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WQ0002349_Annual Report_20060222
a A s F E B 2 2 2006 TOWN OF SPRUCE PINE, NC Ys 2005 ANNUAL REPORT LAND APPLICATION PROGRAM NC PERMIT NO. WQ0002349 RECEIVED FEB 24 2006 Asheville Regional Office OpRoDEB cTiON SECTION 22006 q ANNUAL LAND APPLICATION CERTIFICATION FORM Pe; mit#: WQ0002349 County: Michell Year: 2005 Facility Name (as shown on permit): Town of Spruce Pine Land Application Operator: Southern Soil Builders, Inc. Phone: 336-957-890 Land application of residual solids as allowed by the permit occurred during the past calender year? El Yes ❑ No If No, skip Part A, and Part B and proceed to the certification. Also, if residuals were generated but not land applied, please attach an explanation on how the residuals were handled. Part A: Total number of application fields in permit: 7 Total number of fields land application occurred during the year: 4 Total amount of dry tons applied during the year for all application sites: 51.9 Total number of acres land application occurred during the year: 29.8 Part B: Facility was compliant during calendar year 2005 with all conditions of the land application permit (including but not limited to items 1-12 below) issued by the Division of Water Quality. P Yes ❑ No If no please, provide a written description why the facility was not compliant, the dates, and explain corrective action taken. l . Only residuals approved for this permit were applied to the permitted sites. 2. Soil pH was adjusted as specified in the permit and lime was applied (if needed) to achieve a soil pH of at least 6.0 or the limit specified in the permit. 3. Annual soils analysis were performed on each site receiving residuals during the past calendar year and three (3) copies of laboratory results are attached. 4. Annual TCLP analysis was performed and three (3) copies of certified laboratory results are attached. 5. All other monitoring was performed in accordance with the permit and reported during the year as required and three (3) copies of certified laboratory results are attached. 6. The facility did not exceed any of the Pollutant Concentration Limits in Table 1 of 40 CFR Part 503.13 or the Pollutant Loading Rates in Table 2 of 40 CFR part 503.13 (applicable to 40 CFR Part 503 regulated facilities). 7. All general requirements in 40 CFR Part 503.12 and management practices in 40 CFR Part 503.14 were complied with (applicable to 40 CFR Part 503 regulated facilities). 8. 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 Quality. 9. No contravention of Ground Water Quality Standards occurred at a monitoring well or explanations of violations are attached to include appropriate actions and remediations. 10. Vegetative cover as specified in the permit was maintained on this site and the crops grown were removed in accordance with the crop management plan, 1 1. No runoff of residuals from the application sites onto adjacent property or nearby surface waters has occurred. 12. All buffer requirements as specified on the permit were maintained during each application of residuals. "1 certify, under penalty of law, that the above information is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowin2 violations." AO CAA. e- low /�gw'kt 2 Permittee Name and Title (type or print) Signature of Permittee to Signature of Preparer* Date Signature of Land A plier Date (if different from Permittee) (if different from Permittee and Preparer) Preparer is defined in 40 CFR Part 503.9 (r) DENR FORM ACF (5/2003) ." ANNUAL RESIDUAL SAMPLING SUMMARY FORM Attach this form to the corresponding Annual Report Please note that your permit may contain additional parameters to be analyzed than those required to be summarized on this form. Permit Number: WQ0002349 Laboratory: I.) A&L Eastern Laboratories, Inc Facility Name: Town of Spruce Pine 2) 3) NPDES # or NC0021423 WQ#: 4) WWTP Name: Town of Spruce Pine WWTP 5) Residual Anal sis Data Sample or 10-31-05 Composite Date Percent Solids 2.02 Arsenic 2.2 Cadmium 1.6 Chromium NA Copper 438 �d ;v 'Lead 36 9 Mercu 2.05 Molybdenum 7 y Nickel 24 Selenium 5.01 Zinc 644 v Total Phos horns 22000 TKN 48500 Ammonia-Nitrqen 1500 V Nitrate and NiND with a system "I certify, under penalty of law, that this document was prepared under my a1recuu.1 v, '3uj,.,...