WQ0030998_Modification_20210211

Initial Review
Reviewer Thornburg, Nathaniel
Is this submittal an application? (Excluding additional information.)*
r Yes r No
Permit Number (IR)* WQ0030998
Applicant/Permittee Triple S Farms & Cleaning, Inc.
Applicant/Permittee Address PO Box 709 Beulaville, NC 28518
Is the owner in BIMS? r Yes r No Is the facility in BIMS? r Yes r No
Owner Type Organization
Facility Name Triple S Farms & Cleaning RLAP
County Duplin
Fee Category Minor
Is this a complete
application?*
c Yes r No
Signature Authority
Signature Authority Title
Signature Authority Email
Document Type (if non -application)
Email Notifications
Does this need review bythe hydrogeologist?* r Yes r No
Regional Office
CO Reviewer
Admin Reviewer
Fee Amount $245
Complete App Date 02/11/2021
Below list any additional email address that need notification about a new project.
Email Address
Comments to be added to email notfication
Comments for Kendall
Comments for RO

Comments for Reviewer
Comments for Applicant

Submittal Form
Project Contact Information
Rease provide information on the person to be contacted by N B Staff
Name * Robert T. Branch
Email Address*
[e-mail]
electronic subnittal, confirmation of receipt, and other correspondence.
Project Information
........ ......... ..........................................................................................................................................
Application/Document Type* r New (Fee Req ui red)
c Modification - Major (Fee Required)
r Renewal with Major Modification (Fee
Required)
r Annual Report
r Additional Information
r Other
Phone Number*
3363129007
O Modification - Minor
C Renewal
C GW-59, NDMR, NDMLR, NDAR-1,
NDAR-2
r Residual Annual Report
r Change of Ownership
We no longer accept these monitoring reports through this portal. Please click on the link below and it will take you to the correct form.
https://edocs.deq.nc.gov/Forms/NonDischarge_Monitoring_Report
Permit Type:*
r Wastewater Irrigation
r High -Rate Infiltration
r Other Wastewater
r Reclaimed Water
r Closed -Loop Recycle
r Residuals
r Single -Family Residence Wastewater
r Other
Irrigation
Permit Number:*
WQ0030998
Fbs Current Existing perrrit number
Applicant/Permittee *
Triple S Farms & Cleaning, Inc.
Applicant/Permittee Address*
PO Box709 Beulaville, NC 28518
Facility Name *
Triple S Farms & Cleaning RLAP
Please provide comments/notes
on your current submittal below.
One hardcopy will be coming with permit modification check.
At this time, paper copies are no longer required. If you have any questions about what is required, please contact Nathaniel Thornburg
at [e-mail].
Please attach all information required or requested for this submittal to be reviewed here.*
(Application Form Engineering Rans, Spec'rfications, Calculations, Rc.)
SSS_2021Renewal.pdf 11.35MB
upload only 1 RCF docurn:nt (less than 250 NS). Ma@iple documents nest be corrbined into one RJF file unless file is larger than
upload lirrit.
* W By checking this box, I acknowledge that I understand the application will not be
accepted for pre -review until the fee (if required) has been received by the Non -
Discharge Branch. Application fees must be submitted by check or money order
and made payable to the North Carolina Department of Environmental Quality
(NCDEQ). I also confirm that the uploaded document is a single PDF with all parts
of the application in correct order (as specified by the application).
Mail payment to:
NCDEQ — Division of Water Resources
Attn: Non -Discharge Branch
1617 Mail Service Center
Raleigh, NC 27699-1617
Signature
Submission Date 2/10/2021

APPLICATION FOR PERMIT RENEWAL AND MODIFICATION
PERMIT NO WQ0030998
TRIPLE S FARMS & CLEANING
BEULAVILLE, NORTH CAROLINA
Prepared For:
Triple S Farms & Cleaning, Inc.
PO Box 709
Beulaville, NC 28518
Prepared By:
Branch Residuals & Soils, LLC
1735 Heckle Blvd. Suite 103-291
Rock Hill, SC 29732
February 2021

BRANCH RESIDUALS & SOILS, LLC
1735 Heckle Blvd, Suite 103-291, Rock Hill, SC 29732
PHONE [phone] CELL [phone]
February 9, 2021
NCDENR -Division of Water Resources
Permitting Section — Land Application Unit
Mail Service Center 1617
Raleigh, North Carolina 27699-1617
Attention: Mr. Nathaniel Thornburg
Reference: RENEWAL OF PERMIT NO. WQ0030998
Triple S Farms Land Application Program
Beulaville, North Carolina
BR&S Job No. 2007-71
Dear Ms. Thornburg:
Branch Residuals & Soils, LLC is under contract with the Triple S Farms to provide assistance in the
preparation of a permit renewal and modification for the above referenced facility. For a complete
listing of enclosures with this request, please see the attached Table of Contents. All facilities request
that TCLP monitoring be reduced from annually to once per permit cycle except Wallace and Clayton
due to tonnage. This permit submittal is late due to issues with laboratory data.
Your attention in the review of this application would be greatly appreciated. Please contact me
immediately if you require additional information or have questions in the review of the permit
application. A minor permit modification fee is enclosed.
Sincer ly, 9
Robert T. Branch, L. S. S.
Project Manager
cc: Mr. Eric Smith - Triple S Farms

TABLE OF CONTENTS
Section No. Title
I RESIDUALS LAND APPLICATION PROGRAM — RLAP 06-16
Copy of Existing Permit
Operations and Maintenance Plan
II Residuals Source Facility Summary
III RSCA — Town of Rose Hill 06-16
IV RSCA — Town of Kenansville 06-16
V RSCA — Town of Beulaville 06-16
VI RSCA — Town of Southwestern Plantation WWTP 06-16
VII RSCA — Town of Warsaw 06-16
VIII RSCA — Town of Wallace 06-16
IX RSCA — Murphy Brown Warsaw Sanitation Trailer Wash 06-16
X RSCA — Murphy Brown Rainbow Trailer Wash 06-16
XI RSCA — Murphy Brown Register Trailer Wash 06-16
XII RSCA — Town of Clayton 06-16
Sections III — XII contain the following sections
Facility vicinity map
Process flow diagram and narrative
Justification for residuals production rate
Residuals sampling plan
Analytical Data (TCLP and Nutrient and Metal)

XIII LAND APPLICATION SITE CERTIFICATION - LASC - 06-16
Updated Maps
Site Vicinity Map
Buffer Map
Cumulative Pollutant Loading Rates

RESIDUALS LAND APPLICATION PROGRAM - RLAP 06-16

State of North Carolina
DWR
Department of Environmental Quality
Division of Water Resources
Division of Water Resources 15A NCAC 02T .1100 — RESIDUALS LAND APPLICATION PROGRAM
INSTRUCTIONS FOR FORM: RLAP 06-16 & SUPPORTING DOCUMENTATION
Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional 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.
® 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'
Major (land are permitted for > 300 acres)
F $1,310
i $395
Minor (land are permitted for < 300 acres)
F- $810
$245
- A major modification shall be defined as any permit modification that: increases the generating facility's residuals dry tonnage;
adds additional land application areas not previously approved for that particular program [including transferring of field(s) from
one program to another]; adds additional residuals sources; or includes the addition of new treatment or storage units/processes not
previously permitted. There is no fee for minor modifications to a permit.
C. Cover Letter (All Application Packages)
® List all items included in the application package, as well as a brief description of the requested permitting action.
D. Environmental Assessments (May be Required — See 15A NCAC 1 C .0300)
❑ Submit a copy of the Findings of No Significant Impact (FONSI) or Environmental Impact Statement (EIS). Also, include
information on any mitigating factor(s) from the Environmental Assessment (EA) that impact the construction of the residuals
treatment and storage facilities. An EA may also be required for private systems if any public funds and/or lands are used for
the construction of the subject facilities.
INSTRUCTIONS FOR FORM: RLAP 06-16 Page 1 of 3

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

I. Project Evaluation and Receiver Site Management Plan (All New Application Packages or Modifications that include new sites)
❑ Submit a project evaluation and a receiver site management plan (if applicable) with recommendations concerning cover crops
and their ability to accept the proposed application rates.
J. Hydrogeologic Report (All New Application Packages or Modifications involving increasing the total design capacity)
❑ Submit a detailed hydrogeologic evaluation in accordance with 15A NCAC 02T .1104(d)(4) and current Division Policy
available at: http://www.ncwater.org/Rules Policies and Regulations/. The document shall be signed, sealed and dated by a
qualified professional.
K. Engineering Design Documents (All New or Modification Application Packages with fixed irrigation facilities or irrigation
facilities fed through fixed supply system)
❑ Submit engineering design documents that have been signed, sealed, and dated by a NC licensed Professional Engineer and/or
Professional Land Surveyor in accordance with 15A NCAC 02T J 104(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
fmished product including leaking testing; and
❑ Engineering calculations including hydraulic and pollutant loading, sizing criteria, hydraulic profile, total dynamic head
curve analysis for each pump, and irrigation design.
❑ Soil mapping units shown on all disposal sites.
L. Water Balance (All New Application Packages or Modifications that include new sites utilizing fixed irrigation facilities or
irrigation facilities fed through fixed supply systems)
❑ Submit a completed and accurate water balance in accordance with 15A NCAC 02T J 104(d)(5) and current Division Policy
available at: http://www.ncwater.org/Rules Policies and Regulations/.
M. Property Ownership Documentation (All New or Modification Application Packages involving new and/or relocated treatment
or irrigation components)
❑ 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(1), 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

State of North Carolina
Department of Environmental Quality
Division of Water Resources
Division of Water Resources 15A NCAC 02T .1100 — RESIDUALS LAND APPLICATION PROGRAM
FORM: RLAP 06-16
I. APPLICANT INFORMATION:
1. Applicant's name: Triple S Farms & Cleaning, Inc.
Applicant type: ❑ Individual ® Corporation ❑ General Partnership ❑ Privately -Owned Public Utility
❑ Federal ❑ State ❑ Municipal ❑ County
Signature authority's name per 15A NCAC 02T .0106: Eric Smith Title: Owner
Applicant's mailing address: Post Office Box 709
City: Beulaville State: NC Zip: 28518-
Telephone number: [phone] Email Address: trinlesfarms(i�yahoo.com
2. Consultant's name: Robert T. Branch License Number (for P.E.):
Affiliation: ❑ On Staff ® Retained (Firm: Branch Residuals & Soils, LLC.)
Consultant's mailing address: 1735 Heckle Blvd. Suite 103-291
City: Rock Hill State: SC Zip: 29732-
Telephone number: [phone] Email Address: bbranch(a)branchrs.com
3. Agronomist's name: Robert T. Branch License Number:
Affiliation: ❑ N/A ❑ On Staff ® Retained (Firm: Branch Residuals & Soils, LLC)
Agronomist's mailing address: Same As Above
City: State: Zip: -
Telephone number: (_) = Email Address:
4. Soil Scientist's name: Robert T. Branch License Number: 1180
Affiliation: ❑ N/A ❑ On Staff ® Retained (Firm: Branch Residuals & Soils, LLC.)
Soil Scientist's mailing address: Same As Above
City: State: Zip: -
Telephone number: (_) = Email Address:
5. Fee submitted: $0.00 (See Instruction B)
II. PERMIT INFORMATION:
1. Application is for (check all that apply): ❑ new, ® modified, ® renewed permit
2. If this application is being submitted to renew or modify an existing permit, provide the following:
Permit number: WQ0030998
Date of most -recently issued permit: March 9, 2016
Date of most -recently certified Attachment A (if different than the permit): November 2, 2017
Date of most -recently certified Attachment B (if different than the permit): November 2, 2017
FORM: RLAP 06-16 Pagel of 5

III. RESIDUALS LAND APPLICATION PROGRAM INFORMATION:
1. Residuals Processing Facility's physical address: 3770 Highway 24 East
City: Beulaville State: NC Zip: 28518-
Coordinates: Latitude: 34' 55' 00" N Longitude: 77: 44' 03" W
Datum: NAD 1983 UTM Level of accuracy: 1'
Method of measurement: Man
2. County where residuals land application program is headquartered: Johnston
3. List the Operator In Responsible Charge (ORC) and all Back -Up ORCs for the residuals land application program, their
certification numbers, and their affiliations in the following table:
Designation
Name
Affiliation
Certification Number
Land Applier / Triple S
ORC
Eric Smith
23352
Farms
Back -Up ORC
Bob Branch
Branch Residuals & Soils
15676
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:
4. Complete the following tables regarding management of the residuals land application program:
a.Plant Available Nitrogen Summary: Determine the maximum plant available nitrogen (PAN) generated by all residuals
source -generating facilities as currently certified and proposed for certification with this application and list the results in the
following table:
b.Maximum amount of residuals to be certified: 939 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
23.32
28.36
21,897.29
26,626.83
Five -Year Maximum Adjusted
33.57
36.41
31,524.60
34,189.46
c. 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
13.95
Row Crops
8.93
Hay
107.22
Pasture
Total:
130.1
Methods
Surface
50.26
Incorporation or Injection
79.84
Row Crop and bennudagrass can be injected
Total:
130.1
FORM: RLAP 06-16 Page 2 of 5

d. Residuals Land Application Summary: Determine the minimum acreage required to land apply the residuals as currently
certified and proposed for certification assuming the scenarios listed in the following table:
Assumed
Application Rate
(lbs PAN/ac yi)
Acres Required Using
First -Year PAN Concentrations
Acres Required Using
Five -Year Maximum Adjusted PAN
Concentrations
Surface
Incorporation or
Injection
Surface
Incorporation or
Injection
50
437.95
532.54
630.49
683.79
100
218.97
266.27
315.25
341.89
150
145.98
177.51
210.16
227.93
200
109.49
133.13
157.62
170.95
6. If applicable, provide a plan and a schedule to resolve any known issues that would prevent land application of the proposed
residuals due to the violation of North Carolina Administrative Code (e.g. not enough storage, not enough land, vector reduction
practices not in place, etc.):
7. Specify type of residuals program (See Instruction F): ® Non -dedicated ❑ Dedicated
If Dedicated, specify the following (check all that apply):
❑ Residuals program contains any land application site(s) that receives residuals at rates or frequencies greater than agronomic
rates, explain;
❑ Residuals program contains any land application site(s) that is used primarily for residuals disposal, and agricultural crop
production is of secondary importance, explain;
❑ Residuals program contains any land application site(s) that receives residuals through fixed irrigation facilities or irrigation
facilities fed through a fixed supply system, explain;
IV. RESIDUALS SOURCE INFORMATION: (Required for all new, renewed, or modified residuals source)
Complete and submit the following Residuals Source Certification and all associated documentation.
L
Residuals Source
Certification
V. LAND APPLICATION SITE INFORMATION: (Required for all new, renewed, or modified land application site)
Complete and submit the following Land Applications Site Certification and all associated documentation.
Land Application Siite
Certification.doc
FORM: RLAP 06-16 Page 3 of 5

Note: Item VI. Applicable to Dedicated Program with fixed irrigationystem only.
VI. DESIGN INFORMATION FOR FIXED IRRIGATION SYSTEM
1. The irrigation system is: ❑ Spray ❑ Drip
2. Disposal system is: ❑ existing ❑ proposed.
3. Minimum depth to mean seasonal high water table (SHWT) within irrigation sites(s) per Soil Scientist's Evaluation: feet
below ground surface. Rules 15A NCAC 02T .0505(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?
❑ Yes or ❑ 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?
❑ Yes or ❑ No If No, explain why 15A NCAC 02T .0505(n) is not met:
7. Non -dedicated System Design (fill in the appropriate information for either a spray or drip irrigation system):
Field / Zone
Design Area
(ftZ
Number of
Nozzles
Maximum Application
Rate allons/hr
Design Annual Loading
Rate allons/ r
Total
Spray Irrigation Design Element
Plan Sheet
Number
Specification
Page Number
Wetted diameter of nozzles
ft
Wetted area of nozzles
ft'-
Nozzle capacity
gpm
Nozzle manufacturer / model
/
Elevation of highest nozzle
ft
FORM: RLAP 06-16 Page 4 of 5

Applicant's Certification (signing authority must be in compliance with 15A NCAC 02T .0106):
The applicant or any affiliate has not been convicted of an environmental crime, has not abandoned a wastewater facility without proper
closure, does not have an outstanding civil penalty where all appeals have been exhausted or abandoned, are compliant with any active
compliance schedule, and do not have any overdue annual fees under Rule 15A NCAC 02T .0105.
® Yes ❑ No, Explain;
I, Eric Smith Owner
(Signature Authority's Name — PLEASE PRINT) (Title)
attest that this application for Triple S Farms & Cleaning. Inc.
(Facility Name)
has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that the Division of Water Resources
may not conduct a technical review of this program and approval does not constitute a variance to any rules or statutes unless specifically
granted in the permit. Further, any discharge of residuals to surface waters or the land will result in an immediate enforcement action,
which may include civil penalties, injunctive relief, and/or criminal prosecution. I will make no claim against the Division of Water
Resources should a condition of this permit be violated. I also understand that if all required parts of this application are not completed
and that if all required supporting information and attachments are not included, this application package will be returned to the as
incomplete.
Note: In accordance with North Carolina General Statutes § 143-215.6A and § 143-215.6B, any person who knowingly makes any false
statement, representation, or certification in any application shall be guilty of a Class 2 misdemeanor, which may include a fine not to
exceed $10,000 as well as civil penalties up to $25,000 per violation.
Signature: Date:
FORM: RLAP 06-16 Page 5 of5

Copy of Existing Permit

Water Resources
ENVIRONMENTAL QUALITY
PAT MCCRORY
Gareimur
DONALD R. VAN DER VAART
Sic man
S. JAY ZIMMERMAN
?hev it
March 9, 2016
ERIC R. SMITH —OWNER
TRIPLE S FARMS & CLEANING, INC.
POST OFFICE BOX 709
BEULAVILLE, NORTH CAROLINA 28518
Dear Mr. Smith:
Subject: Permit No. WQ0030998
Triple S Farms & Cleaning
Residuals Application
Land Application of Class B
Residuals (Non -Dedicated)
Duplin County
In accordance with your permit renewal and major modification request received December 14,
20.15, we are forwarding herewith Permit No. WQ0030998 dated March 9, 2016, to Triple S Farms &
Cleaning, Inc. for the continued operation of the subject residuals management program..
Modifications to the subject permit are as follows:
1. Addition of three new residuals sources located in Duplin County totaling 140 tons/year, those
sources being Warsaw Sanitation Trailer Wash, Rainbow Trailer Wash and Register Trailer
Wash. See Attachment A.
2. Changes in maximum residuals allowed for six existing residuals sources in Duplin and Onslow
Counties, those sources being Town of Rose Hill WWTF (51.51 to 38 tonslyear), Town of
Kenansville WWTP (30 to 38 tons/year), Town of Beulaville WWTP (50 to 38 tons/year),
Southwest Plantation WWTF (15 to 5 tons/year), Town of Warsaw WWTP (90 to 38 tons/year)
and Town of Wallace WWTP (380 to 330 tons/year). See Attachment A.
3. Addition of two fields in Duplin County totaling 18.71 acres, those fields being 8 and 9. See
Attachment B.
This permit shall be effective from the date of issuance until February 28, 2021, shall void Permit
No. WQ0030998 issued December 9, 2009, and shall be subject to the conditions and limitations as
specified therein. Please pay particular attention to the monitoring requirements listed in Attachments A
and B for they differ from the previous permit issuance. Failure to establish an adequate system for
collecting and maintaining the required operational information shall result in future compliance problems.
State of -.North Carolina i Eovironmcntal Quality I Water Resources Water Quality Permitting I Non -Discharge Permitting
1617 Mad Service Center Raleigh, North Carolina 27699-1617
919 807 6464

Mr. Eric R. Smith
March 9, 2016
Page 2 of 2
Please note the following permit conditions have been removed since the last permit issuance
dated December 9, 2009:
➢ Old Condition 111.9. — Length of time records to be kept stipulated in each condition where
records need to be kept.
i> Old Condition VI.6. — Redundant since covered by Old Condition V1.7. and Condition V1.6. of
this permit.
Please note the following permit conditions are new since the last permit issuance dated
December 9, 2009:
➢ Condition 1.2. — Wilmington Regional Office notifications of each application under Condition
II1.3. to occur within 90 days.
➢ Condition I.3. — Signage requirements of Condition II1.13. to occur within 180 days.
➢ Condition I1.12. — On grazed pasture land, the crop realistic nitrogen rate shall be reduced by
25%.
➢ Condition III.3. — Wilmington Regional Office to be notified within 24 hours of each
application of residuals.
➢ Condition III.6. — Similar to Old Condition 111.6., but now a copy of the Operations &
Maintenance (O&M) plan and the permit to be on site (rather than in all manned equipment).
➢ Condition III.I 3. — Signage specifications provided.
➢ Condition IV.7.d. — Additional record (approximate area [acres]) to be kept as required in Old
Condition IV.8.
If any parts, requirements or limitations contained in this permit are unacceptable, the Permittee
has the right to request an adjudicatory hearing upon written request within 30 days following receipt of
this permit. This request shall be in the form of a written petition, conforming to Chapter 150B of the North
Carolina General Statutes, and filed with the Office of Administrative Hearings at 6714 Mail Service
Center, Raleigh, NC 27699-6714. Unless such demands are made, this permit shall be final and binding.
If you need additional information concerning this permit, please contact "Troy Doby at (919) 807-
6336 or troy.doby0),ncdcnr.gov.
Sincerely,
-S. Jay Zimmerman, P.G., Director
Division of Water Resources
cc: Duplin County Health Department (Electronic Copy)
Jones County Health Department (Electronic Copy)
Onslow County Health Department (Electronic Copy)
Wilmington Regional Office, Water Quality Regional Operations Section (Electronic Copy)
Bob Branch, LSS — Branch Residuals & Soils, LLC (Electronic Copy)
Beth Buffington — Protection and Enforcement Branch (Electronic Copy)
Digital Permit Archive (Electronic Copy)
Central Files

NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENTAL QUALITY
RALEIGH
LAND APPLICATION OF CLASS B RESIDUALS PERMIT (NON -DEDICATED)
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
Triple S Farms & Cleaning, Inc.
Duplin County
FOR THE
continued operation of a residuals management program for Triple S Farms & Cleaning, Inc. and consisting
of the land application of Class B residuals generated by the approved facilities listed in Attachment A to
the approved sites listed in Attachment B with no discharge of wastes to surface waters, pursuant to the
application received December 14, 2015, and in conformity with other supporting data subsequently filed
and approved by the Department of Environmental Quality and considered a part of this permit. The use
and disposal of residuals are regulated under Title 40 Code of Federal Regulations Part 503. This permit
does not exempt the Permittee from complying with the federal regulations.
This permit shall be effective from the date of issuance until February 28, 2021, shall void Permit No.
WQ0030998 issued December 9, 2009, and shall be subject to the following specified conditions and
limitations:
1. SCHEDULES
No later than six months prior to the expiration of this permit, the Pennittee shall request renewal of
this permit on official Division forms. Upon receipt of the request, the Division will review the
adequacy of the facilities described therein, and if warranted, will renew the permit for such period of
time and under such conditions and limitations as it may deem appropriate. Please note Rule 15A
NCAC 02T .0105(d) requires an updated site map to be submitted with the permit renewal application.
[15A NCAC 02T .0108(b)(2), 02T .0105(d), 02T .0109]
2. The Permittee shall be in full compliance with the regional office notification requirements established
in Condition II1.3. within 90 days of the effective date of this permit. [15A NCAC 02T .0108(b)(2)]
3. The Pennittee shall be in full compliance with the signage requirements established in Condition III.13.
within 180 days of the effective date of this permit. [ l5A NCAC 02T .0108(b)(2)]
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Il. PERFORMANCE STANDARDS
The subject residuals management program shall be effectively maintained and operated at all times so
there is no discharge to surface waters, nor any contravention of groundwater or surface water
standards. In the event the facilities fail to perform satisfactorily, including the creation of nuisance
conditions due to improper operation and maintenance, the Permittee shall immediately cease land
applying residuals to the site, contact the Wilmington Regional Office supervisor, and take any
immediate corrective actions. [G.S. 143-215.1]
2. This permit shall not relieve the Permittee of responsibility for damages to groundwater or surface
water resulting from the operation of this residuals management program. [15A NCAC 02B .0200,
02L .0100]
3. Only residuals generated by the facilities listed in Attachment A are approved for land application in
accordance with this permit. [G.S. 143-215.1 J
4. Only the sites listed in Attachment B are approved for residuals land application. [G.S. 143-215.1 ]
5. Pollutant concentrations in residuals applied to land application sites listed in Attachment B shall not
exceed the following Ceiling Concentrations (i.e., dry weight basis) or Cumulative Pollutant
Loading Rates (CPLRs):
Parameter
Ceiling Concentration
(milligrams per kilogram)
CPLR
(pounds per acre)
Arsenic
75
36
Cadmium
85
34
Copper
4,300
1,338
Lead
840
267
Mercury
57
15
Molybdenum
75
n/a
Nickel
420
374
Selenium
!00
89
Zinc
7,500
2,498
The Pennittee shall determine compliance with the CPLRs using one of the following methods:
a. By calculating the existing cumulative level of pollutants using actual analytical data from all
historical land application events of residuals, or
b. For land where residuals application have not occurred or for which the required data is incomplete,
by determining background concentrations through representative soil sampling.
[ I SA NCAC 02T .1105]
6. Residuals that are land applied shall meet Class B pathogen reduction requirements in 15A NCAC 02T
.1106 (a) and (c). Exceptions to this requirement shall be specified in Attachment A. [ 15A NCAC 02T
.1106]
7. Biological residuals (i.e. residuals generated during the treatment of domestic or animal processing
wastewater, or the biological treatment of industrial wastewater, and as identified in Attachment A)
thatare land applied shall meet one of the vector attraction reduction alternatives in 15A NCAC 02T
.1 107(a). Exceptions to this requirement shall be specified in Attachment A. [ 15A NCAC 021' .l 107]
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8. Setbacks for treatment and storage facilities shall be as follows:
Setback Description
Setback
feet
Habitable residence or place of public assembly under separate ownership or not
100
to be maintained as part of the project site
Property lines
50
Private or public water supply
100
Surface waters (streams — intermittent and perennial, perennial waterbodies, and
wetlands
50
Wells with exception to monitoring wells
100
* All treatment and storage facilities were originally permitted prior to September 1, 2006.
[15A NCAC 02T .1108]
9. Setbacks for Class B land application sites shall be as follows:
Setback by application type
(feet)
Setback Description
Vehicular
Irrigation
Surface
Surface
Injection /
Application
Application
Incorporation
Habitable residence or place of public assembly
under separate ownership or not to be maintained as
400
400
200
art of the project site
Habitable residence or places of public assembly
owned by the Permittee, the owner of the land, or the
0
200
0
lessee/operator of the land to be maintained as part
of the pr9ject site
Property lines
50
150
50
Public right of way
50
50
50
Private or public water supply
100
100
100
Surface waters (streams — intermittent and perennial,
100
100
50
perennial waterbodies, and wetlands)
Surface water diversions (ephemeral streams,
100
25
waterways, ditches)25
Groundwater lowering ditches (where the bottom of
25
100
25
the ditch intersects the SHWT
Subsurface groundwater lowering system
0
100
0
Wells with exception to monitoring wells
100
100
100
Bedrock outcrops
25
25
25
Top of slope of embankments or cuts of two feet or
15
15
15
more in vertical height
Building foundations or basements
0
15
0
Water lines
0
10
0
Swimming pools
100
100
100
Nitrification fields
0
20
0
[15A NCAC 02T .1108]
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10. Land application areas shall be clearly marked on each site prior to and during any residuals application
event. [15A NCAC 02T .0108(b)(1)]
11. Bulk residuals and other sources of Plant Available Nitrogen (PAN) shall not be applied in exceedance
of agronomic rates. Appropriate agronomic rates shall be calculated using expected nitrogen
requirements based on the determined Realistic Yield Expectations (RYE) using any of the following
methods:
a. Division's pre -approved site specific historical data for specific crop or soil types by calculating
the mean of the best three yields of the last five consecutive crop harvests for each field.
b. North Carolina Historical Data for specific crop and soil types as provided by North Carolina State
University Department of Soil Science(http://nutrients.soil.ncsu.edu/vields/index phg). A copy
shall be kept on file and reprinted every five years in accordance with Condition IV.6.
c. If the RYE cannot be determined using methods (a) or (b) above, the Permittee may use the RYE
and appropriate nutrient application rates reported in any of the following documents:
i. Crop management plan as outlined by the local Cooperative Extension Office, the North
Carolina Department of Agriculture and Consumer Services, the Natural Resource
Conservation Service, or other agronomist.
ii. Waste Utilization Plan as outlined by the Senate Bill 1217 Interagency Group - Guidance
Document: Chapter 1
(http://wwxA,.ncag_r.gov/SWC/tech/documents/9di Guidance Doc 100109 pdf).
iii. Certified Nutrient Management Plan as outlined by the Natural Resources Conservation
Services (NRCS). These plans must meet the USDA -MRCS 590 Nutrient Management
Standards(ftp://ftp-fe.sc.ep-ov.tisda.povfNHO/practice-standards/standards/59O. df)
d. If the RYE and appropriate nutrient application rates cannot be determined, the Permittee shall
contact the Division to determine necessary action.
[I 5A NCAC 02T .1109(b)(1)(k)]
12. When residuals are land applied to grazed pasture, hay crop realistic nitrogen rate shall be reduced by
25% in accordance with the USDA -MRCS 590 Nutrient Management Standards. [I 5A NCAC 02T
.0108(b)(1) J
13. if land application sites are to be over -seeded or double -cropped (e.g., bermuda grass in the summer
and rye grass in the winter with both crops to receive residuals), then the second crop can receive an
application of PAN at a rate not to exceed 50 pounds per acre per year (lbs/ac/yr). This practice may
be allowed as long as the second crop is to be harvested or grazed. If the second crop is to be planted
for erosion control only and is to be tilled into the soil, then no additional PAN shall be applied. [15A
NCAC 02T .0108(b)(1)]
14. Prior to land application of residuals containing a sodium adsorption ratio (SAR) of 10 or higher, the
Permittee shall obtain and implement recommendations from at least one of the following: the local
Cooperative Extension Office; the Department of Agriculture and Consumer Services; the Natural
Resource Conservation Service; a North Carolina Licensed Soil Scientist; or an agronomist. The
recommendations shall address the sodium application rate, soil amendments (e.g., gypsum, etc.), or a
mechanism for maintaining site integrity and conditions conducive to crop growth. The Permittee shall
maintain written records of these recommendations and details of their implementation. [I 5A NCAC
02T .0108(b)(1)]
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15. These residuals land application sites were individually permitted on or after December 30, 1983;
therefore, the compliance boundary is established at either 250 feet from the residual land application
area, or 50 feet within the property boundary, whichever is closest to the residual land application area.
An exceedance of groundwater standards at or beyond the compliance boundary is subject to
remediation action according to 15A NCAC 02L .0106(d)(2) as well as enforcement actions in
accordance with North Carolina General Statute 143-215.6A through 143-215.6C. Any approved
relocation of the COMPLIANCE BOUNDARY will be noted in Attachment B. [15A NCAC 02L
.0107(a)]
16. The review boundary shall be established midway between the compliance boundary and the residual
land application area. Any exceedance of groundwater standards at the review boundary shall require
action in accordance with 15A NCAC 02L .0106. [15A NCAC 02L .0108]
I11. OPERATION AND MAINTENANCE RFOUIREMENTS
The residuals management program shall be properly maintained and operated at all times. The
program shall be effectively maintained and operated as a non -discharge system to prevent any
contravention of surface water or groundwater standards. [ 15A NCAC 02T .1110]
2. The Wilmington Regional Office, telephone number [phone], and the appropriate local
government official (i.e., county manager, city manager, or health director) shall be notified at least 48
hours prior to the initial residuals land application to any new land application site. Notification to the
regional supervisor shall be made from 8:00 a.m. until 5:00 p.m. on Monday through Friday, excluding
State Holidays. [15A NCAC 02T .01.08(b)(1)]
3. The Wilmington Regional Office shall be notified via email or telephone, [phone], at least 24
hours prior to conducting any land application activity. Such notification shall indicate, at a minimum,
the anticipated application times, field IDs, and location of land application activities. If it becomes
necessary to apply to additional fields due to unforeseen events, the Regional Office shall be notified
prior to commencing the application to those fields. [15A NCAC 02T .0108(b)(1)]
4. The Pennittee shall maintain an approved Operation and Maintenance Plan (O&M Plan) Modifications
to the O&M Plan shall be approved by the Division prior to utilization of the new plan. The O&M Plan,
at the minimum, shall include:
a. Operational functions;
b. Maintenance schedules:
c. Safety measures;
d. Spill response plan;
e. Inspection plan including the following information:
i. Names and/or titles of personnel responsible for conducting the inspections;
ii. Frequency and location of inspections, including those to be conducted by the ORC, and
procedures to assure that the selected location(s) and inspection frequency are representative
of the residuals management program;
iii. Detailed description of inspection procedures including record keeping and actions to be taken
by the inspector in the event that noncompliance is observed pursuant to the noncompliance
notification requirements under the monitoring and reporting section of the permit;
f. Sampling and monitoring plan including the following information:
i. Names and/or titles of personnel responsible for conducting the sampling and monitoring;
ii. Detailed description of monitoring procedures including parameters to be monitored;
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iii. Sampling frequency and procedures to assure that representative samples are being collected.
Fluctuation in temperature, flow, and other operating conditions can affect the quality of the
residuals gathered during a particular sampling event. The sampling plan shall account for any
foreseen fluctuations in residuals quality and indicate the most limiting times for residuals to
meet pathogen and vector attraction reduction requirements (e.g. facilities that land apply
multiple times per year but have an annual sampling frequency, may need to sample during
winter months when pathogen reduction is most likely to be negatively affected by cold
temperatures).
[I 5A NCAC 02T .1 l 00]
Upon the Water Pollution Control System Operators Certification Commission's (WPCSOCC)
classification of the facility, the Permittee shall designate and employ a certified operator in responsible
charge (ORC) and one or more certified operators as back-up ORCs in accordance with 15A NCAC
08G .0201. The ORC or his back-up shall visit the facilities in accordance with 15A NCAC 08G. 0204,
or as specified in the most recently approved O&M plan (i.e., see Condition I11.4.), and shall comply
with all other conditions of 1.5A NCAC 08G. 0204. For more information regarding classification and
designation requirements, please contact the Division of Water Resources' Protection and Enforcement
Branch at [phone]. [15A NCAC 02T .0117]
6. When the Permittee land applies bulk residuals, a copy of this permit and a copy of O&M Plan shall be
maintained at the land application sites during land application activities. [15A NCAC 02T
.0108(b)(1)]
7. When the Permittee transports or land applies bulk residuals, the spill control provisions shall be
maintained in all residuals transport and application vehicles. [15A NCAC 02T .1110]
8. Residuals shall not be stored at any land application site, unless written approval has been requested
and received from the Division. [G.S. 143-215.1]
9. When the Permittee land applies bulk residuals, adequate measures shall be taken to prevent wind
erosion and surface runoff from conveying residuals from the land application sites onto adjacent
properties or into surface waters. [G.S. 143-215.1 ]
10. When the Permittee land applies bulk residuals, a suitable vegetative cover shall be maintained on land
application sites onto which residuals are applied, or application shall be in accordance with the crop
management plan outlined by the local Cooperative Extension Office, the Department of Agriculture
and Consumer Services, the Natural Resource Conservation Service, or an agronomist and as approved
by thc Division. [15A NCAC 02T .1109(b)(1)]
11. Bulk residuals shall not be land applied under the following conditions:
a. If the residuals are likely to adversely affect a threatened or endangered species listed under section
4 of the Endangered Species Act or its designated critical habitat;
b. If the application causes prolonged nuisance conditions;
c. If the land fails to assimilate the bulk residuals or the application causes the contravention of surface
water or groundwater standards;
d. If the land is flooded, frozen or snow-covered, or is otherwise in a condition such that runoff of the
residuals would occur;
e. Within the 100-year flood elevation, unless the bulk residuals are injected or incorporated within a
24-hour period following a residuals land application event;
f. During a measurable precipitation event (i.e., greater than 0.01 inch per hour), or within 24 hours
following a rainfall event of 0.5 inches or greater in a 24-hour period;

g. If the slope is greater than 10% for surface applied liquid residuals, or if the slope is greater than
18% for injected or incorporated bulk liquid residuals;
h. If the soil pH is not maintained at 6.0 or greater, unless sufficient amounts of lime are applied to
achieve a final soil pH of at least 6.0, or if an agronomist provides information indicating that the
pl-1 of the soil, residuals and lime mixture is suitable for the specified crop. Any approved variations
to the acceptable soil p.14 (6.0) will be noted in this permit;
i. If the land does not have an established vegetative cover unless the residuals are incorporated or
injected within a 24-hour period following a residuals land application event. Any field that is in a
USDA no -till program shall be exempted from meeting this vegetative cover requirement;
j. If the vertical separation between the seasonal high water table and the depth of residuals
application is less than one foot;
k. If the vertical separation of bedrock and the depth of residuals application is less than one foot;
1. Application exceeds agronomic rates.
[15A NCAC 02T .1109]
12. The following public access restrictions apply to residual land application sites:
a. Public access to public contact sites (e.g., golf courses, parks, ball fields, etc.) shall be restricted
for 365 days after a residuals land application event;
b. Public access to non-public contact sites shall be restricted for 30 days after a residuals land
application event.
[l 5A NCAC 02T .I 109(b)(2)]
13. Public access controls shall include the posting of signs with a minimum area of 3 square feet (e.g.,
1.5' x 2'). Each sign shall indicate the activities conducted at each site, permit number, and name and
contact information, including the Permittee or applicator's telephone number. Signs shall be posted
in a clearly visible and conspicuous manner at the entrance to each land application site during a land
application event, and for as long as the public access restrictions required under Condition III.12.
apply. [15A NCAC 02T .0108(b)(1)]
14. The following harvesting and grazing restrictions apply to residual land application sites after each
land application event:
Harvesting and Grazing Description
Restricted
Duration
Animals shall not be allowed to graze during land application activities and
restricted period. Sites that are to be used for grazing shall have fencing to
30 days
prevent access after each land application event.
Food crops, feed crops and fiber crops shall not be harvested for:
30 days
Turf grown on land where residuals have been applied shall not be harvested for:
12 months
Food crops with harvested parts that touch the residual/soil mixture and are
totally above the land surface (e.g., tobacco, melons, cucumbers, squash, etc.)
14 months
shall not be harvested for:
When the residuals remain on the land surface for four months or longer prior to
incorporation into the soil, food crops with harvested parts below the land
20 months
surface (e.g., root crops such as potatoes, carrots, radishes, etc.) shall not be
harvested for:
When the residuals remain on the land surface for less than four months prior to
incorporation into the soil, food crops with harvested parts below the land
38 months
surface shall not be harvested for:
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[15A NCAC 02T .1109(b)(3)]
15. The Permittee shall acquire from each landowner or lessee/operator a statement detailing the volume
of other nutrient sources (i.e., manufactured fertilizers, manures, or other animal waste products) that
have been applied to the site, and a copy of the most recent Nutrient Management Plan (NMP) for those
operations where a NMP is required by the US Department of Agriculture - National Resources
Conservation Service (NRCS) or other State Agencies. The Pennittee shall calculate allowable nutrient
loading rates based on the provided information and use appropriate reductions.
For the purpose of this permit condition, a Crop Management Plan (CMP), Waste Utilization Plan
(WUP) or Certified Nutrient Management PIan (CNMP) shall also be considered a Nutrient
Management Plan. [15A NCAC 02T .0108(b)(1), 02T .1104(c)(4)]
16. No residuals shall be land applied unless the submitted Land Owner Agreement Attachment (LOAA)
between the Permittee and landowners or lessees/operators of the land application site is in full force
and effect. These agreements shall be considered expired concurrent with the permit expiration date,
and shall be renewed during the permit renewal process. [15A NCAC 02T .1104(c)(4)]
IV. MONITORING AND REPORTING REQUIREMENTS
1. Any Division -required monitoring (including groundwater, plant tissue, soil and surface water
analyses) necessary to ensure groundwater and surface water protection shall be established, and an
acceptable sample reporting schedule shall be followed. [15A NCAC 02T' .0108(c)]
2. Residuals shall be analyzed to demonstrate they are non -hazardous under the Resource Conservation
and Recovery Act (RCRA). Residuals that tests or is classified as a hazardous or toxic waste under 40
CFR Part 261 shall not be used or disposed under this permit. The analyses [corrosivity, ignitability,
reactivity, and toxicity characteristic leaching procedure (TCLP)] shall be performed at the
frequency specified in Attachment A, and the Permittee shall maintain these results for a minimum of
five years. Any exceptions from the requirements in this condition shall be specified in Attachment A.
The TCLP analysis shall include the following parameters (the regulatory level in milligrams per liter
is in parentheses):
Arsenic (5.0)
1,4-Dichlorobenzene (7.5)
Nitrobenzene (2.0)
Barium (100.0)
1,2-Dichloroethane (0.5)
Pentachlorophenol (100.0)
Benzene (0.5)
1, 1 -Dichloroethylene (0.7)
Pyridine (5.0)
Cadmium (1.0)
2,4-Dinitrotoluene (0.13)
Selenium (1.0)
Carbon tetrachloride (0.5)
Endrin (0.02)
Silver (5.0)
Chlordane (0.03)
Hexachlorobenzene (0. D)
Tetrachloroethylene (0.7)
Chlorobenzene (100.0)
Heptachlor (and its hydroxide)
(0.00s
Toxaphene (0.5)
Chloroform (6.0)
Hexachioro-1,3-butadiene (0.5)
Trichloroethylene (0.5)
Chromium (5.0)
Hexachloroethane (3.0)
2,4,5-Trichlorophenol (400.0)
m-Cresol (200.0)
Lead (5.0)
2,4,6-Trichlorophenol (2.0)
o-Cresol (200.0)
Lindane (0.4)
2,4,5-TP (Silvex) (1.0)
p-Cresol (200.0)
Mercury (0.2)
Vinyl chloride (0.2)
Cresol (200.0)
Methoxyehlor (10.0)
2.4-13 (10.0)
Methyl ethyl ketone (200.0)
[15A NCAC 13A .0102(b), 02T .1101, 02T .l 1051
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An analysis shall be conducted on residuals from each source generating facility at the frequency
specified in Attachment A, and the Permittee shall maintain the results for a minimum of five years.
The analysis shall include the following parameters:
Aluminum
Mercury
Potassium
Ammonia-Nlitrogen .
Molybdenum
Selenium
Arsenic
Nickel
Sodium
Cadmium
Nitrate -Nitrite Nitrogen
Sodium Adsorption Ratio
(SAR)
Calcium
Percent Total Solids
TKN
Copper
pH
Zinc
Lead
Phosphorus
Magnesium
Plant Available Nitrogen
(by calculation)
[15A NCAC 02T .] 101]
4. Residuals shall be monitored for compliance with pathogen and vector attraction reduction
requirements at the frequency specified in Attachment A, and at the time indicated in the sampling and
monitoring sections of the approved O&M plan. The required data shall be specific to the stabilization
process utilized, and sufficient to demonstrate compliance with the Class B pathogen reduction
requirements in 15A NCAC 02T .1106 (a) and (c), and one vector attraction reduction requirement in
15A NCAC 021' .1107 (a) shall be met. Any exceptions from the requirements in this condition shall
be specified in Attachment A. [ 15A NCAC 02T .1106, 02T .1107, 02T .1111(c)]
5. An annual representative soils analysis (i.e., Standard Soil Fertility Analysis) shall be conducted on
each land application site listed in Attachment B on which a residuals land application event will occur
in the respective calendar year. This analysis shall be in accordance with the "Guidance on Soil
Sampling" located in the Sampling Instructions section of the NC Department of Agriculture &
Consumer Services' website (http://www.ncagr.gov/agronomi/pubs.htm). The Permittee shall maintain
these results and a description of the sampling methodologies used to determine soil fertility for a period
of no less than five years, and shall be made available to the Division upon request. At a minimum, the
Standard Soil Fertility Analysis shall include -the following parameters:
Acidity
Exchangeable Sodium Percentage
Phosphorus
Base Saturation (by calculation)
Magnesium
Potassium
Calcium
Manganese
Sodium
Cation Exchange Capacity
Percent Humic Matter
Zinc
Copper
pH
[.1.5A NCAC 02T . I I i 1(d)]
6. Laboratory parameter analyses shall be performed on the residuals as they are land applied, and shall
be in accordance with the monitoring requirements in 15A NCAC 02B .0505. [15A NCAC 02B .0505]
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7. The Permittee shall maintain records tracking all residual land application events. At a minimum, these
records shall include the following:
a. Source of residuals;
b. Date of land application;
c. Location of land application (i.e., site, field, or zone number as listed in Attachment B);
d. Approximate areas applied to (acres);
e. Method of land application;
f. Weather conditions (e.g., sunny, cloudy, raining, etc.);
g. Predominant Soil Mapping Unit (e.g., CbB2);
h. Soil conditions (e.g., dry, wet, frozen, etc.);
i. Type of crop or crops to be grown on field;
j. Nitrogen Application Rate based on RYEs (if using data obtained from the North Carolina State
University Department of Soil Science Website, the printout page shall be kept on file and reprinted
every five years);
k. Volume of residuals land applied in gallons per acre, cubic yard per acre, dry tons per acre, or wet
ton per acre;
Volume of animal waste or other nutrient source applied in gallons per acre, dry ton per acre, or
wet tons per acre;
m. Volume of soil amendments (e.g., lime, gypsum, etc.) applied in gallons per acre, dry ton per acre,
or wet tons per acre; and
n. Annual and cumulative totals in dry tons per acre of residuals as well as animal waste and other
sources of nutrients (e.g., if applicable), annual and cumulative pounds per acre of each heavy metal
(e.g., shall include, but shall not be limited to, arsenic, cadmium, copper, lead, mercury,
molybdenum, nickel, selenium, and zinc), annual pounds per acre of PAN, and annual pounds per
acre of phosphorus applied to each field.
[15A NCAC 02T .0I09(a)]
8. Three copies of an annual report shall be submitted on or before March 1". The annual report shall
meet the requirements described in the Instructions for Residuals Application Annual Reportina Forms.
Instructions for reporting and annual report forms are available at
littp:Hportal.ncdenr.org/web/wq/aps/lau/repg"m , or can be obtained by contacting the Land
Application Unit directly. The annual report shall be submitted to the following address:
Division of Water Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[ 15A NCAC 02T . I 111(a)]
W00030998 Version 2.0 4hell Vercinn 151 M1 n...... in c /1

9. Noncompliance Notification
The Permittee shall report by telephone to the Wilmington Regional Office, telephone number (910)
796-7215, 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. Land application of residuals abnormal in quantity or characteristic.
b. Any failure of the land application program resulting in a release of material to surface waters.
Any time self -monitoring indicates the facility has gone out of compliance with its permit
limitations.
d. Any process unit failure, due to known or unknown reasons, rendering the facility incapable of
adequate residual treatment.
e. Any spill or discharge from a vehicle or piping system during residuals transportation.
Any emergency requiring immediate reporting (e.g., discharges to surface waters, imminent failure of
a storage structure, etc.) outside normal business hours shall be reported to the Division's Emergency
Response personnel at telephone number [phone], [phone], or [phone].Persons
reporting such occurrences by telephone shall also file a written report in letter form within five days
following first knowledge of the occurrence. This report shall outline the actions taken or proposed to
betaken to ensure that the problem does not recur. [15A NCAC 02T .0105(1), 02T .0108(b)(1)]
V. INSPECTIONS
1. The Permittee shall provide adequate inspection and maintenance to ensure proper operation of the
subject facilities and shall be in accordance with the approved O&M Plan. [15A NCAC 02T .0108(b)]
2. Prior to each bulk residuals land application event, the Permittee or his designee shall inspect the
residuals processing, storage, transport and application facilities to prevent malfunctions, facility
deterioration and operator errors resulting in discharges, which may cause the release of wastes to the
environment, a threat to human health or a public nuisance. The Permittee shall maintain an inspection
log that includes, at a minimum, the date and time of inspection, observations made, and any
maintenance, repairs, or corrective actions taken. The Permittee shall maintain this inspection log for
a period of five years from the date of inspection, and this log shall be made available to the Division
upon request. [15A NCAC 02T .0108(b)]
3. Any duly authorized Division representative may, upon presentation of credentials, enter and inspect
any property, premises or place on or related to the land application sites or facilities permitted herein
at any reasonable time for the purpose of determining compliance with this permit; may inspect or copy
any records required to be maintained under the terms and conditions of this permit; and may collect
groundwater, surface water or leachate samples. [G.S. 143-215.3(a)(2)]
VI. GENERAL CONDITIONS
1. Failure to comply with the conditions and limitations contained herein may subject the Permittee to an
enforcement action by the Division in accordance with North Carolina General Statutes 143-215.6A to
143-215.6C. [G.S. 143-215.6A to 143-215.6C]
2. This permit shall become voidable if the residuals land application events are not carried out in
accordance with the conditions ofthis permit. [15A NCAC 02T .01.10]
3. This permit is effective only with respect to the nature and volume of residuals described in the permit
application and other supporting documentation. [G.S. 143-215.1]
WQ0030998 Version 2.0 Shell Version 151201 Page 11 of 12

4. The issuance of this permit does not exempt the Permittee from complying with any and all statutes,
rules, regulations, or ordinances, which may be imposed by other jurisdictional government agencies
(e.g., local, state, and federal). Of particular concern to the Division are applicable river buffer rules in
15A NCAC 02B .0200; erosion and sedimentation control requirements in 15A NCAC Chapter 4 and
under the Division's General Permit NCG0.10000; any requirements pertaining to wetlands under 15A
NCAC 02B .0200 and 02H .0500; and documentation of compliance with Article 21 Part 6 of Chapter
143 of the General Statutes. [15A NCAC 02T .0105(c)(6)]
5. In the event the residuals program changes ownership or the Permittee changes his name, a formal
permit modification request shall be submitted to the Division. This request shall be made on official
Division forms, and shall include appropriate documentation from the parties involved and other
supporting documentation as necessary. The Permittee of record shall remain fully responsible for
maintaining and operating the residuals program permitted herein until a permit is issued to the new
owner. [ 15A NCAC 02T .0104]
6. This permit is subject to revocation or unilateral modification upon 60-day notice from the Division
Director, in whole or part for the requirements listed in 15A NCAC 02T .0110. [15A NCAC 02T .0110]
7. Unless the Division Director grants a variance, expansion of the permitted residuals program contained
herein shall not be granted if the Permittee exemplifies any of the criteria in 15A NCAC 02T .0120(b).
[15A NCAC 02T .0120]
8. The Permittee shall pay the annual fee within 30 days after being billed by the Division. Failure to pay
the annual fee accordingly shall be cause for the Division to revoke this permit. [15A NCAC 02T
.0105(e)(3)]
Permit issued this the 91 day of March 2016
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
Z�
S. Jay Zimmerman, P.G., Director
Division of Water Resources
By Authority of the Environmental ]Management Commission
Permit Number WQ0030998
W00030998 Version 2.0 Shell Version 151201 paRp i) of i l

