WQ0031725_Annual Report_20180307

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Annual Report Review SOP Class B Land Application
Reporting Period: 11% / 1 j, —
Permit Details: W'D 0031 -4 2—
Is 503? 14-5
Class A orD
Maximum Dry Tons Per Year: 9,CD
Number of acres permitted: (A, 6
• Number of fields in permit: 10
Counties that land is permitted for. VJ►1
Monitoring Frequency for TCLP: A,," wo-1
Monitoring Frequency for Residuals Analysis: A n ^,
Monitoring Frequency for Pathogen & Vector Attraction Reduction: A nr)
Groundwater monitoring:
. Annual Land Application Certification Form
Was a certification form submitted? V
Was land application conducted during the reported year?
! 5/J
�r,v
How many dry tons and dry tons per acre were applied? 14l-> Q 3 D 7-
i, S 19
a 9/4
4" 23a o'G? 7
Were the applications within the permitted amount?
Verify PAN if more than 10 tons/acre?
1,'N.7
1,518
e), 5,24 VIS7
Did it indicate compliance? Y
j ,120
1, 231 '
V,sz)5 I. 84.5
Was it signed by the appropriate people?�/
2. Monitoring
Were the analyses conducted at the required frequency?
Was an analyses taken for each source that was land applied?y/
Were the metals analyses reported on the Residual Sampling Summary Form?y
Were the results reported in mg/kg?l
Were the pH's 6.0 or greater for each residual sample?y told «,4 e �
Were the heavy metals within ceiling concentration permit limits? y
Were the lab analyses attachedTJ
Were all the required parameters tested?w
Was TCLP analysis conducted?
Were the TLCP contami�n is within regulatory limits?
Was a corrosivity, ignitability, and reacti i y analysis conducted?
T�&0 (a.4 >'LaC
p4 3. Field Summary to
Were the land application events recorded on the Field Summary Forms?
How many fields were applied on this year?')Q
Was a Field Summary Form submitted for each field?y
Were all the residuals applied to permitted land?
Were all the residuals applied from permitted sources?
Were the field loading rates for each metal and PAN calculated (year to date)?
Were the cumulative pollutant loading rates calculated? Y
Were the calculations correct?I
Were the PAN loading rates within permit limits?�I
Were the heavy metal cumulative pollutant loading rates within permit limits?
Were the residuals applied on a suitable crop?�
®U,( o-.� 4,T

Were the applications conducted during the crop's growing season?
Were the Field Summary Forms complete? n pq `jl 01)
Was lime application on Field Summary Fofm? No lime applied. y pP l -C �ll -► )
D P3 •-cco4 i i—r }) lll�Y Co 1-1 �)
4. Pathogen and Vector Attraction Reduction p P _(At4&S (U -1-7)
Was a signed copy of the Path�en and Vector Attraction Re�iction Form sl itted?y
Did the form indicate the period of coverage, the residual class, and the pathogen reduction
alternative and the vector auction reduction option used?
Class B Pathogen Review
Alternative 1- Fecal Coliform Density
Was the sampling conducted at the required frequency?
Were seven samples taken? y .
Was the geometric mean calculated and done correctly? y
Did the results show compliance (less than either 2,000,000 MPN/gram of total solids or
2,000,000 Colony Forming Units/gram of total solids)?�
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 (687) 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 (32°F) 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 (95T) to 55°C (131T) 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 Reduction
Was there 38% reduction? -I ErS��°�
Were lab sheets/calculations in report? D Elk
Was the reduction on volatile solids (not total solids)? )/
Were the sam les taken at beginning of digestion process and before application
(Inspection)? '�
• Were calculations correct?�I
Option 2 — 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 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 (867)?
Was the temperature corrected to 20°C (687)?
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
Was a Standard Soil Fertility Analysis conducted for each application field?
Were the soil pH's 6.0 or greater for each application field? (J Q
If no, was lime applied to those fields?V
Were the copper and zinc indexes in th6 soil less than 2000 for each application field?
Was sodium less than 0.5 meq/100 cm^3?
Was the exchangeable sodium percentage (ESP) less than 15%?
6.General
: Was the report in the proper format?y
Was the annual report complete? Y
Was the report submitted on time? 1Jo

5P
Baxter Healthcare Corporation
2017 Annual Report
Land Application Program
Permit No. WQ0031725
MAR ®.7
2®,,
T LS/yNnil r! /j'tyJ�IV� 1
r j
biviSion of Water Resources
LIAR 12 2018
Water Quality Regional Operations
Asheville R2gienal Office

ANNUAL LAND APPLICATiON CERTIFICATION FORM
WQ Permit#: WQ0031725 County: McDowell Year:
2017
V,
Facility Name (as shown on permit):
Land Application Operator:
Baxter Healthcare Corporation
Soutlicrn Sol] Builders_ inc. Phone: [phone]
Land application of residuals as allowed by the permit occurred during the past calendar year?
Yes 0 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 permit:
10
Total number of .fields utilized for land application during the year:
10
Total amount of dry tons applied during the gear for all application sites:
147.03
Total number of acres utilizes for land application during the rear:
69.6
Part B - Annual Comviancc Statement:
Facility was compliant during calendar year 2017 with all conditions of the land application permit
(including but not limited to items 1-13 below) issued by the Division of Water Resources. Yes El No
If no please, provide a written description iyhy the facility was not compliant, the (fates, and explain corrective action
taken.
1) Only residuals approved for this permit Nvere 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.
>) All other monitoring was performed in accordance with the permit and reported during the year as required and three (3)
copies of certified laboraton results are attached.
6) The facility did not exceed any of the Pollutant Concentration Limits in 15A NCAC 02T .1 I05(a) or the Pollutant Loading
Rates in 15A NCAC 02T. I 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 .1.11.1 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 from the Division of Water Resources.
10) No contravention of Ground Water Quality Standards occurred at a monitoring well or explanations of violations are
attached to include appropriate actions and reniediations.
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 lacy, that the above information is, to the best of my knowledge and belief, true, accurate,
and complete. I am aware that there arc significant penalties for submitting false information, including the possibility
of fines and imprisonment for knowing violations." 2
Permittee Name and Title (type or print) Sig 0 lure of Periuittec Date
Signature of Prcparer* 1 1 Date Signature of Land Applier Dale
(if different from Permittee) �l (if different from Permittee and Preparcr)
x Preparcr is defiled in 40 CFR Part 503.9 (r) and 15A NCAC 02T. 1102 (26) DENR FORM ACF (12/2006)

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: WQ0031725
Facility Name:
Residual'Source WQ # or
NPDES #:
WWTP Name:
Residual Analvsis Data
Baxter Healthcare
WQ0031725
Baxter Healthcare
Laboratory:
1)
2)
3)
4)
5)
Waypoint Analytical
Parameter
(mg/kg)
Conc.
Limit
mg/ka k'
Sample or Composite Date
1.-9-1.7
Percent Solids (%)
NA
10.78
'
Arsenic
75
4.54
Cadmium
85
2 V
Copper
4,300
70.7
Chromium
NA
32.3'�
Lead
840
5.5 ✓
Mercury
57
0.4
Molvbdenum
75
5
Nickel
420
1-.2
Selenium
100
5
Zinc
7,500
87.4
Total Phosphorus
NA
8860
TKN
NA
84400
Ammonia -Nitrogen
NA
9180
Nitrate and Nitrite
NA
2.72 '/
For surface disposal facilities the ceiling concentration limits listed in this form are not applicable. Reference the individual permit 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. I am aware that there are
significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
Lily dig
Signature of Preparer * Date
*Preparer is defined in 40 C1'R Part 50 3.9(r) and 15A NCAC 2'1' .1102 (26)
DENR FORM RSSF (12/2006)

