WQ0000672_More Information Received_20230921

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 8/16/2023.
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 to Letter Dated 8-16-23.pdf 16.51 MB
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 9/21/2023

RESPONSE TO LETTER DATED 8-16-23

PO Box 390
Lumberton, NC 28359
Phone: [phone]
Fax: [phone]
September 18, 2023
N.C. Environmental Quality-DWQ
1617 Mail Service Center
Raleigh, NC 27699-1617
Attention: Mr. Zachary J. Mega
Subject: Response to Letter Dated 8-16-23
Mr. Mega,
We have updated the permit application to address the comments as follows (in red):
I. Application (Form: LASC 06-16): 1. Please revise any updated field acreages based on the
comments in Section L below. Field acreages have been updated.
K. Setback Waiver Agreement(s): 1. If a setback waiver will be obtained from a property owner for
reduced setbacks to habitable residences and/or property lines, please provide a signed, notarized, and
recorded Form: NDRMPW-LAS 11-18, which can be downloaded from the Non -Discharge website, for
each parcel. Please make sure to update the associated buffers in the applicable vicinity/setback map. For
habitable residences, please notate the off -site dwelling on the applicable vicinity/setback map to show it
has an associated setback waiver. [15A NCAC 02T .I 108(e)] Setback waivers have been updated.
L. Vicinity/Setback Map(s): 1. Site NC-RO-016 (Fields 1-8) — Amin O. Baker does not own the
parcels adjacent to Fields 2 and 4. Please ensure the 50' property line setback is met for these fields or
submit setback waivers from the property owners of the adjacent parcels to reduce the setback. See
Comment K.1. 50 ft buffer is added.
2. Site NC-RO-016 (Fields 16-19) — Please revise the listed owner in the title block. Arrin O. Baker is
not the owner of these fields. Title block has been updated.
3. Site NC-RO-017 (Fields 24A) — Please show the buffer hatching area within the City of Lumberton
parcels for the surface water features. Hatching has been added.
4. Site NC-RO-020 (Fields 6-8 & 14) — a. The total acreage listed for Field 6 is incorrect. Please revise.
Acreage has been updatcu.

b. Field 14 is not owned by Ronald G. Hammonds. Please ensure the 50' property line setbacks are met to
the parcels containing Fields 7 and 8 or submit setback waivers from Ronald G. Hammonds reducing the
setbacks. See Comment K.1. Setback waivers have been signed and attached.
c. Please split up this vicinity/setback map into two separate figures based on the field landowner (i.e.,
Fields 6-8 for Ronald G. Hammonds, Field 14 for Taylco, Inc.) Figures have been separated.
5. Site NC-RO-020 (Field 4) — Please revise the listed owner in the title block. Ronald G. Hammonds is
not the field landowner. Field owner has been updated.
6. Site NC-RO-020 (Fields 3 & 15-17) — a. Please show the 400' off -site habitable residence setback for
the mobile home located on Parcel No. 180802023 and revise the acreages for Fields 15 and 16
accordingly. This was shown on the June 26, 2019, vicinity/setback map for Permit No. WQ0000527. A
setback waiver from the property owner can also be submitted to reduce the setback. See Comment K.1.
Setback waiver has been signed and attached.
b. Please revise the southeastern boundary of Field 3 to more accurately match the unsuitable area shown
on the April 27, 2017, vicinity/setback map. Boundary has been updated.
7. Site NC-RO-028 (Fields 1-3) — a. Please revise the shifted property boundaries and buffer hatching
lines around Fields 2 and 3. Shifted property boundaries have been revised.
b. Please ensure the 50' property line setback is met for the parcel just north of Field 3 or submit a setback
waiver from the property owner to reduce the setback. See Comment K.1. Property setback has been
signed and attached.
8. Site NC-RO-039 (Fields 1-6) — a. Please split up this vicinity/setback map into four separate figures
based on the field landowner (i.e., Fields IA, 5, and 6 for Patrick L. Bullard, Field 1B for Tracy E.
Bullard, Field 2 for Lyndon A. Bullard, and Fields 3 and 4 for Luzette Bullard). Separate figures have
been made.
b. Please revise the shifted property boundaries and buffer hatching lines around the field boundaries.
Shifted property boundaries and buffer hatching has been updated.
c. Please revise the southeastern boundary of Field IA to more accurately match the unsuitable area (i.e.,
the visible vegetation boundary in the latest aerial imagery) shown on the April 27, 2017, vicinity/setback
map. Boundaries have been updated.
d. If Field IA will be split between parcels owned by both Patrick L. Bullard and Tracy E. Bullard please
submit setback waivers from each of these individuals waiving property line setbacks from one another.
See Comment K.1. Otherwise, please revise the boundaries for Field IA and 1B to meet 50' property line
setbacks from either parcel. Setback waivers have been signed and attached.
e. Parcel No. 27150102002 owned by Mark D. Bullard located between Fields IA, 113, and 2 is
considered off -site. Please either show the 400' off -site habitable residence setback or submit setback
waivers from all landowners that have a field within 400' of Mark D. Bullard's residence to reduce the
setback. Please also ensure 50' property line setbacks are met for all adjacent parcels or submit setback
waivers for each property owner to reduce the setbacks. See Comment K.1. Setback waiver has been
signed and attached.
f. Please ensure the 50' property line setback is met for the southern boundary of Field 2 and the northern
boundary of Field 6 or submit setback waivers from Lyndon A. Bullard and Patrick L. Bullard reducing

