
252-945-8710
Operator:
Same
Field#
Total Acres
Net Acres
Crop(s)
Soil Series
Latitude &
Longitude
1
23.42
14.22
Corn,SB,SMG
Craven
35°37'34.8" N
77°03'50.0" W
2
34.54
26.81
Corn,SB,SMG
Goldsboro
35°37'20.0" N
77°03'56.6" W
23
16.98
12.73
Corn,SB,SMG
Lynchburg
35°37'9.2" N
77°04'0.4" W
3
11.58
7.72
Corn,SB,SMG
Goldsboro
_
35°37'27" N
77°04'25" W
4
70.12
64.02
Corn,SB,SMG
Goldsboro
35°37'09" NL� ~
77'04'35" W
5
21.71
15.92
Bermuda Grass
Rains
35°37'1.2" N
77°04'4.7" W
6
18.82
15.14
Corn,SB,SMG
Lenoir
35°37'8.2" N
77°03'35.5" W
7
15.05
11.82
Corn,SB,SMG
Lenoir
35°37'17.4" N
77°03'39.1" W
8
23.4
19.21
Corn,SB,SMG
Lenoir
35°37'18.5" N
77°03'17.8" W
9
30.52
23.41
Corn,SB,SMG
Craven
-+ 35°38'46.0" N
77°04'18.5" W
10
16.79
14.33
Bermuda
Craven
35°38'39.6" N
77°04'39.0" W
11
9.33
8.46
_
Burmuda
Craven
35°38'30.3" N ~
77°04'45.0" W
12
35.7
29.08
Corn,SB,SMG
Goldsboro
35°37'28.8" N
77°05'21.3" W
13
31.97
24.99
Bermuda
Craven
35°37'36.5" N
Corn,SB,SMG
Goldsboro
77°05'32.8" W
35°37'39.4" N
14 8.19
6.32
77°05'26.7" W
15
16.16
13.48
Corn,SB,SMGPLynEchburg35°37'24.0"
N
77°05'33.9" W
16
29.4
25.44
Corn,SB,SMG35°41'41.0"
N
77°10'13.2" W
TOTALS
413.68
333.1

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Hunter's Roost Farms TN Scale 1 25,000
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.Site: NC-BF-210
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Hunter's Roost Farms f
il TN Scale 1: 12,800
Site: NC-BF-210
Field: 36 afa Zoom l 3-11

v
44�
3
S
AAA
' ■ ■ ■ nRd N1
j(Uhartan 5t o 47, R
d
/■�
4
23
. i * A Structure
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~ S A O
Cemetary
Field Total Acres Applicable Acres o °
1 23.42 14.22 Business
_•�cf Buffer
2 34.54 26.81
3 11.58 7.72 ■ Off Site Dwelling
4 70.12 64.02 Stream
5 21.71 15.92 r �`
Drain
23 16.98 12.73
® Field Boundary
REFERENCE: T c
GIS C.-:'.A LkERS WERE CBTAINED FROM XXXXXX. PLEASE NOTE THIS MAP IS FOR INFORMATIONAL Pond E
PURPJSES ONLY. IT IS NOT MEANT FOR DESIGN LEGAL, OR ANY OTHER USES. THERE ARE NO
GUA.RAN-EESABCUTiTSACCURACY EMA RESOURCES INC. ASSUMES NO RESPONSIBILITY FOR ANY:'.,I�:,�:.•li!i�I?,''�-
DECiS'CNWDEORANYACTIONSTAKEN BYTHE USER BASED UPON THIS INFORMATiON '!iFY, ! Property Boundary
0
SCAL_': 1 „ = 660 , FIGURE NO.
—MA
City of Washington
DATE 12-03-19 � Land Application Program
'?RAi� Ev BC ---Resources, hic.
NC-BF-210
1A1nnnn1n09 Hunter's Roost Farms

19
Field Total Acres Applicable Acres
9 30.52 23.41
10 16.79 14.33
11 9.33 _ 8.46
REFERENCE:
G!S DnTA DYERS'AFRE OBTAINED FROM XXXXXX. PLEASE NOTE THIS MAP IS FOR INFORMATIONA
PURPOSES ONLY. IT. IS NOT MEANT FOR DESIGN. LEGAL. OR ANY OTHER USES. THERE ARE NO
GUARANTE ES ABOUT ITS ACCURACY EMARESOURCES INC. ASSUMES NORESPONSIBILITY FORA
r
DECISION MADE OR ANY ACTIONS TAKEN BY THE USER BASED UPON THIS! NFORMATION.
DATE 12-03-19`J:N Dw BY: e.MA
BC sources, Inc.
'ROJECT NO
r'
7
r
r
N Robeisan. R f l
r
A Structure
' i+•
i Well
■ On Site Dwelling
Buffer
■ Off Site Dwelling
----- Drain
!
® Septage Field
® Field Boundary
L
Pond
NY
Property Boundary
City of Washington
FIGURE NO
Land Application Program
2
NC-BF-210
Hunter's Roost Farms

REFERENCE:
GIs DATA. LAYERS WERE OBTAINED FROM XXXXXX. PLEASE NOTE THIS MAP IS FOR INFORMATIONAL
PURPOSES ONLY. IT IS NOT MEANT FOR DESIGN, LEGAL, OR ANY OTHER USES. THERE ARE NO
GUARANTEES ABOUT ITSACCURACY. EMA RESOURCES INC. ASSUMES NO RESPONSIBILITY FOR ANY
DECISION MADE OR ANY ACTIONS TAKEN BY THE USER BASED UPON THIS INFORMATION-
r
13
15 `"L�►
Field Total Acres Applicable Acres
12 35.7 29.08
13 31.97 24.99
14 8.19 6.32
15 16.16 13.48
SCALE. 1 ' = 440 ' `
DATE 12-03-19
BY BC —Rest
PRO,=CT NC'
W�" :1
A
41
.• zi
s Structure
Well
On Site Dwelling
Buffer
® Off Site Dwelling 3
Stream '
Drain
® Field Boundary
Pond `
c
. ,.:.=max•..... �. - Property Boundary .
City of Washington FIGURE NO
JA Land Application Program
-es. Inc.
N C-B F-210
Hunter's Roost Farms

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: City of Washington WQ Permit #: WQ0001026 Field #: 1 Acres Utilized: 16.5
Land Owner: Hunter Roost Farms Annual Dry Tons Applied: 7.13 Site #: BF210 Acres Permitted: 16.5
Operator: Hunter Roost Farms Predominant Soil Series: CrB Cation Exchange Capacity (non 503): 0
Crop 1 Name: Soybeans Crop 1 Max. PAN: 151 Crop 2 Name: Crop 2 Max. PAN:
I.. a
+�
+; o
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NpDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry,
Wet
Moist)
Precip.
Past 24
Hrs.
inches
Y
b
rn 'd
a c
0
o
%v
--
*
4
PW R
w •,
o
i
0
TKN
mg/kg
Z Y
o
�•
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
( lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop l
Crop 2
5/15
52000
3.29
0.432
Washington
D
<.5"
S
0.5
0.3
58450
8605
322
16.930
NA
Beans
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
1 0.000
0.000
0.000
0.000
0.000
0.000
0.000
0
it
0.000
Residuals Applications totals on FORM
FSF su p ( attach FORM FSF supp
to this form):
0.000
0.000
TOTALS:
01
52000
:::-:'::::::::
As
Cd
Cu
Cr
Pb
HR
Mo
Ni
Se
Zn
P
16.930
0.000
Lime Applied
Annuallbs/acre
0.011
0.001
0.238
0.019
0.024
0.002
0.005
0.012
0.013
0.595
27.000 ::
:
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.018
0.007
0.818
0.195
0.089
0.005
0.036
0.106
0.018
2.311
Current Cumulative lbs/ac
0.029
0.008
1 1.056
0.214
0.113
0.007
0.041
0.118
0.031
2.906
Permitted C. P. L. R.****
36
34
1 1338
267
1 15
374
89
1 2498
rrit PAN Limit 1 t/2nd Crop
Permit
151
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
_ 1/11/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate