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: WQ00031725
.Facility Name:
Residual Source
N.PDES # or WQ#:
WWTP Name:
Residual Analvsis Data
Baxter Healthcare
WQ00031725
Baxter Healthcare
Laboratory: 1) Waypoint Analytical
2)
3)
4)
5)
Parameter
(mg/kg)
Sample or Composite Date
1-9-17
Potassium
2370
Sulfiir
7900
Calcium
7050
Magnesium
2390
Sodium
23 70
Iron
3630
Aluminum
1130
Manganese
36.6
Organic N
75220
14 ; r
pH
7.6 V
"1 certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system
designed to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are
significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
Signature of Preparer x
7jMrK
Date
DENR FORM RSSF - B (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):
Permit #: WQ00 31725 Cation Exchange Capacity (non -503 only):
Operator: Douglas Poplin Owner: Douglas Poplin Predominant Soil Series:
Acres Used: 5.5 Acres Permitted: 5.5 Site #: DPI -A Field #:
11.00
FcC2
DPI. -A
Residual Analysis Data (:Heavy Metals and Total Phosphorus use mPA2, %► Solids use Raw :Percent #):
Sample
or Com-
posite
Date
1
1/9/17
2
3;
41
51,
6'
7
8
10
11
121,
% Solids
10.78
Arsenic
4.54
Cadmium
2
Copper
70.7
hromiun
32.3
Lead
5.5
Mercury
0.4
Mohb-
dcnum
Nickel
13.2
Selen4uu
5
Zinc
87.4
Total
Phos-
plionis
8860
Annual Heavy Metal Field Loadings (Calculated in lbs/acre):
Total
1...
2.
3,s
4.:.
6..
8 i
<.9...
101
11 3
12...
DT/Ac./
I
_5..:
_�J
_.._.:
_.
o
App.
Event
2.00
Arsenic
0.018
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.018
Cadrnium
0.008
0.000
0.000
1 0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.008
Copper
0.283
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.283
Chroininir
0.1.29
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.129
Lead
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
Mcrcun.-
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
Mold b-
0.020
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.020
denum
Nickel
0.053
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.053
Selenium
0.020
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.020
Zinc
0.350
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.350
Total
Phos-
35.440
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
35.440
horns
"l 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
[-11•atiil$
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 Total Dry Tons Applied (Annual): 3.23
Permit #: WQ0031725 Cation Exchange Capacity (non -503 only):
Operator:
Acres Used:
Douglas Poplin Owner: Douglas Poplin Predominant Soil Series: FcC2
1.6 Acres Permitted: 1.6 Site #: DP 1-B Field #: DPI-B
Residual Analysis Data (}Ieavy Metals and Total Phosphorus use mg/kg, %o Solids use Raw Percent #):
Sa.iiple
or Com-
posite
Dale
1 1
1/9/17
21
3
4;
7;
6!
7
8
91
10 `
17 j
12 j
% Solids
10.78
Arsenic
4.54
Cadmium
2
Copper
70.7
hromiun
32.3
Lead
Mercury
0.4
Molvb-
dgwrn
Nickel
13.2
Selenium
5
Zinc
87.4
Total
Phos-
ho111s
8860
Annual Heavy Metal Field Loadings (Calculated in lbs/acre):
Total
2 1
3_ 1
4
5�
7
8
9!
0
1]
11
12 j
DT/Ac./
_)..'
...
_6.1
_ ..
_
_..._..
.._,
H
o
App.
Event
2.02
Arsenic
0.018
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.018
Cadmium
0.008
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.008
Copper
0.286
0.000
0,000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.286
Chroi-niuni
0.131
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.131.
Lead
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
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
M01\=b-
0.020
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.020
dent.1111
Nickel
0.053
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.05 3
Selenium
0.020
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.020
Zinc
0.353
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.353 '
Total
Phos-
35.812
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
35.812
horns
1
155,Vq
"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
03 -a 0,g
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): 6.47
WQ0031725 Cation Exchange Capacity (non -03 only):
Douglas Poplin Owner: Douglas Poplin Predominant Soil Series:
3 Acres Permitted: 3 Site #: DPI -C Field #:
FcC2
DPt-C
Residual Analysis Data (Heavy Metals and Total Phosphorus use m2/k2, °/i Solids use Raw Percent #):
Sample
or Com-
posite
Date
11
1./9/ l 7
2' �
3i
4;
5;
6
7
8
90
' �
1
111
12'
% Solids
10.78
Arsenic
4.54
Cadmium
2
Copper
70.7
hromiun
32.3
Lead
5.5
Mercury
0.4
Moh-b-
denu in
Nickel
13.2
Selenium
5
Zinc
87.4
Total
Phos-
bonus
8860
Annual Heavy Metal Field Loadings (Calculated in lbs/acre):
Total
?._?
?.
3.!
4...
5..1
6'
71
8'
._........
9,
...__.....!
1 O,
1 i i
J
12
DT/Ac./
....___:
App.
Event
2.16
Arsenic
0.020
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.020
Cadmitun
0.009
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1 0.009
Copper
0.305
0.000
0.000
0.000
0.000
0,000
0.000
0.000
0.000
0.000
0.000
0.000
0.305
hromiun
0.139
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.139
Lead
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
Mercun,
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-
0.022
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.022
dellllin
Nickel
0.057
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.057
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
0.377
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.377
Total
Phos-
38.187
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
38.187
horus
i certuy, unaer penalty of taw, 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".
Sign tore of Land Applier
f-as-a fa
Date
V
J
J
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 Total Dry Tons Applied (Annual):
Permit #: WQ0031725 Cation Exchange Capacity (non 5503 only):
Operator: Douglas Poplin Owner: Douglas Poplin Predominant Soil Series:
Acres Used: 9.6 Acres Permitted: 9.6 Site #: DPI-D Field 4:
17.46
FcC2
DPI-D
Residual Analysis Data (Heavy Metals and Total Phosphorus use m2/k2, 0/1 Solids use Raw Percent #):
Sample
or Coln-
posile
Date
1 1
U9/17
2 r
__3j
51
61
7j
8 j
91
101
11 '
12
`%, Solids
10.78
Arsenic
4.54
Cadnlllllll
2
Copper
70.7
hro1niun
32.3
Lead
5.5
Mercun
0.4
Molvb-
denunl
Nickel
13.2
Selenium
5
Zinc
87.4
Total
Phos-
lhonls
8860
Annual Heavy Metal Field Loadings (Calculated in lbs/acre):
Total
�,
2_
4
5
6s
7
8'
1
9?
10
11'
l
12
DT/Ac./
J
_3.!
...........
o
App.
Event
1.82
Arsenic
0.017
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0:000
0.000
0.000
0.017
Cadmium
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
Copper
0.257
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.257
hromitlrl
0.118
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.118
Lead
0.020
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.020
Mercul-y
0.001.
j 0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.001
Molyb
0.018
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.018
de ntl Ill
Nickel
0.048
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.048
Selenium
0.018
0.000
0.000
0.000
1 0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.018
Zinc
0.318
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.318
Total
Phos-
32.233
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
32.233
llorus
I
I
I
I
I
I
I
I
I��„'J
Sa
"1 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..) 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
-aa-901A
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 Total Dry Tons Applied (Annual): 12.06
Permit #: WQ00 3) 1725 Cation Exchange Capacity (non -03 only):
Operator: Douglas Poplin Owner: Douglas Poplin Predominant Soil Series: FcB2
Acres Used: 5.877 Acres Permitted: 5.877 Site #: DP3-Corn Field #: DP3-Corn
Residual Analysis Data (:Heavy Metals and Total Phosphorus use mg/kg, %► Solids use Raw :Percent #):
Sample
or Com-
posite
Date
1?
1/9/ 17
2'
3"
4
5;
6
7
8'
9'
j0j
1 F
12
% Solids
10.78
Arsenic
4.54
Cadmium
2
Copper
70.7
Chromiuni
3 2. 3
Lead
-5.5
Mercury
0.4
Molyb-
de nu Im
Nickel
13.2
Selenium
J
Zinc
87.4
Total
Phos--
bonus
8860
Annual Heavy Metal Field Loadings (Calculated in Ibs/acre):
Total
w
?..1
4...
6.J
7 ?
8 !
9...7
1100 I
11 1
12
DT/Ac./
_1
/
_3_1
__5..?
w
............
H
o
App.
,/
A
Event
2.05
Arsenic
0.019
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.019
Cadmium
0.008
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.008
Copper
0.290
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.290
hromitu
0.1.33
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.133
Lead
0.023
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.023
Mercuryy
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
Moh b-
0.021
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.021
denum
Nickel
0.054
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.054
Sclenitun
0.021
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.021
Zinc
0.359
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.359
Total
©,5;8
Phos-
36.361
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
36.361
horns
"i certity, 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".
i� I-aa-aulA
Sigma ure of Land Applier Date
V
i
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 Total Dry Tons Applied (Annual):
Permit #: WQ003) 1725 Cation Exchange Capacity (non 503 only):
Operator: Douglas Poplin Owner: Douglas Poplin Predominant Soil Series:
Acres Used: 6.983 Acres Permitted: 6.983 Site #: DP3-Grass Field #:
23.65
FcB2
DP3-Grass
Residual Analysis Data (Heavy .M.etals and Total Phosphorus use in2/kg, °/, Solids use Raw Percent 9):
Sample
or Com-
posite
Date
1?
1/9/17
2'
3 j
4;
5
6 1
7 I
8! - -
9 i
10
11
121
'%, Solids
10.78
Arsenic
4.54
CadllliUlll
2
Copper
70.7
Cliroiniuni
3 2. 3
Lead
5.5
Mercury
0.4
Molyb-
dell a 111
Nickel
13.2
Selenium
Zinc
87.4
Total
Pllos-
110111 S
8860
Annual Heavv metal new Loadings ic:alculated in lbs/acrel:
Tolal
a..s
_2...1
.__3..
W4..
....5...
_6_
7_
a._;
9...i.
1._1....i.2._
DT/Ac./
c
App.
Event
3.39
Arsenic
0.031
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.031
Cadmium
0.014
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0,000
0.000
0.014
Copper
0.479
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.479
hronllun
0.219
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.219
Lead
0.037
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.037
Mercin- -
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
Mold b-
dC (111111
0.034
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.034
Nickel
0.089
0.000
0.000
0.000
0.000
0.000
0.000
0.0()0
0.000
0.000
0.000
0.000
0.089
Selenium
0.034
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1 0.000
0.000
0.034
Zinc
0.592
0.000
0.000
0.000
0.000
0.000
0.000
().000
0.000
0.000
0.000
0.000
0.592
Total
Phos-
60.018
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
60.018
horns
l.CI u,y, u,nlCr NCIlau.y of law, that ups uocument was prepares unser 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".
V
v
V
..0
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 Total Dry Tons Applied (Annual): 22.02
Permit #: WQ00 3) 1725 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 #: DP4 Field #: DP4
Residual Analysis Data (.Heavv Nletals and Total Phosphorus use ing/kg. 0/1 Solids use Raw Percent #l:
Sample
or Con1-
posite
Date
1
1/9/17
21
3 1
4
5
6
7!
8- -
9 i
10
11 1
12_
% Solids
10.78
Arsenic
4.54
Cadlniurn
2
Copper
70.7
11ro1111u11
3 2. 3-3
Lcad
S.-S
Mercul-N
0.4
Molyb-
denL1111
Nickel
13.2
Selenium
i
Zinc
87.4
Total
Phos-
horus
8860
Annual rleavv lvtetal .rle1Q LOadlilLYs 11-.111culatea In Insmere►:
Total
1...._
_3_
4...;
5...
6 i
7
8..w
9
10
11
12
DT/Ac./
✓
__...._.
c
App.
y
E\•ent
2.5 3
Arsenic
0.0233
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1 0.000
0.000
1 0.023
Cadmium
0.010
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1 0.0.10
Copper
0.358
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.358
hronliun
0.1.64
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.164
Lead
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
Merctin
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-
dernirn
0.025
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.025
Nickel
0.067
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.067
Selenium
0.025
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.025
Zinc
0.442
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.442
Total
Phos-
44.849
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
44.849
horns I
I
I
0. %?,
ICI uiy, unuC, penaiLy u1 law, that ups uocument was prepared under my mrectlon 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".
w'
V
Signatu e 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 Total Dry Tons Applied (Annual):
Permit #: WQ0031725 Cation Exchange Capacity (non -03 only):
Operator: Douglas Poplin Owner: Douglas Poplin Predominant Soil Series:
Acres Used: 15.9 Acres Permitted: 15.9 Site #: DP5 Field 9:
32.37
FcC2
DP5
Residual Analysis Data (Heavy Metals and Total Phosphorus use m2/k2. 1/0 Solids use Raw Percent 91:
Sample
or Coin-
posite
Date
11
1/9/17
21
31
4i
5i
6i
7?
8
jJ
101
M
11 j
12
% Solids
10.78
Arsenic
4.54
CadlnlLlnl
2
Copper
70.7
hroniiuii
32.3
Lead
5.5
Mercuni
0.4
Molyb-
denunl
Nickel
13.2
SCIC1141111
5
Zinc
87.4
Total
Pllos-
11ortis
8860
Annual heavy lvletal rlela Loadln2s (calculated in Ibs/acrel:
Total
1.....'
?..
3
4.
....5. 3
6...
a... 11
8..
9...!
1_.
�..�....i
1?...'
DT/Ac./
f
o
App.
V
�_
Evcnt
2.04
Arsenic
0.018
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.018
Cadiniuni
0.008
0.000
0.0()0
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
j 0.008
Copper
0.288
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.288
C111-oniiiiiii
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
0.022
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.022
Mercun
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
dciniin
0.020
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.020
Nickel
0.054
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.054
Selenium
0.020
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.020
Zinc
0.356
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.356
Total
Plios-
36.078
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
36.078
horus
36,, l q
eerily, unuer penalty of law, mat tors aocument 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
-0,2 aotA
Date
,€ )9
tl-
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 Total Dry Tons Applied (Annual):
Permit #: WQ00 31725 Cation .Exchange Capacity (non 503 only):
Operator: Douglas Poplin Owner: Douglas Poplin Predominant Soil Series:
Acres Used: 5.5 Acres Permitted: 5.5 V Site #: DP6 Field #:
10.15
FcC2
DP6 v
Residual Analysis Data (Heavy Metals and Total Phosphorus use m-a/kg, 0/0 Solids use Raw Percent #):
Sample
or Com-
posite
Date
1'
1/9/17
2
3;
4
5
6
7!
8j
9j
101
111
1211
`%, Solids
10.78
Arsenic
4.4
Cadinhirn
2
Copper"
70.7
Chroiniuni
32.3
Lead
5.5
Mercury
0.4
Molyb-
denunl
Nickel
13.2
Selenium
5
Zinc
87.4
Total
Phos-
bonus
8860
Annual Heavy lvletal Pield Loadings (Calculated in lbs/acre):
Total
2..
3
4...i
5_
g
7i
8'':.
9
10j
11
12?
DT/Ac./
.
..,
_..........
o
App.
Evcnt
1.85
Arsenic
0.017
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.017
Cadmium
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
Copper
0.261
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.261
c1ii-011141111
0.119
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.119
Lead
0.020
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.020
Mercury
0.001.
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.001
Mol}?b-
0.018
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.018
denunl
Nickel
0.049
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.049
Selenium
0.018
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.0.18
zinc
0.323
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.323
Total
Phos-
32.693
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
32.693
horns
3z?�2
i cercuy, unuer penany or iaw, inat ims aocmnent was preparea unaer my au-ection 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 Alyplier
Vas-aolg
Date
J
v
v
;tad
V
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 Total Dry Tons Applied (Annual): 8.62
Permit #: WQ0031725 Cation Exchange Capacity (non 5503 only):
Operator: Douglas Poplin Owner: Douglas Poplin Predominant Soil Series: FcC2
Acres Used: 4.4 Acres Permitted: 4.4 ✓ Site #: DP7 ✓ Field #: DP7
Residual Analysis Data (.Heavy Metals and Total Phosphorus use m2/Ic2, %► Solids use Raw :Percent #):
Salllple
or Coin-
poslte
Date
1
1./9/17
21
3 I
4 j
5
6
7 1
8'
9 j
10
11
12
% Solids
10.78
Arsenic
4.54
Cadnliuni
2
Copper
70.7
hromiun
32.3
Lead
5.5
Mercurn,,
0.4
Molyb-
denum
Nickel
13.2
ScleniLlIll
5
Zinc
87.4
Total
Pllos-
bonus
8860
Alltlual Heavv lvletal View Loaclin2s ((Alculated III Ibs/acre):
Total
_1....
_2_.1
_3...
4 '
.......
6._!
8_s'
9
10 '
11 i
12
DT/Ac./
/
c
App.
Event
1.96
"
Arsenic
0.018
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.018
Cadmium
0.008
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.008
Copper
0.277
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.277
Chroil-iiiiiii
0.127
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.127
Lead
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
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
MolN b-
0.020
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.020
denum
Nickel
0.052
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.052
Selenium
0.020
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.020
Zinc
0.342
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.342
Total
Pllos-
34.71.3
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
34.713
horns
7,51
I ceru,y, uuuer penalty or law, gnat tins aocument was prepares unaer my alrectlon or supervision in accordance with a
system designed to assure that qualified personnel properly gathered and evaluated the information submitted. I and
aware that there are significant penalties for submitting false information, including the possibility of fines and
imprisonment for knowing violations".
I
V
1/
Signature of Lan Applier Date
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 WQ Permit #: WQ0031725 Field #: DPI -A ✓ Acres Utilized: 1,j
Land Owner: IDou�las Poplin Annual Dry Tons Applied: 11.001 5 Site #: DPI -A Acres Permitted: 5.5
Operator: Douglas Poplin
Crop 1 Name: Fescue
Predominant Soil Series: FCC2 I/
Crop 1 Max. PAN: 158 >,./ Crop 2 Name:
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
`'
o
QLiquid
Volume applied
(enter one) Solids,'
Cu. Yds Gallons
g
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPI:)I S'i_ WQr.
Fort._ Animal
Waste. etc)
Soil
Cond.
(r.)»;.
Wet
Moist)
Precip.
Past 24
Hrs.
inches
>
^ _
o
u o
-
o
-
is
°
N
=
=
°
TKN
m /k
9 9
Z
_
qQ c
m /k
g kgmg/kg
Nitrate
and
Nitrite
PAN Applied
( lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
P
Cro P'-
Crop I
P
Crop
P 2
8-2017
91.51
10.78
1.511
, WQ0031725
dry
0
S
0.5
0.3
84400
9180
2.72
82.047
NA
Fescue
9-2017
29.67
10.78
0.490 V
WQ0031725
dry
0
s
0.5
0.3
84400
9180
2.72
26.602
NA
Fescue
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1
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]
121.18
o
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
I P
108.6491
0.000
Lime Applied
Annuallbs/acre
0.018
0.008
0.283
0.129
0.022
0.002
0.020
0.053
0.020
0.350
35.440 v
Date
Ibs/ac
Prior Years Cumulative lbs/ac
0.12
0.034
2.076
1.371
0.186
0.005
0.08
0.484
0.064
3.799
Current Cumulative lbs/ac
0.138
0.042 V
2.359
1.500
0.208
0.007✓
0.100
0.537
' 0.084
4.149
Permitted C. P. L. R.****
36
34
1338
NA
267
15
1 NA
374
89
2498
Pen -lilt PAN Limit 1st/2nd Crop
1 1.58
"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
I -)a-an
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 (1212006)