property line setbacks from one another. See Comment K.1. Setback waivers has been signed and
attached.
g. Please ensure the 50' property line setback is met for the western boundary of Field 5 or submit a
setback waiver from Luzette Bullard reducing the property line setback from Field 5. See Comment K.1.
Setback waivers has been signed and attached.
h. The two habitable residences south of Fields 5 and 6 are considered off -site to any fields not owned by
Patrick L. Bullard. Please either show the 400' off -site habitable residence setbacks or submit setback
waivers from all landowners that have a field within 400' of Patrick L. Bullards's residences to reduce the
setbacks. Setback waivers has been signed and attached.
i. Is the ditch line that intersects the delineated stream accurate? If not, please revise. Stream has been
shifted left. All streams and ditches are accurate and brought in by North Carolina streams and rivers
shapefiles.
9. Site NC-RO-039 (Field 7 & 8) — a. Please revise the western boundary of Field 7 and the northeastern
and southern boundary of Field 8 to more accurately match the unsuitable area (i.e., areas with denser,
unmaintained vegetation) shown on the April 27, 2017, vicinity/setback map. Boundaries have been
updated.
b. See Comment L.8.1. Has been updated.
10. Site NC-RO-040 (Fields 1-8) — See Comment L.8.b. Has been updated.
11. NC-RO-042 (Fields 1-9) — a. See Comment L.8.b. Has been updated.
b. Please revise the last name of James F. McGirt listed in the title block. Has been changed and updated.

LASC 06-16 UPDATED

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: 1,253.75 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
2.14
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
3.35
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
17.25
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.
25.61
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
7.35
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
5.22
Robeson
Coastal Bermuda/Winter Rye
Ra-Rains Sandy
0 to 2% slopes
R
NC-RO-39-04
Bullard, Quindale; Bullad, Luzette
Bullard, Patrick
14.31
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
4.52
Robeson
Coastal Bermuda/Winter Rye
GoA-Goldsboro
0 to 2% slopes
R
NC-RO-39-08
Bullard, Lyndon
8.15
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

VICINITY SETBACK MAPS

+✓
�j Field 1:
Total Acres:
12.18 Application Area: 11.45
�,.
Field 2:
Total Acres:
5.00 Application Area: 2.14
Field 3:
Total Acres:
3.34 Application Area: 3.34
�•,
Field 4:
Total Acres:
3.99 Application Area: 3.35
1►
Field 5:
Total Acres:
9.91 Application Area: 9.79
Field 6:
Total Acres:
23.63 Application Area: 17.25
Field 7:
Total Acres:
23.52 Application Area: 16.35
Field 8:
Total Acres:
7.54 Application Area: 6.14
As
O 4 ,
0
0 '
6
/ 6//wz
XO//
Legend
i� A #
®
Application Area
On -Site Residence
Parcels
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.
' Source�,Esrl,� x01,,Eart r, gra,h*a/�/n'l I- U munity,
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:
Arrin O. Baker
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 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
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
nisri/rMax,ar!E'arthstarGeographics,a'nd;the 18/6,ser
SITE: NC-RO-16
Field 16 - 19
Owner: Permit Holder: County:
James T CampeT ity of Lumberton Robeson

