WQ0003698_Renewal Application_20220110

Non -Discharge Branch Upload/Submittal Form
NORTH CAROLINA
EnWrvnmemfal Qualify
Version 2 - Revised June 23, 2020
Initial Review
Reviewer
Thornburg, Nathaniel D
Is this submittal an application? (Excluding additional information.)*
Yes No
Permit Number (IR) * WQ0003698
Applicant/Permittee City of Marion
Applicant/Permittee Address PO Drawer 700, Marion, NC 28752
Is the owner in BIMS? Yes No Is the facility in BIMS? Yes No
Owner Type Municipal
Facility Name Corpening Creek SDU
County McDowell
Fee Category Minor Fee Amount $0
Is this a complete application?*
Yes No
Signature Authority
Signature Authority Title
Signature Authority Email
Document Type (if non -application)
Email Notifications
Does this need review by the hydrogeologist?* Yes No
Regional Office
CO Reviewer
Admin Reviewer
Complete App Date
Below list any additional email address that need notification about a new project.
Email Address
Comments to be added to email notfication
Comments for Admin
Comments for RO

Comments for Reviewer
Comments for Applicant

Submittal Form
Project Contact Information
Please provide information on the person to be contacted by NDB Staff regarding electronic submittal, confirmation of receipt, and other correspondence.
Name* Tim Horton
Email Address* Phone Number*
[e-mail] 8286528843
Project Information
Application/Document Type *
New (Fee Required)
Modification - Major (Fee Required)
Renewal with Major Modification (Fee
Required)
Annual Report
Additional Information
Other
Modification - Minor
Renewal
GW-59, NDMR, NDMLR, NDAR-1,
NDAR-2
Residual Annual Report
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: *
Permit Number: *
Applicant/Permittee *
Wastewater Irrigation
Other Wastewater
Closed -Loop Recycle
Single -Family Residence Wastewater
Irrigation
City of Marion
WQ0003698
Has Current Existing permit number
Applicant/Permittee Address* PO Drawer 700, Marion, NC 28752
Facility Name* Corpening Creek SDU
Please provide comments/notes on your current submittal below.
High -Rate Infiltration
Reclaimed Water
Residuals
Other
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 Plans, Specifications, Calculations, Etc.)
Permit Renewal--1.10.22.pdf 1.97MB
Upload only 1 PDF document (less than 250 MB). Multiple documents must be combined into one PDF file unless file is larger
than upload limit.
By checking this box, I acknowledge that I understand the application will not be
accepted for pre -review until the fee (if required) has been received by the Non -
Discharge Branch. Application fees must be submitted by check or money order and
made payable to the North Carolina Department of Environmental Quality (NCDEQ).
I also confirm that the uploaded document is a single PDF with all parts of the
application in correct order (as specified by the application).
Mail payment to:
NCDEQ — Division of Water Resources
Attn: Non -Discharge Branch
1617 Mail Service Center
Raleigh, NC 27699-1617
Signature

Submission Date 1/10/2022

CITY
A
I\
P O. Drawer 700
Marion, North Carolina 28752
January 10, 2022
North Carolina Department of Environmental Quality
Division of Water Resources
Water Quality Permitting Section
Non -Discharge Permitting Unit
Dear Sir or Madam:
OFFICE OF THE
WASTE TREATMENT
PLANT SUPERVISOR
Surface Disposal of Residual Solids (503) Permit
WQ0003698 Ground Water Wells
City of Marion
The City of Marion is submitting an application for renewal of permit WQ0003698 for ground water
monitoring associated with a post -closure care program for a surface disposal unit which has been inactive
since 2001 and closed since 2002.
This site has not been utilized for residuals application since 2001, at which time the City moved to land
application of residuals (permit WQ0019960). We have reviewed our files and correspondence since the
most recent renewal in 2017 and competed this request for permit renewal.
A SDR 06-16 is enclosed. Since this permit is for monitor wells for closed residual pits, no RSC form is
attached. Per conversation with Brett Laverty, a new site map is not required. Enclosed is a copy of the
most recent map.
If youhave any questions, please contact me. My email address is �es� ��e and phone
number is [phone]
Thank you in advance for your time and assistance.
Tim Horton
Water and Wastewater Treatment Superintendent
City of Marion

Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .1100 — SURFACE DISPOSAL OF RESIDUALS
INSTRUCTIONS FOR FORM: SDR 06-16 & SUPPORTING DOCUMENTATION
Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted, the Applicant shall submit one original and two copies of the application and
supporting documentation
For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting Unit ivebsite
General — This application is for construction and operation of residuals disposal in a surface disposal unit (landfill) in accordance
with 15A NCAC 02T .1100.
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Application Form (All Application Packages)
• Submit the completed and appropriately executed Surface Disposal of Residuals (FORM: SDR 06-16) form. Please do not
make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to the
application may be made, as long as the attachments are numbered to correspond to the section and item to which they refer.
• The project name should be consistent on the plans, specifications, etc.
• The Applicant's Certification on Page 3 of this form shall be signed in accordance with 15A NCAC 02T .0106(b). An
alternate person may be designated as the signing official if a delegation letter is provided from a person who meets the
criteria in I5A NCAC 02T _0106(b).
❑ If this project is for a modification of an existing permit, submit one copy of the existing permit.
0 Please submit this application form at least 180 days prior to the expiration date on the existing permit, or 90 days prior to
operation of proposed facility(ies) for application packages involving new or changes to treatment and storage units.
B. Application Fee (Not required for permit renewal without modification)
• Submit a check, money order or electronic funds transfer made payable to: North Carolina Department of Environmental
Quality (NCDEQ).
Facility Classification New Permit Major Modification 1
$395
for disposal > 3,000 dry tons/year) $245
permitted
Major (residuals
Minor (residuals permitted for disposal < 3,000 dry tons/year)
$1,310
$810
- A major modification shall be defined as any permit modification that: increases the disposed residuals dry tonnage; adds
additional residuals sources; adds new disposal areas, or includes the addition of new treatment or storage units/processes not
previously permitted. There is no fee for minor permit modifications.
C. Cover Letter (All Application Packages)
❑❑ List all items included in the application package, as well as a brief description of the requested permitting action.
INSTRUCTIONS FOR FORM: SDR 06-16
Page 1 of 3

