WQ0008008_Renewal Application_20220519

PASQUOTANK COUNTY
WATER TREATMENT
FACILITY
2022 PERMIT
RENEWAL/MODIFICATION
WQ0008008
Submitted by:
Soil Plus
PO Box 1396
Oxford, NC 27565
May 9, 2022
SOIL PLUS

SOIL PLUS
May 9,2022
NCDEQ-DWR
Non-Discharge Branch
1617 Mail Service Center
Raleigh,North Carolina 27699-1617
Attention: Mr. Nathaniel Thornburg
Reference: PERMIT RENEWAL/MODIFICATION
Pasquotank County Regional WTF (RLAP to DCAR)
Permit#WQ0008008
Mr. Thornburg:
Soil Plus, LLC (Soil Plus) is submitting one electronic copy of this permit
renewal/modification application package for the Pasquotank County WTF (WQ0008008).
This package includes:
1. Completed Distribution of Class A Residuals Application (DCAR)
a. O&M Plan
b. Current Permit
2. Completed Residual Source Certification (RSC)
Per our email conversation on March 7th, this application is designed to convert the current
Class B permit to a Class A Distribution permit. The source produces non-biological WTP
residuals that meet all Class A requirements. Pasquotank County would also like to request
an increase in the permitted dry tonnage, to account for increased residuals storage time
and higher % total solids in the lagoon, and that TCLP monitoring frequency be reduced
from "Annual" to "Once per permit cycle". TCLP results from 2022 and 2021 are included
in the application, and all parameters are under regulatory limits. A check for $245 is being
mailed per the Division of Water Resources Land Application Unit's fee schedule for a
major modification to a minor non-discharge permit.
Soil Plus will be responsible for completing this permit renewal for Pasquotank County. If
there is any further information required or questions regarding this permit application,
please do not hesitate to contact me for assistance.
Respectfully,
PO Box 1396
Oxford,NC 27565 Drew Matthews, Soil Plus
[phone] cc:David Smithson,Pasquotank County
[e-mail]
www.soilplus.net

APPENDIX 1
2022 PERMIT RENEWAL/MODIFICATION
Pasquotank County Regional WTF
(WQ0008008)
DCAR
O&M Plan
Current Permit

State of North Carolina
DWRDepartment of Environmental Quality
Division of Water Resources
Division of Water Resources 15A NCAC 02T.1100—DISTRIBUTION OF CLASS A RESIDUALS
INSTRUCTIONS FOR FORM:DCAR 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 website
General—This application is for treatment,storage,transport,distribution,land application,and/or marketing of Class A(or Equivalent)
residuals under 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. Distribution of Class A Residuals(FORM:DCAR 06-16):
❑ Submit the completed and appropriately executed Distribution of Class A Residuals(FORM:DCAR 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 15A
NCAC 02T.0106(b).
❑ If this project is for a modification of an existing permit,submit one copy of the existing permit.
❑ 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(New and Major Modification Application Packages)
❑ 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
Major(residuals permitted for distribution >3,000 dry tons/year) $1,310 $395
Minor(residuals permitted for distribution<3,000 dry tons/year) I $810 I $245
1 -A major modification shall be defined as any permit modification that:increases the generating facility's residuals dry tonnage;
adds additional residuals sources; 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:DCAR 06-16 Page 1 of 3

D. Program Information(All Application Packages)
❑ Provide a narrative explaining the following:
❑ How the materials will be handled and transported from where the residuals were produced to where it will be treated.
❑ How the residuals will be processed/treated(attach process flow diagram).
❑ How leachate collection will be handled.
❑ Where the residuals will be stored until processed.
❑How the final product will be distributed(packaging,bulk,etc.)
❑What nutrients or other constituents(i.e.nitrogen,phosphorous,aluminum,calcium,etc.)are used or recommended as the
limiting parameter for determination of residuals loading rate to ensure that it does not overload the soil and cause
contravention of surface water or groundwater standards,limit crop growth,or adversely impact soil quality.
❑ Attach a marketability statement detailing destinations and approximate amounts of the final product to be distributed.
❑ Provide either a label that shall be affixed to the bagged processed residual or an information sheet that shall be provided to the
person who receives the processed residual. The label or information sheet shall contain, at a minimum, the following
information:
❑Name and address of the person who prepared the residual that is sold or given away.
❑ A statement that application of the residuals to the land shall be in accordance with the instructions on the label or
information sheet.
❑ A statement that the residuals shall not be applied to any site that is flooded,frozen or snow-covered.
❑ A statement that adequate procedures shall be provided to prevent surface runoff from carrying any disposed or stored
residuals into any surface waters.
❑ Information on all applicable setbacks in accordance with 15A NCAC 02T.1108(b).
❑A statement that the residuals shall be applied at agronomic or recommended rates for intended uses.
E. Detailed Plans and Specifications(Application Involving New or Changes to Treatment or Storage Units)
❑ 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 storage units as well as the proximity of the residuals treatment and storage units to other utilities and
natural features within 500 feet of all treatment and storage facilities,and detail drawings of all items pertinent to the residuals
treatment and storage units. Depict minimum separations required in 15A NCAC 02T.1108(a)on the plans.
❑ Specifications must include, at a minimum, the following for all items pertinent to residuals treatment and storage 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 15A 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.
F. Engineering Calculations(Application Involving New or Changes to Treatment or Storage Units)
❑ Submit all design calculations that have been signed, sealed, and dated by a NC Professional Engineer per 15A NCAC 02T
.1104(a).
G. Environmental Assessments(May be Required—See 15A NCAC 1 C.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.
INSTRUCTIONS FOR FORM:DCAR 06-16 Page 2 of 3

H. 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.1110 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 equipments 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.
❑ 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: By Courier/Special Delivery:
1617 MAIL SERVICE CENTER 512 N.SALISBURY STREET
RALEIGH,NORTH CAROLINA 27699-1617 RALEIGH,NORTH CAROLINA 27604
TELEPHONE NUMBER: [phone] FAX NUMBER: [phone]
INSTRUCTIONS FOR FORM:DCAR 06-16 Page 3 of 3

State of North Carolina
DWR Department of Environmental Quality
Division of Water Resources
Division of Water Resources 15A NCAC 02T .1100—DISTRIBUTION OF CLASS A RESIDUALS
FORM: DCAR 06-16
I. APPLICANT INFORMATION:
1. Applicant's name: Pasquotank County
Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership Privately-Owned Public Utility
El Federal ❑ State ❑Municipal ®County
Signature authority's name per 15A NCAC 02T.0106:David Smithson Title:Utilities Director
Applicant's mailing address:PO Box 2245
City:Elizabeth City State:NC Zip:27909-
Telephone number:[phone] Email Address: [e-mail]
2. Consultant's name:Drew Matthews License Number(for P.E.):
Affiliation: ❑ On Staff ® Retained(Firm: Soil Plus,LLC)
Consultant's mailing address:PO Box 1396
City:Oxford State:NC Zip:27565-
Telephone number: [phone] Email Address:[e-mail]
3. Fee submitted: $245.00(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:WQ0008008
Date of most-recently issued permit: September 14,2017
Date of most-recently certified Attachment A(if different than the permit):
III. FACILITY INFORMATION:
1. Name of residuals processing facility:Pasquotank County Regional WTF
City:Elizabeth City State:NC Zip:27909-
Coordinates: Latitude:36° 14'28" Longitude: 76° 10' 19"
Datum:NAD 83 Level of accuracy: Sub-Meter
Method of measurement: GIS
County where facility is located:Pasquotank
2. Facility contact(person familiar with residuals preparation):
Name:David Smithson Title:Utilities Director
Mailing address:PO Box 2245
City:Elizabeth City State:NC Zip: 27909-
Telephone number:[phone] E-mail address: [e-mail]
FORM:DCAR 06-16 Page 1 of 3

3. Is the residual process facility also the generator? ® Yes; p No
If No,please specify delivery frequency and quantity of residual to be processed:
4. Length of residuals storage at facility: >30 Days days(Note:the Division requires minimum 30 days storage in units that are
separate from treatment system,i.e.not in clarifiers,aeration basins,etc.)
IV. RESIDUALS QUALITY INFORMATION:
1. Specify how these residuals will be distributed:
❑ sold or given away in bags or other containers; ❑ lawn(bulk); ❑home garden(bulk);
® other(explain); Bulk Agricultural Land Application
Note:Bulk residuals shall mean residuals that are transported and not sold or giving away in a bag or other receptacles with a
load capacity of one metric ton or less.
2. Complete the following if residuals are to be mixed with other materials:
Type of Materials Amounts to be added
per 1.0 dry ton of residuals(dry ton)
3. Approximate amounts of the residuals received and processed at the facility: See O&M Plan dry tons per year.
4. Approximate amounts of the final product(processed residuals)to be distributed: See O&M Plan dry tons per year.
5. Provide a description of the onsite storage management plan for the treated residuals (including estimated average and
maximum storage times prior to distribution): See O&M Plan
6. Does the facility have a stormwater management plan? ❑ Yes; ® No
Explain whether the treatment and storage areas are under roof or how stormwater runoff will be handled:Residuals are stored
in a holding lagoon
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.
RSC 06-16.doc
FORM:DCAR 06-16 Page 2 of 3

Professional Engineer's Certification: (Application Involving New or Changes to Treatment or Storage Units)
I, ,attest that this application for
has been reviewed by me and is accurate and complete to the best of my knowledge. I 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:
Applicant's Certification:
The 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;
I, David Smithson Utilities Director
(Signature Authority's Name—PLEASE PRINT) (Title)
attest that this application for Pasquotank County
(Facility Name)
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
::::u::000: u
, as we as civil penalties u to$25,000 per violation.
Date: - 2b22
FORM: DCAR 06-16 Page 3 of 3

PASQUOTANK COUNTY REGIONAL WATER
TREATMENT FACILITY
OPERATION AND MAINTENANCE PLAN
DISTRIBUTION AND MARKETING OF CLASS A RESIDUALS
WQ#0008008
Revised March 2022

1.0 ANALYTICAL REQUIREMENTS
Prior to the hauling and land application event being schedule will generate analytical results documenting that all
parameters listed in Condition IV. 2—4 and at the frequency listed in most recent copy of this permit. Four factors
that may ultimately affect the integrity of reported data include: 1) obtaining a representative sample, 2) preventing
contamination of the sample, 3) providing legal documentation of the sampling event, and 4) protecting the sample
from chemical,physical or biological change prior to analysis.
A sample will be collected according to the schedule provided in the most recent copy of the Attachment of this
permit and in accordance with the sampling plan and requirements for each source.
2.0 RESIDUALS REMOVAL,TRANSPORT, AND APPLICATION
Residuals will be transported from the Water Treatment Facility to a suitable land application site. Transport
equipment will be inspected,licensed and appropriately marked,as required,for the purpose of transporting residuals.
Residuals will be delivered to the application sites between sunrise to sunset.
The liquid residuals will be applied uniformly across the application area.To ensure adequate control of the application
rate for each site, the equipment used for spreading the sludge will be calibrated by measuring the amount handled
on a known square footage. While the rate of discharge from the application vehicle is fixed, the speed of the
equipment can be adjusted to maintain the flow rate needed to achieve specific application rates. Spreading operations
will be discontinued during periods of inclement weather and will not be resumed until sufficient drying of the fields
has occurred. This allows equipment access without causing excessive soil compaction or rutting. To prevent
adherence of the residuals,transport vehicles will be equipped with rear mud flaps,thereby preventing residuals from
being tracked onto roadways. Residuals adhering to the mud flap will be scraped off in the field before the truck
returns to the roadway. Examples of our application tracking and summary form/reports can be provided upon
request.
3.0 SITE OPERATION
Residuals will be surface applied at the properly-calculated agronomic rate and in strict accordance with any state and
federal regulations for the land application of the Residuals. Buffer zone distances will be observed in accordance
with applicable state and federal regulations.Buffer zones will be flagged and no residuals will be applied within those
areas. The most restrictive buffer will apply in combined situations. Operational provisions will be taken to prevent
soil loss through erosion. Provisions will include contour application and avoidance of areas where surface drainage
patterns result in concentrated flow of runoff from rainfall. In accordance with sound, industry standard agronomic
practice,areas which are unseasonably wet (and would produce rutting or damage to the field) will not be utilized for
residuals application operations during those periods. Operations will be discontinued when soils are saturated and
will not be resumed until the field has sufficient dried. The number of residuals applied will not exceed the hydraulic
capacity of the soil at the time of each application. If a subsequent pass across a field is necessary to achieve the
desired application rate, sufficient drying time will be allowed between passes.
4.0 TRANSPORTATION SYSTEM ROUTING
Transportation routes will follow primary highways and avoid residential areas where possible. Designated routes are
followed unless a detour is specified. In the event of a detour route, it shall be taken as specified by the detour
authority. There shall be no unscheduled stops when loaded. Transportation vehicles will be inspected,licensed and
appropriately marked as required with identification numbers for the purpose of this contract. All units will be
equipped with spill guards and full mud flaps. This will prevent the residuals from adhering to the tires and
Revised 03/22 ©Pasquotank County Regional WTF Operation and Maintenance Plan

undercarriage of the transport vehicle, thereby preventing residuals from being tracked onto roadways. Residuals
adhering to the mud flap will be scraped off in the field before the truck returns to the roadway. All federal OSHA
and DOT laws and regulations are complied with for the protection of our clients, the community and our drivers.
Examples of vehicle and driver transportation logs and inspection forms can be provided upon request.
5.0 LIQUID RESIDUALS
Liquid residuals will be transported using liquid tankers,pulled by standard road tractors. The tankers will be loaded
per the generator's specifications and standard protocols.The tractor/tanker unit will transport its load to a designated
staging area inside the buffered area of a permitted land application site.
6.0 APPLICATION (SPREADING) —LIQUID RESIDUALS
At the staging area each load will be transferred into a pull behind unit subsequent land application. This unit is
capable of delivering an accurate, calibrated application of liquid residuals over the application site. The uniform
spread pattern ensures that residuals are applied at proper agronomic (nutrient) and hydraulic loading rates. The
application rates for each site, and its corresponding crop,will be determined based on the Plant Available Nitrogen
(PAN) content of the residuals, or other limiting factors.Typical applications will deliver between 75 and 100 percent
of a crop's annual PAN requirement.
7.0 SPILL AND EMERGENCY RESPONSE PROGRAM
In the unlikely event of a spill,the following actions will occur immediately.
• Halt Source of Spill. Use of any leaking or damaged unit which is causing the spill will cease immediately.The
unit will be repaired before resuming its use.
• Contain Spill. In the event large quantities of residuals have been spilled, straw bales will be used where
available and as necessary to either form a barrier or absorb residuals.
• Clean-Up. Depending on the type and number of residuals spilled, a variety of equipment may be used to
remove the residuals: front-end loader, shovels and brooms and vacuum equipment of a liquid residuals
applicator. Any residuals removed from the spill site will be spread on an approved application site,returned
to the WWTP, or disposed of in an approved landfill.
• Final Clean-Up. Flush roadways with water or sweep as necessary to clean. Allow to dry and incorporate if
spill occurs on non-paved and tillable area. In the event a spill occurs on private property, final clean-up
should be completed immediately to the satisfaction of the owner.
• Management of Clean-Up Efforts. The Operations Manager will take immediate charge and initiate clean-up
activities. Contractor labor will be used, with additional labor secured as needed. The Operations Manager
will also communicate with the public on the scene, answering questions and advising of clean-up activities.
• Reporting. All spills will be reported immediately to the Contractor's offices and the client. State and local
agencies will be notified in accordance with their notification requirements. Within 24 hours of the spill, the
Operations Manager will send contractor's office a written report detailing how the spill occurred and remedial
action taken. This report will be provided using the enclosed Spill Report form.
• Spill Prevention. The Operations Manager will implement the following spill prevention measures:
o Ensure truck drivers watch trailer while loading and do not overload;
o Ensure trailer hatches are closed and latched while transporting;
o Ensure trailer seals are inspected on a daily basis and replaced as necessary; and
o Ensure unloading operations in the field are conducted to minimize any potential runoff or tracking.
Revised 03/22 ©Pasquotank County Regional WTF Operation and Maintenance Plan

