WQ0000672_More Information (Received)_20230721

Initial Review
Reviewer
nathaniel.thorn burg
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) * WQ0000672
Applicant/Permittee City of Lumberton
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* Enviro-Choice Recycling, LLC
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*
9107385311
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:*
WQ0000672
Has Current Existing permit number
Applicant/Permittee Address*
700 Lafayette Street
Facility Name*
City of Lumberton Class B Residuals Program
Please provide comments/notes on your current submittal below.
Response for letter dated 6/19/2023.
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.)
Response Submittal V5_7-21-23.pdf 18.73MB
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
M'ch'oe/ Cod N1Jti1
Submission Date 7/21/2023

RESPONSE TO NCDEQ LETTER 6-19-23

PO Box 390
Lumberton, NC 28359
Phone: [phone]
Fax: [phone]
July 19, 2023
N.C. Environmental Quality-DWQ
1617 Mail Service Center
Raleigh, NC 27699-1617
Attention: Mr. Zachary J. Mega
Subject: Response to Letter Dated 6-19-23
Mr. Mega,
We have updated the permit application to address the comments as follows (in red):
C. Application (FORM: RLAP 06-16):
1. Item 111.3. — In regards to the Applicant's response to Comment C. l.a. in the Response
Letter dated March 18, 2023, an ORC Designation Form was not received via email.
Please include a copy of this completed form in the Applicant's response. New copy is
included.
2. Item IIL4.a. — Please revise this table per Comment F. Corrected.
3. Item III.4.b. — Please revise the acreages in this table accordingly per Comment O. They
have been revised.
4. Item III.4.c. — Please revise this table per Comment F. Revised.
F. Application (FORM: RSC 06-16):
1. Lumberton WWTP —
a. Item IL5.e. — The provided PAN concentrations are incorrect. The calculation
spreadsheet uses 0.4 (anaerobic digestion) for the mineralization rate instead of
0.3 (aerobic digestion). Please revise. Revised.

2. Lumberton WTP —
a. Item IL5.e. — The provided PAN concentrations are incorrect. The calculation
spreadsheet uses an incorrect value for Total Kj eldahl Nitrogen (TKN), which
should be 6,500 mg/kg according to the provided laboratory results. Typically, a
mineralization rate of zero is used for WTPs as well. Please revise. Revised.
H. Quantitative Justification(s):
1. Please revise the acreages and PAN calculations accordingly per Comments F and O.
Acerages and PAN Calculations have been corrected.
L Sampling MOO:
Please add Pathogen Reduction and Vector Attraction Reduction details for the
Lumberton WWTP. Added back to plan.
2. Please revise the laboratory testing schedule under the "Pollutants" heading to match the
O&M Plan. Chart added from O&M Plan.
L. Application (Form: LASC 06-16):
1. Please revise the acreages accordingly per Comment O. Acerages have been corrected.
N. Application (Form: LOA 06-16):
On Page 2 of the LOA for Site NC-RO-20 (Fields 3 & 6-8), please clear Section IV and
move that information to the LOA that contains the four fields transferred from Permit
No. WQ00000527. LOA from RO-20 35 6-8 has been corrected. A new LOA was created
for the transferred sites.
2. Please separate the LOA for Site NC-RO-20 (Fields 15-21) into two different LOAs and
have them re -signed and re -notarized. One that has the transferred fields (i.e., Fields 15-
18) with Section IV on Page 2 filled out (See Comment N.1.) and one that has the new
fields (i.e., Fields 19-21). Two separate LOAs have been produced.
Barbara Bullard no longer owns Fields 1A, 1B, and 2 for Site NC-RO-39. Please revise
the associated LOAs to reflect the current landowners. If a single field is located on two
separate parcels with different landowners, please put that field on each LOA. Field IA is
now owned by Patrick Bullard, therefore it was moved to LOA for fields 39-5 & 39-6.
Field 1B was moved to the LOA for Tracy Bullard. Field 2 was moved to LOA for
Lyndon Bullard.

O. Vicinity/Setback Map(s):
Overall — There are discrepancies between the vicinity/setback maps of the previous
permit dated April 27, 2017, and the vicinity/setback maps included in the submitted
application package for the renewed land application fields. The April 27, 2017,
vicinity/setback maps have been included for reference. There are previous comments in
the Additional Information Request letter dated January 3, 2023, that were not addressed
as well. [15A NCAC 02T .1104(c)(1)] All maps were reviewed.
Please verify and revise all vicinity/setback maps for the following:
a. Show the latest property boundaries within 500 feet of the land application
fields. Some maps do not show property boundaries or show them shifted
around, which will make property setbacks incorrect. Recommend combining
adjacent parcels for the same owner. All property boundaries are shown
within 500 ft.
b. Show the line work for streams, surface waters (ponds), channels, and ditches
within 500 feet of the land application fields. Most maps do not have this
delineated while others do. This comment was not addressed in the Additional
Information Request letter dated January 3, 2023. Please refer to the April 27,
2017, vicinity/setback maps, which show drainage features for all renewed
land application fields.
c. Please mark all on -site and off -site habitable residences within 500 feet of the
land application fields. For off -site habitable residences, please show a
setback radius for each individual dwelling that is marked. Please note that for
surface application by vehicle and injection/incorporation by irrigation, there
is no required setback for on -site habitable residences. Some maps have
unlabeled habitable residences, missing setback radii, two habitable residences
contained within one setback radius, setback radii not centered at the habitable
residence, etc.
d. For all setback radii, please show a symbol in the center representing what the
setback is for (i.e., off -site dwelling, well, etc). Please note that for surface
application by vehicle and injection/incorporation by irrigation, there is no
required setback for on -site residences. Most maps do not show these symbols
while others do. This comment was not addressed in the Additional
Information Request letter dated January 3, 2023. Please also distinguish the
symbols used for on -site residences and off -site residences from one another.
[15A NCAC 02T .1108(c)]
e. Please show the area within setback radii, 50-foot property boundary setbacks,
and drainage feature setbacks as unsuitable areas within the property
boundaries of the land application site. Please refer to the April 27, 2017,
vicinity/setback maps, which show these areas buffered out for all renewed
land application fields. [15A NCAC 02T .1108(c)] Property boundary
setbacks have been revised to 50' for all maps.

Please revise the title blocks to show figure number locations but do not add
figure numbers. The figures will be numbered for the draft permit. No figure
numbers were shown on drawings, only the field locations. Not sure what else
you may want on this.
g. Recommend making the line work for the application area the top layer in
ArcGIS.
h. Recommend adding a scale label formatted as "1 in = 500 ft" and adjusting
the map scale to even increments so setbacks are easily verifiable.
i. Recommend that map legends have the same content and follow the same
symbology.
2. Site NC-RO-16 (Fields 1-8) —
a. There are two wells shown on the April 27, 2017, vicinity/setback maps that are
not shown on this map. Please verify and revise. The well at the barn was marked,
however we failed to see a second well. We visited the site on 7-14-23 and found
an old hand pump at the house, however it was inoperable and Mr. Ozzell said "it
hasn't been working for years, we are on county water at the house." Therefore, it
is not buffered.
b. Are 50-foot property boundary setbacks met for Fields 2, 4, 8, and 5? It is hard to
verify this without the property boundaries or buffer areas shown. [15A NCAC
02T .1108(c)] Buffers have been updated properly.
c. Instead of a single radius, the pond boundary should be delineated and buffered
from the pond boundary. Please revise. Ponds have been corrected.
Site NC-RO-16 (Fields 16-19) — Are 50-foot property boundary setbacks met for Fields
2, 4, 8, and 5? It is hard to verify this without the property boundaries or buffer areas
shown. [15A NCAC 02T .I 108(c)] Setbacks on all maps have been corrected.
4. Site NC-RO-17 (Fields 1 & 6) —All airport tax parcels have been merged for these maps
since there are so many parcels and the buffers can get quite confusing.
a. The map is labeled as "Field 1-6", but only the entirety of Fields 1 and 6 are
shown. Please revise. All maps have been printed to reflect what is actually
shown.
b. Compared to the April 27, 2017, vicinity/setback maps, Field 1 is increasing by
roughly 8 acres with no significant change in the application area boundary. The
application area boundary on the north side goes outside of the established field
boundary on the aerial. Please explain this increase in area and revise the
application area boundary. Spatial reference was off in multiple drawings which
caused improper acreages to be reported these all have been corrected. Also the
application area was moved south to the field boundary.
5. Site NC-RO-17 (Fields 2 & 3) —

a. The map is labeled as "Field 1-2", but only the entirety of Fields 2 and 3 are
shown. Please revise. All maps have been printed to reflect what is actually
shown.
b. The property boundaries shown do not match the Robeson County GIS.
Recommend combining all of the City of Lumberton parcels. Please verify and
revise. New parcel data file was brought in, data has changed during this review
period.
c. The drainage features are not buffered correctly. They should be buffered equally
on each side using the appropriate setbacks and rounded where appropriate (i.e.,
at the end of a line). Please refer to the April 27, 2017, vicinity/setback maps,
which show the correct buffer areas and additional drainage features not shown on
this map. Please revise. [15A NCAC 02T .1108(c)] All drainage features (on all
maps) have been corrected and streams and ditches were both buffered. Any
streams that have defined banks have been traced and buffered as well.
d. Compared to the April 27, 2017, vicinity/setback maps, Field 2 is increasing by
roughly 26 acres with additional area being added on the west side. If this
additional area is to be added, please provide a Soil Evaluation per 15A NCAC
02T .1104(c)(2). If not, please remove this area from Field 2. This has been area
has been removed.
e. Compared to the April 27, 2017, vicinity/setback maps, Field 3 is increasing by
roughly 14 acres with no significant change in the application area boundary.
Please explain this increase in area. Was due to spatial ref issues has been
correctd.
f. Both Fields 2 and 3 look heavily saturated in the most recent aerial. Are there
SHGWT issues with these fields or is overapplication occurring? Not
overapplication, these fields have always been like this since the original permit
(see historical aerials). Additionally, these fields are only typically applied during
dry periods.
6. Site NC-RO-17 (Fields 4 & 4A) — Compared to the April 27, 2017, vicinity/setback
maps, Field 4 is increasing by roughly 18 acres with a significant decrease in the
application area boundary. The application area boundary on the northwest side goes
outside of the established field boundary on the aerial. Please explain this increase in area
and revise the application area boundary. The discrepancies were mainly due to spatial
issues, and this has been corrected. The field boundary has been expanded slightly by the
farmer, especially the area of 4A which is newly tilled areas (some of which are not on
the most recent GIS aerials). However, the buffers are planted in common bermuda
which is cut regularly, and occasionally has been bailed by the farmer for hay for animal
feed (bales are stored near the north gate off of all application areas).
7. Site NC-RO-17 (Field 5) — The parcel lines shown do not match the Robeson County
GIS. Recommend combining all of the City of Lumberton parcels. Please verify and
revise. Parcels were misaligned from inadvertent shift in previous maps, has been
corrected.