D. Detailed Plans and Specifications (Not required for permit renewal without modification)
❑ ❑ Submit detailed plans and specifications that have been signed, sealed, and dated by a NC Professional Engineer per
15A NCAC 02T .1104(a). Specifications for standard equipment may only be omitted for municipalities with approved
standard specifications, but use of the standard specifications must be noted on each sheet of the plans.
❑❑ Plans must include the following minimum items: a general location map, a topographic map, plan and profile view
of the residuals treatment and surface disposal units as well as the proximity of the residuals treatment and surface disposal
units to other utilities and natural features within 500 feet of all treatment and surface disposal units, and detail drawings of
all items pertinent to the residuals treatment and surface disposal units. Depict minimum separations required in I5A NCAC
02T .1108(a) on the plans.
El Specifications must include, at a minimum, the following for all items pertinent to residuals treatment and surface disposal
units: description of materials to be used, methods of construction, quality of construction testing procedures to ensure the
integrity of the final product in accordance with I5A NCAC 02T .1104(a)(2)(B), including leakage and pressure testing as
appropriate.
Plans and specifications must not be labeled with preliminary phrases (e.g., FOR REVIEW ONLY, NOT FOR
CONSTRUCTION, etc.) that indicate that they are anything other than final plans and specifications. However, the plans
and specifications may be labeled with the phrase: FINAL DESIGN — NOT RELEASED FOR CONSTRUCTION.
E. Site Map (All New or Renewal Packages)
Submit a site map that must include the following minimum items: plan views of the residuals treatment and surface
disposal units as well as the proximity of the residuals treatment and surface disposal units to other utilities and natural
features, and detail drawings of all items pertinent to the residuals treatment and surface disposal units. Depict minimum
setbacks required in 15A NCAC 02T .1.108(c) on the plans.
F. Engineering Calculations (Not required for permit renewal without modification)
❑ Submit all design calculations that have been signed, sealed, and dated by a NC Professional Engineer per 15A NCAC 02T
.1104(e).
G. Soils Reports (Not required for permit renewal without modification)
❑ Submit all required soils information that are prepared, signed, and sealed by a NC Licensed Soil Scientist and in accordance
with I5A NCAC 02T .1104(e)(3).
H. Hydrogeologic Investigations (Not required for permit renewal without modification)
El Submit a detailed hydrogeologic evaluation in accordance with 15A NCAC 02T .1 I04(cl)(4) and current Division Policy
available at: http://www.ncwater.org/Rules Policies and Regulations/. The document shall be signed, sealed and dated by a
qualified professional.
I. Environmental Assessments (May be Required — See 15A NCAC IC .0300)
❑ ❑ Submit a copy of the Findings of No Significant Impact (FONSI) or Environmental Impact Statement (EIS). Also,
include information on any mitigating factor(s) from the Environmental Assessment (EA) that impact the construction of the
residuals treatment and storage facilities. An EA may also be required for private systems if any public funds and/or lands
are used for the construction of the subject facilities.
J. Property Ownership Documentation (All New or Modification Application Packages involving new surface disposal site)
❑ Property ownership documentation shall consist of one of the following:
❑ Legal documentation of ownership (i.e., GIS, deed or article of incorporation), or
❑ Written notarized intent to purchase agreement signed by both parties with a plat or survey map, or
❑ An easement running with the land specifically indicating the intended use of the property and meeting the requirements
of 15A NCAC 02L .0107(0, or
❑ A written notarized lease agreement signed by both parties, indicating the intended use of the property, as well as a plat or
survey map.
K. Operation and Maintenance Plan (New and Renewal Application Packages)
❑❑ For Modification Application, if there are any changes to the existing plan, submit an updated O&M plan.
❑ ❑ Submit the O&M Plan in accordance with 15A NCAC 02T , 1 1 10 and include at a minimum:
❑❑ Operational functions; describe the operation of the program to show what operations are necessary for the program to
function and by whom the functions are to be conducted.
❑ ❑ Maintenance schedules; may include equipment calibration, maintenance of signs, etc.
❑❑ Safety measures; may include safety training program, manuals, signs, etc.
❑ ❑ Spill response plan; including control, containment, remediation, emergency contact information, etc.
❑❑ Inspection plan including the following information;
❑❑ Names and titles of personnel responsible for conducting the inspections.
INSTRUCTIONS FOR FORM: SDR 06-16 Page 2 of 3

❑❑ Frequency and location of inspections, including those to be conducted by the ORC, and procedures to assure that the
selected location(s) and inspection frequency are representative of the residuals management program.
❑❑ Detailed description of inspection procedures including record keeping and actions to be taken by the inspector in the
event that noncompliance is observed.
❑❑ Sampling and monitoring plan including the following information;
❑❑ Names and titles of personnel responsible for conducting the sampling and monitoring.
❑❑ Detailed description of monitoring procedures including parameters to be monitored.
❑❑ Sampling frequency and procedures to assure that representative samples are being collected. Fluctuation in
temperature, flow, and other operating conditions can affect the quality of the residuals gathered during a particular
sampling event. The sampling plan shall account for any foreseen fluctuations in residuals quality and indicate the most
limiting times for residuals to meet pathogen and vector attraction reduction requirements (e.g. facilities that land apply
multiple times per year but have an annual sampling frequency, may need to sample during winter months when pathogen
reduction is most likely to be negatively affected by cold temperatures.
ONE ORIGINAL AND TWO COPIES OF THE COMPLETED APPLICATION PACKAGE, INCLUDING ALL
SUPPORTING INFORMATION AND MATERIALS, SHALL BE SENT TO THE FOLLOWING ADDRESS:
NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF WATER RESOURCES
WATER QUALITY PERMITTING SECTION
NON -DISCHARGE PERMITTING UNIT
By U.S. Postal Service:
1617 MAIL SERVICE CENTER
RALEIGH, NORTH CAROLINA 27699-1617
TELEPHONE NUMBER: [phone]
By Courier/Special Delivery:
512 N. SALISBURY STREET
RALEIGH, NORTH CAROLINA 27604
FAX NUMBER: [phone]
Page 3 of 3
INSTRUCTIONS FOR FORM: SDR 06-16

