WQ0002897_Renewal (Application)_20230403

Initial Review
Reviewer Nathaniel.Thornburg
Is this submittal an application? (Excluding additional information.) *
Yes No
Permit Number (IR) * WQ0002897
Applicant/Permittee Town of Robersonville
Applicant/Permittee Address PO Box 487, Robersonville, NC 27871
Is the owner in BIMS? Yes ) No Is the facility in BIMS? Yes No
Owner Type
Facility Name
County
Fee Category Minor
Is this a complete application?*
Yes No
Signature Authority
Signature Authority Title
Signature Authority Email
Document Type (if non -application)
Email Notifications
Municipal
Town of Robersonville Class B Residuals Program
Martin
Does this need review by the hydrogeologist? * Yes No
Regional Office
CO Reviewer
Admin Reviewer
Fee Amount
Complete App Date
04/03/2023
$0
Below list any additional email address that need notification about a new project.
Email Address
Comments to be added to email notfication
Comments for Admin
Comments for RO

Comments for Reviewer
Comments for Applicant

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* Drew Matthews
Email Address*
[e-mail]
Project Information
.........................
Application/Document Type*
New (Fee Required)
Modification - Major (Fee Required)
Renewal with Major Modification (Fee
Required)
Annual Report
Additional Information
Other
Phone Number*
2528839301
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:*
WQ0002897
Has Current Existing permit number
Applicant/Permittee *
Town of Robersonville
Applicant/Permittee Address*
PO Box 487, Robersonville, NC 27871
Facility Name*
Town of Robersonville 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 [e-mail].
Please attach all information required or requested for this submittal to be reviewed here.
(Application Form, Engineering Plans, Specifications, Calculations, Etc.)
2023 WQ0002897 Permit Renewal.pdf 8.07MB
Upload only 1 PDF document (less than 250 MB). Multiple documents must be combined into one PDF file unless file is larger
than upload limit.
* By checking this box, I acknowledge that I understand the application will not be accepted for pre -review until the fee (if required) has
been received by the Non -Discharge Branch. Application fees must be submitted by check or money order and made payable to the
North Carolina Department of Environmental Quality (NCDEQ). I also confirm that the uploaded document is a single PDF with all parts
of the application in correct order (as specified by the application).
Mail payment to:
NCDEQ — Division of Water Resources
Attn: Non -Discharge Branch
1617 Mail Service Center
Raleigh, NC 27699-1617
Signature
Submission Date 4/3/2023

TOWN OF
ROBERSONVILLE
2023 PERMIT RENEWAL
CLASS B PROGRAM
WQ0002897
Submitted by:
Soil Plus
PO Box 1396
Oxford, North Carolina 27565

April 3, 2023

April 3, 2023
NCDEQ-DWR
Non-Discharge Branch
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Attention: Mr. Nathaniel Thornburg
Reference: PERMIT RENEWAL
Town of Robersonville Residual Biosolids ÑClass BÒ Program
Permit # WQ0002897
Mr. Thornburg:
Soil Plus, LLC (Soil Plus) is submitting one electronic copy of this permit renewal
application package for the Town of Robersonville (WQ0002897). This package includes:
1.Completed Residual Land Application Program Application (RLAP)
a.Weighted PAN Calculations
b.O&M Plan
2.Completed Residual Source Certification Attachment (RSCA)
a.Field Loading Calculation Sheet
b.Analytical
3.Completed Land Application Site Certification Attachment (LASCA)
a.Land Owner Agreement Form
b.Maps
c.Biosolid Utilization Calculations
d.CPLR Summary
Soil Plus will be responsible for completing this permit renewal for the Town of
Robersonville. If there is any further information required or questions regarding this
permit application, please do not hesitate to contact me for assistance.
Respectfully,
Drew Matthews, Soil Plus
cc: Chris Roberson, Town of Robersonville
Jason Smith, Granville Farms
PO Box 1396
Oxford, NC 27565
[phone]
[e-mail]
www.soilplusllc.com

Residual Land
Application Program
Weighted Source PAN Calculations

O&M Plan

Town of
Robersonville

Residual Source
Certification
2023 Class B

Permit Renewal
Field Loading Calculations
Analytical Data

WQ0002897

Land Application Site

Certification

Robersonville, NC
Land Owner Agreement Form
Maps

Biosolid Utilization
CPLR Summary

APPENDIX 1

2023 PERMIT RENEWAL
Town of Robersonville (WQ0002897)

RLAP
Weighted PAN Calculations
O&M Plan

State of North Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .1100 Î 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 SectionÓs Non-Discharge Permitting Unit
General Î 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 .1100.
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 ApplicantÓs 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)
Submit a check, money order or electronic funds transfer made payable to: North Carolina Department of Environmental
Quality (NCDEQ).

1
Facility Classification New Permit Major Modification
Major (land are permitted for 300 acres) $1,310 $395
Minor (land are permitted for < 300 acres) $810 $245
1
- A major modification shall be defined as any permit modification that: increases the generating facilityÓs 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 Î See 15A NCAC 1C .0300)
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)
For Modification Application, if there are any changes to the existing plan, submit an updated O&M plan.
Submit the O&M Plan in accordance with 15A NCAC 02T .1110 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.
Safety measures; may include safety training program, manuals, signs, etc.
Spill response plan; including control, containment, remediation, emergency contact information, etc.
Inspection plan including the following information;
Names and titles of personnel responsible for conducting the inspections.
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
Provide an explanation of why a dedicated system is required instead of a conventional non-dedicated system.
Provide an explanation of the dedicated system and its operation.
H. Detailed Site Maps (All New or Modification Application Packages)
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:
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.
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
Setbacks as required by 15A NCAC 02T .1108
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 scientistÓs
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

I. Project Evaluation and Receiver Site Management Plan (All New Application Packages or Modifications that include new sites)
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)
Submit a detailed hydrogeologic evaluation in accordance with 15A NCAC 02T .1104(d)(4) and current Division Policy
available at: http://www.ncwater.org/Rules_Policies_and_Regulations/. 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 .1104(d)(2). For Modifications, submit an updated site map
specific to the modification(s) only.
The design documents must include the following minimum items:
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
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 .1104(d)(5) and current Division Policy
available at: http://www.ncwater.org/Rules_Policies_and_Regulations/.
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:
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
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: By Courier/Special Delivery:
1617 MAIL SERVICE CENTER 512 N. SALISBURY STREET
RALEIGH, NORTH CAROLINA 27699-1617 RALEIGH, NORTH CAROLINA 27604

