WQ0002712_Regional Office Historical File Pre 2018

ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
LINDA CULPEPPER
Director
NORTH CAROLINA
Environmental Quality
October 22, 2019
ROBERT W. PEARSON — WATER RESOURCES DIRECTOR
CITY OF LINCOLNTON
PO Box 617
LINCOLNTON, NORTH CAROLINA 28092
Dear Mr. Pearson:
RECEIVED/NCDENR/DWR
OCT 2 4 2019
WQROS
MOORESVILLE REGIONAL OFFICE
Subject: Acknowledgement of
Application No. WQ0002712
City of Lincolnton RLAP
Residuals Management System
Lincoln County
The Water Quality Permitting Section acknowledges receipt of your permit application and
supporting documentation received on October 22, 2019. Your application package has been assigned the
number listed above, and the primary reviewer is Erick Saunders.
Central and Regional Office staff will perform a detailed review of the provided application, and
may contact you with a request for additional information. To ensure maximum efficiency in processing
permit applications, the Division of Water Resources requests your assistance in providing a timely and
complete response to any additional information requests. %
Please note that processing standard review permit applications may take as long as 60 to 90 days
after receipt of a complete application. If you have any questions, please contact
Erick Saunders at [phone] or [e-mail].
Sincerely,
� r--�
Nathaniel D. Thornburg, Supervisor
Division of Water Resources
cc:oresviil4e Regional! .Le Wager +,ualiisy Regional ®peraliatas Seciia
Permit File WQ0002712
North Carolina Department of Environmental Quality I Division of Water Resources
DHE 512 North Salisbury Street 1 1617 Mail Service Center I Raleigh, North Carolina 27699-1617
NORTH GaC1uNA _
oev�nmemoie�.o-o�m��mi919.707.9000

Application For Renewal of
Permit NO. WQ0002712
Land Application of City of Lincolnton, NC
Residuals
RECEIVEDINCI)ENR/DWR
WQRC)S
MOORESVILLE REGIONAL OFFICE
RECEIVED/NCDEQ/DWR
OCT 2 2 2019
Non -Discharge
Prepared by: Permitting Unit
Synagro Central, LLC
Mocksville, NC 27028
P 336-998-7150 F 336-998-8450
October 9, 2019

October 10, 2019
N.C. Department of Environment and Natural Resources RECEIVED/NCDEQ/DWR
Water Quality Section
Non -Discharge Permitting Unit — Aquifer Protection Unit OCT 2 2 2019
1636 Mail Service Center
Raleigh, NC 27699-1636 Non -Discharge
Permitting Unit
ATTENTION: Mr. Nathaniel Thornburg
REFERENCE: RENEWAL OF CITY OF LINCOLNTON LAND APPLICATION
PERMIT WQ0002712
Dear Mr. Thornburg:
Synagro Central LLC is submitting a request to renew a land application program for residuals
generated by the City of Lincolnton Wastewater Treatment Plant and Water Treatment Plant.
One original and two copies of this application to renew the referenced residuals are included.
Seven existing sites, CL-02, CL-05, LT-07, LT-25, LT-39, LT-40, & LT-122 totaling 544.55
applicable acres, are being removed. In addition to the previously stated changes, five new sites,
LT-47, LT-48, LT-49, CA-24 & CA-48 totaling 287.3 The total acreage for the proposed
renewal is 686.95 acres.
This application package contains the information necessary to complete the certification of
this permit. However, if you require any additional information or have further questions about
the information presented herein, please contact me at [e-mail] or at my phone
number (336)-703-8681 I look forward to working with you to ensure a timely and efficient
review of this application.
Sincerely,
Alex Fox
Technical Services Specialist
Synagro Central, LLC

RECEIVED/NCDEQ/DWI
State of North Carolina
OCT 2 2 1019 Department of Environmental Quality
Pf—, C Division of Water Resources
- --{- �' Non -Discharge
Division of Water Resources P46*tR@Xd102T .1100 — RESIDUALS LAND APPLICATION PROGRAM
INSTRUCTIONS FOR FORM: RLAP 06-16 & SUPPORTING DOCUMENTATION
Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted, the Applicant shall submit one original and two copies of the application and
supporting documentation
For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting Unit
General — This application is for treatment, storage, transport, and/or land application of Class B residuals (may include residuals that
are generated from a water treatment plant or other type facilities) on the proposed or currently approved land application site(s) under
15A NCAC 02T .1100.
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Residuals Land Application Program (FORM: RLAP 06-16) Application: (All Application Packages):
Submit the completed and appropriately executed Residuals Land Application Program (FORM: RLAP 06-16) form. Please
do not make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to
the application may be made, as long as the attachments are numbered to correspond to the section and item to which they
refer.
The Applicant's Certification on Page 5 of this form shall be signed in accordance with 15A NCAC 02T .0106(b). An alternate
person may be designated as the signing official if a delegation letter is provided from a person who meets the criteria in 15A
NCAC 02T .0106(b).
If this project is for a modification of an existing permit, submit one copy of the existing permit.
�f Please submit this application form at least 180 days prior to the expiration date on the existing permit, or 90 days prior to
operation of proposed facility(ies) for application packages involving new or changes to treatment and storage units.
B. Application Fee (New and Major Modification Application Packages)
® Submit a check, money order or electronic funds transfer made payable to: North Carolina Department of Environmental
Quality (NCDEQ).
Facility Classification New Permit Major Modification 1
Major (land are permitted for > 300 acres) $1,310 $395
Minor (land are permitted for < 300 acres) F_ $810 —F $245
1 - A major modification shall be defined as any permit modification that: increases the generating facility's residuals dry tonnage;
adds additional land application areas not previously approved for that particular program [including transferring of field(s) from
one program to another]; adds additional residuals sources; or includes the addition of new treatment or storage units/processes not
previously permitted. There is no fee for minor modifications to a permit.
C. Cover Letter (All Application Packages)
List all items included in the application package, as well as a brief description of the requested permitting action.
D. Environmental Assessments (Maybe Required— See 15A NCAC 1C .0300)
Submit a copy of the Findings of No Significant Impact (FONSI) or Environmental Impact Statement (EIS). Also, include
information on any mitigating factor(s) from the Environmental Assessment (EA) that impact the construction of the residuals
treatment and storage facilities. An EA may also be required for private systems if any public funds and/or lands are used for
the construction of the subject facilities.
INSTRUCTIONS FOR FORM: RLAP 06-16 Page 1 of 3

I.
J.
L.
0
i
Project Evaluation and Receiver Site Management Plan (All New Application Packages or Modifications that include new sites)
Submit a project evaluation and a receiver site management plan (if applicable) with recommendations concerning cover crops
and their ability to accept the proposed application rates.
Hydrogeologic Report (All New Application Packages or Modifications involving increasing the total design capacity)
❑ Submit a detailed hydrogeologic evaluation in accordance with 15A NCAC 02T .1104(d)(4) and current Division Policy
available at: hU://www.ncwater.ora)Rules Policies and Regulations/. The document shall be signed, sealed and dated by a
qualified professional.
Engineering Design Documents (All New or Modification Application Packages with fixed irrigation facilities or irrigation
facilities fed through fixed supply system)
�] Submit engineering design documents that have been signed, sealed, and dated by a NC licensed Professional Engineer and/or
Professional Land Surveyor in accordance with 15A NCAC 02T .1104(d)(2). For Modifications, submit an updated site map
specific to the modification(s) only.
The design documents must include the following minimum items:
❑ Engineering plans for the facility and equipment except those previously permitted unless they are directly tied into the new
units or are critical to the understanding of the complete process;
❑ Specifications describing materials to be used, method of construction, and means for ensuring quality and integrity of the
finished product including leaking testing; and
❑ Engineering calculations including hydraulic and pollutant loading, sizing criteria, hydraulic profile, total dynamic head
curve analysis for each pump, and irrigation design.
❑ Soil mapping units shown on all disposal sites.
Water Balance (All New Application Packages or Modifications that include new sites utilizing fixed irrigation facilities or
irrigation facilities fed through fixed supply systems)
EJ Submit a completed and accurate water balance in accordance with 15A NCAC 02T .1104(d)(5) and current Division Policy
available at: hq://www.ncwater.or2/Rules Policies and Regulations/.
Property Ownership Documentation (All New or Modification Application Packages involving new and/or relocated treatment
or irrigation components)
❑ Property ownership documentation shall consist of one of the following:
Legal documentation of ownership (i.e., GIS, deed or article of incorporation), or
❑ Written notarized intent to purchase agreement signed by both parties with a plat or survey map, or
❑ An easement running with the land specifically indicating the intended use of the property and meeting the requirements of
15A NCAC 02L .0107(f) or
❑ A written notarized lease agreement signed by both parties, indicating the intended use of the property, as well as a plat or
survey map.
ONE ORIGINAL AND TWO COPIES OF THE COMPLETED APPLICATION PACKAGE, INCLUDING ALL
SUPPORTING INFORMATION AND MATERIALS, SHALL BE SENT TO THE FOLLOWING ADDRESS:
NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF WATER RESOURCES
WATER QUALITY PERMITTING SECTION
NON -DISCHARGE PERMITTING UNIT
By U.S. Postal Service:
1617 MAIL SERVICE CENTER
RALEIGH, NORTH CAROLINA 27699-1617
TELEPHONE NUMBER: [phone]
By Courier/Special Delivery:
512 N. SALISBURY STREET
RALEIGH, NORTH CAROLINA 27604
FAX NUMBER: [phone]
INSTRUCTIONS FOR FORM: RLAP 06-16 Page 3 of 3

M. RESIDUALS LAND APPLICATION PROGRAM INFORMATION:
1. Residuals Processing Facility's physical address: 550 Highway 150 West By -Pass
City: Lincolnton State: N_C Zip: 28092
Coordinates: Latitude: 35' 26' 56" Longitude: 810 15' 34"
Datum: NAD83 Level of accuracy: Second
Method of measurement: MAP
2. County where residuals land application program is headquartered: Lincoln
3. List the Operator In Responsible Charge (ORC) and all Back -Up ORCs for the residuals land application program, their
certification numbers, and their affiliations in the following table:
4.
Designation
Name
Affiliation
Certification Number
ORC
Mike Cox _
'Synagro Central, LLC _
LA 13191
Back -Up ORC
Robert Roth
Synagro Central, LLC
LA 1001672
Additional Back -Up
ORCs
if applicable
If an ORC and at least one Back -Up ORC are not currently designated for this residuals land application program, provide the
candidates' names, affiliations, and an estimated time schedule for each candidate's completion of the required training school
and certification test:
Complete the following tables regarding management of the residuals land application program:
a. Plant Available Nitrozen Summary: Determine the maximum plant available nitrogen (PAN) generated by all residuals
source -generating facilities as currently certified and proposed for certification with this application and list the results in the
following table:
Maximum amount of residuals to be certified: 1300 dry tons per year.
PAN
Pounds of PAN per Dry Ton
(Weighted Average)
Pounds of PAN per Year
Surface
Incorporation
or Injection
Surface
Incorporation
or Injection
First -Year
50.49
80.49
65,637
104,637
Five -Year Maximum Adjusted
66.25
96.25
86,122
125,122
b. Land Application Site Use Summary: Summarize information regarding the land application sites as currently certified and
proposed for certification with this application:
Category
Use
Acres
Comments
Crops
Forest or Plantation
0
Row Crops
176.8
Hay
118.4
Pasture
391.75
Total:
686.95
—
Methods
Surface
686.95
Incorporation or Injection
0
Total:
FORM: RLAP 06-16 Page 2 of 5

Note: Item VI. Applicable to Dedicated Program with fixed irrigation system only.
)VI. DESIGN INFORMATION FOR FIXED IRRIGATION SYSTEM
1. The irrigation system is: Q. Spray R. Drip
2. Disposal system is: Elexisting 0' proposed.
3. Minimum depth to mean seasonal high water table (SHWT) within irrigation sites(s) per Soil Scientist's Evaluation: F 11 feet
below ground surface. Rules 15A NCAC 02T .0505(n) requires at least one -foot vertical separation between SHWT and ground
surface.
4. Are there any artificial drainage or water movement structures within 200 feet of any irrigation area?
0 Yes or Q' No If Yes, please explain_ if the soil scientist report addresses artificial structures and please indicate if
structures are to be maintained or modified:'
5. Loading rates recommended by the Soil Scientist Evaluation:
Soil Series
Fields within Soil Area
Recommended
Loading Rate
in/hr
Recommended
Loading Rate
in/ r
6. Design loading rates are equal or less than the loading rates recommended by Soil Scientist?
Ej Yes or Fl! No If No, explain why 15A NCAC 02T .0505(n) is not met: I a
7. Non -dedicated System Design (fill in the appropriate information for either a spray or drip irrigation system):
Design Area
Number of
Maximum Application
Design Annual Loading
Field Zone
ftZ
Nozzles
Rate allons/hr
Rate aIlons/ r
Total
Spray Irrigation Design Element
Plan Sheet
Number
Specification
Page Number
Wetted diameter of nozzles
_ ft
Wetted area of nozzles
li ftz
i
Nozzle capacity
I gpm
Nozzle manufacturer / model__
i— -
i
Elevation of highest nozzle
_. --
ft
FORM: RLAP 06-16 Page 4 of 5

OPERATIONS AND MAINTENANCE PLAN
SYNAGRO RESIDUALS LAND APPLICATION FOR WQ0002712 (City of Lincolnton)
Inspection Plan
Inspections will be conducted on a weekly basis at the land application site during activities of this project. Inspection
frequency is based on the time frame to complete the project and the amount of dry tons to be land applied from the
facility. The inspections will consist of inspecting a field that is currently being applied as well as inspecting random
fields that have been completed. These inspections will consist of:
1. Verifying that the "Pre -Operations Check List" has been completed and signed by both operational and technical
staff.
2. Checking the calculated loads to insure the correct amount of residuals are being land applied.
3. Insuring that all manned equipment has a copy of the spill control plan, the permit, and the operations and
maintenance plan.
4. Insuring that the field has been flagged properly and that all buffers are being adhered to.
S. Insuring that the "Crop and Landowner Verification" form has been filled out.
6. Verifying that the residuals have been adequately sampled to confirm compliance.
The records will be kept in the project files in the respective office for the project. The Permittee or Inspector shall
report by telephone to the NCDENR/DWQ Mooresville Regional Office at 704-663-1699, as soon as possible, but no later
than 24 hours after, or the next working day, following the occurrence or first knowledge of the occurrence of the
following.
• Any occurrence with the distribution program resulting in the land application of significant amounts of
material that is abnormal in quantity or characteristics.
• Any failure of the program that results in a release of material to surface waters.
• Any time that self -monitoring information indicates that the program has gone out of compliance with
the permit.
• Any process unit failure that results in the system not adequately treating the residuals.
• Any spill or discharge from a vehicle or piping system during residuals transportation.
Any release that requires immediate reporting outside of normal business hours shall be called in to DENR at 800-662-
7956, 800-858-0368, or 919-733-3300. These numbers are to be called in the event of a release to surface waters or the
imminent failure of a storage system when the event occurs outside of normal business hours. Within 5 days of the first
notice of an occurrence, a written response in the form of a letter shall be sent to DENR outlining the actions taken or
proposed actions taken to ensure that the problem does not recur.
Persons responsible for inspections on this project are as follows:
Robert Roth Technical Services Manager, or his designee.

SPILL RESPONSE PLAN
)PROJECT: CITY OF LINCOLNTON Permit W00002712
IN THE UNLIKELY EVENT OF A SPILL, THE FOLLOWING ACTIONS SHALL BE TAKEN
IMMEDIATELY:
1. MANAGEMENT OF SPILL CLEAN-UP ACTIVITIES:
The Operations Manager shall take immediate charge and initiate clean-up activities. Synagro labor and equipment is to
be utilized. In the event additional labor and equipment is required, assistance may be requested from the City of
Lincolnton or the NC Department of Transportation, and other private contractors as necessary.
2. HALT THE SOURCE OF THE SPILL:
Such as a ruptured container or damaged transport unit.
3. CONTAIN THE SPILL:
Form a barrier. Sufficient quantities of straw shall be used for such purposes. Earthen barriers may be constructed to
augment the straw bale containment area of the spill. The Operations Manager or the person in charge on the spill site
will advise the clean-up personnel where to get the straw, lime, and other items necessary to complete the clean-up
operation, i.e., local farmers, farm supply centers, nurseries, etc.
4. CLEAN-UP:
'Employ front-end loaders, vacuum equipment, sludge application vehicles, and/or local septic tank service to remove as
much of the spilled material as possible. Straw and/or sand should be scattered in the spill area to soak up the remaining
material. The straw- and sand -soaked material will be collected and removed to a disposal area approved by
representatives of the state regulatory agency.
5. FINAL CLEAN-UP:
Employ rotary brush sweeper if needed, and apply lime to the spill area upon the approval of the clean-up efforts by the
state regulatory representative. If the event occurs on private property, the clean-up will be completed to the satisfaction
of the property owner and state regulatory representatives. The ultimate goal will be to restore the spill area to its original
condition if possible.
6. NOTIFICATION:
As soon as possible after the spill occurs, the Synagro Operations Manager or assistant will notify the Synagro Central
office, and they will then be responsible for notifying other key Synagro personnel.
7. REPORTING:
Synagro Central personnel will notify the Mooresville regional office of the NCDENR by telephone [phone]) for
the City of Lincolnton as soon as possible, but not more than 24 hours after, or on the next working day following the
occurrence. The Operations Manager shall provide a written report within 48 hours of the spill to the Technical Services
Director. The report shall list all relative information and actions taken. Synagro Central personnel will file a written
report to the Mooresville Regional office of the NCDENR within 5 days of the occurrence. For after hours reporting the
Division's emergency number shall be called to report all incidences (800-662-7956 or 800-858-0368 or 919-733-3300).

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

RESIDUALS SOURCE FACILITY SUMMARY
Applicant's name: City of Lincolnton
Status
Code
Facility Permit Holder
Facility Name
County
Permit Number
Maximum Dry Tons Per Year
Current b
Proposed
R
City of Lincolnton
Lincolnton WTP
Lincoln
NCO08588
306
300
R
City of Lincolnton
Lincolnton WWTP
Lincoln
NCO025496
13010
1300
i
i
i
i
a Status Code for source facility are: ♦ N (New) ♦ R (Renewed) ♦ M (Modified) e D (Deleted)
b The amount of residuals currently permitted for distribution, land application, or disposal (i.e, not applicable to new facility).
SUMMARY FOR FORM: RSC 06-16 Page 1

State of North Carolina
Department of Environmental Quality
Division of Water Resources
Division of Water Resources RESIDUALS SOURCE CERTIFICATION
FORM: RSC 06-16
I. RESIDUALS SOURCE -GENERATING FACILITY INFORMATION (See Instruction B.):
1. Facility Name: Lincolnton WWTP
2. Facility permit holder is: Federal, 0 State, 0 Local Government, or 0 Private.
Facility permit issued by: Div. of Water Resources, rl Div. of Environmental Health,
or [] Other (explain:).
3. Facility contact person and title: Don Burkey
Complete mailing address: P.O. Box 617
City: Lincolnton State: NC Zip: 28093
Telephone number: (704 736-8960 E-mail address: [e-mail]
4. Facility physical address: 550 Hwy. 150 W. Bypass
City: Lincolnton State: NC Zip: 28093
Coordinates: Latitude: 35' 26' 56" Longitude: 81' 15' 34"
Datum: NAD83 Level of accuracy: Second
Method of measurement: Map
5. Purpose of the facility:
treatment of municipal wastewater, treatment of 100% domestic wastewater,
n treatment of potable water,] treatment of 100% industrial wastewater,
treatment of industrial wastewater mixed with domestic wastewater,
(approximate percentages: (^-� % industrial and = % domestic)
other (explain: = ).
6. Does the facility have an approved pretreatment program: Yes E] No
7. Facility permitted/design flow: 6_0 MGD and facility average daily flow: 2_1 MGD
8. Average amount of residuals being generated at this facility 570 dry tons per year.
9. Specify the following regarding treatment and storage volumes available at the facility:
Type and volume of residuals treatment: Three Anaerobic Digestors 318,000 each
Type and volume of residuals storage (i.e., outside of residuals treatment units): N/A
H. RESIDUALS QUALITY INFORMATION (See Instruction C.):
1. Specify if residuals are regulated under:
40 CFR Part 503 or 40 CFR Part 257.
Note: Only residuals that are generated during domestic/municipal wastewater treatment processes are regulated under 40
CFR Part 503, otherwise, the residuals are regulated under 40 CFR Part 257.
2. Specify if residuals are defined under 15A NCAC 02T.1102(6) as:
Biological Non -Biological
Note: Biological residuals are residuals that have -been generated during the treatment of domestic wastewater, animal
processing wastewater, or the biological treatment of industrial wastewater (biological treatment is a system that utilizes
biological processes including lagoons, activated sludge systems, extended aeration systems, and fixed film systems).
FORM: RSC 06-16 Page 1 of 5

3. Hazardous Waste Determination: Complete the following to demonstrate that the residuals are non -hazardous under
RCRA: (Note - this item does not have to be completed for facilities that are less than 0.5 MGD in design flow that treat
r
100% non -municipal, domestic wastewater only)
a. Are the residuals listed in 40 CFR §261.31-§261.33: II yes no.
If yes, list the number(s): F_7
b. Specify whether or not the residuals exhibit any of the characteristics defined by 40 CFR §261.21-
261.24: n yes N no.
Fill in the following tables with the results of the latest toxicity characteristic leaching procedure (TCLP) analysis as
well as those for corrosivity, ignitability, and reactivity:
Laboratory Shealy Environmental and Date of analysis: 9/26/2019
Passed corrosivity test: yes [f'. no. pH: s.u. (2 < pH < 12.5)
Passed ignitability test: yes! no. Flashpoint: 140 °F (> 140°F)
Passed reactivity test: M yes Ono. HCN: nd mg/kg (<250) & H2S: nd mg/kg (<500)
TCLP Parameter
Limit
(mg/1)
Result
(Mg/1)
TCLP Parameter
Limit
(mg/l)
Result
(nzg/1)
Arsenic
5.0
nd
Hexachlorobenzene
0.13
nd
Barium
100.0
nd
Hexachloro-1,3-Butadiene
0.5
nd
Benzene
0.5
nd
Hexachloroethane
3.0
nd
Cadmium
1.0
nd
Lead
5.0
nd
Carbon Tetrachloride
0.5
nd
Lindane
0.4
nd
Chlordane
0.03
nd
Mercury
0.2
nd
Chlorobenzene
100.0
nd
Methoxychlor
10.0
nd
Chloroform
6.0
nd
Methyl Ethyl Ketone
200.0
nd
Chromium
5.0
nd
Nitrobenzene
2.0
nd
M-Cresol
200.0
nd
Pentachlorophenol
100.0
nd
o-Cresol
200.0
nd
Pyridine
5.0
nd
p-Cresol
200.0
nd
Selenium
1.0
nd
Cresol
200.0
nd
Silver
5.0
nd
2,4-D
10.0
nd
Tetrachloroethylene
0.7
nd
1,4-Dichlorobenzene
7.5
nd
Toxaphene
0.5
nd
1,2-Dichloroethane
0.5
nd
Trichloroethylene
0.5
nd
111-Dichloroethylene
0.7
nd
2,4,5-Trichlorophenol
400.0
nd
2,4-Dinitrotoluene
0.13
nd
2,4,6-Trichlorophenol
2.0
nd
Endrin
0.02
nd
2,4,5-TP (Silvex)
1.0
nd
Heptachlor and its Hydroxide
0.008
nd
Vinyl Chloride
0.2
nd
FORM: RSC 06-16 Page 2 of 5

4. Metals Determination: Complete one of the following tables (i.e., as applicable) to demonstrate that the residuals do not
violate the ceiling concentrations for metals regulated under 15A NCAC 02T .1105.
r"
a. For Distribution/Land Application: Fill in the following table with the results of the latest analyses (i.e., on a dry weight
basis) for the following metal parameters:
'Laboratory: = and Date of analysis:
Parameter
Ceiling
Concentration Limits
(ClassA & ClassB)
(mg/kg)
Monthly Average
Concentration Limits
(Class A Only)
(mg/kg)
Result
(mg/kg)
Arsenic
75
41
7.42
Cadmium
85
39
1.0
Copper
4,300
1,500
190
Lead
840
300
10.8
Mercury
57
17
.04333
Molybdenum
75
n/a
4.93
Nickel
420
420
11.4
Selenium
100
100
5.0
Zinc
7,500
2,800
235
b. For Surface Disposal Unit (landfill): Fill in the following table with the results of the latest analyses (i.e., on a dry weight
basis) for the following metal parameters:
Laboratory: = and Date of analysis:
Distance from Disposal
Unit to Boundary to
Closest Property Line
(meters, check one)
Arsenic
(mg/kg)
Chromium
(mglkg)
Nickel
(mg/kg)
> 0 but <25
30
200
210
E > 25 but < 50
34
220
240
>_ 50 but < 75
39
260
270
> 75 but < 100
46
300
320
> 100 but < 125
53
360
390
>_ 125
62
450
420
Result (mg/kg)
FORM: RSC 06-16 Page 3 of 5

5. Nutrient/Micronutrient Determination: Complete the following:
a. Total solids: 1.66 %.
b. Fill in the following table with the results of the latest analyses (i.e., on a dry weight basis) for the following nutrient and
micronutrient parameters:
Laboratory: Waypoint Analytical and Date of analysis: 09/09/2019
Parameter
Result
(mg/kg)
Aluminum
9090
Ammonia -Nitrogen
36500
Calcium
7130
Magnesium
3440
Nitrate -Nitrite Nitrogen
4.66
pH (Standard Unit)
6.9
Phosphorus
17700
Potassium
5230
Sodium
1870
Total Kjeldahl Nitrogen
72900
c. Using the results listed in Item II. 5b. above, calculate the sodium adsorption ration (SAR): .57
[Note: If residuals contain SAR of 10 or higher, the applicant shall obtain recommendations from the local Cooperative
Extension Office, the Department of Agriculture and Consumer Services, the Natural Resource Conservation Service, a
North Carolina Licensed Soil Scientist, or an agronomist, prior to land application of residuals. The recommendations shall
address the sodium application rate, soil amendments (e.g., gypsum, etc.), or a mechanism for maintaining site integrity
and conditions conducive to crop growth].
d. Specify the mineralization rate to be used in calculating the plant available nitrogen (PAN) of the residuals: 20 %. This
rate is a (check one): 0 default value, or ❑ actually established.
If the residuals are not generated from the treatment of municipal or domestic wastewater, explain or provide technical
justification as to why the selected default value is appropriate to be applied to these residuals: =
e. Calculate the PAN for the residuals (i.e., on a dry weight basis) and fill the results in the following table:
Application Method
First (V) Year PAN
Five -Year
Maximum Adjusted PAN
(mglkg)
(mg/kg)
Surface
25,245
33,124
Injection/Incorporation
40,245
48,124
6. Other Pollutants Determination: Specify whether or not there are any other pollutants of concern in the residuals and provide
the results of the latest analyses: f 1
FORM: RSC 06-16 Page 4 of 5

7. Pathosen Reduction: Per 15A NCAC 02T.1106, specify how residuals will meet the pathogen reduction requirements:
a. For Distribution/Land Application of Class A or Equivalent:
A fecal coliform density that is demonstrated to be less than 1,000 MPN per gram of total dry solids,
or
El A salmonella sp. density that is demonstration to be less than 3 MPN per 4 grams of total dry solids.
AND one of the followings (except for non -biological residuals):
. Alternative 1 [15A NCAC 02T. I 106(b)(3)(A)] - Time/Temperature Compliance.
Alternative 2 [15A NCAC 02T.I 106(b)(3)(B)] - Alkaline Treatment.
] Alternative 3 [15A NCAC 02T. 1 106(b)(3)(C)] - Prior Testing for Enteric Virus/Viable Helminth Ova.
Alternative 4 [15A NCAC 02T.1106(b)(3)(D)] - No Prior Testing for Enteric Virus/Viable Helminth Ova.
II Alternative 5 [15A NCAC 02T.I l06(b (3)(E)-(K)] - Process to Further Reduce Pathogens (PFRP).
Specify one: composting, heat drying, heat treatment,
thermophilic aerobic digestion,] beta ray irradiation,
gamma ray irradiation, or L] pasteurization.
b. For Land Application of Class B:
ltern tiye 1 [: SA -RAC 02T 1106(cjg1i16 Seca C*olif r nslt Denlonstxation
Alternative 2 [15A NCAC 02T.I 106(c)(2)] - Process to S' W t y ca educe a o ens (PSRP).
Specify one: aerobic digestion, 0 air drying, :�' anaerobic digestion,
composting, or El lime stabilization.
c. For Surface Disposal:
] Select One of the Class A or Equivalent Pathogen Reduction Alternatives in Item H. 7a. above.
Select One of the Class B or Equivalent Pathogen Reduction Alternatives in Item II. 7b. above.
Exempt - If Daily Cover Alternative is chosen in Item II.8. below [15A NCAC 02T.1106(a)(2)].
] Not Applicable - Non -Biological Residuals with NO Domestic Wastewater Contribution.
Vector Attraction Reduction (VAR): Per 15A NCAC 02T.1107, specify how residuals will meet the VAR requirements:
Alt-1"nJ ire 1 1.5 NCAC Q2T.11%07!a _ 1. ;] - 3 °% o7J ttl��Salids Re_duc ion (Aerobic/Anaerobic Digestion).
Alternative 2 [15A NCAC 02T.I 107(a)(2)] - 40-Day Bench Scale Test (Anaerobic Digestion).
(Aerobic Digestion).
(Aerobic Digestion).
Alternative 5 [15A NCAC 02T.I 107(a)(5)] -
- Drying of Stabilized Residuals.
r] Alternative 8 [15A NCAC 02T.I 107(a)(8)] - Drying of Unstabilized Residuals.
Alternative 9 [15A NCAC 02T.1107(a)(9)] - Injection.
Alternative 10 [15A NCAC 02T.1107(a)(10)] -Incorporation.
Alternative for Surface Disposal Units Only - Soil/Other Material Cover [15A NCAC 02T.1107(b)(2)].
Not Applicable - Non -Biological Residuals with NO Domestic Wastewater Contribution.
Note: For animal processing residuals, only alternatives 9 or 10 may be chosen due to the nuisance conditions that typically
occur when these residuals are applied and left on the land surface.
FORM: RSC 06-16 Page 5 of 5

VICINITY MAP
Nag
"COUNTY-, Lincoln
U-=j
I.
cm-1)
G-4oafi�;
OWNER(S): City of Lincolnton WWTP _

�� i

Residuals Sampling Plan .
City of Lincolnton Land Application Program (WWTP)
Nutrient and Metal Analysis
WWTP
Sampling Point: Digester
Sampling Frequency: Quarterly
Sample Type: Composite
Lab: Waypoint Environmental
Pathogen Reduction
WWTP
Sampling Point: Digester
Sampling Frequency: Quarterly
Sample Type: Grab
Lab: Lincolnton Lab
Vector Attraction Reduction
WWTP
Sampling Point: Digester
Sampling Frequency: Quarterly
Sample Type: Composite
Lab: Lincolnton Lab
TCLP/RCI
WWTP
Sampling Point: Digester
Sampling Frequency: Once per permit cycle
Sample Type: Composite
Lab: Summit Environmental Technologies Inc.

