WQ0006497_Regional Office Historical File Pre 2018

IRECEIVED/NCDENRlDWR
WQROS
MOORESVILLE REGIONAL OFFICE
RECEIVED
FEB 7 2017
Information Processing Unit
®WP Section
CHARLOTTE-MECKLENBURG UTILITIES
EXCEPTIONAL QUALITY CLASS A
RESIDUALS
Permit No. WQ0006497
2016 ANNUAL REPORT
M

CLASS A ANNUAL DISTRIBUTION AND MARKETING/ SURFACE DISPOSAL CERTIFICATION AND SUMMARY FORM
WQ PERMIT #: WQ0006497 FACILITY NAME: Charlotte -Mecklenburg Utilities Residuals Management Facility
PHONE:[phone] COUNTY: Mecklenburg OPERATOR: Synagro
FACILITY TYPE (please check one): ❑ Surface Disposal (complete Part A (Source(s) and "Residual In" Volume only) and Part C)
❑ Distribution and Marketing (complete Parts A, B, and C)
Was the facility in operation during the past calendar year? Yes ❑ No ❑ —► If No skip parts A, B, C and certifv form below
Part A*:
Part B*:
Month
Sources(s) s) ( include NPDES # if
applicable)
Volume (dry tons)
Recipient Information
Amendment/
Bullring Agent
Residual In
Product Out
Name(s)
Volume (dry tons)
Intended use(s)
January
February
March
April
May
June
July
August
September
October
November
December
Total from FORM DMSDF (sup)
Totals:
Annual (dry tons):
0
0
0.
0
Amendment(s) used: Bulking A ent(s) used:
* If more space is required, attach additional information sheets (FORM DMSDF (supp)): Total Number of Form DMSDF (Supp)
Part C:
Facility was compliant during the past calendar year with all conditions of the land application permit ❑ Yes
(including but not limited to items 1-3 below) issued by the Division of Water Quality: . ❑ No ► If No, Explain in Narritive
1. All monitoring was done in accordance with the permit and reported for the year as required and three (3) copies of certified laboratory results are attached.
2. All operation and maintenance requirements were compiled with or, in the case of a deviation, prior authorization was received from the Division of Water Quality.
3. No contravention of Ground Water Quality Standards occurred at a monitoring well.
"I certify, under penalty of law, that the above information is, to the best of my knowledge and belief, true, accurate and complete. I am aware that there are significant
penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
—d c�
a e of Permittee Date
J
**Preparer is defined in 40 CFR Part503.9(r) and 15A NCAC 2T .1102 (26)
Signature ofPreparer**
(if different from Permittee)
Date
DENR FORM DMSDF (12/2006)

RECEIVED/NMENR/DWR
MAR 1 2016
WG'Ros
in Fo 'ttV'I'LUE: E8'l0NA'L'0FF'-rZ
CHARLOTTE-MiECKLENBU�QI
Li
EXCEPTIONAL QUALITY CS
RESIDUALS 2S 2,016
8Wk-SECT10, N
Permit No. WQWf 4t NWPRV SMW
2015 ANNUAL REPORT

14j
:. A ro, ��-
AL
NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
March 16, 2015
Charlotte Water
4222 Westmont Drive
Charlotte, North Carolina 28217
Attn: Jacqueline A. Jarrell, P.E.
Operations Chief — Environmental Management Division
Dear Ms. Jarrell:
Donald van der Vaart
Secretary
Subject: Acknowledgement of Receipt of the 2014 Annual Report
Charlotte Water Permit No.: WQ0006497
Distribution of Residual Solids (503)
Mecklenburg County
The Mooresville Regional Office received and reviewed the 2014 Annual Report for the above
permit. The form submitted indicates there was no distribution activity during 2014.
This permit was rescinded in 2014; however, should you have any questions or concerns about
this permit, please contact me at [phone].
Sincerely,
Maria Schulte, Environmental Specialist
Mooresville Regional Office
Water Quality Regional Operations Section
Division of Water Resources, NCDENR
CC: Jean Creech, Charlotte Water (email)
Ed Hardee, LAU Compliance, CO -Raleigh (email)
Mooresville Regional Office
610 East Center Avenue, Suite 301, Mooresville, North Carolina 28115
Phone: [phone] I Fax: [phone]/Customer Service 1-877-623-6748
Internet: www.ncdenr.gov
An Equal Opportunity 1 Affirmative Action Employer— Made m part by recycled paper

RECEIVED/NCDENRIDWR
n . � 0 2015
WQROS
MOORESVILLE REGIONAL OFFICE
CHARLOTTE-MECKLENBURG UTILITIES
EXCEPTIONAL QUALITY CLASS A
RESIDUALS
Permit No. WQ0006497
2014 ANNUAL REPORT

CLASS A ANNUAL DISTRIBUTION AND MARKETING/ SURFACE DISPOSAL CERTIFICATION AND SUMMARY FORM
WQ PERMIT #: W00006497 FACILITY NAME: Charlotte -Mecklenburg Utilities Residuals Management Facility
PHONE:[phone] COUNTY: Mecklenburg OPERATOR: Synagro
FACILITY TYPE (please check one): ❑ Surface Disposal (complete Part A (Source(s) and "Residual In" Volume only) and Part C)
❑ Distribution and Marketing (complete Parts A, B, and C)
Was the facility in operation during the past calendar year? Yes ❑ No ❑ —► If No slip parts A, B, C and certify form below
Part A*:
Part B*:
Month
Sources(s) (include NPDES # if
applicable)
Volume (dry tons)
Recipient Information
Amendment/
Bullring Agent
Residual In
Product Out
Name(s)
Volume (dry tons)
Intended use(s)
January
February
March
April
May
June
July
August
September
October
November
December
Total from FORM DMSDF (sup)
....................
Totals:
Annual (dry tons):
` 0
0
0
0
Amendments used: I Bulkin A gent(s) used:
If more space is required, attach additional information sheets (FORM DMSDF (supp)): Total Number of Form DMSDF (Supp)
Part C:
Facility was compliant during the past calendar year with all conditions of the land application permit ❑ Yes
(including but not limited to items 1-3 below) issued by the Division of Water Quality: ❑ No 0 If No, Explain in Narritive
1. All monitoring was done in accordance with the permit and reported for the year as required and three (3) copies of certified laboratory results are attached.
2. All operation and maintenance requirements were compiled with or, in the case of a deviation, prior authorization was received from the Division of Water Quality.
No contravention of Ground Water Quality Standards occurred at a monitoring well.
"I certify, under penalty of law, that the above information is, to the best of my knowledge and belief, true, accurate and complete. I am aware that there are significant
penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
SgnaQeofPermittee Date
*Preparer is defined in 40 CFR Part 503.9(r) and 15A NCAC 2T .1102 (26)
Signature of Preparer** Date
(if different from Permittee)
DENR FORM DMSDF (12/2006)

