WQ0010528_Residual Annual Report 2021_20220318

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Non-Discharge Branch Upload/Submittal Form
NORTH CAROLINA
Environment N Qmilelr
Version 2-Revised June 23,2020
Initial Review
Reviewer Thornburg,Nathaniel D
Is this submittal an application?(Excluding additional information.)*
Yes No
If not an application what is the submittal type?* Annual Report
Residual Annual Report
Additional Information
Other
Annual Report Year* 2021
Permit Number(IR)* WQ0010528
Applicant/Permittee Town of Ramseur
Email Notifications
Does this need review by the hydrogeologist?* 0 Yes OO No
Regional Office Winston-Salem
CO Reviewer
Admin Reviewer

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* Terry Lewallen
Email Address* Phone Number*
[e-mail] 336-824-3939
Project Information
Application/Document Type* New(Fee Required) Modification-Minor
Modification-Major(Fee Required) Renewal
Renewal with Major Modification(Fee GW-59, NDMR,NDMLR, NDAR-1,
Required) NDAR-2
Annual Report Residual Annual Report
Additional Information Change of Ownership
Other
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:* Wastewater Irrigation High-Rate Infiltration
Other Wastewater Reclaimed Water
Closed-Loop Recycle Residuals
Single-Family Residence Wastewater Other
Irrigation
Permit Number:* WQ0010528
Has Current Existing permit number
Applicant/Permittee Address* PO Box 545,Ramseur,NC 27316
Facility Name* Town of Ramseur SDU
Please provide comments/notes on your current submittal below.
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.)
annual sludge disposal report 2021.pdf 2.72MB
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
.t
Submission Date 3/18/2022

NCDENR DWR
+. >;:,tv.a;4i1• Water Quality Permit Section
Non-Discharge Permitting Unit
Information Processing Unit
60 Floor, Division of Water Resources
1617 Mail Service Center
Ramseur Raleigh, NC 27699-1617
Where Foray and Friends Meet The Town of Ramseur surface disposed of 51.11 dry tons of
,4,- 1 water and wastewater plant sludge in 2021. Ramseur used
lime stabilization to meet pathogen reduction and vector
attraction requirements. The facility was compliant during
the past calendar year with all conditions of the land
application permit issued by the Division of Water
TOWNOF Resources.
RAMS EU R The 2021 Annual Sludge Disposal Report for the Town of
Ramseur is attached, It includes the following:
2021 • CLASS A ANNUAL DISTRIBUTION AND MARKETING/
SURFACE DISPOSAL CERTIFICATION AND SUMMARY
FORM
Annual • WWTP ANNUAL RESIDUAL SAMPLING SUMMARY
FORM
Sludge • Environment 1 Lab Results & Associated Data/Forms
• SGS North America Lab Results & Associated
Disposal Data/Forms
• WTP ANNUAL RESIDUAL SAMPLING SUMMARY FORM
Report • Environment 1 Lab Results & Associated Data/Forms
• SGS North America Lab Results & Associated
Data/Forms
• ANNUAL PATHOGEN AND VECTOR ATTRACTION
REDUCTION FORM (02T Rules)
PERM1TTEE / PREPARER • WWTP Lime Log Sheet
Town of Ramseur • WTP Sludge Disposal Record
Vicki Caudle • WTP Vehicle Inspection Forms
P.O. Box 545
724 Liberty St,
Ramseur, NC 27316
336-824-8530
Terry Lewallen
336-824-3939
[e-mail]

ANNUAL RESIDUAL SAMPLING SUMMARY FORM
Attach this form to the corresponding Annual Report
Please note that your permit may contain additional parameters to be analyzed than those required to be summarized on this form.
Permit Number: WQ0010528 Laboratory: 1) Environment 1
Facility Name: Town of Ramseur 2) SGS Accutest
NPDES # or NCG5490019 3)
WQ#:
4)
WWTP Name: Ramseur Water Treatment Plant 5)
Residual Analysis Data
Sample or 3/18/21
Composite Date
Percent Solids 4.53
Arsenic <2.5
Cadmium N/A
Chromium <5.0
o Copper N/A
Lead N/A
a;
E Mercury N/A
ro
Molybdenum N/A
Nickel 10
_
Selenium _ N/A _
rya
Zinc N/A
Total Phosphorus N/A
TKN N/A
Ammonia-Nitrogen N/A
Nitrate and Nitrite N/A
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system
designed to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are
significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
C,/
Signature of Pireparer Date
r I KID rnonn DCCC /Cr'rtr 9\