8. Site NC-RO-20 (Field 4) — Please show the setback radius for the off -site habitable
residence located at 5020 Shannon Road (Parcel No. 181101032) and update the
application area boundary accordingly. [15A NCAC 02T .I 108(c)] Residence was added
and map updated.
9. Site NC-RO-20 (Fields 6-8 & 14) —
a. How did Field 8 stay the same acreage after removing the northwest portion
shown in the April 27, 2017, vicinity/setback maps? Spatial issue reference;
has been corrected. Also, the left off area wasn't supposed to be left off.
b. There is a well next to Field 8 shown on the April 27, 2017, vicinity/setback
maps that is not shown on this map. Please verify and revise. Well was field
verified and added back to map.
c. Since Field 14 is not owned by Ronald G. Hammonds, 50-foot property
boundary setbacks must be shown for Field 14 and the portions of Fields 7
and 8 that border Field 14. Please revise. [15A NCAC 02T .1108(c)]
Boundary setbacks have been added.
10. Site NC-RO-20 (Fields 3 & 15-17) —
a. There are missing setback radii for off -site habitable residences along
Rennert Road. Please revise and update application area boundaries
accordingly. [15A NCAC 02T .1108(c)] All residences have been added.
b. Instead of a single radius, the pond boundary between Fields 3, 15, and 17
should be delineated and buffered from the pond boundary. There are also
drainage features nearby that have not been called out. Please revise. [15A
NCAC 02T .I 108(c)] All nearby ponds have been delineated and buffered
properly.
c. Please delineate the pond boundary near Field 16 and show the setback.
[15A NCAC 02T .1108(c)] Corrected.
d. Compared to the April 27, 2017, vicinity/setback maps, Field 3 is
increasing by roughly 5 acres with no significant change in the application
area boundary. Please explain this increase in area. Spatial issues have
been repaired.
e. Compared to the June 26, 2019, vicinity/setback maps for Permit No.
WQ0000527, Field 15 (previously Field 2) is increasing by roughly 2
acres with no significant change in the application area boundary. Please
explain this increase in area. Spatial issues have been repaired.
11. Site NC-RO-20 (Field 18) —
a. There are four wells shown on June 26, 2019, vicinity/setback maps for
Permit No. WQ0000527, that are not shown on this map. Please verify and
revise. Wells have been shown.

b. Please show the setback radii for the off -site habitable residences located
at 1105 Shannon Road (Parcel No. 20090100301) and Parcel No.
200901002 and update the application area boundary accordingly. [15A
NCAC 02T .1108(c)] These have been added.
12. Site NC-RO-20 (Fields 19 & 21) — Please show the missing property boundaries around
the northwest portion of Field 20 and the entirety of Field 21. All fields owned by
Hammonds were merged into one boundary as it was confusing. Also, all other
boundaries have been shown.
13. Site NC-RO-28 (Fields 1-3) — At the bottom, the owner is shown as Carnell Locklear,
which is incorrect. Please revise. Revised.
14. Site NC-RO-39 (Fields 1-6) —
a. Please add the acreages of Fields 5 and 6 to the table. Added.
b. The property boundaries shown do not match the Robeson County GIS.
Please verify and revise. Parcels have been updated.
c. Please delineate the pond boundaries near Fields 2 and 2 and show the
setbacks. [15A NCAC 02T .1108(c)] pond has been set back.
d. There are multiple wells shown on the April 27, 2017, vicinity/setback
maps that are not shown on this map. Please verify and revise. Wells have
been added, however, the wells that were located close to the road have
been abandoned and no longer there due to the use of county water
landowner/farmer have confirmed.
15. Site NC-RO-39 (Fields 7 & 8) —
a. Please show the pond setback next to Field 7. [15A NCAC 02T .1108(c)]: Shown
b. Please adjust the Field 8 northeast application area boundary to match what was
shown on the April 27, 2017, vicinity/setback maps. All boundaries have been
updated.
c. Please remove the stray text shown along Saddletree Road. Removed
16. Site NC-RO-39 (Field 9) —
a. The total acreage shown in the table is less than the application area. Please verify
and revise. Has been revised.
b. Please adjust the Field 9 application area boundary to match what was shown on
the April 27, 2017, vicinity/setback maps. All boundaries have been updated.
17. Site NC-RO-40 (Fields 1 & 2) — Please show the pond setback next to Field 1 and the
well setback next to Field 2. [15A NCAC 02T .1108(c)] All pond and well setbacks are
shown.
18. Site NC-RO-40 (Fields 4-7) —

a. Please show the well setbacks. [15A NCAC 02T .1108(c)]: Well setbacks shown.
b. There is unsuitable application area shown over the application area boundary for
Field 5. Please verify and revise. All Maps and boundaries have been revised.
19. Site NC-RO-42 (Fields 1-2) — The property boundaries shown do not match the Robeson
County GIS. Please verify and revise. Boundaries have been modified and are up to date.
Q. Updated Cumulative Pollutant Loading Rates (CPLRs):
1. Please provide the updated CPLRs for the four fields transferred from Permit No.
WQ0000527. Fields have been added to CPLR sheet.

RLAP 06-16 FORM

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
sunnorting 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 .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 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)
® Submit a check, money order or electronic funds transfer made payable to: North Carolina Department of Environmental
Quality (NCDEQ).
Facility Classification New Permit Major Modification'
Major (land are permitted for > 300 acres) F $1,310 F $395
Minor (land are permitted for < 300 acres) F_ $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 (Maybe Required —See 15A NCAC 1C .03
❑ Sub:-- ` - --- of the Findings of No Significant Impact (FONSI) or Environmental Impact Statement (EIS). Also, include
info N/A any mitigating factor(s) from the Environmental Assessment (EA) that impact the construction of the residuals
treat :orage 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 appli ims are ones in which land application sites meet the criteria in 15A NCAC 02T
.110202). Specifically, a resit N/A plication program is designated as dedicated if any of the following are applicable:
❑ Any land application site ci ie 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
Q Provide an explanation of why a do N/A ;m is required instead of a conventional non -dedicated system.
❑ Provide an explanation of the dedic _ _ _ 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 I I" 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 rc' ' ' ' ' res and fences within the land application area.
❑ The location of all wells (incl N/A and construction details if available), streams (ephemeral, intermittent, and
perennial), springs, lakes, pond, urface 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 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

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 e accordance with 15A NCAC 02T .1104(d)(4) and current Division Policy
available at: bt!p://www.ncwater.orN/A cies_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 modificatinn(c) only
❑ The design documents the following minimum items:
El Engineering plans f N/A Iand equipment except those previously permitted unless they are directly tied into the new
units or are critical __ ,.....—tanding 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 Package nr M-iffications that include new sites utilizing fixed irrigation facilities or
irrigation facilities fed through fixed supply systi N/A
❑ Submit a completed and accurate water bal, dance with 15A NCAC 02T J 104(d)(5) and current Division Policy
available at: http://www.ncwater.org/Rules_roucies_and_Regulations/.
M. Property Ownership Documentation (All New or Modification Application Packages involving new and/or relocated treatment
or irrigation components)
❑ Property ownership docm ill consist of one of the following:
❑ Legal documentation i N/A (i.e., GIS, deed or article of incorporation), or
❑ Written notarized inter a agreement signed by both parties with a plat or survey map, or
n 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: [phone]
By Courier/Special Delivery:
512 N. SALISBURY STREET
RALEIGH, NORTH CAROLINA 27604
FAX NUMBER: [phone]
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
I. APPLICANT INFORMATION:
1. Applicant's name: City of Lumberton
Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership 11 Privately -Owned Public Utility
❑ Federal 0 State ® Municipal L■ County
Signature authority's name per 15A NCAC 02T .0106: Corey Walters Title: Public Works Deputy Director
Applicant's mailing address: PO Box 1388
City: Lumberton State: NC Zip: 28359-�
Telephone number: [phone] Email Address: ciwalterskci.lumberton.nc.us
2. Consultant's name: Enviro-Choice Recycling, LLC License Number (for P.E.): _
Affiliation: ❑ On Staff ® Retained (Firm: )
Consultant's mailing address: PO Box 390
City: Lumberton State: NC
Zip: 28360-�
Telephone number: [phone]
Email Address: envirochoicenckgmail.com
3. Agronomist's name:
License Number: 0—
Affiliation: ❑ N/A ❑i On Staff
0 Retained (Firm: )
Agronomist's mailing address: —A
City: State:
Zip: �-
Telephone number: (_) =
Email Address: _
4. Soil Scientist's name: Robert P. Willcox, Jr License Number: 1098
Affiliation: ❑ N/A ® On Staff
❑ Retained (Firm:
Soil Scientist's mailing address: 7231B Summerfield Road
City: Summerfield
State: NC Zip: 27358-
Telephone number: [phone]
Email Address: robp_willcoxmabesoil.com
5. Fee submitted: $1,310 (See Instruction B)
IL PERMIT INFORMATION:
1. Application is for (check all that apply): 0 new, 0 modified, 14 renewed permit
2. If this application is being submitted to renew or modify an existing permit, provide the following:
Permit number: W00000672
Date of most -recently issued permit: April 27, 2017
Date of most -recently certified Attachment A (if different than the permit): September 14, 2020
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 Facility's physical address: 700 Lafayette Street
City: Lumberton State: NC
Coordinates: Latitude: 34° 36' 20.1024"
Datum: WGS 84
Method of measurement: Google Earth
Zip: 28358-,
Longitude: 78' 59' 30.426"
Level of accuracy: —25 It
2. County where residuals land application program is headquartered: Robeson
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:
4
Designation
Name
Affiliation
Certification Number
ORC
Matthew F. Markus
Subcontractor
1010549
Back -Up ORC
Paul J. Ivey
Subcontractor
1011842
Additional Back -Up
ORCs
(if applicable)
Henry B Harper Jr.
Chief Operator
1009036
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:
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: 4500 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
21.50
22.96
96,750
103,320
Five -Year Maximum Adjusted
31.96
33.45
143,820
150,525
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
755.85
Hay
140.6
Pasture
361.91
Total:
1,258.36
Methods
Surface
502.51
Incorporation or Injection
755.85
Total:
1,258.36
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/ac 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
1,935.00
2,595.60
3,518.10
3,648.60
100
967.50
1,297.80
1,759.05
1,824.30
150
645.00
865.20
1,172.70
1,216.20
200
483.75
64890
879.53
912.15
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.): Applicant will dewater residuals and haul solids to landfill and/or compost facility if needed.
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.
R
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.
19-1
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 irrigat N/A A Spray ❑ Drip
2. Disposal system is: LJ 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:
Soil Series
Fields within Soil Area
Recommended
Loading Rate
(in/hr)
Recommended
Loading Rate
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):
Field / Zone
Design Area
(ft2)
Number of
Nozzles
Maximum Application
Rate ( allons/hr)
Design Annual Loading
Rate ( allons/ r)
Total
Spray Irrigation Design Element
Plan Sheet
Number
Specification
Pa a Number
Wetted diameter of nozzles
ft
Wetted area of nozzles
It,
Nozzle capacity
gpm
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 ISA 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.
Eyes ❑ No, Explain;
I� iJ - ti..1CL K S i/ip M1+41��i vS D 1 rcc V�
LO
(Signature Authority's Name — PLEASEPRINT) (Title)
attest that this application for
6E'4 o� L�bcr�v.►
(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.
Date:
1/a(o/aZ
FORM: RLAP 06-16 Page 5 of 5

RLAP CALCULATION SPREADSHEETS

Wastewater Treatment Plant
1) SAR Calculation
%Total Solids- 280
Na Ca Mg
31,000 9,900 1,700 mg/kg
868 277 48 mg/L
m Eq= 37.74 13.86 3.97
m Eq =(mg x Valence T) / Molar Mass
SAR= 37.74
2.99
12.64
2) PA------ e
19Year PAN (Surf-)= 19,320 mg/kg 38.6416s/DT
19Year PAN (Inj./Inc)= 2Q620 mg/kg 41.24 Ibs/DT
1. Yea,
2nd Yeai
3rd Yeai
4th Y-
5th Yeai
Ammonia-N(NH3)=
2,600
mg/kg
Mineralization Rate(MR)=
0.3
Nitrate+Nitrite-N(NOx)=
2300.00
mg/kg
Total Kjeldahl Nitrogen (TKN)=
55,000
mg/kg
Volatilization Rzte(VR)=
0.5
Surface Application
1.0 Injection/Incorporation Application
Surface Application
Inj-ion/Incorporation
AppH.dion
Remaining
Remaining
Organic
Organic
TKN
PAN
PAN
Nitrogen
TKN
PAN
PAN
Nitrogen
(mg/kg)
(mg/kg)
(Ibs/DT)
(mg/kg)
(mg/kg)
(mg/kg)
(Ibs/DT)
(mg/kg)
55,000
19,320
38.64
36,680
55,000
20,620
41.24
36,680
36,680
5,502
11.00
31,178
36,680
5,502
11.00
31,178
31,178
2,338
4.68
28,840
31,178
2,338
4.68
28,840
28,840
1,081
2.16
27,758
28,840
1,081
2.16
27,758
27,758
1 520
1 1.04
1 27,238
27,758
1 520
1 1.04
1 27,238
Total 1 29,762 1 57.52 I Total 1 3Q062 1 6Q32
Application Five -Year Max. Adj. Pan(Surfaco)= 35,033 mg/kg %Error= 21.80%
Application Five -Year Max. Adj. Pan(Inj./Inc)= 1 36,333 mg/kg %Error= 20.86%
3) PAN summery
Maximum Dry Tons Permitted Per Year= 2,500 DT/yr
11
Residuals Land Application Summary
Maximum Dry Tons Permitted Per Year= 2,500 DT/yr
M==
,
5) Metals tart
19 Year PAN=(MR x )TKN-NH3))-(VR, NH3)+ NOx
2nd Year PAN =2nd Year TKN x (MR/2)
3rd Year PAN =3rd Year TKN x (MR/4)
4fh Year PAN =4fh Year TKN x (M R/8)
5fh Year PAN =5th Year TKN x (M R/16)
Loading
Parameter Ceiling Kg/Hec Ibs/aue
Arsenic
75
41
36
Cadmium
85
39
34
Copper
4,300
1,500
1,338
Lead
840
300
267
Merwry
57
17
15
Molybdenum
75
N/A
N/A
Nickel
420
420
374
Selenium
100
100
89
Zinc
7,500
2,800
2,498
E=
Pass/Fail
(Kg/Hectare)
0.00008
0.00001
0.00003
0.00004
0.00000
0.00002
0.00006
0.00007
0.00004
2nd Year TKN =)1st Year TKN-NH3)-(MR x (1. Year TKN -NH3))
im

