WQ0006017_More Information (Received)_20210706

SYNI.GRO
YOUR PARTNER FOR A CLEANER, GREENER WORLD
July 6th, 2021
N.C. Department of Environment and Natural Resources
Division of Water Resources
Wilmington Regional Office -Water Quality Regional Operations Section
127 Cardinal Drive Ext.
Wilmington, NC 28405
ATTENTION: Poorva Mokashi
REFERENCE: Additional information request - WQ0006017
Town of Beaufort RLAP
Poorva,
I am addressing Section E of the additional information request for the Town of Beaufort RLAP.
E. Additional Documentation:
1. Land Owner Agreement: a) The Land Owner Agreement (Form LOA 06-16) was not
signed by the permittee. Please resubmit the form signed by Mr. Donovan Willis. b)
Please provide a document for registration of Ms. Debra Jo Mohn as the `executrix' or
existing documentation specifying that she is the 'executrix'.
a.) Please find that the Land Owner Agreement form has been signed by the
perm ittee.
b.) After further investigation, Ms. Debra Jo Mohn's brother, Walter Jon
Wetherington is the current landowner and I obtained his notarized signature.
Find attached the updated LASC (0646,) and LOA (O6-16,forms reflecting the
required alterations.
2. Residuals Source -Generating Facility Information: Process Flow Diagram and/ or
narrative provided is not readable. Please provide a legible copy
Please find that the legible copy of the Process Flow Diagram is attached.
Please let me know if you have any questions or concerns.
Best regar• s,
Chris
Technical Services Specialist

State of North Carolina
Department of Environmental Quality
Division of Water Resources
LAND APPLICATION SITE CERTIFICATION
INSTRUCTIONS FOR FORM: LASC 06-16
Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted, the Applicant shall_ submit one original and two of,the, application and
suppo rtin2 docu_�,n en tatio n
For more information, visit the Water Quality Permitting Section's 1Von-Discharge P erm itt ing Unit
General — This certification provides detailed information, of receiving sites for land application of Class B residuals (may include
water treatment plant or other type residuals) in accordance with. 15A NCAC 02T .1100. Do not submit this certification for review
without a corresponding application form (FORM: RLAP 06-16 or FORM: SDR 06-16).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Land Application Site Certification (FORM: LASC 06-16):
Submit the completed and appropriately executed Land Appliation Site Certification (FORM: LASC 06-16) form. Please
do not make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments
to the application may be made, as long as the attachments are numbered to correspond to the section and item to which they
refer.
E For new or renewed permits, submit the requested information for all hand application sites.
E For modified permits, submit the requested information for only those sites that are new, transferred or affected by the
proposed modification.
B. Land Application Site Information:
El The status of the land application site with respect to this residuals land application program must be provided in table I. The
status categories and their corresponding codes are as follows:
♦ New (N) Renewed (R) ♦ Modified. (M) Transferred (T) Deleted (D)
IZ Attach the following in accordance with each status code:
Required
Item
Status Code
N �
R
M
Tli
Notiflcattondoc
County
Board
eir _
Land Owner
Agreement
�
.
17
✓
1
*
(If
Setback
Agreement
applicable)
iklii
_
Waiver
- - --
i
1
1/ .
V .
An.
for
Residuals
updated
vicinity/setback
Land
Application_
map in accordance
Permits"
with
the
"M� Guidance
N,
f
�
�
*
A soils
Evaluation
and
Policy
agronomic
evaluation
in accordance
with the
"Soil Scientist
,7
_ _ _ _____,
_
_
*
INSTRUCTIONS FOR FORM: LASC 06-16
Page 1 of 3

An
•olluiant
updated
1oadin.
accounting
• rates
CPLRs
of
the
land
application
site's
cumulative
1,/
� �
R
Required
Item
Code
N
_Status
R
T
M
For
Attachment
indicate
thesoil
previously
the
map
permitted
B, submit
location
requirements
of
CountySail
the
sites
in
land
the
without
application
"Soil
SurveyMapore
Scientist
a soil
series
site
Evaluation
t
and
name
indicated
uivalent
equivalent)
in accordance
Policy"
clearly
in
the
with
�
i
i
✓
Acknowledgement
of
field
transfer
from
Land
Owner
(Fields
may not
i
i_
be permitted
to ,_ ._multiple
Permittees
over the
same
time
period},
_.