ANNUAL RESIDUAL SAMPLING SUMMARY FORM
Attach this form to the corresponding Annual Report
Please note that your permit may contain additional parameters to be analyzed than those required to be summarized on this form.
Permit Number: WQ0010528 Laboratory: 1) Environment 1
Facility Name: Town of Ramseur 2) SGS North America
NPDES # or NCG0026565 3)
WQ#:
4)
WWTP Name: Ramseur Waste Water Treatment Plant 5)
Residual Analysis Data
Sample or 12/9121 I
Composite Date
.: Percent Solids 0.53
Arsenic <2.5
Cadmium N/A
Chromium 14
d Copper N/A
'I Lead N/A
EMercury N/A
Molybdenum N/A
Pi
Nickel 15
g Selenium N/A
r. Zinc N/A
Total Phosphorus N/A
TKN N/A
Ammonia-Nitrogen N/A
Nitrate and Nitrite N/A
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system
designed to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are
significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
Signature(of Preparer Date

ANNUAL PATHOGEN AND VECTOR ATTRACTION REDUCTION FORM
Facility Name: Town of Ramseur Permit Number: WQ0010525
WWTP Name: Ramseur WWTP NPDES Number: NC0026565
Monitoring Period: From 1/1/2021 To 12/31/2021
Pathogen Reduction (40 CFR 503.32) - Please indicate level achieved and alternative performed:
Class A: Alternative 1 0 Alternative 2 ❑ Alternative 3 ❑
Alternative 4❑ Alternative 5 ❑ Alternative 6 0
If applicable to alternative performed (Class A only) indicate "Process to Further Reduce Pathogens":
Compost ❑ Heat Drying❑ Heat Treatment LI Thermophilic ❑
Beta Ray ❑ Gamma Ray❑ Pasteurization ❑
Class B: Alternative 1❑ Alternative 2 it Alternative 3 ❑
If applicable to alternative performed (Class B only) indicate "Process to Significantly Reduce Pathogens":
Lime Stabilization El Air Drying❑ Composting ❑ Aerobic Digestion LI
Anaerobic Digestion❑
If applicable to alternative performed (Class A or Class B) complete the following monitoring data:
Allowable Level Pathogen Density Number of Frequency Sample Analytical
Parameter Tech-
in Sludge Excee- of g Minimun_Geo. Mean Units deuces Analysis Type ni4ue
2 x 10 to the 6th
power MPN per
gram of total
solids or 2 x 10 to
Fecal Colifortn the 6th power
CFU per cram of
1000 mpn per
cram of total solid
(dry weight)
Salmonella bacteria 3 MPN per 4
(in lieu of fecal grams total solid
coliform) (dry weight)
Vector Attraction Reduction (40 CFR 503.33) - Please indicate option performed:
Option 1 ❑ Option 2 ❑ Option 3 ❑ Option 4 LI Option 5 0
Option 6 Ea Option 7 LI Option 8 ❑ Option 9 LI Option 10 ❑
No vector attraction reduction options were performed ❑
CERTIFICATION STATEMENT (please check the appropriate statement)
Et "I certify, under penalty of law, that the pathogen requirements in 40 CFR 503.32 and the vector
attraction reduction requirement in 40 CFR 503.33 have been met."
❑ "I certify, under penalty of law, that the pathogen requirements in 40 CFR 503.32 and the vector
attraction reduction requirement in 40 CFR 503.33 have not been met." (Please note if you check
this statement attach an explanation why you have not met one or both of the requirements.)
"This determination has been made under my direction and supervision in accordance with the
system designed to ensure that qualified personnel properly gather and evaluate the information
used to determine that the pathogen and vector attraction reduction requirements have been met. I
am aware that there are significant penalties for false certification including fine and imprisonment."
Terry Lewallen
Preparer Name and Title (type or print) Land Applier Name and Title (if applicable)(type or print)
LJE- i 7 2
Signature j f Preparer Date Signature of Land Applier(if applicable) Date
DENR FORM RF (5/2003)

