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HomeMy WebLinkAboutWQ0019960_Renewal Application_20210225Initial Review Reviewer Thornburg, Nathaniel Is this submittal an application? (Excluding additional information.)* r Yes r No Permit Number (IR)* WQ0019960 Applicant/Permittee City of Marion Applicant/Permittee Address PO Office Drawer 700 Marion, INC 28752-0700 Is the owner in BIMS? r Yes r No Is the facility in BIMS? r Yes r No Owner Type Municipal Facility Name City of Marion County McDowell Fee Category Minor Fee Amount $0 Is this a complete application?* r Yes r No Complete App Date 02/25/2021 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 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 NI3 Staff Name * Zach Key Email Address* zachkey@usbiosolids.com 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* 3369577871 O Modification - Minor G 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:* W00019960 Has Current Existing permt number Applicant/Permittee * City of Marion Applicant/Permittee Address* PO Office Drawer 700 Marion, NC 28752-0700 Facility Name * City of Marion RLAP Please provide comments/notes on your current submittal below. Attached is the land application permit renewal package WQ0019960 for the City of Marion's WWTP. At this time, paper copies are no longer required. If you have any questions about what is required, please contact Nathaniel Thornburg at nathaniel.thornburg@ncdenr.gov. Please attach all information required or requested for this submittal to be reviewed here.* (Application Form Engineering Hans, Specifications, Calculations, Bc.) WQ0019960 Renewal.pdf 2.68MB Upload only 1 RCFdocurrent (less than 250 N8). Nuftiple documents nest be corrbined into one RDFfile unless file is larger than upload limit. * 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 2/25/2021 PO Box 146 Ronda, NC 28670 336-777-6909 www.usbiosolids.com Thursday, February 25, 2021 North Carolina Department of Environmental Quality Division of Water Resources Water Quality Permitting Section Non -Discharge Permitting Unit 1617 Mail Service Center Raleigh, NC 27699-1617 Reference: Permit Renewal for the City of Marion Land Application Permit No. WQ0019960 The City of Marion is applying for a renewal to its current land application permit WQ00019960. There are no changes in this permit renewal package since the last issuance, except for changes the deletion of two fields that have had a change of ownership and have been parceled off. Your attention to this permit application package is greatly appreciated. If you have any questions or concerns, please feel free to contact me at 336-957-7971 or at zachkey@usbiosoilds.com Sincerely, Zach Key US Biosolids, Inc. State of North Carolina 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 Qualio,, Permitting Section's Non -Discharge Permittft 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 I SA 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). C. Facility Classification New Permit Major (land are permitted for > 300 acres) $1,310 . ........... - Major Modification' $3 95 Minor (land are permitted for < 300 acres) $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. Cover Letter (All Application Packages) ❑ List all items included in the application package, as well as a brief description of the requested permitting action. Environmental Assessments (May be Required — See 15A NCAC l 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- l6 Page I 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 .I 110 and include at a minimum: 0 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. El Inspection plan including the following information; 0 Names and titles of personnel responsible for conducting the inspections. El 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; El Names and titles of personnel responsible for conducting the sampling and monitoring. 0 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 C to M ARE REQUIRED FOR DEDICATED PROGRAM ONLY. F. Program Determination El Dedicated residuals land application programs are ones in which land application sites meet the criteria in 15A NCAC 02T .110202 1. 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 I " by 17" plans (electronic format is acceptable - Adobe PDF only). For Modifications, submit plans specific to the modification(s) only. Ej 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 (AI1 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 .1 104 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 .1 104(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 finished product including leaking testing; and ❑ Engineering calculations including hydraulic and pollutant loading, sizing criteria, hydraulic profile, total dynamic head curve analysis for each pump, and irrigation design. Soil mapping units shown on all disposal sites. 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 .1 104 d 5 and current Division Policy available at: htt ://www.ncwater.or /Rules Policies and Re ulationsl. M. Property Ownership Documentation (All New or Modification Application Packages involving new and/or relocated treatment or irrigation components) 0 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 02 L .0107 , 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 rrO 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: (919) 807-6464 INSTRUCTIONS FOR FORM: RLAP 06-16 B.V Courier/S ecial Delivery: 512 N. SALISBURY STREET RALEIGH, NORTH CAROLINA 27604 FAX NUMBER: (919) 807-6496 Page 3 of 3 State of North Carolina Department of Environmental Quality Division of Water Resources VS on o Ater esources 15A NCAC 02T .I 100 — RESIDUALS LAND APPLICATION PROGRAM FORM: RLAP 06-16 I. APPLICANT INFORMATION: 1. Applicant's name: City of Marion Applicant type: ❑ Individual [] Corporation ❑ General Partnership ❑Privately-Owned Public Utility Federal ❑ State ® Municipal ❑ County Signature authority's name per 15A NCAC 02T .0106: Bob Boyette Title: City Manahr Applicant's mailing address: PO Office Drawer 700 City: Marion State: NC Zip: 28752-0700 Telephone number: (828) 652-3551 Email Address: bboyette@marionnc.org 2. Consultant's name: Zach Key License Number (for P.E.): Affiliation: ❑ On Staff ® Retained (Firm: US Biosolids. Inc.) Consultant's mailing address: 958 Hoots Road City: Roaring River State: NC Zip: 28669-9148 Telephone number: (336) 957-7871 Email Address: zachkeyfca,usbiosolids.com 3. Agronomist's name: License Number: Affiliation: 0 NIA 0 On Staff ❑ Retained (Firm: ) Agronomist's mailing address: City: State: Zip: Telephone number: O _- Email Address: 4. Soil Scientist's name: License Number: Affiliation: ❑ NIA ❑ On Staff ❑ Retained (Firm: ) Soil Scientist's mailing address: City: State: Zip: Telephone number: (—) _- Email Address: 5. Fee submitted: $0.00 (See Instruction B) PERMIT INFORMATION: 1. Application is for (check all that apply): ❑ new, modified, 0 renewed permit 2. If this application is being submitted to renew or modify an existing permit, provide the following: Permit number: WQ0019960 Date of most -recently issued permit: 4-14-2106 Date of most -recently certified Attachment A (if different than the permit): 4-14-2016 Date of most -recently certified Attachment B (if different than the permit): 4- 14-20 16 FORM: RLAP 06-16 Page 1 of 5 III. RESIDUALS LAND APPLICATION PROGRAM INFORMATION: I. Residuals Processing Facility's physical address: 3982 Highway 226 South City: Marion State: NC Zip: 28752 Coordinates: Latitude: 350 39' 09.72" Longitude: 810 57' 23.81" Datum: NAD83 Level of accuracy: 0.01 Method of measurement: MAP 2. County where residuals land application program is headquartered: McDowell 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 ORC Dennis Key US Biosolids, Inc. 15704 Back -Up ORC Zach Key US Biosolids, Inc. 27660 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: Maximum amount of residuals to be certified: 29_0 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 37.182 39.982 10782.78 11594.78 Five -Year Maximum Adjusted 39.12 41.92 1 1334.8 121572 b. Laud Application Site Use Summary: Summarize information regarding the land application sites as currently certified and proposed for certification with this application: Category Use Acres Comments Crops Forest or Plantation 0 Row Crops 0 Hay 0 Pasture 56.9 Total: 56.9 Methods Surface 56.9 Incorporation or Injection 0 Total: 56.9 FORM: RLAP 06-16 Page 2 of 5 c. 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 (Ibs PANlac yr) Acres Required Using First -Year PAN Concentrations Acres Required Using Five -Year Maximum Adjusted PAN Concentrations Surface Incorporation or Injection Surface Incorporation or Injection 50 215.65 231.89 226.8 243.14 100 107.82 115.94 113.4 121.5 150 71.88 77.29 75.5 81 200 53.91 57.97 56.7 60.78 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. 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 Ce rtif ication. doc FORM: RLAP 06-16 Page 3 of 5 Note: Item VI. Applicable to Dedicated Program with fixed irrigation system only. V1. DESIGN INFORMATION FOR FIXED IRRIGATION SYSTEM 1. The irrigation system is: ❑ Spray ❑ Drip 2. Disposal system is: 0 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 l 5A NCAC 02T .0505(nl 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 inl 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): 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 Certifieatian (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 I SA N A 5. 93, es ❑ No, Explain; ,• (Signature Authority's Name - PLEASE PRINT) 1 _ D(Title) attest that this application for CI ��[ ,.,E�� n ,� n r>ry f �.► I (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 me as incomplete. Note: In accordance with North Carolina General Statutes §143.215.6A and 3143-215.613, 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 525,000 per violation. Signature' Date: -- FORM: RLAF 06-16 Page 5 of 5 Operation and Maintenance Plan City of Marion, W WTP Permit No. WQ0019960 In accordance with the requirements set forth by the North Carolina Department of Environmental and Natural Resources using NCGS 143-215.1 and 143-215.3(a) based on 15A NCAC 02T .1 10, U.S Biosolids, Inc. and the City of Marion are implementing this Operation and Maintenance Plan. The project manager of the land application event will make sure a daily check off is performed at the start of each workday. This inspection is to prevent any spills, leaks, or run-offs. The daily check -off will consist of inspection the following items: 1. Access to the facility will be controlled with a locked gate and signs to prevent any unauthorized entry into the complex. 2. All pumps and hose will be checked at the start of each day for leaks or loose fittings. 3. All tanker valves are closed prior to loading and lids are closed prior to transport. 4. All dump trailers or dump trucks gates are tightly fastened and do not leak prior to transport. 5. All on road equipment is check as per DOT regulations for any safety or mechanical hazards or issues. 