* This item may be required for land application site with a status code "M", please contact the Division if you need assistant in
determining attachment requirements.
Crop Type should include the most likely crop types for the life of the permit (five years).
Predominant Soils Series Name must be either the name of the soil indicated in Attachment "B" of the existing permit, or
name of the soil series as provided by the licensed soil scientist.
Predominant Soil Mapping Unit or Representative Slope: Either the Soil Mapping Unit or the representative slope of each
site must be provided. The predominant soil -mapping unit must be consistent with the predominant soil series name. Please
note that the soil mapping units are variable between Counties, so care should be taken in properly identifying the correct
mapping unit. If a representative slope is provided, it must be determined accordingly:
[2] For sites previously permitted for use, but do not have an established soil mapping unit (the mapping unit provides
information on boththe soil series name and the slope of the soil), the Applicant may determine the representative slope
by using the average slope provided in the County Soil Survey (or equivalent). A soil type with a slope range of 4 - 8%
would have a representative slope of 6%.
El New Sites to be permitted must have slopes determined as past of the soils report prepared by a licensed soil scientist.
Acceptable methods for determining location coordinates (i.e., latitude and longitude) and their corresponding codes are as
follows:
• Address Matching (ADD)
• Aerial Photography with. Ground Control (AER)
• Cadastral Survey (SU.R)
• Conversion from Coordinate Plane (CP)
• Conversion from Township -Section -Range (TSR)
• Conversion from Universal Trans Mere (UTM)
• Map interpretation by Digital or Manual Extraction (MAP)
C. Waterbody and Classifications Information: (new sites only)
• Digital or Raw Photo Extraction (EXT)
• Geodetic Quality GPS Survey (GEO)
• LORAN-C Navigation Device (LOR)
• Navigation Quality GPS (GPS)
• Remote Sensing (RS)
• Zip Code Centroid (ZIP)
Use an 8.5 by 11-inch copy of the portion of a 7.5-minute USGS Topographic Map to identify the location where the
residuals program activities are planned to occur as well as the closest downslope surface waters as clearly as possible. Each
map portion must be labeled with the map name and number, the identified location, and be of clear and reproducible quality.
Surface water body classifications information may be found at: h ':1/des .ne.:ov/about/divisioris/water-
resources/plann jngLc1ass ficatian-standards/classifications
Any questions concerning the waterbody and its classification, please contact the Division's regional offices.
El A list of the Division's regional offices, their county coverage, and their contact information may be downloaded at:
http://deq.nc.gay/contactfregional-offices
El General Instructions: There are 17 river basins in North Carolina. Each basin has associated waterbodies with assigned
subbasins, location descriptions, stream index numbers and established classifications.
I. Identify the project area on a 7.5 minute USGS topographical map (an 8.5 x 11-inch sheet showing the project area
should be submitted with the permit application regardless of whether a Stream classification was completed).
2. Determine the names of all the closest down slope surface waters from the project site. For unnamed tributaries, see
Table 1: Unnamed Tributaries Entering Other States or for Specific Basin Areas. Label any unnamed tributaries as
"UT to stream name" as the waterbody name,
3. Open the link http:l/deq.nc.gov/aboutldivisions/water-resources/planning/classifieation-standards/classifications.
Ei Stream Classification Process: One of the options below may be used depending on the known initial project information.
EZI KNOWN BASIN WHERE CLOSEST DOWN SLOPE SURFACE WATER IS LOCATED
1. Select proper basic from the List all Waterbodies in Basin sorted report. Sort hydrologically as this will provide
the proper location descriptions if multiple runs.
