WQ0031725_Application_20190311

2018
Baxter Healthcare Corporation
2018 Annual Report
Land Application Program
Permit No. WQ0031725
Division o.Va,,Lr Resources
MAR 1 1 2019
Water Quality Penlonal Operations
I

ANNUALa LAND APPLICATION CERTIFICATION FORM
WQ Permit#: WQ0031725 County: McDowell Year:
2018
Facility Name (as shown on permit):
Land Application Operator:
Baxter Healthcare Corporation
Southern Soil Builders, Inc. Phone: [phone]
Land application of residuals as allowed by the permit occurred during the past calendar year?'
Yes 12 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 Summary:
Total number of application fields in the ermit:
^_ 10
Total number of fields utilized for land application during the year:
10
Total amount of dry tons applied during the year for all application sites:
167.51
Total number of acres utilizes for land application during the year:
_
69.6
rare n - ivnnuai i-ompiance Statement:
Facility was compliant during calendar year 2018 with all conditions of the land application permit
(including but not limited to items 1-13 below) issued by the Division of Water Resources. 21 Yes 0 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 pH 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 .1 105(a) or the Pollutant
Loading Rates in 15A NCAC 02T .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.] 1 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 fi-om 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 remediations.
1 1) 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 fo4submitting f . e information, including the
possibility of fines and imprisonment for knowing violations."
_ 27 57
Permittee Name and Tile (type or print) e of Permittee Date
2
Signatw�(e of Preparer*
�-IS-,7oI
Date Signature of Land
pplier
Date
(if different from Permittee) (if different from Permittee and Preparer)
* Preparer is defined in 40 CFR Part 503.9 (r) and 15A NCAC 02T. 1102 (26) DFNR FnIRM Ar..F ri?i?nna�

ANNUAL RESIDtiAL SAMPLING SUMMARY FORM
Please note that your permit may contain additional parameters to be analyzed. The parameters can be reported in FORM RSSF - B
WQ Permit Number: WQ0031725
Facility Name: Baxter Healthcare Corporation
Residual Source WQ # or
NPDES #:
WQ0031725
WWTP Name: Baxter Healthcare Corporation
Residual Analvsis Data
Laboratory: 1) Waypoint
2)
3)
4)
5)
Parameter
(mg/kg)
Conc.
Limit
�m Q)a
Sample or Composite Date
1-4-2018
Percent Solids (%)
NA
1.3.56
Arsenic
75
4.96
Cadmium
85
2."
Copper
4,300
99,
Chromium
NA
81.2_
Lead
840
7.83
Mercury
57
.0.4
Molybdenum
75
5.43
Nickel
420
24
Selenium
100
5
Zinc
7,500
81.5
Total Phosphorus
NA
13300
TKN
NA
82500'
Ammonia -Nitrogen
NA
7300
Nitrate and Nitrite
NA
23.5
For surface disposal facilities the ceiling concentration limits listed in this form are not applicable. Reference the individual permit for metals limits.
9 certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed
to assure thatqualifiedpersonnel properly gathered and evatlia.led the -information n�rorma.�fon submitted. I am aware that
at there are significant
penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
Signaturerbf PrEgrer *
Date
*Preparer is defined in 40 CFR Part 503.9(r) and 15A \CAC 2T .1102 (26) nrnrn r�nnn nn�r

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: Baxter Healthcare Corporation Total Dry Tons Applied (Annual): 12.09
Permit #: WQ0031725 Cation Exchange Capacity (non 503 only):
Operator: Douglas Poplin Owner: Douglas Poplin Predominant Soil Series: FcC2
Acres Used: 5.5 Acres Perinitted: 5.5 Site #: DP Field #: ].A
Residual Analvsis Data fHenvv MPtale and 'rnfol
Sam le
P or
? i
2
3
4
5
$
uar,
xxaw Furculll
ff
__.l
6_
9...,
10
11 i
12
C0111-
--
-
posite
Date
1/4/18
% Solids
13.56
Arsenic
4.96
Cadmium
2
Copper
99
Chromium
81.2
Lead
7.83 v
Mercury
0.4
Molyb-
denum
5.43 v
Nickel
24 ✓
Selenium
5 ✓
Zinc
81.5 v
Total
Phos-
13300
horus
Annual
Hoax,%, Mot.,]
1;',:„1a
T
1r Ota�
DT/Ac./
App.
Event
Arsenic
Cadmium
Copper
Chromium
Lead
Mercury
Molyb-
----- d - - ----- - ^- - /..•....+•ro k�.su%.uiaLcu III IUJ1aLl"Ci:
1
1 1
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
0.000
1 111
1 1
1 11•
1 111
0.000
1 111
1 111
1 111
1 111
1 111
1 111
1 111
0.000
1 111
1 11•
1�
1111
0.000
1 111
1 lel
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1
1 i�
1 011
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1
1 1
1 111
1 111
1 111
1 101
1 111
1 111
1 111
1 111
1 111
0.000
1 111
1 1
1 11
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 11
J
0.024 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.024
Nickel 0.106 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.106
Selenium 0.022 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.022
Zinc 0.358 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.3581
Total
Phos- 58.493 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 58.493
horus 6,b�V
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
t am aware that there are significant penalties for submitting false information, including the possibility of fines and
imprisonment for knowing violations".
Sign use of Land Applies'Date - -
i
j
DENR FORM MFI RF (19i,�nnF�

ANNUAL, METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: Baxter Healthcare Corporation Total Dry Tons Applied (Annual): 3.53
Permit #: WQ0031725 Cation Exchange Capacity (non 503 only):
Operator: Douglas Poplin Owner: Douglas Poplin Predominant Soil Series: FcC2
Acres Used: 1.6 Acres Permitted: 1.6 Site #: DP Field #: IB
Residual Analvsis Data (Heavy Metals and rotni Phncnhnrnc neP ma/Ira o/ Qnivric ..- 1?-, D- u,.
Sample or
iE.
2
3
5 f
6
7
g
-9
101
111 1
12
Con1-
_
posite
Date
1/4/18
% Solids
13.56
Arsenic
4.96
Cadmium
2
Copper
99
C111-0111iLirn
81.2
Lead
7.83
Mercury
0.4
Molyb-
5.43
denum
Nickel
24
Selenium
5
Zinc
81.5
Total
Phos-
13300
hol-Lis
A- ---I
TT__ _ T
T_
� ���\9SS.�Yl9■.��l.T.���.�•J.7�w:�. Y.�Y.��.1��.. �.. LVV ►Y i/J Li
Total
_
2
IF
4 v
51
g
10
11 I
12
DT/Ac./
^�
App.
0
m
Event
2.21
y
Arsenic
0.022
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.022
Cadmium
0.009
0.000
0.000
0.000
0.00
00.000
0.000
0.000
0.000
0.000
0.000
0.000
0.009
Copper
0.437
0.000
0.000
0.000
0.000
1 0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.437
Chromium
0.359
0.000
0.000
0.000
0.000
o..000
0.000
0.000
0.000
0.000
0.000
0.000
0.359
Lead
0.035
0.000
0.000
0.000
0.000
0.000
0,000
0.000
0.000
6.0 00
0.000
0.000
0.035
Mercury
0.002
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0..000
0.000
0.002.
Molyb-
1
denum
0.024
0.000
0.000
0.000
0.000
0.000
0.000
0.000
.
0000
0.000
0.000
0.000
0.024
Nickel
0.106
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.106
Selenium
0.022
0.000
0.000
0.000
0.000
0.000
0.000
0.0 00
0.000
0.000
0.000
0.000
0.022.
Zinc
0.360
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.360
Total
Phos-
58.733
0.000
0.000
' 0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
58.733
horus
- - - - "--✓ ' `-'--- 41------J "- . "I .•.... lli 1Y"3 ill 01J[l1 Cll unuei- ►uy u►recuon or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
1 am aware that there are significant penalties for submitting'false information, including the possibility of fines and
imprisonment for knowing violations".
Signature of Lai d Appl.ier Date
DENR FORM'MF-LSF (12/2000)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: Baxter Healthcare Corporation Total Dry Tons Applied (Annual): 6.65
Permit #: WQ0031725 Cation Exchange Capacity (non 503 only):
Operator: Douglas Poplin Owner: Douglas Poplin Predominant Soil Series: FcC2
Acres Used: 3 Acres Permitted: 3 Site #: DP Field #: IC
Residual Analvsis Data (Henvv Metals and Tntal nh—h,,.,— ..-- w_—,i__ n, n ,• ,
Sample or
1
2
3I
5-a
6.
g
.0 vUi,u3
um;
paw rercent
ff
;12 ,
Coln-6
Date
1/4/18
% Solids
13.56
Arsenic
4.96
Cadmium
2
Copper
99
Chromium
81.2
Lead
7.83
Mercury
0.4
Molyb-
denum
5.43
Nickel
24
Selenium
5
Zinc
81.5
Total
Phos-
13300
horus
Anneal 14na.,v
Mntnl'V.-IA
T
Total
Event
1 1
1 111
1 111
1 111
1 IOI
1 III
1 111
0 111
1 111
1 111
1 111
1 111
1 1
'
1 11•
1 111
1 111
1 111
1 Ile
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 11•
�'
1 '
1 •1
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 lol
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 ell
1 111
1 111
1 111
1 111
1 111
1
1 111
1 1
1 1
1 111
1 111
1 111
1 III
1 111
1 111
1 111
1 111
1 111
0.000
1 111
1 1
.�
1 ll
11'
1 ell
1111
1 Ill
1III
1 111
1I11
1 110
1111
1 111
1111
1 111
1111
1 111
loll
1 111
1111
1 111
1111
0.000
1 I11
0.002
1111
1111
11 24
1 1.
1 111
I Ill
®®®®®
1 111
1 110
1 111
1 111
1 101
1 111
1 111
0.000
1 111
1 1•
1 1
1 111
1 111
1 111
1 111
1 111
1 111
1111
1 100
1 111
0.000
1 111
1 1
®
•
_
1.
•�.
1 111
1lll
.•..
1 111
1lll
1 111
1lll
1 I l l
1111
1 111
1111
1 I l l
1III
1 111
0111
1 111
1111
1 111
1lll
0.000
1 111
1
1lll
1111
;•
V-1114.1,, u,,.,V, „i,y uu-ecuon or supervision In accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility'of fines and
imprisonment for knowing violations".
Signature of Land pplier Date
DFNR FnRM RAF[ qP

ANNUAL, METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: Baxter Healthcare Corporation Total Dry Tons Applied (Annual):
Permit #: WQ0031725 Cation Exchange Capacity (non 503 only):
Operator: Douglas _Poplin Owner: Douglas Poplin Predominant Soil Series:
Acres Used: 9.6 Acres Permitted: 9.6 Site th DP Field #:
Residual Alnalvsis Data (Heavv Metals and 'Total Phnanh--.......,, 0.
19.98
FcC2
ID
Sample or,
Com=
posite
Date
—Li
1/4/18
2
L3�
4
5 i
6
7
...b."5)
8J
,v vviiva
9
uac
110
11,aw rUK-veill
11 j
ff):
12
% Solids
13.56
Arsenic
4.96
Cadmium
2
Copper
99
Chromium
81.2
Lead
7.83
Mercury
0.4
Molyb-
denum
5.43
Nickel
24
Selenium
5
zinc
81.5
"total
Phos-
�horus
Anneal
13300
utvavv Mp+ol
P;ol,a
T ,.,a:..
�r•_,__-,_�_
, .
—
Total
Event
1:
•
1 1
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 11:
0 111
1 III
1 Ile
1 111
1 Ile
1111
1 111
1 Ile
1 111
1111
1111
•••-
•�
1�
1
1 III
1 111
1 Ile
1 111
1 111
1 111
1 lel
1 Ile
1 111
1 III
1 III
1 111
1 Ill
1 Ill
1 111
1 Ill
1 III
1 Ill
1 111
1 Ill
1 111
1 111 I
i'
1 1
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
0.000
1 111 I
•
•
1 11
1 1
1 111
1 111
1 111
1 111
1 Ill
1 111
1 111
1 111
1 III
1 111
1 III
0 111
1 Ill
1 111
1 Ile
1 111
1 111
1 III
1 Ile I
1 111
®
0.000
1 111
®�
1 11
®®®®
1 111
1 111
1 111
1 1 11
1 111
1 111
1 111
1 Ill
1 111
Ilel
0.000
1111Total
1 111 I
1111 I
®
le
1111
fell
1111
1111
1111
elll
1111
elll
®
Phos-
plioru
I •
�•�.
1 011
1 101
1 111
1 111
1 111
1 110
1 111
1 011
1 111
1 111
1 111 I
0.021 '✓/
0.008 /
0.412
0.338 41
0.033 ►/
0.002 , "
0.023 ✓'
0.100 �
0.021 ✓
0.339
55.355 I a/
_„_....._... ., t„ cha, uu u,lucr Illy uirectlon or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
imprisonment for knowing violations".
Signa ure of Lana Applier
Date .
nFNR FnRnn NAPI cF: liomnna�

ANNUAL. METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: Baxter Healthcare Corporation Total Dry Tons Applied (Annual):
Permit #: WQ0031725 Cation Exchange Capacity (non 503 only):
Operator: Douglas Poplin Owner: Douglas Poplin Predominant Soil Series:
Acres Used: 5.877 Acres Permitted: 5.877 Site #: DP Field #:
Residual Analvsis Data (Aenvv Metnle and r.,+a1 n, n ,.
18.79
Fc132
3-Corn
Sample od-ij
Conn
posite
Date
1/4/18
2_5
6 i
7
8
m9
u-G
10�
naw rercent
11�
ff):
12
% Solids
13.56
Arsenic
4.96
Cadniiuin
2
-
Copper
99
Chromium
81.2
-
Lead
7.83
-
Mercury
0.4
-
Molyb-
denum
5.43
Nickel
24
-
SeleniLIM
5
Zinc
81.5
Total
Phos-
horus
Anneal
13300
Hi avv X40+n1
V.-1'1
T ,,a:..
-
Total
DT/Ac./
App.
Event
Arsenic
Cadmium
Copper
�bromiun-
Lead
Mercury
Molvb-
---- ✓ - ------ - ----- •.,.5.� X-C.X�uIALGu ill lun/ala-Cr:
3.20
0.032
0.013
0.633
0.519
0.050
0.003
0.035
1 111
1111
1 111
1 ell
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 ell
1 111
1 111
1 eel
1 ell
a 111
0 111
1 111
1 Ile
0 111
1 111
1 111
0.000
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 1
1 1
1.
1 •
1 1 1
1 11
1 1
1 111
1 111
1 111
1 111
1 111
1 111
0.000
1 111
1 111
1 111
1 111
1 111
1 111
0.000
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
0.0
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 101
1 111
1 III
1 off
1 111
1 111
1 111
1 Ile
1 lel
1 111
1 111
Nickel
0.153
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.153`1
Selenium
0.032
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.032
Zinc 0.521 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000
"Total
.00
00 0.000 0,521'1
_
Phos- 85.040 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000
0.000 0.000 85.040
horus
"I
certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the
information submitted.
1 am aware that there are significant penalties for submitting false information, including the possibility of fines and
imprisonment for knowing violations".
Signature of Land Applier
Date
DENR FORM MR qF (i9i,)nnr,�

ANNUAL METALS FI.EI,D LOADING SUMMARY :FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: Baxter Healthcare Corporation Total .Dry Tons Applied (Annual):
Permit #: WQ0031725 Cation Exchange Capacity (non 503 only):
Operator: Douglas Poplin Owner: Douglas Poplin Predominant Soil Series:
Acres Used: 6.983 Acres Permitted: 6.983 Site #: DP Field #:
25.00
FcB2
3-Grass _
Residual Analysis Data (Heavy Metals and Total Phosnhorus use mo/kfy_ 0/„ CnliflQ 1,Qp Raw PPrvont 141-
Sample or,
Com
posite
Date
1;
1 /4/ 18
2
3
4
g
6
8 v
V�
10 j
1
�2 -
% Solids
13.56
Arsenic
4.96
Cadmium
2
Copper
99
ChromiLlml
81.2
Lead
7.83
Mercury
0.4
Molyb-
denum
5.43
Nickel
24
Selenium
5
Zinc
81.5
Total
Phos-
horus
13300
riulivat neavv ivietai view Loadinffs lUaleulatea to Ihs/nerel!
•
AW
00000000
Event
11 .
1111
1111
e111
e111
1111
1111
1111
1101
1111
1110
1111
11
.i
11
1 111
1 111
1 lel
1 111
1 111
1 111
1 111
1 111
1111
0.000
1 111
11
••
1 1'
®
1 111
®®®®®®®®®1111
1 111
0 I11
1 111
1 111
1 111
1 111
1 111
1 111
0.000
1 1
®
1
1 111
1 111
1 111
1 111
1 111
1 I11
1 111
1 111
1 111
1 111
1 111
1
1 1 .
1 111
1 111
1 111
1 111
1 111
1 111
1 I11
1 111
1 111
0.000
1 111
1 1
1 11
1 111
1 111
1 111
1 111
1 Ill
1 ell
1 I11
1 111
1 111
1 111
1 111
1 11
•• '
1 1 •
1 111
1 111
1 111
1 111
1 Ile
1 Ile
1 ell
1 111
1 ell
1 111
1 ell
0.039
��
1 111
1 111
1 111
1 111
1 111
1 eel
1 lee
1 Ile
1 111
1 1 1
1 lee
1�
1 1.
1 111
1 111
a 111
1 111
1 111
loll
1 111
1 111
1 111
0 1
1 111
1 1
®
l :�
1 Ile
1 111
1 ell
1 ell
1 111
1 ell
1 Ill
1 111
1 Ile
1 1
1 ell
1
Total
' •
m
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 010
1 111
111
1 111
• :
•
. - tuy, uuuGI l,cuany M iaw, ivat LUIS LIOCnment was prepares unaeC my Uirection or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
imprisonment for knowing violations".
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

ANNUAL, METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: Baxter Healthcare Corporation Total Dry Tons Applied (Annual): 24.09
Permit #: WQ0031725 Cation Exchange Capacity (non 503 only):
Operator: Douglas Poplin Owner: Douglas Poplin Predominant Soil Series: FcB2
Acres Used: 8.7 Acres Permitted: 8.7 Site #: DP Field #• 4 _
Residual Analvsis Data (Heavy Metslls an[I 'FnfaI Phno-h- of
Sample or
1...1
2
-
3
4]
5 1
-- -----i
---- -� -.._
---b"^b7
8.
••, ...,vuuo
uoa
10
ivtaw 1 GA
11
GGIIL tt):
12
Com-
.9
-
posite
Date
1/4/18
% Solids
13.56
--
Arsenic
4.96
-
Cadmium
2
-
Copper
99
-
Chromium
81.2
--
Lead
7.83
-
Mercury
0.4
Molyb-
5.43
denum
Nickel
24
-
Selenium
5
--
Zinc
81.5
-
Total
-
Phos-
13300
horus
Total
!
2 -73
4
5 1
6
7
10 1
11
12�
DT/Ac./
App.
m
Event
2.77
Arsenic
0.027
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
C1.000
0.000
0.027
Cadmium
0.011
0.000
0.000
I
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.0 ] 1
Copper
0.548
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.548
Chromium
0.450
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.548
Lead
0.043
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.043
Mercury
0.002
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.002
Molyb-
0.030 ,
denum
0.030
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
Nickel
0.133
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.133
Selenium
0.028
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.028
Zinc
0.451
0.000-
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.451
Total
-- -
Phos-
73.655
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
73.655
horus
3 C�,
"7 CP.r ifv_
nntipr nonal+v
of
I.- 4h-+
41,:- .1---
--
-✓ -- ---'' J -------'- ♦. "a ti. char L; U11Uc,- u,y wrecuon or supervision In accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
imprisonment for knowing violations".
Signature of Land Applier
Date
DENR FORM MFI qF (i?i?nna�

ANNUAL METAI_,S FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: Baxter Healthcare Corporation Total Dry Tons Applied (Annual): 35.20
Permit #; WQ0031725 Cation Exchange Capacity (non 503 only): �T
Operator: Douglas Poplin Owner: Douglas Poplin Predominant Soil Series: FcC2
Acres Used: 15.9 Acres Permitted: 15.9 Site #: DP Field #: 5
Residual
Analysis
Data
(Heavy
Metals
and Total
Phosphorus
use
mg/kg,
% Solids
use
Raw Percent #):
Sample or
1 I
L113
a
5
6
7
8
`
9 i
�•
10j
1.�
12
Corn-
posite
Date
1 /4/ 18
--
-
-
-
-
-
Solids
13.56
Arsenic
4.96
Cadmium
2
Copper
99
Chromium
81.2
Lead
7.83
Mercury
0.4
Molyb-
denum
5.43
-
-
---
Nickel
24
Selenium
5
Zinc
81.5
--
Total
Phos-
13300
horus
Annual Heavy Metal Field Loadings (Calculated in lbs/acre):
--
Total
_�)
2
3
4
5
6
7
8
9 I
10 11 j
12�
DT/Ac./
y
App.
o
Event
2.21
i
Arsenic
0.022
0.000
0.000
0.000
0.000
0.000
0.000
0.000.
0.000
0.000
0.000
0.000
0.022
Cadmimn
0.009
0.000
0.000
0.000
0:000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.009
1/
✓
Copper
0.438
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.438
✓
Chronium
0.360
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.0 00
0.360
✓
Lead
0.032
0.000
0.000
0.000
0.000
0:000
0.000
0.000
0.000
0.000
0000
0.000
0.035
Mercury
Molyb-
0.024
0.000'
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.00.0
0.000
0.002
,/
✓
denum
0.024
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.024
✓
Nickel
0.106
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0,000
0.000
0.106
Selenium
0.022
0.000
0.000
0.000
0.000
0.000
0.000
O'000
0:000
0.000
0.000
0.000
0.022
✓
Zinc
Total
0.361
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.361D
✓
Phos- 58.892 0.000 0.000 0.000' 0.000 horus 0.000 0.000 0.000 0.000 0.000 0.000 0.000 58.892 `/ "I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the 'information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
imprisonment for knowing violations".
Signature of Land Applier
Data
nFNR Pr)PRA NAM cG ii-rvnncm

ANNUAL METALS FIELD LOADING SUMMARY .FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: Baxter Healthcare Corporation Total Dry Tons Applied (Annual): 12.31
Permit #: WQ0031725 Cation Exchange Capacity (non S03 only):.
Operator: Douglas Poplin Owner: Douglas Poplin Predominant Soil Series: FcC2
Acres Used: 5.5 Acres Permitted: 5.5 Site #: DP Field #: 6
Residual Analvsis Data (Heavy Metals and r,,t.i
Raw Percent #):
12
Sample or
C 0111-
posite
Date
1
1 /4/ 18
_
lllb/ KVO�
8
/U I.3V
9fl
Ub uJC
1
% Solids
13.56
-
Arsenic
4.96
-
CadMiu111
2
--
Copper
99
--
Chronliuni
81.2
-
Lead
7.83
--
Meralry
0.4
-
Molyb-
denum
5.43
Nickel
24
-
Selenium
5
-
Zinc
81.5
Total
Phos-
hOrIIS
Annual
13300
Aeavv Mat
-al vT .ia
r .,a:
/77,7
_,_.
--
-
Total
r
Event
1 1
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 11•
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
� '�i��
1 0ll
1 111
1 111
1 111
1 111
1 111
1 111
1 111
r�lii'�Wi'�IW
o •'
1 111
1 111
1 111
1 111
1 10 0
1 111
1 111
1 111
1 1
1 111
1 111
1 011
1 111
1 111
1 111
1 111
1 111
•• •
1 11
1 1
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
®®®®1 1
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 1
1 lel
1 111
1 111
1 110
1 111
1 111
1 111
1 111
®
Total•
1•
'
1 111
1 011
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 off
10
11 �
L12
H
0
sv
0.000
0.000
0.000
0.022
0.000
0.000
0.000
0.009
0.000
0.000
0.000
0.44 T
0.000
0.000
0.000
0.364�1
0.000
0.000
0.000
0.035
0.000
0.000
0.000
0.002
0.000
0.000
0.000
0.024
0.000
0.000
0.000
0.107 t
0.000
0.000
0.000
0.022
0.000
0.000
0.000
0.365
0.000
0.000[0--0OTO59.557
`�
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
imprisonment for knowing violations".
Signature of Land- � -- ----
pp Date
i
DFNR F17Rnn AAPI c� rl�ionn��,

ANNUAL, METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: Baxter Healthcare Corporation Total Dry Tons Applied (Annual): 9.85
Permit #: WQ0031725 Cation Exchange Capacity (non 503 only):
Operator: Douglas Poplin Owner: Douglas Poplin Predominant Soil Series: FcC2
Acres Used: 4.4 Acres Permitted: 4.4 Site #: DP Field #: 7
Residual Analvsis Data (Henvv UPtale and
Sample or
com-
posite
Date
1/4/18
2
AF
4 j
5 i
6
7
8
,,, vuraua
9 11.0J
ux
naw rul-cent
11�
ff):
12
% Solids
13.56
--
Arsenic
4.96
—
Cadmium
2
Copper
99
--
C111-0111 lllll
81.2
-
Lead
7.83
—
Mercury
0.4
—
Molyb-
denuln
5.43
--
Nickel
24
—
Selenium
5
—
Zinc
$ 1.5
—
Total
Phos-
1101-LIS
Annual
13300
NPavv k
4atal vio°A
T
—
App.
Event
1 1
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 110
1 111
111
1 111
®
1 11 •
1 111
1 111
1 111
1 l e l
1 111
1 111
1 111
1 111
1 111
111
1 111
1'
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
111
1 111
178YWL�WI
1 •'
1 111
1 111
1 111
1 111
1111
1 111
1 101
1 111
1 111
1111
1 111 I
1 1
1 111
1 111
1 111
1 110
1 111
1 111
1 111
1 111
1 111
1 111
1 111 I
••
1 11
l
1 111
l lee
1 111
1 0ll
1 111
a 111
1 111
a eeo
1 111
a loo
1 111
l eeo
1 111
0 ole
1 111
1 ole
1 111
l eeo
1 11
11
1 111 I
0.000
1 0l0
®I
1 1
1 lot
1 Ill
1 111
1 Ile
1111
1 111
111
1111
1 111 I
1 1
1 111
1 111
1 111
1 111
1 111
1 111
1 110
1 111
1 111
0.000Total
1 111
1 111 I
0 111 I
®
1•
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
1 111
' •
•
•
.•,.
1 ell
1 ell
1 ell
1 eel
1 ell
1 111
1 ell
1 ell
1 111
1 111
1 111
0.022
0.009
0.443 ✓
0.364 r/
0.035
0.002—
0.024 I.%
0.107
0.022
0.365 ,.✓
59.557
�%4-6 5
-- , --,--- ----•��•.••.�... sw i vai cU uuue,- my uu•ectnon or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including. the possibility of fines and
imprisonment for knowing violations".
Signature of Land Applier
Date
DENR FORM MFLSF (1?ignnF)

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: Baxter Healthcare
Land Owner: Douglas Poplin
Operator: Douglas Poplin
Crop 1 Name: Fescue
WQ Permit #: WQ0031725 Field #: 1A
Annual Dry Tons Applied: 12.0971 ✓ Site #: DP Acres Permitted: 5.5
Predominant Soil Series: FcC2
Crop l Max. PAN: 158
Acres Utilized: 5.5 1/
Cation Exchange Capacity (non 503):
Crop 2 Name: Crop 2 Max. PAN:
c
Q0
Volume applied
PP
(enter one) Solids/
Liquid
Cu. Yds Gallons
�/o
Solids
Volume
Applied per
PP P
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #. WQ#.
Fert., Animal
Waste, etc)
Soil
Cond.
Wi'
Moist)
Precip.
Past _4
Hrs.
inches
D
K
0
o w
o
7 _
�'
o
_
o
�
TKN
m /kg
9
z ?
d
m /kg
9
Nitrate
and
Nitrite
m /k
9 9
PAN Applied
(]bs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
P
Crop -2
P-
Crop 1
P
Crop 2-
P-
9-2018
57.37
13.56
1..191 V
WQ0031725
dry
0
s V
0.5
0.3 ✓
82500
7300
23.5
62.498
NA
Fescue
10-2018
48.56
13.56
1,008.
WQ0031725
dry
0
s
0.5
0.3
82500
7300
23.5
52.901 J
NA
Fesuue .
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.600
0.000
0.000
0.000
0.000
0.000
0.000
0.006
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
Residuals Applications totals on FORM FSF supp ( attach FORM
FSF supp to this form):
"TOTALS:
J 105.931
0
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn 1,
P
115.399
0.000
Lime Applied
Annual
lbs/acre
0.022 V
0.009 V
0.435,
0.357
0.0347
0.002
0.024
0.106'
0.022
0.358•
/69.493/1
V
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.138 0.042 2.359 1.5 0.208 0.007 0.1 0.537 / 0.084' 4.149
0.160 0.051 1 2.794 1.857 0.242 0.009 0. 124v 0.643V 0.106 4.507
36 34 1338 NA 267 15 NA 374 89 2498
158
0
Current Cumulative lbs/ac
'Permitted C. P. L. R.****
Permit PAN Limit Ist/2nd Crop
.-t certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
aualiiied personnel p-roperiy gathered and evaluated the information submitted, 1 am aware that there nrp 6anifipant "Pnaltipe
information, including the possibility of fines and imprisonment for knowing violations."
I
Signature of Land Applier
Date
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volatilization Rate: Surface - 0,5, Injection/Incorporation - 1.0
*** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
***C.P.L.R.: Cumulative Pollutant Loading Rate

