WQ0016247_More Information (Received)_20210527

UPS Delivery Notification, Tracking Number 1Z51F78W0199808190
UPS Quantum View <[e-mail]>
Mon 10/19/2020 11:40 AM
To: Alex Fox <[e-mail]>
L,r"UPS logo
Hello, your package has been delivered.
Delivery Date: Monday, 10/19/2020
Delivery Time: 11:39 AM
Left At: GARAGE
Set Delivery Instructions
SYNAGRO - MOCKSVILLE
LINCOLN COUNTY
Tracking Number:
Ship To:
Number of Packages:
UPS Service:
Package Weight:
Reference Number:
[0�;�COVID-19
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1Z51F78W0199808190
LINCOLN CO BOARD OF COMMISSIONERS
7868 HALLMAN MILL RD
VALE, NC 28168
us
1
UPS Next Day Air®
0.5 LBS
20-2360-30-60-4310 50-0055
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trademarks of United Parcel Service of America, Inc. All rights reserved.
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UPS Delivery Notification, Tracking Number 1Z51F78W01O9559O66
UPS Quantum View <[e-mail]>
Mon 10/19/2020 10:07 AM
To: Alex Fox <[e-mail]>
I�UPS logo
Hello, your package has been delivered.
Delivery Date: Monday, 10/19/2020
Delivery Time: 10:04 AM
Left At: FRONT DOOR
Lv_,UPS My Choice for home
Set Delivery Instructions Manage Preferences View Delivery Planner
SYNAGRO - MOCKSVILLE
CLEVELAND COUNTY
Tracking Number: 1Z51F78W0109559066
CLEVELAND CO BOARD OF COMMISSIONERS
Ship To: 110 HARBOR POINT DR
CHERRYVILLE, NC 28021
U5
Number of Packages: 1
UPS Service: UPS Next Day Air@
Package Weight: 0.5 LBS
Reference Number: 20-2360-30-60-4310 50-0055
��;COVID-19
Download the UPS mobile app
@ 2020 United Parcel Service of America, Inc. UPS, the UPS brandmark, and the color brown are
trademarks of United Parcel Service of America, Inc. All rights reserved.
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property of their respective owners.
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UPS Delivery Notification, Tracking Number 1Z51F78W0196891980
UPS Quantum View <[e-mail]>
Mon 10/19/2020 9AS AM
To: Alex Fox <[e-mail]>
; UPS logo
Hello, your package has been delivered.
Delivery Date: Monday, 10/19/2020
Delivery Time: 09:43 AM
Left At. FRONT DOOR
&,,UPS My Choice for home
Set Delivery Instructions
SYNAGRO - MOCKSVILLE
CATAWBA COUNTY
Tracking Number:
Ship To:
Number of Packages:
UPS Service:
Package Weight:
Reference Number:
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1ZSIF78WO196891980
CATAWBA BOARD OF COMMISSIONERS
1537 LITTLE HILL RD
NEWTON, NC 28658
us
1
UPS Next Day Air@
0.5 LBS
20-2360-30-60-4310 50-0055
© 2020 United Parcel Service of America, Inc. UPS, the UPS brandmark, and the color brown are
trademarks of United Parcel Service of America, Inc. All rights reserved.
All trademarks, trade names, or service marks that appear in connection with UPS's services are the
property of their respective owners.
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UPS Delivery Notification, Tracking Number 1Z51F78W0199044005
UPS Quantum View <[e-mail]>
Mon 70/19/2020 9:16 AM
To: Alex Fox <[e-mail]>
..Jups logo
Hello, your package has been delivered.
Delivery Date: Monday, 10/19/2020
Delivery Time: 09:12 AM
Left At: OFFICE
Signed by: BOCK
SYNAGRO - MOCKSVILLE
ALEXANDER COUNTY
Tracking Number: 1Z51F78W0199044005
ALEXANDER CO BOARD OF COMMISSIONERS
Ship To: 621 LILEDOUN RD
TAYLORSVILLE, NC 28681
US
Number of Packages: 1
UPS Service: UPS Next Day Air®
Package Weight: 0.5 LBS
Reference Number: 20-2360-30-60-4310 50-0055
Download the UPS mobile app
@ 2020 United Parcel Service of America, Inc. UPS, the UPS brandmark, and the color brown are
trademarks of United Parcel Service of America, Inc. All rights reserved.