8.0 PREVENTION
The goal of a compliance assurance system is to prevent compliance issues from occurring. Prevention involves:
• Ensuring personnel understand their role in assuring compliance;
• Identifying compliance requirements at the federal, state and local levels;
• Implementing a system where compliance tasks are scheduled,assigned and tracked to completion;
• Developing standard operating procedures where appropriate; and
• Reviewing the compliance task list and standard operating procedures on an ongoing basis and modifying
them as appropriate to account for changes in regulations/requirements and operating methods, and to
address compliance deficiencies.
9.0 ASSESMENT
To help ensure compliance requirements are being met and the compliance assurance system is implemented and
working,periodic, consistent, objective and documented assessments of a project/facility's compliance status are
conducted. Contractor personnel have clearly-defined compliance assessment responsibilities and time to conduct
such assessments. The contractor conducts informal site inspections and formal audits on an ongoing basis.
10.0 CORRECTIVE ACTION
Once compliance issues have been identified during the course of day-to-day business and through internal audits
and inspections a system must be in place which ensures that appropriate and timely corrective action is taken, the
cause of the compliance issue is identified and actions are taken to prevent recurrence of the issue.
The contractor's goal is to have no instances of non-compliance. However,issues and incidents may occur and when
this happens employees work to correct the incident in a timely and thorough manner. When compliance issues are
identified, the situation is examined to determine the root cause of the problem and the corrective and preventive
action that must be taken.The preventive action must address the root cause with the goal of preventing a recurrence.
Depending on the nature of the compliance issue,it is assigned to one or more responsible parties to ensure that the
corrective and preventive actions are implemented. A deadline for completion of the task is assigned and the issue is
tracked to completion by regional and corporate compliance personnel.
Revised 03/22 ©Pasquotank County Regional WTF Operation and Maintenance Plan

OPERATION & MAINTENANCE PLAN
Pasquotank County Regional Water Treatment Facility
Distribution and Marketing of Class A Residuals
• Sampling Plan
• Process Diagram
• Volume Justification
• Marketability Statement
• Label
• Vicinity Map
Revised 03/22 ©Pasquotank County Regional WTF Operation and Maintenance Plan

PASQUOTANK COUNTY REGIONAL WTF
SAMPLING PLAN
Using a sterile and appropriate sampling device, collect residuals at multiple sampling points of
the holding lagoon and place them into a stainless-steel container for blending. Once a
representative sample has been collected, transfer the residuals to the lab provided containers
for nutrients, pH, 503 metals, and TCLP analysis. Place all samples in a cooler with ice and
ensure they are received by the lab within the appropriate hold time. The sampling frequency
will be based upon the volume produced and identified in the permit issued by NCDEQ.

i
Pasquotank County WTP
Process Schematic
is Aerator
_6.8 mg/1 Raw Water Storage Pre-1.0 MG
KMnO4 1.0 MG Total-0
C12 Mono-.24 mg/1
5.6 mgi1 Pumps la 'ump Basin .3 MG Free Ammonia 1.1 plus
4 (a71000gpm • pfl
6.5mg1NaOH12%
30 hp ea Polymer.02 mg 1
0 0Phosphate 1.8 mg/1
Filters
Wells 8 x 10'dia
(30) WV anthracite &sand
Q N 3 1,3 5 Pre-Clearwell
D • Ill CLy 5.`3 r,v.'L ! Free C12 .08 mg/I
0 Total-2 mg/1
Raw Water 1400 gpm I. . ,1, Mono-.93 mg/1
2300gpm ree NH3 .18mg11
Iron-S mg/I 6.2 mg/I 5
Manganese-.3 mg/I Cl2 Ill
Hardness-250 mg/1 HFS Clearwells
.9 mg/I
Elev. Tank ill
300Kg
/ < 1300 gpm
Pumps
Post NH3 i 4 a) 1000 gpm
Total-5.5 mg/1 '
Free C12 .03 mg/1 Nth-- Ch.
Mono 5.16 mg/I 1.1 mg/1 6.4 mg/1
Free Ammonia.32 mg/1

PASQUOTANK COUNTY REGIONAL WTF
Quantitative Justification
YEAR DRY TONS
2017 84.63
2018 138.50
2019 0
2020 0
2021 0
AVG DRY TONS 55.78

PASQUOTANK COUNTY REGIONAL WTF
Marketability Statement:
These residuals are generated as part of the water treatment process at the Pasquotank County
Regional Water Treatment Facility. The treatment process uses well water and a few chemicals to
treat the water for potable uses. The generated residuals are a by-product of the remaining solids
separated from the treated water.
The distributed material is classified as "Exceptional Quality" or a "Class A" product. A "Class A"
product is a contains a smaller quantity of regulated metals (e.g. Zinc, Copper, Lead, etc.) than
traditional "Class B" residuals. The residuals also contain a small amount of nutrients that are to be
used at agronomic rates and are intended to be used as a supplement for agriculture fertilizers.

PASQUOTANK COUNTY REGIONAL WTF RESIDUAL LABEL
I. CONTACT INFORMATION
Name: Mr. David Smithson, Utilities Director
Address: P.O. Box 2245
Elizabeth City,NC 27909
Telephone: [phone]
Email: [e-mail]
II. RESTRICTIONS
Residuals shall not be land applied under the following conditions:
• If the residuals are likely to adversely affect a threatened or endangered species listed under section 4
of the Endangered Species Act or its designated critical habitat
• If the application causes nuisance conditions
• If the land fails to assimilate the bulk residuals or the application causes the contravention of surface
water or groundwater standards
• If the land is flooded, frozen, or snow-covered, or is otherwise in a condition such that runoff of the
residuals would occur
• Within the 100-year flood elevation,unless the bulk residuals are injected or incorporated within a
24-hour period following a residuals land application event
• During precipitation events, or within 24 hours following a rainfall event of 0.5 inches or greater in a
24-hour period
• If the slope of the land is greater than 10%when liquid residuals are surface applied, and if the slope
of the land is greater than 18%when the liquid residuals are injected or incorporated
• If the land does not have an established vegetative cover unless the residuals are incorporated or
injected within a 24-hour period following a residuals land application event
• If the vertical separation between the seasonal high water table and the depth of residuals
application is less than one foot
• If the vertical separation of bedrock and the depth of residuals application is less than one foot
• If the application exceeds agronomic rates
III. SETBACKS
Applicable setbacks in accordance with 15A NCAC 02T .1108(b):
Setback by type of
application (feet)
Liquid Cake
Description of Setback Residuals Residuals
Private or public water supply 100 100
Surface Waters (streams—intermittent and perennial,perennial
waterbodies, and wetlands) 100 25
Surface water diversions (ephemeral streams,waterways, ditches) 25 0
Groundwater lowering ditches (where the bottom of the ditch intersects
the SHWT) 25 0
Wells with exception to monitoring wells 100 100
Bedrock outcrops 25 0
IV. APPLICATION RATES
Application Rates should not exceed the calculated nitrogen requirements based on the Realistic Yield
Expectation for a particular crop and the predominant soil series within the application area.

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Drawn by: CSC SOIL PLUS�J TS WQ0008008 O&M PLAN
Reviewed by: Elizabeth City,North Carolina 1
Date: Sept '17 Soil Plus Project# 201007.B11

ROY COOPER
Governor
MICHAEL S.REGAN
Secretary
Water Resources S.JAY ZIMMERMAN
ENVIRONMENTAL QUALITY Director
September 14,2017
DAVID L.SMITHSON—WATER SUPERVISOR
PASQUOTANK COUNTY
POST OFFICE Box 2245
ELIZABETH CITY,NORTH CAROLINA 27909
Subject: Permit No. WQ0008008
Pasquotank County RLAP
Land Application of
Class B Residuals
Pasquotank County
Dear Mr. Smithson:
In accordance with your permit renewal request received May 26,2017,and subsequent additional
information received August 14, 2017 and September 13, 2017, we are forwarding herewith Permit No.
WQ0008008 dated September 14, 2017, to Pasquotank County for the continued operation of the subject
residuals management program.
This permit shall be effective from the date of issuance until August 31, 2022, shall void Permit
No. WQ0008008 issued April 8, 2008, and shall be subject to the conditions and limitations as specified
therein. Please pay particular attention to the monitoring requirements listed in Attachment A for they may
differ from the previous permit issuance. Failure to establish an adequate system for collecting and
maintaining the required operational information shall result in future compliance problems.
Please note the following permit conditions have been removed since the last permit issuance
dated April 8,2008:
➢ Old Condition 1114.—There is no need to void the permit since other land can be found.
➢ Old Condition BI.7.—Redundant since covered by Old Condition IH.6. and Condition Il19.
» Old Condition III.9.h. -- Redundant since covered by agronomic rate requirements of
Conditions II.11.k.
➢ Old Condition IV.8.—Length of time for record keeping is specified in individual condition.
Please note the following permit conditions are new since the last permit issuance dated April
8,2008:
> Condition I.2.—Permittee to be in compliance within 90 days of new permit date of notification
requirements of Condition III.3.
Compares!:,,
State of North Carolina I Environmental Quality[Water Resources I Water Quality Permitting I Non-Discharge Permitting
1617 Mail Service Center I Raleigh,North Carolina 27699-1617
919-807-6332

Mr.David L. Smithson
September 14,2017
Page 2 of 2
➢ Condition I.3.—Permittee to be in compliance within 180 days of new permit date of signage
requirements of Condition 111.13.
➢ Condition II.12.—When residuals are land applied to grazed pasture,hay crop realistic nitrogen
rate shall be reduced by 25%.
➢ Condition 111.3. — Washington Regional Office to be notified at least 24 hours prior to land
application of residuals.
> Condition I11.4.—Operation&Maintenance Plan required.
> Condition 111.6. — Similar to Old Condition 111.5., but now a copy of the O&M plan also
required. Please note that"copy"can include an electronic copy on a device.
> Condition III.11.1.—Bulk residuals are not to be applied above agronomic rates.
➢ Condition 111.13.—Signage requirements provided.
➢ Condition IV.7.d., g.,j. — Similar to Old Condition IV.8., but now records to be kept include
approximate area(acres), predominant soil mapping,and nitrogen application rate.
➢ Condition VI.6. — Similar to Old Condition VI.6., but now 60-day notice required before
modification or revocation.
➢ Condition VI.7—Expansion of facility not permitted without waiver if Permittee has exhibited
behavior detrimental to environment.
If any parts, requirements or limitations contained in this permit are unacceptable, the Permittee
has the right to request an adjudicatory hearing upon written request within 30 days following receipt of
this permit. This request shall be in the form of a written petition,conforming to Chapter 150B of the North
Carolina General Statutes, and filed with the Office of Administrative Hearings at 6714 Mail Service
Center,Raleigh,NC 27699-6714. Unless such demands are made,this permit shall be final and binding.
If you need additional information concerning this permit,please contact Troy Doby at(919) 807-
6336 or troy.doby(l ncdenr.gov.
Sincerely,
Jay Zimmerman,P.G.,Direc r
Division of Water Resources
cc: Pasquotank County Health Department(Electronic Copy)
Washington Regional Office, Water Quality Regional Operations Section (Electronic Copy)
C. Scott Carpenter,LSS—SoilPlus(Electronic Copy)
Beth Buffmgton—Protection and Enforcement Branch(Electronic Copy)
Digital Permit Archive(Electronic Copy)
Central Files

NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENTAL QUALITY
RALEIGH
LAND APPLICATION OF CLASS B RESIDUALS PERMIT
In accordance with the provisions of Article 21 of Chapter 143, General Statutes of North Carolina as
amended, and other applicable Laws, Rules, and Regulations
PERMISSION IS HEREBY GRANTED TO
Pasquotank County
Pasquotank County
FOR THE
continued operation of a residuals management program for Pasquotank County and consisting of the land
application of Class B residuals generated by the approved facility listed in Attachment A to the approved
fields listed in Attachment B with no discharge of wastes to surface waters, pursuant to the application
received May 26, 2017, and subsequent additional information received by the Division of Water
Resources, and in conformity with other supporting data subsequently filed and approved by the
Department of Environmental Quality and considered a part of this permit.The use and disposal of residuals
are regulated under Title 40 Code of Federal Regulations Part 257. This permit does not exempt the
Permittee from complying with the federal regulations.
This permit shall be effective from the date of issuance until August 31, 2022, shall void Permit No.
WQ0008008 issued April 8,2008,and shall be subject to the following specified conditions and limitations:
SCHEDULES
1. No later than six months prior to the expiration of this permit, the Permittee shall request renewal of
this permit on official Division forms. Upon receipt of the request, the Division will review the
adequacy of the facilities described therein, and if warranted,will renew the permit for such period of
time and under such conditions and limitations as it may deem appropriate. Please note Rule 15A
NCAC 02T.0105(d)requires an updated site map to be submitted with the permit renewal application.
[15A NCAC 02T.0108(b)(2), 02T .0105(d), 02T .0109]
2. The Permittee shall be in full compliance with the regional office notification requirements established
in Condition I1I.3.within 90 days of the effective date of this permit. [15A NCAC 02T .0108(b)(2)]
3. The Permittee shall be in full compliance with the signage requirements established in Condition 111.13.
within 180 days of the effective date of this permit. [15A NCAC 02T .0108(b)(2)]
WQ0008008 Version 4.0 Shell Version 170401 Page 1 of 13