6. All equipment is secured at the end of each working day to prevent any tampering or unauthorized use. The ORC or back up ORC will inspect the field after each land application event to make sure all regulations as required by the permit are followed. Also the project manager at the end of each working day during a land application event will make sure that all gates if present are closed. All samples shall be taken as early as possible before the first application event of the calendar year to make sure the facility is compliance. The samples will be taken in a matter that is representative of the residuals and all grab samples will be mixed prior to be placed into the containers that will go to the laboratory. These samples must be collected and transported as outlined in the Sampling Plan attached to this O&M Plan. All records of these laboratory results as well as the annual report and loading rates will be kept on file for a minimum of five (5) years. Also, in the unlikely event of a spill or unintended release of residuals, actions should be immediately taken as outlined in a copy of the spill control plan attached. City of Marion, WWTP Permit No. WQ0019960 SAMPLING PLAN Annually, if a land application event occurs, grab samples are collected from the digester. Samples from the digester will be combined to form individual grab samples to be sent to a laboratory for analysis. If a land application event is to occur in the early part of a calendar year (Le, January or early February) these samples may have to be taken in December so results can be obtained before the land application event, as some results take 30+ days to receive. These individual grab samples are collected and tested for fecal coliform analysis, SOUR test, nutrient analysis, and a TCLP test. These tests will be taken by the City of Marion. All samples with the exception of the SOUR test will be taken to a North Carolina certified laboratory; the SOUR test will be ran in house at the Marion WWTP. All samples taken will be taken in the same condition as the residuals are to be land applied. The volatile solids will first be attempted to be achieved using option 4 [503.33(b) (1)]; Specific Oxygen uptake know as a SOUR test. This sample will be taken from the digester. Fecal Coliform is gathered in seven (7) individual samples and tested to meet the requirements of [503.32(b)(2)]. This requirement is for the geometric mean fecal coliform density of the samples be less than two million (2,000,000) MPN per gram. These samples will be placed in 250ml containers and placed on ice, in a cooler for transport to the laboratory before 1600 hours (4pm) the same day the samples are obtained. Annually, if land application occurs, a composite residual sample will be analyzed, prior to a land application event for: Cadmium, Copper, Lead, Mercury, Molybdenum, Nickel, Selenium, Zinc, Aluminum, Ammonia Nitrogen, Calcium, Nitrate Nitrogen, Magnesium, total Solids, pH, Phosphorus, Potassium, TKN, Sodium From this information, the Plant Available Nitrogen (PAN) and a Sodium Absorption Ratio (SAR) will be calculated. This sample will be collected in a non -breakable container, at least one quart in size. This sample will be taken from the digester. SPILL CONTROL PLAN- U.S. Biosolids Inc. City of Marion NC -Permit No. WQ0019960 In the event of a spill, the following should be taken IMMEDITALY. Make sure all personal and bystanders are safe- if not contact emergency services 2. Halt the source of the spill- overturned truck, leaking valve, ruptured tank. 3. Contain the spill. Use straw bales or earthen barrier to form a dike to contain the spill. 4. Cleanup. Employ vacuum trucks, dump trucks, and loaders to remove as much of the spilled material as possible. Use straw to soak -up the remaining material. Dispose of the some in a landfill. 5. Flush the roadways with water if needed. If the spill occurred on a tillable area, till the same into the soil and spread lime if necessary. If a spill occurs on private property, final clean-up should be to the satisfaction of the owner. 6. Notification. (This should be done as soon as safely possible.) A. U.S Biosolids, Inc. Main Office (336)777-6909 B. City of Marion, WWTP- (828) 652-8843 C. NCDEQ-Asheville Regional Office (828) 296-4500 D. County Emergency Services (Sheriff, Fire Dept.) 911 7. Reporting: The Permittee shall report by telephone to the Asheville Regional Office, telephone number (828) 296-4500, 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. Surface disposal of residuals abnormal in quantity or characteristic. B. Any failure of the surface disposal program resulting in a release of material to surface waters. C. 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 of normal business hours shall be reported to the Division's Emergency Response personnel at telephone number (800) 662-7956, (800) 858-0368, or (919) 733-3300. 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 be taken to ensure that the problem does not recur. 8. Spill Prevention. The easiest way to clean a spill is to prevent one. A. Ensure loading personal watch the vehicle being loaded. B. Ensure all valves and lids are closed C. Inspect all seals and replace if necessary. State of North Carolina W. D. Department of Environmental Quality RDivision 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.1 100. 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 1 1-15) 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 "M,ap_Guidan,ee_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 l of 1 RESIDUALS SOURCE FACILITY SUMMARY Applicant's name: City of Marion Status Codea Facility Permit Holder Facility Name County Permit Number Maximum Dry Tons Per Year Current n Proposed R City of Marion Corpening Creek McDowell WQ0019960 290 290 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 I'acility). SUMMARY FOR FORM: RSC 06-16 Page I State of North Carolina DW Department of Environmental Quality w wRDivision 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: City of Marion Corpening Creek WWTP 2. Facility permit holder is: Federal, 0 State, Z Local Government, or El Private. Facility permit issued by: Div. of Water Resources, Q Div. of Environmental Health, or Other (explain: ). 3. Facility contact person and title: Tim Horton Complete mailing address: PO Drawer 700 City: Marion State: NC Zip: 28752-0700 Telephone number: (828) 652-8843 E-mail address: thorton2marionnc.org 4. Facility physical address: 3982_14ighway 226 South City: Marion State: NC Zip: 28752 Coordinates: Latitude: 35" 39' 09.72" Longitude: 81 ° 57' 23.81 " Datum: NAD83 Level of accuracy: 0.01 Method of measurement: MAP 5. Purpose of the facility: treatment of municipal wastewater, l treatment of 100% domestic wastewater, �] treatment of potable water, Q treatment of 100% industrial wastewater, treatment of industrial wastewater mixed with domestic wastewater. (approximate percentages: % industrial and % domestic) Ej other (explain ). 6. Does the facility have an approved pretreatment program: Yes No 7. Facility permitted/design flow: 330 MGD and facility average daily flow: 0_9 MGD 8. Average amount of residuals being generated at this facility 66.68 dry tons per year. 9. Specify the following regarding treatment and storage volumes available at the facility: Type and volume of residuals treatment: Two 0,780 MG Aeration Basins Type and volume of residuals storage (i.e., outside of residuals treatment units): 700,00)-gallon digester 11. RESIDUALS QUALITY INFORMATION (See Instruction C.): 1. Specify if residuals are regulated under: 0 40 CFR Part 503 or 0 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. l 102(6) as: 0 Biological [ Non -Biological Note: Biological residuals are residuals that have been generated during the treatment of domestic wastewater, animal processing wastewater, or the biological treatment of industrial wastewater (biological treatment is a system that utilizes biological processes including lagoons, activated sludge systems, extended aeration systems, and fixed film systems). FORM: RSC 06-16 Page] of 5 3. Hazardous Waste Determination: Complete the following to demonstrate that the residuals are non -hazardous under RCRA: (Note - this item does not have to be completed for facilities that are less than 0.5 MGD in design flow that treat 100% non -municipal, domestic wastewater only) a. Are the residuals listed in 40 CFR §261.31-§261.33: 0 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 0 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: Pace Analytical and Date of analysis: l 1-12-2020 Passed corrosivity test: yes 0 no. pH: s.u. (2 < pH < 12.5) Passed ignitability test: yes 0 no. Flashpoint: 200 OF (> 140°F) Passed reactivity test: 0 yes Ono. HCN: ND mg/kg (<250) & H2S: ND mg/kg (<500) TCLP Parameter Limit Result TCLP Parameter Limit Result (mg/1) (mg/1) (m9/0 (mg/l) Arsenic 5.0 ND Hexachlorobenzene 0.13 ND Barium 100.0 ND Hexachloro-1,3-Butadiene 0.5 ND Benzene 0.5 ND Hexachloroethane 3.0 ND Cadmium 1.0 ND Lead 5.0 ND Carbon Tetrachloride 0.5 ND Lindane 0.4 ND Chlordane 0.03 ND Mercury 0.2 ND Chlorobenzene 100.0 ND Methoxychlor 10.0 ND Chloroform 6.0 ND Methyl Ethyl Ketone 200.0 ND Chromium 5.0 ND Nitrobenzene 2.0 ND m-Cresol 200.0 ND Pentachlorophenol 100.0 ND o-Cresol 200.0 ND Pyridine 5.0 ND p-Cresol 200.0 ND Selenium 1.0 ND Cresol 200.0 ND Silver 5.0 ND 2,4-D 10.0 ND Tetrachloroethylene 0.7 ND 1,4-Dichlorobenzene 7.5 ND Toxaphene 0.5 ND 1,2-Dichloroethane 0.5 ND Trichloroethylene 0.5 ND 1, 1 -Dichloroethylene 0.7 ND 2,4,5-Trichlorophenol 400.0 ND 2,4-Dinitrotoluene 0.13 ND 2,4,6-Trichlorophenol 2.0 ND Endrin 0.02 ND 2,4,5-TP (Silvex) 1.0 ND Heptachlor and its Hydroxide 0.008 ND Vinyl Chloride 0.2 ND FORM: RSC 06-16 Page 2 of 5 4. Metals Determination: Complete one of the following tables (i.e., as applicable) to demonstrate that the residuals do not violate the ceiling concentrations for metals regulated under 15A NCAC 02T .1 105. a. For Distribution/Lund 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; EYS and Date of analysis: 6-20-2020 Parameter Ceiling Concentration Limits (ClasYA & ClassB) (mg/kg) Monthly Average Concentration Limits (Class A Only) (mg/kg) Result (mg/kg) Arsenic 75 41 28.2 Cadmium 85 39 11.3 Copper 4,300 1,500 422 Lead 840 300 47.5 Mercury 57 17 1.5 Molybdenum 75 n/a 39 Nickel 420 420 20.2 Selenium . 100 100 28.2 Zinc 7,500 2,800 1020 b. For Surface Dls osal Unit land ill : Fill in the following table with the results of the latest analyses (i.e., on a dry weight basis) for the following metal parameters: Laborator y: _. ,: and Date of analysis: Distance from Disposal Unit to Boundary to Closest Property Line (meters, check one) Arsenic (mg/kg) Chromium (mg/kg) Mickel (mg/kg) 0 > 0 but < 25 30 200 210 25 but < 50 34 220 240 [l > 50 but < 75 39 260 270 El > 75 but < 100 46 300 320 0. > 100 but < 125 53 360 390 0 > 125 62 450 420 Result (mg/kg) FORM: RSC 06-16 Page 3 of 5 5. Nutrient/Micronutrient Determination: Complete the following: a. Total solids: 1.8 %. 