All trademarks, trade names, or service marks that appear in connection with UPS's services are the
property of their respective owners.
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UPS Delivery Notification, Tracking Number 1Z51F78W0197495415
UPS Quantum View <[e-mail]>
Mon 10/19/2020 9:03 APIs
To: Alex Fox <[e-mail]>
r�UPS logo
Hello, your package has been delivered.
Delivery Date: Monday, 10/19/2020
Delivery Time: 09:01 AM
Left At: FRONT DOOR
la�,UPS My Choice for home
Set Delivery Instructions Manage Preferences View Delivery Planner
SYNAGRO - MOCKSVILLE
Tracking Number: iZ51F78W0197495415
IREDELL CO BOARD OF COMMISSIONERS
Ship To: 519 N CENTER ST
STATESVILLE, NC 28677
US
Number of Packages: 1
UPS Service: UPS Next Day Air®
Package Weight: 0.5 LBS
Reference Number: 20-2360-30-60-4310 50-0055
,,COVID-19
Download the UPS mobile app
© 2020 United Parcel Service of America, Inc. UPS, the UPS brandmark, and the color brown are
trademarks of United Parcel Service of America, Inc. All rights reserved.
All trademarks, trade names, or service marks that appear in connection with UPS's services are the
property of their respective owners.
Please do not reply directly to this email. UPS will not receive any reply message.
Review the UPS Privacy Notice
Far Questions, Visit Our Help and Support Center

State of North Carolina
DWR
Department of Environmental Quality
Division of Water Resources
Division of Water Resources COUNTY BOARD NOTIFICATION
INSTRUCTIONS FOR FORM: CBN 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 notification is intended to provide the county board in which the land application site is proposed to be located with
general information on the size, location and type of residuals land application proposed to occur in their county, and to give them an
opportunity to comment on the pending permitting request as stipulated in Session Law 2013-340. Notification is not required for
fields deemed permitted to receive Class A residuals under 15A NCAC 02T .1100. Do not submit this document for review
without a corresponding residuals program application form (FORM: RLAP 11-15).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. County Board Notification (FORM: CBN 11-15):
® Submit the completed and appropriately executed County Board Notification (FORM: CBN 11-15). Please do not make any
unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to the form may
be made, as long as the attachments are numbered to correspond to the section and item to which they refer.
® Prepare a separate County Board Notification (FORM: CBN 11-15) for each county in which the proposed land application
sites are located.
B. Critical Watershed Areas Information:
® Under 15A NCAC 02B .0212, no new permitted sites for land application of residuals are allowed within critical watershed
areas. It is the Applicant's responsibility to ensure that the proposed land application sites are not located within these areas.
® For more information regarding Water Supply Watershed Protection Program, please visit the Division website at:
httDs://dea.nc. eov/about/divisions/water-resources/water-resources-rules/water-suDDIv-watershed-Drotection-Droeram
❑ If uncertain about whether the proposed sites are located within the critical areas, contact the Division or call [phone].
C. Notification Package Submission:
® Complete and mail the notification letter, source facility summary, land application site summary, and site location maps to
the appropriate County Board by certified mail with a return receipt requested. It is recommended that a copy of the
notification package also be sent to the County Manager.
® The most current publication of the Directory of State and County Officials may be downloaded at:
hl�2s://www.sosnc.gov/publications/direct.aspx
® A list of the Division's regional offices, their county coverage, and their contact information may be downloaded at:
hllp:Hdeq.nc.gov/contact/reaional-offices.
® The source facility summary shall include: facility name; county where it is located; and the proposed annual dry tonnage
(i.e., a copy of "Residuals Source Facility Summary" is adequate but not required).
® The land application site summary shall include: field ID; acreage; county where it is located; latitude and longitude (i.e., a
copy of "Land Application Site Certification" is adequate but not required).
D. Proof of Submission:
® Attach an 8.5 by 11-inch copy of the return receipt to the back of this attachment prior to submission of the application to the
Division for review.
