WQ0003281_Regional Office Historical File Pre 2018 (5)

o / �
D
RECEIVEDINCDENRIDWR
MAR -- 9 2020
R F ,Pj� p
FEB 2 6 2020
11'�EORWTION PROCESSING UNIT
2019
City of Belmont
Wastewater Treatment Plant
2019 Annual Report
Land Application Program
Permit No. WQ0003281
WQROS
MOORESVILLE REGIONAL OFFICE
FEB 2 � 20Z0
No�_plsch
pe�i�t�n9
E

ANNUAL LAND APPLICATION CERTIFICATION FORM
V
3281 County: Gaston Year: 2019
n on permit): City of Belmont
pplication Operator: Southern Soil Builders, Inc. Phone: [phone]
Fa'nd application of residuals as allowed by the permit occurred during the past calendar year? RECEIVEDINCCENRIDWR
R1 Yes 0 No - If No, skip Part A, and Part B and proceed to Part C. Also, If residuals were
generated but not land applied, please attach an explanation on how the residuals were handled. IdAR -- 2020
Part A - Residuals Application Summary:
Total number of application fields in the ermit:
n.-. w
Total number of fields utilized for land application during the year:
1
Total amount of dry tons applied during the year for all application sites:
84.76
Total number of acres utilizes for. land application during the.year:
42
Part B - Annual Compiance Statement:
Facility was compliant during calendar year 2019 with all conditions of the land application permit
(including but not limited to items 1-13 below) issued by the Division of Water Resources. R1 Yes 0 No
If no please, provide a written description why the facility was not compliant, the. dates, and explain corrective action
taken.
1) Only residuals approved for this permit were applied to the permitted sites.
2) Soil pH was adjusted as specified in the permit and lime was applied (if needed) to achieve a soil pH of at least 6.0 or
the limit specified in the permit.
3) Annual soils analysis were performed on each site receiving residuals during the past calendar year and three (3) copies
of laboratory results are attached.
4) Annual TCLP analysis (if required) was performed and three (3) copies of certified laboratory results are attached.
5) All other monitoring was performed in accordance with the permit and reported during the year as required and three
(3) copies of certified laboratory results are attached.
6) The facility did not exceed any of the Pollutant Concentration Limits in 15A NCAC 02T .1 105(a) or the Pollutant
Loading Rates in 15A NCAC 02T .l 105(b) (applicable to 40 CFR Part 503 regulated facilities).
7) All general requirements in as specified in the Land Application Permit were complied with (applicable to 40 CFR Part
503 regulated facilities).
8) All monitoring and reporting requirements in 15A NCAC 02T .I 1 11 were complied with (applicable to 40 CFR Part
503 regulated facilities).
9) All operations and maintenance requirements in the permit were complied with or, in the case of a deviation, prior
authorization was received from the Division of Water Resources.
10) No contravention of Ground Water Quality Standards occurred at a monitoring well or explanations of violations are
attached to include appropriate actions and remediations.
1 1) Vegetative cover was maintained and proper crop management was performed on each site receing residuals, as
specified in the permit.
12) No runoff of residuals from the application sites onto adjacent property or nearby surface waters has occurred.
13) All buffer requirements as specified on the permit were maintained during each application of residuals.
Part C - Certification:
"I certify, under penalty of law, that the above information is, to the best of my knowledge and belief, true, accurate,
and complete. I am aware that there are significant penalties for submitting fa a information, including the
possibility o nes and imprisonment for knowing violations."
Permittee Narne and Title (type or print) Signature of Permittee Date
Signature of
Date
Signature of Land Applier
Date
OFF
(if different from Permittee) (if different from Permittee and Preparer)
* Preparer is defined in 40 CFR Part 503.9 (r) and 15A NCAC 02T .l 102 (26) nFNR FnRnn Ar.F tioionna)

ANNUAL RESIDUAL SAMPLING SUMMARY FORM
Please note that your permit may contain additional parameters to be analyzed. The parameters can be reported in FORM RSSF - B
WQ Permit Number: WQ0003281
Laboratory: 1)
Facility Name:
City of Belmont
Residual Source WQ # or
2)
NPDES #:
WQ0003281
3)
WWTP Name:
4)
Residual Analysis Data
rtv o e mont
5)
Cone.
Parameter Limit
Sample or Composite Date
4/25/ 001
(mg/kg) (ma/k )a
9
Percent Solids (%) NA
3.86
Arsenic 75
6.4
Cadmium 85
1
Copper 4,300
324
Chromium NA
90.7
Lead 840
25.1
Mercury 57
0.471
Molybdenum 75
4.4
Nickel 420
21.1
Selenium 100
6.35
Zinc 7,500
1570
Total Phosphorus NA
20600
TKN NA
43100
Ammonia -Nitrogen NA
5380
Nitrate and Nitrite NA
4.84
Waypoint
z For surface disposal facilities the ceiling concentration limits listed in this form are not applicable. Reference the individual permit for metals limits.
Ls'Jesrtify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed
re that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant
es for submitting false information, including the possibility of fines and imprisonment for knowing violations.,,
A ,
ate
in 40 CFR Part 503.9(r) and 15A NCAC 2T .1 102 (26)
IIFNIR

ANNUAL RESIDUAL SAMPLING SUMMARY FORM - B
Report all sampling analysis results for parameters not listed in FORM RSSF that are part of the WQ permit or were analyzed for over the past
calendar year. Use additional forms as needed.
WQ Permit Number: WQ0003281
Facility Name:
Residual Source
NPDES # or WQ#:
WWTP Name:
Residual Analvsis Data
City of Belmont
WQ0003281
City of Belmont
Laboratory: 1) Waypoint
2)
3)
4)
5)
Parameter
(mb/kb)
Sample
or Composite
Date
4-25-
2019
Phosphours
20600
Potassium
2150
Sulfur
10000
Calcium
11900
Magnesium
2680
Sodium
6060
Iron
24100
Aluminum
36900
Manganese
961
Organic N
37720
Phosphours
7.8 -
PAN
14010
SAR
2.55
1 certiry, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system
igned to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are
scant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
� y u
ate
in 40 CFR Part 503.9(r) and 15A NCAC 2T .1102 (26)
DENR FORM RSSF - R (igignmi

ANNUAL METALS FIELD LOADING SUMMARY FORM*
rm to the corresponding Field Loading Summary Form to be submitted in Annual Report
P.Ve: City of Belmont
WQ0003281
tor: Lori Warren Owner:
Used: 42 Acres Permitted:
Total Dry Tons Applied (Annual):
Cation Exchange Capacity (non 503 only):
Lori Warren Predominant Soil Series:
42 Site #: BT 9-1 Field #:
84.76
GaB2
BT 9-1
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg. % Solids use Raw Percent #)-
Sample or
Com-
posite
Date
1 1
4/25/19
` I
3 .�
4
51
6
7
8
9�
101
11 j
12
% Solids
3.86
Arsenic
6.4
Cadmium
1
Copper
324
Chromium
90.7
Lead
25.1
Mercury
0.471
Molyb-
denum
4.4
Nickel
21.1
Selenium
6.35
Zinc
1570
Total
Phos-
horus
20600
tAulluill neavv lvlelal rlclu uoauings It.alcuinrefl In Ills/slrrPA*
Total
App.
NONE
Event1
1 1 •
1 111
1 111
1 111
1 111
0.000
1 111
1 111
1 111
1 111
1 111
1 111
1 1
1 11�
1 111
1 111
1 111
1 111
0.000
1 111
1 111
1 111
1 111
1111
1 111
1 11�
•..-
1:
1 111
1 101
1 111
1 110
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1:
.
1 .•
1 110
1 111
1 111
1111
1 Otl
1 111
1 111
1 111
1 111
1111
1111
1 .•
.-.'
1 1
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 1
1 11
1 111
1 111
/ 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
®®®
1 111
1 11
Molyb-
denum
1 1
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 1
1 1:
1 111
1 111
1 111
1 111
1 111
1 111
t 111
1 111
1 111
1 111
1 111
1 1:
1 1 .
1 111
1 111
1 111
1 lee
1 111
1 111
0 Ile
1 111
1 eel
1 111
1 Ilt
1 1
®
.
1 leeTotal
1 111
a 111
1 111
1 111
1 111
1 111
1 111
®®®®®
1 111
1 111
1 111
•
1 111
1 111
1 Ilt
1 Ile
a tee
1 111
1 111
1 lel
1 111
1 ell
1 111
h
- - --•• -•-•-• ••--� ..�........... rrno fir,uval— u,iucr my u►rectlon or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
imprisonment for knowing violations".
02 `/•ao -0 n
Signature of Land Applier
Date
DENR FORM MFI qF /1?/?nnF�

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: City of Belmonr WQ Permit #: WQ0003281 Field #: BT 9-1 Acres Utilized: 42
Land Owner: Lori Warren Annual Dry Tons Applied: 84.7465 Site #: BT 9-1 Acres Permitted: 42
Operator: Lori Warren Predominant Soil Series: GaB2 Cation Exchange Capacity (non 503):
Crop 1 Name: Fescue Crop I Max. PAN: 211 Crop 2 Name: Crop 2 Max. PAN
Volume applied V I Soil �
° y
° c
ry
(enter one) Solids/
%
o ume
Applied per
PP P
Residual Sources
(NPDES #, WQ#,
Cond.
Precip.
Past 24
a
K
o
z r
z Y
c B
Nitrate
PAN Applied
PP
Name of CropType
yP
°
CCJ9
Liquid
Solids
Acre
Fert., Animal
(Dr .
Hrs.
c'u _
�-
w
_
TKNrm
o o
CD
and
Nitrite
(Ibs/acre)
Receiving Residual
Cu. Yds
Gallons
Waste, etc)
Wet
x w
2.
Application
(Dry Tons/Ac)
Moist)
inches
o
0
mg/kg
mg/kg
mg/kg
Crop 1
Crop 2
Crop ]
Crop 2
7-2019
526500
3.86
2.018
W00003281
d
0
0 -
-
0.000
4.)100
5380
4.84
56.541
NA
Fescue
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0 000
0 000
TOTALS:
Annuallbs/acre
0 526s0o
As
0.026
Residuals
Cd
0.004
Applications
Cu
1.368
totals
Cr
0.366
on FORM
Pb
0.101
FSF
Hg
0.002
supp ( attach
Mo
0.018
FORM
Ni I
0.085
FSF supp
Se
0.026
to this form):
Zn P 56.541 1. 0.000
6.337 83.142
131.647 ..
137.984
2498
Lime Applied
Date
lbs/ac
'rior Years Cumulative lbs/ac
0.372
0.121
25.707
28.977
3.435
0.058
0.364
1.89
0.185
I ]-2019
1000
�urrent Cumulative Ibs/ac
0.398
0.125
27.015
29.343
3.536
0.060
0.382
1.975
0.211
permitted C. P. L. R.****
. 36
34
NA
1338
267
15
NA
374
89
3ermit PAN Limit Ist/2nd Crop
211
`I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
ualif ied personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
rmation, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, 1N - Injection, INC - Incorporation
**Volatilization Rate: Surface -0.5, Injection/Incorporation - 1.0
Signatu e of Land Applier Date Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (1212006)

Report Number: 19-119-0202
Account Number: 46381
Send To: Southern Soil Builders
Dennis Key
958 Hoots Road
Roaring River, NC 28669
a
WayPi2int,111
AYTICAL
Project : Belmont
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 ° Fax [phone]
www.waypointanalytical.com
REPORT OF ANALYSIS Date Sampled: 4/25/2019 12:30:00
Lab Number: 66081 Date Received: 04/29/2019 00:00
Sample Id :Belmont Date Reported: 05/07/2019
ouuuk)
iuu.0
AUM
04/30/201915:33
SM-254OG
Moisture'
96.10
100.0
ADM
04/30/201915:33
SM-2540'G
Total Kjeldahl Nitrogen
4.31
43100
250
JPJ
05/05/2019 15:30
SM-4500-NH3C-TKN
Phosphorus
2.06
20600
50.0
KKM
05/03/2019 02:09
6010D
Potassium
0.22
2150
50.0
BKN
05/03/2019 02:09
601 OD
Sulfur
1.00
10000
50.0
KKM
05/03/2019 02:09
6010D
Calcium
1.19
11900
250
KKM
05/03/2019 02:09
6010D
Magnesium
0.27
2680
50.0
KKM
05/03/2019 02:09
6010D
Sodium
0.61
6060
250
KKM
05/03/2019 02:09
601OD
Iron
24100
50.0
BKN
05/03/2019 02:09
6010D
Aluminum
39600
50.0
BKN
05/03/201917:03
6010D
Manganese
961
5.00
KKM
05/03/2019 02:09
6010D
Copper
324
2.50
KKM
05/03/2019 02:09
6010D
Zinc
1570
12.5
BKN
05/03/201917:03
6010D
Ammonia Nitrogen
0.54
5380
100
JPJ
05/06/2019 09:30
SM-4500-NH3C
Organic N
3.77
37720
250
05/05/2019 15:30
CALCULATION
Nitrate+Nitrite-N
<4.84
4.84
ZBD
05/02/201914:08
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
c.,ii8 Bra,+il?" ijsn .".XC;L,.. s R'i� .,�.'?rt,73R;'.%8= US� Oi ia.!'C+,rE:; ;?S. arr� ,t%av r,:.i
i:c--' .rEpfGC. Urv^^�
;,. ....,,. , !' Jfi ... , J??'y' L.•�. �,..,J ;J�'
?ir: cc=f;;n-,r,y .,e%!t, ;ar.;.r,.+,'c?:au
•
reas_..,, .,..., ubii.. san„t,:% en% , s ws.,
,
.,..4�
Pauric McGroary
Agronomist
Pale 3 of 6

Report Number: 19-119-0202
Account Number: 46381
Send To: Southern Soil Builders
Dennis Key
958 Hoots Road
Roaring River, NC 28669
9
Waypoint
ANALYTICAL
Project : Belmont
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-5401 ° Fax [phone]
www.waypointanalytical.com
REPORT OFANALYSIS Date Sampled: 4/25/2019 12:30:00
Lab Number: 66081 Date Received: 04/29/2019 00:00
Sample Id : Belmont Date Reported: 05/07/2019
<'].uu
1.00
KKM
05/03/2019 02:09
6010D
Chromium
90.7
2.50
KKM
05/03/2019 02:09
6010D
Nickel
21.1
2.50
KKM
05/03/2019 02:09
6010D
Lead
25.1
3.00
KKM
05/03/2019 02:09
6010D
Arsenic
6.40
5.00
KKM
05/03/2019 02:09
6010D
Mercury
0.471
0.0154
KKM
05/02/2019 11:06
SW-7471 B
Selenium
6.35
5.00
KKM
05/03/2019 02:09
6010D
pH .
7•8
JSL
05/06/2019 07:11
9045D
Molybdenum
4.40
2.50
KKM
05/03/2019 02:09
6010D
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
art c r:!der`ia' 4. e` , .. ;r.='enis, and ma:: ?"', i r. '(sf!; f�dUf,B,: IR ;!;J;B c?!'U:iF' ,^•n. "T.-a"', ... c. �.,.•., ,.� 7':)�
or ...rr(Xw"'?an ;r; ;�r ;:1:'i'i?!;iS;: ifs. :Yr.,r7:!'.?:'fasn, o'oUlf, pub!:: r.4,'7.^•i:i.'?iCE3!!;v(:'c.SV l,!:7i1'c obtahning nu! rio!'
Pauric McGroary
Agronomist
Wage 4 of 6

PAN
Mineralization
Rate TKN
0.3 43100
NH3 I NO3 NO2
5380 4.84 0
PAN Surface
14010.84 mg/kg
28.02168 lbs/dry ton
lbstotal PAN
0[lbs
#DIV/01 PAN/acre
PAN Injection
16700.84 mg/kg
33.40168 lbs/dry ton
0 1 lbs total PAN
#DIV/01 jibs PAN/acre
Dry Ton s/1000.gal.
0.160962
1st year PAN
lbs./acre
Surface lbs.
Surface
01
#DIV/0!
1st year PAN
lbs./acre
Injected lbs.
Injected
01
#DIV/0!
lecimal Total dry Acres
% Solids tons/year Applied on
0.0386
MR(TKN-NH3)+ + .5(NH3)+NO3+NO2 =mg/kg
mg/kg x .002 =Ibs/dry ton
MR(TKN-NH3) + l(NH3)+NO3+NO2 =mg/kg
mg/kg x .002 =Ibs/dry ton
1000 X 8.34 X %solids X sp. gravity "=dry tons/1000gal."
2000

Sodium Absorption Ratio
Na: Sodium (Mg/L) Equivalent weight: 23
Ca: Calcium (Mg/L) Equivalent weight: 20
Mg : Magnesium (Mg/L) Equivalent weight: 12
Milli Equivalent = Mg/L / Equivalent weight
Na M /L Ca M /L Mg(Mg/L)
233.91 1 459.34 1 103.45
Na (ME)
Ca .(MEN
I Mg -(ME,
10.17
22.967
18.620833
SAR= Na Milli Equivalent/[0.5 X (Ca Milli Equivalent + Mg Milli equivalent)]0.5 power
SAR = 2.559034 (From Mg/L entered above)
SAR= 2.516171 (From ME entered below)
Na ME
Ca (ME)
22.97
Mg (MEN
10
1 .62
The amour
amount of i
Permitting I

Analytical Results
Southern Soil Builders
958 Hoots Road
Roaring River, NC 28669
Receive Date: 04/25/2019
Reported: 06/07/2019
For: Belmont
Comments:
Sample Number Parameter Sample ID . Result
190425-17-01 30 Day Benchscale Belmont
Respectfully submitted,
r
Dena Myers
NC Cert #440,
NCDW Cert #37755,
EPA #NC00909
10.2
p yh h gyp
Ell
Unit Method Analyzed Analyst
EPA625-R-92/0 04/25/2019 WC
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 1 of 3

Analytical Results
Southern Soil For: Belmont
Entered: 04/25/2019
Reported: 06/07/2019
Sample ID: 190425-17
PARAMETER: Vector Attraction Reduction/Aerobically Digested Sludge (30day)
Total Solids
Volatile Solids
% Volatile Solids
Week
1
1.65
0.96
0.5808
Week
2
1.78
1.04
0.5876
Week
3
1.51
1.08
0.7202
Week
4
1.35
0.74
0.5472
Week
5
1.41
0.78
0.5543
Volatile Solids Reduction: 0.5808 - 0.5543 X 100 = 10.2%
0.5808 - (0.5808 X 0.5543)
Respectfully submitted,
Dena Myers
Statesville Analytical, Inc.
NC WW Cert.# 440NC

Condition of Receipt
le Number 190425-17-01 Temp on Arrival: 3.2
Parameter Schedule:
Received on Ice
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 2 of 3

unent:
Address:
(r
PC- apt';
Qontact Person: 0., L ` f
PO # M
Customer time Saa
Sample IN tatrlD N (Grab Oni
R[1,..I � I ICIO Lk7),I'7- 1 rJ.
Phone #
33e- 15--) .
FAX#
33c aa9 -riyo
(lime Date)
Matrix Parameters mqucsred for analysis
Up! W WW
X { S
STAMVILLEANALYTICAL
122 Court Street • P.O. Box 228
Statesville, xC 28687
[phone]
Chain of
Custody Record
Relinquished by:
Time • )S
am, rr Date L 1 / )h
Sampled by:��
Received by:
Time / +'
an) -ODale U-
Transported by:
Relinquished by:
Time
am, pm Date—! _/
f
Holding times met.
Received by:
Time
am, pm Date�-
Compliance work:
CohiNsite.Sampling #1:
Time begin
am, pm Date _/ J
Non-compliance work:
Time end. _._... _.__......_..
am, pm Date
CompositeSam�t'r_n_g�•
Lab Comments;
Samples Transported On Ice:
.
Time begin
am, pm DJate
Time end
am, pm Date �_/_
_
I
IniBals:
r\
rn
�o
co
N O
00
N M
� rn
CD 0-
r\
W
LO
eo
N
U
z
ai
4-
Y
r0
Y
(n
(b
N
N
X
O
m
0
d

Analytical. Results
—""'c"' 0011 Builders
958 Hoots Road
Roaring River, NC 28669
A ANALYTICAL
Receive Date:
04/25/2019
Reported:
For:
04/29/2019
Belmont
Comments:
GM <546 MPN/g
Sample Number
parameter
190425-21-01
Fecal Coliforms
Sample ID
Result
190425-21-01
Percent Solids
B1
<562
�Unit
N/g
�Method
-2006
�Anal�yzedAnalyst
190425-21-02
Fecal Coliforms
B1
B2
3.56
%
SM25408-2011
04/25/2019
WC
190425-21-02
Percent Solids
B2
<541
MPN/g
SM92210E-2o os
04/25/2019
WC
190425-21-03
Fecal Coliforms
B3
3.7
%
SM2540B.2011
04/25/2019
04/25/2019
WC
190425-21-03
Percent Solids
63
<542
MPN/g
SM92210E-2006
04/25/2019
WC
190425-21-04
Fecal Coliforms
B4
3.69
%
SM2540B-2011
04/25/2019
WC
WC
190425-21-04
Percent Solids
B4
<555
MPN/g
SM92210E-2006
04/25/2019
WC
190425-21-05
Fecal Coliforms
B5
3.6
0
/o
SM2540B-2011
04/25/2019
WC
190425-21-05
Percent Solids
B5
<494
MPN/g
SM92210E-2006
04/25/2019
WC
190425 21-06
Fecal Coliforms
gg
4.05
0
/o
SM254OB-2011
04/25/2019
WC
190425-21-06
Percent Solids
gg
<504
MPN/g
SM92210E-2006
04/25/2019
WC
190425-21-07
Fecal Coliforms
67
3.97
%
SM25408-2011
04/25/2019
WC
190425-21-07
Percent Solids
87
<639
MPN/g
SM92210E-2006
04/25/2019
WC
3.13
%
SM25408-2011
04/25/2019 WC
Respectfully submitted,
r
Dena Myers
NC Cert #440,
NCDW Cert *37765,
EPA #NC00909
PO 6ox228 • Statesvi\\e, NC 28687 • 704/972/4697

Condition of Receipt
Number 190425-21-01 Temp on Arrival: 3.2
Parameter Schedule: Percent Solids
Received on Ice
Parameter Schedule: Fecal Coliforms
Sodium Thiosulfate Received on Ice
Chemicals in containers, lab
Sample Number 190425-21-02 Temp on Arrival: 3.2
Parameter Schedule: Percent Solids
Received on Ice
Parameter Schedule: Fecal Coliforms
Sodium Thiosulfate Received on Ice
Chemicals in containers, lab
Sample Number 190425-21-03 Temp on Arrival: 3.2
Parameter Schedule: Percent Solids
Received on Ice
Parameter Schedule: Fecal Coliforms
Sodium Thiosulfate Received on Ice
Chemicals in containers, lab
Sample Number 190425-21-04 Temp on Arrival: 3.2
Parameter Schedule: Percent Solids
Received on Ice
Parameter Schedule: Fecal Coliforms
Sodium Thiosulfate Received on Ice
Chemicals in containers, lab
Sample Number 190425-21-05 Temp on Arrival: 3.2
Parameter Schedule: Percent Solids
Received on Ice
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 2 of 4

' Parameter Schedule: Fecal Coliforms
Sodium Thiosulfate
Received on Ice
Number 190425-21-06 Chemicals in containers, lab
Temp on Arrival: 3,2
Parameter Schedule: Percent Solids
Received on Ice
Parameter Schedule; Fecal Coliforms
Sodium Thiosulfate
Received on Ice
Sample Number 190425-21-07 Chemicals in containers, lab
Temp on Arrival: 3.2
Parameter Schedule: Percent Solids
Received on Ice
Parameter Schedule: Fecal Coliforms
Sodium Thiosulfate
Received on Ice
Chemicals in containers, lab
Pn eoX 228 St-ates \\\e, NC -96% • -713418721469�

nuurass: rj� - STAUSVILLEANALY77CAL
122 Court Street • P.O. Box 228
p Statesville, NC 28687
Phone # EFAX# [phone]
Contact Person:
�3c
PO # 51 �g f �3G S7 g y o Chain of Customer Requisitioned by: (Tmre Dale)
Custody Record Semple IDSI Lab -ID Sampled D N P Date Sampled Maid
(Grab Only) (Grab Only) w WW ['arametersrequcstcdfor malysis
Zt .21.0 1' 0: 3p r
-3s�1
Relinquished by:
r
Time .1 s am, Date.
� �
/ r/%
Sampled
_.L`'
by:—Z.,,,
Received by:
-
Time rL/15 am, J jDate
4VIw/ 161.
Transported
by:
Relinquished by:
Time am, pm Date
Holding times met.-/
Received by:
Time am, pm Date
_/`/
Composite Samp
ji pg#1:
Compliance work:
Time begin
am, pm Date / /
Non-compliance work:
Time end
am, pm Date _/ /
Sampling #2'
Lab Comments.
Samples Transported On Ice:
Time begin
am, pm Date
Time end
am, pm Date
)nitlals:

Analytical Results
Southern Soil Builders
958 Hoots Road
Roaring River, NC 28669
Receive Date: 04/25/2019
Reported: 06/03/2019
For: Belmont
Comments:
Sample Number Parameter Sample ID Result
190425-19-01 TCLP
Respectfully submitted,
Dena Myers
NC Cert #440,
NCDW Cert #37755,
EPA #NC00909
/.�
_ �
A N A IN T I C A sm
4�
1�F
Unit Method Analyzed Analyst
Belmont See Attached as Noted 04/26/2019 PACE
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 1 of 42

Sample Number 190425-19-01 Temp on Arrival: 3.2
I ai ai 11ULM Qk,1 rouuic. 1 %0L.r-
Received on Ice
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 2 of 42

b--'*V�e-T% .--)0=1 8 :
PO # �—
_...
..........
Customer -
SQ2mplelDtl l] Lab
nn-11)/A
Relinquished by:
Received by:
Relinquished by:
Received by:
WKIPOStte Sampling All:
Time begin am, prri Date �f /
Time end am, pm Date I
Composite Sampling #2:
Time begin am, pm Date
Time end am, pm Date
Phone # 3 FAX#
.Y5- �$`7t 336�
Requisitioned by: (rme
b Only), Date Samyled mFT. Matrix
h) , (Grab Onry) c� 16 � w ,y,�
iC (gin `�'�S`14 �< IV I I
Pa —eras mtursred for anal��s
T-CtP
STAWSVILI.E ANALYTICAL
I22 Courtstmet • P.O. Bux 228
StatCsvilte, NC 28687
[phone]
Chain of
Custody Record
Time ;? j S am, Date Sampled by: Z 4
Lr Y
Time 1q15 am Date Transported by:
Time am, pm Date _/ /
-- Holding times met-
_ Time am, pm Date
Compliance work
Non-compliance work
Lab Comments: Samples Transported on ice:
Initials:
r`
rn
� N
N
00 CO
\ N
C) C
O CO
a.
00
LD
00
N
U
z
N
V7
Q1
O
N
N
X
O
m
0
a -

ANALYTICAL. RESULTS
Project: TCLP
Pace Project No.: 92427047
Pace Analytical Services, LLC
9800 KlnceyAve. Suite 400
Huntersville, NC.28078
[phone]
sample: 190425.19-01 Lab ID: 92427047001 Collecled: :04/25/19 12:30 Received: 04/26/19 07:45 Matrix: Solid
Results reported on a "dry weight" basis and are adjusted for percent moisture, sample size and any dilutions.
Parameters Results Units Report Limit OF Prepared Analyzed CAS No. Qual
8081 TCLP Pesticides RVE
Analytical Method: EPA 8081B Preparation Method: EPA 3510C
Leachate Method/Date:.EPA 1311; 05/01/19 19:00 Initial pH: ; Final pH: 5
gamma,BHC (Lindane)
Chlordane (Technical)
NO, uglL 0.50 1 05/02/19 11:.41 05/02/19 18:38 58-89-9
ND
Ehdrin
ug/L 3.0 1 05102/19 11:41 05/02/19 1,8:38 57-74.9
NO
Heptachlor
ug/L. 0.50, 1 051.0211911:41 05/0211918:38 72-20-8
ND
Heptachlor epoxide
uglL 0.50 1 05/0211911:41 05102/191828 76-44.8
NDug/L 0.50
Methoxychlor
1 G5192/19 11:41 05/02/19 18i38 1024-57-3
ND' uglL 1000
Toxaphene
1 05/0211911:41 0.5/0211918:38 .72.43-5
ND uglL
:Surrogates
3.0 1 05/02/19 11:41 05/02/19 18:38 8001-35-2
Decachlorobiphenyl (S)
Telrachloro-m-xylene (S)
41 % 10.138 1 05/02/19 11:41 05/02119 18:38 2051-24-3
51 % 10-110 1 05/02/19 11:41 05/02/19 18:38 877-09-8
80B2 T.CLP'P.CBs RVE.
Analytical Method: EPA.8082A Preparation Method: EPA 3510C
Leachate Method/Date: EPA 1311; 05/01/1.9 19:00 Initial pH: ; Final pH:.5
PCB-1016•(Aroclor 1016)
PCB-1221 (Aroclor 1221)
ND ug/L 1000 1 05/10/19 17:02 05113/19 09:03 12674-11-2 L1
PCB-1232 (Aroclor 1232)
NO ug/L 1000 1 05/10/19 17:02 05/13/19 09:03 11.104-28-2
ND ug/L 1000
PCB-1242 (Aroclor1242)
1 05/10/19 17:02 05/13/19 09:03 11141-16.5.
ND ug/L
PCB-1248{Aroclor 1248)
1000 1 05/10/19 17:02 06/13119 09:03 53469-21-9
ND uglL
PCB-1254 (Aroclor1254)
1000 1 05/10/19 17:02 05/13/19 09:03 12672-29.6
ND ug/L
PCB-1260:(Aroclor 1260)
10D0 1 05/10/19 17:02 05113/19 09:03 11097-69-1
ND ug/L
Surrogates
1000 1 05M0119 17:02 05/13/19 09:03 11096-82-5
Decachlorobiphenyl (S)
69 % 10.132 1 05/10/19 17:02 05/13/19 09:03 2051-24-3
6010 MET:ICP, TCLP
Analytical Method: EPA 6010D Preparation Method: EPA 3010A
Leachate Method/Date: EPA 1311; 05/08119 23:16 Initial pH: 6.95; Final pH: 4.5
Arsenic
Barium
ND mglL 0.050 1 05/09/19 22:52 05/10/19 13:13 7440r38-2
Cadmium
0.58 mg/L 0.25. 1 05/09/19 22:52 05/10/19 13:13 7440.39-3
Chromitim
ND mglL 0.0050 1 05109/19:22:52 05/1011913:13 7440.43.9
Lead
NO mg/L 0.050 1 05/09/19 22i52 05/10/19 13:13 7440.47-3
Selenium
N.D. mg/L U25 1 05/09/19 22:52 05/10/19 13:13 7439-92.1
ND
Silver
mg/L 0.10 1 05/09/19.22:52 05110/1913:13 7782.49-2
NO mg/L 0.625 1 05/09/19 22:52 05/10/19 13:13 7440-22-4
7470 Mercury, TCLP
Analytical Method: EPA 7470A Preparation Method: EPA 7470A
Leachate Method/Date: EPA 1311; 05/08/19 23:16 Initial pH: 6.95; Final pH: 4.5
Mercury
NO mg/L 0.00020 1 05/10/19 08:07 05/10/19 11:26 7439-97-6
8270E MSSV TCLP Sep Funnel
Analytical Method: EPA 8270E Preparation Method: EPA 3510C
1,4-Dichlorobenzene
2,4-Dlnitrotoluene
ND ug/L 60.0 1 05109/1913:13 05/0911914:42 106-46-7
Hexachloro-1,3-butadiene
ND uglL 50.0 1 05/0911913:15 05/09/19 14:42 -121.-14-2
ND ug/L
Hexachlorobenzene
50.0 1 05/09/19 13:13 05/09/1914:42 87-68-3
NO
HeXachloroethane
ug/L 50.0 1 05/09/19 13:13 05109/1914:42 118.74-1
NO
2-Melhylphenol(o-Cresol)
ug/L 50.0 1 05109/1913:13 05109/1914:42 67-72-1
ND ug/L
3&4-Methylphenol(m&p Cresol)
50.0 1 0510911913:13 05/09/4914:42 95.48-7
932 ug/L
50.0 1 05/09/19 13:13 05/09119 14:42 15831-1.0-4
REPORT OF LABORATORY ANALYSIS
Date: 05/2812019 05:02 PM
This report shall not be reproduced, except In full,
without the written consent of Pace Analytical Services. I.I.C.
Page .4 of 39
PO Box 228 • Statesville, NC 28687 e 704/872/4697
Page 7 of 42

0
ANALYTICAL. RESU LTS
Pace Analytical Services, LLC
9800 Kincey.Ave. Suite 100
Huntersville, NC 28078
[phone]
Project: TCLP
Pace Project No.: 92427047
Sample: 190425-19-01
Lab ID: 92427047001 Collected:
04125/19 12:30
Received: 04/26/19 07:45 Matrix: Solid
Results reported on a "dry weight" basis and are adjusted forpercent moisture, sample size and any dilutions.
Parameters
Results Units Report Limit
DF
Prepared Analyzed CAS No. Qual
8270E.MSSV TCLP'Sep Funnel
Analytical Method: EPA8270E Preparation Method:
EPA 3510C
Nitrobenzene
ND ug/L
50.0
1
05/09/19 13:13 05/0911914:42 98-95-3 L1
Pentachlorophenol
ND' uglL
100
1
05/09/19 13:13 05/09/19 14:42 87-86-5
Pyridine
'ND uglL
50.0
1
05/09/19 13:13 0510911914:42 11.0-86.1 M1
2,4,5-Trichlorophenol
ND ug/L
60.0
1
06/09/1'91313 0510911914;42 95-954
'2,4,6-Trichlcrophenol
N.D. ug/L
50.0
1
0510911913:13 05/0911914:42 88.06-2
Surrogates
Nitrobenzene-d5 (S)
33 %
12402
1
05/09/19 13:13 05/09/19 14:42 4166-60-0
2-FlUorobiphenyl (S)
32 %
13.107
1
05109/19 13:13 :05/09/19 14:42 321-60-8
Terphenyl-d14 (S)
61 %
21-132
1
05/09/19 13:13 05/09/19 14:42 1718-51-0
Phenol-d6 (Sy
17 %
10-110
1
05/09/19 13:13 05/09119 14:42 13127-88-3
2-Fluorophehol (S)
23 %
10-110
1
05/09/19 13:13 05/09/19 14:42 367-12-4
2,4,6-Tribroniophenol (S)
57 %
27-108
1
05/09119 13:13 05/09/19 14:42 118.79-6,
82600 MSV T.CLP
Analytical Method: EPA 82600.
Benzene
ND. ug/L
100
20
05/10/19 01:31 71-43-2
2-Bulanone (MEK)
NO ug1L
200
20.
05110/19 01:31 78-93-3
Carbon tetrachloride
ND ugiL
1,00
20
05110119 01:31 56-23.5
Chlorobenzene
ND ug/L
100
20
05110/1901r31 108-90-7
Chloroform
ND ug/L
100
20:
05/10/19 oV31 .67-66-3
1,4-Dichlorobenzene
ND'. uglL.
100
20
05110119 01:31. 106-46-7
1,2-Dichicroethane
ND' ug/L
1.00
20
05/10/19 01:31 107-06-2
1,1-Dichloroathene
ND ug/L
100
20
05110/19 01:31 75-35-4
Tetrachlotoethene
ND ug/L
100
20
05/10119 01:31 127-18-4
Trichloroelhene
ND uglL
100
20
05/10/19 01:31 79-01-6
Vinyl chloride
ND ug/L
100
20
05/10/19 01:31 75.01.4
Surrogates
1,2-Dichloroethane-d4 (S)
96 %
70-130
20
05/10/19 01:31 17060-07=0
Toluene-d8 (S)
104 %
67-.135
20
05/10/19 01:31 2037-26.5
4-Bromofluorobenzene.(S)
98 %
70-130
20
05/10/19 01:31 460-00.4.
Percent Moisture
Analytical Method: ASTM D2974-87
Percent Moisture
96.6 %
0.10
1
0.4129/19 13:38
1010 Flashpoint,Closed Cup
Analytical Method': EPA.1010A
Flashpoint
>200 deg F
70.0
1
05/06/19 16:27
9095 Paint Filter Liquid Test
Analytical Method: EPA90958
Free Liquids
Fail
1.0
1
04/29/19 10:19
733C S Reactive Cyanide
Analytical Method: EPA 9014 Preparation
Method:
SW-846 7.3.3.2
Cyanide, Reactive
ND mgll(g
28.9
1
05/02/19 20:42 05/02119 23:01.
734S Reactive Sulfide
Analytical Method: SM 4500S2F-00 Preparation
Method; SW-846 7.3.4.2
Sulfide, Reactive.
ND mglkg
290
1
05/02/19 20:42 05/02/19 20:53
REPORT OF LABORATORY
ANALYSIS
Thiszreporl shall not be reproduced, except in
full,
Date; 05/28/2019 05:02 PM
without the written consent of Pace Analytical Services, LL'C. Page 5 of 39
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 8 of 42

Fillffecled dat0fline: 014125/19 42:30
Preparation by Method 1311
Result
Analyte
1CLP Extraction
.Fluid 1
loitial pH 6.75
'Final,pH 4:58*
SAMPLE RESULTS - 01
L 1093187
Qualifier Prep
date I tinte,
W412019 9:46�.52 AM
WGI276052
514/2019 9AG;52.,AM
W0276052
5 1 1412019 9A6:52 AM
WG1276052
514/2019,9:46$2-AM
V1131776052
Chl.*ortilated Acid Herbicides (GQ by Method 8151A
Result
Qualifier ROL Limit
Dilution Analysis
Analyte
mg/I
111till Ing[l
(late/ Mw?
2,4,5-TP (Siivex)
NO
0,00200 1
1 05/061201916:58
2,4,D
N ' D
.0.00200 10
1 05t06!2019,16!58
(S) Z4-DichlotophenyJAcetic Acid
7S.8
14.0-158
05510612019 16:58
ACCOUNT:
PamAnalylfcal - Hunterville, NC
PROJECT: SDG:
92427047 L1093787
ONL LAB NA; 10MA11L)E.
Fri]
Batch
W G 1 276472
WG1276472
WG127.6472
El
E
Page 33 of 39
DATE/TIME:
05i071I9'1iA9 5 of'll
PO Box 228 9 Statesville, NC 28687 e 704/872/4697
Page 36 of 42

NCDA&CS Agronomic Division Phone: [phone]
Website: www.ncagr.gov/agronomi/
Report No. FY20-
,ir 41
"�
Client: Thomas Warren
Advisor: Zach Key
i •,
Predictive
1401 Alexis Lucia Rd.
Stanley, NC 28164
Southern Soil Builders,
Inc.
Mehlich-3 Extraction
Soil Report
958 Hoots Rd
.,
Sampled County :Gaston
Roaring River, NC 28669
Links to Helpful Information
Client ID: 478946
Advisor ID: 231531
Sampled: 11/18/2019
Received: 11/22/2019 Completed: 12/18/2019
Farm:
Sample ID: BT91
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tons/acre)
N P2O5
K2O Mg S Mn Zn
Cu B
Information
Lime History:
1-Fescue/OGrass/Tim, M 0.4
120-200 0
80 0 0 0 0
0 0
Note: 12
2 - 0.0
Test Results [units - WN in g/cm3; CEC and Na in meq/100 cm3; NO3-N in mg/dm3]:
Soil Class: Mineral
HM% WN CEC BS% Ac pH P-1 K-1
Ca% Mg% S-1
Mn-I Mn-All Mn-AI2 Zn-I Zn-Al
Cu-I Na ESP SS-1 NO3-N
0.56 0.91 9.3
82 1.7 5.8 250 28
66 14 67
275 182 1443 1443
855 0.2 2
Reprogramming of the laboratory -information -management system that makes this report possible is being funded
through a grant from the North Carolina Tobacco Trust Fund Commission.
Thank you for using agronomic services to manage nutrients and safeguard environmental quality.
- Steve Troxler. Commissioner of Agriculture

NCDA&CS Agronomic Division Phone: [phone] Website: www.ncagr.gov/agronomi/
Thomas Warren
Understanding the Soil Report: explanation of measurements, abbreviations and units
Recommendations
Lime
If testing finds that soil pH is too low for the crop(s) indicated, a lime recommendation will be given in units of either
ton/acre or Ib/1000 sq ft. For best results, mix the lime into the top 6 to 8 inches of soil several months before planting.
For no -till or established plantings where this is not possible, apply no more than 1 to 1.5 ton/acre (50 Ib/1000 sq ft) at
time, even if the report recommends more. You can apply the rest in similar increments every six months until the full r
is applied. If MG is recommended and lime is needed, use dolomitric lime.
Fertilizer
Recommendations for field crops or other large areas are listed separately for each nutrient to be added (in units of
lb/acre unless otherwise specified). Recommendations for N (and sometimes for B) are based on research/field studies
for the crop being grown, not on soil test results. K-1 and P-1 values are based on test results and should be > 50. If they
are not, follow the fertilizer recommendations given. If Mg is needed and no lime is recommended, 0-0-22 (11.5% Mg) is
an excellent source; 175 to 250 lb per acre alone or in a fertilizer blend will usually satisfy crop needs, SS-1 levels appear
only on reports for greenhouse soil or problem samples.
Farmers and other commercial producers should pay special attention to micronutrient levels. If $, pH$, $pH, C or Z
notations appear on the soil report, refer to $Note: Secondary Nutrients and Micronutrients_ In general, homeowners do not
need to be concerned about micronutrients. Various crop notes also address lime fertilizer needs; visit
ncagr.gov/agronomi/pubs.htm.
Report No.
Page
Report Abbreviations
Ac
exchangeable acidity
B
boron
BS%
% CEC occupied by basic cations
Ca%
% CEC occupied by calcium
CEC
cation exchange capacity
Cu-I
copper index
ESP
exchangeable sodium percent
HM%
percent humic matter
K-1
potassium index
K20
potash
Mg%
% CEC occupied by magnesium
MIN
mineral soil class
Mn
manganese
Mn-All
Mn-availability index for crop 1
Mn-AI2
Mn-availability index for crop 2
Mn-I
manganese index
M-O
mineral -organic soil class
N
nitrogen
Na
sodium
NO3-N
ORG
Recommendations for small areas, such as home lawns/gardens, are listed in units of Ib/1000 sq ft. If you cannot find pH
the exact fertilizer grade recommended on the report, visit www.ncagr.gov/agronomilobnart4.html sfind information that P-1
may help you choose a comparable alternate. For more information, read A Homeowners Guide to Fertilizer. P205
Test Results
The first seven values [soil class, HM%, W/V, CEC, BS%, Ac and pH] describe the soil and its degree of acidity. The
remaining 16 [P-I, K-I, Ca%, Mg%, Mn-I, Mn-All, Mn-AI2, Zn-I, Zn-AI, Cu-I, S-I, SS -I, Na, ESP, SS -I, NO3-N (not routinel
available)] indicate levels of plant nutrients or other fertility measurement. Visit www.ncagr.gov/agronomi/uyrst.htm
S-1
SS-1
WN
Zn-AI
nitrate nitrogen
organic soil class
current soil pH
phosphorus index
phosphate
sulfur index
soluble salt index
weight per volume
zinc availability index
Zn-I zinc index

ATHOGEN AND VECTOR ATTRACTION REDUCTION FORM (02T Rules)
Citv of Belmont
City of Belmont
WQ Permit Number: WQ0003281
NPDES Number: NCO21181
From 1/1/2019 To 12/31/2019
athogen Reduction (15A NCAC 02T .1106) - Please indicate level achieved and alternative performed:
Class A:
Alt. A (time/temp) [
Alt B (Alk Treatment) []
Alt. C (Prior Testing)[3
A1t.D (No Prior Test) [l
Process to Further Reduce Pathogengs El
If applicable to alternative performed (Class A only) indicate "Process to Further Reduce Pathogens":
Compost D
Heat Drying D
Heat Treatment Q
Thernmophilic Jj
Beta Ray C
Gamma. Ray
Pasteurization C
Class B:
jAlt. (1) Fecal Density
Alt. (2) Process to Significantly Reduce Pathogens D
If applicable to alternative performed (Class B only) indicate "Process to Significantly Reduce Pathogens":
Lime Stabilization Q
Air Drying 0
1 Composting �
Aerobic Digestion 0
Anaerobic Di esti o C7
g
_ ........ .... _ ....... ......:................,.. ............................... .
If applicable to alternative performed (Class A or Class B) complete the following monitoring data:
Parameter
Allowable Level
in
in Sludge
Pathogen Density
y
Number o
Excee-
ences
Frequency
of Analysis
Sample
Type
Analytical
ni h-
ue Tec
Minimur
Geo. Mean
Maximur
Units
Fecal Coliforrn
2 x 10 to the
6th power
per gram of
total solids
MPN
494
546
639
MPN/g
0
7
grab
sm9221
CFU
1000 mpn per gram
of total solid (dry
weight)
Salmonella bacteria
(in lieu of fecal
coliform)
3 MPN per 4 grams
total solid (dry
weight)
Vector Attraction Reduction (15A NCAC 02T .1107) - Please indicate alternative performed:
Alt.I (VS reduction) Il
Alt. 2 (40-day bench) 2
Alt. 3 (30-day bench) ®
I Alt. 4 (Spec. OZ uptake) C•.�
Alt. 5 (14-Day Aerobic) it
Alt. 6 (Alk. Stabilization El
Alt 7 (Drying - Stable) 0,
1Alt. 8 (Drying - Unstable)
Alt. 9 (Injection) [;1
Alt. 10 (Incorporation) El
No vector attraction reduction alternatives were performed 0
CERTIFICATION STATEMENT (please check the appropriate statement)
21 " I certify, under penalty of law, that the pathogen requirements in 15A NCAC 02T .1106 and the
vector attraction reduction requirement in 15A NCAC 02T .1107 have been met."
LJ "I certify, under penalty of law, that the pathogen requirements in 15A NCAC 02T .1106 and the
vector attraction reduction requirement in 15A NCAC 02T .1107 have not been met." (Please note
if you check this statement attach an explanation why you have not met one or both of the
requirements.)
"This determination has been made under my direction and supervision in accordance with the system
designed to ensure that qualified personnel properly gather and evaluate the information used to determine
that the pathogen and vector attraction reduction requirements have been met. I am aware that there are
significant penalties for false certification including fine and imprisonment."
of u c� a J12 v� , �.�il� P 51 �n�V i r�� enc�ehA - 0Qr, Dennis Key Southern Soil Builders, Inc.
Preparer Name and Title (type or print) Land Applier Name and Title (if applicable)(type or print)
LzbCA I a
Signature f Preparer* 0 Date Sign tore of Land Applier (if applicable) Date
*Preparer is defined in 40 CFR Part 503.9(r) and 15A NCAC 2T .l 102 (26)
DENR FORM PVRF 02T (12/2006)

l= pF:I\RFD
FEB '2 12019
DWR SECTION
iMF RWTION PROCESSING UNI i
2018
City of Belmont, WWTP
2018 Annual Report
Land Application Program
Permit No. WQ0003281
RECEIVEDINCDENRIDWR
r H' 2 5 ZO19
WQROS
MOORESVIL.LE REGIONAL OFFICE

