WQ0031725_Annual Report_20090224

Annual Report Review SOP Class B Land Application
1. Annual Land Application Certification Form
• Was a certification form submitted? y S.
• Was land application conducted during the reported year? NHS
© How many dry tons and dry tons per acre were applied? 151. 7l
• Were the applications within the permitted amount? y.eS
• Verify PAN if more than 10 tons/acre .
• Did it indicate compliance? veS
• Was it signed by the appropriate people? N65
2. Monitoring 1
• Were the analyses conducted at the required frequency?y. 5
• Were the metals analyses reported on the Residual Sampling Summary Form? ..es
a Were the results reported in mg/kg? yf5
B Were the metals within ceiling concentration permit limits? yes
• If no, were the lab analyses attached?
• Were all the required parameters tested?t
'r• Was TCLP analysis conducted?-' & . "�5 / P tcec..: — NO
• Were the TCLP contaminants within regulatory limits? y42S'
3. Field Summary
a Were the land application events recorded on the Field Summary Forms?/e.,
o Was a Field Summary Form submitted for each field applied on?eS
• Were all the residuals applied to permitted land?1 ,5
• Were all the residuals applied from permitted sources? y &Y
• Were the field loading rates for each metal and PAN calculated (year to date)?1 L S'
• iWere the cumulative pollutant loading rates calculated?v,5
• Were the calculations correct? ey � OZ PAN �„it �! NEef Caf°"e�� ®�•
•
© Were the PAN loading rates w°e.5 J7
within permit limits?�a ,ieU . 5- J 4rcli ii/Aloe- i-S' /ow SO
* Were the heavy metal cumulative pollutant loading rates within permit limits? fi€ic1 5-"" kV VP"
• Were the residuals applied on a suitable crop . t(-S r T
• Were the applications conducted during the crop's growing season?j e5
• Were the Field Summary Forms complete?'-9-5
• Was lime application on Field Summary Form?
-C a ° two ' arAker2r
4: Pathogen and Vector Attraction Reduction
• Was a signed copy of. the Pathogen and Vector Attraction
UT ©. / Z f0 D. S'z .b T/4c
fir
Lv4�� q N� - u�gr1yJ' 'T.�arr��
eduction Form submit ed?'jeS
• Did the f indicate the period of coverage, the residual class, and the pathogrn reduction alternative and the
vector attraction reduction option used?
• Was the. app priate documentation to show pathogeand vector attraction reduction included in the report?
® Was path gen and vector attraction reduction demonstrated according to 40 CFR Part 503 or 2T?
.14®
5. Soil Tests
• Was a Standard Soil Fertility Analysis conducted for each field applied on?J
• Were the soil pH's 6.0 or greater for each application field? J0 TI = S. T2. 5. 5) ,SZ 5.3
• Were the copper and zinc indexes in the soil less than 3000 for each application field (state soils lab)? rtef
6. General
• Was the report in the proper format?'45
• Were any parts of the annual report missing?y°es .7)004.4,--e- 4to>^ -Or VAR -
Was•
the report submitted on time?1 p_5
�iav- zoo9- PG-0($7

Vector Attraction Reduction Review ' "�� `4✓�
• Was the sampling conducted at the required frequency? y eJ
38% Volatile Solids Reduction
® Was there 38% reduction? Do,±a nab' Su-br i -i
• Were lab sheets/calculations in report? 64 no+ Subw%
• Was the reduction on volatile solids (not total solids)? '/ S
• Was the samples taken at beginning of digestion process and before application
(Inspection)? Doc+a Ant sab.a.i
• Were calculations correct? po-4A J 4 SLAILYh^►4e$::1_
40-Day Bench Scale Test
• 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 on volatile solids (not total solids)?
a Was the reduction less than 17%?
• Were lab sheets/calculations in report?
• Were calculations correct?
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?
• Was thetest run for 30 days?
• Was the test done at 20°C (68°F)?
a Was the reduction on volatile solids (not total solids)?
o Was the reduction less than 15%?.
© Were lab sheets/calculationsin report?
• Were calculations correct?
Specific Oxygen Uptake Rate (SOUR)
• Were residuals from aerobically digested treatment (Inspection)?
o 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)?
a Was the SOUR equal to or less than 1.5 mg of oxygen per hour per gram of total residual
solids (dry weight basis)?
a Was the sample holding time under two hours?
O Was the test started withinl5 minutes of sampling or aeration maintained?

