NC0049867_Regional Office Historical File Pre 2018 (3)

HCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor l ; ; i Secreta;ry>
'.'L1 L JUL 2 5 2014
July 18, 2014
Danny Gabriel — Mayor
Town of Cleveland
P.O. Box 429
Cleveland, NC 27013-0429
Subject: Acknowledgement of
Application No. WQ0011431
Town of Cleveland
Residuals Managment System
Rowan County
Dear Mayor Gabriel:
The Water Quality Permitting Section acknowledges receipt of your permit application and
supporting documentation received on July 8, 2014. Your application package has been assigned the
number listed above, and the primary reviewer is Alice Wessner.
Central and Mooresville Regional Office staff will perform a detailed review of the provided
application, and may contact you with a request for additional information. To ensure maximum
efficiency in processing permit applications, the Division of Water Resources requests your assistance in
providing a timely and complete response to any additional information requests.
Please note that processing standard review permit applications may take as long as 60 to 90 days
after receipt of a complete application. If you have any questions, please contact
Alice Wessner at [phone] or [e-mail].
Sincerely,
Jon Risgaard, Supervisor
Division of Water Resources
cc: Mooresville-Regional,Ofrice,Water-QualityRegional_Ope rations Section.
Eric Thompson — Synagro 284 Boger Road, Mocksville NC 27028
Pete Rich, Chief Operator, Town of Cleveland
Permit File WQ0011431
1636 Mail Service Center, Raleigh, North Carolina 27699-1636
Phone: [phone]Internet: htto://Portal.ncdenr.org/weblwo
An Equal Opportunity 1 Affirmative Action Employer— Made in part with recycled paper

WATER QUALITY'REGIONAL OPERATIONS SECTION
APPLICATION REVIEW REQUEST FORM
Date: July 25, 2014
To: MRO-WQROS: Michael Parker / Andrew Pitner
From: Alice Wessner, Water Quality Permitting Section - Non -Discharge Permitting Unit
A.
B.
C.
D.
E.
Telephone: [phone] Fax. [phone] E-Mail. [e-mail]
Permit Number: WQ0011431
Applicant: Town of Cleveland
Facility Name: Town of Cleveland
Application:
Permit Type: Land Application of Residual Solids (503)
Project Type: Renewal
JUL . 8 2014
Comments/Other Information: Acreages on fields are changing because of better mapping.
❑ I would like to accompany you on a site visit.
Attached, you will find all information submitted in support of the above -referenced application for your
review, comment, and/or action. Within 45 calendar days, please take the following actions:
® Return a completed WQROSARR Form.
❑ Attach a classification rating sheet.
❑ Attach Attachment B for Certification.
® Return a completed WQROSRSR Staff Report
❑ Attach Well Construction Data Sheet.
❑ Issue an Attachment B Certification.
When you receive this request form, please write your name and dates in the spaces below, make a copy
of this sheet, and return it to the appropriate Central Office Water Quality Permitting Section contact
person listed above.
RO-WOROS Reviewer: Date:
FORM: WQROSARR 02-14 Page 1 of 1

July 1, 2014
N.C. Department of Environment and Natural Resources
Division of Water Resources )U 0 2014
Aquifer Protection Section — Land Application Unit
1636 Mail Service Center
Raleigh, NC 27699-1636
ATTENTION: Mr. John Risgaard
REFERENCE: APPLICATION FOR RENEWAL OF PERMIT #
WQ0011431
TOWN OF CLEVELAND
Dear Mr. Risgaard:
On behalf of the Town of Cleveland, Synagro is submitting this application to renew
the referenced residuals land application permit.
New vicinity, application, topographic, and soil maps are being submitted for sites
RA-54 and RA-56. Each field is listed, on form "LASC", as "modified". This
284 Boger Road occurs due to changes in acreage. The acreage changes occur due to more accurate
Mocksville, NC 27028 mapping techniques: specifically, ArcGIS version 10. There are no significant
877.267.2687 changes, other than the deletion of field "NC-RA-53-1". Forms RLAP, LASC, and
336 • 998 . 8450 RSC are included, along with other required forms.
www.synagro.com The renewal of this permit should switch it to the "27" rules. To that end, I listed the
"Predominant soil" information in this application as it is depicted on the Rowan soil
survey data. Previously, soil descriptions were made based on the limiting soil type,
rather than predominant. Thus, the existing soils data may not match the information
submitted here. Additionally, I would like to point out one of my objections to the
current rules. For field RA-54-213, the predominant soil type is Mecklenburg.
However, the predominant map unit is "EnB". Using ArcGIS, it determined that 36
percent of the field is in the Enon map unit. But, 61 percent of the field is in
Mecklenburg map units. The Mecklenburg map units are in two slope phases, so,
based on the current rules, the field is tied to the RYE rates for Enon.
This application package should contain all of the information necessary to complete
the requested renewal of the Town's permit. However, if you require additional
information or have further questions, please contact me at [phone] or
ethompson@syna-r�. Thank you in advance for the timely and efficient review
of this renewal application.
Sincerely,
,isson
cc: Danny Gabriel, Town of Cleveland

QF W A TF� State of North Carolina
Department of Environment and Natural Resources
r Division of Water Quality
Zi
RESIDUALS LAND APPLICATION PROGRAM
INSTRUCTIONS FOR FORM: RLAP 08-11
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 application and
supporting documentation
For more information or for an electronic version of this form, visit the Land Application Unit (LAU) web site at.-
hgq://portal. ncdenr. org/web/wg1aps/lau
General — This application is for treatment, storage, transport, and/or land application of Class B residuals (may include residuals that
are generated from a water treatment plant or other type facilities) on the proposed or currently approved land application site(s) under
15A NCAC 02T .1100.
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Residuals Land Application Program (FORM: RLAP 08-11) Application: (All Application Packages):
Submit the completed and appropriately executed Residuals Land Application Program (FORM: RLAP 08-11) 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.
The Applicant's Certification on Page 5 of this form shall be signed in accordance with 15A NCAC 02T .0106(b). An
alternate person may be designated as the signing official if a delegation letter is provided from a person who meets the
criteria in 15A NCAC 02T .0106(b).
If this project is for a modification of an existing permit, submit one copy of the existing permit.
Please submit this application form at least 180 days prior to the expiration date on the existing permit, or 90 days prior to
operation of proposed facility(ies) for application packages involving new or changes to treatment and storage units.
B. Application Fee (New and Major Modification Application Packages)
] Submit a check, money order or electronic funds transfer made payable to: North Carolina Department of Environment and
Natural Resources (NCDENR).
STANDARD REVIEW — Submit the appropriate fee for all new and major modification applications as listed in the table
below.
EXPRESS REVIEW — Visit the Express Review webpage for the Express Fee Schedule:
STANDARD APPLICATION REVIEW FEES:
1 - A major modification shall be defined as any permit modification that: increases the generating facility's residuals dry tonnage;
adds additional land application areas not previously approved; adds additional residuals sources; or includes the addition of new
treatment or storage units/processes not previously permitted. There is no fee for minor permit modifications.
C. Cover Letter (All Application Packages)
List all items included in the application package, as well as a brief description of the requested permitting action.
D. Environmental Assessments (May be Required— See 15A NCAC 1C .0300)
0 Submit a copy of the Findings of No Significant Impact (FONSI) or Environmental Impact Statement (EIS). Also, include
information on any mitigating factor(s) from the Environmental Assessment (EA) that impact the construction of the residuals
treatment and storage facilities. An EA may also be required for private systems if any public funds and/or lands are used for
the construction of the subject facilities.
INSTRUCTIONS FOR FORM: RLAP 08-11 Page 1 of 3

NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENT.AND NATURAL RESOURCES
RALEIGH
LAND APPLICATION OF RESIDUALS SOLIDS (S03) PERMIT
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 .
...Town of. OeveRand
Rowan County..
FOR THE .
continued operation of a residuals land application program, for the Town of Cleveland and consisting of
the land application of residuals generated by the residuals source -generating facilities listed in the most
recently -certified Attachment A to the land application sites listed . in the most- recently -certified
Attachment B with no- discharge of wastes to -surface -waters, pursuant to the permit modification
application package received on August 22', 2005 as well as additional information received September 15,
2005 and in conformity with the project plan, specifications, and other supporting data subsequently filed
and approved by the Department of Environment and Natural Resources and considered a part of this
permit_
This permit shall be -effective from the date of issuance until December 30, 2010; shall void Permit
No. WQ0011431, issued on December 15, 2000; and shall be. subject to the following specified conditions
and limitations:
L PERFORMANCE STANDARDS
1. The residuals land application program shall be effectively maintained and operated as a non -
discharge system to prevent the discharge of any wastes resulting from the operation of this
program. .
2. This permit shall become voidable if the soils of the land application sites fail to assimilate the
residuals adequately and may be rescinded unless the land application sites are maintained and
operated in a manner that will protect the assigned water quality .standards of the surface
waters and groundwater.
3. The issuance of this permit shall not relieve the Permittee of the responsibility for damages to
surface waters or groundwater resulting from the operation of this residuals land application
program.
1

4. In the event that the residuals land application program is not operated satisfactorily, including
the creation of nuisance conditions; the Pern-duee shall cease land applying residuals to the
site, contact the Aquifer Protection Section of the appropriate Division of Water Quality'.s.
(Division) regional office, and take any immediate corrective actions as may be required by
the Division.
No residuals other than those generated by the residuals source -generating facilities listed in
the most recently -certified Attachment A of this permit shall be approved for.land application`
in accordance with this permit.
6. The pollutant concentrations in any residuals that are land applied to any land application site
shall not exceed the following .Ceiling Concentrations (i.e., dry weight basis):
.Parameter
Ceiling Concentration
(milligrams per kilograms)
Arsenic
75
Cadmium
85
Copper
4,300
Lead
840
Mercury
57
Molybdenum
75
Nickel
420
Selenium
100
Zinc
7,500
7. When residuals 'are land applied under the conditions of this permit, the Class A pathogen
requirements and site restrictions. in 40 'CFR Part 503.32(a) or the .Class B .pathogen
requirements and site restrictions in 40 CFR Part 503.32(b), and one of vector attraction
reduction requirements in 40 CFR Part 503.33 shall be met: Additionally, an evaluation shall
be performed that demonstrates the residuals' ability to comply with this requirement. Upon
request,'a copy.of this evaluation, including all. test results and calculations, shall be submitted.
Only residuals that are generated by the residuals source -generating facilities that are
identified as being exempt from this condition in the most recently -certified Attachment A
shall not be required to comply with the specified pathogen reduction and vector attraction
reduction requirements.
8. Only the land application sites listed in the most recently -certified Attachment B of this permit
are approved for residuals land application.
This permit shall become voidable unless the agreements between the Permittee and the
landowners and lessees or operators of any land application sites listed in the most recently -
certified Attachment B of this permit not owned by the Permittee are in full force and effect.
These agreements shall be considered expired concurrent with the expiration date of the permit
and shall be renewed at the same time the permit is renewed.
10. The appropriate local governmental official (i.e., county manager, city manager, etc.) shall be
notified at least 24 hours prior to the initial residuals land application event to any new land
application site. In addition, the appropriate county manager's office shall be notified -prior to
the initial residuals land application event on any new site so that they will be aware that
residuals land application activities have commenced on the site.
2

11. The Aquifer Protection Section of the appropriate Division's regional office shall be notified
at least 24 hours prior to the initial residuals land application event on any new land
application site. Such notif cation tc -the Regional Aquifer —Protection Super -visor —shall —be
made during normal office hours (i.e., from 8:00 a.m. until 5:00 p.m.) between Monday and
Friday, but excluding State Holidays. A list of the Division's regional offices, their county
coverage, and their contact information may be downloaded from the web site at
http://h2o.enr.statt.nc.us/iidpu/.
)<Ao OPERATION AND MAINTENANCE REOUIREMIENTS
1. The facilities and land application sites shall be properly maintained and operated at all tunes.
2. Upon classification of the residuals land application program by the Water Pollution Control
System Operators Certification Commission (WPCSOCC); the .Permittee shall. designate a
certified land application/residuals operator to be in responsible charge (ORC) of the program.
The operator shall hold a certificate of the type classification assigned to the program by the
WPCSOCC. The Permittee shall also designate a certified back-up operator of the appropriate
type to comply with the conditions of 15A NCAC 8G .0202.
3. No residuals shall be stored at'any land application site at any.time, unless written approval
has first been requested and obtained from the Division. .
.4. A copy of this permit shall be maintained in all manned equipment at the land application sites
when residuals are being land applied during the. life of this permit. A spill prevention and
control plan shall be maintained in all residuals transport and application vehicles.
.5. When land applying residuals to any land application site, the following buffer zones shall be
maintained at all times:
a. 400 feet from residences or places of public assembly under separate ownership for
surface application methods; however, the buffer zone requirement maybe 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 .
pen -nit;
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 11 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;
3

h. 10 feet from upslope interceptor drains and surface. water diversions for both surface and
subsurface application methods; and.
i. 25 feet from downslope interceptor drains, surface water diversions, grouridwater 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 witli these buffers.
6. Maximum slope for land application of residuals shall be 10 percent for surface application
methods and 18 percent for subsurface application methods.
7. Specific residuals land application area boundaries shall be clearly marked -on each land
application site prior to and. during a residuals land application event.
8:: The metal loading rates on any land application site shall not exceed the following
Cumulative Pollutant Loading ]Rates (CPL]Rs): .
Parameter
CIPLIR
(kilograms per hectare)
CPL1R .
(pounds per acre)
Arsenic
41
36
Cadmium
39
34
Copper
1,500
1,338
Lead
300
267
Mercury
17
15
Molybdenum
n/a
n/a
Nickel
420.
374
Selenium
100
89
Zinc
2,800
2,498
9. An acceptable pH shall be maintained in the soil, residuals, and lime mixture, greater, than 6.0,
on. all land application sites onto which residuals are land applied to ensure optimum yield for
the crops specified in Condition H. 13. The agronomist shall provide information on the pH
best suited for the specified crop and the soil type_
10. Should any of the residuals generated by the residuals source -generating facilities listed in the
most recently -certified Attachment A of this permit contain a high salt content (i.e., high
sodium adsorption ratio (SAR) of five or higher), the exchangeable sodium percentage (ESP)
or other method as approved by the Division, using the results.fror the annual soils analysis
as required by this permit, shall be monitored on all of the land application sites. The local
Cooperative Extension Office, the Department of Agriculture and Consumer Services, the
Natural Resource Conservation Service, a North Carolina -licensed Soil Scientist, or other
agronomist shall review the results and make recommendations regarding soil amendments
(e.g., gypsum, etc.) or other ameliorative mechanism for maintaining the integrity of the site in
terms of suitability for land application of residuals and maintaining conditions conducive to
crop growth. The Per.^,.:ttee shall implement such recommendations accordingly and shall
maintain written records of each monitoring event that includes details of the sites covered and
rate of soil amendment application.
M

11. Prior to land applying residuals to any land application site that has previously received or is
intended to receive animal waste (e.g., poultry litter, etc.) or other source of nutrients (e.g.,
fertilizer, etc.) in the future, the�ermitte��l obtain in ormafion pertaining to the v01un-re�---- -
and analysis of the applied waste/nutrients from the landowner and/or lessee/operator of the
site. The Permittee shall be responsible for verifying the volume of residuals that may be land
applied to the site such that the plant available nitrogen (PAN) loading rate forth(,- specified
crop (i.e., see Condition II. 13.) shall not be exceeded by all of the sources of PAN applied.
Should the maximum PAN loading rate be met or exceeded, then no additional residuals shall
be land applied to the site. :
12. A suitable vegetative cover; 'as listed in Condition U. 13., shall. be maintained. on land
application sites onto which residuals are - land. applied 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 other
agronomist and as approved by the Division.
13. Residuals and other sources of PAN shall be land applied to all land application sites at
agronomic rates in accordance with the crop management plan outlined by the local
Cooperative Extension Office, the North Carolina Department of Agriculture and Consumer
Services, the Natural Resource Conservation Service, or other agronomist. Under -no
circumstances shall the following PAN loading rates land applied to . any site exceed the
following for the specified crops:
PAN .
PAN
Crop
(pounds per .
Crop
(pounds per
acre per year)
acre per year)
Alfalfa
200.
Forest
(Hardwood or Softwood)
75
Bermuda Grass .
220
Milo
100
(Hay or Pasture)
Blue Grass
120
Small Grain
(Wheat, Barley, or Oats)
100
Com
Sorghum or Sudex
180
(Grain)
.160
(Pasture)
Corn
200
Sorghum or Sudex
220
(Silage)
(Silage).
Cotton
70
Soybeans
200
Fescue
250
Timothy, Orchard, or
200
Rye Grasses
The Permittee shall apply for and receive a modification of this permit before land applying
residuals on any land application site that is to be established in a crop other than those listed
above. A maximum PAN loading rate for the desired crop shall be approved. with the permit
modification.
If 'the land application sites are to be overseeded (e.g., bermuda grass in the summer and rye
grass in the winter with BOTH crops to receive residuals), then the second crop shall receive
an application of PAN at a rate of no greater than 50 pounds per acre per year. This practice
shall be allowed as long as the second crop is to be harvested. If the second crop is to be
planted for erosion control only and is to be tilled into the soil, then no residuals shall be land.
applied to these sites because the PAN will essentially be returned to the soil. Residuals shall
not be land applied at rates greater than agronomic rates, unless authorized by the Division..
5

14. Animals shall not be grazed on any land application site for 30 days after any residuals land
application event. Sites that are to be used for grazing shall have fencing that will be used to
_ - — prevent access after each event.
15. Food crops, feed crops, and fiber crops that do not come in contact with the residuals shall not
be harvested for 30 days after any residuals land application event.
16. 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.) shall not be harvested for 14
months after any residuals land application event.
17. Food crops with harvested parts below the surface of the land (i.e., root crops such as potatoes,
carrots, radishes, etc.) shall not be harvested for 20. months after any residuals land application
. event when the residuals remain on the land surface for four months or longer prior to
incorporation into the soil.
18. Food crops with harvested parts below the surface of the land shall not be harvested for 38
months after any residuals land application event when the residuals remain on the land
surface for less than four months prior to incorporation into the soil.
19. Turf shall not be harvested for one year after any residuals land application event.
20. Adequate provisions shall be taken to prevent wind erosion and surface runoff from conveying
residuals from the land application sites onto adjacent properties or into any surface waters.
21. Adequate procedures. shall be provided to prevent surface runoff from carrying any land
applied or stored residuals into. any surface waters.
22. Surface -applied residuals shall be plowed or disced within 24 hours after land application on
land application sites with no cover crop established.
23. For land application sites that are prone to flooding or within the 100-year flood elevation,
residuals shall be land applied only during periods of dry weather. The residuals shall be
incorporated into the soil within 24 hours after land application.
24. Residuals shall not be land applied during inclement weather or until 24 hours following a
rainfall event of 0.5-inch or greater in 24 hours. Any emergency residuals land application
measures shall first be approved in writing by the Division.
25. Residuals shall not be land applied to any land application site that is flooded, frozen, or
snow-covered.
26. Appropriate measures shall be taken to control public access to the land application sites -
during active site use and for the 12-month period following the last residuals land application
event. Such controls may include the posting of signs indicating the activities being
conducted at each site.
6

1X1. MONITORING AND REPORTING REQUIREMENTS
1. Any monitoring (i.e., including groundwater, surface water, residuals, coif, or plant tissue
.analyses) deemed necessary by the Division to ensure protection of the environment shall be
established, and an acceptable sampling and reporting schedule shall be followed.
2. Residuals. generated by each residuals source -generating facility. listed in the most -recently -
certified Attachment A of this permit shall be analyzed to demonstrate. that they are non-
hazardous under the Resource Conservation and Recovery Act (RCRA). A corrosivity,
ignitability, and reactivity analysis as well as a Toxicity Characteristics Leaching Procedure
(TCLP) analysis shall be conducted on residuals generated by each residuals source -
generating facility listed in the most recently -certified Attachment A. of this permit. The
analyses shall be performed at the frequency specified in the most recently -certified
Attachment A of this permit, and the results shall be maintained on file by the Permittee for a
minimum of five years. If residuals' generated by a particular residuals source -generating
facility are land applied at a frequency less than that which is specified in the most recently -
certified Attachment A of this permit, the analyses shall be required for each residuals land
application event. Only residuals that are generated by the residuals, source -generating
facilities that are identified as being exempt from this condition in the most recently -certified
Attachment A of this permit shall not be required to comply with this monitoring requirement.
The TCLP analysis shall include the following parameters (i.e., note the regulatory level in
milligrams per liter in parentheses):
Arsenic (5.0) 1,4-Dichlorobenzene (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)
Chlordane (0.03) Hexachlorobenzene (0.13) Tetrachloroethylene (0.7)
Chlorobenzene (100.0). Heptachlor (and its hydroxide) (0,008) Toxaph6ne (0.5)
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)
o-Cresol (200.0) Lindane (0.4) 2;4,5-TP (Silvex) (1.0)
p-Cresol (200.0) Mercury (0.2) Vinyl chloride (0.2)
Cresol (200.0) Methoxychlor (10.0)
2,4-D (10.0) Methyl ethyl ketone (200.0) .
After the residuals have been monitored as specified above for two years at the frequency
specified in the most recently -certified Attachment A of this permit, the Permittee may submit
a request to the Division for a permit modification to request a reduction of this monitoring
requirement. In no case, however; shall the frequency of monitoring be less than once per
permit cycle.
7

3. An analysis shall be conducted on' residuals generated by each residuals source -generating
fac�ility_listed in the most recently eu ifed Attachzx�ettt A Q this Reunit. The analysis shall be
performed at the frequency specified in the most. recently -certified Attachment A of this
permit, and the results shall be maintained on file by the Permittee for a minimum of five
years. If residuals generated by a particular residuals source -generating facility are land
applied at a frequency less than that which is specified in the most. recently -certified
Attachment A of this pernut, an analysis shall be required for each residuals land application
event. The analysis shall include, but shall not necessarily be limited to, the following
parameters:
Aluminum Magnesium Phosphorus
Ammonia -Nitrogen Mercury Potassium
Arsenic Molybdenum Selenium
Cadmium Nickel Sodium
Calcium Nitrate -Nitrite Nitrogen Total Kjeldahl Nitrogen
Copper Percent Total Solids Zinc
Lead tpH. Plant Available Nitrogen.
(by. calculation)
After the residuals generated by a particular residuals source -generating facility have been
monitored for two years at the frequency specified in the most recently -certified Attachment A
of this permit, the Permittee may submit a request to the Division -for a permit modification to
reduce the frequency of this monitoring requirement. In no case, however, shall the frequency
of this monitoring be less than once per year when a residuals land application event of
residuals generated by the residuals source -generating facility occurs during that year.
4. Residuals -generated by each residuals source -generating facility listed in the. most recently -
certified Attachment A of this permit shall be monitored for compliance with Condition I. 7.
The monitoring shall be performed at the frequency specified in the most recently -certified
Attachment A of this permit, and data to verify pathogen and vector attraction reduction of the
residuals shall .'be maintained on file by the Permittee -for a minimum of five years. The
required data shall be specific to the stabilization process utilized, but also shall be sufficient
to demonstrate clear compliance with the Class A pathogen reduction requirements in 40 CFR
Part 503.32(a) or the Class B pathogen reduction requirements and site restrictions in 40 CFR
Part' 503.32(b) as well as one of vector attraction reduction requirements in 40 CFR Part
503.33. Note that the specific oxygen uptake rate (SOUR) test shall not be used to show
compliance with the vector attraction reduction requirement in 40 CFR. Part 503.33 if the
residuals have a total solids concentration . of two percent or greater. In addition, the
Environmental Protection Agency (EPA) certification statements concerning compliance with
pathogen reduction requirements, vector attraction reduction requirements, and management
practices shall be completed quarterly by the proper authority or authorities, if more than one
is involved (i.e., either the person who prepares the residuals, the person who derives the
material, or the person who applies the residuals). Only residuals that are generated by the
residuals source -generating facilities that are identified as being exempt from Condition I. 7.
in the most recently -certified Attachment A of this permit shall not be required to comply with
this monitoring requirement.

5. . Laboratory analyses as required by Condition III. 2., Condition III. 3., and Condition III. 4..
shall be performed/gathered on the residuals as they are to be land applied. Furthermore,
analytical deteirninations made pursuant to the m nono itorm� reporting requirements of lis
permit shall be made by a laboratory certified by the Division for the required parameter(s)
under 15A NCAC 2H .0800 or 15A NCAC 2'H .1100.
6. Proper records shall be maintained by the Permittee tracking all residuals land application
events. These records shall include, but- are not necessarily limited to, the following
information:
a. Source of residuals;
b. Date of land application;
c: Location of land application (i.e., site, field, or zone number);
d. Method of land application;
e. Weather conditions (i.e., sunny, cloudy, raining, etc.);
f. Soil conditions (i.e., dry, wet, frozen, etc.);
g. Type of crop or crops to be grown on field;
h. Volume of residuals land applied in gallons per acre, dry tons per- acre, or kilograms per
hectare;
i. Volume of animal waste or other nutrient source applied. in gallons per. acre, dry ton per
acre, or kilograms per hectare (if applicable);
j.. Volume of soil amendments (i.e:, lime, gypsum, etc.) applied in gallons per acre, dry ton
per acre, or kilograms per hectare (if applicable); and
k. Annual and cumulative totals of dry tons per acre of residuals as well as animal waste'and
other source of nutrients. residuals. (i.e., if applicable); annual and cumulative pounds per
acre of each heavy metal (i.e., shall include, but shall not be limited to, arsenic, 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.
7. A representative annual soils analysis (i.e., Standard Soil Fertility' Analysis) shall be
conducted on each land application site on which a residuals land application event in the
respective calendar year has occurred or is to occur, and. the results shall be maintained on file
by the Permittee fora minimum of five years. 'The Standard Soil Fertility Analysis shall
include, but is not necessarily limited to,. the following parameters:
Acidity Exchangeable Sodium Percentage (by calculation)
Calcium Magnesium. Phosphorus
Cation Exchange Capacity Manganese Potassium
Copper Percent Humic Matter Sodium
Base Saturation (by calculation) pH Zinc
9

8. Three copies of all required monitoring and reporting requirements as specified in Condition
III. 1., Condition lll. 2., Condition Ill. 3., Condition III.4., Condition III. 5., Condition III. 6.,
and Condition III. 7. shall be submitted annually on or before March 1st of the year following
the residuals land application event to the following address:.
NCDENR-DWQ
Information Processing Unit .
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
9. Noncompliance Notification:
The Pernuttee shall report by telephone to the Aquifer Protection Section of the'Division's
Mooresville Regional Office at telephone number [phone], 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:
a. Any occurrence with the residuals land application program that results in the land
application of - .significant amounts of residuals that are abnormal in quantity or
characteristic. .
b. Any failure of the. residuals land application program resulting in a release of material to
receiving waters.
c. Any time that self -monitoring . information indicates that the residuals land application
program has gone out of compliance with the conditions and limitations of this permit or
the parameters on which the program system was designed.
d. Any process unit failure, due to known or unknown reasons, that render the residuals land
application program incapable of adequate residuals treatment.
e. Any spillage or discharge from a vehicle or piping system transporting residuals to the
application site.
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.
IV.. GROUNDWATER REQUIREMENTS
1. Land. Application Site Requirements:
a. Each land application site identified with a GW-A in the most recently -certified
Attachment B of this permit is dominated by soils with a mean seasonal high water table
greater than tluee feet below the land surface. Residuals land application events may
occur on these -sites throughout the year.
10

b. Each land application site identified with. a GW-B in the most recently -certified
Attachment B of this permit is dominated by soils with a mean seasonal high water table
between one and three feet below the land surface. Residual land application events on
these sites shall be prohibited from December through March, inclusive. No residuals
shall be v land applied to these sites hen the vertical. separation between the depth of
residuals land application and the water table is less than three feet. The actual water
table depth for seasonally -restricted soils shall be verified by soil borings within 24 hours
prior to any residuals land application event that occurs from April through November,
inclusive. The number of borings advanced shall be sufficient to characterize water table
conditions across the land application site adequately. Any open borings shall be properly
filled with native soil, prior to the residuals land application event, to decrease the chance
of any residuals contaminating the groundwater.
2. Applicable Boundary Requirements:
a. The COMPLIANCE BOUNDARY for residuals land application programs is specified by
regulations in 15A NCAC 2L (i.e., "Groundwater Classifications and Standards"). The
Compliance Boundary for each land application site is established* at either 250 feet from
the residuals land application area or 50 feet within the. property boundary, whichever is
closest to the residuals land application area. An exceedance of Groundwater Quality
Standards at or beyond the Compliance Boundary is subject to immediate remediation
action according to 15A NCAC 2L .0106 (d)(2).
b. The REVIEW BOUNDARY ' shall ' be established around' each . land application site
midway between the Compliance Boundary and the perimeter of the residuals land
application area. Any exceedance of Groundwater Quality Standards at the Review
Boundary shall require action in accordance with 15A NCAC 2L .0106 (d)(2).
3. Additional Reguirernentse '
a. Any groundwater quality monitoring, as deemed necessary by the Division, shall be
provided.
V. INSPECTIONS
1. Prior to each residuals land application event, the Permittee or his designee shall inspect the
residuals storage, transport, and application facilities to prevent malfunctions and
deterioration, operator errors, and discharges that may cause or lead to the release of wastes to
the. environment, a threat to human health, or a. nuisance. The Permittee shall maintain an
inspection log . or. suim-nary including at least the date and time of inspection, observations
made, and any maintenance, repairs, or corrective actions 'taken by the Permittee. This log of
inspections shall be maintained by the Per riittee for a period of five years from the date of the
inspection and shall be made available to the Division or other permitting authority, upon
request.
11

2. Any duly authorized officer, employee, or representative of the Division may, upon
presentation of credentials, enter and inspect any property, premises, or place on or related to
the land application sites or facilities. at any reasonable time for the purpose of determining
compliance with this permit; may inspect or copy any records that must be kept under the
terms and conditions of this permit; and may obtain samples of groundwater, surface water, or
leachate.
VI. GENERAL CONDITIONS
1. This permit shall become voidable unless the residuals land application events are carried out
in accordance with the conditions of this permit, the supporting materials, and in the manner
approved by the Division.
2. This permit shall be effective only with respect'to the nature and volume of residuals described
in the application and other supporting data.
3. Failure to abide by the conditions and limitations contained in this. permit may subject the
Permittee to an enforcement action by the Division in accordance with North Carolina General
Statutes § 143-215.6A through § 143-215.6C. .
4. The annual administering and compliance fee shall be paid by the Permittee within 30 days
after being billed by the Division. Failure to pay the fee accordingly may cause the Division
to initiate action to revoke this permit, as specified by 15 NCAC 2H .0205 (c)(4).
.5. .The issuance of this permit does not preclude the Pei.7nittee from complying with any and all
statutes, rules, regulations, or ordinances that may be imposed by other government agencies
(i.e., local, state, and federal) which have jurisdiction, including, but not limited to, applicable
river buffer rules in 15A NCAC 2B .0200, soil erosion and sedimentation control requirements
in 15A:NCAC Chapter 4-and under the Division's General Permit NCGO100000, and any
requirements pertaining to wetlands under 15A NCAC 213.0200 and 15A NCAC .0500.
6. This pen -nit may be modified, revoked, and/or reissued to incorporate any conditions,
limitations and monitoring requirements the Division deems necessary in order to protect the
environment and public health adequately.
7. The Permittee, at least six months prior to the expiration of this permit, shall request its
extension_ Upon receipt of the request, the Division shall review the -adequacy of the facilities.
and residuals land application program described therein, and if warranted, shall extend the
permit for such period of time and under such conditions and limitations as it may deem
appropriate.
12

8. This permit shall not be automatically transferable. In the event that there is a desire for the
residuals land application program to change ownership or to change the name of the
Permittee, a formal permit request shall be submitted to the Division ocumentation from the
parties involved and other supporting materials as may be appropriate. The approval of this
request shall be considered on its merits and may or may not be approved.
Permit issued this the 2511 ay of January 2006.
NORTH CAR
INA ENV MENTAL MANAGEMENT COMMISSION
Division of Water Quality
By Authority of the Environmental Management Commission
Permit Number W00011431
13

ATTACHMENT A -_ Approved residual Source -Generating Facilities
Permit No, W00011431
Town of Cleveland
Town of Cleveland Residuals Land Application Prograin
Owner
Facility Nance
County
Permit
Issued
. Is 503?
Maldmum
. Monitoring
Monitoring
Approved
Number
By
Dry Tons
Frequency for
Frequency for
Mineralization
Per Year
Condition III.2.
Condition III.3. and
hate
Condition III.4.
Town of Cleveland
Cleveland WWTP
Rowan
NCO049867
DWQ
- 503
82.00
Annually
Annually
0130
Total
82.00
1
Permit No. WQ0011.431 Page 1 of 1
Certification Date: Februa%y 6, 2006

ATTACHNEENT B - Approved Land Application Sites
Permit NO. WQ0011431
Toavn of Cleveland
T.own of Cleveland Residuals Land Application Program
Site/Field ID
Landowner
Lessee/Operator
County
Latitude
Longitude
Net Acreage
Applicable
Restriction
Condition
in
iv. 1.
NC-RA-53-01
Teve au h, Mark
Rowan
35045'54"
80042'08"
15.70
GW-A
NC-RA-54-02A
Doby, Darlene
Rowan
35047'17"
80°41'24"
11.20
GW-A
NC-RA-54-02B
Doby, Darlene
Rowan
35°47'12"
80°41'18"
13.70
GW-A
NC-RA-56-OIA
Hodge, Ira
Rowan
35°45'34"
80°42'04"
10.90
OW -Al
NC-RA-56-01B
Hodge, Ira
Rowan
35°45'44"
80042'03"
9.90
GW-A
Total For- County
Carteret
Rowan
61.40'
Total
61.40
1
Permit No. WQ0011431 Page 1 of 1 Certification Date: February 6, 2006

