WQ0016247_Regional Office Historical File Pre 2018

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Shared by others WQPS Acknowledgement Letter WQ0016247 - PDT
ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
S. DANIEL SMITH
Director
NORTH CAROLINA
Environmental Quality
April 17, 2020
ROBERT N. ROTH — TECHNICAL SERVICES MANAGER
SYNAGRO CENTRAL, LLC
284 BOGER RD.
MOCKSVILLE,, NORTH CAROLINA 27028
Dear Mr. Roth:
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Subject.
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https:Hdocumentcloud.adobe.com/link/track/?uri=iim%-'lAaaid%3Ascds%3AUS°/o'IAbe5e... 4/20/2020

M
INITIAL IAL REVIEW
Reviewer Thornburg, Nathaniel
Is this submittal an application? (Excluding additional information.)*
r� Yes r No
Is this a complete
application? Complete App Date
c Yes C No 04/17/2020
Project Number's VV00016247
Applicant/Permittee Synagro Central, LLC
Applicant/Permittee 284 Boger Rd Mocksville, NC 27028
Address
Is the owner in BIMS?
r Yes r No
Owner Type Organization
Facility Name Synagro Western Piedmont RLAP
County Alexander
Fee Category
Major
Signature Authority
Signature Authority Title
Signature Authority Email
Document Type (if
non -application)
Email Notifications
Does this need review by the hydrogeologist?*
r Yes c. No
Regional Office Mooresville
CO Reviewer Ranveer Katyal: eadslrkatyal
Is the facility in BIMS?
r Yes r~. No
Fee Amount
395

For new and modification permit applications, a paper copy may be required. if you have any questions
about what is required, please contact the reviewer or Tessa Monday. If a paper application is required,
be advised, applications accepted for pre -review until both the paper and electronic copies have been
received. The paper copy shall include the following:
• Application Form
• All relevant attachments (calcs, soils report, specs, etc.)
0 one full-size engineering plan set
o One 11x17" engineering plan set
• One extra set of specifications
• Fee (if required)
Mailing address:
By U.S. Postal Service
By Courier/Special Delivery:
--------------------------------------------------------------------_._---__-------
Division of Water Resources
------ _ ----------_-_----------------------------------------
Division of Water Resources ;
._.......
Non -Discharge Branch _
----------•-----------
......._......_.__. - ..._._.__........ ._........... ......
Non -Discharge Branch
---------- ------- ----- --------- ------
1617 Mail Service Center
Att: Nathaniel Thornburg, 91" Floor Office #942W
. _._._. _.__..__..._ ........ .. ..... .
Raleigh, NC 27699-1617
—
---------------- -
! 512 N. Salisbury St. i
---------------- ........ ----------------------------------------
For questions or problems contact Tessa Monday at [e-mail] or 919.707.3660.
By checking this box I acknowledge that I understand the application will not be accepted
for pre -review until the paper copy (if required) and fee (if required) have been received by
the Non -Discharge Branch. I also confirm that the uploaded document is a single PDF with
all parts of the application in correct order (as specified by the application).
Signature
Submission Date 4/16/2020

ZI Y IVHV KU
April 16th1 2020
N.C. Department of Environment and Natural Resources
Division of Water Resources
Water Quality Permitting Section — Class B Residuals Permit (DEDICATED)
1617 Mail Service Center.
Raleigh, NC 27699-1617
ATTENTION: Mr. Nathaniel Thornburg
REFERENCE: APPLICATION FOR MAJOR MODIFICATION
Synagro Western Piedmont WQ0016247
Dear Mr. Thornburg.
Synagro is submitting this application to modify the referenced residuals land application
permit for the Synagro Western Piedmont Permit.
We are requesting to add 6 new sites and more land to a previous site.
AI-13, AL-15, AL-16, CD-03, IR-36, RA-53, RA-05
Enclosed is a check for $395.00 to cover the fee associated with a major permit modification.
This application package should contain all information necessary to complete the requested
modification of the Synagro Western Piedmont permit. However, if you require additional
information or have further questions, please contact me at (336-703-8681) or
[e-mail] Thank you in advance for the timely and efficient review of this renewal
application.
Alex Fox
284 Boger Road, Mocksville, NC 27028 9 Phone: [phone] Fax: [phone]

J �Svnaom Technoloales. Inc.
NCOENR-DWQ-APS LAND APPLICATION UNIT (NC NE;UF-NK-L.)VVR
CKRQ-01222020-RTR
NCDENR-DWR
LAND APPLICATION UNIT
1636 MAIL SERVICE CENTER
RALEIGH NC 27699-1636
United States
860011673
01130/2020
395.00

State of North Carolina
D. WR Department of Environmental Quality
Division of Water Resources
Division of Water Resources 15A NCAC 02T .1100 — RESIDUALS LAND APPLICATION PROGRAM
INSTRUCTIONS FOR FORM: 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 prrocessing and review time for the
¢ "f?y x
perm it,.applications I7iil s_c�tl c trtsrQse notedKthsTA licantzshall�.subtnytaonesvaaa : re�a9` aaacd 'two�ca i���'�'f="th f � laeationrand
siQppo ting:, locatixn a tfition - - - - -
For more information, visit the Water Quality Permitting Section's Non -Discharge Permittin 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 sites) under
15A NCAC 02T .1 100.
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):
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 Ieast 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 Major Modification'
Major (land are permitted for > 300 acres) �� $1,310 $395
Minor (land are permitted for < 300 acres) F $810 $245
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 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.
REnvironmental.A,ssessm'ents;(May be Required — See 15A NCAC 1 C .0300)
Subinrfa c6py of the Findings of No Significant Impact (FONSI) or Environmental Impact Statement (EIS). Also, include
,.1 information on any mitigating factor(s) from the Environmental Assessment (EA) that impact the construction of the residuals
t 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)
t'oidication 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 .1 i 10 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;
LJ Detailed description of monitoring procedures' including parameters to be monitored.'
C1 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
.110202). Specifically, a residuals land application program is designated as dedicated if any of the following are applicable:
C7 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 11" 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 I5A NCAC 02T .1108
Site property boundaries within 500 feet of all waste treatment, storage, and disposal site(s).
El 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

.t. rrol ect 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)
0 Submit a detailed hydrogeologic evaluation in accordance with 15A NCAC 02T .1 I04(d)(4) and current Division Policy
available at: http://www.ncwater.or Rules 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, 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 .1104(d)(5) and current Division Policy
available at: http://www.newater.org/Rules Policies and Regulations/.
M. Property Ownership Documentation (All New or Modification Application Packages involving new and/or relocated treatment
or irrigation components)
EJ 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(fl, or
[3 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. SALIS13URY STREET
RALEIGH, NORTH CAROLINA 27604
FAX NUMBER: [phone]
INSTRUCTIONS FOR FORM: RLAP 06-16 Page 3 of')

DWR
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
I. APPLICANT INFORMATION:
1. Applicant's name: Svnagro Western Piedmont Class B Permit
Applicant type: Individual Corporation Ej General Partnership Privately -Owned Public Utility
Federal [( State Li'Municipal [ County
Signature authority's name per 15A NCAC 02T .0106: Robert Roth Title; TSS Manager
Applicant's mailing address: 284 Boger Rd
City: Mocksville State: NC
Zip: 27028
Telephone number: (336403-4324)
Email Address: [e-mail]
2. Consultant's name: Alex Fox
License Number (for P.E.):
Affiliation: tg On Staff 2 Retained (Firm: Synagro Central LLC.)
Consultant's mailing address: 284 Boger Rd
City: Mocksville State: NC
Zip; 27028
Telephone number: 336 703-8681,
Email Address: afox(@,svnaL-ro.com
3. Agronomist's name:'...
License Number;
Affiliation: Ej N/A [] On Staff
0 Retained (Firm: }
Agronomist's mailing address
City: State: NC
Zip:
Telephone number: ( ,, + ;..
Email Address::,....
4. Soil Scientist's name: Chris Murrav
License Number: 1284
Affiliation: 0 N/A Q On Staff
R Retained (Firm: is ':r.`J
Soil Scientist's mailing address:: 216 S. Swing Rd. Suite I
City: Greensboro State: NC
Zip: 27028
Telephone number: 336 662-5487 Email Address: chris(-}a,piedmontsoil.com
5. Fee submitted: I `•:;'`.I. (See Instruction B)
11. PERMIT Ili -FORMATION:
1. Application is for (check all that apply): El new, 0 modified, 0 renewed permit
2. If this application is being submitted to renew or modify an existing permit, provide the following:
Permit number: W00016247
Date of most -recently issued permit: November 17, 2017
Date of most -recently certified Attachment A (if different than the permit):
Date of most -recently certified Attachment B (if different than the permit):
FORM: RLAP 06-16 Page 1 of 5

III. RESIDUALS LAND APPLICATION PROGRAM INFORMATION:
1. Residuals Processing Facility's physical address: Source Specific
City: State: NC Zip: 28658
Coordinates: Latitude: Longitude:
Datum: NAD83 Level of accuracy: Map
Method of measurement: Second
2. County where residuals land application program is headquartered: Catawba
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
VAN
t.�
Hobert' oth
Synagro
�l�.a16�12
Vl3aekUTpO
A'elrign°an' y
Synagro
1006653':'
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: Alex Fox Spring 2020
4. Complete the following tables regarding management of the residuals land application program:
a. Plant Available titrogen 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: Source SpedflC 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
Five -Year Maximum Adjusted
b. Land Appheation 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
_
Row Crops
369
Hay
350.3
Pasture
264.3
Total:
983.6
'- i
Methods
Surface
983.6
Incorporation or Injection
0
Total:
983.6'>
a
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: Source Specific
Assumed
Application Rate
(Ibs PAN/ac yr)
Acres Required Using
First -Year PAN Concentrations
Acres Required Using
Five -Year Maximum Adjusted PAN
Concentrations
Surface
Incorporation or
Injection
Surface
Incorporation or
Injection
50
100
150
200
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 ofN_orth Carolina Administrative Code (e.g. not enough storage, not enough land, vector reduction
practices not in place, etc.): <s;:+
7. Specify type of residuals program (See Instruction F): E Non -dedicated Q Dedicated
If Dedicated, specify the following (check all that apply):
Residuals programcontainsany land application site(s) that receives residuals at rates or frequencies greater than agronomic
rates, explain; E:;,-.� k.
Residuals program contains any land application sites) that is used primarily for residuals disposal, and agricultural crop
production is of secondary importance, explain; i,_;'���:
[ 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; E
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.
H
Residuals Source
Certif ication
V. LAND APPLICATION SITE INFORMATION: (Required for all new, renewed, or modified Iand application site)
Complete and submit the following Land Applications,Site Certification and all associated documentation.
M
Land Application Siite
Certification.doc
FORM: RLAP 06-16 Page 3 of 5

Note: Item VT. Applicable to Dedicated Program with fixed irrigation system only.
VI. DESIGN INFORMATION FOR FIXED IRRIGATION SYSTEM
1. The irrigation system is: E) Spray El Drip
2. Disposal system is, U1 existing 0 proposed.
feet
3. Minimum depth to mean seasonal high water table (SHWT) within irrigation sites(s) per Soil Scientist's Evaluation. -I , _ . -
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?
EJ Yes or 'M No If Yes, please explain if the soil scientist report addresses artificial structures and please indicate if
structures are to be maintained or
5. Loading rates recommended by the Soil Scientist Evaluation:
Recommended
Recommended
Soil Series
Fields within Soil Area
Loading Rate
Loading Rate
(in/hr)
E..
L
E
M2
6. Design loading rates are equal or less than the loading rates recommended by Soil Scientist?
Lj 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
Number of
Maximum Application
Design Annual Loading
yt2)
Nozzles
Rate (gallons/h!j_
Rate fizallons/yr)
7
L
d
7�77,
j
Total
Spray Irrigation Design Element
Plan Sheet
Number
Specification
Page Number
Wetted diameter of nozzles
IT
Wetted area of nozzles
Nozzle capacity
gpm
Nozzle manufacturer model
Elevation of highest nozzle
I., z'77
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 .0I 05.
Yes B No, Explain;'::`
(Signature Authority's Name — PLEASE PRINT)
attest that this application for UUt ae],r
(Facility
A-n
C e Am.
m.
(Title)
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 masses 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:—. q
FORM: RLAP 06-16 Page 5 of 5

State of North Carolina
Department of Environmental Quality
- Division of Water Resources
Division of Water YResources 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 conies 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 only 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) ♦ Deleted (D)
® Attach the following in accordance with each status code:
Status Code
Required Item
N
R
T
M
.00
County Board
NotlO-ation. doc
W^�
Land Owner
'�
✓
'�
Agreement
(If applicable)
in
IM
✓
✓
✓
✓
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 Policy"
✓
INSTRUCTIONS FOR FORM: LASC 06-16 Page 1 of 3

Alex Fox
From: UPS Quantum View <[e-mail]>
Sent: Tuesday, April 14, 2020 9:52 AM
To: Alex Fax
Subject: UPS Delivery Notification, Tracking Number 1ZS1F78W0197302248
Hello, -your package has.been delivered:
Scheduled Delivery Date: Tuesday, 04/14/2020
Estimated Delivery lime: End Of Day
Left At: FRONT DESK
Signed by: GOODMAN
SYNAGRO - MOCKSVILLE
FRONT DESK
Tracking Number:
Ship To:
Number of Packages:
UPS Service:
Package Weight:
Reference Number.:
Q Dawnload the UPS mobile aap
1Z5 F7$W0187302248
136 W INNES ST
SALISBURY, NC 28144
US
0
UPS Next Day Air@
0.05 LBS
20-2360.30-60-4310 50-0055
O 2020 United Parcel Service of America, Inc. UPS, the UPS brandmark, and the color brown are
trademarks of United Parcel Service of America, Inc. All rights reserved.
All trademarks, trade names, or service marks that appear in connection with UPS's services are the
property of their respective owners.
1

Forth Carolina Department of Environmental Quality
Pat McCrory
Governor
Date: 04/13/2020
Name of Chairman to the Board of County Commissioners: Greg Edds
Complete mailing address: 130 W Inns Street
City: Salisbury State: NC
County where land application sites are located: Rc
From: Applicant's name: Synagro Western Piedmont for 61
Resources in accordance with Session Law 2013-340)
Contact person and title: Alex Fox
Complete mailing address: 284 Boger Rd
City: ,Statesville State: NC
Telephone number: 336) 703-8681 E-mail ac
Subject: Notification of residual land application site
This is to notify you that the Applicant listed above i
Resources for the land application of residual solids to site(s)
will ensure that all federal and state regulations are enforced.
generating sources and locations of the proposed Iand appli(
attachments to the appropriate Department within your Cour
Planning Department) if applicable.
More information of the land application sites inclu,
Division of Water Resources Regional Office:
Name of appropriate regional office: Mooresville Regional Of
Complete mailing address: 610 East Center Avenue Suite 301
City: Mooresville State: NC
Telephone number: (704-235-2184)
Expected date of application submission: 04/15/2020
Zip: 28144
Donald R, van der Vaart
Secretary
(on behalf of the Division of Water
Zip: 27028-f"°
afox%�?a syna-rogr .com
1 be submitting an application to the Division of Water
cated in your county. During this review, the Division
.ttached to this form is information regarding residuals -
ion sites. Please forward this lettei and its associated
(i.e., Health or Environmental Health Department and
in tlus application will be available at the following
28115
Should you desire to comment on this application, please do so no later than 30 calendar days following the
expected application submission date. If you have any questions for comments about this notification, or if you would like
more information, please contact the appropriate regional office at the telephone number provided above. Thank you in
advance for your attention to this matter.
Enclosures: Source Facility Summary
Land Application Site Summary
Maps
Non -Discharge Permitting Unit
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Phone:91H07-646411ntemet h J1 ear, lwablw
An Equal Opportunity iAffirmative Action Employer-?Mde In partwith recycled paper FORM: CBN 06-16

S11
Dlvlslon of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
COUNTY BOARD NOTIFICATION
INSTRUCTIONS FOR FORM: CBN 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 Un
General — This notification is intended to provide the county board in which the land application site is proposed to be located with
general information on the size, location and type of residuals land application proposed to occur in their county, and to give them an
opportunity to comment an the pending permitting request as stipulated in Session Law 2013-340. Notification is not required for
fields deemed permitted to receive Class A residuals under 15A NCAC 02T .1100. Do not submit this document for review
without a corresponding residuals program application form (NORM: RLAP 11-15).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. County Board Notification (FORM: CBN 11-15):
® Submit the completed and appropriately executed County Board Notification (FORM: CBN 11-15). Please do not make any
unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to the form may
be made, as long as the attachments are numbered to correspond to the section and item to which they refer,
® Prepare a separate County Board Notification (FORM: CBN 11-15) for each county in which the proposed land application
sites are located.
B. Critical Watershed Areas Information:
® Under 15A NCAC 02B .0212 no new permitted sites for land application of residuals are allowed within critical watershed
areas. It is the Applicant's responsibility to ensure that the proposed land application sites are not located within these areas.
® For more information regarding Water Supply Watershed Protection Program, please visit the Division website at:
hgps•//deq nc aov/about/divisionshvater-resources/water-resources-rules/water-supply-watershed-protection-program
❑ If uncertain about whether the proposed sites are located within the critical areas, contact the Division or call [phone].
C. Notification Package Submission:
❑ Complete and mail the notification letter, source facility summary, land application site summary, and site location maps to
the appropriate County Board by certified mail with a return receipt requested. It is recommended that a copy of the
notification package also be sent to the County Manager.
❑ The most current publication of the Directory of State and County Officials may be downloaded at:
hgps://www.sosnc.gov/publications/direct.aVx
❑ A list of the Division's regional offices, their county coverage, and their contact information may be downloaded at:
hqpl/deq.nc.gov/contact/regional-offices.
❑ The source facility summary shall include: facility name; county where it is located; and the proposed annual dry tonnage
(i.e., a copy of "Residuals Source Facility Summary" is adequate but not required),
❑ The land application site summary shali include: field ID; acreage; county where it is located; latitude and longitude (i.e., a
copy of "Land Application Site Certification' is adequate but not required).
D. Proof of Submission:
❑ Attach an 8.5 by 11-inch copy of the return receipt to the back of this attachment prior to submission of the application to the
Division for review.
INSTRUCTIONS FOR FORM: CBN 06 16 Page 1 of 1

DMsfon of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
COUNTY BOARD NOTIFICATION
INSTRUCTIONS FOR FORM: CBN 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 a lication and
supporting documentation
For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting Unit
General — This notification is intended to provide the county board in which the land application site is proposed to be located with
general information on the size, location and type of residuals land application proposed to occur in their county, and to give them an
opportunity to comment on the pending permitting request as stipulated in Session Law 2013-340. Notification is not required for
fields deemed permitted to receive Class A residuals under 15A NCAC 02T .1100. Do not submit this document for review
without a corresponding residuals program application form (FORM: RLAP 11-15).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. County Board Notification (FORM: CBN 11-15):
® Submit the completed and appropriately executed County Board Notification (FORM: CBN 11-15). Please do not make any
unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to the form may
be made, as long as the attachments are numbered to correspond to the section and item to which they refer.
® Prepare a separate County Board Notification (FORM: CBN 11-15) for each county in which the proposed land application
sites are located.
B. Critical Watershed Areas Information:
® Under 15A NCAC 02B .0212, no new permitted sites for land application of residuals are allowed within critical watershed
areas. It is the Applicant's responsibility to ensure that the proposed land application sites are not located within these areas.
® For more information regarding Water Supply Watershed Protection Program, please visit the Division website at:
https:HdeQ nc gov/about/divisions/water resources/water-resources-rules/water-supply-watershed-protection-program
❑ If uncertain about whether the proposed sites arc located within the critical areas, contact the Division or call [phone].
C. Notification Package Submission:
❑ Complete and mail the notification letter, source facility summary, land application site summary, and site location maps to
the appropriate County Board by certified mail with a return receipt requested. It is recommended that a copy of the
notification package also be sent to the County Manager.
❑ The most current publication of the Directory of State and Counly Officials may be downloaded at:
hqs://www.sosnc..gov/publications/direct.asvx
❑ A list of the Division's regional offices, their county coverage, and their contact information may be downloaded at:
hq:Hdeq.nc.gov/contact/regional-offices.
❑ The source facility summary shall include: facility name; county where it is located; and the proposed annual dry tonnage
(i.e., a copy of "Residuals Source Facility Summary" is adequate but not required).
❑ The land application site summary shall include: field ID; acreage; county where it is located; latitude and longitude (i.e., a
copy of "Land Application Site Certification" is adequate but not required).
D. Proof of Submission:
❑ Attach an 8.5 by 11-inch copy of the return receipt to the back of this attachment prior to submission of the application to the
Division for review.
INSTRUCTIONS FOR FORM: CBN 06-16 Page 1 of 1

North Carolina Department of Environmental Quality
Pat McCrory Donald R. van der Vaart
Governor Secretary
Date: 04/13/2020
Name of Chairman to the Board of County Commissioners: Greg Edds
Complete mailing address: 130 W Innes Street
City: Salisbury State: NC Zip: 28144
County where land application sites are located: Rowan
From: Applicant's name: Synaaro Western Piedmont for Statesville Waste Water (on behalf of the Division of Water
Resources in accordance with Session Law 2013-340)
Contact person and title: Alex Fox
Complete mailing address: 284 Boger Rd
City: Statesville State: NC Zip: 27028-
Telephone number: [phone] E-mail address: afox o�synagro.com
Subject: Notification of residual land application site proposal
This is to notify you that the Applicant listed above will be submitting an application to the Division of Water
Resources for the land application of residual solids to site(s) located in your county. During this review, the Division
will ensure that all federal and state regulations are enforced. Attached to this form is information regarding residuals -
generating sources and locations of the proposed land application sites. Please forward this letter and its associated
attachments to the appropriate Department within your County (i.e., Health or Environmental Health Department and
Planning Department) if applicable.
More information of the land application sites included in this application will be available at the following
Division of Water Resources Regional Office:
Name of appropriate regional office: Mooresville Regional Office
Complete mailing address: 610 East Centex Avenue Suite 301
City: Mooresville
State: NC
Telephone number: (704-235-2184)
Expected date of application submission: 04/15/2020
Zip: 28115
Should you desire to comment on this application, please do so no later than 30 calendar days following the
expected application submission date. If you have any questions or comments about this notification, or if you would like
more information, please contact the appropriate regional office at the telephone number provided above. Thank you in
advance for your attention to this matter.
Enclosures: Source Facility Summary
Land Application Site Summary
Maps
Nan -Discharge Permitting Unit
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Phone: [phone] Internet; h tp'•lleorlgl.ncdenrorolwebAya
An Equal OppodunitylAffirmalive Action Employer —Made in pat vdth recycled paper
FORM: CBN 06-16

Alex Fox
From: UPS Quantum View <[e-mail]>
Sent: Tuesday, April 14, 2020 9:52 AM
To: Alex Fox
Subject: UPS Delivery Notification, Tracking Number 1Z51F78W0197302248
Hello, your package has been delivered.
Scheduled Delivery Date:. Tuesday, 04114/2020r
Estimated Delivery Time: End Of Day
Left -At: FRONT DESK
Signed by: GOODMAN
SYNAGRO - MOCKSVILLE
FRONT DESK
Tracking'Number:'
iZ51F78W0197302248
Ship To:
130 W INNES ST
SALISBURY, NC 28144..
.Us :.
Number of.Packages:
0
UPS Service:
UPS Next Day Air@
Package Weight:
0.05 L bs
Reference Number: ...
20-2360-30-60-4310 50-0055
I I xl f Download the UPS mobile am
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IM

,Mate vx norin •,aruuna
Department of Environment and Natural Resources
Division of Water Resources
D9vlslon 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 bores 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 Mon -Discharge Permitting Unit
General -- This document is an agreement between the Applicant and land owner(s) of residuals receiving sites for land application of
Class B residuals (may include water treatment plant or other type residuals) in accordance with 15A NCAC 02T .1100. Do not
submit this agreement for review without a corresponding application form (FORM: RLAP 06-16).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Land Owner Agreement (FORM: LOA 06-16):
�ubmit 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
A plicant.
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 landown r or his representative hereby perm'ts:
Applicant's name: T � o tiC6 L/h / `e, Ltel.
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 1D
Lease
(yes/no)
Land Use or
Cropping Patterns
Intended Use of Crops
Residuals Source
(optional)
Special note
(no-till/over-seed!
pasture)
-53-
A/6
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 Pagel of 3

I. STIPULATIONS:
I. The landowner or his representative shall not enter into any additional residuals application contracts or agreements with another permitted
entity for the site(s) specified by this Agreement.
2. Should the landowner or his representative lease or otherwise permit the use of the land application site(s) to a third party, the landowner shall
be responsible to ensure that the third party agrees and complies with the terms and conditions of this Agreement.
3. The landowner or his representative shall adhere to the provisions of this Agreement until all of the site restrictions (under Section 11) 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 time 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 sites) 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 .0105Lh1 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. PIease 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
cgmpliance boundary to the application package)
Fj�A re -defined compliance boundary is not needed for this site.
IV. ACKNOWLEDGEMENT OF FIELD TRANSFER: (if needed)
❑ The land application field(s) ID: , , is currently permitted under another
residuals land application program; Permit Number WQ: The land owner hereby acknowledge that by signing this
agreement, he/she is requesting that the field(s) be removed from the previously permitted residuals land application program and transferred
into the new program;
(Name of the new program)
FORM: LOA 06-16 Page 2 of 3

Landowner's Certification:
I certify that I am a deeded landowner of the above -referenced land application site(s) and am authorized to make decisions
regarding the use of the land application site(s) on behalf of other deeded landowners OR that I am otherwise authorized, through
a power of attorney or other legal delegation, to make decisions regarding the use of the land application site(s) on behalf of the
deeded landowners. I certify that the above -referenced land application site(s) are not included in any waste disposal contract or
agreement with another municipality, contractor, or other permitted. entity. Furthermore, I certify that I have read this Agreement,
understand the stipulations, restrictions, alternatives for water supply wells inside the compliance boundary, acknowledgement of
field transfer, and do hereby grant permission to the Permittee to land apply residuals to the land application site(s) as specified
herein.
Landowner name: M a ( e- 7K
M
Address: r ,
City:-f! 0 Q-w+/ State: G, Zip:
E-mail address: W
Phone: s '� + �U -
Signature:- Date:
NORTH CAROLINA, COITNTX T
I, the undersigned Notary Public do hereby certify that mw� Or��S ` t- & P G cL <�
personally appeared before me this day and acknowledged the due execution of the forgoing instrument. ,t,N��X4
941
VVITNESS my hand and official seal this the _ l lh a�0
day of ' J ' ►*+ �IKr�
Signature and seal: �✓ 47
My commission expires:
Lessee's/Operator's Certification:
Z
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 n e: grt
- Doke r� f� � 7
Signature: ~/vim��— Date•
�C)
4%
FORM: LOA 06-16 Page 3 of 3

atace oa iN orin c.aroitua
Department of Environment and Natural Resources
Division of Water Resources
0" W-7
Mylslon 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 conies 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 .1100. Do not
submit this agreement for review without a corresponding application form (FORM: RLAP 06-16).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Land Owner Agreement (FORM: LOA 06-16):
92,' 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
plication may be made, as long as the attachments are numbered to correspond to the section and item to which they refer.
FePrepare a separate agreement for each set of land application sites that are owned or operated by an entity other than the
plicant.
AA 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: 51 a" fv � q* �r h il m..+1
hereinafter referred to as the Permittee, to land apply residuals from the following facility(ies) onto the following land
application site(s) (Le., 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
o
(optional)
Special note
(no-till/over-seed/
pasture)
1Z - s 3 - 1
v
1.
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 I of 3

1. STIPULATIONS:
1. The landowner or his representative shall not enter into any additional residuals application contracts or agreements with another permitted
entity for the site(s) specified by this Agreement
2. Should the landowner or his representative lease or otherwise permit the use of the land application site(s) to a third party, the landowner shall
be responsible to ensure that the third party agrees and complies with the terms and conditions of this Agreement.
3. The landowner or his representative shall adhere to the provisions of this Agreement until all of the site restrictions (under Section II) are met.
4. Notification of cancellation of this Agreement shall be immediately forwarded to NCDENR-DWR, Non -Discharge Permitting Unit, I636
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.
M.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
compliance boundary to the application package)
51"A re -defined compliance boundary is not needed for this site.
IV. ACKNOWLEDGEMENT OF FIELD TRANSFER: (if needed)
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 program;
(Name of the new program)
FORM: LOA 06-16 Page 2 of 3

Landowner's Certification:
I certify that I am a deeded landowner of the above -referenced land application sites) 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 otherMse 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: Y I ! �� �z��C. (V c%c' Le) 1—.
City: IJ �` d �— ' - - - State: Zip:
Phone: 7 Q — L ?/ E-mail address: J CL u!�
Signature: r Date: (22 — 1 7-
` .3311
NORTH CAROLINA, —T 0 W 2-y✓ —COUNTY
j
I, the undersigned Notary Public do hereby certify that P i I a L- C' JV�,/��-
personally appeared before me this day and acknowledged the due execution of the forgoing instrument.
WITNESS my hand and official seal this the 1 &A
day of C � , 20
Signature and seal:
My commission expires: �
Lessee's/Operator's Certification: � co apelesil�
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 name:
Signature:
Date: 4417w
FORM: LOA 06-16 Page 3 of 3

APPLICATION MAP
a
z
}
LEGEND
APPLICATION AREA -UNSUITABLE AREA
PRIVATE ROAD
STREAM
DRAIN
XX FENCE
PROPERTY LINE
WATER
ONSITE HOUSE
GRAPHIC SCALE
OFFSITE HOUSE 1=660'
OUTBUILDING a 660,
(0
WELL
0
SOIL BORING
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within
in 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. All
locations are approximate.
N C-RA-53
Fields 1-2

SOIL SURVEY . .
GRAPHIC SCALE
in = 660'
660, 0 66U
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within N C-RA-53
in 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. All
locations are approximate. Fields 1-2