Water Treatment Plant
1)
%Total Solids= 1.60
Na Ca Mg
2,500 1 3,700 1 420 mg/kg
40 59 7 mg/L
m Eq= 1.74 2.96 0.56
mEq = (mg x Valence N) / Molar Mass
SAR= 1.74
1.33
2)
1st Vear PAN (Surface) =--------------------
0.08 Ibs/DT
1st Vear PAN (Inj./Inc.) =11111111111111111r 0.11 Ibs/DT
Ammonia-N(NH3)= 24 mg/kg
Minealization Rate(MR)= 0
Nit--Nitrite-N(NO.)= 29.00 mg/kg
Tot.l Kjeldah1 Nitrogen (TKN)= 6,500 mg/kg
Zmilaation Rate(VR)= 0.5 Surface Application
1.0 Injection/Inmrpo,.tio. Application
Surf ace Application
Injection/Incorporation Application
Remaining
Remaining
TKN
PAN
PAN
Organic
Nitrogen
7NN
PAN
PAN
Organic
Nitrogen
(mg/kg)
(mg/kg)
(Ibs/DT)
(mg/kg)
(mg/kg)
(mg/kg)
(Ibs/DT)
(mg/kg)
6,500
41
0.08
6,476
6,500
53
0.11
6,476
6,476
0
0.00
6,476
6,476
0
0.00
6,476
6,476
0
0.00
6,476
6,476
0
0.00
6,476
6,476
0
0.00
6,476
6,476
0
0.00
6,476
6,476
1 0
1 0.00
1 6,476
1 6,476
1 0
1 0.00
1 6,476
��ae� I 1 1 local I 1 1
Application Five- Vear Max. Adj. P..(S.rface)= 1,668 mg/kg %Error= 3968.29%
Appli-ion Five- Vear Max. Adj. Pan (Inj./Inc)= 1,833 mg/kg %Error= 3358.49%
3) PAN Summery
Maxim. m Dry Tons Permitted Per Vear= 2,000 DT/yr
a
Residuals Land Application Summery
Maximum Dry Tons Permitted PerVear= 2,000 DT/yr
5) Metals test
Lit Vear PAN =(MR. (TKN - NH3)) - (VR. NH3)+NO.
2nd Vear PAN= 2nd Vear TKN.(MR/2) 2nd Vear TKN=(Lit VearTKN-NH3)- (MR .(1st Vear TKN-NH3))
3,,1 Vear PAN =3rd Vear TKN. (MR/4)
4th Vear PAN =4th Vear TKN. (MR/8)
5th Vear PAN =Sth Vear TKN. (MR/16)
11:
11�
11
11:
11�
11
1,258.36 C,affied acres
P.m meter
Ceiling
Loading
Kg/He,
Ibs/acre
Arsenic
75
41
36
Cadmium
85
39
34
Copper
4,300
1,500
1,338
Lead
840
300
267
Mercury
57
17
15
Molybdenum
75
N/A
N/A
Nickel
420
420
374
Selenium
100
100
89
Zinc
7,500
2,800
2,498
Lab report
Pass/Fail
Pass/Fail
(mg/Kg)
(Kg/Hectare)
(Ibs/acre)
55
0.00010
0
4.6
0.00001
0.00009
0
0
50
28
0.00005
0.00000
0
0
0.42
12
0.00002
0.00007
0
0
41
50
0.00009
0
27
0.00005
0

RSC 06-16 FORMS
WWTP & WTP

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 Unit
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 Guidance 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 06-16 Page 1 of 1

RESIDUALS SOURCE FACILITY SUMMARY
Applicant's name: City of Lumberton
Status
Code°
Facility Permit Holder
Facility Name
County
Permit Number
Maximum Dry Tons Per Year
Current b
Proposed
R
City of Lumberton
City of Lumberton
Wastewater Treatment Plant
Robeson
NCO024571
2000
2500
'Status Code for source facility are: ♦ N (New) ♦ R (Renewed) ♦ M (Modified) ♦ D (Deleted)
b The amount of residuals currently permitted for distribution, land application, or disposal (i.e, not applicable to new facility).
SUMMARY FOR FORM: RSC 06-16 Page 1

DWR
Division of Water Resources
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: City of Lumberton
2. Facility permit holder is: ULI Federal, 0 State, 0 Local Government, or 0 Private.
Facility permit issued by: Div. of Water Resources, Div. of Environmental Health,
or Other (explain: M.
3. Facility contact person and title: Corey Walters, Public Works Deputy Director
Complete mailing address: P.O Box 1388
City: Lumberton State: NC Zip: 28359=
Telephone number: [phone] E-mail address: ciwaltersgci.lumberton.nc.us
4. Facility physical address: 700 Lafayette Street
City: Lumberton State: NC Zip: 28358
Coordinates: Latitude: 34' 36' 20.1024" Longitude: 78' 59' 30.426"
Datum: WGS 84 Level of accuracy: —25 ft
Method of measurement: Google Earth
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: E MGD and facility average daily flow: 0 MGD
8. Average amount of residuals being generated at this facility 2,000 dry tons per year.
9. Specify the following regarding treatment and storage volumes available at the facility:
Type and volume of residuals treatment: N/A
Type and volume of residuals storage (i.e., outside of residuals treatment units): _
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 0 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: 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: P 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: Pace Analytical Date of analysis: 2/02/2023
Passed corrosivity test: yes no. pH: s.u. (2 <pH < 12.5)
Passed ignitability test: yes no. Flashpoint: 170 OF (> 140°F)
Passed reactivity test: ® yes ao. HCN: 0.75 mg/kg (<250) & H2S: 75 mg/kg (<500)
TCLP Parameter
Limit
(mgfi)
Result
(m917)
TCLP Parameter
Limit
(m917)
Result
(mg17)
Arsenic
5.0
0.2
Hexachlorobenzene
0.13
0.008
Barium
100.0
1.0
Hexachloro-1,3-Butadiene
0.5
0.02
Benzene
0.5
0.0066
Hexachloroethane
3.0
0.018
Cadmium
1.0
0.1
Lead
5.0
0.20
Carbon Tetrachloride
0.5
0.0066
Lindane
0.4
0.000005
Chlordane
0.03
0.008
Mercury
0.2
0.02
Chlorobenzene
100.0
0.0052
Methoxychlor
10.0
0.00001
Chloroform
6.0
0.01
Methyl Ethyl Ketone
200.0
0.068
Chromium
5.0
0.2
Nitrobenzene
2.0
0.018
m-Cresol
200.0
0.007
Pentachlorophenol
100.0
0.05
o-Cresol
200.0
0.009
Pyridine
5.0
0.037
p-Cresol
200.0
0.007
Selenium
1.0
0.5
Cresol
200.0
0.009
Silver
5.0
0.1
2,4-D
10.0
0.0018
Tetrachloroethylene
0.7
0.015
1,4-Dichlorobenzene
7.5
0.016
Toxaphene
0.5
0.016
1,2-Dichloroethane
0.5
0.010
Trichloroethylene
0.5
0.0096
1,1-Dichloroethylene
0.7
0.012
2,4,5-Trichlorophenol
400.0
0.016
2,4-Dinitrotoluene
0.13
0.050
2,4,6-Trichlorophenol
2.0
0.011
Endrin
0.02
0.0000050
2,4,5-TP (Silvex)
1.0
0.00097
Heptachlor and its Hydroxide
0.008
0.0000050
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: Pace Analytical and Date of analysis: 2/27/2023
Parameter
Ceiling
Concentration Limits
(ClassA & ClassB)
(mglkg)
Monthly Average
Concentration Limits
(Class A Only)
(mglkg)
Result
(mglkg)
Arsenic
75
41
35
Cadmium
85
39
3
Copper
4,300
1,500
15
Lead
840
300
18
Mercury
57
17
0.22
Molybdenum
75
n/a
7.7
Nickel
420
420
27
Selenium
100
100
32
Zinc
7,500
2,800
17
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FORM: RSC 06-16 Page 3 of 5

5. Nutrient/Micronutrient Determination: Complete the following:
a. Total solids: 2.8 %.
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
rmcronutnent parameters:
Laboratory: Pace Analytical and Date of analysis: 2/27/2023
Parameter
Result
(mglkg)
Aluminum
16000
Ammonia -Nitrogen
2600
Calcium
9900
Magnesium
1700
Nitrate -Nitrite Nitrogen
2300
pH (Standard Unit)
6.4
Phosphorus
16000
Potassium
4300
Sodium
31000
Total Kjeldahl Nitrogen
55000
c. Using the results listed in Item IL 5b. above, calculate the sodium adsorption ration (SAR): 12.64
[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]. USDA Agronomist was consulted, recommendation is to apply gypsum as
recommended in soil analyses where needed. No immediate recommendations since all soils are sandy and up to a 20 SAR
is allowable without further actions.
d. Specify the mineralization rate to be used in calculating the plant available nitrogen (PAN) of the residuals: %. 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:
Application Method
First (1s) Year PAN
Five -Year
Maximum Adjusted PAN
(mglkg)
(mg/kg)
Surface
19,320
28,762
Injection/Incorporation
28,762
30,062
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:
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:
71 A fecal coliform density that is demonstrated to be less than 1,000 MPN per gram of total dry solids,
or
JJ 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):
14 Alternative 1 [15A NCAC 02T.I 106(b)(3)(A)] - Time/Temperature Compliance.
q Alternative 2 [15A NCAC 02T.I 106(b)(3)(B)] - Alkaline Treatment.
q 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.
JA Alternative 5 [15A NCAC 02T.I 106(b)(3)(E)-(K)] - Process to Further Reduce Pathogens (PFRP).
Specify one: composting, 0 heat drying, 77 heat treatment,
thermophilic aerobic digestion, ❑ beta ray irradiation,
El gamma ray irradiation, or ❑ pasteurization.
b. For Land Application of Class B:
Alternative 1 [15A NCAC 02T.I 106(c)(1)] - Fecal Coliform Density Demonstration.
Alternative 2 [15A NCAC 02T.I 106(c)(2 - Process to Significantly Reduce Pathogens (PSRP).
Specify one: El aerobic digestion, air drying, ❑ anaerobic digestion,
El composting, or lime stabilization.
c. For Surface Disposal:
11 Select One of the Class A or Equivalent Pathogen Reduction Alternatives in Item II. 7a. above.
J Select One of the Class B or Equivalent Pathogen Reduction Alternatives in Item II. 7b. above.
J Exempt -If Daily Cover Alternative is chosen in Item II.8. below [15A NCAC 02T.1106(a)(2)].
J 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:
El Alternative 1 [15A NCAC 02T.I 107(a)(1)] - 38% Volatile Solids Reduction (Aerobic/Anaerobic Digestion).
El Alternative 2 [15A NCAC 02T.I 107(a)(2)] - 40-Day Bench Scale Test (Anaerobic Digestion).
El Alternative 3 [15A NCAC 02T.I 107(a)(3)] - 30-Day Bench Scale Test (Aerobic Digestion).
Alternative 4 [15A NCAC 02T.I 107(a)(4)] - Specific Oxygen Uptake Rate Test (Aerobic Digestion).
El Alternative 5 [15A NCAC 02T.I 107(a)(5)] - 14-Day Aerobic Processes.
El Alternative 6 [15A NCAC 02T.I 107(a)(6)] - Alkaline Stabilization.
El Alternative 7 [15A NCAC 02T.I 107(a)(7)] - Drying of Stabilized Residuals.
El Alternative 8 [15A NCAC 02T.I 107(a)(8)] - Drying of Unstabilized Residuals.
El Alternative 9 [15A NCAC 02T.I 107(a)(9)] - Injection.
El Alternative 10 [15A NCAC 02T.I 107(a)(10)] - Incorporation.
q Alternative for Surface Disposal Units Only - Soil/Other Material Cover [ 15A NCAC 02T.I 107(b)(2)].
Ja 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