Aa aAva.11r.a e.•�.� L A - Al1F/luva.Y 1\l.01%lunx JVUK%,Va
Triple S Farms & Cleaning, Inc.
%-ertmeavion .vale: inaren v, Lulto
Permit Number: WQ0030998 Version: 2.0
Permit
Biological
Maximum
Monitoring
Frequency for Non-
Monitoring
Frequency for
Monitoring
Frequency for
Approved
Owner
Facility Name
County
Number
Residuals
Dry Tons
hazardous
Metals and
Pathogen &
Mineralization
Per Year'
Characteristics Z
Nutrients a,s
Vector Attraction
Rate
Reductions 4.s
Town of Wallace
Wallace WWTP
Duplin
NCO003450
Yes
330
Annually
See Table Below
See Table Below
0.3
Town of Maysville
Maysville WWTP
Jones
NCO021482
Yes
7.5
Once per permit cycle
Annually
Annually
0.3
Town of Warsaw
Warsaw WWTP
Duplin
NCO021903
Yes
38
Once per permit cycle
Annually
Annually
0.3
Town of Bculaville
Bculaville WWTP
Duplin
NCO026018
Yes
38
Once per permit cycle
Annually
Annually
0.3
Town of Kenansville
Kenansville WW'fP
Duplin
NCO036668
Yes
38
Once per permit cycle
Annually
Annually
0.3
Town of Rose I-Iill
Rose Hill WWTF
Duplin
NCO056863
Yes
38
Once per permit cycle
Annually
Annually
0.3
Webb Creek Water & Sewage, Inc.
Webb Creek WWTP
Onslow
NCO062648
Yes
60
Once per permit cycle
Annually
Annually
0.3
Murphy Brown, LLC
Rainbow Trailer Wash
Duplin
WQ0013921
Yes
40
Once per permit cycle
Annually
Annually
0.3
Murphy Brown, LLC
Register Trailer Wash
Duplin
WQ0014247
Yes
50
Once per permit cycle
Annually
Annually
0.3
Murphy Brown, LLC
Warsaw Sanitation
'['railer Wash
Duplin
WQ0023310
Yes
50
Once per permit cycle
Annually
Annually
0.3
Carolina Investments, Inc.
Southwest Plantation
UI�WTF
Onslow
WQ0029601
Yes
5
Once per permit cycle
Annually
Annually
0.3
Total
694.5
1. Maximum Dry Tons per Year is the amount of residuals approved for land application from each permitted facility.
2. Analyses to demonstrate that residuals are non -hazardous (i.e., TCLP, ignitability, reactivity, and corrosivity) as stipulated under permit Condition IV.2.
3. Testing of metals and nutrients as stipulated under permit Condition TV.3.
4. Analyses of pathogen and vector attraction reductions as stipulated under permit Condition IVA.
5. Monitoring frequencies are based on the actual dry tons applied per year using the table below, unless specified above.
Dry Tons Applied
short tons per ear
Monitoring Frequency
Established in 40 CFR 503 and 15A NCAC 02T .1111)
<319
1/Year
=>319 - <1,650
I/ Quarter 4 times per year)
=>1,650 - <1.6,500
1/60 Days 6 times per year
=> 16.500
l/month (12 times per year)
If no land application events occur during a required sampling period (e.g. no land application occur during an entire year when annual monitoring is required), then no
sampling data is required during the period of inactivity. The annual report shall include an explanation for missing sampling data. Those required to submit the annual
report to EPA may be required to make up the missed sampling, contact the EPA for additional information and clarification.
WQ0030998 Version 2.0 Attachment A Page I of I

THIS PAGE BLAND

Certification Date: March 9, 2016
ii l l n k-mvi ti l O - Approveu Lang Appncanon zmes
Triple S Farms & Cleaning, Inc.
Permit Number: WQ0030998 Version: 2.0
Field
Owner
Lessee
County
Latitude
Longitude
A Net a
cr
Dominant Soil Series
Footnotes
I
Eric R. Smith
Duplin
34.9083000
-78.0131000
29.5
NoA Norfolk
1
2
Eric R. Smith
Duplin
34.9122000
-78.0139000
8.48
FoA - Foreston
1
3
Eric R. Smith
Duplin
34.9117000
-78.0164000
19.95
FoA - Foreston
I
4
Eric R. Smith
Duplin
34.913600'
-78.019200.
4.14
FoA-Foreston
1
5
Eric R. Smith
Duplin
34.9139000
-78.0169000
11.2
FoA - Foreston
1
6
Eric R. Smith
Duplin
34.9108000
-78.0111000
13.95
GoA - Goldsboro
I
7
Eric R. Smith
Duplin
34.9067000
-78.013100"
9.57
FoA - Foreston
1
8
Eric R. Smith
Duplin
34.9064470
-78.010478°
9.41
GoA - Goldsboro
1
9
Eric R. Smith
Duplin
34.9045670
-78.010919'
9.3
GoA Goldsboro
1
Total
115.5
-- -
1. See Buffer Map
WQ0030998 Version 2.0 Attachment B Page l of 1

CA"
. . . . . . . . . . .
zw
lao
Ll
F 'o lo 0' Mlw,

Water Resources
ENVIRONMENTAL QUALITY
November 2, 2017
ERIC R. SMITH — OWNER
TRIPLE S FARMS & CLEANING, INC.
POST OFFICE BOX 709
BEULAVILLE, NORTH CAROLINA 28518
Dear Mr. Smith:
ROY COOPER
Governor
MICHAEL S. REGAN
Secrerw)t
S. JAY ZIMMERMAN
/Director
Subject: Attachments A & B Certification
Permit No. WQ0030998
Triple S Farms & Cleaning RLAP
Duplin County
In accordance with your permit modification request received September 14, 2017, we are
forwarding herewith modified Attachments A & B certified November 2, 2017, to Triple S Farms &
Cleaning, Inc. for the subject residuals program.
This certification is being issued to modify Attachments A & B by:
1. Removal of two residual sources totaling 67.5 tons/year, those sources being Webb Creek
WWTP and Maysville WWTP.
2. Addition of one residual source totaling 80.0 tons/year, that source being Little Creek WWTP.
3. Modification of the acreage of five existing fields, those fields being Fields 1, 3, 7, 8 and 9.
This modified Attachments A & B shall be effective from the date of certification until February
28, 2021 (i.e., expiration date of the current permit), shall void Attachments A & B of Permit No.
WQ0030998 issued March 9, 2016, and shall be subject to the conditions and limitations as specified
therein, as well as those specified in the above -referenced permit. Please replace the Attachments A & B
of Permit No. WQ0030998 that was issued March 9, 2016, with these modified Attachments A & B.
If any parts, requirements, and/or limitations contained in this certification or modified
Attachments A & B are unacceptable, you have the right to request an adjudicatory hearing upon written
request within 30 days following receipt of the certification. This request shall be in the form of a written
petition, conforming to Chapter 150B of the North Carolina General Statutes and filed with the Office of
Administrative Hearings at 671.4 Mail Service Center, Raleigh, North Carolina 27699-6714. Unless such
demands are made, this permit shall be final and binding.
'-'Nothing Compares '-.. .
State of North Carolina I Environmental Quality I Water Resources I Water Quality Permitting i Non -Discharge Permitting
1617 Mail Service Center i Raleigh, North Carolina 27699-1617
919-807-6332

Mr. Eric R. Smith
November 2, 2017
Page 2 of 2
If you need any additional information concerning this matter, please contact Troy Doby at (919)
807-6336 or trov.doby! ncdenr.gov.
Sincerely,
I/I CSC n
7 S. Jay Zimmerman, P.G., Directo
Division of Water Resources
cc: Duplin County Health Department (Electronic Copy)
Wilmington Regional Office, Water Quality Regional Operations Section (electronic Copy)
Bob Branch — Branch Residuals & Soils, LLC (Electronic Copy)
Digital Permit Archive (Electronic Copy)
Central Files

ATTACHMENT A —Approved Residual Sources
Triple S Farms & Cleaning, .Inc.
Certification Date: November 2, 2017
Permit Number: WQ0030998 Version: 2.1
Monitoring
Monitoring
Monitoring
Permit
Biological
Maximum
Frequency for Non-
Frequency for
Frequency for
Approved
Owner
Facility Name
County
Number
Residuals
Dry Tons
hazardous
Metals and
Pathogen &
Mineralization
Per Year
Characteristics 2
Nutrients',5
Vector Attraction
Rate
Reductions 4,5
Town of Wallace
Wallace WWTP
Duplin
NC 0003450
Yes
330
Annually
See Table Below
Sec Table Below
0.3
Town of Warsaw
Warsaw WWTP
Duplin
NCO021903
Yes
38
Once per permit cycle
Annually
Annually
0.3
Town of Clayton
Little Creek WWTP
Johnston
NCO025453
Yes
80
Once per pennit cycle
Annually
Annually
0.3
Town of Beulaville
Beulaville Vlr<1i1TP
Duplin
NCO026018
Yes
38
Once per permit cycle
Annually
Annually
0.3
Town of Kenansville
Kenansville WWTP
Duplin
NCO036668
Yes
38
Once per permit cycle
Annually
Annually
0.3
'rown of Rose Hill
Rose Hill WWTF
Duplin
NCO056863
Yes
38
Once per permit cycle
Annually
Annually
0.3
Murphy Brown, LLC
Rainbow Trailer Wash
Duplin
WQ0013921
Yes
40
Once per permit cycle
Annually
Annually
0.3
Murphy Brown, LLC
Register Trailer Wash
Duplin
WQ0014247
Yes
50
Once per permit cycle
Annually
Annually
0.3
Murphy Brown, LLC
Warsaw Sanitation Trailer Wash
Duplin
WQ0023310
Yes
50
Once per permit cycle
Annually
Annually
0.3
Carolina Investments, Inc.
Southwest Plantation WWTF
Onslow
WQ0029601
Yes
5
Once per permit cycle
Annually
Annually
0.3
Total
707
1. Maximum Dry Tons per Year is the amount of residuals approved for land application from each permitted facility.
2. Analyses to demonstrate that residuals are non -hazardous (i.e., TCLP, ignitability, reactivity, and corrosivity) as stipulated under permit Condition IV.2.
3. Testing of metals and nutrients as stipulated under permit Condition IV_3.
4. Analyses of pathogen and vector attraction reductions as stipulated under permit Condition IVA.
5. Monitoring frequencies are based on the actual dry tons applied per year using the table below. unless specified above.
Dry Tons Applied
short tons per ear
Monitoring Frequency
Established in 40 CFR 503 and 15A NCAC 02T .1111
<319
] /Year
=>319 - <1.650
1 / Quarter 4 times per ear
=>l 650 - <16,500
1/60 Days 6 times per ear
=>16 500
1/month 12 times per year
If no land application events occur during a required sampling period (e.g. no land application occur during an entire year when annual monitoring is required), then no sampling data is
required during the period of inactivity. The annual report shall include an explanation for missing sampling data. Those required to submit the annual report to EPA may be required to
make up the missed sampling, contact the EPA. for additional information and clarification.
WQ0030998 Version 2.1 Attachment A Page 1 of 1

THIS PAGE BLANK

ATTACHMENT B — Approved Land Application Sites
Triple S Farms & Cleaning, Inc.
Certification Date: November 2, 2017
Permit Number: WQ0030998 Version: 2.1
Field
Owner
Lessee
County
Latitude
Longitude
Net Acreage
Dominant Soil Series
Footnotes
1
Eric R. Smith
Duplin
34.9083000
-78.0131000
34.20
NoA —Norfolk
1
2
Eric R. Smith
Duplin
34.9122000
-78.0139000
8.48
FoA - Foreston
1
3
Eric R. Smith
Duplin
34.9117000
-78.016400"
21.00
FoA — Foreston
I
4
F.ric R. Smith
Duplin
34.9136000
-78.019200"
4.14
FoA — Foreston
1
5
Eric R. Smith
Duplin
34.91.39000
-78.0169000
11.20
FoA— Foreston
1
6
Eric R. Smith
Duplin
34.9108000
-78.011 1000
13.95
GoA — Goldsboro
l
7
Eric R. Smith
Duplin
34.906700°
-78.0131000
14.50
FoA — Foreston
1
8
Eric It. Smith
Duplin
34.9064470
-78.0104780
13.70
GoA -- Goldsboro
l
9
Eric R. Smith
Duplin
34.904567'
-78.010919°
1 8.93
GoA — Goldsboro
1
Total
130.10
1. Sec Figure 1.
WQ0030998 Version 2.1 Attachment B Page 1 of I

rs '� � Tp's`�`�••F�r

Operation and Maintenance Plan

Operation & Maintenance Plan
Town of Beulaville WWTP
The WWTP ORC (or Backup ORC if ORC is unavailable) shall be in charge of the following
items as it relates to the current land application program:
• Collection of WWTP Samples
o TCLP Samples
o Pathogen reduction samples
o Vector attraction reduction samples
o Nutrient and Metals analyses
o Lime Stabilization (if applicable) — collecting pH measurements:
■ Initial pH
■ Raising the pH to 12
■ Monitoring the pH to see that it stays at 12 for 2 hours, and
■ Making sure it doesn't drop below 11.5 for the next 22 hours.
As Preparer for this facility under 40 CFR Part 503
o Being the individual that is familiar with the routine operation of this facility with
includes:
■ Insuring solids are ready for land application
■ Insuring solids have undergone proper treatment
■ Proper operation of treatment units
■ Proper operation of sludge holding units
■ Proper maintenance of treatment and storage units
■ Notification of state and land appliers of abnormal conditions
The Land Applier shall be in charge of:
• Buffering Land Application Fields
• Spreading Materials at Rates Given for Field, Crop & Soil.
• Calibrating Spreader
• Inspections and Inspection log
• Record keeping regarding disbursement & location of material spread.
• Spill Response
• Signage
Both the WTTP ORC and Land Appliers will complete the aforementioned responsibilities
before the commencement of each land applying event. In the event that an area of
noncompliance is observed, the NCDENR office will be contacted as well as Bob Branch.
Inspections should be performed in the field at the beginning of every land application event,
with every change in loading rate, and post application event for run off. An additional
inspection will be performed if rain occurs after the application event and before the residuals
have had time to desiccate (typically 3 - 5 days). Each field will be inspected pre and post with
each application event. The frequency of inspections will depend on the frequency of
application events.
Please see form RSC 08-13 for a copy of the Sampling and Monitoring Plan.

Operation and Maintenance Plan
Town of Beulaville
Title
Name
Office Phone
Cell Phone
WWTP ORC
Stanley Miller
910 298-4647
Land A plier
Eric Smith
910.298-3991
910.934-7670
Backup Applier
Bob Branch
336.510-0340
336.312-9007
Last Date Modified Name Signature
15-Nov-15 Robert T. Branch

Operation & Maintenance Plan
Town of Clayton
The WWTP ORC (or Backup ORC if ORC is unavailable) shall be in charge of the following
items as it relates to the current land application program:
• Collection of WWTP Samples
o TCLP Samples
o Pathogen reduction samples
o Vector attraction reduction samples
o Nutrient and Metals analyses
o Lime Stabilization (if applicable) — collecting pH measurements:
■ Initial pH
■ Raising the pH to 12
■ Monitoring the pH to see that it stays at 12 for 2 hours, and
■ Making sure it doesn't drop below 11.5 for the next 22 hours.
As Preparer for this facility under 40 CFR Part 503
o Being the individual that is familiar with the routine operation of this facility with
includes:
■ Insuring solids are ready for land application
■ Insuring solids have undergone proper treatment
■ Proper operation of treatment units
■ Proper operation of sludge holding units
■ Proper maintenance of treatment and storage units
■ Notification of state and land appliers of abnormal conditions
The Land Applier shall be in charge of:
• Buffering Land Application Fields
• Spreading Materials at Rates Given for Field, Crop & Soil.
• Calibrating Spreader
• Inspections and Inspection log
• Record keeping regarding disbursement & location of material spread.
• Spill Response
• Signage
Both the WWTP ORC and Land Appliers will complete the aforementioned responsibilities before
the commencement of each land applying event. In the event that an area of noncompliance is
observed, the NCDEQ office will be contacted as well as Bob Branch. Inspections should be
performed in the field at the beginning of every land application event, with every change in
loading rate, and post application event for run off. An additional inspection will be performed if
rain occurs after the application event and before the residuals have had time to desiccate (typically
3 - 5 days). Each field will be inspected pre and post with each application event. The frequency
of inspections will depend on the frequency of application events.
Please see form RSC for a copy of the Sampling and Monitoring Plan.

Operation and Maintenance Plan
Town of Clanton WRF
Title
Name
Office Phone
Cell Phone
WWTP ORC
James Warren
919.553-1536
WTPORC Back
Charles Harrell
919553-1535
Land Applier
Eric Smith
910.298-3991
910.934-7670
Backup Applierl
Bob Branch
1 336.510-0340
1 336.312-9007
Last Date Modified Name Signature
12-Sep-17 Robert T. Branch

Operation & Maintenance Plan
Town of Kenansville
The WWTP ORC (or Backup ORC if ORC is unavailable) shall be in charge of the following
items as it relates to the current land application program:
• Collection of WWTP Samples
o TCLP Samples
o Pathogen reduction samples
o Vector attraction reduction samples
o Collection of Nutrient and Metals analyses
o Lime Stabilization (if applicable) — collecting pH measurements:
■ Initial pH
■ Raising the pH to 12
■ Monitoring the pH to see that it stays at 12 for 2 hours, and
■ Making sure it doesn't drop below 11.5 for the next 22 hours.
• As Preparer for this facility under 40 CFR Part 503
o Being the individual that is familiar with the routine operation of this facility with
includes:
■ Insuring solids are ready for land application
■ Insuring solids have undergone proper treatment
■ Proper operation of treatment units
■ Proper operation of sludge holding units
■ Proper maintenance of treatment and storage units
■ Notification of state and land appliers of abnormal conditions
The Land Applier shall be in charge of:
• Buffering Land Application Fields
• Spreading Materials at Rates Given for Field, Crop & Soil.
• Calibrating Spreader
• Inspections and Inspection log
• Record keeping regarding disbursement & location of material spread.
• Spill Response
• Signage
Both the WTTP ORC and Land Appliers will complete the aforementioned responsibilities
before the commencement of each land applying event. In the event that an area of
noncompliance is observed, the NCDENR office will be contacted as well as Bob Branch.
Inspections should be performed in the field at the beginning of every land application event,
with every change in loading rate, and post application event for run off. An additional
inspection will be performed if rain occurs after the application event and before the residuals
have had time to desiccate (typically 3 - 5 days). Each field will be inspected pre and post with
each application event. The frequency of inspections will depend on the frequency of
application events.
Please see form RSC 08-11 for a copy of the Sampling and Monitoring Plan.
1

Operation and Maintenance Plan
Town of Kenansville
Title
Name Office Phone
Cell Phone
WWTP ORC
Greg Hughes
910.271-2214
Land Applier
Eric Smith 910.298-3991
910.934-7670
Backup Applier
Bob Branch 336.510-0340
336.312-9007
Last Date Modified Name Signature
13-Sep-12 Robert T. Branch

Operation & Maintenance Plan
Murphy Brown Warsaw Sanitation Trailer Wash
The WWTP ORC (or Backup ORC if ORC is unavailable) shall be in charge of the following
items as it relates to the current land application program:
• Collection of WWTP Samples
o TCLP Samples
o Pathogen reduction samples
o Vector attraction reduction samples
o Nutrient and Metals analyses
o Lime Stabilization (if applicable) — collecting pH measurements:
■ Initial pH
■ Raising the pH to 12
■ Monitoring the pH to see that it stays at 12 for 2 hours, and
■ Making sure it doesn't drop below 11.5 for the next 22 hours.
• As Preparer for this facility under 40 CFR Part 503
o Being the individual that is familiar with the routine operation of this facility with
includes:
■ Insuring solids are ready for land application
■ Insuring solids have undergone proper treatment
■ Proper operation of treatment units
■ Proper operation of sludge holding units
■ Proper maintenance of treatment and storage units
■ Notification of state and land appliers of abnormal conditions
The Land Applier shall be in charge of:
• Buffering Land Application Fields
• Spreading Materials at Rates Given for Field, Crop & Soil.
• Calibrating Spreader
• Inspections and Inspection log
• Record keeping regarding disbursement & location of material spread.
• Spill Response
• Signage
Both the WTTP ORC and Land Appliers will complete the aforementioned responsibilities
before the commencement of each land applying event. In the event that an area of
noncompliance is observed, the NCDENR office will be contacted as well as Bob Branch.
Inspections should be performed in the field at the beginning of every land application event,
with every change in loading rate, and post application event for run off. An additional
inspection will be performed if rain occurs after the application event and before the residuals
have had time to desiccate (typically 3 - 5 days). Each field will be inspected pre and post with
each application event. The frequency of inspections will depend on the frequency of
application events.
Please see form RSC 08-13 for a copy of the Sampling and Monitoring Plan.

Operation and Maintenance Plan
Murphy Brown Warsaw Sanitation Trailer Wash
WWTP ORC
Michael Norris
910.293-5575
910.284-0435
Land Applier
Eric Smith
910.298-3991
910.934-7670
Backup Applier
Bob Branch
336.510-0340
336.312-9007
Last Date Modified Name Signature
12-Dec-15 Robert T. Branch

Operation & Maintenance Plan
Murphy Brown Rainbow Trailer Wash
The WWTP ORC (or Backup ORC if ORC is unavailable) shall be in charge of the following
items as it relates to the current land application program:
• Collection of WWTP Samples
o TCLP Samples
o Pathogen reduction samples
o Vector attraction reduction samples
o Nutrient and Metals analyses
o Lime Stabilization (if applicable) — collecting pH measurements:
■ Initial pH
■ Raising the pH to 12
■ Monitoring the pH to see that it stays at 12 for 2 hours, and
■ Making sure it doesn't drop below 11.5 for the next 22 hours.
• As Preparer for this facility under 40 CFR Part 503
o Being the individual that is familiar with the routine operation of this facility with
includes:
■ Insuring solids are ready for land application
■ Insuring solids have undergone proper treatment
■ Proper operation of treatment units
■ Proper operation of sludge holding units
■ Proper maintenance of treatment and storage units
■ Notification of state and land appliers of abnormal conditions
The Land Applier shall be in charge of:
• Buffering Land Application Fields
• Spreading Materials at Rates Given for Field, Crop & Soil.
• Calibrating Spreader
• Inspections and Inspection log
• Record keeping regarding disbursement & location of material spread.
• Spill Response
• Signage
Both the WTTP ORC and Land Appliers will complete the aforementioned responsibilities
before the commencement of each land applying event. In the event that an area of
noncompliance is observed, the NCDENR office will be contacted as well as Bob Branch.
Inspections should be performed in the field at the beginning of every land application event,
with every change in loading rate, and post application event for run off. An additional
inspection will be performed if rain occurs after the application event and before the residuals
have had time to desiccate (typically 3 - 5 days). Each field will be inspected pre and post with
each application event. The frequency of inspections will depend on the frequency of
application events.
Please see form RSC 08-13 for a copy of the Sampling and Monitoring Plan.

Operation and Maintenance Plan
Murphy Brown Rainbow Trailer Wash
WWTP ORC
Michael Norris
910.293-5575
910.284-0435
Land Applier
Eric Smith
910.298-3991
910.934-7670
Backup Applier
Bob Branch
336.510-0340
336.312-9007
Last Date Modified Name Signature
12-Dec-15 Robert T. Branch

Operation & Maintenance Plan
Murphy Brown Register Trailer Wash
The WWTP ORC (or Backup ORC if ORC is unavailable) shall be in charge of the following
items as it relates to the current land application program:
• Collection of WWTP Samples
o TCLP Samples
o Pathogen reduction samples
o Vector attraction reduction samples
o Nutrient and Metals analyses
o Lime Stabilization (if applicable) — collecting pH measurements:
■ Initial pH
■ Raising the pH to 12
■ Monitoring the pH to see that it stays at 12 for 2 hours, and
■ Making sure it doesn't drop below 11.5 for the next 22 hours.
• As Preparer for this facility under 40 CFR Part 503
o Being the individual that is familiar with the routine operation of this facility with
includes:
■ Insuring solids are ready for land application
■ Insuring solids have undergone proper treatment
■ Proper operation of treatment units
■ Proper operation of sludge holding units
■ Proper maintenance of treatment and storage units
■ Notification of state and land appliers of abnormal conditions
The Land Applier shall be in charge o£
• Buffering Land Application Fields
• Spreading Materials at Rates Given for Field, Crop & Soil.
• Calibrating Spreader
• Inspections and Inspection log
• Record keeping regarding disbursement & location of material spread.
• Spill Response
• Signage
Both the WTTP ORC and Land Appliers will complete the aforementioned responsibilities
before the commencement of each land applying event. In the event that an area of
noncompliance is observed, the NCDENR office will be contacted as well as Bob Branch.
Inspections should be performed in the field at the beginning of every land application event,
with every change in loading rate, and post application event for run off. An additional
inspection will be performed if rain occurs after the application event and before the residuals
have had time to desiccate (typically 3 - 5 days). Each field will be inspected pre and post with
each application event. The frequency of inspections will depend on the frequency of
application events.
Please see form RSC 08-13 for a copy of the Sampling and Monitoring Plan.

Operation and Maintenance Plan
Murphy Brown Register Trailer Wash
WWTP ORC
Michael Norris
910.293-5575
910.284-0435
Land Applier
Eric Smith
910.298-3991
910.934-7670
Backup Applier
Bob Branch
336.510-0340
336.312-9007
Last Date Modified Name Signature
12-Dec-15 Robert T. Branch

Operation & Maintenance Plan
Town of Rose Hill
The WWTP ORC (or Backup ORC if ORC is unavailable) shall be in charge of the following
items as it relates to the current land application program:
• Collection of WWTP Samples
o TCLP Samples
o Pathogen reduction samples
o Vector attraction reduction samples
o Collection of Nutrient and Metals analyses
o Lime Stabilization (if applicable) — collecting pH measurements:
■ Initial pH
■ Raising the pH to 12
■ Monitoring the pH to see that it stays at 12 for 2 hours, and
■ Making sure it doesn't drop below 11.5 for the next 22 hours.
• As Preparer for this facility under 40 CFR Part 503
o Being the individual that is familiar with the routine operation of this facility with
includes:
■ Insuring solids are ready for land application
■ Insuring solids have undergone proper treatment
■ Proper operation of treatment units
■ Proper operation of sludge holding units
■ Proper maintenance of treatment and storage units
■ Notification of state and land appliers of abnormal conditions
The Land Applier shall be in charge o£
• Buffering Land Application Fields
• Spreading Materials at Rates Given for Field, Crop & Soil.
• Calibrating Spreader
• Inspections and Inspection log
• Record keeping regarding disbursement & location of material spread.
• Spill Response
• Signage
Both the WTTP ORC and Land Appliers will complete the aforementioned responsibilities
before the commencement of each land applying event. In the event that an area of
noncompliance is observed, the NCDENR office will be contacted as well as Bob Branch.
Inspections should be performed in the field at the beginning of every land application event,
with every change in loading rate, and post application event for run off. An additional
inspection will be performed if rain occurs after the application event and before the residuals
have had time to desiccate (typically 3 - 5 days). Each field will be inspected pre and post with
each application event. The frequency of inspections will depend on the frequency of
application events.
Please see form RSC 08-11 for a copy of the Sampling and Monitoring Plan.

Operation and Maintenance Plan
Town of Rose Hill
Title
Name
Office Phone
Cell Phone
WWTP ORC
Ben Hilliard
910.289-3159
Land Applier
Eric Smith
910.298-3991
910.934-7670
Backup Applier,
Bob Branch
336.510-0340
336.312-9007
Last Date Modified Name Signature
13-Se -12 Robert T. Branch

Operation & Maintenance Plan
South Western Plantation
The WWTP ORC (or Backup ORC if ORC is unavailable) shall be in charge of the following
items as it relates to the current land application program:
• Collection of WWTP Samples
o TCLP Samples
o Pathogen reduction samples
o Vector attraction reduction samples
o Collection of Nutrient and Metals analyses
o Lime Stabilization (if applicable) — collecting pH measurements:
■ Initial pH
■ Raising the pH to 12
■ Monitoring the pH to see that it stays at 12 for 2 hours, and
■ Making sure it doesn't drop below 11.5 for the next 22 hours.
As Preparer for this facility under 40 CFR Part 503
o Being the individual that is familiar with the routine operation of this facility with
includes:
■ Insuring solids are ready for land application
■ Insuring solids have undergone proper treatment
■ Proper operation of treatment units
■ Proper operation of sludge holding units
■ Proper maintenance of treatment and storage units
■ Notification of state and land appliers of abnormal conditions
The Land Applier shall be in charge of:
• Buffering Land Application Fields
• Spreading Materials at Rates Given for Field, Crop & Soil.
• Calibrating Spreader
• Inspections and Inspection log
• Record keeping regarding disbursement & location of material spread.
• Spill Response
• Signage
Both the WTTP ORC and Land Appliers will complete the aforementioned responsibilities before
the commencement of each land applying event. In the event that an area of noncompliance is
observed, the NCDENR office will be contacted as well as Bob Branch. Inspections should be
performed in the field at the beginning of every land application event, with every change in
loading rate, and post application event for run off. An additional inspection will be performed if
rain occurs after the application event and before the residuals have had time to desiccate (typically
3 - 5 days). Each field will be inspected pre and post with each application event. The frequency
of inspections will depend on the frequency of application events.
Please see form RSC 08-11 for a copy of the Sampling and Monitoring Plan.

Operation and Maintenance Plan
South Western Plantation
Title
Name
Office Phone
Cell Phone
WWTP ORC
Sonny Scozzari
910.545-1499
Land Applier
Eric Smith
910.298-3991
910.934-7670
Backup Applier
Bob Branch
336.510-0340
336.312-9007
Last Date Modified Name Signature
9-Feb-21 Robert T. Branch

Operation & Maintenance Plan
Town of Wallace WWTP
The WWTP ORC (or Backup ORC if ORC is unavailable) shall be in charge of the following
items as it relates to the current land application program:
• Collection of WWTP Samples
o TCLP Samples
o Pathogen reduction samples
o Vector attraction reduction samples
o Nutrient and Metals analyses
o Lime Stabilization (if applicable) — collecting pH measurements:
■ Initial pH
■ Raising the pH to 12
■ Monitoring the pH to see that it stays at 12 for 2 hours, and
■ Making sure it doesn't drop below 11.5 for the next 22 hours.
As Preparer for this facility under 40 CFR Part 503
o Being the individual that is familiar with the routine operation of this facility with
includes:
■ Insuring solids are ready for land application
■ Insuring solids have undergone proper treatment
■ Proper operation of treatment units
■ Proper operation of sludge holding units
■ Proper maintenance of treatment and storage units
■ Notification of state and land appliers of abnormal conditions
The Land Applier shall be in charge of:
• Buffering Land Application Fields
• Spreading Materials at Rates Given for Field, Crop & Soil.
• Calibrating Spreader
• Inspections and Inspection log
• Record keeping regarding disbursement & location of material spread.
• Spill Response
• Signage
Both the WTTP ORC and Land Appliers will complete the aforementioned responsibilities before
the commencement of each land applying event. In the event that an area of noncompliance is
observed, the NCDENR office will be contacted as well as Bob Branch. Inspections should be
performed in the field at the beginning of every land application event, with every change in
loading rate, and post application event for run off. An additional inspection will be performed if
rain occurs after the application event and before the residuals have had time to desiccate (typically
3 - 5 days). Each field will be inspected pre and post with each application event. The frequency
of inspections will depend on the frequency of application events.
Please see form RSC 08-13 for a copy of the Sampling and Monitoring Plan.

Operation and Maintenance Plan
Town of Wallace
WWTP ORC
Lisa Cottle
910.665-2091
910.285-5927
Land Applier
Eric Smith
910.298-3991
910.934-7670
Backup Applier
Bob Branch
336.510-0340
336.312-9007
Last Date Modified Name Signature
15-A r-15 Robert T. Branch

Operation & Maintenance Plan
Town of Warsaw
The WWTP ORC (or Backup ORC if ORC is unavailable) shall be in charge of the following
items as it relates to the current land application program:
• Collection of WWTP Samples
o TCLP Samples
o Pathogen reduction samples
o Vector attraction reduction samples
o Nutrient and Metals analyses
o Lime Stabilization (if applicable) — collecting pH measurements:
■ Initial pH
■ Raising the pH to 12
■ Monitoring the pH to see that it stays at 12 for 2 hours, and
■ Making sure it doesn't drop below 11.5 for the next 22 hours.
• As Preparer for this facility under 40 CFR Part 503
o Being the individual that is familiar with the routine operation of this facility with
includes:
■ Insuring solids are ready for land application
■ Insuring solids have undergone proper treatment
■ Proper operation of treatment units
■ Proper operation of sludge holding units
■ Proper maintenance of treatment and storage units
■ Notification of state and land appliers of abnormal conditions
The Land Applier shall be in charge of.
• Buffering Land Application Fields
• Spreading Materials at Rates Given for Field, Crop & Soil.
• Calibrating Spreader
• Inspections and Inspection log
• Record keeping regarding disbursement & location of material spread.
• Spill Response
• Signage
Both the WTTP ORC and Land Appliers will complete the aforementioned responsibilities
before the commencement of each land applying event. In the event that an area of
noncompliance is observed, the NCDENR office will be contacted as well as Bob Branch.
Inspections should be performed in the field at the beginning of every land application event,
with every change in loading rate, and post application event for run off. An additional
inspection will be performed if rain occurs after the application event and before the residuals
have had time to desiccate (typically 3 - 5 days). Each field will be inspected pre and post with
each application event. The frequency of inspections will depend on the frequency of
application events.
Please see form RSC 08-13 for a copy of the Sampling and Monitoring Plan.

Operation and Maintenance Plan
Town of Warsaw
Title
Name
Office Phone
Cell Phone
WWTP ORC
Greg Hughes
910.293-7814
910.385-5994
Land Applier
Eric Smith
910.298-3991
910.934-7670
Backup Applier
Bob Branch
336.510-0340
336.312-9007
Last Date Modified Name Signature
10-Oct-13 Robert T. Branch

RESIDUALS SOURCE FACILITY SUMMARY

RESIDUALS SOURCE FACILITY SUMMARY
Applicant's name: Triple S Farms & Cleaning Inc.
Status
Code a
Facility Permit Holder
Facility Name
County
Permit Number
Maximum Dry Tons Per Year
Current n
Proposed
R
Town of Rose Hill
Rose Hill WWTF
Du lin
NCO056863
38
38
M
Town of Kenansville
Kenansville WWTP
Du lin
NCO036668
38
l0
M
Town of Beulaville
Beulaville WWTP
Du lin
NCO026018
38
30
R
Carolina Investments, Inc.
Southwest Plantation WWTF
Onslow
W 0029601
5
5
M
Town of Warsaw
Warsaw WWTP
Du lin
NCO021903
38
75
R
Town of Wallace
Wallace WWTP
Du lin
NC0003450
330
330
M
Murphy Brown, LLC
Warsaw Sanitation Trailer Wash
Du lin
W 0023310
50
63
M
Murphy Brown, LLC
Rainbow Trailer Wash
Du lin
W 0013921
40
25
M
Murphy Brown, LLC
Register Trailer Wash
Du lin
W 0014247
50
63
M
Town of Clayton
Little Creek WRF
Johnston
WQ0025453
80
300
a Status Code for source facility are: ♦ N (New) ♦ R (Renewed) ♦ M (Modified) ♦ D (Deleted)
b The amount of residuals currently permitted for distribution, land application, or disposal (i.e, not applicable to new facility).
SUMMARY FOR FORM: RSC 06-16 Page 1

Triple S Farms Source Compilation
PAN Surface
■ Facility Dry tons First Year mg/Kg #/DT
Town of Rose Hill
38
9,088
345,354.64
3.15
Town of Kenansville
10
10,045
100,447.20
0.92
Town of Wallace
330
6,167
2,035,096.80
18.59
Southwest Plantation
5
24,050
120,251.00
1.10
Town of Beaulaville
30
24,421
1 732,628.98
6.69
Town of Warsaw
75
13,821
1,036,545.45
9.47
MB Warsaw TW
63
1,867
117,605.25
1.07
MB Rainbow TW
25
8,021
200,534.50
1.83
MB Register TW
63
1,454
91,580.58
0.84
Clayton 1
1 3001
20,562
6,168,600.001
56.34
Totals
Facilitv
939
Dry tons Five Year
10,948,644.40
PAN Surface
mg/Kg #/DT
Town of Rose Hill
38
14,235
540,918.42
3.43
Town of Kenansville
10
16,024
160,237.16
1.02
Town of Wallace
330
8,630
2,847,981.73
18.07
Southwest Plantation
5
37,217
186,085.83
1.18
Town of Beaulaville
30
34,439
1,033,170.82
6.55
Town of Warsaw
75
20,974
1,573,039.91
9.98
MB Warsaw TW
63
2,647
166,761.08
1.06
MB Rainbow TW
25
11,160
279,010.12
1.77
MB Register TW
63
2,158
135,979.76
0.86
Clayton
1
1 3001
29,464
8,839,113.78
80.73
1 otals
Facilitv
939
Dry tons First Year
120,1OL,Ly5.OL
PAN Injection
me/K2 #/DT
Town of Rose Hill
38
9,608
365,114.64
2.74
Town of Kenansville
10
10,055
100,545.20
0.76
Town of Wallace
330
8,232
2,716,546.80
20.40
Southwest Plantation
5
26,115
130,576.00
0.98
Town of Beaulaville
30
24,423
732,701.43
5.50
Town of Warsaw
75
1 1
1 1,036,659.08
7.79
MB Warsaw TW
63
2,432
153,200.25
1.15
MB Rainbow TW
25
10,811
270,284.50
2.03
MB Register TW
63
1,733
109,189.08
0.82
Clayton
1
1 3001
25,662
7,698,600.001
70.32
Uotais
Facility
VAYJ
Dry tons Five Year
13,315,41().95
PAN Injection
me/Kg #/DT
Town of Rose Hill
38
14,755
560,678.42
3.28
Town of Kenansville
10
16,034
160,335.16
0.94
Town of Wallace
330
10,695
3,529,431.73
20.65
Southwest Plantation
5
39,282
196,410.83
1.15
Town of Beaulaville
30
30
900.00
0.01
Town of Warsaw
75
20,975
1,573,153.54
9.20
MB Warsaw TW
63
3,212
202,356.08
1.18
MB Rainbow TW
25
13,950
348,760.12
2.04
MB Register TW
63
2,438
153,588.26
0.90
Clayton
I
1 300
34,564
10,369,113.78
94.71
l'otals 939 17,U94,"/L7.93
Weighted Average
mg/Kg #/DT
11,659.90 23.32
Weighted Average
mg/Kg #/DT
16,786.26 33.57
Weighted Average
mg/Kg #/DT
14,178.29 28.36
Weighted Average
mg/Kg #/DT
18,205.25 36.41

Total PAN For All Sources
NDRLAP Section III 7a. Page 4 of 6
Assumed Acres Required Using Acres Required Using
Application RateFirst-Year PAN Concentratio ve-Year Maximum Adjust P
(lbs PAN/ac yr) Concentrations
Surface or Injection Surface or Injection
50 437.95 532.54 630.49 683.79
100 218.97 266.27 315.25 341.89
150 145.98 177.51 210.16 227.93
200 109.49 133.13 157.62 170.95
Most Restricting PAN 31,524.60
PAN
First -Year
PAN
First -Year
Pounds of PAN per Dry Ton
(Weigh dAvera e)
Pounds of PAN per Year
Surface
Incorporation
or Injection
Surface
Incorporation
or Injection
23.32
28.36
21,897.29
26,626.83
Five Year Maximum Ad'uste
33.57
36.41
31,524.60
34,189.46
Acreage Calculation Rased On RYE
RYE Pounds PAN Per Field
Field Acres First Crop Second Crop First Crop Second Crop
1 34.2 299 50 10225.8 1710
2 8.48 276 50 2340.48 424
3A 13.73 276 50 3789.48 686.5
313 7.27 184 1337.68 0
4 4.14 184 761.76 0
5 11.2 184 2060.8 0
6 13.95 60 837 0
7 14.5 276 50 4002 725
8 13.7 184 2520.8 0
9 8.93 266 50 2375.38 446.5
Totals 30251.18 3992 34243.18
130.1
Totals 30251.18 3992 34243.18
130.1

RESIDUALS SOURCE CERTIFICATION ATTACHMENT
Town of Rose Hill

r-- State of North Carolina
Department of Environmental Quality
I 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
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

DWR
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: Town of Rose Hill
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: Carl Wheeler - ORC
Complete mailing address: Post Office Box 8
City: Rose Hill State: NC Zip: 28458-
Telephone number: [phone] E-mail address: rosehill.carlwheeler(a)embargmail.com
4. Facility physical address: 287 Charlie Teachey Road.
City: Rose Hill State: NC Zip: 28458-
Coordinates: Latitude: 34' 49' 1.19" N Longitude: 78' 0' 21.5" W
Datum: NAD 83 Level of accuracy: Nearest 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: % industrial and % domestic)
❑ other (explain: ).
6. Does the facility have an approved pretreatment program: ❑ Yes ® No
7. Facility permitted/design flow: 0.45 MGD and facility average daily flow: 0.10 MGD
8. Average amount of residuals being generated at this facility 38 dry tons per year.
9. Specify the following regarding treatment and storage volumes available at the facility:
Type and volume of residuals treatment: (3) 44,000 gallon Clarifiers for a total of 132,000 gallons
Type and volume of residuals storage (i.e., outside of residuals treatment units): None
II. 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
FORM: RSC 06-16 Page 1 of 5

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).
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: ❑ yes ® no.
If yes, list the number(s):
b. Specify whether or not the residuals exhibit any of the characteristics defined by 40 CFR §261.21-
261.24: ❑ yes ® no.
Fill in the following tables with the results of the latest toxicity characteristic leaching procedure (TCLP) analysis as well
as those for corrosivity, ignitability, and reactivity:
Laboratory: Environmental Chemists, Inc. and Date of analysis: 11/18/2020
Passed corrosivity test: ® yes ❑ no. pH: s.u. (2 < pH < 12.5)
Passed ignitability test: ® yes ❑ no. Flashpoint: WNI IF (> 140°F)
Passed reactivity test: ® yes ❑no. HCN: 3.35 mg/kg (<250) & H2S: 0.69 mg/kg (<500)
TCLP Parameter
Limit
(mg/1)
Result
(Mg/1)
TCLP Parameter
Limit
NO)
Result
(mg/1)
Arsenic
5.0
<1.00
Hexachlorobenzene
0.13
<0.050
Barium
100.0
<1.00
Hexachloro-1,3-Butadiene
0.5
<0.050
Benzene
0.5
<0.010
Hexachloroethane
3.0
<0.050
Cadmium
1.0
<1.00
Lead
5.0
<1.00
Carbon Tetrachloride
0.5
<0.01
Lindane
0.4
<0.0005
Chlordane
0.03
<0.020
Mercury
0.2
<0.0020
Chlorobenzene
100.0
<0.010
Methoxychlor
10.0
<0.0005
Chloroform
6.0
<0.010
Methyl Ethyl Ketone
200.0
<0.050
Chromium
5.0
<1.00
Nitrobenzene
2.0
<0.050
m-Cresol
200.0
<0.050
Pentachlorophenol
100.0
<0.250
o-Cresol
200.0
<0.050
Pyridine
5.0
<0.050
p-Cresol
200.0
<0.050
Selenium
1.0
<1.00
Cresol
200.0
<0.050
Silver
5.0
<1.00
2,4-D
10.0
<0.003
Tetrachloroethylene
0.7
<0.010
1,4-Dichlorobenzene
7.5
<0.050
Toxaphene
0.5
<0.050
1,2-Dichloroethane
0.5
<0.010
Trichloroethylene
0.5
<0.010
1,1-Dichloroethylene
0.7
<0.010
2,4,5-Trichlorophenol
400.0
<0.050
2,4-Dinitrotoluene
0.13
<0.050
2,4,6-Trichlorophenol
2.0
<0.050
Endrin
0.02
<0.0005
2,4,5-TP (Silvex)
1.0
<0.003
Heptachlor and its Hydroxide
0.008
<0.0005
Vinyl Chloride
0.2
<0.010
FORM: RSC 06-16 Page 2 of 5

4. Metals Determination: Complete one of the following tables (i.e., as applicable) to demonstrate that the residuals do not violate
the ceiling concentrations for metals regulated under 15A NCAC 02T .1105.
a. For Distribution/Land Application: Fill in the following table with the results of the latest analyses (i.e., on a dry weight
basis) for the following metal parameters:
Laboratory: Environmental Chemists, Inc. and Date of analysis: 11/18/2020
Parameter
Ceiling
Monthly Average
Result
Concentration Limits
Concentration Limits
(ClassA & ClassB)
(Class A Only)
(mglk-g)
(mglkg)
(mglkg)
Arsenic
75
41
7.91
Cadmium
85
39
<1.16
Copper
4,300
1,500
359.00
Lead
840
300
43.60
Mercury
57
17
0.8550
Molybdenum
75
n/a
3.19
Nickel
420
420
8.78
Selenium
100
100
6.95
Zinc
7,500
2,800
1170.00
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. Nutrient/Micronutrient Determination: Complete the following:
a. Total solids: 2.35 %.
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: Environmental Chemists. Inc. and Date of analysis: 11/18/2020
Parameter
Result
(mg1kg)
Aluminum
11,400.00
Ammonia -Nitrogen
1,040.00
Calcium
29,600.00
Magnesium
1,400.00
Nitrate -Nitrite Nitrogen
0.28
pH (Standard Unit)
7.14
Phosphorus
21,100.00
Potassium
903.00
Sodium
182.00
Total Kjeldahl Nitrogen
29,600.00
c. Using the results listed in Item II. 5b. above, calculate the sodium adsorption ration (SAR): 0.25
[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: 30 %. This rate
is a (check one): ❑ 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: This mineralization rate is
consistent with lime -stabilization.
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
(mg1kg)
(mg/kg)
Surface
9,088
1 14,235
Injection/Incorporation
9,608
1 14,755
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: None
FORM: RSC 06-16 Page 4 of

7. Pathogen Reduction: Per 15A NCAC 02T.11061 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 I [15A NCAC 02T.I 106(b)(3)(A)] - TimelTemperature Compliance.
❑ Alternative 2 [15A NCAC 02T.I 106(b)(3)(B)] - Alkaline Treatment.
❑ Alternative 3 [15A NCAC 02T.I 106(b)(3)(C)] - Prior Testing for Enteric Virus/Viable Hehninth Ova.
❑ Alternative 4 [15A NCAC 02T.1106(b)(3)(D)] - No Prior Testing for Enteric Virus/Viable Helminth Ova.
❑ Alternative 5 [15A NCAC 02T.1106(b)(3)(E)-(K)] - Process to Further Reduce Pathogens (PFRP).
Specify one: ❑ composting, ❑ heat drying, ❑ heat treatment,
❑ thermophilic aerobic digestion, ❑ beta ray irradiation,
❑ gamma ray irradiation, or ❑ pasteurization.
b. For Land Application of Class B:
® Alternative 1 [15A NCAC 02T. 1 106(c)(1)] - Fecal Coliform Density Demonstration.
® Alternative 2 [15A NCAC 02T.1106(c)(2)] -Process to Significantly Reduce Pathogens (PSRP).
Specify one: ❑ aerobic digestion, ® air drying, ❑ anaerobic digestion,
❑ composting, or ® lime stabilization.
c. For Surface Disposal:
❑ Select One of the Class A or Equivalent Pathogen Reduction Alternatives in Item II. 7a. above.
❑ Select One of the Class B or Equivalent Pathogen Reduction Alternatives in Item II. 7b. above.
❑ Exempt -If Daily Cover Alternative is chosen in Item 11.8. below [15A NCAC 02T.1106(a)(2)].
❑ Not Applicable - Non -Biological Residuals with NO Domestic Wastewater Contribution.
8. Vector Attraction Reduction (VAR): Per 15A NCAC 02T.1107, specify how residuals will meet the VAR requirements:
❑ Alternative 1 [15A NCAC 02T. I 107(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.I 107(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. 1 107(a)(7)] - Drying of Stabilized Residuals.
❑ Alternative 8 [15A NCAC 02T. 1 107(a)(8)] - Drying of Unstabilized Residuals.
® Alternative 9 [15A NCAC 02T. 1 107(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

Facility Vicinity Map

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SCALE: 1 — 1,500 ft qW Triple S Farms Facility
CHECKED BY: RTB Land Application Program Vicinity
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Process Flow Diagram and Narrative

WASTEWATER TREATMENT PLANT PROCESS
The Town of Rose Hill operates a 0.45 million gallon capacity aerobic wastewater treatment plant.
After grit collection and bar screen, the influent goes to an oxidation ditch. After the oxidation ditch,
liquids are sent to one of three clarifiers. Liquids from the clarifiers are controlled by the manual
pump station. Liquids from the clarifier can be sent out for chlorination/dechlorination and discharge
to Reedy Branch. Solids from the clarifiers are pumped to the head of the WWTP as return activated
sludge or sent to the aerated sludge holding tank. Solids are further thickened in the sludge holding
tank. Decant liquids from the sludge holding tank are pumped back to the head of the plant.
The Town of Rose Hill has several drying beds are also kept for use as needed.
A schematic diagram of the plant is found on the following page.

