WQ0003902_Regional Office Historical File Pre 2018 (2)

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DEC �09-M
WQROS
MOORESVILLE REGIONAL OFFIC
October 10, 2019
N:C. Department of Environment and Natural Resources
Water Quality Section
Non -Discharge Permitting Unit — Aquifer Protection Unit
1636 Mail Service Center
Raleigh, NC 27699-1636
ATTENTION: Mr. Nathaniel Thornburg
REFERENCE: RENEWAL OF CITY OF Newton LAND APPLICATION PERMIT
WQ0003902
Dear Mr. Thornburg:
G4
Synagro Central LLC is submitting a request to renew a land application program for resid s Y/,,���
generated by the City of Newton Wastewater Treatment Plant and. gt':One
original and two copies of this application to renew the referenced residuals are included. Three
sites are being completely deleted they are CA-07, CA-14, and CA-17. Site LT-119 is deleting
two fields 3 and 4. This brings the total amount of acres being deleted to 306.9 acres. We plan to
do a permit modification to add more land in the near future. As of right now there 628.7 acres
remain in the program.
This application package contains the information necessary to complete the certification of
this permit. However, if you require any additional information or have further questions about
the information presented herein, please contact me at [e-mail] or at my phone
number (336)-703-8681 I look forward to working with you to ensure a timely and efficient
review of this application.
Sincerely,
Alex Fox
Technical Services Specialist
Synagro Central, LLC

PDlvlslon of Water Resources
GI VV)P �
15A Nakk02T .1100�—CPll
INSTRUCTIONS FOR F0,, P
State of North Carolina
Department of Environmental Quality
Division of Water Resources
IDUALS LAND APPLICATION PROGRAM
06-16 & SUPPORTING DOCUMENTATION
Please use the following instructions as a checklist in order tb ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted, the Applicant shall submit one original and two copies of the application and
supporting documentation
For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting Unit
General — This application is for treatment, storage, transport, and/or land application of Class B residuals (may include residuals that
are generated from a water treatment plant or other type facilities) on the proposed or currently approved land application site(s) under
15A NCAC 02T .1100.
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Residuals Land Application Program (FORM: RLAP 06-16) Application: (All Application Packages):
Submit the completed and appropfiately executed Residuals Land Application Program (FORM: RLAP 06-16) form. Please
do not make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to
the application may be made, as long as the attachments are numbered to correspond to the section and item to which they
_ refer.
The Applicant's Certification on Page 5 of this form shall be signed in accordance with 15A NCAC 02T .0106(b). An alternate
person may be designated as the signing official if a delegation letter is provided from a person who meets the criteria in 15A
NCAC 02T .0106(b).
❑ If this project is for a modification of an existing permit, submit one copy of the existing permit.
Please submit this application form at least 180 days prior to the expiration date on the existing permit, or 90 days prior to
operation of proposed facility(ies) for application packages involving new or changes to treatment and storage units.
B. Application Fee (New and Major Modification Application Packages)
Submit a check, money order or electronic funds transfer made payable to: North Carolina Department of Environmental
Quality (NCDEQ).
Facility Classification New Permit Major Modification r
Major (land are permitted for > 300 acres) $1,310 $39�
Minor (land are permitted for < 300 acres) $810 $245
r - A major modification shall be defined as any permit modification that: increases the generating facility's residuals dry tonnage;
adds additional land application areas not previously approved for that particular program [including transferring of field(s) from
one program to another]; adds additional residuals sources; or includes the addition of new treatment or storage units/processes not
previously permitted. There is no fee for minor modifications to a permit.
C. Cover Letter (All Application Packages)
® List all items included in the application package, as well as a brief description of the requested permitting action.
D. Environmental Assessments (May be Required — See 15A NCAC 1C .0300)
❑ Submit a copy of the Findings of No Significant Impact (FONSI) or Environmental Impact Statement (EIS). Also, include
information on any mitigating factor(s) from the Environmental Assessment (EA) that impact the construction of the residuals
treatment and storage facilities. An EA may also be required for private systems if any public funds and/or lands are used for
the construction of the subject facilities.
INSTRUCTIONS FOR FORM: RLAP 06-16 Page 1 of 3

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

I. Project Evaluation and Receiver Site Management Plan (All New Application Packages or Modifications that include new sites)
❑ Submit a project evaluation and a receiver site management plan (if applicable) with recommendations concerning cover crops
and their ability to accept the proposed application rates.
J. Hydrogeologic Report (All New Application Packages or Modifications involving increasing the total design capacity)
Submit a detailed hydrogeologic evaluation in accordance with 15A NCAC 02T .1104(d)(4) and current Division Policy
available at: hn://www.ncwater.orWRules 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)
F1 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 .I 104(d)(2). For Modifications, submit an updated site map
specific to the modification(s) only.
El The design documents must include the following minimum items:
0 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
[f Engineering calculations including hydraulic and pollutant loading, sizing criteria, hydraulic profile, total dynamic head
curve analysis for each pump, and irrigation design.
El 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.ncwater.org,/Rules Policies and Regulations/.
M. Property Ownership Documentation (All New or Modification Application Packages involving new and/or relocated treatment
or irrigation components)
,0 Property ownership documentation shall consist of one of the following:
Ll Legal documentation of ownership (i.e., GIS, deed or article of incorporation), or
0 Written notarized intent to purchase agreement signed by both parties with a plat or survey map, or
0 An easement running with the land specifically indicating the intended use of the property and meeting the requirements of
15A NCAC 02L .0107(fl. or
A written notarized lease agreement signed by both parties, indicating the intended use of the property, as well as a plat or
survey map.
ONE ORIGINAL AND TWO COPIES OF THE COMPLETED APPLICATION PACKAGE, INCLUDING ALL
SUPPORTING INFORMATION AND MATERIALS, SHALL BE SENT TO THE FOLLOWING ADDRESS:
NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF WATER RESOURCES
WATER QUALITY PERMITTING SECTION
NON -DISCHARGE PERMITTING UNIT
By U.S. Postal Service:
1617 MAIL SERVICE CENTER
RALEIGH, NORTH CAROLINA 27699-1617
TELEPHONE NUMBER: [phone]
By Courier/Special Delivery:
512 N. SALISBURY STREET
RALEIGH, NORTH CAROLINA 27604
FAX NUMBER: [phone]
INSTRUCTIONS FOR FORM: RLAP 06-16 Page 3 of 3

Division of Water Resources
State of North Carolina
RE Department of Environmental Quality
pE� _ 3 2019 Division of Water Resources
Avl ppa�mll"MWiRC 02T .1100 —RESIDUALS LAND APPLICATION PROGRAM;
FORM: RLAP 06-16
I. APPLICANT INFORMATION:
1. Applicant's name: City of Newton
Applicant type: ;❑ Individual ❑ Corporation ❑ General Partnership ❑ Privately -Owned Public Utility
Federal ❑ State ®Municipal ❑County
Signature authority's name per 15A NCAC 02T .0106: Todd Clark Title: City Manager
Applicant's mailing address: P.O. Box 550
City: Newton State: NC Zip: 28658
Telephone number: [phone] Email Address: tclark Onewtonnc.gov
2. Consultant's name: Alex Fox License Number (for P.E.):
Affiliation:[] On Staff ® Retained (Firm: S nanagro Central LLC.)
Consultant's mailing address: 284 Boger Rd
City: Mocksville State: NC
Zip: 27028
Telephone number: [phone]
Email Address: [e-mail]
3. Agronomist's name:
License Number:
Affiliation: '❑ N/A ❑ On Staff
❑ Retained (Finn:: i)
Agronomist's mailing address:
City: State: I
Zip: i -
Telephone number: (1 1), _! : !
Email Address:,
4. Soil Scientist's name:! i
License Number: I
Affiliation: '❑ N/A ❑ On Staff
❑ Retained (Firm: i) .
Soil Scientist's mailing address: !
�'
City:' - State:; - -i
Zip:.
Telephone number: ' !
P (� ' -
Email Address:.
5. Fee submitted: i (See Instruction B)
H. PERMIT INFORMATION:
1. Application is for (check all that apply): ❑ new, ❑ modified, renewed permit
2. If this application is being submitted to renew or modify an existing permit, provide the following:
Permit number: WQ0003902
Date of most -recently issued permit: June 1, 2015
Date of most -recently certified Attachment A (if different than the permit):
Date of most -recently certified Attachment B (if different than the permit):
I
FORM: RLAP 06-16 Page I of 5

III. RESIDUALS LAND APPLICATION PROGRAM INFORMATION:
1. Residuals Processing Facility's physical address: 1407 McKay Farm Rd.
City: Newton State: NC . Zip: 28658
Coordinates: Latitude: 35' 37' 40" Longitude: 810 14' 03"
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
ORC
Mike Cox
Synagro
13191
Back -Up ORC
Robert Roth
Synagro
1001672
Additional Back -Up
ORCs
_ J-�
j
_
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 Nitrogen Summary: Determine the maximum plant available nitrogen (PAN) generated by all residuals
source -generating facilities as currently certified and proposed for certification with this application and list the results in the
following table:
Maximum amount of residuals to be certified: 3438 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
13.00
19.52
44686
67102
Five -Year Maximum Adjusted
17.20
23.72
59147
81562
b. Land Application Site Use Summary: Summarize information regarding the land application sites as currently certified and
proposed for certification with this application:
Category
Use
Acres
Comments
Crops
Forest or Plantation
0
i _]
Row Crops
27.5
r
Hay
75.2
Pasture
526.0
j` _
Total:
628.7
a
Methods
Surface
628.7
�!
Incorporation or Injection
0
Total:
628.7
{
FORM: RLAP 06-16 Page 2 of 5

c. Residuals Land Application Summary: Determine the minimum acreage required to land apply the residuals as currently
certified and proposed for certification assuming the scenarios listed in the following table:
Assumed
Application Rate
qbs 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
893.7
1342
1182.9
1631.2
100
446.9
671
591.5
815.6
150
297.9
447.3
394.3
543.7
200
223.4
335.5
295.7
407.8
6. If applicable, provide a plan and a schedule to resolve any known issues that would prevent land application of the propose&
residuals due to the violation o_f_ N_ orth Carolina Administrative Code (e.g. not enough storage, not enough land, vector reduction
practices not in place, etc.):;
7. Specify type of residuals program (See Instruction F):.M Non -dedicated ',0 Dedicated
If Dedicated, specify the following (check all that apply):
L] Residuals program contains any land application site(s) that receives residuals at rates or frequencies greater than agronomic
rates, explain;
L] Residuals program contains any land application site(s) that is used primarily for residuals disposal, and agricultural crop
production is of secondary importance, explain;
r
Residuals program contains any land application site(s) that receives residuals tluough fixed irrigation facilities or irrigation,
facilities fed through a fixed supply system, explain;
IV. RESIDUALS SOURCE INFORMATION: (Required for all new, renewed, or modified residuals source)
Complete and submit the following Residuals Source Certification and all associated documentation.
I Hu
Residuals Source
Certification
V. LAND APPLICATION SITE INFORMATION: (Required for all new, renewed, or modified land application site)
Complete and submit the following Land Applications Site Certification and all associated documentation.
Land Application Siite
Certification. doc
FORM: RLAP 06-16 Page 3 of 5

Note: Item VI. Applicable to Dedicated Program with fixed irrigation system only.
I. DESIGN INFORMATION FOR FIXED IRRIGATION SYSTEM
1. The irrigation system is: [] Spray [] Drip
2. Disposal system is: 0 existing proposed.
3. Minimum depth to mean seasonal high water table (SHWT) within irrigation sites(s) per Soil Scientist's Evaluation: = feet
below ground surface. Rules 15A NCAC 02T .0505(p) requires at least one -foot vertical separation between SHWT and ground
surface.
4. Are there any artificial drainage or water movement structures within 200 feet of any irrigation area?
D Yes or 0 No If Yes, please explain if the soil scientist report addresses artificial structures and please indicate if
structures are to be maintained or modified: 1 — 1
5. Loading rates recommended by the Soil Scientist Evaluation:
Soil Series
Fields within Soil Area
Recommended
Loading Rate
in/hr
Recommended
Loading Rate
in/ r
L
E�
6. Design loading rates are equal or less than the loading rates recommended by Soil Scientist?
[] Yes or 0 No If No, explain why 15A NCAC 02T .0505(n) is not met: =
7. Non -dedicated System Design (fill in the appropriate information for either a spray or drip irrigation system):
Field / Zone
Design Area
ftz
Numof
ber
Nozzles
Maximum Application
Rate allons/hr
Design Annual Loading
Rate allons/ r
Li
�--
Total
I
��
Spray Irrigation Design Element
Plan Sheet
Number
Specification
Page Number
Wetted diameter of nozzles
`_ j ft
Wetted area of nozzles
ft2
Nozzle capacity
gpm
Nozzle manufacturer / model
Elevation of highest nozzle
�] ft
FORM: RLAP 06-16 Page 4 of 5

Applicant's Certification (signing authority must be in compliance with 15A NCAC 02T .0106):
F
The applicant or any affiliate has not been convicted of an environmental crime, has not abandoned a wastewater facility without proper
closure, does not have an outstanding civil penalty where all appeals have been exhausted or abandoned, are compliant with any active
compliance schedule, and do not have any overdue annual fees under Rule 15A NCAC 02T .0105.
® Yes [] No, Explain; I
1,
0Q
A
(Signature Authority's Name — PLEASE PRINT) ' (Title) �
attest that this application for � t r (M� L w w-T P
(Facility Name)
has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that the Division of Water Resources
may not conduct a technical review of this program and approval does not constitute a variance to any rules or statutes unless specifically
granted in the permit. Further, any discharge of residuals to surface waters or the land will result in an immediate enforcement action,
which may include civil penalties, injunctive relief, and/or ,criminal prosecution. I will make no claim against the Division of Water
Resources should a condition of this permit be violated. I also understand that if all required parts of this application are not completed
and that if all required supporting information and attachments are not included, this application package will be returned to me as
incomplete.
Note: In accordance with North Carolina General Statutes § 143-215.6A and § 143-215.6B, any person who knowingly makes any false
statement, representation, or certification in any application shall be guilty of a Class 2 misdemeanor, which may include a fine not to
exceed $10,000 as well as civil penalties up to $25,000 per violation.
Signature: Date:IP;W�
FORM: RLAP 06-16 Page 5 of 5

SPILL RESPONSE PLAN
'ROJECT: CITY OF Newton Permit WQ0003902
IN THE UNLIKELY EVENT OF A SPILL. THE FOLLOWING ACTIONS SHALL BE TAKEN
IMMEDIATELY:
1. MANAGEMENT OF SPILL CLEAN-UP ACTIVITIES:
The Operations Manager shall take immediate charge and initiate clean-up activities. Synagro labor and equipment is to
be utilized. In the event additional labor and equipment is required, assistance may be requested from the City of
Lincolnton or the NC Department of Transportation, and other private contractors as necessary.
2. HALT THE SOURCE OF THE WILL:
Such as a ruptured container or damaged transport unit.
3. CONTAIN THE SPILL:
Form a barrier. Sufficient quantities of straw shall be used for such purposes. Earthen barriers may be constructed to
augment the straw bale containment area of the spill. The Operations Manager or the person in charge on the spill site
will advise the clean-up personnel where to get the straw, lime, and other items necessary to complete the clean-up
operation, i.e., local farmers, farm supply centers, nurseries, etc.
4. CLEAN-UP:
nploy front-end loaders, vacuum equipment, sludge application vehicles, and/or local septic tank service to remove as
uch of the spilled material as possible. Straw and/or sand should be scattered in the spill area to soak up the remaining
material. The straw- and sand -soaked material will be collected and removed to a disposal area approved by
representatives of the state regulatory agency.
G —W I E116 AX119"I 9
Employ rotary brush sweeper if needed, and apply lime to the spill area upon the approval of the clean-up efforts by the
state regulatory representative. If the event occurs on private property, the clean-up will be completed to the satisfaction
of the property owner and state regulatory representatives. The ultimate goal will be to restore the spill area to its original
condition if possible.
6. NOTIFICATION:
As soon as possible after the spill occurs, the Synagro Operations Manager or assistant will notify the Synagro Central
office, and they will then be responsible for notifying other key Synagro personnel.
ice' VelnoI-QM
Synagro Central personnel will notify the Mooresville regional office of the NCDENR by telephone [phone]) for
the City of Newton as soon as possible, but not more than 24 hours after, or on the next working day following the
occurrence. The Operations Manager shall provide a written report within 48 hours of the spill to the Technical Services
Director. The report shall list all relative information and actions taken. Synagro Central personnel will file a written
report to the Mooresville Regional office of the NCDENR within 5 days of the occurrence. For after hours reporting the
'ivision's emergency number shall be called to report all incidences (800-662-7956 or 800-858-0368 or 919-733-3300).

OPERATIONS AND MAINTENANCE PLAN
SYNAGRO RESIDUALS LAND APPLICATION FOR WQ0003902 (City of newton)
Inspection Plan
Inspections will be conducted on a weekly basis at the land application site during activities of this project. Inspection
frequency is based on the time frame to complete the project and the amount of dry tons to be land applied from the
facility. The inspections will consist of inspecting a field that is currently being applied as well as inspecting random
fields that have been completed. These inspections will consist of:
1. Verifying that the "Pre -Operations Check List" has been completed and signed by both operational and technical
staff.
2. Checking the calculated loads to insure the correct amount of residuals are being land applied.
3. Insuring that all manned equipment has a copy of the spill control plan, the permit, and the operations and
maintenance plan.
4. Insuring that the field has been flagged properly and that all buffers are being adhered to.
5. Insuring that the "Crop and Landowner Verification" form has been filled out.
6. Verifying that the residuals have been adequately sampled to confirm compliance.
The records will be kept in the project files in the respective office for the project. The Permittee or Inspector shall
report by telephone to the NCDENR/DWQ Mooresville Regional Office at 704-663-1699, as soon as possible, but no later
than 24 hours after, or the next working day, following the occurrence or first knowledge of the occurrence of the
following.
• Any occurrence with the distribution program resulting in the land application of significant amounts of
material that is abnormal in quantity or characteristics.
• Any failure of the program that results in a release of material to surface waters.
• Any time that self -monitoring information indicates that the program has gone out of compliance with
the permit.
• Any process unit failure that results in the system not adequately treating the residuals.
• Any spill or discharge from a vehicle or piping system during residuals transportation.
A►eoda
Any release that requires immediate reporting outside of normal business hours shall be called in to -BEN at 800-662-
7956, 800-858-0368, or 919-733-3300. These numbers are to be called in the event of a release to surface waters or the
imminent failure of a storage system when the event occurs outside of normal business hours. Within 5 days of the first
notice of an occurrence, a written response in the form of a letter shall be sent to DEHR outlining the actions taken or
proposed actions taken to ensure that the problem does not recur. ~#Wft
Persons responsible for inspections on this project are as follows:
Robert Roth Technical Services Manager, or his designee.