ANNUAL RESIDUAL 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: W00031725
Facility Name:,
Residual Source WQ # or
NPDES #:
WWTP Name:
Residual Analysis Data
Parameter
(mg/kg)
Percent Solids (%)
Arsenic
Baxter Healthcare
NC0006564
Laboratory:
1)
2)
3)
4)
5)
Pace Analytical
Ceiling
Conc.
Limit
NA
8-26-08
1.8
Sample or Composite Date
75
ND
Cadmium
Copper
85
ND
-Chromium
Lead
4,300
NA
245
87
840
ND
Mercury
57
2.1
Molybdenum
Nickel
75
ND
420
36.2.
Selenium
Zinc
Total Phosphorus
TKN ,
100
7,500
NA
NA
ND
275
9230
18700
Ammonia -Nitrogen
NA
1660
ND
a For surface disposal fac'lities the ceiling concentration limits listed in this form are not applicable. Reference the individual permi for metals limits.
"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
pen ies for submitting false information, including the possibility of fines and imprisonment for knowing violations."
212.o 1601
Nitrate and Nitrite
Signature of Preparer
*Preparer is defined in 40 CFR Part 503.9(r) and I5A NCAC 2T .1 102 (26)
NA
Date
DENR FORM RSSF (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 Total Dry Tons Applied (Annual): 28.90
Permit #:
Operator:
.Acres Used:
WQ0031725 Cation Exchange Capacity (non 503 only):
Derek Teague Owner: Trilby Setzer Predominant Soil Series: CmB2
19.8 Acres Permitted: 19.8 Site #: S-01 Field #: S-0I
Is and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posue
Date
8/26/08
?
3
6
6
8
9
10
11
12
"o Solids
1.8
Arsenic
0
Cadmium
'0
Copper
245
Chromium
87
Lead
0
Mercury
2.1
Molvh-
den um
0
Nickel
36.2
Selenium
0
Zinc
275
Total
Phos-
phorus
9230
,
IDs/acre ):
Total
DT Ac.:
App.
Event
1
1.46
2
±
6
7
6
9
1.0
11
12
Totals:
Arsenic
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
Cadmium
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
Copper
0.716
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.716
Chromium
0.254
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.254
1.ead
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
Mercury
0.006
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.006
Molvb-
denum
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
-
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
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
Zinc
0.804
0.0Q0
0.000
0.000
0,000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.804
Total
Phos-
phorus
26.989
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
d
26.989
"I certify, under penalty of law, that this document was prepared under my d�rect�on or supervision to aecor ance
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".
I,1.JLc �!
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:
Permit #:
Operator:
.Acres Used:
Baxter Healthcare
WQ0031725
Total Dry Tons Applied (Annual): 40.50
Cation Exchange Capacity (non 503 only):
Derek Teague Owner: Trilby Setzer Predominant Soil Series: HsB2
25 Acres Permitted: 25 Site #: S-02 Field #: S-02
d st al Anal sis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample ort�
Com-
posite
Date
8:26/08
?
3
5
6
7
8]
9
10
11
12
% Solids
I .8
Arsenic
0
Cadmium
0
Copper
245
Chromium
87
I.ead
0
Mercury
2.1
Molvb-
denum
0
Nickel
36.2
Selenium
0
Zinc
275
Total
Phos-
phorus
9230
I Hea Metal Field Loadings (C alculated to Ibsiacre):
:,lgII„a vy
Total
I)I Ac.
App.
Lent
1
I.62
2
3
4
5
6
7
8
9
10
11
12
Totals:
Arsenic
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
Cadmium
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
Copper
0.794
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.794
Chromium
0.282
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.282
I.ead
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
Mercury
0.007
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.007
Mol• b
denum
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
Nickel
0.117
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.117
Selenium
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
Y.inc
0.891
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.891
I otal
Phos-
phorus
29.905
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
29.905
"I certify, under penalty of law, that this document was prepared under my airection or supervtston to accor ance
v, ith 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".
7%.
(3- 1)•) .")
Signature or 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:
Permit #:
Operator:
• Acres Used:
Baxter Healthcare Total Dry Tons Applied (Annual):
WQ0031725
Cation Exchange Capacity (non 503 only):
74.72
Derek Teague Owner: Larry Teague Predominant Soil Series: HsB2
26 Acres Permitted: 26 Site #: T-01 Field #: T-01
sis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or_LI
Com-
posite
Dale
8n6/08
2
4
5
6
7
SJ
9
10
11
12'
°'o Solids
1.8
Arsenic
0
Cadmium
0
Copper
245
Chromium
87
I.cad
0
Mercury
2.1
Molyb-
denum
0
Nickel
36.2
Selenium
0
Zinc
275
I otal
t'hos-
phorus
9230
annual Heavy Metal Field Loadings (Calculated in Ibs/acre):
Total
Dt'Ac.
A PP.
.rent
1
2.87
2
3
4
6
7
8
9
10
11
12
c
f
Arsenic
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
Cadmium
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
Copper
1.406
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1.406
Chromium
0.499
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.499
I.cad
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
Mercury
0.012
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.012
v101} b
denum
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
Nickel
0.208
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.208
Selenium
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
Linc
1.579
0,000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1.579
Total
Phos-
phorus
52.980
•
0.000
0.000
_
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
-
0.000
52.980
"I certify, under penalty of law, that this document was prepared under my tree ion or supervision to accordance
rs ith a system designed tp 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 tines and
imprisonment for knowing violations".
a? •1,7-dc�`1
Signature of 1.and Applier
�. PP
•
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:
Permit #:
Operator:
Acres Used:
Baxter Healthcare
WQ0031725
Derek Teague Owner: Larry Teague Predominant Soil Series: MgC2
10 Acres Permitted: 10 Site #: T-02 Field #: T-02
Total Dry Tons Applied (Annual): 7.60
Cation Exchange Capacity (non 503 only):
al Anal sis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
J
8/26/08
2 1_3_
ji
5
6
8
9
10
11
12
% Solids
I.8
Arsenic
0
Cadmium
0
Copper
245
Chromium
87
I.ead
0
Mercury
2.1
Molyb-
denum
0
Nickel
36..2
Selenium
0
Zinc
275
Total
Phos-
phorus
9230
\11IIUAI Ilcllr�
i.■a.■a■ ■�.■.. uvw.....b�
��...._�.�-_�
---------- ,
Total
1)T Ac.
APP.
Event
1
0.76
2
3
b
6
7
8
9
10
11
12
Totals:
Arsenic
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
Cadmium
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.0.00
0.000
0.000
Copper
0.371
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.37I
Chromium
0.132
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.132
Lead
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
Mercury
0.003
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.003
b1c lyh
denum
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
Nickel
0.055
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.055
Selenium
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
Zinc
0.417
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0,417
1 oral
Phos-
phorus
13.993
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000,
0.000
0.000
13.993
on in accordance
"1 certify, under penalty of law, that this document was prepared
direction or supervise
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".
a'
Date
Land Signa Applier
re of
DENR FORM MFLSF (12/2006)