C t.F.IC �LICs
Chemical feed System
-
' Oxfdeticn r
Cowfnd tor/ D i tch
_
Grl t Removal
.
8 Pass Screen
y'
-
"ifi
-
Sampt.l ng
y
Manhel e
i
Influent'
i 1
_
r
Screw PumpAj
r
_ ..
Recycle Sludge Recycle and
• 1---------------'�--�
�Sludge
--4�--------•--'---- Waste Box___----
cw�oR/.,�
-Wastes Sludge• i
Pump Station (�SludgefaStey�
•��olNl�•e-T
�....,�
i
Effluent
�•
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Aerated Sludge
•
Bed Underdra iaage
Holding Tank
Sludge Drylrig Beds
a
.
- SPAAy
ve M
EXHIBIT l- $
...�
�.
SCHEMATIC FLOW DIAGRAM '
'
ROSE HILL WASTEWATER TREATMENT PLANT-.

Justification for Residuals Production Rate

881i3.CI7MC111 k IWAAAA 7 7 &I i1il\�[i ' ' 1111iL�71_Y_C�7►�:711 Y
Review of dry tons produced from this facility indicates the dry tons should be set at 38 dry tons. The
past several years production data support this decrease in dry tons.

Residuals Sampling Plan

WWTP SAMPLING PLAN — TOWN OF ROSE HILL
Annually, multiple grab residual solid samples are collected from the sludge holding tank. These
samples are composited for nutrient and metal analyses. The composited sample is mixed to keep the
solids suspended and containers filled for this analysis. Lime stabilization occurs when the sludge
holding tank reaches capacity. Lime is added to reach proper stabilization requirements for vector
attraction and pathogen reduction. Field measurements of pH and temperature are collected for each
stabilization event to insure pH requirements are met. pH values are later temperature corrected.
Annually, or when the residual solids are to be land applied if application occurs less than annually,
a composite residual solid sample will be analyzed for: Arsenic, Cadmium, Copper, Lead, Mercury,
Molybdenum, Nickel, Selenium, Zinc, Aluminum, Ammonia — Nitrogen, Calcium, Nitrate -Nitrite,
Nitrogen, Magnesium, % Total Solids, pH, Phosphorus, Potassium, TKN, and Sodium. From this
information, the Plant Available Nitrogen (PAN) will be calculated. Once a permit cycle, a composite
TCLP sample will be collected to include:
Arsenic
Hexachlorobenzene
ph for Corrosivity
Barium
Hexachloro-1,3-Butadiene
Benzene
Hexachloroethane
Flash point for ignitability
Cadmium
Lead
Carbon Tetrachloride
Lindane
Sulfides and Cyanides for reactivity
Chlordane
Mercury
1,2-Dichloroethane
Chlorobenzene
Methoxychlor
1,1-Dichloroethylene
Chloroform
Methyl Ethyl Ketone
2,4-Dinitrotoluene
Chromium
Nitrobenzene
Endrin
m-Cresol
Pentachlorophenol
Heptachlor and its Hydroxide
o-Cresol
Pyridine
Trichloro ethylene
p-Cresol
Selenium
2,4,5-Trichlorophenol
Cresol
Silver
2,4,6-Trichlorophenol
2,4-D
Tetrachloroethylene
2,4,5-TP (Silvex)
1,4-Dichlorobenzene
Toxaphene
Vinyl Chloride

Analytical Data From the Town of Rose Hill
TCLP and Nutrient & Metal

747
Environmental Chemists,
Inc.
1
6602 Windmill Way,
Wilmington, NC 28405 • 910.392.0223 Lab • 910.392.4424 Fax
rM
710 Bowsertown Road, Manteo, NC 27954 • 252.473.5702 Lab/Fax
255-A Wilmington Highway, Jacksonville, NC 28540 • 910.347.5843 Lab/Fax
ANALYTICAL & CONSULTING CHEMISTS
[e-mail]
Town of Rose Hill
Date of Report: Nov 18, 2020
P. 0. Box 8
Customer PO #:
Rose Hill NC 28458
Customer ID: 09020035
Attention:
Report #: 2020-17885
Project ID: Sludge
Lab ID Sample ID:
Collect Date/Time Matrix Sampled by
20-45649 Site: Sludge
10/20/2020
8:15 AM Solid/Sludge Carl Wheeler
Test
Method
Results Date Analyzed
Chlordane (TCLP)
SW 846 Method 8081 B/3510
<0.02 mg/L
11/09/2020
Endrin (TCLP)
SW 846 Method 8081 B/3510
<0.0005 mg/L
11/09/2020
Heptachlor (TCLP)
SW 846 Method 8081 B/3510
<0.0005 mg/L
11 /09/2020
Heptachlor epoxide (TCLP)
SW 848 Method 80B1 B/3510
<0.0005 mg/L
11/09/2020
Lindane (TCLP)
SW 846 Method 8081 B/3510
<0.0005 mg/L
11/09/2020
Methoxychlor (TCLP)
SW 846 Method 8081 B/3510
<0.0005 mg/L
11/09/2020
Toxaphene (TCLP)
SW 846 Method 8081 B/3510
<0.05 mg/L
11/09/2020
1,4-Dichlorobenzene (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
11/05/2020
2,4,5-Trichlorophenol (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
11/05/2020
2,4,6-Trichlorophenol (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
11/05/2020
2,4-Dinitrotoluene (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
11/05/2020
Cresol (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
11/05/2020
Hexachloro-1,3-butadiene (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
11/05/2020
Hexachlorobenzene (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
11/05/2020
Hexachloroethane (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
11/05/2020
m + p-Cresol (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
11/05/2020
Nitrobenzene (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
11/05/2020
o-Cresol (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
11/05/2020
Pentachlorophenol (TCLP)
SW 846 method 8270/3510
<0.250 mg/L
11/05/2020
Pyridine (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
11/05/2020
2,4,5-TP (TCLP)
SW846 Method 8151A
<0.003 mg/L
11/09/2020
2,4-D (TCLP)
SW846 Method 8151A
<0.003 mg/L
11/09/2020
1,1-Dichloroethylene (TCLP)
SW846 Method 8260/5030
<0.01 mg/L
10/28/2020
1,2-Dichloroethane (TCLP)
SW846 Method 8260/5030
<0.01 mg/L
10/28/2020
Benzene (TCLP)
SW846 Method 8260/5030
<0.01 mg/L
10/28/2020
Carbon Tetrachloride (TCLP)
SW846 Method 8260/5030
<0.01 mg/L
10/28/2020
G7nr +9. 7n'In 170ac

F"Ppo-- - 71
SM
ANALYTICAL & CONSULTING CHEMISTS
Environmental Chemists, Inc.
6602 Windmill Way, Wilmington, NC 28405 • 910.392.0223 Lab • 910.392.4424 Fax
710 Bowsertown Road, Manteo, NC 27954 • 252.473.5702 Lab/Fax
255-A Wilmington Highway, Jacksonville, NC 28540 • 910.347.5843 Lab/Fax
[e-mail]
Town of Rose Hill
Date of Report: Nov 18, 2020
P. O. Box 8
Customer PO #:
Rose Hill NC 28458
Customer ID: 09020035
Attention:
Report #: 2020-17885
Project ID: Sludge
Chlorobenzene (TCLP)
SW846 Method 8260/5030
<0.01 mg/L
10/28/2020
Chloroform (TCLP)
SW846 Method 8260/5030
<0.01 mg/L
10/28/2020
Methyl ethyl ketone (TCLP)
SW846 Method 8260/5030
<0.05 mg/L
10/28/2020
Tetrachloroethylene (TCLP)
SW846 Method 8260/5030
<0.01 mg/L
10/28/2020
Trichloroethylene (TCLP)
SW846 Method 8260/5030
<0.01 mg/L
10/28/2020
Vinyl Chloride (TCLP)
SW846 Method 8260/5030
<0.01 mg/L
10/28/2020
RCI
Ignitability
EPA 1030
<0.8 mm/sec
10/27/2020
Cyanide
EPA 335.4
3.35 mg/kg
10/30/2020
Sulfide
SM 4500 S D
0.69 mg/kg
10/29/2020
Analyzed outside of hold time
pH
SW 846 Method 9045D
7.14 units
11/17/2020
Sludge Residuals
Aluminum
EPA 200.7
11400 mg/kg
11/04/2020
Arsenic
EPA 200.7
7.91 mg/kg
11 /10/2020
Cadmium
EPA 200.7
<1.16mg/kg
11/04/2020
Calcium
EPA 200.7
29600 mg/kg
11/10/2020
Chromium
EPA 200.7
95.2 mg/kg
11/04/2020
Copper
EPA 200.7
359 mg/kg
11/04/2020
Lead
EPA 200.7
43.6 mg/kg
11/04/2020
Magnesium
EPA 200.7
1400mg/kg
11/04/2020
Molybdenum
EPA 200.7
3.19 mg/kg
11/04/2020
Nickel
EPA 200.7
8.78 mg/kg
11/04/2020
Potassium
EPA 200.7
903 mg/kg
11/04/2020
Selenium
EPA 200.7
6.95 mg/kg
11/04/2020
Sodium
EPA 200.7
182mg/kg
11/04/2020
Zinc
EPA 200.7
1170 mg/kg
11/04/2020
Nitrate+Nitrite-Nitrogen
EPA 353.2
0.28 mg/kg
10/22/2020
Total Solids (%)
SM 2540 B
78.6 %
10/26/2020
Ammonia Nitrogen
SM 4500 NH3 C
1040 mg/kg
10/23/2020
P-n f! nnnn 470OS 0- 1 of 7

6envirochem
ANALYTICAL & CONSULTING CHEMISTS
Environmental Chemists, Inc.
6602 Windmill Way, Wilmington, NC 28405 • 910.392.0223 Lab • 910.392.4424 Fax
710 Bowsertown Road, Manteo, NC 27954 • 252.473.5702 Lab/Fax
255-A Wilmington Highway, Jacksonville, NC 28540 • 910.347.5843 Lab/Fax
[e-mail]
Town of Rose Hill
Date of Report: Nov 18, 2020
P. 0. Box 8
Customer PO #:
Rose Hill NC 28458
Customer ID: 09020035
Attention:
Report #: 2020-17885
Project ID: Sludge
Total Kjeldahl Nitrogen (TKN) sM 4500 0r9 B
29600 mg/kg 10/25/2020
Total Phosphorus 5M 4500 P F
21100 mg/kg 11 /04/2020
Mercury Sw846 74718
0.8550 mg/kg 10/30/2020
TCLP Metals
Arsenic
EPA 200.7
<1.0 mg/L
11/06/2020
Barium
EPA 200.7
<1.0 mg/L
11/06/2020
Cadmium
EPA 200.7
<1.0 mg/L
11/06/2020
Chromium
EPA 200.7
<1.0 mg/L
11/06/2020
Lead
EPA 200 7
<1.O mg/L
11/06/2020
Selenium
EPA 200.7
<1.0 mg/L
11/06/2020
Silver
EPA 200.7
<1.0 mg/L
11/06/2020
Mercury
EPA 245 1
<0.002 mg/L
11/13/2020
Comment: Sludgeresidualsreported on a dry weight basis.
Reviewed by: 6:� Y:��
0—4# nnnn 47noc 0--- 1 -1 n

Environmental Chemist, Inc., Wilmington, NC Lab #94
6602 Windmill Way
Wilmington, NC 28405
910.392.0223
Sample Receipt Checklist
Client: Ro$e O(L -MWN Date: 0 Report Number: c2 Q K_
Receipt of sample: ECHEM Pickup Client Delivery ❑ UPS ❑ FedEx ❑ Other ❑
YES
❑ NO
N/A I. Were custody seals present on the cooler?
❑ YES
❑ NO
N/A 2. If custody seals were present, were they intact/unbroken?
Original temperature upon receipt °C Corrected temperature upon receipt_
How temperature taken: ❑ Temperature Blank 7 Against Bottles
IR Gun ID: Thomas Traceable SIN 192511657 IR Gun Correction Factor °C: 0.0
❑ YES
❑ NO
3. If temperature of cooler exceeded 6°C, was Project Mgr./QA notified?
fW YES
❑ NO
4. Were proper custody procedures (relinquished/received) followed?
YES
❑ NO
5. Were sample ID's listed on the COC?
YES
❑ NO
6. Were samples ID's listed on sample containers?
YES
❑ NO
7. Were collection date and time listed on the COC?
YES
❑ NO
8. Were tests to be performed listed on the COC?
YES
❑ NO
9. Did samples arrive in proper containers for each test?
YES
❑ NO
10. Did samples arrive in good condition for each test?
YES
❑ NO
11. Was adequate sample volume availableT
YES
❑ NO
12. Were samples received within proper holding time for requested tests?
❑ YES
❑ NO
13. Were acid preserved samples received at a pH of <2?
❑ YES
❑ NO
14. Were cyanide samples received at a pH >12?
❑ YES
❑ NO
15. Were sulfide samples received at a pH >9?
❑ YES
❑ NO
116. Were NH3/TKN/Phenol received at a chlorine residual of <0.5 m/L? **
❑ YES
❑ NO
17. Were Sulfide/Cyanide received at a chlorine residual of <0.5 m/L?
❑ YES
❑ NO
118. Were orthophosphate samples filtered in the field within 15 minutes?
* TOC/Volatiles are pH checked at time of analysis and recorded on the benchsheet.
** Bacteria samples
are checked for Chlorine at time of analysis and recorded on the benchsheet.
Sample Preservation: (Must be completed for any sample(s) incorrectly preserved or with headspace)
Samples) were received incorrectly preserved and were adjusted accordingly
by adding (circle one): H2SO4 HNO3 HCI NaOH
Time of preservation: If more than one preservative is needed, notate in comments below
Note: Notify customer service immediately for incorrectly preserved samples. Obtain a new sample or
notify the state lab if directed to analyzed by the customer. Who was notified, date and time:
Volatiles Sample(s) were received with headspace
COMMENTS:
DOC. QA.002 Rev 1
°C

f-
Analytical & Consulting Chemists
ENVIRONMENTAL CHEMISTS, INC
NCDENR: DWQ CERTIFICATION # 94 NCDHHS: DLS CERTIFICATION # 37729
COLLFCTION Amn CNeIN n1Z r_t ICTnnv
6602 Windmill Way Wilmington, NC 28406
OFFICE: 910-392-0223 FAX [phone]
[e-mail]
Client: Town of Rose Hill WWTP
PROJECT NAME: Sludge samples
REPORT NO:
ADDRESS:
CONTACT NAME: Carl Wheeler
PO NO:
REPORT TO:
PHONEIFAX:
COPY TO:
email:
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Sample Identification
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SAMPLE
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TYPE: I = Influent,
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E = Effluent, W = Well, ST = Stream, SO = Soil, SL = Sludge, Other:
� PRESERVATION
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Date
Time
Temp
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Full TCLP, RCI, Nutrients/Metals
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Relinquished By:
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Received By:
DateITime
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Temperature when Received: Accepted: jected: Resample R que ted:
Delivered By: Received By: Date: 1O ?.e Time:
Comments: LTURNAROUND:

RESIDUALS SOURCE CERTIFICATION ATTACHMENT
Town of Kenansville

lum
Division of Water Resources
State of North Carolina
Department of Environmental Quality
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
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

Division of Water Resources
I.
II.
State of North Carolina
Department of Environmental Quality
Division of Water Resources
RESIDUALS SOURCE CERTIFICATION
FORM: RSC 06-16
RESIDUALS SOURCE -GENERATING FACILITY INFORMATION (See Instruction B.):
1. Facility Name: Town of Kenansville
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: Town Manager — Chris Roberson
Complete mailing address: P.O. Box 370
City: Kenansville State: NC Zip: 28349-
Telephone number: [phone] E-mail address: manager(a,kenansville.com
4. Facility physical address: 602 Industrial Dr.
City: Kenansville State: NC Zip: 28349-
Coordinates: Latitude: 35' 58' 16.51" N Longitude: 77' 58' 14.28" W
Datum: NAD 83 Level of accuracy: 1 secondd
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: % industrial and % domestic)
❑ other (explain: ).
6. Does the facility have an approved pretreatment program: ❑ Yes ® No
7. Facility permitted/design flow: 0_3 MGD and facility average daily flow: 0.18 MGD
8. Average amount of residuals being generated at this facility 10 dry tons per year.
9. Specify the following regarding treatment and storage volumes available at the facility:
Type and volume of residuals treatment: 40,000 gallon sludge holding tanks
Type and volume of residuals storage (i.e., outside of residuals treatment units): None
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
FORM: RSC 06-16 Page 1 of 5

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).
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: ❑ yes ® no.
If yes, list the number(s):
b. Specify whether or not the residuals exhibit any of the characteristics defined by 40 CFR §261.21-
261.24: ❑ yes ® no.
Fill in the following tables with the results of the latest toxicity characteristic leaching procedure (TCLP) analysis as well
as those for corrosivity, ignitability, and reactivity:
Laboratory: Environmental Chemists, Inc. and Date of analysis: 7/15/2020
Passed corrosivity test: ® yes ❑ no. pH: s.u. (2 < pH < 12.5)
Passed ignitability test: ® yes ❑ no. Flashpoint: >195 IF (> 140°F)
Passed reactivity test: ® yes ❑no. HCN: <0.05 mg/kg (<250) & H2S: 0.81 mg/kg (<500)
TCLP Parameter
Limit
(mg/1)
Result
(mg/1)
TCLP Parameter
Limit
(mg/1)
Result
(mg/1)
Arsenic
5.0
<1.00
Hexachlorobenzene
0.13
<0.050
Barium
100.0
<1.00
Hexachloro-1,3-Butadiene
0.5
<0.050
Benzene
0.5
<0.01
Hexachloroethane
3.0
<0.050
Cadmium
1.0
<1.00
Lead
5.0
<1.0
Carbon Tetrachloride
0.5
<0.01
Lindane
0.4
<0.0005
Chlordane
0.03
<0.02
Mercury
0.2
<0.0002
Chlorobenzene
100.0
<0.01
Methoxychlor
10.0
<0.0005
Chloroform
6.0
<0.01
Methyl Ethyl Ketone
200.0
<0.050
Chromium
5.0
<1.00
Nitrobenzene
2.0
<0.050
m-Cresol
200.0
<0.05
Pentachlorophenol
100.0
<0.250
o-Cresol
200.0
<0.050
Pyridine
5.0
<0.050
p-Cresol
200.0
<0.050
Selenium
1.0
<1.0
Cresol
200.0
<0.050
Silver
5.0
<1.0
2,4-D
10.0
<0.003
Tetrachloroethylene
0.7
<0.01
1,4-Dichlorobenzene
7.5
<0.050
Toxaphene
0.5
<0.05
1,2-Dichloroethane
0.5
<0.010
Trichloroethylene
0.5
<0.01
1, 1 -Dichloroethylene
0.7
<0.010
2,4,5-Trichlorophenol
400.0
<0.050
2,4-Dinitrotoluene
0.13
<0.050
2,4,6-Trichlorophenol
2.0
<0.050
Endrin
0.02
<0.0005
2,4,5-TP (Silvex)
1.0
<0.003
Heptachlor and its Hydroxide
0.008
<0.0005
Vinyl Chloride
0.2
<0.01
FORM: RSC 06-16 Page 2 of 5

4. Metals Determination: Complete one of the following tables (i.e., as applicable) to demonstrate that the residuals do not violate
the ceiling concentrations for metals regulated under 15A NCAC 02T .1105.
a. For Distribution/Land Application: Fill in the following table with the results of the latest analyses (i.e., on a dry weight
basis) for the following metal parameters:
Laboratory: Environmental Chemists Inc. and Date of analysis: 7/15/2020
Parameter
Ceiling
Monthly Average
Result
Concentration Limits
Concentration Limits
(ClassA & C1assB)
(Class A Only)
(mg/kg)
(mg/k-9)
(mg/kg)
Arsenic
75
41
57.50
Cadmium
85
39
<48.00
Copper
4,300
1,500
353.00
Lead
840
300
<48.00
Mercury
57
17
<3 28
Molybdenum
75
n/a
<48.00
Nickel
420
420
<48.00
Selenium
100
100
<48.00
Zinc
7,500
2,800
763.00
b. For Surface Disposal Unit Randrll): 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. Nutrient/Micronutrient Determination: Complete the following:
a. Total solids: 0.51 ° o.
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: Environmental Chemists Inc. and Date of analysis: 7/15/2020
Parameter
Result
(mg/k-g)
Aluminum
4,040.00
Ammonia -Nitrogen
<19.60
Calcium
17,500.00
Magnesium
1,670.00
Nitrate -Nitrite Nitrogen
80.80
pH (Standard Unit)
6.79
Phosphorus
9,050.00
Potassium
3,040.00
Sodium
11,900.00
Total Kjeldahl Nitrogen
33,200.00
c. Using the results listed in Item II. 5b. above, calculate the sodium adsorption ration (SAR): 1.64
[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: 30 %. This rate
is a (check one): ❑ 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: This mineralization rate is
consistent with lime -stabilization.
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 (111 Year PAN
Five -Year
Maximum Adjusted PAN
(mg1kg)
(mg/kg)
Surface
10,045
1 16,024
Injection/Incorporation
10,055
1 16,034
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: None
FORM: RSC 06-16 Page 4 of

7. Pathogen Reduction: Per 15A NCAC 02T.11061 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.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.I 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.
❑ Alternative 5 [15A NCAC 02T.I 106(b)(3)(E)-(K)] - Process to Further Reduce Pathogens (PFRP).
Specify one: ❑ composting, ❑ heat drying, ❑ heat treatment,
❑ thermophilic aerobic digestion, ❑ beta ray irradiation,
❑ gamma ray irradiation, or ❑ pasteurization.
b. For Land Application of Class B:
® Alternative 1 [15A NCAC 02T. 1 106(c)(1)] - Fecal Coliform Density Demonstration.
® Alternative 2 [15A NCAC 02T.1106(c)(2)] -Process to Significantly Reduce Pathogens (PSRP).
Specify one: ❑ aerobic digestion, ❑ air drying, ❑ anaerobic digestion,
❑ composting, or ® lime stabilization.
c. For Surface Disposal:
❑ Select One of the Class A or Equivalent Pathogen Reduction Alternatives in Item II. 7a. above.
❑ Select One of the Class B or Equivalent Pathogen Reduction Alternatives in Item II. 7b. above.
❑ Exempt -If Daily Cover Alternative is chosen in Item 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. I 107(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.I 107(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.1107(a)(6)] - Alkaline Stabilization.
❑ Alternative 7 [15A NCAC 02T.1107(a)(7)] - Drying of Stabilized Residuals.
❑ Alternative 8 [15A NCAC 02T. 1 107(a)(8)] - Drying of Unstabilized Residuals.
® Alternative 9 [15A NCAC 02T. 1 107(a)(9)] - Injection.
® Alternative 10 [15A NCAC 02T.I 107(a)(10)] - Incorporation.
❑ Alternative for Surface Disposal Units Only - Soil/Other Material Cover [15A NCAC 02T.I 107(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

Facility Vicinity Map

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a
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SCALE: I = 1,500 ft
CHECKED BY: RTB
DRAWN BY: RTB
DATE: I /g/202 I
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NRCan, Esri Japan, METI, Esri China (Hong Kong), Esri Korea, Esri
�aWt't (Thailand), Mapmylndia• NGCC, 0OpenStreetMap contributors, and the
GIS User Communitv
Triple S Farms
Land Application Program
BRANCH Kenansville WWTP
kESIDUALS
& SOILS, LLC Project No. 2007-71
Facility
Vicinity
Map

Process Flow Diagram and Narrative

WASTEWATER TREATMENT PLANT PROCESS
Town of Kenansville operates a 0.3 million gallon capacity aerobic wastewater treatment plant. After
bar screening and grit collection, the influent goes to a splitter box and on to one of the dual 150,000
gallon oxidation ditches. After the oxidation ditch, liquids are sent to 30,000 gallon clarifiers. The
oxidation ditches and clarifiers run parallel. Liquids from the clarifiers are controlled by the manual
pump station. Liquids from the clarifier can be sent out for chlorination/dechlorination and discharge
to Grove Creek. Solids from the clarifiers are pumped to the head of the WWTP as return activated
sludge or sent to the 120,000 gallon aerobic digester. Thickened solids from the digester are sent to
the 40,000 gallon sludge holding tank. Solids are further thickened in the sludge holding tank. Decant
liquids from the sludge holding tank and the digester are pumped back to the head of the plant.
The Town of Kenansville has an additional 150,000 gallon oxidation ditch available as additional
sludge holding. Seven drying beds are also kept for use as needed.
A schematic diagram of the plant is found on the following page.

Influent
Return
RAS or
Decant
From
Digesters
Clarifier
Town of Kenansville WWTP
Bar Screen
Splitter Box
Manual
Pump
Station
0 Dual Oxidation Ditches
150,000 gal each
Oxidation Ditch
150,000 gal Storage
Clarifiers
Clarifier 30,000 gal each
:7
Drying Beds
Backup
Decant From Digesters
Water Disinfection & Discharge Biosolids Ready for Thickening
Land Application
Sludge
Holding
40,000 gal
Digester
120,000 gal

Justification for Residuals Production Rate

JUSTIFICATION FOR WWTP RESIDUALS PRODUCTION RATE
Review of dry tons produced from this facility indicates the dry tons form this facility should be
reduced from 38 to 10 dry tons. Production data from the past several years indicate the decrease is
warranted.

Residuals Sampling Plan

WWTP SAMPLING PLAN — TOWN OF KENANSVILLE
Annually, multiple grab residual solid samples are collected from the sludge holding tank. These
samples are composited for nutrient and metal analyses. The composited sample is mixed to keep the
solids suspended and containers filled for this analysis. Lime stabilization occurs when the sludge
holding tank reaches capacity. Lime is added to reach proper stabilization requirements for vector
attraction and pathogen reduction. Field measurements of pH and temperature are collected for each
stabilization event to insure pH requirements are met. pH values are later temperature corrected.
Annually, or when the residual solids are to be land applied if application occurs less than annually,
a composite residual solid sample will be analyzed for: Arsenic, Cadmium, Copper, Lead, Mercury,
Molybdenum, Nickel, Selenium, Zinc, Aluminum, Ammonia — Nitrogen, Calcium, Nitrate -Nitrite,
Nitrogen, Magnesium, % Total Solids, pH, Phosphorus, Potassium, TKN, and Sodium. From this
information, the Plant Available Nitrogen (PAN) will be calculated. Once a permit cycle, a composite
TCLP sample will be collected to include:
Arsenic
Hexachlorobenzene
ph for Corrosivity
Barium
Hexachloro-1,3-Butadiene
Benzene
Hexachloroethane
Flash point for ignitability
Cadmium
Lead
Carbon Tetrachloride
Lindane
Sulfides and Cyanides for reactivity
Chlordane
Mercury
1,2-Dichloroethane
Chlorobenzene
Methoxychlor
1, 1 -Dichloroethylene
Chloroform
Methyl Ethyl Ketone
2,4-Dinitrotoluene
Chromium
Nitrobenzene
Endrin
m-Cresol
Pentachlorophenol
Heptachlor and its Hydroxide
o-Cresol
Pyridine
Trichloroethylene
p-Cresol
Selenium
2,4,5-Trichlorophenol
Cresol
Silver
2,4,6-Trichlorophenol
2,4-D
Tetrachloroethylene
2,4,5-TP (Silvex)
1,4-Dichlorobenzene
Toxaphene
Vinyl Chloride

Analytical Data From Town of Kenansville
TCLP and Nutrient & Metal

vinviro-runental Chemists, Inc.
ry n 2 7 A ° t 66t12 Windmill'rva}; Wilmington, NC 28405 a 910.392.0223 Lab ' 910.392.4-124 Fa
o-F,9
10 B(i-wscrtown Read, Mantes, NiC 2'954 • 252.473.5702 Lab; F:x
255-A WJmircton Hight:-ax, Jacksonville, VC 28540 ° 9'10347.5843 Lab/Fax
ANAMICAL & CONSULTING CHEMISTS irlo[:i,emrtroumeatulchemismcom
Town of Kenansville
Date of Report: Jul 15, 2020
PO Box 370
Customer PO #:
Kenansville NC 28349
Customer ID: 09020018
Attention:
Report #: 2020-09561
Project ID: Sludge
Lab ID Sample ID:
Collect Date/Time Matrix Sampled by
20-23843 Site: sludge
6/10/2020
10:00 AM Solid/Sludge Garry Benson
Test
Method
Results Date Analyzed
Total Solids (°lo)
SM 2540 B
0.51 %
06/11/2020
Chlordane (TCLP)
SW 846 Method 80818,'3510
<0.02 mg/L
06/23/2020
Endrin (TCLP)
SW 846 Method 8081B/3510
<0.0005 ma/L
06/23/2020
Heptachlor (TCLP)
SW 846 Method Baal813510
<0.0005 mg/L
06/23I2020
Heptachlor epoxide (TCLP)
SW 846 Method 8081B13510
<0.0005 mg/L
06/23/2020
Lindane (TCLP)
SW a46 Method BaalB/3510
<0.0005 mg/L
06/23/2020
Methoxychlor (TCLP)
SW 846 Method 6081B/3510
<0.0005 mg/L
06/23/2020
Toxaphene (TCLP)
SW 846 Method ao61B/3510
<0,05 mg/L
06/23/2020
1,4-Dichlorobenzene (TCLP)
SW 846 method 8270M10
<0.050 mg/L
06123,12020
2,4,5-Trichlorophenol (TCLP)
SW 846 method 827013510
<0.050 mg/L
06/23/2020
2,4,6-Trichlorophenol (TCLP)
SW 846 method 827013510
<0.050 mg/L
06/23/2020
2,4-Dinitrotoluene (TCLP)
SW 846 neihod 8270:3510
<0.050 mg/L
06/23/2020
Cresol (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
06/23/2020
Hexachloro-1, 3-butadiene (TCLP)
SW 8466 method 827013510
<0 050 mg/L
06/23/2020
Hexachlorobenzene (TCLP)
SW 846 method 8270/34-10
<0.050 mg/L
06/23/2020
Hexachloroethane (TCLP)
SW 846 method 827013510
<0.050 mg/L
06/23/2020
m + p-Cresol (TCLP)
SW 846 method 827013510
<0.050 mg/L
06/23/2020
Nitrobenzene (TCLP)
SW 846 method 8270W,0
<0.050 mg/L
06/23/2020
o-Cresol (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
06/23/2020
Pentachlorophenol (TCLP)
SW B46 method 8270,135 10
<0.250 mg/L
06/23/2020
Pyridine (TCLP)
SW 846 method 827013510
<0.050 mg/L
06/23/2020
2,4,5-TP (TCLP)
SW646 Method 8151A
<0.003 mg/L
06/24/2020
2,4-D (TCLP)
SW846 Method a151A
<0.003 mg/L
06/24/2020
1,1-Dichloroethylene (TCLP)
SWO46 Method 826015030
<0.01 mg/L
06/25/2020
1,2-Dichloroethane (TCLP)
SW646 Method 8260/5030
<0.01 mg/L
06/25/2020
Benzene (TCLP)
SW846 Method 826�-/503
<0.01 mg/L
06/25/2020
Report t. 2020-08Sc1
---
Page S of

�-� Chemists Inc.
s $ i 6602 Windmill 6Vav, Wilmirt ton, INC2 405
S 8_uo 910.392.022a Lab ' 91.0.392.4424 Fa 710 Bowsertown Road, wlanteo, NC 27954 * 252.473.5702 Lab/Fat
255-A I-Vilmington Highway, Jacksonville, .W 2854-0 • 910.347.5843 Lab: Fax
ANALYTICAL & CONSULTING CHEMISTS
inioiiienrironmentalcnen�ists.�ori
Town of Kenansviile
PO Box 370
Date of Report: Jul 15, 2020
Kenansville NC
28349
Customer PO #:
Attention:
Customer ID: 09020018
Report #: 2020-09561
Project ID: Sludge
Carbon Tetrachloride (TCLP)
SW848Method 8280/5030
Chlorobenzene (TCLP)
SW846 Method 826015030
<0.01 mg/L
06/25/2020
Chloroform (TCLP)
SW846 Method 8260/5030
40.01 mg/L
06125/2020
Methyl ethyl ketone (TCLP)
SW848 Method 826CJ6030
<0.01 mg/L
06/25/2020
Tetrachloroethylene (TCLP)
SW846 Method 8260/5030
<0.05 mg/L
06/25/2020
Trichloroethylene (TCLP)
SW846 Method 826015030
<0.01 mg/L
06/25/2020
Vinyl Chloride (TCLP)
swe46 Method e2so/so3o
<0.01 mg/L
06/25/2020
RCI
<0.01 mg/L
06/25/2020
Cyanide
Reporting limit elevated due to
EPA 335 4
matrix interference.
<0.05 mg/kg
06/29/2020
Sulfide
SM 4600 S D
1 nitability
g
SW 846 method 1010
0.81 mg/kg
06/16/2020
pH
>195 °F
06/26/2020
SW 848 Method 9045D
Sludge Residuals
6.79 units
07/06/2020
Aluminum
EPA 200.7
Arsenic
4040 mg/kg
06/16/2020
EPA 200 7
Cadmium
57.5 mg/kg
06/16/2020
Calcium
EPA 200.7
<48.0 mg/kg
06/16/2020
Chromium
EPA 200.7
17500 mg/kg
06/16/2020
EPA 200.7
Copper
<48.0 mg/kg
06/16/2020
EPA 200.7
Lead
353 mg/kg
06/16/2020
EPA 200.7
Magnesium
EPA 200.7
<48.0 mg/kg
06/16/2020
Molybdenum
EPA 200.7
1670 mglkg
06/16/2020
Nickel
<48.0 mg/kg
06/16/2020
EPA 200.7
Potassium
EPA 200.7
<48.0 mg/kg
06/16/2020
Selenium
EPA 200.7
3040 mg/kg
06/16/2020
Sodium
EPA 200.7
<48.0 mg/kg
06/16/2020
?inc
11900 mg/kg
06/16/2020
EPA 200.7
Nitrate+Nitrite-Nitrogen
EPA 353.2
763 mg/kg
06/19/2020
Ammonia Nitrogen
SM 4500 NH3 C
80.8 mg/ka
06/20/2020
<19.6 mg/kg
06/11/2020
Report #.: 2020-09551
Page 2 of 3

EvmronMeDILRI Chemists, Inc.
CbL2'W'ndmill Wh , WiirnLploton, N(_'i3 5 O H10392.0223 La',- a 910-3974-2; Fn-'
f ' �SA1• 7=0 eoN'sertown Road,'.lanteo, leiC 27:54 s 2-r,7_.473._;7 LaL!Fa
'_ai-:� iViiLnii`;tcm.=iirhwa=.. ackwnvitle, ?�C'_8 -'0 : } -
47.S�43 Lab I Fax
AN A I-YTICAL & CONSULTING CHEMISTS in rota:envir onmer• taicliemisu.com
Town cf Kenansville Date of Report: Jul 15, 2020
PO Box 370
Customer PO #:
Kenansville NC 28349 Customer ID: 09020018
Attention- Report #: 2020-09561
Project ID. Sludge
Total Kjeldanl Nitrogen (TKN ) SM 4500 Org 5 33200 mg/kg 06/11 /2020
Total Phosphorus SM 4500 P F 9050 mg/kg 06/19/2020
Mercury
SW046 7471E
<3.28 mg/kg
06/15/2020
TCLP Metals
Arsenic
EPA 200.7
<1.0 mg/L
06/25/2020
Barium
EPA 200.7
<1.0mg/L
06/25/2020
Cadmium
EPA 200.7
<1.0 mg/L
06/25/2020
Chromium
EPA 200.7
<1.Omg/L
06/25/2020
Lead
EPA 200.7
<1.0 mg/L
06/25/2020
Selenium
EPA 200.7
<1.0mg/L
06/25/2020
Silver
EPA 200.7
<1.0 mg/L
06/25/2020
Mercury
EPA 2451 <0.0002
mg/L
06/25/2020
Comment:
Sludge residual results, except pH, reported on a dry weight basis. pH
reported an an as received
basis.
Reviewed by:
^
t
PeVCrt ::: 2720.09551
Pape 3 ar 3

Environmental Chemist, Inc., Wilmington, NC Lab #94
6602 Windmill Wav
Wilmington, NC 29405
Sample Receipt Checklist 910,392.0223
Client:�� �IS'u L
�,(� �j
Date : 1 �
t3 Report Number:aQ — Q� � /
Receipt of sample:
❑ YES p NO
Delivered UPS ❑ FedEx ❑ Other ❑
YES
O NO
N/A
N/A
1. Were custody seals present on the cooler?
Original
ri final temperature upon
2. If Custodyseais were
eceipt •C present, were they intact/unbroken?
How temperature taken: Corrected temperature upon receip
❑ t Temperature Blank 'C
IR Gun ID: Thomas Traceable
S/N 192511657 Against Bottles
❑ YES
❑ NO
p IR Gun Correction Fador'C: 0.0
3. If temperature of cooler
YES
D NO
exceeded 6'C, was Project M r./CIA notified?
4. Were proper custody
' YES
❑ NO
procedures (relinquished/received) followed?
S. Were sample ID's listed on the [OC?
I YES
YES
❑ NO
O NO
6. Were samples ID's listed on sample containers?
YES
❑ NO
7. Were collection date and time listed on the CDC?
S.
YES
❑ NO
Were tests to be performed listed on the COC?
YES
❑ NO
9. Did samples arrive in proper containers for each testy
10. Did samples arrive in
YES
❑ NO
good condition for each test?
11. Was adequate sample volume
YE5
❑ NO
available?'
12. w eree samples received within
❑ YES
❑ NO
proper holding time for requested tests?
13. Were acid preserved samples
i❑ YES
❑ NO
received at a pH of <2?
14. Were cyanide samples received
❑ YES
❑ YES
❑ NO
at a pH >12?
15. Were sulfide samples received at a >9?
❑ YES
❑ NO
❑ NO
pH
16. Were NH3/TKN/Phenol received at a chlorine residual of <0.5 m/L? °t
11. Were 5ulfide/Cyanide received
❑ YES
❑ NO _
at a chlorine residual of <0.5 m/L?
18,.—Were o�ttopb
tlekd withitr35-n•tirnrtes?--.
' TOC/Yolavies are pH checked at time of analysis and recorded on the benchsheet.
e a Bacteria samples are checked for
Chlorine at time of analysis and recorded on the benchsheet.
Sample Preservation:
(Must be completed tar any sample(s)
Samples)
incorrect) y preserved or with headspace)
by adding (circle one):
were received incorrectly preserved and were adjusted accordingly
112SO, HNO,
Time of preservation:
HCI NaOH
Note: Notify customer service immediately
If more than one preservative is needed, notate in comments below
for incorrectly
preserved samples. Obtain a new sample or
noti y the state lab if directed to analyzed by the customer. who was not fled date
Valavies Samples)
and time:
were received with headspace
COMMENTS:
DOC. QA.002

RESIDUALS SOURCE CERTIFICATION ATTACHMENT
Town of Beulaville

DWR
Division of Water Resources
State of North Carolina
Department of Environmental Quality
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 .l 100. 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

1.
DWR
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
RESIDUALS SOURCE CERTIFICATION
FORM: RSC 06-16
RESIDUALS SOURCE -GENERATING FACILITY INFORMATION (See Instruction B.):
1. Facility Name: Town of Beulaville
2. Facility permit holder is: ❑ Federal, ❑ State,
Facility permit issued by: ® Div. of Water Resource
or ❑ Other (explain: )
3. Facility contact person and title: Stanley Miller
Complete mailing address: P.O. Box 130
City: Beulaville
Telephone number: [phone]
4. Facility physical address: Lyman Street
City: Beulaville State: NC
Coordinates: Latitude: 34' 54' 38" N
® Local Government, or ❑ Private.
s, ❑ Div. of Environmental Health,
State: NC Zip: 28518-_
E-mail address: [e-mail]
Datum: NAD 83
Method of measurement: MAP
Zip: 28518-
Longitude: 77' 45' 34"
Level of accuracy: Nearest Second
5. Purpose of the facility:
® treatment of municipal wastewater, ❑ treatment of 100% domestic wastewater,
❑ treatment of potable water, ❑ treatment of 100% industrial wastewater,
❑ treatment of industrial wastewater mixed with domestic wastewater,
(approximate percentages: % industrial and % domestic)
❑ other (explain: ).
6. Does the facility have an approved pretreatment program: ❑ Yes ® No
7. Facility permitted/design flow: 0.26 MGD and facility average daily flow: 0_2 MGD
8. Average amount of residuals being generated at this facility 30 dry tons per year.
9. Specify the following regarding treatment and storage volumes available at the facility:
Type and volume of residuals treatment: 105,000 gallon sludge holding tanks
Type and volume of residuals storage (i.e., outside of residuals treatment units): None
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.1 102(6) as:
® Biological ❑ Non -Biological
FORM: RSC 06-16 Page 1 of 5

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).
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: ❑ yes ® no.
If yes, list the number(s):
b. Specify whether or not the residuals exhibit any of the characteristics defined by 40 CFR §261.21-
261.24: ❑ yes ® no.
Fill in the following tables with the results of the latest toxicity characteristic leaching procedure (TCLP) analysis as well
as those for corrosivity, ignitability, and reactivity:
Laboratory: Environmental Chemists. Inc. and Date of analysis: 06/02/2020
Passed corrosivity test: ® yes ❑ no. pH: s.u. (2 < pH < 12.5)
Passed ignitability test: ® yes ❑ no. Flashpoint: >200 OF (> 140°F)
Passed reactivity test: ®yes ❑no. HCN: 0.145 mg/kg (<250) & H2S: <0.50 mg/kg (<500)
TCLP Parameter
Limit
(mg/1)
Result
(mg/1)
TCLP Parameter
Limit
(mg/1)
Result
(mg/1)
Arsenic
5.0
<1.000
Hexachlorobenzene
0.13
<0.050
Barium
100.0
<1.000
Hexachloro-1,3-Butadiene
0.5
<0.050
Benzene
0.5
<0.010
Hexachloroethane
3.0
<0.050
Cadmium
1.0
<1.000
Lead
5.0
<1.000
Carbon Tetrachloride
0.5
<0.010
Lindane
0.4
<0.0005
Chlordane
0.03
<0.020
Mercury
0.2
<0.0002
Chlorobenzene
100.0
<0.010
Methoxychlor
10.0
<0.0005
Chloroform
6.0
<0.010
Methyl Ethyl Ketone
200.0
<0.050
Chromium
5.0
<1.000
Nitrobenzene
2.0
<0.050
m-Cresol
200.0
<0.050
Pentachlorophenol
100.0
<0.250
o-Cresol
200.0
<0.050
Pyridine
5.0
<0.050
p-Cresol
200.0
<0.050
Selenium
1.0
<1.000
Cresol
200.0
<0.050
Silver
5.0
<1.000
2,4-D
10.0
<0.003
Tetrachloroethylene
0.7
<0.010
1,4-Dichlorobenzene
7.5
<0.050
Toxaphene
0.5
<0.050
1,2-Dichloroethane
0.5
<0.010
Trichloroethylene
0.5
<0.010
1, 1 -Dichloroethylene
0.7
<0.010
2,4,5-Trichlorophenol
400.0
<0.050
2,4-Dinitrotoluene
0.13
<0.050
2,4,6-Trichlorophenol
2.0
<0.050
Endrin
0.02
<0.0005
2,4,5-TP (Silvex)
1.0
<0.003
Heptachlor and its Hydroxide
0.008
<0.0005
Vinyl Chloride
0.2
<0.010
FORM: RSC 06-16 Page 2 of 5

4. Metals Determination: Complete one of the following tables (i.e., as applicable) to demonstrate that the residuals do not violate
the ceiling concentrations for metals regulated under 15A NCAC 02T .1105.
a. For Distribution/Land Application: Fill in the following table with the results of the latest analyses (i.e., on a dry weight
basis) for the following metal parameters:
Laboratory: Environmental Chemists. Inc. and Date of analysis: 06/02/2020
Parameter
Ceiling
Monthly Average
Result
Concentration Limits
Concentration Limits
(ClassA & ClassB)
(Class A Only)
(mg/kg)
(mg/kg)
(mg/kg)
Arsenic
75
41
30.70
Cadmium
85
39
<23.20
Copper
4,300
1,500
436.00
Lead
840
300
29.60
Mercury
57
17
2.02
Molybdenum
75
n/a
<23.20
Nickel
420
420
<23.20
Selenium
100
100
<23.20
Zinc
7,500
2,800
1,880.00
b. For Surface Disposal Unit flandfill): 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. Nutrient/Micronutrient Determination: Complete the following:
a. Total solids: 2.07 %.
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: Environmental Chemists. Inc. and Date of analysis: 06/02/2020
Parameter
Result
(mg/kg)
Aluminum
6,280.00
Ammonia -Nitrogen
<4.83
Calcium
19,700.00
Magnesium
2,050.00
Nitrate -Nitrite Nitrogen
7,740.00
pH (Standard Unit)
4.65
Phosphorus
14,400.00
Potassium
3,840.00
Sodium
3,890.00
Total Kjeldahl Nitrogen
55,600.00
c. Using the results listed in Item II. 5b. above, calculate the sodium adsorption ration (SAR): 1.01
[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: 30 %. This rate
is a (check one): ® 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 (I") Year PAN
Five -Year
Maximum Adjusted PAN
(mg/kg)
(mg1kg)
Surface
24,421
34,439
Injection/Incorporation
24,423
34,441
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: None
FORM: RSC 06-16 Page 4 of

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.1 106(b)(3)(D)] - No Prior Testing for Enteric Virus/Viable Helminth Ova.
❑ Alternative 5 [15A NCAC 02T.I 106(b)(3)(E)-(K)] - Process to Further Reduce Pathogens (PFRP).
Specify one: ❑ composting, ❑ heat drying, ❑ heat treatment,
❑ thermophilic aerobic digestion, ❑ beta ray irradiation,
❑ gamma ray irradiation, or ❑ pasteurization.
b. For Land Application of Class B:
® Alternative 1 [15A NCAC 02T.1106(c)(1)] - Fecal Coliform Density Demonstration.
® Alternative 2 [15A NCAC 02T.1 106(c)(2)] - Process to Significantly Reduce Pathogens (PSRP).
Specify one: ❑ aerobic digestion, ❑ air drying, ❑ anaerobic digestion,
❑ composting, or ® lime stabilization.
c. For Surface Disposal:
❑ Select One of the Class A or Equivalent Pathogen Reduction Alternatives in Item II. 7a. above.
❑ Select One of the Class B or Equivalent Pathogen Reduction Alternatives in Item 11. 7b. above.
❑ Exempt -If Daily Cover Alternative is chosen in Item 11.8. below [15A NCAC 02T.] 106(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 I [15A NCAC 02T.1107(a)(1)] - 38% Volatile Solids Reduction (Aerobic/Anaerobic Digestion).
❑ Alternative 2 [15A NCAC 02T. 1107(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.1107(a)(6)] -Alkaline Stabilization.
❑ Alternative 7 [15A NCAC 02T.1107(a)(7)] -Drying of Stabilized Residuals.
❑ Alternative 8 [15A NCAC 02T.]107(a)(8)] - Drying of Unstabilized Residuals.
® Alternative 9 [15A NCAC 02T.]107(a)(9)] - Injection.
® Alternative 10 [15A NCAC 02T.1 107(a)(10)] -incorporation.
❑ Alternative for Surface Disposal Units Only - Soil/Other Material Cover [15A NCAC 02T.1107(b)(2)].
❑ Not Applicable - Non -Biological Residuals with NO Domestic Wastewater Contribution.
Note: For animal processing residuals, only alternatives 9 or 10 may be chosen due to the nuisance conditions that typically occur
when these residuals are applied and left on the land surface.
FORM: RSC 06-16 Page 5 of 5

Facility Vicinity Map

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CHECKED BY: RTB
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DATE: 1/8/2021
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Sources: Esri, HERE, Del-orme, USGS, Intermap, INCREMENT P,
NRCan, Esri Japan, METI, Esri China (Hong Kong), Esri Korea, Esri
(Thailand), Mapmylndia, NGCC, © OpenStreetMap contributors, and the
GIS User Community
Triple S Farms
Land Application Program
Beulaville WWTP
Project No. 1
2007-71
Facility
Map

Process Flow Diagram and Narrative

WASTEWATER TREATMENT PLANT PROCESS
The Town of Beulaville operates a 0.26 million gallon capacity extended air plant that supports a
population of less than 10,000 people and does not have a pretreatment program. This facility
operates under NPDES NC0026018 where it discharges to Persimmon Branch of the Cape Fear River
Basin.
After Bar screening and grit collection, the influent goes to a splitter box and to one of the dual
140,000 gallon oxidation ditches. If the flow is to great, flow from the splitter box is sent to the
aeration basin before re-entering the splitter box and primary clarification and oxidation. Flow from
these units may be cycled again through the return activated sludge or sent to one of the two secondary
clarifiers. Solids from the secondary clarifiers are sent to an aerobic digester. Decanting occurs and
solids are held for sampling, lime stabilization (if desired), and land application. The oxidation ditches
and clarifiers work in parallel but have the ability to work in series. Decan from the clarifiers are sent
to a tertiary fine bubble diffuser and ultraviolet disinfection prior to monitoring and discharge to
Persimmon Branch.
A schematic diagram of the plant is found on the following page.

City of Beulaville Wastewater Treatment Plant Solids Flow Path
Aeration Basin
Primary
Clarifier 0.14 MG
Primary
Clarifier 0.14 MG
Splitter Box
Grit Collection
Pump
Secondary
rifier 0.034
Secondary
rifler 0.034
Aerobic Digestion
0.103 MG
Disposal

Justification for Residuals Production Rate

JUSTIFICATION FOR WWTP RESIDUALS PRODUCTION RATE
Review of dry tons produced from this facility indicates the dry tons should be reduced from 38 to 30
dry tons. The past several years production data indicate making this change.