I. APPLICANT INFORMATION:
1. Applicant s name: City Of Marion
Applicant type: ❑❑❑ Individual
❑❑ Privately -Owned Public Utility
❑❑❑❑ Corporation ❑❑❑❑ General Partnership ❑❑
❑❑❑❑ Federal ❑❑❑❑ State ❑❑ Municipal
County
Signature authority's name per 15A NCAC 02T .0106: J. RobertBoyette Title: City Manager
Applicant's mailing address: PO Drawer 700
City: Marion State: NC Zip: 28752-
Telephone number: [phone] Email Address: bboyettena,marionnc.org';
2. Consultant's name: License Number (for P.E.):
Affiliation:LIE] On Staff ❑❑ Retained (Firm: )
Consultant's mailing address:
City: State: Zip: -
Telephone number: (_ Email Address:
3. Soil Scientist's name: License Number:
Affiliation: DE N/A ❑❑ On Staff ❑❑ Retained (Firm: ! )
Soil Scientist's mailing address:
City: State: Zip: -
Telephone number: (_) Email Address:
4. Fee submitted: $0.00! (See Instruction B)
II. PERMIT INFORMATION:
1. Application is for (check all that apply): ❑❑❑ new, ❑❑❑ modified, ®❑❑ renewed
permit
2. If this application is being submitted to renew or modify an existing permit, provide the following:
Permit number: WQ0003698
Date of most -recently issued permit: 8.1.2017'
Date of most -recently certified Attachment A (if different than the permit):
Date of most -recently certified Attachment B (if different than the permit):
III. FACILITY INFORMATION:
1. Name of residuals disposal facility: City of Marion
City: Marion
Coordinates:
Datum:
Latitude: 35- 39' 14"
State: NC- Zip: 28752-
Longitude: 81 57' 49"
Level of accuracy:
Method of measurement:
County where facility is located: McDowell
2. Facility contact (person familiar with residuals preparation/disposal):
Name: Tim Horton Title: Superintendent
FORM: SDR 06-16
Page 4 of 3

Mailing address: PO Drawer 700
City: Marion
State: NC Zip: 28752-
Telephone number: [phone] E-mail address: thortonamarionnc.org
IV. PROJECT INFORMATION (This section is not required for permit renewal without modification):
1. If project disturbs more than one acre, provide date when an erosion and sedimentation control plan was submitted to the
Division of Land Resources for approval:
2. If project includes any stream or wetland crossings, provide date when Nationwide 12 or 404 permit was submitted for
approval:
3. Provide buffers used to maintain compliance with any applicable river basin rules in 15A NCAC 2B .0200 (e.g., Neuse River
basin buffer rules):
3. Estimated volume of residuals to be disposed at the facility: (dry tons/year).
4. 100-year flood elevation " : feet mean sea level. Source:
5. Specify whether the surface disposal unit(s) located:
a. within the 100-year floodplain? ❑ yes or ❑ no
b. in a seismic impact zone? ❑ yes or ❑ no
c. less than 60 meters from a fault that has displacement in Holocene time? ❑ yes or ❑ no
d. within an unstable area? ❑ yes or ❑ no
6. Does the surface disposal unit(s) restrict base flood (100-year flood) flow? ❑ yes or ❑ no
7. Please provide a description of the surface disposal unit(s) (e.g. lagoons, monofil, etc.):
8. Depth of the seasonal high water table: feet.
9. Vertical distance between bottom of the disposal unit to the seasonal high water table: feet. The Division requires a
minimum of three (3) foot separation.
10. Explain how access to the treatment and disposal units, by both human and animals, will be controlled:
11. Describe how runoff will be -collected and disposed (The runoff collection system must have the capacity to handle runoff
from a 24-hour, 25-year storm event):
12. Describe the liner for the proposed or existing disposal unit (Attach all construction and design specifications):
13. Describe the leachate collection or decanting system for the disposal unit (Attach all construction and design specifications):
V. RESIDUALS SOURCE INFORMATION: (Required for all new, renewed, or modified residuals source)
Complete and submit the attached Residuals Source Certification and all associated documentation
Residuals Source
Certification
Professional Engineer's Certification: (Application Involving New or Changes to Treatment or Surface Disposal Units)
FORM: SDR 06-16
Page 5 of 3