07.1i,'"4`

OPERATIONS AND MAINTENANCE PLAN
SYNAGRO RESIDUALS LAND APPLICATION FOR WQ0002712 (City of Lincolnton)
Sampling Plan
Sampling for this project consists of sampling the residuals once per permit cycle during the permit renewal
process.
The residuals shall be sampled once per permit cycle for the following: (Regulatory level in milligrams per liter in
parentheses.)
Arsenic (5.0)
Barium (100.0)
Benzene (0.5)
Cadmium (1.0)
Carbon tetrachloride (0.5)
Chlordane (0.03)
Chlorobenzene (100.0)
Chloroform (6.0)
Chromium (5.0)
m-Cresol (200.0)
o-Cresol(200.0)
p-Cresol(200.0)
Cresol (200.0)
2,4-D (10.0)
1, 4-Dichlorobenzene (7.5) Nitrobenzene (2.0)
1, 2-Dichloroethane (0.5)
Pentachlorophenol (100.0)
1, 1-Dichloroethylene (0.7)
Pyridine (5.0)
2, 4-Dinitrotoluene (0.13)
Selenium (1.0)
Endrin (0.02)
Silver (5.0)
Hexachlorobenzene (0.13
Tetrachloroethylene (0.7)
Heptachlor (and its hydroxide) (0.008) Toxaphene (0.5)
Hexachloro-1,3-butadiene (0.5)
Trichloroethylene (0.5)
Hexachlorethane (3.0)
2,4,5-Trichlorophenol (400.0)
Lead (5.0)
2,4,6-Trichlorophenol (2.0)
Lindane (0.4)
2,4,5 TP ( Silvex) (1.0)
Mercury (0.2)
Vinyl Chloride (0.2)
Methoxychlor (10.0)
Methyl ethyl ketone (200.0)
The residuals will also be sampled, based on the chart below, for the following constituents
Dry Tons Generated
(short tons per year)
Monitoring Frequency
(Established in 40 CFR 503 and 15A NCAC 02T.1111)
<319
1 time per year
=>319-<1,650
1 per Quarter (4 times per year)
=>1,650-<16,500
1 every 60 days (6 times per year)
=>16,500
1 every month (12 times per year)
Aluminum
Ammonia -Nitrogen
Arsenic
Cadmium
Calcium
Copper
Lead
Sodium Adsorption Ratio (SAR)
Magnesium
Mercury
Molybdenum
Nickel
Nitrate -Nitrite Nitrogen
Phosphorous
Potassium
m
pH
Plant Available Nitrogen (calculation)
Selenium
Sodium
Total Solids
Total Kjeldahl Nitrogen
Zinc
In order to meet pathogen and vector requirements, the material will be sampled for fecal coliform density and th ✓ice
v;litll►d t40 dk3`eftte�s The samples will be taken from the digester. Additional samples will be
taken for TCLP/RCI and nutrients and meta lslanalysis. Methods of sampling will follow the conditions of the permit and
applicable regulations. ` LE�� tiw 1/2/7-
The following people are responsible for sampling:
Robert Roth, Technical Services Manager, or his designee.
Debra V. Tunstall, City of Lincolnton Lab

State of North Carolina
Department of Environmental Quality
Division of Water resources
�D➢vislon of Water Resources RESIDUALS SOURCE CERTIFICATION
INSTRUCTIONS FOR FORM: RSC 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 oril4inai and two copies of the application and
supporting documentation
For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting Unit
General — This certification provides detailed information of residuals source generating facility and its residuals quality for land
application, distribution, or disposal in accordance with 15A NCAC 02T .1100. Do not submit this certification for review without
a corresponding application form (FORM: RLAP 11-15, FORM: DCAR 11-15, or FORM: SDR 11-15).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Residuals Source Certification (FORM: RSC 11-15):
® Submit the completed and appropriately executed Residuals Source Certification (FORM: RSC 11-15) form. Please do not
make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to the
application may be made, as long as the attachments are numbered to correspond to the section and item to which they refer.
® For new or renewed permits, submit a separate certification for each source facility.
❑ For modified permits, submit a separate certification for only those facilities that are affected by the proposed modification.
® Complete the residuals source facility summary page. List all new, renewed, or modified facilities.
B. Residuals Source -Generating Facility Information:
® For each source facility, attach the following:
® Vicinity map - A vicinity map that shows the location of the facility and meets all of the criteria in the "Map Guidance for
Residuals Land Application Permits".
® Process flow diagram and/or narrative - A detailed narrative and/or process flow diagram that describes how the residuals
are to be generated, treated, processed, and stored at the facility.
® Quantitative justification for residuals production rate - A quantitative justification for the value provided in Item I. 8.
Ensure that the amount of residuals listed is the maximum amount expected to be generated by the facility for the life of
the permit. In addition, ensure that this amount is equivalent to that which is actually to be land applied, distributed,
and/or disposed, including any chemicals, amendments, or other additives that are added to the residuals during
processing.
® Sampling plan - A detailed sampling plan for the residuals source -generating facility. Ensure that the plan identifies
sampling points, sampling frequency, sample type, as well as the Division -certified laboratory to be used. In addition,
ensure that the plan details how the facility and/or the residuals are monitored for any applicable pathogen reduction and
vector attraction reduction requirements. Note that all sampling and monitoring must be completed on the residuals as
they are to be land applied, distributed, and/or disposed.
C. Residuals Quality Information:
❑ For each source facility, attach the following:
® Laboratory analytical reports and operational data - reports for all laboratory analyses used to complete this certification.
® Documentation that the facility complies and/or the residuals comply with any applicable pathogen reduction and vector
attraction reduction requirements.
❑ For new facility that may have not yet been constructed and analytical results of residuals cannot be obtained, please
attach analytical results of residuals generated from a similar facility along with the description of similarities of the two
facilities.
INSTRUCTIONS FOR FORM: RSC 06-16 Page 1 of 1

RESIDUALS SOURCE FACILITY SUMMARY
Applicant's name: City of Newton
Status Maximum Dry Tons Per Year
Facility Permit Holder Facility Name County Permit Number
Code I Current b Proposed
R City of Newton Newton WWTP Catawba WQ0003902 3448 3448
3 Status Code for source facility are: ♦ N (New) ♦ R (Renewed) ♦ M (Modified) ♦ D (Deleted)
b The amount of residuals currently permitted for distribution, land application, or disposal (Le, not applicable to new facility).
SUMMARY FOR FORM: RSC 06-16 Page 1

State of North Carolina
Department of Environmental Quality
9 Division of Water Resources
RESIDUALS SOURCE CERTIFICATION
Division of Water Resources uuss
ngEPMj
? �1`a
1. RESIDUALS SOURCE -GENERATING FACILITY INFORMATION (See Instruction B.): DECq�
1. Facility Name: Newton Waste Water Treatment Plant AJ%IQROS
pA00RESVILLE REGIOf IAL OFFICE
2. Facility permit holder is: ❑ Federal, ❑ State, j Local Government, or ❑ Private.
Facility permit issued by: Div. of Water Resources, ❑ Div. of Environmental Health,
or ❑ Other (explain: ` ]).
3. Facility contact person and title: Eric Jones Waste Water Plant Superintendent
Complete mailing address: P.O. Box 550
City: Newton State: NC Zip: 28658
Telephone number: 828 217-4457 E-mail address: [e-mail]
4. Facility physical address: 1407 McKU rd
City: Newton State: NC Zip: 28658
Coordinates: Latitude: 35' 37' 40" Longitude: 81' 14' 00"
Datum: NAD83 Level of accuracy: Second
Method of measurement: Map
L
i 5. Purpose of the facility:
treatment of municipal wastewater, ❑ treatment of 100% domestic wastewater,
treatment of potable water, ❑ treatment of 100% industrial wastewater,
❑ treatment of industrial wastewater mixed with domestic wastewater,
(approximate percentages: �- -- % industrial and f—� % domestic)
❑ other (explain: F i ).
6. Does the facility have an approved pretreatment program: Yes ❑ No
7. Facility permitted/design flow: FT_j MGD and facility average daily flow: 2.25 MGD
8. Average amount of residuals being generated at this facility 650 dry tons per year.
9. Specify the following regarding treatment and storage volumes available at the facility:
Type and volume of residuals treatment: r
Type and volume of residuals storage (i.e., outside of residuals treatment units): E I
H. RESIDUALS QUALITY INFORMATION (See Instruction C.):
1. Specify if residuals are regulated under:
40 CFR Part503 or 40 CFR Part 257.
Note: Only residuals that are generated during domestic/municipal wastewater treatment processes are regulated under 40
CFR Part 503, otherwise, the residuals are regulated under 40 CFR Part 257.
2. Specify if residuals are defined under 15A NCAC 02T.1102(6) as:
Biological ❑ Non -Biological
\ Note: Biological residuals are residuals that have been generated during the treatment of domestic wastewater, animal
processing wastewater, or the biological treatment of industrial wastewater (biological treatment is a system that utilizes
biological processes including lagoons, activated sludge systems, extended aeration systems, and fixed film systems).
FORM: RSC 06-16 Page 1 of 5

I
3. Hazardous Waste Determination: Complete the following to demonstrate that the residuals are non -hazardous under
RCRA: (Note - this item .does not have to be completed for facilities that are less than 0.5 MGD in design flow that treat
100% non -municipal, domestic wastewater only)
a. Are the residuals listed in 40 CFR §261.31-§261.33: 0 yes] no.
If yes, list the number(s):
b. Specify whether or not the residuals exhibit any of the characteristics defined by 40 CFR §261.21-
261.24: yes no.
Fill in the following tables with the results of the latest toxicity characteristic leaching procedure (TCLP) analysis as
well as those for corrosivity, ignitability, and reactivity:
Laboratory: Shealy Environmental and Date of analysis: 11/23/2019
Passed corrosivity test: yes no. pH: s.u. (2 <pH < 12.5)
Passed ignitability test: yes no. Flashpoint: >140 °F (> 140°F)
Passed reactivity test: Myes 'Ono. HCN: nd mg/kg (<250) & H2S: n mg/kg (<500)
TCLP Parameter
Limit
(mg/1)
Result
(mg/1)
TCLP Parameter
Limit
(mg/1)
Result
(mg/1)
Arsenic
5.0
nd
Hexachlorobenzene
0.13
nd
Barium
100.0
.34
Hexachloro-1,3-Butadiene
0.5
nd
Benzene
0.5
nd
Hexachloroethane
3.0
nd
Cadmium
1.0
nd
Lead
5.0
nd
Carbon Tetrachloride
0.5
nd
Lindane
0.4
nd
Chlordane
0.03
nd
Mercury
0.2
nd
Chlorobenzene
100.0
nd
Methoxychlor
10.0
nd
Chloroform
6.0
nd
Methyl Ethyl Ketone
200.0
nd
Chromium
5.0
nd
Nitrobenzene
2.0
nd
in -Cresol
200.0
nd
Pentachlorophenol
100.0
nd
o-Cresol
200.0
nd
Pyridine
5.0
nd
p-Cresol
200.0
nd
Selenium
1.0
nd
Cresol
200.0
nd
Silver
5.0
nd
2,4-D
10.0
nd
Tetrachloro ethylene
0.7
nd
1,4-Dichlorobenzene
7.5
nd
Toxaphene
0.5
nd
1,2-Dichloroethane
0.5
nd
Trichloroethylene
0.5
nd
1,1-Dichloroethylene
0.7
nd
2,4,5-Trichlorophenol
400.0
nd
2,4-Dinitrotoluene
0.13
nd
2,4,6-Trichlorophenol
2.0
nd
Endrin
0.02
nd
2,4,5-TP (Silvex)
1.0
nd
Heptachlor and its Hydroxide
0.008
nd
Vinyl Chloride
0.2
nd
FORM: RSC 06-16
Page 2 of 5

4. Metals Determination: Complete one of the following tables (i.e., as applicable) to demonstrate that the residuals do not
violate the ceiling concentrations for metals regulated under 15A NCAC 02T .1105.
a. For Distribution/Land Application: Fill in the following table with the results of the latest analyses (i.e., on a dry weight
basis) for the following metal parameters:
Laboratory: Waypoint Environmental and Date of analysis: 09/10/2019
Parameter
Ceiling
Concentration Limits
(ClassA & ClassB)
(mg/kg)
Monthly Average
Concentration Limits
(Class A Only)
(mg/kg)
Result
(mg/kg)
Arsenic
75
41
<5.0
Cadmium
85
39
<1.0
Copper
4,300
1,500
164
Lead
840
300
12.1
Mercury
57
17
.123
Molybdenum
75
n/a
3.27
Nickel
420
420
22.6
Selenium
100
100
<5.0
Zinc
7,500
2,800
.904
b. For Surface Disposal Unit (landfill): Fill in the following table with the results of the latest analyses (i.e., on a dry weight
basis) for the following metal parameters:
Laboratory:. and Date of analysis:
Distance from Disposal
Unit to Boundary to
Closest Property Line
(meters, check one)
Arsenic
(mg/kg)
Chromium
(mg/kg)
Nickel
(mg/kg)
> 0 but < 25
30
200
210
> 25 but < 50
34
220
240
> 50 but < 75
39
260
270
> 75 but < 100
46
300
320
> 100 but < 125
53
360
390
> 125
62
450
420
Result (mg/kg)
FORM: RSC 06-16
Page 3 of 5

5. Nutrient/Micronutrient Determination: Complete the following:
a. Total solids: 6.62 %.
b. Fill in the following table with the results of the latest analyses (i.e., on a dry weight basis) for the following nutrient and
micronutrient parameters:
Laboratory: WMoint Ang3tical and Date of analysis: 09/10/2019
Parameter
Result
(mg/kg)
Aluminum
18100
Ammonia -Nitrogen
6520
Calcium
208000
Magnesium
5220
Nitrate -Nitrite Nitrogen
10784
pH (Standard Unit)
8.0
Phosphorus
8240
Potassium
633
Sodium
604
Total Kjeldahl Nitrogen
17300
c. Using the results listed in Item II. 5b. above, calculate the sodium adsorption ration (SAR): 0.85
[Note: If residuals contain SAR of 10 or higher, the applicant shall obtain recommendations from the local Cooperative
Extension Office, the Department of Agriculture and Consumer Services, the Natural Resource Conservation Service, a
North Carolina Licensed Soil Scientist, or an agronomist, prior to land application of residuals. The recommendations shall
address the sodium application rate, soil amendments (e.g., gypsum, etc.), or a mechanism for maintainingsite integrity
and conditions conducive to crop growth].
d. Specify the mineralization rate to be used in calculating the plant available nitrogen (PAN) of the residuals: ! %.
This rate is a (check one): W_ default value, or 0 actually established.
If the residuals are not generated from the treatment of municipal or domestic wastewater, explain or provide technical
justification as to why the selected default value is appropriate to be applied to these residuals:
e. Calculate the PAN for the residuals (i.e., on a dry weight basis) and fill the results in the following table:
Application Method
First (1st) Year PAN
. Five -Year
Maximum Adjusted PAN
(mg1kg)
(mg/k9)
Surface
6499
8,602
Injection/Incorporation
9759
11,862
6. Other Pollutants Determination: Specify whether or not there are any other pollutants of concern in the residuals and provide
the results of the latest analyses: I I
FORM: RSC 06-16
Page 4 of 5

7. Pathol4en Reduction: Per 15A NCAC 02T.1106, specify how residuals will meet the pathogen reduction requirements:
a. For Distribution/Land Application of Class A or Equivalent:
A fecal coliform density that is demonstrated to be less than 1,000 MPN per gram of total dry solids,
or
A salmonella sp. density that is demonstration to be less than 3 MPN per 4 grams of total dry solids.
AND one of the followings (except for non -biological residuals):
Alternative 1 [15A NCAC 02T.1106(b)(3)(A)] - Time/Temperature Compliance.
Alternative 2 [15A NCAC 02T. 1 106(b)(3)(B)] - Alkaline Treatment.
Alternative 3 [15A NCAC 02T.1106(b)(3)(C)] - Prior Testing for Enteric Virus/Viable Helminth Ova.
❑ Alternative 4 [15A NCAC 02T.1106(b)(3)(D)] - No Prior Testing for Enteric Virus/Viable Helminth Ova.
Alternative 5 [15A NCAC 02T.I 106(b)(3)(E)-(K)] - Process to Further Reduce Pathogens (PFRP).
Specify one: ❑ composting, ❑ heat drying, ❑ heat treatment,
❑ thermophilic aerobic digestion, ❑ beta ray irradiation,
gamma ray irradiation, or ❑ pasteurization.
b. For Land Application of Class B:
❑ Alternative 1 [15A NCAC 02T.1106(c)(1)] - Fecal Coliform Density Demonstration.
Alternative 2 [15A NCAC 02T.1106(c)(2)] - Process to Significantly Reduce Pathogens (PSRP).
Specify one:. aerobic digestion, ❑ air drying, ❑ anaerobic digestion,
composting, or lime stabilization.
c. For Surface Disposal:
❑ Select One of the Class A or Equivalent Pathogen Reduction Alternatives in Item II. 7a. above.
Select One of the Class B or Equivalent Pathogen Reduction Alternatives in Item II. 7b. above.
❑ Exempt -If Daily Cover Alternative is chosen in Item 11.8. below [15A NCAC 02T.1106(a)(2)].
Not Applicable - Non -Biological Residuals with NO Domestic Wastewater Contribution.
8. Vector Attraction Reduction (VAR): Per 15A NCAC 02T.1107, specify how residuals will meet the VAR requirements:
Alternative 1 [15A NCAC 02T.1107(a)(1)] - 38% Volatile Solids Reduction (Aerobic/Anaerobic Digestion).
{^ Alternative 2 [15A NCAC 02T. 1 107(a)(2)] - 40-Day Bench Scale Test (Anaerobic Digestion).
[( Alternative 3 [15A NCAC 02T.1107(a)(3)] - 30-Day Bench Scale Test (Aerobic Digestion).
Alternative 4 [15A NCAC 02T.I 107(a)(4)] - Specific Oxygen Uptake Rate Test (Aerobic Digestion).
Alternative 5 [15A NCAC 02T.I 107(a)(5)] - 14-Day Aerobic Processes.
Alternative 6 [15A NCAC 02T.I 107(a)(6)] - Alkaline Stabilization.
❑ Alternative 7 [15A NCAC 02T. I 107(a)(7)] - Drying of Stabilized Residuals.
[� Alternative 8 [15A NCAC 02T.1107(a)(8)] - Drying of Unstabilized Residuals.
Alternative 9 [15A NCAC 02T. 1 107(a)(9)] - Injection.
❑ Alternative 10 [15A NCAC 02T.I 107(a)(10)] - Incorporation.
❑ Alternative for Surface Disposal Units Only - Soil/Other Material Cover [15A NCAC 02T.1107(b)(2)].
[] Not Applicable - Non -Biological Residuals with NO Domestic Wastewater Contribution.
Note: For animal processing residuals, only alternatives 9 or 10 may be chosen due to the nuisance conditions that typically
occur when these residuals are applied and left on the land surface.
FORM: RSC 06-16 Page 5 of 5