CITY OF Lincolnton PERMIT RENEWAL
QUANTITATIVE JUSTIFICATION FOR RESIDUALS PRODUCTION RATE
The following is a record of the annual land application volume for the City of
Lincolnton wastewater treatment plant:'
Year
Dry Tons Land Applied
2018
548.99
2017
744.87
2016
438.28
2015
607.26
2014
512.89
The current permitted volume (1300 dry tons per year) is greater than the anticipated
need for the coming years. Over the 5 years shown above the average number of dry tons
land applied was 570.46 which is well within reason of the permitted dry tonnage. The
extra dry tonnage is suitable for-f=ther expansion.
-�u A,-�

SHEALY ENVIRONMENTAL SERVICES, INC.
Report of Analysis
Synagro
12701 Lancaster Hwy
Pineville, NC 28134
Attention: Alex Fox
Project Name: Lincolnton
Lot Number:U106072
Date Completed:09/26/2019
09/26/2019 4:56 PM
Approved and released by:
Lab Director - Greenville: Lucas Odom
A CCPE DITED
JP
om eAP
The electronic signature above is the equivalent of a handwritten signature.
This report shall not be reproduced, except in its entirety, without the written approval of Shealy Environmental Services, Inc.
Shealy Environmental Services, Inc.
106 Vantage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www.shealylab.com
Page 1 of 13

SHEALY ENVIRONMENTAL SERVICES, INC.
SC DHEC No: 32010001 NELAC No: E87653 NC DENR No: 329 NC Field Parameters No: 5639
Case Narrative
Synagro
Lot Number: U106072
This Report of Analysis contains the analytical result(s) for the sample(s) listed on the Sample Summary
following this Case Narrative. The sample receiving date is documented in the header information
associated with each sample.
All results listed in this report relate only to the samples that are contained within this report.
Sample receipt, sample analysis, and data review have been performed in accordance with the most
current approved NELAC standards, the Shealy Environmental Services, Inc. ("Shealy") Quality
Assurance Management Plan (QAMP), standard operating procedures (SOPS), and Shealy policies. Any
exceptions to the NELAC standards, the QAMP, SOPS or policies are qualified on the results page or
discussed below.
Where applicable, all soil sample analysis are reported on a dry weight basis unless flagged with a "W"
qualifier
If you have any questions regarding this report please contact the Shealy Project Manager listed on the
cover page.
The pH analysis associated with the sample(s) in this report was/were performed after the method
recommended 15 minute holding time.
Metals by ICP
The initial sample amount used for the following sample deviated from the standard procedure: U106072-
001. Due to a low amount of % solids, the initial amount of the samples were weighed out to about 3.0 g
instead of 1.0g. The LOQ has been adjusted accordingly.
Shealy Environmental Services, Inc.
106 Vantage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www.shealylab.com
Page 2 of 13

Client:Synagro Laboratory ID:U106072-001
Description: Lincolnton WWTP Matrix: Solid
Date Sampled:09/05/2019 % Solids: 1.39 09/07/2019 0416
Date Received: 09106/2019
Inorganic
non-metals
Run Prep Method
Analytical Method
Dilution
Analysis Date Analyst
Prep Date Batch
1
(% Solids) SM 254OG
1
09/07/2019 0416 MDD
28205
1 350.1
(Ammonia - N) 350.1
20
09/13/2019 1525 DFR
28582
1
(Ignitability) 1010A
1
09/26/2019 1200 SLC
30162
1
(Nitrate - N ) 9056A
1
09/17/2019 1644 GMH
29171
1
(Nitrite - N ) 9056A
1
09/17/2019 1644 GMH
29240
1
(pH) 9045D
1
09/09/2019 2034 HET
28337
1
(Phosphorus) 365.1
5
09/17/2019 1411 DMA
09/16/2019 0926 29064
1
(Reactive Cya) 7.3.3
1
09/11/2019 2054 MSG
09/09/2019 0934
1
(Reactive Sul) 7.3.4
1
09/10/2019 1655 HET
09/09/2019 0934
1 351.4
(TKN) 351.2
1
09/12/2019 1037 DMA
09/11/2019 1806 28644
CAS
Analytical
Parameter
Number
Method
Result Q
LOQ
DL
Units
Run
% Solids
SM 254OG
1.39
%
1
Ammonia - N (gas diffusion)
350.1
41000
1400
750
mg/kg
1
Ignitability (Pensky-Martens Closed -Cup)
1010A
>140
140
0
° F
1
Nitrate - N (soluble)
9056A
52
36
1.8
mg/kg
1
Nitrite - N (soluble)
9056A
65
14
1.4
mg/kg
1
Soil pH measured in water @ 22.3 ° C
9045D
7.0
su
1
Phosphorus
7723-14-0
365.1
12000
1800
360
mg/kg
1
Reactive Cyanide
7.3.3
ND
50
mg/kg
1
Reactive Sulfide
7.3.4
ND
50
mg/kg
1
TKN
351.2
70000
1800
1800
mg/kg
1
TCLP Volatiles
..un Prep Method Analytical Method
Dilution Analysis Date Analyst
Prep Date
Batch
Leachate Date
1 1311/5030B 8260D
10 09/14/2019 0316 JTH
28924
09/12/2019 1814
CAS
Analytical
Parameter
Number
Method
Result Q
LOQ
DL
Units
Run
Benzene
71-43-2
8260D
ND
0.050
0.0040
mg/L
1
2-Butanone (MEK)
78-93-3
8260D
ND
0.10
0.020
mg/L
1
Carbon tetrachloride
56-23-5
8260D
ND
0.050
0.0040
mg/L
1
Chlorobenzene
108-90-7
8260D
ND
0.050
0.0040
mg/L
1
Chloroform
67-66-3
8260D
ND
0.050
0.0040
mg/L
1
1,2-Dichloroethane
107-06-2
8260D
ND
0.050
0.0040
mg/L
1
1,1-Dichloroethene
75-35-4
8260D
ND
0.050
0.0040
mg/L
1
Tetrachloroethene
127-18-4
8260D
ND
0.050
0.0040
mg/L
1
Trichloroethene
79-01-6
8260D
ND
0.050
0.0040
mg/L
1
Vinyl chloride
75-01-4
8260D
ND
0.010
0.0040
mg/L
1
LOQ = Limit of Quantitalion B = Detected in the method blank E = Quantitation of compound exceeded the calibration range DL = Detection Limit
ND = Not detected at or above the DL N = Recovery is out of criteria P = The RPD between two Qy columns exceeds 40 % J = Estimated result < LOQ and > DL
- - Out of holding time W = Reported on wet weight basis
ealy Environmental Services, Inc.
. _3 Vantage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www.shealylab.com
Page 3 of 13

Client: Synagro Laboratory ID: U106072-001
Description: Lincolnton WWTP Matrix: Solid
Date Sampled:09/05/2019 % Solids: 1.39 09/07/2019 0416
Date Received: 09/0612019
Run 1
Acceptance
Surrogate
Q % Recovery
Limits
Bromofluorobenzene
106
70-130
1,2-Dichloroethane-d4
117
70-130
Toluene-d8
118
70-130
TCLP Semivolatiles
Run Prep Method
Analytical Method Dilution Analysis Date Analyst
Prep Date
Batch
Leachate Date
1 1311/3520C
8270E 1 09/16/2019 1606 JCG
09/13/2019
1657 28844
09/10/2019 2043
CAS Analytical
Parameter
Number Method
Result Q
LOQ
DL
Units
Run
1,4-Dichlorobenzene
106-46-7 8270E
ND
0.040
0.0050
mg/L
1
2,4-Dinitrotoluene
121-14-2 8270E
ND
0.080
0.0050
mg/L
1
Hexachlorobenzene
118-74-1 8270E
ND
0.040
0.0050
mg/L
1
Hexachlorobutadiene
87-68-3 8270E
ND
0.040
0.0050
mg/L
1
Hexachloroethane
67-72-1 8270E
ND
0.040
0.010
mg/L
1
2-Methylphenol
95-48-7 8270E
ND
0.040
0.010
mg/L
1
3+4-Methylphenol
106-44-5 8270E
ND
0.040
0.015
mg/L
1
Nitrobenzene
98-95-3 8270E
ND
0.040
0.015
mg/L
1
Pentachlorophenol
87-86-5 8270E
ND
0.20
0.020
mg/L
1
Pyridine
110-86-1 8270E
ND
0.040
0.0050
mg/L
1
2,4,5-Trichlorophen ol
95-95-4 8270E
ND
0.040
0.0050
mg/L
1
2,4,6-Trichlorophenol
88-06-2 8270E
ND
0.040
0.0050
mg/L
1
Run 1 Acceptance
Surrogate
Q % Recovery Limits
2-Fluorobiphenyl
63 37-129
2-Fluorophenol
34 24-127
Nitrobenzene-d5
54 38-127
Phenol-d5
44 28-128
Terphenyl-d14
102 10-148
2,4,6-Tribromophenol
56 41-144
TCLP Herbicides
Run Prep Method
Analytical Method Dilution Analysis Date Analyst
Prep Date
Batch
Leachate Date
1 131118151A
8151A 1 09/17/2019 0031 DAL1
09/15/2019 1406 28961
09/10/2019 2043
CAS Analytical
Parameter
Number Method
Result Q
LOQ
DL
Units
Run
2,4-D
94-75-7 8151A
ND
0.020
0.0050
mg/L
1
2,4,5-TP (Silvex)
93-72-1 8151A
ND
0.0050
0.0013
mg/L
1
Run 1 Acceptance
Surrogate
Q % Recovery Limits
DCAA
60 50-112
LOQ = Limit of Quantitation
B = Detected in the method blank E = Quantitation of compound exceeded the calibration range
DL = Detection Limit
NO = Not detected at or above the DL
N = Recovery is out of criteria P = The RPD between two GC columns exceeds 40 %
J = Estimated result
< LOQ and > DL
H = Out of holding time
W = Reported on wet weight basis
Shealy Environmental Services, Inc.
106 Vantage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www.shealylab.com
Page 4 of 13

Client:Synagro Laboratory ID: U106072-001
Description: Lincointon WWTP Matrix: Solid
Date Sampled:09/05/2019 % Solids: 1.39 09/07/2019 0416
Date Received:09/06/2019
TCLP Pesticides
Run Prep Method
Analytical Method
Dilution Analysis Date Analyst
Prep Date
Batch
Leachate Date
1 131113520C
8081E
1 09/18/2019 0509 DAL1
09/15/2019 1543
28959
09/10/2019 2043
CAS Analytical
Parameter
Number Method
Result Q
LOQ
DL
Units
Run
gamma-BHC (Lindane)
58-89-9 8081B
ND
0.00040
0.00017
mg/L
1
Chlordane
57-74-9 8081B
ND
0:0040
0.0015
mg/L
1
Endrin
72-20-8 8081B
ND
0.00040
0.00015
mg/L
1
Heptachlor
76-44-8 8081B
ND
0.00040
0.00015
mg/L
1
Heptachlor epoxide
1024-57-3 8081 B
ND
0.00040
0.00016
mg/L
1
Methoxychlor
72-43-5 8081B 0.00040 J
0.0016
0.00021
mg/L
1
Toxaphene
8001-35-2 8081B
ND
0.0080
0.0030
mg/L
1
Run 1 Acceptance
Surrogate
Q % Recovery Limits
Decachlorobiphenyl
80 20-131
Tetrachloro-m-xylene
76 26-132
CVA,A
Run Prep Method
Analytical Method
Dilution Analysis Date Analyst
Prep Date
Batch
1 7471B
7471B
1 09/10120190953 KSH2
09/09/20191520
28269
CAS Analytical
Parameter
Number Method
Result Q
LOQ
DL
Units
Run
Mercury
7439-97-6 7471B
ND
5.5
1.3
mg/kg
1
TCLP Metals
..in Prep Method
Analytical Method
Dilution Analysis Date Analyst
Prep Date
Batch
Leachate Date
1 1311/3010A
6010D
1 09/12/2019 0254 LLL
09/11/2019 1726
28648
09/10/2019 2043
1 131117470A
7470A
1 09/13/2019 1317 KSH2
09/12/2019 1455
28691
09/10/2019 2043
CAS Analytical
Parameter
Number Method
Result Q
LOQ
DL
Units
Run
Arsenic
7440-38-2 6010D
ND
0.15
0.025
mg/L
1
Barium
7440-39-3 6010D
0.070 J
0.25
0.031
mg/L
1
Cadmium
7440-43-9 6010D
ND
0.050
0.0060
mg/L
1
Chromium
7440-47-3 6010D
ND
0.10
0.013
mg/L
1
Lead
7439-92-1 6010D
ND
0.10
0.047
mg/L
1
Mercury
7439-97-6 7470A
ND
0.0020
0.00o91
mg/L
1
Selenium
7782-49-2 6010D
ND
0.20
0.085
mg/L
1
Silver
7440-22-4 6010D
ND
0.10
0.021
mg/L
1
LOQ = Limit of Quantitation B = Detected in the method blank E = Quantitation of compound exceeded the calibration range DL = Detection Limit
NO = Not detected at or above the DL N = Recovery is out of criteria P = The RPD between two GC columns exceeds 40 % J = Estimated result < LOQ and - DL
H = Out of holding time W = Reported on wet weight basis
lly Environmental Services, Inc.
Vantage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www.shealylab.com
Page 5 of 13

Client:Synagro Laboratory ID:U106072-001
Description: Lincolnton WWTP Matrix: Solid
Date Sampled:09/05/2019 % Solids: 1.39 09/07/2019 0416
Date Received: 09/0612019
ICP-AES
Run Prep Method
Analytical Method Dilution Analysis Date Analyst
Prep Date
Batch
1 3050B
6010D 1 09/13/2019 1205 LLL
09/12/2019 0834
28607
CAS Analytical
Parameter
Number Method
Result Q
LOQ
DL
Units
Run
Aluminum
7429-90-5 601OD
12000
480
180
mglkg
1
Arsenic
7440-38-2 601OD
6.3 J
18
5.9
mg/kg
1
Cadmium
7440-43-9 601OD
ND
5.9
1.5
mglkg
1
Calcium
7440-70-2 6010D
9500
5900
740
mglkg
1
Chromium
7440-47-3 6010D
47
12
3.0
mg/kg
1
Copper
7440-50-8 6010D
210
12
5.3
mg/kg
1
Iron
7439-89-6 6010D
12000
120
54
mg/kg
1
Lead
7439-92-1 6010D
12
12
5.3
mg/kg
1
Magnesium
7439-95-4 6010D
5500 J
5900
740
mglkg
1
Manganese
7439-96-5 6010D
250
18
7.0
mg/kg
1
Molybdenum
7439-98-7 6010D
ND
48
12
mg/kg
1
Nickel
7440-02-0 6010D
13 J
48
12
mg/kg
1
Potassium
7440-09-7 6010D
12000
5900
740
mg/kg
1
Selenium
7782-49-2 6010D
9.7 J
24
9.7
mg/kg
1
Sodium
7440-23-5 6010D
3600 J
5900
740
mg/kg
1
Zinc
7440-66-6 6010D
250
59
15
mg/kg
1
LOQ = Limit of Quantitation B = Detected in the method blank E = Quantitation of compound exceeded the calibration range DL = Detection Limit
NO = Not detected at or above the DL N = Recovery is out of criteria P = The RPD between two GC columns exceeds 40 % J = Estimated result < LOQ and > DL
H = Out of holding time W = Reported on wet weight basis
Shealy Environmental Services, Inc.
106 Vantage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www.shealylab.com
Page 6of13

i ecnrncian , Quarter / Year / y �
SM 2540 B-2011, 2540 D -20 1 NCO026496 All weighings are_done in grams
Time Collected
Date Collected
Date / Time In
Date / Time Out
Total Wet Wgt
��r (�
ZX (�
Dish,
rz-
C "S
Wet Sludge Wgt
(I03-105°C) Dried
Wgt
�lU S
Dish
cf ` r"1 23
`7 l D
Dry Solids Wgt
Sf
�E
Q t /
%Solids
3'-Z'��
AVG % Solids'
j
ofY3
Time In/Out
6 �.0 42/0-),3 D
(103-10Dried
wgt
�' v
��_3
69
550°C. Wt
Volatile Solids Wgt
` ,3
J /�
r !
% Volatile Solids
�, so Z_
ar 15
° AVG
/o ! f t
Volatile.Solids (J
% TS DAF =
q r `f 3
% TS Sludge = ]��,
1 0 ,
% VS DAF =
V.
% VS Sludge =
I � y. Y-5—
% Total Solids = Dry Solids Wgt
X •100
Wet Solids Wgt
% Volatile Solids = (Volatile Solids Wgt) X100.
Dried Solids Wgt
% Reduction = (VS DAF - VS Sludge) 100
VS DAF - (VS DAF)(VS Sludge)
---------------

SLUDGE Fecal Coliforms
***See Effluent Fecal Coliform Setup for CIA Data KA.0 ,d• 0999n Gen 91gt PH Temperatures are in.°C
Collection
Water Bath
Setup 4 S hours after Grab Read 24 +/- 2 hours
Colony
Count
Calculate
Colonies
Colonies
%
TOTAL
Reportable
Colonies
ml
Used
Date Time By
Setup Removal
Time in By Temp Time Out By Temp
per
Filter
per
100,mL/Filter
per
100 mLIFllter
SOLIDS
per
•9
A
B
C
D
CID
_
IZV6
`
S1Vl
`�Q�
SQ
y
\ 1
�eCi�zL
Z
CFU
0.1
'h
0.01
�y I (7 �5 y
1
`
I
7
?
� J� �j�j
1
CFU
0.1
/
0.01
� � � ��S��O�
1
CFIJ
0.1
C,
is
0.01
CFU
0.1
0.01�
Jr7�����
1
1�
CFU
�
Jam•
0.1
f
'
0.01
o` a� j J7�
��
j
V
CFU
0.1
0.01
I�/�
11
CFU
v�
1 JC
0.1

Technician Quarter / Year oG111L (--A "y /
" SM 2540 a-2011, 2540 5-2011 NCO025496 All weighings are done in grams
4,= Time Collected
Date Collected J 2-
Date iTirfie In
Ho C9
Date /Time Out
0D
Total Wet Wgt
c, r
�J 31 2'
3
d/ z6y
Dish
2 21Af
V LI- -2-3 93
Wet Sludge Wgt
!L 3
i
(103- I ODried
wgt
Dish
3 1 21.1,9
Dry Solids Wgt
[ Gj
D [ l( c�•s
�'
% Solids
AVG % Solids -C
Time In/Out A rJ A
(103-105°C) Dried
wgt
D 3 6.7 e'
`f 9 -j-� 8,
`1-7.35-
5509C. Wt
Volatile Solids Wgt
6 a
% Volatile Solids
AVG Z2 0
% Volatile Solids
�9
--- - % VS DAF =
% VS Slud e = ? 2
% Total Solids = Dry Solids Wgt X 100
Wet Solids Wgt
r'
l % Volatile Solids = (Volatile Solids Wgt) X 100
!.. Dried Solids Wgt
i
% Reduction = (VS DAF -VS Sludge) X 900
VS DAF - (VS DAF)(VS Sludge)
% TS DAF—
% TS Slud e =

C.42.
Quarter / Year
Technician
SM 2540G-1987,2640D-1997 All weighings are done In grams
Time OP 6 f 0 C
Collected
Date
Collected
7
Date
y-
Time In%��lv-s 11
Date! 17 16 4. +If O�JP .5- b 06
j
Time Out Ilk,I
Total Syl PID Op v2S V/A 75f
�ff�3lzz
Wet Wgt q.
q-q, 02 1, qq,
3 659 1D o KQ C a 0 f, 5731 F, 6et 02- q4
Dish qq, off` 9, 6�q_3
IRY
Wet Sludge
�yyj)-
?_3 0i o
!2a
Wgt
L/
(103-1 060C) 26b -i � t5-yfaq
Dried Wgt 11
Dish
qY 300
Cz, �tdil 3% � q i'�6, )_
vq 1,
Dry Solids ob 2-1 J_ 6•, e_Z01:
Wgt
Wgt
d-, 3
%Solids 2- 0, q
b
Average
% Solids
F•RPD
% Total Solids = Dry Solids Wgt x 100
'Wet Solids Wgt

Technician '�'/
SM 2540 G-1 997. 2540 D -1997
Quarter / Year
All weighings are done In grams
%
V!
gg
WA
Time
Collected
Date
Collected
Date I
Time In
Date /
Y-!r
Time Out
jr—
Total
86,
Wet Wgt
1. Dish
44o
q i817
Wet Sludge
Wgt
(103-1 05-C)
qq.40
q
i.
Dried Wgt
Dish
Dry Solids
Wgt
% Solids
Average
% Solids
% Total Solids = Dry Solids-Wgt —X 100
*Wet Solids Wgt

SLUDGE Fecal Colifforms
a I - I! 4—ne Ml fi
TmmnPr,gtt IrP.9 ere in 0C
Collection
Date Time By
Water Bath
Setup < 8 hours after Grab Read 24 +/- 2 hours
Setup Removal
Time In By Temp Time Out By Temp
Colony
Count
per
Filter
B
Calculate
Colonies
per
100 mL/Filter
Colonies
per
100 mL/Filter
C
%
TOTAL
SOLIDS
D
Reportable
Colonies
per
-9
C/D
ml
Used
A
1D
P'�
o
�'1
i�i•�
�p l0
L�
�j,1ErJ
0.01
�'
(/• I 060
pOt9t`� .
X.
t
CFU
0.1
`�
' f�L� r!
111
U� ��
�r'
�O Z��
7 (•
��
0.01
l 5f�
N1�1�©
`� O�(1(���Z�a
CFU
0.1
0.01
�6Do
CFU
0.1�(�
DU
�dlrt1iL°i`�7
.f L
W
0.01
UG17iJ
I h bba
(l `�
J` c!
�laD l
CFU
`
L 'lC
�� 1. S
6'' `�
►
q t
�12
0.01
O
�i u
�' �
w
CFU
0.1
A
CFU
1.0
0.01
0.1
0.01
i
✓ 1
CFU
0.1
�I.'

SLUDGE (Fecal CoRforms
*—P.. Ffffimnt Ranal Celiform Satan for OA Data
0
v
Temneratures are 1n.0C
Collection
Date Time By
Water Bath
Setup < 8 hours after Grab Read 24 +/- 2 hours
Setup Removal
Time In By Temp Time Out By Temp
Colony
Count
per
Fllter
g
Calculate
Colonies
per
100 mUFilter
Colonies
per
100 mUFilter
C
%
TOTAL
SOLIDS
!D
Reportable
Colonies
per
g
CID
ml
Used
A
pal � �
4q
0
•G�
a� Y�
���,�2 .l
0.1
�-
�p°°
0�
�) Oq
!
jL �?
r
CFU
0.1
3 V
VIA- 5, �
3-D p G
p �'
0.01
CFU
0.1
0.01
I
CFU
0.1
•
0.01
I
I
CFU
0.1
0.01
i
,I
•
CFU
0.1
0.01
i
CFU
0.1

Technician uuarter / Year 5 r
SM 2540 B-2011. 2540 D -2011 N00025498 All weiahinas are done in grams
PEN
Time Collected
C)
Date Collected
2-3-1
Date / Time In
-_7)
Date I Time Out
y �,o Z)
Total Wet Wgt
3.3
Dish
Wet Sludge Wgt
(I 03-105"C) Dded
Wgt
C)
Dish
Dry Solids Wgt
Z 6 �
t ;L,
% Solids
AVG % Solids'
Time In/Out
(103-105°C) Dried
Wgt:
550°C Wt
Volatile Solids Wgt
t ®��
t 01 42/
% Volatile Solids
i<
ANG
%Volatile Solids
% TS Sludge
% VS bAF
% VS Sludge
2
% Total Solids = Dry Solids Wgt -X 100
VV6t Solids Wgt
% Volatile Solids = (Volatile Solids Wgt) _ X 100
Dried Solids Wgt
% Reduction (VS DAF - VS Sludge) -X 100
VS DAF - (VS DAF)(VS Sludge)

SLUDGE Fecal Coliforms
_•. cM + ❑e..al (rnUfnrm Rafe in fnr OA D8t9 KAe4-141 0909r) RM 21 cf ed Temperatures are In-°C
Collection
Water Bath
Setup e 8 hours after Grab Read 24 +/- 2 hours
Colony
Count
Calculate
Colonies
Colonies
%
TOTAL
SOLIDS
Reportable
Colonies
per
ml
Used
Date Time By
Setup Removal
Time In By Temp Time Out By Temp
per
Filter
per
100 mUFilter
per
100 ml./Filter
g
A
B
C
D
CID
00
-(`�
(iQC7
v�
�Cl�r�
0.01
��
`1 �j'
�D
CFU
�-
0.1
3O
�0Ov
q,60o
b����Z�
CFU
`000/�0060
jqf
(OOAIa
DG�
J��(�
I��DO
[00pU
CFU
�,,,,_
D DID
,�
��6q0�
��oroo
30 °° °
�°' �
��
CFU
TN��
0.1
_i.�/ l
�;
1! ,� f
uit-
•I r)
. ,} dZ)
�L�
dry
! t 1
0.01
0 UGi �
! l
� „ 2-
CFU
0.1
V
q
0V
D G Cy
✓v+-
�7 `
©6
0.01
v
i�
CFU
f70
V 6
t��
3 U
✓�ni
A l �7
i �5
03�
��
0.01
q (
L aOo �%
�p00
D q l
CFU
-Fly �G
0.1

Technician
Quarter / Year
3 °,j
SM 2540 G-1997, 2540 D -1997
All weighings are done in grams
SaltipleDige
�toP,
.®l gest®r I
(Digesttt
Time
Collected
C' ,
C% � �1 �
f' Gj 3
V � j
` D
t,.` CDate
! T ! (
r� (�!
�-1 (Y
�l !
2-. ��%�
2 ' Zi'� %
2 7 ✓� /
Collected
Dmeln
��ri J� /�Ul
��B� c7
r� 22'/ j"�r�cu
2 ZI`l
'?_2
Time Out
T
�
Total
0�I�I
���,�U�IY
q�,ls�
$t`S
q,�G03(�
`��6��-7
���'3�2��Ofe.41��t
12,�3�U
��iJ,�fuZ•�
G2`u3�
(ii37��
"1�'}✓
C��l�`�,y
Wet Wgt
`33U�
.3�'
qq. �33�Dish
Y.
Y3,
Wet Sludge
Wgt
'fy5�
s`f
S
; (, 4f#S63z1
(103-105°C)
Dried Wgt►
- .; , c14 31
�15,�� U
�L� �
3
�� ,Sb'fv
yZs, f��`�
r �I�lb
j �'
S�� ?96s�i�
,
�( �f,�`fG�
Dish
��.'71°�'
`f Llx"�'b
�4 S3
�otr 11
z1Lj.�3'k
�l �(530-J
y�. sf
�b,���a�
�`f "t?!G
`f 3,115
Dry Solids
Wgt
�!'?4?t'
1 rl'1�C
y�3
��' S
�����
�r 5�
�55�
S(�L
t
(� i�r/
O. ` 5-
04(Na
!
lc8 10
%Solids
1 J
l `�
o ►��
©�'T (
l b,©�
l
�� L
�,
, �/
t 3
®� 7�
" (
` 1
Average
%Solds
% Total Solids = Dry Solids Wgt X 100
"Wet Solids Wgt

Waypmint"s—ANAIYT[CAL
9/9/2019
Synagro Central LLC/ Lincolnton
Mary Brewer
284 Boger Road
Mocksville, NC, 27028
Ref: Analytical Testing
Report Number: 19-241-0004
Project Description: LINCOLNTON WVVTP
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 ° Fax [phone]
www.waypo'intanalytica l.com
Dear Mary Brewer:
Waypoint Analytical Virginia, Inc. received sample(s) on 8/29/2019 for the analyses presented in the following
report.
The above referenced project has been analyzed per your instructions. The analyses were performed in
accordance with the applicable analytical method. Sub -contracted testing is noted on the Sample Summary Table
if applicable.
The analytical data has been validated using standard quality control measures performed as required by the
analytical method. Quality Assurance, method validations, instrumentation maintenance and calibration for all
parameters (NELAP and non-NELAP) were performed in accordance with guidelines established by the USEPA
(including 40 CFR 136 Method Update Rule May 2012) and NELAC unless otherwise indicated. .
Certain parameters (chlorine, pH, dissolved oxygen, sulfite...) are required to be analyzed within 15 minutes of
sampling. Usually, but not always, any field parameter analyzed at the laboratory is outside of this holding time.
Refer to sample analysis time for confirmation of holding time compliance.
The results are shown on the attached Report of Analysis(s). Results for solid matrices are reported on an as -
received basis unless otherwise indicated. This report shall not be reproduced except in full and relates only to
the samples included in this report.
Please do not hesitate to contact me or client services if you have any questions or need additional information.
Sincerely,
&� &gyp!-
Pauric McGroary
Agronomist
Laboratory's liability in any claim relating to analyses performed shall be limited to, at laboratory's option, repeating the
analysis in question at laboratory's expense, or the refund of the charges paid for performance of said analysis.
Virginia 460014
Page 1 of 6

Waypointz
ANALYTICAL
7621 Whitepi.ne Road, Richmond, VA 23237
Main 804-743-9401 ° Fax [phone]
www.waypointanalytical.com
Sample Summary Table
Report Number: 19-241-0004
Client Project Description: LINCOLNTON WWTP
Lab No Client Sample ID Matrix Date Collected Date Received Method Lab ID
I
67994
LINCOLNTON WWTP
Solids
08/28/2019
12:10
08/29/2019
67994
LINCOLNTON WWTP
Solids
08/28/2019
12:10
08/29/2019
SM-4500-NH3C
WTN
67994
LINCOLNTON WWTP
Solids
08/28/2019
12:10
08/29/2019
9045D
WTN
67994
LINCOLNTON WWTP
Solids
08/28/2019
12:10
08/29/2019
4500NO3F-2011
WTN
67994
LINCOLNTON WWTP
Solids
08/28/2019
12:10
08/29/2019
6010D
WTN
67994
LINCOLNTON WWTP
Solids
08/28/2019
12:10
08/29/2019
SW-74718
WTN
67994
LINCOLNTON WWTP
Solids
08/28/2019
12:10
08/29/2019
SM-4500-NH3C TKN
WTN
67994
LINCOLNTON WWTP
Solids
08/28/2019
12:10
08/29/2019
SM-2540G •
WTN
WTN: Waypoint Analytical - TN, Memphis, TN, Certification: #1354
I
Page 2 of 6

Report Number: 19-241-0004
Account Number: 46467
Send To: Synagro Central LLC/ Lincolnton
Mary Brewer
284 Boger Road
Mocksville , NC 27028
Lab Number: 67994
Sample Id : LINCOLNTON WWTP
way two
ANALYTICAL
7621 Whitepine Road, Richmond,.VA 13237
Main 804-743-94of'o Fax [phone]
www.waypolnta n a locaLcom
Project: LINCOLNTON WWTP
REPORT OF ANALYSIS Date Sampled: 8/28/2019 12:10:00
Date Received: 08/29/2019 00:00
Date Reported: 09/09/2019
Total Solids *
1.66
ADM
08/30/2019 15:57
SM-254OG
Moisture *
98.30
ADM
08/30/2019 15:57
SM-2540G
Total Kjeldahl Nitrogen
7.29
72900
250
JPJ
09/06/2019 09:00
SM-4500-NH3C-TKN
Phosphorus
1.77
17700
50.0
JTR
09/05/2019 21:22
601 OD
Potassium
0.52
5230
50.0
JTR
09/05/2019 21:22
601 OD
Sulfur
0.58
5780
50.0
JTR
09/05/2019 21:22
6010D
Calcium
0.71
7130
250
JTR
09/05/2019 21:22
6010D
Magnesium
0.34
3440
50.0
JTR
09/05/2019 21:22
6010D
Sodium
0.19
1870
250
JTR
09/05/2019 21:22
601 OD
Iron
8600
50.0
JTR
09/05/2019 21:22
601 OD
Aluminum
9090
50.0
JTR
09/06/2019 21:22
601 OD
Manganese
221
5.00
JTR
09/05/2019 21:22
6010D
Copper
190
2.50
JTR
09/05/2019 21:22
6010D
Zinc
235
12.5
JTR
09/05/2019 21:22
6010D
Ammonia Nitrogen
3.65
36500
100
JPJ
09/06/2019 14:30
SM-4500-NH3C
Organic N
3.64
36400
250
09/06/2019 09:00
CALCULATION
Nitrate+Nitrite-N
<4.66
4.66
ZBD
09/04/201915:17
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
��
�i%�f�w
Our reports and letters are for the exclusive and confidential use of our clients, and may not be reproduced in whole or part, nor may any reference be made Pauric McGroary
to the work, the results, or the company in any advertising, news release, or other public announcements without obtaining our prior written authorization. Agronomist
Page 3 of 6

Report Number: 19-241-0004
Account Number: 46467
Send To: Synagro Central LLC/ Lincolnton
Mary Brewer
284 Boger Road
Mocksville , NC 27028
Lab Number: 67994
Sample Id : LINCOLNTON WWTP
Cadmium
Chromium
Nickel
Lead
Arsenic
Mercury
Selenium
pH
Molybdenum
Comments:
e.
W-aypoint
ANALYTICAL
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 11 Fax 804=271-6446
www.waypbintanalotaii.com
Project: LINCOLNTON WWTP
REPORT OF ANALYSIS Date Sampled: 8/28/2019 12:10:00
Date Received: 08/29/2019 00:00
Date Reported: 09/09/2019
<1.00
1.00
JTR
09/05/2019 21:22
601 OD
43.3
2.50
JTR
09/05/2019 21:22
601 OD
11.4
2.50
JTR
09/05/2019 21:22
601 OD
10.8
3.00
JTR
09/05/2019 21:22
601 OD
7.42
5.00
JTR
09/05/2019 21:22
601 OD
0.0433
0.0151
TJS
09/04/2019 13:52
SW-7471 B
<5.00
5.00
JTR
09/06/2019 21:22
6010D
6.9
JSL
09/04/2019 06:13
9045D
4.93
2.50
JTR
09/05/2019 21:22
6010D
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
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.
Pauric McGroary
Agronomist ,
Page 6

I
o�
Waypoint
ANALYTICAL
762i Whitepine Road, Richmond, VA 23237
Main 804-743-9401 ° Fax [phone]
wwwmaypointa nalytica l.co m
Cooler Receipt Form
Customer Number: 46467
Customer Name: Synagro Central LLC/ Lincolnton
Report Number: 19-241-0004
Shipping Method
0 Fed Ex 0 US Postal 0 Lab
UPS 0 Client 0 Courier
0 Other:
Thermometer ID:
Shipping container/cooler uncompromised?
0 Yes
0 No
Number of coolers received1
Custody seals intact on shipping container/cooler?
0 Yes
0 No
Not Required
Custody seals intact on sample bottles?
0 Yes
0 No
Not Required
Chain of Custody (COC) present?
0 Yes
0 No
COC agrees with sample label(s)?
0 Yes
0 No
COC properly completed
0 Yes
0 No
Samples in proper containers?
0 Yes
0 No
Sample containers intact?
0 Yes
0 No
Sufficient sample volume for indicated test(s)?
• Yes
0 No
All samples received within holding time?
0 Yes
0 No
Cooler temperature in compliance?
0 Yes
0 No
Cooler/Samples arrived at the laboratory on ice.
Samples were considered acceptable as cooling
process had begun.
0 Yes
0 No
Water - Sample containers properly preserved
0 Yes
0 No
N/A
Water - VOA vials free of headspace
0 Yes
0 No
N/A
Trip Blanks received with VOAs
0 Yes
0 No
N/A
Soil VOA method 5035 — compliance criteria met
0 Yes
0 No
0 N/A
(— High concentration container (48 hr) F— Low concentration EnCore samplers (48 hr)
High concentration pre -weighed (methanol -14 d) F— Low conc pre -weighed vials (Sod Bis -14 d)
Special precautions or instructions included? 0 Yes • No
Comments:
Signature: lBrandi Watson Date & Time: 08/29/2019 13:57:21
Page 5 of 6

SAMPLING LOG #Illllllllltlllllllllllhllllllllllllllllll[llllllllllllllilllld! a�T-00°Q
p� p ¢� �a r� Svnapr. Control Ll C7 Uncolntr n 29 2019
CUSTOMER: S li I1V/�1�77df O ''� LINCOLNTON WWTP 13:54:34
PROJECT MANAGER: _ kle-x T"o��
Phone: ( 33 �) 7-03
ASS, INC. C Hn,1t.t OF f tl i'TCJ©Y
RECORD D sa i Y ;I
RECORD.
t•,i;13
st that the proper field sampling procedures
were sed during the collection of these samples.
SAM R
A & L CUSTOMER
LAB # SAMPLE I.D.
SAMPLING
LOCATION
SAMPLE
TYPE
# OF
CONTAINERS
SAMPLING
METHOD METHOD
DATE TIME
PRESERVED SHIPPED
Relinquished by Sampler:
�-----
to Time
Recieved: by:
REMARKS:
I
Relinquished by:
Date Time
Recieved by:
Relinquished by:
Date Time
Recieved by:
SPECIAL INSTRUCTIONS:
b14
AIL
For
monitoring purposes.
PO#
SAMPLE
ANALYSIS REQUEST'
I.D.
SLI
SL2
NH4-N
NO3 N
Organic
N
Cd
Cr
NI
Pb
As
H 9
Se
P H
CaCO3
equiv.
Volatile
Solids
Mo
Cl
NO2 N
r
L�„�JnT'en
1 / �
n�
�
�
ln�
n,0
P-
P0
l,,��q
kt�
1400
1000
P0
9109
6�
tiLl: total 5otias (Moisture), Total Kjeldahl Nitrogen, Phosphorus, and Potassium
SL2: Basic Test SL1 plus Sulfur, Calcium, Magnesium, Sodium, Iron, Aluminum, Manganese, Copper and Zinc
Page 6

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

RESIDUALS SOURCE FACILITY SUMMARY
Applicant's name: City of Lincolnton
Status
Code
Facility Permit Holder
Facility Name
County
Permit Number
Maximum Dry Tons Per Year
Current b
Proposed
R
City of Lincolnton
Lincolnton WTP
Lincoln
NC008588
300
300
R
City of Lincolnton
Lincolnton WWTP
Lincoln
NC0025496
1300
1300
I Status Code for source facility are: ♦ N (New) ® R (Renewed) o M (Modified) ♦ D (Deleted)
b The amount of residuals currently permitted for distribution, land application, or disposal (Le, not applicable to new facility).
SUMMARY FOR FORM: RSC 06-16 Page 1

DIW-
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
RESIDUALS SOURCE CERTIFICATION
FORM: RSC 06-16
I. RESIDUALS SOURCE -GENERATING FACILITY INFORMATION (See Instruction B.):
1. Facility Name: Lincolnton WTP
2. Facility permit holder is: Federal, State,Local Government, or [ Private.
Facility permit issued by: Div. of Water Resources, Div. of Environmental Health,
or Other (explain:
3. Facility contact person and title: Robert Pearson
Complete mailing address: P.O. Box 617
City: Lincolnton State: NC Zip: 28093
Telephone number: 104) 736-8970 E-mail address: rpearson n,lincolntonnc.org
4. Facility physical address: 1338 Reepsville Rd
City: Lincolnton State: NC Zip: 28093
Coordinates: Latitude: 35' 26' 56" Longitude: 81' 15' 34"
Datum: NAD83 Level of accuracy: Second
Method of measurement: Map
5. Purpose of the facility:
treatment of municipal wastewater, treatment of 100% domestic wastewater,
treatment of potable water, treatment of 100% industrial wastewater,
treatment of industrial wastewater mixed with domestic wastewater,
(approximate percentages: F 1 % industrial and = % domestic)
other (explain: F I).
6. Does the facility have an approved pretreatment program: Yes ❑ No
7. Facility permitted/design flow: no limit and facility average daily flow: 265,000 gallons
_
8. Average amount of residuals being generated at this facility 3 00 dry tons per year.
9. Specify the following regarding treatment and storage volumes available at the facility:
Type and volume of residuals treatment: One Storage Lagoon 400,000
Type and volume of residuals storage (i.e., outside of residuals treatment units): N/A
H. RESIDUALS QUALITY INFORMATION (See Instruction C.):
1. Specify if residuals are regulated under:
[] 40 CFR Part 503 or 40 CFR Part 257.
Note: Only residuals that are generated during domestic/municipal wastewater treatment processes are regulated under 40
CFR Part 503, otherwise, the residuals are regulated under 40 CFR Part 257.
2. Specify if residuals are defined under 15A NCAC 02T.1102(6) as:
Biological M Non -Biological
Note: Biological residuals are residuals that have been generated during the treatment of domestic wastewater, animal
processing wastewater, or the biological treatment of industrial wastewater (biological treatment is a system that utilizes
biological processes including lagoons, activated sludge systems, extended aeration systems, and fixed film systems).
FORM: RSC 06-16 Page 1 of 5