Professional Engineer's Certification: (Application Involving New or Changes to Treatment or Surface Disposal Units)
1,
attest that this application for
has been reviewed by me and is accurate and complete to the best of my knowledge. 1 further attest that to the best of my knowledge
the proposed design has been prepared in accordance with the applicable regulations. Although certain portions of this submittal
package may have been developed by other professionals, inclusion of these materials under my signature and seal signifies that I have
reviewed this material and have judged it to be consistent with the proposed design.
North Carolina Professional Engineer's Seal, Signature, and Date: n 1 © _ (—/ 0s Jf C— CG /
r S v
Applicant's Certification:
fhe applicant or any affiliate has not been convicted of an environmental crime, has not abandoned a wastewater facility without proper
closure, does not have an outstanding civil penalty where all appeals have been exhausted or abandoned, are compliant with any active
compliance schedule, and do not have any overdue annual fees under Rule 15A NCAC 02T .0105.
Yes D No, Explain;
(Signatu
attest that this application for
tority's Name — PLEASE PRINT) ' (Title
(
acility Name)
/G
has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that the Division of Water Resources
may not conduct a technical review of this program and approval does not constitute a variance to any rules or statutes unless specifically
granted in the permit. Further, any discharge of residuals to surface waters or the land will result in an immediate enforcement action,
which may include civil penalties, injunctive relief, and/or criminal prosecution. I will make no claim against the Division of Water
Resources should a condition of this permit be violated. I also understand that if all required parts of this application are not completed
and that if all required supporting information and attachments are not included, this application package will be returned to me as
incomplete.
:Note: In accordance with North Carolina General Statutes § 143-215.6A and §143-215.6B, any person who knowingly makes any false
statement representation, or certification in any application shall be guilty of a Class 2 misdemeanor, which may include a fine not to
exceed $10,000 as well as civil penalties up to $25,000 per violation.
Signatu
FORM: SDR 06-16
Date:
Page 3 of 3

Operation and Maintenance Plan
For the City of Marion
Surface Disposal of Class B Residuals Permit
December 2021
1

Table of Contents
Table of Contents 2
Information 3
Purpose of this Plan 3
Scope of the Operations and Maintenance Plan Error! Bookmark not defined.
Operational Functions 3
Maintenance Schedules 3
Safety Measures 4
Inspection Plan 4
Surface Runoff Prevention 5
Vegetative Cover 5
Reporting 5
Figure 1 Location of the Four (4) Monitoring Wells Sites 6
Figure 2 City Of Marion Monitoring Well Site Inspection Form .7
2

