WQ0000672_Permit Renewal_20170328

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Water Resources
ENVIRONMENTAL QUALITY -
Wayne Horne = City Manager
City of Lumberton
Post Office. Box .13 88 .
Lumberton, North Carolina 28359
ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
S. JAY-ZIMMERMAN
- Director
March 28, 2017
,l
Subject: Application No. WQ0000672
_ . .... Additional Information. Request
City. of Lumberton REAP .
Residuals Management;.System
Robeson County
Dear Mr: Horne:
Division of. Water Resources' Central and Regional staff has reviewed the application package received .
February 6, 2017. However; additional information isrequired before the review.maybe completed. Please
address the items below no later than the close of business on April- 2017. .
L. In.the 2008. permit, the residuals from.the Lumberton WTP are listed as a residuals source. ,There is no
mention, of this source in -the current: application package: Is -the intention to delete the water treatment
plant as -a source of residuals -or has this omission been an -oversight? If the -intention is delete this as a
source,. please state this explicitly and revise -the submitted Residuals- Source. Facility Summary Form.
If this .is an oversight,, pleaseprovide all .information on the Lumberton .WTP required in -.-Residuals .
Source Certification Form, RSC 08-16. '
2. In the Residuals Source Certification Form, RSC 0841, for the City of Lumberton WWTP, the values
supplied for 2,4-Dinitrotoluene and Hexachlorobenzene are listed as ND (non -detect).- The lab's limit _ .of defection for both 2,4-Dinitrotoluene and Hexachlorobenzene is 0.200 mg/1 'according to the lab
report. This value, however; exceeds the required: limit of 0.13 mg/1 for both. - Therefore, it is not
possible. to determine whether the residuals .are compliant for.these two parameters. Please re -perform
lab assessments for these two -parameters with lower detection limits where it is possible to determine
Whether the residuals'are compliant.
3.. According to the Robeson.County.Tax Office, the owner of FieldNC-RO-18-01.is Bobby Keith P.ittmaw.
(PIN: 034230880000, Parcel Reference Nr: 290901003, DB' 1820,'-Page 134,-8-16-201.1) of-5482'
Singletary Church Road, Lumberton. 28358 and not David Knox McLean (who. sold the. property in
2011). 'Please provide a Land Owner Agreement signed by Mr.'Pittman or indicate that the fields should
no longer -be listed for "residuals application and.make appropriate changes to the Land Application Site
Certification form:
4. According to the Robeson County Tax Office, the owner of Field NC-RO-20-04 is Charles-H.- Brown
(PIN: 937744486.400, Parcel Reference Nr: 181101034, DB. L791, Page 0789, 12-20-2010) of 5478
Lindale Court, Fayetteville, NC 28314 and not Ronald G. Hammohds. Please provide a Land Owner
Agreement signed by Mr. Brown -or indicate. that the ,fields -should no longer be listed for residuals
application and make appropriate changes to the Land Application Site Certification form.
State of North Carolm"a'l Environmental Quality ]-Wafer Resources I Water Quality Permitting I Non -Discharge Permitting
1617 Mail Service Center I Raleigh; North Carolina 27699-1617
919 807 6464

` Mr. Wayne Horne l
March 27, 2017
Page 2 of 2 -
5. According to the Robeson County Tax Office, the. owners of Field NC-RO-20-05 are Eric Locklear and
Karen Locklear,(wife) (PIN: 93.8448987100, Parcel Reference Nr: 201201004, DB 1783, Page 0644,. ,
10-20-2010) of 34.73 Saddletree Road; Lumberton, NC 28360 arid. not Ronald G..Hammonds (who. sold
the property in 2010). - Please provide a -Land .Owner Agreement signed by Mr. or Mrs. Locklear; .or
indicate that the fields should no longer be listed for residuals application and. make appropriate changes
to the Land.Application. Site Certification form... .
6. According to the Robeson.County Tax Office,.the owner of Field NC-RO-20-14 is Taylco Inc. (PIN:
938585967900,. Parcel Reference Nr: 201001002; DB �701; Page 0822, 7-6-2001) of 2643-W. Carthage
Road, Lumberton, NC 28360 with Myra Taylor Norton as President, 4932 White Oak, Lumbertoriand
Keith Taylor as Registered -Agent arid .not .Ronald G: Hammonds. , ; .Please .provide a . Land Owner
Agreement signed by Mr. Taylor or Ms. Norton; or indicate that the fields should no longer be listed
for residuals.application Arid make appropriate changes to the Land Application :Site Certification form.
Please be aware that.you.are responsible for -meeting all requirements. set forth in North Carolina rules and
regulations. Any -oversights that occurred in the review. of the -subject application package are still the
Applicant's.responsibiliN. In -addition;' any omissions made in responding to the outstanding -items above,
or failure to. provide the. additional information on. or before. the :above requested date may. result .in your
application being returned as incomplete.
Please reference the subject application number when providing the. requested information. All revised
and/or additional documentation. shall .be .signed, sealed and .dated .(where' needed), .with .threecopies
submitted to my. attention at the address below. -
If
.you have any questions regarding this -request, please do not hesitate to .contact me at [phone] 'or .
[e-mail]. ' Thank you for your cooperation.
Sincerely; .
Troy Doby, .PE, Engineer.
Division of Water.Resources
cc: Fayetteville Regional Office, Water Quality Regional Operations'Section (Electronic Copy)
Chad M. Hayes — Synagro (Electronic Copy)
Permit Application File WQ0000672

OF W ATFR
State of North Carolina
rJR
epartment of EnvironmentDivision of W teRresources Quality
LAND APPLICATION SITE CERTIFICATION
INSTRUCTIONS FOR FORM: LASC 08-11
c
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 th d
supporting documentation
For more information or for an electronic version of this form, visit the Land Applicr.;:6n Unit (LAU) web9iPg/DW R
http://portaLncdenr. ors/web/wglaps/lay
APR m 6 2017
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 08-11 or FORM: SDR 08-11). WQROS
FAYETTEVILLE REGIONAL OFFIC
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 08-11):
® Submit the completed and appropriately executed Residuals Source Certification (FORM: LASC 08-11) form. Please do not
make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to the
application may be made, as long as the attachments are numbered to correspond to the section and item to which they refer.
® For new or renewed permits, submit the requested information for all land application sites.
® For modified permits, submit the requested information for only those sites that are new, transferred or.affected by the
proposed modification.
( B. Land Application Site Information:
The status of the land application site with respect to this residuals land application program must be provided in table I. The
status categories and their corresponding codes are as follows:
♦ New (N) ♦ Renewed (R) ♦ Modified (M) ♦ Transferred (T) ♦ Deleted (D)
® Attach the following in accordance with each status code:
Status Code
Required Item
N
R
T
M
FYI
✓
County Manager
Notification
21—
Land Owner
Agreement
(If applicable)
w�
Setback Waiver
Agreement
An updated vicinity/setback map in accordance with the "Map Guidance
for Residuals Land Application Permits"
✓
✓
✓
A soils and agronomic evaluation in accordance with the "Soil Scientist
✓
Evaluation Policy'
An updated accounting of the land application site's cumulative
pollutant loading rates (CPLRs)
INSTRUCTIONS FOR FORM: LASC 08-11 Page 1 of 3

Required Item
Status Code
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 Permittee relinquishing field
✓
Acknowledgement of field transfer from Land Owner (Fields may not
✓
be permitted to multiple Permittees over the same time period)
* This item may be required for land application site with a status code "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)
• 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)
C. Waterbody and Classifications Information: (new sites only)
❑ Use an 8.5 by 11-inch copy of the portion of a 7.5-minute USGS Topographic Map to identify the location where the
residuals program activities are planned to occur as well as the closest downslope surface waters as clearly as possible. Each
map portion must be labeled with the map name and number, the identified location, and be of clear and reproducible quality.
❑ Surface water body classifications information may be found at: hq://portal.ncdenr.org(web/wq/ps/csu
❑ 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:
hiip://portal.ncdenr.ora/web/wq/home/ro
❑ 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 hM://h2o.enr.state.nc.us/bims/reports/reportsWB.html. If this link does not work, open
http://portal.ncdenr.or web/wq/s/csu/classifications and download weekly -updated classification lists for named
waterbodies.
_\ ❑ Stream Classification Process: One of the options below may be used depending on the known initial project information.
�i ❑ 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.
2. Locate the name of the identified waterbody (from General Directions) on the list.
INSTRUCTIONS FOR FORM: LASC 08-11 Page 2 of 3