3. Hazardous Waste Determination: Complete the following to demonstrate that the residuals are non -hazardous under
RCRA: (Note - this item does not have to be completed for facilities that are less than 0.5 MGD in design flow that treat
100% non -municipal, domestic wastewater only)
a. Are the residuals listed in 40 CFR §261.31-§261.33: [[ yesno.
If yes, list the number(s):
b. Specify whether or not the residuals exhibit any of the characteristics defined by 40 CFR §261.21-
261.24: [ yes no.
Fill in the following tables with the results of the latest toxicity characteristic leaching procedure (TCLP) analysis as
well as those for corrosivity, ignitability, and reactivity:
Laboratory: Shealy Environmental and Date of analysis: 9/26/2019
Passed corrosivity test: yes no. pH: s.u. (2 < pH < 12.5)
Passed ignitability test: yes ❑ no. Flashpoint: 140 OF (> 140°F)
Passed reactivity test: M yes Ono. HCN: nd mg/kg (<250) & H2S: nd mg/kg (<500)
TCLP Parameter
Limit
(mg/1)
Result
(mg/1)
TCLP Parameter
Limit
(mg/1)
Result
(mg/1)
Arsenic
5.0
nd
Hexachlorobenzene
0.13
nd
Barium
100.0
nd
Hexachloro-1,3-Butadiene
0.5
nd
Benzene
0.5
nd
Hexachloroethane
3.0
nd
Cadmium
1.0
nd
Lead
5.0
nd
Carbon Tetrachloride
0.5
nd
Lindane
0.4
nd
Chlordane
0.03
nd
Mercury
0.2
nd
Chlorobenzene
100.0
nd
Methoxychlor
10.0
nd
Chloroform
6:0
nd
Methyl Ethyl Ketone
200.0
nd
Chromium
5.0
nd
Nitrobenzene
2.0
nd
m-Cresol
200.0
nd
Pentachlorophenol
100.0
nd
o-Cresol
200.0
nd
Pyridine
5.0
nd
p-Cresol
200.0
nd
Selenium
1.0
nd
Cresol
200.0
nd
Silver
5.0
nd
2,4-D
10.0
nd
Tetrachloroethylene
0.7
nd
1,4-Dichlorobenzene
7.5
nd
Toxaphene
0.5
nd
1,2-Dichloroethane
0.5
nd
Trichloroethylene
0.5
nd
1,1-Dichloroethylene
0.7
nd
2,4,5-Trichlorophenol
400.0
nd
2,4-Dinitrotoluene
0.13
nd
2,4,6-Trichlorophenol
2.0
nd
Endrin
0.02
nd
2,4,5-TP (Silvex)
1.0
nd
Heptachlor and its Hydroxide
0.008
nd
Vinyl Chloride
0.2
nd
FORM: RSC 06-16 Page 2 of 5

4. Metals Determination: Complete one of the following tables (i.e., as applicable) to demonstrate that the residuals do not
violate the ceiling concentrations for metals regulated under 15A NCAC 02T .1105.
a. For Distrihtition/Land Application: Fill in the following table with the results of the latest analyses (i.e., on a dry weight
basis) for the following metal parameters:
Laboratory: Shealy Environmental and Date of analysis: 10/08/2019
Parameter
Ceiling
Concentration Limits
(Class-4 & ClassB)
(mg/kg)
Monthly Average
Concentration Limits
(Class A Only)
(mg/kg)
Result
(mg/kg)
Arsenic
75
41
3.6
Cadmium
85
39
nd
Copper
4,300
1,500
6.4
Lead
840
300
nd
Mercury
57
17
nd
Molybdenum
75
n/a
nd
Nickel
420
420
nd
Selenium
100
100
nd
Zinc
7,500
2, 800
nd
b. For Surface Disposal Unit (landfill): Fill in the following table with the results of the latest analyses (i.e., on a dry weight
basis) for the following metal parameters:
Laboratory: = and Date of analysis:
Distance from Disposal
Unit to Boundary to
Closest Property Line
(meters, check one)
Arsenic
(mg/kg)
Chromium
(mg/kg)
Nickel
(mg/kg)
> 0 but < 25
30
200
210
> 25 but < 50
34
220
240
> 50 but < 75
39
260
270
> 75 but < 100
46
300
320
> 100 but < 125
53
360
390
> 125
62
450
420
Result (mg/kg)
FORM: RSC 06-16 Page 3 of 5

5. Nutrient/Micronutrient Determination: Complete the following:
a. Total solids: 4.37 %.
b. Fill in the following table with the results of the latest analyses (i.e., on a dry weight basis) for the following nutrient and
micronutrient parameters:
Laboratory: Shealy Environmental and Date of analysis: 10/08/2019
Parameter
Result
(mg/k9)
Aluminum
710
Ammonia -Nitrogen
660
Calcium
nd
Magnesium
nd
Nitrate -Nitrite Nitrogen
9.1
pH (Standard Unit)
6.8
Phosphorus
6900
Potassium
250
Sodium
3100
Total Kjeldahl Nitrogen
3500
c. Using the results listed in Item II. 5b. above, calculate the sodium adsorption ration (SAR): 0.52i
[Note: If residuals contain SAR of 10 or higher, the applicant shall obtain recommendations from the local Cooperative'
Extension Office, the Department of Agriculture and Consumer Services, the Natural Resource Conservation Service, a
North Carolina Licensed Soil Scientist, or an agronomist, prior to land application of residuals. The recommendations shall
address the sodium application rate, soil amendments (e.g., gypsum, etc.), or a mechanism for maintaining site integrity
and conditions conducive to crop growth].
d. Specify the mineralization rate to be used in calculating the plant available nitrogen (PAN) of the residuals: 20 %. This
rate is a (check one): M default value, or ❑ actually established.
If the residuals are not generated from the treatment of municipal or domestic wastewater, explain or provide technical
justification as to why the selected default value is appropriate to be applied to these residuals: F
e. Calculate the PAN for the residuals (i.e., on a dry weight basis) and fill the results in the following table:
Application Method
First (11t) Year PAN
Five -Year
Maximum Adjusted PAN
(mg/kg)
(mg/kp)
Surface
.36
.71
Injection/Incorporation
.36
.71
6. Other Pollutants Determination: Specify whether or not there are any other pollutants of concern in the residuals and provide
the results of the latest analyses: ( I
FORM: RSC 06-16 Page 4 of 5

7. Pathogen Reduction: Per 15A NCAC 02T.1106, specify how residuals will meet the pathogen reduction requirements:
a. For Distribution/Land Application of Class A or Equivalent.
❑ A fecal coliform density that is demonstrated to be less than 1,000 MPN per gram of total dry solids,
or
❑ A salmonella sp. density that is demonstration to be less than 3 MPN per 4 grams of total dry solids.
AND one of the followings (except for non -biological residuals):
[� Alternative 1 [15A NCAC 02T.1106(b)(3)(A)] - Time/Temperature Compliance.
Alternative 2 [15A NCAC 02T.1106(b)(3)(B)] - Alkaline Treatment.
❑ Alternative 3 [15A NCAC 02T.I 106(b)(3)(C)] - Prior Testing for Enteric Virus/Viable Helminth Ova.
❑ Alternative 4 [15A NCAC 02T. I 106(b)(3)(D)] - No Prior Testing for Enteric Virus/Viable Helminth Ova.
❑ Alternative 5 [15A NCAC 02T. 1 106(b)(3)(E)-(K)] - Process to Further Reduce Pathogens (PFRP).
Specify one: ❑ composting, ❑ heat drying, ❑ heat treatment,
El thermophilic aerobic digestion, [] beta ray irradiation,
gamma ray irradiation, or ❑ pasteurization.
b. For Land Application of Class B:
0 Alternative 1 [15A NCAC 02T.1106(c)(1)] - Fecal Coliform Density Demonstration.
❑ Alternative 2 [15A NCAC 02T.I 106(c)(2)] - Process to Significantly Reduce Pathogens (PSRP).
Specify one: ❑ aerobic digestion, ❑ air drying, 0 anaerobic digestion,
El composting, or ❑ lime stabilization.
c. For Surface Disposal:
❑ Select One of the Class A or Equivalent Pathogen Reduction Alternatives in Item II. 7a. above.
Select One of the Class B or Equivalent Pathogen Reduction Alternatives in Item II. 7b. above.
Exempt - If Daily Cover Alternative is chosen in Item II.8. below [15A NCAC 02T.1106(a)(2)].
❑ Not Applicable - Non -Biological Residuals with NO Domestic Wastewater Contribution.
8. Vector Attraction Reduction (VAR): Per 15A NCAC 02T.1107, specify how residuals will meet the VAR requirements:
Alternative 1 [15A NCAC 02T.1107(a)(1)] - 38% Volatile Solids Reduction (Aerobic/Anaerobic Digestion).
❑� Alternative 2 [15A NCAC 02T.I 107(a)(2)] - 40-Day Bench Scale Test (Anaerobic Digestion).
❑ Alternative 3 [15A NCAC 02T.1107(a)(3)] - 30-Day Bench Scale Test (Aerobic Digestion).
Alternative 4 [15A NCAC 02T.I 107(a)(4)] - Specific Oxygen Uptake Rate Test (Aerobic Digestion).
[� Alternative 5 [15A NCAC 02T.1107(a)(5)] - 14-Day Aerobic Processes.
Alternative 6 [15A NCAC 02T.I 107(a)(6)] - Alkaline Stabilization.
Alternative 7 [15A NCAC 02T. I 107(a)(7)] - Drying of Stabilized Residuals.
❑ Alternative 8 [15A NCAC 02T.I 107(a)(8)] - Drying of Unstabilized Residuals.
Alternative 9 [15A NCAC 02T. I 107(a)(9)] - Injection.
Alternative 10 [15A NCAC 02T. 1 107(a)(1 0)] - Incorporation.
0 Alternative for Surface Disposal Units Only - Soil/Other Material Cover [15A NCAC 02T.I 107(b)(2)].
21 Not Applicable - Non -Biological Residuals with NO Domestic Wastewater Contribution.
Note: For animal processing residuals, only alternatives 9 or 10 may be chosen due to the nuisance conditions that typically
occur when these residuals are applied and left on the land surface.
FORM: RSC 06-16 Page 5 of 5

RAW WATER
RAW WATER PRETREATMENT
_J INTAKE
AIR
RAW WATER
L
FL
CONTROL VALVE
CHEMICAL
STORAGE
0
ULU
ZI.-LIJ
LU3.�
I
*.:c
WR
RAW
PUMP STA ION
RESERVOIR/
PRESETTLING
BASIN
RAW WATER
PUMPNSTATION
O. 1
MEW
SOUTH FORK CATAWBA RIVER
vY
...... ....
J
LAB/ADMIN.
TO DISTRIBUTION
BACKWASH
HOLDING
LAGOON
BASINS
SLUDGE
DEWATERING
"Client relationships are
built on trust and service.
This project is a prime
example of working
together and jointly
selecting a cost effective
solution."
Donald T. Garbrick, PE
President

Alex Fox
.+rom:
Robert W. Pearson<[e-mail]>
Sent:
Tuesday, October 22, 2019 9:19 AM
To:
Alex Fox
Subject:
RE: WTP
Attachments:
DOC102219-10222019091818.pdf
Let me know if you need anything else.
Sludge is generated by the pretreatment and sedimentation processes. The sludge for
pretreatment and sedimentation processes is automatically collected and discharged to a
sludge holding lagoon. The filter backwash is discharged to the sludge holding lagoon,
The combined sludge and backwash flows are gravity thickened. The thickened sludge is
then pumped to a sludge dewatering process. The dewatering process uses a centrifuge to
dewater the sludge. The overflow from the dewatering process is returned to the lagoon.
The lagoon is decanted using a floating decanter. The overflow is dechlorinated and
discharged to the South Fork Catawba River.
Water Resources Director
City of Lincolnton
Water Treatment Plant
Office: [phone]
Cell: [phone]
Fax: [phone]
robertpearson(@.ci.lincolnton.nc.us
JE�szr the ch0 Moun6,iks.Near Perfect.
From: Alex Fox [mailto:[e-mail]]
Sent: Monday, October 21, 2019 7:01 AM

t
}VICINITY MAP
COUNTY: Lincoln
e
t 9t iu '�� � � )d t � �'t'°• i
T005
Em
OWNER(S): City of Lincolnton WTP

I
I
Residuals Sampling Plan
City of Lincolnton Land Application Program (WTP)
Nutrient and Metal Analysis
WTP
Sampling Point:
Lagoon
Sampling Frequency:
Annually
Sample Type:
Composite
Lab:
Waypoint Enviromental
Pathogen Reduction
N/A
Sampling Point:
Sampling Frequency:
Sample Type:
Lab:
Vector Attraction Reduction N/A
Sampling Point:
Sampling Frequency:
Sample Type:
Lab:
TCLP/RCI
WTP
Sampling Point: Lagoon
Sampling Frequency: Once per permit cycle
Sample Type: Composite
Lab: Summit Environmental Technologies Inc.

CITY OF Lincolnton PERMIT RENEWAL
QUANTITATIVE JUSTIFICATION FOR RESIDUALS PRODUCTION RATE
The following is a record of the annual land application volume for the City of
Lincolnton water treatment plant:
Year Dry Tons Land Applied
2018 60.72
2017 0
2016 0
2015 14.09
2014 0
The current permitted volume (300 dry tons per year) is greater than the anticipated need
for the coming years. The primary outlet for this material is the landfill with land
application being option b. The extra tonnage allows them to have the option to move all
of their material to fields if they so choose while covering farther expansion.

Client:Synagro Laboratory ID:UI06072-002
Description: Lincolnton WTP Matrix: Solid
Date Sampled:09/05/2019 % Solids: 3.03 09/07/2019 0416
Date Received: 09106/2019
Inorganic non-metals
Run Prep Method
Analytical Method
Dilution Analysis Date Analyst
Prep Date
Batch
1
(% Solids) SM 2540G
1 09/07/2019 0416 MDD
28205
1
(Ignitability) 1010A
1 09/26/2019 1330 SLC
30162
1
(Paint Filter) 9095B
1 09/15/2019 1540 HET
1
(pH) 9045D
1 09/09/2019 2037 HET
28337
1
(Reactive Cya) 7.3.3
1 09/11/2019 2056 MSG
09/09/2019 0934
1
(Reactive Sul) 7.3.4
1 09/10/2019 1655 HET
09/09/2019 0934
CAS Analytical
Parameter
Number Method
Result Q
LOQ
DL
Units
Run
% Solids
SM 254OG
3.03
%
1
Ignitability (Pensky-Martens Closed -Cup)
1010A
>140
140
0
° F
1
Paint Filter Test
9095B
Fail H*
pass/fail
1
Soil pH measured in water
@ 22 ° C
9045D
6.6
su
1
Reactive Cyanide
7.3.3
ND
50
mg/kg
1
Reactive Sulfide
7.3.4
100
50
mg/kg
1
TCLP Volatiles
Run Prep Method
Analytical Method
Dilution Analysis Date Analyst
Prep Date
Batch
Leachate Date
1 131115030B
8260D
10 09/14/2019 0340 JTH
28924
09/12/2019 1814
CAS Analytical
Parameter
Number Method
Result Q
LOQ
DL
Units
Run
Benzene
71-43-2 8260D
ND
0.050
0.0040
mg/L
1
2-Butanone (MEK)
78-93-3 8260D
ND
0.10
0.020
mg/L
1
rbon tetrachloride
56-23-5 8260D
ND
0.050
0.0040
mg/L
1
Iorobenzene
108-90-7 8260D
ND
0.050
0.0040
mg/L
1
Chloroform
67-66-3 8260D
ND
0.050
0.0040
mg/L
1
1,2-Dichloroethane
107-06-2 8260D
ND
0.050
0.0040
mg/L
1
1,1-Dichloroethene
75-35-4 8260D
ND
0.050
0.0040
mg/L
1
Tetrachloroethene
127-18-4 8260D
ND
0.050
0.0040
mg/L
1
Trichloroethene
79-01-6 8260D
ND
0.050
0.0040
mg/L
1
Vinyl chloride
75-01-4 8260D
ND
0.010
0.0040
mg/L
1
Run 1 Acceptance
Surrogate
Q % Recovery Limits
Bromofluorobenzene
110 70-130
1,2-Dichloroethane-d4
115 70-130
Toluene-d8
120 70-130
TCLP Semivolatiles
Run Prep Method
Analytical Method
Dilution Analysis Date Analyst
Prep Date
Batch
Leachate Date
1 1311/3520C
8270E
1 09/16/2019 1631 JCG
09/13/2019 1657 28844
09/10/2019 2043
CAS Analytical
Parameter
Number Method
Result Q
LOQ
DL
Units
Run
LOQ = Limit of Quantitation B = Detected in the method blank E = Quantitation of compound exceeded the calibration range DL = Detection Limit
ND = Not detected at or above the DL N = Recovery is out of criteria P = The RPD between two GC columns exceeds 40% J = Estimated result < LOQ and > DL
u — ni if of hnlriinn fimc \A/= Po rfori nn wof w inhf ha is
ily Environmental Services, Inc.
/antage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www.shealylab.com
Page 7 of 13

Client:Synagro Laboratory ID: U106072-002
Description: Lincolnton WTP Matrix: Solid
Date Sampled:09/05/2019 % Solids: 3.03 09/07/2019 0416
Date Received: 0910612019
TCLP Pesticides
Run Prep Method Analytical Method Dilution Analysis Date Analyst Prep Date Batch Leachate Date
1 1311/3520C 8081E 1 09/18/2019 0523 DAL1 09/15/2019 1543 28959 09/10/2019 2043
CAS Analytical
Parameter
Number Method
Result Q
LOQ
DL
Units
Run
Chlordane
57-74-9 8081B
ND
0.0040
0.0015
mg/L
1
Endrin
72-20-8 8081 B
ND
0.00040
0.00015
mg/L
1
Heptachlor
76-44-8 8081 B
ND
0.00040
0.00015
mg/L
1
Heptachlor epoxide
1024-57-3 8081 B
ND
0.00040
0.00016
mg/L
1
Methoxychlor
72-43-5 8081B
ND
0.0016
0.00021
mg/L
1
Toxaphene
8001-35-2 8081B
ND
0.0080
0.0030
mg/L
1
Run 1 Acceptance
Surrogate
Q % Recovery Limits
Decachlorobiphenyl
77 20-131
Tetrachloro-m-xylene
72 26-132
TCLP Metals
Run Prep Method
Analytical Method Dilution Analysis Date Analyst
Prep Date
Batch
Leachate Date
1 1311/3010A
6010D 1 09/12/2019 0259 LLL
09/11/2019 1726
28648
09/10/2019 2043
1 131117470A
7470A 1 09/13/2019 1320 KSH2
09/12/2019 1455 28691
09/10/2019 2043
CAS Analytical
Parameter
Number Method
Result Q
LOQ
DL
Units
Run
Arsenic
7440-38-2 6010D
ND
0.15
0.025
mg/L
1
Barium
7440-39-3 6010D
0.097 J
0.25
0.031
mg/L
1
dmium
7440-43-9 6010D
ND
0.050
0.0060
mg/L
1
romium
7440-47-3 6010D
ND
0.10
0.013
mg/L
1
Lead
7439-92-1 6010D
ND
0.10
0.047
mg/L
1
Mercury
7439-97-6 7470A
ND
0.0020
0.00091
mg/L
1
Selenium
7782-49-2 6010D
ND
0.20
0.085
mg/L
1
Silver
7440-22-4 6010D
ND
0.10
0.021
mg/L
1
Footnote(s): `Paint Filter: 64mL collected;
LOQ = Limit of Quanlitation B = Detected in the method blank E = Quantitation of compound exceeded the calibration range DL = Detection Limit
ND = Not detected at or above the DL N = Recovery is out of criteria P = The RPD between two GC columns exceeds 40% J = Estimated result < LOQ and > DL
u = nut of holding time W = Reported on wet weight basis
y Environmental Services, Inc.
antage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www.shealylab.com
Page 9 of 13

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QB Vaa'�fage Pain_ ®rice
AfesfColumbia, South Caa;clina 213172 •
Telephone.No, (803) a Al-9700 Fax hfo, (843) 791-911-1
weprsheaIyiah.rnnt
Number
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[@Ndii-Hszard FMmrrst:ik QSkn.lmtsnt
[1 rd3�d' ®.Rash (Rumu �p::aTy� 7 days ? r Llrcas
D Return to c1lent. plaposal by lab
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`:. f: I gWF,.ha f; ;anptnr _.._
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arra� oleo is are ITtadc
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SHEALY ENVIRONMENTAL SERVICES, INC.
s
t 5"illy Euvlrrn,no:nljl Sgrrim, Inc, of ]
__- DovuID=Ndm1ur.1AF. DISV_t4 P� 0rI
�ffcaVve Lt�e; R�'10IR
SRIU.Ple Relceipt Cheddist (SRC)
Client: Syrlagro
Cooler Inspected b ,'dtttc; nLtN + 9f6'1 ? lot UI0607^
2pR5 ofre¢eipt;
❑ Sl:S'r'I ❑ a3ent j� IJPS FedF.x. Luther —
Yes
No
I_ tYcae custody wins present on the cooler?
Yes
l4a
NA 2_ If c�rstod seals were resei1 +titre die inticrattd unbrukcn?
4 Strip ID. NA
Cltlodno Strip ID: NA Tested by, M-A
Original temperature upon reCript 1 Derived (Cvrm'cted} temperat?,re upon reseiFt °ISQIid Snap Cup tI�: 19-1636
27.1 r'27.1 oC NA j'N- A OC, NA IN?l tram, NA ,INA T —
Nletitod 13Tcmperature Alank Against Botties [R isun IA; S iR Gun Currcctiion F=,Ipr; 0 °C
Method of Coolant: 0 'L4 c: ice ❑ Ice packs 0 Dry ice ®C•taree
0 No
ffy�s
ElNA
3 iftcmperaiure yr�
vfatly cler exceedec[ fi3O'C, wuS Pru. ect MawagerNodfied?
Plri was Nntificd by; pbonc l eniai face -to -line (circle ernNA
❑NA
d, 1s the conimemial conrier's paekinQ slip a aehcd to this fiwrr7'?
YES
• [T_l q N�
S. Were: propffr custody prnccdurgs {*Clinqu9slterl4rccivctl} follov,•ed? -
Ycs LJ No
6. "Were sptnplc Ii)s I i ai;d on the COC?
Yes 0 No
7. Were sam l.c IDs ]iSlz[I on all samp� a contalfivrs?
YeS Na
&. Was collw6un date & time liste l un the COC? —
Yes ONO
9, Was collec#ian date & time listed an all sample containerb?
Yes Ej No
10, Vd all cont—abler ]abet informatlon (ID, date, time) agrto witi5 the Ct?C?
i'es .l No
I I. Were lasts to be inrfonned lislvd on the COC?
Ycs Na
12. Did all surnPJeS atliva in die proper containers for each test and,'or in good condition
(unbroken, lids on, etc)?
Yes 1Vo
13. Was ailegtattte sample volume Lygilable?
Yes ❑ No
14. Were all satnptes received widurl 1 � the holdnig time or 4� hours, wlticliever tames first?
Ycsany-
No
c, _ _•Sam
_.._.
1-3, were (circle-
samples cAnlaitters misSimg; excess cane) sore lev Not listed on C6[:?
NTo
NA
16_ For 110A acid RSK-175 satnples, were buhbles present � °`p4,�-51Zu''r (!/;'or 6mm in diameter)
m anv of the VOA viale?
No
*Yb
_ NA
17, u era all DR,.Olmetals.'natriedll samples received ar a P14 of< 2?
No
ONA
i 8. �5cere all ey;rnide sgmplcs i�ce9vcd at a H > 12 and sulfide simples nece l Ved at a SH
Nc,
M NA
l9- WON all applies le NHS N. c} aRtdelpheftoY 15 (•c MmVL) camp es raft q Fresidual
t0 No Ny 20. Were olient remarks?iegttests (Le, INtrosted dilutionsi -M% 41SDdesignations, etc.•)
correctlytranser;hcd fmal the COC iatu the coninwrit section in LIMS?1C0 2I, Was the uot_enumber listed oii the coRiRincr label? If ves QutNA
_ - reservation (h•4tlst ba (omplelml far any samples) in-;;q1 �ctly prAncrved nr with Jle!adspace.)
hT'{ _were raC@ivC'cl inCat only p7eseavcYl and were adjusted accordingly
receiving witli. NA mt_,ofcircleone;12SO11, HNO3.Nt;l. NaDH ttsitt SR # PdA
eservation NA [f more llirrrt one press native is necded,llluase note in ilia, corritncnts below,
._ v�era rereivedw•ith bubbles>, mm in diallieter.
aniplt:5(5) NA wcr>= ra alved with TRC > 0.5 n&L (C4tl9 is no j pod war,;
adjusted acaeat'd'angly in sample receiving yr ith audinut tlii(tgraifate (Na;5.03) With Shealy ID: Nil
SK bajwdc labels applied kv DM- N Date.- 9,r6f19
Comments: "Lincolnturt" betle forN&M exploded in cooler.
Shealy Environmental Services, Inc.
106 Vantage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www.shealylab.com
Page 13 of 13

SHEALY ENVIRONMENTAL SERVICES, INC.
Report of Analysis
Synagro
12701 Lancaster Hwy
Pineville, NC 28134
Attention: Alex Fox
Project Name: Lincolnton WTP
Lot Number:UJO1004
Date Completed:10/08/2019
10/09/2019 10:04 AM
Approved and released by:
Lab Director - Greenville: Lucas Odom
PCCREp
`ge00�
ACCPEDIT ED
Da— u�—
The electronic signature above is the equivalent of a handwritten signature.
This report shall not be reproduced, except in its entirety, without the written approval of Shealy Environmental Services, Inc.
Shealy Environmental Services, Inc.
106 Vantage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www.shealylab.com
Page 1 of 7

Client:Synagro Laboratory ID: UJ01004-001
Description: Lincolnton WTP Matrix: Solid
)ate Sampled:09/30/2019 1215 % Solids: 4.37 10/01/2019 2358
ate Received:10101/2019
Inorganic non-metals
Run Prep Method
Analytical Method
Dilution Analysis Date Analyst
Prep Date
Batch
1
(% Solids) SM 2540G
1 10/01/2019 2358 HET
30629
1 350.1
(Ammonia - N ) 350.1
1 10/08/2019 1735 DFR
31315
1
(Nitrate - N) 9056A
1 10/03/2019 0320 GMH
30885
1
(Nitrite - N) 9056A
1 10/03/2019 0320 GMH
30886
1
(Phosphorus) 365.1
10 10/07/2019 1652 DMA
10/07/2019 1135 31146
1
(Soil pH meas) 9045D
1 10/02/2019 2033 HET
30806
1 351.4
(TKN) 351.2
1 10/04/2019 1030 DMA
10/03/2019 2058 30934
CAS Analytical
Parameter
Number Method
Result Q
LOQ
DL
Units
Run
% Solids
SM 254OG
4.37
%
1
Ammonia - N (gas diffusion)
350.1
660
23
12
mg/kg
1
Nitrate - N (soluble)
9056A
3.0 J
11
0.56
mg/kg
1
Nitrite - N (soluble)
9056A
6.1
4.6
0.44
mg/kg
1
Phosphorus
7723-14-0 365.1
6900
1100
230
mg/kg
1
Soil pH measured in water @
21.5 o C
9045D
6.8
su
1
TKN
351.2
3500
570
570
mg/kg
1
CVAA
Run Prep Method
Analytical Method
Dilution Analysis Date Analyst
Prep Date
Batch
1 74718
7471 B
1 10/08/2019 1122 KSH2
10/07/2019 1458 30721
CAS Analytical
Parameter
Number Method
Result Q
LOQ
DL
Units
Run
rcury
7439-97-6 7471E
ND
1.8
0.42
mg/kg
1
ICP-AES
Run Prep Method
Analytical Method
Dilution Analysis Date Analyst
Prep Date
Batch
1 3050B
601 OD
1 10/07/2019 0128 LLL
10/04/2019 0920 30717
CAS Analytical
Parameter
Number Method
Result Q
LOQ
DL
Units
Run
Aluminum
7429-90-5 6010D
710
150
56
mg/kg
1
Arsenic
7440-38-2 6010D
3.6 J
5.6
1.9
mg/kg
1
Cadmium
7440-43-9 6010D
ND
1.9
0.47
mg/kg
1
Calcium
7440-70-2 6010D
ND
1900
230
mg/kg
1
Chromium
7440-47-3 6010D
ND
3.7
0.93
mg/kg
1
Copper
7440-50-8 601OD
6.4
3.7
1.7
mg/kg
1
Iron
7439-89-6 601OD
390
37
17
mglkg
1
Lead
7439-92-1 601OD
ND
3.7
1.7
mg/kg
1
Magnesium
7439-95-4 601OD
ND
1900
230
mg/kg
. 1
Manganese
7439-96-5 6010D
120
5.6
2.2
mg/kg
1
Molybdenum
7439-98-7 6010D
ND
15
3.7
mg/kg
1
Nickel
7440-02-0 6010D
ND
15
3.9
mg/kg
1
LOQ = Limit of Quantitation 8 = Detected in the method blank E = Quantitation of compound exceeded the calibration range DL = Detection Limit
ND = Not detected at or above the DL N = Recovery is out of criteria P = The RPD between two GC columns exceeds 40 % J = Estimated result < LOQ and > DL
- ^ut of holding time W = Reported on wet weight basis
ly Environmental Services, Inc.
lantage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www.shealylab.com
Page 3 of 7

Chain of Custody
Miscellaneous Documents
Shealy Environmental Services, Inc.
106 Vantage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www.shealylab.com
Page 5 of 7

SHEALY ENVIRONMENTAL SERVICES, INC.
sAr�]y Lrt'i.�nreenra(r1i6S5 Inc. Yag: l or I
Du zuncot Numl..rr; 3'1��'W t 9C-14 TtFectiw Ewe: 6i'2r-rJ I a
Sample Receipt Cheeldist (SRQ
Client SyMkGR0 Coolerinspecred bv,`date; cxtt r' 1"1-2419 Lat{1` UJO1004
Means ofreocipt: ❑ SESI El
Client ❑ UPS Q FedEx other.
❑ Y esl
01N'0
1. Wcrc custody seals present on tljc cooler ?
Yes
Nol
V1 NA
12. If oustody seals -were P- sent, were they rota; t and unbroken?
RFI Strip i ID: NA
Chlorine S.rip ID: NA - Tested by, >4A
Original temperatwe upon receipt; Dcrived (Cornectexi) tempc:rtture upon m ipt %Sot:d Snap -Cup ID. 19-I616
4.1 14.1 ,C NA f NA 'C NA ,+N A re NA f NA oC
Method: ❑Teml ;ratune Blatlk Wj lgainst Bottles IR Gun ID, 5 IR 43urr Crlrnction Factor: 0 °C
Method of c oolant: W] Wet % ❑ lcc Tacks © Dry I4c ❑ None
El " es ❑ No
3, 1Fternperaturetll`a,tty' uaulc.7 cxc�.dedb_il°C._ 1vAs Froje��t 144amtagerNooiliuE?
NA ~
Phil was Nrlti FLA by; phone.) email } face-to,face (circle r)ni•).
Yes
E] No
L] NA
4. Is the comirwmia. courier's packing slip Washed to this form?
® Yes
ONO
.
5. Derr prupur custody prnc:edtlres (relinquished-'rel;;,ived) followed?
o Ycs
0 Nt7
16. Were sainple II]s lisped an [ha C'i7t"r'
7. Were sample IN listed oil all swnplc wntainers'.
0 Yes
E 9 io
Yes
❑ No
8. Was co! lecrion dstia & time listed on the COC? --
Yes
No
9, Was oollection date & 0mo listed on all sample containers?
0 yes
❑ No
10. laid all container label information 0D., date', tinge} agree with the COC?
Yes
❑ Ni?
I L Were tests to be performed, listed on the COC?
Yes
® No
12. Did all somplcs arrive in the proper containers for such test ati&or.in good condition
(unbroken, lids on, etr rt
Yes
No
13. was 4140quate sample voluTnr, ava€lable 7
WY-5
No
-
14. Were all SUMPICS rccei 'ed within �j the itoldirlc time or 48 haum, whichever Comes first?
Yrs
No
Were any samples containers missinp$xcess (circle one) sam alas Not listed on CQC2
Yes
❑ No
❑ NA
16, For VQA and RSK 175 s. niplr 5, wm- anbbEe prc�errt - «pca-size" Na"or 6mm in diamate:}
in any ofthcVOA vials?
❑ Ycs
lwln
;VA
- --
.17_ ti "em al.I L►RC�+•metulo'nutrient sample,; rnoo[ ed at a %a,af -27
❑ Yes El No
( NA 1S. Were all cyanide sampler mceived at a pH -- 12 ;sod sulfide samples received at a pH'- 9?
❑ Yes ❑ItiTv
RA 79. ti here all applicable: lVFiy�i};1U?4}anideiphenol?G25 < O,5x'q+'L) samplez dree oFrrsidual
Ctilorinc'?
❑ Yes ❑ No
20. Wera l:licLlt rema.P1i5�+rNucsis. (i.e. requested dilations M8iMSD dcsiganatians: et,
®NA
correctly trafiscriWd from tha Coe into the contmr;,trt so, -don in UMS?
Yes a
71, Was the owto number listed on the cone nee label? II' ycF, onote V NA
$unll}IL Presert�tioa (�.'IuSt be canrpleteil Iur an}' .sampte(S} iticorrectEy prt�erved yr v,�th heaclspace.} •
Samplc(s) NA
WM received Lleoirectly pa-seivett rind wtre a4)usted a wordingly
in sample aece�iving with NA_rnL ofctrcle: onG: MSQ4,1 NO3, FICI, Na0lI using SR . I^iA
Time of prwcryalion NA. If niere than ori�- pre€ei-vative is nccded, please risks in the comments below.
Suinple(s) WA
were rwzi%-cd with btiftics >6 mni in diamtcr.
Samples(s) NA were rxeitied with TRC > 0.5 m L (If C9 is n a;s wid -wrc
ingly in
ac.justed awoM
sarriplc rcx civing witli sodium thiosulfate (N:t,S,i}�) wM 5hza[y ID: NA
� SR baronde labels applied la �- LKEi �
pP } . Date: 10-D ]-_019
Shealy Environmental Services, Inc.
106 Vantage Point Drive West Columbia, SC 29172 [phone] Fax [phone] www.shealylab.com
Page 7 of 7