Information
This Operation and Maintenance Plan (O&M Plan) was prepared in accordance with Section III
(Operation and Maintenance Requirements) of the Surface Disposal of Class B Residuals Permit
issued to the City of Marion, effective August 2, 2017 and 15A NCAC 02T.1100. The Plan refers
to the post -closure care program for the surface disposal unit, which consists of 10 pits and has
been inactive since 2001 and was closed in 2002. All residuals disposed of in the surface disposal
unit were generated by the City of Marion's Corpening Creek WWTP (NPDES Permit No.
NC0031879) and Catawba River WWTP (NPDES Permit No. NC0071200). In 2001, monitoring
wells were installed as part of the post -closure care program for the surface disposal unit.
II. Purpose of this Plan
The purpose of this plan is to describe the O&M of the closed surface disposal unit as requested
by the Division of Water Resources. Maintaining an adequate and functioning O&M program
throughout the life of the surface disposal unit is critical to maintaining environmental health.
The scope of the Operations and Maintenance Plan for the City of Marion is outlined
below:
• Operational Functions
• Maintenance Schedules
• Safety Measures
• Inspection Plan
• Surface Runoff Prevention
• Vegetative Cover
• Reporting
IV. Operational Functions
It is the responsibility of the City of Marion Wastewater Treatment Plant (WWTP) Superintendent
to maintain and operate this residual management program at all times. The inspection team will
conduct thorough, routine inspections of the Four (4) monitoring wells. All inspections will be
documented using "City of Marion Monitoring Wells Inspection Report", Figure 2, in this
document. It will include descriptions of any problems found and the remedial actions taken to
correct problems. Problems found will be remedied as soon as possible. Inspection records will be
maintained at the WWTP located on NC Hwy 226S.
V. Maintenance Schedules
Routine maintenance activities are necessary to ensure the long-term integrity of the natural
groundwater in Marion, NC. The routine and preventive maintenance program ensures properly
maintained monitoring wells sites. The established maintenance plan is as follows:
3

Typical Routine and Preventive Maintenance Activities and Frequency
Component
Items 1-8 Refer to Each Well
Activity
Frequency
Required
Maintenance
Public Access Control Entrance
Gate
Inspection for
Lock/Signage
Quarterly
Comments:
Y or N
1.
Pad Locked
Inspection
Quarterly
Comments:
Y or N
2.
Surrounding Area — Mowed,
Vegetative Cover/trees, roots,
Animal burrows
Inspection
Quarterly (Mowing as
required)
Comments:
Y or N
3.
Signage for Monitoring Wells
Inspection
Quarterly
Comments:
Y or N
4.
Soil Cap Erosion or
depressions in soil cap
Inspection
Quarterly
Comments:
Y or N
5.
Surface Area Runoff
Inspection
Quarterly
Comments:
Y or N
6.
Semi Annual Sampling
Testing
Semi -Annually
(May/November)
Comments:
Y or N
7.
Safety — Any issues?
Inspection
Quarterly
Comments:
Y or N
8.
Methane Monitoring
Testing
Semi -Annually
(May/November)
Comments:
Y or N
VI. Safety Measures
The City of Marion will maintain the Four Existing (4) monitoring wells such that they are well
marked, locked, and in good working order. The structural integrity of the monitoring well casing,
soil cap, and well cap will be maintained in such a way as to prevent surface water and contaminants
from the surface from entering the well. There will be no public access to these well sites. The
entrance located off S.R. 1819 will be padlocked at all times. No trespassing signs are posted at gate.
VII. Inspection Plan
The chain of command below shows the responsibility for conducting inspections. Under the direct
supervision of the WWTP Superintendent, the field personnel will conduct the inspections. Possible
field personnel will include, but not be limited to, the following:
Tim Horton, WWTP Superintendent
thortongmarionnc.org
[phone]
Doug Mackey, WWTP Chief Operator
[e-mail]
[phone]
Joe Ward, WWTP Maintenance Supervisor
[e-mail]
[phone]
4