INSTRUCTIONS FOR FORM: CBN 06-16 Page 1 of 1

North Carolina Department of Environmental Quality
Pat McCrory Donald R. van der Vaart
Governor Secretary
Date: 10/15/2020
Name of Chairman to the Board of County Commissioners: Ryan Mayberry
Complete mailing address: 621 Liledoun Rd
City: Taylorsville State: NC Zip: 28681
County where land application sites are located: Alexander
From: Applicant's name: Synagro Western Piedmont for Statesville Waste Water (on behalf of the Division of Water
Resources in accordance with Session Law 2013-340)
Contact person and title: Alex Fox
Complete mailing address: 284 Boger rd
City: Statesville
Telephone number: [phone]
State: NC Zip: 27028--
E-mail address: afox(&syna rg o.com
Subject: Notification of residual land application site proposal
This is to notify you that the Applicant listed above will be submitting an application to the Division of Water
Resources for the land application of residual solids to site(s) located in your county. During this review, the Division
will ensure that all federal and state regulations are enforced. Attached to this form is information regarding residuals -
generating sources and locations of the proposed land application sites. Please forward this letter and its associated
attachments to the appropriate Department within your County (i.e., Health or Environmental Health Department and
Planning Department) if applicable.
More information of the land application sites included in this application will be available at the following
Division of Water Resources Regional Office:
Name of appropriate regional office: Mooresville Regional Office
Complete mailing address: 610 East Center Avenue Suite 301
City: Mooresville State: NC Zip: 28115
Telephone number: (704-235-2184)
Expected date of application submission: 11/15/2020
Should you desire to comment on this application, please do so no later than 30 calendar days following the
expected application submission date. If you have any questions or comments about this notification, or if you would like
more information, please contact the appropriate regional office at the telephone number provided above. Thank you in
advance for your attention to this matter.
Enclosures: Source Facility Summary
Land Application Site Summary
Maps
Non -Discharge Permitting Unit
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Phone: [phone] Internet: http://Portal.ncdenr.org/web/wq
An Equal Opportunity 1 Affirmative Action Employer- Made in part with recycled paper FORM: CBN 06-16

State of North Carolina
DWR
Department of Environmental Quality
Division of Water Resources
Division of Water Resources COUNTY BOARD NOTIFICATION
INSTRUCTIONS FOR FORM: CBN 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 notification is intended to provide the county board in which the land application site is proposed to be located with
general information on the size, location and type of residuals land application proposed to occur in their county, and to give them an
opportunity to comment on the pending permitting request as stipulated in Session Law 2013-340. Notification is not required for
fields deemed permitted to receive Class A residuals under 15A NCAC 02T .1100. Do not submit this document for review
without a corresponding residuals program application form (FORM: RLAP 11-15).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. County Board Notification (FORM: CBN 11-15):
® Submit the completed and appropriately executed County Board Notification (FORM: CBN 11-15). Please do not make any
unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to the form may
be made, as long as the attachments are numbered to correspond to the section and item to which they refer.
® Prepare a separate County Board Notification (FORM: CBN 11-15) for each county in which the proposed land application
sites are located.
B. Critical Watershed Areas Information:
® Under 15A NCAC 02B .0212, no new permitted sites for land application of residuals are allowed within critical watershed
areas. It is the Applicant's responsibility to ensure that the proposed land application sites are not located within these areas.
® For more information regarding Water Supply Watershed Protection Program, please visit the Division website at:
httDs: //dea.nc. eov/about/divisions/water-resources/water-resources-rules/water-suDDIv-watershed-Drotection-Droeram
® If uncertain about whether the proposed sites are located within the critical areas, contact the Division or call [phone].
C. Notification Package Submission:
® Complete and mail the notification letter, source facility summary, land application site summary, and site location maps to
the appropriate County Board by certified mail with a return receipt requested. It is recommended that a copy of the
notification package also be sent to the County Manager.
® The most current publication of the Directory of State and County Officials may be downloaded at:
hl�2s://www.sosnc.gov/publications/direct.aspx
® A list of the Division's regional offices, their county coverage, and their contact information may be downloaded at:
hllp:Hdeq.nc.gov/contact/reaional-offices.