II. PERFORMANCE STANDARDS
1. The subject residuals management program shall be effectively maintained and operated at all times so
there is no discharge to surface waters, nor any contravention of groundwater or surface water
standards. In the event the facilities fail to perform satisfactorily, including the creation of prolonged
nuisance conditions due to improper operation and maintenance,the Permittee shall immediately cease
land applying residuals, contact the Washington Regional Office supervisor, and take any immediate
corrective actions. [G.S. 143-215.1]
2. This permit shall not relieve the Permittee of responsibility for damages to groundwater or surface
water resulting from the operation of this residuals management program. [15A NCAC 02B .0200,
02L .0100]
3. Only residuals generated by the facility listed in Attachment A are approved for land application in
accordance with this permit. [G.S. 143-215.1]
4. Only the fields listed in Attachment B are approved for residuals land application. [G.S. 143-215.1]
5. Pollutant concentrations in residuals applied to land application sites listed in Attachment B shall not
exceed the following Ceiling Concentrations (i.e., dry weight basis) or Cumulative Pollutant
Loading Rates (CPLRs):
Parameter Ceiling Concentration CPLR
(milligrams per kilogram) (pounds per acre)
Arsenic 75 36
Cadmium 85 34
Copper 4,300 1,338
Lead 840 267
Mercury 57 15
Molybdenum 75 nla
Nickel 420 374
Selenium 100 89
Zinc 7,500 2,498
The Permittee shall determine compliance with the CPLRs using one of the following methods:
a. By calculating the existing cumulative level of pollutants using actual analytical data from all
historical Iand application events of residuals,or
b. For land where residuals application has not occurred or for which the required data is incomplete,
by determining background concentrations through representative soil sampling.
[15A NCAC 02T .1105]
6. Residuals that are land applied shall meet Class B pathogen reduction requirements in 15A NCAC 02T
.1106(a)and(c). Exceptions to this requirement shall be specified in Attachment A. [15A NCAC 02T
.1106]
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7. Setbacks for treatment and storage facilities shall be as follows:
Setback Description Setback
_ (feet)
Habitable residence or place of public assembly under separate ownership or not to 100
be maintained as part of the project site
Property lines 50
Private or public water supply 100
Surface waters(streams—intermittent and perennial,perennial waterbodies, and 50
wetlands)
Wells with exception to monitoring wells 100
[15A NCAC 02T .1108]
8. Setbacks for Class B land application sites shall be as follows:
Setback by application type
(feet)
Setback Description Vehicular Irrigation
Surface Surface Injection/
Application Application
Incorporation
Habitable residence or place of public assembly under
separate ownership or not to be maintained as part of 400 400 200
the project site
Habitable residence or places of public assembly
owned by the Permittee,the owner of the land,or the 0 200 0
lessee/operator of the land to be maintained as part of
the project site
Property lines 50 150 50
Public right of way 50 50 50
Private or public water supply 100 100 100
Surface waters (streams—intermittent and perennial, 100 100 50
perennial waterbodies,and wetlands)
Surface water diversions(ephemeral streams,
waterways, ditches) 25 100 25
Groundwater lowering ditches(where the bottom of 25 100 25
the ditch intersects the SHWT)
Subsurface groundwater lowering system 0 100 0
Wells with exception to monitoring wells 100 100 100
Bedrock outcrops 25 25 25
Top of slope of embankments or cuts of two feet or 15 15 15
more in vertical height
Building foundations or basements 0 15 0
Water lines 0 10 0
Swimming pools 100 100 100
Nitrification fields 0 20 0
[15A NCAC 02T .1108]
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9. Land application areas shall be clearly marked on each site prior to and during any residuals application
event. [15A NCAC 02T .0108(b)(1)]
10. Bulk residuals and other sources of Plant Available Nitrogen(PAN)shall not be applied in exceedance
of agronomic rates. Appropriate agronomic rates shall be calculated using expected nitrogen
requirements based on the determined Realistic Yield Expectations (RYE)using any of the following
methods:
a. Division's pre-approved site specific historical data for specific crop or soil types by calculating
the mean of the best three yields of the last five consecutive crop harvests for each field.
b. North Carolina Historical Data for specific crop and soil types as provided by North Carolina State
University Department of Soil Science (http://nutrients.soil.ncsu.edu/yields/index.php). A copy
shall be kept on file and reprinted every five years in accordance with Condition IV.6.
c. If the RYE cannot be determined using methods (a)or(b) above, the Permittee may use the RYE
and appropriate nutrient application rates reported in any of the following documents:
i. Crop management plan as outlined by the local Cooperative Extension Office, the North
Carolina Department of Agriculture and Consumer Services, the Natural Resource
Conservation Service,or other agronomist.
ii. Waste Utilization Plan as outlined by the Senate Bill 1217 Interagency Group - Guidance
Document: Chapter 1
(http://www.ncagr.gov/SWC/tech/documents/9th Guidance_Doc 100109.pdf).
iii. Certified Nutrient Management Plan as outlined by the Natural Resources Conservation
Services (NRCS). These plans must meet the USDA-NRCS 590 Nutrient Management
Standards(ftp://ftp-fc.sc.egov.usda.gov/NHQ/practice-standards/standards/590.pdf).
d. If the RYE and appropriate nutrient application rates cannot be determined, the Permittee shall
contact the Division to determine necessary action.
[15A NCAC 02T .1109(b)(1)(k)]
11. When residuals are land applied to grazed pasture, hay crop realistic nitrogen rate shall be reduced by
25% in accordance with the USDA-NRCS 590 Nutrient Management Standards. [15A NCAC 02T
.0108(b)(1)]
12. If land application sites are to be over-seeded or double-cropped (e.g., bermuda grass in the summer
and rye grass in the winter with both crops to receive residuals), then the second crop can receive an
application of PAN at a rate not to exceed 50 pounds per acre per year(lbs/ac/yr). This practice may
be allowed as long as the second crop is to be harvested or grazed. If the second crop is to be planted
for erosion control only and is to be tilled into the soil,then no additional PAN shall be applied. [15A
NCAC 02T .0108(b)(1)]
13. Prior to land application of residuals containing a sodium adsorption ratio (SAR) of 10 or higher, the
Permittee shall obtain and implement recommendations from at least one of the following: the local
Cooperative Extension Office; the Department of Agriculture and Consumer Services; the Natural
Resource Conservation Service; a North Carolina Licensed Soil Scientist; or an agronomist. The
recommendations shall address the sodium application rate, soil amendments(e.g., gypsum, etc.), or a
mechanism for maintaining site integrity and conditions conducive to crop growth. The Permittee shall
maintain written records of these recommendations and details of their implementation. [15A NCAC
02T .0108(b)(1)]
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14. These residuals land application sites were individually permitted on or after December 30, 1983;
therefore,the compliance boundary is established at either 250 feet from the residual land application
area,or 50 feet within the property boundary,whichever is closest to the residual land application area.
An exceedance of groundwater standards at or beyond the compliance boundary is subject to
remediation action according to 15A NCAC 02L .0106(d)(2) as well as enforcement actions in
accordance with North Carolina General Statute 143-215.6A through 143-215.6C. Any approved
relocation of the COMPLIANCE BOUNDARY will be noted in Attachment B. [15A NCAC 02L
.0107(a)]
15. The review boundary shall be established midway between the compliance boundary and the residual
land application area. Any exceedance of groundwater standards at the review boundary shall require
action in accordance with 15A NCAC 02L .0106. [15A NCAC 02L .0108]
III. OPERATION AND MAINTENANCE REQUIREMENTS
1. The residuals management program shall be properly maintained and operated at all times. The
program shall be effectively maintained and operated as a non-discharge system to prevent any
contravention of surface water or groundwater standards. [15A NCAC 02T .1110]
2. The Washington Regional Office, telephone number [phone], and the appropriate local
government official(i.e., county manager,city manager, or health director)shall be notified at least 48
hours prior to the initial residuals land application to any new land application site. Notification to the
regional supervisor shall be made from 8:00 a.m.until 5:00 p.m.on Monday through Friday,excluding
State Holidays. [15A NCAC 02T .0108(b)(1)]
3. The Washington Regional Office shall be notified via email or telephone, [phone], at least 24
hours prior to conducting any land application activity. Such notification shall indicate,at a minimum,
the anticipated application times, field IDs, and location of land application activities. If it becomes
necessary to apply to additional fields due to unforeseen events,the Regional Office shall be notified
prior to commencing the application to those fields. [15A NCAC 02T .0108(b)(1)]
4. The Permittee shall maintain an approved Operation and Maintenance Plan(O&M Plan)Modifications
to the O&M Plan shall be approved by the Division prior to utilization of the new plan.The O&M Plan,
at the minimum, shall include:
a. Operational functions;
b. Maintenance schedules;
c. Safety measures;
d. Spill response plan;
e. Inspection plan including the following information:
i. Names and/or titles of personnel responsible for conducting the inspections;
ii. 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;
iii. Detailed description of inspection procedures including record keeping and actions to be taken
by the inspector in the event that noncompliance is observed pursuant to the noncompliance
notification requirements under the monitoring and reporting section of the permit;
f. Sampling and monitoring plan including the following information:
i. Names and/or titles of personnel responsible for conducting the sampling and monitoring;
ii. Detailed description of monitoring procedures including parameters to be monitored;
WQ0008008 Version 4.0 Shell Version 170401 Page 5 of 13

iii. 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 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).
[15A NCAC 02T.1100]
5. Upon the Water Pollution Control System Operators Certification Commission's (WPCSOCC)
classification of the facility,the Permittee shall designate and employ a certified operator in responsible
charge (ORC) and one or more certified operators as back-up ORCs in accordance with 15A NCAC
08G.0201.The ORC or his back-up shall visit the facilities in accordance with 15A NCAC 08G. 0204,
or as specified in the most recently approved O&M plan (i.e., see Condition 111.4.), and shall comply
with all other conditions of 15A NCAC 08G. 0204. For more information regarding classification and
designation requirements,please contact the Division of Water'Resources'Protection and Enforcement
Branch at(919)707-9105. [15A NCAC 02T .0117]
6. When the Permittee land applies bulk residuals,a copy of this permit and a copy of O&M Plan shall be
maintained at the land application sites during land application activities. [15A NCAC 02T
.0108(b)(1)]
7. When the Permittee transports or land applies bulk residuals, the spill control provisions shall be
maintained in all residuals transport and application vehicles. [15A NCAC 02T .1110]
8.' Residuals shall not be stored at any land application site, unless written approval has been requested
and received from the Division. [G.S. 143-215.1]
9. When the Permittee land applies bulk residuals, adequate measures shall be taken to prevent wind
erosion and surface runoff from conveying residuals from the land application sites onto adjacent
properties or into surface waters. [G.S. 143-215.1]
10. When the Permittee land applies bulk residuals,a suitable vegetative cover shall be maintained on land
application sites onto which residuals are applied, or application shall be in accordance with the crop
management plan outlined by the local Cooperative Extension Office, the Department of Agriculture
and Consumer Services,the Natural Resource Conservation Service,or an agronomist and as approved
by the Division. [15A NCAC 02T .1109(b)(1)]
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11. Bulk residuals shall not be land applied under the following conditions:
a. If the residuals are likely to adversely affect a threatened or endangered species listed under section
4 of the Endangered Species Act or its designated critical habitat;
b. If the application causes prolonged nuisance conditions;
c. If the land fails to assimilate the bulk residuals or the application causes the contravention of surface
water or groundwater standards;
d. If the land is flooded,frozen or snow-covered, or is otherwise in a condition such that runoff of the
residuals would occur;
e. Within the 100-year flood elevation, unless the bulk residuals are injected or incorporated within a
24-hour period following a residuals land application event;
f. During a measurable precipitation event(i.e., greater than 0.01 inch per hour), or within 24 hours
following a rainfall event of 0.5 inches or greater in a 24-hour period;
g. If the slope is greater than 10% for surface applied liquid residuals, or if the slope is greater than
18%for injected or incorporated bulk liquid residuals;
h. If the land does not have an established vegetative cover unless the residuals are incorporated or
injected within a 24-hour period following a residuals land application event. Any field that is in a
USDA, state or county no-till program shall be exempted from meeting this vegetative cover
requirement;
i. If the vertical separation between the seasonal high water table and the depth of residuals
application is less than one foot;
j, If the vertical separation of bedrock and the depth of residuals application is less than one foot;
k. Application exceeds agronomic rates.
[15A NCAC 02T .1109]
12. The following public access restrictions apply to residual land application sites:
a. Public access to public contact sites (e.g., golf courses, parks,ball fields, etc.) shall be restricted
for 365 days after a residuals land application event;
b. Public access to non-public contact sites shall be restricted for 30 days after a residuals land
application event.
[15A NCAC 02T .1109(b)(2)]
13. Public access controls shall include the posting of signs with a minimum area of 3 square feet (e.g.,
1.5' x 2'). Each sign shall indicate the activities conducted at each site, permit number, and name and
contact information, including the Permittee or applicator's telephone number. Signs shall be posted
in a clearly visible and conspicuous manner at the entrance to each land application site during a land
application event, and for as long as the public access restrictions required under Condition 111.12.
apply. [15A NCAC 02T .0108(b)(1)]
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14. The following harvesting and grazing restrictions apply to residual land application sites after each
land application event:
Harvesting and Grazing Description Restricted
Duration
Animals shall not be allowed to graze during land application activities and
restricted period. Sites that are to be used for grazing shall have fencing to 30 days
prevent access after each land application event.
Food crops,feed crops and fiber crops shall not be harvested for: 30 days
Turf grown on land where residuals have been applied shall not be harvested for: 12 months
Food crops with harvested parts that touch the residual/soil mixture and are
totally above the Iand surface(e.g.,tobacco, melons,cucumbers, squash,etc.) 14 months
shall not be harvested for:
When the residuals remain on the land surface for four months or longer prior to
incorporation into the soil,food crops with harvested parts below the land 20 months
surface(e.g.,root crops such as potatoes, carrots, radishes,etc.)shall not be
harvested for:
When the residuals remain on the land surface for less than four months prior to
incorporation into the soil, food crops with harvested parts below the Iand 38 months
surface shall not be harvested for:
[15A NCAC 02T .1109(b)(3)]
15. The Permittee shall acquire from each landowner or lessee/operator a statement detailing the volume
of other nutrient sources (i.e., manufactured fertilizers, manures, or other animal waste products)that
have been applied to the site,and a copy of the most recent Nutrient Management Plan(NMP)for those
operations where a NMP is required by the US Department of Agriculture — National Resources
Conservation Service(NRCS)or other State Agencies.The Permittee shall calculate allowable nutrient
loading rates based on the provided information and use appropriate reductions.
For the purpose of this permit condition, a Crop Management Plan (CMP), Waste Utilization Plan
(WUP) or Certified Nutrient Management Plan (CNMP) shall also be considered a Nutrient
Management Plan. [15A NCAC 02T ,0108(b)(1), 02T.1104(c)(3)]
16. No residuals shall be land applied unless the submitted Land Owner Agreement between the Permittee
and landowners or lessees/operators of the land application site is in full force and effect. These
agreements shall be considered expired concurrent with the permit expiration date,and shall be renewed
during the permit renewal process. [15A NCAC 02T .1104(c)(4)]
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IV. MONITORING AND REPORTING REQUIREMENTS
1. Any Division-required monitoring (including groundwater, plant tissue, soil and surface water
analyses) necessary to ensure groundwater and surface water protection shall be established, and an
acceptable sample reporting schedule shall be followed. [15A NCAC 02T .0108(c)]
2. Residuals shall be analyzed to demonstrate they are non-hazardous under the Resource Conservation
and Recovery Act(RCRA). Residuals that tests or is classified as a hazardous or toxic waste under 40
CFR Part 261 shall not be used or disposed under this permit. The analyses [corrosivity,ignitability,
reactivity, and toxicity characteristic leaching procedure (TCLP)] shall be performed at the
frequency specified in Attachment A, and the Permittee shall maintain these results for a minimum of
five years. Any exceptions from the requirements in this condition shall be specified in Attachment A.
The TCLP analysis shall include the following parameters (the regulatory Ievel in milligrams per liter
is in parentheses):
Arsenic (5.0) 1,4-Dichlorobenzene(7.5) Nitrobenzene(2.0)
Barium(100.0) 1,2-Dichloroethane(0.5) Pentachlorophenol(100.0)
Benzene(0.5) 1,1-Dichloroethylene(0.7) Pyridine(5.0)
Cadmium(1.0) 2,4-Dinitrotoluene(0.13) Selenium(1.0)
Carbon tetrachloride(0.5) Endrin(0.02) Silver(5.0)
Chlordane(0.03) Hexachlorobenzene(0.13) Tetrachloroethylene(0.7)
Chlorobenzene(100.0) Heptachlor(and its hydroxide) Toxaphene (0.5)
(0.008)
Chloroform(6.0) Hexachloro-1,3-butadiene(0.5) Trichloroethylene(0.5)
Chromium(5.0) Hexachloroethane(3.0) 2,4,5-Trichlorophenol(400.0)
m-Cresol(200.0) Lead(5.0) 2,4,6-Trichlorophenol(2.0)
o-Cresol(200.0) Lindane(0.4) 2,4,5-TP(Silvex)(1.0)
p-Cresol(200.0) Mercury(0.2) Vinyl chloride (0.2)
Cresol(200.0) Methoxychlor(10.0)
2,4-D(10.0) Methyl ethyl ketone(200.0)
[15A NCAC 13A .0102(b), 02T .1101, 02T .1105]
WQ0008008 Version 4.0 Shell Version 170401 Page 9 of 13