' e
NCDENR
North Carolina Department of Environment and Natural
Pat McCrory
Governor
Jacqueline A. Jarrell
City of Charlotte
Charlotte -Mecklenburg Utilities
4222 Westmont Drive
Charlotte, NC 28217
Dear Ms. Jarrell:
December 2, 2014
N.C.Dept. of ENR
DEC 2 2 2014
Winston-Salem
Reaionat Office
John E. Shvarla, III
Secrgtary-
r D
E�, 2 9 2014- i �'Y
L.._........ _
Subject: Permit No. WQ00064.97
Permit Rescission
CMUD-Sludge Mcalpine WW Management
Distribution of Residual Solids
Mecklenburg County
Reference is made to your written rescission request received November 18, 2014 for the subject
Distribution of Residual Solids permit. Staff from the Mooresville Regional Office has confirmed that
the subject permit is no longer required. Therefore, in accordance with your request, Permit No.
WQ0006497 is rescinded, effective immediately.
If in the future you wish again to operate the subject non -discharge system, you must first apply
for and receive a new Distribution of Residual Solids permit. Please be advised that construction and/or
operation of the subject facilities without a valid permit is a violation of North Carolina General Statute
§ 143-215.1 and may subject the owner/operator to appropriate enforcement actions in accordance with
North Carolina General Statute § 143-215.6A-6C. Civil penalties of up to $25,000 per day per violation
may be assessed for failure to secure a permit required by North Carolina General Statute § 143-215.1.
If you need additional information concerning this letter, please contact Ed Hardee (919) 807-
6319 or [e-mail].
cc:
Sincerely,
Thom s A. Reeder, Director
Division of Water Resources
Health Department
Beth Buffington, Public Water Supply Section — Protection and Enforcement Branch
Division of Water Resources Budget Office
Permit File WQ0006497
Non -Discharge Permitting Unit
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Phone: [phone] Internet: htto://portal,ncdenr.org/webtwo
An Equal Opportunity 1 Affirmative Action Employer — Made in part with recycled paper

Permit Rescission Form
Information to be filled out by Central Office:
Facility Name: CMUD-A Sludge/Mcalpin&WW Mgt.
Permit Number: WQ0006497
Regional Office: Mooresville
County: Mecklenburg.
Date Rescission. Requested: 11/18/2014
Permit Expiration: 5/31/201,5
Received, Original Request: Central Office Regional Office
Form of Received Request: Letter Signed Annual Fee Invoice Other
Information to be filled out by Region:
Please Check Appropriately:
❑ Site Visit Performed ❑ Groundwater Concerns A dress d
Render Decision foz` ]Rescission of the Above eferenced Permit:
K.Approved ❑ Denied
Note: If approved this permit will become inactive in the RIMS database and will not be billed
through_ the division billing system.
Complete if Approved: Rescind Immediately
r
Reason for Approval
Y � �WA
Reason for Denial
Date Certified:
Return Completed and gigned Form to. Ed Hardee, Non -Discharge Permitting Unit

CITY OF cHARLOTTE
CHARLOTTE-MECKLENBURG, UTILITIES
Environmental Management
November'7,_,2014
Jon Risgaard, Supervisor
Non -Discharge Permitting; Unit
Water Quality Permitting Section.
40ENR
1636 Mail Service Center
Raleigh, NC 27699-1636
Re: Rescinding of -Charlotte Mecklenburg Utilities (CMU) Permit No. WQ0006497
Debt' Mr. Risgaard:
CMU respectfully requests that the North Carolina Departrrfent of Envirowhen"t and Natural Resources
Please rescind the above referenced Permit that is issued for the: Residuals Processing Facility and
Distribution Program of "Class A Biasolids.
Please let us knowif you require any additional. information or have any questions. Thank you for your
assistance; in this rnatter.
Sincerely,,
�Oqu A. Jarrell
- erations Chief
Cc Jean Creech
REPO GVEDIDPjD Wp,
AV 18 2014
www.charlottenc.gov 14222 estnlonit DriNfa i Charlotte, NG 28211 PH: 704 336.4407

State of North Carolina
bepartment of Environment,
Health and Natural Resources m
Division of Environmental Management"" /
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
A. Preston Howard, Jr., P.E., Director
October 14, 1994
Trille C. Mendenhall, Residuals Manager
Charlotte -Mecklenburg Utility Department
5100 Brookshire Boulevard
Charlotte, North Carolina 28216
MAI
r1••
L—ROVIRI PE,Ea NATURAL RElf �'k
OAT 20,199..
DIVISION OF ENVIRONMENTAL MAIVAURIE
MOORESVILLE REGlOPlAi' I G1 -
jj55
•iif.�_YiiU. (I�I�aE
Subject: Permit No. WQ0006497
Charlotte -Mecklenburg Utility Department
McAlpine Creek WWTP
Distribution of Class A Wastewater Residuals
Mecklenburg County
Dear Ms. Mendenhall:
In accordance with discussions between Bio-Gro Systems, Inc. representatives and the Division
on October 10, 1994, and upon further review by the Division, we are forwarding herewith Permit No.
WQ0006497 as amended, dated October 14, 1994, to the Charlotte -Mecklenburg Utility Department for
the construction and operation of a dual train 40 dry ton per day aerated static pile compost and alkaline
stabilization wastewater residuals facility for the distribution of Class A residuals. The permit is being
amended to separate the total dry tons for each facility and basing the monitoring frequency on the volume
of residuals each individual treatment facility is producing annually, and removing the requirement for the
water treatment plant sludge to be stabilized and tested for the TCLP analysis.
This permit shall be effective from the date of issuance until December 31, 1998, shall void Permit
No. WQ0006497 issued June 15, 1994, and shall be subject to the conditions and limitations as specified
therein. Please pay particular attention to the monitoring and reporting requirements contained in this
permit. Failure to establish an adequate system for collecting and maintaining the required operational
information will result in future compliance problems.
If any parts, requirements, or limitations contained in this permit are unacceptable, you have the
right to request an adjudicatory hearing upon written request within thirty (30) days following receipt of
this permit. This request must be in the form of a written petition, conforming to Chapter 150B of North.
Carolina General Statutes, and filed with the Office of Administrative Hearings, P.O. Drawer 27447,
Raleigh, NC 27611-7447. Unless such demands are made this permit shall be final and binding.
P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper

If you need additional information concerning this matter, please contact Mr. Michael D. Allen at
[phone].
Sincerely,
A. Prest Howard, Jr., P.E.
cc: Mecklenburg County Health Department
Robert H. Forbes, Jr., P.E., CH2M-Hill - Charlotte
,Dee Browder, Bio-Gro Systems, Inc_.
rIvl.,_:ooresville_Regional Office,Water-Quality Section_
Mooresville-Regfonal Office, Groundwater Section
Jack Floyd, Groundwater Section Central Office
Training and Certification Unit (no revised rating)
Facilities Assessment Unit

N.C. DEPT. OP
ENVIRONMENT, HEMLTH,
NORTH CAROLINA & NATURAL RESOUi cR-5
ENVIRONMENTAL MANAGEMENT COMMISSION OCT PC 1994
DEPARTMENT OF ENVIRONMENT, HEALTH AND NATURAL Pt'1§§WQ1W4PfiP,,$MTrL jI�;1M'prly
LIOGRESVILLE REGIONAL Gf IGE
RALEIGH
PERMIT FOR THE DISTRIBUTION OF CLASS A RESIDUALS
In accordance with the provisions of Article 21 of Chapter 143, General Statutes of North Carolina as
amended, and other applicable Laws, Rules, and Regulations
PERMISSION IS HEREBY GRANTED TO THE
Charlotte -Mecklenburg Utility Department
Mecklenburg County
FOR THE
construction and operation of a wastewater residuals facility at the McAlpine Creek WWTP for the
distribution of Class A residuals consisting of the distribution of approximately 14,703.9 dry tons per year
of aerated static pile compost and alkaline stabilized residuals from the sources listed in Condition II 2, to
serve Charlotte -Mecklenburg Utility Department, with no discharge of wastes to the surface waters,
pursuant to discussions between Bio-Gro Systems, Inc. representatives and the Division on October 10,
1994, and upon further review by the Division, and in conformity with the project plan, specifications,
and other supporting data subsequently filed and approved by the, Department of Environment, Health and
Natural Resources and considered a part of this permit.
This permit shall be effective from the date of issuance until December 31, 1998, shall void Permit
No. WQ0006497 issued June 15, 1994, and shall be subject to the following specified conditions and
limitations:
I. PERFORMANCE STANDARDS
1. Upon completion of construction and prior to operation of this permitted facility, a
certification must be received from a professional engineer certifying that the permitted
facility has been installed in accordance with this permit, the approved plans and
specifications.. Mail the Certification to the Permits and Engineering Unit, P.O. Box
29535, Raleigh, NC 27626-0535.
2. The Mooresville Regional Office, phone no. [phone], shall be notified at least
forty-eight (48) hours in advance of operation of the installed facilities so that an in -place
inspection can be made. Such notification to the regional supervisor shall be made during
the normal office hours from 8:00 a.m. until 5:00 p.m. on Monday through Friday,
excluding State Holidays.
3. The distribution of Class A residuals program shall be effectively maintained and operated
as a non -discharge system to prevent the discharge of any wastes resulting from the
operation of this program.

II.
4. This permit shall become voidable in the event of failure of the residuals program to
adequately protect the assigned water quality standards of the surface waters and
groundwaters.
5. The issuance of this permit shall not relieve the Permittee of the responsibility for damages
to surface or groundwaters resulting from the operation of this program.
6. In the event that the residuals program is not operated satisfactorily, including the creation
of nuisance conditions, the Permittee shall take any immediate corrective actions as may be
required by the Division.
7. Diversion or bypassing of the untreated residuals, leachate, or stormwater runoff from the
residual treatment facilities is prohibited.
8. All leachate must be reused as a wetting agent for the processing of residuals or routed to
the head of the treatment plant
9. 'All liquid wastes from the odor control scrubbers must be collected and routed to the head
of the treatment plant.
10. When wastewater residuals are sold or given away, one of the Class A pathogen
requirements in 40 CFR Part 503.32(a) and one of vector attraction reduction requirements
in 40 CFR Part 503.33 must be met. Additionally, an evaluation must be performed which
demonstrates the residuals ability to comply with this requirement. Upon request, a copy
of this evaluation must be submitted to the Assistant Chief, Technical Support Branch,
Division of Environmental.Management, Post Office Box 29535, Raleigh, NC 27626-
0535. The following water treatment plant facilities are exempt from this condition because
there are no domestic contribution present in the residuals:
Franklin WTP
Vest WTP
North Mecklenburg WTP
OPERATION AND MAINTENANCE REQUIREMENTS
1. The residuals treatment facilities shall be properly maintained and operated at all times.
2. No residuals other than the following are hereby approved for distribution in accordance
with this permit:
Permit Estimated Volume
Source County Number (Dry Tons/Year)
McAlpine Creek WWTP Mecklenburg NCO024970 9,400
Sugar Creek WWTP Mecklenburg NCO024937 2,200
Irwin Creek WWTP Mecklenburg NCO024945 3,100 (present)
1,900 (future)
Franklin WTP Mecklenburg 913
Vest WTP Mecklenburg 329
North Mecklenburg WTP Mecklenburg 183
3. All residuals shall be adequately stored to prevent leachate runoff until treated. The
finished product may be placed on a concrete pad, placed under shelter or covered until
such time as it is distributed to the buyer. If an alternate storage site is to be used, approval
must be obtained from the Division of Environmental Management.
2