NCDA&CS Agronomic Division
Phone: [phone]
Webstte: WWw.ncagr:gov/agronomi/
Report No. FY20-SLO24161
Advisor: Alex Fox
SYnagro
284 Boger Rd
Sampled: 01/09/2020 madon Sampled CountyMocksville, NC 27028
Recoivfld: 02/03/2020 � Rowan
completed; 02/06/2020 Client ID: 409414
Agronomist's Comments: Farm: RH-05
This report contains both routine soil test information as well as heavyAdvisor ID: 501947
soil test extrappm, tant, background levels of these metals typically seen in NC soils w
So" t0.2 metals data in a section labeled as Heavy
ppm, lead (Pb)- 4.2 ppm, nickel (Ni)- O.g when analyzed are as follows. Metals under soil test lab results. Using AAehlich 3 as a
not believed to pose a concern for Plant growth, ppm, & selenium
recommendations. Ja athi Kamalakanthan, A ronomiat 2/5/2020 (Se) 0 2 ppm (FY2005-2007 . arsenic (As)- 4.5
g wth, continue to monitor these and note where elevated above background levels_ ppm cadmium. ( he b
Note elevated lead (Pb) in sample 3. Although the abovepmetalshere are
Sample ID: 1
Recommendations: Note an lime
Crop Lime Y and fertilizer
Limo History; (tons/acre)
1 -Fescue/OGrasslTim,
2 - 0.0 120-200
Test Results [units - 3 0.0
WN in glcm , CEC and Na in me 3,
HM% W/y q/10p crr, NO3-N in mg/dml�:
CEC BS% Ac pH
0.18 1.00 8.7 91 0.8 P-I K-1 Ca% Mg%
6.3 11 102
Heavy Metals 55 30
(Parts -per million):
Sample ID: 2 Arsenic, 0.1 Cadmium,-0.0
Recommendations:
Lime
Lime History: Crop
1 -Fes (tons/acre)
Heavy Metals
Client: Allen Livengood
oil
155 Stagecoach Rd
port Mehlich-3 Extraction Cleveland, NC 27013
in s to Helpful ]nfor
P205 "" "LS (ID/acre)
120 00 Og S Mn Zn More
0 0 0 C0 0 Information
No�,12
cue/OGrass/Tim, M p 0 N Pz05
2 - 120-200 110
Test Results [units - W/y in /c 0 0
HM%
9 nr ; CEC and Na in mep/jpp cm3
NO3-N in mgldrrr�j:
WN CEC gS°/, Ac ,
0.32 0.96 7.6 i34 1.2 pH P-[ K-I Ca% Mg%
5.9 13 37
Heavy mew, (paw per million): 58 23
Arsenic,. 0.2 Cadmium, 0:1
North Carolina
?oiut[a irux[ Fund ii�lfsSlt�n
Soil Class: Mineral
S-1 Mn-I Mn-All Mn-AI2
42 Zn-I Zn AI Cu-1 Na ESP S5-1
1754 1065 NO3-N
121 121
Nickel, 0.6 90 0.1 1
Chromium; 0.1
Lead, 2.7 Nutrients (bSelenium, 0.0
/
acre)
p0 Og 0 Mn Zn Cu l3 More
0 p 0 0 ]nformation
Nat 2
Soil Class: Mineral
$-1 Mn-1 Mn-All
Mn-AI2 Zn-1 Zn-AI
52 C1 Na
116 ESP SS-1 NO3-N
Chromium, 0.1
741 462
Nickel, 0.4 116 214 D.1 1
Lead, 2.5 Selenium, 0.0
Reprogramming of the laboratory-information-m
aqement
tha
through a grant from theeNorthCaroliTobacco coTru Fu Possible is being funded
Thank you for using agronomic services to manage nutrients and safeguard ent Fund Commission.
vironmental
Steve Troxler, Commissioner of,Agriculture gualrty

-"own
I

NCDA&CS Agronomic Division Phone: [phone] Website: www.neagr.gov/agronomi/
Report No. FY20-SL024161
Allen Livengood
Page 3 of 3
Understanding the Soil Report: explanation of measurements, abbreviations and units
Recommendations
Report Abbreviations
Lime
Ac
exchangeable acidity
If testing finds that soil pH is too low for the crop(s) indicated, a time recommendation will be given in units of either
B
boron
tonlacre or Ib/1000 sq ft. For best results, mix the lime into the top 6 to 8 inches of soil several months before planting.
BS%
% CEC occupied by basic cations
For no -till or established plantings where this is not possible, apply no more than 1 to 1.5 ton/acre (50 Ib/1000 sq ft) at oni
Ca%
% CEC occupied by calcium
time, even if the report recommends more. You can apply the rest in similar increments every six months until the full rate
CEC
cation exchange capacity
is applied. If MG is recommended and lime is needed, use dolomitric lime.
Cu4
copper index
ESP
exchangeable sodium percent
Fertilizer
HM%
percent humic matter
Recommendations for field crops or other large areas are listed separately for each nutrient to be added (in units of
K-1
potassium index
Ib/acre unless otherwise specified). Recommendations for N (and sometimes for B) are based on research/field studies
K2O
potash
for the crop being grown, not on soil test results. K-1 and P-1 values are based on test results and should be > 50. If they
Mg%
% CEC occupied by magnesium
are not, follow the fertilizer recommendations given. If Mg is needed and no lime is recommended, 0-0-22 (11.5% Mg) is
MIN
mineral soil class
an excellent source; 175 to 250 lb per acre alone or in a fertilizer blend will usually satisfy crop needs, SS-1 levels appear
Mn
Mn-All
manganese
Mn-availability index for crop 1
only on reports for greenhouse soil or problem samples.
Mn-AI2
Mn-availability index for crop 2
Mn-I
manganese index
Farmers and other commercial producers should pay special attention to micronutrlent levels. If $, pH$, $pH, C or Z
M-0
mineral -organic soil class
notations appear on the soil report, refer to $Note: Secondary Nutrients and Micronutrients_ In general, homeowners do not
N
nitrogen
need to be concerned about micronutdents. Various crop notes also address lime fertilizer needs; visit
Na
sodium
ncagr.gov/agronomi/pubs.htm.
NO3-N
nitrate nitrogen
ORG
organic soil class
Recommendations for small areas, such as home lawns/gardens, are listed in units of Ib/1000 sq ft . If you cannot find
pH
current soil pH
the exact fertilizer grade recommended on the report, visit www.ncacrr.aov/agronomUobnart4.hfmll nd information that
P-1
phosphorus index
may help you choose a comparable alternate. For more information, read A Homeowner's Guide to Fertilizer.
P205
phosphate
8-1
sulfur index
Test Results
S84
soluble salt index
WN
weight per volume
The first seven values [soil class, HM%, WN, CEC, BS%, Ac and pH] describe the soil and its degree of acidity. The
Zn Znl
zinc availability index
zinc index
remaining 16 [P-I, K-I, Ca%, Mg%, Mn-1, Mn-All, Mn AI2, Zn-I, Zn-Al, Cu-I, S-I, SS -I, Na, ESP, SS -I, NO3-N (not routine
available)] indicate levels of plant nutrients or other fertility measurement. Visit www•ncagr.crov/apronomi/uyrst.htm

SOIL SURVEY
GRAPHIC SCALE
1" = 800'
800, 0 800,
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within N C-RA-05
in 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, All C
locations are approximate, Fields 1-3

North Carolina Department of Environmental Quality
Pat McCrory Donald R. van der Vaart
Governor Secretary
Date: 10/2/19
Name of Chairman to the Board of County Commissioners: James Mallory
Complete mailing address: 519 N Centter Street
City: Statesville State: NC Zip: 28677
County where land application sites are located: Iredell
From: Applicant`s name: Synagro Western Piedmont for Statesville Waste Water (on behalf of the Division of Water
Resources in accordance with Session Law 2013-340)
Contact person and title: Alex Fox
Complete mailing address: 284 Boger rd
City: Statesville
Telephone number: [phone]
State: NC Zip: 27028-� : _R
J.
E-mail address: afox@@maroxom
Subject: Notification of residual land application site proposal
This is to notify you that the Applicant listed above will be submitting an application to the Division of Water
Resources for the land application of residual solids to site(s) located in your county. During this review, the Division
will ensure that all federal and state regulations are enforced. Attached to this form is information regarding residuals -
generating sources and locations of the proposed land application sites. Please forward this letter and its associated
attachments to the appropriate Department within your County (i.e., Health or Environmental Health Department and
Planning Department) if applicable.
More information of the land application sites included in this application will be available at the following
Division of Water Resources Regional Office:
Name of appropriate regional office: Mooresville Regional Office
Complete mailing address: 610 East Center Avenue Suite 301
City: Mooresville State: NC Zip: 28115
Telephone number: (704-235-2184)
Expected date of application submission: 04/15/2020
Should you desire to comment on this application, please do so no later than 30 calendar days following the
expected application submission date. If you have any questions or comments about this notification, or if you would like
more information, please contact the appropriate regional office at the telephone number provided above. Thank you in
advance for your attention to this matter.
Enclosures: Source Facility Summary
Land Application Site Summary
Maps
Non -Discharge Pemtitting Unit
1617 Mall Service Center, Raleigh, North Carolina 27699-1617
Phone: 91 M07-64641 Intemet:htto•1/portal.ncdenrormWehhvo
An Equal opportunity 1Affirmative Action Employer— Made in part with recycled paper FORM: CBN 06-16

Alex Fox
From: UPS Quantum View <[e-mail]>
Sent: Tuesday, April 14, 2020 9:08 AM
To: Alex Fox
Subject: UPS Delivery Notification, Tracking Number 1Z51 F78W0197388031
Hello, your package has been delivered.
Scheduled Delivery Date: Tuesday, 04/14/2020-
Estimated. Delivery Time_ ; End Of Day
Left At: FRONT DOOR
Set Delivery Instructions Manage Preferences View Delivery Plann;er
SYNAGRO = MOCKSVILLE
FRONT DOOR
Tracking Number: 1ZSIF78WO197388631
Ship To: 519 N CENTER ST
STATESVILL.E, NC 28677.
US
Number of Packages: 0
UPS Service: UPS Next Day Air@ ..
Package Weight: 0.05 LBS
Reference Number: 20-2360-30-60-4310 50-0.055

Department of Environmental Quality
Division of Water Resources
sion of Water Resources
15A NCAC 02T .1100 -- LAND OWNER AGREEMENT
FORM: LOA 06-16
Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted, the Applicant shall submit one original and two conies of the application and
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 .1100. Do not
submit this agreement for review without a corresponding application form (FORM: RLAP 06-16).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Lan Owner Agreement (FORM: LOA 06-16):
Submit the completed and appropriately executed Land Application Site Certification (FORM: LASC 06-16) form. PIease
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.
( lFrepare a separate agreement for each set of land application sites that are owned or operated by an entity other than the
plicant.
A copy of the completed and appropriately executed agreement must be provided to the landowner and the lessee/operator.
AGRIEMENT FOR THE LAND APPLICATION OF RESIDUALS TO PRIVATELY OWNED LAND
The undersigned landowner or his representative hereby permits:
Applicant's name: 5 y Aft N /O jM+s y I
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
(m-till/aver-seed!
pasture)
✓UG� Q -��
✓✓
M4nr
i
The landowner or his representative receives, in consideration, full use of the nutrient value of the applied residuals while the
Permittee receives, in consideration, the use of the land application site(s) described above for the disposal of the residuals.
This Agreement shall remain in effect for the length of the Division's permit for the residuals land application program and
shall be renewed each time this permit is renewed.
The undersigned landowner or his representative and the Permittee agree to abide with the following restrictions and
stipulations until such time as written notification, given 30 calendar days in advance, modifies or cancels this Agreement.
FORM : LOA 06-16 Page 1 of 3

a
0
APPLICATION MAP
LEGEND
APPLICATION AREA
PRIVATE ROAD
STREAM
DRAIN
X X X FENCE
PROPERTY LINE
Q SOIL BORING
UNSUITABLE AREA
WATER
ONSITE HOUSE
OFFSITE HOUSE
OUTBUILDING
WELL
The compliance boundary is established either 250 It from the residuals application area or 54 feet within
in 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. All
locations are approximate.
GRAPHIC SCALE
1 " = 660'
660' 0 660,
NC-RA-05
Fields 1-2

APPLICATION MAP
LEGEND
I, �I APPLICATION AREA
UNSUITABLE AREA
- — — — — - PRIVATE ROAD
WATER
— -- — STREAM
.
ONSITE HOUSE
- DRAIN
.
OFFSITE HOUSE
�-- ����� FENCE
OUTBUILDING
PROPERTY LINE
WELL
SOIL BORING
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within
in 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. All
locations are approximate.
GRAPHIC SCALE
1°=660'
660' 0 669
N C-RA-05
Fields 2-3

Soil Profile Descriptions in Field Locations
Project: Synagro West. Piedmont (WQ 16247) % Slope: 3%
Site: Patrick Starnes Farm Crop: Forage/Pasture
Field: Field 1 Conducted By: GC Murray
Coordinates: 35.8523 N Date: 11/14/2019
-81.3493 W Soil Series: Fairview
grade Structure Type
'weak gr granular
,%derate pl platy
7 pr prismatic
cpr columnar
abk angular blocky
bk subangular blocky
\assive
ngle grained
PIEDMONT
ENYIRQNMENTAL
A s i O C I A Y■ i, P.A.
rr ns
fi s
fi ss
Seasonal High Water Table:
Structure Size . Depth!'(") Type (apparent/perched
f fine - -
med medium
Moist Consistencv
fr friable
vfr very friable
fi firm
A very firm

Soil Profile Descriptions in Field Locations
Project: Synagro West. Piedmont (WQ 16247)
% Slope: 4%
Site: Patrick Starnes Farm
Crop: Forage/Pasture
Field: Field 2
Conducted By: GC Murray
PIEDMONT
Coordinates: 35.8492 N
Date: 11/14/2019
ENVIRONMENTAL
-81.3457 W
Soil Series: Woolwine
a a SO a I ATM S. P. A.
m
O
d N
ua
LU
N
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IL m
m 0
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Legend.
Texture
s
sand
I
loam
si
silt
sil
sift loam
c
clay
cl
clay loam
scl
sandy clay loam
sl
sandy loam
Sid
silty clay loam
Structure Grade
Structure Type
wk weak
gr
granular
m moderate
pl
platy
str strong
pr
prismatic
cpr
columnar
abk
angular blocky
sbk
subangular blocky
sg
single grained
ma
massive
Seasonal Hlgh Water Table:
Structure Size Depth (") Type (apparent/perched)
f fine -
med medium
Moist Consistencv
fr friable
vfr very friable
fi firm
vfi very firm

Soil Profile Descilptions in Field Locations
Project: Synagro West. Piedmont (WQ 16247) % Slope: 4%
Site: Patrick Starnes Farm Crop: Forage/Pasture
Field: Field 2 Conducted By: GC Murray
Coordinates: 35.8475 N Date: 11/14/2019
-81.3446 W Soil Series: Woolwine
y
tll
t
O
O
v
O
O
N
T r"%
S
S
PIEDMONT
6NVIROMMEM AL
ARSOCIAi■S. P.A.
N LU � d
a) H N
O C N s M
G O
a rn U a�
m m
4� Q� X
"a w (j L) L�7
fA .+ 7 N
S S N S s
Ap
0-3
7.5YR
4/4
-
-
-
-
moist
scl
mod
med
gr
fr
ns
n
AB
3-14
7-5YR 6/4
-
-
-
-
moist
sci
mod
med
gr
fr
ns
np
Bt
14-22
5YR 5/8
-
-
-
-
moist
cl
mod
med
sbk
fi
s
BC
22-31
5YR 518
-
-
-
-
moist
scl
mod
med
sbk
fi
ss
sp
CR
31-39
5YR 5/8
Legend.
Texture
s
sand
I
loam
si
sift
sil
silt loam
c
clay
cl
clay loam
scl
sandy clay loam
sl
sandy foam
sid
silty clay loam
Structure Grade
Structure Type
wk weak
gr
granular
m moderate
pl
platy
str strong
pr
prismatic
cpr
columnar
abk
angular blocky
sbk
subangular blocky
sg
single grained
ma
massive
_Seasonal High Water Table:
Structure Size Depth (") TXpe (apparent/perched
f fine - -
med medium
Moist Consistencv
fr friable
vfr very friable
fi firm
A very firm

Soil Prof<le Descriptions in Field Locations
Project: Synagro West. Piedmont (WQ 16247) % Slope: 4%
Site: Patrick Starnes Farm Crop: Forage/Pasture
Field: Field 6 Conducted 8y: GC Murray
Coordinates: 35.8562 N Date: 11/14/2019
81.3761 W Soil Series: Fairview
O
O
v
�
O
O
c
U
U
H
c
5
•
n
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0
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PIEDMONT
ENVIROMMENTAL
A& B O C I A T IS, P. A.
cca
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N
(n
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s
m K
s N
w
s
L
w
L
O
V
0
Wool
Legend.
Texture
s
sand
I
loam
si
silt
sil
silt loam
c
clay
cl
clay loam
scl
sandy clay loam
sl
sandy loam
sicl
silty clay loam
Structure Grade
Structure Type
wk weak
gr
granular
m moderate
pl
platy
str strong
pr
prismatic
cpr
columnar
abk
angular blocky
sbk
subangular blocky
sg
single grained
ma
massive
Seasonal High Water Table:
Structure Size Depth Type (apparent) erched)
f fine - -
med medium
Moist Consistencv
fr friable
vfr very friable
fr firm
vfi very firm

Soil Profile Descriptions in Field Locations
Project: Synagro West. Piedmont (WQ 16247) % Slope: 4%
Site: Patrick Stames Farm Crop: Forage/Pasture
Field: Field 7 . Conducted By: GC Murray PIEDMONT
Coordinates: 35,8576 N Date: 11/14/2019 EPMRQNMENTAL
-81.3747 W Soil Series: Fairview w s s o e I w r■ s, P.A.
Legend.
Texture
s
sand
I
loam
si
silt
sil
silt loam
c
clay
cl
clay loam
scl
sandy clay loam
sl
sandy loam
sid
silty clay loam
Structure Grade
Structure Type
wk weak
gr
granular
m moderate
pi
platy
str strong
pr
prismatic
cpr
columnar
abk
angular blocky
sbk
subangular blocky
sg
single grained
ma
massive
Seasonal High Water Table:
Structure Size Depth (") Type (apparent/perched)
f fine
med medium
Moist Consistencv
fr friable
vfr very friable
fi firm .
vfi very firm

Soil Profile Descriptions in Field Locations
Project: Synagro West. Piedmont (WQ 16247) % Slope: 5%
Site: Patrick Stames Farm Crop: Forage/Pasture
Field: Field 9 Conducted By: GC Murray
Coordinates: 35.8051 N Date: 11/14/2019
-81.3541 W Soil Series: Woofwine
N
to
/.
L
0
0oO
//o
o
T A
S I
S
PIEDMONT
ENVIROMMENTAL
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7.5YR 6/4
-
-
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gr
fr
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Bt
13-28
2.5YR 4/8
-
-
-
-
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c
mod
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sbk
fi
s
BC
28-36
2.5YR 4/8
-
-
-
-
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cl
wk
med
sbk
fi
_ s
p
C
36-43
2.5YR 4/6
-
-
-
-
moist
sl
wk
med
gr
fr
ns
n
Legend.
Texture
s
sand
I
loam
si
silt
sil
silt loam
c
clay
cl
clay loam
scl
sandy clay loam
sl
sandy loam
sicl
silty clay loam
Structure Grade
Structure Type
wk weak
gr
granular
m moderate
pl
platy
str strong
pr
prismatic
cpr
columnar
abk
angular blocky
sbk
subangular blocky
sg
single grained
ma
massive
Seasonal Hiph Water Table:
(") Structure Size Depth T pe a arent/perched
f fine - -
med medium
Moist Consistencv
fr friable
vfr very friable
fi firm
vfi veryfirm

Soil Profile Descriptions in Field Locations
Project: Synagro West. Piedmont (WQ 16247) % Slope: 4%
Site: Danny Millsaps Farm Crop: Forage/Pasture
Field: Field-4 Conducted By: GC Murray
Coordinates: 35.8945 N Date: 11/14/2019
-81.1672 W Soil Series: Fairview
�
N
v
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U
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A S S O C 1 A T R U, P. A.
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*'+'+ •� In 7 N
O O �-
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Ap
1 0-6
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-
-
-
-
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scl
mod
I med
gr
fr
ns
np
Bt
6-29
2.5YR 4/8
-
-
-
-
moist
c
mod
med
sbk
fi
s
BC
29-37
2.5YR 4/8
-
-
-
-
moist
cl
wk
med
sbk
fi
s
p
C
37-48
2.5YR 416
-
-
-
-
moist
sf
wk
med
gr
fr
ns
n
Legend.
Texture
s
sand
I
loam
si
sift
sif
silt loam
c
clay
cl
clay loam
scl
sandy clay loam
sl
sandy loam
sic]
silty clay loam
Structure Grade
wk weak
m moderate
str strong
Structure Type
gr
granular
pl
platy
pr
prismatic
cpr
columnar
abk
angular blocky
sbk
subangular blocky
sg
single grained
ma
massive
Structure Size
f fine
med medium
Moist Consistencv
fr friable
vfr very friable
fi firm
vfi very firm
Seasonal High Water Table:
Depth (") T e a parent/perched

Soil Profile Descriptions in Field Locations
Project: Synagro West. Piedmont (WQ 16247) % Slope: 4%
Site: Danny Millsaps Farm Crop: Forage/Pasture
Field: Field 5 Conducted By: GC Murray
Coordinates: 35.8963 N Date: 11 /14/2019
-81:1635 W Soil Series: Clifford
L
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O
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0
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A
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t
s
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PIEDIRONT
ENVI"NMEWAL
ASSOCIATES. P.A.
c
G1
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C
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x
%
N
w
0
Iv
=v
cA
w
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N
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^
n
n
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Legend:
Texture
s
sand
I
loam
si
silt
sil
silt loam
c
clay
cl
clay loam
scl
sandy clay loam
sl
sandy loam
sid
silty clay loam
Structure Grade
Structure Type
wk weak
gr
granular
m moderate
pl
platy
str strong
pr
prismatic
cpr
columnar
abk
angular blocky
sbk
subangular blocky
sg
single grained
ma
massive
Structure Size
f fine
med medium
Moist Consistencv
fr friable
vfr very friable
fi firm
vfi very firm
Seasonal High Water Table:
Depth f') Type {apparent/ erched}

Soil Prople Descriptions in Field Locations
Project: Synagro West. Piedmont (WQ 16247) % Slope: 4%
Site: Danny Millsaps Farm Crop: Forage/Pasture
Field: Field 6 Conducted By: GC Murray
Coordinates: 35,8798 N Date: 11/14/2019
-81,1305 W Soil Series: Clifford
s
`o
`o
v
O
O
o
T
n
S
S
PIEDMONT
ENWROMMENTAL
ASSOC1A!■!, P.A.
m
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7
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Legend.
Texture
s
sand
I
loam
si
silt
sil
silt loam
c
clay
cl
clay loam
scl
sandy clay loam
sl
sandy loam
sicl
silty clay loam
Structure Grade
Structure Type
wk weak
gr
granular
m moderate
pl
platy
str strong
pr
prismatic
cpr
columnar
abk
angular blocky
sbk
subangular blocky
sg
single grained
ma
massive
Seasonal Hiah Water Table:
Structure Size Depth (") Type (apparent/perched)
f fine - -
med medium
Moist Consistencv
fr friable
vfr very friable
fi firm
vfi very firm

SYNAGRO, WESTERN PIEDMONT CLASS B PERMIT
WQ 0016247
SOIL SCIENTIST CERTIFICATION
This is to certify that soil profile evaluations were conducted on the proposed application
sites for the Western Piedmont project by Piedmont Environmental Associates, P.A. on
behalf of Synagro Central, LLC. The evaluations consisted of hand auger borings and
descriptions of the soils on the application sites. All hand auger borings included in this
package were either performed by me or under my direct supervision. All other work
performed for this permit application was conducted by Synagro Central, LLC.
G. Christopher Murray, L.S.S.
No. 1284
Synagro, Western Piedmont WWfP Project, Various Fields

Soil Profile Descriptions in Field Locations
Project: Synagro West. Piedmont (WQ 16247) % Slope: 3%
Site: Mark Tevepaugh Farm Crop: Forage/Pasture
Field: Field 1 Conducted By: GC Murray
Coordinates: 35.7548 N Date: 1/9/2020
-80.6440 W Soil Series: Cecil
d
s
O
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C
V
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m
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:ii
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5
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PIEDMONT
ENVIRONMENTAL
ASSOCIATES, P. A.
ID p u!
0 N 0.
F�-
3
Q (n V L- V L L O
�
0 77 iC i r?
S S N J. w :.r. F..21
Legend.
Texture
Structure Grade
_Structure Type
s sand
wk weak
gr
granular
I loam
m moderate
pl
platy
Si silt
str strong
pr
prismatic
sil silt loam
cpr
columnar
c clay
abk
angular blocky
cl clay loam
sbk
subangular blocky
scl sandy clay loam
sg
single grained
sl sandy loam
ma
massive
sicl silty clay loam
Seasonal High Water Table:
Structure Size Depth (") Type (apparent/perched)
f fine -
med medium
Moist Consistencv
fr friable
vfr very friable
f firm
vfi very firm

Soil Profile Descriptions in ,Field Locations
Project: Synagro West. Piedmont (WQ 16247) % Slope: 3%
Site: Mark Tevepaugh Farm Crop: Forage/Pasture
Field: Field 2 Conducted By: GC Murray
Coordinates: 35.7599 N Date: 1/9/2020
-80.6418 W Soil Series: Pacolet
N
N
O
O
v
=
O
O
U
V
O
T /'1
S
S
PIEDMONT
ENVIRONMENTAL
A SS 0 CIAT MS. P. A.
�v
C
0
U
S
0
W
N
55
a
N
r
4
m
O
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am
O
C
v
x
N
N
m
K
m
m
O
m
m
O
A0
0
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Legend.
Texture
Structure Grade
Structure Type
s sand
wk weak
gr
granular
I loam
m moderate
pl
platy
si silt
str strong
pr
prismatic
sil silt loam
cpr
columnar
c clay
abk
angular blocky
cl clay loam
sbk
subangular blocky
scl sandy clay loam
sg
single grained
sl sandy loam
ma
massive
sicl silty clay loam
Seasonal High Water Table:
Structure Size Depth (") T e (apparent/perched)
f fine - -
med medium
Moist Consistencv
fir friable
vfr very friable
fi firm
vfi very firm

Soil Profile Descriptions in Field Locations
Project: Synagro West. Piedmont (WQ 16247) % Slope: 3%
Site: Alan Livingood Farm Crop: Forage/Pasture
Field: RA-05 Field 1 Conducted By: GC Murray
Coordinates: 35.7126 N Date. 1/9/2020
-80.6595 W Soil Series: Enon
Nl
N
s
O
O
v
O
O
O =
d
++
44
�L-.
r4-
r n
S
S
PIEDMONT
ENVIRONMENTAL
ASSOCIATES. P . A .
as
R N �
C U w iA F y
C 0� C N �N
N O C
Q m V m O
61 m CC M I
o
O O O x i ` N
Ap
0-6
10YR 4/2
-
-
-
-
moist
sl
wk
med
gr
fr
ns
np
AB
6-12
2.5Y 5/4
-
-
-
-
moist
sl
mod
med
gr
fr
ss
sp
Bt
12-31
7.5YR 4/6
-
-
-
-
moist
c
mod
med
sbk
of
s
p
C
31-48
10YR 6/8
-
-
-
-
moist
sl
structureless
fr
ns
n
Legend:
Texture
s
sand
I
loam
sl
silt
sil
silt loam
c
clay
cl
clay loam
scl
sandy clay loam
si
sandy loam
sid
silty clay loam
Structure Grade
Structure Type
wk weak
gr
granular
M moderate
pl
platy
str strong
pr
prismatic
cpr
columnar
abk
angular blocky
sbk
subangular blocky
sg
single grained
ma
massive
Structure Size
f fine
med medium
Moist Consistencv
fr friable
vfr very friable
fi firm
vfi very firm
Seasonal High Water Table:
Depth (") Type apparent/perched)

Soil Profile Descriptions in Field Locations
Project: Synagro West. Piedmont (WQ 16247) % Slope: 3%
Site: Alan Livingood Farm Crop: Forage/Pasture
Field: RA-05 Field 2 Conducted By: GC Murray
Coordinates: 35.7064 N Date: 1/9/2020
80.6606 W Soil Series: Mecklenberg
Ul
IA
L
O
O
U
O
O
01
T f�l
S
5
PIEDMONT
ENVIRONMENTAL
ASSOCIATES. o . A .
cs rn W a (D
w N 1- y
G1 0� O
UJ
m
'x N
Legend:.
Texture
s
sand
I
loam
si
slit
sil
silt loam
c
clay
cl
clay loam
scl
sandy clay loam
sl
sandy loam
sicl
silty clay loam
Structure Grade
Structure Type
wk weak
gr
granular
m moderate
pl
platy
str strong
pr
prismatic
cpr
columnar
abk
angular blocky
sbk
subangular blocky
sg
single grained
ma
massive
Structure Size
f fine
med medium
Moist Consistencv
fr friable
vfr very friable
fi firm
vfi very firm
Seasonal High Water Table:
Depth (") T e apparentlperched)
I

Sol! Profile Descriptions in Field Locations
Project: Synagro West. Piedmont (WQ 16247) % Slope: 3%
Site: Alan Livingood Farm Crop: Forage/Pasture
Field: RA-05 Field 3 Conducted By: GC Murray
Coordinates: 36.7128 N Date: 1/9/2020
-80.6892 W Soil Series: Dorian
O
O
v
O
O
c •�
U
U
O t
iC
m
T
01
ril
9
S
PIEDMONT
ENVIRONMENTAL
ASSOCIATES. P. A.
'c
=
m
t+
c
Nlu
"
❑
LUfl.
N
N
i—
d
N
m
Q
d
S
rA
m
S
i i
0
No
S
d
v
n
i
v
n
v
::.'
O
�
Legend.
Texture
s
sand
I
loam
si
silt
sil
silt loam
c
clay
cl
clay loam
scl
sandy clay loam
sl
sandy loam
sicl
silty clay loam
Structure Grade
Structure Type
wk weak
gr
granular
m moderate
pl
platy
str strong
pr
prismatic
cpr
columnar
abk
angular blocky
sbk
subangular blocky
sg
single grained
ma
massive
Structure Size
f fine
med medium
Moist Consistencv
fr friable
vfr very friable
fi firm
vfi very firm
Seasonal High Water Table:
Depth (") Type (apparent/perched
2s 1 perched

Soil Profile Descriptions in Field Locations
Project: Synagro West. Piedmont (WQ 16247) % Slope: 3%
Site: Kevin Daniels Crop: Forage/Pasture
Field: AL-16 Field 1 Conducted By: GC Murray
Coordinates: 35.9789 N Date: 1/9/2020
-81.1855 W Soil Series: Clifford
O
O
v
O
O
Y CD
M
r%
S
S
PIEDMONT
ENVIRONMENTAL
ASSOCIATES. P . A .
w
t� N
QU m a) 41 o
m m k « r o U
O O p y P 2
S S I S :� w to
��
� - � �
vaa�o
• •
���®ate
Legend.
Texture
s
sand
I
loam
si
silt
sil
silt loam
c
clay
cl
clay loam
scl
sandy clay loam
al
sandy loam
sid
silty clay loam
Structure Grade
Structure Type
wk weak
gr
granular
m moderate
p]
platy
str strong
pr
prismatic
cpr
columnar
abk
angular blocky
sbk
subangular blocky
sg
single grained
ma
massive
Structure Size
f fine
med medium
Moist Consistencv
fr friable
vfr very friable
fi firm
vfi very firm
Seasonal High Water Table:
Depth (") Type (apparent/ erched)