3. An analysis shall be conducted on residuals from each source generating facility at the frequency
specified in Attachment A, and the Permittee shall maintain the results for a minimum of five years.
The analysis shall include the following parameters:
Aluminum Mercury Potassium
Ammonia-Nitrogen Molybdenum Selenium
Arsenic Nickel Sodium
Cadmium Nitrate-Nitrite Nitrogen Sodium Adsorption Ratio
(SAR)
Calcium Percent Total Solids TKN
Copper pH Zinc
Lead Phosphorus
Magnesium
Plant Available Nitrogen
(by calculation)
[15A NCAC 02T .11011
4. Residuals shall be monitored for compliance with pathogen reduction requirements at the frequency
specified in Attachment A, and at the time indicated in the sampling and monitoring sections of the
approved O&M plan. The required data shall be specific to the stabilization process utilized, and
sufficient to demonstrate compliance with the Class B pathogen reduction requirements in 15A NCAC
02T .1106 (a) and (c) shall be met. Any exceptions from the requirements in this condition shall be
specified in Attachment A. [15A NCAC 02T .1106, 02T .1107, 02T .1111(c)]
5. An annual representative soils analysis (i.e., Standard Soil Fertility Analysis) shall be conducted on
each land application site Iisted in Attachment B on which a residuals land application event will occur
in the respective calendar year. This analysis shall be in accordance with the "Guidance on Soil
Sampling" located in the Sampling Instructions section of the NC Department of Agriculture &
Consumer Services'website(http://www.ncagr.gov/agronomi/pubs.htm).The Permittee shall maintain
these results and a description of the sampling methodologies used to determine soil fertility for a period
of no less than five years,and shall be made available to the Division upon request. At a minimum,the
Standard Soil Fertility Analysis shall include the following parameters:
Acidity Exchangeable Sodium Percentage Phosphorus
Base Saturation(by calculation) Magnesium Potassium
Calcium Manganese Sodium
Cation Exchange Capacity Percent Humic Matter Zinc
Copper pH
[15A NCAC 02T .0108(c), 15A NCAC 02T .1111(d)]
6. Laboratory parameter analyses shall be performed on the residuals as they are land applied, and shall
be in accordance with the monitoring requirements in 15A NCAC 02B .0505. [15A NCAC 02B .0505]
WQ0008008 Version 4.0 Shell Version 170401 Page 10 of 13

7. The Permittee shall maintain records tracking all residual land application events. At a minimum,these
records shall include the following:
a. Source of residuals;
b. Date of land application;
c. Location of land application(i.e., site,field, or zone number as listed in Attachment B);
d. Approximate areas applied to(acres);
e. Method of land application;
f. Weather conditions(e.g., sunny, cloudy,raining, etc.);
g. Predominant Soil Mapping Unit(e.g.,CbB2);
h. Soil conditions(e.g., dry,wet, frozen,etc.);
i. Type of crop or crops to be grown on field;
j. Nitrogen Application Rate based on RYEs (if using data obtained from the North Carolina State
University Department of Soil Science Website,the printout page shall be kept on file and reprinted
every five years);
k. Volume of residuals land applied in gallons per acre, cubic yard per acre,dry tons per acre, or wet
ton per acre;
1. Volume of animal waste or other nutrient source applied in gallons per acre, dry ton per acre, or
wet tons per acre;
m. Volume of soil amendments(e.g., lime, gypsum,etc.)applied in gallons per acre,dry ton per acre,
or wet tons per acre; and
n. Annual and cumulative totals in dry tons per acre of residuals as well as animal waste and other
sources of nutrients(e.g.,if applicable),annual and cumulative pounds per acre of each heavy metal
(e.g., shall include, but shall not be limited to, arsenic, cadmium, copper, lead, mercury,
molybdenum, nickel, selenium, and zinc), annual pounds per acre of PAN, and annual pounds per
acre of phosphorus applied to each field.
[15A NCAC 02T .0109(a)]
8. Three copies of an annual report shall be submitted on or before March 1st. The annual report shall
meet the requirements described in the Instructions for Residuals Application Annual Reporting Forms.
Instructions for reporting and annual report forms are available at
http://deq.nc.gov/about/divisions/water-resources/water-resources-permitslwastewater-branch/non-
discharge-permitting-unit/reporting-forms, or can be obtained by contacting the Non-Discharge
Permitting Unit directly. The annual report shall be submitted to the following address:
Division of Water Resources
Information Processing Unit
1617 Mail Service Center
Raleigh,North Carolina 27699-1617
[15A NCAC 02T .1111(a)]
WQ0008008 Version 4.0 Shell Version 170401 Page 11 of 13

9. Noncompliance Notification
The Permittee shall report by telephone to the Washington Regional Office, telephone number (252)
946-6481,as soon as possible,but in no case more than 24 hours or on the next working day following
the occurrence or first knowledge of the occurrence of any of the following:
a. Land application of residuals abnormal in quantity or characteristic.
b. Any failure of the land application program resulting in a release of material to surface waters.
c. Any time self-monitoring indicates the facility has gone out of compliance with its permit
limitations.
d. Any process unit failure, due to known or unknown reasons, rendering the facility incapable of
adequate residual treatment.
e. Any spill or discharge from a vehicle or piping system during residuals transportation.
Any emergency requiring immediate reporting(e.g., discharges to surface waters, imminent failure of
a storage structure, etc.)outside normal business hours shall be reported to the Division's Emergency
Response personnel at telephone number(800) 662-7956, [phone], or(919)733-3300.Persons
reporting such occurrences by telephone shall also file a written report in letter form within five days
following first knowledge of the occurrence. This report shall outline the actions taken or proposed to
be taken to ensure that the problem does not recur. [15A NCAC 02T .0105(1), 02T ,0108(b)(1)]
V. INSPECTIONS
1. The Permittee shall provide adequate inspection and maintenance to ensure proper operation of the
subject facilities and shall be in accordance with the approved O&M Plan. [15A NCAC 02T.0108(b)]
2. Prior to each bulk residuals land application event, the Permittee or his designee shall inspect the
residuals processing, storage, transport and application facilities to identify malfunctions, facility
deterioration and operator errors that could result in discharges to the environment, a threat to human
health or a public nuisance. The Permittee shall maintain an inspection log that includes,at a minimum,
the date and time of inspection,observations made,and any maintenance,repairs,or corrective actions
taken. The Permittee shall maintain this inspection log for a period of five years from the date of
inspection, and this log shall be made available to the Division upon request. [15A NCAC 02T
.0108(b)]
3. Any duly authorized Division representative may, upon presentation of credentials, enter and inspect
any property,premises or place on or related to the land application sites or facilities permitted herein
at any reasonable time for the purpose of determining compliance with this permit;may inspect or copy
any records required to be maintained under the terms and conditions of this permit; and may collect
groundwater, surface water or leachate samples. [G.S. 143-215.3(a)(2)]
VI. GENERAL CONDITIONS
1. Failure to comply with the conditions and limitations contained herein may subject the Permittee to an
enforcement action by the Division in accordance with North Carolina General Statutes 143-215.6A to
143-215.6C. [G.S. 143-215.6A to 143-215.6C]
2. This permit shall become voidable if the residuals land application events are not carried out in
accordance with the conditions of this permit. [15A NCAC 02T .0110]
3. This permit is effective only with respect to the nature and volume of residuals described in the permit
application and other supporting documentation. [G.S. 143-215.1]
WQ0008008 Version 4.0 Shell Version 170401 Page 12 of 13

4. The issuance of this permit does not exempt the Permittee from complying with any and all statutes,
rules, regulations, or ordinances, which may be imposed by other jurisdictional government agencies
(e.g.,local, state, and federal). Of particular concern to the Division are applicable river buffer rules in
15A NCAC 02B .0200; erosion and sedimentation control requirements in 15A NCAC Chapter 4 and
under the Division's General Permit NCG010000; any requirements pertaining to wetlands under 15A
NCAC 02B .0200 and 02H.0500; and documentation of compliance with Article 21 Part 6 of Chapter
143 of the General Statutes. [15A NCAC 02T .0105(c)(6)]
5. In the event the residuals program changes ownership or the Permittee changes his name, a formal
permit modification request shall be submitted to the Division. This request shall be made on official
Division forms, and shall include appropriate documentation from the parties involved and other
supporting documentation as necessary. The Permittee of record shall remain fully responsible for
maintaining and operating the residuals program permitted herein until a permit is issued to the new
owner. [15A NCAC 02T .0104]
6. This permit is subject to revocation or unilateral modification upon 60-day notice from the Division
Director,in whole or part for the requirements listed in 15A NCAC 02T.0110. [15A NCAC 02T.0110]
7. Unless the Division Director grants a variance,expansion of the permitted residuals program contained
herein shall not be granted if the Permittee exemplifies any of the criteria in 15A NCAC 02T .0120(b).
[15A NCAC 02T .0120]
8. The Permittee shall pay the annual fee within 30 days after being billed by the Division. Failure to pay
the annual fee accordingly shall be cause for the Division to revoke this permit. [15A NCAC 02T
.0105(e)(3)]
Permit issued this the 141 day of September 2017
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
XJ--•e:V%-01444,"
Jay Zimmerman,P.G., Director
Division of Water Resources
By Authority of the Environmental Management Commission
Permit Number WQ0008008
WQ0008008 Version 4.0 Shell Version 170401 Page 13 of 13

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Drawn by: CSC SOIL IT � PLUS' Paquotank Cnty WTP Class B Land App
Reviewed by: J Weeksville, North Carolina 1
Date: Aug'17 Soil Plus Project# 201007.B11

APPENDIX 2
2022 PERMIT RENEWAL/MODIFICATION
Pasquotank County Regional WTF
(WQ0008008)
RSCA
Analytical Data

State of North Carolina
DW RDepartment of Environmental Quality
Division of Water Resources
Division of Water Resources RESIDUALS SOURCE CERTIFICATION
INSTRUCTIONS FOR FORM: RSC 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 certification provides detailed information of residuals source generating facility and its residuals quality for land
application,distribution,or disposal in accordance with 15A NCAC 02T.1100. Do not submit this certification for review without
a corresponding application form(FORM:RLAP 11-15,FORM:DCAR 11-15,or FORM: SDR 11-15).
Unless otherwise noted,the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Residuals Source Certification(FORM:RSC 11-15):
❑ Submit the completed and appropriately executed Residuals Source Certification(FORM: RSC 11-15) 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.
❑ For new or renewed permits,submit a separate certification for each source facility.
❑ For modified permits,submit a separate certification for only those facilities that are affected by the proposed modification.
❑ Complete the residuals source facility summary page.List all new,renewed,or modified facilities.
B. Residuals Source-Generating Facility Information:
❑ For each source facility,attach the following:
❑Vicinity map-A vicinity map that shows the location of the facility and meets all of the criteria in the"Map Guidance for
Residuals Land Application Permits".
❑Process flow diagram and/or narrative-A detailed narrative and/or process flow diagram that describes how the residuals
are to be generated,treated,processed,and stored at the facility.
❑ Quantitative justification for residuals production rate - A quantitative justification for the value provided in Item I. 8.
Ensure that the amount of residuals listed is the maximum amount expected to be generated by the facility for the life of
the permit. In addition, ensure that this amount is equivalent to that which is actually to be land applied, distributed,
and/or disposed, including any chemicals, amendments, or other additives that are added to the residuals during
processing.
❑ Sampling plan - A detailed sampling plan for the residuals source-generating facility. Ensure that the plan identifies
sampling points, sampling frequency, sample type, as well as the Division-certified laboratory to be used. In addition,
ensure that the plan details how the facility and/or the residuals are monitored for any applicable pathogen reduction and
vector attraction reduction requirements. Note that all sampling and monitoring must be completed on the residuals as
they are to be land applied,distributed,and/or disposed.
C. Residuals Quality Information:
❑ For each source facility,attach the following:
❑ Laboratory analytical reports and operational data-reports for all laboratory analyses used to complete this certification.
❑ Documentation that the facility complies and/or the residuals comply with any applicable pathogen reduction and vector
attraction reduction requirements.
❑ For new facility that may have not yet been constructed and analytical results of residuals cannot be obtained, please
attach analytical results of residuals generated from a similar facility along with the description of similarities of the two
facilities.
INSTRUCTIONS FOR FORM:RSC 06-16 Page 1 of 1

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State of North Carolina
DW RDepartment of Environmental Quality
Division of Water Resources
Division of Water Resources RESIDUALS SOURCE CERTIFICATION
FORM:RSC 06-16
I. RESIDUALS SOURCE-GENERATING FACILITY INFORMATION(See Instruction B.):
1. Facility Name: lasquotank County Regional Water Treatment Facility
2. Facility permit holder is: ❑ Federal, J State, • Local Government,or Private.
Facility permit issued by: ® Div.of Water Resources, Div.of Environmental Health,
or ❑ Other(explain: W).
3. Facility contact person and title:David Smithson:1174es Director
Complete mailing address: PO Box 2245
City:plizabeth City State:NC Zip:27909-
Telephone number:O p5-2240 E-mail address: [e-mail]
4. Facility physical address: 1466 Weeksville Re
City:Elizabeth City State:NC Zip:27909-
Coordinates: Latitude: 36' 14'28" Longitude: 76' 10' 19"
Datum:NAD83 Level of accuracy: Sub-Meter
Method of measurement:GIS
5. Purpose of the facility:
▪ treatment of municipal wastewater, 111 treatment of 100%domestic wastewater,
▪ treatment of potable water, a treatment of 100%industrial wastewater,
▪ treatment of industrial wastewater mixed with domestic wastewater,
(approximate percentages:_%industrial and _%domestic)
▪ other(explain:_).
6. Does the facility have an approved pretreatment program: Yes ® No
7. Facility permitted/design flow:• MGD and facility average daily flow:U.075 (Backwash)MGD
8. Average amount of residuals being generated at this facility dry tons per year.
9. Specify the following regarding treatment and storage volumes available at the facility:
Type and volume of residuals treatment: 2.4 MG Conventional
Type and volume of residuals storage(i.e.,outside of residuals treatment units): rpprox. 300,000 Gallon Lagoon
II. RESIDUALS QUALITY INFORMATION(See Instruction C.):
1. Specify if residuals are regulated under:
▪ 40 CFR Part 503 or ® 40 CFR Part 257.
Note: 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.
2. Specify if residuals are defined under 15A NCAC 02T.1102(6)as:
▪ 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

3. Hazardous Waste Determination: Complete the following to demonstrate that the residuals are non-hazardous under
RCRA: (Note -this item does not have to be completed for facilities that are less than 0.5 MGD in design flow that treat
100%non-municipal,domestic wastewater only)
a. Are the residuals listed in 40 CFR§261.31-§261.33: g yes ® no.
If yes,list the number(s):
b. Specify whether or not the residuals exhibit any of the characteristics defined by 40 CFR§261.2 1-
261.24: p yes Ul no.
Fill in the following tables with the results of the latest toxicity characteristic leaching procedure (TCLP) analysis as
well as those for corrosivity,ignitability,and reactivity:
Laboratory: SGS Northerica,Inc. and Date of analysis: 2 20
Passed corrosivity test: ® yes ❑ no. pH: 8.3 s.u.(2<pH< 12.5)
Passed ignitability test: ira yes 0 no. Flashpoint:>209°F(> 140°F)
Passed reactivity test: a yes Mino.HCN:<5.9 mg/kg(<250)&H2S:<19 mg/kg(<500)
TCLP Parameter Limit Result TCLP Parameter Limit Result
(mg/1) (mg/1) (mg/1) (mg/1)
Arsenic 5.0 <0.10 Hexachlorobenzene 0.13 <0.069
Barium 100.0 <2.0 Hexachloro-1,3-Butadiene 0.5 <0.050
Benzene 0.5 <0.0031 Hexachloroethane 3.0 <0.16
Cadmium 1.0 <0.050 Lead 5.0 <0.050
Carbon Tetrachloride 0.5 <0.0036 Lindane 0.4 <0.000022
Chlordane 0.03 <0.00038 Mercury 0.2 <0.0050
Chlorobenzene 100.0 <0.0020 Methoxychlor 10.0 <0.000050
Chloroform 6.0 <0.0030 Methyl Ethyl Ketone 200.0 <0.020
Chromium 5.0 <0.10 Nitrobenzene 2.0 <0.093
m-Cresol 200.0 <0.098 Pentachlorophenol 100.0 <0.50
o-Cresol 200.0 <0.056 Pyridine 5.0 <0.20
p-Cresol 200.0 <0.098 Selenium 1.0 <0.50
Cresol 200.0 <0.154 Silver 5.0 <0.10
2,4-D 10.0 <0.017 Tetrachloroethylene 0.7 <0.0022
1,4-Dichlorobenzene 7.5 <0.050 Toxaphene 0.5 <0.0021
1,2-Dichloroethane 0.5 <0.0031 Trichloroethylene 0.5 <0.0035
1,1-Dichloroethylene 0.7 <0.0032 2,4,5-Trichlorophenol 400.0 <0.074
2,4-Dinitrotoluene 0.13 <0.081 2,4,6-Trichlorophenol 2.0 <0.075
Endrin 0.02 <0.000021 2,4,5-TP(Silvex) 1.0 <0.0013
Heptachlor and its Hydroxide 0.008 <0.000020 Vinyl Chloride 0.2 <0.0041
FORM:RSC 06-16 Page 2 of 5

