WQ0022155_Residual Annual Report 2020_20210220

Initial Review
Reviewer Thornburg, Nathaniel
Is this submittal an application? (Excluding additional information.)*
r Yes r No
If not an application what is the submittal type?* r Annual Report
r Residual Annual Report
r Additional Information
r Other
Annual Report Year* 2020
Permit Number (IR)* WQ0022155
Applicant/Permittee Town of Jefferson
Email Notifications
Does this need review by the hydrogeologist?* 0 Yes r No
Regional Office Winston-Salem
CO Reviewer
Admin Reviewer

Submittal Form
Project Contact Information
Rease provide inforration on the person to be contacted by N B Staff
Name * Tim Church
Email Address*
[e-mail]
electronic subnittal, confirmation of receipt, and other correspondence.
Project Information
........ ......... ....................................................................................................................................... .
Application/Document Type* r New (Fee Req ui red)
r Modification - Major (Fee Required)
r Renewal with Major Modification (Fee
Required)
r Annual Report
r Additional Information
r Other
Phone Number*
336 246-2165
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:* W00022155
Fbs Current Existing perrrit number
Applicant/Permittee Address* P.O. Box 67 Jefferson, NC28640
Facility Name * Town of Jefferson DCAR
Please provide comments/notes on your current submittal below.
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, Specifications, Calculations, Bc.)
Residuals Report A 202020210220_10424899.pdf 1.82MB
Upload only 1 FLFdocurrent (less than 250 fvB). NLRiple documents rust be combined into one FDFfile unless file is larger than
upload limit.
* V 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 2/20/2021

ANNUAL LAND APPLICATION CERTIFICATION FORM
WQ Permit#: WQ0022155 County: Ashe Year: 2020
Facility Name (as shown on permit): Town of Jefferson W WTP
Land Application Operator:
Tim Church
Phone: [phone]
Land application of residuals as allowed by the permit occurred during the past calendar year?
i 1 Yes El No - If No, skip Part A, and Part B and proceed to Part C. Also, If residuals were
generated but not land applied, please attach an explanation on how the residuals were handled.
Part A - Residuals Application Summary:
Total number of application fields in thepermit:
na
Total number of fields utilized for land application during the year:
na
Total amount of dry tons applied during the year for all application sites:
4.5
Total number of acres utilizes for land application during the year:
na
Part B - Annual Compiance Statement:
Facility was compliant during calendar year 2020 with all conditions of the land application permit
(including but not limited to items 1-13 below) issued by the Division of Water Resources. 21 Yes 0 No
If no please, provide a written description why the facility was not compliant, the dates, and explain corrective action
taken.
1) Only residuals approved for this permit were applied to the permitted sites.
2) Soil pH was adjusted as specified in the permit and lime was applied (if needed) to achieve a soil pH of at least 6.0 or
the limit specified in the permit.
3) Annual soils analysis were performed on each site receiving residuals during the past calendar year and three (3) copies
of laboratory results are attached.
4) Annual TCLP analysis (if required) was performed and three (3) copies of certified laboratory results are attached.
5) All other monitoring was performed in accordance with the permit and reported during the year as required and three (3)
copies of certified laboratory results are attached.
6) The facility did not exceed any of the Pollutant Concentration Limits in 15A NCAC 02T .1105(a) or the Pollutant
Loading Rates in 15A NCAC 02T .1105(b) (applicable to 40 CFR Part 503 regulated facilities).
7) All general requirements in as specified in the Land Application Permit were complied with (applicable to 40 CFR Part
503 regulated facilities).
8) All monitoring and reporting requirements in 15A NCAC 02T .1111 were complied with (applicable to 40 CFR Part
503 regulated facilities).
9) All operations and maintenance requirements in the permit were complied with or, in the case of a deviation, prior
authorization was received from the Division of Water Resources.
10) No contravention of Ground Water Quality Standards occurred at a monitoring well or explanations of violations are
attached to include appropriate actions and remediations.
11) Vegetative cover was maintained and proper crop management was performed on each site receing residuals, as
specified in the permit.
12) No runoff of residuals from the application sites onto adjacent property or nearby surface waters has occurred.
13) All buffer requirements as specified on the permit were maintained during each application of residuals.
Part C - Certification:
"I certify, under penalty of law, that the above information is, to the best of my knowledge and belief, true, accurate,
and complete. I am aware that there are significant penalties for submitting false information, including the
possibility of fines and imprisonment for knowing violations."
Tim Church
Permittee Name and Title (type or print)
:Ca5,n.,LJAdL zjzil
Signature of Permittee Date
Signature of Preparer*
Date Signature of Land Applier
Date
(if different from Permittee) (if different from Permittee and Preparer)
* Preparer is defined in 40 CFR Part 503.9 (r) and 15A NCAC 02T. 1102 (26) DENR FORM ACF (12/2006)