Soil Profile Descriptions in Field Locations
Project: Synagro West. Piedmont (WO 16247) % Slope: 3%
Site: Ray Icenhour Crop: Forage/Pasture
Field: AL-15 Field 1 Conducted By: GC Murray
Coordinates: 35.9686 N Date: 1/9/2020
-81.1777 W Soil Series: Fairview
N
�
L
O
O
v
O
O
U
U
C
C
25
!
N
y.l
L
T
P1
S
S.
PIEDMONT
ENVIRONMENTAL
ASSOCIATES. P. A.
as
m 0
c
O W G
fl N O
a in U
m x
"+
�
O
L
y
•O
L
w
�
`
N
fn
�
m
y
�
�'
a��i
•!IN
c
V
O O
N
i
i
C
Ap
0-5
10YR 4/4
-
-
-
-
moist
sl
wk
med
g r
fr
ns
np
Bt
5-11
10YR 4/8
-
-
-
-
moist
c
mod
med
sbk
fi
s
p
BC
11-48
1OR 4/8
-
-
-
-
moist
scl
mod
med
sbk
fi
s
C
11-48
1OR 4/8
-
-
-
-
moist
sl
structureless
fr
ns
np
Legend.
Texture
s
sand
I
loam
si
silt
sil
silt loam
c
clay
cl
clay loam
scl
sandy clay loam
sl
sandy loam
Sid
silty clay loam
Structure Grade
Structure Type
wk weak
gr
granular
m moderate
pl
platy
str strong
pr
prismatic
cpr
columnar
abk
angular blocky
sbk
subangufar blocky
sg
single grained
ma
massive
Structure Size
f fine
med medium
Moist Consistencv
fr friable
vfr very friable
fi firm
vfi very firm
Seasonal High Water Table:
Depth (") Type (apparent/ erched)

Soil Profile Descriptions in Field Locations
Project: Synagro West. Piedmont (WQ 16247) % Slope: 3%
Site: Ray lcenhour Crop: Forage/Pasture
Field: AI_-15 Field 2 Conducted By: GC Murray
Coordinates: 35.9742 N Date: 1/9/2020
81.1784 W Soil Series: Fairview
Legend:
Texture
s
sand
1
loam
si
silt
sil
silt loam
c
clay
cl
clay loam
scl
sandy clay loam
sl
sandy loam
sicl
silty clay loam
Structure Grade
wk weak
m moderate
str strong
Structure !me
gr
granular
pi
platy
pr
prismatic
cpr
columnar
abk
angular blocky
sbk
subangular blocky
sg
single grained
ma
massive
PIEDMONT
ENVIRONMENTAL
ASSOCIATES, P.A.
Seasonal Hi h Water Table:
Structure Size Depth (") Type apparent/perched)
f fine
med medium
Moist Consistencv
fr friable
vfr very friable
fi firm
vfi very firm

Soil Prorrle Descriptions in Field Locations
Project: Synagro West. Piedmont (WQ 16247) % Slope: 3%
Site: Ray Icenhour Crop: Forage/Pasture
Field: AL-15 Field 4 Conducted By: GC Murray
Coordinates: 35.9738 N Date: 1/9/2020
-81.1762 W Soil Series: Fairview
Legend;
Texture
s
sand
I
loam
si
silt
sil
silt loam
c
clay
cl
clay loam
scl
sandy clay loam
sl
sandy loam
sicl
silty clay loam
Structure Grade
wk weak
m moderate
str strong
Structure Type
gr
granular
pl
platy
pr
prismatic
cpr
columnar
abk
angular blocky
sbk
subangular blocky
sg
single grained
ma
massive
Structure Size
f fine
med medium
Moist Conslstencv
fr friable
vfr very friable
f firm
A very firm
PIEDMONT
ENVIRONMENTAL
ASS O C I A T G S, P. A.
Seasonal High Water Table:
Depth(") Type a arent/ erched)

State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
Dlvtslon of Watei 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 on final and two co ies of the anplication and
suppo,rting 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 .1100. Do not
submit this agreement for review without a corresponding application form (FORM: RLAP 06-16).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. La Owner Agreement (FORM: LOA 06-16):
PI Submit the completed and appropriately executed Residuals Source Certification FORM:
S
make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, atttachm attachments not
the
plication 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
A plicant. 1? by an entity other than the
[A copy of the completed and appropriately executed agreement must be provided to the landowner
and the Iessee/operator.
AGREEMENT FOR THE LAND APPLICATION OF RESIDUALS TO PRIVATELY OWNED LAND
The undersigned landowner or his representative hereby permits:
AppIicanfs name:
hereinafter
application
Agreement:
LA
referred to as the Permittee, to land apply residuals from the following facility(ies) onto the following land
site(s) (i.e., see attached setback maps) in accordance with the stipulations and restrictions as given in this
Lease Land Use or Residuals Source
Site/Field ID Special note
(yes/no) Cropping Patterns. Intended Use of Crops
(optional) (no-till/over-seed/
' q pasture)
The landowner or his representative receives, in consideration, full use of the nutrient value of the applied residuals while the
Permittee receives, in consideration, the use of the land application sites) 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
Pagel of 3

I. STIPULATIONS:
I. The landowner or his representative shall not enter into any additional residuals application contracts or agreements with another permitted
entity for the site(s) specified by this Agreement.
2. Should the landowner or his representative lease or otherwise permit the use of the land application site(s) to a third party, the landowner shall
be responsible to ensure that the third party agrees and complies with the terms and conditions of this Agreement.
3. The landowner or his representative shall adhere to the provisions of this Agreement until all of the site restrictions (under Section II) are met.
4. Notification of cancellation of this Agreement shall be immediately forwarded to NCDENR-DWR, Non -Discharge Permitting Unit, 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 p ied crop, ndicatf at ]east 6.0, unless an agronomist provides information iing that the pH of the soil, residuals and lime mixture is suitable for
the specified
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. Speck 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:
L 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 fo
month period following a residuals land application event. ra 14-
5. Food crops with harvested parts below the surface of the land shall not be harvested for a 20-month period following a residuals land
application event when the residuals remain on the land surface for four months or longer prior to incorporation into the soil.
6. Food crops with harvested parts below the surface of the land shall not be harvested for a 38-month period following a residuals land
application event when the residuals remain on the land surface for less than four months prior to incorporation into the soil.
7. Turf grown on land where residuals are applied shall not be harvested for a 12-month period following a residuals land application event.
III. ALTERNATIVES FOR WATER SUPPLY WELLS INSIDE THE COMPLIANCE BOUNDARY: (please check one)
15A NCAC 02L .0107 d
() prohibits water supply wells within the compliance boundary. However, 15A NCAC 02T 0105(h) allows the
compliance boundary to be placed closer to the waste disposal area, such that the water supply well is situated outside of the compliance
boundary provided the groundwater standards can be met at the newly -established compliance boundary. Please mark one of the following;
❑ A re -defined compliance boundary is needed for field(s) ID:
(Please include the rationale for the requested re -location of the compliance boundary and attach a map showing the newly proposed
compliance boundary to the application package)
A re -defined compliance boundary is not needed for this site.
IV. ACKNOWLEDGEMENT OF FIELD TRANSFER: (if needed)
❑ The land application field(s) ID:
residuals land application program; Permit Number WQ: is currently permitted under another
er agreement he/she is requesting that the fields) be removed from the previously permitted residuals land application ppliation progdge ram and transferred
ed
The land own
into the new program;
(Name of the new program)
FORM: LOA 06-16
Page 2 of 3

Landowner's Certification:
I certify that I am a deeded landowner of the above -referenced land application site(s) and am authorized to make decisions
regarding the use of the land application site(s) on behalf of other deeded landowners OR that I am otherwise authorized, through
a power of attorney or other legal delegation, to make decisions regarding the use of the land application site(s) on behalf of the
deeded landowners. I certify that the above -referenced land application site(s) are not included in any waste disposal contract or
agreement with another municipality, contractor, or other permitted entity. Furthermore, I certify that I have read this Agreement,
understand the stipulations, restrictions, alternatives for water supply wells inside the compliance boundary, acknowledgement of
field transfer, and do hereby grant permission to the Permittee to land apply residuals to the land application site(s) as specified
herein.
Landowner name: /t} -
CO
Address: - �{9i
City: State: f
Zip:
19 Phone: C� __ r-�v�-vl E-mail address:l5vyP� (y.yliyy;, 0
Signature: Date: aDaC�
/ A — -
NORTH CAROLINA, k >` a COUNTY
I, the undersigned Notary Public do hereby certify that �� k f I S 5
personally appeared before me this day and acknowledged the due execution of the forgoing instrument..
WITNESS my hand a official seal this the �{ Hh ,♦�`�`�,1i� rF�k ��j,�
day of fY , 20
J �•
Signature and seal:
My commission expires:
Lessee's/Operator's Certification:
by
L
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 official n �� uk / . s f" t
Signature: �� /�'- /
Date:
FORM: LOA 06-16 Page 3 of 3

APPLICATION MAP
LEGEND
APPLICATION AREA
PRIVATE ROAD
STREAM
F ►l
-X X FENCE
PROPERTY LINE
UNSUITABLE AREA
WATER
ONSITE HOUSE
OFFSITE HOUSE
OUTBUILDING
WELL
SOIL BORING
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within
in 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. All
locations are approximate.
GRAPHIC SCALE
1"=660'
660' 0 660'
NC-AL-1 3
Fields 4-5

APPLICATION MAP
LEGEND
P�7a
APPLICATION AREA
PRIVATE ROAD
STREAM
DRAIN
X * X FENCE
PROPERTY LINE
UNSUITABLE AREA
WATER
ONSITE HOUSE GRAPHIC SCALE
OFFSITE HOUSE 1" = 660'
OUTBUILDING 6fi6' 0 660'
WELL
Q
SOIL BORING
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within
in 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. All -
locations are approximate,
NC-AL-13
Field G

.5
�4
5 �S
... �
r:ts� -
ItiCTJ�• CCB
.,�y .
i
3 ri0�5�
,
Church Rd
-
17
:N�
i rc(.2 sFGU-
FcC2

�M6
SOIL SURVEY

TOPOGRAPHIC
NEAP
,
x ` �
.°Fy i--...� y)f lr"M�j wV �' * , '.i"�,{'r� x �'i•�� i'+�E, k
w - �b '`��.
IY f
.
�
��� „'^r 1
-. %:�i�.�caww.,}.�..L.�4.
ui.�" �,y�i j+1� �.cL•��
�d Y 7}�S3
f C
hip,
�✓!
_
F, n,.VIR
yam' 1-6
s
GRAPHIC SCALE
i
III = 660'
sea' a
5
660'
,
The compliance boundary is established either 250 ft from the residuals application area
or 50 feet within
N C-AL-13
in 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 arell
a. ti
locations are approximate,
Field 6

TOPOGRAPHIC MAP
GRAPHIC SCALE
1A-800'
800, 0 800,
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within NC-AL-1 3
in 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. All
locations are approximate. Fields 4-5

NCDA&CS Agronomic Division Phone:. [phone] Website: www.ncagr.goV1agronoml1
Report No:.. FY20-SL017105
Ftc•� rfc•uf•.«b� Client: Alex Fox
Advisor: Alex Fox
a'Heavy Metals Synagro
Synagro
284 Boger Rd
284 Boger Rd
Mehlich-3 Extraction
�O' [ R�pO Mocksville, NC 27028
Mocksville, NC 27028
. ;
�x+vncn+� Sampled County: Alexander
Links to Helpful Infon-mti n
Client ID: 501947
Advisor ID: 501947
Sampled: 11/14/2019' Received: 11/26/2019 compiated: 12/02/2019 Farm: A1-13/ Danny Mullins
Agronomist's Comments:
This report contains both routine soil test information as well as heavy metals data in a section labeled as Heavy Metals under soil test lab results. Using Mehlich 3 as a
soil test extractant, background levels of these metals typically seen in NC soils when analyzed are as follows: arsenic (As)- 4.5 ppm, cadmium
(Cd)- 0.1 ppm, chromium
(Cr)- 0.2 ppm, lead.(Pb)- 4.2 ppm, nickel (Ni)- 0.8 ppm, & selenium (Se)- 0.2 ppm (FY2005-2007). Although the above metals here are not believed to pose a concern for
plant growth, continue to monitor these and note where elevated above background levels. Note any lime and fertilizer recommendations. Jagathi Kamalakanthan
12/2/2019
Sample ID: 4
Recommendations: Lime Nutrients (lb/acre)
More
Crop (tons/acre) N P2O6 K2O Mg S Mn Zn
Cu B
Information
Lime History:
1-Fescue/OGrass/Tm, M 0.8 120-200 130 70 0 0 0 0
0 0
Note: 12
2- 0.0
Test Results [units - WN in glcm3; GEC and.Na in meq/100 cm3; NO3-N in mg/drr?]: Soil Class. Mineral
HM% WN CEC BS% Ac pH P-I K-1 Ca% Mg% S-1 Mn-I Mn-All Mn-Al2 Zn-I Zn-Al
Cu-I -Na ESP 88=1 NO3-N
0.09 0.97 5.0 70 1.5 5.3 6 32 42 24 89 25 32 39 39
72 0.1 2
Heavy Metals (parts per million): Arsenic, 0.1 Cadmium, 0.0 Nickel, . 0.2 Chromium; 0.3 Lead,
5.4 Selenium, OA
Sample ID: 5
Recommendations: Lime Nutrients (lb/acre)
More
Crop (tonslacre) N P2O5 K2O Mg S Mn Zn
Cu B
Information
Lime History:
1-Fescue/OGrass[Tim, M 0.0 120-200 30 0 0 0 0 0
.0 0
Note: 12
2- '0.0
Test Results [units - WN in glcff ; CEC and Na in meq/100 cm3; NO3-N in mg/drn ]: Soil Class: Mineral
HM% W!V CEC BS% Ac pH P-1 K-1 Ca% Mg% 84 Mn-I Mn-All Mn-AI2 Zn4 Zn-AI
Cu-I Na ESP SS4 NO3-N
0.18 1.01 6.5 82 1.2 6.0 45 110 49 25 110 169 118 143 143
167 0.1 2
Heavy.IVletals (parts per million): Arsenic, 0.0 Cadmium, 0.0 Nickel, 0.3 Chromium, 0.4 Lead,
3.1 Selenium, 0.2
.North Carolina
W *xo o cruse f uwd Ciu cskm
Reprogramming of the laboratory -information -management system that makes this report possible is being funded
through a grant from the North Carolina Tobacco Trust Fund Commission.
Thank you for using agronomic services to manage nutrients and safeguard environmental quality.
- Steve Troxler, Commissioner of Acidculture

NCDA&CS Agronomic Division Phone: [phone] Website: www.ncogr.gov/agronomi/ .
Report No. FY20-SLO17105
Alex Fox
Page 2 of 3
Sample ID: 6 Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tonsiacre) N P205
K20
Mg S
Mn Zn
Cu B
Information
Lime History: 1 -Fescue/OGrass/Tim, M 0.0 120-200 100
100
0 . 0
0 0
0 0
Note: 12
2-
Test Results [units - WN in g/crn3; CEC and Na in meq/100 cm3; NO3-N in mg/dm3]:
Soil Class:
Mineral
HM% WN GEC BS% Ac pH P4 K-1 Ca% Mg%
S-1 Mn-I
Mn-All Mn-AI2 Zn-I Zn-AI
Cu-1 Na ESP SS-1 NO3-N
0.32 1.14 5.0 86 0.7 6.3 16 20 58 26
57 229
149
95 95
110 0.1 2
Heavy Metals (parts per million): Arsenic, 0.1 Cadmium, 0.1
Nickel, 0.3
Chromium, 0.4
Lead,
3.4 Selenium, 0.0

NCDA&CS Agronomic Division Phone: [phone] Website: www.ncagr.gov/agronomcl
Report No. FY20-SLO17105
Alex Fox
Understanding the Soil Report: explanation of measurements, abbreviations and units
Recommendations
Lime
If testing finds that soil pH is too low for the crop(s) indicated, a lime recommendation will be given in units of either
ton/acre or Ib/1000 sq ft. For best results, mix the lime into the top 6 to 8 inches of soil several months before planting.
For no -till or established plantings where this is not possible, apply no more than 1 to 1.5 tonfacre (50 Ib/1000 sq ft) at
time, even if the report recommends more. You can apply the rest in similar increments every six months until the full r
is applied. If MG is recommended and lime is needed, use dolomitric lime.
Fert�L
Recommendations for Held crops or other large areas are listed separately for each nutrient to be added (in units of
lb/acre unless otherwise specifred). Recommendations for N (and sometimes for B) are based on research/field studies
for the crop being grown, not on soil test results. K-1 and P-1 values are based on test results and should be > 50. If they
are not, follow the fertilizer recommendations given. If Mg is needed and no lime is recommended, 0-0-22 (11.6% Mg) is
an excellent source; 175 to 250 [b per acre alone or in a fertilizer blend will usually satisfy crop needs, SS-1 levels appear
only on reports for greenhouse soil or problem samples.
Farmers and other commercial producers should pay special attentlon to micronutrient levels. If $, pH$, $pH, C or Z
notations appear on the soil report, refer to $Note: Secondary Nutrients and Micronutrients In general, homeowners do not
need to be concerned about micronutrients. Various crop notes also address lime fertilizer needs; visit
ncagr.gov/agronomi/pubs.htm.
Recommendations for small areas, such as home lawns/gardens, are listed in units of Ib/1000 sq ft . If you cannot find
the exact fertilizer grade recommended on the report, visit www.nca r OwliggronornilobnarM.ht ind information that
may help you choose a comparable aftemate. For more information, read A Homeowner's Guide to Fertilfzei
Test Results
The first seven values [soil class, HM%, WN, CEC, BS%, Ac and pH] describe the soil and Its degree of acidity. The
remaining 16 [P-1, K-I, Ca%, Mg%, Mn-I, Mn-All, Mn-Al2, Zn-I, Zn-AI, Cu-I, S-I, SS -I, Na, ESP, SS -I, NO3-N (not routine[
available)] indicate levels of plant nutrients or other fertility measurement. Visit '•ncaar.aov/aoronomi/uvrst htm
Page 3 of 3
Report Abbreviations
Ac
exchangeable acidity
B
boron
BS%
% CEC occupied by basic cations
Ca%
% CEC occupied by calcium
CEC
cation exchange capacity
Cu-I
copper index
ESP
exchangeable sodium percent
HM%
percent humic matter
K-I
potassium index
K2O
potash
Mg%
% CEC occupied by magnesium
MIN
mineral soil class
Mn
manganese
Mn-All
Mn-availability index for crop 1
Mn-AI2
Mn-availability index for crop 2
Mn-I
manganese index
M-O
mineral -organic soil class
N
nitrogen
Na
sodium
NO3-N
nitrate nitrogen
ORG
organic soil class
PH
current soil pH
Pd
phosphorus index
P2O6
phosphate
S-1
sulfur index
SS-1
soluble salt index
W/V
weight per volume
Zn-AI
zinc availability index
Zn-I
zinc index

State of North Carolina
Department of Environmental Quality
Division of Water Resources
'' Dtvlslon of Water Resources COUNTY BOARD NOTIFICATION
INSTRUCTIONS FOR FORM: CBN 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 Nan -Discharge Permitting Unit
General — This notification is intended to provide the county board in which the land application site is proposed to be located with
general information on the size, location and type of residuals land application proposed to occur in their county, and to give them an
opportunity to comment on the pending permitting request as stipulated in Session Law 2013-340. Notification is not required for
fields deemed permitted to receive Class A residuals under 15A NCAC 02T .1100. Do not submit this document for review
without a corresponding residuals program application form (FORM: RLAP 11-15).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. County Board Notification (FORM: CBN 11-15):
® Submit the completed and appropriately executed County Board Notification (FORM: CBN 11-15). Please do not make any
unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to the form may
be made, as long as the attachments are numbered to correspond to the section and item to which they refer.
® Prepare a separate County Board Notification (FORM: CBN 11-15) for each county in which the proposed land application
sites are located.
B. Critical Watershed Areas Information:
® Under 15A NCAC 02B .02127 no new permitted sites for land application of residuals are allowed within critical watershed
areas. It is the AppIicant's responsibility to ensure that the proposed land application sites are not located within these areas.
For more information regarding Water Supply Watershed Protection Program, please visit the Division website at:
hitps://deq.nc. aov/about/divisions/water-resources/water-resources-rules/water-sunaly-watershed-protection-program
❑ If uncertain about whether the proposed sites are located within the critical areas, contact the Division or call [phone].
C. Notification Package Submission:
❑ Complete and mail the notification letter, source facility summary, land application site summary, and site location maps to
the appropriate County Board by certified mail with a return receipt requested. It is recommended that a copy of the
notification package also be sent to the County Manager.
❑ The most current publication of the Directory of State and County Officials may be downloaded at:
hgps.-I/www.sosne.gov/t)ublications/direct.gw—X
❑ A list of the Division's regional offices, their county coverage, and their contact information may be downloaded at:
hqp://deg.nc.aov/contact/regional-offices.
❑ The source facility summary shall include: facility name; county where it is located; and the proposed annual dry tonnage
(i.e., a copy of "Residuals Source Facility Summary" is adequate but not required).
❑ The land application site summary shall include: field ID; acreage; county where it is located; latitude and longitude (i.e., a
copy of "Land Application Site Certification" is adequate but not required).
D. Proof of Submission:
❑ Attach an 8.5 by 11-inch copy of the return receipt to the back of this attachment prior to submission of the application to the
Division for review.
INSTRUCTIONS FOR FORM: CBN 06-16 Page 1 of 1

North Carolina Department of Environmental Quality
Pat McCrory Donald R. van der Vaart
Governor Secretary
]Date: 04/13/2020
Name of Chairman to the Board of County Commissioners: Ryan Ma,j� berry
Complete mailing address: 621 Liledoun Rd
City: Taylorsville State: NC Zip: 28681
County where Iand application sites are located: Alexander
From: Applicant's name: S 1nagro Western Piedmont for Statesville Waste Water (on behalf of the Division of Water
Resources in accordance with Session Law 2013-340)
Contact person and title: Alex Fox
Complete mailing address: 284 Boger rd
City: Statesville State: NC Zip: 27028MEN
Telephone number: [phone] E-mail address: [e-mail]
Subject: Notification of residual land application site proposal
This is to notify you that the Applicant listed above will be submitting an application to the Division of Water
Resources for the land application of residual solids to site(s) located in your county. During this review, the Division
will ensure that all federal and state regulations are enforced. Attached to this form is information regarding residuals -
generating sources and locations of the proposed land application sites. Please forward this letter and its associated
attachments to the appropriate Department within your County (i.e., Health or Environmental Health Department and
Planning Department) if applicable.
More information of the land application sites included in this application will be available at the following
Division of Water Resources Regional Office:
Name of appropriate regional office: Mooresville Regional Office
Complete mailing address: 610 East Center Avenue Suite 301
City: Mooresville State: NC Zip: 28115
Telephone number: (704-235-2184)
Expected date of application submission: 04/15/2020
Should you desire to comment on this application, please do so no later than 30 calendar days following the
expected application submission date. If you have any questions or comments about this notification, or if you would like
more information, please contact the appropriate regional office at the telephone number provided above. Thank you in
advance for your attention to this matter.
Enclosures: Source Facility Summary
Land Application Site Summary
Maps
Non -Discharge Permitting Unit
1617 Mail Service Center, Raleigh, North Carolina 27699.1617
Phone: [phone]Internet: httn:!/eorlal.ncdenrorR/w_eb
An Equal Opportunity 4 Affirmative Action Employer — Made In part with recycled paper FORM: CBN 06-16

Alex Fox
From: UPS Quantum View <[e-mail]>
Sent: Tuesday, April 14, 2020 9:14 AM
To: Alex Fox
Subject: UPS Delivery Notification, Tracking Number 1Z51 F78W0101154909
Hello, your package has been delivered.
Scheduled Delivery. Date: Tuesday, 04/14/2020
Estimated Delivery Time: End Of Day
Left At: ' INSIDE DLIV
Signed by: LINDA
SYNAGRO - MOCKSVILLE
INSIDE DELIV
Tracking Number:
Ship To:
Number of Packages:
UPS Service:
Package Weight:
Reference Number:
Q Download.the UPS mobile ano
IZSIF78WO1011549Q9
621 LILEDOUN: RD
TAYLORSVILLE; NC 28681
US
0
UPS Next Day Air@
0.05 LBS
20-2360-30-60-4310 50-0055
0
@ 2020 United Parcel Service of America, Inc. UPS, the UPS brandmark, and. the color brown are
trademarks of United Parcel Service of America, Inc. All rights reserved.
All trademarks, trade names, or service marks that appear in connection with UPS's services are the
property of their respective owners.
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Please do not reply directly to this email. UPS will not recelve any reply message.
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A

Department of Environmental Quality
- Division of Water Resources
`IDlvlslon of Water Resources 15A NCAC 02T .1100 —LAND OWNER AGREEMENT
FORM: LOA 06-16
Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted the Applicant shall submit one original and two 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 .1100. Do not'
submit this agreement for review without a corresponding application form (FORM: RLAP 06-16).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Land Owner Agreement (FORM; LOA 06-16):
Ee'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
fer.
I� Prepare a separate agreement for each set of land applications sites that are owned or operated by an entity other than the
pplicant.
A copy of the completed and appropriately executed agreement must be provided to the landowner and the lessee/operator.
AGREEMENT FOR TIM LAND APPLICATION OF RESIDUALS TO PRIVATELY OWNED LAND
The undersigned landowner or his representative hereby permits:
Applicant's name:
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)
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 I of 3

Landowner's Certification:
I certify that I am a deeded landowner of the above -referenced land application site(s) and am authorized to make decisions
regarding the use of the land application site(s) on behalf of other deeded landowners OR that I am otherwise authorized, through
a power of attorney or other legal delegation, to make decisions regarding the use of the land application site(s) on behalf of the
deeded landowners. I certify that the above -referenced land application site(s) are not included: in any waste disposal contract or
agreement with another municipality, contractor, or other permitted entity. Furthermore, I certify that I have read this Agreement,
understand the stipulations, restrictions, alternatives for water supply wells inside the compliance boundary, acknowledgement of
field transfer, and do hereby grant permission to the Permittee to land apply residuals to the land application site(s) as specified
herein.
Landowner name:
Address:
City: i
Phone: —
Signature:
State: - oele Zip:
E-mail
NORTH CAROLINA, , , r� COUNTY
I, the undersigned Notary Public do hereby certify that Ar y AAA T$1 ,� r
personally appeared before me this day and acknowledged the due execution of the forgoing instrument.
WITNESS my hand and official seal this the
q Try
day of O 40 if 520 f
r
Signature and seal: %� ,Z�r
My commission expires: r 2,0
Lessee's/Operator's Certification: � olCO'','`�
I certify that I have read this A ement and do ere by agree to abide by the stipulations and restrictions as specified herein.
Lessee/operator name: 0
Address: t i/
City: State• (�
Zip:
Phone: ' ,G— E-mail address:
Signature: Date:
Permittee's Certification:
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Signing official nam�e:/ 14skr IV /<p jj
Signature: `�%R�"� _
Date:
/1
FORM: LOA 06-16 Page 3 of 3

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NCDA&CS Agronomic Division ' Phone: [phone] Website: www.ncagr.gov/agronomi.f.Keport No. r T cu-JLvcGu P<
Client: Icenhour Poultry & Beef/Ray Advisor: Melvin Goad
Heavy Metals 411 Jolly Cemetary Rd Synagro
Taylorsville, NC 28681 284 Boger Rd
M Mocksville, NC 27028
hs 1 Mehlich-3 Extraction
Soil i I Report
Sampled County: Alexander
4,
Itn"i1` Links to Helpful Information
Client ID: 353745 Advisor ID: 404711
sampled:12117/2019 Received: 01/15/2020 Completed: 01/21/2020 Fann;
Agronomist's Comments:
This report contains both routine soil test information as well as heavy metals data in a section labeled as Heavy Metals under soil test lab results. Using Mehlich 3 as a
soil test extraetant, background levels of these metals typically seen in NC soils when analyzed are as follows: arsenic (As)- 4.5 ppm, cadmium (Cd)- 0.1 ppm, chromium
(Cr)- 0.2 ppm, lead (Pb)- 4.2 ppm, nickel (Ni)- 0.8 ppm, & selenium (Se)- 0.2 ppm (FY2005-2007). Note elevated lead (Pb) in 2 and 3 samples. Although the above metals
here are not believed to pose a concern for plant growth, continue to monitor these and note where elevated above background levels. Note any lime and fertilizer
recommendations. Where soil test phosphorus P is ve high P-1 > 100 crops will not respond to additional P applied. Jaciathi Kamalakanthan 1/1712020
Sample ID: 1
Recommendations: Lime Nutrients (lb/acre)
More
Crop (tons/acre) N P2Oe K2O Mg S Mn Zn Cu B
Information
Lime History:
1 -Corn, grain 0.4 120 -160 0 0 0 0 0 0 0 0
Note: 3
2- 0.0
Test Results [units - W/V in g/cd; CEC and Na in meq/100 cd; NO3-N in mgldd]: Soil Class: Mineral
HM% W/V CEC BS% Ac pH P-1 K-1 Ca% Mg% S-1 Mn-I Mn-All Mn-AI2 Zn-I Zn-AI Cu-I Na ESP SS4 NO3-N
0.51 1.12 5.5 77 1.2 5.7 94 110 50 17 42 309 202 224 224 249 0.1 2
Heavy Metals (parts: per million): Arsenic,. 0.0 Cadmium, 0.1 Nickel, 0.7' Chromium, .0.3 Lead, 4.7 Selenium, 0.1
Sample ID: 2 Recommendations: Lime Nutrients (lb/acre) More
Crop (tonsfacre) N P2O6 K2O Mg S Mn Zn Cu B Information
Lime History: 1 -Corn, grain 0.0 120 -160 0 0 0- 0 0 0 0 0 Note: 3
2- 0.0
Test Results [units - W[V in g/cni ; CEC and Na in meq/100 cm3; NO3-N in mgldm3]: Soil Class: Mineral
HM% WN CEC BS% Ac pH P-1 K4 Ca% Mg% S-1 Mn-I Mn-All Mn-AI2 Zn-I Zn-AI Cu-I Na ESP SS -I NO3-N
0.81 1.01 10.3 89 1.1 6.1 388 280 55 21 42 294 192 793 793 665 0.2 2
Heavy Metals (parts per. million): Arsenic, 0.1 Cadmium, 0.1 Nickel,. 1.0 Chromium, 0.2 Lead, 6.2 Selenium, 0.0
North Carolina
Yot+.iccoTTu%c fund Ctwiti goon
Reprogramming of the laboratory -information -management system that makes this report possible is being funded
through a grant from the North Carolina Tobacco Trust Fund Commission.
Thank you for using agronomic services to manage nutrients and safeguard environmental quality.
- Steve Troxler, Commissioner of A.priculture

NCDA&CS Agronomic Division- Phone: [phone] Websita: www.ncagr.gov/agroh6mi/*
Report No. FY20-SLO22012
Page 2 of 3
Sample ID: 3
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tonstacre) N P206
K20
Mg S Mn
Zn
Cu B
Information
Lime History:
1 -Corn, grain 0.4 120 - 160 0
0
0 0 0
0
0 0
Note: 3
2 - 0.0
Test Results [units -W1V in g/cm3; CEC and Na in meq/100 cm3; NO3-N In mgldm3 :
Soil Class: Mineral
HM% W/V CEC BS% Ac pH P-1 K-1 Ca% Mg%
S-I Mn4
Mn-A11, Mn-Al2 Zn4
Zn AI
Cu-I Na • ESP SS -I NO3-N
0.51 0.88 8.7 85 1.3 5.7 235 180 51 23
47 309
202 540
540
485 0.1 1
Heavy. Metals.(parts per million): Arsenic, 0.1 Cadmium, 0.0
Nickel, 0.7
Chromium, 0.2
Lead,
8.3 Selenium, 0.1

