WQ0004166_2023 Residual Annual Report_20240208 (2)

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
Annual Report Year* 2023
Permit Number (IR) * WQ0004166
Applicant/Permittee Town of Jefferson
Email Notifications
Does this need review by the hydrogeologist? * Yes U No
Regional Office Winston-Salem
CO Reviewer
Admin Reviewer Wanda Gerald

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* Tim Church
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*
13362462165
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:*
WQ0004166
Has Current Existing permit number
Applicant/Permittee Address*
P.O. Box 67
Facility Name*
Town of Jefferson Class B Residuals Program
Please provide comments/notes on your current submittal below.
At this time, paper copies are no longer required. If you have any questions about what is required, please contact Nathaniel Thornburg
at [e-mail].
Please attach all information required or requested for this submittal to be reviewed here.
(Application Form, Engineering Plans, Specifications, Calculations, Etc.)
Residuals Report B 2023[9324].pdf 2.93MB
Upload only 1 PDF document (less than 250 MB). Multiple documents must be combined into one PDF file unless file is larger
than upload limit.
* By checking this box, I acknowledge that I understand the application will not be accepted for pre -review until the fee (if required) has
been received by the Non -Discharge Branch. Application fees must be submitted by check or money order and made payable to the
North Carolina Department of Environmental Quality (NCDEQ). I also confirm that the uploaded document is a single PDF with all parts
of the application in correct order (as specified by the application).
Mail payment to:
NCDEQ — Division of Water Resources
Attn: Non -Discharge Branch
1617 Mail Service Center
Raleigh, NC 27699-1617
Signature
Submission Date 2/8/2024

Town of Jefferson
Class B Residuals
2023
Permit Number WQ0004166
40.4 Dry Tons of Class B liquid residuals were
applied in 2023 at two permitted sites totaling
35 acres.
FILE NAME:
Residuals Report B 2023
Submitted electronically 2/

ANNUAL LAND APPLICATION CERTIFICATION FORM
WQ Permit#; WQ0004166 County:
Facility Name (as shown on permit):
Ashe Year: 2023
Town of Jefferson
Land Application Operator:
Tim Church
Phone: [phone]
Land application of residuals as allowed by the permit occurred during the past calendar year?
21 Yes 0 No - If No, skip Part A, and Part B and proceed to Part C. Also, If residuals were
generated but not land applied, please attach an explanation on how the residuals were handled.
Part A - Residuals Application Summa :
Total number of application fields in the ermit:
2
Total number of fields utilized for land application during the year:
2
Total amount of dry tons applied during the year for all application sites:
40.4
Total number of acres utilizes for land application during the year:
35
Part B - Annual Compiance Statement:
Facility was compliant during calendar year 2023 with all conditions of the land application permit
(including but not limited to items 1-13 below) issued by the Division of Water Resources. R1 Yes LJ No
If no please, provide a written description why the facility was not compliant, the dates, and explain corrective action
taken.
1) Only residuals approved for this permit were applied to the permitted sites.
2) Soil pH was adjusted as specified in the permit and lime was applied (if needed) to achieve a soil pH of at least 6.0 or
the limit specified in the permit.
3) Annual soils analysis were performed on each site receiving residuals during the past calendar year and three (3) copies
of laboratory results are attached.
4) Annual TCLP analysis (if required) was performed and three (3) copies of certified laboratory results are attached.
5) All other monitoring was performed in accordance with the permit and reported during the year as required and three (3)
copies of certified laboratory results are attached.
6) The facility did not exceed any of the Pollutant Concentration Limits in 15A NCAC 02T .1105(a) or the Pollutant
Loading Rates in 15A NCAC 02T .1105(b) (applicable to 40 CFR Part 503 regulated facilities).
7) All general requirements in as specified in the Land Application Permit were complied with (applicable to 40 CFR Part
503 regulated facilities).
8) All monitoring and reporting requirements in 15A NCAC 02T. I 1 I I were complied with (applicable to 40 CFR Part
503 regulated facilities).
9) All operations and maintenance requirements in the permit were complied with or, in the case of a deviation, prior
authorization was received from the Division of Water Resources.
10) No contravention of Ground Water Quality Standards occurred at a monitoring well or explanations of violations are
attached to include appropriate actions and remediations.
l 1) Vegetative cover was maintained and proper crop management was performed on each site receing residuals, as
specified in the permit.
12) No runoff of residuals from the application sites onto adjacent property or nearby surface waters has occurred.
13) All buffer requirements as specified on the permit were maintained during each application of residuals.
Part C - Certification:
"I certify, under penalty of law, that the above information is, to the best of my knowledge and belief, true, accurate,
and complete. I am aware that there are significant penalties for submitting false information, including the
Dossibilitv of fines and imarisonment for knowing violations."
Tim Church, Water Resources Director
Permittee Name and Title (type or print)
Signature of Permittee Date
Signature of Preparer* Date Signature of Land Applier Date
(if different from Permittee) (if different from Permittee and Preparer)
* Preparer is defined in 40 CFR Part 503.9 (r) and 15A NCAC 02T .1102 (26) DENR FORM ACF (12/2006)