ANNUAL LAND APPLICATION CERTIFICATION FORM
it#: WQ0003281
County:
Name (as shown on permit):
Gaston
Year: _ 2018
City of Belmont
nd Application Operator:
Southern Soil Builders, Inc. Phone: [phone]
Land application of residuals as allowed by the permit occurred during the past calendar year?
0 Yes 0 No - If No, skip Part A, and Part B and proceed to Part C. Also, If residuals were
generated but not land applied, please attach an explanation on how the residuals were handled.
Part A - Residuals Application Summary:
Total number of application fields in thepermit:
3
Total number of fields utilized for land application during the year:
I
Total amount of dry tons applied during the year for all application sites:
54.01
Total number of acres utilizes for land application during the year:
42
Part B - Annual Compiance Statement:
Facility was compliant during calendar year 2018 with all conditions of the land application permit
(including but not limited to items 1-13 below) issued by the Division of Water Resources. 0 Yes 0- No
If no please, provide a written description why the facility was not compliant, the dates, and explain corrective action
taken.
1) Only residuals approved for this permit were applied to the permitted sites.
2) Soil pH was adjusted as specified in the permit and lime was applied (if needed) to achieve a soil pH of at least 6.0 or
the limit specified in the permit.
3) Annual soils analysis were performed on each site receiving residuals during the past calendar year and three (3) copies
of laboratory results are attached.
4) Annual TCLP analysis (if required) was performed and three (3) copies of certified laboratory results are attached.
5) All other monitoring was performed in accordance with the permit and reported during the year as required and three
(3) copies of certified laboratory results are attached.
6) The facility did not exceed any of the Pollutant Concentration Limits in 15A NCAC 02T .l 105(a) or the Pollutant
Loading Rates in 15A NCAC 02T .1 105(b) (applicable to 40 CFR Part 503 regulated facilities).
7) All general requirements in as specified in the Land Application Permit were complied with (applicable to 40 CFR Part
503 regulated facilities).
8) All monitoring and reporting requirements in 15A NCAC 02T .l 1 1 1 were complied with (applicable to 40 CFR Part
503 regulated facilities).
9) All operations and maintenance requirements in the permit were complied with or, in the case of a deviation, prior
authorization was received from the Division of Water Resources.
10) No contravention of Ground Water Quality Standards occurred at a monitoring well or explanations of violations are
attached to include appropriate actions and remediations.
1 1) Vegetative cover was maintained and proper crop management was performed on each site receing residuals, as
specified in the permit.
12) No runoff of residuals from the application sites onto adjacent property or nearby surface waters has occurred.
13) All buffer requirements as specified on the permit were maintained during each application of residuals.
Part C - Certification:
"I certify, under penalty of law, that the above information is, to the best of my knowledge and belief, true, accurate,
and complete. I am aware that there are significant penalties for submitting alse information, including the
p7:10
ity of fines and imprisonment for knowing violations."
g. , )� , 6 L NI ".1'. a, .
Permitteepame and Title (typelor print) Signature of Permittee Date
Signature of Preparer*
Dafe Signature of Lanc(Applier
Date
(if different from Permittee� (if different from Permittee and Preparer)
* Preparer is defined in 40 CFR Part 503.9 (r) and 15A NCAC 02T .l 102 (26) DENR FORM ACF (12/2006)

ANNUAL RESIDUAL SAMPLING SUMMARY FORM
Please note that your permit may contain additional parameters to be analyzed. The parameters can be reported in FORM RSSF
WQ Permit Number: WQ0003281
Facility Name: City of Belmont
Residual Source WQ # or WQ0003281
NPDES #:
WWTP Name:
Residual Analvsis Data
City of Belmont
Laboratory:
1)
2)
3)
4)
5)
Waypoint
Parameter
(mg/kg)
Cone.
Limit
(mg/kg)
Sample or Composite Date
1-29-18
Percent Solids (%)
NA
2.73
Arsenic
75
3.84
Cadmium
85
2
Copper
4,300
288
Chromium
NA
26.8
Lead
840
16
Mercury
57
0.491
Molybdenum
75
69.2
Nickel
420
19
Selenium
100
5
Zinc
7,500
603
Total Phosphorus
NA
22000
TKN
NA
58400
Ammonia -Nitrogen
NA
3280
Nitrate and Nitrite
NA
128
For surface disposal facilities the ceiling concentration limits listed in this form are not applicable. Reference the individual permit for metals limits.
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed
to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant
penal &s for submitting false information including the possibility of fines and imprisonment for knowing violations."
467
Signature of Preparer Date
*Preparer is defined in 40 CFR Part 50.3.9(r) and 15A NCAC 2T .1102 (26) ,nizMP Pr)PnA

ANNUAL RESIDUAL SAMPLING SUMMARY FORM - B
Report all sampling analysis results for parameters not listed in FORM RSSF that are part of the WQ permit or were analyzed for over t
calendar year. Use additional forms as needed.
WQ Permit Number: WQ0003281
Facility Name:
Residual Source
NPDES # or WQ#:
WWTP Name:
Residual Analvsis Data
City of Belmont
WQ0003281
City of Belmont
Laboratory:
1)
2)
3)
4)
5)
Waypoint
Parameter
(mg/kg)
Sample or Composite Date
1-29-18
Moisture
97.26
Potassium
3310
Sulfur
8010
Calcium
12300
Magnesium
2930
Sodium
1780
Iron
24500
Aluminum
9760
Manganese
1010
Organic N
55120
pH
6.1
SAR
0.873
PAN
18304
"T rnrtify iinr�Pr nPnalty of law that thig ilnoutment waQ "repared ■ivntMler my dnreet:ou nr u'.:t^.e:Y.�.vu;. ac�vrdance `Y..th a ox—f u
r
designed to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are
significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
Signature of Prepare-
*Preparer is defined in 4 CFR Part 503.9(r) and 15A NCAC 2T .1102 (26)
Date
DEER FORM RSSF - R (12i2006)

Acres Used:
ANNUAL METALS FIELD LOADING SUMMARY FORM*
this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
City of Belmont Total Dry Tons Applied (Annual):
WQ0003281 Cation Exchange Capacity (non 503 only):
Lori Warren Owner: Lori Warren Predominant Soil Series:
42 Acres Permitted: 42 Site #: BT 9-1
54.01
GaB2
Field #: BT 9-1
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw :Percent #):
Sample or
Com-
posite
Date
1
1/29/18
2
3
4
5
6
10
11
12
% Solids
2.73
Arsenic
3.84
Cadmium
2
Copper
288
Chromium
26.8
Lead
16
Mercury
0.491
Molyb-
denum
69.2
Nickel
19
Selenium
5
Zinc
603
Total
Phos-
horus
22000
Annual Heavy Metal Field Loadings (Calculated in lbs/acre):
Total
1r7
i0
App.
Event
l 0 1
1 III
1 111
1 III
1 III
1 III
1 III
1 111
1 III
1 Ile
1 IOI
1 III
1 1 1
1 11
I III
1 111
1 111
1 III
1 III
1 III
1 101
1 III
1 111
I all
1 Ill
III
...-
1�
1 III
1 III
t Ile
1 110
a 111
1 111
1 Ie0
1 III
1 111
1 lel
1 111
1�
1 le°
1 111
1 111
1 111
1 III
1 111
a III
1 001
1 111
1 111
1 141
1 101
1 1••
e e�
a eee
a eee
a eee
a eee
a ell
a eel
a lee
a eee
I III
a lel
1 III
I I�
Ile
1 111
1 ell
a 111
1 ell
1 III
1 111
1 lee
a ell
1 eel
1 111
1 III
Ill
�' '
1
1 ell
1 eee
1 Ile
1 eee
1 111
1 III
1 111
1 111
1 III
1 IIIMM
1 1�•
1 lel
1 ell
1 lee
I III
1 Ile
I Ile
1 ell
1 III
1 Ile
1101
1 III
1 e•.
1 1
1 111
1 eel
1 III
1 III
1 111Im
Ile
1 I01
1 III
1 lle
1 III
a ell
KIT#=
'®®
1 III
1 III
1 111
1 III
1 III
1 III
1 III
1 III
1 III
1 111
I Ill
Total
• •
M
1 III
1 eel
1 IeI
1 ell
1 Ill
1 III
1 101
1 III
1 III
1 IIIMM
certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
imprisonment for knowing violations".
Signat re of Land (pplier
1 -d 3- ) 014,
Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: City of Belmont
Land Owner: Lori Warren
Operator: Lori Warren
Crop 1 Name: Fescue
WQ Permit #: WQ0003281 Field #: BT 9-1
Annual Dry Tons Applied: 54.0176 Site #: BT 9-1
Predominant Soil Series: GaB2
Crop 1 Max. PAN: 211 Crop 2 Name:
Acres Utilized: 42
Acres Permitted: 42
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
_
o r
o
Q
Volume applied
PP
enter one Solids/
( )
Liquid
Cu. Yds Gallons
o
/o
Solids
Volume
Applied per
PP P
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#.
Fert., Animal
Waste, etc)
Soil
Cond.
D
( ry
Wet
Moist)
Precip.
Past 24
Hrs.
Inches
D
K �
cc __
- "
n w
o
�, _
fD F.
o
70
-,
w
x -
r4
TKN
mg/kg
z D
^,' B
o D
CD ❑
w
mglkg
Nitrate
and
Nitrite
mglkg
PAN Applied
( Ibs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
9-2018
474500
2.73
1.286
WQ0003281
Dry
0
s
0.5
0.3
58400
3280
128
47.083
NA
Fescue
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.600
0.000
0.000
0.000
0.000
0:000
0.000
Residuals Applications totals on FORM FSF supp ( attach FORM
FSF supp to this form):
TOTALS:
01
474500
>.:;
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
41.083
0,000
Lime Applied
Annual
lbs/acre
0.010
0.005
0.741
0.069
0.041
0.001
6.178
0.049
0.013
1.551
56.584
.. `
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.362
0.372
36
0.116
0.121
34
24.966
25.707
NA
28.908
28.977
1338
3.394
3.435
267
0.057
0.058
15
0.186
0.364
NA
1.841
1.890
374
0.172
0.185
89
130.096
131.647
2498
0
Current Cumulative lbs/ac
Permitted C. P. L. R.****
Permit PAN Limit lst/2nd Crop
_..
211
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the inforn-ration submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
Signature of Land Applier
I - -du(
Date
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
*** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate

Page: 1 of 2
Report Number: 18-033-0208
Account Number: 46381
Send To: Southern Soil Builders
Dennis Key
958 Hoots Road
Roaring River, NC 28669
Waypoint 0 0
ANALYTICAL
Project : Belmont
7621 Whitepine Road, Richmond, VA 2323
Main 804-743-9401 0 Fax [phone]
www.waypointanalytical.com
REPORT OF ANALYSIS Date Sampled: 1/29/2018 14:30:00
Lab Number: 58432 Date Received: 02/02/2018 00:00
Sample Id : Belmont Date Reported: 02/12/2018
-1-1 -.1-
Z./d
z13Uu
100.0
JM
02/02/2018 13:45
Moisture .
97.26
100.0
JM
02/02/2018 13:45
Total Kjeldahl Nitrogen
5.84
58400
50.0
R D
02/05/2018 08:30
Total Phosphorus
2.20
22000
100
MOS
02/09/2018 16:29
Total Potassium
0.33
3310
100
MOS
02/09/2018 16:29
Total Sulfur
0.80
8010
100
MOS
02/09/2018 16:29
Total Calcium
1.23
12300
100
MOS
02/09/2018 16:29
Total Magnesium
0.29
2930
100
MOS
02/09/2018 16:29
Total Sodium
0.18
1780
100
MOS
02/09/2018 16:29
Total Iron
24500
100
MOS
02/09/2018 16:29
Total Aluminum
9760
100
MOS
02/09/2018 16:29
Total Manganese
1010
5.00
MOS
02/09/2018 16:29
Total Copper
288
5.00
MOS
02/09/2018 16:29
Total Zinc
603
5.00
MOS
02/09/2018 16:29
Ammonia Nitrogen
0.33
3280
50.0
R D
02/05/2018 08:30
Organic N
5.51
55120
50.0
02/05/2018 08:30
Nitrate+ N itrite- N
128
2.29
MMT
02/06/201812:37
All values are on a dry weight
basis except as noted by
asterisk. Detection limit on all N series is on a wet basis.
SM-2540G
SM-2540G
SM-4500-NH3C-TKN
6010C
6010C
6010C
6010 C
6010C
6010C
6010C
6010C
6010C
6010C
6010C
SM-4500-NH3C
CALCULATION
4500NO3P-2011
Pauric McGroary
AaronomiSt

Page: 2 of 2
Report Number: 18-033-0208
Account Number: 46381
Send To: Southern Soil Builders
Dennis Key
958 Hoots Road
Roaring River, NC 28669
Waypoint-G
ANALYTICAL
Project : Belmont
7621 Whitepine Road, Richmond, VA 232
Main 804-743-9401 ° Fax [phone]
www.waypointanalytical.com
REPORT OFANALYSIS Date Sampled: 1/29/2018 14:30:00
Lab Number: 58432 Date Received: 02/02/2018 00:00
Sample Id :Belmont Date Reported: 02/12/2018
<z.uu
2.00
MOS
02/09/2018 16:29
6010C
Total Chromium
26.8
5.00
MOS
02/09/2018 16:29
6010C
Total Nickel
19.0
5.00
MOS
02/09/2018 16:29
6010C
Total Lead
16.0
5.00
MOS
02/09/2018 16:29
6010C
Total Arsenic
3.84
3.00
MOS
02/09/2018 16:29
6010C
Total Mercury
0.491
0.400
MOS
02/09/2018 15:39
SW-7471 B
Total Selenium
<5.00
5.00
MOS
02/09/2018 16:29
6010C
pH *
6•1
1.0
JM
02/05/2018 08:30
9045D
Total Molybdenum
69.2
5.00
MOS
02/09/2018 16:29
6010C
Comments:
NC CERT#257, SC CERT#9300 7001
SULFUR AND ORGANIC NITROGEN NOT FOR COMPLIANCE PURPOSES.

PAN
Mineralization
Rate TKN NH3 NO3
0.3 58400 3280 1 128
PAN Surface
18304 mg/kg 36.608 lbs/dry ton
10! 8 Ibs total PAN
#DIV/0! Ilbs PAN/acre
PAN Injection
19944 mg/kg 39.888 lbs/dry ton
11966.4 Ibs total PAN
#DIV/0! jibs PAN/acre
Dry Tons/1000 gal.
0.113841
1st year PAN
Surface lbs.
10982.4
1st year PAN
Injected lbs.
11966.4
lbs./acre
Surface
#DIV/0!
lbs./acre
Injected
#DIV/0!
as decimal ITotal dry JAcres
NO2 % Solids t_ ons/year Applied on
0 0.0273 300
MR(TKN-NH3)+ + .5(NH3)+NO3+NO2 =mg/kg
mg/kg x .002 =Ibs/dry ton
MR(TKN-NH3) + 1(NH3)+NO3+NO2 =mg/kg
mg/kg x .002 =Ibs/dry ton
1000 X 8.34 X %solids X sp. gravity
2000
"=dry tons/1000gal."

SAR
Sodium Absorption Ratio
Na: Sodium (Mg/L) Equivalent weight: 23
Ca: Calcium (Mg/L) Equivalent weight: 20
Mg : Magnesium (Mg/L) Equivalent weight: 12
Milli Equivalent = Mg/L / Equivalent weight
Na M /L Ca M /L M- (Mg/L)
68.85 1 335.79 179.989
Na ME
Ca ME
M ME
2.993478
1 16.7895
1 6.66575
SAR= Na Milli Equivalent/f 0.5 X (Ca Milli Equivalent + Mg Milli equivalent)]0.5 power
SAR = 0.87412 (From Mg/L entered above)
SAR= 0.873016 (From ME entered below)
Na (ME)
Ca (ME)
M ME
2.99
1 16.79
1 6.67
The amount of exchangeable sodium ions ver
amount of exchangeable calcium & magnesiu
Permitting guidance is if greater than 10 requi

Analytical Results
Southern Soil Builders
958 Hoots Road
Roaring River, NC 28669
Receive Date:
01 /29/2018
Reported:
01/31/2018
For:
Belmont
Comments:
Geometric Mean <684 MPN/g
Sample Number Parameter Sample ID Result Unit Method Analyzed Analyst
180129-09-01
Fecal Coliforms
B1
<635
MPN/g
SM92210E-2006
01/30/2018
WC
180129-09-01
Percent Solids
131
3.15
%
SM2540B-1997
01/30/2018
WC
180129-09-02
Fecal Coliforms
132
<769
MPN/g
SM92210E-2006
01/30/2018
WC
180129-09-02
Percent Solids
B2
2.60
%
SM2540B-1997
01/30/2018
WC
180129-09-03
Fecal Coliforms
63
<702
MPN/g
SM92210E-2006
01/30/2018
WC
180129-09-03
Percent Solids
B3
2.85
%
SM254OB-1997
01/30/2018
WC
180129-09-04
Fecal Coliforms
64
<662
MPN/g
SM92210E-2006
01/30/2018
WC
180129-09-04
Percent Solids
B4
3.02
%
SM254OB-1997
01/30/2018
WC
180129-09-05
Fecal Coliforms
B5
<643
MPN/g
SM92210E-2006
01/30/2018
WC
180129-09-05
Percent Solids
135
3.11
%
SM2540B-1997
01/30/2018
WC
180129-09-06
Fecal Coliforms
136
<687
MPN/g
SM92210E-2006
01/30/2018
WC
180129-09-06
Percent Solids
136
2.91
%
SM2540B-1997
01/30/2018
WC
180129-09-07
Fecal Coliforms
137
<702
MPN/g
SM92210E-2006
01/30/2018
WC
180129-09-07
Percent Solids
67
2.85
%
SM2540B-1997
01/30/2018
WC
Respectfully submitted,
tOO. -VIA, J-Y' 'It
Dena Myers
NC Cert #440,
NCDW Cert #37755,
EPA #NC00909
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 1 of 3

Condition of Receipt
Number 180129-09-01 Temp on Arrival:
Parameter Schedule: Percent Solids
Received on Ice
Parameter Schedule: Fecal Coliforms
Sodium Thiosulfate Received on Ice
Chemicals in containers, lab
Sample Number 180129-09-02 Temp on Arrival:
Parameter Schedule: Percent Solids
Received on Ice
Parameter Schedule: Fecal Coliforms
Sodium Thiosulfate Received on Ice
Chemicals in containers, lab
Sample Number 180129-09-03 Temp on Arrival:
Parameter Schedule: Percent Solids
Received on Ice
Parameter Schedule: Fecal Coliforms
Sodium Thiosulfate Received on Ice
Chemicals in containers, lab
Sample Number 180129-09-04 Temp on Arrival:
Parameter Schedule: Percent Solids
Received on Ice
Parameter Schedule: Fecal Coliforms
Sodium Thiosulfate Received on Ice
Chemicals in containers, lab
Sample Number 180129-09-05 Temp on Arrival:
Parameter Schedule: Percent Solids
Received on Ice
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 2 of 3

Parameter Schedule: Fecal Coliforms
Sodium Thiosulfate Received on Ice
Chemicals in contai
Sample Number 180129-09-06 Temp on Arrival:
Parameter Schedule: Percent Solids
Received on Ice
Parameter Schedule: Fecal Coliforms
lab
Sodium Thiosulfate Received on Ice
Chemicals in containers, lab _
Sample Number 180129-09-07 Temp on Arrival:
Parameter Schedule: Percent Solids
Received on Ice
Parameter Schedule: Fecal Coliforms
Sodium Thiosulfate Received on Ice
Chemicals in containers, lab
PO Box 228 • Statesville, NC 28687 704/872/4697
Page-3 of 3

Analytical Results
Southern Soil Builders
958 Hoots Road
Roaring River, NC 28669
Receive Date: 01/29/2018
Reported: 03/07/2018
For: BELMONT'
Comments:
Sample Number Parameter Sample ID Result Unit Method Analyzed Analyst
180129-20-01 30 Day Benchscale Belmont
180129-20-01 TCLP Belmont
Respectfully submitted,
Dena Myers
NC Cert #440,
NCDW Cert #37755,
EPA #NC00909
12.2 % EPA625-R-92/0 01 /29/2018 WC
See Attached as Noted 02/14/2018 PACE
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 1 of 29

Analytical Results
Southern Soil Builders For: Belmont
958 Hoots Road
Roaring River NC 28669
Entered: 01/29/2018
Reported:03/07/2018
Sample ID: 180129-20-01
PARAMETER: Vector Attraction Reduction/Aerobically Digested Sludge (30day)
Total Solids Volatile Solids % Volatile Solids
Week 1 1.63 0.96 0.5902
Week 2 1.67 0.99 0.5927
Week 3 1.51 0.82 0.5408
Week 4 1.38 0.77 0.5566
Week 5 1.43 0.80 0.5584
Volatile Solids Reduction:
Respectfully submitted,
Dena Myers
Statesville Analytical, Inc.
NC WW Cert.# 440NC
DW Cert. #37755
i.SyUZ - U.5584 X 100 = 12.2%
0.5902 - (0.5902 X 0.5584)

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MTESVILLE ANALYTICAL
122 Court Street • P.O. Box 228
t, Statesville, NC 28687
(704) 8724697
Address: ff S$
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Contact Person:
jt
Pntxte #
FAXN 3 )
Sc)
Chain of
Custody Record
PO # Requisitioned by: (rime Date)
Customer
Sample IDfI
Lab 1D N
Time Sampled
(Grab Only)
,-(Grab
Date Sampled
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Matrix
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Relinquished by:
Received by:
Relinquished by:
Received by:
Composite Sampling
Time begin
Time end
Composite Sampling
Time begin
Time end
#1:
am, pm Date _/
am, pm Date _/
#2:
am, pm Date
am, pm Date
/_
/_
/
Time a' fj) am, rr Date
Time am, pm Date
Time am, pm Date
Time am, pm Date
Lab Comments:
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Sampled by:
Transported by:
Holding times met: r�
Compliance work:
Non-compliance work:
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Analytical
aw,vpaWabs.com
ANALYTICAL RESULTS
Project: 180129-20
Pace Project No.: 92371512
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersv'lle, NC: 28078
[phone]
i
Sample: 180129-20 Lab ID: 92371512001 Collected: 01129118 13:30 Received: 01/31/18 09:53 Matrix: Solid
Results reported on a "dry weight" basis and are adjusted for percent moisture, sample size and any dilutions.
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Clual
8081 GCS Pesticides, TCLP Analytical Method: EPA 8081 Preparation Method: EPA 3510
Leachate Method/Date: EPA 1311; 02/12/18 14:36
amma-BHC (Linda
g ne)
ND
ug/L
0.50 1
02113/1816:02 02/14/18 12:57 58-89-9
Chlordane (Technical)
ND
ug/L
3.0 1
02/13118 16:02 02/14/18 12:57 57-74-9
Endrin
ND
ug/L
0.50 1
02113/1816:02 02114/1812:57 72-20-8
Heptachlor P
ND
uglL
0.50 1
02/13/18 16:02 02/14/18 12:57 76-44-8
Heptachlor epoxide
ND
ug/L
0.50 1
02/13/18 16:02 02/14/18 12:57 1024-57-3
Methoxychlor
ND
ug/L
1000 1
02/13/18 16:02 02114/1812:57 72-43-5
ToxaphenSurrogates
ND
ug/L
3.0 1
02113/1816:02 02/1411812:57 8001-35-2
Surro
urrogaatete s
Decachlorobiphenyl(S)
28
%
10-138 1
02/13/18 16:02 02/14/18 12:57 2051-24-3
Tetrachloro-m-xylene (S)
41
%
10-110 1
02/13/18 16:02 02/14/18 12:57 877-09-8
8151 Chlorinate Herbicide TCLP
Analytical Method: EPA8151
i
Preparation Method: EPA 3510
2,4-D
ND
mg/L
0.010 1
02/07/18 18:56 02/13/18 00:46 94-75-7
2,4,5-TP (Silvex)
Surrogates
ND
mg/L
0.010 1
02/07/18 18:56 02/13/18 00:46 93-72-1
2,4-DCAA (S)
75
%
39-139 1
02/07/18 18:56 02/13/18 00:46 19719-28-9
6010 MET ICP, TCLP
Analytical Method: EPA 6010
Preparation Method: EPA 3010A
Leachate Method/Date:
EPA 1311; 02101/18 18:00 Initial
pH: 4.85; Final pH: 4.5
Arsenic
ND
mg1L
0.050 1
02/02/18 21:55 02/06/18 11:43 7440-38-2
Barium
ND
mg/L
0.25 1
02/02/18 21:55 02/06/18 11:43 7440-39-3
Cadmium
ND
mg1L
0.0050 1
02/02/18 21:55 02/06/18 11:43 7440-43-9
Chromium
ND
mg/L
0.050 1
02/02/18 21:55 02/06/18 11:43 7440-47-3
Lead
ND
mg/L
0.025 1
02/02/18 21:55 02/06/18 11:43 7439-92-1
Selenium
ND
mg/L
0.10 1
02/02/18 21:55 02/06/18 11:43 7782-49-2
Silver
ND
mg/L
0.025 1
02/02/18 21:55 02/06/18 11:43 7440-22-4
7470 Mercury, TCLP
Analytical Method:
EPA 7470 Preparation Method: EPA 7470
Leachate Method/Date: EPA 1311; 02/01/18 18:00 Initial
pH: 4.85; Final pH: 4.5
Mercury
ND
mg/L
0.00020 1
02/02/18 21:45 02/12/18 10:51 7439-97-6
8270 MSSV TCLP Sep Funnel
Analytical Method:
EPA 8270 Preparation Method: EPA 3510
Leachate Method/Date: EPA 1311; 02/12/18 14:36
1,4-Dichlorobenzene
ND
ug/L
50.0 1
02/13/18 11:28 02/14/18 11:42 106-46-7
2,4-Dinitrotoluene
Hexachloro-1,3-butadiene
ND
ND
ug/L
50.0 1
02/13/18 11:28 02/14/18 11:42 121-14-2
Hexachlorobenzene
ND
ug/L
50.0 1
02113/1811:28 02/14/18 11:42 87-68-3
Hexachloroethane
ND
ug/L
50.0 1
02/13/18 11:28 02/1411811:42 118-74-1
2-Methylphenol(o-Cresol)
ND
ug1L
ug/L
50.0 1
50.0
02/13/18 11:28 02114/1811:42 67-72-1
3&4-Methylphenoi(m&p Cresol)
ND
ug/L
1
50.0
02/13/18 11:28 02/14/18 11:42 95-48-7
Nitrobenzene
ND
1
02/13/18 11:28 02/14/18 11:42 15831-10-4
Pentachlorophenol
ND
ug/L
50.0 1
02/13/18 11:28 02/1411811:42 98-95-3
Pyridine
ug/L
100 1
02113/1811:28 02/14/18 11:42 87-86-5
2,4,5-Trichlorophenol
ND
ND
ug/L
50.0 1
02113/1811:28 0211411811:42 110-86-1
2,4,6-Trichlorophenol
ND
ug/L
50.0 1
02113/1811:28 02/14/18 11:42 95-95-4
ug/L
50.0 1
02113/1811:28 02/14/18li:42 88-06-2
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except In full,
Date: 02/14/2018 04:32 PM without the written consent of Pace Analytical Services, I.I.C. Pige 5 of 26
PO Box 228 • Statesville, NC 28687 e 704/872/4697
Page 8 of 29

I
Pace Analytical Service:;, LLC
Analytical 9800 Kincey Ave. Suite 100
wew.pacelabs.cHuntersville, NC 28078
[phone]
I
ANALYTICAL RESULTS
Project: 180129-20
Pace Project No.: 92371512
Sample: 180129-20 Lab ID: 92371512001 Collected: 01/29/18 13:30 Received: 01/31/18 09:53 Matrix: Solid
Results reported on a "dry weight" basis and are adjusted for percent moisture, sample size and any dilutions.
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. i Qual
8270 MSSV TCLP Sep Funnel
Analytical Method: EPA 8270 Preparation Method: EPA 3510 j
Leachate Method/Date: EPA 1311; 02/12/18 14:36
Surrogates
Nitrobenzene-d5 (S)
47 %
12-102
1
02113/18 11:28 02/14/16 11:42 4165-60-0
2-Fluorobiphenyl(S)
37 %
13-107
1
02113/18 11:28 02114/18 11:42 321-60-8
Terphenyl-d14 (S)
49 %
21-132
1
02113/18 11:28 02/14/18 11:42 1718-51-0
Phenol-d6 (S)
11 %
10-110
1
02/13/18 11:28 02/14/18 11:42 13127-88-3
2-Fluorophenol(S)
20 %
10-110
1
02/13/18 11:28 02/14/18 11:42 367-124
2,4,6-Tribromophenol (S)
52 %
27-108
1
02/13/18 11:28 02/14/18 11:42 118-79-6
8260 MSV TCLP
Analytical Method: EPA 8260 Leachate Method/Date: EPA 1311; 02/06/18 11:17
Benzene
ND ug/L
100
20
02108/1811:36 71-43-2
2-Butanone (MEK)
ND ug/L
200
20
02/08/18 11:36 78-93-3
Carbon tetrachloride
ND ug/L
100
20
02/08/18 11:36 56-23-5
Chlorobenzene
ND_ ug/L
100
20
02108/18 11 :36 108-90-7
Chloroform
ND ug/L
100
20
02/08/18 11:36 67-66-3
1,4-Dichlorobenzene
ND ug/L
100
20
02/08/18 11:36 106-46-7
1,2-Dichloroethane
ND ug/L
100
20
02/08/18 11:36 107-06-2
1,1-Dichloroethane
ND uglL
100
20
02/08/1811:36 75-35-4
Tetrachloroethene
ND ug/L
100
20
02/08/18 11:36 127-18-4
Trichloroethene
ND ug1L
100
20
02/08/18 11:36 79-01-6
Vinyl chloride
ND ug1L
100
20
02/08/18 11:36 75-01-4
Surrogates
1,2-Dichloroethane-d4 (S)
104 %
70-130
20
02/08/18 11:36 17060.07-0
Toluene-d8 (S)
104 %
67-135
20
02/08/18 11:36 2037-26-5
4-Bromofluorobenzene(S)
97 %
70-130
20
02/08118 11:36 460-00-4
Percent Moisture
Analytical Method: ASTM D2974-87
Percent Moisture
97.3 %
0.10
1
02/01/18 11:53
1010 Flashpoint,Closed Cup
Analytical Method: EPA 1010
Flashpoint
>200.0 deg F
70.0
1
02/06/18 00:25
9045 pH Soil
Analytical Method: EPA 9045
pH at 25 Degrees C
4.4 Sid. Units
0.10
1
02/03/18 03:02 H1
733C S Reactive Cyanide
Analytical Method: EPA 9014 Preparation
Method: SW-846
7.3.3.2
Cyanide, Reactive
ND mglkg
37.0
1
02/05/18 16:09 02/05/18 22:18
734S Reactive Sulfide
Analytical Method: SM4500S2F-00 Preparation
Method: SW-846 7.3.4.2
Sulfide, Reactive
ND mg/kg
370
1
02/05/18 16:09 02/05/18 21:35
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 02114/2018 04:32 PM without the written consent of Pace Analytical Services, LLC. Page 6 of 26
i
PO Box 228 e Statesville, NC 28687 • 704/872/4697
Page 9 of 29

i
Pace Analytical Services, LLC
W
aceAnalytical
9800 Kincey AvI . Suite 100
Huntersville, NC 28078
wmv.pacelabs.com
(71 4)875.9092
ANALYTICAL RESULTS
�
Project: 180129-20
I
Pace Project No.: 92371512
Sample: 180129-20 PCB
Lab ID; 92371512002
Collected: 01/29/18 13:30
Received: 01/31/18 09:55 Matrix: Water
Parameters
Results
Units
Report Limit DF
Prepared Analyzed CAS No. Qual
8082 GCS PCB
Analytical Method: EPA8082
Preparation Method: EPA 3510 -
PCB-1016 (Aroclor 1016)
ND
ug/L
5.0 1
02/14/18 09:20 02/14/18 12:56 12674-11-2
I
PCB-1221 (Aroclor 1221)
ND
ug/L
5.0 1
02/14/18 09:20 02/14/18 12:56 11104-28-2
PCB-1232 (Aroclor 1232)
ND
ug/L
5.0 1
02/14/18 09:20 02/14/18 12:56 11141-16-5
PCB-1242 (Aroclor 1242)
ND
ug/L
5.0 1
02/14/18 09:20 02114/18 12:56 53469-21-9
PCB-1248 (Aroclor 1248)
ND
ug/L
5.0 1
02/14/18 09:20 02114/18 12:56 12672-29.6 j
PCB-1254 (Aroclor 1254)
ND
ug/L
5.0 1
02/14/18 09:20 02/14/18 12:56 11097-69-1
PCB-1260 (Aroclor 1260)
ND
ug/L
5.0 1
02/14/18 09:20 02/14/18 12:56 11096-82-5
Surrogates
Decachlorob)phenyl(S)
15
%
10-132 1
02/14/18 09:20 02/14/18 12:56 2051-24-3
Date: 02114/2018 04:32 PM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
Page 7 of 26
i
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 10 of 29

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Client: 1+(� o�-n Q - 1 Jo t nc
STATESVILLE ANALYTICAL
122 Court Street • Y.O. Box 228
Statesville, NC 28687
[phone]
Address: Q %
S� r7 0�
39, �
Contact Person:
`t
Phone #
336� gs� '7S7
FAX#
336-,r s-)- 89-1 ti
ain of
Chain
Custody Record
PO # Requisitioned by: (Time Date)
Customer
Sample ID#
Lab-10 #
Time Sampled
(Grab Only)
Date Sampled
(Grab Only)
Matrix
w ww
Parameters requested for analysis
Relinquished by:
Received by:
Relinquished by:
Received by:
Composite Sampling #1:
Time begin am, pm Date _/_/_
Time end am, pm Date /_/_
Composite Sampling #2•
Time SU
Time L
Time
Time
Lab Comments:
am, jDate L /� t�
am, rpm Date` /2 N
am, pm Date _/_/_
am, pm Date _/_/_
Sampled by: 2 14,
Transported by: z i�
Holding times met:
Compliance work:
Non-compliance work:
Time begin
Time end
am, pm Date —/ /_
am, pm Date /

AL PATHOGEN AND VECTOR ATTRACTION REDUCTION FORM (02T Rules)
Irity Name: City of Belmont WQ Permit Number: WQ0003281
WTP Name: City of Belmont NPDES Number: NCO021181
Monitoring Period: From 1/1/2018 To 12/31/2018
Pathogen Reduction (15A NCAC 02T .1106) - Please indicate level achieved and alternative performed:
Class A: Alt. A (time/temp) L� 1 Alt B (Atk Treatment)[] Alt. C (Prior Testing)EI
AIt.D (No Prior Test) ® I Process to Further Reduce Nthogengs
If applicable to alternative performed (Class A only) indicate "Process to Further Reduce Pathogens":
Compost Li Heat Drying U Heat Treatment Cj Them lophilic
Beta Ray 13 Gamma Ray ❑ Pasteurization 11
Class B: JAIL (1) Fecal Density Cj Alt. (2) Process to Significantly Reduce Pathogens C_I
If applicable to alternative performed (Class B only) indicate "Process to Significantly Reduce Pathogens":
Lime Stabilization 1l Alr Drying [I I Composting EJ lAerolbic Diaestion l�
Anaerobic
obic Dig
estion ge s on
b
If applicable to alternative performed (Class A or Class B) complete the following monitoring
data:
Parameter
Allowable Level
Pathogen Density
Number o
Fre �enc
Sample
naytica
in
in Sludge
Excee-
of An�alys
s
Type
Tech -
MinimumGeo.
Mean
Maximu
Units
ce
e
2 x 10 to the
6th power
MPN
635 a
684
769
MPN/ g
0
grab
sm9221
per gram of
Fecal Coliform
total solids
CFU
1000 mpn per gram
T—
of total solid (dry
Salmonella bacteria 3 MPN per 4 grams
(in lieu of fecal total solid (dry
coliform) weight)
Vector Attraction Reduction (15A NCAC 02T _1107) - P1PncP indinarp oltn..,nf;.,o .,.,. c ..,, a.
Alt.1 (VS reduction) [J
Alt. 5 (14-Day Aerobic) 0
Alt. 2 (40-day bench) Q
Alt. 6 (Alk. Stabilization [j
Alt. 3 (30-day bench) 21 jAlt. 4 (Spec. OZ uptake)
Alt 7 (Drying - Stable) El Alt. 9; (Drying - Unstable) Q
Alt. 9 (Injection) [l
!'ITT TYT TIr rl a . r, r., .
Alt. 10 (Incorporation) p
No vector attraction reduction alternatives were performedEl
V lJA\A KA, At rally/1I 01L-X 1L` 1X1L` 1\ 1 �Niease cuecx the appropriate statement)
P-1 "I certify, under penalty of law, that the pathogen requirements in 15A NCAC 02T .1106 and the
vector attraction reduction requirement in 15A NCAC 02T .1107 have been r et.."
u "I certify, under penalty of law, that the pathogen requirements in 15A NC,�C 02T .1106 and the
vector attraction reduction requirement in 15A NCAC 02T .1107 have not been ;met." (Please note
if you check this statement attach an explanation why you have not met one or both of the
requirements.)
"This determination has been made under my direction and supervision in accordance' with the system
designed to ensure that qualified personnel properly gather and evaluate the information used to determine
that the pathogen and vector attraction reduction requirements have been met. I am alwaire that there are
significant penalties for false certification including fine and imprisonment."
Preparer Name and Title (type or print)
JL dA6 V n�4
Signature of Preparer D�eq
Land Applier Nam and Title (if a
Signature of Land Applier (if appl
*Preparer is defined in 40 CFR Part 503.9(r) and 15A NCAC 2T .1102 (26)
�c ( Qv; de/�l
licable)(type or print)
Date
DENR FnRM P\/RF n-)T (Iw9nnr,1

NCDA&CS Agronomic Division Phone: [phone] Website: www.ncagr.gov/agronomi/
Predictive Client:
Thomas Warren Advisor:
Report No. FY19-SL008256
Zach Key
�f� F'
1401 Alexis Lucia
' �'-1
?•,: _•5= Soil ReportMehlich-3 Extraction
Rd.
Stanley, NC 28164
y
Southern Soil Builders, Inc.
.Roaring
958 Hoots Rd
River, NC 28669
Links to Helpful Information Sampled: 10/08l2018
Sampled County : Gaston
Received: 10/15/2018
Farm: Not Provided
Completed: 10/26/2018
Client ID: 478946
Advisor 1D: 231531
Sample ID: BT91
Recommendations: Lime
Nutrients (lb/acre)
Lime History:
Crop (tons/acre) N P2Os
1-Fescue/OGrassrrim, M 0.0 120-200 0
K2O Mg S Mn Zn
Cu B
More
Information
2 - 0.0
70 0 0 0 0
0 0
Note: 12
Test Results [units - WN in 9/cnr3; CEC and Na in meq/100 crrit; NO3-N in
mg/dO]:
Soil Class: Mineral
HM % WN CEC BS% Ac pH P-1 K-1 Ca % Mg %
S-1 Mn-1 Mn-All Mn-Al2 Zn-I Zn-AI
Cu-1 Na ESP SS-1 NO3-N
0.46 1.02 11.0 86 1.5 6.2 145 32 66 19
58 1054 646 1n33 10.11
AIR n 1) O
North Carolina
Tobacco Trust Fund Commission
Reprogramming of the laboratory -information -management system that makes this report possible is
being funded through a qrant from the North Carolina Tobacco Trust Fund Commission.
Thank you for using agronomic services to manage nutrients and safeguard environmental quality.
- Steve Troxler, Commissioner of Agriculture

Schutte, Maria
From: Schutte, Maria
Sent: Friday, March 09, 2018 5:04 PM
To: '[e-mail]'
Cc: '[e-mail]';'[e-mail]'; Gregory, Sonia
Subject: WQ0003281 Belmont RLAP 2017 AR
Attachments: WQ0003281_2017AR_SARck.J PG
Mr. Miller,
This email will serve as the Acknowledgement of Receipt for the referenced annual report. The Mooresville Regional Office
received a copy on February 26th, 2018. The information submitted appears to be in accordance with program
requirements. There is one minor item: by my calculations the Sodium Absorption Ratio = 2.26 NOT 4.10 as reported. It
appears there is an error in the table for the Calcium (Mg/L) value, which I show as 372.96 NOT 32.796. Again this is a minor
item, just noted for future reference. Please contact me with any questions.
Sincerely,
Maria
Maria Schutte
Environmental Specialist
Water Quality Regional Operations Section
Division of Water Resources
North Carolina Department of Environmental Quality
704 663 1699 office
704 235 2184 direct
Maria. schutte(cD-ncdenr.gov
610 East Center Avenue
Suite 301
Mooresville, NC 28115
-�1�Nothing Compares_.
Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties.

V
Schutte, Maria
From: Schutte, Maria
Sent: Friday, March 09, 2018 5:04 PM
To: [e-mail]'
Cc: [e-mail]'; '[e-mail]'; Gregory, Sonia
Subject: WQ0003281 Belmont RLAP 2017 AR
Attachments: WQ0003281_2017AR_SARck.J PG
Mr. Miller,
This email will serve as the Acknowledgement of Receipt for the referenced annual report. The Mooresville Regional Office
received a copy on February 261h, 2018. The information submitted appears to be in accordance with program
requirements. There is one minor item: by my calculations the Sodium Absorption Ratio = 2.26 NOT 4.10 as reported. It
appears there is an error in the table for the Calcium (Mg/L) value, which I show as 372.96 NOT 32.796. Again this is a minor
item, just noted for future reference. Please contact me with any questions.
Sincerely,
Maria
Maria Schutte
Environmental Specialist
Water Quality Regional Operations Section
Division of Water Resources
North Carolina Department of Environmental Quality
704 663 1699 office
704 235 2184 direct
Maria. sch utte(cDncd en r. gov
610 East Center Avenue
Suite 301
Mooresville, NC 28115
K(-1cl-
<,�^Nothmg Compares -
Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties.

ki
SAR & ESP Permit: W00003281: Data Source: 2017 AR i
I
Sodium Absorption Ratio Na V�4 /L Ca M /L ; Mq� aM[ f_L� I,
__. _
Na Sodium (Mg/L) Equivalent weight: 23 180.782 372.96 65.768
i
Ca: Calcium (Mg/L) Equivalent weight- 20
_E
NIg _ Magnesium (Mg/L) Equivalent weight: 12 Na 04E) Ca NIE Mg GAF
7.660087 18.648 5_480667
Milli Equivalent = Mg/L / Equivalent weight i !The amount of exchangeable sodium ions versus the j
iam-ount of exchangeable calcium & magnesium ions ` SAR= Na Milli Equivalent/[0.5 X (Ca Milli Equivalent + Mg Milli equivalent)10.5 power in a material
SAR = 2.262954 (From l.Ag/L entered above)
SAR= 2.26296 (From ME entered below) -
i j i 1
I
Na (ME) C- a (ME) Mg(ME)
7.86
18_648
5.48
Exchangeable Sodium Percentage
ESP = Na (Milli Equivalents_) / CEC X 100 The percentage of sodium ions occupying the cation_ exchange complex of soils I
Field: OT-91 Data Source: 2017 Soil Report Na [LAE) CEC
0.3 9.3
E P = 3.225806 m`o jShould be less than 15%0
Na an NC soil test is expressed as mea.

