WQ0039181_More Information (Received)_20230223

Initial Review
Reviewer
Nathaniel.Thornburg
Is this submittal an application? (Excluding additional information.) *
Yes No
If not an application what is the submittal type?* Annual Report
Residual Annual Report
Additional Information
Other
Permit Number (IR) * W00039181
Applicant/Permittee Carolina Malt House, Inc.
Email Notifications
Does this need review by the hydrogeologist? * Yes No
Regional Office
CO Reviewer
Admin Reviewer

Submittal Form
Project Contact Information
Please provide information on the person to be contacted by NDB Staff regarding electronic submittal, confirmation of receipt, and other correspondence.
......................................................................................................................................................................................................................................................................................... ... ... ... ... ... .. ... ... ... ... ..
Name* mark van Wagenberg
Email Address*
[e-mail]
Project Information
.........................
Application/Document Type*
New (Fee Required)
Modification - Major (Fee Required)
Renewal with Major Modification (Fee
Required)
Annual Report
Additional Information
Other
Phone Number*
7042139334
Modification - Minor
Renewal
GW-59, NDMR, NDMLR, NDAR-1,
N DAR-2
Residual Annual Report
Change of Ownership
We no longer accept these monitoring reports through this portal. Please click on the link below and it will take you to the correct form.
https://edoes.deq.nc.gov/Forms/NonDischarge_Monitoring_Report
Permit Type:*
Wastewater Irrigation
High -Rate Infiltration
Other Wastewater
Reclaimed Water
Closed -Loop Recycle
Residuals
Single -Family Residence Wastewater
Other
Irrigation
Permit Number:*
WQ0039181
Has Current Existing permit number
Applicant/Permittee Address*
12969 Statesville Blvd
Facility Name*
Carolina Malt House WWTF
Please provide comments/notes on your current submittal below.
Application No. WQ0039181
Additional Information Request
Carolina Malt House WWTF
Wastewater Irrigation System
Rowan County
Zachary J. Mega,
Good afternoon attached is the single PDF with the requested additional information. Please let me know if there is anything else you need.
Thanks for your time!
At this time, paper copies are no longer required. If you have any questions about what is required, please contact Nathaniel Thornburg
at [e-mail].
Please attach all information required or requested for this submittal to be reviewed here.
(Application Form, Engineering Plans, Specifications, Calculations, Etc.)
Carolina Malt House WWTF Renewal Application.pdf 3.68MB
Upload only 1 PDF document (less than 250 MB). Multiple documents must be combined into one PDF file unless file is larger
than upload limit.
* By checking this box, I acknowledge that I understand the application will not be accepted for pre -review until the fee (if required) has
been received by the Non -Discharge Branch. Application fees must be submitted by check or money order and made payable to the
North Carolina Department of Environmental Quality (NCDEQ). I also confirm that the uploaded document is a single PDF with all parts
of the application in correct order (as specified by the application).
Mail payment to:
NCDEQ — Division of Water Resources
Attn: Non -Discharge Branch
1617 Mail Service Center

Raleigh, NC 27699-1617
Signature
Submission Date 2/23/2023

Subject: Application No. WQ0039181
Additional Information Request
Carolina Malt House WWTF
Wastewater Irrigation System
Rowan County
A. Section I — Annlicant Information:
1. Item 1 — Please print Mr. Goss' name has been updated.
B. Section V — ORC Information:
1. I have attached Mark van Wagenberg's Operator Designation
Form that we had previously on file.
C. Section IX — Irrigation Fields:
1. The Deeded Owner column has been updated. Please see
attached deed's to reflect this change.
D. Attachment A — Site Man:
1. Please see attached copy of the site map.
E. Attachment L — Setback Waivers:
1. Please see attached copies of setback waivers recorded at the
Rowan County Register of Deeds.
F. Annlicant's Certification:
1. Mr Goss's signature has been updated on application.

Table of Contents:
B. Section V — ORC Information: Page 3
C. Section IX — IrriLwation Fields: Page 5-14
D. Attachment A —Site Man: Page 4
E. Attachment L — Setback Waivers: Pages 15-24
Updated Application: Pages 15 - 31

1 /29/19
Wastewater Branch
Water Quality Permitting Section
Division of Water Resources
1617 Mail Service Center
Raleigh, NC 27699-1617
Subject: Delegation of Signature Authority, Addition to Delegation dated 04/06/2018
Carolina Mat House WWTF
NPDES Permit Number NCW00039181
To Whom It May Concern:
By notice of this letter, I hereby delegate signatory authority to each of the following individuals for all
permit applications, discharge monitoring reports, and other information relating to the operations at
the subject facility as required by all applicable federal, state, and local environmental agencies
specifically with the requirements for signatory authority as specified in 15A NCAC 213.0506.
Individual #1
Name:
Mark Van Wagenberg
Title:
Back-up ORC
Mailing Address:
12969 Statesville Blvd
Cleveland, NC 27013
Physical Address:
n/a
(if different)
Email Address:
[e-mail]
Office Phone:
704 -412- 9962 - -
Mobile Phone:
704 -213 -9334 - -
Individual #2 (ifapplicable)
If you have any questions regarding this letter, please feel free to contact me at
aaronO)carolinamalt.com or 704-412-9962.
Sincerely,
Authorized Signing Official's Name Aaron Goss
Authorized Signing Official's Title President
Mailing Address 12969 Statesville Blvd, Cleveland, NC 27013
Email Address [e-mail]
Office Phone [phone]
Mobile Phone same
cc: Mooresville Regional Office, Water Quality Permitting Section