TELEPHONE NUMBER: [phone] FAX NUMBER: [phone]
INSTRUCTIONS FOR FORM: RLAP 06-16 Page 3 of 3

State of North Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .1100 Î RESIDUALS LAND APPLICATION PROGRAM
FORM: RLAP 06-16
I. APPLICANT INFORMATION:
1. Applicant's name: Town of Robersonville
Applicant type: Individual Corporation General Partnership Privately-Owned Public Utility
Federal State Municipal County
Signature authorityÓs name per 15A NCAC 02T .0106: Chris Roberson Title: Town Manager
ApplicantÓs mailing address: PO Box 487
City: Robersonville State: NC Zip: 27871-
Telephone number: [phone] Email Address: [e-mail]
2. ConsultantÓs name: Drew Matthews License Number (for P.E.):
Affiliation: On Staff Retained (Firm: Soil Plus, LLC)
ConsultantÓs mailing address: PO Box 1396
City: Oxford State: NC Zip: 27565-
Telephone number: [phone] Email Address: [e-mail]
3. AgronomistÓs name: License Number:
Affiliation: N/A On Staff Retained (Firm: )
AgronomistÓs mailing address:
City: State: Zip: -
Telephone number: ( ) - Email Address:
4. Soil ScientistÓs name: License Number:
Affiliation: N/A On Staff Retained (Firm: )
Soil ScientistÓs mailing address:
City: State: Zip: -
Telephone number: ( ) - Email Address:
5. Fee submitted: $0.00 (See Instruction B)
II. PERMIT INFORMATION:
1. Application is for (check all that apply): new, modified, renewed permit
2. If this application is being submitted to renew or modify an existing permit, provide the following:
Permit number: WQ0002897
Date of most-recently issued permit: September 17, 2018
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 Page 1 of 5

III. RESIDUALS LAND APPLICATION PROGRAM INFORMATION:
1. Residuals Processing FacilityÓs physical address: 1149 Rogerson Road
City: Robersonville State: NC Zip: 27871-
Coordinates: Latitude: 35 48 41 Longitude: 77 15 36
Datum: NAD83 Level of accuracy: Sub-Meter
Method of measurement: GIS
2. County where residuals land application program is headquartered: Martin
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 Anthony Branch Envirolink, Inc. 15675
Back-Up ORC Brain Merritt Envirolink, Inc. 993120
Additional Back-Up
ORCs
(if applicable)
If an ORC and at least one Back-Up ORC are not currently designated for this residuals land application program, provide the
candidatesÓ names, affiliations, and an estimated time schedule for each candidateÓs completion of the required training school
and certification test:
4. Complete the following tables regarding management of the residuals land application program:
a. Plant Available Nitrogen 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: 186 dry tons per year.
PAN Pounds of PAN per Dry Ton Pounds of PAN per Year
(Weighted Average)
Surface Incorporation Surface Incorporation
or Injection or Injection
First-Year 19.39 19.73 3,607 3,669
Five-Year Maximum Adjusted 30.36 30.61 5,647 5,693
b. Land Application 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
Hay 59.35
Pasture
Total: 59.35
Methods Surface 59.35
Incorporation or Injection
Total: 59.35
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 Acres Required Using Acres Required Using
Application Rate First-Year PAN Concentrations Five-Year Maximum Adjusted PAN
Concentrations
(lbs PAN/ac-yr)
Surface Incorporation or Surface Incorporation or
Injection Injection
50 72.15 73.38 112.95 113.86
100 36.07 36.69 56.47 56.93
150 24.05 24.46 37.65 37.95
200 18.04 18.35 28.24 28.47
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 of North 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): Non-dedicated 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;
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.
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: Spray Drip
2. Disposal system is: existing proposed.
3. Minimum depth to mean seasonal high water table (SHWT) within irrigation sites(s) per Soil Scientist's Evaluation: feet
below ground surface. Rules 15A NCAC 02T .0505(p) 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 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:
Recommended Recommended
Soil Series Fields within Soil Area
Loading Rate Loading Rate
(in/hr) (in/yr)

6. Design loading rates are equal or less than the loading rates recommended by Soil Scientist?
Yes or 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):
Design Area Number of Maximum Application Design Annual Loading
Field / Zone
2
(ft) Nozzles Rate (gallons/hr) Rate (gallons/yr)

Total
Plan Sheet Specification
Spray Irrigation Design Element
Number Page Number
Wetted diameter of nozzles ft
2
Wetted area of nozzles ft
Nozzle capacity gpm
Nozzle manufacturer / model /
Elevation of highest nozzle ft
FORM: RLAP 06-16 Page 4 of 5

30.61
30.61
Yr PAN (Inj)Weighted Avglbs/DT
15,304.00
15,304.00 5,693
15,304 113.86 56.93 37.95 28.47
30.36
30.36
15,181.00
15,181.00 5,647
15,181 112.95 56.47 37.65 28.24
19.73
19.73
9,863.00
3,607
3,669
73.38 36.69 24.46 18.35
19.399,863.00
19.399,863
9,697.00
100.00%9,697
186.00
9,697.00
5072.15
10036.0715024.0520018.04
PAN RateAcres RequiredAcres RequiredAcres RequiredAcres Required
Robersonville WWTP 186.00
SourceDry TonAvg1st Yr. PAN (Sur)Weighted Avg.lbs/Dt1st Yr PAN (Inj)Weighted Avglbs/Dt5th Yr PAN (Surface)Weighted Avglbs/DT5th