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ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name:
Permit #:
Operator:
Acres Used:
Town of Jefferson WWTP Total Dry Tons Applied (Annual):
WQ0004166 Cation Exchange Capacity (non 503 only):
Tim Church Owner: Fred Walters Predominant Soil Series
26
23.60
15.2
Watauga
Acres Permitted: 26 Site #: Fred Walters Field #: 1
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
5/3/23
2
3
4
5
6
7
8
9
101
11
12
% Solids
1.3
Arsenic
<3.7
Cadmium
1.79
Copper
694
Chromium
0
Lead
18.3
Mercury
0.6
;vlolyb-
denum
7.82
Nickel
28.6
Selenium
<3.7
Zinc
955
Total
Phos-
horus
26900
Annual Heavy Metal Field Loadings (Calculated in Ibs/acre):
Total
1
2
3
4 v
5
6
7
8
9
10
11
121
DT/Ac./
.pw
App.
y
Event
0.91
Arsenic
######
0.000
0.000
1 0.000 1
0.000
0.000 1
0.000 1
0.000
0.000 1
0.000
0.000
0.000
######
Cadmium
0.003
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.003
Copper
1.263
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1.263
Chromium
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
Lead
0.033
0.000
0.000
0.000
0.0o0
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.033
Mercury
0.001
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.001
Molyb-
0.014
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.014
denum
Nickel
0.052
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.052
Selenium
######
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
4#44##
Zinc
1.738
1 0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1.738
Total
Phos-
48.958
0.000
0.000
0.000
o.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
48.958
horus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
imprisonment for knowing violations".
f,�.a"L
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

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ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name:
Permit #:
Operator:
Acres Used:
Town of Jefferson WWTP Total Dry Tons Applied (Annual):
WQ0004166
Tim Church Owner:
9 Acres Permitted;
Cation Exchange Capacity (non 503 only):
Johnny Walters Predominant Soil Series:
9 Site #: Johnny Walters Field #:
16.80
15.3
Watauga
5
R4-Q;d1lal Analvaic Data (Hea.Tv Metals and Total Phosphorus use mg/k2, % Solids use Raw Percent #):
Sample orL
Com-
posite
Date
1
5/3/23
2_
3
4:
51
6
7
8
9
101
11
12
% Solids
1.3
Arsenic
<3.7
Cadmium
1.79
Copper
694
Chromium
0
Lead
18.3
Mercury
0.6
Molyb-
denum
7.82
Nickel
28.6
Selenium
<3.7
Zinc
955
Total
Phos-
horus
26900
Anneal heavy Metal Field Loadings (Calculated in lbs/acre):
Total
1
2
3
4
5
6
7
8
9
10
11
12
H
DT/Ac.i
a�
App.
Event
1.80
Arsenic
######
0.000
0.000
0.000
0.000
0.000
0.000 1
0.000
0.000 1
0.000
0.000
0.000
######
Cadmium
0.006
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.006
Copper
2.498
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
2.498
Chromium
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
Lead
0.066
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.066
Mercury
0.002
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.002
Nlolyb-
0.028
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.028
denum
Nickel
0.103
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.103
Selenium
##4##4
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
######
Zinc
3.438
1 0.000
0.000
0.000
0.000
0.000
0.000
O.Ooo
0.000
0.000
1 0.000
0.000
3.438
Total
Phos-
96.840
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
96.840
horus
_a�
"I certify, under penalty of law, that this document was preparea under my direction or suherviswu iu "LCu
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
imprisonment for knowing violations".
76 allACk zlk) k?,q
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

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CLIENT: JEFFERSON
ADDRESS:
CITY: JEFFERSON
STATE: NC
I n#.
WATER QUALITY LAB & OPERATION, INC.
P.O. BOX 1167,13ANNER ELK, NC 28604
[phone]
SAMPLER: TIM CHURCH
COLLECTED DATE: 22-Aug-23
REPORTED DATE: 22-Sep-23
ANALYSIS
ANALYSIS
MQL's
UNITS
SAMPLE
ANALYSIS INT
RESULTS
LOCATION
COMPLETED
30 DAY BENCH SCALE
START
VOLITILE SOLIDS
69.30
0.1
%
SLUDGE
23-Aug-23
PI
END
VOLITILE SOLIDS
65.80
0.1
%
SLUDGE
22-Sep-23
Pl
VOLITILE SOLIDS REDUCTION
REPORTED BY: NC CERTIFIED LAB # 544
PAUL ISENHOUR, SUPERVISOR
3.50%

WATER QUALITY LAB &OPERATIONS, INC.
LAB No. 544
30 DAY BENCH SCALE VAR OPTION 3
SM 2540 E
ANALYST:- e_--- START DATE: J-2 3 -L �
DIGESTER VOLUME;
CCC
v
VOLITILE SOLIDS REDUCTION:

