WQ0031672_2021 Residual Annual Report_20220509

Initial Review
Reviewer
Thornburg, Nathaniel D
Is this submittal an application? (Excluding additional information.)*
Yes No
If not an application what is the submittal type?* Annual Report
Residual Annual Report
Additional Information
Other
Annual Report Year* 2021
Permit Number (IR) * WQ0031672
ApplicantlPermittee Alltech, Inc.
Email Notifications
Does this need review by the hydrogeologist?* Yes No
Regional Office
CO Reviewer
Admin Reviewer

Submittal Form
Project Contact Information
Please provide information on the person to be contacted by NDB Staff regarding electronic submittal, confirmation of receipt, and other correspondence.
............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................
Name* JP Woodrum
Email Address*
[e-mail]
Project Information
Application/Document Type*
New (Fee Required)
Modification - Major (Fee Required)
Renewal with Major Modification (Fee
Required)
Annual Report
Additional Information
Other
Phone Number*
3366355190
Modification - Minor
Renewal
GW-59, NDMR, NDMLR, NDAR-1,
N DAR-2
Residual Annual Report
Change of Ownership
We no longer accept these monitoring reports through this portal. Please click on the link below and it will take you to the correct form.
hftps://edocs.deq.nc.gov/Forms/NonDischarge_Monitoring_Report
Permit Type: * Wastewater Irrigation
Other Wastewater
Closed -Loop Recycle
Single -Family Residence Wastewater
Irrigation
Permit Number: * WQ0031672
Has Current Existing permit number
Applicant/Permittee Address* [e-mail]
Facility Name* Alltech - Eden Facility
Please provide comments/notes on your current submittal below.
reporting 0 residuals applied for 2021
High -Rate Infiltration
Reclaimed Water
Residuals
Other
At this time, paper copies are no longer required. If you have any questions about what is required, please contact Nathaniel Thornburg
at [e-mail].
Please attach all information required or requested for this submittal to be reviewed here.
(Application Form, Engineering Plans, Specifications, Calculations, Etc.)
D00050922-05092022144658.pdf 944.77KB
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

ANNUAL LAND APPLICATION CERTIFICATION FORM
WQ Permit#: ()()3jL1j2, , County: 110 Cking ham Year:
Facility Name (as shown on permit): A I I+eZk Eden
Land Application Operator: JP W�Xdju-yy' Phone:
Land applicat n of residuals as allowed by the permit occurred during the past calendar yea
El Yes rr?
No - If No, skip Part A, and Part B and proceed to Part C. Also, If residuals were
generated but not land applied, please attach an explanation on how the residuals were handled.
Part A - Residuals Application Sunmiarv:
Total number of application fields in the per lit:
Total number of fields utilized for land application during the year:
total amount of dry tons applied during the year for all application sites:
Total number of acres utilizes for land application during the year:
M
.cart ji - Annual (-;omi2jance Statement:
Facility was compliant during calendar year with all conditions of the land application permit
(including but not limited to items 1-13 below) issued by the Division of Water Resources. Ll Yes El No
If no please, provide a written description why the facility was not compliant, the dates, and explain corrective action
taken.
1) Only residuals approved for this permit were applied to the permitted sites.
2) Soil pH was adjusted as specified in the permit and lime was applied (if needed) to achieve a soil pF1 of at least 6.0 or
the limit specified in the permit,
3) Annual soils analysis were performed on each site receiving residuals during the past calendar year and three (3) copies
of laboratory results are, attached.
4) Annual TCLP analysis (if required) was performed and three (3) copies of certified laboratory results are attached.
5) All other monitoring was performed in accordance with the permit and reported during the year as required and three (3)
Copies of certified laboratory results are attached.
6) The facility did not exceed any of the Pollutant Concentration Limits in 15A NCAC 02T. 1 1,05(a) or the Pollutant
Loading Rates in 15A NCAC 021' 1 105(b) (applicable to 40 CFR Part 503 regulated facilities).
7) All general requirements in as specified in the Land Application Permit were complied with (applicable to 40 CFR Part
503 regulated facilities).
8) All monitoring and reporting requirements in 15A NCAC 02T I I I I were complied with (applicable to 40 CFR Part 503
regulated facilities).
9) All operations and maintenance requirements in the permit were complied with or, in the case of a deviation, prior
authorization was received frown the Division of Water Resources.
10) No contravention of Ground Water Quality Standards occurred at a monitoring well or explanations of violations are
attached to include appropriate actions and reniediations,
11) Vegetative cover was maintained and proper crop management was performed on each site receing residuals, as
specified in the permit.
.12) No runoff of residuals from the application sites onto adjacent property or nearby Surface waters has occurred,
13) All buffer requirements as specified on the permit were maintained during each application of residuals.
Part C - Certification:
"I certify, under penalty of law, that the above information is, to the best of my knowledge and belief, true, accurate,
and complete. I am aware that there are significant penalties for submitting false information, including the
possibility of fines and imprisonment for knowing violations."
TP Wouli%Vy) QL
V �ij
Peri-nittee Name and Tiff (type or print) Siure of Pert-nittee Date
Signature of Preparer* Date Signature of Land Applier Date
(if different from Permittee) (if different from Perwitteeand Preparer)
* Preparer is defined in 40 CFR Part 503.9 (1-) and 15A NCAC 02T . 1102, (26) D E N R FORM AC F (12/2006)