TOWN OF ROBERSONVILLE
OPERATION AND MAINTENANCE PLAN
LAND APPLICATION OF CLASS B RESIDUAL BIOSIOLIDS
WQ#0002897

Revised March 2023

1.0 ANALYTICAL REQUIREMENTS
Prior to the hauling and land application event being schedule the generator must provide analytical results
documenting that all parameters listed in Condition IV. 2 Ï 4 and at the frequency listed in most recent copy of this
permit. The Town of Robersonville will collect the sample prior to land application and will be done in the following
manner:
Four factors that may ultimately affect the integrity of reported data include: 1) obtaining a representative sample, 2)
preventing contamination of the sample, 3) providing legal documentation of the sampling event, and 4) protecting
the sample from chemical, physical or biological change prior to analysis.
A sample will be collected according to the schedule provided in the most recent copy of the Attachment of this
permit and prior to land application one composite sample should be pulled from a designated location from the
generating source. The Town of Robersonville has identified Meritech, Inc. in Reidsville, NC to be used as the
Certified Laboratory. The composite sample should be analyzed for:
% Solids,
Nitrogen Series (TKN, Ammonia, Nitrate, Nitrite, and Organic Nitrogen),
Phosphorus,
Potassium,
Sulfur,
Calcium,
Magnesium,
Sodium,
Iron,
Aluminum,
Manganese,
Copper,
Zinc,
and Remaining 503 Metals (i.e. Arsenic, Cadmium, Chromium, Mercury, Molybdenum, Lead, Nickel,
Selenium)

Approximately 2 quarts of residual should be collected. The sample containers should be clean and sterile. They
should also be labeled so that they are easily identifiable in the lab. The samples should be pulled using the method
listed below:
Collect one sample from each holding tank(s) from which the material will be land applied using a Ñswing
samplerÒ
o The swing sampler must be used with a sterile, plastic 960 ml container
Combine each sample in a stainless steel bucket
Mix thoroughly using a fiberglass rod
Collect each sample from the top of the access point at each holding tank. This access point is obtained by
climbing the installed ladder on the side of the holding tank.

Once the sample is pulled, it should be placed in medium size cooler packed with ice. The sample should be collected
with an enough time so that it can be delivered to the laboratory.
Revised 03/23 ©Town of Robersonville Operation and Maintenance Plan

Once per calendar year a sample should be collected and submitted to Meritech, Inc. in Reidsville, NC. This sample
should be analyzed for:
Full TCLP
Ignitability, Corrositivity, and Reactivity
Requires 5 Liters (In Opac Glass Bottles)
A third should be submitted to Meritech, Inc. for a 30-Day Scale Bench test and Fecal Coliform Density Test. The
30-Day Scale Bench Test also requires 1 quart of ÑclearÒ water from the Clarifier for Dilution if necessary. This
sample would be analyzed for:
30-Day Scale Bench Test (4 Quarts of Residuals and 1 Quart of Clarifier water)
Fecal Coliform Density Test (seven pint samples)
The contact information for the labs is:
Mailing Address
Meritech, Inc.
642 Tamco Road
Reidsville, NC 27320
[phone] (phone)
[phone] (fax)
Sampling frequency will be conducted in accordance with the Table listed in the most recent Attachment A of this
permit. The sample will be collected by a representative of Soil Plus, LLC. For further information please contact:

Drew Matthews
PO Box 1396
Oxford, NC 27565
252-883-9301

Revised 03/23 ©Town of Robersonville Operation and Maintenance Plan

2.0BIOSOLIDS REMOVAL, TRANSPORT, AND APPLICATION
Biosolids will be transported from the generators to suitable, permitted land application sites. Transport equipment
will be inspected, licensed and appropriately marked, as required, for the purpose of transporting biosolids. Biosolids
will be delivered to the application sites between sunrise to sunset.
Both liquid and dewatered biosolids distribution on the land application sites will be uniform throughout the
application area. To ensure adequate control of the application rate for each site, the equipment used for spreading
the sludge will be calibrated by measuring the amount handled on a known square footage. While the rate of discharge
from the application vehicle is fixed, the speed of the equipment can be adjusted to maintain the flow rate needed to
achieve specific application rates. Spreading operations will be discontinued during periods of inclement weather and
will not be resumed until sufficient drying of the fields has occurred. This allows equipment access without causing
excessive soil compaction or rutting. To prevent adherence of the biosolids, transport vehicles will be equipped with
rear mud flaps, thereby preventing biosolids from being tracked onto roadways. Biosolids adhering to the mud flap
will be scraped off in the field before the truck returns to the roadway. Examples of our application tracking and
summary form/reports can be provided upon request.

3.0 SITE OPERATION

Biosolids will be surface applied at the properly-calculated agronomic rate and in strict accordance with any state and
federal regulations for the land application of the biosolids. Buffer zone distances will be observed in accordance with
applicable state and federal regulations. Buffer zones will be flagged and no biosolids will be applied within those
areas. The most restrictive buffer will apply in combined situations. Operational provisions will be taken to prevent
soil loss through erosion. Provisions will include contour application and avoidance of areas where surface drainage
patterns result in concentrated flow of runoff from rainfall. In accordance with sound, industry standard agronomic
practice, areas which are unseasonably wet (and would produce rutting or damage to the field) will not be utilized for
biosolids application operations during those periods. Operations will be discontinued when soils are saturated and
will not be resumed until the field has sufficient dried. The amount of biosolids applied will not exceed the hydraulic
capacity of the soil at the time of each application. If a subsequent pass across a field is necessary to achieve the
desired application rate, sufficient drying time will be allowed between passes.

4.0 PROJECT CONTROL
To ensure biosolids are continuously applied at the correct application rate and in a manner consistent with the
Operations Plan, a Field Manager (provided by the contracted land application company) will be in direct charge of
the field operations, controlling the amount of biosolids delivered to each field, and conducting daily field inspections.
Field inspections will include ensuring that flags are in place, biosolids are applied uniformly at the designated
application rate, setbacks are observed, trucks are unloading at best location, trucks are not driving over biosolids,
trucks are cleaned before leaving the field and the land application equipment is maintained in working condition.

5.0 TRANSPORTATION SYSTEM ROUTING

Per the specifications, transportation vehicles will be equipped with GPS devices that will guide drivers to the land
application sites. Transportation routes will follow primary highways and avoid residential areas where possible.
Designated routes are followed unless a detour is specified. In the event of a detour route, it shall be taken as specified
by the detour authority. There shall be no unscheduled stops when loaded. Transportation vehicles will be inspected,
licensed and appropriately marked as required with identification numbers for the purpose of this contract. All units
will be equipped with spill guards and full mud flaps. This will prevent the biosolids from adhering to the tires and
undercarriage of the transport vehicle, thereby preventing biosolids from being tracked onto roadways. Biosolids
adhering to the mud flap will be scraped off in the field before the truck returns to the roadway. All federal OSHA
Revised 03/23 ©Town of Robersonville Operation and Maintenance Plan

and DOT laws and regulations are complied with for the protection of our clients, the community and our drivers.
Examples of vehicle and driver transportation logs and inspection forms can be provided upon request.
6.0DEWATERED BIOSOLIDS
Dewatered biosolids will be transported in standard end dump trailers. The tankers will be loaded per the generatorÔs
specifications and standard protocols. The aluminum dump trailers used for transportation of dewatered cake
biosolids will be equipped with sealed tailgates and will be completely sealed to prevent leakage. All trucks will be fully
covered and will be fitted with positive lock tailgates.