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: Trilby Setzer
Operator Derek Teague
Croa I Name:
Fescue
WQ Permit 11: WQ0031725
Annual Dry Tons Applied: 28.9388
Predominant Soil Series: CmB2
Crop 1 Max. PAN: 216
Field #: S-01
Site 14: S-01
Crop 2 Name:
Acres Utilized: 19.8
Acres Permitted: 19.8
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
O Y(enter
?;
Volume
one)Solids/
Liquid
Cu. Yds
applied
Gallons
%
Solids
Volume
Applied per
PP
Acre
(Dry Tons/Ac)
Residual Sources
NPDES f<, W #,
( 0
Fen., Animal
Waste, etc)
Soil
Cond.
(Dry
Wet.
Moist)
Precip.Nitrate
Past 24
Hrs.
inches
Application
'Method'
o
m a
a _
_.z.
^
=
Mineralization
Rates*
TKN
mg/kg
Ammonia Y'
Nitrogen E
and
Nitrite
mg/kg
PAN Applied
( Ibs/acre)
Name of Crop Type
Receiving Residual
Application
PP
Crop 1
Crop 2
Crop I
Crop 2
11-2008
168.6
11.5
0.825
WQ0031725
dry
0
s
0.5
0.3
18700
1660
0
9.801
NA
Fescue
12-2008
130.2
11.5
0.637
WQ0031725
dry
0 1
s
0.5
0.3
18700
1660
0
7.568
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
0.000
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form):
'
TOTALS:
298.8
0
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
17.369
0.000
Lime Applied
Annual
lbs/acre
0.000
0.000
0.716
0.254
0.000
0.006
0.000
0.106
0.000
0.804
26.989
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.11
0.05
8.43
0.38
1.47
0.037
0.182
0.465
0.079
12.396
6-2008
2000
Current Cumulative lbs/ac
0.110 v
0.050 v
9.146v
0.6341/
1.470v
0.043v
0.182v
0.571,E
0.079v
13.200✓
Permitted C. P. L. R.****
36
34
1338
NA
267
15
NA
374
89
2498
Permit PAN Limit lstl2nd Crop
216
h
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure ta
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
*Application Method: S - Surface, IN - Injection, INC - Incorporation
2 - 11-,a(Jo y **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
DENR FORM FSF (12/2006)

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 llealthcare
Land Owner: Trilby Selzer
Operator: Derek Teague
Fescue
WQ Permit n: WQ0031725
Annual Dry Tons Applied: 40.5026
Predominant Soil Series: HsB2
Field tt: S-02
Site 14: S-02
Crop 1 Max. PAN: 216
Crop 2 Name:
Acres Utilized: 25
Acres Permitted: 25
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
Precip.-0
Past 24
Hrs.
nches
3 -
3
^ a
« o'
>
<
--•
z -
_
' a
>
z 5
w
P w
•-N"
* w
>
TKN
mg/kg
Ammonia m
rn
Nitrogen E
Nitrate
and
Nitrite
PAN Applied
(Ibs/acre)
Name of Crop Type
Receiving Residual
Application
o
0 =
Q
Volume
(enter one)
Liquid
Cu. Yds
applied
Solids/
Gallons
%
Solids
Volume
Applied per
Acre
(DryTons/Ac)
Residual Sources
(NPDES #_ WQ#.
Fen., Animal
Waste, etc)
Soil
Cont
(Dry.
Wet.
Moist)
mg/kg
Crop 1
Crop 2
Crop 1
Crop 2
0
s
0.5
0.3
18700
1660
0
5.350
NA
Fescue
7-2008
116.2
11.5
0.450
WQ0031725
dry
t
0
s
0.5
0.3
18700
1660
0
1.441
NA
Fescue
8-2008
31.3
11.5
0.121
WQ0031725
dry
0
s
0.5
0.3
18700
1660
0
3.540
NA
Fescue
9-2008
76.9
11.5
0.298
WQ0031725
dry
0
s
0.5
0.3
18700
16600
0
13.409
NA
Fescue
10-2008
193.8
11.5
0.751
WQ0031725
dry
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
FORM FSF supp to this form):
Residuals Applications totals on FORM FSF supp ( attach
TOTALS:
4182
0
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
23.740
0.000
Lime
Applied
Annual
lbs/acre
0.000
0.000
0.794
0.282
0.000
0.007
0.000
0.117
0.000
0.891
29.905
le
Date
lbs/ac
6-2008
2000
Prior Years Cumulative lbs/ac
0
0
0
0
0
0
0
0
0
0
19"23 3
Current Cumulative lbs/ac
0.000 t/
0.000✓
0.794 t/
0.282✓
0.000v
0.007
✓ 0.000'1
0.117✓
0.000;/
0.891'/
36
34
1338
NA
267
15
NA
374
89
2498
Permitted C. P. L. R.****
Permit PAN Limit 1st/2nd Crop
216
• d d to assure that
"I certify, under penalty of law, that this document was prepared under my direction or supervision ►n accordance with a system estgne
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."
7*Application Method: S - Surface, IN - Injection, INC - Incorporation
,G,.--;,, 222- /a- `uvel **Volatilization Rate: Surface-0.5, Injection/Incorporation - 1.0
*** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
// Si na ure of Land Applier Date calldigested -0.3, raw sludge-0.4
g aerobically
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