Facility Name:
Land Owner:
Operator:
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.
City of Washington WQ Permit #: WQ0001026 Field #: 2 Acres Utilized:
Hunter Roost Farms Annual Dry Tons Applied: 20.82 Site #: BF210 Acres Permitted:
Hunter Roost Farms
Crop 1 Name: Small Grain
Predominant Soil Series: GoA Cation Exchange Capacity (non 503):
Crop 1 Max. PAN: 120 Crop 2 Name: Small Grain Crop 2 Max. PAN:
27.5
27.5
0
50
'-
+-
c� o
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES 11 WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
(pry,
Wet,
Moist)
Precip.
Past 24
Hrs.
inches
>
K 0
�'
n. w
�
C
o
10
`r
* w
7y
P n
" `=
* N
Q'.
5
TKN
mg/kg
Z a
i t
o
� 0
p �•
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
( lbs/acre)
Name of Crop
p Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
12/16
84500
4.04
0.518
Washington
D
<.5"
S
1 0.5
0.3
42800
6680
2
14.679
NA
SG
12/17
39000
4.04
0.239
Washington
D
<.5"
S
0.5
0.3
42800
6680
2
6.775
NA
SG
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
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
0
0.000
Residuals Applications totals on FORM
FSF su p ( attach FORM FSF supp
to this form):
0.000
0.000
TOTALS:
01
123500
::::::::::::::
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn P
21.453
0.000
Lime Applied
jAnnuallbs/acre
0.008
0.003
0.313
0.082
0.030
0.002
0.017
0.044
0.008
0.924 33.459 ::
0
0.924
2498
Date
lbs/ac
Prior Years Cumulative lbs/ac
0
0
0
0
0
0
0
0
0
Current Cumulative lbs/ac
0.008
0.003
0.313
0.082
0.030
0.002
0.017
0.044
0.008
Permitted C. P. L. R.****
36
34
1338
267
1 15
374
89
Permit PAN Limit lst/2nd Crop
...::::.. 120 50
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/11/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: City of Washington WQ Permit #: WQ0001026 Field #: 4 Acres Utilized: 65.5
Land Owner: Hunter Roost Farms Annual Dry Tons Applied: 108.93 Site #: BF210 Acres Permitted: 65.5
Operator: Hunter Roost Farms Predominant Soil Series: GoA Cation Exchange Capacity (non 503): 0
Crop 1 Name: Soybeans Crop 1 Max. PAN: 176 Crop 2 Name: Crop 2 Max. PAN:
'" .=
o
A
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/AC)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry,
Wet
Moist)
Precip.
Past 24
Hrs.
inches
Y
"5
n w
7
o
w
*
w
* N
TKN
mgncg
Z a
4
12
�.
mg/kg
Nitrate
and
Nitrite
mglkg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
5/9
156000
2.61
0.259
Washington
D
<,5"
S
0.5
0.3
62650
18500
86
11.707
NA
Beans
5/10
188500
2.61
0.313
Washington
D
<.5"
S
0.5
0.3
62650
18500
86
14.146
NA
Beans
5/12
32500
2.61
0.054
Washington
D
<.S"
S
0.5
0.3
62650
18500
86
2.439
NA
Beans
5/13
260000
2.61
0.432
Washington
D
<.5"
S
0.5
0.3
62650
18500
86
19.511
NA
Beans
5/14
227500
2.61
0.378
Washington
D
<.5"
S
0.5
0.3
62650
18500
86
17.072
NA
Beans
5/15
1
136500
2.61
0.227
Washington
D
<.5"
S
0.5
0.3
62650
18500
86
10.243
NA
Beans
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
0.000
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000
0.000
..................
TOTALS:
0
lool000
::::::::::::::
As
Cd
Cu
Cr
Pb
H P,
Mo
Ni
Se
Zn
11 P
75.118
0.000
Lime Applied
Annuallbs/acre
0.028
0.005
1.014
0.086
0.092
0.002
0.019
0.055
0.024
1.949
98.782 :: ..
::
......................
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.133
0.048
5.398
0.898
0.728
0.032
0.147
0.507
0.103
14.342
2000
Current Cumulative lbs/ac
0.161
1 0.053
6.412
0.984
0.820
0.034
0.166
0.562
0.127
16.291
Permitted C. P. L. R.****
36
34
1338
267
15
374
89
2498
Permit PAN Limit 1 st/2nd Crop
176
"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
2/9/2018 **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

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: City of Washington WQ Permit #: WQ0001026 Field #: 5 Acres Utilized:
Land Owner: Hunter Roost Farms Annual Dry Tons Applied: 25.70 Site #: BF210 Acres Permitted:
Operator: Hunter Roost Farms Predominant Soil Series: Ra Cation Exchange Capacity (non 503):
Crop 1 Name: Wheat Crop 1 Max. PAN: 106 Crop 2 Name: Crop 2 Max. PAN:
16
16
0
S.O .�
+-
N
A
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
D
(�'
We
MOi t
Precip.
Past 24
�•
inches
�
� 10
�
�. �'
a �,
.�
o
o
� -
--
* 1
IMO
0
7y C
� w,
* N'
* w
0
TKN
mg/kg
Z >
o S
oo c
g 2-
mglkg
Nitrate
and
Nitrite
mg/kg
PAN Applied
( Ibs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
10/5
110500
3.27
0.942
Washington
D
<.5"
S
0.5
0.3
86400
14800
235
54.837
NA
Wheat
10/6
78000
3.27
0.665
Washington
D
<.5"
S
0.5
0.3
86400
14800
235
38.708
NA
Wheat
0.00o
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
1
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0
0
0.000
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000
0.000
TOTALS:
01
t88500
::::::::::::::
As
Cd
Cu
Cr
Pb
H P,
Mo
Ni
Se
Zn
P
93.545
1 0.000
Lime A plied
Annuallbs/acre
0.041
0.005
0.838
0.064
0.078
0.004
0.017
0.044
0.057
2.210
106.960 :;:::::::::::::::::::::::::::::
:::
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.037
0.015
2.099
0.382
0.292
0.011
0.045
0.217
0.037
5.307
Current Cumulative lbs/ac
0.078
0.020
2.937
0.446
0.370
0.015
0.062
0.261
0.094
7.517
Permitted C. P. L. R.****
36
1 3
1 1338
267
15
374
89
2498
Permit PAN Limit 1 st/2nd Crop
P
106
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/11/2016 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R: Cumulative Pollutant Loading Rate

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: City of Washington WQ Permit #: WQ0001026 Field #: 6 Acres Utilized: 15.5
Land Owner: Hunter Roost Farms T Annual Dry Tons Applied: 41.01 Site #: BF210 Acres Permitted: 15.5
Operator: Hunter Roost Farms Predominant Soil Series: Le Cation Exchange Capacity (non 503): 0
Crop 1 Name: Soybeans Crop 1 Max. PAN: 146 Crop 2 Name: Crop 2 Max. PAN:
'~ .-
° +-
:� o
Q 0
Volume applied
(enter one) Solids!
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry,
WetHrs.
Moist)
Precip.
Past 24
inches
Y
rc '�?
a o
o
w K
.-
I
�
.y
w
TKN
mg/kg
z
o
❑
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(Ibs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
3/17
240500
3.29
2.129
Washington
D
<.5"
S
0.5
0.3
58450
8605
322
83.352
NA
Beans
3/18
58500
3.29
0.518
Washington
D
<.5"
S
0.5 1
0.3
58450
8605
322
20.275
NA
Beans
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
0.0()
0.000
[t
0
0.000
Residuals Applications totals on FORM
FSF sup (a ch FORM FSF supp
to this form):
0.000
0.000
..................
TOTALS:
0
299000
::::::;:::::::
As
Cd
Cu
Cr
Pb
Hr-
Mo
Ni
Se
Zn P
103,626
0.000
Lime A lied
Annuallbs/acre
0.067
0.008
1.461
0.115
0.149
0,014
0.030
0.074
0.078
3.646 165.375::::::::::
11.33
14.976............................
2498
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.084
0.03
4.982
0.651
0.51
0.02
0.094
0.334
0.083
Current Cumulative lbs/ac
0.151
0.038
6.443
0.766
0.659
0.034
0.124
0.408
0.161
Permitted C. P. L. R.****
36
1 34
1 1338
267
15
1 374
1 89
Permit PAN Limit lst/2nd Crop
146
"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
2/9/2018 **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

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: City of Washington WQ Permit #: WQ0001026 Field #: 7 Acres Utilized: 13.5
Land Owner: Hunter Roost Farms Annual Dry Tons Applied: 35.67 Site #: BF210 Acres Permitted: 13.5
Operator: Hunter Roost Farms Predominant Soil Series: Le Cation Exchange Capacity (non 503): 0
Crop 1 Name: Soybeans Crop 1 Max. PAN: 146 Crop 2 Name: Crop 2 Max. PAN:
° .c
°
A
Volume applied
(enter one Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES # WQ#
Fert., Animal
Waste, etC)
Soil
Cond.
D
Wet,
Moist)
Precip.
Past 24
Hrs.
inches
Y
-0
'9
o
c
o
',
�-
* R.
p0
7y
w -�
ro �'
K.
TKN
mg/kg
Z Y
.�
o
@3 �•
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
( lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
3/18
143000
3.29
1.453
Washington
D
<.5"
S
0.5
0.3
58450
8605
1 322
56.903
NA
Beans
3/19
117000
3.29
1.189
Washington
D
<.5"
S
0.5
0.3
58450
8605
322
46.557
NA
Beans
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
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
t
0.000
0.000
00
0.000
Residuals Applications totals on FORM
FSF supp (attack FORM FSF supp
to this form):
0.000
0.000
.......
.........
.........
TOTALS:
0
260000
::::::::::::::
As
Cd
I Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
I P
103.459
0.000
Lime Applied
Annuallbs/acre
0.067
0.008
1.458
0.114
0.148
0.014
0.030
0.074
0.078
3.641
1165.125
::::::::::::::::::::::
........
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.069
0.026
3.893
0.516
0.416
0.015
0.076
0.272
0.068
8.845
Current Cumulative lbs/ac
0.136
0.034
5.351
0.630
0.564
0.029
0.106
0.346
0.146
12.486
Permitted C. P. L. R.****
36
1 34
1338
267
15
374
89
2498
Permit PAN Limit 1 st/2nd Crop
Pe t p
146
"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
2/9/2018 **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

