Loading...
HomeMy WebLinkAboutWQ0033357_More Information (Received)_20230405Initial 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) * W00033357 Applicant/Permittee S & J Villari Livestock, LLC 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* Gerald Matthews Email Address* gerald.m@vfgmail.com 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* 19102932157 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:* WQ0033357 Has Current Existing permit number Applicant/Permittee Address* 892 Penny Branch Rd. Facility Name* S & J Villari Livestock Class B Residuals Program Please provide comments/notes on your current submittal below. At this time, paper copies are no longer required. If you have any questions about what is required, please contact Nathaniel Thornburg at nathaniel.thornburg@ncdenr.gov. Please attach all information required or requested for this submittal to be reviewed here. (Application Form, Engineering Plans, Specifications, Calculations, Etc.) renew WQ0033357 B.pdf 12.11MB 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 4*t"' WA**~ Submission Date 4/5/2023 070MIR "Divlsion of water Resources State of North Carolina Department of Environmental Quality Division of Water Resources LAND APPLICATION SITE CERTIFICATION INSTRUCTIONS FOR FORM: LASC 06-16 Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional information requested. Failure to submit all of the required items will lead to additional processing and review time for the permit application. Unless otherwise noted. the Applicant shall submit one original and two conies of the application and supporting documentation For more information, visit the Water Quality Permitting Section's Non -Discharge Permittinn Unrt General — This certification provides detailed information of receiving sites for land application of Class B residuals (may include water treatment plant or other type residuals) in accordance with 15A NCAC 02T .1100. Do not submit this certification for review without a corresponding application form (FORM: RLAP 06-16 or FORM: SDR 06-16). Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed below. A. Land Application Site Certification (FORM: LASC 06-16): Submit the completed and appropriately executed Land Application Site Certification (FORM: LASC 06-16) form. Please do not make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to the application may be made, as long as the attachments are numbered to correspond to the section and item to which they refer. ® For new or renewed permits, submit the requested information for all land application sites. ❑ For modified permits, submit the requested information for only those sites that are new, transferred or affected by the proposed modification. B. Land Application Site Information: ❑ The status of the land application site with respect to this residuals land application program must be provided in table I. The status categories and their corresponding codes are as follows: ♦ New (N) ♦ Renewed (R) ♦ Modified (M) ♦ Transferred (T) ♦ Deleted (D) ❑ Attach the following in accordance with each status code: Status Code Required Item N R T M ; County Board ✓ Notif !cation. doc Lander ✓ '� ✓ # Agreement (If applicable) I Bit✓ ✓ ✓ Setback Waiver Agreement An updated vicinity/setback map in accordance with the "Man Guidance for Residuals Land Apolication Permits" ✓ ✓ ✓ A soils and agronomic evaluation in accordance with the "Soil Scientist Baluatinn Policy" _ ✓ INSTRUCTIONS FOR FORM: LASC 06-16 Pagel of 3 An updated accounting of the land application site's cumulative ✓ ✓ pollutant loading rates CPLRs Status Code Required Item NY I R T M For previously permitted sites without a soil series name indicated in the Attachment B, submit County Soil Survey Map (or equivalent) clearly indicate the location of the land application site and in accordance with ✓ ✓ ✓ the soil map requirements in the "Soil Scientist Evaluation Policy" Acknowledgement of field transfer from Land Owner (Fields may not be permitted to multiple Permittees over the same timeperiod) ✓ • This item may be required for land application site with a status code "M", please contact the Division if you need assistant in determining attachment requirements. ❑ Crop Type should include the most likely crop types for the life of the permit (five years). ❑ Predominant Soils Series Name must be either the name of the soil indicated in Attachment "B" of the existing permit, or name of the soil series as provided by the licensed soil scientist. ❑ Predominant Soil Mapping Unit or Representative Slope: Either the Soil Mapping Unit or the representative slope of each site must be provided. The predominant soil -mapping unit must be consistent with the predominant soil series name. Please note that the soil mapping units are variable between Counties, so care should be taken in properly identifying the correct mapping unit. If a representative slope is provided, it must be determined accordingly: ❑ For sites previously permitted for use, but do not have an established soil mapping unit (the mapping unit provides information on both the soil series name and the slope of the soil), the Applicant may determine the representative slope by using the average slope provided in the County Soil Survey (or equivalent). A soil type with a slope range of 4 - 8% would have a representative slope of 6%. ❑ New Sites to be permitted must have slopes determined as part of the soils report prepared by a licensed soil scientist. ❑ Acceptable methods for determining location coordinates (i.e., latitude and longitude) and their corresponding codes are as follows: • Address Matching (ADD) • Aerial Photography with Ground Control (AER) • Cadastral Survey (SUR) • Conversion from Coordinate Plane (CP) • Conversion from Township -Section -Range (TSR) • Conversion from Universal Trans Merc (UTM) • Map Interpretation by Digital or Manual Extraction (MAP) C. Waterbody and Classifications Information: (new sites only) • Digital or Raw Photo Extraction (EXT) • Geodetic Quality GPS Survey (GEO) • LORAN-C Navigation Device (LOR) • Navigation Quality GPS (GPS) • Remote Sensing (RS) • Zip Code Centroid (ZIP) ❑ Use an 8.5 by I 1-inch copy of the portion of a 7.5-minute USGS Topographic Map to identify the location where the residuals program activities are planned to occur as well as the closest downslope surface waters as clearly as possible. Each map portion must be labeled with the map name and number, the identified location, and be of clear and reproducible quality. ❑ Surface water body classifications information may be found at: h!W://deg.nc.gov/about/divisions/water- resources/nlannine/classification-standards/classifications ❑ Any questions concerning the waterbody and its classification, please contact the Division's regional offices. ❑ A list of the Division's regional offices, their county coverage, and their contact information may be downloaded at: htto://deci.nc.gov/contact/regional-offices ❑ General Instructions: There are 17 river basins in North Carolina. Each basin has associated waterbodies with assigned subbasins, location descriptions, stream index numbers and established classifications. 1. Identify the project area on a 7.5 minute USGS topographical map (an 8.5 x 11-inch sheet showing the project area should be submitted with the permit application regardless of whether a Stream classification was completed). 2. Determine the names of all the closest down slope surface waters from the project site. For unnamed tributaries, see Table 1: Unnamed Tributaries Entering Other States or for Specific Basin Areas. Label any unnamed tributaries as "UT to stream name" as the waterbody name. 3. Open the link htto://deg.nc.gov/about/divisions/water-resources/planning/classification-standards/classifications. ❑ Stream Classification Process: One of the options below may be used depending on the known initial project information. ❑ KNOWN BASIN WHERE CLOSEST DOWN SLOPE SURFACE WATER IS LOCATED 1. Select proper basin from the List all Waterbodies in Basin sorted report. Sort hydrologically as this will provide the proper location descriptions if multiple runs. INSTRUCTIONS FOR FORM: LASC 06-16 Page 2 of 3 2. Locate the name of the identified waterbody (from General Directions) on the list. 3. For multiple listings of the same waterbody name in the report, select and verify the location description. The term "source" in the description means the beginning of the waterbody segment (most upstream point). 4. Record all Basins, Stream Index Numbers and Classifications applicable to the project. ❑ KNOWN COUNTY WHERE CLOSEST DOWN SLOPE SURFACE WATER IS LOCATED 1. Select the proper county from the List all Waterbodies in county, hydrologically report. 2. Locate the name of the identified waterbody (from General Directions) on the list. 3. For multiple listings of the same waterbody name in the report, select and verify the location description. The tens "source" in the description means the beginning of the waterbody segment (most upstream point). 4. Record all Basins, Stream Index Numbers and Classifications applicable to the project. ❑ UNKNOWN BASIN WHERE CLOSEST DOWN SLOPE SURFACE WATER IS LOCATED 1. Use the Clickable basin map to hydrologically sorted list report. 2. Click on the approximate project location to bring up the hydrologically sorted list. 3. Locate the name of the identified waterbody (from General Directions) on the list. 4. For multiple listings of the same waterbody name in the report, select and verify the location description. The term "source" in the description means the beginning of the waterbody segment (most upstream point). 