FEB
ion
IAT Xw ffi �'-k'
City of Belmont, WWTP
2017 Annual Report
Land Application Program
Permit No. WQ0003281
RECEIVED/NCDENR/DWR
FEB 2 6 2018
WQROS
MOORESVILLE REGIONAL OFFICE

ANNUAL LAND APPLICATION CERTIFICATION FORM
WQ0003281 County: Gaston Year 2017
ame (as shown on permit):
Application Operator:
City of Belmont
Southern Soil Builders. Inc. Phone:
d application of residuals as allowed by the permit occurred during the past calendar year?
Yes C 3 No - If No. slain Part A. and Part B and nroceed to Part C. Also, If residuals were
generated but not land applied, please attach an explanation on how the residuals were handled.
Rrsirinals Application Summary:
336-957-7871
Total number of application fields in the permit: 3
Total number of fields utilized for land application during the year:
3
Total amount of dry- tons applied during the year for all application sites:
116.5
Total number of acres utilizes for land application during the -,-ear:
81.9
Part B - Annual Comoiance Statement:
Facility was compliant during calendar year 2017 with all conditions of the land application permit
(including but not limited to items 1-13 below) issued by the Division of Water Resources. 21 Yes El No
If no please, provide a written description why the facility was not compliant, the dates, and explain corrective action
taken.
1) Only residuals approved for this permit were applied to the permitted sites.
2) Soil pH was adjusted as specified in the permit and linie was applied (if needed) to achieve a soil pH of at least 6.0 or the
limit specified in the permit.
3) Annual soils analysis were performed on each site receiving residuals during the past calendar year and three (3) copies of
laboratory results are attached.
4) Annual TCLP analysis (if required) was performed and three (3) copies of certified laboratory results are attached.
5) All other monitoring was performed in accordance with the permit and reported during the year as required and three (3)
copies ofccrtified laboratory results are attached.
6) The facility did not exceed any of the Pollutant Concentration Limits in 1 5A NCAC 02T .1 105(a) or the Pollutant Loading
Rates in 1 5A NCAC 02T .1 105(b) (applicable to 40 CFR Part 503 regulated facilities).
7) All general requirements in as specified in the Land Application Permit were complied with (applicable to 40 CFR Part
503 regulated facilities).
8) All monitoring and reporting requirements in l 5A NCAC 02T .1 I I I were complied with (applicable to 40 CFR Part 503
regulated facilities).
9) All operations and maintenance requirements in the permit were complied with or, in the case of a deviation, prior
authorization was received from the Division of Water Resources.
10) No contravention of Ground Water Quality Standards occurred at a monitoring well or explanations of violations are
attached to include appropriate actions and renhedia[lons.
l l) Vegetative cover was maintained and proper crop management was performed on each site reccing residuals_ as specified
in the permit.
12) No runoff of residuals from the application sites onto adjacent properly or nearby- surface waters has occurred.
13) All buffer requirements as specified on the permit were maintained during each application of residuals.
Part C - Certification:
"I certify, under penalty of laws, that the above information is, to the best of my knowledge and belief, true, accurate,
and complete. I am aware that there are significant penalties for submitting false information, including the possibility
of tines and imprisonment for knowing violations."
c J�� M i % �2�1 0# c� �e�1 oS� ,Qn J L✓L Z�ZII
Permittec Nanhc and Title (type or print) d Signature of Periuittee Date
G�-
/-I°%-Is
Signature of Prcparerr* C v /, / Dde Signature of 'L'and Applier Date
(if different from Pernuttee) (if different from Permittcc and Preparer)
x Preparer is defined in 40 CFR Part 503.9 (r) and l 5A NCAC 02T .1102 (26) DENR FORM ACF (12/2006)

ANNUAL RESIDUAL SAMPLING SUMMARY FORM
Please note that your permit may contain additional parameters to be analyzed. The parameters can be reported in FORM RSSF -
WQ Permit Number: WQ0003281
Facility Name:
Residual Source WQ # or
NPDES #:
WWTP Name:
Residual Analvsis Data
Laboratory: 1)
City of.Belmont 2)
NCO021181 3)
4)
City of.Belmont 5)
Waypoint Analytical
Parameter
(mg/kg)
Conc.
Limit
(mg/ka)`i
Sample or Composite Date
4-18-17
Percent Solids (%)
NA
2.59
Arsenic
75
4.21
Cadmium
85
2
Copper
4,300
272
Chromium
NA
68.4
Lead
840
22.2
Mercun'
57
0.51.4
Molvbdenum
75
5
Nickel
420
13.1
Selenium
L00
5
Zinc
7,500
1290
Total Phosphorus
NA
17700
TKN
NA
41.500
Ammonia -Nitrogen
NA
3460
Nitrate and Nitrite
NA
4690
For surl'ace disposal facilities the ceiling concentration limits listed in this form are not applicable. Reference the individual permit for metals limits.
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system
designed to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are
significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
)h'
Signature of Preparer x Da!te
'`Preparer is defined in 40 CFR Part 5039(r) and 15A NCAC 2T .1102 (26) DENR FORM RSSF (12/2006)

ANNUAL RESIDUAL SAMPLING SUMMARY FORM - B
Report all sampling analysis results for parameters not listed in FORM RSSF that are part of the WQ permit or were analyzed 1
calendar year. Use additional forms as needed.
WQ Permit Number: WQ0003281
Laboratory: 1)
Facility Name: City of Belmont
2)
:Residual Source NCO021.181
3)
NP.DES # or WQ#:
4)
WWTP Name: City of Belmont
5)
Ro6ditnl Annlvsic Data
Waypoint A
Parameter
(mg/k-g)
Sample or Composite Date
4-1847
Potassium
2090
Sulfur
10200
Calcium
14400
Magnesium
2540
Sodium
6980
Iron
16600
Aluminum
24300
Manganese
971
Organic N
38040
pH
6.15
"1 certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system
designed to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are
significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
Signature of Preparer Date
DENR FORM RSSF - B (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
ach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
'►me: Cite of .Belmont Total Dry Tons Applied (Annual): 20.36
WQ0003281 Cation Exchange Capacity (non ,503 only):
tor: Tonv Jones Owner: Tonv Jones Predominant Soil Series: CeB2
s Used: 27 Acres Permitted: 27 Site #: BT 6-1 Field 4: BT 6-1
esidual Analysis Data (:Heavy Metals and Total Phosphorus use mg/kg, 0/0 Solids use Raw Percent #):
Sample 1! 2? 3 4 5. 6; 7 8 9! 10 11 12
or Com-
posite
Date 4/ 18/ 1.7
% Solids 2.59
Arsenic 4.21
CBdllllLini 2
Copper 272
-hroiniuni 68.4
Lead 22.2
Mercun� 0.514
Molyb-
i
Nickel 13.1
Selciliuln l
Zinc 1290
Total
Phos- 17700
phorus
Annual Heavy Metal Field Loadings (Calculated in lbs/acre):
Total
1...1
_2_1
..
3
4
5
6�
7
8
9
10'
11
12I
DT/Ac./
_...__..
_._:
__.__.
_._.
_.__.
_.__.
_...._....1
c
App.
Event
0.75
Arsenic
0.006
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.006
Cadmium
0.003
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.0()0
0.000
0.000
0.000
0.003
Copper
0.410
0.000
0.000
0.000
0.000
0.0()0
0.000
0.000
0.000
0.000
0.000
0.000
0.410
hr0nliurl
0.103
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.103
Lead
0.033
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.033
Wrenn,
0.001.
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.001
Molyb-
dcnum
0.008
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.008
Nickel
0.020
0.000
0.000
0.000
0.000
0.00()
0.000
0.000
O.000
0.000
0.000
0.000
0.020
Selenium
0.008
0.000
0.0()0
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.008
Zinc
1.945
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1.945
Total
Phos-
26.692
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
26.692
horns
i ceruiy, unuer penalty ui iaw, that nus aocunient was prepares under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gathered and evaluated the information submitted. I am
aware that there are significant penalties for submitting false information, including the possibility of fines and
imprisonment for knowing violations".
Signature of Land Applier
l- / C1-14
Date
DENR FORM MFLSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM"
this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
me: City of Belmont Total Dry Tons Applied (Annual):
WQ0003281 Cation Exchange Capacity (non -503 only):
.tor: Tonv Jones Owner: Tonv Jones Predominant Soil Series:
Used: 12.9 Acres Permitted: 12.9 Site #: BT 6-3 Field 9:
29.49
CeB2
BT 6-3
ideal Analvsis Data (Heavv Metals and Total Phosphorus use m0k2, %) Solids use Raw .Percent #):
Sample
or Com-
posite
Date
__1_
4/18/1.7
2 ':•
3
4 J
5'
6 1
7
8
9?
10
11
12
`%o Solids
2.59
Arsenic
4.21
Cadmium
2
Copper
272
hromiun
68.4
Lead
22.2
Mercury
0.514
Molyb-
denum
`
Nickel
13.1
Selenium
Zinc
1290
Total
Phos-
honis
17700
Annual Heavy Metal Field Loadings (Calculated in Ibs/acre):
Total
1
2..
3...;
4
5..1
6
7.:
8.
10
11 1
12
.
_
_9..
DT/Ac./
y
App.
Event
2.29
Arsenic
0.019
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.019
Cadnlinnl
0.009
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0:000
0.000
0.009
Copper
1.244
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000:�
1.244
hromiun
0.3:13
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0A0
0.000
0.000
0.313
Lead
0.101
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.101
Mercury,
0.002
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.002
Mohb
0.023.
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.023
denU111
Nickel
0.060
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1 0.060
Selenium
0.023
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.023
Zinc
5.898
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
5.898
Total
Phos-
80.924
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
80.924
horus
"t eertity, under penalty of taw, that this document was prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gathered and evaluated the information submitted. I am
aware that there are significant penalties for submitting false information, including the possibility of fines and
imprisonment for knowing violations".
12,t,� ;4-- -
.
Signature of L d Applier
Date
DENR FORM MFLSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM"
ach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
ame: City of .Belmont 'Total Dry Tons Applied (Annual): 66.65
WQ0003281 Cation .Exchange Capacity (non -03 only):
tor: Lori Warren Owner: Lori Warren Predominant Soil Series: GaB2
s Used: 42 Acres Permitted: 42 Site #: BT 9-1 Field #: BT 9-1
..sidual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, 0/0 Solids use Raw Percent #):
Sample
1!
2 i
31
4 1
51
61
71
8 1
9 1
10
11 j
12
or coin-
posite
Date
4/18/1.7
`%, Solids
2.59
Arsenic
4.21
Cadmium
2
Copper
272
�hronliun
68.4
Lcad
22.2
Mcrcui-N�
0.514
MoIN b-
de11U111
Nickel
13.1
SCIcnillill
l
Zinc
1290
Total
Phos-
17700
Annual Heavy Metal Field Loadings (Calculated in lbs/acre):
Total
1,.
2;
3
4
5
61
7
8
91
101
11
12
DT/Ac./
............
o
App.
E%-ent
1.59
Arsenic
0.013
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1 0.000
0.013
Cadmium
0.006
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.006
Copper
0.863
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.863
hronliuri
0.217
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.217
Lead
0.070
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.070
Mercury
0.002
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.002
Mol\:b
0.016
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.016
CIC11Ui11
Nickel
0.042
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.042
Sclenitull
0.016
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.016
Zinc
4.094
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
4.094
Total
Phos-
56.180
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
56.180
phorus
i 4-c] L Yy uuuer IMIally ui law, Ulal rills Qocunlent was preparea unuer my airectlon of supervision In accordance with a
system designed to assure that qualified personnel properly gathered and evaluated the information submitted. l am
aware that there are significant penalties for submitting false information, including the possibility of fines and
imprisonment for knowing violations".
Signature of Land Appher
Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED OP
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: City- of Belmont
Land Owner: Toni ,Tones
Operator: Tony Jones
Crop I Name: Fescue
WQ Permit #: WQ0003281 Field #: BT 6-1
Annual Dry Tons Applied: 20.3586 Site #: BT 6-1.
Predominant Soil Series: CeB2
Crop 1 Max. PAN
211
Crop 2 Name:
Acres Utilized:
Acres Permitted:
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
o
c
o
Q
Volurne applied
(enter one) Solids`
Liquid
Cu. Yds Gallons
�;,
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NP1.)l S 7_ WQ=-,
I ert,. Animal
Waste. etc)
Soil
Cond.
(Dry,
Wet
Moist)
Precip.
Past 24
FIrs.
inches
>
�' -a
#
o
# a
o
-
:�
# ^
c'
_
TKN
mg/kg
z
- =
o
o
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs%acre)
Name of Crop Type
Recei�-ing Residual
Application
Crop17Crop
2
Crop 1
Crop _
7-2017
188500
2.59
0.754
WQ0003281
dr.=
0
s
0.5
0.3
41500
3460
4690
26.891
NA
Fescue
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
(woo
(woo
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this fo►m):
TOTALS1
01
188500
As
Cd
Cu
Cr
Pb
H _
Mo
Ni
Se
Zn
P
26.891
o.00o
Lime Applied
Annual lbs/acre
0.006
0.003
0.410
0.103
0.033
0.001
0.008
0.020
0.008
1.945
26.692
,
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.151
0.175
62.981
1.968
5.456
0.114
0.466
2.359
0.18
100.644
Current Cimntlative Ibs/ac
0.157
1 0.178
63.391
2.071
5.489
0.115
0.474
2.379
0.188
102.589
Permitted C. P. L. R.****
36
34
NA
1 1338
1 267
15
NA
1 374
1 89
1 2498
Permit PAN Limit Ist/2nd Crop1
21.1
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
Signature of Land Applier
-oA
Date
*Application Method: S - Surface, IN - Injection, INC - Incorporation
*Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
*xK Mineralization Rates: Compost -0.1, anaerobiallV digested -0.2, aerobically
digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: City of Belmont WQ Permit #: WQ0003281 Field #: BT 6-3 Acres Utilized:
Land Owner: Ton-,, .tones Annual Dry Tons Applied: 29.4848 Site #: BT 6-3 Acres Permitted:
Operator: Tony Jones Predominant Soil Series: Cel32 Cation Exchange Capacity (non 503):
Crop I Name: Fescue Crop I Max. PAN: 211 Crop 2 Name: Crop 2 Max. PAN:
o
c
-� o
c�
Q
Volume a lied
I P
(enter one) Solids.
Liquid
Cu. Yds Gallons
�.
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDFS . WQ#.
Fert., Animal
Waste, etc )
Soil
Cond.
(Dry,
Wet.
M.oiSt)
Precip.
Past 24
Hrs.
inches
�
T ci
c
* 2
C
o
�`
iti =
h
o'
-
_
#
TKN
mg/kg
Z �
ac 5
~
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
( lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop I
Crop 2
7-2017
273000
2.59
2.286
WQ0003281
dry
0
s
0.5
0.3
41500
3460
4690
81.515
1 NA
Fescue
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
.0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form):
10'1'ALs:
01
273000
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
81.515
F0.666
Lime Applied
Annuallbs/acre
0.019
0.009
1.244
0.313
0.101
0.002
0.023
0.060
0.023
5.898
80.924
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.585
0.168
59.162
1.708
5.275
0.099
0.445
2.249
0981
87.397
11-17
1000
Current Cumulative lbs/ac
0.604
0.177
60.406
2.021
5.376
0.101
0.468
2.309
1.004
93.295
Permitted C. P. L. R.*"**
36
34
NA
1338
267
15
NA
374
89
2498
Pen -nit PAN Limit I st/2nd Crop
"I certify, under penalty of laFv, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly- gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
Signature of Land Applier
i•-/I-r
Date
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volatilization Rate: Surface - O., Injection/.Incorporation - 1.0
*** Mineralization Rates: Compost -0.1, anaerobially digested -0.2, aerobically
digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loadin2 Rate
DENR FORM FSF (12/2006)

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: Cite of Belmont WQ Permit#: WQ0003281 Field #: BT 9-1. Acres Utilized:
Land Owner: Lori Warren Annual Dry- Tons Applied: 66.6919 Site #: BT 9-1 Acres Permitted:
Operator: Lori Warren Predominant Soil Series: GaB2 Cation Exchange Capacity (non 503):
Crop 1 Name: Fescue Crop 1 Max. PAN: 211 Crop 2 Name: Crop 2 Max. PAN:
�_
oC
r o
Cat
Volume applied
(enter one) Solids'
Liquid
Cu. Yds Gallons
Solids
Volume
Applied er
P
Ache
(Dry TonslAc)
Residual Sourees
(NPI:)I::S . W "
Q'
FerL. Animal
Waste. etc)
Soil
Cond.
Wett
Moist)
Precip.
Past 24
Hrs.
inches
D
K:
^ -0
-
'
-
o
-
°
�
K.
'
c
# v
x o
_
TKN
m /k
9 9
z >
J
c
r o
�•
m /k
9 9
Nitrate
and
Nitrite
m !k
9 9
PAN Applied
(lbs'acre)
Name of Crop "I' pe
Receiving Residual
Application
Crop 1
p
Crop
P 2
Crop 1
P
Crop _
1 2
6-2017
240500
2.59
0.618
WQ0003281
dry
0
s
0.5
0.3
41500
3460
1 4690
22.056
NA
Fescue
7 2017
130000
2.59
0.334
WQ0003281
dry
0
s
0.5
0.3
41500
3460
4690
11.922
NA
Fescue
8-2017
117000
2.59
0.301
WQ0003281
dry
0
s
0.5
0.3
41300
3460
4690
10.730
NA
Fescue
12-2017
130000
2.59
0.334
WQ0003281
dt,v
0
s
0.5
0.3
41500
3460
4690
11.922
NA
Fescue
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
-0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form):
TO'i':al.,s:
01
617500
As
Cd
Cu
Cr
Pb
Fla
Mo
Ni
Se
Zn
P
56.631
o.000
Lime Applied
Annuallbs/acre
0.013
0.006
0.863
0.217
0.070
0.002
0.016
0.042
0.016
4.094
56.180
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.349
0.11
24.103
28.691
3.324
0.055
0.17
1.799
0.156
126.002
I1-17
1000
Current Cumulative lbs/ac
0.362
0.116
24.966
28.908
3.394
0.057
0.186
1.841
0.172
130.096
Permitted C. P. L. R.'"***
36
34
1 NA
1 1338
1 267
1 15
1 NA
1 374
1 89
1 2498
Permit PAN Limit 1st/2nd Crop
211
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for luto`ving violations."
*Application Method: S - Surface, IN - .Injection, INC - Incorporation
Volatilization Rate. Surface - 0.5, Injection/.Incorporation - 1.0
Signature of Land Applier Date
* Mineralization Rates: Compost -0.1, anaerob ially digested -0. 2, aerobically
digested -0.3, raw sludge -0. 4
"""C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

Page: 1 of 2
Report Number: 17-111-0205
Account Number: 46381
Send To: Southern Soil Builders
Dennis Key
958 Hoots Road
Roaring River, NC 28669
Lab Number: 63531
Sample Id : Belmont
•
s
- 4' )DJ
Waypointl."'�L`�`
ANALYTICAL
Project : Belmont
NC Cert#257
REPORT OFANALYSIS
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 ° Fax [phone]
www.waypointanalytical.com
Date Sampled: 4/18/2017 11:46:00
Date Received: 04/21/2017 00:00
Date Reported: 04/28/2017
Total Solids *
2.59
25900
100.0
JM
04/21/2017 15:00
SM-2540G
Moisture *
97.40
100.0
JM
04/21/2017 15:00
SM-2540G
Total Kjeldahl Nitrogen
4.15
41500
50.0
R D
04/24/2017 09:00
SM-4500-NH3C-TKN
Total Phosphorus
1.77
17700
100
MOS
04/24/2017 18:43
6010C
Total Potassium
0.21
2090
100
MOS
04/24/2017 18:43
6010C
Total Sulfur
1.02
10200
100
MOS
04/24/2017 18:43
6010C
Total Calcium
1.44
14400
100
MOS
04/24/2017 18:43
6010C
Total Magnesium
0.25
2540
100
MOS
04/24/2017 18:43
6010C
Total Sodium
0.70
6980
100
MOS
04/24/2017 18:43
6010C
Total Iron
16600
100
MOS
04/24/2017 18:43
6010C
Total Aluminum
24300
100
MOS
04/24/2017 18:43
6010C
Total Manganese
971
5.00
MOS
04/24/2017 18:43
6010C
Total Copper
272
5.00
MOS
04/24/2017 18:43
6010C
Total Zinc
1290
50.0
MOS
04/26/2017 17:51
6010C
Ammonia Nitrogen
0.35
3460
50.0
R D
04/25/2017 09:00
SM-4500-NH3C
Organic N
3.80
38040
50.0
04/24/2017 09:00
CALCULATION
Nitrate+Nitrite-N
4690
21.2
SJB
04/27/201710:57
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.
Our r eports and letters are for the exclusive and confidential use of our clients, and may not be reproduced in whole or part, nor may am reference be rnade
Y 1 y
to the work, the results. or the company in any advertisino, news release, or other public announcements without obtaining our prior written authorization.
Debbie Holt
Laboratory Supervisor

Page: 2 of 2
Report Number: 17-111-0205
Account Number: 46381
Southern Soil Builders
Dennis Key
958 Hoots Road
Roaring River, NC 28669
•
ay i nt
�'�
;`
ANALYTICAL
Project : Belmont
NC Cert#257
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 ° Fax [phone]
www.waypointanalytical.com
REPORT OFANALYSIS Date Sampled: 4/18/2017 11:46:00
Lab Number: 63531 Date Received: 04/21/2017 00:00
Sample Id : Belmont Date Reported: 04/28/2017
.-•-. 1-111
«.uu
2.00
MOS
04/24/2017 18:43
6010C
Total Chromium
68.4
5.00
MOS
04/24/2017 18:43
6010C
Total Nickel
13.1
5.00
MOS
04/24/2017 18:43
6010C
Total Lead
22.2
5.00
MOS
04/24/2017 18:43
6010C
Total Arsenic
4.21
3.00
MOS
04/24/2017 18:43
6010C
Total Mercury
0.514
0.400
SJB
04/25/2017 14:53
SW-7471 B
Total Selenium
<5.00
5.00
MOS
04/24/2017 18:43
6010C
PH (Standard Units) "
6.15
1.00
JM
04/24/2017 09:00
SW-9045D
Total Molybdenum
<5.00
5.00
MOS
04/24/2017 18:43
6010C
Comments:
SULFUR AND ORGANIC NITROGEN NOT FOR COMPLIANCE PURPOSES.
All values are on a dry weight basis except as noted by asterisk. Detection limit on all N series is on a wet basis
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
to the work, the results. or the company in any advetising, news release, or other public announcements without obtaining our prior written authorization.
Debbie Holt
Laboratory Supervisor

PAN
Mineralizationas
decimal
llg!ql dry
tons/near
jAcres
Applied on
1 81.9
Rate
0.3
TKN
41500
NH3
3460
NO3
4690
NO2
0
% Solids
0.0259
1 116.5
PAN Surface
173321nig/kg
,35.664 Iles/dry ton
41 57$56
I Ilan total PAN
50.7111,0841Bias
PAN/acre
PAN Injection
F-1995621mg/kg
3 124 lbs/dry ton
4657,�U61bs
lies AN
55,,6E, 2,58
1 Ibs PAN/acre
Dry Tons/1000 gal.
0.108003
1st year PAN
Surface lbs.
4-1
1st year PAN
Injected lbs.
455
lbs./acre
Surface
50,730874-2791
lbs./acre
Injected
55.65257631
MR(TKN-NH3)+ +.5(NH3)+NO3+NO2 =mg/kg
mg/kg x .002 =Ibs/dry ton
MR(TKN-NH3) + l(NH3)+NO3+NO2 =mg/kg
mg/kg x.002 =Ibs/dry ton
1000 X 8.34 X %solids X sp. gravity
2000
"=dry tons/1 000ga 1. "

Sodium Absorption Ratio
Na: Sodium (Mg/L) Equivalent weight: 23
Ca: Calcium (Mg/L) Equivalent woight:2O
Mg : Magnesium (Mg/L) Equivalent weight: 12
Milli Equivalent = Mg/L / Equivalent weight
SAR= Na Milli Equkaa|ent/[).5 }( (Ca Milli Equivalent + Mg Milli oqukm|ont)10.5 pnvvnr
AR = 4,100941 (From NIgIL entered above)
(FmmMEextend below)
The amour
amount of,
Permitting

15outhern 1.
958 Hoots Roac
Roaring River, f
Receive Date.:
Reported:
For:
Comments:
Sample Number
170418-17-01
170418-17-01
170418-17-02
170418-17-02
170418-17-03
170418-17-03
170418-17-04
170418-17-04
170418-17-05
170418-17-05
170418-17-06
170418-17-06
170418-17-07
170418-17-07
Respectfully sub
Analytical Results
oil Builders
28669
04/ 18/2017
04/20/2017
Belmont
Geometric Mean <880 MPN/g
Parameter
Sample ID
Result
Unit
Method
Analyzed
Analyst
Fecal Coliforms
1
<1176
MPN/g
SM92210E-2006
04/19/2017
WC
Percent Solids
1
1.70
%
SM254OB-1997
04/19/2017
WC
Fecal Coliforms
2
<769
MPN/g
SM92210E-2006
04/19/2017
WC
Percent Solids
2
2.60
ova
SM254OB-1997
04/19/2017
WC
Fecal Coliforms
3
<784
MPN/g
SM92210E-2006
04/19/2017
WC
Percent Solids
3
2.55
%
SM254OB-1997
04/19/2017
WC
Fecal Coliforms
4
<787
MPN/g
SM92210E-2006
04/19/2017
WC
Percent Solids
4
2.54
%
SM254OB-1997
04/19/2017
WC
Fecal Coliforms
5
<772
MPN/g
SM92210E-2006
04/19/2017
WC
Percent Solids
5
2.59
%
SM254OB-1997
04/19/2017
WC
Fecal Coliforms
6
<866
MPN/g
SM92210E-2006
04/19/2017
WC
Percent Solids
6
2.31
%
SM254OB-1997
04/19/2017
WC
Fecal Coliforms
7
<1093
MPN/g
SM92210E-2006
04/19/2017
WC
Percent Solids
7
1.83
%
SM25408-1997
04/19/2017
WC
Dena Myers I
NC Cert #440,
NCDW Cert #3771155,
EPA #NC00909
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 1 of 4

Number 170418-17-01
Condition of Receipt
Temp on Arrival: 3
Parameter Schedule: Percent Solids
Received on Ice
Parameter Schedule: Fecal Coliforms
Sodium Thiosulfate Received on Ice
Sample Number 170418-17-02 Temp on Arrival: 3
Parameter Schedule: Percent Solids
Received on Ice
Parameter Schedule: Fecal Coliforms
Sodium Thiosulfate Received on Ice
Sample Number 170418-17-03 Temp on Arrival: 3
MMMMMMW�
Parameter Schedule: Percent Solids
Received on Ice
Parameter Schedule: Fecal Coliforms
Sodium Thiosulfate Received on Ice
Sample Number 170418-17-04 Temp on Arrival: 3
Parameter Schedule: Percent Solids
Received on Ice
Parameter Schedule: Fecal Coliforms
Sodium Thiosulfate Received on Ice
Sample Number 170418-17-05 Temp on Arrival: 3
Parameter Schedule: Percent Solids
Received on Ice
Parameter Schedule: Fecal Coliforms
Sodium Thiosulfate Received on Ice
Sample Number 170418-17-06 Temp on Arrival: 3
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 2 of 4

Parameter Schedule: Percent Solids
Received on Ice
Parameter Schedule: Fecal Coliforms
Sodium Thiosulfate Received on Ice
Sample Number 170418-17-07 Temp on Arrival: 3
Parameter Schedule: Percent Solids
Received on Ice
Parameter Schedule: Fecal Coliforms
Sodium Thiosulfate Received on Ice
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 3 of 4

Glient:
S (
0 ^y-
rn
Address: ?Sg
p 1
�'��1 d
STAnSVILLEANALYTICAI,
122
fU '°
l\
jZ Nt r
!1
C,
- -
Ccun Street • P.O.6ox 228
Scatewillc,NC 28687
00
Contact Person:
I
-
[phone]
lD
PO #
1
Phone #
�6` �S? �
'�? I
FAX#
- rl S 7 $9y (7
C)f1Alri 0�
N
U
Requisitioned by:
(Time Date)
Custody Record
Z
customer
Sample to#
1
I-ab-ID It
p
Sampled
(Grab only)
Date Sampled
(Grab Orgy)
c
L
Matrix
w vnv Parameters requested for anaWs
=
j
1J�jmon f
1 �1�
-17 J!1: 16Am
`i-.X
xa
��,
ca
to
o0
4
�I
N
N
X
m
a
Relinquished by: �Ik
Time f ��7T,)} am, (�'m� Date '4/ I$ / 17 Sampled by:Received by C�jl( Time 1 Z vV a�n; Fate -U +✓ 4/ 1 7
Transported by:
Relinquished by: Time am, pm Date ___J /
Holding times met:
Received by: Time am, pm Date _/_J
Composite Sampling #1 • Compliance work -
Time begin am, pm Date —/ / Non-compliance work:
Time end am, pm Date _/_/
Lab Comments:
Composite Sampling #2-
Time begin am, pm Date
Time end am, pm Date __/_/

Analytical
Southern Soil
Roaring River, NC 28669
Receive Date: 04/18/2017
Reported: 05/23/2017
For: Belmont
Comments:
Sample Number Parameter Sample ID Result Unit Method Analyzed Analyst
170418-23-01 30 Day Benchscale Belmont 4.3 % EPA625-R-92/0 04/18/2017 WC
Respectfully submitted,
&- w0c, J'Y��-., I
Dena Myers 0
NC Cert #440,
NCDW Cert #37755,
EPA #NC00909
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 1 of 3

Condition of Receipt
e Number 170418-23-01 Temp on Arrival:
Parameter Schedule:
Received on Ice
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 2 of 3

ruAddress: Js I �✓ ictcT�'
S-s �u �'� 9 CI
STATESVILLEAN9ALYTICAL
122 Court Street - P.O. Box 228
r144t �'J(j L d �h 7
Contact Person: � � � �
US #
Customer 71me Se
Sample I Lab-10 Y (Grab �rrry' eC
G
Phone # 35c, "_rig %1
Req=Ationed by:
( y'ed '
.9-I2-11 ,(,
Statesville, NC 28687
[phone]
—
FA" 3 3o - 5,- 3q v p Chain Of
(rime Dale) Custody Record
a Matrix Paamelers requested for analysa
vnv
Relinquished by: 7'
Time l "Q
a S
am, m Date � / 4 /) 7
Sampled by: Z
Received by:
Time
/
_/ / f r
am,® Date 7
Transported by: p'
Relinquished by.
Time
am, pm Date _1 /
Holding times met:
Received by:
Sampling #1'
Time
am, pm DateComposite
Compliance work:
Time begin am, pm Date _I___/
Non-compliance work:
Time end am, pm Date I_1
Composite Sampling #2-
Lab Comments:
Time begin am, pm Date
Time end am, pm Date_/ /
zt
o a
r�
n
00
to
00
N
U
z
4)
N
Y
00
N
N
X
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0
a

Analytical Results
outhern Soil Builders For: Belmont
z758 Hoots Road
Roaring River NC 28669
Entered: 04/18/2017
Reported:05/23/2017
Sample ID: 170418-23-01
PARAMETER: Vector Attraction Reduction/Aerobically Digested Sludge (30day)
Total Solids
Volatile Solids
% Volatile Solids
Week
1
1.23
0.71
0.5783
Week
2
1.29
0.75
0.5810
Week
3
1.27
0.74
0.5869
Week
4
1.20
0.70
0,5835
Week
5
1.11
0.63
0.5675
Volatile Solids Reduction: 0.5783 - 0.5675X100 = 4.3%
0.5783 - (0.5783 X 0.5675)
Respectfully submitted,
Dena Myers
Statesville Analytical, Inc.
NC WW Cert.# 440NC
DW Cert. #37755

Analytical Results
Southern Soil Builders
958 Hoots Road
Roaring River, NC 28669
Receive Date: 04/18/2017
Reported: 05/04/2017
For: Belmont
Comments:
Sample Number Parameter Sample ID Result Unit Method Analyzed Analyst
170418-25-01
Corrosivity
Belmont
See Attached
SW-846 05/02/2017
PACE
170418-25-01
Ignitability
Belmont
See Attached
1010M 05/02/2017
PACE
170418-25-01
Reactivity
Belmont
See Attached
SW-e46 05/02/2017
PACE
170418-25-01
TCLP
Belmont
See Attached
as Noted 05/02/2017
PACE
Respectfully submitted,
tOn
Dena Myers
NC Cert #440,
NCDW Cert #37755,
EPA #NC00909
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 1 of 3

Condition of Receipt
e Number 170418-25-01 Temp on Arrival: 2
Parameter Schedule: Reactivity
Received on Ice
Parameter Schedule: Corrosivity
Received on Ice
Parameter Schedule: Ignitability
Received on Ice
Parameter Schedule: T'CLP
Received on Ice
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 2 of 3

Client:
Address:
uc,
p
STATESVILLEAMUMCAL
122 Court Stay • P.O. Box 228
Statesville, NC 29697
[phone]
Chain of
Custody Record I
` , }
0"'"` N L d r
Contact Person: Phone #
PO # °�L d 3x- 336' qS7 - 99vc
Requisitioned by: time Date)
Customer
Sample IN� 1-eb'tDk
Time sa "'p'ed
(Grab Only)
Date Sampled o
(Grab Ordy} m
Matrlx
.69. w ww Parameters requested for anatysis
L p "fir QS,J•
^7n
I
Relinquished by: Time P' SG am,(prr11 Date -L/� 7
Received by: ) Tlmej 2 ; am, ������//////^ to ! / / 4/
iiL—
Relinquished by: Time am, pm Date
Received by;
Composite Sampling #1
Time begin am, pm Date _/ /
Time end am, pm Date / /_
Composite Sampling #2-
Time begin am, pm Date
Time end am, pm Date _/ /
Time am, pm Date
Sampled by: Z A�—
Transported by:
Holding times met:
Compliance work -
Non -compliance work:
.17
0
t\
t\
00
tD
tb
N
U
z
ai
v
tCo
N
s
00
N
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Analytical
www.pacelabs.ccm
ANALYTICAL RESULTS
Project: 170418-25
Pace Project No.: 92337634
Sample: 170418-25 Lab ID: 92337634001 Collected: 04/18/17 11:46 Received: 04/19/17 09:17
Results reported on a "dry weight' basis and are adjusted for percent moisture, sample size and any dilutions.
Parameters Results Units Report Limit DF p Prepared Analyzed
8081 GCS Pesticides, TCLP
gamma-BHC (Lindane)
Chlordane (Technical)
Endrin
Heptachlor
Heptachlor epoxide
Methoxychlor
Toxaphene
Surrogates
Decachlorobiphenyl (S)
Tetrachloro-m-xylene (S)
8151 Chlorinate Herbicide TCLP
2,4-D
2,4,5-TP (Silvex)
Surrogates
2,4-DCAA (S)
6010 MET ICP, TCLP
Arsenic
Barium
Cadmium
Chromium
Lead
Selenium
Silver
7470 Mercury, TCLP
Mercury
8270 MSSV TCLP Sep Funnel
1,4-Dichlorobenzene
2,4-Dinitrotoluene
Hexachloro-1,3-butadiene
Hexachlorobenzene
Hexachloroethane
2-Methylphenol(o-Cresol)
3&4-Methylphenol(m&p Cresol)
Nitrobenzene
Pentachlorophenol
Pyridine
2,4, 5-Trichlorophenol
2,4,6-Trichlorophenol
Date: 05/03/2017 04:50 PM
Analytical Method: EPA8081 Preparation Method: EPA3510
Leachate Method/Date: EPA 1311; 04/28/17 14:00
ND
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Matrix: Solid
CAS No. Qual
ND
ug/L
5.0
10
05/01/1710:19
05/0211713:06
58-89-9
ND
ug/L
ug/L
30.0
10
05/01/1710:19
05/02/1713:06
57-74-9
ND
ug/L
5.0
10
05/01/1710:19
05/0211713:06
72-20-8
ND
ug/L
5.0
10
05/01/1710:19
05/02/1713:06
76-44-8
ND
ug/L
5.0
10
05/01/1710:19
05/02/1713:06
1024-57-3
ND
ug/L
10000
10
05/01/1710:19
05/02/1713:06
72-43-5
30.0
10
05/01/1710:19
05/02/1713:06
8001-35-2
0
0
%
%
10-138
10
05/01/1710:19
05/02/1713:06
2051-24-3 D3,S4
10-110
10
05/01/1710:19
05/02/1713:06
877-09-8 84
Analytical Method: EPA 8151 Preparation Method: EPA 3510
ND mg/L 0.43 1
ND mg/L 0.43 1
79 % 39-139 1
04/27/17 10:52 05/02/17 02:44 94-75-7
04/27/17 10:52 05/02/17 02:44 93-72-1
04/27/17 10:52 05/02/17 02:44 19719-28-9
Analytical Method: EPA 6010 Preparation Method: EPA 3010A
Leachate Method/Date: EPA 1311; 04/20117 19:00 Initial
pH: 5.58; Final pH: 4.97
ND mg/L 0.050 1
0.87 m9/L
04/21/1716:25
04/2211716:16
7440-38-2
0.25 1
ND mg/L
04/21/1716:25
04/22/1716:16
7440-39-3
0.0050 1
ND mg/L
04121/1716:25
04/22/1716:16
7440A3-9
0.050 1
ND mg/L
04/21/1716:25
04/22/1716:16
7440-47-3
0.025 1
ND mg/L
04/21/1716:25
04/22/1716:16
7439-92-1
0.10 1
ND mg/L
04/21/1716:25
04/22/1716:16
7782-49-2
0.025 1
04/21/1716:25
04/22/1716:16
7440-22-4
Analytical Method: EPA 7470 Preparation Method: EPA
7470
Leachate Method/Date: EPA 1311; 04/20/17 19:00 Initial pH: 5.58; Final
pH: 4.97
ND mg/L 0.00020 1
04/26/17 00:40
04/28/17 05:17
7439-97-6
Analytical Method: EPA8270 Preparation Method: EPA3510
Leachate Method/Date: EPA 1311; 04/28/17 14:00
ND ug/L 50.0 1
ND ug/L
05/03/1712:20
0510311716:20
106-46-7
50.0 1
ND ug/L
05/03/1712:20
05/0311716:20
121-14-2
50.0 1
ND ug/L
05/03/1712:20
05/03/1716:20
87-68-3
50.0 1
ND ug/L
05/03/1712:20
05/03/1716:20
118-74-1
50.0 1
ND
05/03/1712:20
05/03/1716:20
67-72-1
ug/L 50.0 1
ND ug/L
05/03/1712:20
05/03/1716:20
95-48-7
50.0 1
ND ug/L
05/03/1712:20
05/03/1716:20
15831-10-4
50.0 1
ND ug/L
05/03/1712:20
05/03/1716:20
98-95-3
100 1
ND ug/L
05/03/1712:20
05/03/1716:20
87-86-5
50.0 1
ND ug/L
05/03/1712:20
05/03/1716:20
110-86-1
50.0 1
ND ug/L
05/03/1712:20
05/03/1716:20
95-95-4
50.0 1
05/03/1712:20 05/03/1716:20
88-06-2
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
Page 5 of 26

lalytical
(,pacelahscom
ANALYTICAL RESULTS
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
170418-25
92337634
'-25 Lab ID: 92337634001 Collected: 04/18/17 11:46 Received: 04/19/17 09:17 Matrix: Solid
=Nut and on a "dry weight" basis and are adJusted for percent moisture, sample size and any dilutions.
Parameters Results Units Report Limit DF p Prepared Analyzed CAS No. Qua[
8270 MSSV TCLP Sep Funnel Analytical Method: EPA S270 Preparation Method: EPA 3510
Leachate Method/Date: EPA 1311; 04/28/17 14:00
Surrogates
Nitrobenzene-d5 (S)
22
%
2-Fluorobiphenyl (S)
29
%
12-102
1
05/03/17 12:20 05/03/17 16:20
4165-60-0
4 (S)
Terphe-dB
33
%
13-107
1
05/03/17 12:20 05/03/17 16:20
321-60-8
Phenol-dB(S)
(
10
21-110
1
05/03/17 12:20 05/03/17 16:20
1718-51-0
2-Fluorophenol (S)
19
%
10-110
1
05/03/17 12:20 05/03/17 16:20
13127-88-3
2,4,6-Tribromophenol (S)
39
10-110
1
05/03/17 12:20 05/03/17 16:20
367-12-4
%
27-108
1
05/03/17 12:20 05/03/17 16:20
118-79-6
8260 MSV TCLP
Analytical Method: EPA 8260 Leachate Method/Date:
EPA 1311; 04/25/17 08:45
Benzene
2-Butanone (MEK)
ND
ND
ug/L
50.0
10
04/26/17 15:35
71-43-2
Carbon tetrachloride
ND
ug/L
ug/L
10
04/26/17 15:35
78-93-3
Chlorobenzene
ND
ug/L
0.0
50. 0
10
04/26/17 15:35
56-23-5
Chloroform
ND
ug/L
50.0
10
04/26/17 15:35
108-90-7
1,4-Dich[orobenzene
ND
ug/L
50.0
10
04/26/17 15:35
67-66-3
1,2-Dichloroethane
ND
ug/L
50.0
10
04/26/17 15:35
106-46-7
1,1-Dichloroethene
ND
ug/L
50.0
10
04/26/17 15:35
107-06-2
Tetrachloroethene
ND
ug/L
50 .0
10
04126/1715:35
75-35-4
Trichloroethene
ND
ug/L
50.0
10
04/26/17 15:35
127-18-4
Vinyl chloride
ND
ug/L
50.0
10
04/26/17 15:35
79-01-6
Surrogates
50.0
10
04/26/17 15:35
75-01-4
1,2-Dichloroethane-d4 (S)
92
Toluene-d8 (S)
103
%
70-13
10
04/26/17 15:35
17060-07-0
4-Bromofluorobenzene (S)
91
67-135
10
04/26/17 15:35
2037-26-5
Percent Moisture
70-130
10
04/26/17 15:35
460-00-4
Analytical Method: ASTM D2974-87
Percent Moisture
97.7
0.10
1
04/20/17 08:11
1010 Flash point,Closed Cup
Analytical Method: EPA 1010
Flashpoint
>200
deg F
70.0
1
9045 pH Soil
04/20/17 10:11
Analytical Method:
EPA 9045
PH at 25 Degrees C
5.4
Std. Units
0.10
1
733C S Reactive Cyanide
Analytical Method:
04/20/17 20:30
EPA 9014 Preparation Method: SW-846
Cyanide, Reactive
ND
mg/kg
0.99
1
7.3.3.2
04/26/17 14:00 04/26/17 22:52
734S Reactive Sulfide
Analytical Method: SM450032F-00 Preparation
Method:
SW-846 7.3.4.2
Sulfide, Reactive
ND
mg/kg
9.9
1
04/26/17 14:00 04/26/17 21:16
Date: 05/03/2017 04:50 PM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
Page 6 of 26

Analytical
W Wcpacelab&Cbm
ANALYTICAL RESULTS
Project: 170418-25
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Pace Project No.: 92337634
Sample: 170418-25 (PCB WATERS) Lab ID: 92337634002 Collected: 04/18/17 11:46 Received: 04/19/17 09:17 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
8082 GCS PCB
Analytical Method: EPA 8082 Preparation Method: EPA 3510
PCB-1016 (Aroclor 1016)
ND
ug/L
5.0
1
PCB-1221 (Aroclor 1221)
ND
ug/L
04/28/17 14:40
05/01/17 14:46
12674-11-2
PCB-1232 (Aroclor 1232)
ND
ug/L
5.0
1
04/28/17 14:40
05/01/17 14:46
11104-28-2
PCB-1242 (Aroclor 1242)
ND
ug/L
5.0
1
04/28/17 14:40
05/01/17 14:46
11141-16-5
PCB-1248 (Aroclor 1248)
ND
ug/L
5.0
1
04/28/17 14:40
05/01/17 14:46
53469-21-9
PCB-1254 (Aroclor 1254)
ND
ug/L
5.0
1
04/28/17 14:40
05/01/17 14:46
12672-29-6
PCB-1260 (Aroclor 1260)
ND
ug/L
5.0
1
04/28/17 14:40
05/01/17 14:46
11097-69-1
Surrogates
5.0
1
04/28/17 14:40
05/01/17 14:46
11096-82-5
Decachlorobiphenyl (S)
25
10-132
1
04/28/17 14:40
05/01/17 14:46
2051-24-3
Date: 05/03/2017 04:50 PM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
Page 7 of 26