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: Baxter Healthcare
Land Owner: Douglas Poplin
Operator: Douglas Poplin
Crop 1 Name: Fescue
Field #: 1 B
Annual Dry Tons Applied: 3.5333 Site #: DP
Predominant Soil Series: FcC?�
Crop 1 Max. PAN: 158 Crop 2 Name:
WQ Permit #: WQ0031725
Acres Utilized: 1.6 ✓
Acres Permitted: 1.6
Cation Exchange Capacity (non 503):
Cron 2 Max. PAN:
o
a
10-2018
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
30.94
%
Solids
13.56
Volume
Applied per
PP P
Acre
(Dry Tons/Ac)
2.208
Residual Sources
(NPDES #. WQ#-
Fert.. Animal
Waste; etc)
WQ0031725
S01I
Cond.
(Dry,
Wet,�'
Moist)
dry
Precip.
Past 24
Hrs.
inches
0
D
r
- o
o T
-
s
o
_
y'
2
0.5
z
@
N
o
0.3
TKN
mg/kg
82500
z
o
o
CD o
mg/kg
7300
Nitrate
and
Nitrite
mg/kg
23.5
PAN Applied
{ lbs/acre)
Name of CropType
YP
Receiving Residual
Application
PP
Crop 1
115.864
crop 2
Crop I
Crop 2
NA
Fescue
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
o.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
Residuals Applications totals on FORM FSF supp ( attach FORM
FSF supp to this form):
TOTALS:
Annual
30.94 0
lbs/acre
As
0.022 ✓
Cd
0.009
I Cu
0.437,
Cr I
0.359�
Pb
0.035°'
Ha
0.002
Mo
0.024�"
Ni
0.106
Se
0.022°'
Zp
0.360
/�
58.733
115.86 0.000
Lime
Date
Applied
lbs/ac
Prior Years Cumulative ]bs/ac
2.218 1.375 0.192 ,0.007 0.094 0.497 0.08] 3.833
0.136 t34
0.158 ✓2.655 1.734 0.227 0.009 0.118r 0.603 0.103 4.193
t1338
36 NA 267 ]5 NA 374 89 2498
158
0
Current Cumulative lbs/ac
Permitted C. P. L. R.****
Permit PAN Limit lst/2nd Crop
eev ,. ..er_. _ � _--
1 cerirry, under penalty of taw, that tuts document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. 1 am aware that there are sighif,caht penaittes for submittin¢ fai.cP
information, including the possibility fin n imnri onme for 1 -^ --
of fines and ,...s ht .,,..cnowt:tg violations."
*Application Method. S - Surface, IN - Injection, INC - Incorporation
el Gj **Volatilization Rate: Surface - 0.5, In•ection/Incorporation - 1.0
Signature of Land App]ier Date *** Mineralization Rates: Compost-0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: Baxter Healthcare WQ Permit #: W 0031725 Field # 1/
Q 1C Acres Utilized: 3
Land Owner: Douglas Poplin Annual Dry Tons Applied: 6.6486 Site #• DP Acres Permitted: 3
Operator: Douglas Poplin Predominant Soil Series: FeC? Cation Exchange Capacity (non 503):
Crop 1 Name: Fescue Crop 1 Max PAN: 158 V Cro 2 Na
P
me•
Crop
2 Max. PAN:
o �
C)
Volume applied
PP
(enter one) Solids/
o
/o
Volume
Applied per
Residual Sources
(NPDFS #, WQ#,
Soil
Cond.
Precip.
Past 24
>
� -
-2
o
� F
�_
-
'�
z >
=
Nitrate
PAN Applied
Name of Crop Type
Liquid
Solids
Acre
Fert., Animal
(Dry.
Hrs.
rD
-
5
=
TKN
'
and
(]bs/acre)
Receiving Residual
Wet
w'
X N'
a
`D
Nitrite
Application
etc
Cu. Yds Gallons (Dry Tens/Ac) Waste. ) Moist inches J
mg/kg mg/kg mg/kg Crop 1 top 2 Crop 1 Crop 2-
12-2018 58.22 13.56 2.216 a� WQ003 ] 725 dry 0 s 0.5 0.3 82500 7300 23.5 116.278 NA Fescue
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
o_000
0.000
FOTALS: 58.221 01 As
Annual lbs/acre 0.022. v
'rior Years Cumulative )bs/ac 0.71.7-
�urrent Cumulative lbs/ac 0.739.✓
'erinitted C. P. L. R.****T 36
Residuals Applications totals on FORM
FSF supp ( attach FORM FSF supp to this form):
Cd
Cu
I Cr
Pb
Ha
I Mo
Ni
Se
I Zn
0.009
0.439V
0.360
0.03.5'
0.002VI
0.024 '
0.106
0.022
0.361
� 58.946
0.054
2.889
1.75
0.243
0.009
0.118
10.638
0.1
5.247
0.063
3.328
2.110
0.278
O.OI 1
0.142
0.744
0.122
5.608
34
1338
NA
267
15
NA
374
89
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.600 0.000
0.000 0.000
0.000 0.000
0.000 0.000
116.2781 0.000 Lime Applied
Date ) bs/ac
0
2498
'ermit PAN Limit 1st/2nd Crop
158
`I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
lualifted personnel properly gathered and evaluated the information submitted. I a:.. aware that there are significant nen?it;ec fnr c„tt..,;tt;n folco
nformation, including the possibili of fines and imprisonment onment for Iat: ,, g
h' p_.s................ k^owingv;o,a�,or,s.
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volatilization Rate: Surface -0.5, Injection/Incorporation- 1.0
Signature of Land Applier Date Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASEMAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE
Facility Name: Baxter Healthcare
WQ Permit #• W 0031725
' Q
Field #: 1D
Land Owner: Douglas Poplin
Annual Dry Tons Applied: 19.9802
Site #• DP
Acres Utilized: 9.6
Operator: Douglas Poplin
Predominant Soil Series: FcC2
Acres Permitted: 9.6
Cation
Exchange Capacity (non 503):
Crop 1 Name:
Fescue
Crop 1 Max. PAN 158
Crop
2 Name:
Crop 2 Max. PAN:
Volume applied
o (enter one) Solids/
c
o
/o
Volume
Applied per
Residual Sources
(NPDES #, WQ#,
Soil
Cond.
Precip.
Past 24
D
K
o
ry
z ?
= =
Nitrate
PAN Applied
PP d
Name of Crop Type
Q Liquid
9
Solids
Acre
Fert., Animal
Dry,
Wet.
Hrs.
R -
_
_
a
TKN
o -
and
(]bs/acre)
Receiving Residual
Cu. Yds Gallons
;Dry TcnslAc%
Waste, etc)
N
x-
J
Nitrite
Application
1 1-2018 174.9&
1356
2 081
W 003 "
Moist)
inches
0
mg/kg
mg/kg
mg/kg
Crop 1
rop 2
Crop l
Crop 2
0.000
Q 172�
dry
0
s
0.5
0.3
82500
7300
23.5
109.198
NA
Fescue
0.000
0.000
0.000
0.000
0-000
0.000
0.000
0.000
0.000
0.000
0.000
o.000
0.000
0.000
0.000
ET
a.000
0.000
o.000
0.000
0.000
a.00a
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000.
0.000
0.000
0.000
-OTALSI 174.961 01
annual lbs/acre
'rior Years Cumulative lbs/ac
:urrent Cumulative lbs/a+
'ermitted C. P. L. R.****
'ermit PAN Limit 1st/2nd
As
0.021
0.135-
0.156
36
Residuals App
Cd Cu
0.008 0.412
0.035 2.194
0.047 . 2.606
34 1338
ications totals
Cr
on FORM
I Pb
FSF
I HQ
supp ( attach
1 1\40
FORM
Ni
FSF supp
Se
to this
form):
1, Zn
0.339
P
55.35:
0.338
0.033
0.21
0.002
0.023
01.378 .092
O. P00,
0.021
0.586
374
.6 6
8
0.087
9NA
3.633
J3.972
2498
1.716
0.24
.115
267
NA
09.199 0.000 Lime Applied
Date Ibs/ac
0
158
J certify, under penalty of law, that this document was prepared under my direction or supervision in accordance' with a system designed to assure that
lualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
r, �,-rration, including the possibility of fines and imprisonment for knowing violations."
p g.
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE ]MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: Baxter Healthcare WQ Permit #• W 0031725 Field #
• Q - 3-Corn Acres Utilized: 5.877
Land Owner: Douglas Poplin Annual Dry Tons Applied: 18.7845 Site #• DP- Acres Permitted- 5.877
Operator: Douglas Poplin Predominant S '1 S .
3-2018
4-2018
o� ernes. rcDL
�A�YV tia J
Cation Exchange Capacity (non 503):
Crop 1 Name:
Corn
Crop 1 Max. PAN:
214 ✓
Crop 2 Name:
Crop 2 Max. PAN-
Volume applied
PP
Volume
Residual Sources
Soil
Precip.
D
�
�
z D
Nitrate
(enter one) Solids/
/a
Applied per
pp p
(NPDES #, WQ#,
Cond.
past 24
%" E
'-'
TKN
o
PAN Applied
Liquid
Solids
Acre
Fert.. Animal
(Dr`'
Hrs.
-
o
G =
��
�°
and
Nitrite
(]bs/acre)
Cu. Yds Gallons
(Dry Tens/Acl
Waste, etc)
Wet
inches
2
*
o
x ^'
j
54.64
Moist)
mg/kg
mg/kg
mg/,Kg
op 1
Crop 2
13.56
1.062
WQ0031725
dry
0
Inc
]
0.3
82500
7300
23.5
�663.457
NA
909.85
13.56
2.135
WQ0031725
dry
0
Inc
1
0.3
82500
7300
23.5
127.575
NA
TOTALS: 164.491 01
Annual lbs/acre
Prior Years Cumulative lbs/ac
Current Cumulative lbs/ac
Permitted C. P. L. R.****
Permit PAN Limit 1st/2nd
0.000
0.000
0.000
0.000
0.000
0.000
o.00a
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
O.000
0.000
0.000
0.000
0.000
0.000
0.000
to this
form):
0.000
0.000
Residuals Applications
totals
on FORM
FSF
supp ( attach
FORM
FSF supp
As
0.032
Cd
.
1, Cu Cr
.3.
/ Pb I
.
Hg I
Mo 1,
Ni
0.153
Se
Zn
91.03 0.000
0.032
0.521
85.040 10
0.36
0
0.879 4.09
0.546
0.017
0236
]_268
1.421
3
0.536
0.568
12:623
3.4
0.126TFI
2 4.609
0.5.
0.020
29670.395
0A1
36
34
N
Name of Crop Type
Receiving Residual
Application
Crop 1 Crop 2
Corn
Corn
Lime Applied
Date I lbs/ac
10-20181 4000
214
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
Iualified personnel properly gathered and evaluated the information submitted. I am aware that there are si„nif;cant penalties for submitting fake
rnormation, including the possibility of fines and imprisonment for knowing violations,"
a
Signature of Land Applier
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF
THIS BLANK FORM TO BE COMPLETED
AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" 1N A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: Baxter Healthcare
WQ Permit #• W 0031725 Field #
- Q 3-Grass
Land Owner: Douglas Poplin
- Acres Utilized: 6.983
Annual Dry Tons Applied: 25.0118 Site #• DP
Operator: Douglas Poplin
Acres Permitted: 6.983
Predominant Soil Series: FcB2
Crop l Name: Fescue
Cation Exchange Capacity (non 503):
Crop V
I Max. PAN: 194 Crop 2 Name: Crop 2 Max. PAN:
Volume applied Volume
o s (enter one) Solids/ o pp p
c /o A lied per
Soil K
Residual Sources Precip. D z ? Nitrate Name of Crop Type
(NPDES #, WQ#, Cond. Past 24 n � PAN Applied P YP
o
Q 7 1,iquid Solids Acre
TKN o � and R ceivinQ
Fert., Animal (Dry Hrs. o `� ( lbs/acre) o Residual
Cu. Yds Gallons Dry Tons/Ac,
Application
Waste, etc Wei, x o. - ~ Es, Nitrite pp
)
2-2018 57.07 13.56 0.933 ,/
Moist) inches o' mg/kg mg/kg mg/kg Crop 1 Crop 2 Crop 1 Crop 2
WQ0031725 dry 0
3-2018 161.95 13.56 2.649
s 0.5 0.3 82500 7300 23.5 48.968 A Fescue
WQ0031725 dry 0
0.000
s 0.5 0.3 82500 7300 23.5 138.959 NA Fescue
0.000
0.000 0.000
0.000
0.000 0.000
0.000
0.000 0.000
0.000
0.000 0.000
0.000
0.000 0.000
0.000
0.000 0.000
0.000
0.000 0.000
0.000
0.000 0.000
0.000
0.000 0.000
0.000 0.000
Residuals Applications totals on FORM FSF supp ( attach FORM FSF
roTALs: 219.021 01 1 As
Annua] lbs/acre ✓
supp to this form):
Cd Cu 1, Cr I Pb. I HQ I Mo I Ni I Se I Zn �---P� 187.927 0.000 Lime Applied
0.036
Prior Years Cumulative lbs/ac 0.351
0.014✓ 0.709 0.581 0.056� 0.003 0.039 0.172 0.036 0.584 i 95.228 / Date I Ibs/ac
11
�'urrent Cumulative lbs/ac 0.387
0.117 6.195 3.995 0.536 0.017 0.242 1.248 0.545' 12584-'\, 0
0.131
6.904 4.576 0.592 0.020 0.281✓ 1.420 0381 J 13.168
?ermitted C. P. L. R.**** 36
34 1338 NA 267 15 NA 374 89 2498
'ermit PAN Limit Ist/2nd Crop
194
`1 certify, under penalty of law, that this document was prepared under my direction
lualified personnel properly gathered and evaluated
or supervision in accordance with a system designed to assure that
the information
submitted, 1 am aware that there are s1211111 ca,-,t penalties for submitting false
nformation, including the possibility of fines
and imprisonment for knowing violations." V
-b
Z•i-1
*Application Method: S - Surface, IN - Injection, INC - Incorporation
S **Volatilization
Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier
Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE
Facility Name: Baxter Healthcare WQ Permit #: W 0031725 Field #
Q • 4 Acres Utilized: 8.7
Land Owner: Douglas Poplin Annual Dry Tons Applied: 24.0925 Site #: DP Acres Permitted: 8.7
Operator: Douglas Poplin Predominant Soil Series: FcB2 Cation Exchange Capacity (non 503):
Crop l Name: Fescue Crop I Max. PAN 194 Crop 2 Name Crop 2 Max. PAN
o r
c
o
1] 7
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
A lied er
pp p
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soi1
Cond.
(Dry'
Wet.
Moist)
Precip.
Past 24
Hrs.
inches
D
o a
* o•
x. N
k m
I N
o
5-2018
137.53
13.56
1.805
WQ0031725
dry
0
s
5
0.3
6-2018
73.44
13.56
0.964
WQ0031725
dry
0
s
5
20.
0.3
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
Residuals App
TOTALS:
210.971 01
1
As
Cd
I Cu
Annual
lbs/acre
0.027
0.01 ] vJ
0.548
Prior Years Cumulative lbs/ac
0.268,
0.083
4.451.
�urrent Cumulative lbs/ac
0.295
0.094
4.999
3ermitted C. P. L. R.****
36
34
1338
z
TKN o
po 0
mg/kg mg/kg
82500 7300
82500 1 7300
Nitrate PAN Applied
and ( lbs/acre)
Nitrite
mgAg
23.5
23.5
Crop 1
94.716
50.579
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
lications totals on FORM
FSF supp ( attach FORM
FSF supp to this form):
Cr
0.450
I Pb
0.043 'A0.00Q20.0300.028
Hg
Mo
I Ni
Se
Zn
0.45]2.975
0.377
0.1239081
0.151
9.532
3.425
0.420
a[ija
NA
267
15
NA
'74
89
Name of Crop Type
Receiving Residual
Application
Crop 1 Crop 2
Fescue
Fesuue
Lime Applied
Date lbs/ac
0
• � _498
3ermit PAN Limit 1 st/2nd Crop
194
`I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
lualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting fnilep
a-_. _
nformation, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
I5-20 w **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: Baxter Healthcare WQ Permit #: WQ0031725 Field #: 5 Acres Utilized: 15.9
Land Owner: Douglas Poplin Annual Dry Tons Applied: 35.1972 Site #• DP Acres Permitted- 15.9
Operator: Douglas Poplin Predominant Soil Series: FcC2Cation Exchange Capacity (non 503):
/
Crop 1 Name: Fescue Cron 1 Max. PAN: 158 �/ Cron 2 NnmP• r.. -') X11-- n A X -
_
Y
ca
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
PP P
Acre
(Dry
ry TcnslAc)
Residual Sources
(NPDES #. WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry.
Wet,
Moist)
Precip.
Past 24
Hrs.
inches
>
K .0
_
r _
<
o
; T
_
�, -
�- =
o
-
,-�
ry
N
% N
a
TKN
mg/kg
z D
_ =
d -'
rX o
CD -
Es
mg/kg
Nitrate
and
Nitrite
mglkg
'
PAN Applied
( Ibs/acre)
Name of Crop Type
Receiving Residual
Application
PP
Crop ]
Top 2
Crop ]
Crop 2
6-2018
7-2018
8-2018
81.96
114.77
111.48
13.56
13.56
13.56
0.589:
0.824
0.801
WQ0031725
VlWQ0031725
WQ0031725
dry
dry
dry
0
0
0
s
s
s
0.5
0.5
0.5
0.3
0.3
0.3
82500
82500
82500
7300
7300
7300
23.5
23.5
23.5
30.885
NA
Fescue
43.249
NA
Fesuce
42.009
NA
Fescue
0,000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.060
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
o.000
0.000
0.000
ro'rALs: 308.21 01
Annual Ibs/acre
Prior Years Cumulative lbs/ac
�urrent Cumulative lbs/ac
As
0.022
0.235-
0.257
36
Residuals
Cd
5509
0.07'
0.079
34
Applications
1, Cu
0.438'
3.778
4.2]6.
1338
totals
Cr I
0.360
2.44
2.800
NA
on FORM
Pb
0.035
0.338
0.373 J
267
FSF
H
OA02 �1
1 0.012
0.014
15
supp ( attach
- Mo
0.024 /
0.15
0.174!/
NA
FORM
Ni
0.106
, 0.876
0.982
374
FSF supp
Se I
0.022�
0.095
0.117
89
to this
Zn
0.361
7.776
8.137
2498
form):
�1? 116.144 /0.000
/58.892 f
Lime Applied
Date
Ibs/ac
10-2018
2000
?ermitted C- P. L. R.****
'ermit PAN Limit Ist/2nd Crop
61r ..f: F..-,],.
J
158
_ __ ___„ _.._. r .. .., . '-- 1-0 ,,,,.,,.,,.U.,& W a3 p, CpaICU unuer my airectton or supervision in accordance with a system designed to assure that
ivalified personnel properly gathered and evaluated the information submitted. 1 amA aware that there are significant penalties for sub-mitt-ing fak"
nformation, including the possibility of fines and imprisonment for knowing violations." v
ELM
r
Signature of Land Applier
-1S`-oc
Date
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
*** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE
Facility Name: Baxter Healthcare WQ Permit#: WQ0031725 Field # ( ✓
Acres Utilized: 5,5
Land Owner: Douglas Poplin Annual Dry Tons Applied: 12.3129
Site #: DP Acres Permitted: 5.5
Operator: Douglas Poplin Predominant Soil Series: FcC2
Cation Exchange Capacity (non 503):
Crop I Name: Fescue (_ , 1 na..., U A 7a- , co /
N .a...�.
crop
L Max. PAN:
Volume applied
o y
Volume
Residual Sources
Soil
Precip.
D
o
z?
(enter one) Solids/ o
Y o /o
Applied per
(NPDES #, WQ#.
Cond.
Past 24
K -a
a
= J
Nitrate
PAN Applied
Name of CropType
yp
Q Liquid Solids
Acre
Fert., Animal
(Dry,
Hrs.
R
-
o
-
TKN
d o
and
(lbs/acre)
Receiving Residual
Cu. Yds Gallons
(Dry Tans/Aa)
j Waste, etc)
Wet.
T
Y J-
x T
��-
Nitrite
Application
Crop 1
Crop 2
Crop 1
Crop 2
Moist) inches c'
1-2018 89.73 mg/kg mg/kg mg/kg
13.56 ].863 WQ0031725
2-20 ] 8 18.09 13.56
0.376 \/
W 0031725
Q
dry
dry
0
0
s
0.5
0.3
82500
7300
23.5
97.75]
; NA
Fescue
0.000
s
0.5
0.3
82500
7300
23.5
19.707
NA
Fescue
o.000
0.000
0.000
0.000
o:000
0.000
o.000
o.000
0.000
0.000
0.000
o.oao
0.000
o.000
o.000
0.000
a.000
o.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form):
roTALs:
107.8201 1
Annuallbs/acre
As
0.022 ✓
Cd-I Cu
Cr
Pb
Hg
�O
�'
N1
Se
Zn
fP
/
117.45
0.000
Lime A lied
'rior Years Cumulative lbs/ac
0.327
0.009 0.443
0.097
0.364
0.035
0.002
0.024
0.107
0.022
0.365
39.557 11
Date
lbs/ac
-urrent Cumulative lbs/ac
0.34.9
5.373
3.682'
0.497
0.0 1 4
0.207
1.028
0. t 1,2
10.868
1
0
'ermitted C. P. L. R.****
0.106 5.816
4.046.
0-532✓
0.016 `
0.231
1.135
0.134,-
11.233
!�
'ermit PAN Limit lst/2nd Crop
36
34 1338
NA
267
15
NA
374
89
2498
_
158nt
`I certify, under penalty of law. that this dnPmm,,aroc ... ___a___ ___
--- r'---I---. �•_� "A-Y u., cut,uu ur supervision in accordance with a system designed to assure that
lualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
nfQYmatinn �l = •ut,r_� - rr_n
= s . possiU, ,-Ly o, �,es and imprisonment for knowing violations."
Jl--
Signature of Land Applier Date
C''1
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
` Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
Facility Name: Baxter Healthcare
Land Owner: Douglas Poplin
Operator: Douglas Poplin
Crop 1 Name: Fescue
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
WQ Permit #: WQ0031725 Field #: 7
Annual Dry Tons Applied: 9.8519 Site #: DP
Predominant Soil Series: FCC2
Crop 1 Max. PAN: 158 Crop 2 Name:
Acres Utilized: 4.4 ✓
Acres Permitted: 4.4
Cation Exchange Capacity (non 503):
Cron 2 Max. PAN:
o
Volume applied
Volume
Residual Sources
Soil
Precip.
<
o
-
z D
Nitrate
Name of Crop Type
(enter one) Solids/
oho
A lied er
PP P
(NPDES #. WQ#_
Cond.
Past _4
rc _
_
y
TKN
_
d
and
PAN Applied
Receivin- Residual
ec
Liquid
Solids
Acre
Fert., Animal
(Dry,
Hrs.
- �"
o
� '-
D N"
ry �
F.
°° g
D
Nitrite
( Ibs/acre)
Application
PP
Cu. Yds Gallons
D, Tons/Ac
y 1
Waste. etc )
Wet,
Moist)
inches
n -•
�
-
o"
mg/kg
m
mg/kg
mg/kg
Crop 1
Crop 2
Crop 1
Crop 2
1-2018
86.27
13.56
2.239 IdW00031725
dry
0
s
0.5
0.3
82500
7300
23.5
117.4770
NA
Fescue
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
6.000
0.000
0:000
0"000
0.000
0.000
o:000
0.000
0.000
0:00o
0.000
0.000
0.066
0.000
0.000
0.000
0.000
0.000
0.000
o.000
o:000
0.000
Residuals Applications totals on FORM
FSF supp ( attach FORM
FSF supp to this form):
TOTALS:
86.271
01
1
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
4 � ,
117.4771
a:000
Lime Applied
Annual lbs/acre
0.022 0.009 0.443 0.364 0.035 0.002 0.024 0.107 0.022 0.365 59.SS7
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.378 _ 0.013 0.166 .978 0.109 8.31271,�j
0.267 0.075 4"168•tNA
0.289 0.084 4.611 .413 0.015 0.1901.085 0.131 8.677 /
t02
36 34 ]338 77 15 NA 374 89 2498
10-2018
2000
!Current Cumulative lbs/ac
Permitted C. P. L. R.****
Permit PAN Limit 1st/2nd Crop
158
I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information. s,ub;;;itted. I am aware that there are signi ficank penalties forsubmitting false
information, inrinrlincr the possibility of fines and imprison ment for knowing latio^ -'---- '-' 11f'i llg YIO LA LlvalS.fe
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
*'* Mineralization Rates: Compost -0.1, anaerobially digested -0.2, Signature of Land Applier Date
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate

1/2u/201d
Nutrient Management in North Carolina
Realistic Yields for FcC2: Fairview sandy clay loam, 8 to 15 pert ent slopes,
moderately eroded in Wilkes County
Realistic
Estimated Phosphorus
Nitrogen
Nitrogen
Removal
Crop
Yield
Factor
Rate (Ibs/acre)
(Ibs P205/acre)
Barley (Grain)
........................................ ............................ ................. ........... ........................ .................................... I...............................
54 Bushels
1.49
81
21
Corn
........ (... Grain). ),
.............................................................................................................................................................................................................................................................
106 Bushels
0.92
97
46
Corn (Silage)
16 Tons
10.9
...........................................................................................................................................................
174
54
Cotton
520 Pounds
0.081
42
15
Sorghum (Silage)
13.6 Tons
7.6
103
41
Oats (Grain)
68 Bushels
1.13
77
17
Peanuts
0 Pounds
0
0
0
Rye (Grain)
40 Bushels
2.01
80
13
Small Grain (Silage)
7.2 Tons
11.1
80
39
Sorghum (Grain)
........................................................................................................................................................................................................................................................................................................................................................................................................................................................
40 CWT
1.72
69
30
Soybeans (Double Cropped)
..........................................................................................-.....................................................................................................................................................................................................................................................................................................
27 Bushels
0
0
22
Soybeans (Full Season)
........................................................................................................................................................................................................................................................................................................................................................................................................................................................
32 Bushels
0
0
26
Soybeans (Double Cropped - Manured)
...........................................................................................................................................................................................................................................................................................................................................................................................................................................................
27 Bushels
3.89
106
22
Soybeans (Full Season - Manured)
.....................................................................................................................................................
32 Bushels
.
3.89
124
26
Ibbacco (Burley)
...............................................................................................................................................................................................................................................................................................................................................................................................................................
0 Pounds
0.074
0
0
Tobacco (,Flue Cured)
.I .......................... ................................. ............................................ .....................
2080 Pounds
.........................................
0,029
60
10
Triticale (Grain)
.......................... ................. ..-........................................ ................................. ........................... .......................
....
56 Bushels
_..........................................
................................... ......................
1.52
................. .......................... ...................
85
.......................... .... .............................. .................. ...............
19
Tropical Corn (Silage)
.....................................................................................................................................................................................................
16 To
...........................................................................................................................................::.........................................
6.5
104
54
Wheat (Grain)
................................................................................................................................................................................
40 Bushels
.
2.01
80
........ ........................................... .
20
Bahiagrass (Hay)
2.8 Tons
44
123
32
Caucasion/Old World Bluestem (Hay)
2.8 Tons
44
123
33
Common Bermudagrass (Hay)
2.8 Tons
44
123
34
Dallisgrass (Hay)
2.8 Tons
44
123
37
Fescue (Hay)
3,6 Tons
44
158
57
Hybrid Bermudagrass (Hay)
3.6 Tons
44
158
44
Hybrid Bermudagrass overseeded with Rescuegrass
0 Tons
44
0
(Hay)
0
Mixed Cool Season Grass (Hay)
2.6 Tons
44
114
37
Orchardgrass (Hay)
2,8 Tons
44
123
41
Pearl Millet (Hay)
3 Tons
49
147
40
Rescuegrass(Hay)
0 Tons
44
0
0
Sorghum Sudan (Hay)
.....................................................................................................................................................................................
3.4 Tons
...............................................................................................................................................................................................................................................................
49
167
47
Timothy Grass (Hay)
.................................................................................................................................................................................................................................
0 Tons
44 __
0
0
Dr. .David Crouse is responsible for the development and maintenance of the Realistic Yield reporting tool.
http://yields.soil.ncsu.edu/index.php#county