® The source facility summary shall include: facility name; county where it is located; and the proposed annual dry tonnage
(i.e., a copy of "Residuals Source Facility Summary" is adequate but not required).
® The land application site summary shall include: field ID; acreage; county where it is located; latitude and longitude (i.e., a
copy of "Land Application Site Certification" is adequate but not required).
D. Proof of Submission:
® Attach an 8.5 by 11-inch copy of the return receipt to the back of this attachment prior to submission of the application to the
Division for review.
INSTRUCTIONS FOR FORM: CBN 06-16 Page 1 of 1

North Carolina Department of Environmental Quality
Pat McCrory Donald R. van der Vaart
Governor Secretary
Date: 10/15/2020
To: Name of Chairman to the Board of County Commissioners: Randall Isenhour
Complete mailing address: 1537 Little Hill Rd
City: Newton
State: NC Zip: 28658
County where land application sites are located: Catawba
From: Applicant's name: S�nagro Western Piedmont (on behalf of the Division of Water Resources in accordance with
Session Law 2013-340)
Contact person and title: Alex Fox TSS SyLiagro
Complete mailing address: 284 Boger rd
City: Mocksville
Telephone number: (336)-703-8681
State: NC Zip: 27028
E-mail address: awfox(&syna rg o.com
Subject: Notification of residual land application site proposal
This is to notify you that the Applicant listed above will be submitting an application to the Division of Water
Resources for the land application of residual solids to site(s) located in your county. During this review, the Division
will ensure that all federal and state regulations are enforced. Attached to this form is information regarding residuals -
generating sources and locations of the proposed land application sites. Please forward this letter and its associated
attachments to the appropriate Department within your County (i.e., Health or Environmental Health Department and
Planning Department) if applicable.
More information of the land application sites included in this application will be available at the following
Division of Water Resources Regional Office:
Name of appropriate regional office: NC DEQ Mooresville
Complete mailing address: 610 East Center Ave Suite 301
City: Mooresville State: NC Zip: 28115
Telephone number: [phone]
Expected date of application submission: 10/28/20
Should you desire to comment on this application, please do so no later than 30 calendar days following the
expected application submission date. If you have any questions or comments about this notification, or if you would like
more information, please contact the appropriate regional office at the telephone number provided above. Thank you in
advance for your attention to this matter.
Enclosures: Source Facility Summary
Land Application Site Summary
Maps
Non -Discharge Permitting Unit
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Phone: [phone] Internet: http://Portal.ncdenr.org/web/wq
An Equal Opportunity 1 Affirmative Action Employer- Made in part with recycled paper FORM: CBN 06-16

State of North Carolina
DWR
Department of Environmental Quality
Division of Water Resources
Division of Water Resources COUNTY BOARD NOTIFICATION
INSTRUCTIONS FOR FORM: CBN 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 notification is intended to provide the county board in which the land application site is proposed to be located with
general information on the size, location and type of residuals land application proposed to occur in their county, and to give them an
opportunity to comment on the pending permitting request as stipulated in Session Law 2013-340. Notification is not required for
fields deemed permitted to receive Class A residuals under 15A NCAC 02T .1100. Do not submit this document for review
without a corresponding residuals program application form (FORM: RLAP 11-15).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. County Board Notification (FORM: CBN 11-15):
® Submit the completed and appropriately executed County Board Notification (FORM: CBN 11-15). Please do not make any
unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to the form may
be made, as long as the attachments are numbered to correspond to the section and item to which they refer.
® Prepare a separate County Board Notification (FORM: CBN 11-15) for each county in which the proposed land application
sites are located.
B. Critical Watershed Areas Information:
® Under 15A NCAC 02B .0212, no new permitted sites for land application of residuals are allowed within critical watershed
areas. It is the Applicant's responsibility to ensure that the proposed land application sites are not located within these areas.
® For more information regarding Water Supply Watershed Protection Program, please visit the Division website at:
httDs://dea.nc. eov/about/divisions/water-resources/water-resources-rules/water-suDDIv-watershed-Drotection-Droeram
❑ If uncertain about whether the proposed sites are located within the critical areas, contact the Division or call [phone].