7.0 LIQUID BIOSOLIDS

Liquid biosolids will be transported using liquid tankers pulled by standard road tractors, or pumper trucks. The
tankers and pumper trucks will be loaded per the generatorÔs specifications and standard protocols. The
tractor/tanker unit will transport its load to a designated staging area inside the buffered area of a permitted land
application site.

8.0 APPLICATION (SPREADING) Ï DEWATERED BIOSOLIDS

At the staging area each load will be unloaded in a designated area within the land application site. Biosolids will be
loaded into our Side Slinger cake box by a front-end loader. This unit is capable of delivering an accurate, calibrated
application of dewatered biosolids over the application site. The uniform spread pattern ensures that biosolids are
applied at proper agronomic (nutrient) and hydraulic loading rates. The application rates for each site, and its
corresponding crop, will be determined based on the Plant Available Nitrogen (PAN) content of the biosolids, or
other limiting factors. Typical applications will deliver between 75 and 100 percent of a crop's annual PAN
requirement.

9.0 APPLICATION (SPREADING) Ï LIQUID BIOSOLIDS

At the staging area each load will be transferred into a 4,000 gallon capacity pull behind subsequent land application.
This unit is capable of delivering an accurate, calibrated application of liquid biosolids over the application site. The
uniform spread pattern ensures that biosolids are applied at proper agronomic (nutrient) and hydraulic loading rates.
The application rates for each site, and its corresponding crop, will be determined based on the Plant Available
Nitrogen (PAN) content of the biosolids, or other limiting factors. Typical applications will deliver between 75 and
100 percent of a crop's annual PAN requirement.
10.0 SPILL AND EMERGENCY RESPONSE PROGRAM
In the unlikely event of a spill, the Town of Robersonville will take the following actions immediately.
Halt Source of Spill. Use of any leaking or damaged unit which is causing the spill will cease immediately. The
unit will be repaired before resuming its use.
Contain Spill. In the event large quantities of biosolids have been spilled, straw bales will be used where
available and as necessary to either form a barrier or absorb biosolids.
Clean-Up. Depending on the type and amount of biosolids spilled, a variety of equipment may be used to
remove the biosolids: front-end loader, shovels and brooms and vacuum equipment of a liquid biosolids
applicator. Any biosolids removed from the spill site will be spread on an approved application site, returned
to the WWTP, or disposed of in an approved landfill.
Revised 03/23 ©Town of Robersonville Operation and Maintenance Plan

Final Clean-Up. Flush roadways with water or sweep as necessary to clean. Allow to dry and incorporate if
spill occurs on non-paved and tillable area. In the event a spill occurs on private property, final clean-up
should be completed immediately to the satisfaction of the owner.
Management of Clean-Up Efforts. The Operations Manager will take immediate charge and initiate clean-up
activities. The Contract Land Applier along with the Town of Robersonville labor will be used, with additional
labor secured as needed. The Operations Manager will also communicate with the public on the scene,
answering questions and advising of clean-up activities.
Reporting. All spills will be reported immediately to the Town of Robersonville officials. State and local
agencies will be notified in accordance with their notification requirements. Within 24 hours of the spill, the
Operations Manager will send the Town of Robersonville a written report detailing how the spill occurred
and remedial action taken. This report will be provided using the enclosed Spill Report form.
Spill Prevention. The Operations Manager will implement the following spill prevention measures:
o Ensure truck drivers watch trailer while loading and do not overload;
o Ensure trailer hatches are closed and latched while transporting;
o Ensure trailer seals are inspected on a daily basis and replaced as necessary; and
o Ensure unloading operations in the field are conducted to minimize any potential runoff or tracking.

The Town of Robersonville require that the Contract Land Applier shall ensure that all employees receive safety and
spill response training as part to their new hire training and thereafter participate in our monthly safety and spill
response training program. In addition to their internal training and protocols, they must also contract with a regional
emergency response firm - HEPACO - available to respond to an incident in the Central and Eastern North Carolina
area within two hours. A copy of our agreement with HEPACO can be provided upon request.

Names and Titles of Inspection Personnel

Andy Smith, Area Supervisor
Jason Smith, Area Supervisor

JT Bryant, Regional Supervisor

Jay Bryant, Project Supervisor
Matt Foster, Project Supervisor

Jeff Bumpass, Field operators
Curtis Riggs, Field operators
Mark Hurley, Field operators

11.0 PREVENTION

The goal of a compliance assurance system is to prevent compliance issues from occurring. Prevention involves:
Ensuring personnel understand their role in assuring compliance;
Identifying compliance requirements at the federal, state and local levels;
Implementing a system where compliance tasks are scheduled, assigned and tracked to completion;
Developing standard operating procedures where appropriate; and
Reviewing the compliance task list and standard operating procedures on an ongoing basis and modifying
them as appropriate to account for changes in regulations/requirements and operating methods, and to
address compliance deficiencies.