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 Unit
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 Guidance 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 06-16 Page 1 of 1

RESIDUALS SOURCE FACILITY SUMMARY
Applicant's name: City of Lumberton
Status
Code
Facility Permit Holder
Facility Name
County
Permit Number
Maximum Dry Tons Per Year
Current b
Proposed
N
City of Lumberton
City of Lumberton Water
Treatment Plant
Robeson
NC0378010
2000
'Status Code for source facility are: ♦ N (New) ♦ R (Renewed) ♦ M (Modified) ♦ D (Deleted)
b The amount of residuals currently permitted for distribution, land application, or disposal (i.e, not applicable to new facility).
SUMMARY FOR FORM: RSC 06-16 Page 1

DWR
Division of Water Resources
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: City of Lumberton
2. Facility permit holder is: U Federal, 0 State, 0 Local Government, or 0 Private.
Facility permit issued by: Div. of Water Resources, Div. of Environmental Health,
or Other (explain: M.
3. Facility contact person and title: Corey Walters, Public Works Deputy Director
Complete mailing address: P.O Box 1388
City: Lumberton State: NC Zip: 28359=
Telephone number: [phone] E-mail address: ciwaltersgci.lumberton.nc.us
4. Facility physical address: 1451 Lowery Street
City: Lumberton State: NC Zip: 28359
Coordinates: Latitude:34.62655 Longitude:79.02500
Datum: WGS 84 Level of accuracy: —25 ft
Method of measurement: Google Earth
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: 16 MGD and facility average daily flow: 5 MGD
8. Average amount of residuals being generated at this facility 500 dry tons per year.
9. Specify the following regarding treatment and storage volumes available at the facility:
Type and volume of residuals treatment: N/A
Type and volume of residuals storage (i.e., outside of residuals treatment units): _
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 11 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: 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: P 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: Pace Analytical Date of analysis: 2/03/2023
Passed corrosivity test: yes no. pH: s.u. (2 <pH < 12.5)
Passed ignitability test: yes no. Flashpoint: 170 OF (> 140°F)
Passed reactivity test: ® yes ❑no. HCN: 2_7 mg/kg (<250) & H2S: <500 mg/kg (<500)
TCLP Parameter
Limit
(mgfi)
Result
(m917)
TCLP Parameter
Limit
(m917)
Result
(mg17)
Arsenic
5.0
0.2
Hexachlorobenzene
0.13
0.0080
Barium
100.0
1.0
Hexachloro-1,3-Butadiene
0.5
0.02
Benzene
0.5
0.0086
Hexachloroethane
3.0
0.018
Cadmium
1.0
0.01
Lead
5.0
02
Carbon Tetrachloride
0.5
0.00033
Lindane
0.4
0.000005
Chlordane
0.03
0.0080
Mercury
0.2
0.02
Chlorobenzene
100.0
0.0052
Methoxychlor
10.0
0.00001
Chloroform
6.0
0.010
Methyl Ethyl Ketone
200.0
0.068
Chromium
5.0
0.2
Nitrobenzene
2.0
0.018
m-Cresol
200.0
0.007
Pentachlorophenol
100.0
0.05
o-Cresol
200.0
0.009
Pyridine
5.0
0.037
p-Cresol
200.0
0.007
Selenium
1.0
0.5
Cresol
200.0
0.007
Silver
5.0
0.1
2,4-D
10.0
0.0019
Tetrachloroethylene
0.7
0.015
1,4-Dichlorobenzene
7.5
0.016
Toxaphene
0.5
0.016
1,2-Dichloroethane
0.5
0.010
Trichloroethylene
0.5
0.0096
1,1-Dichloroethylene
0.7
0.0072
214,5-Trichlorophenol
400.0
0.016
2,4-Dinitrotoluene
0.13
0.012
2,4,6-Trichlorophenol
2.0
0.011
Endrin
0.02
0.000005
2,4,5-TP (Silvex)
1.0
0.001
Heptachlor and its Hydroxide
0.008
0.000005
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: Pace Analytical and Date of analysis: 2/27/2023
Parameter
Ceiling
Concentration Limits
(ClassA & ClassB)
(mglkg)
Monthly Average
Concentration Limits
(Class A Only)
(mglkg)
Result
(mglkg)
Arsenic
75
41
55
Cadmium
85
39
4.6
Copper
4,300
1,500
50
Lead
840
300
28
Mercury
57
17
0.42
Molybdenum
75
n/a
12
Nickel
420
420
41
Selenium
100
100
50
Zinc
7,500
2,800
27
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Distance F..om Disposal
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Closest Property Linee
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FORM: RSC 06-16 Page 3 of 5

5. Nutrient/Micronutrient Determination: Complete the following:
a. Total solids: 1.6 %.
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
rmcronutnent parameters:
Laboratory: Pace Analytical and Date of analysis: 2/27/2023
Parameter
Result
(mg1kg)
Aluminum
160000
Ammonia -Nitrogen
24
Calcium
3700
Magnesium
420
Nitrate -Nitrite Nitrogen
29
pH (Standard Unit)
5.8
Phosphorus
3600
Potassium
500
Sodium
2500
Total Kjeldahl Nitrogen
6500
c. Using the results listed in Item IL 5b. above, calculate the sodium adsorption ration (SAR): 1.31
[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: 10 %. 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: this waste is generally
similar to compost or raw soil based on research data, therefore 10% was utilized.
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 (1st) Year PAN
Five -Year
Maximum Adjusted PAN
(mg1kg)
(mg/kg)
Surface
41
41
Injection/Incorporation
53
53
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:
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):
q Alternative 1 [15A NCAC 02T.I 106(b)(3)(A)] - Time/Temperature Compliance.
q Alternative 2 [15A NCAC 02T.I 106(b)(3)(B)] - Alkaline Treatment.
q Alternative 3 [15A NCAC 02T.I 106(b)(3)(C)] - Prior Testing for Enteric Virus/Viable Helminth Ova.
EJ Alternative 4 [15A NCAC 02T. 1106(b)(3)(D)] - No Prior Testing for Enteric Virus/Viable Helminth Ova.
J Alternative 5 [15A NCAC 02T.I 106(b)(3)(E)-(K)] - Process to Further Reduce Pathogens (PFRP).
Specify one: ❑ composting, 0 heat drying, heat treatment,
❑ thermophilic aerobic digestion, beta ray irradiation,
❑ gamma ray irradiation, or pasteurization.
b. For Land Application of Class B:
J Alternative 1 [15A NCAC 02T.I 106(c)(1)] - Fecal Coliform Density Demonstration.
J Alternative 2 [15A NCAC 02T.I 106(c)(2 - Process to Si ficantly Reduce Pathogens (PSRP).
Specify one: aerobic digestion, air drying, ii anaerobic digestion,
I composting, or lime stabilization.
c. For Surface Disposal:
El Select One of the Class A or Equivalent Pathogen Reduction Alternatives in Item II. 7a. above.
El Select One of the Class B or Equivalent Pathogen Reduction Alternatives in Item II. 7b. above.
El Exempt -If Daily Cover Alternative is chosen in Item II.8. below [ 15A NCAC 02T.1106(a)(2)].
0 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.I 107(a)(1)] - 38% Volatile Solids Reduction (Aerobic/Anaerobic Digestion).
Alternative 2 [15A NCAC 02T.I 107(a)(2)] - 40-Day Bench Scale Test (Anaerobic Digestion).
Alternative 3 [15A NCAC 02T.I 107(a)(3)] - 30-Day Bench Scale Test (Aerobic Digestion).
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.I 107(a)(7)] - Drying of Stabilized Residuals.
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 [ 15A NCAC 02T.I 107(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

QUANITATIVE JUSTIFICATIONS

Quantitative Justification for Residuals Production Rate
WWTP Source Description:
During the previous permit year 2022, the City produced 1993 dry tons (2021) the City produced
1263 dry tons of residuals. In 2021 Lumberton produced 1263 dry tons, and 1952 dry tons in
2020. Therefore, it is predicted that 2,000 tons will be produced in 2023 at minimum considering
growth (2,500 dry tons is proposed to account for overages).
WTP Source Description:
The City has not applied water treatment plant residuals since at least 2004, when 1200 dry tons
were applied. There is currently a large amount of residuals on hand in the basin, therefore it is
expected that the first couple of years will incur a larger portion of the proposed total application
amount and therefore an allotment of 2,000 dry tons is requested. After basin is emptied, it is
assumed that an average of 500 dry tons/year will be required for disposal.
Justification for All Sources:
The loading rates and nutrient calculations are attached hereto for each individual portion of the
residuals.
In order to determine the maximum dry tonnage that could be applied on the fields in the current
permit, an average PAN assuming the lowest feasible values for row crop plantings (corn) and
actual values for pasture/hay crops the weighted average PAN is approximately 150 lbs
PAN/acre. Assuming an application of 4500 dry tons, a weighted average of WWTP Residuals
(56%) and WTP Residuals (44%), the following is a summary of the residuals land application
scenarios:
Assumed
Acres Required
Application
Acres Required
(Five -Year Max. Adj.
Rate
(1st Year PAN)
PAN)
(lb PAN/ac-
Yr)
Surface
Inj./Inc.
Surface
Inj./Inc.
50
1,935.00
2,595.60
3,518.10
3,648.60
100
967.50
1,297.80
1,759.05
1,824.30
150
645.00
865.20
1,172.70
1,216.20
200
483.75
648.90
879.53
912.15
Since the five-year maximum will require the most acreage it was used to determine the
maximum amount of dry tonnage to be permitted.
With this permit renewal, we will have 1,258.36 acres permitted, which is well above the
necessary acreage to account for 4,500 dry tons max. Should the City ever come close to this dry
tonnage in the future, alternative dewatering means will be utilized at that point to ensure we
remain below the permit limits.

SAMPLING PLAN

Residuals Sampling Plan
Wastewater Treatment Plant Description
The Lumberton Wastewater Treatment Plant (WWTP) is located at 700 Lafayette St in Lumberton North
Carolina. The WWTP is under continuous operation to treat incoming wastewater prior to effluent
discharge to the Lumber River. The majority of wastewater influent is domestic with some industrial.
Residuals are produced constantly during this process; all residuals produced are stabilized via aerobic
digestion. A plant diagram is attached below:
17Q?C}ll.f7R1NATWN -�
A
Figure 1: Process Flow Diagram WWTP
Sewaee Treatment Process
LUMBERTON "w Fa
PIPING AND VALVE;
SCHEMATIC
HOLDING
TANK 3
4
l—
HEADWORKS
The wastewater treatment process includes the headworks, grit chamber, aeration basins, secondary
clarifiers and chlorine contact tanks for disinfection, digesters, and holding tanks. The receiving stream is
the Lumber River. Waste activated sludge and primary sludge are mixed and fed to an aerobic digester
for stabilization.
The digested biosolids are then transferred to holding tanks for storage until loaded into transportation
vehicles and transported to the land application sites.