Residuals Sampling Plan

WWTP SAMPLING PLAN — TOWN OF BEULAVILLE
Annually, multiple grab residual solid samples are collected from the sludge holding tank. These
samples are composited for nutrient and metal analyses. The composited sample is mixed to keep the
solids suspended and containers filled for this analysis. Lime stabilization occurs when the sludge
holding tank reaches capacity. Lime is added to reach proper stabilization requirements for vector
attraction and pathogen reduction. Field measurements of pH and temperature are collected for each
stabilization event to insure pH requirements are met. pH values are later temperature corrected.
Annually, or when the residual solids are to be land applied if application occurs less than annually,
a composite residual solid sample will be analyzed for: Arsenic, Cadmium, Copper, Lead, Mercury,
Molybdenum, Nickel, Selenium, Zinc, Aluminum, Ammonia — Nitrogen, Calcium, Nitrate -Nitrite,
Nitrogen, Magnesium, % Total Solids, pH, Phosphorus, Potassium, TKN, and Sodium. From this
information, the Plant Available Nitrogen (PAN) will be calculated. Once a permit cycle, a composite
TCLP sample will be collected to include:
Arsenic
Hexachlorobenzene
ph for Corrosivity
Barium
Hexachloro-1,3-Butadiene
Benzene
Hexachloroethane
Flash point for ignitability
Cadmium
Lead
Carbon Tetrachloride
Lindane
Sulfides and Cyanides for reactivity
Chlordane
Mercury
1,2-Dichloroethane
Chlorobenzene
Methoxychlor
1,1-Dichloroethylene
Chloroform
Methyl Ethyl Ketone
2,4-Dinitrotoluene
Chromium
Nitrobenzene
Endrin
m-Cresol
Pentachlorophenol
Heptachlor and its Hydroxide
o-Cresol
Pyridine
Trichloroethylene
p-Cresol
Selenium
2,4,5-Trichlorophenol
Cresol
Silver
2,4,6-Trichlorophenol
2,4-D
Tetrachloroethylene
2,4,5-TP (Silvex)
1,4-Dichlorobenzene
Toxaphene
Vinyl Chloride

Analytical Data From Town of Beulaville
TCLP and Nutrient & Metal

rvw"--
gnviroeheml
ANALYTICAL & CONSULTING CHEMISTS
Environmental Chemists, Inc.
6602 Windnull Way, Wilmington, NC 28405 • 910.392.0223 Lab ' 910.392.4424 Fax
710 Bowsertown Road, Manteo, NC 27954 • 252.473.5702 Lab/Fax
255-A Wilmington Highway, Jacksonville, NC 28540 ° 910.347.5843 Lab/Fax
[e-mail]
Town of Beulaville
Date of Report: Jun 02, 2020
PO Box 7085
Customer PO #:
Greenville NC 27835
Customer ID: 08100015
Attention: Angie Miller
Report #: 2020-07646
Project ID: Sludge
Lab ID Sample ID:
Collect Date/Time Matrix Sampled by
20-18820 Site: Sludge
5/7/2020
9:10 AM Solid/Sludge client
Test
Method
Results
Date Analyzed
Chlordane (TCLP)
SW 846 Method 8081B/3510
<0.02 mg/L
05/18/2020
Endrin (TCLP)
SW 646 Method 80818/3510
<0.0005 mg/L
05/18/2020
Heptachlor (TCLP)
SW 846 Method 80818/3510
<0.0005 mg/L
05/18/2020
Heptachlor epoxide (TCLP)
SW 846 Method 8081B/3510
<0.0005 mg/L
05/18/2020
Lindane (TCLP)
SW 846 Method 8081 B/3510
<0.0005 mg/L
05/18/2020
Methoxychlor (TCLP)
SW 846 Method 8081B/3510
<0.0005 mg/L
05/18/2020
Toxaphene (TCLP)
SW 846 Method 8081 B1351 0
<0.05 mg/L
05/18/2020
1,4-Dichlorobenzene (TCLP)
SW 846 method 8270M1a
<0.050 mg/L
05/14/2020
2,4,5-Trichlorophenol (TCLP)
SW 846 method 827013510
<0.050 mg/L
05/14/2020
2,4,6-Trichlorophenol (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
05/14/2020
2,4-Dinitrotoluene (TCLP)
SW 846 method 8270/3610
<0.050 mg/L
05/14/2020
Cresol (TCLP)
SW 848 method 8270/3510
<0.050 mg/L
05/14/2020
Hexachloro-1,3-butadiene (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
05/14/2020
Hexachlorobenzene (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
05/14/2020
Hexachloroethane (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
05/14/2020
m + p-Cresol (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
05/14/2020
Nitrobenzene (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
05/14/2020
o-Cresol (TCLP)
SW 846 method 827013510
<0.050 mg/L
05/14/2020
Pentachlorophenol (TCLP)
SW 846 method 827013510
<0.250 mg/L
05/14/2020
Pyridine (TCLP)
SW 846 method 827013510
<0.050 mg/L
05/14/2020
2,4,5-TP (TCLP)
SW846 Method 8151A
<0.003 mg/L
05/19/2020
2,4-D (TCLP)
SW846 Method 8151A
<0.003 mg/L
05/19/2020
1,1-Dichloroethylene (TCLP)
SW846 Method 8260/5030
<0.01 mg/L
05/13/2020
1,2-Dichloroethane (TCLP)
SW848 Method 8260/5030
<0.01 mg/L
05/13/2020
Benzene (TCLP)
SW846 Method 826015030
<0.01 mg/L
05/13/2020
Carbon Tetrachloride (TCLP)
SW846 Method 8260/5030
<0.01 mg/L
05/13/2020
Report * 2020.07646
Pan(.. 1 of a

Environmental Chemists,
Inc.
enviroeheudN
6602 Windmill Way,
Wilmington, NC 28405 ° 910.392.0223 Lab a 910.392.4424
Fax
.,,
s�'
710 Bowsertown Road, Manteo, NC 27954 • 252.473.5702 Lab/Fax
255-A Wilmington
Highway, Jacksonville, NC 28540 ° 910.347.5843 Lab/Fax
ANALYTICAL & CONSULTING CHEMISTS
[e-mail]
Town of Beulaville
Date of Report: Jun 02, 2020
PO Box 7085
Customer PO #:
Greenville NC 27835
Customer ID: 08100015
Attention: Angie Miller
Report #: 2020-07646
Project ID: Sludge
Chlorobenzene (TCLP)
SW846 Method 8260/5030
<0.01 mg/L
05/13/2020
Chloroform (TCLP)
SW846 Method 8260/5030
<0.01 mg/L
05/13/2020
Methyl ethyl ketone (TCLP)
SW846 Method 8260/5030
<0.05 mg/L
05/13/2020
Tetrachloroethylene (TCLP)
SW846 Method 8260/5030
<0.01 mg/L
05/13/2020
Trichloroethylene (TCLP)
SW848 Method 8260/5030
<0.01 mg/L
05/13/2020
Vinyl Chloride (TCLP)
SW846 Method 8260/5030
<0.01 mg/L
06/13/2020
RCI
Cyanide
EPA 335.4
0.145 mg/kg
05/12/2020
Sulfide SM 4500 s D
Reporting limit elevated due to matrix interference.
<0.50 mg/kg
05/11 /2020
Ignitability
SW 846 method 1010
>200 °F
05/20/2020
pH
SW 846 Method 9045D
4.65 units
05/13/2020
Sludge Residuals
Aluminum
EPA 200.7
6280 mg/kg
05/13/2020
Arsenic
EPA 200.7
30.7 mg/kg
05/13/2020
Cadmium
EPA 200.7
<23.2mg/kg
05/13/2020
Calcium
EPA 200.7
19700 mg/kg
05/13/2020
Chromium
EPA 200.7
23.2 mg/kg
05/13/2020
Copper
EPA 200.7
436 mg/kg
05/13/2020
Lead
EPA 200.7
29.6 mg/kg
05/13/2020
Magnesium
EPA 2007
2050mg/kg
05/13/2020
Molybdenum
EPA 200.7
<23.2mg/kg
05/13/2020
Nickel
EPA 200.7
<23.2 mg/kg
05/13/2020
Potassium
EPA 200.7
3840 mg/kg
05/21/2020
Selenium
EPA 200.7
<23.2mg/kg
05/13/2020
Sodium
EPA 200.7
3890 mg/kg
05/13/2020
Zinc
EPA 200.7
1880 mg/kg
05/13/2020
Nitrate+Nitrite-Nitrogen
EPA 353.2
7740 mg/kg
05/13/2020
Total Solids (%)
SM 2540 s
2.07 %
05/12/2020
Ammonia Nitrogen
SM 4500 NH3 C
<4.83 mg/kg
05/08/2020
Report #:: 2020-07646
P- 1 N 7

Fr' . "I Environmental Chemists, Inc.
6602 Windmill Way, Wilmington, NC 28405 ° 910.392.0223 Lab ° 910.392.4424 Fax
710 Bowsertown Road, Manteo, NC 27954 • 252.473.5702 Lab/Fax
�sM 255-A Wilmington Highway, Jacksonville, NC 28540 ° 910.347.5843 Lab/Far
ANALYTICAL & CONSULTING CHEMISTS [e-mail]
Town of Beulaville Date of Report: Jun 02, 2020
PO Box 7085 Customer PO #:
Greenville NC 27835 Customer ID: 08100015
Attention: Angie Miller Report #• 2020-07646
Project ID: Sludge
Total Kjeldahl Nitrogen (TKN) SM 4500 Org B 55600 mg/kg 05/08/2020
Total Phosphorus SM 4500 P F 14400 mg/kg 05/13/2020
Mercury SW8467471B 2.02mg/kg 05/19/2020
TCLP Metals
Arsenic
EPA 200.7
<1.0 mg/L
05/14/2020
Barium
EPA 200.7
<1.0mg/L
05/14/2020
Cadmium
EPA 200.7
<1.0 mg/L
05/14/2020
Chromium
EPA 200.7
<1.0 mg/L
05/14/2020
Lead
EPA 200.7
<1.0 mg/L
05/14/2020
Selenium
EPA 200.7
<1.0 mg/L
05/14/2020
Silver
EPA 200.7
<1.0 mg/L
05/14/2020
Mercury
EPA245.1
<0.0002mg/L
05/19/2020
Comment:
Sludge residual results reported on a dry weight basis.
Reviewed by:��
Report #:: 2020-07646 Page 3 of 3

Environmental Chemist, Inc., Wilmington, NC Lab #94
6602 Windmill Way
Wilmington, NC 28405
910.392.f777a
}.
bample Receipt Checklist
t>
Client: I
r>
. I'�..(i � �� t/ r ( Date: V: -�f 1 1Report Number:
Delivered UPS ❑ FedEx ❑ Other ❑
Receipt of sample:
❑
YES
❑
NO
N/A
1. Were custody seals present on the cooler?
❑ YES
❑
NO
N/A
2. If custody seals were present, were they intact/unbroken?
Original temperature upon receipt ---;Z:c °C Corrected temperature upon receipt
How temperature taken:
❑ Temperature Blank Against Bottles
IR Gun ID: Thomas Traceable S/N 192511657 IR Gun Correction Factor'C: 0.0
❑ YES
❑
NO
3. If temperature of cooler exceeded 6'C, was Project Mgr./QA notified?
YES
YES
❑
❑
NO
4. Were proper custody procedures (relinquished/received) followed?
NO
5. Were sample ID's listed on the COC?
YES
❑
NO
6. Were samples ID's listed on sample containers?
YES
❑
NO
7. Were collection date and time listed on the COC?
YES
❑
NO
8. Were tests to be performed listed on the COC?
YES
❑
NO
9. Did samples arrive in proper containers for each test?
YES
❑
NO
10. Did samples arrive in good condition for each test?
YES
❑
NO
11. Was adequate sample volume available?'
YES
O
NO
12. Were samples received within proper holding time for requested tests?
❑ YES
NO
NO
13. Were acid preserved samples received at a pH of <2?
❑ YES
NO
NO
14. Were cyanide samples received at a pH >12?
❑ YES
❑
NO
15. Were sulfide samples received at a pH >9?
❑ YES
❑
❑
NO
16. Were NH3/TKN/Phenol received at a chlorine residual of <0.5 m/L? "*
YES
❑
❑
NO
17. Were Sulfide/Cyanide received at a chlorine residual of <O.S m/L?
YES
❑
NO
18. Were orthophosphate samples filtered in the field within 15 minutes?
* TOC/Volatiles are pH checked at time of analysis and recorded on the benchsheet.
** Bacteria samples are checked for Chlorine at time of analysis and recorded on the benchsheet.
Sample Preservation: (Must be completed for any sample(s) incorrectly preserved or with headspace)
Sample(s) were received incorrectly preserved and were adjusted accordingly
by adding (circle one): HZSO, HNO3 HCl NaOH
Time of preservation: If more than one preservative is needed, notate in comments below
Note: Notify customer service immediately for incorrectly preserved samples. Obtain anew sample or
notify the state lab if directed to analyzed by the customer. who was notified, date and time:
Volatiles Samples) were received with headspace
COMMENTS:
DOC. QA.002
'C

ENVIRONMENTAL CHEMISTS, INC
* 910.392.0223 252.473.5702
info®environmentalchemists.com
Analytical &Consulting Chemists NCDENR: DWQ CERTIFICATION # 94 NCDHHS: DLS CERTIFICATION # 37729
COLLECTION AND CHAIN OF CUSTODY
CLIENT: Town of Beulaville
PROJECT NAME: Annual Sludge
REPORT NO:
ADDRESS:
CONTACT NAME:
PO NO:
REPORT TO:
PHONE/FAX:
COPY TO:
email:
Sampled Bv: C' i- SAMPLE TYPE: I = Influent. E = Effluent. W = Well, ST = Stream, SO = Soil, SL = Sludge, Other:
Sample Identification
Collection
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Transfer
Relinquished By:
Date/Time
Received By:
Date/Time
1.
2.
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Temperature when Received: L-'( Accepted: Rejected: Resample
Delivered By: Received By: 4 N Date:_
Comments: 1W f
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Time: J1-pa

RESIDUALS SOURCE CERTIFICATION ATTACHMENT
Southwest Plantation

DWR
State of North Carolina
Department of Environmental Quality
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 conies of the application and
supportine 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

State of North Carolina
Department of Environmental Quality
x_., 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: Southwest Plantation Wastewater Treatment Facility
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: Sonny Scozzari
Complete mailing address: 444 Harris Creek Road
City: Jacksonville State: NC Zip: 28540-
Telephone number: [phone] E-mail address: charles.scozzariAusmc.mil
4. Facility physical address: 444 Harris Creek Road
City: Jacksonville State: NC Zip: 28540-
Coordinates: Latitude: 34' 42' 14" N Longitude: 77' 35' 1" W
Datum: NAD 83 Level of accuracy: Nearest 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: % industrial and % domestic)
❑ other (explain: ).
6. Does the facility have an approved pretreatment program: ❑ Yes ® No
7. Facility permitted/design flow: 0.25 MGD and facility average daily flow: 0.05 MGD
8. Average amount of residuals being generated at this facility 5 dry tons per year.
9. Specify the following regarding treatment and storage volumes available at the facility:
Type and volume of residuals treatment: (2) 7,888 gallon aerated sludge holding tanks
Type and volume of residuals storage (i.e., outside of residuals treatment units): None
II. 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
FORM: RSC 06-16 Page 1 of 5

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).
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: ❑ yes ® no.
If yes, list the number(s):
b. Specify whether or not the residuals exhibit any of the characteristics defined by 40 CFR §261.21-
261.24: ❑ yes ® no.
Fill in the following tables with the results of the latest toxicity characteristic leaching procedure (TCLP) analysis as well
as those for corrosivity, ignitability, and reactivity:
Laboratory: Waypoint Analytical and Date of analysis: 04/1312020, 5/21/2019
Passed corrosivity test: ® yes ❑ no. pH: s.u. (2 < pH < 12.5)
Passed ignitability test: ® yes ❑ no. Flashpoint: >210 OF (> 140°F)
Passed reactivity test: ® yes ❑no. HCN: 0.077 mg/kg (<250) & H2S: 0.49 mg/kg (<500)
TCLP Parameter
Limit
(mg/1)
Result
(mg/1)
TCLP Parameter
Limit
(mg/1)
Result
(mg/1)
Arsenic
5.0
<1.000
Hexachlorobenzene
0.13
<0.050
Barium
100.0
<1.000
Hexachloro-1,3-Butadiene
0.5
<0.050
Benzene
0.5
<0.010
Hexachloroethane
3.0
<0.050
Cadmium
1.0
<1.000
Lead
5.0
<1.00
Carbon Tetrachloride
0.5
<0.010
Lindane
0.4
<0.0005
Chlordane
0.03
<0.020
Mercury
0.2
<0.002
Chlorobenzene
100.0
<0.010
Methoxychlor
10.0
<0.0005
Chloroform
6.0
<0.010
Methyl Ethyl Ketone
200.0
<0.050
Chromium
5.0
<1.000
Nitrobenzene
2.0
<0.050
m-Cresol
200.0
0.400
Pentachlorophenol
100.0
<0.250
o-Cresol
200.0
<0.050
Pyridine
5.0
<0.050
p-Cresol
200.0
0.400
Selenium
1.0
<1.00
Cresol
200.0
0.400
Silver
5.0
<1.00
2,4-D
10.0
<0.003
Tetrachloroethylene
0.7
<0.010
1,4-Dichlorobenzene
7.5
<0.050
Toxaphene
0.5
<0.050
1,2-Dichloroethane
0.5
<0.010
Trichloroethylene
0.5
<0.010
1,1-Dichloroethylene
0.7
<0.010
2,4,5-Trichlorophenol
400.0
<0.050
2,4-Dinitrotoluene
0.13
<0.050
2,4,6-Trichlorophenol
2.0
<0.050
Endrin
0.02
<0.0005
2,4,5-TP (Silvex)
1.0
<0.003
Heptachlor and its Hydroxide
0.008
<0.0005
Vinyl Chloride
0.2
<0.010
FORM: RSC 06-16 Page 2 of 5

4. Metals Determination: Complete one of the following tables (i.e., as applicable) to demonstrate that the residuals do not violate
the ceiling concentrations for metals regulated under 15A NCAC 02T .1105.
a. For Distribution/Land Application: Fill in the following table with the results of the latest analyses (i.e., on a dry weight
basis) for the following metal parameters:
Laboratory: Environmental Chemists, Inc. and Date of analysis: 4/13/2020
Parameter
Ceiling
Monthly Average
Result
Concentration Limits
Concentration Limits
(ClassA & ClassB)
(Class A Only)
(mglkg)
(mglk9)
(mglkg)
Arsenic
75
41
<9.65
Cadmium
85
39
<9.65
Copper
4,300
1,500
158.00
Lead
840
300
<9.65
Mercury
57
17
<0.614
Molybdenum
75
n/a
<9.65
Nickel
420
420
<9.65
Selenium
100
100
<9.65
Zinc
7,500
2,800
854.00
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. Nutrient/Micronutrient Determination: Complete the following:
a. Total solids: 2.54 %.
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: Environmental Chemists, Inc. and Date of analysis: 04/13/2020
Parameter
Result
(mg1kY)
Aluminum
2,970.00
Ammonia -Nitrogen
4,130.00
Calcium
15,100.00
Magnesium
2,460.00
Nitrate -Nitrite Nitrogen
64.20
pH (Standard Unit)
7.07
Phosphorus
16,200.00
Potassium
4,090.00
Sodium
200.00
Total Kjeldahl Nitrogen
77,200.00
c. Using the results listed in Item II. 5b. above, calculate the sodium adsorption ration (SAR): 0.06
[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: 30 %. This rate
is a (check one): ® 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: This mineralization rate is
consistent with lime -stabilization.
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
(m91k9)
Nglkg)
Surface
24,050
37,217
Injection/Incorporation
26,115
39,282
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: None
FORM: RSC 06-16 Page 4 of

7. Pathogen Reduction: Per 15A NCAC 02T.11061 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.I 106(b)(3)(A)] - Time/Temperature Compliance.
❑ Alternative 2 [15A NCAC 02T.1106(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.I 106(b)(3)(D)] - No Prior Testing for Enteric Virus/Viable Helminth Ova.
❑ Alternative 5 [15A NCAC 02T.I 106(b)(3)(E)-(K)] - Process to Further Reduce Pathogens (PFRP).
Specify one: ❑ composting, ❑ heat drying, ❑ heat treatment,
❑ thermophilic aerobic digestion, ❑ beta ray irradiation,
❑ gamma ray irradiation, or ❑ pasteurization.
b. For Land Application of Class B:
® Alternative 1 [15A NCAC 02T.1106(c)(1)] - Fecal Coliform Density Demonstration.
® Alternative 2 [15A NCAC 02T.1106(c)(2)] -Process to Significantly Reduce Pathogens (PSRP).
Specify one: ❑ aerobic digestion, ❑ air drying, ❑ anaerobic digestion,
❑ composting, or ® lime stabilization.
c. For Surface Disposal:
❑ Select One of the Class A or Equivalent Pathogen Reduction Alternatives in Item II. 7a. above.
❑ Select One of the Class B or Equivalent Pathogen Reduction Alternatives in Item II. 7b. above.
❑ Exempt -If Daily Cover Alternative is chosen in Item 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.11071 specify how residuals will meet the VAR requirements:
❑ Alternative 1 [15A NCAC 02T.I 107(a)(1)] - 38% Volatile Solids Reduction (Aerobic/Anaerobic Digestion).
❑ Alternative 2 [15A NCAC 02T.1107(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.1107(a)(4)] -Specific Oxygen Uptake Rate Test (Aerobic Digestion).
❑ Alternative 5 [15A NCAC 02T.I 107(a)(5)] - 14-Day Aerobic Processes.
® Alternative 6 [15A NCAC 02T.I 107(a)(6)] - Alkaline Stabilization.
❑ Alternative 7 [15A NCAC 02T.I 107(a)(7)] - Drying of Stabilized Residuals.
❑ Alternative 8 [15A NCAC 02T.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

Facility Vicinity Map

e Gra"g Ot
SCALE: 1 "= 1,500 ft
CHECKED BY: RTB
DRAWN BY: RTB
DATE: 1 /8/2021
"o,
Horns Creek
holly Sheller Rd
Ot
of
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:krhlat»r \`oe0
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5 opt
Southwest Plantation WWTP
�a
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24
z
-BRANCHL RESIDUAS
& SOILS, LLC
Nelson Rd
Sources: Esri, HERE, Det_orme, USGS, Intermap, INCREMENT P,
NRCan, Esri Japan, MET], Esri China (Hong Kong), Esri Korea, Esri
(Thailand), Mapmylndia, NGCC, O OpenStreetMap contributors, and the
GIS User Community
Triple S Farms
Land Application Program
Southwest Plantation WWTP
Project No. 1
2007-7 t
Facility
Vicinity
Map

Process Flow Diagram and Narrative

WASTEWATER TREATMENT PLANT PROCESS
Southwest Plantation is a package plant that supports a planned community and associated Bear Trail
Golf course. The facility has been granted a conjunctive reuse permit WQ0029601 to allow the
effluent to be sprayed on certain areas of the golf course and commons. This facility is currently in
the first phase of production at 50,000 gallons per day with two parallel trains of the facility operating
as shown on the attached diagram.
As needs require, additional treatment capacity will be added to reach the permitted operation of 0.25
million gallons per day. After bar screening and grit removal, liquids enter the flow equalization tank.
Liquids are split to the aeration basins and sent to the clarifiers. Each train has 2 aeration basins that
are equipped with two 25,582 gallon basins with three 125 cubic feet per minute blowers. Liquids
from the aeration basins are sent to the clarifiers. Clear liquids from the clarifiers are sent through a
fixed media filter and on to ultraviolet disinfection. After test for conjunctive reuse the effluent is
sent to the spray irrigation fields. Solids are sent back around as return activated sludge or sent to one
of two 7,888 gallon sludge holding tanks were is kept under aeration. Sludge is retained in the holding
tanks until time for the stabilization event and subsequent land application.
A schematic diagram of the plant is found on the following page.

1A
Train Sludge Clarifier
1 Flow Holding
Equalization 1 A is 1 C Fixed
Aeration Aeration eration Aeration Media
1 B #1
Clarifier
UV
Tank Effluent
Train Equalization 5,02 A
2 Tank Clarifier
Sludge 2 A 2 6 2 C Fixed
Holding Aeration Aeration Aeration Media
#2
Inflow 7cBraere _ ClariBfier
105'
Southwest Plantation WWTP — Phase 150,000 gpd

Justification for Residuals Production Rate

JUSTIFICATION FOR WWTP RESIDUALS PRODUCTION RATE
Southwest Plantation is currently a 50,000 gallon plant. Based on the size of the past production of
the wastewater plant, the dry tons have been reduced to 5 for annual production. As this plant
continues to operate, the dry ton production rate will be evaluated.

Residuals Sampling Plan

WWTP SAMPLING PLAN — SOUTHWEST PLANTATION
Annually, multiple grab residual solid samples are collected from the sludge holding tanks. These
samples are composited for nutrient and metal analyses. The composited sample is mixed and aerated
to keep the solids suspended and containers filled for this analysis. Lime stabilization occurs when
the sludge holding tank reaches capacity. Lime is added to reach proper stabilization requirements
for vector attraction and pathogen reduction. Field measurements of pH and temperature are collected
for each stabilization event to insure pH requirements are met. pH values are later temperature
corrected for reporting purposes.
Annually, or when the residual solids are to be land applied if application occurs less than annually,
a composite residual solid sample will be analyzed for: Arsenic, Cadmium, Copper, Lead, Mercury,
Molybdenum, Nickel, Selenium, Zinc, Aluminum, Ammonia — Nitrogen, Calcium, Nitrate -Nitrite,
Nitrogen, Magnesium, % Total Solids, pH, Phosphorus, Potassium, TKN, and Sodium. From this
information, the Plant Available Nitrogen (PAN) and Sodium Adsorption Ratio (SAR) will be
calculated. Annually (if application occurs) a composite TCLP sample will be collected to include:
Arsenic
Hexachlorobenzene
ph for Corrosivity
Barium
Hexachloro-1,3-Butadiene
Benzene
Hexachloroethane
Flash point for ignitability
Cadmium
Lead
Carbon Tetrachloride
Lindane
Sulfides and Cyanides for reactivity
Chlordane
Mercury
1,2-Dichloroethane
Chlorobenzene
Methoxychlor
1,1-Dichloroethylene
Chloroform
Methyl Ethyl Ketone
2,4-Dinitrotoluene
Chromium
Nitrobenzene
Endrin
m-Cresol
Pentachlorophenol
Heptachlor and its Hydroxide
o-Cresol
Pyridine
Trichloroethylene
p-Cresol
Selenium
2,4,5-Trichlorophenol
Cresol
Silver
2,4,6-Trichlorophenol
2,4-D
Tetrachloroethylene
2,4,5-TP (Silvex)
1,4-Dichlorobenzene
Toxaphene
Vinyl Chloride

Analytical Data From Southwest Plantation
TCLP and Nutrient & Metal

Analytical 8 Consulting Chemists
ENVIRONMENTAL CHEMISTS, INC
NCDENR: DWO CERTIFICATION # 94 NCDHHS: DLS CERTIFICATION # 37729
COLLECTION AND CHAIN OF CUSTODY
6602 Windmill Way Wilmington, NC 28405
OFFICE: 910-392-0223 FAX [phone]
[e-mail]
CLIENT: ENVIRONMENTAL SERVICES
PROJECT NAME: BEAR TRAIL GOLF COURSE
REPORT NO:
ADDRESS: PO BOX 1054
CONTACT NAME: SONNY SCOZZARI
PO NO:
JACKSONVILLE, NC 28541
REPORT TO:
PHONE/FAX: [phone]
COPY TO:
email: sonnys2220ec.rr.com
Sampled ft' SAMPLE TYPE: I = Influent, E = Effluent, W = Well, ST = Stream, SO = Soil. SL = Sludae. Other:
Sample Identification
Collection
a
E `o
m ..
o
0`
o
lu E
m
g i
PRESERVATION
ANALYSIS REQUESTED
Date
Time
Temp
_
$
0
=
C
z
0
Effluent
C
P
X
BOD, TSS, NO2
Effluent
C
P
X
NO3, NH3, TKN, TP
Effluent - Grab
P
X
Fecal Coliform
G
Effluent - Triannuals
(March, July, November)
C
P
X
TDS, Chloride
:7�L P
Transfer
Aelinquished
Sy:
DatelTime
A f, Received By:
DatelTime
2.
I emperaiure wnen rteceivea: i .-L_ IT Iv �►ccepteq: I R ected: Resample R_equw
Delivered By: Received By:Date: `
TURNAROUND:

envirochem
ANALYTICAL & CONSULTING CHEMISTS
F"Wp�-- -,,Oqql
Environmental Chemists, Inc.
6602 Windmill Way, Wilmington, NC 28405 • 910.392.0223 Lab • 910.392.4424 Fax
710 Bowsertown Road, Manteo, NC 27954 • 252.473.5702 Lab/Fax
255-A Wilmington Highway, Jacksonville, NC 28540 • 910.347.5843 Lab/Fax
infoLenvironmenutichemists.coni
Environmental Services
Date of Report:
Apr 13, 2020
PO Box 1054
Customer PO #:
Jacksonville NC 28541
Customer ID:
14110017
Attention: Sonny Scozzari
Report #:
2020-03793
Project ID: Bear
Trail Golf Course
Lab ID Sample ID:
Collect Date/Time Matrix
Sampled by
20-09213 Site: Sludge
3/4/2020 Solid/Sludge
Sonny Scozzari
Test Method Results Date Analyzed
Chlordane (TCLP)
SW 846 Method 80818/3510
<0.02 mg/L
03/19/2020
Endrin (TCLP)
SW 846 Method 8081B13510
<0.0005 mg/L
03/19/2020
Heptachlor (TCLP)
SW 846 Method 80818/3510
<0.0005 mg/L
03/19/2020
Heptachlor epoxide (TCLP)
SW 846 Method 8081B13510
<0.0005 mg/L
03/19/2020
Lindane (TCLP)
SW 846 Method 80818/3510
<0.0005 mg/L
03/19/2020
Methoxychlor (TCLP)
SW 846 Method 80818/3510
<0.0005 mg/L
03/19/2020
Toxaphene (TCLP)
SW 846 Method 8081B/3510
<0.05 mg/L
03/19/2020
1,4-Dichlorobenzene (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
03/20/2020
2,4,5-Trichlorophenol (TCLP)
SW 646 method 8270/3510
<0.050 mg/L
03/20/2020
2,4,6-Trichlorophenol (TCLP)
SW 846 method 827013510
<0.050 mg/L
03/20/2020
2,4-Dinitrotoluene (TCLP)
SW 846 method 827013510
<0.050 mg/L
03/20/2020
Cresol (TCLP)
SW 846 method 827013510
0.400 mg/L
03/20/2020
Hexachloro-1,3-butadiene (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
03/20/2020
Hexachlorobenzene (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
03/20/2020
Hexachloroethane (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
03/20/2020
m + p-Cresol (TCLP)
SW 846 method 8270/3510
0.400 mg/L
03/20/2020
Nitrobenzene (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
03/20/2020
o-Cresol (TCLP)
SW 846 method 827013510
<0.050 mg/L
03/20/2020
Pentachlorophenol (TCLP)
SW 846 method 827013510
<0.250 mg/L
03/20/2020
Pyridine (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
03/20/2020
2,4,5-TP (TCLP)
SW846 Method 8151A
<0.003 mg/L
03/20/2020
2,4-D (TCLP)
SW846 Method 8151A
<0.003 mg/L
03/20/2020
RCI
Cyanide
EPA 335.4
0.077 mg/kg
03/16/2020
Sulfide
SM 4500 S o
0.49 mg/kg
03/31/2020
Ignitability
SW 846 method 1010
>210 7
03/12/2020
Report #:- 2020-03793 Page 1 of 3

gn:v7irolchem
ANALYTICAL & CONSULTING CHEMISTS
Environmental Chemists, Inc.
6602 Windmill Way, Wilmington, NC 28405 • 910.392.0223 Lab • 910.392.4424 Fax
710 Bowsertown Road, Manteo, NC 27954 • 252.473.5702 Lab/Fax
255-A Wilmington Highway, Jacksonville, NC 28540 • 910.347.5843 Lab/Fax
infotvi,environmentalchemist q.com
Environmental Services
Date of Report: Apr 13, 2020
PO Box 1054
Customer PO #:
Jacksonville NC 28541
Customer ID: 14110017
Attention: Sonny Scozzari
Report #: 2020-03793
Project ID: Bear Trail Golf Course
pH
SW 846 Method 9045D
7.07 units
04/02/2020
Sludge Residuals
Aluminum
EPA 200.7
2970 mg/kg
03/12/2020
Arsenic
EPA 200.7
<9.65 mg/kg
03/12/2020
Cadmium
EPA 200.7
<9.65mg/kg
03/12/2020
Calcium
EPA 200.7
15100 mg/kg
03/12/2020
Chromium
EPA 200.7
12.8 mg/kg
03/12/2020
Copper
EPA 200.7
158 mg/kg
03/12/2020
Lead
EPA 200.7
<9.65 mg/kg
03/12/2020
Magnesium
EPA 200.7
2460 mg/kg
03/12/2020
Molybdenum
EPA 200.7
<9.65 mg/kg
03/12/2020
Nickel
EPA 200.7
<9.65 mg/kg
03/12/2020
Potassium
EPA 200.7
4090 mg/kg
03/24/2020
Selenium
EPA 200.7
<9.65 mg/kg
03/12/2020
Sodium
EPA 200.7
200 mg/kg
03/16/2020
Zinc
EPA 200.7
854 mg/kg
03/12/2020
Nitrate+Nitrite-Nitrogen
EPA 353.2
64.2 mg/kg
03/11/2020
Total Solids (%)
SM 2540 B
2.54 %
03/09/2020
Ammonia Nitrogen
SM 4500 NH3 C
4130 mg/kg
03/10/2020
Total Kjeldahl Nitrogen (TKN)
SM 4500 Org B
77200 mg/kg
03/11/2020
Total Phosphorus
SM 4500 P F
16200 mg/kg
03/19/2020
Mercury
SW846 7471 B
<0.614 mg/kg
03/13/2020
TCLP Metals
Arsenic
EPA 200.7
<1.0 mg/L
03/19/2020
Barium
EPA 200.7
<1.0 mg/L
03/19/2020
Cadmium
EPA 200.7
<1.Omg/L
03/19/2020
Chromium
EPA 200.7
<1.0 mg/L
03/19/2020
Lead
EPA 200.7
<1.0 mg/L
03/19/2020
Selenium
EPA 200.7
<1.0 mg/L
03/19/2020
Silver
EPA 200.7
<1.0 mg/L
03/19/2020
Report #': 2020-03793
Page 2 of 3

[envirochem
ANALYTICAL & CONSULTING CHEMISTS
Environmental Services
PO Box 1054
Jacksonville NC 28541
Environmental Chemists, Inc.
6602 Windmill Way, Wilmington, NC 28405 • 910.392,0223 Lab • 910.392.4424 Fax
710 Bowsertown Road, Ivlanteo, NC 27954 • 252.473.5702 Lab/Fax
255-A Wilmington Highway, Jacksonville, NC 28540 • 910.347.5843 Lab/Fax
info(�c,,environmentalchem ists.com
Date of Report: Apr 13, 2020
Customer PO #:
Customer ID: 14110017
Attention: Sonny Scozzan Report #: 2020-03793
Project ID: Bear Trail Golf Course
Mercury EPA 245.1 <0.0002 mg/L 03/19/2020
Comment: Sludge residual results reported on dry weight basis
Reviewed by: 'owz 09�jl
Report # 2020-03793 Page 3 of 3

Environmental Chemist, Inc., Wilmington, NC Lab tt94
Sample Receipt Checklist
C ,?Do's -
Client: Date: 3 5IZIJ Report Number:
6602 Windmill Way
Wilmington, NC 28405
910.392.0223
9D-3-*-q13
Receipt of sample: Delivered UPS ❑ FedEx ❑ Other ❑
❑ YES 113
NO
N/A
1. Were custody seals present on the cooler?
❑ YES 10
NO
LK N/A
2. If custody seals were present, were they intact/unbroken?
Original temperature upon receipt 4C Corrected temperature upon receipt °C
How temperature taken: ❑ Temperature Blank V Against Bottles
IR Gun ID: Thomas Traceable S/N 192511657 IR Gun Correction Factor °C: 0.0
❑ YES
❑ NO
3. If temperature of cooler exceeded 6°C, was Project Mgr./QA notified?
rA YES
❑ NO
4. Were proper custody procedures (relinquished/received) followed?
YES
❑ NO
5. Were sample ID's listed on the COC?
YES
❑ NO
6. Were samples ID's listed on sample containers?
ER YES
❑ NO
7. Were collection date and time listed on the COC?
YES
❑ NO
8. Were tests to be performed listed on the COC?
J>rl YES
❑ NO
9. Did samples arrive in proper containers for each test?
YES
❑ NO
10. Did samples arrive in good condition for each test?
YES
❑ NO
11. Was adequate sample volume available?'
YES
❑ NO
12. Were samples received within proper holding time for requested tests?
❑ YES
❑ NO
13. Were acid preserved samples received at a pH of <2?
❑ YES
❑ NO
14. Were cyanide samples received at a pH >12?
❑ YES
❑ NO
15. Were sulfide samples received at a pH >9?
❑ YES
113 NO
116. Were NH3/TKN/Phenol received at a chlorine residual of <0.5 m/L? •
❑ YES
10 NO
117. Were Sulfide/Cyanide received at a chlorine residual of <0.5 m/L?
* TOC/Volatiles are pH checked at time of analysis and recorded on the benchsheet.
* • Bacteria samples are checked for Chlorine at time of analysis and recorded on the benchsheet
Sample Preservation: (Must be completed for any sample(s) incorrectly preserved or with headspace)
Sample(s) were received incorrectly preserved and were adjusted accordingly
by adding (circle one): 1-12SO, HNO3 HCI NaOH
Time of preservation: If more than one preservative is needed, notate in comments below
lNote: Notify customer service immediately for incorrectly preserved samples. Obtain a new sample or
notify the state lab if directed to analyzed by the customer. Who was notified, date and time:
Volatiles Sample(s) Nere received with headspace
COMMENTS:
JUL. L1A.UO2

ENVIRONMENTAL
CHEMISTS, INC
ington Hwy
J cksonvlille,NC285 0
Analytical & Consulting Chemists
NCDENR: DWO CERTERICATION # 94 N
DHHS: DLS CERTIFICATION # 37729
OFFICE: 910-347-5863 Lab/Fax
COLLECTION AND CI
IAIN OF CUSTODY
CLIENT:
PROJECT NAME: EF -LUENT REPORT NO:
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ADDRESS: _ lQ�/u-C�/
�� f'^-F CONTACT NAME: PO NO:
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REPORT TO: PHONEIFAX:
COPY TO: E-MAIL:
SBfn led 8y:
SAMPLE TYPE:4 = Influent, E = Effluent, W = Well, ST = Stream, SO = Soil, SL = Sludge, Other:
Collection 2 1 _ PRESERVATION
Ix
Sample Identlfioatlon
E �; n g " = m _
~ o 0 °o a = E g 5 o u o o O o w
ANALYSIS REQUESTED
Date
�n
Time Temp -' z = z o
Eflfuent
C P
G G
X
BOD, TSS
Eflfuent
C P
G G
X
Ammonia
Effluent -Grab
C P
G G X
Fecal
C P
G G
Effluent (Quarterly)
C p
G G X
Total Phosphorus
C P
G G X
Total Nitrogen
_
GL�
� 4
G G 3SA1
C P
G G
C P
NOTICE - DECHLORINATION: Samples for
Transfer
Phenoland
2.
Temperature when Received: Accepted:
Delivered By: Received By:
Comments:
must be dechlorinated (0.2 ppm or less) in the field at the time of collection.
'ime Received By:. j �F�-1 Date/Time
)le Requested-
TURNAROUND:—

en45�= rt�,ocliein=,
ANALYTICAL & CONSULTING CHEMISTS
Environmental Chemists, Inc.
6602 Windmill Way, Wilmington, NC 28405 - 910.392.0223 Lab - 910.392.4424 Fax
710 Bowsertown Road, Manteo, NC 27954 - 232.473.5702 Lab/Fax
255-A Wilmington Highway, Jacksonville, NC 28540 - 910.347.5843 Lab/Fax
inft)@en%-ironmentalchemists.com
Environmental Services
PO Box 1054
Jacksonville NC 28541
Attention: Sonny Scozzari
Date of Report: May 21, 2019
Customer PO #:
Customer ID: 14110017
Report #: 2019-06498
Project ID: Bear Trail Golf Course
Lab ID Sample ID:
Collect Date/Time Matrix Sampled by
19-16389 Site: Sludge
4/22/2019
6:00 PM Solid/Sludge Client
Test
Method
Results Date
Analyzed
Chlordane (TCLP)
SW846 Method 8081 BM510
<0.02 mg/L
05/03/2019
Endrin (TCLP)
SW 846 Method 8081B/3510
<0.0005 mg/L
05/03/2019
Heptachlor (TCLP)
SW 846 Method 8081B/351a
<0.0005 mg/L
05/03/2019
Heptachlor epoxide (TCLP)
SW 846 Method 8081B/3510
<0.0005 mg/L
05/03/2019
Lindane (TCLP)
SW 846 Method 808113/3510
<0.0005 mg/L
05/03/2019
Methoxychlor (TCLP)
SW 846 Method 80818/3510
<0.0005 mg/L
05/0312019
Toxaphene (TCLP)
SW 846 Method 8081B/3510
<0.05 mg/L
05/03/2019
1,4-Dichlorobenzene (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
05/06/2019
2,4,5-Trichlorophenol (TCLP)
SW 846 method 8270t3510
<0.050 mg/L
05/06/2019
2,4,6-Trichlorophenol (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
05/06/2019
2,4-Dinitrotoluene (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
05/06/2019
Cresol (TCLP)
SW 846 method 8270/3510
0.223 mg/L
05/06/2019
Hexachloro-1,3-butadiene (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
05/06/2019
Hexachlorobenzene (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
05/06/2019
Hexachloroethane (TCLP)
SW 848 method 8270/3510
<0.050 mg/L
05/06/2019
m + p-Cresol (TCLP)
SW 846 method 6270I3510
0.223 mg/L
05/06/2019
Nitrobenzene (TCLP)
SW 846 method 82705510
<0.050 mg/L
05/06/2019
o-Cresol (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
05/06/2019
Pentachlorophenol (TCLP)
SW 846 method 8270/3510
<0.250 mg/L
05/06/2019
Pyridine (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
05/06/2019
pH
SW 846 Method e045D
6.94 units
04/24/2019
2,4,5-TP (TCLP)
SW846 Method 8151A
<0.003 mg/L
05/09/2019
2,4-D (TCLP)
SW846 Method 8151A
<0.003 mg/L
05/09/2019
1. 1 -Dichloroethylene (TCLP)
SW846 Method 8260/5030
<0.01 mg/L
05108/2019
1,2-Dichloroethane (TCLP)
SW846 Method 8280/5030
<0.01 mg/L
05/08/2019
Benzene (TCLP)
SW846 Method 8280/5030
<0.01 mg/L
05/08/2019

ANALYTICAL & CONSULTING CHEMISTS
Environmental Chemists, Inc.
6602 Windmill Way, Wilmington, NC 28405 • 910.392.0223 Lab • 910.392.4424 Fax
710 Bowsertown Road, Manteo, NC 27954 • 252.473.5702 Lab/Fax
255-A Wilmington Highway, Jacksonville, NC 28540 0 910.347.5843 Lab/Fax
info emir nmental hems t .com
Environmental Services
Date of Report: May 21, 2019
PO Box 1054
Customer PO #:
Jacksonville NC 28541
Customer ID: 14110017
Attention: Sonny Scozzari
Report #: 2019-06498
Project lD: Bear Trail Golf Course
Carbon Tetrachloride (TCLP)
SW846 Method 8260/5030
<0.01 mg/L
05/08/2019
Chlorobenzene (TCLP)
SW846 Method 826015030
<0.01 mg/L
05/08/2019
Chloroform (TCLP)
SW846 Method 825015030
<0.01 mg/L
05/08/2019
Methyl ethyl ketone (TCLP)
SW846 Method 826015030
<0.05 mg/L
05/08/2019
Tetrachloroethylene (TCLP)
SW846 Method 8260/5030
<0.01 mg/L
05/08/2019
Trichloroethylene (TCLP)
SW846 Method 8260/5030
<0.01 mg/L
05/08/2019
Vinyl Chloride (TCLP)
SW846 Method 8260/5030
<0.01 mg/L
05/08/2019
RCI
Cyanide
EPA 335 4
<0.05 mg/kg
05/07/2019
Analyzed outside of hold time. RL elevated due to matrix Interference.
Sulfide
sM 4500 S D
4.83 mg/kg
05/08/2019
Analyzed outside of hold time.
Ignitability
SW 846 method 1010
>195 °F
04/30/2019
Sludge Residuals
Aluminum
EPA 200.7
1170 mg/kg
04/25/2019
Arsenic
EPA 200.7
<7.79 mg/kg
04/25/2019
Cadmium
EPA 200.7
<7.79 mg/kg
04/25/2019
Calcium
EPA 200 7
6010 mg/kg
04/25/2019
Chromium
EPA 200 7
<7.79 mg/kg
04/25/2019
Copper
EPA 200 7
60.1 mg/kg
04/25/2019
Lead
EPA 200 7
<7.79 mg/kg
04/25/2019
Magnesium
EPA 200.7
1970 mg/kg
04/25/2019
Molybdenum
EPA 200.7
<7.79 mg/kg
04/25/2019
Nickel
EPA 200.7
<7.79 mg/kg
04/25/2019
Potassium
EPA 200.7
3620mglkg
04/25/2019
Selenium
EPA 200.7
<7.79mg/kg
04/25/2019
Sodium
EPA 200.7
10000mg/kg
04/25/2019
Zinc
EPA 200.7
477 mg/kg
04/25/2019
Nitrate+Nitrite-Nitrogen
EPA353.2
105mg/kg
05/02/2019
Total Solids (%)
sM 2540 s
2.58 %
04/24/2019

�- �- Environmental Chemists, Inc.
' 1 ! 6602 Windmill Way, Wilmington, NC 28405 • 910.392.0223 Lab • 910.392.4424 Fax
% Y S
710 Bowsertown Road, Manteo, NC 27954 * 252.473.5702 Lab/Fax
255-A Wilmington Highway, Jacksonville, NC 28540 • 910.3=47.5843 Lab/Fax
ANALYTICAL & CONSULTING CHEMISTS info(i emvironmentalchemisis.com
Environmental Services
Date of Report: May 21, 2019
PO Box 1054
Customer PO #:
Jacksonville NC 28541
Customer ID: 14110017
Attention: Sonny Scozzari
Report #: 2019-06498
Project ID: Bear Trail Golf Course
Ammonia Nitrogen SM 4500 NH3 C
2410 mglkg
04/30/2019
Total Kjeldahl Nitrogen (TKN) SM 4500 Org B
82900 mg/kg
05/02/2019
Total Phosphorus SM 4500 P F
19600 mg/kg
05/07/2019
Mercury SW0467471B
<0.698mg/kg
04/26/2019
TCLP Metals
Arsenic
EPA 200.7
<1.0 mg/L
05/08/2019
Barium
EPA 200.7
<1.0mg/L
05/07/2019
Cadmium
EPA 200.7
<1.0 mg/L
05/07/2019
Chromium
EPA 200 7
<1.0 mg/L
05/07/2019
Lead
EPA 200 7
<1.0 mg/L
05/07/2019
Selenium
EPA 200.7
<1.0 mg/L
05/07/2019
Silver
EPA 200.7
<1.0 mg/L
05/08/2019
Mercury
EPA245 1
<0.0002 mg/L
05/12/2019
Comment:
Sludge residuals reported o a dryeight basis.
Reviewed : b
Y
1 bura I'1��

RESIDUALS SOURCE CERTIFICATION ATTACHMENT
Town of Warsaw

State of North Carolina
DWR
Department of Environmental Quality
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 I of I

DWR
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: Town of Warsaw Wastewater Treatment Plant
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: Greg Hughes - ORC
Complete mailing address: P.O. Box 464
City: Warsaw State: NC Zip: 28398
Telephone number: [phone] E-mail address: cahujzhes41 Aizmail.corn
4. Facility physical address: 384 East Best Street
City: Warsaw State: NC Zip: 28398-
Coordinates: Latitude: 34' 59' 38.54" N Longitude: 74° 04' 49" W
Datum: NAD 83 Level of accuracy: Nearest 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: % industrial and % domestic)
❑ other (explain: ).
6. Does the facility have an approved pretreatment program: ❑ Yes ® No
7. Facility permitted/design flow: 0.915 MGD and facility average daily flow: 0.35 MGD
8. Average amount of residuals being generated at this facility 75 dry tons per year.
9. Specify the following regarding treatment and storage volumes available at the facility:
Type and volume of residuals treatment: 150,000 gallon sludge holding tanks
Type and volume of residuals storage (i.e., outside of residuals treatment units): None
II. 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
FORM: RSC 06-16 Page I of
5

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).
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: ❑ yes ® no.
If yes, list the number(s):
b. Specify whether or not the residuals exhibit any of the characteristics defined by 40 CFR §261.21-
261.24: ❑ yes ® no.
Fill in the following tables with the results of the latest toxicity characteristic leaching procedure (TCLP) analysis as well
as those for corrosivity, ignitability, and reactivity:
Laboratory: Environmental Chemists, Inc. and Date of analysis: 06/02/2020
Passed corrosivity test: ® yes ❑ no. pH: s.u. (2 < pH < 12.5)
Passed ignitability test: ® yes ❑ no. Flashpoint: >185 OF (> 140°F)
Passed reactivity test: ®yes ❑no. HCN: 0.142 mg/kg (<250) & H2S: 0.73 mg/kg (<500)
TCLP Parameter
Limit
(mg/1)
Result
(mg/1)
TCLP Parameter
Limit
(mg/1)
Result
(Mg/1)
Arsenic
5.0
<1.000
Hexachlorobenzene
0.13
<0.050
Barium
100.0
<1.000
Hexachloro-1,3-Butadiene
0.5
<0.050
Benzene
0.5
<0.010
Hexachloroethane
3.0
<0.050
Cadmium
1.0
<1.000
Lead
5.0
<1.000
Carbon Tetrachloride
0.5
<0.010
Lindane
0.4
<0.0005
Chlordane
0.03
<0.020
Mercury
0.2
<0.0002
Chlorobenzene
100.0
<0.010
Methoxychlor
10.0
<0.0005
Chloroform
6.0
<0.010
Methyl Ethyl Ketone
200.0
<0.050
Chromium
5.0
<1.000
Nitrobenzene
2.0
<0.050
m-Cresol
200.0
<0.050
Pentachlorophenol
100.0
<0.250
o-Cresol
200.0
<0.050
Pyridine
5.0
<0.050
p-Cresol
200.0
<0.050
Selenium
1.0
<1.000
Cresol
200.0
<0.050
Silver
5.0
<1.000
2,4-D
10.0
<0.003
Tetrachloroethylene
0.7
<0.010
1,4-Dichlorobenzene
7.5
<0.050
Toxaphene
0.5
<0.050
1,2-Dichloroethane
0.5
<0.010
Trichloroethylene
0.5
<0.010
1,1-Dichloroethylene
0.7
<0.010
2,4,5-Trichlorophenol
400.0
<0.050
2,4-Dinitrotoluene
0.13
<0.050
2,4,6-Trichlorophenol
2.0
<0.050
Endrin
0.02
<0.0005
2,4,5-TP (Silvex)
1.0
<0.003
Heptachlor and its Hydroxide
0.008
<0.0005
Vinyl Chloride
0.2
<0.010
FORM: RSC 06-16 Page 2 of 5

4. Metals Determination: Complete one of the following tables (i.e., as applicable) to demonstrate that the residuals do not violate
the ceiling concentrations for metals regulated under 15A NCAC 02T .1105.
a. For Distribution/Land Application: Fill in the following table with the results of the latest analyses (i.e., on a dry weight
basis) for the following metal parameters:
Laboratory: Environmental Chemists, Inc. and Date of analysis: 06/02/2020
Parameter
Ceiling
Monthly Average
Result
Concentration Limits
Concentration Limits
(C1assA & ClassB)
(Class A Only)
(mglkg)
(mg1kg)
(mglkg)
Arsenic
75
41
30.10
Cadmium
85
39
<14.90
Copper
4,300
1,500
258.00
Lead
840
300
26.80
Mercury
57
17
0.85
Molybdenum
75
n/a
17.30
Nickel
420
420
<14.90
Selenium
100
100
<14.90
Zinc
7,500
2,800
748.00
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. Nutrient/Micronutrient Determination: Complete the following:
a. Total solids: 3.30 %.
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: Environmental Chemists, Inc. and Date of analysis: 06/02/2020
Parameter
Result
(mg/k9)
Aluminum
8,550.00
Ammonia -Nitrogen
<3.03
Calcium
21,800.00
Magnesium
1,470.00
Nitrate -Nitrite Nitrogen
1,910.00
pH (Standard Unit)
6.56
Phosphorus
16,500.00
Potassium
2,940.00
Sodium
1,490.00
Total Kjeldahl Nitrogen
39,700.00
c. Using the results listed in Item II. 5b. above, calculate the sodium adsorption ration (SAR): 0.48
[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: 30 %. This rate
is a (check one): ® 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 (lsh Year PAN
Five -Year
Maximum Adjusted PAN
(mg1kg)
(mg/k-g)
Surface
13,821
20,974
Injection/Incorporation
13,822
20,975
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: None
FORM: RSC 06-16 Page 4 of

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. 1 106(b)(3)(A)] - Time/Temperature Compliance.
❑ Alternative 2 [15A NCAC 02T. 1 106(b)(3)(B)] - Alkaline Treatment.
❑ Alternative 3 [15A NCAC 02T. 1 106(b)(3)(C)] - Prior Testing for Enteric VirusNiable Helminth Ova.
❑ Alternative 4 [15A NCAC 02T. 1 106(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,
❑ thermophilic aerobic digestion, ❑ beta ray irradiation,
❑ gamma ray irradiation, or ❑ pasteurization.
b. For Land Application of Class B:
® Alternative 1 [15A NCAC 02T.1106(c)(1)] -Fecal Coliform Density Demonstration.
® Alternative 2 [15A NCAC 02T.I 106(c)(2)] - Process to Significantly Reduce Pathogens (PSRP).
Specify one: ❑ aerobic digestion, ❑ air drying, ❑ anaerobic digestion,
❑ composting, or ® lime stabilization.
c. For Surface Disposal:
❑ Select One of the Class A or Equivalent Pathogen Reduction Alternatives in Item II. 7a. above.
❑ Select One of the Class B or Equivalent Pathogen Reduction Alternatives in Item II. 7b. above.
❑ Exempt -If Daily Cover Alternative is chosen in Item 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.I 107(a)(3)] - 30-Day Bench Scale Test (Aerobic Digestion).
® Alternative 4 [15A NCAC 02T.I 107(a)(4)] - Specific Oxygen Uptake Rate Test (Aerobic Digestion).
❑ Alternative 5 [15A NCAC 02T.I 107(a)(5)] - 14-Day Aerobic Processes.
® Alternative 6 [15A NCAC 02T.I 107(a)(6)] - Alkaline Stabilization.
❑ Alternative 7 [15A NCAC 02T.1107(a)(7)] - Drying of Stabilized Residuals.
❑ 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

Facility Vicinity Map

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Land Application Program Vicinity
Warsaw WWTP Map
Project No. 1
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Process Flow Diagram and Narrative

WASTEWATER TREATMENT PLANT PROCESS
The Town of Warsaw WWTP is designed for an average daily influent flow of 0.915 MGD.
This flow is routed through a mechanical bar screen, which has a manual bypass bar screen as
a backup. The full flow is then routed to the influent pump station. This pump station is
equipped with three 800 gpm pumps. Any two of the pumps can pump 1,600 gpm with the
third pump out of service. Flow at 1,600 gpm is directed to a 12' x 12' aerated grit removal
unit with dual blowers. The degritted flow is then directed to a flow splitter box, which uses
weirs to split the flow equally to one or all three oxidation ditches. This splitter box also
receives flow from return activated sludge pumps and the filter backwash. Each oxidation
ditch has a volume of approximately 457,500 gallons. This provides approximately 36 hours
of detention time in the oxidation ditches. The WWTP also has three chemical feed pumps,
which allow the use of chemicals such as alum, ferric chloride and polymers to aid in solids
settling and phosphorus removal if needed. Oxidation ditch No. I is the original ditch and its
flow is directed to a flow splitter box located between two existing 30' diameter secondary
clarifiers. Flow from Oxidation ditch No.2 is directed to a 40' diameter clarifier. Flow from
Oxidation ditch No.3 is directed to a 40' diameter clarifier. These units can be run in series or
parallel. At this time, the facility is normally operated in parallel.
Effluent then flows from the clarifiers to another flow splitter box where the flows are divided
equally into two 144 square foot tertiary filters. The filtered effluent goes into a clear well
where it is chlorinated and is available for backwashing the filter. From the clear well, effluent
flows to the chlorine contact tank, to allow adequate time for disinfection to occur. The
disinfected effluent then travels to the post aeration tank, with two floating aerators, which
raise the dissolved oxygen level. Sulfur dioxide is used to reduce the chlorine residual. Sludge
is daily wasted to an aerobic digester. Sludge is thickened, digested, and then transferred to
the aerobic sludge holding tank. The thickened digested sludge is then land applied by a
contract hauler. In the event of a power outage, the entire WWTP has standby power available
with an automatic transfer switch.
A schematic diagram of the plant is found on the following page.