WATER QUALITY LAB & OPERATIONS, INC.
P.O. BOX 1167, BANNER ELK, NC 28604
[phone] ,
fax [phone]�eC or Afffaav
CHAIN OF CUSTODY jQ
�aSSResidua.'Is �`m
LOCATION
FACILITY ID u
SAMPLER NAME
Jefferson WWTP
NCO021709
T Cnurch F Walters
COMPOSITE SAMPLE. START TIME _ 800
H2S0- 2 • HNO3 3, HCL
M . ,,4AOH 5 - NONE 6 - COOL ICE
NAM1103 6 - OTHER Wu[
aov V01��i1e. SO ILS ion <
SAMPLE NAME COLLECTION
DATE TIME TEMP
DELIV.
TEMP
SAMPLE TYPEJ
PRESERVATION' PH CL2 D CL2 LAB SAMPLE
F • FIELD L - LAB ve�if'r YES NO ID NUMBER
6
GRAB COMP
Irfluent 60D/TSS
X
Effluent BOD/TSS
X
6 —
Effluent NH3 N
X
6
_.
Effluent f coldorm
X
G
--
Cyan�tle
Copper, Zinc
Co
o:o I�nCsaharus
o
I
X
X
X
6
G
6
41
21.
—
{ .----- --
I -
,nn
t S
tif'rs!! Hardoess
X
LI
R=LINQUISHED BY.
lv�X"
D JE
A, 12�
TIP:1E
o�t�
RECEIVED GY
�',
DATE
�"-2z.27
TIME
'�"S
rrLINOU;SHEO GY DATE
TIk.".E
RECIS ./FD i;Y
AT
22
Ti'rlr.
l 4/5
Laboratory preseNanon is ensurea oy auutl.Orz v, CJC`va; vca , v. w �.••••r
COnt3mers leaving the lab, unless otherwise nose
Cr_2•D-CL2= Ch:orir-e cnFck and dechlorina;ion venf-cat,on
r=RI_ til"RVATJ,-)N
C-001,lC BOD RESIDUE. CONDUCTIVITY ME1,:S COLOR :.L�:•! I'�ITti CR �,rl TL►R81DiTY
: COOL <C P11.2 H2S0' NH3 NO2-NO3 TKN Olv�G TOC COD �qAR N-ESS PHEN-CLS TOT PROS
Coot. eC PH•:2 HNO3 METALS except CR V,
t ) NCNE CHLORiDE PH r=LLIORIDE SAt.4PLE DEVIATION
OTHER
COOL :C NA2S203 COLIFORM 8ACTEMA
N,o,riI-ICATION __

ANNUAL PATHOGEN AND VECTOR ATTRACTION REDUCTION FORM (02T Rules)
Facility Name: Town of Jefferson WWTP
WWTP Name: Jefferson WWTP
Monitoring Period: From l/l/2023
WQ Permit Number: WQ0004166
NPDES Number: NCO021709
To 12/31/2023
Do46nnnn 1 .A..ofinn 114A Nd-Ad" t12T 11061 _ Please indicate level achieved and alternative performed:
Class A:
Alt. A (tintc''tentp) ❑
Alt B (Alk Treatment)[J
Alt. C (Prior Testing),L]
A1t.D (No Prior Test) ❑ I
Process to Further Reduce Patho2en2s 1
If applicable to alternative performed (Class A only) indicate "Process to Further Reduce Pathogens":
Compost ❑ I Heat Drying ❑ Heat Treatment Cl 1'llermophilic
Beta Rav ❑ 1
Gamma Rav ❑
Pasteurization
Class B: jAlt,
(1) Fecal Density ' J
Alt. ('_) Process to Significantly Reduce Pathocens ❑
If applicable to alternative performed (Class B otily) indicate "Process to Significantly Reduce Pathogens":
Lime Stabilization ❑
Air Drying ❑
Composting ❑ jAerobic
Digestion CJ
Anaerobic Digestion ❑
If applicable to alternative performed (Class A or Class B) complete the following monitoring data:
Allowable Level Pathogen Density um er of Frequency Sample na yuca
Excee Tech -
Parameter of Analysis TN e
in Sludge Minimun Geo. Mean MaXiMUn Units i,n es y P io ,,
2 x 10 to the
NIPN
6th power
CFU
63240
164021
322,300
CFU
0
Daily
Grab
SM9222D
Fecal Coliform
per gram of
total solids
1000 mpn per gram
of total solid (dry
weight)
Salmonella bacteria
3 MPN per 4 grams
(in lieu of fecal
total solid (dry
coliform)
I weight)
Veptnr Attrnetion Reduction (15A NCAC 02T .1107) - Please indicate alternative performed:
Alt.1 (VS reduction) ❑
Alt. 2 (40-day bench) ❑
Alt. 3 (30-day bench) 2
Alt. 4 (Spec. OZ uptake) ❑
Alt. 5 (14-Day Aerobic) ❑
Alt. 6 (Alk. Stabilization ❑
Alt 7 (Drying - Stable) ❑
jAlt. 8 (Drying - Unstable) ❑
Alt. 9 (Injection) ❑
Alt. 10 (Incorporation) ❑
No vector attraction reduction alternatives were performed ❑
CERTIFICATION STATEMENT (please check the appropriate statement)
❑ "1 certify, under penalty of law, that the pathogen requirements in 15A NCAC 02T .1106 and the
vector attraction reduction requirement in I5A NCAC 02T .1107 have been met."
❑ "I certify, under penalty of law, that the pathogen requirements in 15A NCAC 02T .1106 and the
vector attraction reduction requirement in 15A NCAC 02T .1107 have not been met." (Please note
if you check this statement attach an explanation why you have not met one or both of the
requirements.)
"This determination has been made under my direction and supervision in accordance with the system
designed to ensure that qualified personnel properly gather and evaluate the information used to determine
that the pathogen and vector attraction reduction requirements have been met. I am aware that there are
significant penalties for false certification including fine and imprisonment."
Tim Church, Water Resources Director
Prepar r Name and Title (type or print)
Signature of Preparer* Date
Land Applier Name and Title (if applicable)(type or print)
Signature of Land Applier (if applicable) Date
*Preparer is defined in 40 CFR Part 503.9(r) and 15A NCAC 2T . l 102 (26)
DENR FORM PVRF 02T (12/2006)