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: ETS and Date of analysis: 6-2-2020 Parameter Result (mg/k9) Aluminum 20800 Ammonia -Nitrogen 2500 Calcium 15300 Magnesium 5740 Nitrate -Nitrite Nitrogen 511 pH (Standard Unit) 6.2 Phosphorus 23000 Potassium 5570 Sodium 2810 Total Kjeldahl Nitrogen �58400���� c. Using the results listed in Item 11, 5b. above, calculate the sodium adsorption ration (SAR): 0.65 [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): 0 default value, or 0 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 (1") Year PAN Five -Year Maximum Adjusted PAN (mg/k (mg/kg) Surface 18591 18882.86 Injection/incorporation 19991 20282.86 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: FORM: RSC 06-16 Page 4 of 5 7. Pathoeen Reduction: Per 15A NCAC 02T.1 106, specify how residuals will meet the pathogen reduction requirements: a. For Distribution/Land Application of Class A or Equivalent: A fecal coliform density that is demonstrated to be less than 1,000 MPN per gram of total dry solids, or El A salmonella sp. density that is demonstration to be less than 3 MPN per 4 grams of total dry solids. AND one of the followings (except for non -biological residuals): E] Alternative 1 [I5A NCAC 02T.] 106(b)(3)(A)] - Time/Temperature Compliance. Alternative 2 [15A NCAC 02T.I 106(b)(3)(B)] - Alkaline Treatment. { Alternative 3 [15A NCAC 02T.1 106(b)(3)(C)] - Prior Testing for Enteric Virus/Viable Helminth Ova. E3 Alternative 4 [15A NCAC 02T.I 106(b)(3)(D)] - No Prior Testing for Enteric Virus/Viable Helm inth Ova. Alternative 5 [15A NCAC 02T.I I06(b)(3)(E)-(K)] - Process to Further Reduce Pathogens (PFRP). Specify one: 0 composting, El heat drying, rJ heat treatment, El thermophilic aerobic digestion, Q beta ray irradiation, L] 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. 0 Alternative 2 [15A NCAC 02T.1 106(c)(2)] - Process to Significantly Reduce Pathogens (PSRP). Specify one: [] aerobic digestion, [ air drying, ❑ anaerobic digestion, 0 composting, or lime stabilization. c. For Surface Disposal. L1 Select One of the Class A or Equivalent Pathogen Reduction Alternatives in item 11. 7a. above. 0 Select One of the Class B or Equivalent Pathogen Reduction Alternatives in Item 11. 7b. above. Q Exempt - if Daily Cover Alternative is chosen in Item 11.8. below [ 15A NCAC 02T.1 l06(a)(2)]. Not Applicable - Non -Biological Residuals with NO Domestic Wastewater Contribution. 8. Vector Attraction Reduction (VAR): Per I5A NCAC 02T.1 107, specify how residuals will meet the VAR requirements: El Alternative l [15A NCAC 02T.I 107(a)(1)] - 38% Volatile Solids Reduction (Aerobic/Anaerobic Digestion). E] Alternative 2 [15A NCAC 02T. l 107(a)(2)] - 40-Day Bench Scale Test (Anaerobic Digestion). Alternative 3 [I5A NCAC 02T.1 107(a)(3)] - 30-Day Bench Scale Test (Aerobic Digestion). Alternative 4 [I5A NCAC 02T.1 107(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. Q Alternative 7 [15A NCAC 02T.1 107(a)(7)] - Drying of Stabilized Residuals. Q Alternative 8 [15A NCAC 02T. l 107(a)(8)] - Drying of Unstabilized Residuals. [] Alternative 9 [15A NCAC 02T.1 107(a)(9)] - Injection. [] Alternative 10 [15A NCAC 02T.1 107(a)(10)] - Incorporation. Alternative for Surface Disposal Units Only - Soil/Other Material Cover [ I5A NCAC 02T. 1107(b)(2)]. E] 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 My" f f s TV ,erg': a > r S Aw mow AT sew t ripnina Creek WWTP - NCOU31879 QUANTITATIVE JUSTIFICATION FOR RESIDUALS PRODUCTION RATE Since the last issuance of Permit WQ0019960 the City of Marion has produced the following dry tons: 2020 58.06 DT 2019 145.89 DT 2018 0 DT 2017 94.34 DT 2016 35.13 DT This comes to an average of 66.68 Dry Tons peryear, which is less than the amount of dry tons requested in this permit renewal application. City of Marion, WWTP Permit No. WQ0019960 SAMPLING PLAN Annually, if a land application event occurs, grab samples are collected from the digester. Samples from the digester will be combined to form individual grab samples to be sent to a laboratory for analysis. If a land application event is to occur in the early part of a calendar year (i.e. January or early February) these samples may have to be taken in December so results can be obtained before the land application event, as some results take 30+ days to receive. These individual grab samples are collected and tested for fecal coliform analysis, SOUR test, nutrient analysis, and a TCLP test. These tests will be taken by the City of Marion. All samples with the exception of the SOUR test will be taken to a North Carolina certified laboratory; the SOUR test will be ran in house at the Marion WWTP. All samples taken will be taken in the same condition as the residuals are to be land applied. The volatile solids will first be attempted to be achieved using option 4 [503.33(b)(1)]; Specific Oxygen uptake know as a SOUR test. This sample will be taken from the digester. Fecal Coliform is gathered in seven (7) individual samples and tested to meet the requirements of [503.32(b)(2)]. This requirement is for the geometric mean fecal coliform density of the samples be less than two million (2,000,000) MPN per gram. These samples will be placed in 250ml containers and placed on ice, in a cooler for transport to the laboratory before 1600 hours (4pm) the same day the samples are obtained. Annually, if land application occurs, a composite residual sample will be analyzed, prior to a land application event for: Cadmium, Copper, Lead, Mercury, Molybdenum, Nickel, Selenium, Zinc, Aluminum, Ammonia Nitrogen, Calcium, Nitrate Nitrogen, Magnesium, % total Solids, pH, Phosphorus, Potassium, TKN, Sodium From this information, the Plant Available Nitrogen (PAN) and a Sodium Absorption Ratio (SAR) will be calculated. This sample will be collected in a non -breakable container, at least one quart in size. This sample will be taken from the digester. Cto-lificale of Analysis il—M —r I...... r»rr.r Iti I "i" 41.5 2. jo,r, 111 llr 13 13 1 2-2 k W -1 I II.411 MI. 11 1 MW O" Certificate of Analysis Project name: Marion WWTP Collection date: 17-Feb-20 Date received: 17-Feb-20 Sample identification: Sludge #1 : Grab PO Box 7565 Asheville, NC 28802 Phone: (828) 350-9364 Fax: (828)350-9368 Project number: 200217.500 Sample number: 196656 Parameter Method Result RL Units Date Analyst Footnotes Analyzed %TS SM 2540 G 1.7 0. i0 % 17-Fob-20 KEK Mulitple Tube fermentation Procedure SM 9221-E 9520 3.1 MPN 17-Feb-20 KEK Sample identification: Sludge #2 - Grab Sample number 196657 Parameter Method Result RL Units Date Analyst Footnotes Analyzed %TS SM 2540 G 1.8 0.10 % 17-Fob-20 KEK Mulitple Tube Fermentation Procedure SM 9221-F 4140 3.6 MPN 17-Feb.20 KEK Sample identification: Sludge 43 Grab Sample number: 196658 Parameter Method Result RI, Units Date Analyst Footnotes Analyzed %TS SM 2540 G 1.8 0.10 % 17-Feb-20 KEK ivlulitple Tube Fermentation Procedure SM 9221-F 10080 3.6 MPN 17-Feb-20 KEK Sample identification: Sludge 44 Grab Sample number: 196659 Parameter Method Result RL Units Bate Analyst Footnotes Analyzed %TS SM 2540 G 1.7 0.10 % 17-Feb•20 KEK Mulitple Tube Fermentation Procedure SIV4 9221-E 2210 3 A MPN 17-reb-20 KEK Footnotes: RL �, Reporting Limit. Values are reported down to the Reporting Limit only. Date reviewed: Okag • _ NC Certification Number: 600 Data reviewed by: Kellen E. Keenan_ SC Certification Number: 99053 Signature: g NC Drinking Water Certification Number: 37786 This report should not be reproduced, ex pt in its entirety, without the written consent of Environmental Vesting Solutions, ]ac The results in this report relate only to the samples submitted for analysis. Certificate of Analysis Project name: Marion WWTP Collection date: 24-Feb-20 Date received: 24-Feb-20 Sample identification: Sludge #5 - Grab 110 Boa 7565 Asheville, NC 28802 Phone: (828)350-9364 Fax: (828)350-9368 Project number: 200224.501 Sample number 196856 Parameter Method Result RL Units Date Analyst Footnotes Analyzed %TS SM 2540 G 1.8 0.10 % 24-Feb-20 KEK Mulitple Tube Fermentation Procedure SM 9221-E 8100 3.6 MPN 24-Feb-20 KEK Sample identification: Sludge #6 - Grab Sample number: 196857 Parameter Method Result RL Units Rafe Analyst Footnotes Analyzcd %TS SM 2540 G 1.8 0.10 % 24-Feb-20 KEK MulitpleTube Fermentation Procedure SM 9221-E 2340 3.6 MPN 24-F6-20 KEK Sample identification: Sludge #7 Grab Sample number: 196858 Parameter Method Result RL Units Date Analyst Footnotes Analyzed %TS SM 2540 G L8 0.10 % 24-Fcb-20 KEK Mulitple Tube Fermentation Procedure SM 9221-E 2340 3,6 MPN 24-1--eb-20 KEK Footnotes: RL = Reporting Limit. Values are reported down to the Reporting Limit only. Date reviewed: NC Cet-titication Number: 600 Data reviewed by: Kelley E, Keenan SC Certilication Number: 99053 Signature: NC Drinking Water Certilication Number: 37786 This report should not be reprodUiced, wept in its entirety, without the written consent of Environmentil Testing Solutions, 111c The results in this report relate only to the samples submitted for analysis. Time (minutes) a 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Specific Oxygen Uptake Rate SOUR Facility Name. Biosolids Permit Number Date. Digester Temperature Sampling Date/Time Sampled By Analysis Date/Time Analyzed By Sample Volume Total Solids Beginning Temperature End Temperature Dissolved Oxygen Level 7.64 7.4 72 6.98 6.75 6.54 6.3 6.1 5.88 5.63 5.45 5.22 5 4,75 Slope: Intercept: Correlation Coefficient: Oxygen Uptake Rate: Ambient Specific Oxygen Uptake Rate: Average Temperature: Temperature Correction Factor: Corpening Creek WQ 0019960 4/28/2020 16 4/28/2020 0906 TH 4/28/2020 1035 RGC 1000 0.73 25 25 0.2 8.1 1.0 -milliliters '/o Dry Solids legrees Celsius legrees Celsius 13.25 mg Oxygen/hr 1.81 mg Oxygen/g/hr 25 degrees Celsius 0.783526166 Temperature Corrected Specific Oxygen Uptake Rate: 1.42 mg Oxygen/g/hr Instructions: Enter Data in the Blue Boxes, The Calculation and the Spreadsheet execute automatically. 0 G CITY OF MARION CORPENINC CREEK WASTE TREATMENT PLANT LABORATORY T+1111 Solids: In Solid and Semisolid Samples —Dried at 103=1066C 8 atd MOOM61-4 2540 0-2011 Ft N-DATE: '(" TIME IN: d9F5� Y6T. TIME OUT: / Z L10 Time Weighed: R R A A b TEMP IN: /1023 °C TEMP OU %. /O'3 'C (A.t31 X 700 M n w w SAMPLIE; j ID DATE COLLECT sample Vol. ML. Dish— WT. MG Dish Wet sample MO Dish fi Dried Residue MO Residue Weight MG Residue Weight MO Tots Solids 6777 siu'd . 29a,nz0 '/ J6, s"73S' d � I o, :3S'97i to- I3 A Weight of dried residue + dish, mg; 8 weight of dish, C Weight of wet sample + dish, mg , i 46 Total Solids �+ �� c-e 3 i SOUR OXYGEN UPTAKE RATE D.O. WORKSHEET DATE: 4(` 29' T.OZ" TIME: 1035" Z� i TEMPERATURE:�� ANALYST., AERATION TIME START: STOP: DO READING START TIME: RECORD DO READINGS Q Intervals less than one MINUTE FOR AT LEAST ,15 MIN 2 12 Sr 3 �, D 13 Z 4 7r 7�� 14 0� 5 6 S°a`%� 16 7 �p. 5� 17 8 (D.D 18 f05 9 �� /� 19 10 sl 20 r C� Record the temperature at the end of the test: ;) `; r' C°i y = -0.2208x + 8.3008 , Oxygen Uptake Rate Chart 9 8 7 6 j j E i 5 d w > 4 Q i 3 i i 2 1 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 is 16 Time (minutes) Specific Oxygen Uptake Rate Sour Test Corpening Creek Wastewater Lab Marion, N.C. Method: SM 2710 B-2011 Date: 4/28/2020 Time Sampled: 0906 Sampled By: TH Time Started Aeration: 0915 Time Ended Aeration:1030 Time Analyzed:1035 Analyzed By: RGC Total Time of Test: < 2 hrs. ( 1 hour 44 mins. ) Total time of test includes the time sample was aerated. Analytical Results U.S. Biosolids Inc 958 Hoots Road Roaring River, NC 28669 Receive Date: 11112)2020 Reported'. 