41MM I Y
........ U .
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 �
&AX
Y
Legend
® 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
Ditches property boundary, whichever is closest
Parcels to the residuals land application area.
11tar G ;�, , n • GI ur
SITE: NC-RO-17
Graphical Scale
Field 2-4A
0 270 540 1,080 1,620 2,160
Feet
1 Inch = 650 feet Owner: Permit Holder: County:
City of Lumberton I City of Lumberton lRobeson

A.
b
0
C1
j o
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: 48.63 Application Area: 25.61
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
17
Legend
®
Application Area
0
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

r
�.
e
0
Field 6:
Total Acres:
43.68 Application Area:
9.65
Field 7:
Total Acres:
17.63 Application Area:
13.1
Field 8:
Total Acres:
89.01 Application Area:
82.51
C
,,Mi a �.
*'
Legend
Application Area
On -Site Residence
odQ`
Off -Site Residence Buffer
Off Residence
-Site
®
Unsuitable Area
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.
-. Sri, Maxar, Earthstar. Geographies, and the GIS User Community
SITE: NC-RO-20
Graphical Scale
0 290 580 1,160 1,740
2,320
Field 6-8
Feet
Owner:
Permit Holder:
County:
1 Inch = 700 feet
Ronald Hammonds
City of Lumberton
Robeson

�.
�..'.' :Lie; f .L_
prN 1
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 14: Total Acres: 12.81 Application Area: 11.31
f.
104
n��,\,5 ��r, • �� ter` R
Al
Legend
® Off -Site Residence Buffer On -Site Residence
® Unsuitable Area
Off -Site Residence
Parcels
J Well — Streams
ii Well Buffer Ditch
M Pond
® Pond Buffer
Maxar, Earthstar Geographics, and the GIS User Commurn
SITE: NC-RO-20
Graphical Scale
0 290 580 1,160 1,740 2,320 Field 14
Feet
1 Inch = 700 feet Owner: Permit Holder: County:
Taylco, INC. City of Lumberton lRobeson

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
VA) S i, /a/- 4 &��Iellll
�. ����. � � � � uliuuuuuuuuuuuuuuuuu
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` IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII JIIIIIIIIIIII�IIIIIIIII
��/�� �• tau / _
O
Legend
19
Off- Site Residence
i
Ditch
Parcels
®
Unsutable Area
®
Application Area
r
\
The compliance boundary is established
at either 250 feet from the residuals land
®
Pond Buffer
1 _ i
q, �
application area or 50 feet within the
Pond
property boundary, whichever is closest
®
Off Site Habital Residence Buffer
to the residuals land application area.
Source: Esri,. M'J Earthstar Geo GI
SITE: NC-RO-28
Graphical Scale
0
250 500 1,000 1,500 2,000
Field 1-3
Feet
Owner:
Permit Holder:
County:
1 Inch = 600 feet
Robert Baskerville
City of Lumberton
lRobeson

,06
j Field 1A:
Total Acres: 9.50 Application Area: 7.35
Field 5:
Total Acres: 6.10 Application Area: 3.98
Field 6:
Total Acres: 3.51 Application Area: 3.20
r
y
.r s
C
Legend
® Application Area
® Off Site Habital Buffer
® Unsuitable Area
O Well
'i Well Buffer
On -Site Residence
Off -Site Residence
Streams The compliance boundary is established
Ditch at either 250 feet from the residuals land
Pond application area or 50 feet within the
property boundary, whichever is closest
® Pond Buffer to the residuals land application area.
Parcels
Source. nd the GIS User Commuhitlj:
SITE: NC-RO-39
Graphical Scale
0 145 290 580 870 1,160 Field 1A, 5-6
Feet
1 Inch = 350 feet Owner: Permit Holder: County:
Patrick Bullard City of Lumberton Robeson