CLASS A ANNUAL DISTRIBUTION AND MARKETING/ SURFACE DISPOSAL CERTIFICATION AND SUMMARY FORM
WQ PERMIT #: WQ0022155 FACILITY NAME:
PHONE: [phone] COUNTY:
Ashe
OPERATOR:
Town of Jefferson
Tim Church
FACILITY TYPE (please check one): Surface Disposal (complete Part A (Source(s) and "Residual In" Volume only) and Part C)
® Distribution and Marketing (complete Parts A, B, and C)
Was the facility in operation during the past calendar year? Yes 0 No 0 —► If No skip parts A, B, C and certify form below
Part A*:
Part B*:
Month
Sources(s) (include NPDES # if
applicable)
(dry tons)
Recipient Information
AmAmendment/Volume
Bulking Agent
Residual In
Product Out
Name(s)
Volume (dry tons)
Intended use(s)
January
NCO021709
0.88
0.88
Fred Walters
0.88
hay,pasture
February
NCO021709
1.3
1.3
Fred Walters
1.3
hay,pasture
March
NCO021709
1.45
1 A5
Fred Walters
1.45
hay,pasture
April
NCO021709
0.33
0.33
Fred Walters
0.33
hay,pasture
May
June
NCO021709
0.43
0.43
Fred Walters
0.43
hay,pasture
July
August
NCO021709
0.15
0.15
Fred Walters
0.15
hay,pasture
September
October
November
December
Total from FORM DMSDF (sup)
Totals:
Annual (dry tons):
0
4.54
4.54
.. ,: .77
4.54
Amendments used:
1 (}
1 Bulking Agents used: 0
(supp)): Total Number of Form DMSDF (Supp)l
* If more space is required, attach additional information sheets (FORM DMSDF
Part C:
Facility was compliant during the past calendar year with all conditions of the land application permit 0 Yes
(including but not limited to items 1-3 below) issued by the Division of Water Resources: 0 No -0 If No, Explain in Narritive
1. All monitoring was done in accordance with the permit and reported for the year as required and three (3) copies of certified laboratory results are attached.
2. All operation and maintenance requirements were compiled with or, in the case of a deviation, prior authorization was received from the Division of Water Resources.
No contravention of Ground Water Quality Standards occurred at a monitoring well.
"I certify, under penalty of law, that the above information is, to the best of my knowledge and belief, true, accurate and complete. I am aware that there are significant
penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
fj;n-s"/ z
Signature of Permittee Date
Signature of Preparer**
(if different from Permittee)
Date
**Preparer is defined in 40 CFR Part 5039(r) and 15A NCAC 2T .1102 (26)
DENR FORM DMSDF (1212006)

ANNUAL RESIDUAL SAMPLING SUMMARY FORM
Please note that your permit may contain additional parameters to be analyzed. The parameters can be reported in FORM RSSF - B
WQ Permit Number: WQ0022155
Facility Name: Town of Jefferson WWTP
Residual Source WQ # or
NPDES #:
WWTP Name:
R,-QMi15i1 Analveic Tlatn
NCO021709
Jefferson WWTP
Laboratory: 1) Meritech
2)
3)
4)
5)
ParameterSample
'
or Composite Date
--•
Percent SolidsIII i�
®
•
_____-_______
III: ...�I
�� RI/III��II�
i
r • i
• • •
� � r
IIIII��_-_-___,II-,_-_I
- •
'I®®_
--_'III-'_____-.
Molybdenum
I®IIII®�����III�IIIII�II��
Selenium
Total Phosphorus
For surface disposal facilities the ceiling concentration limits listed in this form are not applicable. Reference the individual permit for metals limits.
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed
to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant
penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
Signa ut re of Preparer * Date
*Preparer is defined in 40 CFR Part 503.9(r) and 15A NCAC 2T .1102 (26)
DENR FORM RSSF (12/2006)