ANNUAL DISTRIBUTION AND MARKETING/SURFACE DISPOSAL CERTIFICATION AND SUMMARY FORM
PERMIT #: WQ0010528 FACILITY NAME: Town of Ramseur
PHONE: [phone] COUNTY: Randolph OPERATOR: Terry Lewallen
FACILITY TYPE (please check one): Surface Disposal (complete Part A (Source(s) and "Residual In" Volume only) and Part C)
❑ Distribution and Marketing(complete Parts A, B, and C)
Was the facility in operation during the past calendar year? Del Yes ❑No No If No skip parts A, B, C and certify form below
Part A*: Part B*:
Sources s include NPDES # if Volume (dry tons) Recipient Information
Month ( ) ( Amendment/ Volume (dry
applicable) Bulking Agent Residual In Product Out Name(s) tons) Intended use(s)
January
February
March WTP-NCG590019 0 51 51
April WWTP-NC0026565 0.03 0.08 0.11
May
June
July
August
September
October
November
December
Totals: Annual (dry tons): 0.03 51.08 5I.11 0
Amendment(s) used: Bulking Agent(s) used:
* If more space than given is required, please attach additional information sheet(s). LI Check box if additional sheet(s) are attached
Part C:
Facility was compliant during calendar year _1) 6): , with all conditions of the permit (including but not limited to items 1-3 below) issued by the
Division of Water Resources. NI Yes ❑ No If No, please provide a written description why the facility was not compliant.
1. All monitoring was done in accordance with the permit and reported for the year as required and three (3) copies of certified laboratory results are attached.
2. All operation and maintenance requirements were compiled with or, in the case of a deviation, prior authorization was received from the Division of Water
Resources.
3. No contravention of Ground Water Quality Standards occurred at a monitoring well.
"I certify, under penalty of law, that the above information is, to the best of my knowledge and belief, true, accurate and complete. I am aware
that there are significant penalties for submitting false information, including the p ssi ihty of fines and imprisonment for knowing violations."
Signature of Permittee Date Signature cif Preparer** Date
(if different from Permittee) **Preparer is defined in 40 CFR Part 503.9(r)
DENR FORM DMSDF (11/7nnr)

•
Month pi-t I LIME LOG SHEET
Year 202 r
DATE 7 -7
pH Correction
GAL.WASTED Temp°C Correction
3L v 40 Plus 0.45
Initial TEMP°C
f-I= 39 Plus 0.42
Initial pH,5U 1 38 plusu.33
37 Plus 0.36
1 36 Pius 0,33
LBS OF LIME
35 Plus 0.30
TIME - 34 Plus 0.27
iq�7 33 Plus 0.24
I 32 Plus 0.21
pH,5U 31 Plus 0.18
30 Plus 0.15
TEMP°C 29 Plus 0.12
I'7.3 28 Plus 0.09
Temp Corrected pH,SU 27 Plus 0.06
12.3
26 Plus 0.03
pH after 2 HRS 25 0
24 Minus 0.03
TEMP°C after 2 HRS 23 Minus 0.06
_ 22 Minus 0.09
Temp Corrected pH,SU 21 Minus 0.12
Z I 20 Minus 0.15
pH after 24 I-IRS
19 Minus OAS
18 Minus 0.21
TEMP°C after 24 HRS -1 17 Minus 0.24
r .L 16 Minus 0.27
Temp Corrected pH,SU 15 Minus 0.30
/ 14 MinuS 0.33
•
13 Minus 0.36
12 Minus 0.39
11 Minus 0.42
10 Minus 0.45
"I certify,under penalty of law,that the Class B pathogen requirements in 40 CFR,Part 503.32(b)have been met and the vector attraction reduction requirement in 40
CFR,Part 503.33(b)(4)and(6)have been met. This determination has been made under my direction and supervision In accordance with the system designed to ensure
that qualified personnel properly gather and evaluate the information used to determine that the pathogen and vector attraction reduction requirements have been met.
I am aware that there are significant penalties for false certification including fine and imprisonment."
Printed Name&Title err-k-,y`) c 114 CJ
Signature f /_t/