Water Treatment Plant Description
The Lumberton Water Treatment Plant (WTP) is located at 1451 Lowery Street, Lumberton, NC. The
water that is used by the City of Lumberton is surface water that is pumped from the Lumber River and
Seven (7) deep wells located near the Lumber River. The Wells and Lumber River are fed from the Black
Creek Aquifer. The Wells and River are blended together for Alkalinity and color dilution. Residuals are
produced constantly during this process; all residuals produced are resultant from the "settled" process
described below. A plant diagram is attached below:
TANK
1
LUMBER RIVER 1MG
3 TANK
v q wetk41SC5� wd3�SGij w�A6fSD7] wel715DO) 2M. G.
:!•YU'-
BOOSTER
O C
1 M.G wd 2(SO31 ell s_. wd5TS06)
TANK
NrcOTed P1
wale iaw
datrbueon mxd rau! '
Pump:
4 M G. f fAmad "@* fter dl. RWO S°W ikrh
RESERvpdR SP5 SP5 5i'2
eNF
SETTLED
®
WEST
SP4
SETTLED
■
EAST
SP3
SAMPLE POINT
RAW WATER (SA 1)
Q TREATED WATER JSPZ
SETTLED EAST [SP31
SETTLED WEST ISP41
© FILTERED rSP51
COANNED FILTER EFF [CFT]
FINISHED WATER (EMI
Figure 2: Process Flow Diagram WTP
COMPLIANCE OPERATIONAL CHNICALSADDED
x UQU ID AL UM
x PRIMARY LIME- POLYAMINE. CARBON. POLYMER
TANK
2
x
x
x afLORPNE
k SE•-ONDARY LIME-MOSPHATE. FLOURIDE. CHL.ORK
CHLORINE
1 M.G.
TANK

Pathogen Reduction
WWTP: Class B Alternative 1 pathogen reduction requirements are met by having the geometric mean
of the density of fecal coliform in the samples collected be less than 2,000,000 per gram of total solids
on dry weight basis. The fecals are collected quarterly to maintain compliance.
WTP: Not Applicable - Non -Biological Residuals with NO Domestic Wastewater Contribution therefore
no sampling is required.
Vector Attraction Reduction
WWTP: Vector Attraction reduction is achieved through Option 4, which states that the specific oxygen
uptake rate (SOUR) for biological residuals treated in an aerobic process shall be equal to or less than
1.5 milligrams of oxygen per hour per gram of total solids on a dry weight basis corrected to a
temperature of 20 degrees Celsius. The SOUR is calculated quarterly.
WTP: Not Applicable - Non -Biological Residuals with NO Domestic Wastewater Contribution therefore
no sampling is required.
Pollutants
Representative sampling of the residuals is conducted by a subcontractor on the following schedule:
Dry Tons Generated
(short tons per ear)
Monitoring Frequency
(Established in 40 CFR 503 and 15A NCAC 02T.1111)
<319
1 time per year
=>319-1,650
1/Quarter (4 times per ear)
=>1,650 - <16,500
1/60 Days (6 times per ear)
=>16,500
1/month (12 times per ear)
This is the required minimum monitoring frequency based upon annual residuals production for land
application. The samples that are collected are analyzed at Eurofins Environment Testing Southeast,
Cary, Inc (NC Lab ID #591) and Cameron Testing Services (NC Lab ID #654). The quarterly representative
residuals are collected in teflon plastic bottles from the holding tanks on -site. The samples are packed
on ice and delivered to the following labs:
Eu rofi ns
102 Woodwinds Industrial Ct A
Cary, NC 27511
Cameron Testing Services
219 S. Steele Street
Sanford, NC 27330

The laboratory analyzes the residuals for the following parameters:
Arsenic ( 5. 0)
1, 4-Dichlorobenzene ( 7. 5)
Nitrobenzene ( 2. 0)
Barium ( 100. 0)
1, 2- Dichloroethane ( 0. 5)
Pentachlorophenol ( 100. 0)
Benzene ( 0. 5)
1, 1 - Dichloroethylene ( 0. 7)
Pyridine ( 5. 0)
Cadmium ( 1. 0)
2, 4- Dinitrotoluene ( 0. 13)
Selenium ( 1. 0)
Carbon tetrachloride ( 0. 5)
Endrin ( 0. 02
Silver ( 5. 0)
Chlordane ( 0. 03)
Hexachlorobenzene ( 0. 13)
Chlorobenzene ( 100. 0)
Heptachlor ( and its hydroxide) (0. 008)
Toxaphene ( 0. 5)
Chloroform ( 6. 0)
Hexachloro- 1, 3- butadiene ( 0. 5
Trichloroethylene ( 0. 5)
Chromium (5. 0)
Hexachloroethane ( 3. 0
2, 4, 5 - Trichlorophenol
400.0)
m -Cresol ( 200. 0)
Lead ( 5. 0)
2, 4, 6 -Trichlorophenol ( 2. 0)
o -Cresol ( 200. 0)
Lindane ( 0.4)
2, 4, 5 - TP ( Silvex) ( 1. 0)
p -Cresol (200.0)
Mercury ( 0. 2)
Vinyl chloride ( 0. 2)
Cresol ( 200. 0)
Methoxychlor ( 10. 0)
2, 4- D ( 10. 0)
Methyl ethyl ketone ( 200. 0)
Aluminum
Mercury
Potassium
Ammonia -Nitrogen
Molybdenum
Selenium
Arsenic
Nickel
Sodium
Cadmium
Nitrate -Nitrite Nitrogen
Sodium Adsorption Ratio (SAR)
Calcium
Percert Total Solid
TKN
Copper
pH
Zinc
Lead
Phosphorus
Magnesium
Plant Available Nitrogen (by
calculation)

FORM LASC 06-16

DWR
Division 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 copies of the application and
supporting documentation
For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting
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�n�
ding codes are as follows:
♦ New (N) ♦ Modified (M) ♦ Transferred (T) ♦ Deleted (D)
® Attach the followiith 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 "Man Guidance
for Residuals Land Application Permits"
✓
✓
✓
A soils and agronomic evaluation in accordance with the "Soil Scientist
✓
Evaluation Policy"
INSTRUCTIONS FOR FORM: LASC 06-161'age 1 of

An updated accounting of the land application site's 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 "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 Mere (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 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: hLtp:Hdeg.nc.gov/about/divisions/water-
resources/planning/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:
hLtp:Hdeg.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 hLtp:Hdeg.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 06-16Page 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 tern
"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
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 06-16Page 3 of

LAND APPLICATION SITE CERTIFICATION
Applicant's name: City of Lumberton
Land application sites currently certified: 761.8 net acres and Total to be certified: 1,316.38 net acres.
L LAND APPLICATION SITE INFORMATION (See Instruction B):
Status
Codea
Site/Field ID
Landowner(s)
Lessee(s) or
O erator s
P ()
Net
Acres
County-
Crop(s)
Predominant Soil
Series Name
Mapping
Unit or Rep.
Slope'
R
NC-RO-16-01
Baker, Arrin Ozzell
11.45
Robeson
Coastal Bermuda/Winter Rye
Ra- Rains Sandy
0 to 2% slopes
R
NC-RO-16-2
Baker, Arrin Ozzell
2.49
Robeson
Coastal Bermuda/Winter Rye
GoA- Goldsboro
0 to 2% slopes
R
NC-RO-16-3
Baker, Arrin Ozzell
3.34
Robeson
Coastal Bermuda/Winter Rye
GoA-Goldsboro
0 to 2% slopes
R
NC-RO-16-4
Baker, Arrin Ozzell
3.67
Robeson
Coastal Bermuda/Winter Rye
Ra- Rains Sandy
0 to 2% slopes
R
NC-RO-16-5
Baker, Arrin Ozzell
9.79
Robeson
Coastal Bermuda/Winter Rye
Ra- Rains Sandy
0 to 2% slopes
R
NC-RO-16-6
Baker, Arrin Ozzell
17.27
Robeson
Coastal Bermuda/Winter Rye
NoA- Norfolk
0 to 2% slopes
R
NC-RO-16-7
Baker, Arrin Ozzell
16.35
Robeson
Coastal Bermuda/Winter Rye
NoA-Norfolk
0 to 2% slopes
R
NC-RO-16-8
Baker, Arrin Ozzell
6.14
Robeson
Coastal Bermuda/Winter Rye
WaB-Wagram
0 to 6% slopes
R
NC-RO-16-16
Campen, James T.; Surles, Mary Sydney
Baker, Arrin Ozzell
5.33
Robeson
Coastal Bermuda/Winter Rye
WaB-Wagram
0 to 6% slopes
R
NC-RO-16-17
Campen, James T.; Surles, Mary Sydney
Baker, Arrin Ozzell
6.23
Robeson
Coastal Bermuda/Winter Rye
WaB-Wagram
0 to 6% slopes
R
NC-RO-16-18
Campen, James T.; Surles, Mary Sydney
Baker, Arrui Ozzell
12.25
Robeson
Coastal Bermuda/Winter Rye
WaB-Wagram
0 to 6% slopes
R
NC-RO-16-19
Campen, James T.; Surles, Mary Sydney
Baker, Arrin Ozzell
1.09
Robeson
Coastal Bermuda/Winter Rye
WaB-Wagram
0 to 6% slopes
N/R
NC-RO-17-01
Lumberton Municipal Airport
Allen, Delois
52.97
Robeson
Row Crops
Jo -Johns Sandy
0 to 2% slopes
N/R
NC-RO-17-02
City of Lumberton
Allen, Delois
25.03
Robeson
Row Crops
Lu-Lumbee
0 to 2% slopes
N/R
NC-RO-17-03
City of Lumberton
Allen, Delois
49.30
Robeson
Row Crops
Lu-Lumbee
0 to 2% slopes
N/R
NC-RO-17-04
Lumberton Municipal Airport
Allen, Delois
81.77
Robeson
Row Crops
Jo -Johns Sandy
0 to 2% slopes
N/R
NC-RO-17-04A
Lumberton Municipal Airport
Allen, Delois
57.71
Robeson
Row Crops
Jo -Johns Sandy
0 to 2% slopes
N/R
NC-RO-17-05
Lumberton Municipal Airport
Allen, Delois
35.82
Robeson
Row Crops
Jo -Johns Sandy
0 to 2% slopes
N/R
NC-RO-17-06
Lumberton Municipal Airport
Allen, Delois
33.39
Robeson
Row Crops
Lu- Lumbee Sandy
0 to 2% slopes
N/R
NC-RO-17-07
Lumberton Municipal Airport
Allen, Delois
35.22
Robeson
Row Crops
Jo -Johns Sandy
0 to 2% slopes
R
NC-RO-20-03
Hammonds, Ronald G.
27.64
Robeson
Coastal Bermuda/Winter Rye
WkB-Wakulla
0 to 6% slopes
R
NC-RO-20-04
Brown, Charles H.
Hammonds, R. G.
29.12
Robeson
Coastal Bermuda/Winter Rye
WkB-Wakulla
0 to 6% slopes
FORM: LASC 06-16 Page 1

LAND APPLICATION SITE CERTIFICATION
R
NC-RO-20-06
Hammonds, Ronald G
9.65
Robeson
Row Crops
NoA-Norfolk
0 to 2% slopes
R
NC-RO-20-07
Hammonds, Ronald G
13.1
Robeson
Row Crops
GoA-Goldsboro
0 to 2% slopes
R
NC-RO-20-08
Hammonds, Ronald G
82.51
Robeson
Row Crops
GoA-Goldsboro
0 to 2% slopes
R
NC-RO-20-14
Taylco, Inc
Hammonds, R. G.
11.31
Robeson
Row Crops
GoA-Goldsboro
0 to 2% slopes
N
NC-RO-20-15
Hammonds, Ronald G
25.21
Robeson
Coastal Bennuda/Winter Rye
WkB-Wakulla
0 to 6% slopes
N
NC-RO-20-16
Hammonds, Ronald G
10.32
Robeson
Coastal Bermuda/Winter Rye
WkB-Wakulla
0 to 6% slopes
N
NC-RO-20-17
Hammonds, Ronald G
26.23
Robeson
Coastal Bermuda/Winter Rye
WkB-Wakulla
0 to 6% slopes
N
NC-RO-20-18
Hammonds, Ronald G
6.1
Robeson
Coastal Bermuda/Winter Rye
NoA-Norfolk
0 to 2% slopes
N
NC-RO-20-19
Hammonds, Ronald G
4.93
Robeson
Coastal Bermuda/Winter Rye
GoA-Goldsboro
0 to 2% slopes
N
NC-RO-20-20
Hammonds, Ronald G
45.62
Robeson
Coastal Bermuda/Winter Rye
GoA-Goldsboro
0 to 2% slopes
N
NC-RO-20-21
Hammonds, Ronald G
9.1
Robeson
Coastal Bermuda/Winter Rye
GoA-Goldsboro
0 to 2% slopes
R
NC-RO-28-01
Baskerville, Robert D., Jr.
Locklear, Camell
10.04
Robeson
Row Crops
Ra- Rains Sandy
0 to 2% slopes
R
NC-RO-28-02
Baskerville, Robert D., Jr
Locklear, Camell
53.68
Robeson
Row Crops
GoA-Goldsboro
0 to 2% slopes
R
NC-RO-28-03
Baskerville, Robert D., Jr
Locklear, Camell
12.85
Robeson
Row Crops
GoA-Goldsboro
0 to 2% slopes
R
NC-RO-39-OIA
Bullard, Patrick
Bullard, Patrick
7.30
Robeson
Coastal Bermuda/Winter Rye
GoA-Goldsboro
0 to 2% slopes
R
NC-RO-39-OIB
Bullard, Tracy
Bullard, Patrick
2.81
Robeson
Coastal Bermuda/Winter Rye
GoA-Goldsboro
0 to 2% slopes
R
NC-RO-39-02
Bullard, Lyndon
Bullard, Patrick
1.63
Robeson
Coastal Bermuda/Winter Rye
GoA-Goldsboro
0 to 2% slopes
R
NC-RO-39-03
Bullard, Quindale; Bullad, Luzette
Bullard, Patrick
5.87
Robeson
Coastal Bermuda/Winter Rye
Ra-Rains Sandy
0 to 2% slopes
R
NC-RO-39-04
Bullard, Quindale; Bullad, Luzette
Bullard, Patrick
14.62
Robeson
Coastal Bermuda/Winter Rye
Ly-Lynchburg
0 to 2% slopes
R
NC-RO-39-05
Bullard, Patrick
3.98
Robeson
Coastal Bermuda/Winter Rye
Ly-Lynchburg
0 to 2% slopes
R
NC-RO-39-06
Bullard, Patrick
3.2
Robeson
Coastal Bermuda/Winter Rye
WaB-Wagram
0 to 6% slopes
R
NC-RO-39-07
Bullard, Lyndon; Bullard, Anissa Emanuel
4.83
Robeson
Coastal Bermuda/Winter Rye
GoA-Goldsboro
0 to 2% slopes
R
NC-RO-39-08
Bullard, Lyndon
8.82
Robeson
Coastal Bermuda/Winter Rye
NoA-Norfolk
0 to 2% slopes
R
NC-RO-39-09
Bullard, Tracy Elizabeth
Bullard, Patrick
60.87
Robeson
Coastal Bermuda/Winter Rye
WaB-Wagram
0 to 6% slopes
N
NC-RO-40-1
Chavis, Ben
25.71
Robeson
Coastal Bennuda/Winter Rye
GoA-Goldsboro
0 to 2% slopes
N
NC-RO-40-2
Chavis, Ben
37.04
Robeson
Coastal Bermuda/Winter Rye
GoA-Goldsboro
0 to 2% slopes
N
NC-RO-40-3
Chavis, Ben
6.85
Robeson
Coastal Bennuda/Winter Rye
NoA-Norfolk
0 to 2% slopes
N
NC-RO-40-4
Chavis, Ben
13.23
Robeson
Coastal Bennuda/Winter Rye
NoA-Norfolk
0 to 2% slopes
N
NC-RO-40-5
Chavis, Ben
6.81
Robeson
Coastal Bermuda/Winter Rye
WaB-Eagram
0 to 6% slopes
FORM: LASC 06-16 Page 2