VICINITY MAP S YNP1GRO
Vol
lit
P-11
F-j
ED I
i
gqjc.
RE
G6dgle
Mill
COUNTY: Catawba O'WI\MR(S): Newton WWTP

Residuals Sampling Plan
City of Newton and Application Program (WWTP)
Nutrient and Metal Analysis
Sampling Point:
Sampling Frequency:
Sample Type:
Lab:
WWTP
Digester
Quarterly
Composite
Waypoint Environmental
Pathogen Reduction
- Lime Stabilization done in house by plant operators
Vector Attraction Reduction
- Lime Stabilization done in house by plant operators
TCLP/RCI
Sampling Point:
Sampling Frequency:
Sample Type:
WWTP
Digester
Once per permit cycle
Composite
Lab: Shealy Environmental

Lit
CHL(
BAST,
DECF
DISCHARGE TO
CLARK CREEK 001
UU[IIISENGINEERS
STATION
-N
AERATED GRIT CHAMBERS
:IME ADDITION
EACTOR CLARIFIERS
J
J
i
I
:RATION BASINS I
I
I
i
i
f �
I 1
I
RY I I
I
_OGICAL i
pGE RECYCLE PUMP STATION
I
---------J
U--1---- J
i I � J
RS.
T -0
J
J
I
J PUMP
1 '
J � f
TO REGIONAL
COMPOST FACILITY
OR LAND APPLICATION
CITY OF NEWTON
CLARK CREEK WWTp
FLOW SCHEMATIC
STATION
JANUARY 2005
NO J 949.037 f
SCALE I 1

Quantitative Justification for Residuals Production
Currently, the City of Newton's WWTP is permitted for 3448 dry tons of annual production.
There is no request at this time to change this amount. The facility permitted/design flow is 6
MGD. Even if this maximum amount is reached, we would still be under the permitted dry tons
of annual production. The additional dry tonnage will allow for any future expansions.
Total Dry Tons = gallons of residuals X % solids X 8.341bs./gallon
2,000 lbs./ton
(2,250,000 X 0.0632 X 8.34 lbs./gallon)/ 2,000 lbs./ton = —621 dry tons

Bio-solids Management Summary
City of Newton NC
Clark Creek WWTP
NPDES Permit #NC0036196
The City of Newton disposes of generated residuals from the Clark Creek WWTP
generally by its Land Application Program with a small portion being transported to the
Regional Composting Facility via the City of Conover.
The City of Conover discharges wastewater to the Clark Creek WWTP and is a vested
owner in the Regional Compost Consortium. Presently Conover is transporting
approximately 14% of the bio-solids produced at Clark Creek to the Compost Facility for
treatment and disposal.
The remainder of the bio-solids is land applied in accordance with the City of Newton
Land Application Permit.
Primary clarifier sludge and waste biological solids are pumped to an in -process gravity
thickener. Telescoping valves are utilized to decant water from the surface of the
thickener as solids settle.
If sludge is to be hauled to the Regional Compost Facility by the City of Conover, the
solids are segregated to a separate thickener and gravity thickened only.
Solids for land application are gravity thickened with the addition of lime slurry to the in -
process thickener. Thickened sludge is transferred to one of two holding thickeners
where the pH of the sludge is raised to 12.0 or greater. In two hours, the pH is again
tested to verify a pH of 12.0 or greater. After 22 more hours, a pH is again taken to
confirm a pH of 11.5 or greater to meet the requirements pathogen reduction and vector
attraction elimination. The sludge is then land applied.
Periodic, routine analyses of the bio-solids are performed as required by the Land
Application Permit.

W► ®�ntR aYPNALYTICAL
9/10/2019
Synagro Central LLC/ Newton
Mary Brewer
284 Boger Road
Mocksville, NC, 27028
Ref: Analytical Testing
Report Number: 19-241-0005
Project Description: NEWTON WWTP
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 ° Fax [phone]
www.wayp6intanalytical.com
Dear Mary Brewer:
Waypoint Analytical Virginia, Inc. received sample(s) on 8/2912019 for the analyses presented in the following
report.
The above referenced project has been analyzed per your instructions. The analyses were performed in
accordance with the applicable analytical method. Sub -contracted testing is noted on the Sample Summary Table
if applicable.
The analytical data has been validated using standard quality control measures performed as required by the
analytical method. Quality Assurance, method validations, instrumentation maintenance and calibration for all
parameters (NELAP and non-NELAP) were performed in accordance with guidelines established by the USEPA
(including 40 CFR 136 Method Update Rule May 2012) and NELAC unless otherwise indicated.
Certain parameters (chlorine, pH, dissolved oxygen, sulfite...) are required to be analyzed within 15 minutes of
sampling. Usually, but not always, any field parameter analyzed at the laboratory is outside of this holding time.
Refer to sample analysis time for confirmation of holding time compliance.
The results are shown on the attached Report of Analysis(s). Results for solid matrices are reported on an as -
received basis unless otherwise indicated. This report shall not be reproduced except in full and relates only to
the samples included in this report.
Please do not hesitate to contact me or client services if you have any questions or need additional information.
Sincerely,
Pauric McGroary
Agronomist
Laboratory's liability in any claim relating to analyses performed shall be limited to, at laboratory's option, repeating the
analysis in question at laboratory's expense, or the refund of the charges paid for performance of said analysis.
Virginia 460014
Page 1 of 6

I
r
7621 Whitepi.ne Road, Richmond, VA 23237
Waypoin�„ Main 804-743-9401 ° Fax [phone]
ANALYTICAL www.waypointanaiVUcal.com
Sample Summary Table
Report Number:
Client Project Description:
19-241-0005
NEWTON WWTP
Lab No
Client Sample ID
Matrix
Date Collected
Date Received
Method
Lab ID
67995
NEWTON WWTP
Solids
08/28/2019 10:55
08/29/2019
67995
NEWTON WWTP
Solids
08/28/2019 10:55
08/29/2019
SM-2540G
WTN
67995
NEWTON WWTP
Solids
08/28/2019 10:55
08/29/2019
SW-7471B
WTN
67995
NEWTON WWTP
Solids
08/28/2019 10:55
08/29/2019
SM-4500-NH3C-TKN
WTN
67995
NEWTON WWTP
Solids
08/28/2019 10:55
08/29/2019
4500NO3F-2011
WTN
67995
NEWTON WWTP
Solids
08/28/2019 10:55
08/29/2019
6010D
WTN
67995
NEWTON WWTP
Solids
08/28/2019 10:55
08/29/2019
SM-4500-NH3C
WTN
67995
NEWTON WWTP
Solids
08/28/2019 10:55
08/29/2019
9045D
WTN
67995
NEWTON WWTP
Solids
08/28/2019 10:55
08/29/2019
AOAC 955.01
WTN
WTN: Waypoint Analytical - TN, Memphis, TN, Certification: #1354
Page 2 of 6

Report Number: 19-241-0005
Account Number: 46476
Send To: Synagro Central LLC/ Newton
Mary Brewer
284 Boger Road
Mocksville , NC 27028
Lab Number: 67995
Sample Id : NEWTON WWTP
waypoint"(D
ANALYTICAL
7611 Whitepine Road, Richmond,:VA 13137
Main 904-743-9401'0 pax 904-271-6446
www.wayoointEinalotal.com
Project: NEWTON WWTP
REPORT OF ANALYSIS Date Sampled: 8/28/2019 10:55:00
Date Received: 08/29/2019 00:00
Date Reported: 09/10/2019
Total Solids *
6.62
ADM
08/30/2019 15:57
SM-2540G
Moisture *
93.40
ADM
08/30/2019 15:57
SM-2540G
Total Kjeldahl Nitrogen
1.73
17300
250
JPJ
09/06/2019 09:00
SM-4500-NH3C-TKN
Phosphorus
0.82
8240
50.0
JTR
09/05/2019 21:28
601 OD
Potassium
0.06
633
50.0
JTR
09/05/2019 21:28
601 OD
Sulfur
0.41
4100
50.0
JTR
09/05/2019 21:28
601 OD
Calcium
20.80
208000
5000
BKN
09/D6/201918:07
6010D
Magnesium
0.52
5220
50.0
JTR
09/05/2019 21:28
601 OD
Sodium
0.06
604
250
BKN
09/06/201913:33
601 OD
Iron
11500
50.0
JTR
09/05/2019 21:28
601 OD
Aluminum
18100
50.0
JTR
09/05/2019 21:28
601 OD
Manganese
581
5.00
JTR
09/05/2019 21:28
6010D
Copper
164
2.50
JTR
09/05/2019 21:28
6010D
Zinc
904
12.5
JTR
09/05/2019 21:28
6010D
Ammonia Nitrogen
0.65
6520
100
JPJ
09/06/2019 14:30
SM-4500-NH3C
Organic N
1.08
10780
250
09/06/2019 09:00
CALCULATION
Nitrate+Nitrite-N
<4.87
4.87
ZBD
09/04/201915:18
4500NO3F-2011
All values are on a dry weight basis except as noted by asterisk. Detection limit on all N series is on a wet basis.
B-Analyte detected in blank H - Beyond holding time porzG ►'}t
Our reports and letters are for the exclusive and confidential use of our clients, and may not be reproduced in whole or part, nor may any reference be made Pauric McGroary
to the work, the results, or the company in any advertising, news release, or other public announcements without obtaining our prior written authorization. Agronomist
Page 3 of 6

Report Number: 19-241-0005
Account Number: 46476
Send To: Synagro Central LLC/ Newton
Mary Brewer
284 Boger Road
Mocksville , NC 27028
Lab Number: 67995
Sample Id : NEWTON WWTP
Way nto
i►
P11
MALYTICAL'
7621 Whitepine Road, Richmond, VA 23237
Main. 804-743-9401 0 Fax [phone]
www.Wayp6intanalytical.com
Project: NEWTON WWTP
REPORT OF ANALYSIS Date Sampled: 8/28/2019 10:55:00
Date Received: 08/29/2019 00:00
Date Reported: 09/10/2019
Cadmium
<1.00
1.00
JTR
09/05/2019 21:28
601 OD
Chromium
27.5
2.50
JTR
09/05/2019 21:28
601 OD
Nickel
22.6
2.50
JTR
09/05/2019 21:28
601 OD
Lead
12.1
3.00
JTR
09/05/2019 21:28
601 OD
Arsenic
<5.00
5.00
JTR
09/05/2019 21:28
601 OD
Mercury
0.123
0.0142
TJS
09/04/2019 13:53
SW-7471 B
Selenium
<5.00
5.00
JTR
09/05/2019 21:28
601 OD
pH *
8.0
JSL
09/04/2019 06:13
9045D
Calcium Carbonate Equivalent
46.00 460000
1000
DXT
09/05/2019 10:12
AOAC 955.01
Molybdenum
3.27
2.50
JTR
09/05/2019 21:28
601 OD
Comments:
All values are on a dry weight basis except as noted by asterisk. Detection limit on all N series is on a wet basis. `
B - Analyte detected in blank H - Beyond holding time potir. P,c�O1�Y
Our reports and letters are for the exclusive and confidential use of our clients, and may not be reproduced in whole or part, nor may any reference be made Pauric McGroary
to the work, the results, or the company in any advertising, news release, or other public announcements without obtaining our prior written authorization. Agronomist
Page 4 of 6

s
Waypoint
ANALYTICAL
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 ° Fax [phone]
www.wayp o f nt a n a l ytica I. co ni
Cooler Receipt Form
Customer Number: 46476
Customer Name: Synagro Central LLC/ Newton
Report Number: 19-241-0005
Shipping Method
0 Fed Ex 0 US Postal IS Lab
0 UPS 0 Client 0 Courier
0 Other:
Thermometer ID:
Shipping container/cooler uncompromised?
is Yes
0 No
Number of coolers received
F 1
Custody seals intact on shipping container/cooler?
0 Yes
0 No
Not Required
Custody seals intact on sample bottles?
0 Yes
0 No
I® Not Required
Chain of Custody (COC) present?
• Yes
0 No
COC agrees with sample label(s)?
• Yes
0 No
COC properly completed
4P Yes
0 No
Samples in proper containers?
10 Yes
0 No
Sample containers intact?
0 Yes
0 No
Sufficient sample volume for indicated test(s)?
0 Yes
0 No
All samples received within holding time?
i® Yes
0 No
Cooler temperature in compliance?
i Yes
0 No
Cooler/Samples arrived at the laboratory on ice.
Samples were considered acceptable as cooling
process had begun.
• Yes
0 No
Water - Sample containers properly preserved
0 Yes
0 No
• N/A
Water - VOA vials free of headspace
0 Yes
0 No
• N/A
Trip Blanks received with VOAs
0 Yes
0 No
• N/A
Soil VOA method 5035 — compliance criteria met
0 Yes
0 No
N/A
F_ High concentration container (48 hr) F_ Low concentration EnCore samplers (48 hr)
F_ High concentration pre -weighed (methanol -14 d) F_ Low conc pre -weighed vials (Sod Bis -14 d)
Special precautions or instructions included? 0 Yes 0 No
Comments:
Signature: lBrandi Watson Date & Time: 08/29/2019 14:05:14
Page 5 of 6

SAMP G LOG #
'CUSTOMER: S`YG14AGRO
19-241 0005
III I I ICI II II I I II III II I II I III II1II1 IIIII hill Hill III 1108d 76
-2019
Svnauro Central LLC/ Newton 29
NEWTON WWTP 14:03:13
PROJECT MANAGER: __ file
Phone: _( 33'�) % 3 8'6g 1
A & L CUSTOMER SAMPLING
LAB # SAMPLE I.D. LOCATION
Relinquished by Sampler:
Relinquished by:
Relinquished by:
SPECIAL INSTRUCTIONS:
000 For C, monitoring purposes,
ABS, INC. ONAPH OF CU37ODY
RECORD 9k ANALY303
RECORD
a«Crst that the proper field sampling procedures
were used during the collection of these samples.
— L C __� -
SAMPLER
SAMPLE # OF SAMPLING
TYPE CONTAINERS DATE TIME
f_')Xc 1 6111 Icy; 6�-
METHOD METHOD
PRESERVED SHIPPED
T
Time Recieved by: REMARKS:
Date Time ' . Recieved by:
Date Time Recieved by:
PO#.
Ap
SAMPLE
ANALYSIS REQUEST.
SLI
SL2
NHN
4
M0N
3
UrgNanic
Cd
Cr
NI
Pb.
As
Hg
Se.
PH
CaCO3
equiv.
Volatile
Solids
MO.
CI
NO2 N
I
po
V�
.�� . twat cunus tiviuiszure), imai rdeiaani ivrerogen, Phosphorus, and Potassium
SL2: Basic Test SL1 plus Sulfur, Calcium, Magnesium, Sodium, Iron, Aluminum, Manganese, Copper and Zinc
Page 6 of 6

SHEALY ENVIRONMENTAL SERVICES, INC.
Report of Analysis
Synagro
12701 Lancaster Hwy
Pineville, NC 28134
Attention: Alex Fox
Project Name: Newton WWTP
Lot Number:UK13045
Date Completed:11/25/2019
11 /29/2019 8:34 AM
Approved and released by:
Lab Director - Greenville: Lucas Odom
f�
d
4
AM
,( ACCREDITED
`9eORA��
w—�—
The electronic signature above is the equivalent of a handwritten signature.
This report shall not be reproduced, except in its entirety, without the written approval of Shealy Environmental Services, Inc.
Shealy Environmental Services, Inc.
106 Vantage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www.shealylab.com
Page 1 of 10

SHEAL`i( ENVIRONMENTAL SERVICES, INC.
SC DHEC No: 32010001 NELAC No: E87653 NC DENR No: 329 NC Field Parameters No: 5639
Case Narrative
Synagro
Lot Number: UK13045
This Report of Analysis contains the analytical result(s) for the sample(s) listed on the Sample Summary
following this Case Narrative. The sample receiving date is documented in the header information
associated with each sample.
All results listed in this report relate only to the samples that are contained within this report.
Sample receipt, sample analysis, and data review have been performed in accordance with the most
current approved NELAC standards, the Shealy Environmental Services, Inc. ("Shealy") Quality
Assurance Management Plan (QAMP), standard operating procedures (SOPS), and Shealy policies. Any
exceptions to the NELAC standards, the QAMP, SOPS or policies are qualified on the results page or
discussed below.
Where applicable, all soil sample analysis are reported on a dry weight basis unless flagged with a "W"
qualifier
If you have any questions regarding this report please contact the Shealy Project Manager listed on the
cover page.
The pH analysis associated with the sample(s) in this report was/were performed after the method
recommended 15 minute holding time.
Shealy Environmental Services, Inc.
106 Vantage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www.shealylab.com
Page 2 of 10