EEEDICOEH@RD -T ©®QP®Qatd] Drinking Water ID: 37715
want ,fates xP 10 •
114 OAKMONT DRIVE PHONE[phone]
GREENVILLE, N.C, 278358 FAX [phone]
ID#: 965
RAMSEUR 'WWTP-SLUDGE
724 LIBERTY STREET
PO BOX 525 DATE COLLECTED: 12/09/21
RAMSUER, NC 27316 DATE REPORTED : 01/07/22
REVIEWED BY:
Sludge Analysis Method
PARAMETERS Sample Date Analyst Code
PH, Units 6.5 12/13/21 JMMMS 45001.113-11
Arsenic (dry wt. basis), mg/kg <2.5 12/22/21 MTM 311313-04
Chromium, '1'.(dry wt, basis),mg/kg 14 12/20/21 L1+J EPA200.7
Nickel (dry wt, basis), mg/kg 15 12/20/21 LEI EPA200.7
Total Solids, % 0.53 12/09/21 JMS 2540G-15 •

EE © ii ¶ 0:©®RP®ra t
•
. .. . - Drinking .Watar ID1 37.715 .i
Wastewater IDi 10
114 OAKMONT DRIVE PHONE [phone]
GREENVILLE, N.C. 27858 FAX [phone]
ID#: 950
RAMSEUR WTP-SLUDGE
724 LIBERTY STREET
PO BOX 545 DATE COLLECTED: 03/18/21
RAMSEUR ,NC 27316 DATE REPORTED 04/14/21
REVIEWED B'Y• �� �
Sludge Analysis Method
PARAMETERS Sample Date Analyst Code
PH, Units 3.3 03/23/21 JMS 4500HB-11
Arsenic (dry wt, basis), mg/kg <2.5 04/05/2I MTM 31138-04
Chromium, T.(dry wt. basis),mglkg <5.0 04/08/21 LTFJ EPA200.7
Nickel (dry wt. basis), mg/kg 10 04/01/21 LET EPA200.7
Total Solids, % 4.53 03/23/21 JMS 2540G-11

RAMSEUR WATER TREATMENT PLANT
SLUDGE DISPOSAL RECORD
YEAR: 0P,
Prior to 1st disposal event
1 Collect a sludge sample from the drying beds and test for Percent Solids,
Arsenic, Chromium, Nickel, and TCLP
2 Measure the pH on-site and record result on Chain of Custody
Label the sample location as "Sludge to Disposal"
On Hauling Event Days
1 Complete "Vehicle Inspection" form
2 Complete bottom portion
Date of Volume
Hauling Tank Size # Loads Gallons
�118/2J 4.000 : 1f1 -76,046
34s/ai 4000 Xyt nw 44 to00
/Of (�oo o 17y k),00b
/a) 4r0o0
4j/2a/11 00 0 Ru 1 i y; aeo
`l/2 3/�/ 40c,n !// /UPo
�2,(5,bob

VEHICLE INSPECTION FORM
LIQUID WASTE PUMPING AND HAULING
Pumping Company: Si 4'`r)ort [s
Address S/3 1... 1aa.„ City iedrio n 3- Zip Code Telephone
Name of pumper or representative present during inspection(pleaseprint)
COLLECTION VEHICLES:
Make and Model License Number Tanker Capacity
in Gallons
a 04, i/�4-an-v4-o`_o I /4J- r1 to '.Okoo
3 Volvo AT- hso90 ��000
EQUIPMENT INSPECTION: S=satisfactory U=unsatisfactory
Equipment Condition Inspected Vehicles Complete if any item is
marked "unsatisfactory" in
1 2 3 4 5 columns at left
General All equipment maintained and
Cleanliness cleaned of spillage
Vehicle Mechanics Lights, Horn, Tires, Brakes, ✓
Mirrors, Steering Wheel
Tank Container Leak proof, no dents or corrosion
r
Tank Cover Tight fitting, spill proof
Release Valve and Valve, hose, fittings good, no
/
Hose leaks /
Sewage Suction Sound condition, drained after
Hose each use, sanitary storage
Copy of Located in vehicle
SPCC Plan l
Spill Cleanup Water hose, disinfectant, hand
Equipment sanitizer, 5 gal of absorbent*, 5 7 7 /
gal. bucket, broom& shovel
Overfill Protection Positive check valve present or
contents level gauge
Level Indicator Recommended, but not required
if check valve used (
Pump Type, condition(able to handle
septage without intake strainer)
Date 3/4/Q Inspected by 3c:S p fir
(print name) (Signature)