AL PATHOGEN AND VECTOR ATTRACTION R.EDUCT.I.ON FORM (02T Rules)
City of Belmont
City of Belmont
d: From
WQ Permit Number: WQ0003281
NPDES Number: NC0021181.
I/l/2017 To 12/31/2017
,tion (1.5A NCAC 02T .1106) -.Please indicate level achieved and alternative performed:
Class A:
Alt. A (time/temp) [37
All B (Alk Treatment)(
Alt. C (Prior Testing)[]
A1t.D (No Piior "Lest) LJ
I Process to Further Reduce Pathogen _s El
If applicable to alternative performed (Class A only) indicate "Process to Further Reduce Pathogens":
Compost I
Heat Dryina 0
Ileat Treatinent D
Therniophilic 1
Beta Ray
Gainina Ray U
Pastetu-iza.tion
Class B:
jAlt. (1) Fecal Density
All. (2) Process to SignificantlyReduce Pathogens Ll
If applicable to alternative performed (Class B only) indicate "Process to Significantly Reduce Pathogens":
Lime Stabilization o
Ali -Drying
Composting
Aerobic Digestion El
Anaerobic Digestion
If applicable to alternative performed (Class A or Class B) complete the following monitoring data:
Parameter
Allowable Level
in Sludge
Pathogen Density
um per of
E\cee-
der ces
1'rcquency
ol'Anah sis
Sample
Type
na ytica
Tech
is ue
Minimu
Geo..Mean
M.aximu
Units
Fecal Coliform
2 x 10 to the
6th power
per gram of
total solids
MPN
769
880
1179
MPN/g
0
7
grab
sm9221
1000 mpn per gram
of total solid (dr.v
weight)
Salmonella bacteria
(in lieu of fecal
coliform)
3 WIN per 4 grams
total solid (dr};
weight)
Vector Attraction Reduction (15A NCAC
02T .1107) - Please indicate alternative
nerformed:
Alt. 1. (VS reduction)
jj
Alt. 2 (40-dav bench)
)
Alt. 3 (30-day bench)
JAR. 4 (Spec. 0, uptake)
i...l
Alt. j ( l4-Day Aerobic)
0
Alt. 6 (Alk. Stabilization
Lj
Alt 7 (Drying - Stable) LJ
jAlt. 8 (Drying - Unstable)
LJ
Alt. 9 (Injection)
Ll
Alt. 10 (Lncorporation)
[:j
No vector attraction reduction alternatives were performed
CERTIFICATION STATEMENT (please check the appropriate statement)
"I ceu•tify, under penalty of law, that the pathogen requirements in 15A NCAC 02T .1.106 and the
vector ath,action reduction requirement in 15A NCAC 02T .1.107 have been met."
"I certify, under penalty of law, that the pathogen requirements in 15A NCAC 02T A 106 and the
vector ath'action reduction requirement in 15A NCAC 02T .1107 have not been met." (Please note
if you check this statement attach an explanation why you have not met one or both of the
reauirements.)
"This determination has been made under my direction and supervision in accordance with the system
designed to ensure that qualified personnel properly gather and evaluate the information used to determine
that the pathogen and vector ath•action reduction requirements have been met. .1 am aware that there are
significant penalties for false certification including fine and imprisonment."
1'l AOil � l .(�'�La �9.�p`�4Pt�Cy���Vr'tn+t� nos Key Southern Soil Builders, Inc.
Preparer Name and Title (type or print) Land Applier Name and Title (if applicable)(type or print)
f
Signature of Preparer *Da*tSi(Y4ature oteCand Applier (if applicable) Date
C
*Preparer is defined in 40 CFR Part 503.9(r) and 15A NCAC 2T .1102 (26)
DENR FORM PVRF 02T (12/2006)

NCDA&CS Agronomic Division Phone: [phone] Website: www.ncagr.gov/agronomi/
m3
C IrULTUf Predictive
�o
Client:
Thomas Warren
` 2">
F v Soil Report
o a
Mehlich-3 Extraction
1401 Alexis Lucia Rd.
Stanley, NC28164
Fo �• �� p� \� Links to Helpful Information
U,y
Sam led: 10/17/2017
Sampled County: Gaston
Farm: Not Provided
Received: 10/24/2017
Completed: 1110812017
Client ID: 478946
Sample ID: BT91
Recommendations:
Lime
Nutrients 1
Lime History:
Crop
1 - Fescue/OGrass/Tim, M
(tons/acre) N P205
0.5 120-200 0
K20 Mg S
90
2-
0 0
Test Results [units - WN in g/crrr3• CEC and Na in me /1011 N
rt No:
Advisor: Zach Key
Southern Soil Builders, Inc.
958 Hoots Rd
Roaring River, NC 28669
Advisor ID: 400594
More
Mn Zn Cu B Information
0 0 0 0 Note:12
q c , Os-N in mg/drrr3]: Soil Class: Mineral
HM% WN CEC BS% Ac pH P-1 K-1 Ca% Mg% S-1 Mn-I Mn-AI1 Mn-AI2 Zn-I Zn-AI Cu-1 Na ESP SS-1 NO3-N
0.41 1.02 9.3 81 1.8 5.8 197 25 65 15 66 660 413 1225 1225 702 0.3 3
Reprogramming of the laboratory -information -management system that makes this report possible is
being funded through a grant from the North Carolina Tobacco Trust Fund Commission.
Thank you for using agronomic services to manage nutrients and safeguard environmental quality.
- Steve Troxler, Commissioner of Agriculture

NCDA&CS Agronomic Division Phone: [phone] Website: www.ncagr.gov/agronomi/
GµpULTU1ig� Predictive
Report No.
Client:
' °�02
Ton Jones
Y
Advisor:
Zach Key
W= •
®f �e 1� ® Mehlich-3 Extraction
z p
1418 Nature Preserve Trl.
Denver, NC 28037
Southern Soil Builders, Inc.
958 Hoots Rd
x
Roaring River, NC 28669
�n
_'Fo,,,,_�.x�• Links to Helofut In ,-_ - _-_-_-- Sampted;_10/17/9M 7-
Sampled County: Lincoln
--------..-----
_ __----------.—_
Received: 10/24/2017
Farm: Not Provided
Completed: 11/08/2017
Client ID: 272840
Advisor ID: 400594
Sample ID: BT61
Recommendations: Lime
Nutrients (lb/acre)
Lime History:
Crop (tons/acre) N P2O5 K2O Mg S
1-Fescue/OGrassfTim, M 0.0 120-200 0
Mn
Zn
Cu B
More
Information
2-
0 0 0
0
0
0 0
Note: 12
Test Results [units - WN in g/cO; CEC and Na in meq/100 cm3; NO3-N in mg/dO]:
Soil Class:
Mineral
HM% WN CEC BS% Ac pH P-1 K-I Ca% Mg%
S-1 Mn-I Mn-All Mn Al2
Zn-I
Zn-AI
Cu-I Na ESP SS -I NO3-N
0.56 1.01 12.3 86 1.8 6.1 138 126 60 21
65 304 198
798
798
741 0.3 2
Sample ID: BT63 Recommendations: Lime
Nutrients (lb/acre)
Crop (tons/acre) N P2O5
Lime History: 1- Fescue/OGrassfTim, M 0.3 120-200 0
K2O Mg S
Mn
Zn
More
Cu B Information
2-
0 0 0
0
0
0 0 Note: 12
Test Results [units - WN in g/cO; CEC and Na in meg1100 cm3; NO3-N in mg/doj:
Soil Class:
Mineral
HM% WN CEC BS% Ac pH P-1 K-I Ca% Mg%
S-1 Mn-I Mn-All Mn AI2
Zn-I
Zn-AI
Cu-I Na - ESP SS -I NO3-N
0.71 1.04 11.5 82 2.0 5.9 113 110 59 18
59 152 108
668
668
876 0.2 2
North Carolina
j
Tobacco Trust Fund Commission
Reprogramming of the laboratory -information -management system that makes this report possible is
being funded through a grant from the North Carolina Tobacco Trust Fund Commission.
Thank you for using agronomic services to manage nutrients and safeguard environmental quality.
- Steve Troxler, Commissioner of Agriculture

Schutte, Maria
From: Schutte, Maria
Sent: Tuesday, March 14, 2017 5:03 PM
To: '[e-mail]'
Cc: '[e-mail]'; '[e-mail]'; '[e-mail]';
Gregory, Sonia; Pitner, Andrew
Subject: FW: WQ0003281 City of Belmont WWTP Inspection and Annual Report
Attachments: Belmont Lime-2016.pdf
Thank You Zach,
I believe you have answered all my questions. Your explanation of the sample labeling I think is sufficient for the 2016
report however, if you choose to sample the fields again now that will meet the permit requirements for 2017. 1 have
copied everyone with the City of Belmont and Sonia Gregory in our Central Office, so they will have the information for
their Annual Report copies.
Maria
From: [e-mail] [mailto:[e-mail]]
Sent: Tuesday, March 14, 2017 2:49 PM
To: Schutte, Maria <[e-mail]>
Subject: RE: WQ0003281 City of Belmont WWTP Inspection and Annual Report
Maria,
Attached is PDF copy of the Lime Application Log for the City of Belmont for 2016. The numbering of the
,._fields was a mistake when sampling. What is listed as sample ID BT52 on the soil report should be,field
BT6-3 and BT51 should have been listed as BT6-1. The labeling of BT6-2 on the soil chain of custody was
a mistake in labeling when.the sample was taken and should have been labeled as BT6-3.
I'm going to go ahead and pull another soil sample from the fields so that a soil report with the correct
sample numbers are available.
I will include the lime application log with all future annual reports to prevent such confusion.
If you have any questions, let me .know.
Zach Key
Southern Soil Builders, Inc.
-----=-- Original Message = -------
Subject: RE: WQ000.3281 City of Belmont WWTP Inspection and Annual Report
From: "Schutte, Maria" <maria.schutte@ncdenr.g-ov>
Date: -Thu, March 09, 2017 12:18 pm
To: "zachkey(a)southernsoilbuilders..com"
<zachkey(a)southernsoilbuilders.com>
Zach,
Sorry to hear you were sick and hope you are feeling much better.
You did include the "COC attachment in the_ -Annual Report, but here are my two requests:
1

r
61
The "Field Summary Forms" show BT 6-1; BT 6-3 and BT 9-1. Please confirm that site BT 6-3 Was sampled (Is
BT 6-2 a mislabeling during the soils sampling?).
Email me copies of your lime records (application logs w/ date, amount applied).
Call me with any questions.
Maria
From: [e-mail] [mailto:[e-mail]]
Sent: Wednesday, March 08, 2017 2:54 PM
To: Schutte, Maria <[e-mail]>
Subject: RE: WQ0003281 City of Belmont WWTP Inspection and Annual Report
Maria,
Sorry in the delay in responding, the flu struck -us hard and I'm a few days behind because of it.
I think the confusion with the soil reports comes from Where the lab made a mistake in its labeling
of the fields as BT51 and BT52 instead of BT61 and BT62 as was listed on the soil sample
information sheet that was sent in with the samples. I have included a copy of this with this
email. If needed I can re -sample the fields and get a report with the correct sample numbers, its
something that I will have to do anyway for 2017.
Zach Key
Southern Soil Builders, Inc.
-------- Original Message --------
Subject: 'WQ0003281 City of Belmont WWTP Inspection and Annual Report
From: "Schutte, Maria" <maria.schutte(d)ncdenr.gov>
Date: Wed, March 01, 2017 10:02 am
To: "'zachkey()southernsoilbuilders.com"'
<[e-mail]>
Cc: "'scraftQ&cityofbelmont.org"' <scraft(@cityofbelmont.org>,
"'cflowers(5)cityofbelmont.org"' <cflowersCabcityofbelmont.org>,
"amiller(a)cityofbelmont.org" <amiller(&cityofbelmont.org>, "Gregory,
Sonia" <Sonia.Gre o ncdenr. ov>
Sandra, Chuck And Adrian,
Attached is copy of the recent inspection report for your. records. I may be
reached by phone or email with. any questions.
Zach,
The Mooresville Regional Office received a copy of the referenced facility's
2016.Annual Report on February 27th, 2017. Upon review, I have -
additional questions about lime application, also noted in the attached
inspection report: The soils analyses have recommendations for
lime addition and the Field Summary Forms state 20001 bs./ac was applied
to all 3 fields utilized in December 2016; however, clarification of the field
ID vs the soil summary reporting ID is needed. And please email the.
F]

41
related lime application/purchase tracking records. Please call me to
discuss if needed.
Maria
Maria Schutte
Environmental Specialist
Water Quality Regional Operations Section
Division of Water Resources
North Carolina Department of Environmental Quality
704 663 1699 office
704 235 2184 direct
Maria. schutteCcD-ncdenr.gov
610 East Center Avenue
Suite 301
Mooresville, NC 28115
r:a Nothing. Compares,
Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties.
3

Time
Application
Log -Belmont
'I'P
DATE
Field No. Acres Amount in Tons Spreader Loads Tons per Acre
BT 6-3 12.9 16 Ton
BT 9-1
42 48 Ton
1.24

,
v-4
FE' --R 2 3 2 017
DINR SECTION
INFORMATION PROCESSING UNIT
RECEIVr:D/NCDENRIDWR
F L B 2 7 19 01117
WQROS
MOORESVILLE REGIONAL OFFICE
City of
Belmont
City of Belmont, NC
Waste Water Treatment Plant
2016 Annual Report
Land -Application- Program
NC Permit No. WQ0003281

Ail INUAU LA1VL AYYL11-AI'IU1V l:l+:R11VICAT1UIN FURIV1
WQ0003281 County:
as shown on permit):
on Operator:
Gaston
Year: 2016
City of Belmont
Southern Soil Builders, Inc. Phone: [phone]
►n of residuals as allowed by the permit occurred during the past calendar year?
No - If No, skip Part A, and Part B and proceed to Part C. Also, If residuals were
generated but not land applied, please attach an explanation on how the residuals were handled.
Part A - Residuals Application Summarv:
Total number of application fields in thepermit:
3
Total number of fields utilized for land application during the year:
3
Total amount of dry tons applied during the year for all application sites:
213.85
Total number of acres utilizes for land application during the year:
81.9
Part B - Annual Compiance Statement:
Facility was compliant during calendar year 2016 with all conditions of the land application permit
(including but not limited to items 1-13 below) issued by the Division of Water Resources. 0 Yes ❑ No
If no please, provide a written description why the facility was not compliant, the dates, and explain corrective action
taken.
1) Only residuals approved for this permit were applied to the permitted sites.
2) Soil pH was adjusted as specified in the permit and lime was applied (if needed) to achieve a soil pH of at least 6.0 or
the limit specified in the permit.
3) Annual soils analysis were performed on each site receiving residuals during the past calendar year and three (3) copies
of laboratory results are attached.
4) Annual TCLP analysis (if required) was performed and three (3) copies of certified laboratory results are attached.
5) All other monitoring was performed in accordance with the permit and reported during the year as required and three (3)
copies of certified laboratory results are attached.
6) The facility did not exceed any of the Pollutant Concentration Limits in 15A NCAC 02T .1105(a) or the Pollutant
Loading Rates in' 15A NCAC 02T .l 105(b) (applicable to 40 CFR Part 503 regulated facilities).
7) All general requirements in as specified in the Land Application Permit were complied with (applicable to 40 CFR Part
503 regulated facilities).
8) All monitoring and reporting requirements in 15A NCAC 02T .1111 were complied with (applicable to 40 CFR Part
503 regulated facilities).
9) All operations and maintenance requirements in the permit were complied with or, in the case of a deviation, prior
authorization was received from the Division of Water Resources.
10) No contravention of Ground Water Quality Standards occurred at a monitoring well or explanations of violations are
attached to include appropriate actions and remediations.
11) Vegetative cover was maintained and proper crop management was performed on each site receing residuals, as
specified in the permit.
12) No runoff of residuals from the application sites onto adjacent property or nearby surface waters has occurred.
13) All buffer requirements as specified on the permit were maintained during each application of residuals.
Part C - Certification:
"I certify, under penalty of law, that the above information is, to the best of my knowledge and belief, true, accurate,
and complete. I am aware that there are significant penalties for submitting false information, including the
possibility of fines and imprisonment for knowing violations."
)dO,, 1A.
Permittee Name and Title (type 6r print) Signature of Permittee Date
a-m-9
Signature of Preparer* TSate Signature of Land Applier Date
(if different from Permittee) (if different from Permittee and Preparer)
* Preparer is defined in 40 CFR Part 503.9 (r) and 15A NCAC 02T. 1102 (26) DENR FORM ACF (12/2006)

ANNUAL RESIDUAL SAMPLING SUMMARY FORM
Please note that your permit may contain additional parameters to be analyzed. The parameters can be reported in FORM RSSI
WQ Permit Number: WQ0003281
Facility Name:
Residual Source WQ # or
NPDES #:
City of Belmont
NCO021181
W 7P Name: City of Belmont
Residual Analysis Data
Laboratory: 1)
2)
3)
4)
5)
Waypoint Analyl
Parameter
Cone.or
.
• .• Date
Total. .
a For surface disposal facilities the ceiling concentration limits listed in this form are not applicable. Reference the individual permit for metals limits.
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed
to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant
penalties for somW*g false information, including the possibility of fines and imprisonment for knowing violations."
Signature of Preparer *
Date
*Preparer is defined in 40 CFR Part 503.9(r) and 15A NCAC 2T .1102 (26) DENR FORM RSSF (12/2006)

rame:
h this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Ci of BelmonttY Total Dry Tons Applied (Annual): WQ0003291 Cation Exchange Capacity (non 503 only):
erator: Lori Warren Owner: Lori Warren Predominant Soil Series: GaB2
Acres Used: 42 Acres Permitted: 42 Site #: BT 9-1
Field #: BT 9-1
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or 1 2 3 4 5 6 7 8 9 10 11 12
Com-
posite
Date 3/14/16
Solids 3
Arsenic 5
Cadmium 2
Copper
371
Chromiuff
87
Lead
26
Mercury
0.4
Molyb-
denum
5
Nickel
19
Selenium
5
Zinc
1470
Total
1
Phos-
17400
-_----�---
l
7DT/Ac./
­"Tj 1•=VLal riCiu.,oaamgs
1 2
3
(Ualculated in lbs/acre):
4 5 6 �
8 9
10 11
12
App.
Event
3.97
A:
Arsenic
Cadmium
0.040
0.016
0.000 ;
0.000
0.000
0:000
0.0 00.
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.040
Copper
2.945
0.000
0:000
0.000
0.000
0,000
0.000;
0.000
0.000
0.000
0.000:
0.000
0.000
0.016
Chromium0.691
0.000
0.000
0.000
0.000
0.000.
0.000
0.000
0.00.0.
0.000
0.000
0.000
0.000
2.945
Lead
206
0X-Y
0.000
, 0.000
0.000
0.000
0.000;
0.000,
0:000
0".000.
0.000
0.000
0 000
0.000
0.691
0.003
0.000,.,
.
: ,0.000
0.000
0.000
0.000.
0000
0.000
0000
.0'.00.0
0.000
0`:000
0:000
0.206
.
0.000
0.000
0.000
0.000
0.000
0.003
.040
0.000
`' o:000
o.000
o.000
o.000
o.000
o.000
o.000
o.000
o.000
o.000
0.040
.151
0.000
0.000
0.000
0.000
0.000
0.000
0:000
0.000
0.000
0.000
0.000
0.000
0.151
.040
1.669
0.000
, Q.000
" 0`.000
0.000
0,000
0.000
0.000
0.000
0.000
0:000
0.000
0.0000.000
0.040
0.000
0.000
0.000
0.000
0.000
0.000
6.000
0.000
11.669
8.121
0.000 ;:
0 000
0.000
0.000
0.000;
0.000
0.000
0.000
0.000
0.000
0.000
138.121
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
[ am aware that there are significant penalties for submitting false information, including the possibility of fines and
imprisonment for knowing violations".
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

aa�.i. vriL l.u.ir�i.a r1Li,L LVH111LNky aU1VLLV1AKY YIL) I1
kis form to the corresponding Field Loading Summary Form to be submitted in Annual Report
City of Belmont I Total Dry Tons Applied (Annual): 22.76
WQ0003281 Cation Exchange Capacity (non 503 only):
Tony Jones Owner: Tony Jones Predominant Soil Series: CeB2
27 Acres Permitted: 27 Site #: BT 6-1 Field #: BT 6-1
Residual Analvsis Data (Heaw Metals and Tntal Phncnharne nae maIlim of CnUlrle ,on i n"r Do,.,.,,,,+ .u).
loon
. ,-.NBEHEMEMB
o
i0
0
Com-
P.
Date
Total
h
���
..
rXJULIuai
Axuavy IVAULUi riGiu i,uauiugS
<<,aicuiaiea in ipsiacre):
Total
DT/Ac./
App.
Event
1
0.84
2 J
L3J4
51
6
7 J
1 8
_qj
10
11
12
c
P
••
Arsenic
0.008
0.000
0.000
0.000.
0.000
0.000
0.000
0.000
0.000
0;000
0.-000
0.000
0.008
Cadmium
0.003
0.000 .:
! 0.000
: 0.000 '
0.000
0.000
0.000
0.000
0.000
06000
0.000
0.000
.0.003
Copper
0.626
0.0W :
,i 0.000
0.000
0.000
0.000:
0.000
0.000
0.000
: 0.000
0.000
0.000
0.626
Chromium
0.147
0.000';
; 0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0:0.00
0.000
0.147
Lead
0.044
0.000
l0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.044
Mercury
0.001
0.00,0
0.000
0.000
0.000
0.000 .
0.000
0.000
0.000
0.000
0.000
0.000
0.001
Molyb-
denum
denum
0.008
0.000'
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.008
Nickel
0.032
0.0W
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.0.00 1.0.000
0.032
Selenium
0.008
0.000
; O 000
0.000 :
0,000
0.000_1
0.000
. 0.0.00.
, 0.000.
0.000.
0,0.00
0.600
0.008
Zinc
2.478
0.000
' 0.000
0.000'
0.000
0.000'
` 0.00.0
0.000
0.000
0.000
0 000
0.000
2.478
Total
Phos-
29.336
0.000
-0'.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
29.336
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
imprisonment for knowing violations".
1)'" �k
Signature of Land Applier
do,jl�
Date
DENR FORM MFLSF (1212006)

PAI I1NUAL 1VMIFAL3 MILL LVAU_LLNU bUIV11V1AKY V'VKLVI-
form to the corresponding Field Loading Summary Form to be submitted in Annual Report
City of Belmont Total Dry Tons Applied (Annual):
WQ0003281 Cation Exchange Capacity (non 503 only):
Tony Jones Owner: Tony Jones' Predominant Soil Series:
12.9 Acres Permitted: 12.9 Site #: BT 6-3 Field #:
24.39
CeB2
BT 6-3
Residual
Analysis Data
(Heavy
Metals and Total Phosphorus
use mg/kg,
% Solids use
Raw Percent #):
Sample or
Com-
posite
Date
1
3/14/16
21
3
4
5
6
7
8
9
10
11
12
% Solids
3
Arsenic
5
Cadmium
2
Copper
371
Chromium
87
Lead
26
Mercury
0.4
Molyb-
denum
5
Nickel
19
Selenium
5
Zinc
1470
Total
Phos-
horus
17400
Annual
Heavy Metal Field Loadings
(Calculated in lbs/acre):
Total
DT/Ac./
App.
Event
1
1.89
21
3
4 j
51
6
7
8
9
10
11j
12
o
"
Arsenic
0.019
0.000'
101000
1 0.000
0.000
1 0.000
.0.000
0.000-
. 0.000
0.006
0.000
0.000 1
0.019
Cadmium
0.008
0.000-4V000
0.000
0.000
0.000
. 0.000
.0.000
0.000
0.000
0.000
0.000
0:008
Copper
1.403
0.000'�.
10i000
0.000
0.000
0.000
0.00.0
0.000
0.000
0:000
0:000`
0:000
1.403
Chromium
0.329
0.000
0 000
0.000
0.000
0.060
'0.000
0.000
0.000
0.000
. 0.00.0
0.'000
0.329
Lead
0.098
0.000
'0 000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
. 0.000
0:000
0.008
Mercury
0.002
0.000
0;000
0.000
0.000
6.000
0.000
0.000
0.000
0.000
0.000
0.000
0.002
Molyb-
enum
denum
0.019
0.000
10 000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.019
Nickel
0.072
0.000-
'01000
0.000
0.000
0.0.00
-0.060
0.000
0.000
0.000
0.000
0.000
0.072
Selenium
0.019
0.000;
6i000
0.000
0.000
0.000
0.000
6.000
0.000
0.000
0.000
.0.000
0.019
Zinc
5.560
0.000
;0 000
1 0.006
0.000
0.000
0.000
0.000
0.000
- 0.00.0
0-.000
6.0.00
5.56.0
Total
Phos-
horus
65.807
0.000
0:000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
65.807
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
imprisonment for knowing violations".
,9­1) -J7
Signature of Land pplier
Date
DENR FORM MFLSF (1212006)

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: City of Belmont
Land Owner: Tony Jones
Operator: Tony Jones
Crop 1 Name: Fescue
WQ Permit #: WQ0003281 Field #: BT 6-1
Annual Dry Tons Applied: 22.7682 Site #: BT 6-1
Predominant Soil Series: CeB2
Crop 1 Max. PAN:
211
Crop 2 Name:
Acres Utilized: 27
Acres Permitted: 27
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
0 =
° y
o
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry TonslAc)
Residual Sources
(NPDES # WQ#
Fert,, Animal
Waste, etc)
Soil
Cond.
(Dry,
vest)
Precip.
Past 24
Hrs.
inches
Y
� n
co
r'
o a�
o
o
9
:h 9
w -�
*
TKN
mg/kg
z
ct I
o
°Qco
o w.
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
( lbs/acre) .
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
3-2016
182000
3
0.843
WQ0003281
dry
0
s
0.5
0.3
45300
5330
1 5200
33.488
NA
Fescue
0.000
0.000
0.000
0:000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.0.00
0.00:0
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
Residuals Applications totals on FORM FSF supp ( attach FORM
FSF supp to this form):
'OTALS:
0
182000
"
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
33.488
0.000
Lime Applied
knnuallbs/acre
0:008
0.143
0.151
36
0.063
0.172
0.175
34
0.626
62.355
62.981
NA
0.147
1.821
1.968
1338
u44
5.412
5.456
1 267 1
0.001
0.113
0.114
15
0.008
0.458
0.466
NA
.6.032
2.327
2.359.
374
0.008
0.172
0.180
89
2,478
98.166
100.644'
2498
29.336
Date
lbs/ac
'rior Years Cumulative lbs/ac
12-2016
2000
;urrent Cumulative lbs/ac
'ermitted C. P. L. R.****
'ermit PAN Limit lst/2nd Crop
`I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
lualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
nformation, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date
*** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (1212006)

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: City of Belmont
Land Owner: Tony Jones
Operator: Tony Jones
Crop 1 Name: Fescue
WQ Permit #: WQ0003281 Field #: BT 6-3
Annual Dry Tons Applied: 24.3945 Site #: BT 6-3
Predominant Soil Series: CeB2
Crop 1 Max. PAN: 211
Crop 2 Name: -
Acres Utilized: 12.9
Acres Permitted: 12.9
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
o y
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
PP P
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
Wei'
Moist)
Precip.
Past 24
Hrs.
inches
Y
� 'b
0
a
o
o
o
K -.
*
9
7v 9
w -4
„
* w
R.
TKN
mg/kg
z
cr
o
w
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
3-2016
195000
3
1 1.891
WQ0003281
dry
0
s
0.5
0.3
45300
5330
1 5200
75.097
NA
Fescue
0.000
0.000
- 0.000
0.000
0.000
0.060
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.00.0
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
Residuals Applications totals on FORM FSF supp ( attach
FORM
FSF supp to this form):
oTA1s:
01
195,000
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
I P
75.091
0.000
Lime Applied
k.nnuallbs/acre
0.019
0.566
0.585
36
0.068
0.16
0.168
34
1.403
57.759
59..162
NA 1
0.329
1.379
1.708
1338
0.098
5.177
5.275
1 267
0.002
0.097
0.099
15
0.019
0.426
0.445
NA
0.071
2.177
2.249
374
0.019
0.962
0.981
89
5.560
81.837
87.3.97
2498
1 65.807
.
Date
lbs/ac
'rior Years Cumulative lbs/ac
12-2016
2000
,urrent Cumulative lbs/ac
'ermitted C. P. L. R.****
'ermit PAN Limit lst/2nd Crop
_
211
'I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
lualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
nformation, including the possibility of fines and imprisonment for knowing violations."
Signature of Land Applier
'1-1-1%
Date
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
*** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: City of Belmont
Land Owner: Lori Warren
Operator: Lori Warren
Crop 1 Name: Fescue
WQ Permit #: WQ0003281 Field #: BT 9-1 Acres Utilized: 42
Annual Dry Tons Applied: 166.6958 Site #: BT 9-1 Acres Permitted: 42
Predominant Soil Series: GaB2
Crop 1 Max. PAN:
211
Crop 2 Name:
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
0 �
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
A lied per
Applied
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
wed'
Moist)
Precip.
Past 24
ems•
inches
Y
3 b
o D
a
o
o
w, `_«
* w.
4
:h �
w ti
°?
K.
w
0
TKN
mg/kg
Z
a �
o
as o
w•
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
g
Application
Crop 1
Crop 2
Crop 1
Crop 2
3-2016
500500
3
1.491
WQ0003281
dry
0
s
0.5
0.3
45300
5330
5200
59.202
NA
Fescue
8-2016
234000
3
0.697
WQ0003281
dry
0
s
0.5
0.3
45300
5330
5200
27.679
NA
Fescue
11-2016
598000
3
1.781
WQ0003281
dry
0
s
0.5
0.3
45300
5330
5200
70.734
70.734
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.00.0
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.0.00
0.000
0.000
0.000
0.000
Residuals Applications totals
on FORM FSF supp ( attach FORM FSF supp to this form):
'OTALS:
0
1332500
. _
AS
Cd
Cu
Cr
Pb
H
Mo
Ni
Se
Zn
P
157.615
70.734
Lime A lied
knnual lbs/acre
0.040
0.016
2.945
0.691
0.206
0.003
0.040
0.151
0.040
11.660
13&l2Q
-
Date
lbs/ac
'rior Years Cumulative lbs/ac
0.309
0.349
36
0.094
0.110
34
21.158
-24..103
NA
28
28.691
1338
3.118
3.324
267
0.052
0.055
15
0.13
0.170
NA
1.648
1.799
374
0.116
0.156
89
114.333
126.002
2498
12-2016
2000
;urrent Cumulative lbs/ac
'ermitted C. P. L. R.**** 1
'ermit PAN Limit 1 st/2nd Crop
_ -_ _ _....
211
'I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
lualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
nformation, including the possibility of fines and imprisonment for knowing violations."
Signature of Land Applier
- /`1
Date
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
*** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

Page: 1 of 2
Report Number: 16-076-0237
Account Number: 46381
Send To: SOUTHERN SOIL BUILDERS
DENNIS KEY
958 HOOTS ROAD
ROARING RIVER, NC 28669
Waypoint('-9--�
ANALYTICAL
Project: BELMONT
NC CERT#257
7621 Whitepine Road, Richmond, VA 232:
Main 804-743-9401 ° Fax [phone]r
www.waypointanalytical.co.,.
REPORT OF ANALYSIS Date Sampled: 3/14/2016 11:30:00
Lab Number: 56163 Data Received: 03/16/2016 00:00
Sample Id : BELMONT Data Rpnnrtarl• ni/g•t/on-ia
)UUUU
iuu.0
JM
03/16/201615:35
Moisture #
97,00
100.0
JM
03/16/2016 15:35
Total Kjeldahl Nitrogen
4.53
45300
10.0
JM
03/17/2016 07:59
Total Phosphorus
1.74
17400
100
KM
03/17/2016 10.44
Total Potassium
0.24
2360
100
KM
03/17/2016 10:44
Total Sulfur
1.10
11000
100
KM
03/17/2016 10:44
Total Calcium
1.26
12600
100
KM
03/17/2016 10.44
Total Magnesium
0.30
2980
100
KM
03/17/2016 10:44
Total Sodium
0.61
6130
100
KM
03117/2016 10:44
Total Iron
22600
100
KM
03/17/2016 10:44
Total Aluminum
30400
100
KM
03/17/2016 10:44
Total Manganese
1010
5
KM
03/17/2016 10:44
Total Copper
371
5
KM
03/17/2016 10:44
Total Zinc
1470
5
KM
03/17/2016 10:44
Ammonia Nitrogen
0.53
5330
10.0
JM
03/17/2016 07:59
Organic N
4.00
39970
10.0
03/17/2016 07:59
Nitrate+Nitrite-N
5200
2.00
JM
03/17/2016 08:00
Total Cadmium
<2.0
2.0
KM
03/17/2016 10:44
All values are on a dry weight basis except as noted by asterisk. Detection limit on all N series is on a wet basis.
Our reports and letters are for the exclusive and confidential use ofour clients. and may not be reproduced in 'whole or part. nor may any reference be made
to the work, the results, or the company in any advertising, news release, or other public announcements without obtaining our prior written authorization.
SM-25400
SM 2540G
SM-4500-NH3C-TKN
SW 6010C
SW 6010C
SW 6010C
SW 60100
SW 6010C
SW 6010C
SW 6010C
SW 6010C
SW 6010C
SW 6010C
SW 6010C
SM-4500-NH3C
CALCULATION
SM-450ONO3F
SW 6010C
Debbie Holt

Page: 2 of 2
Report Number: 16-076-0237
Account Number: 46381
Send To: SOUTHERN SOIL BUILDERS
DENNIS KEY
958 HOOTS ROAD
ROARING RIVER, NC 28669
Wayp®intMMa-
ANALYTICAL
Project: BELMONT
NC CERT#257
7621 Whitepine Road, Richmond, VA 2323
Main 804-743-9401 ° Fax [phone]
www.waypointanalytical.cor
REPORT OF ANALYSIS Date Sampled: 3/14/2016 11:30:00
Lab Number: 56163 Date Received: 03/16/2016 00:00
SampFe Id: BELMONT Date Reported: 03/21/2016
iotai L;nromium
87
5
KM
03/17/2016 10:44
SW 6010C
Total Nickel
19
5
KM
03/17/2016 10:44
SW 6010C
Total Lead
26
5
KM
03/17/2016 10:44
SW 6010C
Total Arsenic
5.0
3.0
KM
03117/2016 10:44
SW 6010C
Total Mercury
<0.4
0.4
KM
03/17/2016 09:00
SW-7471 B
Total Selenium
<5,0
5.0
KM
03/17/2016 10:44
SW 6010C
pH (Standard Units) *
6.08
2.00
JM
03A 7/2016 07:59
SW-9045D
Total Molybdenum
<5
5
KM
03/17/2016 10.44
SW 6010C
Comments:
SULFUR AND ORGANIC NITROGEN NOT FOR COMPLIANCE PURPOSES.
QUALIFIER: THE MATRIX SPIKE WAS OUT OF LIMITS FOR "Cr" AND "Fe". ALL OTHER QC DATA IS ACCEPTABLE.
All values are on a dry weight basis except as noted by asterisk. Detection limit on all N series is on a wet basis
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
to the work. the results, or the company in any advertising, news release, or other public announcements without obtaining our prior written authorization.
Debbie Holt

MM
Mineralization
as decimal
ITotal dry
tons/vear
1
IAcres
Applied on
1 81.9
Rate
0.3
TKN
45300
NH3
5330
NO3
5200
NO2
0
% Solids
0.03
213.85
PAN Surface
19856 m /kg 39.712 lbs/dry ton
8492.411 Ilbs total PAN
103.6924 Ibs PAN/acre
PAN Injection
225211 mglkg 45.042 lbs/dry ton
9632.232 1 Ibs total PAN
117.6097 Ibs PAN/acre
Dry Tonsil 000 gal.
0.1251
1st year PAN
Surface lbs.
8492.4112
1st year PAN
Injected Ibs.
9632.2317
Ibs./acre
Surface
103.6924444
Ibs./acre
Injected
117.6096667
MR(TKN-NH3)+ + .5(NH3)+NO3+NO2
mg/kg x .002
MR(TKN-NH3) + 1(NH3)+NO3+NO2
mg/kg x .002
=mg/kg
=Ibs/dry ton
=mg/kg
=Ibs/dry ton
1000 X 8.34 X %solids X sp. gravity "=dry tons/1000gal."
2000

Sodium Absorption Ratio
Na: Sodium (Mg/L) Equivalent weight: 23
Ca: Calcium (Mg/L) Equivalent weight: 20
Mg : Magnesium (Mg/L) Equivalent weight: 12
Milli Equivalent = Mg/L / Equivalent weight
Na M /L Ca(Mg/L) M M /L
183.9 1 378 1 89.4
Na ME
Ca ME
M ME
7.995652
1 18.9
1 7.45
SAR= Na Milli Equivalent/[0.5 X (Ca Milli Equivalent + Mg Milli equivalent)]0.5 power
SAR = 2.202818 (From Mg/L entered above)
SAR= 2.2012 11 (From ME entered below)
Na ME
Ca ME
Mg (ME)
7.99
1 18.9
1 7.45
The amour
amount of E
Permitting I

Analytical Results
Southern Soil Builders
958 Hoots Road
Roaring River, NC 28669
Receive Date: 03/14/2016
Reported: 04/15/2016
For: Belmont ' ' FN
All I
Comments: Geometric Mean 2,058 MPN/g
Sample Number Parameter Sample ID Result Unit Method Analyzed Analyst
160314-15-01 Fecal Coliforms 1 2,337 MPN/g SM92210E-2006 03/15/2016 WL
160314-15-01 Percent Solids 1 2.97 % SM2540B-1997 03/15/2016 WL
160314-15-02 Fecal Coliforms 2 4,467 MPN/g SM92210E-2006 03/15/2016 WL
160314-15-02 Percent Solids 2 2.91 % SM2540B-1997 03/15/2016 WL
160314-15-03 Fecal Coliforms 3 687 MPN/g SM92210E-2006 03/15/2016 WL
160314-15-03 Percent Solids 3 2.91 % SM2540B-1997 03/15/2016 WL
160314-15-04 Fecal Coliforms 4 685 MPN/g SM92210E-2006 03/15/2016 WL
160314-15-04 Percent Solids 4 2.92 % SM2540B-1997 03/15/2016 WL
160314-15-05 Fecal Coliforms 5 4,626 MPN/g SM92210E-2006 03/15/2016 WL
160314-15-05 Percent Solids 5 2.81 % SM2540B-1997 03/15/2016 WL
160314-15-06 Fecal Coliforms 6 4,727 MPN/g SM92210E-2006 03/15/2016 WL
160314-15-06 Percent Solids 6 2.75 % SM2540B-1997 03/15/2016 WL
160314-15-07 Fecal Coliforms 7 1,444 MPN/g SM92210E-2006 03/15/2016 WL
160314-15-07 Percent Solids 7 2.77 % SM2540B-1997 03/15/2016 WL
160314-15-08 Corrosivity Belmont See SW-846 03/28/2016 PACE
Attached
160314-15-08 Ignitability Belmont See 1010M 03/28/2016 PACE
Attached
160314-15-08 Reactivity Belmont See SW-846 03/28/2016 PACE
Attached
160314-15-08 TCLP Belmont See as Noted 03/28/2016 PACE
Attached
160314-15-09 30 Day Benchscale Belmont <1 % EPA625-R-92/0 03/14/2016 WL
Respectfully submitted,
hOP'wft' v ' '%-t I
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 1 of 4

Analytical Results
Southern Soil Builders For: Belmont
958 Hoots Road
Roaring River NC 28669
Entered: 03/14/2016
Reported:04/15/2016
Sample ID: 160314-15-09
PARAMETER: Vector Attraction Reduction/Aerobically Digested Sludge (30day)
Total Solids
Volatile Solids
% Volatile Solids
Week
1
1.99
1.1-7
0.5885
Week
2
1.36
0.84
0.6200
Week
3
1.34
0.84
0.6230
Week
4
1.31
0.79
0.6072
Week
5
1.31
0.79
0.6046
Volatile Solids Reduction: 0.5885 - 0.6046 X 100
0.5885 - (0.5885 X 0.6046)
Respectfully submitted,
Dena Myers
Statesville Analytical, Inc.
NC WW Cert.# 440NC
DW Cert. #37755

race Analytical Services, Inc.
9800 KinceyAve. Suite 100
Huntersville, NC 28078
[phone]
ANALYTICAL RESULTS
Project: 160314-15-08
Pace Project No.: 92290089
Sample: 160314-15-08 Lab ID: 92290089001 Collected: 03/14/16 11:15 Received: 03/15/16 10:00 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
8081 GCS Pesticides, TCLP
Analytical Method: EPA 8081 Preparation Method: EPA 3510
Leachate Method/Date: EPA 1311; 03/26/16 14:00
gamma-BHC (Lindane)
Chlordane (Technical)
ND ug/L 1.0 1 03/28/16 12:50
03/28/16 19:13
58-89-9
Endrin
ND ug/L 6.0 1 03/28/16 12:50
03/28/16 19:13
57-74-9
Heptachlor epoxide
ND ug/L 1.0 1 03/28/16 12:50
ND
03/28/16 19:13
72-20-8
Methoxychlor
ug/L 1.0 1 03/28/16 12:50
ND
03/28/16 19:13
1024-57-3
Toxaphene
ug/L 2000 1 03/28/16 12:50
03/28/16 19:13
72-43-5
Surrogates
ND ug/L 6.0 1 03/28/16 12:50
03/28/16 19:13
8001-35-2
Decachlorobiphenyl (S)
Tetrachloro-m-xylene (S)
51 % 10-138 1 03/28/16 12:50
215
03/28/16 19:13
2051-24-3
% 10-110 1 03/28/16 12:50
03/28/16 19:13
877-09-8 S5
8082 GCS PCB
Analytical Method: EPA 8082 Preparation Method: EPA 3510
PCB-1016 (Aroclor 1016)
PCB-1221 (Aroclor 1221)
ND ug/L 5.0 1 03/18/16 09:07
03/18/16 20:47
12674-11-2
PCB-1232 (Aroclor 1232)
ND ug/L 5.0 1 03/18/16 09:07
ND
03/18/16 20:47
11104-28-2
PCB-1242 (Aroclor 1242)
ug/L 5.0 1 03/18/16 09:07
ND ug/L
03/18/16 20:47
11141-16-5
PCB-1248 (Aroclor 1248)
5.0 1 03/18/16 09:07
ND
03/18/16 20:47
53469-21-9
PCB-1254 (Aroclor 1254)
ug/L 5.0 1 03/18/16 09:07
ND
03/18/16 20:47
12672-29-6
PCB-1260 (Aroclor 1260)
ug/L 5.0 1 03/18/16 09:07
ND ug/L 5.0
03/18/16 20:47
11097-69-1
Surrogates
1 03/18/16 09:07
03/18/16 20:47
11096-82-5
Decachlorobiphenyl (S)
16 % 10-132 1 03/18/16 09:07
03/18/16 20:47
2051-24-3
8151 Chlorinate Herbicide TCLP
Analytical Method: EPA 8151 Preparation Method: EPA 3510
2,4-D
2,4,5-TP (Silvex)
ND mg/L 0.010 1 03/24/16 12:55
03/26/16 01:27
94-75-7
Surrogates
ND mg/L 0.010 1 03/24/16 12:55
03/26/16 01:27
93-72-1
2,4-DCAA (S)
95 % 42-142 1 03/24/16 12:55
03/26/16 01:27
19719-28-9
6010 MET ICP, TCLP
Analytical Method: EPA 6010 Preparation Method: EPA 3010A
Leachate Method/Date: EPA 1311; 03/22/16 03:00 Initial pH: 6.7; Final pH: 5
Arsenic
Barium
ND mg/L 0.050 1 03/23/16 03:00
03/23/16 14:00
7440-38-2
Cadmium
ND mg/L 0.25 1 03/23/16 03:00
03/23/16 14:00
7440-39-3
Chromium
ND mg/L 0.0050 1 03/23/16 03:00
03/23/16 14:00
7440-43-9
Lead
ND mg/L 0.025 1 03/23/16 03:00
'
03/23/16 14:00
7440-47-3
Selenium
ND mg/L 0.025 1 03/23/16 03:00
03/23/16 14:00
7439-92-1
Silver
ND mg/L 0.10 1 03/23/16 03:00
03/23/16 14:00
7782-49-2
ND mg/L 0.025 1 03/23/16 03:00
03/23/16 14:00
7440-22-4
7470 Mercury, TCLP
Analytical Method: EPA 7470 Preparation Method: EPA 7470
Leachate Method/Date: EPA 1311; 03/22/16 03:00 Initial pH: 6.7; Final pH:
5
Mercury
ND mg/L 0.00020 1 03/23/1611:00
03/23/1614:17
7439-97-6
8270 MSSV TCLP Sep Funnel
Analytical Method: EPA 8270 Preparation Method: EPA 3510
Leachate Method/Date: EPA 1311; 03/26/16 14:00
1,4-Dichlorobenzene
2,4-Dinitrotoluene
ND ug/L 500 10 03/28/1611:25
03/29/1611:25
106-46-7
ND ug/L 500 10 03/28/1611:25 03/29/1611:25
121-14-2
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 03/29/2016 04:40 PM
without the written consent of Pace Analytical Services, Inc
-
Page 4 of 27

race Hnalyucai Services, Inc.
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
ANALYTICAL RESULTS
i i JUc L. -1 10W 14-1 b-08
Pace Project No.: 92290089
Sample: 160314-15-08 Lab ID: 92290089001 Collected: 03/14/16 11:15 Received: 03/15/16 10:00 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
8270 MSSV TCLP Sep Funnel Analytical Method: EPA 8270 Preparation Method: EPA 3510
Leachate Method/Date: EPA 1311; 03/26/16 14:00
Hexachloro-1,3-butadiene
Hexachlorobenzene
ND
ug/L
500
10
03/28/16 11:25
03/29/16 11:25
87-68-3
Hexachloroethane
ND
ND
ug/L
500
10
03/28/16 11:25
03/29/1611:25
118-74-1
2-Methylphenol(o-Cresol)
ND
ug/L
ug/L
500
10
03/28/16 11:25
03/29/16 11:25
67-72-1
3&4-Methylphenol(m&p Cresol)
ND
ug/L
500
10
03/28/16 11:25
03/29/16 11:25
95-48-7
Nitrobenzene
ND
500
10
03/28/16 11:25
03/29/16 11:25
Pentachlorophenol
ND
ug/L
500
10
03/28/16 11:25
03/29/16 11:25
98-95-3
Pyridine
ND
ug/L
1000
10
03/28/1611:25
03/2911611:25
87-86-5
2,4,5-Trichlorophenol
ND
ug/L
500
10
03/28/16 11:25
03/29/16 11:25
110-86-1
Trichlorophenol
ND
ug/L
ug/L
500
10
03/28/16 11:25
03/29/16 11:25
95-95-4
Surrogates
Surrogates
500
10
03/28/16 11:25
03/29/16 11:25
88-06-2
Nitrobenzene-d5 (S)
2-Fluorobiphenyl (S)
0
%
12-102
10
03/28/16 11:25
03/29/16 11:25
4165-60-0
D3,84
Terphenyl-d14 (S)
0
0
%
13-107
10
03/28/16 11:25
03/29/16 11:25
321-60-8
S4
Phenol-d6 (S)
0
%
21-132
10
03/28/16 11:25
03/29/16 11:25
1718-51-0
S4
2-Fluorophenol (S)
%
10-110
10
03/28/16 11:25
03/29/16 11:25
13127-88 -3
S40
2,4,6-Tribromophenol (S)
0
%
10-110
10
03/28/16 11:25
03/29/16 11:25
367-12-4
S4
%
27-108
10
03/28/16 11:25
03/29/16 11:25
118-79-6
S4
8260 MSV TCLP
Analytical Method:
EPA 8260 Leachate
Method/Date:
EPA 1311; 03/16/16
10:42
Benzene
2-Butanone (MEK)
ND
ND
ug/L
100
20
03/22/16 00:48
71-43-2
Carbon tetrachloride
ND
u9 /L
ug/L
00
20
03/22/16 00:48
78-93-3
Chlorobenzene
ND
ug/L
1
100
100
20
03/22/16 00:48
56-23-5
Chloroform
ND
ug/L
20
03/22/16 00:48
108-90-7
1,4-Dichlorobenzene
ND
ug/L
100
20
03/22/16 00:48
67-66-303/22/16
1,2-Dichloroethane
ND
ug/L
100
20
00:48
106-46-7
1,1-Dichloroethene
ND
ug/L
100
20
03/22/16 00:48
107-06-2
Tetrachloroethene
ND
ug/L
100
20
03/22/16 00:48
75-35-4
Trichloroethene
ND
ug/L
100
20
03/22/16 00:48
127-18-4
Vinyl chloride
ND
ug/L
100
20
03/22/16 00:48
79-01-6
Surrogates
100
20
03/22/16 00:48
75-01-4
1,2-Dichloroethane-d4 (S)
100
%
70-130
20
Toluene-d8 (S)
101
03/22/16 00:48
17060-07-0
4-Bromofluorobenzene(S)
101
%
20
03/22/16 00:48
2037-26-5
70-130
20
03/22/16 00:48
460-00-4
Percent Moisture
Analytical Method: ASTM D2974-87
Percent Moisture
96.6
%
0.10
1
03/24/16 11:39
1010 Flashpoint,Closed Cup
Analytical Method: EPA 1010
Flashpoint
183
deg F
70.0
1
03/27/16 12:15
9045 pH Soil
Analytical Method: EPA 9045
pH at 25 Degrees C
5.8
Std. Units
0.10
1
03/18/1614:35
H6
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 03/29/2016 04:40 PM without the written consent of Pace Analytical Services, Inc..
Page 5 of 27