SHEALY ENVIRONMENTAL SERVICES, INC.
Sample Summary
Synagro
Lot Number: UK13046
Sample Number Sample ID Matrix Date Sampled Date Received
001 Newton TCLP Solid 11/12/2019 1010 11/13/2019
(1 sample)
Shealy Environmental Services, Inc.
106 Vantage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www.shealylab.com
Page 3 of 10

SHEALY ENVIRONMENTAL SERVICES, INC.
Deflection Summary
Synagro
Lot Number: UK13045
Sample Sample ID
Matrix
Parameter
Method Result Q
Units
Page
001 Newton TCLP
Solid
Ignitability (Pensky-Martens
1010A >140
° F
5
001 Newton TCLP
Solid
Paint Filter Test
9095E Fail
pass/fail
5
001 Newton TCLP
Solid
3+4-Methylphenol
8270D 0.63
mg/L
6
001 Newton TCLP
Solid
Barium
6010D 0.34
mg/L
8
(4 detections)
Shealy Environmental Services, Inc.
106 Vantage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www.shealylab.com
Page 4 of 10

Client: Synagro Laboratory ID: UK13045-001
Description: Newton TCLP Matrix: Solid
Date Sampled:11/1212019 1010
Date Received: 1111312019
r
Inorganic non-metals
nun Prep Method
Analytical Method
Dilution Analysis Date Analyst
Prep Date
Batch
1
(Ignitability) 1010A
1 11/18/2019 1125 SLC
36130
1
(Paint Filter) 9095B
1 11/19/2019 2307 HET
1
(Reactive Cya) 7.3.3
1 11/20/2019 1803 KFE
11/19/2019 0956
1
(Reactive Sul) 7.3.4
1 11/19/2019 1819 HET
11/19/2019 0956
1
(Soil pH meas) 9045D
1 11/20/2019 2122 HET
36570
CAS Analytical
Parameter
Number Method
Result Q
LOQ
Units
Run
Ignitability (Pensky-Martens Closed -Cup)
1010A
>140
140
° F
1
Paint Filter Test
9095B
Fail
pass/fail
1
Reactive Cyanide
7.3.3
ND
50
mg/kg
1
Reactive Sulfide
7.3.4
ND
50
mg/kg
1
Soil pH measured in water @ 20.2 ° C
9045D
9.3
su
1
TCLP Volatiles
Run Prep Method
Analytical Method
Dilution Analysis Date Analyst
Prep Date
Batch Leachate Date
1 1311/5030B
8260B
10 11/16/2019 2207 STM
35975 11/14/2019 1931
CAS Analytical
Parameter
Number Method
Result Q
LOQ
Units
Run
Benzene
71-43-2
8260B
ND
0.050
mg/L
1
2-Butanone (MEK)
78-93-3
8260B
ND
0.10
mg/L
1
Carbon tetrachloride
56-23-5
8260B
ND
0.050
mg/L
1
Chlorobenzene
108-90-7
8260B
ND
0.050
mg/L
1
loroform
67-66-3
8260B
ND
0.050
mg/L
1
!-Dichloroethane
107-06-2
8260B
ND
0.050
mg/L
1
i, I-Dichloroethene
75-35-4
8260B
ND
0.050
mg/L
1
Tetrachloroethene
127-18-4
8260B
ND
0.050
mg/L
1
Trichloroethene
79-01-6
8260B
ND
0.050
mg/L
1
Vinyl chloride
75-01-4
8260B
ND
0.010
mg/L
1
Run 1 Acceptance
Surrogate
Q % Recovery Limits
1,2-Dichloroethane-d4
81 70-130
Bromofluorobenzene
82 70-130
Toluene-d8
86 70-130
TCLP Semivolatiles
Run Prep Method
Analytical Method Dilution Analysis Date Analyst
Prep Date
Batch Leachate Date
1 1311/3520C
8270D 1 11/22/2019 1409 SCD
11/19/2019 1853 36299 11/18/20191915
CAS Analytical
Parameter
Number Method
Result Q
LOQ
Units Run
1,4-Dichlorobenzene
106-46-7 8270D
ND
0.040
mg/L 1
2,4-Dinitrotoluene
121-14-2 8270D
ND
0.080
mg/L 1
LOQ = Limit of Quantitation B = Detected in the method blank E = Quantitation of compound exceeded the calibration range
ND = Not detected at or above the LOQ N = Recovery is out of criteria P = The RPD between two GC columns exceeds 40 %
H = Out of holding time W = Reported on wet weight basis
fly Environmental Services, Inc.
✓antage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www.shealylab.com
Page 5 of 10

Client: Synagro Laboratory ID: UK13045-001
Description: Newton TCLP Matrix: Solid
Date Sampled:1111212019 1010
Date Received:11/1312019
TCLP Semivolatiles
mun Prep Method Analytical Method Dilution Analysis Date Analyst Prep Date Batch Leachate Date
1 1311/3520C 8270D 1 11/22/2019 1409 SCD 11/19/20191853 36299 11/18/20191915
CAS Analytical
Parameter Number Method Result Q LOQ Units Run
Hexachlorobenzene
118-74-1
8270D
ND
0.040
mg/L
1
Hexachlorobutadiene
87-68-3
8270D
ND
0.040
mg/L
1
Hexachloroethane
67-72-1
8270D
ND
0.040
mg/L
1
2-Methylphenol
95-48-7
8270D
ND
0.040
mg/L
1
3+4-Methylphenol
106-44-5
8270D
0.63
0.040
mg/L
1
Nitrobenzene
98-95-3
8270D
ND
0.040
mg/L
1
Pentachlorophenol
87-86-5
8270D
ND
0.20
mg/L
1
Pyridine
110-86-1
8270D
ND
0.040
mg/L
1
2,4,5-Trichlorophen ol
95-95-4
8270D
ND
0.040
mg/L
1
2,4,6-Trichlorophenol
88-06-2
8270D
ND
0.040
mg/L
1
Run 1 Acceptance
Surrogate
Q % Recovery Limits
2-Fluorobiphenyl
69
37-129
2-Fluorophenol
39
24-127
Nitrobenzene-d5
69
38-127
Phenol-d5
70
28-128
Terphenyl-d14
85
10-148
2,4,6-Tribromophenol
84
41-144
TCLP Herbicides
In Prep Method
Analytical Method Dilution
Analysis Date Analyst Prep Date Batch - Leachate Date
1311/8151A
8151A 1
11/22/2019 0209 DAL1 11/20/2019 2055 36413 11/18/2019 1915
CAS Analytical
Parameter
Number Method Result Q LOQ
Units Run
2,4-D 94-75-7 8151A ND 0.020 mg/L 1
2,4,5-TP (Silvex) 93-72-1 8151A ND 0.0050 mg/L 1
Run 1 Acceptance
Surrogate Q % Recovery Limits
DCAA 77 50-112
TCLP Pesticides
Run Prep Method Analytical Method Dilution Analysis Date Analyst Prep Date Batch Leachate Date
1 131113520C 8081E 1 11/25/20191509 DAL1 11/21/20191856 36571 11/18120191915
CAS
Analytical
Parameter
Number
Method
Result Q
LOQ
Units
Run
gamma-BHC (Lindane)
58-89-9
8081B
ND
0.00040
mg/L
1
Chlordane
57-74-9
8081B
ND
0.0040
mg/L
1
Endrin
72-20-8
8081B
ND
0.00040
mg/L
1
LOQ = Limit of Quantitalion B = Detected in the method blank E = Quantitation of compound exceeded the calibration range
ND = Not detected at or above the LOQ N = Recovery Is out of criteria P = The RPD between two GC columns exceeds 40 %
H = Out of holding time W = Reported on wet weight basis
fly Environmental Services, Inc.
✓antage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www.shealylab.com
Page 6 of 10

Client:Synagro Laboratory ID:UK13045-001
Description: Newton TCLP Matrix: Solid
Date Sampled:11/12/2019 1010
)ate Received: 11/1312019
TCLP Pesticides
nun Prep Method
Analytical Method Dilution Analysis Date Analyst
Prep Date
Batch Leachate Date
1 1311/3520C
8081E 1 11/25/2019 1509 DAL1
11/21/2019 1856 36571 11/18/2019 1915
CAS Analytical
Parameter
Number Method
Result Q
LOQ
Units
Run
Heptachlor
76-44-8 8081B
ND
0.00040
mg/L
1
Heptachlor epoxide
1024-57-3 8081 B
ND
0.00040
mg/L
1
Methoxychlor
72-43-5 8081B
ND
0.0016
mg/L
1
Toxaphene
8001-35-2 8081E
ND
0.0080
mg/L
1
Run 1 Acceptance
Surrogate
Q % Recovery Limits
Decachlorobiphenyl
43 20-131
Tetra chlo ro-m-xylen e
71 26-132
TCLP Metals
Run Prep Method Analytical Method Dilution Analysis Date Analyst Prep. Date Batch Leachate Date
1 1311/3010A 6010D 1 11/21/2019 0023 LLL 11/20/2019 0931 36328 11/18/2019 1915
1 1311/7470A 7470A 1 11/21/20191746 KSH2 11/20/2019 1455 36377 11/18/2019 1915
CAS
Analytical
Parameter
Number
Method
Result Q
LOQ
Units
Run
Arsenic
7440-38-2
601OD
ND
0.15
mg/L
1
Barium
7440-39-3
6010D
0.34
0.25
mg/L
1
Cadmium
7440-43-9
601OD
ND
0.050
mg/L
1
Chromium
7440-47-3
6010D
ND
0.10
mg/L
1
ad
7439-92-1
601OD
ND
0.10
mg/L
1
�. Drcury
7439-97-6
7470A
ND
0.0020
mg/L
1
oelenium
7782-49-2
601OD
ND
0.20
mg/L
1
Silver
7440-22-4
601OD
ND
0.10
mg/L
1
Footnote(s): *Paint Filter: 13mL collected;
LOQ = Limit of Quantitation B = Detected in the method blank E = Quantitation of compound exceeded the calibration range
NO = Not detected at or above the LOQ N = Recovery is out of criteria P = The RPD between two GC columns exceeds 40 %
H = Out of holding time W = Reported on wet weight basis
i
aly Environmental Services, Inc.
Vantage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www.shealylab.com
Page 7 of 10

Chain of Custody
and
Miscellaneous Documents
Shealy Environmental Services, Inc.
106 Vantage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www.shealylab.com
Page 8 of 10

ro
tra
Slloialy Enviranm ntaI Services, lnr,,
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unless oiFier arran�pyman.ts are. made_ Y O.N Efica I+aok
Qceun-en: Plxnber. MEWZOVI-01
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SHEALY ENVIRONMENTAL SERVICES, INC.
I
5h,nly Envimnrnc@tal Setyjr, tm
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�+ •�j �'-+ �-y �r
SampleRec_ipt C�. e&llst (iSRC) GiS�ri.rDUlaW.'12DIS
Client: SYNA4iTtd Coolerlru.ec[edFt};.'date_tx J 11i13°19 Lo-#: UK13tJ45
i. eatennfreceipt;
L,j 41=5I Client W UFS. [J FedE Qrfaer:—
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1, M1et'd eigstod scats prrWAIL Uzi the CnriYcr?
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] NA 4. It; the Lf"Ie"RI 2011tit! 's pacl.-ing {[ip attached
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yes
to .(his form?
s. VrWe raper a lu hxly pauc0rlllr�w teli,t�nisi_teowcR
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No
6.
"=- sample IDs listed an the —21 _
3s'0s Nsy
7. Were satnpir 1Ds Jisteil sm all sat111l1e cfjntninerg?
Y&S ❑ No
Q Yas O No
S. �'e'als collection slat❑ c' titrn_ss lis[ed rn] the CQC;'?
3'sas
9. '!i'qa cullectlty l elllkc. & tint& listatl Rn all Na vpie wntainers?
❑ No
0 NO
10. Did all container hibel infoymatioa (ID, elate, tirrlc) c faith th, GC?
y"
1.1.IV, rc testa to be pOrtoamerd JiStta3 On the coo?
Ye9 LJ No
12. Did uti saanp1i;s arrive nt the FOP" &on.tairtcts for each test andJor in gawd c s}ncfirisn
(tmlrroken' lists on,
i'es
10331Nn
1?. fah arterltwte satrtpio volutae svaiiabl��?
ire
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1 j, Were all samples reccived witlain ,, the Balding link or 449 hours, ti4hichetrer calancz first?
�i£re
ff
EJ, any S miles contahlerL ntLS&iilzlex x'e (Circlo One) laiilple; Np(. ILsted L311 CO ?
r�--pp
to[ Yes
�yy
t1 No NA 16. For 1rOA and RSK-175 satnppcs, �i't� bubbles prewrit>° peA_,gize, (W'or 6r= in &g11e.(er)
in fany of the VOA vials?
Yes
NO LL
NA l ,'. We rC all D1��,riile1 15Jn1A6mit sarltl)les received Fit s1 pIi of 2?
Yes
Ivn
ETA 13. l�Telr all cyanide NgmpleS rece[s a<l ad a rod 12 $nd suIr �c saai 8cs received :1l u Or � C),
19. 'eta
des
aEl a lira i 1
N.s 0 MA
13
yes NeJ N.4 ?.U. Ware clicatr ramoFksercyacsrs (i.c, mgnested slilutiotts; Tt $? LSD de,iXrtatiol�., fe..-}
earteetly transeril aratrt the CQ into Fltu ceiitm0r t:tio 1 in I .Lh45?
Yea N'o 21.1V, t}10 uule number listed nr1 the coaatainr a label? I[ ya s, t lute NApi Sa .Presex4atlnn (Must be corrtpletctl for attdv seanpl :(s)iatcoaWdY presen-c,l of with headspace.)
Satnple4c) NA_x re roceiti'ed inr otxc ely gr&zi7lSL'dl urd were adjttsla d accsterlinglt'
n,autple r0ceic'ingva'itlt T[4 InL Ofcircle oeuc: Yr-2904, HNO3, IiC;'I,
iNaUNtrsirg 5R-3` [.1A
ilile s71 rsresPa�atioll 1vA If Man thacl. one preservali."c is ner"dedp incase noto ill & con m!&ts b dow,
Sar ple(s) NA -
_xcre ieuGit'ed lvilja 6tltblcs ?6 7nnt in eliflrlerer.
8atnplcs(s} 1'A were mneiv d lwid, TI {.C. --• G,5 mgo'L (if fr19 is no )lend tiverc
acljuytrcd accordiragly in sample ttdueiving with si,eliutn lhicsulfate (N%S,df) with Shealy Ill: NIA
Slt b;uoady labcls zpplied by- I MO —� pate: 11113719
(;rnitenetYl�.
Shealy Environmental Services, Inc.
106 Vantage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www.shealylab.com
Page 10 of 10

Weekly Retail Gasoline and Diesel Prices
(Dollars per Gallon, Including Taxes)
Area: I Lower Atlantic (PADD iC) vj Period: Weekly v
®Dovmtoad Series t'ristory ODetfitions,
Sources & Notes
Show Dam By:
G Product O Area
Gasoline - All Grades_ _
G 3pn
Chr
I Q^ ❑
�.V.
1 2.423
2.451
2.440
2.415
2.430
r
2.461
Vjew
History.
11993-2019
All Grades - Conventional
Areas
*" ❑
2.428
2.457
2.446
2.421
2.436
2.469
-1994-2019
All Grades ='Reformulated_
Areas.
❑
2.353
2.367
2.363
2.349
2.358
2.362
19942019
Regular
9q+ ❑
2.343
2.372
2.362
2.335
2.351
2-383
1993-2019
Conventional Areas
❑
2.349
2.379
2.368
2.341
2.357
2.391
1993-2019
Reformulated Areas .
Frn ❑
2.272
2.2g1
2275
2.260
2270I
2.275
1994-2019
Midgrade
0- ❑
2.691
2.712
2.699I
2.680
2.691
2.722
1994-2019
Conventional Areas
-0- ❑
2.697
2.720
2.706
2.686
2.697
2.731
1994-2019
Reformulated Areas
t- ❑
2.623
2.629
2.624
2.616
2.624
2.627
1994-2019
Premium
❑
2.981
3.004
2.996
2.978
2.982
3.009
1994-2019
Conventional Areas
0- ❑
2.996
3.020
3.010
2.991
2.9961
3.025
1994 2019
Reformulated Areas
4�- ❑
2.836
2.843
2.815
2.846
2.852
Z853
1994-2019
Diesel(On-Highway) - All Types
0- ❑
2.wp
932
t ,1
2.905
2.919
€
2.922
.,
2.921
928
972019
Ultra Low Sulfur (15 ppm and
Under)
0^ ❑
2.932
2.928
20072019
0- Click on the source key icon to leam how to drn-mtoad series into Excel, or to embed a chart or map an yourvrebsite.