5. Record all Basins, Stream Index Numbers and Classifications applicable to the project. ❑ Notes on index number and unnamed streams: Unnamed Streams 15A NCAC 02B .03016) ❑ Any stream which is not named in the schedule of stream classifications carries the same classification as that assigned to the stream segment to which it is tributary (at the point of entry) except: (A) unnamed streams specifically described in the schedule of classifications; (B) unnamed freshwaters tributary to tidal saltwaters will be classified "C; or (C) after November 1, 1986, any newly created areas of tidal saltwater which are connected to Class SA waters by approved dredging projects will be classified "SC" unless case -by -case reclassification proceedings are conducted. ❑ The following river basins have different policies for unnamed streams entering other states or for specific areas of the basin: Unnamed Tributaries Entering Other States or for Specific Basin Areas Hiwassee River Basin Streams entering Georgia or Tennessee shall be classified "C Tr." Little Tennesse River Basin And Savannah River Drainage Area Streams entering Georgia or Tennessee shall be classified "C Tr." Such streams in the Savannah River drainage area entering South Carolina shall be classified "B Tr." French Broad River Basin Streams entering Tennessee will be classified "B." Watauga River Basin Streams entering the State of Tennessee are classified "C." Broad River Basin Streams entering South Carolina are classified "C." New River Basin Streams entering the State of Tennessee are classified "C." Catawba River Basin Streams entering South Carolina are classified "C." Yadkin -Pee Dee River Basin Streams entering Virginia are classified "C," and such streams entering South Carolina are classified "C." Lumber River Basin Streams entering South Carolina are classified "C Sw." Roanoke River Basin Streams entering Virginia are classified "C." Except that all backwaters of John H. Kerr Reservoir and the North Carolina portion of streams tributary thereto not otherwise named or described shall carry the classification "B," and all backwaters of Lake Gaston and the North Carolina portion of streams tributary thereto not otherwise named or described shall carry the classification "C and B." Chowan River Basin Streams entering Virginia are classified "C." Tar -Pamlico River Basin All drainage canals not noted in the schedule are classified "C Sw." except the main drainage canals to Pamlico Sound and its bays which shall be classified "SC." Pas uotank River Basin All drainage canals not noted in the schedule are classified "C." INSTRUCTIONS FOR FORM: LASC 06-16 Page 3 of 3 a v e a /1111111 as �e �111111 z z x IIIII I1111. U A A v O V � � u � IIIII' c g � � 11111 C ati N111111� i �� 2 �y y= h U x x z z z z z c z r ° u 1111111 0. W �UIIII1111 U N N S 00 � 9s � �111111 A 3 w w U W C C q G C C C C Sz z z z z z z z 8 9 O C t � E � Sa , s iiiiii R 9 N ii+itii®. M Miiiiii! a .a 9 — N 111111 � a y 'n State of North Carolina DWR Department of Environmental Quality Division of Water Resources Division of Water Resources 15A NCAC 02T .1100 — RESIDUALS LAND APPLICATION PROGRAM INSTRUCTIONS FOR FORM: RLAP 06-16 & SUPPORTING DOCUMENTATION ]Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional information requested. Failure to submit all of the required items will lead to additional processing and review time for the permit application. Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting Unit General — This application is for treatment, storage, transport, and/or land application of Class B residuals (may include residuals that are generated from a water treatment plant or other type facilities) on the proposed or currently approved land application site(s) under 15A NCAC 02T .l 100. Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed below. A. Residuals Land Application Program (FORM: RLAP 06-16) Application: (All Application Packages): Submit the completed and appropriately executed Residuals Land Application Program (FORM: RLAP 06-16) form. Please do not make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to the application may be made, as long as the attachments are numbered to correspond to the section and item to which they refer. The Applicant's Certification on Page 5 of this form shall be signed in accordance with 15A NCAC 02T .0106(b). An alternate person may be designated as the signing official if a delegation letter is provided from a person who meets the criteria in 15A NCAC 02T .0106(b). If this project is for a modification of an existing permit, submit one copy of the existing permit. Please submit this application form at least 180 days prior to the expiration date on the existing permit, or 90 days prior to operation of proposed facility(ies) for application packages involving new or changes to treatment and storage units. B. Application Fee (New and Major Modification Application Packages) IM Submit a check, money order or electronic funds transfer made payable to: North Carolina Department of Environmental Quality (NCDEQ). FFacility Classification ) New Permit Major Modification' Major (land are permitted for > 300 acres) $1,310 $395 Minor (land are permitted for < 300 acres) �— $810 $245 A major modification shall be defined as any permit modification that: increases the generating facility's residuals dry tonnage; adds additional land application areas not previously approved for that particular program [including transferring of field(s) from one program to another]; adds additional residuals sources; or includes the addition of new treatment or storage units/processes not previously permitted. There is no fee for minor modifications to a permit. C. Cover Letter (All Application Packages) List all items included in the application package, as well as a brief description of the requested permitting action. D. Environmental Assessments (May be Required— See 15A NCAC IC .0300) 171 Submit a copy of the Findings of No Significant Impact (FONSI) or Environmental Impact Statement (EIS). Also, include information on any mitigating factor(s) from the Environmental Assessment (EA) that impact the construction of the residuals treatment and storage facilities. An EA may also be required for private systems if any public funds and/or lands are used for the construction of the subject facilities. INSTRUCTIONS FOR FORM: RLAP 06-16 Page 1 of 3 E. Operation and Maintenance Plan (New and Renewal Application Packages) Q For Modification Application, if there are any changes to the existing plan, submit an updated O&M plan. El Submit the O&M Plan in accordance with 15A NCAC 02T .I 110 and include at a minimum: Operational functions; describe the operation of the program to show what operations are necessary for the program to function and by whom the functions are to be conducted. Maintenance schedules; may include equipment calibration, maintenance of signs, etc. Q Safety measures; may include safety training program, manuals, signs, etc. 0 Spill response plan; including control, containment, remediation, emergency contact information, etc. Inspection plan including the following information; IM Names and titles of personnel responsible for conducting the inspections. FN Frequency and location of inspections, including those to be conducted by the ORC, and procedures to assure that the selected location(s) and inspection frequency are representative of the residuals management program. Detailed description of inspection procedures including record keeping and actions to be taken by the inspector in the event that noncompliance is observed. Sampling and monitoring plan including the following information; Names and titles of personnel responsible for conducting the sampling and monitoring. Detailed description of monitoring procedures including parameters to be monitored. Sampling frequency and procedures to assure that representative samples are being collected. Fluctuation in temperature, flow, and other operating conditions can affect the quality of the residuals gathered during a particular sampling event. The sampling plan shall account for any foreseen fluctuations in residuals quality and indicate the most limiting times for residuals to meet pathogen and vector attraction reduction requirements (e.g. facilities that land apply multiple times per year but have an annual sampling frequency, may need to sample during winter months when pathogen reduction is most likely to be negatively affected by cold temperatures. THE FOLLOWING ADDITIONAL ITEMS (G to M) ARE REQUIRED FOR DEDICATED PROGRAM ONLY. F. Program Determination Dedicated residuals land application programs are ones in which land application sites meet the criteria in 15A NCAC 02T .1102(12). Specifically, a residuals land application program is designated as dedicated if any of the following are applicable: Any land application site certified for the residuals land application program that receives residuals at rates or frequencies greater than agronomic rates. Any land application site certified for the residuals land application program that is used primarily for residuals disposal, and agricultural crop production is of secondary importance. Any land application site certified for the residuals land application program that receives residuals through fixed irrigation facilities or irrigation facilities fed through a fixed supply system. Please contact the Non -Discharge Permitting Unit if you need any assistance in determining whether your residuals program falls under the dedicated program definitions. G. Program Information Ej Provide an explanation of why a dedicated system is required instead of a conventional non -dedicated system. El Provide an explanation of the dedicated system and its operation. H. Detailed Site Maps (All New or Modification Application Packages) 0' Submit three (3) sets of standard size plans and two (2) sets of 11" by 17" plans (electronic format is acceptable - Adobe PDF only). For Modifications, submit plans specific to the modification(s) only. ❑ Plans must include the following minimum items: 0 A general location map, a vicinity map and a topographic map with contours not exceeding 10 feet or 25% of the total site relief and showing all facility related structures and fences within the land application area. Q 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 the land application site(s). Delineation of the review and compliance boundaries Q Setbacks as required by 15A NCAC 02T .1 I08 Site property boundaries within 500 feet of all waste treatment, storage, and disposal site(s). A map showing the entire irrigation area with an overlay of the suitable irrigation area depicted by the soil scientist's evaluation. The irrigation plans shall show each nozzle/emitter and wetted area (when applicable). Clearly label spray irrigation zones as they will be operated. Plans must depict a completed design and not be labeled with preliminary phrases (e.g., FOR REVIEW ONLY, NOT FOR CONSTRUCTION, etc.) that indicate that they are anything other than final plans. However, the plans may be labeled with the phrase: FINAL DESIGN - NOT RELEASED FOR CONSTRUCTION INSTRUCTIONS FOR FORM: RLAP 06-16 Page 2 of 3 1. Project Evaluation and Receiver Site Management Plan (All New Application Packages or Modifications that include new sites) 'u; Submit a project evaluation and a receiver site management plan (if applicable) with recommendations concerning cover crops and their ability to accept the proposed application rates. J. Hydrogeologic Report (All New Application Packages or Modifications involving increasing the total design capacity) El Submit a detailed hydrogeologic evaluation in accordance with 15A NCAC 02T .1104(d)(4) and current Division Policy available at: httr)://www.newater.ouVRules Policies and Reeulations . The document shall be signed, sealed and dated by a qualified professional. K. Engineering Design Documents (All New or Modification Application Packages with fixed irrigation facilities or irrigation facilities fed through fixed supply system) Submit engineering design documents that have been signed, sealed, and dated by a NC licensed Professional Engineer and/or Professional Land Surveyor in accordance with 15A NCAC 02T. I 104(d)(2). For Modifications, submit an updated site map specific to the modification(s) only. The design documents must include the following minimum items: 13 Engineering plans for the facility and equipment except those previously permitted unless they are directly tied into the new units or are critical to the understanding of the complete process; Specifications describing materials to be used, method of construction, and means for ensuring quality and