--• designed to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." Date Signature of Preparer DENR FORM RSSF (5/2003) ANNUAL METALS FIELD LOADOU JUMMAKY VU1tM-- Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report Facility Name: Permit #: Operator: Acres Used: Town of spruce Pine Total Dry Tons Applied (Annual): WQ0002349 Cation Exchange Capacity (non 503 only): Thomas Phillips Owner: Thomas Phillips 14 Acres Permitted: 14 Site #: P-01 Field #: 11.144 P-01 A>>_+a lT _na Mntale and Tntal Phnsnhnrnc nce mo/ko- % Solids use Raw Percent #): Sample or Com- posite Date 1 10/31/05 2 j 3 4 5 6 7 8 9 10 11 12 Solids 2.02 Arsenic 2.2 Cadrr:iiurn 1.6 Chromium 0 Copper 438 Lead 36 Mercury 2.05 Molyb- 7 Nickel 24 Selenium 5.01 Zinc 644 Total Phos horus 22000 Annual Nnaw Matal uipitt 1 .nnainue f1 'nirnmten In Ins/acrel: moll • way M. Total '• 1� 1 1 1 1 1 1 1 1 1 1 .• "I certify, under penalty of law, that tills document was prepareu unuer my uirecuuu ur supervimuu L11 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" 1..,.wt,. ��Gy7 % •y o Signature of Land plier Date ' See bottom of FSF Form for helpful instructions for this MFLSF Form and the mathematically linked FSF Form DENR FORM MFLSF (512003) ANNUAL LAND APPLICATION FIELD SUMMARY FORM PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH APPLICATION FIELD. PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE. Facility Name: Town of Spruce Pine Permit #: WQ0002349 Annual Dry Tons Applied: 11.144 Owner: Thomas Phillips Operator: Thomas Phillipa Cation Exchange Capacity (non 503): Site #: P-01 Field #: P-01 Acres Utilized: 14 Acres Permitted: Must Select Crop 1 or Crop 2 o 1 um. a Cu.Yd. QReport Totals in Gal. 10-05 77,500 11-05 55000 Totals % I Dry Tons Per Solids Acre Acre TOTALS: 1 94641.. Annual lbs/acre Current Cumulative lbs/a Prior Years Cumulative lbs/ac Permitted C P L R *** — Inches Appli- Residual Cond. Precip. cation Sources 'Past 24 Meth - (Summarize) Wet, Hrs. od* Voli- Miner- Ammo- Ni- tila- ala- TKN ma- trate PAN 1 PAN 2 zation zation Ni- and Rate** Rate trogen Nitrite 14 Crop 1 I Crop 21 * 0.466295357 0.330911286 �00000�00 Permit PAN Limit 1 st/2nd Crop 250 "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." % a 'Y - 12- ° 1�1_ *Application Method: S - Surface, IN - Injection, INC - Incorporation Signature, and Applier Date **Volitilization Rate: Surface- O.S. Iniection/Incorporation - 1.0 ***C.P.L.R.: Cumulative Pollutant Loading Rate **** The RSSF Data and the Dry Tons Per Acre are to be entered on the MFLSF Form. The FSF and MFLSF are mathematically linked so this information needs to be entered into the same numbered column on the MFLSF as is entered on the identically numbered FSF row to properly complete the metals equations. ie. FSF row ## 1 to MFLSF DENR FORM FSF (5/2003) ANNUAL METALS FIELD LUAIRINU JU1vLvlAni rvlvvl Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report Facility Name: Town of Spruce Pine Total Dry Tons Applied (Annual): 19.79 Permit #: WQ0002349 Cation Exchange Capacity (non 503 only): Operator: Penland -Bailey Co Inc. Owner: Penland -Bailey Co nic. Acres Used: 7.8 Acres Permitted: 7.8 Site #: SP-01A Field #: SP-01A irT_ __-- 1•R_1-1.. ,.tea 9r i.—1 Dhna hnr.aa tic a ma/ka- 0/a Solids use Raw Percent #): nesluum Sample t&llmybla -1j Lata 2 �uVnVJ 3 _4j 5 Jj 7 8 9 10 11 12 or Com- posite Date 10/31/05 % Solids 2.02 Arsenic 2.2 Cadrriurri 1.6 Chromium 0 Copper 438 Lead 1 36 Mercury 2.05 Molyb- denum 7 Nickel 24 Selenium 5.01 Zinc 644 Total Phos- 22000 horus lit ,.��Il00000000aoo� • ., 1 1 1 1 1 1 1 1 1 1 1 R "I certity, under penalty of law, teat tuts uuum-couL vyaa Na-P--w ...,.,.. ...j - -- -- - 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" - -)- U �^ Si attire of Land pplier Date * See bottom of FSF Form for helpful instructions for this MFLSF Form and the mathematically linked FSF Form DENR FORM MFLSF (5/2003) ANNUAL LAND APPLICATION FIELD SUMMARY FORM PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH APPLICATION FIELD. PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE. Facility Name: Town of Spruce Pine Permit #: WQ0002349 Annual Dry Tons Applied: 19.79 )wner: Penland -Bailey Co Inc Operator: Penland -Bailey Co Inc Cation Exchange Capacity (non 503): Field #: SP-01A Acres Utilized: 7.8 Acres Permitted: 7.8 SP-0lA - ite ft: Inches Appli- Voli- Miner- t e o Totals % Dry Tons Per Residual Cond. Precip. cation tila- ala- TKN 0 oPer F Solids Acre Sources Summarize (Summarize) �y et Wet, Past 24 Meth- zation zation a Acre Hrs. od* Rate** Rate 4-05 5-05 6-05 7-05 8-05 9-05 10,000 75000 25000 20000 30000 75000 TOTALS: Annual lbs/acre 1282.1 9615.4 3205.1 2564.1 3946.2 9615.4 0 0 0 0 0 0 30128 2.02 2.02 2.02 2.02 2.02 2.02 Current Cumulative lbs/ac Prior Years Cumulative lbs/ac WWTP dry 0 s 0.5 30% 48500 WWT-p �y 0 s 0.5 30% 48500 s 0.5 30% 48500 WWTP dry 0 s 0.5 30% 48500 WWT-P dry 0 s 30% 48500 WWP dry 0 s !0.5 .5 30% 48500 WWTP dry 0 Ammo- Ni- nia- trate Ni- and trogen Nitrite 1500 0 1500 0 1500 0 1500 0 1500 0 1500 0 Cr Cu Pb I HR Mo I Ni Se Zn 0 2.19 0.18 0.01025 0.035 0.12 0.02505 3.22 0 90.6105 68.0501 0.38425 0.34296 3.34376 0.22358 98.3534 0 88.4205 67.8701 0.374 0.30796 3.22376 0.19853 95.1334 Permitted C. P. L. R.