Facility Name:
Land Owner:
Operator:
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.
City of Washington WQ Permit #: WQ0001026 Field #: 8 Acres Utilized:
Hunter Roost Farms Annual Dry Tons Applied: 48.16 Site #: BF210 Acres Permitted:
Hunter Roost Farms Predominant Soil Series: _
Crop 1 Name: Soybeans Crop 1 Max. PAN: 146
Le
Crop 2 Name:
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
17.5
17.5
0
+, o
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
"�o
Solids
Volume
Applied per
Acre
(Dry Tons/ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry,
Wet,
Moist
Precip.
Past 24
Hrs.
inches
�
0 =
c o
o
c
P, w
; -
* w
o
� �
; "
N w
*
o
o
TKN
mg/kg
Z >
o e
w
mg/kg
Nitrate
and
Nitrite
mglkg
PAN Applied
( lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
3/19
45500
3.29
0.357
Washington
D
<.5"
S
0.5
0.3
58450
8605 1
322
13.967
NA
Beans
3/20
169000
3.29
1.325
Washington
D
<.5"
S
0.5
0.3
58450
8605
322
51.877
NA
Beans
5/14
84500
3.29
0.662
Washington
D
<.5"
S
0.5
0.3
58450
8605
322
25.939
NA
Beans
5/15
52000
3.29
0.408
Washington
D
<,5"
S
0.5
0.3
58450
8605
322
15.962
NA
Beans
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
0
OA00
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000
0.000
TOTALS:
01
351000
::::::::::::::
As
Cd
I Cu
Cr
Pb
Hg,
Mo
Ni
Se
Zn
P
107.7461
0.000
Lime Applied
AnnualIbs/acre
0.070
0.008
1.519
0.119
0.155
0.015
0.031
0.077
0.081
3.792
172.000 :::::::::::::::::::::::::
:::::::::::::::::::::::::::::::::::::::::
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.055
0.021
2.863
0.392
0.326
0.01
0.059
0.215
0.054
6.535
Current Cumulative lbs/ac
0.125
0.029
4.382
0.511
0.481
0.025
0.090
0.292
0.135
10.327
Permitted C. P. L. R.****
36
34
1338
267
15
374
89
2498
Permit PAN Limit Ist/2nd Crop
146
"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
2/9/2018 _ _ _ **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

Facility Name:
Land Owner:
Operator:
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.
City of Washington WQ Permit #: WQ0001026 Field #: 12 Acres Utilized:
Hunter Roost Farms Annual Dry Tons Applied: 35.45 Site #: BF210 Acres Permitted:
Hunter Roost Farms Predominant Soil Series: GoA Cation Exchange Capacity (non 503):
Crop 1 Name: Wheat Crop l Max. PAN: 136 Crop 2 Name: Crop 2 Max. PAN:
27.5
27.5
0
Y
o
Q
Volume applied
enter one Solids/
( )
Liquid
Cu. Yds Gallons
/o
Solids
Volume
lied r
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
PDES #, W
(N Q#,
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry,
Wet,
Moist)
Precip.
Past 24
Hrs.
inches
Y
. d
o
o�
r o
0
o
;d �'.
;
* �.
-
:;
P-
# N
?:
0
TKN
mg/kg
z
=�
o
�; $
e �.
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Frop 2
Crop 1
Crop 2
10/2
143000
3.27
0.709
Washington
D
<.5"
S
0.5
0.3
86400
14800
235
41.289 ii
NA
Wheat
1015
117000
3.27
0.580
Washington
D
<.5"
S
0.5
0.3
86400
14800
235
33.782
NA
Wheat
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
U
0.000
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000
0.000
TOTAi
0
260000
:::::::::>:;
As
Cd
Cu
Cr
Pb
H
Mo
Ni
Se
Zn
P
75.07t
0.000
Lime Applied
Annuallbs/acre
0.033
0.004
0.673
0.052
0.063
0.003
0.014
0.036
0.046
1.774
85.847
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.035
0.013
2.166
0.312
0.233
0.01
0.041
0.161
0.035
5.091
Current Cumulative lbs/ac
0.068
0.017
2.839
0.364
0.296
0.013
0.055
0.197
0.081
6.865
Permitted C. P. L. R.****
36
34
1338
267
15
374
89
2498
Permit PAN Limit I st/2nd Crop
136
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/30/2017 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate

Facility Name:
Land Owner:
Operator:
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.
City of Washington WQ Permit #: WQ0001026 Field #: 13 Acres Utilized:
Hunter Roost Farms Annual Dry Tons Applied: 35.46 Site #: BF210 Acres Permitted:
Hunter Roost Farms Predominant Soil Series: CrA Cation Exchange Capacity (non 503):
Crop 1 Name: Wheat Crop 1 Max. PAN: 112 Crop 2 Name: Crop 2 Max. PAN:
26.5
26.5
0
°
+; o
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(DryTons/Ac)
Residual Sources
(NpDES #, W
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry,
Wet,
Moist}
Precip.
past 24
Hrs.
inches
Y
6 d
i?'
c w,
�
o
%`�
*
Ft
* w
0
TKN
mg/kg
z >
o �
�;
m'
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
( lbs/acre)
Name of Crop Type
g Receivin Residual
Application
_
Crop I
Crop 2
Crop 1
Crop 2
10/4
221000
3.27
1.137
Washington
D
<.5"
S
0.5
0.3
86400
14800
235
66.218
NA
Wheat
10/6
39000
3.27
0.201
Washington
D
<.5"
S
0.5
0.3
86400
14800
235
11.686
NA
Wheat
0.000
0.000
0.000
0.000
0.000
0.000
o.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
0
0.000
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000
0.000
TOTAL&I
01
260000
As
Cd
Cu
Cr
Pb
H g
Mo
Ni
Se
Zn
P
77.904
0.000
Lime Applied
Annuallbs/acre
0.034
0.004
0.698
0.054
0.065
0.003
0.015
0.037
0.047
1.841
89.111 :: :-
::
Date
Ibs/ac
Prior Years Cumulative lbs/ac
0
0
0
0
0
0
0
0
0
0
Current Cumulative lbs/ac
0.034
0.004
0.698
0.054
0.065
0.003
0.015
0.037
0.047
1.841
Permitted C. P. L. R.****
36
1 34
1 1338
267
15
374
89
1 2498
Permit PAN Limit 1 st/2nd Crop
112
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/30/2017 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: City of Washington WQ Permit #: WQ0001026 Field #: 14 Acres Utilized: 6
Land Owner: Hunter Roost Farms Annual Dry Tons Applied: 12.41 Site #: BF210 Acres Permitted: 6
Operator: Hunter Roost Farms Predominant Soil Series: GoA Cation Exchange Capacity (non 503): 0
Crop 1 Name: Wheat Crop 1 Max. PAN: 136 Crop 2 Name: Crop 2 Max. PAN:
°
o
Q
Volume applied
enter one Solids/
( )
Liquid
Cu. Yds Gallons
o
/o
Solids
Volume
Applied per
PP P
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry,
Wet,
Moist)
Precip.
Past 24
Hrs.
inches
Y
4 �
8
o o
0
c
� �
* w
o
�
�
;V �
o
0
TKN
mg/kg
� a
rr El
CR El
lv.
mglkg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(]bs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
10/3
91000
3.27
1 2.068
Washington
D
<.5"
S
0.5
1 0.3
86400
14800
235
120.426
NA
Wheat
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
0
0
0.000
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000
0.000
.....
..........
TOTALS:
[�
91000
;:::::::::::
As
Cd
Cu
Cr
Pb
H
Mo
Ni
Se
I Zn
P
120.4261
0.000
Lime Applied
Annuallbs/acre
0.053
0.006
1.079
0.083
0.101
0.005
0.022
0.057
0.073
2.846 .
137.729 :::::::::::::::::::::::::::::
-
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.047
0.016
3.22
0.387
0.284
0.013
0.055
0.182
0.047
7.213
Current Cumulative ]bs/ac
0.100
0.022
4.299
0.470
0.385
0.018
0.077
0.239
0.120
10.059
Permitted C. P. L. R.****
1 36
34
1 1338
1
1 267
15
1 374
1 89
2498
Permit PAN Limit 1st/2nd Crop
. . . . . . . . . 136
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/30/2017 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date
*** Mineralization Rates: Compost -0.1, anaerobialty 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: City of Washington WQ Permit #: WQ0001026 Field #: 15 Acres Utilized: 13
Land Owner: Hunter Roost Farms Annual Dry Tons Applied: 21.27 Site #: BF210 Acres Permitted: 13
Operator: Hunter Roost Farms Predominant Soil Series: Ly Cation Exchange Capacity (non 503): 0
Crop 1 Name: Wheat Crop 1 Max. PAN: 106 Crop 2 Name: Crop 2 Max. PAN:
C> -a
Q9
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/AC)
Residual Sources Soil
Cond.
(NPDES 4, WQ#, (Dry,
Fert., Anima] Wet,
Waste, etc) Moist)
Precip.
Past 24
Hrs.
inches
>
4 '*
0 '�
8.
ory o
o
c
m
c =
*
:ti �
-:
�=
TKN
mg/kg
Z Y
q �
o Q
°; 0
o w
mglkg
Nitrate
and
Nitrite
mglkg
PAN Applied
( ibs/acre)
Name of Crop Type
Receiving Residual
Application
Crop I
Crop 2
Crop 1
Crop 2
1013
156000
3.27
1.636
Washington
D
<.5"
S
0.5
0.3
86400
14800
235
95.282
NA
Wheat
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
0
i1
0.000
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000
0.000
TOTALS:
0
156000
:-::::::;:::::
As
Cd
Cu
Cr
Pb
H,-,
Mo
Ni
Se
Zn
P
95.282
0.000
Lime Applied
Annual lbs/acre
0.042
0.005
0.854
0.065
0,080
0.004
0.018
0,045
0.058
2.251
108.958
::::::::::::::::: : ::::::::::::::
Date
lbs/ac
Prior Years Cumulative lbs/ac
0
0.042
36
0
0.005
34
0
0.854
1338
0
0.065
0
0.080
267
0
0.004
15
0
0.018
0
0.045
374
0
0.058
89
0
2.251
2498
:::
Current Cumulative lbs/ac
Permitted C. P. L. R.****
Permit PAN Limit Ist/2nd Crop
106
"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
T 1/30/2017 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: City of Washington
WQ Permit #: WQ0001026 Field #: 16 Acres Utilized: 25.5
Land Owner: Hunter Roost Farms
Annual Dry Tons Applied: 61.53
Site #: BF210 Acres Permitted: 25.5
Operator: Hunter Roost Farms
Predominant Soil Series:
CrA Cation Exchange Capacity (non 503): 0
Crop 1 Name: Soybeans,
Crop 1 Max. PAN: 154
Crop 2 Name: Crop 2 Max. PAN•
Volume applied Volume
° Y
Residual Sources Soil Preci . a
Cond. p cs
C z Y Name of Crop Type
.j0 5' Nitrate
enter one Solids/ o
( ) /o Applied per
(NPDES #, WQ#, Past 24 co
�' :1 pAN Applied
TKNo c and Receiving Residual
1141
° Li Liquid
9 Solids Acre
(Dry,
Fert., Animal Hrs. o P
_
* N P. co a (lbs/acre)
�• Nitrite Application
A
Cu. Yds Gallons (Dry Tons(Ac)
Waste, etc Wet, �, o'
) Moist inches
*
mglkg mg/kg mg/kg Crop 1 Crop 2 Crop 1 Crop 2
3/14 97500 3.29 0.525
Washington D <.5" S
0.5 0.3 58450 8605 322 20.540 NA Beans
3/15 195000 3.29 1.049
Washington D <.5" S
0.5 1 0.3 58450 8605 322 41.079 NA Beans
3/16 156000 3.29 0.839
Washington D <•5" S
0.5 0.3 58450 9605 322 32.864 NA Beans
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 0 0.000
Residuals Applications totals on FORM FSF supp (attach FORM FSF supp to this form): 0.000 0.000
TOTALS: 01 448500 :::::::::::-:: As
Cd Cu Cr Pb H v
Mo Ni Se Zn I P 94.483 0.000 Lime A lied
Annuallbs/acre 0.061
0.007 1.332 0.104 0.136 0.013
0.027 0.067 0.071 3.325 150.813:;5:::::::::::.:':':-:':::::::=:::: Date lbs/ac
Prior Years Cumulative lbs/ac 0.054
0.019 3.483 0.489 0.366 0.016
0.064 0.25 0.054 8.133
-Current Cumulative lbs/ac 0.115
0.026 4.815 0.593 0.502 0,029
0.091 0.317 0.125 11.458:::::':::::::::::::::::::::::::::::.:....:.:.:
Permitted C. P. L. R.**** 36
34 1338 267 15
374 89 2498
Permit PAN Limit I st/2nd Crop
-
154
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/30/2017
**Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier
Date
*** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH APPLICATION FIELD.
PLACE A "NIA" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: City of Washington Permit #: WQ0001026 Annual Dry Tons Applied: 43.02
Owner: Taylor Barnhill
Site #: PI200
Field #:
Operator: Taylor Barnhill
1 Acres Utilized:
27.2
Cation Exchange Capacity (non 503):
Acres Permitted: 27.2
o
o
s ecifY
Totals
Per
Acre
%
Solid
s
Dry Tons Per
Acre
Residual
Sources
(Summarize)
Site
Cond.
Dry,
Wet,
Inches
Precip.
Past 24
Hrs.
A li
pp
cation
Meth-
od*
Vola-
tili-
zation
Rate**
Miner-
ali-
zation
Rate
TKN
Ammo
nia-
Ni-
trogen
Ni-
trate
and
Nitrite
PAN 1
PAN 2
Must Select
Crop 1 or Crop
p p
2
Gal-
Cu.Yd.
ReportQ Totals
in Gal.
Crop 1
Crop 2
11/22
78000
2867.6
4.29
0.5130
Washington WWTP
Dry
<.5"
S
0.5
0.3
37100
7460
37.3
12.9885
#######
Wheat
1
11/23
84500
3106.6
4.29
0.5558
Washington WWTP
Dry
<.5"
S
0.5
0.3
37100
7460
37.3
14,0709
#######
Wheat
2
11/24
78000
2867.6
4.29
0.5130
Washington WWTP
Dry
<.5"
S
0.5
0.3
37100
7460
37.3
12.9885
#######
Wheat
3
0
0.0000
0
0
4
0
0.0000
1
1 0
0
15
0
0.0000
0
0
6
0
0.0000
0
0
7
0
0.0000
0
0
s
0
0.0000
0
0
9
0
0.0000
0
0
110
0
0.0000
0
0
11
0
0.0000
0
0
12
TOTALS:
8842
.::::::::::::
As
Cd
Cr
Cu
Pb
He
Mo
Ni
Se
Zn
P
PAN I
PAN 2
Lime A)plied
Annuallbs/acre
0.0253
0.0063
0.1930
0.8637
0.1171
0.0041
0.0190
0.0886
0.0158
2.4360
61.3738
40.0479
0
Date
lbs/ac
:>
Current Cumulative Ibs/ac
0.0339 0.0088 0.1930 1.4176 0.1639 0.0075 0.0298 0.1174 0.0210 3.6680
0.0086 0.0025 0.0000 0.5539 0.0468 0.0034 0.0108 0.0288 0.0052 1.2320
36 34 1 1 1338 1 267 15 374 89 1 2498 .............................
100
Prior Years Cumulative Ibs/ac
Permitted C. P. L. R.***
Permit PAN Limit 1 st/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 suing false information, including the possibility of fines and imprisonment for knowing violations."
�".•zz.� 1/14/2014 *Application Method. S - Surface, IN - Injection, INC - Incorporation
Signature of Land Applier Date "Volatilization Volatilization Rate: Surface - 0.5, Iniection/Incorvoration - 1.0
***C.P.L.R.: Cumulative Pollutant Loading Rate
* * * * The RSSF Data and the Dry Tons Per Acre are to be entered on the MFLSF Form. The FSF and MFLSF are mathematically linked so this information needs to be entered into
the same numbered column on the MFLSF as is entered on the identically numbered FSF row to properly complete the metals equations. ie. FSF row # 1 to MFLSF column # 1.

SITE MONITORING REPORT
In pounds per acre
Project:
Washington
Owner:
Taylor Barnhill
Permit #:
WQ0001026
Crop:
Wheat
Weather Code
2
Operator:
Same
Field #:
P1200-02
Acres:
7.7
Site Code
2
Application Method
Injection
Date
Gallons % Solids
Gal/Ac
Dt/Ac
PAN
NO3-NO2
NH3
P
K
Pb
Zn
Cu
Ni
Cd
As
Hg
Se
ME)
10/17/10
26,000 2.34
3376.623
0.3295
14.7504
0.0422
5.9307
21.2847
1,4497
0.0244
0.5252
0.2300
0.0119
0.0013
0.0046
0.0016
0.0033
0.0040
10/18/10
58,500 2.34
7597.403
0.7413
33.1884
0.0950
13.3441
47.8905
3.2619
0,0549
1.1817
0.5175
0.0267
0.0030
0.0104
0.0036
0.0074
0.0089
0
0.0000
0.0000
0.0000
0.0000
0.0000
0,0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0,0000
0.0000
0.0000
0
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0,0000
0.0000
0
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
Totals:
Annual:
84.500
10974.03
1.0708
1 47.9388
0.1373
19.2748
69.1752
4.7116
1 0.0792
1.7069
0.7474
0.0385
0.0043
0.0150
0.0051
0.0107
0.0128
Total Cumulatives
0.2857
7,1468
3.1934
0.1656
0.0154
0.0531
0.0202
0.0337
0.0604
Prior Years Cumulatives
0.2065
5.4399
2.4460
0.1271
0.0111
0.0381
0.0151
0.0230
0.0476
Annual Dr Tons
8.2453
(Lifetime Permit
SOIL MONITORING
Soil PH Lime A pl. Ton/AC
Zn
Bather Code: 1) >90F 2) 70-90F 3)32-70F ""'"* A) Less than 1/2 inch rainfall B) Greater than 1/2 inch rainfall in past 24 hours
Site Condition Code: 11 Excessively Dry 2 Dry 3) Moist 4) Wet
I, __ _ representative of EMA Resources, Inc., hereby certify that this site was operated in compliance with the conditions of Nondischarge Permit No. W00001026