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. f
Facilitv Name: Baxter Healthcare
Land Owner: Douglas Poplin
Operator: Douglas Poplin
Crop 1. Name: Fescue
WQ Permit #: WQ003172-5 Field #: DP1-13
Annual Dry Tons Applied: 3.2329 Site #: DPI-13
Predominant Soil Series: FCC2
Crop 1 Max. PAN: 158 J Crop 2 Name:
Acres Utilized: 1.6
Acres Permitted: 1.6
Cation Exchange Capacity (non -503):
Crop 2 Max. PAN:
o
w o
Q
Volume applied
(enter one) Solids.
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
D Tons/Ac
(Dry )
Residual Sources
(NPDF-S 4.1 WQ/=.
Fert._ Animal
Waste, etc)
Soil
Coed.
(DrY,
Wet,
Moist)
Preci p
Past 24
Hrs.
inches
D
=
o
y
<
°
c
-
:x
°
K.
- =
°
TKN
m /k
9 9
z
°
m /k
9 9
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs sere)
Name of CropType
}
Receivin- Residual
Application
Cro I
p
Cro p-
Crop 1
p
Crop 2
1
9-2017
35.61
10.78
2.021
WQ0031725
dry
0
S
0.5
0.3
84400
9180
2.72
109.752
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
(.000
0.000
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form):
TOT.US:
35.611
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
109.7521
0.000
Lime Applied
Amluallbs/acre
0.018
0.008
0.286
0.131
0.022
0.002
0.020
0.053
0.020
0.353
35.812
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.118
0.032
1.932
1.244
0.17
0.005
0.074
0.444
0.061
3.48
Current Cumulative lbs/ac
0.136 t/
0.040
.
1218
1.375
0.192
0.007v
0.094
0.497
- 0.081
3.833
Permitted C. P. L. R.****
36
34
1338
NA
267
15
NA
374
89
2498
Pemiit PAN Limit 1st/2nd Crop
1 158
"I certif}, 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 ol'Land Applier
1 2-a o
Date
*Application Method: S - Surface, IN - Injection, INC - Incorporation
^''Volatilization Rate: Surface - 0.5, Injection/.Incorporation - 1.0
*** Mineralization Rates: Compost -0.1, anaerobially di„ested -0.2, aerobically
digested -0.3, raw sludhe -0.4
*"C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