*** 36 34 NA 1338 267 15 NA 374 89 2498 250 / S Permit PAN Limit 1 st/2nd Crop "I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." *Application Method: S - Surface, IN - Injection, INC - Incorporation -Land Appher Date **Yolitilization Rate: Surface - 0.5. Iniection/Incorporation - 1.0 Signature o ***C.P.L.R.: Cumulative Pollutant Loading Rate 0.107992308 0.809942308 0.269980769 0.215984615 0.323976923 0.809942308 0 0 0 0 0 0 As 0.1203076 0.1093076 Cd 0.008 0.08135 0.07335 P 110 PAN 1 3.20737 PAN 2 ####### Must Select Crop 1 or Crop 2 Crop 1 Fescue Crop 2 1 24.0553 ####### Fescue 2 8.01843 ####### Fescue 3 6.41474 ####### Fescue 4 9.62211 ####### Fescue 5 24.0553 ####### Fescue E 0 0 0 0 i 0 0 0 0 1 0 0 1 0 PAN 1 75.3732 0 PAN 2 0 ILime Applied Date 1 I Ibs/ac **** The RSSF Data and the Dry Tons Per Acre are to be entered on the MFLSF Form. The FSF and MFLSF are mathematically linked so this information needs to be entered bered FSF row to properly complete the metals equations. ie. FSF row # 1 to MFLSF into the same numbered column on the MFLSF as is entered on the identicall} num DENR FORM FSF (5/2003) ANINUAL MLIALJ 111hL1J LVtIJJIINkj aUlvllvuini FUL'U" Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report Facility Name: Permit #: Operator: Acres Used: Town of Spruce Pine Total Dry Tons Applied (Annual): WQ0002349 Cation Exchange Capacity (non 503 only): Unimin Co. Owner: Penland Bailey Co 3.5 Acres Permitted: 3.5 Site #: U-0I Field #: 2.31 U-01 n _: J__ 1 A i -i- luo. —, Mn+ola on.i Tn+41 Phnenhnrns imp malka- % Solids use Raw Percent #): Sample or Com- posite Date 1 1 10/31/05 2 3 _4j 5 j _6j 7 8 _gj Loj Llj 12 % Solids 2.02 Arsenic 2.2 Cadmium 1.6 Chromium 0 Copper 438 Lead 36 Mercury 2.05 Molyb- denum 7 Nickel 24 Selenium 5.01 Zinc 644 Total Phos- horns 22000 ME . . MEN !TWW W MEMO— • MEN "I certify, under penalty of law, tnat tnls aocument was preparcu uuuci «<y tell q"«Uu V, aup�l via,.,- -u 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 Adprier Date * See bottom of FSF Form for helpful instructions for this MFLSF Form and the mathematically linked FSF Form DF_NR FORM MFLSF (5/2003) ANNUAL LAND APPLICATION FIELD SUMMARY FORM PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH APPLICATION FIELD. PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE. Facility Name: Town of Spruce Pine Permit #: W00002349 Annual Dry Tons Applied: 2.31 )wner: Penland Bailey Co Operator: Unimin Co. Cation Exchange Capacity (non 503): ite #: U-01 Field #: U-0I Acres Utilized: 3.5 Acres Permitted: 3.5 o Gal. Totals Per Solid Cu. Yd. Report Totals Acre in Gal. 5-05 27,500 7857.1 2.02 0 0 0 0 0 0 0 0 0 0 0 OTALS: 1 7857 annual Ibs/acre :urrent Cumulative lbs/ac 'rior Years Cumulative lbs/ac Dry Tons Per Residual Sources Acre (Summarize) t e ConDry, ry', Wet, Inches Precip. Past 24 11rs Appli- cation Meth- od* Voli- tila- zation Rate** Miner- ala- zation Rate TKN Ammo- ma- Ni- trogen Ni- trate and Nitrite PAN 1 PAN 2 Must Select Crop 1 or Crop 2 Crop 1 Crop 2 dry 0 s 0.5 30% 22000 1500 0 9.13337 0 ####### 0 Fescue i 2 0 0 3 0 0 4 .0 0 5 0 0 E 0 0 0 0 F 0 0 0 0 1 0 0 1 Cu 0.57816 0.04752271 Pbr0.21871 Mo 0.00924 Ni 0.03168 Se 0.00661 Zn 0.85008 P 29.04 0 PAN 1 9.13337 0 PAN 2 0 Lime Applied Date 1 lbs/ac 20.0282 2.07752 0.34714 1.17868 0.17561 36.2129 19.45 2.03 16 0.3379 1.147 0.169 35.3628 2498 'ermitted C. P. L. R.*** 36 34 NA 1 1339 267 15 NA 374 89 256 'ermit PAN Limit 1 st/2nd Crop `I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system lesigned 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." % h� �/ *Application Method: S - Surface, IN - Injection, INC - Incorporation Signature and Applier Date **Volitilization Rate: Surface - 0.5, Iniection/Incorvoration - 1.0 ***C.P.L.R.: Cumulative Pollutant Loading Rate k*** The RSSF Data and the Dry Tons per Acre are to be entered on the MFLSF Form. The FSF and MFLSF are mathematically linked so this information needs to be entered into the same numbered column on the MFLSF as is entered on the identically numbered FSFrow to properly complete the metals equations. ie. FSF row # 1 to MFLSF DENR FORM FSF (5/2003) ANNUAL METALS HELD WaVIivu 3u1Vl1r,�+r31 rviv,i Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report Facility Name: Permit #: Operator: Acres Used: Town of Spruce Pine Total Dry Tons Applied (Annual): WQ0002349 Cation Exchange Capacity (non 503 only): Unimin Co Owner: Penland Bailey Co 4.5 Acres Permitted: 4.5 Site #: U-02 Field #: UO2 18.675 n_ ,-1. 