SITE MONITORING REPORT
In pounds per acre
Project:
Washington
Owner:
Taylor Barnhill
Permit #:
WQ0001026
Crop:
Wheat
Weather Code
2
Operator:
Same
Field #:
P1200-03
Acres:
13.4
Site Code
2
Application Method
Injection
Date
Gallons % Solids
Gal/Ac
DVAc
PAN
NO3-NO2
NH3
P
K
Pb
Zn
Cu
Ni
Cd
As
Hg
Se
Mo
10/16/10
13,000 2.34
970.1493
0-0947
4.2380
0.0121
1.7040
6.1154
0.4165
0.0070
0.1509
0.0661
0.0034
0.0004
0.0013
0.0005
0.0009
0.0011
10/17/10
149,500 2.34
11156.72
1.0887
48.7369
0.1396
19.5957
70.3268
4.7901
0.0806
1.7353
0.7599
0.0392
0.0044
0.0152
0.0052
0,0109
0.0131
0
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0
0,0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0
0.0000
0,0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
Totals:
Annual:
162,500
12126.87
1.1833
1 52.9749
0.1517
21.2997
76.4422
5.2066
0.0876
1.8862
0.8260
0.0426
0.0047
0.0166
0.0057
0.0118
0.0142
Total Cumulatives
0.1983
4.8037
2.1378
0.1107
0.0107
0.0370
0.0138
0.0242
0.0398
Prior Years
Cumulatives
0.1107
2.9175
1.3118
0.0681
0.0060
0.0204
0.0081
0.0124
0.0256
Annual Dry
Tons
15.8564
(Lifetime
SOIL MONITORING
Soil PH Lime Appl. Ton/AC
Weather Code: 1) >90F 2) 70-90F 3)32-70F """""" A) Less than 1/2 inch rainfall B) Greater than 112 inch rainfall in past 24 hours
Site Condition Code: 1) Excessively Dry 2 Dry 3) Moist 4) Wet
I, _ , representative of EMA Resources, Inc., hereby certify that this site was operated in compliance with the conditions of Nondischarge Permit No. WQ0001026

SITE MONITORING REPORT
In pounds per acre
Project:
Washington
Owner:
Taylor Barnhill
Permit #:
W00001026
Crop:
Wheat
Weather Code
2
Operator:
Same
Field #:
P1200-04
Acres:
6.7
Site Code
2
Application Method
Injection
Date
Gallons % Solids
Gal/Ac
Dt/Ac
PAN
NO3-NO2
NH3
P
K
Pb
Zn
Cu
Ni
Cd
As
Hg
Se
Mo
10/16/10
71,500 2.34
10671.64
1.0413
46.6179
0,1335
18.7437
67.2691
4.5818
0.0771
1.6599
0.7268
0.0375
0.0042
0.0146
0.0050
0.0104
0.0125
0
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0
0.0000
0.0000
0,0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0
0.0000
0.0000
0.00W
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
R0000
0
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0,0000
0.0000
0.0000
0.0000
Totals:
Annual:
71,500
10671.64
1.0413
46.6179
0.1335
18.7437
67.2691
4,5818
0.0771
1.6599
0.7268
0.0375
0.0042
0.0146
0.0050
0.0104
0.0125
Total Cumulatives
0.1246
2.9103
1.2890
0.0667
0,0068
0.0234
0.0085
0.0157
0.0235
Prior Years Cumulatives
0.0475
1.2504
0.5622
0.0292
0.0026
0,0088
0.0035
0.0053
0.0110
Annual Dry
Tons
6.9768
Permit
SOIL MONITORING
Soil PH Lime Appl. Ton/AC
Weather Code: 1) >90F 2) 70-90F 3)32-70F `""'" A) Less than V2 inch rainfall B) Greater than 1/2 inch rainfall in past 24 hours
Site Condition Code: 1 Excessively Dry 2) Dry 3 Moist 4 Wet
I, , representative of EMA Resources, Inc., hereby certify that this site was operated in compliance with the conditions of Nondischarge Permit No. WQ0001026

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: City of Washington WQ Permit #: WQ0001026 Field #: 2 Acres Utilized:
Land Owner: Will Congleton Annual Dry Tons Applied: 57.58 Site #: P1201 Acres Permitted:
Operator: Will Congleton Predominant Soil Series: ^ ExA Cation Exchange Capacity (non 503):
Crop 1 Name: Small Grain Crop 1 Max. PAN: 106 Crop 2 Name: Crop 2 Max. PAN:
30.4
30.4
0
'^ ,�
o
0
Q
Volume applied
enter one Solids/
( )
Liquid
Cu. Yds Gallons
o
/o
Solids
Volume
Applied per
PP P
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#
Fert., Animal
Waste, etc)
Soil
Cond.
We
Moist
Precip
Past 24
�•
inches
a
0 �
a
o
%�
w
# m
0
7y
* wry,'
9
TKN
mg/kg
Z Y
ci S
o 8
CD 0
o •
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
Name of Crop Type
Receiving Residual
Application
Crop l
Crop 2
Crop 1
Crop 2
10/31
214500
3.54
1.042
Washington
D
<.5"
S
0.5
0.3
49800
11230
78
35.964
NA
SG
11/1
175500
3.54
0.852
Washington
D
<.5"
S
0.5
0.3
49800
11230
78
29.425
NA
SG
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
[�
0.000
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000
0.000
..................
TOTALS:
0
390000::::::::;:;:::
As
Cd
Cu
Cr
Pb
H
Mo
Ni
Se
Zn
P
65.389
0.000
Lime Applied
Annuallbs/acre
0.022
0.008
1.390
0.117
0.144
0.006
0.024
0.072
0.021
3.061
116.860:::::::::::::::::::::::::::::::::
::::::::::::::::::::::: ::::: ::::::::
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.0229
0.0076
1.4398
0.2095
0.16
0.0114
0.0267
0.0762
0.0152
3.9614
2000
Current Cumulative lbs/ac
0.045
0.015
2.830
0.327
0.304
0.018
0.050
0.148
0.036
7.022
Permitted C. P. L. R.****
36
34
1338
267
15
374
1 89
2498
Permit PAN Limit lst/2nd Crop
106
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1 /30/2017 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R: Cumulative Pollutant Loading Rate

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: City of Washington WQ Permit #: WQ0001026 Field #: 3 Acres Utilized: 7.7
Land Owner: Will Congleton Annual Dry Tons Applied: 14.39 Site #: P1201 Acres Permitted: 7.7
Operator: Will Congleton Predominant Soil Series: LoA Cation Exchange Capacity (non 503): 0
Crop 1 Name: Small Grain Crop 1 Max. PAN: 90 Crop 2 Name: Crop 2 Max. PAN:
°
° i
Q
Volume applied
(enter one) Solids/
Liquid
Q
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons�Ac}
Residual Sources
(NPDES # WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
D
met'
Moist
Precip.
p 24
Hrs•
inches
B
rs o
a o
°
o
m 5
# m.
a
w y
" m
;
* 0
TKN
mg/kg
z
o 5
vo C
R.
mg/kg
Nitrate
and
Nitrite
mglkg
PAN Applied
( Ibs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
11/1
71500
3.54
1.371
Washington
D
<.5"
S
0.5
0.3
49800
11230
78
47.329
NA
SG
11/2
26000
3.54
0.498
Washington
D
<.5"
S
0.5
0.3
49800
11230
78
17,210
NA
SG
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
1
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.00o
0.000
0
0
0.000
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000
0.000
..................
TOTALS:
0
97SU0
?;:;:;:;:;:
As
Cd
Cu
Cr
Pb
H
Mo
Ni
Se
Zn
P
64.539
0.000
Lime A lied
Annuallbs/acre
0.022
0.007
1.372
0.116
0.142
0.006
0.023
0.071
0.021
3.020
115.317:::::::::::::::::::::::::::::::::::.
:::::::::::::::::::::::::::::::::::.::::::::
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.0211
0.007
1.3263
0.193
0.1474
0.0105
0.0246
0.0702
0.014
3.6492
2000
Current Cumulative lbs/ac
0.043
0.014
2.698
0.309
0.289
0.017
0.048
0.141
0.035
6.670
Permitted C. P. L. R.****
36
34
1338
267
15
374
89
2498
Igo
Permit a PAN Limst/2n d Crop
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/30/2017 **Volatilization Rate: Surface - 0.5, Injection/Incorporatiion - 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