INSTRUCTIONS FOR FORM: LASC 06-16
Page 2 of 3

2. Locate the name of the identified waterbody (from General Directions) on the list.
3. For multiple listings of the same waterbody name in the report, select and verify the location description. The term
"source" in the description means the beginning of the waterbody segment (most upstream point).
4. Record all Basins, Stream Index Numbers and Classifications applicable to the project.
El KNOWN COUNTY WHERE CLOSEST DOWN SLOPE SURFACE WATER IS LOCATED
1. Select the proper county from the List all Waterbodies in county, hydrologically report.
2. Locate the name of the identified waterbody (from General Directions) on the list.
3. For multiple listings of the same waterbody name in the report, select and verify the location description. The term
"source" in the description means the beginning of the waterbody segment (most upstream point).
4. Record all Basins, Stream index Numbers and Classifications applicable to the project.
EI UNKNOWN BASIN WHERE CLOSEST DOWN SLOPE SURFACE CATER IS LOCATED
1. Use the CI.ickable basin map to hydrologically sorted list report.
2. Click on the approximate project location to bring up the hydrologically sorted list,
3. Locate the name of the identified waterbody (from General Directions) on the list.
4. For multiple listings of the same waterbody name in the report, select and verify the location description. The term
"source" in the description means the beginning of the waterbody segment (most upstream point).
5. Record all Basins, Stream Index Numbers and Classifications applicable to the project.
El Notes on index number and unnamed streams:
Unnamed Streams 1ST NCAC 02BM301(ij.
El Any stream which is not named in the schedule of stream classifications carries the same classification as that assigned
to the stream segment to which it is tributary (at the point of entry) except:
(A) unnamed streams specifically described in the schedule of classifications;
(B) unnamed freshwaters tributary to tidal saltwaters will be classified "C"; or
(C) after November 1, 1986, any newly created areas of tidal saltwater which are connected to Class SA waters by
approved dredging projects will be classified "SC" unless case -by -case reclassification proceedings are conducted.
The following river basins have different policies for unnamed streams entering other states or for specific areas of the
basin:
Unnamed
Tributaries
Entering
Other
States or for Specific
Basin
Areas
Hiwassee
River
Basin
Streams
enterin
u Geor!ia
or Tennessee
shall
be classified
"C Tr4"
Little
Basin
River
Tennesse
And
Drama:
Savannah
River
Area
Streams
entering
Georgia
or
Tennessee
shall
be classified
"C Tr." Such
streams
in
the
Savannah
River
drainage
area.
entering
South
Carolina
shall
be classified
"B
r."
French
Basin
Broad
Streams
entering
Tennessee
will
be classified
" .
Watau..a
-
Basin
Streams
entering
the
State
of Tennessee
are
classified
"C."
_
Broad
River
Basin
Streams
entering
South
Carolina
are
classified
"C."
New
River
Basin
Streams
entering
the
State
of
Tennessee
are
classified
"C."
Catawba
River
Basin
Streams
entering
South
Carolina
are
classified
....
Yadkin
Basin
-Pee
Dee River
Streams
classified
entering
'PC."
Virginia
are
classified
"C,"
and
such
streams
entering
South
Carolina
are
Lumber
River
Basin
Streams
entering
South
Carolina
are classified
"C Sw."
Roanoke
River
Basin
Streams
Reservoir
described
Carolina
classification
and
shall
"C
the
cany
and
North
the
B."
Carolina
classification
_
classified
portion
thereto
"B,"
"C."
of
and
streams
Except
all
otherwise
backwaters
tributary
thereto
backwaters
of
Lake
described
not
Gaston
otherwise
and
named
the
North
Kerr
or
usChowan
River
Basin
Streams
entering
Viriinia
are
classified
"C."
Tar -Pamlico
Basin
River
All
canals
drainage
to
Pamlico
canals
Sound
not
noted
and
in
its
the
ba
schedule
s which
shall
are
classified
be classified
"C Sw." except
"SC." _ _
the
main
drainage
Pasouotank
River
Basin
All
drainale
canals
not
noted
in
the schedule
are classified
"C."