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Justification for Residuals Production Rate

JUSTIFICATION FOR WWTP RESIDUALS PRODUCTION RATE
Warsaw Wastewater Treatment Plant is currently operating at 0.35 million gallons per day (MGD).
This is much less than their current capacity of 0.915 MGD plant. Based on the past several years
production, the dry tons have been increased from 38 to 75 dry tons for annual production.

Residuals Sampling Plan

WWTP SAMPLING PLAN — TOWN OF WARSAW
Annually, multiple grab residual solid samples are collected from the sludge holding tanks. These
samples are composited for nutrient and metal analyses. The composited sample is mixed and aerated to
keep the solids suspended and containers filled for this analysis. Lime stabilization occurs when the
sludge holding tank reaches capacity. Lime is added to reach proper stabilization requirements for vector
attraction and pathogen reduction. Field measurements of pH and temperature are collected for each
stabilization event to insure pH requirements are met. pH values are later temperature corrected for
reporting purposes. The Town of Warsaw may elect to meet pathogen reduction by the collection of 7
fecal samples. In addition, vector attraction reduction may be met by incorporation/injection into the soil
or collection of samples for the 30-day bench test for aerobic digestion or SOUR tests.
Annually, a composite residual solid sample will be analyzed for: Arsenic, Cadmium, Copper, Lead,
Mercury, Molybdenum, Nickel, Selenium, Zinc, Aluminum, Ammonia — Nitrogen, Calcium, Nitrate -
Nitrite, Nitrogen, Magnesium, % Total Solids, pH, Phosphorus, Potassium, TKN, and Sodium. From this
information, the Plant Available Nitrogen (PAN) and Sodium Adsorption Ratio (SAR) will be calculated.
Once every permit cycle a composite TCLP sample will be collected to include:
Arsenic
Hexachlorobenzene
ph for Corrosivity
Barium
Hexachloro-1,3-Butadiene
Benzene
Hexachloroethane
Flash point for ignitability
Cadmium
Lead
Carbon Tetrachloride
Lindane
Sulfides and Cyanides for reactivity
Chlordane
Mercury
1,2-Dichloroethane
Chlorobenzene
Methoxychlor
1,1-Dichloroethylene
Chloroform
Methyl Ethyl Ketone
2,4-Dinitrotoluene
Chromium
Nitrobenzene
Endrin
m-Cresol
Pentachlorophenol
Heptachlor and its Hydroxide
o-Cresol
Pyridine
Trichloroethylene
p-Cresol
Selenium
2,4,5-Trichlorophenol
Cresol
Silver
2,4,6-Trichlorophenol
2,4-D
Tetrachloroethylene
2,4,5-TP (Silvex)
1,4-Dichlorobenzene
Toxaphene
Vinyl Chloride

Analytical Data From Town of Warsaw WWTP
TCLP and Nutrient & Metals

eikaEs o602 Windmiit Way, Wilmington, NC 28405 ° 910.392.0723 Lab ° 910.392.4424 Pax
cif 710 Bowsertown Road, Nfanteo, NC 27954 ° 252.473.5702 Lab/Fa
255-A Wilmington Higllway, Jacksonville, NC 28540 ' 910.347.5843 Lab/lax
ANALYTICAL & CONSULTING CHEMISTS
info(iuenvironmentsticbemists.cam
Town of Warsaw Date of Report: Jun 02, 2020
P.O. Box 464 Customer PO 4:
Warsaw NC 28398 Customer ID: 09070029
Attention: Greg Hughes Report #: 2020-07645
Project ID: Sludge
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
20-18819 Site: Sludge 5/7/2020 8:00 AM Solid/Sludge Greg Hughes
Test
Method
Results
Date Analyzed
Chlordane (TCLP)
SW 848 Method 80818/3510
<0.02 mg/L
06/18/2020
Enddn (TCLP)
SW 846 Method 80818/3510
<0.0005 mg/L
05/18/2020
Heptachlor (TCLP)
sw 846 Method eoe1e/3510
<0.0005 mg/L
05/18/2020
Heptachlor epoxide (TCLP)
SW 846 Method 8081B13510
<0.0005 mg/L
05/18/2020
Lindane (TCLP)
SW 846 Method 8081e/3510
<0.0005 mg/L
05/18/2020
Methoxychlor (TCLP)
SW 846 Method 6081e/3510
<0.0005 mg/L
05/18/2020
Toxaphene (TCLP)
SW a46 Method 80819/3510
<0.05 mg/L
05/18/2020
1,4-Dichlorobenzene (TCLP)
SW 845 method 8270/3510
<0.050 mg/L
05/14/2020
2,4,5-Trichlorophenol (TCLP)
SW 846 method 827013510
<0.050 mg/L
05/14/2020
2,4,6-Triehlorophenol (TCLP)
sw 846 method 8270/3610
<0.050 mg/L
05/14/2020
2,4-Dinitrotoluene (TCLP)
SW 846 method 827013610
<0.050 mg/L
05/14/2020
Cresol (TCLP)
SW 846 method 827013510
<0.050 mg/L
05/14/2020
Hexachloro-1,3-butadiene (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
05/14/2020
Hexachlorobenzene (TCLP)
SW 846 method 827013510
<0.050 mg/L
05l14/2020
Hexachloroethane (TCLP)
SW 846 method 827013510
<0.050 mg/L
06/14/2020
m + p-Cresol (TCLP)
SW 846 method 827013510
<0.050 mg/L
05/14/2020
Nitrobenzene (TCLP)
SW 848 method 8270/3510
<0.050 mg/L
05/14/2020
o-Cresol (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
05/14/2020
Pentachlorophenol (TCLP)
SW 846 method 827013510
<0.250 mg/L
05114/2020
Pyridine (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
05/14/2020
2,4,5-TP (TCLP)
SW846 Method 8151A
<0.003 mg/L
05/19/2020
2,4-D (TCLP)
SW846 Method 8151A
<0.003 mg/L
05/19/2020
1,1-Dichloroethylene (TCLP)
SW846Method 828015030
<0.01 mg/L
05/13/2020
1,2-Dichloroethane (TCLP)
SW846 Method82=5030
<0.01 mg/L
05/13/2020
Benzene (TCLP)
SV046 Method 8260/5030
<0.01 mg/L
05/13/2020
Carbon Tetrachloride (TCLP)
SW846 Method 8260/5030
<0.01 mg/L
05/13/2020
Report k:: 2020-07646

Y a
6602 Windmill GVay,
Wilmington, NC 28405 0 910.392.02?3 Lab ° 910.392.4424 Fati
sti
-
710 Sowsertown Road, Manteo, NC 27954 ° 252.473.57702 Lab/Fax
255-AW'ilmingtan
Higttway, jacksonville, NC 28540 ° 910,3473843 iAb/Fax
ANALYTICAL & CONSULTING CHEMISTS
info(tgenvironmeni alchemtsts.co m
Town of Warsaw
P.O. Box 464
Date of Report: Jun 02, 2020
Customer PO #:
Warsaw NC 28398
Customer ID: 09070029
Attention: Greg Hughes
Report #: 2020-07645
Project ID: Sludge
Chlorobenzene (TCLP)
SW846 Method 8260/5030
<0.01 mg/L
05/13/2020
Chloroform (TCLP)
SW846 Method 8260/5030
<0.01 mg/L
05/13/2020
Methyl ethyl ketone (TCLP)
SW846 Method 826015030
<0.05mg/L
Tetrachloroethylene (TCLP)
SW846 Method 826015030
05/13/2020
Trichloroethylene (TCLP)
SW846 Method 8260/5030
<0.01 m /L
9
05l13/2020
<0.01 m /L
9
05113/2020
Vinyl Chloride (TCLP)
SW848Method 8280/5030
<0.01 m /L
g
05/13/2020
RCI
Cyanide
EPA335.4
0.142m /k
9 9
05/12/2020
Sulfide
SM 4500 S D
0.73 mg/kg
05/11/2020
Ignitability
SW 846 method 1010
>185 °F
05/21/2020
pH
SW 846 Method W45D
6.56 units
05/13/2020
Sludge Residuals
Aluminum
EPA 200.7
8550mg/kq
05/13/2020
Arsenic
EPA 200.7
30.1 mg/kg
05/13/2020
Cadmium
EPA 200.7
<14.9 m /k
9 g
05/13/2020
Calcium
EPA 200.7
21800 mg/kg
05/13/2020
Chromium
EPA200.7
21.2mg/kg
05/13/2020
Copper
EPA 200.7
258 mg/kg
05/13/2020
Lead
EPA 200.7
26.8 m /k
9 9
05/1312020
Magnesium
EPA 200.7
1470 mg/kg
05/13/2020
Molybdenum
EPA 200.7
Nickel
17.3 m /k
9 9
05/13/2020
EPA 200.7
<14.9 m /k
9 9
05/13/2020
Potassium
EPA 200.7
Selenium
2940 m /k
9 9
05/21/2020
EPA 200.7
<14.9 m /k
9 9
05/13/2020
Sodium
EPA 200 7
1490 mg/kg
05/13/2020
Zinc
EPA 200.7
748 m !k
9 g
05/13/2020
Nitrate+Nitrite-Nitrogen
EPA 353.2
Total Solids (%)
SM 2540 s
1910 m /k
9 9
05/13/2020
Ammonia Nitrogen
SM 4500 NH3 C
3.30
05/12/2020
<3.03 m /k_
g 4
05/08/2020
Total Kjeldahl Nitrogen (TKN)
sea 4500 0r9 a
39700 m 9/k9
05/0812020
Report 7 2020-07645

Environmental Chemists, Inc.
n a 6602 Windmill Way, Wilmington, VC?S-t05 57 n y � • �,
10.392.i1223 I-1b W392- 4-1. 4 Fax
n; 710 Rosyserto:vn Road, Nlanteo, NC 27954 • 252-474.5702 Lab/ Fit
255-A t":ilmingioa f-lighwav, Jacksonville, NC285,10 • 91 t},347,5843 Lab/Fax
ANALYI [CAL & CONSULTING CHEMISTS inib(iti;nviroll irie!italc:heMN".cosn
Town of Warsaw
Date of Report: Jun 02, 2020
P.O. Box 464
Customer PO #:
Warsaw NC
28398
Customer ID: 09070029
Attention: Greg Hughes
Report #: 2020-07645
Project ID: Sludge
Total Phosphorus
SM 4500 P F
16500 mg/kg
05/13/2020
Mercury
SW846 7471 B
0.8450 mg/kg
05/19/2020
TCLP Metals
Arsenic
EPA 200.7
<1.0 mg/L
05/14/2020
Barium
EPA 2001
<1.0 mg/L
05/14/2020
Cadmium
EPA 200 7
<1.0 mg/L
05114/2020
Chromium
EPA 200.7
<1.0 mg/L
05/14/2020
Lead
EPA 200.7
<1.0 mg/L
05/14/2020
Selenium
EPA 200.7
<1.0 mg/L
05/14/2020
Silver
EPA 200.7
<1.0 mq/L
05/14/2020
Mercury
EPA245.1
<0.0002mg/L
05/19/2020
Comment: Sludge residual results reported on a dry weight basis.
Reviewed by:
Report t, 2020.07645

RESIDUALS SOURCE CERTIFICATION ATTACHMENT
Town of Wallace

State of North Carolina
DWR
Department of Environmental Quality
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
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 Pen -nits".
® 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

Division of Water Resources
1.
II.
State of North Carolina
Department of Environmental Quality
Division of Water Resources
RESIDUALS SOURCE CERTIFICATION
FORM: RSC 06-16
RESIDUALS SOURCE -GENERATING FACILITY INFORMATION (See Instruction B.):
1. Facility Name: Town of Wallace Wastewater Treatment Plant
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: Lisa Cottle
Complete mailing address: 311 East Murphy Street
City: Wallace State: NC Zip: 28466
Telephone number: [phone] E-mail address: [e-mail]
4. Facility physical address: 851 Old Wilmington Road
City: Wallace State: NC Zip: 28466-
Coordinates: Latitude: 34' 43' 53" Longitude: 77' 58' 59"
Datum: NAD 83 Level of accuracy: Nearest 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: % industrial and % domestic)
❑ other (explain: ).
6. Does the facility have an approved pretreatment program: ❑ Yes ® No
7. Facility permitted/design flow: 5_2 MGD and facility average daily flow: 1_2 MGD
8. Average amount of residuals being generated at this facility 330 dry tons per year.
9. Specify the following regarding treatment and storage volumes available at the facility:
Type and volume of residuals treatment: 38,000 gallons aerated digestion
Type and volume of residuals storage (i.e., outside of residuals treatment units): None
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
FORM: RSC 06-16 Page 1 of
W

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).
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: ❑ yes ® no.
If yes, list the number(s):
b. Specify whether or not the residuals exhibit any of the characteristics defined by 40 CFR §261.21-
261.24: ❑ yes ® no.
Fill in the following tables with the results of the latest toxicity characteristic leaching procedure (TCLP) analysis as well
as those for corrosivity, ignitability, and reactivity:
Laboratory: Environmental Chemists, Inc. and Date of analysis: 1/28/2020
Passed corrosivity test: ® yes ❑ no. pH: s.u. (2 < pH < 12.5)
Passed ignitability test: ® yes ❑ no. Flashpoint: >205 IF (> 140°F)
Passed reactivity test: ®yes ❑no. HCN: <0.125 mg/kg (<250) & H2S: 0.32 mg/kg (<500)
TCLP Parameter
Limit
(mg/1)
Result
(mg/1)
TCLP Parameter
Limit
(mg/1)
Result
(mg/1)
Arsenic
5.0
<1.00
Hexachlorobenzene
0.13
<0.050
Barium
100.0
<1.00
Hexachloro-1,3-Butadiene
0.5
<0.050
Benzene
0.5
<0.01
Hexachloroethane
3.0
<0.050
Cadmium
1.0
<1.00
Lead
5.0
<1.00
Carbon Tetrachloride
0.5
<0.01
Lindane
0.4
<0.0005
Chlordane
0.03
<0.02
Mercury
0.2
<0.0002
Chlorobenzene
100.0
<0.01
Methoxychlor
10.0
<0.0005
Chloroform
6.0
<0.01
Methyl Ethyl Ketone
200.0
0.06
Chromium
5.0
<1.00
Nitrobenzene
2.0
<0.050
m-Cresol
200.0
<0.050
Pentachlorophenol
100.0
<0.250
o-Cresol
200.0
<0.050
Pyridine
5.0
<0.050
p-Cresol
200.0
<0.050
Selenium
1.0
<1.00
Cresol
200.0
<0.050
Silver
5.0
<1.00
2,4-D
10.0
<0.003
Tetrachloroethylene
0.7
<0.010
1,4-Dichlorobenzene
7.5
<0.050
Toxaphene
0.5
<0.050
1,2-Dichloroethane
0.5
<0.010
Trichloroethylene
0.5
<0.010
1, 1 -Dichloroethylene
0.7
<0.010
2,4,5-Trichlorophenol
400.0
<0.050
2,4-Dinitrotoluene
0.13
<0.050
2,4,6-Trichlorophenol
2.0
<0.050
Endrin
0.02
<0.0005
2,4,5-TP (Silvex)
1.0
<0.003
Heptachlor and its Hydroxide
0.008
<0.0005
Vinyl Chloride
0.2
<0.010
FORM: RSC 06-16 Page 2 of 5

4. Metals Determination: Complete one of the following tables (i.e., as applicable) to demonstrate that the residuals do not violate
the ceiling concentrations for metals regulated under 15A NCAC 02T .1105.
a. For Distribution/Land Application: Fill in the following table with the results of the latest analyses (i.e., on a dry weight
basis) for the following metal parameters:
Laboratory: Environmental Chemists, Inc. and Date of analysis: 04/30/2020
Parameter
Ceiling
Monthly Average
Result
Concentration Limits
Concentration Limits
(C1assA & ClassB)
(Class A Only)
(mg/k-g)
(mg/hg)
(mg1k-t)
Arsenic
75
41
<17.30
Cadmium
85
39
<17.30
Copper
4,300
1,500
669.00
Lead
840
300
47.20
Mercury
57
17
3.46
Molybdenum
75
n/a
<17.30
Nickel
420
420
<17.30
Selenium
100
100
<17.30
Zinc
7,500
2,800
1,110.00
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/k-g)
❑ > 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. Nutrient/Micronutrient Determination: Complete the following:
a. Total solids: 2.84 %.
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
micronutnent parameters:
Laboratory: Environmental Chemists, Inc. and Date of analysis: 04/30/2020
Parameter
Result
(mg/kg)
Aluminum
11,400.00
Ammonia -Nitrogen
4,130.00
Calcium
21,500.00
Magnesium
2,760.00
Nitrate -Nitrite Nitrogen
0.96
pH (Standard Unit)
7.25
Phosphorus
21,300.00
Potassium
3,700.00
Sodium
3,370.00
Total Kjeldahl Nitrogen
17,800.00
c. Using the results listed in Item II. 5b. above, calculate the sodium adsorption ration (SAR): 0.97
[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: 30 %. This rate
is a (check one): ❑ 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: This mineralization rate is
consistent with lime -stabilization and aerobic digestion processes.
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 (11h Year PAN
Five -Year
Maximum Adjusted PAN
img�kg)
(Mg/kg)
Surface
6,167
1 8,630
Injection/Incorporation
8,232
1 10,695
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: None
FORM: RSC 06-16 Page 4 of

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 I [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.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.I 106(b)(3)(E)-(K)] - Process to Further Reduce Pathogens (PFRP).
Specify one: ❑ composting, ❑ heat drying, ❑ heat treatment,
❑ thermophilic aerobic digestion, ❑ beta ray irradiation,
❑ gamma ray irradiation, or ❑ pasteurization.
b. For Land Application of Class B:
® Alternative 1 [15A NCAC 02T.I 106(c)(1)] - Fecal Coliform Density Demonstration.
® Alternative 2 [15A NCAC 02T.1106(c)(2)] - Process to Significantly Reduce Pathogens (PSRP).
Specify one: ❑ aerobic digestion, ❑ air drying, ❑ anaerobic digestion,
❑ composting, or ® lime stabilization.
c. For Surface Disposal:
❑ Select One of the Class A or Equivalent Pathogen Reduction Alternatives in Item II. 7a. above.
❑ Select One of the Class B or Equivalent Pathogen Reduction Alternatives in Item II. 7b. above.
❑ Exempt -If Daily Cover Alternative is chosen in Item 11.8. below [15A NCAC 02T.1106(a)(2)].
❑ Not Applicable - Non -Biological Residuals with NO Domestic Wastewater Contribution.
8. Vector Attraction Reduction (VAR): Per 15A NCAC 02T.1107, specify how residuals will meet the VAR requirements:
® Alternative 1 [15A NCAC 02T. I 107(a)(1)] - 38% Volatile Solids Reduction (Aerobic/Anaerobic Digestion).
❑ Alternative 2 [15A NCAC 02T. 1 107(a)(2)] - 40-Day Bench Scale Test (Anaerobic Digestion).
® Alternative 3 [15A NCAC 02T.I 107(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. 1 107(a)(6)] - Alkaline Stabilization.
❑ Alternative 7 [15A NCAC 02T.I 107(a)(7)] - Drying of Stabilized Residuals.
❑ Alternative 8 [15A NCAC 02T. 1107(a)(8)] - Drying of Unstabilized Residuals.
® Alternative 9 [15A NCAC 02T.1107(a)(9)] - Injection.
® Alternative 10 [15A NCAC 02T.I 107(a)(10)] - Incorporation.
❑ Alternative for Surface Disposal Units Only - Soil/Other Material Cover [ 15A NCAC 02T.I 107(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

Facility Vicinity Map

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SCALE: 1 "= 1,500 ft
Triple S Farms Facility
CHECKED BY: RTB Land Application Program Vicinity
RTB BRANCH Wallace WWTP Ma
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DATE: 1/8/2021 SOILS, LLC Project No. 200 / - / 1
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Wastetroatmt:otpt�

Process Flow Diagram and Narrative

WASTEWATER TREATMENT PLANT PROCESS
The Wallace Regional Waste Water Treatment Plant is a three basin Sequenced Batch Reactor (SBR)
system with a designed capacity of 5.2 mgd. It is an automated system with scada ran components.
It uses a defused air system to add dissolved oxygen to the waste water supplied by five belt driven
blowers. The plant is currently being utilized in two basin mode with an average flow of 1.2 mgd.
The third basin will be brought on line as soon as average flow reaches 3.0 mgd. This facility operates
under NPDES NC0003450 where it discharges to Little Rockfish Creek of the Cape Fear River Basin.
Flow enters the plant from two mains. One being a gravity line form the back side of the plant, the
other is a force main coming in the front of the plant. The force main is connected to the Town of
Burgaw. All of the flow comes together and flows through the headworks where it goes through a
spiral screen and most of the solids are removed. Next the flow is sent through the grit chamber where
flow is slowed to 1.5 ft/sec and the grit is settled out. Both the trash and the grit are placed in trash
bins that are taken offsite for disposal.
After the grit chamber, the wastewater flows to the influent wet well, where the plant's four influent
pumps are located. The waste water is pumped to one of the two SBR basins. Each basin has the
capacity of 1.87 mg. The following steps happen to the each basin to treat the raw waste water: mix
fill/ react -fill/ react/ settle/ decant/ sludge waste. Throughout the timed process floating mixers and
defused air are used to promote biological breakdown of the organics and to add oxygen creating the
aerobic environment.
At the end of the settle cycle, the clear water is decanted off the top. The water flows by gravity to
the post equalization tank where the flow is control feed to the two cloth disk filters. The disk filters
use a cloth medium to grab any solids that may have come out during the decant phase. As the water
passes through the cloth the solids are trapped and the clean water flows through. The disks are back
washed periodically or if the level of the disk filter basin reaches a preset height. All of these caught
solids are returned to the influent wet well and sent back the SBR basins. After filtering the clean

water goes through the disinfection part of the treatment process. This consists of two channels of
ultraviolet (UV) lights, with each channel containing three modules of 40 bulbs each. Once the water
has had contact with the with the UV lights, if flows through a series of weirs that feed the effluent
wet well. The effluent wet well consists of four pumps that pumps the treated waste water to the
discharge point of Little Rockfish Creek.
Near the end of the decant cycle, two pumps move sludge from the bottom of the SBR basin to the
digester. This digester can be aerated and mixed to prevent it from going septic. Sludge can be
decanted and settled out and moved to the sludge thickening basins for disposal.
A schematic diagram of the plant is found on the following page.

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4

Justification for Residuals Production Rate

JUSTIFICATION FOR WWTP RESIDUALS PRODUCTION RATE
Wallace Regional Waste Treatment Plant is currently operating at 1.2 million gallons per day (MGD).
This is much less than their current capacity of 5.2 MGD plant. Based on the size of the wastewater
plant and expected production, the dry tons are expected to remain the same at 330 dry tons for annual
production. This change is supported by the facility's current production amounts.

Residuals Sampling Plan

WWTP SAMPLING PLAN — TOWN OF WALLACE
Quarterly, multiple grab residual solid samples are collected from the sludge holding tanks. These
samples are composited for nutrient and metal analyses. The composited sample is mixed and aerated to
keep the solids suspended and containers filled for this analysis. Lime stabilization occurs when the
sludge holding tank reaches capacity. Lime is added to reach proper stabilization requirements for vector
attraction and pathogen reduction. Field measurements of pH and temperature are collected for each
stabilization event to insure pH requirements are met. pH values are later temperature corrected for
reporting purposes. The Town of Wallace may elect to meet pathogen reduction by the collection of 7
fecal samples. In addition, vector attraction reduction may be met by incorporation/injection into the soil
or collection of samples for the 30-day bench test for aerobic digestion or SOUR tests.
Quarterly, a composite residual solid sample will be analyzed for: Arsenic, Cadmium, Copper, Lead,
Mercury, Molybdenum, Nickel, Selenium, Zinc, Aluminum, Ammonia — Nitrogen, Calcium, Nitrate -
Nitrite, Nitrogen, Magnesium, % Total Solids, pH, Phosphorus, Potassium, TKN, and Sodium. From this
information, the Plant Available Nitrogen (PAN) and Sodium Adsorption Ratio (SAR) will be calculated.
Annually (if application occurs) a composite TCLP sample will be collected to include:
Arsenic
Hexachlorobenzene
ph for Corrosivity
Barium
Hexachloro-1,3-Butadiene
Benzene
Hexachloroethane
Flash point for ignitability
Cadmium
Lead
Carbon Tetrachloride
Lindane
Sulfides and Cyanides for reactivity
Chlordane
Mercury
1,2-Dichloroethane
Chlorobenzene
Methoxychlor
1,1-Dichloroethylene
Chloroform
Methyl Ethyl Ketone
2,4-Dinitrotoluene
Chromium
Nitrobenzene
Endrin
m-Cresol
Pentachlorophenol
Heptachlor and its Hydroxide
o-Cresol
Pyridine
Trichloroethylene
p-Cresol
Selenium
2,4,5-Trichlorophenol
Cresol
Silver
2,4,6-Trichlorophenol
2,4-D
Tetrachloroethylene
2,4,5-TP (Silvex)
1,4-Dichlorobenzene
Toxaphene
Vinyl Chloride

Analytical Data From Town of Wallace WWTP
TCLP, Nutrient & Metal and Fecals

FPO",—. -2 -q"7 Environmental Chemists, Inc.
envirochem 6602 Windmill Way, Wilmington, NC 23405 • 910.392.0223 Lab • 910.392.4424 Fax
710 Bowsertown Road, Manteo, NC 27954 • 252.473.5702 Lab/Fax
255-A Wilmington Highway, Jacksonville, NC 28540 • 910.347.5843 Lab/Fax
ANALYTICAL & CONSULTING CHEMISTS info eoenvironnientalcilemists.com
Branch Residuals/Bob Branch
Date of Report: Jan 28, 2020
Customer PO #:
Customer ID: 15060009
Attention:
Report #: 2020-00160
Project ID: WWTP LTMP
Lab ID Sample ID:
Collect Date/Time Matrix Sampled by
20-00344 Site: Sludge
1/6/2020
10:50 AM Solid/Sludge Lisa Cottle
Test
Method
Results
Date Analyzed
Chlordane (TCLP)
SW 846 Method 808113/3510
<0.02 mg/L
01/10/2020
Endrin (TCLP)
SW 846 Method 808113/3510
<0.0005 mg/L
01/10/2020
Heptachlor (TCLP)
SW 846 Method 8081B13510
<0.0005 mg/L
01/10/2020
Heptachlor epoxide (TCLP)
SW 846 Method 8081 B1351 0
<0.0005 mg/L
01/10/2020
Lindane (TCLP)
SW 846 Method 80818/3510
<0.0005 mg/L
01/10/2020
Methoxychlor (TCLP)
SW 846 Method 8081813510
<0.0005 mg/L
01/10/2020
Toxaphene (TCLP)
SW 846 Method 8081813510
<0.05 mg/L
01/10/2020
1,4-Dichlorobenzene (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
01/08/2020
2,4,5-Trichlorophenol (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
01/08/2020
2,4,6-Trichlorophenol (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
01/08/2020
2,4-Dinitrotoluene (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
01/08/2020
Cresol (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
01/08/2020
Hexachloro-1,3-butadiene (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
01/08/2020
Hexachlorobenzene (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
01/08/2020
Hexachloroethane (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
01/08/2020
m + p-Cresol (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
01/08/2020
Nitrobenzene (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
01/08/2020
o-Cresol (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
01/08/2020
Pentachlorophenol (TCLP)
SW 846 method 8270/3510
<0.250 mg/L
01/08/2020
Pyridine (TCLP)
SW 846 method 8270t3510
<0.050 mg/L
01/08/2020
2,4,5-TP (TCLP)
SW846 Method 8151A
<0.003 mg/L
01/09/2020
2,4-D (TCLP)
SW846 Method 8151A
<0.003 mg/L
01/09/2020
1,1-Dichloroethylene (TCLP)
SW846 Method 8260/5030
<0.01 mg/L
01/09/2020
1,2-Dichloroethane (TCLP)
SW846 Method 8260/5030
<0.01 mg/L
01/09/2020
Benzene (TCLP)
SW846 Method 8260/5030
<0.01 mg/L
01/09/2020
Carbon Tetrachloride (TCLP)
SW846 Method 8260/5030
<0.01 mg/L
01/09/2020
Report # : 2020.00160
Page 1 of 4

envirochem
(�n
ANALYTICAL & CONSULTING CHEMISTS
FF17-741
Environmental Chemists, Inc.
6602 Windmill Way, Wilmington, NC 28405 • 910.392.0223 Lab • 910.392.4424 Fax
710 Bowsertown Read, Manteo, NC 27954 • 252.473.5702 Lab/Fax
255-A Wilmington Highway, Jacksonville, NC 28540 C 9"10.347.5843 Lab/Fax
info a;environnientalchemists.com
Branch Residuals/Bob Branch
Date of Report: Jan 28, 2020
Customer PO #:
Customer ID: 15060009
Attention:
Report #: 2020-00160
Project ID: WWTP LTMP
Chlorobenzene (TCLP)
SW846 Method 8260/5030
<0.01 mg/L
01/09/2020
Chloroform (TCLP)
SW846 Method 8260/5030
<0.01 mg/L
01/09/2020
Methyl ethyl ketone (TCLP)
SW846 Method 8260/5030
0.06 mg/L
01/09/2020
Tetrachloroethylene (TCLP)
SW846 Method 8260/5030
<0.01 mg/L
01/09/2020
Trichloroethylene (TCLP)
SW846 Method 8260/5030
<0.01 mg/L
01/09/2020
Vinyl Chloride (TCLP)
SW846 Method 0260/5030
<0.01 mg/L
01/09/2020
RCI
Cyanide
EPA 335.4
<0.125 mg/kg
01/08/2020
Reporting limit elevated due to
matrix interference.
Sulfide
SM 4500 S D
0.32 mg/kg
01/10/2020
Ignitability
SW 846 method 1010
>205 °F
01/10/2020
Sludge Residuals
Aluminum
EPA 200.7
13400 mg/kg
01/07/2020
Arsenic
EPA 200 7
<11.7 mg/kg
01/07/2020
Cadmium
EPA 2007
<11.7mg/kg
01/07/2020
Calcium
EPA 200 7
28000 mg/kg
01/07/2020
Chromium
EPA 200 7
32.5 mg/kg
01/07/2020
Copper
EPA 200 7
989 mg/kg
01/07/2020
Lead
EPA 200 7
64.9 mg/kg
01/07/2020
Magnesium
EPA 200.7
3390mg/kg
01/07/2020
Molybdenum
EPA 200 7
<11.7 mg/kg
01/07/2020
Nickel
EPA 2007
22.1 mg/kg
01/07/2020
Potassium
EPA 200 7
4600 mg/kg
01/07/2020
Selenium
EPA 200.7
<11.7 mg/kg
01/07/2020
Sodium
EPA 200.7
6550 mg/kg
01/13/2020
Zinc
EPA 200.7
1400 mg/kg
01/07/2020
Nitrate+Nitrite-Nitrogen
EPA353.2
3050mg/kg
01/13/2020
Total Solids (%)
SM 2540 B
1.74 %
01/06/2020
pH
SM 4500 H 8
5.92 units
01/20/2020
Ammonia Nitrogen
SM 4500 NH3 C
<5.75 mg/kg
01/08/2020
Report 8:: 2020-00160 Page 2 of 4

envirochem
117)
ANALYTICAL & CONSULTING CHEMISTS
Environmental Chemists, Inc.
6602 Windmill Way, Wilmington, NC 28405 • 910.392.0223 Lab • 910.392.4424 Fax
710 Bowsertown Road, Manteo, NC 27954 • 252.473.5702 Lab/Fax
255-A Wilmington Highway, Jacksonville, NC 28540 • 910.347.5843 Lab/Fax
inro(cienvrronmen talcheniisls.com
Branch Residuals/Bob Branch
Date of Report: Jan 28, 2020
Customer PO #:
Customer ID: 15060009
Attention:
Report #: 2020-00160
Project ID: WWTP LTMP
Total Kjeldahl Nitrogen (TKN)
SM 4500 Org B
35000 mg/kg
01/08/2020
Total Phosphorus
SM 4500 P F
24400 mg/kg
01 /10/2020
Mercury
SW8467471B
1.97mg/kg
01/17/2020
TCLP Metals
Arsenic
EPA 2007
<1.0mg/L
01/13/2020
Barium
EPA 200 7
<1.0 mg/L
01/13/2020
Cadmium
EPA 200 7
<1.0 mg/L
01/13/2020
Chromium
EPA 2007
<1.0mg/L
01/13/2020
Lead
EPA 200 7
<1.0 mg/L
01/13/2020
Selenium
EPA 200 7
<1.0 mg/L
01/13/2020
Silver
EPA 200 7
<1.O mg/L
01/13/2020
Mercury
EPA 245 1
<0.0002 mg/L
01/20/2020
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
20-00346 Site: 001 1/6/2020 10:50 AM Solid/Sludge Lisa Cottle
Test Method Results Date Analyzed
Total Solids (%)
SM 2540 B
1.91 % 01/06/2020
Fecal Density
SM 9221C E MPN 24 hr 503
<943 MPN/g 01/06/2020
Lab ID Sample ID:
Collect Date/Time
Matrix Sampled by
20-00348 Site: 002
1/6/2020 10:50 AM
Solid/Sludge Lisa Cottle
Test
Method
Results Date Analyzed
Total Solids (%)
SM 2540 B
1.57 % 01/06/2020
Fecal Density
SM 9221C E MPN 24 hr 503
<1147 MPN/g 01/06/2020
Lab ID Sample ID:
Collect Date/Time
Matrix Sampled by
20-00349 Site: 003
1/6/2020 10:50 AM
Solid/Sludge Lisa Cottle
Test
Method
Results Date Analyzed
Total Solids (%)
SM 2540 B
1.91 % 01/06/2020
Fecal Density
SM 9221C E MPN 24 hr 503
<943 MPN/g 01/06/2020
Report # 2020-00160 Page 3 of 4

POW""'.
SM
ANALYTICAL & CONSULTING CHEMISTS
Environmental Chemists, Inc.
6602 Windmill Way, Wilmington, NC 28405 • 910.392.0223 Lab • 910.392.4424 Fax
710 Bowsertown Road, Nlanteo, NC 27954 • 252.473.5702 Lab/Fax
255-A Wilmington Highway, Jacksonville, NC 28540 • 910.347.5843 Lab/Fax
into((�em•ironnientalchemists.coni
Branch Residuals/Bob Branch
Date of Report: Jan 28, 2020
Customer PO #:
Customer ID: 15060009
Attention:
Report #: 2020-00160
Project ID: WWTP LTMP
Lab ID Sample ID:
Collect Date/Time Matrix Sampled by
20-00350 Site: 004
1/6/2020
10:50 AM Solid/Sludge Lisa Cottle
Test
Method
Results Date Analyzed
Total Solids (%)
SM 2540 B
1.86 % 01/06/2020
Fecal Density
SM 9221C E MPN 24 hr 503
<968 MPN/g 01/06/2020
Lab ID Sample ID:
Collect Date/Time Matrix Sampled by
20-00351 Site: 005
1/6/2020
10:50 AM Solid/Sludge Lisa Cottle
Test
Method
Results Date Analyzed
Total Solids (%)
SM 2540 B
1.81 % 01/06/2020
Fecal Density
SM 9221C E MPN 24 hr 503
<995 MPN/g 01/06/2020
Lab ID Sample ID:
Collect Date/Time Matrix Sampled by
20-00352 Site: 006
1/6/2020
10:50 AM Solid/Sludge Lisa Cottle
Test
Method
Results Date Analyzed
Total Solids (%)
SM 2540 B
1.83 % 01/06/2020
Fecal Density
SM 9221C E MPN 24 hr 503
<984 MPN/g 01/06/2020
Lab ID Sample ID:
Collect Date/Time Matrix Sampled by
20-00353 Site: 007
1/6/2020
10:50 AM Solid/Sludge Lisa Cottle
Test
Method
Results Date Analyzed
Total Solids (%)
SM 2540 B
1.61 % 01/06/2020
Fecal Density
SM 9221C E MPN 24 hr 503
<1119 MPN/g 01/06/2020
Comment: Sludge residuals reported on a dry weight basis.
1 r
Reviewed by:
,
Report #.. 2020-00160 Page 4 of 4

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[enviroichem
ANALYTICAL & CONSULTING CHEMISTS
Environmental Chemists, Inc.
6602 Windmill Way, Wilmington, NC 28405 • 910.392.0223 Lab • 910.392.4424 Fax
710 Bowsertown Road, Nlanteo, NC 27954 • 252.473.5702 Lab/Fax
255-A Wilmington Highway, Jacksonville, NC 28540 • 910.347.5843 Lab/ Fax
into rr?environmentalchemists.com
Town of Wallace Date of Report: Apr 30, 2020
316 E. Murray Street Customer PO #:
Wallace NC 28466 Customer ID: 09010063
Attention: Brent Dean, ORC (WWTP) Report #: 2020-06497
Project ID: WWTP Sludge
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
20-16001 Site: Sludge 4/20/2020 10:20 AM Solid/Sludge Grayson Powell/ Lisa Cottle
Test
Method
Results
Date Analyzed
Sludge Residuals
Aluminum
EPA 200.7
11400 mg/kg
04/22/2020
Arsenic
EPA 200.7
<17.3 mg/kg
04/22/2020
Cadmium
EPA 200.7
<17.3 mg/kg
04/22/2020
Calcium
EPA 200.7
21500 mg/kg
04/22/2020
Chromium
EPA 200.7
27.1 mg/kg
04/22/2020
Copper
EPA 200.7
669 mg/kg
04/22/2020
Lead
EPA 200.7
47.2 mg/kg
04/22/2020
Magnesium
EPA 200.7
2760 mg/kg
04/22/2020
Molybdenum
EPA 200 7
<17.3 mg/kq
04/22/2020
Nickel
EPA 200 7
<17.3 mg/kg
04/22/2020
Potassium
EPA 200 7
3700 mg/kg
04/22/2020
Selenium
EPA 200 7
<17.3 mg/kg
04/22/2020
Sodium
EPA 200 7
3370 mg/kg
04/28/2020
Zinc
EPA 200 7
1110 mg/kg
04/22/2020
Nitrate+Nitrite-Nitrogen
EPA 353 2
0.96 mg/kg
04/24/2020
Total Solids (%)
SM 2540 B
2.84 %
04/21/2020
pH
SM 4500 H B
7.25 units
04/29/2020
Ammonia Nitrogen
SM 4500 NH3 C
4130 mg/kg
04/21/2020
Total Kjeldahi Nitrogen (TKN)
SM 4500 Org B
17800 mg/kg
04/22/2020
Total Phosphorus
SM 4500 P F
21300 mg/kg
04/29/2020
Mercury
Sw8467471B
346mg/kg
04/21/2020
Report # 2020-06497 Paae t of 3

!S,rJn.
ANALYTICAL & CONSULTING CHEMISTS
Environmental Chemists, Inc.
6602 Windmill "lay, Wiltniltgton, NC 28409 • 910.392.0223 Lab • 910.392.4424 Fat
710 Bowsertown Road, Manteo, NC 27954 • 252.473.5702 Lab/Fax
255-.A Wilmington Flighwav, Jacksonville, NC 28540 • 910.347.5843 Lab/Fax
into(cienaironmentalchemists.com
Town of Wallace Date of Report: Apr 30, 2020
316 E. Murray Street Customer PO #:
Wallace NC 28466 Customer ID: 09010063
Attention: Brent Dean, ORC (WWTP) Report #: 2020-06497
Project ID: WWTP Sludge
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
20-16003 Site: 001 4/20/2020 10:20 AM Water Grayson Powell/ Lisa Cottle
Test Method Results Date Analyzed
Total Solids (%) SM 2540 B 2.62 % 04/21 /2020
Fecal Density SM 9221C E MPN 24 hr 503 49619 MPN/g 04/20/2020
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
20-16004 Site: 002 4/20/2020 10:20 AM Water Grayson Powell/ Lisa Cottle
Test Method Results Date Analyzed
Total Solids (%) SM 2540 B 2.78 % 04/21 /2020
Fecal Density SM 9221C E MPN 24 hr 503 28418 MPN/g 04/20/2020
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
20-16005 Site: 003 4/20/2020 10:20 AM Water Grayson Powell/ Lisa Cottle
Test Method Results Date Analyzed
Total Solids (%
Fecal Density
Lab ID Sample ID:
20-16006 Site:004
Test
SM 2540 B 2.78 % 04/21 /2020
SM 9221C E MPN 24 hr 503 28418 MPN/g 04/20/2020
Collect Date/Time Matrix Sampled by
4/20/2020 10:20 AM Water Grayson Powell/ Lisa Cottle
Method
Results Date Analyzed
Total Solids (%) SM 2540 B 2.67 % 04/21 /2020
Fecal Density SM 9221C E MPN 24 hr 503 29589 MPN/g 04/20/2020
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
20-16007 Site: 005 4/20/2020 10:20 AM Water Grayson Powell/ Lisa Cottle
Test Method Results Date Analyzed
Total Solids (%) SM 2540 B 2.96 % 04/21/2020
Fecal Density SM 9221C E MPN 24 hr 503 43919 MPN/g 04/20/2020
Report # 2020.06497 Paqe 2 of 3

www-
envirochem
ANALYTICAL & CONSULTING CHEMISTS
Environmental Chemists, Inc.
6602 Windmill Way, Wilmington, NC 28405 • 910.392.0223 Lab ° 910.392.4424 Fax
710 Bowsertown Road, Manteo, NC 27954 • 252.473.5702 Lab/ Fax
255-A Wilmington Highway, Jacksonville, NC 28540 • 910.347.5843 Lab/Fax
infota environmetltalchetnists.com
Town of Wallace Date of Report: Apr 30, 2020
316 E. Murray Street Customer PO #:
Wallace NC 28466 Customer ID: 09010063
Attention: Brent Dean, ORC (WWTP) Report #: 2020-06497
Project ID: WWTP Sludge
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
20-16008 Site: 006 4/20/2020 10:20 AM Water Grayson Powell/ Lisa Cottle
Test Method Results Date Analyzed
Total Solids (%)
Fecal Density
Lab ID Sample ID:
20-16009 Site:007
Test
Total Solids (%)
Fecal Density
SM 2540 B
SM 9221 C E MPN 24 hr 503
2.71 % 04/21 /2020
339484 MPN/g 04/20/2020
Collect Date/Time Matrix
4/20/2020 10:20 AM Water
Method
SM 2540 B
SM 9221 C E MPN 24 hr 503
Results
Sampled by
Grayson Powell/ Lisa Cottle
Date Analyzed
3.03 % 04/21 /2020
115512 MPN/g 04/20/2020
Comment: Sludge residuals,
except pH, reported on a dry weight basis. pH reported on an as received basis.
Reviewed by: � a �I'D& Qwat
Report #:: 2020-06497 Paqe 3 of 3