State of North Carolina
Dr- 1. W, t. Department of Environmental Quality
Division of Water Resources
Division of Water Resources LAND APPLICATION SITE CERTIFICATION
INSTRUCTIONS FOR FORM: LASC 06-16
Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted, the Applicant shall submit one original and two copies of the application and
supporting documentation
For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting Unit
General — This certification provides detailed information of receiving sites for land application of Class B residuals (may include
water treatment plant or other type residuals) in accordance with 15A NCAC 02T .1100. Do not submit this certification for review
without a corresponding application form (FORM: RLAP 06-16 or FORM: SDR 06-16).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Land Application Site Certification (FORM: LASC 06-16):
® Submit the completed and appropriately executed Land Application Site Certification (FORM: LASC 06-16) form. Please
do not make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments
to the application may be made, as long as the attachments are numbered to correspond to the section and item to which they
refer.
® For new or renewed permits, submit the requested information for all land application sites.
❑ For modified permits, submit the requested information for only those sites that are new, transferred or affected by the
proposed modification.
Land Application Site Information:
® The status of the land application site with respect to this residuals land application program must be provided in table I. The
status categories and their corresponding codes are as follows:
♦ New (N) ♦ Renewed (R) ♦ Modified (M) s Transferred (T) 0 Deleted (D)
® Attach the following in accordance with each status code:
Status Code
Required Item
N
R
T
M
H
County Board
Notification. doc
t
Land Owner
Agreement
(If applicable)
t
Setback Waiver
Agreement
An updated vicinity/setback map in accordance with the "Map Guidance
for Residuals Land Application Permits"
✓
✓
✓
A soils and agronomic evaluation in accordance with the "Soil Scientist
✓
Evaluation Policy"
INSTRUCTIONS FOR FORM: LASC 06-16 Page 1 of 3

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

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

LAM) APPLICATION SITE CERTIFICATION
Applicant's name: Town of Lincolnton
Land application sites currently certified: 686.95 net acres and Total to be certified: F 4 net acres.
I. LAND APPLICATION SITE INFORMATION (See Instruction B):
Status
Code'
Site/Field ID
s
Landowner()
Lessee(s) or
Operator(s)
Net Acres
Count Y
Crop(s) s
p()
Predominant Soil
Series
Nameb
Mappi
ng
Unit
D
C-LT-25-1
Jeff Carpenter
16.6
Lincoln
[�
D
NC-LT-25-2
Jeff Carpenter
4.2
Lincoln
D
NC-LT-25-3
Jeff Carpenter
6.2
Lincoln
D
NC-LT-25-4
Jeff Carpenter
13.0
Lincoln
D
NC-LT-25-5
Jeff Carpenter
27.9
Lincoln
D
NC-LT-25-6
Jeff Carpenter
13.6
Lincoln
D
NC-CL-02-1
Jeff Carpenter/Stanley
20.5
Cleveland
D
NC-CL-02-3
Jeff Carpenter/Stanley
2.8
Cleveland
D
NC-CL-02-4
Jeff Carpenter/Stanley
24.9
Cleveland
D
NC-CL-02-5
Jeff Carpenter/Stanley
11.7
Cleveland
D
NC-CL-02-6
Jeff Carpenter/Stanley
Cnrneffifer
3.7
Cleveland
D
NC-CL-02-7
Jeff Carpenter/Stanley
33.4
Cleveland
D
NC-CL-05-1
Le6n Leonliardt
12.7
Cleveland
D
NC-CL-05-2
Leon Leonhardt
11.3
Cleveland
D
NC CCL-05-3
Leon LeonhardU
23.9
Cleveland
D
NC-CL-OS-4
peon Leonhard
15.0
Cleveland
D
NC-CL-05-5
eon teonhardi
16.9
Cleveland
D
NC-CL-05-6
Leon Leonl�ar bdbd
13.6
Cleveland
D
NC-CL-05-7
1eonLeonardti
8.8
Cleveland
D
NC-CL-05-8
Leon Leonhard
1
13.3
Cleveland
FORM: LASC 06-16 Page 1

LAND Al 1 LICATION SITE CERTIFICATION
D
NC-CL-05-9
Q eon Leon�ar UdUd
18.9
Cleveland
D
NC-CL-05-10
I on-) eonhardti
11.8
Cleveland
D
NC-CL-05-11
Leon_Leonhcrd�
31.3
Cleveland
D
NC-CL-0512
E;6fi:Teonbard�
27.5
Cleveland
D
NC-CL-05-13
Leon'L'e— onh�
4.5
Cleveland
D
NC-CL-05-14
Eeori Le� 'oiharO
8.2
Cleveland
D
NC-LT-7-1
Darrell Propst
L
26.9
Lincoln
D
C-LT-40-IA
James Houser
Darrell Propst
7.4
Lincoln
`�
1
D
NC-LT-401B
James Houser
Darrell Propst
31.8
Lincoln
D
NC-LT-122-1
Nick Woodruff
14.5
Lincoln
!
D
NC-LT-122-2
Nick Woodruff
14.8
Lincoln
D
NC-LT-122-3
Nick Woodruff
16.9
Lincoln
N
NC-LT-47-1
Randy Leatherman
10.36
Lincoln
Fescue, Corn, Soybeans, Wheat
Cecil
N
NC-LT-47-2
Randy Leatherman
[
13.28
Lincoln
Fescue, Corn, Soybeans, Wheat
Cecil
N
NC-LT-47-3
Randy Leatherman
i10
Lincoln
Fescue, Corn, Wheat, Beans
Cecil
N
NC-LT-47-4
Sue Gilbert
Pandy Leatherman
31
Lincoln
Fescue, Corn, Soybeans, Wheat
Cecil
N
NC-LT-47-5
Ginger Crisman
2 57 9
Lincoln
Fescue, Corn, Soybeans, Wheat
Cecil
Randy Leatherman
N
NC-LT-48-1
Mike Davis
�]
6.2
Lincoln
Fescue, Corn, Soybeans
Cecil
N
NC-LT-48-2
Mike Davis
10`95
Lincoln
Fescue
Cecil
N
NC-LT-48-3
Mike Davis
10 0
Lincoln
Fescue
Cecil
N
NC-LT-48-5
Mike Davis
26.53
Lincoln
Fescue
Cecil
N
NC-LT-48-7
Mike Davis
E 431,
Lincoln
Fescue
acolet
N
NC-LT-48-8
Mike Davis
2 8
Lincoln
Fescue
adiso a
N
NC-CA-48-4
Mike Davis
17.6
Catawba
Fescue
Cecil
N
NC-CA-48-6
Mike Davis
1 4,
Catawba
Fescue, Corn
Cecil
N
C-CA-48-10
Mike Davis
1-1.58;
Catawba
Fescue, Corn
Cecil
N
C-CA-48-11
Mike Davis
6.41
Catawba
Fescue, Corn
Cecil
FORM: LASC 06-16 Page 2

LAND APPLICATION SITE CERTIFICATION
N
NC-LT-49-1
Mickey Wesson
j
16.81
Lincoln
Fescue
Cecil
N
NC-LT-49-2
Mickey Wesson
23.00
Lincoln
Fescue
Cecil
N
NC-LT-49-3
Mickey Wesson
11.20
Lincoln
Fescue
Cecil
R
NC-CA-35-1
Sidney Turbyfill
Jeff Elmore
20�4;
Catawba
Fescue, Corn, Wheat, Beans
Ugyd
R
C-CA-35-2aj
Sidney Turbyfill
reff Elmore
.9
Catawba
Corn, wheat, Beans
Loyd
R
C-CA-35-2b
Sidney Turbyfill
"Jeff Ehn roe
Catawba
Fescue
0oy
R
C-CA-35-2c
Sidney Turbyfill
reffElmore
9.9
Catawba
Fescue
R
C-CA-35-3a
Sidney Turbyfill
§eff Elmore
41
Catawba
Fescue
L 1:0 yd'
R
C-CA-35-3b
Sidney Turbyfill
Jeff Elm roe
8^8'
Catawba
Fescue
Lloyd
R
NC-Cl-04-1
Dennis Martin
E5 3
Cleveland
Fescue
Cecil
R
NC-Cl-04-2
Dennis Martin
r0
Cleveland
Fescue
Cecil
R
NC-Cl-04-3
Dennis Martin
�15_2
Cleveland
Fescue
Cecil
R
Dennis Martin
¢5.7
Cleveland
Fescue
Cecil
R
FNC-CI-04-4
-LT-06-1
Mike Macomson
44.6
Lincoln
Fescue
LloydR
-LT-06-2
Mike Macomson
Lincoln
Fescue
Cecil
R
NC-LT-19-1
Chuck Waters
4_L8
Lincoln
Fescue,Sudex,Com
Lloyd
R
NC-LT-19-2
Chuck Waters
1'
Lincoln
Fescue
�loyd
R
NC-LT-19-3
Chuck Waters
13 l
Lincoln
Fescue
Rivervie
R
NC-LT-36
Jeff Lingerfelt, Joann
Lincoln Lincoln
Corn, Beans, Wheat„ Fescue
Cecil
R
NC-LT-36
Jeff Lingerfelt, Joann
[17_5
Lincoln
Corn, Beans, Wheat„ Fescue
Cecil
Leatherman
R
NC-LT-36
Jeff Lingerfelt, Joann
--
Lincoln
Coin, Beans, Wheat„ Fescue
Cecil
Leatherman
R
NC-LT-36
Jeff Lingerfelt, Joann
2 1
Lincoln
Corn, Beans, Wheat„ Fescue
Cecil
Leatherman
R
NC-LT-LTt�J�effLingerfelt,
Joann
Lincoln
Corn, Beans, Wheat„ Fescue
Ceciln
a Status Code for land application sites are: e N (New) ♦ R (Renewed) ♦ M (Modified) ♦ T (Transferred) ♦ D (Deleted)
b Soil Series Name (i.e. Appling, Cecil, etc.)
a Mapping Unit must be consistent with those used in the County Soil Survey (i.e. for a 2-8% slope Cecil in Anson County the mapping unit is Ce132)
H. WATERBODY AND CLASSIFICATIONS INFORMATION (See Instruction Q:
FORM: LASC 06-16 — Page 3

LAND Ai 1 LICATION SITE CERTIFICATION
Site/Field ID
Latitude
Longitude
Location
Datum
Location Method Code
Location Accuracy
Waterbody Subbasin and
Stream Index No.
Current and Class Proposed
NC-LT-47-1
350 34' 102"
810 26' 675"
NAD 83
MAP
Nearest Second
Indian Creels 11-129-8-(1)
WS-II;HQW
WS-II;HQW
NC-LT-47-2
350 33' 852"
810 26' 697"
NAD 83
MAP
Nearest Second
Indian Creek 11-129-8-(1)
WS-II;HQW
WS-II;HQW
NC-LT-47-3
35° 33' 866"
810 26' 518"
NAD 83
MAP
Nearest Second
Indian Creek 11-129-8-(1)
WS-II;HQW
WS-II;HQW
NC-LT-47-4
350 32' 659"
810 24' 232"
NAD 83
MAP
Nearest Second
Howards Creek 11-129-4
c
c
NC-LT-47-5
350 29' 974"
8 1 " 23' 972"
NAD 83
MAP
Nearest Second
Indian Creek 11-129-8-(1)
WS-II;HQW
WS-II;HQW
NC-CA-24-6
350 34' 139"
810 28' 573"
NAD 83
MAP
Nearest Second
Little Indian Creek 11-129-8-2
WS-II;HQW
WS-II;HQW
NC-CA-48-4
35° 34' 356"
810 26' 183"
NAD 83
MAP
Nearest Second
Indian Creels 11-129-8-(1)
WS-II;HQW
WS-II;HQW
NC-CA-48-10
350 33' 998"
81° 26' 842"
NAD 83
MAP
Nearest Second
Indian Creek 11-129-8-(1)
WS-II;HQW
E]WS-
NC-CA-48-11
35° 34' 150"
810 26' 813"
NAD 83
MAP
Nearest Second
Indian Creek 11-129-8-(1)
WS-II;HQW
WS-I4 I_HQ'W
NC-LT-48-1
350 32' 438"
810 25' 560"
NAD 83
MAP
Nearest Second
Indian Creek 11-129-8-(1)
WS-II;HQW
WS-II;HQW
NC-LT-48-2
350 32' 632"
810 26' 148"
NAD 83
MAP
Nearest Second
21-1-1
WS-II;HQW
WS-II;HQW
NC-LT-48-3
350 33' 676"
810 26' 924"
NAD 83
MAP
Nearest Second
Little Indian Creek 11-129-8-2
WS-II;HQW
WS II;HQW
NC-LT-48-5
350 31' 924"
810 25' 912"
NAD 83
MAP
Nearest Second
Little Indian Creek 11-129-8-2
WS-II;HQW
WS-II;HQW
NC-LT-48-7
350 30' 941"
810 24' 332"
NAD 83
MAP
Nearest Second
Indian Creek 11-129-8-(1)
WS-II;HQW
WS-II;HQW
NC-LT-48-8
350 33' 927"
810 27' 363"
NAD 83
MAP
Nearest Second
WS-II;HQW
WS-II;HQW
NC-LT-49-1
350 32' 31.23"
810 28' 36.02"
NAD 83
MAP
Nearest Second
Little Indian Creek 11-129-8-2
WS-II;HQW
WS-II;HQW
NC-LT-49-2
350 32' 12"
810 28' 20.06"
NAD 83
MAP
Nearest Second
Little Indian Creek 11-129-8-2
WS-II;HQW
WS-II;HQW
NC-LT-49-3
350 32' 5.19"
810 28' 23.09"
NAD 83
MAP
Nearest Second
Little Indian Creek 11-129-8-2
WS-II;HQW
WS-II;HQW
Note: Please keep the site information (I.) and waterbody information (II.) of the same field on the same page.
FORM: LASC 06-16 Page 4

State of North Carolina
PVDepartment of Environmental Quality
.....ems=
Division of Water Resources
'91vlsion of Water �Resources ^ 15A NCAC 02T .1100 — LAND OWNER AGREEMENT
FORM: LOA 06-16
Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted, the Applicant shall submit one original and two copies of the application and
supporting documentation
For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting Unit.
General — This document is an agreement between the Applicant and land owner(s) of residuals receiving sites for land application of
Class B residuals (may, include water treatment plant or other type residuals) in accordance with 15A NCAC 02T .1100. Do not
submit this agreement for review without a corresponding application form (FORM: RLAP 06-16).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Lan wner Agreement (FORM: LOA 06-16):
PJ�Submit the completed and appropriately executed Land Application Site Certification (FORM: LASC 06-16) form. Please
do not make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments
to the application may be made, as long as the attachments are numbered to correspond to the section and item to which they
refer.
Prepare a separate agreement for each set of land application sites that are owned or operated by an entity other than the
Aplicant.
W
copy of the completed and appropriately executed agreement must be provided to the landowner and the lessee/operator.
AGREEMENT FOR THE LAND APPLICATION OF RESIDUALS TO PRIVATELY OWNED LAND
The undersigned landowners or his repr sentative herebyf ermits:
Applicant's name: l ' a 41 L, 1 TOf
hereinafter referred to as the Permittee, to land apply residuals from the following facility(ies) onto the following land
application site(s) (i.e., see attached setback maps) in accordance with the stipulations and restrictions as given in this
Agreement:
Site/Field ID
Lease
es/no
(Y )
Land Use or
Cropping Patterns
PP g
Intended Use of Crops
Residuals Source
(optional)
Special note
(no-till/over-seed/
pasture)
Alc
1:�5CqL AS Lf
/
t,101R r
The landowner or his representative receives, in consideration, full use of the nutrient value of the applied residuals while the
Permittee receives, in consideration, the use of the land application site(s) described above for the disposal of the residuals.
s Agreement shall remain in effect for the length of the Division's permit for the residuals land application program and
shall be renewed each time this permit is renewed.
The undersigned landowner or his representative and the Permittee agree to abide with the following restrictions and
stipulations until such time as written notification, given 30 calendar days in advance, modifies or cancels this Agreement.
FORM: LOA 06-16 Pnap 1 „fq

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

Landowner's Certification:
I certify that I am a deeded landowner of the above -referenced land application site(s) and am authorized to make decisions
f ! regarding the use of the land application site(s) on behalf of other deeded landowners OR that I am otherwise authorized, through
a power of attorney or other legal delegation, to make decisions regarding the use of the land application site(s) on behalf of the
deeded landowners. I certify that the above -referenced land application site(s) are not included in any waste disposal contract or
agreement with another municipality, contractor, or other permitted entity. Furthermore, I certify that I have read this Agreement,
understand the stipulations, restrictions, alternatives for water supply wells inside the compliance boundary, acknowledgement of
field transfer, and do hereby grant permission to the Permittee to land apply residuals to the land application site(s) as specified
herein.
C ,r
Landowner name: ! C 0'> e I/ 'A
Address: ! T 3 V I c °-�, f J c7 j C r� % R C`/
City: 144 State: s e C Zip:
Phone: 33,6- 7/ 3 — 69 2e a E-mail address:
Signature:% Date:
NORTH CARQ'LINA,!, �Dpo.�: Q,
COUNTY
I, the undersigned Notary Public do hereby certify that G� (initials ��) personally
appeared before me this day, and, being duly sworn, stated that in his/her presence '8' ; , A# U&S S®mn signed
the attached document and acknowledged the due execution of the foregoing instrument.
WITNESS my hand and official seal this the 9� �=' day of i8cfob_�—, 20 B q
Signature and seal:
My commission expires:
Lessee's/Operator's Certification:
ROPE k�T �� ROTH
NOTARY PI ia(!�
GUILFORD COUNTY
STATE OF NORTH CAROLINA
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Lessee/operator name:
Address:
City:
Phone:
Signature:
Permittee's Certification:
State:
E-mail address:
Date:
Zip:
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Signing officia ame: /(d {�� r j (�J • ���� �,. SoN
Signature:)
FORM: LOA 06-16 Page 3 of 3

v
SITE SUMMARY
Lincolnton Land Application Program (WQ 00002712)
2T RULES
Site ID: NC-LT-49
Owners Name: Mickey Wesson
Address: 1434 North Brook # 3 School Rd
Vale, NC 28168
Phone: .[phone]
Operator: same
Address:
Phone:
Estimated Rye Based
Applicable Annual Predominant
Fields Acres Croo(s) PAN Limit (Ib/aclvr) Soil Series
1
16.8
escue pastur
157
Cecil CeB2
2
23.0
escue pastur
157
Cecil CeB2
3
11.2
escue astur
157
Cecil CeB2
TOTALS 51.0
Notes:
Date: 10/10/19

NCDA&CS Agn" -' Ic Division Phone:. (919) .733-2655 Website: www.n/ "Iov/agronomi/
ReportNo. F" - ` ;L006842
�%qLA L,q-.�,
Client: Michael Wesson
Advisor: Alex Fox
�;. Heavy Metals
I¢w
1434 N. Brooke III Sch Road
Vale, NC 28168
S na ro
Y 9
284 Boger Rd
k Soil Report Mehlich-3 Extraction
Mocksville, NC 27028
Sampled County: Lincoln
Links to Helpful Information
Client ID: 436921
Advisor ID: 501947
Sampled: 09/16/2019 Received: 09/27/2019 Completed: 10/02/2019 Farm: NC-Lt-49
Agronomist's Comments:
This report contains both routine soil test information as well as heavy metals data in a section labeled as Heavy Metals under soil test lab results.
Using Mehlich 3 as a
soil test extractant, background levels of these metals typically seen in NC soils when analyzed are as follows: arsenic (As)- 4.5 ppm, cadmium
(Cd)- 0.1 ppm, chromium
(Cr)- 0.2 ppm, lead (Pb)- 4.2 ppm, nickel (Ni)- 0.8 ppm, & selenium (Se)- 0.2 ppm (FY2005-2007). Although the above metals here are not believed to pose a concern for
plant growth, continue to monitor these and note where elevated above background levels.
Note any lime and fertilizer recommendations. Tissue
testing is advised where
soil pH is hi h as in sam les found here. Ja athi Kamalakanthan 10/212019
Sample ID: 01
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tons/acre) N P205
K20 Mg S Mn Zn
Cu B
Information
Lime History:
1-Fescue/OGrass/Tim, E 0.0 50-70 50
0 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-AI1 Mn-Al2 Zn-I Zn-AI
Cu-I Na ESP SS-1 NO3-N
0.46 1.27 7.5 88 0.9 6.5 43 52 63 22
28 193 125 82- 82
62 0.0
';Heavy'Metals. (parts, per million):' Arsenic, %'0'.1 Cadmium, 0.0
Nickel, . 0.5 Chromium,, 0.4 Lead,
4.0' Selenium; , 0.0
Sample ID: 02
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tons/acre) N P205
K20 Mg S Mn Zn
Cu B
Information
Lime History:
1-Fescue/OGrass/Tim, M. 0.0 120-200 0
0 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-Al2 Zn-1 Zn-Al
Cu-I Na ESP SS-1 NO3-N
0.46 1.03 9.5 89 1.1 6.3 64 106 59 24
97 96 70 234 234
265 0.1 1
Heavy Mefals'(parts per million): Arsenic; .0:1 Cadmium, 0.0 ',Nickel,
'0'.5. ' Chrorriiuni, 0.4" Lead,
2.9'- Selenium, '0;1-'
North Carolina
�rr h'j Y:I
TaLINCCO Trust Fund Coal lis%lon
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/ Report No. FY20-SL006842
Michael Wesson
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 time 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 i
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 -I 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.
Recommendations for small areas, such as home lawns/gardens, are listed in units of Ib/1000 sq ft. If you cannot find
the exact fertilizer grade recommended on the report, visit www.ncagr.gov/apronomi/obpart4.Mn-7A( ind information that
may help you choose a comparable alternate. For more information, read A Homeowner's Guide to Fertilizei
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-Al, 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/agronomUuvrsLhtm
Page 2 of 2
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
K2O
potash
Mg%
% CEC occupied by magnesium
MIN
mineral soil class
Mn
manganese
Mn-AI1
Mn-availability index for crop 1
Mn-AI2
Mn-availability index for crop 2
Mn-I
manganese index
M-0
mineral -organic soil class
N
nitrogen
Na
sodium
NO3-N
nitrate nitrogen
ORG
organic soil class
pH
current soil pH
P-1
phosphorus index
P2O5
phosphate
S-1
sulfur index
SS-1
soluble salt index
W/v
weight per volume
Zn-AI
zinc availability index
Zn-I
zinc index

APPLICATION
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GRAPHIC SCALE
1"=1,000'
1,000' 0 1,000'
i he compliance boundary is established either 250 ft from the residuals application area or 50 feet within
N C-LT-49
in the property boundary, whichever is closest to the application area. The review boundary is established
midway between the compliance boundary and the perimeter of the residuals application area. All
locations are approximate.
Fields 1-3

VICINITY MAP
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GRAPHIC SCALE
V = 4,000'
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The compliance boundary is established either 250 ft from the residuals application area or 50 feet within
N C-LT-49
in the property boundary, whichever is closest to the application area. The review boundary is established
midway between the compliance boundary and the perimeter of the residuals application area. All
locations are approximate.
Fields
IeIds 1-3

SYNAGRO, NEWTON CLASS B PERMIT
WQ 0003902
SOIL SCIENTIST CERTIFICATION
This is to certify that soil profile evaluations were conducted on the proposed application
sites for the Newton VWVTP project by Piedmont Environmental Associates, P.A. on
behalf of Synagro Central, LLC. The evaluations consisted of hand auger borings and
descriptions of the soils on the application sites. All hand auger borings included in this
package were either performed by me or under my direct supervision. All other work
performed for this permit application was conducted by Synagro Central, LLC.
G. Christopher Murray, L.S.S.
No. 1 284
Synagro, Newton VVWTP Project, Various Fields

Soil Profile Descriptions in Field Locations
Project: Uncolnton Permit (WQ 0002712) % Slope: 3%
Site: Mickey Wesson Farm Crop: Forage/Pasture
Field: Wesson Farm Field 1 Conducted By: GC Murray
Coordinates: 35.5435 N Date: 9/16/2019
-81.4790 W Soil'Series: Cecil
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Legend.
Texture
Structure Grade
Structure Type
Structure Size
s
sand
wk weak
gr
granular
f fine
I
loam
m moderate
pl
platy
med medium
si
silt
str strong
pr
prismatic
sil
silt loam
cpr
columnar
c
clay
abk
angular blocky
cl
clay loam
sbk
subangular blocky
Moist Consistency
scl
sandy clay loam
sg
single grained
fr friable
sl
sandy loam
ma
massive
vfr very friable
sicl
silty clay loam
fi firm
vfi very firm
Seasonal High Water Table:
Depth (") Type (apparent/perched)

I
I
I
I
I
Soil Profile Descriptions in Field Locations
Project: Lincolnton Permit (WQ 0002712) % Slope: 3%
Site: Mickey Wesson Farm Crop: Forage/Pasture
Field: Wesson Farm Field 2 Conducted By: GC Murray
Coordinates: 35.5351 N Date: 9/16/2019
I 81.4728 W Soil Series: Cecil
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Structure Grade
Structure Type
s l sand
wk weak
gr
granular
II loam
m moderate
pl
platy
sil silt
str strong
pr
prismatic
sill silt loam
cpr
columnar
c' clay
abk
angular blocky
cl, clay loam
sbk
subangular blocky
scl sandy clay loam
sg
single grained
sll sandy loam
ma
massive
sicl silty clay loam
I
I
Seasonal High Water Table:
Structure Size Depth (") Type (apparent/perched)
f fine
med medium
Moist Consistencv
fr friable
vfr very friable
fi firm
vfi very firm

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

North Carolina Department of Environmental Quality
Pat McCrory Donald R. van der Vaart'
Governor Secretary
Date: 8/2/2019
To: Name of Chairman to the Board of County Commissioners: Carrol Mitchem
Complete mailing address: 7868 Hallman Mill Road
City: Vale
State: NC Zip: 28168
County where land application sites are located: Lincoln
From: Applicant's name: Town of Lincolnton (on behalf of the Division of Water Resources in accordance with Session
Law 2013-340)
Contact person and title: Don Burkey Waste Water Superintendent
Complete mailing address: 600 W. Hwy 150 ByPass
City: Lincolnton State: NC Zip: 28093
Telephone number: [phone] E-mail address: [e-mail]
Subject: Notification of residual land application site proposal
This is to notify you that the Applicant listed above will be submitting an application to the Division of Water
Resources for the land application of residual solids to site(s) located in your county. During this review, the Division
will ensure that all federal and state regulations are enforced. Attached to this form is information regarding residuals-t°
generating sources and locations of the proposed land application sites. Please forward this letter and its associated
attachments to the appropriate Department within your County (i.e., Health or Environmental Health Department and
Planning Department) if applicable.
More information of the land application sites included in this application will be available at the following
Division of Water Resources Regional Office:
Name of appropriate regional office: NC DEQ Mooresville
Complete mailing address: 610 East Center Ave Suite 301
City: Mooresville
State: NC
Telephone number: [phone]
Expected date of application submission: 10/10/19
Zip: 28115
Should you desire to comment on this application, please do so no later than 30 calendar days following the
expected application submission date. If you have any questions or comments about this notification, or if you would like
more information, please contact the appropriate regional office at the telephone number provided above. Thank you in
advance for your attention to this matter.
Enclosures: Source Facility Summary
Land Application Site Summary
Maps
Non -Discharge Permitting Unit
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Phone: [phone] Internet: http://portal.nGdenr.orglweblwg
An Equal Opportunity Affirmative Action Employer —Made in part with recycled paper
FORM: CBN 06-16

Review Your Shipment DEtdis
Address ;Infonnatiori
Ship To
LINCOLN COUNTY `
Ship From
SYNAGRO PVIOCKSVIIIE
Return Address
SYNAGRO MOCKSVILLE
CARROLmrfdHEr,A;-.
ALD FOX.. -
ALEXFOX
7868 HALLMAN MILL RD .
•284 BOGER RD
284 0 - CiER RD
VALE NC2816a "
'
'.MOCKSVILLE, NC27028 _
MOCKSVILLE iJC27tt28
.United States '
.U,nited S,lafes`
United States
Telephone: "704 736-8473,
Telephone: [phone]
Telephone: [phone]fiB1
Fax:
Fax
Package Inform Ation
Dimensionsd
Tracking #� Weight . Insured Value Reference Numbers
packaging
1. 1Z51178WA210882254 .5 lbs UPS Letter g Reference#1-
Reference#2 - 20-2360-30-60-4310 50-0055
UPS_S_hippmg Barytes and Shipping QpticnS `
service
Next Day Air
shipment Date:,
10109/2D19
Shipping Fees Subtotal:
EE Sitm-i Shiobino Fees Subtotal DeMls . .
Additional Services
Canfumat owof Delivery:
Packag41: Delivery:Confirhiadof Adult Signature Requin

Tracking Details I UPS
Page 1 of 1
Proof of Delivery
Dear Customer,
This notice serves as proof of delivery for the shipment listed below.
Tracking Number
1Z51F78WA210882254
Weight
0.50 LBS
Service
UPS Next Day Air®
Shipped / Billed On
10/09/2019
Additional Information
Adult Signature Required
Delivered On
10/11/2019 11:31 A.M.
Delivered To
VALE, NC, US
Received By
WYLIE
Left At
Residential
Thank you for giving us this opportunity to serve you. Details are only available for shipments
delivered within the last 120 days. Please print for your records if you require, this information after
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Tracking results provided by UPS: 10/17/2019 11:59 A.M. EST
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SITE SUMMARY
Lincolnton Land Application Program (WQ 00002712)
Site ID: NC-CA-48
Owners Name: Mike Davis
Address: 7436 Reeps Grove Church RD
Vale, NC 28168
Phone: [phone]
Operator: same
Address:
Phone:
Estimated Rye Based
Applicable Annual Predominant
Fisids ArrPc rmn(cz1 PAM I imif /lhhrJvrl Q-1 C`orieo
4
17.6
escue pastur
157
Cecil CeB2
10
11.5
fescue, Corn
157
Cecil CeB2
11
6.4
fescue, Corn
157
Cecil CeB2
TOTALS 35.6
Notes:
Date: 10/10/19

ivision of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water resources
15A NCAC 02T .1100 — LAND OWNER AGREEMENT
FORM: LOA 06-16
Please use the following instructions as a checklist in -order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted, the Applicant shall submit one original and two copies of the application and
supporting documentation
For more information, visit the Water Quality Permitting Section's Non -Discharge Perm4feqg Unit.
General — This document is an agreement between the Applicant and land owner(s) of residuals receiving sites for land application of
Class B residuals (may include water treatment plant or other type residuals) in accordance with 15A NCAC 02T .1100. Do not
submit this agreement for review without a corresponding application form (FORM: RLAP 06-16).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Lan Owner Agreement (FORM: LOA 06-16):
Submit the completed and appropriately executed Land Application Site Certification (FORM: LASC 06-16) form. Please
do not make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments
to the application may be made, as long as the attachments are numbered to correspond to the section and item to which they
fer.
Prepare a separate agreement for each set of land application sites that are owned or operated by an entity other than the
plicant.
[A copy of the completed and appropriately executed agreement must be provided to the landowner and the lessee/operator.
AGREEMENT FOR THE LAND APPLICATION OF RESIDUALS TO PRIVATELY OWNED LAND, .
The undersigned landowner or his representative hereby permits:
Applicant's name: 4.4, L
hereinafter referred to as the Permittee, to land apply residuals from the following facility(ies) onto..thi,.following, land
application site(s) (i.e., see attached setback maps) in accordance with the stipulations and restrictions as given in this
Agreement:
Site/Field ID
Lease
es/no
(Y )
Land Use or
Cropping Patterns
PP� g
Intended Use of Crops
Residuals Source
(optional)
Special note
(no-till/over-seed/
pasture)
-L
Wo
}}
i�
��11 ti
The landowner or his representative receives, in consideration, full use of the nutrient value of the applied residuals while the
Permittee receives, in consideration, the use of the land application site(s) described above for the disposal of the residuals.
is Agreement shall remain in effect for the length of the Division's permit for the residuals land application program and
..,all be renewed each time this permit is renewed.
The undersigned landowner or his representative and the Permittee agree to abide with the following restrictions and
stipulations until such time as written notification, given 30 calendar days in advance, modifies or cancels this Agreement.
FORM: LOA 06-16 Page 1 of 3

I. STIPULATIONS:
1. The landowner or his representative shall not enter into any additional residuals application contracts or agreements with another permitted
entity for the site(s) specified by this Agreement.
2. Should the landowner or his representative lease or otherwise permit the use of the land application site(s) to a third party, the landowner shall
be responsible to ensure that the third party agrees and complies with the terms and conditions of this Agreement.
3. The landowner or his representative shall adhere to the provisions of this Agreement until all of the site restrictions (under Section II) are met(
4. Notification of cancellation of this Agreement shall be immediately forwarded to NCDENR-DWR, Non -Discharge Permitting Unit, 1617
Mail Service Center, Raleigh, NC 27699-1617.
5. The Permittee must request and obtain a permit modification from the Division prior to a transfer of the land application site(s) to a new
landowner. In addition, the current landowner shall give a notice to the new landowner that gives full details of the residuals applied at the
land application site(s).
6. The Permittee has provided the landowner or his representative with information and data concerning the residuals land application program,
including an analysis of constituents of the residuals, residuals application methods, schedules for typical cropping patterns, a description of
the equipment used by the Permittee.
7. The Permittee will provide the landowner or his representative with a copy of the residuals permit prior to commencement of any residuals
land application event and a copy of the results of each soil analysis.
8. If the soil pH of the land application site(s) is not maintained at 6.0 or greater, sufficient amounts of lime shall be applied to achieve a final
soil pH of at least 6.0, unless an agronomist provides information indicating that the pH of the soil, residuals and lime mixture is suitable for
the specified crop.
9. The landowner or his representative and the Permittee will agree on residuals application rates and schedules based on crop patterns, results of
soil samples, and the permitted application limits.
10. The landowner or his representative will provide the Permittee with information regarding the amount and analysis of other sources of
nutrients (e.g., fertilizer, unregulated animal waste, etc.) that have been applied to the land application site(s).
11. The landowner or his representative will inform the Permittee of any revisions or modifications to the intended use and cropping patterns for
the^land application site(s) prior to each planting season to enable the Permittee to amend this Agreement and schedule residuals land
applic ition events at appropriate periods.
12. Specific residuals land application area boundaries shall be clearly marked on the land application site(s) by the Permittee, the landowner, or
his representative prior to and during a residuals land application event.
13. The landowner or his representative hereby authorizes the Permittee, local officials, and State officials or their representatives to; enter and
inspect any property, premises, or place on or related to the land application site(s) at any reasonable time for the purpose of determining
compliance with the permit; establish monitoring facilities on or near the land application site(s) as required by the permit; copy any records
that must be kept under the terms and conditions of the permit; take necessary leachate, surface water, groundwater, or soil samples during the
term of. and 12 months after termination of, this Agreement.
II. I STRIC-R.j
1I, Appropriatga i ures must be taken by the Permittee and/or the landowner or his representative to control public access to the land
application s.ite,() during active use and for the 12-month period following a residuals land application.eyent..Such'controls may include the
Yel post :ofs8 that indicate the activities being conducted at the land application site(s).
2 titleslxakl ittst'be grazed on the land application site(s) for a 30-day period following a residuals land application event. Land application
sites that are to be used for grazing shall have fencing that will be used to prevent access during these periods after such residuals land
application events.
3. Food crops, feed crops, and fiber crops shall not be harvested for a 30-day period following a residuals land application event.
4. Food crops with harvested parts that touch the residuals/soil mixture and are totally above the land surface shall not be harvested for a 14-
month period following a residuals land application event.
5. Food crops with harvested parts below the surface of the land shall not be harvested for a 20-month period following a residuals land
application event when the residuals remain on the land surface "for four months or longer prior to incorporation into:the soil.
6. Food crops with harvested parts below the surface of the rand shall riot be Harvested f0t a 38-month period following;a residuals land
application event when the residuals remain on the land surface for less than four months prior to incorporation into the oil..
7. Turf grown on land where residuals are applied shall not be harvested for a 12-month period following a residuals land application event.
III. ALTERNATIVES FOR WATER SUPPLY WELLS INSIDE THE COMPLIANCE BOUNDARY: (please check one)
15A NCAC 02L .0107(d) prohibits water supply wells within the compliance boundary. However, 15A NCAC 02T..01'05(h) allows the
compliance boundary to be placed closer to the waste disposal area, such that the water supply well is situated' outside of thfe 'compliance
boundary provided the groundwater standards can be met at the newly -established compliance boundary. Please mark one of the following;
❑ A re -defined compliance boundary is needed for field(s) ID:
(Please include the rationale for the requested re -location of the compliance boundary and attach a map showing the ' newly 'pr(
compliance boundary to the application package)
❑ A re -defined compliance boundary is not needed for this site.
IV. ACKNOWLEDGEMENT OF FIELD TRANSFER: (if needed)
❑ The land application field(s) ID: is currently permitted under anothe
residuals land application program; Permit Number WQ: The land owner hereby acknowledge that by signing thi .
agreement, he/she is requesting that the field(s) be removed from the previously permitted residuals land application program and transferred
into the new Dromm;
(Name of the new program)
FnR ra• r n A nA-t r, Paae 2 of 3