ANNUAL RESIDUAL SAMPLING SUMMARY FORM - B
Report all sampling analysis results for parameters not listed in FORM RSSF that are part of the WQ permit or were analyzed for over the past
calendar year. Use additional forms as needed.
WQ Permit Number: WQ0022155
Facility Name: Town of Jefferson
Residual Source NCO021709
NPDES # or WQ#:
WWTP Name: Jefferson WWTP
Raeirinal Analveic data
Laboratory:
1)
2)
3)
4)
5)
Meritech
Parameter
(mg/kg)
Sample or Composite Date
7.9.20
Aluminum
8310
Calcium
10800
Magnesium
3300
Sodium
513
SAR
1.1
PAN
4452
Potassium
1990
pH
6.5
"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 Preparer
*Preparer is defined in 40 CFR Part 503.9(r) and 15A NCAC 2T .1102 (26)
zk&u
Date
DENR FORM RSSF - B (12/2006)

ANNUAL PATHOGEN AND VECTOR ATTRACTION REDUCTION FORM (503 Rules)
Facility Name: Town of Jefferson WWTP
WWTP Name: Jefferson WWTP
WQ Permit Number:
NPDES Number:
WQ0022155
NCO021709
Monitoring Period: From 1.1.20 To 12.31.20
Pathogen Reduction (40 CFR 503.32) - Please indicate level achieved and alternative performed:
Class A:
Alternative 1 10
Alternative 2 0
Alternative 3 El
Alternative 4 ®
Alternative 5
Alternative 6 E�
If applicable to alternative performed (Class A only) indicate "Process to Further Reduce Pathogens":
Compost 1:1
Heat Drying 1
Heat Treatment [I �-Tii
-ermophilic CI
Beta Ray C]
Gamma Ray El
Pasteurization El
Class B:
Alternative 1 E3
Alternative 2 El
........................................................ .
If applicable to alternative performed (Class B only) indicate "Process to Significantly Reduce Pathogens":
Lime Stabilization
Air Drying[]
Composting C#
jAerobic Digestion ❑
Anaerobic Digestion 0
If applicable to alternative performed (Class A or Class B) complete the following monitoring data:
Parameter
Allowable Level
in Sludge
g
Pathogen Density
Number ot
Excee-
Frequency
of Analysis
Sample
Type
na ytica
'rech-
i
Minimu
Geo. Mean
Maximu
Units
Fecal Coliform
2 x 10 to the
6th power
per gram of
total solids
MPN
220
220
220
MPN
0
1
Grab
SM9222D
CFU
1000 mpn per gram
of total solid (dry
weight)
Salmonella bacteria
(in lieu of fecal
coliform)
3 MPN per 4 grams
total solid (dry
weight)
Vector Attraction Reduction (40 CFR 503.33) - Please indicate option performed:
Alt.1 (VS reduction) C3
Alt. 2 (40-day bench) ®
Alt. 3 (30-day bench) [I
I Alt. 4 (Spec. OZ uptake)
Alt. 5 (14-Day Aerobic) El
Alt. 6 (Alk. Stabilization ©
Alt 7 (Drying - Stable) iJ
JAIt. 8 (Drying - Unstable) E
Alt. 9 (Injection) 0
Alt. 10 (Incorporation) 0
No vector attraction reduction alternatives were performed 13
CERTIFICATION STATEMENT (please check the appropriate statement)
Rl "I certify, under penalty of law, that the pathogen requirements in 40 CFR 503.32 and the vector
attraction reduction requirement in 40 CFR 503.33 have been met."
® "I certify, under penalty of law, that the pathogen requirements in 40 CFR 503.32 and the vector
attraction reduction requirement in 40 CFR 503.33 have not been met." (Please note if you check
this statement attach an explanation why you have not met one or both of the requirements.)
"This determination has been made under my direction and supervision in accordance with the system
designed to ensure that qualified personnel properly gather and evaluate the information used to determine
that the pathogen and vector attraction reduction requirements have been met. I am aware that there are
significant penalties for false certification including fine and imprisonment."
Tim Church, Water Resources Director
Preparer Name and Title (type or print)
( AMA S ,
Signature of Preparer* Date
Land Applier Name and Title (if applicable)(type or print)
Signature of Land Applier (if applicable) Date
*Preparer is defined in 40 CFR Part 503.9(r) and 15A NCAC 2T .1 102 (26)
DENR FORM PVRF 503 (12/2006)

Class A Dry Bios, ' olids Production Record
.R
eduction eduction Alternative I
DATE
Thermal Fluid
Temperature F
Discharge
Temperature F
Drying Time, hrs.
(includes fill time)
4 of batches
made today
1. 10#4
t15�
3
17. Z6
45n
1?,.
-
Z7. W
-
4156
q56
/Z ?"b
Y,5 6
X,
2-6
1
ZR7
- Z6
&n
-X-Aj
q50