INSTRUCTIONS FOR FORM: LASC 06-16
Page 3 of 3

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LAND APPLICATION SITE CERTIFICATION

Division of Water Resources
State of North Carolina
Department of Environmental Quality
division of Water Resources
15A NCAC 02T .1100 — LAND OWNER AGREEMENT
FORM: LOA 06-16
Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted the A licant shall submit one original and two copies of the application and
supporting documentation
For more information, visit the Water Quality Permitting Section ' Non-harge Permitting Unit.
General — This document is an agreement between the Applicant and land owner(s) of residuals receiving sites for land application of
Class B residuals (may include water treatment plant or other type residuals) in accordance with I Soh NCAC 02T .1100. Do not submit
this agreement for review without a corresponding application form (FORM: RLAP 06-16).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Land Owner Agreement (FORM: LOA 06-16):
Z Submit the completed and appropriately executed Land Application Site Certification (FORM: LASC 06.46) form, Please do
not make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to
the application may be made, as long as the attachments are numbered to correspond to the section and item to which they
refer.
Ei Prepare a separate agreement for each set of land application sites that are owned or operated by an entity other than the
Applicant.
� A copy of the completed and appropriately executed agreement must be provided to the landowner and the lessee/operator.
AGREEMENT FOR THE LAND APPLICATION OF RESIDUALS TO PRIVATELY OWNED LAND
The undersigned landowner or his representative hereby permits:
Applicant's name: Beaufort WAVTI)
hereinafter referred to as the Permittee, to land apply residuals from the following facility(ies) onto the following land
application site(s) i.e., see attached setback maps) in accordance with the stipulations and restrictions as given in this
Agreement:
The landowner or his representative receives, in consideration, full use of the nutrient value of the applied residuals while the
Permittee receives, in consideration, the use of the land application site(s) described above for the disposal of the residuals,
This Agreement shall remain in effect for the length of the Division's permit for the residuals land application program and
shall be renewed each time this permit is renewed.
The undersigned landowner or his representative and the Permittee agree to abide with the following restrictions and
stipulations until such time as written notification, given 30 calendar days in advance, modifies or cancels this Agreement.
Site/Field
ID
Lease
(yes/no)
Cropping
Land
Use
or
Patterns
intended
Use
of Crops
Residuals
(optional)
Source
Special
(no-till/over-seedl
pasture)
note
NC-CR-7-3A
N
Row Crop
Animal
Feed
.11111111111111
11111111111111.1111
NC-CR-7-3U
N
Row Crop
Animal
Feed
FORM: LOA 06-16
Page 1 of 3

I. STIPULATIONS:
1. The landowner or his representative shall not enter into any additional residuals application contracts or agreements with another permitted
entity for the site(s) specified by this Agreement.
2. Should the landowner or his representative lease or otherwise permit the use of the land application site(s) to a third pasty, the landowner shall
be responsible to ensure that the third party agrees and complies with the terms and conditions of this Agreement.
3. The landowner or his representative shall adhere to the provisions of this Agreement until all of the site restrictions (under Section II) are met.
4. Notification of cancellation of this Agreement shall be immediately forwarded to NCDENRDWR, Nan -Discharge Permitting Unit, 1617 Mail
Service Center, Raleigh, NC 27699-1617.
S. The Permittee must request and obtain a permit modification from the Division prior to a transfer of the land application site(s) to a new
landowner. In addition, the current landowner shall give a notice to the new landowner that gives ful.! details of the residuals applied at the land
application site(s),
6. The Permit -tee has provided the landowner or his representative with information and data concerning thy residuals lard application program,
including an analysis of constituents of the residuals, residuals application methods, schedules for typical cropping patterns, a description of the
equipment used by the Permittee.
7. The Permittee will provide the landowner or his representative with a copy of the residuals permit prior to commencement of any residuals land
application event and a copy of the results of each soil analysis.
8. If the soil pH of the land application site(s) is not maintained at 6.0 or greater, sufficient amounts of lime shall be applied to achieve a final soil
pH of at least 6.0, unless an agronomist provides information indicating that the pH of the soil, residuals and lime mixture is suitable for the
specified crop.