3. For multiple listings of the same waterbody name in the report, select and verify the location description. The term
"source" in the description means the beginning of the waterbody segment (most upstream point).
4. Record all Basins, Stream Index Numbers and Classifications applicable to the project.
❑ KNOWN COUNTY WHERE CLOSEST DOWN SLOPE SURFACE WATER IS LOCATED
1. Select the proper county from the List all Waterbodies in county, hydrologically report.
2. Locate the name of the identified waterbody (from General Directions) on the list.
3. For multiple listings of the same waterbody name in the report, select and verify the location description. The term
"source" in the description means the beginning of the waterbody segment (most upstream point).
4. Record all Basins, Stream Index Numbers and Classifications applicable to the project.
❑ UNKNOWN BASIN WHERE CLOSEST DOWN SLOPE SURFACE WATER IS LOCATED
1. Use the Clickable basin map to hydrologically sorted list report.
2. Click on the approximate project location to bring up the hydrologically sorted list.
3. Locate the name of the identified waterbody (from General Directions) on the list.
4. For multiple listings of the same waterbody name in the report, select and verify the location description. The term
"source" in the description means the beginning of the waterbody segment (most upstream point).
5. Record all Basins, Stream Index Numbers and Classifications applicable to the project.
❑ Notes on index number and unnamed streams:
Unnamed Streams 15A NCAC 02B .0301(i).
❑ Any stream which is not named in the schedule of stream classifications carries the same classification as that assigned
to the stream segment to which it is tributary (at the point of entry) except:
(A) unnamed streams specifically described in the schedule of classifications;
(B) unnamed freshwaters tributary to tidal saltwaters will be classified "C; or
(C) after November 1, 1986, any newly created areas of tidal saltwater which are connected to Class SA waters by
approved dredging projects will be classified "SC' unless case -by -case reclassification proceedings are conducted.
❑ The following river basins have different policies for unnamed streams entering other states or for specific areas of the
basin:
Unnamed Tributaries Entering Other States or for Specific Basin Areas
Hiwassee River Basin
Streams entering Georgia or Tennessee shall be classified "C Tr."
Little Tennesse River
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 08-11 Page 3 of 3

LAND APPLICATION SITE CERTIFICATION
Applicant's name: City of Lumberton
Land application sites currently certified: 1695.6 net acres and Total to be certified: _ net acres.
I. LAND APPLICATION SITE INFORMATION (See Instruction B):
Status
Code'
Site/Field ID
Landowner() s
or O s
Lessee() Operator(s)
Net Acres
County
Coun
s)
Crop(s)
Predominant Soil
Series Name b
Mapping Unit
or Rep. Slope
D
NC-RO-19-01,
Jennings Hayes
Same
20.7
Robeson
D
NC-RO-19-05
Jennings Hayes
Same
7.4
Robeson
D
NC-RO-19-08
Jennings Hayes
Same
12.7
Robeson
D
NC-RO-19-09
Jennings Hayes
Same
11.9
Robeson
D
NC-RO-19-10
Jennings Hayes
Same
18.6
Robeson
D
NC-RO-19-11
Jennings Hayes
Same
13.3
Robeson
D
NC-RO-19-12
Jennings Hayes
Same
30.2
Robeson
D
NC-RO-19-13A
Jennings Hayes
Same
22.0
Robeson
a Status Code for land application sites are: ♦ N (New) ♦ R (Renewed) o 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)
H. WATERBODY AND CLASSIFICATIONS INFORMATION (See Instruction C):
Site/Field ID
Latitude
Longitude
Location
Datum
Location Method Code
Location Accuracy
Waterbody Subbasin and
Stream Index No.
Current and Proposed
p
Class
Do ❑' Fill
110 11 � j,
NAD 83
ADD
Nearest Second
E° ❑' Ell
Cj° F1' D,
NAD 83
ADD
Nearest Second
C�
0
[]° Fj' L'j"
[]° r j' Fjj"
NAD 83
ADD
Nearest Second
0
0
G'° C j' G'"
Cj° Cj' F71"
NAD 83
ADD
Nearest Second
0
D 11, E?
Do 11, D,
NAD 83
ADD
Nearest Second
�
0
0
❑° 1 j' D,
rl' FIj"
NAD 83
ADD
Nearest Second
0
0
E? [1, D,
❑' F"
NAD 83
ADD
Nearest Second
]°
[]0
NAD 83
ADD
Nearest Second
Note: Please keep the site information (I.) and waterbody information (II.) of the same field on the same page.
FORM: LASC 08-11
Page 1

LAND APPLICATION SITE CERTIFICATION
Applicant's name: City of Lumberton
Land application sites currently certified: 1695.6 net acres and Total to be certified: _ net acres.
I. LAND APPLICATION SITE INFORMATION (See Instruction B):
Status
Code°
Site/Field ID
Landowners
()
Ls O s
Lessee(s) (� or Operator(s) ()
NA
et Acres
County
C
s
Crop(s) P()
Predominant Soil
Series Name b
Mapping Unit
or Rep. Slope'
D
NC-RO-19-13B
Jennings Hayes
Same
28.3
Robeson
D
NC-RO-19-15
Jennings Hayes
Same
17.2
Robeson
D
NC-RO-19-20
Jennings Hayes
Same
111.8
Robeson
D
NC-RO-19-21
Jennings Hayes
Same
18.6
Robeson
D
NC-RO-19-22
Jennings Hayes
Same
50.6
Robeson
D
NC-RO-19-23
Jennings Hayes
Same
26.0
Robeson
D
NC-RO-19-25
Roland Pittman
Jennings Hayes
29.4
Robeson
D
NC-RO-19-29
Alfred M Pittman
Jennings Hayes
2.6
Robeson
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)
H. WATERBODY AND CLASSIFICATIONS INFORMATION (See Instruction C):
Site/Field ID
Latitude
Longitude
Location
Datum
Location Method Code
Location Accuracy
Waterbody Subbasin and
Stream Index No.
Current and Proposed
p
Class
�'O D Fit,
G'O �j' C"
NAD 83
ADD
Nearest Second
Ij° El, Q,
[]° F"
NAD 83
ADD
Nearest Second
0
00 0' Q"
Cj° ❑' 7j'"
NAD 83
ADD
Nearest Second
�
0
[]o G'' r j"
[]° rf F"
NAD 83
ADD
Nearest Second
0
C° 11, D,
rj'° Cj' C'j"
NAD 83
ADD
Nearest Second
C�
G'O Ej' Cj"
[]' E"
NAD 83
ADD
Nearest Second
L�
[]o []' E]"
r j° C j' ❑"
NAD 83
ADD
Nearest Second
��
0
�]
❑° 0' D,
E? 0' D,
NAD 83
ADD
Nearest Second
[�
0
Note: Please keep the site information (I.) and waterbody information (II.) of the same field on the same page.
FORM: LASC 08-11
Page 2

LAND APPLICATION SITE CERTIFICATION
Applicant's name: City of Lumberton
Land application sites currently certified: 1695.6 net acres and Total to be certified: _ net acres.
I. LAND APPLICATION SITE INFORMATION (See Instruction B):
Status
Code°
Site/Field ID
Landowners
()
Lessees or Operator(s)
()
Net Acres
CountyCrop(s)
Predominant Soil
Series Nameb
Mapping Slope'
or Rep. Slope
D
NC-RO-19-30
Alfred M Pitmman
Same
12.2
Robeson
D
NC-RO-19-34
Jennings Hayes
Same
28.1
Robeson
D
NC-RO-19-35
Jennings Hayes
Same
23.6
Robeson
D
NC-RO-19-36
Jennings Hayes
Same
12.6
Robeson
D
NC-RO-19-37
Jennings Hayes
Same
11.6
Robeson
D
NC-RO-19-38
Jennings Hayes
Same
20.8
Robeson
D
NC-RO-22-01
F K Biggs
Dexter Locklear
8.9
Robeson
D
NC-RO-22-02
F K Biggs
Dexter Locklear
44.9
Robeson
° 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)
H. WATERBODY AND CLASSIFICATIONS INFORMATION (See Instruction C):
Site/Field ID
Latitude
Longitude
Location
Datum
Location Method Code
Location Accuracy
Waterbody Subbasin and
Stream Index No.
Current and Proposed
p
Class
D D'
NAD 83
ADD
Nearest Second
0
[�
]° E]'[]"
C j° [71' 7"
NAD 83
ADD
Nearest Second
0
Lj° 11, D,
�'j° ❑' 71"
NAD 83
ADD
Nearest Second
[loll, ❑"
Do [1, D,
NAD 83
ADD
Nearest Second
0
0
E'° 11, D,
Cj° [j' OF,
NAD 83
ADD
Nearest Second
0
]° ❑' E]"
Cj° ❑' ❑"
NAD 83
ADD
Nearest Second
0
0
j° El' D,
Cj° 0' 7j"
NAD 83
ADD
Nearest Second
0
[�
Ej° E j' D,
D E, D,
NAD 83
ADD
Nearest Second
FORM: LASC 08-11
Page 3

LAND APPLICATION SITE CERTIFICATION
Note: Please keep the site information (I.) and waterbody information (II.) of the same field on the same page.
Applicant's name: City of Lumberton
Land application sites currently certified: 1695.6 net acres and Total to be certified: _ net acres.
I. LAND APPLICATION SITE INFORMATION (See Instruction B):
Status
Code'
Site/Field ID
Landowner() s
Lessee() Operator(s) or O s)
Net Acres
County
s)
Crop(s)
Predominant Soil
Series Nameb
Mapping Unit
or Rep. Slope'
D
NC-RO-22-03
F K Biggs
Dexter Locklear
26.0
Robeson
D
NC-RO-27-01
F K Biggs
Chris McClean
22.7
Robeson
D
NC-RO-27-02
F K Biggs
Chris McClean
16.4
Robeson
D
NC-RO-27-06
F K Biggs
Chris McClean
35.9
Robeson
D
NC-RO-27-07
F K Biggs
Chris McClean
35.2
Robeson
D
NC-RO-37-01
Michael McCarthy
Danny Smith
3.1
Robeson
D
NC-RO-37-02
Michael McCarthy
Danny Smith
8.4
Robeson
D
NC-RO-37-03
Danny Smith
Danny Smith
8.9
Robeson
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)
H. WATERBODY AND CLASSIFICATIONS INFORMATION (See Instruction C):
Site/Field ID
Latitude
Longitude
Location
Datum
Location Method Code
Location Accuracy
Waterbody Subbasin and
Stream Index No.
Current and Proposed
Class
U° ❑' []"
[]0 7' 71"
NAD 83
ADD
Nearest Second
11011, Q,
[]- Cj' []"
NAD 83
ADD
Nearest Second
0
G° Cj' Lj"
[]0 []' []"
NAD 83
ADD
Nearest Second
0
[]° ]' C]"
[]0 []' F111
NAD 83
ADD
Nearest Second
0
? Elf []"
110 C j' D"
NAD 83
ADD
Nearest Second
0
[]° []' []"
[]0 j' 7f'
NAD 83
ADD
Nearest Second
[]0 � j' C j"
[]- []' Fill
NAD 83
ADD
Nearest Second
�'° C j' D"
1110C J' C j"
NAD 83
ADD
Nearest Second
FORM: LASC 08-11
Page 4