E. Operation and Maintenance Plan (New and Renewal Application Packages)
�f For Modification Application, if there are any changes to the existing plan, submit an updated O&M plan.
Submit the O&M Plan in accordance with 15A NCAC 021.1110 and include at a minimum:
Operational functions; describe the operation of the program to show what operations are necessary for the program to
function and by whom the functions are to be conducted.
® Maintenance schedules; may include equipments calibration, maintenance of signs, etc.
Safety measures; may include safety training program, manuals, signs, etc.
Spill response plan; including control, containment, remediation, emergency contact information, etc.
Inspection plan including the following information;
Names and titles of personnel responsible for conducting the inspections.
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.
Detailed description of inspection procedures including record keeping and actions to be taken by the inspector in the
event that noncompliance is observed.
®. Sampling and monitoring plan including the following information;
® Names and titles of personnel responsible for conducting the sampling and monitoring.
Detailed description of monitoring procedures including parameters to be monitored.
® 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.
THE FOLLOWING ADDITIONAL ITEMS (G to M) ARE REQUIRED FOR DEDICATED PROGRAM ONLY.
F. Program Determination
[] Dedicated residuals land application programs are ones in which land application sites meet the criteria in 15A NCAC 02T
.1102(12). Specifically, a residuals land application program is designated as dedicated if any of the following are applicable:
Any land application site certified for the residuals land application program that receives residuals at rates or frequencies
greater than agronomic rates.
Any land application site certified for the residuals land application program that is used primarily for residuals disposal,
and agricultural crop production is of secondary importance.
0. Any land application site certified for the residuals land application program that receives residuals through fixed
irrigation facilities or irrigation facilities fed through a fixed supply system.
Please contact the Aquifer Protection Section if you need any assistance in determining whether your residuals program falls
under the dedicated program definitions.
G. Program Information
Provide an explanation of why a dedicated system is required instead of a conventional non -dedicated system.
] Provide an explanation of the dedicated system and its operation.
H. Detailed Site Maps (All New or Modification Application Packages)
Submit three (3) sets of standard size plans and two (2) sets of I I" by 17" plans (electronic format is acceptable - Adobe PDF
only). For Modifications, submit plans specific to the modification(s) only.
Plans must include the following minimum items:
A general location map, a vicinity map and a topographic map with contours not exceeding 10 feet or 25% of the total site
relief and showing all facility related structures and fences within the land application area.
Q The location of all wells (including usage and construction details if available), streams (ephemeral, intermittent, and
perennial), springs, lakes, ponds, and other surface drainage features within 500 feet of the land application site(s).
0 Delineation of the review and compliance boundaries
0 Setbacks as required by 15A NCAC 02T .1108
IQ Site property boundaries within 500 feet of all waste treatment, storage, and disposal site(s).
A map showing the entire irrigation area with an overlay of the suitable irrigation area depicted by the soil scientist's
evaluation. The irrigation plans shall show each nozzle/emitter and wetted area (when applicable). Clearly label spray
irrigation zones as they will be operated.
0 Plans must depict a completed design and not be labeled with preliminary phrases (e.g., FOR REVIEW ONLY, NOT FOR
CONSTRUCTION, etc.) that indicate that they are anything other than final plans. However, the plans may be labeled
with the phrase: FINAL DESIGN - NOT RELEASED FOR CONSTRUCTION
INSTRUCTIONS FOR FORM: RLAP 08-11 Page 2 of 3

I. Project Evaluation and Receiver Site Management Plan (All New Application Packages or Modifications that include new
sites)
❑ Submit a project evaluation and a receiver site management plan (if applicable) with recommendations concerning cover
crops and their ability to accept the proposed application rates.
T Hydrogeologic Report (All New Application Packages or Modifications involving increasing the total design capacity)
❑ Submit a detailed hydrogeologic evaluation in accordance with 15A NCAC 02T .1104(d)(4) and current Division Policy
available at: http://portal.nedenr.org/web/wq/aps/lgWpolicies. The document shall be signed, sealed and dated by a qualified
professional.
K. Engineering Design Documents (All New or Modification Application Packages with fixed irrigation facilities or irrigation
facilities fed through fixed supply system)
❑ Submit engineering design documents that have been signed, sealed, and dated by a NC licensed Professional Engineer and/or
Professional Land Surveyor in accordance with 15A NCAC 02T .1104(d)(2). For Modifications, submit an updated site map
specific to the modification(s) only.
❑ The design documents must include the following minimum items:
❑ Engineering plans for the facility and equipment except those previously permitted unless they are directly tied into the
new units or are critical to the understanding of the complete process;
❑ Specifications describing materials to be used, method of construction, and means for ensuring quality and integrity of the
finished product including leaking testing; and
Engineering calculations including hydraulic and pollutant loading, sizing criteria, hydraulic profile, total dynamic head
curve analysis for each pump, and irrigation design.
Soil mapping units shown on all disposal sites.
L. Water Balance (All New Application Packages or Modifications that include new sites utilizing fixed irrigation facilities or
irrigation facilities fed through fixed supply systems)
❑. Submit a completed and accurate water balance in accordance with 15A NCAC 02T .I 104(d)(5) and current Division Policy
available at: hgp://portal.ncdenr.org/web/wg/aps/lgiVpolicies.
M. Property Ownership Documentation (All New or Modification Application Packages involving new and/or relocated treatment
or irrigation components)
❑ Property ownership documentation shall consist of one of the following:
[ I Legal documentation of ownership (i.e., GIS, deed or article of incorporation), or
Written notarized intent to purchase agreement signed by both parties with a plat or survey map, or
❑ An easement running with the land specifically indicating the intended use of the property and meeting the requirements of
15A NCAC 02L .0107(fl, or
A written notarized lease agreement signed by both parties, indicating the intended use of the property, as well as a plat or
survey map.
ONE ORIGINAL AND TWO COPIES OF THE COMPLETED APPLICATION PACKAGE, INCLUDING ALL
SUPPORTING INFORMATION AND MATERIALS, SHALL BE SENT TO THE FOLLOWING ADDRESS:
NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
AQUIFER PROTECTION SECTION
LAND APPLICATION UNIT
By U.S. Postal Service:
1636 MAIL SERVICE CENTER
RALEIGH, NORTH CAROLINA 27699-1636
TELEPHONE NUMBER: [phone]
By Courier/Special Delivery:
2728 CAPITAL BOULEVARD
RALEIGH, NORTH CAROLINA 27604
FAX NUMBER: [phone]
INSTRUCTIONS FOR FORM: RLAP 08-11 Page 3 of 3

I.
II.
State of forth Carolina
Department of Environment and Natural resources
Division of Water Quality
RESIDUALS SOURCE CERTIFICATION
FORM: RSC 08-11
RESIDUALS SOURCE -GENERATING FACILITY INFORMATION (See Instruction B.):
1. Facility Name: Cleveland WWTP
2. Facility permit holder is: Federal,] State, ® Local Government, or E] Private.
Facility permit issued by: Div. of Water Quality, 0 Div. of Environmental Health,
or Other (explain: [: i).
3. Facility contact person and title: Pete Rich, Chief Operator
Complete mailing address: PO Box 429
City: Cleveland State: NC Zip: 27013-0429
Telephone number: 704) 881-4598 E-mail address:
4. Facility physical address: 625 Third Creek Church Road
City: Cleveland State: NC Zip: 27013
Coordinates: Latitude: 35' 44' 35" Longitude: 80' 40' 59"
Datum: NAD83 Level of accuracy: Second
Method of measurement: MAP
5. Purpose of the facility:
treatment of municipal wastewater, D treatment of 100% domestic wastewater,
treatment of potable water, j treatment of 100% industrial wastewater,
F] treatment of industrial wastewater mixed with domestic wastewater,
(approximate percentages: I j % industrial and 4 % domestic)
other (explain: F 1 ).
6. Does the facility have an approved pretreatment program: Yes] No
7. Facility permitted/design flow: 0.27 MGD and facility average daily flow: 0.1554 MGD
8. Average amount of residuals being generated at this facility 6_5 dry tons per year.
9. Specify the following regarding treatment and storage volumes available at the facility:
Type and volume of residuals treatment: two oxidation ditches totaling 270,000 gallons plus one 80,000 gal digester
Type and volume of residuals storage (i.e., outside of residuals treatment units): N/A
RESIDUALS QUALITY INFORMATION (See Instruction C.):
1. Specify if residuals are regulated under:
40 CFR Part 503 or 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 15A NCAC 02T.1102(6) as:
. Biological Non -Biological
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).
FORM: RSC 08-11 Page 1 of 5

III. RESIDUALS LAND APPLICATION PROGRAM INFORMATION:
1. Residuals Processing Facility's physical address: 625 Third Creek Church Road
City: Cleveland State: N.C.
Coordinates: Latitude: 35' 44' 35"
Datum: NAD83
Method of measurement: MAP
Zip: 27013
Longitude: 80' 40' 59"
Level of accuracy: second
2. County where residuals land application program is headquartered: Rowan
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
Michael Boone
Synagro Central, LLC
LA 987521
Back -Up ORC
Eric Norman Thompson
Synagro Central, LLC
LA 29096
Additional Back -Up ORCs
(if applicable)
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: F 1
4. Complete the following tables regarding management of the residuals land application program:
a. Plant Available Nitro,een Summary: 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: 82 dry tons per year.
PAN
Pounds of PAN per Dry Ton
(Weighted Average)
Pounds of PAN per Year
Surface
Incorporation
or Injection
Surface
Incorporation
or Injection
First -Year
49.57
52.99
4065
4345
Five -Year Maximum Adjusted
63.62
67.04
5217
5498
b. Land Application Site Use Summary: 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
0.0
Row Crops
22.2
Hay
0.0
Pasture
22.1__
Total:
44.3
Methods
Surface
44.3
Incorporation or Injection
0.0
_
Total:
44.3
FORM: RLAP 08-11 Page 2 of 5

c. Residuals Lain Application 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
qbs PAN/ac yr)
Concentrations
Surface
Incorporation or
Surface
Incorporation or
Injection
Injection
50
81.3
86.9
104.3
110.0
100
40.7
43.5
52.2
55.0
150
27.1
29.0
34.8
36.7
200
20.3
21.7
26.1
27.5
6. If applicable, provide a plan and a schedule to resolve any brown 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.): f
7. Specify type of residuals program (See Instruction F): Non -dedicated '[] Dedicated
If Dedicated, specify the following (check all that apply):
F] Residuals program contains _any land application site(s) that receives residuals at rates or frequencies greater than
agronomic rates, explain;;
'0 Residuals program contains any land applicationsite(s) that is used primarily for residuals disposal, and agricultural crop
production is of secondary importance, explain; _
p_ Residuals program contains any land application site(s) that __r_eceives residuals through fixed irrigation facilities or
irrigation facilities fed through a fixed supply system, explain; F i
IV. RESIDUALS SOURCE INFORMATION: (Not required if no new, renewed, or modified residuals source)
Complete and submit the following Residuals Source Certification and all associated documentation.
+tom{lai
'' E
Residuals Source
Certification
V. LAND APPLICATION SITE INFORMATION: (Not required if no new, renewed, or modified land application site)
Complete and submit the following Land Applications Site Certification and all associated documentation.
�I
Land Application Site
Certification. doc
FORM: RLAP 08-11 Page 3 of 5

Note: Item VI. Applicable to Dedicated Program with fixed irri satg ion system only.
DESIGN INFORMATION FOR FIXED IRRIGATION SYSTEM
1. The irrigation system is: 0 Spray ❑ Drip
2. Disposal system is: '0 existing] proposed.
3. Minimum depth to mean seasonal high water table (SHWT) within irrigation sites(s) per Soil Scientist's Evaluation: I
feet below ground surface. Rules 15A NCAC 02T .0505(p) 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 ID No If Yes, please explain if the soil scientist report addresses artificial structures and please indicate if
structures are to be maintained or modified: I
5. Loading rates recommended by the Soil Scientist Evaluation:
Recommended
Recommended
Soil Series
Fields within Soil Area
Loading Rate
Loading Rate
(in/hr)
(in/ r
[....___.�.1
6. Design loading rates are equal or less than the loading rates recommended by Soil Scientist?
] Yes or 0 No If No, explain why 15A NCAC 02T .0505(n) 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
ft2)
Number of
Nozzles
Maximum Application
Rate allons/hr
Design Annual Loading
Rate (gallons/ r
Total
ZZaaYY
,g
Plan Sheet
Specification
Spray Irrigation Design Element
Number
Page Number
Wetted diameter of nozzles
�,_ ft
Wetted area of nozzles
[` _ v ft
Nozzle ca aci
p
gPrn
------- :
L_.___ _
Nozzle manufacturer / model
_ __.'
Elevation of highest nozzle
-------- ; ft
_
_-
FORM: RLAP 08-11 Page 4 of 5

Applicant's Certification (signing authority must be in compliance with 15A NCAC 02T .0106):
ie applicant or any affiliate has not been convicted of an environmental crime, has not abandoned a wastewater facility without
poper closure, does not have an outstanding civil penalty where all appeals have been exhausted or abandoned, are compliant with any
active compliance schedule, and do not have any overdue annual fees under Rule 15A NCAC 02T .0105.
Yes [f No, Explain;
I, Danny Gabriel Mayor Town of Cleveland
(Signature Authority's Name — PLEASE PRINT) (Title)
attest that this application for Town of Cleveland
(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 Quality
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 Quality 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 §143-215.6B, any person who knowingly makes any
false statement, representation, or certification in any application shall be guilty of a Class 2 misdemeanor, which may include a fine
it to exceed $10,000 as well as civil penalties up to $25,000 per violation.
Signature:
FORM: RLAP 08-11 Page 5 of 5

OF W A TF.9 State of North Carolina
Department of Environment and Natural resources
Division of Water Quality
RESIDUALS SOURCE CERTIFICATION
INSTRUCTIONS FOR FORM: RSC 08-11
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 application and
supporting documentation
For more information or for an electronic version of this form, visit the Land Application Unit (LAU) web site at:
http: //portal. ncdenr. orb/web/wg1aps/lay
General — This certification provides detailed information of residuals source generating facility and its residuals quality for land
application, distribution, or disposal in accordance with 15A NCAC 02T .1100. Do not submit this certification for review without
a corresponding application form (FORM: RLAP 08-11, FORM: DCAR 08-11, or FORM: SDR 08-I1).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Residuals Source Certification (FORM: RSC 08-11):
® Submit the completed and appropriately executed Residuals Source Certification (FORM: RSC 08-11) 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.
® For new or renewed permits, submit a separate certification for each source facility.
❑ For modified permits, submit a separate certification for only those facilities that are affected by the proposed modification.
® Complete the residuals source facility summary page. List all new, renewed, or modified facilities.
Residuals Source -Generating Facility Information:
® For each source facility, attach the following:
® Vicinity map - A vicinity map that shows the location of the facility and meets all of the criteria in the "Map Guidance for
Residuals Land Application Permits".
® Process flow diagram and/or narrative - A detailed narrative and/or process flow diagram that describes how the residuals
are to be generated, treated, processed, and stored at the facility.
® Quantitative justification for residuals production rate - A quantitative justification for the value provided in Item 1. 8.
Ensure that the amount of residuals listed is the maximum amount expected to be generated by the facility for the life of
the permit. In addition, ensure that this amount is equivalent to that which is actually to be land applied, distributed,
and/or disposed, including any chemicals, amendments, or other additives that are added to the residuals during
processing.
® Sampling plan - A detailed sampling plan for the residuals source -generating facility. Ensure that the plan identifies
sampling points, sampling frequency, sample type, as well as the Division -certified laboratory to be used. In addition,
ensure that the plan details how the facility and/or the residuals are monitored for any applicable pathogen reduction and
vector attraction reduction requirements. Note that all sampling and monitoring must be completed on the residuals as
they are to be land applied, distributed, and/or disposed.
C. Residuals Quality Information:
® For each source facility, attach the following:
® Laboratory analytical reports and operational data - reports for all laboratory analyses used to complete this certification.
® Documentation that the facility complies and/or the residuals comply with any applicable pathogen reduction and vector
attraction reduction requirements.
❑ For new facility that may have not yet been constructed and analytical results of residuals cannot be obtained, please
attach analytical results of residuals generated from a similar facility along with the description of similarities of the two
facilities.
INSTRUCTIONS FOR FORM: RSC 08-11 Page 1 of 1

RESIDUALS SOURCE FACILITY SCARY
Applicant's name: Town of Cleveland
Status Maximum Dry Tons Per Year
Facility Permit Holder Facility Name County Permit Number
Code' Current n Proposed
R Town of Cleveland Cleveland WWTP Rowan NC0049867 82 82
'Status Code for source facility are: o N (New) o R (Renewed) o M (Modified) 9 D (Deleted)
v The amount of residuals currently permitted for distribution, land application, or disposal (Le, not applicable to new facility).
SUMMARY FOR FORM: RSC 08-11 Page 1

State of North (Carolina
Department of Environment and Natural Resources
Division of Water Quality
RESIDUALS SOURCE CERTIFICATION
FORM: RSC 08-11
I. RESIDUALS SOURCE -GENERATING FACILITY INFORMATION (See Instruction B.):
1. Facility Name: Cleveland WWTP
2. Facility permit holder is: E] Federal,] State, 0 Local Government, or 0 Private.
Facility permit issued by: Z Div. of Water Quality, El Div. of Environmental Health,
or Other (explain: L:D.
3. Facility contact person and title: Pete Rich, Chief Operator
Complete mailing address: PO Box 429
City: Cleveland State: NC Zip: 27013-0429
Telephone number: [phone] E-mail address:
4. Facility physical address: 625 Third Creek Church Road
City: Cleveland State: NC Zip: 27013 !_ _
Coordinates: Latitude: 350 44' 35" Longitude: 80' 40' 59"
Datum: NAD83 Level of accuracy: Second
Method of measurement: MAP
5. Purpose of the facility:
N treatment of municipal wastewater, F1 treatment of 100% domestic wastewater,
F] treatment of potable water, U] treatment of 100% industrial wastewater,
r] treatment of industrial wastewater mixed with domestic wastewater,
(approximate percentages: I % industrial and f % domestic)
El other (explain: ! ).
6. Does the facility have an approved pretreatment program: Yes No
7. Facility permitted/design flow: 0.27 MGD and facility average daily flow: 0.1554 MGD
8. Average amount of residuals being generated at this facility 6_5 dry tons per year.
9. Specify the following regarding treatment and storage volumes available at the facility:
Type and volume of residuals treatment: two oxidation ditches totaling 270,000 gallons plus one 80,000 gal digester
Type and volume of residuals storage (i.e., outside of residuals treatment units): N/A
H. RESIDUALS QUALITY INFORMATION (See Instruction C.):
1. Specify if residuals are regulated under:
40 CFR Part 503 or rl 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 15A NCAC 02T.1102(6) as:
W. Biological [I. Non -Biological
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).
FORM: RSC 08-11 Page 1 of 5

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
i
100% non -municipal, domestic wastewater only)
a. Are the residuals listed in 40 CFR §261.31-§261.33:] yes ® no.
If yes, list the number(s):
b. Specify whether or not the residuals exhibit any of the characteristics defined by 40 CFR §261.21-
261.24: El yes N no.
Fill in the following tables with the results of the latest toxicity characteristic leaching procedure (TCLP) analysis as
well as those for cor-osivity, ignitability, and reactivity:
Laboratory: Pace Anal ical and Date of analysis: 03-27-12
Passed coirosivity test: yes El. no. pH: 5_0 s.u. (2 < pH < 12.5)
Passed ignitability test: yes El no. Flashpoint: >200 OF (> 140°F)
Passed reactivity test: Eyes .]no. HCN: <0.025 mg/lcg (<250) & H2S: <100 mg/kg (<500)
TCLP Parameter
Limit
(mg/1)
Result
(mg/1)
TCLP Parameter
Limit
(mg/1)
Result
(mg/1)
Arsenic
5.0
<0.025
Hexachlorobenzene
0.13
<0.050
Barium
100.0
1.40
Hexachloro-1,3-Butadiene
0.5
<0.050
Benzene
0.5
<0.10
Hexachloroethane
3.0
<0.050
Cadmium
1.0
<0.005
Lead
5.0
<0.025
Carbon Tetrachloride
0.5
<0.10
Lindane
0.4
<0.0005
Chlordane
0.03
<0.003
Mercury
0.2
<0.0002
Chlorobenzene
100.0
<0.10
Methoxychlor
10.0
<1.0
Chloroform
6.0
<0.10
Methyl Ethyl Ketone
200.0
<0.20
Chromium
5.0
0.090
Nitrobenzene
2.0
<0.050
m-Cresol
200.0
<0.050
Pentachlorophenol
100.0
<0.10
o-Cresol
200.0
<0.050
Pyridine
5.0
<0.050
p-Cresol
200.0
<0.050
Selenium
1.0
<0.10
Cresol
200.0
<0.050
Silver
5.0
<0.025
2,4-D
10.0
<0.010
Tetrachloroethylene
0.7
<0.10
1,4-Dichlorobenzene
7.5
<0.050
Toxaphene
0.5
<0.003
1,2-Dichloroethane
0.5
<0.10
Trichloroethylene
0.5
<0.10
1,1-Dichloroethylene
0.7
<100
2,4,5-Trichlorophenol
400.0
<0.050
2,4-Dinitrotoluene
0.13
<0.050
2,4,6-Trichlorophenol
2.0
<0.050
Endrin
0.02
<0.0005
2,4,5-TP (Silvex)
1.0
<0.010
Heptachlor and its Hydroxide
0.068
<0.0005
Vinyl Chloride
0.2
<0.10
FORM: RSC 08-11 Page 2 of 5

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 Application: 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: Statesville Anal3lical and Date of analysis: W03/2012
Parameter
Ceiling
Concentration Limits
(ClassA & ClassB)
(mg/kg)
Monthly Average
Concentration Limits
(Class A Only)
(mg/kg)
Result
(mg/kg)
Arsenic
75
41
0.89
Cadmium
85
39
2.84
Copper
4,300
1,500
469
Lead
840
300
22.7
Mercury
57
17
1.47
Molybdenum
75
n/a
0.0909
Nickel
420
420
24.4
Selenium
100
100
1.82
Zinc
7,500
2,800
1030
b. For Surface Disposal Unit (landfill): 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: I i and Date of analysis: f
Distance from Disposal
Unit to Boundary to
Closest Property Line
(meters, check one)
Arsenic
(mg/kg)
Chromium
(mg/kg)
Nickel
(mg/kg)
d > 0 but < 25
30
200
210
> 25 but < 50
34
22.0
240
> 50 but < 75
39
260
270
[] > 75 but < 100
46
300
320
Ej 100 but < 125
53
360
390
I'El > 125
62
450
420
Result (mg/kg
FORM: RSC 08-11 Page 3 of 5

5. Nutrient/Micronutrient Determination: Complete the following:
a. Total solids: 0.88 %.
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: Statesville Analytical and Date of analysis: 03/27/2012
Parameter
Result
(mg/k9)
Aluminum
3 523
Ammonia -Nitrogen
3420
Calcium
21,364
Magnesium
1892
Nitrate -Nitrite Nitrogen
12,273
pH (Standard Unit)
5.44
Phosphorus
20,455
Potassium
93.3
Sodium
9204
Total Kjeldahl Nitrogen
39,432
c. Using the results listed in Item H. 5b. above, calculate the sodium adsorption ration (SAR): 1.52
[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: 30 %. This
rate is a (check one): 0. default value, or E] 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: This is a default value for
water treatment plant alum residuals.
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 (1") Year PAN
Five -Year
Maximum Adjusted PAN
(mg/kg)
(mg/kg)
Surface
24,787
31,812
Injection/Incorporation
26,497
33,522
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: No
FORM: RSC 08-11 Page 4 of 5

7. Pathogen Reduction: Per 15A NCAC 02T.1106, specify how residuals will meet the pathogen reduction requirements:
a. For Distribution/Land Application of Class A or Eguivalent.-
El
b. For Land Application of Class B:
® Alternative 1 [15A NCAC 02T.1106(c)(1)] -Fecal Coliform Density Demonstration.
El Alternative 2 [15A NCAC 02T.1106(c)(2)] -Process to Significantly Reduce Pathogens (PSRP).
Specify one: ❑ aerobic digestion, ❑ air drying, F1 anaerobic digestion,
❑ composting, or ❑ lime stabilization.
c. For Surface Disposal:
0 Select One of the Class A or Equivalent Pathogen Reduction Alternatives in Item II. 7a. above.
Select One of the Class B or Equivalent Pathogen Reduction Alternatives in Item II. 7b. above.
F] Exempt - If Daily Cover Alternative is chosen in Item I1.8. below [15A NCAC 02T. 1 106(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. I 107(a)(1)] - 38% Volatile Solids Reduction (Aerobic/Anaerobic Digestion).
Alternative 2 [15A NCAC 02T. 1 107(a)(2)] - 40-Day Bench Scale Test (Anaerobic Digestion).
Z Alternative 3 [15A NCAC 02T.1107(a)(3)] - 30-Day Bench Scale Test (Aerobic Digestion).
C] Alternative 4 [15A NCAC 02T.I 107(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.
El Alternative 8 [15A NCAC 02T. 1 107(a)(8)] - Drying of Unstabilized Residuals.
❑ Alternative 9 [15A NCAC 02T.1107(a)(9)] - Injection.
Alternative 10 [15A NCAC 02T.1107(a)(10)] - Incorporation.
] Alternative for Surface Disposal Units Only - Soil/Other Material Cover [15A NCAC 02T.1107(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 08-11 Page 5 of 5

of \NArFR State of North Carolina
Q� Department of Environment and Natural Resources
C Division of Water Quality
CO
p RESIDUALS SOURCE CERTIFICATION
INSTRUCTIONS FOR FORM: RSC 08-11
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 application and
supporting documentation
For more information or for an electronic version of this form, visit the Land Application Unit (LAU) web site at:
hUp: //portal. ncdenr. orb/web/wq/aps/lau
General — This certification provides detailed information of residuals source generating facility and its residuals quality for land
application, distribution, or disposal in accordance with 15A NCAC 02T .1100. Do not submit this certification for review without
a corresponding application form (FORM: RLAP 08-11, FORM: DCAR 08-11, or FORM: SDR 08-11).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Residuals Source Certification (FORM: RSC 08-11):
❑ Submit the completed and appropriately executed Residuals Source Certification (FORM: RSC 08-11) 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.
❑ For new or renewed permits, submit a separate certification for each source facility.
❑ For modified permits, submit a separate certification for only those facilities that are affected by the proposed modification.
❑ Complete the residuals source facility summary page. List all new, renewed, or modified facilities.
Residuals Source -Generating Facility Information:
❑ For each source facility, attach the following:
❑ Vicinity map - A vicinity map that shows the location of the facility and meets all of the criteria in the "Map Guidance for
Residuals Land Application Permits".
❑ Process flow diagram and/or narrative - A detailed narrative and/or process flow diagram that describes how the residuals
are to be generated, treated, processed, and stored at the facility.
❑ Quantitative justification for residuals production rate - A quantitative justification for the value provided in Item I. 8.
Ensure that the amount of residuals listed is the maximum amount expected to be generated by the facility for the life of
the permit. In addition, ensure that this amount is equivalent to that which is actually to be land applied, distributed,
and/or- disposed, including any chemicals, amendments, or other additives that are added to the residuals during
processing.
❑ Sampling plan - A detailed sampling plan for the residuals source -generating facility. Ensure that the plan identifies
sampling points, sampling frequency, sample type, as well as the Division -certified laboratory to be used. In addition,
ensure that the plan details how the facility and/or the residuals are monitored for any applicable pathogen reduction and
vector attraction reduction requirements. Note that all sampling and monitoring must be completed on the residuals as
they are to be land applied, distributed, and/or disposed.
C. Residuals Quality Information:
❑ For each source facility, attach the following:
❑ Laboratory analytical reports and operational data - reports for all laboratory analyses used to complete this certification.
❑ Documentation that the facility complies and/or the residuals comply with any applicable pathogen reduction and vector
attraction reduction requirements.
❑ For new facility that may have not yet been constructed and analytical results of residuals cannot be obtained, please
attach analytical results of residuals generated from a similar facility along with the description of similarities of the two
facilities.
INSTRUCTIONS FOR FORM: RSC 08-11 Page 1 of 1

'113�ESIb u.,&LS SOURCE FACILITY SUMMARY
Applicant's name: Town of Cleveland
Status Maximum Dry Tons Per Year
Facility Permit Holder Facility Name County Permit Number
Code • Current'' Proposed
R Town of Cleveland Cleveland WWTP Rowan NCO049867 82 82
'Status Code for source facility are: O N (New) O R (Renewed) 0 M (Modified) o D (Deleted)
b The amount of residuals currently permitted for distribution, land application, or disposal (i.e, not applicable to new facility).
SUMMARY FOR FORM: RSC 08-11 Page 1

OF W ATER State of North Carolina
�0, �� Department of Environment and Natural Resources
UUQ)
r Division of Water Quality
—I
(:� _� RESIDUALS SOURCE CERTIFICATION
FORM: RSC 08-11
I. RESIDUALS SOURCE -GENERATING FACILITY INFORMATION (See Instruction B.):
1. Facility Name: Cleveland WWTP
2. Facility permit holder is: ❑ Federal, ❑ State, E Local Govermnent, or ❑ Private.
Facility permit issued by: Div. of Water Quality, ❑ Div. of Environmental Health,
or Other (explain:
3. Facility contact person and title: Pete Rich, Chief Operator
Complete mailing address: PO Box 429
City: Cleveland State: NC Zip: 27013-0429
Telephone number: [phone] E-mail address: [e-mail]
4. Facility physical address: 3746 Hwy 15-501 N
City: Pittsboro State: NC Zip: 27312
Coordinates: Latitude: 35' 44' 35" Longitude: 80' 40' 59"
Datum: NAD83 Level of accuracy: Second
Method of measurement: MAP
5. Purpose of the facility:
® 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: I ^ % industrial and r i % domestic)
❑ other (explain: % _ I).
6. Does the facility have an approved pretreatment program: Yes ❑ No
7. Facility permitted/design flow: 0.27 MGD and facility average daily flow: 0.1554 MGD
8. Average amount of residuals being generated at this facility 6_5 dry tons per year.
9. Specify the following regarding treatment and storage volumes available at the facility:
Type and volume of residuals treatment: two oxidation ditches totaling 270,000 gallons plus one 80,000 gal digester
Type and volume of residuals storage (i.e., outside of residuals treatment units): N/A
H. RESIDUALS QUALITY INFORMATION (See Instruction C.):
1. Specify if residuals are regulated under:
❑ 40 CFR Part 503 or 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 15A NCAC 02T.1102(6) as:
❑ Biological Non -Biological
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).
FORM: RSC 08-11 Page 1 of 5

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: d yes no.
If yes, list the number(s):.l
b. Specify whether or not the residuals exhibit any of the characteristics defined by 40 CFR §261.21-
261.24: D 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: 03-27-12
Passed corrosivity test: ® yes E] no. pH: 5_0 s.u. (2 < pH < 12.5)
Passed ignitability test: yes no. Flashpoint: >200 OF (> 140°F)
Passed reactivity test: yes 'Ono. HCN: <0.025 mg/kg (<250) & H2S: <100 mg/kg (<500)
TCLP Parameter
Limit
(nzg/l)
Result
(zng/l)
TCLP Parameter
Limit
(mg/1)
Result
(mg/1)
Arsenic
5.0
<0.025
Hexachlorobenzene
0.13
<0.050
Barium
100.0
1.40
Hexachloro-1,3-Butadiene
0.5
<0.050
Benzene
0.5
<0.10
Hexachloroethane
3.0
<0.050
Cadmium
1.0
<0.005
Lead
5.0
<0.025
Carbon Tetrachloride
0.5
<0.10
Lindane
0.4
<0.0005
Chlordane
0.03
<0.003
Mercury
0.2
<0.0002
Chlorobenzene
100.0
<0.10
Methoxychlor
10.0
<1.0
Chloroform
6.0
<0.10
Methyl Ethyl Ketone
200.0
<0.20
Chromium
5.0
0.090
Nitrobenzene
2.0
<0.050
m-Cresol
200.0
<0.050
Pentachlorophenol
100.0
<0.10
o-Cresol
200.0
<0.050
pyridine
5.0
<0.050
p-Cresol
200.0
<0.050
Selenium
1.0
<0.10
Cresol
200.0
<0.050
Silver
5.0
<0.025
2,4-D
10.0
<0.010
Tetrachloroethylene
0.7
<0.10
1,4-Dichlorobenzene
7.5
<0.050
Toxaphene
0.5
<0.003
1,2-Dichloroethane
0.5
<0.10
Trichloroethylene
0.5
<0.10
1,1-Dichloroethylene
0.7
<100
2,4,5-Trichlorophenol
400.0
<0.050
2,4-Dinitrotoluene
0.13
<0.050
2,4,6-Trichlorophenol
2.0
<0.050
Endrin
0.02
<0.0005
2,4,5-TP (Silvex)
1.0
<0.010
Heptachlor and its Hydroxide
0.008
<0.0005
Vinyl Chloride
0.2
<0.10
FORM: RSC 08-11 Page 2 of 5

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/Laizd Applicatiozz: 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: Statesville Analytical and Date of analysis: 04/03/2012
Parameter
Ceiling
Concentration Limits
(ClassA & ClassB)
(mg/kg) .
Monthly Average
Concentration Limits
(Class A Only)
(nzg/kg)
Result
(mg/kg)
Arsenic
75
41
0.89
Cadmium
85
39
2.84
Copper
4,300
1,500
469
Lead
840
300
22.7
Mercury
57
17
1.47
Molybdenum
75
n/a
0.0909
Nickel
420
420
24.4
Selenium
100
100
1.82
Zinc
7,500
2,800
1030
b. For Surface Disposal Unit (landfill): 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
Unit to Boundary to
Closest Property Line
(meters, check one)
Arsenic
(mg/kg)
Chromium
(mg/kg)
Nickel
(m9/k9)
Q > 0 but < 25
30
200
210
Q > 25 but < 50
34
220
240
Q > 50 but < 75
39
260
270
] > 75 but < 100
46
300
320
Q > 100 but < 125
53
360
390
Q >_ 125
62
450
420
Result (mg/kg)
FORM: RSC 08-11 Page 3 of 5

5. Nutrient/Micronutrient Determination: Complete the following:
a. Total solids: 0.88 %.
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: Statesville Analytical and Date of analysis: 03/27/2012
Parameter
Result
(mg/kg)
Aluminum
3523
Ammonia -Nitrogen
3420
Calcium
21,364
Magnesium
1892
Nitrate -Nitrite Nitrogen
12,273
pH (Standard Unit)
5.44
Phosphorus
20,455
Potassium
93.3
Sodium
9204
Total Kjeldahl Nitrogen
39,432
c. Using the results listed in Item II. 5b. above, calculate the sodium adsorption ration (SAR): 1.52
[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: 30 %. This
rate is a (check one): M default value, or El 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: This is a default value for
water treatment plant alum residuals.
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 (15t) Year PAN
Five -'Year
Maximum Adjusted PAN
(nzg/kg)
(mg/kg)
Surface
24,787
31,812
Inj ection/Incorporation
26,497
33,522
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: No
FORM: RSC 08-11 Page 4 of 5

7. Pathogen Reduction: Per 15A NCAC 02T.1106, specify how residuals will meet the pathogen reduction requirements:
a. 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
d A sabnonella 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.1106(b)(3)(A)] - Time/Temperature Compliance.
El Alternative 2 [15A NCAC 02T.1106(b)(3)(B)] - Alkaline Treatment.
❑ Alternative 3 [15A NCAC 02T. 1 106(b)(3)(C)] - Prior Testing for Enteric Virus/Viable Helminth Ova.
El Alternative 4 [15A NCAC 02T.1106(b)(3)(D)] - No Prior Testing for Enteric Virus/Viable Helminth Ova.
E❑ Alternative 5 [15A NCAC 02T.I 106(b)(3)(E)-(K)] - Process to Further Reduce Pathogens (PFRP).
Specify one: [I composting, EJ heat drying, r! heat treatment,
El thermophilic aerobic digestion, ❑beta ray irradiation,
❑ gamma ray irradiation, or ❑ pasteurization.
b. For Land Application of Class B:
Alternative 1 [15A NCAC 02T.1106(c)(1)] - Fecal Coliform Density Demonstration.
E] Alternative 2 [15A NCAC 02T.1106(c)(2)] -Process to Significantly Reduce Pathogens (PSRP).
Specify one: Q, aerobic digestion, ❑ air drying, F] anaerobic digestion,
El composting, or ❑ lime stabilization.
c. For Surface Disposal:
r] Select One of the Class A or Equivalent Pathogen Reduction Alternatives in Item II. 7a. above.
_❑ Select One of the Class B or Equivalent Pathogen Reduction Alternatives in Item II.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).
E] Alternative 2 [15A NCAC 02T.I 107(a)(2)] - 40-Day Bench Scale Test (Anaerobic Digestion).
® Alternative 3 [15A NCAC 02T. 1 107(a)(3)] - 30-Day Bench Scale Test (Aerobic Digestion).
❑ Alternative 4 [15A NCAC 02T.I 107(a)(4)] - Specific Oxygen Uptake Rate Test (Aerobic Digestion).
E] 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.I 107(a)(8)] - Drying of Unstabilized Residuals.
] Alternative 9 [15A NCAC 02T.I 107(a)(9)] - Injection.
Alternative 10 [15A NCAC 02T.1107(a)(10)] - Incorporation.
] Alternative for Surface Disposal Units Only- Soil/Other Material Cover [15A NCAC 02T.1107(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 08-11 Page 5 of 5