ANALYTICAL RESULTS
Project: 160 314-15-0 8
Pace Project No.: 92290089
race Analytical Services, Inc.
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Sample: 160314-15-08
Lab ID: 92290089001 Collected:
03/14/16 11:15
Received: 03/15/16 10:00 Matrix: Water
Parameters
Results Units Report Limit DF
Prepared Analyzed CAS No. Qual
9095 Paint Filter Liquid Test
Analytical Method: EPA 9095
Free Liquids
FAIL
1.0 1
03/17/16 14:40
733C Reactive Cyanide
Analytical Method: SW-846 7.3.3.2
Cyanide, Reactive
ND mg/L
0.010 1
03/21/16 21:04
734S Reactive Sulfide
Analytical Method: SW-846 7.3.4.2
Sulfide, Reactive
ND mg/L
1.0 ' 1
03/21/16 18:20
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 03/29/2016 04:40 PM without the written consent of Pace Analytical Services, Inc..
Page 6 of 27

LNJU"v%.11ull r VICV1 (UL'r Rules)
rName: City of Belmont WQ Permit Number:
TP Name: City of Belmont NPDES Number:'
onitoring Period: From 1/1/2016 To 12/31/2016
Pathogen Reduction (15A NCAC 02T .1106) - Please indicate level achieved and alternative
Class A: Alt. A (time/temp) ❑ AltB —(A lk Treatment) ❑ I Alt. C (Prior Testis
Alt.D (No Prior Test) ❑ Process to Further Reduce Pathoge
If applicable to alternative performed (Class A only) indicate "Process to Further Reduce Pathogen,
Compost ❑ Heat Drying ❑ Heat Treatment ElThermophili
Beta Ray ❑ Gamma Ray ❑ Pasteurization ❑
Class B: jAlt. (1) Fecal Density
If applicable to alternative performed (Cl;
Lime Stabilization ❑ I Air
Anaerobic Digestion ❑
If applicable to alternative performed
Parameter Allowable Level
in Sludge Minirr
2 x 10 to the WN 685
6th power
per gram of
Fecal Coliform total solids CFU
1000 mpn per gram
of total solid (dry
weight)
Salmonella bacteria 3 NTN per 4 grams
(in lieu of fecal total solid (dry
0I Alt. (2) Process to Signi:
iss B only) indicate "Process to
Drying ❑ co nr
aptly Reduce Pathoge
gnificantly Reduce Pa
ting ❑ Aerobic
iss A or Class B) complete the
Pathogen Density
Geo. Meanaxim Units
WQ0003281
NCO021181
)erformed:
7) ❑
7
gs ❑
f.
;FT -
;ens":
;estion ❑
allowing monitoring data:
umber ot Frequency Sample
Excee-
dences of Analysis Type
Tech-
2058 I 4127 I MPN/g I 0 I 7 I grab I sm9221
Vector Attraction Reduction (15A NCAC 02T .1107) - Please indicate alternative performed:
Alt.1 (VS reduction) ❑ Alt. 2 (40-day bench) ❑ Alt. 3 (30-day bench) 21 JAIt. 4 (Spec. 02 uptake) ❑
Alt. 5 (14-Day Aerobic) ❑ Alt. 6 (Alk. Stabilization ❑ Alt 7 (Drying - Stable) ❑ JAIt. 8 (Drying - Unstable) ❑
Alt. 9 (Injection) ElAlt. 10 (Incorporation) ❑ lNo vector attraction reduction alternatives were performed ElCERTIFICATION STATEMENT (please check the appropriate statement)
0 " I certify, under penalty of law, that the pathogen requirements in 15A NCAC 02T .1106 and the
vector attraction reduction requirement in 15A NCAC 02T .1107 have been met."
❑ "I certify, under penalty of law, that the pathogen requirements in 15A NCAC 02T .1106 and the
vector attraction reduction requirement in 15A NCAC 02T .1107 have not been met." (Please note
if you check this statement attach an explanation why you have not met one or both of the
requirements.)
"This determination has been made under my direction and supervision in accordance with the system
designed to ensure that qualified personnel properly gather and evaluate the information used to determine
that the pathogen and vector attraction reduction requirements have been met. I am aware that there are
significant penalties for false certification including fine and imprisonment."
( 4t&1`1 S 4, Ft S -% A a7i li Dennis Key Southern Soil Builders, Inc.
Preparer Name nd Title ( or print) Land Applier Name and Title (if applicable)(type or print)
117
Si e of Prep er* Date Signature of Lid Applier (if applicable) Date
*Preparer is defined in 40 CFR Part 503.9(r) and 15A NCAC 2T .1102 (26)
DENR FORM PVRF 02T (1212006)

NCDA&CS Agronomic niyicinn Dk ;,»,e:
Predictive
IF/�•r ��i' pry$ +� ������'� ��� Soil Report
Websiie. www.ncagr.goviagronomi/ Report No. FY17
Client: Southern Soil Builders, Inc. Advisor:
958 Hoots Rd
Roaring River, NC 28669
Mehlich-3 Extraction
Sampled County: Gaston
Sampled: 11/17/2016 Received: 11/21/2016 completed: 12/22/2016 Farm: Links to Helpful Information
Sample ID: MH25 Recommendations: Lime Nutrients (lb/acre) More
Crop (tons/acne) N P205 K20 Mg S Mn Zn Cu B Information
Lime History: 1- Fescue/OGrass/Tim, M 0.0 120-200 0 0 0 0 0 0 0 0 Note: 12
2-
Test Results [units - WN in g/crri3 CEC and N . /1 rna
a m meq 00 c ; N034N in mg/drrrr]:
Soil Class:
Mineral
HM% WN CEC
BS% Ac pH P-1 K-1
Ca% Mg% S4 Mnd
Mn-All Mn Al2
Zn4 Zn AI
Cu4 Na ESP SS4 NO3-N
0.51 1.10 7.9
85 1.2 6.2 135 88
63 16 31 329
211
125 125
206 0.1 1
Sample ID: B+64-
}
Recommendations: Lime
Nutrients (lb/acre)
Lime History:
Crop (tons/acre)
1- Fescue/OGrass/Tim, M 1.0
N P205 K20
120-200 0
Mg S
Mn Zn
Cu B
More
Information
2-
0
0 0
0 0
0 0
Note: 12
Test Results [units - WN
in /cnr3 CEC d N
gI an a m meq/100 c , NO3-N in mg/drrr3]:
Soil Class:
Mineral
HM% W/V CEC
BS% Ac pH P-1 K4 Ca% Mg% S4
Mn-I
Mn-All
Mn-AI2
Zn4 Zn AI
Cu-I
Na
ESP SS4 NO3-N
0.56 0.95 10.0
79 2.1 5.5 120 114 55 18 48
242
162
350 350
318
0.1
1
Sample ID: tom_ 2
�'l cO�
Recommendations: Lime
Nutrients (lb/acre)
More
Lime History:
Crop (tons/acre) N P205
1-Fescue/OGrassTm, M 1.3 120-200 0
K20
Mg
S
Mn Zn
Cu
B
Information
2-
0
0
0
0 0
0
0
Note: 12
Test Results [units - WN in g/ca; CEC and Na in meg1100 crrr;; NO3-N in mg/drrr?]:
Soil Class:
Mineral
HM% WN CEC
BS% Ac pH P-1 K4 Ca% Mg% S-1
Mn-I
Mn-All
Mn Al2
Zn4 Zn-AI
Cu-I
Na
ESP SS4 NO3-N
0.51 0.95 10.7
77 2.5 5.3 113 102 54 18 51
212
144
373 373
479
0.1
1
North Carolina
!A
?.,t+auo irmt F and Cr�-ancuwon
Reprogramming of the laboratory -information -management system that makes this report possible is being funded
through a grant from the North Carolina Tobacco Trust Fund Commission.
Thank you for using agronomic services to manage nutrients and safeguard environmental quality.
- Steve Trox

�. .._..
�.. ,.
o!A.ne- 19191 733-2655
ReporiNo. FY17-S7of
PagSample
ID: BT91
Recommendations: Lime
Nutrients (lb/acre)
MCrop
(tons/acre)
N P2O5
K2O Mg
S
Mn Zn
Cu B
InformLime
History:
1- Fescue/OGrass/Tim, M 1.2
120-200 0
0 0
0
0 0
0 0
Note:
2-
Test Results [units - WN in g/cd; CEC and Na in meq/100 crrP; NO3-N in mg/drrP]:
Soil Class:
Mineral
HM% WN CEC
BS% Ac pH P4 K-1
Ca% Mg% S-1
Mn-1 Mn-All
Mn-AI2
Zn-I Zn-AI
Cu-1 Na ESP SS-1 NO3-N
0.56 0.92 9.8
76 2.3 5.3 114 82
54 18 49
203 139
331 331
430 0.1 1

LAB NUMBER
SAMPLE
(Leave blank) IDENTIFICATION
1
ran
N a s
2
_
I
3
�T
�a
4
5
16
7
8
9
10
I attestthat the accompanying samples mete collected in Nor#h. Carolina.
LIME APPLIED WITHIN
PAST 12 MONTHS
Tons/Acre Month Year
you jor using agronomre servrces 10 manage
You must specify a crop CODE to receive a recommendation (see reverse side of form)
FIRST CROP CODE SECOND CROP
CODE
tsc as s
os-,

Water Resources
ENVIRONMENTAL QUALITY
March 22, 2016
Mr. Adrian Miller, Interim City Manager
P.O. Box 431
Belmont, North Carolina 28012
PAT MCCRORY
' Governor
I', K � i•
DONALD R. VA.Na,ER=F/AART
Secre/ary
S. JAY ZIMMERMAN
Director
Subject: Acknowledgement of Receipt of the 2015 Annual Report
City of Belmont WWTP - Permit No.: WQ0003281
Land Application of Residuals
Gaston County
Dear Mr. Miller:
The Mooresville Regional Office (MRO) .received and reviewed the 2015 Annual Report
for the above permit. Please note:
• The VS% reduction calculations were not included.
• The Certification Form under Part B, "Facility was compliant during calendar
year", states 2014.
Please submit any necessary corrections and data to me and make a note for next -
yeaes submission. I may be reached at maria.schutte&hcdenr.gov. or [phone]
with any questions.
Sincerely, .
Maria Schulte, .Envir`onmental. Specialist.
Mooresville Regional Office
Water Quality Regional: Operations Section
Division of Water Resources, NCDEQ
CC: Chuck Flowers, Utilities Director, Belmont (Email)
Sandra Craft, WWTP Supervisor, Belmont (Email)
Dennis Key c/o Zach Key, Southern Soil Builders (email)
Nathaniel Thornburg, LAU.Compliance, CO -Raleigh (email)
State of North Carolina Environmental Quality I Water Resources I Water Quality Regional Operations
Mooresville Regional Office) 610 East Center Avenue, Suite 3011 Mooresville, North Carolina 28115
704 663 1699

/ 4 p"L
SyG A--
E'VEI)/NCDENR/DWR
FEB 17 2016
QROS
MOORESVILLE
REGIONgL OFFICE
9OF071 ED
FEB 10 2016
INFORMATION SECTION
UNIT
City of
Belmont
City of Belmont, NC
Waste Water Treatment Plant
2015 Annual Report
Land Application Program
NC Permit No. WQ0003281

AlrlrUAL LAINJJ AYYlAUA11OP1 UERT11N UATION FORM
it#: WQ0003281
County:
ty Name (as shown on permit):
Gaston
Year: 201-4)
City of Belmont
d Application Operator:
Southern Soil Builders, Inc.
Phone: [phone]
Land application of residuals as allowed by the permit occurred during the past calendar year,?ECEIVED/NMENR/OWFt
A Yes El No - If No, skip Part A, and Part B and proceed to Part C. Also, If residuals wereEEB 17 2016
generated but not land applied, please attach an explanation on how the residuals were handled.
Part A - Residuals Application Summary: WQROs
Total number of application fields in the permit:
'3� "ctu� NAL OFFIC -
Total number of fields utilized for land application during the year:
F1
Total amount of dry tons applied during the year for all application sites.-F
164.98
Total number of acres utilizes for land application during the year:
42
Part B - Annual Compiance Statement:
Facility was compliant during calendar year 2014 with all conditions of the land application permit
(including but not limited to items 1-13 below) issued by the Division of Water Resources. 0 Yes C1 No
If no please, provide a written description why the facility was not compliant, the dates, and explain corrective action
taken.
1) Only residuals approved for this permit were applied to the permitted sites.
2) Soil pH was adjusted as specified in the permit and lime was applied (if needed) to achieve a soil pH of at least 6.0 or
the limit specified in the permit.
3) Annual soils analysis were performed on each site receiving residuals during the past calendar year and three (3) copies
of laboratory results are attached.
4) Annual TCLP analysis (if required) was performed and three (3) copies of certified laboratory results are attached.
5) All other monitoring was performed in accordance with the permit and reported during the year as required and three (3)
copies of certified laboratory results are attached.
6) The facility did not exceed any of the Pollutant Concentration Limits in 15A NCAC 02T .1105(a) or the Pollutant
Loading Rates in 15A NCAC 02T .1105(b) (applicable to 40 CFR Part 503 regulated facilities).
7) All general requirements in as specified in the Land Application Permit were complied with (applicable to 40 CFR Part
503 regulated facilities).
8) All monitoring and reporting requirements in 15A NCAC 02T .1111 were complied with (applicable to 40 CFR Part
503 regulated facilities).
9) All operations and maintenance requirements in the permit were complied with or, in the case of a deviation, prior
authorization was received from the Division of Water Resources.
10) No contravention of Ground Water Quality Standards occurred at a monitoring well or explanations of violations are
attached to include appropriate actions and remediations.
11) Vegetative cover was maintained and proper crop management was performed on each site receing residuals, as
specified in the permit.
12) No runoff of residuals from the application sites onto adjacent property or nearby surface waters has occurred.
13) All buffer requirements as specified on the permit were maintained during each application of residuals.
Part C - Certification:
"I certify, under penalty of law, that the above information is, to the best of my knowledge and belief, true, accurate,
and complete. I am aware that there are significant penalties for subm' t' g false information, including the
possibility of fines and imprisonment for knowing violations."
Petee Name and Title (type or print) Signature of Permittee Date
ate
of Lag Applier
Date
(if different from Permittee) (if different from Permittee and Preparer)
* Preparer is defined in 40 CFR Part 503.9 (r) and 15A NCAC 02T .1102 (26) nFNR F(-)l?nn Ar.F (i 9i,)nnri

ANNUAL RESIDUAL SAMPLING SUMMARY FORM
Please note that your permit may contain additional parameters to be analyzed. The parameters can be reported in FORT
WQ Permit Number: WQ0003281
Facility Name:
Residual Source WQ # or
NPDES #:
City of Belmont
NCO021181
WWTP Name: City of Belmont, WWTP
Residual Analysis Data
Laboratory:
1)
2)
3)
4)
5)
A&L Eastern Labs
Parameter
(mg/kg)
Cone.
Limit
m a
Sample or Composite Date
4-20-15
Percent Solids (%)
NA
3.46
Arsenic
75
17
Cadmium
85
2
Copper
4,300
599
Chromium
NA
54
Lead
840
41
Mercury
57
2
Molybdenum
75
5
Nickel
420
24
Selenium
100
5
zinc
7,500
786
Total Phosphorus
NA
15000
TKN
NA
41900
Ammonia -Nip ogen
NA
5780
Nitrate and Nitrite
NA
2
For surface disposal acilifies the ceiling concentration limits listed in this form are not applicable. Reference the individual permit for metals limits.
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed
to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant
penaltio for submitting false ' formation, including the possibility of fines and imprisonment for knowing violations."
/. 1
Signature of Preparer * Date
*Preparer is defined in 40 CFR Part 503.9(r) and 15A NCAC 2T .1102 (26) DENR FORM RSSF (12/2006)

AINA UAL MEIALN FIEL-D LOADING SUMMARY FORM*
this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
ame:
Used:
City of Belmont Total Dry Tons Applied (Annual):
WQ0003281 Cation Exchange Capacity (non 503 only):
Lori Warren Owner: Lori Warren Predominant Soil Series:
42 Acres Permitted: 42 Site #: BT 9-1 Field #: BT 9-1
164.98
GaB2
Residual Analvsis Data (Heavv Metals and Total Phncnhnrm mp mQ/kv_ 0/ Cnlidlc ace, Raw Pa. -rant i4l.
Com-
..
Date
M.
®
Total
.
..
iii
t-Vl.0 LLal IICi2VV IVICLs I PICIU JUMMILIVIN iLaicuiaien In Ins/nerp).
Total
1
L 2
3
4
5
L.6-F
7
L8F
[-91
10
11
12
DT/Ac./
App,
a
Event
3.93
Arsenic
0.134
0.000
0.000
0.000
0.000
0.000
0.000
1 0.000
0.000
0.000
0.000
0.000
0.134
Cadmium
0.016
0.000
0.000
0.000
0.000
0.000
0.000
1 0.000
0.000
0.000
0.000
0.000
0.016
Copper
4.706
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
4.706
Chromium
0.424
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.424
Lead
0.322
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1 0.000
0.000
0.322
Mercury
0.016
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.016
Molyb-
denum
0.039
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.039
Nickel
0.189
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000 1
0.189
Selenium
0.039
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.039
Zinc
6.175
0.000
0.000
0.000 1
0.000
0.000
0.000 1
0.000
0.000
0.000
0.000
0.000
6.175
Total
Phos-
117.840
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
117.840
horus
VIT ___r.•P_
1 V. 4A1" uuuv. Ncua.iy VA .nVV, MM •u„ uv4;wilCui was prepares unaer my alrection or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
imprisonment for knowing violations".
/Tp-j * I - as-- I rj-
Sign re of Land Applier Date
r1FNP 1:f1RAA AAGf RF /1010nna�

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: City of Belmont
Land Owner: Lori Warren
Operator: Lori Warren
Crop 1 Name: Fescue
WQ Permit #: WQ0003281 Field #: BT 9-1
Annual Dry Tons Applied: 164.9865 Site #: BT 9-1
Acres Utilized: 42
Acres Permitted: 42
Predominant Soil Series: GaB2 Cation Exchange Capacity (non 503)•
Crop 1 Max. PAN: 211 Crop 2 Name: Cron 2 Max. PAN!
O
r11(
Q
3-2015
Volume applied
enter one Solids/
)
Liquid
Cu. Yds Gallons
299000
o
/o
Solids
3.46
Volume
Applied per
Acre
(Dry Tons/Ac)
1.027
Residual Sources
DES # W #
Q
Fert., Animal
Waste, etc)
WQ0003281
Soil
Cond.
wry,
Wet,
Moist)
dry
Preci P
Past 24
Hrs.
inches
0
a
a
cc �+
5r o'
o
s
G
o
%�
g EF
N'
0.5
CD
�,
o
0.3
TKN
mg/kg
41900
Z
�,° o
c,
� �,
mg/kg
5780
Nitrate
and
Nitrite
mg/kg
2
PAN Applied
pp
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
28.201
20.845
NA
NA
Fesuce
Fesuce
1-2015
i-2015
7-2015
221000
207500
416000
3.46
3.46
3.46
0.759
0.713
1.429
WQ0003281
WQ0003281
WQ0003281
dry
dry
dry
0
0
0
s
s
s
0.5
0.5
0.5
0.3
0.3
0.3
41900
41900
41900
5780
5780
5780
2
2
2
19.571
NA
Fesuce
39.237
NA
Fesuce
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
�TALs:
nnuallbs/acre
01 1143500,
As
0.134
Residuals Applications
Cd Cu
0.016 4.706
totals
Cr
0.424
on FORM FSF
Pb Hsz
0.322 0.016
supp ( attach
Mo
0.039
FORM FSF supp to this form):
Ni Se Zn P 107.854 0.000
0.189 0.039 6.175 117.840
1.459 0.077 108.158
1.648 0.116 114.333
374 89 2498
Lime Applied
Date lbs/ac
'ior Years Cumulative lbs/ac
0.175
0.078
16.452
27.576
2.796
0.036
0.091
urrent Cumulative lbs/ac
0.309
0.094
21.158
28.000
3.118
0.052
0.130
;rmitted C. P. L. R.****
36
34
NA
1338
267
15
NA
:rmit PAN Limit lst/2nd Crop
- ..
211
_-_ -__„ ,..-- t,.,.,-j - «,,., Luaa LU" u��uiueni was preparea unaer my direction or supervision in accordance with a system designed to assure that
:alified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
&Urmiatiou, including the possibility of fines and imprisonment for knowing violations."
E
Signature of Land Applier
1-)s-
Date
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
*** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (1212006)

Page: 1 of 2
Report Number: 15-113-0205
Account Number: 46381
Send To: SOUTHERN SOIL BUILDERS
DENNIS KEY
958 HOOTS ROAD
ROARING RIVER, NC 28669
Lab Number: 61568
Sample Id: BELMONT
�xL A&L Eastern Laboratories, Inc.
7621 Whitepine Road Richmond, Virginia 23237 [phone] Fax [phone]
www.aleastem.com
Project: BELMONT
NC CERT#257
REPORT OF ANALYSIS
Date Sampled: 4/20/2015 15:00:00
Date Received: 04/23/2015 00:00
Date Reported: 04/29/2015
Total Solids *
3.46
34600
100.0
BW
04/23/2015 15:00
SM-2540G
Moisture *
96.54
100.0
BW
04/23/2015 15:00
SM-2540G
Total Kjeldahl Nitrogen
4.19
41900
10.0
JM
04/24/2015 09:00
SM-4500-NH3C-TKN
Total Phosphorus
1.50
15000
100
KM
04/24/2015 11:56
SW 6010C
Total Potassium
0.32
3150
100
KM
04/24/2015 11:56
SW 6010C
Total Sulfur
0.67
6710
100
KM
04/24/2015 11:56
SW 6010C
Total Calcium
0.95
9520
100
KM
04/24/2015 11:56
SW 6010C
Total Magnesium
0.26
2640
100
KM
04/24/2015 11:56
SW 6010C.
Total Sodium
0.20
1960
100
KM
04/24/2015 11:56
SW 6010C
Total Iron
23100
100
KM
04/24/2015 11:56
SW 6010C
Total Aluminum
46800
100
KM
04/24/2015 11:56
SW 6010C
Total Manganese
283
5
KM
04/24/2015 11:56
SW 6010C
Total Copper
599
5
KM
04/24/2015 11:56
SW 6010C
Total Zinc
786
5
KM
04/24/2015 11:56
SW 6010C
Ammonia N trogen,
0.58
5780
10.0
JM
04/24/2015 09:00
SM.
Organic N
3.61
36120
10.0
04i24/2015 09:00
CALCULATION
Nitrate+Nitrite-N
<2.00
2.00
JM
04/27/2015 09:25
SM-450ONO3F
Total Cadmium
<2.0
2.0
KM
04/24/2015 11:56
SW 6010C
All values are on a dry weight basis except as noted by asterisk. Detection limit on all N series is on a wet basis. Our reports and fetters are for the exclusive and confdepuai use of our ciients. and n:ay not be reproduced in whole or pan, nor may any refersnce be made m�C..///►SQL
to the work, fne results, or ti7e company in any advertising. nev✓s release. or other public announcements without obtaining our prior written authorization.
Debbie Holt

Page: 2 of 2
Report Number: 15-113-0205
Account Number: 46381
Send To: SOUTHERN SOIL BUILDERS
DENNIS KEY
958 HOOTS ROAD
ROARING RIVER, NC 28669
Lab Number: 61568
Sample Id: BELMONT
�YL A&L Eastern Laboratories, Inc.
7621 Whitepine Road Richmond, Virginia 23237 [phone] Fax [phone]
wwwaleastem.com
Project: BELMONT
NC CERT#257
REPORT OF ANALYSIS
Date Sampled: 4/20/2015 15:00:00
Date Received: 04/23/2015 00:00
Date Reported: 04/29/2015
Total Chromium
54
5
KM
04/24/2015 11:56
SW 6010C
Total Nickel
24
5
KM
04/24/2015 11:56
SW 6010C
Total Lead
41
5
KM
04/24/2015 11:56
SW 6010C
Total Arsenic
17.0
3.0
KM
04/24/2015 11:56
SW 6010C
Total Mercury
2.0
0.4
KM
04/24/2015 09:00
SW-7471 B
Total Selenium
<5.0
5.0
KM
04/24/2015 11:56
SW 6010C
pH (Standard Units) *
7.04
2.00
JM
04/27/2015 09:24
SW-9045D
Total Molybdenum
<5
5
KM
04/24/2015 11:56
SW 6010C
Comments:
SULFUR AND ORGANIC NITROGEN NOT
FOR COMPLIANCE PURPOSES.
QUALIFIER: THE MATRIX SPIKE WAS OUT OF LIMITS FOR "Ca" AND "S".THE RPD WAS OUT OF LIMITS FOR "NO3/NO2-N". ALL OTHER
QC DATA IS
ACCEPTABLE.
All values are on a dry weight basis except as noted by asterisk. Detection limit on all N series is on a wet basis.
Our reports and letters are hor the exclusive and confidential use of our clients. and iray net be reproduced in whole or part, nor may any reference be made
to the work. the results. or the compami in any advertising. ne ✓s release, er other p! �oiic announcements without obtaining our prior written authorizatio!,.
/ l I i . - -A
Debbie Holt

Sodium Absorption Ratio
Na: Sodium (Mg/L) Equivalent weight: 23
Ca: Calcium (Mg/L) Equivalent weight: 20
Mg : Magnesium (Mg/L) Equivalent weight: 12
Milli Equivalent = Mg/L / Equivalent weight
Na M /L Ca M /L M Mc/L
67.816 329.39 91.34�
Na _(NIA}
2.948522
Ca ffi\4[Q
I k1gTM
7.61:7
16.4695
SAR= Na Milli Equivalent/[0.5 X (Ca Milli Equivalent + Mg Milli equivalent)]0.5 power
SAR = 0.849723 (From Mg/L. entered above)
SAR= 0.84747 (From ME entered below)
Na ME
2.94 1
Ca (ME)
Ma (ME).
16.46
I 7.61
The amour
amount of E
/ Permitting I

PAN
Mineralization
— .
as decimal
Total dry
tonsIvear
Acres
Applied on
42
Rate
0.3
TKN
41900
T 3
ffl:�,
578n
8(
NO
2
0
Solids
0.0346
164.98
PAN Surface
137281nngiRg 27.456 lbskinj ton
452d.691 jibs total PAN
107.3498libs PAMIacra
PAN Injection
166i 8 1 rnglk@ 3:3.236 lbs/dry ton
5483.275 1 IbS total PANI
130.5542libs PAN/acre
Dry Tonsil 000 gal.
0.144,282
1st year PAN
Surface lbs.
4529.690881
1st year PAN
Injected lbs.
5483.275281
lbs./acre
Surface
107.8497829
lbs./acre
Injected
130.5541733
MR(TKN-NH3)+ +.5(NH3)+NO3+NO2 =mg/kg
mg/kg x.002 =Ibs/dry ton
MR(TKN-NH3) + 1(NH3)+NO3+NO2
mg/kg x.002
=mg/kg
=Ibs/dry ton
1000 X 8.34 X %solids X sp. gravity "=dry tons/1 000gal.
2000

Analytical Results
Southern Soil Builders
958 Hoots Road
Roaring River, NC 28669
Receive Date:
04/07/2015
Reported:
04/09/2015
For:
Belmont
Comments:
Geometric
Mean 768 MPN/g
Sample Number
Parameter
Sample ID
Result
Unit
Method
Analyzed
Analyst
150407-37-01
Fecal Coliforms
1
<758
MPN/g
SM92210E-2006
04/07/2015
CL
150407-37-01
Percent Solids
1
2.64
%
SM2540B-1997
04/07/2015
CL
150407-37-02
Fecal Coliforms,
2
<760
MPN/g
SM92210E-2006
04/07/2015
CL
150407-37-02
Percent Solids
2
2.63
%
SM2540B-1997
04/07/2015
CL
150407-37-03
Fecal Coliforms
3
<760
MPN/g
SM92210E-2006
04/07/2015
CL
150407-37-03
Percent Solids
3
2.63
%
SM2540B-1997
04/07/2015
CL
150407-37-04
Fecal Coliforms
4
<787
MPN/g
SM92210E-2006
04/07/2015
CL
150407-37-04
Percent Solids
4
2.54
%
SM2540B-1997
04/07/2015
CL
150407-37-05
Fecal Coliforms
5
<760
MPN/g
SM92210E-2006
04/07/2015
CL
150407-37-05
Percent Solids
5
2.63
%
SM2540B-1997
04/07/2015
CL
150407-37-06
Fecal Coliforms
6
<778
MPN/g
SM92210E-2006
04/07/2015
CL
150407-37-06
Percent Solids
6
2.57
%
SM2540B-1997
04/07/2015
CL
150407-37-07
Fecal Coliforms
7
<775
MPN/g
SM92210E-2006
04/07/2015
CL
150407-37-07
Percent Solids
7
2.58
%
SM2540B-1997
04/07/2015
CL
Respectfully
submitted,
'Op. (A, J'n)-�C� ,
Dena Myers
NC Cert #440,
NCDW Cert #37755,
EPA #NC00909
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 1 of 1

Analytical Results
Southern Soil Builders
958 Hoots Road
Roaring River, NC 28669
Receive Date: 04/07/2015
Reported: 05/08/2015
For: Belmont
Comments:
Sample Number Parameter Sample ID Result Unit Method Analyzed Analyst
150407-40-01 30 Day Benchscale Belmont <1 % EPA625-R-92/0 04/08/2015 WL
Respectfully
submitted,
Dena Myers
NC Cert #440,
NCDW Cert #37755,
EPA #NC00909
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 1 of 1

Analyticcil Results
Southern Soil Builders
958 Hoots Road
Roaring River, NC 28669
Receive Date: 04/07/2015
Reported: 04/27/2015
For: Belmont
Comments:
Sample Number Parameter Sample ID Result Unit Method Analyzed Analyst
150407-39-01 Corrosivity
Belmont See SW-846 04/15/2015 PACE
Attached
150407-39-01 Ignitability
Belmont See 1010M 04/15/2015 PACE
Attached
150407-39-01 Reactivity
Belmont See SW-846 04/15/2015 PACE
Attached
150407-39-01 TCLP Belmont See as Noted 04/15/2015 PACE
Attached
Respectfully
submitted,
Dena Myers
NC Cert #440,
NCDW Cert #37755,
EPA #NC00909
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 1 of 1

www,pacelabs.com
Pace Analytical Servicos, Inc.
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
ANALYTICAL RESULTS
Project: 150407-39
Pace Project No.: 92244570
Sample: 150407-39
Parameters
Lab ID: 92244570001 Collected: 04/07/15 12:20 Received: 04/08/15 16:23 Matrix: Water
Results Units Report Limit DF Prepared Analyzed CAS No. Qual
8081 GCS Pesticides, TCLP
Analytical Method: EPA 8081
Preparation Method: EPA 3510
Leachate Method/Date: EPA
1311; 04/21/15 09:00
gamma-BHC (Lindane)
ND ug/L
0.50 1
04/23/15 08:45
04/23/15 13:18
58-89-9
Chlordane (Technical)
ND ug/L
3.0 1
04/23/15 08:45
011/23/15 13:18
57-74-9
Endrin
ND ug/L
0.50 1
04/23/15 08:45
04/23/15 13:18
72-20-8
Heptachlor epoxide
ND ug/L
0.50 1
04/23/15 08:45
04/23/15 13:18
1024-57-3
Methoxychlor
ND ug/L
1000 1
04/23/15 08:45
04/23/15 13:18
72-43-5
Toxaphene
ND ug/L
3.0 1
04/23/15 08:45
04/23/15 13:18
8001-35-2
Surrogates
Decachlorobiphenyl (S)
53 %
10-138 1
04/23/15 08:45
04/23/15 13:18
2051-24-3
Tetrachloro-m-xylene (S)
56 %
10-110 1
04/23/15 08:45
04/23/15 13:18
877-09-8
8151 Chlorinate Herbicide TCLP
Analytical Method: EPA 8151
Preparation Method: EPA 3510
2,4-D
ND mg/L
0.010 1
04/20/15 08:00
04/21/15 01:13
94-75-7
2,4,5-TP (Silvex)
ND mg/L
0.010 1
04/20/15 08:00
04/21/15 01:13
93-72-1
Surrogates
2,4-DCAA (S)
88 %
42-142 1
04/20/15 08:00
04/21/15 01:13
19719-28-9
6010 MET ICP, TCLP
Analytical Method: EPA 6010
Preparation Method: EPA 3010
Leachate Method/Date: EPA 1311;
04/13/15 01:30
Arsenic
ND mg/L
0.050 1
04/14/15 21:35
04/15/15 19:43
7440-38-2
Barium
0.79 mg/L
0.25 1
04/14/15 21:35
04/15/15 19:43
7440-39-3
Cadmium
ND mg/L
0.0050 1
04/14/15 21:35
04/15/15 19:43
7440-43-9
Chromium
ND mg/L
0.025 1
04/14/15 21:35
04/15/15 19:43
7440-47-3
Lead
ND mg/L
0.025 1
04/14/15 21:35
04/15/15 19:43
7439-92-1
Selenium
ND mg/L
0.10 1
04/14/15 21:35
04/15/15 19:113
7782-49-2
Silver
ND mg/L
0.025 1
04/14/15 21:35
04/15/15 19:43
7440-22-4
7470 Mercury, TCLP
Analytical Method: EPA 7470
Preparation Method: EPA 7470
Leachate Method/Date: EPA 1311;
04/13/15 01:30
Mercury
ND mg/L
0.00020 1
04/15/15 09:50
04/15/15 15:07
7439-97-6
8270 MSSV TCLP Sep Funnel
Analytical Method: EPA 8270
Preparation Method: EPA 3510
Leachate Method/Date: EPA 1311;
04/21/15 09:00
1,4-Dichlorobenzene
ND ug/L
50.0 1
04/22/15 09:50
04/24/15 08:56
106-46-7
2,4-Dinitrotoluene
ND ug/L
50.0 1
04/22/15 09:50
04/24/15 08:56
121-14-2
Hexachloro-1,3-butadiene
ND ug/L
50.0 1
04/22/15 09:50
04/24/15 08:56
87-68-3
Hexachlorobenzene
ND ug/L
50.0 1
04/22/15 09:50
04/24/15 08:56
118-74-1
Hexachloroethane
ND ug/L
50.0 1
04/22/15 09:50
04/24/15 08:56
67-72-1
2-Methylphenol(o-Cresol)
ND ug/L
50.0 1
04/22/15 09:50
04/24/15 08:56
95-48-7
3&4-Methylphenol(m&p Cresol)
ND ug/L
50.0 1
04/22/15 09:50
04/24/15 08:56
L2
Nitrobenzene
ND ug/L
50.0 1
04/22/15 09:50
04/24/15 08:56
98-95-3
Pentachlorophenol
ND ug/L
100 1
04/22/15 09:50
04/24/15 08:56
87-86-5
Pyridine
ND ug/L
50.0 1
04/22/15 09:50
04/24/15 08:56
110-86-1
2,4,5-Trichlorophenol
ND ug/L
50.0 1
04/22/15 09:50
04/24/15 08:56
95-95-4
2,4,6-Trichlorophenol
ND ug/L
50.0 1
04/22/15 09:50
04/24/15 08:56
88-06-2
Surrogates
Nitrobenzene-d5 (S)
55 %
12-102 1
04/22/15 09:50
04/24/15 08:56
4165-60-0
REPORT OF LABORATORY ANALYSIS
This report shall not
be reproduced, except in
full,
Date: 04/24/2015 11:41 AM
without the written consent
of Pace Analytical Services,
Inc-
Page 4 of 20

. .O
www.pacelabs.com
Pace Analytical Services, Inc.
9800 Kincey Ave. Suite 100
Huntersville, NC: 28078
[phone]
ANALYTICAL RESULTS
Project: 150407-39
Pace Project No.: 92244570
Sample: 150407-39
Parameters
Lab ID: 92244570001 Collected: 04/07/15 12:20
Results Units Report Limit DF
Received: 04/08/15 16:23 Matrix: Water
Prepared Analyzed CAS No. Clual
8270 MSSV TCLP Sep Funnel
Analytical Method: EPA 8270 Preparation Method: EPA 3510
Leachate Method/Date: EPA 1311; 04/21/15
09:00
Surrogates
2-Fluorobiphenyl (S)
51 %
13-107
1
04/22/15 09:50
04/24/15 08:56
321-60-8
Terphenyl-dl4 (S)
83 %
21-132
1
04/22/15 09:50
04/24/15 08:56
1718-51-0
Phenol-d6 (S)
20 %
10-110
1
04/22/15 09:50
04/24/15 08:56
13127-88-3
2-Fluorophenol (S)
27 %
10-110
1
04/22/15 09:50
04/24/15 08:56
367-12-4
2,4,6-Tribromophenol (S)
53 %
27-108
1
04/22/15 09:50
04/24/15 08:56
118-79-6
8260 MSV TCLP
Analytical Method: EPA 8260 Leachate Method/Date: EPA 1311; 04/09/15 14:16
Benzene
ND ug/L
125
25
04/20/15 14:11
71-43-2
2-Butanone (MEK)
ND ug/L
250
25
04/20/15 14:11
78-93-3
Carbon tetrachloride
ND ug/L
125
25
04/20/15 14:11
56-23-5
Chlorobenzene
ND ug/L
125
25
04/20/1514:11
108-90-7
Chloroform
ND ug/L
125
25
04/20/15 14:11
67-66-3
1,4-Dichlorobenzene
ND ug/L
125
25
04/20/15 14:11
106-46-7
1,2-Dichloroethane
ND ug/L
125
25
04/20/15 14:11
107-06-2
1,1-Dichloroethene
ND ug/L
125
25
04/20/15 14:11
75-35-4
Tetrachloroethene
ND ug/L
125
25
04/20/15 14:11
127-18-4
Trichloroethene
ND ug/L
125
25
04/20/15 14:11
79-01-6
Vinyl chloride
ND ug/L
125
25
04/20/15 14:11
75-01-4
Surrogates
1,2-Dichloroethane-d4 (S)
105 %
70-130
25
04/20/15 14:11
17060-07-0
Toluene-d8 (S)
98 %
67-135
25
04/20/15 14:11
2037-26-5
4-Bromofluorobenzene (S)
103 %
70-130
25
04/20/15 14:11
460-00-4
1010 Flashpoint,Closed Cup
Analytical Method: EPA 1010
Flashpoint
>200 deg F
70.0
1
04/16/15 14:00
9040 pH
Analytical Method: EPA 9040
pH
5.0 Std. Units
0.10
1
04/09/15 16:15
H6
733C Reactive Cyanide
Analytical Method: SW-846 7.3.3.2
Cyanide, Reactive
ND mg/L
0.010
1
04/15/15 19:00
734S Reactive Sulfide
Analytical Method: SW-846 7.3.4.2
Sulfide, Reactive ND mg/L 1.0 1 04/15/15 15:00
Date: 04/24/2015 11:41 AM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc..
Page 5 of 20

.11 uAL rA1 riVUEN AND VtUTOR ATTRACTION IREDUCTION FORM (02T Rules)
Name: City of Belmont
Name: City of Belmont, WWTP
n2 Period:
From 1/1/2015 To
Pathogen Reduction (15A NCAC 02T.
Class A: Alt. A (time/temp) C
Alt.D (No Prior Test)
If applicable to alternative performed (Cla
Compost D Heat Drying D
Beta Ray D Gamma Ray D
WQ Permit Number: WQ0003281
NPDES Number: NCO021181
12/31/2015
106) - Please indicate level achieved and alternative performed:
Alt B (Alk Treatment) ® Alt. C (Prior Testing) El
® Process to Further Reduce Pathogengs Cl
A only) indicate "Process to Further Reduce Pathogens":
Heat Treatment D Ther7nophilic D
Pasteurization ® _ ................... - -
Class B: jAlt. (1) Fecal Density vD I Alt. (2) Process to Significantly Reduce Pathogens D
If applicable to alternative performed (Class B only) indicate "Process to Significantly Reduce Pathogens":
Lime Stabilization ® Air Drying D —Composting® Aerobic Digestion D
Ana
erobic
obrc Dig
estion ges t on
C.]
If applicable to alternative performed (Class A or Class B) complete the following monitoring data:
Allowable Level Pathogen Density u-mmber na yti-
Parameter in Sludge g Excee- Frequency Sample Tech-
g Minim Geo. Meanaxim Units dences I of Analysis Type
n.nna
2 x 10 to the MPN 758
6th power
per gram of
Fecal Coliform total solids CFU
1000 mpn per gram
of total solid (dry
Salmonella bacterial 3 MPN per 4 grams
(in lieu of fecal total solid (dry
Vector Attraction Redneflnn (1 SA wrA r
761.07 1 787 1 MPN/g 1 0
7 1 grab I sm9221
7171 (VS reduction) ®
Alt. 5 (14-Day Aerobic) D
- --- -_—_ .�
Alt. 2 (40-day bench) D
Alt. 6 (Alk. Stabilization D
_ _.,.,,,., aaaul�•s{{i {aaw■uauvc YG11VI711CU:
Alt. 3 (30-day bench) Cl jAlt. 4 (Spec. OZ uptake) D
Alt 7 (Drying - Stable) Ll Alt. 8 (Drying - Unstable) D
Alt. 9 (Injection) ®
Alt. 10 (Incorporation) D
No vector attraction reduction alternatives were performed D
CERTU TirATUM CTAT-Vn/rUXrm
i..i - _L__7_ ,,
---
a .r.. »�........ {.,V IZFPX UVJI ULC Niaiemen1)
R1 "I certify, under penalty of law, that the pathogen requirements in 15A NCAC 02T .1106 and the
vector attraction reduction requirement in 15A NCAC 02T .1107 have been met."
® "I certify, under penalty of law, that the pathogen requirements in 15A NCAC 02T .1106 and the
vector attraction reduction requirement in 15A NCAC 02T .1107 have not been met." (Please note
if you check this statement attach an explanation why your have not met one or both of the
requirements.)
"This determination has been made under my direction and supervision in accordance with the system
designed to ensure that qualified personnel properly gather and evaluate the information used to determine
that the pathogen and vector attraction reduction requirements have been met. I am aware that there are
significant penalties for false certification including fine and imprisonment."
Sgn�c�rf,t C'.�'� ���'� L""'d�� Dennis Key Southern Soil, Builders, Inc.
Prepargr Name and Title (type or print) Land Applier Name and Title (if applicable)(type or print)
Signature of Prepay *atSignature of Land Applier (if applicable) Date
*Preparer is defined in 40 CFR Part 503.9(r) and 15A NCAC 2T .1102 (26)