Revised 03/23 ©Town of Robersonville Operation and Maintenance Plan

12.0 STANDARD OPERATING PROCEDURES (SOP's)
The Town of Robersonville will direct the Contract Land Applier to develop and implement SOPs to ensure
compliance tasks are completed consistently across the company. The SOP provides standard forms to use, approved
biosolids analytical methods, frequency of monitoring information, etc. Another key SOP relative to preventing
compliance issues from occurring is the use of a "Pre-Operating and Buffer Checklist".
The Pre-Operating and Buffer Checklist ensures federal, state and local regulations and permit requirements are met
prior to initiating biosolids applications at field sites. Compliance items on the Checklist include:
The field is permitted and suitable for the biosolids/residuals type being applied;
Pre-application requirements are met;
Farmer and landowner agreements are current and the crop to be grown has been verified;
The field is flagged to prevent applications in buffer zones and restricted areas;
The appropriate application rate and field capacity is calculated; and
Any special permit or local requirements are met.
A listing of the buffer zones and restricted areas where biosolids/residuals cannot be applied
A listing of operating requirements including notification requirements,
application method requirements, and inclement weather operating requirements
13.0ASSESMENT
To help ensure compliance requirements are being met and the compliance assurance system is implemented and
working, periodic, consistent, objective and documented assessments of the project/facility's compliance status are
conducted.
14.0CORRECTIVE ACTION
Once compliance issues have been identified during the course of day to day business and through internal audits and
inspections a system must be in place which ensures that appropriate and timely corrective action is taken, the cause
of the compliance issue is identified and actions are taken to prevent recurrence of the issue.
The Town of RobersonvilleÔs goal is to have no instances of non-compliance. However, issues and incidents may
occur and when this happens employees work to correct the incident in a timely and thorough manner. When
compliance issues are identified, the situation is examined to determine the root cause of the problem and the
corrective and preventive action that must be taken. The preventive action must address the root cause with the goal
of preventing a recurrence.
Depending on the nature of the compliance issue, it is assigned to one or more responsible parties to ensure that the
corrective and preventive actions are implemented. A deadline for completion of the task is assigned and the issue is
tracked to completion by regional and corporate compliance personnel.
Revised 03/23 ©Town of Robersonville Operation and Maintenance Plan

15.0 TRAINING
An effective compliance training program involves:
Identifying training needs and requirements;
Assigning personnel to provide training and providing them the resources they need to conduct training;
Documenting and tracking that mandatory t raining has occurred; and
An employee's training needs and requirements, as well as their training responsibilities, are based on
his/her position within the company.

Revised 03/23 ©Town of Robersonville Operation and Maintenance Plan

SpillResponse/CleanUp
THEFOLLOWINGACTIONSMUSTBETAKENINTHEEVENTOFASPILL
Haltthesourceofthespill:Rupturedlineorvalve,ordamagedtankunit.
Containspill:Usestrawbalestoformabarrier.Straworhaybalescanbeobtained
fromseveralsourcesforthispurpose.Soilnearthesitecanalsobeusedtoforma
barrierforcontainment.
Cleanup:Useapplicationequipmenttorecoverasmuchofthematerialaspossible.
Aftertheapplicationequipmenthasrecoveredasmuchmaterialaspossible,itwill
belandappliedasperthemanagementplan.Atemporarysumppitmaybedugin
thecontainmentareaandspilledmaterialwashedintoittoenhancerecovery.
FinalCleanup:Anyunrecoverablematerialwillbewashedfromroadsurfacesand
incorporatedintoanadjacenttillablearea.
Notification:Assoonaspossibleafteraspilloccursnotify:
(252)
Smith
(919)6908000
DepartmentofEnvironmentalQuality
DivisionofWaterResources
WashingtonRegionalOffice
(252)9466481
FireDepartmentifassistanceisrequiredforwashdownͻВЊЊͼ
HighwayPatrolifaccidentisonapublicroadͻВЊЊͼ
Managementofcleanupefforts:Thefieldsuperintendentwilltakeimmediate
chargeofthecleanupactivities.Additionallaborwillberequestedfromthe
groundwaterrecoverysiteandotherdepartmentsasneeded.
Reporting:Within24hoursofaspill,thefieldsuperintendentwillpresentawritten
reportdetailingthecauseofthespillandallactionstakeninresponsetothespill.
ThereportwillbesenttotheNCDEQRegionalofficehavingjurisdictionatthe
locationinwhichthereleaseoccurred.

ROBERSONVILLE WWTP
Quantitative Justification
YEARGALLONSDRY TONS
2018404,80079.67
201900
2020543,40038.30
202100
2022851,50058.59
AVERAGE 599,90058.85

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SOURCE LOCATION MAP
Scale:1 inch = 1 miles
Figure
Drawn by: CSCWQ0002897 O&M PLAN
1
Reviewed by:Robersonville, North Carolina
Date: Dec '17Soil Plus Project # 200702.A10

APPENDIX 2
2023 PERMIT RENEWAL
Town of Robersonville (WQ0002897)
RSCA
Field Loading Calculations
Analytical

State of North Carolina
Department of Environmental Quality
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 SectionÓs Non-Discharge Permitting Unit
General Î 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 ÐMap Guidance for
Residuals Land Application PermitsÑ.
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 06-16 Page 1 of 1

Page 1

Proposed
b
Maximum Dry Tons Per Year
Current
).
icable to new facility
D (Deleted)
sposal (i.e, not appl
M (Modified)
y Name County Permit Number
R (Renewed)

for distribution, land application, or di
N (New)

Town of Robersonville
Facility Permit Holder Facilit
a

R Town of Robersonville Robersonville WWTP Martin NC0026042 186 186
he amount of residuals currently permitted
Status Code
T
Status Code for source facility are:
RESIDUALS SOURCE FACILITY SUMMARY Applicant's name: a b SUMMARY FOR FORM: RSC 06-16

State of North Carolina
Department of Environmental Quality
Division of Water Resources
RESIDUALS SOURCE CERTIFICATION
FORM: RSC 06-16
I. RESIDUALS SOURCE-GENERATING FACILITY INFORMATION (See Instruction B.):
1. Facility Name: Robersonville WWTP
2. Facility permit holder is: Federal, State, Local Government, or Private.
Facility permit issued by: Div. of Water Resources, Div. of Environmental Health,
or Other (explain: ).
3. Facility contact person and title: Richard Sink, Public Works/Utilities Director
Complete mailing address: PO Box 487
City: Robersonville State: NC Zip: 27871-
Telephone number: [phone] E-mail address: [e-mail]
4. Facility physical address: 1149 Rogerson Road
City: Robersonville State: NC Zip: 27871-
Coordinates: Latitude: 35 48 41 Longitude: 77 15 36
Datum: NAD83 Level of accuracy: Sub-Meter
Method of measurement: GIS
5. Purpose of the facility:
treatment of municipal wastewater, treatment of 100% domestic wastewater,
treatment of potable water, treatment of 100% industrial wastewater,
treatment of industrial wastewater mixed with domestic wastewater,
(approximate percentages: % industrial and % domestic)
other (explain: ).
6. Does the facility have an approved pretreatment program: Yes No
7. Facility permitted/design flow: 1.8 MGD and facility average daily flow: 0.51 MGD
8. Average amount of residuals being generated at this facility 59 dry tons per year.
9. Specify the following regarding treatment and storage volumes available at the facility:
Type and volume of residuals treatment: (2) 1.35 MG Oxidation Ditches
Type and volume of residuals storage (i.e., outside of residuals treatment units): (2) 365,000 Gallon Aerobic Digesters
II. RESIDUALS QUALITY INFORMATION (See Instruction C.):
1. Specify if residuals are regulated under:
40 CFR Part 503 or 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 Non-Biological
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).
FORM: RSC 06-16 Page 1 of 5