N.11A
SYNAGIO
LOCATION CATION MAP A Residuals Afanagement Company
COUNTY ROWAN OWNER TOWN OF CLEVELAND WWTP
Attachment 2-a

Town of Cleveland VVWTP - Process Flow Diagram
Permit #WQ0011431
Oxidation Ditch # 2
0.18 mgd
Clarifier #2
Aerobic Digestor
80,000 gallons
Chlorine
Contact
Chamber
Clarifier # 1
Oxidation Ditch # 1
0.09 mgd
Flow
Splitter
Box
Influent
Structure

Quantitative Justification for Residuals Production Rate
Facility:
Town of Cleveland WWTP
Maximum Permitted hate:
82 dry tons/year
Justification:
The Town of Cleveland WWTP currently produces an average of 6.5 dry tons of
biosolids per year. The calculations below indicate less than that average. The amount
of production has been steadily decreasing, with no land application occurring in 2013.
Calculations:
Based on rule -of -thumb that average daily flow is approximate to annual volume of
residuals produced:
(155,400 gal/yr)(0.88 % solids) x (8.5 lbs/gall � 5.8 dt/yr
(2,000 lbs/ton)

Residuals Sampling Plan
Town of Cleveland Land Application Program
Nutrient and Metal Analysis
Sampling Point: Digester
Sampling Frequency: Annual
Sample Type: Composite
Lab: Statesville Analytical
Pathogen Reduction
Sampling Point: Digester
Sampling Frequency: Annual
Sample Type: Grab
Lab: Statesville Analytical
Vector Attraction Reduction
Sampling Point: Digester
Sampling Frequency: Annual
Sample Type: Composite
Lab: Statesville Analytical
TCLP/RCI
Sampling Point: Digester
Sampling Frequency: Annual
Sample Type: Composite
Lab: Pace Analytical

A1 alyti�al Res-Ults
Town of Cleveland
PO Box 429
Cleveland NC 27013
Entered 3/1212012 -
Reported: 4/10/2012
for: Digester
Sample ID
Parameter Chat 10
ResRit.
Unit:..::�:.j.�;
illl thud
"
Date Alralyze¢i
Analyst ;
120312-2
% Solids' Digester
0.88
%
SM25408
3112112
CL
120312-2
Aluminum-flamelsolid]igester
3523.
mglkg
SM 3111 D
3/27/12:
Mb
. 120312-2
Arsenic-Pumace/sollOigester
0.89
mg/kg
SM3113 B
413112
MD
120312-2
Cadmium- Digester
2.84
mg/kg
SM3111B
3/21/12
MD
120312-2
Calclum-Fiame/solidDigester
21,364
mg/kg
SM 3111 D
3/19/12
MD
4 V0312-2
Chromluln- Digester
685
mg/kg
SM3111B
3127/12 -
MD'
D312 2
Copper Plsme/solid Digester.
469
mg/kg
SM3111H
3/19/12
MD
120312-2
Lead-furnace/solid Digester
22.7
mg/kg
SM3111B
3121/12
MD
120312-2 .L
Magnesium- Digester
• 1892
mg/kg
SM 3111 D
3/27/12
MD
120312-2
Mercury -solid • Digester
1.47
ing/kg
245.1
3f21112
MD
120312-2
Molybdamum- Digester
0.09090000 mg/kg
EPA200.7
3126112
PACE
120312 2
NH3N-solid Digester
3420
mg/kg
SM4500NH3B 3112/12
CL
120312 2
Nickel-Flame/solid Digester
24A
mg/kg
SM3111B
3127/12
MD
1203i2-2
NO3NO2•solid Digester
12,273
mg/kg
SM4500F/A
3127112
CL
120312-2
pH Digester
5.44
STD units
SM4600HB
3/12112
CL
120312 2
Potasslum-10•P/solid Digester
93.3
mg/kg
EPA200.7
3126112
PACE
120312 2
Selenlum-solid Digester
1.82
mg/kg
SM 311313
3/20/12
MD
120312 2
Sliver-Flasme/solid Digester
8.3
mg/kg
SM3111B
3/27112
MD
120312-2
Sodium -solid Digester
9204
mg/kg
SM 3111-13
3119/12
MD
120312 2
T,Phosphorous-soildDigwW
20,455
mg/kg
SM450OPE
3/2-7/12
CL
120312-2
TCLP Digester
See Attached
1311'
3126/12
PACE
12b312 2
TKN-solid Digester
39,432
mg/kg
SM4UONHSB 3/15/12
MD
120312-2
Zinc Ffamelsolld Digester
1030
mg/kg
SM8411B
3/19/12
Mid
�/��ee ��T2dGs,�
3�,e�1
ram%
(�,�•�,e.
P.Q.'Box 228 o Statesville, North Carolina n687.704/872J4697
T 62eol
TeOX4Rjeud 9TjTAs8q.e,4S
Wd6D=•b
PTDz OT -�

Town of Cleveland
PO Box 429
eveland NC 27013
Entered 3/12/2042 •
Reported: 4M 0/2012
For. Digester
Sample ID Para r Cust I®.
Respectfully submitted,
Dena Myers
NC Cert #440,
NCDW Cent #37755;
EPA NCO0909
1
P.O. Sox 228 s Statesville; North Camlina 28687.704/872/4697
abed LBLz-8L6 bOL ILOt-4RIeUU aTlTnsa-4e4S Wd60ti, 2TOe 01 .�d8

Pacsn� cal t3ervtce4; tot. �?aca(Oat
L -��®q� J �yy,Q Q _ lyt!' yt(i�8e�vlc�s,ine,•' _ Pae�-Anatytraalt3egvi48s,ina.
lZrl r ti(�/. 905EaatMeadowRc�td-SulteA 2225f�(dersfdeDr. 880oKltweyAve. SuHeioO
rM 0* 0, Eden,H027248 Ash avlle,NO28404 Hunisrsrtlle,NC28076
(330}S23t392i [phone] 1704)876.9D92
ANAM- (CAL RESULTS
Project: 120312
Pace Project No.: 02114247
Sample: 420312-2
Parameters
Lab•Ib, 92114247001
Results. units
Collected: 03f12112.Op:00
Report Limit DF
Reoeiv$d: '031>4/12I0I0 Matrix;'Water .
Prepared Anajyzed •CAS.No. Qual
8081 CC$ Pestictdes, TCLP SPE
MalytioatMethed: EPA-8081 -Preparation Method: EPA $=
Le2chate Meth6dIDate: EPA 1311; 03/23112 08:00
§amma-BHC (Lirrdane)
ND ug/L,
0.50 1
0312311209.46 03/27/19.18:i9 68.89-9
Chlordane (Technical)
NQ ug/L
3.0 1
03120112;09:46. 0.�47I1210:19. 57.74,9
Endrin
ND uglL
0,50 • 1
03/2311209:46 03/2741218.19 72-20-8
Heptachlor epoxide
NO ug/L
oxo 1
03/23112.09:46••03127.1? 10:19; 102"-1.3
Methoxychlor
ND uglL
1000- --1•
03/23/12'09:45 03/27/1216:18 72-43-5
Toxaphene
N4 uglL
3.0 1
03/23/12-09:45 03l27/'i210:'I9 8061-36.2
surrogates
Decachloroblphenyl (S)
Tetreohloro-m-xylene (s)
8181 Chlorinato Herbicide TCLP
2,4-D
2,4,5-TP (SIWX)
Surrogates
2,4-DCAA (S)
200.7 MET ICP
Molybdenum
Potassium '
6010 METICP, TCLP
Arsenio
Barlum
Cadmium
Chromium
Lead
Selenlum
Silver
7470 Mercury, TCLP
Mercury
8270 M88V TCLP Sep Funnel
1,4-DlchlDrobenzene
2,4-Dlnitrotoluene
Hexaettlorv-1,3• butad lene
Hexaahlorobehzene
Hexachlordelhana
2-Mettty ano!(o=Cresol)
38A-Methyiphenol(m&p Cresol)
Nitrobenzene
Date: 03/29/2012 05:13 PM
9 a2ecl
ID-13B 1
0=311209.46 03/27/'(21e:19 2061'-24.3
126 `Yo• 10-110 1
0312311209.45 0312711216119 877-M-8 -82 -
Arialytkal Method: EPA8161
ND trQIL 0.01D 1
0312811212.36 03127/1204:47 94-76.7
ND mWL 0.01D 1
0312A/1212:35.03/2711204:47 03-72-1
113 % 70-130 1
0312311212:35 0312711204:47 10719.28.9
Analytical Method: EPA-200.7 Preparation Method; EPA200,7
90.9 ug/L 5.0' T
03117J1214:06, 03/23/12 02:48 7439.98.7
933(10 Lot 5000 1
03117)1214:06 031236-�-02AB 7440.00.7
Analytical Method: EPA6010 Preparation; Method: EPA3010
Leachate Method/Date: EPA 1311; 03123/1219:00
ND mg/L - 0.025 1
03/254211:00 =6112 15:21 7440-WZ
IA mg/L 0.60 1
:031261121i:00 03126/i202:26 7440-3"
-ND mgiL 0.0060 - 1
03/25/1211:00 0=11202.26 7440-45-9
.0,080 mg/L 0.026. 1
0312611211:00 .03r2,0/13,.02:26 7440.47.3
ND M91L 0.025 1.'
03/25j1211:t?0- 03/YElt4. 02:25 7439 92-1
ND mg/L 0.10 1
03126/.121100-- D3/26112-0225 778249-2
NO mglL 0.026 1
0312611211:00- 03126/12 02:25 7440-22-4
Analytical Melh(5d: EPA7470 Preparation Method: EPA7470
Leachate Method/Date: EPA 1311; 0312311219:66
ND ug/L 0.20 - .1
W26/12 13:06 03/16/1216:35.7439,97.6
Analyticat Method: EPA0270 Preparation Method: EPA3610
Leachate Method/Date: EPA 1$11;-03123/12 08:00
NO 0911- 50.0 1
03/23/12 09:00 03W1218:57 106-46-7
NO ug/L 60.0- 1
0MV12 09:00 03128H218:67 121-14.2
ND ug/L 60.0 1
-
03/23/12 09:00 03/26/1210757 87-68-3
ND uglL 50.0 1
03i231120:00 03120/9218:57 118-74-1
NO ug1L 50.0 1
03123/1209:00. 03126/t218:57 67=72-1
NO ug/L 50,0 1
03/231120900 03126/1216;67 95-48-7
ND ug/L $0.0 1
03123(12.09 00 03128112•.18:57
ND ug/L 60.0 1
03123/1209:00 6312611218:67 98-0"
REPORT OF LAE)ORATORY ANALYSIii
Page 4 of 21
rh report shall not boreprodumd, bxoept In fur,
without tha vriHen con seht or PaceAaelyiCel Services, ]no..
LBLZ-8G8-bDL IeaigRXeud aIITAaagegS
Wd8•b:z zTDz 01 JdU

� • �. -Pace An.a ilcijl sivlce�;:igc. ; FacsAneiyticei pomoesi roc; P,.A0Analytksl8ervicea, (no.
p2D6 E4ist Meadab-Rofxd� BujteA 2226:Riverslda �P; 98dOKmceliAYa. $vile 10t)
Eden, F1C.27288 AahavIle. NC 28604 Huntarsvlle, NC 28078
(338�23-8921 _ [phone] [phone]
ANALYTICAL RESULTS
Project: 120312
Pace Project No.: 92114247
Sample: 92D312.2
Lab ID: 02344247009
Golleciad:'.0311?/928,0:00
Received: W1411-2:9b!19 :Maldx:water
Parameters
Results Units
Report Llrrilt
DF •
Prepared* Analyzed' CAS No. Qual
8270 PASSV TCL-P Seep. Funnel
Analytical Method: EPA 0270 PrOPp Iratlon MOftd: EPA3510
Leachate Method/Dale.-EPA 1311; 03123t12 08:00
Pentachlorophenol
ND ug/L
100
1
03/23/12 0.9•:00. OW2611218:57 87-86-5
Pyridlne
ND u9/L
80.0
1
03123/12,0.9:0,0.:03128112.113.M. 110.86,1
2,4,&Trichlorophenoi
ND ug/L
50.0
i
03123/12i1J;OQ Q3I2$(12-18:87 045
2,4,6-Trichlorophenol
ND ug/L
60.0
i
D 23112:oa;Od_03128N216;57. 88-00-2-
Surrogrtitos
Mtrobenzena•d6 (8)
41
12-102
1
03/23/12 09:00 0312811218:57 4166.80.0
2-muorbbiphenyl (S)
40 r5
13-1.07
1-
"23/1i&F.00• :0312i (12 0:. 7 321-6D 8
Terphenyl-d14(8)
62 %
21;-132
1
D3/23(1209:00 6i16/121$67 1716.51-0
Phenot-de (S)
13 %
10-110 -
1
.03/2311909:00 03/e O?.1218:67
13127-88.3
2-Fluorophenol (8)
22 %
10-110
1
03123f120:00 031201S2:f8:5.7
-067--12-4
2,4,6-Tribromophenol (8)
46 %
27-108
1
03J12 09:00 �03128112 18:67 198-78-6
3f2
8260 M$V TO.P
Analytical Method, EPA 8260
Benzans
ND ug/,L
100 .
20
03/2311212:27. 71•-43-2
2-Butahone (M5K)
ND ug/L
200
20
03/2$192'12:27 70.93-3
Carbon tetraohlodde
ND ug/L
100
20
1)3123192 12:27 56-23-5
Chlorobenzene
PID uglL
100
20
' 031=1212:27 108-90-7
Chloroform
ND ug/L
-100
20
03/MIA 12:27 67.08-3
1,4431ohlorobenzene _
ND ug/L:
100
20
O3/23f1212:27- f0646-7
1,2-131chloroethane
ND ug/L
100
20
O3/23/12 12,27. 107-06-2
1,1-01chlbroethene
ND ug/L
f00
20
03/23l1212,27 75-35-4..
Tetrachforaethene
. ND -ug&
IOU
20
0$/23N212:27 197-18-4
Trichloroethene
NO ug/L
100•
20
OW2311212:27 79.01-6
Vinyl otllodde
ND ug/L
too
20
03123192'12:27 75.0f-4
Sumogales
1,24110 lloroethane-d4 (S)
117 %
70-130
20
03/23/1212:27 17060-OT-0
Toluene-d8 (S)
96 %
67-135
20
03123112.12:27 203728-5
4-13romofluorobenzene (S)
97 %
70-130
20
0312VI212:27 460-DO-4
Dlbromofluorothethane (8)
114 %
70-130
20
03/22j1212t27 186"3.7-
Percent Mofsttire
Analytical Method: ASTM D2974-87
Percent Moisture
98.9 Syo
0.60
1
03/21/12 00:00
1010 Flashpolnt,Closert Cup
Analytical Method: EPA 1010
Flashpolnt
>200 deg F
70.0
1
Q3/27/12 09:00
Reactive Sutflda
Analytical Method: SNt-846 7.3.4.2
Sulfide; Reactive
ND mg/kg
100
1
0=311212:15
OM pH
Analytical Method: EPA 9040
PH
5.0 Sid. Units
OAO
f
03/fefi2 f3:30 H8
733C S Reactive Cyanide
Analytical Method: S M46 7.3.3.2
Cyanide, Reactive
ND mg/kg
0.025
1
OW311211:12
Date: 03/29,Wf2 05:13 PM REP6RT OF LABORATORY ANALYSIS
This report she] not bb reproduced, except In full,
without the vrrltten consent of Pace Analytical Services, Inc..
L a2ed G8G�-SGt3 1rOG YeoY�Rieud a[Iinsa�e�S
Page 6 of 21
Wd8t,:Z� eloa OT adO

e �1 � )),,,,AApp�
•
Parsel�nalyt�cal:gei�ii:sa`, fnc � .. ' .''I�at®�'t'tal�,abK.S�rrlc�a,inC.. _
206'Easfl4i�&dgviRoati=SuKeA 25Rlverelde.Dr.
- JAi�aeAndlytilpt�l8enttcme, Inc.
98AOKkiceyAve_ Suit8100
�tWpt crrn
Eden, NC27260 Aahevlle, NA assoa
tlunterklle, NO Z079
(9.36)620.8921 {828)254 7170
(704)e78-8092
SAMPLE ANA, LYTE'.Cbf}IR4T
Projea: .120312
Pace Project No.: ' 92114247
Lob l® 8ample'IB
" mottlod Analysis_ _
Anafytes
Re6ort0d
'Laboritory
92i14247001 120312 2
EPA$081 ' _ REF
8
PASI-C
EPAS161 SMB
.3
PA51-0
EPA200.' SHB
2
PASI A
EPA1's010 JMW -
7
PASI-A
EPA7470 DIVIS-
1
PASI•A
EPA8270 PPM
18
PASI-C
EPA8260 KJM
15
PASI•C
ASTM 02974-87 DVVC
1
PAM *K
EPA 1010 SMW
i
PASI-A
SVV-846 7,3,4.2 OL
1
PASI-K
EPASO40 EWS
1
PASI-A
SW-846 7.3.3.2 OL
1
PASI-K
REPORT OF ]LABORATORY. ANALYS[S Page 3 of2i
This report shall not be reproduced, except in rum,
vWlhout iha vrriftn conserd of Pace ArWySml Services, Inc..
g abed LBLz-BL8-f�oL Year�Rteu(j aYlrnsa�e�g Wd6b:Z 2I82 01 udE!

r aceArtsiy)£Cal9efaitoea,:iriir:'.: - • �eueApgltrH i,serrld�s, Inc. PaoeAnalyticalServk®s, Inc.
3 ,d, R _.
205 E8s11feaa IQo d:. i 4A. 2226,FtivarsulsC)r, 9800'KincyyAvey Suite 100
J " Eden, NO27�80 AsheW10, NC.28804 HuntaisY'le, Nd2807S
(338)823-S921- [phone] (704)875-%92
QUALITY CONTROL DATA
Project: 120312
Pace Project No,: 92114247
QC Batch: GCSV/7896 Analysis, Method: EPA 8161
QC Batch Phathod: 'EPA 8161 Analysis'Description: 8161 GCS Herbidde"sTCLP
Assodated Lab Samples: 92114247001
METHOD BLANK: • 351748 � Matrix: Water
Associated Lab Samples: 921142470P1
13fank Reporting
Parameter Units Result L[mlt Ahelyzed Qualifiers
2,4,6-TP (Silvex) rnglL ND 0.010'-03/27112 (13:47
2,4-D mg1L ND 0.010 03/27A9 Q3:47
2,4-DCAA(S) % 111 70.130 •6*71120 :47
LABORATORY CONTROL SAMPLE: 301749.
Spike LCS LCS % 1t00
Parameter Units Gorrc. - Result % Rec Limits .Qualifiers
2,4,5-TP (SIWx) mg1L . -.012- 0.014- . • 117 70-130
2,4-D mg/L .06 0.069 116 70-130
2,4 •D CAA (S) % 1 t0 70.130
MATRD(SPIKE 8, MATRIX SPIKE DUPLIGATE,
3.61130
361991
MS
MSD
92i14247001
Spike
Sp"
MS
MSD
MS
MSD
% Rea
Parameter Units
Result
C4nc,
CM0.
Result
Resuft•' -
% Rea
% Rbc •
Limits RFD Qua[
2,4,6--TP (Sifvex) mg/L
'ND
.012
.012
. 0,014
0.0'14
•118
116
_ 70-130 3
2,4•D mg/L
ND
D6
•.O6
0.076
0.072
126
120
70.130 6
2A-DCAA (S) %
113
109.
70-130
Date: 03/29/2012 06:13 PM REPORT OF LABORATORY ANALYSIS
We report 6hA not ba reprpduced, except In fu4,
without the writtsn consent or Pace Arre!$t W Services, Ina.
6 abed 1,BL�-8L8 i�OL ie014RleUH aT T IAS94egS
Page 6of21
Wd61r:Z aTOi� 0T add

I
Q
205 i:aAJ
-Eden, N P 2128a AbhWdle; NO 28694 - HUnteteV110, KC 2808
.wi
Project: 120812
Pace Project No.! 92114247
QUAUTY CONTRPL-DATA
QG Batch: MERP14131
'Amlyals Wfethbd.
EPA-7470
0
QG Batch Method: EPA747'
Analysis bkicdoiQll,
?470 Merc.0 TCLP-
ry.
Associated Lab Samplev 92114247001
METHOD BLANK, 740923 -
Mktdx, VAier.
Associated Lab Samples, 02114247001
Blank Reporting
Parameter
Units
Result' Urdf
..Anelyzed. Qualifiers
Mercury
_U91L
ND 0.20 03l2QMZJ6.14
LABORATORY CONTROL SMPLR:
740924
Spike LOS
LOS Rea
Pardmeter
Units
Conc. Result-
"A Rea Limb Qualifiers
Mercury
ug/L'
2.ti 21
103 M120
MATRIX SPIKE SAMPLE:
740925
b2114047001 Spike
ms Ms. % Roe;
Parameter
Units
Result d6nd;
RQ8011 ula Ree Limits Qualifiers
Mercury-
Ug/L-
7.
ND 2.6
2.6 103
SAMPLE DUPLICATE. 740928
M1446WI Dup
Parameter
Units
ReWt Result
RFD Quallflers
Mercury
4L
ND ND
Date: 03129/2012 05:13 PM iREPQRT OF. LAHORATOJRY AMALYSIS Page 7 of 21
Thia report shall not baseproduodd, except in full,
YAlhoutih. wfiftn con'ssftt of Wo An*Ucd Services, I=.
OT abed L8L2_8&8_i10L JeC)T4R1RUW 611TAS94e4S WcJ6i,:0 _aTOO OT JdU

Client:
STATESVILLEANALWICAL
122 Court Street • P.O. Pox 22S !
Address:
Statesville, NC 28687
[phone]
CAI of
Custody Record
Contact Person: Phone # FAX#
PC # Requisitioned by: Mme . Date)
I
Customer
SampleMY
Lab -ID #
Timo sampled
(Grab Only)
Date Sampled
(Grab Only)
a
Matrix
P rameters requested for analysis
sroago
W
�} t�
1
X
T
x
X
4 - 1
14
Relinquished by:
Time ,j am, 0mn Date : / � -2-
Sampled by:
I
Received by:
` ' Time j �:I �3a oDate /t �/
Transported by;
Relinquished by:
Time am, pm Date / /
/
Holding times met:
Received by:
Time am, pm Date �/ I_
Compliance work:
Composite Sampling
91:
Time begin
am, pm Date _/
/
Non-compliance work:
Time end
am, pm Date /
/ Lab Comments;
Composite Sampling
#2:
Time begin
am, pm Date I
/_
Time end
am, pm Date
;l�

Analytical Results
Town of Cleveland
PO Box 429
Cleveland NC 27013
Entered 113012012
Reported: 411212012
ForDigester Sludge
Sample ID Parameter Cust ID Result Units Method Date Analyzed Analyst
120130-7.1
% Solids
1
0.80
%
SM2540B
1131112
CL
120130-7.1
Fecal Coliform MTF
1
<2500
MPN1g
SM9221 CE
1131112
CL
120130-7.1
Geometric Mean
1
<2520
MPN/g
dry wt. basis
211112
CL
120130-7.2
% Solids
2
0.77
%
SM2540B
1131112
CL
120130-7.2
Fecal Coliform MTF
2
<2597
MPN/g
SM9221 CE
1131112
CL
120130-7.3
% Solids
3
0.79
%
SM2540B
1131112
CL
120130-7.3
Fecal Coliform MTF
3
2532
MPN1g
SM9221 CE
1131112
CL
120130-7.4
% Solids
4
0.83
%
SM2540B
1131112
CL
120130-7.4
Fecal Coliform MTF
4
<2490
MPN/g
SM92210E
1131112
CL
120130-7.5
% Solids
5
0.78
%
SM2540B
1131112
CL
120130-7.5
Fecal Coliform MTF
5
<2564
MPN1g
SM9221 CE
1131112
CL
120130-7.6
% Solids
6
0.77
%
SM2540B
1131112
CL
120130-7.6
Fecal Collform MTF
6
<2597
MPN/g
SM9221 CE
1131112
CL
120130-7.7
% Solids
7
0.79
%
SM2540B
1131112
CL
120130-7.7
Fecal Coliform MTF
7
<2532
MPN1g
SM9221 CE
1131112
CL
120130-7.8
Bench 30 Day
Digester Basin
4.19
%
EPA625R-9210315112
CL
P.O. Box 228 * Statesville, North Carolina 2S687 * 7041872/4697

Town of Cleveland
PO Box 429
Cleveland NC 27013
Entered 113012012
Reported; 411212012
For:
Sample ID Parameter Cust ID Result Units Method Date Analyzed Analyst
Respectfully submitted,
Dena Myers
NC Cert #440,
NCDW Cert #37755,
EPA NCO0909
P.O. Box 228 * Statesville, Nortli Carolina 28687 * 704187214697

Town of Cleveland WwriP
PO Box 429
Cleveland, NC 27013
Enterad:• 1/30/2012
Reported; 3/2/2012
_ Sample ID.;120130-7.8
PARAMETER: Vector Attracticri.Reduttiort/ 1er*cal€ti:Diite_ted
5ludte (9.4daV
Total Solids
. Volatile Solids
% Valatlle.5ollds
Week 1 0.73
0.49
0.6728
I
Week 2. 0.73.
0.49
.
0:6726.
Week 3 0.69
0.46
0.6634
Week 4 0.69
0.46
0.6634
Week 5 0.66 •
0.44
0.663.3
Volatile Solids Reduction;
0.6728 - 0.6633 X 100 = 4:19 %
6.6728 (6.6728 X 0:663S)
Respectfullj submitted,
Dena Myers
Statesville Analytical, Inc.
NC WW Cert.# 44ONC
DW Cert. #37755
P.O. Box 228 • Statesville, North Carolina 28687 . 7041872/4697
Z abed L8L2 BL8-trOL TeOz4BTeuC 811Tns84e4S 4ld8i,:2 2T02 01 -•add

Apr 10 2012 2:48PM Statesville Analytical 704--878--2787 Page 3
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wAT FRQG State of North Carolina
1 Department of Environment and Natural resources
r Division of Water Quality
CO
LAND APPLICATION SITE CERTIFICATION
INSTRUCTIONS FOR FORM: LASC 08-1.1
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 application and
supporting documentation
For more information or for an electronic version of this form, visit the Land Application Unit (LAU) web site at:
http://
portal. ncdenr.orghyeb/wq/a sap /lazy
General — This certification provides detailed information of 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 certification for review
without a corresponding application form (FORM: RLAP 08-11 or FORM: SDR 08-11).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Land Application Site Certification (FORM: LASC 08-11):
® Submit the completed and appropriately executed Residuals Source Certification (FORM: LASC 08-11) 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.
® For new or renewed permits, submit the requested information for all land application sites.
❑ For modified permits, submit the requested information for only those sites that are new, transferred or affected by the
proposed modification.
Land Application Site Information:
® The status of the land application site with respect to this residuals land application program must be provided in table I. The
status categories and their corresponding codes are as follows:
♦ New (N) 0 Renewed (R) ♦ Modified (M) o Transferred (T) 0 Deleted (D)
® Attach the following in accordance with each status code:
Status Code
Required Item
N
R
T
M
✓
County Manager
Notification
71 R-ai I
Land Owner
Agreement
(If applicable)
✓
✓
✓
✓
Setback Waiver
Agreement
An updated vicinity/setback map in accordance with the "Map Guidance
for Residuals Land Application Permits"
✓
✓
✓
A soils and agronomic evaluation in accordance with the "Soil Scientist
✓
Evaluation Policv"
An updated accounting of the land application site's cumulative
✓
✓
pollutant loading rates (CPLRs)
INSTRUCTIONS FOR FORM: LASC 08-11 Page 1 of 3

Required Item
Status Code
N
R
T
M
For previously permitted sites without a soil series name indicated in the
Attachment B, submit County Soil Survey Map (or equivalent) clearly
✓
✓
✓
indicate the location of the land application site and in accordance with
the soil map requirements in the "Soil Scientist Evaluation Policv"
Acknowledgement of field transfer from Permittee relinquishing field
✓
Acknowledgement of field transfer from Land Owner (Fields may not
✓
be permitted to multiple Permittees over the same timeperiod)
This item may be required for land application site with a status code "M", please contact the Division if you need assistant in
determining attachment requirements.
® Crop Type should include the most likely crop types for the life of the permit (five years).
® Predominant Soils Series Name must be either the name of the soil indicated in Attachment `B" of the existing permit, or
name of the soil series as provided by the licensed soil scientist.
® Predominant Soil Mapping Unit or Representative Slope: Either the Soil Mapping Unit or the representative slope of each
site must be provided. The predominant soil -mapping unit must be consistent with the predominant soil series name. Please
note that the soil mapping units are variable between Counties, so care should be taken in properly identifying the correct
mapping unit. If a representative slope is provided, it must be determined accordingly:
® For sites previously permitted for use, but do not have an established soil mapping unit (the mapping unit provides
information on both the soil series name and the slope of the soil), the Applicant may detennine the representative slope
by using the average slope provided in the County Soil Survey (or equivalent). A soil type with a slope range of 4 - 8%
would have a representative slope of 6%.
❑ New Sites to be permitted must have slopes determined as part of the soils report prepared by a licensed soil scientist.
® Acceptable methods for determining location coordinates (i.e., latitude and longitude) and their corresponding codes are as
follows:
• Address Matching (ADD) • Digital or Raw Photo Extraction (EXT)
© Aerial Photography with Ground Control (AER) • Geodetic Quality GPS Survey (GEO)
• Cadastral Survey (SUR) 0 LORAN-C Navigation Device (LOR)
• Conversion from Coordinate Plane (CP) • Navigation Quality GPS (GPS)
• Conversion from Township -Section -Range (TSR) • Remote Sensing (RS)
• Conversion from Universal Trans Merc (UTM) s Zip Code Centroid (ZIP)
• Map Interpretation by Digital or Manual Extraction (MAP)
C. Waterbody and Classifications Information: (new sites only)
❑ Use an 8.5 by 11-inch copy of the portion of a 7.5-minute USGS Topographic Map to identify the location where the
residuals program activities are planned to occur as well as the closest downslope surface waters as clearly as possible. Each
snap portion must be labeled with the map name and number, the identified location, and be of clear and reproducible quality.
❑ Surface water body classifications information may be found at: http://portal.nedenr.org/web/wq/ sn /csu
❑ Any questions concerning the waterbody and its classification, please contact the Division's regional offices.
❑ A list of the Division's regional offices, their county coverage, and their contact information may be downloaded at:
http://portal.ncdenr.org/web/wq/home/ro
❑ General Instructions: There are 17 river basins in North Carolina. Each basin has associated waterbodies with assigned
subbasins, location descriptions, stream index numbers and established classifications.
1. Identify the project area on a 7.5 minute USGS topographical map (an 8.5 x 11-inch sheet showing the project area
should be submitted with the permit application regardless of whether a Stream classification was completed).
2. Determine the naives of all the closest down slope surface waters from the project site. For unnamed tributaries, see
Table 1: Unnamed Tributaries Entering Other States or for Specific Basin Areas. Label any unnamed tributaries as
"UT to stream name" as the waterbody name.
3. Open the link http://h2o.enr.state.ne.us/bims/reports/rgportsWB.html. If this link does not work, open
http://portal.nedenr.org;/web/wq/ps/csu/classifications and download weekly -updated classification lists for named
waterbodies.
❑ Stream Classification Process: One of the options below may be used depending on the known initial project information.
❑ KNOWN BASIN WHERE CLOSEST DOWN SLOPE SURFACE WATER IS LOCATED
INSTRUCTIONS FOR FORM: LASC 08-11 Page 2 of 3

Neuse
1. Select pro er basin from the List all Waterbodies in Basin sorted
Hydrologically �'
- - report. Sort hydrologically as this will provide the proper location descriptions if multiple
runs.
2. Locate the name of the identified waterbody (from General Directions) on the list.
3. For multiple listings of the same waterbody name in the report, select and verify the location description. The tern
"source" in the description means the beginning of the waterbody segment (most upstream point).
4. Record all Basins, Stream Index Numbers and Classifications applicable to the project.
❑ KNOWN COUNTY WHERE CLOSEST DOWN SLOPE SURFACE WATER IS LOCATED
� �
1. Select the proper county from the List all Waterbodies iri Alamance - county, hydrologically report.
2. Locate the name of the identified waterbody (from General Directions) on the list.
3. For multiple listings of the same waterbody name in the report, select and verify the location description. The term
"source" in the description means the beginning of the waterbody segment (most upstream point).
4. Record all Basins, Stream Index Numbers and Classifications applicable to the project.
❑ UNKNOWN BASIN WHERE CLOSEST DOWN SLOPE SURFACE WATER IS LOCATED
1. Use the Clickable basin snap to hydrologically sorted list report.
2. Click on the approximate project location to bring up the hydrologically sorted list.
3. Locate the name of the identified waterbody (from General Directions) on the list.
4. For multiple listings of the same waterbody name in the report, select and verify the location description. The term
"source" in the description means the beginning of the waterbody segment (most upstream point).
5. Record all Basins, Stream Index Numbers and Classifications applicable to the project.
❑ Notes on index number and unnamed streams:
Unnamed Streams 15A NCAC 02B .0301(i).
❑ Any stream which is not named in the schedule of stream classifications carries the same classification as that assigned
to the stream segment to which it is tributary (at the point of entry) except:
(A) unnamed streams specifically described in the schedule of classifications;
(B) unnamed freshwaters tributary to tidal saltwaters will be classified "C"; or
(C) after November 1, 1986, any newly created areas of tidal saltwater which are connected to Class SA waters by
approved dredging projects will be classified "SC" unless case -by -case reclassification proceedings are conducted.
❑ The following river basins have different policies for unnamed streams entering other states or for specific areas of the
basin:
Unnamed Tributaries Entering Other States or for Specific Basin Areas
Hiwassee River Basin
Streams entering Georgia or Tennessee shall be classified "C Tr."
Little Tennesse River
Basin And Savannah
River Drainage Area
Streams entering Georgia or Tennessee shall be classified "C Tr." Such streams in the Savannah
River drainage area entering South Carolina shall be classified "B Tr."
French Broad River
Basin
Streams entering Tennessee will be classified "B."
Watauga River Basin
Streams entering the State of Tennessee are classified "C."
Broad River Basin
Streams entering South Carolina are classified "C."
New River Basin
Streams entering the State of Tennessee are classified "C."
Catawba River Basin
Streams entering South Carolina are classified "C."
Yadkin -Pee Dee River
Basin
Streams entering Virginia are classified "C," and such streams entering South Carolina are
classified "C."
Lumber River Basin
Streams entering South Carolina are classified "C Sw."
Roanoke River Basin
Streams entering Virginia are classified "C." Except that all backwaters of John H. Kerr
Reservoir and the North Carolina portion of streams tributary thereto not otherwise named or
described shall carry the classification "B," and all backwaters of Lake Gaston and the North
Carolina portion of streams tributary thereto not otherwise named or described shall carry the
classification "C and B."
Chowan River Basin
Streams entering Virginia are classified "C."
Tar -Pamlico River
Basin
All drainage canals not noted in the schedule are classified "C Sw." except the main drainage
canals to Pamlico Sound and its bays which shall be classified "SC."
Pasquotank River Basin
All drainage canals not noted in the schedule are classified "C."
INSTRUCTIONS FOR FORM: LASC 08-11 Page 3 of 3