LAND APPLICATION SITE CERTIFICATION
N
NC-RO-40-6
Chavis, Ben
5.84
Robeson
Coastal Bermuda/Winter Rye
NoA-Norfolk
0 to 2% slopes
N
NC-RO-40-7
Chavis, Ben
9.38
Robeson
Coastal Bermuda/Winter Rye
NoA-Norfolk
0 to 2% slopes
N
NC-RO-40-8
Chavis, Ben
24.18
Robeson
Coastal Bermuda/Winter Rye
NoA-Norfolk
0 to 2% slopes
N
NC-RO-42-1
McGirt, James
Hardin Farms
34.33
Robeson
Row Crops
GoA-Goldsboro
0 to 2% slopes
N
NC-RO-42-2
McGirt, James
Hardin Farms
3.88
Robeson
Row Crops
GoA-Goldsboro
0 to 2% slopes
N
NC-RO-42-3
McGirt, James
Hardin Farms
59.24
Robeson
Row Crops
Ra-Rains Sandy
0 to 2% slopes
N
NC-RO-42-4
McGirt, James
Hardin Farms
4.69
Robeson
Row Crops
Me-Meggett Fine Sandy
0 to 2% slopes
N
NC-RO-42-5
McGirt, James
Hardin Farms
7.20
Robeson
Row Crops
Me-Meggett Fine Sandy
0 to 2% slopes
N
NC-RO-42-6
McGirt, James
Hardin Farms
9.72
Robeson
Row Crops
Me-Meggett Fine Sandy
0 to 2% slopes
N
NC-RO-42-7
McGirt, James
Hardin Farms
25.62
Robeson
Row Crops
Me-Meggett Fine Sandy
0 to 2% slopes
N
NC-RO-42-8
McGirt, James
Hardin Farms
1.07
Robeson
Row Crops
Ra-Rains Sandy
0 to 2% slopes
N
NC-RO-42-9
McGirt, James
Hardin Farms
25.62
Robeson
Row Crops
NoA-Norfolk
0 to 2% slopes
a Status Code for land application sites are: ♦ N (New) ♦ R (Renewed) ♦ M (Modified) ♦ T (Transferred) ♦ D (Deleted)
b Soil Series Name (i.e. Appling, Cecil, etc.)
Mapping Unit must be consistent with those used in the County Soil Survey (i.e. for a 2-8% slope Cecil in Anson County the mapping unit is CeB2)
FORM: LASC 06-16 Page 3

LAND APPLICATION SITE CERTIFICATION
II. WATERBODY AND CLASSIFICATIONS INFORMATION (See Instruction Q:
Site/Field ID
Latitude
Longitude
Location
Location
Location Accuracy
Waterbody Subbasin and
Current and Proposed
Datum
Method Code
Stream Index No.
Class
NC-RO-17-01
34.611136
-79.054205
Google Maps
39.7 meters RMSE
Lumber River Basin / 14-17
C;Sw
NC-RO-17-02
34.599260
-79.074230
Google Maps
39.7 meters RMSE
Lumber River Basin / 14-17
QSw
NC-RO-17-04
34.609154
-79.059053
Google Maps
39.7 meters RMSE
Lumber River Basin / 14-17
QSw
NC-RO-17-04A
34.606287
-79.063723
Google Maps
39.7 meters RMSE
Lumber River Basin / 14-17
QSw
NC-RO-17-05
34.617194
-79.05339
Google Maps
39.7 meters RMSE
Lumber River Basin / 14-17
QSw
NC-RO-17-06
34.605947
-79.054299
Google Maps
39.7 meters RMSE
Lumber River Basin / 14-17
QSw
NC-RO-17-07
34.610854
-79.063432
Google Maps
39.7 meters RMSE
Lumber River Basin / 14-17
QSw
NC-RO-20-15
34.790247
-79.079081
Google Maps
ADD
39.7 meters RMSE
Lumber River Basin / 14-10-4
C;Sw
NC-RO-20-16
34.790247
-79.079081
Google Maps
ADD
39.7 meters RMSE
Lumber River Basin / 14-10-4
QSw
NC-RO-20-17
34.790247
-79.079081
Google Maps
ADD
39.7 meters RMSE
Lumber River Basin / 14-10-4
QSw
NC-RO-20-18
34.722911
-79.071572
Google Maps
ADD
39.7 meters RMSE
Lumber River Basin / 14-10-(5.5)
WS-IV;Sw
NC-RO-20-19
34.722830
-79.028887
Google Maps
ADD
39.7 meters RMSE
Lumber River Basin / 14-12-3
C:Sw
NC-RO-20-20
34.725264
-79.025476
Google Maps
ADD
39.7 meters RMSE
Lumber River Basin / 14-12-3
C:Sw
NC-RO-20-21
34.722268
-79.023093
Google Maps
39.7 meters RMSE
Lumber River Basin / 14-12-3
C:Sw
NC-RO-40-1
34.736106
-79.012886
Google Maps
ADD
39.7 meters RMSE
Lumber River Basin / 14-22-3
C;Sw
NC-RO-40-2
Google Maps
39.7 meters RMSE
Lumber River Basin / 14-22-3
QSw
34.736072
-79.009727
NC-RO-40-3
Google Maps
39.7 meters RMSE
Lumber River Basin / 14-22-3
QSw
34.739551
-79.004684
NC-RO-40-4
Google Maps
39.7 meters RMSE
Lumber River Basin / 14-22-3
QSw
34.737437
-79.004360
NC-RO-40-5
Google Maps
39.7 meters RMSE
Lumber River Basin / 14-22-3
QSw
34.7377870
-79.001929
NC-RO-40-6
Google Maps
39.7 meters RMSE
Lumber River Basin / 14-22-3
QSw
34.735540
-79.004643
NC-RO-40-7
Google Maps
39.7 meters RMSE
Lumber River Basin / 14-22-3
QSw
34.735823
-79.002922
NC-RO-40-8
Google Maps
39.7 meters RMSE
Lumber River Basin / 14-22-3
QSw
34.732211
-79.003509
NC-RO-42-1
34.682377
-78.966435
Google Maps
39.7 meters RMSE
Lumber River Basin / 14-22-3-4
C;Sw
NC-RO-42-2
Google Maps
39.7 meters RMSE
Lumber River Basin / 14-22-3-4
QSw
34.684425
-78.964811
NC-RO-42-3
Google Maps
39.7 meters RMSE
Lumber River Basin / 14-22-3-4
QSw
34.679899
-78.965605
FORM: LASC 06-16 Page 4

LAND APPLICATION SITE CERTIFICATION
NC-RO-42-4
Google Maps
39.7 meters RMSE
Lumber River Basin / 14-22-3-4
QSw
34.678297
-78.961545
NC-RO-42-5
Google Maps
39.7 meters RMSE
Lumber River Basin / 14-22-3-4
QSw
34.675302
-78.963078
NC-RO-42-6
Google Maps
39.7 meters RMSE
Lumber River Basin / 14-22-3-4
QSw
34.675109
-78.960408
NC-RO-42-7
34.672928
-78.960029
Google Maps
ADD
39.7 meters RMSE
Lumber River Basin / 14-22-3-4
QSw
NC-RO-42-8
Google Maps
39.7 meters RMSE
Lumber River Basin / 14-22-3-4
QSw
34.672942
-78.963529
NC-RO-42-9
Google Maps
39.7 meters RMSE
Lumber River Basin / 14-22-3-4
QSw
34.681116
-78.958910
Note: Please keep the site information (L) and waterbody information (II.) of the same field on the same page.
FORM: LASC 06-16 Page 5

LOA 06-16 FORMS CORRECTED

DWR
Division of Water Resources
State of North Carolina
Department of Environmental Quality
W Division of Water Resources
15A NCAC 02T .1100 — 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 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 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:
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:
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)
NC-RO-39-lA
N
Pasture
Animal Feed
City of Lumberton
WWTP
NC-RO-39-5
N
Pasture
Animal Feed
City of Lumberton
WWTP
NC-RO-39-6
N
Pasture
Animal Feed
City of Lumberton
WWTP
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: LOA 06-16 Page 1 of 3

L 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.
H. 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-monthperiod 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.
HL 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 l 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. I 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 herj�by grant permission to the Permittee to I d apply residuals to the land application site(s) as specified
herein. . ' / 1 I
Landowner
Address:
City:
Phoneai
Signature:
State: /Al.
ail address:
NORTH CAROLINA, COUNTY
I, the undersigned Notary Public do hereby certify that
Zip:
Date:
personally appeared before me this day and acknowledged the due execution of the forgoing instrument.
WITNESS my hand and official sea] this the
,-t"
dayof �1,[� , 20 VZ
Signature and sea[:
My commission expires:
Lessee's/Operator's Certification:
am
�o-TARS.'. iN
XC' .`
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: State:
Phone: E-mail address:
Signature; Date:
Permittee's Certification:
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: wCI1A" -
Signature: -
Date:
FORM: LOA 06-16 Page 3 of 3

DWR
Division of Water Resources
State of North Carolina
Department of Environmental Quality
W Division of Water Resources
15A NCAC 02T .1100 — 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 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 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:
Applicant's name: L
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)
NC-RO-39-2
N
Pasture
Animal Feed
City of Lumberton
WWTP
NC-RO-39-7
N
Pasture
Animal Feed
City of Lumberton
WWTP
NC-RO-39-8
N
Pasture
Animal Feed
City of Lumberton
WWTP
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: LOA 06-16 Page 1 of 3