'l /'2u/2ul d
Nutrient Management in North Carolina
Realistic Yields for FcB2; Fairview sandy clay loam, 2 to 8 percent slopes,
moderately eroded in Wilkes County
Realistic
Estimated Phosphorus
Nitrogen
Nitrogen
Removal
Crop
Yield
Factor
Rate (Ibs/acre)
(Ibs PzOS/acre)
Barley (Grain)
...................................................... .............................................. ................... ................... .................................................
67 Bushels
............................................
1.49
99
25
Corn (Grain)
............................................................................................................................................................................................................................................................................................................................................................................................................................................................
.
129 Bushels
................................ ... ..
0.92
............................................................... ......................................................................
119
.............. I .......................... .
57
Corn (Silage)
19.6 Tons
10.9
214
67
Cotton
637 Pounds
0.081
52
18
Sorghum (Silage)
16.7 Tons
7,6
127
50
Oats (Grain)
83 Bushels
1.13
94
21
Peanuts
0 Pounds
0
0
0
Rye (Grain)
49 Bushels
2.01
98
16
Small Grain (Silage)
8.8 Tons
11.1
98
48
Sorghum (Grain)
.......................................................................................................................................................................................................................................................................................................................................................................................................................................................
49 CWT
1.72
84
37
Soybeans (Double Cropped)
....................................................................................................................................................................................................................................................................................................................................................................................................................I.................._
33 Bushels
0
0
27
Soybeans (Full Season)
..................................................................................................................................................................................................................................................................................................................................................................................................................................................
39 Bushels
0
0
31
Soybeans (Double Cropped - Manured)
.........................................................................................................................................................................................................................................................................................................................................................................................................................................................
'33 Bushels
3.89
130
27
Soybeans (Full Season - Manured)
................................................ ............................................... ................................ ...................................................... ......
39 Bushels
............................................ _
3.89
................................ ... ..
152
31
Tobacco (.Burley)
............................................................................................................................................................................................................................................................................................................................................................................................................................
0 Pounds
0.074
................ ............................................... .............
0
............ ............................................................... I ............. ..........
0
Tobacco (Flue Cured)
1. .............................................................................................................................................................................................................................................................................................................................................................................................
2548 Pounds
0.029
74
13
Triticale (Grain)
....................................................................................................................................................................................................................................................................................................................................................................................................................................................
69 Bushels
1.52
104
23
Tropical Corn (Silage) ........................................................................................................................................................................................................................................................................................................................................
19.6 Tons
6.5
127
67
Wheat (Grain)
........................................ .............. ...................................................................... :............. ................................. ................
49 Bushels
.... ....................................... .
........ 2.01
98
25
Bahiagrass (Hay)
3.4 Tons
........................... .......
44
................ .......................................... .................
151
....................... .............................................. ........................ .
39
Caucasion/Old World Bluestem (Hay)
3.4 Tons
44
151
41
Common Bermudagrass (Hay)
3.4 Tons
44
151
42
Dallisgrass (Hay)
3.4 Tons
44
151
45_
Fescue (Hay)
4.4 Tons
44
194
69
Hybrid Bermudagrass (Hay)
4.4 Tons
44
194
54
Hybrid Bermudagrass overseeded with Rescuegrass
0 Tons
44
0
0
(Hay)
Mixed Cool Season Grass (Hay)
3.2 Tons
44
140
45
Orchardgrass(Hay)
3.4 Tons
44
151
50
Pearl Millet (Hay)
3.7 Tons
49
180
49
Rescuegrass (Flay)
0 Tons
44
0
0
Sorghum Sudan (Hay)
I. ................. ......... .......................... .......................... ..................... ........................................................... ......................
4.2 Tons
...............................................
49
204
58
Timothy Grass (Hay)
.................................... ............................................................................................................................ ..........
.........
0 Tons
..................... ....................... ....................................
.......................... ...................
44 ..
........................... ................... ..........
0
................................................. .............. .......
......... ....... .... ...................................... ................ ............... ... .....
.............................................. 0
-__._--
I:)r. David Crouse is responsible for the development and maintenance of the Realistic Yield reporting tool,
http://yi el ds. soi l.ncsu,edu/index.php#county 2/2

0/0 jd
SAR
Sodium Absorption Ratio
Na: Sodium (Mg/L) Equivalent weight: 23
Ca: Calcium (Mg/L) Equivalent weight: 20
Mg : iviagnesium (Mg/L) Equivalent weight: 12
Milli Equivalent = Mg/L / Equivalent weight
Na M /L Ca M /L Md(Mg/L) .
288.82 768.85 1 321.37
Na (ME)
1 12.55739
I Ca ME
I Mac ME
126.78083 i
138.4425
SAR= Na Milli Equivalen 0.5 X (Ca Milli Equivalent + Mg Milli equivalent)]0.5 power
SAR = 2.198938 (From Mg/L entered above)
SAR= 2.199451 (From ME entered below)
Na ME
Ca (ME)
M ME
12.56
38.44
26.78
The amount of exchangeable sodium ions vei
amount of exchangeable calcium & magnesiu
Permitting guidance is if greater than 10 requi

PAN
I Mineralization
I bate I TKN
NH3 NO3
> 0.3 1 82500
7300 23.5
PAN Surface
26233.5 I mg/kg
52.467 lbs/dry ton
0 lbs total PAN
/
#DIV/0! Ibs PAN/acre
i/ PAN Injection
29883.5 mg/kg
59.767 lbs/dry ton
0 lbs total PAN
#DIV/0! Ibs PAN/acre
Dry Tons/1000 gal.
0.565452
1st year PAN
lbs./acre
Surface lbs.
0
Surface
#D1V/0!
1st year PAN
lbs./acre
Injected lbs.
0
Injected
#D1V/OI
lac decimal ITutui dI
Y IAcres
NO2 % Solids tnnch�ewr n i
0 �N�ieu tJll
0.1356 ''/
MR(TKN-NH3)+ + .5(NH3)+NO3+NO2 =mg/kg
mg/kg x .002 =Ibs/dry ton
MR(TKN-NH3) + l (NH3)+NO3+NO2 =mg/kg
mg/kg x .002 =Ibs/dry ton
1000 X 8.34 X %solids X sp. gravity "=dry tons/1000gal."
2000

ANNUAL RESIDUAL SAMPLING .SUMMARY FORM - B
Report all sampling analysis results for parameters not listed in FORM RSSF that are part of the WQ permit or were analyzed for over the past
calendar year. Use additional forms as needed.
WQ Permit Number: WQ0031725
Facility Name: Baxter Healthcare Corporation
Residual Source
NPDES # or WQ#:
WQ0031725
WWTP Name: Baxter Healthcare Corporation
Residual Analysis Data
Laboratory: 1) Waypoint
2)
3)
4)
5)
Parameter
(mg/kg)
Sample or Composite Date
1-4-2018
Moisture
86.43
Potassium
3030 ;
Sulfur
9600
Calcium
5670
Magnesium
2370
Sodium
2130
Iron
5910
Aluminum
1100
Manganese
44.4
Organic N
75200
SAR
2.199
PAN
26233.5
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system
designed to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are
significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
Date
*Preparer is defined in 40 CFR Part 503.9(r) and 15A NCAC 2T .1102 (26)
- DENR FORM RSSF - B (12/2006)

Page: 1 of 2
Report Number. 18-008-0201
Account Number: 46381
Send To: Southern Soil Builders
Dennis Key
958 Hoots Road
Roaring River, NC 28669
Lab Number: 57974
Sample Id : Baxter
i.a
Proiect : Baxter
REPORT OF ANALYSIS
kk"-"te P"kya `ROad?, MC:7'!i3C�,d1, .A
C4 Lli};'J.k•;��'�'�`�Dli s-Ca?'23f V [i d'c - �c^..'Xt
Date Sampled: 1/4/2018 12:45:00
Date Received: 01/08/2018 00:00
Date Reported: 01/15/2018
Total Solids *
13.56
135600
100.0
R D
01/08/2018 15:15
SM-254OG
Moisture *
86.43
100.0
R D
01/08/2018 15:15
SM-254OG
Total Kjeldahl Nitrogen
8.25
82500
50.0
R D
01/09/2018 09:00
SM-4500-NH3C-TKN
Total Phosphorus
1.33
13300
100
MOS
01/11/2018 13:47
6010C
Total Potassium
0.30
3030
100
MOS
01/11/2018 13:47
6010C
Total Sulfur
0.96
9600
100
MOS
01/11/2018 13:47
6010C
Total Calcium
0.57
5670
100
MOS
01/11/2018 13:47
6010C
Total Magnesium
0.24
2370
100
MOS
01/11/2018 13:47
6010C
Total Sodium
0.21
2130
100
MOS
01/11/2018 13:47
6010C
Total Iron
5910
100
MOS
01/11/2018 13:47
6010C
Total Aluminum
1100
100
MOS
01/11/201818:45
6010C
Total Manganese
44.4
5.00
MOS
01/11/2018 13:47
6010C
Total Copper
99.0
5.00
MOS
01/11/2018 13:47
6010C
Total Zinc
81.5
5.00
MOS
01/11/2018 13:47
6010C
Ammonia Nitrogen
0.73
7300
50.0
R D
01/09/2018 09:00
SM-4500-NH3C
Organic N
7.52
75200
50.0
01/09/2018 09:00
CALCULATION
Nitrate+Nitrite-N
<23.5
23.5
MMT
01/15/201813:02
4500NO3F-2011
All values are on a dry weight basis except as noted by asterisk. Detection
limit on all N series is on a wet basis.
f al«
I, ,
m` G0'0
Pauric McGroary
Agronomist

Page: 2 of 2
Report Number: 18-008-0201
Account Number: 46381
Se11d o: Southern Soil Builders
Dennis Key
958 Hoots Road
Roaring River, NC 28669
Lab Number: 57974
Sample Id : Baxter
Total Cadmium
Total Chromium
Total Nickel
Total Lead
Total Arsenic
Total Mercury
Total Selenium
pH *
Total Molybdenum
5.81
�y c
by
AI:(A B'TICr.L
<2.00
81.2
24.0
7.83
4.96
<0.400
<5.00
5.43
Comments:
NC CERT#257, SC CERT#9300 7001
SULFUR AND ORGANIC NITROGEN NOT FOR COMPLIANCE PURPOSES.
PM-10ct : Baxter
REPORT OFANALYSIS
/6121; Whk tC-Or?e Yt--�a^. V• -'9 .
s`i4:ir'-
,;.a:;vv.wva�ps.intrza=y'' ��.co;n
Date Sampled: 1/4/2018 12:45:00
Date Received: 01/08/2018 00:00
Date Reported: 01/15/2018
2.00
MOS
01/11/201813:47
6010C
5.00
MOS
01/11/201818:45
6010C
5.00
MOS
01/11/201818:45
6010C
5.00
MOS
01/11/201818:45
6010C
3.00
MOS
01/11/201813:47
6010C
0.400
MOS
01/11/201816:36
SW-7471B
5.00
MOS
01/11/201813:47
6010C
1.00
R D
01/09/2018 09:00
SW-9045D
5.00
MOS
01/11/201818:45
6010C
All values are on a dry weight basis except as noted by asterisk. Detection limit on all N series is on a wet basis.
Pauric McGroary
Agronomist

S
Meritech, Inc.
hn,
Environmental Laboratory
3
l:aboratoty Certification No, 165
j
i
Contact: C. Little
Date:
f
Page 1Report
11/30/2018
Client: Statesville Analytical
122 Court ;it
Statesville, NC 28677
Project: Southern Soil (Baxter)
Date
Sample Rcvd:
1.1/6/2018
Meritech Work Order # 11061.8130 Sample: 181101.21.01. Grab
11/1%201.8 i
1311 - TCLP Metals
Parameter
Results Analysis Date Det, Limit
Reg, Limit
4 thod
Arsenic
<0,100 mg/L. 11./8/201.8 U.aAO
5.0
}
EPA 200.7 I
Barium
<0.050 mg/L a1:/8/2018 0.050
100.0
EPA 200.7
Cadmil1111
<0.020 u1g/L 11/8/2018 0.020
1.0.
EPA 200.7
Chromium
<0.050 mg/l, 11/8/201.8 0.0:50
5.0
EPA 200.7
Lead
<0.100 mg/L 11/8/2018 0.100
5.0
LPA 2D0.7
Mercury
Selenium
<0'02 mg/L 11/13/2018 0.02
0.2
EPA 245,1
Silver
0.116 mg/L :1.:1/8/2018 0.100
1.0
EPA 200.7
<0,050 mg/l.. 11/15/2018 0.050
5.0
EPA 200.7 j
TCLP Orvanics
Parameter
Results
Analysis Date
Reporting Limit
Method
Volatiles B260
Attached
11/13/2018
8260
Semi Vol. 8270
Attached
11/20/2018
8270
Other Tests
Parameter
Results
Analysis Date
a -porting Limit
Method
Cyanide, total
<0,500 mg/kg
11/14/2018
0.500 mg/kg
EPA 33S.4
Sullide
Jgnitahiiity
1.84• n1g/kg
11./12/.2018
10.0 mg/kg
SW 84.6 9038
Will Not Ignite
11/14/2018
EPA 1030
Corrositivity (PH)
7.7 S.U.
11/18/2018
1.0 -14.0 S.U.
SM 4500 FIB
642 Tamco Road, Reidsville, North Carolina 27320
j
i
I
l
t
tel.[phone] fax.[phone]
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 4 of 7

Merftech, Inc.
Environmental Laboratory
Laboratory Certification No. 165
Contact: C, Little
Client: Statesville Analytical
122 Court St
Page 2
Report Date: 11/30/20.1.8
Statesville, NC'28677 Project: Southern Soil (Baxter)
Date Sample Rcvd: 11/6/2018
Meritech Worlc Order # 11.0618130 Sample: 181'101,21.01 Grab
• :11/1/2018
1311 - TCLP Pesticides & Herbicides
Pesticide - SW 84fi 8081A
Parameter Results Analysis Date Det. i Reg. Limit Dilution Factor
Endrin
Chlordane
<0.002 nrg/L
11/14-1.6/:1.8
0.002
0.03
1
Tomphene
<0.003 mg/L
<0.050 m L
g/
11 14-16 18
11/14-1.6/18
/ f
0.5
1
Methox chlor
Y
< 1.00 mg/L
11/14•-16/18
0.050
U.050
1..00
0.5
10.0
1
1.
Heptachlor
Lindane
<0.0008 mg/l..
11/14-16 18
0OA
1
<0.040 in /I.,
1.1/14-16/18
U 040
1
Herbicides - SMI-846 8151A
Parameter
Restilts
Analysis Date
Limit
Ileg. Limit
Dilution Fartol-
2,4-0
2,4•,5-7'P (Silvex)
<1.0 mg/l,
<0.10 mg/L
11/14-1.6/18
1.:1./1.4-:1.6/18
1.0
10.0
1
.0.10
1..0
1
1 hereby cer•ti%y that I,have reviewed and approve these data.
Laboratory Representative
642 Tamco Road, Reidsvidte, Nortb Carolina 27320
tel.[phone] fax.[phone]
u
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 5 of 7
11

3
: MERI
T'ECHI INC.
Environmental Laboratories
'}
Laboratory Certificate #165
Client;
Statesville Analytical
Project:
Southern SOH (Baxter)
Client Sample ID:
181101-21-0.1
Sample Collection:
1 1/01/18
I
Meritech Sample Ill:
110618130
1
s
1_311 - TCLP Or aanics
i
Volnttics: SIV-846 8260
Analysis: 11/13/18
Extraction:
1 1i07/I 8
Analyst: Vwv
Report Ditto:
11119118
Parameter
Result Units Det. Limit
Rez Limit
Dilution Vaelor
Benzene
110.0100 mg/1., 0.0100
0.50
i
10
Carbon Tetrachloride
<0:0100 ing/L 0.0100
0.50
IU
Chlorobenzene
<:0.01.00 mg/L 0.0100
100
IU
Chlorolbrrn
<:0.0100 mg/L 0.0100
6.0
10
1,2-Dichlorocthane
< 0.0100 mN`l.• 0.0100
0.50
10
L1-Dichloroethene
<-0.0100' mg/L. 0.0100
0.70
10
'Hethyl Ethyl Ketone
•Tetrachloroethylene
0.864, ntg/L 01100
200
10
<0.0100 mg/L 010100
0.70
io
Triahloroethene
<0.0100 ntg/l. 0.0100
O.SO
10
vinyl Chloride
<_ U.0200 mg/1• 0.020
0.20
10 [
Semi-Volntiles: M-846 8270
Analysis: 1I/20(18
l.''xtraction:
11/07/18
1
Analyst: PM
Report Dwo:
11/21/18
Parameter
Rcsulf Units DeL L1nii1
Rea. Llmii
Dilution haetor
1,4-pichlorobenzene
<0.100 Mg/1- 0.100
7.5
10
liexaohlorobenzenc
<=O.IOU mg/L 0.100
0.13
i
10
Flexachloro-1,3-IJ(Itadiene
<0.100 mg/I, 0.100
0.5
10
I- Iemwhloroethnne
<0.100 nig/L 0.100
3.00
10 {
o-c:resol
<O.IOU nag/1- U.100
200
10
ITI&P-cresol
<0,200 ntgn- 0,200
200
10
Total cresols
<0.300 nacfL 0.300
200
10
Nitrobenzene
<o.100 mg/L 0.1.00
2.00
10
Pentad)lorophenol
<0.500 mg/L 0.500
100
10
I'yricline
<,0.100 mg/1.. 0.100
5.0
10 ;
2,4,5-'I'richlrn•opireiusl
<0.100 rn1/L 0,100
400
10
2,4,6.Trichlorophenol
<0.100 nag/L 0.100
2.00
10
2:1-Dinih'ololuenc
<:o..100 mgiL 0.100
0.13
10
/ lrerclly certify Ihat I have
r•evfeu'ed rmd approve these data,
er� l/u t
Laboratory Representative
642 Tamco Road * Reidsville, NC 27320
[phone] * 111fo@meritechlabs,com
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 6 of 7

srst,z
Chain of Custody Record (COC)
NPDES#:
Client: 1'TCSVt � ANAW I I hone:
Address: 1-22 LC� ST_ Fax:
SThf?=,SVMT WC 2�'(y % Email: ((��
Project: JOy atltnl
P.O.#:
Attention: TumAround Time`
BRUSH work needs prior approval,
How would you like your report sent? Char es Aoolv
Std(10s) 3-S Da- s 24 4811
Circle all that apply: Email (preferred) , Fax, Mail
E � i � �6.+ � INC.
`.. ENVIRONMENTAL LABORATORIES
642 Tamco Rd. Phone: [phone]
r ' - Reidsville NC 27320 Fax: [phone]
Email: [e-mail]
www.mei-itechlabs.com
Sample Location and/or ID #
Sampling Dates &Times
Person Taking Sample (Sign/Print):
Lab use only
Start
End -
Comp?
Grab?
# of
Cont.
Test(s) Required
on Ice?
Yes/ No
pH OK?
Cl OK?
Date
Time
Date
Time
i H(A-2j-QI
ii txlt
I=
'I CLP I �
Temperature Upon
Receipt:
Method of
*"' Dechlorination (<0.5 ppm) of Ammonia, Cyanide, Phenol and TKN samples must be done in the field prior to preservation. "'
��
� ;S
Shipment:
Comments:
Compositor #
UPS
:ug#
,n Fed Ex
Are t ese rPults for regulat purposes? Yes -
No
Report results In: mgJL mg/kg (=
ug/L ❑:
Hand Delivery
Relinquished by: r ! ' q Date - ime:
-7
Z
Received ( Time:
Patrr� —.
Other
Relinquished e: -rm
i �r��J--- t
Received b Y-_ Date: Time:
Relinquished by: - Date: Ti e:
Received ,% D4 e: I Ti e••
t.a J..
r-
00
u?
00
rN
U
z
y
+1
00
fV
N
X
0
m
O
rz