Year k I I
City of Newton - Clark Creek WWTP
Sludge Grab Sampling Data
DATE
Sample ID
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2 Hour Sample
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Collection
Analysis
Collection
Analysis
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_
By
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re
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Temp
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Sampling Collect #1 sample for pH when tank is ready for testing. pH is measured in s.u.
Guidelines Collect #1 sample for pH when tank is ready for testing. pH Method - SM4500 H+B-2000 (Aqueous)
Sample must arrive in lab within 15 minutes of collection. pH is corrected to 25°C

City of Newton - Clark Creek WWTP
�f11G Cliirlan rrah Samnlina Bata
`
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22 Hour Sample
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Collection
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DATE
Sample ID
By
Time
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Corrected
PH
Temp
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By
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By
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Time
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Sampling Collect #1 sample for pH when tank is ready for testing. pH is measured in s.u.
Guidelines, Collect #1 sample for PH when tank is ready for testing. pH Method - SM4500 H+B-2000 (Aqueous)
Sample must arrive in lab within 15 minutes of collection. pH is corrected to 25°C

State of North Carolina
Department of Environmental Quality
Division of Water resources
D�ivlsion of Water Resources LAND APPLICATION SITE CERTIFICATION
INSTRUCTIONS FOR FORM: LASC 06-16
Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted the Applicant shall submit one original and two copies of the application and
supporting documentation
For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting Unit
General — This certification provides detailed information of receiving sites for land application of Class B residuals (may include
water treatment plant or other type residuals) in accordance with 15A NCAC 02T .1100. Do not submit this certification for review
without a corresponding application form (FORM: RLAP 06-16 or FORM: SDR 06-16).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Land Application Site Certification (FORM: LASC 06-16):
® Submit the completed and appropriately executed Land Application Site Certification (FORM: LASC 06-16) form. Please
do not make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments
to the application may be made, as long as the attachments are numbered to correspond to the section and item to which they
refer.
® For new or renewed permits, submit the requested information for all land application sites.
® For modified permits, submit the requested information for only those sites that are new, transferred or affected by the
proposed modification.
I. 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 (I) ♦ 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
H
County Board
✓
Notification. doc
Land Owner
✓
✓
✓
Agreement
(If applicable)
vo
✓
✓
✓
✓
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

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

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

LAND ArrLICATION SITE CERTIFICATION
Applicant's name: City of Newton
Land application sites currently certified: 541.1 net acres and Total to be certified: 0 net acres.
I. LAND APPLICATION SITE INFORMATION (See Instruction B):
Status
Code,'
Site/Field
ID
Landowner(s) s
or O s
Lessee() Operator(s)
Net Acres
County
Coun
s)
Crop(s)
p�
Predominant Soil
Series Nameb
Mapping Unit
or Rep. Slope°
D
CA-07-1
Lina Draughan
Jeff Smyre
10.4
Catawba
D
CA-07-2
Lina Draughan
Jeff Smyre
15.1
Catawba
D
CA-07-3
Lina Draughan
Jeff Smyre
8.0
Catawba
D
CA-14-IA
Nelda Lee
Chuck Waters
21.3
Catawbaj
D
CA-14-113
Nelda Lee
Chuck Waters
9.1
Catawba
D
CA-14-IC
Nelda Lee
Chuck Waters
8.2
Catawba
�J
D
CA-14-2A
Nelda Lee
Chuck Waters
27.5
Catawba
D
CA-14-2B
Nelda Lee
Chuck Waters
4.9
Catawba
D
CA-14-3
Nelda Lee
Chuck Waters
34,
Catawba
D
CA-14-4
Nelda Lee
Chuck Waters
[1 8
Catawba
D
CA-17-1
Chuck Waters
Catawba
D
CA-17-2
Jane Be 'lrry
Chuck Waters
4
Catawba
D
CA-17-3
J ne —Berr
Chuck Waters
11 3,
Catawba
D
CA-17-4
kn Be_ a
Chuck Waters
25_5!
Catawba
D
CA-17-5
cane Berry
Chuck Waters
C 0
Catawba
D
CA-17-6
Jane Berry
Chuck Waters
[10.7
Catawba
D
CA-17-7
Jane Berry
Chuck Waters
30.3!
Catawba
D
CA-17-8
Jan BeeJan Bee m
Chuck Waters
21 d'
Catawba
D
CA-17-9
Jane Berr j
Chuck Waters
8 9;
Catawba
D
LT-119-3
Gordy Goins
9 2
Lincoln
D
LT-119-4
Gordy Goo s
L10.7
^incoln
D
CA-18-1
Truce Hunsuck
Gordy Goins
�q
;Catawba
Fescue
loy
FORM: LASC 06-16 Page 1

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LAND Arjt�LICATION SITE CERTIFICATION
R
CA-111-1
City of Newton
Sigmond0
Catawba
Fescue
acolet
R
CA-111-2
C of Newton
Danny Sigmond
43�
Catawba
esctee
,loyd
R
LT-119-1
Rebecca Platy
Gordy-Goms
110^3
incoln
Fe scud
Wadis
R
LT-119-2
Rebecca Plate
Gordy Goins'
Bin
o
Fescue
Llo dd
8 Status Code for land application sites are: s N (New) ♦ R (Renewed) s M (Modified) ♦ T (Transferred) 0 D (Deleted)
b Soil Series Name (i.e. Appling, Cecil, etc.)
° Mapping Unit must be consistent with those used in the County Soil Survey (i.e. for a 2-8% slope Cecil in Anson County the mapping unit is CeB2)
II. WATERBODY AND CLASSIFICATIONS INFORMATION (See Instruction Q:
Site/Field ID
Latitude
Longitude
Location
Datum
Location Method Code
Location Accuracy
Waterbody Subbasin and
Stream Index No.
Current and Class Proposed
(�° ' G"
[]' � J' [j"
NAD 83
ADD
Nearest Second
� ]
D 11' D,
j'
NAD 83
ADD
Nearest Second
L
F° D D,
[j° !—I' F]"
NAD 83
ADD
Nearest Second
E° ❑' 0"
�j° -' D,
NAD 83
ADD
Nearest Second
�-r ° []' I j-7
E-] "
Lj° F ]' [_ "'
NAD 83
ADD
Nearest Second
1
��
FORM: LASC 06-16 Page 3

LAND ArrLICATION SITE CERTIFICATION
�f
° u' D,
D M, Ej"
NAD 83
ADD
Nearest Second
° 11' D,
F �1, El"
NAD 83
ADD
Nearest Second
° 11' D,
IJ° G' G"
NAD 83
ADD
Nearest Second
Note: Please keep the site information (I.) and waterbody information (II.) of the same field on the same page.
FORM: LASC 06-16 Page 4

r
SITE SUMMARY
City of Newton
Newton, NC
Site ID:
NC-CA-111
"�� ��
Owner:
n - City of Newton
Address:
P.O. Box 550
Newton, NC 28658
Phone:
[phone]
Operator:
Wally Saine
Address:
707 Westside Drive
Newton, NC 28658
Phone:
[phone]
Catawba
Estimated RYE -based Predominant Latitude &
Applicable Annual PAN limits Soil Series Longitude
Fields Acres Croo(s) (pounds/acre/vear) (map unit) (D.M.S)
1
3.0
Fescue (hay)
hay 139/pasture 104
Pacolet
35°40'02.4" N
(PaE3)
81°05'59.3" W
Lloyd
35°39'46.7" N
2
4.3
Fescue (hay)
hay 216/pasture 162
(LcB)
81°06'39.7" W
TOTAL 7.3
Notes:
U
Date: 11/21/14

State of North Carolina
Department of Environmental Quality
P-WRDivision of Water Resources15A NCAC 02T.1100 — LAND OWNER AGREEMENT
'Division of Water Resources
FORM: LOA 06-16
Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted, the Applicant shall submit one original and two 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 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
e
fer.
prepare 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.
AGREEMENT FOR THE LAND APPLICATION OF RESIDUALS TO PRIVATELY OWNED LAND
.une undersigned
Applicant's name:
Ale
or is representative hereby permits:
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.
its Agreement shall remain in effect for the length of the Division's permit for the residuals land application program and
...all be renewed each time this permit is renewed.
The undersigned landowner or his representative and the Permittee agree to abide with the following restrictions and
stipulations until such time as written notification, given 30 calendar days in advance, modifies or cancels this Agreement.
FORM: LOA 06-16 Page 1 of 3

I. STIPULATIONS:
1. The landowner or his representative shall not enter into any additional residuals application contracts or agreements with another permitted
entity for the site(s) specified by this Agreement.
2. Should the landowner or his representative lease or otherwise permit the use of the land application site(s) to a third party, the landowner shall
be responsible to ensure that the third party agrees and complies with the terms and conditions of this Agreement.
3. The landowner or his representative shall adhere to the provisions of this Agreement until all of the site restrictions (under Section II) are met.
4. Notification of cancellation of this Agreement shall be immediately forwarded to NCDENR-DWR, Non -Discharge Permitting Unit, 1617
Mail Service Center, Raleigh, NC 27699-1617.
5. The Permittee must request and obtain a permit modification from the Division prior to a transfer of the land application site(s) to a new
landowner. In addition, the current landowner shall give a notice to the new landowner that gives full details of the residuals applied at the
land application site(s).
6. The Permittee has provided the landowner or his representative with information and data concerning the residuals land application program,
including an analysis of constituents of the residuals, residuals application methods, schedules for typical cropping patterns, a description of
the equipment used by the Permittee.
7. The Permittee will provide the landowner or his representative with a copy of the residuals permit prior to commencement of any residuals
land application event and a copy of the results of each soil analysis.
8. If the soil pH of the land application site(s) is not maintained at 6.0 or greater, sufficient amounts of lime shall be applied to achieve a final
soil pH of at least 6.0, unless an agronomist provides information indicating that the pH of the soil, residuals and lime mixture is suitable for
the specified crop.
9. The landowner or his representative and the Permittee will agree on residuals application rates and schedules based on crop patterns, results of
soil samples, and the permitted application limits.
10. The landowner or his representative will provide the Permittee with information regarding the amount and analysis of other sources of
nutrients (e.g., fertilizer, unregulated animal waste, etc.) that have been applied to the land application site(s).
11. The landowner or his representative will inform the Permittee of any revisions or modifications to the intended use and cropping patterns for
the land application site(s) prior to each planting season to enable the Permittee to amend this Agreement and schedule residuals land
application events at appropriate periods.
12. Specific residuals land application area boundaries shall be clearly marked on the land application site(s) by the Permittee, the landowner, or
his representative prior to and during a residuals land application event.
13. The landowner or his representative hereby authorizes the Permittee, local officials, and State officials or their representatives to; enter and
inspect any property, premises, or place on or related to the land application site(s) at any reasonable time for the purpose of determining
compliance with the permit; establish monitoring facilities on or near the land application site(s) as required by the permit; copy any records
that must be kept under the terms and conditions of the permit; take necessary leachate, surface water, groundwater, or soil samples during the
term of, and 12 months after termination of, this Agreement.
H. RESTRICTIONS:
1. Appropriate measures must be taken by the Permittee and/or the landowner or his representative to control public access to the land
application sites) during active use and for the 12-month period following a residuals land application event. Such controls may include the
posting of signs that indicate the activities being conducted at the land application site(s).
2. Animals shall not be grazed on the land application site(s) for a 30-day period following a residuals land application event. Land application
sites that are to be used for grazing shall have fencing that will be used to prevent access during these periods after such residuals land
application events.
3. Food crops, feed crops, and fiber crops shall not be harvested for a 30-day period following a residuals land application event.
4. Food crops with harvested parts. that touch the residuals/soil mixture and are totally above the land surface shall not be harvested for a 14-
month period following a residuals land application event.
5. Food crops with harvested parts below the surface of the land shall not be harvested for a 20-month period following a residuals land
application event when the residuals remain on the land surface for four months or longer prior to incorporation into the soil.
6. Food crops with harvested parts below the surface of the land shall not be harvested for a 38-month period following a residuals land
application event when the residuals remain on the land surface for less than four months prior to incorporation into the soil.
7. Turf grown on land where residuals are applied shall not be harvested for a 12-month period following a residuals land application event.
III. ALTERNATIVES FOR WATER SUPPLY WELLS INSIDE THE COMPLIANCE BOUNDARY: (please check one)
15A NCAC 02L .0107(d) prohibits water supply wells within the compliance boundary. However, 15A NCAC 02T .0105(h) allows the
compliance boundary to be placed closer to the waste disposal area, such that the water supply well is situated outside of the compliance
boundary provided the groundwater standards can be met at the newly -established compliance boundary. Please mark one of the following;
❑ A re -defined compliance boundary is needed for field(s) ID:
(Please include the rationale for the requested re -location of the compliance boundary and attach a map showing the newly proposed
compliance boundary to the application package)
❑ A re -defined compliance boundary is not needed for this site.
W. 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)
'RnTara• T n A nr,-t r, Paize 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: C) 4tj Di' M& -1 hn 6YY e k k4 J 6V
Address: r 0- bo;� 5 5 D
City: kie(n! _ l on State: Zip:
Phone: (�i 'f 25� E-mail address: IT-4,,lee l0
Signature: Date:
NORTH CAROLINA, COUNTY
r
I, the undersigned Notary Public do hereby certify that �� CaL
personally appeared before me this day and acknowledged the due execution of the forgoing instrument.
WITNESS my hand and official seal this the i
day of 20
Signature and seal:
My commission expires:
Lessee's/Operator's Certification:
,t4®'PAR),
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 off
Signature:
FORM: LOA 06-16 Page 3 of 3

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VICINITY MAP
i��,,ito,
��`
a
r;.
q
.
flux
�
R
i
j
GRAPHIC SCALE
1" = 2,500'
2,500' 0 2,500'
i ne 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-CA-111
Fields 1-2

TOPOGRAPHIC MAP
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5 j
Y�
{�31� �•
S
{. _ .Y' b�•� R } aE40. Ili F L d �Y
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' 4
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1" = 660'
660, 0 660'
L
l
TI it, Lr„1 npliance boundary is established either 250 ft from the residuals application area or 50 feet within
i 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-CA-111
Fields 1-2

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f r T3 z . t; ', 1 4, xR i F-'*.
' y` �. +.. s 1� : 'r.S`�• �'' R r [" :. r z c�.r� '�'ai�,.t,� ` � .P't"�� y ��, I�. - 4 I ' i `s r• �. }{ti. :S-. �' �` _'s
yi h• `�. Y ,-. - i rev ; � fi .' 3 • '`^ r i; .'.� i t �F � i'�'iy. � i` -a �5 .p„ c a ..Y J -.
� �, x w -+C ,.: t. ���'�` � `, � ' �" �, �. °;�y P' � 't ,+ • �- .`ram .= � '�-� � f ''t" � ', �S�' �ak�'� ,.
:s,'�t�'k`.�'& •-� 1 t ;1 =. �.�� �.� c'�� �'r} �- ` =a - �' `�• t� at .,.- y -.` i r s ,,,r C�'r(L�,' ,r, �.,w 'b 't -'+:
s 1,;.• t, t i�4 -� +., s �. Y "�''�s`,5 t a i�'� rot �"i c�.� a .1! "��,r +n

CUMULATIVE METAL LOADINGS (LBS/ACRE) AS OF 11/22/2019
The Cumulative metals for this report come from LTD Period Table records (i.e. a Monthly Report has been produced and the loadings have been archived to History
In cases where a trace metal lab result was Not Reported to Synagro or tracking of the metal loading was Not Required the loading on the report is displayed as "NR"
Date
Field ID Last Applied
As Cd Cr Cu Pb jjR Mo Ni So Z
NC-CA-00111-0-0001 02/2004
0.2736 0.1211 3.3066 12.3571 1.4124 0.0305 0.4016 2.9534 0.1851 29.7782
NC-CA-00111-0-0002 10/2003
0.2400 0.1022 2.3122 9.8410 1.0389 0.0236 0.2995 2.6942 0.1528 23.5719
Page; 1 of 1 11/22/2019

Site ID:
NC-CA-16
Owner:
Richard Biggerstaff
Address:
4148 Biggerstaff Road
Maiden, NC 28650
Phone:
[phone]
Operator:
Same
Estimated
Applicable
FiPldrs
Acreq Cron(sl
SITE SUMMARY
City of Newton
Newton, NC
Catawba
RYE -based Predominant Latitude &
Annual PAN limits Soil Series Longitude
(hounds/acre/vear) (map unit) (D.M.S)
Cecil
35°33'41.2" N
1
12.0
Fescue (pasture)
hay 216/pasture 162
(CaB)
81°15'24.9" W
Lloyd
35°33'32.1" N
2
15.0
Fescue (pasture)
hay 216/pasture 162
(LdB2)
81'15'09.3" W
TOTAL
27.0
Notes:
Date: . 11/21/14

State of Forth Carolina
Department of Environmental Quality
Division of Water Resources
-'Dlvlsion of Water Re .. _" sources 15A NCAC 02T .1100 — LAND OWNER AGREEMENT
,
L.
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 later Quality Permitting Section's Non -Discharge Permittin, Unit.
General — This document is an agreement between the Applicant and land owner(s) of residuals receiving sites for land application of
Class B residuals (may include water treatment plant or other type residuals) in accordance with 15A NCAC 02T .1100. Do not
submit this agreement for review without a corresponding application form (FORM: RLAP 06-16).
Unless otherwise noted, the Applicant shall submit one original and two copies ofthe 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. 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
er.
Prepare a separate agreement for each set of land application 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 THE LAND APPLICATION OF RESIDUALS TO PRIVATELY OWNED LAND
undersigned Iando Y
or his representative hereby permits:
Applicant's name: ` Ig
hereinafter referred to as the Permittee, to land apply residuals from the following facility(ies) onto the following land
application site(s) (i.e., see attached setback maps) in accordance with the stipulations and restrictions as given in this
Agreement:
Site/Field ID
Lease
es/no
(Y )
Land Use or
Cropping Patterns
PP g'
Intended Use of Crops
Residuals Source
(optional)
Special note
(no-till/over-seed/
pasture)
C.A-
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.
Agreement shall remain in effect for the length of the Division's permit for the residuals land application program and
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. _ _ If
Lands
Addr(
City:
Phone: 2-22-0 E-mail address:
P.
Signature: oe Date: ?_
NORTH CAROLINA, P, 4,C dr c� COUNTY
I, the undersigned Notary Public do hereby certify that z..
personally appeared before me this day and acknowledged the due execution of the forgoing instrument.
WITNESS my hand and official seal this the ! �� �,���i�l16��21
w� ♦ 1[ bl9 Ii
'I
day of NA , 20 '�' a
Signature and seal:
My commission expires: 0J - t
Lessee's/Operator's Certification: t��ilc®It�'�ti0
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: State: Zip:
Phone: 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 name: C!- o 4j C lo. r i c
Signature:
Date:
la�il1 Ili►�a a Me 01
Page 3 of 3

t 'r`�aToK rrj W'���i�l�n i9
��� ,

APPLICATION MAP
AM
f
i N
lrtt�fi �.4 .. .ZA .� _ r1 f• i
{ a a
6 F,jT-0' • � 'Sx
LEGEND
APPLICATION AREA
UNSUITABLE AREA
— — — — — — PRIVATE ROAD
OW
WATER
— — — — STREAM
ONSITE HOUSE
— DRAIN
®
OFFSITE HOUSE
X X X FENCE
OUTBUILDING
PROPERTY LINE
0
WELL
I ne 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'
1
N C-CA-16
Fields 1-2