4. No other residuals other than those specified under Condition II 2 above may be
distributed. The Permittee shall request and obtain a permit amendment from the Division
of Environmental Management for each additional residual source prior to acceptance of
that residual.
5. For a Class A residual to be sold or given away in bags or other container for application to
the land, the following must be satisfied:
The Ceiling Concentrations (Dry Weight Basis) and the Pollutant Monthly
Average Concentrations (Dry Weight Basis) must be maintained:
Ceiling Monthly Average
Concentrations Concentrations
Parameters mg/kg mg kg
Arsenic
75
41
Cadmium
85
39
Chromium
3,000
1,200
Copper
4,300
1,500
Lead
840
300
Mercury
57
17
Molybdenum
75
----
Nickel
420
420
Selenium
100
36
Zinc
7,500
2,800
6. Upon classification of the facility by the Certification Commission, the Permittee shall
employ a certified residuals operator to be in responsible charge (ORC) of the residuals
program. The operator must hold a certificate of the type classification assigned to the
residuals program by the Certification Commission. The Permittee must also employ a
certified back-up operator of the appropriate type to comply with the conditions of Title
15A NCAC 8A, .0202.
7. A label shall be affixed to the bag or other container in which residuals that are sold or
given away for application to the land, or an information sheet shall be provided to the
person who receives the residuals sold or given away in an other container for application
to the land. The label or information sheet shall contain the following information:
a. The name and address of the person who prepared the residuals that is sold or given
away in a bag or other container for application to the land.
b. A statement that application of the residuals to the land is prohibited except in
accordance with the instructions on the label or information sheet.
c. Information on all applicable buffers including a 10 foot buffer between application site
and any public or private water supply source (including wells) and any stream, lake,
or river.
d. Adequate procedures shall be provided to prevent surface runoff from carrying any
disposed or stored residuals into any surface waters.
e. Residuals shall not be applied to any site that is flooded, frozen or snow-covered.
8. Adequate provisions shall be taken to prevent wind erosion and surface runoff from
conveying pollutants from the residuals treatment area onto the adjacent property or into
any surface waters.
3

III. MONITORING AND REPORTING REQUIREMENTS
1. Any monitoring (including groundwater, surface water, residuals, soil, or plant tissue
analyses) deemed necessary by the Division of Environmental Management to insure
protection of the environment will be established and an acceptable sampling and reporting
schedule shall be followed.
2. Proper records shall be maintained by the Permittee tracking all residual activities. These
records shall include, but are not necessarily limited to the following information:
a. source, volume and analysis of each residuals
b . name of residuals' recipient, volume received, and intended use
3. A residuals analysis will be conducted annually from the date of permit issuance by the
Permittee on the following facilities:
Franklin WTP
Vest WTP
North Mecklenburg WTP
A residuals analysis will be conducted every sixty (60) days from the date of permit
issuance by the Permittee on the following facilities:
McAlpine Creek WWTP
Sugar Creek WWTP
Irwin Creek WWTP
The results maintained on file by the Permittee for a minimum of five years. If land
application occurs at a frequency less than annually, a residuals analysis will be required
for each instance of .land application. The residuals analysis shall include but is not
necessarily limited to the following parameters:
Arsenic
Aluminum
Cadmium
Ammonia -Nitrogen
Chromium
Calcium
Copper
Nitrate -Nitrite Nitrogen
Lead
% Total Solids
Mercury
pH
Molybdenum
Phosphorus
Nickel
Plant Available Nitrogen (by calculation)
Selenium
Potassium
Zinc
Sodium
Magnesium
TKN
After the residuals have been monitored for two years at the above frequency, the Permittee
may submit a request to the Division for a permit modification for the reduction of the
frequency of monitoring for pollutant concentrations and for the pathogen density
requirements, but in no case shall the frequency of monitoring be less than once per year
when residuals sold or given away.
4. A Toxicity Characteristics Leaching Procedure (TCLP) analysis shall be conducted by the
Permittee annually on the following facilities:
McAlpine Creek WWTP
Sugar Creek WWTP
Irwin Creek WWTP
4

The TCLP analysis shall include the following parameters (please note the regulatory level
in mg/1- in parentheses):
Arsenic (5.0)
Benzene (0.5)
Carbon tetrachloride (0.5)
Chlorobenzene (100.0)
Chromium (5.0)
m-Cresol (200.0)
Cresol (200.0)
1,4-Dichlorobenzene (7.5)
1,1-Dichloroethylene (0.7)
Endrin (0.02)
Hexachlorobenzene (0.13)
Hexachloroethane (3.0)
Lindane (0.4)
Methoxychlor (10.0)
Nitrobenzene (2.0)
Pyridine (5.0)
Silver (5.0)
Toxaphene (0.5)
2,4,5-Trichlorophenol (400.0)
2,4,5-TP (Silvex) (1.0)
Barium (100.0)
Cadmium (1.0)
Chlordane (0.03)
Chloroform (6.0)
o-Cresol (200.0)
p-Cresol (200.0)
2,4-D (10.0)
1,2-Dichloroethane (0.5)
2,4-Dinitrotoluene (0.13)
Heptachlor (and its hydroxide) (0.008)
Hexachloro-1,3-butadiene (0.5)
Lead (5.0)
Mercury (0.2)
Methyl ethyl ketone (200.0)
Pentachlorophenol (100.0)
Selenium (1.0)
Tetrachloroethylene (0.7)
Trichloroethylene (0.5)
2,4,6-Trichlorophenol (2.0)
Vinyl chloride (0.2)
5. The following facilities will be monitored every sixty (60) days from the date of permit
issuance for compliance with condition 110 of this permit:
McAlpine Creek WWTP
Sugar Creek WWTP
Irwin Creek WWTP
Data to verify stabilization and vector attraction reduction of the residuals must be
maintained by the Permittee. The required data is specific to the stabilization process
utilized, but should be sufficient to clearly demonstrate compliance the Class A pathogen
requirements in 40 CFR Part 503.32(a) or with the Class B pathogen requirements and site
restrictions in 40 CFR Part 503.32(b), and one of vector attraction reduction requirements
in 40 CFR Part 503.33. In addition, the EPA certification statements concerning
compliance with pathogen requirements, vector. attraction reduction requirements and
management practices must be completed at the same frequency specified above, by the
proper authority or authorities if more than one is involved, either the person who prepares
the residuals, the person who derives the material, or the person who applies the residuals.
After the residuals have been monitored for two years at the above frequency, the Permittee
may request a permit modification for the reduction of the frequency of monitoring for
pollutant concentrations and for the pathogen density requirements, but in no case shall the
frequency of monitoring be less than once per year when residuals are sold or given away.
6. Three copies of all required monitoring and reporting requirements as specified in
conditions III 1,1112, III 3, III 4, and I115 shall be submitted annually on or before March
1 of the following year to the following address:
NC Division of Environmental Management
Water Quality Section
Facility Assessment Unit
PO Box 29535
Raleigh, NC 27626-0535
5

