WQ0031725_Residual Annual Report 2020_20210225

Initial Review
Reviewer Thornburg, Nathaniel
Is this submittal an application? (Excluding additional information.)*
r Yes r No
If not an application what is the submittal type?* r Annual Report
r Residual Annual Report
r Additional Information
r Other
Annual Report Year* 2020
Permit Number (IR)* W00031725
Applicant/Permittee Baxter Healthcare Corporation
Email Notifications
Does this need review by the hydrogeologist?* r Yes r No
Regional Office Asheville
CO Reviewer
Admin Reviewer

Submittal Form
Project Contact Information
Rease provide information on the person to be contacted by N B Staff regarding electibnittal, confirmation of receipt, other
.......................................................... electronic surece, aner correspondence.
_ -
Name * Corey Carpentier
Email Address*
[e-mail]
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*
8287566636
O Modification - Minor
C Renewal
C GW-59, NDMR, NDMLR, NDAR-1,
NDAR-2
IT 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:* WQ0031725
Has Current Existing perm number
Applicant/Permittee Address* 65 Pitts Station Road
Facility Name * Baxter Healthcare Corporation RLAP
Please provide comments/notes on your current submittal below.
2020 Annual Report for Land Application of WWTP Sludge Residuals
At this time, paper copies are no longer required. If you have any questions about what is required, please contact Nathaniel Thornburg
at [e-mail].
Please attach all information required or requested for this submittal to be reviewed here.*
(Application Form Engineering Rans, Specifications, Calculations, Rc.)
2020 Annual Sludge Report WQ0031725.pdf 1.35MB
Upload only 1 FLFdocurrent (less than 250 fvt3). Miltiple documents rust be contained into one FDFfile unless file is larger than
upload limit.
* V By checking this box, I acknowledge that I understand the application will not be
accepted for pre -review until the fee (if required) has been received by the Non -
Discharge Branch. Application fees must be submitted by check or money order
and made payable to the North Carolina Department of Environmental Quality
(NCDEQ). I also confirm that the uploaded document is a single PDF with all parts
of the application in correct order (as specified by the application).
Mail payment to:
NCDEQ — Division of Water Resources
Attn: Non -Discharge Branch
1617 Mail Service Center
Raleigh, NC 27699-1617
Signature
Cot'e� ca�Pe�►ret'
Submission Date 2/25/2021

2020
Baxter Healthcare Corporation
2020 Annual Report
Land Application Program
Permit No. WQ0031725

ANNUAL LAND APPLICATION CERTIFICATION FORM
WQ Permit#: WQ0031725 County: McDowell Year: 2020
Facility Name (as shown on permit): Baxter Healthcare Corporation
Land Application Operator: US Biosolids, Inc. Phone: [phone]
Land application of residuals as allowed by the permit occurred during the past calendar year?
a Yes ❑ No - If No, skip Part A, and Part B and proceed to Part C. Also, if residuals were
generated but not land applied, please attach an explanation on how the residuals were handled.
Part A - Residuals ADDHC860n Summarr.
Total number of application fields in thepermit:
10
Total number of fields utilized for land application during the year:
9
Total amount of dry tons applied during the year for all application sites:
149.68
Total number of acres utilizes for land application during the year:
68.8
Part B - Annual Compiance Statement:
Facility was compliant during calendar year 2020 with all conditions of the land application permit
(including but not limited to items 1-13 below) issued by the Division of Water Resources. © Yes ❑ No
If no please, provide a written description why the facility was not compliant, the dates, and explain corrective action
taken.
1) Only residuals approved for this permit were applied to the permitted sites.
2) Soil pH was adjusted as specified in the permit and lime was applied (if needed) to achieve a soil pH of at least 6.0 or
the limit specified in the permit.
3) Annual soils analysis were performed on each site receiving residuals during the past calendar year and three (3) copies
of laboratory results are attached.
4) Annual TCLP analysis (if required) was performed and three (3) copies of certified laboratory results are attached.
5) All other monitoring was performed in accordance with the permit and reported during the year as required and three
(3) copies of certified laboratory results are attached.
6) The facility did not exceed any of the Pollutant Concentration Limits in 15A NCAC 02T .I 105(a) or the Pollutant
Loading Rates in 15A NCAC 02T .l 105(b) (applicable to 40 CFR Part 503 regulated facilities).
7) All general requirements in as specified in the Land Application Permit were complied with (applicable to 40 CFR Part
503 regulated facilities).
8) All monitoring and reporting requirements in 15A NCAC 02T .1 1 I 1 were complied with (applicable to 40 CFR Part
503 regulated facilities).
9) All operations and maintenance requirements in the pen -nit were complied with or, in the case of a deviation, prior
authorization was received from the Division of Water Resources.
10) No contravention of Ground Water Quality Standards occurred at a monitoring well or explanations of violations are
attached to include appropriate actions and remediations.
l 1) Vegetative cover was maintained and proper crop management was performed on each site receing residuals, as
specified in the permit.
12) No runoff of residuals from the application sites onto adjacent property or nearby surface waters has occurred.
13) All buffer requirements as specified on the permit were maintained during each application of residuals.
Part C - Certification:
"1 certify, under penalty of law, that the above information is, to the best of my knowledge and belief, true, accurate,
and complete. I am aware that there are significant penalties for submitting false information, including the
possibility of fines and imprisonment for knowing violations."
-J Go 17 J ` Vv E2t3Cct; /�srr- �A-Ec l or?—
Permittee Name and Title (type or print)
Sianatuof
267-fi
Signature of Pe ittee Date
2-let � Zi 8, 1 , T
Date 5 gnature of _and Applier
I -as
Date
(if different from Penmittee) (if different from Permittee and Preparer)
* Preparer is defined in 40 CFR Part 503.9 (r) and I SA NCAC 02T .1102 (26) DENR FORM ACF (12t2006)

ANNUAL RESIDUAL SAMPLING SUMMARY FORM
Please note that your permit may contain additional parameters to be analyzed. The parameters can be reported in FORM RSSF - B
WQ Permit Number: WQ0031725 Laboratory: 1)
Facility Name: Baxter Healthcare Corporation 2)
Residual Source WQ # or WQ0031725 3)
NPDES #: 4)
WWTP Name: Baxter Healthcare Corporation 5)
Residual Analvsis Data
Statesville Analytical
Parameter
Conc.
Limit
m a
Sample or C mposite Date
1-23-20
Percent Solids (%)
NA
12.7
Arsenic
75
3.7
Cadmium
85
0.54
Copper
4,300
80.6
Chromium
NA
NA
Lead
840
3.071
Mercury
57
0.126
Molybdenum
75
5.04
Nickel
420
11.18
Selenium
100
3.7
Zinc
7,500
8 4. 3)
Total Phosphorus
NA
2677
TKN
NA
86866
Ammonia -Nitrogen
NA
20107
Nitrate and Nitrite
NA
66.9
"For surface disposal facilities the ceiling concentration limits listed in this form are not applicable Reference the individual permit for metals limits.
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed
to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant
penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
J
i¢nature Pren r *
Date
*Preparer is defined in 40 CFR Part 503.9(r) and 15A NCAC 2T .1 102 (26) DENR FORM RSSF (12/2006)