C. Notification Package Submission:
❑ Complete and mail the notification letter, source facility summary, land application site summary, and site location maps to
the appropriate County Board by certified mail with a return receipt requested. It is recommended that a copy of the
notification package also be sent to the County Manager.
❑ The most current publication of the Directory of State and County Officials may be downloaded at:
hl�2s://www.sosnc.gov/publications/direct.aspx
❑ A list of the Division's regional offices, their county coverage, and their contact information may be downloaded at:
hllp:Hdeq.nc.gov/contact/reaional-offices.
❑ The source facility summary shall include: facility name; county where it is located; and the proposed annual dry tonnage
(i.e., a copy of "Residuals Source Facility Summary" is adequate but not required).
❑ The land application site summary shall include: field ID; acreage; county where it is located; latitude and longitude (i.e., a
copy of "Land Application Site Certification" is adequate but not required).
D. Proof of Submission:
❑ Attach an 8.5 by 11-inch copy of the return receipt to the back of this attachment prior to submission of the application to the
Division for review.
INSTRUCTIONS FOR FORM: CBN 06-16 Page 1 of 1

North Carolina Department of Environmental Quality
Pat McCrory Donald R. van der Vaart
Governor Secretary
Date: 10/15/2020
Name of Chairman to the Board of County Commissioners: James Mallory
Complete mailing address: 519 N Centter Street
City: Statesville State: NC Zip: 28677
County where land application sites are located: Iredell
From: Applicant's name: Synagro Western Piedmont for Statesville Waste Water (on behalf of the Division of Water
Resources in accordance with Session Law 2013-340)
Contact person and title: Alex Fox
Complete mailing address: 284 Boger rd
City: Statesville
Telephone number: [phone]
State: NC Zip: 27028--
E-mail address: afox(&syna rg o.com
Subject: Notification of residual land application site proposal
This is to notify you that the Applicant listed above will be submitting an application to the Division of Water
Resources for the land application of residual solids to site(s) located in your county. During this review, the Division
will ensure that all federal and state regulations are enforced. Attached to this form is information regarding residuals -
generating sources and locations of the proposed land application sites. Please forward this letter and its associated
attachments to the appropriate Department within your County (i.e., Health or Environmental Health Department and
Planning Department) if applicable.
More information of the land application sites included in this application will be available at the following
Division of Water Resources Regional Office:
Name of appropriate regional office: Mooresville Regional Office
Complete mailing address: 610 East Center Avenue Suite 301
City: Mooresville State: NC Zip: 28115
Telephone number: (704-235-2184)
Expected date of application submission: 10/28/2020
Should you desire to comment on this application, please do so no later than 30 calendar days following the
expected application submission date. If you have any questions or comments about this notification, or if you would like
more information, please contact the appropriate regional office at the telephone number provided above. Thank you in
advance for your attention to this matter.
Enclosures: Source Facility Summary
Land Application Site Summary
Maps
Non -Discharge Permitting Unit
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Phone: [phone] Internet: http://Portal.ncdenr.org/web/wq
An Equal Opportunity 1 Affirmative Action Employer- Made in part with recycled paper FORM: CBN 06-16

State of North Carolina
DWR
Department of Environmental Quality
Division of Water Resources
Division of Water Resources COUNTY BOARD NOTIFICATION
INSTRUCTIONS FOR FORM: CBN 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 notification is intended to provide the county board in which the land application site is proposed to be located with
general information on the size, location and type of residuals land application proposed to occur in their county, and to give them an
opportunity to comment on the pending permitting request as stipulated in Session Law 2013-340. Notification is not required for
fields deemed permitted to receive Class A residuals under 15A NCAC 02T .1100. Do not submit this document for review
without a corresponding residuals program application form (FORM: RLAP 11-15).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. County Board Notification (FORM: CBN 11-15):
® Submit the completed and appropriately executed County Board Notification (FORM: CBN 11-15). Please do not make any
unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to the form may
be made, as long as the attachments are numbered to correspond to the section and item to which they refer.
® Prepare a separate County Board Notification (FORM: CBN 11-15) for each county in which the proposed land application
sites are located.