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� I S/M 10� � I S/P I UflN I U!N— IC/C I PART ��
Rowan County Assessor's Office
This -certifies that there are no delinquent ad valorem real estate taxes, which the
Rowan County Tax Collector is c arggd wOith llecting, that are a lien on:
Property Identification Number i� �S
This zs not a certification that the Rowan County Property Identification Number
matches this Deed description. nil
Tonya Parnell 4 = lr
Rowan Co. Tax Collections Manager Jerk ate/Time
Illllllflllllflllllllfllllllllllllllllllllllllllllllllll(Ililllllllllllllllllllh.
Doc ID: 014948230005 Type: CRP
Recorded: 02/11/2022 at 04:17:36 PM
Fee Amt: $191.00 Page i of 5
Revenue Tax: $165.00
Rowan, NC
J. E. Brindle Register of Deeds
BK 1395 PciM
NORTH CAROLINA QUITCLAIM DEED
Drawn by: Carolina Malt House, Inc.
Mail to: Grantee
Excise tax: $ 165 0D
Part of Tax Parcel No. 263 008
This Deed, made this A day of February, 2022, by and between
AMBER WAVES HOLDINGS LLC, a North Carolina limited liability company ("Grantor"),
having an address of 12969 Statesville Blvd., Cleveland, NC 27013
and
CAROLINA MALT HOUSE, INC., a North Carolina corporation ("Grantee"), having an
address of 12969 Statesville Blvd., Cleveland, NC 27013.
The designations Grantor and Grantee as used herein shall include said parties, their heirs,
successors and assigns, and shall include singular, plural, masculine, feminine, or neuter as required by
context.
WITNESSETH, that the Grantor, for a valuable consideration paid by the Grantee, the receipt cf
which is hereby acknowledged, has and by these presents does grant, bargain, sell and convey unto the
Grantee, all of Grantor's interest in that -certain lot or parcel of land situated in Rowan County, North
Carolina and more particularly described as follows:
See Exhibit A. attached hereto and incorporated herein by reference.
1of5
Book: 1395 Page: 85 Page 1 of 5

i
i
The property hereinabove described was acquired by Grantor by deed recorded in Book 1277 at
Page 888 of the Rowan County Public Registry.
The property herein conveyed does not include the primary residence of the Grantor.
Grantor hereby conveys, releases, and quitclaims all of Grantor's rights, title, and interest in and
to the above -described property and premises to the Grantees, and to the Grantee's heirs, successors,
and assigns forever, so that neither Grantor nor Grantor's heirs, legal representatives, or assigns shall
have, claim, or demand any right or title to the property, premises, or appurtenances, or any part
thereof.
TO HAVE AND TO HOLD the aforesaid tract or parcel of land and all privileges thereunto
belonging to the said Grantees and their heirs and assigns free and discharged from all right, title,
claim, or interest of the said Grantors or anyone claiming by, through, or under them. Title to the
property hereinabove described is subject to the following exceptions if any:
Ad valorem real property taxes for the year 2022 and subsequent years, rights of way of U.S. Highway
70 (Statesville Boulevard), and any and all of public record.
IN TESTIMONY WHEREOF, said Grantors have hereunto set their hands and seal the day and year
above written.
&A6V1_ (SEAL)
Aaron F. Goss
Member -Manager, Amber Waves Holdings LLC
2 of 5
Book: 1395 Page: 85 Page 2 of 5

STATE OF NORTH CAROLINA
COUNTY OF ROWAN
I, a Notary Public of said State and County, do hereby certify that the above -named person
personally appeared before me this day, and (i) I have personal knowledge of the identify of the
Grantor, or (ii) I have seen satisfactory evidence of the Grantor's identity, by current state or federal
identification with the Grantor's photograph, or (iii) a credible witness has sworn to the identity of the
Grantor, each acknowledging to me that he or she voluntarily signed the foregoing document for the
purpose stated herein and in the capacity indicated. -
Witness my hand and seal this
• 2 .
Z
$f 11
Mail tax statements to:
Carolina Malt House, Inc.
12969 Statesville Blvd.
Cleveland, NC 27013
day of r X�l q►v� , in the year 2�Z�
(Sn . (A)
Notary. Public Official Signature
Notary Typed or Printed Name
3 of 5
Book: 1395 Page: 85 Page 3 of 5

Lying and being in Cleveland Township, Rowan County, North Carolina and being more
particularly described as follows:
BEGINNING at a point in the center line of the North Lane of New U.S. Highway No. 70 and in
the center line of Third Creek where the same is crossed by said highway, and runs thence with
the center line of the North Lane of New U.S. Highway No. 70, North 58 deg. 59 min. West
1369 feet to a point therein; thence with the center line of an old road and with E.B. Davis, as
follows: (1) South 65 deg. 45 min. West 221 feet, (2) South 81 deg. West 110 feet to a pine, (3)
North 80 deg. West 109 feet, (4) North 62 deg. 30 min. West 200 feet to a pine, and (5) North 51
deg. West 100 feet to an iron; thence two lines with E. B. Davis: (1) South 29 deg. 30 min. East
726 feet to a stake; and (2) South 81 deg. West 911 feet to a stone; E. B. Davis' corner in
Phifer's line; thence with Phifer's and Thompson's lines, South 1 deg. 30 min. East 924 feet to a
point in the center line of the old creek channel and in Cook's line; thence with the old creek
channel, about North 75 deg. East 677 feet, more or less, to a point in the center line of Third
Creek; thence with the center line of Third Creek North 67 deg. East 1808 feet to the point of
BEGINNING, containing 45.2 acres, more or less.
LESS AND EXCEPT the property conveyed to the Department of Transportation, an agency of
the State of North Carolina, by deed recorded in Book 1065 at Page 135 of the Rowan County
Register of Deeds and SUBJECT TO the terms and conditions contained in said deed.
TOGETHER WITH Grantor's right, title and interest, if any; in and to any differences between
the property described on Exhibit A and the property described on Exhibit B attached hereto, and
Grantor makes no warranties, express or implied, as to title to any such differences between the
property described on Exhibit A and the property described on Exhibit B.
4of5
Book: 1395 Page: 85 Page 4 of 5