ANNUAL RESIDUAL SAMPLING SUMMARY FORM - B
Report all sampling analysis results for parameters not listed in FORM RSSF that are part of the WQ permit or were analyzed for over the past
calendar year. Use additional forms as needed.
WQ Permit Number: WQ0031725
Facility Name: Baxter Healthcare Corporation
Residual Source WQ0031725
NPDES # or WQV:
WWTP Name: Baxter Healthcare Corporation
Residual Analvsis Data
Laboratory: 1) Statesville Analytical
2)
3)
4)
5)
Parameter
Sample or Composite Date
------------
"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. 1 am aware that there are
significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
Signature 6f Prepare"
*Preparer is defined in 40 CFR Part 503.9(r) and 15A NCAC 2T .1 102 (26)
Date
DENR FORM RSSF - B (1212006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: Baxter Healthcare Corporation Total Dry Tons Applied (Annual): 10.70
Permit #: WQ0031725 Cation Exchange Capacity (non 503 only):
Operator: Douglas Poplin Owner: Douglas Poplin
Acres Used: 5.5 Acres Permitted: 5.5 Site #:
Predominant Soil Series: FCC2
DP Field #: 1A
Residugl Analvsis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Com-
posite
Date
Annual Heavy Metal Field Loadings (Calculated in Ibslacre):
Total
Annual Heavy Metal Field Loadings (Calculated in Ibslacre):
Total
11
-
2
3t
41
5
6
7
8
91
10
11I
12
tl
U!"Ac.
App.
v
Event
1.95
Arsenic
0,014
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.014
Cadmium
0.002
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.002
Copper
0.314
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.314
Chromium
#4####
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
######
Lead
0.012
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.012
Mercury
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
Molyb-
0.020
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.020
denum
Nickel
0.044
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.044
Selenium
0.014
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.014
Zinc
0.328
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.328
Total
Phos-
10.419
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
10.419
horus
"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.
am aware that there are significant penalties for submitting false information, including the possibility of fines and
imprisonment for knowing violations".
1-f h_
Signature of Land Applier
Date
DENR FORM MFLSF (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 "NIA" 1N A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: Baxter Healthcare Corporation
Land Owner. Douglas Poplin
Operator: Douglas Poplin
Crop I Name: Fescue
WQ Permit #: WQ0031725
Annual Dry Tons Applied: 10.7020
Predominant Soil Series: FeC2
Field #: 1A
Acres Utilized: 5.5
Site #: DP Acres Permitted: 5.5
Cation Exchange Capacity (non 503):
Crop 1 Max. PAN: 158 Crop 2 Name:
Crop 2 Max. PAN:
=
ca c
�
VL.olume applied
( eater one) Solids/
Liquid
Cu. Yds Gallons
o
/o
Solids
Volume
A tied r
PP ie per
Acre
(Dry TansrAc)
Residual Sources
(NP0F.S C H Q#.
Fert.. Animal
Waste, etc)
Soil
Cond.
(Dry.
wet.
Moist)
Precip
past 24
Hrs.
inches
�
�•
z E
� j•
a
=
rt W
K -
o.
3
n
;, L
ti
. ,�
1'K'�i
-P9
z a
o 2
,ro
m
mgr+�9
Nitrate
and
Nitrite
m91k9
PAN Applied
t lWacre)
Name of Crop TyPC
ReceivingResidual
Application
Crop 1
Crop 2
Crap 1
Crop 2
8-2020
100.06
12.7
1.946
W00031725
dry
0
1 s
0.5
0.3 1
86W
20107 1
66.9
117 326
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
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:
100.061
0
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
I Zn
P
117.326
0.000
Lime Aimlied
Annuallbs/acre
0.014
0.002
0.314
4#114###
0.012
0.000
0.020
0.044
0.014
0.328
10.419
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.199
0.055
3.259
2.384
0.064
0.011
0.15
0.787
0.128
4.959
0
Current Cumulative lbs/ac
0.213
0.057
3.573
#######
0.076
0.011
0.170
0.831
0 142
5.287
Permitted C. P. L. R.****
36 1
34
1 1338
1 NA
267
15
NA
374
89
2498
Permit PAN Limit Ist/2nd Crop
158
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
Signature of Land Applier
Date
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
*** Mineralization Rates: Compost -0.1, anserobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: Baxter Healthcare Corporation _Total Dry Tons Applied (Annual): 3.12
Permit #: WQ0031725 Cation Exchange Capacity (non 503 only):
Operator: Douglas Poplin Owner: Douglas Poplin Predominant Soil Series: FcC2
Acres Used: 1.6 Acres Permitted: 1.6 Site #: DP Field #: 1B
Residual Analysis Data (Heavy Metals and Total Phosphorus use mgtkg, % Solids use Raw Percent #):
4amnle or . 2 3 4 5J 6 7 8 9 10 11 12
Com-
posite
Date
1 `23 :20
0o Solids
12.7
Arsenic
3.7
Cadmium
0.54
Copper
80.6
1.'hrorniurn
NA
Lead
3.071
Mercury
0.126
Molyb-
504
denum
Nickel
11.18
Selenium
3.7
zinc
84.3
Total
Phos-
2677
A.,.,. A Hanary Matal l ipid Il -na.linae !C'alenlated in Ihslacrel:
Total
1
2
3
4
5
6
7
8
9
1t}
11
12
DT Ac.l
°
App.
w
14
Event
1.95
Arsenic
1 0.014
0.000
0.000
0.000 1
0.000
0.000
0.000 1
0.000
0.000
0.000
0.000
0.000
0.014
Cadmium
0.002
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.002
Copper
0.315
0.000
0.000
0A00
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.315
Chromium
4#####
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
4#####
Lead
0.012
0.000
0.000
0.000
0.000 1
0.000
0.000
0.000
0.000
1 0.000
0.000
0.000
1 0.012
Mercury
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1 0.000
Molyb-
0.020
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.020
enunt
Nickel
0.044
1 0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.044
Selenium
0.014
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.014
Zinc
0.329
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.329
Total
Phos-
10.451
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
10.451
horus
1.1 certify, under penalty of taw, teat tn13 document was preparea under my alrectlon or supervision In accoraance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
1 am aware that there are significant penalties for submitting false information, including the possibility of fines and
imprisonment for knowing violations".
Signature of Land Applier
Date
DENR FORM MFLSF (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" 1N A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: Baxter Healthcare Corporation WQ Permit #: WQ0031725 Field #:
Land Owner: Douglas Poplin Annual Dry Tons Applied: 3.1231 Site
Operator: Douglas Poplin
Crop I Name: Fescue
Predominant Soil Series: FcC2
Crop 1 Max. PAN: 158 Crop 2 dame:
I Acres Utilized:
DP Acres Permitted:
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
1:.6
1.6
Volume applied
Volume
Residual Sources
Soil
Preci p•
a
¢
�'
-Z >
- 3
Nitrate
PAN Applied
Name of Crop Type
(enter one) Solids/
%
Applied per
(NPDES #. WQ#,
Fond
Past 24
R '
z =
R
TKN
+3 3
and
(Ibslacre}
Recervmg Residual
o
Liquid
Solids
Acre
Fert.. Animal
(Dq.
Wet.inches
lirs.
P.
R
Nitrite
Application
Crop I
Crop 2
Cmp I
Crop 2
Cu. Yds Gallons
(Dry TonslAc)
Waste, etc)
Moist)
'
`_
mglkg
mgrkg
mgncg
5-2020
29.2
12.7
1.952
WQ0031725
dry
0
s
05
03
86866
20107
669
117.695
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
o.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
1
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
2921
0
As
Cd
Cu
Cr
Pb
H&
Mo
Ni
Se
Zn
I P
117.6951
0.000
Lime Applied
Annual Ibs/acre
0.014
0 002
0.315
#######
0.012
0.000
0.020
0.044
0.014
0.329
10.451
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.196
0.053
3.106
2.245
0.265
0.01 l
0.143
0.742
0.124
4.631
0
Current Cumulative Ibs/ac
0.210
0.055
3.421
#######
0.277
0.011
0.163
0.786
0,139
4.960
Permitted C. P. L. R.****
36
34
1338
NA
267
l5
NA
374
89
2498
Permit PAN Limit IsU2nd Crop
158
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1-.74-.;N1 f -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 Loadine Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: Baxter Healthcare Corporation Total Dry Tons Applied (Annual): 5.83
Permit If: WQ0031725 Cation Exchange Capacity (non 503 only):
Operator: Douglas Poplin Owner: Douglas Poplin Predominant Soil Series: FcC2
Acres Used: 3 Acres Permitted: 3 Site #: DP I Field #: IC
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent ft
Sample or
Com-
posite
Date
1 `23.20
% Solids
12.7
Arsenic
3.7
Cadmium
0.54
Copper
80.6
Chromiur6
NA
Lead
3.071
Mercury
0.126
Molyb-
5.04
num
Nickel
11.18
Selenium
3.7
Zinc
84.3
Total
Phos-
1 2677
Annual Heavy Metal
Total
DT!Ac J
App
Event 1.94
Field Loadings (Calculated
2' 3 45�
in lbs/acre):
6 7 8 9! 10 11 12
0
as
Arsenic 0.014 1
0.000
0.000 0.000 1
0.000
0.000
0.000
0.000 1
0.000
0.000
0.000
0.000
0.014
Cadmium 0.002
0.000
0.000 0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.002
Copper 0.313
0.000
0.000 0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.313
Chromium ######
0.000
0.000 0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
######
Lead 0.012
0.000
0.000 0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.012
Mercury 0.000
0.000
0.000 0.000
0.000
0.000
0.000
0.000
0.000
1 0.000
0.000
0.000
0.000
Molyb- 0.020
0.000
0.000 0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.020
denum
Nickel 0.043
0.000
0.000 0.000
0.000 1
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1 0.043
Selenium 0.014
0.000
0.000 0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.014
line 0.328
0.000
0.000 0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.328
Total
1
Phos- 10.403
0.000
0.000 0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
10.403
"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.
1 am aware that there are significant penalties for submitting false information, including the possibility of fines and
imprisonment for knowing violations".
t Si naure of Land A tier
�. PP
Date
DENR FORM MFLSF (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 "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: Baxter Healthcare Corporation WQ Permit #: WQ0031725 Field #: IC
Land Owner: Douglas Poplin Annual Dry Tons Applied: 5.829E Site #: DP
Acres Utilized: 3
Acres Permitted: 3
Operator: Douglas Poplin
Predominant Soil Series: FcC2
Cation Exchange Capacity (non 503):
Crop 1 Name:
Fescue
Crop I Max.
PAN:
158
Crop 2 Name:
Crop 2 Max. PAN:
Volume applied
Volume
Residual Sources
Soil
Preci p
>
o
9
?
.-
Nitrate
,
PAN Applied
Name ol'Crop f 5pe
=
{toter one) Solids/
o
�u
Applied per
(NPI)ES N. N4Q#.
Cond.
Past 24
z i`
m =
m n
m'_
TKN
o3 a
fm
and
( Ibslacre)
Receiving Residual
V
Liquid
Solids
Acre
Fen.. Animal
t1)r3`•
n'
m
ry
; =
w -L
_
a s
iv
NilClle
Application
Cu Yds
Gallons
(Dry TenwAc)
Waste. etch
Wet,Hrs.
Moist)
inches
.
3
mgtkg
mg/kg
mglkg
Crap 1
Crop 2
Crop I
Crop 2
5-2020
453
12.7
1.615
WQ0031725
dry
0
0.5
03
86866
20107
66..9
97.381
NA
Fescue
6-2020
9.2
12.7
0.328
WQ0031725
dry
0
r
0.5
0.3
86866
20107
66.9
19.777
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
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 { attack
FORM
FSF supp to this form):
TOTALS:
>4.5
0
As
Cd
Cu
Cr
Pb
H
Mo
Ni
Se
Zn
P
117.158
0.000
Lime A lied
Annual Ibslacre
0.014
0.002
0 313
#######
0,012
0 000
0.020
0.043
0.014
0.329
10.403
Date
Ibslac
Prior Years Cumulative ibs/ac
0.778
0.067
3.79
2.634
0.317
0.013
0.168
0.887
0.144
6.057
12-2020
1000
Current Cumulative lbs/ac
0.792
0.069
4.103
#######
0.329
0.013
o.188
0.930
0 158
6.385
Permitted C. P. L. R.****
36
34
1338
NA
267
15
NA
374
1 89
2499
Permit PAN Limit Ist/2nd Crop
158
"1 certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a Sy'lehhh Ur-a,gncu .,, a0001 � •••a•
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."
of Land Applier
*Application Method: S - Surface, IN - Injection, INC - Incorporation
i�•�� S **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Date *** Mineralization Rates: Compost -0.1, annerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (1212006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: Baxter Healthcare Corporation Total Dry Tons Applied (Annual): 17.86
Permit #: WQ0031725 Cation Exchange Capacity (non 503 only):
Operator: Douglas Poplin Owner: Douglas Poplin Predominant Soil Series: FcC2
Acres Used: 9.6 Acres Permitted: 9.6 Site #: DP Field #: 1D
Residual Analvsis Data (Heave Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Com-
posite
rotal
Phos-
phorusMENEENEENEEN
Annual Heavy Metal Field Loadings (Calculated in lbs/acre):
Total
1.1
_2j
3
4
5j
6
7
8
9
t0
�t
12
APp•
y
Event
1.86
'
Arsenic
0.014
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.014
Cadmium
0.002
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.002
Copper
0.300
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.300
Chromium
######1
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
######
Lead
0.011
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.011
Mercury
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
Molyb-
0.019
0.000
0.000
0.000
0-000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.019
denum
Nickel
0.042
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.042
Selenium
0.014
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.014
Zinc
0.314
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.314
Total
Phos-
9.958
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
9.958
horus
"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".
-7
Signature of Lan Applier Date
DENR FORM MFLSF (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
Facility Name: Baxter Healthcare Corporation
Land Owner: Douglas Poplin
Operator: Douglas Poplin
Crop 1 Name. Fescue
PLACE A "NIA" 1N A BLANK OR BOX WHEN NOT APPLICABLE.
WQ Permit #: WQ0031725 Field #: 1D
Annual Dry Tons Applied: 17.9584 Site #: DIP
Predominant Soil Series: FeC2
Crop 1 Max. PAN: 158 Crop 2 Name:
Acres Utilized: 9.6
Acres Permitted: 9.6
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
G
Y o
0
Volume applied
(enter one) Solids/
liquid
Cu. Yds Gallons
%
Solids
Volume
Applied prr
Acn
(Dry ronsift)
Residual Sources
(NPI)F.S #. WQ#-
I crl.. Animal
Wasfe. etc)
Soil
Cond.
(Dry,
Wei
Moisl)
Precip.
Pasi 24
Hrs.
inches
>
�' a
3 n
'a c
C
°=
„ J
>
x
n "
:�
R
>
TKN
n)Wkg
z 3
o '
ry
3 p
mglkg
Nitrate
and
Nitrite
mglkg
PAN Applied
( lbs/acre)
Name ofCroP rYPc
Receivina Residual
Applicaron
Crop 1
Crop 2
: rop l
Crop 2
5-2020
66.41
12.7
0.740
WQ0031725
dry
0
s
0.5
03
96966
20107
66.9
44.613
NA
fescue
8-2020
100.56
12.7
1.120
WQ0031725
dr%
0
s
0.5
0.3
86966
20107
66.9
67 554
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
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
16697
o
As
Cd
Cu
Cr
Pb
N
Mo
Ni
Se
Zn
P
112 166
0,000
Lime Applied
Annual lbs/acre
0.014
0 002
0.300
#######
0.011
0.000
0 019
0 042
0 014
0.314
9.958
Date
Ibs/ac
Prior Years Cumulative lbs/ac
0.192
0.051
3.041
2.209
0.284
0.009
0.139
0.714
0,108
4.394
12-2020
2000
Current Cumulative lbslac
0.206
0,053
3.341
#######
0.295
0.009
0.158
0756
0.122
4.708
Permitted C. P. L. R.****
36
34
1338
1 NA
267
15
NA
374
89
2498
Permit PAN Limit Ist/2nd Crop
F 158
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, 1N - Injection, INC - Incorporation
**Volatilization Rate: Surface - 0.5, injection/Incorporation - 1.0
Signature of Land Applier Date **" Mineralization Rates: Compost -0.1, anserobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
""C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (1212006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: Baxter Healthcare Corporation Total Dry Tons Applied (Annual): 20.76
Permit #: WQ0031725 Cation Exchange Capacity (non 503 only):
Operator: Douglas Poplin Owner: Douglas Poplin Predominant Soil Series: FcB2
Acres Used: 5.887 Acres Permitted: 5.887 Site #: DP Field #: 3-Corn
Residual Analysis Data (Heavy Metals and Total Phosphorus use mgtkg, % Solids use Raw Percent #):
Sample or 1 2 3 4 5 6 7 8 9 10 11 12
Com-
posite
Date
1!21`20
% Solids
12.7
Arsenic
3.7
Cadmium
0.54
Copper
80.6
Chromium
NA
Lead
3.071
Mercury
0.126
Molyb-
5.04
enum
Nickel
11.18
Selenium
3.7
Zinc
84.3
Total
Phos-
2677
Annual Heavy Metal
Field
Loadings (Calculated
in Ibslacre):
Total 1
2
3 4
5
6
S
9
10
11
12
D'r/Ac .
0
m
A pp
Event 3.53
Arsenic 0.026
0.000
0.000 0.000 1
0.000
0.000
0.000 1
0.000
0.000
0.000
0.000
0.000
0.026
Cadmium 0.004
0.000
0.000 0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.004
Copper 0.569
0.000
0.000 0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.569
Chromium ######1
0.000
0.000 0.000
0.000
0.000
0.000
0.000
0.00o
0.000
0.000
0.000
######
j Lead 0.022
1 0.000
0.000 0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.022
Mercury 0.001
0.000
0.000 0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.001
Molyb- 0.036
0.000
0.000 0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.036
den -um
Nickel 0.079
0.000
0.000 0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.079
Selenium 1 0.026
0.000
0.000 0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.026
Z.tnc 0.595
0 000
0.000 0.000
0.000
0.000
0.000
0.o00
0.000
0.000
0.000
0.000
0.595
Total
Phos- 18.884 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.0ao 18.s84
horus
"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".
.w•
Sig mature of Land Appiier
Date
DENR FORM MFLSF (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 "N/A" 1N A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: Baxter Healthcare Corporation
WQ Permit #: WQ0031725
Field #: 3-Corn Acres Utilized: 5.887
Land Owner: Douglas Poplin
Annual Dry Tons Applied: 20.7634
Site #: DP Acres Permitted: 5.887
Operator: Douglas Poplin
Predominant Soil Series: FCB2
Cation Exchange Capacity (non 503):
Crop I Name:
Corn
Crop I Max. PAN: 214
Crop 2 Name: Crop 2 Max. PAN:
`o
Volume applied
Volume
Residual Sources
Soil
Cond.
Precip•
>
<
_
K
z
-
Nitratc
PAN Applied
PP
Name ofCrop 'fype
Rccerving Residual
(enter one} Solids!
o/,
Applied per
(NPDES tt, WQ#,
(Dn.
i'tisE 24
=
51 �
�+ _=
a °�_-
i'KN
"0
and
( Ibs/acrL)
Application
y
«- o
0
1.i uid
A
Solids
Acre
1 c rt., Animal
Wet'
Firs.
o F
'
+ V
= 3.
Nitrite
PP
Cu. Yds
Gallons
(DryTons/Ac)
Waste. etc)
Moist)
'�h�
o
mgikg
kg
mglkg
Crop 1
Crop 2
Crop 1
Crop 2
3-2020
194.13
12.7
3.527
WQ0031725
dr)
0
s
0.5
03
86M6
20107 1
669
212.664
NA
Corn
0.000
0.000
0.000
0.000
0.000
0.000
0,000
0.000
i 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
:T
Residuals Applications totals on FORM FSF
supp ( attach
FORM
FSF supp
to this formy
At.S.
194.13
0
As
Cd
Cu
Cr
Pb
H
Mo
Ni
Se
Zn
P
212.664
0.000
Lime A lied
Annual lbs/acre
0.026
0.004
0.569
0090
0.022
0.001
0.036
0.079
0.026
0.595
18,884
1
Date
lbs/ac
Prior Years Cumulative Ibs/ac
0.456
0.133
2.236
5.43
0.657
0.023
0.311
1.644
0.602
13.848
12-2020
1000
Current Cumulative lbs/ac
0.482
0.137
2.805
#000
0.679
0.024
0.347
1.723
0.628
14.443
Permitted C. P. L. R.****
36
34
1 1338
NA
1 267
15
NA
374
1 89
2498
Permit PAN Limit 1 st/2nd Crop
214
" I certify, under penalty of law, that this document was prepared under my direction
or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false
information, including the possibility
of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC- Incorporation
1
;6-P I
**Volatilization Rate: Surface - 0.5, Injection/incorporation - 1.0
rrr
*** Mineralization Rates; Compost -0.1, anserobially digested -0.2,
Signature of Land Applier
Date
aerobically digested -0.3, raw sludge -0.4
""*"C.P.L.R.: Cumulative Pollutant Loadine Rate
DENR FORM FSF (1212006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: Baxter Healthcare Corporation Total Dry Tons Applied (Annual): 21.75
Permit #: W00031725 Cation Exchange Capacity (non 503 only):
Operator: Douglas Poplin Owner: Douglas Poplin Predominant Soil Series: Fc82
Acres Used- 6.983 Acres Permitted: 6.983 Site #: DP Field #: 3-Grass
Residual
Analysis
Data (Heavy
Metals and Total
Phosphorus
use mg/kg,
% Solids
use
Raw Percent):
Sample or
1
2j 1
3
4 5
61
11 8
9
10
11 12
Com-
posite
Date
1123/20
% Solids 1
12.7
Arsenic
3.7
Cadmium
0.54
Copper
80.6
Chromiuml
NA
Lead
3.071
Mercury
0.126
Molyb-
5.04
num
Nickel
11.18
Selenium
3.7
Zinc
84.3
Total
Phos-
2677
horus
Annual
Heavy
Metal Field Loadings
(Calculated
in Ibslacre):
Total
1
2 3
4 ; 53
6 7 $ , 91 Lo 11 12
UrAc. r
m
App
w
Event
3.12
Arsenic
0.023
0.000 0.000
0.000 0.000
0.000 0.000 0.000 0.000 0.000 0.000 0.000
0.023
Cadmium
0.003
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.003
Copper
0.502
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.502
Chromiurn
#4####
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
######
Lead
0.019
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.019
Mercury
0.001
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0,000
0.000
0.000
1 0.001
Molyb-
0.031
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.031
enum
Nicke;
1 0.070
0.000
1 0.000
0.000
1 0.000
0.000
0.000
0.000
0.000
1 0.000
0.000
0,000
0.070
Selenium
0.023
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1 0.000
0.000
0.000
0.023
Zinc
0.525
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0-000
0.000
1 0.525
Total
Phos-
16.678
0.000
0.000
o.o00
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
16.678
horus
"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.
1 am aware that there are significant penalties for submitting false information, including the possibility of fines and
imprisonment for knowing violations".
Signature of Land Applier
Date
DENR FORM MFLSF (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: Baxter Healthcare Corporation WQ Permit #: WQ0031725 Field #: 3-Grass
Land Owner: Douglas Poplin Annual Dry Tons Applied: 21.7527 Site #: DP
Operator: Douglas Poplin
Crop 1 Name: Fescue
Predominant Soil Series: FcB2
Crop l Max. PAN: 194 Crop 2 Name:
Acres Utilized: 6.983
Acres Permitted: 6.983
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
�
_
C
Volume applied
(enter one) Solids/
Liquid
Cu. Yds. Gallons
Cu.
%
Solids
Volume
Applied per
Acre
{DryTonslAc)
Residual Sources
(NPDES #. WQ#.
Fert.. Animal
Waste. inc)
Soil
Cond.
(Dry
Wet-
Moist}
Pircip
Past 24
Hrs.
>
r �
c _
* '
t
m =
`3
3
x R
;
°
TKN
mglkg
Z D
.� �
r o o
U'
niWkg
Nitrate
and
Nitrite
�9
PAN Applied
(1b aL }
Name of Crop Type
Receiving Residual
Application
Crop I
P
Crop 2
P
Crop 1
P
Crop 2
P
2-2020
106.6
12.7
1.633
WQ0031725
di)
0
s
0.5
0.3
86866
20107
66.9
98.449
NA
Fescue
3-2020
26.13
12.7
0.400
WQ0031725
dry
0
s
0.5
0.3
86866
20107
66.9
24.132
NA
Fescue
11-2020
70.65
12.7
1.082
WQ0031725
dry
0
s
0.5
0.3
86866
20107
66.9
65.248
NA
Fescue
0.000
0.000
0.000
0.000
0 000
0.000
0.000
0.000
O.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
20=
0
As
Cd
Cu
I Cr
Pb
Hg
Mo
Ni
Se
Zn
P
187.8281
0.000
Lime Applied
Annual Ibs/acre
0.023
0.003
0.502
#######
0.019
0.001
0,031
0 070
0 023
0.525
16.678
Date
Ibs/ac
Prior Years Cumulative lbs/ac
0.451
0.138
7.668
5.441
0.657
0.023
0.323
1.656
0.617
13.91
0
Current Cumulative lbs/ac
0.474
0.141
8.170
#######
0A76
0.024
0.354
1.726
0.640
14.435
Permitted C. P. L. R.****
36
1 34
1338
NA
267
15
NA
374
89
2498
Permit PAN Limit 1st/2nd Crop
F 194
"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."
of Land Applier
*Application Method: S - Surface, IN - Injection, INC - Incorporation
a-1bi**Volatilization Rate: Surface-0.5, Injection/Incorporation - 1.0
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
DEN FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: Baxter Healthcare Corporation Total Dry Tons Applied (Annual): 19.86
Permit #: WQ0031725 Cation Exchange Capacity (non 503 only):
Operator: Douglas Poplin Owner: Douglas Poplin Predominant Soil Series: FcB2
Acres Used: 8.7 Acres Permitted: 8.7 Site #: DP Field #: 4
Recidwgl Analvsic Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Com-
posite
Date
BIT
1 .
Phos-
1 1 rusiMEMENNEENEEN
Annual Heavv Metal Field Loadings (Calculated in Ibslacre):
Total
2
_3j
4 v
5
_6j
7j
8
__9,1
10
ill
12
DT/Ac.'
App.
m
Event
2.28
Arsenic
0.017
0.000
0.000
0.000 1
0.000
0.000
0.000
0-000
0.000
0.000
0.000
0.000 1
0.017
Cadmium
0.002
0.000
0.000
0.000
0.000 1
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.002
Copper
0.368
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.368
Chromium
######
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
######
Lead
0.014
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.014
Mercury
0.001
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.001
Moiyb-
0.023
0.000
0.000
0.000
0.000
0.000
0 000
0.000
0.000
0.000
0.000
0.000
0.023
denum
Nickel
1 0.051
0.000
1 0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.051
Selenium
0.017
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.017
Zinc
0.385
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.385
"iota i
Phos-
12.223
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
12.223
horus
"1 certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
imprisonment for knowing violations".
Signature of Ladd Applier
Date
DENR FORM MFLSF (1212006)