ANNUAL PATHOGEN AND VECTOR ATTRACTION REDUCTION FORM (02T Rules)
Facility Name: Baxter Healthcare Corporation WQ Permit Number: WQ0031725
WWTP Name: Baxter Healthcare Corporation NPDES Number: NC0006564
Monitoring Period: From 1 /1 /2018 To 12/31 /2018
Pathogen Reduction (15A NCAC 02T .1106) - Please indicate level achieved and alternative performed:
Class A:
Alt. A (time/temp) C1
I Alt B (Alk Treatment)[
Alt. C (Prior Testing)D
A1t.D (No Prior Test)
Process to Further Reduce Pathogengs
If applicable to alternative performed (Class A only) indicate "Process to Further Reduce Patlogens":
Compost
Heat Drying C
Heat: Treatment: El
_
Thermophilic 1l
Beta Ray 11
Gamma Ray 11
Pasteurization L-
Class B:
Alt. (1) Fecal Density R1
I Alt. (2) Process to Significantly Reduce Pathogens [
_
If applicable to alternative performed (Class B only) indicate "Process to Significantly Reduce Pathogens":
Lime Stabilization D
Air Drying
Composting 0
lAerobic Digestion Gl
Anaerobic Digestior. '(
:.J .,.
If applicable to alternative performed (Class A or Class B) complete the following
..:.....
monitoring data:
Parameter
Allowable Level
Pathogen Density
urn, er o
Excee-
Frequency
Sample
Analytical -
Tech -
Minimurn
Geo. Mean
Maximurr,
--
Units
in Sludge
of Analysis
Type
ence
111CILie
2 x 10 to the
6th power
MPN
593
2025
3650
MPN/g
0
7
grab
srn9221
per gram of
Fecal Coliform
total solids
CFU
1000 mpn per gram
of total solid (dry
weight)
Salmonella bacteria
3 MPN per 4 grams
(in lieu of fecal
total solid (dry
coliform
weight)
vector Attraction Reduction (1SA NCAC 02T .1107) -Please indicate alternative performed:
Alt.l (VS reduction) > .
Alt. 2 (40-day bench) [I
Alt. 3 (30-day bench) ®
Alt. 4 (Spec. O2 uptake) i?
Alt. 5 (14-Day Aerobic) ®
Alt. 6 (Alk. Stabilization 1l
Alt 7 (Drying - Stable) EJ
Alt. 8 (Drying - Unstable) l 1
Alt. 9 (Injection) 0
Alt. 10 (Incorporation) [j
No vector attraction reduction alternatives were performed 0
CERTIFICATION STATEMENT (please check the appropriate statement)
RI "I certify, under penalty of law, that the pathogen requirements in 15A NCAC 02T .1106 and the
vector attraction reduction requirement in 15A NCAC 02T .1107 have been met."
"1 certify, under penalty of law, that the pathogen requirements in 15A NCAC 02T .1106 and the
vector attraction reduction requirement in 15A NCAC 02T .1107 have not been met." (Please note
if you check this statement attach an explanation why you have not met one or both of the
requirements.)
"This determination has been made under my direction and supervision in accordance with the system
designed to ensure that qualified personnel properly gather and evaluate the information used to determine
that the pathogen and vector attraction reduction requirements have been met. I am aware that there are
significant penalties for false certification including fine and imprisonment."
ZA 601re C�"ee- Dennis Key Southern Soil Builders, Inc.
Prepa.rer Name and Title (type or print) Land Applier Name and Title (if applicable)(type or print)
Signat e of Pi pacer* Date Si n tore of Lan A lien if applicable) g Pp ( pP ) Date
*Preparer is defined in 40 CFR Part 503.9(r) and I5A NCAC 2T .1 102 (26)
DENR FORM PVRF 02T (12/2006)

VS in 0.0156 v
VS out 0.0076 V
VSFR= 0.516748
VSFR= (0.0156 - 0.0076) / (0.0156 - (0,0156 * 0.0076))
'Ube I La5tl
r p 1,5 qp-

Analytical Results
Southern Soil Builders
958 Hoots Road
Roaring River, NC 28669
Receive Date: 01/04/2018
Reported: 08/22/2013
For: Baxter
Comments: Geometric Mean 2025 MPN/g
Sample Number
Parameter
Sample ID
Result
Unit
Method
Analyzed
Analyst
180104-15-01
180104-15-01
180104-15-02
180104-15-02
180104-15-03
180104-15-03
180104-15-04
180104-15-04
180104-15-05
180104-15-05
180104-15-06
180104-15-06
180104-15-07
180104-15-07
180104-15-08
180104-15-09
Fecal Coliforms
Percent Solids
Fecal Coliforms
Percent Solids
Fecal Coliforms
Percent Solids
Fecal Coliforms
Percent Solids
Fecal Coliforms
Percent Solids
Fecal Coliforms
Percent Solids
Fecal Coliforms
Percent Solids
% Volatile Solids
% Volatile Solids
1
1
2
2
3
3
4
4
5
5
6
6
7
7
A
B
3623
13.8
593
13.5
3546
14.1
2500
13.6
809
13.6
3650
13.7
2481
13.3
0.76
1.56
MPN/ 9
%
MPN/ 9
%
MPN/ 9
��
MPN/ 9
%
MPN/ 9
%
MPN/ 9
%
MPN/ 9
%
��
%
%
SM92210E-2aos
SM254OB-1997
SM92210E-2006
SM254OB-1997
SM92210E-2006
SM254OB-1997
SM92210E-2006
SM25408-1997
SM92210E-200s
SM254OB-1997
SM92210E-2aos
SM25408-1997
SM92210E-2006
SM2540B-1997
SM254OG
SM2540G
01/05/2018
01 /05/2018
01 /05/2018
01 /05/2018
01/05/2018
01 /0572018
01 /05/2018
01 /05/2018
01 /05/2018
01 /05/2018
01 /05/2018
01 /05/2018
01 /05/2018
01 /05/2018
01 /05/2018
01 /0512018
'mot
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
WC
Respectfully submitted,
'Or. --V"'DG :YY)
Dena Myers
NC Cert #440,
NCDW Cert #37755,
EPA #NC00909
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 1 of 5

�NCDA&CS Agronomic Division Phone: [phone] Website: www.ncagr.gov/agronomi/
Report No. FY19-SL004329
i
Predictive Client:
Doug Poplin
Advisor:
Zach Key
594 Austin Little Mtn Rd
Souther Soil Builders, Inc.
't (zti Mehlich-3 Extraction
ziaG� r T Soil Report
Ronda, NC 28670
958 Hoots Rd
Roaring River, NC 28669
v
Links to Helpful Information Sampled: 09/05/2018
p
Sampled County: Wilkes
`u�otu m
Received: 09/10/2018
_
Farm: Not Provided Completed: 09/20/2018.
Client ID: 160157
Advisor ID: 231531
Sample 0: DP 1A
Recommendations: Lime
Nutrients (ib/acre)
More
Crop (tons/acre) N P2O5
K2O Mg S
Mn Zn
Cu B
Information
Lime History:
1-Fescue/OGrass/Tim, M 0.0 120-200 0
0 0 0
0 0
0 0
Note: 12
2 - 0.0
Test Results [units - WN in g/crrP; CEC and Na in meg1100 crrr3; NO3-N in mg/drift
Soil Class:
Mineral
HM% WN CEC BS% Ac pH / P-1 K-1 Ca% Mg%
S-1 Mn-I Mn-All Mn-AI2
Zn-1 Zn-AI
Cu-I %Na ESP SS-1 NO3-N
+(
t/
0.66 0.96 15.2 89 1.6 6.3 551 334 58 20
49 185 124
513 513
1409 0.2 1
Sample ID; DP1B ✓
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tonslacre) N P2O5
K2O Mg S
Mn Zn
Cu B
Information
j Lime History:
1- Fescue/OGrass/Tim, M 0.0 120-200 0
0 0 0
0 0
0 0
Note: 12
i
2 - 0.0
Test Results [units - W/V in g/crn3; CEC and Na in meq/100 crrP; NO3-N in mg/drrr3]:
Soil Class:
Mineral
fHM% WN CEC BS% Ac pH / P-1 K-1 Ca% Mg%
S-1 Mn-I Mn-All Mn-AI2
Zn-I Zn-AI
Cu-I'`�jNa . ESP SS-1 NO3-N
✓
0.46 0.95 13.5 90 1.4 6.4. 286 151 59 25
52 155 104
727 727
879 0.2 v 1
( Sample ID: DP1C /
Recommendations: Lime
Nutrients (lb/acre)
More
I/
Crop (tonslacre) N P2O5
K2O Mg S
Mn Zn
Cu B
Information
Lime History:
1- Fescue/OGrass/Tim, M 0.0 120-200 0
0 0 0
0 0
0 0
Note: 12
2 - 0.0
Test Results [units - WN in g/crrr3; CEC and Na in meq/100 cnr3; NO3-N in mg/dm3]:
Soil Class:
Mineral
f riivi% VVIV t,ci_ isS io sac pi-i° / F-i K-i is Mg o
S-i ivin-i Win -AN ivin-Ai2
Zn-i /Zn-Hi
C.u-i'Na i ror J SS-i ivv3-iv j
V0.2
0.56 1.01 12.0 86 1.6 6.2 226 80 60 23
43 271 176
.
641 '/ 641
1366 �d 2
North Carolina
•ft ,,
Tobacco Trust Fund Commission
Reprogramming of the laboratory -information -management system that makes this report possible is
beinq funded through a qrant from the North Carolina Tobacco Trust Fund Commission.
Thank you for using agronomic services to manage nutrients and safeguard environmental quality.
Steve Troxler, Commissioner of Agriculture

NCDA&CS Agronomic Division Phone: [phone] Website: vvww.ncagr.gov/agronomi/
Ronnrt Aln CV!a el nnn2on
uoug Koplin - ---- __-
Page 2 of 4
Sampl=DP1D
ecommendations: Lime Nutrients (lb/acre) More
rop (tons/acre) N P2O5 K2O Mg S Mn Zn Cu B Information
Lime H- Fescue/OGrass/Tim, M 0.0 120-200 0 10 0 0 00 0 0Note:12
- 0.0
Test Results [units _ Wni i., g,! 3- CEC ^�a ��� q �^^ rrr3; NO3-N in mgidrrr3j:
y,�... ' �"�'�� �n iiie�/""' `' Soil Class: Mineral
URAD/ rv'iv CEI. BS% AC p• H P_ o . o
1 K- I r .,a /° Pvjg /° S-i Mjn-i Mn-Ail Mn-AI2 Zn-I Zn-AI Cu-I Na ESP SS-1 NO3-N
0.51 1.01 10.7 85 1.6 6.2 201 77 57 25 50 246 162 1/
Sample ID: DP2 522 "522 647 '" 0.2✓ 2
Recommendations: Lime Nutrients (lb/acre)
More
Crop (tons/acre) N P2O5 K2O Mg S Mn Zn Cu B Information
Lime History: 1 -Corn, silage 0.8 180-220 0 0 0 0 0
0 0 0 Note:3
2- 0.0
Test Results [units - W/V in 9/crrr3; CEC and Na in .meq/100 cm3; NO3-N in mg/dm3]: Soil Class: Mineral
HM% W/V CEC BS% AC (pH P-1 K-1 Ca% Mg% S-1 Mn-I Mn-All Mn-AI2 Zn-I Zn-AI Cu-I Na ESP SS-1 NO3-N
0.46 0.99 7.8 75 2.0 179 136 48 18 64 163 115
208 208 638 0.2 3 � Sample ID: DP3C ✓ Recommendations• Lime Nutrients (lb/acre)
Crop tons/acre More
( ) N PzOs Kz0 Mg S Mn Zn Cu B Information
Lime History: 1- Fescue/OGrass/Tim, M 1.8 120-200 0 0 0 0 D 0
2 0.0
0 0 Note:12
-
Test Results [units - W/V in 9/crr73; CEC and Na in meq/100 cnr; NO3-N in mg/dnr3]: Soil Class: Mineral
HM% W/V CEC BS% Ac pH� P-1 K-1 Ca% Mg% S-1 Mn-I Mn-All Mn-Al2 Zn-I Zn-AI Cu-I Na ESP SS -I NO3-N !
0.71 0.93 8.0 63 2.9 5.0 / 332 109 37 19 133 123 91
507 507 554 0.2 3
V More
Sample ID: DP3G / Recommendations: Lime Nutrients (lb/acre)
Crop (tons/acre) N P2O5 K2O Mg S Mn Zn Cu B Information
Lime History: 1 -Corn, silage 0.0 180-220 0 160 0 0 0 0
0 2 0.0 0 Note:3 -
Test Results [units - WN in g/cnr ; CEC and Na in meq/100 cm3; NO3-N in mg/drrr3]; Soil Class: Mineral
HM% W/V CEC BS% Ac pH P-1 K-1 Ca% Mg% S-1 Mn-I Mn-All Mn-AI2 Zn-I
0.41 0.94 9.7 83 1.7 6.1 89 22 51 31 68 94 71 -O3-N
424449 020 2 v 1j I

NCDA&CS Agronomic Division Phone: [phone] Website: www.ncagr.gov/agronomi/
Ronnrt Ain CV1a ci nnw��n
uuug ropnn
Sample ID: DP4 /
V
Recommendations: Lime
Crop , (tons/acre)
N
Lime History:
1 -Fescue/OGrass/Tim, M 0.0
120-200
2 - 0.0
Test Results [units - WN in g/crnr ; CEC and Na in nmeq/100 crn3; NO3-N
in
mg/dm3]:
i HM% Wni CEC
t.c
BS°o on j K-!
Ca% Mg%
/
0.46 1.03 13.5
J
90 1.4 6.5 175 31
56 33
Sample ID: DP5 /
�J
Recommendations: Lime
Crop (tons/acre)
N F
Lime History:
1 - Fescue/OGrassMm, M 0.8
120-200
2 - 0.0
Test Results [units - WN in g/cm3; CEC and Na in meq/100 crr13; NO3-N in mg/drrr3]:
HM% W/V CEC
BS% Ac pH P-1 K-1
�b.6
Ca% Mg%
0.46 1.02 9.9
79 2.1 130 40
5126
Sample ID: DP6
Recommendations:, Lime
Crop (tons/acre)
N P
Lime History:
1 - Fescue/OGrass/Tim, M 0.0
120-200
2- 0.0
Test Results [units - W/V
in g/crrr3; CEC and Na in meq/100 cm3; NO3-N in mg/drn3]:
HM% W/V CEC
BS% Ac pH / P-1 K-1
Ca% Mg%
0.51 1.05 11.2
88 1.4 6.2 73 89
58 26
Sample ID: DP7 /
Recommendations: Lime
l/
Crop (tons/acre)
N pA,
Lime History:
1 - Fescue/OGrass/Tim, M 110
120-200 I
2- 0.0
Test Results [units - WN in g/cm3; CEC and Na in meq/100 cm3; NO3-N in mg/dm3]:
HM% W/V CEC
P-1 K-1
BS% Ac f15.5
Ca% Mg%
0.56 1.05 9.4
77 2.1 ' 302 78
57 17
Page 3 of 4
Nutrients (lb/acre) More
P205 K20 Mg S Mn Zn Cu B Information
0 80 0 0 0 0 0 0 Note 12
Soil Class: Mineral
S4 In-I ivin-Ail ruin-Al2 Zn-I /Zn-AI C6-1 Na ESP SS-1 NO3-N
58 98 69 1025 - 1025 690 0.2t-' 1`�
Nutrients (lb/acre) More
K20 Mg S Mn Zn Cu B Information
60 0 0 0 0 0 0 Note:12
Soil Class: Mineral
S-1 Mn-I Mn-All Mn-AI2 Zn-I Zn-AI Cu-I Na ESP SS-1 NO3-N
59 104 79 531 ✓ 531 510 0.2 1/2 L/
Nutrients (lb/acre) More
K20 Mg S Mn Zn Cu B Information
0 0 0 0 0 0 0 Note:12
Soil Class:
Mineral
S-1 Mn-I
Mn-All Mn-AI2
Zn-I
Cu-I
Na -ESP -ESP SS-1 NO3-N
49 138
97
/Zn-AI
640 ✓ 640
' 481 1/e,
0.2 ` 2 p/' `
Nutrients (lb/acre)
More
K20
Mg S
Mn Zn
Cu
B
Information
TO
0 0
0 0
0
0
Note:12
Soil Class: Mineral
S-1 Mn-I Mn-All Mn-AI2 Zn-I Zn-AI Cu-I fNa ESP- / SS-1 NO3-N
52 155 110 513 �513 qqR n 9%/ 0. J