1 A...:L,a;o T%. *t lu"aw matala and Tntal Phosnhorus use mzlkp-, % Solids use Raw Percent #): . 11.-0 . 11 © © e �� �00�0��s���0000 ...- c • �0�000�0 0� 't t 0�000�00�00 1 t' • �M1 �� tal ••. h "I certify, under penalty of law, that tills aocument was prepal-cu unt Ul uay u.. w..vu — --fY . '- 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" l� Si ature of Land A ier Date " See bottom of FSF Form for helpful instructions for this WLSF Form and the mathematically linked FSF Form DENR FORM MFLSF (5/2003) ANNUAL LAND APPLICATION FIELD SUMMARY FORM PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH APPLICATION FIELD. PLICABLE Facility Name: owner: Town of Spruce Pine Penland Bailey Co Operator: r.• -3u. TT_(17 PLACE A N/A IN A BLANK OR BOX WHEN NOT AP Annual Dry Tons Applied: Permit 4: Unimin Co. Acres Utilized: WQ0002349 4.5 Cation Exchange Capacity (non 503): 18.675 Acres Permitted: 4.5 iite 4: U-UL r le U rr. - - Inches Precip. Past 24 Hrs. 0 0 Appli- cation Meth- od* s s s s Voli- tila- zation Rate** 0.5 0.5 0.5 0.5 Miner- ala- zation Rate 30% 30% 30% 30% TKN 48500 48500 48500 48500 Ammo- ma- Ni- trogen 1500 1500 1500 1500 Ni- trate and Nitrite 0 0 0 0 PAN 1 11.1189 54:2046 33.3567 25.0175 PAN 2 ####### ####### ####### ####### Must Select Crop 1 or Crop 2 * 1 2 3 4 �' o 8 Q 4-05 specify S ci Totals Per Acre 4444.4 Solids 2.02 Dry Tons Per Acre 0.374373333 Residual Sources (Summarize) WWTP T e Cond. �y , Wet Moist dry Gal. Cu.Yd. <:' Report Totals in Gal. 20,000 Crop 1 Fescue Fescue Fescue Fescue Crop 2 5-05 97500 21667 2.02 1.82507 WWTP dry 9-05 60000 13333 2.02 1.12312 WWTP dry 0 10-05 45000 10000 2.02 0.84234 WWTP dry 0 0 0 0 0 5 6 0 0 0 0 0 0 7 0 0 .0 0 8 0 0 0 0 9 0 0 0 0 10 0 0 0 0 11 0 0 H 0.01702 0.29133 0.27431 Mo 0.0581 0.30535 O.NA 5 Ni 0.1992 1.65626 1.37406 Se 0.04158 0.26482 0.28924 Zn 5.3452 49.5001 424989 0 0 P PAN 1 PAN 2 182.6 123.698 0 Lime Applied Date lbs/ac 12 0 0 TOTALS: 49444 Annuallbs/acre Current Cumulative lbs/ac As 0.01826 0.12826 0.11 36 Cd 0.01328 0.16998 0.1567 34 Cr 0 0 NA Cu 3.6354 27.5711 23.9357 Pb 0.2158 2.76867 2 26 87 Prior Years Cumulative lbs/ac Permitted C. P. L. R.*** 250 Permit PAN Limtt 1 st/2na k,rop "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." *Application Method: S - Surface, IN - Injection, INC - Incorporation **Volitilization Rate: Surface - 0.5, Iniection/Incornoration - 1.0 ***C.P.L.R.: Cumulative Pollutant Loadine Rate , �J Signatur of Land Applier Date **** The RSSF Data and the Dry Tons Per Acre are to be entered on the MFLSF Form. The FSF and MFLSF are mathematically linked so this information needs to be entered into the same numbered column on the MFLSF asis entered on the identically numbered FSF row to properly complete the metals equations. ie. FSF row # 1 to MFLSF DENR FORM FSF (5/2003) ANNUAL PATHOGEN AND VECTOR ATTRACCIUIN KLUUk; I IVty ruKivi Facility Name: Town of Spruce Pine Permit Number: WWTP Name: Town of Spruce. Pine WWTP NPDES Number: Monitoring Period: From 1/1/2005 To 12/31/2005 WQ0002349 NC0021423 Patho an Reduction (40 CFR 503.32) - Please indicate level achieved and alternative performed: g Class A: Alternative 1 ❑ Alternative 2 ❑ Alternative 3 ❑ Alternative 40 Alternative 5 ❑ Alternative 6 ❑ If applicable to alternative performed Class A only) indicate "Process to Further Reduce Pathogens": Compost ❑ Heat Drying ❑ Heat Treatment ❑ Thermophilic ❑ Beta Ray 01 Gamma Ray Pasteurization ❑ Class B: Alternative 1 Alternative 2 ❑ Alternative 3 ❑ If applicable to alternative erformed Class B only)indicate "Process to Significantly Reduce Pathogens": Lime Stabilization ❑ Air Drying ❑ Composting ❑ jAerobic Digestion Anaerobic Digestion[] If applicable to alternative performed Class A or Class B complete the followingmonitoring data: Pathogen Density um ber o Frequency Sample AnalyticalParameter Level in Excee- of -1 e YID Tech -pique inim Geo. Mean aximu Units 6th Power NTN per 260606 977237.2 1900000 NEPN/G 0 7 grab sm9221 e gram of total solids or 2 x 10 to Fecal Coliform the 6th power CFU per gram of 1000 mpn per gram of total solid (dry weight) Salmonella bacteria 3 NTN per 4 (in lieu of fecal grams total solid coliform) (dry weight) Vectnr Attraction Reduction (40 CFR 503.33) - Please indicate option performed: Option 1 ❑ Option 2 ❑Option 3 Option 4 ❑ Option 5 ❑ Option 6 ❑ 1 Option 7 ❑ 1 Option 8 ❑ 10pbon 9 ❑ Option 10 ❑ No vector attraction reduction options were performed ❑ CERTIFICATION STATEMENT (please check the appropriate statement) 19 "I certify, under penalty of law, that the pathogen requirements in 40 CFR 503.32 and