VICINITY MAP
'aa
1273
�4
"110��
GRAPHIC SCALE
1"=1,500'
1,500' 0 1,500'
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within N C-CA-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 1-2

,
TOPOGRAPHIC MAP
I
1—_E 1 i 55
� + Pr`i� �° -.L +�I I 1. � � �--I � lit L t L � � • +a}k :ly I L7 �i:VZia I� �
i yr_
,11 11.
T
,
5
r• 5
1 75 0o7 • ../ ` Ir
AV
GRAPHIC SCALE
1 " = 660'
660' 0 660'
I I
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within I V C-CA' 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 .9
locations are approximate. Fields 1-2

SOIL SURVEY
i + M
ae`y'l .- `mot• E _' k �'.`•�r
tea— w c r
S
F �
t��.;e•m � ai_ %. 'ia. �._ `w.' ••. •:'. tier:•
YJ
GRAPHIC SCALE
1" = 660'
660' 0 660'
R�
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.
,r r
N C-CA-16
Fields 1-2

CUMULATIVE METAL LOADINGS (LBS/ACRE) AS. OF 11/22/2019
The Cumulative metals for this report come from LTD period Table records (i.e. a Monthly Report has been produced and the loadings have been archived to History
In cases where a trace metal lab result was Not Reported to Synagro or tracKing of the metal loading was Not Required the loading on the report is displayed as "NW'
Date
Field ID
Last Applied
As Cd Cr Cu Pb Hg Mo Ni Se Zn
NC-CA-00016-0-0001
1112016
0.1205 0.0472 1.2113 6.8279 0.4209 0.0241 0.1604 0.5859 0.1229 23.8108
NC-CA-00016-0-0002
11/2016
0.1424 0.0595 1.4435 8.4794 0.5092 0.0275 0.1945 0.7408 0.1531 30.6880
Page: 1 of 1 11/22/2019

SITE SUMMARY
City of Newton, Clark Creek WWTP
Newton, NC
Site ID: NC-CA-15
Name: Steve Fox
Address: 7286 River Road
Claremont, North Carolina 28610
Phone:
[phone]
Operator:
Ray Isenhour (Farm Manager)
Address:
2072 Friendship Church rd
Taylorsville, North Carolina 28681
Phone:
(828-312-6563) mobile
Estimated
Applicable Predominant Latitude &
Fields Acres Crop(s) Soil Series Longitude
1
13.5
Fescue
Clifford
35.48.44 N
81.09.55 W
2
6.6
Fescue
Rasalo-Zion
35.48.49 N
81.09.53 W
3
11.0
Fescue
Rasalo-Zion
35.48.49 N
81.09.53 W
4
9.6
Fescue
Clifford
35.49.05 N
81.09.53 W
5
1.6
Fescue
Clifford
35.49.09 N
81.09.50 W
6
5.2
Fescue
Clifford
35.49.13 N
81.09.53 W
7
19.5
Fescue
Clifford
35.49.03 N
81.09.42 W
9
1.1
Fescue
Clifford
35.49.00 N
81.09.32 W
10
22.1
Fescue, Corn, Wheat
Clifford
35.48.56
81.09.29
11 1
6.7
Fescue
Clifford
35.48.55
TOTALS 96.9
Notes: coordinate all activity with ray Isenhour
Date:
12/1/19

State of North Carolina
Department of Environmental Quality
} Division of Water Resources
'✓ ��`` ` '- '` 15A NCAC 02T .1100 - LAND OWNER AGREEMENT
Dlvislon .of Water Resources
FORM: LOA 06-16
Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted, the Applicant shall submit one original and two 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. Luno 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
fer.
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
i i►e undersigned lando)Xner pr 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)
,vL-C,A- IS
`�e5Y
Qoder
e.
The landowner or his representative receives, in consideration, full use of the nutrient value of the applied residuals while the
Permittee receives, in consideration, the use of the land application site(s) described above for the disposal of the residuals.
its Agreement shall remain in effect for the length of the Division's permit for the residuals land application program and
__all be renewed each time this permit is renewed.
The undersigned landowner or his representative and the Permittee agree to abide with the following restrictions and
stipulations until such time as written notification, given 30 calendar days in advance, modifies or cancels this Agreement.
FORM: LOA 06-16 Page 1 of 3

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

Landowner's Certification:
I certify that I am a deeded landowner of the above -referenced land application site(s) and am authorized to make decisions
d� 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: ��� �'/ (.► {r'o�C `�12r�S�` ��fiI►i�)C Tl�(QS�
Address: 72 L (1 e j� 13 arc C! G�. --
City: 4!!�"ZAAe 20017` State: /�C �- zip: 2e6 O
Phone: C� g 3� t �'i9'1 5 E-mail address: -^
Signature: Date: -$2pr Zs
NORTH CAROLINA,t ft V L., COUNTY
I, the undersigned Notary Public do hereby certify that LOA 1eq C,. 5 X Tr,A
personally appeared before me this day and acknowledged the due execution of the forgoing instrument.
WITNESS my hand and official seal this the
I f p /
day of &Q -M�n ���- , 20�"L _ A�`M�*r,�i,,
Signature and seal:
My commission expires: ocj �' Zr Z 2a 2" 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 herein.
Lessee/operator name:
Address: 1? 4
C AAe i
City: A k'�D�f' State: C Zip: 2�0��
Phone ��O ��/� ���� E-mail address:�,p,
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 �4e:. 104 oc r k ,
Signature:
Date:
FORM: LOA 06-16 Page 3 of 3

APPLICATION MAP
y _ Y i
i T
i at r '1�s F Fy
yY "i t ✓'�[P'$Y2 �'d he �� �X �t t
13,
a�'�k"
i ay�a•. fi _� 4f e,
@
'77-
�4��fa�.y
i �- �.'d es, { l � R� :r R � � t ♦ � �R � �. } { y Sad �y, �F i#y�'�A !'{ {t .k ".r
dot
t' yy 1.; i f ': ! .: k R3-A'RRR��� 1-C •tt. K S, µq i. :,4 iqA S 1'�' �"b"S yyyu ifY '4ybR Y .WIP
M�rekIWrti�Yf�n.
i` K �'
'j0 g...
ems' a.
,� � "�. ;x _. s ^ ' =_: ! C � � s # S t ,�.'4tix ��tS �• t 4''�r.&'�',�,!"' f<•..
,,�yr 9. _ � .�-�j,M• ! �. sr� ^c ;: ' �7 ��� SttY ! : A"};.�ir s, R�.� 7 z��„ z -
� ��,.
i�..,
4tFi'°
14 i
rz®
Xj
-17
'!
4V,
Ejo zTv
�
T
LEGEND
APPLICATION AREA UNSUITABLE AREA
- — — — — - PRIVATE ROAD O WATER GRAPHIC SCALE
— - - — STREAM ONSITE HOUSE 1"=660'
660' 0 660'
- DRAIN OFFSITE HOUSE I '
I
—;�- FENCE ❑ OUTBUILDING
PROPERTY LINE 0 WELL
i tie compliance boundary is established either 250 ft from the residuals application area or 50 feet within
N C-CA-15
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- /-7
,9-1 1

VICINITY MAP
'
pp�
-` rl�1760
i { �
r4K3;,
1
i
iyerlbe�t�r�sk
17 ri�
� TomIlk
.r�23
�a.
# VI
GRAPHIC SCALE
1" = 2,500'
2,500' 0 2,500'
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-CA-15
Field 1-7,9-11

r.�
'
v
5
i
,
TOPOGRAPHIC MAP
-
77
f
i
9
S`
O
GRAPHIC SCALE
1" = 800'
800' 0 800,
I I
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within N C-CA-15
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 1-7,9-11

Z ,x '4 n.y � `� ��"1 �iwe-7���y *„v ,34��y-•2 , ''f., �s 76 �w`� _ 'a'+.,g.�" T „c
Lill i
if
t"t^`.'.-` x ���,}� �`-r.-'�� ".•.R -` � 't � .•�S.6r ,'�t��'�.''�-. ��'1f�Sf',�i��. y 4 •�i...n+'�'}.
9 W.RF i _ ttt fia3 "• '.&xiai'� ,� •.,r,+� 5 )�':, ¢� ; ,..r :-i ,
J` l ~'�' x }�*�r'�`-r t w$ �'�� '.a;�.,r' F:. ; r { s ,,� �� 'p „¢� � ' 1 +><• 8'�,>�, t, 'i
i•�e�..�-�•:"� ;• � - '�s�'��'p r`.4f � ; r'� `pyPr � to �e .,i f a .,t6. f"f� • i !
� �z y �
r � 4• ♦ +Y t fy + .µa� t�'ls7'4HC7 p. e„� • •'l .. �i,C ' f {
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�� " � �� "�9/•i�t' �i(; 4 ;9� i
t 4 �p�!'� � -: Y c 4 N ay` � ,•. j � �.,•`r�,'�} °,'•y',+ '. �' yji'. � v��
'�� � ruj�i':•.A *'"�•'�y�"`# Y'. �ry��y��y��j�J���a�ir�;9R t j`vcr+ ,� 'r '�' 'ic, � ',"`��t` ' � /� rY+� y�
} 4 's.-O.TC ,} �} D 9aB9'aleD `4• Q s d Y'"4Y'. a o a\3.�V,Jq •.1�v n, '�a t' 'yy2
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X�4 J_ __ , .1 �i� 94��. '�>, e•q'�� �`y�`n 1JY�,�v. 'fel1�"�14,�r;� fy44 �+r�' ..;.{�
'�µ'. rsf�,, t "&fr'r s ���g' ! � ; v _`�,+ �l➢txau�r � v �• ,ti,��,..�x1}'�t" �,-ne 1 ���. * �.,.Ka ��'�,- i �; �':,,
t ll�.Tf��r. �s12}�'ai vp t^s� y�a,•�''E ~ �.y��" � i!� F, y ` -;, +ram "qJ 1

CUMULATIVE METAL LOADINGS (LBSCACRE) AS OF 11122/2019
The Cumulative metals for this report come from LTD Period Table records (i.e. a Monthly Report has been produced and the loadings have been archived to History
In cases where a trace metal lab result was Not Reported to Synagro or tracking of the metal loading was Not Required the loading on the report is displayed as "NW'
Date
Field ID
Last Applied
As
Cd
Cr
Cu
Pb
Hg
Mo
Ni
Se
Zn
NC-CA-00015-0-0001
07/2018
0,121 B
0.0425
0.7332
3.1820
0.2566
0.0103
0.1005
1.3270
0.0991
16.2337
NC-CA-00015-0-0002
07/2018
0.0624
0.0260
0.6036
2.7396
0.2487
0.0084
0.0651
0.4357
0.0818
18.6616
NC-CA-00015-0-0003
07/2018
0.1621
0.0439
0.9397
4.4062
0.3901
0.0126
0.1226
0,7781
0,1309
25,8519
NC-CA-00015-0-0004
07/2018
0.0877
0.0361
0.5761
3.4300
0.3747
0.0040
0.0615
0.5179
0.1527
15.4295
NC-CA-00015-0-0005
10/2005
0.0181
0.0154
0.4826
1.5403
0.2259
0.0043
0.0821
0,2259
0.0165
3.6043
NC-CA-00015-0-0006
10/2005
0.1549
0.0552
0.8995
3.0690
0.3451
0.0093
0.1344
3.4108
0.0792
6.9530
NC-CA-00015-0-0007
01/2015
0.0732
0.0125
0.1926 '
0.9574
0.0691
0.0024
0.0428
0.2143
0.0280
2.3006
NC-CA-00015-0-0008
10/2005
0.0780
0.0324
0.6493
2.1600
0.2703
0.0063
0.1022
1.6272
0.0436
4.9534
NC-CA-00015-0-0009
0712003
0.0507
0.0085
0.1289
0.6447
0,0464
0.0016
0.0292
0.1461
0.0189
1.4615
NC-CA-00015-0-0010
0712003
0.0907
0.0152
0.2307
1.1638
0.0830
0.0029
0.0523
0.2615
0.0338
2.6153
NC-CA-00015-0-0011
1012005
0.0598
0.0388
0.6210
3.1144
0.3773
0.0036
0.0956
0.4350
0.1260
6.9533
Page: 1 of 1 11/22/2019

SITE SUMMARY
City of Newton
Newton, NC
Site ID: NC-CA-32
Owner: Ronnie Sigmon
Address: 456 Dover Street
Claremont, NC 28610
Phone: [phone]
Operator: Same
Catawba
Estimated RYE -based
Applicable Annual PAN limits
Fields Acres Croh(s) (hounds/acre/vearl
Predominant Latitude &
Soil Series Longitude
/man iinitl /n RA C1
1
12.2
Fescue (hay)
hay 237/pasture 177
Appling
35'40'02.4"' N
(AsB)
81'05'59.3" W
2
7.4
Fescue (pasture)
hay 237/pasture 177
Appling
35'39'46.7" N
(AsB)
81°06'39.7" W
TOTAL
19.6
Notes:
Date: 11/21/14

State of North Carolina
Department of Environmental Quality
D____
Division of Water Resources
`®ivIsion 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):
Submit the completed and appropriately executed Land Application Site Certification (FORM: LASC 06-16) form. Please
do not make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments
to the application may be made, as long as the attachments are numbered to correspond to the section and item to which they
refer.
Prepare a separate agreement for each set of land application sites that are owned or operated by an entity other than the
[�plicant.
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
iue undersigned land nerpr his representative hereb ermits:
Applicant's name: Ly' ,� ®�" 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
(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 Iand application site(s) described above for the disposal of the residuals.
is Agreement shall remain in effect for the length of the Division's permit for the residuals land application program and
---ill be renewed each time this permit is renewed.
The undersigned landowner or his representative and the Permittee agree to abide with the following restrictions and
stipulations until such time as written notification, given 30 calendar days in advance, modifies or cancels this Agreement.
FORM: LOA 06-16 Page 1 of 3

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

Landowner's Certification:
I certify that I am a deeded landowner of the above -referenced land application site(s) and am authorized to make decisions
regarding the use of the land application site(s) on behalf of other deeded landowners OR that I am otherwise authorized, through
a power of attorney or other legal delegation, to make decisions regarding the use of the land application site(s) on behalf of the
deeded landowners. I certify that the above -referenced land application site(s) are not included in any waste disposal contract or
agreement with another municipality, contractor, or other permitted entity. Furthermore, I certify that I have read this Agreement,
understand the stipulations, restrictions, alternatives for water supply wells inside the compliance boundary, acknowledgement of
field transfer, and do hereby grant permission to the Permittee to land apply residuals to the land application site(s) as specified
herein.
Landowner name:
Address: 4(Ca ( bo�'•Lpr
City: \ Vi re- r 693 State: A) C Zip: c 1 L
Phone: 4 _ 91( E-mail address: rjl i !� y-no n @ em bcaylogl j
Signature: W a= Date: z)"�� f
NORTH CAROLINA, ,� C2��Ck COUNTY
I, the undersigned Notary Public do hereby certify that
personally appeared before me this day and acknowledged the due execution of the forgoing instrument.
WITNESS my hand andf0icial eal this the sNNW
g
II p
day of k5tu3'i , 20 t "� .A,
Signature and seal: W
My commission expires: Dcl Z. Z
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 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 nq;Re: ® L _ 1 J9_ fc
FORM: LOA 06-16 Page 3 of 3

eoltittlfetto
Q
1

Ve!
■rt :Yy:Y2'„,y,V }.. R' .. - 1 �, t '4s f'
T71W,
:� � �, ' ;� jj� Vic* �L4,F �+'v� ' :_.T • 1' rr 1 � ,� �, - s"S'1 '�� "�' r
•1' `� - c f, : �/4� 9�. ,.�� \iIf �> r� 11 7. � � ttr., v _ ;'7" 4 � � ■ t �, '
Yid ? 1 1 !\ !E*r+► a s 4c+��,r. •`�
AIV
4�
to
�Y'_: •� . ;,r u1 'flw:_t sx•P .2 tli:�+! _