Fenton Environmental Technologies, Inc.
RK Series Municipal B osolids Dehydrator"
1(800) 777-1 71
Class A►. Cam fiance Under the 503 Rules
Tbe SludgeMASTER RK series automatic �atch style biosolids dehydrator is uniquely suited to
in.sure compliance with the 40 CFR 503 regulations pertaining to achieving Class *A" biosoUds.
The RK dehydration i loadedautomaticallywith apredetermined amountof dewatered
biosoUds which starts the batch
TI--- total sludge load is subjected to a minini= emperature of 212 degrees F fbr a mUnm of
• and one-half hours t n exceedsthe ar and temperature requirementsof f !
regulations pertaining to tom, oAi R :n a• • This complianA is shown . follows using Regime
or 20
A under Alternative I wbich requires that solids be heated at 50 degrees C or higher f
minutes or s
Time (in days) = 131.700,044
14^ o.I4 (temperature) Q„r, for the RK dehydrator at 212 degrees F (=I00 C)
rune= 131,704.000 or Tune 131.7(1Q M or Time = less than 1.3/1DA6 day.
I Q^ 0.14(100) IOA1
The time • :a in the RK fbr reduction would • r.• minute. r • •e
rt r u nr .• - to • # f• f• pathogen:�: . ► « a r ! ' «= nr • t a :r a • r •
the 20-minute requirement, theRK dehydrator ibc time by : • a ! 1
• ,cycle time isdetermined Rachieving the a t ei•sludge dryness. n normally .
vector a actlon'rcdiiajb (Fully digested sludges need be dried to 75°fo- 503.33 "Option 7".)
The SludgeMLASTER RK patented process automatically adjusts the time and temperature regime
for the varying incoming wet e solids content. This fmture isverY impor=t since dewatering
operations from n • yn` in solids a• must maintain consistent
• • • • : tf an ant;•through n • adjustr f•
+
conditions n.a a ti a a +theirnormal operation mid t compromising the finished is Product
Class "A' parameters.
Please refer to 40 CFR 503.32 Pashogens (a) (3) (17 (g) for pathogen reduction requirements and
to 40 CFR 503.33 () (7) and (8) for vector attraction reduction requirements.
i a r • i ar f. • :ais. t to • C n • a • «• •a
: a • • � t a at •�
In choosing Class A biosolids thermal dehydration lrti izing SludgeMASTER RK technology, your
utility will be assured of an environmentally correct sludgt handling solution for many years in the
future.

Contact: Tim Church
Client: Town ofJefferson VVW7P
P.8.Box 67
Jefferson, NC3U64O
Me.~tech Inc.
Environmental Laboratory
Laboratory Certification No. 165
Sample: Class A dry residuals Grab
Revised Date.,
Report Date:
NPDES#:
Project
PO.#:
Date SanopleRovd:
Page 3
712912020
7/27/2020
NCO042269
Class A Residuals
2165
7/9/2020
7/8/Z020
Analysis Date
Reporting Limit
MethodParametersResults
96Total Solids
94'2%
7/10/2020
0-100%
GM35408
Ammonia, Nitrogen
2.288nmQ/kc,
7/10/3030
I0noe/kc
SPA35O'l
TKN
13,3QOcng/k�
7/I5/3020
20nog/kg
EPA3SI.1
NiCrato/NitriLo,N|UrVReo
<1O.6mmg/��
7/9/20�U
lO.6uu�/k�
EPA353.Z
Aluminum, total
— -
8,31Qmu�/bo
- -
7/15/3020
��� /ko
. on�, ��
.
�B&3OO7
Arsenic, total
<8.521
7/15/2020
0L531 mglkg
EPA 200.7
Cadmium, total
0-683 mg k-
7/35/3O20
0.200000/ke
EP&2O07
Calcium, total
10^8QOmuo/�o
7/15/3U3U
1O.0noe/ke
EPA 200.7
Copper, total
- -
425 mg/kg
7/I5/2020
s
1.00 nu~' o/b,
EPA %0A'7
Lead, total
13.9 mmg/kg
7/l5/2020
0500 nog/bc,
EPA2O0.7
Naancsium'tozu|
3,300 mg/kg
7/15/2020
10.0 mg/k�
EPAZO0.7
Mercury, total
2:176 ro�/ko
7/14/2820
0.82 mg/kg
CPA245.l
Molybdenum, total
6.10 mg/kg
7/15/2020
0.500 oo�/k�
EPAJOO.7
Nickel, total
19.1 mg/kg
7/15/ J82O
�0 /k
.rn� g
EPA �
Phosphorus, total
17.600 rng/ke
-
7/I5/2UZO
2.00 roB' , /ks
0.7
EPA 2U020
Potassium, total
1'990 mg/kg
7/I5/2020
/k
20.0 mg/kg g
EPA%UO.7
Selenium, total
<0,G33 moa/k�
7/I5/ZO20
0.531 mn�/kR
EP&2OO.7
Sodium, total
�
SlB mg/kg
7/I5/ �O�O
2UOmg/kgGPA�00�7
.
Zinc, total
8 k
G4 mu�/ �
7/I5/20Z0
' '
05OOnn�/k�
� .
EPA �
pH
6.5G.U.
7/9/2020
1.0-14.05'O.
SK445OO'H8
/ hereby certify that Jhave reviewed and approve these data.
Laboratory Representative
64%TacomoRoad, Reidsville, North Carolina 3732Q