integrity of the finished product including leaking testing; and E3 Engineering calculations including hydraulic and pollutant loading, sizing criteria, hydraulic profile, total dynamic head curve analysis for each pump, and irrigation design. Soil mapping units shown on all disposal sites. L. Water Balance (All New Application Packages or Modifications that include new sites utilizing fixed irrigation facilities or irrigation facilities fed through fixed supply systems) Submit a completed and accurate water balance in accordance with 15A NCAC 02T .I 104(d)(5) and current Division Policy available at: http://www.ncwater.orgLRules Policies and Reeulations/. M. Property Ownership Documentation (All New or Modification Application Packages involving new and/or relocated treatment or irrigation components) Property ownership documentation shall consist of one of the following: Q Legal documentation of ownership (i.e., GIS, deed or article of incorporation), or [( Written notarized intent to purchase agreement signed by both parties with a plat or survey map, or Q' An easement running with the land specifically indicating the intended use of the property and meeting the requirements of 15A NCAC 02L .0107(f), or °_] A written notarized lease agreement signed by both parties, indicating the intended use of the property, as well as a plat or survey map. ONE ORIGINAL AND TWO COPIES OF THE COMPLETED APPLICATION PACKAGE, INCLUDING ALL SUPPORTING INFORMATION AND MATERIALS, SHALL BE SENT TO THE FOLLOWING ADDRESS: NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY DIVISION OF WATER RESOURCES WATER QUALITY PERMITTING SECTION NON -DISCHARGE PERMITTING UNIT By U.S. Postal Service: 1617 MAIL SERVICE CENTER RALEIGH, NORTH CAROLINA 27699-1617 TELEPHONE NUMBER: (919) 807-6464 By Courier/Suecial Delivery: 512 N. SALISBURY STREET RALEIGH, NORTH CAROLINA 27604 FAX NUMBER: (919) 807-6496 INSTRUCTIONS FOR FORM: RLAP 06-16 Page 3 of 3 State of North Carolina DWR Department of Environmental Quality Division of Water Resources Division of Water Resources 15A NCAC 02T .1100 — RESIDUALS LAND APPLICATION PROGRAM FORM: RLAP 06-16 1. APPLICANT INFORMATION: 1. Applicant's name: S & J Villari Livestock LLC Applicant type: 93Individual @I Corporation General Partnership E3 Privately -Owned Public Utility M Federal E3 State EB Municipal 0 County Signature authority's name per 15A NCAC 02T .0106: Sam Villari Title: Owner Applicant's mailing address: 892 Penny Branch Rd. City: Wallace State: NC Zip: 283984 s`P` Telephone number: 910) 293-2157 Email Address: sam.v vfgmail.com 2. Consultant's name: License Number (for P.E.): `'M Affiliation: M On Staff ❑ Retained (Firm: _) Consultant's mailing address: _ City: M State — Zip: ZiP -. '... Telephone number: (-) _ s_ Email Address:' 3. Agronomist's name: License Number: am Affiliation: [3 N/A 0 On Staff r3 Retained (Firm: En Agronomist's mailing address:' City: EM State: _:_ Zip: Telephone number: (_) _ ` Email Address: MW 4. Soil Scientist's name: _ License Number: ME Affiliation: O N/A ❑ On Staff 0 Retained (Firm: Soil Scientist's mailing address: City: u State: „� Zip: Telephone number (�) Email Address: 5. Fee submitted:'1_ (See Instruction B) IL PERMIT INFORMATION: 1. Application is for (check all that apply): M new, 13 modified, to renewed permit 2. If this application is being submitted to renew or modify an existing permit, provide the following: Permit number: W00033357 Date of most -recently issued permit: November 112017 Date of most -recently certified Attachment A (if different than the permit): Date of most -recently certified Attachment B (if different than the permit): FORM: RLAP 06-16 Pagel of 5 Ill. RESIDUALS LAND APPLICATION PROGRAM INFORMATION: I. Residuals Processing Facility's physical address: 892 Penny Branch Rd. City: Warsaw State: NC Zip: 28398 Coordinates: Latitude: 35' 0' 39" Longitude: 78. T 20" Datum: Unknown Level of accuracy: Unknown Method of measurement: Man interpretation by extraction 2. County where residuals land application program is headquartered: Dunlin 3. List the Operator In Responsible Charge (ORC) and all Back -Up ORCs for the residuals land application program, their certification numbers, and their affiliations in the following table: Designation Name Affiliation Certification Number ORC Gerald L Matthews The Pork Company 1007103 Back -Up ORC Joshua Tray Batchelor. Agriment Services 993694 Additional Back -Up ORCs (if applicable) NM If an ORC and at least one Back -Up ORC are not currently designated for this residuals land application program, provide the candidates' names, affiliations, and an estimated time schedule for each candidate's completion of the required training school and certification test: EM 4. Complete the following tables regarding management of the residuals land application program: a. Plant Available Nuronen Summary: Determine the maximum plant available nitrogen (PAN) generated by all residuals source -generating facilities as currently certified and proposed for certification with this application and list the results in the following table: Maximum amount of residuals to be certified: 11.6 dry tons per year. PAN Pounds of PAN per Dry Ton (Weighted Average) Pounds of PAN per Year Surface Incorporation or Injection Surface Incorporation or Injection First -Year 13.2 153.1 Five -Year Maximum Adjusted 25.6 Sm 297.0 b. Land Aoolieation Site Use Summary: Summarize information regarding the land application sites as currently certified and proposed for certification with this application: Category Use Acres Comments Crops Forest or Plantation Row Crops EN Hay 5.52 TIM Pasture Total: 5.52 Methods Surface 5.52 Contract tanker spreader Incorporation or Injection Total: 5.52 FORM: RLAP 06-16 Page 2 of 5 c. Residuals Land Application Summary: Determine the minimum acreage required to land apply the residuals as currently certified and proposed for certification assuming the scenarios listed in the following table: Assumed Application Rate (lbs PAN/ae yr) Acres Required Using First -Year PAN Concentrations Acres Required Using Five -Year Maximum Adjusted PAN Concentrations Surface Incorporation or Injection Surface Incorporation or Injection 50 3.06* 5.94 100 1.53 _ a ics 2.97 150 1.02 v 1.98 200 0.77 1.48 6. If applicable, provide a plan and a schedule to resolve any known issues that would prevent land application of the proposed residuals due to the violation ofNorth Carolina Administrative Code (e.g. not enough storage, not enough land, vector reduction practices not in place, etc.): N/A 7. Specify type of residuals program (See Instruction F): In Non -dedicated 63 Dedicated If Dedicated specify the following (check all that apply): Residuals program contains any land application site(s) that receives residuals at rates or frequencies greater than agronomic rates, explain, M Residuals program contains any land application site s) that is used primarily for residuals disposal, and agricultural crop production is of secondary importance, explain; Residuals program contains any land application site(s) that receives residuals through fixed irrigation facilities or irrigation facilities fed through a fixed supply system, explain; IV. RESIDUALS SOURCE INFORMATION: (Required for all new, renewed, or modified residuals source) Complete and submit the following Residuals Source Certification and all associated documentation. Residuals Source Certification V. LAND APPLICATION SITE INFORMATION: (Required for all new, renewed, or modified land application site) Complete and submit the following Land Applications Site Certification and all associated documentation. ft Land Application Siite Certification. doc FORM: RLAP 06-16 Page 3 of 5 Note: Item VI. Applicable to Dedicated Program with fixed irrigation system only. VI. DESIGN INFORMATION FOR FIXED IRRIGATION SYSTEM 1. The irrigation system is: 0 Spray NDrip 2. Disposal system is: n existing ® proposed. 3. Minimum depth to mean seasonal high water table (SHWT) within irrigation sites(s) per Soil Scientist's Evaluation: 11 feet below ground surface. Rules 15A NCAC 02T .0505(n) requires at least one -foot vertical separation between SHWT and ground surface. 4. Are there any artificial drainage or water movement structures within 200 feet of any irrigation area? Yes or 11 No If Yes, please explain if the soil scientist report addresses artificial structures and please indicate if structures are to be maintained or modified: 5. Loading rates recommended by the Soil Scientist Evaluation: Soil Series I Fields within Soil Area Recommended Loading Rate inlhr Recommended Loading Rate in! r 6. Design loading rates are equal or less than the loading rates recommended by Soil Scientist? Yes or E No If No, explain why 15A NCAC 02T .0505(n) is not met: 7. Non -dedicated System Design (fill in the appropriate information for either a spray or drip irrigation system): Field / Zone Design Area Number of Nozzles Maximum Application Rate allons/hr Design Annual Loading Rate allons/ r ® ATE ry 4: Total ® _ Spray Irrigation Design Element Plan Sheet Number Specification PaLe Number Wetted diameter of nozzles ft — Wetted area of nozzles — ftz ® — Nozzle capacity _ gpm ® S Nozzle manufacturer / model ®/ Elevation of highest nozzle _ ft FORM: RLAP 06-16 Page 4 of 5 Applicant's Certification (signing authority must be in compliance with 15A NCAC 02T .0106): The applicant or any affiliate has not been convicted of an environmental crime, has not abandoned a wastewater facility without proper closure, does not have an outstanding civil penalty where all appeals have been exhausted or abandoned, are compliant with any active compliance schedule, and do not have any overdue annual fees under Rule 15A NCAC 02T .0105. 0 Yes D No, Explain; I, -S'ALVAT 0tZ6- VILLA/Lk MAr/AGING ML4M136n, (Signature Authority's Name — PLEASE PRINT) (Title) attest that this application for + S V I LLA(1 1- I VdS 'Fa C 41 L L c (Facility Name) has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that the Division of Water Resources may not conduct a technical review of this program and approval does not constitute a variance to any rules or statutes unless specifically granted in the permit. Further, any discharge of residuals to surface waters or the land will result in an immediate enforcement action, which may include civil penalties, injunctive relief, and/or criminal prosecution. I will make no claim against the Division of Water Resources should a condition of this permit be violated. I also understand that if all required parts of this application are not completed and that if all required supporting information and attachments are not included, this application package will be returned to me as incomplete. Note: In accordance with North Carolina General Statutes § 143-215.6A and § 143-215.613, any person who knowingly makes any false statement, representation, or certification in any application shall be guilty of a Class 2 misdemeanor, which may include a fine not to exceed $10,000 as well as civil penalties up to $25,000 per violation. Signature: J / 4� Date: 0 /1 7/.,Ia FORM: RLAP 06-16 Page 5 of 5 State of North Carolina DWR Department of Environmental Quality Division of Water Resources Division of Water Resources RESIDUALS SOURCE CERTIFICATION INSTRUCTIONS FOR FORM: RSC 06-16 Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional information requested. Failure to submit all of the required items will lead to additional processing and review time for the permit application. Unless otherwise noted the Applicant shall submit one original and two copies of the application and supporting documentation For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting Un t General — This certification provides detailed information of residuals source generating facility and its residuals quality for land application, distribution, or disposal in accordance with 15A NCAC 02T .1100. Do not submit this certification for review without a corresponding application form (FORM: RLAP 11-15, FORM: DCAR 11-15, or FORM: SDR 11-15). Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed below. A. Residuals Source Certification (FORM: RSC 11-15): ❑ Submit the completed and appropriately executed Residuals Source Certification (FORM: RSC 11-15) form. Please do not make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to the application may be made, as long as the attachments are numbered to correspond to the section and item to which they refer. ❑ For new or renewed permits, submit a separate certification for each source facility. ❑ For modified permits, submit a separate certification for only those facilities that are affected by the proposed modification. ❑ Complete the residuals source facility summary page. List all new, renewed, or modified facilities. B. Residuals Source -Generating Facility Information: ❑ For each source facility, attach the following: ❑ Vicinity map - A vicinity map that shows the location of the facility and meets all of the criteria in the "Map C uidance for Residuals Land Application Permits". ❑ Process flow diagram and/or narrative - A detailed narrative and/or process flow diagram that describes how the residuals are to be generated, treated, processed, and stored at the facility. ❑ Quantitative justification for residuals production rate - A quantitative justification for the value provided in Item I. 8. Ensure that the amount of residuals listed is the maximum amount expected to be generated by the facility for the life of the permit. In addition, ensure that this amount is equivalent to that which is actually to be land applied, distributed, and/or disposed, including any chemicals, amendments, or other additives that are added to the residuals during processing. ❑ Sampling plan - A detailed sampling plan for the residuals source -generating facility. Ensure that the plan identifies sampling points, sampling frequency, sample type, as well as the Division -certified laboratory to be used. In addition, ensure that the plan details how the facility and/or the residuals are monitored for any applicable pathogen reduction and vector attraction reduction requirements. Note that all sampling and monitoring must be completed on the residuals as they are to be land applied, distributed, and/or disposed. C. Residuals Quality Information: ❑ For each source facility, attach the following: ❑ Laboratory analytical reports and operational data - reports for all laboratory analyses used to complete this certification. ❑ Documentation that the facility complies and/or the residuals comply with any applicable pathogen reduction and vector attraction reduction requirements. ❑ For new facility that may have not yet been constructed and analytical results of residuals cannot be obtained, please attach analytical results of residuals generated from a similar facility along with the description of similarities of the two facilities. INSTRUCTIONS FOR FORM: RSC 06-I6 Page i of 1 L d � e m � � a L - a a N Q Q F A E � � L U L � E � z M M o g Gr 3 Y f�. 7 O U O Q U O d E m N � ZT Y _ cn y Y O 19y W y s ti W w 7 Y b � U � v a .DWR ..._._... . Division of Water Resources State of North Carolina Department of Environmental Quality Division of Water Resources RESIDUALS SOURCE CERTIFICATION FORM: RSC 06-16 1. RESIDUALS SOURCE -GENERATING FACILITY INFORMATION (See Instruction B.): 1. Facility Name: S & J Villari Livestock 2. Facility permit bolder is: in Federal, IN State, 12 Local Government, or 12 Private. Facility permit issued by: 10 Div. of Water Resources, in Div. of Environmental Health, or IM Other (explain: 3. Facility contact person and title: Gerald Matthews Complete mailing address: 892 Penny Branch RD. City: Warsaw State: NC Zip: 28398 Telephone number: 9(� 293-2157 E-mail address: Gerald.mAvfgmail.com 4. Facility physical address: 892 Penny Branch Rd. City: Warsaw State: NC Zip: 28398- Coordinates: Latitude: 350 0' 22" Longitude: 780 7' 20" Datum: Unknown Level of accuracy: Unknown Method of measurement: Map interpretation by extraction 5. Purpose of the facility: treatment of municipal wastewater, 11 treatment of 100% domestic wastewater, treatment of potable water, 12 treatment of I 00% industrial wastewater, treatment of industrial wastewater mixed with domestic wastewater, (approximate percentages: IM % industrial and MM % domestic) other (explain: ). 6. Does the facility have an approved pretreatment program: Yes No 7. Facility permitted/design flow: 0.1000260 MGD and facility average daily flow: 0.070000 MGD 8. Average amount of residuals being generated at this facility 11.6 dry tons per year. 9. Specify the following regarding treatment and storage volumes available at the facility: Type and volume of residuals treatment: Biological sludge —and grit remaining after solid separation rendered off -site and facultative digestion in a 3,650,4428- gallon synthetically lined lagoon and 1.88 million gallon above -around stainless steel storage tank. Type and volume of residuals storage (i.e., outside of residuals treatment units): None II. RESIDUALS QUALITY INFORMATION (See Instruction C.): 1. Specify if residuals are regulated under: 40 CFR Part 503 or In 40 CFR Part 257. Note: Only residuals that are generated during domestic/municipal wastewater treatment processes are regulated under 40 CFR Part 503, otherwise, the residuals are regulated under 40 CFR Part 257. 2. Specify if residuals are defined under 15A NCAC 02T.1102(6) as: Biological M Non -Biological FORM: RSC 06-16 Page I of 5 Note: Biological residuals are residuals that have been generated during the treatment of domestic wastewater, animal processing wastewater, or the biological treatment of industrial wastewater (biological treatment is a system that utilizes biological processes including lagoons, activated sludge systems, extended aeration systems, and fixed film systems). 3. Hazardous Waste Determination: Complete the following to demonstrate that the residuals are non -hazardous under RCRA: (Note - this item does not have to be completed for facilities that are less than 0.5 MGD in design flow that treat 100% non -municipal, domestic wastewater only) a. Are the residuals listed in 40 CFR §261.31-§261.33: 0 yes no. If yes, list the number(s): b. Specify whether or not the residuals exhibit any of the characteristics defined by 40 CFR §261.21- 261.24: E yes 0 no. Fill in the following tables with the results of the latest toxicity characteristic leaching procedure (TCLP) analysis as well as those for corrosivity, ignitability, and reactivity: Laboratory: Envirochem and Date of analysis: 2023-16-01 Passed corrosivity test: yes 13 no. pH: 8.08 s.u. (2 < pH < 12.5) Passed ignitability test: yes IN no. Flashpoint: >212 OF (> 140°F) Passed reactivity test: Byes o. HCN: <1 mg/kg (<250) & H2S: 0.25 mg/kg (<500) TCLP Parameter Limit (m8/1) Result (mg/1) TCLP Parameter Limit (mg/1) Result NO) Arsenic 5.0 <1.0 Hexachlorobenzene 0.13 <.050 Barium 100.0 <1.0 Hexachloro-1,3-Butadiene 0.5 <0.050 Benzene 0.5 <0.01 Hexachloroethane 3.0 <0.050 Cadmium 1.0 <1.0 Lead 5.0 <1.0 Carbon Tetrachloride 0.5 <0.01 Lindane 0.4 <0.0005 Chlordane 0.03 1 <0.02 Mercury 0.2 <0.0002 Chlorobenzene 100.0 <0.01 Methoxychlor 10.0 <0.0005 Chloroform 6.0 <0.01 Methyl Ethyl Ketone 200.0 <0.05 Chromium 5.0 <1.0 Nitrobenzene 2.0 <0.050 m-Cresol 200.0 <0.050 Pentachlorophenol 100.0 <0.250 o-Cresol 200.0 <0.050 Pyridine 5.0 <0.050 p-Cresol 200.0 <0.050 Selenium 1.0 <1.0 Cresol 200.0 <0.050 Silver 5.0 <I.0 2,4-D 10.0 <0.003 Tetrachloroethylene 0.7 <0.01 1,4-Dichlorobenzene 7.5 <0.050 Toxaphene 0.5 <0.05 1,2-Dichloroethane 0.5 <0.001 Trichloroethylene 0.5 <0.01 1, 1 -Dichloroethylene 0.7 <0.001 2,4,5-Trichlorophenol 400.0 <0.050 2,4-Dinitrotoluene 0.13 <0.050 2,4,6-Trichlorophenol 2.0 <0.050 Endrin 0.02 <0.0005 2,4,5-TP (Silvex) 1.0 <0.003 Heptachlor and its Hydroxide 0.008 <0.0005 Vinyl Chloride 0.2 <0.01 FORM: RSC 06-16 Page 2 of 5 4. Metals Determination: Complete one of the following tables (i.e., as applicable) to demonstrate that the residuals do not violate the ceiling concentrations for metals regulated under 15A NCAC 02T .1105. a. For Distribution/Land Application: Fill in the following table with the results of the latest analyses (i.e., on a dry weight basis) for the following metal parameters: Laboratory: Envirochem and Date of analysis: 2023-06-01 Parameter Ceiling Concentration Limits (C1assA & ClassB) (mg/kg) Monthly Average Concentration Limits (Class A Only) (mg/kg) Result (mg/kg) Arsenic 75 41 <64.4 Cadmium 85 39 <12.9 Copper 4,300 1,500 653 Lead 840 300 70.3 Mercury 57 17 <0.742 Molybdenum 75 n/a 18.1 Nickel 420 420 25.0 Selenium 100 100 <12.9 Zinc 7,500 2,800 1220 b. For Surface Disposal Unit (landfil): Fill in the following table with the results of the latest analyses (i.e., on a dry weight basis) for the following metal parameters: Laboratory: IM and Date of analysis: Distance from Disposal Unit to Boundary to Closest Property Line (meters, check one) Arsenic (mglkg) Chromium (mglkg) Nickel (mg/kg) > 0 but < 25 30 200 210 > 25 but < 50 34 220 240 > 50 but < 75 39 260 270 > 75 but < 100 46 300 320 >_ 100 but < 125 53 360 390 > 125 62 450 420 Result (mg/kg) FORM: RSC 06-16 Page 3 of 5 5. Nutrieut/Micronutrient Determination: Complete the following: a. Total solids: 2.36 %. b. Fill in the following table with the results of the latest analyses (i.e., on a dry weight basis) for the following nutrient and micronutrient parameters: Laboratory: Envirochem and Date of analysis: 2023-06-01 Parameter Result (mg/kg) Aluminum 1 110 Ammonia -Nitrogen 17600 Calcium 14400 Magnesium 1280 Nitrate -Nitrite Nitrogen 27.9 PH (Standard Unit) 8.08 Phosphorus 27.9 Potassium 3780 Sodium 9620 Total Kjeldahl Nitrogen 54500 c. Using the results listed in Item 11. 