LAND APPLICATION SITE CERTIFICATION
Applicant's name: City of Lumberton
Land application sites currently certified: 1695.6 net acres and Total to be certified: _ net acres.
I. LAND APPLICATION SITE INFORMATION (See Instruction B):
Status
Code"
Site/Field ID
Landowners
()
Lessees or Operator(s)
()
Net Acres
Count Y
Crop(s) s
P()
Predominant Soil
Series Name b
Mapping Unit
or Rep. Slope'
D
NC-RO-37-04
Phillip B Culbreth
Danny Smith
15.1
Robeson
D
NC-RO-37-05
Phillip B Culbreth
Danny Smith
4.1
Robeson
D
NC-RO-37-06
Phillip B Culbreth
Danny Smith
4.4
Robeson
D
NC-RO-16-20
Thomas Maynor
Ozell Baker
8.6
Robeson
D
NC-RO-16-21
Thomas Maynor
Ozell Baker
25.0
Robeson
D
NC-RO-38-01
Leroy Harris
Ray Locklear
11.6
Robeson
Hay
Norfolk
NoA
D
NC-RO-38-02
Leroy Harris
Ray Locklear
19.4
Robeson
Hay
Norfolk
NoA
R
NC-RO-16-01
Ozell Baker
Same
16.9
Robeson
Pasture
Rains Sandy
Ra
R
NC-RO-16-02
Ozell Baker
Same
3.6
Robeson
Pasture
Goldsboro
GoA
R
NC-RO-16-03
Ozell Baker
Same
3.4
Robeson
Pasture
Goldsboro
GoA
'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)
H. WATERBODY AND CLASSIFICATIONS INFORMATION (See Instruction C):
SitefField ID
Latitude
Longitude
Location
Datum
Location Method Code
Location Accuracy
Waterbody Subbasin and
Stream Index No.
Current and Proposed
P
Class
Ej°
L'1° � j L'j"
NAD 83
ADD
Nearest Second
11, Ell D"
[ jj° []' L'1"
NAD 83
ADD
Nearest Second
0
0
D ❑' D,
110 11' D,
NAD 83
ADD
Nearest Second
0
t�
E]° Cj' [ j"
[]0 []' pi"
NAD 83
ADD
Nearest Second
❑° ❑' D"
Fj° []' ]"
NAD 83
ADD
Nearest Second
�]
C j° 0' []"
[J° F' F711'
NAD 83
ADD
Nearest Second
❑°
[]°
NAD 83
ADD
Nearest Second
FORM: LASC 08-11
Page 5
/J�

LAND APPLICATION SITE CERTIFICATION
El- El, Dj" I E]- Ej' [ j" 1 NAD 83 1 ADD Nearest Second
FORM: LASC 08-11
Page 6

LAND APPLICATION SITE CERTIFICATION
Applicant's name: City of Lumberton
Land application sites currently certified: 1695.E net acres and Total to be certified: _ net acres.
I. LAND APPLICATION SITE INFORMATION (See Instruction B): .
Status
Code°
Site/Field ID
Landowneressee
(s)
L(s) O s p ()
or Operator(s)
et Acres
NA
Cty
County
Crop(s)
Predominant Soil
Series Name b
Mapping Unit
or Rep. Slope'
R
NC-RO-16-04
Ozell Baker
Same
3.6
Robeson
Pasture
Rains sandy
RA
R
NC-RO-16-05
Ozell Baker
Same
8.7
Robeson
Hay
Rains Sandy
RA
R
NC-RO-16-06
Ozell Baker
Same
14.8
Robeson
Hay
Norfolk
NoA
R
NC-RO-16-07
Ozell Baker
same
17.5
Robeson
Row Crop
Norfolk
NoA
R
NC-RO-16-08,
Ozell Baker
Same
7.6
Robeson
Pasture
Wagram
WaB
M
NC-RO46-16
Campen Farms
Ozell Baker
5.0
Robeson
Hay
Wagram
WaB
M
NC-RO-16-17
Campen Farms
Ozell Baker
6.0
Robeson
Hay
Wagram
WaB
M
NC-RO-16-18
Campen Farms
Ozell Baker
12.3
Robeson
Hay
Wagram
WaB
'Status Code for land application sites are: ♦ N (New) ♦ R (Renewed) o 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 a2-8% slope Cecil in Anson County the mapping unit is Cel32)
H. WATERBODY AND CLASSIFICATIONS INFORMATION (See Instruction C):
Site/Field ID
Latitude
Longitude
Location
Datum
Location Method Code
Location Accuracy
Waterbody Subbasin and
Stream Index No.
Current and Proposed
p
Class
NAD 83
ADD
Nearest Second
❑' Ej"
Cj° []' Cj"
NAD 83
ADD
Nearest Second
0
Q° 1 j' D,
D Fj' D,
NAD 83
ADD
Nearest Second
0
0
0
110 ❑' 11"
110 ❑' 0"
NAD 83
ADD
Nearest Second
Uj° 11, D"
❑° 11, ❑"
NAD 83
ADD
Nearest Second
0
00 ❑' D"
[I° �f D"
NAD 83
ADD
Nearest Second
❑° O' Cj"
[ j'° []' ]"
NAD 83
ADD
Nearest Second
0
0
[j° 0' D"
[]° E]l Cj"
NAD 83
ADD
Nearest Second
FORM: LASC 08-11
Page 7

LAND APPLICATION SITE CERTIFICATION
Applicant's name: City of Roxboro
Land application sites currently certified: 1695.6 net acres and Total to be certified: - net acres.
III. LAND APPLICATION SITE INFORMATION (See Instruction B):
Predominant Soil
Status
Code"
Site/Field ID
r n
Landowner(s)
(s)
or O erator
L(s) s P ()
Net Acres
Count y
Crop(s)
Series Name b
Mapping Unit
or Rep. Slope`
M
NC-RO-16-19
Campen Farms
Ozell Baker
1.6
Robeson
Hay
Wagram
WaB
R
NC-RO-17-01
City of Lumberton
Delois Allen
36.4
Robeson
Row Crop
Johns Sandy
Jo
R
NC-RO-17-02
City of Lumberton
Delois Allen
25.4
Robeson
Row Crop
Lumbee sandy
Lu
R
NC-RO-17-03
City of Lumberton
Delois Allen
28
Robeson
Row Crop
Lumbee sandy
Lu
loam
R
NC-RO-17-04
City of Lumberton
Delois Allen
47.7
Robeson
Row Crop
Johns Sandy
Jo
Loam
M
NC-RO-18-01
Bobby Keith Pittman
same
16.6
Robeson
Row Crop
Wagrsand am loamy
WaB
M
NC-RO-18-02
McLean, David Knox
same
49.3
Robeson
Row Crop
Norfolk loamy
NoA
sand
M
NC-RO-20-03
R G Hammonds
same
24.9
Robeson
Pasture
Wakulla sand
WkB
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)
IV. WATERBODY AND CLASSIFICATIONS INFORMATION (See Instruction C):
Site/Field ID
Latitude
Longitude
Location
Datum
Location Method Code
Location Accuracy
Waterbody Subbasin and
Stream Index No.
Current and Proposed
P
Class
D 11, E?
[]°
NAD 83
ADD
Nearest Second
�° j' �"
G'°' ❑"
NAD 83
ADD
Nearest Second
NAD 83
ADD
Nearest Second
❑' E?
0° [1' 5"
NAD 83
ADD
Nearest Second
0
r j° ❑' 0"
]° [].1
NAD 83
ADD
Nearest Second
11011,1111
D Ej' D"
NAD 83
ADD
Nearest Second
L _
0- D E j?
D 11, D,
NAD 83
ADD
Nearest Second
FORM: LASC 08-11
Page 8
0