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a�RIClJR.TtfRAL PRODUCTS
151 CLAUDE WARREN RD., MTN. CITY, TENN 37683
PHJNE 727-7286
'CUSTOMERS ORDER NO. I PHONE i UAJ r
ADDRESS
F '
SOLD BY CASH I C.D.D. I CHARGE ON AGGT. I tl--�- DSE. RET'G.I PAID OUT
j i i I I
OTY i DESCRI€'TION AMOUNT
9.06
1
i I
I
i
I i
I
l I
l
1N 1 EREST WILT BF- ADDED TO ALL ACCOUNTS l
I OVER 30 DAYS. TAX
All claims and returned goods must br! accompanied by this bill
F E hank A'
Humphrey Masonry Supply Inc.
Quality Materials Dependable Service
L'�,t ._�
1
A108in Humphrey
3124 Roan Creek Rd.
Mountain City, TN
Ofrice:(423)-727-5345
Mobile:(423)-471-I183
[e-mail]
www.humphreymasonry.com

Meritech, Inc.
Environmental Laboratory
Laboratory Certification No. 165
s
Page 3
Report Date: 5/25/2023
Contact: Tim Church NPDES #: NCO021709
Client: Town of Jefferson WWT1' Project: Class B Sludge
P.O. Box 67 P.O. #: 2165
Jefferson, NC 28640 Date Sample Rcvd: 5/3/2023
3
Meritech Work Order # 050323121 Sample: Sludge Digester Grab S / /2023
Parameters Results Analysis D0te Reporting Limit Method
Total Solids
Ammonia, Nitrogen
TKN
Nitrate/Nitrite, Nitrogen
Aluminum, total
Arsenic, total
"Nidmium, total
.alcrum, total
Copper, total
Lead, WWI
Magnesium, total
Mercury, total
Molyl)denum, total
Nickel, total
Phosphorus, total
Potassium, total
Selenium, total
Sodium, total
Zinc, total
1.33 %
5/4/23
0-100 1%
SM 25I-013
<752 mg/kg
5/4/23
752 rng/kg
EPA 350.1
86,500 mg/kg
5/10/23
20 mg/kg
EPA 351.2
<752 mg/kg
5/5/23
752 nig/lcg
EPA 353.2
11.100 rng/kg
5/5/23
2.50 rng/kg
EPA 2003
<:3.76 r11g/lcg
5/5/23
3,76 mg/Ica
EPA 200.7
1.79 mg/kn
5/8/23
0.575 ma/kg
EPA 200.7
19,500 mE/ >; k_
5/5/23
5/5/2:3
MO ink;/Icy
1.00 mg/kg
rI A 200.7
1:PA2(10.7
694 mg/kb
18.3 mg/kg
S/5/23
0.500 nig/lcg
EPA 200.7
7,520 mg/kg
5/5/23
10.0 mg/kg
EPA 200.7
0.602 mg/kg
5/9
0.02 rng/kg
EPA 245.1
7.82 mg/kg
5/5/23
0.500 mg/4
EPA 200.7
28.6 rng/kg
S/5/23
2.0 mg/kg
EPA 200.7
26,900 mu/kg
S/8/23
2.00 rng/kg
EPA 200.7
7,900 mg/kg
5/5/23
20.0 rrrg/kg
EPA 200.7
<3.76 mg/kg
5/5/23
3.76 mg/kg
EPA 200.7
3,830 rng/lcg
5/5/23
20.0 mg/kg
EPA 200.7
95S mg/lcg
5/8/23
0.500 mg/kg
EPA 200.7
LIMIT MG/KG
ReSU4S
Ay- 75. ---
< 3.76
C
1. 7q
p ll 14,300
(0 Na
herebycertify that I have reviewed and approve these data. �� �`
75 7. 8?,,/
642 Tamco Road, Reidsville, North Caroli C 3.7&
tel.[phone] fax.(336)34"2-11 Sly
Zn 7560 9 55 .

Meritech, Inc.
Environmental Laboratory
--� Laboratory Certification No. 165
I'i3ge 1
Report Date: 5/2S/2023
Contact: Tim Church NPDES #: NCO021709
Client: Town of Jefferson WWTP Project: Class 1i Sledge
P.O. Box 67 P.O. #: 2165
3
Jefferson, NC 28640 Date Sample Rrvd: 5/3/202
Meritech Work Order # 050323121 Sample: Sludge Digester Grab 5/3/2023
1311 - TCLP Metals
Parameter
Results
Analysis Date
Det, Limit
RS.g. U-11iii
Method
Arsenic:
<0.100 mg/L
5/10/23
0.100
5.{}
EPA 200.7
Barium
<0.050 mg/L
5/1.0/23
0.050
lU(!.0
EPA 20{}.7
CaChniUm
<0.020 mg/L
5/10/23
0.020
1.0
EPA 200.7
Chromium
<0.050 mg/l,
5/10/23
0.050
5.0
EPA 200.7
� ea Cl
<0.100 mg/L
5/10/23
0.100
5.0
EPA '-00.7
Mercury
<0.020 mg/L
5/9/23
0.020
0.2
L PA 245.1
Selenium
<0.100 mg/L
S/10/23
0.100
1.0
EPA 200.7
Silver
<0.0S0 mg/l.
5/10/23
0.050
5.0
EPA 200.7
TCLP Organics
Para tt ter
Results
Anal i� Date
Reporting
Limit
Method
Volatiles 8260
Attachedl
5/13/23
82n0
Semi Vol. 8270
Attached
S/23/23
8270
Other Tests
earnmetei Results Analysis jute Reportij)g Limit Method
Cyanide, total <0.500 mg/kg 5/9/23 0.500 mg/k- EI'A 335A
Sulfide <10.0 mg/kg 5/9/23 10.0 mg/kg SM4500S2D
Flash Paint >140 °F 5/9/23 - EPA 1020C
Corrositivity (pl-1) 6.6 S.U. 5/4/23 1.0- 1.4,0 S.U. SM 4500 IIB
642 `i'amco Road, Reidsville, North Carolina 27320
tel.[phone] fax.[phone]