Facility Name: Baxter Healthcare
Land Oivner: Douglas Poplin
Operator: Douglas Poplin
Crop 1. Name:
Fescue
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. C�
Acres Utilized: 3 v
WQ Permit#: WQ003172i Field #: DPI-C
Annual Dry Tons Applied: 6.4658 Site #: DP1-C
Acres Permitted: 3
Predominant Soil Series: FCC2 Cation Exchange Capacity (non 503):
Crop I Max. PAN: 158 r-/ Crop 2 Name: Crop 2 Max. PAN:
o
r o
Q �
Volume applied
(enter one) Solids
Liquid
Cu. Yds Gallons
g
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(N1'DI S '" WQ:=.
Fert.. Animal
_ Wade. etc)Wet.
Soil
Cond.
(Dn:
Moisl)
Precip.
Past 24
I lrs.
inches
D
r
2- =
-. o•
o
-
c
?"
o.
N
G
=
*
o
I KN
mg/kg
Z
=
d
m' o
=
"
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
( lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
9-2017
71.22
10.78
2.155 ✓
WQ0031725
dry-
0
S
0.5
0.3
84400
1 9180
2.72
117.069
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:
71.22
o
As
Cd
Cu
Cr
Pb
Ho,
Mo
Ni
Se
Zn
P
1 17.069
0.000
Lime Applied
Annuallbs/acre
0.020
0.009
0.305
0.139
0.024
0.002
0.022
0.057
0.022
0377
38.187 ✓
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.697
0.045
2.584
1.611
0.219
0.007
0.096
0.581
0.078
4.87
1 1-17
1000
Current Cumulative lbs/ac
0.717 v
0.054
2.889
1.750
0.243
0.009 v
0.118
' 0.638
' 0.100'
5.247
Permitted C. P. L. R.* *
36
34
1338
1 NA
1 267
15
1 NA
374
89
2498
Permit PAN Limit I st/2nd Crop
I.S8
"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 ImoNving violations."
//
Signature of Land Applier
•1 Application Method: S - Surface, IN - Injection, INC - Incorporation
- 4.101$ ,"-."Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Date * * * Mineralization Rates: Compost-0.1, anaerobially digested -0.2, aerobicalh digested -0.3, raw sludge -0. I
"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. V/
Facility Name: Baxter Healthcare WQ Permit #: WQ0031725 Field #: DPI-D Acres Utilized: 9.6
Land Owner: Douglas Poplin Annual Dry Tons Applied: 17.4591 v/ Site #: DPI-D Acres Permitted: 9.6
Operator: Douglas Poplin Predominant Soil Series: FCC2 Cation Exchange Capacity (non 503):
Crop 1 Name: Fescue Crop 1 Max. PAN: 158 Crop 2 Name: Crop 2 Max. PAN:
O
cs o
Ca
Volume applied
one) Solids/
Liquid
Cu. Yds Gallons
o,�
Solids
VOIUnIe
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPD1=S 4WQ:�.
Fert.. Animal
Waste. etc)
Soil
Cond
(Dry,
Wet,
Moist)
Precip.
Past 24
Hrs.
inches
D
J
o
C
O'
-
x
�� _
F =
#
* o
_
TKN
mg/kg
z
mglkg
Nitrate
and
Nitrite
mg/kg
PAN Applied
( lbs/acre)
Na me of Crop Type
Receiving Residual
Application
Crop I
Crop 2
Crop 1
Crop
12-17
1 192.31
10.78
1.819
WQ0031725
dry
0
S
0.5
1 0.3
84400
9180
1 2.72
98.785
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
1
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.0oo
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form):
TOTALS:
192.311
0
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
98.785
0.000
Lime Applied
Annuallbs/acre
0.017
0.118
0.135 ✓
36
0.007
0.032
0.039
34
0.257
1.937
2.194 V
1338
0.118
1.26
1.378
NA
0.020
0.194
0.214 If
267
0.001
0.004
0.005 v
15
0.018
0.074
0.092
1 NA
0.048
0.432
0.480
374
0.018
0.048
0.066 `
89
0.318
3.315
3.633
2498
32.233
Date
lbs/ac
Prior Years Cumulative lbs/ac
Current Cumulative lbs/ac
Permitted C. P. L. R-****
Permit PAN Limit I st/2nd Crop
1�8
"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
I-ad-2
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, rasludge -0.4w
;:*'.,C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL LAND APPLICATION FIELD SUMMARY FORM D P 3 --�; - l�',(0'q-c- Q--(.
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 #: DP3-Corn Acres Utilized: -5,g77
Land O«vner: Douglas Poplin Annual Dry Tons Applied: 12.0610 ✓ Site #: DP3-Corn Acres Permitted: 5.877
Operator: Douglas Poplin Predominant Soil Series: FcB2 Cation Exchange Capacity (non 503):
Crop 1. Name: Com-Silage Crop .1 Max. PAN: 214 Crop 2 Name: Crop 2 Max. PAN:
o
w f
Q
Volume applied
(enter one) Solids,"
Liquid
Cu. Yds Gallons
g1
Solids
Volume
Applied per
Acre
D Tons/Ac
(Dry )
Residual Sources
(NPI:)13S i. WQi=,
Fert._ Animal
Waste. ete)
Soil
Cond.
(Dry.
Mold
Precip.
Past 24
I-Irs.
inches
C T
o
_
*
°
C-,R
#
2
TKN
m /k
9 9
fz
c =
d
bo o
`-' y
m /k
9 9
Nitrate
and
Nitrite
m /k
9 9
PAN Applied
PP
(lbs%acre)
Name or Crop Type
Receiving Residual
Application
Crop I
Crop 2
Crop I
Crop 2
3-2017
52.72
10.78
0.814 V
WQ0031723
dry
0
Inc.
1
0.3
84400
9180
2.72 -
51.713
NA
Corn
4-2017
80.13
10.78
1.238
W00031725
dry
0
Ina
1
0.3
84400
9180
2.72
78.599
NA
Corn
0.000
0.000
0.000
0.000
0.000
0.0()0
0.000
1
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1
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):
TOT:-U,sl
132.s5
0
As
Cd
Cu
Cr
Pb
R9,
Mo
Ni
Se
Zn
P
130.31 1
0.000
Lime Applied
Annuallbs/acre
0.019
0.344
0.363
36
0.008
0.105
0.1 13.
34
0.290
0.5893
0.879
1338
0.133
3.957
4.090
NA
0.023
0.523
0.546 X
267
0.002
0.015
0.017 L
15
0.021
0.215
'0.236,
NA
0.054
1.214
1.268
374
0.021
0.515
0.536 L,
89
0.359
12.264
12.623
2498
36.361 V
Date
lbs/ac
Prior Years Cumulative lbs/ac
1 1-17
1000
Current Cumulative lbs/ac
Permitted C. P. L. R_****
Permit PAN Limit 1 st/2nd Crop
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
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
"aJ 0t8 `Volatilization Rate: Surface - 0.5,1njection/.Incorporation - 1.0
Date Y"" Mineralization Rates: Compost -0.1, anaerobially digested -0.2, aerobicalh
ditiested -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 I lealthcare.
Land Owner: Douglas Poplin
Operator: Douglas Poplin
Crop 1 Name:
Fescue
WQ Permit#: WQ0031725 Field #: DP3-Grass
Annual Dry Tons Applied: 23.6525 J Site 9: DP3-Grass
Predominant Soil Series: FcB2
Crop I Max. PAN:
194
Crop 2 Name:
Acres Utilized: 6.983
Acres Permitted: 6.983
Cation Exchange Capacity (non -03):
Crop 2 Max. PAN:
o
c� o
�
Volume a i died
1 1
(enter one) Solids'
Liquid
9
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPi:)ES . \./Q
Fert._ Animal
Waste. etc )
Soil
Cond.
(D�y
Wet.
Moist)
Precip.
,
Fast 24
I1rs.
inches
D
0 =
_
.� o,
<
_
=
�.
_
N
- Cc
x. �•
*
�
°
TKN
mglkg
Z >
_
-- _
8
~.
-'
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs%acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
1-2017
3.6
10.78
0.047
WQ0031725
dry
0
S
0.5
0.3
84400
9180
2.72
2.542
NA
Fescue
2-2017
138.23
10.78
1.797
WQ0031725
dry
0
S
0.5
0.3
84400
9180
2.72
97.61 e
NA
Fescue
-2017
118.7
10.78
1.543
WQ0031725
dr.
0
S
0.5
0.3
84400
9180
2.72
83.824
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
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form):
TOTALS:
260.�3t
0
As
Cd
Cu
Cr
Pb
H
Mo
Ni
Se
Zn
P
183,982
0.000
Lime Applied
Annual
lbs/acre
0.031 ✓
0.014
0.479
0.219
0.037
0.003
0.034.
0.089
0.034
0.592
60.018
S/
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.32
0.351
36
0.103
0.1 17 t,
34
5.716
6.195
1 1338 1
3.776
3.995
NA 1
0.499
0.536
267 1
0.014
0.017
15 1
0.208
` 0.242
NA 1
1.159 -
/ 1.248
374
0.511
0.545v
8 13498
11.992
12.584
V
1 1-17
1000
Current Cumulative Ibs/ac
Permitted C. P. L. R.****
Permit PAN Limit i st/2nd Crop
I t94
"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 tines and imprisonment for knowing violations."
Signature o'f 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, anacrobially 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 Healthcare WQ Permit #: WQ0031725 Field #: DP4 ✓ Acres Utilized: 8 7
Land Otvner: Douglas Poplin
Operator: Douglas Poplin
Crop 1 Name: Fescue
Annual Dry Tons Applied: 22.0148 Site #: DP4
Predominant Soil Series: FCB2
Crop I Max. PAN: 194 "' Crop 2 Name:
Acres Permitted: 8.7
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
Volume applied
(enter one) Solids'
Liquid
Cu. Yds Gallons
Solids
Volume
Applied ier
t
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES i. WQ/ ,
Fert.. Animal
Wastc. etc)
Soil
Cond.
Wet(Dry.
Moist)
Preci i
,
last _-'4
Hrs.
inches
F. ?
�'
<
� =
o'
` �
#
c'
0
fICN
mg/kg
Z
_
o �
(JoQ
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
Name of Cro 1-` e
P . P
Receiving Residual
Application
Crop 1
Crop _
Crop I
Crop _
3-2017
1 50.18
10.78
0.524
WQ0031725
do
U
S
0.5
0.3
84400
9180
2.72
28.443
NA
Fescue
5-2017
85.02
10.78
0.887
WQ0031725
dry
0
S
0.5
0.3
84400
9180
2.72
48.190
NA
Fescue
6-2017
107.29
10.78
1.120
WQ0031725
dry-
0
S
0.5
0.3
84400
9180
2.72
60.813
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, oo--
0.000
0.000
(7,3
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form):
TOTALS:
242.49
0
As
Cd
Cu
Cr
Pb
H g
Mo
Ni
Se
Zn
P
137.4471
0.000
Litne Applied
A umal lbs/acre
0.023 ✓
0.245
0.?68 ✓
36
0.010
0.073
0.083
34
0.358
4.093
' 4451
1 1338 1
0.164
2.811
2.975
NA
0.028
0.349
0.377 t,
1 267
0.002
(.1.Q1 1
0.013
15
0.025
0.151
0.176 V
NA
0.067
0.956
1.02'3
374
0.025
0.098
0.1?3
89
0.442
8.639
9.081�
2498
44.849 ✓
✓
Date
lbs/ac
Prior Years Cumulative lbs/ac
11-17
2000
Current Cumulative Ibs/ac
Permitted C. P. L. R.****
Penuit PAN Limit 1st/2nd Crop
F 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
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
NO- 070
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, ravv 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 WQ Permit 4: WQ0031725 Field #: DPj Acres Utilized: 15.9
Land Ovvner: Douglas Poplin Annual Dry Tons Applied: 32.3717 ✓ Site th DP5 Acres Permitted: 15.9
Operator: Douglas Poplin Predominant Soil Series: FCC2 Cation Exchange Capacity (non 503):
Crop I Name: Fescue Crop .1 Max. PAN: 158 V Crop 2 Name: Crop 2 Max. PAN:
o
cs o
V011mle applied
(enter one) Solids
Liquid
Cu. Yds Gallons
g,
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residua] Sources
(NPI:>L S ft, W(�
Fert._ Animal
Waste. etc)
Cond.
(Dry.
Moist)
Prccip.
fast 24
Ilrs.
inches
>
�.
c -
z n
=
-
� -
x•
�.
°
* �'
°
TKN
mg/kg
Z �
_ =
3
=_
mg/kg
Nitrate
and
Nitrite
mglkg
PAN Applied
(lbs/acre)
Name of Crop Type
Receivma Residual
"
Application
Crop l
Crop 2
Crop 1
Crop 2
7-2017
1 215.57
1 10.78
1.231
WQ0031725
dry
0
S
0.5
1 0.3
84400
1 9180
2.72
66.858
NA
Fescue
11-2017
141
10.78
0.805
WQ0031725
dry
0
S
0.5
0.3
84400
9180
2.72
43.730L•
NA
Fescue
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1
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
-U.000
0.000
0.000
2.OV4
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form):
ro'r:v s:
356.571
0
_�As '
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
110.588
r 0.000
Lime Applied
Annuallbs/acre
0.018 V
0.217
✓0.235
36
0.008
0.062
0.070 V
34
0.288
3.49
3.778
1 1338
0.132
2.308
2.440
NA
0.022
0.316
0.338 t,
1 267 1
0.002
0.01
0.013
15
0.020
0.13,
0.150V
NA
0.054
0.822
0.876"
1 374
0.020
0.075
0.095
89
0.356
7.42
7.776-�
2498
36.078 ✓
Date
lbs/ac
Prior Years Cumulative lbs/ac
Current Cumulative lbs/ac
Permitted C. P. L. R.****
Permit PAN Limit 1 st/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 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
t og�a
Date
`Application Method: S - Surface, IN - Injection, INC - Incorporation
"Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
x x Mineralization Rates: Compost -0.1, anaerobially digested -0.2, aerobically
digested -0.3, ravv 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. v.-
Facility Name: Baxter Healthcare
Land Werner: Douglas Poplin
Operator: Douglas Poplin
Crop 1 Name: Fescue
WQ Permit #: WQ003172i Field #:
Annual Dry Tons Applied: 10.1490 '0"� Site #:
Predominant Soil Series: FCC2
Crop I Max. PAN: 158 V, Crop 2 Name:
DP6
D P 6
Acres Utilized: 1,j
Acres Permitted: 5.5
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
c�
p
VOIUme a) )lied
1 I
(enter one) Solids.;g
Liquid
Cu. Yds Gallons
a
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)�
Residual Sources
(NPI:)13S 4. WQ%,
Fen - Animal
Waste- etc)
Soil
COed•
Wet,
Moist)
Precip.
Past
14rs.
inches
>
T
w o-
o'
o
o -
x
x a
%� =
=
N
r
2
TKN
mg/kg
z _
r °
^.
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
( Ibs/acre)
Name of Crop 7 ypc
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
10-2017
111.79
10.78
1.845 '�
WQ0031725
dry
0
S
0.5
0.3
84400
9180
2.72
100.23&-
NA
Fescue
0.000
0.006
o.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
1 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):
Tol"ALS
111.791
o
As
Cd
Cu
Cr
Pb
H-
Mo
Ni
Se
Zn
P
100.2301
Lime Applied
Annuallbs/acre
0.017
0.007
0.261•
0.119
0.020
0.001
0.018
0.049
0.018
0.323
32.693 10
Date
Ibs/ac
Prior Years Cumulative lbs/ac
0.31
0.09
5.112
3.563
0.477
0.013
0.189
0979
0.094
Current Cumulative lbs/ac
0.327 ✓
0.097
• 5.373•'
3.682
0.497
" 0.014,-
0 207"
1.028
` 0.1 12
10.868
Penmitted C. P. L. R.****
36
34
1 1338
NA
267
15 1
NA
374
89
2498
Pen -nit PAN Limit 1st/2nd Crop
1
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 submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of tines and imprisonment for knowing violations."
ignature of Land Applier
%-j rd- cl o
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, acrobically
digested -0.3, raw.sludge -0.4
""C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL LAND APPLiCATI.ON FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORMTO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" 1N A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: Baxter I lealtheare•
Land Owner: Dou,las Poplin
Operator: Douglas Poplin
Crop I Name: Fescue
WQ Permit #: WQ0031725 Field #: DP7
Annual Dry Tons Applied: 8.6211 Site #: DP7 �✓`
Predominant Soil Series: FcC2 Cation Exchange Capacity (non 503):
Crop I Max. PAN: 158 V Crop 2 Name: Crop 2 Max. PAN:
Acres Utilized: 4.4
Acres Permitted: 4.4
w o
c�
Ca
VOILmI@ applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
pF t
Acre
(Dry Tons/Ac)
Residual Sources
(NPI)];S t, \hQ#.
F erL_ Animal
Waste, etc
Soil
Cond.
(l:hy,
Wet;
Moist)
Precip.
,
Past 24
Hrs.
inches
.y
c _
a
2
o
,
c
c -
v'
*
_
c
* E-
� �'
# o
TKN
mg/kg
Z
°
= �
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
( lbs/acre)
Name. of Crop Type
Receiving Residual
Application
Crop 1
Ca•op 2
Crop 1
Crop 2
8-2017
94.96
10.78
1.959
WQ0031725
dry
0
S
0.5
0.3
84400
9180
2.72
106.426r
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
omo
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):
rO'r:aLs:
94.961
(T
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
F
106.426
0.000
Lime Applied
Amorallbs/acre
0.018
0.008
0.277
0.127
0.022
0.002
0.020
0.052
0.020
0.342
34.713
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.249
4?67
36
0.067
0.075
34
3.891
4.168
1338
2.613
2.740
NA
0.356
0.378 V
267
0.011
0.013
15
0.146
r 0. 166V
NA
0926
0.978
374
0.089
0.1.09.
89
7.97.
8.312
2498
1V
11-17
1000
Current Cumulative lbs/ac
Permitted C. P. L. R.****
Permit PAN Limit 1 st/2nd Crop
1.58
"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
k aq-dol
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)