7. Noncompliance Notification:
The Permittee shall report by telephone to the Mooresville Regional Office, telephone
number [phone], as soon as possible, but in no case more than 24 hours or on the
next working day following the occurrence or first knowledge of the occurrence of any of
the following:
a. Any occurrence with the distribution program which results in the land application of
significant amounts of wastes which are abnormal in quantity or characteristic.
b. Any failure of the distribution program resulting in a release of material to receiving
waters.
c. Any time that self -monitoring information indicates that the facility has gone out of
compliance with the conditions and limitations of this permit or the parameters on
which the system was designed.
d. Any process unit failure, due to known or unknown reasons, that render the facility
incapable of adequate residual treatment.
e. Any spillage or discharge from a vehicle or piping system during transportation of
residuals.
Persons reporting such occurrences by telephone shall also file a written report in letter
form within 15 days following first knowledge of the occurrence. This report must outline
the actions taken or proposed to be taken to ensure that the problem does not recur.
IV. INSPECTIONS
1. The Permittee or his designee shall inspect the residuals storage, transport, and treatment
facilities to prevent malfunctions and deterioration, operator errors and discharges which
may cause or lead to the release of wastes to the environment, a threat to human health, or a
nuisance. The Permittee shall maintain an inspection log or summary including at least the
date and time of inspection, observations made, and any maintenance, repairs, or corrective
actions taken by the Permittee. This log of inspections shall be maintained by the Permittee
for a period of five years from the date of the inspection and shall be made available to the
Division of Environmental Management or other permitting authority, upon request.
2. Any duly authorized officer, employee, or representative of the Division of Environmental
Management may, upon presentation of credentials, enter and inspect any property,
premises or place on or related to the treatment site or facility at any reasonable time for the
purpose of determining compliance with this permit; may inspect or copy any records that
must be kept under the terms and conditions of this permit; and may obtain samples of
groundwater, surface water, or leachate.
V . GENERAL CONDITIONS
1. This permit shall become voidable unless the distribution activities are carried out in
accordance with the conditions of this permit, the supporting materials, and in the manner
approved by this Division.
2. This permit is effective only with respect to the nature and volume of residuals described in
the application and other supporting data.
3

3. This permit is not automatically transferable. In the event that there is a desire for the
facilities to change ownership or a name change of the Permittee, a formal permit request
must be submitted to the Division of Environmental Management accompanied by an
application fee, documentation from the parties involved, and other supporting materials as
may be appropriate. The approval of this request will be considered on its merits and may
or may not be approved.
4. Failure to abide by the conditions and limitations contained in this permit may subject the
Permittee to an enforcement action by the Division of Environmental Management in
accordance with North Carolina General Statute 143-215.6(a) to 143-215.6(c).
5. The annual administering and compliance fee must be paid by the Permittee within thirty
(30) days after being billed by the Division. Failure to pay the fee accordingly may cause
the Division to initiate action to revoke this permit as specified by 15 NCAC 2H .0205
(c)(4).
6. The issuance of this permit does not preclude the Permittee from complying with any and
all statutes, rules, regulations, or ordinances which may be imposed by other government
agencies (local, state, and federal) which have jurisdiction.
7. The Permittee, at least six (6) months prior to the expiration of this permit, shall request its
extension. Upon receipt of the request, the Commission will review the adequacy of the
facilities described therein, and if warranted, will extend the permit for such period of time
and under such conditions and limitations as it may deem appropriate.
8. This permit may be modified, or revoked and reissued to incorporate any conditions,
limitations and monitoring requirements the Division of Environmental Management deems
necessary in order to adequately protect the environment and public health.
Permit issued this the fourteenth day of October, 1994
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
t9. C
A. Presto oward, Jr., .E., Director
Division o nvironmental Management
By Authority of the Environmental Management Commission
Permit No. WQ0006497
7

Permit No. WQ0006497
October 14, 1994
ENGINEER'S CERTIFICATION
as a duly registered Professional Engineer in the State of North
Carolina, having been authorized to observe (periodically, weekly, full time) the construction of the
project, , for the
Project Name Location
Permittee hereby state that, to the best of my abilities, due care and diligence was used in the observation
of the construction such that the construction was observed to be built within substantial compliance and
intent of this permit, the approved plans and specifications, and other supporting materials.
Signature
Date
Registration No.

mmm m a n m M " M = a m M " IN =
CLASS A ANNUAL DISTRIBUTION AND MARKETING/ SURFACE DISPOSAL CERTIFICATION AND SUMMARY FORM
WQ PERMIT #: WQ0006497 FACILITY NAME: Charlotte -Mecklenburg Utilities Residuals Management Facility
PHONE:[phone] COUNTY: Mecklenburg OPERATOR: Synagro
FACILITY TYPE (please check one): ❑ Surface Disposal (complete Part A (Source(s) and "Residual In" Volume only) and Part C)
0 Distribution and Marketing (complete Parts A, B, and C)
War the facility in oneration during the nast calendar vear? Yes ❑ No ® —r If No skip parts A, B, C and certify form below
Part A*•
Part B*:
Month
Sources(s) (include NPDES # if
applicable)
Volume (dry tons)
Recipient Information
Amendment/ Bullring Agent
Residual In
Product Out
Name(s)
Volume (dry tons)
Intended use(s)
January
February
March
April
May
June
July
August
September
October
November
December
Total from FORM DMSDF (sup)
Totals:
Annual (dry tons):
0
;0
0
Amendment(s) used: Bulking A ent(s) used:
If more'space is required, attach additional information sheets (FORM DMSDF (supp)): Total Number of Form DMSDF (Supp)
Part C:
Facility was compliant during the past calendar year with all conditions of the land application permit ❑ Yes
(including but not limited to items 1-3 below) issued by the Division of Water Quality: ❑ No —® If No, Explain in Narritive
1. All monitoring was done in accordance with the permit and reported for the year as required and three (3) copies of certified laboratory results are attached.
2. All operation and maintenance requirements were compiled with or, in the case of a deviation, prior authorization was received from the Division of Water Quality.
3. No contravention of Ground Water Quality Standards occurred at a monitoring well.
"I certify, under penalty of law, that the above information is, to the best of my knowledge and belief, true, accurate'and complete. I am aware that there are significant
penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
Sign re of Permittee (�� /J Date Signature of Prepat�er'r.:r• Date
4 qac&��f' (if different from Permittee)
""''Preparer is defined in 40 CFR Part 503.9(r) and 15A NCAC 2T .1102 (26)
DENR FORM DMSDF (12/2006)