VICINITY MAP
GRAPHIC SCALE
1" = 2,000'
2,000' 0 2,000'
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within N C-CA-32
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
z
A
i;F
-' 1W
N
I'M
t Y Q5
k 7. ul
U1 V
It
A
DWI . ....
NJ
4
-4 Id ft 4IF4 2 5�11 S.
GRAPHIC SCALE
Ill = 800'
800' 0 800,
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within NC-CA-32
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
`ral+'�rL � � a, is a 4• w,t t �1 c t` f f _x _ _ �c,r! '_ �J`J' �r �� �t i � r `"# �}"�' *tt� s{� t e€ �` ��
`i +� � t'i. ` -: tY'. r, !r �'�4` �fit1R?i . 2 � ' `,� � " ��3. r..li • J � � 4 t i `� +'21��Jc �.l.� t�t:
-
.3
N ,
t',,r
�.C�*xr t - }€17�i �� Ii.�1. h v��a �, i ���3 4 ' l4r 4l t e � •;
`'i." .4 r� .44 tr t%'� , M irr.r-r ® �'3, a{ �pr�!•"' p �;Y j x.,cr '.4 .s �.
° [ �� 'r kc
3R
4 j• � R71
71E�I�
_. _:4y,rhic;.✓ ie'i:''�•+d) t.t, sC 41•
�1 � .,� T.�1 1 titL�fi ♦�s6 ,, 'K t
�r..ti�y,ddd,�,ut ,1({� 1 { �.}�!'S�'C'.�®��®7'`x�}��;� S�C� r _
9 r,, �`�i,'�7a <s f 1 ee`9.. ,�,�< � e. n e ♦ _e��,q.; �,r"� � , . � •�h i,�}p�I
.. z •'L�>♦ f5�ir. 'H t'i{�i .'.'i, r':'�'"u�L' �ssac' c:. 111e'1, �' '�.. ) T ,tCr
I •� t
r.
a V
` � Y
y i�.'fiti ,.i�-t��`*�s` ••44 mL' ; f ',,�X �^-" r - rayy
i r { .h t.Y k. _,x f,. `t rr W:9 'rf ,,,r g;•.
i ` , a��s , ilk �e$fatJ `{ a♦ in •,
}4
r;'.
a 'F, fir.' �''9 � _` ; `!$•l f . .�� ar, •. t � ' g 5.ii 3 wr�lis,� �^�� � • ;
AI
F„'� .; �r• ji'b '���`,fi � �i., t; tiY.`i. f'j.,� ~ 7 � �f 'ref•• ', r O( :k
�'�t a. r' x�Ra �`� `
,i 1� ,t (`
+A�
oa �'� •' -:.�- �3 1 �� } Y I I �� Yti g', €,€ ; �x p, r. 4 k� ^yir{ ` '�? �.�:
�1" saw 1�� - - - - t3�s� �.AFP .xi.�1-4 y'' T • :�� „ti r:.. f�l.^i�
LEGEND
APPLICATION AREA
UNSUITABLE AREA
— — — — — — PRIVATE ROAD
OW
WATER
— — — — STREAM
®
ONSITE HOUSE
— DRAIN
.
OFFSITE HOUSE
-X—X— FENCE
OUTBUILDING
PROPERTY LINE
WELL
me 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'
r
N C-CA-32
Field 2

++.. � � ,� 8 rl e ` s ••. r ( M Y. ���� '�`, � •`�i c �.:.� �"���•—__ - +` �•: � rjJ rk
• � "4 ��'`p=~^�� 1r '1.:4 �� i if x 1i+�.y ..t sr"� ,�_`�� _-�I,L� `„D
k;;�' f 'f„�
21U,
FF+i
¢,� 4. rs ` tix .. �� ' � �l-y`� �� i •iA` p F t�'ly..p('•' �[1I� � � �y{�J�-Y' f � `� �F9 Y Q�{yFt ^si
� ,�,;� r�1p, �u �= � �"� ter, 1° �,z r ., � � �' • � S .1'. � �r,'� � x ``��� ��yC:
`'p � � i 9`+ ^ r+y},�i _ mot. ,�e`��y=•` � �,���.,� pp;� ^f'`
� a-„�""'i '-ram j . ,✓"' a�h�"F-�' ,,''�jl�,\..Y' ✓ , �Y � �` �44 _ ��.ti3 : fit. �U��fi
rs , � � ��,� ��� .+. �Y�-. '- •.`.�,� i�9�Yk� �9g�:- #+iM#lDas&.

CUMULATIVE METAL LOADINGS (LBS/ACRE) AS OF 14122/2019
The Cumulative metals for this report come from LTD Period Table records (i.e. a Monthly Report has been produced and the loadings have been archived to History
In cases where a trace metal lab result was Not Reported to Synagro or tracking of the metal loading was Hot Required the loading on the report is displayed as "MR'
Date
Field ID Last Applied
As Cd Cr Cu Pb BR Mo Ni Se Zn
NC-CA-00032-0-0001 0312018
0.0744 0.0466 0.9947 5.3028 0.3719 0.0054 0.1040 0.5317 0.1556 18.8737
NC-CA-00032-0-0002 03/2018
0.0403 0.0264 0.8406 4.0420 0.2094 0.0053 0.0787 0.3364 0.0705 17.0703
Page: 1 of 1 11/22/2019

State of forth Carolina
Department of Environmental Quality
Division of 'Water Resources
Division of Water Resources
15A NCAC 02T .1100 — LAND OWNER AGREEMENT
FORM: LOA 06-16
Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted, the Applicant shall submit one original and two 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 wner 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
re er.
Prepare a separate agreement for each set of land application sites that are owned or operated by an entity other than the
cant.
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
.t ue undersigned land caner , his representative her ' by 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.
epis Agreement shall remain in effect for the length of the Division's permit for the residuals land application program and
-__all be renewed each time this permit is renewed.
The undersigned landowner or his representative and the Permittee agree to abide with the following restrictions and
stipulations until such time as written notification, given 30 calendar days in advance, modifies or cancels this Agreement.
FORM: LOA 06-16 Page 1 of 3

I. STIPULATIONS:
1. The landowner or his representative shall not enter into any additional residuals application contracts or agreements with another permitted
entity for the site(s) specified by this Agreement.
2. Should the landowner or his representative lease or otherwise permit the use of the land application site(s) to a third parry, 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, 1617
Mail Service Center, Raleigh, NC 27699-1617.
5. The Permittee must request and obtain a permit modification from the Division prior to a transfer of the land application site(s) to a new
landowner. In addition, the current landowner shall give a notice to the new landowner that gives full details of the residuals applied at the
land application site(s).
6. The Permittee has provided the landowner or his representative with information and data concerning the residuals land application program,
including an analysis of constituents of the residuals, residuals application methods, schedules for typical cropping patterns, a description of
the equipment used by the Permittee.
7. The Permittee will provide the landowner or his representative with a copy of the residuals permit prior to commencement of any residuals
land application event and a copy of the results of each soil analysis.
8. If the soil pH of the land application site(s) is not maintained at 6.0 or greater, sufficient amounts of lime shall be applied to achieve a final
soil pH of at least 6.0, unless an agronomist provides information indicating that the pH of the soil, residuals and lime mixture is suitable for
the specified crop.
9. The landowner or his representative and the Permittee will agree on residuals application rates and schedules based on crop patterns, results of
soil samples, and the permitted application limits.
10. The landowner or his representative will provide the Permittee with information regarding the amount and analysis of other sources of
nutrients (e.g., fertilizer, unregulated animal waste, etc.) that have been applied to the land application site(s).
11. The landowner or his representative will inform the Permittee of any revisions or modifications to the intended use and cropping patterns for
the land application site(s) prior to each planting season to enable the Permittee to amend this Agreement and schedule residuals land
application events at appropriate periods.
12. Specific residuals land application area boundaries shall be clearly marked on the land application site(s) by the Permittee, the landowner, or
his representative prior to and during a residuals land application event.
13. The landowner or his representative hereby authorizes the Permittee, local officials, and State officials or their representatives to; enter and
inspect any property, premises, or place on or related to the land application site(s) at any reasonable time for the purpose of determining
compliance mith the permit; establish monitoring facilities on or near the land application site(s) as required by the permit; copy any records
that must be kept under the terms and conditions of the permit; take necessary leachate, surface water, groundwater, or soil samples during the
term of, and 12 months after termination of, this Agreement.
H. RESTRICTIONS:
1. Appropriate measures must be taken by the Permittee and/or the landowner or his representative to control public access to the land
application site(s) during active use and for the 12-month period following a residuals land application event. Such controls may include the
posting of signs that indicate the activities being conducted at the land application site(s).
2. Animals shall not be grazed on the land application site(s) for a 30-day period following a residuals land application event. Land application
sites that are to be used for grazing shall have fencing that will be used to prevent access during these periods after such residuals land
application events.
3. Food crops, feed crops, and fiber crops shall not be harvested for a 30-day period following a residuals land application event.
4. Food crops with harvested parts, that touch the residuals/soil mixture and are totally above the land surface shall not be harvested for a 14-
month period following a residuals land application event.
5. Food crops with harvested parts below the surface of the land shall not be harvested for a 20-month period following a residuals land
application event when the residuals remain on the land. surface for, four months or longer prior to incorporation into the soil.
6. Food crops with harvested parts below the surface of the land shall not be harvested for a 38-month period following a residuals land
application event when the residuals remain on the land surface for less than four months prior to incorporation into the soil.
7. Turf grown on land where residuals are applied shall not be harvested for a 12-month period following a residuals land application event.
IMALTERNATIVES FOR WATER SUPPLY WELLS INSIDE THE COMPLIANCE BOUNDARY: (please check one)
15A NCAC 02L .0107(d) prohibits water supply wells within the compliance boundary. However, 15A NCAC 02T .0105(h) allows the
compliance boundary to be placed closer to the waste disposal area, such that the water supply well is situated outside of the compliance
boundary provided the groundwater standards can be met at the newly -established compliance boundary. Please mark one of the following;
❑ A re -defined compliance boundary is needed for field(s) ID:
(Please include the rationale for the requested re -location of the compliance
compliance boundary to the application package)
❑ A re -defined compliance boundary is not needed for this site.
IV. ACKNOWLEDGEMENT OF FIELD TRANSFER: (if needed)
boundary and attach a map showing the newly proposed
❑ The land application field(s) ID: _, is currently permitted under another
residuals land application program; Permit Number WQ: The land owner hereby acknowledge that by signing this
agreement, he/she is requesting that the field(s) be removed from the previously permitted residuals land application program and transferred
into the new program;
(Name of the new program)
,.,-VDA r. r n n n,_� , K 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: �i't�/9/I EGG / y/Jiyii�i �t� eo / /l/Jg ® C o KI 5,71eV411 C
Address: k4U 1-3 a x
City: At hied A y State:
/VC
Zip:
Phone: �� Q " �� V E-mail address:
Signature: Date:
NORTH CAROLINA, Cd� COUNTY
I, the undersigned Notary Public do hereby certify that W,. �'• �� Jf'�
personally appeared before me this day and acknowledged the due execution of the forgoing instrument.
WITNESS my hand and official seal this the 2 1;
day of
Signature and seal:
My commission expires:
Lessee's/Operator's Certification:
aV a
UNTI
I certify that I have read this Agreement and
do
here/by agree to abide by the stipulations and restrictions as specified herein.
Lessee/operator name:
Address: _ ' 7W 4-7 ske, 4WA Q�
City: ✓Ae,o&n State: Zip: 7 Ov" 6o
Phone: — —7 2T '" ` 2cl( E-mail address:
Signature: J✓t. 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 off
Signature:
FORM: LOA 06-16 Page 3 of 3

SITE SUMMARY
City of Newton, Clark Creek WWTP
Newton, NC
Site ID: NC-CA-20
Name:
Harold Sherrill
Address:
5080 16th St. NE
Hickory, North Carolina 28601
Phone:
[phone]
Operator:
Tim Woodriff (Farm Manager)
Address:
4697 Startown Road
Newton, North Carolina 28658
Phone:
(980-722-4283) mobile
Estimated
Total Applicable
Fields Acres Acres Crop(s)
Predominant Latitude &
Soil Series Longitude
3
57.3
41.7
Fescue
Lloyd
35.35.54 N
81.15.47 W
4
25.2
24.5
Fescue
Lloyd
35.36.08 N
81.15.41 W
5
48.0
43.3
Fescue
Lloyd
35.36.11 N
81.15.58 W
6
17.2
12.5
Fescue
Lloyd
35.36.07 N
81.16.08 W
7
57.0
47.3
Fescue
Lloyd
35.37.55 N
81.15.35 W
8
28.5
22.0
Fescue
Lloyd
35.37.11 N
81.15.27 W
9
55.4
47.5
Fescue
Lloyd
35.37.04 N
81.15.55 W
10
48.0
36.0
Fescue
Lloyd
35.37.00 N
81.16.07 W
11
32.5
23.2
Fescue
Lloyd
35.36.43 N
81.16.17 W
N
W
TOTALS 369.1 298.0
Notes: coordinate all activitv with Tim Woodriff .
Date: 11 /17/19

no
D'
i�
VICINITY MAP
GRAPHIC SCALE
I" = 4,000'
4,000' 0 4,000'
1.
Tne compliance boundary is established either 250 ft from the residuals application area or 50 feet within N C-CA-20
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 3-1 q 1

TOPOGRAPHIC MAP
�Ft
"
L i.,\ 1�•
� i�
- - l
4
�
:a�
.` rye`,^••,h._
,.
. .- ..
.. .
-
`13'xxi '.�vd-.tl`
ImmIjj ■ S
_
S 'LDS
YV
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-CA-20
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 3-6

r7 `
h
1
'
..1
t.
L
•� e
'I
Az
t�
•
i
i x ;L;
IEL
4
�� • �'
j
t �
3 1
,
tt
ti
rx
1._
r
GRAPHIC
GRAPHIC SCALE
1" e 800'
soo, o 8e0,
fhe compliance boundary is established either 250 ft from the residuals application area or 50 feet within N C-CA-20
i 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 7`8

TOPOGRAPHIC MAP
St 1� < It
rae •r r r F5T L'Clr`a'j i ; —yy4 eTs �LFlL57 .. ♦ '�. .. l
�,t
71
zi-
�� ,fi.,, �1 }r f ��, � Yi 1 � r �'. � i �.• � .fir . •.
,6 .� �i 1 ` � - s a .�. 4 4Jtt�'' tr ;! � . }•t x Ca 4 - ( 1 1- *3. E
i 1 �yJ t j r ,Y •t.. a,
k �+ E§.t r it iI �tr ��r`;*,'... ' .Y,.iUt3,t•� .. — r - it. lCfit_��trt�h�� j ,,;.-1
t t � ii�'+ti ty 't. _ � ;� ,p�,-,� fp fr{ J�: — rt'�f � '.�%a,� '�•�`•. � j �(i
��� y. to � a` i — , r- ^`-� �•a ' ) �i
9
} • ,
tf
i 1 J •-"�
14t s ts.;m if k e ['r1 t tt '`I .. IS \ I \ ! t:l l �1•; H„aF t r • L 1T ,Sit 1r k�: r �`',
�(1. f� t�j� �ftu� __ � .l"5 � f� � `+d > r J'- 'Ct YJ •,l�F � 4i.�_- ` -.��.% .
jt li. � }� . 1 � 1.. f � .. •ca �"��� I
'' �s�` � F#�JCy � } 1 j 4 �1r� a6 + i f �1 , i S �_•�c�\ ?1
-VA _u
��
.�'�>i I t a'' �r" —a7u'�.f r Y . .. r ;`•t, ..+rkt kr _ r
444 i I a rr
i'W
� 7
GRAPHIC SCALE
1" = 800'
aoa` 0 saor
I
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within N C-CA-20
i 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 9-11

7rF, A V pp p i 9 p p p p ♦ • ♦ p ♦ p V ♦ ♦ Y ♦ ♦ V,o,F� k.
v
ev v q ► �'
/ys wp ® ♦ d p v v e s
q ♦ a
♦ i ,p
►.lsa a ♦ � • a
•v
e q A a
ap
• � d �a q
A �♦ 1
♦ A♦ ► - ... v P III �
dq ► � q
� a `
1 i
`®Ab d. P P p ��,♦ P','f'��.ya��D A A. a �y�/! :, ��x—=z"'� �M1��P+�
s
1i
LEGEND
APPLICATION AREA
UNSUITABLE AREA
— — — — — — PRIVATE ROAD
`' V�
WATER
— — — — STREAM
ONSITE HOUSE
— DRAIN
®
OFFSITE HOUSE
X —XX FENCE
OUTBUILDING
PROPERTY LINE
WELL
Tfie compliance boundary is established either 250 ft from the residuals application area or 50 feet within
n 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'
660' 0 660'
NC-CA-20
Fields 3-6

APPLICATION MAP
{ rti , i!"�4art`"�lf� '` s+ � � ' * {<d�s�a '" �e•�5r.^' °aL�- c 4�.�, a c „t
F /
tt�i
�! z � '^'° h� � t k � r�i7 ApY � ; ;t � t h. t yh ttt' a t S�e `�t w�if��1t•}�,�r�+ i.,
. ;>�, r<rec,tr�pd ;a ���r � yyi. � '. _ , e ti � i , : �, '� t � •` r���s s4i � r vr� - $ � n���*`s
;�t� ii i " �,'j' d, !r � yL,,�Uf � j [°= 4 +E� � 1 � ' :, � 4. � , S .pLn�'�y� ��•a
Nti
, l fir: 5. YL yr..., t �, ' '� ' r, a ?s. 7'. =` y�,ery y�>•-h 8
4
.� � `t F c a { Y,r l�x Jos ,. � { y�e , -� ,�-. '�1•
v ,
��•.s -, � �° ����� ° t r � •. ,. `� � j'e�s h� �. � �.e _ 3r'�t .0 �'a:e c! r� � �' +, u� �.
r' 4 " t� `�' `4* i r.,?�'r t r-C-'Tr, �r� � �`xct rt [ 4, x•a',9ti"'�� .e [ 2 sx�f t ♦ L t<
Sit
s �.� hc4 •, r � ���t �Et i.•, S+ t . E� x,F� ,�qc
ac 1! *�!.OF `ti 7 �psr,n35{l .a, �6� i �,lG�y.}�F��� f'6�L'i�•�°,�Si
h. -.d' N� + t a S 's �'• +� L pp •L• !r L'i Gt 'ao `e
$a��tjtw�"
r
��
?^ s � ` � u � 1iys�ti a l�t�'•E�Ctat tir 4 �Y+�� '� r r M
'4 s
f, ti �.
-,\�.� i•,i. `" Vy 4••� iN •1� 0 3` ! f a
'eye1 %.. 1 �c >„1 °' .\ 5 lax 1...•i±'"'..°t''"te°r
��4kM�!
SerAl'y" �. a.°"x
r ' �
•�-#yiic',�Ct
,. rirt���j�4+,`t}�l
yyel�t Z
)'Ei��4e`
Y` --- k r r t -J � � • ,� � � {, . `t P� � � -k t b`C i � .�i' g � �l E ,} ,�C � :�.,T r tq (elf
yOaSn a iech�i i t, 'kJ 04S
1
` F. li� Y{ .�t ,yu �` e» ® •' ~ b^Js.'#i . i �t¢',r $cF.44y, vi.r
4 V
l c
Ptx ° m.h S ti Si�R:l
LEGEND
n n APPLICATION AREA
UNSUITABLE AREA
— — — — — — PRIVATE ROAD
®
WATER
— — — — STREAM
®
ONSITE HOUSE
— DRAIN
®
OFFSITE HOUSE
X X X FENCE
OUTBUILDING
PROPERTY LINE
0
WELL
Thu 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-CA-20
Fields 7-8

t�.
APPLICATION MAP
MOWi. {v, �,d t t •g "'.t ate%
` Y4� [� �4rt T• t `
1 - ! �t ,�' I.j.. Ti_ try.� `L t'.a r,�°'" � �� °.;o. 1:, n r ::. . t ♦ r>•i.. ci ,� '�•�,
.� 1 r r i + • ;� aj .qi'` T`pLj gel .t ' . ;bp s� F. w r. >Y t x F �tlf`.fk+
1.J' ,-(' _ -a. '�� � ��i.7 On a ` �, ��'2�° �•s - `"_i>' ,.,. e;. .._ .- i. ...`as.•
LEGEND
APPLICATION AREA
UNSUITABLE AREA
— —�— — — PRIVATE ROAD
CD
WATER
— — — — STREAM.
®
ONSITE HOUSE
— DRAIN
®
OFFSITE HOUSE
X X X FENCE
OUTBUILDING
PROPERTY LINE
WELL
Tne 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'
r r i
NC-CA-20
Fields 9-1 0

LEGEND
APPLICATION AREA
PRIVATE ROAD
STREAM
DRAIN
FENCE
PROPERTY LINE
APPLICATION MAP
UNSUITABLE AREA
WATER
ONSITE HOUSE
OFFSITE HOUSE
OUTBUILDING
WELL
Tne compliance boundary is established either 250 ft from the residuals application area or 50 feet within
i 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'
�11
N C-CA-20
Field 11

A
WtYO�"
H,
il A,
Z '4111.1"N'Ir�71N"� 11,
RAWN
Wtiv
NO,S.