Lying and being in Cleveland Township, Rowan County, North Carolina and being more
particularly described as follows:
BEGINNING at a 45 rebar in the southerly margin of the right of way of Statesville Blvd — US
Hwy 70, said beginning point being South 56 deg. 19 min. 17 sec. East 102.19 feet from a
concrete right of way monument on the southerly margin of US Hwy 70; thence from said point
of BEGINNING and continuing with said southerly margin of Statesville Blvd — US Hwy 70 a
line South 56 deg. 19 min. 17 sec. East 32.41 feet to a concrete right of way monument on the
southerly margin of US Hwy 70; thence with the right of way South 46 deg. 54 min. 15 sec. East
90.98 feet to a concrete right of way monument in the margin of US Hwy 70, said monument
being located at NAD 83(2011) coordinates N 727753.80 ft E 1492234.03 ft; thence with the
right of way South 56 deg. 25 min. 06 sec. East 1251.15 feet to.a point in Third Creek, said
point being located North 56 deg. 25 min. 06 sec. West 748:99 feet from a concrete right of way
monument located at NAD 83(2011) coordinates N 726647.61 ft E 1493900.14 ft; thence 8 lines
within Third Creek as follows: 1) South 69 deg. 01 min. 33 sec. West 126.76 feet; 2) South 72
deg. 17 min. 13 sec. West 181.51 feet; 3) South 69 deg. 30 min. 09 sec. West 351.06 feet; 4)
South 66 deg. 40 min. 08 sec. West 211.94 feet; 5) South 69 deg. 02 min. 46 sec. West 212.17
feet; 6) South 71 deg. 41 min. 36 sec. West 282.39 feet; 7) South 64 deg. 34 min. 25 sec. West
228.79 feet; and 8) South 71 deg. '54 min. 57 sec. West 77.57 feet to a point; thence a line South
76 deg. 19 min. 28 sec. West 357.09 feet to a #4 rebar; thence a line South 76 deg. 19 min. 28
sec. West 327.00 feet to a 44 rebar in the line of Thomas J. Thompson and wife, Margie S.
Thompson (DB 688 Pg 493); thence with Thompson's line North 0 deg. 10 min. 32 sec. West
500.64 feet to a capped #4 rebar, corner of Thompson and Eula W. Smith & Annetta Evans (DB
DC445 Pg 127); thence with Smith & Evans North 0 deg. 10 min. 32 sec. West 423.36 feet to a
stone in the line of Smith & Evans and corner of Carolina Malt House, Inc. (DB 1260 Pg 31);
thence a line with Carolina Malt House, Inc. North 82 deg. 13 min. 30 sec. East 824.33 feet to a
nail set at a bent 3/aD7 iron pipe, corner with Carolina Malt House, Inc.; thence a line with Carolina
Malt House, Inc. North 26 deg. 36 min. 52 sec. West 726.07 feet to a 95 rebar, corner of Carolina
Malt House, Inc.; thence a line with'Carolina Malt House, Inc. South 57 deg. 53 min. 31 sec.
East 354.02 feet to a nail set at a bent 3/a" iron pipe, corner of Carolina Malt House, Inc.; thence a
line with Carolina Malt House, Inc. South 83 deg. 04 min. 37 sec. East 165.00 feet to a #5 febar,
corner of Carolina Malt House, Inc.; thence a line with Carolina Malt House, Inc. North 69 deg.
28 min. 11 sec. East 147.31 feet to the point and place of BEGINNING, being a 41.139 Acres
tract (more or less) shown on a plat of survey titled "Property Owned by Graham Enterprises
Boundary Survey of Property to be Acquired by Carolina Malt House, Inc." dated September 7,
2016, by Lake Norman Surveying & Mapping PLLC.
'5 of 5
Book: 1395 Page: 85 Page 5 of 5

Page 1 of 4
iM AP S/M PAR I S/P I UAN I LAN 1=1 PART I INT
Y40?
Rowan County Assessor's Office
This certifies that there are no delinquent ad valorem real estate taxes, which the
Rowan County Tax Collector is c " e wt coltroperty
cting, that are a lien on:
Property Identification Numl
This is not a certification that the Rowan ounty Identification,Number
matches this Deed description.
Tonya Parnell
Rowan Co. Tax Collections Manager Clerk Date/I une
/IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIDoc ID: IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII \
Recorded0102/ii/2022 atp04:i9P57 PM
Fee Amt: $1,228.00 Pale 1 of 4
Revenue Tax: $1,202.00
Rowan, NC
J. E. Brindle Register of Deeds
BK 1395 PG86
NORTH CAROLINA QUITCLAIM DEED
Drawn by: Carolina Malt House, Inc.
Mail to: Grantee
Excise tax: $ 112-02s 00
Part of Tax Parcel No. 265 001 I
Brief Description for Index: 18.728 ACRES, CLEVELAND TWP
This Deed, made this ItA day of February, 2022, by and between
AMBER WAVES HOLDINGS LLC, a North Carolina limited liability company ("Grantor"),
having an address of 12969 Statesville Blvd., Cleveland, NC 27013
and
CAROLINA MALT HOUSE, INC., a North Carolina corporation ("Grantee"), having an
address of 12969 Statesville Blvd., ,Cleveland, NC 27013.
The designations Grantor, and Grantee as used herein shall include said parties, their heirs,
successors and assigns, and shall include singular, plural, masculine, feminine, or neuter as required by
context.
i
WITNESSETH, that the Grantor, for a valuable consideration paid by the Grantee, the receipt of
which is hereby acknowledged, has and by these presents does grant, bargain, sell and convey unto the
Grantee, all of Grantor's interest in that certain lot or parcel of land situated in Rowan County, North
Carolina and more particularly described as follows:
See Exhibit A. attached hereto and incorporated herein by reference.
i
1of4
Book: 1395 Page: 86 Page 1 of 4

Page 2 of 4
The property hereinabove described was acquired by Grantor by deed recorded in Book 1270 at
Page 806 of the Rowan County Public Registry.
The property herein conveyed does not include the primary residence of the Grantor.
Grantor hereby conveys, releases, and quitclaims all of Grantor's rights, title, and interest in and
to the above -described property and premises to the Grantees, and to the Grantee's heirs, successors,
and assigns forever, so that neither Grantor nor Grantor's heirs, legal representatives, or assigns shall
have, claim, or demand any right or title to the property, premises, or appurtenances, or any part
thereof.
TO HAVE AND TO HOLD the aforesaid tract or parcel of land and all privileges thereunto
belonging to the said Grantees and their heirs and assigns free and discharged from all right, title,
claim, or interest of the said Grantors or anyone claiming by, through, or under them. Title to the
property hereinabove described is subject to the following exceptions if any:
ANY AND ALL OF PUBLIC RECORD
IN TESTIMONY WHEREOF, said Grantors have hereunto set their hands and seal the day and year
above written.
1, ye ? (SEAL)
Aaron F. Goss -
Member -Manager, Amber Waves Holdings LLC
2of4
Book: 1395 Page: 86 Page 2 of 4