12/1 OJ2020 For: MARION Comments: Sample Number Parameter Sample ID Result Unit Method Analyzed Analyst 201112-18-01 TCLP MARION See Attached a5 Now 1V13/2020 PACE Respectfully submitted, Dona Myers NC Cert #440, NCDW Cert #37755, EPA #NC00909 PO Box 228 * Statesville, NC 28687 • 704/972/4697 Page 1 of 30 Condition of Receipt Sample Number 201112-18-01 Temp on Arrival: 3.0 Parameter Schedule: TCLP Received on Ice PO Box 229 • Statesville, NC 28687 • 704/872/4697 Page 2 of 3U h 01 � O N O 00 m � m CWrd $ . Aa�ress: q'SQ ..firs_ 00 h Iz2c.,�na.R� r.o.t z_t+ Shb.:.iUt.`r(� 2W7 t0 1\OM i 17,13)Ri?-iF47 rN N Phone R St� o'r ! FAXN — Chain of � Contact Person. Zw� t.� _ _ _ 7 f QC3 y Requisitioned by: fTlme Hale) L.Uctudy ReCt►rd � _ ... _. _..._ -... ... ._ — Ma�r1r ---- TlmcSarn�en l>a=e5amed.. I•arauc�.�s�ewoeekd>, > COWh•uti — SempicQPa 3�La0IDa (Grab pnlY; - 6J to ---_�- 1 X _— n O i I Relinquished by: I -_-_- --- Time isy am, Date �!11121iv Sampled by: CR•,� Received by: I ! `---_-.__ TimprtlJ e 'I Date r � 1I z Transported by: L� Reiinquishetl by: Time am, pm Date ___ 1 I Molding times met: Received by: Time am, pm Date 1 _1_ Compliance work - Time begin_ am. pm Date ! ! Non-compliance work. Time end..-----__-. am, pm Date T! - _1 Lab GOMMWOS_ Samples Tranepoded On Ire: Time begin am. pm Date I Time end.- . -__ am, pm Date T aceArwca! rwaeeNNs.rnw ANALYTICAL RESULTS Pace Analyticar Servleee, L40 967D Kincey Aoa Suft 1 DO Hvnlersdie, NC 28078 17D4)875-9092 Project US 0i0 Marion Pace ProleCl No: 92506064 Sample: Sludge Lab ID: 22506084001 Colleclad: 11/12120 11:30 Received: 1111312o 08-55 Matrix, Solid Restlats reported on a "dry weigh!' basis and are adjusted for percent moisture, sample size and any dilutions. Parameters Results Units Reporl Limit OF Prepared Analyzed CAS No. Qual Chlorinated Herb- (dC)9161A AnalylicalMelhod:EPA8151A PreoaraeonMelhod:8151A Leachale MethadiDale: 1311. 1111912009.49 lA11W pH'. 5.72: Final pH- 5 Pace National - Mt. Juliet 2.4 5-TP (S4vex) ND mg7L 0.00200 1 11121120 19 D9 11/25120 n N 93-72-1 2 40 NO mg7L 0.00200 1 11/21120 19 09 1V2512C 23:32 94-75-1 Surrogates 2.4•DCAA(S) 714 45 14.0-158 1 111211201909 11!2512023:32 19119-28.9 8081 TCLP Pesticides RVE Analytical Melhoq EPA 8081E Preparation Method: EPA 351W Leachale MelhadlDate: FPA 1311', 11/24120 16:55 Initial pH. ; Final pH: 6 Pace Analytical Services • Charlotte gamma-BHC (Llndanel ND uglt 0 w 1 11130f20 08:06 11130/20 15:11 58.89-9 ChiorGane (Technical) NO ug)L 3 0 1 11130I20 08:06 11130/20 15:11 5T-74-9 Endrin ND ug1L 0.50 1 li,'21 2D 08'.06 T1130120 t5:ll 72.20-B Heptachlor NO ugrL 0.50 1 11r3012008'.06 1113012015,11 76.44.8 Heptmhlorepoxtde ND ugrL 050 1 111301200&06 111301'201511 1024,57.3 Methoxychbr ND Ug'L 16D0 1 11130120 08'06 I IJ30120 15.11 72.43.5 Toxaphene ND U91L 3.0 1 11130120 Ca.06 11/30120 15 11 8001-35.2 Surrogatea Decachlorobiphenyl (S) 103 % 10-154 1 11130.20 08'06 11/30120 15.11 2051-24.3 Tetrachlord-m.xylene IS) 26 % 10-184 1 11r30120 06:06 n130120 15:11 877-09-8 8082 TCLP PCBs RVE Analytical Method. EPA 8082A Preparation Method: EPA 3510C Leachale MalhedlDate: EPA 1311. 11124120 15:55 Initial pH:. Final pH- 5 Pars A.-talylical Services • Charlotte PCB-1016(Arodo(1016) NO ugrL 1000 1 11r301200739 11i3012013:17 12674.11-2 PCB-1221 (Afodor 1221) ND ugrL 1000 1 1113012007.39 116012015:17 111D4-2B-2 PCB-1232 (Arocbr 1232) ND ugrL lom t 1113012007.39 11130)2013.17 11141-16.5 PC8-&1242 (Arocor 1242) ND uyL 1006 1 1113012007,39 11130/2013 17 53469-21-9 PCB-1248 (Arottor 1248) NO ugrL 100C 1 11/301200739 11!30720 13:17 12672.29.6 PCB•1254(Arocior1254) NO ugll. 1000 1 11301200739 1130/2013:17 11097-69-1 PCS-1260 (ArodoF 1260) NO uggiL 1000 1 11130�20 07.39 1113012D 13.17 11096-82-5 Surrogatas Decachlombiphanyl {S) 78 % 10.181 1 11130120 07 39 11130/20 13.17 2051.24.3 601D MET ICP, TCLP Analytical Memo: EPA 6010D Preparation Method EPA 3010A Leachale MelhodlDate: EPA 13l l: 11116120 15:37 Initial pH:: Final pH: 2 Pace Analytical Services - Asheville Arsenic ND mg7L 0,050 1 11118f200211 11118120 11 18 7440.314.2 133rwrn NO mg1L 025 1 1111512002,31 11118/2011,113 1440-39,3 Cadr1111m NO mg7L 0.0050 1 111181200211 11118r2011.14 7440-43-9 Chromium NO mq'L 1).C50 1 111182602L31 11118r2D1t'10 7440-47.3 Lead NO mg7L D,C25 I 1111812002'31 11!18/2011.18 7439-92-i Selenium NO mg7L 0.10 1 1111812D 02:31 1111600 11 18 7782-49-2 Silver NO mg7L 0.026 1 Ili 4812D 0731 ll118i2011'18 1440-22-4 REPORT OF LABORATORY ANALYSIS 11iis reuorl shall not be reproeuceo. euceot in hiA, Dale 12!0812020 05-14 PM without the written consent of Pace Am^ijcal Sem"5, LtC Page 5 of 27 PO Box 228 a Statesville, NC 28687 a 704/872/4697 Page 8 of 30 1. ceAralytical -. rlale.aaulelscae ANALYTICAL RESULTS Pate Amlytical Strikes, LLC 98M Kincey Ave Suite 100 Huntersvllle, NC 28010 (704)875-9092 Prcieck- US Bio Marlon Pace Protect No : 92506064 Sample: Sludge Lab IQ: 92506084001 Cdiecled: 11112121) 11 30 Received 111I T20 98 55 Matrix, Solid Results reported on a -dry weight- basis and are adjusted for pereanl moisture, sample sire and any dilutions. Parameters Results Units Repon Limit DF Prepared Analyzr:d CAS No Qual 7470 Mercury, TCLP Analyticai Method, EPA 7470A Preparation Method- EPA 7470A Laachate MelhodlDate: EPA 1311, 1lil6120 15:37 Intltal pH: Final pH: 2 Pace Analytical Services - Asheville Mercury NO ni 0.00020 1 11118/20 11.30 1111912C 14:04 7439-97.6 8270E TCLP RVE Analytical Method: EPA 8270E Pre9arahnn Method EPA 351 DO Leachale MelhodlDale. EPA 1311: 11 f24120 15:55 Iniliw pH.: Final pH: 5 Pace Analytrcal Services - Charlotte I.4-clthtorobenzene NO ug1L 50.0 1 11 J3012008.04 1V3012014:40 106-46-1 2,4•pulitrotoluene NO ug1L 50.0 1 11 J30120 08 04 1VM2014:40 121-14-2 Hexachloro-1.3-buladlene NO ug1L 50.0 1 1113012008:04 11130r O W40 87-U-3 Hexachlcrobenzene ND ug/L 500 1 1113012008:04 1113000 14:4 0 118,74.1 Hexacriloroelhare ND ugfl- 50.0 1 1113012008'04 lV30/2014,40 67-72.1 2-Melhylphetlol(o-Cresol) ND ug1L 50.0 1 1113012008:04 11PNU2014'.40 95.48-7 384-Melhylphwto4mdPCresol) NO ug/L 50,0 1 11130)2008.04 1113012014A0 15831.10-4 Niuobenzerie NO og1L 50-0 1 1113012008:04 1113D12014:40 9B-95-3 Pentachiorophenol ND ug/L 100 1 11130/2008.04 11/3012014,40 57-1516-6 Pyridine NO uglL 50.0 1 11130f20 OB-04 11/30/20 1440 110-86.1 2,43-Trichlprophenol NO ug1L 50 0 1 11130/20 08:04 1 VM20 14:40 95-95A 2,4.6-Trichloropllernol ND ugll 50 D 1 11)3012001104 1113020 14-.40 B8-06-2 Surrogates Nitrobenzene-d5(Si 77 ?k 10-144 1 11130120 08 04 1V3072014:40 4165-60.0 2-I'Wrobiphenyl (S I 54 % 10-130 1 11/30120 08:04 1 V30120 14 40 321-60-8 Terphenyt-d14 (S) 108 `'7e 34-163 1 1113CIZC 08:04 11/30;20 1440 1718.51-0 Phenol-d6(S) 41 % 10-130 1 1113012008'04 11130r2014'4D 13127-68-3 2-Fuo(ophenoi IS) 58 A 10-130 1 1113N20 a8.04 11/30120 1440 367-12-4 2.4.6-Tr Invomophenol(S) 75 % 10-144 1 11/30120 08 04 11130/70 14,4t1 118-79.6 8260D MSV TCLP Analylical Method: EPA 8260D Learhate MethodfDale: EPA 1111: 11123/20 17:16 Pace Analytical Seances - Charlotte Benzene NO uglL 1DO 20 1112412017:22 71-43-2 2•Butanone(MEK! NO ug!L 200 20 11 Q4120 17,22 78-93-3 Carbon tetrachloride NO uglL 100 217 llf24i201722 56-23-5 Chlarooenzerle NO ug!!L 100 211 11i24/2017,22 108-90-7 cNicrololm N, uglL 10G 20 ili?412017.22 67-66-3 1,4.0lchldrohenzene NO ug1L t00 20 1112412017.22 106-46.7 12-DichioMetrlare NO ugiL 10b 20 11124,72017,22 167-06.2 1,1-Dichtoroelhene NO ug1L 100 20 11;242017,22 75.35.4 Telrachiorpetharl6 NO ug!L 100 20 11124/20 17:22 127-18-4 Tridlloroetnere NO ug1L 100 20 1124f201722 79.01-6 Vinyl chloride NO ugll 100 20 11124f20 1722 75-01.4 Surrogates 1.2-Dirhloroathane,d4 (S) 100 °% 70.130 20 11124120 17:22 17060.07-0 Toluene-d8 (S) IQ °% 67-135 20 11/24120 t7:22 2037.25-5 4-8rorneuoMbenzana JSF 98 % 70.130 20 1I!24120 t7:22 460.004 REPORT OF LABORATORY ANALYSIS Tias report Shalt ncE t7e reproeuoed. ex"pi in full. Date: 12M 2020 05:14 PM without the wriffm consent M Face Analytical Services L LC. Page 6 of 27 PO Box 228 a Statesville, NC 28687 a 704/972/4697 Page 9 of 30 /-,�aceAnaloca( y1rlr,eedlNllM ANALYTICAL RESULTS Pace AnNyti64t Servicsz, LLC WOO Kmcey Ave Suite I Hm+lerswee, NE 2a0T8 f7,41815-9092 Project: US Bio Marion Pace Project No. 92606W4 Sample: Sludge Lab ID: 92506094001 Cotlected: 11(1212011:30 Received: 11)1312008:55 Matruh Solid Results reported on a 'dry weight' basis and are adjusted for percent moisture, sample sire and any dilutions. parameters Results Units Report Limit OF Prepared Analyzed CAS No ouai Percent kiloisture Analytical Method: ASTM 02974.67 Pace Analytical Services - Charinne Percent Moisture 98.3 % 0.10 1 11113120 19:38 1010 Flashpolnt,Closed Cup Analytical Method. EPA 1010A Para Analytical Services - Ashevitle Flashocint >200 deg F 10.0 1 12106/20 14:42 9045 pH Soil Analytical Method. EPA 90450 Pace Analytical Services - Asheville PH at 25 Degrees C 5.9 Sid. Units 0-t0 1 IV07120 16 45 H3 9095 Paint Filter Liquid Teat Analytical Method. EPA 9095E Pace Analytical Services - Ashevele Free Liquids Fail 1.0 1 12.102120 16'21 733C S Reactive Cyanide Analytical MethodEPA9014 Preparation Method: SW-846 7.3.3.2 Pace Analytical Services - Greensburg Cyanide, Reactive ND rnglkg 0,99 1 111'18/20 1823 1109120 18:58 734E Reactive Sulhde Analytical Method: SM. 4500S2F-2011 Preparation Method. SW-846 7,34,2 Pace Analytical Services - Greensburg Sulfide, Reactive ND mgAg 9.9 1 11,'1&20 18,23 Ili18120 1825 Sample, PCB Pararneters Lab ID: 92506004002 Collected: 11/12120 11:30 Resul(s Units Report Limit OF Received' 11/13120 0855 Matrix: Water Prepared Analyzed CAS No. Qual 0002 GCS PCB RVE Analytical Method: EPA 8082A Preparation Method: EPA 351 OC Pace Analytical Serv.ces - Charintte PCB-1016(Arocldr1016) NO uglL 2,5 1 1MV2010:28 QM212002.16 12674-11.2 PCB-1221 (Aroclor 1221) NO u91L 2.5 1 12101120 10:28 1210212002.le 11104-28-2 POP- 1232(Arodor1232) ND ugll- 25 1 1210112010:28 1210212002,16 11141-16.5 PCB-1242 (Arodor 1242) NO u9A 2.5 1 12W120 10-.2B 12/02120 WAf; 5A69-21-9 PCB-1248 (Aroclor 12481 NO uglL 2-5 1 12r01f20 10:28 12l02!2C 02:16 12672.29-5 PCB-t254(Aroclor1254j NO uq/L 25 1 12.10112010:28 12M212002:16 11097-60-1 PCB-1260 (Arodor 1260} NO ugil- 2.5 1 12101120 10,28 12/02120 02.16 11096-82-5 Surrogates Decacriloroblphenyl(5) 42 % 10-181 1 1210112010:26 121C212002.16 2051-24.3 REPORT OF LABORATORY ANALYSIS 1r,s MpW shall not be repr6auced. iUG&pt in tali_ Date: 12/08/2020 05:14 PM without the written consent of Pace Anaiyitcal Services, LLC Page 7 01 27 PO Box 229 a Statesville, NC 28687 a 704/872/4697 Page 10 of 30 State of North Carolina Department of Environmental Quality .W Division of Water Resources Division of Water Resources LAND APPLICATION SITE CERTIFICATION INSTRUCTIONS FOR FORM: LASC 06-16 Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional information requested. Failure to submit all of the required items will lead to additional processing and review time for the permit application. Unless otherwise noted. the Applicant shall submit one original and two copies of the application and supp rting 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 .I 100. 