5b. above, calculate the sodium adsorption ration (SAR): 20.6 [Note: If residuals contain SAR of 10 or higher, the applicant shall obtain recommendations from the local Cooperative Extension Office, the Department of Agriculture and Consumer Services, the Natural Resource Conservation Service, a North Carolina Licensed Soil Scientist, or an agronomist, prior to land application of residuals. The recommendations shall address the sodium application rate, soil amendments (e.g., gypsum, etc.), or a mechanism for maintaining site integrity and conditions conducive to crop growth]. d. Specify the mineralization rate to be used in calculating the plant available nitrogen (PAN) of the residuals: 20 %. This rate is a (check one): 0 default value, or M actually established. If the residuals are not generated from the treatment of municipal or domestic wastewater, explain or provide technical justification as to why the selected default value is appropriate to be applied to these residuals: Same as current surface irrigation permit residuals are anaerobically digested. e. Calculate the PAN for the residuals (i.e., on a dry weight basis) and fill the results in the following table: Application Method First (151) Year PAN Five -Year Maximum Adjusted PAN (mglkg) (mg/kg) Surface 19900 38556 Injection/incorporation 6. Other Pollutants Determination: Specify whether or not there are any other pollutants of concern in the residuals and provide the results of the latest analyses: None FORM: RSC 06-16 Page 4 of 5 7. Pathogen Reduction: Per 15A NCAC 02T.1106, specify how residuals will meet the pathogen reduction requirements: a. For Distribution/Land Application of Class A or Equivalent. A fecal coliform density that is demonstrated to be less than 1,000 MPN per gram of total dry solids; or A salmonella sp. density that is demonstration to be less than 3 MPN per 4 grams of total dry solids. AND one of the followings (except for non -biological residuals): Alternative 1 [15A NCAC 02T. I 106(b)(3)(A)] - Time/Temperature Compliance. Q Alternative 2 [15A NCAC 02T.1106(b)(3)(8)] - Alkaline Treatment. Alternative 3 [15A NCAC 02T.I 106(b)(3)(C)] - Prior Testing for Enteric Virus/Viable Helminth Ova. Q Alternative 4 [15A NCAC 02T. I 106(b)(3)(D)] - No Prior Testing for Enteric Virus/Viable Helminth Ova. [] Altemative 5 [15A NCAC 02T.I I06 b (3)(E)-(K)] - Process to Further Reduce Pathogens (PFRP). Specify one: composting E heat drying, heat treatment, thermophilic aerobic digestion, beta ray irradiation, gamma ray irradiation, or pasteurization. b. For Land Application of Class B: ffJ Alternative 1 [I5A NCAC 02T.1106(c)(1)] - Fecal Coliform Density Demonstration. in Alternative 2 [15A NCAC 02T.I 106(c)(2)] - Process to Significantly Reduce Pathogens (PSRP). Specify one: aerobic digestion, air drying, E anaerobic digestion, composting, or lime stabilization. c. For Surface Disposal., Select One of the Class A or Equivalent Pathogen Reduction Alternatives in Item II.7a. above. IM Select One of the Class B or Equivalent Pathogen Reduction Alternatives in Item 11. 7b. above. Exempt -If Daily Cover Alternative is chosen in Item 11.8. below [15A NCAC 02T.1106(a)(2)]. Not Applicable - Non -Biological Residuals with NO Domestic Wastewater Contribution. 8. Vector Attraction Reduction (VAR): Per 15A NCAC 02T.1107, specify how residuals will meet the VAR requirements: Alternative 1 [15A NCAC 02T.1107(a)(1)] - 38% Volatile Solids Reduction (Aerobic/Anaerobic Digestion). Altemative 2 [15A NCAC 02T.I 107(a)(2)] - 40-Day Bench Scale Test (Anaerobic Digestion). n Alternative 3 [I5A NCAC 02T.1107(a)(3)1- 30-Day Bench Scale Test (Aerobic Digestion). 0 Alternative 4 [15A NCAC 02T.I 107(a)(4)] - Specific Oxygen Uptake Rate Test (Aerobic Digestion). Alternative 5 [15A NCAC 02T.I 107(a)(5)] - 14-Day Aerobic Processes. Alternative 6 [15A NCAC 02T.I 107(a)(6)] - Alkaline Stabilization. Alternative 7 [15A NCAC 02T. 1 107(a)(7)] - Drying of Stabilized Residuals. 0 Alternative 8 [15A NCAC 02T.1107(a)(8)] - Drying of Unstabilized Residuals. Alternative 9 [15A NCAC 02T.I 107(a)(9)] - Injection. Alternative 10 [15A NCAC 02T.I 107(a)(10)] - Incorporation. Alternative for Surface Disposal Units Only - Soil/Other Material Cover [I5A NCAC 02T.I 107(b)(2)). fq Not Applicable - Non -Biological Residuals with NO Domestic Wastewater Contribution. Note: For animal processing residuals, only alternatives 9 or 10 may be chosen due to the nuisance conditions that typically occur when these residuals are applied and left on the land surface. FORM: RSC 06-16 Page 5 of 5 Environmental Chemists, Inc. •71 6602 Windmill Way, Wilmington, NC 28405 • 910-392.0223 Lab • 910.392.4424 Fax 71.0 Bowsertown Road, Manteo, NC 27954 < 252-473.5702 Lab/Fax 255-A Wilmington Highway, Jacksonville, NC 28540 - 910.347.5843 Lab/Fax ANALYTICAL & CONSULTING CHEMISTS info(iremvironmentatchemists.com The Pork Company Revised Report: Mar 30, 2023 892 Penny Branch Road Original Report slate: Jan 30, 2023 Warsaw NC 28398 Report #: 2022-25796 Attention: Customer ID: 08100099 Project ID: Sludge Lab ID Sample ID: Collect Date/Time Matrix Sampled by 22-63453 Site: Lagoon Sludge 12/16/2022 9:00 AM Solid/Sludge Gerald Matthews Test Method Results Date Analyzed PAN Calmlation 19900 mg/kg 03/30/2023 BAR Caicaiation 20.6 03/29/2023 Chlordane (TCLP) SW-8468081 S <0,02 mg/L 01116/2023 Enddn(TCLP) SW-84680818 <0.0005mg/L 01/16/2023 Heptachlor (TCLP) SW-846 ea61 a <0A005 mg/L 01/16/2023 Heptachlor epoxide (TCLP) SW-84680818 <0.0005mg/L 01/16/2023 Lindane (TCLP) sw-e468oe+ a <0.0005 mg/L 01/16/2023 Methoxychlor(TCLP) SW-84680818 <0.0005mg/L 01/1612023 Toxaphene (TCLP) SW-8468081 a <0.05mg/L 01/16/2023 2,4,5-TP(TCLP) SW8468151A <0.003mg/L 01/16/2023 2,4-D(TCLP) SW-8468151A <0.003mg1L 01116/2023 1,4-Dichlorobenzene(TCLP) SW-8468270E <0.050mg/L 01/13/2023 2,4,5-Trichlorophenol(TCLP) SW48468270E <0.050mgA. 01f13312023 2,4,6-Trichlorophenol (TCLP) SW 846 6270 E <0.050 mg/L 01113/20323 2,4-Dinitrotoluene(TCLP) SW-8468270E <0.050mg/L 01/13/2023 Cresol (TCLP) SW-8468278E <0.050mg/L 01/13/2023 Hexachloro-1,3-butadiene(TCLP) SW-8468270E <0.050mg/L 01113/2023 Hexachlorobenzene(TCLP) SW-8468270E <0.050mg/L 0111312023 Hexachloroethane(TCLP) SW-8468270E <0.050mg/L 01/13/2023 m + p-Cresol (TCLP) SW-8465270 E <0.050mg/L 01/13/2023 Nitrobenzene (TCLP) SW-8468270 E <0.050 mg/L 01/13/2023 o-Cresol(TCLP) SW-8468270E <0,050mg/L 01/13/2023 Pentachiorophenol(TCLP) sw-8468276E <0250mg/L 01/13/2023 Pyridine (TCLP) SW-846 $270 E <0.050 mg/L 01/13/2023 1,1-Dichloroethyiene(TCLP) SW-846Method 8280o <0.01mg/L 1/1312023 1,2-Dichloroethane(TCLP) SW-040Method 8250D <0.01mg/L V13/2023 !7: � Environmental Chemists, Inc. hem 6602 Windmill Way, Wilmington, NC 28405 • 910.392.0223 Lab • 910.392.4424 Fax 710 Bowsertown Road, Manteo, NC 27954 • 252.47-1.57021ab/Fax 255-A Wilmington Highway, Jacksonville, NC W40 • 910.347.5843 Lab/Fax ANALYTICAL & CONSULTING CHEMISTS info@environmentatchemists.coni The Pork Company 892 Penny Branch Road Warsaw NC Attention: 28398 Revised Report: Mar 30, 2023 Original Report Date: Jan 30, 2023 Reportft: 2022-25796 Customer ID: 08100099 Project ID: Sludge Benzene (TCLP) SW4346 Method 8260D < 0.01 mg/L 1/13/2023 Carbon Tetrachloride (TCLP) swae6Method 8250D <0.01 mg/L 1/13/2023 Chloroberizene(TCLP) SW-846 Method 8260D <0.01mg/L 1/13/2023 Chloroform (TCLP) SW4846 Method 8260D < 0.01 mg/L 1/13/2023 Methyl ethyl ketone (TCLP) SW-846 Method 82e0D < 0.05 mg/L 1/13/2023 Tetrachloroethylene (TCLP) SW.846 Method 82600 < 0.01 mg/L 1/13/2023 Trlchloroethylene(TCLP) SW.848Method 8260D <0.01mg/L 1/13/2023 Vinyl Chloride (TCLP) SW-846Method6260D <0.01mg/L 1/13/2023 RCI Cyanide SM4500CND•2016 <1mg/kg 01/09/2023 Sulfide SM4600 S 0 0.25 mg/kg 01/0312023 Ignitabiiity SW 846 method 1010 >158 °F 01/06/2023 pit SIN 846 Method 90450 8.08 units 01 /10/2023 Result estimated. Analyzed out of 15 minutes hold time. Sludge Residuals Aluminum EPA 200.7, Rev- 4.4, 1994 1110 mg/kg 01/04/2023 Arsenic EPA 200.7, Rev. 4A, 1994 <64.4 mgikg 01/06/2023 Cadmium EPA200.7, Rev, 4.4, 1994 <12.9 mg/kg 01/04/2023 Calcium EPA 200.7, Rev. 4.4,1994 14400 mg/kg 01/04/2023 Chromium EPA 200.7,Rm4.4,1994 31.2mg/kg 01/04/2023 Copper EPA 200.7, Rev, 4.4, 1994 653 mg/kg 01/04/2023 Lead EPA 200.7, Rev. 4.4, 1994 70.3 mgikg 01/04/2023 Magnesium EPA 200.7, Rev. 4.4, 1994 1280 mg/kg 01 /0412023 Molybdenum EPA 200.7, Rev. 4.4. IOU 18.1 mg/kg 01/0412023 Nickel EPA 200.7, Rev .4.4, 1994 25.0 mg/kg 01/04/2023 Potassium EPA 200.7. Rev. 4.4,1994 3780 mgikg 01104/2023 Selenium EPA 200.7, Rev. 4.4, 1994 <12.9 mg/kg 01/04/2023 Sodium EPA 200.7,Rev .4.4,1994 9620mg/kg 01/04/2023 Zinc EPA 200.7, Rev. 4 4, 1994 1220 mgikg 01/04/2023 Nitrate+Nitrite-Nitrogen EPA353.2 27.9mg/kg 01103/2023 Environments Chemists, Inc. 6602 Windmill Way, Wilmington, NC 29405 ` 910.392.0223 Lab " 910.392.4424 Fax 710 Bowsertown Road, Manteo, NC 27954 ° 252.473.5702 Lab/Fax ` 255-A Wilmington Highway, Jacksonville, NC 28540 ' 910.3475843 Lab/Fax ANALYTICAL 8 CONSULTING CHEMISTS inCeGenvironmentatchemists,com The Pork Company Revised Report: Mar 30, 2023 892 Penny Branch Road Original Report Date: Jan 30, 2023 Warsaw NC 28398 Report #: 2022-25796 Attention: Customer ID: 08100099 Project ID: Sludge Total Solids (%) SM 2540 B 2.36 % 01/03/2023 Ammonia Nitrogen SM 4500 NH3 C-2011 17600mg/kg 01/13/2023 Total Kieldahl Nitrogen (TKN) SM 4500 Norg B-2011 54500mg/kg 01/0112023 Total Phosphorus SM 4500 P tF-H)-2011 27.9 mglkg 01/09/2023 Mercury sW-64074713 <0.742mg/kg 01/13/2023 TCLP Metals Arsenic (TCLP) EPA 200.7. Rev 4.4, 1994 <1.0 mg/L 01/17/2023 Barium (TCLP) EPA 200.7, Rev 4.4, 1994 <1.0 mg/L 01/17/2023 Cadmium (TCLP) EPA 200.7,Rev. 4A1994 <1.0mg/L 01/17/2023 Chromium (TCLP) EPA 200.7.Rev, 4.4,1994 <1.0mg/L 01/17/2023 Lead (TCLP) EPA 200.7. Rev. 4 4, 1994 <1.0 mg/L 01/1712023 Selenium (TCLP) EPA 200.7,Rev 4A41994 <1.0mg/L 01/1712023 Silver (TCLP) EPA 200.7, Rev. 4.4, 1994 <1.0 mg/L 01117/2023 Mercury (TCLP) EPA245.1 <0.0002mg/L 01113/2023 Comment: Sample received near hold time limit. TCLP organics extracted outside of hold time limit Sludge residuals reported on a dry weight basis. AMENDED 03-29-2023 to add SAR result. AMENDED 03/30/2023 to add PAN result. _ Reviewed by: +---...... .,..,. 1-- P— t of i Environmental Chemist, Inc., Wilmington, NC Lab #94 6592 Vlmdmil" v,,av w1imi3gton" k!c 28:,C,5 Sample Receipt Checklist 910 2022- Q5_79� ip a;^f ie UCII 1 17 7pp !�c k �w) Client 0 YES M—�� 11 -UstcCly seats Present on 'JU coo!er? N/A CtHiodY seals v/ere present, v)ere Original ternperat urE, I Ltley intact Unin en? _ipon receipt Corrected temperature upon re,-e;pt HOW temperature laken: Tempe C t R Gun 11): ThOfflaS T1- ..ra ure Blank IL Against Battles �Cfna S/N H0886869 IR Gun Correcti;-"Tac7t�r Factor 0 NO 3, tf temperature of caofer exceeded 6"C, was Project Mgc(i1A poll led? YES 0 No A. Were prope_rcuSIOJ�y Proced�uTre�s—(rel��nq,,ishe�d/r�,ce,,;ed7fOTiocved7�— YES 0 NO S. Were La r�P q 10's listed on COC? 6 We Z-- re Samples ID s listed On Sample Containers? NO 7. Were collection date and time listed on the CDC? YES_ 0- No- 8, Were tests to be performed listed o`oth—e---_--_ MESA NO COC� 9, Did samples arrive n Proper containers for Each tesO YES 13 NO — 10. Did Samples arrive in good condition YES sample F"On for each test? ample j 11. Was adequate e volume available?' YES 0 NO --- 12, Were samples - received within �proper holding time for requesteel tests?— — — ,0 YES D NO 13. Were acid preserved samples received at a PH. - U YES_ 0 NO 14, Were cyanide samples received at a PH >1 of <2? Y, I Is El N 0 15. Were '!