Page 3 of 4
STATE OF NORTH CAROLINA
COUNTY OF ROWAN
I, a Notary Public of said State and County, do hereby certify that the above -named person
personally appeared before me this day, and (i) I have personal knowledge of the identify of the
Grantor, or (ii) I have seen satisfactory evidence of the Grantor's identity, by current state or federal
identification with the Grantor's photograph, or (iii) a credible witness has sworn to the identity of the
Grantor, each acknowledging to me that he or she voluntarily signed the foregoing document for the
purpose stated herein and in the capacity indicated.
Witness my hand and seal this
day of rI , in the year
`.� ``1%,ERE 111
IV
Notary Public Official Signature
= Z.0
VN•
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9 {jpsp��`
Notary Typed or Printed Name
Mail tax statements to:
Carolina Malt House, Inc.
1-2969 Statesville Blvd.
Cleveland, NC 27013
3of4
l
Book: 1395 Page: 86 Page 3 of 4

Page 4 of 4
EXHIBIT A
BEGINNING at #5 Rebar located in the margin of the right of way of Statesville Boulevard (U.S.
Hwy. 70), thence a line with the right of way of Statesville Boulevard South 49 deg. 20 min. 49 sec.
East 21.32 feet to a Concrete RW Mon.; thence continuing with the right, of way of Statesville
Boulevard a line South 35 deg. 15 min.,19 sec. East 61.85 feet to a Concrete RW Mon.; thence
continuing with the right of way of Statesville Boulevard a line South 49 deg. 20 min. 49 sec. East
169.97 feet to a Concrete RW Mon.; thence continuing with the right of way of Statesville
Boulevard a line South 51. deg. 59 min. 06 sec. East 106.76 feet to a Concrete RW Mon.; thence
continuing with the right of way of Statesville Boulevard a line South 49 deg. 40 mini. 12 sec. East
201.60 feet to a Concrete RW Mon.; thence continuing with the right of way of Statesville
Boulevard a curve to the left with a radius of 5,834.58 feet, length of 518.35 feet, and'chord bearing
and distance of South 52 deg. 52 min. 43 sec. East 518.18 feet to a Concrete RW Mon.; thence
continuing with the right of way of Statesville Boulevard South 56 deg. 05 min. 43 sec. East 201.76
feet to a Concrete RW Mon.; thence continuing with the right. of way of Statesville Boulevard a line
South 56 deg. 24 min. 56 sec. East 102.30 feet to a #5 Rebar, corner with Graham Enterprises (D.B.
1065 Pg. 135, D.B. 568 Pg. 147, D.B. 568 Pg. 144); thence a line with Graham Enterprises South 69
deg. 28 min. 39 sec. West 147.30 feet to a #5 Rebar; thence continuing with Graham Enterprises a
line North 83 deg. 04 min. 21 sec. West 165.00 feet to a bent 1/2" iron pipe; thence continuing with
Graham Enterprises a line North 57 deg. 54 min. 21 sec. West 354.00 feet to a #5 Rebar; thence
continuing with Graham Enterprises a line South 26 deg. 37 min. 39 sec. East 726.00 feet to a bent
1/2" iron pipe; thence continuing with Graham Enterprises South 82 deg. 12 min. 52 sec. West
824.19 feet to an Existing Stone (said stone being North 51 deg. 20 min. 26 sec. West 0.35 feet from
an existing 1/2" iron pipe) in the line of Eula W. Smith & Annetta Evans (D.B: 1163 Pg. 677);
thence'continuing with Smith & Evans a line North 0 deg. 09 min. 41 sec. East 95.34 feet to a bent
1/2" iron pipe; thence continuing with Smith & Evans a line North 0 deg. 25 min. 18 sec. East
207.60 feet to a tall 1/2" iron pipe; thence continuing with Smith & Evans a line North 0 deg. 13
min. 43 sec. East 192.96 feet to a tall 1/2" iron pipe; thence continuing with Smith & Evans a line
North 0 deg. 13 min. 54 sec. East 205.78 feet to a tall 1/2" iron pipe; thence continuing with Smith &
Evans a line North 0 deg. 22 min. 38 sec. East 755.85 feet to the point and place of BEGINNING,
being a 18.728 Acres tract shown on Property Survey For: Carolina Malt House, Incorporated, by
Shulenburger- Surveying Company, P.A., dated 9-2-2015.
Being the same property the Grantor acquired by General Warranty Deed on May 13, 2016, in Book
1270, page 806, Rowan County Registry. Included in this transfer is Grantor's interest, if any, in any
land that Grantor may have obtained title to as a result of the difference between the two legal
descriptions included in Book 1260, page 31 (Exhibits,4 & B) Rowan County Registry.
4of4
Book: 1395 Page: 86 Page 4 of 4

Spray Irrigation Design Elements
Nozzlewetted diameter:
trt
Nozzle, wetted area:
Nozzle capacity-,
Nozzleufae r r/mode 1:
Elevation of highest nozzle --
Specification Section:
11114 SETBACKS
1
4}
8.38 GPM
nnr / 50 Series
765 ff
Sep Irrigation Section
(drawings)
Drip p Irrigation
Emitter wetted area:
Distance between laterals:
D i slanc e between emitters.
Emitter capacity:
Emitter manufacturer/model:
Elevation of hi het a itter:
SpecificationSection:
] Does the project comply with all setbacks found in the river basin rules
If no, list nOTI-Compliant setbacks:
s:
Have any setbackwaivers been obtained in order to comply with and
ft 2
ii
PH
}? Z Yes or EJ No
?ZYes or❑No
If e have written, notarized fined by all parties and recorded with the County Register of
rn
Deeds? Z Yes or EJ No
3. Provide the minimum field observed
distances
for
each setbackparameter to the 'Irrigation system and treatment/storage
units (NOTE
—
Distances greater than
500 feet may
be
marked
N/A):
Setback Parameter
Any habitable residence or place of assembly under separate ownership or not to b
maintained as part of the pet site
Any habitable residence or place of assembly owned by the Perm ittee to be maintained as
part of ` the ELoject site
Any pnv to or public water supply source
Surface waters (streams — intermittent and perennial, perennial waterbodies, and wetlands)
Groundwater lowering ditches (where the bottom of the ditch intersects the HWT
Subsurface groundwater lowering drainage systems
Surface water diversions (ephemeral streams, waterways, ditches)
Any well with exception of monitoring wells
Any property l ine
Top of slope of embankments or cuts of two feet or more in vertical height
Any water line from a disposal system
Any swimmingpool
Public right of way
Nitrification field
Any building foundation or basement
Impounded public water supplies
Public shallow groundwater supply (less than SO feet deep)
. Does the
Applicant intend
on
complying with
property
t
lures?
El
Yes or
No
Irrigation
stem
1 00F
1'
I�►I%1
t
/
M
Treatment
Storage Unit
in order to Dave reduced irrigation setbacks to
T
If yes, complete the following table by providing the required concentrations as determined in the Engineering Calculations:
FORM, W JS 06-16 Pale 12 of 1