Meritech, Inc.
Environmental Laboratory
Laboratory Certification No. 165
Contact: Tim Church
Client: Town of Jefferson WWTP
11.0. Box 67
Jefferson, NC 28640
Page 2
Report Date:
5/25/".'t)'L:;
NPDES #:
NC0021709
Project:
Class B Sludge
P.O. #:
2165
Date Sample Rcvd:
5/3/2023
Meritech Work Order # 050323121 Sample: Sludge Digester Grab 5/3/23
1311 - TCLP Pesticides & Herbicides
Pesticide - SW-846 8081A
Parameter Results Analysis Date Det. Limit Reg. Limit Dilution Factor
Endrin Attached
Chlordane Attached -
Toxaphene Attached -
'--"ethoxychlor Attached
.teptachlor• Attached
Lindane Attached
Herbicides - SW-846 8151A
Parameter Results Analysis Date Det. Limit Reg. Limit Dilution Factor
2.4-D Attached -
11,4,5-TP (Silvex) f\ttaehed
642 Tamco Road, Reidsville, North Carolina 27320
tcl.[phone] fax.[phone]

11
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1
44'C1::� 2305051y
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2712t1
Reeei\ ed 1
Prolrrt/-
TC•1.1, Pesticides
Client ID#
Lab ID# Collected :1n:ihte
{ten 1,1111 Result Units
Matrix Nle(Ilii(I I)F
iteg[,rl
111111
1na11'tiE
05032.E-121
001 5/31'2023 Chlordane, total
25.0 ND Ng1L
Solid EPA 80818 10
30.0
5112/2023
PGP
050323-121
001 51312023 Toxaphene
50.0 ND lig/L
Solid EPA 80818 10
500
5112/2023
PGP
050323-121
001 513/2023 Endrin
5.00 ND pg/L
Solid EPA 80818 10
200
5/12/2023
PGP
050323-121
001 5/312023 gamma-BHC
5.00 ND llgll.
Soho EPA 8081B 10
400
5Y1212,023
PGP
050323-121
001 5/312023 Heptachlor
5.00 ND ug/L
Solid EPA 8081 B 10
8.00
5i l212023
PGP
050323-121
001 5/3/2023 Heptachlor epoxide
5.00 ND l,g/L
Solid EPA 80818 10
8 n0
511212023
PGP
050323-121
001 513/2023 Methoxyrhlor
5.00 ND llg1L
Solid EPA 80818 M
10000
5112!2023
PGP
TC'1.11 [lei hicides
('lien[ ID# Lab I1)tt Collected Anahlo Rep boil Result L nits \lalrii Method OF Re;l,1l R1111 lnah%I
050323-121 001 5/3/2023 2.4-D 0 500 NIL) mcl/L
—41x50323.121 U01 5/312023 2,4,5-TP U 500 ND mg/L
Page 4 of 12
Solid EPA 83L 16 50 100 5i1112023 JDB
Solid EPA 83'21B 50 T 00 5111!2023 JOB

-: MERI CH. INC.
._" Environmental Laboratories
Laboratory Certificate #165
Client: TON\ n (11• West Jet erson
Project.: Cla,,, 13 SltldQe
Client Sample 11): Digester '.�ItldLw
Sample Collection: 05A)3,'23
R•1eritech Sample 11). 050323121
1311 - TCLP Orcanics
Volatiles: S\\-846 8260
•\natttiis: 05 11 'i
?•;
\ %\
kcl�l,l-t 1 ),lt l':
0i It, 2 ;
Pserameter
12esnit
twits
Oct. Limit
Ettl . Limit
DA11(iurl I ;lCim
IfCrlldnC
- 0,01110
111C 1
11.11100
II.�I)
10
Carbon Ietraeh!„ride
0.0100
111t l
().()II)o
0.50
10
C IIIorohenZenc
0.0I0O
nlg I.
0.01110
100
iu
C'hlorolbrin
0.0100
n1g I.
0.01 n0
h,❑
I I}
1.2-1*111oroct.hane
(1.0100
mg1
0.0100
0.4;11
ttY
1.1-I)ichloroclhent:
' (U)10(1
m 1
0.0100
(00
l{}
\Iet11N1 I Ili\I Ketone
0.1on
1
0.101)
2M)
10
t•etraChloweIh%ltinC
0.0100
nig11
0.010a
0.70
10
! richloroethelle
0.0100
mg 1,
(1,01oo
0.50
10
Vim C hloritle
OJI21)(1
ill_L'.1.
0.02o
0.20
1U
tienli-Volaltiles: S\V-846 8270
I'\lracl ion;
114;,0823
PnraAncter
Rtcw,lt
l nit,
Del. Lintit
R2:, Lignil
Dilution F tcior
IA-I)iehlorohen/one
• (1.100
1112 1
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7,5
►u
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• 11.100
InL 1
0.100
1)
lu
Ilr�achtoru-1.3-17'utatiicne
-0.100
Ina 1.
0,100
I Ic�at hhsruelhune
1i,100
Ing I.
0.11M
t,-erewl
11.1011
111L I
O.101)
NO
l0
Ina,P-Cresoj
0.20o
Ing l
o 2u[)
200
JtY
Iowl cresuls
0_1(lu
IlIg I
(I.30o
200
li}
Nitrohen/ene
-:0.100
Ing 1.
0.1110
2.00
l0
Pentuchlorophenn!
. 0.500
niL, 1.
0.500
10(1
11)
Pyridine
-.0,100
Ili g,1.
(1.100
5.0
to
2.4,5-1 richlornphenol
0.100
Ing]
O. I (11)
•loll
10
2.4.6-1 richlorophenol
0.100
n14 I
0. It10
2.0O
III
2.4-DiniIRA011101C
0.100
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Lahurworr Reprewwative
642 Tamco Road ` Reidsville, NC 27320
[phone] * irlfo@meritechlabs. coin