LAND APPLICATION SITE CERTIFICATION
IE'° 11' C j" Cj° 0' []" NAD 83 1 ADD Nearest Second
Applicant's name: City of Lumberton
Land application sites currently certified: X net acres and Total to be certified: X net acres.
I., LAND APPLICATION SITE INFORMATION (See Instruction B):
Predominant Soil
Status
Codes
Site/Field ID
Landowner(s)
Lessee(s) or Operator(s)
Net Acres
County
Crop(s)
Series Name b
Mapping Unit
or Rep. Slope°
M
NC-RO-20-04
Charles H. Brown
R.G. Hammonds
31.2
Robeson
Hay
Wakulla sand
WkB
NC-RO-20-
Eric and Karen Locklear
Robeson
Goldsboro loamy
D
05
RG Hammonds
33.6
Hay
sand
GoA
R
N6C-RO-20-
R G Hammonds,
Same
6.7
Robeson
Row Crop
Norfolk loamy sand
NoA
R
R G Hammonds
Same
13
Robeson
Row Crop
Goldsboro loamy
GoA
ON7C-RO-20-
sand
R
R G Hammonds
Same
73.2
Robeson
Row Crop
Goldsboroloamy
GoA
8C-RO-20-
R
NC-RO-20-
Taylco c/o Keith Taylor
R G Hammonds
10.6
Robeson
Row Crop
Goldsboro loamy
GoA
14
sand
M
NC-RO-21-01
Fannie Oxendine
Lacy Cummings
36.1
Robeson
Row Crop
Norfolk loamy sand
NoA
M
NC-RO-21-02A
Fannie Oxendine
Lacy Cummings
38.4
Robeson
Row Crop
Norfolk loamy sand
NoA
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)
II. WATERBODY AND CLASSIFICATIONS INFORMATION (See Instruction C):
SitefField ID
Latitude
Longitude
Location
Datum
Location Method Code
Location Accuracy
Waterbody Subbasin and
Stream Index No.
Current and Proposed
p
Class
['j° G' E"
Ej° rl G'"
NAD 83
ADD
Nearest Second
0
C j° ❑' D,
[]° F j' Fill
NAD 83
ADD
Nearest Second
0
[]O []' ,If
NAD 83
ADD
Nearest Second
0
��
IJ° El, D,
[ 0 E], Cl,
�
NAD 83
ADD
Nearest Second
0
L
[�]
[]° �' �"
�,
0
[]' ' Fill
NAD 83
ADD
Nearest Second
110 11, D,
❑° []' F"
NAD 83
ADD
Nearest Second
00 ❑' � j ,
110 E' D,
NAD 83
ADD
Nearest Second
FORM: LASC 08-11 Page 9

LAND APPLICATIONSITE CERTIFICATION
0 Ef ❑' [ - Ej° E1' Cj" NAD 83 ADD Nearest Second L� 0
Note: Please keep the site information (I.) and waterbody information (II.) of the same field on the same page.
Applicant's name: City of Lumberton
Land application sites currently certified: X net acres and Total to be certified: X net acres.
I. LAND APPLICATION SITE INFORMATION (See Instruction B):
Status
Code"
Site/Field.ID
Landowners
()
Lessees or Operator(s)
()
Net Acres
County
tY
Crop(s) s
P()
Predominant Soil
Series Name b
Mapping Unit
or Rep. Slope°
M
NC-RO-21-02B
Fannie Oxendine
Lacy Cummings
5.1
Robeson
Row Crop
Wagram loamy sand
WaB
M
NC-RO-21-03
Fannie Oxendine
Lacy Cummings
3.4
Robeson
Row Crop
Wagram loamy sandl
WaB
M
NC-RO-21-04
Fannie Oxendine
Lacy Cummings
11.3
Robeson
Row Crop
Wagram.loamy sand
WaB
M
NC-RO-21-05
Fannie Oxendine
Lacy Cummings
15.1
Robeson
Row Crop
Goldsboroloamy
sand
GoA
R
NC-RO-28-01
Robert Baskerville
Carnell Locklear
11.6
Robeson
Row Crop
Dunbar sandy loam
Dn
R
NC-RO-28-02
Robert Baskerville
Carnell Locklear
56.9
Robeson
Row Crop
Rains Sandy Loam
Ra
R
NC=RO-28-03
Robert Baskerville
Carrell Locklear
10.4
Robeson
Row Crop
GoldsboorroSandy
GoA
R
NC-RO-39-OIA
Barbara Bullard
Patrick Bullard
5.3
Robeson
Pasture
Goldsboro Loamy
GoA
R
NC-RO-39-O I B
Barbara Bullard
Patrick Bullard
2.6
Robeson
Pasture
Goldsboro Loamy
Rnnd
GoA
R
NC-RO-39-02
Barbara Bullard
Patrick Bullard
1.4
Robeson
Pasture
Goldsboro Loamy
Sand
GoA
R
NC-RO-39-03
Quindale Bullard
Patrick Bullard
5.1
Robeson
Pasture
Rains Sandy Loam
Ra
R
NC-RO-39-04
Quindale Bullard
Patrick Bullard
14.8
Robeson
Hay
Lynchburg Sandy
Ly
'Status Code
for land anplication
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)
II. WATERBODY AND CLASSIFICATIONS INFORMATION (See Instruction C):
Site/Field ID
Latitude
Longitude
Location
Datum
Location Method Code
Location Accuracy
Waterbody Subbasin and
Stream Index No.
Current and Proposed
P
Class
El° 11, D,
D Lj' D,
NAD 83
ADD
Nearest Second
0
— C�-
—�'O ❑''-�j"—
—[ j° ❑' ❑"—
NAD 83
ADD
Nearest Second
0
110 El, D
� - El' D,
NAD 83
ADD
Nearest Second
�
C_
FORM: LASC 08-11
Page 10
L�

LAND APPLICATION SITE CERTIFICATION
L�
�° ❑' Ej"
[]° O' Cj'
NAD 83
ADD
Nearest Second
��
�'j° ❑' [�j"
[j° L j' j"
NAD 83
ADD
Nearest Second
D 11, D,
11° 11, D"
NAD 83
ADD
Nearest Second
0
1:1O D ❑"
Q° []' ❑"
NAD 83
ADD
Nearest Second
E.11' 111,
� ;° 11' []"
NAD 83
ADD
Nearest Second
0
[�
Applicant's name: City of Robeson
Land application sites currently certified: X net acres and Total to be certified: X net acres.
I. LAND APPLICATION SITE INFORMATION (See Instruction B):
Status
Code"
Site/Field ID
Landowners
()
Lessees or Operator(s)
()
Net Acres
County
�'
Crop(s) s
p()
Predominant Soil
Series Name b
Mapping Unit
or Rep. Slope'
R
C-RO-39-05
Barbara Bullard
Patrick Bullard
3.8
Robeson
Hay
Lynchburg Sandy
Loam
Ly
R
C-RO-39-06
Barbara Bullard
Patrick Bullard
2.9
Robeson
Hay
Wagr and°amy
WaB
R
C-RO-39-07
Lyndon Bullard
Same
3.7
Robeson
Hay
Goldsboro Loamy
GoA
R
C-RO-39-08
Lyndon Bullard
Same
7.4
Robeson
Hay
Norfolk Loamy Sand
NoA
R
C-RO-39-09
Tracy Bullard
Same
62.5
Robeson
Hay
Wagram Loamy
WaB
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)
H. WATERBODY AND CLASSIFICATIONS INFORMATION (See Instruction C):
Site/Field ID
Latitude
Longitude
Location
Datum
Location Method Code
Location Accuracy
Waterbody Subbasin and
Stream Index No.
Current and Proposed
p
Class
E'° D' D,
[_]° ❑' Fj"
NAD 83
ADD
Nearest Second
0
�
— °_❑,_�„—
—G° �, �'„—
NAD 83—
—ADD—
—Nearest-rest
_ __
Ej° 11' r '"
I NAD 83
ADD
Nearest Second
FORM: LASC 08-11
Page 11

3
State of North Carolina
Department of Environmental Quality
Division of Water Resources
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 land checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information Irequested. 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 — Tl is 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!
i
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 undersigi ed landowner or his rep esentative hereby permits:
Applicant's name: O `}—
hereinafter referred to as the Permittee, to land' apply residuals from the following facility(ies) onto the following land
application site(s) (i.e., see attached setback maps) in accordance with the stipulations and restrictions as given in this
Agreement:
Site/Field ID
Lease
(yes/no)
Land Use or
Cropping Patterns
Intended Use of Crops
Residuals Source
(optional)
Special note
(no-till/over-seed/
pasture)
'
I
I
i
I
I
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.
I

I. STIPULATIONS:
1. Thp 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.
III. ALTERNATIVES FOR WATER SUPPLY WELLS INSIDE THE COMPLIANCE BOUNDARY: (please check one)
15A NCAC 02L .0107(d) prohibits water supply wells within the compliance boundary. However, 15A NCAC O2T .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 delegatibii,,-,to,make decisions regarding the use of the land application site(s) on behalf of the
deeded'1'andowners.. I certify .that the above-refer'eftced 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: v i
Address:
/f,-I-,- of
City: eLI✓�,0 G✓�l//� State: AG, Zip:
Phone: Z-/0 47 / 3 E-mail address: / %Iv 71)o, e4 -Xc-j)i/
5C Signature: - �i✓`- Date:
NORTH CAROLINA, COUNTY
I, the undersigned Notary Public do hereby certify that 1C
personally appeared before me this day and acknowledged the due execution of the forgoing instrument..
WITNESS my hand and official seal this the 1 1�p:M)_Hq,J;',�i�:c�
day of 20 L 7
p1' "'A
Signature and seal: fUL = n : `_ • +� �� "' _,
`8��U:�
My commission expires: •
Lessee's/Operator's Certification:
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Lessee/operator name:
Address:
City:
Phone:
Signature:
Permittee's Certification:
State:
E-mail 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: 0. f •Z 0J e_
Signature: a c_ Date-
FORM: LOA 06-16 Page 3 of 3

f
- THw
Divlslon of Water Resources
State of Forth Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T -�100 — 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):
to 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.
[X 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:
C3 l
Applicant's name: _ lI c� CI.
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
Residuals Source Special note
Intended Use of Crops no-till/over-seed/
(optional
_ t►as�ure)
Roo o-- v q
es
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.