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OFTHIS 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: Baxter Healthcare Corporation WQ Permit #: WQ0031725 Field #: 4
Land Owner: Douglas Poplin Annual Dry Tons Applied: 19.8617 Site #: DP
Operator: Douglas Poplin
Crop I Name: Fescue
Predominant Soil Series: FcB2
Crop 1 Max. PAN: 194 Crop 2 Name:
Acres Utilized: 8.7
Acres Permitted: 8.7
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
o f
.2 o
Q
Volume applied
enter one Solids!
( ) .
liquid
Cu. Yds Gallons
/o
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #. WQ#.
I�ert.. Animal
Waste. etc)
Sad
Cond.
(Dry.
Wet
Moist)
11recip.
Nast 24
11rs.
Ino es
a
9 b
n
� k-
as ^
x '
t= _
�,
3
9 R
�
:.,^
TKN
mg*g
z
o 3
�? �
-
mglkg
Nitrate
and
Nitrite
nv'kg
PAN Applied
( Ibs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crap 1
Crop 2
1-2020
51.3
12.7
0.631
WQ0031725
dry
0
s
0.5
0.3
86866
20107
66.9
38.027
NA
Fescue
2-2020
81.6
12.7
1.003
WQ0031725
dry
0
s
0.5
0.3
86866
20107
66.9
60.488
NA
Fescue
9-2020
52.8
12.7
0.649
WQ0031725
dry
0
s
0.5
0.3
86866
20107
66.9
39.139
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
0.000
0.000
0.000
.000
0.000
.000
Residuals Applications totals on FORM FSF supp ( attach FORM
FSF supp to this form):
a
TOTALS
185.7
0
As
Cd
Cu
Cr
Pb
H
Mo
Ni
Se
Zn
P
.000
Lime Applied
Annual Ibs/acre
0.017
0.344
0.361
36
0.002
0.1
0.102
34
0.368
5.579
5.947
k 133$
#######
4.083
#######
1 NA
0 014
0.469
0.483
267
0.001
0-017
0.019
15
0.023
0.238
0.261
NA
0 051
1.335
1.386
1 374
0.017
0.179
0.196
89
0 385
10.096
10.481
1 2498
12.223
Date
Ibs/ac
Prior Years Cumulative Ibs/ac
0
Current Cumulative Ibs/ac
Permitted C. P. L. R.****
Permit PAN Limit lst/2nd Crop
194
"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. 1 am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
Signature of Land Applier
*Application Method: S - Surface, IN - Injection, INC - Incorporation
.�•)p 2 j **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loadine Rate
DENR FORM FSF (1212006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: Baxter Healthcare Corporation Total Dry Tons Applied (Annual): 31.01
Permit 4: WQ0031725 Cation Exchange Capacity (non 503 only):
Operator: Douglas Poplin Owner: Douglas Poplin Predominant Soil Series: FcC2
Acres Used: 15.9 Acres Permitted: 15.9 Site #t: DP Field #: 5
Residual Analysis Data (Heavy Metals and Total Phosphorus use mglkg, % Solids use Raw Percent #}:
a Q 10 11 12
Corm
polite
Date
1.23 20
°o Solids
12.7
Arsenic
3.7
Cadmium
0.54
Copper
80.6
:hromiurn
NA
Lead
3.071
Mercury
0.126
Molyb-
5.04
denurn
Mickel
11.18
Selenium
3.7
Zinc
84.3
Total
Pros-
2677
Annual Heavy Metal
Field Loadings (Calculated
in lbs/acre):
Total I 1
2 3 4 5_
6 7 8 9 10 11 12
DT-Ac..
e
App.
Event 1.95
Arsenic 0.014 1
0.000 1
0.000 0.000 1
0.000
0.000
0.000 1
0.000
0.000
0.000
0.000
0.000
0.014
Cadmium 0.002
0.000
0.000 0-000
0.000
0.000
0.000
0.000
0.000
0.000 1
0.000
0.000
0.002
Copper 0.314
0.000
0.000 0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.314
Chromic ##00
0.000
0.000 0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
wall
Lead 0.012
0.000
0.000 0.000
0.000
0.000
0.000
0.000
1 0.000
0.000
0.000
0.000
0.012
Mercury 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
Molyb- 0.020
0.000
0.000 0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.020
enu �
Nickel 0.044
0.000
0.000 0.000
0.000
0.000
0.000
0.000
0.000
0.000
O.o00
0.000
0.044
Selenium 0.014
0.000
0.000 0.000
0.000
1 0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.014
zinc 0.329
0.000
0.000 0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.329
Total
1
Phos- 10.440
0.000
0.000 0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
10.440
"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".
401%.• ' ---- _ j. }j•170 01
Si azure of Land -Applier-ierr Date
DENR FORM MFLSF (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
Facility Name: Baxter Healthcare Corporation
Land Owner: Douglas Poplin
Operator: Douglas Popl in
Crop I Name: Fescue
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
WQ Permit #: WQ0031725 Field #: 5
Annual Dry Tons Applied: 31.0076 Site IN: DP
Predominant Soil Series: FcC2
Crop I Max. PAN: 158 Crop 2 Name:
Acres Utilized: 15.9
Acres Permitted: 15.9
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
c
0 a
4-2020
Volume applied
(enter one) Solids,'
Liquid
Cu Yds Gallons
118.32
qo
l ds
12.7
Volume
Applied per
Acre
(Dry 7onsrAcl
0.796
Residual Sources
(NPDIS #- WQ#.
Fort.. Animal
Wash. rtc l
WQ0031725
Soil
C and
(Dn.
Wet.c
Moist)
dr)
Preeip
Past 24
Hrs.
�
0
>
3 3
�
-
* '
s
c
R
�
.>_
0.5
K
rt
� �'
* 3
0.3
TKN
mglkg
96866
z 3
r c
� m•
mglkg
20107
Nstrate
and
Nitrite
mglkg
66.9
PAN Applied
t Ibs/acPe)
Name of Crop 1'%.pe
Receiving Residual
App'ication
( rup I
47.991
Crop 2
NA
Crop t
Fescue
Crop 2
7-2020
74.3
12.7
0.500
WQ0031725
dry
0
4
0.5
0.3
86866
20107
66.9
30.136
NA
Fescue
11-202P
97.29
12.7
0.654
W00031725
dr)
0
,
0.5
0.3
86866
20107
66.9
39.461
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
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):
TOTAI %
289.91
0
As
Cd
Cu
I Cr
Pb
Hg
Mo
Ni
Se
Zn
P
1175871
0.000
Lime Applied
Annuallbs/acre
0.014
0.002
0.314
#######
0.012
0.000
0.020
0.044
0014
0.329
10.440
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.289
0.083
4.589
3.222
0.405
0.015
0.195
1.097
0.135
8.499
12-2020
1000
Current Cumulative lbs/ac
0.302
0.095
4.903
#######
0.417
0.015
0.215
1 141
0.149
8.829
Permitted C. P. L. R.****
36
34
1338
NA
1 267
1 15
1 NA
374
1 89
2498
Permit PAN Limit I st/2nd Crop
158
"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. 1 am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
Signature of Land Applier
-'4L
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, taw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (1212006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: Baxter Healthcare Corporation Total Dry Tons Applied (Annual): 10.76
Permit #: WQ0031725 Cation Exchange Capacity (non 503 only):
Operator: Douglas Poplin Owner: Douglas Poplin Predominant Soil Series: FcC2
Acres Used: 5.5 Acres Permitted: 5.5 Site #: DP Field #: 6
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or 2� 3 4 11 5! 6; 7 8 9 10 12
Com-
posite
Date
1123120
"o Solids
12.7
Arsenic
3.7
Cadmium
0.54
Copper
80.6
Chromium
NA
Lead
3.071
Mercury
0.126
Molyb.
5.04
denurn
Mickel
11.18
Selenium
3.7
zinc
84.3
Total
Phos-
2677
Annual Heavy
Metal Field Loadings (Calculated
in Ibs/acre):
Total 1
2 3 4 5
6 7 8 8 10 11 12
DT/Ac.,
App.
Event 1.96
Arsenic 0.014
0.000 0.000 0.000 0.000
0.000 0.000 0.000 0.000 a.oa0 0.000 0.000 0.014
Cadmium 0.002
0.000 0.000 0.000 0.000
0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.002
Copper 0.315
0.000
0.000 0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.315
Chromium 4#####
0.000
0.000 0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
######
Lead 0.012
0.000
0.000 0.000
0.000
1 0.000
0.000
0.000
0.000
0.000
0.000
0,000
0.012
Mercury 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
Molyb- 0.020
0.000
0.000 0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.020
denum
Nickel 0.044
0.000
0.000 0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.044
Selenium 0.014
0.000
0.000 0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.014
Zinc 0.330
0.000
0.000 0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.330
Total
Phos- 10.472
0.000
0.000 1 0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
10.472
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
imprisonment for knowing violations".
Signature of Land Applier
Date
DENR FORM MFLSF (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 "NIA" 1N A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: Baxter Healthcare Corporation WQ Permit M WQ0031725 Field #: 6
Land Owner: Douglas Poplin Annual Dry Tons Applied: 10.7598 Site #: DP
Operator: Douglas Poplin
Crop 1 Name:
Fescue
Predominant Soil Series: FcC2
Crop 1 Max. PAN: 158 Crop 2 Name:
Acres Utilized: 5.5
Acres Permitted: 5.5
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
`
0
o
o
QLiquid
Volume applied
(enter one) Solids/
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(Np[-)I:ti #. 1b'()#.
Fert.. Animal
Waste. etc)
Soil
Cond.
(Dry.
Wet
Moist)
Prrcip.
Past 24
Hrs
inches
D
=
^'. f y
3
o
d °»
g
N
I
sa
:3
1'KN
z a
o 3
rro 0
a �•
^�k9
Nitrate
and
Nitrite
9
PAN Applied
( lbs/acre)
Name ol'Crop Type
Receiving Residual
Application
Crop I I
Crop 2
Cn)p 1
Crop 2
12-2020
100.6
12.7
1.956
WQ0031725
dry
0
s
0.5
0.3
86866
20107
66.9
117.9591
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
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
tOO.6
0
As
Cd
Cu
Cr
Pb
H
Mo
Ni
Se
Zn
P
! 17.959
0.000
Lime A lied
Annual ibs/acre
0.014
0.002
0.315
#######
0.012
0.000
0.020
0 044
0.014
0.330
10.472
Date
Ibs/ac
Prior Years Cumulative lbs/ac
0.383
0.11
6.222
4.506
0.566
0.017
0.253
1.26
0 153
11.627
0
Current Cumulative Ibs/ac
0.397
0.112
6.537
#######
0.578
0.017
0.273
1.304
0.167
1 11.957
Permitted C. P. L. R.****
36
34
1338
NA
267
15
NA
374
i 89
2498
Permit PAN Limit lst/2nd Crop
I1513
" I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
Signature of Land Applier
*Application Method: S - Surface, 1N - Injection, INC - Incorporation
-74-20al **Volatilization Rate: Surface -0.5, Injection/Incorporation- 1.0
Date *** Mineralization Rates: Compost -0.1, snserobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name:
Permit #:
Operator:
Acres Used:
Baxter Healthcare Corporation Total Dry Tons Applied (Annual): 8.02
WQ0031725 Cation Exchange Capacity (non 503 only):
Douglas Poplin Owner: Douglas Poplin Predominant Soil Series: FcC2
4.4 Acres Permitted: 4.4 Site #: DP Field #: 7
Metalsand Total Phosphorus use inWka, % Solids use Raw Percent it):
Com-
posite
WIN
®phorus_00MENNINEEMEM
-----------
Total
Phos-
Annual Heavy Metal Field Loadings (Calculated in lbs/acre):
Total
1
2
8
4 v
5-
6
7
8
9
10
11
12
D'r ,Ac
App.
m
y
Event
1.82
Arsenic
0.013 1
0.000
0.000
0.000
0.000
0.000 1
0.000
0.000
0.000
0.000
1 0.000
0.000
1 0.013
Cadmium
0.002
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.002
Copper
0.294
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1 0.294
Chromium
######
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
######
Lead
0.011
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1 0.000
0.000
0.000
0.011
Mercury
0.000
0.000
0.000
0.000
1 0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
Molyb-
0.018
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.018
denurn
Nickel
0.041
0.000
1 0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.041
Selenium
0.013
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.013
Zinc
0.307
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.307
Total
Phos-
9.760
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
9.760
horus
"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".
Slgttatttre of Land Appl+er
Date
DENR FORM MFLSF (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 "NIA" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: Baxter Healthcare Corporation
Land Owner: Douglas Poplin
Operator: Douglas Poplin
Crop 1 Name: Fescue
WQ Permit #: WQ0031725 Field #: 7 Acres Utilized: 4.4
Annual Dry Tons Applied: 8.0228 Site #: DIP Acres Permitted: 4.4
Predominant Soil Series: FcC2
Crop 1 Max. PAN: 158 Crop 2 Name:
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
L
p w
aU C
Volumes lied
PP
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(l]ryronsrAcl
Residual Sources
(NPDFS #. WQ#_
Fcrt.. Animal
Waste. etc)
S"'I
Cond.
( Dry.
s
Moist) W
Preel R•
Past 24
IIr,.
;,,fig
a
S
?
s �'
0 w
" a
c
_
=
r, --
+ ;Z.
�
x R
x+
� `
o
TKN
TngAg
?
.. 3
S B
"9t `_
3
mg/kg
Nitrate
and
Nitrite
m9fk8
PAN Applied
pP
( lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
10-2020
49.91
12.7
1.213
WQ0031725
dry
0
s
0.5
0.3
86866
20107
66.9
73.153
NA
Fescue
12-2020
25.1
12.7
0.610
WQ0031725
dry
0
s
0.5
0.3
86866
20107
66.9
36.789
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
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):
TUTAI.S.
75.011
0
As
Cd
Ctt
Cr
Pb
I Hg
Mo
Ni
Se
Zn
P
109,941
0.000
Lime Ai3viied
Annuallbs/acre
0.013
0.002
0.294
#######
0.011
0.000
0.018
0.041
0.013
0.307
9.760
Date
Ibs/ac
Prior Years Cumulative Ibs/ac
0.328
0.088
5.074
3.629
0.452
0.017
0.216
1.228
0.153
9.127
12-2020
1000
Current Cumulative lbs/ac
0.341 i
0.090
5.368
#######
0.463
0.017
0.234
1.269
0.166
9.434
Permitted C. P. L. R.****
36
34
1338
NA
267
15
NA
3-74
1 89
2498
Permit PAN Limit Ist/2nd Crop
F 158
"1 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. 1 am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
I -
of Land Applier
*Application Method: S - Surface, IN - Injection, INC - Incorporation
;- a6il "Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3. raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loadin¢ Rate
DENR FORM FSF (1212006)