�1_1lut5arnP;es received at a PH >.9 o— 1_�chlorfne residuz of d0— - - 6, Were NH3/TKNL/1Pb,�enoI_ C1 Nreservedd at YES 0 NO YES 0 NO chlorine residual or <0.5 m the field within 15 minutes? TC)C/V0jjuje5 are PH checked -ked at time of analysis ar=d recorded 01 the bej-hsheet BactP'la SamPlPs are checked for Chlorine at Of analysis and recorded on the benchshee-1. tamPle Preservation: Must be completed for any Sample( �ampte(s) fVLUy preserved Or with headspacel vH 0 ea Y Preserved and were adjusted d accordingly we ire received incO(rectlY Preserved and were adjusted accordingly ly adding (circle one), HISO, C, HNO3 HO NaOH me Of Preservation, e 1f more than One preservative is oeeded, notate to comments belov., ­ --------- a _d _ -i. eiv Presa'Ved San nPles, ub�aln a PQ�j 5"'Pj;3 ' the lune lac.f dg"t'v M a,'Zlyd "'the "Sto'Me'r, V'Jfio V,a5 nafifi-j date and were UL received with h..H,... COMMENTS: DOC- QA,002 Rev I ,z� W, 41-r- Division of Neater Resources State of North Carolina Department of Environmental Quality Division of Water Resources 15A NCAC 02T .1100 —LANDOWNER AGREEMENT FORM: LOA 06-16 Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional information requested. Failure to submit all of the required items will lead to additional processing and review time for the permit application. Unless otherwise noted, the Applicant ihall submit one original and two copies of the application and supporting documentation For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting Unit. General — This document is an agreement between the Applicant and land owner(s) of residuals receiving sites for land application of Class B residuals (may include water treatment plant or other type residuals) in accordance with 15A NCACA2T .I 100. Do not submit this agreement for review without a corresponding application form (FORM: RLAP 06-16). Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed below. A. Land Owner Agreement (FORM: LOA 06-16): Submit the completed and appropriately executed Land Application Site Certification (FORM: LASC 06-16) form. Please do not make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to the application may be made, as long as the attachments are numbered to correspond to the section and item to which they refer. ® Prepare a separate agreement for each set of land application sites that are owned or operated by an entity other than the Applicant. ® A copy of the completed and appropriately executed agreement must be provided to the landowner and the lessee/operator. AGREEMENT FOR THE LAND APPLICATION OF RESIDUALS TO PRIVATELY OWNED LAND The undersigned landowner or his representative hereby permits: Applicant's name: S&J Villari Livestock,LLC hereinafter referred to as the Permittee, to land apply residuals from the following facility(ies) onto the following land application site(s) (i.e., see attached setback maps) in accordance with the stipulations and restrictions as given in this Agreement: Site/Field ID Lease (yes/no) Land Use or Cropping Patterns Intended Use of Crops Residuals Source (optional) Special note (no-till/over-seed/ pasture) i-PIVOT No Hay Hay 2-SSET No Hay Hay The landowner or his representative receives, in consideration, full use of the nutrient value of the applied residuals while the Permittee receives, in consideration, the use of the land application site(s) described above for the disposal of the residuals. This Agreement shall remain in effect for the length of the Division's permit for the residuals land application program and shall be renewed each time this permit is renewed. The undersigned landowner or his representative and the Permittee agree to abide with the following restrictions and stipulations until such time as written notification, given 30 calendar days in advance, modifies or cancels this Agreement. FORM: LOA06-16 Pagel of3 1. STIPULATIONS: I. The landowner or his representative shall not enter into any additional residuals application contracts or agreements with another permitted entity for the site(s) specified by this Agreement. 2. Should the landowner or his representative lease or otherwise permit the use of the land application site(s) to a third party, the landowner shall be responsible to ensure that the third party agrees and complies with the terms and conditions of this Agreement. 3. The landowner or his representative shall adhere to the provisions of this Agreement until all of the site restrictions (under Section 11) are met. 4. Notification of cancellation of this Agreement shall be immediately forwarded to NCDENR-DWR, Non -Discharge Permitting Unit, 1617 Mail Service Center, Raleigh, NC 27699-1617. 5. The Permittee must request and obtain a permit modification from the Division prior to a transfer of the land application site(s) to a new landowner. In addition, the current landowner shall give a notice to the new landowner that gives full details of the residuals applied at the land application site(s). 6. The Permittee has provided the landowner or his representative with information and data concerning the residuals land application program, including an analysis of constituents of the residuals, residuals application methods, schedules for typical cropping patterns, a description of the equipment used by the Permittee. 7. The Permittee will provide the landowner or his representative with a copy of the residuals permit prior to commencement of any residuals land application event and a copy of the results of each soil analysis. 8. If the soil pH of the land application site(s) is not maintained at 6.0 or greater, sufficient amounts of time shall be applied to achieve a final soil pH of at least 6.0, unless an agronomist provides information indicating that the pH of the soil, residuals and time mixture is suitable for the specified crop. 9. The landowner or his representative and the Permittee will agree on residuals application rates and schedules based on crop patterns, results of soil samples, and the permitted application limits. 10. The landowner or his representative will provide the Permittee with information regarding the amount and analysis of other sources of nutrients (e.g., fertilizer, unregulated animal waste, etc.) that have been applied to the land application site(s). 11. The landowner or his representative will inform the Permittee of any revisions or modifications to the intended use and cropping patterns for the land application site(s) prior to each planting season to enable the Permittee to amend this Agreement and schedule residuals land application events at appropriate periods. 12. Specific residuals land application area boundaries shall be clearly marked on the land application site(s) by the Permittee, the landowner, or his representative prior to and during a residuals land application event. 13. The landowner or his representative hereby authorizes the Permittee, local officials, and State officials or their representatives to; enter and inspect any property, premises, or place on or related to the land application site(s) at any reasonable time for the purpose of determining compliance with the permit; establish monitoring facilities on or new the land application site(s) as required by the permit; copy any records that must be kept under the terms and conditions of the permit; take necessary leachate, surface water, groundwater, or soil samples during the term of, and 12 months after termination of, this Agreement. IL RESTRICTIONS: 1. Appropriate measures must betaken by the Permittee and/or the landowner or his representative to control public access to the land application site(s) during active use and for the 12-month period following a residuals land application event. Such controls may include the posting of signs that indicate the activities being conducted at the land application site(s). 2. Animals shall not be grazed on the land application site(s) for a 30-day period following a residuals land application event. Land application sites that are to be used forgrazing shall have fencing that will be used to prevent access during these periods after such residuals land application events. 3. Food crops, feed crops, and fiber crops shall not be harvested for a 30-day period following a residuals land application event. 4. Food crops with harvested parts that touch the residuals/soil mixture and are totally above the land surface shall not be harvested for a 14-month period following a residuals land application event. 5. Food crops with harvested parts below the surface of the land shall not be harvested for a20-month period following a residuals land application event when the residuals remain on the land surface for four months or longer prior to incorporation into the soil. 6. Food crops with harvested parts below the surface of the land shall not be harvested for a 38-month period following a residuals land application event when the residuals remain on the land surface for less than four months prior to incorporation into the soil. 7. Turf grown on land where residuals are applied shall not be harvested for a 12-month period following a residuals land application event. I11.ALTERNATIVES FOR WATER SUPPLY WELLS INSIDE THE COMPLIANCE BOUNDARY: (please check one) 15A NCAC 02L .0107(d) prohibits water supply wells within the compliance boundary. However, 15A NCAC 02T .0105(h) allows the compliance boundary to be placed closer to the waste disposal area, such that the water supply well is situated outside of the compliance boundary provided the groundwater standards can be met at the newly -established compliance boundary. Please mark one of the following; ❑ A re -defined compliance boundary is needed for field(s) ID: (Please include the rationale for the requested re -location of the compliance boundary and attach a map showing the newly proposed compliance boundary to the application package) ❑ A re -defined compliance boundary is not needed for this site. IV. ACKNOWLEDGEMENT OF FIELD TRANSFER: (if needed) ❑ The land application field(s) ID: is currently permitted under another residuals land application program; Permit Number WQ: . The land owner hereby acknowledge that by signing this agreement, he/she is requesting that the field(s) be removed from the previously permitted residuals land application program and transferred into the new program;. (Name of the new program) FORM: LOA 06-16 Page 2 of 3 Landowner's Certification: I certify that I am a deeded landowner of the above -referenced land application site(s) and am authorized to make decisions regarding the use of the land application site(s) on behalf of other deeded landowners OR that I am otherwise authorized, through a power of attorney or other legal delegation, to make decisions regarding the use of the land application site(s) on behalf of the deeded landowners. 