Landowner's Certification:
I certify that I am a deeded landowner of the above -referenced land application site(s) and am authorized to make decisions
( regarding the use of the land application site(s) on behalf of other deeded landowners OR that I am otherwise authorized, through
a power of attorney or other legal delegation, to make decisions regarding the use of the land application site(s) on behalf of the
deeded landowners. I certify that the above -referenced land application site(s) are not included in any waste disposal contract or
agreement with another municipality, contractor, or other permitted entity. Furthermore, I certify that I have read this Agreement,
understand the stipulations, restrictions, alternatives for water supply wells inside the compliance boundary, acknowledgement of
field transfer, and do hereby grant permission to the Permittee to land apply residuals to the land application site(s) as specified
herein.
Landowner name: MoA4,0 6 t s
Address: 7�,3�. ,�QL��/1S �rdye d4
City: & State: /0— Zip: 9,qA1,k
Phone: ��� ,��/ E� 7Sd E-mail address: I "Ale—yi 5
Signature: ` /��Q,y Date:
NORTH CAROLINA, ,� �Dlv `E- 6:dU)ba COUNTY
J, the undersigned Notary Public do hereby certify that A iGiL re x (initials: 1) personally
appeared before me this day, and, being duly sworn, stated that in his/her presence �c fA&e_ i Uwe S signed
the attached document and acknowledged the due execution of the foregoing instrument.
WITNESS my hand and official se this.the #' day of ,f �oo b[Y 20 r4
Signature and seal:
My commission expires: t
NOTARY F - ,
GUILFORD
STATE OF NOR VN,
Lessee's/Operator's Certification:
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Lessee/operator name:
Address:
City: State: Zip:
Phone: E-mail address:
Signature: Date:
Permittee's Certification:
I certify that I have read this Agreement and do
Signing officia e: r';
Signature: ,Bl�
agree to abide by the stipulations and restrictions as specified herein.
Date: & //,f//
FORM: LOA 06-16
Pale 3 of 3

CA-48
Application Area (sf)
Application Area (ac)
Latitude
Longitude
4
769160
17.66
35' 34.356'N
81° 26.183'W
10
504408
11.58
35' 33.998'N
81' 26.842'W
11
279152
6.41
35' 34.150'N
81' 26.813'W
TOTAL
35.65

NCDA&CS Ag-' iic Division Phone: [phone] Website: www.--' 'Jov/agronomi/ Report No. "SL006845
¢ti •tclient: Mike Damp*�S Advisor: Alex Fox
Heavy Metals 7436 Reaps Grove Church Rd S na ro
Vale, NC 28168 284 Boger Rd
I
s`J Soil Report Mehlich-3 Extraction Mocksville, NC 27028
Sampled County: Catawba
Links to Helpful Information
Client ID: 502963 Advisor ID: 501947
Sampled: 09/16/2019 Received: 09/27/2019 Completed: 10/02/2019 Farm: CA-24
Agronomist's Comments:
This report contains both routine soil test information as well as heavy metals data in a section labeled as Heavy Metals under soil test lab results. Using Mehlich 3 as a
soil test extractant, background levels of these metals typically seen in NC soils when analyzed are as follows: arsenic (As)- 4.5 ppm, cadmium (Cd)- 0.1 ppm, chromium
(Cr)- 0.2 ppm, lead (Pb)- 4.2 ppm, nickel (Ni)- 0.8 ppm, & selenium (Se)- 0.2 ppm (FY2005-2007). Although the above metals here are not believed to pose a concern for
plant growth, continue to monitor these and note where elevated above background levels. Note any lime and fertilizer recommendations. Where soil test phosphorus (P) is
very high (P-1 > 100), crops will not respond to additional P applied.Tissue testing is advised where soil pH is high as in samples found here. Jagathi Kamalakanthan
10/2/2019
Sample ID: 09
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, E 0.0 50-70 0 0 0 0 pH$ 0 0 0
Note: 12 Note:
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% W/V CEC BS% Ac pH P-1 K-1 Ca% Mg% S-1 Mn-I Mn-All Mn-AI2 Zn-I Zn-AI Cu-I Na ESP SS-1 NO3-N
0.36 1.13 10.5 95 0.5 7.0 144 88 69 23 35 167 103 295 295 507 0.1 1
Heavy Metals (parts per million): Arsenic, 0.2 Cadmium, 0.0 Nickel, 0.6 Chromium, 0.4 Lead, 4.5 Selenium, 0.0
1 rrt C2,ol na
Tobacco Trust FL.rarl C1.Tar 11, F5. nia
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 ofA.ariculture

NCDA&CS Agronomic Division Phone: [phone] Website: www.ncagr.gov/agronomi/
Kepori No. r T 4U-0L0000'+J
Mike Dans
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 i
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%u Mg) is
an excellent source; 175 to 250 lb per acre alone or in a fertilizer blend will usually satisfy crop needs, SS -I 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.
Recommendations for small areas, such as home lawns/gardens, are listed in units of Ib/1000 sq ft. If you cannot find
the exact fertilizer grade recommended on the report, visit www ncagr gov/agronomi/obpart4.htmAsfind information that
may help you choose a comparable alternate. For more information, read A Homeowner's Guide to Fertilizei
Test Results
The first seven values [soil class, HM%, WN, CEC, BS%, Ac and pH] describe the soil and its degree of acidity. The
remaining 16 [P-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 ncagrgov/agronomi/uyrst.htm
Page 2 of 2
Report Abbreviations
Ac
exchangeable acidity
B
boron
BS%
% CEC occupied by basic cations
Ca%
% CEC occupied by calcium
CEC
cation exchange capacity
Cu-1
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-1
manganese index
M-O
mineral -organic soil class
N
nitrogen
Na
sodium
NO3-N
nitrate nitrogen
ORG
organic soil class
pH
current soil pH
P-1
phosphorus index
P205
phosphate
S-1
sulfur index
SS-1
soluble salt index
WN
weight per volume
Zn-Al
zinc availability index
Zn-I
zinc index

A
1
T r, *. "��d® ®�ta'�yY✓ ;' ., i rc•. 'k'"! x �„r ir''"'j
t
Y ,
Y
A"`t
INc a`F [', y'•Sy ® a l9>
{ D �'
�,� �� r i Jy d L f f
i i "�" • � is � S •i .' '}� 7 '-,. i...::
Aiv
n 4 t � rti
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x
4 , '` � � � � } � � 1, it � t� iry t ijj ,� "'• �, �F 1`tih€5 � : `

SOIL SURVEY
GRAPHIC SCALE
1" = 660'
660' 0 660'
,�he compliance boundary is established either 250 ft from the residuals application area or 50 feet within
in the property boundary, whichever is closest to the application area. The review boundary is established
midway between the compliance boundary and the perimeter of the residuals application area, All
locations are approximate.
N C-CA-48
Fields 10-11

0 TOPOGRAPHIC MAP
7�
• � �.r.✓ 1 i& F y �i
Ln
' �
Kegi � • Y
l j ,.
{-. � d � $ i °yam • �+,� � A4�
1 e`
\V
s
GRAPHIC SCALE
1"=1,000'
1,000' 0 1,000'
Se compliance boundary is established either 250 ft from the residuals application area or 50 feet within
N C-CA-48
in the property boundary, whichever is closest to the application area. The review boundary is established
midway between the compliance boundary and the perimeter of the residuals application area. All
locations are approximate.
Q
Fields 4, 10 CX 11

MAP
rVICINITY
S�
.
1 1
r
• ,` v r v
r.rr ..
1 1 i ! � \. i `r-1 '` -,�`, i) , X
`f✓ +'..- ^^�.�/ r�'^ (� ti tidy. \�I >
a �
:� r i'�D4 *A' /'� Ili �`r
�'T�'l
!i '� •\ if
ry � � 1
_ • ram-'; '4i1 ` i �/� r� :.. �' r 3 ;`:!� �_y� `'r r--��'l . y1' I� .-� y `I'
�
� �L,
.
/ l ,'�f. 1 ',�h ��.1. `i ` i.,.', _ r t,, { ? • ,, r�.y� i J f.c � J '`, r " -,., � -
"
,
� ^�.v
ram, V •x::i � �
� �^u .\ , �� � � r•��9 � � � , _
+gym L� ; ��
'r.
t ,� � . � I v s � � �•� `.•��
cro �
GRAPHIC SCALE
1" = 4,000'
4,0001 0 4,000'
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within
N C-CA-48
in the property boundary, whichever is closest to the application area. The review boundary is established
midway between the compliance boundary and the perimeter of the residuals application area. All
locations are approximate.
Fields 4,10 & 11

Soil Profile Descriptions in Field Locations
Project: Lincolnton Permit (WQ 0002712) % Slope: 3%
Site: Mike Davis Farm Crop: Forage/Pasture
Field:- Davis Farm Field 4 Conducted By: GC Murray
Coordinates: 35.5721 N Date: 9/16/2019
81.4347 W Soil Series: Cecil
a�
M
G
U
c
N .�
T n
O
L)
K
5
N
O
V
m
S
�
O
O
O
Q
2
5
N
m
S
m
A
V
0
U
x
rY
O
L
.%
S
L
�
PIEDMONT
ENVIRONMENTAL
A S X O C I A* i f. P. A.
LU
w
NIL
c� N
a C N
L allL O (n y
� +' Y G
3 O 7 N v N
L L L O 'U
A A A S A 11
Legend.
Texture
s
sand
I
loam
si
silt
sil
silt loam
c
clay
cl
clay loam
scl
sandy clay loam
sl
sandy loam
sicl
silty clay loam
Structure Grade
Structure Type
Structure Size
wk weak
gr
granular
f fine
m moderate
pl
platy
med medium
str strong
pr
prismatic
cpr
columnar
abk
angular blocky
sbk
subangular blocky
Moist Consistency
sg
single grained
fr friable
ma
massive
vfr very friable
fi firm
vfi very firm
Seasonal High Water Table:
Depth (") Type (apparent/perched)

Soil Profile Descriptions in Field Locations
Project: Lincolnton Permit (WQ 0002712) % Slope: 3%
Site: Mike Davis Farm Crop: Forage/Pasture
Field: Davis Farm Field 10 Conducted By: GC Murray
Coordinates: 35.5667 N Date: 9/16/2019
81.4472 W Soil Series: Cecil
v
o
0
O
O
o
w
T I
S
S
G�
W
O N
Lt
Q fA
m CD
F+
O O
OC
U
x
O
U
m
N
d
�-
U
PIEDMONT
EIiMROMMENTAL
ASSOCIA,rt3, P.A.
WLU
v
N . IL Q
U) F N
I C N
m
Ap
0-6
7.5YR 4/4
-
moist
sl
mod
I med
gr
fr
ns
np
Bt1
6-24
1 OR 4/6
-
-
-
-
moist
c
mod
med
sbk
fi
s
p
Bt2
34-42
1 OR 4/6
10YR 6/8
com
med
-
moist
cl
mod
med
sbk
fi
s
p
BC
42-48
1 OR 4/8
-
-
-
-
moist
scl
mod
med
sbk
fi
s
p
Legend.
Texture
s
sand
I
loam
si
silt
sil
silt loam
c
clay
cl
clay loam
scl
sandy clay loam
sl
sandy loam
sicl
silty clay loam
[�S�easonal.High Water Table:
Structure Grade Structure Type Structure Size Depth (") Type (apparent/perched)
wk weak gr granular f fine -
m moderate pl platy med medium
str strong pr prismatic
cpr columnar
abk angular blocky
sbk subangular blocky Moist Consistency
sg single grained fr friable
ma massive vfr very friable
fi firm
vfi very firm

t SITE SUMMARY
t
Lincolnton Land Application Program (WQ 00002712)
Site ID: NC-LT-48
Owners Name: Mike Davis
Address: 7436 Reeps Grove Church RD
Vale, NC 28168
Phone: [phone]
Operator: same
Address:
Phone:
Estimated Rye Based
Applicable Annual Predominant
Fields Acres Cron(s) PAN Limit (lb/ac/vr) Soil Series
1
6.2
escue pastur
157
Cecil CeB2
2
10.9
fescue
157
Cecil CeB2
3
10.0
fescue
157
Cecil CeB2
5
26.5
escue pasturi
157
Cecil CeB2
7
9.4
escue pastur
157
Cecil CeB2
8
24.8
fescue
126
Madison
TOTALS 87.9
Notes:
Date: 10/10/19

LT-48
Application Area (sf) '
Application Area (ac)
Latitude
Longitude
1
270105
6.20
35' 32.438'N
81' 25.560'W
2
477040
10.95
35' 32.632'N
81' 26.148'W
3
436497
10.02
35' 33.676'N
81' 26.924'W
5
1155577
26.53
35' 31.924'N
81° 25.912'W
7
410654
9.43
35' 30.941'N
81' 24.332'W
8
1081331
24.82
35° 33.927'N
81° 27.363'W
TOTAL
87.95

NCDA&CS Agin iic'Division Phone: [phone] Website: wwwa
,rgov/agrononii/ Report No. 1` ''`•SL006844
gt(JIIIJCk
Client: Mike [3W' Advisor: Alex Fox
o''
Heavy Metals
" r
7436 Reeps Grove Church Rd Synagro
Vale, NC 28168 284 Boger Rd
Soil Report Mehlich-3 Extraction
Mocksville, NC 27028
Sampled County: Lincoln
row
_
x'�'��r•Nti Links to Helpful Information
Client ID: 502963 Advisor ID: 501947
Sampled: 09/16/2019 Received: 09/27/2019 Completed: 10103/2019 Farm: NC-Lt-48
Agronomist's Comments:
This report contains both routine soil test information as well as heavy metals data in a section labeled as Heavy Metals under soil test lab results. Using Mehlich 3 as a
soil test extractant, background levels of these metals typically seen in NC soils when analyzed are as follows: arsenic (As)- 4.5 ppm, cadmium (Cd)- 0.1 ppm, chromium
(Cr)- 0.2 ppm, lead (Pb)- 4.2 ppm, nickel (Ni)- 0.8 ppm, & selenium (Se)- 0.2 ppm (FY2005-2007). Although the above metals here are not believed to pose a concern for
plant growth, continue to monitor these and note where elevated above background levels.
Note any lime and fertilizer recommendations. Where soil test phosphorus (P) is
very high (P-1 > 100), crops will not respond to additional P applied.Tissue testing is advised where soil pH is high as in samples found here. Jagathi Kamalakanthan
10/2/2019
Sample ID: 1
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tons/acre) N N05
K2O Mg S Mn Zn Cu B
Information
Lime History:
1- Fescue/OGrass/Tim, E 0.6 50-70 0
0 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 Clam, Mineral
HM% WN CEC BS% Ac pH P-1 K-1 Ca% Mg%
S-1 Mn-1 Mn-All Mn-Al2 Zn-1 Zn-AI Cu-1 Na ESP SS-1 NO3-N
0.36 1.17 9.9 89 1.1 6.4 281 49 64 23
37 195 126 475 475 551 0.1 1
Heavy'.Metals•(part`s'per million): Arsenic, 03 Cadmium, 0.0
Nickel, 0.6 Chromium, 0.3' -Lead, 3.4 Selenium,, 0.1
Sample ID: 2
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, E 1.4 50-70 0
10 0 0 0 0 0 0
Note: 12
2 - 0.0
Test Results [units - W/V in g/cm3; CEC and Na in meq/100 cm3; NO3-N in mg/dm3]:
Soil Class: Mineral
HM% W/V . CEC BS% Ac pH P-1 K-1 Ca"/o Mg%
S-1 Mn-1 Mn-All Mn-AI2 Zn-I Zn-AI Cu-1 Na ESP SS-1 NO3-N
0.41 1.06 9.6 84 1.6 5.9 135 43 57 24
44 133 89 371 371 356 0.1 1
Heavy Metals {parts'per`million): Arsenic, 0.2r - Cadmium, 0.0
Nickel, • 0.5 Chromium, .0.2. .Lead, 32. Selenium; 0.1
10"' Ca;�r�� ~'rya
ik ti+
Pt .lyttik 'Y
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 Aariculture
cca Truss Furad CmiriFssion

NCDA&CS Agronomic Division Phone:.[phone] Website: www.ncagr.gov/agronomi/
Report No. FY20-SL006844
Mike Dans
Page 2 of 4
Sample ID: 3
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tons/acre) N P205
K20
Mg S Mn
Zn
Cu
B
Information
Lime.History:
1 -Fescue/OGrass/Tim, E 1.3 50-70 10
70
0 20 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-1
Mn-All Mn-AI2 Zn-I
Zn-AI
Cu-I
Na ESP SS-1 NO3-N
0.41 1.14 6.1 76 1.5 5.7 70 19 54 20
24 123
83 69
69
128
0.1 2
Heavy Metals (parts per million):. - Arsenic, 0.1 Cadmium, 0.0
Nickel, D-.5
Chromium, 0.2 -
'Lead,
4.3 .
Selenium,,' 0.0
Sample ID: 4
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tons/acre) N P205
K20
Mg S Mn
Zn
Cu
Information
Lime History:
1- Fescue/OGrass/Tim, E 1.0 50-70 60
0
0 0 0
0
0:]B
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
0.46 1.09 7.3 84 1.2 6.1 38 53 58 22
38 120
81 92
92
141
0.1 1
Heavy Metals (parts per million): Arsenic, 0.1 Cadmium, 0.0
Nickel, 0.5
Chromium, ' 0.2
Lead,
3.5
Selenium,, .0.1
Sample ID: 5
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tons/acre) N P205
K20
Mg S Mn
Zn
Cu
B
Information
Lime History:
1- Fescue/OGrass/Tim, E 0.0 50-70 0
0
0 0 pH$
0
0
0
Note: 12 Note:
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-AI
Cu-I
Na ESP SS-1 NO3-N
0.56 1.18 12.5 95 0.6 6.9 159 123 58 32
44 226
139 380
380
311
0.1 1
Heavy'Metals.(parts per million)':. Arsenic, 013 Cadmium, 0.0
Nickel, 0.5
Chromium, 0.2
Lead,
3.7
Selenium,, 0.1

NCDA&CS Agr; ;ic Division Phone: [phone] Website: wwwx�
Report No. f''
.3L006844
Mike Dans
Page 3 of 4
Sample ID: 7 Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tons/acre) N P205
K20
Mg S Mn
Zn
Cu
B
Information
Lime History: 1- Fescue/OGrass/Tim, E 0.0 50-70 0
0
0 0 pH$
0
0
0
Note: 12 Note:
2 - 0.0
Test Results [units - W/V 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-I Ca% Mg%
S-1 Mn-I
Mn-All Mn-AI2 Zn-I
Zn-AI
Cu-I
Na ESP
SS-1 NO3-N
0.41 1.11 11.7 94 0.7 6.8 176 106 68 21
34 353
216 351
351
501
0.1 1
Heavy Metals -(parts per million): Arsenic, 0.2 Cadmium, 0.0
Nickel, 0.7
Chromium, 0.4
Lead,
3.2- '
Selenium,
0.0
Sample ID: 8
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tons/acre) N P205
K20
Mg I S Mn
Zn
Cu
B
Information
Lime History:
1- Fescue/OGrass/Tim, E 0.6 50-70 0
0
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-AI
Cu-I
Na ESP
SS-1 NO3-N
0.41 0.96 9.9 88 1.2 6.4 105 73 55 29
67 164
108 316
316
382
0.1 1
Heavy'Metals.(parts ;per million) Arsenic,. 0.l ' Cadmium,'-0 0
Nickel, �0.5.
Chromium, 0:2
Lead,
4.3,
_.Selenium;.
0.1. .
Sample ID: 10
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tons/acre) N P205
K20
Mg S Mn
Zn
Cu
B
Information
Lime History:
1- Fescue/OGrass/Tim, E 1.5 50-70 0
0
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-1
Mn-All Mn-AI2 Zn-I
Zn-AI
Cu-I
Na ESP
SS-1 NO3-N
0.51 1.10 7.2 76 1.7 5.7 172 81 55 15
63 139
93 220
220
478
0.1 1
Heavy Metals,(pprts per million): Arsenic, 0.2 Cadmium, 0.0
Nickel, , .0.6
Chromium,. 0.3 -
ILead,
4.2
�'.Seienium, .0.0,

NCDA&CS Agronomic Division Phone: [phone] Website: www.ncagr.gov/agronomi/
ReportNo. FY20-SL006844
Mike Dans
Page 4 of 4
Understanding the Soil Report: explanation of measurements, abbreviations and units
Recommendations
Report Abbreviations
Lime
Ac
exchangeable acidity
If testing finds that soil pH is too low for the crop(s) indicated, a time recommendation will be given in units of either
B
boron
ton/acre or Ib/1000 sq ft. For best results, mix the lime into the top 6 to 8 inches of soil several months before planting.
BS%
% CEC occupied by basic cations
For no -till or established plantings where this is not possible, apply no more than 1 to 1.5 ton/acre (50 Ib/1000 sq ft) at on
Ca%
% CEC occupied by calcium
time, even if the report recommends more. You can apply the rest in similar increments every six months until the full rate
CEC
cation exchange capacity
is applied. If MG is recommended and lime is needed, use dolomitric lime.
Cu-1
copper index
ESP
exchangeable sodium percent
Fertilizer
HM%
percent humic matter
Recommendations for field crops or other large areas are listed separately for each nutrient to be added (in units of
K-1
potassium index
lb/acre unless otherwise specified). Recommendations for N (and sometimes for B) are based on research/field studies
K2O
potash
for the crop being grown, not on soil test results. K-1and P-1 values are based on test results and should be > 50. If they
Mg%
% CEC occupied by magnesium
are not, follow the fertilizer recommendations given. If Mg is needed and no lime is recommended, 0-0-22 (11.5% Mg) is
MIN
mineral soil class
an excellent source; 175 to 250 lb per acre alone or in a fertilizer blend will usually satisfy crop needs, SS-1 levels appear
Mn
manganese
only on reports for greenhouse soil or problem samples.
Mn-All
Mn-availability index for crop 1
Mn-Al2
Mn-availability index for crop 2
Farmers and other commercial producers should pay special attention to micronutrient levels. If $, pH$, $pH, C or Z
Mn-
Mn-I
manganese index
mineral-organicmanganese
d soil class
notations appear on the soil report, refer to $Note: Secondary Nutrients and Micronutrients_ In general, homeowners do not
N
nitrogen
need to be concerned about micronutrients. Various crop notes also address lime fertilizer needs; visit
Na
sodium
ncagr.gov/agronomi/pubs.htm.
NO3-N
nitrate nitrogen
ORG
organic soil class
Recommendations for small areas, such as home lawns/gardens, are listed in units of Ib/1000 sq ft. If you cannot find
pH
current soil pH
the exact fertilizer grade recommended on the report, visit www.ncagr.pov/aaronomi/obaart4.html`fifsEind information that
P-1
phosphorus index
may help you choose a comparable alternate. For more information, read A Homeowner's Guide to Fertilizer.
P2O5
phosphate
S-1
sulfur index
Test Results
SS-1
soluble salt index
W/V
weight per volume
The first seven values [soil class, HM%o, W/V, CEC, BS%, Ac and pH] describe the soil and its degree of acidity. The
Zn-AI
zinc availability index
remaining 16 [P-I, K-I, Ca%o, Mg%, Mn-I, Mn-All, Mn-AI2, Zn-1, Zn-Al, Cu-I, S-1, SS -I, Na, ESP, SS -I, NO3-N (not routinel
Zn-I
zinc index
available)] indicate levels of plant nutrients or other fertility measurement. Visit www•ncapr.pov/apronomi/uyrst.htm

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V 1,000'
1,000- 0 1,000,
'he compliance boundary is established either 250 ft from the residuals application area or 50 feet within
N C-LT-48
in the.property boundary, whichever is closest to the application area. The review boundary is established
midway between the compliance boundary and the perimeter of the residuals application area. All
locations are approximate.
Fields 1 -2,5

TOPOGRAPHIC MAP
GRAPHIC SCALE
1"=1,000'
1,000' 0 1,000'
the compliance boundary is established either 250 ft from the residuals application area or 50 feet within
in the property boundary, whichever is closest to the application area. The review boundary is established
midway between the compliance boundary and the perimeter of the residuals application area. All
locations are approximate.
NC-LT-48
Fields 3 & 8

.9
VICINITY MAP
GRAPHIC SCALE
1" = 4,000'
4,000' 0 4,000'
he compliance boundary is established either 250 ft from the residuals application area or 50 feet within
in the property boundary, whichever is closest to the application area. The review boundary is established
midway between the compliance boundary and the perimeter of the residuals application area. All
locations are approximate.
If
N C-LT-48
Fields 1-3,5,7,8

1 SYNAGRO, LINCOLNTON WWTP CLASS B PERMIT
WQ 0002712
SOIL SCIENTIST CERTIFICATION
0
This is to certify that soil profile evaluations were conducted on the proposed application
sites for the Lincolnton VWVFP project by Piedmont Environmental Associates, P.A. on
behalf of Synagro Central, LLC. The evaluations consisted of hand auger borings and
descriptions of the soils on the application sites. All hand auger borings included in this
package were either performed by me or under my direct supervision. All other work
performed for this permit application was conducted by Synagro Central, LLC.
G. Christopher Murray, L.S.S.
No. 1284
Synagro, Lincolnton WWTP Project, Various Fields

Soil Profile Descriptions in Field Locations
Project: Lincolnton Permit (WQ 0002712)
% Slope: 3%
Site: Mike Davis Farm
Crop: Forage/Pasture
Field: Davis Farm Field 1_
Conducted By: GC Murray
Coordinates: 35.5409 N
Date: 9/16/2019
-81.4264 W
Soil Series: Cecil
w
w
N
R
0
s
V
o
a
7
d
C
UV
C •C
O
f..)
O
V
.0
Q
N_
f/)
O
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O
N
,C
�+
f!
d
d
d
X
U)
++
v
Gam'
C
C
w
C
N
0
n
PIEDMONT
ENWROMMENTAL
A s! O C i A r■ s, P. A.
w
Na U)
Q
C C1
v V N y
p V
•n •n S n n
Legend.
Texture
s
sand
I
loam
si
silt
sil
silt loam
c
clay
cl
clay loam
scl
sandy clay loam
sl
sandy loam
sid
silty clay loam
Seasonal High Water Table:
Structure Grade Structure Type Structure Size Depth (") Type (apparent/perched)
wk weak gr granular f fine - -
m moderate nl nlaty med medium
str strong pr prismatic
cpr columnar
abk angular blocky
sbk subangular blocky Moist Consistency
sg single grained fr friable
ma massive vfr very friable,
fi firm
vfi very firm

Soil Profile Descriptions in Field Locations
Project: Uncolnton Permit (WQ 0002712) % Slope: 3%
Site: Mike Davis Farm Crop: Forage/Pastur
Field: Davis Farm Field 2 Conducted By: GC Murray
Coordinates: 35.5439 N Date: 9/16/2019
-81.4358 W Soil Series: Cecil
N
�
0
0
U
C
c '
U
U
o
N .F+
O 0%
x
S-
m
++
c
a�
R
0
'O
.Q
Q
N
co
v
t�
W
°'
o
An
0
0
0
0
e PIEDMONT
ENVIRONMENTAL
A i 3 0 C 1 A T R;. P. A.
w
LLI
LU
N ya. +�-
(9 U)
N N
c
L L L 0 w
v v v U r
0 w w n S A
Legend.
Texture
s
sand
I
loam
si
silt
sil
silt loam
c
clay
cl
clay loam
scl
sandy clay loam
sl
sandy loam
sid
silty clay loam
Seasonal High Water Table:
Structure Grade Structure Type Structure Size Depth (") Type (apparent/perched)
wk weak gr granular f fine -
m mnHimrnta nl nlaty mad medium
str strong pr prismatic
cpr columnar
abk angular blocky
sbk subangular blocky Moist Consistency
sg single grained fr friable
ma massive vfr very friable
fi firm
vfi very firm

Soil Profile Descriptions in Field Locations
Project: Lincolnton Permit (WQ 0002712)
%.Slope: 3%
Site: Mike Davis Farm
Crop: Forage/Pasture
Field: Davis Farm Field 3
Conducted By: GC Murray
Coordinates: 35.5618 N
Date: 9/16/2019
-81.4482 W
Soil Series: Pacolet/Cecil
w
❑
�
N
fC
a�
0
s
v
O
O
C
v
N
.�
CZ
N
C7
F
ci
ci
¢
Cn
O
c
o
=
x
m
m
m
X
0
c
c
C
0
PIEDMONT
ENVIRONMENTAL.
An 3 0 C I A T■ i, P. A.
W V
N } c
C W
CD 0
++
cO. p V
N
�n •n S n n
Ap
0-6
7.5YR
4/4
-
-
-
-
moist
sl
mod
med
gr
fr
ns
np
Bt.
6-34.
10R 4/6
-
-
-
-
moist
cl
mod
med
sbk
fi
s
p
BC
34-44
10R 4/6
-
-
-
-
moist
scl
mod'
med
sbk
fi
s
p
C
44-48
10R 416
-
-
-
-
moist
sl
wk
med
sbk
fr
ss
sp
Legend.
Texture
s
sand
I
loam
si
silt
sil
silt loam
c
clay
cl
clay loam
scl
sandy clay loam
sl
sandy loam
sicl
silty clay loam
Seasonal High Water Table:
Structure Grade Structure Type Structure Size Depth (") Type (apparent/perched)
wk weak gr granular f fine - -
m moderate nl nlaty med medium
str strong pr prismatic
cpr columnar
abk angular blocky
sbk subangular blocky Moist Consistency
sg single grained fr friable
ma massive vfr very friable
fi firm
vfi very firm

Soil Profile Descriptions in Field Locations
Project: Lincolnton Permit (WQ 0002712)
%
Slope: 3%
Site: Mike Davis Farm
Crop: Forage/Pasture
Field: Davis Farm Field
5
Conducted By: GC Murray
Coordinates' 35.5327 N
.
Date: 9/16/2019
-81.4318 W
Soil Series: Cecil
w
m
(D
V
L.
O
I-
O
.7
d
ii
C
(n
V
1
O
O
-Q
N
O
d
►�.
O
r
k
d
d
d
K
T)
7
w
v
O
GI
c
c
c
C
N
C
n
PIEDMONT
ENVIRONMENTAL
A S S O C 1 A T■ 3, P. A.
N
w U
°- CD
U)
1--
. 4
I
L
1
L
C
O
N
d
L
L
O
fC
,n
en
S
A
A
Legend:
Texture
s
sand
I
loam
si
silt
sil
silt loam
c
clay .
cl
clay loam
scl
sandy clay loam
sl
sandy loam
sicl
silty clay loam
Seasonal Hlqh Water Table:
Structure Grade Structure Type ..Structure Size Depth (") Type (apparent/perched)
wk weak gr granular f fine - -
m moderate ni nlaty med medium
str strong pr prismatic
cpr columnar
abk angular blocky
sbk subangular blocky Moist Consistency
sg single grained fr friable
ma massive vfr very friable
fi firm
vfi very firm

Soil Profile Descriptions in Field Locations
Project: Lincolnton Permit (WQ 0002712) % Slope: 3%
Site: Mike Davis Farm Crop: Forage/Pasture
Field: Davis Farm Field 7 Conducted By: GC Murray
Coordinates: 35.5158 N Date: 9/16/2019
-81.4059 W Soil Series: Pacolet
w
C V w (7
CO U]
m
r c U U Q co U 2
N a� aye a� x
0 Pa) S S IFS+ S N S n
PIEDMONT
ENVIRONMENTAL
ASSOCIATES, P. A.
LU
N �a
L)
+;
L L
L L
C
o
N
O
N
.!C
r
(Q
,n ,n
S
rn
n
Ap
0-3
7.5YR 5/4
-
-
-
-
moist
sl
mod
med
gr
fr
ns
np
AB
3-10
10R 3/3
-
-
-
-
moist
scl
wk
med
sbk
fi
ss
sp
Bt
10-33
10R 4/6
-
-
-
-
moist
c
mod
med
sbk
fi
s
p
BC
33-48
10R 418
-
-
-
-
moist
cl
mod
med
sbk
fi
s
p
Legend.
Texture
s
sand
I
loam
si
silt
sil
silt loam
c
clay
cl
clay loam
scl
sandy clay loam
sl
sandy loam
sicl
silty clay loam
Structure Grade
Structure Type
Structure Size
wk weak
gr .
granular
f fine
m moderate
pl
platy
med medium
str strong
pr
prismatic
cpr
columnar
abk
angular blocky
sbk
subangular blocky
Moist Consistency
sg
single grained
fr. friable
ma
massive
vfr very friable
fi firm
vfi very firm
Seasonal High Water Table:
Depth (") Type (apparent/perched)

Soil Profile Descriptions in Field Locations
Project: Lincolnton Permit (WQ 0002712) % Slope: 3%
Site: Mike Davis Farm Crop: Forage/Pasture
Field: Davis Farm Field 8 Conducted By: GC Murray
Coordinates: 35.5665 N Date: 9/16/2019
-81.4563 W Soil Series: Madison
y
N
L
O
0
V
G
U
c
U
O =
x
m
N
T /a1
S
S
N
.n
Op
Q
in
V
i
x
w
O
N
X
S
0
N
0
d
P1.ED',NONT
ENVIRONMENTAL
ASSOCIATES, P. A.
LU
i
WLU v
N IL
t7 U) H
O d
Ap
0-6
7.5YR 6/8
-
-
-
-
-
moist
sl
mod
med
..1
gr
-
fr
W1
ns
u
np
AB
6-16
7.5YR 5/8
-
-
-
-
moist
scl
mod
med
sbk
fi
s
p
Bt
16-32
7.5R 4/8
(Flakes of mica In Bt, BC and c horizons)
moist
c
mod
med
sbk
fi
s
p
BC
32-41
7.5R 4/8
-
-
-
-
moist
scl
wk
med
sbk
fr
ss
sp
C
41-48
7.5R 4/8
-
-
-
-
moist
sl
mod
med
gr
fr
ns
np
Legend.
Texture
s
sand
I
loam
si
silt
sil
silt loam
c
clay
cl
clay loam
scl
sandy clay loam
sl
sandy loam
sicl
silty clay loam
Structure Grade
_Structure Type
wk weak
gr
granular
m moderate
pl
platy
str strong
pr
prismatic
cpr
columnar
abk
angular blocky
sbk
subangular blocky
sg
single grained
ma
massive
Seasonal High Water Table:
Structure Size Depth (") Type (apparent/perched)
f fine - -
med medium
Moist Consistencv
fr friable
vfr very friable
fi firm
vfi very firm