Facility Name: Baxter Healthcare
Land Owner: Larry Teague
Qperator: Derek Teague
Crop 1 Name: Fescue Crop 1 Max. PAN: 216
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES WQ#.
Fen.. Animal
Waste. etc)
1-2008
2-2008
3-2008
4-2008
6-2008
87.1
11.5
0.324
213.3
11.5
0.795
WQ0031725
Soil
Cond.
(Dry.'
Wet.
Moist)
WQ0031725
194.6
199.2
11.5
11.5
0.725
0.742
WQ0031725
WQ0031725
77.2
11.5
0.288
WQ0031725
0.000
dry
Precip.
Past 24
Hrs.
inches
ANNIUAI. 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.
WQ Permit /t: WQ0031725 Field i : T-01 Acres Utilized: 26
Site #: T-01 Acres Permitted: 26
Annual Dry Tons Applied: 74.7100
Predominant Soil Series: HsB2 Cation Exchange Capacity (non 503):
• Crop•.2 Max. PAN:
Crop 2 Name:
UO! T'Lw1PiOn
1KN
mg/kg
fi
mg/kg
Nitrate
and
N itrite
mg/kg
PAN Applied
( Ibs acre)
Name of Crop Type
Receiving Residual
Application
Crop I
Crop 2
Crop 1
Crop 2
0
s
0.5
0.3
18700
1660
0
3.856
NA
Fescue
dry
dry
dry
0
0
0
s
s
s
0.5
0.5
0.5
0.3
0.3
0.3
18700
18700
18700
1660
1660
1660
0
0
0
9.442
8.615
8.818
NA
NA
NA
Fescue
Fescue
Fescue
dry
0
s
0.5
0.3
18700
1660
0
3.417
NA
Fescue
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
TOTALS: 771.4 0
Annual lbs/acre
Prior Years Cumulative lbs/ac
Current Cumulative lbs/ac
Permitted C. P. L. R.****
0.000
As
0.000
0.108
0.108 ✓
36
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form):
P
Cd
0.000
0.01
0.010 /
34
Cu
1.406
1.86
3.266 ✓
1338
Cr
0.499
0
0.499 ✓
NA
Pb
0.000
0.157
0.157�
267
Hg
0.012
0.0066
0.019 ✓
15
Mo
0.000
0.145
0.1451--
NA
Ni
0.208
0.1178
374
Se
0.000
0.0158
0.016✓
89
Zn
1.579
1.704
3.283 ✓
2498
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
52.980
34.1484- 0.000
Lime Applied
Date
lbs/ac
6-2008
2000
216
Permit PAN Limit 1 st/2nd Crop
"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."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
� 2- 1 ) --3(.• C 5 **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
DENR FORM FSF (12/2006)

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: Larry Teague
Operator: Derek Teague
Crop 1 Name:
Fescue
Crop I Max. PAN: 162
WQ Permit #: WQ0031725
.Annual Dry Tons Applied: 7.5833
Field #: T-02
Site #: T-02
Acres Utilized: 10
Acres Permitted: 10
Predominant Soil Series: MgC2 Cation Exchange Capacity (non 503):
Crop 2 Name: •
Crop 2 Max. PAN:
a) c(
Q
Volume
(enier one)
Liquid
Cu. Yds
applied.
Solids/
Gallons
0/0.
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES p. WQ4,
Fen., Animal
Waste, etc)
Soil
Cond.
Wet. (i)r�'
Moist)
preci p.
past 24
Hrs.
inches
>
>
K
? -
Volatilization
Rate**
Mineralization
Rate***
TKN
mg/kg
Ammonia g
rn
Nitrogen E
Nitrate
and
Nitrite
PAN Applied
lbs acre)
Name of Crop Type
Receiving Residual
Application
mg/kg
Crop I
Crop 2
Crop 1
Crop 2
5-2008
78.3
11.5
0.758
WQ0031725
dry
0
s
0.5
0.3
18700
1660
0
9.012
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
0.000
0.000
0.000
0.000
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form):
TOTALS:
78.3
0
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
9.0121 0.000
Lime
Applied
lbs/acre
0.000
0.000
0.371
0.132
0.000
0.003
0.000
0.055
0.000
0.417
13.993
Date
lbs/ac
Annual
Cumulative Ibs/ac
0
0
0
0
0
0
0
0
0
0
6-2008
2000
Prior Years
Cumulative lbs/ac
0.000 d
0.000✓
0.371 "
0.132 V
0.000.-
0.003 y
0.0001,-
0.055 v
0.000 i.
0.417✓
Current
Permitted C. P. L. R.****
36
34
1338
NA
267
15
NA
374
89
2498
Permit PAN Limit lst/2nd Crop
162
h
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure ta
qualified personnel properly gathered and evaluated the information submitted. 1 am aware that there are significant penalties for submitting false
information, including the ossibility of fines and imprisonment for knowing violations."
Signature of Land Applier
9- /2•2LG ?
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
DENR FORM FSF (12/2006)

Analytical Results
Southern Soil Builders
958 Hoots Road
Roaring River
Entered 11/20/2008
Reported: 11/25/2008
Sample Remark
NC 28669
For: Baxter
STATESVILLE
ANALYTICAL
Sample ID Parameter Cust ID Result Units Method Date Analyzed Analyst
081120-3 % Solids
Respectfully submitted,
Dena Myers
NC Cert #440,
NCDW Cert #37755,
EPA NC00909
11.5
0/0
SM2540B 11/24/08 CL
P.O. Box 228 • Statesville, North Carolina 28687 • 704/872/469 7