LAND _ __ PLICATION SITE CERTIFICATION
Applicant's name: Town of Cleveland
Land application sites currently certified: 61.40 net acres and Total to be certified: 44.3 net acres.
I. LAND APPLICATION SITE INFORMATION (See Instruction B):
Status
Code'
Site/Field
ID
Landowner(s)
Lessee(s) or Operator(s)
Net Acres
County
Crop(s)
Predominant Soil
Series Name
Mapping Unit
or Rep. Slope'
M
RA-54-2A
Karlene Doby
(same)
10.3
Rowan
Fescue (pasture)
Lloyd
LdB2
M
RA-54-213
Karlene Doby
(same)
11.8
Rowan
Fescue (pasture)
Enon
EnB
M
RA-56-IA
Ira F. Hodge
(same)
8.4
Rowan
Row Crops
Lloyd
LdB2
M
RA-56-1B
Ira F. Hodge
(same)
13.8
Rowan
Row Crops
Lloyd
LdB2
an
aLatus Uoae for iana appucation sites are: e N (New) o R (Renewed) o M (Modified) ♦ T (Transferred) ♦ D (Deleted)
b Soil Series Name (i.e. Appling, Cecil, etc.)
'Mapping Unit must be consistent with those used in the County Soil Survey (i.e. for a 2-8% slope Cecil in Anson County the mapping unit is CeB2)
II. WATERBODY AND CLASSIFICATIONS INFORMATION (See Instruction C):
Site/Field ID
Latitude
Longitude
Location
Datum
Location Method Code
Location Accuracy
Waterbod Subbasin and
y
Stream Index No.
Current and Proposed
Class
Note: Please Keep the site information (1.) and waterbody intormation (11.) of the same field on the same page.
FORM: LASC 08-11 Page 1

SITE SUMMARY
Town of Cleveland
Cleveland,NC
Site ID: NC-RA-54
Owner: Karlene Doby
Address: 1630 Baker Mill Road
Cleveland, North Carolina 27013
Phone: [phone]
Operator: same
Estimated
Applicable
Fields Acres Cror)(s)
Rowan County
RYE -based
Annual PAN limits
(pounds/acre/veer)
Predominant
Latitude &
Soil Series
Longitude
(mar) unit)
(D.M.S)
2A
10.3
fescue (pasture)
216
Lloyd
35.47.17 N
(LdB2)
80.41.24 W
213
11.8
fescue (pasture)
188
Enon
35.47.12 N
(EnB)
80.41.18 W
TOTAL 22.
Notes: Entrance gate may be locked, notify Karlene Doby in advance of application event.
Date: 07/01 /14

State of Forth Carolina
Department of Environment and Natural Resources
Division of Water Resources
DlvlsIon of Water Resources 15A NCAC 02T .1100 — LAND OWNER AGREEMENT
FORM: LOA 08-13
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 application and
supporting documentation
For more information or for an electronic version of this form, visit the Land Application Unit (EAU) web site at:
http: //portal. ncdenr. org/web/wa/aps/lau
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 08-13).
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 08-13):
® Submit the completed and appropriately executed Residuals Source Certification (FORM: LASC 08-13) 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
..ie undersigned landowner or his representative hereby permits:
Applicant's name: Town of Cleveland
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
(yes/no)
Land Use or
Cropping Patterns
Intended Use of Crops
Residuals Source
(optional)
Special note
(no-till/over-seed/
pasture)
RA-54-2A and -213
No
Fescue Pasture
Animal Feed
Town of Cleveland
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.
its Agreement shall remain in effect for the length of the Division's permit for the residuals land application program and
all 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 08-13 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, Land Application Unit, 1636 Mail Service
Center, Raleigh, NC 27699-1636.
5. The Permittee must request and obtain a permit modification from the Division prior to a transfer of the land application sites) 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.
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.
IMALTERNATIVES 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 program;
(Name of the new program)
FORM: LOA 08-13 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: Wj2�1
Address: 162 3 d Aftk��72
City: /,i v �v� l6 State: V(
Phone: �� Z 6 ". `f E-mail addre
Zip: Z 7J4 3
Date: IYP / 10
I %J V I I
NORTH CAROLINA,COUNTY
I, the undersigned Notary Public do hereby certify that�,ml;�
personally appeared before me this day and acknowledged the due execution of the forgoing instrument.
WITNESS my hand and official seal this the1 f (
day of -j r9A%�� , 20 Jq
Signature and seal:
My commission expires:
NOTARY PUBLIC
ME OF NORTH CAROLINA
Lessee's/Operator's Certification:
I certify that I have read this Agree ent 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:
E-mail
Date:
Zip:
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Signing
Signature:
M_
Date: / — %�
FORM: LOA 08-13 Page 3 of 3

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Site RA-54 (all locations approximate) 1 inch = 7,500 feet

Site: RA-54 (all locations approximate) 1 inch = 1,000 feet

q Application Area Map
s'• �; �' 1� �1t{n z'z 1 - 235
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Legend (all locations approximate)
The compliance boundary is established at
Stream Propertyt_ine \Q\ OnSiteWell either 250 feet from the residuals application
area or 50 feet within the property boundary,
—'— Drain ApplicationArea ® Unsuitable whichever is closest to the application area.
The review boundary is established midway
SurfaceWater OnSiteHouse between the compliance boundary and the
perimeter of the residuals application area.
Feet
x®— x -Fence Outbuilding
Site: RA-54 0 160320 640 960 1,280

Soil Map
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She: RA-54 (all locations approximate) 1 inch = 1,000 feet

CUMULATIVE METAL LOADINGS (LBS/ACRE) AS OF 6/27/2014
The Cumulative metals for this report come from LTD Period Table records (i.e. a Monthly Report has been produced and the loadings have been archived to History
In cases where a trace metal lab result was Not Reported to Synagro or tracking of the metal loading was Not Required the loading on the report is displayed as "NR"
Date
Field ID Last Applied As Cd Cr Cu Pb Hg Mo Ni Se Zn
NC-RA-00054-0-0002-A 05/2011 0.0184 0.1873 0.6999 7.0311 0.4945 0.0551 0.3767 0.3649 0.0838 15.6806
NC-RA-00054-0-0002-B 04/2012 0.0134 0.1539 0.9035 5.9868 0.4050 0.0451 0.2915 0.3545 0.0618 13.3953
Page: 1 of 1 6/27/2014

SITE SUMMARY
Town of Cleveland
Cleveland,NC
Site ID: NC-RA-56
Owner: Ira F. Hodge
Address: 2520 Third Creek Church Road
Cleveland, North Carolina 27013
Phone: [phone]
Operator: same
Estimated
Applicable
Fields Acres Cron(sl
Rowan County
RYE -based
Annual PAN limits
(noundslacrelvear)
Predominant
Latitude &&
Soil Series
Longitude
(mar) unit)
(D.M.S)
corn (grain)
131
Lloyd
35.45.34 N
1A
8.4
soybeans (fs/dc)
172/145
(LdB2)
80.42.04 W
wheat
98
corn
131
Lloyd
35.45.44 N
1 B
13.8
soybeans (fs/dc)
172/145
(LdB2)
80.42.03 W
wheat
98
TOTAL
22.2
Notes:
Date: 07/01 /14

State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
H3IvI5ioaa of Water . - Resources 15A NCAC 02T .1100 — LAND OWNER AGREEMENT
FORM: LOA 08-13
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 application and
supportina documentation
For more information or for an electronic version of this form, visit the Land Application Unit (LAU) web site at:
http:/1portal. ncdenr. org/web/ivg/aps/lay
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 08-13).
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 08-13):
® Submit the completed and appropriately executed Residuals Source Certification (FORM: LASC 08-13) 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
-tiie undersigned landowner or his representative hereby permits:
Applicant's name: Town of Cleveland
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
(yes/no)
Land Use or
Cropping Patterns
Intended Use of Crops
Residuals Source
(optional)
Special note
(no-till/over-seed/
pasture)
RA-56-IA and -113
No
row crops
Animal Feed
Town of Cleveland
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.
its Agreement shall remain in effect for the length of the Division's permit for the residuals land application program and
all 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 08-13 Page I 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 11) are met.
4. Notification of cancellation of this Agreement shall be immediately forwarded to NCDENR-DWR, Land Application Unit, 1636 Mail Service
Center, Raleigh, NC 27699-1636.
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.
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.
IMALTERNATIVES 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 marls 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
compliance boundary to the application package)
® A re -defined compliance boundary is not needed for this site.
IV. ACKNOWLEDGEMENT OF FIELD TRANSFER: (if needed)
boundary and attach a map showing the newly proposed
❑ 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 nroaram;
(Name of the new program)
FORM: LOA 08-13 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: /
Address:7�f%
City: State: /J C`
G
Phone: _ Z .7 v L �`'�, E-mail address:
NORTH CAROL., COUNTY
Zip: Z -70 J 3
Date: i9 Z 4
I, the undersigned Notary Public do hereby certify that
personally appeared before me this day and acknowledged the due execution of the forgoing instrument.
WITNESS my hand and official seal this the (Gvj 7l'a
day of
Signature and seal:
My commission expires:
, 20
NOTARY PUBLIC
STATE OF FORTH CAROUNA
Lessee's/Operator's Certification:
N
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:
E-mail address:
Date:
Zip:
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Signing
Signature:
Dater
FORM: LOA 08-13 Page 3 of 3

Site: RA-56 (all locations approximate) 9 inch = 7,500 feet

Topographic Map
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Site RA-56 (all locations approximate) 1 inch = 1,000 feet

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Legend
11- -- Stream x — x - Fence ® OnSiteHouse
— — Drain PropertyLine Outbuilding
® Pond" ApplicationArea Unsuitable
Site: RA-56
1 inch = 660 feet
(all locations approximate)
The compliance boundary is established at
either 250 feet from the residuals application
area or 50,feet within the property boundary,
whichever is closest to the application area.
The review boundary is established midway
between the compliance boundary and the
perimeter of the residuals application area.
Feet
0 160320 640 960 1,286

Site: RA-56 (all locations approximate) 9 inch = 1,000 feet

CUMULATIVE METAL LOADINGS (LBS/ACRE) AS OF 6/27/2014
The Cumulative metals for this report come from LTD Period Table records (i.e. a Monthly Report has been produced and the loadings have been archived to History
In cases where a trace metal lab result was Not Reported to Synagro or tracking of the metal loading was Not Required the loading on the report is displayed as "NR"
Date
Field ID Last Applied As Cd Cr Cu Pb Hq Mo Ni Se Zn
NC-RA-00056-0-0001-A 02/2006 0.0001 0.0012 0.0425 0.0480 0.0039 0.0003 0.0036 0.0024 0.0005 0.1398
NC-RA-00056-0-0001-B 08/2007 0.0073 0.0619 2.6639 2.7726 0.2510 0.0145 0.1550 0.1483 0.0262 7.0284
Page: 1 of 1 6/27/2014

OPERATIONS AND MAINTENANCE PLAN
SYNAGRO RESIDUALS LAND APPLICATION FOR WQ0011431 (Synagro Central, LLC)
Operational Functions
The operational function of this project involves land application of residuals for the Town of Cleveland's
wastewater treatment plant. This material will be loaded onto tractor trailers or "spreader trucks" and
hauled to land application sites. The residuals will be spread at agronomic rates, as determined by a
recently analyzed nutrients and metals sample. The material will be land applied with a liquid applicator
that will use pressure to achieve a consistent spread pattern. The fields applied will have a crop, either
established or planted soon after application, which is to be utilized for animal consumption.
Safety Measures
Synagro believes in operating in a safety -conscious manner and has all employees participate in
quarterly online safety courses. These courses are designed to help employees recognize safety issues
and take steps to prevent accidents from occurring. In addition, all Synagro employees have the
authority to stop operations if they think any aspect of the operation could cause environmental or
personal harm.
Maintenance Schedule
Synagro will follow the maintenance schedule specified by their fleet management section for the
equipment necessary to complete the job.

OPERATIONS AND MAINTENANCE PLAN
SYNAGRO RESIDUALS LAND APPLICATION FOR WQ0011431 (Synagro Central, LLQ
Inspection Plan
Inspections will be conducted on a weekly basis at the land application site during activities of this project. Inspection
frequency is based on the time frame to complete the project and the amount of dry tons to be land applied from the
facility. The inspections will consist of inspecting a field that is currently being applied as well as inspecting random
fields that have been completed. These inspections will consist of:
1. Verifying that the "Pre -Operations Check List" has been completed and signed by both operational and technical
staff.
2. Checking the calculated loads to insure the correct amount of residuals are being land applied.
3. Insuring that all manned equipment has a copy of the spill control plan, the permit, and the operations and
maintenance plan.
4. Insuring that the field has been flagged properly and that all buffers are being adhered to.
S. Insuring that the "Crop and Landowner Verification" form has been filled out.
6. Verifying that the residuals have been adequately sampled to confirm compliance.
The records will be kept in the project files in the respective office for the project. The Permittee or Inspector shall
report by telephone to the NCDENR/DWQ Mooresville Regional Office at 704-663-1699, as soon as possible, but no later
than 24 hours after, or the next working day, following the occurrence or first knowledge of the occurrence of the
following.
• Any occurrence with the distribution program resulting in the land application of significant amounts of
material that is abnormal in quantity or characteristics.
• Any failure of the program that results in a release of material to surface waters.
• Any time that self -monitoring information indicates that the program has gone out of compliance with
the permit.
• Any process unit failure that results in the system not adequately treating the residuals.
• Any spill or discharge from a vehicle or piping system during residuals transportation.
Any release that requires immediate reporting outside of normal business hours shall be called in to DENR at 800-662-
7956, 800-858-0368, or 919-733-3300. These numbers are to be called in the event of a release to surface waters or the
imminent failure of a storage system when the event occurs outside of normal business hours. Within 5 days of the first
notice of on occurrence, a written response in the form of a letter shall be sent to DENR outlining the actions taken or
proposed actions taken to ensure that the problem does not recur.
Persons responsible for inspections on this project are as follows:
Eric Thompson, Soil Scientist/Technical Services Specialist, or his designee (Eric Thompson is the designated land
application ORC for this project.)

OPERATIONS AND MAINTENANCE PLAN
SVNAGRO RESIDUALS LAND APPLICATION FOR WQ0011431(Synagro Central, LLC)
Sampling Plan
Sampling for this project consists of sampling the residuals just before land application is to occur. Based on
the dry tonnage of this plant, there will be one sample for each parameter per year.
The residuals shall be sampled annually for the following: (Regulatory level in milligrams per liter in parentheses.)
Arsenic (5.0)
1, 4-Dichlorobenzene (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)
Chlordane (0.03)
Hexachlorobenzene (0.13
Tetrachloroethylene (0.7)
Chlorobenzene (100.0)
Heptachlor (and its hydroxide) (0.008) Toxaphene (0.5)
Chloroform (6.0)
Hexachloro-1,3-butadiene (0.5)
Trichloroethylene (0.5)
Chromium (5.0)
Hexachlorethane (3.0)
2,4,5-Trichlorophenol (400.0)
m-Cresol (200.0)
Lead (5.0)
2,4,6-Trichlorophenol (2.0)
o-Cresol (200.0)
Lindane (0.4)
2,4,5 TP ( Silvex) (1.0)
p-Cresol (200.0)
Mercury (0.2)
Vinyl Chloride (0.2)
Cresol (200.0)
Methoxychlor (10.0)
2,4-D (10.0)
Methyl ethyl ketone (200.0)
The residuals will also be sampled, based on the chart below, for the following constituents
Dry Tons Generated
(short tons per year)
Monitoring Frequency
(Established in 40 CFR 503 and 15A NCAC 02T.1111)
<319
1 time per year
=>319-<1,650
1 per Quarter (4 times per year)
=>1,650-<16,500
1 every 60 days (6 times per year)
=>16,500
1 every month (12 times per year)
Aluminum
Ammonia -Nitrogen
Arsenic
Cadmium
Calcium
Copper
Lead
Sodium Adsorption Ratio (SAR)
Magnesium
Mercury
Molybdenum
Nickel
Nitrate -Nitrite Nitrogen
Phosphorous
Potassium
pH
Plant Available Nitrogen (calculation)
Selenium
Sodium
Total Solids
Total Kjeldahl Nitrogen
Zinc
In order to meet pathogen and vector requirements, the material will be sampled for fecal coliform density and the 30-
day bench test. The samples will be taken from the digester. Additional samples will be taken for TCLP/RCI and
nutrients and metals analysis. Methods of sampling will follow the conditions of the permit and applicable regulations.
The following people are responsible for sampling:
Eric Thompson, Soil Scientist/Technical Services Specialist, or his designee.

Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
February 6, 2006
JAMES A. BROWN, MAYOR
TOWN OF CLEVELAND
P.O. BOX L869 It?. V
INE *PGR--TC2$-570
'J F'�'DVsi'9 Kf
F E B 1 0 2006
NC DENR IviRO
nwn - AOLlifer Protection
Subject: Permit No. WQ0011431 Correction
Town of Cleveland
Town of Cleveland Residuals Land
Application Program
Land Application of Residual Solids (503)
Rowan County
Dear Mr. Brown:
In accordance with an emailed request received on February 3, 2006, we are forwarding herewith the
corrected Permit No. WQ0011431 issued January 25, 2006 for the subject facility.
The following corrections have been made to the permit:
I. Reference to attachments A and B in the cover letter have been removed.
2. . Attachments A and B have been modified (correct source has been added and the footnotes have been
removed).
Please replace your permit with the corrected Permit No. WQ0011431, issued_ January 25, 2006.
If you have any questions regarding this request, please do not hesitate to contact Michelle McKay at (919)
715-6187. Thank you for your cooperation.
Sincerely,
,,if Alan W. Klimek, P.E.
Cc: Scott Berg, Synagro Southeast, 6220A Hackers Bend Court, Winston Salem, NC 27103
Rowan County Health Department
11Vlooresville-Regional_Office-Aquifer Protection -Section`,
Technical Assistance and Certification Unitf : -�
APS Central Files
APS Files
LAU Residuals Program Coordinator
Aquifer Protection Section 1636 Mail Service Center Raleigh, NC 27699-1636 Phone [phone] Customer Service
Internet: http://h2o.enr.State.nc.us 2728 Capital Boulevard Raleigh,.NC 27604 Fax [phone]
Fax [phone]
An Equal Cppoitunity/Affirmative Action Employer-50% Recycled/10% Post Consumer Paper

Michael F. Easley. Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E. Director
Division of Water Quality
January 25, 2006
JAMES A. BROWN, MAYOR
TOWN OF CLEVELAND
P.O. Box 1869
NEWPORT, NC 28570
Subject: Permit No. WQ001143.1
Town of Cleveland
Town of Cleveland Residuals Land
.Application Program
Land Application of Residual Solids (503)
Rowan County
Dear Mr. Brown:
In accordance with your permit renewal and modification application package received on August
22, 2005 as well as additional information received September 15, 2005 we are forwarding herewith a
modified Permit No. WQ0011431, dated January 25, 2006, to the Town of Cleveland for the subject
residuals land application program.
7 l��'
This permit shall be effective from the date of issuance until December 3 ,/-2 -0—shall void
Permit No. WQ0011431, issued on December 15, 2000; and shall be subject to the conditions and
limitations ; as specified therein. Make note of this permit's expiration date and the fact that a permit
renewal application is due to the Division of Water Quality (Division) no later than six months prior to
that date (i.e., see Condition VI. 7.), as the Division does not send reminders to apply for permit renewal.
This permit approves the continued operation of the residuals land application program for
another five-year cycle. As always, remember to take the time to review this permit thoroughly, as
some of the conditions contained therein may have been added, changed, or deleted since the last
issuance. Pay particular attention to the monitoring requirements in this permit. Failure to establish an
adequate system for collecting and maintaining the required operational information will result in future
compliance problems.
If any parts, requirements, and/or limitations contained in this permit are unacceptable, you have
the right to request an adjudicatory hearing upon written request within 30 days following receipt of this
permit. This request shall be in the from 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, North Carolina 27699-6714. Unless such demands are made, this permit shall be final
and binding.
NorthCarolina
Naturally
Aquifer Protection Section 1636 Mail Service Center
Internet: http://h2o.enr.state.nc.us 2728 Capital Boulevard
Raleigh, NC 27699-1636 Phone [phone] Customer Service
Raleigh, NC 27604 Fax [phone] _ 1-877-623-6748
Fax [phone]
An Equal Opportunity/Affirmative Action Employer — 50% Recycled/10% Post Consumer Paper

Mr. James A. Brown
January 25, 2006
Page 2
If you need any additional information concerning this matter, please contact Michelle McKay by
telephone at [phone], or via e-mail at inichelle.mckay @ncmail.net.
Sincerely,
for Alan W. Klimek, P.E.
cc: Scott Berg, Synagro Southeast, 6220A Hackers Bend Court, Winston Salem, NC 27103
Rowan County Health Department
Mooresville Regional Office -Aquifer Protection Section
Technical Assistance and Certification Unit
APS Central Files
APS Files
LAU Residuals Program Coordinator

NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
RALEIGH
LAND APPLICATION OF RESIDUALS SOLIDS (503) PERMIT
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
Town of Cleveland
Rowan County
FOR THE
continued operation of a residuals land application program for the Town of Cleveland and consisting of
the land application of residuals generated by the residuals source -generating facilities listed in the most
recently -certified Attachment A to the land application sites listed in the most recently -certified
Attachment B with no discharge of wastes to surface waters, pursuant to the permit modification
application package received on August 22, 2005 as well as additional information received September 15,
2005 and in conformity with the project plan, specifications, and other supporting data subsequently filed
and approved by the Department of Environment and Natural Resources and considered a part of this
permit.
311,1 L�f
This permit shall be effective from the date of issuance until December 3f,-20t0; shall void Permit
No. WQ0011431, issued on December 15, 2000; and shall be subject to the following specified conditions
and limitations:
I.. PERFORMANCE STANDARDS
The residuals land application program shall be effectively maintained and operated as a non -
discharge system to prevent the discharge of any wastes resulting from the operation of this
program.
2. This permit shall become voidable if the soils of the land application sites fail to assimilate the
residuals adequately and may be rescinded unless the land application sites are maintained and
operated in a manner that will protect the assigned water quality standards of the surface
waters and groundwater.
3. The issuance of this permit shall not relieve the Permittee of the responsibility for damages to
surface waters or groundwater resulting from the operation of this residuals land application
program.

4. In the event that the residuals land application program is not operated satisfactorily, including
the creation of nuisance conditions, the Permittee shall cease land applying residuals to the
site, contact the Aquifer Protection Section of the appropriate Division of Water Quality's
(Division) regional office, and take any immediate corrective actions as may be required by
the Division.
No residuals other than those generated by the residuals source -generating facilities listed in
the most recently -certified Attachment A of this permit shall be approved for land application
in accordance with this permit.
The pollutant concentrations in any residuals that are land applied to any land application site
shall not exceed the following Ceiling Concentrations (i.e., dry weight basis):
Parameter
Ceiling Concentration
(milligrams per kilograni)
Arsenic
75
Cadmium
85
Copper
4,300
Lead
840
Mercury
57
Molybdenum
75
Nickel
420
Selenium
100
Zinc
7,500
7. When residuals are land applied under the conditions of this permit, the Class A pathogen
requirements and site restrictions in 40 CFR Part 503.32(a) or the Class B pathogen
requirements and site restrictions in 40 CFR Part 503.32(b), and one of vector attraction
reduction requirements in 40 CFR Part 503.33 shall be met. Additionally, an evaluation shall
be performed that demonstrates the residuals' ability to comply with this requirement. Upon
request, a copy of this evaluation, including all test results and calculations, shall be submitted.
Only residuals that are generated by the residuals source -generating facilities that are
identified as being exempt from this condition in the most recently -certified Attachment A
shall not be required to comply with the specified pathogen reduction and vector attraction
reduction requirements.
8._ Only the land application sites listed in the most recently -certified Attachment B of this permit
are approved for residuals land application.
9. This permit shall become voidable unless the agreements between the Permittee and the
landowners and lessees or operators of any land application sites listed in the most recently -
certified Attachment B of this permit not owned by the Permittee are in full force and effect.
These agreements shall be considered expired concurrent with the expiration date of the permit
and shall be renewed at the same time the permit is renewed.
10. The appropriate local governmental official (i.e., county manager, city manager, etc.) shall be
notified at least 24 hours prior to the initial residuals land application event to any new land
application site. In addition, the appropriate county manager's office shall be notified. prior to
the initial residuals land application event on any new site so that they will be aware that
residuals land application activities have commenced on the site.
2

11. The Aquifer Protection Section of the appropriate Division's regional office shall be notified
at least 24 hours prior to the initial residuals land application event on any new land
application site. Such notification to the Regional Aquifer Protection Supervisor shall be
made during normal office hours (i.e., from 8;00 a.m. until 5:00 p.m.) between Monday and
Friday, but excluding State Holidays. A list of the Division's regional offices, their county
coverage, and their contact information may be downloaded from the web site at
http://h2o.enr.state.nc.us/ndpu/.
II. OPERATION AND MAINTENANCE REQUIREMENTS
The facilities and land application sites shall be properly maintained and operated at all times.
2. Upon classification of the residuals land application program by the Water Pollution Control
System Operators Certification Comrnission (WPCSOCC), the Permittee shall designate a
certified land application/residuals operator to be in responsible charge (ORC) of the program.
The operator shall hold a certificate of the type classification assigned to the program by the
WPCSOCC. The Permittee shall also designate a certified back-up operator of the appropriate
type to comply with the conditions of 15A NCAC 8G .0202.
3. No residuals shall be stored at any land application site at any time, unless written approval
has first been requested and obtained from the Division.
4. A copy of this permit shall be maintained in all manned equipment at the land application sites
when residuals are being land applied during the life of this permit. A spill prevention and
control plan shall be maintained in all residuals transport and application vehicles.
5. When land applying residuals to any land application site, the following buffer zones shall be
maintained at all times:
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 Il 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 lakeor 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 downslope 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.
6. Maximum slope for land application of residuals shall be 10 percent for surface application,
methods and 18 percent for subsurface application methods.
7. Specific residuals land application area boundaries shall be .clearly marked on each land
.application site prior to and during a residuals land application event.
The metal loading rates on any land application site shall not exceed the following
Cumulative Pollutant Loading Rates (CPLRs):
Parameter
CPLR
(kilograms per hectare)
CPLR
(pounds per acre)
Arsenic
41
36
Cadmium
39
34
Copper
1,500
1,338
Lead
300
267
Mercury
17
15
Molybdenum
n/a
n/a
Nickel
420
374
Selenium
100
89
Zinc
2,800
2,498
9. An acceptable pH shall be maintained in the soil, residuals, and lime mixture, greater than 6.0,
on all land application sites onto which residuals are land applied to ensure optimum yield for
the crops specified.in Condition II. 13. The agronomist shall provide information on the pH
best suited for the specified 'crop and the soil type.
10. Should any of the residuals generated by the residuals source -generating facilities listed in the
most recently -certified Attachment A of this permit contain a high salt content (i.e., high
sodium adsorption ratio (SAR) of five or higher), the exchangeable sodium percentage (ESP)
or other method as approved by the Division, using the results from the annual soils analysis
as required by this permit, shall be monitored on all of the land application sites. The local
Cooperative Extension Office, the Department of Agriculture and Consumer Services, the
Natural Resource Conservation Service, a North Carolina -licensed Soil Scientist, or other
agronomist shall review the results and make recommendations regarding soil amendments
(e.g., gypsum, etc.) or other ameliorative mechanism for maintaining the integrity of the site in
terms of suitability for land application of residuals and maintaining conditions conducive to
crop growth. The Permittee shall implement such recommendations accordingly and shall
maintain written records of each monitoring event that includes details of the sites covered and
rate of soil amendment application.
0

11. Prior to land applying residuals to any land application site that has previously received or is
intended to receive animal waste (e.g., poultry litter, etc.) or other source of nutrients (e.g.,
fertilizer, etc.) in the future, the Permittee shall obtain information pertaining to the volume
and analysis of the applied waste/nutrients from the landowner and/or lessee/operator of the
site. The Permittee shall be responsible for verifying the volume of residuals that may be land
applied to the site such that the plant available nitrogen (PAN) loading rate for the specified
crop (i.e., see Condition II. 13.) shall not be exceeded by all of.the sources of PAN applied.
Should the maximum PAN loading rate be met or exceeded, then no additional residuals shall
be land applied to the site.
12. A suitable vegetative cover, as listed in Condition 11. 13., shall be maintained on land
application sites onto which residuals are land applied 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 other
agronomist and as approved by the Division.
13. Residuals and other sources of PAN shall be land applied to all land application sites at
agronomic rates in accordance with the crop - management plan outlined by the local
Cooperative Extension Office, the North Carolina Department of Agriculture and Consumer
Services, the Natural Resource Conservation Service, or other agronomist. Under no
circumstances shall the following PAN loading rates land applied to any site exceed the
following for the specified crops:
PAN
PAN
Crop
(pounds per
Crop
(pounds per
acre per year)
acre per year)
Alfalfa
200
Forest
75
(Hardwood or Softwood)
Bermuda Grass
(Hay or Pasture)
220
Milo
100
Blue Grass
120
Small Grain
100
(Wheat, Barley, or Oats)
Corn
160
Sorghum or Sudex
180
(Grain)
(Pasture)
Corn
200
Sorghum or Sudex
220
(Silage)
(Silage)
Cotton
70
Soybeans
200
Fescue
250
Timothy, Orchard, or
200
Rye Grasses
The Permittee shall apply for and receive a modification of this permit before land applying
residuals on any land application site that is to be established in a crop other than those listed
above. A maximum PAN loading rate for the desired crop shall be approved with the permit
modification.
If the land application sites are to be overseeded (e.g., bermuda grass in the summer and rye
grass in the winter with BOTH crops to receive residuals), then the second crop shall receive
an application of PAN at a rate of no greater than 50 pounds per acre per year. This practice
shall be allowed as long as the second crop is to be harvested. If the second crop is to be
planted for erosion control only and is to be tilled into the soil, then no residuals shall be land
applied to these sites because the PAN will essentially be returned to the soil. Residuals shall
not be land applied at rates greater than agronomic rates, unless authorized by the Division.
5

14. Animals shall not be grazed on any land application site for 30 days after any residuals land
application event. Sites that are to be used for grazing shall have fencing that will be used to
prevent access after each event.
15. Food crops, feed crops, and fiber crops that do not come in contact with the residuals shall not
be harvested for 30 days after any residuals land application event.
16. 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.) shall not be harvested for 14
months after any residuals land application event.
17. Food crops with harvested parts below the surface of the land (i.e., root crops such as potatoes,
carrots, radishes, etc.) shall not be harvested for 20 months after any residuals land application
event when the residuals remain on the land surface for four months or longer prior to
incorporation into the soil.
18. Food crops with harvested parts below the surface of the land shall not be harvested for 38
months after any residuals land application event when the residuals remain on the land
surface for less than four months prior to incorporation into the soil.
19. Turf shall not be harvested.for one year after any residuals land application event.
20. Adequate provisions shall be taken to prevent wind erosion and surface runoff from conveying
residuals from the land application sites onto adjacent properties or into any surface waters.
21. Adequate procedures shall be provided to prevent surface runoff from carrying any land
applied or stored residuals into any surface waters.
22. Surface -applied residuals shall be plowed or disced within 24 hours after land application on
land application sites with no cover crop established.
23. For land application sites that are prone to flooding or within the 100-year flood elevation,
residuals shall be land applied only during periods of dry weather. The residuals shall be
incorporated into the soil within 24 hours after land application.
24. Residuals shall not be land applied during inclement weather or until 24 hours following a
rainfall event of 0.5-inch or greater in 24 hours. Any emergency residuals land application
measures shall first be approved in writing by the Division.
25. Residuals shall not be land applied to any land application site that is flooded, frozen, or
snow-covered.
26. Appropriate measures shall be taken to control public access to the land application sites
during active site use and for the 12-month period following the last residuals land application
event. Such controls may include the posting of signs indicating the activities being
conducted at each site.
9

III. MONITORING AND REPORTING REQUIREMENTS
1. Any monitoring (i.e., including groundwater, surface water, residuals, soil, or plant tissue
analyses) deemed necessary by the Division to ensure protection of the environment shall be
established, and an acceptable sampling and reporting schedule shall be followed.
2. Residuals generated by each residuals source -generating facility listed in the most -recently -
certified Attachment A of this permit shall be analyzed to demonstrate that they are non-
hazardous under the Resource Conservation and Recovery Act (RCRA). A corrosivity,
ignitability, and reactivity analysis as well as a Toxicity Characteristics Leaching Procedure
(TCLP) analysis shall be conducted on residuals generated by each residuals source -
generating facility listed in the most recently -certified Attachment A of this permit. The
analyses shall be performed at the frequency specified in the most recently -certified
Attachment A of this permit, and the results shall be maintained on file by the Permittee for a
minimum of five years. If residuals generated by a particular residuals source -generating
facility are land applied at a frequency less than that which is specified in the most recently -
certified Attachment A of this permit, the analyses shall be required for each residuals land
application event. Only residuals that are generated by the residuals source -generating
facilities that are identified as being exempt from this condition in the most recently -certified
Attachment A of this permit shall not be required to comply with this monitoring requirement.
The TCLP analysis shall include the following parameters (i.e., note the regulatory level in
milligrams per liter in parentheses):
Arsenic (5.0)
IA-Dichlorobenzene (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)
Chlordane (0.03)
Hexachlorobenzene (0.13) Tetrachloroethylene (0.7)
Chlorobenzene (100.0)
Heptachlor (and its hydroxide) (0.008) Toxaphene (0.5)
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)
o-Cresol (200.0)
Lindane (0.4) 2,4,5-TP (Silvex) (1.0)
p-Cresol (200.0)
Mercury -(0.2) Vinyl chloride (0.2)
Cresol (200.0)
Methoxychlor (10.0)
2,4=D (10.0)
Methyl ethyl ketone (200.0)
After the residuals have been monitored as specified above for two years at the frequency
specified in the most recently -certified Attachment A of this permit, the Permittee may submit
a request to the Division for a permit modification to request a reduction of this monitoring
requirement. In no case, however, shall the frequency of monitoring be less than once per
permit cycle.
7

3. An analysis shall be conducted on residuals generated by each residuals source -generating
facility listed in the most recently -certified Attachment A of this permit. The analysis shall be
performed at the frequency specified in the most recently -certified Attachment A of this
permit, and the results shall be maintained on file by the Permittee for a minimum of five
years. If residuals generated by a particular residuals source -generating facility are land
applied at a frequency less than that which is specified in the most recently -certified
Attachment A of this permit, an analysis shall be required for each residuals land application
event. The analysis shall include, but shall not necessarily be limited to, the following
parameters:
Aluminum
Ammonia -Nitrogen
Arsenic
Cadmium
Calcium
Copper
Lead
Magnesium
Mercury
Molybdenum
Nickel
Nitrate -Nitrite Nitrogen
Percent Total Solids
pH
Phosphorus
Potassium
Selenium
Sodium
Total Kjeldahl Nitrogen
Zinc
Plant Available Nitrogen
(by calculation)
After the residuals generated by a particular residuals source -generating facility have been
monitored for two years at the frequency specified in the most recently -certified Attachment A
of this permit, the Permittee may submit a request to the Division for a permit modification to
reduce the frequency of this monitoring requirement. In no case, however, shall the frequency
of this monitoring be less than once per year when a residuals land application event of
residuals generated by the residuals source -generating facility occurs during that year.
4. Residuals generated by each residuals source -generating facility -listed in the most recently -
certified Attachment A of this permit shall.be monitored for compliance with Condition I. 7.
The monitoring shall be performed at the frequency specified in the most recently -certified
Attachment A of this permit, and data to verify pathogen and vector attraction reduction of the
residuals shall be maintained on file by the Permittee for a minimum of five years. The
required data shall be specific to the stabilization process utilized, but also shall be sufficient
to demonstrate clear compliance with the Class A pathogen reduction requirements in 40 CFR
Part 503.32(a) or the Class B pathogen reduction requirements and site restrictions in 40 CFR
Part 503.32(b) as well as one of vector attraction reduction requirements. in 40-CFR Part
503.33. Note that the specific oxygen uptake rate (SOUR) test shall not be used to show
compliance with the vector attraction reduction requirement in 40 CFR Part 503.33 if the
residuals have a total solids concentration . of two percent or greater. In addition, the
Environmental Protection Agency (EPA) certification statements concerning compliance with
pathogen reduction requirements, vector attraction reduction requirements, and management
practices shall be completed quarterly by the proper authority or authorities, if more than one
is involved (i.e., either the person who prepares the residuals, the person who derives the
material, or the person who applies the residuals). Only residuals that are generated by the
residuals source -generating facilities that are identified as being exempt from Condition 1. 7.
in the most recently -certified Attachment A of this permit shall not be required to comply with
this monitoring requirement.