Page 1 of 3
Report Number: 15-356-0587 0
Account Number 46381 ® Waypoint'
��'/
Send To: SOUTHERN SOIL BUILDERS ANALYTICAL
DENNIS KEY Every acre ... Evefyyear.",
958 HOOTS ROAD
ROARING RIVER NC 28669
SOIL ANALYSIS REPORT
Date Received: 12/22/2015 Date Of Analysis: 12/23/2015 Date Of Report: 12/23/2015
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 ° Fax [phone]
www.waypointanalytical.com
Grower: SOUTHERN SOIL BUILDEka
Analytical Method(s):
Mehlich 3
Sample
OM
W/V
ENR
Phosphorus
Potassium
Magnesium
Calcium
Sodium
pH
Acidity
C.E.0
ID
Lab
Field ID
Number
%
Soil
Ibs/A
Mehlich 3
Reserve
K
M g
Ca
Na
Soil
Buffer
H
Rate
Class
ppm Rate
ppm Rate
ppm Rate
ppm
Rate
ppm
Rate
ppm
Rate
pH
Index
meq/100g
meq/100g
23077
5.5
148
56 H
50 VL
194
H
1053
M
8
VL
6.0
6.80
1.3
8.3
MIN
H
NC = 47
NC = 26
RP2
23078
4-9
138
33 M
36 VL
166
H
836
M
7
VL
6.0
6.83
1.0
6.7
MIN
M
NC = 27
NC = 18
C2-1
23079
4.0
157
122
H
31 VL
182
VH
652
M
6
VL
6.2
0.7
5.6
MIN
M
NC = 47
NC = 16
M1
6.7
199 VH
145 H
306
VH
1007
M
9
VL
23080
150
6.2
1.1
9.1
MIN
H
NC = 166
NC = 74
MH 2-4
5.5
VH
133 H
263
H
1023
M
9
VL
23081
1178
147
6.0
6.79
1.4
9.1
MIN
H
NC = 148
NC = 68
Percent Base Saturation
Nitrate
Sulfur
Zinc
Manganese
Iron
Copper
Boron
Soluble Salts
Chloride
Aluminum
Sample ID
--
-- -
- -- --
Field ID
K
Mg
Ca
Na
H
NON
S
Zn
Mn
Fe
Cu
B
SS
CI
AI
%
%
%
%
%
ppm Rate
ppm Rate
ppm Rate
ppm Rate
ppm
Rate
ppm Rate
ppm
Rate
ms/cm
Rate
ppm Rate
ppm
BT9-1
22 M
H
24 H
162
VH
1.1 M
0.4
L
1.5
19.5
63.4
0.4
15.7
14.4
NC = 46
NC = 110.0
NC = 150
NC = 55.0
RP2
16 M
3.3 M
18 M
121
VH
0.7 L
0.2
VL
1.4
20.6
62A
I 0.5
14.9
NC=33
NC=82.5
NC=113
NC=35.0
C2-1
9 VL
H
25 H
126
VH
1.9 H
0.3
VL
1.4
27.1
58.2
0.5
12.5
15.1
NC = 19
NC = 127.5
NC = 156
NC = 95.0
M1
4 VL
VH
20 M
249
VH
11.6 VH
0.7
M
4.1
28.0
55.3
0.4
12.1
114.6
NC=8
NC=365.0
NC=125
NC=580.0
MH 2-4
1 VL
V11
H
248
VH
8.7 VH
0.6
M
3.7
24.1
56.2
0.4
15.4
113.4
�23
NC=2
NC=335.0
NC=144
NC=435.0
Values on this report represent the plant available nutrients in the Explanation of symbols: % (percent), ppm (parts per million), Ibs/A This report applies to sample(s) tested. Samples are retained a
soil. Rating after each value: VL (Very Low), L (Low), M (Medium), (pounds per acre), ms/cm (milli -mhos per centimeter), meq/100g maximum of thirty days after testing. by I��uur� �c
H(High), VH Ve High). ENR - Estimated Nitrogen Release.
(Veryg (milli equivalent per 100 grams). Conversions: ppm x 2 =Ibs/A, Soluble Analysis prepared by: Waypoint Analytical Virginia, Inc.
C.E.C. -Cation Exchange Capacity. Salts ms/cm x 640 =ppm.
Pauric McGroary

.NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory Donald van der Vaart
Governor Secretary
March 19, 2015
Mr. Barry L. Webb, City Manager
P.O. Box 431
Belmont, North Carolina 28012
Subject: Acknowledgement of Receipt of the 2014 Annual Report
City of Belmont WWTP - Permit No.: WQ0003281
Land Application of Alum Residuals
Gaston County
Dear Mr. Webb:
The Mooresville Regional Office received and reviewed the 2014 Annual Report for the above
permit. The data submitted appears to be in accordance with permit requirements.
Please note the expiration date of your permit is June 30, 2016. A renewal application is due,at
least 180 days prior to this date. I may be reached by phone at [phone] or email
(maria. schutte(D-ncdenr.gov) should you have questions about this permit or the renewal.
Maria Schulte, Environmental Specialist
Mooresville Regional Office
Water Quality Regional Operations Section
Division of Water Resources, NCDENR
CC: Chuck Flowers, Utilities Director, Belmont (Email)
Sandra Craft, WWTP Supervisor, Belmont (Email)
Dennis Key c/o Zach Key, Southern Soil Builders (Email)
Ed Hardee, LAU Compliance, CO -Raleigh (Email)
Mooresville Regional Office
610 East Center Avenue, Suite 301, Mooresville, North Carolina 28115
Phone: [phone] / Fax: [phone]/Customer Service 1-877-623-6748
Internet: www,ncdenr.gov
An Equal Opportunity 1 Affirmative Action Employer— Made in part by recycled paper

prA� 3IZ4� F05'- A
City of
Belmont
City of Belmont
2014 Annual Report
Land Application Program
NC Permit No. WQ00003281
I
R!7 fl, r, i E D
DiVIS10,M 0"' VYATER QUALITY
FEB 10 2015
MOORESVil-'LE REG&NAL OFFICE
%,�E P1, 5 NO IV
1w&Q,,/QW
W,
A
A i i
'k
os
a 1,01)
0)�

WQ0003281 County: Gaston Year: 2014
Name (as shown on permit):
City of Belmont
Application Operator:
Southern Soil Builders, Inc. Phone: [phone]
Land application of residuals as allowed by the permit occurred during the past calendar year?
EJ Yes 0 No - If No, skip Part A, and Part B and proceed to Part C. Also, If residuals were
generated but not land applied, please attach an explanation on how the residuals were handled.
Part A - Residuals Application Summary:
Total number of application fields in the ermit:
3
Total number of fields utilized for land application during the year:
3
Total amount of dry tons applied during the year for all application sites:
99.26
Total number of acres utilizes for land application during the year:
79.9
Part B - Annual Compiance Statement:
Facility was compliant during calendar year 2014 with all conditions of the land application permit
(including but not limited to items 1-13 below) issued by the Division of Water Resources. 0, Yes [--J No
If no please, provide a written description why the facility was not compliant, the dates, and explain corrective action
taken.
1) Only residuals approved for this permit were applied to the permitted sites.
2) Soil pH was adjusted as specified in the permit and lime was applied (if needed) to achieve a soil pH of at least 6.0 or
the limit specified in the permit,
3) Annual soils analysis were performed on each site receiving residuals during the past calendar year and three (3) copies
of laboratory results are attached,
4) Annual TCLP analysis (if required) was performed and three (3) copies of certified laboratory results are attached.
5) All other monitoring was performed in accordance with the permit and reported during the year as required and three (3)
copies of certified laboratory results are attached.
6) The facility did not exceed any of the Pollutant Concentration Limits in 15A NCAC 02T .1105(a) or the Pollutant
Loading Rates in 15A NCAC 02T .1105(b) (applicable to 40 CFR Part 503 regulated facilities).
7) All general requirements in as specified in the -Land Application Permit were complied with (applicable to 40 CFR Part
503 regulated facilities).
8) All monitoring and reporting requirements in 15A NCAC 02T ,1111 were complied with (applicable to 40 CFR Part
503 regulated facilities),
9) All operations and maintenance requirements in the permit were complied with or, in the case of a deviation, prior
authorization was received from the Division of Water Resources.
10) No contravention of Ground Water Quality Standards occurred at a monitoring well or explanations of violations are
attached to include appropriate actions and remediations,
11) Vegetative cover was maintained and proper crop management was performed on each site receing residuals, as
specified in the permit.
12) No runoff of residuals from the application sites onto adjacent property or nearby surface waters has occurred.
13) All buffer requirements as specified on the permit were maintained during each application of residuals.
Part C - Certification:
"I certify, under penalty of law, that the above information is, to the best of my knowledge and belief, true, accurate,
and complete. I am aware that there are significant penalties for submitting false information, including the
possibility of fines and imprisonment for knowing violations."
"hacf-0 O's, i��-) )Oax na (10 C
Permittee ame and Title (type or pri t)
Signatu e Permittee Date
I"dd-r
Signature of Preparert / D to Si ature of Land Applier Date
(if different from Permittee) (if different from Permittee and Preparer)
* Preparer is defined in'40 CFR Part 503.9 (r) and 15A NCAC 02T .1102 (26) DEN FORM ACF (12/2006)

ANNUAL RESIDUAL SAMPLING SUMMARY FORM
Please note that your permit may contain additional parameters to be analyzed. The parameters can be reported in FORM RSSF
WQ Permit Number: WQ0003281 Laboratory: I)
Facility Name: City of Belmont 2)
Residual Source WQ # or NCO021181 3)
NPDIES #: 4)
WWTP Name: City of Belmont, WWTP 5)
Residual Anal sis Data
A&L Eastern La
Parameter
(mg/kg)
Cone.
Limit
"(mg/kg) a
Sample or Composite Date
6-25-14
Percent Solids (%)
NA
2.36
Arsenic
75
4
Cadmium
85
2
Copper
4,300
565
Chromium
NA
58
Lead
840
33
Mercury
57
1.7
Molybdenum
75
5
Nickel
420
23
Selenium
100
5
Zinc
7,500
1790
Total Phosphorus
NA
17100
TKN
NA
50800
Ammonia -Nitrogen
NA
7630
Nitrate and Nitrite
NA
1510
x "1 0Wkal U u ZFU.Jai 1aLi11L1c:5 L11e cemuig concentration limits listed m this form are not applicable. Reference the individual permit for metals limits.
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed
to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant
penaltie for submitting false information, including the possibility of fines and imprisonment for knowing violations."
��Y low
n 0, as
Signature of Preparer * Date
*Preparer is defined in 40 CFR Part 503.9(r) and 15A NCAC 2T _1102 (26) DENR FORM RSSF (1 2/2006)

ach this form
- ---- ... -. , - u �,1 rl -1 X UnIVY"
to the
corresponding Field Loading Summary Form to be submitted in Annual Report
ame;
rperator.,
City of Belmont Total Dry Tons Applied (Annual): 20.47
WQ0003281 Cation Exchange Capacity (non 503
Aesse:
only):
Y)
Tony Jones Owner: Tony Jones Predominant Soil Series: Cecile
14.6 Acres Permitted: 14.6 Site #: BT 6-1 Field #: BT 6-1
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids
Sample or 1 ?
3 4 use Raw Percent #);
Com-
5 6"7 $ 9_ 10 11
posite
Date 6/25/14
% Solids 2.36
Arsenic 4
Cadmium 2
Copper 565
Chromium 58
Lead 33
Mercury 1.7
Molyb-
denum 5
Nickel 23
Selenium 5
Zinc 1790
Total
Phos- 17100
horus
Annual Heavy Metal Field Loadings (Calculated in lbs/acre);
Total ?"
DT/Ac./
3 4 5 6j 7 8 9 10 11 12
- - - _
App.
o
Event 1.40
Arsenic 0.011 0.000
Cadmium 0.006 0.000
y
0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.011
Copper 1.584 0.000
0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.011
0.000 0.000 0.000 06
�lu•omium 0,163 0.000
0.000 0.000 0.000 0.000 0.000 0.000 0.000 1,584
0.000 0.000 0.000 0.000
Lead 0,093 0,000
0.000 0.000 0.000 0.000 0.000 0.000 0.163
0.000 0.000 0.000 0.000 0.000 0.000 -To _00
Mercury 0.005 0.000
M 1 b
0.000 0.000 0.000 0.093
0.000 0.000 0.000 0.000 0.000 0.000 0 000 0 000
o Y
denum 0,014 0.000 0.000 0.000 0.000 0.000 0.000
0.000 0.000 0.005
0.000 0.000
Nickel 0.04 0.000 0.000 0.000 0.000 0,000 0.000
0.000 0.000 0.000 0.014
0.000
Selenium 0.01 4 0.000 0.000 0.000 0.000 0.000 0.000
0.000 0.000 0.000 0.000 0.064
0.000
Zinc 5.019 0.000 0.000 0.000 0.000 0.000 0.000
0.000 0.000 0.000 0.000 0.014
0.000 0.000
Total
0.000 0.000 0.000 5.019
Phos- 47.948 0.000 0.000 0.000 0.000 0.000 0.000
horus
0.000 0.000 0.000 0.000 0.000
47.948
'I certify, under penalty of law, that this document 'was prepared under
vith a system designed to assure that qualified personnel
my direction or supervision in accordance
properly gathered
am aware that there are significant penalties for submitting
and evaluated the information submitted.
false information, including the possibility of fines and
mprisonment for knowing violations".
ignature of Land Kpplier
j- )�,)Y
Date
fICAID C/IDBe NAM C%r dninnnn.

Residual Anna
Sample or;.
Com-
posite
this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
City of Belmont Total Dry Tons Applied (Annual): 20.41
WQ0003281 Cation Exchange Capacity (non 503 only):
Tony Jones Owner: Tony Jones Predominant Soil Series: Cecile
23.3 Acres Permitted: 23.3 Site #: BT 6-3 Field #: BT 6-3
ysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Date
6/25/14
% Solids
2.36
Arsenic
4
Cadmium
2
Copper
565
chromiu
58
Lead
33
Mercury
1.7
Molyb-
denum
5
Nickel
23
Selenium
5
Zinc
1790
Total
Phos-
17100
Annual Heavy
Total
DT/Ac./
App,
Event
0.88
Arsenic
0.007
Cadmium
0.004
Copper
0.990
�hromiu
0.102
Lead
0.058
Mercury
Molyb-
denum
0.003
0.009
Nickel
0.040
Selenium
0.009
Zinc
3.136
Total
Phos-
29.959
eld Loadings (Calculated in lbs/acre):
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 11
1 11�
1 ••1
1 1
1 1
1 11
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 11'
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 11•
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
i
• • •
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
'I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
vith a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
am aware that there are significant penalties for submitting false information, including the possibility of fines and
mprisonment for knowing violations".
signature of Land Applier
Date
DENR FORM MFLSF (12/2005)

this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
City of Belmont Total Dry Tons Applied (Annual):
WQ0003281 Cation Exchange Capacity (non 503 only):
Lori Warren Owner: Lori Warren Predominant Soil Series:
Al Acres Permitted: 42 Site #: BT 9-1 Field #: BT 9-1
Residual Analvsis Data (Heavv Metals and Tntnl Phnenhnr„c „QP of — n D
58.38
GaB2
Sample or
..1
2
3
4
5
6
7
8]
9
10
11
12
Com-
posite
Date
6/25/14
% Solids
2.36
Arsenic
4
Cadmium
2
Copper
565
Chromium
58
Lead
33
Mercury
1.7
Molyb-
5
denum
Nickel
23
Selenium
5
Zinc
1790
Total
Phos-
17100
horus
R!}III Y\9.l• 010 I.IT\!!!!IN IIY.! 111 !ff UW N
•
_
r
Event
Mill
NOT, ffill
Im Me is
Iwo M,
� -• ♦
„ I
/ 1 1 ,
1 1 / ,
/ 1 1 1
' 1 , /
' / / ,
/ 1 / /
1 , 1 1
1 / / /
/ , / /
/ / / /
/ 1 / 1
, / �
1'111
-� - r- -, �- �_-�• .u=� ••�• ••••.�..rrao t„ upai Gu u„ er my u,rection or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
imprisonment for knowing violations".
Signature of Land Apgier Date
DENR FORM MFI SF (1919WA)

ANNUAL ]LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED OP
PLACE A "N/A" IN A BLANIL-
Facility Name: City of Belmont
R BOX WHEN NOT APPLICABLE.
Land Owner: Tony Jones
WQ Permit #: WQ0003281 Field #: J13T 6_1 Acres Utilized:
14.6
Annual Dry Tons Applied: 20.4697
Operator: Tony Jones
Site #: g1 C_1 Acres Permitted: 14.6
Predominant Soil Series: Cecile
Crop 1 Name:
Fescue
Cation Exchange n 503):
Capacity (no
Crop 1 Max. PAN: 211 Crop 2 Name:
Volume applied
o -
Volume
Crop 2 Max. PAN:
Soil
Residual Sources Preci <
(enter one) Solids/ %
s ° Liquid
Applied per
_
Cond_ p 0 z a Nitrate
(NPDES #, WQ# Past 24 rn PAN Applied Name of Crop Type
Ca Solids
Acre
(Dry, � � � " TKN o -1 and pp
Fert., Animal Hrs. o 0 (Ibs/acre) Receiving Residual
`�°
Cu_ Yds Gallons
(Dry Tons/Ac)
Waste, etc WeL o''_ Nitrite Application
)
8-2014 208000 2.36
1.402
Moist) inches o'
WQ000328I 0 mg/kg mg/kg mg/kg Crop 1 Crop 2 Crop 1 Crop 2
0
0.000
s 0.5 0.3 50800 7630 1510 51.247 NA Fescue
0.000
0.000 0.000
_-_ ...
0.000
0.000 0.000
o_000
o-000---
0.000
0.000 0.000
0.000
0.000 0.000
0.000
0.000 0.000
0.000
0.000 0.000
0.000
0.000 0.000
0.000
0.000 0.000
0.000
0.000 0.000
0-000 0.000
Residuals Applications totals on FORM FSF
TOTA1 s: 0 208000
As
supp ( attach FORM FSF supp to this form):
Cd Cu Cr
Annual lbs/acre
0.011
Pb H
51.247 0.000 Lime A lied
0.006 1.584 0.163 0.093 0.005
Prior Years Cumulative lbs/ac
0.132
0.014 0.064 0 014 5 0 9 47 948
0.166 60.771 1.658 Date lbs/ac
Current Cumulative lbs/ac
0.143
5.319 0.108 0.444 2.263 0.158 93.147
Permitted C_ P. L_ R.****
0.172 62.355 1.821 5.412 0.113 0.458 2.327 0.172 98
Permit PAN Limit Ist/2nd Crop
36
34 NA 1338 267 15 NA 374 .166
89 2498
"I certify, under penalty of law, that this document was prepared under my direction
qualified personnel properly gathered
and evaluated
or supervision in accordance with a system designed to assure that
the information
information, including the possibility of fines
submitted. I am aware that there are significant penalties forsubmitting false
and imprisonment
for knowing violations.,,
Application Method: S - Surface, IN- Injection, INC - Incorporation
Signature of Land Applier
Volatilization Rate: Surface - 0-5, Injectiomgncorporation - 1.0
***
Date Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0-4
****C-P.L_R.: Cumulative Pollutant Loading Rate
f1CA1� CrlOnn rc�r in-i in �r�..

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A By OR B
Facility Name: City of Belmont
OX WHEN NOT APPLICABLE.
Land Owner: Tony Jones
WQ Permit #: WQ0003281
Field #: BT C-3
Acres Utilized: 23.3
Annual Dry Tons Applied: 20.4697
Operator: Tony Jones
Predominant Soil Series: Cecile.
Site #: BT C-3
Acres Permitted: 233
Crop 1 Name:
Fescue
Cation Exchange Capacity p ty (non 503):
b
Crop 1 Max. PAN: 211
Crop
2 Name:
Volume applied
Volume
Soil
Residual Sources Precip. y
o
Crop 2 Max. PAN:
(enter one) Solids/ o
/o
Cc Liquid
Applied per
Cond. a
(NPDES #, WQ#, Past 24
w w
Z y
w CD TKN
Nitrate Name of Crop Type
PAN Applied
6 Solids
Acre
(Dry, -
Fert., Animal Hrs. o
o
c) � o
_. �,
and Receiving
( lbs/acre) b Residual
Cu. Yds Gallons
(Dry
Waste, etc) Wet, c o.
Waste,
w
w
Nitrite Application
8-2014 208000 2.36
0.879
WQ0003281 Moist ) inches
�3 mg/kg mg/kg
mg/kg Crop 1 Crop 2 Cro 1 C 2
ury 0 s p rop
0.000
0 5 0.3 50800 7630 1510 32.112 NA Fescue
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form): 0.000
oTALs- 0 208000 As Cd Cu Cr Pb H
annual lbs/acre 0.007 0.004 0.990 0.102 0.058 0.003 09 0.040 0.009 3.136 29.959 32.112 0.000 Lime A lied
or Years Cumulative lbs/ac 0.559 0.156 56.769 L277 5.119 0.094 0.417 2.137 0.953 78.701 Date lbs/ac
:urrent Cumulative lbs/ac 0.566 0.160 57.759
'1.379 5.177 0.097 0.426 2.177 0.962 ermitted C. P. L. R.**** 36 34 NA ]338 267 81.837
ermit PAN Limit lst/2nd Crop l5 NA 374 1 89 1 2498
I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system
l
ualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties forsubmitting false that
►formation, including the possibility of fines and imprisonment for knowing violations.,,
2��, :::e�� *Application Method: S - Surface, IN - Injection, INC -Incorporation
**Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant LoadinE Rate ,,J
r'� lJ�F� ` DENR FORM FSF (12/2006)

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BO
Facility Name: City of Belmont
WQ Permit #: WQX WHEN NOT APPLICABLE.
0003281 Field #: BT 9-1
Annual Dry Tons Applied:
Land Owner: Lori Warren 582107 Site # Acres Utilized: 42
Operator: Lori Warren : RT 9-1 Acres Permitted: 42
Predominant Soil Series: GaB2 Cation Exchange Capacity (non 503): Crop 1 Name: Fescue Crop 1 Max. PAN: 211 Crop2 Name:
ame:
V1 Crop 2 Max. PAN:
o ume applied
o
(enter one) Solids/ o
Volume
Residual Sources
Soil
Precip-
y
o
Z a
a) �
o /o
� Liquid
Applied per
(NPDES #, WQ#
Cond.
p� 24
w
can
TKN
F3
o
Q Solids
Acre
Fen Animal
(Dry,
Hrs.
_
o 3
�-
�
"
°�
Cu- Yds Gallons
(Dry Tons/Ac)
Waste, etc )
Wet�,-
_
m
� =-
7-2014 143000 2.36
0-335
WQ0003281
Moist)
inches
-1
0
0
mg/kg
mg/kg
8-2014 448500 2-36
I-O51
WQ0003281
dry
0
s
0-5
0.3
50800
7630
0.000
dry
s
0-5
0-3
50800
7630
0.000
0-000
0-000
0.000
0-000
0-000
0.000
o-ono
0.000
>TALS:
Residuals Applications totals on FORM FSF supp ( attach FORM FSF
0 591500
As
Cd Cu
Cr
Pb
H
Mo
Ni
supp
to this
nnual lbs/acre
0-011
0-006 1.571
0-161
0-092
0-005
0.014
Se
Zn
-ior Years Cumulative lbs/ac
0-164
0-072
0 064
0014
4 76
976
urrent Cumulative lbs/ac
0-175
14.881
27-415
2-704
0-031
0-077
1395
0.01
14.
;iznitted C- P. L- R.****
0.078 16-452
27-576
2-796
0-036
0-091
1-459
0-077
108-i58
.unit PAN Limit lst/2nd Crop
36
34 NA
1338
267
15
NA
374
89
2498
Nitrate
and PAN Applied
Nitrite (lbs/acre)
mg/k9 Crop 1
1510 12.247
1510 38-412
0.000
0-000
0.000
0-000
0.000
0-000
a-0 0
o-000
o-000
0-000
P 50.660
47.538
Crop 2
NA
NA
0-000
0-000
0-000
0-000
0-000
0-000
0-000
0.000
0-0 00
0-000
Name of Crop Type
Receiving Residual
Application
Crop 1 Crop 2
Fescue
Fescue {
0-000 Lime A lied
Date lbs/ac
certtiy, under penalty of law, that this document was prepared under my direction or supervision in accordance with a sy211
stem designed to assure that
talified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
formation, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, R4 - Injection, INC - Incorporation
I **Volatilization Rate: Surface - 0-5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C-P-L_R: Cumulative Pollutant Loading Rate

Page: 1 of 2
Report Number: 14-183-0204
Account Number: 46381
Submitted By: ZACH KEY
Send To: SOUTHERN SOIL BUILDERS
DENNIS KEY
958 HOOTS ROAD
ROARING RIVER, NC 28669
AYL
www.aleastern.com
A&L Eastern Laboratories, Inc.
7621 Whitepine Road Richmond, Virginia 23237 [phone] Fax (804) 271= 6
Project: BELMONT
NC CERT#257
Lab Number: 56261 REPORT OF ANALYSIS
Sample Id: BELMONT
Total Solids
Moisture
Total Kjeldahl Nitrogen
Total Phosphorus
Total Potassium
Total Sulfur
Total Calcium
Total Magnesium
Total Sodium
Total Iron
Total Aluminum
Total Manganese
Total Copper
Total Zinc
Ammonia Nitrogen
Organic N
Nitrate+Nitrite-N
Total Cadmium
2.36
97-64
5.08
1.71
0.30
1.41
1.61
0.34
0.88
0.76
4.32
23600
JM
JM
JM
KM
KM
KM
KM
KM
KM
KM
KM
KM
KM
KM
JM
JM
KM
All values are on a dry weight basis except as noted by asterisk. Detection limit on all N series is on a wet basis
50800
17100
3010
14100
16100
3390
8750
24100
21000
848
565
1790
7630
43170
1510
2.0
100.0
100.0
10.0
100
100
100
100
100
100
100
100
5
5
5
10.0
10-0
2.00
2.0
:..:;..- t•c::, cr ,-ea � -�� �=.-... . , - _,..�...._....,.__ ... ,........ -.-arc rn: - ,..-. -
Date Sampled: 6/25/2014 14:00:00
Date Received: 07/02/2014 00:00
Date Reported: 07/08/2014
07/02/2014 14:05
07/02/2014 14:05
07/03/2014 07:09
07/03/2014 12:53
07/03/2014 12:53
07/03/2014 12--53
07/03/2014 12:53
07/03/2014 12:53
07/03/2014 12:53
07/03/2014 12:53
07/03/2014 12:53
07/03/2014 12:53
07/03/2014 12:53
07/03/2014 12--53
07/03/2014 07:09
07/03/2014 07:09
07/03/2014 07:10
07/03/2014 12:53
Debbie Holt
i
SM-2540G
SM-2540G
SM-4500-NH3C-TKN
SW 6010C
SW 6010C
SW 6010C
SW 6010C
SW 6010C
SW 6010C
SW 6010C
SW 6010C
SW 6010C
SW 6010C
SW 6010C
SM-4500-NH3C
CALCULATION
SM-450ONO3F
SW 6010C

Page_ 2 of 2
Report Number 14-183-0204 AFL EasternLaboratories, Inc.
Account Number 46381@P.
7621 Whitepine Road Richmond• Virginia 23237 [phone] Fax [phone]
Submitted By_ 7ACH KEY
Wwwaleastern.com
Send To: SOUTHERN SOIL BUILDERS Project: BELMONT
DENNIS KEY NC CERT#257
958 HOOTS ROAD
ROARING RIVER, NC 28669
Lab Number: 56261 REPORT OF ANALYSIS Date Sampled: 6/25/2014 14:00:00
Date Received: 07/02/2014 00:00
Sample Id : BELMONT Date Reported: 07/08/2014
ob
5
KM
07/03/2014 12:53
SW 6010C
Total Nickel
23
5
KM
07/03/2014 12:53
SW 6010C
Total Lead
33
5
KM
07/03/2014 12:53
SW 6010C
Total Arsenic
4.0
3.0
KM
07/03/2014 12:53
SW 6010C
Total Mercury
1.7
0.4
KM
07/03/2014 09:00
SW-7471 B
Total Selenium
5-0
5.0
KM
07/03/2014 12:53
SW 6010C
PH (Standard Units) `
6.40
2.00
JM
07/03/2014 07:30
SW-9045D
Total Molybdenum
5
5
KM
07/03/2014 12:53
SW 6010C
Comments:
SULFUR AND ORGANIC NITROGEN NOT FOR COMPLIANCE PURPOSES.
QUALIFIER: THE MATRIX SPIKE WAS OUT OF LIMITS FOR "Al" AND "Se"- ALL OTHER QC DATA IS ACCEPTABLE.
All values are on a dry weight basis except as noted by asterisk- Detection limit on all N series is on a wet basis.
Debbie Holt

SAR
Sodium Absorption Ratio
Na: Sodium (Mg/L) Equivalent weight: 23
Ca: Calcium (Mg/L) Equivalent weight: 20
Mg : Magnesium (Mg/L) Equivalent weight: 12
Milli Equivalent = Mg/L / Equivalent weight
mclJMla.� /11
206.5 1 379,96 go
0\4F"A
I 8.1z)78261
'18-998
6.(Y-306(3-�
M
SAR= Na Milli Equivalent/[0,5 X (Ca Milli Equivalent + Mg Milli equivalent)]0.5 power
ilbOVU))
'3 1
SAF'i:--- 2. 15 OAU-M-31 (1*-: 1,(.) 1.1-1 IVII*.-.,
cnterod bf.-Ilow)
N�IVIC:).
8,97 18.99
The amour
amount of (
Permitting !

:'AN
Mineralization
Rate rK
0.3 50800
NH3 1 1103 1 NO2
7630 1510 0
PAN Surface
_-
PAN
PAN Injection
Dry Tons/1000 gal.
F :J:L -e�
1st year PAN
Surface lbs.
_,c2S. 521
1st year PAN
Injected lbs.
�ecirnal Totat drV Acres
% Solids tonslyear Applied on
0.0236 99-26 1 '79-9
MR(TKN-NH3)+ +.5(NH3)+NO3+NO2 =mg/kg
mg/kg x.002 =Ibs/dry ton
MR(TKN-NH3) + 1(NH3)+NO3+NO2 =mg/kg
mg/kg x.002 =Ibs/dry ton
1000 X 8.34 X %solids X sp. gravity "=dr-y tons/1000gal."
2000
lbsJacre
Surface
(4v-
-,LDlbs./acre
Injected

Analytical Results
Southern Soil Builders
958 Hoots Road
Roaring River NC 28669
Entered 6/25/2014
Reported: 7/16/2014
For; Belmont
Sample ID Parameter Cust ID Result Units Date
Method Analyzed Analyst
140625-27 Corrosivity Belmont See Attached SW-846
7/11/14 PACE
140625-27 Ignitability Belmont See Attached 1010M
7/11/14 PACE
140625-27 Reactivity Belmont See Attached SW-846
7/11/14 PACE
140625-27 TCLP Behnont See Attached 1311
7/11/14 PACE
Respectfully submitted,
JM1,
Dena Myers
NC Cert #440,
NCDW Cert #37755,
EPA NCO0909
R,O, Box 228 • Statesville, North Carolina 28587 • 704/872/4697

Analytical
www.pacolabs.com
ANALYTICAL RESULTS
Pace Analytical Services, Inc.
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Project: 140625-27
Pace Project No.: 92206997
Sample; 140625.27 Lab ID: 92206997001 Collected: 06/25/14 14:20 Received: 06/26/14 14:50 Matrix: Solid
Results reported on a "dryweight" basis
Parameters
Results Units Report Limit DF
---_ p Prepared Analyzed CAS No. Qua]
8081 GCS Pesticides, TCLP
Analytical Method: EPA 8081 Preparation Method:
EPA 3510
Leachate Method/Date: EPA 1311; 06/27/14 14:00
gamma-BHC (Lindane)
ND ug/L
Chlordane (Technical)
ND ug/L 2.5 5
06/30/14 11:36 07/01/14 16:59 58.89-9
Endrin
15.0 5
ND ug/L
06/30/14 11:36 07/01/14 16:59 57.74-9
Heptachlor epoxide
2.6 5
ND ug/L
06/30/14 11:36 07/01/14 16:59 72-20-8
Melhoxychlor
2,5 5
ND ug/L
06/30/14 11:36 07/01/14 16:59 1024.57.3
Toxaphene
ND u/L 5000 5
g
06/30/14 11:36 07/01/14 16:69 72-43-5
Surrogates
15.0 5
06/30/14 11:36 07/01/14 16:59 8001-35-2
Decachlorobiphenyl (S)
0 %
Telrachl0ro-m-xylene (S)
0 % 10.138 5
06/30/14 11:36 07/01/14 16:59 2061-24-3 D3,S4
8151 Chlorinate Herbicide TCLP
10.110 5
Analytical Method: EPA8151
06/30/14 11:36 07/01/14 16:59 877-09-8
Preparation Method: EPA3510
2,4-D
2,4,5-TP (Silvex)
ND mg/L
ND mg/L 0.010 1
07/08/14 08:40 07/08/14 22:32 94.75-7
Surrogates
0.010 1
07/08/14 08:40 07/08/14 22:32 93-72.1
2,4-DCAA (S)
91
6010 MET ICP, TCLP
42-142 1
07/08/14 08:40 07/08/14 22:32 19719-28.9
Analytical Method: EPA 6010 Preparation Method: EPA
3010
Leachate Method/Date: EPA 1311; 06/27/14 15:30
Arsenic
Barium
ND mg/L 0.050 1
0.63 mg/L
06/30/14 15:30 07/01/14 15:02 7440-38-2
Cadmium
0.25 1
ND m /L
9
06/30/14 15:30 07/01/14 15:02 7440-39-3
Chromium
0.0050 1
ND mg/L
06/30/14 15:30 07/01/14 15:02 7440.43-9
Lead
ND mg/L 0.025 1
06/30/14 15:30 07/01/14 15:02 7440-47-3
Selenium
ND mg/L 0,025 1
06/30/14 15:30 07/01/14 15:02 7439.92.1
Silver
ND mg/L 0.10 1
06/30/14 15:30 07/01/14 15:02 7782.49.2
7470 Mercury, TCLP
0.025 1
06/30/14 15:30 07/01/14 15:02 7440-22-4
Analytical Method: EPA 7470 Preparation Method: EPA 7470
Leachate Method/Date: EPA 1311: 06/27/14 15:30
Mercury
ND ug/L
8270 MSSV TCLP Sep Funnel
0.20 1
Analytical Method: EPA 8270 Preparation Method:
06/30/1418:00 07/01/1416:23 7439.97-6
EPA
3510
Leachate Method/Dale: EPA 1311; 06/27/14 14:00
1,4-Dichlorobenzene
ND ug/L
2,4-Dinitrotoluene
2500 10
ND ug/L
06/30/14 11:35 07/01/14 15:05 106.46.7
Hexachloro-1,3-butadiene
2500 10
ND ug/L
06/30/14 11:35 07/01/14 15:05 121.14-2
Hexachlorobenzene
2500 10
ND ug/L
06/30/14 11:35 07/01/14 15:05 87-68-3
Hexachloroethane
2500 10
ND ug/L
06/30/14 11:35 07/01/14 15:05 4.1 118-7
118-7
2-Methylphenol(o-Cresol)
2500 10
g/L
06/30/14 11:35 07/01/14 15:05 1
3&4-Melhylphenol(m&p Cresol)
2500 10
ND uND
9
06/30/14 11:35 07/01/14 15:05 95.48.7
Nilrobenzene
2500 10
ND ug/L
06/30/14 11:35 07/01/14 15:05
Pentachlorophenol
2500 10
ND ug/L
06/30/14 11:35 07/01/14 15:05 98.95-3
Pyridine
ND ug/L 5000 10
06/30/14 11:35 07/01/14 15:05 87-86-5
2,4,5-Trichlorophenol
2500 10
ND ug/L
06/30/14 11:35 07/01/14 15:05 110.86-1
2,4,6-Trichlorophenol
2500 10
ND ug/L
06/30/14 11:35 07/01/14 15:05 95-95.4
2500 10
06/30/14 11:35 07/01/14 15:05 88-06.2
REPORT OF LABORATORY ANALYSIS
Dale: 07/15/2014 04:38 PM This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc..
Page 4 of 22

Anal4lcal
�wnxpacelabs.com
ANALYTICAL RESULTS
Pace Analytical Services, Inc.
9800 Kincey Ave. Suite 100
Hunlersville, NC 28078
[phone]
Project: 140625-27
Pace Project No.: 92206997
Sample; 140625.27 Lab ID; 92206997001 Collected: 06/25/14 14:20 Received: 06/26/14 14:50 Matrix: Solid
Results reported on a "d h "
ry werg t basis
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qua[
8270 MSSV TCLP Sep Funnel Analytical Method: EPA 8270 Preparation Method: EPA 3510
Leachate Method/Date: EPA 1311; 06/27/14 14:00
Surrogates
Nitrobenzene-d5 (S)
0 %
12.102
10
06/30/14 11:35 07/01/14 15:05
4165-60.0 D3,P3,
2-Fluorobiphenyl (S)
Terpheobiph4 yl
0 %
%
13.107
10
06/30/14 11:35 07/01/14 15:06
S4
321.60-8
Phenol-d6 (S)
0
0 %
10
06/30/14 11:3 5 07/01/14 15:05
1718-51-0
2•Fluorophenol (S)
0 %
0.
10.1
110
10
06/30/14 11:35 07/01/14 15:05
13127-88-3
2,4,6 Tribromophenol (S)
0
10.110
10
06/30/14 11:35 07/01/14 15:05
367.12-4
27-108
10
06/30/14 11:35 07101/1415:05
118.79.6
8260 MSV TCLP
Analytical Method: EPA 8260 Leachale
Method/Date:
EPA 1311; 07/01/14 15:25
Benzene
2-Bulanone (MEK)
ND ug/L
ND ug/L
50.0
10
07/11/14 14:37
71-43.2
Carbon tetrachloride
ND ug/L
0
10
07/11/14 14:37
78-93-3
Chlorobenzene
ND u /L
g
50.0,0
10
07/11/14 14:37
56-23-5
Chloroform
ND ug/L
50.0
10
07/11/14 14:37
108.90-7
1,4•Dichlorobenzene
ND ug/L
50.0
10
07/11/14 14:37
67-66.3
1,2-Dichloroelhane
ND u /L
9
50.0
10
07/11/14 14:37
106.46.7
1,1-Dichloroethene
ND ug/L
50.0
10
07/11/14 14:37
107.06-2
Tetrachloroethene
ND u /L
9
50,0
10
07/11/14 14:37
75-35-4
Trichloroelhene
ND ug/L
50.0
10
07/11/14 14:37
127.18.4
Vinyl chloride
ND u /L.
9
50.0
10
07/11/14 14:37
79.01.6
Surrogates
50.0
10
07/11/14 14:37
75.01.4
1,2-Dichloroethane-d4 (S)
104 %
70-130
10
Toluene-d8 (S)
102 %
07/11/14 14:37
17060-07-0
4•BromoFluorobenzene (S)
94
67-135
10
07/11/14 14:37
2037-26.5
70-130
10
07/11/14 14:37
460-00-4
Percent Moisture
Analytical Method: ASTM D2974-87
Percent Moisture
99.7 %
0.10
1
07/11/14 15:24
1010 Flashpolnt,Closed Cup
Analytical Method: EPA 1010
Flashpoinl
>200 deg F
70.0
1
07/04/14 01:30
9045 pH Soil
Analytical Method: EPA 9045
pH at 25 Degrees C
5.3 Sid. Units
0.10
1
07/02/14 17:35
Sample; 140625.27
Lab ID; 92206997002 Collected:
06/25/14 14:20
Received: 06/26/14 15:50 Matrix: Water
Parameters
Results Units Report Limit
p
DF
Prepared Analyzed
CAS No. Qual
7330 Reactive Cyanide
Analytical Method: SW-846 7.3.3,2
Cyanide, Reactive
ND mg/L
0.010
1
07l02/14 01:39
Dale: 07/15/2014 04:38 PM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc..
Page 5 of 22

Analytical
iwiw.pacelabs.com
Project: 140625-27
Pace Project No.: 92206997
Sample; 140625.27
Parameters
734S Reactive Sulfide
Sulfide, Reactive
Pace Analytical Services, Inc.
9800 Kincey Ave, Suite 10o
Huntersville, NC 28078
[phone]
ANALYTICAL RESULTS
Lab ID; 92206997002 Collected; 06/25/14 14.20 Received; 06/26/14 15;50 Matrix: Water
Results Units Report Limit DF
_ Prepared Analyzed CAS No, Qual
Analytical Method: SW-846 7,3.4,2 1-_
ND mg/L 1.0 1
07/01/14 17;00
REPORT OF LABORATORY ANALYSIS
Date: 07/15/2014 04:38 PM This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc„
Page 6 of 22

Analytical Results
Southern Soil Builders
958 Hoots Rd. For; Belmont
Roaring River, NC 28669
Entered; 7/16/2014
Reported; 8/21/2014
Sample ID; 140716-20
• ���� Wcc[or'yttraction Reduction Aerobicall Digested Sludge 3
Total Solids Volatile Solids o
/o Volatile Solid;
eek 1.52 _
090
0,591
/eek 3 1.44
0,84
0,584
'eek 4 1.41
0,83
0.590
eek 5 1,32
0.77
0.5R1c
Volatile Solids Reduction; 0.6053
- 0,5819 X 100 = 9.24 Ya
0.6053 - (0,6053 X 0,5819)
Respectfully submitted, �
/-Allv(l
Dena Myers 1
1
Statesville Analytical, Inc.
NC WW Cert,# 440NC
DW Cert. #37755
ve rb
P.O. Box 228 9 Statesville, North Carolina 28687 0 704/872/4697

Analytical Results
Southern Soil Builders
958 Hoots Road
Roaring River NC 28669
Entered 6/25/2014
Reported: 6/30/2014
For: Belmont
Sample ID
Parameter Cust ID
Result
Units
Date
Method
Analyzed Analyst
140625-25,1
%Solids
140625-25.1
1
Fecal Coliform MTF l
2,21
%
SM2540B-1997
6/26/14
CL
140625-25.1
Geometric Mean 1
<905
MPN/g
SM92210E-2006
6/26/14
CL
140625-25,2
%Solids 2
<885
MPN/g
dry wt, basis
6/27/14
CL
140625-25.2
Fecal Coliform MTF 2
2,24
%
SM2540B-1997
6/26/14
CL
140625-25.3
%Solids 3
<893
MPN/g
SM92210E-2006
6/26/14
CL
140625-25.3
Fecal Coliform MTF 3
2,33
%
SM2540B-1997
6/26/14
CL
140625-25.4
%Solids 4
<858
MPN/g
SM92210E-2006
6/26/14
CL
'140625-25.4
Fecal Coliform MTF 4
2,22
SM25408-1997
6/26/14
CL
'140625-25,5
%Solids S
<901
MPN/g
SM9221 CE-2006
6J26/14
CL
140625-25.5
Fecal Coliform MTF g
2,28
%
SM2540B-1997
6/26/14
CL
140625-25.6
%Solids 6
<877
MPN/g
SM92210E-2006
6/26/14
CL
140625-25.6
Fecal Coliform MTF 6
2.23
%
SM2540B-1997
6/26/14
CL
140625-25,7
%Solids 7
`897
MPN/9
SM9221 CE-2006
6/26/14
CL
140625-25,7
Fecal Coliform MTF 7
2.32
%
SM2540B-1997
6/26/14
CL
<862
MPN/g
SM9221 CE-2006
6/26/14
CL
P•O, Box 228 9 Statesville, North Carolina 28687 9 704/872/4697

ringots Road
River
Entered 6/25/2014
Reported; 6/30/2014
For;
NC 28669
Sample ID Parameter Cust ID Result Units Date
Method
Analyzed Analyst
Respectfully submitted,
Dena Myers
NC Cert #440,
NCDW Cert #37755,
EPA NCO0909
P 0, Box 228 • Statesville, North Carolina 28687 • 704/872/4697

ity Name: City of Belmont "�u'1 �161 nures)
WTP Name: City of Belmont WQ Permit Number: WQ0003281
Monitoring Period; From NPDES Number; NCO021181
1/l/2014 To 12/31/2014
Pathogen Reduction (15A NCAC 02T .1106) - Please indicate level achieved and alternative performed:
Class A: Alt. A (time/temp) (� Alt B (Alk Treatment) [:1 Alt. C (Prior Testing A1t,D (No Prior Test b)�-•l
��� Process to Further Reduce Pathogen gs7
If applicable to alternative performed (Class A only) indicate "Process to Further Reduce Pathogens";
Compost C Heat Drying y g Heat Treatment C G
Beta Ray �,.� GammThermophilic
a Ray (�
Pasteurization
Class B: Alt, (1) Fecal Density _ Alt, 2 Process
If applicable to alternative per for med (Class B onl irrdic "Process
to Significantly Reduce Pathogens "[ 1
Lime Stabilization y 3) ate Process to Significantly Reduce Pathogens";
Air Drying Com )ostim, �� Aerobic Digestion I
Anaerobic Digestion L ;.:;:<:....:.;:.:.::. ;.>:.:.:..:.;:.:.:.:...:.::::..::.....::....:.:...:.:.
I f applicable le
0 a
I' r c a b
t
p 1 to rnative performed (Class A or Class B) complete tine following monitorin data;
Parameter Allowable Level Pathogen Density um er o g
in Slud e MiFrequency Sample a yt'c
g Minim Geo. Mean aximu Units Excee- of Analysis T Tech-
2 x 10 to the ,N dences Typ
e
858 885 ni ue
6th power 905 MPN/g 0 7
per gram of grab sm92?..1
Fecal Coliform total solids CFU
1000 mpn per gram
Of total solid (dry
Salmonella bacteria 3 PON per 4 grams
(in lieu of fecal total solid (dry
coliform wei ht
Vector Attraction Reduction (15A NCAC 02T .1107) - Please indicate alternative performpd:
Alt.I (VS reduction) EJ Alt, 2 (40-day bench
Alt. 5 (14-Day Aerobic ) Alt. 3 (30-day bench) Alt, 4 (Spec, 02 uptake)
(�,� Alt, 6 (Alk. Stabilization � Alt 7 (Drying -Stable Alt. 9 (Injection) Alt. 10 (Incorporation) ) � Alt. 8 (Drying - Unstable)
CERTIFICATION STATEIAlt ) E.._I No vector attraction reduction alternatives were performed
NT (please check the appropriate statement)
IV' "I certify, under penalty of law, that the pathogen requirements in 15A NC
vector attraction reduction requirement in 15A NCAC 02T .1107 have h,,,,, 02T .1106 and the
- -- - -, 3 NC,iauy of law, that the pathogen requirements in 15A NCAC 02T .1106 and the
vector attraction reduction requirement in 15A NCAC 02T .1107 have not been met." (Please note
if you check this statement attach an explanation why you have not met one or both of the
requirements,)
"This determination has been made under my direction and supervision in accordance with the system
designed to ensure that qualified personnel properly gather and evaluate the information used to deem
that the pathogen and vector attraction reduction requirements have been met. I am aware that determine
significant penalties for false certification including fine and imprisonment." t there are
n P, o Q— Dennis Key Southern Soil Builders In
Prepare •Name and Title (type or print) Land Applier Name and Title (if a licabl c
•� pP e)(type or print)
Signature of Preparer* Date Sign rare of Land Applier (if applicable
Date
*Preparer is defined in 40 CFR Part 503.9(r) and 15A NCAC 2T .1102 (26)
DENR FORM P\/RF mT (1')1,)nnc%