Facility Name:
Land Owner:
Operator:
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.
City of Washington WQ Permit #: WQ0001026 Field #:
Will Congleton Annual Dry Tons Applied: 66.20 Site #:
Will Congleton
4 Acres Utilized: 35.4
P1201 Acres Permitted: 35.4
Predominant Soil Series: GoA Cation Exchange Capacity (non 503): 0
Crop 1 Name: Small Grain Crop I Max. PAN: 120 Crop 2 Name:
Crop 2 Max. PAN:
° y
o
Q 0
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry TonslAc)
Residual Sources
(NPDES # WQ#,
Fert, Animal
Waste, etc)
Soil
Cond.
(Dry,
Wet,
Moist
Precip.
Past 24
Hrs.
inches
Y
� ,
�
a c
°
o
,.
^
* r.
7y
w .,
?'
*
TKN
mg/kg
Z >
ti
o El
o �•
mglkg
Nitrate
and
Nitrite
mg/kg
p AN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
11/2
247000
3.54
1.030
Washington
D
<.5"
S
0.5
0.3
49800
11230
1 78
35.563
NA
SG
11/3
201500
3.54
0.840
Washington
D
<.5"
S
0.5
0.3
49800
11230
78
29.012
NA
SG
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
1 0.000
0.000
0.000
0.000
0.000
0.000
0.000
0
0
0.000
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp
to this form):
0.000
0.000
..................
TOTALS:
0
448500
:::::::::=::
As
Cd
Cu
Cr
Pb
H
Mo
Ni
Se
Zn P
64.576
0.000
Lime A lied
Annuallbs/acre
0.022
0.007
1.373
0.116
0.142
0.006
0.023
0.071
0.021
3.022 115.379:::::::::::::::::::::::::::::::::::
..................
............................
3.2885::::::::::::::::::::::::::::::::::::::::::::::
6.310
2498
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.019
0.0063
1.1952
0.1739
0.1328
0.0095
0.0221
0.0632
0.0126
2000
Current Cumulative lbs/ac
0.041
0,014
2.568
0.290
0.275
0.016
0.045
0.134
0.033
Permitted C. P. L. R.****
36
34
1 1338
267
IS
374
89
2 Cr
1 nd o Permit PAN Limit st/ P
- - -
120
G°I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1/30/2017 **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date
*** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH APPLICATION FIELD.
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: City of Washington Permit #: _ WQ0001026 Annual Dry Tons Applied:
Owner: Will Congleton Operator: Will Congleton Cation Exchange Capacity (non 503):
Site #: PI201
Field #: 10 Acres Utilized: 7.8
17.87
Acres Permitted: 7.8
N
0 o
cet
A
:�: S cifv
Totals
Per
Acre
%
Solid
sHrs.
Dry Tons Per
Acre
Residual
Sources
(Summarize)
iie
Cond.
Dry,
Wet,
Inches
Precip.
Past 24
Appli-
cation
Meth-
od*
Vola-
tili-
zation
Rate**
Miner-
ali-
zation
Rate
TKN
Ammo
nia-
Ni-
trogen
Ni-
trate
and
Nitrite
PAN 1
PAN 2
Must Select
Crop 1 or Crop
p p
2
Gal.
CuNd.
Report
Totals
in Gal.
Crop 1
Crop 2
11/14
104000
13333
4.12
2.2907
Washington WWTP
Dry
<.5"
S
0.5
0.3
33700
2880
2
48.9664
#####0
SG
1
0
0.0000
0
0
2
0
0.0000
0
0
3
0
0.0000
0
0
4
0
0.0000
0
0
5
0
0.0000
0
0
6
0
0.0000
0
0
7
0
0.0000
0
0
8
1101
0
0.0000
0
0
9
0
0.0000
0
0
0
0.0000
0
0
11
0
0.0000
0
0
12
TOTALS:
13333
=::::::::
As
Cd
Cr
Cu
Pb
H ,
Mo
Ni
Se
Zn
P
JrAN 1
PAN 2
Lime A
lied
Annuallbs/acre
0.0275
0.0092
0.2840
0.9575
0.1649
0.0053
0.0729
0.1283
0.0229
2.7397
69.8664
148.9664
0
Date
lbs/ac
Current Cumulative lbs/ac
0.0275 0.0092 0.2840 0.9575 0.1649 0.0053 0.0229 0.1283 0.0229 2.7397 ::
0.0000 1 0.0000 1 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000
36 34 1338 267 15 374 89 2498
- 100 50
2000
Prior Years Cumulative lbs/ac
Permitted C. P. L. R.***
Limit 1 st/2nd Cop
Permit PAN Li t rP
"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 suhmitting false information, including the possibility of fines and imprisonment for knowing violations."
_ 2!:f 4;:: " _ 1/22/2015 *Application Method: S - Surface, IN - Injection, INC - Incorporation
Signature of Land Applier Date **Volatilization Rate: Surface - 0.5, Iniection/Incorporation - 1.0
***C.P.L.R.: Cumulative Pollutant Loading Rate
* * * * The RSSF Data and the Dry Tons Per Acre are to be entered on the- MFLSF Form. The FSF and MFLSF are mathematically linked so this information needs to be entered into
the same numbered column on the MFLSF as is entered on the identically numbered FSF row to properly complete the metals equations. ie. FSF row # 1 to MFLSF column # 1.
M r-Ll , F-nnne ror /G/nflAIM

SITE MONITORING REPORT
In pwnds per acre
Project:
Washington
Owner:
Congleton Farms
Permit #:
WQ0001026
Crop:
Corn
Weather Code
2
Operator:
Will Congleton
Field #:
P1201-11
Acres:
12.0
Site Code
2
Application Method
Injection
Date
Gallons % Solids
Gal1Ac
DUAc
PAN
NO3-NO2
NH3
P
K
Pb
Zn
Cu
Ni
Cd
As
Hg
Se
Mo
05/02108
123,500 2.7
10291.67
1,1587
58.4723
0.0023
22.7113
85.0514
6.2572
0.0788
1.8030
0.7485
0.0487
0.0042
0.0123
0.0060
0.0097
0.0185
05/03/08
97,500 2.7
8125
0.9148
46.1623
0.0018
17.9300
67.1459
4.9399
0.0622
1.4234
0.5910
0.0384
0.0033
0.0097
0.0048
0.0077
0.0146
0
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0,0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
Totals:
Annual:
221,000
18416.67
2.0735
1 104.63 66
0.0041
40.6412
152,1973
11.1971
0.1410
3.2264
1.3395
0.0871
0.0075
0.0220
0.0108
0.0174
0.0332
Total Cumulatives
0.1410
3.2264
1.3395
0.0871
0.0075
0.0220
0.0108
0.0174
0.0332
Prior Years Cumulatives
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
0.0000
Annual Dry Tons
24.8824
(Lifetime
SOIL MONITORING
Soil Lime A Ro. Ton/AC
Weather Code: 1) >90F 2) 70-90F 3)32-70F "" ' A) Less than 1/2 inch rainfall B) Greater than 1/2 inch rainfall in past 24 hours
Site Condition Code: 1) Excessively Dry 2) Dry 3) Moist 4 Wet
1,_ representative of EMA Resources, Inc., hereby certify that this site was operated in compliance with the conditions of Nondischarge Permit No. W00001026

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH APPLICATION FIELD.
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: City of Washington
Owner: Will Congleton Operator:
Site #: PI201
Permit #: WQ0001026 Annual Dry Tons Applied: 17.87
Will Congleton Cation Exchange Capacity (non 503):
Field #: 12 Acres Utilized: 9 Acres Permitted: 9
°
«t o
A
s eciR
Totals
Per
Acre
%
Solid
s
Dry Tons Per
Acre
Residual
Sources
(Summarize)
1[e
Cond.
Dry,
Wet
Inches I Appli-
precip.' cation
Past 24 Meth-
Hrs. od*
Vola-
tili-
zation
Rate**
Miner-
ali-
zation
Rate
TKN
Ammo
ma-
Ni-
trogen
Ni-
trate
and
Nitrite
PAN 1
PAN 2
Must Select
Crop 1 or Crop
2
Cu.Yd.
..
Report
Totals
in Gal.
Crop 1
Crop 2
11/14
26000
2888.9
4.12
0.4963
Washington WWTP
Dry
<.5"
S
0.5
0.3
33700 1
2880
2
10.6094
#000
SG
1
11115
78000
8666.7
4.12
1.4890
Washington WWTP
Dry
<.5"
S
0.5
0.3
33700
2880
2
31.8282
#######
SG
2
0
0.0000
0
0
3
0
0.0000
0
0
4
0
0.0000
0
0
s
0
0.0000
0
0
6
0
0.0000
0
0
7
0
0.0000
0
0
8
0
0.0000
0
0
9
0
0.0000
0
0
1
10
0
0.0000
0
0
11
0
0.0000
0
0
12
TOTALS:
11556
::::: >::
As
Cd
Cr
Cu
Pb
Ha
Mo
Ni
Se
Zn
P
PAN 1
PAN 2
Lime A
lied
Annual lbs/acre
0.0238
0.0079
0.2462
0.8299
0.1429
0.0046
0.0199
0.1112
0.0199
2.3744
60.5517
42.4376
0
Date
lbs/ac
Current Cumulative lbs/ac
0.0238 0.0079 0.2462 0.8299 0.1429 0.0046 0.0199 0.1112 0.0199 2.3744
0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000
36 34 1 1 1338 267 15 374 89 2498
100 50
Prior Years Cumulative lbs/ac
Permitted C. P. L. R.
Perm it PAN Limit 1 stl2nd Crop P
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system
designed to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are
significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
Z�fz 1/22/2015 *Application Method: S - Surface, IN - Injection, INC - Incorporation
Signature of Land Applier Date **Volatilization Rate: Surface - 0.5, Iniection/Incorvoration - 1.0
***C.P.L.R.: Cumulative Pollutant Loading Rate
* * * * The RSSF Data and the Dry Tons Per Acre are to be entered on the MFLSF Form. The FSF and MFLSF are mathematically linked so this information needs to be entered into
the same numbered column on the MFLSF as is entered on the identically numbered FSF row to properly complete the metals equations. ie. FSF row # 1 to MFLSF column # 1.
r�rur, r�r��e rc+r ro.n nnm