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

North Carolina Department of Environmental Quality
Pat McCrory Donald R. van der Vaart
Governor Secretary
Date: 8/2/2019
To: Name of Chairman to the Board of County Commissioners: Carrol Mitchem
Complete mailing address: 7868 Hallman Mill Road
City: Vale
State: NC Zip: 28168
County where land application sites are located: Lincoln
From: Applicant's name: Town of Lincolnton (on behalf of the Division of Water Resources in accordance with Session
Law 2013-340)
Contact person and title: Don BurkU Waste Water Superintendent
Complete mailing address: 600 W. Hwy 150 ByPass
City: Lincolnton State: NC Zip: 28093
Telephone number: [phone] E-mail address: donaldburkU(cr�,ci.lincolnton.nc.us
Subject: Notification of residual land application site proposal
This is to notify you that the Applicant listed above will be submitting an application to the Division of Water
Resources for the land application of residual solids to site(s) located in your county. During this review, the Division
will ensure that all federal and state regulations are enforced. Attached to this form is information regarding residuals -
generating sources and locations of the proposed land application sites. Please forward this letter and its associated
attachments to the appropriate Department within your County (i.e., Health or Environmental Health Department and
Planning Department) if applicable.
More information of the land application sites included in this application will be available at the following
Division of Water Resources Regional Office:
Name of appropriate regional office: NC DEQ Mooresville
Complete mailing address: 610 East Center Ave Suite 301
City: Mooresville State: NC Zip: 28115
Telephone number: 704) 663-1699
Expected date of application submission: 10/10/19
Should you desire to comment on this application, please do so no later than 30 calendar days following the
expected application submission date. If you have any questions or comments about this notification, or if you would like
more information, please contact the appropriate regional office at the telephone number provided above. Thank you in
advance for your attention to this matter.
Enclosures: Source Facility Summary
Land Application Site Summary
Maps
Non -Discharge Permitting Unit
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Phone: 9IM07-64641 Internet: http://Portal.ncdenr.org/web/wQ
An Equal Opportunity I Affirmative Action Employer —Made in partwith recycled paper FORM: CBN 06-16

Address Information CATAWBA COUNTY
RANDALL ISENHOWER
1537 LITTLE HILL RD
NEWTON, NC 28658
United States
Telephone: [phone]
Fax:
i Ship From: - -�- --- --------
--. -----Return Address: �-- ---
SYNAGRO - MOCKSVILLE
SAAGRO-IMOCKSVILLE
ALEX FOX
ALEX FOX
284 BOGER RD
284 BOGER RD
MOCKSVILLE,-NC 27028
United States
Telephone: [phone]
Fax:
UPS Shipinent,ID: 1Z51F78lAfA298594204
Status: Complete
Entered Weight, :5
Total Billable Weight .5
MOCKSVILLE, TIC 27028
United States
Telephone: [phone]
PackagaInformation.
Tracking #: Weight Dimensions / Insured Value Reference Numbers
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1. 1ZSIF78WA298594204 .5 Ibs UPS Letter g Reference#1 -
Reference#2 - 20-2360-30-60-4310 50-0055
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Shipping Fees Subtotal: 18.30 USD
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Total E5tln3ate 2 a 2q.USD

Tracking Details I UPS
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Proof of Delivery.
Dear Customer,
This notice serves as proof of delivery for the shipment listed below..
Tracking Number
1Z51F78WA298594204
Weight
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Shipped / Billed On
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Additional Information
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Delivered To
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SITE SUMMARY
Lincolnton Land Application Program (WQ 0000430)
Site ID: NC-CA-24
Owner: Mike Davis
Address: 7436 Reeps Grove church Rd
Vale, North Carolina 28168
Phone: [phone]
Operator: same
Estimated Rye Based Predominant
Total Applicable Annual Soil Series
Fields Acres Acres Crop(s) PAN Limit (lb/ac/yr) (map unit)
9 19.4 19.4 Corn, Millet, Hay 209 Cecil
(CeB2)
TOTALS 19.4 19.4
Notes:
Date: ######

CA-24
Application Area (sf)
Application Area (ac)
Latitude
Longitude
9
845647
19.41
35' 34.139'N
81° 28.573'W
TOTAL
19.41

State of North Carolina
Department of Environmental Quality
�= Division of Water Resources
�61
DIeIslon of Water Resources _ 15A NCAC 02T .1100 — LAND OWNER AGREEMENT
s ,
FORM: LOA 06-16
Lease use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted, the Applicant shall submit one original and two copies of the application and
supporting documentation
For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting Unit.
General — This document is an agreement between the Applicant and land owner(s) of residuals receiving sites for land application of
Class B residuals (may include water treatment plant or other type residuals) in accordance with 15A NCAC 02T .1100. Do not
submit this agreement for review without a corresponding application form (FORM: RLAP 06-16).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. La d Owner Agreement (FORM: LOA 06-16):
Submit the completed and appropriately executed Land Application Site Certification (FORM: LASC 06-16) form. Please
do not make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments
to the application may be made, as long as the attachments are numbered to correspond to the section and item to which they
4fer.
plepare a separate agreement for each set of land application sites that are owned or operated by an entity other than the
pplicant.
A copy of the completed and appropriately executed agreement must be provided to the landowner and the lessee/operator.
AGREEMENT FOR THE LAND APPLICATION OF RESIDUALS TO PRIVATELY OWNED LAND
undersigned land wne or his representative
Applicant's name: 0/' 1-f A
hereinafter referred to as the Permittee, to land apply residuals from the following facility(ies) onto the following: land
application site(s) (i.e., see attached setback maps) in accordance with the stipulations and restrictions as given in this
Agreement:
Site/Field ID
Lease
(yes/no)
Land Use or
Cropping Patterns
Intended Use of Cro
Crops
Residuals Source
(optional)
Special note
( no-till/over-seed/
pasture)
✓�
o
#1
The landowner or his representative receives, in consideration, full use of the nutrient value of the applied residuals while the
Permittee receives, in consideration, the use of the Iand application site(s) described above for the disposal of the residuals.
Agreement shall remain in effect for the length of the Division's permit for the residuals land application program and
i be renewed each time this permit is renewed.
i
xne undersigned landowner or his representative and the Permittee agree to abide with the following restrictions and
stipulations until such time as written notification, given 30 calendar days in advance, modifies or cancels this Agreement.
FORM: LOA 06-16 Page 1 of 3

Y.

Landowner's Certification:
I certify that I am a deeded landowner of the above -referenced land application site(s) and am authorized to make decisions
regarding the use of the land application site(s) on behalf of other deeded landowners OR that I am otherwise authorized, through
a power of attorney or other legal delegation, to make decisions regarding the use of the land application site(s) on behalf of the
deeded landowners. I certify that the above -referenced land application site(s) are not included in any waste disposal contract or
agreement with another municipality, contractor, or other permitted entity. Furthermore, I certify that I have read this Agreement,
understand the stipulations, restrictions, alternatives for water supply wells inside the compliance boundary, acknowledgement of
field transfer, and do hereby grant permission to the Permittee to land apply residuals to the land application site(s) as specified
herein.
Landowner name: �rou Q -7,60 -
Address:G /f,ee,:P3 ( eoue- 0
City: 4^ le State: ��� Zip: v2�1✓�
Phone:
Signatu
NORTH CAROLINA, CiQT7�� �r4 COUNTY
I, -the undersigned Notary Public do hereby certify that A Itx 'ex- (initials: 1 g) personally
appeared before me this day, and, being duly sworn, stated that in his/her presence 01, chael 4'ftar f signed
the attached document and acknowledged the due execution of the foregoing instrument.
WITNESS my hand and official seal this the 7 day of Q&Obe , 20 161
Signature and seal:
My commission expires
Lessee's/Operator's Certification:
ROBERT N. ROTH
NOTARY PUBLIC
OUiLTOno 00U*1TV -
STATE OF NORTH CAROLINA
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Lessee/operator name:
Address:
City:
Phone:
Signature:
Permittee's Certification:
I certify that I have read this Agreement and do
Signing official ame: of
Signature: o
State:
E-mail address:
Date:
Zip:
to abide by the stipulations and restrictions as specified herein.
Date: _ aZ
FORM: LOA 06-16
Page 3 of 3

i

' 7hC1` r a CwYi i
Ai-
• '7' .. •, Y n ;,�. ,'•,-ter 1 �� ".w�`.JtJET 1 ���CcC , � �r '•17ti
/61
• - �� i!;G '�'t'x ��" r'1`{', �M ' �,.i. �^7 --a. use x 'il� {;`j -ti!
, f �o � � ,max. �fF a v ��,' �• '� ,' � x - � � 8 ;
., •� � �" /t "can � � rigc � .
--fie �i i f,,* f ��By� 't�' ���a ���'�+� „',--•,��•�7 � ,-fie • -T �• 4�,�'. 'r 1 F i `. .
Pf .`' r khE2 {i `' }y'J I'l,E2
�' nttiA

l
i TOPOGRAPHIC MAP
. s
I t i f
\ I �-"",... f ` ,� j �;. 4t�. ✓ �� Id f f � �, if
`4° file, • • • + /
i 3 x�c3 I�✓ � .i
124
�1 • f
6
b � , . •� r` Y � . .�a � '" .ism.. •�■ C. P�
GRAPHIC SCALE
V=1,000'
1,000' 0 1,000'
-'he compliance boundary is established either 250 ft from the residuals application area or 50 feet within N C-CA-24
in the property boundary, whichever is closest to the application area. The review boundary is established
midway between the compliance boundary and the perimeter of the residuals application area. All
locations are approximate. Field 9

VICINITY MAP
•� �
4_ �
� I.
.i' �- ' 1! :j l t•`) flf ..f : m�i')l'r � .i ,� f `�,
:,.� , •��/
1 %. � i' � `� _ j -•.tee a� \ �t/�/' \. � .1f f11 j `' '`
s
� 4�_ w � ) ter• J V '�� �w � ��` �' ' � .�If. _��
✓�
{ •' Q'(! �J' yy 1
C T'! �J }'^� i\ ° J s �
�
`,ti .�.� 1 \ i i � - :
y `� "�vt �l �.\ - 1 J
•
�!l „� �� �� �, f, � \� . _,e.;'• til �� ���i ` Im •cam � � �' \` ��`"_ � , ��`
,�
�, � � I, i {'Z "l fl� rs
% .:5 •1 D � t • sue. �.
GRAPHIC SCALE
1" = 4,000'
4,000' 0 4,000'
he compliance boundary is established either 250 ft from the residuals application area or 50 feet within
N C_CA_24
in the property boundary, whichever is closest to the application area. The review boundary is established
midway between the compliance boundary and the perimeter of the residuals application area. All
locations are approximate.
Field 9

Soil Profile Descriptions in Field Locations
Project: Lincolnton Permit (WQ 0002712) % Slope: 3%
Site: Mike Davis Farm Crop: Forage/Pasture
Field: Davis Farm Field 9 Conducted By: GC Murray
Coordinates: 35.5691 N Date: 9/16/2019
-81.4777 W Soil Series: Cecil
U)
U)
U
O
O
=
U
C
U
O
++
0
(PIEDMONT
ENMROMMENTAL
A s s O C 1 A r s s, P. A.
m
W
.a
C
C
a
d
O
0)
U)
�,
c>
C
O
O
yO
L
N
t9
N
U)
LU
a.,
F-
d
N
U)N
O
C
O
C
N
ti
O
c
d
w
rL.+
.O
Legend. -
Texture
Structure Grade
Structure Type
s sand
wk weak
gr
granular
I loam
m moderate
pl
platy
si silt
str strong
pr
prismatic
sil silt loam
cpr
columnar
c clay
abk
angular blocky
cl clay loam
sbk
subangular blocky
scl sandy clay loam
sg
single grained
sl sandy loam
ma
massive
sicl silty clay loam
Seasonal High Water Table:
Structure Size Depth (") Type (apparent/perched)
f fine - -
med medium
Moist Consistencv
fr friable
vfr very friable
fi firm
vfi very firm

SITE SUMMARY
Lincolnton Land Application Program (WQ 00002712)
Site ID: NC-LT-47
Owners Name: Randy Leatherman Florance Giner Crismai Sue Gilbert
Field 1-3 field 4 field 5
Address: 3322 Dansbury Ln
Vale, NC 28168
Phone: [phone]
Operator: same
Address:
Phone:
Estimated Rye Based
Applicable Annual Predominant
Fields Acres Cron(s) PAN Limit (Ib/ac/vr) Soil Series
1
10.3
corn, beans
157
Cecil CeB2
2
13.3
corn, beans
157
Cecil CeB2
3
10.8
, corn, beans
157
Cecil CeB2
4
31.2
corn, beans
157
Cecil CeB2
5
27.6
corn, beans
157
Cecil CeB2
TOTALS 93.3
Notes: 238 Corn Silage
115 Wheat
185 Beans
I
Date: 10/10/19

LT-47
Application Area (sf)
Application Area (ac)
Latitude
Longitude
1
451114
10.36
35' 34.102'N
81' 26.675'W
2
578668
13.28
35' 33.852'N
81° 26.697'W
3
471395
10.82
35' 33.866'N
81' 26.518'W
4
1360168
31.23
35° 32.659'N
81° 24.232'W
5
1201986
27.59
35° 29.974'N
81° 23.972'W
TOTAL
93.28

o" W,
DlvIsion of Wii&ir Resources
lwqL
State of North Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .1100 — LAND OWNER AGREEMENT
FORM: LOA 06-16
-viease use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted,_ the Applicant shall submit one original and two copies of the application and
supportin,u documentation
For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting Unit
General — This document is an agreement between the Applicant and land owner(s) of residuals receiving sites for land application of
Class 13 residuals (may include water treatment plant or other type residuals) in accordance with 15A NCAC 02T .1100. Do not
submit this agreement for review without a corresponding application form (FORM: RLAP 06-16).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Land Owner Agreement (FORM: LOA 06-16):
Fr Submit the completed and appropriately executed Land Application Site Certification (FORM: LASC 06-16) form. Please
do not make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments
to the application may be made, as long as the attachments are numbered to correspond to the section and item to which they
[efer.
Prepare a separate agreement for each set of land application sites that are owned or operated by an entity other than the
plicant.
A copy of the completed and appropriately executed agreement must be provided to the landowner and the lessee/operator.
AGREEMENT FOR THE LAND APPLICATION OF RESIDUALS TO PRIVATELY OWNED LAND
indersigned Ian owne or his repre entative her permits:
Applicant's name:
hereinafter referred to as the Permittee, to land apply residuals from the following facility(ies) onto the following land
application site(s) (i.e., see attached setback maps) in accordance with the stipulations and restrictions as given in this
Agreement:
Site/Field ID
Lease
(yes/no)
Land Use or
Cropping Patterns
Intended Use of Crop s
p
Residuals Source
(optional)
Special note
(no-till/over-seed/
pasture)
The landowner or his representative receives, in consideration, full use of the nutrient value of the applied residuals while the
Permittee receives, in consideration, the use of the Iand application site(s) described above for the disposal of the residuals.
Lgreement shall remain in effect for the length of the Division's permit for the residuals land application program and
ie renewed each time this permit is renewed.
The undersigned landowner or his representative and the Permittee agree to abide with the following restrictions and
stipulations until such time as written notification, given 30 calendar days in advance, modifies or cancels this Agreement.
FORM: LOA 06-16 Page 1 of 3

Landowner's Certification:
I certify that I am a deeded landowner of the above -referenced land application site(s) and am authorized to make decisions
regarding the use of the land application site(s) on behalf of other deeded landowners OR that I am otherwise authorized, through
a power of attorney or other legal delegation, to make decisions regarding the use of the land application site(s) on behalf of the
deeded landowners. I certify that the above -referenced land application site(s) are not included in any waste disposal contract or
agreement with another municipality, contractor, or other permitted entity. Furthermore, I certify that I have read this Agreement,
understand the stipulations, restrictions, alternatives for water supply wells inside the compliance boundary, acknowledgement of
field transfer, and do hereby grant permission to the Permittee to land apply residuals to the land application site(s) as specified
herein.
Landowner name:
Address:
L
r�,/
City: VCt [C , / State: / & C Zip: � �,6
Phone: 6 ! o- `�' 75 E-mail address:
Signature: Date:
NORTH CAROLINA, 4 Z/V C4011y COUNTY
I, the undersigned Notary Public do hereby certify that Ala bC (initials: f) personally
appeared before me this day, and, being duly sworn, stated that in his/her presence J,, IZA t iff signed
the attached document and acknowledged the due execution of the foregoing instrument.
ui_4-L"
WITNESS my hand and offigjgl seal this
Signature and seal:
My commission expires:
Lessee's/Operator's Certification:
day of 01�06tY , 20 M
R®EERT N. ROTH
NOTARY PUBLIC
GUILFORD CC"UNTY
STATE OF NORTH CAROL
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Lessee/operator name:
Address:
City:
Phone:
Signature:
Permittee's Certification:
I certify that I have read this
State:
E-mail
Date:
Zip:
and do hereby agree to abide by the stipulations and restrictions as specified herein.
Signing official ame: CIA,, 't ILi
Signature: Date:
FORM: LOA 06-16 Pate 3 of 3

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

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

• F
Landowner's Certification:
I certify that I am a deeded landowner of the above -referenced land application site(s) and am authorized to make decisions
( regarding the use of the land application site(s) on behalf of other deeded landowners OR that I am otherwise authorized, through
a power of attorney or other legal delegation, to make decisions regarding the use of the land application site(s) on behalf of the
deeded landowners. I certify that the above -referenced land application site(s) are not included in any waste disposal contract or
agreement with another municipality, contractor, or other permitted entity. Furthermore, I certify that I have read this Agreement,
understand the stipulations, restrictions, alternatives for water supply wells inside the compliance boundary, acknowledgement of
field transfer, and do hereby grant permission to the Permittee to land apply residuals to the land application site(s) as specified
herein.
Landowner name:`
Address: C Gi `'� �'� 11C414
City: State: Zip:
Phone: --7- 3 — b �_—1 `i E-mail address:X
Signature: ✓� ��--- Date:
NORTH CAROLINA, Z_ /'W D /, COUNTY
I, the undersigned Notary Public do hereby certify thatAltico.,L (initials:Lr personally
appeared before me this day, and, being duly sworn, stated that in his/her presence L
6 signed
the attached document and acknowledged the due execution of the foregoing instrument.
WITNESS my hand and official seal this the
Signature and seal:
My commission expires:
Lessee's/Operator's Certification:
I certify that I have read this �reeyhent and do
I
Lessee/operator name:
nn
Address: � � r� 6
Piss day of Oa9pe-r 20
R4BERT N. RC'- ;
GUILFORO COU --..' '
STATE OF NORTH Ct=: �''v •.pyas ra : - j
by agree to abide by the stip?�lations and restrictions as specified herein.
Girl
Za,1-z'
City: � �� State: 6-4- Zip: / [,
Phone:
Signatu
Permittee's Certification:
I certify that I have read this greement and do
Signing officia name: ~
Signature:
Date: 1,4 c7
agree to abide by the stipulations and restrictions as specified herein.
Date:
FORM: LOA 06-16 Page 3 of 3

State of North Carolina
.3
Division of Water Resources
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .1100 — LAND OWNER AGREEMENT
FORM: LOA 06-16
Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted, the Applicant shall submit one original and two copies of the application and
supporting documentation
For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting Unit.
General — This document is an agreement between the Applicant and land owner(s) of residuals receiving sites for land application of
Class B residuals (may include water treatment plant or other type residuals) in accordance with 15A NCAC 02T .1100. Do not
submit this agreement for review without a corresponding application form (FORM: RLAP 06-16).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. La3nA Owner Agreement (FORM: LOA 06-16):
Rr Submit the completed and appropriately executed Land Application Site Certification (FORM: LASC 06-16) form. Please
do not make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments
to the application may be made, as long as the attachments are numbered to correspond to the section and item to which they
refer.
Prepare a separate agreement for each set of land application sites that are owned or operated by an entity other than the
pplicant.
A copy of the completed and appropriately executed agreement must be provided to the landowner and the lessee/operator.
AGREEMENT FOR THE LAND APPLICATION OF RESIDUALS TO PRIVATELY OWNED LAND
The undersigned land ner or his rep r entative hereby permits:
Applicant's name: d A0 A;
hereinafter referred to as the Permittee, to land apply residuals from the following facility(ies) onto the followingAand,
application site(s) (i.e., see attached setback maps) in accordance with the stipulations and restrictions as given in this
Agreement:
Site/Field ID
Lease
(yes/no)
Land Use or
Cropping Patterns
Intended Use of Crops
Residuals Source
(optional)
Special note
(no-till/over-seed/
pasture)
The landowner or his representative receives, in consideration, full use of the nutrient value of the applied residuals while the
Permittee receives, in consideration, the use of the land application site(s) described above for the disposal of the residuals.
its Agreement shall remain in effect for the length of the Division's permit for the residuals land application program and
snali be renewed each time this permit is renewed.
The undersigned landowner or his representative and',the Permittee agree to abide with the following restrictions and
stipulations until such time as written notification, given 30 calendar days in advance, modifies or cancels this Agreement.
FORM: LOA 06-16 Pagel of 3

I. STIPULATIONS:
1. The landowner or his representative shall not enter into any additional residuals application contracts or agreements with another permuted
entity for the site(s) specified by this Agreement.
2. Should the landowner or his representative lease or otherwise permit the use of the land application site(s) to a third party, the landowner shall
be responsible to ensure that the third party agrees and complies with the terms and conditions of this Agreement.
3. The landowner or his representative shall adhere to the provisions of this Agreement until all of the site restrictions (under Section II) are med
4. Notification of cancellation of this Agreement shall be immediately forwarded to NCDENR-DWR, Non -Discharge Permitting Unit, 1617
Mail Service Center, Raleigh, NC 27699-1617.
5. The Permittee must request and obtain a permit modification from the Division prior to a transfer of the land application site(s) to a new
landowner. In addition, the current landowner shall give a notice to the new landowner that gives full details of the residuals applied at the
land application site(s).
6. The Permittee has provided the landowner or his representative with information and data concerning the residuals land application program,
including an analysis of constituents of the residuals, residuals application methods, schedules for typical cropping patterns, a description of
the equipment used by the Permittee.
7. The Permittee will provide the landowner or his representative with a copy of the residuals permit prior to commencement of any residuals
land application event and a copy of the results of each soil analysis.
8. If the soil pH of the land application site(s) is not maintained at 6.0 or greater, sufficient amounts of lime shall be applied to achieve a final
soil pH of at least 6.0, unless an agronomist provides information indicating that the pH of the soil, residuals and lime mixture is suitable for
the specified crop.
9. The landowner or his representative and the Permittee will agree on residuals application rates and schedules based on crop patterns, results of
soil samples, and the permitted application limits.
10. The landowner or his representative will provide the Permittee with information regarding the amount and analysis of other sources of
nutrients (e.g., fertilizer, unregulated animal waste, etc.) that have been applied to the land application site(s).
11. The landowner or his representative will inform the Permittee of any revisions or modifications to the intended use and cropping patterns for
the land application site(s) prior to each planting season to enable the Permittee to amend this Agreement and schedule residuals land
application events at appropriate periods.
12. Specific residuals land application area boundaries shall be clearly marked on the land application site(s) by the Permittee, the landowner, or
his representative prior to and during a residuals land application event.
13. The landowner or his representative hereby authorizes the Permittee, local officials, and State officials or their representatives to; enter and
inspect any property, premises, or place on or related to the land application site(s) at any reasonable time for the purpose of determining
compliance with the permit; establish monitoring facilities on or near the land application site(s) as required by the permit; copy any records
that must be kept under the terms and conditions of the permit; take necessary leachate, surface water, groundwater, or soil samples during the
y vJet 1.,of, and 12 months after termination of, this Agreement.
U. I&STRICTIONS:
1�? Appropriate measures must be taken by the Permittee and/or the landowner or his representative to control public access to the land
application site(s) during active use and for the 12-month period following a residuals land application event. Such controls may include the
posing of signs that indicate the activities being conducted at the land application site(s).
2:= i ffils shall not be grazed on the land application site(s) for a 30-day period following a residuals land application event. Land application
sites that are to be used for grazing shall have fencing that will be used to prevent access during these periods after such residuals land
application events.
3. Food crops, feed crops, and fiber crops shall not be harvested for a 30-day period following a residuals land application event.
4. Food crops with harvested parts that touch the residuals/soil mixture and are totally above the land surface shall not be harvested for a 14-
month period following a residuals land application event.
5. Food crops with harvested parts below the surface of the land shall not be harvested for a 20-month period following a residuals land
application event when the residuals remain on the land surface for four months or longpr prior to incorporation into the soil.
6. Food crops with harvested parts below the surface of the land shall not be harvested for' a 38-month period following a residuals land
application event when the residuals remain on the land surface for less than four months prior to incorporation into the soil.
7. _ Turf grown on land where residuals are applied shall not be harvested for a 12-month period following a residuals land application event.
III. ALTERNATIVES FOR WATER SUPPLY WELLS INSIDE THE COMPLIANCE BOUNDARY: (please check one)
15A NCAC 02L .0107(d) prohibits water supply wells within the compliance boundary. However, 15A NCAC 02T .0105(h) allows the
compliance boundary to be placed closer to the waste disposal area, such that the water supply well is situated outside of the compliance
boundary provided the groundwater standards can be met at the newly -established compliance boundary. Please mark one of the following;
❑ A re -defined compliance boundary is needed for field(s) ID:
(Please include the rationale for the requested re -location of the compliance
compliance boundary to the application package)
❑ A re -defined compliance boundary is not needed for this site.
IV. ACKNOWLEDGEMENT OF FIELD TRANSFER: (if needed)
boundary and attach a map showing the newly proposed
❑ The land application field(s) ID: , is currently permitted under anothei
residuals land application program; Permit Number WQ: The land owner hereby acknowledge that by signing this;
agreement, he/she is requesting that the field(s) be removed from the previously permitted residuals land application program and transferred
into the new program;
(Name of the new program)
Fnun/r• r nA n4_14 T) .-0 _-FQ

Landowner's Certification:
I certify that I am a deeded landowner of the above -referenced land application site(s) and am authorized to make decisions
regarding the use of the land application site(s) on behalf of other deeded landowners OR that I am otherwise authorized, through
a power of attorney or other legal delegation, to make decisions regarding the use of the land application site(s) on behalf of the
deeded landowners. I certify that the above -referenced land application site(s) are not included in any waste disposal contract or
agreement with another municipality, contractor, or other permitted entity. Furthermore, I certify that I have read this Agreement,
understand the stipulations, restrictions, alternatives for water supply wells inside the compliance boundary, acknowledgement of
field transfer, and do hereby grant permission to the Permittee to land apply residuals to the land application site(s) as specified
herein.
Landowner name: -sa 6 (9 j/✓�-F�"� I /
Address: lQ�! �'*��5� %1[� �iAl/-eA/l Aj Al d9q-,
: S-tafe-- Zip:
Phone: 74 P E-mail address:
Signature: Date:
NORTH CAROLINA, A v a G COUNTY
I, the undersigned Notary Public do hereby certify that , (initials-`4' )personally
appeared before me this day, and, being duly sworn, stated that in his/her presence S �' i J) signed
the attached document and acknowledged the due execution of the foregoing instrument.
WITNESS my hand and officiala�al this +' r�'
Signature and seal:
of urxu E-F 220 1
My commission expires: ROTH `_
NOTARY PUBLIC
GUILFORD COUN T Y
Lessee's/Operator's Certification: STATE OF NORTH CAROL'° `s?a
pq
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Lessee/operator name:
Address:
City:
Phone:
Signature:
Permittee's Certification:
State:
E-mail address:
Date:
Zip:
I certify that I have read thAs Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Signing official ame: 0 � (�� "���, {"S&yj
Signature: Date: __ 62
FORM: LOA 06-16 Page 3 of 3

.i�F : ..... .. .. i
.. ... .�
�a - ... - .. r �.

NCDA&C&Agi iic Division Phone: [phone] Website: www.nce
v/agronomi/ Report N, '10-SL006841
LTUI?,,
Heavy Metals Client:
Randy Leatherman Advisor: Alex Fox
c
�2N
3322 Dansbury Ln Synagro
Mehlich-3 Extraction
Soil Report
Vale, NC 28168 284 Boger Rd
Mocksville, NC 27028
Sampled County: Lincoln
Links to Helpful Information Sampled: 09/16/2019
Received: 09/27/2019
Farm: NC-Lt-47 Completed: 10/02/2019
Client ID: 502961 Advisor ID: 501947
Agronomist's Comments:
This report contains both routine soil test information as well as heavy metals data in a section labeled as Heavy Metals under soil test lab results. Using Mehlich 3 as a soil test
extractant, background levels of these metals typically seen in NC soils when analyzed are as
follows: arsenic (As)- 4.5 ppm, cadmium (Cd)- 0.1 ppm, chromium (Cr)- 0.2 ppm, lead (Pb)-
4.2 ppm, nickel (Ni)- 0.8 ppm, & selenium (Se)- 0.2 ppm (FY2005-2007). Note elevated lead
(Pb) in sample 6. Although the above metals here are not believed to pose a concern for plant
growth, continue to monitor these and note where elevated above background levels. Note any lime and fertilizer recommendations. Where soil test phosphorus (P) is very high (P-1 > 100),
crops will not respond to additional P applied. Ja athi Kamalakanthan 10/2/2019
Sample ID: 2
Recommendations: Lime
Nutrients (Ib/acre)
More
Crop (tons/acre) N P2O5
K2O Mg S Mn Zn Cu B
Information
Lime History:
1- Corn, grain 1.0 120 - 160 0
0 0 0 0 0 0 0
Note: 3
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% W/V CEC BS% Ac pH P-1 K-1 Ca% Mg%
S-1 Mn-I Mn-All Mn-Al2 Zn-I Zn-AI Cu-I Na ESP SS-1 NO3-N
0.76 0.93 7.5 74 2.0 5.4 199 92 53 15
49 121 90 313 313 432 0.1 1
Heavy, Metals (parts, per million): Arsenic,. 0.2 'Cadmium, 0.0
Nickel, .0.6 -Chromium,- 0.2 Lead, 2.9 Selenium, 0.0
Sample ID: 4
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tons/acre) N P2O5
K2O Mg S Mn Zn Cu B
Information
Lime History:
1 -Corn, grain 1.1 120 - 160 0
30 0 0 0 0 0 0
Note: 3
2 - 0.0
Test Results [units - W/V in g/cnr ; CEC and Na in meq/100 cm3; NO3-N in mg/drri3]:
Soil Class: Mineral
HM% W/V CEC BS% Ac pH P-1 K-1 Ca% Mg%
S-1 Mn-I Mn-All Mn-Al2 Zn-I Zn-AI Cu-I Na ESP SS-1 NO3-N
0.66 1.05 7.8 72 2.2 5.4 93 55 51 18
42 150 107 563 563 251 0.1 1
'Heavy Metals (parts per million): Arsenic, 0.3' Cadmium, 0.0
Nickel; 0.8 Chromium, 0.4 Lead; 4.6 Selenium, .0.0
North Carolina
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

NCDA&CS Agronomic'Division Phone: [phone] Website: www.ncagr.gov/agronomi/
Report No..FY20-SL006841
Randy Leatherman
Page 2 of 4
Sample ID: 6
Recommendations:
Lime
Nutrients (lb/acre)
More
Crop
(tons/acre) N P205
K20
Mg S
Mn
Zn
Cu B
Information
Lime History:
1 -Corn, grain
0.0 120 - 160 0
30
0 0
0
0
0 0
Note: 3
2 _
0.0
Test Results [units - WN in g/cO; CEC and Na in meq/100 cm3; NO3-N in mg/drrr3]:
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
0.36 1.04 16.9 92 1.3 6.3
688 61 83 7
35 260
168
640
640
281 0.1 1
Heavy Metals (parts per million): Arsenic,
0.3 Cadmium, 0.1
Nickel, 0.6
Chromium, 0.2
Lead,
9.2 Selenium,
0.0
Sample ID: 5
Recommendations:
Lime
Nutrients (lb/acre)
More
Crop
(tons/acre) N P205
K20
Mg S
Mn
Zn
Cu B
Information
Lime History:
1- Corn, grain
0.0 120 - 160 0
0
0 0
0
0
0 0
Note: 3
2 -
0.0
Test Results [units - WN in g/crn3; CEC and Na in meq/100 cm3; NO3-N in mg/do]:
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
0.36 0.96 10.9 89 1.2 6.2
95 87 62 23
41 90
68
426
426
334 0.1 1
Heavy Metals (parts per million): Arsenic,
0.2 Cadmium,_ 0.0
Nickel, 0.6
Chromium, 0.3
Leah,
3.5 Selenium,
0.0
Sample ID: 7
Recommendations:
Lime
Nutrients (lb/acre)
More
Crop
(tons/acre) N P205
K20
Mg S
Mn
Zn
Cu B
Information
Lime History:
1 -Corn, grain
1.0 120 - 160 0
10
0 0
0
0
0 0
Note: 3
2 -
0.0
Test Results [units - WN in g/crrr3; CEC and Na in meq/100 cnr3; NO3-N in mg/dnr3]:
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
0.71 1.07 7.8 73 2.1 5.4
226 73 57 12
34 517
327
197
197
126 0.1 1
Heavy Metals (parts per million):. Arsenic,
0.2 Cadmium, 0.1
Nickel, 0.6
Chromium, 0.2
Lead,
5.9 Selenium,
0.0
� I!

a
NCDA&CS.Agr, c Division Phone: [phone] Website: www.nc- /agronomi/
Report.Nc 0-SL006841
Page 3 of 4
Randy Leatherman
Sample ID: 8
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tons/acre) N P2O5
K2O
Mg S
Mn
Zn Cu
B
Information
Lime History:
1 -Corn, grain 0.0 120 - 160 0
50
0 20
0
0 0
0
Note: 3
2 - 0.0
Test Results [units - WN in g/cO; CEC and Na in meq/100 cO; NO3-N in mg/do]:
Soil Class:
Mineral
HM% W!V CEC BS% Ac pH P-1 K-1 Ca% Mg%
S-1 Mn-I
Mn-All Mn-Al2
Zn-I
Zn-AI Cu-I
Na ESP SS-1 NO3-N
0.41 1.24 6.3 82 1.2 6.1 95 44 61 17
22 316
205
156
156 283
0.0
`Heavy-Metals:(paits per million): Arsenic;. 0.1` Cadmium, 0.0
Nickel, 0.5
Chromium, 0.3.
Lead, 4.5
`' Selenium; 0.1

NCDA&CS Agronomic Division Phone: [phone] Website: www.ncagr.gov/agronomi/ Report No. FY20-SL006841
Randy Leatherman
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.
Recommendations for small areas, such as home lawns/gardens, are listed in units of Ib/1000 sq ft. If you cannot find
the exact fertilizer grade recommended on the report, visit www.ncagr.qov/apronomi/ob,oart4.hLn2 fTind information that
may help you choose a comparable alternate. For more information, read A Homeowner's Guide to Ferti/izei
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•ncacrr.crov/aaronomi/uvrst.htm
Page 4 of 4
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-Al2
Mn-availability index for crop 2
Mn-I
manganese index
M-O
mineral -organic soil class
N
nitrogen
Na
sodium
NOs-N nitrate nitrogen
ORG
organic soil class
pH
current soil pH
P-1
phosphorus index
P205
phosphate
S-1
sulfur index
SS-1
soluble salt index
WN
weight per volume
Zn-AI
zinc availability index
Zn-I
zinc index

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0
TOPOGRAPHIC MAP
-.�.� i 1 ;
i
IT
VNJ
GRAPHIC SCALE
1"=1,000'
1,000' 0 1,000'
fhe compliance boundary is established either 250 ft from the residuals application area or 50 feet within N C-LT-47
in the property boundary, whichever is closest to the application area. The review boundary is established
midway between the compliance boundary and the perimeter of the residuals application area. All
locations are approximate. Fields 1-3

TOPOGRAPHIC MAP
Z
j n3z i t j
C, 1•
s� oo
5
fj � � x fFpp r
ri
w
GRAPHIC SCALE
1"=1,000'
1,000- 0 1,000-
'he compliance boundary is established either 250 ft from the residuals application area or 50 feet within
N C-LT- 7
in the property boundary, whichever is closest to the application area. The review boundary is established
midway between the compliance boundary and the perimeter of the residuals application area. All
locations are approximate.
Field 4

a
z
TOPOGRAPHIC MAP
GRAPHIC SCALE
1"=1,000'
1,000. o t,000-
.'he compliance boundary is established either 250 ft from the residuals application area or 50 feet within N C-LT-47
in the property boundary, whichever is closest to the application area. The review boundary is established
midway between the compliance boundary and the perimeter of the residuals application area. All
locations are approximate. Field 5