Report Number: 14-342-0606
1114
Account Number_ 46381
y� �^
A �L ,��Ste%I I La��%aLtO1 I �S
Send To: SOUTHERN SOIL BUILDERS
7621 Whitepine Road Richmond, Virginia 23237 [phone] Fax [phone]
WWWaleastem.com
DENNIS KEY
Grower:
958 HOOTS ROAD
Submitted
SOUTHERN SOIL BUILDERS
By- ZACH KEY
ROARING RIVER NC 28669
Farm ID:
Date Received: 12/08/2014
SOIL ANALYSIS REPORT Analytical Method(s):
Date Of Analysis: 12/09/2014 Date Of Report: 12/09/2014 Mehlich 3
Sample ID Lab Organic Matter
Phosphorus Potassium
Field ID Number % Rate
Magnesium Calcium Sodium
ENR Mehllch Reserve 3
pH Acidity C_E.0
BT 6-1
K
Ca Na
Ibs/A ppm Rate ppm Rate ppm Rate ppm Mg Rate
Soil Buffer H
07026 7.7 VH
ppm
150 404 VH 584 Rate ppm Rate
pH Index meq/100g meq/100g
VH 313 H 1496 M 27
NC = 337 VL
BT 6-3
NC = 299
6-1 6.74 1.9 13.6
07027 6-4 H
150 467 VH 61 VL 272
NC = 389 M 2335 H 32 VL
BT 9-1
NC = 31
6.4 1.4 15-6
0 '028 6-6 H
150 191 VH 159 H 294
NC = 159 H 1330 M 21 VL
NC = 81
5-9 6.73 2,0 11.6
07029 2-6 M
89 148 VH
VH 289 VH
952
NC = 123 M 22 VLQ� = 82
L
6-0
07030 2.9 M
91 225 VH 311
6-79 1.4 9_1
VH 388
NC = 187 VH 1312 M 20 VL
Percent Base Saturation
NC = 159
6.3 1.3 11.9
Nitrate
Sample ID Sulfur Zinc Manganese Iron Field ID K Mg Ca Na Copper
%
Boron
°H NON S Zn Mn
Soluble Salts Chloride Aluminum
BT 6-1
Fe
ppm Rate ppm Rate Cu B
pPtn Rate ppm Rate ppm Rate
SS Cl Al
11-0 192 55.0 0-9
ppm Rate
13.7 24 M PPm Rate
17-5 VH 15 M
ms/cm Rate ppm Rate pptn
11
BT 6-3
367 VH 17.2 VH 0-9
NC = 50 NC = 437.5 NC = 94 M
NC = 860-0
1-0 14-5 74.8 0.9
8.9 23 M 28.4 VH 17 M 215 VH 18.8
BT g-1
VH 1-0 M
NC = 48 NC = 7M 10-0 NC = 106
NC = 940-0
3.5 21-1 57.3 0-8
17.1 20 23-1 VH 14 M 212 VH 12-8 VH
!�4
0.8 M
NC = 42 NC = 577-5 NC = 88
NC = 640-0
4.5 26,5 52-3 1.1
15.3 17 M 4 7 H 48 H 197 VH 6.8
�1
VH 0.3 VL NC = 35 NC = 117-5 NC = 300
I
NC = 340-0
6.7 27.2 55-1 0.7
10.6 17 M 11-4 VH 25 H 269 VH 12.4 VH
al represent
alues on this report represent the plant available nutrients in
0.6 M
NC=35 NC=285.0 NC=-
NC = 620.0
Rating after each value_ the
(Very Low), L (Low), M (Medium),
(High), VH (Very High). ENR -Estimated Nitrogen Release.
planation of symbols: % (percent), ppm (Parts per million), Ibs/A This report applies to samples) tested. Samples
(Pounds per acre), ms/cm (milli -mhos per centimeter),
.E.C. - Cation Exchange Capacity
are
meq/1 OOg maximum of thirty days after testing.
(milli -equivalent per 100 grams). Conversions:
Salts ms/cm x 640 = PPm x 2 =Ibs/A, Soluble
retained a
ppm- Analysis prepared by: A&L Eastern Laboratories, Inc.
by:
Y �aulcc

4 1 �
NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory John E. Skvarla, III
Governor Secretary
June 5, 2014
Mr. Chuck Flowers, Utilities Director
P.O. Box 431
Belmont, North Carolina 28012
Subject: Acknowledgement of Receipt of the 2013 Annual Report
City of Belmont WWTP - Permit No.: WQ0003281
Land Application of Residuals
Gaston County
Dear Mr. Flowers:
The Mooresville Regional Office (MRO) received and reviewed the 2013 Annual Report for
the above permit. The data submitted appears to be in accordance with permit
requirements. I may be reached by phone at [phone] or email
(maria.schutte(cD-ncdenr.gov) should you have any permit issues to discuss.
Sincerely,
Maria Schutte, Environmental Specialist
Mooresville Regional Office
Water Quality Regional Operations Section
Division of Water Resources, NCDENR
CC: Sandra Craft, WWTP Supervisor, City of Belmont (email)
Dennis Key c/o Zach Key, Southern Soil Builders (email)
Ed Hardee, LAU Compliance, CO -Raleigh (email)
Mooresville Regional Office, 610 East Center Avenue, Mooresville, North Carolina 28155
Phone: [phone] Internet: www.ncdenr.gov
An Equal Opportunity 1 Affirmative Action Employer. Made in part by recycled paper

N
city Of
Belmont,
NC
City of Belmont, NC
2013 Annual Report
Land Application Program
NC Permit No. WQ0003281
F-ECEIVED
M
FEB 2 12014
WATER QUALff Y SECTION
mpopMATION PROCESSING UNIT
2r
11A I W 1--"
0-
-2
R E. En D
QUALITY
VEB 4 2014
V�
61

ANNUAL LAND APPLICATION CERTIFICATION FORM
it#: WQ0003281 County:. Gaston Year: 2013
cility Name (as shown on permit):
City of Belmont
Land Application Operator:
Southern Soil Builders, Inc. Phone: [phone]
Land application of residuals as allowed by the permit occurred during the past calendar year?
❑ Yes ❑ No - If No, skip Part A, and Part B and proceed to Part C. Also, If residuals were
generated but not land applied, please attach an explanation on how the residuals were handled.
Part A - Residuals Application Summary:
Total number of application fields in thepermit:
3
Total number of fields utilized for land application during the year:
1
Total amount of dry tons applied during the year for all application sites:
85.7
Total number of acres utilizes for land application during the year:
42
Part B - Annual Compiance Statement:
Facility was compliant during calendar year 2013 with all conditions of the land application permit
(including but not limited to items 1-13 below) issued by the Division of Water Resources.❑ Yes ❑ No
If no please, provide a written description why the facility was not compliant, the dates, and explain corrective action
taken.
1) Only residuals approved for this permit were applied to the permitted sites.
2) Soil pH was adjusted as specified in the permit and lime was applied (if needed) to achieve a soil pH of at least 6.0 or
the limit specified in the permit.
3) Annual soils analysis were performed on each site receiving residuals during the past calendar year and three (3) copies
of laboratory results are attached.
4) Annual TCLP analysis (if required) was performed and three (3) copies of certified laboratory results are attached.
5) All other monitoring was performed in accordance with the permit and reported during the year as required and three (3)
copies of certified laboratory results are attached.
6) The facility did not exceed any of the Pollutant Concentration Limits in 15A NCAC 02T .1105(a) or the Pollutant
Loading Rates in 15A NCAC 02T .1105(b) (applicable to 40 CFR Part 503 regulated facilities).
7) A11 general requirements in as specified in the Land Application Permit were complied with (applicable to 40 CFR Part
503 regulated facilities).
8) All monitoring and reporting requirements in 15A NCAC 02T .1111 were complied with (applicable to 40 CFR Part
503 regulated facilities).
9) All operations and maintenance requirements in the permit were complied with or, in the case of a deviation, prior
authorization was received from the Division of Water Resources.
10) No contravention of Ground Water Quality Standards occurred at a monitoring well or explanations of violations are
attached to include appropriate actions and remediations.
1 1) Vegetative cover was maintained and proper crop management was performed on each site receing residuals, as
specified in the permit.
12) No runoff of residuals from the application sites onto adjacent property or nearby surface waters has occurred.
13) All buffer requirements as specified on the permit were maintained during each application of residuals.
Part C - Certification:
"I certify, under penalty of law, that the above information is, to the best of my knowledge and belief, true, accurate,
and complete. I am aware that there are significant penalties for submitting false information, including the
possibility of fines and imprisonment for knowing violations."
PerMe and Title (type or print) Si t of Permittee ate
Signature of Preparer* (/ Date Signature of LancfApplier Date
(if different from Permittee) (if different from Permittee and Preparer)
* Preparer is defined in 40 CFR Part 503.9 (r) and 15A NCAC 02T .1102 (26) DENR FORM ACF (12/2006)

ANNUAL RESIDUAL SAMPLING SUMMARY FORM
Please note that your permit may contain additional parameters to be analyzed. The parameters can be reported in FORM RSSF - B
WQ Permit Number: W00003281 Laboratory: 1)
Facility Name: City of Belmont 2)
Residual Source WQ # or NCO021181 3)
NPDES #: 4)
WWTP Name: 5)
A&L Eastern Labs
- _
Parameter
Cone.•le
or Composite
Percent Solids (/o)
_-_-_
Selenium
Total Phosphorus
Nitrate and Nitrit-
a For surface disposal facilities the ceiling concentration limits listed in this form are not applicable. Keterence the marviauai permit ror metais iunits.
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed
to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant
penal#es for submitting false information, including the possibility of fines and imprisonment for knowing violations."
ignature of Preparer
Date
*Preparer is defined in 40 CFR Part 503.9(r) and 15A NCAC 2T .1102 (26) DENR FORM RSSF (12/2006)

Wty Name:
ermit #:
vYc� awi .
Acres Used:
ANNUAL METALS FIELD LOADING SUMMARY FORM*
this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
City of Belmont
WQ0003281
Lori Warren Owner:
42 Acres Permitted:
Total Dry Tons Applied (Annual):
Cation Exchange Capacity (non 503 only):
Lori Warren Predominant Soil Series:
42 Site #: BT 9-1 Field #:
85.68
GaB2
BT 9-1
Residual Analysis Data (Heavy Metals and Total Phosphorus use m:r/ka, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1 11
9/10/13
L2J
1314
J
L5J
6
L7J
L8J
L 9
10 J
11
12
% Solids
2.55
Arsenic
5
Cadmium
2
Copper
731
Chromium
50
Lead
39
Mercury
3.1
Molyb-
denum
6
Nickel
20
Selenium
5
Zinc
2160
Total
Phos-
horus
19400
Annuai neavv ivietai riem Loaains (taicuiatea in ins/acre):
Total
1
2
3
4
5
6
7
8
9
10
11
12
DT/Ac./
c
App.
cv
Event
2.04
y
Arsenic
0.020
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.020
Cadmium
0.008
0.000
0.000
1 0.000
0.000
0.000
0.000
0.000
1 0.000
0.000
0.000
1 0.000
0.008
Copper
2.982
0.000
0.000 1
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1 0.000
2.982
Chromium
0.204
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.204
Lead
0.159
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.159
Mercury
0.013
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1 0.013
Molyb-
denum
0.024
0.000
0.000
0.000
0.000
0,000
0.000
0.000
0.000
0.000
0.000
0.000
0.024
Nickel
0.082
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.082
Selenium
0.020
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.020
Zinc
8.813
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
8.813
Total
Phos-
79.1.52
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
79.152
horus
1 ceruiy, unuer penairy of iaw, inat tms aocument was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
imprisonment for knowing violations".
y
Signature of Lan Applier
Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "NIA" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: City of Belmont WQ Permit #: WQ0003281 Field #: BT 9-1 Acres Utilized: 42
Land Owner: Lori Warren Annual Dry Tons Applied: 85.7060 Site #: BT 9-1 Acres Permitted: 42
Operator: Lori Warren
Crop I Name: Fescue
Predominant Soil Series: GaB2
Crop I Max. PAN: 211 Crop 2 Name:
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
�
y
0) c
Q
Volume applied
pp
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
D
( ry,
Moist)
Preci p
Past 24
Hrs.
inches
D
cc �3
g �•
o w
a
* °
o
w -
* N'
w
�,
* N
* a
TKN
mg/kg
Z a
�
o
n o
R.
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
( lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
9-2013
117000
2.55
0.296
WQ0003281
dry
0
s
0.5
0.3
63100
27100
2
14.427
NA
Fescue
10-2013
689000
2.55
1.744
WQ0003281
dry
0
s
0.5
0.3
63100
27100
2
84.959
NA
Fescue
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form):
TOTALS:
0
806000
As
Cd
Cu
Cr
Pb
H
Mo
Ni
Se
Zn
P
99.386
0.000
Lime A lied
Annuallbs/acre
0.020
0.008
2.982
0.204
0.159
0.013
0.024
0.082
0.020
8.813
79.152
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.144
0.064
11.899
27.211
2.545
0.018
0.053
1.313
0.043
94.369
Current Cumulative lbs/ac
0.164
0.072
14.881
27.415
2.704
0.031
0.077
1.395
0.063
103.182
Permitted C. P. L. R.****
36
1 34
1 NA
1338
267
1 15
NA
374
89
1 2498
Permit PAN Limit Ist/2nd Crop
211
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
Signature of Land Applier
(-13-i
Date
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
*** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

Page: 1 of 2
Report Number: 13-255-0205
Account Number: 46381
Submitted By: ZACH KEY
Send To: SOUTHERN SOIL BUILDERS
DENNIS KEY
958 HOOTS ROAD
ROARING RIVER, NC 28669
Lab Number: 95472
Sample Id: BELMONT WWTP
�T A&L Eastern Laboratories, Inc.
7621 Whitepine Road Richmond, Virginia 23237 (804) 743-S401 Fax (804) 271bW6
www.aleastem.cotn
Project: BELMONT WWTP
NC CERT#257
REPORT OF ANALYSIS Date Sampled: 9/10/2013 12:18:00
Date Received: 09/12/2013 00:00
Date Reported: 09/18/2013
Total Solids `
2.55
25500
100.0
JM
09/12/2013 13:45
SM-2540G
Moisture'
97.45
100.0
JM
09/12/201313:45
SM-2540G
Total Kjeldahl Nitrogen
6.31
63100
10.0
JM
09/13/2013 07:59
SM-4500-NH3C-TKN
Total Phosphorus
1.94
19400
100
KM
09/13/2013 12:10
SW 6010C
Total Potassium
0.27
2660
100
KM
09/13/2013 12:10
SW 6010C
Total Sulfur
1.51
15100
100
KM
09/13/2013 12:10
SW 6010C
Total Calcium
2.09
20900
100
KM
09/13/2013 12:10
SW 6010C
Total Magnesium
0.32
3180
100
KM
09/13/2013 12:10
SW 6010C
Total Sodium
0.77
7650
100
KM
09/13/2013 12:10
SW 6010C
Total Iron
22700
100
KM
09/13/2013 12:10
SW 6010C
Total Aluminum
15800
100
KM
09/13/2013 12:10
SW 6010C
Total Manganese
876
5
KM
09/13/2013 12:10
SW 6010C
Total Copper
731
5
KM
09/13/2013 12:10
SW 6010C
Total Zinc
2160
5
KM
09/13/2013 12:10
SW 6010C
Ammonia Nitrogen
2.71
27100
10.0
JM
09/13/2013 07:59
SM-4500-NI3C
Organic N
3.60
36000
10.0
09/13/2013 07:59
CALCULATION
Nitrate+Nitrite-N
<2.00
2.00
JM
09/13/2013 08:00
SM-450ONO3F
Total Cadmium
2.0
2.0
KM
09/13/2013 12:10
SW 6010C
All values are on a dry weight basis except as noted by asterisk. Detection limit on all N series is on a wet basis. 4wun t reproduced i w role r art nor ma an reference be made M�l
Our repots and letters are for the exclusive and confidential use of our clients, and may no ben / o p y y
to the work, the results, or the company in any advertising, news release, or other public announcements without obtaining our poor written authorization.
Debbie Holt

Page: 2 of 2
Report Number: 13-255-0205
Account Number: 46381
Submitted By: ZACH KEY
Send To: SOUTHERN SOIL BUILDERS
DENNIS KEY
958 HOOTS ROAD
ROARING RIVER, NC 28669
Lab Number: 95472
Sample Id: BELMONT WWTP
A&L Eastern Laboratories, Inc.
7921 Whitepine Road Richmond, Virginia 23237 [phone] Fax (804) 271-WS
www.sleastem.com
Project: BELMONT WWTP
NC CERT#257
REPORT OF ANALYSIS Date Sampled: 9/10/2013 12:18:00
Date Received: 09/12/2013 00:00
Date Reported: 09/18/2013
Total Chromium
50
5
KM
09113/2013 12:10
SW 6010C
Total Nickel
20
5
KM
09/13/2013 12.10
SW 6010C
Total Lead
39
5
KM
09/13/2013 12:10
SW 6010C
Total Arsenic
5.0
3.0
KM
09/13/2013 12:10
SW 6010C
Total Mercury
3.1
0.4
KM
09/13/201309:00
SW-7471B
Total Selenium
5.0
5.0
KM
09/13/2013 12:10
SW 6010C
pH (Standard Units) `
8.16
2.00
JM
09/13/2013 07:59
SW-9045D
Total Molybdenum
6
5
KM
09/13/2013 12:10
SW 6010C
Comments:
SULFUR AND ORGANIC NITROGEN NOT FOR COMPLIANCE PURPOSES.
QUALIFIER: THE MATRIX SPIKE WAS OUT OF LIMITS FOR "Al" AND "S". ALL OTHER QC DATA IS ACCEPTABLE.
All values are on a dry weight basis except as noted by asterisk. Detection limit on all N series is on a wet basis.
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
to the work, the results, or the company in any advertising, news release, or other public announcements without obtaining our prior written authorization.
Debbie Holt

T
Mineralization
as decimal
ITotal dry
tons/year
lAcres
Applied on
1 42
Rate
0.3
TKN
63100
NH3
27100
NO3
2
NO2
0
% Solids
0.0255
1 85.7
PAN Surface
243521mglkg 48.704 lbs/dry ton
4173.933 jibs total AN
99.37935 Ibs PAN/acre
PAN Injection
379021mg/kg 75.804 lbs/dry ton
6496.403 lbs- total PAN
154.6763 lbs PAN/acre
Dry Tons/1000 gal.
0.106335
1st year PAN
lbs./acre
Surface lbs.
Surface
4173.93281
1 99.37935238
1st year PAN
lbs./acre
Injected lbs.
Injected
6496.4028
1 154.6762571
MR(TKN-NH3)+ + .5(NH3)+NO3+NO2 =mg/kg
mg/kg x .002 =Ibs/dry ton
MR(TKN-NH3) + l (NH3)+NO3+NO2 =mg/kg
mg/kg x .002 =Ibs/dry ton
- 1000 X 8.34 X %solids X sp. -gravity "=dry tons/1000gal."
2000

Sodium Absorption Ratio
Na: Sodium (Mg/L) Equivalent weight: 23
Ca: Calcium (Mg/L) Equivalent weight: 20
Mg : Magnesium (Mg/L) Equivalent weight: 12
Milli Equivalent = Mg/L / Equivalent weight
Na M /L Ca M /L M M /L
195.075 1 532.95 1 81.09
Na ME
Ca ME
Mg (ME)
8.481522
1 26.6475
1 6.7575
SAR= Na Milli Equivalent/[0.5 X (Ca Milli Equivalent + Mg Milli equivalent)]0.5 power
SAR = 2.07531 (From Mg/L entered above)
SAR= 2.074783 Yrom ME entered below)
Na ME
Ca ME
M ME
8.48
26.65
1 6.76
The amour
amount of E
Permitting I

Analytical Results
Southern Soil Builders
958 Hoots Road
Roaring River NC 28669
Entered 9/10/2013
Reported: 9/20/2013
For:
Sample ID Parameter Cust ID Result Units Date
Method Analyzed Analyst
130910-21.1
% Solids
1
2.73
%
SM2540B-1997
9/11/13
MD
130910-21.1
Fecal Coliform MTF
1
<733
MPN/g
SM92210E-2006
9/11/13
MD
130910-21.2
% Solids
2
2.78
%
SM2540B-1997
9/11/13
MD
130910-21.2
Fecal Coliform MTF
2
<719
MPN/g
SM92210E-2006
9/11/13
MD
130910-21.3
% Solids
3
2.72
%
SM2540B-1997
9/11/13
MD
130910-21.3
Fecal Coliform MTF
3
<735
MPN/g
SM9221 CE-2006
9/11/13
MD
130910-21.4
% Solids
4
2.72
%
SM2540B-1997
9/11/13
MD
130910-21.4
Fecal Coliform MTF
4
<735
MPN/g
SM9221 CE-2006
9/11/13
MD
130910-21.5
% Solids
5
2.75
%
SM2540B-1997
9/11/13
MD
130910-21.5
Fecal Coliform MTF
5
< 727
MPN/g
SM92210E-2006
9/11/13
MD
130910-21.6
% Solids
6
2.69
%
SM2540B-1997
9/11/13
MD
130910-21.6
Fecal Coliform MTF
6
<743
MPN/g
SM92210E-2006
9/11/13
MD
130910-21.7
% Solids
7
2.76
%
SM2540B-1997
9/11/13
MD
130910-21.7
Fecal Coliform MTF
7
<725
MPN/g
SM92210E-2006
9/11/13
MD
130910-21.7
Geometric Mean
7
<731
MPN/g
dry wt. basis
9/12/13
MD
P.O. Box 228 9 Statesville, North Carolina 28687 9 704/872/4697

n Soil Builders
r
Road
iver NC 28669
Entered 9/10/2013
Reported: 9/20/2013
For:
Date
Sample ID Parameter Cust ID Result Units Method Analyzed Analyst
Respectfully submitted,
Dena Myers
NC Cert #440,
NCDW Cert #37755,
EPA NCO09O9
P.O. Box 228 • Statesville, North Carolina 28687 • 704/872/4697

Client: 5��1he, ��. ldrr5i T1 n�.
h
Address: Q S ��a� I S P J
Ro«i, /rr �,C
Contact Person: c .
O#
Customer Lab ID # Time Sampled
Sample ID# - (Grab Only)
Relinquished by:
Received by:
Relinquished by:
Received by:
Y
Composite Sampling
#1:
Time begin
Time end
Composite Sampling
am, pm
am, pm
#2:
Date
Date
Time begin
Time end
am, pm
am, pm
Date
Date
STATESVILLE ANALYTIC
122 Court Street • P.O. Box
Statesville, NC 28687
-" (704) 872-697
Phone # 3�. i�11 FAX# "�� G S ti Chain of
Requisitioned by: (Time Date) Custody Record
Date Sampled E Matrix parameters requested for analysis
(Grab Only) 8 Sludge W WW
10- ► 3 1 Y
Time I ' Lf < am, l6pate / f 6 / � 3 Sampled by:
Time am, pm Date —/_/ Transported ,b :
Time am, pm Date _/ Holding times met:
Time pm ate / l / Com liance work:
P
Lab Comments:
Non-compliance work:

Condition of Receipt
Sample ID 130910-21 Client Southern Soil Builders
Temp on Arrival 6
pH upon Arrival Parameter Schedule % Solids
❑
HNO3
❑
HCl
❑
NaOH
❑
H2SO
❑
Na2S2O
❑
Dechlorinated
pH upon Arrival Parameter Schedule
Fecal Coliform MTF
❑
HNO3
❑
HCl
❑
NaOH
❑
H2SO
0
Na2S2O
❑
Dechlorinated
❑ Chemicals in containers, client
❑ Chemicals upon receipt
RI Received on Ice
❑ Samples chilled upon receipt
❑ Chemicals in containers, lab
❑ Chemicals in containers, client
❑ Chemicals upon receipt
0 Received on Ice
❑ Samples chilled upon receipt
W Chemicals in containers, lab
Page 1 of 1

Southern Soil Builders
958 Hoots Rd
Roaring River, NC 28669
Entered: 9/24/13
Reported: 11 /12/13
Sample ID: Belmont
Parameter: Vector Attraction Reduction/Aerobically Digested Sludge
(30 Day)
%Total Solids
%Volatile Solids
% Volatile Fraction
Week 1
2.6
1.52
0.5840
Week 2
2.38
1.37
0.5748
Week 3
2.36
1.37
0.5782
Week 4
2.30
1.34
0.5820
Week 5
2.28
1.32
0.5790
Volatile Solids Reduction:
Respectfully submitted,
.QAA Iw?
Dena Myers
NCWW Cert #440
NCDW Cert #37755
EPA NC 00909
(0.5840-0.5790) X100 = 2.04%
0.5840-(O.584OX0.579O)
P.O. Box 228 9 Statesville, North Carolina 28687 9 704/872/4697

Client:
S I`�I�Pr n
S
TIC
STATESVILLEANALx
122 Court Street P.O. Box
Statesville, NC 28687
[phone]
Address: ) )V !1 f
f'<U
C�Uar•r aJal N` �pb�
Contact Person:
�.�, 1,�
Phone
#
FAX# 3 L 91 $9 �� J
3
Chain of
PC #
Customer
Sample ID#
Lab -ID #
Requisitioned by:
Time Sampled _Date Sampled
(Grab Only) (Grab Only)
E
CO)
(Time Date) Custody Record .
Matrix parameters requested for analysis
Sludge w ww
BeIa,.
Relinquished by:
Received by:
Relinquished by:
Received by:
Composite Sampling
Time begin
Time end
Composite Sampling
Time begin
Time end
„kl
#1:
am, pm
am, pm
#2:
am, pm
am, pm
Date
Date
Date
Date
!_/
_/ /
/ /
Time j
Time/;
Time
Time
Lab Comments:
am,"OM Date //
am, ,gym date �>' t'/ �7
am, pm Date _/
am, pm Date _/
Sampled by:
Transported b .
Holding times met:
Compliance work: f
Non-compliance work:

Condition of Receipt
Sample ID 130924-18 Client Southern Soil Builders
Temp on Arrival 6
pH upon Arrival
Parameter Scheduled Bench 30 Day
❑
HNO3
❑
HCl
❑
NaOH
❑
H2SO4
❑
Na2S2O
❑
Dechlorinated
❑ Chemicals in containers, client
❑ Chemicals upon receipt
v Received on Ice
❑ Samples chilled upon receipt
❑ Chemicals in containers, lab
Page 1 of 1

Client:
Sc•)
I
��.Id<<,
TIC,
•>---��
STATESVILLE ANALYTI
122 Court Street • P.O. Box 2
Statesville, 2- 28687
(704) 872�697
Address: C� S 0 j l� y� d
b I
UL r
b
Contact Person Z 1 V
�,
Phone # 33 6 - q
FAX#
Chain of
Custody Record
PO # Requisitioned by: (Time Date)
Customer
Sample ID#
Lab -ID #
Time Sampled
(Grab Only)
Date Sampled
(Grab Only)
E
Matrix
Parameters requested for analysis
sludgel
w
I ww
01
I n.• b. l
Relinquished by:
Received by:
Relinquished by:
Received by:
Composite -Sampling
Time begin
Time end
Composite Sampling
Time begin
Time end
#1:
am, pm
am, pm
#2:
am, pm
am, pm
Date _/_/
Date _/
Date
Date _/_/
/
Time r/ `�S
Time
Time
Time
Lab Comments:
am, rr Date [
am, pm Date _/
am, pm Date _/
a bpm Date
/ U /
/
/_
(0 /�
Sampled by:
Transported by:
Holding times met:
Compliance work:
Non-compliance work:

Condition of Receipt
Sample ID 130910-18 Client Southern Soil Builders
Temp on Arrival 6
pH upon Arrival
Parameter Schedule TCLP
❑
HNO3
❑
HCl
❑
NaOH
❑
H2SO
❑
Na2S2O
❑
Dechlorinated
❑ Chemicals in containers, client
❑ Chemicals upon receipt
❑v Received on Ice
❑ Samples chilled upon receipt
❑ Chemicals in containers, lab
Page 1 of 1

Analytical
www.pacelabs.com
Project: 130910-18
Pace Project No.: 92171797
Pace Analytical Services, Inc.
205 East Meadow Road - Suite A
Eden, NC 27288
[phone]
Pace Analytical Services, Inc.
2225 Riverside Dr.
Asheville, NC 28804
[phone]
ANALYTICAL RESULTS
Pace Analytical Services, Inc.
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Sample: 130910-18 Lab ID: 92171797001 Collected: 09/10/13 12:22 Received: 09/11/13 15:40 Matrix: Solid
Results reported on a "dry -weight" basis
Parameters Results Units Report Limit DF Prepared
8081 GCS Pesticides, TCLP
gamma-BHC (Lindane)
Chlordane (Technical)
Endrin
Heptachlor epoxide
Methoxychlor
Toxaphene
Surrogates
Decachlorobiphenyl (S)
Tetra chIoro-m-xylene (S)
8151 Chlorinate Herbicide TCLP
2,4-D
2,4,5-TP (Silvex)
Surrogates
2,4-DCAA (S)
6010 MET ICP, TCLP
Arsenic
Barium
Cadmium
Chromium
Lead
Selenium
Silver
7470 Mercury, TCLP
Mercury
8270 MSSV TCLP Sep Funnel
1,4-Dichlorobenzene
2,4-Dinitrotoluene
Hexachloro-1,3-butadiene
Hexachlorobenzene
Hexachloroethane
2-Methylphenol(o-Cresol)
3&4-Methylphenol(m&p Cresol)
Nitrobenzene
Pentachlorophenol
Pyridine
2,4,5-Trichlorophenol
Date: 09/24/2013 05:26 PM
Analytical Method: EPA 8081 Preparation Method: EPA 3510
Leachate Method/Date: EPA 1311; 09/12/13 14:25
Analyzed CAS No. Qual
ND ug/L
2.5
5
09/16/13 08:30
09/17/13 21:42
58-89-9
ND ug/L
15.0
5
09/16/13 08:30
09/17/13 21:42
57-74-9
ND ug/L
2.5
5
09/16/13 08:30
09/17/13 21:42
72-20-8
ND ug/L
2.5
5
09/16/13 08:30
09/17/13 21:42
1024-57-3
ND ug/L
5000
5
09/16/13 08:30
09/17/13 21:42
72-43-5
ND ug/L
15.0
5
09/16/13 08:30
09/17/13 21:42
8001-35-2
0 %
10-138
5
09/16/13 08:30
09/17/13 21:42
2051-24-3 D3,S4
0 %
10-110
5
09/16/13 08:30
09/17/13 21:42
877-09-8
Analytical Method: EPA 8151 Preparation Method: EPA 3510
ND mg/L
0.010
1
09/17/13 08:00
09/18/13 02:05
94-75-7
ND mg/L
0.010
1
09/17/13 08:00
09/18/13 02:05
93-72-1
88 %
70-130
1
09/17/13 08:00
09/18/13 02:05
19719-28-9
Analytical Method: EPA 6010 Preparation Method: EPA 3010
Leachate Method/Date: EPA 1311; 09/17/13 23:00
ND mg/L
0.050
1
09/19/13 07:45
09/19/13 20:40
7440-38-2
ND mg/L
0.25
1
09/19/13 07:45
09/19/13 20:40
7440-39-3
ND mg/L
0.0050
1
09/19/13 07:45
09/19/13 20:40
7440-43-9
ND mg/L
0.025
1
09/19/13 07:45
09/19/13 20:40
7440-47-3
ND mg/L
0.025
1
09/19/13 07:45
09/20/13 10:47
7439-92-1
ND mg/L
0.10
1
09/19/13 07:45
09/19/13 20:40
7782-49-2
ND mg/L
0.025
1
09/19/13 07:45
09/19/13 20:40
7440-22-4
Analytical Method: EPA 7470 Preparation Method:
EPA 7470
Leachate Method/Date: EPA 1311; 09/17/13 23:00
0.46 ug/L G 0,7, ' 1 b
0.20
1
09/18/13 20:30
09/19/13 15:49
7439-97-6
Analytical Method: EPA 8270 Preparation Method:
EPA 3510
Leachate Method/Date: EPA 1311; 09/12/13 14:25
ND ug/L
500
10
09/13/13 09:00
09/16/13 15:39
106-46-7
ND ug/L
500
10
09/13/13 09:00
09/16/13 15:39
121-14-2
ND ug/L
500
10
09/13/13 09:00
09/16/13 15:39
87-68-3
ND ug/L
500
10
09/13/13 09:00
09/16/13 15:39
118-74-1
ND ug/L
500
10
09/13/13 09:00
09/16/13 15:39
67-72-1
ND ug/L
500
10
09/13/13 09:00
09/16/13 15:39
95-48-7
ND ug/L
500
10
09/13/13 09:00
09/16/13 15:39
ND ug/L
500
10
09/13/13 09:00
09/16/13 15:39
98-95-3
ND ug/L
1000
10
09/13/13 09:00
09/16/13 15:39
87-86-5
ND ug/L
500
10
09/13/13 09:00
09/16/13 15:39
110-86-1
ND ug/L
500
10
09/13/13 09:00
09/16/13 15:39
95-95-4
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc..
Page 4 of 20

Analytical
www.pacelabs.com
Pace Analytical Services, Inc.
205 East Meadow Road - Suite A
Eden, NC 27288
[phone]
Pace Analytical Services, Inc.
2225 Riverside Dr.
Asheville, NC 28804
[phone]
ANALYTICAL RESULTS
Pace Analytical Services, Inc.
9800 KlnceyAve. Suite 100
Huntersville, NC 28078
[phone]
Project: 130910-18
Pace Project No.: 92171797
Sample: 130910-18
Lab ID: 92171797001 Collected:
09/10/13 12:22
Received: 09/11/13 15:40 Matrix: Solid
Results reported on a "dry -weight"
basis
Parameters
Results Units Report Limit
DF
Prepared
Analyzed
CAS No. Qual
8270 MSSV TCLP Sep Funnel
Analytical Method: EPA 8270 Preparation Method: EPA 3510
Leachate Method/Date: EPA 1311; 09/12/13 14:25
2,4,6-Trichlorophenol
ND ug/L
500
10
09/13/13 09:00
09/16/13 15:39
88-06-2
Surrogates
Nitrobenzene-d5 (S)
0 %
12-102
10
09/13/13 09:00
09/16/13 15:39
4165-60-0 D3,S4
2-Fluorobiphenyl (S)
0 %
13-107
10
09/13/13 09:00
09/16/13 15:39
321-60-8
Terphenyl-d14 (S)
0 %
21-132
10
09/13/13 09:00
09/16/13 15:39
1718-51-0
Phenol-d6 (S)
0 %
10-110
10
09/13/13 09:00
09/16/13 15:39
13127-88-3
2-Fluorophenol (S)
0 %
10-110
10
09/13/13 09:00
09/16/13 15:39
367-12-4
2,4,6-Tribromophenol (S)
0 %
27-108
10
09/13/13 09:00
09/16/13 15:39
118-79-6
8260 MSV TCLP
Analytical Method: EPA 8260
Benzene
ND ug/L
100
20
09/23/13 05:12
71-43-2
2-Butanone (MEK)
ND ug/L
200
20
09/23/13 05:12
78-93-3
Carbon tetrachloride
ND ug/L
100
20
09/23/13 05:12
56-23-5
Chlorobenzene
ND ug/L
100
20
09/23/13 05:12
108-90-7
Chloroform
ND ug/L
100
20
09/23/13 05:12
67-66-3
1,4-Dichlorobenzene
ND ug/L
100
20
09/23/13 05:12
106-46-7
1,2-Dichloroethane
ND ug/L
100
20
09123/1305:12
107-06-2
1,1-Dichloroethene
ND ug/L
100
20
09/23/13 05:12
75-35-4
Tetrachloroethene
ND ug/L
100
20
09/23/13 05:12
127-18-4
Trichloroethene
ND ug/L
100
20
09/23/13 05:12
79-01-6
Vinyl chloride
ND ug/L
100
20
09/23/13 05:12
75-01-4
Surrogates
1,2-Dichloroethane-d4 (S)
122 %
70-130
20
09/23/13 05:12
17060-07-0
Toluene-d8 (S)
102 %
67-135
20
09/23/13 05:12
2037-26-5
4-Bromofluorobenzene (S)
104 %
70-130
20
09/23/13 05:12
460-00-4
1010 Flashpoint,Closed Cup
Analytical Method: EPA 1010
Flashpoint
>200 deg F
70.0
1
09/18/13 17:08
Reactive Sulfide
Analytical Method: SW-846 7.3.4.2
Sulfide, Reactive
ND mg/kg
100
1
09/17/13 15:30
9045 pH Soil
Analytical Method: EPA 9045
pH at 25 Degrees C
7.9 Std. Units
0.10
1
09/23/13 12:07
733C S Reactive Cyanide
Analytical Method: SW-846 7.3.3.2
Cyanide, Reactive
ND mg/kg
0.025
1
09/17/13 09:57
Date: 09/24/2013 05:26 PM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc..
Page 5 of 20

ANNUAL PATHOGEN AND VECTOR ATTRACTION REDUCTION FORM (02T Rules)
name: City of Belmont
Name: City of Belmont
ig Period:
WQ Permit Number:
NPDES Number:
From 1/1/2013 To 12/31/2013
WQ0003281
NCO021181
I atiluguli Reduction (15A NCAC 023 .1106) - Please indicate level achieved and alternative performed:
Class A:
Alt. A (time/temp) ❑
Alt B (Alk Treatment) ❑
I Alt. C (Prior Testing) ❑
A1t.D (No Prior Test) ElProcess
--]
to Further Reduce Pathogengs ❑
If applicable to alternative performed (Class A only) indicate "Process to Further Reduce Pathogens":
Compost El
Heat Drying El
Heat Treatment ElThetmophilic
❑
Beta Ray ❑
Gamma Ray ❑
Pasteurization ❑
Class B:
Alt. (1) Fecal Density ,❑
Alt. (2) Process to Significantly Reduce Pathogens ❑
If applicable to alternative performed (Class
B only) indicate "Process to Significantly Reduce Pathogens":
Lime Stabilization ❑
Air Drying ❑
Composting ❑
jAerobic Digestion ❑
Anaerobic Digestion ❑
.....: .
If applicable to alternative performed (Class A or Class B) complete the following monitoring data:
Parameter
Allowable Level
in Sludge
Pathogen Density
Number of
Excee-
c
Frequency
of Analysis
Sample
Type
Analytical
Tech-
nioue
Minimum
Geo. Mean
axim
Units
Fecal Coliform
2 x 10 to the
6th power
per gram of
total solids
MPN
719
731
743
MPN/g
0
7
grab
sm9221 e
CFU
1000 mpn per gram
of total solid (dry
weight)
Salmonella bacteria
(in lieu of fecal
coliform)
3 MPN per 4 grams
total solid (dry
weight)
Vector Attraction Reduction (15A NCAC 02T .1107) - Please indicate alternative performed:
Alt.l (VS reduction) ❑
Alt. 2 (40-day bench) ❑
Alt. 3 (30-day bench) p
JAIL 4 (Spec. OZ uptake) ❑
Alt. 5 (14-Day Aerobic) ❑
Alt. 6 (Alk. Stabilization ❑
Alt 7 (Drying - Stable) ❑
1Alt. 8 (Drying - Unstable) ❑
Alt. 9 (Injection) ❑
Alt. 10 (Incorporation) ❑
No vector attraction reduction alternatives were performed ❑
CERTIFICATION STATEMENT (please check the appropriate statement)
!] "I certify, under penalty of law, that the pathogen requirements in 15A NCAC 02T .1106 and the
vector attraction reduction requirement in 15A NCAC 02T .1107 have been met."
❑ "I certify, under penalty of law, that the pathogen requirements in 15A NCAC 02T .1106 and the
vector attraction reduction requirement in 15A NCAC 02T .1107 have not been met." (Please note
if you check this statement attach an explanation why you have not met one or both of the
requirements.)
"This determination has been made under my direction and supervision in accordance with the system
designed to ensure that qualified personnel properly gather and evaluate the information used to determine
that the pathogen and vector attraction reduction requirements have been met. I am aware that there are
significant penalties for false certification including fine and imprisonment."
�s rc,--C co--c-f, A-0 W :S-9—�v k-�: rZ
Preparer ame and Title (type or print) t) R-�--
JU�
Signature of Preparer* f Date
Dennis Key Southern Soil Builders, Inc.
Land Applier Name and Title (if applicable)(type or print)
�, -/3 ►)
Si ature of La Applier (if applicable) Date
*Preparer is defined in 40 CFR Part 503.9(r) and 15A NCAC 2T .1102 (26)
DENR FORM PVRF 02T (12/2006)

Page 2 of 2
Report Number: 13-343-0622
Account Number: 46381
Send To: SOUTHERN SOIL BUILDERS WWW.*aSt/m.00M
DENNIS KEY
958 HOOTS ROAD
ROARING RIVER NC 28669
Date Received: 12/09/2013 -Date Of Analysis: 12/10/2013
A&L Eastern Laboratories
7621 Whitepine Road Richmond, Virginia 23237 (804) 7433401 Fax (804) 271- W6
Grower: Submitted By: ZACH KEY
SOUTHERN SOIL BUILDERS Farm ID:
SOIL ANALYSIS REPORT Analytical Method(s):
Mehlich 3
Date Of Report: 12/10/2013
Sample ID
Lab
Organic Matter
Phosphorus
Potassium
Magnesium
Calcium
Sodium
pH
Acidity
C.E.0
Field ID
Number
% Rate ENR
Mehlich 3
Reserve
K
Mg
Ca
Na
Soil
Buffer
H
Ibs/A
ppm Rate
ppm Rate
ppm Rate
ppm
Rate
ppm
Rate
ppm
Rate
pH
Index
meq/100g
meq/100g
Al�J�
21733
7.1 VH 150
92 H
265 VH
300
VH
1090
M
16
VL
6.5
0.7
9.4
NC = 77
NC = 136
21734
4.7 M 134
65 H
144 H
1228
VH
796
M
1 16
VL
6.3
0.7
7.1
NC=54
NC=74
21736
5.6 H 150
73
H
85 L
277
VH
873
M
15
VL
6.6
0.4
7.4
NC=61
NC=43
rf:7
F21737
5.7 H 150
92
H
168 VH 1320
VH
1018
M
16
VL
6.6
0.5
8.8
NC=77
NC=86
Sample
Percent Base Saturation
Nitrate
Sulfur
Zinc
Manganese
Iron
Copper
Boron
Soluble Salts
Chloride
Aiuminum
ID
Field lb
K
Mg,
Ca
Na
H
NO,N
S
Zn
Mn
Fe
Cu
B
SS
Cl
AI
%
%
%
%
%
ppm Rate
ppm Rate
ppm Rate
ppm Rate
ppm
Rate
ppm Rate
ppm
Rate
ms/cm Rate
ppm Rate
ppm
10 L
3.2 M
30 H
84
VH
1.5 M
0.1
VL
7.2
26.6
58.0
0.7
7.4
NC=21
NC=80.0
NC=188
NC=75.0
5.2
26.8
56.1
1.0
10.5
6 VL
12.6 M
18 M
1103
VH
1.8 H
10.1
VL
NC=12
NC=65.0
NC=113
NC=90.0
7 VL
1.9 L
M
103
VH
1.5 M
0.1
VL
2.9
312
59.0
0.9
5.9
119
NC=15
NC=47.5
NC=119
NC=75.0
BT9-1
4 VL
5.2 H
33 H
VH
1.9 H
VL
4.9
30.3
57.8
0.8
5.9
1NC=206
182
10.3
NC=8
NC=130.0
NC=95.0
values on this report represent the plant available nutrients in the Explanation of symbols: % (percent), ppm (parts per million), Ibs/A This report applies to sample(s) tested. Samples are retained a
soil. Rating after each value: VL (Very Low), L (Low), M (Medium), (pounds per acre), ms/cm (milli -mhos per centimeter), meq/1009 maximem of thirty days after testing. PF
H (High), VH (Very High). ENR - Estimated Nitrogen Release. (milli -equivalent per 100 grams). Conversions: ppm x 2 = Ibs/A, Soluble by ? Awr`
C.E.C. - Cation Exchange Capacity. Analysis prepared by: A&L Eastern Laboratories, Inc.
9 P lI/� Sails ms/cm x 640 =ppm.
Pauric McGroary