B. Critical Watershed Areas Information:
® Under 15A NCAC 02B .0212, no new permitted sites for land application of residuals are allowed within critical watershed
areas. It is the Applicant's responsibility to ensure that the proposed land application sites are not located within these areas.
® For more information regarding Water Supply Watershed Protection Program, please visit the Division website at:
httDs: //dea.nc. eov/about/divisions/water-resources/water-resources-rules/water-suDDIv-watershed-Drotection-Droeram
® If uncertain about whether the proposed sites are located within the critical areas, contact the Division or call [phone].
C. Notification Package Submission:
® Complete and mail the notification letter, source facility summary, land application site summary, and site location maps to
the appropriate County Board by certified mail with a return receipt requested. It is recommended that a copy of the
notification package also be sent to the County Manager.
® The most current publication of the Directory of State and County Officials may be downloaded at:
hl�2s://www.sosnc.gov/publications/direct.aspx
® A list of the Division's regional offices, their county coverage, and their contact information may be downloaded at:
hllp:Hdeq.nc.gov/contact/reaional-offices.
® The source facility summary shall include: facility name; county where it is located; and the proposed annual dry tonnage
(i.e., a copy of "Residuals Source Facility Summary" is adequate but not required).
® The land application site summary shall include: field ID; acreage; county where it is located; latitude and longitude (i.e., a
copy of "Land Application Site Certification" is adequate but not required).
D. Proof of Submission:
® Attach an 8.5 by 11-inch copy of the return receipt to the back of this attachment prior to submission of the application to the
Division for review.
INSTRUCTIONS FOR FORM: CBN 06-16 Page 1 of 1

North Carolina Department of Environmental Quality
Pat McCrory Donald R. van der Vaart
Governor Secretary
Date: 10/15/2020
To: Name of Chairman to the Board of County Commissioners: Doug Bridges
Complete mailing address: 110 Harbor Point Dr
City: CheMville State: NC Zip: 28021
County where land application sites are located: Cleveland
From: Applicant's name: Synagro Western Piedmont (on behalf of the Division of Water Resources in accordance with
Session Law 2013-340)
Contact person and title: Alex Fox
Complete mailing address: 263 Boger rd
City: Mocksville
Telephone number: [phone]
State: NC Zip: 27028
E-mail address: [e-mail]
Subject: Notification of residual land application site proposal
This is to notify you that the Applicant listed above will be submitting an application to the Division of Water
Resources for the land application of residual solids to site(s) located in your county. During this review, the Division
will ensure that all federal and state regulations are enforced. Attached to this form is information regarding residuals -
generating sources and locations of the proposed land application sites. Please forward this letter and its associated
attachments to the appropriate Department within your County (i.e., Health or Environmental Health Department and
Planning Department) if applicable.
More information of the land application sites included in this application will be available at the following
Division of Water Resources Regional Office:
Name of appropriate regional office: NC DEQ Mooresville
Complete mailing address: 610 East Center Ave Suite 301
City: Mooresville State: NC Zip: 28115
Telephone number: [phone]
Expected date of application submission: 11/10/20
Should you desire to comment on this application, please do so no later than 30 calendar days following the
expected application submission date. If you have any questions or comments about this notification, or if you would like
more information, please contact the appropriate regional office at the telephone number provided above. Thank you in
advance for your attention to this matter.
Enclosures: Source Facility Summary
Land Application Site Summary
Maps
Non -Discharge Permitting Unit
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Phone: [phone] Internet: http://Portal.ncdenr.org/web/wq
An Equal Opportunity 1 Affirmative Action Employer- Made in part with recycled paper FORM: CBN 06-16

State of North Carolina
DWR
Department of Environmental Quality
Division of Water Resources
Division of Water Resources COUNTY BOARD NOTIFICATION
INSTRUCTIONS FOR FORM: CBN 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 notification is intended to provide the county board in which the land application site is proposed to be located with
general information on the size, location and type of residuals land application proposed to occur in their county, and to give them an
opportunity to comment on the pending permitting request as stipulated in Session Law 2013-340. Notification is not required for
fields deemed permitted to receive Class A residuals under 15A NCAC 02T .1100. Do not submit this document for review
without a corresponding residuals program application form (FORM: RLAP 11-15).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. County Board Notification (FORM: CBN 11-15):
® Submit the completed and appropriately executed County Board Notification (FORM: CBN 11-15). Please do not make any
unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to the form may
be made, as long as the attachments are numbered to correspond to the section and item to which they refer.