ANNUAL PATHOGEN AND VECTOR ATTRACTION REDUCTION FORM (02T Rules)
Facility Name: Baxter Healthcare Corporation WQ Permit Number: W00031725
WWTP Name: Baxter Healthcare Corporation NPDES Number: NC0006564
Monitoring Period: From Ul 2020 To 12/3112020
Pathogen Reduction (15A NCAC 02T .1106) -Please indicate level achieved and alternative performed:
Class A: Alt. A (ttmeltem) ❑ Alt B (Alk Treatment)❑ Alt. C (Prior Testin )❑
Alt.D (No Prior Test) ❑ Process to Further Reduce Pathogengs ❑
If a livable to alternative performed (Class A only) Indicate "Process to Further Reduce Pathogens":
Compost ❑ Heat Drying ❑ Heat Treatment ❑ Thermophilic ❑
Beta Ray ❑ I Gainina Ray [1-1 Pasteurization ❑
Class B: Alt. (l} Fecal Density 21 Alt. (2) Process to Significantly Reduce Patho7ens ❑
If applicable to alternative performed (glass B onh•) indicate "Process to Significantly Reduce Path ens":
Lime Stabilization ❑ Air Drying ❑ Composting ❑ jAerobic Digestion ❑
Anaerobic Di estior. ❑
If applicable to alternative performed Class A or Class B) complete the followiI
monitorin data:
Aliowable Level Pathogen Density um er requency Sample Ana ytu
Parameter Excee-f Analysis T a Tech -
in Sludge Minimu Geo. Mean Maximu Units de YPniaue
2 x 10 to the MPN 1769
6th power
per gram of
Fecal Coliform total solids cFU
I000 mpn per gram
of total solid (dry
Salmonella bacteria 3 MPN per 4 grams
(in lieu of fecal total solid (dry
coliform wei ht
VnrFrnr Affenotinn Rminetinn t15A
1843.8 1 1949 1 MPN/g 1 0
7 1 grab I sm9221
' 02T .11071 - Please indicate alternative performed:
AIt.I (VS reduction)
❑
Alt. 2 (40-day bench) ❑
Alt. 3 (30-day bench) El
Alt. 4 (Spec. O, uptake)
Li
Alt. 5 (14-Day Aerobic)
Tit. 9 (Injection)
❑
❑
Alt. 6 (Alk. Stabilization ❑
Alt. 10 (Incorporation) ❑
Alt 7 (Drying - Stable) ❑ Alt. 8 (Drying - Unstable)
No vector attraction reduction alternatives were performed
❑
❑
CERTIFICATION STATEMENT (please check the appropriate statement)
21 "1 certify, under penalty of law, that the pathogen requirements in 15A NCAC 02T. 1106 and the
vector attraction reduction requirement in 15A NCAC 02T .1107 have been met."
Li "I certify, under penalty of law, that the pathogen requirements in 15A NCAC 02T .1106 and the
vector attraction reduction requirement in 15A NCAC 02T .1107 have not been met." (Please note
if you check this statement attach an explanation why you have not met one or both of the
requirements.)
"This determination has been made under my direction and supervision in accordance with the system
designed to ensure that qualified personnel properly gather and evaluate the information used to determine
that the pathogen and vector attraction reduction requirements have been met. I am aware that there are
significant penalties for false certification including fine and imprisonment."
Dennis Key US Biosolids, Inc.
Preparer Name and Title (type or print) Land Applier Name and Title (if applicable)(type or print)
- � -11�- -NY 1
Signature of Preparer* Date Signature of Land Applier (if applicable) Date
*Preparer is defined in 40 CFR Part 503.9(r) and 15A NCAC 2T .I 102 (26)
DENR FORM PVRF 02T (1212006)