112U12018
Nutrient Madagement in North Carolina
Realistic Yields for FcB2e Fairview sandy clay loam, 2 to 8 percent slopes,
moderately eroded in !Wilkes County
Crop Yiel
Barley (Grain) 67 Bush Is
Corn (Grain)
......................................................................................................................................................................................................................................
129 Bushels
Corn (Silage)
19.6 To
Cotton
637 Pourids
Sorghum (Silage)
16,7 Ton
Oats (Grain)
83 Bushels
Peanuts
0 Pound
Rye (Grain)
49 Bushels
Small Grain (Silage)
8.8 Tons
Sorghum (Grain)
......................................................................................................................................................................................................................................
49 CWT
Soybeans (Double Cropped)
......................................................................................................................................................................................................................................
33 Bushels
Soybeans (Full Season)
......................................................................................................................................................................................................................................
39 Bushels
Soybeans (Double Cropped - Manured)
...........................................................................................................................................................................................
33 Bushels
Soybeans (Full Season - Manured)
............................. ................. ............ ................. ............................... ..................... .......................................................
...........................................
... 39 Bushels
Tobacco (Burley)
...............................................................................................................................................................................................................................
................................. .I...........
0 Pound
Tobacco (Flue Cured)
.....................................................................................................................................................................................................................................
2548 Po
nds
Triticale (Grain)
.......................................................................................................................................................................................
69 Bushels
Tropical Corn (Silage)
.............................................................................................................................................................................................--..............
...........................................
19.6 Ton
Wheat (Grain)
.................. ................................................................................................... ....................... .......................... I...................
49 Bushels
Bahiagrass (Hay)
_............................. .......
3A Tons
......
Caucasion/Old World Bluestem (Hay)
3A Tons
Common Bermudagrass (Hay)
3.4 Tons
Dallisgrass (Hay)
3.4 Tons
Fescue (Hay)
4.4 Tons
Hybrid Bermudagrass (Hay)
4.4 Tons
Hybrid Bermudagrass overseeded with Rescuegrass
0 Tons
(Hay)
Mixed Cool Season Grass (Hay)
3.2 Tons
Orchardgrass (Hay)
3.4 Tons
Pearl Millet (Hay)
3.7 Tons
Rescuegrass (Hay)
0 Tons
Sorghum Sudan (Hay)
4.2 Tons
Timothv Grass
Realistic
Nitrogen
Rate (Ibs/acre)
99
119
Estimated Phosphorus
Removal
(Ibs P205/acre)
25
57
10.9
214
67
0.081
52
18
7.6
127
50
1.13
94
21
0
0
0
2.01
98
16
11.1
98
48
1.72
.........................................................................................................................................................
84
37
0
.........................................................................................................................................................
0
27
0
.........................................................................................................................................................
0
31
3.89
.........................................................................................................................................................
130
27
3.89
.........................................................................................................................................................
152
31
0.074
...............................................................................................................................................
0
0
0.029
.................................................................................................................................................
74
13
1,52
.......................................................................................................................................................
104
23
6.5
.....-.............. ..............
127
... ................................................ .................
67
............................................
2.01
.........................................................................................................................................................
98
25
44
151
39
44
151
41
44
151
42
44
151
45
44
194
69
44
194
54
44
0
0
44
140
44
151
49
180
44
0
49
204
0 Tons 44 0
I:)r. -David Crouse is responsible for the development and mainter}ance of the Realistic Yield reporting tool.
45
50
49
0
58
0
http://yields.sail.ncsu.edulindox.php#county 12/2

"U'LU/Zu1 d
Nutrient M4, agement in North Carolina
Realistic fields for FcC2a Fairview san
moderately eroded in Wilkes County
clay loam, 8 to 15 percent slopes,
Realistic
Estimated Phosphorus
Nitrogen
Nitrogen
Removal
Crop
Yiel
I
Factor
Rate (Ibs/acre)
(Ibs P205/acre)
Barley (Grain)
. ................................ .............................................. _.................................... ......................................................................
54 Bush
. ............................
Is
1,49
81
21
Corn (Grain)
..................................................................................................................................................................................................................................................................................................................................................................................................................................................
106 Bus
.............. ...
iels
............. .................... .........
0.92
........................................................ .......
97
........................................................ :............................................... .
46
Corn (Silage)
16 Tons
10.9
174
54
Cotton
520 Pou
ids
0.081
42
15
Sorghum (Silage)
13.6 Tor
s
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 CWTJ
1.72
69
30
Soybeans (Double Cropped)
................................................................................................................................................................................................................
27 Bush
ds
0
0
22
Soybeans (Full Season)
...........................................................................................................................................................................................................................................................................................................................................................................................................................................
32 Bush
Is
0
0
26
Soybeans (Double Cropped - Manured)
................... ..................... .......................................................................................................................
27 Bush
.Is
3.89
106
22
........... .................
Soybeans(Full Season - Manured)
............................. ..............
.
................................... .......
........... ............................................ :...............................................................................................
...... ............ .
.............................................................................................................................................................................................................................................................................................................................
32 Bush
Is
3.89
124
26
Tobacco(Burley)
............................. ............................................ ........... .................. .......................... -........................................................
0 Pound
..............................
............. ....
0.074
..................
0
...........................................................
0
Tobacco (Flue . . .Flue . Cured)
......................................................................................................................................................................
2080 Po ................................................................................................................................................................................................................................
nds
.
.................................
0.029
..................................... ......... .......................................................
60
.........................................................
10
Triticale (Grain)
............................................................................................................................................................................._.........................................................................................................................................................................................................................................................................
56 Bush
Is
1.52
85
i9.
Tropical Corn (Silage)
..........................................................................................................................................................................................................
16 Tons
. 6.5
104
54
Wheat (Grain)
40 Bush
..................................
Is
2.01
80
20
Bahiagrass (Hay)
2.8 Tons
44
123
32
Caucasion/Old World Bluestein (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 Grouse is responsible for the development and maintenance of the Realistic Yield reporting tool.
hftp://yields.soil.ncsu.edLVindex.php#county 212

Page: 2 of 2
Report Number: 17-012-0208
Account Number: 46381
Send To: Southern Soil Builders
Dennis Key
958 Hoots Road
Roaring River, NC 28669
Lab Number: 61653
Sample Id : Baxter
,ma's sue.
�:
Waypoint''.
r�rANALYTICAL I
Project: Baxter
NC Cert #257
REPORT OFANAL-YSIS
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 ° Fax [phone]
www.waypointanalytical.com
Date Sampled: 1/9/2017 12:30:00 /
Date Received: 01/12/2017 00:00
Date Reported: 01/19/2017
Total Cadmium
<2.00
2.00
JTR
01/16/2017 20:03
6010C
Total Chromium
32.3
5.00
JTR
01/16/2017 20:03
6010C
Total Nickel
13.2
5.00
JTR
01/16/2017 20:03
6010C
t
Total Arsenic
4.54
3.00
JTR
01/16/2017 20:03
6010C
Total Mercury
<0.400
0.400
JM
01/18/2017 09:00
SW-7471 B
Total Selenium
<5.00
5.00
JTR
01/1612017.20:03
6010C
pH (Standard Units)
7.60
1.00
SJB
1�0312017 09:30
SW-9045D
Total Molybdenum
<5.00
5.00
JTR
01/16/2017 20:03
6010C
Comments:
SULFUR AND ORGANIC NITROGEN NOT FOR COMPLIANCE PURPOSES.
I 151E'q- ®,k
�Wpb
All values are on a dry weight basis except as noted by asterisk. Detection limit on all N series is on a wet basis.
Our reports and letters are for the exclusive and confidential use of our clienis. and may not be reproduced in whole or part, nor may any reference be made 9&UMM
to the work, the results. or the cornpany in any advertising, news release, or oL4er public announcements without obtair;ing our prior v✓r,tten authorization.
Debbie Holt
Laboratory Supervisor

Page: 1 of 2
Report Number: 17-012-0208
Account Number: 46381
Send To: Southern Soil Builders
Dennis Key
958 Hoots Road
Roaring River, NC 28669
Lab Number: 61653
Sample Id : Baxter
Ore
Project : Baxter
NC Cert #257
REPORT OFANALIYSIS
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 ° Fax [phone]
www.waypointanalytical.com
Date Sampled: 1/9/2017 12:30:00
Date Received: 01/12/2017 00:00
Date Reported: 01/19/2017
Total Solids"
10.78
107800
100.0
R D
01/12/2017 15:30
SM-2540G
Moisture `
89.21
100.0
R D
01/12/2017 15:30
SM-254OG
Total Kjeldahl Nitrogen
8.44
84400
10.0
SJB
01/16/2017 10:25
SM-4500-NH3C-TKN
TdiarPhospITOrus
R
O tt16/20 r
Total Potassium
0.24
2370
1000
JTR
01/16/2017 20:08
6010C
Total Sulfur
0.79
7900
100
JTR
01/16/2017 20:03
6010C
Total Calcium
0.71
7050
-100
JTR
01/16/2017 20:03
6010C
Total Magnesium
0.24
2390
100
JTR
01/16/2017 20:03
6010C
Total Sodium
0.24
2370
100
JTR
01/16/2017 20:03
6010C
Total Iron
3630
100
JTR
01/16/2017 20:03
6010C
Total Aluminum
1130
100
JTR
01/16/2017 20:03
6010C
Total Manganese
36.6
5.00
JTR
01/16/2017 20:03
6010C
Total Copper
70.7
5.00
JTR
01/16/2017 20:03
6010C
Total Zinc
87.4
5.00
JTR
01/16/2017 20:03
6010C
Ammonia Nitrogen
0.92
9180
10.0
SJB
01/13/2017 09:30
SM-4500-NI3C
Organic N
7.52
75220
10.0
01/13/2017 09:30
CALCULATION
Nitrate+Nitrite-N
<2.72
2.72
SJB
01/13/201713:45
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.
Our reports and letters are for the exclusive and confidential use of our clients. and may not be reproduced in whole or part, nor .may any reference be made A,m dg
to the work, the results. or the company in any advertising, new. s re?ease, or other public announcements without obtaining our prior written authorization.
Debbie Holt
Laboratory Supervisor

Mineralization
as decimal
JTotal dry
JAcres
PAN Surface
114.7456libs PAN/acre
PAN Injection
134A318311bs PAN/acre
mg/kgx.002 =|bs/dryton
MR(TKN'NH3)+1(NH3)+NO3+NO2 =mO/kg
mg/kg x.002 =Ibs/dry ton
Dry Tm sMUOO gal.
20000,4,49526
1st year PAN |ba./acre
Surface|bs. Surface
1styear PAN |bs./aonu
Injected lbs. Injected
` -`

SAR
1'`1-' Vle
Sodium Absorption Ratio
Na(M
Ca'Mc/L
MgCMcj/Li
Na : Sodium (Mg/L) Equivalent weight: 23
255.486 1
759.99
257.642
Ca: Calcium (Mg/L) Equivalent weight: 20
Mg : Magnesium (Mg/L) Equivalent weight: 12
n' 'mg
Cd
[Via (ME)
11,10809
7.9995
21.47017
Milli Equivalent = Mg/L / Equivalent weight The amour
amount of
SAR= Na Milli Equivalent/[0.5 X (Ca Milli Equivalent + Mg Milli equivalent)]0.5 power
tI Permitting
SAR = 2,0317073 (From, cult;,/i_. entered < bov(:;)
SA = 2.037589 (Pro€n ME onterod Naov�)
Na ME
1
Ca (ME)
Mg (ME)
1
11.11
37.99
21.47