NCDA&C•S Agronomic Division Phone:. (919) 733=2655 Website:. www.ncagr.gov/agronomi/
Report No. FY20-SL022012-
Page 3 of 3
Understanding the Soil Report: explanation of measurements, abbreviations and units
Recommendations
Report Abbreviations
Lime
Ac
exchangeable acidity
If testing finds that soil pH is too low for the crop(s) indicated, a lime recommendation will be given in units of either
B
boron
ton/acre or Ib/1000 sq ft. For best results, mix the lime into the top 6 to 8 inches of soil several months before planting.
BS%
% CEC occupied by basic cations
For no -till or established plantings where this is not possible, apply no more than 1 to 1.5 tonfacre (50 Ib/1000 sq ft) at on
Ca%
% CEC occupied by calcium
time, even if the report recommends.more. You can apply the rest in similar increments every six months until the full rate
CEC
cation exchange capacity
is applied. -If MG is recommended and lime is needed, use dolomitric lime.
Cu-I
copper index
ESP
exchangeable sodium percent
Fertilizer
HM%
percent humic matter
Recommendations for field crops or other large areas are listed separately for each nutrient to be added (in units of
K4
potassium index
lb/acre unless otherwise specified). Recommendations for N (and sometimes for B) are based on research/field studies
K20
potash
for the crop being grown, not on soil test results. K-1 and P-1 values are based on test results and should be > 50. If they
Mg%
% CEC occupied by magnesium
are not, follow the fertilizer recommendations given. If Mg is needed and no lithe is recommended, 0-0-22 (11.5% Mg) is
MIN
mineral soil class
an excellent source; 175 to 250 lb per acre alone or In a fertilizer blend will usually satisfy crop needs, SS -I levels appear
Mn
Mn-AI1
manganese
Mn-availability index for crop 1
only on reports for greenhouse soil or problem samples.
Mn-Al2
Mn-availability index for crop 2
Mn-I
manganese index
Farmers and other commercial producers should pay special attention to micronuf ent levels. If $, pH$, $pH, C or Z
M-O
mineral -organic soil class
notations appear on the soil report, refer to $Note: Secondary NuM' ats anUlVljr-oputrients. In general, homeowners do not
N
nitrogen
need to be concerned about micronutrients. Various crop notes also address lime fertilizer needs; visit
Na
sodium
ncagr.gov/agronomi/pubs.htm.
NO3-N
nitrate nitrogen
ORO
organic soil class
Recommendations for small areas, such as home lawnstgardens, are listed in units of 1b/1000 sq ft. If you cannot find
pH
current soil pH
the exact fertilizer grade recommended on the report, visit wwwncaor aov1aaronomi1obnart4.hfrr ind information that
P-I
phosphorus index
may help you choose a comparable alternate. For more information, read A Homeowner's Guide to Fertilizer.
P206
phosphate
S-I
sulfur index
Test Results
SS-1
soluble salt index
WN
weight per volume
The first seven values [soil class, HM%, WN, CEC, BS%, Ac and pH] describe the soil and its degree of acidity. The
Zn-AI
Zn-!
zinc availability index
zinc index
remaining 16 [P-I, K-I, Ca%, Mg%, Mn-I, Mn-All, Mn-AI2, Zn-I, Zn-AI, Cu-I, S-1, SS -I, Na, ESP, SS -I, NO3-N (not routine)
available)] indicate levels of plant nutrients or other fertility measurement Visit www•ncaarygov/acrronomiluvrst.htm

State of North Carolina
Divlslon of Water it
Department of Environmental Quality
Division of Water Resources
COUNTY BOARD NOTIFICATION
INSTRUCTIONS FOR FORM: CBN 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 notification is intended to provide the county board in which the land application site is proposed to be located with
general information on the size, location and type of residuals land application proposed to occur in their county, and to give them an
opportunity to comment on the pending permitting request as stipulated in Session Law 2013-340. Notification is not required for
fields deemed permitted to receive Class A residuals under 15A NCAC 02T .1100. Do not submit this document for review
without a corresponding residuals program application form (FORM: RLAP 11-15).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. County Board Notification (FORM: CBN 11-15):
M Submit the completed and appropriately executed County Board Notification (FORM: CBN 11-15). Please do not make any
unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to the form may
be made, as long as the attachments are numbered to correspond to the section and item to which they refer.
® Prepare a separate County Board Notification (FORM: CBN 11-15) for each county in which the proposed land application
sites are located.
B. Critical Watershed Areas Information:
® Under 15A NCAC 02B .0212, no new permitted sites for land application of residuals are allowed within critical watershed
areas. It is the Applicant's responsibility to ensure that the proposed land application sites are not located within these areas.
® For more information regarding Water Supply Watershed Protection Program, please visit the Division website at:
hns;//dea nc gov/about/divisions/water-resources/water-resources-rules/water-supply-watershed-protection-oroeram
❑ If uncertain about whether the proposed sites are located within the critical areas, contact the Division or call [phone].
C. Notification Package Submission:
❑ Complete and mail the notification letter, source facility summary, land application site summary, and site location maps to
the appropriate County Board by certified mail with a return receipt requested. It is recommended that a copy of the
notification package also be sent to the County Manager.
❑ The most current publication of the Directory of State and County Officials may be downloaded at:
hops://www.sosnc.goy/Rublications/direct.Wx
❑ A list of the Division's regional offices, their county coverage, and their contact information may be downloaded at:
ho://dN.nc.gov/contact/reaional-offices.
❑ The source facility summary shall include: facility name; county where it is located; and the proposed annual dry tonnage
(i.e., a copy of "Residuals Source Facility Summary" is adequate but not required).
❑ The land application site summary shall include: field ID; acreage; county where it is located; latitude and longitude (i.e., a
copy of "Land Application Site Certification" is adequate but not required).
D. Proof of Submission:
❑ Attach an 8.5 by I Much copy of the return receipt to the back of this attachment prior to submission of the application to the
Division for review.
INSTRUCTIONS FOR FORM: CBN 06-16 Page I of 1

North Carolina Department of Environmental Quality
Pat McCrory Donald R. van der Vaart
Governor Secretary
Date: 04/13/2020
Name of Chairman to the Board of County Commissioners: Ryan Mayberry
Complete mailing address: 621 Liledoun Rd
City: Taylorsville
State: NC Zip: 28681
County where land application sites are located: Alexander
From: Applicant's name: Synagro Western Piedmont for Statesville Waste Water (on behalf of the Division of Water
Resources in accordance with Session Law 2013-340)
Contact person and title: Alex Fox
Complete mailing address: 284 Boger rd
City: Statesville State: NC Zip: V028-
Telephone number: [phone] E-mail address: [e-mail]
Subject: Notification of residual Iand application site proposal
This is to notify you that the Applicant listed above will be submitting an application to the Division of Water
Resources for the land application of residual solids to site(s) located in your county. During this review, the Division
will ensure that all federal and state regulations are enforced. Attached to this form is information regarding residuals -
generating sources and locations of the proposed land application sites. Please forward this letter and its associated
attachments to the appropriate Department within your County (i.e., Health or Environmental Health Department and
Planning Department) if applicable.
More information of the land application sites included in this application will be available at the following
Division of Water Resources Regional Office:
Name of appropriate regional office: Mooresville Regional Office
Complete mailing address: 610 East Center Avenue Suite 301
City: Mooresville
State: NC
Telephone number: (704-23572184)
Expected date of application submission: 04/15/2020
Zip: 28115
Should you desire to comment on this application, please do so no later than 30 calendar days following the
expected application submission date. If you have any .questions or comments about this notification, or if you would like
more information, please contact the appropriate regional office at the telephone number provided above. Thank you in
advance for your attention to this matter.
Enclosures: Source Facility Summary
Land Application Site Summary
Maps
Non -Discharge Permitting Unit
1617 Mall Service center, Raleigh. North Carolina 27699.1617
Phone: 91M07-64641Internet h1to:11wrtaI.ncdenr.orxt ebtwa
An Equal Opportunity t Affirmative Action Employer - Made in part with recycled paper
FORM: CBN 06-16

Alex Fox
From: UPS Quantum View <[e-mail]>
Sent: Tuesday, April 14, 2020 9:14 AM
To: Alex Fox
Subject: UPS Delivery Notification, Tracking Number 1Z51F78W0101154909
Hello; your package has been delivered.
Scheduled Delivery Date: Tuesday, 04/14/2020
Estimated Delivery Time: End Of Day
Left At: INSIDE DELIV
Signed' by: LINDA
SYNAGRO - MOCKSVILLE
INSIDE DELIV
Tracking Number:
Ship To:
Number of Packages;
UPS Service:
Package Weight;
Reference Number:
0 Download the UPS motile p
1251F78W0101154909
621 LILEDOUN RD
TAYLORSVILLE; NC 28681
US
0
UPS Next Day Air@
0.05 LBS
20-2360-30-60-4310 50-0055
@ 2020 United Parcel Service of America, Inc. UPS, the UPS bmndmark, and the color brown are
trademarks of United Parcel Service of America, Inc. All rlghts reserved.
All.trademarks, trade. names, or service marks that appear in connection with UPS's services are the
property of their respective owners.
1

Please do not reply directly to this email. UPS will not receive any reply message.
Review the UPS Prnracy Notice
For questions, Visit Our Hilo and Support Center
IN

Department of Environmental Quality
Division of Water Resources
Dlvlslon of Water Resources
15A NCAC 02T .1100 — LAND OWNER AGREEMENT
FORM: LOA 06-16
Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted, the Applicant shall submit one original and two 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 .1100. Do not
submit this agreement for review without a corresponding application form (FORM: RLA.1' 06-16).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Land Owner Agreement (FORM: LOA 06-16):
Submit the completed and appropriately executed Land Application Site Certification (FORM: LASC 06-16) form, Please
do not make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments
to the application may be made, as long as the attachments are numbered to correspond to the section and item to which they
Pfer.
repare a separate agreement for each set of land application sites that are owned or operated by an entity other than the
A licant.
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: —:SvA%m Vti hr& rAen
hereinafter referred to as the Permittee, to land apply residuals from the following facility(ies) onto the following Iand
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)
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

Landowner's Certification:
I certify that I am a deeded landowner of the above -referenced land application site(s) and am authorized to make decisions
regarding the use of the land application site(s) on behalf of other deeded landowners OR that I am otherwise authorized, through
a power of attorney or other legal delegation, to make decisions regarding the use of the land application site(s) on behalf of the
deeded landowners. I certify that the above -referenced land application site(s) are not included in any waste disposal contract or
agreement with another municipality, contractor, or other permitted entity. Furthermore, I certify that I have read this Agreement,
understand the stipulations, restrictions, alternatives for water supply wells inside the compliance boundary, acknowledgement of
field transfer, and do hereby grant permission to the Permittee to land apply residuals to the land application site(s) as specified
herein.
Landowner name.
Address: yZ i Z_l ...j
City: _ l State: Zip: u a? i
Phone:'3 ar r ctire� E-mail address: C
Signature: )) Date: Z —
NORTH CAROLINA, �M X tR 4#_ COUNTY
I, the undersigned Notary Public do hereby certify that k-f ✓t%1. �� 44 [ s
personally appeared before me this day and acknowledged the due execution of the forgoing instrument. t`1111l1d8�i
WITNESS my hand and official seal this the 3�� Ma� t
day of
Signature and seal:
My commission expires: Or,� i Z Z
Lessee's/Operator's Certification:
H
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 official nape,,o � e_r- � • � � ;
Signature: _ _ _ Date:
FORM: LOA 06-16 Page 3 of 3

PRIVATE ROAD
STREAM
DRAIN
X X X FENCE
PROPERTY LINE
APPLICATION MAP
LEGEND
P77a
UNSUITABLE AREA
WATER
ONSITE HOUSE GRAPHIC SCALE
OFFSITE HOUSE 111 - 660'
OUTBUILDING ssa o sso'
1
WELL
SOIL BORING
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within
in 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. All
locations are approximate,
Z[ffall aR$
Field 1

"
.'
€. ,.
`'•"�'
Vic.^._'j
'
'
1 j
FsE2',
r {
r�,0.
t
a
't
tF
Zv1 •y
!
yyF�b

V
TOPOGRAPHIC MAP
GRAPHIC SCALE
1 It
= 800'
NO, 0 800,
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within N C-AL-16
in 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. All
locations are approximate. Field 1

NCDABCS Agronomic Division Phone: [phone] Website: www.ncagr.gov/agronami Report No. FY20-SLO22014
Client: Kevin Daniels Advisor: Alex Fox
Heavy Metals 1128 Braswell Rd. Synagro
' Goldsboro, NC 27530 284 Boger Rd
} Soil Report Mehlich-3 Extraction Mocksville, NC 27026
Sampled County: Alexander
Links to Helpful Information
Client ID: 383574 Advisor ID: 501947
Sampled: 12/1712019 Received: 01/15/2020 Completed: 01121/2020 Farm:
Agronomist's Comments:
This report contains both routine soil test information as well as heavy metals data in a section labeled as Heavy Metals under soil test lab results. Using Mehlich 3 as a
soil test extractant, background levels of these metals typically seen in NC soils when analyzed are as follows: arsenic (As)- 4.5 ppm, cadmium (Cd)- 0.1 ppm, chromium
(Cr)- 0.2 ppm, lead (Pb)- 4.2 ppm, nickel (Ni)- 0.8 ppm, & selenium (Se)- 0.2 ppm (FY2005-2007). Note elevated lead (Pb) in the sample. Although the above metals here
are not believed to pose a concern for plant growth, continue to monitor these and note where elevated above background levels. Note any lime and fertilizer
recommendations. Where soil test phosphorus P is very high P-1 > 100), crops will not respond to additional P applied. Ja athi Kamalakanthan 1/17/2020
Sample ID: 1
Recommendations: Lime Nutrients (lb/acre)
More
Crop (tonsfacre) N P205 K20 Mg S Mn Zn Cu B
Information
Lime History:
1- Fescue/OGrass/Tim, M 0.0 120-200 0 0 0 0 0 0 0 0
Note: 12
2 - o.a
Test Results [units - WN in g/cnr ; CEC and Na In meq/100 cm3; NO3-N in mg/dm3]: Soli Class: Mineral
HM% Will CEC BS% Ac pH P-1 K-I Ca% Mg% S-1 Mn-I Mn-All Mn-Al2 Zn-1 Zn-Al Cu-I Na ESP SS-1 NO3-N
0.60 1.07 9.3 87 1.2 5.9 403 102 66 16 34 221 150 804 804 624 0.1 1
Heavy Metals (parts per•milllon): Arsenic, 0.1 Cadmium, 0.1 Nickel, Ob Chromium; . 0.2 Lead, 6.7 Selbnlium, .0.0
North Carolina
Tobicrd Trust Fum l Cemm6s-Moan
Reprogramming of the laboratory -information -management system that makes this report possible is being funded
through a grant from the North Carolina Tobacco Trust Fund Commission.
Thank you for using agronomic services to manage nutrients and safeguard environmental quality.
- Steve Troxier. Commissioner ofAAriculture

NCDA&CS•Agrbnomic Division Phone: [phone] .. Website: www.ncagr.govlagronomil
ReportNo. FY20-SL022014
Kevin Daniels
Page 2 of 2
Understanding the Soil Report: explanation of measurements, abbreviations and units
Recommendations
Report Abbreviations
Lime
Ac
exchangeable acidity
If testing finds that soil pH is too low for the crop(s) indicated, a 1/me recommendation will be given in units of either
13
boron
ton/acre or Ib/1000 sq ft. For best results, mix the lime into the top 6 to 8 inches of soil several months before planting.
BS%
% CEC occupied by basic cations
For no -till or established plantings where this is not possible, apply no more than 1 to 1.5 ton/acre (50 lb/1000 sq ft) at on
Ca%
% CEC occupied by calcium
time, even if the report recommends more. You can apply the rest in similar increments every six months until the full rate
CEC
cation exchange capacity
Is applied. If MG is recommended and lime is needed, use dolomitric lime.
Cu4
copper Index
ESP
exchangeable sodium percent
Fertilizer
HM%
percent humic matter
Recommendations for field crops or other large areas are listed separately for each nutrient to be added (in units of
K-1
potassium index
lb/acre unless otherwise specified). Recommendations for N (and sometimes for B) are based on research/field studies
K20
potash
for the crop being grown, not on soil test results. K-1 and P-1 values are based on test results and should be > 60. If they
Mg%
% CEC occupied by magnesium
are not, follow the fertilizer. recommendations given. If Mg is needed and no lime is recommended, 0-0-22 (11.5% Mg) is
MIN
mineral soil class
an excellent source; 175 to 250 lb per acre alone or in a fertilizer blend will usually satisfy crop needs, SS-1 levels appear
Mn
manganese
only on reports for greenhouse soil or problem samples.
Mn-All
Mn-availability index for crop 1
Mn-AI2
Mn-availability Index for crop 2
Farmers and other commercial producers should pay special attention to mlcronutrlenE levels. If $, pH$, $pH, C or Z
manganese index
notations appear on the soil report, refer to Mote: secondary Nutrients and Micronutdants In general, homeowners do not
M-o
N
mineral -organic sal class
nitrogen
need to be concerned about micronutrients. Various crop notes also address lime fertilizer needs; visit
ncagr.gov/agronomi/pubs.htm.
Na
sodium
NOa-N
nitrate nitrogen
ORG
organic soil class
Recommendations for small areas, such as home lawns/gardens, are listed in units of lb/1000 sq ft. If you cannot find
pH
current soil pH
the exact fertilizer grade recommended on the report, visit www.nca r. ov/a ronomi/o6 art4.h and information that
P-I
phosphorus index
may help you choose a comparable alternate. For more information, read A Homeowner's Guide to Fertilizer.
P205
phosphate
S-1
sulfur index
Test Results
SS-1
soluble salt index
WN
weight per volume
The first seven values [soil class, HM%, W/V, CEC, BS%, Ac and pH] describe the soil and its degree of acidity. The
Zn-AI
zinc availability Index
remaining 16 [P-1, K-1, Ca%, Mg%, Mn-I, Mn-All, Mn-AI2, Zn-I, Zn-AI, Cu-I, S-1, SS-1, Na, ESP, SS -I, NO3-N (not routinel
Z"-I
zinc index
available)] indicate levels of plant nutrients or other fertility measurement. Visit www.ncaar aovlaaronomilbyrst.htm

State of North Carolina
Department of Environmental Quality
W.
Division of Water Resources
R
Dlvlslon of Water Resources COUNTY BOARD NOTIFICATION
INSTRUCTIONS FOR FORM: CBN 06-16
Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted, the Applicant shall submit one original and two conies of the application and
supporting documentation
For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting Unit
General — This notification is intended to provide the county board in which the land application site is proposed to be located with
general information on the size, location and type of residuals land application proposed to occur in their county, and to give them an
opportunity to comment on the pending permitting request as stipulated in Session Law 2013-340. Notification is not required for
fields deemed permitted to receive Class A residuals under 15A NCAC 02T .1100. Do not submit this document for review
without a corresponding residuals program application form (FORM: RLAP 11-15).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. County Board Notification (FORM: CBN 11-15):
® Submit the completed and appropriately executed County Board Notification (FORM: CBN I I-15). Please do not make any
unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to the form may
be made, as long as the attachments are numbered to correspond to the section and item to which they refer.
® Prepare a separate County Board Notification (FORM: CBN 11-15) for each county in which the proposed laud application
sites are located.
B. Critical Watershed Areas Information:
® Under 15A NCAC 02B .0212, no new permitted sites for land application of residuals are allowed within critical watershed
areas. It is the Applicant's responsibility to ensure that the proposed land application sites are not located within these areas.
® For more information regarding Water Supply Watershed Protection Program, please visit the Division website at:
bttps:Hdeg.nc.aoy/about/divisions/water-resources/water-resources-rules/water-supply-watershed-protection-program
❑ If uncertain about whether the proposed sites are located within the critical areas, contact the Division or call [phone].
C. Notification Package Submission:
❑ Complete and mail the notification letter, source facility summary, land application site summary, and site location maps to
the appropriate County Board by certified mail with a return receipt requested. It is recommended that a copy of the
notification package also be sent to the County Manager.
❑ The most current publication of the Directory of State and County Officials may be downloaded at:
hqps://www.sosne.goy/publicatio.ns/direct.@5px
❑ A list of the Division's regional offices, their county coverage, and their contact .information may be downloaded at:
htM://deg.nc.gov/contact/regional-offices.
[] The source facility summary shall include: facility name; county where it is located; and the proposed annual dry tonnage
(i.e., a copy of "Residuals Source Facility Summary" is adequate but not required).
❑ The land application site summary shall include: field ID; acreage; county where it is located; latitude and longitude (i.e., a
copy of "Land Application Site Certification" is adequate but not required).
D. Proof of Submission:
❑ Attach an 8.5 by I 1-inch copy of the return receipt to the back of this attachment prior to submission of the application to the
Division for review.
INSTRUCTIONS FOR FORM: CBN 06-16 Page 1 of 1

North Carolina Department of Environmental Quality
Pat McCrory Donald R. van der Vaart
Governor Secretary
Date: 04/13/2020
Name of Chairman to the Board of County Commissioners: Ryan Mayberry
Complete mailing address: 621 Liledoun Rd
City: Taylorsville State: NC Zip: 28681
County where land application sites are located: Alexander
From: AppIicant's name: Synagro Western Piedmont for Statesville Waste Water (on behalf of the Division of Water
Resources in accordance with Session Law 2013-340)
Contact person and title: Alex Fox
Complete mailing address: 284 Boger rd
City: Statesville
Telephone number: 336) 703-8681
State: NC Zip: 27028El
-
Email address: [e-mail]
Subject: Notification of residual land application site proposal
This is to notify you that the Applicant listed above will be submitting an application to the Division of Water
Resources for the land application of residual solids to site(s) located in your county. During this review, the Division
will ensure that all federal and state regulations are enforced. Attached to this form is information regarding residuals -
generating sources and locations of the proposed land application sites. Please forward this letter and its associated
attachments to the appropriate Department within your County (i.e., Health or Environmental Health Department and
Planning Department) if applicable.
More information of the land application sites included in this application will be available at the following
Division of Water Resources Regional Office:
Name of appropriate regional office: Mooresville Regional Office
Complete mailing address: 610 East Center Avenue Suite 301
City: Mooresville
State: NC Zip: 28115
Telephone number: (704-235-2184)
Expected date of application submission: 04/15/2020
Should you desire to comment on this application, please do so no later than 30 calendar days following the
expected application submission date. If you have any questions or comments about this notification, or if you would like
more information, please contact the appropriate regional office at the telephone number provided above. Thank you in
advance for your attention to this matter.
Enclosures: Source Facility Summary
Land Application Site Summary
Maps
Non -Discharge Permitting Unit
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Phone: [phone] Internet httD:lloortat.ncdenr.orglweblwg -
An Equal Opportunity 1AffmrativeActbn Employer— Made in pwt%ith recycled paper
FORMl : CBN 06-16

Alex Fox
From: UPS Quantum View <[e-mail]>
Sent: Tuesday, April 14, 2020 9:14 AM
To: Alex Fox
Subject: UPS Delivery Notification, Tracking Number 1Z51 F78W0101154909
Hello, your package has been delivered.
Scheduled Delivery Date: Tuesday, 04/14/2020
Estimated Delivery Time: End Of, Day
Left At: INSIDE DELIV
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INSIDE DELIV
Tracking Number:
Ship To:
Number of Packages:
UPS Service:
Package Weight:
Reference Number:
Q Download the UPS mobile aon
=51 F78=10 11 54909
621 LILEDOUN RD
TAYLORSVILLE, NC 28681
US
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20-2360-30-60-4310 50-0055-
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19

W 7"
Dlvlslon 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 .1100. Do not
submit this agreement for review without a corresponding application form (FORM: RLAP 06-16).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Land Owner Agreement (FORM: LOA 06-I6):
Q�<ubmit 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.
0/4repare a separate agreement for each set of land application sites that are owned or operated by an entity other than the
[A plicant.
copy of the completed and appropriately executed agreement must be provided to the Iandowner and the lessee/operator.
AGREEMENT FOR THE LAND APPLICATION OF RESIDUALS TO PRIVATELY OWNED LAND
The undersigned landowner or his representative hereby permits:
AppIicanfs name: ,,
hereinafter referred to as the Permittee, to land apply residuals from the following facility(ies) onto the following Iand
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
(yeslno)
Land Use or
Cropping Patterns
Intended Use of Crops
ua Residls Source
(options!)
Special note
(no-till/over-seedl
pasture)
Q'03 -;3 4r
o
J�4/cro
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
Pagel 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 thud 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-I636.
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 .0I07(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
cojnpliance 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 ffeld(s) ID: is currently permitted under another
residuals land application program; Permit Number WQ: The land owner hereby acknowledge that by signing this
agreement, he/she is requesting that the field(s) be removed from the previously permitted residuals land application program and transferred
into the new program;
(Name of the new program)
FORM: LOA 06-16 Page 2 of 3

Landowner's Certification:
I certify that I am a deeded landowner of the above -referenced land application site(s) and am authorized to make decisions
regarding the use of the land application site(s) on behalf of other deeded landowners OR that I am otherwise authorized, through
a power of attorney or other legal delegation, to make decisions regarding the use of the land application site(s) on behalf of the
deeded Iandowners. 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 Permitteeto land apply residuals to the land application site(s) as specified
herein.
Landowner name: ra,T f i C/: Nee/ 5 T4%n
Address:
City: ele9,io0 ra I1 S State: zip:
Phone: ��g _ V� I E-mail address: AQr,, -f i'ck! 01 e-V 72
Signature: . p� Date: z (0 2�
NORTH CAROLINA, l �,i� COUNTY —
I, the undersigned Notary Public do hereby certify thatojr�et- (
personally appeared before me this day and acknowledged the due execution of the forgoing instrument.
WITNESS my hand and official seal this the
day of .e 320 Z-J j►
Signature and seal: : „�
w
My commission expires: Q) J
�rrM�
Lessee's/Operator's Certification:
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Lessee/operator name:
Address:
City:
Phone:
Signature:
Permittee's Certification:
State:
E-mail
I certify that I have read this Agreement and do hereby
Signing official name:
Signature:
Zip:
Date:
to abide by the stipulations and restrictions as specified herein.
Date: 44&h7,C)
FORM: LOA 06-16
Page 3 of 3

APPLICATION MAP
LEGEND
APPLICATION AREA
UNSUITABLE AREA
— — — — — — PRIVATE ROAD
CaD
WATER
— — — — STREAM
.
ONSITE HOUSE
GRAPHIC SCALE
— DRAIN
.
�_
OFFSITE HOUSE — 660
FENCE
OUTBUILDING 610, 0 660'
PROPERTY LINE
jo
WELL
Q
SOIL BORING
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within C_CD�V3
in the property boundary, whichever is closest to the application area. The review boundary is established 1J
midway between the compliance boundary and the perimeter of the residuals application area. All
locations are approximate. Fields 2-3

SOIL SURVEY
LL'
a
z
GRAPHIC SCALE
1" = 660'
660, 0 66Y
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within
in 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. All
locations are approximate.
NC-CD-03
Fields 2-3

APPLICATION MAP
iid
LEGEND
APPLICATION AREA
PRIVATE ROAD
STREAM
max— f FENCE
PROPERTY LINE
CD
UNSUITABLE AREA
WATER
ONSITE HOUSE
OFFSITE HOUSE
OUTBUILDING
WELL
SOIL BORING
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within
in 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. All
locations are approximate.
GRAPHIC SCALE
1 " = 660'
6W 0 660'
NC-CD-03
Fields 6-7

SOIL SURVEY
GRAPHIC SCALE
1"=660'
ssa, o 660'
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within
in 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. All
locations are approximate.
NC-CD-03
Fields 6-7

APPLICATION MAP
LEGEND
APPLICATION AREA
PRIVATE ROAD
STREAM
DRAIN
as-- FENCE
PROPERTY LINE
0
0
UNSUITABLE AREA
WATER
ONSITE HOUSE
OFFSITE HOUSE
OUTBUILDING
WELL
SOIL BORING
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within
in 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. All
locations are approximate.
GRAPHIC SCALE
1"=660'
660' 0 660'
NC-CM3
Field 9

SOIL SURVEY
GRAPHIC SCALE
1"=660'
sso' o - 660'
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within
in 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. Ail
locations are approximate.
NC-CD-03
Fields 9

NCDABCS Agronomic Division Phone: [phone]: Website: www.neagr.gov/agronomcl Report No. FY20-SLO17106
Client: Patrick Starnes Advisor: Alex Fox
Heavy Metals PO Box 414 Synagro.
Granite Falls, NC 28630 284 Boger Rd
SoRe p Meh[ich-3 Extraction Mocksville, NC 27028
k Sampled County: Caldwell
Links to Helpful Information
Client ID: 494622 Advisor ID: 501947
Sampled: 11/14/2019 Received: 11/26/2019 completed: 12/02/2019 Farm: CD-s
Agronomists Comments:
This report contains both routine soil test information as well as heavy metals data in a section labeled as Heavy Metals under soil test lab results. Using Mehlich 3 as a
soil test extractant, background levels of these metals typically seen in NC soils when analyzed are as follows: arsenic (As)- 4.5 ppm, cadmium (Cd)- 0.1 ppm, chromium
(Cr)- 0.2 ppm, lead (Pb)- 4.2 ppm, nickel (Ni)- 0.8 ppm, & selenium (Se)- 0.2 ppm (FY2005-2007). Note elevated nickel(Ni) in many samples.Although the above metals
here are not believed to pose a concem for plant growth, continue to monitor these and note where elevated above background levels. Note any lime and fertilizer
recommendations. Where soil test Lhosphorus P is vea high (P-I > 100),crops will not respond to additional P applied. Jagathi Kamalakanthan 12/2/2019
Sample ID: 1
Recommendations: Lime Nutrients (lb/acre)
More
Crop (tons/acre) N P206 K20 Mg S Mn Zn Cu B
Information
Lime History:
1 -Corn, silage 0.0 180-220 70 110 0 0 0 0 0 0
Note: 3
2-So bean 0.0 0 60 50 0 0 0 0 0 0
Note:3
Test Results [units - WN in g1cm3; GEC and Na in meq/100 cm3; NO3-N in mg/drri3]: Soil Class. Mineral
HM% WN CEC B5% Ac pH P-1 K-1 Ca% Mg% S4 Mn-I Mn-All Mn-AI2 Zn-I Zn-AI Cu-I Na ESP SS4 NO3-N
0.18 1.03 6.2 85 0.9 6.2 33 45 54 28 184 89 68 61 128 128 ill 0.1 2
Heavy Metals (parts per million): Arsenic, 0.0• Cadmium; 0.1 Nickel,. 2.1 Chromium, .0.2 ...,.Lead, 2.9 Selenium, 0.2
Sample ID: 2
Recommendations: Lime Nutrients (lb/acre)
More
Crop (tonsfacre) N P205 K20 Mg S Mn Zn Cu B
Information
Lime History:
1-FescuelOGrass/Tim, M 0.6 120-200 0 30 0 0 0 0 0 0,
Note: 12
2- 0.0 ,
Test Results [units - WN in glcrrt3; CEC and Na in meq/100 cm3; NO3-N in mg/dmi): Soil Class: Mineral
HM% WN CEC as% Ac pH P-1 K-I Ca% Mg% S-1 Mn-I Mn-All Mn-AI2 Zn4 Zn-AI Cu-I Na ESP SS4 NO3-N
0.51 1.14 5.0 72 1.4 5.6 96 56 45 21 41 104 79 90 90 132 0.1 2
Heavy Metals.(parts per million): Arsenic, 0.1 Cadmium, 0.1 Nickel, 2.7 Chromium, 0.3 Lead, 5.9 Selenium, 0.1
Forth. Carolina
+ r�
r '�•,kc
Tobacco Tru;r Fund CINnnitwou
Reprogramming of the laboratory -information -management system that makes this report possible is being funded
through a grant from the North Carolina Tobacco Trust Fund Commission.
Thank you for using agronomic services to manage nutrients and safeguard environmental quality.
Steve Troxier. Commissioner of Aoriculture