4. Metals Determination: Complete one of the following tables (i.e., as applicable) to demonstrate that the residuals do not
violate the ceiling concentrations for metals regulated under 15A NCAC 02T.1105.
a. For Distribution/Land Application:Fill in the following table with the results of the latest analyses(i.e.,on a dry weight
basis)for the following metal parameters:
Laboratory:environment 1,11 and Date of analysis:F/2/2022
Parameter Ceiling Monthly Average Result
Concentration Limits Concentration Limits
(ClassA& ClassB) (Class A Only)
(mg/kg) (mg/kg) (mg/kg)
Arsenic 75 41 <2.5
Cadmium 85 39 <0.5
Copper 4,300 1,500 11
Lead 840 300 5.2
Mercury 57 17 <0.04
Molybdenum 75 nia <5.0
Nickel 420 420 <5.0
Selenium 100 100 <5.0
Zinc 7,500 2,800 19
b. For Surface Disposal Unit(landfill): Fill in the following table with the results of the latest analyses(i.e.,on a dry weight
basis)for the following metal parameters:
Laboratory: and Date of analysis:
Distance from Disposal Arsenic Chromium Nickel
Unit to Boundary to
Closest Property Line
(meters, check one) (mg/kg) (mg/kg) (mg/kg)
❑ >0but<25 30 200 210
❑ >25 but<50 34 220 240
❑ >50 but<75 39 260 270
❑ >75 but< 100 46 300 320
❑ > 100 but< 125 53 360 390
❑ > 125 62 450 420
Result(mg/kg)
FORM:RSC 06-16 Page 3 of 5

5. Nutrient/Micronutrient Determination: Complete the following:
a. Total solids: ag%.
b. Fill in the following table with the results of the latest analyses(i.e., on a dry weight basis)for the following nutrient and
micronutrient parameters:
Laboratory:environment 1,Ind and Date of analysis:L/2/2022
Parameter Result
(mg/kg)
Aluminum 4,593
Ammonia-Nitrogen 41.90
Calcium 21,911
Magnesium 2,092
Nitrate-Nitrite Nitrogen 19.95
pH(Standard Unit) 8.4
Phosphorus 6,427
Potassium <500
Sodium <1,250
Total Kjeldahl Nitrogen 1,930
c. Using the results listed in Item II. 5b. above, calculate the sodium adsorption ration (SAR): 179
[Note: If residuals contain SAR of 10 or higher, the applicant shall obtain recommendations from the local Cooperative
Extension Office, the Department of Agriculture and Consumer Services, the Natural Resource Conservation Service, a
North Carolina Licensed Soil Scientist,or an agronomist,prior to land application of residuals. The recommendations shall
address the sodium application rate, soil amendments (e.g., gypsum, etc.), or a mechanism for maintaining site integrity
and conditions conducive to crop growth].
d. Specify the mineralization rate to be used in calculating the plant available nitro en(PAN)of the residuals: I%. This rate
is a(check one): default value,or actually established.
If the residuals are not generated from the treatment of municipal or domestic wastewater, ex lain or provide technical
justification as to why the selected default value is appropriate to be applied to these residuals:
e. Calculate the PAN for the residuals(i.e.,on a dry weight basis)and fill the results in the following table:
Application Method First(1st)Year PAN Five-Year
Maximum Adjusted PAN
(mg/kg) (mg/kg)
Surface 41 41
Injection/Incorporation 62 62
6. Other Pollutants Determination: Specify whether or not there are any other pollutants of concern in the residuals and provide
the results of the latest analyses: None Know
FORM:RSC 06-16 Page 4 of 5

7. Pathogen Reduction:Per 15A NCAC 02T.1106,specify how residuals will meet the pathogen reduction requirements:
a. For Distribution/Land Application of Class A or Equivalent:
A fecal coliform density that is demonstrated to be less than 1,000 MPN per gram of total dry solids,
or
id A salmonella sp. density that is demonstration to be less than 3 MPN per 4 grams of total dry solids.
AND one of the followings(except for non-biological residuals):
MI Alternative 1 [15A NCAC 02T.1106(b)(3)(A)] -Time/Temperature Compliance.
GI Alternative 2 [15A NCAC 02T.1106(b)(3)(B)]-Alkaline Treatment.
Alternative 3 [15A NCAC 02T.1106(b)(3)(C)]-Prior Testing for Enteric Virus/Viable Helminth Ova.
EJ Alternative 4[15A NCAC 02T.1106(b)(3)(D)] -No Prior Testing for Enteric Virus/Viable Helminth Ova.
El Alternative 5 [15A NCAC 02T.1106(b)(3)(E)-(K)]-Process to Further Reduce Pathogens(PFRP).
Specify one: composting, 111 heat drying, 71 heat treatment,
thermophilic aerobic digestion, ❑ beta ray irradiation,
❑ gamma ray irradiation, or ❑ pasteurization.
b. For Land Application of Class B:
q Alternative 1 [15A NCAC 02T.1106(c)(1)]-Fecal Coliform Density Demonstration.
51 Alternative 2 [15A NCAC 02T.1106(c)(2)]-Process to Significantly Reduce Pathogens(PSRP).
Specify one: ❑ aerobic digestion, I air drying, ❑ anaerobic digestion,
❑ composting,or lime stabilization.
c. For Surface Disposal:
11 Select One of the Class A or Equivalent Pathogen Reduction Alternatives in Item II.7a.above.
El Select One of the Class B or Equivalent Pathogen Reduction Alternatives in Item II. 7b.above.
Exempt-If Daily Cover Alternative is chosen in Item II.8.below[15A NCAC 02T.1106(a)(2)].
El Not Applicable-Non-Biological Residuals with NO Domestic Wastewater Contribution.
8. Vector Attraction Reduction(VAR):Per 15A NCAC 02T.1107,specify how residuals will meet the VAR requirements:
El Alternative 1 [15A NCAC 02T.1107(a)(1)]-38%Volatile Solids Reduction(Aerobic/Anaerobic Digestion).
El Alternative 2 [15A NCAC 02T.1107(a)(2)] -40-Day Bench Scale Test(Anaerobic Digestion).
El Alternative 3 [15A NCAC 02T.1107(a)(3)]-30-Day Bench Scale Test(Aerobic Digestion).
El Alternative 4[15A NCAC 02T.1107(a)(4)]-Specific Oxygen Uptake Rate Test(Aerobic Digestion).
El Alternative 5 [15A NCAC 02T.1107(a)(5)] - 14-Day Aerobic Processes.
El Alternative 6[15A NCAC 02T.1107(a)(6)] -Alkaline Stabilization.
El Alternative 7 [15A NCAC 02T.1107(a)(7)]-Drying of Stabilized Residuals.
El Alternative 8 [15A NCAC 02T.1107(a)(8)] -Drying of Unstabilized Residuals.
El Alternative 9[15A NCAC 02T.1107(a)(9)]-Injection.
El Alternative 10[15A NCAC 02T.1107(a)(10)]-Incorporation.
la Alternative for Surface Disposal Units Only-Soil/Other Material Cover[15A NCAC 02T.1107(b)(2)].
Not Applicable-Non-Biological Residuals with NO Domestic Wastewater Contribution.
Note: For animal processing residuals, only alternatives 9 or 10 may be chosen due to the nuisance conditions that typically
occur when these residuals are applied and left on the land surface.
FORM:RSC 06-16 Page 5 of 5

I"
AGMAN
.1. 1.�, FIELD LOADING ESTIMATES
Facility Pasquotank County Regional Water
Sampling Date 2/2/2022
Solids 13.44
Mineralization Rate 0
Gallons per DT 1,784.29
pH 8.4
Sodium Absorpotion 0.79 <5.0 Safe 5.0- 10.0 Careful Management >15.0 Do Not Land Apply
Ratio
NITROGEN APPLICATION NUTRIENT APPLICATION
TKN(mg/Kg) 1,930 lbs./1,000 gal 2.16 Potassium lbs./1,000 gal 0.56
Ammonia Nitrogen(mg/Kg) 41.90 lbs./1,000 gal 0.05 Phosphorus lbs./1,000 gal 7.20
Nitrate-Nitrite (mg/Kg) 19.95 lbs./1,000 gal 0.02 Calcium lbs./1,000 gal 24.56
PLANT AVAILABLE NITROGEN SURFACE APPLIED Magnesium lbs./1,000 gal 2.34
PAN(mg/Kg) 41 lbs./1,000 gal 0.05 Manganese lbs./1,000 gal
PLANT AVAILABLE NITROGEN INJECTED/INCORPORATED APPLIED Sulfur lbs./1,000 gal
PAN(mg/Kg) 62 lbs./1,000 gal 0.07 Molybdenum lbs./1,000 gal 0.01
Volatization Rate=0.5 Surface Application
1.0 Injection/Incorporation
EPA METAL LIMITS
Class A Ceiling Class B Ceiling
Limits (mg/Kg) Limits (mg/Kg) HEAVY METAL CONCENTRATION HEAVY METAL LOADING
41 75 Arsenic(mg/Kg) 2.50 Arsenic lbs./1,000 gal 0.00
39 85 Cadmium(mg/Kg) 0.50 Cadmium lbs./1,000 gal 0.00
1,500 4,300 Copper(mg/Kg) 11.00 Copper lbs./1,000 gal 0.01
300 840 Lead(mg/Kg) 5.20 Lead lbs./1,000 gal 0.01
17 57 Mercury(mg/Kg) 0.04 Mercury lbs./1,000 gal 0.00
420 420 Nickel(mg/Kg) 5.00 Nickel lbs./1,000 gal 0.01
100 100 Selenium(mg/Kg) 5.00 Selenium lbs./1,000 gal 0.01
2,800 7,500 Zinc(mg/Kg) 19.00 Zinc lbs./1,000 gal 0.02
RESIDUAL NITROGEN CALCULATION
Surface Application Injection/Incorporation Application
Remaining Remaining
Organic Organic
PAN PAN Nitrogen PAN PAN Nitrogen
TKN (mg/kg) (lbs/DT) (mg/Kg) TKN (mg/kg) (lbs/DT) (mg/Kg) Equations
1st Year 1,930 41 0.08 1,889 1,930 62 0.12 1,868 1st Yr.PAN(mg/Kg)=(MR x(TKN-NH3))+(VR x NH3)+NOx
2nd Year 1,889 0 0.00 1,889 1,868 0 0.00 1,868 2nd Yr PAN(mg/Kg)=2nd Yr.TKN x(MIZ/2)
3rd Year 1,889 0 0.00 1,889 1,868 0 0.00 1,868 3rd Yr PAN(mg/Kg)=3rd Yr.TKN x(MR/4)
4th Year 1,889 0 0.00 1,889 1,868 0 0.00 1,868 4th Yr PAN(mg/Kg)=4th Yr.TKN x(MR/8)
5th Year 1,889 0 0.00 1,889 1,868 0 0.00 1,868 5th Yr PAN(mg/Kg)=5th Yr.TKN x(MR/16)
Total 41 0.08 Total 62 0.12

EMMIDMIDITAtill'a [[] 111©217N921111 Drinking Water Ih: 37715
Wastewater ID: 10
114 OAKMONT DRIVE PHONE [phone]
GREENVILLE, N.C. 2785€3 FAX [phone]
ID#: 149
PASQUOTANK CO. WATER (SLUDGE)
MR. MICHAEL L. HARRIS
1466 WEEKSVILLE ROAD DATE COLLECTED: 02/02/22
ELIZABETH CITY, NC 27909 DATE REPORTED : 03/01/22
REVIEWED BY:
Water Plant Analysis Method
PARAMETERS Sludge Date Analyst Code
PH (not to be used for repor4ing) 8.4 02/02/22 CAW 4500HB-11
Aluminum, (dry svt. basis), mg/kg 4593 02/08/22 LFJ EPA200.7
Arsenic (dry wt. basis), mg/kg <2.5 02/10/22 MTM 3113B-04
Calcium (dry wt. basis), mg/kg 21911 02/08/22 LFJ EPA200.7
Cadmium (dry wt. basis), mg/kg <0.5 02/08/22 MTM 3113E-04
Copper (dry wt. basis), mg/kg 11 02/08/22 LFJ EPA200.7
Chromium, T.(dry wt. basis),mg/kg 10 02/08/22 LEI EPA200.7
Lead (dry weight basis), mg/kg 5.2 02/09/22 MTM 3113B-04
Magnesium (dry wt. basis), mg/kg 2092 02/08/22 LFJ EPA200.7
Mercury (dry wt. basis), mg/kg <0.04 02/10/22 MTM EPA7471B
Nickel (dry wt. basis), mg/kg <5.0 02/08/22 LFJ EPA200.7
Potassium (dry wt basis), mg/kg <500 02/09/22 LEI EPA200.7
Selenium (dry wt. basis), mg/kg <5.0 02/11/22 MTM 3113B-04
Sodium (dry wt. basis), mg/kg <1250 02/08/22 LFJ EPA200.7
Zinc (dry wt. basis), mg/kg 19 02/08/22 LFJ EPA200.7
Total Solids, % 13.44 02/03/22 BLV 2540G-15
TKN (dry svt.), mg/kg c 1930 02/08/22 TRJ 351.2 R2-93
Ammonia Nitrogen (dry wt.),mg/kg c 41.90 02/08/22 IKES 350.1 R2-93
Phosphorus, T. (dry wt.), mg/kg c 6427 02/08/22 BMD 365.4-74
Nitrate+Nitrite (dry wt.), mg/kg c 19.95 02/09/22 TRJ 353,2 R2-93
Plant Available Nitrogen, mg/kg 796 02/15/22 MAO
Molybdenum (dry wt. basis), mg/kg <5.0 02/08/22 LEJ EPA200.7
c Uncertified data. DWR does not offer non-aqueous certification for this analytical procedure.