Analytical Results
Southern Soil Builders
958 Hoots Road
Roaring River, NC 28669
Receive Date: 01/23/2020
Reported: 03/02/2020
For: BAXTER
Comments:
STATESVILLE
ANALYTICAL
�,
Sample Number (Parameter Sample ID Result Unit Method Analyzed Analyst
200123-31-01
Ammonia Nitrogen
BAXTER
20107.1
mg/kg
6m"w"" 38r-1 ?
01/28/2020
WE
200123-31-01
Arsenic - Solid
BAXTER
<3.70
mg/kg
SM31138.2004
02/03/2020
MT
200123-31-01
Calcium
BAXTER
9750
mg/kg
EPA 20D 7
01/3012020
MD
200123-31-01
Copper
BAXTER
80.6
mg/kg
EPA2D0.7
01/29/2020
MD
200123-31-01
Conosivity
BAXTER
See Attached
sw-UG
01/24/2020
PACE
200123-31-01
Ignitability
BAXTER
See Attached
1010M
01/2412020
PACE
200123-31-01
Lead -Solid
BAXTER
3.071
mg/kg
SM3113B
01/31/2020
MD
200123-31-01
Magnesium
BAXTER
2940
mg/kg
EPA206.7
01/30/2020
MD
200123-31-01
Mercury Solid
BAXTER
0.126
mg/kg
sM3112&2011
02/05/2020
MD
200123-31-01
Nitrate/Nitrite -
BAXTER
66.9291
mg/kg
5M4WQF1A
01/23/2020
CL
Solids
200123-31-01
Percent Solids
BAXTER
127
%
SM25408.2077
01/27/2020
MD
200123-31-01
pH
BAXTER
791
Std Units
swwms-2011
01/23/2020
CL
200123-31-01
Potassium - Solid
BAXTER
2420
mglkg
EPAM.7
02/0312020
MT
200123-31-01
Reactivity
BAXTER
See Attached
sw-s
01/2412020
PACE
200123-31-01
Selenium
BAXTER
<370
mg/kg
EPA200.7
02/03/2020
MT
200123-31-01
Sodium - Solid
BAXTER
222835
mg/kg
SM 31118
01/29/2020
MD
200123-31-01
T. Phosphorus Solid BAXTER
2677
mg/kg
SM45DWE-2011
01/31/2020
CL
200123-31-01
TCLP
BAXTER
See Attached
iN01ed
01/24/2020
PACE
200123-31-01
TKN
BAXTER
86866 1
mg/kg
s'"''4S00'' n 8-201'
01129/2020
CL
200123-31-01
Total Solids
BAXTER
154833
mg1L
SiA 540.1"7
01/27/2020
MD
200123-31-01
Zinc
BAXTER
843
mg/kg
VAMI
01/29/2020
MD
PO Box 228 • Statesville, NC 28687 •704/872/4697
Page 1 of 2

Sample Number
Parameter
Sample ID
Result
Unit
Method
Analyzed
Analyst
200123-31-01
Aluminum
BAXTER
1130
rng/kg
EPA 2W.? FWAA H"
b1/30/2020
MD
200123-31-01
Cadmium ICP
BAXTER
0.54
mg/kg
EPA 2W7
01/30/2020
MD
200123-31-01
Molybdenum
BAXTER
5.04
mg/kg
EPA2W.i
01/30/2020
MD
200123-31-01
Nickel - Solid
BAXTER
11.18
mg/kg
SM313 a
01/29/2020
MD
Respectfully submitted,
:1. Y : rR- 0'. 1) .-)41
Dena Myers
NC Cer# #440,
NCDW Cert #37755,
EPA #NC00909
P4 Box 228 it Statesville, NC 28687.704/872/4697
Pape 2 of 2