Additional WWTP personnel will also be involved in the inspections as required. The O&M plan
includes scheduling maintenance activities (see Section V) to minimize damaging effects to
disposal units' performance. This O&M plan presents information based on the system design as of
the present date. This plan will be updated or revised when relevant or substantive changes are made
to the operating.
VIII.'' Surface Runoff Prevention
Surface Runoff Prevention will be maintained as needed for these four (4) monitoring well sites.
Presently, there is no surface runoff on these sites.
IX. Vegetative Cover
A protective vegetative cover will be maintained on the surface disposal units at all times. No large
trees, shrubs, or other woody vegetation is allowed on the surface of the units. Mowing will occur
quarterly as shown in section V.
X. Reporting
It is the responsibility of the WWTP division of the City of Marion Public Works Department to
maintain and operate this residual management program at all times. A copy of the NC Environmental
Management Commission, Department of Environmental Quality Surface Disposal of Class B
Residuals Permit and this Operation & Maintenance Plan shall be maintained on site at the City of
Marion Wastewater Treatment Plant located on Hwy 226S.
5

Figure 1 Location of the Four (4) Monitoring Wells Sites.
6

CITY OF MARION MONITORING WELL
Name of Inspector(s):
Date of Inspection:
SITE INSPECTION FORM
Purpose of Inspection: Routine Well Sampling Methane Monitoring
Time on Site:
Time off Site:
Weather Conditions:
A. Inspection checklist
COMPONENT
PRESENT
(Circle Response)
COMMENTS
Entrance Gate Locked
Yes or No
Entrance Gate Signage
Yes or No
Crushed Stone Roadbeds
Acceptable or Poor
MONITORING WELLS
MW1
MW2
MW3
MW4
Cap Pad
Locked
Yes or No
Yes or No
Yes or No
Yes or No
MW S1RROUNDING AREAS
(INCLUDING
ALL PIT SOIL CAPS)
Mowed
Yes or No
Yes or No
Yes or No
Yes or No
Vegetative
Cover
Yes or No
Yes or No
Yes or No
Yes or No
Trees, bushes,
etc. present?
Yes or No
Yes or No
Yes or No
Yes or No
Animal
burrows
Yes or No
Yes or No
Yes or No
Yes or No
Signage for
Wells
Yes or No
Yes or No
Yes or No
Yes or No
Any Soil Cap
Erosion?
Yes or No
Yes or No
Yes or No
Yes or No
Any Significant
Depressions in
Soil Cap?
Yes or No
Yes or No
Yes or No
Yes or No
Any Surface-
Area Runoff
Yes or No
Yes or No
Yes or No
Yes or No
Semi-annual
Sampling
Yes or No
Yes or No
Yes or No
Yes or No
Any Safety
Issues
Yes or No
Yes or No
Yes or No
Yes or No
Methane
Monitoring
Yes or No
Yes or No
Yes or No
Yes or No
7

B. Description of further action requirements
1. Location:
2. Recommendations:
3. Corrective Actions: (If corrective actions are necessary, record the date
corrective actions were made)
*Continue listing for additional action requirements. Use additional sheets if more
room is needed.
FIGURE 2
8