I
• f r � F
1 2013
CHARLOTTE-MECKLENBURG UTILITIES
EXCEPTIONAL QUALITY CLASS A
RESIDUALS
Permit No. WQ0006497
2012 ANNUAL REPORT

CLASS A ANNUAL DISTRIBUTION AND MARKETING/ SURFACE DISPOSAL CERTIFICATION AND SUMMARY FORM
WQ PERMIT #: WQ0006497 FACILITY NAME: Charlotte -Mecklenburg Utilities Residuals Management Facility
PHONE:336-998=7150 COUNTY: Mecklenburg OPERATOR: Synagro
FACILITY TYPE (please check one): ❑ Surface Disposal (complete Part A (Source(s) and "Residual In" Volume only) and Part C)
0 Distribution and Marketing (complete Parts A, B, and C)
Was the facility in operation during the Dast calendar near? Yes ❑ No ® --* If No skip parts A, B, C and certify form below
Part A*:
Part B*:
Month
Sources(s) (include NPDES # if
applicable)
Volume (dry tons)
Recipient Information
Amendment/
Bulking Agent
Residual In
Product Out
Names)
Volume (dry tons)
Intended use(s)
January
February
March
April
May
June
July
August
September
October
November
December
Total from FORM DMSDF (sup)
`.
Totals:
Annual (dr tons):
0,
: 0
` 0
0 .
Amendments used: 7 Bulking Agent(s) used:
* If more space is required, attach additional information sheets (FORM DMSDF (supp)): Total Number of Form DMSDF (Supp)
Part C:
Facility was compliant during the past calendar year with all conditions of the land application permit ❑ Yes
(including but not limited to items 1-3 below) issued by the Division of Water Quality: ❑ No ► If No, Explain in Narritive
1. All monitoring was done in accordance with the permit and reported for the year as required and three (3) copies of certified laboratory results are attached.
2. All operation and maintenance requirements were compiled with or, in the case of a deviation, prior authorization was received from the Division of Water Quality.
3. No contravention of Ground Water Quality Standards occurred at a monitoring well.
"I certify, under penalty of law, that the above information is, to the best of my knowledge and belief, true, accurate and complete. I am aware that there are significant
penalties for submitting false information including the possibility of fines and imprisonment for knowing violations."
SigLture of Permittee Date Signature of Preparer** Date
(if different from Permittee)
**Preparer is defined in 40 CFR Part 503.9(r) and 15A NCAC 2T .1102 (26)
DENR FORM DMSDF (12/2006)

sc
CHARLOTTE-MECKLENBURG UTILITIES
EXCEPTIONAL QUALITY CLASS A
RESIDUALS
Permit No. WQ0006497
2011 ANNUAL REPORT
� r _ c4 F 6 V F
F-
FEB 1 6 2012
Lnforriation ,�'rocessing Unit
DWGUDOG

CLASS A ANNUAL DISTRIBUTION AND MARKETING/ SURFACE DISPOSAL CERTIFICATION AND SUMMARY FOR
WQ PERMIT #: WQ0006497 FACILITY NAME: Charlotte -Mecklenburg Utilities Residuals Management Facility
PHONE: [phone] COUNTY: Mecklenburg' OPERATOR: Synagro
FACILITY TYPE (please check one): ❑ Surface Disposal (complete Part A (Source(s) and "Residual In" Volume only) and Part C)
0 Distribution and Marketing (complete Parts A, B, and C)
Was the facility in operation during the past calendar year? Yes ❑ No ❑ ---► If No skip parts A, B, C and certify form below
Amenament(s) usea:1 "Ulmlig �g�...-
* If more space is required, attach additional information sheets (FORM DMSDF (supp)): Total Number of Form DMSDF (Supp)
Part C:
Facility was compliant during the past calendar year with all conditions of the land application permit ❑ Yes
(including but not limited to items 1-3 below) issued by the Division of Water Quality: ❑ No o, If No, Explain in Narritive
1. All monitoring was done in accordance with the permit and reported for the year as required and three (3) copies of certified laboratory results are attached.
2. All operation and maintenance requirements were compiled with or, in the case of a deviation, prior authorization was received from the Division of Water Quality.
3. No contravention of Ground Water Quality Standards occurred at a monitoring well.
"I certify, under penalty of law, that the above information is, to the best of my knowledge and belief, true, accurate and complete. I am aware that there are significant
penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
nat , e of Permitte Date Signature of Preparer** Date
(if different from Permittee)
**Preparer is defined in 40 CFR Part 503.9(r) and 15A NCAC 2T .1102 (26)
N
DENR FORM DMSDF (12/2006)

CHARLOTTE-MECKLENBURG UTILITIES
EXCEPTIONAL QUALITY CLASS A
RESIDUALS
Permit No. WQ0006497
2010 ANNUAL REPORT
....
. .........