I. oTIPULA.TIONS:
1. The landowner or his representative shall not enter into any additional residuals application contracts or agreements with another permitted
entity for the site(s) specified by this Agreement.
2. Should the landowner or his representative lease or otherwise permit the use of the land application site(s) to a third party; the landowner shall
be responsible to ensure that the third party agrees and complies with the terms and conditions of this Agreement.
3. The landowner or his representative shall adhere to the provisions of this Agreement until all of the site restrictions (under Section II) are met.
4. Notification of cancellation of this Agreement shall be immediately forwarded to NCDENR-DWR, Non -Discharge Permitting Unit, 1617
Mail Service Center, Raleigh, NC 27699-1617.
5. The Permittee must request and obtain a permit modification from the Division prior to a transfer of the land application site(s) to a new
landowner. In addition, the current landowner shall give a notice to the new landowner that gives full details of the residuals applied at the
land application site(s).
6. The Permittee has provided the landowner or his representative with information and data concerning the residuals land application program,
including an analysis of constituents of the residuals, residuals application methods, schedules for typical cropping patterns, a description of
the equipment used by the Permittee.
7. The Permittee will provide the landowner or his representative with a copy of the residuals permit prior to commencement of any residuals
land application event and a copy of the results of each soil analysis.
8. If the soil pH of the land application site(s) is not maintained at 6.0 or greater, sufficient amounts of lime shall be applied to achieve a final
soil pH of at least 6.0, unless an agronomist provides information indicating that the pH of the soil, residuals and lime mixture is suitable for
the specified crop.
9. The landowner or his representative and the Permittee will agree on residuals application rates and schedules based on crop patterns, results of
soil samples, and the permitted application limits.
10. The landowner or his representative will provide the Permittee with information regarding the amount and analysis of other sources of
nutrients (e.g., fertilizer, unregulated animal waste, etc.) that have been applied to the land application site(s).
11. The landowner or his representative will inform the Permittee of any revisions or modifications to the intended use and cropping patterns for
the land application. site(s) prior to each planting season to enable the Permittee to amend this Agreement and schedule residuals land
application events at appropriate periods.
12. Specific residuals land application area boundaries shall be clearly marked on the land application site(s) by the Permittee, the landowner, or
his representative prior to and during a residuals land application event.
13. The landowner or his representative hereby authorizes the Permittee, local officials, and State officials or their representatives to; enter and
inspect any property, premises, or place on or related to the land application site(s) at any reasonable time for the purpose of determining
compliance with the permit; establish monitoring facilities on or near the land application site(s) as required by the permit; copy any records
that must be kept under the terms and conditions of the permit; take necessary leachate, surface water, groundwater, or soil samples during the
term of, and 12 months after termination of, this Agreement.
II. RESTRICTIONS:
1. Appropriate measures must be taken by the Permittee and/or the landowner or his representative to control public access to the land
application site(s) during active use and for the 12-month period following a residuals land application event. Such controls may include the
posting of signs that indicate the activities being conducted at the land application site(s).
2. Animals shall not be grazed on the land application site(s) for a 30-day period following a residuals land application event. Land application
sites that are to be used for grazing shall have fencing that will be used to prevent access during these periods after such residuals land
application events.
3. Food crops, feed crops, and fiber crops shall not be harvested for a 30-day period following a residuals land application event.
4. Food crops with harvested parts that touch the residuals/soil mixture and are totally above the land surface shall not be harvested for a 14-
month period following a residuals land application event.
-----nnrl rrnnc with harvested nartc hPlnw the mnrface of the land shall not be harvested for a 20_month ueriod_follo_wing_a residuals,land
z
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.
M. 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.
Address: ���7P Z 7 Wa l e, ,%Ci6/�P r�
City: 6Q n'e Z l State: )Vr, zip: 5j./j�-
Phone: l�' . - / -E-mailaddress: -
=^�
aturDate:
= NORTH CARgOLINA, O
I, the undersigned Notary Public do hereby certify that
pers6nally appeared before me this day and acknowledged the due execution of the forgoing instrument.
WITNESS my hand and official seal this the
clay of , 20
Signature and'seal:
"My commissign'expires:
Lessee's/Operator's Certification:
I certify that I have read thi�S,.,Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
IV
Address:
City: Lo"It _J A)
Phone: [L) - 7nn3
Signature: (�
Permittee's Certification:
State: A - C- zip: (%
E-mail address:
Date: 7—Co - 17
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Signing officialZ
e- b&V �^��
Signature:a cr 74 Date: P /�
FORM: LOA 06-16 Page 3 of 3

1
i

DW,
Divlsion of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T A 100 — 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
sporting 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 .I 100. Do -not
submit this agreement for review without a corresponding application form (FORM: RLAP 06-16).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Land Owner Agreement (FORM: LOA 06-16):
Submit the completed and appropriately executed Land Application Site Certification (FORM: LASC 06-16) form. Please
do not make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments
to the application may be made, as long as .the attachments are numbered to correspond to the section and item to which they
refer.
Prepare a separate agreement for each set of land application sites that are owned or operated by an entity other than the
Applicant.
® A copy of the completed and appropriately executed agreement must be provided to the landowner and the lessee/operator. -
AGREEMENT FOR THE LAND APPLICATION OF RESIDUALS TO PRIVATELY OWNED LAND
The undersigned landowner or his representative hereby permits:
/1 1 0 1 t _J_-_
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)
eS
k6�vi
The landowner or his. representative receives, inconsideration, 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.

I: STIPULATIONS:
1. The landowner or his representative shall not enter into any additional residuals application contracts or agreements with another permitted
entity for the site(s) specified by this Agreement.
2. Should the landowner or his representative lease or otherwise permit the use of the land application site(s) to a third party, the landowner shall
be responsible to ensure that the third party agrees and complies with the terms and conditions of this Agreement.
3. The landowner or his representative shall adhere to the provisions of this Agreement until all of the site restrictions (under Section II) are met.
4. Notification of cancellation of this Agreement shall be immediately forwarded to NCDENR-DWR, Non -Discharge Permitting Unit, 1617
Mail Service Center, Raleigh, NC 27699-1617.
5. The Permittee must request and obtain a permit modification from the Division prior to a transfer of the land application site(s) to a new
landowner. In addition, the current landowner shall give a notice to the new landowner that gives full details of the residuals applied at the
land application site(s).
6. The Permittee has provided the landowner or his representative with information and data concerning the residuals land applicationprogram,
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 Pennittee will agree on residuals application rates and schedules based on crop patterns, results of
soil samples, and the permitted application limits.
10. The landowner or his representative will provide the Permittee with information regarding the amount and analysis of other sources of
nutrients (e.g., fertilizer, unregulated animal waste, etc.) that have been applied to the land application site(s).
11. The landowner or his representative will inform the Permittee of any revisions or modifications to the intended use and cropping patterns for
the land application site(s) prior to each planting season to enable the Permittee to amend this Agreement and schedule residuals land
application events at appropriate periods.
12. Specific residuals land application area boundaries shall be clearly marked on the land application site(s) by the Permittee, the landowner, or
his representative prior to and during a residuals land application event.
13. The landowner or his representative hereby authorizes the Permittee, local officials, and State officials or their representatives to; enter and
inspect any property, premises, or place on or related to the land application site(s) at any reasonable time for the purpose of determining
compliance with the permit; establish monitoring facilities on or near the land application site(s) as required by the permit; copy any records
that must be kept under the terms and conditions of the permit; take necessary leachate, surface water, groundwater, or soil samples during the
term of, and 12 months after termination of, this Agreement.
II. RESTRICTIONS:
1. Appropriate measures must be taken by the Permittee and/or the landowner or his representative to control public access to the land
application site(s) during active use and for the 12-month period following a residuals land application event. Such controls may include the
posting of signs that indicate the activities being conducted at the land application site(s).
2. Animals shall not be grazed on the land application site(s) for a 30-day period following a residuals land application event. Land application
sites that are to be used for grazing shall have fencing that will be used to prevent access during these periods after such residuals land
application events.
3. Food crops, feed crops, and fiber crops shall not be harvested for a 30-day period following a residuals land application event.
4. Food crops with harvested parts that touch the residuals/soil mixture and are totally above the land surface shall not be harvested for a 14-
month period following a residuals land application event.
5. Food crops with harvested parts below the surface of the land shall not be harvested for a 20-month period following a residuals land
application event when the residuals remain on the land surface for four months or longer prior to incorporation into the soil.
6. Food crops with harvested parts below the surface of the land shall not be harvested for a 38-month period following a residuals land
application event when the residuals remain on the land surface for less than four months prior to incorporation into the soil.
7. Turf grown on land where residuals are applied shall not be harvested for a 12-month period following a residuals land application event.
III. ALTERNATIVES FOR WATER SUPPLY WELLS INSIDE THE COMPLIANCE BOUNDARY: (please check one)
15A NCAC 02L .0107(d) prohibits water supply wells within the compliance boundary. However, 15A NCAC 02T .0105(h) allows the
compliance boundary to be placed closer to the waste disposal area, such that the water supply well is situated outside of the compliance
boundary provided the groundwater standards can be met at the newly -established compliance boundary. Please mark one of the following;
❑ A re -defined compliance boundary is needed for field(s) ID:
(Please include the rationale for the requested re -location of the compliance boundary and attach a map showing the newly proposed
compliance boundary to the application package)
❑ A re -defined compliance boundary is not needed for this site.
IV. ACKNOWLEDGEMENT OF FIELD TRANSFER: (if needed)
❑ The land application field(s) ID: is currently permitted under another
�J 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: }�/�QQ' ^?�,,,7"
Address: eo LC _ � l//�C nk1 /-�eoL�' r
f
City: LY�ygY1� co 1,1 State: ,/ v G Zip:
Phone:` _ l ©1 3 %{ �` E-mail address: C ACjC77 S,-TY-(L�
Signature: Date:
NORTH CAROLINA, co COUNTY
I, the undersigned Notary Public do hereby certify that
personally appeared before me this day and acknowledged the due execution of the forgoing instrument.-`��,�����
WITNESS m hand and official seal this the - Q.0 ••Hq y
day of
Signature and seal: . q ,, �
My commission expires:
Lessee's/Operator's Certification:.
I certify that I have read
* Lessee/operator name:
Address:
OT^R
= C')
zr) ,pU13LIG :L;
• c>0 YCD
and do hereby agree to abide by the stipulations and restrictions as specified herein.
City: • zlulm f�� L {� State: N r� Zip:
Phone: 9 %(� %� 77 G 7 j E-mail address:
Signature: R off_ 81-Ah Date:
Permittee's Certification:
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
FORM: LOA 06-16 Page 3 of 3