9. The landowner or his representative and the Permittee will agree on residuals application rates and schedules based on crop patterns, results of
soil samples, and the permitted application limits.
10. The landowner or his representative will provide the Permittee with information regarding the amount and analysis of other sources of nutrients
(e.g., fertilizer, unregulated animal waste, etc.) that have been applied to the land application sites).
11. The landowner or his representative will inform the Permittee of any revisions or modifications to the intended use and cropping patterns for
the land application site(s) prior to each planting season to enable the Permittee to amend this Agreement and schedule residuals land application
events at appropriate periods.
12. Specific residuals land application area boundaries shall be clearly marked on the land application site(s) by the Permittee, the landowner, or
his representative prior to and during a residuals land application event.
13. The landowner or his representative hereby authorizes the Permittee, local officials, and State officials or their representatives to; enter and
inspect any property, premises, or place on or related to the land application site(s) at any reasonable time for the purpose of determining
compliance with the permit; establish monitoring facilities on or near the land application site(s) as required by the permit; copy any records
that must be kept under the terms and conditions of the permit; take necessary leachate, surface water, groundwater, or soil samples during the
term of, and 12 months after termination of, this Agreement.
II. RESTRICTIONS:
1. Appropriate measures must be taken by the Permittee and/or the landowner or his representative to control public access to the land application
site(s) during active use and for the 12-month period following a residuals land application event. Such controls may include the posting of
signs that indicate the activities being conducted at the land application site(s),
2. Animals shall not be grazed on the hand application site(s) fora 3Oday period following a residuals land application event. Land application
sites that are to be used for grazing shall have fencing that will be used to prevent access during these periods after such residuals land application
events.
3. Food crops, feed crops, and fiber crops shall not be harvested for a 30-day period following a residuals hand application event.
4. Food crops with harvested parts that touch the residuals/soil mixture and are totally above the land surface shall not be harvested fora i4month
period fallowing a residuals land application event.
5. Food crops with harvested parts below the surface of the land shall not be harvested fora 20-month period following a residuals land application
event when the residuals remain on the land surface for four months or longer prior to incorporation into the soil.
6. Food crops with harvested parts below the surface of the land shall not be harvested fora 38-month period following a residuals land application
event when the residuals remain on the land surface for less than four months parlor to incorporation into the soil.
7. Turf grown on land where residuals are applied shall not be harvested fora 12-month period following a residuals land application event.
III.ALTERNATIVES FOR WATER SUPPLY WELLS INSIDE THE COMPLIANCE BOUNDARY: (please check one)
15A NCAC 02L .0107(d) prohibits water supply wells within the compliance boundary. However, 15A NCAC 02T .01 QS(h1 allows the compliance
boundary to be placed closer to the waste disposal area, such that the water supply well is situated outside of the compliance boundary provided
the groundwater standards can be met at the newly -established compliance boundary. Please mark one of the following;
A re -defined compliance boundary is needed for field(s) ID:
{Please include the rationale for the requested re -location of the compliance boundary and attach a map showing the newly proposed compliance
boundary to the application package}
El A re -defined compliance boundary is not needed for this site.
IV. ACKNOWLEDGEMENT OF FIELD TRANSFER: (if needed)
❑ The land application field(s) ID: is currently permitted under another
residua.ls land application program; Permit Number WQ: . The land owner hereby acknowledge that by signing this
agreement, he/she is requesting that the fields) be removed from the previously permitted residuals land application program and transferred
into the new program;,
(Name of the new program)
FORM: LOA 06-16 Page 2 of 3

Landowner's Certification:
I certify that I am a deeded landowner of the abovemreferenced land application site(s) and am authorized to make decisions
regarding the use of the hand application site(s) on behalf of other deeded landowners OR that I am otherwise authorized, through
a power of attorney or other legal delegation, to make decisions regarding the use of the land application site(s) on behalf of the
deeded landowners. I certify that the above -referenced land application site(s) are not included in any waste disposal contract or
agreement with another municipality, contractor, or other permitted entity. Furthermore, I certify that I have read this Agreement,
understand the stipulations, restrictions, alternatives for water supply wells inside the compliance boundary, acknowledgement of
field transfer, and do hereby gram permission to the Permittee to land apply residuals to the land application site(s) as specified
herein.