Doe ID: 013661680003 Type: ORP
Recorded: 04/18/2017 at 03:27:36 PM
Fee Amt: $26.00 Page 1 of 3
Rowan, NC
J. E. Brindle Register of Deeds
BK 12 V V PG4 2 0
DOCUMENT COVER SHEET
DOCUMENT TYPE:
PREPARED BY:
GRANTOR(S):
GRANTEE(S):
BENEFICIARY:
IF APPLICABLE:
RETURN TO:
carol i ria m"I+ tome' l r.c, .
TAX MAP
BRIEF DESCRIPTION:
PARCEL NUMBER
Book: 1288 Page: 420 Page 1 of 3

Wastewater Setback Waiver
This Agreement is between Amber Waves Holdings LLC ("AWIT ), a North Carolina
limited liability company which may be found at 12969 Statesville Blvd, Cleveland, NC
27013 and Carolina Malt House, Inc. ("CMH" ), a North Carolina corporation which may
be found at 12969 Statesville Blvd, Cleveland, NC 27013.
Whereas AWH owns 18.728 acres (more or less) along Statesville Boulevard in Rowan
County west of the town of Cleveland, further described in that deed recorded in Book
1270, Page 806, Rowan County Registry ("Parcel One");
Whereas AWH also owns 41.139 acres (more or less) along Statesville
Boulevard in Rowan County west of the town of Cleveland, adjoining Parcel One, further
described in that deed recorded in Book 1277, Page 888, Rowan County Registry
("Parcel Two"); and
Whereas AWH has authorized CMH to operate a wastewater irrigation system on Parcel
One and Parcel Two;
For good and valuable consideration including the sum of $10.00, the receipt and
sufficiency of which is hereby affirmed, the parties agree that CMH is authorized to
irrigate, dig, place equipment, and do anything otherwise prohibited within the setback
areas defined in rule 15A NCAC 02T 0.0506 (a) along the property line between Parcel
One and Parcel Two, on both Parcel One and Parcel Two.
This Waiver is made in contemplation of C1kMH.r.,eceiving a permit from the State of
North Carolina to operate a wastewater irrigatiorisystein::on the above -noted Parcels. In
the event that CMH abandons its intent to operate tllis wastewater irrigation system (for
example by abandoning its permit and failirg.to renew, or.',.seek new authority to operate),
then this Waiver will terminate. M
t' tiiy
loft
Book: 1288 Page: 420 Page 2 of 3

Amber Waves Holdings, LLC
4-77
By: �,ti
Printed Name: Aaron Goss
Title: Manaaer
Date: 14112117
( 1
North Carolina
1301%im
County
Carolina Malt House, Inc.
By: � �%�i
Printed Name: Stephan Bauk
Title: Vice President
Date:
I, Sly lu^ CJA&gcs,.,a„ , a Notary Public for said County and State, do hereby
certify that Aaron Goss and Stephan Bauk personally appeared before me this day and
acknowledged the due execution of the foregoing instrument.
Witness my hand and official seal, this the Jq� day of , 20 17
My commission expires:
Nooly Public ,CM E
V4S�,'
RY
CO
Z
�i, � �p oz►Z� �,..
2of2
Book: 1288 Page: 420 Page 3 of 3

DOCUMENT TYPE:
PREPARED BY
GRANTOR(S):
GRANTEE(S):
BENEFICIARY:
IF APPLICABLE:
RETURN TO:
IIII1111111111111111111111111111111111111111111111111111111111111111111111111111
Doc ID: 013795450006 TVPe: CRP
Recorded: 11/03/2017 at 10:19:53 AM
Fee Amt: $26.00 Page i of 6
Revenue Tax: $0.00
Rowan, NC
J. E. Brindle Register of Deeds
BK 1299 PG365
DOCUMENT COVER SHEET
'Wafts �A0kCV1A.1s j1(1
C m
0 l i 1 VA m ak$ h-o uSe-f l n G
TAX MAP
BRIEF DESCRIPTION:
aw av"- - of
l�asa' v tii
PARCEL NUMBER
Book: 1299 Page: 365 Page 1 of 6

Wastewater Spray Authorization and Grant of
Easement Running with the Land
This Easement is granted January 1, 2017 ("Effective Date") by
to
Amber Waves Holdings, LLC ("Grantor"), a North Carolina limited liability company
located at 12969 Statesville Blvd, Cleveland, NC 27013
Carolina Malt House, Inc. ("Grantee"), a North Carolina corporation located at 12969
Statesville Blvd, Cleveland, NC 27013.
Grantor covenants that it is the owner of 18.728 acres (more or less) along Statesville
Boulevard in Rowan County west of the town of Cleveland, further described in that deed
recorded in Book 1270, Page 806, Rowan County Registry ("Servient Parcel One");
and furthermore that it is the owner of 41.139 acres (more or less) along Statesville
Boulevard in Rowan County west of the town of Cleveland, adjoining Parcel One, further
described in that deed recorded in Book 1277, Page 888, Rowan County Registry
("Servient Parcel Two") (together with Servient Parcel One, the "Servient Parcels").
1 Grant of Easement.
Whereas Grantee intends to set up a spray irrigation system for its spent malt steeping
water, Grantor hereby grants to Grantee an easement (the "Easement"), to run with the
Servient Parcels, to build and operate a wastewater management system (as more
particularly identified below in Section 5) on the Servient Parcels, and to do all things
necessary or required by law in connection therewith. The Easement shall run with the
Servient Parcels and shall be binding on and inure to future owners, transferees, heirs,
and assigns of the Servient Parcels. Grantee shall not grant, convey, assign or otherwise
transfer to any other person or entity any of its right, title or interest in this Easement or
its liabilities or obligations under this Agreement, unless such transfer is part of its
transfer of the wastewater permit described herein. The Easement shall be binding upon
and inure to the Grantor, Grantee, and their respective heirs, representatives, successors
and assigns.
2 Use.
AWH authorizes CMH to build and maintain a waste storage pond and use spray
irrigation to distribute over Parcel One and Parcel Two the wastewater from the storage
pond, and to otherwise use Parcel One and Parcel Two as CMH deems necessary to
1of3
Book: 1299 Page: 365 Page 2 of 6