VICINITY MAP
GRAPHIC SCALE
V = 4,000`
4,000' 0 4,000'
i
he compliance boundary is established either 250 ft from the residuals application area or 50 feet within N C-LT-47
in the property boundary, whichever is closest to the application area. The review boundary is established
midway between the compliance boundary and the perimeter of the residuals application area. All
locations are approximate. Fields 1-5

Soil Profile Descriptions in Field Locations
Project: Lincolnton Permit (WQ 0002712)
% Slope: 2%
Site: Randy Leatherman Farm
Crop: Forage/Pasture
PIEDMONT
Field: Leatherman Farm Field 2
Conducted By: GC Murray
Coordinates: 35.5642 N
Date: 9/16/2019
P
EDMR014NEIMTAL
-81.4444 W
Soil Series: Cecil
A s s o C I w r e :. .. w.
COj
U)
w
❑
�
N
w U
a.
t O O
C
7
Of C
U)
H MnV
�N
C = U U
Q
V W ID
m
m
N
°_' m
X 2
!2
NS
XJUIP
S
SS
N S 1�
n
n
n S n
Legend.
Texture
s
sand
I
loam
si
silt
sil
silt loam
c
clay
cl
clay loam
scl
sandy clay loam
sl
sandy loam
sicl
silty clay loam
Structure Grade
Structure Type
Structure Size
wk weak
gr
granular
f fine
m moderate
pl
platy
med medium
str strong
pr
prismatic
cpr
columnar
abk
angular blocky
sbk
subangular blocky
Moist Consistency
sg
single grained
fr friable
ma
massive
vfr veryfriable
fi firm
vfi very firm
Seasonal High Water Table:
Depth (") Type (apparent/perched)

Soil Profile Descriptions in Field Locations
Project: Lincolnton Permit (WQ 0002712) % Slope: 2%
Site: Randy Leatherman Farm Crop: Forage/Pasture
Field: Leatherman Farm Field 4 Conducted By: GC Murray
Coordinates: 35.5428 N Date: 9/16/2019
-81.4069 W Soil Series: Cecil
.0
O
O
U
(
NOI
++
++
O a)
W
0
a)
m
�
o
'a
L)
O
O
N
Cn
O
O
O
O
y
O
O
PIEDMONT
ENVIRONMENTAL
A l i O C I A T■ s, '. A.
w
o L)
N a. +�
a
Lo
i a0 O N
N y
p V (C
.�'.. n S n n
Legend:
Texture
s
sand
I
loam
si
silt
sil
silt loam
c
clay
cl
clay loam
scl
sandy clay loam
sl
sandy loam
sicl
silty clay loam
Seasonal High Water Table:
Structure Grade Structure Type Structure Size Depth (") Type (apparent/perched)
wk weak gr granular f fine - -
r„ mnrlarata nl nlnty med medium
str strong pr prismatic
cpr columnar
abk angular blocky
sbk subangular blocky Moist Consistency
sg single grained fr friable
ma massive vfr very friable
fi firm
vfi very firm

Soil Profile Descriptions in Field Locations
Project: Lincolnton Permit (WQ 0002712) % Slope: 4%
Site: Randy Leatherman Farm Crop: Forage/Pasture
Field: Leatherman Farm Field 5 Conducted By: GC Murray
Coordinates: 35.4991 N Date: 9/16/2019
-81:3994 W Soil Series: Cecil
U)
N
.0
O
O
U
O
O
r
U
U
O
=
X
G)
T
^
S
S
m
0
U
O N
.0
Q to
m m
S S
O
U
x
01
N
�
4-1 2
4
.�
PIEDPIONT
ENVIRONMENTAL
Azz.oCiATss. P.A.
►.0
w
UJIN G. i✓
0 H An
G N
i ry O
Legend.
Texture
s
sand
I
loam
si
silt
sil
silt loam
c
clay
cl
clay loam
scl
sandy clay loam
sl
sandy loam
sid
silty clay loam
Structure Grade
Structure Type
Structure Size
wk weak
gr
granular
f fine
m moderate
pl
platy
med medium
str strong
pr
prismatic
cpr
columnar
abk
angular blocky
sbk
subangular blocky
Moist Consistency
sg
single grained
fr friable
ma
massive
vfr very friable
fi firm
vfi very firm
Seasonal High Water Table:
Depth (") Type (apparent/perched)

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

North Carolina Department of Environmental Quality
Pat McCrory Donald R. van der Vaart
Governor Secretary
Date: 8/2/2019
To: Name of Chairman to the Board of County Commissioners: Carrol Mitchem
Complete mailing address: 7868 Hallman Mill Road
City: Vale
State: NC Zip: 28168
County where land application sites are located: Lincoln
From: Applicant's name: Town of Lincolnton (on behalf of the Division of Water Resources in accordance with Session
Law 2013-340)
Contact person and title: Don Burkey Waste Water Superintendent
Complete mailing address: 600 W. HM 150 ByPass
City: Lincolnton State: NC Zip: 28093
Telephone number: [phone] E-mail address: donaldburkeyt@,ci.lincolnton.nc.us
Subject: Notification of residual land application site proposal
This is to notify you that the Applicant listed above will be submitting an application to the Division of Water
Resources for the land application of residual solids to site(s) located in your county. During this review, the Division
will ensure that all federal and state regulations are enforced. Attached to this form is information regarding residuals -
generating sources and locations of the proposed land application sites. Please forward this letter and its associated
attachments to the appropriate Department within your County (i.e., Health or Environmental Health Department and
Planning Department) if applicable.
More information of the land application sites included in this application will be available at the following
Division of Water Resources Regional Office:
Name of appropriate regional office: NC DEQ Mooresville
Complete mailing address: 610 East Center Ave Suite 301
City: Mooresville
State: NC Zip: 28115
Telephone number: [phone]
Expected date of application submission: 10/10/19
Should you desire to comment on this application, please do so no later than 30 calendar days following the
expected application submission date. If you have any questions or comments about this notification, or if you would like
more information, please contact the appropriate regional office at the telephone number provided above. Thank you in
advance for your attention to this matter.
Enclosures: Source Facility Summary
Land Application Site Summary
Maps
Non -Discharge Permitting Unit
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Phone: [phone] Internet: http://portal.ncdenr.org/weblwo
An Equal Opportunity I Affirmative Action Employer —Made in part with recycled paper
FORM: CBN 06-16

SITE SUMMARY
City of Lincolnton
Lincolnton, NC
Site ID:
NC-CA-35
Owner:
Turbyfill Properties LLC; Sidney Turbyfill, Manager
Address:
4300 Biggerstaff Road
Maiden, NC 28650
Phone:
[phone]
Operator:
Jeff Elmore/Elmore Farms
Address:
4862 Range Ridge Road
Claremont, NC 28610
Catawba
Li
Estimated
Applicable
RYE -based
Predominant
Latitude &
Fields
Acres Crop(s)
Annual PAN limits
(pounds/acre/year)
Soil Series
(map unit)
Longitude
(D.M.S)
1
Corn
20.4 Soybeans
131
do 145 / fs 172
Lloyd
(LcB)
35°34'05.8" N
81°15'37.9"
Wheat
98
W
2A
4.9 Fescue (pasture)
hay 216 / pasture 162
Lloyd
35°34'13.3" N
(LcB)
81°15'35.5" W
2B
6.4 — Fescue (pasture)
hay 216 / pasture 162
Lloyd
35°34'08.6" N
'
(LcB)
81°15'27.6" W
2C
9.9 Fescue (pasture)
hay 216 / pasture 162
Lloyd
35°34'08.3" N
(LcB)
81°15'20.8" W
3A
41.6 Fescue (pasture)
hay 216 / pasture 162
Lloyd
35°33`59.0" N
(LcB)
81°15'07.6" W
3B
8.8 Fescue (pasture)
hay 216 / pasture 162
Lloyd
35°33'57.4" N
(LcB)
81°15'16.3" W
TOTAL
92.0
Notes:
Coordinate all activity through Sidney Turbyfill
Date: 08/15/14

�Z
A d i
f'+ * - t��'d+ Y .+ - • fir, i �
l l ► < 4
Ta + A t 1 a ► a ► 1 4 r' Yid !i r� - f ..
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♦ 'tib+'. A�fti' r �3 s'e ► l �,' �'1d � ♦ �� !`` p�5a p��y
F
� "^�'. �� °?��,//o.> • � <� a v� °<:s e
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''.'"^s�`�C�w� #^ ��i'. �`�x�`�fi �`s:•"g,, i=a'`-i��y r'�^`e`�' ��///�n�� •/r l d
LEGEND
APPLICATION AREA
UNSUITABLE AREA
—--n—n�— PRIVATE ROAD
O
WATER
— — — — STREAM
ONSITE HOUSE
— DRAIN
®
OFFSITE HOUSE
FENCE
OUTBUILDING
PROPERTY LINE
WELL
GRAPHIC SCALE
I" = 660'
660' 0 660'
ie compliance boundary is established either 250 ft from the residuals application area or 50 feet within N C-CA-35
the property boundary, whichever is closest to the application area. The review boundary is established
midway between the compliance boundary and the perimeter of the residuals application area. All
1 locations are approximate. Fields 1-3

h..
101
Uf
VICINITY MAP
GRAPHIC SCALE
1" = 2,000'
2,000- 0 2,000'
impliance boundary is established either 250 ft from the residuals application area or 50 feet within
roperty boundary, whichever is closest to the application area. The review boundary is established
I I iidway between the compliance boundary and the perimeter of the residuals application area. All
locations are approximate.
NC-CA-35
Fields 1-3

SOIL SURVEY
T
J ~
M � -,
t •r ,mil .�1 • i.! ' '
d �• I �� r � j t�,' �'��4 e p
✓iyf=� `s .4✓ W; y .r' wK+ , • L# ,=�Ms9 RY-2,. 1. e
t
r _�s
"� � �" • � � � � fit:, ' :i��'.'
GRAPHIC SCALE
1" = 660'
660' 0 660'
r
he compliance boundary is established either 250 ft from the residuals application area or 50 feet within
the property boundary, whichever is closest to the application area. The review boundary is established
midway between the compliance boundary and the perimeter of the residuals application area. All
locations are approximate.
NC-CA-35
Fields 1-3

TOPOGRAPHIC MAP
f iA',M
GRAPHIC SCALE
V = 660'
660' 0 660'
T1,. compliance boundary is established either 250 ft from the residuals application area or 50 feet within N C-CA-3 iJ
e property boundary, whichever is closest to the application area. The review boundary is established J
midway between the compliance boundary and the perimeter of the residuals application area. All
I locations are approximate. Fields 1-3

1
State of North Carolina
Department of Environmental Quality
Division of Water Resources
Division of Water Resources 15A NCAC 02T .1100 — LAND OWNER AGREEMENT
FORM: LOA 06-16
Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted, the Applicant shall submit one original and two copies of the application and
supporting documentation
For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting Unit.
General — This document is an agreement between the Applicant and land owner(s) of residuals receiving sites for land application of
Class B residuals (may include water treatment plant or other type residuals) in accordance with 15A NCAC 02T .1100. Do not
submit this agreement for review without a corresponding application form (FORM: RLAP 06-16).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. La wner Agreement (FORM: LOA 06-16):
Submit the completed and appropriately executed Land Application Site Certification (FORM: LASC 06-16) form. Please
do not make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments
to the application may be made, as long as the attachments are numbered to correspond to the section and item to which they
efer.
Prepare a separate agreement for each set of land application sites that are owned or operated by an entity other than the
pplicant.
A copy of the completed and appropriately executed agreement must be provided to the landowner and the lessee/operator.
AGREEMENT FOR THE LAND APPLICATION OF RESIDUALS TO PRIVATELY OWNED LAND
ue undersigned landow er or is representative hereby permits:
Applicant's name: ' l Ok r1knC11% I& n
hereinafter referred to as the Permittee, to land apply residuals from the following facility(ies) onto the following land
application site(s) (i.e., see attached setback maps) in accordance with the stipulations and restrictions as given in this
Agreement:
Site/Field ID
Lease
)
Land Use or
CroppingPatterns
Intended Use of Crops
Residuals Source
o
(optional)
Special note
(no-till/over-seed/
pasture)
C-Ci -3c 1
b3 �AseaA�
i(Yes/no
"Ie
1pa c�
4u
a
�►. 1
The landowner or his representative receives, in consideration, full use of the nutrient value of the applied residuals while the
Permittee receives, in consideration, the use of the land application site(s) described above for the disposal of the residuals.
is Agreement shall remain in effect for the length of the Division's permit for the residuals land application program and
_L11 be renewed each time this permit is renewed.
The undersigned landowner or his representative and the Permittee agree to abide with the following restrictions and
stipulations until such time as written notification, given 30 calendar days in advance, modifies or cancels this Agreement.
FORM: LOA 06-16 Page 1 of 3

1. STIPULATIONS:
1. The landowner or his representative shall not enter into any additional residuals application contracts or agreements with another permitted
entity for the site(s) specified by this Agreement.
2. Should the landowner or his representative lease or otherwise permit the use of the land application site(s) to a third parry, the landowner shall
be responsible to ensure that the third party agrees and complies with the terms and conditions of this Agreement.
3. The landowner or his representative shall adhere to the provisions of this Agreement until all of the site restrictions (under Section II) are met.
4. Notification of cancellation of this Agreement shall be immediately forwarded to NCDENR-DWR, Non -Discharge Permitting Unit, 1617
Mail Service Center, Raleigh, NC 27699-1617.
5. The Permittee must request and obtain a permit modification from the Division prior to a transfer of the land application site(s) to a new
landowner. In addition, the current landowner shall give a notice to the new landowner that gives full details of the residuals applied at the
land application site(s).
6. The Permittee has provided the landowner or his representative with information and data concerning the residuals land application program,
including an analysis of constituents of the residuals, residuals application methods, schedules for typical cropping patterns, a description of
the equipment used by the Permittee.
7. The Permittee will provide the landowner or his representative with a copy of the residuals permit prior to commencement of any residuals
land application event and a copy of the results of each soil analysis.
8. If the soil pH of the land application site(s) is not maintained at 6.0 or greater, sufficient amounts of lime shall be applied to achieve a final
soil pH of at least 6.0, unless an agronomist provides information indicating that the pH of the soil, residuals and lime mixture is suitable for
the specified crop.
9. The landowner or his representative and the Permittee will agree on residuals application rates and schedules based on crop patterns, results of
soil samples, and the permitted application limits.
10. The landowner or his representative will provide the Permittee with information regarding the amount and analysis of other sources of
nutrients (e.g., fertilizer, unregulated animal waste, etc.) that have been applied to the land application site(s).
11. The landowner or his representative will inform the Permittee of any revisions or modifications to the intended use and cropping patterns for
the land application site(s) prior to each planting season to enable the Permittee to amend this Agreement and schedule residuals land
application events at appropriate periods.
12. Specific residuals land application area boundaries shall be clearly marked on the land application site(s) by the Permittee, the landowner, or
his representative prior to and during a residuals land application event.
13. The landowner or his representative hereby authorizes the Permittee, local officials, and State officials or their representatives to; enter and
inspect any property, premises, or place on or related to the land application site(s) at any reasonable time for the purpose of determining
compliance with the permit; establish monitoring facilities on or near the land application site(s) as required by the permit; copy any records
that must be kept under the terms and conditions of the permit; take necessary leachate, surface water, groundwater, or soil samples during the
term of, and 12 months after termination of, this Agreement.
II. RESTRICTIONS:
1. Appropriate measures must be taken by the Permittee and/or the landowner or his representative to control public access to the land
application site(s) during active use and for the 12-month period following a residuals land application event. Such controls may include the
posting of signs that indicate the activities being conducted at the land application site(s).
2. Animals shall not be grazed on the land application site(s) for a 30-day period following a residuals land application event. Land application
sites that are to be used for grazing shall have fencing that will be used to prevent access during these periods after such residuals land
application events.
3. Food crops, feed crops, and fiber crops shall not be harvested for a 30-day period following a residuals land application event.
4. Food crops with harvested parts, that touch the residuals/soil mixture and are totally above the land surface shall not be harvested for a 14-
month period following a residuals land application event.
5. Food crops with harvested parts below the surface of the land shall not be harvested for a 20-month period following a residuals land
application event when the residuals remain on the land surface for four months or longer prior to incorporation into the soil.
6. Food crops with harvested parts below the surface of the land shall not be harvested for a 38-month period following a residuals land
application event when the residuals remain on the land surface for less than four months prior to incorporation into the soil.
7. Turf grown on land where residuals are applied shall not be harvested for a 12-month period following a residuals land application event.
M.ALTERNATIVES FOR WATER SUPPLY WELLS INSIDE THE COMPLIANCE BOUNDARY: (please check one)
15A NCAC 02L .0107(d) prohibits water supply wells within the compliance boundary. However, 15A NCAC 02T .0105(h) allows the
compliance boundary to be placed closer to the waste disposal area, such that the water supply well is situated outside of the compliance
boundary provided the groundwater standards can be met at the newly -established compliance boundary. Please mark one of the following;
❑ A re -defined compliance boundary is needed for field(s) ID:
(Please include the rationale for the requested re -location of the compliance boundary and attach a map showing the newly proposed
compliance boundary to the application package)
❑ A re -defined compliance boundary is not needed for this site.
IV. ACKNOWLEDGEMENT OF FIELD TRANSFER: (if needed)
❑ The land application field(s) ID: , is currently permitted under another
residuals land application program; Permit Number WQ: The land owner hereby acknowledge that by signing this
agreement, he/she is requesting that the field(s) be removed from the previously permitted residuals land application program and transferred
into the new program:
(Name of the new program)
'RC)PM• T.OA m-1F n.,,,o') -P2

Landowner's Certification:
I certify that I am a deeded landowner of the above -referenced land application site(s) and am authorized to make decisions
regarding the use of the land application site(s) on behalf of other deeded landowners OR that I am otherwise authorized, through
a power of attorney or other legal delegation, to make decisions regarding the use of the land application site(s) on behalf of the
deeded landowners. I certify that the above -referenced land application site(s) are not included in any waste disposal contract or
agreement with another municipality, contractor, or other permitted entity. Furthermore, I certify that I have read this Agreement,
understand the stipulations, restrictions, alternatives for water supply wells inside the compliance boundary, acknowledgement of
field transfer, and do hereby grant permission to the Permittee to land apply residuals to the land application site(s) as specified
herein.
Landown
Address:
City: t►1gJt State: oc Zip:- Z SG
Phone: R7 !Z- 36x- S(11 E-mail address. J
Signature: e Date:01
/ .�-
00 �Z
NORTH CAROLINA, C 4! -v COUNTY p
I, the undersigned Notary Public do hereby certify that
personally appeared before me this day and acknowledged the due execution of the forgoing instrumenq\®soNle ®s
WITNESS my hand and official seal this the Z
day of i m u JULY
G�- 20 e �
Signature and seal: v021
My commission expires: �. \y ZU aL! °d°�
Lessee's/Operator's Certification:
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Lessee/operator name: _
Address:
City:
Phone:
Signature:
Permittee's Certification:
I certify that I have read
Signing officia ame: _
Signature.
State:
E-mail
Date:
Zip:
and do hereby agree to abide by the stipulations and restrictions as specified herein.
Date: 1i' I IS/ I q
FORM: LOA 06-16 Page 3 of 3

CUMULATIVE METAL LOADINGS (LBS/ACRE) AS OF 10/21/2019
The Cumulative metals for this report come from HISTORY records (i.e. a Monthly Report has been produced and the loadings have been archived to History).
In cases where a trace metal lab result was Not Reported to Synagro or tracking of the metal loading was Not Required the loading on the report is displayed as "NR"
Date
Field ID
Last Applied
As
Cd
NC-CA-00035-0-0001
03/22/2014
0.2421
0.1565
NC-CA-00035-0-0002
12/21/2005
0.2240
0.1195
NC-CA-00035-0-0002-A
08/01/2019
0.3715
0.1664
NC-CA-00035-0-0002-B
07/29/2019
0.3974
0.1742
NC-CA-00035-0-0002-C
08/02/2-019
0.3917
0.1744
NC-CA-00035-0-0003
12/23/2005
0.0899
0.0807
NC-CA-00035-0-0003-A
07/12/2019
0.2686
0.1419
NC-CA-00035-0-0003-B
04/29/2019
0.2919
0.1378
Cr
Cu
Pb
Hg
Mo
Ni
- Se
Zn
5.0419
16.5181
1.9411
0.0627
0.5477
2.0893
0.2553
35.1922
2.7591
11.1460
1.2721
0.0427
0.3325
1.3206
0.1978
22.2698
5.7595
18.7425
1.6228
0.0534
0.5624
1.8948
0.3447
31.9753
5.7623
19.4719
1.7527
0.0561
0.5888
1.9978
0.3509
34,5583
5.7146
19.027:
1.6392
0.0542
0.5716
1.8835
0.3544
32.1953
2.1203
6.2507
0.9955
0.0347
02550
1.0438
0.1348
16.0243
5.5995
17.6416
1.4553
0.0495
0.5149
1.7314
0.3159
27.5537
5.1587
26.9171
1.4657
0.0504
0.4803
1.7441
0.2946
26.1490
Page; 1 of 1 10/21/2019

City of Lincolnton
Lincolnton, NC
f f e ID:
NC-CL-04
Owner:
Dennis Martin
William Martin
Address:
P.O. Box 114
4408 Fallston Road
Fallston, NC 28042
Shelby, NC 28150
Phone:
[phone]
.[phone]
Operator:
Same
Cleveland
Estimated
RYE -based
Applicable
Annual PAN limits
Fields
Acres
Cron►sl (nminrlc/arrPArrmrl
Predominant Latitude &
Soil Series Longitude
[Mon 11niA /n M C1
1
25.3
Fescue (pasture),
(p )
hay 209 /pasture 156
Cecil
35°24'02.9" N
(CaB2)
81°29'32.9" W
2
19.0
Fescue (pasture)
hay 209/ pasture 156
Cecil
35°26'11.8" N
(CaB2)
81'29'23.1" W
3
15.2
Fescue (pasture)
hay 209/ pasture 156
Cecil
35`26'19.7" N
(CaB2)
81'29'28.3" W
4
25.7
Fescue (hay)
hay 209/ pasture 156
Cecil
35°26'22.5" N
(CaB2)
81°29'36.5" W
TOTAL 85.2
Notes:
Date: 08/15/14

CUMULATIVE METAL LOADINGS (LBS/ACRE) AS OF 10121/2019
The Cumulative metals for this report come from HISTORY records (i.e. a Monthly Report has been produced and the loadings have been archived to History).
In cases where a trace metal lab result was Not Reported to Synagro or tracking of the metal loading was Not Required the loading on the report is displayed as "NR"
Date
Field ID
Last Applied
As
Cd
Cr
Cu
Pb
Hoc,
Mo
NC-CL-00004-0-0002
08/22/2016
0.0093
0.0040
0.0897
0.4143
0.0254
0.0008
0.0100
NC-CL-00004-0-0003
08/24/2016
0.0130
0.0056
0.1266
0.5803
0.0355
0.0011
0.0140
NC-CL-00004-0-0004
08/19/2016
0.0029
0.0014
0.0432
0.1557
0.0089
0.0003
0.0037
Ni
Se
Zn
0.0310
0.0100
0.4948
0.0437
0.0140
0.6908
0.0134
0.0037
0.1669
Page: 1 of 1 10/21/2019

APPLICATION MAP
r-
111�
4
LOW 0i XF
qA
A-V
4 Lit
1AV, ,
F.�
6-22
Wk.
.7
Ix,
WV_ k
W�
ASN
"S
X-V
A
4.
61 Q _5
-h,
LEGEND
APPLICATION AREA UNSUITABLE AREA
PRIVATE ROAD WATER GRAPHIC SCALE
STREAM ONSITE HOUSE I" = 660'
660' 0 660,
DRAIN OFFSITE HOUSE
FENCE OUTBUILDING
PROPERTY LINE 0 WELL
�ie compliance boundary is established either 250 ft from the residuals application area or 50 feet within
NC-CL-04
11', Lhe property boundary, whichever is closest to the application area. The review boundary is established
midway between the compliance boundary and the perimeter of the residuals application area. All
locations are approy1mate.
Field I

APPLICATION MAP
kt' ieh,�l`w'l
My'° Y 33!
. `w Y�9.{ $�++q�'a 4 aK' e'4` .� 4.�1�1 a R ,q,'i 4 a e,�2 "''�✓�# •a "&4 �l
�\
4
���1,�m��r%bY Y Y, {r'Tt .a�� p. • P� /7. p��yy� q� � k" 4, y., .,#,�{'�t ! ___yyy...
y R t� _ '4.f • n' AAAkkk !
,
�1,11a � �i$ ;
*'4 gt sir �...� 1 �?'S.t t"s����•, l� �
,' _� �
�
d "�� q': "� ' t• s,2y�4aae� } �x-.sr�k• a� a. T*8m `.
tiff• 4�
jsaa rN,,
��
-- "� '$
� $:;c�,
� >d ,-...'' viz rg a t •, � � ��1 bf �$� R �� 9vE X� e9'9 Y[�
e } t /
AZ
•
'a �r , e ;f' i t fi' 4 ➢rk
NrR
{rt�A-A k t
{�tMA �� A '� � � �GO {A .? � i � �'� 'k�� �,.• � �is �Y.gy �„".. �,r ti •J �
A, � s.5z} 2 X.
O\ tl{f ` '4 $ �t•'�' t.
� �; � `�$ Y 'Y b/ �.- YRf88Yl ..y?�C � E�39 T1� k a
,_o
WV
��ai �, cis �� ems. , h'�,, - �•��.
LEGEND
APPLICATION AREA UNSUITABLE AREA
— — — — — — PRIVATE ROAD WATER GRAPHIC SCALE
— — — — 1" s 660'
STREAM ONSITE HOUSE
660' 0 660,
— DRAIN ® OFFSITE HOUSE I
X X X FENCE OUTBUILDING
PROPERTY LINE/ WELL
'he compliance boundary is established either 250 ft from the residuals application area or 50 feet within
N C—CL-04
in the property boundary, whichever is closest to the application area. The review boundary is established
midway between the compliance boundary and the perimeter of the residuals application area. All
locations are approximate.
Fields 2-4

VICINITY MAP
Heme-na v sflwl"��)
GRAPHIC SCALE
V = 2,500'
2,500' 0 2,500'
compliance boundary is established bither250 ft from the residuals application area or 50 feet within
NC-CL-04
�i Lne property boundary, whichever is closest to the application area. The review boundary is established
midway between the compliance boundary and the perimeter of the residuals application area, All
locations are approximate.
Fields I - 4

_,.SOIL SURVEY
•• -
� 'tea-' -
1
� 4 �� SZr �.
Wt
��' µ�
f(✓ -
,� �
ij
`� '1 r �� 1 jems, �71
el r �;,i����"'� ��la _�1p »� 3•,�X�R � � . 1�'', i�t r.
4�a '��,'�.'
10
• P§kS 6Cf a P e�c�
AA
.. + g..1iy ✓. � z�
r"
�r �.�. � ?♦♦,tom �'' r � � ,s � (1 j '�� r1 �� -_ �;f ��' .��� �,,
iN
w
fir. kAli
A
t'
g
71
GRAPHIC SCALE
V = 660'
660' 0 660'
ie compliance boundary is established either 250 ft from the residuals application area or 50 feet within
N C-CL-04
he property boundary, whichever is closest to the application area. The review boundary is established
midway between the compliance boundary and the perimeter of the residuals application area. All
locations are approximate.
Field 1

SOIL SURVEY
aa' ...
-K'J
'�.,. _ r.rf ''° '4R• •' � � � ° 'yf �a -fly, �i, R# Ti r
�
F 1; *.. t
'ey4�py,w (y��iy�
~ �
9�'--_ �� y} ,�i '_ : � 0.,'.�#'+.'F' �-i
�1�.�
_.'4�Tv''-
-'�
�•,y Rti t ��.,: sf'� s� -P, a°�-''�.a# '�'N I
i8' � �r� . > `ib'�e• a .�i � A. � �'3�A�C�� �. i'�' � igt'P'`S..6g } r y 3: �t }� t `f • .•. '�ti
sgS�: t
�- �C. t �l
��
aa't � �tt�.7�,�•4*'�� •..'C 2 7`�� ; ��. ;Fe 9 -
1 - I _ `37'
S fix"
�� �k��s ` �'
�• y'
��,r ra: �z. "� p
dy;,,,A •Y a M�Raf -F � "`1� ed i TI@<,; w`� ,�. V �i'"ti'�'T�9' �. t�'`s ���`j'et
' � �.... �� y� 0`T �iv}e>i.dt• �j1 *K �ij''d��M1�..1Lz��,�;< -r �y�� C i4 �'1t 5
�$�Tp�1% f.L;+� ry Ya
,]7� `{l b R 3=.ih J as •a'Y R 4 �? F -. C� ,4 =8i F' ._, I {N d �t yr - •� � y�F f j#_ ' y
r• .p��y,� � Z.�•:.'y� 1�, �� _a3, � 1.. f� +i q, ..0. "�«f �..,'`. -'x� ir'i �C Tyf��.k
�`t�S '�
KY M t ��p `i°q�,-LR1�1't _r✓i I-�'T�'��a Yf, L.dx� � P t { F.1 r�s_�i J\ � � _
,g11,lWWiS/i)��ij C t '� �t s L b
'�ci2'vrfr$'1. �i`{_J" ''si fJ• 'f�,i ;f -,` �e y~�3�*•r`E,1 n,l '
b ,A6
' �r � �C. t , Af y i.• $ - r�ua�t. i. s• 'r` =�0��\ M1 � .
" s• `i,.f 4 ! •: `I
' ,TI --i rF., r�
? •rf A1'�[ �.i �. S`r��y�:iXJB"tfl Fes.'
R.
i � 1pr• i,' .�' 'Yt
`1 a�:�,8y�•iri�+ t � �,' `�� Foy' l{�Y/r
tnEO`�r ,!: �.kF iq� y�lj d "�Sl. •'�"�` +'�Sf{i L�^ i'it u � s � � Y �C`ey '�.
�° �� rl �� r = , �,yy,, 0 �` aj, sr'� o . - � ..� L fir` °,t 't '-
�. • � .t' *�+�`
• Hj �. 'C%# �``� � yy�.J �a f` '•T'- 6,.. 1 t fy � C, t S`
.art ii K
s ` �• yf tali
12
t�.
^
a� 1 yt�riS'
:,ytrr
Y'
t
2.�1� a • R
? �.j L 4, t
c, A �l iA ' ^�a: �# L,&` S+t t3 . '�'t t yt t' � I \ ,7,9 V_-y'ft':.
g�5�`cla'
� 51M`l'"g'
�h �^A't
lRq lC: Ntg �Rv gkF
`��• Yk �l4i }t iT r #"1 W'M`S TES' !
F�
A�i
�g$,•,k
'y-tFf �''f' i. �t � f 1'h f ",.i a � -it t #t�� y :ir t � F e ___._ n �s ��.
Ny ' tr a.�a�
r �F�4tg•.�s� � t' t .yY,,� f� �i+r � { 1<1 . r �-'• 4)�'9..i �—f��r— - 1, � •� - 4 r- .�,
i k -4 %'ylym'�'ffi y�1.4}'
lo- '
y`� '$ r. yr. a«i 4 1 Ty •'<..-•ryry F'�'4 - � �
� �r
�"e � *� i a-+4i g `�'�yr�`' ii 1 S � 1 -0.j�.7� } .h L c -ioiY 'T Aa. �w�� � d �• C 3
''.ertF+Tez. i�i"(�r, i �'.L� L6 �. ��'1.�,{fl��'Y'MS�'-i ,/i ,ih 'S 4.15 � .t.. I4 f ` 1.: �!1 �i "�+G]6.a� 'j •ik. R4;t � v.
GRAPHIC SCALE
V = 660'
sso' o ssot
fhe compliance boundary is established either 250 ft from the residuals application area or 50 feet within
N C-CL-04
„i the property boundary, whichever is closest to the application area. The review boundary is established
eate. Fields 2 e 4
midway between the compliance boundary and the perimeter of the residuals application area. All
locations are approxim

TOPOGRAPHIC MAP
I� 11
I
CU.':lil_tt'tt'
-� IIA•Il"; ',
ems__ __
_ :I,II'I'I" ; ..I_II'IT'i
VA
I I
,
.i
.
tl.l'tl:l.tl'11! .• O 11r 1'.':I•-I.tidl�
I'LIUIi"I'1' :'lggd'I'•i i ]dl"i
i•
:
\
1
,'l..II Il'I I'' I !'1.1:':I:1.'dl'11' .'I.I:'• I:1.',111'
1] I� � e I i '�',!r!1.1'I•S. gJld'P';
I
I
'
GRAPHIC SCALE
1" = 660'
660' 0 660'
A ;ompliance boundary is established either 250 ft from the residuals application area or 50 feet within
N C-C L-04
`' , property boundary, whichever is closest to the application area. The review boundary is established
midway
between the compliance boundary and the perimeter of the residuals application area. All
locations are approximate.
Field 1

TOPOGRAPHIC MAP
3
io
t:
O
O
t
GRAPHIC SCALE
1" = 660'
660' 0 660,
;ompliance boundary is established either 250 ft from the residuals application area or 50 feet within
C�C L-®4
\ property boundary, whichever is closest to the application area. The review boundary is established
midway between the compliance boundary and the perimeter of the residuals application area. All
locations are approximate.
Fields 2-4

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

i
Landowner's Certification:
I certify that I am a deeded landowner of the above -referenced land application site(s) and am authorized to make decisions
regarding the use of the land application site(s) on behalf of other deeded landowners OR that I am otherwise authorized, through
a power of attorney or other legal delegation, to make decisions regarding the use of the land application site(s) on behalf of the
deeded landowners. I certify that the above -referenced land application site(s) are not included in any waste disposal contract or
agreement with another municipality, contractor, or other permitted entity. Furthermore, I certify that I have read this Agreement,
understand the stipulations, restrictions, alternatives for water supply wells inside the compliance boundary, acknowledgement of
field transfer, and do hereby grant permission to the Permittee to land apply residuals to the land application site(s) as specified
herein.
Landowner name:
Address: 21q 0 �r r� t15� �
City: Pi State: Zip:
// GL®f�G'cva,�
Phone:7OV-4 E-mail address: /In 4-
Signature: �V.s a ��� Date: O l 1 �j
NORTH CAROLINA, �' 4e,'jGi ✓/ COUNTY
qq �
I, the undersigned Notary Public do hereby certify that iF �C )C (initials: t personally
appeared before me this day, and, being duly sworn, stated that in his/her presence ~44 signed
the attached document and acknowledged the due execution
��beyPTxecution of the foregoing instrument.
WITNESS my hand and officj seal this the `r day of D�, 20
{ Signature and seal:
My commission expires:
Lessee's/Operator's Certification:
N. ROT
GU(LFORD GVUNT
STATE OF NORTH CAR(2204 '
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Lessee/operator name:
Address:
City:
Phone:
Signature:
Permittee's Certification:
State:
E-mail
Date:
Zip:
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Signing
Signature:
Date: ) 01/// Yl / q
FORM: LOA 06-16 Page 3 of 3

SITE SUMMARY
Site ID:
NC-LT-19
Owner:
Chuck Waters
Address:
3529 Killian Road
Lincolnton, NC 28092
Phone:
[phone]
Operator:
Same
Estimated
Applicable
Fields
Acres Crops)
City of Lincolnton
Lincolnton, NC
Lincoln County
RYE -based
Annual PAN limits
(pounds/acre/year)
Predominant
Latitude &
Soil Series
Longitude
(map unit)
(D.M.S)
1
41.8
Fescue (pasture)
hay 216 / pasture 162
Lloyd
35°32'35.1" N
(LdB2)
81°18'35.4" W
2
12.7
Fescue (pasture)
hay 216 / pasture 162
Lloyd
35°32'39.8" N
(LdB2)
81°18'25.0" W
3
13.2
Fescue (pasture)
hay 198 / pasture 148
Riverview
35°32'28.3" N
(RvA)
81°18`51.3" W
TOTAL
67.7
Notes:
Date: 08/15/14

CUMULATIVE METAL LOADINGS (LBSIACRE) AS OF 10121/2019
The Cumulative metals for this report come from HISTORY records (i.e. a Monthly Report has been produced and the loadings have been archived to History).
In cases where a trace metal lab result was Not Reported to Synagro or tracking of the metal loading was Not Required the loading on the report is displayed as "NR"
Field ID
NC-LT-00019-0-0001
N C-LT-00019-0-0001-A
N C-LT-00019-0-0001-B
N C-LT-00019-0-0002
NC -LT 00019-0-0003
NC-LT-00019-0-0004
NC-LT-00019-0-0005
Date
Last Applied
As
Cd
Cr
Cu
Pb
Hg
Mo
08/24/2018
0.1900
0.0770
7.5862
14.5138
0.7943
0.0322
0.4611
02/01 /2019
0.2152
0.0806
7.7528
15.2890
0.8341
0.0324
0.4819
03/2212019
0.2058
0.0802
7.7119
15.5232
0.8465
0.0323
0.4758
05/21/2019
0.2834
0.1362
26.8153
17.2792
2.4688
0.0896
0.8076
08/24/2018
0.1360
0.0646
6.0231
9.9542
0.6900
0.0300
0.4024
07/01/2003
0.0053
0.0070
0.6576
. 0.5988
0.0405
0.0036
0.0342
11/09/2002
0.0678
0.0372
13.1948
3.2818
1.1390
0.0377
0.2255
Ni
Se
Zn
0.9995
0.1781
14.9136
1.0404
0.1961
16.0190
1.1441
0.1940
16.3755
1.6320
0.2212
28.0843
0.7464
0.1657
13.7590
0.0474
0.0181
0.9471
0.4398
0.0165
8.0522
Page: 1 of 1 10/21/2019

CUMULATIVE METAL LOADINGS (LBS/ACRE) AS OF 10/21/2019
The Cumulative metals for this report come from HISTORY records (i.e. a Monthly Report has been produced and the loadings have been archived to History).
In cases where a trace metal lab result was Not Reported to Synagro or tracking of the metal loading was Not Required the loading on the report is displayed as "NW'
Date
Field ID Last Applied. As Cd Cr Cu Pb Hq Mo Ni — Zn
NC-LT-00006-0-0001 04/29/2017 0.1620 0.1060 11.5021 17.2974 1.5031 0.0543 0.6943 1.1724 0.1627 27.2799
NC-LT-00006-0-0002 03/08/2017 0.1533 0.0858 6.2977 13,4414 0.6670 0.0340 0.4174 0.8154 0.1923 13.6260
10121/2019
Page: 1 of 1

APPLICATION MAP
LEGEND
AREA
UNSUITABLE AREA
APPLICATION
WATER
— — — — — — PRIVATE ROAD
— — — — STREAM
ONSITE HOUSE
— DRAIN
®
OFFSITE HOUSE
#� FENCE
OUTBUILDING
PROPERTY LINE
0/
WELL
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within
in the property boundary, whichever is closest to the application area. The review boundary is established
midway between the compliance boundary and the perimeter of the residuals application area. All
locations are approximate.
GRAPHIC SCALE
I" = 660'
660' 0 660'
l � ,
NC-LT-1 9
FieldS 1-3

VICINITY MAP
a,
d
t
r
1
l
.S
1
g Xy
��"�til 3AU �i1 �is 4i �i •
4
kt
GRAPHIC SCALE
V = 2,000'
2,000' 0 2,000'
1 1
e compliance boundary is established either 250 It from the residuals application area or 50 feet within
N C-LT- 19
in the property boundary, whichever is closest to the application area. The review boundary is established
midway between the compliance boundary and the perimeter of the residuals application area. All
locations are approximate.
Fields 1-3

SOIL SURVEY
GRAPHIC SCALE
V = 660'
660' 0 660'
( The compliance boundary is established either 250 ft from the residuals application area or 50 feet within NC-LT1 9
in the property boundary, whichever is closest to the application area. The review boundary is established
midway between the compliance boundary and the perimeter of the residuals application area. All locations are approximate. Fields a� l —3

TOPOGRAPHIC NEAP
, ,)
z
O
O '
' er.
d
I
f }�
GRAPHIC SCALE
1 ° = 660'
660' 0 660'
1 1
� 1
-The compliance boundary is established either 250 ft from the residuals application area or 50 feet within
N C—LT-19
in the property boundary, whichever is closest to the application area. The review boundary is established
Fields 1-3
midway between the compliance boundary and the perimeter of the residuals application area. All
locations
are approximate.