® Prepare a separate County Board Notification (FORM: CBN 11-15) for each county in which the proposed land application
sites are located.
B. Critical Watershed Areas Information:
® Under 15A NCAC 02B .0212, no new permitted sites for land application of residuals are allowed within critical watershed
areas. It is the Applicant's responsibility to ensure that the proposed land application sites are not located within these areas.
® For more information regarding Water Supply Watershed Protection Program, please visit the Division website at:
httDs: //dea.nc. eov/about/divisions/water-resources/water-resources-rules/water-suDDIv-watershed-Drotection-Droeram
® If uncertain about whether the proposed sites are located within the critical areas, contact the Division or call [phone].
C. Notification Package Submission:
® Complete and mail the notification letter, source facility summary, land application site summary, and site location maps to
the appropriate County Board by certified mail with a return receipt requested. It is recommended that a copy of the
notification package also be sent to the County Manager.
® The most current publication of the Directory of State and County Officials may be downloaded at:
hl�2s://www.sosnc.gov/publications/direct.aspx
® A list of the Division's regional offices, their county coverage, and their contact information may be downloaded at:
hllp:Hdeq.nc.gov/contact/reaional-offices.
® The source facility summary shall include: facility name; county where it is located; and the proposed annual dry tonnage
(i.e., a copy of "Residuals Source Facility Summary" is adequate but not required).
® The land application site summary shall include: field ID; acreage; county where it is located; latitude and longitude (i.e., a
copy of "Land Application Site Certification" is adequate but not required).
D. Proof of Submission:
® Attach an 8.5 by 11-inch copy of the return receipt to the back of this attachment prior to submission of the application to the
Division for review.
INSTRUCTIONS FOR FORM: CBN 06-16 Page 1 of 1

North Carolina Department of Environmental Quality
Pat McCrory Donald R. van der Vaart
Governor Secretary
Date: 10/15/2020
To: Name of Chairman to the Board of County Commissioners: Carrol Mitchem
Complete mailing address: 7868 Hallman Mill Road
City: Vale
State: NC Zip: 28168
County where land application sites are located: Lincoln
From: Applicant's name: Synagro Western Piedmont (on behalf of the Division of Water Resources in accordance with
Session Law 2013-340)
Contact person and title: Alex Fox
Complete mailing address: 263 Boger rd
City: Mocksville
Telephone number: [phone]
State: NC Zip: 27028
E-mail address: [e-mail]
Subject: Notification of residual land application site proposal
This is to notify you that the Applicant listed above will be submitting an application to the Division of Water
Resources for the land application of residual solids to site(s) located in your county. During this review, the Division
will ensure that all federal and state regulations are enforced. Attached to this form is information regarding residuals -
generating sources and locations of the proposed land application sites. Please forward this letter and its associated
attachments to the appropriate Department within your County (i.e., Health or Environmental Health Department and
Planning Department) if applicable.
More information of the land application sites included in this application will be available at the following
Division of Water Resources Regional Office:
Name of appropriate regional office: NC DEQ Mooresville
Complete mailing address: 610 East Center Ave Suite 301
City: Mooresville State: NC Zip: 28115
Telephone number: [phone]
Expected date of application submission: 11/10/20
Should you desire to comment on this application, please do so no later than 30 calendar days following the
expected application submission date. If you have any questions or comments about this notification, or if you would like
more information, please contact the appropriate regional office at the telephone number provided above. Thank you in
advance for your attention to this matter.
Enclosures: Source Facility Summary
Land Application Site Summary
Maps
Non -Discharge Permitting Unit
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Phone: [phone] Internet: http://Portal.ncdenr.org/web/wq
An Equal Opportunity 1 Affirmative Action Employer— Made in part with recycled paper FORM: CBN 06-16