L 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.
H. 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-monthperiod 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-monthperiod 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.
HL 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 1 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. I 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:
Address:
City: State: A Zip:fff�__��`
Phone: 4 E-mai I address:
Signature: 44,4, iL F Date:
NORTH /AR0LFNA,'
CQ ( S�YI COUNTY
1, the undersigned Notary Public do hereby certify that L ndO + Y
personally appeared before me this day and acknowledged the due execution of the forgoing instrument.
14
WITNESS my hand and official seal this the L_ 0
day of Yn QLnn, 20 �� ...•..........
O�p1tY
Signature and seal: ti .s
My commission expires:
Lessee's/Operator's Certification:
9`
FAX �C
'"",,a 14As141W
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: Zip:
E-mail address:
Date:
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: 3�e2�r �1ozZ
FORM: LOA 06-16 Page 3 of 3

DWR
Division of Water Resources
State of North Carolina
Department of Environmental Quality
W Division of Water Resources
15A NCAC 02T .1100 — 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 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 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:
Applicant's name: Tracy Elizabeth Bullard
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)
NC-RO-39-lB
Y
Pasture
Animal Feed
City of Lumberton
WWTP
NC-RO-39-9
Y
Pasture
Animal Feed
City of Lumberton
WWTP
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: LOA 06-16 Page 1 of 3

L 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.
H. 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-monthperiod 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.
HL 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. I 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: 2 �' QC-'
Address: ��+Re ^ J �i
City
�.GL►'7' ho State: I *tom 7_il): U
Phone:
Signature:
E-mail address:
Date:
NORTH(+OLINA, Pauw COUNTY
1, the undersigned Notary Public do hereby certify that %G1L
personally appeared before me this day and acknowledged the
WITNESS my hand and official seal this the
. . FIRM
Signature and seal:
My commission expires:
Lessee's/Operator's Certification:
I certify that I have read thijFreement and, do herebyNr `elto
Lessee/operator name:
Addr V 01 1 1
City:
Phone:
Signatu
Permittee's Certification:
execution of the forgoing instrument.
,2o_L7_
by the stipulations and restrictions as specified herein.
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Sign'sng affiaial namJ
e: � " "t"
Signature:
Date:
FORM: LOA 46-16 Page 3 of 3

DWR
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .1100 — 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 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 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:
Applicant's name: Ronald Hammonds
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)
NC-RO-20-19
N
Row Crops
Animal Feed
City of Lumberton
WWTP
NC-RO-20-20
N
Pasture/Hay
Pasture/Hay
City of Lumberton
WWTP
NC-RO-20-21
N
Row Crops
Animal Feed
City of Lumberton
WWTP
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: LOA 06-16 Page 1 of 3

L 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 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 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.
H. 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.
HL ALTERNATIVES FOR WATER SUPPLY WELLS INSIDE THE COMPLIANCE BOUNDARY: (please check one)
15A NCAC 02L .0I07(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. I 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:
WiTUNTW
Address: I a/ Y qeR KMojJrt?5 R� _
City:_ LV'M��a2-�oV State: A'C • ' zip: ?8344
Phone: U" 7 __ — Xd— ! E-mail ad
Signature: Y��@.Lr!�L 6-1`ffL16 m
NORTH CAROLINA, 1C cbts l COUNTY
I, the undersigned Notary Public do hereby certify that
Date: 9_J_&'3-1
personally appeared before me this day and acknowledged the due execution of the forgoing instrument.
WITNESS my hand and official seal this the L(0++) •"""
r.
day of sT , ZO
:•
O
Signature and seal:
My commission expires:
Lessee's/Operator's Certification:
NO
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 address:
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: (aru 1 U , Woa l �tr-'>
Signature:
Date:
91-aG-.2r
FORM: LOA 06-16 Page 3 of 3

DWR
Division of Water Resources
State of North Carolina
Department of Environmental Quality
W Division of Water Resources
15A NCAC 02T .1100 — 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 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 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:
Applicant's name: Ronald Hammonds
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:
Lease
Land Use or
Residuals Source
Special note
Site/Field ID
(yes/no)
Cropping Patterns
Intended Use of Crops
(optional)
(no-till/over-seed/
pasture)
NC-RO-20-15
N
Pasture/Hay
Pasture/Hay
City of Lumberton
WWTP
NC-RO-20-16
N
Pasture/Hay
Pasture/Hay
City of Lumberton
WWTP
NC-RO-20-17
N
Pasture/Hay
Pasture/Hay
City of Lumberton
WWTP
NC-RO-20-18
N
Row Crops
Animal Feed
City of Lumberton
WWTP
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: LOA 06-16 Page 1 of 3

L 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 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 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.
H. 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.
Ill. 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: NC-RO-20 2,9,10,11,12, is currently permitted under another residuals land application program, Permit
Number WQ: 0000527 . 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;
City of Lumberton
(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. I 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:
WiTUNTW
Address: I a/ Y qeR KMojJrt?5 R� _
City:_ LV'M��a2-�oV State: A'C • ' zip: ?8344
Phone: U" 7 __ — Xd— ! E-mail ad
Signature: Y��@.Lr!�L 6-1`ffL16 m
NORTH CAROLINA, 1C cbts l COUNTY
I, the undersigned Notary Public do hereby certify that
Date: 9_J_&'3-1
personally appeared before me this day and acknowledged the due execution of the forgoing instrument.
WITNESS my hand and official seal this the L(0++) •"""
r.
day of sT , ZO
:•
O
Signature and seal:
My commission expires:
Lessee's/Operator's Certification:
NO
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 address:
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: (aru 1 U , Woa l �tr-'>
Signature:
Date:
91-aG-.2r
FORM: LOA 06-16 Page 3 of 3

DWR
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .1100 — 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 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 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:
Applicant's name: Ronald Hammonds
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:
Lease
Land Use or
Residuals Source
Special note
Site/Field ID
(yes/no)
Cropping Patterns
Intended Use of Crops
(optional)
(no-till/over-seed/
pasture)
NC-RO-20-3
N
Pasture/Hay
Pasture/Hay
City of Lumberton
WWTP
NC-RO-20-6
N
Row Crops
Pasture/Hay
City of Lumberton
WWTP
NC-RO-20-7
N
Row Crops
Pasture/Hay
City of Lumberton
WWTP
NC-RO-20-8
N
Row Crops
Animal Feed
City of Lumberton
WWTP
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: LOA 06-16 Page 1 of 3

L 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.
H. 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.
Ill. 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. I 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:
WiTUNTW
Address: I a/ Y qeR KMojJrt?5 R� _
City:_ LV'M��a2-�oV State: A'C • ' zip: ?8344
Phone: U" 7 __ — Xd— ! E-mail ad
Signature: Y��@.Lr!�L 6-1`ffL16 m
NORTH CAROLINA, 1C cbts l COUNTY
I, the undersigned Notary Public do hereby certify that
Date: 9_J_&'3-1
personally appeared before me this day and acknowledged the due execution of the forgoing instrument.
WITNESS my hand and official seal this the L(0++) •"""
r.
day of sT , ZO
:•
O
Signature and seal:
My commission expires:
Lessee's/Operator's Certification:
NO
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 address:
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: (aru 1 U , Woa l �tr-'>
Signature:
Date:
91-aG-.2r
FORM: LOA 06-16 Page 3 of 3

VICINITY SETBACK MAPS

`I
Field 1:
Field 2:
Total Acres:
Total Acres:
12.18 Application Area:
4.65 Application Area:
11.45
2.49
Field 3:
Total Acres:
3.34 Application Area:
3.34
Field 4:
Total Acres:
3.67 Application Area:
3.67
Field 5:
Total Acres:
9.91 Application Area:
9.79
4
Field 6:
Total Acres:
23.61 Application Area:
17.27
Field 7:
Total Acres:
23.52 Application Area:
16.35
t ®
0, o r
Field 8:
Total Acres:
7.54 Application Area:
6.14
N
�///, P � 414 / el l ! i .
3
Legend
�y
® Application Area
Parcels
On -Site Residence
Off -Site Residence
® Offsite Residence Buffer
® Unsuitable Area
—
Streams
!. The compliance boundary is established
Well
Ditches
at either 250 feet from the residuals land
Pond
application area or 50 feet within the
.�
�. •
Well Buffer
®
Pond Buffer
property boundary, whichever is closest
to the residuals land application area.
SITE: NC-RO-16
Graphical Scale
0 250 500 1,000 1,500 2,000 Field 1-8
Feet
1 Inch = 600 feet Owner: Permit Holder: County:
Ozzell Baker City of Lumberton Robeson

/
Field 1 6:
Total Acres:
5.33 Application Area:
5.33
Field 1 7:
Total Acres:
6.23 Application Area:
6.23
Field 1 8:
Total Acres:
12.25 Application Area:
12.25
Field 1 9:
Total Acres:
1.77 Application Area:
1.09
19
The compliance boundary is established
at either 250 feet from the residuals land
application area or 50 feet within the
property boundary, whichever is closest
to the residuals land application area.
Legend
®
Application Area
On -Site Residence
Parcels
Off -Site Residence
®
Offsite Residence Buffer
®
Unsuitable Area
—
Streams
C
Well
Ditches
ii
Well Buffer
Pond
®
Pond Buffer
Graphical Scale
0 165 330 660 990 1,320
Feet
1 inch = 400 feet
sri;,Max-ar!E'arthstar Geographics,'a'nd,the 18/6,ser
SITE: NC-RO-16
Field 16 - 19
Owner: Permit Holder: County:
Ozzell Baker City of Lumberton Robeson
I

Field 1. , ���` ' N-�
Total Acres: 52.97 Application Area: 52.97Ilk
Field 4:
Total Acres: 81.77 Application Area: 81.77 \ ✓� r
Field 5:
Total Acres: 39.98 Application Area: 35.82'�
Field 6: '
Total Acres: 33.39 Application Area: 33.39 �. .
Field 7:
Total Acres: 43.20 Application Area: 35.22 © -
,• �~ _ %jai
` ♦ � go
Ilk
'4+
WR
O J
Legend _
►� � 2 t n t'1F
® Application —Area ,� The compliance boundary is established
® Unsuitable Area at either 250 feet from the residuals land
Streams application area or 50 feet within the
property boundary, whichever is closest
Ditches to the residuals land application area.
Parcels _
SITE: NC-RO-17
Graphical Scale
Field 1, 4-7
0 350 700 1,400 2,100 2,800
Feet
1 Inch = 850 feet Owner: Permit Holder: County:
City of Lumberton City of Lumberton Robeson

G
CD
11
O
Legend
® Application_ Area
® Unsuitable Area
Streams
Ditches
Parcels
1 0 270 540
O
L1
Field 2:
Total Acres:
40.87 Application Area: 25.03
Field 3:
Total Acres:
52.36 Application Area: 49.30
Field 4A:
Total Acres:
61.00 Application Area: 57.71
F �
OF
The compliance boundary is established
at either 250 feet from the residuals land
application area or 50 feet within the
property boundary, whichever is closest
v to the residuals land application area.
i
M , E Uttar G ;�, , nd - GIS User C munity
SITE: NC-RO-17
Graphical Scale
Field 2-4A
1,080 1,620 2,160
Feet
1 Inch = 650 feet Owner:TPermit Holder: County:
City of Lumbertonof Lumberton Robeson

o �s
Field 19: Total Acres: 12.33 Application Area: 4.93
Field 20: Total Acres: 51.62 Application Area: 45.62
. Field 21: Total Acres: 18.0 Application Area: 9.1
Legend
® Application Area
On -Site Residence
® Off -Site Residence Buffer
® Unsuitable Area Off -Site Residence
Parcels — Streams
The compliance boundary is established Well Ditch
at either 250 feet from the residuals land �i Well Buffer Pond
application area or 50 feet within the ® Pond Buffer
property boundary, whichever is closest
to the residuals land application area.
Iource: E ,;i`fMa riEarthstar Geocjraphics, and the GIs User.: Co '. unity.
SITE: NC-RO-20
Graphical Scale
0 205 410 820 1,230 1,640 Field 19-21
Feet
1 Inch = 500 feet Owner: Permit Holder: County:
Ronald Hammonds City of Lumberton Robeson

r - w - .: � - I - . r
Field i • i Application Area: •
. %7_7-
�.
#*
y .?. M .
Legend
The compliance boundary is established
at either 250 feet from the residuals land`"��..
application area or 50 feet within the
property boundary, whichever is closest
to the residuals land application area. L,
obi lwsjpq Maxar, Earthstar Geographil. , i GI IU
SITE: NC-RO-20
Graphical Scale
960 Field 18
� Feet
1 Inch = 300 feet Owner: Permit Holder: County:
Ronald Hammonds City of Lumberton lRobeson
0 120 240 480 720
1A%
®
Application Area
On -Site Residence
®
Off -Site Residence Buffer
Off -Site Residence
®
Unsuitable Area
Parcels
—
Streams
Well
Ditch
ii
Well Buffer
Pond
®
Pond Buffer