SYNAGRO
March, 28th 2017
Mr. Nathaniel Thornburg, Unit Supervisor
NC DENR / Non -Discharge Permitting Unit
512 N. Salisbury St
Raleigh, NC 27604
RE: Permit WQ000672
Mr. Thornburg,
Please accept this as a formal -request to remove the City of Lumberton Water
Treatment Plant as a source from the land application permit.
Please let me know if you require further information to complete this request.
Thanks,
_Sz_�X
Chad Hayes
Technical Services Specialist
Synagro Central, LLC
284 Boger Road, Mocksville, NC 27028 • Phone: [phone] • Fax: [phone]

Summit Environmental Technologies, Inc.
U 1 3310 Win St.
F.NVIROMMr:tdTAL T r:CHIJOL.DGIES, iNc Cuyahoga Falls, Ohio 44223
Analytical t.rrboratarigs TEL: [phone] FAX. [phone]
Websitet htiP.1 www.settekcom
March 23; 2017
C Hayes
Synagro _ .
284 Boger Rd.. RECEIVEDINCDENWR
Mocksville, NC.27028 MAR 3 0 2017
TEL: [phone]
FAX: [phone] Non -Discharge
Permitting Unit
RE: Lumberton WWTP
Dear C Hayes: Order No.: 16020218
Summit Environmental Technologies, Inc. received.I sample(s) on 2/3/2016 for the
analyses presented in the following report.
There were no problems with the analytical events associated with this report unless noted
in the Case Narrative.
Quality control data is within laboratory defined or method specified acceptance limits
except where noted.
If you have any -questions regarding these tests results, please feel free to call the
laboratory.
Sincerely,
Jennifer Woolf
Project Manager
3310 Win St.
Cuyahoga Falls, Ohio 44223
Alabama 41600, Arkansas 88-0735, California 07256CA, Colorado, Connecticut PH-0108, Delaware, Florida NELAC E87688, Georgia E87688, Idaho
OH00923, Illinois 200061,,Indiana C-OH-13, Kansas E-10347, Kentucky (Underground Storage Tank) 3, Kentucky 90146, Louisiana 04061, Maryland
339, Massachusetts M-OPH923, Minnesota 409711, New Hampshire 2996, New Jersey OH006, New York 11777, North Carolina 39705 and 631, North
Dakota R-201, Ohio Drinking Water 4170, Ohio VAP CL0052, Oklahoma 9940, Oregon OH2O0001, Rhode Island LA000317, South Carolina 92016001,
Texas T104704466-11-5, Region 8 871MS-L, USDA/APHIS P330-11-00244, Utah OH009232011-1, Vermont VT-87688, Virginia 00440 and 1581,
Washington C891, West Virginia 995712
Page 1 of 12

` SUMMIT
Summit Environmental Technologies, Inc. Case Narrative
_ = 3310 Win St.
F.NVIRONlAENThLTF-CHNOLOGIES.INC. . Cuyahoga Falls, Ohio44223 WO#: 16020218
Analytical Labopatodes TEL: [phone] FAX.- [phone]
Website: httn:/hvww.settek.com Date: 3/23/2017
CLIENT: Synagro
Project: Lumberton WWTP-
WorkOrder Narrative:
16020218: This report in its entirety consists of the following documents: Cover Letter, Case Narrative,
Analytical Results, QC Summary Report, Applicable Accreditation Information, Chain -of -Custody,
Cooler Receipt Form; and other applicable forms as necessary. All documents contain the Summit
Environmental Technologies, Inc.; Work Order Number assigned to this -report.
Summit Environmental Technologies,. Inc., holds the accreditations/certifications listed at the bottom of
the cover letter that may or -may not pertain to this report. State Certificates and Scopes: of Accreditation -
are attached as applicable. Results provided in this report for any parameter not listed on the Scope of
Accreditation should be considered "not certified."
The information contained in this. analytical report is the sole property of Summit Environmental
Technologies, Inc. and that of the customer. It cannot be reproduced in any form without the consent of
Summit Environmental Technologies, Inc. or the customer for which this report was issued. The results
contained in this report are only representative of the samples received. Conditions can vary at different
times and at different sampling conditions. Summit Environmental Technologies, Inc. is not responsible
for use or interpretation of the data included herein.
All results for Solid Samples are reported on an "as "received" or "wet Weight"'basis unless indicated as
"dry weight" using the "-dry" designation on the reporting units.
This report is believed to meet all of the requirements of the accrediting agency; where applicable. Any
comments or problems with the analytical events associated with this report are noted below.
REVISED REPORT: Lower reporting limits for 2,4rDinitrotoluene and. Hexachlorobenzene per client
request. jmw 3/23/17
Revision v1
Page 2 of 12

Summit Environmental Technologies, In, QuallflePS and Acronyms .
SOM1 l � 3310 Win 5
' ENVIRONPAENTALTECFEfS0=1ES, INC Cuyahoga Falls, Ohio44Z WO#: 16020218
Analytical L' aboratorles TEL: [phone] FAX. [phone]
Website: httP.1Avmv.se1tekco. Date: 3/23/2017
These commonly used Qualifiers and Acronyms may or may not be present in this report.
Qualifiers
U The compound was analyzed for but was not detected
J The reported value is greater than the Method Detection Limit but less than the Reporting Limit.
H The hold time for sample preparation and/or analysis was exceeded.
D The result is reported from a dilution.
E The result exceeded the linear range of the calibration or is estimated due to interference.
MC The result is below the Minimum Compound Limit.
* The result exceeds the Regulatoy Limit or Maximum Contamination Limit.
in Manual integration was used to determine the area response.
N The result is presumptive based on a Mass Spectral library search assuming a 1:1 response.
P The second column confirmation exceeded 25% difference.
C The result has been confirmed by GC/MS.
X The result was not confirmed when GUMS Analysis was performed.
B/MB+ The analyte was detected in the associated blank.
G The ICB or CCB contained reportable amounts of analyte.
QC-/+ The CCV recovery failed low (-) or high (+).
R/QDR The RPD was outside of accepted recovery limits.
QL-/+ The LCS or LCSD recovery failed low (-) or high (+).
QLR The LCS/LCSD RPD was outside of accepted recovery limits.
QM /+ The MS or MSD recovery failed low.(-) or high (+).
QMR The MS/MSD RPD was outside of accepted recovery limits.
QV-/+ The ICY recovery failed low (-) or high (+).
S The spike result was outside of accepted recovery limits.
Z Deviation; A deviation from the method was performed; Please refer to the Case Narrative for
additional information
Acronyms
ND
Not Detected
RL
Reporting Limit
QC
Quality Control
MDL
Method Detection Limit
MB
Method Blank
LOD
Level of Detection
LCS
Laboratory Control Sample
LOQ
Level of Quantitation
LCSD
Laboratory Control Sample Duplicate
PQL
Practical Quantitation Limit
QCS
Quality Control Sample
CRQL
Contract Required Quantitation Limit
DUP
Duplicate
PL
Permit Limit
MS
Matrix Spike
RegLvl
Regulatory Limit
MSD
Matrix Spike Duplicate
MCL
Maximum Contamination Limit
RPD
Relative Percent Different
MinCL
Minimum Compound Limit
ICV
Initial Calibration Verification
RA
Reanalysis
ICB
Initial Calibration Blank -
RE
Reextraction
CCV
Continuing Calibration Verification
TIC
Tentatively Identified Compound
CCB
Continuing Calibration Blank
RT
Retention Time
RLC
Reporting Limit Check
CF
Calibration Factor
DF
Dilution Factor
RF
Response Factor
This list of Qualifiers and .Acronyms reflects the most commonly utilized Qualifiers and. Acronyms for reporting. - -
Please refer to the Analytical Notes in the Case Narrative for any Qualifiers or Acronyms that do not appear in this
list or for additional information regarding the use of these Qualifiers on reported data.
Revision v1
Page 3 of 12