NOTES
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D.B. 519, PG. 961
LONGITUDE = 815749.1069
NORTHING S (21 221507 M)
FASTING =1,119.727.1085V (341,293.030 m)
ET CENTERLINE 0
ELL
es a. Tl wM?: f,6 s555Tez• E—
SHIELEY ANN MCEINNEY. ET CON.
D.B. 392. PG. 713
\
OM.H. 366.ALCOLM G. FOX
P0. 220
ADDITIONAL LEGEND
R NCDOT AR/VI MONUMENT
SPIKE0 RAILROAD 0 PUNCHMARKON CONCRETE SLAB
O 5/6' RE9AR SET
SURVEY OF A PORTION OF THAT PROPERTY DESCRIBED IN A DEED TO
TOWN OF MARION, NORTH CAROLINA
DEED BOOK 93, PAGE 269
SHOWING LOCATION OF MONITORING WELLS AND OF FLAGS PLACED BY CITY AT CORNERS OF SLUDGE PITS
AND BEING THE OLD CITY LANDFILL
SEE ALSO DEED BOOK 766, PAGE 947
15-055
6-148R
3-166
9T E REIIVENiHECONNAC C CONTACTPERSONC1111TH0 THE ECITYHOF MARION WAS T LARRY
CARLER
AT THE WASTE WATER TREATMENT
• ELEVATIONS WERE DETERMINED BY TRIGONOMETRIC MEANS
AND ARE MONUMENT
ON THE PUBLISHED ELEVATION OF
NCCS 'LEMON lR IS 431.15
METERS ) OR 1414.5(
ERTY AND WERE NOT RESURVEYED ON THIS OCCASION.
ALL BEARINGS FRC., 1988 SURVEY HAVE BEEN ROTATED
AND TRANSLATED TO N.C. GRID.
AREA OF ENTIRE TRACT PER 1988 SURVEY WAS 6135
R II LAi MEEFIGaLL STATUTORY RE-
QUIREMENTS RECORDING.P
RENEVY OFFICER
FILED R RECORD IN THE cDOWELL COUNTY REGISTER OF
EEDS DFOFFIC /PM PM ON LIVE
,20- _ & RECORDED IN BOOK_ __ PAGE__.
LEGEND
❑ MONUMENT
0• EXISTING IRON PIPE (NOW OR FORMERLY)
® TE mONVMErvi
• PoNITOG WELL
PIN FLAGS OUTLINING SLUDGE PITS
UNMARKED POINT
HARDWOOD TREE CORNER
opPINE CORNER
O RAILROAD SPIKE SET - HORIZONTAL CONTROL
MONUMENT M. TBM,
6 UTILITY POLE -LOCATION OF METHANE MONITER
LINES SURVEYED 2006 SURVEY
LINES SURVEYED 1988 SURVEY
VICINITY MAP
n ¢errnro oxun[x.4tapmo auM MmXesiv� xor e[ coxsmsRto
R.L GREENE SURVEYING AND MAPPING
ne (82a)652-3220
survey CITY OE MARION
e00xee. HIGGINS TOWNSHIP
MCDOWELL COUNTY NORTH CAROLINA
Ted. 81.81.,TOSL
Le.. 12/9/03
300 150 0
300
600
900

R.L GREEN, SURVEYING 050 GINEERING, PA, 0-761
61 g street, Marion Nortn cor(ge)628752220EN
UNIVERSAL FUR . USTRIEB
N��.B. 512, PG. 96
SURVEY OF A PORTION OF THAT PROPERTY DESCRIBED IN A DEED TO
TOWN OF MARION, NORTH CAROLINA
DEED BOOK 93, PAGE 269
SHOWING LOCATION OF MONITORING WELLS AND OF FLAGS PLACED BY CITY AT CORNERS OF SLUDGE PITS
AND BEING THE OLD CITY LANDFILL
SEE ALSO DEED BOOK 766, PAGE 947
15-055
6-148R
3-166
Pt.No. Code
164
16]
169
199
174
North East 81evotion Desc
704321i5]] 1120724.438
704335,598 1120705 094
7043..214 1120688.011
704361.960
20g..42i5
704488.252 1120556.232 04450.914 1120628.847
20.500 tt20655.80]
704405.715
]04026-24] 1120683,120
704390.678 1120726.183
YF
YF
182
12
187
193
194
195
207
208
09
20
215
221
224
225
226
227
230
231
234
242
243
246
2.
249
254
1120795.839
112080,370
704369,867 1120824.699
1120828.779
704473,312 i1
20]6912 7;
704453,341
]044139.60fi 1120]]3,461 2
.868 954 vF2
705114.398 1120272,174
705118.157 t1120235 ]66 YF3
705104,540 1120196.628
705042.553 1120194.244 vF3
022.33
705054360 1120271.860
]05t]2 8]0 112030231
705183.239 9,586
705191.975 030,861
705195.384 1120287_164
705483_346 1119984.636
705496.355 1119957_185
05506.039 1119961.570
705506.361 1120026 024
255
256
278
259
260
054..380 1119921.352
705477.788 1119900,696
705469,232
297
fl052 119866�429
705467,171 1119857.963
705466.818
vF6
rF
rrFF
300 150 0
300
600
900