Analytical Re#ults
Southern Soil Builders
958 Hoots Road
Roaring River, NC 28669
Receive Date: 01/09/2017
Reported: 01 /30/2017
For: Baxter
Comments:
Sample Number Parameter Sample ID Result
170109-08-01
Corrosivity
170109-08-01
Ignitability
170109-08-01
Reactivity
170109-08-01
TCLP
Respectfully submitted,
Dena Myers
NC Cert #440,
NCDW Cert #37755,
EPA #NC00909
Baxter
See
Baxter
See
Baxter
See
Baxter
See
Unit Method Analyzed Analyst
SW-84s
1010M
sw-846
as Noted
01/27/2017 PACE
01/27/2017 PACE
01/27/2017 PACE
01/27/2017 PACE
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 1 of 1

aceAnalytrcal
www.pacelabacom
ANAL
Project: 170109-08
Pace Project No.; 92325878
RESULTS
Pace Analytical Services, LLC
9800 Kincey Ave, Suite 100
Huntersville, NC 28078
[phone]
Sample: 170109-08 Lab ID: 92325878001 Collected: 01/09/17 12:30 Received: 01/11/17 08:30 Matrix: Water
Parameters Results Units Rellort Limit DF Prepared Analyzed CAS No. Qual
8081 GCS Pesticides, TCLP
gamma-BHC (Lindane)
Chlordane (Technical)
Endrin
Heptachlor
Heptachlor epoxide
Methoxychlor
Toxaphene
Surrogates `
Decachlorobiphenyl (S)
Tetrachloro-m-xylene (S)
8082 'G CS PC8
PCB-1016 (Aroclor 1016)
PCB-1221 (Aroclor 1221)
PCB-1232 (Aroclor 1232)
PCB-1242 (Aroclor 1242)
PCB-1248 (Aroclor 1248)
PCB-1254 (Aroclor 1254)
PCB-1260 (Aroclor 1260)
Surrogates
Decachlorobiphenyl (S)
8151 Chlorinate Herbicide TCLP
2,4-D
2,4,5-TP (Silvex)
Surrogates
2,4-DCAA (S)
6010 MET ICP, TCLP
Arsenic
Barium
Cadmium
Chromium
Lead
Selenium
Silver
7470 Mercury, TCLP
Mercury
8270 MSSV TCLP Sep Funnel
1,4-Dichlorobenzene
Date: 01/27/2017 06:48 PM
Analytical Method: EPA8081 Prep,,
Leachate Method/Date: EPA 1311;
ND
ug/L
ND
ug/L
ND
ug/L
ND
ug/L
ND
ug/L
ND
ug/L
ND
ug/L
74 %
61 %
Analytical 'Method: -EPA 8082
ND
ug/L
ND
ug/L
ND
ug/L
ND
ug/L
ND
ug/L
ND
ug/L
ND
ug/L
25 %
Analytical Method: EPA 8151
ND mg/L
ND mg/L
92 %
Analytical Method: EPA6010 Preps
Leachate Method/Date: EPA 1311;
ND mg/L
ND mg/L
ND mg/L
ND mg/L
ND mg/L
ND mg/L
ND mg/L
Analytical Method: EPA7470 Preps
-Leachate Method/Date: EPA 1311•; f
ND mg/L
Analytical Method: EPA 8270 Preps
Leachate Method/Date: EPA 1311;
ND ug/L
REPORT OF LABC
This report shall not be
without the written consent a
ration Method: EPA3510
1/21117 14:00
2.5
5
01/23/17 13:11
01/26/17 04:24
58-89-9
, 15:0
5
01/23/17 13:11
01/26/17 04:24
57-74-9
2.5
5
01/23/17 13:11
01/26/17 04:24
72-20-8
2.5
5
01/23/17 13:11
01/26/17 04:24
76-44-8
2.5
5
01/23/17 13:11
01/26/17 04:24
1024-57-3
5000.
5
01/23/17 13:11
01/26/17 04:24
72-43-5
.15..0
5
01/23/17 13:11
01/26/17 04:24
8001-35-2
10-138 5 01/23/17 13:11 01/26/17 04:24 2051-24-3 D3
10-110 5 01/23/17 13:11 01/26/17 04:24 877-09-8
ation -Method: EPA 3510
1
01/13/17 08:48
01/14/17 02:36
12674-11-2
1.0
1
01/13/17 08:48
01/14/17 02:36
11104-28-2
1.0
1
01/13/17 08:48
01/14/17 02:36
11141-16-5
1.0
1
01/13/17 08:48
01/14/17 02:36
53469-21-9
1.0
1
01/13/17 08:48
01/14/17 02:36
12672-29-6
1.0
1
01/13/17 08:48
01/14/17 02:36
11097-69-1
1.0
1
01/13/17 08:48
01/14/17 02:36
11096-82-5
10-132 1 01/13/17 08:48 01/14/17 02:36 2051-24-3
ation Method: EPA3510
0.010 1 01/24/17 22:55 01/27/17 07:34 94-75-7 L3, MO
0.010 1 01/24/17 22:55 01/27/17 07:34 93-72-1
39-139 1 01/24/17 22:55 01/27/17 07:34 19719-28-9
ation Method: EPA3010A
/12/17 17:25 Initial pH: 6.9; Final pH: 6.9
0.050 1
01/13/1710:55
01114/1714:44
7440-38-2
0.25 1
01/13/1710:55
01/14/1714:44
7440-39-3
0.0050 1
01/13/1710:55
01/14/1714:44
7440-43-9
0.050 1
01/13/1710:55
01/14/1714:44
7440-47-3
0.025 1
01/13/1710:55
01/14/1714:44
7439-92-1
0.10 1
01/13/1710:55
01114/1714:44
7782-49-2
0.025 1
01/13/1710:55
01/14/1714:44
7440-22-4
ation Method: EPA7470
/12/17 17,25 -Initial
pH: 6.9; -Final -pH: 6.5
0.QO020 1
01/13/1712:35
01/16/1711:52
7439-97-6
ation Method: EPA3510
/21/17 14:00
50.0 1 01123/1711:00 01/23/1717:53 106-46-7
TORY ANALYSIS
educed, except in full,
RAnalytical Services, LLC.
Page 5 of 27

aceAnalytical
wmpacelabs.com
Project: 170109-08
Pace Project No.: 92325878
Sample: 170109-08
Parameters
8270 MSSV TCLP Sep Funnel
2,4-Dinitrotoluene
Hexachloro-1, 3-butadiene
Hexachlorobenzene
Hexachloroethane
2-Methylphenol(o-Cresol)
3&4-Methylphenol(m&p Cresol)
Nitrobenzene
Pentachlorophenol
Pyridine
2,4,5-Trichlorophenol
2,4,6-Trichlorophenol
Surrogates
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
Trichloroethene
ANAL
Lab ID: 92325878001
Results
Units Rel
Analytical Method:
EPA 8270 Prep,,
Leachate Method/Date: EPA 1311;
ND
ug/L
ND
ug/L
ND
ug/L
ND
ug/L
ND
ug/L
_ 106.
ug/L
ND
ug/L
ND
ug/L
ND
ug/L
ND
ug/L
ND
ug/L
59
%
80
%
94
%
28
%
39
%
113
%
Analytical Method:
EPA8260
ND
ug/L
ND
ug/L
ND
ug/L
ND
ug/L
ND
ug/L
ND
ug/L
J`I ND
ug/L
Q� ND
ug/L
ND
ug/L
Vinyl chloride
Surrogates
,
1,2-Dichloroethane-d4 (S)
Toluene-d8
S� yy
4=Bromofli%robenzene )
U
1010 Flash point,Closed -up
Flashpont
9044, H_
v
PH
\90 aiaint Filter Liquid Test 1
Free Ligt3i s
`\
Date: 01/27/2017 06:48 PM
ND ug/L
ND ug/L
98 %
106 %
98 %
Analytical Method: EPA 1010
>200 deg F
Analytical Method: EPA9040
6.7 Std. Units
Analytical Method: EPA 9095
FAIL
J
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
RESULTS
01/09/17 12:30 Received: 01/11/17 08:30 Matrix: Water
)ort Limit
DF
Prepared
Analyzed
CAS No.
iration Method: EPA3510
11/21/1714:00
50;0
1
01/23/1711:00
01/23/1717:53
121-14-2
60.0
1
01/23/1711:00
01/23/1717:53
87-68-3
50.0
1
01/23/1711:00
01/23/1717:53
118-74-1
50.0
1
01/23/1711:00
01/23/1717:53
67-72-1
50.0
1
01/23/1711:00
01/23/1717:53
95-48-7
50.0
1
01/23/1711:00
01/23/1717:53
50.0
1
01123/1711:00
01/23/1717:53
98-95-3
,100,
1
01/23/1711:00
01123/1717:53
87-86-5
50.0
1
01123/1711:00
01/23/1717:53
110-86-1
50.0
1
01/23/1711:00
01/23/1717:53
95-95-4
50.0
1
01/23/1711:00
01/23/1717:53
88-06-2
M1
12-102
1
01/23/1711:00
01/23/1717:53
4165-60-0
13-107
1
01/23/1711:00
01/23/1717:53
321-60-8
21-132
1
01/23/1711:00
01/23/1717:53
1718-51-0
10-110
1
01/23/1711:00
01/23/1717:63
13127-88-3
10-110
1
01/23/1711:00
01/23/1717:53
367-12-4
27-108
1
01/23/1711:00
01/23/1717:53
118-79-6 SO
ate Method/Date:
EPA 1311; 01/12/17 09:30
100,
20
01/24/17 16:05
71-43-2
200
20
01124/1716:05
78-93-3
.100.
20
01/24/1716:05
56-23-5
100
20
01/24/1716:05
108-90-7
100
20
01/24/1716:05
67-66-3
100
20
01/24/1716:05
106-46-7
100
20
01/24/1716:05
107-06-2
100
20
01/24/1716:05
75-35-4
100
20
01/24/1716:05
127-18-4
100
20
01/24/1716:05
79-01-6
100
20
01/24/1716:05
75-01-4
70-130 20
67-135 20
70-130 20
70.0 1
0.10 1
1.0 1
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
01 /24/17 16: 05 17060-07-0
01/24/1716:05 2037-26-5
01/24/1716:05 460-00-4
Qual
01/12/17 09:27
01/13/1715:09 �H6
01/17/1710:26
mil
6
Page 6 of 27

aceAnaIXieal
www.pacelabacam
ANAL
Project: 170109-08
Pace Project No.: 92325878
RESULTS
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Sample: 170109-08 Lab ID: 92325878001 Colle ed: 01/09/17 12:30 Received: 01/11/17 08:30 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Quaff
733C S Reactive Cyanide Analytical Method: EPA 9014 Pre aration Method: SW-846 7.3.3.2
Cyanide, Reactive ND mglkg 1.0 1 01/17/17 12:46 01/17/17 17:44
734S Reactive Sulfide Analytical' Method: SM4500S2F-0� Preparation Method: SW-846 7.3.4.2
Sulfide, Reactive ND mglkg 10 1 01/17/17 12:46 '01/17/1717:13
Date: 01/27/2017 06:48 PM
REPORT OF LAB RATORY ANALYSIS
This report shall not b reproduced,• except in full,
without the written consent of Pace Analytical Services, LLC.
Page 7 of 27