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SAR Calculator
Irrigation - Sodium Adsorption Ratio (SAR)
Note: A water SAR below 4 minimizes soil hardening.
mg/L as ion ppm / mg/L as
(unless checked) CaCO3
Calcium - Ca+2 259
Magnesium - Mg+2 100
Sodium - Na+ 50
Calculate
SAR: 0.67
5/3/zoZa
�� x % Solids =m9��
14
CA lQ15C0 x 0.0133=Z59.
M
� 7 570 X 0.0133
Na age x oms = so

WATER QUALITY LAB & OPERATIONS, INC.
P.O. BOX 1167
BANNER ELK, NC 28604
[phone]
CLIENT: JEFFERSON
CLASS S SAMPLER:
RESIDUALS RECEIVED DATE:
REPORTED DATE
ID#: NCO021709
PSRP
20Z3
TIM CHURCH
See analysis date below
3-Aug-12
ANALYSIS
ANALYSIS
MQL's
UNITS
SAMPLE
ANALYSIS
METHOD
INT
RESULTS
LOCATION
STARTED
CODE
TOTAL SOLIDS
1.9
%
SLUDGE
FECAL COLIFORM
63240
1
CFU's
1 of 7
14-Mar-23
SM-9222D
WPS
TOTAL SOLIDS
1.8
%
SLUDGE
FECAL COLIFORM
123550
1
CFU's
2 of 7
15-Mar-23
SM-92221)
WPS
TOTAL SOLIDS
1.81
%
SLUDGE
FECAL COLIFORM
88230
1
CFU's
3 of 7
20-Mar-23
SM-9222D
WPS
TOTAL SOLIDS
1.7
%
SLUDGE
FECAL COLIFORM
322300
1
CFU's
4 of 7
21-Mar-23
SM-9222D
WPS
TOTAL SOLIDS
2.2
%
SLUDGE
FECAL COLIFORM
252440
1
CFU's
5 of 7
22-Mar-23
SM-9222D
WPS
TOTAL SOLIDS
1.6
%
SLUDGE
FECAL COLIFORM
188950
1
CFU's
6 of 7
27-Mar-23
SM-9222D
:!P3
TOTAL SOLIDS
2.1
%
SLUDGE
FECAL COLIFORM
301580
1
CFU's
7 of 7
28-Mar-23
SM-9222D
WPS
REPORTED BY: NC CERTIFIED LAB # 544
PAUL ISENHOUR, SUPERVISOR
Gt0ff&I'G mf&� = 101 Dzl
E U's
BOG
3.1�.23
(A3,2"
y.2007
3.15. z3
��,55d
5. D 91 g
3.?�0.23
g$,23d
9qz
3. LUZ
3m oc
5. so9 ✓
3.22.. 3-
2-5z, WO
5- 962]
3.z7. z3
129,950
5.2, - /76
3. 29. ZZ,
301,596
5.q7 q q

WATER QUALITY LAB & OPERATIONS, INC,
P.O. BOX 1167, BANNER ELK, NC 28604
O [phone]
fax [phone]
CHAIN OF CUSTODY
! OCA i !ON
FACILITY #D ,t
SAMPLER NAME
Jefferson tf;r-%ITP
NCO0217C9 --
T Criwcn F %Nalters —
ACII lis*NE 6 - COOL ICE
"S2r" - ni'I-EP
J_ 1
COMPOSITE 5AMPLE S'rAR'I* TIME Ko �C=
'iSAMPL1= NAML COLLECTIUPJ DELIVSAMPLE TYPE PRESERVATION' I PF{ CL2-D-CL2 LABSar.1Pl Y I
DATE' i IfvjETEMI' TEft.1P Gf�A6 COP�1P F - FIELD. L - LAB verify YES NO ID NUMBER !
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Effiuen180D.,TSS X
Elfiut;n: NH3 1-4 �� �2 nn�r�22/�, X 6' I 1--- =- -- -
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C....•U•(;l,:'= [:'i:� r,n Cn.: - end c _�hi^rt',=.. on
writ',' :eq : r,or it) J3,nii
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. f:E_h;F C1•It.DR'l;l Pii i L�_!r-)ii!::l'.
{