5. Laboratory analyses as required by Condition III. 2., Condition 111. 3., and Condition III. 4.
shall be performed/gathered on the residuals as they are to be land applied. Furtliermore,
analytical determinations made pursuant to the monitoring and reporting requirements of this
permit shall be made by a laboratory certified by the Division for the required parameter(s)
under 15A NCAC 2H .0800 or 15A NCAC 2H .1100.
6. Proper records shall be maintained by the Permittee tracking all residuals land application
events. These records shall include, but are not necessarily limited to, the following
information:
a. Source of residuals;
b. Date of land application;
c. Location of land application (i.e., site, field, or zone number);
d. Method of land application;
e. Weather conditions (i.e., sunny, cloudy, raining, etc.);
f. Soil conditions (i.e., dry, wet, frozen, etc.);
g. Type of crop or crops to be grown on field;
h. Volume of residuals land applied in gallons per acre, dry tons per acre, or kilograms per
hectare;
i. Volume of animal waste or other nutrient source applied in gallons per acre, dry ton per
acre, or kilograms per hectare (if applicable);
j. Volume of soil amendments (i.e., lime, gypsum, etc.) applied in gallons per acre, dry ton
.per acre, or kilograms per hectare (if applicable); and
k. Annual and cumulative totals of dry tons per acre of residuals as well as animal waste and
other source of nutrients residuals (i.e., if applicable), annual and cumulative pounds per
acre of each heavy metal (i.e., shall include, but shall not be limited to, arsenic, 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.
7. A representative annual soils analysis (i.e., Standard Soil Fertility Analysis) shall be
conducted on each land application site on which a residuals land application event in the
respective calendar year has occurred or is to occur, and the results shall be maintained on file
by the Permittee for a minimum of five years. The Standard Soil Fertility Analysis shall
include, but is not necessarily limited to, the following parameters:
Acidity Exchangeable Sodium Percentage (by calculation)
Calcium Magnesium Phosphorus
Cation Exchange Capacity Manganese Potassium
Copper Percent Humic Matter Sodium
Base Saturation (by calculation) pH Zinc
9

8. Three copies of all required monitoring and reporting requirements as specified in Condition
III. 1., Condition III. 2., Condition III. 3., Condition III. 4., Condition III. 5., Condition 111. 6.,
and Condition II1. 7. shall be submitted annually on or before March 1st of the year following
the residuals land application event to the following address:
NCDENR-DWQ
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
9. Noncompliance Notification:
The Permittee shall report by telephone to the Aquifer Protection Section of the Division's
Mooresville Regional Office at telephone number [phone], 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:
a. Any occurrence with the residuals land application program that results in the land
application of significant amounts of residuals that are abnormal in quantity or
characteristic.
b. Any failure of the residuals land application program resulting in a release of material to
receiving waters.
c. Any time that self -monitoring information indicates that the residuals land application
program has gone out of compliance with the conditions and limitations of this permit or
the parameters on which the program system was designed.
d. Any process unit failure, due to known or unknown reasons, that render the residuals land
application program incapable of adequate residuals treatment.
e. Any spillage or discharge from a vehicle or piping system transporting residuals to the
application site.
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.
IV. GROUNDWATER REQUIREMENTS
1. Land Application Site Requirements:
a. Each land application site identified with a GW-A in the most recently -certified
Attachment B of this permit is dominated by soils with a mean seasonal high water.table
greater than three feet below the land surface. Residuals land application events may
occur on these sites throughout the year. -
10

b. Each land application site identified with a GW-B in the most recently -certified
Attachment B of this permit is dominated by soils with a mean seasonal high water table
between one and three feet below the land surface. Residual land application events on
these sites shall be prohibited from December through March, 'inclusive. No residuals
shall be land applied to these sites when the vertical, separation between the depth of
residuals land application and the water table is less than three feet. The actual water
table depth for seasonally -restricted soils shall be verified by soil borings within 24 hours
prior to any residuals land application event that occurs from April through November,
inclusive. The number of borings advanced shall be sufficient to characterize water table
conditions across the land application site adequately. Any open borings shall be properly
filled with native soil, prior to the residuals land application event, to decrease the chance
of any residuals contaminating the groundwater.
2. Applicable Boundary Requirements:
a. The COMPLIANCE BOUNDARY for residuals land application programs is specified by
regulations in 15A NCAC 2L (i.e., "Groundwater Classifications and Standards"). The
Compliance Boundary for each land application site is established at either 250 feet from
the residuals land application area or 50 feet within the property boundary, whichever is
closest to the residuals land application area. An exceedance of Groundwater Quality
Standards at or beyond the Compliance Boundary is subject to immediate remediation
action according to 15A NCAC.2L .0106 (d)(2).
b. The REVIEW BOUNDARY shall be established around each land application site
midway between the Compliance Boundary and the perimeter of the residuals land
application area. Any exceedance of Groundwater Quality Standards at the Review
Boundary shall require action in accordance with 15A NCAC 2L .0106 (d)(2).
3. Additional Requirements:
a. Any groundwater quality monitoring, as deemed necessary by the Division, shall be
provided.
V. INSPECTIONS
Prior to each residuals land application event, the Permittee or his designee shall inspect the
residuals storage, transport, and application facilities to prevent malfunctions and
deterioration, operator errors, and discharges that may cause or lead to the release of wastes to
the environment, a threat to human health, or a nuisance. The Permittee shall maintain an
inspection log or summary including at least the date and time of inspection, observations
made, and any maintenance, repairs, or corrective actions taken by the Permittee. This log of
inspections shall be maintained by the Permittee for a period of five years from the date of the
inspection and shall be made available to the Division or other permitting authority, upon
request.
11

2. Any duly authorized officer, employee, or representative of the Division may, upon
presentation of credentials, enter and inspect any property, premises, or place on or related to
the land application sites or facilities at any reasonable time for the purpose of determining
compliance with this permit; may inspect or copy any records that must be kept under the
terms and conditions of this permit; and may obtain samples of groundwater, surface water, or
leachate.
VI. GENERAL CONDITIONS
This permit shall become voidable unless the residuals land application events are carried out
in accordance with the conditions of this permit, the supporting materials, and in the manner
approved by the Division.
2. This permit shall be effective only with respect to the nature and volume of residuals described
in the application and other supporting data.
3. Failure to abide by the conditions and limitations contained in this permit may subject the
Permittee to an enforcement action by the Division in accordance with North Carolina General
Statutes § 143-215.6A through § 143-215.6C.
4. The annual administering and compliance fee shall be paid by the Permittee within 30 days
after being billed by the Division. Failure to pay the fee accordingly may cause the Division
to initiate action to revoke this permit, as specified by 15 NCAC 2H .0205 (c)(4).
5. The issuance of this permit does not preclude the Permittee from complying with any and all
statutes, rules, regulations, or ordinances that may be imposed by other government agencies
(i.e., local, state, and federal) which have jurisdiction, including, but not limited to, applicable
river buffer rules in 15A NCAC 2B .0200, soil erosion and sedimentation control requirements
in 15A NCAC Chapter 4 and under the Division's General Permit NCGO100000, and any
requirements pertaining to wetlands under 15A NCAC 2B .0200 and 15A NCAC .0500.
6. This permit may be modified, revoked, and/or reissued to incorporate any conditions,
limitations and monitoring requirements the Division deems necessary in order to protect the
environment and public health adequately.
7. The Permittee, at least six months prior to the expiration of this permit, shall request its
extension. Upon receipt of the request, the Division shall review the adequacy of the facilities
and residuals land application program described therein, and if warranted, shall extend the
permit for such period of time and under such conditions and limitations as it may deem
appropriate.
12

8. This permit shall not be automatically transferable. In the event that there is a desire for the
residuals land application program to change ownership or to change the name of the
Permittee, a formal permit request shall be submitted to the Division documentation from the
parties involved and other supporting materials as may be appropriate. The approval of this
request shall be considered on its merits and may or may not be approved.
Permit issued this the 25`h day of January 2006.
NORTH
AL MANAGEMENT COMMISSION
Lor Alan W. Klimek, P.E., Director
Division of Water Quality
By Authority of the Environmental Management Commission
Permit lumber WQ0011431
13

ATTACHMENT A - Approved Residual Source -Generating Facilities
Permit No. WQ0011431
Town of Cleveland
Town of Cleveland Residuals Land Application Program
Owner
Facility Name
County
Permit
Issued
Is 503?
Maximum
Monitoring
Monitoring
Approved
Number
By
Dry Tons
Frequency for
Frequency for -
Mineralization
Per Year
Condition III.2.
Condition III.3. and
Rate
Condition III.4.
Town of Cleveland
Cleveland WWTP
Rowan
NCO049867
DWQ
503
82.00
Annually
Annually
0.30
Total
82.00

ATTACHMENT B - Approved Land Application Sites
Permit No. WQOO11431
Town of Cleveland
Town of Cleveland Residuals Land Application Program
Site/Field ID
Landowner
Lessee/Operator
County
Latitude
Longitude
Net Acreage
Applicable
Restriction in
Condition IV.1.
NC-RA-53-01
Teve augh, Mark
Rowan
35°45'54"
80042'08"
15.70
GW-A
NC-RA-54-02A
Doby, Darlene
Rowan
35°47'17"
80°41'24"
11.20
GW-A
NC-RA-54-02B
Doby, Darlene
Rowan
35°47'12"
80°41'18"
13.70
GW-A
NC-RA-56-OIA
Hodge, Ira
Rowan
35045'34"
80°42'04"
10.90
GW-A
NC-RA-56-01B
Hodge, Ira
Rowan
35045'44"
80°42'03"
9.90
GW-A
Total For County
Total
Carteret
Rowan
61.40
61.40
Permit No. WQ0011431 - Page 1 of 1 Certification Date: February 6, 2006

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7
JAMES A. BROWN, MAYOR
TOWN OF CLEVELAND
P.O. Box 1-M-0
NEWPQRS '`r, t570
Dear Mr. Brown:
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
January 25, 2006
-,z �tq 1,3
C� LE 0io V�r
C,
F E P .1 0 2005
NC dENR MMR0
DWQ -Aquifer Protection
Subject: Permit No. WQ0011431
Town of Cleveland
Town of Cleveland Residuals Land
Application Program
Land Application of Residual Solids (503)
Rowan County
In accordance with your permit renewal and modification application package received on August
22, 2005 as well as additional information received September 15, 2005 we are forwarding herewith a
modified Permit No. WQ0011431, dated January 25, 2006, to the Town of Cleveland for the subject
residuals land application program.
This permit shall be effective from the date of issuance until December 30, 2010; shall void
Permit No. WQ0011431, issued on December 15, 2000; and shall be subject to the conditions and
limitations as specified therein. Make note of this permit's expiration date and the fact that a permit
renewal application is due to the -Division of Water Quality (Division) no later than six months prior to
that date (i.e., see Condition VI. 7.), as the Division does not send reminders to apply for permit renewal.
This permit approves the continued operation of the residuals land application program for
another five-year cycle. As always, remember to take the time to review this permit thoroughly, as
some of the conditions contained therein may have been added, changed, or deleted since the last
issuance. Pay particular attention to the monitoring requirements in this permit. Failure to establish an
adequate system for collecting and maintaining the required operational information will result in future
compliance problems. Of special interest to you are the following:
♦ Footnote "a" of the Attachment A contains a requirement to submit the results of the residual
analyses for ignitability, con-osivity, and reactivity that is required of all municipal land
application programs.
♦ Footnote "a" of the Attachment B contains a requirement to submit updated buffer maps of
land application areas that are required for all permit renewals.
No'thCarolina
Naturally
Aquifer Protection Section 1636 Mail Service Center Raleigh, NC 27699-1636 Phone [phone] Customer Service
Internet: http://h2o.enr.state.nc.us 2728 Capital Boulevard Raleigh, NC 27604 Fax [phone]
Fax [phone]
An Equal Opportunity/Affirmative Action Employer-50% Recycled/l0% Post Consumer Paper

Mr. James A. Brown
January 25, 2006
Page 2
If any parts, requirements, and/or limitations contained in this permit are unacceptable, you have
the right to request an adjudicatory hearing upon written request within 30 days following receipt of this
permit. This request shall be in the from 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, North Carolina 27699-6714. Unless such demands are made, this permit shall be final
and binding.
If you need any additional information concerning this matter, please contact Michelle McKay by
telephone at [phone], or via e-mail at michelle.mckay @ncmail.net.
Sincerely,
Lor Alan W. Klimek, P.E.
cc: Scott Berg, Synagro Southeast, 6220A Hackers Bend Court, Winston Salem, NC 27103
Rowan County Health Department
Mooresville f egionaf-O.ffice�Aquifer_Protection Sectio_n_ '
Technical Assistance and Certification Unit
APS Central Files
APS Files
LAU Residuals Program Coordinator

NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
RALEIGH
LAND APPLICATION OF RESIDUALS SOLIDS (503) PERMIT
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
Town of Cleveland
Rowan County
FOR THE
continued operation of a residuals land application program for the Town of Cleveland and consisting of
the land application of residuals generated by the residuals source -generating facilities listed in the most
recently -certified Attachment A to the land application sites listed in the most recently -certified
Attachment B with no discharge of wastes to surface waters, pursuant to the permit modification
application package received on August 22, 2005 as well as additional information received September 15,
2005 and in conformity with the project plan, specifications, and other supporting data subsequently filed
and approved by the Department of Environment and Natural Resources and considered a part of this
permit.
This permit shall be effective from the date of issuance until December 30, 2010; shall void Permit
No. WQ0011431, issued on December 15, 2000; and shall be subject to the following specified conditions
and limitations:
I. PERFORMANCE STANDARDS
The residuals land application program shall be effectively maintained and operated as a non -
discharge system to prevent the discharge of any wastes resulting from the operation of this
program.
2. This permit shall become voidable if the soils of the land application sites fail to assimilate the
residuals adequately and may be rescinded unless the land application sites are maintained and
operated in a manner that will protect the assigned water quality standards of the surface
waters and groundwater.
The issuance of this permit shall not relieve the Permittee of the responsibility for damages to
surface waters or groundwater resulting from the operation of this residuals land application
program.

4. In the event that the residuals land application program is not operated satisfactorily, including
the creation of nuisance conditions, the Permittee shall cease land applying residuals to the
site, contact the Aquifer Protection Section of the appropriate Division of Water Quality's
(Division) regional office, and take any immediate corrective actions as may be required by
the Division.
No residuals other than those generated by the residuals source -generating facilities listed in
the most recently -certified Attachment A of this permit shall be approved for land application
in accordance with this permit.
6. The pollutant concentrations in any residuals that are: land applied to any land application site
shall not exceed the following Ceiling- Concentrations (i.e., dry weight basis):
'Parameter
Ceiling Concentration
(milligrams per kilogram)
Arsenic
75
Cadmium
85
Copper
4,300
Lead
840
Mercury
57
Molybdenum
75
Nickel
420
Selenium
100
Zinc
7,500
7. When residuals are land applied under the conditions of this permit, the Class A pathogen
requirements and site restrictions in 40 CFR Part 503.32(a) or the Class B pathogen
requirements and site restrictions in 40 CFR Part 503.32(b), and one of vector attraction
reduction requirements in 40 CFR Part 503.33 shall be met. Additionally, an evaluation shall
be performed that demonstrates the residuals' ability to comply with this requirement. Upon
request, a copy of this evaluation, including all test results and calculations, shall be submitted.
Only residuals that are generated by the residuals source -generating facilities that are
identified as being exempt from this condition in the most recently -certified Attachment A
shall not be required to comply with the specified pathogen reduction and vector attraction
reduction requirements.
8. Only the land application sites listed in the most recently -certified Attachment B of this permit
are approved for residuals land application.
9. This permit shall become voidable unless the agreements between the Permittee and the
landowners and lessees or operators of any land application sites listed in the most recently -
certified Attachment B of this permit not owned by the Permittee are in full force and effect.
These agreements shall be considered expired concurrent with the expiration date of the permit
and shall be renewed at the same time the permit is renewed.
10. The appropriate local governmental official (i.e., county manager, city manager, etc.) shall be
notified at least 24 hours prior to the initial residuals land application event to any new land,
application site. In addition, the appropriate county manager's office shall be notified prior to
the initial residuals land application event on any new site so that they will be aware that
residuals land application activities have commenced on the site.
Pa

11. The Aquifer Protection Section of the appropriate Division's regional office shall be notified
at least 24 hours prior to the initial residuals land application event. on any new land
application site. Such notification to the Regional Aquifer Protection Supervisor shall be
made during normal office hours (i.e., from 8:00 a.m. until 5:00 p.m.) between. Monday and
Friday, but excluding State Holidays. A list of the Division's regional offices, their county
coverage, and their contact information may be downloaded from the web site at
littp:Hh2o.enr.state.nc.us/ndpu/.
II. OPERATION AND MAINTENANCE REQUIREMENTS
I. The facilities and land application sites shall be properly maintained and operated at all times
2. Upon classification of the residuals land application program by the Water Pollution Control
System Operators Certification Commission (WPCSOCC), the Permittee shall designate a
certified land application/residuals operator to be in responsible charge (ORC) of the program.
The operator shall hold a certificate of the type classification assigned to the program by the
WPCSOCC. The Permittee shall also designate a certified back-up operator of the appropriate
type to comply with the conditions of 15A NCAC 8G .0202.
3. No residuals shall be stored at any land application site at any time, unless written approval
has first been requested and obtained from the Division.
4. A copy of this permit shall be maintained in all manned equipment at the land application sites
when residuals are being land applied during the life of this permit. A spill prevention and
control plan shall be maintained in all residuals transport and application vehicles.
When land applying residuals to any land application site, the following buffer zones shall be
maintained at all times:
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
iminimum 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 II 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 downslope 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.
6. Maximum slope for land application of residuals shall be 10 percent for surface application
methods and 18 percent for subsurface application methods.
7. Specific residuals land application area boundaries shall be clearly marked on each land
application site prior to and during a residuals land application event.
8. The metal loading rates on any land application site shall not exceed the following
Cumulative Pollutant Loading Rates (CPLRs):
Parameter
CPLR
(kilograms per hectare)
CPLR
(pounds per acre)
Arsenic
41
36
Cadmium
39
34
Copper
1,500
1,338
Lead
300
267
Mercury
17
15
Molybdenum
n/a
n/a
Nickel
420
374
Selenium
100
89
Zinc
2,800
2,498
9. An acceptable pH shall be maintained in the soil, residuals, and lime mixture, greater than 6.0,
on all land application sites onto which residuals are land applied to ensure optimum yield for
the crops specified in Condition Il. 13. The agronomist shall provide information on the pH
best suited for the specified crop and the soil type.
10. Should any of the residuals generated by the residuals source -generating facilities listed in the
most recently -certified Attachment A of this permit contain a high salt content (i.e., high
sodium adsorption ratio (SAR) of five or higher), the exchangeable sodium percentage (ESP)
or other method as approved by the Division, using the results from the annual soils analysis
as required by this permit, shall be monitored on all of the land application sites. The local
Cooperative Extension Office, the Department of Agriculture and Consumer Services, the
Natural Resource Conservation Service, a North Carolina -licensed Soil Scientist, or other
agronomist shall review the results and make recommendations regarding soil amendments
(e.g., gypsum, etc.) or other ameliorative mechanism for maintaining the integrity of the site in
terms of suitability for land application of residuals and maintaining conditions conducive to
crop growth. The Permittee shall implement such recommendations accordingly and shall
maintain written records of each monitoring event that includes details of the sites covered and
rate of soil amendment application.
0

11. Prior to land applying residuals to any land application site that has previously received or is
intended to receive animal waste (e.g., poultry litter, etc.) or other source of nutrients (e.g.,
fertilizer, etc.) in the future, the Permittee shall obtain information pertaining to the volume
and analysis of the applied waste/nutrients from the landowner and/or lessee/operator of the
site. The Permittee shall be- responsible for verifying the volume of residuals that may be land
applied to the site such that the plant available nitrogen (PAN) loading rate for the specified
crop (i.e., see Condition II. 13.) shall not be exceeded by all of the sources of PAN applied.
Should the maximum PAN loading rate be met or exceeded, then no additional residuals shall
be land applied to the site.
12. A suitable vegetative cover, as listed in Condition II. 13., shall be maintained on land
application sites onto which residuals are land applied 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 other
agronomist and as approved by the Division.
13. Residuals and other sources of PAN shall be land applied to all land application sites at
agronomic rates in accordance with the crop management plan outlined by the local
Cooperative Extension Office, the North Carolina Department of Agriculture and'Consumer
Services, the Natural Resource Conservation Service, or other agronomist. Under no
circumstances shall the following PAN loading rates land applied to any site exceed the
following for the specified crops:
PAN
PAN
Crop
(pounds per
Crop
(pounds per -
acre per year)
acre per year)
Alfalfa
200
Forest
75
(Hardwood or Softwood)
Bermuda Grass
(Hay or Pasture)
220
Milo
100
Blue Grass
120
Small Grain
100
(Wheat, Barley, or Oats)
Corn
160
Sorghum or Sudex
180
(Grain)
(Pasture)
Corn
200
Sorghum or Sudex
220
(Silage)
(Silage)
Cotton
70
Soybeans
200
Fescue
250
Timothy, Orchard, or
200
Rye Grasses
The Permittee shall apply for and receive a modification of this permit before land applying
residuals on any land application site that is to be established in a crop other than those listed
above. A maximum PAN loading rate for the desired crop shall be approved with the permit
modification.
If the land application sites are to be overseeded (e.g., bermuda grass in the summer and rye
grass in the winter with BOTH crops to receive residuals), then the second crop shall receive
an application of PAN at a rate of no greater than 50 pounds per acre per year. This practice
shall be allowed as long as the second crop is to be harvested. If the second crop is to be
planted for erosion control only and is to be tilled into the soil, then no residuals shall be land
applied to these sites because the PAN will essentially be returned to the soil. Residuals shall
not be land applied at rates greater than agronomic rates, unless authorized by the Division.
5

14. Animals shall not be grazed on any land application site for 30 days after any residuals land
application event. Sites that are to be used for grazing shall have fencing .that will be used to
prevent access after each event.
15. Food crops, feed crops, and fiber crops that do not come in contact with the residuals shall not
be harvested for 30 days after any residuals land application event.
16. 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.) shall not be harvested for 14
months after any residuals land application event.
17. Food crops with harvested parts below the surface of the land (i.e., root crops such as potatoes,
carrots, radishes, etc.) shall not be harvested for 20 months after any residuals land application
event when the residuals remain on the land surface for four months or longer prior to
incorporation into the soil.
18. Food crops with harvested parts below the surface of the land shall not be harvested for 38
months after any residuals land application event when the residuals remain on the land
surface for less than four months prior to incorporation into the soil.
19. Turf shall not be harvested for one year after any residuals land application event.
20. Adequate provisions shall be taken to prevent wind erosion and surface runoff from conveying
residuals from the land application sites onto adjacent properties or into any surface waters.
21. Adequate procedures shall be provided to prevent surface runoff from carrying any land
applied or stored residuals into any surface waters.
22. Surface -applied residuals shall be plowed or disced within 24 hours after land application on
land application sites with no cover crop established.
23. For land application sites that are prone to flooding or within the 100-year flood elevation,
residuals shall be land applied only during periods of dry weather. The residuals shall be
incorporated into the soil within 24 hours after land application.
24. Residuals shall not be land applied during inclement weather or until 24 hours following a
rainfall event of 0.5-inch or greater in 24 hours. Any emergency residuals land application
measures shall first be approved in writing by the Division.
25. Residuals shall not be land applied to any land application site that is flooded, frozen, or
snow-covered.
26. Appropriate measures shall be taken to control public access to the land application sites
during active site use and for the 12-month period following the last residuals land application
event. Such controls may include the posting of signs indicating the activities being
conducted at each site.
6

III. MONITORING AND REPORTING REQUIREMENTS
Any monitoring (i.e., including groundwater, surface water, residuals, soil, or plant tissue
analyses) deemed necessary by the Division. to ensure protection of the environment shall be
established, and an acceptable sampling and reporting schedule shall be followed.
2. Residuals generated by each residuals source -generating facility listed in the [most -recently -
certified Attachment A of this permit shall be analyzed to demonstrate that they are non-
hazardous under the Resource Conservation and Recovery Act (RCRA). A corrosivity,
ignitability, and reactivity analysis as well as a Toxicity Characteristics Leaching Procedure
(TCLP) analysis shall be conducted on residuals generated by each residuals source -
generating facility listed in the most recently -certified Attachment A of this permit. The
analyses shall be performed at the frequency specified in the most recently -certified
Attachment A of this permit, and the results shall be maintained on file by the Permittee for a
minimum of five years. If residuals generated by a particular residuals source -generating
facility are land applied at a frequency less than that which is specified in the most recently -
certified Attachment A of this permit, the analyses shall be required for each residuals land
application event. Only residuals that are generated by the residuals source -generating
facilities that are identified as being exempt from this condition in the most recently -certified
Attachment A of this permit shall not be required to comply with this monitoring requirement.
The TCLP analysis shall include the following parameters (i.e., note the regulatory level in
milligrams per liter in parentheses):
Arsenic (5.0)
1,4-Dichlorobenzene (7.5) Nitrobenzene (2.0)
Barium (100.0)
112-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)
Chlordane (0.03)
Hexachlorobenzene (0.13) Tetrachloroethylene (0.7)
Chlorobenzene (100.0)
Heptachlor (and its hydroxide) (0.008) Toxaphene (0.5)
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)
o-Cresol (200.0)
Lindane (0.4) 2,4,5-TP (Silvex) (1.0)
p-Cresol (200.0)
Mercury (0.2) Vinyl chloride (0.2)
Cresol (200.0)
Methoxychlor (10.0)
2,4-D (10.0)
Methyl ethyl ketone (200.0)
After the residuals have been monitored as specified above for two years at the frequency
specified in the most recently -certified Attachment A of this permit, the Permittee may submit
a request to the Division for a permit modification to request a reduction of this monitoring
requirement. In no case, however, shall the frequency of monitoring be less than once per
permit cycle.
7

3. An analysis shall be conducted on residuals generated by each residuals source -generating
facility listed in the most recently -certified Attachment A of this permit. The analysis shall be
performed at the frequency specified in the most recently -certified Attachment A of this
permit, and the results shall be maintained on file by the Permittee for a minimum of five
_years. If residuals generated by a particular residuals source -generating facility are land
applied at a frequency less than that which is specified in the most recently -certified
Attachment A of this permit, an analysis shall be required for each residuals land application
event. The analysis shall include, but shall not necessarily be limited to, the following
parameters:
Aluminum
Ammonia -Nitrogen
Arsenic
Cadmium
Calcium
Copper
Lead
Magnesium
Mercury
Molybdenum
Nickel
Nitrate -Nitrite Nitrogen
Percent Total Solids
pH
Phosphorus
Potassium
Selenium
Sodium
Total Kjeldahl Nitrogen
Zinc
Plant Available Nitrogen
(by calculation)
After the residuals generated by a particular residuals source -generating facility have been
monitored for two years at the frequency specified in the most recently -certified Attachment A
of this permit, the Permittee may submit a request to the Division for a permit modification to
reduce the frequency of this monitoring requirement. In no case, however, shall the frequency
of this monitoring be less than once per year when a residuals land application event of
residuals generated by the residuals source -generating facility occurs during that year.
4. Residuals generated by each residuals source -generating facility listed in the most recently -
certified Attachment A of this permit shall be monitored for compliance with Condition I. 7.
The monitoring shall be performed at the frequency specified in the most recently -certified
Attachment A of this permit, and data to verify pathogen and vector attraction reduction of the
residuals shall be maintained on file by the Permittee for a minimum of five years. The
required data shall be specific to the stabilization process utilized, but also shall be sufficient
to demonstrate clear compliance with the Class A pathogen reduction requirements in 40 CFR
Part 503.32(a) or the Class B pathogen reduction requirements and site restrictions in 40 CFR
Part 503.32(b) as well as one of vector attraction reduction requirements in 40 CFR Part
503.33. Note that the specific oxygen uptake rate (SOUR) test shall not be used to show
compliance with the vector attraction reduction requirement in 40 CFR Part 503.33 if the
residuals have a total solids concentration of two percent or greater. In addition, the
Environmental Protection Agency (EPA) certification statements concerning compliance with
pathogen reduction requirements, vector attraction reduction requirements, and management
practices shall be completed quarterly by the proper authority or authorities, if more than one
is involved (i.e., either the person who prepares the residuals, the person who derives the
material, or the person who applies the residuals). Only residuals that are generated by the
residuals source -generating facilities that are identified as being exempt from Condition I. 7.
in the most recently -certified Attachment A of this permit shall not be required to comply with
this monitoring requirement.