NCDA&CS Agronomic Division Phone: [phone] Website:. www.ncagr.gov/agronomi/
ReportNo..
FY20-SLO17106
Patrick Starnes
Page 2 of 4
Sample ID: 3 Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tonslacre) N P205 K20
Mg S
Mn
Zn
Cu
B
Information
Lime History: 1 -Corn, silage 0.0 180-220 0
50
0 0
0
0
0
0
Note: 3
2- 0.0
Test Results [units - WIV in g1cm3; CEC and Na in megI100 cm3; NO3-N in mgfflm ]:
Soil Class:
Mineral
HM% WIV CEC BS% Ac pH P-1 K-1 Ca% Mg%
S-1 Mn-I
Mn-All Mn-AI2
Zn-I
Zn-AI
Cu-I
Na ESP SS -I NO3-N
0.46 1.18 6.0 85 0.9 6.4 102 77 54 24
29 176
117
96
96
115
0.1 2
Heavy Metals (parts. per million): Arsenic, 0.1 Cadmium, 0.1
Nickel; . 1.5
Chromium, 0.3
Lead,
4.9
Selenium,
0:1
Sample ID: 70 Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tons/acre) N P205
K20
Mg S
Mn
Zn
Cu
B
Information
Lime History: 1-Fescue/OGrass/Tim, M 0.0 120-200 70
70
0 0
0
0
0
0
Note: 12
2- 0.0
Test Results [units - WIV in glcm3; CEC and Na in meg1100 cm3; NO3-N in mg/do]:
Soil Class;
Mineral
HM% WIV CEC BS% Ac pH P4 K-1 Ca% Mg%
S-i Mn-I
Mn-Ali Mn-AI2
Zn-I
Zn-AI
Cu-1
Na ESP
SS-1 NO3-N
0.18 1.13 6.0 85 0.8 6.5 27 32 56 26
119 104
72
32
32
26
0.1 2
Heavy Metals.(parts per million): Arsenic, 0:,1. Cadmium, 0:1
Nickel, 0:2
Chromium; 0.3
Lead,.
4.5
Selenium,
0.2
Sample ID: 100 Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tonslacre) N P205
K20
Mg S
Mn
Zn
Cu
B
Information
Lime History: 1 -Corn, silage 0.0 180-220 60
180
0 0
0
0
0
0
Note: 3
2- 0.0
Test Results [units - WiV in gicn ; CEC and Na in meq/100 cm3; NO3-N in mg/dm3]:
Soil Class:
Mineral
HM% WN CEC BS% Ac pH P4 K-1 Ca% Mg%
S-1 Mn-I
Mn-Ali Mn-Al2 Zn-I
Zn-AI
Cu-I
Na ESP
SS-1 NO3-N
0.22 1.12 6.4 84 1.0 6.4 37 14 56 27
58 69
52
76
76
229
0.1 2
Heavy Metals (parts per million): Arsenic, 0.1 Cadmium, 0.0
Nickel, 1.6
Chromium, .0:3
Lead,.
2.8
Selenium,
0.3

NCDA&CS Agronomic'Division Phone: [phone] Website: www.neagr.gov/agronbmU
Report No.
FY20-SLO17106
Patrick Starnes
Page 3 of 4
Sample ID: 6
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tonslacre) N P205
K20
Mg S
Mn
Zn
Cu
B
Information
Lime History:
1-Fescue/OGrass/Tim, M 1.1 120-200 50
70
0 0
0
0
0
0
Note: 12
2 - 0.0
Test Results [units - WN in glcm3; CEC and Na in meq/100 cm3; NO3-N in mg/dFT ]:
Soil Class:
Mineral
HM% W1V CEC BS% Ac pH P4 K-1 Ca% Mg%
S4 Mn-I
Mn-All Mn-AI2
Zn-I
Zn-AI
Cu-1
Na ESP
SS-f NO3-N
0.41 1.16 4.0 53 1.9 5.1 38 34 35 13
49 48
46
26
26
41
0.1 3
Heavy Metals (parts per million): Arsenic, 0.1 Cadmium, 0.1
Nickel, 3.1
Chromium, 0.3
Lead,
5.1
Selenium,
0.0
Sample ID: 9
Recommendations: Lime
Nutrients (Ib/acre)
More
Crop (tonslacre) N P206
K20
Mg S
Mn
Zn
Cu
B
Information
Lime History:
1 -Fescue/OGrass/Tim, M 0,6 120-200 140
130
0 0
0
$
0
0
Note: 12 Note:
2 - D.0
Test Results [units - WN in g/cnr ; CEC and Na in meq/100 cm3; NO3-N in mgldm3]:
Soil Class:
Mineral
HM% WN CEC BS% Ac pH P-1 K-1 Ca% Mg%
S-1 Mn-1
Mn-All Mn-Al2 Zn-I
Zn-AI
Cu-I
Na ESP
SS-1 NO3-N
0.13 1.06 5.7 76 1.4 5.5 4 9 52 24 225 48
46
25
25
67
0.1 2
Heavy Metals (parts per million): Arsenic, .0.1 Cadmium, 0.0
Nickel, 0.2
Chromium, 0.2
Lead,
2.9
Selenium,
0.2

NCDA&CS Agronomic Division Phone: [phone] Website: www.ncagr.gov/agronomi/
Report No. FY20-SLO17106
Patrick Starnes
Page 4 of 4
Understanding the Soil Report: explanation of measurements, abbreviations and units
Recommendations
Report Abbreviations
Lima
Ac
exchangeable acidity
If testing finds that soil pH is too low for the crop(s) indicated, a lime recommendation will be given in units of either
B
boron
tonlacre or Ib/1000 sq ft. For best results, mix the lime into the top 6 to 8 inches of soil several months before planting.
BS%
% CEC occupied by basic cations
For no -fill or established plantings where this is not possible, apply no more than 1 to 1.5 ton/acre (50 Ib/1000 sq ft) at on
Ca%
% CEC occupied by calcium
time, even if the report recommends more. You can apply the rest in similar increments every six months until the full rate
CEC
cation exchange capacity
is applied. If MG is recommended and lime is needed, use dolomitric lime.
Cu-I
copper index
ESP
exchangeable sodium percent
Fertilizer
HM%
percent humic matter
Recommendations for field crops or otherlarge areas are listed separately for each nutrient to be added (in units of
K-1
potassium index
lb/acre unless otherwise specified). Recommendations for N (and sometimes for B) are based on research/field studies
K20
potash
for the crop being grown, not on soil test results. K-1 and P-1 values are based on test results and should be > 50. if they
Mg%
% CEC occupied by magnesium
are not, follow the fertilizer recommendations given. If Mg Is needed and no lime is recommended, 0-0-22 (11.5% Mg) is
MIN
mineral soil class
an excellent source; 175 to 250 lb per acre alone or in a fertilizer blend will usually satisfy crop needs, SS-1 levels appear
Mn
manganese
only on reports for greenhouse soil or problem samples.
Mn-Ali
Mn-availability index for crop 1Mn-AI2
Mn-availability index for crop 2
Farmers and other commercial producers should pay special attention to micronutrient levels. If $, pH$, $pH, C or Z
Mn4
manganese index
notations appear on the soil report, refer to $Note: Secondary Nutrients and Micronutrients_ In general, homeowners do not
M-0
N
mineral -organic soil class
nitrogen
need to be concerned about micronutrients. Various crop notes also address lime fertilizer needs; visit
Na
sodium
ncagr.gov/agronomi/pubs.htm.
NO3-N
nitrate nitrogen
ORG
organic soil class
Recommendations forsmall areas, such as home lawns/gardens, are listed In.units of lb/1000 sq ft. If you cannot find
pH
current soil pH
the exact fertilizer grade recommended on the report, visit . www.ncaar.Clov/aoronomilobpart4.htmfffind information that
P-1
phosphorus index
may help you choose a comparable alternate. For more information, read A Homeowners Guide to Fertilizer.
P206
phosphate
S-1
sulfur Index
Test Results
SS-1
soluble salt index
WN
weight per volume
The first seven values [soil Gass, HM%a, WAt, CEC, BS%, Ac and pH] describe the soil and its degree of acidity. The
zn AI
zinc availability index
remaining16 I K-I Ca% M %, Mn-1, Mn-All, Mn-AI2, Zn-1 Zn-AI Cu-I S-[ SS -I, ESP' SS -I, NO3-N (not routinel
g Na,ww.nc
Zn4
zinc index
available)] indicate levels of plant nutrients or other fertility measurement. Visit r v/a ronomi/u t.htm

State of North Carolina
Department of Environmental Quality
Division of Water Resources
b Islon of Water Resources COUNTY BOARD NOTIFICATION
INSTRUCTIONS FOR FORM: CBN 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 apnlication and
supporting documentation
For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting Unit
General — This notification is intended to provide the county board in which the land application site is proposed to be located with
general information on the size, location and type of residuals land application proposed to occur in their county, and to give them an
opportunity to comment on the pending permitting request as stipulated in Session Law 2013-340. Notification is not required for
fields deemed permitted to receive Class A residuals under 15A NCAC 02T .1100. Do not submit this document for review
without a corresponding residuals program application form (FORM: RLAP 11-15).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. County Board Notification (FORM: CBN 11-15):
® Submit the completed and appropriately executed County Board Notification (FORM: CBN 11-15). Please do not make any
unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to the form may
be made, as long as the attachments are numbered to correspond to the section and item to which they refer.
® Prepare a separate County Board Notification (FORM: CBN 11-15) for each county in which the proposed land application
sites are located.
B. Critical Watershed Areas Information:
® Under 15A NCAC 02B .0212, no new permitted sites for land application of residuals are allowed within critical watershed
areas. It is the Applicant's responsibility to ensure that the proposed land application sites are not located within these areas.
® For more information regarding Water Supply Watershed Protection Program, please visit the Division website at:
b-qs:/Ideg.ne.,2ov/about/divisions/water-resources/water-resources-rules/water-supply-watershed-protection-program
❑ If uncertain about whether the proposed sites are located within the critical areas, contact the Division or call [phone].
C. Notification Package Submission:
❑ Complete and mail the notification letter, source facility summary, land application site summary, and site location maps to
the appropriate County Board by certified mail with a return receipt requested. It is recommended that a copy of the
notification package also be sent to the County Manager.
❑ The most current publication of the Directory of State and County Officials may be downloaded at:
hgps://Nvww.sosnc.gov/publications/direct.aspx
❑ A list of the Division's regional offices, their county coverage, and their contact information may be downloaded at:
htta://dea.nc.gov/contact/regional-offices.
❑ The source facility summary shall include: facility name; county where it is located; and the proposed annual dry tonnage
(i.e., a copy of "Residuals Source Facility Summary" is adequate but not required).
❑ The land application site summary shall include:. field ID; acreage; county where it is located; latitude and longitude (i.e., a
copy of "Land Application Site Certification" is adequate but not required).
D. Proof of Submission:
❑ Attach an 8.5 by 11-inch copy of the return receipt to the back of this attachment prior to submission of the application to the
Division for review.
INSTRUCTIONS FOR FORIVI: CBN 06-16 Page 1 of I

North Carolina Department of Environmental Quality
Pat McCrory Donald R. van der Vaart
Governor Secretary
Date: 04/13/2020
Name of Chairman to the Board of County Commissioners: Randy Church
Complete mailing address: 905 West Ave NW
City: Lenior
State: NC Zip: 28645
County where land application sites are located: Caldwell
From: Applicant's name: S nag;ro Western Piedmont for Granite Falls Waste Water (on behalf of the Division of Water
Resources in accordance with Session Law 2013-340)
Contact person and title: Alex Fox
Complete mailing address: 284 Boger rd
City: Statesville
Telephone number: (336 703-8681
State: NC Zip: 27028- ll . <
E-mail address: [e-mail]
Subject: Notification of residual land application site proposal
This is to notify you that the Applicant listed above will be submitting an application to the Division of Water
Resources for the land application of residual solids to site(s) located in your county. During this review, the Division
will ensure that all federal and state regulations are enforced. Attached to this form is information regarding residuals -
generating sources and locations of the proposed land application sites. Please forward this letter and its associated
attachments to the appropriate Department within your County (i.e., Health or Environmental Health Department and
Planning Department) if applicable.
More information of the land application sites included in this application will be available at the following
Division of Water Resources Regional Office:
Name of appropriate regional office: Asheville Regional Office
Complete mailing address: 2090 US-70
City: Swannanoa State: NC Zip: 28778
Telephone number: (828)-296-4500
Expected date of application submission: 04/15/2020
Should you desire to comment on this application, please do so no later than 30 calendar days following the
expected application submission date, if you have any questions or comments about this notification, or if you would like
more information, please contact the appropriate regional office at the telephone number provided above. Thank you in
advance for your attention to this matter.
Enclosures: Source Facility Summary
Land Application Site Summary
Maps
Non -Discharge Permitting Unit
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Phone: 91M07-64641Internet: htto:l/rmrtal.ncdenccrahuebhrio
An Equal Cpportunitj 1Affirmative Action Employer —Made in part with recycled paper FORM: CBN 06-16

Alex Fox
From: UPS Quantum View <[e-mail]>
Sent: Tuesday, April 14, 202-0 9:48 AM
To: Alex Fox
Subject: UPS Delivery Notification, Tracking Number 1Z51F78W0197016058
Hello, :your package has been. delivered.
Scheduled Delivery Date: Tuesday, 04/14/2020
Estimated Del€very Time: End Of Day
Left.At: RECEIVER.
S€gned by: WHITT
SYNAGR,O - MOCKSVILLE
RECEIVER
Tracking Number:
Ship To:
Number of Packages:
UPS Service:
Package Weight:
Referenoe Number: .
0. Download the UPS. mobile aao
1Z51F78W4197016058
905 'WEST AVE NW
LENOIR, NC 2864S.
us
0
UPS Next Day Aire
0.05 LBS
20-2360-30-60-4310 50-0055
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A

Ula." c Vi 11 VA LU %—UA uu ulu
R DW Department of Environment and Natural Resources
Division of Water 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 .1100. Do not
submit this agreement for review without a corresponding application form (FORM: RLAP 06-16).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation. listed
below.
A. Land Owner Agreement (FORM: LOA 06-16):
® Submit the completed and appropriately executed 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 er Imits:
Applicant's name: f)v nac ro U. tern C....n
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
Lease
Land Use or
Cropping Patterns
Intended Use of Crops
Residuals Source
(optional)
Special note
(no-fill/over-seed/
pasture)
�./
r
P
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 I 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 _R that l .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:l�
Address: J
City: State: J ' zip:
r {
Phone: 70 4 S ..s E-mail address: C-9)" n C. �, 4
Signature: (� fr Date:
NORTH CAROLINA, .. :14 l! _ COUNTY
I, the undersigned Notary Public do hereby certify that LjAe �^
personally appeared before me this day and acknowledged the due execution of the forgoing instrument �`yt11!lgj�
WITNESS my hand and official seal this the 2�rL �ow
day of G _ , 20 2 C
Signature and seal:UV
My commission expires: Z 2 •O
`t
Lessee's/Operator's Certification:
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified here in.
Lesseeloperator 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 name: o b e° I �' V 0 91
Signature: -Date:���� O
FORM: LOA 06-16 Page 3 of 3

Department of Environment and Natural Resources
DW.RDivision of Water 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 Aipplicant shall submit one original and two CDWO of the apytication 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 _ 1100. Do not
submit this agreement for review without a corresponding application form (FORM: RLAP 06-16).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Land Owner Agreement (FORM: LOA 06-16):
® Submit the completed and appropriately executed 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:
hereinafter referred to
application site(s) (ie.,
Agreement:
t qq
as the Permittee, to land apply residuals from the following facility(ies) onto the following land
see attached setback maps) in accordance with the stipulations and restrictions as given in this
Site/Field IB
Lease.
(yes/no)
Land Use or
Cropping Patterns
Intended Use of Crops
Residuals Source
{optional)
Special note
(no-till/over-seed/
pasture)
�3 -
`
t�V
RO✓ cw
Q rtY '
The landowner or his representative receives, in consideration, full use of the nutrient value of the applied residuals while. the
Perm ittee receives, inconsideration, 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 Pagel 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: d^^ U1
Address: _
City: T' 1 State: ,! iJ _Zip: �/✓��r
Phone: E-mail address: vn Sl ul / Cam: i jr�l C�i
Signature: //� Date:
NORTH CAROLINA,lc f 1 _ COUNTY II I
I, the undersigned Notary Public do hereby certify that u r . S l� tr..—
personally appeared before me this day and acknowledged the du) execution ` of the forgoing instrument. ,,`�`1 f
WITNESS my hand and official seal this the Q
day of r, rr, 120
, / (Z�
Signature and seal: ""Vtll
My commission expires:
Lessee's/Operator's Certification:
5
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Lessee/operator name:
Address:
City:
Phone:
Signature:
Permittee's Certification:
State: Zip:
E-mail address:
Date:
I certify that I have read this Agreement and do hereby ag
r
ee to abide by the stipulations and restrictions as specified herein.
Signing official name: To
Signature: X `� Date:
FORM: LOA 06-16 Page 3 of 3

APPLICATION MAP
I rnrnrn
APPLICATION AREA
UNSUITABLE AREA
— — — — — — PRIVATE ROAD
WATER
— — — — STREAM
.
ONSITE HOUSE GRAPHIC SCALE
- DRAIN
.
OFFSITEHOUSE n -
- 660
X FENCE
OUTBUILDING sso o ssa
PROPERTY LINE
WELL
Q
SOIL BORING
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within N C^I R-36
in 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, All
locations are approximate. Fields 1-2

a
0
APPLICATION MAP
LEGEND
APPLICATION AREA
PRIVATE ROAD
STREAM
L11"I' l
X )( )6 FENCE
PROPERTY LINE
UNSUITABLE AREA
WATER
ONSITE HOUSE
OFFSITE HOUSE
OUTBUILDING
WELL
SOIL BORING
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within
in 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. All
locations are approximate.
GRAPHIC SCALE
1 " = 660'
sso' a 669
NC-IR-36
Fields 3-4

APPLICATION MAP
LEGEND
APPLICATION AREA
PRIVATE ROAD
STREAM
DRAIN
X * X FENCE
PROPERTY LINE
El
0
0
UNSUITABLE AREA
WATER
ONSITE HOUSE
OFFSITE HOUSE
OUTBUILDING
WELL
SOIL BORING
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within
in 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. All
locations are approximate.
GRAPHIC SCALE
1°=660'
660' a 669
N C- I R-36
Field 5

�,l
• 1 ' 1
• ; �
_ ..
r l �L7 i
-112
I
1 f
{ !
i Iv
61
Ir

SOIL SURVEY
GRAPHIC SCALE
1" = 660'
eso, o 660'
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within
in 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. All
locations are approximate.
NC-IR-36
Fields 3-4

DW,
,--S lon of Water ResaUrsea
State of North Carolina
Department of Environmental Quality
Division of Water Resources
COUNTY BOARD NOTIFICATION
INSTRUCTIONS FOR FOIM: CBN 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 notification is intended to provide the county board in which the land application site is proposed to be located with
general information on the size, location and type of residuals land application proposed to occur in their county, and to give them an
opportunity to comment on the pending permitting request as stipulated in Session Law 2013-340. Notification is not required for
fields deemed permitted to receive Class A residuals under 15A NCAC 02T .1100. Do not submit this document for review
without a corresponding residuals program application form (FORM: RLAP 11-15).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. County Board Notification (FORM: CBN 11-15):
® Submit the completed and appropriately executed County Board Notification (FORM: CBN 11-15). Please do not make any
unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to the form may
be made, as long as the attachments are numbered to correspond to the section and item to which they refer.
® Prepare a separate County Board Notification (FORM: CBN 11-15) for each county in which the proposed land application
sites are located.
B. Critical Watershed Areas Information:
® Under I 5A NCAC 02B .0212, no new permitted sites for land application of residuals are allowed within critical watershed
areas. It is the Applicant's responsibility to ensure that the proposed land application sites are not located within these areas.
® For more information regarding Water Supply Watershed Protection Program, please visit the Division website at:
bqs://deg.nc.aov/about/divisions/water-resources/water-resources-rules/water-supply-watershed-protection-program
❑ If uncertain about whether the proposed sites are located within the critical areas, contact the Division or call [phone].
C. Notification Package Submission:
®' Complete and mail the notification letter, source facility summary, land application site summary, and site location maps to
the appropriate County Board by certified mail with a return receipt requested. It is recommended that a copy of the
notification package also be sent to the County Manager.
most current publication of the Directory . of State and County Officials may be downloaded at:
hkttps-://www.sosnc.goy/publications/direct.W-A
A list of the Division's regional offices, their county coverage, and their contact information may be downloaded at:
httn:Hdeg.nc.gov/contact/regional-offices.
e source facility summary shall include: facility name; county where it is located; and the proposed annual dry tonnage
(i.e., a copy of "Residuals Source Facility Summary" is adequate but not required).
e land application site summary shall include: field ID; acreage; county where it is located; latitude and longitude (i.e., a
copy of "Land Application Site Certification" is adequate but not required).
D. Proof of Submission:
❑ Attach an 8.5 by 11-inch copy of the return receipt to the back of this attachment prior to submission of the application to the
Division for review.
INSTRUCTIONS FOR FORM: CBN 06-16
Page 1 of 1

SYNAGRO, WESTERN PIEDMONT CLASS D PERMIT
WQ 0016247
SOIL SCIENTIST CERTIFICATION
This is to certify that soil profile evaluations were conducted on the proposed application
sites for the Western Piedmont project by Piedmont Environmental Associates, P.A. on
behalf of Synagro Central, I -LC. The evaluations consisted of hand auger borings and
descriptions of the soils on the application sites. All hand auger borings included in this
package were either performed by me or under my direct supervision. All other- work
performed for this permit application was conducted by Synagro Central, LLC.
G. Christopher Murray, L.S.S.
No. 1284
Synagro, Western Piedmont WWTP Project, Various Fields

Soil Profile Descriptions in Field Locations
Project: Synagro West. Piedmont (WQ 16247) % Slope: 3%
R9-Q Site: Mark Tevepaugh Farm Crop: Forage/Pasture
Field: Field 1 Conducted By: GC Murray
Coordinates: 35.7548 N Date: 1/9/2020
-80.6440 W Soil Series.- Cecil
0
0
0
0
0 a)
01
AIX, ft
PIEDMOCOMT
VE U '.R 0 N N3 E NTA L
ASS 0 C I ATE S, P.A.
Uj >
0
0 CI L11 C
(D
r_ U) LU
CO 0 9 N
CU 0 0) F_
0
N
ID 0
0 01
Q
x QV
U)
x 0
0 0 (D W
IM
Legend:
Texture
6
sand
I
loam
si
silt,
sil
silt loarn
c
clay
cl
clay loam
scl
sandy clay loam
sl
sandyioam-
sic]
silty clay loam
Structure Grade
Structure Type
wk weak
'gr
granular
m moderate
pi
platy
str strong
pr
prismatic
cpr
columnar
abk
angular blocky
sbk
subangular blocky
sg
single grained
ma
massive
Structure Size
f fine
med medium
Moist Consistency
fr friable
vfr very friable
fi firm
vfi very firm
Seasonal Hiah Water Table:
Depth (") Type (apparent/perched)

Soil profile Descriptions in Field Locations
Project: Synagro West. Piedmont (WQ 16247) % Slope: 3%
RA- Site: Mark Tevepaugh Farm Crop: Forage/Pasture
Field: Field 2 Conducted By: GC Murray
Coordinates: 35.7599 N Date: 1/9/2020
-80.6418 W Soil Series: Pacolet
U
L L V' w
U O C N p
C O O G
c U U
OI .c25 m ai ct> X
O WCU A 4 0 GS
PIEDMONT
ENVIROMMENTAL
A 5 5 0 C I AT ES, P. A.
Ltd LIJ
p
v
UJ
(L
(9
N
in
y
F N
L
L
L 0
L
i
Lo
L p iU fC
Legend:
Texture
s
sand
I
loam
si
silt
sil
silt loam
c
clay
cl
clay loam
scl
sandy clay loam
sl
sandy loam
sicl
silty clay loam
Structure Grade
Structure Twe
Structure Size
wk weak
gr
granular
f fine
m moderate
pl
platy.
med medium
str strong
pr
prismatic
cpr
columnar
abk
angular blocky
sbk
subangular blocky
Moist Consistency
sg
single grained
fr friable
ma
massive
vfr very friable
fi firm
vfi very firm
Seasonal High Water Table:
Depth (") Type (apparent/perched)

Soil Profile Descriptions in Field Locations
Project: Synagro West. Piedmont (WQ 16247)
%
Slope: 4%
_ 13 Site: Danny Millsaps Farm
'Crop: Forage/Pasture
PIEDMONT
Field: Field 4 Conducted
By: GC Murray
Coordinates: 35.8945 N
Date: 11/14/2019
ERWOONNMMr
-81.1672 W
Soil Series: Fairview
'ASSOCIATES. P.A.
U
y
W
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-
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p
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29-37
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37-48
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-
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Legend:
Texture
-s
sand
I
loam
si
silt
sil
silt loam
c
clay
cl
clay loam
scl
sandy clay loam
sl
sandy loam
Sid
silty clay loam
Structure Grade
Structure Type
Structure Size
wk weak
gr
granular
f fine
m moderate
pl
platy
med medium
str strong
pr
prismatic
cpr
columnar
abk
angular blocky
sbk
subangular blocky
Moist Consistency
sg
single grained
fr friable
ma
massive
vfr very friable
fi firm
vfi very firm
Seasonal High Wafer Table:
Depth (") Type (apparent/perched)

Soil Profile Descriptions in Field Locations
Project: Synagro West. Piedmont (WQ 16247)
% Slope: 4%
Site: Danny Millsaps Farm
Crop: Forage/Pasture
PIEDM HT
Field: Field 5
Conducted By: GC Murray
Coordinates: 35.8963 N
Date: 11/14/2019
fk
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-81.1635 W
Soil Series: Clifford
A .s u o c i w r a s@ P.A.
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Texture
s
sand
I
loam
. si
silt
sil
silt loam
c
clay
cl
clay loam
scl
sandy clay loam
sl
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sicl
silty clay loam
Structure Grade
Structure Type
wk weak
gr
granular
m moderate
pl
.platy
str strong
pr
prismatic
cpr
columnar
abk
angular blocky
sbk
subangular blocky
sg
single grained
ma
massive
Structure Size
f fine
med medium
Moist Consistencv
fr friable
vfr very friable
fi firm
vfi veryfirm
Seasonal High Water Table:
Depth (") 'Type (apparent/perched)

Soil Profile Descriptions in Field Locations -
Project: Synagro West. Piedmont (WQ 16247) % Slope: 4%
AwS Site: Danny Millsaps Farm Crop: Forage/Pasture
Field: Field 6 Conducted By: GC Murray
Coordinates: 35.8798 N Date: 11/14/2019
-81.1305 W Soil Series: Clifford
cn
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Texture
Structure Grade .
Structure Type
Structure Size
s
sand
wk weak
gr
granular
f fine
I
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m moderate
pl
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med medium
si
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pr
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Moist Consistency
scl
sandy clay loam
sg
single grained
fr friable
sl
sandy loam
ma
massive
vfr veryfriable
sicl
silty clay loam
fi firm
vfi very firm
Seasonal High Water Table:
Depth (") Type (apparent/perched)

Soil Profile Descriptions in Fier Locations
Project: Synagro West. Piedmont (WQ 16247)
% Slope: 3%
Site: Patrick Starnes Farm
Crop: Forage/Pasture
Field: Field 1 Conducted
By: GC Murray
{
Coordinates: 35.8523 N
Date: 11/14/2019
-81.3493 W
Soil Series: Fairview,
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Texture
s
sand
I
loam
si
silt
sil
silt loam
c
clay
cl
clay loam
scl
sandy clay loam
sl
sandy loam
sid
silty clay loam,
Structure Grade
Structure Type
Structure Size
wk weak
gr
granular
f fine
m moderate
pl
platy
med medium
str strong
pr
prismatic
cpr
columnar
abk
angular blocky
sbk
subangular blocky
Moist Consistencv
sg
single grained
fr friable
ma
massive
vfr very friable
fi' firm
vfi very firm
Seasonal High Water Table:
Depth (") Type (apparent/perched)

Soil Profile Descriptions in Field Locations
Project:
x
Synagro West. Piedmont (WQ 16247)
% Slope: 4%
Site:
Patrick Starnes Farm
Crop: Forage/Pasture
N EDMONT
Field:
Field 2 Conducted
By: GC Murray
Coordinates:
35.8492 N
Date: 11/14/2019
-81.3457 W
Soil Series: Woolwine
_
N
ui
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Texture
s
sand
I
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si
silt
sil
silt loam
c
clay
cl
clay loam
scl
sandy clay loam
sl
sandy loam
sicl
silty clay loam
Structure Grade
Structure Type
Structure Size
wk weak
gr
granular
f fine
m moderate
pi
platy
med medium
str strong
pr
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cpr
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abk
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. Moist Consistency
sg
single grained
fr friable
me
massive
vfr very friable
fi firm
vfi very firm
Seasonal High Water Table:
Depth (") Type (apparent/perched)
~�
Ip
0

Soil Profile Descriptions in Field Locations
Project: Synagro West. Piedmont (WQ 16247) % Slope: 4%
Site: Patrick Starnes Farm Crop: Forage/Pasture
Field: Field 2 Conducted By: GC Murray
Coordinates: 35.8475 N Date: 11/14/2019
-81.3446 W Soil Series: Woolwine
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3-14
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-
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Bt
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-
-
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cl
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-
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-
-
-
-
-
-
-
-
Legend.
Texture
s
sand
I
loam
si
silt
sil
silt loam
c
clay
cl
clay loam
scl
sandy clay loam
sl
sandy loam
sicl
silty clay loam
Structure Grade
Structure Type
wk weak
gr
granular
m moderate
pl
platy
str strong
pr
prismatic
cpr
columnar
abk
angular blocky
sbk
subangular blocky
sg
single grained
ma
massive
Seasonal High Water Table:
Structure Size Depth (") Type (apparent/perched)
f fine - -
mad medium
tom' tag
Moist Consistency
fr friable
vfr veryfriable
fi firm
At very firm