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 1. 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: Required Item Status Code N R T M County Board Notification, doc Land pawner ✓ ✓ Agreement (If applicable) ik;T .:.:.,. ✓ ✓ ✓ ✓ Setback Waiver Agreement An updated vicinity/setback map in accordance with the "Map _Guidance for Resi,duals-Land Application ferm.its' A soils and agronomic evaluation in accordance with the "Soil Scientist Evaluation Policy," ✓ INSTRUCTIONS FOR FORM: LASC 06-16 Page I of 3 s An updated accounting of the land application site's cumulative _pollutant loading rates CPLRs Required Item Status Code N R T M For previously permitted sites without a soil series name indicated in the Attachment B, submit County Soil Survey Map (or equivalent) clearly indicate the location of the land application site and in accordance with the soil map re uirements 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 it status code "M please contact the Division if you need assistant in determining attachment requirements. ❑ Crop Type should include the most likely crop types for the life of the permit (Five years). ❑ Predominant Soils Series Name must be either the name of the soil indicated in Attachment "B" of the existing permit, or name of the soil series as provided by the licensed soil scientist. ❑ Predominant Soil Mapping Unit or Representative Slope: Either the Soil Mapping Unit or the representative slope of each site must be provided. The predominant soil -mapping unit must be consistent with the predominant soil series name. Please note that the soil mapping units are variable between Counties, so care should be taken in properly identifying the correct mapping unit. If a representative slope is provided, it must be determined accordingly: ❑ For sites previously permitted for use, but do not have an established soil mapping unit (the mapping unit provides information on both the soil series name and the slope of the soil), the Applicant may determine the representative slope by using the average slope provided in the County Soil Survey (or equivalent). A soil type with a slope range of 4 - 8% would have a representative slope of 6%. ❑ New Sites to be permitted must have slopes determined as part of the soils report prepared by a licensed soil scientist. ❑ Acceptable methods for determining location coordinates (i.e., latitude and longitude) and their corresponding codes are as follows: • Address Matching (ADD) • 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 Mere (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 I 1-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: htt ://de .nc. Gov/about/divisions/water- resources/ tannin /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: htt://de .nc. ov/contact/re 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 I 1-inch sheet showing the project area should be submitted with the permit application regardless of whether a Stream classification was completed). 2. Determine the names of all the closest down slope surface waters from the project site. For unnamed tributaries, see Table 1: Unnamed Tributaries Entering Other States or for Specific Basin Areas. Label any unnamed tributaries as UT to stream name' as the waterbody name. 3. Open the link http://deq.nc.gov/about/divisions/water-resources/planning/classification-standards/classifications. ❑ Stream Classification Process: One of the options below may be used depending on the known initial project information. ❑ KNOWN BASIN WHERE CLOSEST DOWN SLOPE SURFACE WATER IS LOCATED 1. Select proper basin from the List all Waterbodies in Basin sorted report. Sort hydrologically as this will provide the proper location descriptions if multiple runs. INSTRUCTIONS FOR FORM: LASC 06-16 Page 2 of 3 2. Locate the name of the identified waterbody (from General Directions) on the list. 3. For multiple listings of the same waterbody name in the report, select and verify the location description. The term "source" in the description means the beginning of the waterbody segment (most upstream point). 4. Record all Basins, Stream Index Numbers and Classifications applicable to the project. ❑ KNOWN COUNTY WHERE CLOSEST DOWN SLOPE SURFACE WATER 1S 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 .030E(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 enteri[Ig South Carolina are classified "C." New River Basin Streams entering the State of Tennessee are classified "C." Catawba River Basin Streams entering South Carolina are classified "C." Yadkin -Pee Dee River Basin Streams entering Virginia are classified "C," and such streams entering South Carolina are classified "C." Lumber River Basin Streams entering South Carolina are classified "C Sw." Roanoke River Basin Streams entering Virginia are classified "C." Except that all backwaters of John H. Kerr Reservoir and the North Carolina portion of streams tributary thereto not otherwise named or described shall carry the classification "B," and all backwaters of Lake Gaston and the North Carolina portion of streams tributary thereto not otherwise named or described shall carry the classification "C and B." Cho van River Basin Streams entering Virginia are classified "C." Tar -Pamlico River Basin All drainage canals not noted in the schedule are classified "C Sw." except the main drainage canals to Pamlico Sound and its bays which shall be classified "SC." Pas uotank River Basin All drainage canals not noted in the schedule are classified "C." INSTRUCTIONS FOR FORM: LASC 06-16 Page 3 of LAND APPLICATION SITE CERTIFICATION Applicant's name: City of Marion Land application sites currently certified: 103.6 net acres and Total to be certified: 56.9 net acres. L LAND APPLICATION SITE INFORMATION (See Instruction B): Status CodeA Site/Field ID Landowners O Lessees or Operator(s) O Net Acres Count y Crop(s) s PO Predominant Soil Series Namee Mapping Unit or Rep. Slope' D K I Mario DeLuca 16.4 McDowell Fescue Hayesville HaC D K2 Mario DeLuca 30.3 McDowell Fescue Hayesville HaC R F I John Fisher 9.9 McDowell Fescue Braddock BrB2 R F2 John Fisher 2.4 McDowell Fescue Braddock BrB2 R F3 John Fisher 7.0 McDowell Fescue Hayesville HaC R F4 John Fisher 6.7 McDowell Fescue Hayesville HaC R R I Brian Kay 17.2 McDowell Fescue Hayesville HaC R R2 Brian Kay 13.7 McDowell Fescue Hayesville HaC i Status Code for land application sites are: • N (New) ♦ R (Renewed) ♦ M (Modified) ♦ 1' (Transferred) • D (Deleted) e Soil Series Name (i.e. Appling, Cecil. etc.) ° Mapping iJnit 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 CcB2) IL 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 Class K1 350 34' 43" 810 51' 48" NAD 83 ADD Nearest Second S Fork Hoppers Creek 1 1-32-2-9 C C K2 35' 34' 43" 81051' 58" NAD 83 ADD Nearest Second S Fork Hoppers Creek 1 1-32-2-9 C C F1 350 35' 39" 810 51' 04" NAD 83 ADD Nearest Second Magazine Creek 1 ]-32-2-9-2 C C F2 350 35' 32" 81° 50' 60" NAD 83 ADD Nearest Second Magazine Creek 1 1-32-2-9-2 C C F3 35" 35' 33" 810 50' 42" NAD 83 ADD Nearest Second Magazine Creek 1 1-32-2-9-2 C C F4 350 35' 31" 810 50' 36" NAD 83 ADD Nearest Second Magazine Creek 1 1-32-2-9-2 C C R 1 350 34' 40" 810 51' 24" NAD 83 ADD Nearest Second S Fork Hoppers Creek 11-32-2-91 C C R2 350 34' 50" 810 51' 20" NAD 83 ADD Nearest Second S Fork Hoppers Creek 1 1-32-2-91 C C Note: Please keep the site inhumation (I.) and waterbody information (11.) of the same field on the same page. FORM: LASC 06-16 Page 1 Division of Water Resources State of North Carolina Department of Environmental Quality Division of Water Resources 15A NCAC 02T .1100 -- LANDOWNER AGREEMENT FORM: LOA 06-16 Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional information requested. Failure to submit all of the required items will lead to additional processing and review time for the permit application. Unless otherwise noted, the Applicant shall submit one original and two copies „of, the application and supporting documentation For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting Unit. General — This document is an agreement between the Applicant and land owner(s) of residuals receiving sites for land application of Class B residuals (may include water treatment plant or other type residuals) in accordance with 15A NCAC 02T .1 100. Do not submit this agreement for review without a corresponding application form (FORM: RLAP 06-16). Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed below. A. Land Owner Agreement (FORM: LOA 06-16): ❑ Submit the completed and appropriately executed Land Application Site Certification (FORM: LASC 06-16) form. Please do not make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to the application may be made, as long as the attachments are numbered to correspond to the section and item to which they refer. ❑ Prepare a separate agreement for each set of land application sites that are owned or operated by an entity other than the Applicant. ❑ A copy of the completed and appropriately executed agreement must be provided to the landowner and the lessee/operator. AGREEMENT FOR THE LAND APPLICATION OF RESIDUALS TO PRIVATELY OWNED LAND The undersigned landowner or his representative hereby permits: Applicant's name: City of Marion hereinafter referred to as the Permittee, to land apply residuals from the following facility(ies) onto the following land application site(s) (i.e., see attached setback maps) in accordance with the stipulations and restrictions as given in this Agreement: Site/Field ID Lease (yes/no) Land Use or Cropping Patterns Intended Use of Crops Residuals Source (optional) Special note (no-till/over-seed/ pasture) Fl no Pasture Animal Feed F2 no Pasture Animal Feed F3 no Pasture Animal Feed F4 no Pasture Animal Feed The landowner or his representative receives, in consideration, full use of the nutrient value of the applied residuals while the Permittee receives, in consideration, the use of the land application site(s) described above for the disposal of the residuals. This Agreement shall remain in effect for the length of the Division's permit for the residuals land application program and shall be renewed each time this permit is renewed. The undersigned landowner or his representative and the Permittee agree to abide with the following restrictions and stipulations until such time as written notification, given 30 calendar days in advance, modifies or cancels this Agreement. FORM: LOA 06-16 Page I of 3 I. STIPULATIONS: I. The landowner or his representative shall not enter into any additional residuals application contracts or agreements with another permitted entity for the site(s) specified by this Agreement. 