ace Analytical
www.pacelabs.com
Project SLUDGE ANALYSIS
Pace Project No. 9226439
Pace Analytical Services, Inc. Pace Analytical Services, Inc.
2225 Riverside Dr. 9800 Kincey Ave. Suite 100
Asheville, NC 28804 Huntersville, NC 28078
[phone] [phone]
ANALYTICAL RESULTS
Sample: DIGESTER SLUDGE Lab ID: 9226439001 Collected: 08/26/08 12:30 Received: 08/26/08 15:15 Matrix: Solid
Results reported on a "dry -weight" basis
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
8081 GCS Pesticides, TCLP SPE Analytical Method: EPA 8081 Preparation Method: EPA 3535
gamma-BHC (Lindane) ND ug/L 0.50 1 09/03/08 00:00 09/04/08 21:24 58-89-9
Chlordane (Technical) ND ug/L 3.0 1 09/03/08 00:00 09/04/08 21:24 57-74-9
Endrin ND ug/L 0.50 1 09/03/08 00:00 09/04/08 21:24 72-20-8
Heptachlor epoxide ND ug/L 0.50 1 09/03/08 00:00 09/04/08 21:24 1024-57-3
Methoxychlor ND ug/L 1000 1 09/03/08 00:00 09/04/08 21:24 72-43-5
Toxaphene ND ug/L 3.0 1 09/03/08 00:00 09/04/08 21:24 8001-35-2
Decachlorobiphenyl (S) 79 % 10-138 1 09/03/08 00:00 09/04/08 21:24 2051-24-3
Tetrachloro-m-xylene (S) 33 % 10-110 1 09/03/08 00:00 09/04/08 21:24 877-09-8
6010 MET ICP Analytical Method: EPA 6010 Preparation Method: EPA 3050
Aluminum 2270 mg/kg 458 1 08/29/08 10:10 09/02/08 22:49 7429-90-5
Arsenic ND mg/kg 22.9 1 08/29/08 10:10 09/02/08 22:49 7440-38-2
Cadmium ND mg/kg 4.6 1 08/29/08 10:10 09/02/08 22:49 7440-43-9
Calcium 17800 mg/kg 458 1 08/29/08 10:10 09/02/08 22:49 7440-70-2
Chromium 87.0 mg/kg 22.9 1 08/29/08 10:10 09/02/08 22:49 7440-47-3
Copper 245 mg/kg 22.9 1 08/29/08 10:10 09/02/08 22:49 7440-50-8
Lead ND mg/kg 22.9 1 08/29/08 10:10 09/02/08 22:49 7439-92-1
Magnesium 3170 mg/kg 458 1 08/29/08 10:10 09/02/08 22:49 7439-95-4
Molybdenum ND mg/kg 22.9 1 08/29/08 10:10 09/02/08 22:49 7439-98-7
Nickel 36.2 mg/kg 22.9 1 08/29/08 10:10 09/02/08 22:49 7440-02-0
Potassium ND mg/kg 22900 1 08/29/08 10:10 09/02/08 22:49 7440-09-7
Selenium ND mg/kg 45.8 1 08/29/08 10:10 09/02/08 22:49 7782-49-2
Sodium ND mg/kg 22900 1 08/29/08 10:10 09/02/08 22:49 7440-23-5
Zinc 275 mg/kg 45.8 1 08/29/08 10:10 09/02/08 22:49 7440-66-6
6010 MET ICP, TCLP Analytical Method: EPA 6010 Preparation Method: EPA 3010
Arsenic ND mg/L 0.025 1 09/04/08 14:27 09/05/08 12:56 7440-38-2
Banum ND mg/L 0.025 1 09/04/08 14:27 09/05/08 12:56 7440-39-3
Cadmium ND mg/L 0.0050 1 09/04/08 14:27 09/05/08 12:56 7440-43-9
Chromium ND mg/L 0.025 1 09/04/08 14:27 09/05/08 12:56 7440-47-3
Lead ND mg/L 0.025 1 09/04/08 14:27 09/05/08 12:56 7439-92-1
Selenium ND mg/L 0.050 1 09/04/08 14:27 09/05/08 12:56 7782-49-2
Silver ND mg/L 0.025 1 09/04/08 14:27 09/05/08 12:56 7440-22-4
7470 Mercury, TCLP Analytical Method: EPA 7470 Preparation Method: EPA 7470
Mercury ND ug/L 0.20 1 09/05/08 10:20 09/05/08 15:34 7439-97-6
7471 Mercury Analytical Method: EPA 7471 Preparation Method: EPA 7471
Mercury 2.1 mg/kg 0.22 1 08/29/08 11:40 08/30/08 10:53 7439-97-6
8270 MSSV TCLP Sep Funnel Analytical Method: EPA 8270 Preparation Method: EPA 3510
1,4-Dichlorobenzene ND ug/L
2,4-Dinitrotoluene ND ug/L
Hexachloro-1,3-butadiene ND ug/L
Hexachlorobenzene ND ug/L
Date: 09/10/2008 05:26 PM
50.0 1 09/03/08 00:00 09/05/08 00:50 106-46-7
50.0 1 09/03/08 00:00 09/05/08 00:50 121-14-2
50.0 1 09/03/08 00:00 09/05/08 00:50 87-68-3
50.0 1 09/03/08 00:00 09/05/08 00:50 118-74-1
REPORT OF LABORATORY ANALYSIS Page 3 of 25
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc..