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: 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: yes 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: Meritech, Inc. / Summit Environmental Technologies, Inc. and Date of analysis: 3/7/2023
Passed corrosivity test: yes no. pH: 7.2 s.u. (2 < pH < 12.5)
oo
Passed ignitability test: yes no. Flashpoint: >140 F (> 140F)
Passed reactivity test: yes no. HCN: <0.500 mg/kg (<250) & HS: <10.0 mg/kg (<500)
2
TCLP Parameter Limit Result TCLP Parameter Limit Result
(mg/l) (mg/l) (mg/l) (mg/l)
Arsenic 5.0 <0.100 Hexachlorobenzene 0.13 <0.100
Barium 100.0 0.096 Hexachloro-1,3-Butadiene 0.5 <0.100
Benzene 0.5 <0.0100 Hexachloroethane 3.0 <0.100
Cadmium 1.0 <0.020 Lead 5.0 <0.100
Carbon Tetrachloride 0.5 <0.0100 Lindane 0.4 <0.005
Chlordane 0.03 <0.025 Mercury 0.2 <0.02
Chlorobenzene 100.0 <0.0100 Methoxychlor 10.0 <0.005
Chloroform 6.0 <0.0100 Methyl Ethyl Ketone 200.0 <0.100
Chromium 5.0 <0.050 Nitrobenzene 2.0 <0.100
m-Cresol 200.0 <0.200 Pentachlorophenol 100.0 <0.500
o-Cresol 200.0 <0.100 Pyridine 5.0 <0.100
p-Cresol 200.0 <0.200 Selenium 1.0 <0.100
Cresol 200.0 <0.300 Silver 5.0 <0.005
2,4-D 10.0 <0.0100 Tetrachloroethylene 0.7 <0.0100
1,4-Dichlorobenzene 7.5 <0.100 Toxaphene 0.5 <0.05
1,2-Dichloroethane 0.5 <0.0100 Trichloroethylene 0.5 <0.0100
1,1-Dichloroethylene 0.7 <0.0100 2,4,5-Trichlorophenol 400.0 <0.100
2,4-Dinitrotoluene 0.13 <0.100 2,4,6-Trichlorophenol 2.0 <0.100
Endrin 0.02 <0.005 2,4,5-TP (Silvex) 1.0 <0.0100
Heptachlor and its Hydroxide 0.008 <0.005 Vinyl Chloride 0.2 <0.0200

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: Meritech, Inc. and Date of analysis: 3/7/2023
Parameter Ceiling Monthly Average Result
Concentration Limits Concentration Limits
(ClassA & ClassB) (Class A Only)

(mg/kg) (mg/kg) (mg/kg)
Arsenic 75 41 <1.66
Cadmium 85 39 0.384
Copper 4,300 1,500 294
Lead 840 300 26.8
Mercury 57 17 0.0993
Molybdenum 75 n/a 2.39
Nickel 420 420 10.8
Selenium 100 100 <3.31
Zinc 7,500 2,800 384
b. For Surface Disposal Unit (landfill): 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: and Date of analysis:
Distance from Disposal Arsenic Chromium Nickel

Unit to Boundary to
Closest Property Line
(meters, check one) (mg/kg) (mg/kg) (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. Nutrient/Micronutrient Determination: Complete the following:
a. Total solids: 3.02 %.
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: Meritech, Inc. and Date of analysis: 3/7/2023
Parameter Result
(mg/kg)
Aluminum 17,200
Ammonia-Nitrogen <331
Calcium 9,640
Magnesium 1,820
Nitrate-Nitrite Nitrogen <331
pH (Standard Unit) 7.1
Phosphorus 9,740
Potassium 2,340
Sodium 4,770
Total Kjeldahl Nitrogen 31,000
c. Using the results listed in Item II. 5b. above, calculate the sodium adsorption ration (SAR): 2.02
\[Note: If residuals contain SAR of 10 or higher, the applicant shall obtain recommendations from the local Cooperative
Extension Office, the Department of Agriculture and Consumer Services, the Natural Resource Conservation Service, a
North Carolina Licensed Soil Scientist, or an agronomist, prior to land application of residuals. The recommendations shall
address the sodium application rate, soil amendments (e.g., gypsum, etc.), or a mechanism for maintaining site integrity
and conditions conducive to crop growth\].
d. Specify the mineralization rate to be used in calculating the plant available nitrogen (PAN) of the residuals: 30 %. This
rate is a (check one): default value, or 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:
e. Calculate the PAN for the residuals (i.e., on a dry weight basis) and fill the results in the following table:

st
Application Method First (1) Year PAN Five-Year

Maximum Adjusted PAN
(mg/kg)
(mg/kg)
Surface 9,697 15,181
Injection/Incorporation 9,863 15,304
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 Known
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 \[15A NCAC 02T.1106(b)(3)(A)\] - Time/Temperature Compliance.
Alternative 2 \[15A NCAC 02T.1106(b)(3)(B)\] - Alkaline Treatment.
Alternative 3 \[15A NCAC 02T.1106(b)(3)(C)\] - Prior Testing for Enteric Virus/Viable Helminth Ova.
Alternative 4 \[15A NCAC 02T.1106(b)(3)(D)\] - No Prior Testing for Enteric Virus/Viable Helminth Ova.
Alternative 5 \[15A NCAC 02T.1106(b)(3)(E)-(K)\] - Process to Further Reduce Pathogens (PFRP).
Specify one: composting, heat drying, heat treatment,
thermophilic aerobic digestion, beta ray irradiation,
gamma ray irradiation, or pasteurization.
b. For Land Application of Class B:
Alternative 1 \[15A NCAC 02T.1106(c)(1)\] - Fecal Coliform Density Demonstration.
Alternative 2 \[15A NCAC 02T.1106(c)(2)\] - Process to Significantly Reduce Pathogens (PSRP).
Specify one: aerobic digestion, air drying, 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.
Select One of the Class B or Equivalent Pathogen Reduction Alternatives in Item II. 7b. above.
Exempt - If Daily Cover Alternative is chosen in Item II.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).
Alternative 2 \[15A NCAC 02T.1107(a)(2)\] - 40-Day Bench Scale Test (Anaerobic Digestion).
Alternative 3 \[15A NCAC 02T.1107(a)(3)\] - 30-Day Bench Scale Test (Aerobic Digestion).
Alternative 4 \[15A NCAC 02T.1107(a)(4)\] - Specific Oxygen Uptake Rate Test (Aerobic Digestion).
Alternative 5 \[15A NCAC 02T.1107(a)(5)\] - 14-Day Aerobic Processes.
Alternative 6 \[15A NCAC 02T.1107(a)(6)\] - Alkaline Stabilization.
Alternative 7 \[15A NCAC 02T.1107(a)(7)\] - Drying of Stabilized Residuals.
Alternative 8 \[15A NCAC 02T.1107(a)(8)\] - Drying of Unstabilized Residuals.
Alternative 9 \[15A NCAC 02T.1107(a)(9)\] - Injection.
Alternative 10 \[15A NCAC 02T.1107(a)(10)\] - Incorporation.
Alternative for Surface Disposal Units Only - Soil/Other Material Cover \[15A NCAC 02T.1107(b)(2)\].
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

FIELD LOADING ESTIMATES
FacilityRobersonville WWTP
Sampling Date3/7/2023
% Solids3.02
Mineralization Rate
0.30
Gallonsper DT7,940.67
pH7.1
Sodium Absorpotion 2.02<5.0 Safe5.0 - 10.0 Careful Management>15.0 Do Not Land Apply
Ratio
NITROGEN APPLICATIONNUTRIENT APPLICATION
TKN (mg/Kg)31,000lbs./1,000 gal7.81Potassium lbs./1,000 gal0.59
Ammonia Nitrogen (mg/Kg)
331.00lbs./1,000 gal0.08Phosphorus lbs./1,000 gal2.45
Nitrate-Nitrite (mg/Kg)331.00lbs./1,000 gal0.08Calcium lbs./1,000 gal2.43
Magnesium lbs./1,000 gal0.46
PLANT AVAILABLE NITROGEN SURFACE APPLIED
Manganese lbs./1,000 gal
PAN (mg/Kg)9,697lbs./1,000 gal2.44
Sulfur lbs./1,000 gal
PLANT AVAILABLE NITROGEN INJECTED/INCORPORATED APPLIED
Molybdenum lbs./1,000 gal0.00
PAN (mg/Kg)9,863lbs./1,000 gal2.48
Volatization Rate= 0.5 Surface Application
1.0 Injection/Incorporation
EPA METAL LIMITS
Class A Ceiling Class B Ceiling
HEAVY METAL CONCENTRATIONHEAVY METAL LOADING
Limits (mg/Kg)Limits (mg/Kg)
4175Arsenic (mg/Kg)1.66Arsenic lbs./1,000 gal0.00
85
39Cadmium (mg/Kg)0.38Cadmium lbs./1,000 gal0.00
4,300
1,500Copper (mg/Kg)294.00Copper lbs./1,000 gal0.07
300840Lead (mg/Kg)
26.80Lead lbs./1,000 gal0.01
1757Mercury (mg/Kg)
0.10Mercury lbs./1,000 gal0.00
420420Nickel (mg/Kg)10.80Nickel lbs./1,000 gal0.00
100100Selenium (mg/Kg)3.31Selenium lbs./1,000 gal0.00
2,8007,500Zinc (mg/Kg)384.00Zinc lbs./1,000 gal0.10
RESIDUAL NITROGEN CALCULATION
Surface ApplicationInjection/Incorporation Application
Remaining Remaining
Organic Organic
Nitrogen Nitrogen
PAN PAN PAN PAN
TKNTKN
Equations
(mg/kg)(lbs/DT)(mg/Kg)(mg/kg)(lbs/DT)(mg/Kg)
1st Year31,0009,69719.3921,3039,86319.731st Yr. PAN (mg/Kg)=(MR x (TKN-NH3))+(VR x NH3)+NOx
31,00021,137
2nd Year21,3033,1956.3918,10721,13717,9673,1716.342nd Yr PAN (mg/Kg)= 2nd Yr. TKN x (MR/2)
3rd Year18,1071,3582.7216,74917,96716,6191,3482.703rd Yr PAN (mg/Kg)= 3rd Yr. TKN x (MR/4)
4th Year16,7496281.2616,12116,61915,9966231.254th Yr PAN (mg/Kg)= 4th Yr. TKN x (MR/8)
5th Year16,1213020.6015,81915,9963000.6015,6965th Yr PAN (mg/Kg)= 5th Yr. TKN x (MR/16)
Total15,18130.36Total15,30430.61

APPENDIX 3

2023 PERMIT RENEWAL
Town of Robersonville (WQ0002897)

LASCA
Land Owner Agreement Form
Maps
Biosolid Utilization
CPLR Summary

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 copies of the application and
supporting documentation
For more information, visit the Water Quality Permitting SectionÓs Non-Discharge Permitting Unit
General Î 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
Notification.doc

*
Land Owner
Agreement

(If applicable)

Setback Waiver
Agreement

An updated vicinity/setback map in accordance with the Ð Map Guidance

*
for Residuals Land Application PermitsÑ
A soils and agronomic evaluation in accordance with the Ð Soil Scientist
*
Evaluation PolicyÑ
INSTRUCTIONS FOR FORM: LASC 06-16 Page 1 of 3