the vector attraction reduction requirement in 40 CFR 503.33 have been met." Cl "I certify, under penalty of law, that the pathogen requirements in 40 CFR 503.32 and the vector attraction reduction requirement in 40 CFR 503.33 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." D/Yrr-e. �l 6tAwn Preparer Name and Title (type or print) A &-L Signature of Preparer Date Southern Soil Builders, Inc Dennis Key Land Applier Name and Title (if applicable)(type or print) Si ature of Land pplier (if applicable) Date DENR FORM RF (5/2003) Report Number: A&L EASTERN LABORATORIES, INC. 2005-R306-804 7621 Whitepine Road • Richmond, Virginia 23237 • (804) 743-9401 Fax No. (804) 271-6446 Lab Number: 44244 Pagel Account Number: Samples Submitted By: 46381 DENNIS KEY Send To: SOUTHERN SOIL BUILDERS SPRUCE PINE DENNIS KEY 958 HOOTS ROAD ROARING RIVER NC 28669 NC CERT # 257 Sample ID: SPRUCE PINE Detection Result Result Limit Analysis Analysis %) (mg/kg) (mg/kg) Analyst Date Time Parameter 2.02 20200 100 JCM 11/01/2005 16:00 SOLIDS(AS IS) SOLIDS AS IS) 4.85 48500 100 KCS 11/02/2005 16:00 ) NITROPHOSPHORUS 2.20 22000 100 JCM 11/02/2005 14:00 0.56 5600 100 JCM 11/02/2005 14:00 POTASSIUM 0.67 6700 100 JCM 11/02/2005 14:00 SULFUR 1.44 14400 100 JCM 11/02/2005 14:00 CALCIUM 0.52 5200 100 JCM 11/02/2005 14:00 MAGNESIUM11/02/2005 0.22 0 100 JCM 14:00 SODIUM 17567560 1 1112005 % 2 14:00 IRON 20140 10 JCM 11/02/2005 14:00 ALUMINUM , 1533 1 JCM 11/02/2005 14:00 MANGANESE 438 1 JCM 11/02/2005 14:00 COPPER 644 1 JCM 11/02/2005 14:00 ZINC 0.15 1500 100 KCS 11/02/2005 14:0 AMMONIA -NITROGEN ND 10 KCS 11/02/2005 15:00 NO3-NO2 NITROGEN 1.6 1 JCM 12/20/2005 14:00 CADMIUM 24 5 JCM 11/02/2005 14:00 NICKEL 36 5 JCM 12/20/2005 14:00 LEAD CORRECTION FOR Cd Date Sampled: 10/31/2005 Date Received: 11/01/2005 Date Reported: 12/21/2005 Method Reference SM 2540 G EPA 351.3 SW 846-6010B SW 846-6010B SW 846-6010B SW 846-6010B SW 846-6010B SW 846-6010B SW 846-6010B SW 846-6010B SW 846-6010B SW 846-6010B SW 846-6010B EPA 350.2 SM 4500-NO3 F SW 846-6010B SW 846-6010B SW 846-6010B qZ't C— PAUL C. H. CHU Pb whole Ourtu,Uryrwn ll`-itlt, t r� arr-1.for the crnnpany rnttany ;�rlve..rr. i�gsnew,<;,rElelase.` or ether publoc annolur> (iernenisrwrthoufrobtau r q r pnor wnttencautl crizra(ioa P Report Number: 2005-R306-804 Lab Number: 44244 Account Number: 46381 Send To: A&L EASTERN LABORATORIES, INC. 7621 Whitepine Road • Richmond, Virginia 23237 • (804) 743-9401 Fax No. (804) 271-6446 Page 2 SOUTHERN SOIL BUILDERS DENNIS KEY 958 HOOTS ROAD ROARING RIVER NC 28669 Sample ID: SPRUCE PINE SPRUCE PINE NC CERT # 257 Samples Submitted By: DENNIS KEY Date Sampled: 10/31/2005 Date Received: 11/01/2005 Date Reported: 12/21/2005 Detection Result Result Limit Analysis Analysis Parameter (mg/kg) (mg/kg) Analyst Date Time Method Reference ARSENIC 2.20 0.2 KMM 11/03/2005 15:00 SW 846-7061A MERCURY 2.05 0.2 KMM 11/03/2005 15:00 SW 846-7471A SELENIUM 5.01 0.1 KMM 11/03/2005 15:00 SW 846-7741A PH (STD.UNITS;AS IS) 6.58 RD 11/02/2005 12:30 EPA 150.1 ORGANIC NITROGEN 4.70 47000 100 DCH 11/02/2005 CALCULATION MOLYBDENUM 7 5 JCM 12/20/2005 14:00 SW 846-6010B CORRECTION FOR Cd PAUL C. H. CHU Pb Our reports and letters are for tl're exclusive and rontidentral use of our cfienis, and may not be reproduced;n whole or in pall. nor may any reference be made wrtfiput obtaining our prior written authorization. to the work. the result::, or the. rornpany rn ally advertising. news letease. or other public announcernents lU/UD/4VUJ LIM 14.4V VnA o4ouvow"a WATER QUALITY LAB & OPERATIONS, INC. P.O. BOX 1167 BANNER -ELK, NC 28604 (828) 898-6277 CLIENT: TOWN OF SPRUCE PINE LOGIN TIME: ADDRESS: SAMPLER: CITY: RECEIVED DATE: STATE: NC REPORTED DATE: ID#: DARRELL GRAHAM 6-Oct-05 ANALYSIS::::::::::: ... .�-$jpl: . ................ AimySIS : '-.':M .-., ..... - -:.:� - -.LWl:4-'::::":Mji-TH.QP:: ' - X : . :::SAM -..'E::: . K ... ANAl.YSIS`::-:ANT- .. ........ ........................... ..... I ..................... ........................... .................. *.......-.... ......... ... ... .......... .......................... ........... ........ .......................... ............ .................... ........... ..... .. LOCATION ............ .. ... . TOTAL SOLIDS 3 % SPRUCE SLUDGE FECAL 1 1, 133; 333 1.00 MPNIG SM9221E2 PINE 30-Se 5 PVWPS TOTAL SOLIDS .3 % SPRUCE SLUDGE FECAL 2 1,766,6661 1.00 MPNIG SM9221E2 PINE 30-Sep-06 PVWPS TOTAL SOLIDS 3 % SPRUCE SLUDGE FECAL 3 570,570 1.00 MPNIG SM9221E2 PINE 30-Sep-05 PVWPS TOTAL SOLIDS 3 % SPRUCE SLUDGE FECAL 4 1,433,333 1.00 MPNIG SM9221E2 PINE 30-Se 5 PVWPS TOTAL SOLIDS 3 % SPRUCE SLUDGE FECAL 5 260,606 1.00 MPNIG SM9221 E2 PINE 30-Sep-05 PI/WPS TOTAL SOLIDS 3 % SPRUCE SLUDGE FECAL 6 1,333,333 1.00 MPN/G SM9221E2 PINE 30-Sep-05 PVWPS TOTAL SOLIDS 3 1 % SPRUCE SLUDGE FECAL 7 1,800,000 1.00 MPNIG SM9221E2 PINE 30-Sep-05 _PI/WPS REPORTED BY: NC CERTIFIED LAB # 544 A� PAUL ISENHOUR, SUPERVISOR -.n,i7,'2005 THU 12:06 F.kX 8288986255 a WATER QUALITY SERVICES, INC. P.O. BOX 1102 BANNER ELK, NO 28604 (828) 733- 3142 CLIENT: TOWN OF SPRUCE PINE LOGIN TIME: SOUTHERN SOIL BUILDERS SAMPLER: wirintrin nATF, REPORTED DATE: DARRELL GRAHAM 78v'wrAn" 3-Nov-05 T ANAUT ti ......Sh dA BEFORE VOLITILE SOLIDS 47.0 1.00 % 3-Oct-05 Pi FTER 30 DAYS AFTER PROLIDS 41.3 1.00 % 2-Nov-05 PI 044 -rsD 5 jU PlEapor' y; NC (=RTjFJEn LAB PAUL IsENHOUR, SUPERVISOR sin, L R TORIES, INC. www. parlabs. com PAR Laboratories, Inc. 2217 Graham Park Drive PO Box 411483 Charlotte, NC 28241-1483 Phone: 704-588-8333; Fax: 704-588-8335 NC Cerr a ao; SC Cerr x 99003 REPORT OF ANALYSES Attn: DENNIS KEY SOUTHERN SOIL BUILDERS PROJECT NAME: NOV 05 958 HOOTS ROAD DATE: 12/16/05 ROARING RIVER, NC 28669-0000 SAMPLE N"IMBER- tif1516 SAMPLE ID- SSB SPR'-ICE, DATE SAMPLED- 11/29/05 'LIME SAMPLED-• 093) DATE RECEIVED- 11/30/05 SAMPLER- ZACH KEY RECEIVED BY- MJ TIME RECEIVED- 1030 DELIVERED BY- ZACH KEY TYPE SAMPLE- Grab Page 1 of 2 ANALYSIS ANALYSIS METHOD DATE TIME BY RESULT UNITS TCLP CHARACTERISTICS TCLP 12/06/05 KMG pH VALUE TCLP 12/06/05 KMG CORROSIVITY TCLP 12/06/05 KMG REACTIVITY TCLP 12/06/05 KMG FLASH POINT TCLP 12/06/05 KMG IGNITABILITY TCLP 12/06/05 KMG PAINT FILTER TEST TCLP 12/06/05 KMG TCLP METALS TCLP 12/06/05 KMG ARSENIC TCLP 12/06/05 KMG BARIUM TCLP 12/06/05 KMG CADMIUM TCLP 12/06/05 KMG CHROMIUM TCLP 12/06/05 KMG LEAD TCLP 12/06/05 KMG MERCURY TCLP 12/06/05 KMG SELENIUM TCLP 12/06/05 KMG SILVER TCLP 12/06/05 KMG TCLP PESTICIDES TCLP 12/06/05 KMG ENDRIN TCLP 12/06/05 KMG LINDANE TCLP 12/06/05 KMG METHOXYCHLOR TCLP 12/06/05 KMG TOXAPHENE TCLP 12/06/05 KMG 7.10 S.U. < NON < NON > 140 degrees F < NON < NFL < 0.5 ppm < 1.0 ppm < 0.1 ppm < 0.5 ppm < 0.5 ppm < 0.02 ppm < 0.1 ppm < 0.5 ppm < 0.002 ppm < 0.04 ppm < 1 ppm < 0.05 ppm L R TORIES, INC. www. parlabs. com PAR Laboratories, Inc. 2217 Graham Park Drive PO Box 411483 Charlotte, NC 28241-1483 Phone: 704-588-8333; Fax: 704-588-8335 NC Cert M 20; SC Cert # 99003 Page 2 of 2 CONTINUATION OF DATA FOR SAMPLE NUMBER 68516 ANALYSIS ANALYSIS METHOD DA?E TIME BY RESULT UNITS CHLORDANE TCLP 12/06/05 KMG < 0.003 ppm HEPTACHLOR (AND ITS EPDXIDE) TCLP 12/06/05 KMG < 0.0008 ppm TCLP HERBICIDES TCLP 12/06/05 KMG 2,4-D TCLP 12/06/05 KMG < 1 ppm 2,4,5-TP(SILVEX) TCLP 12/06/05 KMG < 0.1 ppm TCLP ORGANICS TCLP 12/06/05 KMG BENZENE TCLP 12./06/!•..5 KMG < 0,05 p , CARBON TETRACHLORIDE TCLP 12/06/05 KMG <. 0.05 ppm CHLOROBENZENE TCLP 12/06/05 KMG < 10 ppm CHLOROFORM TCLP 12/06/05 KMG < 0.6 ppm o-CRESOL TCLP 12/06/05 KMG < 20 ppm p-CRESOL TCLP 12/06/05 KMG < 20 ppm m-CRESOL TCLP 12/06/05 KMG < 20 ppm 1,4-DICHLOROBENZENE TCLP 12/06/05 KMG < 0.75 ppm 1,2-DICHLOROETHANE TCLP 12/06/05 KMG < 0.05 ppm 1,1-DICHLOROETHYLENE TCLP 12/06/05 KMG < 0.07 ppm 2,4-DINITROTLUENE TCLP 12/06/05 KMG < 0.013 ppm HEXACHLOROBENZENE TCLP 12/06/05 KMG < 0.013 ppm HEXACHLOROBUTDIENE TCLP 12/06/05 KMG < 0.05 ppm HEXACHLOROETHANE TCLP 12/06/05 KMG < 0.3 ppm METHYL ETHYL KETONE TCLP 12/06/05 KMG < 20 ppm NITROBENZENE TCLP 12/06/05 KMG < 0.2 ppm PENTACHLOROPHENOL TCLP 12/06/05 KMG < 10 ppm PYRIDINE TCLP 12/06/05 KMG < 0.5 ppm TETRACHLORETHYLENE TCLP 12/06/05 KMG < 0.07 ppm TRICHLOROETHYLENE TCLP 12/06/05 KMG < 0.05 ppm 2,4,5-TRICHLOROPHENOL TCLP 12/06/05 KMG < 40 ppm 2,4,6-TRICHLORPHENOL TCLP 12/06/05 KMG < 0.2 ppm VINYL CHLORIDE TCLP 12/06/05 KMG < 0.02 ppm LABORATORY DIRECTOR par - LABORATORIES, INC. www.parlabs.com Shipping: 2217 Graham Park Drive Charlotte, NC 28273 CHAIN OF CUSTOD Y PAR Laboratories, Inc Phone (704) 588-8333 Fax (704) 588-8335 Mailing: PO Box 411483 Charlotte, NC 28241-1483 It is essential that all information recorded on this Chain of Custody document for acceptance by PAR Laboratories, Inc. and the North Carolina Department of Environmental and Natural Resources. Company Name (billing) COMMENTS/SPECIAL SOUTHERN SOIL BUILDERS INSTRUCTIONS Address 958 HOOTS RD City, State & Zip Code ROARING RIVER, NC 28669 Point of Contact & Telephone Number DENNIS KEY 336-957-8909 Sample taken by: IS THIS FOR STAZ or EPA REPORTING? YES NO *Sample type: WW X GWMW HW Soil Other Sample Temp at time of sampling: !