2. Should the landowner or his representative lease or otherwise permit the use of the land application site(s) to a third party, the landowner shall be responsible to ensure that the third party agrees and complies with the terms and conditions of this Agreement. 3. The landowner or his representative shall adhere to the provisions of this Agreement until all of the site restrictions (under Section 11) are met. 4. Notification of cancellation of this Agreement shall be immediately forwarded to NCDENR-DWR. Non -Discharge Permitting Unit, 1617 Mail Service Center, Raleigh, NC 27699-1617. 5. The Permittee must request and obtain a permit modification from the Division prior to a transfer of the land application site(s) to a new landowner. In addition, the current landowner shall give a notice to the new landowner that gives full details of the residuals applied at the land application site(s). 6. The Permittee has provided the landowner or his representative with information and data concerning the residuals land application program. including an analysis of constituents of the residuals. residuals application methods, schedules for typical cropping patterns, a description of the equipment used by the Permittee. 7. The Permittee will provide the landowner or his representative with a copy of the residuals permit prior to commencement of any residuals land application event and a copy of the results of each soil analysis. 8. If the soil pH of the land application site(s) is not maintained at 6.0 or greater, sufficient amounts of lime shall be applied to achieve a final soil pH of -at least 6.0. unless an agronomist provides information indicating that the pH of the soil. residuals and lime mixture is suitable for the specified crop. 9. The landowner or his representative and the Permittee will agree on residuals application rates and schedules based on crop patterns. results of soil samples, and the permitted application limits. 10. The landowner or his representative will provide the Permittee with information regarding the amount and analysis of other sources of nutrients (e.g., fertilizer, unregulated animal waste, etc.) that have been applied to the land application site(s). 11. The landowner or his representative will inform the Permittee of any revisions or modifications to the intended use and cropping patterns for the land application site(s) prior to each planting season to enable the Pennittee to amend this Agreement and schedule residuals land application events at appropriate periods. 12. Specific residuals land application area boundaries shall be clearly marked on the land application site(s) by the Permittee, the landowner.. or his representative prior to and during a residuals land application event. 13. The landowner or his representative hereby authorizes the Permittee, local officials. and State officials or their representatives to; enter and inspect any property, premises, or place on or related to the land application site(s) at any reasonable time for the purpose of determining compliance with the permit; establish monitoring facilities on or near the land application site(s) as required by the permit; copy any records that must be kept under the terms and conditions of the permit; take necessary Ieachate, surface water. groundwater, or soil samples during the term of, and 12 months after termination of, this Agreement. 11. RESTRICTIONS: 1. Appropriate measures must be taken by the Permittee and/or the landowner or his representative to control public access to the land application site(s) during active use and for the 12-month period following a residuals land application event. Such controls may include the posting of signs that indicate the activities being conducted at the land application site(s). 2. Animals shall not be grazed on the land application site(s) for a 30-day period following a residuals land application event. Land application sites that are to be used for grazing shall have fencing that will be used to prevent access during these periods after such residuals land application events. 3. Food crops, feed crops, and fiber crops shall not be harvested for a 30-day period following a residuals land application event. 4. Food crops with harvested parts that touch the residuals/soil mixture and are totally above the land surface shall not be harvested for a 14-month period following a residuals land application event. 5. Food crops with harvested parts below the surface ofthe land shall not be harvested for a 20-month period following a residuals land application event when the residuals remain on the land surface for four months or longer prior to incorporation into the soil. 6. Food crops with harvested parts below the surface of the land shall not be harvested for a 38-month period following a residuals land application event when the residuals remain on the land surface for less than four months prior to incorporation into the soil. 7. Turf grown on land where residuals are applied shall not be harvested for a 12-month period following a residuals land application event. III.ALTERNATIVES FOR WATER SUPPLY WELLS INSIDE THE COMPLIANCE BOUNDARY: (please check one) 15A NCAC 02L .0107(d) prohibits water supply wells within the compliance boundary. However. 15A NCAC 02T A 1051h1 allows the compliance boundary to be placed closer to the waste disposal area. such that the water supply well is situated outside of the compliance boundary provided the groundwater standards can be met at the newly -established compliance boundary. Please mark one of the following; ❑ A re -defined compliance boundary is needed for field(s) 11): (Please include the rationale far the requested re -location of the compliance boundary and attach a map showing the newly proposed compliance boundary to the application package) ® A re-dctined compliance boundary is not needed for this site. IV. ACKNOWLEDGEMENT OF FIELD TRANSFER: (if needed) ❑ The land application field(s) ID:.__ , is currently permitted under another residuals land application program; Permit Number WQ: The land owner hereby acknowledge that by signing this agreement, he/she is requesting that the field(s) be removed from the previously permitted residuals land application program and transferred into the new program; (Name of the new program) FORM: LOA 06-16 Page 2 of 3 Landowner's Certification: f certifv that I am a deeded landowner of the above -referenced land application site(s) and am authorized to make decisions regarding the use of the land application sitc(s) on behalf of other deeded landowners OR that 1 am otherwise authorized, throueh a power of attorney or other legal delegation, to make decisions regarding the use of the land application site(s) on behalf of the deeded landowners. I certify that the above -referenced land application sile(s) are not included in anv waste disposal contract or agreement with another municipality, contractor, or other permitted entity. Furthermore, I certify that i have read this Agreement, understand the stipulations, restrictions. alternatives for water supply wells inside the compliance boundary, acknowledgement of Field transfer. and do hereby grant permission to the Permittee to land apply residuals to the land application site(s) as specified herein. Landowner name: _ John Fisher Address: _.._...�_ 398 Dairy -,Road _..........___ City: State: --- _._ iC._. - Zip:.._. .'8761 Phone: _ 828-439-40.35 _ _-- E-mail address Signature: Date - NORTH CAROLINA, _ !''� ��.,r,•.�...,� COUNTY 1, the undersigned Notary Public do hereby certify that personally appeared before me this day and acknowledged the due execution of the forgoing instrument. WITNESS my hand and official seat this the lllllilfl day of zb r- Signature and seal: My commission expires: Lessee's/Operator's Certification: 1 �-N-23 3 NofQty_pJ._ Z Coup c O t. I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein. Lessec/operator name:.__,...,_ Address City: Phone: Signature: Permittee's Certification: State: E-mail address: Date: zip. I certify that I have read this Agreement and do hereby agree to abide by the stipulations nnrf ri—irivrinm ne enaoifi 4 i oral., Signing off Signature: FORM: LOA 06-16 Page 3 of 3 MIN Division of Water Resources State of North Carolina Department of Environmental Quality Division of Water Resources ISA NCAC 02T .I 100 — LAND OWNER AGREEMENT FORM: LOA 06-16 Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional information requested. Failure to submit all of the required items will lead to additional processing and review time for the permit application. Unless otherwise noted, the Applicant shall submit one original and two copies of„the application and supporting documentation For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting_Unit. General - This document is an agreement between the Applicant and land owner(s) of residuals receiving sites for land application of Class B residuals (may include water treatment plant or other type residuals) in accordance with 15A NCAC 02T .1 100. Do not submit this agreement for review without a corresponding application form (FORM: RLAP 06-16). Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed below. A. Land Owner Agreement (FORM: LOA 06-16): ❑ Submit the completed and appropriately executed Land Application Site Certification (FORM: LASC 06-16) form. Please do not make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to the application may be made, as long as the attachments are numbered to correspond to the section and item to which they refer. ❑ Prepare a separate agreement for each set of land application sites that are owned or operated by an entity other than the Applicant. ❑ A copy of the completed and appropriately executed agreement must be provided to the landowner and the lessee/operator. AGREEMENT FOR THE LAND APPLICATION OF RESIDUALS TO PRIVATELY OWNED LAND The undersigned landowner or his representative hereby permits: Applicant's name: City of Marion____ hereinafter referred to as the Permittee, to land apply residuals from the following facility(ies) onto the following land application site(s) (i.e., see attached setback maps) in accordance with the stipulations and restrictions as given in this Agreement: Site/Field ID Lease (yes/no) (Y ) Land Use or Cropping Patterns pp� g Intended Use of Crops Residuals Source (optional) Special note (no-till/over-seedl pasture) R2 no Pasture Animal Feed R1 no Pasture Animal Feed The landowner or his representative receives, in consideration, full use of the nutrient value of the applied residuals while the Permittee receives, in consideration, the use of the land application site(s) described above for the disposal of the residuals. This Agreement shall remain in effect for the length of the Division's permit for the residuals land application program and shall be renewed each time this permit is renewed. The undersigned landowner or his representative and the Permittee agree to abide with the following restrictions and stipulations until such time as written notification, given 30 calendar days in advance, modifies or cancels this Agreement. FORM: LOA 06-16 Page l of') I. STIPULATIONS: I. The landowner or his representative shall not enter into any additional residuals application contracts or agreements with another permitted entity for the site(s) specified by this Agreement, 2. Should the landowner or his representative lease or otherwise permit the use of the land application site(s) to a third party, the landowner shall be responsible to ensure that the third party agrees and complies with the terms and conditions of this Agreement. 