MERITECH, INC.
Environmental Laboratories
Laboratory Certificate #165
Client: Town of Jefferson \VWTP
Project: Class A Residuals
Client Sample ID: Class A Dry Residuals
Sample Collection: 0 7! 0 8/2 0
Meritech Sample ID: 07092022
1311 - TCLP Organics
Volatilcs: SW-846 $260
Analysis: 07/1&20
Extraction:
07/13/20
Analyst: Vwv
Report Date:
07f20J20
Parameter
Result
Units
net. Limit
Reg. Limit
Dilution Factor
Benzene
< O.GI 100
m-,'L
0.0100
0.50
10
Carbon Tetrachloride
< 0.0100
mg
0.0100
0.50
) 4)
Chlornberizene
< 0.0100
inkVL
0.0100
100
10
Chlorot-orm
< 0.0100
M 0Cr.! L
0,0100
6,0
10
42-Dichloroethane
< 0.0100
InCL
0.0100
0.50
10
1. 1 -Dichlomcihene
< 0.0100
ITIg/L
0.0100
0.70
10
Nleth} I ELhvi Ketone
< 0.100
mg. l-
0.100
200
10
Tetrach loroethyl ene
< O.O 100
rng"L
0.(1)00
0.70
1
Trichloroethene
< O.O 100
nn izy L
0.0100
0, io
I
Vinvi Chloride
< 0.0200
M 0-1
0.020
0.20
10
Semi-Volatiles: SW-846 8270
Analysis: 07117120
Extraction:
UV 13/20
Analyst: PM
Report Dute:
07120/20
Parameter
Result
Units
net. Lifflit
Rest. Limit
Dilution Factor
1,4-Diclik-robenzene
<0. 100
rn g/ L
0,100
7.5
10
Hexachloroberizene
<0. 100
rn gil-
0.100
0.13
10
Hexachloro- 13-butadiene
<0, 100
rnrL
0.100
0,5
10
1-1 exach I orueth ai i L:
<0' 100
M g/L
0.100
3.00
10
0-cresol
<Q. 1 (0
ingil-
0.100
200
10
ni&p-cresol
0,253
n)gfL
0,200
200
10
Total cresols
0.253
anal,
0.300
200
10
Mirobenzeric
--o. I ff",
M Z; 1,
0,101)
2.0f-)
I ()
Peritnchlkoropheno
<t0OU
ma.1.
0. j1}))
100
)0
Pyridine
< -0.100
in & 1.
0, 100
:'O
10
5-Tricoro ,4. hl . phenol
100
40o
10
14,6-Trichlorophenol
<0. 100
nigil.
0.100
2.00
10
2.4-Dinitrololuene
<0, 100
Ing"I.
0.100
0.13
10
/ /
. , 11
I herehy certify that I have reviewed awl approve
these itata.
e /I
Luburatoly Representative
642 Tamco Road * Reidsville, NC 27320
[phone] * info@meritechlabs-com