Soil Profile Descriptions in Field Locations
Project: Synagro West. Piedmont (WQ 16247)
% Slope: 4%
A- 0 1 Site: Patrick Starnes Farm
Crop: Forage/Pasture
Field: Field 6
Conducted By: GC Murray
Coordinates: 35.8562 N
Date: 11/14/2019
-81.3761 W
Soil Series: Fairview
y
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Texture
s
sand
i
loam
si
silt
sil
silt loam
c
clay
cl
clay loam
sci
sandy clay loam
sl
sandy loam
sid
silty clay loam
Structure Grade
Structure Type
Structure Size
wk weak
gr
granular
f fine
m moderate
of
platy,
med medium
str strong
pr
prismatic
cpr
columnar
abk
angular blocky
sbk
subangular blocky
Moist Consistency
sg
single grained
fr friable
ma
massive
vfr very friable
fi firm
vfi very firm
Seasonal High Water Table:
Depth (") Type (apparent/perched)
SOIL sc,
sOPH
1 4

Soil Profile Descriptions in wield Locations
Project: Synagro West. Piedmont (WQ 16247)
%
Slope: 4%
Site: Patrick Starnes Farm
Crop: Forage/Pasture
,.
Field: Field 7
Conducted By: GC Murray
''
Coordinates: 36.8576 N
Date; 11/14/2019
-81.3747 W
Soil Series: Fairview
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A s$ P c B Arius. P. A.
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Texture
s
sand
I
loam
si
silt
sil
silt loam
c
clay
ci
clay loam
scl
sandy clay loam
sl
sandy loam
sic]
silty clay loam
Structure Grade
Structure Type
Structure Size
wk weak
gr
granular
f fine
m moderate
pl
platy
med medium
str strong
pr
prismatic
cpr
columnar
abk
angular blocky
sbk
subangular blocky
Moist Consistencv
sg
single grained
fr friable
ma
massive
vfr very friable
fi firm
vfi very firm
Seasonal High Water Table:
Depth (") Type (apparent/perched)
'��r4'

Sail Profile Descriptions in Field Locations
Project: Synagro West. Piedmont (WQ 16247)
% Slope: 5%
• Site: Patrick Starnes Farm
Crop: Forage/Pasture
IEDNO"IN
Field: Field 9
Conducted
By: GC Murray
Coordinates: 35.8051 N
Date: 11/14/2019
-81.3541 W
•
Soil Series: Woolwine
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sl
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gr
fr
ns
np
AB
5-13
7.5YR 6/4
-
-
-
-
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scl
mod
med
gr
fr
ns
np
Bt
13-28
2.5YR 4/8
-
-
-
-
moist
c
mod
med
sbk
fi
s
p
BC
28-36
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-
-
-
-
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cl
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sbk
fi
s
p
C
36-43
2,5YR 4/6
-
-
-
-
moist
sl
wk
med
gr
fr
ns
np
Legend.
Texture
s
sand
I
loam
si
silt
sil
silt loam
c
clay
cl
clay loam
scl
sandy clay loam
sl
sandy loam
sicl
silty clay loam
Structure Grade
I
Structure Type
Structure Size
wk weak
gr
granular
f fine
m moderate
pl
platy
med medium
str strong
pr
prismatic
cpr
columnar
abk
angular blocky
sbk
subangular blocky
Moist Consistency
sg
single grained
fr friable
ma
massive
vfr veryfriable
fi firm
vfi very firm
Seasonal High Water Table:
Depth (") Type (apparent/perched)

Soil Profile Descriptions in Field Locations
Project:
Synagro West. Piedmont (WQ 16247) % Slope: 3%
Site:
IR 36-1
Crop: Forage/Pasture
r
Field:
Field 1
Conducted By: GC Murray
Coordinates:
35.7862 N
Date: 4/9/2020
V'IE;Dug7L
-80.7948 W
Soil Series: Pacolet
Ass o c I AT E S P A.
w
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np
Bt
5-37 •
2.5YR 4/8
-
-
-
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c
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sbk
fi
s
p
BC
37-48
2.5YR 5/8
-
-
-
-
moist
cl
wk.
med
sbk
fi
ss
p
Legend.
Texture
Structure Grade
Structure Type
Structure Size
s sand
wk weak
gr
granular
f fine
I loam
m moderate
pl
platy
med medium
si silt
str strong
pr
prismatic
sil silt loam
cpr
columnar
c clay
abk
angular blocky
cl clay loam
sbk
subangular blocky
Moist Consistency
scl sandy clay loam
sg
single grained
fr friable
sl sandy loam
ma
massive
vfr very friable
sicl silty clay loam
fi firm
vfi veryfirm
Seasonal High Water Table:
Depth (") Type (apparen*lperched)

Soil ,profile Descriptions in Field Locations
Project: Synagro West. Piedmont (WQ 16247)
% Slope: 3%
Site: IR 36-2
Field: Field 2
Conducted
Crop: Forage/Pasture
By: GC Murray
j
tD NT
E Im
Coordinates: 35.7847 N
Date: 4/9/2020
UMMEHTAL
-80.7878 W
Soil Series: Wedowee
—
A 6 S o c I ATE S. P. A.
C�
y
W
w
LU
LL C
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Legend:
Texture
s
sand
I
loam
sl
silt
sil
silt loam
c
clay
cl
clay loam
scl
sandy clay loam
sl
sandy loam
sicl
silty clay loam
Structure Grade
Structure Type
Structure Size
wk weak
gr
granular
f fine
m moderate
pl
platy
med medium
str strong
pr
prismatic
cpr
columnar
abk
angular blocky
sbk
subangular blocky
Moist Consistency
sg
single grained
fr friable
ma
massive
vfr very friable
fi firm
vfi very firm
Seasonal High Water Table:
Depth(") Type (apparent/perched)

Soil Profile Descriptions in Field Locations
Project: Synagro West. Piedmont (WQ 16247)
% Slope: 3%
Site: IR 36-3
Crop: Forage/Pasture
PIEDMONT
Field: Field 3
Conducted By: GC Murray
i-
9
Coordinates: 35.8490 1�
Date: 4/9/2020
�
rMV R DAL,
-80.7967 W
Soil Series: Tomlin
` "`•
ASSOCI ATE$, P.A.
l9
ua
w c
W
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p
Q
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v O .'
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U
d
cn d
U
p
Legend:
Texture
Structure Grade
Structure Type
Structure Size
s sand
wk weak
gr
granular
f fine
loam
m moderate
pl
platy
med medium
si silt
str strong
pr
prismatic
sil silt loam
cpr
columnar
c clay
abk
angular blocky
cl clay loam
sbk
subangular blocky
Moist Consistencv
scl sandy clay loam
sg
single grained
fr friable
sl sandy loam
ma
massive
vfr very friable
sicl silty clay loam
fi firm
vfi very firm
Seasonal High Water Table:
Depth (") Type (apparent/perched)

Soil Profile Descriptions in Field Locations
Project: Synagro West. Piedmont (WQ 16247) % Slope: 3%
Site: I 36-4 Crop: Forage/Pasture
Field: Field 4 Conducted By: GC Murray
Coordinates: 35.8534 N Date: 4/9/2020
-80.7824 W Soil Series: Tomlin
`).-PIEIDMONT
r...aIN51Mu
AS S O CI ATE 5, P. A_
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m
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s
n
n
n
f'
Legend.
Texture
s
sand
I
loam
si
silt
sil
silt loam
c
clay
cl
clay loam
scl
sandy clay loam
sl
sandy foam
sicl
silty clay loam
Structure Grade
Structure Type
Structure Size
wk weak
gr
granular
` fine
m moderate
pl
platy
med medium
str strong
pr
prismatic
cpr
columnar
abk
angular blocky
sbk
subangular blocky
Moist Consistency
sg
single grained
fr friable
ma
massive
vfr very friable
fi firm
vfi very firm
Seasonal High Water Table:
Depth (") Type (apparent/perched)

Soil Profile Descriptions in Field Locations
Project: Synagro West, Piedmont (WQ 16247)
% Slope: 3%
Site: IR 36-5
Conducted
Crop: Forage/Pasture
By: GC Murray
PIEDMONT
Field: Field 5
Coordinates: 35.8539 N
Date: 4I9I2020
-80.7837 W
Soil Series: Tomlin;
v,
w
Q
w
c
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Legend:
Texture
s
sand
I
loam
si
silt
sil
silt loam
c
clay
cl
clay loam
scl
sandy clay loam
sl
sandy loam
sicl
silty clay loam
Structure Grade
Structure Type
Structure Size
wk weak
gr
granular
f fine
m moderate
pl
platy
med medium
str strong
pr
prismatic
cpr
columnar
abk
angular blocky
sbk
subangular blocky
Moist Consistency
sg
single grained
fr friable
ma
massive
vfr very friable
fi firm
vfi very firm
Seasonal High Water Table:
Depth (") Type (apparent/perched)
OIL

t APPLICATION MAP
LEGEND
APPLICATION AREA UNSUITABLE AREA
PRIVATE ROAD
STREAM
DRAIN
X X X FENCE
PROPERTY LINE
CD
WATER
ONSITE HOUSE
OFFSITE HOUSE
OUTBUILDING
WELL
SOIL BORING
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within
in 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. All
locations are approximate.
GRAPHIC SCALE
1" = 660'
660' 0 660'
NC-RA-53
Fields 1-2

APPLICATION MAP
LEGEND
APPLICATION AREA
UNSUITABLE AREA
——�—n—n�—
PRIVATE ROAD
WATER
GRAPHIC SCALE
— - - —
STREAM a
ONSITE HOUSE 1" = 660'
—
DRAIN
sso' o 660'
OFFSITE HOUSE
--x---x—�--
FENCE
OUTBUILDING
PROPERTY LINE
WELL
SOIL BORING
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within V � I C—(�\A_05
in 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. All
locations are approximate, Fields 1-2

APPLICATION MAP
LEGEND
APPLICATION AREA UNSUITABLE AREA
— — — — — — PRIVATE ROAD W � WATER
— — — -- STREAM
ONSITE HOUSE
DRAIN
® OFFSITE HOUSE
—X X FENCE
OUTBUILDING
— PROPERTY LINE
O WELL
SOIL BORING
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within
in 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. All
locations are approximate.
GRAPHIC SCALE
1 " = 660'
660' 0 660,
im
Fields 2-3

VICINITY MAP
GRAPHIC SCALE
1" = 4,000'
4,000' o a,000,
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within
in 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. All
locations are approximate.
NC-RA-05
Fields 1-3

SOIL SURVEY
GRAPHIC SCALE
1" = 800'
800, 0 800'
The compliance boundary is established either 250 It from the residuals application area or 50 feet within N C-RA-05
in 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. All
locations are approximate. Fields 1-3

TOPOGRAPHIC MAP
IYi�iiJ
� t ✓�7 I`
� {i ty �� a t+ t / �� -y � � 4 ` _
748
t},'�'
�'
"1
a , � ' j' �•�`� 7 �: � r,
II' : j r i�, 1 k�1
(�
i i-_ if • •� r I� '�;\ ""�� %4 '
_ \4
•
`'tip
'�' ` 1 —
1� � •
. t 1—''�`"'� y � — 1
-
� ��
/t aro�v. _ -�� l�
/
r ,� �
;
GRAPHIC SCALE
1" = 1,000'
1,000. 0 1,000.
The
compliance boundary is established either 250 ft from the residuals application area or 50 feet within
N C-RA-05
in 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. All
locations are approximate.
Fields 1-3

VICINITY MAP
GRAPHIC SCALE
1" = 4,000'
4,000' 0 4,000'
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within
in 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. All
locations are approximate.
NC-IR-36
Fields 1-5

SOIL SURVEY
GRAPHIC SCALE
1" = 660'
660' 0 660'
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within N C—RA-53
in 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. All
locations are approximate. Fields 1-2

TOPOGRAPHIC MAP
GRAPHIC SCALE
1" = 1,000'
1,000, 0 1,000,
I � i
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within N C- RA-53
in 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. All
locations are approximate. Fields 1-2

8
0 F
VICINITY MAP
GRAPHIC SCALE
1" = 4,000'
4,000- 0 4,000-
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within N C-RA-53
in 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. All
locations are approximate. Fields 1-2

APPLICATION MAP
f�
a
F
}y
r r
tF
,y
�'6 i#„ � r+4.. 'Y g. it ,r .; "w'p '�,+ a •�,, ,�' ,� + ,(` ,.k �'i. �.
4 d "� 1 ? (•� 1'T t I..i3".`"� ��>) ! - 4• � c � L� -v x �5`1..� ' i t ""�-^� ,i '�f9'i: L"� t r Yu,�ti �"" Y,
—
ft
�'�d��F ya� .�'1! � �\ram �!• r �`' r�
i a
r Y
� y 5 1� � ! ,, k ' .,+.� � �is '�5 �., d . � ° , '.�..•.
kA.NN
x r
S``�f ,y. ., "•/!,{•.fir }"�� s ��I ��` OJ,�c ;t
r
f
4''' .T �. C t..^.: . A'�t + { Jti r�!, �e��ri�e � •„�'`.fie
LEGEND
APPLICATION AREA UNSUITABLE AREA
WATER
— — — — — — PRIVATE ROAD
— — — — STREAM ONSITE HOUSE GRAPHIC SCALE
DRAIN ® OFFSITE HOUSE
1"=660'
660, o sso'
X x--- 4(— FENCE OUTBUILDING
- PROPERTY LINE 0 WELL
SOIL BORING
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within N C-AL-1 3
in 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. All
locations are approximate" Fields 4-5

APPLICATION MAP
LEGEND
APPLICATION AREA
UNSUITABLE AREA
iV
WATER
— — — — — — PRIVATE ROAD
— — — — STREAM
ONSITE HOUSE
— DRAIN
®
OFFSITE HOUSE
X X —x-- FENCE
OUTBUILDING.
PROPERTY LINE
WELL
SOIL BORING
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within
in 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. All
locations are approximate.
GRAPHIC SCALE
1" = 660'
660' 0 660'
NC-AL-13,
Field 6

SOIL SURVEY
GRAPHIC SCALE
1" = 660'
660' 0 660'
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within N C-AL-13
in 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. All
locations are approximate. Fields 4`5

SOIL SURVEY
- % a, a ' .zap» � + i�
t N R^' � to `��.'"* '� � 4�++'� .. it �'� � ,• rxt� �� '�` x `'� 7�. „°" _
iL*
"� .'�y�, � t ,1.�� `�" bpi t '^C k:�a � x � �� x �f••x {c't,�� rs-.- x -�`
df
f FF
's+
r1jr,
T-.
,1t t {
ll
,x
a
aA
Y pT•< 8 3� F"uF �:."i4 fFttL IyK/t. {,. `
f a!`55a ✓«-; Rf xgi����4 ��T' � s,�» �' r�=�Yv k � ,^ � ;. �� s
S 'yy � S � P � .. tf 4EF'• "4�'4 c.� i .. Y � MMF.
y/ y g
?� � ✓ . F° 'y ''p1 � 3 � t�4 ,p�``.,�,✓� ' f �' w '1� �,I ^ � y t�ft .'� r m, q'••.,,�F4�� �"f '.
GRAPHIC SCALE
1 " = 660'
660, 0 660'
i f
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within I V C-AL-13
in 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. All
locations are approximate. Field 6

TOPOGRAPHIC MAP
Jk
10
% ' "� •`
J /
_ ,,..-.•�- `III � � � #f„ - ,. �-�.-_, ..�1..--�
) -�
GRAPHIC SCALE
1" = 660'
sso 0 660'
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within
in the property boundary, whichever is closest to the application area. The review boundary is established
N C-AL-13
field 6
Field
midway between the compliance boundary and the perimeter of the residuals application area. All
locations are approximate.

TOPOGRAPHIC MAP
dY
GRAPHIC SCALE
1" = 800'
800, 0 800,
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within N C-AL-13
in the properly 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. All
locations are approximate. Fields 4-5

4115;
VICINITY MAP
GRAPHIC SCALE
1" = 4,000'
4,000' 0 4,000-
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within
in 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. All
locations are approximate.
NC-AL-13
Fields 4-6

l l • 1 a
A
q�
► 'P `�li
��A ♦ ,� 4�Af►► V f O 41 `.. d
��
K �♦ ®
�dd /IiddIIll��d I,,��l
s a i .! �►
�.,, ar ' 4 A
' � �(` # M 0►
p. I IIIOIIIIIdI/IIIIOds���� Q �� d . .
r► II Ij I,I�Id II
#
"y f +'r ., . �p `� `
a
♦ ► �/ �III� ��} dam' 4
.� ,
*
ir'.€ � $ h, 0►A , gr�► ��I►
�, r l4, f
Y..�w QF I• ©
rj14s4+Iii jl/ii�I ,t
�.le�/I�j�/II,IjIIfj Y�"�• a.
`'� .Listd I�jl�sdj
9
e A �
4 F a• 4
s'ti'•
! r��,t
t�� y��'b �;'i i��b
WArA
I wil 11
1 1 1• 1. .1 '• � 1 .11 • . • �
1
1 • 1 1 1. 1 /' • .1 • �

SOIL SURVEY
GRAPHIC SCALE
V = 660'
660' 0 660'
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within N C-AL-1 5
in 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. All
locations are approximate. Fields 1-3

TOPOGRAPHIC MAP_
GRAPHIC SCALE
1" = 800'
800' 0 800,
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within
in the properly 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. All
locations are approximate.
NC-AL-15
Fields 1-3

VICINITY MAP
GRAPHIC SCALE
1" = 4,000'
4,000' 0 4,000'
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within
in 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. All
locations are approximate.
NC-AL-15
Fields 1-3

APPLICATION MAP
LEGEND
APPLICATION AREA UNSUITABLE AREA
— — — — — — PRIVATE ROAD WATER
— — — — STREAM ® ONSITE HOUSE
— DRAIN . OFFSITE HOUSE
X X X FENCE OUTBUILDING
------- PROPERTY LINE 0 WELL
SOIL BORING
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within
in 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. All
locations are approximate.
GRAPHIC SCALE
V = 660'
660, 0 660'
NC-AL-16
Field 1

SOIL SURVEY
GRAPHIC SCALE
1" = 660'
660' 0 660'
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within I V C-AL-16
in the properly 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. All
locations are approximate. Field 1

TOPOGRAPHIC MAP
W
GRAPHIC SCALE
1 " = 800'
800' 0 800,
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within N C-AL-1 6
in the property boundaryy, 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. All
locations are approximate. Field 1

VICINITY MAP
GRAPHIC SCALE
1" = 4,000'
4,000' 0 4,000'
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within
in the properly 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. All
locations are approximate,
NC-AL-16
Field 1

[ r � yy+,�, *,i ,r} rz c�, 7 � n %"' _ . � • a • _ .v zap[ +� ;
. Apea•
\\\'T
I Ali
Ali
�,6
`�TP
F "e F'i1 e7 Wl�w.�%=- �s°a�y ti.. r .� P't11,`�,� t. / !✓.'�.Ky�_'.
•�}r y ��, t.. fix. � v4� cm,� A't`'.. 6¢*�a�yi ���o f� r *�'� t �� .,���
"'+t '��r .'�+';�� � apj%� 4• r��f _"" `6i�C�aC �'"�'/6A' 'r t'��, \\\\� '�'��. �}
y ,, �.�r4c ; F' ,a t' r"���`�{ � �r9� n 4� rghr,•:' .t., � C'� .,d�:l�i� '� .P ;
{C.�, �i '.�. -.Ta.r, e��� •.'�4� ter *� i i"' .��,"p}�.
ip y
'�"�� '"�` ! ir* pv e � p /���r�_� �3 gip, ,+ ' �a a �`,i �;•=a
'•i.g r *1`"',...: " sp+� O e®�l� 6�; >zS r t�_�„c i s � tr � * �r+i�:4;bdd+�.
a'
_ ./� '+34,.
�� :� � � � j�:'� ;r"'" • x ram. _ .�.`;• "
Y S
a.
44,
L

r ?` 14, !
F6C2 pp•y {; ,� {,r * �`? oD,':La + +- :'
HW
� ra iri Owl
Y
�} p
03[• t .� � �r ��Z`' 4 '` � _ter- .,Jn. �- k�� - � �. � -. �} �!
4
+V fi
t.7• 1 i t'I+y t V�qG „�' ��I �r `�, w ��� r - ''w,� t �'„ I �,��tYrf
�„dl,Ir.
IIiK 't
1s;. � -�,� � '+ A y4t'Yy YA A A '_! 41k��" •V` � '.'�'
j A
` tr n��' .. � ,I a,� JIl' ,`,r � ` t'r}'�..• Lt' '{ r.QY�' .

.rj� _ A' Zi.�
�r,yY' ,/.K�� �'i'�.YFA d1�{ T T ••i
-fS
�'� : •i ftn� � 1'��
v

fx�
SOIL SURVEY
GRAPHIC SCALE
1" = 660'
660' 0 660'
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within
in 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. All
locations are approximate,
NC-CD-03
Fields 6-7

APPLICATION MAP
I4,iA x CgS J 31� _ f'xi} if a` t'h Ska1
.a,'r �. k L FX
9 ,
x<s�
�` ^��' �71 , . � A P , �" � 1� r• �" �� dty��t� ���'�ti, �� , t. ,t �f w s, �`�
� �' 'ram;fxi c+- � �• ''4 � ���i .�gw 4 ad` r',i
I �'=.� 'd 3 •- z�. ate, � '�' ,� �:
111
{)i`,
t p. rr t
f�a tl ix '"��� fiq.�* V4e xxvd,`sxa�l yqa �a�f� i
1 + `
l 1 L fi
.—
r� G 4K j
E1
v7vs gz
t`�>a)
,;� yin a'• j ` .t �,� �'r TLER CR '"
3
LEGEND
crF
�s r
01
Z'h3.'�pi
APPLICATION AREA
UNSUITABLE AREA
— — — — — — PRIVATE ROAD
Ul
WATER
— — — — STREAM
ONSITE HOUSE
— DRAIN
®
OFFSITE HOUSE GRAPHIC SCALE
1 " = 660'
X X X FENCE
OUTBUILDING
sso' o sso'
PROPERTY LINE
(Zj
WELL
0
SOIL BORING
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within
in 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. All
locations are approximate.
NC-CD-o3
Field 9

SOIL SURVEY
GRAPHIC SCALE
V = 660'
sso' o sso'
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within
in 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. All
locations are approximate.
NC-CD-03
Fields 9

TOPOGRAPHIC MAP
GRAPHIC SCALE
1" = 1,000'
1,000, 0 1,000-
�.e
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within
in 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. All
locations are approximate.
NC-CD-03
Fields 2-3, 10

r�.
TOPOGRAPHIC MAP
GRAPHIC SCALE
1" = 800'
800' 0 800,
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within
in 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. All
locations are approximate.
NC-CD-03
Field 9

TOPOGRAPHIC MAP
GRAPHIC SCALE
V = 800'
soo' o 800,
f
f
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within N C-C D s0 3
in 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. All
locations are approximate. Field 9

VICINITY MAP
GRAPHIC SCALE
V = 4,000'
4,000' 0 4,000-
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within
in 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. All
locations are approximate.
NC-CD-03
Fields 2-3,6,7,9,10

r APPLICATION MAP
T•
'1'J-- 1 ._3'j,y if" .. � '� r "•�.."�' F ��5a1 .*1 � ._� •E>�J�`r"'af' "#'f'�z t
�� �, A"4 i
PJR '¢
a
G
" wr 7 r
�� f a.r '� i S4 st
lip
^ .� N� if�� f J e. < •A ,��"� it A � f f �`�.t�il ?: ' � �'
5 `AIL lnC
e!, fl! f.
'� tf }' �N°
♦ Ji ,?r% } .
:, E
I *
1
1
zee
JO
Y Re d,
a
r
R
LEGEND
0`�
APPLICATION AREA UNSUITABLE AREA
— — — — — — PRIVATE ROAD WATER
— — — — STREAM ® ONSITE HOUSE
GRAPHIC SCALE
— DRAIN ® OFFSITE HOUSE
I" = 660'
660'
X FENCE OUTBUILDING
0 660'
-- ---- PROPERTY LINE 0 WELL
SOIL BORING
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within
N C',-I R-36
in the properly 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. All
locations are approximate.
Fields 1-2

APPLICATION MAP
I CnEkin
APPLICATION AREA
UNSUITABLE AREA
— — — — — — PRIVATE ROAD
WATER
— — — — STREAM
®
ONSITE HOUSE
— DRAIN
.
OFFSITE HOUSE GRAPHIC SCALE
1"=660'
X X—=X FENCE
OUTBUILDING
sso' o sso'
-- --- PROPERTY LINE
WELL
Q
SOIL BORING
The compliance boundary is established either 250 ft from the residuals application area or 50'feet within
in 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. All
locations are approximate.
NC-IR-36
Field 5

SOIL SURVEY
V. {y
AN
i Me
I
q
q
q
'fie. \ is "•%" y � �`` h — I ..�i&.
uO
> — �" •ram_. '- ,..._ _ .... ,, #.
GRAPHIC SCALE
1" = 660'
660, 0 660'
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within N C-I R-36
in [lie 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. All
locations are approximate. Fields 1-2

SOIL SURVEY
GRAPHIC SCALE
1" = 660'
ssor 0 ssor
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within N C_ I R-36
in 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. All
locations are approximate. Fields 3-4

TOPOGRAPHIC MAP `
IT C
GRAPHIC SCALE
1" = 800'
800, 0 800,
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within N C- I R-36
in 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. All
locations are approximate. Fields 1-2

TOPOGRAPHIC MAP
w
GRAPHIC SCALE
1"= 1,000'
1,000, 0 1,000,
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within N C-I R-36
in 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. All
locations are approximate. Fields 3-5

ROY COOPER
Governor
MICHAEL S. RECAN
SICrerury
UNDA CULPEPPER
Dircc'nt'
NORTH CAROLINA
Environmental Quality
May 16, 2019
ROBERTN. ROTH —TECHNICAL SERVICES MANAGER
SYNAGRO CENTRAL, LLC
284 BOGER ROAD
MOCKSVILLE, NORTH CAROLINA 27028
Subject: Permit No. WQ0016247
Synagro Western Piedmont RLAP
Attachment A Certification
Alexander County
Dear Mr. Roth:
In accordance with your permit major modification request received April 16, 2019, we are
forwarding herewith a modified Attachment A certified May 16, 2019, to Synagro Central, LLC for the
subject residuals management program.
Modification to the subject Attachment is as follows: Addition of 315 dry tons per year from the
Norwood WWTP (Permit No. NC0021628, Stanly County).
The modified Attachment A shall be effective from the date of certification until October 31, 2022
(i.e., expiration date of the current permit), shall void Attachment A of Permit No. WQ0016247 issued
November 17, 2017, and shall be subject to the conditions and limitations as specified therein, as well as
those specified in the above -referenced permit. Please replace Attachment A of Permit No. WQ0016247
that was issued November 17, 2017 with the modified Attachment A. Please note that the Permittee shall
submit a renewal application no later than May 4, 2022.
If any parts, requirements or limitations contained in this certification are unacceptable, the
Permittee has the right to request an adjudicatory hearing upon written request within 30 days following
receipt of this permit. This request shall be in the form of a written petition, conforming to Chapter 150B
of the North Carolina General Statutes, and filed with the Office of Administrative Hearings at 6714 Mail
Service Center, Raleigh, NC 27699-6714. Otherwise, this certification shall be final and binding.
If you need any additional information concerning this matter, please contact Troy Doby at (919)
707-3655 or troy.dobvic nedenngov.
Sincerely,
Linda Culpepper, Director _ J
Division of Water Resources
cc: Alexander County Health Department (Electronic Copy)
Caldwell County Health Department (Electronic Copy)
;.North Carolina Department of rnvlromnental Quality ; Divlslan of WWCr Resources
Do E
_ 512 worth Salisbury Street 1617 ivlail Service C.mter 1 Rale;gli, north C�)rolina 27699-ib17
:tea , ti u 919.70i9000

Mr. Robert N. Roth
May 16, 2019
Page 2 of 2
Iredell County Health Department (Electronic Copy)
Polk County Health Department (Electronic Copy)
Stanly County Health Department (Electronic Copy)
Mooresville Regional Office, Water Quality Regional Operations Section (Electronic Copy)
Laserfiche File (Electronic Copy)
Digital Permit Archive (Electronic Copy)
Central Files

ATTACHMENT A — APPROVED RESIDUAL. SOURCES
Synagro Central, LLC
Certification Date: May 16, 2019
Permit Number: WQ0016247 Version: 4A
Monitoring
Maximum
Monitoring
Monitoring
Frequency for
Approved
Owner
Facility Name
County
Permit
Biological
Dry Tons
Frequency for
Frequency for
Pathogen &
Mineralization
Number
Residuals
per Year t
Non -hazardous
Metals and
Vector Attraction
Rate
Characteristics 2
Nutrients
Reductions 1, 5
City of Statesville
Third Creek WWTP
I Iredell
NCO020591
( Yes
972.9
Annually
See Table Below
See Table Below
0.3
of Columbus
Columbus WWTP
Polk
NCO021369
Yes
Annually
Annually
Annually
0.3
—Town
Town of Norwood
Norwood WWTP
Stanly
NC0021628
Yesv
_80
315
Annually
Annually
_ Annually
0.3
Town of Granite Falls
Granite Falls WWTP
Caldwell
I NCO021890
Yes
200
4 Annually
Annually
Annually
0.3
City of Statesville
Fourth Creek WWTP
IredellW
f NCO031836
Yes
1,055.7
Annually
See Table Below
See Table Below
^`Annually
0.3
Stanly County Utilities
West Stanly WWTP
Stanly
NCO043532
Yes
300
Annually
Annually
0.3
Town of Granite Falls
Granite Falls WTP
Caldwell
NCO082546
No
45
Once per permit
cy cle
Annually
None6
-
_
_ Total ---I
r �.-•m..
-�__
2,968.E
_ _ _
1. Maximum Dry Tons per Year is the amount of residuals approved for land application from each permitted facility.
2. Analyses to demonstrate that residuals are non -hazardous (i.e., TCLP, ignitability, reactivity, and corrosivity) as stipulated under permit Condition IV.2.
3. Testing of metals and nutrients as stipulated under permit Condition IV.3.
4. Analyses of pathogen and vector attraction reductions as stipulated under permit Condition IVA.
5. Monitoring frequencies are based on the actual dry tons applied per year using the table below, unless specified above.
Dry Tons Applied
Monitoring Frequency
Dry Tons Applied (metric tons)
(short tons per year)
(40 CFR 503 and 15A NCAC 02T
.1111(c))
< 290
< 319
Once per year (Annually)
> 290 to < 1,500
{ >_ 319 to < 1,650
Once per quarter (4 x Year)
>_ 1,500 to < 15,000
I >_ 1,650 to < 16,500
Once per 60 days (6 x Year)
> 15,000
( > 16,500
Once per month (12 x Year)
6. Class A water treatment plant residuals are exempt from meeting the pathogen and vector attraction reduction requirements in Condition IVA, provided they are not mixed with residuals that have
been generated during the treatment of domestic wastewater, the treatment of animal processing wastewater, or the biological treatment of industrial wastewater. The Class A water treatment plant
residuals must be treated and processed in a manner as to not meet the definition of "Biological Residuals" as defined in 15A NCAC 02T .1102(6).
If no land application events occur during a required sampling period (e.g., no land application occur during an entire year when annual monitoring is required), then no sampling data is
required during the period of inactivity. The annual report shall include an explanation for missing sampling data. Those required to submit the annual report to United States Environmental
Protection Agency (US EPA) may be required to make up the missed sampling. Contact the US EPA for additional information.
WQ0016247 Version 4.1 Attachment A Page 1 of 1