`►�
"
Legend
®
Application Area
®
Off Site Habital Buffer
®
Unsuitable Area
O
Well
'i
Well Buffer
On -Site Residence
Off -Site Residence
—
Streams
Ditch
Pond
®
Pond Buffer
Parcels
Field 2:
Total Acres: 1.63 Application Area: 1.63
ii
O V////A 'y
�ad
Graphical Scale
0 145 290 580 870 1,160
Feet
1 inch = 350 feet
I
n
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.
=sri, Maxar, Earthstar Geographics, and GIS C
SITE: NC-RO-39
Field 2
Owner: Permit Holder: County:
Lyndon Bullard City of Lumberton Robeson

Legend
®
Application Area
®
Off Site Habital Buffer
®
Unsuitable Area
Well
'i
Well Buffer
On -Site Residence
Off -Site Residence
—
Streams
Ditch
Pond
®
Pond Buffer
Parcels
Graphical Scale
0 145 290 580 870 1,160
Feet
1 inch = 350 feet
Field 3:
Total Acres: 7.76 Application Area: 5.22
A- Field 4:
Total Acres: 18.41 Application Area: 14.31
O
EZOad
Oe� i
ilL
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.
3sri, Maxar, Earthstar Geographic , he GIS User Comm
SITE: NC-RO-39
Field 3-4
Owner: Permit Holder: County:
Luzette Bullard City of Lumberton Robeson

T
Legend
®
Application Area
®
Off Site Habital Buffer
®
Unsuitable Area
O
Well
'i
Well Buffer
On -Site Residence
Off -Site Residence
—
Streams
Ditch
Pond
®
Pond Buffer
Parcels
�ad
Graphical Scale
0 145 290 580 870 1,160
Feet
1 inch = 350 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.
:sri, Maxar, Earthstar Geographics, and GIS C
SITE: NC-RO-39
Field 1 B
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
4 Field 4:
Field 8:
Total Acres:
13.50 Application Area:
13.23
Total Acres:
29.19 Application Area: 24.18
O
Legend
®
Application Area
®
Off Site House Buffer
®
Unsutable Area
O
Well
�i
Well Buffer
On- Site Residence
Off -Site Residence
—
Stream
Ditch
Pond
®
Pond Buffer
Parcel
0
C
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.
- 7 "Source:;EsIrk MaV*r, Earthtstar Geogrg,.h_, /aj;�,tffl§10 5 C
Graphical Scale
0 310 620 1,240 1,860 2,480
Feet
1 inch = 750 feet
SITE: NC-RO-40
Field 1 - 8
Owner: Permit Holder: County:
Ben Chavis City of Lumberton Robeson

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
20 y a
10
Indian Heritage Road
0
0
1-
V"A((
r
O 4
� O
Legend
® Application Area'°+
iz1 Off -Site Residence Buffer ,
® Unsuitable Area
8 1�
On -Site Residence
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 to the residuals land application area.
Sourc@ GI
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 Robeson

SETBACK WAIVERS

Hook 2424 Page 230
RETURN: ENVIRO CHOICE
P.O. Box 390
LUMBERTON, NC 28359
2023008948
ROBESON CO, NC FEE $25.00
PRESENTED S RECORDED.
09-20-2023 12:54:28 PM
VICKI L LOCKLEAR
i REGMvp 6? Free
BY- 1[ATELON FLOYD HUNT
Decurr
BK: D 2424
PG: 230-231
State of North Carolina
Department of Environmental Quality
Division of Water Resources
NON -DISCHARGE RESIDUALS MANAGEMENT PROGRAM WAIVER
FOR THE APPLICATION OF CLASS B RESIDUALS
AGREEMENT TO WAIVE SETBACKS PURSUANT TO
ISA NCAC 02T .I I08[c]
1, RoAld liammonds certify that I am a deeded owner of the property located at:
Address: 1218 Hammonds Road
City
Lumberton
Parcel No.: 201001001, 200701036
State: NC Zip Cade: 28360 County: RobMn
Furthermore, I certify that I am authorized to make decisions regarding this property, and that I do hereby
agree that the setback distances cited below be granted to the AppiicantlPermittee listed on the following
page -
For the parcel identified above, I consent to a reduced setback from so feet to _A — feet,
thereby allowing the application of Class B residuals as near as o feet from my property line.
❑ For the parcel identified above, I consent to a reduced setback from feet to feet,
thereby allowing the application of Class B residuals as near as feet from my residence.
"THIS WAIVER SHALL BE TERMINATED UPON CHANGE OF OWNERSHIP OF ANY PARTIES INVOLVED"
k��
Signature: hate: ' 03
FORM: NDRMPW-LAS I I-18 Page I oft