1 certify that the above -referenced land application site(s) are not included in any waste disposal contract or agreement with another municipality, contractor, or other permitted entity. Furthermore, I certify that I have read this Agreement, understand the stipulations, restrictions, alternatives for water supply wells inside the compliance boundary, acknowledgement of field transfer, and do hereby grant permission to the Permittee to land apply residuals to the land application site(s) as specified herein. Landowner name: Sam Vil1a� S if J ✓/6" S/Orx L�G Address: City: Phone: State: NC Zip: E-mail Signature: r fl`n Date: 1 r /a a NORTH CAROLINA, O1'.n COUNTY I, the undersigned Notary Public do hereby certify that GQrn U Id t personally appeared before me this day and acknowledged the due execution of the forgoing instrument. WITNESS my hand and official seal this the 15 -1-,% day of QQ01 Signature and seal: My commission exF Lessee's/Operator's Certifi, I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein. Lessee/operator name Address: City: Phone: Signature: Permittee's Certification: State: E-mail Date: Zip: I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein. Signing official name: Signature: Date: FORM: LOA 06-16 Page 3 of 3 ID Ll El 0 0 M 4 B & a ffi h MG6o� 2rc5-4 i e S & L VIL RESIDUALS LIVESTOCK mLLAR, RESIDUALS PLAN W0003335] CAVANAUGH SOIM'ws Vwug� NlepiN aMCe�b�,0 WATER POLLUTION CONTROL SYSTEM OPERATOR DESIGNATION FORM (WPCSOCC) NCAC SSA 8G .0201 Press TAB to enter information PermitteeOwner/Officer Name: Sam Villari Mailing Address: 892 Penny Branch Rd. City: Warsaw Email Address. Sam.v@vfgmail.com Signature: Facility Name: S & J Villari Livestock LLC Phone:910-293-6594 State: NC DP: 28398 Date: Permit# WO0033357 YOU MUST SUBMIT A SEPARATE FORM FOR EACH TYPE AND CLASSIFICATION OF SYSTEM: Facility Type: I SeIW LA —� Facility Grade: Select N/A OPERATOR IN RESPONSIBLE CHARGE (ORC) Print Full Name. Gerald L Matthews Work Phone: 910-289-7500 Certificate Type: Select LA Certificate Grade: Select Certificate #: 1007103 Email Address: gerald.m@vfgmail.com Signature: Effective Date. 3/9/2023 01 certify that 1 agree to my designation as the Operator in Responsible Charge for the facil ty noted 1 understand and will abide by the rites and regulations pertaining to the respotrsd6ihties of the ORC as set Earth in 15A NCAC OSG .0204 and failing to do so can result in DisciplinoryActionsby the WoWr Pollution Controfsystem Operators Certification Commission." SNOW~ Print Full Name: )i e*.w- ""�•r.. F ¢3. .+1e Work Phone: �101 °ytt lr �j Certificate Type: Select L.e eZ Certificate Grade: Select L..,R, j J,�W Certificate Email Address: .tar Sf2 Signature: Effective Date: I certify thot i agree to my designation as a Back -alp Operator in Responsible Charge for the facility noted. I understand and will abide by the rules and regulations pertaining to the responsibilities of the ORC as set forth in ISA NC4COSG.0204 and failing to do so can malt in Mail, fax or email WPCSOCC, 1618 Mail Se ORIGINALto: Raleigh, NC 27699-1618 Mail or Fax Asheville Fayetteville a COPY to: 2090 US Hwy 70 225 Green St., Suite 714 Swannanoa NC 28779 Fa i8 Nl� 13 i rti l a Mooresville 610 E. Center Ave., Suite 301 Mooresville NC 28115 I ceMdJm[n Sncdenr.gcv Raleigh 380O Barrett Dr. Ralei h. NC 27609 RESIDUALS LAND APPLICATION OPERATION AND MAINTENANCE PLAN TABLE OF CONTENTS Description of the Operational Components and Design Parameters of the Facilities II. Description of the Operation of the Facilities III. Description of Anticipated Maintenance IV. Provisions for Safety Measures Including Restriction of Access 1) Restriction of Access 2) Emergency Contact V. Spill Control Provisions 1) Response to Upsets including Control Containment and Remediation 2) Contact Information for Plant Personnel, Emergency Responders, and Regulatory Agencies Appendix A - Villari Residuals Map OPERATIONS & MAINTENANCE O&M-1 November 2017 Villari Residuals Land Application Operations & Maintenance Plan I. Description of the Operational Components and Design Parameters of the Facilities This Residuals Land Application Operation & Maintenance Plan is for the purpose of applying land residuals produced by the treatment of the wastewater produced by the Villari Food Group livestock processing operations. S & J Villari Livestock (the Facility) operates a swine slaughtering facility located at 892 Penny Branch Road in Warsaw, North Carolina. The Facility currently operates under a Non -Discharge Spray Irrigation System Permit administered by the North Carolina Department of Environmental Quality (NCDEQ) (Permit No. W00016376). This permit was last issued on May 17, 2013 and Is stated to remain in effect from the date of issuance to April 30, 2018. The Facility's permit allows for the continued operation of a 100,260 GPD surface irrigation treatment facility consisting of a T-R solids Separator, a curbed 20 feet by 24 feet solids collection area with leachate collection and daily solids rendering collection, a 10,000 gallon storage tank, a 2,000 gallon pump tank with duel solids handling pumps, a 3,650,428-gallon (volume corrected based on field measurements) synthetically - lined facultative lagoon with a curtain baffle across the width of the lagoon to separate it into two cells, two 10 HP floating aerators, a 1.88 million gallon above- ground stainless steel storage tank with a treatment capacity of 100,260 gallons per day, and continued operation of a solid set irrigation system (Zones 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, and 13) which consists of 137 sprinkler heads in thirteen (13) irrigation zones covering approximately 21.45 effectively irrigated acres, and continued operation of a center pivot irrigation system (formerly consisting of 23,11 acres in one zone) effectively irrigation 20.56 acres in Zones 14E and 14W for a total of 42.01 acres. Currently, the Facility performs solid separation of raw waste, then sends wastewater to the lagoon for treatment by aerobic, facultative, and anaerobic bacteria, then pumps wastewater to the irrigation storage tank, then through the chlorine contact chamber, and finally to land application via irrigation. This plan describes the operating and maintenance procedures necessary to enable the Facility to land apply residuals built up primarily in the irrigation storage tank and also in the lagoon. The application frequency is predicted to be once per year, or less frequently if residuals accumulation is less than predicted. Residuals will be applied on existing, intensively -managed hay land, comprised of Coastal Bermuda and small grain hay that surrounds the existing spray irrigation fields. II. Description of the Operation of the Facilities OPERATIONS & MAINTENANCE O&M - I November 2017 Villari Residuals Land Application Operations & Maintenance Plan The Land Application of Residual Solids Permit for S&J Villari Livestock administered by NCDEQ (Permit No. WC0033357) allows for the application of up to 11.6 dry tons per year of residuals in the designated residuals land application areas surrounding the spray irrigation fields, which matches the 11.6 dry tons per year that are estimated to be produced by the Facility; therefore, the application frequency is predicted to be once per year. The applicable residual application areas are shown in the Villari Residuals Map that is included as Appendix A of this O&M plan. On a yearly basis, residuals will be pumped from the irrigation storage tank and the lagoon into a tanker truck, and the truck operator will spray the residuals in a uniform manner in the designated application areas; the truck operator will ensure that residuals are sprayed uniformly so as not to create concentrated areas of residuals application. The operator will also take care to keep the vegetation intact, which aids in the uniform application of the residuals by avoiding the creation of tire ruts and similar effects that would otherwise promote undesired concentration of the residuals. The operator should consider recent weather events, such as wet application areas that could be impaired by truck application; in such cases, it may be decided to delay application until the areas are dryer in order to keep the areas well maintained. III. Sampling Plan As stated in Attachment A of the existing permit (W00033357), "Sampling and analysis for TCLP, as described in Permit Condition IV.2, shall be performed only once every permit cycle.". Condition IV.2 requires "A corrosivity, ignitability, and reactivity analysis as well as a Toxicity Characteristics Leaching Procedure (TCLP) analysis" to be conducted on the residuals. The results shall be maintained on file by S&J Villari Livestock for a minimum of five years. Condition IV.2 lists all the constituents that must be analyzed. In addition, Condition IV.3 lists additional analysis and constituents that must be analyzed. IV. Description of Anticipated Maintenance On an annual basis, measure the depth of residuals in the irrigation storage tank the lagoon to determine whether the residuals need to be pumped out for land application. V. Provisions for Safety Measures Including Restriction of Access 1) Restriction of Access - A tree border is utilized between the site and the road. "No Trespassing" signs are located along the property line. 2) Emergency Contact - Information is posted near the entrance. OPERATIONS & MAINTENANCE O&M-2 November 2017 Villari Residuals Land Application Operations & Maintenance Plan VI. Spill Control Provisions 1) Response to Upsets and Bypasses including Control, Containment, and Remediation — Upsets are contained within the freeboard of the structures; no bypasses exist. 2) Contact Information for Plant Personnel, Emergency Responders, and Regulatory Agencies — Phone numbers are posted at the site. OPERATIONS & MAINTENANCE O&M-3 Jep. ID. 1UUC a:[Ynm vdva11dutI[ ^•• •••• State of North Carolina Department of Environment and Natural Resources Division of Water Quality SETBACK 4'St'AiYER AGREEMENT ATTACHMENT ForlAnd Application of Residual Solids (FORM: SW AA 070807) (THIS FORM MAY BEPHOTOCOPIED FOR USEASAN ORIGWAL) The Division of Water Quality (Division) will loot accept this attachment unless all the instswdous are followed. failure to submit all required items will lead to additional processing and review thee. . For snoreinfomweicn,tdrftaterwebsitea(; r+.•/rh2a.exrruvs.nauslkeu/gt'rzhm+t WSTRUCnONS TQ THE APPLICANT: A, Attachment inrm ✓ Do not submit this attachment tarot for review without Its corresponding residuals program application futon "Itbit NDRLAP). ✓ Any changes to this Waehrmatn form will result in the application package being rozorne& B. Prepare a separate aftdoneal form for each ptaperty acts which a waiver from 1SA NCAC ZT .1708(b)(2Xfor habitable reattleuctrs or place of public assembly) is boiagsoughL ✓ Any other sabaeks rettuirul by 15A NCAC 2T .1108, other than thou refereaced above, cannot be waived through execution of" anadment foam. I. ✓ A copy of the completed aid appropriately executed atuchruent form must be provided to the property owner. I AG1R EhtMNTTOWAIVETM6ETBACSUQUIRSDBYI5ANCAC2T.1108(b)(2)(habfmbleredtdeaax) Applicants name: . 