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•
Orlando, FL • 021213122
The results set forth herein are provided by SGS North America Inc.. Ila `dcop j 2,
A ittoaita€ed RpoiÍ
Technical Report for
Environment 1, Inc
Pasquotank Co Water; 1466 Weeksville Rd, Elizabeth City, NC
149
- SUS Job Number: FA92936
• Sampling Date: 02/02/22
;r '
Report to:
Environment 1, Inc
PO Box 7085
Greenville, NC 27835
abrownurw@environment 1 inc.com
ATTN: Ann Brown
Total number of pages in report: 1.4
z:
7
Test results contained within this data package meet the requirements Norm Farmer
of the National Environmental Laboratory Accreditation Program Technical Director
and/or state specific certification programs as applicable.
Client Service contact: Jean Dent-Smith 407-425-6700
Certifications:FL(E83510),LA(03051),KS(E-I0327),NC(573),N7(FL002),NY(12022),SC(96035001)
DOD ELAP(ANAS L2229),AZ(AZ0806),CA(2937),TX(T104704404),PA(68-03573),VA{46o177),
AL,AK,AR,CT,IA,KY,MA,MI.MS,ND,NH,NV,OK,OR,IL,UT,VT,WA,WI,WV
This report shall not be reproduced,except in its entirety,without the written approval of SGS.
Test results relate only to samples analyzed.
SOS North America Inc. • 4405 Vineland Road • Suite C-15 • Orlando,FL 32811 • tel:[phone] - fax:[phone]
SOS is the sole authority for authorizing edits or mndilieutions to this document. Please share your ideas about SGS i of 1,
Unauthorized modil.cation of tits report is strictly prohibited. how we t'an serve you better at: --

Sections:
T.able of Contents
Section 1: Sample Summary 3
Section 2: Summary of Hits 4
Sections 3: Sample Results A.............a......<.,,e.sa,.b.,........,o_.....o .eo......<...>...A,..os..<.. . .,,...s .
5
3.1: FA92936-1: WATER PLANT SLUDGE 6
3.2: FA92936-1L: WATER PLANT SLUDGE 7
Section 4: Misc. Forms 12
4.1: Chain of Custody 13

SGS North America Inc.
Sample Summary
Environment 1, Inc
Job No: FA92936
Pasquotank Co Water; 1466 Weeksville Rd, Elizabeth City, NC
Project No: 149
Sample Collected Matrix Client
Number Date Time By Received Code Type Sample ID
This report contains results reported as-ND - Not detected„The following applies:
Organics ND = Not detected above the MDL
FA92936-I 02/02/22 09:00 AW 02/07/22 SO Sludge WATER PLANT SLUDGE
FA92936-IL 02/02/22 09:00 AW 02/07/22 SO Sludge WATER PLANT SLUDGE
Soil.samples reported on a dry weight basis unless otherwise indicated on result page.
3 SGS_ of
...

Summary of Hits Page 1 of 1
Job Number: FA92936
Account: Environment 1, Inc
Project: Pasquotank Co Water; 1466 Weeksville Rd, Elizabeth City,NC
Collected: 02/02/22
Lab Sample ID Client Sample ID Result/
Analyte Qual RL MDL Units Method
FA92936-1 WATER PLANT SLUDGE
Corrosivity as pH 8.3 su SW846 CHAP7
Ignitability(Flashpoint)a >200 Deg. F SW846 1020C MOD
FA92936-1L WATER PLANT SLUDGE
No hits reported in this sample.
(a)Not ignitable.
4 of

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•Sample Results
Report of AnalYsis
5of1,

SGS North America Inc.
Report of Analysis Page 1 of 1
Client Sample ID: WATER PLANT SLUDGE
Lab Sample ID: FA92936-1 Date Sampled: 02/02/22
Matrix: SO-Sludge Date Received: 02/07/22
Percent Solids: 25.6
Project: Pasquotank Co Water; 1466 Weeksville Rd, Elizabeth City,NC
General Chemistry
Analyte Result RL Units DF Analyzed By Method
Corrosivity as pH 8.3 su 1 02/11/22 09:58 sH SW846 CEAP7
Cyanide Reactivity <5.9 5.9 mg/kg 1 02/28/22 10:24 AC SW846 CHAP7
Ignitability(Flashpoint)a 200 Deg. F 1 02/10/22 14:30 RA SW846 1020C MOD
Solids, Percent 25.6 % 1 02/16/22 19:14 AK SM19 2540G
Sulfide Reactivity <19 19 mg/kg 1 02/16/22 15:10 JC SW846 CHA137
(a)Not ignitable.
RL = Reporting Limit
. .
5afi
. ._.

SOS North America Inc.
Report of Analysis Page of 1 1,
�2
Client Sample ID: WATER PLANT SLUDGE '
Lab Sample ID: FA92936-IL Date Sampled: 02/02/22
Matrix: SO- Sludge Date Received: 02/07/22
Method: SW846 8260D SW846 1311 Percent Solids: 25.6
Project: Pasquotank Co Water; 1466 Weeksville Rd, Elizabeth City,NC
File ID DF Analyzed By Prep Date Prep Batch Analytical Batch
Run#1 2P8553I.D 10 02/09/22 18:52 CF 02/08/22 13:00 OP89629 V2P3394
Run#2
Purge Volume
Run##1 5.0nl
Run#2
VOA TCLP List TCLP Leachate method SW846 1311
CAS No. Compound Result HW#i MCL RL MDL Units Q
71-43-2 Benzene ND D018 0.50 0.010 0.0031 mg/1
78-93-3 2-Butanone(MEK) ND D035 200 0.050 0.020 mg/1
56-23-5 Carbon Tetrachloride ND D019 0.50 0.010 0.0036 mg/1
108-90-7 Chlorobenzene ND D021 100 0.010 0.0020 mg/1
67-66-3 Chloroform ND D022 6.0 0.010 0.0030 mgll
106-46-7 1,4-Dichlorobenzene ND D027 7.5 0.010 0.0026 mg/1
107-06-2 1,2-Dichloraethane ND D028 0.50 0.010 0.0031 mg/I
75-35-4 1,1-Dichloroethylene ND D029 0.70 0.010 0.0032 mg/1
127-18-4 Tetrachloroethylene ND D039 0.70 0.010 0.0022 mg/I
79-01-6 Trichloroethylene ND D040 0.50 0.010 0.0035 mg/1
75-01-4 Vinyl Chloride ND D043 0.20 0.010 0.0041 mg/1
CAS No. Surrogate Recoveries Run#I Run#2 Limits
1868-53-7 Dibromofluoromethane 99% 83-118%
17060-07-0 1,2-Dichloroethane-D4 103% 79-125%
2037-26-5 Toluene-D8 94% 85-112%
460-00-4 4-Bromofluorobenzene 100% 83-118%
ND = Not detected MDL = Method Detection Limit J = Indicates an estimated value
MCL = Maximum Contamination Level(40 CFR 261 7/1/11) B = Indicates analyte found in associated method blank
E = Indicates value exceeds calibration range N = Indicates presumptive evidence of a compound
7of1=

SGS North America Inc.
Report of Analysis Page 1 of 1
Client Sample ID: WATER PLANT SLUDGE
Lab Sample ID: FA92936-1L Date Sampled: 02/02/22
Matrix: SO -Sludge Date Received: 02/07/22
Method: SW846 8270E SW846 3510C Percent Solids: 25.6
Project: Pasquotank Co Water; 1466 Weelcsviile Rd, Elizabeth City,NC
File ID DF Analyzed By Prep Date Prep Batch Analytical Batch
Run#1 6F13315.D 1 02/18/22 22:52 WH 02/18/22 12:00 OP89832 S6F496
Run#2
Initial Volume Final Volume
Run#1 10.0:nl 1.0 ml
Run#2
ABN TCLP List TCLP Leachate method SW846 1311
CAS No, Compound Result HW# MCL RL MDL Units Q
95-48-7 2-Methylphenol ND D023 200 0.50 0.056 mg/1
38z4-Metbylphenol ND D024 200 0.50 0.098 mg/I
87-86-5 Pentachlorophenol ND D037 100 2.5 0.50 mg/I
95-95-4 2,4,5-Trichlorºphenol ND D041 400 0.50 0.074 mg/1
88-06-2 2,4,6-Trichlorophenol ND D042 2.0 0.50 0.075 mg/1
106-46-7 1,4-Dichlorobenzene ND D027 7.5 0.50 0,050 mg/1
121-14-2 2,4-Dinitrotoluene ND D030 0.13 0.50 0.081 mg/1
118-74-1 Hexachlorobenzene ND D032 0.13 0.50 0.069 mg/1
87-68-3 Hexachlorobutadiene ND D033 0.50 0.50 0.050 mg/I
67-72-1 Hexachloroethane ND D034 3.0 0.50 0.16 mg/I
98-95-3 Nitrobenzene ND D036 2.0 0.50 0.093 Ong/1
110-86-1 Pyridine ND D038 5.0 1,0 0.20 mg/1
CAS No. Surrogate Recoveries Ran#1 Run#2 Limits
367-12-4 2-Fluorophenol 34% 14-67%
4165.62-2 Phenol-d5 24% 10-50%
118-79-6 2,4,6-Tribromophenol 75% 33-118%
4165-60-0 Nitrobenzene-d5 69% 42-108%
321-60-8 2-Fluorobiphenyl 72% 40-106%
1718-51-0 Terphenyl-d14 84% 39-121%
ND = Not detected MDL = Method Detection Limit J = Indicates an estimated value
MCL = Maximum Contamination Level(40 CFR 261 7/1/11) B = Indicates analyte found in associated method blank
E = Indicates value exceeds calibration range N = Indicates presumptive evidence of a compound
--. _ 8of1,

SGS North America Inc.
Report of Analysis Page 1 of 1
Client Sample ID: WATER PLANT SLUDGE
Lab Sample ID: FA92936-1I, Date Sampled: 02/02/22 `.
Matrix: SO -Sludge Date Received: 02/07/22
Method: SW846 8151A SW846 3510C Percent Solids: 25.6
Project: Pasquotank Co Water; 1466 Weeksville Rd, Elizabeth City, NC
File Ill DF Analyzed By Prep Date Prep Batch Analytical Batch
Run#1 CC080211.D 1 02/20/22 22:52 NJ 02/18/22 12:00 0P89827 GCC2022
Run#2
Initial Volume Final Volume
Run#1 10.0 mi 5.0 ml
Run#2
Herbicide TCLP List TCLP Leachate method SW846 1311
CAS No. Compound Result IIW# MCL RL MDL Units Q
94-75-7 2,4-D ND 0016 10 0.050 0.017 mg/1
93-72-1 2,4,5-TP(Silvex) ND D017 1.0 0.0050 0.0013 mg/1
CAS No. Surrogate Recoveries Run#1 Run#2 Limits
19719-28-9 2,4-DCAA 95% 39-135%
ND — Not detected MDL = Method Detection Limit J = Indicates an estimated value
MCL = Maximum Contamination Level(40 CFR 261 7/1/11) B = Indicates analyte found in associated method blank
E = Indicates value exceeds calibration range N = Indicates presumptive evidence of a compound
•
94f1•

SGS North America Inc.
Report of Analysis Page 1 of 1
Client Sample ID: WATER PLANT SLUDGE
Lab Sample ID: F A92936-1 L Date Sampled: 02/02/22 !:=
Matrix: SO-Sludge Date Received: 02/07/22
Method: SW846 8081B SW846 3510C Percent Solids: 25.6
Project: Pasquotank Co Water; 1466 Weeksville Rd, Elizabeth City, NC
File ID DF Analyzed By Prep Date Prep Batch Analytical Batch
Run#1 ST159863.D 1 02/18/22 19:38 WEI 02/18/22 13:30 OP89833 GST3888
Run 42
Initial Volume Final Volume
Run 41 100 mI 5.0 tnl
Run#2
Pesticide TCLP List TCLP Leachate method SW846 1311
CAS No. Compound Result HW# MCL RL MDL Units Q
58-89-9 gamma-BHC(Lindane) ND D013 0.40 0.00010 0.000022 ►ng/1
12789-03-6 Chlordane ND D020 0.030 0.0010 0.00038 mg/I
72-20-8 Endrin ND D012 0.020 0.00020 0.000021 mg/1
76-44-8 Heptachlor ND D031 0.0080 0.00010 0.000026 mg/1
1024-57-3 Heptachlor epoxide ND D031 0.0080 0..00010 0.000020 mg/1
72-43-5 Methoxychlor ND D014 10 0.00020 0.000050 mg/1
8001-35-2 Toxaphene ND D015 0.50 0.0050 0.0021 mg/1
CAS Nº. Surrogate Recoveries Run#1 Run#2 Limits
877-09-8 Tetrachloro-m-xylene 125% 42-127%
2051-24-3 Decachlorobiphenyl 115% - 27-127%
ND = Not detected MDL = Method Detection Limit J Indicates an estimated value
MCL = Maximum Contamination Level(40 CFR 261 7/1/11) B = Indicates analyte found in associated method blank
E = Indicates value exceeds calibration range N = Indicates presumptive evidence of a compound
i(Svf3

SGS North America Inc.
Report of Analysis Page 1 of 1
g.
Client Sample ID: WATER PLANT SLUDGE
.Lab Sample ID: FA92936-1L Date Sampled: 02/02/22
Matrix: SO -Sludge Date Received: 02/07/22
Percent Solids: 25.6
Project: Pasquotank Co Water; 1466 Wecksville Rd,Elizabeth City,NC
Metals Analysis,TCLP Leachate SW846 131i
Analyte Result HW# MCL RL Units DF Prep Analyzed By Method Prep Method
Arsenic <0.10 D004 5,0 0.10 mg/1 1 02/15/22 02/16/22 LM SW846 6010D 2 SW846 3010A 4
Barium <2.0 D005 100 2.0 mg/1 1 02/15/22 02/16/22 LM SW1146601002 SW8463010A4
Cadmium <0,050 D006 1.0 0.050 mg/1 1 02/15/22 02/16/22 LM SW846 6010D 2 SW846 3010A 4
Chromium <0.10 D007 5.0 0.10 mg/1 1 02/15/22 02/16/22 LM SW846 6010D 2 SW846 3010A 4
Lead <0.050 D008 5.0 0.050 mg/1 1 02/15/22 02/16/22 LM SW846 6010D 2 SW846 3010A 4
Mercury <0.0050 D009 0.20 0.0050 ing/1 1 02/16/22 02/16/22 IC SW846 7470A 1 SW846 7470A 5
Selenium <0.50 D010 1.0 0.50 mg/1 5 02/15/22 02/17/22 LM SW846 6010D 3 SW846 3010A 4
Silver <0.10 D011 5.0 0.10 mg/1 1 02/15/22 02/16/22 LM SW846 60100 2 SW846 3010A 4
(1)Instrument QC Batch:MAI8461
(2)Instrument QC Batch: MA18463
(3) Instrument QC Batch: MA18466
(4)Prep QC Batch: MP40294
(5)Prep QC Batch: MP40301
RL = Reporting Limit
MCL = Maximum Contamination Level(40 CFR 261 7/1/11)
--. 19of1

ñ
SGS ,
Apr ; �
Orlando, FL
Section 4
Mist. Formats
C
Custody Documents and Other Forms
Includes the following where applicable:
• Chain of Custody
12of1,