effectuate a wastewater irrigation permit that CMH anticipates receiving from the State of
is North Carolina, more particularly described in Section 5 below.
Said wastewater shall consist chiefly of steeping water produced as a byproduct of
malting grains, and shall not include sewage.
3 Compliance with 15A NCAC 02L .0107
The Easement shall comply with 15A NCAC 02L .0107 to the extent required by 15A
NCAC 02T .0604, and the remaining provisions of this Section shall be read narrowly or
broadly as necessary to meet the requirements of that regulation.
Construction and operation of water wells within the compliance boundary, as defined in
15A NCAC 02L, is prohibited.
The right is reserved to the permittee and the State to enter on the Servient Parcels within
the compliance boundary as defined in 15A NCAC 02L for groundwater monitoring and
remediation purposes.
4 Choice of Law.
This agreement shall be governed by and construed in accordance with the internal laws
of the State of North Carolina, U.S.A., without reference to any conflicts of law
provisions.
• 5 Identification of the Permit.
The Easement is issued in contemplation of Grantee obtaining a permit from the State of
North Carolina to operate a wastewater disposal system on the Servient Parcels, which
upon receipt and prior to recording of this document shall be identified as follows:
Permit Number:
Description of the Type of Permit:
Name, Address, and Telephone Number of the Permitting Agency:
6 Recording.
Grantee shall, at its expense, record this Easement Agreement in the records of Rowan
County, North Carolina, and shall provide Grantor with conformed copies of the recorded
instruments, as well as executed originals of all documents. Such recording shall take
place within ten (10) business days following the issuance of the permit to be identified
in Section 5.
• 2 of 3
Book: 1299 Page: 365 Page 3 of 6

El
Amber Waves Holdings, LLC
By: d
Printed Name: Aaron F. Goss
Title: ManaL-er
Date: li-th7-117
Carolina Malt House, Inc.
By: a �.�
Printed Name: Stephan P. Bauk
Title: Vice President
Date: WIZ/17
North Carolina
Wastewater irrigation system
permit identification (to be filled
in later :
VQ Q 00 301 rat
County
• I,n�lC.n LJ1 eVaS�,,, a Notary Public for said County and State, do
hereby cek-tify that Aaron F. Goss and Stephan P. Bauk personally appeared before me
this day and acknowledged the due execution of the foregoing instrument.
Witness my hand and official seal, this the i�� day of /�-j x,,)} . 20 17.
e� (_ �7,
Not Public
My commission expires:
is
3 of 3
Book: 1299 Page: 365 Page 4 of 6

senl* w� ParcLl D ��
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NOTE: A PORTION OF TB PROPERTY YES WITHIN DFTUOIATED FTDm
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• RN 37104794004.
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SUUEY AND NAP BY 9OENKIA R IBNKYNID COPAN/. PA SRN 0 0-411M
N4 N. MAN SU SUE A. SAIASRRY. MAL ROE: 704-N37-9673
Book: 1299 Page: 365 Page 5 of 6

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----—
Book: 1299 Page: 365 Page 6 of 6

State of North Carolina
DWR
Department of Environmental Quality
Division of Water Resources
Division of Water Resources 15A NCAC 02T .0500 — WASTEWATER IRRIGATION SYSTEM — RENEWAL
FORM: WWIS-R 02-21
Pursuant to 15A NCAC 02T .0107(b), if the application does not include all required information and the necessary supporting
documentation, the application shall be returned. The application and attachments shall be prepared in accordance with 15A
NCAC 02T .0100. 15A NCAC 02T .0500. and Division Policies. For more information, visit the Water Quality Permitting
Section's Non -Discharge Branch website. The Applicant shall submit an electronic copy of the application and attachments
uploaded as a single Portable Document Format (PDF) file to
httils: /edoes.dea.ne.gov/Forms/NonDiseh4 e-Branch-Submittal-Form-Ver2, or emailed to
Non-Discharge.ReDorts(d,ncdenr.gav if less than 20 megabytes (MB).
SECTION I —APPLICANT INFORMATION
1. Applicant: Aaron Goss
2. Permit No.: WQ00 39181
3. Signature authority: Aaron Goss
Phone number: (704) 412 - 9962
4. Mailing address: 12969 Statesville Blvd
City: Cleveland
5. Contact person: Mark van Wagenberg
Primary phone number: [phone]
Title: President
Email: [e-mail]
State: NC Zip: 27013 -
Email: [e-mail]
Secondary phone number: ( ) -
CTION II — FACILITY INFORMATION
1. Physical address: 12969 Statesville Blvd County:Rowan Parcel No.: 265 001
City: Cleveland
2. Treatment facility coordinates to the sixth decimal degree:
Latitude: Longitude:-80.71476 °
35.73871 °
State: NC Zip: 27013 -
Method: map interpretation by extraction
SECTION III — F1111115MATION
1. Permitted flow: 6,053
GPD (The maximum allowable flow based on what has been permitted)
2. As -built flow: 6,053
GPD (The maximum allowable flow based on what has been constructed)
3. Average flow: 5,378
GPD (The average of all reported flows on the previous calendar year's NDMRs)
4. Hydraulic capacity:.89
% (Divide the average flow in Item 3 by the As -built flow in Item 2)
5. Wastewater composition: Domestic : % Industrial: 100 % Stormwater: %
ECTION IV — BILLING INFORMATION
1. Billing address: 12969 Statesville Blvd
City: Cleveland State: NC Zip: 27013 -
2. Verify the Applicant does not have any overdue annual fees:
httDs://deo.ne. cov/about/divisions/water-resources/water-resources-hermits/wa-ehavments
FORM: WWIS-R 02-21 Page 1 of 6