Landowner name:
0,14, 7.:‘, We-4w,-;
Address: k'5 Wa
City: 5ktt4
Gtr
Phone: ZSZi'tl on
Signature:
NORTH CAROLINA,
State:
E-mail address:
cav+ekt+
I, the undersigned Notary Public do hereby certify that
zip ZISTL
Date: i �2 Lot�
COUNTY
Via Pzir
personally appeared before me this day and acknowledged the due execution of the forgoing instrument.
\\TIThESS my hand and official seal this the 1ptj
day of
7
Signature and seal:
1r 41° -,421P+fr•k2i4°.r 2.1
My commission expires: I
Lessee's/Operator's Certification:
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Lessee/operator name:
Address:
City:
State: Zip:
Phone: E-mail address:
Signature:
Permittee's Certification:
Date:
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
-8;_s
r•
Signing official name:
Signatur
£7r dv4/1
FORM: LOA 06-16
Page 3 of 3

Beaufort WWTP - Process Flow Diagram
__� __ _ —.�
aohiaite 0,71`rokf
*,. +_ _i. 41.. ��_____ -- Iron --

State of North Carolina
Department of Environmental Quality
Division of Water Resources
RESIDUALS SOURCE CERTIFICATION
FORM: RSC 06-16
I. RESIDUALS SOURCE -GENERATING FACILITY INFORMATION (See Instruction B.):
1. Facility Names Beaufort WWTP
..... _
2. Facility permit holder is: Federal, State, Local Government, or Private.
Facility permit issued by: El Div. of Water Resources, LI: Div. of Environmental Health,
or rOther (explain: ).
3. Facility contact person and. title: Donovan Willis• Su erintendent
Complete mailing address:
City: Beaufort State: NC Zip: 28516-
Telephone number: (252) 728-71 6
412 Hedrick Street
E-mail address: [e-mail]
4. Facility physical address: 301 Freedom Park Dr
City: Beaufort State: NC
Coordinates: Latitude:
34° 43' 03"
Datum: NAD 84
Method of measurement: Map
S. Purpose of the facility:
treatment of municipal wastewater,
treatment of potable water,
Zip: 285 _____
Longitude:
76° 38' 16"
Level of accuracy: Second
treatment of 100% domestic wastewater,
treatment of 100% industrial wastewater,
treatment of industrial wastewater mixed with domestic wastewater,
(approximate percentages:
other (explain: ).
industrial and % domestic)
6. Does the facility have an approved pretreatment program: Yes No
7. Facility permitted/design flow: 1.5 MGD andfacility average daily flow: 0.77 MOD
8. Average amount of residuals being generated at this facility 73.6 dry tons per year.
9. Specify the following regarding treatment and storage volumes available at the facility:
Type and volume of residuals treatment: Aerobic digesters
Type and volume of residuals storage i.e., outside of residuals treatment units): Cake storage pad — annual residuals
H. RESIDUALS QUALITY INFORMATION (See Instruction C.):
1. Specify if residuals are regulated under:
jzi --------------
Note.: 4OCFRPart257.
Only residuals that are generated during domestic/municipal wastewater treatment processes are regulated under 40
CFR Part 503, otherwise, the residuals are regulated under 40 CFR Part 257.
Z. Specify if residuals are defined under J5AJiCC--..2LLW2L as:
El Biological Non -Biological
Note: Biological residuals are residuals that have been generated during the treatment of domestic wastewater, animal
processing wastewater, or the biological treatment of industrial wastewater (biological treatment is a system that utilizes
biological processes including lagoons, activated sludge systems, extended aeration systems, and fixed film systems).
FORM: RSC 06-16 Page 1 of 5