CLASS A ANNUAL DISTRIBUTION AND MARKETING/ SURFACE DISPOSAL CERTIFICATION AND SUMMARY FORM
WQ PERMIT #: WQ0006497 FACILITY NAME: Charlotte -Mecklenburg Utilities Residuals Management Facility
PHONE:[phone] COUNTY: Mecklenburg OPERATOR: Synagro
FACILITY TYPE (please check one): ❑ Surface Disposal (complete Part A (Source(s) and "Residual In" Volume only) and Part C)
Distribution and Marketing (complete Parts A, B, and C)
Was the facility in operation during the past calendar year? Yes ® No 0 —+- If No skip parts A, B, C and certify form below
Part A*:
Part B*:
Month
Sources(s) (include NPDES # if
applicable)
Volume (dry tons)
Recipient Information
Amendment/
Bulking Agent
Residual In
Product Out
Name(s)
Volume (dry tons)
Intended use(s)
January
February
March
April
May
June
July
August
September
October
November
December
Total from FORM DMSDF (sup)
Totals:
Annual (dry tons):
0 . ...
,. - 0 '"^:...
9
-
Amendment(s) used: Bulking Agent(s) used:
If more space is required, attach additional information sheets (FORM DMSDF (supp)): Total Number of Form DMSDF (Supp).
Part C
Facility was compliant during the past calendar year with all conditions of the land application permit ® Yes
(including but not limited to items 1-3 below) issued by the Division of Water Quality: ® No If No, Explain in Narritive
1. All monitoring was done in accordance with the permit and reported for the year as required and three (3) copies of certified laboratory results are attached.
2. All operation and maintenance requirements were compiled with or, in the case of a deviation, prior authorization was received from the Division of Water Quality.
No contravention of Ground Water Quality Standards occurred at a monitoring well.
"I certify, under penalty of law, that the above information is, to the best of my knowledge and belief, true, accurate and
penalties for submitting false information, including the possibility of fines and imprisonment for knowing violatiolis.11 4 :: "' _:' :'
�Signat't�e of Permittee,�` Date
Jr
�1,.
**Preparer is defined in 40 CFR Part 503.9(r) and 15A NCAC 2T .1102 (26)
Signature of Preparer**
(if different from Permittee)
I am aware that there are significant
Date
DENR FORM DMSDF (12/2006)

State of North Carolina
Department of Environment,
Health and Natural Resources
Division of Environmental Management
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
A. Preston Howard, Jr., P.E., Director
December 9, 199
3
/®•
ENVIRONMENT,, RZV' `o
& NATURAL RrQtT <OE�
Trille C. Mendenhall DEC 1 .3 1993
Charlotte Mecklenburg Utitilies Department
5100 Brookshire Blvd. Si9P; CT,r,tLr k,tir y
Charlotte, NC 28216GuSti_ixr�aie}!`
Subject: Annual Monitoring and Reporting Requirements
Stabilization of Residuals/Sludge
Permit No. WQ0006497
Mecklenburg County
Dear Ms. Mendenhall:
The purpose of this letter is a reminder that the monitoring requirements contained in
the subject permit must be completed by no later than December 31, 1993 and'the Annual
Report submitted to the Division of Environmental Management (DEW by no later March
1, 1994. The Report must be submitted (in triplicate) to the following address. Due to
limitations in storage space, please submit the reports in bound form rather,than in
notebook form. Permittees are subject to civil penalty for failing to submit the Annual
Report as required by their permit.
DEBNR/DEM/Water Quality Section
Facilities Assessment Unit
P. O. Box 29535
Raleigh, North Carolina 27626-0535
Enclosed are summary and certification sheets that must be attached to your annual
report. Please complete these sheets and if necessary make copies of the blank forms if
extra forms are needed for additional sites.
If there is a need for any additional information or clarification on the State reporting
requirements, please do not hesitate to contact either Lou Polletta of our staff or myself at
919/733-5083.
Si nc ely, A
Dennis R. Ramsey
Assistant Chief for Operations
cc: Mooresville Regional Office - Water Quality
Facilities Assessment Unit
Central Files
P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone [phone]kK6:__. FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper

ANNUAL LANDFILLICOMPOST/STABILIZTION CERTIFICATION AND SUMMARY FORM
FACILITY .NAME PERMIT # COUNTY
FACILITY TYPE (please check one): 0 Landfill ( complete Parts A and C )
0 Compost/ Stabilization Facility ( complete Parts A, B, and C) t
VVAS THE FACILITY IN OPERATION DURING THE PAST CALENDAR YEAR? YES NO. If NO, skip Parts A, B, and C and certify form below. ' J
Part A*Sam
...z
Reci lent Information
Month Source(s) Volume Name(s) Volume Intended use(s)
residuall sludge dry tons dry tons
January
February
March
April
May
June
July
August
September
October
November
December
Totals: Annual (dry tons)
If more space is required then given, please use the comment space provided below or attach additional sheet(s). ED Check box it additional sheet(s) are attached.
t
Comments:
Part C
Facility was compliant during calendar year 1993 with all conditions of the permit (including but not limited to items 1-3 below) issued by the
Division of Environmental Management YES NO. If NO, please provide a written desription why the facility was not compliant.
1. All monitoring was performed in accordance with the permit and reported during the year as required and three (3) copies of certified laboratory results are attached.
2. All operations and maintenance requirements were compiled with or, in the case of a deviation, prior authorization was received from the Division of Environmental Management.
3. No contravention of Ground Water Quality Standards occurred at a monitoring well.
1 CERTIFY THAT THE ABOVE INFORMATION IS ACCURATE AND COMPLETE TO THE BEST OF MY KNOWLEDGE, AND ALL THE INFORMATION IN THE
SUCCEEDING PAGES IS ACCURATE AND COMPLETE
PERMITEE SIGNATURE
DATE OPERATOR OR AGENT SIGNATURE DATE

\' %
CHARLOTTE-MECKLENBURG UTILITIES
EXCEPTIONAL QUALITY CLASS A
RESIDUALS
Permit No. WQ0006497
2007 ANNUAL REPORT
� n
D
T�
�
o
070
I D O
1 6 _0 `?