3. The landowner or his representative shall adhere to the provisions of this Agreement until all ofthe site restrictions (under Section 11) are met. 4. Notification of cancellation of this Agreement shall be immediately forwarded to NCDENR-DWR. Non -Discharge Permitting Unit, 1617 Mail Service Center, Raleigh, NC 27699-1617. 5. The Permittee must request and obtain a permit modification from the Division prior to a transfer of the land application site(s) to a new landowner. In addition, the current landowner shall give a notice to the new landowner that gives full details of the residuals applied at the land application site(s). 6. The Permittee has provided the landowner or his representative with information and data concerning the residuals land application program, including an analysis of constituents of the residuals. residuals application methods, schedules for typical cropping patterns. a description ofthe equipment used by the Permittee. 7. The Permittee will provide the landowner or his representative with a copy of the residuals permit prior to commencement of any residuals land application event and a copy ofthe results of each soil analysis. 8. If the soil pH of the land application site(s) is not maintained at 6.0 or greater. sufficient amounts of lime shall be applied to achieve a final soil pH of at least 6.0. unless an agronomist provides information indicating that the pi I of the soil, residuals and lime mixture is suitable for the specified crop. 9. 'The landowner or his representative and the Permittee will agree on residuals application rates and schedules based on crop patterns, results of soil samples, and the permitted application limits. 10. The landowner or his representative will provide the Permittee with information regarding the amount and analysis oi'other sources of'nutrients (e.g., fertilizer, unregulated animal waste, etc.) that have been applied to the land application site(s). 11. The landowner or his representative will inform the Permittee of any revisions or modifications to the intended use and cropping patterns for the land application site(s) prior to each planting season to enable the Permittee to amend this Agreement and schedule residuals ]and application events at appropriate periods. 12. Specific residuals land application area boundaries shall be clearly marked on the land application sitc(s) by the Permittee, the landowner. or his representative prior to and during a residuals land application event. 13. The landowner or his representative hereby authorizes the Permittee, local officials, and State officials or their representatives to; enter and inspect any property, premises, or place on or related to the land application site(s) at any reasonable time for the purpose of determining compliance with the permit; establish monitoring facilities on or near the land application site(s) as required by the permit: copy any records that must be kept under the terms and conditions of the permit:. take necessary leachate. surface water, groundwater, or soil samples during the term of.. and 12 months after termination ol'. this Agreement. 11, RESTRICTIONS: I . Appropriate measures must be taken by the Permittee and/or the landowner or his representative to control public access to the land application sitc(s) during active use and for the 12-month period IbIlowing a residuals land application event. Such controls may, include the posting of signs that indicate the activities being conducted at the land application site(s). 2. Animals shall not be grazed on the land application site(s) for a 30-day period following a residuals land application event. Land application sites that are to be used forgrazing shall have fencing that will be used to prevent access during these periods after such residuals land application events. 3. Food crops, feed crops, and fiber crops shall not be harvested for a 30-day period following a residuals land application event. 4. Food crops with harvested parts that touch the residuals/soil mixture and are totally above the land surface shall not be harvested for a 14-month period following a residuals land application event. 5. Food crops with harvested parts below the surface ofthe land shall not be harvested for a 20-month period follo,,t ing a residuals land application event when the residuals remain on the land surface f f)r lour months or longer prior to incorporation into the soil. 6. Food crops with harvested parts below the surface of the land shall not be harvested for a 38-month period following a residuals land application event when the residuals remain on the land surface for less than four months prior to incorporation into the soil. 7. Turfgrown on land where residuals are applied shall not be harvested for a 12-month period following a residuals land application event. Il1.ALTERNATIVES FOR WATER SUPPLY WELLS INSIDE THE COMPLIANCE BOUNDARY: (please check one) 15A NCAC 021.0107(d) prohibits water supply wells within the compliance boundary. However, 15A NCAC 02T .0105 h allows the compliance boundary to be placed closer to the waste disposal area, such that the water supply well is situated outside of the compliance boundary provided the groundwater standards can be met at the newly -established compliance boundary. Please mark one of the following; ❑ A re -defined compliance boundajti is needed for field(s) ID: (Please include the rationale for the requested re -location ofthe compliance boundary and attach a map showing the newly proposed compliance bonndan' to the application package) ® A re -defined compliance boundary is not needed for this site. IV. ACKNOWLEDGEMENT OF FIELD TRANSFER: (if needed) ❑ The land application field(s) ID: is currently permitted under another residuals land application program; Permit Number WQ: The land owner hereby acknowledge that by signing this agreement, he/she is requesting that the field(s) be removed from the previous]), permitted residuals land application program and transferred into the new program; (Name of the new program) FORM: LOA 06-16 Page 2 of 3 Landowner's Certification: I certify that 1 anti a deeded landowner of the above -referenced land application site(s) and am authorized to make decisions regarding the use of the land application site(s) on behalf of other deeded landowners OR that I am otherwise authorized, through a power of attorney or other legal delegation, to make decisions regarding the use of the Land application site(s) on behalf of the deeded landowners. I certify that the above -referenced land application site(s) are not included in any waste disposal contract or agreement with another municipality, contractor, or other permitted entity. Furthermore, I certily that I have read this Agreement, understand the stipulations, restrictions, alternatives for water supply wells inside the compliance boundary, acknowledgement of Field transfer. and do hereby grant peniiission to the Permittee to land apply residuals to the land application she(s) as specified herein. Landowner nante: Brian Kav Address: 98U Arlvs Lane City: Nebo State: Zip: ?&7 Phone: E-mail address: Signature: Date: NORTH CAROLINA, — f ' '4: 001,04 I( .--_COUNTY 1, the undersigned Votary Public do hereby certify that personally appeared before me this day and acknowledged the due execution ofthe forgoing instrument. WITNESS my hand and official sea] this [lie ' . '��az%HE.Ry'�%�,, day of �1.� s•.�•r 20 �. " o or y a€,oxo Signature and seal: = wllFk My commission expires: L ' L U 0 2 H �? CARrJL\ Lessee'slOperator's Certification: I certify that 1 have read this Aarcemeni and do hereby agree to abide by the stipulations and restrictions as specified herein Lessee"operator name: Address: City: Phone: Signature: Perm ittee's Certification: I certify that I have read this Signing official nanrer�- Signature: — %- State: E-mail address: [late: Zip: ;reernent and do hereby agree to abide by the stipulations and restrictions as specified herein. ;a__6A vl YV ,-v j to c a � _ 7 � Date: FORM: I.AA 06-16 Page 3 of The Compliance Boundary is estahlished either 250 feet from the perimeter of the residuals application area or 50 feet within the property boundary, whichever is closer. The Review Boundary is established midway between the Compliance Boundary and the perimeter or the residuals application area. '— 7- - - • Field R2 i' 2.7 acres A r t: Ross, Wayne: Buffer Map Parcel 1657001 A 1637 McDowell County, NC Field R1 17.2 acres r �A AIJ R 'y / + •' . Field R2 r• 13.7 acres + w 1 f A' 't 1W * /• t 1 ti ` Buffers Property Line (50' Perennial Stream (100') House (400') Well (100' ) t Legend } Propery Line Field Boundary a Well Perennial Stream House = Surface Water ® Unused Area 1,a - . 5 o h CaraLlina Stateptans. NADB3 �1. O O OE inra aILI 0C OW •�a Ln lfi CU o i LL v E -a a) `!�� L Qy, LL S m LmC (u iJ a� a `M � - - - c o C 41' 'N� a LL a w D r I J ♦ ` } al K 11 L a. •i d4 D u O m c om i u M 2 t v C ^' 1' E ` u ' roe + v� C Ey u .� Loco •J to s � � N 1 G F: M 1A c�p L cl i V1 'i r Q N U 0.0 L Cm Cp r G S`i F2 NO des � q � o .0 � a 4 8 mto 3 O ➢0 L -,o U v ° �a w a� a to E �; o �ZoU a N �O E' its, a. m eon ANNUAL LAND APPLICATION FIELD SUMMARY FORM PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE. Facility Name: City of Marion WQ Permit #: W00019960 Field #: F1 Acres Utilized: 9.9 Land Owner: John Fisher Annual Dry Tons Applied: 8,2941 Site #: Fl Acres Permitted: 9.9 Operator: John Fisher Predominant Soil Series: BrB2 Cation Exchange Capacity (non 503): Crop I Name: Fescue Crop I Max. PAN: 239 Crop 2 Name: Crop 2 Max. PAN: O - c y Q Volume applied ( enter one) Solid,/ Liquid u. Yds Gallons o /o Solids volume Applied per Acre (Dry TonslAc) Residual Source, , (NI)DES # u Q#. Fen- Animal Waste. etc) (hand. (Dry, Moist) Precip. , �_ ] ast 1 firs mr-hes > K � = - 5 c z = = - . � � ry � - ry ' - TKN mg/kg z n ti G ro y. mglkg Nitrate and Nitrite mglkg PAN Applied I Ibslacre) Name Of CropTy Receiving Residual Application Crnp 1 Crop 2 Crop 1 Crop 2 7-2020 110500 ).8 0.838 NCO031879 dry 0 S 0.5 0.3 58400 2800 1 511 31.151 NA Fescue 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0A00 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 Residuals Applications totals on FORM FSF supp ( Attach FORM FSF supp to this form): TG1'ALS 0 11u500 As Cd Cu Cr Pb Hg Mo Ni Se Zn P 31.151 0.000 Lime Applied Annual Ibs/acre 0.047 0.103 0.150 36 0 019 0 046 0.065 34 0.707 5.27 5977 NA ####### 0 ######a 1338 0.080 0.828 0.908 267 0.003 0.322 0.325 15 0.065 0.243 0.308 NA 0.034 0.393 0.427 374 0.047 0.101 0.148 89 1310 15,683 17.393 2498 38.548 Date lbs/ac Prior Years Cumulative lbs/ac 12-2020 2000 Current Cumulative lbs/ac Permitted C. P. L. R.