Environment 1,inc. CHAIN OF CUSTODY RECORD A ‘1 2 4:1 3 G
P.O.Box?085,114 Oakmont Dr. 1 1 -I
Greenville,NC 27853 � Page__of
'
environment ine.carn DISINFECTION
CI-LORINE NEUTRALIZED AT COEL[CT#ON
Phone(252)75A-6208•Fox(252)756-47633 l—{,
I E CffLURlNíy
CLIENT: 144 Wee&c 10 �•rrr pNCHECit((11$► ,
u UV .
PASQUOTANIC CO.WATER(SLUDGE) �NONE1111
�` PP P G G G G � CCNCAINERTYPE,FiG
MR,rvffCliA$L L.HAIiRIS1 • .
1466 WEEKSVILI,E ROAD ! CHEMICAL PRESERVATION �
ELIZAAET'H CITY NC 27409 � A A A A � A A _
�7 � A•4ONE O•NA�i0a R �(257)334-4e06 Z 1 9� á � � 1 B-HNO� E-NCL �c[- U � � �o � bczi� 1 � .1á � w ;� w � C-Ha50e f-21NCAGETAT'e/NAOHCOtLECTiON �_rn s� � a a � a G-NATh1OSJLFATE..SA61PLEE.IX�ATiON DATE TIME ro p 1:r 1 � CJ tV-' ' É�+ E+ á • I 1
� ° � � $%3 �;WuterPiureLSio e � � � i� � CLASSIFICATION:
i
- ❑.WASIEWATER(f@Pí]ESI e
l
� ' [2.1 DAIN3(INGWATER
� � Dl4'R1GW
f ' • ...-• ��
r •
� 50LiOWASTESECTION
IN AL ASSESSMENT ff CHAIN OF CUSTODY'[SEAL)MAINTAINED
DL1RíNG¡S�HIPhJ�ENT/DELIVEITV l
LJ.; N
lit•:t. �I(� +.��—Í— ~SAtJt'LESCCDLI.ECTEDBI�
i � t
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(FTc�tsePmr}��t/�íY�l��
SANiPLES!RECEIVED INLARAT LI,2.;=G'
RELMOIJISHED 6V(SIG.)(SAMFLERI OA)TETaAE pr
r � � .By(BG.) � WAIF
COMMENTS:���<- _��t+�e, 'e�4,.>'- f�.. ���� ).S?
aQ��WCJLi��0ar z
�N11SHEOr) iG1 DATE/TIME
2��/A2 ?:ocO R O��-"..-
á��I,�� %'���Rcicl ��� ILIA c� .D°C
REL Is: DA-íFITIME: RECEIVED 6Y{SIc DATT:/tIME I '
2 a.� tdS'� Au�kl�aAn li�� 11D'-50
; j {
� � ?1F� 2�Z(2Z �15 Sampler Inusl place a'�tarcornposite sample or a'Vier
PLEASE READ tor GODlptet{thg Ibis form an the reverse side. Na 8998�44 i
znRse�s � Grab samotein the blocks above ter each oatameterlsoussted.
FA92936: Chain of Custody
Page ! of 2
S�r_ . 13af
� .. 1

SGS Sample Receipt Summary
Job Number: PA92936 Client: ENVIRONMENT 1,INC Project: PASQUOTANK CO.WATER(SLUDGE)
Date I Time Received: 217/2022 9:15100 AM Delivery Method: FEDEX Airbill#'s: 5230 2508 4527
Therm ID: IR4;
Therm CF: 0,6; #of Coolers: 1
Cooler Temps(Raw Measured)"C: Cooler 1:(4.2):
Cooler Tamps(Corrected)`C: Cooler 1:(4.8); .P
Cooler informatiqin Y or N. Sample Information Y or N NIA ..
1.Custody Seals Present © 13 1.Sample labels present an bottles 2 9
2.Custody Seals Intact 2 0 2.Samples preserved properly l:
3.Temp criteria achieved ❑ 3.Sufficient volume/containers raced for analysis: 2 0
4.Cooler temp verification IR Gun 4.Condition of sample Intact
5.Cooler media ice¡Baal 5.Sample raced within HT ❑W ❑
0_DatesltimesllDs on COC match Sample Label 2 ❑
Trip Blank Informatlol' Y or N N/A 7.VOCs have headspace ❑ © D
1.Trip Blank present I cooler ❑ ❑ [] 8.Bottles received for unspecified tests ❑ 2
2.Trip Blank listed on COC ❑ © 2 9,Composiling instructions clear ❑ ❑ 0
W or S NIA 10.Voa Soil Kits/Jars received past 48hrs? I:: ❑ 2
11.%Solids Jar received? ❑ © ❑y
3.Type Of TB Received ❑ n E
12.Residual Chlorine Present? ❑ © lki
I Misc.Informatiott
Number of Encores: 25-Gram 5-Gram Number of 5035 Field Kits: Number of Lab Filtered Metals:
Test Strip Lot tis: pH 0-3 230315 pH 10.12 219813A Other: (Specify)
Residual Chlorine Test Strip Lot#:
III Comments -_ T _
SIA1
Rev.Dale 1151311}7 Technician: SAMUELM Date: 2/7/2022 9;15:00 AM Reviewer: Date:
Rev.D
FA92936: Chain of Custody
Page 2 of 2
SGS14of1•

Y e t tl tCéC1 a p r ,• ,1-1,Nun*
3P
�ar � • � 3� y§� rate^ a a �t
Orlando, FL ��a . `d� fx , .�� ,�� ü31Q1/21
The results set forth herein are provided by SOS North America Inc. tlrCICOJJy 2.
Automated Report
Technical Report for
Environment 1, Inc
,Kl
' ' ''�i' Pasquotank Co Water; 1466 Weeksville Rd, Elizabeth City, NC
11:111y) . # �+' 149:
SGS Job Number: FA83170
Sampling Date: 02/10/21
f
Report to:
Environment 1, Inc
PO Box 7085
Greenville, NC 27835
[e-mail]
ATTN: Arm Brown
Total number of pages in report: 16
Test results contained within this data package meet the requirements Norm Farmer
of the National Environmental Laboratory Accreditation Program Technical Director
and/or state specific certification programs as applicable.
Client Service contact: Jean Dent-Smith 407-425-6700
Certifications:FL(E83510),LA(03051),KS(E-10327),IL(200063),NC(573),NJ(FL002),NY(12022),SC(96038001)
DoD ELAP(ANAB L2229),AZ(AZ0806),CA(2937),TX(T104704404),PA(68-03573),VA(460177),
AK,AR,IA,KY,MA,MS,ND,NH,NV,OK,OR,UT,WA,WV
This report shall not be reproduced,except in its entirety,without the written approval of SOS.
Test results relate only to samples analyzed.
SGS North America Inc. • 4405 Vineland Road • Suite C-15 • Orlando,FL 32811 • tel:[phone] • fax:[phone]
SGS is the sole authority for authorizing edits or modifications to this document. Please share your ideas about 1 of 16
Unauthorized modification of this report is strictly prohibited. how we can serve you better at: SGS Review standard terms at: http://www.ses.contien terms-and-conditions EIlS.US.Customereareíd!ses.com FAe317o

Sections: II
Table of Contents
-1-
Section 1: Sample Summary 3
Section 2: Summary of Hits 4
Section 3: Sample Results 5 eat
3.1: FA83170-1: WATER PLANT SLUDGE 6
3.2: FA83170-1 L: WATER PLANT SLUDGE 7
Section 4: Misc. Forms 12
4.1: Chain of Custody 13
4.2: Chain of Custody (SGS Dayton,NJ) 15
•
SGg2of16
FA83170

SGS North America Inc.
Sample Summary
Environment 1, Inc
Job No: FA83170
Pasquotank Co Water; 1466 Weeksville Rd, Elizabeth City, NC
Project No: 149
Sample Collected Matrix Client
Number Date Time By Received Code Type Sample ID
This report contains results reported as ND = Not detected:The following applies:
Organics ND = Not detected above the MDL
FA83170-1 02/10/21 08:45 RA 02/13/21 SO Sludge WATER PLANT SLUDGE
FA83170-IL 02/10/21 08:45 RA 02/13/21 SO Sludge WATER PLANT SLUDGE
Soil samples reported on a dry weight basis unless otherwise indicated on result page.
SGS3of16
FA03170

Summary of Hits Page 1 of 1
Job Number: FA83170
Account: Environment 1, Inc
Project: Pasquotank Co Water; 1466 Weeksville Rd, Elizabeth City,NC
Collected: 02/10/21
Lab Sample ID Client Sample ID Result/
Analyte Qual RL MDL Units Method
FA83170-1 WATER PLANT SLUDGE
Corrosivity as pH 8.0 su SW846 CHAP7
Ignitability(Flashpoint)° >200 Deg. F SW846 1010A MOD
FA83170-1L WATER PLANT SLUDGE
No hits reported in this sample.
(a)Not ignitable.
4of16
SGg
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Section 3 ��m,
Sample Results •
Report of Analysis
— SGSI 5 of 16
FA83170

SGS North America Inc.
Report of Analysis Page 1 of 1
Client Sample ID: WATER PLANT SLUDGE ré:4"
Lab Sample ID: FA83170-1 Date Sampled: 02/10/21
Matrix: SO-Sludge Date Received: 02/13/21
Percent Solids: 22.9
Project: Pasquotank Co Water; 1466 Weeksville Rd, Elizabeth City,NC
General Chemistry
Analyte Result RL Units DF Analyzed By Method
Corrosivity as pH 8.0 su 1 02/26/21 14:42 JB SW846 CHAP7
Cyanide Reactivity a <44 44 mg/kg 1 02/22/21 10:56 ANJ SW846 CHAP7/9012 B
Ignitability(Flashpoint)b >200 Deg. F 1 02/19/21 08:07 Cs SW846 1010A MOD
Solids, Percent 22.9 % 1 02/17/21 13:33 HH SM19 2540G
Sulfide Reactivity <220 220 mg/kg 1 02/17/21 10:30 JC SW846 CHAP7
(a)Analysis performed at SGS Dayton, NJ.
(b)Not ignitable.
RL = Reporting Limit
SGg6 of 16
FA83170

SGS North America Inc.
Report of Analysis Page 1 of 1 cu
Client Sample ID: WATER PLANT SLUDGE
Lab Sample ID: FA83170-1L Date Sampled: 02/10/21 � ',:.'
Matrix: SO- Sludge Date Received: 02/13/21
Method: SW846 8260B SW846 1311 Percent Solids: 22.9
Project: Pasquotank Co Water; 1466 Weeksville Rd, Elizabeth City, NC
File ID DF Analyzed By Prep Date Prep Batch Analytical Batch
Run#1 5E26563.D 10 02/16/21 17:53 SO 02/15/21 10:50 OP84118 V5E1222
Run#2
Purge Volume
Run#1 5.0 m1
Run#2
VOA TCLP List TCLP Leachate method SW846 1311
CAS No. Compound Result HW# MCL RL MDL Units Q
71-43-2 Benzene ND D018 0.50 0.010 0.0031 mg/1
78-93-3 2-Butanone(MEK) a ND D035 200 0.050 0.020 mg/1
56-23-5 Carbon Tetrachloride ND D019 0.50 0.010 0.0036 mg/1
108-90-7 Chlorobenzene ND D021 100 0.010 0.0020 mg/1
67-66-3 Chloroform ND D022 6.0 0.010 0.0030 mg/1
106-46-7 1,4-Dichlorobenzene ND D027 7.5 0.010 0.0026 mg/1
107-06-2 1,2-Dichloroethane ND D028 0.50 0.010 0.0031 mg/1
75-35-4 1,1-Dichloroethylene ND D029 0.70 0.010 0.0032 mg/1
127-18-4 Tetrachloroethylene ND D039 0.70 0.010 0.0022 mg/1
79-01-6 Trichloroethylene ND D040 0.50 0.010 0.0035 mg/1
75-01-4 Vinyl Chloride ND D043 0.20 0.010 0.0041 mg/1
CAS No. Surrogate Recoveries Run#1 Run#2 Limits
1868-53-7 Dibromofluoromethane 100% 83-118%
17060-07-0 1,2-Dichloroethane-D4 109% 79-125%
2037-26-5 Toluene-D8 99% 85-112%
460-00-4 4-Bromofluorobenzene 97% 83-118%
(a)Associated CCV outside of control limits high, sample was ND.
ND = Not detected MDL = Method Detection Limit J = Indicates an estimated value
MCL = Maximum Contamination Level(40 CFR 261 7/1/11) B = Indicates analyte found in associated method blank
E = Indicates value exceeds calibration range N = Indicates presumptive evidence of a compound
SCSI 7 of 16
FA83170

SGS North America Inc.
Report of Analysis Page 1 of 1 icsa
r
Client Sample ID: WATER PLANT SLUDGE
Lab Sample ID: FA83170-1L Date Sampled: 02/10/21
Matrix: SO-Sludge Date Received: 02/13/21
Method: SW846 8270D SW846 3510C Percent Solids: 22.9
Project: Pasquotank Co Water; 1466 Weeksville Rd, Elizabeth City,NC
File ID DF Analyzed By Prep Date Prep Batch Analytical Batch
Run#1 X074664.D 1 02/24/21 17:39 WH 02/23/21 08:00 OP84240 SX3043
Run#2
Initial Volume Final Volume
Run#1 100 m1 1.0 m1
Run#2
ABN TCLP List TCLP Leachate method SW846 1311
CAS No. Compound Result HW# MCL RL MDL Units Q
95-48-7 2-Methylphenol ND D023 200 0.050 0.0056 mg/1
3&4-Methylphenol ND D024 200 0.050 0.0098 mg/1
87-86-5 Pentachlorophenol ND D037 100 0.25 0.050 mg/1
95-95-4 2,4,5-Trichlorophenol ND D041 400 0.050 0.0074 mg/1
88-06-2 2,4,6-Trichlorophenol ND D042 2.0 0.050 0.0075 mg/1
106-46-7 1,4-Dichlorobenzene ND D027 7.5 0.050 0.0050 mg/1
121-14-2 2,4-Dinitrotoluene a ND D030 0.13 0.050 0.0081 mg/1
118-74-1 Hexachlorobenzene ND D032 0.13 0.050 0.0069 mg/1
87-68-3 Hexachlorobutadiene ND D033 0.50 0.050 0.0050 mg/1
67-72-1 Hexachloroethane ND D034 3.0. 0.050 0.016 mg/1
98-95-3 Nitrobenzene ND D036 2.0 0.050 0.0093 mg/1
110-86-1 Pyridine ND D038 5.0 0.10 0.020 mg/1
CAS No. Surrogate Recoveries Run#1 Run#2 Limits
367-12-4 2-Fluorophenol 38% 14-67%
4165-62-2 Phenol-d5 25% 10-50%
118-79-6 2,4,6-Tribromophenol 86% 33-118%
4165-60-0 Nitrobenzene-d5 81% 42-108%
321-60-8 2-Fluorobiphenyl 82% 40-106%
1718-51-0 Terphenyl-d14 105% 39-121%
(a)Associated BS outside control limits high, sample was ND.
ND = Not detected MDL = Method Detection Limit J = Indicates an estimated value
MCL = Maximum Contamination Level(40 CFR 261 7/1/11) B = Indicates analyte found in associated method blank
E = Indicates value exceeds calibration range N = Indicates presumptive evidence of a compound
SGS- 8 of 16
« FA83170

SGS North America Inc.
Report of Analysis Page 1 of 1 ti
Client Sample ID: WATER PLANT SLUDGE
Lab Sample ID: FA83170-1L Date Sampled: 02/10/21 4.
Matrix: SO-Sludge Date Received: 02/13/21
Method: SW846 8151A SW846 3510C Percent Solids: 22.9
Project: Pasquotank Co Water; 1466 Weeksville Rd, Elizabeth City, NC
File ID DF Analyzed By Prep Date Prep Batch Analytical Batch
Run#1 CC073067.D 1 02/26/21 14:06 JA 02/25/21 12:10 OP84276 GCC1802
Run#2
Initial Volume Final Volume
Run#1 10.0 ml 5.0 m1
Run#2
Herbicide TCLP List TCLP Leachate method SW846 1311
CAS No. Compound Result HW# MCL RL MDL Units Q
94-75-7 2,4-D ND D016 10 0.050 0.017 mg/1
93-72-1 2,4,5-TP (Silvex) ND D017 1.0 0.0050 0.0013 mg/1
CAS No. Surrogate Recoveries Run# 1 Run#2 Limits
19719-28-9 2,4-DCAA 41% 39-135%
ND = Not detected MDL = Method Detection Limit J = Indicates an estimated value
MCL = Maximum Contamination Level(40 CFR 261 7/1/11) B = Indicates analyte found in associated method blank
E = Indicates value exceeds calibration range N = Indicates presumptive evidence of a compound
9 of 16
SGS
FA8317o