Pursuant to 15A NCAC 02T .0120(c), permits for renewing facilities shall not be granted if the Applicant or any affiliation has
an unpaid annual fee.
FORM: WWIS-R 02-21 Page 2 of 6

SECTION V — OPERATOR IN RESPONSIBLE CHARGE (ORC) INFORMATION
1. ORC: Lynn Aldrigdge
Grade: SI Certification No.: 993778
Mailing address: 1200 Crossover ridge Dr.
City: Salisbury
State: NC Zip: 28147 -
Phone number: (704) 431- 5266
Email:[e-mail]
2. Back -Up ORC: Mark van Wagenberg
Grade: SI Certification No.: 1006711
Mailing address: 12969 Statesville Blvd
City: Cleveland
State: NC Zip: 27013 -
Phone number: ( 704 ) 213 - 9334
Email: [e-mail]
SECTION VI— OPEN -ATMOSPHERE STRUCTURES
I. List all open -atmosphere treatment and storage structures associated with the renewing permit. Attach additional sheets if
necessary.
Type Parcel No. Volume (gal) Liner Type Freeboard (ft) Latitude Longitude
lagoon 265 001 366,281 synthetic 211 35.738 . 0-80.715 . 0
1. List all wastewater permits (i.e., sewer, collection system, NPDES, residuals) that have interactions with the renewing permit.
Attach additional sheets if necessary.
Permit Type Permit No. Relationship Type
wastewater irrigation system WQ0039181
1. List all groundwater monitoring wells associated with the renewing permit. Attach additional sheets if necessary.
Well Name Parcel No. Status Gradient Location Latitude Longitude
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
FORM: WWIS-R 02-21 Page 3 of 6

1. List all irrigation fields associated with the renewing permit. Attach additional sheets if necessary
Field County
Parcel No.
Deeded Owner
Area Cover Crop
Latitude
Longitude
Rowan
265 001
Carolina Malt House, Inc.
35.737260
-80.713600
I
1.1 Fescue
O
0
Rowan
265 001
Carolina Malt House, Inc.
1.1
35.7385760
-80.713262`
2A
Fescue
0
0
Rowan
265 001
Carolina Malt House, Inc.
1.0
35.7379900
-80.712133`
2B
Fescue
0
0
0
0
0
0
0
0
0
0
0
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0
0
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0
0
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0
0
0
0
0
0
0
0
0
0
0
0
0
FORM: WWIS-R 02-21 Page 4 of 6

MR
MR
Total Acreage: 3.2
TTACHMENTA— S
Was the facility originally permitted or had a major modification issued after September 1, 2006?
❑ ❑ Yes — Pursuant to 15A NCAC 02T .0105(d), submit a site map pursuant to the requirements in 15A NCAC 02T .0504(d).
These requirements are:
❑ A scaled map of the site with topographic contour intervals not exceeding 10 feet or 25 percent of total site relief and
showing all facility -related structures and fences within the wastewater treatment, storage, and irrigation areas.
❑ Soil mapping units shown on all irrigation sites.
❑ The location of all wells (including usage and construction details if available), streams (ephemeral, intermittent, and
perennial), springs, lakes, ponds, and other surface drainage features within 500 feet of all wastewater treatment, storage,
and irrigation sites.
❑ Delineation of the compliance and review boundaries per 15A NCAC 02L .0107 and .0108, and 15A NCAC 02T .0506(c)
if applicable.
❑ Setbacks as required by 15A NCAC 02T .0506.
❑ Site property boundaries within 500 feet of all wastewater treatment, storage, and irrigation sites.
❑ All habitable residences or places of public assembly within 500 feet of all treatment, storage, and irrigation sites.
❑ ❑ No — Skip Attachment A.
MEJANOWNATURE AUTHORITY DELEGATIO
Does the signature authority in Section I, Item 3 meet the requirements pursuant to 15A NCAC 02T .0106(b)? ❑
❑ ❑ Yes — Skip Attachment B.
❑ No — Submit a delegation letter pursuant to 15A NCAC 02T .0106(c) authorizing the signature authority to sign.
TTACHMENT C — FLOW REDUCTION
Does the existing permit include an approved flow reduction?
❑ ❑ Yes — Submit a copy of the flow reduction approval letter, as well as the measured monthly average amount of wastewater
flow contributed per unit for the 12 months prior to permit renewal. If any of these monthly averages are within 20% of the
approved flow reduction value, the Permittee shall provide a reevaluation of the reduced flow value pursuant to the
requirements in 15ANCAC 02T .0114(fl.
❑ ❑ No — Skip Attachment C.
HMENT UBLIC CONVENIENCE AND NECESSITY
Is the Applicant a Privately -Owned Public Utility? ❑
❑ ❑ Yes — Pursuant to 15A NCAC 02T .0115(a)(1), submit the Certificate of Public Convenience and Necessity from the North
Carolina Utilities Commission demonstrating the Applicant is authorized to hold the utility franchise.
❑ No — Skip Attachment D.
ATTACHMENT E — OPERATIONAL AGREEMENT
Is the Applicant a Home/Property Owners' Association or Developer of Lots to be Sold? ❑
El El Yes (Home/Property Owners' Association) — Pursuant to 15A NCAC 02T _0115(a)(2), submit an executed Onerational
Aereement (FORM: HOA). Pursuant to 15A NCAC 02T .0I15(c). if the applicant is a legally formed Homeowners' or Property
Owner's Association, submit a copy of the Articles of Incorporation, Declarations, and By-laws.
❑ ❑ Yes (Developer of Lots to be Sold) — Pursuant to 15A NCAC 02T .0115(a)(2), submit an executed Operational Acreement
(FORM- DFV). Pursuant to 15A NCAC 027 0115(,W if the applicant is a developer of lots to be sold, submit a copy of the
Articles of Incorporation, Declarations, and By-laws.
❑ No — Skip Attachment E.
FORM: WWIS-R 02-21 Page 5 of 6