THIS PAGE BLANK

litdaPer Resources
ENVIRONMENTAL QUAL3rY
November 17, 2017
WI I. i ,I.A.M P. COITER — REGIONAL VICE .PR.ESIDENT
SYNAGRO CENTRAL, I.<LC
284 BOGER ROAD
MOCK MLI.,E, NORTH CAROLINA 27028
Dear :Mr. Cotter:
ROY COOPER
Gcwernor
MICHAEL S..REGAN
Secreiw y
LINDA CULPE.PPER
Interim Director
Subject: Permit No. WQ0016247
Synagro Western Piedmont RLAP
Land Application of
Class B Residuals
Alexander County
In accordance with your permit major modification and renewal request received September 6,
2017, and subsequent additional information received October 25, 2017, we are forwarding herewith Permit
No. WQ0016247 dated November 17, 2017, to Synagro Central, LLC for the continued operation of the
subject residuals management program.
Modifications to the subject permit are as follows:
L Removal of six fields in Alexander County totaling 146.6 acres, those fields being NC-AL-
0 14-0 1 A. NC-AL-0 14-0 1 B, NC-AL-014-02, NC-AL-01.4-03, NC-AL-014-04, and NC-AL-
014-05;
2. Removal of seven fields in Iredell County totaling .148.0 acres, those fields being NC-1R-22-
01, NC-1R-22-02, NC-IR-22-03, NC-IR-22-04, NC-IR-23-01, NC-IR-25-01 and NC-1R-29-01.
3. Removal of three fields in Stanly County totaling 14.8 acres; those fields being NC-ST-15-01,
NC: ST'-15-02 and NC-ST-15-03.
4. Addition of four fields in I:redell County totaling 99.2 acres, those fields being NC-IR-35-01,
NC-IR-35-02, NC-IR-35-03 and NC-IR-35-04.
This permit shall be effective from the date of issuance until October 31, 2022, shall void Permit
No. WQOO16247 issued March 27, 2009, and shall be subject to the conditions and limitations as specified
therein. Please payparticular attention to the monitoring requirements listed in Attachment A for they may
differ from the previous permit issuance. Failure to establish an adequate system for collecting and
maintaining the required operational information shall result in future compliance problems.
-° .>-Nothin C:omp re ­.;_M.
State of North Carolina, Environmental Quality 1Water Resources' Water Quality Permitting' Non -Discharge Permitting
1617 hail Service Center ( Raleigh, North Carolina 27699-1617
9.19-807-6332

Mr. William P. Cotter
November 17, 2017
Page 2 of 3
Please note the following permit conditions have been removed since ibe last permit issuance
dated March 27,2009:
> Old Condition 1U.5. —No need to void permit if land does not assimilate residuals since other
land sites can be found.
> Old Condition 111.8. — Redundant since covered by Old Condition 1.11.7. and Condition 111.9,
> Old Condition Ill, I O.h. —Replaced by Condition ,111. I LL
> Old Condition IV.9. —Record retention requirements now part of individual. conditions.
Please note the following permit conditions are new since the last permit issuance dated
March 27, 2009:
> Condition 1.2. —Permittee to be in compliance with notification requirements of Condition 111.1
within 90 days of permit issuance. -
Condition 1.3. — Permittee to be in compliance with signage requirements of Condition Ill. 13
within 90 days of permit issuance.
Condition 11.9. — Similar to Old Condition 11.7.b.., but now more setback requirements than
before. Read carefully.
> Condition 11,12. — Grazed pastureland shall have a 25% reduction in realistic nitrogen
application rate, 0
> Condition 111.3. — Mooresville Regional Office to be notified at least 48 hours in advance prior
to applying residuals,
> Condition 111.6. — Similar to Old Condition 11.1.6., but now Operation & Maintenance Plan to
be kept on site during application. Note that "copy" may include electronic copy.
> Condition 111. 1 Lk. — Bulk residuals not to be applied if exceeds agronomic application rate.
> Condition 111. 13. —Public access controls specified.
Condition VI.6. — Similar to Old Condition VI.6., but 60-day notification required before either
modification or revocation.
> Condition V1.7. — Expansion of facility not permitted without waiver if Permittee exhibits
behavior detrimental to environment.
If any parts, requirements or limitations contained in this permit are unacceptable, the Permittee
has the riRht, to request an adjudicatory hearing upon written request within 30 days following receipt of
this permit. This request shall be in the form of a written petition, conforming to Chapter 150B of the North
Carolina General Statutes, and filed with the Office of Administrative Hearings at 6714 Mail Service
Center, Raleigh, NC 27699-6714. Unless such demands are made, this permit shall be final and binding.

Mr. William P. Cotter
November 17,2017
Page 3 of 3
If you need additional information concerning this pen -nit, please contact Troy Doby at (919) 807-
6336 or tra.doby,'Anederingov.
Sincerely,
inch Culpepper, Interim. Director
Division
d
gon of Water Resources
ivisi
cc: Alexander County Health Department (Electronic Copy)
Mooresville Regional Office, Water Quality Regional Operations Section (Electronic Copy)
ErikBruce — Synagro, Central, I-ILC (Electronic Copy)
Beth Buffington — Protection and Enforcement Branch (Electronic Copy)
Digital Permit Archive (Electronic Copy)
Central Files

z . t i►: " ,

ENWRONMENTAL MANAGEMENT COMMISSION
I �i 111� --J� I i I I
In accordance with the provisions of Article 21 of Chapter 1.43, General Statutes of North Carolina as
amended, and other applicable Laws, Rules, and. Regulations
PERMISSION IS HEREBY GRANTED TO
-74
iiynagro Central, LLG
Alexander County
continued operation of a residuals management program for Synagro Central, LLC and consisting of the
land application of Class B residuals generated by the approved facilities listed in Attachment A to the
approved fields listed in Attachment B with no discharge of wastes to surface waters, pursuant to the
application received September 6, 201.7, and subsequent additional information received by the Division of
Water Resources, and in conformity with other supporting data subsequently filed and approved by the
Department of Environmental Quality and considered a part of this permit. The use and disposal of residuals
are regulated. under Title 40 Code of Federal Regulations Part 503. This permit does not exempt the
Permittee from complying with the federal regulations.
This permit shall be effective from the date of issuance until October 31, 2022, shall void Permit No.
WQ0016247 issued March 27, 2009, and shall be subject to the following specified conditions and
limitations:
I. SCHEDULES
No later than six months prior to the expiration of this permit, the Permittee shall request renewal of
this permit on official Division forms, Upon receipt of the request, the Division will review the
adequacy of the facilities described therein, and if warranted, will renew the permit for such period of
time and under such conditions and limitations as it may deem appropriate. Please note Rule 15A
NCAC 02T.01.05(d) requires an updated site map to be submitted with the permit renewal application.
[15A NCAC 02T.0108(b)(2). 02T.0105(d), 02T.01 09]
2. The Permittee shall be in full compliance with the regional office notification requirements established
in Condition 111.33. within 90 days of the effective date of this permit. [ 15A NCAC 02T .0108(b)(2)]
3. The Permittee shall be in full compliance with the signage requirements established in Condition.111.13,
within 180 days of the effective date of this permit, [ 1 5A NCAC 02T .0 108(b)(2)1
WQOO 16247 Version 4.0 Shell Version 17 1103 Page 1 of 13

,,o
The subject residuals management program shall be effectively maintained and operated at all times so
there is no discharge to surface waters, nor any contravention of groundwater or surface water
standards. In the event the facilities fail to perform satisfactorily, including the creation of prolonged
nuisance conditions due to improper operation and maintenance, the Permittee shall immediately cease
land applying residuals, contact the Mooresville Regional Office supervisor, and take any immediate
corrective actions. [G.S. 143-215.1]
2. This permit shall not relieve the Permittee of responsibility for damages to groundwater or surface
water resulting from the operation of this residuals management program, [15A NCAC 02B .0200,
02L.0100]
3. Only residuals generated by the facilities listed in Attachment A are approved for land application in
accordance with this permit. [G. S . 143-215.1 ]
4. Only the fields listed in Attachment B are approved for residuals land application, [G.S. 143-215. 1 ]
5. Pollutant concentrations in residuals applied to land application sites listed in Attachment B shall not
exceed the following Ceiling Concentrations (i.e., dry weight basis) or Cumulative Pollutant
Loading Rates (CPLRs):
Parameter
Ceiling Concentration
(milligrams per kilograin)
CPLR
(pounds per acre)
Arsenic
75
36
Cadmium
85
34
Copper
4,300
1,338
Lead
840
267
Mercury
57
15
Molybdenum
75
n/a
Nickel
. . . . . 420
374
Selenium
......... ..
100
89
Zinc
7,500
2,498
The Permittee shall determine compliance with the CPI,Rs using one of the following methods:
a. By calculating the existing cumulative level of pollutants using actual analytical data from all
historical land application events of residuals, or
b. For land where residuals application has not occurred or for which the required data is incomplete,
by determining background concentrations through representative soil sampling.
[15A NCAC 02T. 1105]
6. Residuals that are land applied shall meet Class B pathogen reduction requirements in 15ANCAC 02T
.1106 (a) and (c), Exceptions to this requirement shall be specified in Attachment A. [15ANCAC 02T
.1106]
7. Biological residuals (i.e. residuals generated during the treatment of domestic or animal processing
wastewater, or the biological treatment of industrial wastewater, and as identified in Attachment A)
that are land applied shall. meet one of the vector attraction reduction alternatives in 15A NCAC 02T
3.107(a). Exceptions to this requirement shall be specified in Attachment A. [15ANCAC 02T.I.107]
WQOO 16247 Version 4.0 Shell Version 171103 Page 2 of 13

8. Setbacks for treatment and storage facilities shall be as follows:
Setback Description
Setback
(feet)
Habitable residence or place of public assembly under separate ownership or not to
100
be maintained as part of the project site
Property tines
50
Private or public water supply
100
Surface waters (streams — intermittent and perennial, perennial waterbodies, and
50
wetlands)
Wells with exception to monitoring wells
100
* All treatment and storage facilities were originally permitted prior to September 1, 2006.
[I 5A NCAC 02T. 1108]
9. Setbacks for Class B land application sites shall be as follmvvs:
Setback by application type
(feet)
Setback Description
Vehicular
Irrigation
Surface
Surface
Injection
Application
Application
Incorporation
Habitable residence or place of public assembly under
separate ownership or not to be maintained as part of
400
400
200
the project site
Habitable residence or places of public assembly
owned by the Permittee, the owner of the land, or the
0
200
0
lessee/operator of the land. to be maintained as part of
the project site
Property lines
50
150
50
Public right of way
50
so
50
Private or public water supply
... .... ... . .. .. .....
100
100
100
Surface waters (streams — intermittent and perennial,
100
100
50
perennial waterbodies, and wetlands)
Surface water diversions (ephemeral streams,
25
100
25
waterways, ditches)
Groundwater lowering ditches (where the bottom of
25
100
25
the ditch intersects the SF WT)
Subsurface groundwater lowering system
0
too
0
Wells with exception to monitoring wells
100
100
100
Bedrock outcrops
25
25
25
Top of slope of embankments or cuts of two feet or
15
15
15
more in vertical height
Building foundations or basements
0
15
0
Water lines
0
10
0
Swimming pools
100
100
too
Nitrification fields
0
20
0
[.15A NCAC 02T. 1108]
WQOO 16247 Version 4.0 Shell Version 171103 Page 3 of 13

10. Land application areas shall be clearly marked on each site prior to and during any residuals application
event. [15ANCAC 02T.0108(b)(1)]
11. Bulk residuals and other sources of Plant Available Nitrogen (PAN) shall not be applied in exceedance
of agronomic rates. Appropriate agronomic rates shall be calculated using expected nitrogen
requirements based on the determined Realistic Yield Expectations (RYE) using any of the following
methods:
a. Division's pre -approved site specific historical data for specific crop or soil types by calculating
the mean of the best three yields of the last five consecutive crap harvests for each field,
b, North Carolina Historical Data for specific crop and soil types as provided by North Carolina State
University Department of Soil Science liittp:,,,Inutrients.s�oil.nc.s4.edu/vields­`/��inde�,x. hqp _). A copy
shall be kept on file and reprinted every We years in accordance with Condition W.6,
c, If the RYE cannot be determined using methods (a) or (b) above, the Permittee may use the RYE
and appropriate nutrient application rates reported in any of the following documents:
i. Crop management plan as outlined by the local Cooperative Extension Office, the North
Carolina Department of Agriculture and Consumer Services, the Natural Resource
Conservation Service, or other agronomist.
ii. Waste Utilization Plan as outlined by the Senate Bill 1217 Interagency Group - Guidance
Document: Chapter I
(http://,N-A,w.ticaar.9-ov/SWC/tech/documeiits/9th Guidance Doe 100109,pdf).
iii. Certified Nutrient Management Plan as outlined by the Natural Resources Conservation
Services (MRCS). These plans must meet the USDA-NRCS 590 Nutrient Management
Standards (ftp://ft -fc.sc.egov.usda.,gov/NH 1pLactice-standards/standar
d. If the RYE and appropriate nutrient application rates cannot be determined, the Permittee shall
contact the Division to determine necessary action.
[15ANCAC 02T . I 109(b)(1)(k)]
12. When residuals are land applied to grazed pasture, hay crop realistic nitrogen rate shall be reduced by
25% in accordance with the USDA -MRCS 590',Nutrient Management Standards. [15A NCAC 02T
,0108(b)(I)]
13. If land application sites are to be over -seeded or double -cropped (e.g., beimuda grass in the summer
and rye grass in the winter with both crops to receive residuals), then the second crop can receive an
application of PAN at a rate not to exceed 50 pounds per acre per year (lbs/ac/yr). This practice may
be allowed as long as the second crop is to be harvested or grazed. If the second crop is to be planted
for erosion control only and is to be tilled into the soil, then no additional PAN shall be applied. [15A
NCAC 02T.0108(b)(1)]
14., Prior to land application of residuals containing a sodium adsorption ratio (SAR) of 10 or higher, the
Permittee shall obtain and implement recommendations from at least one of the following: the local
Cooperative Extension Office: the Department of Agriculture and Consumer Services-, the Natural
Resource Conservation Service; a North Carolina Licensed Soil Scientist; or an agronomist. The
recommendations shall address the sodium application rate, soil amendments (e.g,, gypsum, etc.), or a
mechanism for maintaining site integrity and conditions conducive to crop growth. The Permittee shall
maintain written. records of these recommendations and details of their implementation, [15AN'CAC
02T.0108(b)(1)]
WQOO.l 6247 Version 4.0 Shell Version 171103 Page 4 of 13

15. These residuals land application sites were individually permitted on or after December 30, 1983;
therefore, the compliance boundary is established at either 250 feet from the residual land application
area, or 50 feet within the property boundary, whichever is closest to the residual land application area.
An exceedance of groundwater standards at or beyond the compliance boundary is subject to
remediation action according to I5A NCAC 02L .0106(d)(2) as well as enforcement actions in
accordance with North Carolina General Statute 143-2.1.5.6A through 1.43-2.15.6C. Any approved
relocation of the COMPLIANCE BOUNDARY will be noted in Attachment B. [15A NCAC 02L
.0107(a)]
16. The review boundary shall be established midway between the compliance boundary and the residual
land application area. Any exceedance of groundwater standards at the review boundary shall require
action in accordance with 15A NCAC 02L .0106. [15A NCAC 02L .0108]
III. OPERAATION AND MAINTENANCE REQUIREMENTS
1. The residuals management program shall be properly maintained and operated at all times. The
program shall be effectively maintained and operated as a non -discharge system to prevent any
contravention of surface water or groundwater standards. [15A NCAC 02T .l 11.0]
The Mooresville Regional Office, telephone number [phone], and the appropriate local
government official (i.e., county manager, city manager, or health. director) shall be notified at least 48
hours prior to the initial residuals land application to any new land application site. Notification to the
regional supervisor shall be made from 8:00 a.m. until 5:00 p.m. on Monday through Friday, excluding
State Holidays. [15ANCAC 02T .0108(b)(1)]
3. The Mooresville Regional Office shall be .notified via email or telephone, [phone], at least 24
hours prior to conducting any land application activity. Such notification shall indicate, at a minimum,
the anticipated application times, field IDs, and location of land application activities. If it becomes
necessary to apply to additional fields due to unforeseen events, the Regional Office shall be notified
prior to commencing the application to those fields. [15A NCAC 02T .0.108(b)(1)]
4. The :Permittee shall maintain an approved Operation and Maintenance:Plan (O&M Plan) Modifications
to the O&M Plan shall be approved by the Division prior to utilization of the new plan. The O&M Plan,
at the minimum, shall include:
a. Operational functions;
b. Maintenance schedules;
c. Safety measures;
d. Spill response plan;
e. Inspection plan including the following information:
i. Names and/or titles of personnel responsible for conducting the inspections;
ii. Frequency and location of inspections, including those to be conducted by the ORC, and
procedures to assure that the selected location(s) and inspection frequency are representative
of the residuals management program;
iii. Detailed description of inspection procedures including record keeping and actions to be taken
by the inspector in the event that noncompliance is observed pursuant to the noncompliance
notification requirements under the monitoring and reporting section of the permit;
f. Sampling and monitoring plan .including the following information:
i. Names and/or titles of personnel responsible for conducting the sampling and monitoring;
ii. Detailed description of monitoring procedures including parameters to be monitored;
WQ0016247 Version 4.0 Shell Version 171103 Page 5 of 13

iii. Sampling frequency and procedures to assure that representative samples are being collected.
Fluctuation in temperature, flow, and other operating conditions can affect the quality of the
residuals gathered during a particular sampling event. The sampling plan shall account for any
foreseen fluctuations in residuals quality and indicate the most limiting times for residuals to
meet pathogen and vector attraction reduction requirements (e.g. facilities that land apply
multiple times per year but have an annual sampling frequency, may need to sample during
winter months when pathogen reduction is most likely to be negatively affected by cold
temperatures).
[15A NCAC 02T .I 100]
Upon the Water Pollution Control System Operators Certification Commission's (WPCSOCC)
classification of the facility, the Permittee shall designate and employ a certified operator in responsible
charge (ORC) and one or more certified operators as back-up ORCs in accordance with 15A NCAC
08G .0201. The ORC or his back-up shall visit the facilities in accordance with 15A NCAC 08G. 0204,
or as specified in the most recently approved O&M plan (i.e., see Condition 111.4.), and. shall comply
with all other conditions of 15A NCAC 08G. 0204. For more information regarding classification and
designation requirements, please contact the Division of Water Resources' Protection and Enforcement
Branch at [phone]. [1.5A NCAC 02T .0117]
6. When the Permittee land applies bulk residuals, a copy of this permit and a copy of O&M Plan shall be
maintained. at the land application sites during land application activities. [15A NCAC 02T
.0108(b)(.1)]
When the Permittee transports or land applies bulk residuals, the spill control provisions shall be
maintained in all residuals transport and application vehicles. [15A NCAC 02T .1.110]
8. Residuals shall not be stored at any land application site, unless written approval has been requested
and received .from. the Division. [G.S. 143-215.1 ]
9. When the Permittee land applies bulk residuals, adequate measures shall be taken to prevent wind
erosion and surface runoff from conveying residuals from the land application sites onto adjacent
properties or into surface waters. [G.S. 143-215.1]
10. When the Permittee land applies bulk residuals, a suitable vegetative cover shall be maintained on land
application sites onto which residuals are applied, or application shall be in accordance with the crop
management plan outlined by the local Cooperative Extension Office, the .Department of Agriculture
and Consumer Services, the Natural Resource Conservation Service, or an agronomist and as approved
by the Division. [15A NCAC 02T .l 109(b)(1)]
WQ0016247 Version 4.0 Shell Version. 171103 Page 6 of 13

11. Bulk residuals shall not be land applied under the following conditions:
a. If the residuals are likely to adversely affect a threatened or endangered species listed under section
4 of the, Endangered Species Act or its designated critical habitat;
b. If the application causes prolonged nuisance conditions;
c. If the land fails to assimilate the bulk residuals or the application causes the contravention of surface
water or groundwater standards;
d. If the land is flooded, frozen or snow-covered, or is otherwise in a condition such that runoff of the
residuals would occur;
e. Within the I 00-yeat flood elevation, unless the bulk residuals are injected or incorporated within a
24-hour period following a residuals land application event;
f. During a measurable precipitation event (i.e., greater than 0.01 inch, per hour), or within 24 hours
following a rainfall event of 0.5 inches or greater in a 24-hour period;
g. If the slope is greater than 10% for surface applied liquid residuals, or if the slope is greater than
18% for injected or incorporated bulk liquid residuals;
h. If the land does not have an established vegetative cover unless the residuals are incorporated or
injected within a 24-hour period following a residuals land application event. Any field that is in a
USDA no -till program shall be exempted from. meeting this vegetative cover requirement;
i. If the vertical separation between the seasonal high water table and the depth of residuals
application is less than one foot; I
j. If the vertical separation of bedrock and the depth of residuals application is less than one foot;
L Application exceeds agronomic rates,
[I 5A NCAC 02'r.1109]
12. The following public access restrictions apply to residual land application sites:
a. Public access to public contact sites (e.g., golf courses, parks, ball fields, etc.) shall be restricted
for 365 days after a residuals land application event;
b. Public access to non-public contact sites shall be restricted for 30 days after a residuals land
application event.
[ 15A NCAC 02T. 1, 109(b)(2)]
13. Public access controls shall include the posting of signs with a minimum area of 3 square feet (e.g.,
1.5' x 2'). Each sign shall indicate the activities conducted at each site, perinit number, and. name and
contact information, including the Permittee or applicator's telephone number. Signs shall be posted
in a clearly visible and conspicuous manner at the entrance to each land application site during a land
application event, and for as long as the public access restrictions required tinder Condition 111.12.
apply, [15ANCACO2T.0108(b)(1)]
WQOO 16247 Version 4.0 Shell Version 171103 - Page 7 of 13

14. The following harvesting and grazing restrictions apply to residual land application sites after each
land application event:
Harvesting and Grazing Description
Restricted
Duration
Animals shall not be allowed to graze during land application activities and
restricted period. Sites that are to be used for gazing shall have fencing to
30 days
prevent access after each land application event.
Food crops, feed crops and fiber crops shall not be harvested for:
E 30 days
Turf grown on land where residuals have been applied shall not be harvested for:
12 months
Food crops with harvested parts that touch the residual/soil mixture and are
totally above the land surface (e.g,, tobacco, melons, cucumbers, squash, etc,)
14 months
shall not be harvested for:
............
When the residuals remain on the land surface for four months or longer prior to
incorporation into the soil, food crops with harvested parts below the land
surface (e.g., root crops such as potatoes, carrots, radishes, etc.) shall not be
20 months
harvested for:
When the residuals remain on the land surface for less than four months prior to
incorporation into the soil, food crops with harvested parts below the land
38 months
surface shall not be harvested for:
[I 5A NCAC 02T I 109(b)(33)]
15. The Permittee shall acquire from each. landowner or lesseeloperator a statement detailing the volume
of other nutrient sources (i.e., manufactured fertilizers, manures, or other animal waste products) that
have been applied to the site, and a copy of the most recent Nutrient Management Plan (NIM.P) for those
operations where a NMIP is required by the US Department of Agriculture — National Resources
Conservation Service (NRCS) or other State Agencies. 'Ihe Permittee shall calculate allowable nutrient
loading rates based on the provided information and use appropriate reductions.
For the, purpose of this permit condition, a Crop Management Plan (CMP), Waste Utilization Plan
-(WUP) or Certified Nutrient Management Plan (CNMP) shall also be considered a Nutrient
Management :flan. [ 1.5A NCAC 02T .0108(b)(1), 02T .1104(c)(3)]
16. No residuals shall be land applied unless the submitted Land 0,,vner Agreement between the Permittee
and landowners or lessees/operators of the land application site is in full force and effect. These
agreements shall be considered expired concurrent with the permit expiration date, and shall be renewed
during the permit renewal process, [15ANCACO2T.1104(g)(4)]
C
WQOO 16247 Version 4.0 Shell Version 171103 Page 8 of 13

1. Any Division -required monitoring (including groundwater, plant tissue, soil and surface water
analyses) necessary to ensure groundwater and surface water protection shall be established, and an
acceptable sample reporting schedule shall be followed. [15A NCAC 02T .0108(c)]
2. Residuals shall be analyzed to demonstrate they are non -hazardous under the Resource Conservation
and Recovery Act (.RCRA). Residuals that tests or is classified as a hazardous or toxic waste under 40
CFR Part 261 shall not be used or disposed under this permit. The analyses [corrosivity, ignitability,
reactivity, and toxicity characteristic leaching procedure (T1CLP)l shall be performed at the
frequency specified in Attachment A, and the Permittee shall maintain. these results for a minimum of
five years. Any exceptions from the requirements in this condition shall be specified .in Attachment A.
The TCLP analysis shall include the following parameters (the regulatory level in milligrams per liter
is in parentheses):
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)
IJ-Dichloroethylene (0.7)
Pyridine (5.0) .
Cadmium (1.0)
2,4-Dinitrotoltiene (0.13)
Selenium (1.0)
Carbon tetrachloride (0.5)
Endrin (0.02)
Silver (5.0)
Chlordane (0.03)
Hexachlorobenzene (0.13)
Tetrachloroethylene (0.7)
i 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= iP (Silvex) (1.0}
p-Cresol (200.0)
Mercury (0.2)
Vinyl chloride (0.2)
Cresol (200.0)
Methoxychlor (10.0)
1
2,4-D (10.0}
Methyl ethyl ketone (200.0)
j
Once the residuals have been monitored for two years at the frequency specified in Attachment A, the
Permittee may submit a permit modification request to reduce the frequency of this monitoring
requirement. In no case shall the monitoring frequency be less than once per permit cycle.
[ 15A NCAC 13A .0102(b), 02T .1101, 02T .1105]
WQ0016247 Version 4.0 Shell Version 171103 Page 9 of 13

An analysis shall be conducted on. residuals from each source generating facility at the frequency
specified in Attachment A, and the Permittee shall maintain the results for a minimum of five years.
The analysis shall include the following parameters:
Aluminum
Mercury
Potassium
Ammonia -Nitrogen
Molybdenum
Selenium
Arsenic
Nickel
Sodium
Cadmium
Nitrate -Nitrite Nitrogen
Sodium Adsorption Ratio
(SAR)
Calcium
Percent Total Solids
TKN
Copper
pH
Zinc
Lead
Phosphorus
:Magnesium
Plant Available Nitrogen
(by calculation)
[15A NCAC 02T .1101 ]
4. Residuals shall be monitored for compliance with pathogen and vector attraction reduction
requirements at the frequency specified in Attachment A, and at the time indicated in the sampling and
monitoring sections of the approved O&M plan. The required data shall be specific to the stabilization
process utilized, and sufficient to demonstrate compliance with the Class B pathogen reduction
requirements in 15A NCAC 02T .1.106 (a) and (c) , and one vector attraction reduction requirement in
15A NCAC 02T .11.07 (a) shall be met. Any exceptions from the requirements in this condition shall
be specified in Attachment A. [15A NCAC 02T .1106, 02T .1107, 02T .l 11.1.(c)]
An annual representative soils analysis (i.e., Standard Soil Fertility Analysis) shall be conducted on
each land application site listed in Attachment B on which a residuals land application event will occur
in the respective calendar year. This analysis shall be in accordance with the "Guidance on Soil
Sampling" located in the Sampling Instructions section of the NC Department of Agriculture &
Consumer Services' website(http:fr`www.neagr.gov!agronomilpubs.litm). The Permittee shall maintain
these results and a description of the sampling methodologies used to determine soil fertility for a period
of no less than five years, and shall be made available to the Division upon request. At a minimum, the
Standard Soil Fertility Analysis shall include the following parameters:
Acidity
Exchangeable Sodium Percentage
Phosphorus
Base Saturation (by calculation)
Magnesium
Potassium
Calcium
.......
Manganese_
...
Sodium
Cation Exchange Capacity
Percent Humic :Matter
Zinc
Copper
pH
[15A NCAC 02T .0108(c), .]5A NCAC 02T.] I I l(d)]
6. Laboratory parameter analyses shall be performed on the residuals as they are land applied, and shall
be in accordance with the monitoring requirements in 15A NCAC 02B .0505. [15A NCAC 0213 .0505]
WQ0016247 Version 4.0 Shell Version 171 103 Page 10 of 13

7. The Permittee shall maintain records tracking all residual land application events. At a minimum, these
records shall include the following:
a. Source of residuals;
b. Date of land application;
c. Location of land application (i.e., site, .field, or zone number as listed in Attachment B);
d. Approximate areas applied to (acres);
e. Method of land application;
f. Weather conditions (e.g., sunny, cloudy, raining, etc.);
g. Predominant Soil Mapping Unit (e.g., CbB2).
h. Soil conditions (e.g., dry, wet, frozen, etc.);
i. Type of crop or crops to be grown on field;
j. Nitrogen Application Rate based on RYEs (if using data obtained from the North Carolina State
University Department of Soil Science Website, the printout page shall be kept on file and reprinted
every five years);
k. Volume of residuals land applied in gallons per acre, cubic yard per acre, dry- tons per acre, or wet
ton per acre;
1. Volume of animal waste or other nutrient source applied in gallons per acre, dry ton per acre, or
wet tons per acre;
in. Volume of soil amendments (e.g., lime, gypsum, etc.) applied in gallons per acre, dry ton per acre,
or wet tons per acre; and
n. Annual and cumulative totals in drN, tons per acre of residuals as well as animal waste and other
sources of nutrients (e.g., if applicable), annual and cumulative pounds per acre of each heavy metal
(e.g., shall include, but shall not be limited to, arsenic, cadmium, copper, lead, mercury,
molybdenum, nickel, selenium, and zinc), annual pounds per acre of ['AN, and annual pounds per
acre of phosphorus applied to each field.
I 5A NCAC 02T .0109(a)]
8. Three copies of an annual report shall be submitted on or before March 111. The annual report shall
meet the requirements described in the Instructions .for Residuals Application Annual R.._ epotting forms.
Instructions for reporting and annual report forms are available at
httt):/Ideci.ne.aov`/abotit/divisionsr'Nvater-resotirces/-vvater-resources-r)emiiti/Nva,stewater-branclulnon-
discharge-pennittin -unit/reporting-forms, or can be obtained by contacting the Non -Discharge
9
Permitting Unit directly. The annual report shall be submitted to the following address:
Division of Water Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[15A NCAC 02-17.111 l(a)]
WQOO 16247 Version 4.0 Shell Version 171103 Pace
11, of 13