5. Laboratory analyses as required by Condition III. 2., Condition III. 3., and Condition 1fI. 4.
shall be performed/gathered on the residuals as they are to be land applied. Furthermore,
analytical determinations made pursuant to the monitoring and reporting. requirements of this
permit shall be made by a laboratory certified by the Division for the required parameter(s)
under 15A NCAC 2H .0800 or 15A NCAC 2H .1100.
6. Proper records shall be maintained by the Permittee tracking all residuals land application
events. These records shall include, but are not necessarily limited to, the following
information:
a. Source of residuals;
b. Date of land application;
c. Location of land application (i.e., site, field, or zone number);
d. Method of land application;
e. Weather conditions (i.e., sunny, cloudy, raining, etc.);
f. Soil conditions (i.e., dry, wet, frozen, etc.);
g. Type of crop or crops to be grown on field;
h. Volume of residuals land applied in gallons per acre, dry tons per acre, or kilograms per
hectare;
i. Volume of animal waste or other nutrient source applied in gallons per acre, dry ton per
acre, or kilograms per hectare (if applicable);
j. Volume of soil amendments (i.e., lime, gypsum, etc.) applied in gallons per acre, dry ton
per acre, or kilograms per hectare (if applicable); and
k. Annual and cumulative totals of dry tons per acre of residuals as well as animal waste and
other source of nutrients residuals (i.e., if applicable), annual and cumulative pounds per
acre of each heavy metal (i.e., shall include, but shall not be limited to, arsenic, 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.
7. A representative annual soils analysis (i.e., Standard Soil Fertility Analysis) shall be
conducted on each land application site on which a residuals land application event in the
respective calendar year has occurred or is to occur, and the results shall be maintained on file
by the Permittee for a minimum of five years. The Standard Soil Fertility Analysis shall
include, but is not necessarily limited to, the following parameters:
Acidity Exchangeable Sodium Percentage (by calculation)
Calcium Magnesium Phosphorus
Cation Exchange Capacity Manganese Potassium
Copper Percent Humic Matter Sodium
Base Saturation (by calculation) pH Zinc
9

Three copies of all required monitoring and reporting requirements as specified in Condition
III. 1., Condition III. 2., Condition III. 3., Condition III. 4., Condition 111. 5., Condition III. 6.,
and Condition III. 7. shall be submitted annually on or before March 1st of the year following
the residuals land application event to the following address:
NCDENR-DWQ
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
9. Noncompliance Notification:
The Permittee shall report by telephone to the Aquifer Protection Section of the Division's
Mooresville Regional Office at telephone number [phone], 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:
a. Any occurrence with the residuals land application program that results in the land
application of significant amounts of residuals that are abnormal in quantity or
characteristic.
b. Any failure of the residuals land application program resulting in a release of material to
receiving waters.
c. Any time that self -monitoring information indicates that the residuals land application
program has gone out of compliance with the conditions and limitations of this permit or
the parameters on which the program system was designed.
d. Any process unit failure, due to known or unknown reasons, that render the residuals land
application program incapable of adequate residuals treatment.
e. Any spillage or discharge from a vehicle or piping system transporting residuals to the
application site.
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.
IV. GROUNDWATER REQUIREMENTS
Land Application Site Requirements:
a. Each land application site identified with a GW-A in the most recently -certified
Attachment B of this permit is dominated by soils with a mean seasonal high water table
greater than three feet below the land surface. Residuals land application events may
occur on these sites throughout the year.
10

b. Each land application site identified with a GW-B in the most recently -certified
Attachment B of this permit is dominated by soils with a mean seasonal high water table
between one and three feet below the land surface. Residual land application events on
these sites shall be prohibited from December through March, inclusive. No residuals
shall be land applied to these sites when the vertical separation between the depth of
residuals land application and the water- table is less than tluee feet. The actual water
table depth for seasonally -restricted soils shall be verified by soil borings within 24 hours
prior to any residuals land application event that occurs from April through November,
inclusive. The number of borings advanced shall be sufficient to characterize water table
conditions across the land application site adequately. Any open borings shall be properly
filled with native soil, prior to the residuals land application event, to decrease the chance
of any residuals contaminating the groundwater.
2. Applicable Boundary Requirements:
a. The COMPLIANCE BOUNDARY for residuals land application programs is specified by
regulations in 15A NCAC 2L (i.e., "Groundwater Classifications and Standards"). The
Compliance Boundary for each land application site is established at either 250 feet from
the residuals land application area or 50 feet within the property boundary, whichever is
closest to the residuals land application area. An exceedance of Groundwater Quality
Standards at or beyond the Compliance Boundary is subject to immediate remediation
action according to 15A NCAC 2L .0106 (d)(2).
b. The REVIEW BOUNDARY shall be established around each land application site
midway between the Compliance Boundary and the perimeter' of the residuals land
application area. Any exceedance of Groundwater Quality Standards at the Review
Boundary shall require action in accordance with 15A NCAC 2L .0106 (d)(2).
3. Additional Requirements:
a. Any groundwater quality monitoring, as deemed necessary by the Division, shall be
provided.
V. INSPECTIONS
Prior to each residuals land application event, the Permittee or his designee shall inspect the
residuals storage, transport, and application facilities to prevent malfunctions and
deterioration, operator errors, and discharges that may cause or lead to the release of wastes to
the environment, a threat to human health, or a nuisance. The Permittee shall maintain an
inspection log or summary including at least the date and time of inspection, observations
made, and any maintenance, repairs, or corrective actions taken by the Permittee. This log of
inspections shall be maintained by the Perr ittee for a period of five years from the date of the
inspection and shall be made available to the Division or other permitting authority, upon
request.
11

2. Any duly authorized officer, employee, or representative of the Division may, upon
presentation of credentials, enter and inspect any property, premises, or place on or related to
the land application sites or facilities at any reasonable time for the purpose of determining
compliance with this permit; may inspect or copy any records that must be kept under the
terms and conditions of this permit; and may obtain samples of groundwater, surface water, or
leachate.
VI. GENERAL CONDITIONS
1. This permit shall become voidable unless the residuals land application events are carried out
in accordance with the conditions of this perinit, the supporting materials, and in the manner
approved by the Division.
2. This permit shall be effective only with respect to the nature and volume of residuals described
in the application and other supporting data.
3. Failure to abide by the conditions and limitations contained in this permit may subject the
Permittee to an enforcement action by the Division in accordance with North Carolina General
.Statutes § 143-215.6A through § 143-215.6C.
4. The annual administering and compliance fee shall be paid by the Permittee within 30 days
after being billed by the Division. Failure to pay the fee accordingly may cause the Division
to initiate action to revoke this permit, as specified by 15 NCAC 2H .0205 (c)(4).
5. The issuance of this permit does not preclude the Permittee from complying with any and all
statutes, rules, regulations, or ordinances that may be imposed by other government agencies
(i.e., local, state, and federal) which have jurisdiction, including, but not limited to, applicable
river buffer rules in 15A NCAC 2B .0200, soil erosion and sedimentation control requirements
in 15A NCAC Chapter 4 and under the Division's General Permit NCGO100000, and any
requirements pertaining to wetlands under 15A NCAC 2B .0200 and 15A NCAC .0500.
6. This permit may be modified, revoked, and/or reissued to incorporate any conditions,
limitations and monitoring requirements the Division deems necessary in order to protect the
environment and public health adequately.
7. The Permittee, at least six months prior to the expiration of this permit, shall request its
extension. Upon receipt of the request, the Division shall review the adequacy of the facilities
and residuals land application program described therein, and if warranted, shall extend the
permit for such period of time and under such conditions and limitations as it may deem
appropriate.
12

This permit shall not be automatically transferable. In the event that there is a desire for the
residuals land application program to change ownership or to change the name of the
Permittee, a formal permit request shall be submitted to the Division documentation from the
parties involved and other supporting materials as may be appropriate. The approval of this
request shall be considered on its merits and may or may not be approved.
Permit issued this the 251i day of January 2006.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
for Alan W. Klimek, P.E., Director
Division of Water Quality
By Authority of the Environmental Management Commission
Permit Number WQ0011431
13

ATTACHMENT A - Approved Residual Source -Generating Facilities
Permit No. WQ001143I
Town of Cleveland
Town of Cleveland Residuals Land Application Program
Owner
Facility Name
County
Permit
Issued
Is 503?
Maximum
Monitoring
Monitoring
Approved
Number
By
Dry Tons
Frequency for
Frequency for
Mineralization
Per Year
Condition III.2.
Condition III.3. and
Rate
Condition III.4.
Town of Newport
Newport WWTP
Carteret
NCO049867
DWQ
1 503
1 82.00
1 Annually
I Annually
0.30
Total
1
1 82.00
'Within 90 calendar days of this permit's issuance, the results of reactivity, ignitability and corrosovity analyses as specified in Condition III. 2. shall be submitted to and
acknowledged by the Division. Submit two copies of these analytical results to the Land Application Unit, 1636 Mail Service Center, Raleigh, NC 27699-1636'.
Permit No. WQ0008349 Page 1 of 1 Certification Date: August 26, 2005

ATTACHMENT B - Approved Land Application Sites
Permit No. WQ0011431
Town of Cleveland
Town of Cleveland Residuals Land Application Program
Site/Field ID
Landowner
Lessee/Operator
County
Latitude
Longitude
Net Acreage
Applicable
Restriction in
Condition IV. 1.
NC-RA-53-01
Tevepaugh, Mark
Rowan
35°45'54"
80042'08"
15.70
GW-A
NC-RA-54-02A
Doby, Darlene
Rowan
35°47'17"
80041'24"
11.20
GW-A
NC-RA-54-02B
Doby, Darlene
Rowan
35°47'12"
80°41'18"
13.70
GW-A
NC-RA-56-OIA
Hodge, Ira
Rowan
35°45'34"
80°42'04"
10.90
GW-A
NC-RA-56-OIB
Hodge, Ira
Rowan
35°45'44"
80°42'03"
9.90
GW-A
Total For County
Carteret
Rowan
61.40
Total
1
1 61.40
"Within 60 calendar days of this permit's issuance, an updated buffer map(s) of this land application site, prepared in accordance with current Division guidance, shall be prepared and
submitted to the Division for review. Mail two copies of the buffer map(s) to the NCDENR-DWQ, Aquifer Protection, Land Application Unit, c/o Residuals Program Coordinator,1636
Mail Service Center, Raleigh, NC 27699-1636.
Permit No. WQ0011431 Page 1 of 1 Certification Date: February 6, 2006

SYNAGIRO
VICINITY MAP
A Residuals Alanasanent Company
rOUNTY KJ � �' OWNER .<T = / `"` 116 f $�� .

SYNAGRO
APPLICATION AREA MAP
Owner _1.' . ``�i�7+��r�G
Scale: 1" _ /�
Field # , � /B
Total
Acres 2 , '
Net Acres
?Q,,
. -> STREAM
APPLICATION AREA -
- - - - -
PRIVATE ROAD
. > DRAIN
®
kiOUSE
FORESTED AREA
CDSURFACE WATER
❑ -OUTBUILDING
UNSUITABLE
FENCE
WELL
CD®STORAGE AREA
SOIL DESCRIPTION
SUITABLE FOR
INCORPORATION,
PROPERTY LINE
8-12% SLOPE

Ql SYN AGRO
APPLICATION AREA MAP
A Reriduah Aranagawnt ComPally
Owner e&-J'e 1z-
494,/
Scale: V _ D� Field # 21
Ne `ko.'2 7-5y -
Total
Acres y% 2—
Net Acres 2�f,
. >
STREAM
APPLICATION AREA -
- - - - - PRIVATE ROAD
. - >
DRAIN
®
HOUSE
FORESTED AREA
OSURFACE
WATER
❑
OUTBUILDING
UNSUITABLE
FENCE
0
WELL
STORAGE AREA
O
SOIL DESCRIPTION
SUITABLE, FOR
® INCORPORATION,
�� ��
PROPERTY LINE
8-I2% SLOPE

NN SYNAGRO-
VICINITY MAP A Residuals Management Company
COUNTY /POO)Ajy-/(Q/, OWNER Alaf -Ietl,,P
lye -

AQUIFER PROTECTION REGIONAL STAFF REPORT
Date: 11/08/05 County: Rowan
To: Aquifer Protection Central Office Permittee/Owner: Town of Cleveland
Central Office Reviewer: Michelle McKay Application No.: W00011431
I. GENERAL INFORMATION
1. This application is (check all that apply): ❑ New ❑ Renewal ® Renewal with mod.
❑ Minor Modification ❑ Major Modification
❑ Surface Irrigation ❑ Reuse ❑ Recycle ❑ High Rate Infiltration ❑ Evaporation/Infiltration Lagoon
® Land Application of Residuals ❑ Attachment B included ® 503 regulated ❑ 503 exempt
❑ Distribution of Residuals ❑ Surface Disposal
❑ Closed -loop Groundwater Remediation ❑ Other Injection Wells (including in situ remediation)
Was a site visit conducted in order to prepare this report? ❑ Yes or ❑ No.
a. Date of site visit: 10/27/2005
b. Person contacted and contact information: Scott Berg, SYNAGRO, 336/766-0328 ext.
c. Site visit conducted by: Ellen Huffman, MRO
d. Inspection Report Attached: ❑ Yes or ® No.
2. Is the following information entered into the BIMS record for this application correct?
® Yes or ❑ No. If no, please complete the following or indicate that it is correct on the current application.
For Treatment Facilities:
a. Location: Third creek church Road
b. Driving Directions: go to BIMS and click the map button.
c. USGS Quadrangle Map name and number:
d. Latitude: 35.44.40 Longitude: 80.40.58
e. Regulated Activities / Type of Wastes (e.g., subdivision, food processing, municipal wastewater):
For Disposal and Injection Sites: All field information has been entered into BIMS
a. Location(s):
b. Driving Directions:
c. USGS Quadrangle Map name and number:
d. Latitude: Longitude:
FORM: WQ0011431C1eveland110805 1

AQUIFER PROTECTION REGIONAL STAFF REPORT
III. RENEWAL AND MODIFICATIONAPPLICATION
Description Of Waste(S) And Facilities
1. Are there appropriately certified ORCs for the facilities? ❑ Yes or ❑ No.
Operator in Charge: Bobby Jones Certificate #: 21056
Backup- Operator in Charge: Frankie Singleton Certificate #: 13595
2. Is the design, maintenance and operation (e.g. adequate aeration, sludge wasting, sludge storage, effluent
storage, etc) of the treatment facilities adequate for the type of waste and disposal system? ® Yes or ❑ No.
3. Are the site conditions (soils, topography, depth to water table, etc) maintained appropriately and adequately
assimilating the waste? ® Yes or ❑ No. If no, please explain:
4. Has the site(s) changed in any way that may affect permit (drainage added, new wells inside the compliance
boundary, new development, etc.)? ® Yes or ❑ No. If yes, please explain:
5. Is the residuals management plan for the facility adequate and/or acceptable to the Division?
® Yes or ❑ No. If no, please explain:
6. Are the existing application rates (hydraulic or nutrient) still acceptable? ® Yes or ❑ No.
7. Is the existing groundwater monitoring program (number of wells, frequency of monitoring, monitoring
parameters, etc.) adequate? ❑ Yes ❑ No ® N/A.
8. Will seasonal or other restrictions be required for added sites? ❑ Yes ® No ❑ N/A
9. Are there any buffer conflicts (treatment facilities or disposal sites)? ❑ Yes or ® No.
10. Is the description of the facilities, type and/or volume of waste(s) as written in the existing permit correct?
® Yes or ❑ No. If no, please explain:
11. Were monitoring wells properly constructed and located? ❑ Yes or ❑ No ® N/A
12. Has a review of all self -monitoring data been conducted (GW, NDMR, and NDAR as applicable)? ❑ Yes or
® No ❑ N/A. Please summarize any findings resulting from this review:
13. Check all that apply: ® No compliance issues; ❑ Notice(s) of violation within the last permit cycle; ❑
Current enforcement action(s) ❑ Currently under SOC; ❑ . Currently under JOC; ❑ Currently under
moratorium. If any items checked, please explain and attach any documents that may help clarify
answer/comments (such as NOV, NOD etc):
14. Have all compliance dates/conditions in the existing permit, (SOC, JOC, etc.) been complied with? ❑ Yes
❑ No ❑ Not Determined ® N/A.. If no, please explain:
15. Are there any issues related to compliance/enforcement that should be resolved before issuing this permit? ❑
Yes or ® No ❑ N/A. If yes, please explain:
FORM: WQ00114310eveland110805 2

AQUIFER PROTECTION REGIONAL STAFF REPORT
V. EVALUATIONAND RECOMMENDATIONS
1. Provide any additional narrative regarding your review of the application.: All field data regarding this
application has been entered into BIMS by the MRO.
2. Do you foresee any problems with issuance/renewal of this permit? ❑ Yes ® No
3. List any items that you would like APS Central Office to obtain through an additional information request.
Make sure that you provide a reason for each item: None
4. List specific Permit conditions that you recommend to be removed from the permit when issued. Make sure
that you provide a reason for each condition: None
5. List specific special conditions or compliance schedules that you recommend to be included in the permit when
issued. Make sure that you provide a reason for each special condition: None
6. Recommendation: ® Issue ❑ Hold, pending receipt and review of additional information by regional office;
❑ Hold, pending review of draft permit by regional office; ❑ Issue upon receipt of needed additional
information; ❑ Issue; ❑ Deny. If deny, please state reasons:
7. Signature of report preparer(s):
Signature of APS regional super
Date:
ADDITIONAL REGIONAL STAFF REVIEW ITEMS
None
FORM: WQ0011431C1eveland110805 3

ATTACHMENT B - Approved Land Application Sites
Permit Number: WQ0011431 Version:A
Town of Cleveland
Cleveland Town -A Sludge/Lars
GW
Field/Zone Id Owner Lessee County Latitude Longitude Restrictions Net Acreage
NC-RA-53-01 Tevepaugh, Mark Rowan 35045'54" 80042108" GWA 15.70
NC-RA-54-02A Doby, Darlene
Rowan 35047'17" 80041'24" . GWA 11.20
NC-RA-54-02B
Doby, Darlene
Rowan
35047'12" 80041'18" GWA
13.70
NC-RA-56-OIA
Hodge, Ira
Rowan
35045'34" . 80042'04" GWA
10.90
NC-RA-56-01B
Hodge, Ira
Rowan
35045'44" 80042'03" GWA
9.90
_Total For County
Rowan
61.40
Total
61.40

WATER POLLUTION CONTROL SYSTEM OPERATOR DESIGNATION FORM (WP.CSOCC)
NCACI5A-8G ..0201
Press TAB to enter information
Permittee'Owner/Officer Name: Town of'Cleveland
Mailing Address: PO Box 429 Phone: [phone]
City: Cleveland State NC zip: 27013
Email Address: elev .Ilan dclerk@clevelak c. rg -
Signature: Date:
Facility Name: Town of Cleveland WWTP Permit # IV C ®O 2 9&!7
County: Rowan
YOU MUST SUBMIT A SEPARATE FORM FOR EACH TYPE AND CLASSIFICATION OF SYSTEM:
Facility Type:.
1NVV
0
Facility Grade:
111
El
Print Full Name: Paul Land � > . S hCi-i !:� Aa SJ'e,
Work'Phone: [phone]
Certificate. Type: WW - A 0 Certificate Grader 11
El Certificate #: (0 ~
Email Address: Aland@cle\tel c.Org
Signature:
Effective Date: c01.
1 certify that 1 agree to my designation as the Operator, in Responsible Charge for
the facility noted. I understand and will.abide by the
rules and regulations pertaining to the responsibilities of the ORC as set forth in 15A
NCAC 08G .0204 and failing to do so can result in
Disciplinary. Actions by the Water Pollution Control System Operators Certification Commission."
BACKUP ORC
Print Full Name: Timothy J. Taylor
Work Phone:[phone]
Certificate Type: WW Q Certificate Grade: I
Certificate #;1004M
Email Address: [e-mail]
Signature:
Effective Date:—
"7 certify that agree to mydesignation as a Sack -up Operator in Responsible Charge for the.facility noted. 1 understand and will abide by
the rules and regulationspertaining to the responsibilities of the ORC as set forth in
15A NCAG 08G.0204 and failing to do so can result in
Disciplinary Actions by the Water Pollution Control System Operators Certification Commission."
Mail, fax or email WPC SOCC,1618 Mail Service Center, Fax: [phone] Email: certadmin@ncdenrgov.
ORIGINACto: Raleigh, NC276991618,
Mail or Fax Asheville Fayetteville
Mooresville Raleigh
a COPY to: 2090 US Hwy 70 225 Green St., Suite 714
610 E. Center Ave,, Suite 301 3800 Barrett t Dr.
Swannanoa, NC 28778 Fayetteville, NC 28301-5043
Mooresville, NC 28115 Raleigh, NC 27669
Fax:[phone] Fax:910-Q6-0707
Fax:[phone] Fax:[phone]
Phone:[phone] Phone:910-433=3300
Phone-704-663-1699 Phone:[phone]
Washington Wilmington
Winston-Salem -
943 Washington Sq. Mail 127 Cardinal Dr.
'45 W. Hanes M6II Rd.
Washington, NC 27889 Wilmington, NC`28405-2845
Winston-Salem, NC 27105
Fax:[phone] Fax:[phone]
Fax:[phone]
Phone: [phone] Phone:[phone] `
Phone:3M-776-9800 Revised 412016

OPERATOR. IN RESPONSIBLE CHARGE (ORC)
Print Full Name: Timothy J TaylorWork Phone: [phone]
Certificate Type: CS . Certificate Grade: I Certificate #
_ ioo.53
Email Address'' [e-mail]
Signature: /" _ Effective Date:
"I certify that 1 agree to my desi otion as the Operator in Responsible. Charge for the facility noted. ]understand and will abide by the
rules and regulations pertaining to the responsibilitiesofthe ORC as set forth in 15A NCAC 08G .0204 and failing to do so can. result in
Disciplinary Actions by the Water Pollution Control System Operators Certification Commission."
�e4CIC�Is OI$C .
Print Full Name: Work Phone:
Certificate. Type: Select Certificate Grade- Select Certificate #:
Email Address:
Signature: Effective Date;
"I certify that / agree to my designation as a Back-up Operator in Responsible. Charge for the facility noted. I understand and will obide by
the rules and regulations pertaining to the responsibilities of the ORC as set forth in 15A NCAC 08G .0204. and failing -to do so can result in
Disciplinary Actions by the Water Pollution Control System Operators Certification Commission."
Mail, fax or email' WPCSOCC, 1618 Mail Service Center, Fax: [phone] Email: [e-mail]
ORIGINAL to: Raleigh, NC 27699=1618
Mail or Fax . Asheville Fayetteville Mooresville Raleigh
a COPY to: 2090,US Hwy79 225 Green St., Suite 714 610 E. Center Ave., Suite 301 3800 Barrett Dr.
Swannanoa, NC 28778 . Fayetteville, NC 28301=5043 Mooresville, NC 28115 Raleigh, NC 27609
Fax:[phone] Fax:[phone]. Fax:[phone] Fax:[phone]
Phone:[phone] Phone:[phone] Phone: [phone] Phone:[phone]
Washington Wilmington Winston-Salem` .
943 Washington Sq. Mall 127 Cardinal pr. 45 W. Hanes Mall Rd:
Washington, NC 27889 Wilmington, NC 284OS-2845 Winston-Salem, NC 27105
Fax:[phone] Fax:[phone] Fax: [phone]
Phone; 252-946-6481 Phone: [phone] Phone::[phone] Revisedarzms

Water Pollution Control System Operator Designation Form
W PCSOCC
NCAC1.5A 8C .0201
Permitte€ Owner/Officer Names n n Qfii / 0- �Q
— t
]Mailing Address: Pc,� 6 OX l a
City; .1/ Ct.z'ld State: N -Zip: A —100 - Phone #: ` (}` 7 74 7 7,
Email address: �; I P Y P_ I �'ts�r'� C_�P C r'!..((� C' t�_if 2 (� nA rI (° I rt } i_ q
r J
Signature: Date:
................................. a ......,..................................................o.................................
Facility Name: o W n 6e _ 2 I G �' (.tl i' i'errrtig #: o iJ l
County: 0 wa 1-)
.......... .. ..
SUBlM�ITA SEPARATE. ......
FORM FOR EACH TYPE SYSTEIO�I�...e.
Facility Type/Grade (CHECK ONLY ®NE): ----
Biological Collection PhysicaKhemieal Surface Irrigation Land Application -
Operator in Responsible Charge (ORC) l
Print Full Name: IZZ 1&4 V 6a -IP.,l Email:
Certificate Type / Gracie f Number: L- q?5CI Work Phone #: y' — % L �U� 6
Signature: Date: 6)G ZC/�v
"I certify that I agree to my designation as the Operator in Responsible Charge for the facility noted. I understand and will abide by the rules
and regulations pertaining to the responsibilities of the ORC asset forth in 15A NCAC 08G .0204-and failing to do so can result in Disciplinary
Actions by the Water Pollution Control System Operators Certification' Commission."
Back -Up Operator in Responsible Charge (BU ORC)
Print Full Name:
j�
Certificate Type / Grade /Number: f� �'� Work Phone #: nj
�-.
Signature:/ ---- ,. Data:
"I certify that I agree to my designation. as a Sack -up Operator in Responsible Chargefor the facility noted. I'understand and wit] abide by the
rules and regulations pertaining to the responsibilities of the B J ORC as set forth in 15A NCAC 08G .0205 and failing to. do so can result in
Disciplinary Actions by the Water Pollution Control System Operators Certification Commission."
...... ...........
fail; fax or.ernail the - WPCSOCC, 1618 Mail Service Center; .Raleigh, NC 27699-1618 1Fax: [phone]
2ri2ltW to: Email: certadmin(a7nedenr.aov
Mail or fax a cony to the .Asheville Fayetteville Mooresville Raleigh
appropriate Regional Offace: 2090 US Hwy 70' 225 Green St 610 H Center Ave 3800 Barrett Dr
Swannanoa 28778 Suite 714 Suite 301 Raleigh 27609
Fax: [phone] Fayetteville 28301-5043 Mooresville 28115 Fax: [phone]
Phone:[phone] Fax.[phone] Fax:[phone] Phone:[phone]
Phone. [phone] Phone- 704.663.1699
Washington
Wilmington
943. Washington Sq Mall
127 Cardinal Dr
Washington 27889
Wilmington 28405-2945
Fax:[phone]
F'ax:.91.0350.2004
Phone:[phone]
Phone:[phone]
Winston-Salem
450 W. Hanes Mall Rd
Winston-Salem 21105
Fax: [phone]
Phone: [phone]
Revised 05-2015

RE CEIVEDINCDENRIDWR
it
WQROS
MC)ORESVILLE REGIONAL OFFICE
1 6 � J
a 1 ads
"�',r
q,oOC7
mph,

Water Resources
ENVIRONMENTAL QUALITY
March 08, 2018
Mr. Danny Gabriel, Mayor
Town of Cleveland
P.O. Box 429
Cleveland, North Carolina 27013
f' jOYlICOOPER
Governor
MICHAEL S. REGAN
Secrelaq
LINDA CULPEPPER
Interim Director
Subject: Acknowledgement of Receipt of the 2017 Annual Report
Town of Cleveland - Permit No.: WQ0011431
Land Application of Residuals
Rowan County
Dear Mr. Gabriel:
The Mooresville Regional Office (MRO) received and reviewed the 2017 Annual Report for the
above permit. The data submitted appears to be correct.
The report presents the Sodium Absorption Ratio (SAR) value, but it did not present the
populated formula for SAR. Please provide this information by email. The MRO this requesting
the populated SAR formula be presented in future reports.
Should you have any concerns or questions, please contact me at edward.watson(a)ncdenr.gov
or [phone].
Sincerely,
dd Watson, H e
olo 9 ist
Mooresville Regional Office
Water Quality Regional Operations Section
Division of Water Resources, NCDEQ
CC: Dena Myers, Contract ORC, Statesville Analytical (Email)
State of North Carolina I Environmental Quality I Water Resources I Water Quality Regional Operations
Mooresville Regional Office) 610 East Center Avenue, Suite 3011 Mooresville, North Carolina 28115
704 663 1699

Water Resources
ENVIRONMENTAL QUALITY
April 27, 2017
TI4E HONORABLE DANNY GABRIEL —MAYOR
TOWN OF CLEVELAND
POST OFFICE BOX 429
CLEVELAND, NORTH CAROLINA27013_
Dear Mayor Gabriel:
ROY COOPER
Governor
MICHAEL S. REGAN
Secretary .
S. JAY ZIMMERMAN
Director
Subject: Attachment B Certification
Permit No. WQ0011431
Town of Cleveland RLAP
Rowan County
In accordance with your permit modification request received March 14, 2017, we are forwarding
herewith a..modified Attachment B, certified April 27, 2017 to the Town of Cleveland for the subject
residuals program.
This certification is being issued to modify Attachment B by: a net decrease of 12.1 acres with
removal of two fields (NC-RA-54-02A and NC-RA-54-02B) totaling 22.1 acres; and addition of one 10-
acre field located in Rowan County (Site 01/01).
This modified Attachment B shall be effective from the date of certification until December 31,
2019 (i:e. expiration date of the current permit), shall void Attachment B of Permit No. WQ0011431 issued
October 24, 2014i and shall be subject to the conditions and limitations.as specified therein, as well as those
specified in the above -referenced permit. Please replace the Attachment B of Permit No. WQ0011431 that
was -issued on October 24, 2014 with this modified Attachment B.
Please note that only the maps for any new residuals -generating sources and/or: land application
sites are attached to this letter. It is the Permittee's responsibility to ensure that a complete permit is
created by inserting these documents into the previously issued permit.
If any parts, requirements, and/or limitations contained in this certification or modified Attachment
B are unacceptable, you have the right to request an adjudicatory hearing upon written request within 30
days following receipt of the certification. 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 ofAdministrative Hearings
at 6714 Mail Service Center, Raleigh, North Carolina 27699-6714. Unless such. demands are made, this
permit shall be final and binding.
<5� Norhfng Compares"
State of North Carolina I Environmental Quality I Water Resources I Water Quality Permitting I Non -Discharge Permitting
1617 Mail Service Center I Raleigh, North Carolina 27699-1617
919-807-6332

The Honorable Danny Gabriel
April 27, 2017
Page 2 of 2
If you need any additional information concerning this matter, please contact Troy Doby at (919)
807-6336 or troy doby@iicdenr. og_v.
Sincerely,
012
?--S. Jay Zimmerman, P.G., Director
Division of Water Resources
cc: Rowan County Health Department (Electronic Copy)
Mooresville Regional Office, Water Quality Regional Operations Section (Electronic Copy)
Rob Wilcox, LSS — Martin & Mabe Soil Solutions (Electronic Copy)
Martin Mabe — Martin & Mabe Soil Solutions (Electronic Copy)
Digital Permit Archive (Electronic Copy)
Central Files

ATTACEMENT B - Approved Land Application Sites
Town of Cleveland
Certification Date: April 27, 2017
Permit Number: WQ0011431 Version: 3.1
Meld
Owner
Lessee
County
Latitude
Longitude
Net
Acreage
Dominant Soil Series
Footnotes
NC-RA-01-01
Byrd, Guy Richard
Rowan
35.7382780
-80.666472'
10.0
EnB - Enon
1
NC-RA-56-OIA
Hodge, Ira F.
Rowan
35.7593640
-80.701103'
8.4
LdB2 - Lloyd
2
NC-RA-56-01 B
Hodge, Ira F.
Rowan
35.7620830
=-80.7040808013.8
LdB2 - Lloyd
2
Total
32.2
1. See Figure 1.
2. See Figure 2.
WQ0011431 Version 3.1 Attachment B Page 1 of 1

u
I

State of North Carolina
Division of Water Resources
Water Quality Regional Operations Section
Environmental Staff Report
Quality
To: ❑ NPDES Unit ® Non -Discharge Unit Application No.: WQ0011431
Attn: Danny Gabriel, Mayor Facility name: Town of Cleveland
From: (Edward Watson)
Mooresville Regional Office
Note: This form has been adapted from the non -discharge facility staff report to document the review of both non -
discharge and NPDES permit applications and/or renewals. Please complete all sections as thU are applicable.
I. GENERAL AND SITE VISIT INFORMATION
1. Was a site visit conducted? ® Yes or ❑ No
a. Date of site visit: 04/13/2017
b. Site visit conducted by: Edward Watson
c. Inspection report attached? ® Yes or ❑ No
d. Person contacted: Todd Robinson_ and their contact information: (704)- 872- 4697 ext.
e. Driving directions:
2. Discharge Point(s): N/A
Latitude: Longitude:
Latitude: Longitude:
3. Receiving stream or affected surface waters: N/A
Classification:
River Basin and Subbasin No.
Describe receiving stream features and pertinent downstream uses:
H. EXISTING FACILITIES: MODIFICATION AND RENEWAL APPLICATIONS
1. Are there appropriately certified Operators in Charge (ORCs) for the facility? ® Yes ❑ No ❑ N/A
ORC: Sherrill Ray Gambill Certificate 4:985951 Backup ORC: Denise Gambill Harrison Certificate 4:989912
2. Is the design, maintenance and operation of the treatment facilities adequate for the type of waste and disposal
system? ® Yes or ❑ No
If no, please explain:
Description of existing facilities: This is a modification for the additional of a 10.9-acre field to the Land
Application of Residuals Program
Explain anything observed during the site visit that needs to be addressed by the permit, or that may be important
for the permit writer to know (i.e., equipment condition, function, maintenance, a change in facility ownership,
etc.)
FORM: WQROSSR 04-14 Page 1 of 3

State of North Carolina
Department of Environmental Quality
Division of Water Resources
d Divislon of Water Resources
WATER QUALITY REGIONAL OPERATIONS SECTION
NON -DISCHARGE APPLICATION REVIEW REQUEST FORM
July 3, 2017
To: . , y. , (PMS "t Rfft Y as r
RECEIVEDINCDENRIDWR
JUL - 7 ZOV
WQROS
From: Troy Doby, Water Quality Permitting Section - Non -Discharge Permitting Unit MOORESVILLE REGIONALOFFIC15
Permit Number: WQ0011431 Permit Type: Land Application of Residual Solids (503)
Applicant: Town of Cleveland
Owner Type: Municipal
Facility Name: Town of Cleveland RLAP
Signature Authority: The Honorable Danny Gabriel
Address: Post Office Box 429, Cleveland, North Carolina 27013
Fee Category: Non -Discharge Minor
Comments/Other Information:
Project Type: Minor Modification
Owner in BIMS? Yes
Facility in BIMS? Yes
Title: Mayor
County: Rowan
Fee Amount: $0
Attached, you will find all information submitted in support of the above -referenced application for your review,
comment, and/or action. Within 45 calendar days, please take the following actions:
® Return this form completed. ® Return a completed staff report.
❑ Attach an Attachment B for Certification. ❑ Issue an Attachment B Certification.
When you receive this request form, please write your name and dates in the spaces below, make a copy of this sheet, and
return it to the appropriate Central Office Water Quality Permitting Section contact person listed above.
RO-WQROS Reviewer: Ab�nuJ Gt/,e;soN
Date: l 2 Zo 1--7
FORM: WQROSNDARR 09-15 Page 1 of 1

Water Resources
ENVIRONMENTAL QUALITY
July 6, 2017
THE HONORABLE DANNY GABRIEL — MAYOR
TOWN OF CLEVELAND
POST OFFICE BOX 429
CLEVELAND, NORTH CAROLINA 27013
Dear Mayor Gabriel:
ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
S. JAY Z13\4MERMAN
Director
Subject: Acknowledgement of
Application No. WQ0011431
Town of Cleveland RLAP
Residuals Management System
Rowan County
The Water Quality Permitting Section acknowledges receipt of your permit application and
supporting documentation received on July 3, 2017. Your application package has been assigned the
number listed above, and the primary reviewer is Troy Doby.
Central and Regional Office staff will perform a detailed review of the provided application, and
may contact you with a request for additional information. To ensure maximum efficiency in processing
permit applications, the Division of Water Resources requests your assistance in providing a timely and
complete response to any additional information requests.
Please note that processing standard review permit applications may take as long as 60 to 90 days
after receipt of a complete application. If you have any questions, please contact
Troy Doby at [phone] or [e-mail].
Sincerely,
Nathaniel D. Thornburg, Supervisor
Division of Water Resources
cc: ooresllelegoaLQfiC,Vat®rQ:ua1y `egao a_iCl eratioMection_�
Permit File WQ0011431
=—Not} ing Compares 1_
State of North Carolina I Environmental Quality I Water Resources I Water Quality Permitting I Non -Discharge Permitting
1617 Mail Service Center I Raleigh, North Carolina 27699-1617
919-807-6332

State of North Carolina
JUL _ Z017 Department of Environmental Quality
a Division of Water Resources
f�„ ischarge
Division of Water Resources 15A_N 00 1 :if? 00 —RESIDUALS LAND APPLICATION PROGRAM
INSTRUCTIO'NSr�OR ORM: RLAP 06-16 & SUPPORTING DOCUMENTATION
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 application and
supporting documentation
For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting Unit
General — This application is for treatment, storage, transport, and/or land application of Class B residuals (may include residuals that
are generated from a water treatment plant or other type facilities) on the proposed or currently approved land application site(s) under
15A NCAC 02T .1100.
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Residuals Land Application Program (FORM: RLAP 06-16) Application: (All Application Packages):
�j Submit the completed and appropriately executed Residuals Land Application Program (FORM: RLAP 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.
® The Applicant's Certification on Page 5 of this form shall be signed in accordance with 15A NCAC 02T .0106(b). An alternate
person may be designated as the signing official if a delegation letter is provided from a person who meets the criteria in 15A
NCAC 02T .0106(b).
If this project is for a modification of an existing permit, submit one copy of the existing permit.
❑ Please submit this application form at least 180 days prior to the expiration date on the existing permit, or 90 days prior to
operation of proposed facility(ies) for application packages involving new or changes to treatment and storage units.
B. Application Fee (New and Major Modification Application Packages)
❑ Submit a check, money order or electronic funds transfer made payable to: North Carolina Department of Environmental
Quality (NCDEQ).
____._...__._...___._......__.....__....... .... __.._...__.....:
Facility Classification New Permit i Major Modification'
Major (land are permitted for o 300 acres) i $1,310 j $395
Minor (land are permitted for < 300 acres) $810 j $245
_......__....._--__..__...__..._......... ............. __._....__...__._..._...----......_..._._..-_....... ..-- - _..._--- ---------- ..... --... -.....--..._.._...__.._.....-.._........... _... .................._.... f
' - A major modification shall be defined as any permit modification that: increases the generating facility's residuals dry tonnage;
adds additional land application areas not previously approved for that particular program [including transferring of field(s) from
one program to another); adds additional residuals sources; or includes the addition of new treatment or storage units/processes not
previously permitted. There is no fee for minor modifications to a permit.
C. Cover Letter (All Application Packages)
(� List all items included in the application package, as well as a brief description of the requested permitting action.
D. Environmental Assessments (May be Required — See 15A NCAC 1 C .0300)
❑ Submit a copy of the Findings of No Significant Impact (FONSI) or Environmental Impact Statement (EIS). Also, include
information on any mitigating factor(s) from the Environmental Assessment (EA) that impact the construction of the residuals
treatment and storage facilities. An EA may also be required for private systems if any public funds and/or lands are used for
the construction of the subject facilities.
INSTRUCTIONS FOR FORM: RLAP 06-16 Pagel of 3