Book 2424 Page 231
Applicant/Permittee: City of Lumberton
Address: PO Box 1388 Parcel No.: 201001001, 200701036
City: Lumberton State: INC Zip Code: 28359 County: Robeson
NORTH CAROLINA, COUNTY
I, C QY Y qn -T_5Ytwo a Notary Public for County, North Carolina,
do hereby certify that C!�)ffiTr JV\C personally appeared before me this day
and acknowledged the due execution of the foregoing instrument.
Witne9s my hand and official seal, this the -day of '�,,P Y ? jt Y Q) e, 13.
SEAL
CARRIGAN I SHEPHERD
NOTARY PUBLIC
Wake County
North Carolln�
My CommNslon Expires `►11� .yt
Signature QfNotary Public
,Vy co►►rmission expires U I i 3 I 10
Once notarized, this form shall be recorded at the Register of Deeds in the county or
counties in which the described properties are located, A copy of the recorded
waiver shall be sent to the following address:
Division of Water Resources
Non -Discharge Branch
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
FORM: NDRMPW-LA5 t 1-18 Page 2 of

RETURN: ENVIROCHOICE
P.O. BOX 390
LUMBERTON, NC 28359
2023008890
ROBESON CO, NC FEE $26.00
PRESENTED & RECORDED.
09-19-2023 02:10:30 PM
VICKI L LOCKLEAR
REC[STER OF DEEPS
BY- KARINA ORTIZ
DEPUTY
BK: D 2424
PG: 17-18
State of North Carolina
Department of Environmental Quality
Division of Water Resources
NON -DISCHARGE RESIDUALS MANAGEMENT PROGRAM WAIVER
FOR THE APPLICATION OF CLASS B RESIDUALS
AGREEMENT TO WAIVE SETBACKS PURSUANT TO
15A NCAC 02T .I 1 08(c)
I, Quindale & I.uzzette Bullard , certify that I am a deeded owner of the property located at:
2.7150 ) o 1.1--.1-
Address: 3971 W Dew Road Parcel No.: '*Ar) "oo] ❑
7.47 ]"'bo ) cx4A a7. A
City: Rowland State: NC Zip Code: 28386 County: Robeson
Furthermore, i certify that I am authorized to make decisions regarding this property, and that I do hereby
agree that the setback distances cited below be granted to the Appiicant/Permittee listed on the following
page
© For the parcel identified above, i consent to a reduced setback from 50 feet to U feet,
thereby allowing the application of Class B residuals as near as tl feet from my property line.
0 For the parcel identified above, I consent to a reduced setback from 400 feet to 150 feet,
thereby allowing the application of Class B residuals as near as 150 _ feet from my residence,
**`PHIS WAIVER SHALT. 13E TERMINATED UPON CHANGE OF OWNERSHIP OF ANY PARTIES INVOLVED**
Signature:
Date:,
FORM: NDRMPW-LAS 11-18 Page I oft

AppIicant/Perinittee: Q;
tw)IBo]4--X.X0
Address: Parcel No.: 7.`7l tvolv�.7.
W)
City: State: CSC Zip Code: _County:
NORTH CAROLINA, 11 kf aa6 e5 c,COUNTY
I+ {Cif [� E-4 rx,+i?—a Notary Public for u t3 e:e50 "_% County, North Carolina,
do hereby certify that 1-14 u t i& &,u personally appeared before me this day
and acknowledged the due execution of the foregoing instrument.
Witness my hand and official seal, this the = day of s v
SEAL /�
L' I
Signature of Notary Public
PUBLIC �
.A Afr commission expires
�kPSON COO'
Once notarized, this form shall be recorded at the Register of Deeds in the county or
counties in which the described properties are located. A copy of the recorded
waiver shall be sent to the following address:
Division of Water Resources
Non -Discharge Branch
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
FORM:NDRMPW-LAS 11-18 Page 2of2