�>- - °C Sample Temp upon receipt: °C ** Preserved: Yes No Ion Liner/ Zero Headspace: Yes _ No _ N/A Client Sample,) D , (Sample Location (Number] ,�� ifs C x �Qa ?reery '`,aI` Setup z D.at@�flme:_Date/jfrie, GOI�f ectton 9 nalyses Requested" R e o„ %. s rienngwsnea Dy: RelinquishedXy: uate/ I ime 11-30-05' R 30 Date/Time Received by: Date/Time ���, i ' C=Composite G=Grab DW=Drinking Water WW=Wastewater GWMW=Groundwater Monitoring Well HW=Hazardous Waste • • See Other Side o� NrnAx.rc Agronomic Division Phone: (919)733-2655 Web Site: www. No: 10138 --- (;rower. Southern Soil Builders, Inc. 958 Hoots Rd _.:r <.<: Roaring River, N(: ?8661) ...,,.` oil Test Report Farm: e „n/.nnnC CFRVINC N c RFginFNTN FOR OVER60 YEARS Mitchell County Agronomist Comments Field Information Applied Lime Recommendations Sample No. Last Crop Mo Yr T/A Crop or Year Lime U1 1st Crop: Fes/OG/Pim,M 1.7T 2nd Crop: 'r—f RPcnttC Copes To C -- 12 P205 K20 Mg S Cu Zn B Mn See Note 120-200 0 50-70 0 0 0 0 .0 0 12 0 i Soil Class HM% W/V CEC BS% Ac pH P-1 K-1 Ca% Mg% Mn-,Mn-AI(I)Mn-AI(2) Zn-I Zn-AI va Cu-1 S-1 SS -I NO3-� ��¢-� 0.1 MIN 0.27 0.93 5.2 54.0 2.4 4.5 164 40 38.0 14.0 442 282 505 505 353 121 Field Information Applied Recommendations Recommendatio See Zn B Mn See Note Sample No. Last Crop Mo Yr T/A Crop or Year Lime P205 K20 Mg S Cu 12 U2 1st Crop:- Fes/OG/I'im,M 1.6T 120-200 0 0-20 0 0 0 0 .0 0 2nd Crop: 0 Test Results Mn-1 Mn-AI(I)Mn-AI(2) Zn-1 Zn-AI Cu-1 S-I SS -I NO3-N NH4-N Na W/V CEC BS% Ac pH P-1 K I Ca% Mg% Soil Class HM% 1.00 67.0 2.4 4.9 232 81 45.0 16.0 932 576 902 902 515 98 MIN 0.6 7.2 Field Information Applied Lime Recommendations K20 Mg S Cu Zn See Note Sample No. Last Crop Mo Yr T/A Crop or Year PzOs 0 0 12 SP1 1st Crop: Fes/OG/Piq 2nd Crop: I 0 Test Results Zn-1 Zn-AI Cu-I S-1 SS-1 NO3-N NH4-N Na Soil Class HM% W/V CEC BS% Ac pHPI 11585 1585 1453 59 0.1 MIN 0.6 1.04 8 9 8 .0 3 1.5 5.8 409 I � V- NCDA&CS Agronomic Division Phone: (919)733-2655 Web Site: www.ncagr.com/agronomi/ Report No: 15576 Grower: Southern Soil Builders, Inc. Col)!es To: 958 Hoots Rd t' Roxriq River, NC 28669 Soil Test RePort Farm: 1/10/2006 SERVING N.C. RESIDENTS FOR OVER 60 YEARS Mitchell County Agronomist Comments C 12 Fieldnformatton Allied Ime Recommen�dattons . �. . Sample No. Last Crop Mo Yr T/A Crop or Year Lime P205 K20 Mg S Cu Zn B Mn See Note PO1 Ist Crop: Fes/OG/fim,M 0 120-200 0 20-40 0 0 0 0 .0 0 12 2nd Crop: 0 Test Results Soil class HM% W/V CEC BS% Ac pH P-I K1 Ca% Mg% Mn-1 Mn-AI(1)Mn-AI(2) Zn-I Zn-AI Cu-1 S-I SS-1 NO3-N NH4-N Na MIN 0.86 1.10 13.3 95.0 0.7 6.3 158 55 73.0 19.0 350 222 555 555 347 46 0.1 Annual Reuort Review SOP 5P 1. Annual Land Application Certification Form- a Was a certification form submitted? y45 • Was land application conducted during the reported year? ye o How many dry tons and dry tons per acre were applied? 5'1.g 07 q 7s- Drl.411- • Were the applications within the permitted amount?y..O-i. . • Verify PAN if more than 10 tons/acre 0 h- • Did it indicate compliance? V4-5 • Was it signed by the appropriate people? f'S 2. M.onitoring R.srdr.."Js _ YZs Fuca t-Y� • Were the analyses conducted at the required frequency? rcjP t:oryos,, Is- • Were the metals analyses reported on the Residual Sampling Summary Form? yes • Were the results reported in mg/kg? yP-S • : Were the heavy metals within ceiling concentration permit limits?*YES • If no, were the lab analyses attached? • Were all the required parameters tested? 4-s Moir r�s I cta& -'�( 4 -T&LP NO S o < (� An n(y s%-' Was TCLP analysis conducted? 1-5 y ' 3. Field Summary Add• • Were the land applicationevents recorded on the Field Summary Forms? Y es • Was a Field Summary Form submitted for each field? y t, 5 • Were all the residuals applied to permitted land? ye.S • Were all the residuals applied'frpm permitted sources? q-es • Were the field loading rates for each metal and PAN calculated (year to date)?ye-S • Were the cumulative pollutant loading rates calculated? YGs • Were the calculations correct? YQp �, ,�/ P44V .7 4-,al a12 F; ejd I u-o t � A� �d' • Were the PAN loading rates within permit Iimits? ye-5 • Were the heavy metal cumulative pollutant loading rates within permit limits? yes • Were the residuals applied on a suitable crop? qtx. • Were the applications conducted during the crop's growing season?