E. Operation and Maintenance Plan (New and Renewal Application Packages)
❑ For Modification Application, if there are any changes to the existing plan, submit an updated O&M plan.
❑ Submit the O&M Plan in accordance with 15A NCAC 02T .1110 and include at a minimum:
❑ Operational functions; describe the operation of the program to show what operations are necessary for the program to
function and by whom the functions are to be conducted.
❑ Maintenance schedules; may include equipment calibration, maintenance of signs, etc.
❑ Safety measures; may include safety training program, manuals, signs, etc.
❑ Spill response plan; including control, containment, remediation, emergency contact information, etc.
❑ Inspection plan including the following information;
Names and titles of personnel responsible for conducting the inspections.
❑ 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.
❑ Detailed description of inspection procedures including record keeping and actions to be taken by the inspector in the event
that noncompliance is observed.
❑ Sampling and monitoring plan including the following information;
❑ Names and titles of personnel responsible for conducting the sampling and monitoring.
❑ Detailed description of monitoring procedures including parameters to be monitored.
❑ 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.
THE FOLLOWING ADDITIONAL ITEMS (G to M) ARE REQUIRED FOR DEDICATED PROGRAM ONLY.
F. Program Determination
❑ Dedicated residuals land application programs are ones in which land application sites meet the criteria in 15A NCAC 02T
.1102(12). Specifically, a residuals land application program is designated as dedicated if any of the following are applicable:
❑ Any land application site certified for the residuals land application program that receives residuals at rates or frequencies
greater than agronomic rates.
❑ Any land application site certified for the residuals land application program that is used primarily for residuals disposal,
and agricultural crop production is of secondary importance.
❑ Any land application site certified for the residuals land application program that receives residuals through fixed irrigation
facilities or irrigation facilities fed through a fixed supply system.
❑ Please contact the Non -Discharge Permitting Unit if you need any assistance in determining whether your residuals program
falls under the dedicated program definitions.
G. Program Information
❑ Provide an explanation of why a dedicated system is required instead of a conventional non -dedicated system.
❑ Provide an explanation of the dedicated system and its operation.
H. Detailed Site Maps (All New or Modification Application Packages)
❑ Submit three (3) sets of standard size plans and two (2) sets of I I" by 17" plans (electronic format is acceptable - Adobe PDF
only).. For Modifications, submit plans specific to the modification(s) only.
❑ Plans must include the following minimum items:
❑ A general location map, a vicinity map and a topographic map with contours not exceeding 10 feet or 25% of the total site
relief and showing all facility related structures and fences within the land application area.
❑ The location of all wells (including usage and construction details if available), streams (ephemeral, intermittent, and
perennial), springs, lakes, ponds, and other surface drainage features within 500 feet of the land application site(s).
❑ Delineation of the review and compliance boundaries
❑ Setbacks as required by 15A NCAC 02T .1108
❑ Site property boundaries within 500 feet of all waste treatment, storage, and disposal site(s).
❑ A map showing the entire irrigation area with an overlay of the suitable irrigation area depicted by the soil scientist's
evaluation. The irrigation plans shall show each nozzle/emitter and wetted area (when applicable). Clearly label spray
irrigation zones as they will be operated.
❑ Plans must depict a completed design and not be labeled with preliminary phrases (e.g., FOR REVIEW ONLY, NOT FOR
CONSTRUCTION, etc.) that indicate that they are anything other than final plans. However, the plans may be labeled with
the phrase: FINAL DESIGN - NOT RELEASED FOR CONSTRUCTION
INSTRUCTIONS FOR FORM: RLAP 06-16 Page 2 of 3

I. Project Evaluation and Receiver Site Management Plan (All New Application Packages or Modifications that include new sites)
❑ Submit a project evaluation and a receiver site management plan (if applicable) with recommendations concerning cover crops
and their ability to accept the proposed application rates.
J. Hydrogeologic Report (All New Application Packages or Modifications involving increasing the total design capacity)
❑ Submit a detailed hydrogeologic evaluation in accordance with 15A NCAC 02T .1104(d)(4) and current Division Policy
available at: http://www.ncwater.or2/Ruies Policies and Regulations/. The document shall be signed, sealed and dated by a
qualified professional.
K. Engineering Design Documents (All New or Modification Application Packages with fixed irrigation facilities or irrigation
facilities fed through fixed supply system)
❑ Submit engineering design documents that have been signed, sealed, and dated by a NC licensed Professional Engineer and/or
Professional Land Surveyor in accordance with 15A NCAC 02T .1 104(d)(2). For Modifications, submit an updated site map
specific to the modification(s) only.
❑ The design documents must include the following minimum items:
El Engineering plans for the facility and equipment except those previously permitted unless they are directly tied into the new
units or are critical to the understanding of the complete process;
❑ Specifications describing materials to be used, method of construction, and means for ensuring quality and integrity of the
finished product including leaking testing; and
❑ Engineering calculations including hydraulic and pollutant loading, sizing criteria, hydraulic profile, total dynamic head
curve analysis for each pump, and irrigation design.
❑ Soil mapping units shown on all disposal sites.
L. Water Balance (All New Application Packages or Modifications that include new sites utilizing fixed irrigation facilities or
irrigation facilities fed through fixed supply systems)
Submit a completed and accurate water balance in accordance with 15A NCAC 02T .1104(d)(5) and current Division Policy
available at: hitp://www.ncwater.or.g/Rules Policies and Regulations/.
M. Property Ownership Documentation (All New or Modification Application Packages involving new and/or relocated treatment
or irrigation components)
❑ Property ownership documentation shall consist of one of the following:
❑ Legal documentation of ownership (i.e., GIS, deed or article of incorporation), or
❑ Written notarized intent to purchase agreement signed by both parties with a plat or survey map, or
❑ An easement running with the land specifically indicating the intended use of the property and meeting the requirements of
15A NCAC 02L .0107(f), or
❑ A written notarized lease agreement signed, by both parties, indicating the intended use of the property, as well as a plat or
survey map.
ONE ORIGINAL AND TWO COPIES OF THE COMPLETED APPLICATION PACKAGE, INCLUDING ALL
SUPPORTING INFORMATION AND MATERIALS, SHALL BE SENT TO THE FOLLOWING ADDRESS:
NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF WATER RESOURCES
WATER QUALITY PERMITTING SECTION
NON -DISCHARGE PERMITTING UNIT
By U.S. Postal Service:
1617 MAIL SERVICE CENTER
RALEIGH, NORTH CAROLINA 27699-1617
TELEPHONE NUMBER: [phone]
By Courier/Special Delivery:
512 N. SALISBURY STREET
RALEIGH, NORTH CAROLINA 27604
FAX NUMBER: [phone]
INSTRUCTIONS FOR FORM: RLAP 06-16
Page 3 of 3

State of North Carolina
Department of Environmental Quality
Division of Water Resources
Division of Water Resources 15A NCAC 02T .1100 —RESIDUALS LAND APPLICATION PROGRAM
FORM: RLAP 06-16
1. APPLICANT INFORMATION:
1. Applicant's name: Town of Cleveland
Applicant type: 0 Individual [I Corporation El General Partnership El Privately -Owned Public Utility
0 Federal El State X Municipal 0 County
Signature authority's name per 15A NCAC 02T .0106: Danny Gabriel Title: Mayor
Applicant's mailing address: PO Box 429
RECEIVEDI CDEO P
City: Cleveland State: NC Zip: 27013
Telephone number: [phone] Email Address: [e-mail]
JUL a 2017
2. Consultant's name: Rob Willcox, L.S.S. License Number (for P.E.): N/A
Non -Discharge
Affiliation: 0 On Staff 5d Retained (Firm: Willcox & Mabe Soil Solutions, PLLC)
Permitting Anil
Consultant's mailing address: 1205 W. Bessemer Ave.. Suite 202
City: Greensboro State: NC Zip: 27408
Telephone number: (336 312-9128 Email Address: [e-mail]
3. Agronomist's name: Martin Mabe License Number: N/A
Affiliation: ❑ N/A [] On Staff X Retained (Firm: Willcox & Mabe Soil Solutions, PLLC)
Agronomist's mailing address: 1205 W. Bessemer Ave., Suite 202
City: Greensboro State: NC Zip: 27408
Telephone number: [phone] Email Address: [e-mail]
4. Soil Scientist's name: Rob Willcox, L.S.S. License Number: N/A
Affiliation: ❑ N/A 0 On Staff X Retained (Firm: Willcox & Mabe Soil Solutions, PLLC)
Soil Scientist's mailing address: 1205 W. Bessemer Ave., Suite 202
City: Greensboro State: NC Zip: 27408
Telephone number: [phone] Email Address: [e-mail]
5. Fee submitted: (See Instruction B)
II. PERMIT INFORMATION:
1. Application is for (check all that apply): 0 new, modified, 0 renewed permit
2. If this application is being submitted to renew or modify an existing permit, provide the following:
Permit number: W00011431
Date of most -recently issued permit: January 1, 2015
Date of most -recently certified Attachment A (if different than the permit):
Date of most -recently certified Attachment B (if different than the permit): April 27, 2017
FORM: RLAP 06-16 Page l of 5

III. RESIDUALS LAND APPLICATION PROGRAM INFORMATION:
1. Residuals Processing Facility's physical address: 625 Third Creek Church Road
City: Cleveland State: NC Zip: 27013
Coordinates: Latitude: 35044a 37.7a Longitude: 80140a 59.8a
Datum: NAD83 Level of accuracy: one tenth of a second
Method of measurement: MAP
2. County where residuals land application program is headquartered: Rowan
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
Sherrill Ray Gambill
Bio-Green Services, Inc.
985951
Back -Up ORC
Denise Gambill Harrison
Bio-Green Services, Inc.
989912
Additional Back -Up
ORCs
if applicable)
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 Nitrogen Summary: 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: 82.0 dry tons per year.
PAN
Pounds of PAN per Dry Ton
(Weighted Average)
Pounds of PAN per Year
Surface
Incorporation
or Injection
Surface
Incorporation
or Injection
First -Year
24.73
24.92
2,028
2,043
Five -Year Maximum Adjusted
37.87
38.06
3,105
3,121
b. Land Application Site Use Summary: 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
Row Crops
Hay
32.2
10 change of ownership
Pasture
Total:
32.2
Methods
Surface
32•2
Incorporation or Injection
Total:
32.2
FORM: RLAP 06-16 Page 2 of 5

c, Residuals Land Application 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
(Ibs PAN/ac yr)
Concentrations
Surface
Incorporation or
Surface
Incorporation or
Injection
Injection
50
40.6
40.9
62.1
62.4
100
20.3
20.4
31.1
31.2
150
13.5
13.6
20.7
20.8
200
10.1
10.2
15.5
15.6
6. If applicable, provide a plan and a schedule to resolve any known 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.):
7. Specify type of residuals program (See Instruction F): N Non -dedicated 0 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;
0 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.
M"v
Residuals Source
Certification N/A — NO REQUESTED CHANGES
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.
firT
1'
Land Application Siite
Certification. doc
FORM: RLAP 06-16 Page 3 of 5

Note: 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
2. 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 .0505 (p) 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:
Soil Series
Fields within Soil Area
Recommended
Loading Rate
(in/hr)
Recommended
Loading Rate
(in/ r)
6. Design loading rates are equal or less than the loading rates recommended by Soil Scientist?
❑ Yes or ❑ No If No, explain why 15A NCAC 02T .0505(n) 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
ftZ
Number of
Nozzles
Maximum Application
Rate allons/hr
Design Annual Loading
Rate allons/ r
Total
N, wa,
���.. .. §%n �t4ar, ?��� �, ��^ s ar.
Spray Irrigation Design Element
Plan Sheet
Number
Specification
Page -Number
Wetted diameter of nozzles
ft
Wetted area of nozzles
fe
Nozzle capacity
"' gpm
Nozzle manufacturer / model
/
Elevation of highest nozzle
ft
FORM: RLAP 06-16 Page 4 of 5

Applicant's Certification (signing authority must be in compliance with 15A NCAC 02T .0106):
The 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
compliance schedule, and do not have any overdue annual fees under Rule 15A NCAC 02T .0105.
Yes Fj No, Explain;
I, Danny Gabriel Mayor
(Signature Authority's Name — PLEASE PRINT) (Title)
attest that this application for Modification to the Town of Cleveland Non -Discharge Permit W00011431
(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 § 143-215.6B, any person who knowingly makes any false
statement, representation, or certification in any application shall be guilty of a Class 2 misdemeanor, which may include a fine not to
exceed $10,000 as well as civil penalties up to $25,000 per violation.
Signature: Date:
v
FORM: RLAP 06-16 Page 5 of 5

Division of Water Resources
State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
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 application and
supporting documentation
For more information, visit the Water 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 .1 100. 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 Residuals Source 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: Town of Cleveland
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
(yes/no)
Land Use or
Cropping Patterns
Intended Use of Crops
Residuals Source
(optional)
Special note
(no-till/over-seed/
pasture)
NC-RA-01-01
NO
HAYFIELD
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

I. STIPULATIONS:
l . 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, 1636
Mail Service Center, Raleigh, NC 27699-1636.
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 .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)
0 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)
D. - I _F'I

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: Town of Cleveland
Address:
City: Cleveland State: NC Zip: 27013
Phone: [phone] E-mail address: [e-mail]
Signature: a -99Z Date:
NORTH CAROLINA, ROWN COUNTY
I, the undersigned Notary Public do hereby certify that DANNY GABRIEL
personally appeared before me this day and acknowledged the due execution of the forgoing instrument.
WITNESS my hand and official seal this the 28" day of June, 2017
Signature and seal:
My commission expires: January 5, 2020
Lessee's/Operator's Certification:
C
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:
E-mail
Date:
Zip:
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Signing official
Signature:
Date: (D

�`'i4'��
J7y a�j yt'
§ f i ri Ya.,LLL, 4 r'r u
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water resources
LAND APPLICATION SITE CERTIFICATION
INSTRUCTIONS'FOR FORM: LASC 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 application and
supporting documentation
For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting, Unit
General — This certification provides detailed information of 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 certification for review
without a corresponding application form (FORM: RLAP 06-16 or FORM: SDR 06-16).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Land Application Site Certification (FORM: LASC 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.
❑ For new or renewed permits, submit the requested information for all land application sites.
For modified permits, submit the requested information for pnly those sites that are new, transferred or affected by the
proposed modification.
B. Land Application Site Information:
The status of the land application site with respect to this residuals land application program must be provided in table I. The
status categories and their corresponding codes are as follows:
® New (N) ® Renewed (R) ♦ Modified (M) ♦ Transferred (T) e Deleted (D)
[� Attach the following in accordance with each status code:
Required Item
Status Code
N
R
T
M
County Board
Notification. doc
Land Owner
✓
`�
'�
Agreement
(If applicable)
lilt,
Setback Waiver
Agreement
An updated vicinity/setback map in accordance with the "Map Guidance
for Residuals Land Application _Permits-
✓
✓
✓
A soils and agronomic evaluation in accordance with the "Soil Scientist
Evaluation I'olicv"
✓
INSTRUCTIONS FOR FORM: LASC 06-16 Page 1 of 3

An updated accounting of the land application site's cumulative
pollutant loading rates CPLRs
Status Code
Required Item
N
R
T
M
For previously permitted sites without a soil series name indicated in the
Attachment B, submit County Soil Survey Map (or equivalent) clearly
indicate the location of the land application site and in accordance with
the soil mapre uirements in the "Soil Scientist Evaluation Policy"
Acknowledgement of field transfer from Land Owner (Fields may not
be permitted to multiple Permittees over the same timeperiod)
* This item may be required for land application site with a status code "M", please contact the Division if you need assistant in
determining attachment requirements.
Crop Type should include the most likely crop types for the life of the permit (five years).
Predominant Soils Series Name must be either the name of the soil indicated in Attachment `B" of the existing permit, or
name of the soil series as provided by the licensed soil scientist.
Predominant Soil Mapping Unit or Representative Slope: Either the Soil Mapping Unit or the representative slope of each
site must be provided. The predominant soil -mapping unit must be consistent with the predominant soil series name. Please
note that the soil mapping units are variable between Counties, so care should be taken in properly identifying the correct
mapping unit. If a representative slope is provided, it must be determined accordingly:
❑ For sites previously permitted for use, but do not have an established soil mapping unit (the mapping unit provides
information on both the soil series name and the slope of the soil), the Applicant may determine the representative slope
by using the average slope provided in the County Soil Survey (or equivalent). A soil type with a slope range of 4 - 8%
would have a representative slope of 6%.
❑ New Sites to be permitted must have slopes determined as part of the soils report prepared by a licensed soil scientist.
❑ Acceptable methods for determining location coordinates (i.e., latitude and longitude) and their corresponding codes are as
follows:
• Address Matching (ADD) • Digital or Raw Photo Extraction (EXT)
• Aerial Photography with Ground Control (AER) • Geodetic Quality GPS Survey (GEO)
• Cadastral Survey (SUR) • LORAN-C Navigation Device (LOR)
• Conversion from Coordinate Plane (CP) • Navigation Quality GPS (GPS)
• Conversion from Township -Section -Range (TSR) • Remote Sensing (RS)
• Conversion from Universal Trans Merc (UTM) e Zip Code Centroid (ZIP)
• Map Interpretation by Digital or Manual Extraction (MAP)
C. Waterbody and Classifications Information: (new sites only)
❑ Use an 8.5 by 11-inch copy of the portion of a 7.5-minute USGS Topographic Map to identify the location where the
residuals program activities are planned to occur as well as the closest downslope surface waters as clearly as possible. Each
map portion must be labeled with the map name and number, the identified location, and be of clear and reproducible quality.
❑ Surface water body classifications information may be found at: http://de .nc.7g /about/divisions/water_
resources/)lan ping/class i ficati on-standards/c lass ifications
❑ Any questions concerning the waterbody and its classification, please contact the Division's regional offices.
❑ A list of the Division's regional offices, their county coverage, and their contact information may be downloaded at:
http://deci.nc.gov/contact/regional-offices
❑ General Instructions: There are 17 river basins in North Carolina. Each basin has associated waterbodies with assigned
subbasins, location descriptions, stream index numbers and established classifications.
1. Identify the project area on a 7.5 minute USGS topographical map (an 8.5 x 11-inch sheet showing the project area
should be submitted with the permit application regardless of whether a Stream classification was completed).
2. Determine the names of all the closest down slope surface waters from the project site. For unnamed tributaries, see
Table 1: Unnamed Tributaries Entering Other States or for Specific Basin Areas. Label any unnamed tributaries as
"UT to stream name" as the waterbody name.
3. Open the link http://decLnc�gov/about/divisions/water-resources/plannintr/classification-stancards/class ifications.
❑ Stream Classification Process: One of the options below may be used depending on the known initial project information.
❑ KNOWN BASIN WHERE CLOSEST DOWN SLOPE SURFACE WATER IS LOCATED
1. Select proper basin from the List all Waterbodies in Basin sorted report. Sort hydrologically as this will provide
the proper location descriptions if multiple runs.
INSTRUCTIONS FOR FORM: LASC 06-16 Page 2 of 3

2. Locate the name of the identified waterbody (from General Directions) on the list.
3. For multiple listings of the same waterbody name in the report, select and verify the location description. The term
"source" in the description means the beginning of the waterbody segment (most upstream point).
4. Record all Basins, Stream Index Numbers and Classifications applicable to the project.
❑ KNOWN COUNTY WHERE CLOSEST DOWN SLOPE SURFACE WATER IS LOCATED
1. Select the proper county from the List all Waterbodies in county, hydrologically report.
2. Locate the name of the identified waterbody (from General Directions) on the list.
3. For multiple listings of the same waterbody name in the report, select and verify the location description. The term
"source" in the description means the beginning of the waterbody segment (most upstream point).
4. Record all Basins, Stream Index Numbers and Classifications applicable to the project.
❑ UNKNOWN BASIN WHERE CLOSEST DOWN SLOPE SURFACE WATER IS LOCATED
1. Use the Clickable basin map to hydrologically sorted list report.
2. Click on the approximate project location to bring up the hydrologically sorted list.
3. Locate the name of the identified waterbody (from General Directions) on the list.
4. For multiple listings of the same waterbody name in the report, select and verify the location description. The term
"source" in the description means the beginning of the waterbody segment (most upstream point).
5. Record all Basins, Stream Index Numbers and Classifications applicable to the project.
❑ Notes on index number and unnamed streams:
Unnamed Streams 15A NCAC 02B .0301 M.
❑ Any stream which is not named in the schedule of stream classifications carries the same classification as that assigned
to the stream segment to which it is tributary (at the point of entry) except:
(A) unnamed streams specifically described in the schedule of classifications;
(B) unnamed freshwaters tributary to tidal saltwaters will be classified "C"; or
(C) after November 1, 1986, any newly created areas of tidal saltwater which are connected to Class SA waters by
approved dredging projects will be classified "SC" unless case -by -case reclassification proceedings are conducted.
❑ The following river basins have different policies for unnamed streams entering other states or for specific areas of the
basin:
Unnamed Tributaries Entering Other States or for Specific Basin Areas
Hiwassee River Basin
Streams entering Georgia or Tennessee shall be classified "C Tr."
Little Tennesse River
Basin And Savannah
River Drainage Area
Streams entering Georgia or Tennessee shall be classified "C Tr." Such streams in the Savannah
River drainage area entering South Carolina shall be classified "B Tr."
French Broad River
Basin
Streams entering Tennessee will be classified "B."
Watauga River Basin
Streams entering the State of Tennessee are classified "C."
Broad River Basin
Streams entering South Carolina are classified "C."
New River Basin
Streams entering the State of Tennessee are classified "C."
Catawba River Basin
Streams entering South Carolina are classified "C."
Yadkin -Pee Dee River
Basin
Streams entering Virginia are classified "C," and such streams entering South Carolina are
classified "C."
Lumber River Basin
Streams entering South Carolina are classified "C Sw."
Roanoke River Basin
Streams entering Virginia are classified "C." Except that all backwaters of John H. Kerr
Reservoir and the North Carolina portion of streams tributary thereto not otherwise named or
described shall carry the classification "B," and all backwaters of Lake Gaston and the North
Carolina portion of streams tributary thereto not otherwise named or described shall carry the
classification "C and B."
Chowan River Basin
Streams enteriR& Virginia are classified "C."
Tar -Pamlico River
Basin
All drainage canals not noted in the schedule are classified "C Sw." except the main drainage
canals to. Pamlico Sound and its bays which shall be classified "SC."
Pas uotank River Basin
All drainage canals not noted in the schedule are classified "C."
INSTRUCTIONS FOR FORM: LASC 06-16 Page 3 of 3

LAND APPLICATION SITE CERTIFICATION
Applicant's name: Town of Cleveland
Land application sites currently certified: 32.2 net acres and Total to be certified: 32.2 net acres.
I. LAND APPLICATION SITE INFORMATION (See Instruction E):
--rr-------- "---.. -.-• • • �• •••••� •� �............../ . is \i•avuulL.u� v L k L 14u51tlltu) v 11 kueletea)
'Soil Series Name (i.e. Appling, Cecil, etc.)
`Mapping Unit must be consistent with those used in the County Soil Survey (i.e. for a 2-8% slope Cecil in Anson County the mapping unit is CeB2)
II. WATERDODY AND CLASSIFICATIONS INFORMATION (See Instruction C):
Site/Field ID
Latitude
Longitude
g
Location
Datum
Location Method Code
Location Accuracy
Waterbody Subbasin and
Stream Index No.
Current and Proposed
P
Class
.' '
NAD 83
ADD
Nearest Second
""
NAD 83
ADD
Nearest Second
° ' :"If°
NAD 83
ADD
Nearest Second
NAD 83
ADD
Nearest Second
°
°I ItNAD
'
NAD 83
83
ADD
ADD
Nearest Second
Nearest Second
°I if°
<
NAD 83
ADD
Nearest Second
Nnto• Alo a Yo ., a,.. „
°
..r�..Y...: _ it � --�
�' I)
- --� - ..
NAD 83
ADD
Nearest Second
- ----- - ----- ----r "-•, •••••• •••••••••••••••+•• �••� ..•... ....w.vvu� uuvi ua4uvu k—,) VL LiIIJ JdLllt LIOIU Vll Lilt 51tl11t Pdb't.
FORM: LASC 06-16
Page 1

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-,
A
SWVWWfdr' 02T Wkstd, not:; Discharged;- to Syl*g Waters '�, was adopfed Aopor-Ohigi, "this.
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ry hearing'ui—ow'wMnittefeque-§Vw- hih"30A S,Uf
-qc ot-;iof
this- perrri[t, rcIlis request -shall be in the foam of W- t
North Cqgqli 9�e d e�f' ffl Hearings -at. 6 --
ina qqaf- -StAiVieg', Aft filed' - -ith-*" .Administrative V'- :14 Mat
0
shall, al,
,C -410ig 'N 2-7699-6714-Uftk§s�,,kidh. de m*'and -.,-.are..,madq;jh z &pp M-I 'fi*-
so R ,C s
LAWdin,91.-
jIfyou k,need add,tj46 on" ,ddiicOfiik-thi§ Mattel please. contact,
Eric,
Water.
(Efectrofiii,, Copy "
/h6'
0 sAA., Rxed'e'r,,Pirecior,
nNision of. V*rgqsqqrces

NORTRUAROLINA,
DEPARTMENT OF E NVIRO NMENTANWNATURALRESOURCE&
.LANIYAPP. -ICA.T.ION'.Ori'-.C,,L,-,k,SS"B-..,RE,SED,TJ,A-L-S,.PE,R-MIT".'(NON;DEDIC,AT,F-D)
=Stiitiito�6fNbfthCatoliiiaas,,
amended, andRegulations
PERMISSION; IS 1JEREBYGRANTEDTO
TOW,
of'-C,ev,,el- Wd,
P,5 -Q-0-inti-,
FOR THE
continued aperatiQn of a residuals 4nagoom program ft v lid odns4ti4of e,
land'appikation, 6f,,'CW§ B., residuals gefietdt6d I by 419 ff the ,approved' facflities�.'.,Iisied.in,�Afta6hmeift.."
- the
approved sites listed in Attachment; 1):,,WM to disc,-argp of w4*0Q, "Surf WOOS-irtf; to: the
appincation received1J:July 201-4iand-Jco ity-
with otlidt sO �Porfing..-,.data,stibs-e"q.u'ohtlY.filed and,
approved
The wo-,
T4be; -t 5-h4fl ooOt0; j-ouslvoid. I'
to the
W,QO, -u.31.,iIf :subject Mnuary`,25, 2006`6nd bd ecAb6flowing., specified --conditions: and
limitations-
11 SCHEDULES
Matto oPf.,-Thifqt P— Ath6-" 4e��" rpq- st.,fe1.n1.owa— 1
this permit on: 6ffk.iALDi-vW§i6h -f6tffis�,., U.0o n- teceipt..�ofth&,.reques�, the-Di.vision. will, review, the
adequacy of*,_ , faq and if warranted, wail renew the
04, f
time and under such conJOsandIftO ifg as it may .de
em pr6priat6, PleasenoteR`616, 1'5A MAG 02T �jies an updated. site mqpc, be. submitted w tie pp xenewal
-requ to
P-
�-.i The shall: be in full compliance'. with the regional office.,optif requirements
permittee icafibn
estaftrshed
in ConditionIll jbyFebruary
5. The perm''itt6e -shall .be. ;An.fitly compliance withthei sgnage reqi;iremenis,- established. in tondiffou
-Yet*41- 4M4 ,Page J2 df`12

PERFORMANCE
1, The subject; id—uat' and,
operatedmes
so there is ro di§dlfArg&,, to surface waters, qq any cQntraventzon of groutidwafer or surface -waier,
standards :Ii the crq4 P.,Q nuisance
conditions -Au - e ,ent the ". n "d maintenance, the PerrriitEe shelf
6 land
� Q imprqpevoperatio An main
e
applying �r.-,--z,residuals. -to,- the ss`icontact the 1��Iooresille, regional t-. eI IM supervis
or; and: *eany
immediate -correct toqertv-i..o.i
of their responsilllitY fair groundwater; or
surface .-.water .-resulting from the op' "ici i9residuals.ha'a-in-i" 'agerb. entprqgraip�
O-,—hIy generated by the �faOW66SIfsted n AOPOPeztA 04.qaccordance with fhispermit " f4'land: ,dpp:fication,-M�I
y ;the sites listeIn,, chiridit B,;tire,.at)i)roved for- residuals ;land qg - 4 ticiii
S.: Polluiantzoncenfratipas in reside, ats apIk4i6id OOtfbhti6h,.sit6s listed in,fittaclmentfshall,noti
Ceiling; C- -y- -w basis
exceed, the following e ing, oncentianon& Or' CithilihitiVei ?Outant.
--g weight
6m1lrgram per kilogrram
C-P--
Ap
Arsenic
75.
Cadmium
85?
34
Copper,
4i5 ON
1338
Lead'
840-,
267
Nf qfy.bdenUM
_75.
Nickel,
420.
'374!
Selenium,
:90'
"ZIA
7,500,
2,498,
The P&hfifttee..:sha'ff.0.- compliance ,A�f OiAs d§in 66��O-ftheT Rowing , s-,
ermine, .b ---
4., By qile0 inge�&k
cumulative
level.,of` pollutants, using-EetualI analytical.. data :ft6m: alf.
histdricat'lafid application events r uftlg, or]
b. For land, w --- application residuals app ic 16ri, -fidV6 )abt o,- f which
_IWr rest, occurred
p OM11hrO tep resentAtive soil-samplffig,
'6: Residuals- that are land Cl4s§-B-pathogpn reducti'p ,Kq 'in, 15A
appiew a me 0 t$
NCAC-
Q2,T -110 ''Exceptions `ia-this requirement;sWII0.'specifiedlh Attdchfi-ient.A, in
7. Biological residuals, j a rogidaAls generated :d6tih 41id.-treAtment.of domestic
wastewater`, or the, ;Iziologicalrtreatment,of industrial` wastewater, 8 i i1fifi6dAn,
-.1 'Attachmeni'A
that. are land applied shallmeetone of the vector
r6diktibn 41ternaiives in NCAC 0
l 1p`l() Exceptions to this t haUbe sp
ecified pecified.iia, Attachment
8. Setb'a`ck§ f6r,C-lass B ;Iand,-,.4p.pji,c'4(iqIysfte h0b R tto
WO,0011431 VersionS,;6 Sh6lNersion. .14,0324 "Nge,,2 of 12

Seiback Type
Vehicular,
I[ff- iga ti o
Setbacklb,'escri ption
Surface,
Applteatioi
Surface
Application
Incoxitiration
Habitable residence or place of_pubhc assembly;
under separate 0 hership ornot Q be=am am, ols
40-0,.
400
200
of
o r �p-aqe s,o,. public asseribIy
owned bvthe.P6rmitteej ihe• owner of'the land',.or ifie;
.0:
lessee%operator ofihe land to be n!Aiht4
of the ia'ect�site; -
,pr,,y, Hiles
'50:
pilwkifl - h Q Way
50
50i
p or pibuwaier-ppPly
suf-fd&6 W.
ID&
IGO
50;
-.Pe nial waterbodies, and w6flAnM
Sn vsatetd�eivqrsi6oss� , p
'rway,
00.
wale ditc. )
Gppundwater lo*oifia- s where the bottom.of
Subsurface groundwater
Wells with exception to inoiiitaririg yvelis
LOGI
IGO
100;,
outcropsBedrock -2-6
Top oif sldp-.Je,.o einb-40n . OW8:o twq;eot-of
IS
15
In n -yerfibal Wgfit,
.'.-
0 Hainoqu a ion S0r g'' . -68eniduts�
01
15"
a
Swimming p
100.
'06
100;
Nitrification -fields:.
zo;
4.
9'. .clearly Ladd 4ppjj�atiph areas shall, be li%k mhnkp.d on' each site
applicanon,event;
i-o... Bulk residuals "the''r-'sA p;. -ir.Qgen. Q, All not be: 4- d ba s�i An o Qurces 0 bk- "Nit" �e� app 10 in
exceedance .of' rates-. Appropriate. agronomic rA6E';*.shall 'be --calculated: uiing. expected:
n requirements based on detprmj A YW F�cp�ptatibfvq- using ft , q) - 9-1� , ". 4 any of the,
jtFoge'..
follovvmg rfiethods'--
a-- 44,for -sp specific prp% s9*1 types c-dlcuW -j�c tQ crop t, y
title mean of of the last consecutive ar-'-'t§ v-fkh'iflUd,
`five,`five,es . bfe
N. Orolifta Historical. Data -,for specific q ',p as provided by North Carolina;
C pp,#n4 §,pilly,
State UhivetAtyDe'pAffud-fit of (h ): hu61solnesu,ed vie S Ind6x A copy=shall.bekepr an,f le and reprinted
eyqr.y-five ,yqqTqJn"'acco qpp"10
d:usln&methods above, the Permittee-may use,"the RYNT,
reportbd in any, h6 follqvy' jocftments:,i
af@ 4pPT application raie&
iod the;' local Cooperative &N Crop , "�y 1W of dtth
t,arolina 'Nepartment of' Agriculture, .and Consumer Services;, the Xatural. gggpqrce.,
WQOQ1:14.3;1 V.6s 11-0,

iu
group P
wiw& tr Bill
i 13, kteragpncy, 9 4
1)66ijthW.Ch6pter-1
040tica�a"W echAd6bi nentsl9th OWda'-n-c'e. D66 'If
-fir by the X 0 nserva on
,ifl; Cert ied: N
;09011 4490
SOiyk plans
These bi, US1AA­NRCS Managetnet
XYOV.-Usda.pp
d; If tlae.lYE aril appropriate nut-rie Ii t d nt,�ap
Ok. P We' p, icationra rates 49tq 'per
RP'. 1 mitt
ZqntacfthetYivislonlodoterdoterm ne noppssarrac' 6. _y 00c
_t 'Wh"sid is 4fe; land applied "Apasture, hay ..crop: realistic,nitrogezi rate shall be,xeduced by
'
12. ifland op lWtjbifsfte­ be dW.'".,d'-ou'ble'4,cropped,,(&.g-,.,bennud�,gr -g-
p q., e over or., §JA"Ifiq summer
an reqqJyp residuals), then the,second
ive, an
(1b
application Pei ilpfe� rye;Vf..�g/a6/yr)- This prqo-'�orp4y,
ON, A i --- 50 Otin4 P­­
_pp
k_- allowed.8 1 , on:k 8 or:graz_ed."j if--"th'e:�sec.-on-'d..,,Cr-of) ls� . tio,"beii1aiited
13. Prior to land. Oka a I dsorpt"i6mra
Pennittee, shall obtain and' iMp1qqjgnt,.-recommendations : from the. WcdL
p.
Cooperative the Ppen-�: 0 Department' And, Consumer Services; Ae-Nifural'
. -
Resource-C
onservation. Seivicd,, a North -Carolina Licensed. Soil Scientist, br au -4grOp. -' A
� -
recommendations 0._t address *o',so, '4�ftimin,etc-.){. or, a,
shall
in t­ ity­an`d` d h­
for", Oita` Ung site ITY P 'Con � Itfolls"Icoridii6w to crop. growfftL The 9,r
shall ifia,-uit4ih,wr'itten,.records ,,6f,ihmrecommendatiansand details oftheir
nfati qMf , io
-The 'compliance ,bd-U' id--p- - .residual: qV­ 1'A"' ­- '. & . e-sp , accordance wfil),
Ary, orland` ica i6n,sites: A 611`b specified in.
15AWCAC:.'These sites were indi'viboyp 02L .0 1.07(b) erniiffqd,Orf--:oar after , 983
therefore, the compliance _boundary
',fs- -e'sta' 44. -4 Oj 250-Addtfro-"'lffici'res'-idu4l'�land,appfl
,ic
,afea, or 50 A -Mf if Ad,propeitY boundary;whibhever is to.lh��pqpjoq land application.,tton,.,
area: An-.exceedanreof groundwater siaqo,gi, :at or compliance oo­undAryis §0bq­
tct to
'remea4fio action apOr Ing: t-.0­115A NC_kC,02L. 01_66(d)(Z)
aWdUmasenforcement; adionsin,
-AddofdhhdeWith.,N6rth C.arblimi General- Statute 143-2I5 6A through! 143 - 7 t ; )�W ,appraved
_
Att h OA
relocation
15. In accordance with" ISANCAC 02L.0.10S the reviewboundary&jfbe established M-10way, bp uweeA
the compliance boundary and iho ro5jdoglI_ard application area
AAny exceeddf-gr6undwafer
sta
vuh aA C
OPERATION ANDTAIAINT-9NA jkEOtjRE
1. Thd`f&si al§ 'hfdfiAgi6ihe'hf program- shall be,: p d ap:4:,p ia�-- I - - ­. I __ PP rat tarries.. U6
Topql�rmainta' operated
PTIPPMshall'be effectively maintained and operated as a d is'd I i 4-p system: 'to prevent any
c6 at §1
do.flon, -w Idr� dw.dW,"stand d
2. The, Mooresville, 4piqq nuffiNT, (7_04%). d' ff, telephone ,,,an , e appmpffde: local'
govomm'Pot Qfflloial . (1, 1 h ditediot) shall j f
"0,
,county Tan;g a
y .,At.� east
7 d I's manager,
1, "
48; hours prior -to the. iftial, residu _1 d a app *"ation siteI Notification td ;
6, f the
,:supervisorregional A& be from
tn-on,.-Monday through .-Tridavi7
WQOO-t 14n, Version.3,'O- 4,_� Pagp�4 of,12