Condition of Receipt
Sample Number 180104-15-01 Temp on Arrival: 3
Parameter Schedule: Percent Solids
Received on Ice
Parameter Schedule: Fecal Coliforms
Sodium Thiosulfate Received on Ice
Sample Number 180104-15-02 TemMMOWMM�p on Arrival: 3
Parameter Schedule: Percent Solids
Received on Ice
Parameter Schedule: Fecal Coliforms
s
Sodium Thiosulfate Received on Ice
Sample Number 180104-15-03 Temp on Arrival: 3
Parameter Schedule: Percent Solids
Received on Ice
Parameter Schedule: Fecal Coliforms
Sodium Thiosulfate Received on Ice
Sample Number 180104-15-04
Temp on Arrival: 3
Parameter Schedule: Percent Solids
Received on Ice
Parameter Schedule: Fecal Coliforms
MOMFEM Sodium Thiosulfate Received on Ice
Sample Number 180104-15-05
Temp on Arrival: 3
Parameter Schedule: Percent Solids
Received on Ice
Parameter Schedule: Fecal Coliforms
Sodium Thiosulfate Received on Ice
Sample Number 18010.4-15-06 Temp on Arrival: 3
PO Box 228 • Statesville, NC 28687 e 704/872/4697
Page 2 of 5

Parameter Schedule: Percent Solids
Received on Ice
Parameter Schedule: Fecal Coliforms
Sodium Thiosulfate Received on Ice
Sample Number '180104-15-07 Temp on Arrival: 3
Parameter Schedule: Percent Solids
Received on Ice
Parameter Schedule: Fecal Coliforms
Sodium Thiosulfate Received on Ice
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 3 of 5

Client:
AddtesS. J 1-4 K d "
� n
PO #
Customer \ LD 8
Sample IDri ab 1
Re, ...L 142 t
Relinquished by: ) '
Received by:
Relinquished by:.
Received by:
Composite Sampling #1
Time begin am, pm Date
Time end am, pm Date _/_/
Comcsasite SamWing#2:
Time begin am, pm Date
Time end am, pm Date
itioned by:
I® STAMVILLEANALvjrrAL
d 22 Cs i 1c P.O. Box 228 I
SLt
Ctatrcy:ll� fir -3...7
(704) 8724697
Chain of
ON Custody Record
nalysis
7777
Pe'-, I
Time , j U am, &ate J "t /Jff-p� Sampled by: �.
Time % am, pm Date Z / / �!
Transported by: 77, Y
— Time am, pm Date i/ /
Holding times met: V
Time am, pm Date —JJ
Compliance work:
Non-compliance work:
Lab Comments: Samples Transported on Ice:
+
initials:
rn
kD
N o
00
00
to
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•
00
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00
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Client: }}
SQ.J
Address:
® STATFSVILLE ANALYTICAL
ern
I.J 9
r n
HQiV3 90
I
122 Comet Street • P.O. Box 228
I h
eor
A. v<.- PC�� GG
Statesville. NC 28687
[phone]
Contact Person:
7
Get
Phone # FAX#
� 3G 4s7 - ���t
Chain of
PO #
Requisitioned by: (rime
Date)
CUSIOtljr RecoIYl
Customer
Sample IDk
Lab -ID #
Time Sampled
(Grab only)
Date Sampled Matrix
(Grab Only) m
Pardmerers regmstod for analysis
pp �gg
x, ww
C?io vs
Relinquished by:
Time : 7V am, OMDate
/-"
Sampled by:
Received by:
Time j d ram, Date
pm
Transported by:
Relinquished by:
Time am, pm Date
_I
Holding times met.
Received by:
Time am, pm Date
Composite SamAling
#y -
Compliance work:
Time begin
am, pm Date _/ /
Non, -compliance work:
Time end
am, pm Date
Composite Sampling
Lab Comments:
Samples
Transported On Ice:
Time begin
am, pm Date—/ /_
Time end
am, pm Date
Initials:
00
N
N
X
O
tb
0
d

Southern S&I Builders
958 Hoots Road
Roaring River, NC 28669
Receive Date
Reported
For:
Comments:
Analytical Results
11/01/2018
12/03/2018
Baxter
eA ;y� � �
N, Sid -;1
F
Sample Number
Parameter
Sample ID
Result
Unit Method
Analyzed
Analyst
181101-21-01
Corrosivity
Baxter
See Attached
SW-846
11/07/2018
Meritech
181101-21-01
Ignitability
Baxter
See Attached
ioioM
11/07/2018
Meritech
181101-21-01
Reactivity
Baxter
See Attached
sw-846
11/07/2018
Meritech
181101-21-01
TCLP
Baxter
See Attached
as Noted
11/07/2018
Meritech
Respectfully submitted,
Dena Myers
NC Cert #440,
NCDW Cert #37755,
EPA #NC00909
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 1 of 7

Condition of Receipt
Sample Number 181101-21-01 Temp on Arrival: 2.3
Parameter Schedule: Reactivity
Received on Ice
Parameter Schedule: Corrosivity
Received on Ice
Parameter Schedule: Ignitability
Received on Ice
Parameter Schedule: TCLP
Received on Ice
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 2 of 7

-v
O
m
0
x
N
N
00
in
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nt
rD
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anent. 10J�1`frrl
Address: n
Contact Person:
PC�tt ---
Customer Lab -ID $1 Time Sampled
Sample IDt! (Grab Only)
gP x�1 r __ ! S 1! 01- 2 +
Relinquished by: '
Received by:
Relinquished by:
Received by:
Composite Sampling #1:
Time begin__ am, pm Date
Time end am, pm Date
Composite Sampling #2-
Time begin am, pm Date
Time end ._._..._ am, pm Date
22L nc� rla.� FAX# •���_r.�_ o.,.,�
✓-=� --r - i a / I ✓ aI _7 r ' o `ly V
ned by: frame _.__ Date)
I-1-ao
P--wrs rzyuested for:malysis
7c,L P - r,-
ST,4 TF,S VI(,I,E ANALYT1 Ut,L
122 Coun Street • P.o. Box '—?)8
Slalesvillo,N 28b3i
(704) 8724697
Chain of
Custody Record
Time /j rj am, pm Date /1 t I ! Op Sampled by:
Time 1 �J�J� am, pm Date Transported by:
Time am, pm Date _/_/ Holding times met:
Time am, pm Date _/_/_
Compliance work:
Non-compliance work:
Lab Comments: Samples Transported On Ice:
Initials:

FAT WCAZ Q,
:fi -,t , ,
z;JQ6
NIfGH J. Ft A SEN F W 90 E tk,
BA-'X'.T,,ER,,]�ffE�-A'L�','T-,'HC�'AR'B'-',; OW RATIO!,
.MA'WO!�,-,'N,_6kTWCAR W5Z
'BaxterMealificare Cbrporafionk.RL.AP­,
L'and;Apphcat6n,ezf Class
McDowell'CoRnO
Mat mtpf
Im,
hif *jOk- "J"O A- Z hft�mtkv 0101A IS,
.WPv
22 ,-6, in onofthe, potg", for the continued opera
Pleaso,.--ndtp that. this -r�p ppwp#ppm ,if §444 ;PO-Off-OCO pltl
pmo:
Thsa permit .*M,-be-gff40vq,from September (mbert',"'If w 'I 'O"4A'tl` otc NtnIt'* iiss-JdedSJj -- t- "' "ba -it - ObT 41 4 hj*� A if ilZI IN I -and shall,
em-,
d� MW a WA&
ton f
'Pip a r
16 the conditions as sppcifte, therein, 'o
besubj�ct, &.1imifations, d ­`_ ereiij, #§e Pay p
V*f6riOg- rgiqq4gM fisted Attachments,,04 tii 'th'' -�N previous
A fax they: may differ -or, 0 p
Us6afic',e. Failv5stablish., d g-,",,an � maintaining,the required operational
in
6ftinie,,fecof& to bekept Art,,.Oait,.,,6fthe--condiiion,-where-,records.
tqbe.k .ept-speqif
,
.PWSe__It6,twt,h)6 fallowing pet ed sink the: last permIf
10"g4ce q#ed Sp**Opp,
rather lhan,,,2' hournotiflication"19, be. givpn,.
C-oriciitf UIJ�', Notificatton to r, be OWk MhOVille Regional, Offide each; time residuads,
q pjiv ,4�
p 11
Q5jIdJfi`0jn41.4. --0 eratioo iffid.1.4i nteraa .... ..

Mt Michael prk;
,duly 14, 2f .1 &
Rage 2 of 2
4: C©ridrhon Iit Similar to UYd CQndx0 Al S z but;l ovY �apy of permit.:and G 1VI Irian to=b
kept h site -(rdber han fi each manned uehieT&).,
Gox�dtrpn IIT 11 1 — Bu7lt re�duas n+ot to be "pphed if agrcararrxtcarate .exceeded:,
,6; Condition IY4,,. d... ,Additional record of'approxxmate areatiort whtcl re iduats applied is :to be.
pep -
7 C6ndition V16, -- ' m�Tar•£ta Qld`r or►cTi e n V Tx6r, be t uo r GG Q-dad citatziic icon roquireOb"
perM me difed grxevQ "
81 `Condition. VI 7: = Expansion. af,=faeiliiy.ndt.allowed,,without,uaxiancl xf Pggq tie�I Urt �'
behavior detxmentl to etixYorittnt
Tf .any rarts, regixrements or. lrnitatians cosztamed:xn thsa pertnxt are unacceptable tle,perxnttte
has the right tosequest an adjudicatory hearing upan written request �itlilxi 3(} days foli_wtr g r ce pt.,of:
this permit, T'Srequ,,rn eCer,l SOB, aihe'Wortlioniodwxfri
Carolina Generit Staiutes, -and :filed", with vfh Office: of Adrriinislrative Reari�gs at{ 671� Ivlaxl Secyice,
�ea�ter, Ral�igh,,;�T� 2769� 67`i"4 LTriless su�Iz demands ark nriac�e, this, pei`tr� i� slail 'b� .firia:l a�€�. b�iicTng
if,}ou rived additional infonii ti6n-;concemring,thi's perml,t; please cexntacti r Roby;fit (1 };BUS
6336 or°trc .d bu . cde r. ov,-
6&._
Beth Buffington—:Pr:.otectionand>nforce
Digital L'eirtn�t archive (Electrarue CopY:'
Sixcexel�*�
S. Jay Zimmerman, G, Direct€xx
DivisxQri`+of woo, Fesc tirces`

I.
91
, IYlt]Ei - rPA
EN VIRONMENTAL MANAGEMENT COMMISSION
n,,4 f North"tt'"04"10
4j `Genera!,,,S
am�n&dj. and.otlierapplicable Laws; Rtiles� and-kegukt
lPERvIISTONI# TO
FORTIM,
bfthe,Ja6d,"kAtion 6KIas�
Resources and in
"Title: 4'0-'Cbd6.
(Mnare Ce►xporatort
mitt- . . .1 trn
" fd dllifies
[coal 'ttformatiort, rek-e-JV-04 f
py V,
,,bta s6s'equefiflyyjfiled and ,,,'approved ,'6yythe:
of this 7,
, T puff
30 art' I Tlug z:permit: does':not, exempf-f-he.,
from Sept tuber 1 MIA uilnMl, A-bigu"A31 2M."T shall void' Pennit'N-b'-
This permit
Sqpte1riber"t'82061-and theAttachments ft9114sit'.
t.: ,,N utef-�,�th
to. th-o
dine; and, under such, conditions , and
CSC 0-2719wq 02-T ,Q
V, q.-
1-f - "
iation& as,it m4y
02T, -'a"10-9.]
I., The subject residuals m anagement program dial
discharge tsurface waters;
W.Orf
utusarxce PAO PM,
_ptopero atiow-a
land- applyuig`,resrduls tip ":the safe•,• contact -flee
immediate corrective actions i [, SwI43 15. ]'
Ont'rayeut va
shaltrequesf renewal of
*Wq wilt ovrew the;
%riirit; for such period of
,l qp q.,ata�11tImes go-
w Or, surface*4w�
Le creation-ofprol'ongpd,
shall , 7,
o i 6A 14,Ol yl(-
rper gor,, dud'. tape. -any,
*Q*MI *04 u 15 V4$ W*-1 Page 1•of-11,

bf­­ if
rIz4voRs! I I or-, �'. AMIO ace
Tltts p9roksNIt not re Nt�#i#qe 1 ty4i"i d- ..... . td, �grbufidwater ov
water "Oswj ungOf-thig residuals mana pmed program
:
02t .vtqo
fiT­l'. t e, approved for I 'ad 7_1 y­tesi, �_Iywtlef . On!O.� xe m Atta'thmeut Aar. ii6— I - qpd­
,accordance wi ffus.perrnitl (GS. 1484111-5,1
4- Owtho srtes fist 1114A 'A','are approved for re9idud& land application, 1.4
A, -h a 11 not
exceed. floe ft Ilowi`n #PPI'
-
application
Ceiling C
M, g.- f-76 fatibfig> weight basis)", or CamulNitit 'afive, g'
ant
I
Loading ,,.Rates .(_C
fin --�kz
� p
Arsenic
7S
3
34'
Copper
:4
Leah
9,40
267
Mercury
577,
Malybdenurx
31,74'
Selenium
6lenium
TOO,89
merit
7,500
The,,.Nrmiffee shallAderinfile,,compliance w.iihih'e,C-_PLR ivg sius qje. of. t 4e foliaw ng me
.a,. By°'calculahng. tho existj dU
4014V U d Of OpllutAhts using actual , analytical data from all
Bistofical land application events ofresidual§,,..or,
p iO4 104, Avdnpl_#cq t wh cli the required dak, is> incomplete,
$ydeteriuenvng 6c, nid6jitk6tiob ns through representafivvsoil sampling
6. Resfduals, that are distribute shall,nieet Class R.pitfiogpn--,reducffm requirempiits�-, jp_�A .j,�A'XC- 'Os
T
soci4eq 1'4,Atw!ftOft'tA.., [U-,ANCAC
06 ;8'x -pp is
rgq rqmqiqts44 e-
02T J,
77- Biological .residuals. (i qWU Sid als, generated during the treatment
of doW&§tji0j orApimal.&6ces7sifig
*4§0*dt0, and, a§idenbfied fmAttachm-erif
W_ the blotogwc4,ir�O 6 ta
that are land -,',appl
ied: shall,,meetone.,-ofihe,vector,-attmetioil,,.re4'uc'-t-lonalto s in 1:5A­ WA ' Oa
la0dihAUk-hrnefit.A. [15XNCAQ�O
_.Wq)� Exccp s"T �t)*: r mqA� shall ��' ' _�O ( 1.11.11. 2T .11071
W'Q60 LtVersion 1., 6, Sfiejt Versfol)' t662`10 p4ize'z"Of rs

S ��etbac�s for'treatrnent d s�o�rag� �cilxties �f�al�,be as ��alltsws;
9:. Selbac�Cs. tt�r Gl.;�ss B;;�ax�d a�plicatio� sites, shall 6;e a� fo�loc�sr
Setb ck bt sk p f a
Veha ular
Itrigahc i
Inectibri,I;
Sure
t ppl�caf on
Surface.
Appl at oTx
In corporation
Habttablo zesidertce air place 6f jublzc asscmll�i
tznc'er eparate.owners p or. natt sae mainta ed as
400,
400
Q(
arf of llte ` t'a ect sate;
Tab�table residence s places of public assembly:
o�v»ed by ,the l'ez nittee,"the o tter o :(Ko Ian it or fil e
Q'
20
fl
_lessee/Q aeraIortes£°tlte;Ihnrl,ta be:ma ntaixied as part,
Qflle , io'1. ect sift
Property.ltnes
50;
1-.StI.
SQ
Pptilfe IW of ways - _
54.
S0°
P ivy of�p&Ic water supply
I,Q,Q
I QQ`
1-:Q.Q
Surifaee waters (streams;— infermittent a-d:perennW
ren�u�l'viate�rbc3d�es,.<�nd vt�etlaudse
1Q0
�Q(}
�0;
�water d+ersg©ns;(ephemert streams;;
ateras; dot he
S
] Uil
25
Groundwater lbwering ditches {where
t1rdrtcl� iritersecf the SHW 1'
,M
IQ '
5
ubsudace-groundwater lowering sysfemi,
Q
1QQ
0;
�t?'ells O' except m tp xnqntterfz►g: vuells
14 '
1„0(k
l p p.
Be&oelc=cahtcrops
25
25
2'S , .
Top; of slope cif etnbastk�nehts Qr cuts of two;fee� o`
l`
1 Sir
`I
ulcZig foundations ar vssernents
0
i,'
Water li ize
I6
Q
S i mmirrg pools
160-1
I Qp�
10(l
Afic,at on A04
WQQO� 132S�V'er�io� �, t�- Shell Version,,1 bb214� Page 3! o� ;13