RETURN: ENVIROCHOICE
P.O. Box 390
LUMBERTON, NC 28359
202300889/
ROBESON CO. NC FEE $26.00
PRESENTED & RECORDED:
09-19-2023 02:10:31 PM
"MM VICKI L LOCKLEAR
REGISTER OF ❑EEDS
BY: KARINA DRT1Z
DEPUTY
BK: D 2424
PG: 19-20
State of North Carolina
Department of Environmental Quality
Division of Water Resources
NON -DISCHARGE RESIDUALS MANAGEMENT PROGRAM WAIVER
FOR THE APPLICATION OF CLASS B RESIDUALS
AGREEMENT TO WAIVE SETBACKS PURSUANT TO
15A NCAC 02T .I 108(c)
Tracy E. Bullard
Address. 4169 W Dew Road
City: Rowland
certify that I ain a deeded owner of the property located at:
Parcel No.: 27150102102 & 2715010200)
State: NC' Gip Code: --8383
County: Robeson
Furthermore. I certify that I aln authorized to make decisions regarding this property, and that 1 do hereby
agree that the setback distances cited below be granted to the Applicant/Perniittee listed on the following,
page.
For the parcel identified above, I consent to a reduced setback from 50 feet to 0 feet,
thereby allowing the application of Class B residuals as near as 0 feet from my property line.
❑ For the parcel identified above, I consent to a reduced setback from feet to feet,
thereby allowing the application of Class B. residuals as near as feet from my residence.
I I S WAIVER SHALL BE TERMINATED UPON CHANGE OF OWNERSHIP OF ANY PARTIES INVOLVED*"
Signature:
Date: `'jg gj�1&7av13
FORM: NDRMPW-LAS 11-18 Page 1 of

Applicant/Permittee:
'].rl 1 �01 aa�va l
Address: Parcel No.:
City: �urr,� State: tom_ Zip Cade: _23�6M County:
NORTH CAROLINA, � �1� COUNTY
416 fAA[l . )a� a Notary Public for CAk2&' fug County, North Carolina,
do Hereby certify thatpersonally appeared before me this day
and acknowledged the due execution of the foregoing instrument.
Witness my hand and official seal, this the 0151L, day of 6
4
SEAL
TAMMY C WAGNER
Notary Public
Cabarrus Co., North Carolina
My Commission Expires Mar. 28, 2028
4 -)IVN
Signature of Notary Public
my commission expires rVtQC U 'J
Once notarized, this form shall be recorded at the Register of Deeds in the county or
counties in which the described properties are located. A copy of the recorded
waiver shall be sent to the following address:
Division of Water Resources
Non -Discharge Branch
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
FORM: NDRMPW-LAS 1 1-18 Page 2 of 2

RETURN: ENVIROCHOICE
P.0- BCC 399
LUMBERTON, NC 28359
2023008892
ROBESON CO, NC FEE $2&00
PRESENTED& RECORDED.
09-19-2023 02:10:32 PM
VICKI t_ LOCKLEAR
PEGISItR OF DEEDS
BY: KARINAORTIZ
DEPUTY
BK: ❑ 2424
PG: 21-22
State of North Carolina
Department of Environmental Quality
Division of Water Resources
NON -DISCHARGE RESIDUALS MANAGEMENT PROGRAM WAIVER
FOR THE APPLICATION OF CLASS B RESIDUALS
AGREEMENT TO WAIVE SETBACKS PURSUANT TO
15A NCAC 02T .110$(c)
I Patrick Ballard
Address: 4109 W Dcw Road
City: Rowland
certify that I am a deeded owner of the property located at:
27150102003,27150102105.
Parcel No.: 271501021.27€50102104, 27150102103A
State: NC Zip Code: 283s3
County: Robcsou
Furthermore, I certify that 1 am authorized to make decisions regarding this property, and that I do hereby
agree that the setback distances cited below be granted to the Applicant/Permittee listed on the following
page -
El For the parcel identified: above, I consent to a reduced setback from ;() feet to �, feet,
thereby allowing the application of Class B residuals as near as a feet from my property line.
© For the parcel identified above, I consent to a reduced setback from 400 feet to 150 feet,
thereby allowing the application of Class B residuals as near as 15a feet from my residence.
**THIS WAIVER SHA L BE TERMINATE❑ UPON CHANGE OF OWNERSHIP OF ANY PARTIES INVOLVED**
/�Z)Signature: Date: 5171z_�
FORM: NDRMPW-LAS 11-18 Page I oft