Meritech, Inc.
Environmental Laboratory
Laboratory Certification No. 165
Page 1
Report Date: 7/27/2020
Contact: Tim Church NPDES #: NCO042269
Client: Town of Jefferson WWTP Project: Class A Residuals
P.O. Box 67 P.O. #: 2165
Jefferson, NC 28640 Date Sample Rcvd-. 7/9/2020
Meritech Work Order # 07092022 Sample: Class A dry residuals Grab 7/8/2020
1311 -
TCLP Metals
Parameter
Result
Analvsis Date
Det. Limit
Reg, Limit
Method
Arsenic
<0.100 mg/L
7/22/2020
0.100
5.0
EPA 200.7
Barium
1.23 m,g/L
7/22/2020
0.050
100.0
EPA 200.7
Cadmium
<OMO mg/L
7/22/2020
0.020
1.0
EPA 200.7
Chromium
0.060 mg/L
7/22/2020
0.050
5.0
EPA 200,7
Lead
<0100 mg/L
7/22/2020
0,100
5.0
EPA 200.7
Mercury
<0.02 ma, L
7/21/2020
0.02
0.2
EPA 245.1
Seieniurn
<0.100 m,-/L
7/22/2020
0.100
1.0
EPA 200.7
Silver
<0.050 mg/L
7/22/2020
0.050
5.0
EPA 200.7
TCLP Organics
Parameter Results Analvsis Date ReportingLimitMethod
Volatiles 8260 Attached 7/16/2020 8260
Semi Vol. 8270 Attached 7/17/2020 8270
Other Tests
Parameter
Result
Ana]Ysis Date
Reporting Limi Mgthod
Cyanide, total
1.29 mg/kg
7/16/2020
0.500 mg/kg EPA 335.4
Sulfide
<10 mg/kg
7/15/2020
10.0 rng/kg SM4S00S2DB
Flash Point
>140 'F
7/16/2020
EPA 1020B
Corrositivity (pH)
6.5 S.U.
7/9/2020
LO - 14.0 S.U. SM 4500 HB
642 Tamco Road, Reidsville, North Carolina 27320
tel.[phone] fax.[phone]

RESEARCh&ANAtyTiCA1
I-AboRAToRks, INC.
AnolyficollPrc>cess Consultations
Toxici!y Characteristic Leachate Procedure CLP) Analysis forMeritech, Inc., collected 018 July 2020)
07092022
EPA HW Quantitation Results Characteristic
Number Contaminant Limit(m LMZ/-Ll Level(mgLL) EPA Method Analvst
1, TCLP PESTICIDESMERBICIDES
D-020
Chlordane
D-016
2,4-D
D-012
Endrin
D-031
Heptachlor
D-013
Lindane
D-014
Methoxychlor
D-015
Toxaphene
D-017
2,4,5-TP(Silvex)
Sample Number
Sample Date
Sample Time (hrs)
Sample Matrix
Date Analyzed
0M3
BQL
0.030
8081
MG
1.000
BQL
10.0
8151
MG
0.002
BQL
0,020
8081
MG
0,0008
BQL
0.008
8081
MG
0.040
BQL
0.400
9081
MG
1.000
BQL
10.0
8091
MG
0.05
BQL
0.500
9081
MG
0,100
BQL
1.00
8151
MG
84584-01
07/08/20
1130
Slud©e
a
07/20/20
mgAg - milliV-ArupcT kilogram - parts per million (ppm) BQL - Below Quwthatlon Limits

Meritech, Inc.
Environmental Laboratory
Laboratory Certification No. 165
Page 2
Report Date: 7/27/2020
Contact: Tini Church NPDES#: NCO042269
Client: Town of Jefferson WVVTP Project: Class A Residuals
P.O. Box 67 P.O. #: 2165
Jefferson, NC 28640 Date Sample Rcvd: 7/9/2020
Meritech Work Order# 07012037 Sample: NCC Building/Solar Panel 6/30/20
1311 - TCLP Pesticides & Herbicides
Pesticide - SW-846 8081A
Parameter Results Analysis Date Det. Limit Reg. Limit Dilution Factor
Endrin
Attached
Chlordane
Attached
Toxaphene
Attached
Methoxychlor
Attached
Heptachlor
Attached
Lindane
Attached
Herbicides - SW-846 8151
Parameter Results Analysis Date Det Limit Rgg. Limit Dilution Facto
44-1) Attached
2,4,5-TP (Silvex) Attached
642 Tanico Road, Reidsville, North Carolina 27320
tel.[phone] fax.[phone]