6.
P-11., gpp a, be, Iv k , nea prior 99. J( 441 S qPp - 040
cka� "blat &do . chsitepr *,d' 4
fi,SANC 0271. # '-ffl( -
ou
event.
1 1", Bulk tesi4als Oji"ther; §dut,O, cif, -latAtA-vaild]
of :agronomic :cafes_. . Appropriate AgrQnqmW_'
�,PqAtrg 909 bo$04- on"t-h—a" t
0#000
l
j)Jvisibn'`s pre-pipmq _gv c4 site specific 4a# fjaecYfccxopyor
r
V
the.
bNoAh.Carolina Historical l5ka"fog 'sppe
'A rff Carolina State, W$,,as'prov.
tFoiw , D_0014,(*.of ", Soil S /4A SU Idndix A A-
11�q W660. -_'.eduNje� s/i
sh4it.be.kept,,onllfil'e,"and,repr,intedevery fire dears
in- a0c
If *AV 1 60*0 ttee may use the, RYP-,
Pnq�* 40tO4i6dd,p4 ftfanddt�, (a), or a c�p ;j y,
reported,m'�nany of the fb'llowjngq _u
Ektensidif Office, fhe North
L Cro f as 901410 by the to Cqopetaf,
'P, M#n9k91PIR04
c ri Of, ture, and Corisurner Services, the: Natural Resource:
ConservationSer"Vice, orothcT,'agrononiist
outl ed 4, the: Si�fiatd BSIft 121714teragency Group. -,Cpidane,p
iii. CO-Off6d Xft)(he­&,r-,Ma Abagement'Plan as outlined, by, the kesoprce-s C€-nservation
Services (NR-,.CST p must' Mee 49se ,t S� 5594 Nuirierit= Management
��t - the V��
Standards k6R��r-b:c"tide-stiindArdg/siandard'sl;50.0-ndfl:,
d'JfAhe1R-YYE.:and._-appropxiateattrieni application : rates car be40,0,min4 -tfi �,P' iffcc�'Shalt
eoritact the r
I at
f,15ANCA_C 02T .11109(b)(1)(k)]
11When-,re aIS are landappliedtogr=."dpasture, h,a y, pc, r ,op,r eAt k Aitrogqn.,rate shall be, reduced
d by
25,W:ia akd agpm t, 8tanda
W_ rds, [15A.MAC UST
1 fiand: ap -40460 -,to be, 'er ­ 1 1 ­04 - '6 - 311. application' sites arc: ov -Seed6d.,,or double;;cropped. (&i g��.berm
grass T the: winter WO rO " then U, §600h(L.66.0;, can receive an,
�PO both crpp�.tq,,ppcp, v
acr
4PP iu�,pja, e,�Oer;year (lbslac/yr) practice may,
be a1lb.wed as, long as ,the second.cropis to beharvested. or gazed to be aiit oa
for'er0000poAtrPtq1RjY-'aodls�to be the iltheir itca� ton'4l PAN Shalt 6e.ajpplied[I 57A,
XCAC 02TAI-100)
to land rapplication of tesj fg 00ta-mi 10(or higher, thip,
votmrttee shall obtainhaud itfi­pftmeh V, recommendations from, atleast one of the following.-. the 10*
Cooperative EVension Office- th Department. of Agrreulture 'Ab­ 4ftr Se"tV."w'O" ;"tile N �Itur an. pris a �al
kourcp, 6ogomt ery 'Oefttist;,or, an agronotnist',
W ,Tk Card iftAL" ed. S'' R S'
Licensed, '61,
�s� , g
Tle
tizqomin,�,adatioiissMIl-,,addr,essitie.sodiumapplicatioty,, rate oil amendments �..
gyp
-Te6apism for !i�ai4;giniingsite integritty and conclrtlons.cortducttie to cr
op Ule Ferinitteeshall,
-indiixtamNol ten records ofth'se rvc� 6r,n`med4tions andetails.oftheirimpementation
[t$,A,AC;
62T,
A108(b)(1)]
WQO_Q31,725'VOfsiO'n Z,, ShellVewsibil 16021.0 PAOP,4 of 1

a. e _ecedii
ft 198,
i5 These residuals, :#P
. isedabliA &a.cidile 50. 'fF, iherefke­thc�'complianice boundary- r,2; -fee ,f rom the, xesihal land,:
w
­ ­
u Never , closest 114
fto
An .eceedatEe of groundwater b d th, 'boundary a er 9 W§� at gy0h, e, --com' pliance, . oun ary is suhjeictio,
2L A-10
as -� well coins �4
remediWort action wdj to 1,SA'
X...
i� ;through 14,
�C od, Carolina X.A]Refai� 3;,'2-"l Any ApprOM
relocall'bw,offhe COMPLME,'UOUNDARY' will be noted inAtt 13 ZL
16., Ther,.review-bo.undarv.shalI and, f y he rs 444
Viand applzcatior► area; An�r 994goo cif groutncwaferr stanch#cls at'
Acti IS WCAC 02-L",l e,-, 0:1,04, [15AXCA.C. 0211,
L: The. ,re siduals managemerif pro aproperly ined and, operated at all
gram shall be maintained
any
A d" h 10,
Program` shall to� 4 and 01 '45, charge SY pre
contravehtioctof slir%O 44iidafds., ,[.155AWCAC 02T. 1419,]
:2Tho Ashville -
on �28) 19645
and tine ap 'w b
mv bffl­ at least
E
p ication4o any 00
Fe6q Pr " MS� ougli Friday; ext lucking
S Midays., [15ANCAC.42T.0108(b)
Thy A"Ablev, k Rv n t PI
1 � vi
h6u, r-s-v"n" or�,,4�,.tz,or,.,,ozonil-ucti-iig-.�any,�" shalfindic f J Such"'n6fificati"on: ataminftnurq;,-
the attexpatecl =applicationtimes, :, an Apple "-4 .04
I it
nece saiy to doty fc radditional. fieldsdvo q,uJ'JBa"re'-seen event e. eg6641,0
Mi shall'bemofified,.
prior- -ofcommencing thqapplicatiom-16tfipse fields'. [15AN 02T "Al, Qg(b)j:,
A, the Pei4i4fiitam ap . I- I—- Operation 1 -.1, �_ 4difitiffidiis ea Op'Otaf md
-iothe,O"&,,M'P.lan,.shatlbe,,--appr.o,,.v,ebyih-e,,,.Eiivisioiii.prior'fe.,-utilizationofthe-new,�l*ani*,04 loni,
at ih gjj�qigitf4i, st
ii' C!jjeratibhil.ffirktionk
Safety aguiegw
itispectior PlAnviii6ludhig the -Wro* Inf on
i, Natwandlox, titles of resppos ble far eond cOng the OK
fiib I 'o -,., be,''condiidied ty, the -ORQ, and-',
it. Ff�q 6 inspeciloms, se, 16, And� 16,64tioh f,
"
proceduresrprocedures to�A§sqmt44the selected fo'ca frequency
:A� WI
iiii -Detailed,,desciip€ion;,6fii speefion procediires-including,rec�ord,".,ke.eep'in "and actto tsto,,e-'.. en
by the at "o 400) WOW w. the lionowip li�pe,
JPMPP't 'the"
or, In Oy b
ncatificatian requirements undeff emoni -of h t6fifig,,and4-eportlng secti6w fh - pem—fit.,
$gMpftqu4 goniiaz t g plan
i. Nbitnes afidf6f,'-titl&8;-of peis6fineLrespdnsiblef6r. condiieting�theusanupi-mg,,an'd.mo ".. i
U'. 0� )5qla of wP., j" g"'p , �
'7
Shell V,6miou 1,60110- Page 5;""

d that prescntafi�,e��
frequency,46 -,ptoce, ifeigto assure,- atre -
Flluc6aGn in temperature, flow and pthlor-ppor4f, the -,
q :th
restctEals gathered quality-
d qA-particular samp tnggv Oellf'Th --,gamplibg,plan shall ac'eouni.for-py.
ores=-'auctuationsinresiduals; quality ind icp4h r residuals 0.
meet ;pathogen
and attraction - ludt--, t�,� "'fo: O�Ahat, land' apply
Aq� A;- d�IQo
"
pImg;fjr'equency.,, may aced �t0�sampf 'A
enter monthswhen pathogn redW--4
most fik
[15AANCAMT lJQG]
Control System
0017aft§Gertrficatiau, Commission's Glassi ihc-,&c, the Permiffee shall designafe-an&emplqyyalte fi
char ..offe ormow-c-ortif-
-pr, a, -a th,15ANCAC.
igd,operAtor b-- k - - p 6 - `0--Jid - -j-
[P
`�u
n.A,
h Asit the facilities2
,oras: specified in the most recently: approved OMWplan-(hz:�,see Q!ou -Ij
PQreply'
wi&-another wila iovs ofISA NCAC ,$a .0 """d*',,gc'las�sificai.,ion and',
02 4, FOO#Ojei�, idn rew'. I in
44ii re0rren eats, please ct ntacttlss R"ion,ofWiterResourcesl?".P,r'o't'ec'�-00 naftdltit
.-
ceitiorjt
.8ranch, f. -911-71
T,
-Whe' nJhb'i'P0nitt0d W:4004fes Eaulk re itials; a-cqpy
,oflWi&,pernfft and a.co-pyqI 'O'M'P,I" sha
ll .
maintained atthey land.46plicatioisites during jaa4 appjf44604 4dti5AWAC 02T
T: "When :the Penniftee franspofts or land applies,. bulk resij&al§�, the ,spicontrolll hiii pPbvisio s -I he
tnaintainedxn 4" 0-11" anw-'.arid _ANCAC 111,01
Aq-�RP-Rkti vehicles; 2T
,n po w "th
S. Residiials-.shall not be. stored.atrany land application''. u .I tlf,on situ approval �, (4s been requested.
Vheii the Perrnittee land ,applies b.ulk, residualsa', adequate'! mqqsures,,shall: be taken to pr",eveijtW,4n4
runoff fromophy it -1Q�- �6- - -
:eKO4 andsyffA5 conveying rqsid.,_pm tile: 0,laudapdatiw§ites--t onto adjacent
`properties,ofirit6l§
:M. 'Wheiyt4e P6rmjlkpqland applrtes biAkr, - id -als , surtatTe"vegtatavc toyer - li[t4al. q,. m4m. in on-, and
1, b
:application sites oatlwhiO r0iftajsl -a'r'&'APPRO4,, or, application shall, be, in accordance -with the crop
management plaw.outlinedly-Ific, local Cooperative: Extension'O theill
and Consumer Service, Wfal, sb-1- C`­-'--- Extension
f dfi� A# as"
�),-PMCTY4 IPIX. �OWPOP' ohbiniAand approved
J�Y,`tbel)Msi
WQ003l725,'V--,r8iO 2-9: 'SheUfWrsiori.11,60210," --N

1 l Bulls �esid�tal shall not bel4nd app�ed under the��t�I�c��ng et�ndctitit�s
a, Iftie cestdital"s atrltkely`ta Arsel 'affec�.aLfi weatexi 6 dttA,.g
igo
4 ofihe Endangered,'Speeies "Aar or-it`s designated Critical lzabztat V:
]fete,Q,pp,1.xcat��rr,;use�;grolanged;nutsance �an�iitxo�s
e., T tl#c:,land €ails:Oo assiniitate-the btilk, residual`s or:the appplication causes:' the:cozitrauention.o£surfa
water ar gre►unclwater staac#az dsx
d. if fhe, tand,. is f1a c}aed� fz open ar :snc? v: c Ycred,, or Fs'".otJ erov sc zn a conditidn such that unoff¢ the
reszuals`�youtd C`f4�ttr
with, the :l40 tear floo°<l elevatzen, unless, balk- es duals are nJeete+d err lneorpor ted wttltin a.
24.-hc�ur period foll6wing °r.,esiduals.land.applieation ,event
f Daring a easurabie preczpttat bn event J,".0 greater than a �l 'inch peg iotlr), or
fr-iff'oring"a,rainfall"event of 0..5 inehes;ar. greater;ln:a 2�-hour,per--iod
1 the slppe is greater "than l Q°a fc� surface applred ligtzid restdualsy +ar f t2te alQp e z .reate than;
1"€1°1a forin�ected�:ox �ncorporated:�ulk liquzd"-residuals; .
pRof%e sozlx,resfdua`ts and limeiitzxtine is,sziitaY le"f6rlha,spe+c%fied crop:' 4ny appr-oveel variations;
to the aceept4bl� �ozl, pH�(6 U�.�zill be.;noted,n this permtt�; ,
i. 1=f;theJand'=d6es,,not;ltave an es abliAed vegetative eoverFunless her residuals are incorporated :or:
U Q tthuY am shad be exezrr ed rorrfs ais xand 4pplie�t�o4Ovot. �4rzy �old'that
J py $
p g p ng ;tlia vegetattk caner" requzreittent,.
1f the tecicat separation 'between the seasonal highvatex table anal tlae" epth of teidlals
applxcatzaiz _is Less tltazt cite fo�it:. _ , . . -
k. , lftl e vertical--separation,€o,of bedrock, and e depth ofxesiduals applrcat vn less t[tan ane fcacat ;
t . A:licatlon exceeds agrnnmzcrats,
C""� s�rre�c;_a�T l.rog
The,followznguWic access restEicttcns apply to=residual ianil applicattan sites;
a public access to puliiic:c©ntact sitese.g; golf courses�.parks ball fields eic )" shah be restrctdc.
far 365 days after a resdualsland,applzeata et!ett
b; `P,i blic accessz_Aa nom publics oontact,,-sitoss".Sball :be ,restricted; -for 30. days after a residuals; Iartd'.
4pplzcari
13 Public access eontr is shall include the, p sstizig of zgi a with a" In-1 aka cif ,3 squaie feet- -e
IS' x '):. Each sigaAall:i dzcate the activzttes :conducted at -'each -.,site, pertn aumber; and' name and:
contact inforirtafit" on; hcludng tl►e."PFermittee or. applicator's telepkione numbergz�s shall be posted
ri a clearly visibie,td cnspzcuotk manner af:tie entrance ri :each land apptcattorisite durzng,a land:
application event, and for lang.as the public access ,restricticrzs requird under: condition III 12 ;.
apply. [15ANC�C tl2T 131Q$(b�(�;��
W
RjQQ!J 1725erzori 2.t: Heil V`ersian 16ti2 t f'a" 7 of 1

tikw, gr, apply to r sYdualan, --Ik.P 100aft10msites, cr each:
_
Dek otion
1),grap9p
Anm�4 shall not gLand oppli!*P'Or(Ac ifigi§ and,
restricted period., S�tes:that are;toYbe used g shall have: &Ucing tq,
3� days
i
,-prevenfaccess after -eacb,landiapPlc i ati -event.,
Food crops, feed -Qr, qos acid 1er'�dfbp' haltn'6tbe,"harvested for-.,-, ,-�3Q
days
Turf gowvom, Adwhere residual&' aye been applied.shall not be harvested for'
12 rnorifl?s
crops kith 440 pouch
't*Il$ �aboveAholAd
shall not bv,'4Wqsteq -ro 41
When the resxiivals r„ematif 0p:t4b land `surface for but trionthspr, Iongervior to,
iifeot6rala,no-into-the soil,,f6od,,cr6p.g,with,.:harvested parts -below, - the lance.
-16m " Q I hihs-:
surface , asppta _,cg 0 etc, shall Cbe.
WI%n the residuals reittain 6n.-ft land kirfamf6r less.,ihan,,four..nr-onihs,,,poor`io
i`ncor-
por4ion.idto the sqij,,Tq d.crqps�wj, k4rv, q*4 hoiiiid
y
IS ifibritfig,
surface harvested ov
151�. The' "Pe"nnittbe, shall acquire,Rom each landowner ckrlessee/o I nfent,do*ing. theryolu�
lessee/operator; a'state
of oilier nutrient sources ; 'anV, ' tuned manures, 6 46, ikal Wde products]. that: have een apV tedl�,sit
and
Erin c
US oftlo"
operations, whema'NMP is requiied.."by the, _­ �P­_�p of Agr
A
, Tho Pef ttee,shall ca MafAe,' allowiblenutrieni"
,foadin,$, r_ate&'s-based fin ,the-,,'p­'rG"v,'.ided ififbfin4tioaiid...us.e,,,appropr.-iate7reducitons,
F the purpose of thzs permit condtttan, a Crop
Managementllizaii n Plan
n W_ t o P,
-(WJUTP�, or t 'Plan-, (CNW
shall also ,,- be, -oonsidered aIutrent
'Management,'Plan.
tc ats', bW '14- Ap5ed unless ,the zIsUbTfiitteJ­Land OwnerAgreemenf,A&chment between .the P6rmittee and -landowners -orc,. lesseps�ooeraiors:,, pfffig landapplication foidd
_h cat, ts,�
and effect, These agoW�Atg she! be cor►stder d. expiFed1 co curter f v ifh the permit eypiration-44tej
and Shaltb6-,fenewcd,, during the:pen- fiitrenewal process.. I 15,',-.A,,NCAC 021, A _1164(6)(4)]l
Wqoo_34115, Version.—Iff 'Shell'Versloil-'1'661,10 Pit e: R of'13

1,. Any Divtsi4n=requutl motoring (inctding grcund?statr ptasxt.sur sosi and srfce tier
analyse) 'necessa .`ta;ensure groundwater and ,space:Water,pro ce tion -shall be .esiabl'ished, and an,
zcceptable sample roportu2g clledute sl�att; be f l t� �d'. SA, CAC (12T ,111, Y8{c)j
2. :Residiak shalt be analyzed to deYnonstr0e ihe� are non -hazardous ur der-'tlie Rescumo Conserva , A
ij
,and Reca�re�y Act {12.C�.) �tes�duais thantests or rs Flassxfied as� hazatdou� cix toxic waste under 40'
GFR Fart,2bl.,shalI not €� used fir. d pose ` under'ttus p tmit. The. r atyses ccaa°rtis vii tg rtab" V
rwil v y,,: awd to -It characteristic: li achi g p mcednare, { *}f shalt be performed at Ih7e>
firegWDO sped fied fif. ttach ertt ,and. er ermitt€e sl?all maintain t es resu(s fear a minimum a
fiveyeas Aty eGet�oaas:froin thes: zequirsnez�ts ictt tts'coadtfott shall %e, scired. iri.Aacr�ietA;
The FCLI? aralis sha1I melude th faliowig pararxzeters, {thereguiatory Ile u, mlltgxans'tFiex
. i �n -parentheses)
Arssuzc$ 0 ✓
i;4.=T�ehcrob nzene75
ftraUe. U ✓
131tiUC11 (l:t}0,0) ✓
1,2 DIGtt ©TOetIt (O:S) �
Pel taGiliQcflpheiio`l (100`d0) V
Benzenes 0 ✓
1,"-lizctoroeth gene +.
id`[ne 5 ,Q<
v
}4-D Yt atbYn ie 1.3 '/
ler Turn
Carbon: te`trachlor�de tl..� ":
...........
Endrin 0',.02. r/-
Sler ��.'�
Chlordane ,{ 03;
Hgxaehtorxbenzq {0'�
`'etxaGhlor+oethylene
Chlarolenzene `{I OO,Q
eptachlor l and its hydroxide H
Ei U t%
(. U..
Toxhe apne {O S}:
Clorofor (6;0 :
Hexacl�ara-1 bit€"enk Q
Tichlaroetli lene Q..'
Clram�►tm_(S a ✓
exachtaaraethane {3 Q}:,4,5=
Crzchtra�anol (4(} ft},
m, Cis�l .(00
2,4;6 Trrchtorophenol (2':0� v
o CresalQ{1t0: ✓
I;intiane :0..'" +/
21 S pF; Srlvex 1 Oa
Cresol 2p0,4:
er�u 0 2
�znytehior�de;{0 ��
esol { OCi
l�tethoxychlor'(1 of
',4-T {1t? 0 ✓
WW etltyi 1€e o* (2t10; Q)
Oncel e�,residuAs have.<been moriitored.f6r f vo yeses:at the frequency.
Perrnttree mad° $y*jm a ,-perziilf modxfiga o3� 1900O.WrOuq the
requireinezit: In:do cage -shalt. tire-riig�zitiii irig frequez�o, tie lvss`tiia�,.ari
[1 SA NC�►C lA 01,02{b), {12T 11,411 02T 1105�=
in Attachment r „ the
off' this ;monrCormg:
WQF�Q t72 Versinn1`0 Shell %Iersian t 6U 1 ti Pale 9' of 13;