Environmental Chemist, Inc., Wilmington, NC Lab #94
6602 Wnomill Wav
Wilmington, NC 28405
910.392 0223
Sample Receipt Checklist
Client
' • `
WjL�t,l�
4 fap /QzU
Oate
( Report Number:L
Receipt of sample.
Delivere
O
' C7
YES
❑
NO
N/A
UPS D FedEi D Other ❑
1 Were custody seals
YES ❑ NO N/A
�Orig,nal temperature
present on the cooler?
2. If custody seals were present, were they
upon
Now temperature taken:
intact/
receipt 16 unbroken?
s?
Corrected
❑ Temperature Blank temperature upon receipt QC
IR Gun ID:
Thomas Traceable S/N 192511657 I'llAgainst Bottles
�❑
YES
O
NO
IR Gun Correction Factor'C: 0.0
3 If temperature of cooler
YES
O
NO
exceeded 6'C, was Pro ect M r.11
4 Were proper custod I g /� notified
Y procedures
YES
O
NO
(relinquished/received) followed?
sample
5• Were sam a ID's listed on the COCA
YES
YES
O
❑
NO
NO
6. Were samples ID's listed on sample containers?
YE5
O
NO
7. Were collection date and time listed on the COC?
8.
YES
O
NO
Were tests to be performed listed on the COC?
9.
g
YES
O
NO
Did samples arrive in proper containers for each test?
10. Did samples arrive in
YES
O
NO
food condition for each test?
11. Was adequate sample
YES
O
NO
volume available?'
12. Were samples received
❑
YES
O
NO
within ig tom�2�•requested tests
13. Were acid preserved samples
D
YES
❑
NO
received atlafpH
14. Were cyanide samples
O
YES
O
NO
received at a pH >12?
15. Were sulfide samples received
D
YES
O
NO
at a pH >9?
1. Were NH3/TKN/Phenol
❑
YES
O
NO
received at a chlorine residual of c0,5 m/L ? S.
17. Were Suflide/Cyanide
received at a chlorine residual of <0.5 m/L�
1' TOC/VolstIks are pH checked at time of anali and recorded on the Bacteria samplesbenchsheet
are checked for Chlorine at tame of analys's and recorded on the benchsheet
Sample Preuryatlon: (Must be completed for any samples► incorrect)
Samples) Y preserved or with headspace)
were received incorrectly preserved and were adjusted accordingly
cy adding (circle one) H SO
Time ofPreservation= HNOj NCI NaOH
Note, Notify If more than one preservative is needed, notate in comments below
Gusto"wr service immed,att
W for m[OrretSiy preservep faRlplts, Obtain a new fa
notify the state lob if directed to analv:ed b, the customers notifiedA— and te
Who wa,
Volatiles Samples) rine
were received with headspace
LOMMFatTc
r'111r n• 11n1
vv�.. ♦an. vvc

ENVIRONMENTAL CHEMISTS INC 6602Windmd,Way, Wilmmgton,NC25405
/ Office•. 910-39. 0223 Fax: [phone]
Analytical & Consulting Chemists NCDENR: DWQ certification #94 NHCDHHS: DLS certification #37729 [e-mail]
Collection and Chain of Custody
Client: Town of Wallace WWTP
Project name: WWTP LTMP-sludge samples
Report No:
Address: 316 E Murray St
Contact name:
PO No:
Wallace, NC 28466
Report To: Lisa Cottle, ORC
Phone/Fax: Lisa 910-285-5927
Copy to: Brent Dean, [e-mail]
Email: [e-mail]
Sampled by: JWQ.
I S&A L V R
SAMPLE TYPE: 1= Influent, E= Effluent, W=Well, ST= stream, SO= Soil, SL=Sludge, Other:
Sample Identification
collection
Gi n
n
n
°u o
a
° o
aj
o
u E
E
z
Preservation
Analysis required
date
time
temp
C
Zo
J
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0 Ln
=
O
i
p
z
_
o
Sludge -(Quarterly)
G
P
1(-OL
t
X
X
X
CN
Ag,As,Cd,Cr,Cu,Hg,Mo,Ni,Pb,Se,Zn
Total N
1. sludge
G
P
(�, 00.5.
X
Fecal Density,%TS
2. sludge
G
P
0e, Lf
X
Fecal Density,% TS
3. sludge
G
P
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X
Fecal Density,%TS
4. sludge
G
P
I,, DO
X
Fecal Density,% TS
5. sludge
G
P
Lo oL)
X
Fecal Density,%TS
6. sludge
G
P
112W
X
Fecal Density,%TS
7. sludge
G
P
1. 1,9 0U9
X
Fecal Density,%TS
sluge (annual)
TCLP,RCI
Al
NH3-N,Mg,Ph,plant aval. N,Ca, SAR
NO3+NO2,P, K,Na, TKN,
Transfer R
' quished By:
Date/time
Receive y•
Date/time
1
�oa�
2
temp when received: + Accepted: Rejected: Resample:
delivered By: Received by: date/time '� , /(� . -v rr-
Comments: turnaround:

RESIDUALS SOURCE CERTIFICATION ATTACHMENT
Murphy Brown — Warsaw Sanitation Trailer Wash

State of North Carolina
DWR
Department of Environmental Quality
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

State of North Carolina
DW
R
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: Murphy Brown, LLC — Warsaw Sanitation Trailer Wash
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: Michael Norris — LNM Specialist
Complete mailing address: Post Office Box 856
City: Warsaw State: NC Zip: 28398-
Telephone number: (210J 293-5575 E-mail address: mnorrisAsmithfield.com
4. Facility physical address: 135 Old Courthouse Road
City: Warsaw State: NC Zip: 28398-
Coordinates: Latitude: 34' 59' 41.5" Longitude: 7V 8' 54.96"
Datum: NAD 83 Level of accuracy: I second
Method of measurement: Mau
5. Purpose of the facility:
❑ treatment of municipal wastewater, ❑ treatment of 100% domestic wastewater,
❑ treatment of potable water, ❑ treatment of 100% industrial wastewater,
❑ treatment of industrial wastewater mixed with domestic wastewater,
(approximate percentages: % industrial and % domestic)
® other (explain: Trailer Wash ).
6. Does the facility have an approved pretreatment program: ❑ Yes ® No
7. Facility permitted/design flow: 0.02 MGD and facility average daily flow: 0.01 MGD
8. Average amount of residuals being generated at this facility 63 dry tons per year.
9. Specify the following regarding treatment and storage volumes available at the facility:
Type and volume of residuals treatment: 1.33 acre lagoon X 6ft
Type and volume of residuals storage (i.e., outside of residuals treatment units): None
II. 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
FORM: RSC 06-16 Page 1 of
5

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).
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: ❑ yes ® no.
If yes, list the number(s):
b. Specify whether or not the residuals exhibit any of the characteristics defined by 40 CFR §261.21-
261.24: ❑ yes ® no.
Fill in the following tables with the results of the latest toxicity characteristic leaching procedure (TCLP) analysis as well
as those for corrosivity, ignitability, and reactivity:
Laboratory: Environmental Chemists, Inc. and Date of analysis: 12/17/2020
Passed corrosivity test: ® yes ❑ no. pH: s.u. (2 < pH < 12.5)
Passed ignitability test: ® yes ❑ no. Flashpoint: >210 IF (> 140°F)
Passed reactivity test: ® yes ❑no. HCN: 2.31 mg/kg (<250) & H2S: 1.23 mg/kg (<500)
TCLP Parameter
Limit
(Mg/1)
Result
(Mg/1)
TCLP Parameter
Limit
(mg/1)
Result
(mg/1)
Arsenic
5.0
<1.000
Hexachlorobenzene
0.13
<0.050
Barium
100.0
<1.000
Hexachloro-1,3-Butadiene
0.5
<0.050
Benzene
0.5
<0.010
Hexachloroethane
3.0
<0.050
Cadmium
1.0
<1.000
Lead
5.0
<1.00
Carbon Tetrachloride
0.5
<0.010
Lindane
0.4
<0.0005
Chlordane
0.03
<0.020
Mercury
0.2
<0.0002
Chlorobenzene
100.0
<0.010
Methoxychlor
10.0
<0.0005
Chloroform
6.0
<0.010
Methyl Ethyl Ketone
200.0
<0.050
Chromium
5.0
<1.000
Nitrobenzene
2.0
<0.050
m-Cresol
200.0
<0.050
Pentachlorophenol
100.0
<0.250
o-Cresol
200.0
<0.050
Pyridine
5.0
<0.050
p-Cresol
200.0
<0.050
Selenium
1.0
<1.00
Cresol
200.0
<0.050
Silver
5.0
<1.00
2,4-D
10.0
<0.003
Tetrachloroethylene
0.7
<0.010
1,4-Dichlorobenzene
7.5
<0.050
Toxaphene
0.5
<0.050
1,2-Dichloroethane
0.5
<0.010
Trichloroethylene
0.5
<0.010
1,1-Dichloroethylene
0.7
<0.010
2,4,5-Trichlorophenol
400.0
<0.050
2,4-Dinitrotoluene
0.13
<0.050
2,4,6-Trichlorophenol
2.0
<0.050
Endrin
0.02
<0.0005
2,4,5-TP (Silvex)
1.0
<0.003
Heptachlor and its Hydroxide
0.008
<0.0005
Vinyl Chloride
0.2
<0.010
FORM: RSC 06-16 Page 2 of 5

4. Metals Determination: Complete one of the following tables (i.e., as applicable) to demonstrate that the residuals do not violate
the ceiling concentrations for metals regulated under 15A NCAC 02T .1105.
a. For Distribution/Land Application: Fill in the following table with the results of the latest analyses (i.e., on a dry weight
basis) for the following metal parameters:
Laboratory: Environmental Chemists, Inc. and Date of analysis: 12/17/2020
Parameter
Ceiling
Concentration Limits
(ClassA & ClassB)
(mg/kg)
Monthly Average
Concentration Limits
(Class A Only)
(mglkP)
Result
(mgA-g)
Arsenic
75
41
8.29
Cadmium
85
39
<7.49
Copper
4,300
1,500
228.00
Lead
840
300
<7.49
Mercury
57
17
<0.27
Molybdenum
75
n/a
<7.49
Nickel
420
420
<7.49
Selenium
100
100
<7.49
Zinc
7,500
2,800
1,570.00
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/k-g)
❑ > 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. Nutrient/Micronutrient Determination: Complete the following:
a. Total solids: 6.48 %.
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
nucronutnent parameters:
Laboratory: Environmental Chemists, Inc. and Date of analysis: 12/17/2020
Parameter
Result
(mg1kg)
Aluminum
4,430.00
Ammonia -Nitrogen
1,130.00
Calcium
4,600.00
Magnesium
702.00
Nitrate -Nitrite Nitrogen
2.75
pH (Standard Unit)
6.91
Phosphorus
2,610.00
Potassium
1,540.00
Sodium
829.00
Total Kjeldahl Nitrogen
5,460.00
c. Using the results listed in Item II. 5b. above, calculate the sodium adsorption ration (SAR): 0.76
[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: 30 %. This rate
is a (check one): ® 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: This mineralization rate is
consistent with primary treatment.
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 (lsh Year PAN
Five -Year
Maximum Adjusted PAN
Surface
1,867
1 2,647
Injection/ Incorporation
2,432
1 3,212
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: None
FORM: RSC 06-16 Page 4 of

7. Pathogen Reduction: Per 15A NCAC 02T.11061 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.I 106(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.I 106(b)(3)(E)-(K)] - Process to Further Reduce Pathogens (PFRP).
Specify one: ❑ composting, ❑ heat drying, ❑ heat treatment,
❑ thermophilic aerobic digestion, ❑ beta ray irradiation,
❑ gamma ray irradiation, or ❑ pasteurization.
b. For Land Application of Class B:
® Alternative 1 [15A NCAC 02T.I 106(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, ❑ anaerobic digestion,
❑ composting, or ® lime stabilization.
c. For Surface Disposal:
❑ Select One of the Class A or Equivalent Pathogen Reduction Alternatives in Item II. 7a. above.
❑ Select One of the Class B or Equivalent Pathogen Reduction Alternatives in Item II. 7b. above.
❑ Exempt -If Daily Cover Alternative is chosen in Item 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.I 107(a)(3)] - 30-Day Bench Scale Test (Aerobic Digestion).
® Alternative 4 [15A NCAC 02T. 1 107(a)(4)] - Specific Oxygen Uptake Rate Test (Aerobic Digestion).
❑ Alternative 5 [15A NCAC 02T.I 107(a)(5)] - 14-Day Aerobic Processes.
® Alternative 6 [15A NCAC 02T.I 107(a)(6)] - Alkaline Stabilization.
❑ Alternative 7 [15A NCAC 02T.1107(a)(7)] - Drying of Stabilized Residuals.
❑ 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

Facility Vicinity Map

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Sources: Esri. HERE, Del-orme, USGS. Intermap, INCREMENT P,
NRCan, Esri Japan, METi, Esri China (Hong Kong), Esri Korea, Esn
(Thailand), Mapmylndia, NGCC, J OpenStreetMap contributors, and the
GIs User Community
Triple S Farms Facility
CHECKEDBY: RTB Land Application Program Vicinity
RTB �TBRANCH MB Warsaw Trailer Wash WWTP Ma
DRAWN BV: RESIDUALS
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DATE:
1/8/2021 & SOILS, LLC Project No. 2007- / 1

Process Flow Diagram and Narrative

TREATMENT PLANT PROCESS
The Murphy Brown Warsaw Sanitation Trailer Wash is permitted at 7.3 million gallon per year. Fresh
water is metered and used to wash the trailers in the truck bays. The wash water from the trucks
enters a solids separation unit (SWEECO) where solids are retained and liquids are sent to the lagoon.
Solids are collected in a roll off container and picked up By McGill Environmental Systems. Water
from the lagoon is pumped to one of thirteen spray fields totaling 32.46 acres under permit
WQ0023310.
A schematic diagram of the plant is found on the following page.

Justification for Residuals Production Rate

JUSTIFICATION FOR WWTP RESIDUALS PRODUCTION RATE
Based on the size of the lagoon as this facility and a current review of a sludge survey, the approximate
amount of residuals that it will contain at the time of cleanout will be increased from 50 to 63 dry
tons, based on the recent production rates. This is an approximation at best and may be changed based
on the actual haul events.

Residuals Sampling Plan

SAMPLING PLAN — MURPHY BROWN — WARSAW SANITATION TRAILER WASH
Annually, multiple grab residual solid samples are collected from the trailer wash lagoon. These
samples are composited for nutrient and metal analyses. The composited sample is mixed to keep the
solids suspended and containers filled for this analysis. Lime stabilization occurs when the lagoon
reaches capacity. Lime is added to reach proper stabilization requirements for vector attraction and
pathogen reduction. Field measurements of pH and temperature are collected for each stabilization
event to insure pH requirements are met. pH values are later temperature corrected. The facility may
elect to meet pathogen reduction by the collection of 7 fecal samples. In addition, vector attraction
reduction may be met be a 40-day anaerobic digestion test or by injection or incorporation.
Annually, or when the residual solids are to be land applied if application occurs less than annually,
a composite residual solid sample will be analyzed for: Arsenic, Cadmium, Copper, Lead, Mercury,
Molybdenum, Nickel, Selenium, Zinc, Aluminum, Ammonia — Nitrogen, Calcium, Nitrate -Nitrite,
Nitrogen, Magnesium, % Total Solids, pH, Phosphorus, Potassium, TKN, and Sodium. From this
information, the Plant Available Nitrogen (PAN) will be calculated. Once a permit cycle, a composite
TCLP sample will be collected to include:
Arsenic
Hexachlorobenzene
ph for Corrosivity
Barium
Hexachloro-1,3-Butadiene
Benzene
Hexachloroethane
Flash point for ignitability
Cadmium
Lead
Carbon Tetrachloride
Lindane
Sulfides and Cyanides for reactivity
Chlordane
Mercury
1,2-Dichloroethane
Chlorobenzene
Methoxychlor
1,1-Dichloroethylene
Chloroform
Methyl Ethyl Ketone
2,4-Dinitrotoluene
Chromium
Nitrobenzene
Endrin
m-Cresol
Pentachlorophenol
Heptachlor and its Hydroxide
o-Cresol
Pyridine
Trichloroethylene
p-Cresol
Selenium
2,4,5-Trichlorophenol
Cresol
Silver
2,4,6-Trichlorophenol
2,4-D
Tetrachloroethylene
2,4,5-TP (Silvex)
1,4-Dichlorobenzene
Toxaphene
Vinyl Chloride

Analytical Data From the Murphy Brown Warsaw Sanitation Trailer Wash
TCLP and Nutrient & Metal

ro"', _.- _. '0""1 Environmental Chemists, Inc.
envirochem 6602 Windmill Way, Wilmington, NC 28405 • 910.392.0223 Lab • 910.392.4424 Fax
710 Bowsertown Road, Manteo, NC 27954 ■ 252.473.5702 Lab/Fax
-255-A Wilmington Highway, Jacksonville, NC 28540 • 910.347.5843 Lab/Fax
ANALYTICAL & CONSULTING CHEMISTS infoLenvironmentalchemists.com
Smithfield Hog Productions -Warsaw Date of Report: Dec 17, 2020
Post Office Box 856 Customer PO M
Warsaw NC 28398 Customer ID: 08110011
Attention: Report M 2020-19677
Project ID: Warsa4&&k_W �
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
20-50057 Site: Residuals 11118/2020 10:21 AM Solid/Sludge James Cox
Test Method Results Date Analyzed
Cyanide
SM 4500 CN D
2.31 mg/kg
11 /30/2020
Chlordane (TCLP)
SW 846 Method 80818/3510
<0.02 mg/L
12/02/2020
Endrin (TCLP)
SW 846 Method 80818/3510
<0.0005 mg/L
12/02/2020
Heptachlor (TCLP)
SW 846 Method 80818/3510
<0.0005 mg/L
12/02/2020
Heptachlor epoxide (TCLP)
SW 846 Method 8081B/3510
<0.0005 mg/L
12/02/2020
Lindane (TCLP)
SW 846 Method 8081B/3510
<0.0005 mg/L
12/02/2020
Methoxychlor (TCLP)
SW 846 Method 80818/3510
<0.0005 mg/L
12/02/2020
Toxaphene (TCLP)
SW 846 Method 8081W3510
<0.05 mg/L
12/02/2020
1,4-Dichlorobenzene (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
12/01/2020
2,4,5-Trichlorophenol (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
12/01/2020
2,4,6-Trichlorophenol (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
12/01/2020
2,4-Dinitrotoluene (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
12/01/2020
Cresol (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
12/01/2020
Hexachloro-1,3-butadiene (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
12/01/2020
Hexachlorobenzene (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
12/01/2020
Hexachloroethane (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
12/01/2020
m + p-Cresol (TCLP)
SW 846 method 827013510
<0.050 mg/L
12/01/2020
Nitrobenzene (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
12/01/2020
o-Cresol (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
12/01/2020
Pentachlorophenol (TCLP)
SW 846 method 8270/3510
<0.250 mg/L
12/01/2020
Pyridine (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
12/01/2020
2,4,5-TP (TCLP)
SW846 Method 8151A
<0.003 mg/L
12/01/2020
2,4-D (TCLP)
SW846 Method 8151A
<0.003 mg/L
12/01/2020
1,1-Dichloroethylene (TCLP)
SW846 Method 8260/5030
<0.01 mg/L
11/20/2020
1,2-Dichloroethane (TCLP)
SW846 Method 8260/5030
<0.01 mg/L
11/20/2020
Benzene (TCLP)
SW846 Method 8260/5030
<0.01 mg/L
11/20/2020
Reportk 2020-18677 Page 1 of 3

--0"7
Environmental Chemists, Inc.
• 6602 Windmill Way, Wilmington, NC 28405 • 910.392.0223 Lab • 910.392.4424 Fax
710 Bowsertown Road, Manteo, NC 27954 • 252.473.5702 Lab/Fax
255-A Wilmington Highway, Jacksonville, NC 28540 • 910.347.5843 Lab/Fax
ANALYTICAL & CONSULTING CHEMISTS [e-mail]
Smithfield Hog Productions - Warsaw
Post Office Box 856
Warsaw NC 28398
Attention:
Date of Report: Dec 17, 2020
Customer PO #:
Customer ID: 08110011
Report #: 2020-19677
Project ID: Warsaw
Carbon Tetrachloride (TCLP)
SW846 Method 826015030
<0.01 mg/L
11/20/2020
Chlorobenzene (TCLP)
SW846 Method 8260/5030
<0.01 mg/L
11/20/2020
Chloroform (TCLP)
SW046 Method 8260/5030
<0.01 mg/L
11/20/2020
Methyl ethyl ketone (TCLP)
SW846 Method 826015030
<0.05 mg/L
11/20/2020
Tetrachloroethylene (TCLP)
SW846 Method8280/5030
<0.01 mg/L
11/20/2020
Trichloroethylene (TCLP)
SW846 Method8260/5030
<0.01 mg/L
11/20/2020
Vinyl Chloride (TCLP)
SW846 Method 8260/5030
<0.01 mg/L
11/20/2020
RCI
Sulfide
SM 4500 S D
1.23 mg/kg
11/24/2020
Ignitability
SW 846 method 1010
>210 OF
12/03/2020
pH
SW 848 Method 9045D
6.91 units
12/08/2020
Sludge Residuals
Aluminum
EPA 200.7
4430 mg/kg
12/08/2020
Arsenic
EPA 200.7
8.29 mg/kg
11/20/2020
Cadmium
EPA 200.7
<7.49 mg/kg
11/20/2020
Calcium
EPA 200.7
4600 mg/kg
11/20/2020
Chromium
EPA 200.7
<7.49mg/kg
11/20/2020
Copper
EPA 200.7
228 mg/kg
11/20/2020
Lead
EPA 200.7
<7.49 mg/kg
11/20/2020
Magnesium
EPA 200.7
702 mg/kg
11/20/2020
Molybdenum
EPA 200.7
<7.49 mg/kg
11/20/2020
Nickel
EPA 200.7
<7.49mg/kg
11/20/2020
Potassium
EPA 200.7
1540 mg/kg
11/20/2020
Selenium
EPA 200.7
<7.49mg/kg
11/20/2020
Sodium
EPA 200.7
829 mg/kg
11/20/2020
Zinc
EPA 200.7
1570 mg/kg
12/04/2020
Nitrate+Nitrite-Nitrogen
EPA353.2
2.75mg/kg
11/25/2020
Total Solids (%)
SM 2540 s
6.48 %
11/24/2020
Ammonia Nitrogen
SM 4500 NH3 C
1130 mg/kg
11/19/2020
Total Kjeldahl Nitrogen (TKN)
SM 4500 Org a
5460 mg/kg
11 /19/2020
Report #:: 2020.19877
Page 2 of 3

ANALYTICAL & CONSULTING CHEMISTS
Environmental Chemists, Inc.
6602 Windmill Way, Wilmington, NC 28405 V 910.392.0223 Lab • 910.392.4424 Fax
710 Bowsertown Road, Manteo, NC 27954 • 252.473.5702 Lab/Fax
255-A Wilmington Highway, Jacksonville, NC 28540 • 910.347.5843 Lab/Fax
[e-mail]
Smithfield Hog Productions - Warsaw Date of Report: Dec 17, 2020
Post Office Box 856 Customer PO #:
Warsaw NC 28398 Customer ID: 08110011
Attention: Report #: 2020-19677
Project ID: Warsaw
Total Phosphorus SM 4500 P F 2610 mg/kg 12/02/2020
Mercury Swe467471B <0.265mg/kg 11/20/2020
TCLP Metals
Arsenic
EPA200.7
<1 mg/L
12/01/2020
Barium
EPA200.7
<1 mg/L
12/01/2020
Cadmium
EPA200.7
<1 mg/L
12/01/2020
Chromium
EPA200.7
<1 mg/L
12/01/2020
Lead
EPA200.7
<1 mg/L
12/01/2020
Selenium
EPA200.7
<1 mg/L
12/01/2020
Silver
EPA200.7
<1 mg/L
12/01/2020
Mercury
EPA245.1
<0.0002mg/L
11/30/2020
Comment: Results reported on a dry weight basis.
Reviewed by: KalL�C)W, AuWf)-�
Report #:: 2020-19577 Page 3 of 3

Environmental Chemist, Inc., Wilmington, NC Lab #94 6602 Windmill"
Wilmington, NC 284
910.392.02
C �r (�1_ rr fj 1. Sample RReceipt Checklist
Client: SRII 7-V ft e U —VV a((' 0.0,Q Date: b (J -cK%D Report Number:
Receipt of sample: E . HEM Pickupk Client Delivery ❑ UPS ❑ FedEx ❑ Other ❑
❑ YES ❑ NO N/A 1. Were custody seals present on the cooler?
❑ YES ❑ NO N/A 2. If custody seals were present, were they intact/unbroken?
Original temperature upon receipt °C Corrected temperature upon receipt
How temperature taken: ❑ Temperature Blank IX Against Bottles
IR Gun ID: Thomas Traceable S/N 192511657 IR Gun Correction Factor'C: 0.0
❑
YES
I ❑
NO
1 3. If temperature of cooler exceeded VC, was Project Mgr./QA notified?
IR
YES
I ❑
NO
4. Were proper custody procedures (relinquished/received) followed?
YES
10
NO
5. Were sample ID's listed on the COC?
YES
10
NO
6. Were samples ID's listed on sample containers?
YES
10
NO
7. Were collection date and time listed on the COC?
YES
10
NO
8. Were tests to be performed listed on the COC?
YES
10
NO 1
9. Did samples arrive in proper containers for each test?
YES
10
NO 110.
Did samples arrive in good condition for each test?
14.
YES
10
NO 111. Was adequate sample volume available?'
YES
❑
NO 112. Were samples received within proper holding time for requested tests?
❑
YES
❑
NO 113. Were acid preserved samples received at a pH of <2?
❑
YES
10
NO 114. Were cyanide samples received at a pH >12?
O
YES
JEJ
NO 115. Were sulfide samples received at a pH >9?
❑
YES
❑
NO 116. Were NH3/TKN/Phenol received at a chlorine residual of <0.5 m/L? **
❑
YES
10
NO 17. Were Sulfide/Cyanide received at a chlorine residual of <0.5 m/L?
❑
YES
10
NO 18. Were orthophosphate samples filtered in the field within 15 minutes?
* TOC/Volatiles are pH checked at time of analysis and recorded on the benchsheet.
** Bacteria samples are checked for Chlorine at time of analysis and recorded on the benchsheet.
lb
ample Preservation: (Must be completed for any samples) incorrectly preserved or with headspace)
ample(s) were received incorrectly preserved and were adjusted accordingly
y adding (circle one): HZSO, HNO3 HCI NaOH
ime of preservation: If more than one preservative is needed, notate in comments below
Note: Notify customer service immediately for incorrectly preserved samples Obtain a new sample or
notify the state lab if directed to analyzed by the customer. Who was notified, date and time:
Volatiles Samples) were received with headspace
COMMENTS:
DOC. QA.002 Rev ]

Analytical & Consulting Chemists
ENVIRONMENTAL CHEMISTS, INC
NCDENR: DWQ CERTIFICATION # 94 NCDHHS: DLS CERTIFICATION # 37729
COLLECTION AND CHAIN OF CUSTODY
6602 Windmill Way Wilmington, NC 28405
OFFICE: 910-392-0223 FAX [phone]
[e-mail]
Client: Smithfield Hog Production -Warsaw
PROJECT NAME: Wa
REPORT NO: 2v — 7
ADDRESS:
CONTACT NAME: MeA v
PO NO:
REPORT TO: Kraig Westerbeek
PHONE/FAX:
COPY TO:
email:
Sampled By: SAMPLE TYPE: I = Influent, E = Effluent, W = Well, ST = Stream, SO = Soil, SL = Sludge, Other:
Sample Identification
Collection
cm
E c
m
o a
C `o
o
m _
ct9
`o
cia
m
c
.2 I
v
ow
m
gZ
PRESERVATION
ANALYSIS REQUESTED
Date
Time
Temp=
_
i
x
0
N
g
=
c
i
o
w
o
Residuals
�v "Z
C
P
5C)o
X
Full TCLP, RCI, Nutrients/Metals
G
G
C
P
G
G
C
P
G
G
C
P
G
G
C
P
G
G
C
P
G
G
C
P
G
G
C
P
G
G
C
P
G
G
Transfer
Relinquished By:
Date/Time
Received By:
Date/Time
1.
- ZU /L13
2.
Temperature when eceived °C: Accepted:
Delivered By: Received By:
Comments:
pie Requested:
II -I`6-Za Time:
TURNAROUND:

RESIDUALS SOURCE CERTIFICATION ATTACHMENT
Murphy Brown — Rainbow Trailer Wash

State of North Carolina
DWR
Department of Environmental Quality
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 Pen -nits".
® 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

DWR
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: Murphy Brown, LLC — Rainbow Trailer Wash
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: Michael Norris - LNM Specialist
Complete mailing address: Post Office Box 856
City: Warsaw State: NC Zip: 28398-
Telephone number: (2_10) 293-5575 E-mail address: mnorris(a smithfield.com
4. Facility physical address: 1251 Lanefield Road
City: Magnolia State: NC Zip: 28453-
Coordinates: Latitude: 34' 56' 52.35" N Longitude: 78 ° 1' 48.52" W
Datum: NAD 83 Level of accuracy: 1 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: % industrial and % domestic)
® other (explain: Trailer Wash ).
6. Does the facility have an approved pretreatment program: ❑ Yes ® No
7. Facility permitted/design flow: 0.004 MGD and facility average daily flow: 0.0035 MGD
8. Average amount of residuals being generated at this facility 25 dry tons per year.
9. Specify the following regarding treatment and storage volumes available at the facility:
Type and volume of residuals treatment: 0.23 acre lagoon X 6ft
Type and volume of residuals storage (i.e., outside of residuals treatment units): None
II. 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
FORM: RSC 06-16 Page 1 of 5

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).
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: ❑ yes ® no.
If yes, list the number(s):
b. Specify whether or not the residuals exhibit any of the characteristics defined by 40 CFR §261.21-
261.24: ❑ yes ® no.
Fill in the following tables with the results of the latest toxicity characteristic leaching procedure (TCLP) analysis as well
as those for corrosivity, ignitability, and reactivity:
Laboratory: Environmental Chemists, Inc. and Date of analysis: 12/17/2020
Passed corrosivity test: ® yes ❑ no. pH: s.u. (2 < pH < 12.5)
Passed ignitability test: ® yes ❑ no. Flashpoint: >215 OF (> 140°F)
Passed reactivity test: ® yes ❑no. HCN: 4.46 mg/kg (<250) & H2S: 2.31 mg/kg (<500)
TCLP Parameter
Limit
(mg/1)
Result
NO)
TCLP Parameter
Limit
(mg/1)
Result
(mg/1)
Arsenic
5.0
<1.000
Hexachlorobenzene
0.13
<0.050
Barium
100.0
<1.000
Hexachloro-1,3-Butadiene
0.5
<0.050
Benzene
0.5
<0.010
Hexachloroethane
3.0
<0.050
Cadmium
1.0
<1.000
Lead
5.0
<1.00
Carbon Tetrachloride
0.5
<0.010
Lindane
0.4
<0.0005
Chlordane
0.03
<0.020
Mercury
0.2
<0.0002
Chlorobenzene
100.0
<0.010
Methoxychlor
10.0
<0.0005
Chloroform
6.0
<0.010
Methyl Ethyl Ketone
200.0
<0.050
Chromium
5.0
<1.00
Nitrobenzene
2.0
<0.050
m-Cresol
200.0
<0.050
Pentachlorophenol
100.0
<0.250
o-Cresol
200.0
<0.050
Pyridine
5.0
<0.050
p-Cresol
200.0
<0.050
Selenium
1.0
<1.00
Cresol
200.0
<0.050
Silver
5.0
<1.00
2,4-D
10.0
<0.003
Tetrachloroethylene
0.7
<0.010
1,4-Dichlorobenzene
7.5
<0.050
Toxaphene
0.5
<0.050
1,2-Dichloroethane
0.5
<0.010
Trichloroethylene
0.5
<0.010
1,1-Dichloroethylene
0.7
<0.010
2,4,5-Trichlorophenol
400.0
<0.050
2,4-Dinitrotoluene
0.13
<0.050
2,4,6-Trichlorophenol
2.0
<0.050
Endrin
0.02
<0.0005
2,4,5-TP (Silvex)
1.0
<0.0003
Heptachlor and its Hydroxide
0.008
<0.0005
Vinyl Chloride
0.2
<0.010
FORM: RSC 06-16 Page 2 of 5

4. Metals Determination: Complete one of the following tables (i.e., as applicable) to demonstrate that the residuals do not violate
the ceiling concentrations for metals regulated under 15A NCAC 02T .1105.
a. For Distribution/Land Application: Fill in the following table with the results of the latest analyses (i.e., on a dry weight
basis) for the following metal parameters:
Laboratory: Environmental Chemists. Inc. and Date of analysis: 12/17/2020, 1/08/2021
Parameter
Ceiling
Concentration Limits
(C1assA & C1assB)
(mglkg)
Monthly Average
Concentration Limits
(Class A Only)
(mglkg)
Result
(mglkg)
Arsenic
75
41
73.10
Cadmium
85
39
<45.80
Copper
4,300
1,500
2,270.00
Lead
840
300
<45.80
Mercury
57
17
<1.52
Molybdenum
75
n/a
<45.80
Nickel
420
420
<45.80
Selenium
100
100
<45.80
[77Zinc
7,500
2,800
7,110.00
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. Nutrient/Micronutrient Determination: Complete the following:
a. Total solids: 1.06 %.
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: Environmental Chemists, Inc. and Date of analysis: 12/17/2020
Parameter
Result
img/k-Si
Aluminum
19,300.00
Ammonia -Nitrogen
5,580.00
Calcium
122,000.00
Magnesium
7,880.00
Nitrate -Nitrite Nitrogen
5.38
pH (Standard Unit)
6.96
Phosphorus
6,190.00
Potassium
6,370.00
Sodium
2,300.00
Total Kjeldahl Nitrogen
23,000.00
c. Using the results listed in Item II. 5b. above, calculate the sodium adsorption ration (SAR): 0.18
[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: 30 %. This rate
is a (check one): ® 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: This mineralization rate is
consistent with primary treatment.
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 (15t) Year PAN
Five -Year
Maximum Adjusted PAN
(mg/hg)
(mg/kg)
Surface
8,021
11,160
Injection/Incorporation
10,811
13,950
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: None
FORM: RSC 06-16 Page 4 of

7. Pathogen Reduction: Per 15A NCAC 02T.11061 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.I 106(b)(3)(A)] - Time/Temperature Compliance.
❑ Alternative 2 [15A NCAC 02T.1106(b)(3)(13)] - 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. 1 106(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,
❑ thermophilic aerobic digestion, ❑ beta ray irradiation,
❑ gamma ray irradiation, or ❑ pasteurization.
b. For Land Application of Class B:
® Alternative 1 [15A NCAC 02T.1106(c)(1)] -Fecal Coliform Density Demonstration.
® Alternative 2 [15A NCAC 02T.I 106(c)(2)] - Process to Significantly Reduce Pathogens (PSRP).
Specify one: ❑ aerobic digestion, ❑ air drying, ❑ anaerobic digestion,
❑ composting, or ® lime stabilization.
c. For Surface Disposal:
❑ Select One of the Class A or Equivalent Pathogen Reduction Alternatives in Item II. 7a. above.
❑ Select One of the Class B or Equivalent Pathogen Reduction Alternatives in Item II. 7b. above.
❑ Exempt -If Daily Cover Alternative is chosen in Item 11.8. below [15A NCAC 02T.1106(a)(2)].
❑ Not Applicable - Non -Biological Residuals with NO Domestic Wastewater Contribution.
8. Vector Attraction Reduction (VAR): Per 15A NCAC 02T.1107, specify how residuals will meet the VAR requirements:
❑ Alternative 1 [15A NCAC 02T.I 107(a)(1)] - 38% Volatile Solids Reduction (Aerobic/Anaerobic Digestion).
® Alternative 2 [15A NCAC 02T.1107(a)(2)] - 40-Day Bench Scale Test (Anaerobic Digestion).
❑ Alternative 3 [15A NCAC 02T.1107(a)(3)] - 30-Day Bench Scale Test (Aerobic Digestion).
® Alternative 4 [15A NCAC 02T.I 107(a)(4)] - Specific Oxygen Uptake Rate Test (Aerobic Digestion).
❑ Alternative 5 [15A NCAC 02T.I 107(a)(5)] - 14-Day Aerobic Processes.
® Alternative 6 [15A NCAC 02T.I 107(a)(6)] - Alkaline Stabilization.
❑ Alternative 7 [15A NCAC 02T.1107(a)(7)] - Drying of Stabilized Residuals.
❑ Alternative 8 [15A NCAC 02T. 1 107(a)(8)] - Drying of Unstabilized Residuals.
® Alternative 9 [15A NCAC 02T.I 107(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

Facility Vicinity Map

goYe��c R
a
Murphy Brown Rainbow Trailer Wash
Ra
Ra,01
Ok
Qs
b
c� C
�a Sources: Esri, HERE, Del-orme, USGS. Intermap, INCREMENT P,
NRCan, Esri Japan, METI, Esri China (Hong Kong), Esri Korea, Esri
(Thailand), Mapmylndia, NGCC. J OpenStreetMap contributors, and the
GIs User Community
SCALE: 1 1,500 ft
Triple S Farms Facility
CHECKED BY: RTB Land Application Program Vicinity
DRAWN BY: RTB
BRANCH MB Rainbow Trailer Wash WWTP Map
RESIDUALS 1
DATE: 1/8/202 t SOILS, LLC Project No. 200/ - / 1

Process Flow Diagram and Narrative

TREATMENT PLANT PROCESS
The Murphy Brown Rainbow Trailer Wash is permitted at 1.255 million gallon per year. Fresh water
is metered and used to wash the trailers in the truck bays. The wash water from the trucks enters the
lagoon outside the wash bay. Water from the lagoon is pumped to one of two spray fields totaling
6.05 acres under permit WQ0023310.
An aerial view of the plant is found on the following page.

M
�I
-V-
Murphy Brown Rai bbowT offer Was1k
pf -P
SALE: 1 in = 200 ft Triple S Farms & Cleaning, Inc.
RTe Land Application Program Site
Cn EAKE° N; BRANCH Murphy Brown Rainbow Aerial
°R""N°RTs RESIDUALS Trailer Wash Map
DATE: &&2015 SOILS, LLC r.u,ui 2007-71

Justification for Residuals Production Rate

JUSTIFICATION FOR FACILITY RESIDUALS PRODUCTION RATE
Based on the size of the lagoon as this facility and a current review of a sludge survey, the approximate
amount of residuals that it will contain at the time of cleanout has been reduced from 40 to 25 dry
tons, based on the current production rates. This is an approximation at best and may be changed
based on the actual haul events.

Residuals Sampling Plan

SAMPLING PLAN — MURPHY BROWN — RAINBOW TRAILER WASH
Annually, multiple grab residual solid samples are collected from the trailer wash lagoon. These
samples are composited for nutrient and metal analyses. The composited sample is mixed to keep the
solids suspended and containers filled for this analysis. Lime stabilization occurs when the lagoon
reaches capacity. Lime is added to reach proper stabilization requirements for vector attraction and
pathogen reduction. Field measurements of pH and temperature are collected for each stabilization
event to insure pH requirements are met. pH values are later temperature corrected. The facility may
elect to meet pathogen reduction by the collection of 7 fecal samples. In addition, vector attraction
reduction may be met be a 40-day anaerobic digestion test or by injection or incorporation.
Annually, or when the residual solids are to be land applied if application occurs less than annually,
a composite residual solid sample will be analyzed for: Arsenic, Cadmium, Copper, Lead, Mercury,
Molybdenum, Nickel, Selenium, Zinc, Aluminum, Ammonia — Nitrogen, Calcium, Nitrate -Nitrite,
Nitrogen, Magnesium, % Total Solids, pH, Phosphorus, Potassium, TKN, and Sodium. From this
information, the Plant Available Nitrogen (PAN) will be calculated. Once a permit cycle, a composite
TCLP sample will be collected to include:
Arsenic
Hexachlorobenzene
ph for Corrosivity
Barium
Hexachloro-1,3-Butadiene
Benzene
Hexachloroethane
Flash point for ignitability
Cadmium
Lead
Carbon Tetrachloride
Lindane
Sulfides and Cyanides for reactivity
Chlordane
Mercury
1,2-Dichloroethane
Chlorobenzene
Methoxychlor
1,1-Dichloroethylene
Chloroform
Methyl Ethyl Ketone
2,4-Dinitrotoluene
Chromium
Nitrobenzene
Endrin
m-Cresol
Pentachlorophenol
Heptachlor and its Hydroxide
o-Cresol
Pyridine
Trichloroethylene
p-Cresol
Selenium
2,4,5-Trichlorophenol
Cresol
Silver
2,4,6-Trichlorophenol
2,4-D
Tetrachloro ethylene
2,4,5-TP (Silvex)
1,4-Dichlorobenzene
Toxaphene
Vinyl Chloride

Analytical Data From the Murphy Brown Rainbow Trailer Wash
TCLP and Nutrient & Metal

Environmental Chemists, Inc.
nvirochem 6602 Windmill Way, Wilmington, NC 28405 : 910.392.0223 Lab • 910.392.4424 Fax
710 Bowsertown Road, Nlanteo, NC 27954 . 252.473.5702 Lab/Fax
255-A Wilmington Hicy
ghway, Jacksonville, NC 28540 t 910.347.5843 Lab/Fax
ANALYTICAL & CONSULTING CHEMISTS info : environmentalchemists.com
Smithfield Hog Productions -Warsaw Revised Report: Jan 08, 2021
Post Office Box 856 Original Report Date: Dec 17, 2020
Warsaw NC 28398 Report #: 2020-19679
Attention: Customer ID: 08110011
Project ID: Rainbow Truck Wash
Lab ID Sample ID:
20-50059 Site: Residuals
Test
Collect Date/Time
11/18/2020 9:35 AM
Method
Matrix Sampled by
Solid/Sludge James Cox
Results Date Analyzed
Cyanide
SM 4500 cN D
4.46 mg/kg
11 /30/2020
Chlordane (TCLP)
SW 846 Method 8081813510
<0.02 mg/L
12/02/2020
Endrin (TCLP)
SW 846 Method 8081B/3510
<0.0005 mg/L
12/02/2020
Heptachlor (TCLP)
SW 846 Method 8081B/3510
<0.0005 mg/L
12/02/2020
Heptachlor epoxide (TCLP)
SW 846 Method 808113/3510
<0.0005 mg/L
12/02/2020
Lindane (TCLP)
SW 846 Method 8081B/3510
<0.0005 mg/L
12/02/2020
Methoxychlor (TCLP)
SW 846 Method 8081 B1351 0
<0.0005 mg/L
12/02/2020
Toxaphene (TCLP)
SW 846 Method 8081B13510
<0.05 mg/L
12/02/2020
1,4-Dichlorobenzene (TCLP)
SW 846 method 827013510
<0.050 mg/L
12/01/2020
2,4,5-Trichlorophenol (TCLP)
SW 846 method 827013510
<0.050 mg/L
12/01/2020
2,4,6-Trichlorophenol (TCLP)
SW 848 method 8270/3510
<0.050 mg/L
12101 /2020
2,4-Dinitrotoluene (TCLP)
SW 846 method 827013510
<0.050 mg/L
12/01/2020
Cresol (TCLP)
SW 646 method 827013510
<0.050 mg/L
12/01/2020
Hexachloro-1,3-butadiene (TCLP)
SW 846 method 827013510
<0.050 mg/L
12/01/2020
Hexachlorobenzene (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
12/01/2020
Hexachloroethane (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
12/01/2020
m + p-Cresol (TCLP)
SW 846 method 827013510
<0.050 mg/L
12/01/2020
Nitrobenzene (TCLP)
SW 846 method 827013510
<0.050 mg/L
12/01/2020
o-Cresol (TCLP)
SW 846 method 827013510
<0.050 mg/L
12/01/2020
Pentachlorophenol (TCLP)
SW 846 method 8270/3510
<0.250 mg/L
12/01/2020
Pyridine (TCLP)
SW 846 method 827013510
<0.050 mg/L
12/01/2020
pH
SW 846 Method 9045D
6.96 units
12/08/2020
2,4,5-TP (TCLP)
SW846 Method 8151A
<0.003 mg/L
12/01/2020
2,4-D (TCLP)
SW846 Method 8151A
<0.003 mg/L
12/01/2020
1, 1 -Dichloroethylene (TCLP)
SW846 Method8260/5030
<0.01 mg/L
11/27/2020
1,2-Dichloroethane (TCLP)
SW846 Method 8260/5030
<0.01 mg/L
11 /27/2020
Report # 2020-19579
_
Page 1 of 3

Environmental Chemists, Inc.
6602 Windmill Way, Wilmington, NC 28405 • 910.392.0223 Lab • 910.392.4424 Fax
710 Bowsertown Road, ivlanteo, NC 27954 • 252.473.5702 Lab/Fax
..., -r 255-A Wilmington Highway, Jacksonville, NC 28540 • 910.347.5843 Lab/Fax
ANALYTICAL & CONSULTING CHEMISTS info environmentalchemists.com
Smithfield Hog Productions - Warsaw
Revised Report:
Jan 08, 2021
Post Office Box 856
Original Report Date: Dec 17, 2020
Warsaw NC
28398
Report #:
2020-19679
Attention:
Customer ID:
08110011
Project ID:
Rainbow Truck Wash
Benzene (TCLP)
SW846 Method 8260/5030
<0.01 mg/L
11/27/2020
Carbon Tetrachloride (TCLP)
SW846 Method 8260/5030
<0.01 mg/L
11/27/2020
Chlorobenzene (TCLP)
SW846 Method 8260/5030
<0.01 mg/L
11/27/2020
Chloroform (TCLP)
SW846 Method 8260/5030
<0.01 mg/L
11/27/2020
Methyl ethyl ketone (TCLP)
SW846 Method 8260/5030
<0.05 mg/L
11/27/2020
Tetrachloroethylene (TCLP)
SW846 Method 8260/5030
<0.01 mg/L
11/27/2020
Trichloroethylene (TCLP)
SW846 Method 8260/5030
<0.01 mg/L
11/27/2020
Vinyl Chloride (TCLP)
SW846 Method 8260/5030
<0.01 mg/L
11/27/2020
RC I
Sulfide
SM 4500 S D
2.31 mg/kg
11/24/2020
Ignitability
SW 846 method 1010
>215 OF
12/03/2020
Sludge Residuals
Aluminum
EPA 200 7
19300 mg/kg
12/03/2020
Arsenic
EPA 200.7
73.1 mg/kg
11/20/2020
Cadmium
EPA 2001
<45.8 mg/kg
11/20/2020
Calcium
EPA 200.7
122000 mg/kg
11/20/2020
Chromium
EPA 200.7
68.4 mg/kg
11/20/2020
Copper
EPA 200.7
2270 mg/kg
11/20/2020
Lead
EPA 200.7
<45.8 mg/kg
11/20/2020
Magnesium
EPA 200.7
7880 mg/kg
11/20/2020
Molybdenum
EPA 200.7
<45.8 mg/kg
11/20/2020
Nickel
EPA 200.7
<45.8 mg/kg
11/20/2020
Potassium
EPA 200.7
6370 mg/kg
11/20/2020
Selenium
EPA 200.7
<45.8 mg/kg
11/20/2020
Sodium
EPA 200 7
2300 mg/kg
11/20/2020
Zinc
EPA 200 7
9430 mg/kg
12/04/2020
Nitrate+Nitrite-Nitrogen
EPA 353 2
5.38 mg/kg
11/25/2020
Total Solids (%)
SM 254o B
1.06 %
11/24/2020
Ammonia Nitrogen
SM 4500 NH3 C
5580 mg/kg
11/19/2020
Report #:: 2020-19679
Page 2 of 3

envirochem
ANALYTICAL & CONSULTING CHEMISTS
Smithfield Hog Productions - Warsaw
Post Office Box 856
Warsaw NC 28398
Attention:
Environmental Chemists, Inc.
6602 Windmill Way, Wilmington, NC 28405 - 910.392.0223 Lab • 910.392.4424 Fax
710 Bowsertown Road, A2anteo, NC 27954 - 252.473 5702 Lab/Fax
255-A Wilmington Highway, Jacksonville, NC 28540 - 910.347.5843 Lab/Fax
info:, environmen talchemisu.com
Revised Report:
Jan 08, 2021
Original Report Date: Dec 17, 2020
Report #:
2020-19679
Customer ID:
08110011
Project ID:
Rainbow Truck Wash
Total Kjeldahl Nitrogen (TKN)
SM 4500 or9 B
23000 mg/kg
11/19/2020
Total Phosphorus
SM 4500 P F
6190 mg/kg
12/01/2020
Mercury
SW8467471B
<1.52mg/kg
11/2012020
TCLP Metals
Arsenic
EPA200.7
<1 mg/L
12/01/2020
Barium
EPA200.7
<1 mg/L
12/01/2020
Cadmium
EPA200.7
<1 mg/L
12/01/2020
Chromium
EPA 2007
<1 mg/L
12/01/2020
Lead
EPA 200.7
<1 mg/L
12/01/2020
Selenium
EPA2007
<1 mg/L
12/01/2020
Silver
EPA200.7
<1 mg/L
12/01/2020
Mercury
EPA 245.1
<0.0002 mg/L
11 /30/2020
Lab ID Sample ID:
Collect Date/Time
Matrix Sampled by
20-50059A Site: Residuals
11/18/2020 9:35 AM
Solid/Sludge James Cox
Test
Method
Results Date Analyzed
Zinc EPA 200 7 7110 mg/kg 01 /06/2021
Comment: Results reported on a dry eight basis. Amended 1/8/2021 to add Zinc re -analysis
:
Y
Reviewed b ,
Report # 2020-19679 Page 3 of 3