9. Noncompliance Notification
The Permittee shall report by telephone to the Mooresville Regional Office, telephone number (704)
663-1699,gssoon 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. Land application of residuals abnormal in quantity or characteristic.
b. Any failure of the land application. program resulting in a release of material to surface waters.
c. Any time self -monitoring indicates the facility has gone out of compliance with its permit
limitations.
d. Any process unitfailure, due to known or unknown reasons, rendering the facility incapable of
adequate residual treatment.
e. Any spill or discharge .from a vehicle or piping system during residuals transportation.
Any emergency requiring immediate reporting (e.g., discharges to surface waters, imminent failure of
a storage structure, etc.) outside normal business hours shall be reported to the Division's Emergency
Response personnel at telephone number [phone], [phone], or (919) 73 )3-3300.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
betaken to ensure that the problem does not recur, [1.SANC.ACO2T.0105(1),02T.0108(b)(1)]
V. LNSPECTIONS
1. The Pen-nittee shall provide adequate inspection and maintenance to ensure proper operation of the
subject facilities and shall be in accordance with the approved O&M Plan. [15ANCACO2T.0108(b)]
1
2. Prior to each bulk residuals land application event, the Permittee or his designee shall inspect the
residuals transport and application facilities to identify malfunctions, facility deterioration and operator
errors that could result in discharges to the environment, a threat to human health or a public nuisance.
The Permittee shall maintain an inspection log that includes, at a minimum, the date and time of
inspection, observations made, and any maintenance, repairs, or corrective actions taken. The Pen-nittee
shall maintain this inspection log for a period of five years from the date of inspection, and this log
shall be made available to the Division upon request. [15ANCACO21'.0108(b)]
3. Any duly authorized Division representative may, upon presentation of credentials, enter and inspect
any property, premises or place on or related to the land application sites or facilities permitted herein
at any reasonable time for the purpose of determining compliance with this permit; may inspect or copy
any records required to be maintained under the terms and conditions of this permit, and may collect
groundwater, surface water or leachate samples. [G.S. 143-215.3(a)(2)]
1. Failure to comply with the conditions and limitations contained herein may subject the Permittee to an
enforcement action by the Division in accordance with North Carolina General Statutes 1.43-215.6A to
143-215.6C. [G.S. 143-215.6A to 143-215.6C]
I This permit shall become voidable if the residuals land application events are not carried out in
accordance with the conditions of this permit. [15ANCACO2T.011.0]
3. This permit is eff6etive only with respect to the nature and volume of residuals described in the permit
application and other supporting documentation. [G.S. 143-215. 1
WQOO 16247 Version 4.0 Shell Version 171103 Page 12 of 13

4. The issuance of this permit does not exempt the Permittee from complying with any and all statutes,
rules, regulations, or ordinances, which may be imposed by other jurisdictional government agencies
(e.g., local, state, and federal). Of particular concern to the Division are applicable river buffer rules in
15A NCAC 02B .0200; erosion and sedimentation control requirements in 15A NCAC Chapter 4 and
under the Division's General Permit NCGOI 0000; any requirements pertaining to wetlands under I -5A
NCAC 02B .0200 and 02H.0500, and documentation of compliance with Article 21 Part 6 of Chapter
143 of the General Statutes. [15A NCAC 02T .0105(c)(6)]
In the event the residuals program changes ownership or the Permittec changes his name, a formal
permit modification request shall be submitted to the Division. This request shall be made on official
Division forms, and shall include appropriate documentation from the parties involved and other
supporting documentation as necessary. The Permittee of record shall remain fully responsible for
maintaining and operating the residuals program permitted herein until a permit is issued to the new
owner. [15A NCAC 02T .0104]
6. This permit is subject to revocation or unilateral modification upon 60-day notice from the Division
Director, in whole or part for the requirements listed in 15ANCAC 02T.01 10. [ 15A NCAC 02T .0110]
7. Unless the Division Director grants a variance, expansion of the pemiitted residuals program contained
herein shall not be granted if the Permittee exemplifies any of the criteria in 15A NCAC 02T.0120(b).
[ I 5A NCAC 02T .0120]
8. The Permittee shall pay the annual fee within' )0 days after being billed by the Division. Failure topay
the annual fee accordingly shall be cause for the Division to revoke this permit. [15A NCAC 021'
.0105(e)(3)] i
Permit issued this the 17' day of November 2017
NORTH CAROL.I.NA.ENV .IIZON.MEN"l.4,.L MANAGEMENT COMMISSION
F1 6 inda Culpepper, :Interim Director -
Division of 'Water Resources
By Authority of the Environmental Management Commission
Permit Number WQ0016247
WQOO 16247 Version 4.0 Shell Version 17 U 03 Page 13 of 13

a 9 r�� %s� � i$, � .
� e ATM.... ry Fi ti�4 a g y

ATTACHMENT A — Approved Residual Sources
Synagro Central, LLC
Certification Date: November 17, 2017
Permit Number: WQ0016247 Version: 4.0
Maximum
Monitoring
Monitoring
Monitoring
Frequency for
Approved
Owner
Facility Name
County
Permit
Number
Biological
Residuals
Dry Tons
Frequency for
Non -hazardous
Frequency for
Metals and
Pathoen &
g
Mineralizati 01,
Per Year t
Characteristics
Nutrients
Vector Attraction
4, 5
Rate
----------
Reductions
City of Statesville
Third Creek WWTP
Iredell
.. . . . ..............
NC0020591
Yes
972-9
Annually
See 'l'able Below
See Table Below
0.3
Town of Columbus
Columbus WWTP
Polk
NCO021369
Yes
80
Annually
Annually
Annually
0.3
Town of Granite Falls
Granite Falls WWTP
"dwell
NCO021890
Yes
200
Annually
Annually
Annually
0.3
City of Statesville
Fourth Creek WWTP
Iredell
NCO031836
Yes
1,0553
Annually
See Table Below
See TableBelow
0.3
. . ......... ____ . ......
Stanly County Utilities,
West Stanly WWTP
Stanly
NCO043532
Yes
300
.
Annually
Annually
Annually
0.3
Town of Granite Falls
Granite Falls WTP
Caldwell
. .............
NCO082546
... . .
No
.....
45
Once per permit
acle
Annually
None 6
-
Total
. . .. ......... . . ............
2,653.6
.. . ..
...... . .... . ...... . ....
.
1. Maximum Dry Tons per Year is the amount of residuals approved for land application 11-orn each permitted facility.
2. Analyses to demonstrate that residuals are non -hazardous (i.e., UP, ignitability, reactivity, and corrosivity) as stipulated under permit Condition IV.2.
3. Testing ofinctals and nutrients as stipulated under permit Condition IV.3.
4. Analyses of pathogen and vector attraction reductions as stipulated under permit Condition IVA,
5. Monitoring frequencies are based on the actual dry tons applied per year using the table below, unless specified above.
Dry Tons Applied
(short tons per year)
Monitoring Frequency
(Established in 40 CFR 503 and 15A NCAC 02T.1111)
_
<31.9
1/Year
=->319 - <1,650
I/ Quarter (4 times pSr Year)
=>1,650 - <16,500
1166-Days Wiimcs per ye
"-> 16,599 ..........
6. Class A water treatment plant residuals are exempt from meeting the vector attraction reduction requirements in Condition IVA, provided they are not mixed with residuals that have been generated
during the treatment of domestic wastewater, the treatment of animal processing wastewater, or the biological treatment of industrial wastewater. The Class A water treatment plant residuals must
be treated and processed in anianner as to not incet the definition of "Biological Residuals" as defined in 15A NCAC 02T .1102(6).
If no land application events occur during
uring a required sampling period (e.g. no land application occur during an entire year when annual monitoring is required), then no sampling data is
required during the period of inactivity. The annual report shall include an explanation for missing sampling data. Those required to submit the annual report to EPA may be required to
make up the missed sampling, contact the EPA for additional information and clarification.
WQ0016247 Version 4.0 Attachment A Page I of 1

ril
W
I i1fill 1 5 VII-Pril I kill

ATTACHMENT B - Approved Land Application Sites
Synagro Central, .LLC
Certification Date: November 17,2017
Permit Number: WQ0016247 Version: 4.0
Field
Owner
Lessee
County
Latitude
Longitude
Not
A _SLeage
Dominant SoilSeriesSeries
Footnotes
NC-AL-13-01A
Millsaps, Arlene
Millsaps, Danny
Alexander
35.880531'
-81.127719'
15:1
Pacolet
. . . ........
NC-AL-13-OIB
Millsaps, Arlene
Miltsaps, Danny
Alexander
35.877117'
-8L124533'
14.7
Clifford
I
NC-AL-13-02
Milb%ps, Danny Ray
Alexander
35.881317'
-81,134081'
15.6
Cecil
I
. . ........
7btalfor Alexander County
454
NC-CD-02-01
Hayes Family Farms, lite.
Wilson, M. Shane
Caldwell
35.8603440
-81.486053"
13.3
Fairview
2.
NC-CD-02-02
Hayes Family Farms, Inc.
Wilson, M. Shane
Caldwell
35.8079610
. . . . .
-81,4888890
. ..... ..................
11.2
Fairview
2
NC-CD-02-03
Wilson, Troy E., Jr.
i Wilson, M. Shane
Caldwell
35.804456'
-81.4911470
15,7
Fairview
2
. . ..... . ... ..........
NC-CD-02-04
Wilson, Jennie B., Living Trust
Wilson, M. Shane
Caldwell
1 35.8040920
1 -81.493981"
6.4
Fairview
3
. .. . ......... .
NC-CD-02-05
Wilson, J. Dykes
CAdell
135.801542'_l
.81.502878'
ILO
Fairview
3
NC-CD-15-01
Prestwood, Louie; Prostwood, Nora
Caldwell
135.8532 8 30
-81.5158030
14.6
Fairview
4
Total for Caldwell County
72.3.
NC-IR-20-01
I Sandra L. Phillips and Dennis G- Phillips LivingTrust
Iredell
35.7978530
-90.7751420
11'1
Appling
5
NC-IR-20-02
i Sandra L. Phillips and Dennis G. Phillips Living Trust
Iredell
35.7981030
-80.77150610
11.5
Cecil
5
NC-IR-20-03
Sandra L. Phillips and Dennis G. Phillips Living Trust
liedell
35.799286"
-30.766903"
10A
Cecil
5,7
NC-IR-20-04A
Sandra L. Phillips and Dennis G. Phillips Living Trust
Iredell
1 35.7951640
40.7592420
34.9
Cecil
6
NC-IR-20-04B
Sandra L. Phillips and Dennis G. Phillips Living Trust
fredell
35.792019"
-80.7607140
14.1
Cecil
6
NC-IR-20-06
Sandra L. Phillips and Dennis G. Phillips Living Trust
Iredell
35.8008860
-80.7681470
15.0
Helena
7
NC-tR-20-07
Sandra L. Phillips and Dennis G. Phillips Living Trust
Iredell
35.8030080
-80,7692110
15.2
Helena
7
NTC-IR-20-08
Sandra L. Phillips and Dennis G. Phillips Living Trust
Iredell
35.8057190
-80.7678640
10.3
Appling
7
NC-IR-20-69
Sandra L. Phillips and Dennis G. Phillips Living Trust
Iredell
35.805042'
-80,7659310
.11.4
Cecil
7
NC-IR-20-11
Sandra L. Phillips mid Dennis G. Phillips Living Trust
Iredell
35,809644P
-80.76292 20
319
Cecil
7
NC-IR-20-12
Sandra L. Phillips and Dennis G. Phillips Living Trust
Iredell
35.8081310
-80.7663030
2.7
. ....... . .......
Cecil
7
NC-IR-23-02
Page, Lorane Porter Irrevocable Dynasty Trust
Porter, Shane
Iredell
35.835581'
-80.7263530
38.1
Cecil
8
NC-IR-23-03
. . ............... . . .....
Page, Lorane Porter Irrevocable Dynasty Trust
Porter, Shane
Iredell
35.84M6720
-803270360
27.4
Cecil
9
WQOO 16247 Version 4.0 Attachment B Page 1 of 3

ATTACHMENT B - Approved Land Application Sites
Synagro Central, LLC
Certification Date: November 17,-201.7
Permit Number: WQ0016247 Version: 4.0
NC-IR-23-04
........ . .. .
Page, J. W., Family Trust
. . .... . ....... .
Porter, Shane
Iredell
35.8408580
-80.7233060
14,8
Cecil
9
Field
Owner
Lessee
County
Latitude
Longitude
Net
Acreage
Dominant Soil
Series
Footnotes
NC-IR-23-05
Page, J. W., Family Trust
Potter, Shane
Iredell
. .........
35.8378330
-80.722264"
19.6
Cecil
9
Deal, Sammy H.; Deal, Jane
Iredell
35,777533"
-80.808397'
22.5
Appling
10
NC-IR-35-02
. . . ...
Deal, Sammy H.; Deal, Jane
.........
Iredell
35.776342'
.
-80.8111470
. .. . ..... ..........
6.3
Pacolet
10
NC-IR-35-03
Deal, Sammy H., Deal, Jane
Iredell
35.770428"
-80.806269"
351
Pacolet
11
NC-IR-35-04
Deal, Sammy I -I.; Deal, Jane; Deal, Craig Howard,
Tucker, Kelli D.; Tucker, Marty Alan
Iredell
35.768617'
-80.80916IQ
.....
35.2
..... ...
Pacolet
11
TotaIjbr,Ire,-Ie[I Crmqy
368.6
NC-PO-06-01
Holbert, Robert L. Holbert, Linda Y.
Davis, William V.
Polk
35.2472750
............... ..
-82.0827390
8.1
Cecil
. .....
12
NC-PO-06-02
NC-PO-06-03
Holbert, Robert L.; Holbert, Linda Y.
Edwards, Dale Y.
Davis, William V.
. .........
. . .........
Polk
......................
Polk
35,246589'
35.2443470
- -------------
-82.0806470
-82.079436"
16.2
71
Cecil
Cecil
12
12
NC-PO-07-01
Edwards, Danny K.; Edwards, Ethan L.
. ............. .
Polk
352221140
I
-92,0842170
10.6
Cecil
13, 21..' 22
NC-PO-07-02
'Taylor, Roy Lee; Taylor, Emogene J.
........ . ...... -
Polk
35,225783*
-82.0873030
7.7
Pacolet
13
Tolalfor Polk- Counly
49.8
NC-ST-01-01
Misenbeimer, Donald Eugene
................ -
Stanly
35.2913520
-80.345302'
5.9
Tarrus
. . ......
14
NC-ST-01-02
Misenheitner, Donald Eugene
. .......... .
Stanly
35,291103'
-80,3478420
TO
Georgeville
14
NC-ST-0 1 -03
.
Misenheirner. Donald Eugene
. . ..........
Stanly
.
3 5.29057CP
.................... . .
-80350444'
10.6
Tarrus
14
NC-ST-01-04
Misenheirner, Donald Eugene
.............
Stanly
-80,350485'
17.6
Tarrus
14
NC-ST-0 1-05
Misenheimer,.Donald Eugene
Stanly
35.3262250
-80,3498040
17.3
Kadin
15
NC-ST-01-06
tYlisenheitner, Donald Eugene
1
.
Stanly
. . . ............. . .
35.3280680
-80,3537690
22.3
Badin
15
NC-ST-01-07
Misenbeitner, Donald Eugene
...
Stanly
353277220
-80.3 7827"
262
Tarrus
16
NC-ST-02-01
.. . ....
Little, Clifford Sylvestor
Stanly
35.2105280
-80.283348" 1
13.0
Badin
. . ........ . . . ........ ..
17,23
NC-ST-02-02
Little, Clifford Sylvestor
. .
........ . . . . .
Stanly
352103980
i
-80.291238D i
5.6
Badin
. . . . ......... . ..........
17,24
NC-ST-03-01.
. ..............
NC-ST-03-02
L--� . -
Ridenhour, Robert Barrie
Ridenhour, Robert Barrie
. ......... -- . ...... I.-
Stanly
Stanly
35.364397"
35.363526'
-80.374313"
-80.372367'
. .... . .... .
19.1
3.3
.............
Badin
But ad
18
=
WQOO 16247 Version 4.0 Attachment B Page 2 of 3

A` TAC EN'T .B — Approved band Application Sites
Synagro Central, LLC
Certification Date: November 17, 2017
Permit Number: WQ0016247 Version: 4.0
} NC-SI'-03-03
____
Ridenhour, Robert Barrie
— .................._.
___...
Stanly
........._
35,368843'
__
-80,3741420
24.6
Badin
18
Field
Owner
Lessee
County
Latitude
Longitude
Net
Aerea a
Dominant soil
series
Footnotes
NC-ST-03-04
Ridenhour, Robert Barrie; Ridenhour, Billy Joe
Stanly
35.378182'
-80,3642930
8.4
Goldston
19
NC-ST-03-05
Ridenhour, Robert Barrie; Ridenhour,. Billy Joe
..
Stanly
........
35.3755590
-80.361261"
12.4
_...... _...
Goldston
19�
NC-ST-03-06
Ridenhour, Robert Barrie
_
Stanly
35.372552°
-80.362299"
4.0
Goldston
19
i
NC-ST-03-07
Ridenhour, Robert Barrie; Ridenhour, Billy Jive
Stanly
35.3695180
-80.3605060
_
18.1
Badin
19�
NC-ST-04-01
Henry W. Anderson Living Trust
Stanly
35.2362560
-80,306856'
26.8
Badin
20
NC-ST-04-02
Lynette W. Anderson Living Trust
Stanly
35.236256"
-80.3068560 _.
12.8
Goldston
20
NC-ST-04-03
Henry W. Anderson Living Trust
Stanly
35.233820'
-80.3056160
6.9
Badin
20
NC-ST-04-04
Lynette W. Anderson Living Trust
Stattly
35.2315760
-80.307522"
8.9
Badin
20
NC-ST-04-05
Lynette W. Anderson Living Trust
.... ....... _..�
Siznly
35.229633"
-80.3095580
__....__.
6.7
--
Misenheimer
20
Total for :Stanly Couniy
2775
Total
813.6
I to 20. See Figure I to 20, respectively.
2 L A. reduced setback from a residence under separate ownership has been approved for this land application site. Residuals may be land applied within 100 feet of the residence owned by Mickey
Edwards and Teressa Edwards of 400 Eagle Nest Road, Columbus, NC 28722, regardless ol'whether a surface or a subsurface application method is used.
22. A reduced setback from a residence under separate ownership has been approved for this land application site. Residuals maybe land applied within 100 feet of the residence owned by Louise
Edwards of 332 Eagle Nest Road, Columbus, NC 28722, regardless of whether a surface or a subsurface application method is used.
23. A reduced setback from a residence under separate ownership has been approved for this land application site. Residuals may be land applied within 100feet of the residence owned by liaiTy and
Betty Stegner of 9905 Stogner-:Little Road, Oakboro, NC 281.29, regardless of whether a surface or a subsurface application method is used.
24. A reduced setback from a residence under separate ownership has been approved for this land application site. Residuals may be land applied within 100 feet of the residence owned by .Frances
L. Et7rd of 9803 Stogner-Little Road, Oakboro, NC 28129, regardless of whether a surface or a subsurface application method is used.
WQ0016247 Version 4.0 Attachment Ef Page 3 of 3

APPLICATION MAP
IAMI,
APPLICATION AREA
UNSUITABLE AREA
PRIVATE ROAD
'" ¢; } ;
WATER
----- u — --�---
STREAM�
—�
aNSITE HOUSE
— - -
DRAIN
OFFSITE HOUSE
-aE-a�---�--
FENCE
OUTBUILDING
PROPERTY LINE
WELL
(�
SOIL BORING
The compliance boundary is established either 250 It from the residuals application area or 50 teat Wthin
In 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, All
locations are approximate;
GRAPHIC SCALE
I° = 660'
884' a sgp
W=f

APPLICATION MAP
LEGEND
APPLICATION AREA
UNSUITABLE AREA
- - - - - - PRIVATE ROAD
WATER
-- - - — STREAM
ONSITE HOUSE
- DRAIN
OFFSITE HOUSE
X X -- FENCE
a
OUTBUILDING
PROPERTY LINE �( WELL
OO SOIL BORING X�
The compliance boundary is established either 250 ft from the residuals application. area or 50 feet within
in tie 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 applicator: area. All
locations are approximate.
GRAPHIC SCALE
9"=660'
6sa' a 660,
wi�
NC-CD-02
Fields 4-5

LEGEND
APPUCATION AREA
UNSUITABLE AREA
— — — _
PRIVATE ROAD
WATER
----- — — -
STREAM
ONSITE HOUSE
--
DRAIN
OFFSITE HOUSE
--
FENCE
OUTBUILDING
PROPERTY LINE
WELL
OO
SOIL BORING
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within
in 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. All
locations are approximate.

-qM
APPLICATION AREA
®
UNSUITABLE AREA
PRIVATE ROAD
WATER
--- - - —
STREAM
ONSITE HOUSE
--
DRAIN
FENCE
PROPERTY LINE
enu unraltilr.
X�
OFFSiTi=HOUSE
OUTBUILDING
WELL
The compliance boundary Is established either 250 it from the residuals application area or 50 feet within
in the properly 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. All
locations are approximate.
Figure 0
GRAPHIC SCALE
664' d 860'
APPLICATION

All
■
INK934ZL
APPLICATION AREA UNSUITABLE AREA
- - - - - - PRIVATE ROAD �-' ;�;'1 WATER GRAPHIC SCALE
- - — STREAM ONSITE HOUSE 1 ° - 660'
----- - DRAIN ssa, o sso'
OFFSITE HOUSE I '
FENCE
OUTBUILDING
PROPERTY LINE �{ WELL
Q SOIL BORING _ X�
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within
in 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. All
locations are approximate.

I ME
APPLICATION MAP
LEGEND
APPLICATION AREA UNSUITABLE AREA
- , —der— - PRIVATE ROAD WATER
-- - - --- STREAM
GRAPHIC SCALE
ONSITE HOUSE
lit= 6$0
-- - —.. DRAIN
OFFSITE HOUSE
6W a esa
x n x FENCE
OUTBUILDING
PROPERTYLiNE �( WELL
Figure 7
Q SOIL BORING X�
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within
N f+ . �ry�ry
in the property boundary, whichever is closest to the application area. The review boundary Is established
LC✓✓ R GG
midway between the compliance boundary and the perimeter of the residuals application area. All
locations are approximate.
ReIds 3,6-9,1 1-12

APPLICATION MAP
LEGEND
APPLICATION AREA
UNSUITABLE AREA
— — — — — —
PRIVATE ROAD
,�',;�
WATER
-- - - ---
STREAM
ONSiTE HOUSE
-- — ---
DRAIN
OFPS1TE HOUSE
FENCE
OUTBUILDING
PROPERTY LINE
Q
SOIL BORING
WELL
The compliance boundary is established either 250 0 from the residuals application area or So test within
In 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. All
locations are approximate.
GRAPHIC SCALE
1" = 66V
667 0 66V
Field 2

IMF
II II
r e e l 1 i r
s
LEGEND
APPLICATION AREA
yz�
— — — -- — —
PRIVATE ROAD
/-
--- — — --
STREAM
--- —
DRAIN
FENCE
❑
PROPERTY LINE
enu ona1R1n
UNSUITABLE AREA
WATER
ONSITE HOUSE
OFFSITE HOUSE
OUTBUILDING
WELL
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within
in the properly 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. All
_locations are approximate.
GRAPHIC SCALE
T' = 660'
6W a 6&a'
Fields 3-5

f
APPLICATION MAP
LEGEND
APPLICATION AREA
UNSUITABLE AREA
— — — — — —
PRIVATE ROAD
�'"��
WATER
— — — —
STREAM
ONSITE HOUSE
--- —
DRAIN
OFFSITE HOUSE
FENCE
OUTBUILDING
PROPERTY LINE
�{
Y�
WELL
Q
SOIL BORING
.
The compliance boundary Is established either 250 It from the residuals application area or 50 feet within
in 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. All
locations are approximate.
GRAPHIC SCALE
1"=660'
660, 0 e60'
Figure 10
SIC-IR-35
Fields 1-2

APPLICATION MAP
LEGEND
APPLICATION AREA
�
UNSUITABLE AREA
— — — — — —
PRIVATE ROAD
�,�;
WATER
-- — — --
STREAM
ONSITE HOUSE
-- —
DRAIN
OFFSITE HOUSE
�--�.—�—
FENCE
OUTBUILDING
-��-----
PROPERTY LINE
WELL
n
enu ano�nir_
The compliance boundary Is established either 250 ftfrom the residuals application area or 50 feet within
in 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. All
locations are approximate.
GRAPHIC SCALE
1 ° = 660'
660' 0 660'
t
fad +
N C-I R-35
Fields 3-4

APPLICATION MAP
LEGEND
APPLICATION AREA
UNSUITABLE AREA
— — — — — —
PRIVATE ROAD 1
WATER
GRAPHIC SCALE
- - - -
STREAM
ONSITE HOUSE
V 660
--
DRAIN
sW a ssa
OfFSiTE HOUSE
l .�
—;�—
FENCE ❑
OUTBUILDING
PROPERTY LINE
WELL
Figure 12
{:}
SOIL BORING
The compliance boundary is established either 250 f. from the residuals application area or 50 feet within t\ I _D/ O,OC
in the property boundary, whichever is closest to the application area. The review boundary Is established t V t— V
midway between the compliance boundary and the perimeter of the residuals application area. All
locations are approximate.. Fields 1-3

APPLICATION L
1. cf
APPLICATION AREA
UNSUITABLE AREA
PRIVATE ROAD
�' �n�
WATER
— - - --
STREAM
ONSITE HOUSE
- --
DRAIN
OFPSITE'HOUSE
-�t-3c--
FENCE
❑
OUTBUILDING
PROPERTY LINE
�{
WELL
Q
SOIL BORING
X�
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within
in 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. All
locations are approximate.
GRAPHIC SCALE
1" = 660'
669 0 660'
NC-PO-07
Fields 1 m2

APPLICATION MAP
LEGEND
APPLICATION AREA
UNSUITABLE AREA
- — — -- - - PRIVATE ROAD.
WATER
— - - --- STREAM
ONSITE HOUSE
- DRAIN
OFFSITE HOUSE
=r FENCE
❑
OUTBUILDING
PROPERTY LINE
(
WELL
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within
In 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. All
locations are approximate.
GRAPHIC SCALE
Ili =660'
660' 0 660,
l '
Figure 1
N C-ST-01
Fields 1-4

LEGEND
!, d APPLICATION AREA
VZ/1
UNSUITABLE AREA
PRIVATE ROAD
WATER
— - - — STREAM
ONSITE HOUSE
- DRAIN
OFFSITE HOUSE
FENCE
OUTBUILDING
PROPER TYLINE
WELL
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within
in 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. All
locations are approximate.
GRAPHIC SCALE
1 ° = 66Y
669 a 660,
l i

k
APPLICATION MAP
LEGEND
APPLICATION AREA UNSUITABLE AREA
— — — -- -- -- PRIVATE ROAD Cam_ vv J WATER
GRAPHIC SCALE
— — — -- STREAM ONSITE HOUSE
1" = 660'
DRAIN OFFSITE HOUSE 566' 0 660'r
FENCE OUTBUILDING
PROPERTY LINE 0 WELL Figure 1.
The compliance boundary is established either 250 R from the residuals application area or 50 feet within N C-ST-01
in 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. All
locations are approximate. Field 7

APPLICATION MAP
APPLICATION AREA PROPERTY LINE
—»•--»• STREAM ONSITE HOUSE
DRAIN OFFSITE HOUSE
UNSMABLE AREA WELL
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.
1 - inch = 660 feet All locations are approximate.
Figure 17
N&sT-02
Fields 1-2

APPLICATION NEAP
APPLICATION AREA
— — — — — — PRIVATE ROAD
CD
WATER
GRAPHIC SCALE
— - - — STREAM
ONSITE HOUSE
lit ='660'
DRAIN
OFFSITE HOUSE
sso• o sso•
—�� FENCE
OUTBUILDING
— PROPERTY LINE
0
WELL
Figure 18
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within N C-ST-03
in 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. All
locations are approximate. FITS 1-3

APPLICATION MAP
-- - - —` STREAM
ONSITE HOUSE
-�- - DRAIN
OFFSITE HOUSE
X X=�- FENCE
OUTBUILDING
PROPERTY LINE
WELL
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within
in 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. All
locations are approximate.
GRAPHIC SCALE
1"=660'
sso� o sso�
LZ

APPLICATION MAP
LEGEND
APPLICATION AREA
UNSUITABLE AREA
- — — — — - PRIVATE ROAD
UV
WATER
— - - — STREAM
ONSITE HOUSE
-- - DRAIN
OFFSITE HOUSE
FENCE
F1
OUTBUILDING
- PROPERTY LINE
WELL
The compliance boundary is established either 250 it from the residuals application area or 50 feet within
in 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. Ail
locations are approximate.
GRAPHIC SCALE
1"=660'
660' 0 660,
Figure .20
Fields 1-5

State of North Carolina
Department of Environmental Quality
I)W.R Division of Water Resources
WATER QUALITY REGIONAL OPERATIONS SECTION
Division of Water Resources NON -DISCHARGE APPLICATION REVIEW REQUEST. FORM
April 17, 2019
APR 2 4 2019
To: MR®r`vR40,0Sa��:�d e i'tr e `,!,Gorey Bas nger
WQROS
From: Troy Doby, Water Quality Permitting Section - Non -Discharge Branch hri00RESVILLE REGIONAL OFFICE'
Permit Number: WQ0016247 Permit Type: Land Application of Residual Solids (503)
Applicant: Synagro Central, LLC
Owner Type: Organization
Facility Name: Synagro Western Piedmont RLAP
Signature Authority: Robert N. Roth
Address: 284 Boger Rd., Mocksville, NC 27028
Fee Category: Non -Discharge Major
Comments/Other Information:
Project Type: Major Modification
Owner in BIMS? Yes
Facility in BIMS? Yes
Title: Technical Services Manager
County: Alexander
Fee Amount: $395 - Major Modification
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.
4
RO-WQROS Reviewer:
Az4iy_�
Date: �/Y 1?1G _� F
FORMWQROSNDARR 09-15
Page 1 of 1

ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
LINDA CULPEPPER
Director
NORTH CAROLINA
Environmental Quality
April 17, 2019
ROBERT N. ROTH — TECHNICAL SERVICES MANAGER
SYNAGRO CENTRAL, LLC
284 BOGER RD.
MOCKSVILLE, NORTH CAROLINA 27028
Subject: Acknowledgement of
Application No. WQ0016247
Synagro Western Piedmont RLAP
Residuals Management System
Alexander County
Dear Mr. Roth:
The Water Quality Permitting Section acknowledges receipt of your permit application and
supporting documentation received on April 16, 2019. 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: W �%iot
1IleT�e;gional�Office; �Nater �1za�li,, RilQp°eicins,Secti©n��►
ile Q0)016�247
North Carolina Department of Environmental Quality I Division of Water Resources
,E 512 North Salisbury Street 1 1617 Mail Service Center I Raleigh, North Carolina 27699-1617
NORTHOt!NA
nqw. m w of Emrironmonw o.nry 919.707.9000