CLASS A ANNUAL DISTRIBUTION AND MARKETING/ SURFACE DISPOSAL CERTIFICATION AND SUMMARY FORM
WQ PERMIT #: WQ0006497 FACILITY NAME: Charlotte -Mecklenburg Utilities Residuals Management Facility
PHONE:[phone] COUNTY: Mecklenburg OPERATOR: Synagro
FACILITY TYPE (please check one): ❑ Surface Disposal (complete Part A (Source(s) and "Residual In" Volume only) and Part C)
® Distribution and Marketing (complete Parts A, B, and C)
Was the facility in operation during the past calendar year? Yes ❑ No II —► If No skip parts A, B, C and certify form below
Part A*:
Part B*:
Month
Sources(s) (include NPDES # if
applicable)
Volume (dry tons)
Recipient Information
Amendment/
Bulking Agent
Residual In
Product Out
Name(s)
Volume (dry tons)
Intended use(s)
January .
February
March
April
May
June
July
August
September
October
November
December
Total from FORM DMSDF (sup)
Totals:
Annual (dry tons):
0
0
0
0
Amendment(s) used: I Bulking Agent(s) used:
* If more space is required, attach additional information sheets (FORM DMSDF (supp)): Total Number of Form DMSDF (Supp)
Part C:
Facility was compliant during the past calendar year with all conditions of the land application permit ❑ Yes
(including but not limited to items 1-3 below) issued by the Division of Water Quality: ❑ No 0, If No, Explain in Narritive
1. All monitoring was done in accordance with the permit and reported for the year as required and three (3) copies of certified laboratory results are attached.
2. All operation and maintenance requirements were compiled with or, in the case of a deviation, prior authorization was received from the Division of Water Quality.
3. No contravention of Ground Water Quality Standards occurred at a monitoring well.
"I certify, under penalty of law, that the above information is, to the best of my knowledge and belief, true, accur Le and coA ware that there are significant
penalties for submitting false information, including the possibility of fines and imprisonment for knowing violat."
g ture . f Permittee Date
**Preparer is defined in 40 CFR Part 503.9(r) and 15A NCAC 2T .1102 (26)
Signature of Preparer**
(if different from Permittee)
M rn
co
C M
"'
Date
OLJ
° K
�
C:)
o
.
n O
ono
o
DENR FORM DMSDF (12/2006)

1 .5&4_0 /-->&�
oft
MzP
SYNAGRO
A Residuals Management Company
March 19, 2008
Ellen Huffman
NCDENR-LAU
Mooresville Regional Office
610 East Center Ave.
Mooresville, NC 28115
near Ads. H fft an:
C.
On March 14, I called to inform you of an application event on site NC-RA-I8-11 that had been flagged
incorrectly with respect to an off -site house buffer on the southwestern most portion of the field that had
been discovered by Synagro staff while conducting an internal compliance inspection. This letter is to
serve as the required written notification and report for that event.
On Friday, March 14, the Synagro Technical Services Manager (TSM), while conducting an internal
compliance inspection on the field and operations crew, discovered that a buffer area on the southwestern
portion of the field had been flagged incorrectly. The TSM reviewed the map for the field in question and
observed that the application area map did not have the off -site house indicated. Due to the fact that the
off -site house was old (i.e., constructed more than 35 years ago) and not drawn on the map, the Synagro
Operations Manager (OM) simply overlooked it as he was flagging the field. The OM is aware that any
new structure, pond, etc. must be identified and accounted for in flagging and acreage calculation;
however, it is rare that an existing structure impacts that approved application are. The affected area was
estimated at no greater than 0.1 acres, thus any impact on public health and/or the environment is likely
small if not non-existent.
Based on my evaluation of the situation, the OM mistakenly overlooked the importance verifying all
structures and items of concern for set -backs every time a field is flagged. The fact that the buffer is based
on an incorrectly drawn map (i.e., house not identified) provides some relief in --the fact that, had the house
been drawn correctly, there would not be an issue with this application event. Due to this event, the
importance of the Jn-gifts site conditions has been emphasized to the OM by the Syr_agro Technic.- I
Services Director (TSD). He has been instructed that all structures and other items (ponds, ditches, etc...)
within 500' of the application area must be verified to not affect the application area during the flagging
of the field. In the upcoming renewal to the Salisbury program, all application maps will be updated to
verify all site conditions are correctly identified.
If you have any questions or require any additional information for your evaluation of this situation,
please let me know.
Sincerely,
V
Todd E. Shearin, Technical Services Director
Cc: Eric Helms, City of Salisbury
i�
284 Boger Road • Mocksville, NC 27028-7619 • Ph: [phone] • Fax: [phone] • Toll Free: [phone]

fnD12-0
CHARLOTTE-MECKLENBURG UTILITIES
EXCEPTIONAL QUALITY CLASS A
RESIDUALS
Permit No. WQ0006497
2005 ANNUAL REPORT
RECLcIVED
rt" 2 7 Z006
wor at on Proc- roc ,�cc.: TION
essing Unit
wt5
y;�AR i 2006
IBC MEI MRO
MWQ -Aquife�ction

ANNUAL DISTRIBUTION AND MARKETING/ SURFACE DISPOSAL CERTIFICATION AND SUMMARY FORM
PERMIT #: WQ0006497 FACILITY NAME: Charlotte -Mecklenburg Utilities Residuals Management Facility
PIiONE:336-766-0328 COUNTY: Mecklenburg OPERATOR: Synagro
FACILITY TYPE (please check one): ❑ Surface Disposal (complete Part A (Source(s) and "Residual In" Volume only) and Part C)
® Distribution and Marketing (complete Parts A, B, and C)
Was the facility in operation during the past calendar year? ❑ Yes ® No No If No skip parts A, B, C and certify form below
Part A*:
Part B*:
Month
Sources s) (include NPDES # if
(
applicable)
Volume (dry tons)
Recipient Information
Admendment/
Bulking Agent
Residual In'
Product Out
Name(s)
Volume (dry
tons)
Intended use(s)
January
February
March
April
May
June
July
,
August
-- n
September
October
. =�
November
December
Totals:
Annual (dry tons):
1 0
0
0
::: . '
0
Admen
ens used:1
Bulking Agent(s) used:
* if more space than given is required, please attach additional information sheet(s). ❑ Check box if additional sheet(s) are attached
Part C:
Facility was compliant during calendar year 2005 with.all conditions of the permit (including but not limited to items 1-3 below) issued by the
Division of Water Quality. E3 Yes ❑ No If No, please provide a written description why the facility was not compliant.
1. All monitoring was done in accordance with the permit and reported for the year as required and three (3) copies of certified laboratory results are attached
2. All operation and maintenance requirements were compiled with or, in the case of a deviation, prior authorization was received from the Division of Water
Quality.
3. No contravention of Ground Water Quality Standards occurred at a monitoring well.
"I certify, under penalty of law, that the above information is, to the best of my knowledge and belief, true, accurate and complete. I am aware
that there are significant penalties for submitting false informaiton, including the possibility of fines and imprisonment for knowing violations."
� Y LJ�-�l -2 ,�
S' of Permittee Date Signature of Pre arer** Date
g P
(if different from Permittee) * *Preparer is defined in 40 CFR Part 503.9(r)
Author Daryl D. Merritt DENR FORM DMSDF (7/2002)