State of North Carolina
Department of Environmental Quality
Division of 'Water Resources
Sivlsion of Water Resources
15A NCAC 02T .1100 — LAND OWNER AGREEMENT
FORM: LOA 06-16
Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted, the Applicant shall submit one original and two copies of the application and
supporting documentation
For more information, visit the Water Quality Permitting, Section's Non -Discharge Permitting Unit.
General — This document is an agreement between the Applicant and land owner(s) of residuals receiving sites for land application of
Class B residuals (may include water treatment plant or other type residuals) in accordance with 15A NCAC 02T .1100. Do not
submit this agreement for review without a corresponding application form (FORM: RLAP 06-16).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Lan caner Agreement (FORM: LOA 06-16):
Submit the completed and appropriately executed Land Application Site Certification (FORM: LASC 06-16) form. Please
do not make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments
to the application may be made, as long as the attachments are numbered to correspond to the section and item to which they
ex.
Prepare a separate agreement for each set of land application sites that are owned or operated by an entity other than the
Applicant.
A copy of the completed and appropriately executed agreement must be provided to the landowner and the lessee/operator.
AGREEMENT FOR THE LAND APPLICATION OF RESIDUALS TO PRIVATELY OWNED LAND
t-ne undersigned landrer/or his rep esentative hereby permits:
Applicant's name: l�� ` 7 O J_.`I t o ,y
ll
hereinafter referred to as the Permittee, to land apply residuals from the following facility(ies) onto the followinglaud
application site(s) (i.e., see attached setback maps) in accordance with the stipulations and restrictions as given in this
Agreement:
Site/Field ID
Lease
es/no
(yes/no)
)
Land Use or
in Patterns
Cropping g,%
Intended Use of Crops
Residuals Source
o tional
(optional)
Special note
(no-till/over-seed/
pasture)
/
l
The landowner or his representative receives, in consideration, full use of the nutrient value of the applied residuals while the
Permittee receives, in consideration, the use of the land application site(s) described above for the disposal of the residuals.
s Agreement shall remain in effect for the length of the Division's permit for the residuals land application program and
___11 be renewed each time this permit is renewed.
The undersigned landowner or his representative and the Permittee agree to abide with the following restrictions and
stipulations until such time as written notification, given 30 calendar days in advance, modifies or cancels this Agreement.
FORM: LOA 06-16 Page 1 of 3

I. STIPULATIONS:
1. The landowner or his representative shall not enter into any additional residuals application contracts or agreements with another permitted
entity for the site(s) specified by this Agreement.
2. Should the landowner or his representative lease or otherwise permit the use of the land application site(s) to a third parry, the landowner shall
be responsible to ensure that the third party agrees and complies with the terms and conditions of this Agreement.
3. The landowner or his representative shall adhere to the provisions of this Agreement until all of the site restrictions (under Section II) are met.
4. Notification of cancellation of this Agreement shall -be immediately forwarded to NCDENR-DWR, Non -Discharge Permitting Unit, 1617
Mail Service Center, Raleigh, NC 27699-1617.
5. The Permittee must request and obtain a permit modification from the Division prior to a transfer of the land application site(s) to a new
landowner. In addition, the current landowner shall give a notice to the new landowner that gives full details of the residuals applied at the
land application site(s).
6. The Permittee has provided the landowner or his representative with information and data concerning the residuals land application program,
including an analysis of constituents of the residuals, residuals application methods, schedules for typical cropping patterns, a description of
the equipment used by the Permittee.
7. The Permittee will provide the landowner or his representative with a copy of the residuals permit prior to commencement of any residuals
land application event and a copy of the results of each soil analysis.
8. If the soil pH of the land application site(s) is not maintained at 6.0 or greater, sufficient amounts of lime shall be applied to achieve a final
soil pH of at least 6.0, unless an agronomist provides information indicating that the pH of the soil, residuals and lime mixture is suitable for
the specified crop.
9. The landowner or his representative and the Permittee will agree on residuals application rates and schedules based on crop patterns, results of
soil samples, and the permitted application limits.
10. The landowner or his representative will provide the Permittee with information regarding the amount and analysis of other sources of
nutrients (e.g., fertilizer, unregulated animal waste, etc.) that have been applied to the land application site(s).
11. The landowner or his representative will inform the Permittee of any revisions or modifications to the intended use and cropping patterns for
the land application site(s) prior to each planting season to enable the Permittee to amend this Agreement and schedule residuals land
application events at appropriate periods.
12. Specific residuals land application area boundaries shall be clearly marked on the land application site(s) by the Permittee, the landowner, or
his representative prior to and during a residuals land application event.
13. The landowner or his representative hereby authorizes the Permittee, local officials, and State officials or their representatives to; enter and
inspect any property, premises, or place on or related to the land application site(s) at any reasonable time for the purpose of determining
compliance with the permit; establish monitoring facilities on or near the land application site(s) as required by the permit; copy any records
that must be kept under the terms and conditions of the permit; take necessary leachate, surface water, groundwater, or soil samples during the
t-of, and 12 months after termination of, this Agreement.
H. TRICTIONS:
1. 1
Appropriate measures must be taken by the Permittee and/or the landowner or his representative to control public access to the land
application site(s) during active use and for the 12-month period following a residuals land application event. Such controls may include the
., posting of signs that indicate the activities being conducted at the land application site(s).
2. Animals shall not be grazed on the land application site(s) for a 30-day period following a residuals land application event. Land application
sites that are to be used for grazing shall have fencing that will be used to prevent access during these periods after such residuals land
application events.
3. Food crops, feed crops, and fiber crops shall not be harvested for a 30-day period following a residuals land application event.
4. Food crops with harvested parts, that touch the residuals/soil mixture and are totally above the land surface shall not be harvested for a 14-
month period following a residuals land application event.
5. Food crops with harvested parts below the surface of the land shall not be harvested for a 20-month period following a residuals land
application event when the residuals remain on the land surface for four months or longer prior to incorporation into the soil.
6. Food crops with harvested parts below the surface of the land shall not be harvested for a 38-month period following a residuals land
application event when the residuals remain on the land surface for less than four months prior to incorporation into the soil.
7. Turf grown on land where residuals are applied shall not be harvested for a 12-month period following a residuals land application event.
HLALTERNATIVES FOR WATER SUPPLY WELLS INSIDE THE COMPLIANCE BOUNDARY: (please check one)
15A NCAC 02L .0107(d) prohibits water supply wells within the compliance boundary. However, 15A NCAC 02T .0105(h) allows the
compliance boundary to be placed closer to the waste disposal area, such that the water supply well is situated outside of the compliance
boundary provided the groundwater standards can be met at the newly -established compliance boundary. Please mark one of the following;
❑ A re -defined compliance boundary is needed for field(s) ID:
(Please include the rationale for the requested re -location of the compliance boundary and attach a map showing the newly proposed
compliance boundary to the application package)
❑ A re -defined compliance boundary is not needed for this site.
M ACKNOWLEDGEMENT OF FIELD TRANSFER: (if needed)
❑ The land application field(s) ID: , is currently permitted under another
residuals land application program; Permit Number WQ: The land owner hereby acknowledge that by signing this
agreement, he/she is requesting that the field(s) be removed from the previously permitted residuals land application program and transferred
into the new program;
(Name of the new program)
Vnur/f• r n A n9_1 1� Paae 2 of 3

Landowner's Certification:
I certify that I am a deeded landowner of the above -referenced land application site(s) and am authorized to make decisions
regarding the use of the land application site(s) on behalf of other deeded landowners OR that I am otherwise authorized, through
a power of attorney or other legal delegation, to make decisions regarding the use of the land application site(s) on behalf of the
deeded landowners. I certify that the above -referenced land application site(s) are not included in any waste disposal contract or
agreement with another municipality, contractor, or other permitted entity. Furthermore, I certify that I have read this Agreement,
understand the stipulations, restrictions, alternatives for water supply wells inside the compliance boundary, acknowledgement of
field transfer, and do hereby grant permission to the Permittee to land apply residuals to the land application site(s) as specified
herein. o / f1
Landowner name:
Address:
City: i I ✓ P/✓ ��/✓ State: �,� , Zip: IV 1-Fo®9
Phone: E-mail address'.
Signature: Date:
NORTH CAROLINA, `& COUNTY
I, the undersigned Notary Public do hereby certify that ka4- F9 pt (initials: personally
appeared appeared before me this day, and, being duly sworn, stated that in his/her presence Chcq L U4eYS signed
the attached document and acknowledged the due execution of the foregoing instrument.
WITNESS my hand and official seal this the 4-b day of Q o bC V' , 20�
Signature and seal: Owe-
My commission expires: U ni
PUBLIC
GUILFORD COUNTY
STATE OF NORTH CAROLING'.
Lessee's/Operator's Certification:
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Lessee/operator name:
Address:
City:
Phone:
Signature:
Permittee's Certification:
I certify that I have read this
i
Signing official ame:
Signature:
State:
E-mail address:
Date:
Zip:
and do hereby agree to abide by the stipulations and restrictions as specified herein.
Date: 101,8114
FORM: LOA 06-16 Page 3 of 3

i
i

SITE SUMMARY
City of Lincolnton
Lincolnton, NC
Site ID:
NC-LT-36
Owner:
Jeff Lingerfelt (1-2)
Joann Leatherman (3-5)
Address:
7338 West Highway 27
7322 West Highway 27
Vale, NC 28168
Vale, NC 28168
Phone:
[phone]
[phone]
Operator:
Jeff Lingerfelt
Address:
Same
Lincoln
Estimated
RYE -based Predominant Latitude &
Applicable
Annual PAN limits Soil Series Longitude
Fields
Acres Crov(s)
(pounds/acre/vearl (man unitl (D.M.S)
1
11.8
Fescue (pasture)
hay 209 / pasture 156
Cecil
35°30'03.1" N
(CeB2)
81°28'58.4" W
2
17.5
Fescue (pasture)
hay 209 / pasture 156
Cecil
35°29'50.3" N
(CeB2)
81°28'58.6" W
corn
131
Cecil
35°29`48.1" N
3
8.6
soybeans
do 155 / fs 185
(CeB2)
81°28'47.4" W
wheat
115
corn
131
Cecil
35°29`35.7" N
4
24.1
soybeans
do 155 / fs 185
(Ce132)
81°28'36.5" W
wheat
115
corn
131
Cecil
35°29'37.7" N
5
13.5
soybeans
do 155 / fs 185
(CeB2)
81°28'22.0" W
wheat
115
TOTAL
75.5
Notes:
Date: 08/15/14

CUMULATIVE METAL LOADINGS (LBSIACRE) AS OF 10/21/2019
The Cumulative metals for this report come from HISTORY records (i.e. a Monthly Report has been produced and the loadings have been archived to History).
In cases where a trace metal lab result was Not Reported to Synagro or tracking of the metal loading was Not Required the loading on the report is displayed as "MR"
Date
Field ID
Last Applied
As
Cd
Cr
Cu
Pb
ha
Mo
NC -LT 00036-0-0001
02/19/2016
0.0723
0.0261
2.5329
4.5752
0.1964
0.0103
0.1685
NC-LT-00036-0-0002
08/19/2019
0.1052
0.0342
2.9671
5.7452
0.2494
0.0093
0.1841
NC-LT-00036-0-0003
05/23/2019
0.1271
0.0357
3.2681
6.6320
0.2928
0.0117
0.2231
NC-LT-00036-0-0004
11/29/2018
0.0346
0.0134
1.6870
2.5549
0.1105
0.0048
0.0915
NC-LT.-00036-0-0004-A
07/02/2014
0.0495
0.0192
1.8770
3.2078
0.1351
0.0065
0.1123
NC-LT-00036-0-0004-5
07/01/2014
0.0488
0.0191
1.8661
3.1856
0.1334
0.0064
0.1116
NC-LT-00036-0-0005
05/23/2019
0.1210
0.0350
2.5025
6.9507
0.2641
0,0106
0.1965
Ni
Se
Zn
0.3798
0.0653
5.4511
0.4484
0.0947
6.9768
0.5032
0.1070
8.1406
0.2169
0.0286
2.9870.
0.2615
0.0379
3.8540
0.2688
0.0378
3.8171
0.4151
0.0999
7.7142
Page: 1 of 1 10/21/2019

'
�
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�
�
;fie i M� ' i� ♦ D a t
1
y
♦ �Li
► �d� 0 all
A 3, t1
t
` ,
lJJfSfJJJ♦ .i
r
♦/'/s�®7,♦ �� � � `�+R � x � � '
\ 1
t®�� a J �i. e ► �M/.
RE
4
� s <
•,'� ►, r . �/ �j ,
wila• a
VIA.
V.
• � 1 • • l , 4 � l � 1.

VICINITY MAP
E-1:4767
GRAPHIC SCALE
V = 4, 000'
97 0 4,000'
)mpliance boundary is established either 250 It from the residuals application area or 50 feet within NC-LT-36
�d the property boundary, whichever is closest to the application area. The -review boundary is established
midway between the compliance boundary and the perimeter of the residuals application area. fidl
locations are approximate. Fields 1-5

SOIL SURVEY
GRAPHIC SCALE
V = 660'
660' o 660'
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within N C-LT-36
in the property boundary, whichever is closest to the application area. The review boundary is established
midway between the compliance boundary and the perimeter of the residuals application area. All
locations are approximate. Fields 1 `5

j TOPOGRAPHIC MAP
O
O
O
O
O
GRAPHIC SCALE
Ilk = 660'
660' 0 660'
i
a compliance boundary is established either 250 ft from the residuals application area or 50 feet within
N C`LT-36
ii,'tile property boundary, whichever is closest to the application area. The review boundary is established
midway between the compliance boundary and the perimeter of the residuals application area. All
locations are approximate.
Fields 1-5

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

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

Landowner's Certification:
I certify that I am a deeded landowner of the above -referenced land application site(s) and am authorized to make decisions
regarding the use of the land application site(s) on behalf of other deeded landowners OR that I am otherwise authorized, through
a power of attorney or other legal delegation, to make decisions regarding the use of the land application site(s) on behalf of the
deeded landowners. I certify that the above -referenced land application site(s) are not included in any waste disposal contract or
agreement with another municipality, contractor, or other permitted entity. Furthermore, I certify that I have read this Agreement,
understand the stipulations, restrictions, alternatives for water supply wells inside the compliance boundary, acknowledgement of
field transfer, and do hereby grant permission to the Permittee to land apply residuals to the land application site(s) as specified
herein.
Landowner name
.i gel Ir I7Z
Address: 7 3 7
City: C State: Zip:
Phone: c� E-mail address:
Signature: Dater V d
NORTH CAROLINA, _1lw C COUNTY
r
I, the undersigned Notary Public do hereby certify that At � l Q 3c (initials: I ) personally
appeared before me this day, and, being duly sworn, stated that in his/her presence SA'_ Q� f.4'�! {� signed
the attached document and acknowledged the due.execution of the foregoing instrument.
WITNESS my hand and offi ' 1 seal thhiis%the T�
Signature and seal: �� " r
My commission expires: i i, Is �4 Z D
Lessee's/Operator's Certification:
day of ®fh h C!C , 20�
GUILFORD COUNTY
STATE OF NORTH CAROLINA
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Lessee/operator name:
Address:
City:
Phone:
Signature:
Permittee's Certification:
I certify that I have read
Signing official name: _
Signature:
State:
E-mail address:
Date:
Zip:
and do hereV agree to abide by the stipulations and restrictions as specified herein.
Date: 1 i 11VI
FORM: LOA 06-16 Page 3 of 3

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

I. STIPULATIONS:
1. The landowner or his representative shall not enter into any additional residuals application contracts or agreements with another permitted
entity for the site(s) specified by this Agreement.
2. Should the landowner or his representative lease or otherwise permit the use of the land application site(s) to a third party, the landowner shall
be responsible to ensure that the third party agrees and complies with the terms and conditions of this Agreement.
3. The landowner or his representative shall adhere to the provisions of this Agreement until all of the site restrictions (under Section II) are met.
4. Notification of cancellation of this Agreement shall be immediately forwarded to NCDENR-DWR, Non -Discharge Permitting Unit, 1617
Mail Service Center, Raleigh, NC 27699-1617.
5. The Permittee must request and obtain a permit modification from the Division prior to a transfer of the land application site(s) to a new
landowner. In addition, the current landowner shall give a notice to the new landowner that gives full details of the residuals applied at the
land application site(s).
6. The Permittee has provided the landowner or his representative with information and data concerning the residuals land application program,
including an analysis of constituents of the residuals, residuals application methods, schedules for typical cropping patterns, a description of
the equipment used by the Permittee.
7. The Permittee will provide the landowner or his representative with a copy of the residuals permit prior to commencement of any residuals
land application event and a copy of the results of each -soil analysis.
8. If the soil pH of the land application site(s) is not maintained at 6.0 or greater, sufficient amounts of lime shall be applied to achieve a final
soil pH of at least 6.0, unless an agronomist provides information indicating that the pH of the soil, residuals and lime mixture is suitable for
the specified crop.
9. The landowner or his representative and the Permittee will agree on residuals application rates and schedules based on crop patterns, results of
soil samples, and the permitted application limits.
10. The landowner or his representative will provide the Permittee with information regarding the amount and analysis of other sources of
nutrients (e.g., fertilizer, unregulated animal waste, etc.) that have been applied to the land application site(s).
11. The landowner or his representative will inform the Permittee of any revisions or modifications to the intended use and cropping patterns for
the land application site(s) prior to each planting season to enable the Permittee to amend this Agreement and schedule residuals land
application events at appropriate periods.
12. Specific residuals land application area boundaries shall be clearly marked on the land application site(s) by the Permittee, the landowner, or
his representative prior to and during a residuals land application event.
13. The landowner or his representative hereby authorizes the Permittee, local officials, and State officials -or their representatives to; enter and
inspect any property, premises, or place on or related to the land application site(s) at any reasonable time for the purpose of determining
compliance with the permit; establish monitoring facilities on or near the land application site(s) as required by the permit, copy any records
I, z�nust,,be kept under the terms and conditions of the permit; take necessary leachate, surface water, groundwater, or soil samples during the
'term of Od 12 months after termination of� this Agreement.
4� rs
II. RI; TRICTIONS:
1. c Appropriate measures must be taken by the Pemrittee and/or the landowner or his representative to control public access to the land
% 'I
ppliM4Wi site(s) during active use and for the 12-month period following a residuals land application event. Such controls may include the
posting of!signs that indicate the activities being conducted at the land application site(s).
2. Animals shall not be grazed on the land application site(s) for a 30-day period following a residuals land application event. Land application
sites that are to be used for grazing shall have fencing that will be used to prevent access during these periods after such residuals land
application events.
3. Food crops, feed crops, and fiber crops shall not be harvested for a 30-day period following a residuals land application event.
4. Food crops with harvested parts, that touch the residuals/soil mixture and are totally above the land surface shall not be harvested for a 14-
month period following a residuals land application event.
5. Food crops with harvested parts below the surface of the land shall not be harvested for a 20-month period following a residuals land
application event when the residuals remain on the land surface for four months or longer prior to incorporation into the soil.
6. Food crops with harvested parts below the surface of the land shall not be harvested for a 38-month period following a residuals land
application event when the residuals remain on the land surface for less than four months prior to incorporation into the soil.
7. Turf grown on land where residuals are applied shall not be harvested for a 12-month period following a residuals land application event.
IMALTERNATIVES FOR WATER SUPPLY WELLS INSIDE THE COMPLIANCE BOUNDARY: (please check one)
15A NCAC 02L .0107(d) prohibits water supply wells within the compliance boundary. However, 15A NCAC 02T .0105(h) allows the
compliance boundary to be placed closer to the waste disposal area, such that the water supply well is situated outside of the compliance
boundary provided the groundwater standards can be met at the newly -established compliance boundary. Please mark one of the following;
❑ A re -defined compliance boundary is needed for field(s) ID:
(Please include the rationale for the requested re -location of the compliance boundary and attach a map showing the newly proposed
compliance boundary to the application package)
❑ A re -defined compliance boundary is not needed for this site.
IV. ACKNOWLEDGEMENT OF FIELD TRANSFER: (if needed)
❑ The land application field(s) ID: is currently permitted under another
residuals land application program; Permit Number WQ: The land owner hereby acknowledge that by signing this l
agreement, he/she is requesting that the field(s) be removed from the previously permitted residuals land application program and transferred
into the new program;
(Name of the new program)

Landowner's Certification:
I certify that I am a deeded landowner of the above -referenced land application site(s) and am authorized to make decisions
regarding the use of the land application site(s) on behalf of other deeded landowners OR that I am otherwise authorized, through
a power of attorney or other legal delegation, to make decisions regarding the use of the land application site(s) on behalf of the
deeded landowners. I certify that the above -referenced land application site(s) are not included in any waste disposal contract or
agreement with another municipality, contractor, or other permitted entity. Furthermore, I certify that I have read this Agreement,
understand the stipulations, restrictions, alternatives for water supply wells inside the compliance boundary, acknowledgement of
field transfer, and do hereby grant permission to the Permittee to land apply residuals to the land application site(s) as specified
herein_
Landowner name
Address: ::Z ;-�_ �,/- h` `f`/ 11,7
City: LA C State: ®' ' C zip: ,') /6 eS
Phone: E-mail address:
' Signature: Date: _ � C
NORTH CAROLINA, AQ l COUNTY
I, the undersigned Notary Public do hereby certify that Azi m Foy, (initials personally
appeared before me this day, and, being duly sworn, stated that in his/her presence�p^V101 It �eY^*-,"y% signed
the attached document and acknowledged the due execution of the foregoing instrument.
WITNESS my hand and ofcia eal this theA. h day of 0K3'0 klf , 20 Iq
w
Signature and seal:
My commission expires: Q(9• $° "� fl R®EERT N. R®TI.'
FORM: LOAA 090814 Pagel of 3 GUIL.FORD COU41tochment Order 3-c
STATE OF NORTH CARO "" ;
Lessee's/Operator's Certification:
I certify that I have read this A eement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Lessee/operator name: _ i i t— r A) P1 �'e21i 1('f
Address: '� �j `� `/ i
City: �, f State: o C- zip: vim'
Phone: - y ` l I �� E-mail address:
Signature: --e Date: 1/J
f
Permittee's Certification:
I certify that I have read this Aveement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Signing official name: GC& r3rnn
Signature: �,(�.. Date:
FORM: LOA 06-16 Page 3 of 3

SITE SUMMARY
Site ID: NC-LT-06
Owner: Mike Macomson
Address: 2739 River Road
Lincolnton, NC 28092
Phone: [phone]
Operator: Same
Estimated
Applicable
Fields Acres Crop(s)
City of Lincolnton
Lincolnton, NC
Lincoln County
RYE -based
Annual PAN limits
(pounds/acre/vear)
Predominant
Latitude &
Soil Series
Longitude
(map unit)
(D.M.S)
1
44.6
Fescue (pasture)
hay 216 / pasture 162
Lloyd
35°31'24.5" N
(LdB2)
81°16'52.6" W
2
29.4
Fescue (hay)
hay 209 / pasture 156
Cecil
35°30'40.3" N
(CeB2)
81`15'55.8" W
TCJ rAL
Notes
74.0
Date: 08/15/14

CUMULATIVE METAL LOADINGS (LBSIACRE) AS OF 10121/2019
The Cumulative metals for this report come from HISTORY records (i.e. a Monthly Report has been produced and the loadings have been archived to History).
In cases where a trace metal lab result was Not Reported to Synagro or tracking of the metal loading was Not Required the loading on the report Is displayed as "NR"
i
Date
Field ID Last Applied As Cd Cr Cu Pb Hq Mo Ni Se Zn
NC-LT-00006-0-0001 04/29/2017 0.1620 0.1060 11.6021 17.2974 1.5031 0.0543 0.6943 1.1724 0.1627 27.2799
NC-LT-00006-0-0002 03/08/2017 0.1533 0.0858 6.2977 13,4414 0.6670 0.0340 0.4174 0.8154 0.1923 13.6260
Page: 1 of 1 10/21/2019

APPLICATION MAP
�d
{R ` Sf'
A. i.,.3•' 1 rayr .
r $�'�'�`,' tom•: � g .'�-G t
��� - 3 f 1 -• � t i 1
I t io
g Y ! t
.�. "f` 3 !j ( Q ~ t n• eft �...' _
LEGEND
APPLICATION AREA UNSUITABLE AREA
_ — — — — — PRIVATE ROAD O WATER GRAPHIC SCALE
— — — STREAM ONSITE HOUSE
�" = 660'
660' 0 660'
DRAIN OFFSITE HOUSE
FENCE OUTBUILDING
PROPERTY LINE 0 WELL
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within N C-LT-06
in the property boundary, whichever is closest to the application area. The review boundary is established
midway between the compliance boundary and the perimeter of the residuals application area. All Field
locations are approximate.

10
ADDI irATIC) i MAP
LEGEND
APPLICATION AREA
UNSUITABLE AREA
O
WATER
GRAPHIC SCALE
_ — — — — — PRIVATE ROAD
I" = 660'
STREAM '=.
ONSITE HOUSE
0 660'
660'
— DRAIN ■
OFFSITE HOUSE
�- FENCE
OUTBUILDING
PROPERTY LINE 0
WELL
'l The compliance boundary is established either 250 ft from the residuals application area or 50 feet within
The boundary is established F::
N C-LT-06
in the property boundary, whichever is closest to the application area. review
midway between the compliance boundary and the perimeter of the residuals application area. All
I
Field 2
locations are approximate.

VICINITY MAP
Pf .•
fl
GRAPHIC SCALE
1" = 2,000'
2,000' 0 2,000'
r
compliance boundary is established either 250 It from the residuals application area or 50 feet within
N G`_L`I _06
property boundary, whichever is closest to the application area. The review boundary is established
midway between the compliance boundary and the perimeter of the residuals application area. All
locations are approximate.
Fields 1-2

SOIL SURVEY
GRAPHIC SCALE
V = 660'
660' 0 660'
,
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within N C_LT_06
in the property boundary, whichever is closest to the application area. The review boundary is established
midway between the compliance boundary and the perimeter of the residuals application area. All locations are approximate. Field I

CP111 gIIR\/PY
GRAPHIC SCALE
1" = 660'
660' 0 660'
• The compliance boundary is established either 250 ft from the residuals application area or 50 feet within N C-LT-06
in the property boundary, whichever is closest to the application area. The review boundary is established
midway between the compliance boundary and the perimeter of the residuals application area. All Field
locations are approximate.

TOPOGRAPHIC MAP
GRAPHIC SCALE
1" = 660
660' 0 660'
The compliance boundary is established either 250 ft from the residuals application area or 50 feet within N C-LT-06
in the property boundary, whichever is closest to the application area. The review boundary is established
midway between the compliance boundary and the perimeter of the residuals application area. All
locations are approximate. Field 1

TOPOGRAPHIC
-
lin
.1 t �G✓I
1 h
t.
n.M
Z[
GRAPHIC SCALE
V = 660'
660' 0 669
I 1
'he compliance boundary is established either 250 ft from the residuals application area or 50 feet within
N G-LT-06
the property boundary, whichever is closest to the application area. The review boundary is established
Field 2
midway between the compliance boundary and the perimeter of the residuals application area. All
locations
are approximate.

State of North Carolina
Department of Environmental Quality
Division of Water Resources
` Division ofWater Resources 15A NCAC 02T .1100 — LAND OWNER AGREEMENT
FORM: LOA 06-16
Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted, the Applicant shall submit one original and two copies of the application and
supporting documentation
For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting Unit.
General — This document is an agreement between the Applicant and land owner(s) of residuals receiving sites for land application of
Class B residuals (may include water treatment plant or other type residuals) in accordance with 15A NCAC 02T .1100. Do not
submit this agreement for review without a corresponding application form (FORM: RLAP 06-16).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Lan wner Agreement (FORM: LOA 06-16):
Submit the completed and appropriately executed Land Application Site Certification (FORM: LASC 06-16) form. Please
do not make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments
to the application may be made, as long as the attachments are numbered to correspond to the section and item to which they
er.
Prepare a separate agreement for each set of land application sites that are owned or operated by an entity other than the
Aplicant.
copy of the completed and appropriately executed agreement must be provided to the landowner and the lessee/operator.
AGREEMENT FOR THE LAND APPLICATION OF RESIDUALS TO PRIVATELY OWNED LAND '
x ue undersigned landowner or his re resentative hereby permits:
Applicant's name: �,; / L ,,ncD(n L
hereinafter referred to as the Permittee, to land apply residuals from the following facility(ies) onto the following' land
application site(s) (i.e., see attached setback maps) in accordance with the stipulations and restrictions as given in this
Agreement:
Site/Field ID
Lease
es/no
(Y )
Land Use or
Cropping Patterns
pp g
Intended Use of Crops
Residuals Source
(optional)
Special note
(no-till/over-seed/
pasture)
The landowner or his representative receives, in consideration, full use of the nutrient value of the applied residuals while the
Permittee receives, in consideration, the use of the land application site(s) described above for the disposal of the residuals.
Agreement shall remain in effect for the length of the Division's permit for the residuals land application program and
____1 be renewed each time this permit is renewed.
The undersigned landowner or his representative and the Permittee agree to abide with the following restrictions and
stipulations until such time as written notification, given 30 calendar days in advance, modifies or cancels this Agreement.
FORM: LOA 06-16 Page 1 of 3

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

Landowner's Certification:
I certify that I am a deeded landowner of the above -referenced land application site(s) and am authorized to make decisions
regarding the use of the land application site(s) on behalf of other deeded landowners OR that I am otherwise authorized, through
a power of attorney or other legal delegation, to make decisions regarding the use of the land application site(s) on behalf of the
deeded landowners. I certify that the above -referenced land application site(s) are not included in any waste disposal contract or
agreement with another municipality, contractor, or other permitted entity. Furthermore, I certify that I have read this Agreement,
understand the stipulations, restrictions, alternatives for water supply wells inside the compliance boundary, acknowledgement of
field transfer, and do hereby grant permission to the Permittee to land apply residuals to the land application site(s) as specified
herein.
Landowner name:
Address: <MO1*7 3 1
City: /® rnco 1,0 A,I State: A I Zip:
Phone: -e — e �l s% E-mail address:
Signatur Date: 1 ®/ -70 t i
NORTH CAROLINA, d!C( J t e. COUNTY
I, the undersigned Notary Public do hereby certify that
—Ala, r®� I�s
appeared before me this day, and, being duly sworn, stated that in his/her presence (� !s Personally
the attached document and acknowledged the due execution of the foregoing instrument. signed
WITNESS my hand and offfc' seal this th �day
of leer -
Signature and seal: ' ZO
My commission expires:
Lessee's/Operator's Certification:
ntisa�c�cs■ ®....a....—
TARY PUBLIC
GUILFORD COU
STATE OF N0R—t i TAROM! IN,,
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Lessee/operator name:
Address:
City:
Phone:
Signature:
Permittee's Certification:
I certify that I have read
Signing officia name:
Signature:
State:
E-mail address:
Date:
Zip:
Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Date:
FORM: LOA 06-16 Page 3 of 3

1