Environmental Chemist, Inc., Wilmington, NC Lab #94 6602 Windmill
Wilmington, NC 2!
910.392.(
(p ( Sample Receipt Checklist
Client:�l�l"Vll f ��� t� Date: (q ZQ Report Number:
Receipt of sample: ECHEM Pickup Client Delivery ❑ UPS ❑ FedEx ❑ Other ❑
O YES ❑ 1
NO N/A . bVere custody seals present on the cooler?
❑ YES ❑ NO N/A 12. If custody seals were present, were they intact/unbroken?
Original temperature upon receipt °C Corrected temperature upon receipt
How temperature taken: ❑ Temperature Blank IX Against Bottles
IR Gun ID: Thomas Traceable S/N 192511657 IR Gun Correction Factor "C: 0.0
❑ YES ❑ NO 3. If temperature of cooler exceeded VC, was Project Mgr./QA notified?
YES ❑ NO 4. Were proper custody procedures (relinquished/received) followed?
YES ❑ NO 5. Were sample ID's listed on the COC?
YES ❑ NO 6. Were samples Us listed on sample containers?
YES ❑ NO 7. Were collection date and time listed on the COC?
YES ❑ NO 8. Were tests to be performed listed on the COC?
YES ❑ NO 9. Did samples arrive in proper containers for each test?
YES ❑ NO 10. Did samples arrive in good condition for each test?
YES ❑ NO 11. Was adequate sample volume available?'
YES ❑ NO 12. Were samples received within proper holding time for requested tests?
❑ YES ❑ NO 13. Were acid preserved samples received at a pH of <2?
❑ YES ❑ NO 14. Were cyanide samples received at a pH >12?
❑ YES ❑ NO 15. Were sulfide samples received at a pH >9?
❑ YES ❑ NO 16. Were NH3/TKN/Phenol received at a chlorine residual of <0.5 m/L?'i
❑ YES ❑ NO 17. Were Sulfide/Cyanide received at a chlorine residual of <0.5 m/L?
❑ YES ❑ NO 18. Were orthophosphate samples filtered in the field within 15 minutes?
* TOC/Volatiles are pH checked at time of analysis and recorded on the benchsheet.
*" Bacteria samples are checked for Chlorine at time of analysis and recorded on the benchsheet.
Sample Preservation: (Must be completed for any sample(s) incorrectly preserved or with heaAbelow
Sample(s) were received incorrectly preserved and were adjusted a
by adding (circle one): H2SO: HNO; HCl NaOH
Time of preservation: If more than one preservative is needed, notate in comm
Vote- Notify customer service immediately for incorrectly preserved samples Obtain a new sample or
notify the state lab if directed to analyzed by the customer, who was notified, date and time
Volatiles Sample(s) were received with headspace
COMMENTS:
DOC. QA.002 Rev 1

6602
l Way
mington
ENVIRONMENTAL CHEMISTS, INC OFFICE: 10i1392-02 311FAX[phone]
Analytical & Consulting Chemists NCDENR: DWQ CERTIFICATION # 94 NCDHHS: DLS CERTIFICATION # 37729 [e-mail]
COLLECTION AND CHAIN nF Cl Icrnnv
Client: Smithfield Hog Production -Warsaw
PROJECT NAME: gal oi.J
REPORT NO: D _'
ADDRESS:
CONTACT NAME: Qt-we's o)o
PO NO:
REPORT TO: Kraig Westerbeek
PHONE/FAX:
COPY TO:
email:
Sampled By: SAMPLE TYPE: I = Influent. E = Effluent. W = Well. ST = Stream_ An = Snit ci = c1... 4— tUk .
Sample Identification
Collection
q T
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IPRESERVATION
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ANALYSIS REQUESTED
Date
Time
Temp
z
Z
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ZiE
p
W
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Res=duals
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Full TCLP, RCI Nutrients/Metals
G
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Relinquished By- Date/Time
Received By:
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Comments:
pie Requested:
//- /k -Zy Time:
URNAROUND:

RESIDUALS SOURCE CERTIFICATION ATTACHMENT
Murphy Brown — Register Trailer Wash

State of North Carolina
DWR
Department of Environmental Quality
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 " Nlap Guidance for
Residuals Land Application Pen -nits".
® 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

State of North Carolina
DWR
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: Murphy Brown, LLC — Warsaw Sanitation Trailer Wash
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: Michael Norris — LNM Specialist
4. Complete mailing address: Post Office Box 856
City: Warsaw State: NC Zip: 28398-
Telephone number: [phone] E-mail address: mnorrisasmithfield.com
5. Facility physical address: 2098 NC Highway 11 S
City: Rose Hill State: NC Zip: 28458-
Coordinates: Latitude: 34' 50' 54.57" N Longitude: 77' 57' 34.61" W
Datum: NAD 83 Level of accuracy: 1 second
Method of measurement: May
6. Purpose of the facility:
❑ treatment of municipal wastewater, ❑ treatment of 100% domestic wastewater,
❑ treatment of potable water, ❑ treatment of 100% industrial wastewater,
❑ treatment of industrial wastewater mixed with domestic wastewater,
(approximate percentages: % industrial and % domestic)
® other (explain: Trailer Wash ).
7. Does the facility have an approved pretreatment program: ❑ Yes ® No
8. Facility permitted/design flow: 2_5 MGD and facility average daily flow: 0.012 MGD
9. Average amount of residuals being generated at this facility 63 dry tons per year.
10. Specify the following regarding treatment and storage volumes available at the facility:
Type and volume of residuals treatment: (2) 0.99 acre lagoons X 7.5 ft
Type and volume of residuals storage (i.e., outside of residuals treatment units): None
II. 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
FORM: RSC 06-16 Page 1 of 5

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).
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: ❑ yes ® no.
If yes, list the number(s):
b. Specify whether or not the residuals exhibit any of the characteristics defined by 40 CFR §261.21-
261.24: ❑ yes ® no.
Fill in the following tables with the results of the latest toxicity characteristic leaching procedure (TCLP) analysis as well
as those for corrosivity, ignitability, and reactivity:
Laboratory: Environmental Chemists, Inc. and Date of analysis: 12/17/2020
Passed corrosivity test: ® yes ❑ no. pH: s.u. (2 < pH < 12.5)
Passed ignitability test: ® yes ❑ no. Flashpoint: WNI OF (> 140°F)
Passed reactivity test: ® yes ❑no. HCN: 2.73 mg/kg (<250) & H2S: <10.0 mg/kg (<500)
TCLP Parameter
Limit
(mg/1)
Result
NO)
TCLP Parameter
Limit
(mg/1)
Result
NO)
Arsenic
5.0
<1.000
Hexachlorobenzene
0.13
<0.050
Barium
100.0
<1.000
Hexachloro-1,3-Butadiene
0.5
<0.050
Benzene
0.5
<0.010
Hexachloroethane
3.0
<0.050
Cadmium
1.0
<1.000
Lead
5.0
<1.000
Carbon Tetrachloride
0.5
<0.010
Lindane
0.4
<0.0005
Chlordane
0.03
<0.020
Mercury
0.2
<0.0002
Chlorobenzene
100.0
<0.010
Methoxychlor
10.0
<0.0005
Chloroform
6.0
<0.010
Methyl Ethyl Ketone
200.0
<0.050
Chromium
5.0
<1.000
Nitrobenzene
2.0
<0.050
m-Cresol
200.0
<0.050
Pentachlorophenol
100.0
<0.250
o-Cresol
200.0
<0.050
Pyridine
5.0
<0.050
p-Cresol
200.0
<0.050
Selenium
1.0
<1.000
Cresol
200.0
<0.050
Silver
5.0
<1.000
2,4-D
10.0
<0.003
Tetrachloroethylene
0.7
<0.010
1,4-Dichlorobenzene
7.5
<0.050
Toxaphene
0.5
<0.050
1,2-Dichloroethane
0.5
<0.010
Trichloroethylene
0.5
<0.010
1,1-Dichloroethylene
0.7
<0.010
2,4,5-Trichlorophenol
400.0
<0.050
2,4-Dinitrotoluene
0.13
<0.050
2,4,6-Trichlorophenol
2.0
<0.050
Endrin
0.02
<0.0005
2,4,5-TP (Silvex)
1.0
<0.003
Heptachlor and its Hydroxide
0.008
<0.0005
Vinyl Chloride
0.2
<0.010
FORM: RSC 06-16 Page 2 of 5

4. Metals Determination: Complete one of the following tables (i.e., as applicable) to demonstrate that the residuals do not violate
the ceiling concentrations for metals regulated under 15A NCAC 02T .1105.
a. For Distribution/Land Application: Fill in the following table with the results of the latest analyses (i.e., on a dry weight
basis) for the following metal parameters:
Laboratory: Environmental Chemists, Inc. and Date of analysis: 12/17/2020
Parameter
Ceiling
Monthly Average
Result
Concentration Limits
Concentration Limits
(C1assA & ClassB)
(Class A Only)
(mglkg)
(mglkg)
(mglkg)
Arsenic
75
41
6.99
Cadmium
85
39
<1.72
Copper
4,300
1,500
382.00
Lead
840
300
5.81
Mercury
57
17
<0.06
Molybdenum
75
n/a
3.82
Nickel
420
420
11.40
Selenium
100
100
<1 72
Zinc
7,500
2,800
3,190.00
b. For Surface Disposal Unit (landFll): 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. Nutrient/Micronutrient Determination: Complete the following:
a. Total solids: 28.0 %.
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: Environmental Chemists, Inc. and Date of analysis: 12/17/2020
Parameter
Result
(MO-9)
Aluminum
7,170.00
Ammonia -Nitrogen
559.00
Calcium
20,000.00
Magnesium
1,520.00
Nitrate -Nitrite Nitrogen
0.86
pH (Standard Unit)
7.30
Phosphorus
3,220.00
Potassium
774.00
Sodium
353.00
Total Kjeldahl Nitrogen
4,470.00
c. Using the results listed in Item II. 5b. above, calculate the sodium adsorption ration (SAR): 0.34
[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: 30 %. This rate
is a (check one): ® 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: This mineralization rate is
consistent with primary treatment.
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 (Pt) Year PAN
Five -Year
Maximum Adjusted PAN
(mg1k-g)
(mg/kg)
Surface
1,454
1 2,158
Injection/Incorporation
1,733
1 2,438
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: None
FORM: RSC 06-16 Page 4 of 5

7. Pathogen Reduction: Per 15A NCAC 02T.11061 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. 1 106(b)(3)(A)] - Time/Temperature Compliance.
❑ Alternative 2 [15A NCAC 02T. 1 106(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.I 106(b)(3)(E)-(K)] - Process to Further Reduce Pathogens (PFRP).
Specify one: ❑ composting, ❑ heat drying, ❑ heat treatment,
❑ thermophilic aerobic digestion, ❑ beta ray irradiation,
❑ gamma ray irradiation, or ❑ pasteurization.
b. For Land Application of Class B:
® Alternative 1 [15A NCAC 02T.I 106(c)(1)] - Fecal Coliform Density Demonstration.
® Alternative 2 [15A NCAC 02T. 1 106(c)(2)] - Process to Significantly Reduce Pathogens (PSRP).
Specify one: ❑ aerobic digestion, ❑ air drying, ❑ anaerobic digestion,
❑ composting, or ® lime stabilization.
c. For Surface Disposal:
❑ Select One of the Class A or Equivalent Pathogen Reduction Alternatives in Item II. 7a. above.
❑ Select One of the Class B or Equivalent Pathogen Reduction Alternatives in Item II. 7b. above.
❑ Exempt -If Daily Cover Alternative is chosen in Item 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.1107(a)(2)] - 40-Day Bench Scale Test (Anaerobic Digestion).
❑ Alternative 3 [15A NCAC 02T.1107(a)(3)] - 30-Day Bench Scale Test (Aerobic Digestion).
® Alternative 4 [15A NCAC 02T.I 107(a)(4)] - Specific Oxygen Uptake Rate Test (Aerobic Digestion).
❑ Alternative 5 [15A NCAC 02T.I 107(a)(5)] - 14-Day Aerobic Processes.
® Alternative 6 [15A NCAC 02T.1107(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.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

Facility Vicinity Map

��ndttll Rd ,i
Solon far{O11 Ln
stockln9 Head Rd
a
Murp'hyytBrown RegiS�C�trailer Wash
Pte*
Wclls Brothers Rd
n
u;
e
J
N
_L
t:
Sources Esri, HERE, DeLorme, USGS, Intermap, INCREMENT P.
NRCan, Esn Japan, METI, Esri China (Hong Kong), Esri Korea, Esri
(Thailand), Mapmylndia, NGCC, © OpenStreetMap contributors, and the
GIS User Community
SCALE: 1 = 1,500 ft
Triple S Farms Facility
CHECKED BY: RTB Land Application Program Vicinity
RTB BRANCH MB Register Trailer Wash WWTP Ma
DRAWN BY: SIDU T S
DATE: 1/8/2021 SOILS, LLC Project No. 2007- / 1

Process Flow Diagram and Narrative

TREATMENT PLANT PROCESS
The Murphy Brown Register Trailer Wash is permitted at 8.76 million gallon per year. Fresh water
is metered and used to wash the trailers in the truck bays. The wash water from the trucks enters a
grit chamber where sand and grit are collected and removed into the grit chamber and liquids are sent
to the holding lagoon. Water from the lagoon is pumped to one of three spray fields totaling 31.28
acres under permit WQ0014247.
An aerial photograph of the plant is found on the following page.

SCALE: 1 in 200 ft
'NECKED Bl RTB
DRAWN BY: RTB
DATE: &6 2015
Murphy Brown Registelo,
pp� 44.
I
Triple S Farms & Cleaning, Inc.
Land Application Program Site
BRANCH Murphy Brown Register Aerial
kESIDUALS Trailer Wash Map
& SOILS, LLC pmjed No. 2007-7I

Justification for Residuals Production Rate

JUSTIFICATION FOR RESIDUALS PRODUCTION RATE
Based on the size of the lagoon as this facility and a current review of a sludge survey, the approximate
amount of residuals that it will contain at the time of cleanout has been increased from 50 to 63 dry
tons, based on the current production. This is an approximation at best and may be changed based on
the actual haul events.

Residuals Sampling Plan

SAMPLING PLAN — MURPHY BROWN — REGISTER TRAILER WASH
Annually, multiple grab residual solid samples are collected from the trailer wash lagoon. These
samples are composited for nutrient and metal analyses. The composited sample is mixed to keep the
solids suspended and containers filled for this analysis. Lime stabilization occurs when the lagoon
reaches capacity. Lime is added to reach proper stabilization requirements for vector attraction and
pathogen reduction. Field measurements of pH and temperature are collected for each stabilization
event to insure pH requirements are met. pH values are later temperature corrected. The facility may
elect to meet pathogen reduction by the collection of 7 fecal samples. In addition, vector attraction
reduction may be met be a 40-day anaerobic digestion test or by injection or incorporation.
Annually, or when the residual solids are to be land applied if application occurs less than annually,
a composite residual solid sample will be analyzed for: Arsenic, Cadmium, Copper, Lead, Mercury,
Molybdenum, Nickel, Selenium, Zinc, Aluminum, Ammonia — Nitrogen, Calcium, Nitrate -Nitrite,
Nitrogen, Magnesium, % Total Solids, pH, Phosphorus, Potassium, TKN, and Sodium. From this
information, the Plant Available Nitrogen (PAN) will be calculated. Once a permit cycle, a composite
TCLP sample will be collected to include:
Arsenic
Hexachlorobenzene
ph for Corrosivity
Barium
Hexachloro-1,3-Butadiene
Benzene
Hexachloroethane
Flash point for ignitability
Cadmium
Lead
Carbon Tetrachloride
Lindane
Sulfides and Cyanides for reactivity
Chlordane
Mercury
1,2-Dichloroethane
Chlorobenzene
Methoxychlor
1,1-Dichloroethylene
Chloroform
Methyl Ethyl Ketone
2,4-Dinitrotoluene
Chromium
Nitrobenzene
Endrin
m-Cresol
Pentachlorophenol
Heptachlor and its Hydroxide
o-Cresol
Pyridine
Trichloroethylene
p-Cresol
Selenium
2,4,5-Trichlorophenol
Cresol
Silver
2,4,6-Trichlorophenol
2,4-D
Tetrachloro ethylene
2,4,5-TP (Silvex)
1,4-Dichlorobenzene
Toxaphene
Vinyl Chloride

Analytical Data From the Murphy Brown Register Trailer Wash
TCLP and Nutrient & Metal

envirochem
ANALYTICAL & CONSULTING CHEMISTS
F0500- -- _747
Environmental Chemists, Inc.
6602 Windmill Way, Wilmington, NC 28405 . 910.392,0223 Lab • 910.392.4424 Fax
710 Bowsertown Road, Manteo, NC 27954 a 252.473.5702 Lab: Fax
255-A Wilmington Highway, Jacksonville, NC 28540 • 910.347.5843 Lab/Fax
info a environmentalchemists.com
Smithfield Hog Productions - Warsaw
Post Office Box 856
Warsaw NC 28398
Attention:
Date of Report: Dec 17, 2020
Customer PO #:
Customer ID: 08110011
Report #: 2020-19678
Project ID: RegisterI�,k (,�A61-
Lab ID Sample ID:
Collect Date/Time Matrix Sampled by
20-50058 Site: Residuals
11/18/2020
9:00 AM Solid/Sludge James Cox
Test
Method
Results Date Analyzed
Cyanide
SM 4500 CN D
2.73 mg/kg
11 /30/2020
Chlordane (TCLP)
SW 846 Method 8081813510
<0.02 mg/L
12/02/2020
Endrin (TCLP)
SW 846 Method 8081B13510
<0.0005 mg/L
12/02/2020
Heptachlor (TCLP)
SW 846 Method B081B13510
<0.0005 mg/L
12/02/2020
Heptachlor epoxide (TCLP)
SW 846 Method BOB 1B/3510
<0.0005 mg/L
12/02/2020
Lindane (TCLP)
SW 846 Method 8081 B1351 0
<0.0005 mg/L
12/02/2020
Methoxychlor (TCLP)
SW 846 Method 8081813510
<0.0005 mg/L
12/02/2020
Toxaphene (TCLP)
SW 846 Method 8081813510
<0.05 mg/L
12/02/2020
1,4-Dichlorobenzene (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
12/01/2020
2,4,5-Trichlorophenol (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
12/01/2020
2,4,6-Trichlorophenol (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
12/01/2020
2,4-Dinitrotoluene (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
12/01/2020
Cresol (TCLP)
SW 84e method 8270/3510
<0.050 mg/L
12/01/2020
Hexachlaro-1,3-butadiene (TCLP)
SW 848 method 8270/3510
<0.050 mg/L
12/01/2020
Hexachlorobenzene (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
12/01/2020
Hexachloroethane (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
12/01/2020
m + p-Cresol (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
12/01/2020
Nitrobenzene (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
12/01/2020
o-Cresol (TCLP)
SW 846 method 8270/3510
<0.050 mg/L
12/01/2020
Pentachlorophenol (TCLP)
SW 846 method 8270/3510
<0.250 mg/L
12/01/2020
Pyridine (TCLP)
SW 848 method 8270/3510
<0.050 mg/L
12/01/2020
2,4,5-TP (TCLP)
SW846 Method 8151A
<0.003 mg/L
12/01/2020
2,4-D (TCLP)
SW846 Method 8151A
<0.003 mg/L
12/01/2020
1,1-Dichloroethylene (TCLP)
SW846 Method826015030
<0.01 mg/L
11/27/2020
1,2-Dichloroethane (TCLP)
SW846 Method 8260/5030
<0.01 mg/L
11/27/2020
Benzene (TCLP)
SW846 Method 826015030
<0.01 mg/L
11/27/2020
Report #• 2020-18678 Page 1 of 3

Cenv7hrochem
Environmental Chemists, Inc.
6602 Windmill Way, Wilmington, NC 28405 • 910.392.0223 Lab • 910.392.4424 Fax
710 Bowsertown Road, Manteo, NC 27954 0 252.473.5702 Lab/Fax
255-A Wilmington Highway, Jacksonville, NC 28540 • 910.347.5843 Lab/Fax
ANALYTICAL & CONSULTING CHEMISTS [e-mail]
Smithfield Hog Productions - Warsaw
Date of Report: Dec 17. 2020
Post Office Box 856
Customer PO #:
Warsaw NC 28398
Customer ID: 08110011
Attention:
Report #: 2020-19678
Project ID: Register
Carbon Tetrachloride (TCLP)
SW846 Method 826015030
<0.01 mg/L
11/27/2020
Chlorobenzene (TCLP)
SW846 Method 826015030
<0.01 mg/L
11/27/2020
Chloroform (TCLP)
SW846 Method 8260f5O3O
<0.01 mg/L
11/27/2020
Methyl ethyl ketone (TCLP)
SW846 Method 826015030
<0.05 mg/L
11/27/2020
Tetrachloroethylene (TCLP)
SW046 Method 826015030
<0.01 mg/L
11/27/2020
Trichloroethylene (TCLP)
SW846 Method 826015030
<0.01 mg/L
11/27/2020
Vinyl Chloride (TCLP)
SW846 Method 826015030
<0.01 mg/L
11/27/2020
RCI
Ignitability
EPA 1030
<0.8 mm/sec
12/03/2020
Sulfide
SM 4500 S D
26.6 mg/kg
11/24/2020
pH
SW 846 Method 9045D
7.30 units
12/08/2020
Sludge Residuals
Aluminum
EPA 200.7
7170 mg/kg
12/03/2020
Arsenic
EPA 200.7
6.99 mg/kg
11/20/2020
Cadmium
EPA 200.7
<1.72 mg/kg
11/20/2020
Calcium
EPA 200.7
20000mg/kg
11/20/2020
Chromium
EPA 200.7
15.1 mg/kg
11/20/2020
Copper
EPA 200.7
382 mg/kg
11/20/2020
Lead
EPA 200.7
5.81 mg/kg
11/20/2020
Magnesium
EPA 200.7
1520 mg/kg
11/20/2020
Molybdenum
EPA 200.7
3.82 mg/kg
11/20/2020
Nickel
EPA 200.7
11.4 mg/kg
11/20/2020
Potassium
EPA 200.7
774 mg/kg
11/20/2020
Selenium
EPA 200.7
<1.72 mg/kg
11/20/2020
Sodium
EPA 200.7
353mg/kg
11/20/2020
Zinc
EPA 200.7
3190 mg/kg
12/04/2020
Nitrate+Nitrite-Nitrogen
EPA 353.2
0.86 mg/kg
11/25/2020
Total Solids (%)
SM 2540 B
28.0 %
11 /24/2020
Ammonia Nitrogen
SM 4500 NH3 C
559 mg/kg
11 /19/2020
Total Kjeldahl Nitrogen (TKN)
SM 4500 Org B
4470 mg/kg
11 /19/2020
Report #:: 2020-19678
Page 2 of 3

Environmental Chemists, Inc.
envirochem 6602 Windmill Way, Wilmington, NC 28405 - 910.392.0223 Lab • 910.392.4424 Fax
710 Bowsertown Road, Manteo, NC 27954 - 252.473.5702 Lab/Fax
rr 255-A Wilmington Highway, Jacksonville, NC 28540 - 910.347.5843 Lab/Fax
ANALYTICAL & CONSULTING CHEMISTS [e-mail]
environmentalchemists.com
Smithfield Hog Productions - Warsaw
Post Office Box 856
Warsaw NC 28398
Attention:
Date of Report: Dec 17, 2020
Customer PO #:
Customer ID: 08110011
Report #: 2020-19678
Project ID: Register
Total Phosphorus
SM 4500 P F
3220 mg/kg
12/02/2020
Mercury
Sw646 7471 B
<0.056 mg/kg
11 /20/2020
TCLP Metals
Arsenic
EPA 200.7
<1.0 mg/L
12/04/2020
Barium
EPA 200.7
<1.0 mg/L
12/04/2020
Cadmium
EPA 200.7
<1.0 mg/L
12/04/2020
Chromium
EPA 200.7
<1.0 mg/L
12/04/2020
Lead
EPA 200.7
<1.0 mg/L
12/04/2020
Selenium
EPA 200.7
<1.0 mg/L
12/08/2020
Silver
EPA 200.7
<1.0 mg/L
12/04/2020
Mercury
EPA 245.1
<0.0002 mg/L
12/03/2020
Comment: Results reported on a dry weight basis.
Reviewed by:
Report #: 2020-19678 Pape 3 of 3

Environmental Chemist, Inc., Wilmington, NC Lab #94
6602 Windmill V
Wilmington, NC 28,
910.392.02
( ( Sample Receipt Checklist
Client: 3m+1� ��"t ICi—V�O,t/—'Q0 Date: ZD Report Number: ZQ-1"1(0—T8
Receipt of sample: . I Pickup Client Delivery ❑ UPS ❑ FedEx ❑ Other ❑
❑ YES ❑ NO N/A 1. Were custody seals present on the cooler?
YES ❑ NO N/A 2. If custody seals were present, were they intact/unbroken?
Original temperature upon receipt 'C Corrected temperature upon receipt °
How temperature taken ❑ Temperature Blank Against Bottles
IR Gun ID: Thomas Traceable S/N 192511657 IR Gun Correction Factor °C: 0.0
❑ YES ❑ NO 3. If temperature of cooler exceeded 6°C, was Project Mgr./QA notified?
YES ❑ NO
4.
Were proper custody procedures (relinquished/receiv
YES ❑ NO
5.
Were sample ID's listed on the COC?
YES ❑ NO
6.
Were samples ID's listed on sample containers?
YES ❑ NO
7.
Were collection date and time listed on the COC?
YES ❑ NO ::f:!:.:
Were tests to be performed listed on the COC?
followed?
YES
❑
NO
9. Did samples arrive in proper containers for each test?
NO
10. Did samples arrive in good condition for each test?
NO
11. Was adequate sample volume available?'
NO
12. Were samples received within proper holding time for requested tests?
NO
13. Were acid preserved samples received at a pH of <2?
NO
W2.
14. Were cyanide samples received at a pH >12?
PJO
15. Were sulfide samples received at a pH >9?
NO
16. Were NH3/TKN/Phenol received at a chlorine residual of <0.5 m/L? 4
NO
17. Were Sulfide/Cyanide received at a chlorine residual of <0.5 m/L?
NO
18. Were orthophosphate samples filtered in the field within 15 minutes?
* TOCIVolatiles are pH checked at time of analysis and recorded on the benchsheet.
*= Bacteria samples are checked for Chlorine at time of analysis and recorded an the benchsheet.
Sample Preservation: (Must be completed for any sample(s) incorrectly preserved or with headspace)
5ample(s) were received incorrectly preserved and were adjusted accordingly
by adding (circle one): HMSO; HNO; HCI NaOH
Time of preservation: If more than one preservative is needed, notate in comments below
Vote: Notify customer service irnrrediate'y for incorrectly preserved samples. Obta,n a nevi sample or
notify th= state lab if dire ted to analyzed by the ;.us'omer. 'Who was notif _ed, date and time._ _
Lola tiles Samples) were received with headspace
COMMENTS:
DOC. QA.002 Rev 1

ton
ENVIRONMENTAL CHEMISTS, INC 6602 l E:9 0392-02231FAX[phone]
Analytical & Consulting Chemists NCDENR: DWQ CERTIFICATION # 94 NCDHHS: DLS CERTIFICATION # 37729 [e-mail]
COLLECTION AND CHAIN OF CUSTODY
Client: Smithfield Hog Production -Warsaw
PROJECT NAME: /a �r
REPORT NO: — �07
ADDRESS:
CONTACT NAME: J qwS o
PO NO:
REPORT TO: Kraig Westerbeek
PHONE/FAX:
COPY TO:
email:
Sampled By: SAMPLE TYPE: I = Influent. E = Effluent. W = Well. ST = Stream. SO = Soil. SL = Sludge_ Other -
Sample Identification
Collection
m y
E
N
d
Usp
COL `o �
0
c(7
9 tj
U a
�J
o rn
U E
OW
m M
Z
PRESERVATION
v
ANALYSIS REQUESTED
Date
Time
Temp
].zz-
Ocnc
=
eo
=
x
xo
z
o
rcm
�'
W
~O
Residuals
C
P
��5"
Full TCLP, RCI, Nutrients/Metals
G
G
C
P
G
G
C
P
G
G
C
P
G
G
C
P
G
G
C
P
G
G
C
P
G
G
C
P
G
G
C
P
G
G
Transfer
Relinquished By:
Date/Time
Received By:
Date/Time
1.
2.
Temperature whe°C: L 7 Accepted:
n eceived
Delivered By: L-e Recl
By:
Requested:
?zy Time:
TURNAROUND:

RESIDUALS SOURCE CERTIFICATION ATTACHMENT CLAYTON - RSC 06-16

Division of Water Resources
State of North Carolina
Department of Environmental Quality
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
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 I1-15) 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 1. 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

DWR
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: Town of Clayton
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: 1.
3. Facility contact person and title: James O. Warren, ORC
Complete mailing address: Post Office Box 879
City: Clayton State: NC Zip: 27528
Telephone number: (919 9) 553-1536 E-mail address: jowarren(a)townofclayton.org
4. Facility physical address: 100 Durham Street Extension
City: Clayton State: NC Zip: 27520-
Coordinates: Latitude: 35' 38' 27.17" Longitude: 78' 27' 37.8"
Datum: NAD 1983 UTM 17N Level of accuracy: 1"
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: % industrial and % domestic)
❑ other (explain: ).
6. Does the facility have an approved pretreatment program: ® Yes ❑ No
7. Facility permitted/design flow: 2_5 MGD and facility average daily flow: 1.72 MGD
8. Average amount of residuals being generated at this facility 300 dry tons per year.
9. Specify the following regarding treatment and storage volumes available at the facility:
Type and volume of residuals treatment: 2 — 0.36 million gallon aerated sludge holding tanks
Type and volume of residuals storage (i.e., outside of residuals treatment units): None
II. 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 domesticimunicipal 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
FORM: RSC 06-16 Page 1 of
5

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).
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: ❑ yes ® no.
If yes, list the number(s):
b. Specify whether or not the residuals exhibit any of the characteristics defined by 40 CFR §261.21-
261.24: ❑ yes ® no.
Fill in the following tables with the results of the latest toxicity characteristic leaching procedure (TCLP) analysis as well
as those for corrosivity, ignitability, and reactivity:
Laboratory: Waypoint Analytical and Date of analysis: 9/29/2020
Passed corrosivity test: ® yes ❑ no. pH: s.u. (2 < pH < 12.5)
Passed ignitability test: ® yes ❑ no. Flashpoint: >200 IF (> 140°F)
Passed reactivity test: ®yes ❑no. HCN: <1.0 mg/kg (<250) & H2S: <10.0 mg/kg (<500)
TCLP Parameter
Limit
(mg/1)
Result
(mg/1)
TCLP Parameter
Limit
(mg/1)
Result
(mg/1)
Arsenic
5.0
<0.250
Hexachlorobenzene
0.13
<0.100
Barium
100.0
<0.250
Hexachloro-1,3-Butadiene
0.5
<0.100
Benzene
0.5
<0.0116
Hexachloroethane
3.0
<0.100
Cadmium
1.0
<0.0500
Lead
5.0
<0.100
Carbon Tetrachloride
0.5
<0.0100
Lindane
0.4
<0.0016
Chlordane
0.03
<0.0080
Mercury
0.2
<0.0200
Chlorobenzene
100.0
<0.0100
Methoxychlor
10.0
<0.0016
Chloroform
6.0
<0.0100
Methyl Ethyl Ketone
200.0
<0.200
Chromium
5.0
<0.100
Nitrobenzene
2.0
<0.100
m-Cresol
200.0
<0.020
Pentachlorophenol
100.0
<0.200
o-Cresol
200.0
<0.010
Pyridine
5.0
<0.100
p-Cresol
200.0
<0.020
Selenium
1.0
<0.500
Cresol
200.0
<0.500
Silver
5.0
<0.0500
2,4-D
10.0
<0.0200
Tetrachloroethylene
0.7
<0.0100
1,4-Dichlorobenzene
7.5
<0.0100
Toxaphene
0.5
<0.01200
1,2-Dichloroethane
0.5
<0.0100
Trichloroethylene
0.5
<0.0100
1,1-Dichloroethylene
0.7
<0.0100
2,4,5-Trichlorophenol
400.0
<0.100
2,4-Dinitrotoluene
0.13
<0.100
2,4,6-Trichlorophenol
2.0
<0.100
Endrin
0.02
<0.0016
2,4,5-TP (Silvex)
1.0
<0.002
Heptachlor and its Hydroxide
0.008
<0.0016
Vinyl Chloride
0.2
<0.0100
FORM: RSC 06-16 Page 2 of 5

4. Metals Determination: Complete one of the following tables (i.e., as applicable) to demonstrate that the residuals do not violate
the ceiling concentrations for metals regulated under 15A NCAC 02T .1105.
a. For Distribution/Land Application: Fill in the following table with the results of the latest analyses (i.e., on a dry weight
basis) for the following metal parameters:
Laboratory: Waypoint Analytical and Date of analysis: 3/02/2020
Parameter
Ceiling
Monthly Average
Result
Concentration Limits
Concentration Limits
(ClassA & ClassB)
(Class A Only)
(mglkg)
(mglkg)
(mglkg)
Arsenic
75
41
<20.80
Cadmium
85
39
<4.17
Copper
4,300
1,500
164.00
Lead
840
300
<12.5
Mercury
57
17
<0.625
Molybdenum
75
n/a
<10.40
Nickel
420
420
11.60
Selenium
100
100
<20.80
Zinc
7,500
2,800
492.00
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. Nutrient/Micronutrient Determination: Complete the following:
a. Total solids: 2.35 %.
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: 03/02/2020
Parameter
Result
(mg1k-g)
Aluminum
10,600.00
Ammonia -Nitrogen
10,200.00
Calcium
13,700.00
Magnesium
5,210.00
Nitrate -Nitrite Nitrogen
642.00
pH (Standard Unit)
6.4
Phosphorus
28,400.00
Potassium
9,540.00
Sodium
3,890.00
Total Kjeldahl Nitrogen
59,600.00
c. Using the results listed in Item II. 5b. above, calculate the sodium adsorption ration (SAR): 1.10
[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: 30 %. This rate
is a (check one): ® 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
(mg1kg)
(mg1k-g)
Surface
20,562
29,464
Injection/Incorporation
25,662
34,564
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: None
FORM: RSC 06-16 Page 4 of

7. Patho¢en Reduction: Per 15A NCAC 02T.11061 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.I 106(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.1106(b)(3)(E)-(K)] - Process to Further Reduce Pathogens (PFRP).
Specify one: ❑ composting, ❑ heat drying, ❑ heat treatment,
❑ thermophilic aerobic digestion, ❑ beta ray irradiation,
❑ gamma ray irradiation, or ❑ pasteurization.
b. For Land Application of Class B:
® Alternative 1 [15A NCAC 02T.I 106(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, ❑ anaerobic digestion,
❑ composting, or ® lime stabilization.
c. For Surface Disposal:
❑ Select One of the Class A or Equivalent Pathogen Reduction Alternatives in Item II. 7a. above.
❑ Select One of the Class B or Equivalent Pathogen Reduction Alternatives in Item II. 7b. above.
❑ Exempt -If Daily Cover Alternative is chosen in Item 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.I 107(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.I 107(a)(3)] - 30-Day Bench Scale Test (Aerobic Digestion).
® Alternative 4 [15A NCAC 02T.I 107(a)(4)] - Specific Oxygen Uptake Rate Test (Aerobic Digestion).
❑ Alternative 5 [15A NCAC 02T.I 107(a)(5)] - 14-Day Aerobic Processes.
® Alternative 6 [15A NCAC 02T.I 107(a)(6)] - Alkaline Stabilization.
❑ Alternative 7 [15A NCAC 02T. 1 107(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.I 107(a)(10)] - Incorporation.
❑ Alternative for Surface Disposal Units Only - Soil/Other Material Cover [ 15A NCAC 02T.I 107(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

Facility Vicinity Map WRF

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Sources: Esri, HERE, Del-orme, USC..S, Intermap, INCREMENT P.
NRCan,'Esri Japan, MET], Esri China*ftHong Kong), Esri Korea, Esn
(Thailand), Mapmylndia, NGCC, © OpLynStreetMap contributors.. and the
U c°, GIS User Community
SCALE: � rr — 1,500 ft
Triple S Farms Facility
CHECKED BY: RTB Land Application Program Vicinity
DRAWN BY:
RTB BRANCH Clayton WWTP Map
RESIDUALS
DATE: 1/8/2021 SOILS, LLC Project No. 2007-71

Process Flow Diagram and Narrative WRF

WASTEWATER RECLAMATION FACILITY PROCESS
The Town of Clayton owns and operates a 2.5 mgd water reclamation facility. The facility is
named; Little Creek Water Reclamation Facility and operates under NPDES Permit # NC0025453.
The facility also delivers reclaim water to the Pine Hollow Golf under Permit # WQ0022224. The
facility is also covered under Stormwater Permit #NCGI 10000.
The plant consists of a mechanical and manual bar screen, Jeta (Vortex) type grit removal system,
9 inch parshall flume with flow meter, and a composite sampler. The influent pumping station has
three 60 hp dry pit submersible pumps and one 40 hp pump. Biological nutrient removal is
achieved by a Carrousel Denite R System (Eimco), the system contains an anaerobic selector, two
anoxic tanks, and two oxidation ditches. The biological system is controlled by a PLC based
control system that monitors oxygen throughout the system. The plant also has three circular
clarifiers, two mixed bed tertiary filters, ultraviolet disinfection, effluent pumping station, in plant
reuse pumping system, and a reclaim water pumping station. In addition to the biological systems,
the plant has chemical feed for alkalinity (magnesium hydroxide), alum precipitation (alum
sulfate), and flocculation (polymer).
The sludge conditioning and disposal systems consist of. two drum thickeners (80 gpm & 300
gpm), polymer flocculation, two .36 mg aerated holding tanks, one .09 mg aerobic digester, and
sludge transfer pump.
A process schematic for the Town of Clayton WRF is presented on the following page.

Justification for Residuals Production Rate WRF

JUSTIFICATION FOR CLAYTON RESIDUALS PRODUCTION RATE
The dry tons permitted for this facility is currently 80 dry tons. With anticipated changes, the
permitted number of dry tons for Clayton WRF will be increased to 300 dry tons.

Residuals Sampling Plan WRF

WRF SAMPLING PLAN
The following sampling protocols shall be followed. All samples will be collected in clean and/or
sterilized containers provided by the contract laboratory. Chain of custody information is required
for each sample collected (see attachment one). Sampling equipment shall be cleaned prior to and
after sample collection. Sampling equipment used to collect fecal coliforms shall be sterilized prior
to sample collection; all others will be cleaned with laboratory grade detergent and rinsed with
deionized water.
Sample Requirements:
Sample frequencies shall be determined by the Land Application Permit. The sampling frequencies
is dependent on total pounds of material applied per year. The Town of Clayton is listed as having
a sample frequency of quarterly but due to past limitations with the current land base, less than
318 dry tons of biosolids are expected to be land applied. Based on this projection the sample
frequency will be set at annually. If it seems likely the amount of biosolids land applied will be
greater than 318, the sample frequency will increase to quarterly to reflect the increase in land
applied volume. Biosolids taken to the landfill or compost facility will not be included in this
total, but will be identified in the annual report.
Annual or Quarterly Samples (depending on pounds of material applied per year) Note
sampling is not required when no events occur in the quarter:
Location: Sludge Holding Tanks
Analytical Tests for Nutrient and Metals Analysis
Aluminum, Ammonia -Nitrogen, Arsenic, Cadmium, Calcium, Copper, Lead, Magnesium,
Mercury, Molybdenum, Nickel, Nitrate -Nitrite Nitrogen, Phosphorus, Potassium, pH, Plant
Available Nitrogen (by calculation), Selenium, Sodium, Silver, % Total Solids, TKN, Zinc.
Sample Collection
Fecal coliforms will be collected from the sludge holding tank form the walkway using a sterilized
stainless -steel dipper. This walkway is the only safe means to sample this tank. Samples will be
collected prior to disposal. The number of samples will depend on the amount of biosolids expected
to be land applied within the year. Plant staff should request a five-day turn -around on all samples
collected and be aware of the short holding times of 6 hours. In order to meet Class B requirements,
the geometric mean must be less than 2 million (MPN/gram TS, or CFU/gram TS). If the counts
exceed the regulatory limits the biosolids may not be land applied until the limits are met.
Nutrient and metals analysis contained in the land application and composting permits will be
collected from the sludge holding tank via a clean dipper using a four sample composite method.
The aliquots shall be collected from the walkway at two hour intervals. The aliquots should be

800 milliliters and placed in a gallon jug in the laboratory refrigerator. After the fourth sample is
added the sample should be well mixed and transferred into the proper sample containers. A chart
is provided on specific sample requirements. Temperature and pH are grab samples and the pH
shall be temperature corrected.
Plant personnel will document and use the following chart for the temperature correction for all
pH readings.
pH Temperature Correction Factors at Varying Temperatures from Standard (25°C)
Temp°C
Correction Factor
40
Plus 0.45
39
Plus 0.42
38
Plus 0.39
37
Plus 0.36
36
Plus 0.33
35
Plus 0.30
34
Plus 0.27
33
Plus 0.24
32
Plus 0.21
31
Plus 0.18
30
Plus 0.15
29
Plus 0.12
28
Plus 0.09
27
Plus 0.06
26
Plus 0.03
25
0.00
24
Minus 0.03
23
Minus 0.06
22
Minus 0.09
21
Minus 0.12
20
Minus 0.15
19
Minus 0.18
18
Minus 0.21
17
Minus 0.24
16
Minus 0.27
15
Minus 0.30
14
Minus 0.33
13
Minus 0.36
12
Minus 0.39
11
Minus 0.42

10 1 Minus 0.45
Vector Attraction Reduction:
Vector attraction reduction will consist of alkali addition directly into either sludge holding tank.
Prior to land application a contractor will be used to supply calcium carbonate at a level to achieve
a ph of > 12 units for two hours and maintain a pH of > 11.5 for an additional 22 hours. There will
be no additional material added to the tank until the land application is complete. A log sheet will
be maintained on -site and will contain the following information: date, times, location, purpose,
amount of material added, initial pH, pH after addition, pH two hours after addition, pH twenty
two hours after addition, names of persons involved, completion date and volume of biosolids land
applied. If the required parameters are not met the process must be successfully completed prior
to land applying the sludge. Note: It is a good practice to perform ajar test to the contents of the
tank prior to treatment, in order to determine the required amount of alkali to add.
Alternatively a specific oxygen uptake may be performed if the solids concentration is less than
two percent and enough digestion time has been provided, a spreadsheet provided by the land
application unit shall be used for the calculations, a minimum of seven samples must be taken for
the monitoring period. The number of samples will depend on the amount of biosolids expected to
be land applied within the year.
Once per permit cycle
A sample for toxicity characteristics leaching procedure to include ignitability, corrosivity, and
reactivity as listed below:
Location: Sludge Holding Tanks
Arsenic
Hexachlorobenzene
ph for Corrosivity
Barium
Hexachloro-1,3-Butadiene
Benzene
Hexachloroethane
Flash point for ignitability
Cadmium
Lead
Carbon Tetrachloride
Lindane
Sulfides and Cyanides for reactivity
Chlordane
Mercury
1,2-Dichloroethane
Chlorobenzene
Methoxychlor
1,1-Dichloroethylene
Chloroform
Methyl Ethyl Ketone
2,4-Dinitrotoluene
Chromium
Nitrobenzene
Endrin
m-Cresol
Pentachlorophenol
Heptachlor and its Hydroxide
o-Cresol
Pyridine
Trichloroethylene
p-Cresol
Selenium
2,4,5-Trichlorophenol
Cresol
Silver
2,4,6-Trichlorophenol
2,4-D
Tetrachloroethylene
2,4,5-TP (Silvex)
1,4-Dichlorobenzene
Toxaphene
Vinyl Chloride

Lab Analytical Reports and Operational Data WRF

Waypoint.(Z)
ANALYTICAL
3/4/2020
Town Of Clayton
POB 879
Clayton, NC, 27528
7621 whitepine Road, Richmond, VA 23237
Main 804-743-9401 ° Fax [phone]
www.waypointanalytical.com
Ref: Analytical Testing
Report Number: 20-055-0007
Project Description: Holding Tank #1
Waypoint Analytical Virginia, Inc. received sample(s) on 2/24/2020 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,
P,�. Ir 60-r
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.
Page 1 of 6

Waypoint-
ANALYTICAL
Report Number: 20-055-0007
Client Project Description: Holding Tank #1
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 ° Fax [phone]
www.waypointanalytical.com
Sample Summary Table
Lab No Client Sample ID Matrix Date Collected Date Received Method Lab ID
70553
Holding Tank
#1
Solids
02/20/2020
11:00
02/24/2020
70553
Holding Tank
#1
Solids
02/20/2020
11:00
02/24/2020
SM-4500-NH3C
WP
MTN
70553
Holding Tank
#1
Solids
02/20/2020
11:00
02/24/2020
9045D
WP
MTN
70553
Holding Tank
#1
Solids
02/20/2020
11:00
02/24/2020
4500NO3F-2011
WP
MTN
70553
Holding Tank
#1
Solids
02/20/2020
11:00
02/24/2020
6010D
WP
MTN
70553
Holding Tank
#1
Solids
02/20/2020
11:00
02/24/2020
SW-7471B
WP
MTN
70553
Holding Tank
#1
Solids
02/20/2020
11:00
02/24/2020
SM-4500-NH3C-TKN
WP
MTN
70553
Holding Tank
#1
Solids
02/20/2020
11:00
02/24/2020
SM-2540G
WP
MTN
WP MTN - Memphis, TN: Waypoint Analytical - TN, Memphis, TN
Page 2 of 6

0
•
Waypoint.
7621 Whitepine
Road, Richmond, VA 23237
Main 804-743-9401 ° Fax [phone]
ANALYTICAL
www.waypointanalytical.com
46546
Town Of Clayton
POB 879
Project
Holding Tank #1
Report Date : 03/04/2020
Information :
Received : 02/24/2020
Clayton , NC 27528
Pam«
c r
m 6�
Pauric McGroary
Report Number: 20-055-0007
REPORTOFANALYSIS
Agronomist
Lab No : 70553
Matrix:
Solids
Sample ID : Holding Tank #1
Sampled: 2/20/2020 11:00
Test
Results
Units
MOL
DF
Date / Time
By
Analytical
Analyzed
Method
Moisture
97.6
%
0.010
1
02/26/2017:01
ADM
SM-254OG
Test
Results
Units
MOL
DF
Date / Time
By
Analytical
Analyzed
Method
Ammonia Nitrogen
10200
mg/Kg - dry
4170
1
03/02/20 13:00
JPJ
SM-4500-NH3C
Nitrate+Nitrite-N
642
mg/Kg - dry
208
1
03/02/20 14:10
ZBD 4500NO3F-2011
Organic N
49600
mg/Kg - dry
10400
1
03/02/20 10:00
DH
CALCULATION
pH
6.4
S.U.
1
03/02/20 05:41
JSL
9045D
Total Solids
2.35
%
0.010
1
02/26/20 17:01
ADM
SM-2540G
Total Kjeldahl Nitrogen
59600
mg/Kg - dry
10400
1
03/02/20 10:00
JPJ >M-4500-NH3C-T0
Phosphorus
28400
mg/Kg - dry
208
1
02/26/20 16:46
JTR
6010D
Aluminum
10600
mg/Kg - dry
208
1
02/26/20 16:46
JTR
6010D
Arsenic
<20.8
mg/Kg - dry
20.8
1
02/26/20 16:46
JTR
6010D
Calcium
13700
mg/Kg - dry
1040
1
02/26/20 16:46
JTR
6010D
Cadmium
<4.17
mg/Kg - dry
4.17
1
02/26/20 16:46
JTR
6010D
Chromium
16.4
mg/Kg - dry
10.4
1
02/26/20 16:46
JTR
6010D
Copper
164
mg/Kg - dry
10.4
1
02/26/20 16:46
JTR
6010D
Lead
<12.5
mg/Kg - dry
12.5
1
02/26/20 16:46
JTR
6010D
Magnesium
5210
mg/Kg - dry
208
1
02/26/20 16:46
JTR
6010D
Mercury
<0.625
mg/Kg - dry
0.625
1
02/26/20 12:51
TJS
SW-7471B
Molybdenum
<10.4
mg/Kg - dry
10.4
1
02/26/20 16:46
JTR
6010D
Qualifiers/ DF Dilution Factor
L Limit
Exceeded
Definitions MQL Method Quantitation Limit
Page 3 of 6

Waypointo
ANALYTICAL
46546
Town Of Clayton
POB 879
Clayton , NC 27528
Report Number:20-055-0007
Lab No : 70553
Sample ID : Holding Tank #1
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 ° Fax [phone]
www.waypointanalytical.com
Project Holding Tank #1
Information :
REPORT OPANAL YSIS
Report Date : 03/04/2020
Received : 02/24/2020
Pauric McGroary
Agronomist
Matrix: Solids
Sampled: 2/ 20/ 2020 11:00
Test
Results
Units
MQL
DF
Date / Time
Analyzed
By
Analytical
Method
Nickel
11.6
mg/Kg - dry
10.4
1
02/26/20 16:46
JTR
6010D
Potassium
9540
mg/Kg - dry
208
1
02/26/20 16:46
JTR
6010D
Selenium
<20.8
mg/Kg - dry
20.8
1
02/26/20 16:46
JTR
6010D
Silver
<10.4
mg/Kg - dry
10.4
1
02/26/20 16:46
JTR
6010D
Sodium
3890
mg/Kg - dry
1040
1
02/26/20 16:46
JTR
6010D
Zinc
492
mg/Kg - dry
52.1
1
02/26/20 16:46
JTR
6010D
Sodium Absorption Ratio
1.11
1
CALCULATION
Qualifiers/ DF Dilution Factor
Definitions MQL Method Quantitation Limit
L Limit Exceeded
Page 4 of 6

Way
oint
ANALYTICAL
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 0 Fax [phone]
www.waypointanalytical.com
Shipment Receipt Form
Customer Number: 46546
Customer Name: Town Of Clayton
Report Number: 20-055-0007
Shipping Method
Fed Ex US Postal U Lab
UPS Client 0 Courier
Other
Thermometer ID:
Shipping container/cooler uncompromised?
Yes
No
Number of coolers/boxes received
Custody seals intact on shipping container/cooler?
O Yes
No
Not Present
Custody seals intact on sample bottles?
0 Yes
No
Not Present
Chain of Custody (COC) present?
Yes
No
COC agrees with sample label(s)?
Yes
No
COC properly completed
Yes
No
Samples in proper containers?
Yes
No
Sample containers intact?
Yes
No
Sufficient sample volume for indicated test(s)?
Yes
No
All samples received within holding time?
Yes
No
Cooler temperature in compliance?
Yes
No
Cooler/Samples arrived at the laboratory on ice.
Samples were considered acceptable as cooling
process had begun.
Yes
No
Water - Sample containers properly preserved
0 Yes
No
N/A
Water - VOA vials free of headspace
O Yes
No
N/A
Trip Blanks received with VOAs
0 Yes
No
N/A
Soil VOA method 5035 — compliance criteria met
O Yes
No
N/A
r High concentration container (48 hr) F Low concentration EnCore samplers (48 hr)
F_ High concentration pre -weighed (methanol -14 d) F_ Low conc pre -weighed vials (Sod Bis -14 d)
Special precautions or instructions included?
Comments:
Yes
No
Signature: 113randi Watson Date & Time: 2/24/2020 10:11:21
Page 5 of 6