Summit Environmental Technologies, Inc. WOrkOrder
3310 Win St.
mint
ENVIRONMENTAL •TECHtIOLOd1ES, INC Cuyahoga Falls, Ohio44223 Sample Summary
Analytf=f Labormtorles TEL: [phone] FAX. [phone] WO#: 16020218
Website: http:/Lwww.settekcom 23 Mar-17
CLIENT: Synagro
Project: Lumberton WWTP
Lab SamplelD Client Sample ID Tag No Date Collected Date Received Matrix
16020218-001 Lumberton WWTP 1/25/2016 9:40:00 AM 2/3/2016 12:00:00 PM Solid
Page 4 of 12

EEMSummit
Environmental Technologies, Inc.
SUM 1 T
DATES: REPORT
3310 Win St.
WVIRON1aENTAL
TECHNOLOGIES,
INC. Cuyahoga Falls, Ohio 44223
Analy
flcal Laboratbries
TEL: [phone] F.9X.• [phone]
WO#: 16020218
Wehsite: httn://www.settek.com
23-Mat-17
Client:
Synagro
Project:
Lumberton WWTP
Sample ID
Client Sample ID
Collection Date Matrix Test Name Leachate Date
Prep Date, Analysis Date
16020218-001A
Lumberton VAM
1/25/2016 9:40:00 AM Solid Flashpoint Determination (1010)
2/11/2016 10:50:24 AM
pH (SW9045D)
2/9/2016 2:20:00 PM
Reactive Cyanide (9014/7.3.3.2)-Solid
2/9/2016 9:25:00 AM
Reactive Sulfide (9034)
2/9/2016 9:25:00 AM
SVOC 8270 TCLP BNA List 2/4/2016 4:00:00 PM
2/8/20167:00:00 AM 2/9/2016 9:02:00 PM
SVOC SW 846: '8081-TCLP Pesticide., 2/4/2016 4:00:00 PM
2/8/2016 8:00:00 AM 2/8/2016 9:18:00 PM
SVOC SW 846: 8321 Herbicides-TCL
2/4/2016 4:00:00 PM 2/9/2016 5:03:00 AM
TCLP Mercury Analysis (1311/7470) 2/4/2016 4:00:00 PM
2/11/2016 9:30:00 AM 2/11/2016 3:34:27 PM
TCLP Metals Analysis (6010) 2/4/2016 4:00:00 PM
2/5/2016 10:00:00 AM 2/5/2016 2:00:37 PM
VOC by GC/MS (8260)-TCLP
2/5/2016 6:57:00 PM
Revision vl
Page. 5 of 12

Eza�llsummiy
SummitErrvironmental Technologies, Inc.
3310 Win St.
Analytical Report
ENVIRONMENTALTECHNOLOGIES, INC
Cuyahoga Falls, Ohio 44223
(base report)
Analytical [abdrgforles
TEL: [phone] FAX. [phone]
WO#: 16020218
Website: http:/Avww.settekcom
Date Reported: 3/23/2017
CLIENT:
Synagro
Tag Number:
Matrix:
SOLID
Collection -Date:
1/25/2016 9:40:00 AM
Lab ID:
16020218-001A
Project:
Lumberton WWTP
Client Sample ID Lumberton WWTP.
Analyses
Result RL Qual Units
DF Date Analyzed
RCI
SW9045D
Analyst: DHC
PH (SW9045D)
pH
.6.49 s.u.@19.3C
1 2/9/2016 2:20:00 PM
Qualifiers: Value exceeds Maximum Contaminant Level.
H Holding times for preparation or analysis exceeded
MC Value is below Minimum Compound Limit.
\J ND Not Detected at the Reporting Limit
P Second column confirmation exceeds
R RPD outside accepted recovery limits
E Value above quantitation range
M Manual Integration used to determine area response
N Tentatively identified compounds
O RSD is greater than RSDlimit
PL Permit Limit Revision v1
RL Reporting Detection Limit
Page 6 of 12

Summit Environmental Technologies, Inc.
U M I "t 3310 Win St.
ENVIRONMENTAL'T£CHNOLOMES, INc Cuyahoga Falls, Ohio 44223
Analytical Laboaateries TEL: [phone] FAX., (330) 2534489
Website: httP.11www.settekcom
WO#:
16620218
Date Reported:
3/23/2017
Company:
Synagro
Address:
284 Boger Rd.
Mocksville NC 27028
Received:
2/3/2016
Project#:
Lumberton WW
TCLP Metals Analysis (6010)
Client ID#
Lab ID# Collected Analyte .
Rep Lmt Result Units
Matrix
Method
DF
RegLvl
Run
Analyst
Lumberton WWTP
001
1/25/2016 TCLP Arsenic(As)
0.500
NO mg/L
Solid
EPA 6010 C
1
5.00
2/5/2016
WK
Lumberton WWTP
001
1/25/2016 TCLP Barium(Ba)
5.00
NO mg/L
Solid
EPA 6010 C
1
100
2/5/2016
WK .
Lumberton WWTP
001
1/25/2016 TCLP Cadmium(Cd)
0.100
NO mg/L
Solid
EPA 6010 C
1
1.00
2/5/2016
WK
Lumberton WWTP
001
1/25/2016 TCLP Chromium(Cr)
0.200
NO mg/L
Solid
EPA 6010 C
1
5.00
2/5/2016
WK
Lumberton WWTP
001
1/25/2016 TCLP Lead(Pb)
0.500
NO mg/L
Solid
EPA 6010 C
1
5.00.
2/5/2016
WK
Lumberton WWTP
001
1/25/2016 TCLP Selenium(Se)
0.500
NO mg/L
Solid
EPA 6010 C
1
1.00
2/5/2016
WK
Lumberton WWTP
001
1/25/2016 TCLP Silver(Ag)
0.500
NO mg/L
Solid
EPA 6010 C
1
5.00
2/512016
WK
TCLP Mercury Analysis (1311/1470)
Client ID#
Lab ID# Collected Analyte...
Rep Lmt Result Units
Matrix
Method
DF
RegLvl
Run
Analyst
Lumberton WWTP
001
1/25/2016 TCLP Mercury
0.00200 NO mg/L
Solid
EPA 7470 A
1
0.200
2/11/2016
MFW
tom/
SVOC SW-846: 8081=TCLP Pesticides
Client ID#
Lab ID# Collected Analyte
Rep Lmt Result Units
Matrix
Method
DF
RegLvl.
Run
Analyst
Lumberton WWTP
001
1/25/2016 Chlordane, total
25.0 NO pg/L
Solid
EPA 8081 B
1
30.0
2/8/2016
JBN
Lumberton WWTP
001
1/25/2016 Toxaphene
50.0 NO pg/L
Solid
EPA 8081 B
1
500
2/8/2016
JBN
Lumberton WWTP
001
1/25/2016 Endrin
2.50 NO pgIL
Solid
EPA 8081 B
1
20.0
2/8/2016
JBN
Lumberton WWTP
001
1/25/2016 gamma-BHC
2.50 NO pg/L
Solid
EPA 808113
1
400
2/8/2016
JBN
Lumberton WWTP
001
1/25/2016 Heptachlor
2.50 NO pg/L
Solid
EPA 8081 B
1
8.00
2/8/2016
JBN
Lumberton WWTP
001
1/25/2016 Heptachlor epoxide
2.50 NO pg/L
Solid.
EPA 8081 B
1
8.00
2/8/2016
JBN
Lumberton WWTP
001
1/25/2016 Methoxychlor
2.50 NO ug/L
Solid
EPA 8081 B
1
10000
2/8/2016
JBN
Lumberton WWTP
001
1/25/2016 Sun': TCMX
5-119 77.6 %Rec
Solid
EPA 8081 B
1
2/8/2016
JBN
Page 7 of 12