SOIL SURVEY
40`1
GRAPHIC SCALE
III =660'
660' 0 660'
a
I he compliance boundary is established either 250 ft from the residuals application area or 50 feet within N C_CA_2®
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 pp
locations are approximate. Fields 7-8

"Rar
NO
IL
7TA-
17

CUMULATIVE METAL LOADINGS (LBSIACRE) AS OF 11/22/2019
The Cumulative metals for this report come from LTD Period Table records (i.e. a Monthly Report has been produced and the loadings have been archived to History
In cases where a trace metal lab result was Not Reported to Synagro or tracking of the metal loading was Not Required the loading on the report is displayed as "NR"
Date
Field ID
Last Applied
As
Cd
Cr
Cu
Pb
Flg,
Mo
NC-CA-00020-0-0001
01/2016
0.0338
0.0220
0.2383
15.9293
0.0907
0.0111
0.0749
NC-CA-00020-0-0002
0412016
0.0249
0.0160
0.1961
12.6108
0.0753
0.0066
0.0597
NC-CA-00020-0-0003
1212017
0.1458
0.0837
1.6313
9.4008
0.6113
0.0197
0,2282
NC-CA-00020-0-0005
0812013
0,0780
0.0323
0.7319
3.9983
0.2468
0.0078
0.0975
NC-CA-00020-0-0007
08/2019
0.1378
0,0514
1,3213
7.2178
0.4623
0.0124
0.1982
NC-CA-00020-0-0008
07/2016
0.1138
0.0551
1.2372
7.0643
0.4542
0.0135
0.2063
NC-CA-00020-0-0009
01/2017
0.0911
0.0438
0.8088
4.3421
0.3128
0.0157
0.1230
NC-CA-00020-0-0010
06/2012
0.0420
0.0176
0.8192
3.1068
0.1968
0.0126
0,0882
NC-CA-00020-0-0011
01/2014
0.0426
0,0123
0.5435
2.1938
0.1549
0.0044
0,0839
Ni
Se
Zn
0.3913
0.0652
2.6297
0.3287
0,0504
2.2491
1.0525
0.2130
41.5571
0.3712
0.0841
12.4234
0.6616
0.1523
27.1044
0.5917
0.1317
26.2749
0.4299
0.1069
16,5602
0.2695
0.0244
9.9059
0.1646
0.0260
6.3732
Page: 1 of 1 11/22/2019

SITE SUMMARY
City of Newton, Clark Creek VWVTP
Newton, NC
Site ID:
NC-LT-119
Name:
Gordy Goins
Address:
2924 Blackburn Bridge Rd
Lincolnton, North Carolina 28092
Phone:
(828-312-3247
Operator:
Address:
Phone:
Estimated
Total Applicable Predominant Latitude &
Fields Acres Acres Crop(s) Soil Series Longitude
1
0.0
10.3
Fescue
Madison
35.33.18 N
81.18.10 W
2
0.0
3.8
Fescue
Lloyd
35.33.12 N
81.18.08 W
TOTALS 0.0 14.1
Notes:
Date: 11 /4/19

IM State of Forth Carolina
Department of Environmental Quality
Division of Water Resources
Q Ddvision 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 oriy_inal 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 laud owner(s) of residuals receiving sites for land application of
Class 13 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):
V' 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
efer.
Prepare a separate agreement for each set of land application sites that are owned or operated by an entity other than the
Vpplicant.
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
to undersigned landowner Qr his represe> ative hereby perm/its:
Applicant's name: JT Ne ..-.4a,
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)
f r
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.
_. is Agreement shall remain in effect for the length of the Division's permit for the residuals land application program and
,11 be renewed each time this permit is renewed.
The undersigned landowner or his representative and the Permittee agree to abide with the following restrictions and
stipulations until such time as written notification, given 30 calendar days in advance, modifies or cancels this Agreement.
FORM: LOA 06-16 Page 1 of 3

I. STIPULATIONS:
1. The landowner or his representative shall not enter into any additional residuals application contracts or agreements with another permitted
entity for the sites) 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 parry, 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, 1617
Mail Service Center, Raleigh, NC 27699-1617.
5. The Permittee must request and obtain a permit modification from the Division prior to a transfer of the land application site(s) to a new
landowner. In addition, the current landowner shall give a notice to the new landowner that gives full details of the residuals applied at the
land application site(s).
6. The Permittee has provided the landowner or his representative with information and data concerning the residuals land application program,
including an analysis of constituents of the residuals, residuals application methods, schedules for typical cropping patterns, a description of
the equipment used by the Permittee.
7. The Permittee will provide the landowner or his representative with a copy of the residuals permit prior to commencement of any residuals
land application event and a copy of the results of each soil analysis.
8. If the soil pH of the land application site(s) is not maintained at 6.0 or greater, sufficient amounts of lime shall be applied to achieve a final
soil pH of at least 6.0, unless an agronomist provides information indicating that the pH of the soil, residuals and lime mixture is suitable for
the specified crop.
9. The landowner or his representative and the Permittee will agree on residuals application rates and schedules based on crop patterns, results of
soil samples, and the permitted application limits.
10. The landowner or his representative will provide the Permittee with information regarding the amount and analysis of other sources of
nutrients (e.g., fertilizer, unregulated animal waste, etc") that have been applied to the land application site(s).
11. The landowner or his representative will inform the Permittee of any revisions or modifications to the intended use and cropping patterns for
the land application site(s) prior to each planting season to enable the Permittee to amend this Agreement and schedule residuals land
application events at appropriate periods.
12. Specific residuals land application area boundaries shall be clearly marked on the land application site(s) by the Permittee, the landowner, or
his representative prior to and during a residuals land application event.
13. The landowner or his representative hereby authorizes the Permittee, local officials, and State officials or their representatives to; enter and
inspect any property, premises, or place on or related to the land application site(s) at any reasonable time for the purpose of determining
compliance with the permit; establish monitoring facilities on or near the land application site(s) as required by the permit; copy any records
that must be kept under the terms and conditions of the permit; take necessary leachate, surface water, groundwater, or soil samples during the
term of, and 12 months after termination of this Agreement.
II. RESTRICTIONS:
1. Appropriate measures must be taken by the Permittee and/or the landowner or his representative to control public access to the land
application site(s) during active use and for the 12-month period following a residuals land application event. Such controls may include the
posting of signs that indicate the activities being conducted at the land application site(s).
2. Animals shall not be grazed on the land application site(s) for a 30-day period following a residuals land application event. Land application
sites that are to be used for grazing shall have fencing that will be used to prevent access during these periods after such residuals land
application events.
3. Food crops, feed crops, and fiber crops shall not be harvested for a 30-day period following a residuals land application event.
4. Food crops with harvested parts. that touch the residuals/soil mixture and are totally above the land surface shall not be harvested for a 14-
month period following a residuals land application event.
5. Food crops with harvested parts below the surface of the land shall not be harvested for a 20-month period following a residuals land
application event when the residuals remain on the land surface for fopr 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.
in. ALTERNATIVES FOR WATER SUPPLY WELLS INSIDE THE COMPLIANCE BOUNDARY: (please check one)
15A NCAC 02L .0107(d) prohibits water supply wells within the compliance boundary. However, 15A NCAC 02T .0105(h) allows the
compliance boundary to be placed closer to the waste disposal area, such that the water supply well is situated outside of the compliance
boundary provided the groundwater standards can be met at the newly -established compliance boundary. Please mark one of the following;
❑ A re -defined compliance boundary is needed for field(s) ID:
(Please include the rationale for the requested re -location of the compliance boundary and attach a map showing the newly proposed
compliance boundary to the application package)
❑ A re -defined compliance boundary is not needed for this site.
IV. ACKNOWLEDGEMENT OF FIELD TRANSFER: (if needed)
❑ The land application field(s) ID: is currently permitted under another
residuals land application program; Permit Number WQ: The land owner hereby acknowledge that by signing this
agreement, he/she is requesting that the field(s) be removed from the previously permitted residuals land application program and transferred
into the new 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:?
Address:
City: k�J aC., It► to a State: ✓/ (, Zip:
Phone: 4f 7$' d 3 f), ^ 31 A4 1 E-mail address:
Signature:'t /M Date: AM
NORTH CAROLINA, An, 41 L® ( n COUNTY
I, the undersigned Notary Public do hereby certify that of f'�/ l7d v A �
personally appeared before me this day and acknowledged the due execution of the forgoing instrument.
WITNESS my hand and official seal this the I s �
day of
Signature and seal:
My commission expires:
Lessee's/Operator's Certification:
Vj
u
2q.0
40-n
iCOV�!,�
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 off
Signature:
FORM: LOA 06-16 Page 3 of 3

CUMULATIVE METAL LOADINGS (LBSIACRE) AS OF 11/2212019
The Cumulative metals for this report come from LTD Period Table records (i.e. a Monthly Report has been produced and the loadings have been archived to History
In cases where a trace metal Iab result was Not Reported to Synagro or tracking of the metal loading was Not Required the loading on the report is displayed as "NW'
Date
Field ID
Last Applied
As
Cd
Cr
Cu
Pb
Hg,
Mo
Ni
Se
Zn
NC-LT-00119-0-0001
10/2015
0.1546
0.1193
2.0901
10.1691
0.7062
0.0208
0.2612
0.8688
0.1340
38.6526
NC-LT-00119-0-0002
10/2015
0.0865
0.0B60
0.9507
5.6049
0.3713
0.0105
0.1322
0.5035
0.0968
24.6124
NC-LT-00119-0-0003
0512019
0.2059
0.1322
2.7723
13.6309
0.8799
0.0237
0.3580
1.2539
0.2110
52.6058
NC-LT-00119-0-0004
05/2019
0.1866
0.1241
2.5359
12.4727
0.8228
0.0229
0.3100
1.1032
0.1740
47.0376
Page: 1 of 1 11/22/2019

VICINITY MAP
GRAPHIC SCALE
1" = 2,000'
2,000' 0 2,000'
f
d
Tnu compliance boundary is established either 250 ft from the residuals application area or 50 feet within
i 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-LT-119
Field 1-4

GRAPHIC SCALE
1" = 660'
660' 0 660'
Tiit compliance boundary is established either 250 ft from the residuals application area or 50 feet within NC-LT-1 19
n 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 1-4

APPLICATION MAP
+' ' ^a M'+4' x. : + a `a ,�:'E} e j' '+ •: .. t �' .� aY t� � r rti �' '�� - t a �' r t ",7
ar3 z s egg t a� •y �`a$�•s $ 1 a �j � : i ��4 y) � y�F`:a � �' ��t Ir �_ f - ,±�'
t •. .j�i�"��gYl� y! �i-,. ` �� �% 'l $ • C�l �� 'E. � ' �� `Iwd� �M'17A<i� ha"'�. � S dg� � '. lY� � �1 gyp, hl i
1 f�3 � * � � ��+��1¢��'qJ{ fF� � pp �+���t}� Vr II`�dTi3ti��tppt • }`'ri ,a Y4` ii' �- '} }5 ;„(y%�r�.k'.
-,+4 S.lt R 'tKAt�t k+TeQl: ji �f`�cay J� i� J'I.
3 9tk -�4C jt%Y 1✓ ^f V k � t .,.. M � �3yi? ti `� Yi� R
"'.s° �+"� 4.tif'a 4
Z
•iaY s
It�7.
-.
J'
�I
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_ 1 •>;�i t�fi'��_-3t.'... Aq, Y��.F� ; ,'� 1 �a'
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1� L �r0% A
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rt�iF $$ kSF �S bwy br•`a'a j j fii�'t"�y;i� t
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J t �; (,r6C ✓,_i1 MPYyy'..(�. y' •�S y T° ,��F +i�i e`4i-J.tx.. !'S:tR1 eOt .D z`T St4t:ebTiig�•.G
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.s t*+.; •s Y .A' a h dR''il � t � W c., t � t 1 i ?at' F y< S ��t t •y ,
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�` ��.t+l:�����,�fg�3 st��"�i'e' 'ih�. as'�L� v' 2do b• a+,"-"a.�.t�'
t
...
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LEGEND
APPLICATION AREA
UNSUITABLE AREA
— — — — — — PRIVATE ROAD ®
WATER
GRAPHIC SCALE
— — — — STREAM
ONSITE HOUSE 1" = 660'
660' 0 660'
— DRAIN
OFFSITE HOUSE �1
----x—— FENCE
OUTBUILDING
PROPERTY LINE 0
WELL
I'( ra Compliance, boundary is.established either 250 ft from the residuals
application area or 50 feet within
NC-LT-1 19
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 1-4

SOIL SURVEY
,� l P , ; 1 CIA � �'• �$�F�u�.4t f' ,� f ��.
Al
AV
��
RRR"'
ry ,
GRAPHIC SCALE
1" = 500'
500' 0 500'
I ne 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-LT-119
Fields 1-4

SITE SUMMARY
City of Newton, Clark Creek WWTP
Newton, NC
Site ID: NC-CA-21
Name: Thomas Warlick
Address: P.O. Box 267
Newton, North Carolina 28658-0267
Phone: [phone]
Operator:
Tim Woodriff (Farm Manager)
Address:
4697 Startown Road
Newton, North Carolina 28658
Phone:
(980-722-4283) mobile
Estimated
Total Applicable
Fields
Acres Acres Crop(s)
Predominant Latitude &
Soil Series Longitude
1
0.0
27.5
Fescue
Lloyd
35.36.59 N
81.15.31 W
2
0.0
50.7
Fescue
Lloyd
35.36.41 N
81.15.44 W
TOTALS 0.0 78.2
Notes: coordinate all activity with V Tim Wooddriff
I
Date: 1114/19

CUMULATIVE METAL LOADINGS (LBS/ACRE) AS OF 11/2212019
The Cumulative metals for this report come from LTD Period Table records (i.e. a Monthly Report has been produced and the loadings have been archived to History
In cases where a trace metal lab result was Not Reported to 5ynagro or tracking of the metal loading was Not Required the loading on the report is displayed as "NR"
Date
Field ID Last Applied As Cd Cr Cu Pb Hg Mo Ni Se Zn
NC-CA-00021-0-0001 03/2013 0,0817 0.0382 1.3058 5.3585 0.3429 0.0142 0.1386 0.4838 0.0854 19.8406
NC-CA-00021-0-0002 0912019 0.1518 0.0444 1.6551 6.4022 0.4661 0.01.78 0.1751 0,6072 0.1238 23.5032
Page: 1 of 1 11/2212019

VICINITY MAP
I4.f
t ii •:33 o
Yti ,I.
A
{
-55
1 �
:�
�-�'..
• .
'_ ! fit: _
Uk(pp
;ll i
rj
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-CA-21
in the property boundary, whichever is closest to the application area. The review boundary is established
Field 1 'ry
G
midway between the compliance boundary and the perimeter of the residuals application area. All
locations are approximate.

TOPOGRAPHIC MAP
1
F
t
. r
0i
1
�1
� e
—
1`Vol,_
1
..' J
y
GRAPHIC SCALE
1" = 800'
800, 0 e00,
1 L
j
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-CA-21
Fields 1-2

APPLICATION MAP
I r:r-%r:nln
APPLICATION AREA
UNSUITABLE AREA
— — — — — — PRIVATE ROAD
OW
WATER
— — — — STREAM
■
ONSITE HOUSE
— DRAIN
OFFSITE HOUSE
XX X X FENCE
OUTBUILDING
PROPERTY LINE
0
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'
660' 0 660'
N C-CA-21
Fields 1-2

SOIL SURVEY
GRAPHIC SCALE
1"=800'
800' 0
800'
1
i ne 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-CA-21
Fields 1-2

CUMULATIVE METAL LOADINGS (LBS/ACRE) AS OF 12/22/2014
The Cumulative metals for this report come from LTD Period Table records (i.e. a Monthly Report has been produced and the loadings have been archived to History
In cases where a trace metal lab result was Not Reported to Synagro or tracking of the metal loading was Not Required the loading on the report is displayed as "NR"
Date
Field ID Last Applied As Cd Cr Cu Pb Hg Mo Ni Se Zn
NC-CA-00021-0-0001 03/2013 0.0817 0.0382 1.3058 5.3585 0.3429 0.0142 0.1386 0.4838 0.0854 19.8406
NC-CA-00021-0-0002 12/2011 0.0918 0.0235 1.2713 4.1652 0.3163 0.0142 0.1176 0.3421 0.0545 12.3617
Page: 1 of 1 12/22/2014