ace Analytical
w,vw.pacelabs.com
Project SLUDGE ANALYSIS
Pace Project No.: 9226439
Pace Analytical Services, Inc.
2225 Riverside Dr
Asheville, NC 28804
[phone]
ANALYTICAL RESULTS
Pace Analytical Services, Inc.
9800 Kincey Ave Suite 100
Huntersville, NC 28078
[phone]
Sample: DIGESTER SLUDGE Lab ID: 9226439001
Results reported on a "dry -weight" basis
Parameters Results
Collected: 08/26/08 12:30 Received: 08/26/08 15:15 Matrix: Solid
Units Report Limit DF Prepared
Analyzed CAS No. Qual
8270 MSSV TCLP Sep Funnel
Hexachloroethane
2-Methylphenol(o-Cresol)
3&4-Methylphenol(m&p Cresol)
Nitrobenzene
Pentachlorophenol
Pyridine
2.4.5-Tnchlorophenol
2.4.6-Trichlorophenol
Nitrobenzene-d5 (S)
2-Fluorobiphenyl (S)
Terphenyl-d14 (S)
Phenol-d6 (S)
2-Fluorophenol (S)
2.4.6-Tribromophenol (S)
8260 MSV TCLP
Benzene
2-Butanone (MEK)
Carbon tetrachloride
Chlorobenzene
Chloroform
1.4-Dichlorobenzene
1.2-Dichloroethane
1,1-Dichloroethene
Tetrachloroethene
Tnchloroethene
Vinyl chloride
1.2-Dichloroethane-d4 (S)
Toluene-d8 (S)
4-Bromofluorobenzene (S)
Dibromofluoromethane (S)
Percent Moisture
Percent Moisture
2540G Total Percent Solids
Total Solids
9045 pH Soil
pH at 25 Degrees C
Plant Available Nitrogen
Plant Available Nitrogen
Date' 09/10/2008 05:26 PM
Analytical Method: EPA 8270 Preparation Method: EPA 3510
ND ug/L
ND ug/L
951 ug/L
ND ug/L
ND ug/L
ND ug/L
ND ug/L
ND ug/L
69 %
67 %
81
25
34 %
90 %
Analytical Method: EPA 8260
ND ug/L
ND ug/L
ND ug/L
ND ug/L
ND ug/L
ND ug/L
ND ug/L
ND ug/L
ND ug/L
ND ug/L
ND ug/L
111 %
121 %
99 ok
111 %
50.0 1 09/03/08 00:00
50.0 1 09/03/08 00:00
50.0 1 09/03/08 00:00
50.0 1 09/03/08 00:00
50.0 1 09/03/08 00:00
50.0 1 09/03/08 00:00
50.0 1 09/03/08 00:00
50.0 1 09/03/08 00:00
30-150 1 09/03/08 00:00
30-150 1 09/03/08 00:00
30-150 1 09/03/08 00:00
25-150 1 09/03/08 00:00
25-150 1 09/03/08 00:00
25-150 1 09/03/08 00:00
09/05/08 00:50 67-72-1
09/05/08 00:50 95-48-7
09/05/08 00:50
09/05/08 00:50 98-95-3
09/05/08 00.50 87-86-5
09/05/08 00-50 110-86-1
09/05/08 00:50 95-95-4
09/05/08 00:50 88-06-2
09/05/08 00:50 4165-60-0
09/05/08 00:50 321-60-8
09/05/08 00:50 1718-51-0
09/05/08 00:50 13127-88-3
09/05/08 00:50 367-12-4
09/05/08 00:50 118-79-6
125 25 09/07/08 11:11 71-43-2
250 25 09/07/08 11:11 78-93-3
125 25 09/07/08 11.11 56-23-5
125 25 09/07/08 11:11 108-90-7
125 25 09/07/08 11:11 67-66-3
125 25 09/07/08 11:11 106-46-7
125 25 09/07/08 11:11 107-06-2
125 25 09/07/08 11:11 75-35-4
125 25 09/07/08 11:11 127-18-4
125 25 09/07/08 11:11 79-01-6
125 25 09/07/08 11:11 75-01-4
79-120 25 09/07/08 11:11 17060-07-0
70-120 25 09/07/08 11:11 2037-26-5 S3
87-109 25 09/07/08 11:11 460-00-4
85-115 25 09/07/08 11:11 1868-53-7
Analytical Method: ASTM D2974-87
98.2 % 0.10 1
Analytical Method: SM 2540G
1.8 % 0.10 1
Analytical Method: EPA 9045
7.3 Std. Units 0.10 1
Analytical Method: 40CFR PART 503
2530 mg/kg 1.0 1
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent
A��
of Pace Analytical Services, Inc..
09/02/08 14:53
09/02/08 14:53
09/04/08 10:50
09/10/08 14:47
Page 4 of 25

ace Analytical
www.pacelabs. com
Project SLUDGE ANALYSIS
Pace Project No.. 9226439
Pace Analytical Services, Inc.
2225 Riverside Dr.
Asheville, NC 28804
[phone]
ANALYTICAL RESULTS
Pace Analytical Services, Inc.
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Sample: DIGESTER SLUDGE Lab ID: 9226439001 Collected: 08/26/08 12:30 Received: 08/26/08 15:15 Matrix: Solid
Results reported on a "dry -weight" basis
Parameters Results Units Report Limit. DF
Prepared Analyzed CAS No. Qual
Specific Oxygen Uptake Rate
Oxygen, Dissolved
350.1 Ammonia
Nitrogen. Ammonia
351.2 Total Kjeldahl Nitrogen
Nitrogen. Kjeldahl, Total
353.2 Nitrogen, NO21NO3
Nitrogen. Nitrate
Nitrogen, Nitrite
Nitrogen, NO2 plus NO3
365.1 Phosphorus, Total
Phosphorus
4500 Chloride in Soil
Chlonde
ASTM D516-90 Sulfate Soil
Sulfate
Analytical Method: 40CFR PART 503
1.72 mg/g/hr 0.010 1
Analytical Method: EPA 350.1
1660 mg/kg 275 1
Analytical Method: EPA 351.2
18700 mg/kg 3850 7
Analytical Method: EPA 353.2
ND mg/kg 585 1
ND mg/kg 585 1
ND mg/kg 585 1
Analytical Method: EPA 365.1
9230 mg/kg 726 7
Analytical Method: SM 4500-CI-E
12500 mg/kg 2640 1
Analytical Method: ASTM D516-90
14800 mg/kg 2750 1
08/26/08 12:20 7782-44-7
09/04/08 19:01 7764-41-7
09/06/08 15:44 7727-37-9
09/09/08 11:48
09/09/08 11:48
09/09/08 11:48
09/04/08 14:40 7723-14-0
09/10/08 13:20 16887-00-6
08/29/08 11:30 14808-79-8
Sample: DIGESTER SLUDGE (SAR) Lab ID: 9226439002 Collected: 08/26/08 12:20 Received: 08/26/08 15:15 Matrix: Water
Parameters
Results
Units Report Limit DF Prepared Analyzed CAS No. Qual
6010 MET ICP
Calcium
Magnesium
Sodium
Sodium Adsorption Ratio, SAR
Sodium Adsorption Ratio
Date 09/10/2008 05:26 PM
Analytical Method: EPA 6010 Preparation Method: EPA 3010
405000 ug/L
51500 ug/L
274000 ug/L
Analytical Method: EPA 6010
5000
100
250000
50 09/03/08 15:27
1 09/03/08 15:27
50 09/03/0815:27
09/05/08 12:21
09/04/08 15:48
09/05/08 12:21
3.4 meq/L 1 09/10/08 14:44
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc..
1. IGiCLCr�:
7440-70-2
7439-95-4
7440-23-5
Page 5 of 25