3. The.`Mooresyi'116A6gional Of c' e shall b&notified viaeriiail &16160h6ne, (704) 663.46,99, at least.24'
hours prior, to, conducting any .land _application actiz!ity Such notification shall indicate al ar
miiiiinum; -tl a anticipated' application tiiries, field,IDs; aid location of'lanciapplieatioii activ."ities..If:it
:becomes necessary. fo apply to additional`'felds due to unforeseen events, the Regional Office shall be,
notified prtor`to. eommencipg the application ta„ thosefields,,;
4., The Penn ittee;shall maintain an approved Operation and Maintenance' Plan ,(O&M'P.lan). pursuant.to°
15A NCAC `02T A.T. to -the Q&M Dian shall be approved by the D!visian prior to
iitilitiafilon of;the_ixevu plan.;"The;O&M`Plant at =minimum; shell include;
Operational functions;
b). ,Mairitenarice scliedulesr
c) Safety:me, ures
d} Spill res _On$ P.81,
e} Inspection plan including the following information
;. Names_and/br titles-ofp ersonnel,respoasible for cooduet�ng ti a �gspeetions!
E,. Frequency;%And. IQcation"of inspections„'including those to, be cbaducted by the. ORC, and',
procedures; to assure thakhe"selected loc_ ation(s) and inspect on<frequency"..are represezitat ve
offtle residuals maiagemOit program;
iii: Detailed.of`ihsp
. description ection. ;procedures including record; keeping:, and actions. to be
faker b} <tfte inspector in the: 'event that; noncompliance is ,observed: pursuant to'� "tlhe,,
nonconipliarice:'iiotificatioi xegi it"e"meats undex the riianitorii g ai d reporting secfion of the:
permit;
f) 9amphng and monitoring plan',mclti g the:_:followingm ormation;;
f-a Names..and/or iitl'es:af personnel responsible for:,conductmgAhe:sampling.andmonitoring
ii;, Detailed description of monitoring procedures including parameters to be -monitored-;
i i, Sam*mg=:frequency and°,procedures to-:assure:that`iepresentative, samples aie being;collectedA:
>jucivation..in tempera#ure, flow,, and, other operating conditions can._aff6ei the qualify o the
residuals: gathered' during a particular sampling event._The_ sampling plan_ "shall :accoupt 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; facilrttes that;
land apply. mulfiple, dines. per year t of have an annual 'samp mg frequency, iriay need to
sample during ,winter months when paihogen9 reduction is mast likely., fo. be negatively:
affected by cold temperatures).:
5 Upon the Water. Pollution Control; System Operators Cer_ti_f_ edification Commissiol 's (WFCSO:CC)T
classification: o£ t11e facility, the Perin tree shall. designate aiid; erin, 0 -a. Cpi•ttfied, operator' i i
responsible charge: (ORC) <- n one or more: certified".operators as .back up'fSRCs in accordance: with_=
15A.NCAC 08G Q20.1 The ORC ar their back-up slsall visit the; facilities accordance` with. -1
NCA C. 08G: 02044 'or as specified: m .tlie most recently approved "QBiM plait- (i e.,"_see "Co &WI -:III:"
4.,) ; and sha11 comply, with alf other" conditions of15A N'CAC 08G: 0. 04'. For'more information,;
regarding; classification, -and designation requirements,. please contact: the Division; of. Water
Resources"Technical Assistance & Certification Unit -at: (9.19) 733 0026.,
d;; When the i'eimittee;land.applies balk residuals,. a oopy`:of this permit,and" a -cop -,-of. -Q&NM Plan shall;
be:Maintained at the. land'application, sites,d0ring land application activities:
`] . When the Permtttee transports or land ::applies bulls residuals, the spill. control provisions, shal_1, be
maintained'-in"a1l.residuals tran5port�and application vehicles:.
$. Residuals ".shall notbe scored at any land application site, unloss written approval hats beent`requesie3
.arid received fromafie Division.,,
WQ001,1`431 Version 3.Q 5he1- V`",ersioz� 140324 Page 5,,.oF 12

91, Who 1 the p"er'.ml`, weland :applies
Nlk6siduabadequate nqpsgeo take
n,
-v4rzc,
0666A sufface runoff
pyt ppoy-
flee -'arid "Pplio sites'd jacent
pcgperties-q Wo quOicowaft.
lb."Mieb,the POrinifte6.land applies -'Ov
halt; be — 4� 44it!a 0 Vl�niaintaancd .on
049-,land application sites onto w c te i ui
crop 11 the 16661, j opperAtive E' qp�jo4i 0
ca pan, ou e, - c , W
'Ape, the 1),,opaxtig o-
Agri6iilfor&and-,,Gbsumer 8 ic s ffieN ddl - � - 1.0,
PFY on ag.ronomi
approvedatrcl as 'b,- -the"bivIsfou.'
1:1. Buik;-t,egidiAig)'shAlLndf,,be Ian "'A �pp*under :
following co w
the Tesjidu* are likdy to adversely 4,thr.6406 oi, endangered sp listedunder
I - — 1; - --� Y,, affect Poles
Endangered`Species
0 6 4,bf-, -EAc
applzcstzan causes�,
161d,"tallft s to assun i athe b , e . e u I lkrresidualst or the ,appl!4004 causes the: w4taven 'of
surface,water orgroundw pds�
is4themik: in a condition such 0* run0jw-
e; -With year- oo, c unless ;the'lu I 46si'duAls'are injected oriwormweg wi
1100 taeric 4, 6fl0Wifi4A.tesfduiI§ lan(Lappl pafioq event;,
f", During:4, pa ,yecip'lia6O evet(, Wthan"'O�04iiiehk Ter,
hour)orwithiO,,24 hours.fallowing a rainfall event©f`0:5 ifi6he5,or - 'greate r,lftj--a,,24--hourpei9d-
g. lfthe,sIopc4&-greaiprlhan 1,66% far rsurface applied jj4Ujd residuals,or,if tkie.slape, -A*.eafer than,
T$% forinlecteOr,MO.-OtporAtOt bulk, liq Ux.csi ua
-If the "soil pI4 IS, not'ahifained at 6, or -ea
ter,iu s stiffxcien amartrits offkeire app
lied
achiere a final :soil Q ofat des-,11ifonnationfildi -that-the:
XW' -f ��44 49t Otn 6�J` j v
spoci�ied'Crop,,, A,Y:4ppTQve -
---d
& s �fbvflie,
pfl 's.011, residuals and lime mixturei ,-u
variations.lo the;acceptable sail,11" thi5"'permit'
land does iia", iwo an'es
- 'ta vbgdtdtiVe,.-,elver-unless the M§idqaIs-pr or
injectedI within a 244-hour-ppriod fblllpwlr g, a residuals Iancl application,event..any-field ,thatf A S in
go,-i11 -,progr44sh*b0 O"(W ftA fAe6tffig thisvd v
e°coverxeqytrqMpp4
lititCseo"on--, between the $ego%4 wat
ert , dePth f4esidu1's:;
application, is - less ihwonpf
tithe OMcW: epOatidh of l?edroek,and-theAcpth ofresiduals,appjjc*fjp;q-jsje4$ than one foot;
12. 'The -fOjl9wig&py rqs#4Gtwns;', -
a = Pubfi `access to'pitbl c contact sites (e gt,,golf cottrses, parks,, b44,00140m tosihAltb
) rOO A 04
for, 165, days after, a,residuatslancf-a -IT
Public_ 4008. ton"UbJic.,wittier §itb`s§halllie: re§tri6ted-,f6r I _land
4aym ftor. residuals
Public -l'access ,,-co"pltt,- - 1 , halt W the - -,rn' finum,,---gpq,: �q feet Q.0 s posting with a,! im p square fed 1,
sing, d sips, 7
'sh6llindicateAheadivifipermit
sign'i'lom number, an manie,an
contact anforznattoa=Xuoludtag the Permittee. or sAelephovom, nuer Signs shall baipog
�p glu-4, 1, "A
`fhAfifier af-the-, - i
entrance4o', eac land ap lica. Otte in a clearly vszble;and an
apOR66tibievent,, and for ow, required "und dt��`HL.12 4ptily,,,
144 T-­h6-,f­-I -0i A."S ap an aPpAq At
land kog� On- grazing,�,,res 'Olywtoresiduatl d, 'I"
application - .- t event. � en
WOO' 1143.1. Version" Shell,Versrou,14U324r ]Paged of 12

61
'Ve. ti Ir, ikgb.,.gscn p
Pg P _1R
Resit4cied
.... ... ....
Djikati6h.
Animalsshall Allowd._fo_-gr :404gjai4 4pp! 4094 activities and
restricted period 'd for ­11_1._­­ hall; h-'-' e used.,Vmin� g-,,!,s , e fencing to.
30' days:
prevent access after each 1=4`,ap aifen. p�ic �event.
P"Qo ,&6,pg, feed crop o, e harvested
34, daysTurf
land .-where.-re-giduals h;iCve.,-46en-"'. applied shall -di tli&.1 dNb§fe4,,fdf.!:
12Indtitlig
.I-
Foort qo with t 4msfed,parts-that touchthe rr.psio0pil mixture a#4-,. go
hii f
totallyabove,.tlie 'd an, Au, TA (61ks,bdhkd Jfiel' cii b0 :s`q),aid§hs6,1c.)
14 ihWith§
"shall:vot'be' .-harvested for;
When ,th ;re land surface for four monihs-or"longer -p to
_'parts
harvested -,bbl6 I W. th, 4,
e,. an-
Zn months.
UhalLno,t,,bG
harvested .for
Whenthe -:r.esi u-ai's;..r-,,em,,-ai�n-,o,n7.th& land surface less th-an-ftoqr-months
, 9 prWfo-
food.cro smith harvested parts,below..; the, land
i - qcqKp-qraii6n- lnio-fhe -soil; P
months
surface" shall not b harvested fp r
15.
�'he,Pernoattee shall aqqpj�gfiom eachland��wner-�or lessee/operatora statementA6taR' ihg,_­ volume;
of Mid nutrient sources '(1.0, maAuf,6'tuied'f6fti other animal waste. products): that
have been , applied:1a the: site; and -,a. copy -of-the:mosf recent Nutrient ManagementTl4n. -N for,
those: operationsd"b th, AJ_:§� Department 0 Agriculture
Conservation 'Service (NRcs,)ordthor State Age,ndies. The PbJ sha11 calculateallowable
nutrient loading rates,based on the:providednforination and, use 4p pyqpriater_*Ctions.
C
For .the purpose 6f'this�-P&fnit co �o .condition; a g m ana� ffi6nt:Tldft­ Waste- Utilization: Plan,,'
or, .Certified _N gnagqmenf P!an (Q shall also be considered: a. 'Nutrieiit.
Mah4$0iridfit Plan,.,
16.,,.N&sh
all aWb�qW-id applied. unless- thesubmitted' Land Owner- Agreement -Attachment IfLO-AA)
between _qP and,.landowners;
-d I d th -W rm
and effect., These.1,agre6inents shall.be oorisiddre&exip ked,66deliftefit' ith the%pe- - it, ex0iration daf6,
-aga sh411­be renew the �p e T
renewed rotp,:op
I.V.. MONITORING AND REPORTING REQUIREMENTS
L. Any' Divisi6if td40ifdd,-JhdfiitdtJAg clu'aftig, _9tbutftAWf;plant �soil,and surface W06r analyses} ;necessary to ensure groundwat&,Andsurface. Watie'u'piotection-,shall be established,. and an
acceptable sample. reporting schedule shall fqllow,.
2. Residuals shall be anal�-zed,to demonstrate.-they:,,ird-.iioii-hdzaxd6.us under the -Resource Conservation
.es
an& kecoyey Apt Q�C, Pie (gprrosWy;jjAh440ty,:rqagiivloi, 410 4*ity.
leachinig,; (TCIk-)] shalt be: 06d the:; fr&q0efic-'y speci ihe A Ji�i
Mach A and theP*'�rniiftec:shall maintainthesel results - fora. minimum1 9 , x.
Jiye.years, Any
orom: 64 uire,,
eikdept.i­ns 11 -th oql specified. ri' AitaehriieritA.
WQ004.143:1 Version 3.6- 'Shell.Versfon-14.052-4 , Page of12

n_,o.TQ,L,P­ah4lY,9is sh-allincluide:Ae f6lr&w.iihg Varbitnbters.(the reguldtory-level in milligrams
is !n_,_parenthese0,,.
Arsenic;
1,4=Dichldfbbenzene (7,51_);
Nitrobenzene�.(,2'.,Q)
-Barium (1:0"
61;
T,��Dic oTotowio(6;5)
On 404 (j Op
,
I -1-i Nch Ot, Ohylen
Pyfidine.,
1%1
Cadinium.,(
i,4�Di' lue,ne (0:0),-
zhiiroto
`.Se.Lq*M
Carbon c fifokjdg� .
02)
Qhldrdaftt':(tf', 03)
Hdxdchl6k6beJnz&ne (0.13)-
Tetrachloroethylenpr(Qj)
, *
roen qe:(0.b
Heptachlor
'Chlorofonn.; (6.0)
ene.,
T n 5)
H0ad,hlbfbdtWane1 'Q),
(
2;4,57Tdchlbro enol.(400.0)
bn'Cf6sol.'(20.0'.Q),
Lead"(5.0)
f1,1f,10W(- ,, 4)
2j4,5"v;,TP- (Silvex) V Q),
Mercury (0.
Vinyl chfq#de
Eresol.pa.-O),
Methyl _,,ethyl -.ketone 200,0)
'.0fice. thee residuals: have % been. monitored; for -af.theliequency, �p�o I ffiAtta- ih'-,,- tA
- - — - �w yqqs ­11­ 11 1 — specified ... Omen -. -.,,
Ae'Permi4pp may, submit'apprrh fit- -1 -d'fi­fi J' to r"-educe the frdq'-v-' hq--y'.`,of this monitoring-
reqpjfdnient' In no lessAhan oncipr�per
An -analysis shall be -conducted on residuals from -0 lity'k-Ilid- frequency,,.'frequency,,.'abh �00r�q ge�era W&-fAbi
specified and the Pdhiitt6e shall .maintain the results fora>m1nimum of"fve years.
The-analysis,shall iqclu4elihetfollow ing�paramqtqr
Aluminum
MerpUry,
Potassium
MON'Y"b'd enum
Selenium
Arsehf&
Nickel
Sodium
Nitrate -N#�qgqn
Sediulql�Ad"ti' n Ratio;Cadmium,
--- (50)
Calcium
Copper
pH,
zhir,
Lead:
'Phosphorus:
Magnesium:
Plant Available Nitrogen
4, -kesido0s, shall 'be,-mO( 6d, for compi4fice with pathogen vector' attraction reduction,
re qu I be me'AtsAt.: the :frequency s p e 6 f, e d, in i Attachment A, and. at the - ti m e _. indicated in the. samgling,
and monitoring, sections. of the, , ap-proved' OW pl-Jhe, r0quIitlod data: - shall 4espc4fI i6, the
stabilization p- utilized, C 16 dem6fisftAtc boifiolidfice; with ihe.Class 8 p*pgeft
processdhd 'suiffl'i6rit.
redu66on requirements in 15A NCA�C, 02T1 106(4) and �. '-()(Z) d one vector
treduction;
rpOrpmeqt In 15A NCA0�,02T 167a�� aemetAAy"exceptions , bIn e requirements in this c I ofi8it�otf 8hWIN spec ffi6d_ifi.Atfiwhment A.
; O
W,Q'0641431 Verst'OR4.0; 12
$41j��iop..140324� :Page 8:,of

5 , An annual representaiN soils analysis (i a Standard. Soil Eertility:Aiialysis) shallbe .conduded'°one
eacji Iand application site l�stec m Attachment: B on .which a_resxduals land' application event will..
occur in the:respeciive_ealendar yea`r:: This analysis��sl all lse in accordancerwith the "Gtiidaric'e tin. Soil:
Sampling}' Igcated in the Sampling Instructions section of the NC Department of Agriculture,
Consumer Services' website,, -(l tttP llwuvw magrgo i/agn?nam ipub ,him) The: Pennzttee sl ai '
mainiain fhew.,results.and:a deseripiion of the sampling metho' dologles-:used, -deterinine.soif fertility
for a penocl of no less that five years, and- shall 6e made availhbWAo the Division upon reepiest Af-a;
minimum, the Standard Soil.Eertility Analysis sliajl,inclucle the:: following.paratUdtets:
Aci'dl
Exthan cable S aium,Peccerita` "e
Pl os llarus
Ba'se:Saturafion (by calculation)
Magnesium.
P.otassium::
�aleium
Mang opse
Sodium.
Cat ba,Bkohdige Capacity
Percent`Humic Matter,
;Zinc
Copper'
pFI1
6: 'Lot oratory.paramefer analyses shall,tie perfoimed on tlie-residuals as fhey,are land applied; at d shall.
be in accordance with thexrxionatoring regui�remenfs_m ,l 5A NCAC 929 050:
7. The Permittee shall::majhtairi iec'ords. tracking all ies dual. Ianci application events. At a:,nf-h iritImr ,.
fihese records, sh '11 include -the. following:
a.; Sizurce::of:residuals
b Date of land; application%
o:. LQcafon;;of jail application (e ,site; field, ar zone:numlier as lsfed.xi: Attaclinent B}
d. Approximate areas_appltedto (acres);..
e, :Method`:of land'iapplcatioi::
£ Weather Condit ons,nnyi
cloudyj rai iing :eic.);.
g. Piedoiiiiiant Sgl Map" pmg IFnfi (e g,,: CbB2)
h Sofl conditions (e g ,;dry;, wet; frozen, etc
i, Type oi'crop or:crops; to be,grawn on fiejd
j,: Nitrogen: Application: Rate: based on RYEs.,(if using-data.;obtained; from the North .Carolina State;
University Department of �Sbil Science Website, -the printout; page,, sliall. bg k.ept;'on file arid.
reprinted. every five years);
k Volume ;of residpals land,.applied x gallons per acre, cubic yard per acre; dry tons gex acre, or. wet;
ton per acre; _ .
1., Volume,of anumal:waste or other nutrientaource_ applied ingaIlonspdy tonpig, acxor ,:r
wet tons°per acre; ,
nil, V'olume 'Of soil amendments ,(e g„ Time,,, gypsums -etc.} applied, in,,g It ns per`aere� dty ton .per,
acre,. orwet twits-per'_aere,.and
n:i Annual`%and cumulative totals to dry :tons per acre of'residua.ls:,as well. as animal Qvaste and other,
sources. of'nutrients (e;:g, if''applicable); :annual and cumulative pounds per, acre of each heavy
rrietal (e,g , shad, include, Uut; shall not be;lunitecl: to, arsenic, cadmium; copper,. lead,. ra 'liry, ;
molybdenum; nickel,,,selenium, and°,zine),,4m.Wtkl pounds:per acre of FAN, and. annual-pounds..per°
acre ol'phosplorus applied'ta;each field,
WQ0011431 Vern on3 0'-- Shell V'ersion 1.40324, Page 9.-:of II

North Carolina Department of Environmental Quality
Land Quality Section: 610 E Center Ave Suite 301 Mooresville, NC 28115, Phone: [phone]
COUNTY: Cabarrus PROJECT: King's Way Baptist Church RIVER BASIN: YADKIN-PEE DEE
PERSON FINANCIALLY RESPONSIBLE: Russell Price, Khhing's Way Baptist Church of PROJECT # CABAR-2013-062
ADDRESS: 7550 Ruben Linker Road Conco�Cl NC: 7 Carolina, Inc. CASE #
1. PROJECT LOCATION: 7550 Ruben Linker Drive Concord NC
Pictures: Video: Digital:
2. Weather and Soil Conditions: 80'S, SUNNY, DRY
First Inspection:NO
3. Is site currently under Notice of Violation? NO
4. Is the site in compliance with S.P.C.A. and rules? YES
5. Violations:
6. Is the site in compliance with NPDES Permit NCG 010000?: YES
7. Has Sedimentation Damage occurred since last inpections?
Lake/natural watercourse on the tract: Lake/natural watercourse off the tract: Other Property:
Description:
Degree of Damage:
Stormwater Discharge Outfall with high turbidity or sedimentation loss:
8. Contact Made with (name): Title:
Inspection Report: SENT TO PERSON FINANCIALLY RESPONSIBLE Date Given/Sent: JUL 07, 2017
9. Corrective Actions Needed:
10. COMMENTS: Site appears stable.
Permanent ground cover sufficient to restrain erosion has been established. No additional self -monitoring or
self -inspections are required. Project is released and coverage under NPDES General Stormwater Permit for
Construction Activities is terminated.
Report By: Isaiah Reed
Date of Inspection: JUN 29, 2017
Others Present: LYNNE HAYS
Time Arriving on Site: 3:25 PM
Time Leaving Site: 3:50 PM
cc;
Revision Date 10/16/2015 Page 1 of 1

i
North Carolina Department of Environmental Quality
Land Quality Section: 610 E Center Ave Suite 301 Mooresville, NC 28115, Phone: [phone]
COUNTY: Cabarrus PROJECT: King's Way Baptist Church RIVER BASIN: YADKIN-PEE DEE
PERSON FINANCIALLY RESPONSIBLE: RussellltPriiNcee,,�Khhing's Way Baptist Church of PROJECT # CABAR-2013-052
ADDRESS: 7550 Ruben Linker Road Concord � 28II27 Carolina, Inc. CASE #
1. PROJECT LOCATION: 7550 Ruben Linker Drive Concord NC
Pictures: Video: Digital:
2. Weather and Soil Conditions: 80'S, SUNNY, DRY
3. Is site currently under Notice of Violation? NO
4. Is the site in compliance with S.P.C.A. and rules? YES
5. Violations:
First Inspection:NO
6. Is the site in compliance with NPDES Permit NCG 010000?: YES
7. Has Sedimentation Damage occurred since last inpections?
Lake/natural watercourse on the tract: Lake/natural watercourse off the tract: Other Property:
Description:
Degree of Damage:
Stormwater Discharge Outfall with high turbidity or sedimentation loss:
8. Contact Made with (name): Title:
Inspection Report: SENT TO PERSON FINANCIALLY RESPONSIBLE Date Given/Sent: JUL 07, 2017
9. Corrective Actions Needed:
10. COMMENTS: Site appears stable.
Permanent ground cover sufficient to restrain erosion has been established. No additional self -monitoring or
self -inspections are required. Project is released and coverage under NPDES General Stormwater Permit for
Construction Activities is terminated.
Report By: Isaiah Reed Others Present: LYNNE HAYS
Date of Inspection: JUN 29, 2017 Time Arriving on Site: 3:25 PM Time Leaving Site: 3:50 PM
cc;
Revision Date 10/16/2015 Page 1 of 1

water Rut ion,-C..ontr I System 0 'signa,66h, R W Orm,
perator A
wkosocc
INCAC-15A WAIN
Perinittibe.Owii6i/Ofjffcer'Nitme:I
ITIANIO-1,
L
Mailing Address:
ICitYlneState: I—IZiP:, Phone -2f 741'77:
Email.. addiessi
Sip-nattire:
6V Date-,
a . . . . . ......................... ........ M ........ i ... ..; . ..( ........ ............... . ..... zi..ni ........ i .... w i,.. . w i ........
Facility.Name:.
0.66,11 3
I I
ebotp ED cat)
'Print Full N
Certificate Type- /Grade Nurnber: Work. Phone #: 3 -1&-.27 !-L(3 ro-3
Signature- gg!ZZ Date:
"1 certify lbat-I agree to my designation. as the cratoT inResponsible, Charge fbi th rule the facility noted.1-understand and will abide b, y e s
and Lre94 lations pertaining to the responsibilities, 6�.tbe , ORC as -setfort'hin 15A NCAC'O`8'G-;0204'and` failing to-do so can result in Disciptifiary
Actions,by the Water Pollution Control Syst6m Operatot's'Certifie'ation,Cpmnussi
on,"
...................................................................................... .................
Back -Up Operator'in.Responsible'Chargie(BU ORC),
Print kull Name:
Certificate Typp-/:G,rade/Numbe�r:'i, brk Phone
A:
Signature:
"I certify that lagret-to my-desigridtion,as-a Back -i4p'Operator,tn.Pesporisibl!�Ch acility noted. Lunderstand and will abide by ihcdrke for the.f
rules,and regulatioiis�pertainin toJh,� responsibilities cif"thetU,
,9 ORCasset forth in-15ANi�ACO$(.�T.,0205and.,failfngtO-'dbs,o-caii,resul'tici
Disc iplihary,A4t!ofils,,bythe W,ater,Pollution QontrqL$Ystem,Operators Certification Commission."�
................................................... I .......... I ...........
Mail, fax or email lite WVC-SOCC, I'618-MAH Service Center, Raleigh,NC17699-1618 Fax: 910.tls.27-26
,.odgi inal io. cciiaa !n(ia7nedenr.ioV
Mail orfax aM to the Asheviile
Fayettevi I lie
M I ooiesvilte
'ap Hate Regional Office: 2090 US Hwy 70
,_prop
'225 Green'St
'6l`O,'9-Center Aye
8waimanoa 28118
Suite 714,
Suite,301
Fax: [phone]
Fayetteville 28501-5043
Mooresville
Phohe:828:296.4500:
Tax.,910.496.0707
Fax[phone],
'Phone:-,910:4333300
Phone: [phone]
'Washington
_W*imin 6n
Wjmi6n-Salem
943-Washington.Sqmall
127Parlinal Dr
450 W. Hanes Mall )R4,
Was - hingtbq27889
Wilmington 28405-2845
Winston-Salem 27105,
Fax; 251946.9215
,
Fax0i6350.2004
1
Fax-: 336.776.9797
2
Phone; 25.946.6481
Phoife., 910.7,06.7215
h
Pone: 3i6i7i6AOO
Raleigh
3866'Barreftbr
'Raleigh 2709
Fay". 919.571;4718
Revlsecl 05,201'5

ROWAN COUNTY LANDFILL
WOOPLEAF.NC 27054
(7104) 278-222:1
000693 Town of cieveiand
PO Box 429
Cleveland NC 27013
Scal,e 1 Wt. LB
Stored Tare Wt. 9,8 1 60 LR
LANDFILL-; 5230 CATHERINE ALLISON
DATE IiT
PATE OUT T E IN 'CIME OUT VEHICLEF
03/24/17 2�
0
OF
==L/j4/17 5 5 12:5.5
2624
ROWAN CQTMTy
1nb6und'- 'Charge ticket
UNI
DESCRIPTION
3.5.0
TON
COMMERCIAL WASTE
RATE RATE
•34.00
"l-I :Lours /':4L) to 4:00 Monday thru Friday.
8:00 to 2:00 Saturday
ALL VEHICLES MrJST BE TARPPED BEFORE ENTERING' THE LANDFILL-.
SIGNATURE
119. 110 ;;0,0 126.'00

S Sout'hern
S S0,11
B Builders, Inc
958 Hoots Road
Roaring River,, NC 28660
Ph,[phone] Fax [phone]
Invoice Date Invoice No.
Purchase
OrderNo.
For: BioSalids Haul &
Land Appli fion
Town of Cleveland
PO Box 429
Cleveland, .NC'27013
TERMS: 36 Days-
A Finanbe Charge of 1 .5% Mont Will b6 A.dd0d
To- Past, Q e, Acc I punts
Date
Gal tons
Farmer
Field No.
Unit Price
Amount
311012016
78.j000
Lee Walker
LW3
$0 , 065
'$5,07 0.00
311112016
6,500
Lee Walker
LW3
$0.,065
$422.50
726.7 Loaded
Miles
$4.001.
$2,906.80
Mobilization
$750.00
$750.00
fotal A mounuuue,j
Guc=, $9,149.30

Bj"reen Services, Inc.
383 Pqtts'Road
Advance, NC 27006,
6iog'reensvc0abl.com
R I" I' � ; r-� � ---, F--
I I Y
911) To
Cathy Payne CIVIC,
PO Box 429
Cleveland, NC 2701.3
INVOICE #,3665
,DATE 11/23/2016
DUE DATE 11/2312016
TERMS Que on receipt
D A: If E AQi-1VH'f OTY RATE AN40UN'Y
11/23/2016 TRANSFER 91,00a 0.11 10,010.00
Transfer to Concord Wastewater Treatment
.Plant
BALANCE DUE $109010.00
Blo-,green; Services, 'Inc.

Fyn gro SoUth, LLC�
435' illiarns Court Suite 100
Balt'pmore, IVID,
(44 1 3) 489-9000
Bill; To:
Cleveland, NC
Town of Cleveland
Attn: Cathy Pavne
Cleveland NC 27013'
Invoice #:
Invoice Date:
Page,
2&-104281
12/31/2015
1
Please note our'new remittance address, bc-Daw
Purchase Order No. Customer ID Sales, I D Payment Terms
173485 UEC2015 2113 NT30
Plant Quantity Description U of M Unit Price Ext. Price
CLEVELAN0,NC 1.00000 Mobilization
'CLEVELAND,NC 40;800:00000 TRANSFER LIQUID TO INCINERATOR
Ptei
iSU n'Fd1111L I U.
Synagro South, LLC
C/o SYMAGRO TEC14NOLOGIE8,114C.
7773 SOLUTION CENTER
CHICAGO IL 60677-7007
For questions regarding thi's invoice, please dall.
tysa Finnerty at 1-443-489-9086 or e,--mail at
if.'[e-mail].
E 512.60000 $512.60
Q 0.21000 $8,568.00
Subtotal: $9,1080 " '60
Misc: $0.00'
Tax: $0.00
Total: $9,080.60
-Current
0-30 Days
31-60 Days
61-90 bays
-Balance
$0.00
$0.00
t0.00
$0.00
Finance Charges will be, applied to Past Due Invoices

T
Synagro S6uth, LLC
435'Williaffs CoUrt, Suil:6 1,00
.Baltimore, -MD 21220
(443) 09-6660
Bill To:
Cleveland, NC
Town of Cleveland
Attn: Cathv Pavne
Cleveland NC 27013
Invoice#: 25-10391r9
Invoice Date: 8/31/2015
Page.
Please- note out new rerhittance address below
Purchase Order No.. Custome0l) Sales ID Payment Terms
AUGUST 2015 -21173 NT30
Plant Quantity Description U of M Unit Price Ext. Price
CLEVELAND., NC 1.00060 - Mobifizaffbn fee for August 2015 event E 512.60000 $512.60
CLEVELAND,NC 40,800-.00000 G 0.21000 $8,568.00
TRANSFER LIQUID TO INCINERATOR
Please. Remit To:
Syriagro South, LLC
c/o SYNAGRO TECHNOLOGIES, INC.
7773 SOLUTION CENTER
CHICAGO IL 60617-7007
For questions regarding this invoice, please
contact Yatavia Knox at, (44:3):-489:-9108 or e-mail
at [e-mail].
Subtotal: $9,080.60
Misc:' $0.00
Tax: $0.00.
Total: $9,0.80.60
Current
b-30 Days
31=60 Days
61-90 Days
Balance
$0.00
t0.00
$0.00
$0.06
$0.00
Finance Charges will be, applied to Past Due Invoices

Project 2 —3 .%EVELANP, NC ,.
Plant 01 CLEVELAND, NC
Feld ID Item Code
27-rt-Z=-z-=
Feld ID Item Code
NC-C"OINC-O-RORI
NC-CB-OQINGO-RORI
NC-C6-OO1NC-0-RORI
NC-CB-OOINC-O-RORI
NC-CB-00ING0-RORI,
NC-CS-OOINC-O-RORI
NCt&OOINC-0-RORI
NC-CB=00INC 0-RORI
NC CB-OOINC-O-RORI
NC-CB-OOINGO-RORI
NC-CS-60INC-0-RORI
Loads By Product :Code (BIQ
8/1/2015 Thru 8/31/2015
TFtUCK�NUM
:AMOUNT
nit'.
Pro ecETotal '
40,802 00 •�
Plant Total
DEMOBILIZATION
Date Load
Ytem Total
1.00
DEMOBILIZATION
08/31/15
MI-2926272
1.00
0
XFER
S-AEDLIQ-L-G-XFER
Date load
Item Total
40,800.00
G
XFER
S-AEDU¢L-G-XFER
08/12/15
T-722566-1
3;600.00
3,600A0
G
XFER
S-AEDLIQ-L-G-XFER
08/12/15
T 722566-2
T-722566-3
9,600.'00
G
XFER
S-AEDLIQ-L-G-XFER
08/,12/15
08/12/15
T 781228-1
3,800.00
G
XFER
S-AEDLIQ-L-G-XFER
'S-AEDLIQ-L-G--)FER
08/12/35
T-781228-2
3,800.00
G
XFER
08/12/15
T-781228-3
3,800.00
G
XFER
S-AEDLIQ-L-G-XFER
08/13/15
T-722567=1
3,600.00
G
XFER
S-AEDL'IQ-L-G-XFER
08/13/15
T-722567 2
3,600.00
G
XFER.
S-AEDLIQ-L-G-XFER
08/13/15
T-781233.1
3,800.00
G
XFER
S=AEDLIQ=L-C=XFER
03/13/15
T-781233-2
3,890.00
G
-XFER
S-AEDLIQ-L-G-XFER
OB/13/15
T-781231-3
3,800.00
G
XFER
S-AEDLIQ-L-G-XFER
Page 1:of 1
pdrrted on 91912016 2:25:36 PM