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH APPLICATION FIELD.
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: City of Washington Permit #: WQ0001026 Annual Dry Tons Applied: 14.52
Owner: Will Congleton Operator: Will Congleton Cation Exchange Capacity (non 503):
Site #: P1201 Field #: 13 Acres Utilized: 6.7 Acres Permitted: 6.7
S ecii� tte Must Select
Inches Appli- Vola- Miner- Ammo Ni-
I
*
o Gal. Totals % Residual Cond. Crop 1 or Crop
Dry Tons Per Precip. cation tili- ali- nia- trate
CuNd. Per Solid Sources Dry, TKN PAN 1 PAN 2 2
Report Acre Past 24 Meth- zation zation Ni- and
(Summarize) Wet
Q Totals Acre s Hrs. od* Rate** Rate trogen Nitrite Crop 1 Crop 2
in Gal.
11/13 26000 3880.6 4.12 0.6667 Washington WWTP Dry <.5" S 0.5 0.3 33700 2880 2 114.2514 ####### SG
1
11/14 58500 8731.3 4.12 1.5001 Washington WWTP Dry <.5" S 0.5 0.3 33700 2880 2 132.0657 ####### SG
2
0 0.0000 0 0
3
0 0.0000 0 0
4
0 0.0000 0 0
5
0 0.0000 0 0
6
0 0.0000 0 0
7
0 0.0000 0 0
8
0 0.0000 0 0
9
0 0.0000 0 0
10
0 0.0000 0 1 0 111
0 0.0000 0 0 112
TOTALS: 12612 ::::::=: As Cd Cr Cu Pb Hg Mo Ni Se Zn P PAN 1 PAN 2 Lime Applied
Annual lbs/acre 0.0260 0.0087 0.2687 0.9057 0.1560 0.0050 0.0217 0.1213 0.0217 2.5915 66.0874 46.3171 0 Date lbs/ac
Current Cumulative lbs/ac 0.0260 0.0087 0.2687 0.9057 0.1560 0.0050 0.0217 0.1213 0.0217 2.5915 .:: 2000
Prior Years Cumulative lbs/ac 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000
Permitted C. P. L. R.*** 36 34 1338 267 15 374 89 2498
Limit 1st/ i PAN Li t Per2n d Crop 100 50
mit t p
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system
designed to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are
significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
25L 1/22/2015 *Application Method: S - Surface, IN - Injection, INC - Incorporation
_ _
Signature of Land Applier Date **Volatilization Rate: Surface - 0.5. Iniection/Incorvoration -1.0
***C.P.L.R.: Cumulative Pollutant Loading Rate
**** The RSSF Data and the Dry Tons Per Acre are to be entered on the MFLSF Form. The FSF and MFLSF are mathematically linked so this information needs to be entered into
the same numbered column on the MFLSF as is entered on the identically numbered FSF row to properly complete the metals equations. ie. FSF row # 1 to MFLSF column # 1.
nl--wio r'^13RA CQC /G/�ll�l141

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH APPLICATION FIELD.
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: City of Washington Permit #: - WQ0001026 Annual Dry Tons Applied: 81.52
Owner: Will Congleton
Site #: PI201 Field #:
Operator:
14
Will Congleton Cation Exchange Capacity (non 503):
Acres Utilized: 36.6
Acres Permitted: 36.6
o �
0 o
co
A �
S ecif
Totals
Per
Acre
%
Solid
s
Dry Tons Per
Acre
Residual
Sources
(Summarize)
Site
Cond.
Dry,
Wet,
Mom
Inches
Precip.
Past 24
Hrs.
Appli-
cation
Meth-
od*
Vola-
tili-
zation
Rate* *
Miner-
ali-
zation
Rate
TKN
Ammo-
nia-
Ni-
trogen
Ni-
trate
and
Nitrite
PAN 1
PAN 2
Must Select
Crop 1 or Crop
p p
2
*
*
� Gal.
CuNd.
Report
Totals
in Gal. I
Crop 1
Crop 2
11/11
78000
2131.1
4.12
0.3661
Washington WWTP
Dry
<.5"
S
0.5
0.3
33700
2880
2
7.8266
#######
SG
1
11/12
240500
6571
4.12
1.1289
Washington WWTP
Dry
<.5"
S
0.5
0.3
33700
2880
2
24.132
#######
SG
2
11/13
156000
4262.3
4.12
0.7323
Washington WWTP
Dry
<.5"
S
0.5
0.3
33700
2880
2
15.6532
#######
SG
3
0
0.0000
0
0
4
0
0.0000
0
0
5
0
0.0000
0
0
6
0
0.0000
0
0
7
0
0.0000
0
0
8
0
0.0000
0
0
9
0
0.0000
0
0
10
0
0.0000
0
0
11
0
0.0000
0
0
12
TOTALS:
12964
::::::::::
As
Cd
Cr
Cu
Pb
Her
Mo
Ni
Se
Zn
P
PAN 1
PAN 2
Lime Applied
Annual lbs/acre
0.0267
0.0089
0.2762
0.9310
0.1604
0.0051
0.0223
0.1247
0.0223
2.6639
67.9327
47.6118
0
Date
lbs/ac
Current Cumulative lbs/ac
0.0267 0.0089 0.2762 0.9310 0.1604 0.0051 0.0223 0.1247 0.0223 2.6639
o.0000 o.0000 o.0000 o.0000 o.0000 o.0000 o.0000 o.0000 o.oaoo .:
0.0000 :
36 34 1338 267 15 374 89 2498
100 50
2000
Prior Years Cumulative Ibs/ac
Permitted C. P. L. R.
n
Pe rnlit PAN Limit 1 st/2 d 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."
_ 2�"''e 2" _ 1/22/2015 *Application Method: S - Surface, IN - Injection, INC - Incorporation
Signature of Land Applier Date **Volatilization Rate: Surface - 0.5. Iniection/Incorvoration -1.0
***C.P.L.R.: Cumulative Pollutant Loading Rate
* * * * The RSSF Data and the Dry Tons Per Acre are to be entered on the MFLSF Form. The FSF and MFLSF are mathematically linked so this information needs to be entered into
the same numbered column on the MFLSF as is entered on the identically numbered FSF row to properly complete the metals equations. ie. FSF row # 1 to MFLSF column # 1.

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH APPLICATION FIELD.
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: City of Washington
Owner: Will Congleton Operator:
Site #: PI201
Field #: 15
Permit #: WQ0001026 Annual Dry Tons Applied:
Will Congleton
Acres Utilized: 8.8
Cation Exchange Capacity (non 503):
14.91
Acres Permitted: 8.8
o
Q
s iecif)
Gal.
Totals
Per
Acre
%
Solid
s
Dry Tons Per
Acre
Residual
Sources
(Summarize)
Site
Cond.
Dry,
Wet
Mniqt
Inches
Precip.
Past 24
Hrs.
Appli-
cation
Meth-
od*
Vola-
tili-
zation
Rate**
Miner-
ali-
zation
Rate
TKN
Ammo
nia-
Ni-
trogen
Ni-
trate
and
Nitrite
PAN 1
PAN 2
Must Select
Crop 1 or Crop
p p
Z
Cu.Yd.
..
Report
in Gal.
Crop 1
Crop 2
4/13
136500
15511
2.62
1.6947
Washington WWTP
Dry
<.5"
INJ
1
0.3
67200
9160
57.3
90.2562
#######
Corn
1
0
0.0000
0
0
2
0
0.0000
0
0
3
0
0.0000
0
0
4
0
0.0000
0
0
1
5
0
0.0000
1 0
0
6
0
0.0000
0
0
7
0
0.0000
0
0
8
0
0.0000
0
0
9
0
0.0000
0
0
10
0
0.0000
0
0
11
0
0.0000
0
0
12
TOTALS:
15511
.:::::::::::::
As
Cd
Cr
Cu
Pb
H.P,
Mo
Ni
Se
Zn
P
PAN 1
PAN 2
Lime Applied
Annuallbs/acre
0.0339
0.0068
0.1525
1.0609
0.1051
1 0.0068
0.0203
0.0610
0.0169
3.1284
93.2085
90.2562
0
Date
lbs/ac
Current Cumulative lbs/ac
0.0339 0.0068 0.1525 1.0609 0.1051 0.0068 0.0203 0.0610 0.0169 3.1284 ::
0.0000 1 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000
36 34 1338 267 15 374 1 89 2498
200
Prior Years Cumulative lbs/ac
Permitted C. P. L. R.***
2 Cro
't PAN Limit 1 s t/ nd
Permt p
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system
designed to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are
significant penalties for suhmm%itting false information, including the possibility of fines and imprisonment for knowing violations."
e�z
z 4�'- 1/9/.2013 *Application Method: S - Surface, IN - Injection, INC - Incorporation
Signature of Land Applier Date **Volatilization Rate: Surface - 0.5, Iniection/Incorporation -1.0
***C.P.L.R.: Cumulative Pollutant Loading Rate
* * * * The RSSF Data and the Dry Tons Per Acre are to be entered on the MFLSF Form. The FSF and MFLSF are mathematically linked so this information needs to be entered into
the same numbered column on the MFLSF as is entered on the identically numbered FSF row to properly complete the metals equations. ie. FSF row # i to MFLSF column # 1.
- -RA rater iunnnn�

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH APPLICATION FIELD.
Facility Name:
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
City of Washington Permit #: WQ0001026 Annual Dry Tons Applied:
Owner: Will Congleton Operator:
Site #: P1201 Field #: 16
Will Congleton
Acres Utilized:
Cation Exchange Capacity (non 503):
7.81
3.8 Acres Permitted: 3.8
o
0 C
4 o
Q
s eci
Totals
Per
Acre
%
Solid
s
Dry Tons Per
Acre
Residual
Sources
(Summarize)
rte
Cond.
Dry,
Wet,
Moira
Inches
Precip.
Past 24
Hrs.
Appli-
cation
Meth-
od*
Vola-
tili-
zation
Rate**
Miner-
al i-
zation
Rate
TKN
Ammo
nia-
Ni-
trogen
Ni-
trate
and
Nitrite
PAN 1
PAN 2
Must Select
Crop 1 or Crop
2
*
Gal-
CuNd.
..
Report
Totals
in Gal.
Crop 1
Crop 2
4/12
71500
18816
2.62
2.0557
Washington WWTP
Dry
<.5"
INJ
1
0.3
67200
9160
57.3
109.484
#######
Corn
1
0
0.0000
1 0
0
2
0
0.0000
0
0
3
0
0.0000
0
0
4
0
0.0000
0
a
5
0
0.0000
0
0
6
0
0.0000
0
0
7
0
0.0000
0
0
8
0
0.0000
0
0
9
0
0.0000
0
0
10
0
0.0000
0
0
11
0
0.0000
0
0
12
TOTALS:
18816
:::::::::
As
Cd
Cr
Cu
Pb
I HE
Mo
Ni
Se
Zn
P
PAN 1
PAN 2
Lime Applied
Annuallbs/acre
0.0411
0.0082
0.1850
1.2869
0.1.275
0.0082
0.0247
0.0740
0.0206
3.7948
113.064
109.484
0
Date
lbs/ac
Current Cumulative lbs/ac
0.0411 0.0082 0.1850 1.2869 0.1275 0.0082 0.0247 0.0740 0.0206 3.7948
0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000
36 34 1338 267 15 374 89 2498 =:
200
Prior Years Cumulative lbs/ac
Permitted C. P. L. R.***
Li it 1st/ 2nd C ro
' m e P Permit p
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system
designed to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are
significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
zl_ 1/9/2013 *Application Method: S - Surface, IN - Injection, INC - Incorporation
Signature of Land Applier Date **Volatilization Rate: Surface - 0.5. Iniection/Incornoration -1.0
***C.P.L.R.: Cumulative Pollutant Loadine Rate
**** The RSSF Data and the Dry Tons Per Acre are to be entered on the MFLSF Form. The FSF and MFLSF are mathematically linked so this information needs to be entered into
the same numbered column on the MFLSF as is entered on the identically numbered FSF row to properly complete the metals equations. ie. FSF row # 1 to MFLSF column # 1.
r�r��rs r�rien rc�r /e l�nno\

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH APPLICATION FIELD.
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: City of Washington
Owner: Will Congleton Operator:
Site #: PI201
Field #: 17
Permit #: WQ0001026
Will Congleton
Acres Utilized: 5.3
Annual Dry Tons Applied: 9.94
Cation Exchange Capacity (non 503):
Acres Permitted: 5.3
°
01 o
Q
S ecir�
Totals
Per
Acre
%
Solid
s
Dry Tons Per
Acre
Residual
Sources
(Summarize)
rte
Cond.
Dry,
Wet
Moist
Inches
Precip.
Past 24
Hrs.
Appli-
cation
Meth-
od*
Vola-
till-
zation
Rate**
Miner-
all-
zation
Rate
TKN
Ammo
nia-
Ni-
trogen
Ni-
trate
and
Nitrite
PAN 1
1
PAN 2
Must Select
Crop i or Crop
2
Gal.
Cu.Yd.
. •
Report
Totals
in Gal.
Crop 1
Crop 2
4/11
19500
3679.2
2.62
0.4020
Washington WWTP
Dry
<.5"
1NJ
1
0.3
67200
9160
57.3
21.4085
#######
Corn
1
4/12
71500
13491
2.62
1.4739
Washington WWTP
Dry
<.5"
INJ
1
0.3
67200
9160
57.3
78.4978
######f#
Corn
2
0
0.0000
0
0
3
0
0.0000
0
0
4
0
0.0000
0
0
5
_
0
0.0000
0
0
1
6
0
0.0000
0
0
7
0
0.0000
0
0
8
110
0
0.0000
0
0
9
0
0.0000
0
0
0
0.0000
0
0
11
0
0.0000
0
0
12
TOTALS:
17170
:::::::.:
As
Cd
Cr
Cu
Pb
H,,
Mo
Ni
Se
Zn
P
PAN 1
PAN 2
Lime Applied
Annuallbs/acre
0.0375
0.0075
0.1688
1 1.1743
0.1163
0.0075
0.0225
0.0675
0.0188
3.4629
103.175
99.9062
0
Date
lbs/ac
Current Cumulative lbs/ac
0.0375 0.0075 0.1688 1 1.1743 0.1163 0.0075 0.0225 0.0675 1 0.0188 1 3.4629
0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000
36 34 1338 267 15 374 1 89 2498
200
Prior Years Cumulative lb5/ac
Permitted C. P. L. R.***
Pe trnit PANi it 1 st/2n d 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."
ze�z
__ 1/9/2013 *Application Method: S - Surface, IN - Injection, INC - Incorporation
Signature of Land Applier Date **Volatilization Rate: Surface - 0.5. Iniection/Incornoration -1.0
* * *C.P.L.R.: Cumulative Pollutant LoadinL, Rate
* * * * The RSSF Data and the Dry Tons Per Acre are to be entered on the MFLSF Form. The FSF and MFLSF are mathematically linked so this information needs to be entered into
the same numbered column on the MFLSF as is entered on the identically numbered FSF row to properly complete the metals equations. ie. FSF row # I to MFLSF column # 1.
ncsio Cnone 0017 !L!O/Vl4\

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH APPLICATION FIELD.
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: City of Washington Permit #: - WQ0001026 Annual Dry Tons Applied:
Owner: Will Congleton
Site #: PI201 Field #:
Operator:
18
Will Congleton Cation Exchange Capacity (non 503):
Acres Utilized: 14.2
29.83
Acres Permitted: 14.2
�? oPer
::J specify
%
Solid
s
Dry Tons Per
Acre
Residual
Sources
(Summarize)
ite
Cond.
Dry,
Wet,
Inches
Precip.
Past 24
Hrs.
Appli-
cation
Meth-
od*
Vola-
tili-
zation
Rate**
Miner-
ali-
zation
Rate
TKN
Ammo
nia-
Ni-
trogen
Ni-
trate
andAcre
Nitrite
PAN 1
PAN 2
Must Select
Crop 1 or Crop
2
Gal.Totals
Crop 1
Crop 2
4/10
149500
10528
2.62
1.1502
Washington WWTP
Dry
<.5"
INJ
1
0.3
67200
9160
57.3
61.2604
#######
Corn
1
4/11
123500
8697.2
2.62
0.9502
Washington WWTP
Dry
<.5"
INJ
1
0.3
67200
9160
57.3
50.6064
#######
Corn
2
0
0.0000
0
0
3
0
0.0000
0
0
4
0
0.0000
0
0
5
0
0.0000
0
0
6
0
0.0000
0
0
7
0
0.0000
0
0
8
0
0.0000
0
0
9
0
0.0000
0
0
10
0
0.0000
0
0
1111
0
0.0000
0
0
12
TOTALS:
I19225
:::=::::
As
Cd
Cr
Cu
Pb
Hg
Mo
Ni
Se
Zn
P
JPAN 1
PAN 2
Lime A
lied
Annuallbs/acre
0.0420
0.0084
0.1890
1.3149
0.1302
0.0084
0.0252
0.0756
0.0210
3.8773
115.522
111.867
0
Date
lbs/ac
Current Cumulative lbs/ac
0.0420 0.0084 0.1890 1.3149 0.1302 0.0084 0.0252 0.0756 0.0210 3.8773
0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 o.0000
36 34 1338 267 15 374 89 2498 ::
2 00
Prior Years Cumulative lbs/ac
Permitted C. P. L. R.***
Permit PA N Limit 1st/ 2nd Cro p
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system
designed to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are
significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
Z 1/9/2013 *Application Method: S - Surface, IN - Injection, INC - Incorporation
Signature of Land Applier Date **Volatilization Rate: Surface - 0.5. Iniection/Incorporation -1.0
***C.P.L.R.: Cumulative Pollutant Loading Rate
* * * * The RSSF Data and the Dry Tons Per Acre are to be entered on the MFLSF Form. The FSF and MFLSF are mathematically linked so this information needs to be entered into
the same numbered column on the MFLSF as is entered on the identically numbered FSF row to properly complete the metals equations. ie. FSF row # 1 to MFLSF column # 1.