An updated accounting of the land application siteÓs cumulative

pollutant loading rates (CPLRs)
Status Code
Required Item
N 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 Ð Soil Scientist Evaluation Policy Ò
Acknowledgement of field transfer from Land Owner (Fields may not

be permitted to multiple Permittees over the same time period)
* This item may be required for land application site with a status code Ð M Ñ, 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 ÐBÑ 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:
Digital or Raw Photo Extraction (EXT)
Address Matching (ADD)
graphy with Ground Control (AER) Geodetic Quality GPS Survey (GEO)
Aerial Photo
Cadastral Survey (SUR) LORAN-C Navigation Device (LOR)
Conversion from Coordinate Plane (CP) Navigation Quality GPS (GPS)
Conversion from Township-Section-Range (TSR) Remote Sensing (RS)
Conversion from Universal Trans Merc (UTM) Zip Code Centroid (ZIP)
y Digital or Manual Extraction (MAP)
Map Interpretation b
C. Waterbody and Classifications Information: (new sites only)
Use an 8.5 by 11-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: http://deq.nc.gov/about/divisions/water-
resources/planning/classification-standards/classifications
Any questions concerning the waterbody and its classification, please contact the DivisionÓs regional offices.
A list of the DivisionÓs regional offices, their county coverage, and their contact information may be downloaded at:
http://deq.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 http://deq.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 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.
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 .0301(i).
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 Streams entering Georgia or Tennessee shall be classified "C Tr." Such streams in the Savannah
Basin And Savannah River drainage area entering South Carolina shall be classified "B Tr."
River Drainage Area
French Broad River Streams entering Tennessee will be classified "B."
Basin
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 Streams entering Virginia are classified "C," and such streams entering South Carolina are
Basin classified "C."
Lumber River Basin Streams entering South Carolina are classified "C Sw."
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
Roanoke River Basin 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 All drainage canals not noted in the schedule are classified "C Sw." except the main drainage
Basin canals to Pamlico Sound and its bays which shall be classified "SC."
Pasquotank River Basin All drainage canals not noted in the schedule are classified "C."
INSTRUCTIONS FOR FORM: LASC 06-16 Page 3 of 3

c

Page 1

Fo
BoB
GoA

Class
or Rep. Slope
Mapping Unit

b

Current and Proposed

Predominant Soil

Foreston
Bonneau
Goldsboro
Series Name

Stream Index No.

Waterbody Subbasin and
Bermuda HayBermuda HayBermuda Hay
ing unit is CeB2)

D (Deleted)

MartinMartinMartin
Nearest SecondNearest SecondNearest SecondNearest SecondNearest SecondNearest SecondNearest Second

Location Accuracy
T (Transferred)
11.0910.7837.48

net acres.
59.35
ADDADDADDADDADDADDADD

Location Method Code
M (Modified)

Datum
NAD 83 ADD Nearest Second NAD 83NAD 83NAD 83NAD 83NAD 83NAD 83NAD 83
Location

R (Renewed)
information (II.) of the same field on the same page.

net acres and Total to be certified:

CERTIFICATION

N (New)
59.35

ith those used in the County Soil Survey (i.e. for a 2-8% slope Cecil in Anson County the mapp
Landowner(s) Lessee(s) or Operator(s) Net Acres County Crop(s)

Town of RobersonvilleTown of RobersonvilleTown of Robersonville

ID

TR-01TR-02TR-03
Site/Field

a
Site/Field ID Latitude Longitude
LAND APPLICATION SITE INFORMATION (See Instruction B): WATERBODY AND CLASSIFICATIONS INFORMATION (See Instruction C):
R R R
N N N N N

Code
Status

Status Code for land application sites are: Mapping Unit must be consistent w
Soil Series Name (i.e. Appling, Cecil, etc.)
LAND APPLICATION SITE Applicant's name: Town of Robersonville Land application sites currently certified: I.a bc II.Note: Please keep the site information (I.) and waterbody FORM: LASC
06-16

State of North Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .1100 Î LAND OWNER 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 shall submit one original and two copies of the application and
supporting documentation
For more information, visit the Water Quality Permitting SectionÓs Non-Discharge Permitting Unit.
General Î 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 NCAC 02T .1100. 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:
Town of Robersonville
Applicant's name:
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:
Special note
Lease Land Use or Residuals Source
Site/Field ID Intended Use of Crops (no-till/over-seed/
(yes/no) Cropping Patterns (optional)
pasture)

Animal Consumption
TR Fields 1-3 Yes Bermuda 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 DivisionÓs 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: LOA 06-16 Page 1 of 3

I. STIPULATIONS:
1. 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 II) 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 lime 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 lime 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 near 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.
II. RESTRICTIONS:
1. Appropriate measures must be taken 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 for grazing 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 a 20-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.
III. 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

#
#
"
#
#
²
FIELD 1
!
#
FIELD 2
FIELD 3
V
Legend
House
"
#
!
#
#Structure
"
Well
!
Ditch
#
Stream
The Compliance Boundary is established either 250
FIELDNET AC.
#
V
V
feet from the residuals application area or 50 feet
Application Area
!111.09
"
within the property boundary, whichever is closest to
210.78
Buffer
the application area. The Review Boundary is
337.48
Field Boundary
established midway between the Compliance
Pond
Boundary and the perimeter of the residuals
4002000400
Property Boundary
application area.
Feet
Scale:1 inch = 400 feet
TR FIELDS 1-3 BUFFER MAP
Figure
Town of Robersonville RLAP (WQ0002897)
Drawn by: DM
Reviewed by:Robersonville, North Carolina
Date: March 2023Soil Plus Project # 201107.A10

10.41
617.76
82,645.25

Dry Tons Per Ac.
Total Gallons Gallons Per Ac. Total Dry Tons
1,044,485 913,759 2,946,751
ApplicationN Req.GallonsTotal Gallons
Bermuda HaySurface23094,183Bermuda HaySurface20784,764Bermuda HaySurface19278,622
14.1311.0913.5310.7839.6237.48
Totals67.2859.354,904,995
(8)Derived from http://nutrients.soil.ncsu.edu/yields/ for Martin County (Realistic Nitrogen Rate)(9)Column (8) divided by 19.39 lbs N per DT multiplied by 7,940 Gallons Per DT
(10)Column (9) multiplied by Column (5)
(1)(2)(3)(4)(5)(6)(7)(8)(9)(10)
TR1Goldsboro (GoA)TR2Foreston (Fo)TR3Bonneau (BoB)
FarmFieldSoil TypeGross Ac.Net Ac.CropMethod(lbs/Ac.)Per Ac.Per Field

Metals (lbs/Acre)
ArsenicCadmiumCopperLeadMercuryNickelSeleniumZinc
TR10.2450.58927.7362.8210.0301.5760.37357.892TR20.2370.58727.0232.7300.0301.5440.36756.377TR30.2090.58724.4602.3870.0261.4710.32152.526
SITEFIELD
CPLR SUMMARY