WATER QUAJTY LAB & OPERATIONS, INC,
P.O. BOX 1167, BANNER ELK, NC 28604
o�7�828) 898-6277
C1�ss Re dU�
fax [phone]
S
1 OC,' T!ON
FACILIT) ID,','
SAMPLER NA"-11L
Jefferson
NC002 1 -C9
F
C01N11POSITE SAMPLE STMRT TIME KID
CHAIN OF CUSTODY
3 HCt.
,;DOE, . - 'NONE 6 COOL ,CE
_ 'S2C!' O' HER
SAMPLE NAME
�
COLLECTION DE:LIV
Sr"MPLE TYPE1-PRESEPVATZ)
� PH
CL2-D CL2�B
DATE
FIELD L� LAB ivenfvj
YES NO; ID r•�UMBER;
I!•flt;r.11: 600/TSS
--
X
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EfflucP! SOD1TSS
I
I
X
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X
Cooper !Inc
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I3ELINIOUISHEC BY Dr\T I;ECEi` EU G'i . E TIF.1E
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- LabOra:gry !.��r.sr•rvatlon 15 e�sure� by 3tld1! on �` !;r n^,�1;'v.'sS nr.o• to Sam;,•��
containers Ic•o•-ling the !ab, unless otherwise
C1.2-0-CL2= Cil,o•1l1., ch*.•ck and decNormatisn ,enfca-r
_ .,'�`! _ ...;' �LS;[s�... (� a�lD{1":''i`. TY f.'3:.5 CO�Cr? ••Lr:.'•L,�„ rf: T��P ir`.I.•',
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WATER QUALITY LAB & OPERATIONS, INC.
of"Wall P.O. BOX 1167, BANNER ELK, NC 28604
at [phone]
fax [phone]
lass 2) CHAIN OF CUSTODY
LOCATION
FACILITY 1134
SAPOPLEIR NAIME
Jefferson VVVVTp
NCO021709
T C'lLircn F bAla!'e,s
UOMPOSITE SAMPI.E- 'FlNiE , — Krl
h2SO4 iM031 3 - HCL
-iAOH 5 - NONE 5 - COOL ICE
c- 0—HER
SAMPLE NAME COLLECTION IDELIVISAMPLE TYPE PRESERVATION- PH CL2-D-CL2 LAB SAI'OPLE!
DATE TIMETEhnP TEMP GRAB COMP F FIELD L LAB verify' YES_ NO 10 NIJMBFR
Irf --,cin: BOD,,'TSS F- X
Effluent BODITSS X
EIfl;-v!l'.NH3 N X
Odleft C0111cl!", K&23107h�
Covoer, Zinc
RELINQUISHED BY
' IME
RECEIVED BY
1 `31 1 L U BY 1 r,-)f,T'-- :7ECF'VF7) RY w DATP 1 -F, �'F
s. r-is.reri 'r, otrnl cri
irle I'cjt? ")-;ass olrjer,,,,j$e
chlonflo cl Ind
600 RESOLE COLOR N11"t I'LIRBI'DITY
c-c)(11", -'c m-3 NO2-i3O! PHENOLS TCT -0
C INI L C 1' 0 R P
OTI-11ER
. I . VC NA2S203 COLIFOM.' RACTERV.