**** Permit PAN Limit Ist/2nd Crop 239 "l certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." *Application Method: S - Surface, IN - Injection, INC - Incorporation **Volatilization Rate: Surface- 0.5, Injection/Incorporation - 1.0 Signature of Land Applies Date .** Mineralization Rates: Compost -0.1, anaerobially digested -0.2, aerobically digested -0.3, raw sludge -0.4 ****C.P.L.R.: Cumulative Pollutant Loading Rate DENR FORM FSF (1212006) ANNUAL LAND APPLICATION FIELD SUMMARY FORM PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON PLACE A "NIA" IN A BLANK OR BOX WHEN NOT APPLICABLE. Facility Name: City of Marion WQ Permit #: WQ00199b0 Field #• F2 Acres utilized: 2.4 Land Owner: John Fisher Annual Dry Tons Applied: 1.4637 Site #: F2 Acres Permitted: 2.4 Operator: John Fisher Predominant Soil Series: BrB2 Cation Exchange Capacity (non 503): Crop I Name: Fescue Crop 1 Max. PAN- 239 Crop 2 Name: Cron 2 Max. PAN: r c Volume a Iled PP (enter one) Solids! ]Jquid Cu. Yds Gallons q4, Solids V0411TIC Applied per p P Acre 1Dry Torts/AC) Residual Sources (NI I)ES #. 1� Q4. l:ert.. Animal Waite, etc) Soil Cond. (17r- N'ct. moist) Prccip. Past 24 lirs. nLh25 D a -- -_~ � _ ? x _ TKN mglkg z _� _ c a mglkg Nitrate and Nitrite mg/kg PAN Applied (lhslacre) Name ol-Cru Cv P _ Pe Receiving Residual Application Crap 1 Crop 2 Crop 1 Crop 2 7-2020 19500 1.8 0.610 NC0031879 do 0 s 0.5 0.3 58400 2800 k 51 ] 22.676 NA Fescue 0.000 0.000 0.000 0.000 0.000 um 0.000 0.000 0.000 0,000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0-000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 Residuals Applications totals on FORM F'SF supp ( attach FORM FSF supp to this form): F. TOTA1,5: 01 195M As Cd Cu Cr Pb I HP, Mo Ni Se Zn P 22.676 0.000 Lime Applied Annual lbs/acre 0.034 0.014 0.513 ####### 0.058 0.002 0.048 0.025 0.034 1.244 28.060 Date lbs/ac Prior Years Cumulative lbs/ac 0.132 0.166 36 0.172 0 186 34 4.016 4.531 NA r 0 #a#4449 1338 0.611 0.669 267 0.032 0.034 15 1.81 1.858 NA 0.288 0.313 374 0.078 0.112 89 11.589 12.833 2498 0 Current Cumulative lbs/ac Permitted C. P. L. R.**** Permit PAN Limit Ist/2ndCrop 239 --a ccruly, unuer penalty of law, tnat tnls 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, 1N - Injection, INC - Incorporation � ?�7�a **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0 Signature of Lan Applier Date Mineralization Rates: Compost -0.1, anaerobialty digested -0.2, aerobically digested -0.3, raw sludge -0.4 ****C.P.L.R.: Cumulative Pollutant Loading Rate DENR FORM FSF (12l2006) ANNUAL LAND APPLICATION FIELD SUMMARY FORM PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON PLACE A "NIA" IN A BLANK OR BOX WHEN NOT APPLICABLE. Facility Name: City of Marion WQ Permit 9: WQ0019960 Field #: F3 Acres Utilized: 7 Land Owner: John Fisher Annual Dry Tons Applied: 9,7820 Site #: F3 Acres Permitted: 7 Operator: John Fisher Predominant Soil Series: HaC Cation Exchange Capacity (non 503): Crop I Name: Fescue Crop 1 Max. PAN: 7Q2 Crop 2 Name: CroD 2 Max. PAN: w Volume applied Volurne Residual Sources Soil Wecip. 7 < ? D Nitraic Name ol'CruP Type ` one) Solids/ fi Applied r (\PI)1S f. 1Q#. P tti24 K x ?(enter KN and PAN Applied Receiving Residual Liquid Solids Acre Fert.. Anima! (t)r,, Hrs. n -- M r Zf Z Nitrite t Ihs/acre) Application Cu. Yds Gallons (DryTonslAc) Waste, etc) w,eE Moist) lncnes Y ,Z m rk9 T"r9fk9 m Aq Crop I Crop Crop I Crop 2 7-2020 J 117000 1.8 1.255 N(:0031879 dry 0 s 0.5 03 58400 2800 1 511 46.648 NA rescue 0.000 0.000 0.000 0.000 0.000 0,000 0.000 0.00() 1 0.wo 0.000 0.000 0,000 0.000 0.000 0.000 U.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form): TOYALS, 01 117000 As Cd Cu Cr Pb Hg Mo Ni Se I Zn P 46.648 O.OUO Lime Applied Annual Ibs/acre 0.071 0.028 1.059 ##q#### 0.119 0,004 9.098 0.051 0.071 2.560 57.730 Date Ibs/ac Prior Years Cumulative !bs/ac 0.353 0.424 36 0.143 0.171 34 9,888 10.947 NA 1.763 ####### 113 1.46 1.579 2267 0.051 0.055 15 1 0.639 0.737 NA 0.624 0.675 374 0.349 0.420 89 27.39 29.950 2498 12-2020 200t) Current Cumulative lbs/ac Permitted C. P. L. R.**** Permit PAN Limit 1 st/2nd Crop 202 i %XJ ►uy, uJiucl- penalty UI law, tnat tuts aocument was prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." *Application Method: S - Surface, 1N - Injection, INC - Incorporation �"' ��" �•i **Volatilization Rate: Surface- 0.5, Injection/Incorporation - 1.0 Signature of Land Applier Date Mineralization Rates: Compost -0.1, anaerobially digested -0.2, aerobically digested -0.3, raw sludge -0.4 ****C.P.L.R.: Cumulative Pollutant Loading Rate DENR FORM FSF (1212006) ANNUAL LAND APPLICATION FIELD SUMMARY FORM PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE, Facility Name: City of Marion WQ Permit #. WQ0019960 Field #: F4 Acres Utilized: 6.7 Land Owner: John Fisher Annual Dry Tons Applied: 6.3426 Site #; F4 Acres Permitted: 6.7 Operator: John Fisher Predominant Soil Series. HaC Cation Exchange Capacity (non 503): Crop I Name: Fescue Crop I Max. PAN: 202 Crop 2 Name: Crop 2 Max. PAN: 0 o VolLimC ii Ill'd pp (enter one Sn1id< Liquid Cu. Yds Gallons y Solids Volume Applied per Acre Ory ToiVAc) Re.idualSources (NPD.S 9, WQ9, Fert.. Animal Wastc. cle) Sn31 Cored. IDrv. Wlt Moist) F'recip. ,, _ 1 ast 24 11rs. arches > z ry _ z a 0 = r- _ 5 n ry= y TKN mg1k9 z �' - a ry M �. mglkg Mir= and Nitrite r;glkg PAN Applied ( Ibs/acre) Name ofCrupType Receiving Residual Application Crup I Crop 2 Crop I Crop 2 7-2020 84500 1.8 1 0.947 NCO031879 dry 0 s 0.5 0.3 59400 2800 511 35.198 NA Fescue 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.Wo 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0,000 0.000 Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form): TOTALS 0 84500 As Cd Cu Cr Pb Hg Mo Ni Se Zn P 3 5. 198 0.000 Lime Applied Annuallbs/acre 0.053 0.021 0.799 flfih#4#u 0.090 0.003 0.074 0.038 0.053 1.932 43.562 Date lbslae Prior Years Cumulative lbslae 0.341 0.884 12.479 2.109 1.759 0.062 0.632 0.755 0.351 30.412 12-2020 1000 Current Cumulative lbslae 0.394 0.905 13.279 #fiu9444 1.849 0.065 0.706 0.793 0.404 32.344 Permitted C. P. L. R.**** 36 34 NA 1338 1 267 15 NA 374 89 2498 Permit PAN Limit Ist/2nd Crop 202 "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." Q *Application Method: S - Surface, 1N - Injection, INC- Incorporation **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0 Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2, aerobically digested -0.3, raw sludge -0.4 ****C.P.L.R.; Cumulative Pollutant Loadint3 Rate DENR FORM FSF (12/2006) ANNUAL LAND APPLICATION FIELD SUMMARY FORM PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON PLACE A "VIA" IN A BLANK OR BOX WHEN NOT APPLICABLE. Facility Name: City of Marion WQ Permit #t WQ0019960 Field #: RI Acres Utilized: 17.2 Land Owner: Brian Kay Annual Dry Tons Applied: 15.6125 Site #: RI Acres Permitted: 172 Operator: Brian Kay Predominant Soil Series: HaC Cation Exchange Capacity (non 503): Crop I Name: Fescue Crop I Max. PAN: 202 Cron 2 Name: Cron 2 Max_ PAN_ o Volume a lied PP Vuhime Rrsidual Sourer~ ~oil Yrrcip. 7 Z Nitrate Name of Crop -type y o (enter one) Solids/ (N o A Irui per pp p' � (N1 DES #. INQ4. Cond. , 1 as 224 � � 3 _ ;n _ x � '4 "1 KN = r and PAN Applied Receiving Residual ro I.icluid Solids Acre Fen- Animal tDr}, llrs. �` ^• Nitrite t ihsl:ier) Application Cu. yds Gallons (DyTonsAc) Waste. etc) N1Ws3 1 rche5 � - � m !k 9 9 m, R Q 9 m k �9 Cra 1 p [.r15 2 P Crop ] P Crop � p- 7-2120 209000 1.8 0.908 N00031879 do 0 s U.5 0.3 58400 2800 1 511 33.750 NA Fescue 0.000 0.000 0.000 0.000 0,040 {1,000 0.000 0.000 0.000 0.000 0-000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 9.000 o 000 0.000 R000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form): T0TA1,S"i 01 208000 As Cd Cu Cr Pb Hg Mo NJ Se Zn P 33.750 O.ur}0 Lime Applied Annual Ibs/acre 0.051 0.021 0.766 ####### 0.086 0.0(13 0071 0.037 0.051 1.852 4E.768 0.151 0.079 10.257 1.475 1.545 0.059 1.33 0.635 0.192 25.99 0.202 0.100 11.023 44#4494 1.631 0.062 1 4111 0.672 0.243 27.842 36 34 1 NA 1 1338 267 1 15 NA 374 1 89 2498 Date ]bs/ac Prior Years Cumulative Ibs/ac 12-20 1000 Current Cumulative lbs/ac Permitted C. P. L. R.**** Permit PAN Limit I st/2nd Crop 202 t Uri My, unuer penalty 01 taw, Mal IRIS 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 a,are 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 a-3 '"Volatilization Rate: Surface- 0.5, Injection/Incorporation - 1.0 Signature of• Land Applier Date* Mineralization Rates: Compost -0.1, anaerobially digested -0.2, aerobically digested -0.3, raw sludge -0.4 ****C.P.L.R.: Cumulative Pollutant Loading Rate DENR FORM FSF (1212006) ANNUAL LAND APPLICATION FIELD SUMMARY FORM PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLF,TED AND SUBMITTED FOR EACH FIELD APPLIED ON PLACE A "NIA" 1N A BLANK OR BOX WHEN NOT APPLICABLE. Facility Name: City of Marion WQ Permit 4: WQ0019960 Field #: R2 Acres Utilized: Land Owner: Brian Kay Annual Dry Tons Applied: 17.5640 Site #: R2 Acres Permitted: Operator: Brian Kay Predominant Soil Series: HaC Cation Exchange Capacity (non 503): Crop 1 Name: Fescue Crop 1 Max. PAN: 202 Crop 2 Name: Crop 2 Max. PAN: 13.7 13.7 0 Volume applied { enter one> tiolids/ l.icuicl I Cu. Yds Gallons /o Solids Volume Applied per Acre (DryTnnstAcl Residual Sources (NYl)GS, W(1q, Fert.. Animal Waste. etc) Soil Cond. {1)n. Wei.11rs. Moist) Precip. > Past -4 inches > b = _ - r. �, f _ - K x , - n - 1'K\ mglkg Z. � a- mg/kg Nitrate , and Nitrite mg(kg PAN Applied (khs/acre) Name ol'Crop Type Receiving Residual Application Crop I Crop 2 Crop I Crop 2 7-2020 234000 1.8 1.282 NCO031879 dry 0 s 0.5 0.3 58400 2800 511 47.669 NA Fescue 0.000 0.000 0.000 0.000 0.000 0"000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0,000 0.000 0.000 0.000 6.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0,000 0.000 0.000 0,000 0"000 Residuals Applications totals on FORM FSF supp (attach FORM FSF supp to this form): TOTALS a 234000 As Cd Cu Cr Pb H.L Mo Ni I Se Zn P 47.669 0.000 Lime Applied Annuallbs/acre 0.072 0.159 0.231 36 0.029 0.086 0.115 34 1 1.082 10.76 11.842 NA #4#4### 0.065 0494004 1339 0.122 1.386 1.508 267 0.004 0.341 0.345 15 0,100 1,039 1.139 NA 0,052 0.602 0.654 374 0.072 0.179 0.251 89 2.615 25.62 28,235 2498 59.972 Date lbs/ac Prior Years Cumulative lbs/ac 0 Current Cumulative Ibs/ac Permitted C. P_ L_ R.**** Permit PAN Limit 1 st/2nd Crop 202 "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." JI-4 r Signature of Land Applier 12t03 Date "Application Method: S - Surface, IN - Injection, INC - Incorporation "*Volatilization Rate: Surface - 0.5, Injection/incorporation - 1.0 *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2, aerobically digested -0.3, raw sludge -0.4 *"*"C.P.L.R.: Cumulative Pollutant LoadinS Rate DENR FORM FSF (1212006)