SGS North America Inc.
Report of Analysis Page 1 of 1 K.,
Client Sample ID: WATER PLANT SLUDGE
Lab Sample ID: FA83170-1L Date Sampled: 02/10/21
Matrix: SO-Sludge Date Received: 02/13/21
Method: SW846 8081B SW846 3510C Percent Solids: 22.9
Project: Pasquotank Co Water; 1466 Weeksville Rd, Elizabeth City, NC
File ID DF Analyzed By Prep Date Prep Batch Analytical Batch
Run#1 KK100235.D 1 02/23/21 17:58 WH 02/23/21 08:00 OP84241 GKK3206
Run#2
Initial Volume Final Volume
Run#1 100 ml 5.0 ml
Run#2
Pesticide TCLP List TCLP Leachate method SW846 1311
CAS No. Compound Result HW# MCL RL MDL Units Q
58-89-9 gamma-BHC(Lindane) ND D013 0.40 0.00010 0.000022 mg/1
12789-03-6 Chlordane ND D020 0.030 0.0010 0.00038 mg/1
72-20-8 Endrin ND D012 0.020 0.00020 0.000021 mg/1
76-44-8 Heptachlor ND D031 0.0080 0.00010 0.000026 mg/1
1024-57-3 Heptachlor epoxide ND D031 0.0080 0.00010 0.000020 mg/1
72-43-5 Methoxychlor ND D014 10 0.00020 0.000050 mg/1
8001-35-2 Toxaphene ND D015 0.50 0.0050 0.0021 mg/1
CAS No. Surrogate Recoveries Run#1 Run#2 Limits
877-09-8 Tetrachloro-m-xylene 104% 42-127%
2051-24-3 Decachlorobiphenyl 98% 27-127%
ND = Not detected MDL = Method Detection Limit J = Indicates an estimated value
MCL = Maximum Contamination Level(40 CFR 261 7/1/11) B = Indicates analyte found in associated method blank
E = Indicates value exceeds calibration range N = Indicates presumptive evidence of a compound
SGg10 of 16
FA83170

SGS North America Inc.
Report of Analysis Page 1 of 1
Client Sample ID: WATER PLANT SLUDGE
Lab Sample ID: FA83170-1L Date Sampled: 02/10/21
Matrix: SO-Sludge Date Received: 02/13/21
Percent Solids: 22.9
Project: Pasquotank Co Water; 1466 Weeksville Rd, Elizabeth City, NC
Metals Analysis, TCLP Leachate SW846 1311
Analyte Result HW# MCL RL Units DF Prep Analyzed By Method Prep Method
Arsenic <0.10 D004 5.0 0.10 mg/1 1 02/17/21 02/17/21 LM SW846 6010D 1 SW846 3010A 4
Barium <2.0 D005 100 2.0 mg/1 1 02/17/21 02/17/21 LM SW846 6010D 1 SW846 3010A 4
Cadmium <0.050 D006 1.0 0.050 mg/1 1 02/17/21 02/17/21 LM SW846 6010D 1 SW846 3010A 4
Chromium <0.10 D007 5.0 0.10 mg/1 1 02/17/21 02/17/21 LM SW846 6010D 1 SW846 3010A 4
Lead <0.050 D008 5.0 0.050 mg/I 1 02/17/21 02/17/21 LM SW846 6010D 1 SW846 3010A 4
Mercury <0.0050 D009 0.20 0.0050 mg/1 1 02/25/21 02/25/21 JC SW846 7470A 3 SW846 7470A 5
Selenium <0.50 DO10 1.0 0.50 mg/1 5 02/17/21 02/18/21 LM SW846 6010D 2 SW846 3010A 4
Silver <0.10 DOl 1 5.0 0.10 mg/1 1 02/17/21 02/17/21 LM SW846 6010D 1 SW846 3010A 4
(1)Instrument QC Batch: MA17471
(2)Instrument QC Batch: MA17476
(3)Instrument QC Batch: MA17493
(4)Prep QC Batch: MP38575
(5) Prep QC Batch: MP38604
RL = Reporting Limit
MCL = Maximum Contamination Level(40 CFR 261 7/1/11)
11 of 16 SGg
FA83170

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Section 4
Misc. Forms
Custody Documents and Other Forms
Includes the following where applicable:
• Chain of Custody
• Chain of Custody(SGS Dayton, NJ)
12 of 16
SGg
FAB3170

�.
Environment 1,Inc. CHAIN OF CUSTODY RECORD rAItsrto •
P.O.Box 7085,114 Oakmont Dr. Page 1 of 1
Greenville,NC 27858 .
eov i ronment l inacom DISINFECTION
� CHLORINE NEUTAALCCED AT COLLECTION
Phone[phone]•Fax[phone]
❑ CIILORINP.
CLIENT: 149 Week:10 uv
� pH CHECK(LAB)
_
PASQUOTANIC CO.WATER(SLUDGE) (-} NONE I a f 9P P P G G G G
CONTAINER TYPE.PAi
MR.MICHAEL L.HARRIS �J
1466 WEEICSVILLE ROAD .
ELIZAllETH CITY NC 27909 CI A A A AKA A CHEMICAL PRESERVATION P
.-.1.
áó r y `� A-NONE D•NAOH
Ep � � � ' �,.
[phone]' u;c� á� 2 � �� � ^
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COLLECTION � •ó g. � � É . '� � é ry «
LL � � � k `� ó Ú Ú F"j �� ¢ G-NAiNIDSULFA�
SAMPLE LOCATION DATE TIME ro ó 1 á ,04 '^ x -- rK ,��0 U ¡t�-�� �yF,� .,�Hs� E+ �o-
I Water Plant Sludge - O- 0845 4P �� �� �� � "^' `� W.1
`''"`'� " T �"` w=' � � CLASS;FICATION:
� I aj
❑ WASTEWAIER(tJPDES)
❑ DRINKING WATER
•
❑ DWtiR'iW
. .
jEll 1OLID5vA5iESECi1DN
CHAIN OF CUSTODY(SEAL)MAINTAINED
DURING 1PMENTIDELIVERY
N
SAMPLES COLLECTED BY:
(Reese Prinl)
•
� `` �t�c /\llAl R
� J:º-- SAMPLES RECEIVED th LAB AT 3.D °C
REUNOUISHmOY(SIG.)(SAMPLER) DATErOME R EIYEDBY(SIG.) DATFJOME CpMMOffS; Pb#� QL¡I kg 02122-I 0��
� 1�.'� a-to-al I og3o :�a:t.,.�.ln �ü:�0;�v}� �/�/21II2:►H n� ' '',,r���ALn a
RÉlI ISHEDBY(SI�) DATE/TIME R (�) DATE/IMAE KcC� ��I�V,� arc.
O�— 2`12:21IS:oO �� Z 4`6D
'e,,r��?EDBY(SIC.) DATE/OME: ' CE�F BY(SKI _ . . ...... .. .. OATEIIIME
� 11T.o.. z1t1�21111'•pl • .
�/'i ) ��jO '��� IIO:�ji) yv��f 2{It)�t thlo
' PLEASE REAgañstn>1 Uoós for completing this form on the reverse side: Sampler must place a"C'for composite sample or a`G'for O
FORM CO Grab sample in the blocks above for each parameter requested. N_ 3 8 9 3 9 5
FA83170: Chain of Custody
Page 1. of 2
13 of 16
SGg...-
FAe3170

SGS Sample Receipt Summary
Job Number: FA83170 Client: ENVIRONMENT 1 Project: 149
Date I Time Received: 2/13/2021 3:15:00 PM Delivery Method: FEDEX Airbill#'s:
Therm ID: IR 1; Therm CF: -1.8; #of Coolers: 1
Cooler Temps(Raw Measured)°C: Cooler 1:(2.6);
Cooler Temps(Corrected)°C: Cooler 1:(0.8); A
s
Cooler Information Y or N Sample Information Y or N NIA
1.Custody Seals Present ® 0 1.Sample labels present on bottles ® ❑ A
2.Custody Seals Intact ® E 2.Samples preserved properly ® ❑ .. +
3.Temp criteria achieved ® ❑ 3.Sufficient volume/containers recvd for analysis: ® ❑
4.Cooler temp verification IR Gun 4.Condition of sample Intact
5.Cooler media Jce/Baal 5.Sample recvd within HT ® E
6.Dates/Times/IDs on CDC match Sample Label 2 E
Trio Blank Information Y or N N/A 7.VOCs have headspace ❑ E
1.Trip Blank present/cooler ❑ ❑ ® 8.Bottles received for unspecified tests E
2.Trip Blank listed on COC ❑ ❑ ® 9.Compositing instructions clear ❑ ❑
W or S NIA 10.Voa Sail Kits/Jars received past 48hrs? ❑ ❑
11.%Solids Jar received? ❑ ❑
3.Type Of TB Received ❑ ❑ ® 12.Residual Chlorine Present? ❑ E
Misc.Information
Number of Encores: 25-Gram 5-Gram Number of 5035 Field Kits: Number of Lab Filtered Metals:
Test Strip Lot#s: pH 0-3 230315 pH 10-12 219813A Other: (Specify)
Residual Chlorine Test Strip Lot#:
Comments
swot
Rev.Dale BRYANG Date: 2/13/2021 3:15:00 PM Reviewer. Date:
Rev.Dale 0524/17
FA83170: Chain of Custody
Page 2 of 2
SGg14 of 16
FA83170

SGS vv / CHAIN OF CUSTODY Page 1 of 2
�/ SGS North America Inc.-Orlando rPouie�,y/1
4405 Vineland Road,Suite C•15 Orlando,FI 32611 r %K?153�56�¡r
TE1.407•425-0700 FAX:[phone] acdu,n• /� YJ �/ xe,m•
vn•w,epe,comlehauu FA93170
Cllenll RºpoNnOlnforms0on Project Information Roct.no alod Anatyel. eeo TEST CODE ahwl) MolriA Codes
Ca.,n•me. Pmlecl Ram..
SGS Nodh Amanes Ine. Posquotonk Co Woler,1460 Weekaville Rd.EfuoheN City,NC o++•Omwgwaaa
aw-�roaa wa.
aeat Marro Sal
_S -wam
4405 Vtwland Rd,Suits C•16 SW•sm.a.VOW
Ur suu zp Cal 5uu Oilgngllom..e4nllan•r.mrmmRreenlal 50•53; 1�Cu"°an' SL�du,. Y.
Orlando Ft. 32611 SED6.Y;mn1
Pm¡eelCanua' Em.i Nast, Sue.AaY,n• OI•d'+ IV
lA•AdU;. 9,IJC
laa.dant+mangay. R•M
SO�DmerSota .,.:..•.fatale
rve ...a Ci.4 M.amrac■O Ca, Suu Lo P•Wa. .111h,
407-425-6700
re.r.ea Buns
S•^Wt•1Namgl) Pran.PmpcMrrugar Annym. EO�EqupmNlL.n
RA , RUIRn1ee;N . ...
. TD•Trg 6'.nL
G•n.n M y .
u.em
•-+•• FieldIDl Paint ofCoOocuon ur:avnv;• o•,• la or w•,• •amw i � � áni �; á ó �
. _ 4 = a W u LAB USE ONLY
1 WATER PLANT SLUDGE \..., 2/10f21 0:45;00AM RA SO 1 X x C..1
1)
Tundwna lime(Iluvnm•ears Dala Dernerepla Infdrnbtai Cunm[nn l Spacial ImvuGure
Anm.•ah pa..M:ro..: O Cbmmanal•R Ita+d11 Q ew.iarm. Plinio aueeunuadlaSGS Oman,NJ.Do not send enllrueampte,pleosa
❑Mansard loo,le.m.m••) 1:11 Camm.rswatLe..lal 1=1 cno,emnal take an aliquot ofoil9inalsamplb for wDcontraciing.Thank you,
❑51waw.a•,•INaN Inili+JAs9^5:•men(3.4_9_IQ �Ream t�•ua1 =gamr
ElatAw..aOq.wan i Q fULT,ILe.alq �
W ..❑ah . Oars Ial4R Izbal Verification a . ..t
o 1 hBalm,aa,CR v A•
EROer•CT O cmm�:Cunmu•I• •Ha,© to.
® clir D.31RtR1 Cºnn..clN•e••Rafts•OC Surma,
em.g.I,6 R:un VA eau rasa.l•L•Wnk AwaY am,b RllSlvEmrg.c7 TAT Cm•nwaY T•Ra,+n•OC 5u.m.,•Past Ram aau h1!0:/Avrrr.595 numinNtennYnnd{ondnians
Sampr•Custody mua16•Oocvnam.d Calom aWi Ilme f amplm change pus•..abn,IMiEllp caW of d.lh.ry.
Ir•r...+.,a..wn o•anm,; A.ww..en .r.�,+ aan o.
.A .rL>.� /%l.Z¡J emnre.:
1 1 f ed� 2 /'e�C-x �/,tf4�, _ �Li
R•r�,ar.a.la�pan o..,w,.: Rvw.le,: A•.rT'YA••h: �ii•.: i
3 3 4 4
A.l.mulad1T. o.l•,M•.� Ad,rer, O.•.16Wa LJ /,�y 7
5 5 O n..a.a Pr*In.•s.r.u.rtim di: IT
1a aoe..,... �•7 C1J0
FA83170: Chain oi'Custody
Page 1 of 2
SCS Dayton, NJ
. 15 of 16
FA03170

SGS Sample Receipt Summary
Job Number: FA83170 Client: Project:
Date I Time Received: 2/17/2021 12:40:00 PM Delivery Method: Fed Ex Alrbill#'s: 9231 5384 5694
Cooler Temps(Raw Measured)°C: Cooler 1:(2.3);
Cooler Temps(Corrected)°C: Cooler 1:(1.0);
A
Cooler Security Y or N Y or N Sample Integrity-Documentation Y or N N
1.Custody Seals Present: ® ❑ 3.COC Present: ® ❑ 1.Sample labels present on bottles: ® ❑
2.Custody Seals Intact: © ❑ 4.Smpl Dates/Time OK © ❑ ❑
2.Container labeling complete:
Cooler Temperature Y or N 3.Sample container label/COC agree: © ❑
1.Temp criteria achieved: ® ❑ Sample Integrity-Condition Y or N
2.Cooler temp verification: IR Gun ❑
1.Sample recvd within HT:
3.Cooler media: Ice(Bag)
2.All containers accounted for. ® ❑
4.No,Coolers: 1
3.Condition of sample: Intact
Quality Control Preservation Y or N N/A Sample Integrity-Instructions Y or N N/A
1.Trip Blank present/cooler: ❑ ❑
1.Analysis requested Is clear: ® ❑
2,Trip Blank listed on COC: ❑ ❑ ® 2.Bottles received for unspecified tests ❑
3.Samples preserved properly: ® ❑ 3.Sufficient volume recvd for analysis: ® ❑
4.VOCs headspace free: ❑ ❑ 0 4.Composiling instructions clear. ❑ ❑
5.Filtering instructions clear: ❑ ❑
Test Strip Lot#s: pH 1-12: 212820 pH 12+: 203117A Other: (Specify)
Comments
SM089-03
Rev.Dale 12/7/17
FA83170: Chain of Custody
Page 2 of 2
16 of 16
SGS
._
FA83170

Non-Discharge Branch Upload/Submittal Form .°� .
NORTH CAROLINA
EnMentaJQuuuty
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)* WQ0008008
Applicant/Permittee Pasquotank County
Applicant/Permittee Address PO Box 2245,Elizabeth City,NC 27909
Is the owner in BIMS? Yes No Is the facility in BIMS? Yes No
Owner Type County
Facility Name Pasquotank County Class B Residuals Program
County Pasquotank
Fee Category Minor Fee Amount $245
Is this a complete application?*
Yes No Complete App Date 05/19/2022
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
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* Drew Matthews
Email Address* Phone Number*
[e-mail] 2528839301
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:* WQ0008008
Has Current Existing permit number
Applicant/Permittee* Pasquotank County
Applicant/Permittee Address* PO Box 2245,Elizabeth City,NC 27909
Facility Name* Pasquotank County Class B Residuals Program
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.)
2022 Pasquotank County Permit Renewal-Modification.pdf 17.65MB
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 5/9/2022