>r<<, Chain of Custody Record (COC)
NPDES#:- NC Z (% 0}
�oppWLL4.t1. �JSfffLz�?Yi� Phone:_
— —
MURITECH INC.Client:
Q•&x 7
Address: f. Fax:
ENVIRONMENTAL LABORATORIES
,� Sou � Emailjl15 C
642 Taco Rd. Phone: [phone]
lny�Ca_._
(`(V
�(',fftmoi /�,n((11 i1 Projectt: o�s f };� f d I, I r)
Reidsville NC 27320 Fax: [phone]
? t
P.O.#:_�'
Email: intt7merlteCillat)S.COrY)
Turn Around Time*
Attention: 1 G
-•—`� 'RUSH vJork nes!ds prior approval
Now would you like your report sent?
w1i1Is"1eritec l a Js, co i-i
Std 10 da s} m � s 24 ss Hfr
Circle all that apply: Emari rxoerredi , Fax, Mail -- ^
Sampling Dates twos fit i Iryle5
Person Taking Sample (Sign/Print) t I
(J
Lake Use Only
Sample Location and/or ID #
Start End
Comp? $1 of
On Ice? Yes pi'l 0K?
Date
Time
Date
.rime
Grab? Cont. Test(s) Required
/ Na Cl OK?
classyes ci u
.30
'74 To+AI's 011as�mi1�J. 3_
- C t:_. i O
> 6 L
_
t-e
111
s � i
Is
20
0
Temperature Upon Receipt,
*"« "**
\'r
Method Of
Dechlorination (<0.5 m) of Ammonia, Cyanide, Phenoi anti TKN samples must be done in the field prior to preservation.
Shipment;
Comments:
Compositor 1t _
Jug #
UPS
j-J, Fed Ex
Are ese cults for regulatory purposes? Yes No „ '
Report results in: mgJt mg/kg =V,�[ ug/L
�.
Hand Delivery
Relinquished) by: + %Date . rime: /f��
�
Received Icy: Date: Time:
JOther
Relinquished by: Mile: Time:
Received by: Date: Time:
Reiirtquished by: pate: Tirne:.
, ve<1 t t �: „..---- Dues.. T.r e,_—

118/2021 SAR Calculator — Oklahoma State University Turtgrass Science
SAR Calculator ft
ass A 6ipso��G{S
Adjusted SAR Calculator
EC 1 Its
Ca 1102061 mg/l or ppm
Mg �0mg/l or ppm
Na 482. mg/l or ppm
HCO3 mg/l or ppm
SAR
adj SAR 0.6
Use the larger of the two
Reset
adj Classification
SAR
< I Excellent
1-2 Good
2-4 Fair
EMBERVIVI
8-15 Very Poor
> 15 Unacceptable
Management Considerations
None
Little concern, add pelletized gypsum periodically
Aerify soil, sand topdress, apply pelletized gypsum, monitor soil
salinity
Aerify soil, sand topdress, apply pelletized gypsum, leach soil
regularly, monitor soil salinity closely
Requires special attention; consult water quality specialist
Do not use
C) 2021 - OkIalionia State University I All rights reserved
turf.okstate.edutwater-qualitylsar-calculator 411

r I A
d1w.4m.
A
-'Ut
CLIENT, JEFFERSON
ADDRESS:
CITY:
STATE
ID#:
WATER QUALITY LAB a OPERATION, INC.
P.O, BOX 1167,BANNER ELK, NC 28604
[phone]
LOGIN TIME. 1:50 Pm
SAMPLER:
COLLECTED DATE: 6-Apr-20
REPORTED DATE: 6-May-20
ANALYSIS
ANALYSIS
MQL*s
UNITS
SAMPLE
ANALYSIS
METHOD
INT
RESULTS
LOCATION
COMPLETED
CODE
TOTAL SOLIDS
93.1
%
CLASS A
FECAL COLIFORM
220
1
MPN
SLUDGE
7-Apr-20
SM-9222D
WPS
REPORTED BY: NC CERTIFIED LAB it 544
PAUL ISENHOUR, SUPERVISOR