Analytical Environmental Services, Inc.
CLIENT: Pace Analytical Services, Inc. Client Sample ID: DIGESTER SLUDGE
Project: 9226439 Collection Date: 8/26/2008 12:30:00 PM
Lab ID: 0808H95-001 Matrix: SOLID
Analyses Result Reporting Qual Units BatchlD Dilution Date Analyzed
Limit Factor
HERBICIDES, TCLP SW1311/8151A (SW3510B) Analyst: EGM
2,4,5-TP (Silvex) BRL 0.20 mg/L 103708 1 9/4/2008 3:16 PM
2.4-D BRL 0.20 mg/L 103708 1 9/4/2008 3:16 PM
SUIT DCAA 103 44.7-146 %REC 103708 1 9/4/2008 3.16 PM
Qualifiers:
Date: 08-Sep-08
Value exceeds Maximum Contaminant Level E Estimated (Value above quantitation range)
BRL Below Reporting Limit S Surrogate Recovery outside accepted recovery limns
1-1 Holding times for preparation or analysis exceeded Narr See Case Narrative
N Analyte not NELAC certified NC Not Confirmed
13 Analyte detected in the associated Method Blank Page I of. I

' ANNUAL PATHOGEN AND VECTOR ATTRACTION REDUCTION FORM (02T Rules)
Facility :Name: )Baxter Healthcare
WQ Permit Number: W00031725
`Y WTP Name: Baxter Healthcare
Monitoring Period: From
1 / I /2008
To
NPUES Number: N0000656-I
12/31 /2008
'atho en Reduction (15A NCAC 02T .1106) - Please indicate level achieved and alternative performed:
g
Class A:
Alt. A (time/temp)
•
Alt B (Alk Treatment) ■ 1
Alt. C (Prior Testing) ■
Alt.D (No Prior Test)
•
Process to Further Reduce Pathogengs •
If applicable to alternative
performed (Class
A only) indicate "Process to Further Reduce Pathogens":
Compost
■
Heat Drying
•
Heat Treatment
•
Thermophilic
■
Beta Ra\
■
Gamma Ray
■
Pasteurization
•
Class B:
Alt. (1) Fecal Density D
Alt. (2) Process to Significantly Reduce Pathogens •
If applicable to alternative performed (Class B only) indicate "Process to Significantly Reduce Pathogens":
Lime Stabilization
■
Air Drying
•
Composting
•
Aerobic Digestion D
Anaerobic Digestion
■ I
If applicable to alternative performed (Class A or Class B) complete the following monitor'ng data:
Parameter
Allowable Level
in Sludge
Pathogen Density
Number of-
I.xcee-
dences
Frequency
nt Analysis
Sample
-Type
Analytical
fech-
ruut,e
Minimum
Geo. MeanMaximum
Units
Real 0olilorm
2 x 10 to the
6th power
MPN
13372
16982
30303
MPN/g
0
7
grab
sm922 I e
per gram of
total solids
C Tll
1000 mpn per gram
of total solid (dry
weight)
;,Irnonella bacteria
(in lien of fecal
conform)
3 MPN per 4 grams
total solid (dry
weight)
ctor Attraction Reduction (15A NCAC 02T .l 107) - Please indicate alternave perfo
tir
Alt. I ( VS reduction)
D
Alt. 2 (40-day bench)
•
Alt. 3 (30-day bench)
■
Alt. 4 (Spec. O, uptake)
■
Alt. 6 (Alk. Stabilization
I
Alt 7 (Drying - Stable)
■
Alt. 8 (Drying - Unstable)
•
Alt. 5 (I-t-Da\ Aerobic)
•
Alt. 10 (Incorporation)
•
No vector attraction reduction alternatives were performed
IN
Alt 9 ( Injection)
•
CERTIFICATION STATFMENT (please check the appropriate statement)
0 "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 I5A 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."
SILft( nl 6--o-u,(r(, Linslo,NiUa• rk.N T
Prepare!. Name and Title (type or print)
rF
Signature of Preparer*
■
V�
t^iCF-N ti6IZ
J2b loC
Date
Dennis Key President Southern Soil Builders, Inc.
)..and Applier Name and Title (if applicahle)(type or print)
Signature of Land pplie r (if applicahle)
'Preparer is delined in 40 CFR Part 503.9(r) and I SA NCAC 2T .1102 (26)
Date
DENR FORM PVRF 02T (12/2006)

.4
Analytical Results
Pace Analytical
9800 Kincey Suite 100
Huntersville
Entered 10/8/2008'
Reported: 10/16/2008
Sample Remark
NC 28078
For: 9229480
Sample ID Parameter Cust ID Result Units Method Da1te Analyzed Ain inlyst
08108-17.1 % Solids 922948001 1.69 % SM2540B '10/8/08 CIl.
08108-17.1 Fecal Coliform MTF 922948001 —17,751 MPN/g SM92210E '10/8/08 C 4.
08108-17.1 Geometric Mean 922948001 16,982 MPN/g dry wt. basis '10/9/08 (:::.
08108-17.2 % Solids 922948002 1.66 % SM2540B '10/8/08 C Il.
08108-17.2 Fecal Coliform MTF 922948002—43,855 MPN/g SM92210E '10/8/08 Cl..
08108-17 3 % Solids 922948003 1.72 % SM2540B 'I 0/8/06 G I..
08108-17.3 Fecal Coliform MTF 922948003 —13,372 MPN/g SM92210E "'0/8/08 CI.
08108-17,4 % Solids 922948004 1.73 % SM2540B '10/8/08 (:I.
08108-17.4 Fecal Coliform MTF 922948004—17,341 MPN/g SM92210E ' 0/8/08 Cl.
08108-17.5 % Solids 922948005 1.65 % SM2540B "0/8/08 (:1.
08108-17.5 Fecal Coliform MTF 922948005 —30,303 MPN/g SM92210E 10/8/a CI.
08108-17.6 % Solids 922948006 1.69 % SM2540B 10/8/08 CI.
08108-17.6 Fecal Coliform MTF 922948006 —13,609 MPN/g SM92210E 10/8/08 CI.
08108-17.7 % Solids 922948007 1.72 % SM2540B 10/8/08 Cl,.
08108-17.7 Fecal Coliform MTF 922948007 . 17,442 MPN/g SM92210E 10/8/08 C:1.
Respectfully submitted,
,OuvA
Dena Myers
NC Cert #440,
NCDW Cert #37755,
EPA NC00909
P.Q. Box 228 • Statesville, North Carol, na 28687 4 04/872/469)7