WASTEWATER SAMF IaIBIIIIinIIIIIIINNIIINIIIIiN�lllglllll�l�°°°'
• rrx.,,, a aMir,
kO l J Tim 07 2+.C.0
7611 Whntpine Rawl Rrrhnaund bA 21' 101045
3F CUSTODY Accounts
tanul..lnal .om
Submitted By Charge To Copy To
Tarn c� if
h- L. K 7
Cla y' ?464- 2 75 Z&
Phone-% _53- - /_ j36 Fax' E-mail oul.f ai ��Y.n c�k Inc �,
L�
Project
Sample Information
Lab Number
Collecuon Information
Container information
?.lease ile in Desned Tests
Sample10
(Lab Use
Number
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GI>CSS
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Relincuished 8 (S.Inatuirel
Date
Time
Received G (-`, nature;
Date
Time
2. 21
Test Available
Special Instructions or Remarks
Nitrogen Series' Total Kieldahl. Ammonium Ninate & Organic. Nitrogen
Phosphorus(total. orthor). Poalssium. Sulfate -Sulfur, Calcium, Magnesium, Sodium, Iron. Aluminum
Manganese. Copper. Zinc, Arsenic. Barium Cadmium, Chromium, Cobalt. Molybdenum, Mercury. Lead,
Se'enrum Silver Nickel Acidity (Total). Alkalinity (Total). Biochemical Oxygen Demand (5 days) Boron
Chemical Oxygen Demand Chloride. Conductance (Specilic). Hexavalent Chromium, Oil and Grease (EPA)
pH, Phenol, Solids (Dissolved, Suspended. Total, Volatile)
Page 6 of 6

Waypoi rat
ANALYTICAL
10/8/2020
Town Of Clayton
POB 879
Clayton, NC, 27528
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 ° Fax [phone]
www.waypointanalytical.com
Ref: Analytical Testing
Report Number: 20-268-0013
Project Description: Holding Tank 2
Waypoint Analytical Virginia, Inc. received sample(s) on 9/24/2020 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,
,OWW # �. M (
Pauric McGroary
Agronomist
iyQowy/
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.
Page 1 of 10

Waypoint. 7621 (2) Whitepine Road, Richmond, VA 23237
Main 804-743-9401 ° Fax [phone]
ANALYTICAL www.waypointanalytical.com
Sample Summary Table
Report Number: 20-268-0013
Client Project Description: Holding Tank 2
Lab No
Client Sample ID
Matrix
Date Collected
Date Received
Method
Lab ID
73774
Holding Tank 2
TCLP
09/23/2020 13:00
09/24/2020
SW-1311
WP MTN
73774
Holding Tank 2
TCLP
09/23/2020 13:00
09/24/2020
8081A
WP MTN
73774
Holding Tank 2
TCLP
09/23/2020 13:00
09/24/2020
SW-1311 (ZHE)
WP MTN
73774
Holding Tank 2
TCLP
09/23/2020 13:00
09/24/2020
8151A
WP MTN
73774
Holding Tank 2
TCLP
09/23/2020 13:00
09/24/2020
6010D
WP MTN
73774
Holding Tank 2
TCLP
09/23/2020 13:00
09/24/2020
8260B
WP MTN
73774
Holding Tank 2
TCLP
09/23/2020 13:00
09/24/2020
8270C
WP MTN
73774
Holding Tank 2
TCLP
09/23/2020 13:00
09/24/2020
7470A
WP MTN
73775
Holding Tank 2
Solids
09/23/2020 13:00
09/24/2020
SW-9045C
WP MTN
73775
Holding Tank 2
Solids
09/23/2020 13:00
09/24/2020
SW-7.3.4
WP MTN
73775
Holding Tank 2
Solids
09/23/2020 13:00
09/24/2020
SW-7.3.3
WP MTN
73775
Holding Tank 2
Solids
09/23/2020 13:00
09/24/2020
ASfM D93-80
WP MTN
WP MTN - Memphis, TN: Waypoint Analytical - TN, Memphis, TN
Page 2 of 10

0
Waypoint.
7621 Whitepine
Road, Richmond, VA 23237
Main 804-743-9401 ° Fax [phone]
ANALYTICAL
www.waypointanalytical.com
46546
Town Of Clayton
Project
Holding Tank 2
pOB 879
Report
Date : 10/08/2020
Information :
Received : 09/24/2020
Clayton , NC 27528
l� (
awf C
6* W/I �
Pauric Mc Groary Ph.D., CPA
Report Number:20-268-0013
REPORT
Agronomist
Lab No : 73774
Matrix: TCLP
Sample ID : Holding Tank 2
Sampled: 9/23/2020 13:00
Test
Results
Units
MQL
DF
Date / Time By
Analytical
Analyzed
Method
TCLP Herbicide Extraction
Combined
1
09/29/20 15:19 RMW
SW-1311
TCLP Metals Extraction
Combined
1
09/29/20 15:19 RMW
SW-1311
TCLP Pesticide Extraction
Combined
1
09/29/20 15:19 RMW
SW-1311
TCLP SVOC Extraction
Combined
1
09/29/20 15:19 RMW
SW-1311
TCLP VOC ZHE Extraction
Combined
1
09/29/20 15:02 RMW
SW-1311 (ZHE)
Analytical Method: 6010D
Prep Batch(es):
L514001
09/30/20 09:22
Prep Method: 3015A
Test
Results
Units
MQL
DF
Date / Time By
Analytical
Analyzed
Batch
TCLP Arsenic
<0.250
mg/L
0.250
1
10/01/20 08:04 ]ADS
L514304
TCLP Barium
<0.250
mg/L
0.250
1
10/01/20 08:04 ]ADS
L514304
TCLP Cadmium
<0.0500
mg/L
0.0500
1
10/01/20 08:04 JADS
L514304
TCLP Chromium
<0.100
mg/L
0.100
1
10/01/20 08:04 ]ADS
L514304
TCLP Lead
<0.100
mg/L
0.100
1
10/01/20 08:04 ]ADS
L514304
TCLP Selenium
<0.500
mg/L
0.500
1
10/01/20 08:04 ]ADS
L514304
TCLP Silver
<0.0500
mg/L
0.0500
1
10/01/20 08:04 ]ADS
L514304
Qualifiers/ DF Dilution Factor
Definitions
MQL Method Quantitation Limit
Page 3 of 10

0
Waypoint.
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 ° Fax [phone]
ANALYTICAL
www.waypointanalytical.com
46546
Town Of Clayton
Project Holding Tank 2
POB 879
Report Date : 10/08/2020
Information :
Received
: 09/24/2020
Clayton , NC 27528
6eto rwy
Pauric Mc Groary Ph.D., CPA
Report Number : 20-268-0013
REPORTOFANALYSiS
Agronomist
Lab No : 73774
Matrix: TCLP
Sample ID : Holding Tank 2
Sampled: 9/23/2020 13:00
Analytical Method: 7470A
Prep Batch(es):
L515414
10/08/20 07:30
Prep Method: 7470A
Test
Results
Units
MOL
DF Date / Time By
Analytical
Analyzed
Batch
TCLP Mercury
<0.0200
mg/L
0.0200
1 10/08/20 14:57 DDB
L515563
Analytical Method: 8081A
Prep Batch(es):
L514155
09/30/20 16:40
Prep Method: 3510C
Test
Results
Units
MQL
DF Date / Time By
Analytical
Analyzed
Batch
TCLP Endrin
<0.001600
mg/L
0.001600
10 10/01/20 02:20 VIC
L514318
TCLP gamma-BHC
<0.001600
mg/L
0.001600
10 10/01/20 02:20 VIC
L514318
TCLP Methoxychlor
<0.001600
mg/L
0.001600
10 10/01/20 02:20 VIC
L514318
TCLP Toxaphene
<0.01200
mg/L
0.01200
10 10/01/20 02:20 VIC
L514318
TCLP Chlordane
<0.008000
mg/L
0.008000
10 10/01/20 02:20 VIC
L514318
TCLP Heptachlor Epoxide
<0.001600
mg/L
0.001600
10 10/01/20 02:20 VIC
L514318
TCLP Heptachlor
<0.001600
mg/L
0.001600
10 10/01/20 02:20 VIC
L514318
Surrogate: Decachlorobiphenyl
90.92
Limits: 36-116% 10 10/01/20 02:20 VIC
L514318
Surrogate: Tetrachloro-m-xylene
98.08
Limits: 25-123% 10 10/01/20 02:20 VIC
L514318
Analytical Method: 8151A
Prep Batch(es):
L514409
10/01/20 17:40
Prep Method: 8151A
Test
Results
Units
MQL
DF Date / Time By
Analytical
Analyzed
Batch
TCLP 2,4-D
<0.0200
mg/L
0.0200
1 10/02/20 21:34 VIC
L514792
TCLP 2,4,5-TP (Silvex)
<0.0020
mg/L
0.0020
1 10/02/20 21:34 VIC
L514792
Surrogate: DCAA
40.80
Limits: 20-120% 1 10/02/20 21:34 VIC
L514792
Qualifiers/ DF Dilution Factor
MQL Method Quantitation Limit
Definitions
Page 4 of 10

Waypointo.
ANALYTICAL
46546
Town Of Clayton
POB 879
Clayton , NC 27528
Report Number : 20-268-0013
Lab No : 73774
Sample ID : Holding Tank 2
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 ° Fax [phone]
www.waypointanalytical.com
Project Holding Tank 2
Information :
REPORT OFANALYSIS
Report Date : 10/08/2020
Received
09/24/2020
p
owfC I'�i kDWy
Pauric Mc Groary Ph.D., CPA
Agronomist
Matrix: TCLP
Sampled: 9/ 23/ 2020 13:00
Analytical Method: 8260E
Prep Batch(es):
L514230 09/30/20 09:21
Prep Method: 5030E
Test
Results
Units
MOIL
DF
Date / Time
By
Analytical
Analyzed
Batch
TCLP Benzene
0.0116
mg/L
0.0100
1
09/30/20 18:04
MKD
L514248
TCLP Carbon Tetrachloride
<0.0100
mg/L
0.0100
1
09/30/20 18:04
MKD
L514248
TCLP Chlorobenzene
<0.0100
mg/L
0.0100
1
09/30/20 18:04
MKD
L514248
TCLP Chloroform
<0.0100
mg/L
0.0100
1
09/30/20 18:04
MKD
L514248
TCLP 1,4-Dichlorobenzene
<0.0100
mg/L
0.0100
1
09/30/20 18:04
MKD
L514248
TCLP 1,2-Dichloroethane
<0.0100
mg/L
0.0100
1
09/30/20 18:04
MKD
L514248
TCLP 1,1-Dichloroethene
<0.0100
mg/L
0.0100
1
09/30/20 18:04
MKD
L514248
TCLP Methyl Ethyl Ketone (MEK)
<0.200
mg/L
0.200
1
09/30/20 18:04
MKD
L514248
TCLP Tetrachloroethene
<0.0100
mg/L
0.0100
1
09/30/20 18:04
MKD
L514248
TCLP Trichloroethene
<0.0100
mg/L
0.0100
1
09/30/20 18:04
MKD
L514248
TCLP Vinyl Chloride
<0.0100
mg/L
0.0100
1
09/30/20 18:04
MKD
L514248
Surrogate:4-Bromofluorobenzene
91.2
Limits:71-137%
1 09/30/20 18:04 MKD
L514248
Surrogate: Dibromofluoromethane
86.2
Limits: 70-128%
1 09/30/20 18:04 MKD
L514248
Surrogate: 1,2-Dichloroethane - d4
95.2
Limits: 63-136%
1 09/30/20 18:04 MKD
L514248
Surrogate: Toluene-d8
80.6
Limits: 70-130%
1 09/30/20 18:04 MKD
L514248
Analytical Method: 8270C
Prep Batch(es):
L514571 10/02/20 12:10
Prep Method: 3510C
Test
Results
Units
MOL
DF
Date / Time
By
Analytical
Analyzed
Batch
TCLP 2-Methylphenol
<0.100
mg/L
0.100
5
10/05/20 16:38
CCB
L514730
TCLP 3&4 Methylphenol
<0.200
mg/L
0.200
5
10/05/20 16:38
CCB
L514730
TCLP 2,4-Dinitrotoluene
<0.100
mg/L
0.100
5
10/05/20 16:38
CCB
L514730
Qualifiers/ DF Dilution Factor
MQL
Method Quantitation Limit
Definitions
Page 5 of 10

Waypointo
ANALYTICAL
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 ° Fax [phone]
www.waypointanalytical.com
46546
Town Of Clayton Project Holding Tank 2
POB 879 Report Date : 10/08/2020
Information : Received : 09/24/2020
Clayton , NC 27528
41ci &(&Wy
Report Number: 20-268-0013 REPORTOFANALYSIS Pauric Mc Groary Ph.D., CPA
p Agronomist
Lab No : 73774 Matrix: TCLP
Sample ID : Holding Tank 2 Sampled: 9/23/2020 13:00
Analytical Method: 8270C
Prep Method: 3510C
Test
Results
Prep Batch(es):
Units
L514571 10/02/20 12:10
MOL DF
Date /Time By
Analyzed
Analytical
Batch
TCLP Hexachlorobenzene
<0.100
mg/L
0.100
5
10/05/20 16:38 CCB
L514730
TCLP Hexachlorobutadiene
<0.100
mg/L
0.100
5
10/05/20 16:38 CCB
L514730
TCLP Hexachloroethane
<0.100
mg/L
0.100
5
10/05/20 16:38 CCB
L514730
TCLP Nitrobenzene
<0.100
mg/L
0.100
5
10/05/20 16:38 CCB
L514730
TCLP Pentachlorophenol
<0.200
mg/L
0.200
5
10/05/20 16:38 CCB
L514730
TCLP Pyridine
<0.100
mg/L
0.100
5
10/05/20 16:38 CCB
L514730
TCLP 2,4,5-Trichlorophenol
<0.100
mg/L
0.100
5
10/05/20 16:38 CCB
L514730
TCLP 2,4,6-Trichlorophenol
<0.100
mg/L
0.100
5
10/05/20 16:38 CCB
L514730
Surrogate: TCLP 2,4,6-Tribromophenol
56.3
Limits: 42-102%
5 10/05/20 16:38 CCB
L514730
Surrogate: TCLP 2-Fluorobiphenyl
45.0
Limits: 24-86%
5 10/05/20 16:38 CCB
L514730
Surrogate: TCLP 2-Fiuorophenol
18.0
Limits: 13-37%
5 10/05/20 16:38 CCB
L514730
Surrogate: TCLP 4-Terphenyl-d14
64.5
Limits: 30-122%
5 10/05/20 16:38 CCB
L514730
Surrogate: TCLP Nitrobenzene-d5
45.0
Limits: 25-78%
5 10/05/20 16:38 CCB
L514730
Surrogate: TCLP Phenol-d6
12.5
Limits: 9-27%
5 10/05/20 16:38 CCB
L514730
Qualifiers/ DF Dilution Factor MQL Method Quantitation Limit
Definitions
Page 6 of 10

■
Waypoint.
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 ° Fax [phone]
ANALYTICAL
www.waypointanalytical.com
46546
Town Of Clayton
Project
Holding Tank 2
PO8 879
Report Date : 10/08/2020
Information :
Received : 09/24/2020
Clayton , NC 27528
mm
41C
I'I( Cw&Wy
Pauric Mc Groary Ph.D., CPA
Report Number: 20-268-0013
REPORTOFANALYSZS
Agronomist
Lab No : 73775
Matrix: Solids
Sample ID : Holding Tank 2
Sampled: 9/23/2020 13:00
Test
Results
Units
MQL DF Date / Time By Analytical
Analyzed Method
Cyanide (Reactivity)
<0.125
mg/Kg
0.125 1 10/06/20 10:45 FMM SW-7.3.3
Ignitability
>96
degrees C
1 10/06/20 08:39 ]DT ASTM D93-80
pH
6.7
S.U.
1 10/05/2013:00 ADM SW-9045C
Sulfide (Reactivity)
<25.0
mg/Kg
25.0 1 10/06/20 10:45 FMM SW-7.3.4
Qualifiers/ DF Dilution Factor
Definitions MQL Method Quantitation Limit
L Limit Exceeded
Page 7 of 10

Waypoint
ANALYTICAL
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 ° fax [phone]
www.waypointanalytical.com
Client: Town Of Clayton CASE NARRATIVE
Project: Holding Tank 2
Lab Report Number: 20-268-0013
Date: 10/8/2020
Semivolatile Organic Compounds - GC/MS (TCLP) Method 8270D
Sample 73774 (Holding Tank 2)
QC Batch No: 1-514730/1-514571
The sample was diluted due to the nature of the sample matrix. Reporting limits have been adjusted accordingly.
Page 8 of 10

WaypA�i rat
NALYTICAL
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 ° Fax [phone]
www.waypointanalytical.com
Shipment Receipt Form
Customer Number: 46546
Customer Name: Town Of Clayton
Report Number: 20-268-0013
Shipping Method
Fed Ex US Postal (_) Lab
UPS Client 0 Courier
Other
Thermometer ID:
Shipping container/cooler uncompromised?
0 Yes
No
Number of coolers/boxes received
1
Custody seals intact on shipping container/cooler?
O Yes
No
Not Present
Custody seals intact on sample bottles?
O Yes
No
Not Present
Chain of Custody (COC) present?
Yes
No
COC agrees with sample Iabel(s)?
Yes
No
COC properly completed
Yes
No
Samples in proper containers?
Yes
No
Sample containers intact?
Yes
No
Sufficient sample volume for indicated test(s)?
Yes
No
All samples received within holding time?
Yes
No
Cooler temperature in compliance?
Yes
No
Cooler/Samples arrived at the laboratory on ice.
Samples were considered acceptable as cooling
process had begun.
10 Yes
No
Water - Sample containers properly preserved
J Yes
O No
N/A
Water - VOA vials free of headspace
O Yes
O No
N/A
Trip Blanks received with VOAs
O Yes
0 No
N/A
Soil VOA method 5035 — compliance criteria met
0 Yes
0 No
N/A
High concentration container (48 hr) F Low concentration EnCore samplers (48 hr)
F— High concentration pre -weighed (methanol -14 d) [— Low conc pre -weighed vials (Sod Bis -14 d)
Special precautions or instructions included?
Comments:
Yes IS No
Signature: ISamantha Clarke Date & Time: 9/24/2020 10:54:42
Page 9 of 10

I
WASTEWATER SAMPLE TRANSMIT'r NL FOkW(HAHN OF CUSTODY Account
\Vaypoint Analytical
Rh lgqi.c R.ad Hi I mmud 2 QI Id 4114 '41 )4 11 1 Ax '404 1 '44^ 1 nw& I ic;il —ill
Customer Information
SubmittedByCharge
To
Copy To
-7(>edA) d— 01QAOA)
saow
#
rti Ak c27-5"
Project
Phoneq/ q Fax E-mail -lbA)AQf
Sample Information
Lab Number
corection 1,%.— wuw
Carta no, infurmanon
mease Writem Dented Tests
S31nlr)e ID
{Lab Use
Onl,fi
T)pe
Dale
Tame
Number
Oil
H6K—V1—
Composite
compos te
Grar,
Ccn .t Or *a
as
Grab
campus
Relrr,qu shad By (S.qnatura I
DIIIYe
Time
Received By (Si nature)
Date
Time
I j
V,
Test Available
Special Instructions or Remarks
Nitrogen Series. Total Kle4dahl. Ammonium Nitrate & Organic Nitrogen
Phosphonis(lotal orlhor). Poalssiurn- Sulfait- Sulfur Calcium klagnesiurn. SMium Iron Alunvnum
Manganese, Copper, Zinc Arsenic, Barium Cadmium Clifomiurn Cobalt. Motybdenurn Mercury Laid
Selenium Silver, Nickel Acidity (Total), Alkalituty, (Total) Biochein,cal Oxygen Demand 6 days). Baron, Chemical
Oxygen Demand. Chloride. Conduclance (Specific), Hexavalent Chromium, Oil and Grease (EPA),
pit, Phenol, Solids (Dissolved. Suspended. Total Volatile)
oc !I
4�5
3-0 0

LAND APPLICATION SITE CERTIFICATION ATTACHMENT
LASC 06-16

Division of Water Resources
State of North Carolina
Department of Environmental Quality
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.
B. Land Application Site Information:
® The status of the land application site with respect to this residuals land application program must be provided in table I. The
status categories and their corresponding codes are as follows:
♦ New (N) ♦ Renewed (R) ♦ Modified (M) ♦ Transferred (T) ♦ Deleted (D)
❑ Attach the following in accordance with each status code:
Status Code
Required Item
N
R
T
M
u�
County Board
Notification. doc
L�
✓
✓
✓
Land Owner
Agreement
(If applicable)
Setback Walver
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 06-16Page 1 of

An updated accounting of the land application site's cumulative pollutant
loading rates CPLRs
Status Code
Required Item
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 "W', please contact the Division if you need assistant in
determining attachment requirements.
® Crop Type should include the most likely crop types for the life of the permit (five years).
® Predominant Soils Series Name must be either the name of the soil indicated in Attachment `B" of the existing permit, or name
of the soil series as provided by the licensed soil scientist.
® Predominant Soil Mapping Unit or Representative Slope: Either the Soil Mapping Unit or the representative slope of each site
must be provided. The predominant soil -mapping unit must be consistent with the predominant soil series name. Please note
that the soil mapping units are variable between Counties, so care should be taken in properly identifying the correct mapping
unit. If a representative slope is provided, it must be determined accordingly:
❑ For sites previously permitted for use, but do not have an established soil mapping unit (the mapping unit provides
information on both the soil series name and the slope of the soil), the Applicant may determine the representative slope
by using the average slope provided in the County Soil Survey (or equivalent). A soil type with a slope range of 4 - 8%
would have a representative slope of 6%.
❑ New Sites to be permitted must have slopes determined as part of the soils report prepared by a licensed soil scientist.
® Acceptable methods for determining location coordinates (i.e., latitude and longitude) and their corresponding codes are as
follows:
• Address Matching (ADD) • Digital or Raw Photo Extraction (EXT)
• Aerial Photography with Ground Control (AER) • Geodetic Quality GPS Survey (GEO)
• Cadastral Survey (SUR) • LORAN-C Navigation Device (LOR)
• Conversion from Coordinate Plane (CP) • Navigation Quality GPS (GPS)
• Conversion from Township -Section -Range (TSR) • Remote Sensing (RS)
• Conversion from Universal Trans Merc (UTM) • Zip Code Centroid (ZIP)
• Map Interpretation by Digital or Manual Extraction (MAP)
C. Waterbody and Classifications Information: (new sites only)
❑ Use an 8.5 by 11-inch copy of the portion of a 7.5-minute USGS Topographic Map to identify the location where the residuals
program activities are planned to occur as well as the closest downslope surface waters as clearly as possible. Each map portion
must be labeled with the map name and number, the identified location, and be of clear and reproducible quality.
❑ Surface water body classifications information may be found at: http://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://deq.nc. gov/contact/re,g ional-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 htip:Hdeq.nc.pov/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.
❑ 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 06-16Page 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. Ken 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 06-16Page 3 of

LAND APPLICATION SITE CERTIFICATION
Applicant's name: Triple S Farms
Land application sites currently certified: 130.1 net acres and Total to be certified: 130.1 net acres.
I. LAND APPLICATION SITE INFORMATION (See Instruction B):
Status
Code'
Site/Field
ID
Landowner() s
or O s
Lessee() Operator(s)
Net Acres
County
Coun
Cro s)
Crop(s)
Predominant Soil
Series Name
Mapping Unit
or Rep. Slope'
R
1
Eric Smith
34.2
Du lin
Bermudagrass
Norfolk
NoA
R
2
Eric Smith
8.48
Du lin
Bermudagrass
Foreston
FoA
R
3A
Eric Smith
13.73
Du lin
Bermudagrass
Foreston
FoA
R
3B
Eric Smith
7.27
Du lin
Fescue
Foreston
FoA
R
4
Eric Smith
4.14
Du lin
Fescue
Foreston
FoA
R
5
Eric Smith
11.2
Du lin
Fescue
Foreston
FoA
R
6
Eric Smith
13.95
Du lin
Trees
Goldsboro
GoA
R
7
Eric Smith
14.5
Du lin
Bermudagrass
Foreston
FoA
R
8
Eric Smith
13.7
Du lin
Fescue
Goldsboro
GOA
R
9
Eric Smith
8.93
Du lin
Row Crops
Goldsboro
GoA
' Status Code for land application sites are: ♦ N (New) ♦ R (Renewed) ♦ M (Modified) ♦ T (Transferred) ♦ D (Deleted)
b Soil Series Name (i.e. Appling, Cecil, etc.)
`Mapping Unit must be consistent with those used in the County Soil Survey (i.e. for a 2-8% slope Cecil in Anson County the mapping unit is Ce132)
II. WATERBODY AND CLASSIFICATIONS INFORMATION (See Instruction C):
Site/Field ID
Latitude
Longitude
Location
Datum
Location Method Code
Location Accuracy
Waterbody Subbasin and
Stream Index No.
Current and Proposed
p
Class
° ' 11
° ' if
NAD 83
ADD
Nearest Second
° ' 11
° ' 11
NAD 83
ADD
Nearest Second
° ' 11
° ' it
NAD 83
ADD
Nearest Second
° ' 11
° ' 11
NAD 83
ADD
Nearest Second
° '
NAD 83
ADD
Nearest Second
Note: Please keep the site information (1.) and waterbody information (11.) of the same field on the same page.
FORM: LASC 06-16 Page 1

LAND APPLICATION SITE CERTIFICATION
FORM: LASC 06-16 Page 2

Updated Maps

Site Vicinity Maps

�Q
0
1*1
•��na 7-0la
iz
Qa
Triple S Farms
ti
Sources: Esri, HERE, Detwe, USGS, Intermap, INCREMENT P,
6 NRCan, Esri Japan, METI, rs%'China (Hong Kong), Esd Korea, Esri r°%. (Thailand), Mapmylndia. NGCOpenStreetMap contributors, and the
ti GIS User Community
SCALE: 1 "= 1,500 ft Triple S Farms Facility
cuechED BY: RTB BRANCH Land Application Program Vicinity
RTB Triple S Farms Fields Map
DROMN BY: RESIDUALS
DATE: 2/2/202' 1 8l SOILS, LLC Project Via. 200 /^7 - /^7
1

Buffer Maps

1
_ 1
r
AL
1
Raw
Field •
R
as ,►"�'' �./� � . - � -
.n��+
.� . '>. +Y
• . • y -_ ,�* �`��, , *! rf.- ram.... X ,..-
_ 1•Compliance Boundary 1 feet from• • application area or 1 feet fromproperty
closest.whichever is Boundarybetween theCompliance Boundaryandthe residuals• application

Cumulative Pollutant Loading Rates

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH APPLICATION FIELD.
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: Triple S Farms WQ Permit #: WQ0030998 Field #: I Acres Utilized: 34.20
Owner: Eric Smith nnual Dry Tons Applied: 132.49 Site #: I Acres Permitted: 34.20
Operator: Eric Smith Predominat Soil Series NoA Cation Exchange Capacity (non 503): NA
Crop 1 Name: Bermudagrass Crop 1 Max PAN: 299.00 Crop 2 Name: Small Grain Crop 2 Max. PAN 50.00
C7
�'
CD
o
Specify
Totals
Per Acre
% Solids
As
Decimal
Volume
Applied per
Acre
DT/Ac
Residual Sources
(NPDES #, WQ#,
Fert., Animal Waste,
etc. )
Site
Cond.
(Dry'
Wet'
Moist)
Precip.
Past 24
Hrs.
Inches
b
b
_
w
°* o
<
d w
* N
* °=
o
5'
^w_
*
*
TKN
mg/kg
z Y
'
o0 o
°
5
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
lbs/acre
( )
Must Select
Crop 1 or Crop
2
Gal.
Cu.Yd.
Report
Totals
in Gal.
Crop 1
Crop 2
Crop 1
Crop 2
Jan-19
42,000
1,228
0.51
0.03
Kenansville WWTP
S
0.50
0.30
33,400
20
2,500
0.65
X
Feb-19
65,200
1,906
2.45
0.19
Little Creek WRF
S
0.50
0.30
82,800
4,400
4,040
11.59
X
Feb-19
384,000
11,228
2.57
1.20
Wallace WWTP
IN
1.00
0.30
7,020
1,960
3,900
17.73
X
Mar-19
69,000
2,018
2.22
0.19
Beulaville WWTP
S
0.50
0.30
40,100
5
199
4.57
X
Mar-19
240,000
7,018
2.57
0.75
Wallace WWTP
IN
1.00
0.30
7,020
1,960
3,900
11.08
X
Apr-19
156,000
4,561
2.87
0.55
Warsaw WWTP
S
0.50
0.30
26,800
3
10
8.79
X
May-19
80,000
2,339
2.22
0.22
Beulaville WWTP
S
0.50
0.30
40,100
5
199
5.30
X
Jun-19
144,000
4,211
2.87
0.50
Warsaw WWTP
S
0.50
0.30
26,800
3
10
8.11
X
Dec-19
83,000
2,427
2.45
0.25
Little Creek WRF
S
0.50
0.30
82,800
4,400
4,040
14.76
X
TOTALS:
36,936
As
Cd
Cr
Cu
Pb
Hg
Mo
Ni
Se
Zn
P
PAN 1
PAN 2
Lime Applied
Annuallbs/acre
0.13
0.12
0.17
4.66
0.32
0.01
0.09
0.14
0.13
9.35
136.08
37.85
44.73
Date
lbs/ac
Current Cumulative Ibs/acre
0.77 0.74 NA 44.44 4.25 0.08 NA 1.51 0.92 89.53
0.64 0.61 NA 39.77 3.94 0.07 NA 1.37 0.79 80.18
36 34 NA 1,338 267 15 NA 374 89 2,498
299 1 50.00
Prior Years Cumulative lbs/acre
Permitted C. P. L. R.****
Permit PAN Limit 1 st/2nd Crop
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system
designed to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are
significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
Signature of Land Applier Date
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volitilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
***Mineralization Rates: Compost - 0.1, Anaerobically Digested - 0.2,
Aerobically Digested - 0.3, Raw Sludge - 0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH APPLICATION FIELD.
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: Triple S Farms WQ Permit #: W00030998 Field #: I Acres Utilized:
Owner: Eric Smith .nnual Dry Tons Applied: 24.33 Site #: 2 Acres Permitted: _
Operator: Eric Smith Predominat Soil Series FoA Cation Exchange Capacity (non 503):
Crop 1 Name: Bermudagrass Crop 1 Max PAN: 276.00 Crop 2 Name: Small Grain Crop 2 Max. PAN
8.48
8.48
NA
50.00
C7
p'
ca
Specify
Totals
Per Acre
o
/o Solids
AS
Decimal
Volume
Applied per
Acre
DT/AC
Residual Sources
(NPDES #, WQ#,
Fert., Animal Waste,
etc.)
Site
Cond.
(Dry'
Wet'
Moist)
Precip.
Past 24
Hrs.
Inches
3 b
r?
0 w
* 0
<
0
�, =:
w w
N
* w
0.
°
5'
z n
1,
* N
°o
TKN
mg/kg
z Y
=: B
o
a ?
w
mgtkg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Must Select
Crop 1 or Crop
2
Gal.
Cu.Yd.
Report
Totals
in Gal.
Crop1
Crop 2
p
Crop 1
p
Crop 2
p
Jan-19
36,000
4,245
0.51
0.09
Kenansville WWTP
S
0.50
0.30
33,400
20
2,500
2.26
X
Feb-19
48,000
5,660
2.57
0.61
Wallace WW'rP
IN
1.00
0.30
7,020
1,960
3,900
8.94
X
Jul-19
12,600
1,486
2.58
0.16
southwest Plantation
S
0.50
0.30
82,900
2,410
105
1 8.14
X
Jul-19
177,177
20,894
2.31
2.01
Wallace WWTP
IN
1.00
0.30
44,100
2,810
1,180
65.96
X
TOTALS:
32,285
_._
As
Cd
Cr
Cu
Pb
Hg
Mo
Ni
Se
Zn
P
PAN 1
PAN 2
Lime A lied
Annuallbs/acre
0.09
0.09
0.18
5.05
0.32
0.01
0.08
0.12
0.09
7.85
170.62
74.10
11.20
Date
lbs/ac
Current Cumulative lbs/acre
0.69 0.67 NA 36.29 3.58 0.07 NA 1.33 0.75 69.91
0.59 0.58 1 NA 31.24 3.26 0.06 NA 1.21 0.66 62.06
36 34 NA 1,338 267 15 NA 374 89 2,498 . . .
276 50.00
Prior Years Cumulative lbs/acre
Permitted C. P. L. R.****
Permit PAN Limit 1 st/2nd CropF
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system
designed to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are
significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
Signature of Land Applier
Date
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volitilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
***Mineralization Rates: Compost - 0.1, Anaerobically Digested - 0.2,
Aerobically Digested - 0.3, Raw Sludge - 0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH APPLICATION FIELD.
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: Triple S Farms WQ Permit #: W00030998 Field #: I Acres Utilized: 21.00
Owner: Eric Smith nnual Dry Tons Applied: 51.86 Site #: 3 Acres Permitted: 21.00
Operator: Eric Smith Predominat Soil Series FoA Cation Exchange Capacity (non 503): NA
Crop 1 Name: Bermudagmss. Crop 1 Max PAN: 276.00 Crop 2 Name: Small Grain Crop 2 Max. PAN 50.00
C7
o ?;
fD
Specify
Totals
Per Acre
% Solids
As
Decimal
Volume
Applied per
Acre
DT/Ac
Residual Sources
(NPDES #, WQ#,
Fert., Animal Waste,
etc.)
Site
Cond.
(Dry,
Wet,
)
Precip.
Past 24
Hrs.
Inches
.n
h,
_
°n w
o
<
o
m -
* N
0
5'
W
g
* N
o
TKN
mg/kg
z
o
°
mg/kg
Nitrate
and
Nitrite
mgtkg
PAN Applied
(lbs/acre)
Must Select
Crop 1 or Crop
2
Gal.
Cu.Yd.
Report
Totals
in Gal.
Crop 1
Crop 2
Crop 1
Crop 2
Jan-19
50,000
2,381
2.87
0.28
Warsaw WWTP
S
0.50
0.30
26,800
3
10
4.59
X
Mar-19
47,800
2,276
2.45
0.23
Little Creek WRF
S
0.50
0.30
82,800
4,400
4,040
13.84
X
Sep-19
210,300
10,014
2.45
1.02
Little Creek WRF
S
0.50
0.30
82,800
4,400
4,040
60.90
X
Oct-19
54,000
2,571
2.45
0.26
Little Creek WRF
S
0.50
0.30
82,800
4,400
4,040
15.64
X
Nov-19
53,600
2,552
2.45
1 0.26
Little Creek WRF
S
0.50
0.30
82,800
4,400
4,040
15.52
X
Dec-19
83,300
3,967
2.45
0.41
Little Creek WRF
S
0.50
0.30
82,800
4,400
4,040
24.12
X
TOTALS:
23,762
i
As
Cd
Cr
Cu
Pb
Hg
Mo
Ni
Se
Zn
P
PAN 1
PAN 2
Lime Applied
Annuallbs/acre
0.03
0.01
0.01
0.96
0.06
0.00
0.03
0.06
0.03
2.84
126.79
90.37
44.23
Date
lbs/ac
Current Cumulative lbs/acre
0.37 0.33 NA 18.27 1.62 0.04 NA 0.61 0.43 36.74
0.34 0.32 NA 17.31 1.56 0.04 NA 0.55 0.40 33.90
36 34 NA 1,338 267 15 NA 374 1 89 2,498 .........
........ 276 1 50.00
Prior Years Cumulative lbs/acre
Permitted C. P. L. R.****
Permit PAN Limit lst/2nd Crop
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system
designed to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are
significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
Signature of Land Applier
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volitilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
***Mineralization Rates: Compost - 0.1, Anaerobically Digested - 0.2,
Date Aerobically Digested - 0.3, Raw Sludge - 0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH APPLICATION FIELD.
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: Triple S Farms WQ Permit #: W00030998 Field #: 1 Acres Utilized: 4.14
Owner: Eric Smith nnual Dry Tons Applied: 9.81 Site #: 4 Acres Permitted: 4.14
Operator: Eric Smith Predominat Soil Series FoA Cation Exchange Capacity (non 503): NA
Crop 1 Name: Small Grain Crop 1 Max PAN: 115.00 Crop 2 Name: Fescue Crop 2 Max. PAN 50.00
C�
O
S eci '
Totals
Per Acre
o
/a Solids
As
Decimal
Volume
Applied per
Acre
DT/Ac
Residual Sources
(NPDES #, WQ#,
Fert., Animal Waste,
etc.
Site
Cond.
D
( ry'
Wet,
Moist)
Precip.
Past 24
Hrs.
Inches
.d
b
7 _.
o w
M o•
°
<
o
w
* N
F
B
w
* N
* m
0'
oI
TKN
mg/kg
z
a o
5 ?
w'
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Must Select
Crop 1 or Crop
2
Gal.
Cu.Yd.
Report
Totals
in Gal.
Crop 1
Crop 2
Crop 1
Crop 2
Mar-19
30,000
7,246
2.45
0.74
Little Creek WRF
S
0.50
0.30
82,800
4,400
4,040
44.06
X
Sep-19
66,000
15,942
2.45
1.63
Little Creek WRF
S
0.50
0.30
82,800
4,400
4,040
96.94
X
TOTALS:
23,188
As
Cd
Cr
Cu
Pb
H
Mo
Ni
Se
Zn
P
PAN 1
PAN 2
Lime Applied
Annuallbs/acre
0.02
0.00
0.00
0.90
0.05
0.00
0.02
0.06
0.02
2.71
129.35
96.94 1
44.06
Date
lbs/ac
Current Cumulative lbs/acre
0.18 0.17 NA 11.07 0.76 0.02 NA 0.57 0.24 31.21
------------
0.16 0.16 NA 10.17 0.71 0.02 NA 0.51 0.21 28.50-------------
36 34 NA 1,338 267 15 NA 374 89 2,498
115 1 50.00
Prior Years Cumulative lbs: acre
Permitted C. P. L. R.****
Permit PAN Limit 1 st/2nd Crop
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system
designed to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are
significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
Signature of Land Applier Date
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volitilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
***Mineralization Rates: Compost - 0.1, Anaerobically Digested - 0.2,
Aerobically Digested - 0.3, Raw Sludge - 0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH APPLICATION FIELD.
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: Triple S Farms WQ Permit #: W00030998 Field #: I Acres Utilized: 11.20
Owner: Eric Smith nnual Dry Tons Applied: 35.40 Site #: 5 Acres Permitted: 11.20
Operator: Eric Smith Predominat Soil Series FoA Cation Exchange Capacity (non 503): NA
Crop 1 Name: Fescue Crop 1 Max PAN: 207.00 Crop 2 Name: Small Grain Crop 2 Max. PAN 50.00
C7
CD
-1
S eci N
Totals
Per Acre
o
/o Solids
As
Decimal
Volume
Applied per
Acre
DT/Ac
Residual Sources
(NPDES #, WQ#,
Fert., Animal Waste,
etc. )
Site
Cond.
(Dry,
Wet'
Moist)
Precip.
Past 24
Hrs.
Inches
b
0 �.
n w
* °
o
<
o
w w
+ N
* w
°
�'
X �
* d
N
* CO
o
TKN
mglkg
z
° a
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Must Select
Crop 1 or Crop
2
Gal.
Cu.Yd.
Report
Totals
in Gal.
Crop1
Crop 2
p
Crop 1
p
Crop2
Jan-19
280,700
25,063
2.45
2.56
Little Creek WRF
S
0.50
0.30
82,800
4,400
4,040
152.40
X
Nov-19
65,800
5,875
2.45
0.60
Little Creek WRF
S
0.50
0.30
82,800
4,400
4,040
35.73
X
TOTALS:
30,938
As
Cd
Cr
Cu
Pb
Hg
Mo
Ni
Se
Zn
P
PAN 1
PAN 2
Lime Applied
Annuallbs/acre
0.03
0.01
0.00
1.21
0.07
0.00
0.03
0.08
0.03
3.62
172.58
152.40
1 35.73
Date
lbs/ac
Current Cumulative lbs/acre
0.47 0.44 NA 20.91 2.01 0.05 NA 0.83 0.51 39.31
0.44 0.43 NA 19.71 1.94 0.05 NA 0.75 0.48 35.69
36 34 NA 1,338 267 15 NA 374 89 2,498
207 1 50.00
Prior Years Cumulative lbs/acre
Permitted C. P. L. R.****
Permit PAN Limit 1 st/2nd Crop
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system
designed to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are
significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
Signature of Land Applier Date
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volitilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
***Mineralization Rates: Compost - 0.1, Anaerobically Digested - 0.2,
Aerobically Digested - 0.3, Raw Sludge - 0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH APPLICATION FIELD.
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: Triple S Farms WQ Permit #: W00030998 Field #: 1 Acres Utilized: 13.95
Owner: Eric Smith nnual Dry Tons Applied: 2.71 Site #: 6 Acres Permitted: 13.95
Operator: Eric Smith Predominat Soil Series GoA Cation Exchange Capacity (non 503): NA
Crop 1 Name: Forest Crop 1 Max PAN: 60.00 Crop 2 Name: #N/A Crop 2 Max. PAN #N/A
C1
m
fD
Specify
Totals
Per Acre
a
/a Solids
As
Decimal
Volume
Applied per
Acre
DT/Ac
Residual Sources
(NPDES #, WQ#,
Fert., Animal Waste,
etc.)
Site
Cond.
(Dry'
Wet,
Moist)
Precip.
Past 24
Hrs.
Inches
n
„
_.
6 m
=
<
0
X E:
m w`
N
* °=
0
5'
z
w
* N
* o,
o
TKN
mg/kg
z Y
q' B
�o o
5 °
w
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(Ibs/acre)
Must Select
Crop1 or Crop
p
2
Gal.
Cu.Yd.
Report
Totals
in Gal.
Crop 1
p
Crop 2
p
Crop 1
p
Crop 2
p
Feb-19
12,600
903
2.58
0.10
Southwest Plantation
S
0.50
0.30
82,900
2,410
105
4.95
X
Apr-19
12,600
903
2.58
0.10
Southwest Plantation
S
0.50
0.30
82,900
2,410
105
4.95
X
TOTALS:
1,806
As
Cd
Cr
Cu
Pb
Hg
Mo
Ni
Se
Zn
P
PAN 1
PAN 2
Lime Applied
Annuallbs/acre
0.00
0.00
0.00
0.02
1 0.00
0.00
0.00
0.00
0.00
0.19
7.62
1 9.90
0.00
Date
lbs/ac
Current Cumulative lbs/acre
0.05 0.05 NA 0.29 0.05 0.00 NA 0.06 0.05 1.48
0.04 0.04 NA 0.26 0.04 0.00 NA 0.06 0.04 1.30
36 34 NA 1,338 267 15 NA 374 89 2,498
60_L #NIA
Prior Years Cumulative lbs/acre
Permitted C. P. L. R.****
Permit PAN Limit 1 st/2nd Crop
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system
designed to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are
significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
Signature of Land Applier Date
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volitilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
***Mineralization Rates: Compost - 0.1, Anaerobically Digested - 0.2,
Aerobically Digested - 0.3, Raw Sludge - 0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH APPLICATION FIELD.
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: Triple S Farms WQ Permit #: W00030998 Field #: 1 Acres Utilized: 14.50
Owner: Eric Smith nnual Dry Tons Applied: 6.67 Site #: 7 Acres Permitted: 14.50
Operator: Eric Smith Predominat Soil Series FoA Cation Exchange Capacity (non 503): NA
Crop 1 Name: Bermudagrass Crop 1 Max PAN: 276.00 Crop 2 Name: #N/A Crop 2 Max. PAN #N/A
C7
o
Specify
Totals
Per Acre
u
/o Solids
As
Decimal
Volume
Applied per
Acre
DT/AcMoist)
Residual Sources
(NPDES #, WQ#,
Fert., Animal Waste,
etc.)
Site
Cond.
(Dry,
Wet,
Precip.
Past 24
Hrs.
Inches
b
K b
5 �.
a
*
<
o
w
* N
*
8
S
� "
w
* N
* o.
TKN
mgtkg
z a
�
UQ o
w
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Must Select
Crop 1 or Crop
2
Gal.
Cu.Yd.
Report
Totals
in Gal.
Crop 1
Crop 2
Crop 1
Crop 2
Oct-19
72,000
4,966
2.22
0.46
Beulaville WwrP
S
0.50
0.30
40,100
5
199
11.24
X
TOTALS:
4,966
As
Cd
Cr
Cu
Pb
Hg
Mo
Ni
Se
Zn
P
PAN 1
PAN 2
Lime Applied
Annuallbs/acre
0.01
0.01
0.02
0.42
0.03
0.00
0.01
0.01
0.01
1.52
15.08
11.24
0.00
Date
lbs/ac
Current Cumulative lbs/acre
0.01 0.01 NA 0.42 0.03 0.00 NA 0.01 0.01 1.52
0.00 0.00 NA 0.00 0.00 0.00 NA 0.00 0.00 0.00 -
36 34 NA 1,338 267 15 NA 374 89 2,498
2"6
Prior Years Cumulative lbs/acre
Permitted C. P. L. R.****
Permit PAN Limit l st/2nd Crop
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system
designed to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are
significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
Signature of Land Applier Date
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volitilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
***Mineralization Rates: Compost - 0.1, Anaerobically Digested - 0.2,
Aerobically Digested - 0.3, Raw Sludge - 0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH APPLICATION FIELD.
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: Triple S Farms WQ Permit #: W00030998 Field #: I Acres Utilized:
Owner: Eric Smith nnual Dry Tons Applied: #VALUE! Site #: 8 Acres Permitted: 13.70
Operator: Eric Smith Predominat Soil Series GoA Cation Exchange Capacity (non 503): NA
Crop 1 Name: #N/A Crop 1 Max PAN: #N/A Crop 2 Name: #N/A Crop 2 Max. PAN #N/A
d
0
� o
S eci
Totals
Per Acre
% Solids
As
Decimal
Volume
Applied per
Acre
DT Ac
Residual Sources
(NPDES #, WQ#,
Fert., Animal Waste,
etc.)Wet,
Site
Cond.
(Dry,
Moist)
Precip.
Past 24
Hrs.
inches
n
„
0 �.
Q m
o
C
w
* N
5'
X
*
a
TKN
mg/kg
Z >
o 'w
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Must Select
Crop 1 or Crop
2
Gal.
Cu.Yd.
Report
Totals
in Gal.
Crop 1
Crop 2
Crop 1
Crop 2
TOTALS:
0
As
Cd
Cr
Cu
Pb
Hg
Mo
Ni
Se
Zn
P
PAN 1
PAN 2
Lime Applied
Annuallbs/acre
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
Date
lbs/ac
Current Cumulative lbs/acre
0.00 0.00 NA 0.00 0.00 0.00 NA 0.00 0.00 0.00
0.00 0.00 NA 0.00 0.00 0.00 NA 0.00 0.00 0.00
36 34 NA 1,338 267 15 NA 374 89 2,498
PN/A I #N/A
Prior Years Cumulative lb& acre
Permitted C. P. L. R.****
Permit PAN Limit I st/2nd Crop
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system
designed to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are
significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volitilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date ***Mineralization Rates: Compost - 0.1, Anaerobically Digested - 0.2,
Aerobically Digested - 0.3, Raw Sludge - 0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH APPLICATION FIELD.
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: Triple S Farms WQ Permit #: W00030998 Field #: 1 Acres Utilized: 8.93
Owner: Eric Smith nnual Dry Tons Applied: 29.38 Site #: 9 Acres Permitted: 8.93
Operator: Eric Smith Predominat Soil Series GoA Cation Exchange Capacity (non 503): NA
Crop 1 Name: Bermudagrass Crop 1 Max PAN: 299.00 Crop 2 Name: Small Grain Crop 2 Max. PAN 50.00
C7
O
� o
Specify
Totals
Per Acre
o
/o Solids
As
Decimal
Volume
Applied per
Acre
DT/Ac
Residual Sources
(NPDES #, WQ#,
Fert., Animal Waste,
etc.
Site
Cond.
(Dry,Past
Wet,
Moist)
Precip.
24
Hrs.
Inches
3 b
_.
0 ;v
a o•
°
<
0
�, =:
w w
* N
*
5'
z 0
w
o
❑
TKN
mgtkg
z %
� �
o
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(Ibs/acre)
Must Select
Crop 1 or Crop
2
Gal.
Cu.Yd.
Report
Totals
in Gal.
Crop 1
Crop 2
Crop 1
Crop 2
Jan-19
95,000
10,638
2.87
1.27
Warsaw WWTP
S
0.50
0.30
26,800
3
10
20.50
X
Sep-19
48,000
5,375
0.51
0.11
Kenansville WWTP
S
0.50
0.30
33,400
20
2,500
2.86
X
Sep-19
142,000
15,901
2.87
1.90
Warsaw WWTP
S
0.50
0.30
26,800
3
10
30.64
1 X
TOTALS:
31,915
._ _ _ _ _ _ _ _
As
Cd
Cr
Cu
Pb
Hg
Mo
Ni
Se
I Zn
P
PAN 1
PAN 2
Lime Applied
Annuallbs/acre
0.08
0.08
0.10
1.60
0.16
0.01
0.08
0.08
0.08
4.03
88.56
33.51
20.50
Date
lbs/ac
Current Cumulative lbs/acre
0.16 0.25 NA 4.20 0.36 0.01 NA 0.25 0.25 8.57
0.09 0.17 NA 2.60 0.19 0.00 NA 0.17 0.17 4.54 ....
36 34 NA 1,338 267 15 NA 374 89 2,498
299 50.00
Prior Years Cumulative lbs/acre
Permitted C. P. L. R.****
Permit PAN Limit lst/2nd Crop
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system
designed to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are
significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
Signature of Land Applier Date
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volitilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
***Mineralization Rates: Compost - 0.1, Anaerobically Digested - 0.2,
Aerobically Digested - 0.3, Raw Sludge - 0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)