D',\
P�0- BOX I 102, :'K EL.K, -NC. 21 860-41
(828)-898-627-t
Fax (828)-S98-6255
v aids C) Ye, oc >
SAiNIPLE I'YPE: FS I R i jDL
LOCA,rION: i - i-12SO4. jLf"\O
�1 3- HCL.
Jefferson %VisteNv.iter-]*re,-itii,,L�i,,t Plant
FA C I L ITY I Dits: NA0H. 3 - 6 - COO[ k E.
S,-I, N-1 P L E R NAME: Tim Church 7 - N,-% 2 S2 0' ), 8 - O'l :. t_.
CO3kVjPOSj'jT SAMPLE; START TIME: ST011 �TML
180D INF-
COlUECTION
DATE 1 Tlt-IE T.- I
D;-',- I V � S fir .1 P L E T) -, F: v,;+t
1-EMPHGVAB I CO.'.',[' t
TSS
�130D - EFF,
J-;
'OIL & GREASE,
1-ro,rAL NIT,
JU
I-MTAL PHOS.
AIL
IFFCAL -
Won!
1
F!: C AL - DOWN
IA,MN FSS
LA I )NI S 1:1
11-1 t
F—i
1—f
i
c( ZIN.,c
i
i
iT,2 I
L'i
I- 1-,tit) N
S I L L I
1) X-1 I U IM
C I I R ()NI i UNI
—j--7
-77--
!SII S I'Ll
-rE HfD By� T \ i F REUNQU
12- 4 0305- P
TE IN U I S 14 E D A IT F
7 %A7
Uaioratory pcscrvation is rnsurvJ by Lddlition o(prcsc(v:sw,-c% prior to s2m-lc
cow3mers !raving the lab, unless ozhcm%i(,tn-f:v-1
C! Chkinre chc,-k and t:,-chlvrina!wji vcrificanom
Pr ESI;- RVA,no"�
C 00 L 4C 8()D. RIE S I D U E, C 0 N D U CTI V I TY, 'N i Ui A S. C J L Q R. Ai --N L!!-1 TY. --'K, 1. Li
COOL 4C , PH,2H2SO.' NH3, 11402-NO3, TKN. 0-'G.TOC, COD, HAM !LFSS, IPHF N'OLS, 0", Pt
C'UOL -*C. IIH-n. H111103 NIIETALS cxccpt CR. V1
'I NONE C-HLOR1[)E, ilij. FLUORIDE
OTI I EK

SOUTH FORK 6-1-0 B osol des Fertilizer
Produced by Town of Jefferson
P.D. Bozo 67 Jefferson, NC 28640
South Fork 6-1-0 (SF 610) is a high organic content fertilizer manufactured by the Town of Jefferson Wastewater
Treatment Facility. This product produces superior results on lawns, Christmas trees, flower beds, and shrubs
providing nutrients at the rates; indicated below.
GUARANTEED ANALYSIS
Total Nitrogen ........................................ 6 %
Water Insoluble Nitrogen ..................... ...4.5%
Available Phosphoric Acid........................1 `/.
Soluble Potash.......... .............................0 %
Iron...................................... 'l0
RECOMMENDED APPLICATION RATES
Lawn -Sod Establishment:, Apply SIB' 610 at a rate of 30 IbsJI000 square feet at time of planting
Turf Maintenance: Apply SIP 610 at a rate of 10-131 eJ1000 square.feet every 3 months
Plant Bed Establishment: Apply SF 610 at a rate of 1 lbs. / 100 square feet and mix into the soil
Plant Bed Maintenance. Apply SF 610 at a rate of 2 tbs. / 100 square feet in the Spring and Fall
WA RNINGS: HC 610 is environmentally safe when used as directed, but can become a hazard if mismanaged. " This product
s6.)utd not be used on soils 'intended for food crop production. This product should not be used as a starting medium for
genninating seeds other than grasses. Coder SF 610 with a tarp or plastic during transport. Store SF 610 in a dry area away from
webs or surface -waters where it tould.be washed into stream: keep bulk product away from areas wherechil4ren may play or pets
may wander.
LIMITED WARRANTY AND DISCLAIMER: The Town of Jelin warrants that SF 610 tweets the specifications meted
above, and that the heavy metals content is less than or equal to limitations specified 'tn EPA acid l+lC DENR sludge quality
criteria for land application. There are no warrantees expressed or implied that Mend beyond the description contained herein.
Specifically, there are no warrantees of merchantability or fitness for a particular purpose. If S ' 610 fails to meet its specifications
the buyer's sole remedy shall be the recovery of the purchase price. Under no circumstances shall the Town of Jefferson be liable
for any other damages, including direct, indirect, consequential or special damages,
ACKNOWLEDGEMENT: The undersigned Buyer acknowledges that he/she has read this brochureand is familiarwith its
contents. The undersigned Buyer agrees to abide by the following restrictions:
1. SF 610 shall not be applied to land except in accordance with the instructions contained herein.
2. SF 610 shall not be applied to any site that is flooded, frozen;, or snow-covered.
3. SF 610 shall not be applied within 25 feet,of any water supply, stream, or lake.
4 Adequate meaW= snail Z
rovded to prevent surface runoff from carrying this, product into surface waters.
. u yer Signature., Date
Name (print)r_ Quantity: T. Lbs Tons
Address b6r%�1DUL_ Intended use u
NC &
416
� Zl( $$_..�.___
1'i��t fhvne. Arnflum Collected