FORM: WWIS-R 02-21 Page 6 of 6

_ ATTACHMENT F—JEMONSTRAIMIS FUTURE WASTEWATER TREATMENT CAPACITIES
Is the applicant a municipality, county, sanitary district, or public utility?
❑ ❑ Yes — Proceed to the next question.
❑ ❑ No — Skip Attachment F.
Does the hydraulic capacity in Section III, Item 4 exceed 70%?
❑❑ Yes (the hydraulic capacity is greater than 70%, but less than 80%) — Pursuant to 15A NCAC 02T _0118(1) prior to
exceeding 80 percent of the system's permitted hydraulic capacity (based on the average flow during the last calendar year), the
permittee shall submit an engineering evaluation of their future wastewater treatment, utilization, and disposal needs. This
evaluation shall outline plans for meeting future wastewater treatment, utilization, or disposal needs by either expansion of the
existing system, elimination or reduction of extraneous flows, or water conservation and shall include the source of funding for
the improvements. If expansion is not proposed or is proposed for a later date, a justification shall be made that wastewater
treatment needs will be met based on past growth records and future growth projections, and as appropriate, shall include
conservation plans or other measures to achieve waste flow reductions.
❑ ❑ Yes (the hydraulic capacity greater than 80%) — Proceed to the next question.
❑ ❑ No — Skip Attachment F.
If answered Yes above, does the hydraulic capacity in Section III, Item 4 exceed 80%?
❑ ❑ Yes (the hydraulic capacity is greater than 80%) — Pursuant to 15A NCAC 02T .0118(2), prior to exceeding 90 percent of the
system's permitted hydraulic capacity (based on the average flow during the last calendar year), the permittee shall obtain all
permits needed for the expansion of the wastewater treatment, utilization, or disposal system and, if construction is needed,
submit final plans and specifications for expansion, including a construction schedule. If expansion is not proposed or is
proposed for a later date, a justification shall be made that wastewater treatment needs will be met based on past growth records
and future growth projections, and as appropriate, shall include conservation plans or other specific measures to achieve waste
flow reductions.
❑ ❑ No — Skip Attachment F.
ATTACHMENT G — EASEMENT, ENC&ACHMENT, AND LEASE AGREEMENTS
Does the Permittee own all of the land associated with the wastewater collection, treatment, conveyance, and irrigation system?
❑ ❑ Yes — Skip Attachment G.
❑ ❑ No —Pursuant to 15A NCAC 02T .0116(c), provide a copy of all easements, lease agreements, and encroachment agreements
allowing the Permittee to operate and maintain the wastewater collection, treatment, conveyance, and irrigation system on
property not owned by the Permittee.
ATTACHMENT H — AFFILIATIONS
Are the Permittee's affiliations of record correct? Check affiliations.
❑ ❑ Yes — Skip Attachment H.
❑ ❑ No — Provide the corrected affiliations and their contact information.
TTACHMENmQMPLIANCE SCHEDULE
Does the existing permit include any Compliance Schedules? (See Section I of the most recently issued permit)
❑ ❑ Yes — Submit documentation that the compliance schedules have been met.
❑ ❑ No — Skip Attachment I.
HMENT,—�ALTIES AND OUTSTANDING VIOLATION
Does the Permittee have any existing civil penalties or outstanding violations?
❑ ❑ Yes (civil penalties) — Submit payment for the civil penalty, or proof of remission request.
❑ ❑ Yes (violations) — Submit a copy of your response to the Notice of Violation.
❑ ❑ No — Skip Attachment J.
FORM: WWIS-R 02-21 Page 7 of 6

ATTACHMENT Kgl§JWL WASTEWATER
Does the wastewater composition in Section III, Item 5 include any industrial wastewater?
❑ ❑ Yes — Proceed to the next question.
❑ ❑ No — Skip Attachment K.
Has the nature of the industrial wastewater changed since the last permit issuance (i.e., changes in industrial process, introduction
of new materials or chemicals, etc.)?
❑ ❑ Yes — Provide a chemical analysis of the wastewater pursuant to the requirements in 15A NCAC 02T .0504(h). Provide an
overview of the manufacturing process; an inventory of all chemical and biological materials used in the manufacturing
process; and an overview of the cleaning and treatment methodology.
❑ ❑ No — Provide an overview of the manufacturing process; an inventory of all chemical and biological materials used in the
manufacturing process; and an overview of the cleaning and treatment methodology.
Our manufacturing process has not changed; it consists only of water and small grains.
TTACHMENT L — SETBACK WAIVERS
Does the existing permit include setback waivers?
❑ Yes — Pursuant to 15A NCAC 02T .0506(d), provide setbacks waivers that have been written, notarized, signed by all parties
involved, and recorded with the county Register of Deeds. Waivers involving the compliance boundary shall be in accordance
with 15A NCAC 02L.0107.
❑ No — Skip Attachment L.
APPLICANT'S CERTIFICATION
I Aaron Goss attest that this application
(Signature authority's name as noted in Section I, Item 3)
has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that if all required parts of this
application package are not completed, and that if all required supporting information and attachments are not included, this
application package will be returned as incomplete. I further certify pursuant to 15A NCAC 02T .0120(b), that the applicant, or
any parent, subsidiary, or other affiliate of the applicant has: not been convicted of environmental crimes under; not previously
abandoned a wastewater treatment facility without properly closing the facility; not paid a civil penalty; not been compliant with
any compliance schedule in a permit, settlement agreement, or order; not paid an annual fee.
Note: The Applicant's Certification shall be signed pursuant to 15A NCAC 02T .0106(b). An alternate person may be delegated as
the signing official if a letter is provided pursuant to 15A NCAC 02T .0106(c). Pursuant to § 143-215.6A and § 143-215.613, any
person who knowingly makes any false statement, representation, or certification in any application package shall be guilty of a
Class 2 misdeme hi h include a fine not to exceed $10,000 as well as civil penalties up to $25,000 per violation.
Signature: x4lix Date: 2-23-23
THE COMPLETED APPLICATION AND ATTACHMENTS SHALL BE SUBMITTED AS A SINGLE PDF FILE VIA:
Email:
Non-Discharge.Reno rts(d..ncdenr. gov
Laserfiche Upload:
httils: edoes.den.ne.gov/Forms[NonDischar=-B.ra..n.ch-Sijb
mittal-Form-Ver2
FORM: WWIS-R 02-21 Page 8 of 6