ENVIRONMENTAL TtdHHOLDGrcS, IDVC
CIJIAn_;lYt!ojlLabaraIo#-fes
Summit Environmental Technologies, Inc. WO#: 16020218
3310 Win St.
Cuyahoga Falls, Ohio 44223 Date Reported: 3/23/2017
TEL: [phone] FAX: [phone] Company: Synagro
Website: httD✓Avww.settekcom Address: 284 Boger Rd.
Mocksville NC 27028
Received: 2/3/2016
Project#: Lumberton WW '
VOC by GUMS (8260)-TCLP
Client ID#
Lab ID# Collected Analyte
Rep Lmt Result Units
Matrix
Method
DF
RegLvl
Run
Analyst
Lumberton WWTP
001
1/25/2016 1,1-Dichloroethene
100
ND pg/L
Solid
EPA 8260 B
1
700
2/5/2016
MES
Lumberton WWTP
001
1/25/2016 1,2-Dichloroethahb
100
ND pg/L
Solid
EPA 8260 B
1
500
2/5/2016
MES
Lumberton WWTP
001
1/25/2016 MEK
2000
ND pg/L
Solid
EPA 8260 B
1
200000
2/5/2016
MES
Lumberton WWTP
001
1/25/2016 Benzene
100
ND pg/L
Solid
EPA 8260 B
1.
500
2/5/2016
MES
Lumberton WWTP
001
1/25/2016 Carbon tetrachloride
100
ND pg/L
Solid
EPA 8260 B
1
500
2/5/2016
MES
Lumberton WWTP
001
1/25/2016 Chlorobenzene
100
ND pg/L
Solid
EPA8260 B
. 1
100000
215/2016
MES
Lumberton WWTP
001
1/25/2016 .Chloroform
100
ND NgIL
Solid
EPA 8260 B
1
6000
2/5/2016
MES
Lumberton WWTP
001
1/25/2016 Tetrachloroethene
100
ND pg/L
Solid
EPA 8260 B
1
700_
2/5/2016
MES
Lumberton WWTP
001
1/25/2016 Trichloroethene
1.00
ND pg/L
Solid
EPA 8260 B
1
500
2/5/2016
MES
Lumberton WWTP
001
1/25/20.16 Vinyl chloride
200
ND pg/L
Solid
EPA 8260 B
1
200
2/5/2016
MES
Lumberton WWTP
001
1/25/2016 Surr: 4-
70-130
98.6 %Rec
Solid
EPA 8260 B
1
2/5/2016
MES
Bromofluorobenzene
Lumberton WWTP
001
1/25/2016 Surr:
70-130
101 %Rec
Solid 'EPA
8260 B
1
2l5/2016
MES
Dibromofluoromethane
-
',,umberton WWTP
001
1/25/2016 Sun: Toluene-d8
70-130
101 %Rec
Solid
EPA 8260 B
1
2/512016
MES
SVOC 8270 TCLP BNA List
Client ION
Lab 1D# Collected Analyte Rep Lmt Result Units
Matrix
Method
DF
RegLvl
Run
Analyst
Lumberton WWTP
001
1/25/2016 1,4-Dichlorobenzene
0.200
ND mg/L
Solid
'EPA 8270 C
2
7.50
2/9/2016
MO
Lumberton WWTP
001
1/25/2016 2,4,5-Tdchlorophenol
0.500
ND mg/L
Solid
EPA 8270 C
2
400
2/9/2016
MO
Lumberton WWTP
001
1/25/2016 2,4,6-Tdchlorophenol
0.500
ND mg/L
Solid
EPA 8270 C
2
2.00
2/9/2016
MO
Lumberton WWTP
001
1/25/2016 2,4-Dinitrotoluene
0.100
ND mg/L
Solid :
EPA 8270 C
2
0.130
2/9/2016
MO
Lumberton WWTP
001
1/25/2016 Cresols, Total
10.0
ND mg/L
Solid
EPA 8270 C
2
200
2/9/2016
MO
Lumberton WWTP
001
1/25/2016 Hexachloro-1,3-
0.200
ND mg/L- .
Solid
EPA 8270 C
2
0.500
2/9/2016
MO
butadiene
Lumberton WWTP
001
1/25/2016 Hexachlorobenzene
0.100
ND mg/L
Solid,
EPA 8270 C
2
0.130
2/9/2016
MO .
Lumberton WWTP
001
1/25/2016 Hexa.chloroethane
0.200
ND mg/L
Solid
EPA 8270 C
2
3.00
2/9/2016
MO
Lumberton WWTP
001
1/25/2016 Nitrobenzene
0.200
0.398 mg/L
Solid
EPA 8270 C
2
2.00
2/9/2016
MO
Lumberton; WWTP
001
1/25/2016 Pentachlorophenol
0.500
ND mg/L
Solid
EPA 8270 C
2
100
2/9/2016
MO
Lumberton WWTP
001
1/25/2016 Pyridine
0.500
ND mg/L
Solid
EPA 8270 C
2
5.00
2/9/2016
MO
Lumberton WWTP
001
1/25/2016 Surr: 2-Fluorophenol
5-109
55.6 %Rec
Solid
EPA 8270 C
2
2/9/2016
MO
Lumberton WWTP
001
1/25/2016 Surr: Phenol-d6'
5-109
48.0 %Rec
Solid
EPA 8270 C
2
2/9/2016
MO
Lumberton WWTP
001
1/25/2016 Surr: Nitrobenzene-
19-120
21.4 %Rec
Solid
EPA 8270 C
2
2/9/2016
MO
d5
Lumberton WWTP
001
1/25/2016 Surr. 2,4,6-
10-120
107 %Rec
Solid
EPA 8270 C
2
2/9/201.6
MO
Tribromophenol
Lumberton WWTP
001
1/25/2016 Surr: 2-
22-117
91.6 %Rec
Solid
EPA 8270 C
2
2/9/2016
MO
Fluorobiphenyl
Lumberton WWTP
001
1/25/2016 Surr: p-Terphenyl-
34-116
1.52 %Rec
Solid
EPA 8270 C
2
2/9/2016
MO
d14
�i
C
Page 8 of 12

Summit Environmental Technologies, Inc. WO#: 16020218
3310 Win St.
ENVIRON MENTAL TECHNOLO GIES, INC Cuyahoga Falls, Ohio44223 Date Reported: 3/23/2017
Analytical Laboratories TEL: [phone] FAX. [phone] Company: Synagro
Website: httv.lAvww.settekcom Address: 284 Boger Rd'.
Mocksville NC 27028
Received: 2/3/2016
Project#: Lumberton WW
SVOC SW-846: 8321 Herbicides-TCLP
Client W#
Lab H)# Collected Analyte
Rep Lmt Result Units
Matrix
Method
DF
RegLvl
Run
Analyst
Lumberton WWTP
001 1/25/2016 2,4-D
5.00 ND mg/L
Solid
EPA 8321 A
1
10.0
2/9/2016
BJH
Lumberton'WWTP
001 1/25/2016 2,4,5-TP
0.500 ND mg/L .
Solid
EPA 8321 A
1
1.00
2/9/2016
BJH
i
Page 9 of 12

Summist r=ouSummit Environmental Technologies, Inc.
WO#: 16020218
_
3310 Win St.
y
FKVIRONIMEWAL
4ECHNOLQGIES, INC Cuyahoga Falls, Ohio 44223
Date Reported: 3/23/2017 .
Analytfcat
Loboratorlp. TEL: [phone] FAX. [phone]
Company: Synagro
Website: httD:/hvww.settekcom
Address: 284 Boger Rd.
Mocksville NC 27028
Received: 2/3/2016
Project#: Lumberton WW
Client ID#
Lab HW Collected Analyte Result Units
Matrix Method DF PQL
Run Analyst
Lumberton WWTP
001 1/25/2016 Flashpoint (140°F) >140 °F
Solid EPA 1010 1
2/11/2016 TAH
Lumberton WWTP
001 1/25/2016 Cyanide, Reactive ND mg/Kg
Solid EPA 9014 1 .0.500
2/9/2016 MS'
Lumberton WWTP
001 1/25/2016 Sulfide, Reactive ND mg/Kg
Solid EPA 9034 1 25.0
2/9/2016 MS
Page 10 of 12

1
Summit Environmental Technologies, Inc.
3310 Win Street
Cuyahoga Falls, Ohio 44223 Tel: [phone] Fax: 330.253.448
9
Analysis Request/Chain' of Custody
For Summit Environmental Technologies, Inc. use only
Page of SET No.
Company Name (Please Print)
Project Name
Analytical Parameters and Methods
J
N
Comp�i r1d ess� �
'rojoct Address
„lll� NCB
�
Client Phone No
Repor
Ic
Client Fax No. Please Fax Results_ /
PO# VRi
a�Client
A
Emai I'J . i -R c iltc
vie No.
d
e
Contact
M, "
rQ d
Sampled
Check if Ohio,rAP samples
./
o
r
r
#
Sample Identification
Date
Time
Collected
Collected

DO-?
Rey, 14
Summit Environrpgntel TechnQiogies, ins.
Cooler Receipt Farm
owlsnr'
P
lnitiab of person Inspecting
cooler and samples:,
r
----�--...s Order. Number�
Data Received: Z — Tint. -Received: U0 Dale
Number of cooterslBoxes:
coole(s) opened and
sampes inspected:
WA
Shipper_ UPS DHL Airborne US Postal Walk-in Pfckup Other:
Packaging: Peanuts
P
Paper Foam None Other:
Tape on coobr/barc - �
,
Custody Seals intact
N
NIA
C-O-C In plastic
�Y (N
l0k—L Blue ice
V N
MIA
Sample Temperature IR Gun #JfQ2pM CIF
Present / absent / melted
oC
NIA
Radiological Testing Instrument serial
(see page 2 for scan results)
r C
Y N
NIA
Per sample for Redlotopieal Yvsting, _
Irgtnedtabty 1/ aarntita A tiOT, the Radlologica( Safety Otticar must be rtatNled
C-O•C filled out properly
� rOY
Samples in separate bags
N
N/A
Semple containers Intact'
N
0Y
WA
*If no, list broken sampta(s):
N
WA
Sample labels) complete (ID, date, etc.).
N
Label(s) agree wC-O-C
N
NIA
Correct containers used
-
N/A
Sufficientsamplo received
N
�
N/A
N
NIA
-
Samples roceived within holding time
Z N
Bubbles absent tram 40 mL vlaa -
Y N
A
*'Samples with bubbles samm are acceptable- Indi ate bubble size if >$Mm.
Was client contacted about samples Y
N
Will client send new samples Y
N
Client contaei
Date/Trtne:
Loyaed in by:
Comments:
Page 1 of 2
Page 12 of 12