J; An, candircted on res 0, -
-'I ing, at'ihe ft'p y
generafi :h facility q
specified in Attachment A. an,(ithe--,Perm�it,-tee-..sh4u _f mini fl "os,
The analyats.slrall toOe7lho, -OT
.Aluminum,
McrCur-Y
A
A ic°
Nickel,
---
✓Uk i,-
SodiumA-dsorpfion ROO
(W)
Calclum
Per-cent,11dial SolidsT
hopper
Ziod
LP ao
Magfte§Wm
cqJ'CIUl*io0
rl, i*tCt" C Q2"T-. A-161]
4-, Re di §hsll, 66, mp fift -­ d f h "' -ce' with ihop
— pre -or,, cQmpan pa n and vector attraction reduction,
rNuirement&-pi-the.fiequenqY spec-iced-ilil,and 40he.ti me mdcote44mplir morErtoring-,,se offhomproy- .00(pun-1h04*6if1"O data --shall d1,
-bo.speci-fiC, to-the--stabi izatiom.
prooess utffized, and suflieient, to demonstrate cdmptianec with the, Class -0 pa hogen tedvctjpq
,requirement in IAA NCAQ02T
d
tO Mttioio,,re
lii:,1- 2T-.11070`8 alj,bemet:,Ac M�rcqu ny"Ovep'tions.." from t e kernentsini-thig.conditiop, shall
'be specifj6d: inAtiachmenfA., [I.-5A.9CAC'0T.1.jJ64-, OIT,',
Aij,�Ori Q. re-pi,,0,p soils; analysis e , Standard Sdil Rhility-Analysis):. shall be conducted on
'eack,-bnd application site fisted .in,A ftach�irienf!Bll on, Kihich a -residuals eveqt-,� bc4r-
vp
in the,', N4pec jvqc4leg4a" ii jyAis shall; ,be
T y-eW jg-� Ain the "Guidance on Soil
ud"-, NC- Department of'A.,grk-Wtur -Sc
si�ioilfel Watddiw the Sampling-, hi�t Wrig geetionof the
'Yebsfte, hff:`lam -.nPIa rgov&g.ronomi ubs.."hPermrttee:sl" allmaim, in
hid, period
,of no: less than, five years, and: shAlI,.be made availableicy 'the. bi ` ibnyp qpfTqqug,9,t., At,4,, hlo
Standard g alysis shall include tho"fbilow, indto
Acidik
EDxc;haqgqabje,,-SodiAM Pe
Phosphorus
OW S4'woodaoy-alciilat
m4ft"Wurh
Potassium
CE&WM
AfAnganeqe°
podium
IN
Poo Au. !"10"
-,Mattor
-Zinc-,
Capper
6i Laho ' r, analyses shall, be performed an the as , --I ',,,�p -
ratory-parainete they and pl and'
i
be iq.,,4cgOr44Owith ,:tli r- 28,05,05, [j5A,N
--- --- gmohitpt, g 9quirdin 1,:I�A �N� 0,'
WQ0031725, Version 2:0 %Ojt-Vor4iOii -1602,1& ?42e.10 of 11,

7, The ,Rer idee shall rnaintaiii recordstmc in a`ll residual=land a iica ozi: vents . At a ninimum, ;these=
;,records shall ii�elude e 1?ollowi�tl
a. Source of residuailq-- -
b' 0ate4laud applz att
c. Ira'cats+a.+�f<Iandaat�catc�;,, safe?:fie�d,aar verniers. ttsrd.tr� tlactu18
i ,A;pprotr ate areas appiied toacres
IVletacl of land appficati'ri
f 4 Bather Condkfiotls (e g sunny clogoy} raining, etc;,
Predonit tins S ail Rapp g iixi t e :, ' bB
h So l,condiliotts (: ,dry,_ wet, _frozen etc :
7x T,}'}ze o�'c�op or crops do be gr� ctn'eld-
j,. ltrrogen-Applica ion Rate based on RYl s itfa sir�g•data-,obtained hom.the North Carolina Stag
I3tirersty;DeRartment of Soil Sckence?Neiasitex the printout.page shall be epfi.vu file.at�%prait�td
e�y fi.ears)
Volume of restdu is Iand,app iecl zn gailan9,per apt cubzc. ,srd per acre; dry toas per acre, or,, wot`;
tottper acriv
of:anrmai �raste onother nut ent, source applied ail, g�llous per, acro? dry f+an er,aere; or
wct't'ort� per acre;; .
:m.. Uolume,ofsoil arnendments,(e g., lime. gypaum� etc:} appI �d iu gallons per acre;, dry Cots pe�'acz�
or, wet toits'per sore; acid
n ,A nnuALand cumulative totals in dry ;tons per acre;of residuals :as well; as anima waste and:ottier
squrces ot'nutr(erzts �e € 4 Waptslicabps le , annuat and c ttlattve oundper`acre c� e+a eh freaky icitetal;
e g,, shalt tnclU e? brit shall not Ede titiiiteci to, arsert e� cacopper, lead;,-inercury
4m6lybdenum, nickdl�, selenium, and:zinc ?, annual;pounds,,:per aere of PA rand annual o�urzds pei
acre=p phosaph4rt s appt e�weach,£teed.
[15S1NCAC
8, Three e"opies of �:tx`
meer'the: ree{uiremer
lnstxucfa for'.
%$ue l� �T l Ala}�=;
Owl,be su6m'tu d, o r x bcfoxe luSarch 1 The al nual. repair. s61
are.
",
rap lauftor t or can b obta ned. '.li coxitacting the. Lan&
initualFrepo# shall lie submitted-fo fihe^f€ lZsavu%ng addras :
L?tstrn �r1Vater'I%sources
ldorm tion: I?roeessing Unit,
lWMail Service: Center
-Metgh *,.Nailli araliva 27,69946U,
,Q003:47 Version-llb ghell'Bison 160210 page 11;of13f

V.
M
�. 'l�ancaimplt�tice No'taficatead
The 'brmitiec shall report �y telephone i AheAshevUle. Regsanal off cg, teleplioneitumbex f 82� -290:-
4 OQ ,as sot n;as iasstixie, t?ut tt�,no case-trlore tlfgn 2OoUis or dn,the fiext=:working day fallowing the
occurrence .6 "fli4,'uowledge of the occurrence of'any of the hollow #&;
a Laud applxcat�ari;of residuals abnormal �n quanftty or eharacterisfic::,
b An failure of°tits land application;program;resulting,ina release ofrnafenai tu:�ttrface waters:.
Any time, self-znozzxt r tzg riic tcates the fuczlf "give out of co pbattce t itl ,its permit
lii'tatiot?s..:
d Any process unit faihue, due;.tcr kncswa or unknawri.reasons, rertder�g the factitty`%ncapalle .of`'
ode note residual treatrtetit..
e.. Any spill or. riischarge-,'from a;vehicleor piping system during re dpals.iranspo
Any emergency refit rwgjm7ned ate repc?rtin (e g ,discharges to,sur`facewaters, Jmm nent failure=o
a storage sft-6ture;.etc) outside normal :business hours shall. be reporfed to tine Divistoil's Emergency
Response personneFat telephone zttiunber'($4f } 6611956 ( ) &58=03Gf1,.b.(919)7 33 3 44 l�etsc�ns
reporiing soccurrences :by telphone`,shall,:alsc fi uchR.le a written report..in letter form within -five= dy
Mowing first knoNvledge.-of, fhe, occurrence This report shall outhrte the actions taken ar'prop i ed.:to
be,fakento ensure-that,t>ze prnt�letr� dcapsrnotrecur [1,,SANCAG.q.?T_4lfl�(,lj�a Q�'1 .(ii08.. I
NSPECTIO S
l,. The Permrttee shail,'protde adequate inspecfiizt and ;aaiiteriance to ensure proper, operation ,of the=
.subjeet,facilif ds=and,.shall,be,in accordancewith the appraved.GBcM,l'lan [I;5AX AC O T .01_ g{b) ^
27, , rt©r to each= bulk residuals„ w applfilatiori, event,
xesidtfals pracessrng storage, transport -and applies
`deterioCatld resit in.
healfh or. a public riaisanc.e. Thb POffi tee'shalt r �ainti
the.date and time of zspec6off, obseiroaiions. made,.an
taken: The Po"ittee sEr R ma2ntam this mspect'Im
inap�ectiori,. and this' -loge shalt bet. trade°. availatle'to
,O1ft
3. And duly..ad%1cxrtzecl,.lzvzsaan repxeserifative,may; up
>anyvroperty; premises or place 9p or'relatedtto the la
,the l?emittee, or .his -.designee :shall inspect the
tics facilities to iderrtify malfunctions, 'facility
discharges to tt envirrinrrieut a threat to humai
log or period of .five years from :the dafe, of
the. Division i4ponf request; [15A.�1CC OAT
pre sentattnn<=-of"
any records regipited'f , l e._maintained= under�'ihe terms and conditiof s of
:groundwater, surface Water or leachate samples. [0, 1,43 215 3(a) 2)I
;GE-NERALCONDITIONS
.n6als? enter: and Eirspect'
tc�btYes pertttitted lereitx..
mit;;may inspect or, copy
perr< ty and fray et l CO
1.ailurto,couplywth the conditions and:limitafions eantaiiiedherein iriay.subect=the Fermittee:to:art
enforcemenf>,action'by'the Division.zn accordance.wiihiNorth..Carolina Cotieral Statutes 1! 3 2ZS _fA fig
l43 2,fS 6G.: '[G sSm 143 215 &t to 143 2] 6G]
2: This, permit shall become -voidable,, if, 'the .residuals land application events are: not, oarriecfi .out", is
;accordWe'w'4 he conditions of ihisv permit .[j �A NCAC 42T Q116 .
3;;, This.permit is effective only %,nth.respect:io=the<nature:and-volume of'residuW described in tho pertit "t
apptotderuppvrttgcumenG43 2151h1]
WQO:03,1725. Version:2.0 Shell, V!eraziin;.16421;4' F'aec

under the �1�visFon's General Permit �CG01 t}ft00� and requue�nents periainin� tag �eiland� under � S�A
1� ;004.*02 Voo, and "rfoetWP!4&j 6 Arti
S, in tie event the residuals program :qh4pgog, okvne ship *-
pa, mwtviod,M iidb""
This<requesti"
L ivisionfiOlw", jRA4 shall iiieludegp patties l1 , � d6cumentati6n, from, ifie pafi ihv -!�yo v� gpqqi
Pomg'�aMgo, tton 's n�ees to Wy 4ik-0y
maintaining and. e,.residuils.-pro.gyam- enw'tdl6feinfntila,perui `isJssuetoAhenew
-P MKI--'W 10", 0
'm.6c,ation, tor tiiWAial,odi.&, Ati6li.,tipoA,,6.0days nbfiwlrom�lhe Ulvision..
.6 Thispeinnit is,, s0i edfla r
pmq
1%,
&. TheFerm�ttee°shall pay the annual-�f6e r�v# 3"qsafte
r being billed. b the IIivistarx PW)ur Jppad
'
the iv T
',oW4'- f op f" p [j5 -A Q2
.-Pwlwk,
Divisioii ofWWdterResourc6&
$YAA*Y'ofthe tpyi
:Permit 'Number WQQ03
-a
WQ -,"0
� - Q0,172-5-W �Qe $Wl V-Otsi 1.0040," 'Pale ,JXof`l'3-

ATTACHMENT AA�P#roved ResidOAVRO.Urc
O'k ,C 7, 14, "
ter-mi er--- W QQ317 5 Ye I
Oul ortl%-.
Ol". OMW,�.
on!toring
',Frequency fog
Ow
y 46fr", "'
T
Meta
W�
R
Coro,, Sian Plant
WPOueti
Nei 9005-0-11
A*4v
t nt u l ly,
TOW
4 i00
d W"' th"
'p- 'eiriitted �fadlity-
Arxaly es.t demonstrate that skid) k4foq*�', Ol Otip, zvtipulated
0" ar
inlormatton dud clarifYidti
WOWMVersioW,2_0 Attachment *A'Pagel ofJ,

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A1"'8 Eppraved' L,na=:PP»�q�n Snrs
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Annual Report Review SOP Class B Land Application
Reporting Period: fb f a ^ /9/314!�
Permit Details: WQ 0() 3 j''25 �jgv` (4v 4pp
• Is 503?
Class A or B&
Maximum Dry Tons Per Year:
Number of acres permitted: A 4
Number of fields in permit: to
Counties that land is permitted for: +/I�eS (�nAe
Monitoring Frequency for TCLP: A411t" t
Monitoring Frequency for Residuals Analysis: f�n�U,
Monitoring Frequency for Pathogen & Vector Attraction Reduction: Ann
Groundwater monitoring: N' A
1. Annual Land Application Certification Form
Was a certification form submitted?
Was land application conducted duri g the reported year?
How many dry tons and dry tons per acre were applied?
Were the applications within the permitted amount? y
Verify PAN if more than 10 tons/acre? VJ f�
Did it indicate compliance? y
Was it signed by the appropriate people? \/
2. Monitoring I
Were the analyses conducted at the required frequency? y
Was an analyses taken for each source that was land applied?
Were the metals analyses reported on the Residual Sampling Summary Form? �)
Were the results reported in mg/kg? y I
Were the pH's 6.0 or greater for each residual sample?'OO PH 'S
Were the heavy metals within ceiling concentration permit limits?
Were the lab analyses attached? "I
Were all the required parameters tested f
Was TCLP analysis conducted? '`� 1 f� l:a ;3 -� �� �� �'� '`O10
Were the TLCP contaminants within regulatory limit 9 evvva
T--
Was a corros vity, ignitabilyty, and reacttty analysis conducted?
3. Field Summary!
Were the land application events recorded on the Field Summary Forms? 1How many fields were applied on this year? 1
Was a Field Summary Form submitted for each field?�{
Were all the residuals applied to permitted land? \) 1
Were all the residuals applied from permitted sources? \1
Were the field loading rates for each metal and PAN calculated (year to date)? �I
Were the cumulative pollutant loading rates calculated?�
Were the calculations correct?
Were the PAN loading rates within permit limits?
Were the heavy metal cumulative pollutant loading'rates within permit limits?\(
Were the residuals applied on a suitable crop? �(

Were the applications conducted during the crop's growing season?
Were the Field Summary Forms complete? `�
Was lime application on Field Summary Folr ?•No lime applied. D9 I �, �w,l
D $'_12
4. Pathogen and Vector Attraction Reduction D p 5
Was a signed copy of the Pathogen aqd Vector Attractir Reduction Form submitted?
Did the form indicate the period of Lyoverage, the residual class, and the patHeen reduction
alternative and the vector attra ion reduction option used?
Class B Pathogen Review
Alternative 1 — Fecal Coliform Density
Was the sampling conducted at the required frequencyxl-ia�
Were seven samples taken? �j ' �10� OV. L 7 w4�
Was the geometric mean calculated and done correctly? 'A
Did the results show compliance (less than either 2,000,000 N PN/gram of total solids or
2,000,000 Colony Forming Units/gram of total solids)? \1
Alternative 2 —Use of Process to Significantly Reduce Pathogens (one of five)
• Was the sampling conducted at the required frequency?
1. Aerobic Digestion
Was it an aerobic process (Inspection)?
Were logs submitted showing time and temperature?
Were temperatures within range for complete time period?
Was the time and temperature between 40 days at 20°C (68T) and 60 days at 15°C
(59°F)?
2. Air Drying
Were the residuals on sand beds or pave or unpaved basins for three months?
Was the ambient temperature above 0°C (32T) for two months?
Were the residuals partially digested?
Were residuals exposed to atmosphere during two months above 0°C (not snow
covered)?
3. Anaerobic Digestion
• Was it an anaerobic process (Inspection)?
• Were logs submitted showing time and temperature?
• Were temperatures within range for complete time period?
Was the time and temperature between 15 days at 35°C (95°F) to 55°C (131°F) and 60
days at 20°C (68°F)?
4. Composting (usually will be Class A when composting is used)
Was it a composting procedure (not natural decay under uncontrolled conditions)?
Were logs submitted showing time and temperature?
Was the temperature raised to 40
5. Lime Stabilization
Was alkaline material added to residuals a form of lime (hydrated lime, quicklime, lime
containing kiln dust or fly ash)?
• Were logs submitted showing time and temperature?

Was the pH raised to 12 after two hours of contact?
Were logs submitted showing time and pH?
Was temperature corrected to 25°C (77'F)?
Alternative 3 — Use of Processes Equivalent to RSRP
(Not commonly use. See White House Manual page 100-103, tables 11-1 and 11-2.)
Vector Attraction Reduction Review
• Was the sampling conducted at the required frequency?
Option 1 — 38% Volatile Solids Reductio
Was there 3 8% reduction? 10
Were lab sheets/calculations in report? tit b
Was the reduction on volatile solids (not total solids)?
Were the samples taken at beginning of digestion process and before application
(Inspection)?
Were calculations correct?.\I
Option 2 — 40-Day Bench Scale Test I
Were residuals from anaerobically digested treatment (Inspection)?
Were residuals anaerobically digested in lab?
Was the test run for 40 days?
Was the test done between 30'C (86'F) and 37'C (99'F)?
Was the reduction of on volatile solids (not total solids)?
Was the reduction less than 17%?
Were lab sheets/calculations in report?
Were calculations correct?
Option 3 — 30-Day Bench Scale Test
Were residuals from aerobically digested treatment (Inspection)?
Were residuals aerobically digested in lab?
Were residuals 2% or less total solids?
If not 2% total solids, was the test ran on a sample diluted to 2% with unchlorinated
effluent?
Was the test run for 30 days?
Was the test done at 20'C (68'F)?
Was the reduction of on volatile solids (not total solids)?
Was the reduction less than 15%?
Were lab sheets/calculations in report?
Were calculations correct?
Option 4 — Specific Oxygen Uptake Rate(SOUR)
Were residuals form aerobically digested treatment (Inspection)?
Were residuals 2% or less total solids (dry weight basis) (not diluted)?
Was the test done between 10°C (50°F) and 30'C (86'F)?
Was the temperature corrected to 20'C (68°F)?
Was the SOUR equal to or less than 1.5 mg of oxygen per hour per gram of total
residual solids (dry weight basis)?
Was the sampling holding time two hours?
Was the test started within 15 minutes of sampling or aeration maintained?

Option 5 — 14-Day Aerobic Process
Were the residuals from aerobically digested treatment (Inspection)?
Were the residuals treated for 14 days?
Was the residuals temperature higher than 40°C (104°F) for a 14-day period?
Was the average residuals temperature higher than 45°C (113°F)?
Option 6 — Alkaline Stabilization
Was the pH of the residuals raised to 12 or higher by the addition of alkali?
Did the pH of residuals remain at 12 or higher for two hours without the addition of
more alkali?
• Did the pH of residuals remain at 11.5 or higher for an additional twenty-two hours
without the addition of more alkali?
• Was the pH corrected to 25°C (77 17)?
Option 7 — Drying of Stabilized Residuals
Does the residuals contain any unstabilized residuals?
Were the residuals mixed with any other materials?
Were the residuals dried up to 75% total solids?
Option 8 — Drying of Unstabilized Residuals
Were the residuals mixed with any other materials?
Were the residuals dried to 90% total solids?
Option 9 —Injection
• Was there any significant amount of residuals on land surface one hour after injection
(Inspection)?
Was injection done on pasture or hay field?
Was injection done at time that crop was growing?
If Class A with respect to pathogen, were residuals injected with eight hours after
discharge from pathogen treatment?
• Was the appropriate -documentation to show pathogen and vector attraction reduction included
in the report?
• Was pathogen and vector attraction reduction demonstrated according to 40 CFR Part 503?
5. Soil Tests S �
Was a Standard Soil Fertility Analysis conducted for each application field. �� �tl �f'C r
Were the soil pH's 6.0 or greater for each application field? No D _P
If no, was lime applied to those fields? DP (3=1' 5 Cp 6""�
Were the copper and zinc indexes in the soil less than 2000 for each application field?
Was sodium less than 0.5 meq/100 cm^3? r J'
Was the exchangeable sodium percentage ( SP) less than 15%?
6.General
Was the report in the proper format?
Was the annual report complete?
Was the report submitted on time? o _ S � _&m (� 0 0