SAR
Sodium Absorption Ratio
Na: Sodium (MgIL) Equivalent weight: 23
Ca : Calcium (MgIL) Equivalent weight: 20
Mg : Magnesium (MgIL) Equivalent weight: 12
Milli Equivalent = MgIL / Equivalent weight
Na M IL Ca M IL M M I
283 1 1238.25 1 373.38
Na (ME)
12 30435
Ca (MEI
Mg (ME
31.115
61.9125
SAR= Na Milli Equivalent/(0.5 X (Ca Milli Equivalent + Mg Milli equivalent)]0 5 power
SAR = 1.80413 (From MgIL entered above)
SAR= 1.80376 (From ME entered below)
Na (ME) Ca (ME) MgME,
123 61.9 31.1
The amour
amount of e
Permitting

PAN
Mineralization
as decimal
ITotal dry
ton ear
lAcres.
Awlied on
Rate
0.3
TKN
86866.1
NH3
201071
NO3 NO2
66.9291 0
% Solids
0.127
PAN Surface
30148.17911 mg/kgmgLkg 60.29636 lbs/dry ton
0 1 Ibs total PAN
#DIVlO! jibs PAN/acre
PAN Injection
40201.72911 mglkg 80.40346 lbs/dry, ton
0 1 Ibs total PAN
#DIVIO! jibs PAN/acre
Dry Tonsf1000 gal.
0.52959
1st year PAN
Surface lbs.
0
1st year PAN
In ected Ibs.
0
IbsJacre
Surface
#DIV/0!
Ibs.lacre
Injected
#DIV/0-
MR(TKN-NH3)+ + .5(NH3)+NO3+NO2 =mg/kg
mglkg x .002=lbsldry ton
MR(TKN-NH3) + 1(NH3)+NO3+NO2 =mg/kg
mg/kg x .002=lbs/dry ton
1000 X 8 34 X %solids X sip cravi y "=dry tons/1000gal."
2000

Analytical Results
U.S. Biosolids Inc
958 Hoots Road
Roaring River, NC 28669
Receive Date: 01/23/2020
Reported: 05/08/2020
For: BAXTER
Comments:
Sample Number
Parameter
Sample IA
Result
Unit
Method
Analyzed
Analyst
200123-32-01
Fecal Coliforms
61
loll
MPN1g
SM92210E-2006
01124/2020
WC
200123-32-01
Percent Solids
B1
12.7
%
SM25AOB-20"
01/24/2020
WC
200123-32-02
Fecal Coliforms
62
1870
MPNIg
SM92210E-2006
01/2412020
WC
200123-32-02
Percent Solids
B2
12.3
%
SM254oB-201
01/24/2020
WC
200123-32-03
Fecal Coliforms
133
1769
MPN1g
s1092210E-M6
01/24/2020
WC
200123-32-03
Percent Solids
83
13
%
5M25400.2011
01/24/2020
WC
200123-32-04
Fecal Coliforms
B4
1797
MPNIg
SM92210E-2000
01/24/2020
WC
200123-32-04
Percent Solids
84
12.8
%
sM2540B.2011
01/24/2020
WC
200123-32-05
Fecal Coliforms
B5
1949
MPN,g
SM92210E-2006
01/2412020
WC
200123-32-05
Percent Solids
85
11.8
%
SM25408.2011
01/24/2020
WC
200123-32-06
Fecal Coliforms
B6
1917
MPN?g
51A92210E-2W6
01/24/2020
WC
200123-32-06
Percent Solids
B6
12
%
SM25400-2011
01/24/2020
WC
200123-32-07
Fecal Coliforms
87
1825
MPNrg
SM9221cE-2M
01124/2020
WC
200123-32-07
Percent Solids
B7
126
%
SM25408.2011
01124/2020
WC
Respectfully submitted,
Dena Myers
NC Cert #440,
NCDW Cert #37755,
EPA #NC00909
PO Box 228 • Statesville, NC 28687 a 704/872/4697
Page 1 of 4

Condition of Receipt
Sample Number 200123-32-01 Temp on Arrival 6.0
Parameter Schedule. Percent Solids
Received on Ice
Parameter Schedule- Fecal Coliforms
Sodium Thiosulfate Received on Ice
Chemica s in containers, lab
Sample Number 200123-32-02 Temp on Arrival: 6.0
Parameter Schedule Percent Solids
Received on Ice
Parameter Schedule. Fecal Coliforms
Sodium Thiosulfate Received on Ice
Chemicals n containers, lab
Sample Number 200123-32-03 Temp on Arrival: 6.0
Parameter Schedule Percent Solids
Received on Ice
Parameter Schedule Fecal Coliforms
Sodium Thiosulfate Received on Ice
Chemicals in containers, lab
Sample Number 200123-32-04 Temp on Arrival: 6.0
Parameter Schedule: Percent Solids
Received on Ice
Parameter Schedule: Fecal Coliforms
Sodium Thiosulfate Received on Ice
Chemicals in containers, lab
Sample Number 200123-32-05 Temp on Arrival: 6.0
Parameter Schedule: Percent Solids
Received on Ice
p0 Box 228 • Statesville, NC 28687 • 704/872/4697
Page 2 of 4

Parameter Schedule: Fecal Coliforms
Sodium Thiosulfate Received on Ice
Chemicals in containers, lab
Sample Number 200123-32-06 Temp on Arrival: 6.0
Parameter Schedule: Percent Solids
Received on Ice
Parameter Schedule: Fecal Coliforms
Sodium Thiosulfate Received on Ice
Chemicals in containers, lab
Sample Number 200123-32-07 Temp on Arrival: 6.0
Parameter Schedule: Percent Solids
Received on Ice
Parameter Schedule: Fecal Coliforms
Sodium Thiosulfate Received on Ice
Chemicals in containers, lab
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 3 of 4

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Time end _ am. Pm Date -�—r— ! tab C..,r*at:
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0
Co
0
Q.

i
t
PacgmNniceY
F
/'!�p L1 /�"� !n'j
A� Sate 100
- �yG, r �r4Qf
Humerlville. NC 2bo76
vissaeolfte"
(704)876-ON2
ANALYTICAL RESULTS
Project BAXTER
Pace Prored No : 92462233
Sample: Samples-200123.31.01
Lab lD• 92462233001 Collected: 01r23120 13:30 Pwaived 01124/20 14:55
Matrix- Solid
Results reported on a "dry weight' basis and are adjusted tar percent moisture. sample adze and any dilutions.
Parameters
Results Units Report Limit OF Prepared Analyiatl
CAS No. Qua:
Chlorinated Herb. (4C) 81E1A
Analytrcal McJvd. EPA 815t A Preparalion MethpH- 8151A
Leachate MdhoUlDale: 1311. 01r"20 20.25 Initial
pH: 7 12: Final pH. 5.06
2A.5-TP ($ilvax)
NO
mgll
0.00200
1 02/03/20 07:10 02/03120 20:08 93.72.1
24.0
NO
m911-
0.00200
1 02103120 0TI O 02M3120 20:06 94.75-7
Surrogates
2 44)CAA (5)
690
%
140.158
1 02/03/20 07:10 02M3120 20:08 19719-28-9
8081 TCLP Pestletdas RYE
Analytcal Method: EPA 80816
Preparation Method. EPA 3510C
L ea(Aa:e Me01od47ate-
EPA 1311. 0128120 15:49 In Ile! pH: 7.69- Final pH. 4
gamma-BHC (Lindane}
NO
ug/L
0.50
1 012920 11.34 01r30120 17 32 58-89-9
CNordsne (Tedm,ceq
NO
ugA.
30
1 0112912011.34 010=0 17,32 57-74.9
Enonn
NJ
ug4
0-50
1 01r29f2011.34 01-30201732 72.20-8
Heptachlor
NO
ug11-
0.50
1 01129/20 1134 0IM12017 32 76.44.8
Heptachlor epoxide
ND
uglL
0.50
1 0t12920 11,34 OIfd020 17 32 1024.57.3
Meltwxyctdor
NO
ug&
WOO
1 01129120It34 011=017:32 72.43.5
Toxephene
NO
ug/L
3.0
1 0112912011,34 01r3012017-32 8001.35.2
Surrogates
Decachoroblpnenyl(S)
102
%
10.138
1 nV29r2011:34 OVA7017:32 2051.24.3
Tetrachloro-rtrxylene (S)
75
%
10.110
1 01129M 11.34 0IM70 17.32 877-09-8
8082 GCS PCe
Analytical Method: EPA8082A
Preparation Method: EPA 3546
PCB-1016 (kodor 10161
ND
ug*9
232
1 0t12720 It 32 01128120 23-55 12674.11.2
PCB-1221 1Arodor 12211
NO
ugikg
232
1 Ot27/2011-32 OWOM 23:55 11104.28-2
PCB-1232 01wodor 12321
NO
ugikg
232
1 OV27120 1t 32 OM8120 23:55 11141.16-5
PCB-1242 (Arodor 1242)
ND
ugikg
232
1 01 27120 11 32 01'28120 23755 53469-21.9
PCB.1248 (Arodor 1248)
NO
ugikg
232
1 0112720 11 32 012820 2155 12672-29.0
PCB-1254 (Araclor 1254)
NO
ugikg
232
1 01271201132 01128/20 23'55 11097.690
PCB-1260 (Aratlor 1260t
NO
ugikg
232
1 01272011 32 Ot/28120 23:55 11096.82-5
Sulrooales
Decachlorobiphenyl(S►
45
%
10-130
1 01727/20 1132 Ov2&20 23.55 2051-24-3
$092 TCLP Pees RVE
Analytical Method- EPA 8082A
Preparation McOtod, EPA 3510C
Leachate Melhod(Date EPA 1311 01f28t20 15:49 Initial pH- 7,69 Final pH 4
PCB-1016 (Arodor 1016)
No
uplL
1000
1 0112912011 34 01/30/20 15 06 12674-11.2
PCB 1221 (Arodor 1221)
NO
ugrl
1000
1 01129/'2011 34 0113002016:06 11104-28-2
PCB-1232(A(odor 1232)
NO
ug1L
1030
1 01/29/2011 34 0113012015.06 11W-16.5
PC8 1242 (Arodor 1242)
NO
ug1L
1000
1 01129/20 1134 01r4W() 15:06 53469-21.9
PCB.1248 (Arodor 1248)
NO
ugll
1000
1 01IM2011 34 01/30120 15:06 12672-29-6
PC13•1254 (Arodor 1254)
NO
ug)L
1000
1 011MO 11 34 01130120 15:06 1t097$9.1
PCS-1260 (Arodor 1260)
NO
ug1L
1000
1 01r29120 11 34 01/30120 15,06 11096-82.5
Surrogates
Oecad+loi bq) anN (5)
99
%
10-132
1 01129f20 11 34 01130/20 15:06 2051.24.3
6010 MET ICP, TCLP
Anatyllcal Method: EPA 601OD
Preparation Method, EPA 30I0A
I.eachole MelhodlDate, EPA 1311. 0210WO 17
10 What pH 9 23- Final pH 4 5
Arsenic
NO
mg/L
0 050
1 02;04/20 12 00 021052016:32 7440.38.2
Barium
0.26
mglL
0.25
1 02104120IZ00 02IM2011132 7440.39-3
REPORT
OF LABORATORY
ANALYSIS
7fns report ahax not be reprodLmW except m ha
Dale 0210712020 04-49 PM
*WwM Owe iltcn cons"t of FwaAnayccal Sereices LLC
Page 5 of 26
PO Sox 228 a Statesville, NC 28687 a 704187214697
Page 21 of 42