'J l •P 4 re- ..F vn t+ - ..0 . Complete mailing address of applicant: f 4 ¢ 0 City: kG v State: C-�%Zip: c2let�3 Tolephoaenumber ( �y a-r/_3 y�.s�Paesimilenwnher:(—) 8,mait addtusa: boretadwr r,:terred to as the Prerndttae, to land appiv residuals within than 100 feet) of the resident or place of pubb assembly lo�d){St th Location addmss of property: O�/ City: State: _&- '---- Zip: feet (t.e, oaumt be less This Agreemad shall remain In effect tot the length of the Division ot'W2t& Qoa)lty's (Dividou) patmit for the reaiduah land application program and shalt be stimwatl oath time this perm* is renewed. In addtttah, ilia Agreement shag only rmulp in effect for as long sa rho anda slgned property owner owns &a property described hereln. The utderaigne3 property owner agrees to abide by Ibis Agreement Until such ibne as written nolfncatimn, 3o calendar days is advance, soodif a or caums this Agreement. I xxtify that 1 am a deeded property owner of above referenced property and ass authorized to make dxisious regarding rhis propetry on b&AV of other deeded propeny owners. Fbttharmore, I certify that I have read and undaxnmd dos Agreement and do hereby grant parmission to the Yesenittee to land apply tasiduals to land applicaton sites) as spesX��e' bbereft. Property ow sine:, ,;t .e 4/$•\ 3'i }�!' //� � {Is h nJ\ Signature; �-ex�, It Date: FORM: SWAA 070807 P'a80 I of 1 Attachment Order 3-d TO/10 3E)Vd IWIIIA 999EE6Z0T6T E5:40 800Z/7Z/60 Nit Sep.15, 2008 8:29AM Cavanaugh No.4015 P. 2 State of North Carolina Department of Environment and Natural Resources Division of Water Quality SETBACK WAIVER AGREEMENT ATTACHMENT lror iaud Application of Residual Solids (FORM: S'WAA 070807) (M FORMMAYSE PROWCOPIRD FOR OSSASAN ORIOINAL) Via Division of'W&W QnaNly Pyislon) will not accept this attachment miles$ all the lnstractfons err followed. FaUum to submit all required items will lead to additlonal processing and review time, For lore trtfomwtim, visit our web site at:hrm.//h2o �,v ru,u.nc us?au/mala—trm INSTRUCTIONS TO TIM APPLICANT: A. Attachment Farm: ✓ Do not submit this attachment roan for review without its cor"onding redduals program application form (FORM: NDRUP). ✓ Any changes to this atracbmcm fnanwill resuh in the appHutioa package beingretemed. B. prepare a separate a,tartment form for each property from which a waiver from ISA NCAC 2T .1I08(b)(2)(for babitable raddenees or placcof public assembly) is baing sought. ✓ Any otber satbacka required by 15A NCAC 2T .l 108, other then Chow refereomd above, oam ba waived through execution of this attachment forts ✓ A 00py of the completed and appropriately executed amahment form mast W provided to the property owner. AGitF.Ll MNT TO WAIM TM SrfUCtt UQilMMBY ISA NCAC2T.l108(b)(2)(habitablo reWcoces) The undorsipod pro ownerhrrlypermitst Applicant's name: frn ( e_C,,.,r/ Complete maiunaaddranofapplipaaG 1 2 City: jAlf5/) c ,-G E State: Telephone number; { } Fr mail. addmm _ Faosimilonumber: (_) heteinaflcr refined to as the Permutes, to land apply resldtmis within foot (Le., cannot be less tban100feet)afthcratlsnetorplaceofpublic,blyltatthe �oliawing yt /} IzeadonaddressofProperty! /E71`a-ce City: State: 44 ( . Zip: This Agreament shall rmnaln in effeet for the length of tbdDi"A of Water Quality's (Division) permit for The resldnats land application prwum and shall be renowed each time "permit is renewtd. In addition, this Agreement shall only remain in efface for as long as tho undersigned property owner owns the property desaribed hereto. 'The audersiped property owner agres to abide by this Agreement Until such time as written UOMl ttlo)y 730 calendar days In advance„ modifies or cancels ibis Agreement. certify thm I am a deeded property owner of above.rafaranoed property and am acthodad to snake decisious regarding this property on behalf of other deeded property owam. i aiffie m m, I certify that I have read and understtvod this Ag"mmt and do hereby scant permission to the Permittee to land apply residuals To land applicatoa sites) at specified herein. Property owner name: Slgnatute:.fs.0 r RAA> Data' C}-•fJ- D FORM: SWAA 070807 page I of 1 Attarlunent Order 3•d I0/10 39Cd INN CIA 999££6Z016I £V:L0 800Z/£0/Bi ainaaarramriurraM Dac Na' 100259]8 Re ed: i 01081201909:35:51 AM Fee AmtS2600 Paget of5 Exdse Tax: 50.00 Duplin County N" Carolina Jwe H. Hargrave. Register of Deeds BK1906 PG469-493(6) 11 THE ATTORNEY PREPARING THIS INSTRUMENT, J. GARRETT LIIDLUM, A LICENSED NORTH CAROLINA ATTORNEY, HAS MADE NO RECORD SEARCH OR TITLE EXAMINATION AS TO THE PROPERTY HEREIN DESCRIBED UNLESS THE SAME IS SHOWN BY HIS WRITTEN AND SIGNED CERTIFICATE. DELINQUENT TAXES, IF ANY, TO BE PAID BY THE CLOSING ATTORNEY TO THE COUNTY TAX COLLECTOR UPON DISBURSEMENT OF CLOSING PROCEEDS. NORTH CAROLINA DEED OF EASEMENT DUPLIN COUNTY THIS DEED OF EASEMENT, made this Th day of October, A. D., 2019, by and between RSJ PROPERTIES, LLC, a North Carolina limited liability company, hereinafter referred to as "Grantor" and, S & J VILLARI LIVESTOCK, LLC, a Delaware limited liability company, hereinafter referred to as "Grantee". WITNESSETH: THAT WHEREAS, the said Grantor is the owner of that 46.06 acre parcel located on NCSR 1340 (Blackmore Road) depicted in Map Book 19, Page 224, of the Duplin County Registry, in Warsaw Township, Duplin County, North Carolina and more particularly described on Exhibit A attached hereto and incorporated herein by reference; and WHEREAS, the easement described herein is for the sole use of the Grantee, its heirs and assigns, for the property now or hereafter located upon the real property referenced above and more particularly described on Exhibit A attached hereto; and Book 1906 Page 490 WHEREAS, the Grantor desires to convey and warrant tc the Grantee its heirs and assigns a non-exclusive perpetual easement across, along, in, upon and under the property described on the attached Exhibit A; and NOW, THEREFORE, Grantor, for valuable consideration paid by the Grantee the receipt which is hereby acknowledged, has and by these presents, does give, grant and convey to Grantee a non-exclusive perpetual easement across, along, in, upon and under the property described on the attached Exhibit A, containing 46.06 acres, more or less. TO HAVE AND TO HOLD the rights and easement hereby granted to the respective Grantee and their successors in title, wherever; This grant of easement includes permittee and State inspection, monitoring and maintenance of wastewater disposal system, and it is further agreed that this easement can be terminated by the Director of Environmental Quality, or his successor, when its purposes have been fulfilled or when it is no longer needed; and during the term of the easement there is no construction of or operation of water supply wells within the compliance boundary on property hereinabove referred to; IN TESTIMONY WHEREOF, said parties have hereunto set their hands and seals the day and year first above written. RSJ PROPERTIES, LLC By: �Lteclo J,eC.KI (SEAL) Rocco Villad, Manager S & J VILLARI LIVESTOCK, LLC By: S� M(SEAL) Sal�o�,ager Book 19M Page 491 STATE OF NORTH CAROLINA 'DU41in COUNTY 1, , a Notary Public, do hereby certify that Rocco Villari, personally appeared b fore me this day and acknowledged that he is Manager of RSJ Properties, LLC, a North Carolina limited liability company, and further acknowledged the due execution of this Deed of Easement on behalf of the limited liability company. Witness my hand and official stamp or seal, this —1`�h day of October, 2019. Notary Public My Commission Expires: ) 1� Z _ NOTARY STATE OF NORTH CAROLINA & jOUBLIG 2V€ n COUNTY ` IV coVa M% a Notary Public, do hereby certify that Salvatore J. Villari, personally appeared b ore me this day and acknowledged that he is Manager of S & J Villari Livestock, LLC, a Delaware limited liability company, and further acknowledged the due execution of this Deed of Easement on behalf of the limited liability company. Witness my hand and official stamp or seal, this 7") day of October, 2019 Notary Public aaa ON W My Commission Expires: NOTARY PERMITTING AGENCY: North Carolina Department of Environmental Quality N9 PUBOG yq'rON Division of Water Resources COQ Water Quality Permitting Section aaaw Non -Discharge Permitting Unit 1617 Mail Service Center Raleigh, North Carolina 27699-1617 (919)807-6464 telephone number Permit#W00016376Type: Wastewater Irrigation Permit#W00033357 Type: Land Application (Class B Residuals) BOOk 1906 Page 492 EXHIBIT A Located in Warsaw Township, Duplin County, State of North Carolina and being described with bearings relative to the North Carolina Grid Meridian (N.A.D. 1983) Beginning at a railroad spike found in the center of the pavement of S. R. No. 1340 (Blackmore Road) over a culvert in the run of Mill Branch, said spike having N. C. grid coordinates (N.A.D. 1983) of North 459,640.73 feet, and East 2,263,802.13 feet, said spike being the northeast corner of the S & J Villari Livestock land as recorded in Book 1225, Page 461 of the Duplin County Registry, and runs thence With the run of the Mill Branch South 76 degrees 24 minutes 45 seconds West 216.66 feet to a point, thence With the run of the Mill Branch South 69 degrees 25 minutes 53 seconds West 697.37 feet to an iron pipe found, thence With the run of the Mill Branch South 76 degrees 43 minutes 00 seconds West 165.22 feet to a point, North 88 degrees 00 minutes 36 seconds West 44.55 feet to a point, North 42 degrees 24 minutes 44 seconds West 56.56 feet to a point, and North 51 degrees 02 minutes 53 seconds West 978.40 feet to an iron pipe found, thence With the William Costin, Jr. line (Bk. 1140, Pg. 488) along a ditch North 03 degrees 31 minutes 53 seconds East 765.89 feet to a point, thence With the William Costin line North 87 degrees 26 minutes 53 seconds East 10.00 feet to a 3% inch iron rod set on the bank of a ditch, thence With the William Costin line North 87 degrees 26 minutes 53 seconds East 874.00 feet to a 3/4 inch iron rod set, thence With the William Costin line North 72 degrees 31 minutes 53 seconds East 395.23 feet to a P-K nail found in the center of the pavement of S. R. No. 1340 (Blackmore Road) and runs thence With the center of the pavement of S. R. No. 1340 South 27 degrees 51 minutes 42 seconds East 277.84 feet to a 5/8 inch iron rod found, thence With the center of the pavement of S. R. No. 1340 South 25 degrees 38 minutes 51 seconds East 225.06 feet to a railroad spike found in the centerline intersection of S. R No. 1340 (Blackmore Road) and S. R. No. 1387 (Bruce Costin Road), thence Book 790E Page 493 With the center of the pavement of S. R. No. 1340 South 25 degrees 19 minutes 31 seconds East 90.58 feet to a Mag nail set, South 23 degrees 09 minutes 10 seconds East 100.01 feet to a Mag nail set, South 20 degrees 13 minutes 24 seconds East 100.02 feet to a Mag nail set, South 19 degrees 10 minutes 13 seconds East 155.56 feet to a Mag nail set, South 20 degrees 44 minutes 30 seconds East 100.01 feet to a Mag nail set, South 22 degrees 32 minutes 25 seconds East 100.01 feet to a Mag nail set, South 25 degrees 02 minutes 17 seconds East 120.17 feet to a Mag nail set, and South 26 degrees 46 minutes 49 seconds East 99.76 feet to the point of beginning, containing 46.06 acres, more or less, as surveyed by Brent H. Whitfield L-3589 on January 23, 2004. Being that land as shown on a map entitled "Boundary Survey for: Joseph P. Villari and Salvatore J. Villari as recorded in Map Book 19, Page 224 of the Duplin County Registry. Being all that land as described in Book 950, Page 315; Book 950, Page 319; Book 1150, Page 19; and Book 549, Page 09 of the Duplin County Registry.