ANNUAL PATHOGEN AND VECTOR ATTRACTION REDUCTIONFORM (02T Rules)
Facility Name: Baxter Healthcare Corporation WQ Permit Number: WQ0031725
WWTP Name: Baxter Healthcare Corporation NPDES Number: NC0006564
Monitoring Period: From I/l/2017 To 12/31/2017
Pathogen Reduction (15A NCAC 02T .1106) - Please indicate level achieved and alternative performed:
Class A:
Alt. A (time/temp) (
All B (Alk -Treatment)
Alt. C (Prior Testing)[1
Alt.D (No Prlor'Fest) EJ
Process to Furtlier Redtice Pathooenas
If applicable to alternative performed (Class A only) indicate "Process to Further Reduce Pathogens":
Compost El
Ileat Dn_ling
Heat Treatment 11 4
Thennophilic
Beta Ray
Gamma Ray
Pasteurization L�
Class B:
lAlt. (1) Fecal Density
Ali. (2) Process to Significantly Reduce PathogensLl
If applicable to alternative performed (Class B only) uidicate "Process to Significantly Reduce Pathogens":
Lillie Stabilization
Air Drying 0
Compostin,T 13
Aerobic Digestion
Anaerobic Digestion
If applicable to alternative performed (Class A or Class B) complete the following monitoring data:
Parameter
Allowable Level
in Sludge
Pathogen Density
Number o
r\ece
del ce
Trequency
oi'Analysis
Sample
Type
Analytical
Tech
ni ue
MAnimurr,
Geo..Mean
N4axlmum
Units
Fecal Coliform
2 z 10 to the
6th power
Per gram of
total solids
MPN
1550
1755
1802
MPN/g
0
7
grab
sm9221
CPI.I
1000 Illpll per gralll
of total solid (dry
wveight)
Salmonella bacteria
(in lieu ol* fecal
colilorm)
3 MPN per 4 grails
total solid (dry
Nveiaht)
Vector Attraction Reduction (15A NCAC 02T .1107) -Please indicate alternative performed:
Alt.1 (VS reduction)
0
Alt. 2 (40-day bench)
Fj
Alt. 3 (30-day bencli) El
jAlt. 4 (Spec. 0, uptake)
Alt. 5 (14-Day Aerobic)
0
Alt. 6 (Alk. Stabilization
Alt 7 (Drying - Stable)
lAlt. 8 (Drying - Unstable)
L3
Alt. 9 (Injection)
J
Alt. 10 (Incorporation)
.No vector attraction reduction alternatives were performed
CERTIFICATION STATEMENT (please check the appropriate statement)
"I certify, under penalty of law, that the pathogen requirements in I SA NCAC 02T .1.106 and the
vector attraction reduction requirement in :15A NCAC 02T .1107 have been met."
tj "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 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."
SZEVoLta 6tArC, E(t S SI r*mjiGNnEaSC Dennis .Key Southern Sol] Builders, Inc.
Preparer Name and Title (type or print) Land Applier Name and Title (if applicable)(type or print)
Signature of Preparer* Date Signature of Land Applier (if applicable) Date
*Preparer is defined in 40 CFR Part 503.9(r) and 15A NCAC 2T .1102 (26)
DENR FORM PVRF 02T (12/2006)

Analytical R
Southern soil Builders
958 Hoots Road
Roaring River, NC 28669
Receive Date: 02/08/2017
Reported: 02/10/2017
For: Baxter
Comments: Geometric Mean <1755 MPN/g
Sample Number Parameter Sample ID Result
170208-08-01
Fecal Coliforms
1
<1786
170208-08-01
Percent Solids
1
11.2
170208-08-02
Fecal Coliforms
2
<1802
170208-08-02
Percent Solids
2
11.1
170208-08-03
Fecal Coliforms
3
<1802
170208-08-03
Percent Solids
3
11.1
170208-08-04
Fecal Coliforms
4
<1786
170208-08-04
Percent Solids
4
11.2
170208-08-05
Fecal Coliforms
5
<1786
170208-08-05
Percent Solids
5
11.2
170208-08-06
Fecal Coliforms
6
<155&,.
170208-08-06
Percent Solids
6
12.9
170208-08-07
Fecal Coliforms
7
<1786
170208-08-07
Percent Solids
7
11.2
Respectfully submitted,
Dena Myers
NC Cert #440,
NCDW Cert #37755,
EPA #NC00909
ults
Unit Method Analyzed Analyst
MPN/g
MPN/g
MPN/g
MPN/g
MPN/g
MPN/g
MPN/g
SM92210E-2006
SM2540B-1997
SM9221 CE-2006
SM2540B-1997
SM9221 CE-2006
SM2540B-1997
SM9221 CE-2006
SM2540B-1997
SM9221 CE-2006
SM2540B-1997
SM9221 CE-2006
SM2540B-1997
SM9221 CE-2006
SM25409-1997
02/09/2017 WC
02/09/2017 WC
02/09/2017 WC
02/09/2017 WC
02/09/2017 WC
02/09/2017 WC
02/09/2017 WC
02/09/2017 WC
02/09/2017 WC
02/09/2017 WC
02/09/2017 WC
02/09/2017 WC
02/09/2017 WC
02/09/2017 WC
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 1 of 4

.I
Condition of
eceipt
Sample Number 170208-08-01
Temp on Arrival: 3
Parameter
chedule:
Percent Solids
Received on Ice
Parameter
chedule:
Fecal Coliforms
Sodium Thiosulfate
Received on Ice
Sample Number 170208-08-02
Temp on Arrival: 3
Parameter
chedule:
Percent Solids
Received on Ice
Parameter
chedule:
Fecal Coliforms
Sodium Thiosulfate
Received on Ice
Sample Number 170208-08-03
Temp on Arrival: 3
Parameter
chedule:
Percent Solids
Received on Ice
Parameter
I
chedule:
Fecal Coliforms
Sodium Thiosulfate
Received on Ice
Sample Number 170208-08-04
Temp on Arrival: 3
Parameter
chedule:
Percent Solids
Received on Ice
Parameter
chedule:
Fecal Coliforms
Sodium Thiosulfate
Received on Ice
Sample Number 170208-08-05
Temp on Arrival: 3
Parameter
chedule:
Percent Solids
Received on Ice
Parameter
chedule:
Fecal Coliforms
Sodium Thiosulfate
Received on Ice
Sample Number 170208-08-06
Temp on Arrival: 3
PO Box 228 • Statesville, NC 28687 • 704/8
Page
72/4697
?of 4

S
Parameter
Parameter
Sodium Thiosulfate
mber 170208-08-07 Temp on Arrival: 3
Parameter
Parameter
Sodium Thiosulfate
le: Percent Solids
Received on Ice
edule: Fecal Coliforms
Received on Ice
le: Percent Solids
Received on Ice
le: Fecal Coliforms
Received on Ice
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 3 of 4

Client:
-Ild r L
STATESVILLE ANALYTICAL
122 Court Street • P.O. Box 228
Statesville, NC 28687
[phone]
Address: s $ t v �; �_ J
1 !� q
Q
i�Ats .-
Contact Person: L
Phone # 33C'
FAX" 33G _ Q 57 _ 95 y o
Chain of
Custody Record
PO # Requisitioned by: (Time Data)
Customer
Sample IDn
i a"D B
one Sampled
(GrabOnty)
Dale Sampled
(Grab Only)
¢
c�
s
Matrlx
w
ww
Parameters requested for analysis
U2
7`
k
0
CMG
>1
1`
Relinquished by:
Received by: I
Relinquished by:
Received by:
Composite Samplings #9:
Time begin am, pm Date —J_J
Time end am, pm Date _/�_
Composite Sampling #2:
Time begin am, pm Date / /
Time end am, pm Date
Time : G am,Date og l d-9
Time : (00 am(r Date � I � Y �
Time am, pm Date _0 !
Time am, pm Date _I I
Lab Comments:
Sampled by: k�
Transported by. � K 4)
Holding times met:
Compliance work:
Non-compliance work:
n
00
tD
tb
N
v
z
ai
CU
to

Analytical Re�ults
Southern Soil Builders
958 Hoots Road
Roaring River, NC 28669
Receive Date: 01/09/2017
Reported; 01/10/2017
For:
Comments:
Sample Number Parameter sample ID Result
170109-09-01
% Volatile Solids
Baxter A
0.24
170109-09-01
Percent Solids
Baxter A
0.39
170109-09-02
% Volatile Solids
Baxter B
0.69
170109-09-02
Percent Solids
Baxter B
1.68
Respectfully submitted,
Dena Myers
NC Cert #440,
NCDW Cert #37755,
EPA #NC00909
Unit Method Analyzed Analyst
ova SM254OG
01/09/2017
MD
SM254OB-1997
01/09/2017
MID
SM2540G
01/09/2017
MD
SM254OB-1997
01/09/2017
MD
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 1 of 2

VS in 0.0069
VS out 0.0024
VSFR= 0.653743
VSFR=
,0()()
(0.0069-0.0024)/(0.0069-(0.0069*0
r
i �, 5-(:7"
24))
31 `1

Condition of Receipt
le Number 170109-09-01 Temp on Arrival: 3
Parameter chedule: Percent Solids
I Received on Ice
Parameter Schedule:
Received on Ice
Sample Number 170109-09-02 Temp on Arrival: 3
Parameter chedule:
I Received on Ice
Parameter chedule: Percent Solids
Received on Ice
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 2 of 2

Client:
cJ'�}.ar tN � �;
,�.,,Ic�N�j T��
r;
_
STATESVILLE ANALYTICAL
122 Court Street P.O. Box 228
Statesville, NC 28687
[phone]
Address: C dj g
S �� ci `� f ndi
q
Contact Person:
l
Phone # ; 3r - j S) .7 •-�j
FAX#
Chain of
Custody Record
PO # Requisitioned by: (Time
Date)
Customer
Sample ID#
Lab -ID #
Time Sampled
(Grab Only)
Date Sampled
(Grab Only)
a
0
a
�
Matrix
Parameters requested for analysis
4 y
swaeB
w
ww
Relinquished by:
Received by:
Y
Relinquished by:
Received by:
Composite Sampling
Time begin
Time end
Composite Samplings
Time begin
Time end
#1:
am, pm
am, pm
#2:
am, pm
am, pm
Date / /
Date / /
Date
Date _/ /
Time - �� amJprt)' Date �/ C� /� Sampled by:
l _ Time . am,Qate i / /
iTransported by: Z Y e e:�:
Time am, pm Date _/ / Holding times met: ./
Time am, pm Date _/ Compliance work:
Non-compliance work:
Lab Comments:

Analytical Re�ults 1z—MWI
Southern Soil Builders
958 Hoots Road
Roaring River, NC 28669
r
Receive Date: 02/08/2017
Reported: 02/10/2017
For: Baxter
Comments: Geometric Mean <1755 MPN/g
Sample Number Parameter Sample ID Result
170208-08-01
Fecal Coliforms
1
<1786
170208-08-01
Percent Solids
1
11.2
170208-08-02
Fecal Coliforms
2
<1802
170208-08-02
Percent Solids
2
11.1
170208-08-03
Fecal Coliforms
3
<1802'�
170208-08-03
Percent Solids
3
11.1
170208-08-04
Fecal Coliforms
4
<1786
170208-08-04
Percent Solids
4
11.2
170208-08-05
Fecal Coliforms
5
<1786
170208-08-05
Percent Solids
5
11.2
170208-08-06
Fecal Coliforms
6
<1550 N
170208-08-06
Percent Solids
6
12.9
170208-08-07
Fecal Coliforms
7
<1786
170208-08-07
Percent Solids
7
11.2
Respectfully submitted,
hnP' -ma, J�' X/"" l
Dena Myers
NC Cert #440,
NCDW Cert #37755,
EPA #NC00909
Unit Method Analyzed Analyst
MPN/g
MPN/g
MPN/g
MPN/g
MPN/g
MPN/g
MPN/g
SM9221 CE-2006
SM254OB-1997
SM9221 CE-2006
SM254OB-1997
SM9221 CE-2006
SM254OB-1997
SM92210E-2006
SM254OB-1997
SM92210E-2006
SM254OB-1997
SM9221 CE-2006
SM254OB-1997
SM92210E-2006
SM2540B-1997
02/09/2017 WC
02/09/2017 WC
02/09/2017 WC
02/09/2017 WC
02/09/2017 WC
02/09/2017 WC
02/09/2017 WC
02/09/2017 WC
02/09/2017 WC
02/09/2017 WC
02/09/2017 WC
02/09/2017 WC
02/09/2017 WC
02/09/2017 WC
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 1 of 4