aceAna!
a
11)!
rrrrul.tM�sae
ANALYTICAL RESULTS
Pace Analytical Services, LLC
99001tarceyAve Suite+OD
HoVitrsvee NC 28078
(704AM9092
Project BAXTER
Pace Protect No. 92462233
Semple,. Samples.200123.31.01
Lab 10: 92462233001 Collected 0123t20 13 30 Re"nred- 01124120 14 55 Malnx• Solid
Resulfs rep~ on a 'dry wftht'
frasls and are adjusted ila patent moisture, sample sire and any dltudons.
Parameters
Results Un is Report Lim-1 OF Prepared Analyzed CAS No. QLW
6010 MET 1CR TCLP
Analytical Method EPA 60100 Preparation Method, EPA 3010A
Leachate MelhodlDale EPA 1311 02103/20 17 10 Initial pH 9 23 Final pH 4.5
Cadmium
NO mg1L ; :}150 1 02104120 12 00 021 WID 16.32 744043-9
Chromium
NO mg-1- 0 050 1 02-0420 12 00 02105120 16:32 7440.47 3
Lead
NO mg.-L 0 925 1 02104120 12-00 021MO 15.32 7439.92.1
Selenium
NO mg1L 0.10 1 02M4120 12 00 02M5120 16:32 7782.49-2
Silver
NO mgR 0025 1 02*4201200 02M5i2016:32 7440.22.4
7470 Mercury, TCLP
Analytical Method EPA 7470A Preparation Method: EPA 7470A
Leachate Mefhod/Date- EPA 1311 02/03120 17 10 India pH 9.23: Rnal P►+ 4.5
Mercury
ND Ing/L. 00002D 1 02r042013.30 02MW O12.07 7439-97.6
8270E MSSV TCLP Sep Funnel Anstytkal Method EPA 8270E preparation Melhod EPA 3510C
14-81chlorobenzene
NO
u21L
50.0
1
02r04120 OS-07 02MS12011:58 106-46-7
2.4d3fiitrolo-uene
NO
--91L
50-0
1
02104:2008:07 02105J2011.58 121.14.2
Hexachbro-1 3-butaduene
NO
uWL
50.0
1
07+0420 06.07 02W20 11 58 87-66-3
Henachlaaben=ene
NO
ugr.
$0.0
1
02*$20 08:07 0210512011.68 118-74 1
Hexachlowelhane
NO
u]rL
50.0
1
0210420 05.07 02105120 11 58 67.72-1
2-Mathylphend(o-Creso)
NO
tg!L
50.0
1
02(04)20 08:07 02105/20 11 58 95.46-7
3d4-Methylphenol(m9p Creso i
NO
i.gk
50.0
1
02r0420 08.07 02/OS120 11 58 15831.104
Nitrobenzene
ND
ugA
50.0
1
02M4120 06:07 021144M 11 58 98.95-3
Perdachlorophend
NO
1911
Ma
1
02104/20 OS.07 02r0520 11 58 87-8&5
Pyridine
NO
..g2
50.0
1
0210420 D5.07 021tiWN 11 58 110-86.1
2,4 5-Tnchlorophenol
NO
ug1L
50.0
1
02*470 08 07 02/05120 1158 95.95.4
2.4,6-TrkNoraphenol
NO
ug1L
50.0
1
02fO4FA08'07 02/051201v55 88.06.2
Sw"gates
Nllrobenzene-0 ($1
41
%
12-102
1
02/04120 O8 07 02105/20 1158 4165.60-0
2-Fluorobiphenyl (S)
40
%
13.107
1
021`04120 08:07 02IM20 1158 321.)0-S
Terph rnyl-d14 (S)
55
%
21 132
1
07JO41200807 02/05120 1158 1718.51-0
Phenol-d6 (S)
13
%
10-110
1
0204420 06.07 02/05/20 11 58 13127-88.3
2-Fluorophanol(S)
19
%
10.110
1
0210412006.07 0210520It58 367-12-4
2.4,8 Tribromophenol (S)
38
%
27-108
1
02/04120 08.07 02105/2011 58 116-79.8
82600 MSY TCLP
Analytical Method EPA 82WD
Benzene
NO
ugk
100
20
021062019:51 71.43-2
2-Butanone (MEK)
NO
ug1L
200
20
02MMO 19,51 78-93-3
Carbon tevachlo!"
NO
ug1L
100
20
0210620 19:51 56.23-5
Chlorobenzene
NO
ug1L
1D0
20
02/062019:51 10$-90.7
Chloroform
NO
ug1L
100
20
02/W2019:51 67.66-3
1,4-Dichlorobenzene
NO
ug1L
100
20
02/062019:51 106-46.7
1.2-Dichioroethane
NO
ug1L
100
20
02M&201951 107-M-2
11-Dichlomathene
NO
ugx
100
20
0210612019,51 75-35-4
Tatrachlotoelhene
NO
ugiL
100
20
02/OW2019:61 127-184
Tnehloroo hens
NO
ugil.
100
20
07JO6120 19.51 79.01.8
Vinyl rhkK!de
NO
OWL
100
20
02r06120 19:51 75-01-4
Surrogates
1,2-D,chloroethane-d4 (S)
99
%
70.130
20
02106/20 19:51 17ON-07-0
REPORT OF LABORATORY
ANALYSIS
This repon shall net be rapadi led. artapl in hati.
Date- 02/0712020 04:49 PM
without ills MriaM consent of Pace Arelytcat Services, LLC
Page S of 25
PO Box 228 a Statesville, NC 28687 a 704/972/4697
Page 22 of 42

=A aiOc it k
ANALYTICAL RESULTS
Pace An0y11aa Sarvkaa- LLC
9a00KkX"AV0 Slxtel[[
Hunterevq NC 2000
[phone]
Protect BAXTER
Pace Project No. 92462233
Sample: Samples-200123.31.01 Lab ID: 92462233001 Collected- 01,23120 13.30 Received- 01124r20 14 55 Matrix Sold
Aesutts reported on a "dry wNpht' basis and are adjusted for percent mmsturs, sample size and any dilutions.
Parameters Results units Report Limit OF Prepared Analyzed CAS No 4ual
a290D MSV TCLP
Analytical Method FPA8260D
Surropatas
Toluene.0(S)
104 %
67.135
20
OM'20 19,51 2037.26 5
4-Bromofluorobanzene (S)
97 %
70.130
20
02.'0612019 51 460-00.4
Percent MolMure
Analytical Method ASTM 02974.87
Percent Moisture
85.7 %
010
t
01f24f20 16.41
1010 Flashpotot,Closed Cup
Analytical Method* EPA 1010A
FlashpoiM
3-200 deg F
70.0
1
02/03/20 12-35
904S pH $oil
Analylicsi trlelhod: EPA 90450
pH at 25 Degrees C
7.7 Sid Units
OA0
1
01/2712015.24 H3
NOS Paint Filter Liquid Test
Analytical Method, EPA 9095E
Free Liquids
Pass
1.0
1
01131!YO 18 27
733C S Reactive cyanide
Anayt(cal Method EPA 9014 Preparation Method SW-846 7 ] 3.2
Cyanide. Reactive
ND mglkg
7.0
1
01i29120 15:57 01129120 16,36
7343 Reactive Sulfide
Analytical Method, SM 4500521'-201t
Preparaiion
Method.
SW-846 7,34.2
Sulfide, Reactive
NO m911(9
69.8
1
Ot129R015:57 O1f2912016-00
REPORT OF LABORATORY ANALYSIS
This spat shah real tie reproduced, except n hie
Data 02M?!2020 04:49 PM wi9qut d» mitim com"I of Pen Analybc Service{- LLC Page 7 of 26
PO Box 228 a Statesville, NC 28687 a 704/872/4697
Page 23 of 42
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Analytical Results
U.S. Biosolids Inc
958 Hoots Road
Roaring River_ NC 28669
Receive Date: 03/19/2020
Reported: 04/27/2020
For. BAXTER
Comments:
STATESVILLE
ANALYTICAL
Sample Number Parameter Sample ID Result Unit Method Analyzed Analyst
200319-21-01 30 Day Benchscale BAXTER
Respectfully submitted,
'Op ,�A..)n, �C, I
Dena Myers
NC Cart #440,
NCDW Cert #37755.
EPA #NC00909
<1
% EPAWS-R-M 03/19/2020 WC
PO Box 228.Statesville, NC 28687.704/872/4697
Page 1 of 3

30 Day Bench Worksheet Sample ID # ?) Qa 31 q 21
WFFK t
Samples
Total Solids
Volatile Solids
% Volatile Fraction
I
2
2
I
1•
05
3
I
1. I
02`7-7
Average:
—Al
'
WEEK 2
Sam les
Total Solids
Volatile Solids
% Volatile Fraction
1
1
2
-
3
; L4
. a
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I • -7
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24
WEEK 3
Samples
1
2
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WEEK 4
Total Solids Volatile Solids latle
/o Voi
Samples
Total Solids
Volatile Solids
% Volatile Fraction
1
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---
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I
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1
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3 15
WEEK 6
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101
Samples
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I, 4U
Volatile Solid
LZ-jL--.—Mft25
% VolatileFra-ction
I
2
1. t4112
I
f
3
. -7
Avers e:
1
Van Kleeck Reduction: a/ Vol. FLa . Final % Val. EM . X 100 = %
rutial % Vo[. C. - ( Initial % Vol. Frac. X Final % Vol. Frac.)
FINAL RESU %

Condition of Receipt
Sample Number 200319-21-01 Temp on Arrival.
Parameter Schedule;
=7M— I M-1
PO Box 228 • Statesville, NC 29687.7041872/4697
Page 2 of 3

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NCDA&CS Agronomic Division Phone: [phone] Website: www.ncagr.gov/agronomil
Report No. FY21-SLO13784
"
' Predictive
Client: Doug Poplin
594 Austin Little Mtn Rd
Advisor:
Zach Key
Southern Sod Builders
Mehlich- 3 Extraction
Soil Report
Ronda, NC 28670
958 Hoots Rd
Roaring R ver, NC 28669
-
Sampled County � Wilkes
�' "• " 610M to Helpful Information
Client ID: 160157
AdvisorlD:
231531
Sampled- Received: 11/13/2020 Compieted. 12109/2020 Farm.
Sample ID: DP1A
Recommendations: Lime
Nutrients (lblacre)
More
Crop (tonslacre) N P20S
K20 Mg S
Mn
Zn
Cu
B
information
Lime History:
1-FescuelOGrass/Tim, M 0.0 120-200 0
0 0 0
0
0
0
0
Note: 12 I
2- 0.0
Test Results [units - WN in glcrr?; CEC and Na In meg1100 cm3; NO3-N in mgldrti):
Soil Class:
Mineral
HM% WN CEC BS% Ac PH P-1 K4 Ca% Mg%
S4
Mn-1 Mn-All Mn Al2
Zn-I
Zn-AI
Cu-1
Na ESP SS4 NO3-N
0.51 0.94 10.0 85 1.5 6.1 196 131 55 23
42
181 125
315
315
934
0.1 1
Sample ID: DP18
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tonsfacre) N P205
K20 Mg S
Mn
Zn
Cu
B
Information
Lime History:
1- FescuelOGrasslTim, M 0.0 120-200 0
0 0 0
0
0
0
0
Note: 12
2- 0.0
Test Results [units - WN In glcrr?; CEC and Na in meg1100 cars; NO3-N in mgldlrf ):
Soil Class:
Mineral
HM% WN CEC BS% Ac pH P-1 K4 Ca% Mg%
S-1
Mn-I Mn-All Mn-Al2
Zn4
Zn AI
Cu-1
Na ESP SS4 NO3-N
0.60 0.95 12.6 88 1.5 6.2 305 140 61 22
51
133 93
657
657
1613
0.2 2
Sample ID: DP1C
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tonstacre) N P205
K20 Mg S
Mn
Zn
Cu
B
Information
Lime History:
1- Fescue/OGrass/TIm, M 0.3 120-200 0
0 0 0
0
0
0
0
Note 12
2- 0.0
I
Test Results [units - WN in glcrf?: CEC and Na in mag1100 cm3; NO3-N in mgldm ):
Soil Class:
Mineral
HM% WN CEC SS11/6 Ac pH P-1 Kd Ca% Mg%
S4
Mn-1 Mn-All Mn-AI2
Zn4
Zn-AI
Cu-1
Na ESP SS-1 NO3-N
0.51 0.93 11.4 84 1.8 5.9 203 145 56 21
45
205 140
773
773
1310
0.2 2
North Carolina
Reprogramming of the laboratory -information -management system that makes this report possible is being funded
through a grant from the North Carolina Tobacco Trust Fund Commission.
Thank you for using agronomic services to manage nutrients and safeguard environmental quality.
- Steve Troxler. Commissioner of Avriculture