60
O
Field 6: Total Acres: 42.86 Application Area: 9.65
Field 7: Total Acres: 17.63 Application Area: 13.1
Field 8: Total Acres: 89.01 Application Area: 82.51
Field 14: Total Acres: 12.81 Application Area: 11.31
+ 14
Legend
04
®
Application Area
On -Site Residence
u
®
Off -Site Residence Buffer
ff�
Off Residence
•
®
Unsuitable Area
-Site
lip
Parcels
—
Streams
The compliance boundary is established
Well
Ditch
at either 250 feet from the residuals land
�i
Well Buffer
Pond
application area or 50 feet within the
®
Pond Buffer
property boundary, whichever is closest
to the residuals land application area.
Esri, Maxar, Earthstar Geoghics, and<th .GdS User Go mu5ity/
r p
SITE: NC-RO-20
Graphical Scale
0 290 580 1,160 1,740 2,320 Field 6-8, 14
Feet
1 Inch = 700 feet Owner: Permit Holder: County:
Ronald Hammonds City of Lumberton Robeson

The compliance boundary is established
at either 250 feet from the residuals land
application area or 50 feet within the
property boundary, whichever is closest
to the residuals land application area.
Field 4: Total Acres: 32.06 Application Area: 29.12 I
C
Legend
®
Application Area
On -Site Residence
®
Off -Site Residence Buffer
Off -Site Residence
®
Unsuitable Area
Parcels
—
Streams
Well
Ditch
ii
Well Buffer
Pond
®
Pond Buffer
SITE: NC-RO-20
Graphical Scale
0 165 330 660 990 1,320 Field 4
Feet
1 Inch = 400 feet Owner: Permit Holder: County:
Ronald Hammonds City of Lumberton Robeson

J
The compliance boundary is established
at either 250 feet from the residuals land
application area or 50 feet within the
property boundary, whichever is closest
to the residuals land application area.
Field 3: Total Acres: 46.61 Application Area: 27.64
Field 15: Total Acres: 29.98 Application Area: 25.21
Field 16: Total Acres: 15.16 Application Area: 10.32
Field 17: Total Acres: 26.75 Application Area: 26.23
f e'o
■
Legend
®
Application Area
On -Site Residence
®
Off -Site Residence Buffer
Off -Site Residence
®
Unsuitable Area
Parcels
—
Streams
O
Well
Ditch
ii
Well Buffer
Pond
®
Pond Buffer
SITE: NC-RO-20
Graphical Scale
0 250 500 1,000 1,500 2,000 Field 3, 15-17
Feet
1 Inch = 600 feet Owner: Permit Holder: County:
Ronald Hammonds City of Lumberton Robeson

1::'A
O
1t
Field 1:
'�''�" •- Total Acres: 13.13 Application Area: 10.04
Field 2:
Total Acres: 63.58 Application Area: 53.68
Field 3:
Total Acres: 14.16 Application Area: 12.85
0
. �i%I. `••��. ••��� :__ �~ice_ � � � � ���ii��=
Legend
19 Off- Site Residence
Ditch
® Unsutable Area
® Application Area
® Pond Buffer
Pond
® Off Site Habital Residence Buffer
Parcels
Graphical Scale
0 250 500 1,000 1,500 2,000
Feet
1 inch = 600 feet
The compliance boundary is established
at either 250 feet from the residuals land
application area or 50 feet within the
property boundary, whichever is closest
to the residuals land application area.
Earthstar'G� , GI
SITE: NC-RO-28
Field 1-3
Owner: Permit Holder: County:
Robert Baskerville I City of Lumberton Robeson

Application Area Map
w

0
Legend
®
Application Area
®
Off Site Habital Buffer
®
Unsuitable Area
O
Well
®
Well Buffer
On -Site Residence
Off -Site Residence
—
Streams
Ditch
Pond
®
Pond Buffer
1�
Field 7:
Total Acres: 8.49 Application Area: 4.83
Field 8:
Total Acres: 15.87 Application Area: 8.82
a
The compliance boundary is established
at either 250 feet from the residuals land i
application area or 50 feet within the
property boundary, whichever is closest
to the residuals land application area.
SITE: NC-RO-39
Graphical Scale
Field 7-8
0 120 240 480 720 960
Feet
1 Inch = 300 feet Owner: Permit Holder: County:
Lyndon Bullard City of Lumberton Robeson

a �
0
� O4 9
�o
C
Legend
®
Application Area
®
Off Site Habital Buffer
®
Unsuitable Area
0
Well
®
Well Buffer
10
On -Site Residence
Off -Site Residence
—
Streams
Ditch
M
Pond
®
Pond Buffer
Graphical Scale
0 185 370 740 1,110 1,480
Feet
1 inch = 450 feet
Field 9:
Total Acres: 66.37 Application Area: 60.87
,NEW_
The compliance boundary is established
at either 250 feet from the residuals land
application area or 50 feet within the
property boundary, whichever is closest
to the residuals land application area.
SITE: NC-RO-39
Field 9
Owner: Permit Holder: County:
Tracy Bullard City of Lumberton Robeson

=
Field 1:
Field 5:
Total Acres: 25.71 Application Area: 25.71
Total Acres: 7.39 Application Area: 6.81
Field 2:
Field 6:
Total Acres: 41.89 Application Area: 37.04
Total Acres: 6.60 Application Area: 5.84
Field 3:
Field 7:
Total Acres: 12.24 Application Area: 6.85
Total Acres: 9.38 Application Area: 9.38
Field 4:
1 Field 8:
Total Acres: 13.50 Application Area: 13.23 H Total Acres: 29.19 Application Area: 24.18
774)
A
0
Legend
®
Application Area
®
Off Site House Buffer
®
Unsuitable Area
O
Well
Well Buffer
On- Site Residence
Off -Site Residence
—
Stream
Ditch
Pond
®
Pond Buffer
Parcel
1 0 310 620 1,240
2
c
The compliance boundary is established
at either 250 feet from the residuals land
application area or 50 feet within the
N property boundary, whichever is closest
t �° to the residuals land application area.
ource Esri, Maxaf, Ea+r1'h�Sta Geb"- i� ,�h Ghee GiS User C"
SITE: NC-RO-40
Graphical Scale
1,860 2,480 Field 1 - 8
Feet
1 Inch = 750 feet owner: Permit Holder: County:
Ben Chavis City of Lumberton Robeson

�4 /
0
Field 1:
Field 5:
Total Acres:
43.69 Application Area: 34.33
Total Acres:
9.93 Application Area:
7.20
Field 2:
Field 6:
Total Acres:
3.88 Application Area: 3.88
Total Acres:
10.94 Application Area:
9.72
Field 3:
Field 7:
Total Acres:
66.46 Application Area: 59.24
Total Acres:
28.99 Application Area:
25.62
Field 4:
Field 8:
Total Acres:
5.77 Application Area: 4.69
Total Acres:
1.36 Application Area:
1.07
Field 9:
Total Acres:
32.52 Application Area:
25.62
Y'
V
O
O
Indian Heritage Road
>�•
i
Legend
®
Application Area
®
Off -Site Residence Buffer
®
Unsuitable Area
7
O
^
0
On -Site Residence
a
Off -Site Residence
The compliance boundary is established
at either 250 feet from the residuals land
—
Streams
application area or 50 feet within the
Ditch
property boundary, whichever is closest
Parcels
i'ti+
to the residuals land application area.
hstar G ograph''�c GIS C
SITE: NC-RO-42
Graphical Scale
0
350 700 1,400
2,100 2,800
Field 1 -9
Feet
1 Inch = 850 feet
Owner:
Permit Holder:
County:
James McGirts
City of Lumberton
lRobeson

CUMULATIVE POLLUTANT LOADING RATLS (CPLRs)

CPLR Ceiling Limit
Field Name
NC-RO-16-01
NC-RO-16-2
NC-RO-16-3
NC-RO-16-4
NC-RO-16-5
NC-RO-16-6
NC-RO-16-7
NC-RO-16-8
NC-RO-16-16
NC-RO-16-17
NC-RO-16-18
NC-RO-16-19
NC-RO-17-01
NC-RO-17-02
NC-RO-17-03
NC-RO-17-04
NC-RO-20-03
NC-RO-20-04
NC-RO-20-06
NC-RO-20-07
NC-RO-20-08
NC-RO-20-14
NC-RO-20-15
NC-RO-20-16
NC-RO-20-17
NC-RO-20-18
NC-RO-28-01
NC-RO-28-02
NC-RO-28-03
NC-RO-39-0 lA
NC-RO-39-01B
NC-RO-39-02
NC-RO-39-03
NC-RO-39-04
NC-RO-39-05
NC-RO-39-06
NC-RO-39-07
NC-RO-39-08
NC-RO-39-09
rsenic ICadmium lCopper ILead IMercury I Molybdenj Nickel
361 341 13381 2671 15 1 n/a 1 374
Ozzell Farm
enium IZinc
891 2498
0.113
0.034
11.931
0.568
0.009
0.197
1.033
0.124
19.162
0.113
0.039
10.745
0.631
0.008
0.122
0.625
0.116
21.352
0.092
0.038
5.764
0.312
0.005
0.109
0.537
0.102
9.092
0.097
0.037
8.79
0.509
0.006
0.109
0.548
0.102
16.714
0.0971
0.035
8.557
1.347
0.0061
0.161
0.84
0.1
16.251
0.26
0.046
12.992
1.576
0.03
0.225
1.146
0.308
22.123
0.2
0.031
10.874
1.87
0.026
0.169
0.875
0.254
18.505
0.116
0.045
6.044
0.362
0.005
0.123
0.578
0.124
10.134
Baker Farms
0.278
0.127
39.385
3.861
0.044
0.738
3.283
0.25
32.459
0.196
0.118
37.845
3.94
0.169
0.751
3.02
0.16
32.775
0.282
0.127
44.954
4.36
0.047
0.777
3.11
0.257
41.931
0.153
0.12
39.428
4.905
0.236
0.388
2.401
0.612
24.46
Airport Fields
0.09
0.04
11.175
1.87
0.02
0.624
1.052
0.0178
8.745
0.16
0.087
20.128
1.667
0.035
0.419
1.969
0.193
20.616
0.1
0.06
9.674
0.494
0.012
0.192
0.963
0.14
15.755
0.157
0.073
28.421
1.75
0.017
0.461
1.698
0.108
16.43
Hammonds Farms
0.15
0.062
12.305
2.036
0.026
0.261
1.433
0.13
22.131
0.249
0.078
17.582
1.957
0.038
0.364
2.001
0.183
31.217
0.007
0.001
2.625
1.562
0
0.069
0.391
0.003
5.839
0.05
0.006
4.093
1.758
0.003
0.767
0.559
0.048
9.417
0.074
0.003
3.841
1.208
0.01
0.063
0.327
0.0931
6.684
0.001
0
10.033
0.33
0
0
0
0
14.341
0.431
0.195
10.945
2.192
0.067
0.77
1.698
0.198
63.389
0.474
0.173
10.486
2.447
0.063
0.874
1.821
0.191
63.361
0.3111
0.1151
8.085
1.5291
0.51
0.5271
1.07
0.143
53.513
0.51
01
0.6191
9.41
01
01
0.31
0.2
0.524
Carrell Farms
0.015
0.01
1.719
0.077
0.002
0.026
0.139
0.026
1.972
0.061
0.012
3.569
0.236
0.006
0.066
0.501
0.062
4.955
0
0
0
01
0
0
0
0
0
Patrick Bullard Farms
0.001
0
0.026
0.001
0
0
0.002
0.001
0.111
0.001
0
0.028
0.001
0
0
0.002
0.001
0.121
0
0
0
0
0
0
0
0
0
0.001
0
0.02
0.001
0
0
0.001
0.001
0.085
0.001
0
0.0231
0.001
0
0
0.002
0.0011
0.1
0.001
0
0.024
0.001
0
0
0.002
0.001
0.102
0.001
0
0.031
0.001
0
0
0.002
0.001
0.134
0.046
0.005
1.313
0.094
0.003
0.037
0.143
0.046
3.246
0.0011
01
0.025
0.0011
01
01
0.0021
0.001
3.078
0.031
0.0021
7.1961
0.6921
0.0041
0.0821
0.4561
0.0361
13.331