CLASS A ANNUAL DISTRIBUTION AND MARKETING/ SURFACE DISPOSAL CERTIFICATION AND SUMMARY FORM
WQ PERMIT #: 2D i FACILITY NAME: 101l h
PHONE: nk (#35�1 o COUNTY: KLD� OPERATOR: f "—ry1
FACILITY TYPE (please check one): [ Surface isposal (complete fart A (Source(s) and "Residual In" Volume only) and Part C)
Zlj Distribution and Marketing {complete Parts A, B, and C)
Was the facility in operation during the past calendar year? Yes D No 11 —lo If No skip parts A, B, C and certify form below
Part A*:
Part B*:
Montle
Sources(s) (include NPDES # if
applicable)
Volume {;dry tons)
Recipient Information.
Amendment)
Bulking Agent.
Residual In
Product Out
Name(s)
Volume (dry tans)
Intended use(s)
January
February
March
April
May
,rune
July
fop
August
September
October
November
December
Total from FORM DMSDF (sup)
Totals:
Annual (dry tons):
Amendment(s) used: I Bulkin, Lent(s) used:
If more space is required,. attach additional information sheets (FORM DMSDF (supp)): Total Number of Form DMSDF (Sapp)
Part C:
Facility was compliant during the past calendar year with all conditions of the land application permit Yes
(including but not limited to items 1- below) issued by the Division of Water Resources: 0 No ► If No, Explain in Narritive
1. All monitoring was done in accordance with the permit and reported for the year as required and three (3) copies of certified laboratory results are attached.
2. All operation and maintenance requirements were compiled with or, in the case of a deviation, prior authorization was received from the Division of Water Resources.
3. No contravention of Ground Water Quality Standards occurred at a monitoring well.
"I certify, under penalty of law, that the above information is, to the best of my knowledge and belief, true, accurate and complete. I am aware that there are significant
penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
C�q4- - 6--2_
ature of Permittee Date
**Preparer is defined in 40 CFR Part 503.9(r) and 15A NCAC 2T .1102 (26)
Signature of Preparer**
(if different from Permittee)
Date
11 li![aal.i1r11a]'I.YNgHN 1 .

CLASS A ANNUAL DISTRIBUTION AND MARKETING/ SURFACE DISPOSAL CERTIFI+CATION AND SUMMARY FORM
Supplemental Information
WQ PERMIT #: U33 j (tt_7.;L, FACILITY NAME: A1 1
PHONE: —53U Li'Sjqt:> COUNTY: Rt)"Llaxy-, OPERATOR:
FACILITY TYPE (please check one): 0 Surface l4isposal (complete Part A -"Month", "S ource(s)" and "Residual In" columns only)
Distribution and Marketing (complete Parts A, and B)
Part A*:
Part B*:
Month
Sources(s) (include NPDES if
applicable)
Volume (dry tons)
Recipient Information
Amendment)
Bulking Agent
Residual In
Product Out
Name(s)
Volume (dry,
tons)
Intended use(s)
Totals:
Annual (dry tons):
Amendment(s) used: I Bulking A ent(s) used:
If more space is required, attach additional information sheets (FORM DMSDF (supp)): Total Number of Farm DMSDF (Supp)
DENR FORM DM DF (Rupp) (12/2006)