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LOCATION
FACILITY ID it
SAMPLER NAME
WATER QUALITY LAB 8, OPERATIONS, INC.
P.O. BOX 1167, BANNER ELK, NC 28604
[phone]
fax [phone]
Jefferson lA'WTP
NCO021709
T Church F Walters
COMPOSITE SAMPLE START TIME 800
CHAIN OF CUSTODY
t-,2'50; 2) - HNO3 3 - HCL.
- N;,CH 5 . NONE 6 - COOL ICE
aC1
.SAMPLE WOE
COLLECT_ I_ON _
DATE 1'It,�k�TEtvtP
DELIV (SAMPLE
TEA1P
GRAB I
D CL. AD SANI'LE l
TYPE! PRE�Ef;V�TION' PH CL2 "'
COP:IPIF FIELD! L LAB _venfy YES NrJ ID NUMBER
X =1 6I—.ice-
n 5r—�---i---f------ _.___,
x
Effluent BODITSS
Effluunt NH'.' N
-,
I
A—
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Copper Zinc
_ rtqow
IISHED L','I
DATE] i-',r.IE l RECEIVE-0 B',' DAI-E i 1"i�aE
J
f': LEFi('IJIL:NL D (3`% Dfil'E- T 1 :'[- ID%,TE i
Libnrato y ncr--ser.aoion Is •s•zsurea by ad .r:or to 5omp'e
containers teavir c the lap, un!ess otherv:,SE n0:i 7
0I.?•D-CL2= Chlorine check and d r_chlannation verification
':'OQL ':C BCD RES•Dt E CONDU'. -,r ; -'r %lBAS COLOR ALK ,L•°1i T `, C'R ',ri '•URSIDii Y
C i `t 4C PH 21-12SO•• t•.}i: 1`20:' NO3 TVN 0SG roC OE,ES`. PHENOLS TOT PHOS
C;L)r:)L 7C PFI -' HNO2 ME t ALS C R ".':
! ON'E CHLOR•Dr PH FLOORID S>: %IPLE �EVINrION
OTHER - -
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WATER QUALITY LAB & OPERATICNS, INC,
P.O. BOX 1167, BANNER ELK, NC 28604
5
[phone]
fax [phone]
0OSS � �') C' �Js
LOCA.'f ION Jefferson 1,1'V1iV1'P
FACILITY 10 :a NCO021709
SANIPLER NAME T C:uuch F WaRers
COMPOSITE SAN41DLE START TIME _ 830
CHAIN OF CUSTODY
';aCH - NONE 6 COOL ICE
S2 C) i 0-t-1EIR
q­
SAMPLE NAME—
COLLECTION_ —DELI`.'—
DATE TIME TEMP
SAMPLE
TEMP GRAB
TYPE
C©P.1P
I RESERVtL.TION'
F FiE[_D L LAB
—_ =. _._ _ _ _
PH
vertfy
��
CL2-D CL2
LAB SANIJDt F
!D rduPJtl3ER�
YES NO
80D/TSS
_..�—
X
G
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Effluent B00.'I"SS
X
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--- - -
NH3 N
X
�
clE€fti:ent
_ col,forr!!
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Labors
:ory oresi-Yvation :S 2'!Sured by ,iddi: on o` i rrr$" `rtl:.,_•5 i"f.yf tC? $.7'I'.jii
;;onta,ners I •a:'tl•ny the ,ao ir!es5 omr@ se -1c
Ct D CL?= Chlprll?,= ch—= and d„Chlo`Ina:ion veal! ,at ;r
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WATER QUALITY LAB & OPERATIONS, INC'.
P.O. BOX 1167, BANNER ELK, NC 28604
�- 7 [phone]
n r d
fax [phone]
losS jCC5IS
CHAIN OF CUSTODY
LOCA'r I ON
FACILITY IC
SAMPLE"' NAME
Jefferson VJ44TP
NCOa217G9
T C'-iurcn F `Jokers
C;OMPOSiTE SA,%11D.E. STAR-r Tip: E Vo
!-SC' 2 /it-:1C' 3 HCL.
AO--i NONE 5 COOL ICE
OTHER
AMPLE NAME
F_fiiuent SODITSS
€EI(I �'lt rIH3 N
w2w" coi€iorrrl
I COLLECTION
OATE
_ _
3.27.23
_ _
JIDELEV SAMPLE
TIMETEP:�P-rEtv1P GRAB
I
1
QSQSi i
_
TYPEJ PRESERVATION' PH CL2-D CL2 LAB SAMPLE {
COMP F F1EL0 L Lab varlfY YES NQ ID NUMBER �
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REUNO-WISHED Bti' DATE 71t:1E I: C E 1 V E 0
312,7/23 0,F10
1 `.4l.
L._
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Ci.2-10-CL2= Ch<or€n.e chE71<. and de-chiormwoon :erif,caton
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0TNr.15 - ------
:0i 1 :r '`;.,2S203 COLJFOPt,'—
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WATER QUALITY LAB & OPERATIONS, INC.
P.O. BOX 1167, BANNER ELK, NC 28604
o / [phone]
` fax [phone]
r �
'�CdSS Ovals CHAIN OF CUSTODY
LOCATION Jefferson V!WTP H280 : 2 - I fINO]" 3 • HCL
FACILITY ID 4 NC0021709 4 -'dMOH 5 • PONE 5 - COOL ICE
SAMPLER NAIME T Church F Walters - '.';.?S2C3 8 - OTHER
COMPOSITE SAMPLE S-Tr,RT TiflJE V0
SArn17LE `JAn�1E COLLECTION DLL1V (SAMPLE TYPErPRESEIRNJATION• i PH CL2-D' CL21LAi §A-t,1PLE
_ DATE I11Mk 11"EMP TEr�71' GRAB COP�1P F f L� L I_aL��`renfy 1'ES NO ID rJUAAC ER
-- --- -�--- 1----�- —-----------
Ini;rn! BODt'TS5 --_ - - X r, ---- ---- �—� _--�
Effluent DODr'I'S5 j X (5
Eff1u:_ it NH3 N X r�
I cnh mi 2$ 500 - - -- --- — - - -- i� l -- -�--� -- - - - I
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1- r1 - "=Hess —.. ry --- -- --- i_ _ —1- X -- - - ----• -
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?E .. �'.•�UI�IIcD BY :•.�':" TI-Ar- r�1=1`.'i:
"f�iY =i:.T�
rwo,v �r.. ti,:ry 1,'.n IS r'1c (L r C9 :1G'CII; C'1 i :3! :6 :nS i'r �r IC'. s:imp'le
1-c-.rs I,. -I.. *r o .a:
D-CL 2= Ch'nr " Cflr ulmj C•;0'-Dnnn,,,nn ..erlf Cut
'`X)L :C 600 RESIDUE COND'UCTI`.r,TY MISAS COLOR ALK:r-! %i'N' Cr ':' "UR31'uITY
CO -A 4C ELF•{<2 H'2SO•: NH3 NO2-NO3 Tv-N O&G TOC COLD Or R[. %.FSIS PHENI0'. S TOT rr-CIF-
, COOL "C' PH-:; Hr''n3 MET A' -So K%vp', C PN ':�1
r`;u",F CHLOR JE, PH PI-JORWE S= MPI—L- 10h,
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