1
Analytical Results
Pace Analytical
9800 Kincey Suite 100
Huntersville
Entered 8/27/2008
Reported: 9/3/2008
Sample Remark
NC 28078
For: 9226439
STATESVILLE
ANALYTICAL
Sample ID Parameter Cust ID Result Units Method Date Analyzed Analyst
080827-1 % Solids 9226439001 1.69 % SM2540B 8/27/08 CL
080827-1 Fecal Coliform MTF 9226439001 53,254 MPN/g SM92210E 8/27/08 CL
Respectfully submitted,
Dena Myers
NC Cert #440,
NCDW Cert #37755,
EPA NC0O909
P.O. Box 228 • Statesville, North Carolina 28687 • 704/872/4697

Analytical Results
Pace Analytical
9800 Kincey Suite 100
Huntersville
Entered 11/11/2008
Reported: 11/14/2008
Sample Remark
NC 28078
For: 9231693
Sample ID Parameter Cust ID Result Units Method Dante Analyzed AtInlyst
081111-2.1 VSS
081111-2.2 VSS
Respectfully submitted,
kOzA
Dena Myers
NC Cert #440,
NCDW Cert #37755,
EPA NC00909
9231693003 3360 mg/L SM2540G 11/13/08
9231693004 12200 mg/L SM2540G 11/13/08
P.O. Box 228 • Statesville, North Carolina 28687 ':04/872/4697

Re ort No• 14S76
NCDA&CS Agronomic Division
Phone: (919) 15.5-'Lb55 WCD �rte: www.ncagr.cuuvngl vuvuui
P
Grou 'r Southern Soil Builders, Inc.
958 !loots Rd
Roaring River, NC 28669
Farm:
Catawba County
Copies To:
4
O A 4 ,
' N s
• � � r Soil
, ...
ro ;.rF.y�S
ink '0
• ' 1.I/19/2008 . , 1',RUING
0 Report
•
Agronomist Comments
C -- 12, $
Field Information
Applied Lime
Recommendations
Sample No. Last Crop
T1
Mo Yr T/A
6 2008 1.0
Crop or Year
1st Crop: Fes/OG/fim,M
2nd Crop:
Lime
.6T
N P205 K20
120-200 50-70 40-60
Mg S
0 0
0
Cu
0
Zn
0
B
.0
Mn
0
See Note
12
Test Results
Soil Class HM% W/V CEC BS% Ac pH P-I K-I
MIN 1.14 0.98 8.9 73.0 2.4 5.4 34 43
Ca% Mg%
52.0 19.0
Mn-I Mn-AI(1)Mn-AI(2) Zn-I
63 55 200
Zn-AI
200
Cu=/
159
S-1
51
SS -I
NO3-N NH4-N Na
0.1
Field Information
Applied Lime
Recommendations
.
Sample No. Last Crop
T2
Mo Yr TIA
6 2008 1.0
Crop or Year
1st Crop: Fes/OG/Tim,M
2nd Crop:
Lime
0
N P205 K20
120-200 60-80 50-70
Mg S
0 0
0
Cu
0
Zn
0
B
.0
Mn
0
See Note
12
Test Results
Soil Class HM% W/V CEC BS% Ac pH P-I K-1
MIN 1.19 1.08 6.7 75.0 1.7 5.5 27 38
Ca% Mg%
52.0 20.0
Mn-I Mn-AI(1)Mn-AI(2) Zn-1
61 61 117
Zn-AI
117
Cu-I
98
.
-
S-I
44
SS -I
NO3-N NH4-N Na
0.1
Field Information .
Applied Lime
Recommendations
Sample No. Last Crop
Si
Mo Yr TIA
6 2008 1.0
Crop or Year
1st Crop: Fes/OG/1'im,M
2nd Crop:
Lime
0
N P205 K20
120-200 40-60 40-60
Mg S
0 0
0
Cu
0
Zn
0
B
.0
Mn
pli$
See Note
12
Test Results
Soil Class HM% W/V CEC BS% Ac pH P-I K-I
MIN 0.66 1.15 7.1 90.0 0.7 6.5 36 45
Ca% Mg%
54.0 33.0
Mn-I Mn-AI(1)Mn-A/(2) Zn-I
99 69 32
Zn-AI
32
Cu-I
102
-
S-I
28
SS -I
NO3-N NH4-N Na
0.1
Field Information
Applied Lime
Recommendations
Sample No. Last Crop
52
Mo Yr TIA
6 2008 1.0
Crop or Year
1st Crop: Fes/OG/I'im,M
211d Crop:
Lime
.4T
N P205 K20
120-200 20-40 0
Mg S
0 0
0
Cu
0
Zn
0
B
.0
Mn
0
See Note
12
Test Results
Soil Class HM% W/V CEC BS% Ac pH P-1 K-1
MIN 0.51 1.15 6.i 72.0 1.8 5.3 46 87
Ca% Mg%
41.0 24.0
Mn-I Mn-AI(1)Mn-AI(2) Zn-I
177 123 44
Zn-Al
44
Cu-I
124
,
S-/
34
SS -I
NO3-N NH4-N Na
0.0