�615 • Were the Field Summary Forms complete? y4S 4. Pathogen and Vector Attraction Reduction • Was a signed copy of the Pathogen and Vector Attractioeduction Form submitted?yey • Did the form indicate the period of coverage, -the residual class, and the pathogen reduction alternative and the vector attraction reduction option used? • Was the a ropriate documentation to show pathogen and vector tt action 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?yes • Were the soil pH's 6.0 or greater for each application field? No flea U I �{, S rwj 1t1=4-q 1:10-14 S1>9='S.8 • Were the copper and zinc indexes in the soil less than 3000 for each application field? Y65 6. General :. • Was the report in the proper format? a • Were any parts of the annual report mussing? • Was the report submitted on time),O- * Any violations of ceiling concentrations should be reported to Pretreatment for municipalities only. S Southern S Soil $ Builders, Inc. Wednesday, October 04, 2006 Division of Water Quality Information Processing Unit 1617 Mail Service Center Raleigh, NC 27699-1617 958 Hoots Road -Roarinag-Rive�C 28669 (336) 957-8909 ,':Fax �3g36) 957-8940 Subject: Compliance Evaluation Inspection OCT 17 2006 ;�<9k �c,' illo regional Offecq Protection RECEIVED 1 DENR f DkNQ AQUIFFR-PRnTFCTION SECTION OCT 13 2006 The Division of Water Quality conducted a compliance evaluation inspection of the Town of Spruce Pine; permit WQ0002349. There were three issues with the 2005 Annual Report that was brought up. The first was the Exchangeable Sodium Percentage Calculation. The ESP for the fields is as follows: field Ul 1.9, field U2 1.3, field SP1 1.1, and field P01 0.7 The Second issue was the percent volatile reduction for the 30-day bench scale. I contacted the lad and the percent reduction was 12.13%. The third issue was the PAN calculation for the field U-01. The PAN for this field was incorrectly reported as 9.13337. The correct PAN is 19.2992. The TKN was entered +ly. incorrectly as 22,000 in this spreadsheet. The correct TKN of 48,500 and the corrected PAN of 19.2992 has been entered into a new Annual Land Application Field Summary Form and is included in triplicate. The last item brought to our attention, is the Operator in Responsible Charge. Southern Soil Builders, Inc, no longer provides the Town of Spruce Pine with Land Application services as of August 4, 2006. If the Town decides to Land Apply in the future, the Town will have to provide the Division an updated ORC form with the new ORC listed. If you have any questions feel free to contact me at anytime. i Zach Key Southern Soil Builders I ANNUAL LAND APPLICATION FIELD SUMMARY FORM PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH APPLICATION FIELD. PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE. Facility Name: Town of Spruce Pine Permit #: WQ0002349 Annual Dry Tons Applied: 2.31 Owner: Penland Bailey Co. Operator: Uninun Co. Cation Exchange Capacity (non 503): c;+P 41• i 1-01 Field #: U-01 Acres Utilized: 3.5 Acres Permitted: 3.5 S eci Totals Per Acre 7714.3 % Solids 2.02 Dry Tons Per Acre 0.649805143 0 Residual Sources (Summarize) WWTP Site Cond. �' Wet, dry Inches Precip. Past 24 Hrs. 0 Appli- cation Meth- od* s Voli- tila- zation Rate** 0.5 Miner- ala- zation Rate 30% TKN 48500 Ammo- pia- Ni- trogen 1500 Ni- trate and Nitrite 0 PAN 1 19.0 0 PAN 2 ####### 0 Must Select Crop 1 or Crop 2 1 2 o 0 o Q Gal. Cu.Yd. ,: Report Totals in Gal.moist 27,000 Crop 1 fescue Crop 2 5-05 0 0 0 0 0 3 0 0 0 0 4 0 0 0 0 5 0 0 0 0 6 0 0 0 0 7 0 0 0 0 8 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 PAN 2 Lime A lied 10 11 12 TOTALS: 7714 ............... As Cd Cr Cu Pb H Mo Ni Se Zn P P Pp Annual lbs/acre 0.010164 0.00739 0 2.02356 0.12012 0.00947 0.03234 0.11088 0.00929 2.975281 101.64 19.2992 0 Date lbs/ac Current Cumulative lbs/ac 0.339664 0.13839 4736 2.15012 0.22547 0.37024 1.25788 0.17829 38.3381 Prior Years Cumulative lbs/ac 0.3295 0.131 #NA 9.45 2.03 0.216 0.3379 1.147 0.169 35.3628 Permitted C P L R*** 36 34 338 267 15 NA 374 89 2498 Permit PAN Limit 1 st/2nd Crop250 .1 _ -. »..1+., „s 1+ho++i,:c Anr„mPn+ way nrPnnred 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." **** 11-22 2T *Application Method: S - Surface, IN - Injection, INC - Incorporation Signature of Land Applier Date **Volitilization Rate: Surface - 0.5. Iniection/Incorvoration -1.0 ***C.P.L.R.: Cumulative Pollutant Loading Rate The RSSF Data and the Dry Tons Per Acre are to be entered on the MFLSF Form. The FSF and MFLSF are mathematically linked so this information needs to be entered into the same numbered column on the MFLSF as is entered on the identically numbered FSF row to properly complete the metals equations. ie. FSF row # 1 to MFLSF DENR FORM FSF (5/2003) ) C) S-- .1 �D T- Ot 7- QDT A 4- -IJO-- Iq 3 x x 6 3 ;2 39 7(o 92-3 7- -Z// o/ A P ao� �� %--X----.- �' ° z_�_o, as ��i_!6�pT- - ---------- - ----- -- - -- - 7 00 qI IbID7 I 9(l Z) 7 �tc o03S-077z/.- lbljlc' P-O/ -o077S'qq(o o 513 /5- S,q� ------ -- - -- - -- - - -- ---- - ---- - - -- - -- -- -- X_ _. 3 7 y3 7 3 3 3 3 - - -- - -- --- - -------------- ----- ---- may=---,�°.3'-'�S-�----y- --- -._o/ 7-e7(,6- . It - -- - -- - -- - - -- --- - --- - -- F� i �1 �1 �i