NCDABCS Agronomic Division Phone: [phone] �Website: www.ncagr.govlagronomil
Report No. FY21-SLO13784
Doug Pop.in
Page 2 of 4
Sample ID: DP1D
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tonslacre)
N P205
K20
Mg
S
Mn
Zn
Cu
B
Information
Lime History:
1- Fescue/OGrass/Tim, M 1.2
120-200 0
10
0
0
0
0
0
0
Note: 1
2- 0.0
Test Results [units - WN in glcd; CEC and Na in meg1100 cm3: NO3-N In mgldni):
Soil Class:
Mineral
HM%o WN CEC BS% Ac pH P4 K4
Ca% Mg%
S-1
Mn-I
Mn-All
Mn-Al2
Zn4
Zn AI
Cu-I
Na ESP SS-1 NO3-N
0.71 0.98 7.4
70 2.2 5.3 126 73
47 18
46
V0
83
403
403
450
0.1 1
Sample ID: DP2
Recommendations: Lime
Nutrients (Iblacre)
More
Crop (tonslacre)
N P205
K20
Mg
S
Mn
Zn
Cu
B Information
Lime History:
1-SGlCom silage 00
80- 100 0
30
0
0
pH$
0
0
0 Note: 3 Notet
2- 0.0
Test Results [units - WN in glcm3; CEC and Na in meg1100 cm3; NO3-N In mgldrr?]:
Soil Class:
Mineral
HM% WN CEC BS% Ac pH P4 K4
Ca% Mg%
S4
Mn-1
Mn-Alt
Mn-Al2
Zn4
Zn-Al
Cu-I
Na ESP SS-1 NO3-N
0.36 0.99 10.0
91 0.9 6.7 203 91
57 29
73
146
88
685
685
791
0.2 2
Sample ID: DP3C
Recommendations: Lime
Nutrients (Iblacre)
More
Crop (tonslacre)
N P205
K20
Mg
S
Mn
Zn
Cu
B
Information
Lime History:
1-FescuelOGrass(Tim, M 1.0
120-200 0
20
0
0
0
0
0
0
Note. 12
2- 0.0
Test Results [units - WN in g/cm3; CEC and Na in meg1100 cm3; NO3-N in mgldnr):
Soil Class:
Mineral
HM% WN CEC US% Ac pH P-1 K4
Ca% Mg%
S-1
Mn-I
Mn-Ali
Mn-Al2
Zn4
Zn-AI
Cu-I
Na ESP SS-1 NO3-N
0.46 0.89 8.6
75 2.2 5.5 345 65
48 23
90
90
71
629
629
664
0.2 2
Sample ID: DP3G
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tonslacre)
N P205
K20
Mg
S
Mn
Zn
Cu
S
Information
Lime History:
1- SG/Corn silage 0.0
80-100 0
150
0
0
0
0
0
0
Note 3
2- 0.0
Test Results [units - WN in glcd- CEC and Na in meg1100 cm13; NO3-N in mgldrvt):
Soil Class:
Mineral
HM%. WN CEC BS% Ac pH P-1 K4
Ca% Mg%
S4
Mn-I
Mn-All
Mn-Al2
Zn4
Zn-AI
Cu-1
Na ESP SS-1 NO3-N
0.51 0.87 10.4
85 16 6.1 136 26
53 31
57
72
52
546
546
356
0.2 2

NCDA&CS Agronomic Division Phone: [phone]
i
Website: www.neagr.gov/agronomi/
Report No.
FY21-SL013784
Doug Poplin
Page 3 of 4
Sample ID: DP4
Recommendations: Lime
Nutrients (Iblacre)
More
Crop (tonslacre)
N P205
KzO
Mg
S
Mn
Zn
Cu B
Information
Lime History:
1-FescuelOGrass[Tim, M 0.0
120-200 0
10
0
0
PH$
0
0 0
Note: 12 Note: S
2- 0.0
Test Results [units - W1V in glans; CEC. and Na in meg1100 cm3, NO3-N in mgldrrtt]:
Soil Class:
Mineral
HM% WN CEC BS°% Ac PH P4 K-1
Ca% Mg%
S-1
Mn-i
Mn-All
Mn-AI2
Zn4
Zn-Al
Cu-I Na ESP SS-1 NO3-N
0,56 0.94 12.1
91 1.1 6.6 151 72
54 35
60
227
144
626
626
748 0.2
2
Sample ID: DP5
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tonslacre)
N P205
K20
Mg
S
Mn
Zn
Cu 8
Information
Lime History:
1-FescuelOGrassfrim, M 0.3
120-200 0
0
0
0
0
0
0 0
Note: 12
2- 0.0
Test Results [units - WN in g1cd; CEC and Na in meg1100 cart; NO3-N in mgldrrl3]:
Soil Class:
Mineral
HM% WN CEC BS% Ac pH P-1 K-I
Ca% Mg%
S4
Mn-I
Mn All
Mn-Al2
Zn-I
Zn-AI
Cu4 Na ESP
33-1 NO3-N
0.66 0.83 11.4
83 1.9 5.9 161 108
51 27
52
112
84
857
857
554 0.2
2
Sample ID: DP6
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tonslacre)
N P205
K20
Mg
S
Mn
Zn
Cu B
Information
Lime History:
1- FescuelOGrassMm, M 0.0
120-200 0
0
D
0
pHS
0
0 0
Note: 12 Nole:
2- 0.0
Test Results [units - WN in glcrr?; CEC and Na in meg1100 cm3; NO3-N in mgldnrj:
Soil Class:
Mineral
HM% WN CEC 135 % Ac pH P-1 K4
Ca% Mg%
S-1
Mn4
Mn-AI1
Mn-Al2
Zn4
Zn-AI
Cu-I Na ESP SS-1 NO3-N
0.60 0.97 11.5
91 11 6.5 93 93
54 32
48
102
70
607
607
515 0.1
1
Sample 1D: DP7
Recommendations. Lime
Nutrients (lb/acre)
More
Crop (tonslacre)
N P205
K20
Mg
S
Mn
Zn
Cu B
Information
Lime History:
1-Fescue/OGrassffim, M 08
120-200 0
70
0
0
0
0
0 0
Note. 12
2- 0.0
Test Results [units -WN in g/crr?,, CEC and Na in meg1100 cm3; NO3-N in mgldnl3]:
Soil Class:
Mineral
HM% WN CEC OS°% Ac pH P4 K-1
Ca% Mg%
S-1
Mn-I
Mn-Ali
Mn-Al2
Zn4
Zn-AI
cu-i Na ESP SS-1 NO3-N
0.56 0.94 9.4
78 20 5.6 228 32
54 23
57
134
97
563
563
929 0.1
1

NCDABCS Agronomic Division Phone: [phone] Website: www.ncagr.gov/agranomi/ - Report No. FY21-SLO13784
Doug Poplin Page 4 of 4
Understanding the Soil Report: explanation of measurements, abbreviations and units
Recommendations Report Abbreviations
Lime
If testing finds that soil pH is too low for the crop(s) indicated, a time recommendation will be given in units of either
ton/acre or Ib11000 sq ft. For best results, mix the lime into the top 6 to S inches of soil several months before planting.
For no -till or established plantings where this is not possible, apply no more than 1 to 1.5 ton/acre (50 Ib/1000 sq ft) at
time, even if the report recommends more. You can apply the rest in similar increments every six months until the full r
is applied. If MG is recommended and lime is needed, use dolomitric lime_
Fertilizer
Recommendations for field crops or other large areas are listed separately for each nutrient to be added (in units of
lb/acre unless otherwise specified). Recommendations for N (and sometimes for B) are based on research/field studies
for the crop being grown, not on soil test results. K-1 and P-1 values are based on test results and should be > 50. If they
are not, follow the fertilizer recommendations given. If Mg is needed and no lime is recommended, 0-0-22 (11.5% Mg) is
an excellent source; 175 to 250 lb per acre alone or in a fertilizer blend will usually satisfy crop needs, SS-1 levels appear
only on reports for greenhouse soil or problem samples.
Farmers and other commercial producers should pay special attention to micronutHent levels. If $, pH$, $pH, C or Z
notations appear on the soil report, refer to ote_ Secondaly_Nutriepts and Micn)nutnents. In general, homeowners do not
need to be concerned about micronutrients. Various crop notes also address lime fertilizer needs; visit
ncaqr.qov/aqronomi/pubs.htm.
i Recommendations for small areas, such as home lawns/gardens, are listed in units of Ib/1000 sq ft. If you cannot find
the exact fertilizer grade recommended on the report, visit www.ncaar.vovlaaronomilobow14.htn end information that
may help you choose a comparable alternate. For more information, read A Homeowner's Guide to Fertilizer
Test Results
The first seven values ]soil class, HM%, WN, CEC, B5%, Ac and pH] describe the soil and its degree of acidity. The
remaining 16 [P-I, K-1, Ca%, Mg%, Mn-I, Mn-All, Mn-Al2, Zn-I, Zn AI, CA. S-I, SS-1, Na. ESP, SS -I, NO3-N (not routinell
available)] indicate levels of plant nutrents or other fertility measurement. Vis.t wwwncear.aov/agronomiluvrsthim
Ac
exchangeable acidity
B
boron
BS%
% CEC occupied by basic cations
Ca%
% CEC occupied by calcium
CEC
cation exchange capacity
Cu-I
copper index
ESP
exchangeable sodium percent
HM%
percent humic matter
K4
potassium index
K20
potash
Mg%
% CEC occupied by magnesium
MIN
mineral soil class
Mn
manganese
Mn All
Mn-availability index for crop 1
MnAl2
Mn-availability index for crop 2
Mn-I
manganese index
M-0
mineral -organic soil class
N
nitrogen
Na
sodium
NO3-N
nitrate nitrogen
ORG
organic soil class
pH
current soil pH
P-1
phosphorus index
P205
phosphate
S-1
sulfur index
SS-1
soluble salt index
WN
weight per volume
Zn-AI
zinc availability index
Zn4
zinc index