Applicant/Permiiiee: t�{) lie)
Address: 0100 ] a�.)103 A 1171 1a1ao
Parcel No.:
City: rn ` Slate:
Zip Code: County:
NORTH CAROLINA, COUNTY
a Notary Public for County, North Carolina,
do here certify that �(, �1W personally appeared before me this day
and acknowledged the due execution of the foregoing instrument.
Witness my hand and official sea[, this the day of ljrjl.
.tttt►N �11�►��i
SEAL =► �C9
n WOO"
J.
'ZRr A140
G
Signature Notarl• Public
Mt! commissio►r expires i r l - a-+
Once notarized, this form shall be recorded at the Register of Deeds in the county or
counties in which the described properties are located. A copy of the recorded
waiver shall be sent to the following address:
Division of Water Resources
Non -Discharge Branco
1617 Mail Service Center
Raleigh, North Carolina 27699-16I 7
FORM: NDRMPW-LAS 1 1-18 Page 2 of

2023008893
ROBESON CO, NC FEE $26.00
PRESENTED$. RECORDED
09-19-2023 02:10:33 PM
VICKI L LOCKLEAR
•+ter REGISTER OF DUDS
BY,' KARINAORTIZ
RETURN: ENVIROCHOICE = oFrlmgK: D 2424
P.O. BOX 390 PG: 23-24
LUMBERTON, NC 28359
State of North Carolina
Department of Environmental Quality
Division of Water Resources
NON -DISCHARGE RESIDUALS MANAGEMENT PROGRAM WAIVER
FOR THE APPLICATION OF CLASS B RESIDUALS
AGREEMENT TO WAIVE SETBACKS PURSUANT TO
I5A NCAC 02T .I I 08(c)
1, Lyndon A. Bullard certify that I am a deeded owner of the property located at:
Address: 4169 W Dew Road Parcel No.: 27150102002
City: Rowland
State:_NC Zip Code: _2B_3R; Caui)ty: Robeson
Furthermore. I certify that I am authorized to make decisions regarding this properly, and that I do hereby
agree that the setback distances cited below be granted to the Applicant/Permittee listed on the following
page.
© For the parcel identified above, I consent to a reduced setback from 50 feet to u feet,
thereby allowing the application of Class B residuals as near as 0 feet from my property line.
❑ For the parcel identified above, I consent to a reduced setback from feet to feet,
thereby allowing the application of Class B residuals as near as feet from my residence.
"*THIS WAIVER SHALT. BE TEWMINATED UPON CHANGE OF OWNERSHIP OF ANY PARTIES I VOI-VED**
Signature: L
Date:
FORM: NDRMP%'-LAS I 1-18 Page I oft

ApplicantlPermittee:)&�==, I
_J
Pa '
Addres . 13`�,� Parcel No,��q
City. �e�agState: AIC Zip Cade: County:f
NORTH CARQLI<NA,KbDCOUNTY
'-R
a Notary Public for &5DN County, North Carolina,
do hereby certify that W 1• personally appeared before me this day
and acknowledged the due execution of the foregoing instrument.
Witness my hand and official seal, this the day of
a
SEAL ......... ei
•'`407
= ►-L - Signature uf'Notarj, Public
01 .Q ► --77 j
A tr canmrission expires lQ
r'��!!fllklk�l�a
Once notarized, this form shall be recorded at the Register of Deeds in the county or
counties in which the described properties are Iocated. A copy of the recorded
waiver shall be sent to the following address:
Division of Water Resources
Non -Discharge Branch
1617 Mail Service Center
Raleigh, North Carolina 27699-I617
FORM; NDRMPW-LAS I I-18 Page 2of2