Condition of Receipt
Sample Number 170208-08-01
Temp on Arrival: 3
Parameter S
hedule:
Percent Solids
Received on Ice
Parameter S
hedule:
Fecal Coliforms
Sodium Thiosulfate
Received on Ice
Sample Number 170208-08-02
Temp on Arrival: 3
Parameter Schedule:
Percent Solids
Received on Ice
Parameter Schedule:
Fecal Coliforms
Sodium Thiosulfate
Received on Ice
Sample Number 170208-08-03
Temp on Arrival: 3
Parameter Schedule:
Percent Solids
Received on Ice
Parameter Schedule:
Fecal Coliforms
Sodium Thiosulfate
Received on Ice
Sample Number 170208-08-04
Temp on Arrival: 3
Parameter Schedule:
Percent Solids
Received on Ice
Parameter
chedule:
Fecal Coliforms
Sodium Thiosulfate
Received on Ice
Sample Number 170208-08-05
Temp on Arrival: 3
Parameter Schedule:
Percent Solids
Received on Ice
ParameterSchedule:
Fecal Coliforms
Sodium Thiosulfate
Received on Ice
Sample Number 170208-08-06
Temp on Arrival: 3
PO Box 228 • Statesville, NC 28687 • 704/8
Page'.
72/4697
>_of4

Parameter
Parameter
Sodium Thiosulfate
Number 170208-08-07 Temp on Arrival: 3
Parameter
Parameter
Sodium Thiosulfate
Percent Solids
Received on Ice
Fecal Coliforms
Received on Ice
Percent Solids
Received on Ice
le: Fecal Coliforms
Received on Ice
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 3 of 4

Client: C
C ,
STATESVILLEAN.IMICAL
122 Csurt Sttext P.O. Box 226
Statesville, NC 28687
[phone]
Address: Q S g J 1 S�
1 /� u T
R.L- �e. ��. a�f��t
Contact Person.
pC #
Phone 0 33c - 9
Requisitioned by:
3 ,7'1)811
FAX# 93 � - 9 $1- 5 y y p
(Time vets)
Chain Of
Custody Record
customer
Sample 100
Lab 10
ime Sampled
(Grab Only)
Date Sampled
(Grab Only)
sg.
Matrix
w
ww
Parameters requested far analysis
�
!J
0-5
07
I
Relinquished by. � `
Received by
Relinquished by:
Received by:
Composite Sampling 91:
Time begin am, pm Date _I—!
Time end am, pm Date _ 1_I_
Composite Sampling #2•
Time begin am, pm Date
Time end am, pm Date
Time J +rJ am, Date O� 1 1�
Time ©� am prr Date $
Time am, pm Date s/ /
Time am, pm Date _/ !
Lab comments:
Sampled by: k�
Transported by: Z l'�.a,
Holding times met:�-�
Compliance work:
Non-compllance work:
n
00
00
N
U
z
ai
Ln
N
41
V)
to
00
N
N
X
0
ca

NCDA&CS Agronomic Division Phone: [phone] Website: www.ncagr.gov/agronomi/
Report No. FY18-SL007023
Predictive Client:
Doug Poplin
Advisor:
Zach Key
�AG��CULTURRµQ
ae�� �ZNc
594 Austin Little Mtn Rd
Southern Soil Builders, Inc.
Soil Report Mehlich-3 Extraction
Ronda, NC 28670
958 Hoots Rd
Wp A
Roaring River, NC 28669
•Fomr��. �� Links to Helpful Information Sampled: 09/28/2017
Sampled County :Wilkes
Received: 10/02/2017
Farm: Not Provided Completed: 10/11/2017
Client ID: 160157
Advisor ID: 400594
Sample ID: DP1A
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tons/acre) N P205
K20 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-
Test Results [units - WN in g/cO; CEC and Na in meq/100 cO; NO3-N in mg/do]:
Soil Class:
Mineral
HM% WN CEC BS% Ac pH P-1 K4 Ca% Mg%
S4 Mn-I Mn-All Mn-Al2
Zn-I
Zn-AI
Cu-I Na ESP SS-1 NO3-N
0.56 0.88 19.3 90 2.0 6.2 / 536 423 56 23
58 139 97
802v
802
1768 0.2 1 V
Sample ID: DP1B V
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tons/acre) N P205
K20 Mg S
Mn
Zn
Cu B
Information
Lime History:
1-Fescue/OGrass/Tim, M 0.0 120-200 0
0 0 0
pH$
0
0 0
Note: 12 Note: $
2-
Test Results [units - W/V in g/cm3; CEC and Na in meq/100 crrr3; NO3-N in mg/dO]:
Soil Class:
Mineral
HM% W/V CEC BS% Ac H P-I K_I Ca% Mg%
SJ Mn J Mn AL1—Mn-AI2
Zn-�Zfr
^•,.:-6'�;�aE&P—SS-1—N
0.41 0.93 14.3 92 1.1 6.6 t/ 238 222 59 26
52 123 81
747x,'/
747
966/ 0.2 1/ 1 1%
Sample lD: DP1C
Recommendations: 'Lime
Nutrients'(Ib/acre)
More
Crop (tons/acre) N P205
K20 Mg S
Mn
Zn
Cu B
Information
Lime History:
1-Fescue/OGrass/Tim, M 0.5 120-200 0.
0 0 0
0
0
0 0
Note: 12
2-
Test Results [units - W/V in g/carp; CEC and Na in meq/100 co; NO3-N in mgfdo]:
Soil Class:
Mineral
HM% W/V CEC BS% Ac H P-1 K4 Ca% Mg%
S-1 Mn-I Mn-All MnAI2
Zn-1 J
Zn-AI
Cu-1 Na ,ESP SS4 NO3-N
✓ /.
�/
0.51 0.94 14.0 85 2.1 5.8 281 201 56 22
60 247 165
1256
1256
1278 0.2 1 V
North Carolina
Tobacco Trust Fund Commission
Reprogramming of the laboratory -information -management system that makes this report possible is
being funded through a grant 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: www.ncagr.gov/agronomi/
Report No. FY18-SL007023
Doug Poplin
Page 2 of 4
Sample ID: DP1 D V
Recommendations: Lime
Nutrients (lb/acre)
Crop (tons/acre)
N P205
K20
Mg S Mn Zn
Cu B
More
Information
Lime History:
1-Fescue/OGrass/Tim, M 0.0
120-200 0
0
0 0 0 0
0
2-
0
Note: 12
Test Results [units - W/V in g/cO; CEC and Na in meq/100 crrP; NO3-N in mg/dm3]:
Soil Class: Mineral
HM% WN CEC
BS% Ac pH J P-1 K4
V
Ca% Mg% S-1
Mn-1
Mn-All Mn-Al2 Zn-I Zn-AI
Cu-I Na
ESP SS-1 NO3-N
0.56 0.94 13.7
87 1.8 6.1 361 139
60 21 72
170
118 1224 1224
1574 0.2
1 ��
Sample ID: DP2
Recommendations: Lime
Nutrients (lb/acre)
Crop (tons/acre)
N P205
K20
Mg S Mn Zn
Cu B
More
Information
Lime History:
1- Fescue/OGrassMm, M 1.7
120-200 0
20
0 0 0 0
0
0
Note: 12
2-
Test Results [units - WN in g/cO; CEC and Na in meq/100 crn3; NO3-N in mg/dO]:
Soil Class: Mineral
HM% WN CEC
BS% Ac pH P-1 K4
Ca% Mg% S-1
Mn-I
Mn-All Mn-AI2 Zn-I Zn-AI
Cu-I Na
ESP SS-1 NO3-N
0.66 1.00 7.7
64 2.8 5.1 185 67
44 15 101
113
85 320 320
785 o.2
3
Sample ID: DP3C V
Recommendations: Lime
Nutrients (lb/acre)
Crop (tons/acre)
N P205
K20
Mg S Mn Zn
Cu B
More
Information
Lime History:
1 -Corn, silage 1.5
180-220 0
20
0 0 0 0
0
2-
0
Note: 3
-Iest Results Lunits - VY7V
in g c ; CSC and NNa� in meq/100 c ; NO3-N in mg/dO]:
Soil Class: Mineral
HM% WN CEC
BS% Ac / pH \ �� P-1 K4
Ca% Mg% S-1
Mn-I
Mn All Mn AI2 Zn-I / Zn-AI
Cu-I Na
ESP SS-1 NO3-N
0.51 0.97 7.9
67 2.6 5.2 ,�,� 266 99
39 22 162
101
78 414 ✓ 414
410V 0.3
4
Sample ID: DP3G v
Recommendati . Lime
Nutrients (lb/acre)
Crop (tons/acre)
N P205
K20
Mg S Mn Zn
Cu B
More
Information
Lime History:
1-Fescue/OGrass/Tim, M 0.3
120-200 0
70
0 0 0 0
0
2-
0
Note: 12
Test Results [units - WN
in g/cnil; CEC and N�a in meq/100 crrr3; NO3-N in mg/dO]:
Soil Class: Mineral
%
HM% WN CEC
BS% Ac (pH P-1 K-1
Ca% Mg% S-1
Mn-I
Mn-All Mn-Al2 Zn-I Zn-AI
Cu-1 Na
ESP SS-1 NO3-N
0.51 0.96 9.9
81 1.8 1 5.9 95 36
53 97 as
a7
7rZ
J - - GUJ U.L L V
V

NCDA&CS Agronomic Division Phone: [phone]
Website: www.ncagr.gov/agronorni/
Report No. FY18-SL007023
Doug Poplin
Page 3 of 4
Sample ID: DP4 V
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tons/acre)
N P205
K20
Mg S
Mn Zn
Cu
B
Information
Lime History:
1-Fescue/OGrass/Tim, M 1.1
120-200 0
30
0 0
0 0
0
0
Note: 12
2-
Test Results [units - WN in
g/crrP; CEC and Na'in m1eq/100 cO; NO3-N in mg/drr$]:
Soil Class:
Mineral
HM% WN CEC BS% Ac pH y P-1 K-1
i
Ca% Mg% S-1
Mn-I
Mn-All Mn Al2
Zn-I -Al
Cu-I✓
Na ESP SS-1 NO3-N
0.86 0.90 11.7,
76 2.8 5.6 .� 173 55
48 26 70
127
93
1208 1208
845
0.2
2 V
Sample ID: DP5 V
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tons/acre)
N P205
K20
Mg S
Mn Zn
Cu
B
Information
Lime History:
1-Fescue/OGrass/Tim, M 0.0
120-200 0
0
0 0
pH$ 0
0
0
Note: 12 Note:
2-
Test Results [units - WN in
9/cm3; CEC and Na in meq/100 crrp; NO3-N in mg/drrr?]:
Soil Class:
Mineral
HM% WN CEC BS% Ac pH V P-1 K4
Ca% Mg% S-1
Mn-I
Mn-All MnAl2
Zn-I / Zn-AI
Cu-I�
Na ESP SS-1 NO3-N
0.60 0.94 12..
92 1.0 6.5 84 125
57 30 60
122
82
774 v 774
603
0.2 V
2
Sample ID: DP6 V
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tons/acre)
N P205
K20
Mg S
Mn Zn
Cu
B
Information
Lime History:
1-Fescue/OGrass/Tim, M 0.0
120-200 0
60
0 0
0 0
0
0
Note: 12
2-
Its-(units — WNin-gtcm";
CEC anfi a in meq cffP; NO3-N
in mg
Soil Class:
Mineral
HM% WN CEC BS% Ac pH ,. / P-1 K4
Ca% Mg% S-1
Mn-1
Mn-All Mn-Al2
Zn-I Zn-AI
Cu-I
Na ESP SS-1 NO3-N
0.46 •0.97 12.2
85 1.8 6.0 133 40
60 23 54
116
87
988 988
889
0.2 v 2 V1
Sample ID: DP7 V
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tons/acre)
N P205
K20
Mg S
Mn Zn
Cu
B
Information
Lime History:
1-Fescue/OGrass/Tim, M 0.6
120-200 0
0
0 0
0 0
0
0
Note: 12
2-
Test Results [units - WN in g/crrr3; CEC and Na in meq/100 cm3; NO3-N in mg/dO]:
Soil Class:
Mineral
HM% WN CEC BS%
Ac pH P-1 K-I
Ca% Mg% S4
Mn-I
Mn-All Mn AI2
Zn-I /Zn-AI
Cu-IL/
Na iESP SS-1 NO3-N
0.51 0.94 10.4 82 1.9 5.7 23 110
55 21 58
91
72
554 ✓ 554
1014
0.2 ✓ 2 i%
v