R € � D
FEB 0 5 2013
INFp�� p�rt �I`� I+Y'Rt7�ES 1 JI, UNIT
City of
Belmont
City of Belmont
2012 Annual Report
Land Application Program
NC Permit No. WQ0003281

ANNUAL LAND APPLICATION CERTIFICATION FORM
IW-mit#: WQ0003281 County:
ity Name (as shown on permit):
and Application Operator:
Gaston Year:
City of Belmont
2012
Southern Soil Builders, Inc. Phone: [phone]
Land application of residuals as allowed by the permit occurred during the past calendar year?
CI Yes ❑ No - If No, skip Part A, and Part B and proceed to Part C. Also, If residuals were
generated but not land applied, please attach an explanation on how the residuals were handled.
Part A - Residuals Apmlication Summary:
Total number of application fields in thepermit: 3
Total number of fields utilized for land application during the year:
3
Total amount of dry tons applied during the year for all application sites:
11 1.87
Total number of acres utilizes for land application during the year:
79.9
Part B - Annual Comniance Statement:
Facility was compliant during calendar year 2012 with all conditions of the land application permit
(including but not limited to items 1-13 below) issued by the Division of Water Quality. 21 Yes ❑ No
It' no please, provide a written description why the facility was not compliant, the dates, and explain corrective action
taken.
I ) Only residuals approved for this permit were applied to the permitted sites.
2) Soil pH was adjusted as specified in the permit and lime was applied (if needed) to achieve a soil pH of at least 6.0 or
the limit specified in the permit.
3) Annual soils analysis were performed on each site receiving residuals during the past calendar year and three (3) copies
of laboratory results are attached.
4) Annual TCLP analysis (if required) was performed and three (3) copies of certified laboratory results are attached.
5) All other monitoring was performed in accordance with the permit and reported during the year as required and three (3)
copies of certified laboratory results are attached.
6) The facility did not exceed any of the Pollutant Concentration Limits in 15A NCAC 02T .l 105(a) or the Pollutant
Loading Rates in 15A NCAC 02T .1 105(b) (applicable to 40 CFR Part 503 regulated facilities).
7) All general requirements in as specified in the Land Application Permit were complied with (applicable to 40 CFR Part
503 regulated facilities).
8) All monitoring and reporting requirements in 15A NCAC 02T.] 1 1 1 were complied with (applicable to 40 CFR Part
503 regulated facilities).
9) All operations and maintenance requirements in the permit were complied with or, in the case of a deviation, prior
authorization was received frorn the Division of Water Quality.
10) No contravention of Ground Water Quality Standards occurred at a monitoring well or explanations of violations are
attached to include appropriate actions and remediations.
1 1) Vegetative cover was maintained and proper crop management was performed on each site receing residuals, as
specified in the permit.
12) No runoff of residuals from the application sites onto adjacent property or nearby surface waters has occurred.
13) All buffer requirements as specified on the permit were maintained during each application of residuals.
Part C - Certification:
"I certify, under penalty of law, that the above information is, to the best of my knowledge and belief, true, accurate,
and complete. I am aware that there are significant penalties for submitting false information, including the
possibility of fines and imprisonment for knowing violations."
6A'R-1 C . 106-616 el-ry MA�6r2
Permittee Name and Title (ype or print)
I
Signatu of Permittee Date
Signature of Prepares& Date Signature of Land Applier Date
(if different from Permittee) (if different from Permittee and Preparer)
* Preparer is defined in 40 CFR Part 503.9 (r) and 15A NCAC 02T. 1102 (26) DENR FORM ACF (12/2006)

ANNUAL RESIDUAL SAMPLING SUMMARY FORM
Please note that your permit may contain additional parameters to be analyzed. The parameters can be reported in FORM RSSF - 1
WQ Permit Number: WQ0003281
Facility Name:
Residual Source WQ # or
NPDES 4:
WWTP Name:
Residual Analvsis Data
City of Belmont
NCO021181
Laboratory:
1)
2)
3)
4)
5)
A&L Eastern Labs
Parameter
(mg/kg)
Conc.
Limit
(mg/kg) a
Sample or Composite Date
7-16-12
Percent Solids (%)
NA
3.44
Arsenic
75
4
Cadmium
85
2
Copper
4,300
667
Chromium
NA
54
Lead
840
33
Mercury
57
2.4
Molybdenum
75
5
Nickel
420
21
Selenium
100
3
Zinc
7,500
1970
Total Phosphorus
NA
15900
TKN
NA
57000
Ammonia -Nitrogen
NA
9590
Nitrate and Nitrite
NA
2
a For surface disposal facilities the ceiling concentration limits listed in this form are not applicable. Reference the individual permit for metals limits.
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed
to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant
penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
e .A #
/ -af-13
Signature of Prepare(—*
Date
*Preparer is delined in 40 CFR Part 503.9(r) and I SA NCAC ? I .I 102 (26) DENR FORM RSSF (12/2006)

Acres Used:
ANNUAL METALS FIELD LOADING SUMMARY FORM*
s form to the corresponding Field Loading Summary Form to be submitted in Annual Report
City of Belmont Total Dry Tons Applied (Annual):
WQ0003281 Cation Exchange Capacity (non 503 only):
Tony Jones Owner: Tony Jones Predominant Soil Series
14.6
Acres Permitted: 14.6 Site #: BT 6-1 Field #
40.09
Cecil
BT 6-1
Residual Analvsis Data (Heavy Metals and Total Phosphorus use mLy/kt!, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
7/16/12
2
3
4
5
6
7
8
9
10
Llj
12
°o Solids
3.44
Arsenic
4
Cadmium
2
Copper
667
Chromium
54
Lead
33
Mercury
2.4
Molyb-
denum
5
Nickel
21
Selenium
3
Zinc
1970
Total
Phos-
horus
15900
Annual H eavv M eta l H'ield I ,oadinus W' lculated in lbs/acre):
•
©
won
•.•
EN
ME
Event--100001
1
1 1
1 111
1 111
1 111
Mir, 1
1 111
1 111
1 111
1 111
1 111
1 111
MITI 11
fff M1
1 1
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 1
••
1 111
Min
1 111
WITIT,1
1 111
ffITIT,1
Mir, 1
1 111
ffITIM
1 111
1 111
••
1•
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1•
1:
1 111
1 111
1 111
1 111
I l l s
1 111
1 111
1 111
1 111
1 111
1 111
1
®
1 1
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 1
®MMMMMMMMMMMMM
1
1 111
1 1
��
1 111
1 111
1 111
Mr, 11
1 111
MITI=1
111
1 111
1 111
1 111
1 111
�i
1 1 .
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 1 •
®
1 •
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 : •
Total
•
:
1 111
1 ill
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
.•
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
imprisonment for knowing violations".
Signa re of Land Applier
Date
DENR FORM MFLSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
form to the corresponding Field Loading Summary Form to be submitted in Annual Report
City of Belmont Total Dry Tons Applied (Annual): 32.64
WQ0003281 Cation Exchange Capacity (non 503 only):
Tony Jones Owner: Tony Jones Predominant Soil Series: Cecil
Acres Used: 23.3 Acres Permitted: 23.3 Site H.,BT 6-3 Field #: BT -
T1_L_ /TT-.-,_._. ...,,a T-t.l Ahnenhnrnc nce ma/kpF- % Solids use Raw Percent #):
I<CJIU LIU
Sample or
ti Ilalja
_ 1
a Lu.[a �.
2
i.. a..J .•a.._»-+
3
-----
4
- -----
5j
- --- -
6
7
_8
-9j
10
11
12
Com-
posite
Dare
7/16/12
% Solids
3.44
Arsenic
4
Cadmium
2
Copper
667
Cliromium
54
Lead
33
Mercury
2.4
Molyb-
5
denum
Nickel
21
Selenium
3
Zinc
1970
Total
Phos-
15900
horus
Foial
•
Event
•1
1 1
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 1
®
®
1 11•
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 11
• .-
:•�
�
1111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1111
1 111
1 111
1 111
1111
1 111
1111
1 111
1 111
1 111
1111
1 111
1111
1 111
.•
®
1 t�
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 1
®
1 11
1 111
1 111
1 111
1 111
1 111
1 111
1 ItldellUni
1 111
1 111
1 111
1 111
1 11
Molyb-
1 1
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 1
1 1 �
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 1
®
1 11:
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 11:
®�
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
t 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
-
in R'�11TiRYTr■■I.I.YL-
"I certify, Under penalty oI law, Tnat tins uut umullt — v,up",au ,....... ._ ------r-- ---- -
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
imprisonment for knowing violations".
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
h this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
rrm
Name:
#:
Operator:
Acres Used:
City of Belmont
WQ0003281
Lori Warren Owner:
42 Acres Permitted:
Total Dry Tons Applied (Annual):
Cation Exchange Capacity (non 503 only):
Lori Warren Predominant Soil Series:
42 Site #: BT 9-1 Field #:
39.14
Ga132
BT 9-1
RPcifinnl Annlvci.c data (Heavv Metals and Total Phosphorus use mg/ka, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
_ 1
7/ 16/ 12
2
3
4
5
6
7
8
91
10
11
12
% Solids
3.44
Arsenic
4
Cadmium
2
Copper
667
Chromium
54
Lead
33
Mercury
2.4
Molyb
denum
5
Nickel
21
Selenium
3
Zinc
1970
Total
Pros-
horus
15900
Annual Heavv Metal Held Loadings (Calculated in lbsiacre):
..
1
1 11
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 11
'®
1 11�
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 1
• •-
�
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 1
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 1
®
1 1.
1 111
1 111
1 111
t 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 1
®
1 11�
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
111
1 11
�
1 11•
1 ill
1 111
1 111
1 111
1 ill
1 111
1 111
1 111
1 111
1 111
1 111
1 11
�
1 1 `
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 1 •
®
1 11•
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 11•
®�
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
Total
Plies-
phORIS
"I certify, under penalty of law, that this document was prepared under my direction or supervision to accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
imprisonment for knowing violations".
Signature of Lanq Applier
I->>-13
Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: City of Belmont WQ Permit #: WQ0003281 Field #: BT 6-1 Acres Utilized: 14.6
Land Owner: Tony Jones Annual Dry Tons Applied: 40.0937 Site #: BT 6-1 Acres Permitted: 14.6
Operator: Tony Jones
Crop 1 Name: Fescue
Predominant Soil Series: Cecile
Crop 1 Max. PAN: 211
Crop 2 Name:
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
-
y
o
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry'
�
�e1'
Moist)
Precip.
Past 24
Hrs.
inches
D
K
b
o a
o
o
w
n'
*
o"
w w
* N
m
TKN
mg/kg
z D
3
c
on o
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
( lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
7-2012
279500
3.44
2.746
wg0003281
dry
0
s
0.5
0.3
57000
9590
2
104.463
NA
fescue
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1 0.000
0.000
0.000
1 0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form):
TOTALS:
01
279500
As
Cd
Cu
Cr
Pb
Mo
Ni
Se
Zn
P
104.463
0.000
Lime Applied
Annual lbs/acre
0.022
0.011
3.663
0.297
0.181
-Hg
0.013
0.027
0.115
0.016
10.819
87.323
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.11
0.155
57.108
1.361
5.138
0.095
0.417
2.148
0.142
82.328
11-2012
1000
Current Cumulative Ibs/ac
0.132
0.166
60.771
1.658
5.319
0.108
0.444
2.263
0.158
93.147
Permitted C. P. L. R.****
36
34
NA
1338
267
15
NA
374
89
2498
Permit PAN Limit 1st/2nd Crop
211
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volatilization Rate: Surface -0.5, Injection/Incorporation - 1.0
Sivnature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: City ol' Belmont WQ Permit #: WQ0003281 Field #: BT 6-3 Acres Utilized: 23.3
Land Owner: Tony Jones Annual Dry Tons Applied: 32.6344 Site #: BT 6-3 Acres Permitted: 23.3
Operator: Tony Jones Predominant Soil Series: Cecil Cation Exchange Capacity (non 503):
Crop I Name: Fescue Crop 1 Max. PAN: 211 Crop 2 Name: Crop 2 Max. PAN:
y
Q
Volume applied
PP
enter one Solids/
( )
Liquid
Cu. Yds Gallons
o
/o
Solids
Volume
Applied per
Acre
(Dry Tons/Ac
Residual Sources
(NPDES #; WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry'
Wet,
Moist)
Pre 'P.
Past 24
Hrs.
inches
D
o
o
;?
N'
w CD
*
w
�
TKN
m /k
s 9
z D
o
°A
g
m Ik
9 9
Nitrate
and
ite
Nitrite
m !k
9 9
PAN Applied
(Ibs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
P
Cro 2
P
Crop 1
P
Crop 2
P
7-2012
1
227500
1 3.44
1.401
WQ003281
dry
0
s
0.5
0.3
1 57000
9590
2
53.280
NA
fescue
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form):
TOTALS:
01
227500
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
53.280
0.000
Lime Applied
Annual lbs/acre
0.011
0.006
1.869
0.151
0.092
0.007
0.014
0.059
0.008
5.520
44.552
Date
lbs/ac
Prior Years Cumulative Ibs/ac
0.548 1
0.15
54.9
1.126
5.027
0.087
0.403
2.078
0.945
73.181
I1-2012
1000
Current Cumulative lbs/ac
0.559
0.156
56.769
1.277
5.119
0.094
0.417
2.137
0.953
78.701
Permitted C. P. L. R.****
36
34
NA
1338
267
15
NA
374
89
2498
Permit PAN Limit Ist/2nd Crop
1 211
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loadinp- Rate
DENR FORM FSF (12/2006)

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED OIs
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: City of Belmont WQ Permit #: WQ0003281 Field #: BT 9-1 Acres Utilized: 42
Land Owner: Lori Warren Annual Dry Tons Applied: 39.1613 Site #: BT 9-1 Acres Permitted: 42
Operator: Lori Warren
Crop l Name
Fescue
Predominant Soil Series: GaB2
Crop 1 Max. PAN:
211
Crop 2 Name:
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
y
o
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Pert., Animal
Waste, etc)
Soil
Cond.
(Dry.
Wet.
Moist)
Precip.
Past 24
Hrs.
inches
>
T �'
0 o
o
w =
rD
N
TKN
mg/kg
z
E3
o �
ro o
ry
w
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
( Ibs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop I
Crop 2
7-2012
273000
3.44
0.932
WQ003281
dry
0
s
0.5
0.3
57000
9590
2
35.469
NA
fescue
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form):
TOTALS:
01
273000
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
35.469
0.000
Lime Applied
Annual Ibs/acre
0.007
0.004
1.243
0.101
0.062
0.004
0.009
0.039
0.006
3.672
29.638 1
Date
I lbs/ac
Prior Years Cumulative Ibs/ac
0.137
0.06
10.656
27.11
2.483
0.014
0.044
1.274
0.037
90.697
Current Cumulative lbs/ac
0.144
0.064
11.899
27.211
2.545
0.018
0.053
1.313
0.043
94.369
Permitted C. P. L. R.****
36
34
NA
1338
267
15
NA
374
89
2498
Permit PAN Limit I st/2nd Crop
1 1 211
"1 certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
titi
SignatEfre of Land Applier
Date
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
*** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

Page: 1 of 2
Report Number: 12-199-0206
Account Number: 46381
Submitted By: ZACH KEY
Send To: SOUTHERN SOIL BUILDERS
DENNIS KEY
958 HOOTS ROAD
ROARING RIVER, NC 28669
�L
www.aleastern.com
A&L Eastern Laboratories, Inc.
7621 Whitepine Road Richmond, Virginia 23237 (804) 7433401 Fax [phone]
Project: BELMONT
NC CERT#257
REPORT OF ANALYSIS Date Sampled: 7/16/2012 13:00-00
Lab Number: 88634 Date Received: 07/17/2012 00:00
Sample Id: BELMONT Date Reported: 07/24/2012
VI01 IJUIIUJ
3.44
344Q0
100.0
JM
07/17/201214:30
Moisture `
96.56
100.0
JM
07/17/2012 14:30
Total Kjeldahl Nitrogen
5.70
57000
10.0
JM
07/18/2012 07:59
Total Phosphorus
1.59
15900
100
KM
07/23/2012 19:03
Total Potassium
0.24
2410
100
KM
07/23/2012 19:03
Total Sulfur
1.53
15300
100
KM
07/23/2012 19:03
Total Calcium ::
1.54
15400
100
KM
07/23/2012 19:03
Total Magnesium
0.33
3330
100
KM
07/23/2012 19:03
Total Sodium
0.76
7590
100
KM
07/23/2012 19:03
Total Iron
21200
1
KM
07/23/2012 19:03
Total Aluminum
22100
10
KM
07/23/2012 19:03
Total Manganese
831
1
KM
07/23/2012 19:03
Total Copper
667
1
KM
07/23/2012 19:03
Total Zinc
1970
1
KM
07/23/2012 19:03
Ammonia Nitrogen
0.96
9590
10.0
JM
07/18/2012 07:59
Organic N
4.74
47410
10.0
07/18/2012 07:59
Nitrate+ N itrite- N
<2.00
2.00
JM
07/18/2012 08:00
Total Cadmium
2.0
1.0
KM
07/23/2012 19:03
All values are on a dry weight basis except as noted by asterisk. Detection limit on all N series is on a wet basis
Our reports and letters are for the exclusive and confidential use or our clients, and may not be reproduced in whole or part, nor may any reference be made
to the work, the results, or the company in any advertising, news release, or other public announcements without obtaining our prior written authorization.
SM-2540G
SM-2540G
SM-4500-NH3C-TKN
SW 6010C
SW 6010C
SW 6010C
SW 6010C
SW 6010C
SW 6010C
SW 6010C
SW 6010C
SW 6010C
SW 6010C
SW 6010C
SM-4500-NH3C
CALCULATION
SM-450ONO3F
SW 6010C
Debbie Holt

Page: 2 of 2
Report Number: 12-199-0206
Account Number: 46381
Submitted By: ZACH KEY
Send To: SOUTHERN SOIL BUILDERS
DENNIS KEY
958 HOOTS ROAD
ROARING RIVER, NC 28669
Lab Number: 88634
Sample Id: BELMONT
A&L Eastern Laboratories, Inc.
7621 Whitepine Road Richmond, Virginia 23237 (804) 743-W1 Fax [phone]
wwwaleastern.com
Project: BELMONT
NC CERT#257
REPORT OF ANALYSIS
Date Sampled: 7/16/2012 13:00:00
Date Received: 07/1712012 00:00
Date Reported: 07/24/2012
Total Chromium
54
5
KM
07/23/2012 19:03
SW 6010C
Total Nickel
21
5
KM
07/23/2012 19:03
SW 6010C
Total Lead
33
5
KM
07/23/2012 19:03
SW 6010C
Total Arsenic
4.0
1.0
KM
07/23/2012 19:03
SW 6010C
Total Mercury
2.4
0.4
KM
07/18/2012 09:00
SW-7471 B
Total Selenium
3.0
1.0
KM
07/23/2012 19:03
SW 6010C
pH (Standard Units) `
7.35
JM
07/18/2012 07:39
SW-9045D
Total Molybdenum
5
5
KM
07/23/2012 19:03
SW 6010C
Comments:
SULFUR AND ORGANIC NITROGEN NOT FOR COMPLIANCE TESTING
All values are on a dry weight basis except as noted by asterisk. Detection limit on all N series is on a wet basis.
Our reports and letters are for /he exclusive and confidential use of our clients, and may not be reproduced in whole or pail, nor may any reference be made
to the work, the results, or the company in any advertising, news release, or other public announcements without obtaining our prior written authorization.
Debbie Holt

PAN
Mineralization
I Rate I TKN I NH3 I NO3
0.3 57000 9590 2
PAN Surface
19020 mg/kg 38.04 lbs/dry ton
4255.535 Ibs total PAN
53.26076 Ibs PAN/acre
PAN Injection
23815 m /k 47.63 lbs/dry ton
5328.368 Ibs total PAN
66.68796 Ibs PAN/acre
Dry Tons/1000 gal.
0.143448
1st year PAN
Ibs./acre
Surface Ibs.
Surface
4255.5348
53.26076095
1st year PAN
Ibs./acre
Injected lbs.
Injected
5328.3681
66.6879612
as decimal
Total dry
tons/year
Acres
Applied on
NO2
0
% Solids
0.0344
111.87
79.9
MR(TKN-NH3)+
MR(TKN-NH3) +
+ .5(NH3)+NO3+NO2 =mg/kg
mg/kg x .002 =Ibs/dry ton
l(NH3)+NO3+NO2 =mg/kg
mg/kg x .002 =Ibs/dry ton
1000 X 8.34 X %solids X sp. gravity "=dry tons/1000gal."
2000

sorption Ratio
Na: Sodium (Mg/L) Equivalent weight: 23
Ca: Calcium (Mg/L) Equivalent weight: 20
Mg : Magnesium (Mg/L) Equivalent weight: 12
Milli Equivalent = Mg/L / Equivalent weight
Na M /L Ca(Mg/L) M M /L
261.09 1 529.76 1 114.55
Na (ME)
I Ca ME
M ME
11.351741
26.488
1 9.545833
SAR= Na Milli Equivalent/[0.5 X (Ca Milli Equivalent + Mg Milli equivalent)]0.5 power
SAR = 2.674374 (From Mg/L entered above)
SAR= 2.674181 (From ME entered below)
Na ME
Ca ME
Ma (ME)
11.35
1 26.488
1 9.54
The amour
amount of
Permitting

Orr Analytical Results
Southern Soil Builders
958 Hoots Road
Roaring River NC 28669
Entered 7/13/2012
Reported: 7/18/2012
For: Belmont
Sample ID
Parameter Cust ID
Result
Units
Method
Date Analyzed
Analyst
120713-19.1
% Solids 1
2.87
%
SM2540B
7/13/12
CL
120713-19.1
Fecal Coliform MTF 1
4530
MPN/g
SM92210E
7/13/12
CL
120713-19.1
Geometric Mean 1
4688
MPN/g
dry wt. basis
7/18/12
CL
120713-19.2
% Solids 2
3.01
%
SM2540B
7/13/12
CL
120713-19.2
Fecal Coliform MTF 2
2658
MPN/g
SM92210E
7/13/12
CL
120713-19.3
% Solids 3
2.92
%
SM2540B
7/13/12
CL
120713-19.3
Fecal Coliform MTF 3
5822
MPN/g
SM9221 CE
7/13/12
CL
120713-19.4
% Solids 4
3.06
%
SM2540B
7/13/12
CL
120713-19.4
Fecal Coliform MTF 4
5556
MPN/g
SM92210E
7/13/12
CL
120713-19.5
% Solids 5
2.94
%
SM2540B
7/13112
CL
120713-19.5
Fecal Coliform MTF 5
17,007
MPN/g
SM92210E
7/13/12
CL
120713-19.6
% Solids 6
3.08
%
SM2540B
7/13/12
CL
120713-19.6
Fecal Coliform MTF 6
5519
MPN/g
SM92210E
7/13/12
CL
120713-19.7
% Solids 7
2.94
%
SM2540B
7/13/12
CL
120713-19.7
Fecal Coliform MTF 7
1361
MPN/g
SM92210E
7/13/12
CL
Respectfully submitted,
Dena Myers
NC Cert #440,
NCDW Cert #37755,
EPA NCO0909
P.O. Box 228 • Statesville, North Carolina 28687 • 704/872/4697

Client:
Jt �'1i r
.� i rj., I, l •l �,^;
::
STATESVIIA,EANA _
122 Court Street • P.O.
Statesville, NC 28687
Address: �., �i ,j
-
--�
[phone]
Contact Person: Phone
IRri
# ;
Dt'- 9S
, _
, �5��
FAX# » ;
J b c'�.
.3q=/�
Chain of
t
Custody Record
PO # Requisitioned by: (Time Date)
Customer
Sample
Lab -ID #(Grab
Time Sampled
Only)
Date Sampled
(Grab Only)
Fa
s
Matrix
Parameters re uested for anal sis
q y
Sludge
W
WW
' r
I
\<
R
t
j
�
4
1
%`
Relinquished by:
;% -
Time
J.WJ
am,tpm; Date i / �S/t
Sampled by:,
U
Received by:
Time
am, pm Date _/_/_
Transported by: f ,
Relinquished b
q Y
Time
am, m Date
p
Holding times met:
Received by:
���_1���—='�`-
Time
arrpm bate _ 1 //
Compliance work:
Composite Sampling #1:
Time begin
am, pm Date _/ /_
Non-compliance work:
Time end
am, pm Date _/_/_
Lab Comments:
Composite Sampling #2:
Time begin
am, pm Date
Time end
am, pm Date _/_/

Condition of Receipt
Sample ID 120713-19 Client Southern Soil Builders
Temp on Arrival
pH upon Arrival
pH upon Arrival
Parameter Schedule % solids
❑
HNO3
❑
HCl
❑
NaOH
❑
H2SO
❑
Na2S2O
Dechlorinated
Parameter Schedule
Fecal Coliform MTF
❑
HNO3
❑
HCI
❑
NaOH
❑
H2SO
W
Na2S2O
❑
Dechlorinated
❑ Chemicals in containers, client
❑ Chemicals upon receipt
Received on Ice
❑ Samples chilled upon receipt
❑ Chemicals in containers, lab
❑ Chemicals in containers, client
❑ Chemicals upon receipt
Received on Ice
❑ Samples chilled upon receipt
[J Chemicals in containers, lab
Page 1 of I

Orr Analytical Results
Southern Soil Builders
958 Hoots Road
Roaring River NC 28669
Entered
Reported
For:
7/24/2012
7/30/2012
Sample ID Parameter Cust ID Result Units Method Date Analyzed Analyst
120724-27 % Volatile Solids Belmont A
Respectfully submitted,
Dena Myers
NC Cert #440,
NCDW Cert #37755,
EPA NCOO9O9
1.56 % SM2540G 7/25/12 MD
P.O. Box 228 • Statesville, North Carolina 28687 • 704/872/4697

Orr Analytical Results
Southern Soil Builders
958 Hoots Road
Roaring River NC 28669
Entered 7/24/2012
Reported: 7/30/2012
For
Sample ID
Parameter
Cust ID
Result
Units
Method
Date Analyzed
Analyst
120724-28
% Volatile Solids
Belmont B
0.63
%
SM2540G
7/25/12
MD
Respectfully submitted, l
Dena Myers
NC Cert #440,
NCDW Cert #37755,
EPA NCOO9O9
P.O. Box 228 • Statesville, North Carolina 28687 9 704/872/4697

VS out
VSFR=
0.0156
0.0063
0.599933

Orr Analytical Results
Southern Soil Builders
958 Hoots Road
Roaring River NC 28669
Entered 7/13/2012
Reported: 8/23/2012
For: Belmont
Sample ID
Parameter Cust ID
Result Units
Method
Date Analyzed
Analyst
120713-18
Corrosivity
See Attached
SW-846
7/25/12
PACE
120713-18
Ignitability
See Attached
1010M
7/25/12
PACE
120713-18
Reactivity
See Attached
SW-846
7/25/12
PACE
120713-18
TCLP
See Attached
1311
7/25/12
PACE
Respectfully submitted,
Dena Myers
NC Cert #440,
NCDW Cert #37755,
EPA NCO0909 -
P.O. Box 228 • Statesville, North Carolina 28687 • 704/872/4697

Client:
) .TO,
:At`=�_
S'I'A'1'ESVILLGANAL
122 Court Strcet 7Statesville, NC 28687 [phone]
Address:
W—A
Contact Person: sue^
Phone #
SJ6 "',,
'�'
;l
FAX#
fah
��r,•,v
Chain of
Custody Record
PO # Requisitioned by: (Time Date)
Customer
Sample ID#
Lab -ID #
Time Sampled
(Grab Only)
Date Sampled
(Grab Only)
a
Matrix
Parameters requested for analysis
Sludge
w
ww
Relinquished by:
Received by:
Relinquished by:
Received by:
Composite Sampling
Time begin
Time end
Composite Sampling
Time begin
Time end
/fir'` J I� -
` j(`�
�-�
#1:
am, pm Date _/_/_
am, pm Date _/_/
#2:
am, pm Date
am, pm Date _/_/
_
--
Time
Time
Time
Time l JJ
Lab Comments:
am, bmDate `1 / '_� /
m , am Date _/_/_
P
am, pm Date
a p�' Datel
Sampled by:
i
'f
Transportedrtiy:
Holding timesPfnet:
Compliance work:
Non-compliance work:

Pace Analytical Services, Inc.
205 East Meadow Road - Suite A
Eden, NC 27288
[phone]
Pace Analytical Services, Inc.
2225 Riverside Dr.
Asheville, NC 28804
[phone]
ANALYTICAL RESULTS
Project: 120713-18
Pace Project No.: 92124170
Pace Analytical Services, Inc.
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Sample: 120713-18 Lab ID: 92124170001 Collected: 07/13/12 11:00 Received: 07/13/12 14:47 Matrix: Solid
Results reported on a "dry -weight" basis
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
8081 GCS Pesticides, TCLP SPE
Analytical Method: EPA 8081
Preparation Method: EPA 3535
Leachate Method/Date: EPA 1311; 07/17/12 15:00
gamma-BHC (Lindane)
ND ug/L
2.0 4
07/18/12 13:00
07/19/12 15:21
58-89-9
Chlordane (Technical)
27.0 ug/L
12.0 4
07/18/12 13:00
07/19/12 15:21
57-74-9
Endrin
ND ug/L
2.0 4
07/18/12 13:00
07/19/12 15:21
72-20-8
Heptachlor epoxide
ND ug/L
2.0 4
07/18/12 13:00
07/19/12 15:21
1024-57-3
Methoxychlor
ND ug/L
4000 4
07/18/12 13:00
07/19/12 15:21
72-43-5
Toxaphene
ND ug/L
12.0 4
07/18/12 13:00
07/19/12 15:21
8001-35-2
Surrogates
Decachlorobiphenyl (S)
67 %
10-138 4
07/18/12 13:00
07/19/12 15:21
2051-24-3
Tetrachloro-m-xylene (S)
52 %
10-110 4
07/18/12 13:00
07/19/12 15:21
877-09-8
8151 Chlorinate Herbicide TCLP
Analytical Method: EPA 8151
2,4-D
ND mg/L
0.010 1
07/18/12 08:00
07/18/12 18:00
94-75-7
2,4,5-TP (Silvex)
ND mg/L
0.010 1
07/18/12 08:00
07/18/12 18:00
93-72-1
Surrogates
2,4-DCAA (S)
90 %
70-130 1
07/18/12 08:00
07/18/12 18:00
19719-28-9
6010 MET ICP, TCLP
Analytical Method: EPA 6010
Preparation Method: EPA 3010
Leachate Method/Date: EPA
1311; 07/21/12 15:00
Arsenic
ND mg/L
0.025 1
07/25/12 01:05
07/25/12 .14:42
7440-38-2
Barium
ND mg/L
0.50 1
07/25/12 01:05
07/25/12 14:42
7440-39-3
Cadmium
ND mg/L
0.0050 1
07/25/12 01:05
07/25/12 14:42
7440-43-9
Chromium
ND mg/L
0.025 1
07/25/12 01:05
07/25/12 14:42
7440-47-3
Lead
ND mg/L
0.025 1
07/25/12 01:05
07/25/12 14:42
7439-92-1
Selenium
ND mg/L
0.10 1
07/25/12 01:05
07/25/12 14:42
7782-49-2
Silver
ND mg/L
0.025 1
07/25/12 01:05
07/25/12 14:42
7440-22-4
7470 Mercury, TCLP
Analytical Method: EPA 7470
Preparation Method: EPA 7470
Leachate Method/Date: EPA
1311; 07/21/12 15:00
Mercury
ND ug/L
0.20 1
07/26/12 09:15
07/26/12 14:24
7439-97-6
8270 MSSV TCLP Sep Funnel
Analytical Method: EPA 8270
Preparation Method: EPA 3510
Leachate Method/Date: EPA
1311; 07/17/12 15:00
1,4-Dichlorobenzene
ND ug/L
50.0 1
07/18/12 09:00
07/19/12 15:20
106-46-7
2,4-Dinitrotoluene
ND ug/L
50.0 1
07/18/12 09:00
07/19/12 15:20
121-14-2
Hexachloro-1,3-butadiene
ND ug/L
50.0 1
07/18/12 09:00
07/19/12 15:20
87-68-3
Hexachlorobenzene
ND ug/L
50.0 1
07/18/12 09:00
07/19/12 15:20
118-74-1
Hexachloroethane
ND ug/L
50.0 1
07/18/12 09:00
07/19/12 15:20
67-72-1
2-Methylphenol(o-Cresol)
ND ug/L
50.0 1
07/18/12 09:00
07/19/12 15:20
95-48-7
3&4-Methylphenol(m&p Cresol)
ND ug/L
50.0 1
07/18/12 09:00
07/19/12 15:20
Nitrobenzene
ND ug/L
50.0 1
07/18/12 09:00
07/19/12 15:20
98-95-3
Pentachloro phenol
ND ug/L
100 1
07/18/12 09:00
07/19/12 15:20
87-86-5
Pyridine
ND ug/L
50.0 1
07/18/12 09:00
07/19/12 15:20
110-86-1
2,4,5-Trichlorophenol
ND ug/L
50.0 1
07/18/12 09:00
07/19/12 15:20
95-95-4
Date: 07/27/2012 04:46 PM REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc..
Page 4 of 21

cal
s.com
Pace Analytical Services, Inc.
205 East Meadow Road - Suite A
Eden, NC 27288
[phone]
Pace Analytical Services, Inc.
2225 Riverside Dr.
Asheville, NC 28804
[phone]
ANALYTICAL RESULTS
Pace Analytical Services, Inc.
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Project: 120713-18
Pace Project No.: 92124170
Sample: 120713-18 Lab ID: 92124170001 Collected: 07/13/12 11:00 Received: 07/13/12 14:47 Matrix: Solid
Results reported on a "dry -weight" basis
Parameters Results Units Report Limit DF Prepared Analyzed CAS No, Qual
8270 MSSV TCLP Sep Funnel
Analytical Method: EPA 8270 Preparation Method: EPA 3510
Leachate Method/Date: EPA 1311; 07/17/12 15:00
2,4,6-Trichlorophenol
ND ug/L
50.0
1 07/18/12 09:00
07/19/12 15:20
88-06-2
Surrogates
Nitrobenzene-d5 (S)
32 %
12-102
1 07/18/12 09:00
07/19/12 15:20
4165-6.0-0
2-Fluorobiphenyl (S)
35 %
13-107
1 07/18/12 09:00
07/19/12 15:20
321-60-8
Terphenyl-dl4 (S)
60 %
21-132
1 07/18/12 09:00
07/19/12 15:20
1718-51-0
Phenol-d6 (S)
15 %
10-110
1 07/18/12 09:00
07/19/12 15:20
13127-88-3
2-Fluorophenol (S)
22 %
10-110
1 07/18/12 09:00
07/19/12 15:20
367-12-4
2,4,6-Tribromophenol (S)
36 %
27-108
1 07/18/12 09:00
07/19/12 15:20
118-79-6
8260 MSV TCLP
Analytical Method: EPA 8260
Benzene
ND ug/L
5.0
1
07/23/12 18:15
71-43-2
2-Butanone (MEK)
34.0 ug/L
10.0
1
07/23/12 18:15
78-93-3
Carbon tetrachloride
ND ug/L
5.0
1
07/23/12 18:15
56-23-5
Chlorobenzene
ND ug/L
5.0
1
07/23/12 18:15
108-90-7
Chloroform
ND ug/L
5.0
1
07/23/12 18:15
67-66-3
1,4-Dichlorobenzene
ND ug/L
5.0
1
07/23/12 18:15
106-46-7
1,2-Dichloroethane
ND ug/L
5.0
1
07/23/12 18:15
107-06-2
1,1-Dichloroethene
ND ug/L
5.0
1
07/23/12 18:15
75-35-4
Tetrachloroethene
ND ug/L
5.0
1
07/23/12 18:15
127-18-4
Trichloroethene
ND ug/L
5.0
1
07/23/12 18:15
79-01-6
Vinyl chloride
ND ug/L
5.0
1
07/23/12 18:15
75-01-4
Surrogates
1,2-Dichloroethane-d4 (S)
ill %
70-130
1
07/23/12 18:15
17060-07-0
Toluene-d8 (S)
97 %
67-135
1
07/23/12 18:15
2037-26-5
4-Bromofluorobenzene (S)
104 %
70-130
1
07/23/12 18:15
460-00-4
Dibromofluoromethane (S)
115 %
70-130
1
07/23/12 18:15
1868-53-7
Percent Moisture
Analytical Method: ASTM D2974-87
Percent Moisture
96.7 %
0.10
1
07/17/12 16:26
1010 Flashpoint,Closed Cup
Analytical Method: EPA 1010
Flashpoint
>200 deg F
70.0
1
07/19/12 17:30
Reactive Sulfide
Analytical Method: SW-846 7.3.4.2
Sulfide, Reactive
ND mg/kg
100
1
07/19/12 10:15
9045 pH Soil
Analytical Method: EPA 9045
pH at 25 Degrees C
6.9 Std. Units
0.10
1
07/18/12 09:30
733C S Reactive Cyanide Analytical Method: SW-846 7.3.3.2
Cyanide, Reactive ND mg/kg 0.025 1 07/18/12 18:17
Date: 07/27/2012 04:46 PM REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc..
Page 5 of 21

UAL PATHOGEN AND VECTOR ATTRACTION REDUCTION FORM (02T Rules)
Name: City of Belmont
Name: City of Belmont
onitoring Period: From
WQ Permit Number:
NPDES Number:
1 / 1 /2012 To 12/31 /2012
W Q0003281
NCO021 181
Pathogen Reduction (15A NCAC 02T .1106) - Please indicate level achieved and alternative performed:
Class A:
Alt. A (time/temp) ET—F
Alt B (Alk Treatment) ❑
Alt. C (Prior Testing)❑
A1t.D (No Prior Test) ❑ I
Process to Further Reduce Pathogengs ❑
If applicable to alternative performed (Class A only) indicate "Process to Further Reduce Pathogens":
Compost ❑ I
Heat Drying ❑
Heat Treatment ❑
Thertnophilic ❑
Beta Ray ❑
Gamma Ray ❑
Pasteurization ❑
Class B: JAII.
(1) Fecal Density Z
Alt. (2) Process to Significantly Reduce Pathoocns ❑
If applicable to alternative performed (Class B only) indicate "Process to Significantly Reduce Pathogens":
Lime Stabilization ❑
Air Drying ❑
Composting ❑
jAerobic Digestion ❑
Anaerobic Digestior. ❑
If applicable to alternative performed (Class A or Class B) complete the following monitoring data:
Parameter
Allowable Level
in Sludge
In
Pathogen Density
umer o
Excee-
dences
Frequency
of Analysis
Sample
Type
Ana I ytica
Tech -
ni ue
Minimum
Geo. Mean
Maximu
Units
Fecal Coliform
2 x 10 to the
6th power
per gram of
total solids
MPN
1361
4688
17007
MPN/g
0
7
grab
sm922 I e
CFU
1000 mpn per gram
of total solid (dry
weight)
Salmonella bacteria
(in lieu of fecal
coliform)
3 MPN per 4 grams
total solid (dry
weight)
Vector Attraction Reduction (15A NCAC 02T .1107) - Please indicate alternative performed:
Alt.1 (VS reduction) Z
Alt. 2 (40-day bench) ❑
Alt. 3 (30-day bench) ❑
I Alt. 4 (Spec. O, uptake) F.
Alt. 5 (14-Day Aerobic) ❑
Alt. 6 (Alk. Stabilization ❑
Alt 7 (Drying - Stable) ❑
jAlt. 8 (Drying - Unstable) Ci
Alt. 9 (Injection) ❑
Alt. 10 (Incorporation) ❑
No vector attraction reduction alternatives were performed
CERTIFICATION STATEMENT (please check the appropriate statement)
C� "I certify, under penalty of law, that the pathogen requirements in 15A NCAC 02T .1106 and the
vector attraction reduction requirement in 15A NCAC 02T .1107 have been met."
❑ "I certify, under penalty of law, that the pathogen requirements in 15A NCAC 02T .1106 and the
vector attraction reduction requirement in 15A NCAC 02T .1107 have not been met." (Please note
if you check this statement attach an explanation why you have not met one or both of the
requirements.
"This determination has been made under my direction and supervision in accordance with the system
designed to ensure that qualified personnel properly gather and evaluate the information used to determine
that the pathogen and vector attraction reduction requirements have been met. I am aware that there are
significant penalties for false certification including fine and imprisonment."
ahC�A0. n C1I-- , 0(Z,,,�°. Dennis Key Southern Soil Builders, Inc.
Preparer Name and Title (type or print) Land.Applier Name and Title (if applicable)(type or print)
Signature of Preparer Date Sig ature of Land Applier (if applicable) Date
*Preparer is defined in 40 CFR Part 503.9(r) and 15A NCAC 2T .1102 (26)
DENR FORM PVRF 02T (12/2006)

�NCDA&CS Agronomic Division Phone: [phone]
Website: www.ncagr.gov/agronomi/
Report No.
FY13-SL01
Client:
Bill Johnson
Advisor:
(_ Predictive
958 Hoots Rd.
ROARING RIVER, NC 28669
Mehlich-3 Extraction
Soil Report
County: Lincoln
.
Links to Helpful Information
sampled: Received: 11/29/2012
completed: 12/10/2012
Farm:
Sample ID: BT61
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tons/acre)
N P2O5
K2O
Mg S
Mn Zn
Cu B
Information
Lime History:
1-Fes/OGfTim,M 0.4
120-200 0
20
0 0
0 0
0 0
Note: 12
2 -
$pH
Test Results [units - W/V in g/cnt3; CEC and Na in meq/100 crnP; NO3-N in mg/drtt3]:
Soil Class:
Mineral
HM% WN CEC BS% Ac pH P-1 K-1
Ca% Mg%
S-1
Mn-I
Mn-All Mn-AI2
Zn-I Zn-AI
Cu-I Na ESP
SS-1 NO3-N
0.56 1.14 9.8 84 1.6 5.8 125 66
63 17
50
302
198
557 557
647 0.1
1
Sample ID: BT63
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tons/acre)
N P2O5
K2O
Mg S
Mn Zn
Cu B
Information
Lime History:
1-Fes/OG/Tim,M 0.5
120-200 0
0
0 0
0 0
0 0
Note: 12
2 -
$pH
Test Results [units - WN in g/crrr3; CEC and Na in meq/100 cO; NO3-N in mg/do]:
Soil Class:
Mineral
HM% WN CEC BS% Ac pH P-1 K-1
Ca% Mg%
S-1
Mn-1
Mn-All Mn-AI2
Zn-1 Zn-AI
Cu-1 Na ESP SS-1 NO3-N
0.71 0.99 13.5 88 1.7 5.8 184 110
65 18
68
281
186
1020 1020
779 0.1
1
Sample ID: BT91
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tons/acre)
N P2O5
K2O
Mg S
Mn Zn
Cu B
Information
Lime History:
1-Fes/OG/Tim,M 0.0
120-200 0
80
0 0
0 0
0 0
Note: 12
2 -
$pH
Test Results [units - W/V in g/c0; CEC and Na in meq/100 cm3; NO3-N in mg/d0]:
Soil Class:
Mineral
HM% WN CEC BS% Ac pH P-1 K-1
Ca% Mg%
S-1
Mn-I
Mn-All Mn-Al2
Zn-1 Zn-AI
Cu-1 Na ESP SS-1 NO3-N
0.56 0.95 13.4 92 1.1 6.3 200 31
78 13
58
465
292
1371 1371
713 0.2
1
North Carolina
Reprogramming of the laboratory -information -management system that makes this report possible is being funded
through a grant from the North Carolina Tobacco Trust Fund Commission.
Thank you for using agronomic services to manage nutrients and safeguard environmental quality.
- Steve Troxler, Commissioner of Agriculture